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Biomedical subjects

W Petritsch

Publications and source records attributed to W Petritsch.

52 records · Page 3Linked to original sources
PubMed1990

[Cowden syndrome].

A patient with multiple hamartoma syndrome or Cowden's disease with multiple gastrointestinal polyps and malignant melanoma is presented. The syndrome is characterized by hamartomatous tumors of the skin, fibrocystic disease of the breasts, gastrointestinal polyps and disease of the thyroid gland such as goiter and adenoma. In addition, other abnormalities and malformations occur in the skeletal system, central nervous system and urogenital tract. Recognition of this syndrome is important because of the association with malignant tumors of the breast and thyroid gland and with malignant melanoma. Gastrointestinal hamartomatous polyps may lead to the diagnosis of Cowden's disease which must be separated from other intestinal polyposis syndromes.

Adenomatous Polyposis Coli↗
PubMed1989

[Management of acute intrathoracic aortic dissection].

At the intensive care station of the Internal Medicine Department, University Clinic Graz, all patients admitted were promptly and carefully examined in case of suspected acute intrathoracic aortic dissection and immediately treated. In 1987 a total of 4446 patients were referred to this CCU, 893 suffered from acute thoracic pain. In 21 patients of the latter a clinical suspicion of aortic dissection was observed. In 9 patients of these, diagnosis could be established within 5 hours by echocardiography, CT and angiography. 11 patients had no dissection while one positive finding could only be determined by postmortem exam. Retrospectively, these figures for 1982 were 3908 admitted patients, 790 suffering from acute thoracic pain of which only 5 showed suspected dissection. In 3 cases dissection could be confirmed using the same diagnostic procedures, but 2 were without finding. Further 3 patients out of the total series were affected with dissection which could only be determined postmortem. Out of the 9 patients with positive diagnosis, 6 showed Typ I, 1 Typ II and 2 Typ III dissection according to DeBakey (8m, 1f, range 46-78 years). 2 patients underwent surgery immediately after diagnosis, 1 after 12 hours, while 4 cases were conservatively treated. These 7 patients have survived by controlled hypotension up to now (10 to 22 months). Two patients died 2 and 10 hours, respectively, after admission with positive diagnosis. In spite of the severity of this disease prompt and efficient diagnosis and rapid therapeutic management are the key to survival.

Aged↗
PubMed1989

[Sonography and cytology of cold thyroid nodules].

270 patients with a scintigraphically cold thyroid nodule of sonographically increased (n = 34), diminished (n = 72) or neutral (n = 86) echogenity or cystic criteria (n = 78) were subjected to fine needle aspiration biopsy. This revealed unequivocal malignancy in 8 and follicular neoplasia in another 30 patients, 10 of whom proved to have malignomas on further evaluation. A total of 12 papillary and 2 follicular carcinomas, 2 non-Hodgkin lymphomas, 1 sarcoma and the metastasis of a breast carcinoma were diagnosed. The most sensitive criteria for malignancy were diminished echogenity, an inhomogeneous echo pattern and the occurrence of a solitary nodule. The incidence of malignancy was increased among males but not among especially young persons. There was no sonographic feature that would permit omission of fine needle aspiration.

Adenocarcinoma↗
PubMed1989

Intravenous atrial natriuretic peptide does not affect water and ion transport in the human small intestine.

Atrial natriuretic peptide (ANP) increases renal sodium and water excretion in several species including man. In rats ANP was also found to influence water and electrolyte transport in the small intestine. In the present study we investigated whether ANP can alter transport in the jejunum and ileum of healthy volunteers using a triple-lumen perfusion technique. The small intestine was perfused under steady-state conditions with a plasma-like electrolyte solution using polyethylene glycol as a nonabsorbable volume marker. After an initial control period with intravenous saline infusion ANP was administered intravenously at a dose of 400 pmol kg-1 h-1. This dose led to a significant (P less than 0.05) increase in the plasma levels of ANP (up to 22-fold) and cGMP (up to 15-fold), and of urine volume. Intestinal water and electrolyte transport were, however, not affected by ANP. Our results suggest that circulating ANP does not play a role in the regulation of mucosal water and ion transport in the human small intestine.

Adult↗
PubMed1988

[Serum bile acids in diffuse liver parenchymal damage and their relation to ultrasound diagnosis].

40 patients with sonographically detected diffuse liver diseases of different severity and 8 controls with normal ultrasound of the liver were evaluated for fasting concentrations of serum bile acids (SBA) using an enzymatic method. Differences of SBA levels were significant among 4 groups classified as to severity by ultrasonography; SBA levels above 4.6 mumol/l were specific for the more severe grades of liver disease. Measurement of SBA and the evaluation of echographic patterns may be helpful in the decision to perform a liver biopsy.

