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Biomedical subjects

W Swobodnik

Publications and source records attributed to W Swobodnik.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Ultrasound guided fine- and coarse-needle puncture of the abdominal and retroperitoneal space].

Within a period of 21 months, 167 fine-needle and 86 cannula (1.67 mm external diameter) punctures of the abdominal or retroperitoneal space were performed under sonographic control. Sufficient material was obtained with 93.4% of fine-needle punctures. With regard to differentiation between malignant and benign lesions, fine-needle punctures had a sensitivity of 86% and specificity of 100%, if the material was examined by an experienced cytologist. Sensitivity dropped to 55,1% if the same material was interpreted by a less experienced cytologist, but specificity was still 98.1%. Sufficient material for histological examination was always obtained with the cannula, already at the first puncture. With cannula puncture there were two complications: bleeding requiring transfusion and peritonitis.

Abdomen↗
PubMed1987

[Sonography of the meniscus and its lesions].

It is the considered opinion of the authors that meniscus sonography can largely replace arthrography. This opinion is based on their detailed examinations and studies. Sonographic visualisation of all lesions produced by a scalpel was demonstrated using knees of corpses. Even cracks having the fineness of a human hair were visualised by sonography. A comparison between sonographic and surgical findings in meniscus lesion yielded in 82 patients an agreement of 95.1%. In 47 patients it was possible to prove that sonography was more accurate than arthrography as far as diagnosis was concerned. A comparison of 94 sonographically and arthrographically established findings yielded agreement in 89% of the cases. Sonography is suitable for meniscus imaging especially on account of the good imaging reproducibility of meniscus morphology; through safe detection of a pathological process in the meniscus; through the safe presentation of lesions; through the accurate imaging of all parts of the meniscus; and, furthermore, through the invaluable advantage of noninvasiveness, freedom from pain and hazards; and, last but not least, rapid manipulation and unlimited repeatability.

Arthrography↗
PubMed1987

[Non-invasive diagnosis of the venous system of the leg in pregnancy].

During pregnancy one should largely avoid invasive and radiological diagnostic methods. However, real-time sonography and venous occlusion plethysmography yield non-hazardous information on venous morphology and venous function. It became possible to demonstrate by means of these examination methods that the diameters of the veins are enlarged in pregnancy compared to the situation post partum. The difference in significant. Venous occlusion plethysmography points to a deterioration of venous function post partum, since the difference to the values in the third trimenon is not significant. Venous function measurement often pointed to the existence of an obstacle to flow during pregnancy, whereas sonographically a dilatation of the veins was revealed the existence of an obstacle to flow represented by the pregnant uterus. Hence, it appears meaningful to combine both investigation methods to confirm the occurrence of venous changes during pregnancy.

Blood Flow Velocity↗
PubMed1987

Influence of increased fibre intake on biliary lipids.

Influence of increased fibre intake on biliary lipids. The influence of dietary fibres (30 g wheat bran per day) on the lithogenicity of the bile was studied in ten healthy persons, whose body weight was 76.8 +/- 2.3 kg, height 189.9 +/- 2.1 cm, age 25.5 +/- 0.26 years. These 10 young male volunteers were given twice daily 15 g wheat bran additionally for six weeks in addition to their normal diet. The bile was obtained endoscopically prepapillarily following stimulation of the gallbladder with ceruletid. The contraction of the gallbladder was controlled sonographically. Increased dietary fibre intake resulted in significant lowering of cholesterol concentration in the bile from 3.27 +/- 0.89 mmol/1 to 2.50 +/- 0.67 mmol/1. The lithogenic index (Admirand and Small, 1968) decreased statistically significant from 1.01 +/- 0.14 to 0.67 +/- 0.11. Total cholesterol and HDL and LDL cholesterol remained unchanged; likewise, there was no change in serum triglyceride and phospholipid concentrations. Hence, an increased intake of dietary fibres of the wheat bran type should be the first dietary measure in both prevention and treatment of cholesterol gallstone disease.

Adult↗
PubMed1987

[Lithogenicity and bile acid pattern in choleretic administration (3-n-butoxy-1-phenoxy-propanol: febuprol) in patients with functional right upper quadrant pain].

