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Biomedical subjects

R Ammann

Publications and source records attributed to R Ammann.

At least 163 records · Page 9Linked to original sources
PubMed1976

["Senile" chronic pancreatitis; a new nosologic entity? Studies in 38 cases. Indications of a vascular origin and relationship to the primarily painless chronic pancreatitis].

47 of 170 cases of chronic pancreatitis observed and controlled in the last 12 years in this department were of unknown etiology (idiopathic form). The age distribution of these 47 cases showed 2 peaks, a "juvenile" group of 9 cases (average age 29 years) and a "senile" group of 38 cases (average age 62 years). Idiopathic "senile" chronic pancreatitis (ISCP) is characterized by advanced age at the time of first manifestation (95% over 50 years), a prevalence of males (81%), a high incidence of calcifications (60%) and a rather benign, often painles course (74%). Clinically there is some overlap between ISCP and painless chronic pancreatitis (PSCP). In contrast to PSCP, ISCP seems, however, to comprise a homogeneous group of patients as far as etiology is concerned, and typical episodes of pancreatitis occurred in about 25% of cases with ISCP. Ther is an unusually high incidence of signs of arteriopathy associated with ISCP. Arteritis of the lower limbs and/or coronary heart disease was detected in 42% of cases, 14 of 17 deaths were due to cardiovascular disease and arteriosclerotic risk factors were found in 87% of the patients. In our experience ISCP seems to be a special form of chronic pancreatitis which can be differentiated from alcohol-induced chronic pancreatitis and from the other forms with rare causes. Furthermore, our findings suggest that a vascular factor is of importance in causing ISCP.

Adult↗
PubMed1976

[The value of endoscopic retrograde cholangiopancreatography in negative or undetermined cholecystocholangiography].

In 299 patients with negative cholecystocholangiogram, endoscopic retrograde cholangio-pancreatography (ERCP) was performed. In obstructive jaundice ERCP is the method of choice, while in cholestasis it is indicated if the intravenous cholecystocholangiogram is insufficient. In unclear abdominal conditions and in "postcholecystectomy syndrome" ERCP may be carried out after other abdominal diseases have been ruled out.

Cholangiography↗
PubMed1976

[Diagnosis of treated and untreated chronic-aggressive hepatitis].

A total of 121 patients with chronic active hepatitis (CAH) of two Zurich hospitals were controlled over a mean time of 5 years and 4 months. All patients of one hospital were consequently treated with corticosteroids and azathioprine, whereas those of the other hospital were not treated unless a severe deterioration occurred. In this case treatment was as short as possible. Results indicate that long - time treatment of CAH results in better prognosis than does no or short - time treatment. Death rate per observed patient - year was 0.079 in the no - therapy group, 0.035 in the short - therapy group and 0.025 in the long - time therapy group.

Adrenal Cortex Hormones↗
PubMed1976

[Juvenile colonic mucosal polyps in adults].

The histology of all intestinal polyps removed endoscopically during the last 30 months has been reviewed. Among the 90 patients with a total of 154 polyps, 3 cases of juvenile polyps were found. All three were male adults who were aged 29, 34, and 50 years. In two patients the lesion was solitary, while one had polyposis with about 100 polyps. Macroscopically the juvenile polyps cannot be distinguished from adenomatous polyps, but their histologic appearance is typical. They are considered to be hamartomas and have no tendency to become malignant. Thus, juvenile polyposis does not represent a precancerous lesion as adenomatous polyposis does, and must therefore be treated differently. Therapy consists of endoscopic removal of all polyps. In order to differentiate juvenile from adenomatous polyps with certainty, histological examination of at least one polyp is necessary. This differential diagnosis is the indispensable precondition for appropriate therapy.

Adenoma↗
PubMed1976

[Diagnosis and differential diagnosis of pancreatitis--diagnostic relevance of clinical and biochemical changes during the course of the disease and of endoscopic retrograde pancreatography (author's transl)].

