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Biomedical subjects

J Altorfer

Publications and source records attributed to J Altorfer.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Anti-HCV test in patients with chronic non-A, non-B hepatitis].

Our study was designed to evaluate the clinical significance of the ELISA-anti-HCV test. 90 patients with histologically proven chronic non-A, non-B hepatitis (NANBH) and a control group consisting of 36 patients with primary biliary cirrhosis (PBC) were analyzed for antibodies to hepatitis C virus (anti-HCV). Frozen serum samples were tested with the ortho-HCV-ELISA. 67 of 90 (74%) patients with chronic NANBH showed antibodies to the hepatitis C virus. The prevalence of anti-HCV in patients with parenterally transmitted and sporadic chronic NANBH was 70% (23 of 33) and 77% (44 of 57) and in patients with chronic active and chronic persistent NANBH 73% (27 of 37) and 76% (40 of 53) respectively. No significant difference in the prevalence of anti-HCV in the 4 subgroups of patients with chronic NANBH was found. 2 of 36 patients (6%) with PBC were anti-HCV positive without evidence of previous HCV infection. Our results bear out the experience of other authors, that HCV is the commonest pathogen of chronic NANBH. The low prevalence of anti-HCV in patients with PBC suggests good specificity. There have been reports in the literature of "false positive results", particularly in autoimmune hepatitis, and it has been shown that borderline positive test results are often unspecific and therefore to be interpreted with care.

Adult↗
PubMed1992

[Diagnostic problems in infectious colitis in the framework of an HIV infection].

Between 1988/89 1207 HIV-positive patients were registered at the Medical Policlinic of the University Hospital Zurich. In 57 of these patients colonoscopy or rectosigmoidoscopy was performed because of serious symptoms or symptoms refractory to therapy (diarrhea, bloody diarrhea, massive abdominal pain, weight loss). 24/57 (42%) had a negative colonoscopy and in 6/57 patients (10%) Kaposi's sarcoma was found. 14/57 (25%) had unspecific colitis. In 13/57 (23%) cases with colitis, one or multiple bacterial or viral agents were diagnosed: CMV (n = 5), herpes (n = 2), Mycobacterium avium-intracellulare (n = 3), different bacterial agents (n = 5), HIV (n = 1). One patient had a double and one a triple infection. Another had colitis with HIV as the only isolated pathogenic agent in the colon epithelium.

Adult↗
PubMed1991

[Long-term therapy of Ménétrier disease using ranitidine and pirenzepine].

A 22-year-old woman with hypertrophic protein-losing gastropathy (Ménétrier's disease) is described. During treatment with ranitidine (Zantic) and pirenzepine (Gastrozepin) the gastric mucosa and protein loss were normalized within 4 years. Clinical and histological remission has now been observed for 5 and 3 years respectively. In a 57-year-old woman with hypertrophic gastropathy, 8 months' treatment with ranitidine and pirenzepine was associated with decrease in protein loss and improvement of the histological appearance of the gastric mucosa after one year. Long-term treatment of hypertrophic gastropathy with ranitidine and/or pirenzepine should, therefore, be considered in such cases instead of gastrectomy.

Adult↗
PubMed1991

[Prevalence and significance of ant-HCV-antibodies in ambulatory patients with raised transaminases].

From November 1989 to April 1990 we analyzed prospectively the prevalence of anti-hepatitis C virus antibodies and the possible mode of infection in 90 outpatients with repeatedly elevated alanine-aminotransferase levels. The clinical and serological course of these patients was evaluated after 1, 3 and 6 months. Initially, 24 patients (26.6%) were positive for anti-HCV antibodies, but subsequently only 14 of these patients (15.5%) were positive in the follow-up tests. 9 patients (10%) showed no antibodies against HCV in control evaluations and one patient dropped out of the investigation. The 9 patients with a negative result in the control tests had median relative anti-HCV concentrations of 2.0 (range 1.2-4.1) in contrast to 5.5 (range 1.6-256.5) in the 14 patients with a confirmed anti-HCV test (p less than 0.001). None of those 9 patients had received blood transfusions, 7 had consumed drugs intravenously and only 2 had no specific risk for HCV infection. The consistently anti-HCV positive patients had median alanine-aminotransferase levels between 115 and 200 U/l, whereas the levels in initially anti-HCV positive and subsequently negative patients ranged from 75-90 U/l. The initial prevalence of anti-HCV antibodies in 26.6% of our patients is related to the high rate of either false positive results or sero-conversion in 38% of this group. We recommend cautious interpretation of anti-HCV test results with relative anti-HCV concentrations less than or equal to 2 in equivocal clinical situations.

Adult↗
PubMed1991

[Hepatitis C antibodies in acute Non-A, Non-B hepatitis].

