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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 379 records · Page 21Linked to original sources
PubMed1994

Acceptance and outcome of endoscopic screening for colonic neoplasia in patients undergoing clinical rehabilitation for gastrointestinal and metabolic diseases.

Our purpose was to study the acceptance and the outcome of endoscopic screening investigations of the colon in patients between 50 and 60 years of age in a clinical rehabilitation center. A total of 1,166 patients (m = 691, f = 475) entered the study. After guaiac testing all patients for fecal occult blood loss (FOBT), 667 patients (57%; m = 407, 61%; f = 260, 39%; n.s.) accepted a sigmoidoscopy. Of 658 (m = 403, f = 255) patients with complete investigation, 153 (23%) (m = 104, 26%; f = 49, 19%; n.s.) had a total of 272 neoplastic polyps, including 1 carcinoma. Adenomas = /> 10 mm were found exclusively in male patients (n = 25, p < 0.001). In comparing patients aged 50-55 years (n = 386) with those aged 56-60 years (n = 272), prevalences of neoplasia were found to be 19%/29% (p < 0.01), and prevalences of adenomas = /> 10 mm were 2%/10% (p < 0.05). The acceptance of a colonoscopy in patients with neoplastic polyps at sigmoidoscopy was 116/153 (m = 78, 75%; f = 38, 78%; n.s.). In 39 of these patients (34%) (m = 31, 40%; f = 8, 21%; p < 0.05), 68 further adenomas were detected but no carcinoma or adenoma with severe dysplasia. Multiple adenomas in the proximal colon were seen in 17 cases (15%) (m = 16, 21%; f = 1.3%; p < 0.01). The FOBT was positive in 10/658 patients, including the case with a carcinoma, but only in 4/25 with adenomas = /> 10 mm. In 5 cases with positive FOBT sigmoidoscopy and complementary colonoscopy did not reveal any pathology.

Colonic Neoplasms↗
PubMed1993

Endoscopic and bioptic diagnosis of malignant non-Hodgkin's lymphoma of the stomach.

Experience in the endoscopic and bioptic diagnosis of malignant non-Hodgkin's lymphomas of the stomach in 66 patients is reported all of which were B cell lymphomas originating in the mucosa associated lymphoid tissue (MALT) type. Two types of tumor could be differentiated by their appearance on endoscopy (two patients had both types). An exophytic type (n = 24) was easily recognized as malignancy on endoscopy and the diagnosis confirmed by endoscopic biopsy (mean of 1.2 endoscopic-bioptic examinations). It could be classified according to the Palmer classification; 50% were low-grade malignancies and 50% high-grade malignancies. Resection (n = 17) showed wall penetration beyond the muscularis propria in 70%. An infiltrative type (n = 44) was difficult to diagnose by means of endoscopy and biopsy (mean of 2.9 endoscopic-bioptic examinations); in one case a histological diagnosis could only be established on surgery. A classification system is suggested for this type (I--elevated, II--flat, III--cavitated). Most of these lymphomas were low-grade malignancies (77%), and limited to the mucosa and submucosa (79% of 34 resected cases). It is concluded that attention should be paid especially to the infiltrative type of gastric lymphoma which is difficult to diagnose and to differentiate from other gastric conditions such as ulcers and erosions, but which is most often found at an early stage and has a better prognosis. Complete tumor resection (R0) was achieved in 49 of 51 patients undergoing surgery (96%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Prevalence of lymphoid follicles and aggregates in Helicobacter pylori gastritis in antral and body mucosa.