In order to classify a patient with pancreatitis according to the Marseille clasiffication the following criteria must be fulfilled: (a) an acute attach of pancreatitis must be observed, (b) the cause of pancreatitis has to be established, (c) the patient has to be followed over longer periods of time in order to find out, whether the process becomes chronic (involving progredient endocrine and exocrine insufficiency). Diagnostic problems of acute pancreatitis, relapsing pancreatitis, and chronic pancreatitis are discussed taking into account the author's own results. It is concluded, that repeated tests of pancreatitis function and demonstration of pancreatic calcification are more important for establishing the diagnosis of chronic pancreatitis than studies of pancreatic morphology including endoscopic retrograde pancreatography (ERP). ERP may help to find the cause of relapsing pancreatitis of unknown origine; it may help as well preoperatively to diagnose local changes of the pancreatic duct system in chronic pancreatitis.

Acute Disease↗
PubMed1976

[Multiple adenomatous papillary colonic polyps in a family with frequent cases of stomach carcinoma--a new phenotype of familial colonic polyposis].

A kindred of "minor adenomatous polyposis" associated with a high incidence of gastric cancer is described. Five out of 14 mainly asymptomatic individuals in 2 generations of kindred examined clinically, by panendoscopy and coloscopy exhibited multiple polyps of colon or/and stomach and jejunum. Single or multiple papillary adenomas were detected mainly in the right or middle colon (3 times or in the jejunum (once). Hyperplastic polyps were found in the stomach (3 times) and in the colon (twice of these 5 individuals. Our findings suggest that "minor adenomatous polyposis" associated with gastric cancer may represent another, hitherto unrecognized, phenotype of familial multiple polyposis.

Colonic Diseases↗
PubMed1975

[Pancreatic carcinoma in chronic pancreatitis].

Chronic pancreatitis and carcinoma of the pancreas are being diagnosed with increasing frequency throughout the world. When both occur together, the question of their causal relationship arises. Secondary chronic pancreatitis following carcinoma of the pancreas is relatively frequent and can be proven histologically in at least 10% of pancreatic cancers. How often primary chronic pancreatitis develops into carcinoma is controversial. So far, there are only a few prospective clinical studies of chronic pancreatitis which cover this problem. We have followed 146 cases of chronic pancreatitis for an average of 8.7 years. Two thirds of our patients show pancreatic calcifications. Our series includes a family with congenital pancreatic insufficiency. So far only one adenocarcinoma of the head of the pancreas has been diagnosed in a 58-year-old male. Another 57-year-old male patient died from a solid metastatic carcinoma, probably of pancreatic origin. Therefore, the incidence of pancreatic cancer in our series is 0.7 and 1.4% respectively. However, 8 more patients suffering from extrapancreatic malignancies have turned up during the follow-up period: 2 cancers of the tongue, 2 colonic carcinomas, 2 bladder papillomas, and 1 bronchial and 1 gastric carcinoma. Our studies indicate that carcinoma of the pancreas probably does not occur more frequently in chronic non-hereditary pancreatitis than in the average population. A review of the literature suggests that there may be a higher incidence of carcinoma in families with hereditary chronic pancreatitis. The frequency of extrapancreatic cancer in our patients is remarkable. As pancreatic carcinoma is rare in chronic pancreatitis there is no reason for early aggressive surgery, e.g. pancreatectomy, in these patients.

Adenocarcinoma↗
PubMed1975

[The Hollander test: an unsuitable method aimed at judging success following selective proximal vagotomy].

In a prospective, randomized study, proximal selective vagotomy with or without pyloroplasty was used as the exclusive procedure for elective treatment of duodenal ulcer without pyloric stenosis in man. Three months postoperatively 32 out of the first 35 patients exhibited incomplete vagotomy assessed by the 2-deoxy-D-glucose test. This incomplete vagal denervation of the parietal cell mass is due mainly to the principle of proximal selective vagotomy. In order to maintain the motility of the gastric antrum the denervation should be halted at a distance of 7 cm from the pylorus.

Denervation↗