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Biomedical subjects

H Bühler

Publications and source records attributed to H Bühler.

At least 91 records · Page 5Linked to original sources
PubMed1987

Treatment of distal ulcerative colitis with beclomethasone enemas: high therapeutic efficacy without endocrine side effects. A prospective, randomized, double-blind trial.

Sixteen patients with 18 attacks of distal ulcerative colitis were treated randomly with either 0.5 mg topically administered beclomethasone dipropionate (BDP) or 5 mg betamethasone phosphate (BMT). The effect of the steroid enemas on adrenocortical function was examined by ACTH tests, which were performed before and 20 days after treatment. At completion of the trial, a marked suppression of the adrenocortical function was found in seven of eight patients treated for nine attacks with BMT but not in any patients in the BDP group (P less than 0.01). The mean posttreatment basal and stimulated plasma cortisol levels in the BMT group were significantly lower as compared with the BDP group. The overall therapeutic response assessed by score systems was comparable in the two treatment groups. It is concluded that, in the topical treatment of ulcerative colitis, BDP is preferable to BMT because it exerts an equal anti-inflammatory action without affecting adrenocortical function.

Adrenocorticotropic Hormone↗
PubMed1987

Comparative diagnostic value of the calcium-pentagastrin test versus the tolbutamide test in a patient with a somatostatinoma.

We describe a patient with a small somatostatinoma of the papilla of Vater without clinical evidence for diabetes mellitus, diarrhea, steatorrhea, or cholelithiasis, showing normal plasma basal levels for somatostatinlike immunoreactivity. The diagnosis was based on histologic and immunohistochemical analysis of tumor tissue and hypersomatostatinemia induced by the calcium-pentagastrin test. Before removal of the tumor both diagnostic tests recommended for the detection of a somatostatinoma, a tolbutamide test and a calcium-pentagastrin test, were performed. Whereas the calcium-pentagastrin test provoked a markedly elevated plasma somatostatin level in association with a depressed plasma neurotensin level, the tolbutamide test surprisingly did not. After removal of the tumor the calcium-pentagastrin test no longer induced hypersomatostatinemia. Further studies are needed to determine whether the calcium-pentagastrin test is a more reliable diagnostic test than the tolbutamide test in somatostatinomas with normal plasma basal levels.

Adenoma, Islet Cell↗
PubMed1986

[Estrogen and progesterone receptors in human liver: does their study contribute to a better understanding of benign contraceptive-associated liver tumors?].

The estrogen and progesterone receptor content of liver cytosol was measured in female patients with focal nodular hyperplasia associated with oral contraceptive use and compared with the receptor content of non-tumorous liver and of primary hepatocellular carcinomas. Receptors were found in very low concentrations or were not measurable at all. In one case of focal nodular hyperplasia the estrogen receptor content of the tumor was higher than that in the adjacent normal liver. Malignant liver tumors and the male liver were characterized by a low or non-measurable receptor content. The study of nuclear receptors combined with the use of monoclonal antibodies may be more helpful in elucidating the complex relationship between oral contraceptive use, benign liver tumors and hepatic steroid receptors.

Adult↗
PubMed1986

[Mesenterial anemia as a cause of jogging anemia?].

Anemia in runners is common but its origin is unknown. The present study reports on frequency and origin of gastrointestinal blood loss in cross-country skiers and runners. 41 participants in the Engadin Ski Marathon were checked by questionnaire and occult blood test. 8 (19%) had diarrhea or abdominal pain during or immediately after skiing and 3 (7%) had hemoccult-positive stools. In addition, the blood flow of the superior mesenteric artery was measured by duplex scanning in two trained runners after standardized exercise. While the mesenteric blood flow in the asymptomatic runner changed only insignificantly there was an impressive decrease in the second runner, who had been treated for anemia, down to 20% and 40% (30 and 90 min respectively) after exercise. It is concluded that the occurrence of gastrointestinal blood loss in cross-country skiing, and the significant decrease in mesenteric blood flow in a symptomatic runner, indicate a close and possible causal relationship between mesenteric ischemia and "jogging anemia".

Adult↗
PubMed1986

[Gastrointestinal involvement in acquired immunologic deficiency syndrome (AIDS)].