Bile Acids and Salts↗
PubMed1987

[Pathologic enzyme patterns in sonographically verified liver metastases].

The serum enzyme pattern, consisting of GOT, GPT, lactate dehydrogenase, gamma glutamyl transpeptidase and alkaline phosphatase, was investigated in 128 patients with sonographically verified liver metastases. Gamma glutamyl transpeptidase and alkaline phosphatase turned out to be the most sensitive enzymes, being elevated in 89% and 88%, respectively. The GOT was elevated in 45% GPT in 37.5% and lactate dehydrogenase in 56% of all cases. The enzyme elevation did not correlate with the degree of liver involvement. In conclusion, pathological serum enzyme patterns are useful for the detection and follow up of liver metastases. Normal serum enzyme levels do not rule out the presence of liver metastases.

Enzymes↗
PubMed1987

[Is sonography superior to enzyme diagnosis in the detection of hepatic steatosis?].

In order to evaluate the diagnostic value of sonography in steatosis of the liver, liver biopsies were performed in 52 patients with sonographically diagnosed steatosis of the liver. 27 of 28 patients with normal serum enzymes showed an estimated steatosis of 10 to 40% on histological examination. In the other 24 patients with increased serum enzyme levels histological steatosis was found in 20 patients. 8 further patients with presumed systemic disorders had both normal sonographic findings and normal serum enzyme levels and when subjected to liver biopsy showed an estimated steatosis in the range of 5 to 10%. Reliable sonographic diagnosis of steatosis of the liver can be made only if the degree of steatosis exceeds 10% at least. Normal serum enzyme levels do not exclude steatosis of the liver.

Enzymes↗
PubMed1986

Effect of pancreatic polypeptide on the motility of the guinea-pig small intestine in vitro.

The effect of porcine pancreatic polypeptide (PP) on the motor activity of the longitudinal and circular muscles of the guinea-pig isolated small intestine was investigated. PP (0.2-20 nM) inhibited cholinergic contractions of the longitudinal muscle in response to electrical field stimulation, the maximal effect being a 30% reduction of the contraction amplitude. Carbachol-induced contractions of the longitudinal muscle were not affected by PP (10 nM). PP (0.3-30 nM) also inhibited reflex contractions of the circular muscle elicited by balloon distension and recorded orally to the site of distension; the maximal effect was a 80% reduction of the reflex contraction. In contrast, carbachol-induced contractions of the circular muscle remained unaltered by PP (10 nM). It was further found that PP (10 and 100 nM) enhanced the threshold intraluminal pressure at which peristaltic waves were triggered. All these effects of PP appeared to be transient. Taken together, these data indicate that PP does not act on intestinal smooth muscle but can modulate the activity of certain enteric neurones which are involved in the regulation of intestinal motility.

Animals↗
PubMed1986

[Sonographic comparative studies of the portal vascular system before and following endoscopic sclerosing of esophageal varices].

On the occasion of 35 episodes of oesophageal injection therapy in which partly the intravascular and partly the perivascular injection technique were used, real time sonographic measurements were performed on the veins of the portal system immediately before and after sclerotherapy. In the case of intravascular injection, both the portal and the splenic vein and the confluens of the splenic and the superior mesenteric vein showed an increase in diameter, whereas in the cases of perivascular injection such changes were minimal or absent. The practical applicability of such sonographic calibrations could possibly lie in certain conclusions that could be drawn concerning the degree of vascular compression or obliteration during each session of sclerotherapy.

Esophageal and Gastric Varices↗
PubMed1985

[Differential diagnosis and therapy possibilities of hematochezia in elderly patients].

In a survey the differential diagnosis and the exploratory and therapeutic possibilities in massive colonic hemorrhage are discussed. In elderly patients the most frequent sources are diverticular hemorrhage and bleeding angiodysplastic lesions. Scintigraphy is the least invasive method of localizing the source of bleeding. Angiography presents, apart from diagnosis, therapeutic possibilities such as embolization or intraarterial administration of vasopressin. In case of failure of conservative treatment hemicolectomy is indicated.

Aged↗
PubMed1985

[Significance of pancreatic polypeptide in gastrointestinal diseases].

