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Biomedical subjects

W Kurtz

Publications and source records attributed to W Kurtz.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Percutaneous transhepatic lysis of gallstones using methyl tert-butyl ether. Report on 15 patients].

In 15 patients (13 women and two men) with cholesterol stones in the gall-bladder a special (Thistle) catheter was introduced into the gall-bladder under local anaesthesia by percutaneous transhepatic puncture. Methyl-tert-butyl ether, 2-15 ml, was injected via the catheter and removed again after 2 min. The number of stones per gall-bladder averaged 6.3 (1-20), size of stones 1.7 cm (0.5-2.8 cm), and duration of treatment 11.9 h (5-24 h). The stones dissolved in 13 patients (87%). In three patients stone débris remained: in one it was ultimately sucked out after reduction of the amount of débris with an EDTA-containing solution. The side effects of treatment--nausea and vomiting--were minor. In one patient there was a leak of bile from the gall-bladder after the procedure; a cholecystectomy was uneventfully performed. Another patient developed haemobilia which responded to conservative treatment. MTBE treatment has thus proved to be a successful and cheap method, low in side effects, in the treatment of patients with gall-stones.

Adult↗
PubMed1988

Dissolution of gall stones with an ursodeoxycholic acid menthol preparation: a controlled prospective double blind trial.

In a controlled prospective double blind trial patients with cholesterol gall bladder stones are treated with ursodeoxy-cholic acid (group A: UDCA 11.1 mg/kg per day; n = 16) and Ursomenth respectively (group B: a mixture of UDCA/menthol: 4.75 mg/kg per day each; n = 17). With same stone number and size (10-12 mm) there is a complete dissolution rate in group A of 38%, and of 53% in group B within 15-16.9 months. The response rate (complete + partial dissolution) amounted to 75% and 76% respectively. In group A there is one case of stone calcification, in group B none. Both preparations are free of unwanted effects. This suggests that the cyclic monoterpene menthol enhances the effect of UDCA and is of comparable effect to a mixture of six different terpenes used in former times.

Adult↗
PubMed1988

Endoscopy of the gallbladder as control of gallstone therapy with methyl-tert-butyl ether.

We report on a 36-yr-old woman with six gallstones measuring 2.1 cm each. Within 21 h of methyl-tert-butyl ether (MTBE) treatment, the stones had dissolved to a small amount of residue. As could be seen from cholesterol concentrations of samples of aspirated gallbladder bile and MTBE fractions, the dissolution process was slow to begin with, and gained momentum during hours 6-11, after which it decelerated. We discontinued treatment after 20 h, since the stone residue showed no change. Cholecystoscopy performed with an Edwards angioscope via a catheter showed that there were no stone remnants, but that there were flat polyps on the gallbladder wall. One hour later, we stopped the therapy. Cholecystoscopy is a useful method of assessing the results of MTBE treatment.

Adult↗
PubMed1987

Prostaglandin E2 directly protects isolated rat gastric surface cell membranes against bile salts.

Rat gastric surface cell membranes were prepared and the effect of taurocholic acid assessed by ESR spectroscopy using the 16-doxylstearic acid spin label. Taurocholic acid increased the polar part of the spectra, indicating an augmented amount of spin label molecules with a polar environment. Concomitantly, mobility of the spin label molecule was augmented. The effect of taurocholic acid was completely prevented by the previous addition of prostaglandin E2. This suggests a direct protective efficiency of prostaglandin E2 on rat gastric surface cell membranes without the metabolic participation of intact cells.

Animals↗
PubMed1987

[Alagille syndrome, a rare differential diagnosis of intrahepatic cholestasis].

In Alagille's syndrome cholestasis is caused by a congenital hypoplasia of the intrahepatic bile ducts. If cardiac and arterial malformations are present in conjunction with the typical-but not pathognomonic-facies, this rare syndrome must be considered. ERCP shows a highly rarified bile duct system. Liver histology with a paucity of interlobular bile ducts establishes the diagnosis. Inheritance appears to be autosomal dominant. The relatively good prognosis of the disease calls for caution concerning invasive procedures.

Abnormalities, Multiple↗
PubMed1985

Gallstone dissolution with ursodeoxycholic acid in patients with chronic active hepatitis and two years follow-up. A pilot study.

Chemical dissolution of cholesterol gallstones using ursodeoxycholic acid (UDCA) in six patients with histologically confirmed HBsAg-negative chronic active hepatitis was started after a minimum of one year of therapy with steroids, azathioprine, or chloroquine and a treatment-free period of 8-15 months. The treatment with UDCA lasted 3-20 months with a daily dose of 8-11 mg/kg. Four patients served as controls. A decrease in transaminases (P less than 0.05) occurred in all patients during the UDCA therapy. After completion of the treatment, the figures rose again, but did not return to the initial value. The stones dissolved in five patients. A second liver biopsy was carried out in two patients after UDCA therapy, and this showed no detectable deterioration. Four patients refused biopsy because the laboratory parameters had improved under UDCA. A stone recurred in one patient six months after the end of therapy; the others have remained free of stones for up to 24 months.

Adult↗
PubMed1985

Diurnal rhythm of bile lipid composition after cholecystectomy and papillotomy. Postpapillotomy biliary lithogenicity.

The influence of the gallbladder and the sphincter of Oddi on the diurnal rhythm of bile lipid composition was assessed by determining the lithogenic index at 4-h intervals over a period of 24 h in 29 cholecystectomized and papillotomized patients with a nasobiliary tube receiving a normal hospital diet and in 9 during 1-day fast. With a normal diet, biliary cholesterol concentrations dropped during the daytime (p less than 0.05), and total biliary lipid, bile acid, phospholipid, and cholesterol concentrations rose at night (p less than 0.05). During fasting, total biliary lipid, phospholipid, and cholesterol concentrations rose continuously (p less than 0.01). Even with loss of function of the gallbladder and sphincter of Oddi, a diurnal rhythm of biliary lithogenicity persisted, caused mainly by cholesterol increases during fasting. Concomitant increases in phospholipids and, to a lesser extent, bile acids modulated these changes.

Aged↗
PubMed1984

[Blood flow measurement in esophageal varices using an endoscopic Doppler ultrasonic probe].

A new ultrasound Doppler probe allows endoscopic measurement of blood flow in oesophageal varices. First investigations in 6 patients show that the measurements are easy and well reproducible. Velocity of blood flow depends on respiration. Cephalad flow increases during inspiration. Caudalad flow may be enhanced by expiration and decreased by inspiration. Cephalad and caudalad blood flow in the same varix may point to drainage by a perforating vein. During and after endoscopic sclerosing, changes in blood flow can be demonstrated. This method gives us the possibility to assess blood flow in oesophageal varices not only for pathophysiological studies, but also for planning and control of sclerosing therapy.

Blood Flow Velocity↗
PubMed1984

[New technics].

Explore the source record for details and available documents.

Endoscopes↗
PubMed1984

Detection of biliary stones by means of endosonography.

For its particular qualities, endoscopic ultrasound tomography ( EUT ) appears to be a suitable method for achieving better results in diagnostics of bile duct alterations than conventional UT. In 10 patients with enlarged common bile duct. EUT was carried out with three different prototypes (mechanical sector scan, ultrasound gastrofiberscope . Olympus/ Aloka ). The encouraging results suggest that the high discriminating investigational technique of EUT may be superior to conventional UT for finding common bile duct stones, probably for the differential diagnosis of biliary drainage problems caused by tumors, too.

Adult↗