AIMS: To evaluate the prevalence of lymphoid follicles and aggregates in the antral and body mucosa in Helicobacter pylori gastritis and to assess if there were correlations with ulcers in the duodenum, pylorus, or stomach, and with chronic antral erosions. METHODS: Patients (n = 2692) with histologically confirmed H pylori antral gastritis were investigated. These comprised five groups: those with duodenal ulcers; those with pyloric ulcers; those with gastric ulcers; those with chronic erosions; and those with no associated lesions. In 1446 cases at least two additional biopsy specimens from the oxyntic mucosa were available. RESULTS: Lymphoid follicles and aggregates were found in 53.8% of cases in the antral mucosa compared with 14.8% in the oxyntic mucosa (p < 0.001). The various diseases showed significant differences in terms of the prevalence of follicles and aggregates: The highest numbers in the antral mucosa as well as the lowest in the oxyntic mucosa were found in patients with duodenal ulcers (60.5% and 9.2%, respectively). The highest numbers of follicles and aggregates in the oxyntic mucosa occurred in patients with gastric ulcers. CONCLUSIONS: The detection of lymphoid follicles and aggregates in oxyntic mucosa and the higher prevalence in antral mucosa fits well with the distribution of primary gastric lymphomas. This adds further weight to the notion that the development of follicles and aggregates, triggered by H pylori, might be an early precursor to gastric lymphoma. The differences between the groups investigated might be due to different strains of H pylori or differences in the respective sizes of antral and oxyntic mucosa.

Female↗
PubMed1993

Long-term follow-up after eradication of Helicobacter pylori with a combination of omeprazole and amoxycillin.

Early studies have suggested that omeprazole may facilitate the eradication of Helicobacter pylori. Sixty patients with duodenal ulcer and H. pylori colonization were randomly assigned to receive either omeprazole monotherapy (n = 30) or combination therapy with omeprazole and amoxycillin (n = 30) for a total duration of 6 weeks. Four patients receiving monotherapy and three receiving combination therapy had to be withdrawn from the study. All (100%) duodenal ulcers healed in patients receiving combination therapy, and 25 out of 26 (96%) healed in the group receiving monotherapy. H. pylori was eradicated in 22 out of 27 (82%) patients receiving combination therapy; only two ulcer relapses (9%) occurred within 18 months in these 22 patients. Of the five patients who remained H. pylori-positive after combination therapy, two relapsed during the 18-month follow-up. In the monotherapy group, all patients remained H. pylori-positive after treatment, and duodenal ulcer relapsed in 16 out of 25 (64%) patients within the median follow-up of 18 months. Adverse events were not reported in the group treated with combination therapy; one patient receiving monotherapy reported severe headache. These results lend further support to existing data that H. pylori eradication prevents duodenal ulcer relapse and show that combination therapy with omeprazole and amoxycillin is effective and well tolerated.

Adolescent↗
PubMed1993

[Clostridium difficile in early childhood ulcerative pancolitis].

Ulcerative colitis is a rare disease in young infants. Less than one per cent of cases occur during the first two years of life. We describe a male child who developed frequent bloody diarrhea at the age of 20 months. More common causes like infections or gastrointestinal food allergy were excluded. Endoscopy and histopathological evaluations revealed ulcerative colitis of the entire colon. Treatment with sulfasalazine and prednisone resulted in a clinical remission after seven weeks. The follow-up of 15 months was complicated by Rotavirus infection. Two relapses were caused by Clostridium difficile infections. The latter were successfully treated with oral vancomycine, but in the last relapse an increased dosage of prednisone was required, too. In relapses of inflammatory bowel disease gastrointestinal infections, especially caused by Clostridium difficile should be considered and treated adequately.

Biopsy↗
PubMed1993

[Familial juvenile polyposis with predominant stomach involvement].

Juvenile Polyposis (JP) is a rare disease that may be found anywhere within the gastrointestinal tract, almost most cases so far reported have involved the colon. It is a precancerous condition, with the subsequently developing carcinomas so far also being found almost exclusively in the colon. A familial form is found in 20 to 50% of the cases. The present paper describes a family in whom three members of the second generation developed massive JP in the stomach requiring partial resection of the stomach or gastrectomy. Three members of the first generation died of carcinoma of the stomach and a forth of carcinoma of the colon. A male member of the second generation was treated at the age of 38 years for a carcinoma of the colon; 16 years later, he underwent resection of the stomach for juvenile polyposis and the histological work-up of the surgical specimen revealed in addition, areas of dysplasia and early carcinomas restricted to the mucosa.

