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Biomedical subjects

J Altorfer

Publications and source records attributed to J Altorfer.

At least 55 records · Page 3Linked to original sources

[Hepatitis B virus infection and hepatocellular carcinoma: indication for a possible causal connection even in non-endemic Switzerland].

62 patients with histologically proven hepatocellular carcinoma have been investigated for the presence of serological markers of hepatitis B virus infection, and the findings have been related to alpha 1-fetoprotein measurements and to the nature of the basic disease process affecting the liver. The results document a statistically significant increase in the prevalence of hepatitis B virus markers as compared to patients with cirrhosis of the liver only, pointing to a probable etiological relationship between hepatitis B virus infection and hepatocellular carcinoma even in areas of the world where the infection is not endemic. Early detection of hepatocellular carcinoma is limited by the remarkably high percentage of patients who have no, or only marginal, elevation of serum alpha 1-fetoprotein.

Adult↗

[Long-term course of sporadic non-A, non-B hepatitis: a biochemical, immunologic and histologic follow-up study].

36 patients with acute sporadic non-A, non-B viral hepatitis were prospectively followed up. Study parameters included biochemical and immunological (hepatitis A/B) data, histology of the acute and chronic stage of the disease and immunohistology for hepatitis B markers. The mean follow-up period for the patients with complete remission was 8.5 months, and 30.5 months for the patients with progression to chronic liver disease. 13 (36%) patients developed histologically confirmed chronic hepatitis (6 CPH, 7 CAH). In the chronic stage of the disease, the transaminases showed a markedly fluctuating course in 8 of the 13 patients. Two of the 6 patients with CPH showed complete remission after 25 and 58 months respectively; in the 4 others the disease remained unchanged. In the 7 patients with CAH no remission occurred, but in 2 patients complete cirrhotic transformation of the liver was demonstrated after 36 and 38 months respectively. Hence the prognosis of chronic sporadic non-A, non-B hepatitis seems to be worse than the prognosis of chronic posttransfusion non-A, non-B hepatitis.

Adolescent↗

Pneumatosis cystoides coli: a rare complication of colonoscopy.

A case of colonic pneumatosis cystoides intestinales (PCI) which occurred three days after a routine colonoscopy is presented. A review of the literature revealed only two other cases of PCI following colonoscopy. The close temporal association to the colonoscopy supports the mechanical hypothesis as the probably mechanism leading to intramural PCI.

Aged↗

Hepatocellular carcinoma and hepatitis B virus infection. Analysis of 75 cases from Switzerland.

The prevalence of serological markers of hepatitis B virus (HBV) infection was investigated in 75 patients with histologically confirmed hepatocellular carcinoma (HCC). Hepatitis Bs-antigen (HBs-Ag) was found in 30.8% and evidence of present or past infection in 61.5%. In a control group of 115 patients with liver cirrhosis of various etiologies in whom evidence of a coexistent HCC was lacking, the corresponding numbers were significantly lower (16.5% and 41.7% resp., p less than 0.05). Below the age of 65 years, markers of present or past HBV-infection were significantly more frequent than in patients above 65 years of age (p less than 0.025). All patients positive for HBs-Ag had an underlying cirrhosis; in seven cases, HCC was found in a non-cirrhotic liver. Alpha-fetoprotein measurements failed to identify patients with HCC in up to 43.6% of the HBs-Ag negative cases. It is concluded that HBV-infection does represent a cofactor in the malignant transformation of the liver, even in areas of lower incidence. Alpha-fetoprotein measurements need to be complemented by other investigations if early recognition of HCC is to lead to better survival.

Adult↗

Diabetic gastroparesis: treatment with domperidone--a double-blind, placebo-controlled trial.

6 patients with severe symptomatic diabetic gastroparesis were studied in a placebo-controlled randomized manner to establish if intravenous domperidone accelerates the delayed gastric emptying of a semisolid homogenized meal. Domperidone, 10 mg intravenously, shortened the gastric emptying half-time in all of the 6 patients significantly, but not in the healthy control subjects. These results suggest that intravenous domperidone may be potentially beneficial to diabetic gastroparesis patients by improving delayed gastric emptying.

Adult↗

Multiple hepatitis attacks with immunothrombocytopenia in a heroin addict.

A 25-year-old heroin-addict had four episodes of acute hepatitis, each of them associated with thrombocytopenia. Serologically, hepatitis A and B as well as cytomegalo- or Epstein-Barr virus infections were excluded. High levels of circulating immune complexes and antibodies reacting with aminophospholipids, a component of both liver cell and platelet membranes, were detected during the last two attacks of hepatitis, but were absent during remission. Platelet-associated antibodies of the IgM class paralleled the 'anti-phospholipid' antibodies during the fourth attack. These findings demonstrate an immunological basis of the thrombocytopenia and point to the possibility of a direct association between liver cell injury and peripheral platelet destruction in certain patients.

Adult↗

[Importance of ultrasonography in the diagnosis of diffuse parenchymal disorders of the liver].

In a retrospective analysis, ultrasonographic findings were compared with the individual histological diagnosis in 49 patients with diffuse parenchymal liver disease and 5 healthy controls. Ultrasonography differentiates with great accuracy between normal liver tissue on the one hand and diffuse parenchymal liver disease such as cirrhosis and fatty liver on the other, but only poorly between cirrhosis and fatty liver. The combination of 4 single ultrasonographic criteria serves for diagnosis of liver cirrhosis with a very high degree of specificity but with low sensitivity. Among the various single criteria adopted, sound transmission is that for which interobserver variation is highest.

Diagnosis, Differential↗

Acute hepatitis non-A, non-B; are there any specific light microscopic features?

Coded examination of liver biopsies from a total of 24 patients with acute hepatitis non-A, non-B revealed two main histological trends: (a) acute viral hepatitis with confluent necrosis (sublobular and bridging) carrying a relatively good prognosis and taking a chronic course in only four out of 14 patients (29%); and (b) acute viral hepatitis with severe portal infiltration rich in lymphocytes and plasma cells, lymph follicles with germinal centers and bile duct lesions, as described by Poulsen & Christoffersen. The latter group showed a very high tendency to transition to chronic hepatitis (six out of seven patients, 86%) or a course characterized by one or multiple acute relapses (one out of seven patients, 14%). Bile duct lesions, if present in biopsies of patients with acute hepatitis, are of diagnostic and prognostic value. They point to the etiological possibility of a hepatitis non-A, non-B and, at the same time, they indicate a high likelihood of evolution to chronic liver disease.

Adult↗

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↗

[(Intrahepatic cholestasis with jaundice due to amyloidosis of the liver) ].

Two cases of severe intrahepatic cholestasis due to amyloidosis of the liver seen within 9 months are described and compared with the pertinent literature. In both, the diagnosis was established by needle biopsy of the liver, and the amyloidosis associated with a myeloma. The methods available for reaching a definite diagnosis are discussed, and the possible diagnostic importance of percutaneous transhepatic cholangiography, as performed in one of the two patients, is stressed. Amyloidosis of the liver complicated by jaundice is possibly not such a rare disease; it has a very poor prognosis, and the patients do not survive more than a few months.

Adult↗

[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↗

[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↗