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Biomedical subjects

R Streuli

Publications and source records attributed to R Streuli.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Diagnosis and clinical course of periarteritis nodosa].

The clinical symptoms, diagnostic procedure and course under treatment in 10 patients with polyarteritis nodosa are studied retrospectively. Clinically, 3 patients showed peripheral arterial occlusive disease in the lower extremities. 3 patients had evidence of preceding acute type B hepatitis. The diagnosis was confirmed by biopsy in 7 cases, by selective arteriography of the kidneys showing multiple small aneurysms in one case; in 2 patients the diagnosis was based upon the clinical findings only. Complete remission was achieved in 7 of 10 treated patients, in 5 patients with corticosteroids alone and in 2 patients with a combination of corticosteroids and cytotoxic agents. 4 patients died, one of them from vasculitis and 3 from other causes. 5-year survival for all patients was 52%. The diagnostic value of arteriography, the clinical picture of polyarteritis nodosa with peripheral arterial occlusive disease, and the association between hepatitis B infection and polyarteritis nodosa are discussed.

Adult↗
PubMed1986

[Clinical aspects of cytomegalovirus infection in nonimmunosuppressed adults].

The histological changes in cytomegalovirus (CMV) infection were first described by RIBBERT in 1881, and for years the virus was dreaded as the agent of infection in newborns. An infectious mononucleosis-like disease with negative heterophil antibodies in otherwise healthy adults was described in 1965. We present six previously healthy adults with CMV mononucleosis observed in 1984. The diagnosis was established by CMV-IgM-ELISA. All patients were febrile for an average of 20 days. The general state of health was reduced in three patients; one patient suffered from headache and another from abdominal pain. Physical examination showed splenomegaly and mild tonsillitis in one patient each, but in no case lymphadenopathy. All patients had lymhocytosis with reactive forms (virocytes). Elevation of transaminases was seen in four cases. Compared to Epstein-Barr virus mononucleosis, fever in CMV mononucleosis lasts significantly longer and lymphadenopathy is evidently rarer. The combination of fever of unknown origin, a negative heterophil antibody titer and the presence of virocytes prompts suspicion of CMV mononucleosis.

Adolescent↗
PubMed1985

[Mefenamic acid (Ponstan)-induced acute interstitial nephritis with reversible, severe, non-oliguric renal failure].

Acute interstitial nephritis is a rare complication of treatment with non-steroidal antiinflammatory drugs. A case is reported with severe, reversible, non-oliguric renal failure caused by biopsy-proven acute interstitial nephritis after therapy with mefenamic acid (Ponstan). Prednisone treatment resulted in normalization of renal function within 4 weeks.

Acute Kidney Injury↗
PubMed1985

Stereospecific modulation of the calcium channel in human erythrocytes by cholesterol and its oxidized derivatives.

To study the effect of cholesterol and its pathophysiologically important oxidized derivatives (OSC) on the calcium entry channel, the human red blood cell was used as a model system. The calcium ejecting adenosinetriphosphatase (ATPase) was inhibited by vanadate. The cells were loaded with OSC at concentrations between 1.25 X 10(-5) and 25 X 10(-5) mol/l. 22-Hydroxycholesterol, cholestan-3 beta,5 alpha,6 beta-triol, 5 alpha-cholestan-3 beta-ol,3 beta,5 alpha-dihydroxycholestan-6-one and 3 beta-hydroxy-5 alpha-cholestan-7-one stimulated 45Ca2+ influx by up to almost 90%, whereas 25-hydroxycholesterol, 7 beta-hydroxycholesterol, 20 alpha-hydroxycholesterol and 7-oxocholesterol inhibited influx by up to 75%. Both stimulation and inhibition were dependent on the amount of OSC incorporated into the membrane. More than 90% of the total modification of calcium influx by OSC was accounted for by an influence on the nitrendipine-inhibitable part of influx. Enrichment of cholesterol in the membrane greatly stimulated, and cholesterol depletion inhibited, Ca2+ influx. These results demonstrate that cholesterol and its oxidized derivatives are able to modulate the calcium channel in human red blood cells in a highly stereospecific manner.