Release of pancreatic polypeptide (PP) into blood by pancreatic PP cells is closely correlated with pancreatic exocrine secretion and is thus stimulated by food intake. PP causes inhibition of exocrine pancreatic secretion and bile acid output. In insufficiently treated diabetics elevated basal and postprandial serum levels of PP are found, which return to normal when adequate treatment is administered. In patients with autonomous diabetic neuropathy insulin induced hypoglycemia leads to subnormal increases of serum PP levels. Low PP secretion is found in chronic pancreatitis only when pronounced pancreatic insufficiency is observed. In patients with duodenal ulcus significantly elevated but also normal serum PP concentrations were found. Endocrine active pancreatic tumors may cause highly increased PP levels together with other hormones and elevated serum PP levels may be used as a diagnostic indication in such rare cases. However the determination of PP serum levels is not suited as a routine diagnostic method.

Blood Glucose↗
PubMed1985

Influence of calcitonin on serum levels of pancreatic polypeptide in man.

In groups of 8 patients each, the increases in pancreatic polypeptide (hPP) serum level were measured after a protein-rich test-meal; one group received an infusion of 200 IU Salmon-calcitonin for a period of 3 hour while the other group did not. Calcitonin causes a significant inhibition of both the basal and the stimulated hPP serum level. Among the patients who did not receive a calcitonin infusion, the stimulated values after 15 to 120 minutes were significantly higher than the initial values, while patients receiving calcitonin did not show a significant increase. With calcitonin, the area under the secretion curve was 43% smaller. yet, on the basis of our results, the known gastrointestinal effects of calcitonin on pancreas secretion cannot be completely explained by the observed inhibition of hPP secretion.

Adult↗
PubMed1981

[Comparison of 100 micrograms TRH intravenously and 40 mg TRH orally in euthyroidism (author's transl)].

Euthyroid in-patients were investigated with 100 micrograms TRH given intravenously and with 40 mg TRH given orally in order to compare the sensitivity of intravenous and oral TRH-test. In all patients (age 15-91 years) maximal TSH-levels 180 min after 40 mg TRH are significantly (p less than 0.01) higher than maximal TSH-levels 30 min after 100 micrograms TRH. In patients under 50 years of age TSH-30 and TSH-180 are identical on average (6.42 +/- 0.29 microunits/ml vs. 6.53 +/- 0.54 microunits/ml/log x +/- SDlog). In patients older than 50 years TSH-30 is significantly lower (p less than 0.02) than in patients aging less than 50 years (2.11 +/- 0.88 microunits/ml vs. 6.42 +/- 0.29 microunits/ml). Both age-related groups demonstrate no significant difference (p greater than 0.2) in TSH-180 after 40 mg TRH (6.53 +/- 0.54 microunits/ml vs. 3.65 +/- 0.74 microunits/ml). 14 cases (34%) are low or non responders to 100 micrograms TRH intravenously, 8 (19.5%) only following 40 mg TRH orally. Patients with complete TSH-suppression (both iv. and oral TRH-test negative) show significant (p less than 0.05) higher ETR, T4 and fT4 than patients with partial TSH-suppression (iv. negative and oral TRH-test positive). The dose of 100 micrograms TRH does not increase the sensitivity of the test, the specificity is decreased in older patients, the dose of 100 micrograms TRH seems to be to low to yield reliable results. 40 mg TRH orally does not show any false positive findings, because TSH-stimulation is longer and more intensive. T3 increase three hours after orally TRH-application indicates an intact feedback mechanism.

Administration, Oral↗
PubMedDate not supplied

Helical CT of the small bowel with an alternative oral contrast material in patients with Crohn disease.

BACKGROUND: We assessed the usefulness of helical computed tomography (CT) with a negative oral contrast material for detecting Crohn disease. METHODS: Thirty-eight patients with proven Crohn disease were examined. We administered a large volume of a new negative oral contrast material (Mucofalk suspended in water) and then proceeded with helical CT scanning. This technique is an alternative to CT and conventional enteroclyses that use a nasojejunal tube. Two radiologists interpreted the scans, and patients were interviewed about their tolerance of the procedure. We created multiplanar reformatted images in all cases. Potential of small bowel distention by Mucofalk was evaluated by two observers on a three-point scale, and interobserver agreement was calculated with kappa statistics. RESULTS: All patients who underwent enteroclysis stated that CT was the more comfortable method, the taste of the peroral contrast medium was considered good by 52.6% and acceptable by 47.4%. Small bowel distention was excellent in 55% of cases, moderate in 26%, and poor in 19%, with an interoberserver agreement of 78%. CT findings correlated with enteroclysis in 27 patients who underwent both methods. Analysis of CT versus enteroclysis showed a sensitivity of 89% for CT versus 78% for small bowel enteroclysis. CONCLUSION: Mucofalk CT is a simple, rapid, noninvasive, and accurate method of evaluating extramucosal manifestations of Crohn disease. The tubeless procedure improved patients' comfort and decreased time, cost, and radiation exposure.

Administration, Oral↗