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Biomedical subjects

H Kistler

Publications and source records attributed to H Kistler.

15 recordsLinked to original sources
PubMed1991

[Tumoral calcinosis with superinfection and sepsis].

Tumoral calcinosis (TC) is a rare syndrome involving ectopic calcifications in the vicinity of the large joints. In about one third of patients the disorder is familial and is associated with hyperphosphatemia, elevation of 1,25-dihydroxy-vitamin-D levels and peculiar dental lesion. TC is inherited in an autosomal-recessive manner. In a normophosphatemic male patient with alcoholic cirrhosis of the liver, TC occurred first in the thoracic wall. Seven years after excision of the first lesion, a large tumor mass around the right hip developed. Infection of the calcified masses with Staph. aureus led to extensive abscess formation, septicemia and death at the age of 64. Clinical, dental and biochemical examination of the 7 descendants of the patient revealed no constitutional signs of the disease, thus identifying our patient as a sporadic case. Clinical and pathological findings in the patient are discussed and the literature is reviewed.

Abscess↗
PubMed1989

[Swiss simvastatin multicenter study: 1. Efficacy of 10 mg simvastatin daily in patients with primary hypercholesterolemia].

In a Swiss multicenter study with determination of lipid and lipoprotein parameters in a central laboratory, the efficacy of simvastatin, MSD, was evaluated in patients with primary hypercholesterolemia. Lipid and lipoprotein values were determined in 109 patients before and after 6 weeks' therapy with 10 mg simvastatin per day. A significant decrease in total cholesterol, LDL-cholesterol and apo B, of 21.1, 25.8 and 24.1% respectively, was observed. No influence of simvastatin on apo A-II was found, but HDL-cholesterol and apo A-I were slightly increased (+6.1 and 4.4% respectively). The data show that HMG-CoA reductase inhibitors constitute a new class of effective drugs for the treatment of hypercholesterolemia.

Adult↗
PubMed1984

[Enteral protein loss in regional enteritis of the terminal ileum: treatment by segmental resection of the small intestine].

A case report is given of a 37 year old patient who suffered from excessive intestinal protein losses caused by inflammatory changes of the terminal ileum. Conservative treatment improved neither hypoproteinemia nor weight loss. Finally surgical removal of the afflicted intestinal segment did lead to healing. This rare indication for surgical removal of an intestinal segment is discussed on the basis of literature reviewed.

Adult↗
PubMed1983

[Hemiplegia following injection of heroin].

Two young drug abusers with nontraumatic hemiplegia have been observed. Onset of symptoms occurred within minutes after intravenous administration of heroin. One case had cerebral infarction and the other cerebral hemorrhage. Hypersensitivity to heroin or an unknown adulterant may play a role.

Adolescent↗
PubMed1983

Low- and high-risk malignant melanoma--III. Prognostic significance of the resection margin.

The influence of the resection margin on the prognosis of malignant melanoma was investigated in 577 cases (stage I), 285 with later recurrences and 292 disease-free for at least 5 yr. The resection margins varied considerably, with less than or equal to 10 mm in 172 cases and ca. 50 mm in 85 cases. Low- and high-risk melanomas (determined by means of tumor thickness and mitotic index) were found to be distributed evenly, with only minor variations for different resection margins. The occurrence of metastases was found to be independent of the resection margin, and several statistical methods were used (correlation coefficients, chi-square tests, discriminant analyses). This was also true when high-risk cases were analyzed separately. In contrast, for low-risk melanoma (68 cases), the six metastatic cases had a resection margin less than or equal to 20 mm (11.8% vs 0%, P = 0.3). Furthermore, local recurrences (40 in 482 cases) were seen more frequently in cases with a resection margin less than 30 mm (10.0 vs 2.9%, P = 0.02). However, local recurrences did not appear to be responsible for disseminated disease, as 82.1% were at high and 10.3% were at medium risk. The benefit of a 5-cm resection margin could not be substantiated in this study. A 3-cm resection margin may be necessary to lower the risk of local recurrences and a 2-cm margin appeared to be sufficient for low-risk melanoma.

Adolescent↗
PubMed1976

[Primary hyperparthyroidism. Analysis of 152 patients with special reference to acute life threatening complications (acute hyperparathyroidism)].