Stored serum samples of 20 patients with clinically and bioptically proven non-A, non-B hepatitis (NANBH) in the acute stage were tested for the presence of antibodies to hepatitis C virus (anti-HCV) by means of the Ortho ELISA system. After a mean period of 8 weeks from onset of the disease, 8 of 20 patients (40%) had anti-HCV. Our follow-up study included 14 patients. Of 9 primarily anti-HCV-negative patients, 2 became positive after 2 and 7 months respectively, whereas 7 patients remained anti-HCV-negative up to 52 months (range 1-128) after the onset of hepatitis. The prevalence of anti-HCV was 71% in 7 patients with parenteral hepatitis related to transfusions (n = 2) or drug abuse (n = 5), and 38% in 13 patients with sporadic NANBH. Of the 8 anti-HCV-negative patients with sporadic NANBH, 5 had stayed in one of the countries where enterically transmitted NANBH is endemic 3 to 6 weeks before the onset of their disease. Our results show that at present the anti-HCV-test supplies an etiologic basis for approximately half of all cases of NANBH in acute stage. Nevertheless, in most cases the acute NANBH remains a diagnosis of exclusion.

Adolescent↗
PubMed1991

[Colorectal diseases: diagnosis].

Colonoscopy is now the accepted diagnostic procedure for most colorectal diseases, although studies comparing sensitivity and specificity of double-contrast barium enema with total colonoscopy or combined procedures such as sigmoidoscopy and same-day double-contrast barium enema versus colonoscopy are still being performed. For diagnosis of diverticulitis and fistulas, however, barium enema is still the diagnostic procedure of first choice. Several studies have demonstrated a high sensitivity and specificity for ultrasonography in diagnosis of appendicitis. It seems that the number of unnecessary laparotomies in suspected appendicitis can be reduced by ultrasonography. In rectal carcinoma the therapeutic procedures are determined by the grade of local tumor infiltration and by tumor invasion of local lymph nodes. To predict the tumor stage, rectal endosonography has become the most reliable method. New genetical tests have been developed to diagnose presymptomatic stages in persons at risk of family adenomatous polyposis.

Colonic Diseases↗
PubMed1988

[The role of the liver in the intestinal immune system. Origin of specific B-lymphocytes in the liver following intestinal immunization].

After intestinal priming with cholera toxin (CT) the highest number of specific B-cells is found in the liver, whereas after an intestinal booster dose of CT, high numbers of specific B-cells also locate to the intestine. Correspondingly, after priming, 70% of biliary IgA anti-CT are synthesized within the liver and after boosting approximately 30%. To test the hypothesis that the B-cells in the liver are derived from intestinal lymphoid tissue, thoracic duct lymphocytes (TDL) from intestinally primed and boosted donor rats were transferred to syngeneic recipients. TDL from primed donors predominantly homed to the liver of recipients, and TDL from boosted donors in high numbers to the intestine also. High biliary IgA anti-CT titers in both groups of recipients proved that the immune response was transmitted successfully. In the rat, at any rate, the liver is part of the intestinal immune system not only in terms of IgA transport but also as a specific homing organ for intestinal B-cells.

Animals↗
PubMed1988

[Campylobacter pylori: cause of gastritis and ulcer disease?].

Several studies have shown a striking association between the presence of Campylobacter pylori (C.p) in the gastric mucosa and histologically confirmed gastritis and ulcer disease. The microorganism has been found in up to 90% of patients with active chronic antral (type B) gastric ulcer, and in up to 70% of patients with duodenal ulcer. Voluntary ingestion of C.p. by two persons and two epidemic occurrences after apparent C.p. contamination of stomach probes, with demonstration of the bacterium in the mucosa, have shown that C.p. can induce acute gastritis; in one volunteer the acute gastritis progressed to the active chronic form. Eradication of C.p. by antibacterial treatment is associated with resolution of gastritis. Relapse of peptic ulcer is closely related to infection by C.p. The microorganism has important virulence factors allowing it to select an ecological niche below the mucus layer on the gastric mucosa. C.p. exhibits strong mucolytic activity through proteases which could damage the mucus barrier and therefore increase susceptibility to development of gastritis and peptic ulcers; however, the pathogenic impact of C.p. remains unknown. C.p. is diagnosed by histological or microbiological examination of gastric biopsy specimens or by serological techniques. Bismuth salts alone or in combination with antibiotics are effective against C.p., but the efficacy of antimicrobial treatment of gastritis and ulcer disease associated with C.p. has still to be proven by large double-blind placebo-controlled trials. The hitherto published findings do not allow definite evaluation of the pathogenetic significance of C.p. in gastritis and ulcer disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Campylobacter↗
PubMed1987

Specific antibody synthesis and biliary secretion by the rat liver after intestinal immunization with cholera toxin.

