Search PubMed⌕ Search

Biomedical subjects

K Elster

Publications and source records attributed to K Elster.

At least 19 recordsLinked to original sources
PubMed1979

Evaluation of histological classification in early gastric cancer (an analysis of 300 cases).

Using the Lauren approach of histological classification, 300 cases of early gastric cancer (EGC) were analysed with regard to their age distribution, to predisposing lesions, including gastritis, and survival rate. The average age of onset for EGC of the diffuse type is 56, ten years earlier than for the intestinal type. There was a significantly high percentage of EGC of the diffuse type without gastritis. On the other hand, gastritis in pernicious anaemia falls in the high-risk group. The survival rate in our cases is 98%, corrected for age. The results show that it is of utmost importance to differentiate between the histological types of gastric carcinoma; for there may be indeed a difference in pathogenesis and aetiology.

Adenocarcinoma↗
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

[Reflux esophagitis--morphology (author's transl)].

Comparative evaluation of the clinical and morphologic-histologic findings in reflux esophagitis led to the following staging; Stage I: Discrete leukocyte infiltrations of the tunica propria, and epithelial changes primarily of a hyperregenerative nature (noticeable only by histology). Stage II: macroscopic changes with erythematous stripes in the mucosa, which are shown histologically to be erosions or fibrinous necrosis; endoscopic feature: "white stripes." Stage III: deep, confluent necrosis with stenosis. This clinical-morphologic staging is a basis for therapy.

Biopsy↗
PubMed1978

[Histological classification of early gastric cancer in 300 cases - clinical significance (author's transl)].

Early gastric cancers of 300 patients were evaluated using the Lauren approach of histological classification, that is to say distinguishing between a diffuse and an intestinal type of cancer. It turned out, that the role of gastritis in the pathogenesis of early gastric cancer is rather ill defined. A high percentage of early cancers of the diffuse type were found in gastric mucosa showing no inflammatory changes whatsoever. From the point of view of pathogenesis both types of cancer have to be considered as separate nosological entities. This difference is most obvious during the early stages of development. Therapeutical consequences will certainly have to be drawn in the future from this subdivision for patients at risque. Early gastric cancer presents in a high percentage of cases at first as an ulcerative lesion; this stresses the importance of careful gastroscopic and bioptic examination of patients with gastric ulcera, and of frequent examinations of these patients.

Adolescent↗
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

[Biopsy and cytology in the diagnosis and treatment of surgical diseases (author's transl)].

Surgical lesions of the gastrointestinal tract are usually of an ulcerous or polypoid nature. The macroscopic pathologic changes can be given a clinical diagnosis only after the histologic findings are known. Endoscopic biopsy meets this purpose. Furthermore, endoscopic snare biopsy can be a curative therapeutic procedure. Cytology should only be used as a method of second choice, for example when stenosis proximal to the lesion hinders biopsy.

Biopsy↗
PubMed1977

Multicentric early gastric carcinoma mimicking type I (10 years after B-I-surgery).

10 YEARS AFTER B-I-partial gastrectomy for a proven benign gastric ulcer a multicentric early gastric carcinoma type II b, c was detected by endoscopy and histology. This early carcinoma differed from published cases in respect of its macroscopic classification, localization and expansion. The carcinoma situated next to the anastomosis invaded the duodenal mucosa. It also invaded a polypoid fold caused by the previous surgery, thus imitating an early gastric carcinoma type I.

Adenocarcinoma, Mucinous↗
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

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↗
PubMed1975

[Endoscopic polypectomy of the upper gastro-intestinal tract: results and clinical features (author's transl)].

247 polyps were removed by electroresection through an endoscope (and 240 recovered) in 160 patients, aged 24-81 years. The histological substrate varied widely. Comparison of histological findings in the biopsy specimen with those of the entire polyp after polypectomy gave differing results in 41 of 87 gastric polyps. Complication rate of endoscopic polypectomy was 1.6%: postoperative bleeding occurred in three, which was treated conservatively, while in one patient ligation of a blood vessel by laparotomy became necessary. There were no perforation or lethal complications. Among three patients with hyperplasiogenic gastric polyps a "borderline lesion" was found in two (early carcinoma type I; adenocarcinoma). In 13 other patients with hyperplasiogenic polyps follow-up examination after one year revealed recurrence in three, absence of polyps in eight. In one patient a small gastric carcinoma (about 1 cm in diameter) was discovered four months later. It is possible that patients with hyperplasiogenic polyps are at a higher risk of cancer. Six-monthly endoscopic observation is, therefore, indicated.

Adenocarcinoma↗
PubMed1975

[Antral morphology and serum-gastrin levels in achlorhydria].

38 patients were found to have achlorhydria after maximal stimulation with pentagastrin and on multiple biopsies (atrophy of gastric mucosa). It was demonstrated that the sequence pH-antroreceptors-G cells-parietal cells-pH antroreceptors was interrupted already in mild or moderately severe superficial gastritis of the antral mucosa involving more than half of the antral surface. Reduction of specific functional epithelium is unlikely in this form of inflammation so that it is probably an effect of the pH receptors.

Achlorhydria↗
PubMed1975

Gastric polypectomy.

In 138 patients of 215 gastric polyps were removed by electroresection through a fiberscope and the polyps recovered in toto by suction or special grasper-forceps. Discepancies of histological findings in the biopsy specimens and in the tissue of the whole polyps were often found. Follow-up examinations of the cases were presented. Based on our experiences a new histological classification of gastric polyps is neccessary.

Adenoma↗
PubMed1975

Is chronic gastritis a reversible process? Follow-up study of gastritis by step-wise biopsy.

In 36 patients step-wise biopsies of gastric mucosa were performed in 1971 and in 1974/75. A comparison of the histological changes revealed identical findings in 15, progression of superficial gastritis in 9 and regression of superficial gastritis in 7. In 5 patients regression of chronic atrophic gastritis was seen. In one patient an essentially normal mucosa was found in all biopsy specimens, in other patients parietal cells reappeared without any specific therapy.

Adult↗