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Biomedical subjects

E Seifert

Publications and source records attributed to E Seifert.

At least 127 records · Page 7Linked to original sources
PubMed1979

Diagnosis of early gastric cancer.

Early gastric cancer is being encountered with increasing frequency in Germany as well as Japan and elsewhere through greater awareness, selection of high risk patients and improved diagnostic methods. We consider endoscopy superior to radiology in the detection of early gastric cancer. Polypoid lesions of the stomach need endoscopic biopsy or removal for proper diagnosis. Gastric ulcers should be followed by endoscopy and guided biopsies until healing is complete. Adequate sampling of a suspected gastric lesion may require multiple biopsy specimens for accurate histological interpretation.

Biopsy↗
PubMed1978

Endoscopic papillotomy and removal of gallstones.

Summarizing our results we come to the following conclusions: 1. In high risk but operable patients, EPT is a useful treatment in cases with choledocholithiasis and with papillary stenosis. 2. The risk of the procedure is lower than by surgical intervention. 3. Complications can occur in 7.3%, most of them within 24 hours. 4. The mortality rate was 1.7% and depends on the precise selection of the patients; on the knowledge of the post-papillotomy treatment and on the experience of the examiner. 5. This procedure, at the present time, should be limited to centers with well trained and experienced endoscopists.

Ampulla of Vater↗
PubMed1977

[The glandular cyst, a polypoid lesion of the gastric mucosa (author's transl)].

Confusion in the nomenclature of gastric polyps and the resulting uncertainties regarding prognosis and treatment have made a new classification necessary, consisting of focal hyperplasia, polyp of manifold aetiology, adenoma, and benign hyperplasiogenic polyp, the latter the most common one, found only in the stomach. But 110 cases of polypoid mucosal changes could not be classified. These "polyps" grow to be at most 8 mm in diameter and are characterized histologically by non-inflammatory cysts of varying size located within the intact fundal glands. Possible causes are hamartoma or functional secretory disorders. These glandular cysts have not previously been described. They do not fit the pattern of cystic gastritis. The clinical significance lies in the differentiation from gastric polyposis.

Adult↗
PubMed1977

[Therapeutic Esophagogastroduodenoscopy (author's transl)].

Therapeutic esophagogastroduodenoscopy covers: 1. therapeutic polypectomy (in cases of obstruction, hemorrhage, early cancer I in inoperable patients); 2. palliative treatment of inoperable tumors (when obstruction or bleeding occurs); 3. endoscopic blood staunching (can be performed by drugs, mechanically, or by laser coagulation; 4. removal of foreign bodies).

Duodenum↗
PubMed1977

Endoscopic results in five patients with Crohn's disease of the esophagus.

In our experience with five cases of Crohn's disease of the esophagus, the endoscopic appearance has been demonstrated. Corresponding to the basic pathological changes, the findings are very different, but two stages may be differentiated: Stage I in which inflammatory changes predominate as a mild or more often erosive-ulcerative esophagitis. Stage II is a stenosing form similar to a peptic stenosis or to a stenosing tumor. The morphological changes are predominantly limited to the lower part of the esophagus with a tendency to extend to the proximal regions. The diagnosis may be established endoscopically only in special cases with shallow ulcerations within a normal mucosa or with cobble-stone relief which is usually seen in the colon. In all other cases, a specific macroscopical appearance of Crohn's disease of the esophagus does not exist and no specific differentiation is possible from other forms of esophagitis. Only by a combination of endoscopy, radiology and histology can the diagnosis be suspected. Guided biopsies are not able to confirm the diagnosis histologically. The exact diagnosis of Crohn's disease of the esophagus is only possible by histological examination of the resected esophagus.

Adult↗
PubMed1977

A new technuque of ERC(P) using a straight-view fiberscope.

A new technuque of ERC(P) using a forward-veiwing fiberscope is described in details. By this procedure the position of the maximal bended tip of the instrument provides a more selective cannulation of the common bile duct, preventing the risk of pancreatic duct filling. The method was performed in 15 cases and succeeded in 12. ERCP, using this technique, can be performed after normal esophago-gastro-duodenoscopy. However, at present time it is not a routine procedure. Technical improvements on the instrument are necessary to facilitate the method.

Ampulla of Vater↗
PubMed1977

Peroral direct cholangioscopy (PDCS) using routine straight-view endoscope: first report.

A new endoscopic method, the peroral direct cholangioscopy (PDCS) is described. A prograde fiberscope of 8.8 mm diameter can be directly inserted, without using a second scope as a guide, into the biliary system after EPT (endoscopic papillotomy). The lumen of the common bile duct is observed entirely and exactly. The image is excellent. Also acessories may be inserted into the duct via the biopsy channel under direct control.

Aged↗
PubMed1977

Duodenoscopic guided biopsy of the biliary and pancreatic duct.

