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  • 1
    Online Resource
    Online Resource
    Endoscopic Retrograde Cholangiopancreatography in Acute Pancreatitis
    S. Karger AG ; 1988
    In:  Digestive Surgery Vol. 5, No. 3 ( 1988), p. 156-159
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 5, No. 3 ( 1988), p. 156-159
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000171853
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1988
    detail.hit.zdb_id: 1468560-7
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  • 2
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    Online Resource
    Transabdominal Ultrasound with Echoenhancement by Contrast Media in the Diagnosis of Hepatocellular Carcinoma
    S. Karger AG ; 2009
    In:  Digestive Diseases Vol. 27, No. 2 ( 2009), p. 109-113
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 27, No. 2 ( 2009), p. 109-113
    Abstract: According to the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), ultrasound (US) is the recommended tool for surveillance of patients at risk of developing hepatocellular carcinoma (HCC). Larger HCCs can be diagnosed with a high accuracy by conventional US. However, the differentiation of smaller malignant lesions in cirrhotic livers can be improved by contrast-enhanced ultrasound (CEUS). Second-generation contrast agents consisting of microbubbles enable us to visualize specific tumor vascularization patterns. With CEUS, it is not only possible to detect and characterize HCC nodules, but to control the effects of ablation techniques of HCC as well, evaluating the former lesion with respect to complete necrosis or residual viable tumor. Limitations of CEUS are its inability to characterize lesions distant to the applicator. Moreover, so far the use of contrast agents in US did not result in increased sensitivity in the detection of small HCCs ( 〈 1 cm). Thus, there is currently no indication to use contrast agents to increase the detection rate of HCC in patients undergoing US surveillance.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000218342
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482221-0
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  • 3
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    Online Resource
    Preface
    S. Karger AG ; 2016
    In:  Digestive Diseases Vol. 34, No. 5 ( 2016), p. 461-461
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 34, No. 5 ( 2016), p. 461-461
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000445851
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 1482221-0
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  • 4
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    Online Resource
    Hepatocellular Carcinoma in Southern Germany: Epidemiological and Clinicopathological Characteristics and Risk Factors
    S. Karger AG ; 2001
    In:  Digestive Diseases Vol. 19, No. 4 ( 2001), p. 345-351
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 19, No. 4 ( 2001), p. 345-351
    Abstract: The aetiology of chronic liver disease leading to hepatocellular carcinoma (HCC) and the clinical characteristics of patients with HCC vary considerably internationally and intranationally. This study analyses the characteristics of HCC patients in southern Germany, a low endemic area of HCC. 〈 i 〉 Methods: 〈 /i 〉 The files of 118 consecutive patients with HCC observed in a single tertiary care hospital between 1994 and 2000 have been reviewed. Epidemiological and clinicopathological characteristics such as age at presentation, ethanol consumption, serological hepatitis virus markers, and fibrosis were studied. Additionally, serum levels of α-fetoprotein (AFP) were analysed at the time of diagnosis in 77 patients. 〈 i 〉 Results: 〈 /i 〉 The male:female ratio was 4:1 and the mean age at presentation was 61.8 years. Alcohol abuse (49.2%) and chronic hepatitis C infection (17.8%) were the most frequent risk factors. Histologically proven liver cirrhosis in the surrounding non-tumorous tissue was present in only 59.0% of cases. AFP levels were elevated in 78% of cases, but only 34% reached 〉 500 ng/ml, a value considered to be significant for the diagnosis of HCC. AFP levels correlated with the stage of fibrosis. 〈 i 〉 Summary and Conclusions: 〈 /i 〉 The sensitivity of AFP serum levels as a tumour marker is poor but might help to detect at least a minority of cases. As in other populations within Europe, chronic alcohol abuse is frequently associated with HCC in southern Germany, confirming that alcohol is still the most important risk factor for hepatocarcinogenesis in areas with low hepatitis virus prevalence. Considering the poor prognosis of HCC, prevention is of pivotal importance, particularly for patients with chronic liver disease and other risk factors for the development of HCC.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000050702
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2001
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  • 5
    Online Resource
    Online Resource
    Trichuris suis Ova, Lecithin and Other Fancy Molecules
    S. Karger AG ; 2014
    In:  Digestive Diseases Vol. 32, No. Suppl. 1 ( 2014), p. 67-73
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 32, No. Suppl. 1 ( 2014), p. 67-73
