Biomedical subjects

B Pfaffenbach

Publications and source records attributed to B Pfaffenbach.

46 records · Page 3Linked to original sources

PubMed1994

[Systemic fungal infections in hematologic neoplasms. An autopsy study of 1,053 patients].

BACKGROUND: Mycoses are common complications of haematological neoplasias. For successful antimycotic treatment, a knowledge of preferential underlying disease, frequency, species and site of the mycosis is of importance. PATIENTS AND METHODS: Postmortem material comprising clinical data, autopsy protocols and histological sections obtained between 1976 and 1990 from 1,053 patients with leukaemia and malignant lymphomas following antineoplastic therapy was analysed retrospectively. RESULTS: Autopsy revealed systemic mycoses in 184 patients (17.5%). Between 1976 and 1990, the incidence of fungal infections increased from 12% to 30%, most being found in acute leukaemia (24%). Myeloproliferative syndrome (18%), non-Hodgkin's lymphomas (16%), Hodgkin's disease (10%) and plasmocytoma (2.5%) were less frequently associated with mycoses. With no preference for any particular malignancy in evidence, aspergillosis predominated at histology (85 cases), while candidosis occurred in 75 cases. A combination of two mycoses (aspergillosis and candidosis) (14 patients), zygomycosis (eight patients) and cryptococcosis (two patients) were much less common. While aspergillosis caused mostly pulmonary (81 cases) and cerebral (18 cases) infections, candidosis most frequently affected the GI tract (83 cases). The fungal infection was regarded as the main cause of death in some 76% of the cases. An analysis of bone marrow of patients with mycosis (184 cases) revealed a predominance of hypoplasia (54%) over tumour infiltration (34%) and normal bone marrow (12%). In malignancies with no mycoses (869 cases) in contrast, hypoplasia was significantly less common (19%) than infiltration (59%) or normal bone marrow (22%) (p < 0.001). CONCLUSION: The incidence of mycoses in haematological neoplasias in our post mortem series has continued to increase. Bone marrow hypoplasia in particular predisposes to fungal infection. The lungs are the organs of predilection, and aspergillosis is likely to be the infection presenting.

Autopsy↗

PubMed1994

[Ultrasound measurement of gastric emptying of a solid test meal. Correlation with scintigraphy in diabetic patients and reproducibility in healthy probands].

Measurement of gastric emptying of liquids by sagittal antral planimetry is established. Ultrasonic measurement of gastric emptying of solids has not been assessed although gastroparesis often reveals a delayed gastric emptying of solids first. Therefore in this prospective study we used a solid meal (50 g rye bread, 1 egg, 40 g butter, 200 ml orange juice; 280 kcal) to examine intraindividual reproducibility of ultrasound in 20 healthy volunteers. Moreover, in 20 diabetics antral planimetry assessed by ultrasound was compared to scintigraphy. Antral planimetry showed a coefficient of variation, that was nearly three times greater between subjects than between two measurements performed on the same subject. This results reflect a good intraindividual reproducibility. Gastric emptying half-times assessed by ultrasound and scintigraphy did not correlate in diabetics (R = 0.2). However, correlation between sonographic measurement of antral area and scintigraphy at defined times (60, 120, 180, 240 min) was significant (R = 0.7; p < 0.001). These results imply that ultrasonic antral planimetry is a suitable orientating method for measuring gastric emptying of solids.

Adult↗

PubMed1994

Endosonographically guided fine-needle aspiration puncture of paraesophagogastric mass lesions: preliminary results.

Mass lesions adjacent to the gastroesophageal wall can be visualized in detail by endoscopic ultrasonography. However, in many patients tissue diagnosis of these mass lesions is urgently required. We evaluated the efficiency of transmural fine-needle aspiration puncture guided by endosonography for cytological confirmation of such mass lesions. Endosonographically guided transmural fine-needle aspiration (EUS-guided FNA) puncture was performed in 12 patients with extrinsic mass lesions adjacent to the gastro-esophageal wall. In seven patients a malignant tumor and in four patients a benign lesion, were identified by EUS-guided FNA puncture, while in one patient no diagnostic tissue specimen could be obtained. No complications were observed. The cytological result of a malignant lesion was confirmed in six patients either by autopsy (n = 3), resection of tumor metastasis (n = 1) or by demonstration of a local recurrence of a previously histopathologically diagnosed carcinoma (n = 2), while the benign cytological results in four patients were confirmed by a follow-up period of at least 13 months (n = 3) and appropriate diagnostic tests (n = 1). It is concluded that EUS-guided FNA puncture is an efficient diagnostic technique for the assessment of malignancy and tissue diagnosis of extrinsic paragastroesophageal mass lesions. An important precondition for the successful performance of transmural EUS-guided FNA puncture is the application of endosonographic transducers with longitudinal scanning in the axis of the endoscope.

