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Biomedical subjects

H Bühler

Publications and source records attributed to H Bühler.

At least 127 records · Page 7Linked to original sources
PubMed1982

[Early diagnosis of stomach cancer: reality or illusion?].

Cancer of the stomach is, in Switzerland, the fourth most common malignant tumor in both sexes. The five year survival rate is between 10 and 20% in Europe; where the cancer is diagnosed early, however, the patients have a survival rate of 85-95%. Of the 305 cases diagnosed in the last 5 years, 51.5% were operatively curable. In 29.5% of the cases palliative surgery was possible and 19% were inoperable. The rate of early cancer is 12% and thereby constitutes the largest portion of the total five year survival rate. Improvement of prognosis is only realizable through early detection, but even today this prospect is largely illusory. Practicable ways of obtaining optimum results are demonstrated.

Aged↗
PubMed1982

[Endoscopic papillotomy in benign papillary stenosis].

Since 1977 endoscopic sphincterotomy has been indicated in 18 patients because of benign papillary stenosis. In 17 patients cholecystectomy had been performed some time before. The sphincterotomy was successful in 15 patients. In one patient slight bleeding occurred. In 2 of 3 patients in whom sphincterotomy did not succeed, the endoscopic procedure was complicated by cholangitis and pancreatitis respectively. 12 of the 15 patients in whom sphincterotomy was successful were symptom-free over a median period of 21 months. Therefore, endoscopic sphincterotomy appears to be an effective treatment for benign papillary stenosis and is a low-risk procedure compared with surgical sphincterotomy.

Adult↗
PubMed1982

[Endoscopic papillotomy].

Endoscopic sphincterotomy is a new procedure for the management of extrahepatic cholestasis. The main indications are residual or recurrent common bile duct stones and papillary stenosis. In high risk patients endoscopic sphincterotomy is the procedure of choice even in the absence of previous cholecystectomy. In these cases especially, mortality is considerably lower compared to surgical therapy. Sphincterotomy is successful in more than 90% of patients, and in about 85% passage of common bile duct stones occurs. Follow-up studies have thus far revealed no significant adverse effects.

Ampulla of Vater↗
PubMed1982

Regression of liver cell adenoma. A follow-up study of three consecutive patients after discontinuation of oral contraceptive use.

Three consecutive young female patients with unresected liver cell adenoma and a history of contraceptive use of several years' duration were followed up over a period of 2-4.5 yr after withdrawal of hormonal medication. One patient presented multiple adenomas and in another, the adenoma was associated with a Budd-Chiari syndrome due to bilateral thrombotic hepatic vein occlusion. Complete regression of the adenomas was documented in all 3 patients by ultrasonography, liver radionuclide scan, laparoscopy, or computerized tomography. It is concluded that, in selected cases, conservative management after withdrawal of hormonal contraception may be a valid alternative to surgical therapy.

Adult↗
PubMed1982

Comparative diagnostic accuracy of four tubeless pancreatic function tests in chronic pancreatitis.

The comparative sensitivity of 4 tubeless pancreatic function tests was evaluated in 125 patients with proved chronic pancreatitis associated with various degrees of pancreatic insufficiency. NBT-PABA, immunoreactive trypsin (IRT), and pancreatic isoamylase (P-iso) were studied in relation to the fecal chymotrypsin test (FCT) and steatorrhea. In advanced insufficiency (steatorrhea or FCT less than 20 micrograms/g) PABA, IRT, and P-iso were pathologically low in only 70-85% of patients. In less severe pancreatic insufficiency (FCT 21-120 micrograms/g) these tests yielded pathological results in 35-53% of patients. Thus the sensitivity of the three tests was comparable and rather low. IRT values (and P-iso) were constantly low or progressively decreasing in 64% of patients (30/47) studied repeatedly over an average of 17 months. The serum enzyme tests seem, therefore, to be valuable for monitoring pancreatic insufficiency, like the FCT. This is particularly important for the differential diagnosis of acute (reversible) and chronic (progressive) pancreatitis.

4-Aminobenzoic Acid↗
PubMed1981

[Non-A, non-B viral hepatitis: occurrence, epidemiology and prognosis].

Out of 117 cases with acute viral hepatitis, 37 (32%) were classified as hepatitis A, 50 (43%) as hepatitis B and 30 (25%) as hepatitis non-A-non-B (NANB). In 21 of the 30 patients with hepatitis NANB, a possible mode of parenteral transmission could be found. The mean incubation period was 53 days. Only 3 patients had had blood transfusions. 14 (52%) of the 27 patients with sporadic hepatitis (without transfusions) had a mild course of the acute illness without, or with only mild, jaundice and transaminase values below 500 IU. The remaining 13 patients had a more severe form of acute hepatitis (bilirubin above 5 mg/dl, GPT above 500 IU), and in 11 of these 13 cases confluent necrosis was demonstrable on liver biopsy. 10 (37%) of the sporadic cases, of whom 8 had a mild form of acute hepatitis, and the 3 cases of posttransfusion hepatitis, were followed by a chronic course.

Hepatitis C↗
PubMed1981

[Unusual features of perihepatitis in the differential diagnosis of upper abdominal pain].

Over a period of 3 years acute perihepatitis has been diagnosed in 7 women. Clinically the pain was localized to the right upper abdomen in 4, whereas 1 patient complained of bilateral upper quadrant pain; 2 patients presented with exclusively left-sided upper abdominal symptoms. In the literature perihepatitis is characterized clinically as a syndrome limited to the right upper abdominal quadrant. However, our own experience shows that this disease entity must also be considered in the differential diagnosis of left-sided upper abdominal pain in young female patients.

Abdomen↗
PubMed1981

Acute viral hepatitis B with bridging necrosis: a follow-up study.

Forty patients with bridging necrosis (BN) on biopsies taken during the course of acute viral hepatitis B were included in a prospective study to assess the prognostic significance of this lesion. Of the 22 patients with complete clinical, biochemical and histological follow-up (histological follow-up 5-33 months), only two failed to eliminate HBs- and HBe-antigen in serum, a finding paralleled by transition to chronic active hepatitis and by the persistence of focal HBc- and HBs-antigen expression in liver tissue. Nineteen of 22 patients showed complete histological healing; one developed inactive cirrhosis. It is concluded that, in the setting of acute viral hepatitis B, the histological lesion of BN is of no particular prognostic significance, and that transition to chronic liver disease is much less frequent than has been assumed from previous studies of etiologically heterogeneous patient populations. Markers of poor prognosis are the failure of serological elimination of HBs- and HBe-antigen and the persistence of spotty expression of HBc- and HBs-antigen on immunofluorescence histology.

Acute Disease↗
PubMed1981

[HLA-antigens in the diagnosis and genetics of schizophrenia].

We found no convincing association of HLA-antigens and Schizophrenia with exception of a significant reduction of Aw19 in our study of 140 schizophrenic patients. The incidence of the haploids HLA-AI,B7, -A2,B18, -A2, Bw35, -A3,Bw35, -A1,Cw3, -A2,Cw3 has been significantly increased and the haploids HLA-A1,B8, -A2,B5, -A2,B7, -A2,Cw2, -B12,Cw4, -B27, Cw2 significantly decreased compared with normals. HLA-A1,B8, -A2,B5, -A2,B7, -A2,Cw2, -B12,Cw2 have shown an important imbalance of the alleles possibly induced by the lowered fertility and migration of schizophrenic patient.

Female↗