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H Sulser

Publications and source records attributed to H Sulser.

At least 37 records · Page 2Linked to original sources

[Actinomycosis of the colon: clinical, endoscopic, serological and therapeutic aspects].

The case of a 73-year-old woman with extensive abdominal actinomycosis is reported. It appears to be the first case of abdominal actinomycosis in which endoscopic and serologic investigations have been performed before and after medical therapy. Ultrasonography, CT scan and surgical exploration revealed an extensive inflammatory tumor of the sigmoid colon involving the urinary bladder and uterus. Histologic examination revealed typical sulfur granules. Longterm highdose therapy with penicillin was performed.

Actinomyces↗

[Pathology of gastric mucosa polyps].

More frequent use of the endoscope to remove gastric mucosal polyps has also led to better knowledge of the pathology of these polyps. Their classification is still a matter of debate, and hence, by way of introduction, the notions of hyperplastic, hyperplasiogenous and hyperplastic-adenomatous polyp, adenoma, borderline lesion protruded type, foveolar hyperplasia and cysts of the gastric glands are presented. The authors give preference to the WHO classification of 1977. Among 196 mucosal polyps examined between 1970 and 1982 84% were hyperplastic (hyperplasiogenous) polyps, 15.5% adenomas and there was a single specimen of hamartomatous polyp. One in every 6 adenomas showed malignant changes and 5 of the 165 hyperplastic polyps were associated with gastric carcinoma. Problems of diagnosis, classification and prognosis are briefly discussed.

Adenoma↗

[Colonic complications after renal transplantation (author's transl)].

From December 1964 to June 1980, 569 kidney allotransplants were performed in 524 patients at the University Hospital in Zurich. Necrokidneys were used exclusively. Twelve of these patients exhibited severe colonic complications: four perforations (1 perforated diverticulitis of the sigmoid, 1 perforation of the cecum during cytomegalovirus infection, 2 cases of ischemic colitis), 5 cases of ischemic colitis without perforation, and 3 patients with erosive colitis. In 9 of the 12 patients, hypotonic episodes were noted 4-17 days previously. The 2% complication rate in our patients is comparable with the mean rate of complications mentioned in the literature (2.4%). The lethality of 75% also corresponds with the results of other authors. The most important pathogenetic factor for colonic complications is ischemia; prevention of hypotonic episodes after renal transplantation is therefore mandatory.

Adult↗

[Burkitt's lymphoma in a Swiss patient].

In summer 1978, Burkitt lymphoma was diagnosed in a 23 year old Swiss male. A brief report on this patient appears justified for the following reasons: (1) Burkitt lymphoma is very rarely diagnosed in Switzerland. (2) The tumor cells of this patient could be established as a cell line. They have now been subpassaged in vitro for over 9 months. (3) In contrast to the majority of non-African Burkitt lymphomas, these tumor cells produce small amounts of Epstein-Barr virus.

Adult↗

[Clinical pathology of colonic mucosal polyps].

Of 636 polyps removed during endoscopy between 1973 and 1975 at the University Hospital, Zurich, 36 (5.5%) were of the hyperplastic and 18 (2.8%) of the juvenile type. One polyp was seen in a female patient with Peutz-Jeghers syndrome. The vast majority of the polyps (581, 91.5%) were neoplastic in origin; 70% were tubular adenomas, 16% villous adenomas, and 14% intermediate forms or tubulo-villous adenomas. On the basis of a continuous spectrum in histologic structure and similar cellular dedifferentiation, these three types of adenoma may be viewed as different forms in the development of the same neoplastic process. Hyperplastic and hamartomatous polyps are innocuous, whereas the neoplastic forms may well turn aggressive. Malignant change was observed in 5.1% of our material, particularly in villous adenomas and in polyps exceeding 1 cm in diameter. The presence or absence of invasive growth through the muscularis mucosae is of prime importance for therapy. In accordance with WHO nomenclature, the term carcinoma is used only in the presence of such infiltration. If, in addition, the tumor tissue is not well differentiated, additional segmental resection may be required. The term "focal carcinoma" is no longer in use and has been replaced by "severe focal atypia". In these cases, primary polypectomy for diagnostic purposes is also the optimal therapy, and is as effective here as in cases of benign adenoma.

