Biomedical subjects
Publications and source records attributed to S Jenny.
In cases without a history of gastrointestinal or cardiac disease, acute odynophagia prompts the tentative diagnosis of drug-induced esophageal ulcer. Possible causes are tetracycline, clindamycin, emepronium bromide, potassium chloride, etc. Other diseases such as carcinoma can be ruled out by endoscopy and biopsy. To avoid such esophageal lesions drugs should be taken with sufficient fluid and not immediately before bedrest.
Angiodysplasias of the colon are rare causes of intestinal bleeding. Diagnosis is by angiography or colonoscopy. In 6 patients with severe anemia in whom conventional methods had failed to reveal the source of bleeding, colonoscopy demonstrated angiodysplasias in the cecum or ascending colon. They were treated endoscopically. In a follow-up period of 3 months to 4 years only 1 patient has sometimes suffered occult fecal blood loss, but is adequately treated by oral iron therapy. No patient has had a severe recurrence of bleeding, nor was colonic resection necessary. It is concluded that endoscopic therapy of angiodysplasias is a valuable alternative to surgery with low risk and high efficiency.
Alcoholism frequently goes undiagnosed in day-to-day medical practice because the possibility of successfully treating alcoholics on an out-patient basis is too little known. Concepts of how alcoholism arises usually relate to an isolated individual and, therefore, do not cover the whole reality of this multifactorial disease. Treatment in a "social network" presupposes that the patient's problems are understood as disturbed interactions with his environment. With this concept in mind it is possible to approach the essential conditions of the disease. 484 patients have been treated according to this program. 352 (72.7%) were followed up for an average of 8.3 years (range 2--19 years). 37.4% were in complete remission, 33.7 had markedly improved and 28.9% were unchanged or worse.
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Postoperative examination of 600 patients with carcinoma of the large bowel showed: 1. in emergency operation mortality is 30%, in elective surgery 10%; 2. operation risk in elderly patients is not significantly higher than in young patients; 3. only a decrease in "patient and doctor delay" and/or mass screening will provide better results.
The only practicable method for mass screening for carcinoma of the colon is detection of occult blood in stool. In a coloscopically controlled study with the Haemoccult test, dependent from diet, 54-66% of polyps and 77-100% of carcinomas were detected. The Haemoccult test is therefore a suitable method for mass screening for colon carcinoma.
"Patient delay" in carcinoma of the stomach has been, in the past 10 years, 4 months on average. However, "doctor delay" has increased from 10 weeks to 8 months. A shortening of "doctor delay" is possible only if early endoscopy is carried out.
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.
Local 8-methoxypsoralen black-light treatment was carried out on sixty-two patients. For the first time, oil was employed as a preparation base in order to increase the transparency and so the effectiveness of irradiation. Also the need for a descaling pretreatment was avoided. In investigations still being carried out, 27.5% patients showed very good improvement, 48-4% good and 24-2% unsatisfactory results of treatment. In many cases, less than fifteen irradiation sessions were necessary for clinical healing. However, to obtain a uniform pigmentation, additional irradiation proved necessary.
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