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Biomedical subjects

W Kurtz

Publications and source records attributed to W Kurtz.

46 records · Page 3Linked to original sources

Pancreatic pseudocysts and tumors in endosonography.

In endoscopic ultrasound tomography (UT), the ultrasound probe positioned in the stomach has direct access to the pancreatic region. In first experiences, 62 patients were investigated by EUT . 22 of them had a pancreatic infection. EUT seems to be a new method being a valuable complement to conventional UT with a high diagnostic potential and with broad possibilities of application. The increased resolution of structural details of pathological alterations could be of diagnostic value.

Adult↗

Diagnostic efficacy of endoscopic ultrasound tomography in pancreatic cancer and cholestasis.

By direct access to the target organs and by improved detail resolution, endoscopic ultrasound tomography (EUT) broadens the range of sonographic diagnostics. In this preliminary study, the accuracy of EUT was tested in 34 patients with suspected pancreatic carcinoma and/or painfree jaundice. In all 10 patients with pancreatic carcinoma and in all 6 patients with chronic pancreatitis, the diagnosis made by EUT was correct. Three patients with benign tumors of the pancreas were also diagnosed correctly. The diagnostic sensitivity of EUT in pancreatic cysts was in 4 of 5 cases 80%, in dilatations of the main pancreatic duct in 10 of 11 cases 91%, and in cholestasis in 14 of 15 cases 93%. All 5 common bile duct concrements and all 3 tumors of the papilla Vateri were diagnosed by EUT. The differential diagnosis between pancreatic tumor and pancreatitis was improved by EUT in 1 of 18 cases. In the region of the papilla Vateri, EUT was superior to conventional UT in the diagnosis of ampullary concrements and papillary tumors in 6 of 8 cases (4/5 and 2/3, respectively). EUT could become an important complementary diagnostic method for disorders of the pancreas and the common bile duct with a particular sensitivity for the region of the papilla Vateri.

Adult↗

Diameters of abdominal veins and arteries during nitrate therapy.

The effects of 1.6 mg NTG on the diameter of abdominal veins and arteries were investigated by means of ultrasound tomography in 26 and 28 healthy persons respectively. Fourteen patients served as controls in the venous studies and 28 in the arterial measurements. The diameter of the caval vein decreased in anterior-posterior direction within 5 minutes after nitroglycerin administration by about 22% from 14.2 +/- 4.0 mm to 11.1 +/- 3.3 mm (p less than 0.005). In contrast, the portal vein enlarged by about 27% from 10.3 +/- 1.8 mm to 13.1 +/- 2.3 mm, the superior mesenteric vein by about 12% from 8.2 +/- 1.6 to 9.2 +/- 1.4 mm, and the splenic vein by about 23% from 6.6 +/- 2.3 mm to 8.1 +/- 1.8 mm (p less than 0.001). The superior mesenteric artery and the proper hepatic artery dilated by about 12% from 7.8 +/- 0.9 mm to 8.7 +/- 0.9 mm and from 6.5 +/- 1.0 mm to 7.3 +/- 0.7 mm respectively (p less than 0.001). There was no significant change in the diameter of the abdominal aorta, however. The results show that NTG induces a relaxation of the abdominal veins and of the abdominal arteries of the muscular type. They suggest that the splanchnic veins participate essentially in the therapeutically important venous pooling effect of NTG. The reduced peripheral venous return is made sonographically visible by a collapse of the inferior vena cava. Furthermore, the influence on the windkessel function after administration of NTG seems to be mediated not by the aorta itself, but rather by its large muscular-type branches like the mesenteric and hepatic arteries.

Abdomen↗

Sex differences in rat liver bile acids.

Male Wistar rats show higher relative liver weights and higher weights of mitochondrial and microsomal fractions than females. Their relation of subcellular fraction weights tends more to the microsomal side. In liver homogenate and subcellular compartments, males contain significantly higher concentrations of beta-muricholic acid and other metabolites of chenodeoxycholic acid, females higher proportions of chenodeoxycholic acid. Higher concentrations of potentially toxic nonsulphated dihydroxy bile acids in the liver of female rats could be a sign of slower elimination, and the cause of higher susceptibility of females to liver injury induced by bile acid administration.

Animals↗

[Peritoneoscopy and liver biopsy in the diagnosis of liver disease (author's transl)].

In two prospective studies including 962 patients and one retrospective study including 165 patients the problem was investigated, to what extend ultrasonography might change the diagnostic value of clinical examination, peritoneoscopy, guided liver biopsy and blind liver biopsy. It turned out, that liver biopsy is the method of choice in diffuse-parenchymatous disease (e.g. chronic active hepatitis, chronic persistent hepatitis, fatty liver), whereas laparoscopy is to be preferred if focal lesions (e.g. liver carcinoma) are present. Diffuse liver disease was present in 80% of the cases investigated; in this group of patients the diagnostic value of blind biopsy is equivalent to the diagnostic value of guided biopsy. Thus, blind biopsy does yield satisfactory results in most patients if it is possible to differentiate between diffuse and focal disease by ultrasonography. Such differentiation could be achieved in 77-98% of our cases, thus ultrasonography could intake a decrease in numbers of peritoneoscopies and an increase of blind liver biopsy.

Biopsy, Needle↗

[The influence of chenodeoxycholic acid on the concentrations of nonsulfated bile acids in the small and large intestinal mucosa of rats (author's transl)].

In male Wistar rats nonsulfated bile acids of small and large intestinal wall and feces are analysed after 2, 5, 9 and 14 days of oral administration of 20 or 90 mg chenodeoxycholic acid (CDCA)/kg. Development of body, intestinal, and fecal weights is assessed. A transient reduction of daily body weight gain and small and large intestinal weights is compensated after 14 days. Fecal weights are above controls under 20 mg/kg, below controls under 90 mg/kg. Containing about 2 mg, i.e. nearly 4% of the bile acid pool, the intestinal wall holds four times more bile acids than the liver. Under CDCA administration bile acid concentrations in the small intestinal wall and feces rise, and remain almost unchanged in the colonic wall. Changes after CDCA administration suggest that bile acid absorption is accompanied by an increase in mucosal bile concentration. In the colonic wall the increase in bile acid concentration after CDCA administration correlates with the passive permeability coefficient.

Animals↗

[Morphologic investigations on the toxicity of orally applied CDCA in the liver, gastro intestinal tract, kidney and adrenal gland of the rat (author's transl)].

Light- and electron microscopic alterations of the liver and light microscopic findings in the gastro intestinal tract, the kidney and adrenal gland of 80 female Wistar-Rats under CDCA therapy are reported. CDCA was applied by means of an endopharnygeal tube over a period of 60 days in doses of 150, 250, 500 and 1000 mg/kg body weight. The organs were examined at different times. We compared the achieved findings to results obtained already beforehand by light- and electron microscopy after application of 20, 50 and 90 mg/kg body weight and day: Up to a dosage of 90 mg/kg morphological changes of the liver were only visible electron optically, from 150 mg/kg onward they could be seen light optically as well. After 60 days a cirrhosis-like picture had developed. The lethal dose was established at 1000 mg/kg. There were no pathological alterations in the gastrointestinal tract and no definite ones in the kidneys. The adrenal glands were unchanged.--Since there are in the rats, in spite of potent mechanisms of detoxication of CDCA and LCA, even at low doses morphological alterations to be seen, the existence of other toxic, at this moment still unknown metabolites is being discussed.

Administration, Oral↗