The findings of 152 patients with proven primary hyperparathyroidism are reportedmthe purpose of the analysis was to find difference between the various clinical manifestations of the disease. Furthermore the occurrence of acute hyperparathyroid crisis in our series as well as in the literature are described. 65.8% of the patients were females, 34.2% were males. The leading symptom in 98 patients (group I) were kidney stones and in 23 patients (group II) cystic bone disease. Both manifestations of the disease occurred in only 7 patients (group III) and no symptoms related to the kidneys or to the bones occurred in 24 patients (group IV). Because of the difference of the clinical manifestations the additional data were analyzed for each group separately and compared with each other. There was no difference in the mean serum calcium levels for all four groups, however, patients of group I were on the average younger, the duration of the disease was longer and the weight of the parathyroid adenoma was lower compared to the other three groups, Data are presented regarding calcium excretion, phosphate clearance and tubular reabsorption of phosphate for each group. At operation single or multiple adenoma formation was present in 133 patients, whereas diffuse hyperplasia was found in 17 and carcinoma in 2 other patients. 46 of the adenomas were found in an atypical anatomical localisation. This observation is responsible for the many unsuccessful or second explorations of the neck; The weight of the adenomas varied between 0.1 and 23.5 g. The most difficult diagnosis was that of diffuse hyperplasia. The sucess of the surgical intervention was usually established in over 80% of the cases within 24 to 48 hours after the operation with a significant fall of serum calcium. There ist still no definite explanation for the variability of the clinical manifestations of primary hyperparathyroidism. Parathyroid hormone determinations on larger numbers of patients are not yet published. The assumption, that different hormones or peptide fragments are reposible for the different action on bone and kidney is discussed; In our series of 152 patients acute hyperparathyroid crisis occurred eight times. Our findings are compared to the other well documented cases in the literature. Main symptoms were nausea, vomiting, abdominal pain and different states of cerebral dysfunction. Most of the patients had calcium levels over 16 mg/100 ml. Partial renal insufficiency with elevated blood urea and phosphate retention was found in over 50% of the cases. Overall mortality of all cases with acute parathyroid crisis is 52.5%. The pathogenesis of acute hyperparathyroidism and the implications of high calcium levels are discussed. According to our own experience hypercalcenia can be controlled with an intensive therapeutic program and emergency operation for acute parathyroid crisis is no longer necessary.

Acute Disease↗
PubMed1976

[Primary hyperparathyroidism. An analysis of 152 patients with special references to acute life threatening complications (acute hyperparathyroidism)].

Tthe findings of 150 patients with proven primary hyperparathyroidism are reported. The purpose of the analysis was to find differences between the various clinical manifestations of the disease. Furthermore the occurrence of acute hyperparathyroid crisis in our series as well as in the literature are described. 65.8% of the patients were females, 34.2% were males. The leading symptom in 98 patients (group I) were kidney stones and in 23 patients (group II) cystic bone disease. Both manifestations of the disease occurred in only 7 patients (group III) and no symptoms related to the kidneys or to the bones occurred in 24 patients (group IV). Because of the difference of the clinical manifestations the additional data were analyzed for each group separately and compared with each other. There was no difference in the mean serum calcium levels for all four groups, however, patients of group I were on the average younger, the duration of the disease was longer and the weight of the parathyroid adenoma was lower compared to the other three groups. Data are presented regarding calcium excretion, phosphate clearance and tubular reabsorption of phosphate for each group. At operation single or multiple adenoma formation was present in 133 patients, whereas diffuse hyperplasia was found in 17 and carcinoma in 2 other patients. 46 of the adenomas were found in atypical anatomical localisation. This observation is responsible for the many unsuccessful or second explorations of the neck. The weight of the adenomas varied between 0.1 and 23.5 g. The most difficult diagnosis was that of diffuse hyperplasia. The success of the surgical intervention was usually established in over 80% of the cases within 24 to 48 hours after the operation with a significant fall of serum calcium. There is still no definite explanation for the variability of the clinical manifestations of primary hyperparathyroidism. Parathyroid hormone determinations on larger numbers of patients are not yet published. The assumption, that different hormones or peptide fragments are responsible for the different action on bone and kidney is discussed. In our series of 152 patients acute hyperparathyroid crisis occurred eight times. Our findings are compared to the other well documented cases in the literature. Main symptoms were nausea, vomiting abdominal pain and different states of cerebral dysfunction. Most of the patients had calcium levels over 16 mg/100 ml. Partial renal insufficiency with elevated blood urea and phosphate retention was found in ov er 50% of the cases. Overall mortality of all cases with acute parathyroid crisis is 52.5%. The pathogenesis of acute hyperparathyroidism and the implications of high calcium levels are discussed. According to our own experience hypercalcemia can be controlled with an intensive therapeutic program and emergency operation for acute parathyroid crisis is no longer necessary.

Acute Disease↗