10 patients with right upper quadrant pain were treated with a choleretic agent (Febuprol; 3 X 200 mg t. i. d.) and placebo in a cross-over double dummy technique for 16 weeks. Lithogenic index, bile acid profile and serum lipids were determined every 4 weeks. During Febuprol application the clinical symptoms were relieved (0.87 +/- 1.3 vs. 1.39 +/- 0.21 (placebo); p less than 0.05, semiquantitative score). Biliary lithogenicity (1.45 +/- 0.6 vs. 1.09 +/- 0.12; n. s.), bile acid profile and serum lipids showed no statistically significant change, although serum cholesterol levels seemed to fall during Febuprol application.

1-Propanol↗
PubMed1986

[Results of sonographic diagnosis of choledochal calculi].

To evaluate sonographic accuracy in the diagnosis of choledochal calculi 44 patients were examined prospectively with a mechanical sector scanner before endoscopic retrograde cholangiography (ERC). Calculi with a diameter of more than 1.5 cm could be detected in all cases. Smaller stones (less than 1 cm) were missed in 50% of cases. To quantitate sensitivity in daily clinical practice, the data of 229 patients, suspected to have common bile duct stones, were analysed retrospectively. The overall accuracy was 76%, 90% when an experienced sonographer performed the examination and 47% if the examiner was less experienced. From these data it is concluded that the sonographic detection of choledochal calculi is influenced by the examination technique, experience of the examiner and diameter of the stones.

Adult↗
PubMed1986

[Sonography of gallbladder calculi: possibilities and limits in the selection of gallstone patients suitable for conservative lysis].

The sonographic patterns of artificially produced pure cholesterol and pigment gallstones were evaluated in vitro. Cholesterol calculi exhibited a smooth echo with a relatively high beam penetration, whereas pigment calculi showed a sickle-like surface echo without beam penetration. Clinical evaluation of these criteria in 107 patients was based on correlating preoperative sonographic diagnosis with postoperative microchemical analysis of the calculi. Although small, smooth cholesterol calculi were detected via ultrasound with an accuracy of more than 90 percent, pigment calculi could not be separated and identified with satisfactory precision.

Adult↗
PubMed1985

Rapid and accurate reversed-phase high-performance liquid chromatographic determination of conjugated bile acids in human bile for routine clinical applications. Therapeutic control during gallstone dissolution therapy.

This paper introduces a new method to detect the taurine and glycine conjugates of five different bile acids (cholic acid, deoxycholic acid, chenodeoxycholic acid, ursodeoxycholic acid and lithocholic acid) in human bile. Advantages of this method are sufficient separation of compounds within a short period of time and a high rate of reproducibility. Using a mobile phase gradient of acetonitrile and water, modified with tetrabutylammonium hydrogen sulphate (0.0075 mol/l), we were able to maximize the differentiation between ursodeoxycholic acid and lithocholic acid, which is of primary interest during conservative gallstone dissolution therapy. Use of this gradient reduced analysis time to less than 0.5 h. Recovery rates for this modified method ranged from 94% to 100%, and reproducibility was 98%, sufficient for routine clinical applications.

Bile↗
PubMed1985

Ultrasound characteristics of the pancreas in children with cystic fibrosis.

Eighteen patients (3 months to 16 years) with cystic fibrosis (CF) were examined with a real-time mechanical sector-scanner (5 MH transducer). Compared with age-matched controls, each CF patient showed morphologic changes in the pancreas on abdominal ultrasound examination. A very common finding was a decrease in organ anterior-posterior diameters (CF versus controls: head, 1.25 +/- 0.38 cm versus 2.44 +/- 0.39 cm; body, 0.56 +/- 0.35 cm versus 0.98 +/- 0.3 cm; tail, 0.83 +/- 0.28 cm versus 1.81 +/- 0.38 cm) and a pronounced, age-independent increase in tissue echogenicity. In younger patients, small cystic degenerations could be observed in the pancreatic tail. No correlation could be found between ultrasound morphology, especially pancreatic duct imaging, and exocrine pancreatic function.

Adolescent↗
PubMed1985

[Ultrasonically targetted fine-needle aspiration cytology in the immediate postoperative follow-up of transplanted kidneys].