Aged↗

PubMed1994

[Endometriosis in retroperitoneal lymph nodes].

This is a case report on an endometriosis in retroperitoneally situated lymphatic nodes in a 29-year-old patient. The patient had a cervical carcinoma FIGO Ib and was treated surgically by radical hysterectomy after Wertheim-Meigs-Okabayashi with pelvic lymphonodectomy. Endometriosis was found in two lymphatic nodes of the retroperitoneum. The patient had no anamnesis or clinical symptoms of endometriosis. Endometriosis could also not be found in any other parts of the abdomen.

Adult↗

PubMed1991

[Deep mycoses in leukemia and malignant lymphoma].

1053 autopsies were performed from 1976 to 1990 in patients with leukemia and malignant lymphomas. At autopsy 184 of these (17.4%) presented with deep seated mycoses. There was an increasing percentage of mycoses per year with a maximum of 30% in 1990. Today deep seated mycoses are the most frequent letal complication in hematologic neoplasias. As expected their number was especially high in patients with acute leukemia but in recent years they were nearly just as numerous in myeloproliferative disorders. Among NHL they were twice as frequent in low grade cases as in high grade cases possibly due to a different extent of bone marrow infiltration. In contrast to former years more aspergilloses than candida infections are found, probably as a result of antimycotic therapy.

Acute Disease↗

PubMed1991

[Autopsy results of deep mycoses in hematologic neoplasms (1053 patients].

1053 autopsies were performed during the period from 1976 to 1990 in patients with leukaemia and malignant lymphomas. At autopsy 184 of these (17.4%) presented with deep-seated mycoses. There was an increasing percentage of mycoses per year with a maximum of 30% in 1990. Today deep-seated mycoses are the most frequent lethal complication in haematologic neoplasias. As expected their number was especially high in patients with acute leukaemia but in recent years they were nearly just as frequent in myeloproliferative disorders. Among Non-Hodgkin lymphomas (NHL) they were twice as frequent in low-grade cases as in high-grade cases possibly due to a different extent of bone marrow infiltration. In contrast to former years more aspergillosis than Candida infections are found, probably as a result of antimycotic therapy.

Autopsy↗

PubMed1991

[Fungal infections after bone marrow transplantation--an autopsy study].

This report analyses the frequency, the pattern and the severity of mycotic infection in a necropsy series of 103 bone marrow transplantations. Fungal infection was documented in 33 (32%) of all death cases. The risk of mycotic infection was increased in patients with graft failure and after retransplantation. At post mortem examination, most cases showed invasive fungal infections. The most frequent organ manifestations were the lungs, the gastrointestinal tract, the kidneys, the heart and the brain. In 19 of 33 patients (57%), mycotic disease was the primary cause of death. Fungal infections still cause major problems in clinical diagnosis, because there remain cases that will be documented only if post mortem examination is performed.

Aspergillosis↗

PubMedDate not supplied

Esophageal motility patterns in patients with and without coronary heart disease and healthy controls.

BACKGROUND/AIMS: The aim of the study was to evaluate esophageal motility patterns in patients with chest pain with and without coronary artery disease, in order to elucidate the question: Does "non-cardiac" chest pain really exist? METHODOLOGY: Patients with chest pain and normal coronary angiograms, patients with chest pain and coronarographically diagnosed coronary artery disease and controls were prospectively studied with long-term manometry. RESULTS: The pressure amplitudes were 38.3 (NCA)/39.82(CAD) and 30 (CG) mmHg (p<0.02, p<0.02) distally and 30/28.1 and 25.5 mmHg (p<0.02) proximally. The percentage of propulsive contractions were 51.5%/45% and 53.5% (p<0.05) and of simultaneous contractions were 18.5%/23% and 10% (p<0.0005, p<0.0001). CONCLUSIONS: Esophageal motility patterns of patients with chest pain and normal coronary angiograms and coronary artery disease differ significantly from controls. Both patient groups show a considerable overlap in motility disturbances. These data indicate that the term "non-cardiac" chest pain in fact does not sufficiently characterize patients' status.