Adenomatous Polyposis Coli↗
PubMed1993

Differential diagnosis of adenomas and dysplastic lesions in patients with ulcerative colitis.

In a retrospective study, unequivocal neoplastic lesions (126 circumscribed lesions, 10 large-area lesions) in 76 patients with known ulcerative colitis were classified into adenomas and dysplastic lesions on the basis of pathomorphological criteria. The macroscopic appearance, gland architecture, mucin vacuoles, the appearance of the nucleus, the stroma/gland ratio, the position of the proliferation zone, the interface between the lesion and the surrounding mucosa, and the state of neighbouring mucosa were all assessed. In 31 patients (41%), the lesions were classified as adenomas, in 42 patients (55%) as dysplastic lesions. A further three patients (4%) were found to have both adenomas and dysplastic lesions. The average age of the patients with adenomas was 66.0 years, that of those with dysplastic lesions 43.4 years. The mean duration of the disease in patients with adenomas was 7.2 years, and in patients with dysplastic lesions 12.6 years. Among the patients with adenomas, 65% has solitary and 35% multiple lesions; among the patients with dysplastic lesions, the corresponding figures were 27% and 73%. No significant differences were found in sex distribution, the extent of the ulcerative colitis or the site of the lesions. Successful differentiation between adenomas and dysplastic lesions in ulcerative colitis patients requires a differentiated therapeutic response.

Adenomatous Polyps↗
PubMed1993

Giant fold gastritis--a special form of Helicobacter pylori associated gastritis.

We investigated the question as to how frequently Helicobacter pylori gastritis is present in cases of endoscopically detected giant folds of the corpus and fundic mucosa, and whether this gastritis differs from Helicobacter pylori associated gastritis with no giant folds. Biopsy material obtained from 138 patients with giant folds (sex ratio: 1.0 men: 105 women; average age 61.0 years) was evaluated histologically and compared with that obtained from 1,196 patients with H. pylori associated gastritis without giant folds (1.1 men: 1.0 women; average age 51.9 years). Among the patients with giant folds, H. pylori colonisation of the gastric mucosa was found in 88.4% of the cases. The degree of H. pylori colonisation determines the degree and activity of the gastritis in the antrum and corpus (p < 0.001). A comparison of the degree of colonisation with H. pylori, the degree of gastritis and the activity of the gastritis in patients with giant folds and in H. pylori gastritis without giant folds revealed no statistically significant differences within the antrum. In contrast, in the case of the corpus, a comparison between the two groups showed that H. pylori colonisation, degree of gastritis, and activity of gastritis were statistically significantly more pronounced in patients with giant folds than in patients with H. pylori gastritis but no giant folds (p < 0.0001). A comparative analysis showed that giant fold formation in the fundus and corpus of the stomach may be a consequence of severe high-grade active H. pylori gastritis, that is, a special and rare form of reaction to the colonisation of the gastric mucosa with Helicobacter pylori.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1993

Histomorphological age changes and ultrastructural characteristics of the preputial and clitoral glands of mice.

The preputial and clitoral glands of 111-114-week-old B6C3F1-mice from a carcinogenesis experiment showed histomorphological characteristics. The lesions were considered to be spontaneous age changes, because the type, incidence and severity do not distinguish treated animals from controls. The most common findings were atrophy of the acini, lymphocytic infiltrates and hyperplasia of the squamous cell epithelium. Less frequently abscesses, fibrosis following a possible inflammatory process, an increase in the amount of subepithelial connective tissue, cystic dilatation of the central duct or secondary malignant lymphocytic infiltration were found. Neoplasms were not diagnosed. Similar lesions were found in the preputial- and clitoral glands of untreated 75-week-old mice, which were investigated for comparison. No abnormal histomorphological findings were found in the glands of 10-week-old mice. Ultrastructural characteristics of the mouse preputial and clitoral glands are dense bodies in the cytoplasm and intramitochondrial granules, which decreases in number with age.