    Abstract: During the last 20 years, treatment paradigms as well as drugs used for IBD have changed significantly. However, there are still many unmet needs and a significant number of patients needing better therapy. It is obvious from this situation that many attempts have been made to implement new drugs and treatment algorithms including biologicals, new formulations of old drugs and ‘fancy molecules or approaches'. For about 10 years, the application of Trichuris suis ova has been promoted and used in quite a number of patients. Two early studies suggested positive effects in ulcerative colitis as well as in Crohn's disease. These studies were based on experimental data in animal models as well as in vitro experiments. However, two large randomized controlled trials were not able to provide significant clinical effects in active Crohn's disease as compared to placebo, although a biological reaction (eosinophilia) was found. Another approach is the use of locally released phosphatidylcholine in ulcerative colitis. This approach is based on decreased phosphatidylcholine concentrations in the colonic mucus in patients, and showed positive effects in a number of monocentric trials in steroid-refractory and chronic active ulcerative colitis. A dose-finding study gave a positive signal in the highest-dose group and this approach is being tested further in controlled trials. Many other ‘fancy molecules' including cannabis, vitamin D, thalidomide, hyaluronic acid, lidocaine, clonidine, chondroitin sulfate, naltrexone and melatonin have been tested in patients with claims of success. For most of those, however, controlled data in appropriate studies are lacking. Many more substances have been used in animal models and are probably applied in individual patients. Results of preliminary studies on some of the molecules mentioned are presented.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000367831
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
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  • 6
    Online Resource
    Online Resource
    Inflammatory Bowel Diseases 2003 – From Genetics to Biological Therapy
    S. Karger AG ; 2003
    In:  Digestive Diseases Vol. 21, No. 2 ( 2003), p. 83-84
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 21, No. 2 ( 2003), p. 83-84
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000073240
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2003
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  • 7
    Online Resource
    Online Resource
    Intracellular Transport of High-Density Lipoprotein 3 in Intestinal Epithelial Cells (Caco-2) Is Tubulin Associated
    S. Karger AG ; 2000
    In:  Digestion Vol. 61, No. 1 ( 2000), p. 47-58
    Details
    In: Digestion, S. Karger AG, Vol. 61, No. 1 ( 2000), p. 47-58
    Abstract: 〈 i 〉 Background: 〈 /i 〉 A retroendocytotic pathway for high-density lipoprotein 3 (HDL 〈 sub 〉 3 〈 /sub 〉 ) in cultured intestinal epithelial cell lines has been described. In small intestinal crypt cells and Caco-2, HDL 〈 sub 〉 3 〈 /sub 〉 is internalized, transported to lipid droplets and, after solubilization of these lipid droplets, resecreted. In the present study we examined the mechanisms of intracellular transport of HDL 〈 sub 〉 3 〈 /sub 〉 in the Caco-2 cell line. 〈 i 〉 Methods: 〈 /i 〉 Apolipoprotein E free HDL 〈 sub 〉 3 〈 /sub 〉 was gold-labeled for transmission electron microscopy and 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine iodide [DiI(3)] labeled for fluorescence and confocal laser scanning microscopy. For tubulin desintegration Caco-2 cells were incubated with taxol, colchicine and β- and γ-lumicolchicine. Tubulin staining was performed using a FITC labeled antibody. Uptake of HDL 〈 sub 〉 3 〈 /sub 〉 was quantified by FACS analysis. 〈 i 〉 Results: 〈 /i 〉 HDL 〈 sub 〉 3 〈 /sub 〉 was rapidly internalized and found to be in contact with lipid droplets in the perinuclear region after 10 min. By transmission electron microscopy a frequent colocalization of HDL 〈 sub 〉 3 〈 /sub 〉 -containing vesicles and tubular structures was demonstrated. The close association of HDL 〈 sub 〉 3 〈 /sub 〉 -containing vesicles with fluorescence stained tubulin could be confirmed by confocal laser scanning microscopy. Preincubation of the cells with taxol and colchicine did not completely prevent internalization but reduced it during a 2-hour incubation period to less than 50% of the control cells. The transport of DiI(3)-labeled HDL 〈 sub 〉 3 〈 /sub 〉 to the lipid droplets in the perinuclear region was almost completely blocked by taxol and colchicine. 〈 i 〉 Conclusion: 〈 /i 〉 Internalization and intracellular transport of HDL 〈 sub 〉 3 〈 /sub 〉 in intestinal epithelial cells (Caco-2) is dependent on a tubulin-mediated mechanism.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000007735
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2000
    detail.hit.zdb_id: 1482218-0
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  • 8
    Online Resource
    Online Resource
    The Role of Drug Treatment in Variceal Bleeding
    S. Karger AG ; 1994
    In:  Digestion Vol. 55, No. 1 ( 1994), p. 1-12
    Details
    In: Digestion, S. Karger AG, Vol. 55, No. 1 ( 1994), p. 1-12
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000201115