Angina Pectoris↗

PubMedDate not supplied

Effect of hyperthyroidism on antral myoelectrical activity, gastric emptying and dyspepsia in man.

BACKGROUND/AIMS: The objective of the present study was to investigate the effect of hyperthyroidism on antral myoelectrical activity, gastric emptying and dyspepsia in man. METHODOLOGY: Twenty-three patients with manifest hyperthyroidism and dyspepsia confirmed by a standardized protocol were studied by electrogastrography (EGG). The following EGG parameters were determined: dominant frequency (DF cycles per minute (cpm), DF (%) in the normal range (2-4 cpm)), bradygastria (< 2 cpm), tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and postprandial to fasting power ratio. Data were correlated to results obtained in 18 age- and gender-matched controls. In 10 patients, a control measurement was performed after antithyroid therapy. In addition, in 15 consecutive patients, EGG data were compared to gastric emptying of radionuclides recorded simultaneously (gamma camera). RESULTS: Hyperthyroid patients revealed a significant increase in preprandial DF, and in pre- and post-prandial tachygastrias compared to controls (3.3 cpm vs 3.1 cpm; 8.8% vs 3.5%; 12.3% vs 3.5%; p < 0.05). After antithyroid therapy, postprandial tachygastrias were reduced significantly. About 50% of the patients exhibited delayed gastric emptying compared to previously evaluated normal values (t 60 nuclide retention: > 68%). However, these patients did not differ in tachygastria and the other EGG parameters from those with normal gastric emptying (p > 0.05). Both EGG and radioscintigraphy did not correlate significantly with dyspepsia. CONCLUSIONS: Dyspeptic patients with hyperthyroidism frequently display tachygastria and delayed gastric emptying. However, tachygastria has no important effect on gastric motor activity in hyperthyroidism.

Aged↗

PubMedDate not supplied

Gastric emptying and antral myoelectrical activity in chronic alcoholics with dyspepsia.

BACKGROUND/AIMS: Chronic alcoholism is known to effect gastric motor activity. An association between gastric motility disorders and abnormal myoelectrical activity has been observed in various gastrointestinal and extra-intestinal diseases. The aim of this study was to investigate the effect of chronic alcoholism on gastric emptying and antral myoelectrical activity. METHODOLOGY: Electrogastrography (EGG) was performed on 20 chronic alcoholics with chronic dyspepsia using a pair of electrodes sonographically placed on the skin overlying the gastric antrum. After an overnight fast, patients were tested over a period of one hour in the a) fasting and b) fed state, after ingestion of a 370 kcal liquid-solid test meal. The following EGG parameters were determined: dominant frequency (DF (cpm); DF (%) in the normal range (2-4 cpm); bradygastria (<2 cpm); tachygastria (4-10 cpm); dominant frequency instability coefficient (DFIC), and postprandial to fasting power ratio (PR). The data were correlated with results obtained from 20 controls matched for age and sex. In 18 alcoholics, the EGG data were compared to the percentage of radionuclides (liquid phase labeled with 99m Tc colloid) remaining in the stomach after 60 minutes (%) (gamma camera system). Moreover, for the alcoholics, various parameters such as ethanol consumption, and gastrointestinal symptoms were determined and related to EGG values and scintigraphy. RESULTS: About 50% of the alcoholics showed delayed gastric emptying compared to normal values previously reported (t 60 values: >68%). In opposite to scintigraphy, the alcoholics did not exhibit abnormalities in antral myoelectrical activity. They had significantly decreased bradygastria measures compared to controls (p<0.05). The scintigraphic t 60 values did not correlate either with EGG values or with dyspepsia and clinical parameters. EGG values did not correlate with dyspepsia. However, increased preprandial DF was significantly correlated with ethanol consumption. CONCLUSIONS: Chronic alcoholism induces a disturbance of gastric emptying, probably resulting from toxic damage of the gastrointestinal smooth muscles. Disturbances in antral myoelectrical activity were not found.

Adult↗