The gastrointestinal tract is a major target organ of the acquired immunodeficiency syndrome. Opportunistic infections or Kaposi's sarcoma within the gastrointestinal tract are the two most frequent lesions. Diarrhoea, weight loss or odynophagy may be the presenting symptoms or signs for which a gastroenterological consultation is sought. In this report we present our own observations of patients with AIDS. Diagnostic and therapeutic aspects of this new syndrome are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Significance of immunoreactive lipase in the diagnosis of pancreatic diseases].

The diagnostic value of a new enzyme immunoassay for lipase (IRL) was evaluated in controls (n = 65), in acute pancreatitis (n = 11) and in extrapancreatic hyperamylasemia (n = 15) by comparing IRL with serum amylase (TA), pancreatic isoamylase (PA) and lipase (turbidimetrically: TL). IRL and immunoreactive trypsin (IRT) of 60 patients with alcoholic chronic calcified pancreatitis were also studied and correlated with duration of disease and degree of pancreatic insufficiency (based on fecal chymotrypsin test: FCT). IRL was constantly elevated in patients with acute pancreatitis. In extrapancreatic hyperamylasemia IRL was mainly normal, in contrast to PA, which was elevated in 7 patients with macroamylasemia. In 56.7% of all patients with chronic pancreatitis, IRL was pathologically low; in association with advanced insufficiency (FCT less than 20 micrograms/g) this figure was 74%, and after duration of disease of greater than or equal to 15 years 77%. For IRT comparable results were found in 79% and 77% respectively. This new lipase test thus seems to be useful for the diagnosis of acute pancreatitis, the differential diagnosis of extrapancreatic hyperamylasemia and the detection and monitoring of severe chronic pancreatitis.

Acute Disease↗
PubMed1985

[Prospective follow-up study of radically resected colorectal carcinoma. Status after 5 years].

207 patients curatively resected for colorectal cancer have been followed up in a prospective, controlled study using serial CEA, ultrasound, colonoscopy and clinical examination for early detection of recurrent tumor. After a median follow-up of 2.5 years, 52 recurrences (25%) have been detected, rising CEA value being the most sensitive indicator (86%) among the diagnostic procedures. 26 patients were reoperated for recurrent disease; in 10 out of 19 patients with local and 3 out of 7 patients with distant recurrence a potentially curative resection was possible. Median survival of patients not operated upon (n = 26) or incompletely resected (n = 13) is 8.5 months, whereas median survival for the 13 patients reoperated for cure has not yet been reached at 2 1/2 years. With respect to resectability, thorough clinical examination and endoscopy have been the most sensitive examinations (both 44%). Aggressive follow-up for suitable patients with colorectal cancer will detect most of the recurrences in an early asymptomatic phase, increase the rate of resectability and prolong survival in selected, curatively reresected cases.

Carcinoembryonic Antigen↗
PubMed1985

[Endoscopic division of an obstructive intraluminal duodenal diverticulum].

Intraluminal duodenal diverticula are rare malformations which usually are noted first in adulthood. High intestinal obstruction predominates the clinical picture. Surgical resection of the diverticulum is the treatment of choice. In a 52-year-old woman it was possible to split the intraluminal obstruction along its whole length by endoscopic means. This method would seem to present a possible alternative to surgical intervention.

Diverticulum↗
PubMed1985

[Primary colon tuberculosis].

Two cases of primary gastrointestinal tuberculosis are reported. One patient showed radiologic, colonoscopic and histopathologic features of Crohn's disease. After a five-year follow-up, acid-fast bacilli were identified in colonic tissue cultures. In both patients fecal cultures were repeatedly negative for Mycobacterium tuberculosis. The two patients were successfully treated with antituberculous therapy. The authors emphasize the importance of considering tuberculosis in patients presenting with Crohn's disease. In this regard colonoscopy with tissue culture of targeted biopsy may be a valuable aid in establishing the diagnosis of tuberculous colitis.

Adult↗
PubMed1985

Endoscopic removal of a large, obstructing and bleeding duodenal Brunner's gland adenoma.

About 10-30% of benign duodenal tumors are Brunner's gland tumors. These are almost always benign. Usually they present as incidental findings in the form of small polypoid lesions at barium examination or at panendoscopy. We present a case with a large obstructing and bleeding Brunner's gland adenoma located in the duodenal bulb which was removed by endoscopic polypectomy.

Adenoma↗