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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 415 records · Page 23Linked to original sources
PubMed1991

Fish oil reduces ethanol-induced damage of the duodenal mucosa in humans.

Eight healthy volunteers were studied before and after 3 weeks of dietary supplementation with fish oil (10.5 g day-1, 18% (1.9 g) eicosapentaenoic acid). Duodenal mucosal lesions were induced by instillation of 40 ml ethanol (40%). Mean endoscopic lesion score was lower after fish oil treatment (1.62 +/- 0.32; mean +/- SEM) than before (3.25 +/- 0.31; P less than 0.01). Histologic lesion score fell from 22.75 +/- 1.98 before treatment to 13.50 +/- 1.51 after fish oil (P less than 0.01). Basal and pentagastrin-stimulated gastric acid output remained unaffected. Release of prostaglandin E2, 6-keto-prostaglandin F1 alpha, and thromboxane B2 from biopsy specimens of the duodenal mucosa in vitro was not significantly altered after fish oil ingestion. In the same in vitro system calcium ionophore A23187-induced release of total leukotriene C (LTC) increased from 10.6 +/- 1.5 ng g-1 mucosa 20 min before treatment to 30.4 +/- 3.2 ng after fish oil. High pressure liquid chromatography analysis showed that this increase was partly due to formation of LTC5 as after fish oil 28% of total LTC were identified as LTC5 whereas 72% were LTC4. We conclude that in humans fish oil reduces ethanol-induced damage of the duodenal mucosa without inhibiting gastric acid secretion or stimulating prostaglandin formation. It remains to be clarified if the changes in leukotriene formation are relevant for the mucosaprotective fish oil effect.

6-Ketoprostaglandin F1 alpha↗
PubMed1991

[Collagenous duodenitis and ileitis in a patient with collagenous colitis].

Collagenous colitis is a disease accompanied by chronic watery diarrhea, of which the etiology is unknown. Sporadic cases of collagen deposits in the upper gastrointestinal tract are meanwhile reported. We here report the case of a 53-year-old female patient suffering from collagenous colitis with additional collagen deposits in the duodenum and ileum. The favourable effect of a therapeutical trial with bismuth nitrate is described.

Basement Membrane↗
PubMed1991

Failure of ranitidine and omeprazole treatment in eosinophilic gastritis with ulceration.

In a 32-year-old woman with an ulcer that had persisted for more than 13 months despite treatment with the H2 blocker ranitidine, the latter was replaced by the H+K(+)-ATPase inhibitor omeprazole. Treatment with omeprazole also failed to bring about healing of the ulceration which, at times, measured up to 10 cm in diameter. On account of a hemorrhage from the ulcer, a Billroth II resection of the stomach had to be performed. The histological work-up of the surgical specimen confirmed the tentative diagnosis of a secondary ulceration in underlying eosinophilic gastritis established on the basis of the work-up of biopsy material obtained from the ulcer. The reason for the failure of the lesion to respond to the H2 blocker or omeprazole in this case was a diffuse infiltration of the antral wall with eosinophilic granulocytes, and the resulting secondary persistent ischaemic ulceration.

Adult↗
PubMed1991

[Helicobacter pylori colonization of the gastric mucosa in rheumatic patients].

This study examines whether infections with Helicobacter pylori are more frequent in patients suffering from rheumatoid arthritis than in patients with non-inflammatory rheumatic diseases. The study furthermore examines whether the colonisation by H. pylori is favoured by antiphlogistic-antirheumatic treatment. For this purpose gastric biopsies obtained by endoscopy from 123 patients were histologically evaluated for the presence of H. pylori. 85 patients with rheumatoid arthritis were compared with 38 patients with non-inflammatory rheumatic diseases. Although an increased susceptibility for infections can be expected in persons with rheumatoid arthritis undergoing long-term antirheumatic treatment, this could not be confirmed by our results for the colonisation of the stomach by H. pylori. It is therefore statistically confirmed that rheumatoid arthritis itself and treatment with short-term effective antirheumatic drugs has no significant influence on the colonisation rate. Still it is doubtful whether any lesion associated with NSAR and H. pylori must necessarily be considered an NSAR-"induced". Future studies will have to elaborate whether NSAR in H. pylori infected mucosa will lead to higher incidence of damage.

Adult↗
PubMed1991

Cryptosporidiosis of the appendix vermiformis: a case report.

The present case report describes a 30-year-old man with AIDS who developed cryptosporidiosis of the appendix vermiformis. The patient had been admitted to hospital with all the symptoms of appendicitis, and an appendectomy was performed. The histological work-up of the surgical specimen revealed an acute phlegmonous appendicitis, and also a welldeveloped cryptosporidiosis, which was confirmed by electron-microscopic examination. Two years later, the patient died of pneumonia contracted during a generalised CMV infection. The postmortem examination revealed cryptosporidial organisms in the biliary tract. As far as we know, this is the first ever report of cryptosporidiosis of the appendix vermiformis.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Lymph follicle formation and development of intestinal metaplasia in antrum mucosa as a reaction to Helicobacter pylori infection].