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1994
    detail.hit.zdb_id: 1482218-0
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  • 9
    Online Resource
    Online Resource
    Low Risk of 〈i〉Clostridium difficile〈/i〉 Infections in Hospitalized Patients with Inflammatory Bowel Disease in a German Tertiary Referral Center
    S. Karger AG ; 2011
    In:  Digestion Vol. 84, No. 3 ( 2011), p. 187-192
    Details
    In: Digestion, S. Karger AG, Vol. 84, No. 3 ( 2011), p. 187-192
    Abstract: 〈 i 〉 Introduction: 〈 /i 〉 Many reports, mainly from the US and Canada but also a recent report from a center in Europe, have documented the increasing impact of 〈 i 〉 Clostridium difficile 〈 /i 〉 infections in patients with inflammatory bowel disease (IBD) during the last years. To determine the prevalence of 〈 i 〉 C. difficile 〈 /i 〉 infections in hospitalized IBD patients in a tertiary referral center in Germany, we conducted this retrospective analysis. 〈 i 〉 Methods: 〈 /i 〉 Data of all IBD in-patients treated due to an acute flare of their IBD at the Department of Internal Medicine I of the University of Regensburg between January 1, 2001, and June 30, 2008, were analyzed. In patients with a concomitant diagnosis of 〈 i 〉 C. difficile 〈 /i 〉 infection, further variables such as IBD-related treatment at the time of infection or outcome were examined. 〈 i 〉 Results: 〈 /i 〉 In total, 995 in-patients with IBD were treated in this hospital [638 patients with Crohn’s disease (CD), 357 with ulcerative colitis (UC)] during the study period. Of these, 279 patients with CD and 242 patients with UC were admitted with an acute flare and suffering from diarrhea and abdominal pain. Only 10 of those were diagnosed as having a concomitant infection with 〈 i 〉 C. difficile 〈 /i 〉 . Six patients were female and the median age was 49 years (range: 15–80). Six patients with 〈 i 〉 C. difficile 〈 /i 〉 infections suffered from UC and 4 patients from CD, all with previous colonic involvement. Eight patients used immunosuppressive therapies; only 2 patients were treated with antibiotics before infection. 〈 i 〉 Conclusion: 〈 /i 〉 In contrast to recent reports from other countries, only a low percentage of hospitalized patients with acute flares of their IBD were identified as having an underlying 〈 i 〉 C. difficile 〈 /i 〉 infection in this German tertiary referral center. However, in IBD patients with an acute flare, a concomitant 〈 i 〉 C. difficile 〈 /i 〉 infection should be excluded, especially in patients with immunosuppressive treatment and colonic involvement of their disease. Further research is needed to evaluate if regions with different risks of 〈 i 〉 C. difficile 〈 /i 〉 infections exist and to find out more about potential reasons for this observation.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000324617
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1482218-0
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  • 10
    Online Resource
    Online Resource
    Rationale for Probiotic and Antibiotic Treatment Strategies in Inflammatory Bowel Diseases
    S. Karger AG ; 2003
    In:  Digestive Diseases Vol. 21, No. 2 ( 2003), p. 105-128
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 21, No. 2 ( 2003), p. 105-128
    Abstract: Inflammatory bowel diseases (IBD), commonly referred to as Crohn’s disease and ulcerative colitis are chronic aggressive disorders which share many similarities concerning pathomechanism and clinical course, but have very distinct features. Both entities are mainly located in areas with high bacterial concentrations, such as the terminal ileum and cecum in Crohn’s disease and the rectum in ulcerative colitis. In recent years, overwhelming evidence accumulated, supporting the hypothesis that IBD are characterized by a genetically determined, overly aggressive immune response towards ubiquitous luminal antigens, especially commensal bacteria and their products. Trials in both human IBD and experimental colitis have demonstrated that broad-spectrum antibiotics may influence the course of ulcerative colitis and Crohn’s disease and antibiotics with narrow activity against the anaerobic fraction of the flora can prevent relapse in Crohn’s disease after surgically induced remission. Since relevant antibiotic strategies can be associated with some side effects, the ongoing research recently focused on alternative methods to modify the intestinal flora in patients with IBD. Clinical observations including few controlled trials, basic research, and animal studies have suggested a potential role for probiotic bacteria within the treatment regimens for IBD. However, the mode of action of these organisms is still largely unclear and in vitro studies are inconclusive. This review summarizes recent in vitro and in vivo data regarding the role of the intestinal microflora in the pathogenesis of chronic intestinal inflammation and possible therapeutic mechanisms of probiotic bacteria relevant to IBD. Furthermore, we will review clinical trials examining the efficacy of antibiotic and probiotic treatment strategies in IBD.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000073243
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2003
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