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Biomedical subjects

H A Kühn

Publications and source records attributed to H A Kühn.

At least 19 recordsLinked to original sources
PubMed1981

Columnar-lined oesophagus (Barrett's syndrome) - congenital or acquired?

A segment of the distal oesophagus lined with columnar epithelium (endobrachy oesophagus, Barrett's oesophagus), is very frequently seen in association with chronic reflux conditions. Usually, this entity is an asymmetrical columnar-cell metaplasia of varying extent, with an unsharp epithelial junction line cranial, and showing various large residual islands of squamous epithelium. In addition, usually well-developed peptic lesions are also found. More rarely seen are cases with a longer, symmetrical, cranially sharply delimited columnar-epithelial-lined segment, in which peptic lesions and strictures are usually either restricted to the proximal section, or are lacking altogether. Among more than 100 patients presenting with endobrachy-oesophagus, 14 cases had the latter form of the condition. Seven had a solitary, high peptic stricture, and only 50% unequivocal hiatus hernia. In four patients there were no inflammatory changes at all. In 8 patients, fundic glands were observed. Of particular interest was the segment-like arrangement of cardiac and fundic glands in 2 of the patients. In only a single case were scar formations seen in the columnar-lined segment. Considered from the point of view of our embryological knowledge, certain forms of endobrachy-oesophagus would appear to represent a congenital anomaly.

Adult↗
PubMed1980

[Virus hepatitis, an overview (author's transl)].

It has now been known for 40 years that the particular liver disease which has been called "icterus catarrhalis" in former times is being caused by virus infection. Before that, Virchow's thesis ("occlusion of the papilla by mucus"), and later on Eppinger's thesis ("serous hepatitis due to intoxication by unidentified protein break-down products") were held to be true. Only after liver biopsy was introduced became it known that this particular disease is in fact an inflammatory process. Since neither bacteria nor protozoa could be found, it had to be assumed that viruses were the positive agents. It then took another 30 years until two viruses causing hepatitis (A and B) could be identified. The most important steps in this process of identification were: (1) proof of the oral and parental route of infection by Voegt in Germany and by American authors (following yellow fever vaccination in the US Army); (2) detection of the Australia (HBS) antigen by Blumberg; and (3) transfer of the infectious disease to monkeys. In conclusion, the present day status of hepatitis research (virology, epidemiology, immunology) is presented and chances of prevention are discussed.

Animals↗
PubMed1979

Therapy of Crohn's disease with metronidazole -- an uncontrolled trial --.

Twelve patients with Crohn's disease (C.D.), in whom there was no improvement of symptoms and signs under protracted corticosteroid and salicylazosulphapyridine medication, were treated with 1 000 mg metronidazole (M.) daily. Crohn's Disease Activity Index (CDAI) was used as a criterion of therapeutic response. Seven patients showed improvement of symptoms with a concomitant fall of the CDAI from 300 +/- 84 to 56 +/- 32 (mean +/- SD) after 10 to 45 days. In one patient, therapeutic success was judged to be doubtful, a negative result being obtained in 4 patients. During follow-up, which was maximally 21 months, patients failed to relapse while receiving a maintenance dose of 250 and 500 mg of M. per day. -- Judicious attempts at drug withdrawal were undertaken during the first 6 months but were invariably followed by a relapse. -- Metronidazole given over a protracted period did not give rise to side-effects. -- A reduction of anaerobic bacterial invaders of the intestine is suggested to underlie the favourable therapeutic effect of M.

Adolescent↗
PubMed1978

[Heart tumour in the right atrium: clinical recognition and therapeutical management (author's transl)].

A 62 year old lady came to the hospital in cause of right heart failure. Right and left heart catheterization and cineangiocardiography revealed a tumour in the right atrium. Further angiographic investigations demonstrated a hypernephroma in the left kidney. The operation of both tumours was successful. Pathohistological examination confirmed the diagnosis of hypernephroma in the left kidney with metastasis into the right atrium.

Adenocarcinoma↗
PubMed1977

[Therapy of hepatitis B. Practical implications].

There is as yet no specific treatment for viral hepatitis, and in an uncomplicated course no further action apart from moderate bedrest is necessary. The patient should however, be isolated in a special ward. In fulminant hepatic failure the benefit of glucocorticoid therapy is still controverted and appears to depend on an early beginning. Treatment with HBsAg-rich human serum in fulminant hepatitis B is still under evaluation. In chronic active hepatitis the administration of azathioprine in combination with glucocorticoids is highly effective, and it appears to be irrelevant whether HBsAg is present in plasma or not; however, the best results have been achieved in "lupoid" hepatitis. The use of transfer factor, laevamisol or thymosin to suppress T-cell action on antibody production of the B-cells cannot yet be finally evaluated with respect to its effectiveness in chronic active hepatitis. Prevention is of major importance in solving the problems involved in hepatitis B infections. Recent experience with active immunization using HBsAg-rich sera or purified formalin inactivated HBsAg preparations suggest the possibility of successful vaccination against hepatitis B in the near future, but the precondition for obtaining sufficient quantities of vaccine is to find suitable culture media for the virus.

Azathioprine↗