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W Vogt

Publications and source records attributed to W Vogt.

At least 19 recordsLinked to original sources
PubMed2006

[Toxic megacolon--the position of the internist].

Toxic megacolon is a rare but typical complication of ulcerative colitis. But also every inflammatory bowel disease may be cause of toxic megacolon, including especially Crohn's colitis and pseudomembranous colitis (PMC). There is to mention, that PMC becomes more frequent and more important in the last years. Toxic megacolon is defined by radiological, clinical and labaratory criteria: colonic distension (<6 cm), fever, tachycardia, hypotension, electrolyte disturbances, leucocytosis and anemia. Intensive medical therapy is primarly the therapy of choice, but clinical parameters should be closely monitored. In patients with ulcerative colitis high dosis of corticosteroids are given intravenously. If there is no clinical improvement after 48 to 72 hours, colectomy is required. The use of alternative therapies like cyclosporine or infliximab has to be discussed as possible before toxic megacolon occurs.

Adrenal Cortex Hormones↗
PubMed2006

Acceptance of flexible sigmoidoscopy as a screening examination for colorectal cancer in an outpatient clinic.

BACKGROUND AND STUDY AIM: Flexible sigmoidoscopy (FS) is a feasible examination technique and a suitable tool for population-based screening, but very little is known about determinants of endoscopic screening participation. The aim of this study was to determine the acceptance rate and the factors influencing the decision of participating in a screening program for patients in an outpatient clinic. MATERIALS AND METHODS: In this prospective study, a colorectal cancer screening by FS was offered to 631 patients older than 40 years. Three strategies were available, (1) to have the endoscopy on the same day, (2) to make an appointment for another day, or (3) to take time to think about if they wanted the procedure. The reasons for refusal of the FS were documented. RESULTS: 419 of the 631 (66.4%) patients had no interest to take part in the screening program during their outpatient visit. Two hundred twelve (33.6%) patients were primarily interested on FS, but only 110 of them were finally examined. In total, 102 patients did not make an appointment for FS or did not appear for the endoscopy. The participation rate was therefore 17.4% (110/631) of all patients. Of the patients who agreed to receive an on-site examination, 78.3% were examined compared to 18.8% of patients who fixed the appointment for another day or after taking time to reflect upon the FS procedure. More male than female patients accepted the FS screening. Recommended colonoscopy was finally performed in 76%. Thirty-three polyps were found during the screening program of which 18 were larger than 0.5 cm. No CRC was detected. All patients agreed to repeat the FS every 5 years. CONCLUSIONS: This study demonstrates that a screening examination will be most likely performed if it is done as an on-site examination. In contrast, the participation rate is low if the patient has to make an appointment by himself. Acceptance of FS screening is also dependent on the patient's gender and family history of cancer. Additional strategies are needed to further improve participation.

Ambulatory Care Facilities↗
PubMed2005

[Gastroenterology in the elderly].

The medical care of old patients becomes more and more important. Currently about 21% of all people are older than 60 years. Decisions about therapeutical procedures often cannot be based on guidelines, because studies leading to this guidelines have normally excluded older patients. Decisions have often to be made individually in view of different factors like comorbidity and social structures. All symptoms occuring in older patients need a careful diagnostic work-up, even the majority of complaints as in younger people are of functional origin. In view of the high life expectancy and quality of life the use of difficult and expansive diagnostic and therapeutical tools are justified also in older people. So diagnostic and interventional endoscopic procedures can be done with low risk in older patients.

Abdominal Pain↗
PubMed2005

Mode-locked laser diode with an ultrafast integrated uni-traveling carrier saturable absorber.

A novel two-section integrated mode-locked laser diode (MLLD) with a separate ultrafast uni-traveling carrier (UTC) saturable absorber section and semiconductor optical amplifier gain section is demonstrated. The UTC absorber is composed of a thin p-InGaAsP absorbing layer and an intrinsic InGaAsP collecting layer. By confining the photoexcitation process to the thin highly doped absorbing layer, the diffusion-limited hole extraction process is greatly enhanced. The investigated MLLD produces 600 fs uncompressed optical pulses at a 42 GHz repetition rate.

Journal Article↗
PubMed2005

[Value of ultrasound and doppler sonography in chronic hepatitis and liver cirrhosis].

Ultrasound is unquestionably of great importance in the diagnosis of liver diseases due to the technical improvements of the last years. Indications for an ultrasound examination are the primary diagnosis of chronic liver disease and the screening for hepatocellular carcinoma. Apart from the diagnosis of portal hypertension in liver cirrhosis a portal vein thrombosis should be detected or excluded in cases of new or refractory ascites. The Budd-Chiari syndrome is another rare but important indication. There is a considerable improvement in the differential diagnosis of focal liver lesions especially due to contrast-enhanced sonography. Using phase-inversion harmonic sonography it is possible to detect tumor vascularity in a very sensitive manner. The accuracy of contrast-enhanced sonography is comparable with helical-CT or MRT, and contrast-enhanced sonography is very useful in the evaluation of response to ablation therapy of hepatocellular carcinoma.