Age Factors↗
PubMed1993

[Echinococcosis--current status of diagnosis and therapy].

The most frequent parasitosis in Europe is the infection by Echinococcus spp. Echinococcus granulosus is identified worldwide, 60% of all human infection are found in the liver, where cysts (hydatides) are built. Echinococcus alveolaris is found in the northern hemisphere, endemic in Middle Europe in Southern Germany, Austria and parts of Switzerland. 98% of all human infection are localized in the liver, where infiltrative growth destroying the tissue is found. Diagnosis is based on serological techniques, ultrasound and CT-scanning. Surgery is the only curative therapy by resection of cystic areas followed by chemotherapy with Mebendazole. In studies Albendazole has shown better results. CT-guided percutaneous drainage followed by instillation of hypertonic saline is performed in case of non-resectable hydatidosis.

Diagnosis, Differential↗
PubMed1993

[Adenocarcinoma of the vermiform appendix].

Primary adenocarcinoma of the appendix vermiformis is very rare. We report on a patient who died with the age of 75 years. On the occasion of an inguinal herniotomia scrotal mucinous metastases were discovered. After appendectomy the diagnosis of primary adenocarcinoma of the appendix vermiformis was ensured. The further course was very unusual. Even though metastases were spread all over the abdominal cavity, the patient survived for further 13 years without therapy. At the postmortem examination there was found a widespread carcinosis of peritoneum and pleura as well as several liver metastases.

Adenocarcinoma, Mucinous↗
PubMed1993

Clinical and pathomorphological findings in patients with colorectal carcinoma complicating ulcerative colitis.

In a retrospective investigation, the clinical and pathomorphological findings of 27 patients (18 men, 9 women) with ulcerative colitis and colorectal carcinoma were analysed. Their average age at the onset of the disease was 32.4 years, the duration of the illness at the time of the diagnosis of carcinoma 12.5 years, and age at the time carcinoma was diagnosed 45.4 years. In 23 patients (85%), total colitis presented. In 15% of the cases, multiple carcinomas developed. Eighty-six percent of the carcinomas were located in the left colon, and 54% of all carcinomas were in the rectosigmoid. Forty-four percent of the carcinomas were primarily diffusely stenosing lesions. Nineteen percent were mucus-producing adenocarcinomas. Eighty-nine percent of the lesions were well or moderately well differentiated. At the time of the diagnosis of carcinoma, 35% of the patients had lymph node or distant metastasis. In 85% of the cases, dysplastic lesions were found in the close and more distant vicinity of the carcinoma.

Adenocarcinoma↗
PubMed1993

[The syndrome of juvenile polyposis].

Juvenile polyposis (JP) was first distinguished from other gastrointestinal polyposis syndromes in 1964. Since then, some 272 cases of this entity have been reported in the literature. The underlying polyps found in JP are of the hamartomatous type, but it is known that juvenile polyps may contain adenomatous tissue, or may be accompanied by adenomas. For the most part, juvenile polyps are found in the colon, but may also develop in the stomach, duodenum, jejunum or ileum. In 20 to 50% of the cases, juvenile polyposis occurs as a familial condition. Extra-intestinal anomalies are found in approximately 11% of JP patients. A particular clinical feature is anaemia caused by chronic gastrointestinal bleeding. In infants and young children, however, massive diarrhoea may become life-threatening. A reported malignant degeneration rate of 17.6% (among known cases) justifies the classification of JP as a precancerous condition, and has both therapeutic and, in particular, prophylactic consequences. These include the need to carry out regular follow-up examinations of the entire gastrointestinal tract, and also screening examinations in other members of the family.

Adenomatous Polyposis Coli↗