This study was designed to investigate the location, specificity, and significance of antibody-containing cells in the liver. After intestinal administration of cholera toxin, high numbers of specific antibody-containing cells appeared in the liver during the early priming period and after boosting. In contrast, a significant number of specific antibody-containing cells appeared in the lamina propria of the intestine only after boosting. In the liver, the specific antibody-containing cells were predominantly located in the sinusoidal region of zone 1 of the liver lobules. About 80% of the specific antibody-producing cells in the liver synthesized anticholera toxin antibody of the immunoglobulin A class. During the priming period, the concentration of immunoglobulin A anticholera toxin in bile paralleled the increase and decrease in the number of specific antibody-containing cells in the liver. Liver perfusion experiments indicated that during the priming period at least 70% of the biliary immunoglobulin A anticholera toxin antibody was synthesized within the liver, whereas 30% was synthesized in the liver after boosting. Thus, during the early immune response, the liver seems to be the major source for specific biliary antibody to intestinally administered cholera toxin.

Animals↗
PubMed1985

Bullous esophageal lesions due to cotrimoxazole: an immune-mediated process?

A 78-yr-old man experienced a generalized bullous eruption of the skin (a Stevens-Johnson variant of erythema multiforme) with simultaneous involvement of the esophagus due to co-trimoxazole. Immunologic tests revealed specific antibodies of the immunoglobulin G class but not of the immunoglobulin E class against sulfamethoxazole, and in particular against trimethoprim. Lymphocyte transformation tests demonstrated sensitized lymphocytes against trimethoprim but not sulfamethoxazole. The esophageal mucosa showed intraepithelial vesicle formation with diffuse cytoplasmic deposits of immunoglobulin G. This adverse drug reaction involving both the skin and the esophagus appears to be immune-mediated.

Aged↗
PubMed1984

[Delta superinfection of hepatitis B in Switzerland: histology and serology of 28 patients].

A series of 610 consecutive liver biopsies collected from Jan. 1980 to Oct. 1983 in two Swiss gastro-enterological centers was studied by immunohistology for the presence of delta-antigen, HBsAg and HBcAg in frozen sections. This led to the identification of 46 tissue and 45 serum samples of 28 patients, including 5 with follow-up biopsies. All had ongoing hepatitis B (HB) with delta-superinfection, representing 13.3% of all patients with HB. The sera were studied for HBsAg, anti-HBs, anti-HBc and HBe-markers by RIA, for anti-delta by indirect immunofluorescence on delta-positive test sections and for Dane particles by immune electromicroscopy. 18 of the 21 native Swiss patients were i.v. drug users between 20 and 28 years of age (30% of all drug users in this series). The other patients were residents from Mediterranean countries (n = 5), Eastern Europe (n = 1) and Asia (n = 1). Female patients (n = 5) were seen only among i.v. drug users. The most frequent histological type of HB was chronic active (aggressive) hepatitis (CAH) (26 of 46 biopsies or 13 of 28 patients, respectively), followed by acute HB with histological signs of possible transition to chronicity (8 of 46 biopsies or 6 of 28 patients), and acute lobular HB (6 of 46 biopsies or 5 of 28 patients). Chronic persistent HB (CPH) was rare (5 of 46 biopsies, final diagnosis in 3 patients). The delta-infection was found to persist in sequential biopsies when a chronic HB was established, the longest documented period being 72 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Interferon production in acute virus hepatitis].

Serum interferon activity was measured in 40 patients with acute viral hepatitis A, B and non-A-non-B during the acute stage of the disease and correlated with the severity, the long-term outcome and the viral etiology of the disease. Patients with alcoholic hepatitis, patients with an influenza-like illness and healthy volunteers served as controls. 80% of all patients with virus hepatitis revealed no measureable or only borderline interferon activity in their serum. No correlation was found with severity and long-term outcome of the disease, but patients with virus hepatitis A showed a stronger interferon induction than patients with hepatitis B and non-A-non-B. Further investigations of the interferon system in patients with virus hepatitis might help to improve our understanding of the different forms of the disease. The data presently available, however, do not permit as yet to define the value of interferon in the treatment of severe forms of acute virus hepatitis.

Hepatitis A↗
PubMed1983

[Bouveret syndrome].

Bouveret syndrome, a rare form of gallstone ileus predominantly encountered in elderly female patients, is clinically characterized by the sequelae of duodenal obstruction. Two patients observed within one year are presented and the clinical, diagnostic and therapeutic aspects of the disease are discussed. The surgical treatment of choice is one-stage removal of stone, closure of fistula and cholecystectomy completed by a careful search for residual stones in the small and large intestine.

Aged↗