We examined 171 patients (76 females and 95 males) with definite type B-Gastritis. Antrum specimens were taken from all participants for histological examination. We studied the correlations between the formation of lymphoid follicles, the severity of gastritis, the degree of activity of gastritis and the density of Helicobacter pylori colonization. In addition we noted the distribution and extent of the intestinal metaplasia. In patients with high degree HP-colonization we found formation of lymphoid follicles in 59.8%, in patients with low degree HP-colonization in 35% and in patients without colonization only in 10.2% (high degree vs. low degree colonization p less than 0.05, low degree vs. absent colonization p less than 0.025, high degree vs. absent colonization p less than 0.0005). In patients with high grade type B-Gastritis we detected formation of lymphoid folliclesin 58%. There was no case of formation of lymphoid follicles in patients with low grade type B-Gastritis. Patients with a high grade activity of the type B-Gastritis displayed a formation of lymphoid follicles in a higher percentage as patients with a low grade activity of the gastritis (66% vs. 33%, p less than 0.0005). In the antrum intestinal metaplasia of the types I and II could be found significantly more frequent in patients with high grade Type B-Gastritis than in patients with low grade Type B-Gastritis (34.1% vs. 8.8%, p less than 0.005). Intestinal metaplasia was found more frequently in connection with high and low activity of type B-Gastritis than without activity (p less than 0.005 and p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Giardiasis--a simple diagnosis that is often delayed.

In a retrospective study performed on 125 patients with histologically diagnosed giardiasis, it is shown that this disease can lead to a variegated picture involving numerous gastroenterological symptoms. The main symptoms noted were epigastralgia (41%), diarrhoea (32%), nausea and vomiting (23%), and loss of weight (20%). The material for histological diagnosis was obtained in hospitals in 49% of the cases, in the doctor's office in 32%, and in two gastroenterological rehabilitation centres in 19%. The average duration of symptoms before establishment of the diagnosis was 2.01 years (range: 1 week to 30 years). In only 8% of the cases was the disease preceded by a visit to an endemic area. Treatment with nitroamidazole preparations completely relieved symptoms in 78% of the patients and remained unsuccessful in 4%; for the remaining 18% of the patients, no follow-up data were available. On the basis of these results, it is recommended that in patients with upper abdominal pain, diarrhoea, loss of weight, meteorism, flatulence, nausea and vomiting, the possibility of giardiasis should be considered, and that during endoscopy, two or three forceps biopsies should be obtained from macroscopically normally-appearing mucosa of the descending part of the duodenum to enable a histological search for Giardia lamblia.

Adolescent↗
PubMed1991

The diagnosis of early gastric lymphoma.

In analogy to the early carcinoma of the stomach, early gastric lymphoma is defined as a tumour with a maximum depth of infiltration extending into the submucosa. Among 94 consecutive gastric surgical specimens investigated, 45 (47.9%) early lymphomas were diagnosed. Macroscopically, most of these tumours present a non-uniform "variegated picture". There appears to be no relationship between the largest transversal diameter of the gastric lymphoma and its depth of penetration. In contrast, a statistically significant relationship was detected between the degree of malignancy and the depth of infiltration. Involvement of the regional lymph nodes by lymphoma is increased significantly with a high degree of malignancy and greater depths of infiltration, while the incidence of lymph follicles decreases. An analysis of the morphology of the surgical specimens reveals that - in common with early cancer of the stomach - early lymphomas, too, pass through a "malignant cycle". Depth of infiltration and degree of malignancy also have an influence on the number of endoscopic/biopsy examinations necessary to permit a definitive diagnosis of lymphoma.

Adult↗
PubMed1990

Collagenous gastroduodenitis on collagenous colitis.

We report on a case of collagenous gastroduodenitis with concomitant collagenous colitis in a 75-year-old woman with watery diarrhea of approximately six months' standing. The step biopsy material obtained from the colon revealed continuous collagenous colitis with thickening of the basal membrane to 30 microns. The biopsies taken from the stomach and duodenum also revealed a band-like deposition of collagen in the duodenum (bulb and proximal portion of the descending portion) along the basal membrane of the lining epithelium, associated with partial atrophy of the villi. In the stomach, this band of collagen was located, parallel to the mucosal surface, at the level of the floor of the foveolae.

Aged↗
PubMed1990

Inflammatory fibroid polyp of the stomach.

Among 3,200 polyps of the stomach, we diagnosed inflammatory fibroid polyp in 143 patients (4.5%). The average age of the patients was 63.6 years (women) and 63.9 years (men), the sex ratio being 1.6 women to 1.0 men. In 77.6% of the cases, the polyp was located within the antrum, in 9.8% in the angular notch region, 1.4% in the pylorus, and 0.7% each in the fundus and cardia. The characteristic histological feature of these lesions is an eosinophil-containing, loosely structured fibrous tissue comprising an onion-skin-like arrangement of reticular fibers with spindle-shaped nuclei localized in the submucosa and the base of the mucosa. The polypous bulging mucosa was eroded in 26.8% and ulcerated in 3.5% of the cases. A comparison of the 147 cases collected from the literature with our own 143 cases revealed no differences. The rarity of inflammatory fibroid polyps in the stomach, their predominant location in the antrum, the age distribution and the observation that, after removal, these lesions do not recur, all go to suggest that the lesion is a reactive process (allergic or foreign body reaction), possibly a residual state following infestation by a parasite larva.