Budd-Chiari Syndrome↗
PubMed2005

[Inflammatory bowel disease--diagnosis and therapy].

The first intention in the management of patients with inflammatory bowel disease (IBD) is the improvement of quality of life. It is important to avoid unnecessary investigations and to protect the patients from therapeutic approaches, which efficacy is not proven. The following remarks are based on the guidelines of The German Society of Gastroenterology for diagnosis and therapy of ulcerative colitis and Crohn's disease, which include an accurate diagnosis, the treatment of the acute phase, the maintaining of remission and the management of complications. The therapy depends on the severity of the acute phase and on the localisation of the disease. Immunosuppressive therapy with azathioprine or mercaptopurine is indicated in patients with steroid-dependent or steroid-resistant disease.

Adrenal Cortex Hormones↗
PubMed2003

[Phenprocoumon-induced liver failure].

HISTORY: A 61-year-old woman was referred because of painless jaundice, laboratory tests having indicated hepatitis with impaired liver functions. For the past two years she had been taking phenprocoumon because she had atrial fibrillation. INVESTIGATIONS: Serological tests largely excluded infectious, autoimmune or metabolic etiology, so that the diagnosis of drug-induced hepatic disease was made. Liver biopsy showed necrotic liver cells and mild inflammatory reaction. TREATMENT AND COURSE: A perforating duodenal ulcer required urgent surgical intervention, after which liver functions further deteriorated. The patient having refused liver transplantation she was treated symptomatically (oral vitamin K. lactulose, diuretics), phenprocoumon was discontinued and her condition slowly improved. She was discharged after two months. At subsequent examination she was symptom-free, the INR was 1.41, transaminases were normal and ultrasound merely showed a slightly inhomogeneous internal structure. CONCLUSION: Phenprocoumon can cause liver damage even when the drug has been taken for prolonged periods without any problems. A careful history about previously administered drugs should be taken in any case of hepatitis of uncertain etiology.

Anticoagulants↗
PubMed2003

[Imaging in gastroenterology--what is new?].

In the last years there are a lot of developments in endoscopical, radiological and sonographical imaging techniques for example virtual colonoscopy, capsule endoscopy and contrast-enhanced sonography. The MR- or CT-colonography has a high sensitivity of about 90% in the detection of polyps > 1 cm. But what there is to be said against virtual colonoscopy as a routine examination is the need for bowel cleansing with an oral lavage and the high costs due to a long examination and evaluation time. The capsule endoscopy is a very interesting new imaging technique for the diagnostic evaluation of small bowel diseases. The capsule endoscopy is superior to push-enteroscopy, the gold-standard until now. But it is not clear, whether there is change in therapeutical procedures due to the results of the capsule endoscopy and whether the high costs for the examination are justified. The contrast-enhanced sonography improves especially the detection and characterization of solid liver lesions and some CT- and MR-examination will be unnecessary in the future.

Colonography, Computed Tomographic↗
PubMed2003

[Pantoprazole-induced hepatitis].

HISTORY: A 46-year-old woman presented for an emergency admission because of colic-like upper abdominal pain and markedly impaired general condition. Eight days before admission she had started and continued to take pantoprazole because of symptoms of gastroesophageal reflux. INVESTIGATIONS: Clinical examination and laboratory tests indicated abnormal liver functions suggesting hepatitis. Serology largely excluded an infectious, autoimmunological or metabolic cause. Duplex sonography gave no evidence of bile obstruction or Budd-Chiari syndrome. DIAGNOSIS AND COURSE: The patient's condition and laboratory tests after the drug had been discontinued gradually improved on symptomatic treatment, indicating pantoprazole-induced hepatitis. CONCLUSION: Intake of proton pump inhibitors is a rare cause but should be considered in the differential diagnosis of hepatitis of uncertain etiology.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2002

[Interventions in gastroenterology and hepatology: indications and results].

Interventional therapy and above all the endoscopic interventions have gained importance in the last years. There are a lot of interventional procedures with curative or palliative intention, which value have to be compared with surgical therapy as the therapeutical gold standard. Today the endoscopic hemostasis for ulcer or variceal bleeding are the therapy of choice with very good results. Thus the need for surgery is low. The treatment of benign esophageal stenosis is a domain of the endoscopic therapy. Dilatation with bougies or balloon dilatation get comparable results. In patients with achalasia age and comorbidity of the patients are of great importance for the choice of therapy. In young patients the botulinum toxin injection should be avoided because of a very low long-term efficiency and because surgery become more difficult after botulinum toxin injection. As colorectal cancer is a frequent tumor endoscopic polypectomy and mucosectomy are very important endoscopic procedures, because there is a possibility of cancer prevention and when risk factors are be considered a curative therapy of early colorectal cancer is possible.

