Search PubMed⌕ Search

Biomedical subjects

B Schott

Publications and source records attributed to B Schott.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Endoscopic bile duct drainage in malignant obstructive jaundice--an alternative procedure to palliative surgery].

74 patients suffering from malignant bile duct obstruction were treated by endoscopic endoprosthesis placement. Improvement and standardization of the technique resulted in successful decompression in 97% of the cases. Also, the complication rate could be reduced to 6.9% (fatal complications, 4.6%). The mean survival time after decompression was 4.5 months, 25 patients of them being still alive. The endoprosthesis had to be replaced after an average of 2.3 months due to occlusion. The endoscopic bile duct decompression is better than surgical palliation in patients with proximal bile duct obstruction. At present, endoscopic endoprothesis placement can be recommended as an alternative method for the palliation of malignant bile duct obstruction.

Aged↗
PubMed1983

[Endoscopic diagnosis and therapy of papillary tumors].

Endoscopic papillotomy (EPT) allows biopsy of tumors of the Vater's papilla using coils or forceps. EPT is a preoperative diagnostic procedure in patients with carcinoma of the papilla, who can be operated upon, a palliative procedure in patients which cannot be operated upon anymore, and a curative procedure in patients with benign tumors which cannot be operated upon because of general risk factors. EPT is also a preparatory procedure for internal drainage of the bile duct system by endoscopy.

Aged↗
PubMed1983

[Neurophysiologic study of 2 cases of hemianesthesia as a result of subcortical lesions. Results of recording far-field somatosensory evoked potentials].

The volume-conducted responses of the lemniscal pathways to median nerve stimulation at wrist may be recorded on the scalp (far-field potentials). These positive far-field SEPs components are widely distributed on the scalp and their peaking latencies vary between 9 and 15 milliseconds. In normal adults a maximum of 4 far-field potentials (P9, P11, P13 and P14) may be individualized; two of them (P9 and P14) are constant. These SEPs were studied in two patients with lateralized somatosensory loss; one with a cervico-medullary traumatic lesion, the other with a thalamic infarct. These observations allow the following conclusions 1) the P9 component takes origin in the proximal part of the brachial plexus roots; 2) the P14 potential has a brainstem origin; 3) the contralateral N20 potential is generated in (or close to) the primary somato-sensory cortex (SI). Thus it is possible with a single channel to record the activity of the somatosensory pathways from dorsal roots up the parietal cortex.

Adult↗
PubMed1982

[Endoscopic transpapillary bile duct drainage in malignant obstructive jaundice].

Endoscopic biliary duct drainage was performed in 54 patients with obstructive jaundice caused by papillary carcinoma (n = 4), periampullar carcinoma (n = 4), carcinoma of head of pancreas (n = 16), primary biliary duct carcinoma (n = 14), biliary bladder carcinoma (n = 14) and hilar lymph node metastases (n = 2) using a bilioduodenal endoprosthesis. Drainage was successful in 45 cases; serum bilirubin decreased rapidly, well-being improved, appetite and weight increased. The average survival time was 4.8 months. The initially high rate of complications, mainly due to cholangitis, with a mortality rate of 9.3% could be reduced drastically after use of a duodenoscope with a 3.7 mm bore instrumentation canal enabling insertion of well-draining wide-lumen endoprostheses. Drainage should only be used in non-resectable tumours, general inoperability or for preoperative relief of biliary ducts in jaundice and prospective curative surgical intervention. As results improve with mounting experience it may be expected that endoscopic biliary duct drainage will replace palliative surgery, especially in elderly patients at risk.

Aged↗
PubMed1982

[History of Guillain-Barré syndrome].

1916: birth in Paris of a modest syndrome presented to a weekly meeting of the Société Médicale by Georges Guillain, Jean-Alexandre Barré and André Strohl. 1981: glorification of the syndrome as a world event in Santa Inez Valley at the International Conference held under the auspices of the Kroc Foundation. This is indeed a long way from a few clinicians and internists to the representatives of all branches of the Neurological Sciences for "la radiculo-névrite avec dissociation albumino-cytologique à évolution spontanément régressive "studied in two soldiers of the Vth French Army. Every neurologist from clinician to researcher currently knows this model of inflammatory and demyelinating diseases of the peripheral nervous system and the pros and cons of cellular vs humeral immunity which are presumed to be its pathophysiological process. What is less known is "la petite histoire" i.e. that of men and events which surrounded its birth and growth to being an entity. Why did André Strohl disappear? Who were L. Duménil and O. Landry? Should we say Guillain-Barré?, Landry-Guillain-Barré?, Duménil-Landry-Guillain-Barré? Unexpected or poorly known facts are not lacking in this story the last of which being that most references to that most French syndrome are to be found in English and American books.

Albumins↗
PubMed1982

[Primary non-Hodgkin's lymphoma of the brain, sarcoidosis, thyroid cancer and immunity cell deficiency (author's transl)].