Calcium↗
PubMed1984

[Temperature-dependent spontaneous platelet aggregation in polycythemia vera and primary thrombocythemia: a diagnostic criterion].

In twenty patients suffering from myeloproliferative syndromes (nine with polycythaemia vera, 11 with primary thrombocythaemia) platelet aggregation was tested following incubation of blood samples at 4 degrees C, room temperature, 30 degrees C and 37 degrees C. A spontaneous platelet aggregation following incubation at room temperature took place in 65% of patients with primary thrombocythaemia. At the two higher temperatures, positive results were seen in 72% and 92% of cases, respectively. Seven of nine patients (78%) showed a pathological spontaneous platelet aggregation at room temperature. Pathological spontaneous platelet aggregation at 30 degrees C occurred in eight of nine (89%) cases. The spontaneous platelet aggregation test is a simple method to diagnose primary thrombocythaemia and asymptomatic polycythaemia vera, the sensitivity of which increases considerably following incubation of blood samples at two and three different temperatures.

Adult↗
PubMed1984

[What does computer tomography and abdominal ultrasound studies accomplish in the staging of Hodgkin's disease?].

In a prospective series of 25 patients with early-stage Hodgkin's disease, abdominal assessment by computer tomogram and ultrasound was controlled by staging laparotomy. It was found that the probability of Hodgkin's disease increased with increasing diameter of the abdominal lymph nodes. 42% of the nodes between 16-20 mm in diameter had evidence of disease. Overall accuracy and specificity for the assessment of abdominal lymph nodes by CT and US was around 90%. Sensitivity was much lower than in other series, probably due to the fact that our patient sample was relatively small and consisted of patients in earlier stages with small lymph nodes. Assessment of lymph nodes by US is more, and assessment by CT less, dependent on individual factors. It is concluded that neither CT or US can replace staging laparotomy if precise information about abdominal lymph nodes is needed. Assessment of the spleen by CT and US is usually unreliable and needs histologic confirmation.

Adult↗
PubMed1984

On the pathogenesis of pancreatic ascites.

The pancreatic ascites of 2 patients and the drainage fluid collected adjacent to the pancreas postoperatively of 1 of them were analyzed for protein composition and enzyme activity. We did not find a proteolytic activity, especially enzymatically active trypsin and chymotrypsin in these fluids. Immunoreactive (inactive) trypsin was, however, present in rather high concentrations. The drainage fluid changed from an inflammatory exudate to a fluid similar in composition to pancreatic juice later on. Our results indicate that pancreatic ascites consist of a combination of enzyme-rich pancreatic fluid and protein-rich exudate from the inflamed pancreas. No evidence of peritonitis or of proteolytic activity capable of inducing peritonitis was found.

Adult↗
PubMed1984

Cholesterol and its oxidized derivatives modulate the calcium channel in human red blood cells.

The human red blood cell was used as a model system in order to study the effect of cholesterol and its medically important oxidized derivatives (OSC = oxidized sterol compounds) on the calcium entry channel. The calcium-ejecting adenosine triphosphatase (ATPase) was inhibited by vanadate and the influx of 45Ca2-into the cells measured. The cells were loaded with OSC at concentrations between 0.075 and 1.5 micrograms OSC/10(7) cells. Two classes of OSC could be distinguished: one stimulating Ca2+ influx dose-dependently by almost 100% at maximum concentrations, the other inhibiting it dose-dependently by up to 80%. The calcium channel blocker nitrendipine inhibited influx by 70% at 15 microM. More than 90% of the total stimulation or inhibition was accounted for by an influence on the nitrendipine-inhibitable part of influx, i.e. the calcium channel. Cholesterol (incorporated using liposomes) had a stimulatory (+288%), cholesterol depletion an inhibitory effect on calcium influx (-18%). These results demonstrate that cholesterol and its oxidized derivatives modulate the calcium channel in a highly stereospecific manner and provide new insights into the mechanism of action and the atherogenic effect of these compounds.

Calcium↗
PubMed1983

[Bedside diagnosis of pancreatitis using the urinary amylase test tape. Preliminary results].

