[Massive hemorrhage from the nose as a result of posttraumatic rupture of the internal carotid artery].
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Biomedical subjects
Publications and source records attributed to W Bartnik.
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The aim of this study was to determine serum retinol levels in patients with inflammatory bowel disease and to attempt to elucidate the mechanism of changes in vitamin A metabolism in these disorders. It was found that in 15 patients with active ulcerative colitis, 14 patients with active Crohn's disease and in 3 operated patients with recurrent Crohn's disease serum retinol levels and retinol-binding protein were significantly lower than in controls. Concentrations of vitamin A did not depend on the localization of inflammatory bowel disease, previous ileal resections, duration of the disease or age and sex of the patients. During successful treatment of active ulcerative colitis normalization of serum retinol levels without substitution of vitamin A was observed. Repeated determinations in patients with Crohn's disease who had low serum retinol levels in an active phase of disease revealed normal vitamin A levels in an inactive phase. The absorption of vitamins A and E in patients with inflammatory bowel disease was normal. The normal serum retinol concentrations in patients with diarrhea due to irritable bowel syndrome, and in those with anorexia nervosa exclude the influence of diarrhea and body weight itself on vitamin A levels. The results of this study indicate that serum retinol levels in patients with active inflammatory bowel disease are secondary to the decreased serum retinol-binding protein concentrations, and probably depend on the increased protein catabolism in these disorders.
Insertion of biliary endoprosthesis was attempted in 151 patients with obstructive jaundice and was successful in 124 patients (82%). The indications for the procedure were: 1) biliary and pancreatic neoplasms (79 patients) and 2) non-neoplastic diseases such as common bile duct stones or postoperative biliary strictures (45 patients). Successful drainage of bile was obtained in 95% of patients from the first group and in 93% of those from the second group. The mean survival time of patients with neoplasms was 4.5 months and the majority of them were free of jaundice and itching. In 32 patients with non-neoplastic diseases there was no recurrence of jaundice after a mean time of 20 months. Serious complications occurred in 5 patients (4%), 4 of them died (3.2%). The most frequent late complication was clogging of the endoprosthesis (19% of patients from the first group after a mean time of 5 months and in 28% of those from the second group after a mean time of 16 months). Replacement of the endoprosthesis was carried out mainly on the ambulatory basis. Endoscopic biliary stenting is an effective method of palliative biliary drainage in patients with non-operable biliary and pancreatic tumours. In high risk patients with non-neoplastic obstructive jaundice the technique may be an alternative for surgical treatment.
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Using an enzymatic method for their isolation, it has been shown that human colonic lamina proprial lymphocytes, isolated from patients with various colonic diseases and depleted of polymorphonuclear leukocytes and macrophages, demonstrated K-cell activity in two antibody-dependent cell-mediated cytotoxicity assays in vitro. No differences were found between the activities of lamina proprial lymphocytes isolated from colonic specimens involved by Crohn's disease, chronic ulcerative colitis, or colonorectal carcinoma. K-cell activity was demonstrable using lymphoid cells isolated from the colons of patients receiving steroid therapy at the time of the therapeutic resections. These findings indicate the need for further investigation of possible roles for K-cells in local immune responses in the human bowel mucosa in inflammatory and neoplastic diseases.
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In 18 patients with ulcerative colitis and in 8 with Crohn's disease two tests were performed simultaneously: a) the leukocyte migration inhibition test using Kunin antigen, and b) titration of serum antibodies against this antigen. Leukocyte migration was studied by the agarose plate technique. At the concentration of 25 microgram/ml, Kunin antigen inhibited migration in five cases of ulcerative colitis and in one with Crohn's disease. This phenomenon was not observed in any of 33 control subjects. All patients in whom leukocyte migration was inhibited were in the active phase of the disease. Titers of antibodies against Kunin antigen were determined by the passive hemagglutination test in an expended group of patients comprising 61 with Crohn's disease. The antibody titer, expressed as the geometric mean of hemagglutinin titers, was nearly three times as high in patients as in 324 healthy controls. The titers were not correlated either with clinical activity of both diseases or with the results of the leukocyte migration inhibition test. The significance of these findings is discussed in the light of other data indicating that Kunin antigen plays a role in the pathogenesis of inflammatory bowel disease.
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