A 66-year-old man presented with a primary malignant lymphoma of the cerebellum and brain stem. The lymphoma was of type V (Bryon's classification) with predominant B cells, and was associated, as in previously reported cases, with a peripheral blood T lymphocyte deficiency. This case was unusual, in that autopsy revealed an active multivisceral sarcoidosis (considered as being cured more than 10 years previously), a clear-cell renal adenoma demonstrating nearly all the characteristics of a Grawitz's tumor, and a papillary epithelioma of the thyroid gland. These findings lead to discuss the significance of immuno-surveillance lack in this particular case: was it dependent on the sarcoidosis (during which a reduction in T lymphocytes is known to occur), or was it primary and perhaps genetic, a son of the patient having Hodgkin's disease? Whatever the case may be, the encephalic proliferation of the B lymphocyte clone, the peripheral epitheliomas, the sarcoidosis, and the deficit in T lymphocytes in the peripheral blood constitute a group of factors singularly rich in questions, this being, apparently, the first case of this type reported in the published literature.

Aged↗
PubMed1981

[Spontaneous migration of large stones from the bile duct (author's transl)].

Spontaneous migration of bile-duct stones through the papilla into the intestine was directly observed in two patients with choledocholithiasis. The mechanism of such spontaneous migration lies in the development of a pressure necrosis at the papilla causing a tear in its pore. Spontaneous migration of stone from the common bile duct can be assumed when endoscopic retrograde cholangiopancreatography reveals a balloon-shaped swollen papilla with a torn pore, and previously observed obstructive jaundice regresses in the presence of stone-free, though perhaps somewhat dilated, bile passages.

Aged↗
PubMed1981

[Motor negligence in a case of right thalamic hematoma (author's transl)].

In a patient with left motor negligence CT scan showed a right thalamic hematoma of small size, involving the posterior thalamic region. The clinical picture was pure, including neither marked distal or proximal motor deficiency, nor auditory or visual or somesthetic disorders except sensory extinction. Cortical somesthetic evoked potentials were normal. Motor negligence presented 3 basic elements: 1) lack of spontaneous movements of the left side of the body, particularly of the upper limb; 2) absence of nociceptive reactivity; 3) immediate total reversibility of the disorder following verbal commands. Emphasis is placed on this latter sign which indicates the thalamic origin of the disturbance. Of the various explanations proposed for the disorder the most likely one would appear to be a disorder of a relatively specific activation system of motor activities, a system arising from the posterior thalamic nuclei: 1) pulvinar and laterodorsal nuclei projecting over area 23 (posterior cingulum); 2) intralaminar formations, particularly the lateral superior central nucleus, projecting over area 24 (anterior cingulum). The disturbance in this system, at its thalamic origin, might explain the differences between this motor negligence behaviour and lack of spontaneous motility syndromes resulting from frontal cortical lesions. It might also be that the right lateralisation of the lesion plays a relatively minor role.

Diagnosis, Differential↗
PubMed1981

[Effects of physostigmine on amnesic syndromes (author's transl)].

Eserine sulphate (physostigmine) tests were conducted in 23 patients with amnesia due to cerebral lesions. Psychometric examinations were performed before and after treatment. Results were analysed statistically for the whole group, and after distribution of patients as a function of the etiology, of the mechanism involved, and of the presumed lesions: 1) amnesias related to lesions along Papez' circuit as shown on CT scans were compared with those with normal CT scans; 2) amnesias of the "hippocampic" types were compared with other neuropsychological types. After eserine sulphate learning ability rapidly improved, in all cases, whereas spontaneous or assisted recall was only slightly improved. No significant differences in learning or recall were noted between the group with normal CT scans and that with evidence of bilateral lesions. In contrast, the efficiency of physostigmine was clearly related to the nature of neuropsychological disorders both for learning and recall of verbal material : a positive effect occurred only in the group with obvious evocation and recall disorders (mamillary, thalamic, or cingular lesions). For improvement to occur the product had be be injected before learning. The role of cholinergic mediators in memory is discussed with regard to these observations. Overall benefit was poor since lasting improvement in fixation was noted in one case only. Thus eserine sulphate appears of little value for prolonged therapy. It may be useful for a functional test during neuropsychological investigations.

Adult↗
PubMed1980

[Primary postural hypotension. Physiopathological study of 8 cases (author's transl)].

Physiological tests showed that both branches of the baroreflex arc-vagal cardiomoderator and, predominantly, sympathetic vasoconstrictor--were affected. There was no rise in serum and urinary noradrenaline levels in standing position, and adrenaline concentrations were rarely increased under induced hypoglycaemia. Dopamine beta-hydroxylase activity and reactivity of the renin-angiotensin-aldosterone system remained normal in most cases. Physiopathologically, the two clinical forms described (i.e. with and without central nervous symptoms) cannot be differentiated.

Aged↗
PubMed1980

[Endoscopic papillotomy for acute pancreatitis caused by biliary disease (author's transl)].

In 15 patients with acute pancreatitis caused by biliary disease endoscopic sphincterotomy was performed after diagnostic ERCP. All patients had a history of symptoms pointing to long-standing biliary disease, such as typical right-sided upper abdominal pain, signs of biliary stasis, and jaundice. An impacted solitary ampullar stone was demonstrated in eight patients while in seven several stones were found in the biliary tract. In one patient pancreaticogram also revealed a gall-stone which had slipped in Wirsung's duct. After endoscopic sphincterotomy and extraction of stone rapid and marked improvement occurred in all 15 patients and the biochemical abnormalities were restored towards normal. All patients became pain-free immediately after the procedure. The markedly raised levels of serum-alpha-amylase (mean of 21 700 U/l immediately before the procedure) fell tonormal values within 48 hours (400--3000 U/l). Endoscopic sphincterotomy is thus an alternative to early operation in acute pancreatitis of biliary origin.

Ampulla of Vater↗