Biomedical subjects
Publications and source records attributed to E Zinsser.
The diagnostic and therapeutic management is described in four cases with foreign bodies of the biliary tract: ball of thread, T-bougie, shell splinter, peel of greens. The possibilities of therapeutic endoscopy are emphasized.
In a random test of 95 patients with carcinoma of the stomach who were gastroscopised during 1974 to 1977 a sex distribution of 2:1 for men to women was found. The male patients had more frequently an adenocarcinoma, the female patients more frequently a solid carcinoma. The patients with carcinoma of the stomach had more frequently a chronic atrophic gastritis than a control group of patients with functional gastropathy. The precanceroses, such as the atypical intestinal metaplasia were found only among the carriers of carcinomas, but in no case in the control group. The curative operability was given in the antrum carcinomas in 72%, in the corpus carcinomas only in 30% of the cases. Despite a higher age average the operability of women was more favourable than that of men in a not different distribution of the carcinomas to corpus and antrum. The necessary early recognition of the carcinomas for the improvement of the results of therapy is emphasized.
Patients with ventricular ulcer (n = 109) were examined endoscopically and bioptically concerning the frequency of an at the same time existing gastritis. It was shown that stomachs with ulcer practically without any exception, i.e. in 96 per cent, had a pangastritis. In the endoscopic comparative group without focal lesions (n = 231) a gradually less pronouncedly expressed gastritis is present than in patients with ulcer. Patients with gastric ulcer and such persons with endoscopical negative dyspepsia (endoscopic comparative group) have common the more pronounced appearance of the gastritis in the antrum (antritis) than in the corpus. Gastric ulcers appeared in males at the age from 30 to 49 years twice as often as in females. The latter showed an approximately linear increase of the frequency of corpus ulcers between 20 and 69 years. In antrum ulcers like in duodenal ulcers the males dominate at the age from 20 to 59 years, whereas the females prevail in the 7th decennium.
In a random test of 128 patients with neoplasms of the stomach and in a control group of 170 persons corresponding to age without any focal lesion at the stomach the connection between carcinoma of the stomach and the chronic gastritis was tested. The carcinoma of the stomach is always accompanied by chronic gastritis. The chronic atrophic gastritis with intestinal metaplasia is significantly more frequent than in control persons. We found the chronic atrophic gastritis with intestinal metaplasia more frequently than in the adenocarcinoma (environmental carcinoma) than in the solid carcinoma. The clear dependence of age of the carcinoma of the stomach is confirmed; particularly great increase of the frequency of the carcinoma in the male in the fourth to the seventh decennium of life, in which case males more frequently have an adenocarcinoma, females, on the other hand, a solid carcinoma.
In 211 bulboscopies 108 normal findings, 29 duodenal ulcers, 44 cases of scar bulb, 4 times erosions of the bulb and 26 times a bulbitis alone (macroscopically) were found. The macroscopic findings duodenitis were confirmed histologically in 85%, the macroscopic findings normal bulbous mucous membrane only in 30% of the cases. In patients with the histological findings duodenitis the bulbous mucous membrane was endoscopically regarded as normal in 70% of the cases. Patients with duodenitis more frequently have an antrum gastritis and less frequently a corpus gastritis than a control group corresponding to age without any macroscopic changes at the stomach and duodenal bulb. On account of its clinico-therapeutic importance is referred to the fact to demarcate the peptic corrosive bulbitis (bulbitis with bulboscopically probable lesion) from the bulbitis without bulboscopic lesion.
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