From March 1982 to September 1983 62 ultrasound-guided fine needle aspiration cytologies in 22 patients with cadaveric kidney transplants had been performed during the postoperative hospitalisation period. In any case it was possible to guide the needle tip into the cortico-medullary boundary or in sonolucent parenchymal areas occurring during acute cellular rejection episodes. Thus technical failures could be reduced to 6% (4 out of 22). In 79% the clinically suspected diagnosis could be confirmed by FNAC. Aspirates from circumscript sonolucent parenchymal areas allowed rejection diagnosis in 95%. In 17% cellular signs of rejection were seen cytologically despite a regular transplant function.

Adult↗
PubMed1984

[Wheat bran-type roughage reduces the lithogenicity of bile].

The effect of 30 g wheat bran on the lithogenic potency of bile was studied in ten healthy males (age 25.5 +/- 0.76 years; height 182.9 +/- 2.1 cm, weight 76.8 +/- 2.3 kg). Wheat bran was taken for over six weeks, at 15 g twice daily. Bile fluid was sucked out from the prepapilla after bile stimulation. Contraction of the gallbladder was checked by ultrasound. Concentration of total bile acids and bile acid spectrum, as well as the concentration of phospholipids, remained unchanged for the six weeks of increased wheat bran intake. Cholesterol concentration in bile decreased from 3.27 +/- 0.89 mmol/l to 2.50 +/- 0.67 mmol/l. The lithogenic index fell from 1.01 +/- 0.14 to 0.67 +/- 0.11. Concentrations and composition of lipids and lipoproteins in serum remained unchanged. An increased intake of wheat bran was thus shown to be a decisive dietary measure in the prevention and treatment of cholesterol gallstones.

Adult↗
PubMed1984

[Dissolution of recurrent stones in the choledochus by a modified irrigation treatment via an indwelling nasobiliary catheter].

Alternating fluid rinsing with a modified glyceromono-octanoate (GMOC) and bile salt-EDTA (BA-EDTA) solution via an endoscopically placed indwelling nasal biliary catheter was performed on 15 patients (13 women, 2 men) with recurrent stones in the choledochal duct after cholecystectomy. Of 12 radiotranslucent and three radioopaque concrements with a mean diameter of 1.72 X 2.05 cm (largest concrement: 3.0 X 3.5, smallest 1.0 X 2.1 cm) 13 were dissolved (87% success rate). In one patient chemolitholysis had to be stopped because of electrolyte abnormalities, before treatment had been completed. After the end of treatment all patients were free of symptoms and during a fairly long follow-up period no stone recurrences were observed.

Aged↗
PubMed1984

[Modified fasting in the therapy of obesity. A comparison of total fasting and low-calorie diets of various protein contents].

Modified fasting represents a successful therapy for obesity without severe side effects. The daily energy-substitution (1000-1700 kJ) consists of 30-50 g high quality protein, 20-40 g carbohydrates and small amounts of fat. The mean weight loss is 11-14 kg in a four-week treatment period. In contrast to total fasting the weight loss achieved with modified fasting consisted in a percentage of 79% adipose tissue and a minimal protein loss of 3%. The nitrogen equilibrium was reached after one to three weeks thus avoiding the risks of greater protein losses.

Diet, Reducing↗
PubMed1984

Nitrogen balance studies during modified fasting.

Protein or nitrogen depletion may be harmful and deleterious as reports of deaths in obese patients fed by liquid protein diets have shown. The aim of our studies was to determine the protein losses (by urinary nitrogen losses) during treatment of obesity with modified fasting over four weeks under inpatient conditions. Sixty-one patients were treated in our metabolic ward with modified fasting randomized into four groups. The daily diet consisted of 33-50 g protein/day, 1-10 g fat/day and 25-45 g carbohydrates/day thus providing 240 to 450 kcal/day or 1.0 to 1.9 MJ. The mean weight losses ranged between 11.0 +/- 0.7 kg and 13.9 +/- 0.9 kg in 28 days. The acceptability and compliance of the four applied diets were excellent and no severe side effects could be observed. The nitrogen balances could be equilibrated from the third week on. The composition of weight lost during modified fasting was as follows. The percentage of body protein ranged between 3% and 16% and the percentage of adipose tissue between 63% and 79% of the total weight loss. Therefore modified fasting represents a very effective and safe therapy of massive obesity.

Adipose Tissue↗