First experiences with duodenoscopic guided biopsy of the biliary and the pancreatic duct on 11 cases using a special designed forceps showed that this method gave good and representative results in the biliary duct and from the papilla. However, in the present stage of development guided biopsy from the pancreatic duct does not aid exact differential diagnosis of benign or malignant lesions. In 3 out of 4 cases with pancreatic cancer the histological diagnosis was false negative. The biopsy specimens are very small and need an exact preparation and great experience of the histologist. Cytologic criteria must be relied on more here as in other areas of the GI-tract. However, the criteria of malignancy rest not in the nature of the individual cell but in the manner of proliferation, namely the infiltration of the deeper layers. This is the advantage of guided biopsy compared to cytological examination. Complications of the method may be avoided by exact guiding of the forceps and by limiting the numbers of specimens.

Aged↗
PubMed1977

[The radiological diagnosis of non-calculous biliary duct obstruction (author's transl)].

A diagnosis of obstructive biliary duct disease was achieved in 80% of 63 patients using endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous trans-jugular cholangiography (PTJC) alone or in combination, and taking account of the clinical features. In obstructions of themajor intrahepatic ducts and of the hepatic ducts (type I) a smooth occlusion indicated a carcinoma. Narrow forms of stenoses could not be differentiated, but with a history of previous operation, fibrous strictures were most likely. Obstructions at the point of confluence (type II) showed smooth narrowing if due to fibrous strictures, whereas carcinomas produced an irregular termination. Obstructions of the common bile ducts (type III) resembled those of type II. A smooth termination within the pancreas indicates a pancreatic carcinoma. Inflammatory disease in the head of the pancreas usually produces a tubular stenosis, while cysts of the pancreas result in smooth impressions and displacement.

Bile Duct Neoplasms↗
PubMed1977

Carcinoids of the stomach. Report of two cases.

Endoscopic, histologic and clinical findings of two cases with disseminated carcinoids restricted to the stomach are described. Endoscopically different forms of polypoid lesions were observed: 1. polypoid type of Yamada III, usually seen in epithelial tumors; 2. small lesions elevated with bridging folds and 3. slightly elevated types with necrotic surface similar to an early stage of cancer. An exact diagnosis is possible with sections obtained by polypectomy, button-hole-biopsy or by hot-biopsy. There are some problems in interpreting the histology, especially the differentiation from carcinomas. Carcinoids limited to the stomach do not produce typical clinical symptoms. 5-HIA and serotonin levels in the thrombocytes are in the normal range. Since surgical procedures depend upon the exact localization and the invasive or noninvasive morphological character, endoscopy with polypectomy is of great help in assessing the pathology as well as the necessity for surgery.

Biopsy↗
PubMed1977

Endoscopic retrograde cholangiopancreatography. Evaluation based on experience with 805 examinations.

ERCP was evaluated on the basis of 805 examinations. Visualization of the common bile duct and the pancreatic duct was possible in 44%, of the common bile duct in 22% and of the pancreatic duct alone in 24.6% of the cases. The ductal systems were not opacified in 9.4% but the failure rate decreased from 18.2% to 5.4% within increasing experience. Pathological changes were found in both ducts in 2%, in the common bile duct in 42.2% and the pancreatic duct in 11.4% of the cases. Diagnostic information was supplied by ERCP in 84.4% of the cases. Complications developed in four cases (acute pancreatitis in three and cholangitis in one). There was no mortality in the entire series. It is concluded that ERCP is a valuable diagnostic method that is frequently successful and reasonably safe.

Biliary Tract Diseases↗
PubMed1977

[A comparison between radiologic and endoscopic examinations of early cancer of the stomach (author's transl)].

Comparison between radiologic and endoscopic-bioptic examinations shows that, in early cancer, great demands are made on the radiologic technique and experience of the examiner. An integrated technique using relief- and double-contrast with additional induced hypotony can achieve demonstration of circumscribed shallow changes of less than 2 cm diameter in all segments of the stomach. With this technique over 80% of early cancers can be detected radiologically.

False Negative Reactions↗
PubMed1977

[Cholelithiasis--indications for cholecystectomy, papillotomy and gallstone dissolution (author's transl)].

Patients under 50 years without risk factors carrying gallstones should be operated upon for the following reasons: (1) These patients will have complications in up to 40% of cases with increasing age; (2) only 18% of patients are without complaints after a duration of this disease of twenty years; (3) mortality of surgery is 1,06% in patients with no other risk factors. Patients at risk for other reasons, with a functional gallbladder and carrying calcium-free stones should be treated with chenodesoxycholic acid. Patients at risk for other reasons carrying residual stones after cholecystectomy, or suffering from stenosis of the papilla, or harboring stones in the choledochus after choledochoduodenostomy should be subjected to endoscopic papillotomy. Patients at risk for other reasons suffering from cholecystolithiasis or choledocholithiasis should be subjected at first to endoscopic papillotomy, and only thereafter to cholecystectomy. This will decrease the risk of surgery.

Adult↗