Botulinum Toxins↗
PubMed2002

[Colorectal carcinoma: screening--early detection].

Colorectal cancer is the second leading cancer disease in Germany. The mortality is still 60%. 75% of the patients have no risk factors for colorectal cancer, 18% have a positive family history for the disease. In these patients colorectal cancer arise from benign adenomatous polyps. A 76-90% reduction in colorectal cancer incidence can be achieved by endoscopic polypectomy. Tumor stage is an important determinant of outcome. In Dukes stage A the overall survival rate is over 90%. By annual fecal occult blood test the incidence and mortality rate of colorectal cancer can be reduced significantly. The combination of fecal occult blood test and flexible sigmoidoscopy seems to be more effective. An alternative strategy is a colonoscopy every ten years. But the important problem in Germany is the very low compliance of the patients. Only 16% of the men and 34% of the women are participating in cancer surveillance program.

Cause of Death↗
PubMed2002

[The patient with hematemesis. What to do?].

In patients with hematemesis an emergency endoscopy has to be done as soon as possible. In ulcer disease emergency endoscopic treatment is indicated in ulcers with active bleeding or with visible vessels in the base of the ulcer. There is no significant difference in the efficacy between the various endoscopic methods of hemostasis. Gold standard in the treatment of acute variceal bleeding is the hemostasis by endoscopic ligation or sclerotherapy. Because of the very low complication rate variceal ligation is the therapy of choice in the prevention of variceal rebleeding. Especially in patients with preexisting portal hypertensive gastropathy an additional therapy with beta-blocker is recommended. In the prevention of first variceal bleeding a combination therapy with beta-blocker and nitrate is indicated in patients with big varices with red colour signs and in patients with decompensated liver cirrhosis (Child B).

Adrenergic beta-Antagonists↗
PubMed2001

[The value of shockwave therapy in treatment of humero-radial epicondylitis].

Numerous therapies exist for the treatment of radial Epicondylitis. A new treatment, Extracorporal Shock-Wave Therapy (ESWT) has recently been proposed. Based on a review of the medical literature various mechanisms of action are presented. Except for the treatment of conditions of the urinary system, ESWT is controversial. Scientific proof of enhanced efficacy of ESWT compared to other treatments of radial Epicondylitis is still lacking. Prospective, randomized follow-up studies of large patient populations under standardized technical conditions are needed. Based on current knowledge, ESWT of radial Epicondylitis should only be applied if three conditions are fulfilled: 1) the diagnosis of radial Epicondylitis has been ascertained, 2) conservative therapies for at least one year failed, and 3) the only alternative is surgery.

Humans↗
PubMed2001

Xenotransplantation of parathyroids in rats using barium-alginate and polyacrylic acid multilayer microcapsules.

The integrity and function of encapsulated parathyroid tissue following xenotransplantation is limited by oxygen and nutrition supply and capsule fibrosis. Since some of these factors depend on stability and biocompatibility of the coating material, multilayer microcapsules have been developed. Parathyroid tissue pieces and digested single cells from pigs were encapsulated in barium-alginate and in polyacrylic acid (PAA) multilayer capsules. After 7 days of culture the function of the encapsulated cells were assessed. Subsequently, in a part of the cultured microcapsules the viability was directly assessed whereas the other part was transplanted in dark animal [DA] rats for 30 days. After explantation viability and fibrotic reaction were examined. Single cells showed a significant increase in parathyroid hormone [PTH] secretion when exposed to medium low in calcium, whereas minced tissue pieces revealed necrosis without stimulatory responsiveness. Morphometry showed significantly better viability of single cells compared with minced tissue in vitro and in vivo. The fibrotic reaction against capsules with minced tissue was more pronounced than for capsules containing single cells. There was no difference between barium alginate and PAA capsules when containing minced tissue. In single cells, however, the fibrous tissue reaction differed significantly between barium alginate and PAA capsules. Encapsulated single cells of parathyroid tissue maintain detectable function and viability. In contrast minced tissue underwent necrosis and induced significantly more connective tissue reaction than single cells indicating an interrelationship between necrosis and fibrosis.

Acrylic Resins↗
PubMed2000

[Abdominal ultrasound diagnosis].

The doppler sonography is an important tool in the diagnosis of liver diseases, even by using new techniques like the power doppler. There are a lot of indications for the evaluation of the hepatic vessels. Apart from the diagnosis of portal hypertension in liver cirrhosis a portal vein thrombosis should be detected or excluded in cases of new or refractory ascites. The Budd-Chiari syndrome is another important indication. Focal liver lesions can have characteristic findings in doppler sonography, but an exact differentiation of liver tumors is not possible. But doppler sonography even using the power doppler technique is be used more and more in hepatocellular carcinoma to evaluate the response to treatment with chemoembolization, radiofrequency thermoablation or percutaneous ethanol injection. The accuracy is compatible to angiography and computer-tomography.

Carcinoma, Hepatocellular↗