Adenoma↗

[The primary ovarian carcinoid. Case report].

A rare primary carcinoid tumor of the ovary, found incidentally in a 68-year-old woman, is reported. There had been no symptoms of carcinoid syndrome. Grossly, the unilateral tumor was cystic, measuring 13 cm in greatest diameter. Microscopically it consisted mainly of solid epithelial cords. The demonstration of argentaffin cells and the absence of a concomitant teratoma, dermoid or pseudomucinous cyst led to the diagnosis of a pure primary ovarian carcinoid tumor. On average the prognosis of such lesions is good and recurrence or fatal metastases are rare. Treatment consists of salpingo-oophorectomy. To rule out a metastasizing carcinoid with similar histologic features, the contralateral ovary should be biopsied since metastases almost invariably occur bilaterally.

Aged↗

[Primary malignant lymphoma of the stomach. Analysis of 38 cases].

A retrospective analysis is presented of 38 cases of malignant lymphomas of the stomach, 20 of the reticulum cell type, 6 lymphoblastic, 6 lymphocytic and 4 mixed forms. Two patients had a primary Hodgkin's malignant lymphogranuloma. A follow-up was obtained for 35 patients. There proved to be no significant difference between the symptomatology of carcinoma and lymphoma of the stomach. In patients with lymphomas only signs of stenosis were missing, although the majority of the tumors were located in the antrum. As a consequence of the extreme tendency of the lymphomas to exulcerate (89%), the mean duration of symptoms of 21/2 months (patient's delay) is shorter than that for carcinomas. Malignant lymphomas of the stomach are very difficult to identify as such by radiology and endoscopy, because of their uncharacteristic macroscopic appearance. The best diagnostic method has proved to be endoscopic wire-loop biopsy, which serves to obtain adequate material for histology. An unexpected finding was that at the time of operation half of the patients had clinical stage I E. This indicates that lymphomas remain limited to the stomach longer than carcinomas do. The prognosis depends on both histological type and clinical stage. It is somewhat better than that of nodal malignant lymphomas. The 5-year survival rate of all cases with malignant lymphoma of the stomach is 31%.

Adolescent↗

[Angiodysplasia of the colon: diagnosis and therapy].

Angiodysplasias of the colon are rare causes of intestinal bleeding. Diagnosis is by angiography or colonoscopy. In 6 patients with severe anemia in whom conventional methods had failed to reveal the source of bleeding, colonoscopy demonstrated angiodysplasias in the cecum or ascending colon. They were treated endoscopically. In a follow-up period of 3 months to 4 years only 1 patient has sometimes suffered occult fecal blood loss, but is adequately treated by oral iron therapy. No patient has had a severe recurrence of bleeding, nor was colonic resection necessary. It is concluded that endoscopic therapy of angiodysplasias is a valuable alternative to surgery with low risk and high efficiency.

Aged↗

[Nonspecific ulcer of the colon: a report on 12 endoscopically diagnosed cases].

Report on 12 patients with nonspecific ulcers of the colon diagnosed by colonscopy and biopsy. In 10 patients the course was favorable with conservative management. In 2 patients the symptoms were aggravated; in both patients this was due to a penetrating malignant tumour diagnosed at laparotomy a few weeks later. It is proposed that nonspecific ulcers of the colon should be managed conservatively. Further investigations and laparotomy are indicated only when symptoms progress.

Aged↗

[Comparative endoscopic, light microscopy and scanning electron microscopy studies of the gastric mucosa in patients with chronic uremia].

Ten patients suffering from chronic uremia were selected for comparison studies of gastric mucosa. With endoscopy erosive gastritis was seen in the corpus and antrum of five patients and in the fundus of two patients. Conventional microscopy (nine patients) revealed chronic gastritis I three times in the fundus and five times in the corpus. Gastritis II was localized once in the corpus and twice in the antrum. Gastritis III was present in the antrum of four patients. Under the scanning electron microscope lesions of gastric mucosa were present in all ten cases. Single cell necrosis (A), mucosal defects involving basal membrane (B), destruction of tunica propria (C), and muscularis mucosae with bleeding (D) were seen. Mucosal lesions A and B are early stages of gastric erosions. The most severe lesions were seen in the antrum mucosa with all three methods.

Chronic Disease↗