A test strip for rapid detection of alpha-amylase in urine was evaluated in 12 patients with an acute episode of acute or chronic pancreatitis and in 16 patients with hyperamylasemia of varying origin. The test strip was positive in 11 of 12 patients with acute pancreatitis and in 8 of 13 patients with hyperamylasemia. In 3 patients with macroamylasemia the test strip was negative. The specificity was 98% in 100 ambulatory patients without evidence of pancreatic disease.

Acute Disease↗
PubMed1983

[Non-Hodgkin lymphoma of the testis].

Non-Hodgkin's lymphomas of the testis comprise 25-50% of testicular tumors in men over 50 years of age. Using the Rappaport histologic terminology, most testicular lymphomas are of the diffuse histiocytic type. Concomitant involvement of Waldeyer's ring or of paranasal sinuses frequently occurs. Eight patients with primary non-Hodgkin's lymphoma of the testis and 2 patients with a lymphoma which arose in the paranasal sinuses and later involved the testis are reported. The median age of the 10 patients was 57 years. 5 of 8 patients with primary testicular lymphoma were in clinical stage IE. 8 of the 10 patients had diffuse histiocytic lymphoma. Using the Kiel histologic terminology, 4 of these 8 patients had diffuse centroblastic lymphoma and 4 had immunoblastic sarcoma. 5 of the 8 patients with primary testicular lymphoma had complete remission after orchiectomy followed by radio- and/or chemotherapy. The median survival of the 8 patients with primary testicular lymphoma was 30 months. The median survival of patients with complete remission was 44 months and in patients without remission 12 months. Careful staging of patients with testicular lymphoma is of decisive therapeutic and prognostic significance.

Humans↗
PubMed1982

[Clinical staging and course of chronic lymphatic leukemia].

77 patients with chronic lymphocytic leukemia were clinically staged according to a staging system recently proposed by Binet and limited to 3 stages. The 49 patients with stage A disease (not more than 2 areas of palpable nodes or organs) had a median survival time of 141 months; the 17 patients with stage B disease (three or more involved areas) had a median survival time of 71 months and the 11 patients with stage C disease (anemia and/or thrombopenia) had a median survival of 37 months. With this simple three-stage system statistically significant differences of survival between the three groups of patients have been observed. This staging system is useful for the prognostic evaluation of patients with chronic lymphocytic leukemia.

Adult↗
PubMed1979

[Diagnosis and therapy in daily practice].

Diagnosis and treatment are two essential elements of medical practice. For obvious reasons, it is often impossible to make a definite diagnosis during the initial work-up. This raises the problem of how extensive diagnostic procedures should be to initiate adequate treatment. It is evident that the professional experience of a physician exerts a great influence on therapeutic measures instituted in the private office or in the hospital. Consequently, in certain instances, treatment may be started without a definite diagnosis. Nevertheless, the axiom "no treatment without prior diagnosis" remains a basic principle of medicine.

Diagnosis↗
PubMed1978

[Familial mesomelial dwarfism (Nievergelt syndrome)].

Familial mesomelic dwarfism was first described in 1944 by K. NIEVERGELT, who reported on a father and 3 sons by 3 different mothers who had shortening of the middle segment limbs. in the present study the family described by NIEVERGELT in 1944 is reevaluated and the mode of inheritance investigated over a period of 3 generations. Six patients with mesomelic dwarfism were found out of 43 family members. Two patients, a son of the first patient with mesomelic dwarfism and his son, were seen at our institution. Both presented a rare deformity-combination of the upper and lower extremities. In the upper extremities radio-ulnar synostosis, asymmetrically shaped elbow joints, subluxations of the radial head and a deficient supination capacity of the forearm were diagnosed. The deformities were nearly symmetrical, but a slight predilection for the left forearm was noted. In the lower extremities atypical club-feet with supination of the forefeet, shortening of tibia and fibula and marked synostosis of tarsal and metatarsal bones were seen. The legs were rhombic and supination and pronation of the forefeet were severely reduced. Synostosis of the tibia and fibula and deformities of the toes were found in both patients. The mode of inheritance was considered to be autosomal dominant with high penetrance. It is concluded that familial mesomelic dwarfism is an autosomal dominant disease of the upper and lower limbs with atypical club-feet, marked radio-ulnar, tibia-fibular and tarsal synostosis and deformities of the elbow joints.

Chromosome Aberrations↗