Search PubMed⌕ Search

Biomedical subjects

M Heer

Publications and source records attributed to M Heer.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Primary colon tuberculosis].

Two cases of primary gastrointestinal tuberculosis are reported. One patient showed radiologic, colonoscopic and histopathologic features of Crohn's disease. After a five-year follow-up, acid-fast bacilli were identified in colonic tissue cultures. In both patients fecal cultures were repeatedly negative for Mycobacterium tuberculosis. The two patients were successfully treated with antituberculous therapy. The authors emphasize the importance of considering tuberculosis in patients presenting with Crohn's disease. In this regard colonoscopy with tissue culture of targeted biopsy may be a valuable aid in establishing the diagnosis of tuberculous colitis.

Adult↗
PubMed1985

Bullous esophageal lesions due to cotrimoxazole: an immune-mediated process?

A 78-yr-old man experienced a generalized bullous eruption of the skin (a Stevens-Johnson variant of erythema multiforme) with simultaneous involvement of the esophagus due to co-trimoxazole. Immunologic tests revealed specific antibodies of the immunoglobulin G class but not of the immunoglobulin E class against sulfamethoxazole, and in particular against trimethoprim. Lymphocyte transformation tests demonstrated sensitized lymphocytes against trimethoprim but not sulfamethoxazole. The esophageal mucosa showed intraepithelial vesicle formation with diffuse cytoplasmic deposits of immunoglobulin G. This adverse drug reaction involving both the skin and the esophagus appears to be immune-mediated.

Aged↗
PubMed1985

Mucosal biopsy of vascular ectasia (angiodysplasia) of the large bowel detected during routine colonoscopic examination.

Between 1975 and 1983, 9434 colonoscopic examinations were performed at the University Hospital of Zürich. Localized vascular ectasia was detected in 84 patients and there were 48 mucosal biopsies from 46 patients. From the total of 48 biopsies only 24 (50%) showed vascular anomalies. The most frequent lesion encountered was groups of thin-walled dilated vessels in the lamina propria seen in 21 biopsies from 20 patients. These dilated vessels are not specific but in respect of age (median 69 years), location (predominantly in the caecum and the ascending colon) and frequent multiplicity, they are suggestive of angiodysplasia. Five of the 20 patients suffered from chronic anaemia due to haemorrhages. The three other positive biopsies (from two patients) revealed a tiny haemangioma in the sigmoid colon of a 28-year-old woman and a few large, thick-walled probably malformed vessels in the mucosa of the caecum of a 17-year-old boy. Twenty-four biopsies did not show any histologically significant vascular anomaly. Mucosal biopsy of vascular lesions detected during routine colonoscopic examination will, if positive, most frequently simply confirm the endoscopically diagnosed vascular ectasia and may in rare cases show or alert suspicion to vascular lesions other than angiodysplasia. Definitive morphological diagnosis will however only rarely be achieved by this method of investigation.

Cecum↗
PubMed1984

[Clinical significance of colonic angiodysplasias].

Among 9343 colonoscopic examinations (1975-1983) colonic angiodysplasias (AD) were diagnosed in 78 patients (0.8%). The mean age of patients with AD was 68 (17-86) years which was significantly higher than that of patients without AD (p less than 0.0001). 76% of the AD were localized in cecum or colon ascendens, 13% in colon transversum, 4% in colon descendens and 6% in sigmoid colon. 69 patients (88.5%) had 1-4 AD; 4 (5.1%) 5-10 AD and 5 (6%) more than 10 AD. A high incidence of associated diseases leading to vascular complications (i.e. hypertension, diabetes mellitus) was noted. 14 of the 78 patients had anticoagulation or bleeding disorders, possibly precipitating intestinal bleeding. The 21 patients (26.9%) with symptomatic AD had either lower intestinal bleeding (n = 8) or severe anemia (n = 13). In 57 patients (73.1%) the AD were asymptomatic during a mean follow-up of 48 (1-108) months. Whereas age and sex distribution were not significantly different between symptomatic and asymptomatic patients, the number and size of AD were significantly increased in symptomatic patients (p less than 0.005).

Adolescent↗
PubMed1984

Monoclonal gammopathy in chronic active hepatitis.

Immunoelectrophoresis was performed in 31 of 272 patients with chronic active hepatitis (CAH) because of an M-spike component (seven patients, 2.6%) or hypergammaglobulinemia (24 patients) revealing a monoclonal gammopathy (MG) in 11 patients. In addition, 50 randomly selected patients with CAH and no evidence for an M-spike component were tested by immunoelectrophoresis. In 13 patients (26%), an MG was found. The mean age of the 24 patients with MG was 57.4 years (range: 23-76). HBsAg was present in nine patients (37.5%), no HBV-marker was detected in ten patients (41.7%). The immunoglobulin class of MG was IgG in ten patients (41.7%), IgA in one patient (4.2%) and IgM in 11 patients (45.8%). In two patients, Bence Jones protein was found in either serum or urine. In only one patient was the MG associated with multiple myeloma, whereas none of the other 23 patients developed a malignant lymphoproliferative disease within the median observation period of 6 years. We conclude that there is an unexpectedly high prevalence of benign MG in patients with CAH.

Adolescent↗
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

[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↗
PubMed1983

[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↗
PubMed1983

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↗
PubMed1983

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↗
PubMed1983

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↗
PubMed1983

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↗
PubMed1983

[Megacolon as a rare complication of diabetes mellitus].

The clinical and radiological features of diabetic megacolon and gastroparesis occurring in a 48-year-old woman are presented. The only two other well-documented cases of diabetic megacolon from the literature are reviewed. The predominant dilatation of the sigmoidal colon in the setting of a generalized megacolon may be, especially if associated with bladder atony, a clue to the diagnosis of the diabetic nature of a megacolon.

Constipation↗