Adult↗
PubMed1990

Giardiasis: analysis of histological changes in biopsy specimens of 80 patients.

Histological changes in duodenal biopsy specimens from 80 patients infected with Giardia lamblia were defined and compared with changes in duodenal biopsy specimens from 80 randomly chosen "healthy" patients. Villous architecture, the number of intraepithelial lymphocytes, the occurrence of lymphoid follicles and the density of colonisation by G lamblia trophozoites were examined. Grade 1 villous flattening was observed in 41% of cases positive for Giardia and in 37.5% of the control cases. The mean content of intraepithelial lymphocytes was 24.5 compared with 22.6 intraepithelial lymphocytes/100 epithelial cells in the positive and negative groups, respectively. Lymphoid follicles were more frequently observed in Giardia positive specimens, but their incidence was not significantly higher compared with that of controls. Twenty five per cent of patients positive for Giardia showed light, 41% intermediate, and 34% heavy colonisation by Giardia trophozoites. In 76% the parasites were observed in all specimens obtained. It is concluded that histological changes induced by G lamblia are not specific, and that two duodenal biopsy specimens might suffice to detect the trophozoites.

Adolescent↗
PubMed1990

[Malignant somatostatinoma--diagnosis after 6 years].

UNLABELLED: Early symptoms of malignant somatostatinoma with dyspeptic complaints, moderate diabetes mellitus and cholecystolithiasis are the reason of primary treatment of these patients by surgeons. CASE REPORT: In a 34-year old patient with typical anamnesis of cholecystitis and moderate diabetes mellitus liver metastases were seen during laparotomy. In the beginning the metastases were mistaken for hepatocellular carcinoma histologically. There was no deterioration until June 1988 when a high-grade stenosis of the duodenum has developed. Now a malignant somatostatinoma was diagnosed histologically and confirmed by immunohistology. Somatostatinomas are generally diagnosed by repeated measures of increased plasma SLI associated with decreased insulin, glucagon, pancreatic-polypeptide (PP) and vasoactive-intestinal-peptide (VIP). In normally or moderately increased plasma SLI concentrations provocation with tolbutamid may be helpful. Treatment should remove most of the tumor by surgical intervention, while chemotherapy must be less pronounced.

Adenoma, Islet Cell↗
PubMed1990

Elimination of Helicobacter pylori under treatment with omeprazole.

Biopsies from the stomachs (antrum and corpus) of 201 patients with peptic ulcers or reflux oesophagitis were retrospectively investigated for the effect of treatment with omeprazole on the elimination of Helicobacter pylori (HP) and on gastritis. Of 64 patients without gastritis two (3.1%) developed gastritis during treatment. Among 134 patients with HP gastritis undergoing treatment, 48 (35.8%) experienced no HP elimination, in 41 (30.6%) there was HP elimination from the antrum, but HP persistence in the corpus, while in 45 (33.6%) HP was eliminated from both antrum and corpus. HP elimination led to a reduction in the degree and activity of gastritis under omeprazole treatment. Only eight patients were examined after completion of treatment, and in three in whom HP had been eliminated, recolonization was found to have occurred. The disappearance of HP in Type A gastritis coupled with the fact that HP is highly sensitive to contamination with other bacteria--as observed in the laboratory--suggests that this now partially established elimination of HP under the strongly acid-inhibiting omeprazole therapy can be traced back to a bacterial overgrowth of the gastric mucosa.

Adult↗
PubMed1990

[Type I or IIa early stomach carcinoma. Comparative studies of the prognosis following limited or radical therapy].

In a retrospective study of 190 patients with type I (n = 100) or type IIa (n = 90) early gastric carcinoma, we investigated the question as to whether after limited therapy--endoscopic polypectomy (n = 49), large forceps biopsy (n = 4) or local surgical excision (n = 14)--or surgical resection (n = 123), differences in prognosis are to be found between the groups. In comparison with the age-adjusted 5-year survival rate, no differences were found between the limited therapy group and the resected group. Postoperative mortality was 3.0% in the limited therapy group and 17.1% in the resected group. Up to the fourth year of follow-up the prognosis was better for malignancy grade 1 than for malignancy grade 2 or 3, and also for tumours with a diameter of less than 3 mm than for those with larger diameters. No difference in 5-year survival rates was to be found with respect to the histological classification, depth of invasion, gross tumour type or multiple tumours. The results of these investigations indicate that limited treatment can be considered for type I or type IIa early gastric carcinoma when the carcinoma is restricted to the mucosa and is of the intestinal cell type of malignancy grade 1 or 2.

Adult↗