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Biomedical subjects

J Hoff

Publications and source records attributed to J Hoff.

At least 19 recordsLinked to original sources

Hypercalcemia and breast cancer related to parathormone-like secretion by liver metastases.

A premenopausal woman developed hypercalcemia 30 months after treatment for infiltrating breast cancer. After bone metastases had been excluded, primary hyperparathyroidism was suspected. A parathyroid adenoma was removed and histologically confirmed. Hypercalcemia, associated with low plasma phosphate and severely depressed plasma parathormone (PTH) levels, persisted. Further investigations showed liver metastases from the primary breast cancer and also secretion of a PTH-like substance. Antitumoral treatment was effective on the liver metastases and also normalized calcemia and the PTH-like substance, demonstrating the existence of a paraneoplastic syndrome related to the secretion of a PTH-like substance by disseminated liver metastases of primary breast cancer.

Breast Neoplasms

[Malignant hypercalcemia after treatment of breast cancer].

A premenopausal woman developed hypercalcemia 30 months after treatment for infiltrating breast cancer. After bone metastases had been excluded, primary hyper parathyroidism was suspected. A parathyroid adenoma was removed and histologically confirmed. Hypercalcemia persisted, associated with low plasma phosphate and severely depressed plasma parathormone (PTH) levels. Further investigations showed liver metastases from the primary breast cancer and also secretion of a PTH-like substance. Anti-tumoral treatment was effective on the liver metastases and also normalized calcemia and the PTH-like substance, demonstrating the existence of a paraneoplastic syndrome related to the secretion of a PTH-like substance by disseminated liver metastases of primary breast cancer.

Breast Neoplasms

Prognostic value of intravenous dipyridamole thallium imaging in patients with diabetes mellitus considered for renal transplantation.

Patients with diabetes and end-stage renal failure are known to have a high risk for cardiac morbidity and mortality associated with renal transplantation. The most efficient method to determine preoperative cardiac risk has not been established. To determine the effectiveness of intravenous dipyridamole thallium imaging in predicting cardiac events, 40 diabetic renal transplant candidates were studied preoperatively in a prospective trial. The study group consisted of 40 patients whose average age was 42 years (range 27 to 64); 34 (85%) were hypertensive and 21 (53%) were cigarette smokers. Cardiac history included chest pain in 6 patients and prior myocardial infarction in 3 patients. Dipyridamole thallium imaging showed reversible defects in 9 patients, fixed defects in 8 patients and normal scans in 23 patients. Dipyridamole thallium imaging was performed using 0.56 mg/kg of dipyridamole infused intravenously over 4 minutes. Cardiac events occurred only in patients with reversible thallium defects, of which there were 6. Of these 6 patients, 3 had cardiac events before transplantation and 3 had them in the early postoperative phase (within 6 weeks of surgery). Of 21 patients who underwent renal transplantation, 3 had cardiac events within 6 weeks of transplantation. The average duration of follow-up was 11 months (range 1 to 21). Thus, dipyridamole thallium imaging is an effective method of identifying renal transplant candidates likely to develop cardiac complications. Routine coronary angiography may not be necessary to screen all renal transplant candidates for coronary artery disease before surgery.

Adult

Introital adenosis associated with the Stevens-Johnson syndrome.

A young woman presented with erosive lesions of the labia minora, which appeared 3 years ago after Stevens-Johnson syndrome. Pathological examination showed 'vulval adenosis'. A similar case has been previously reported. Vaporization by carbon-dioxide laser gave satisfactory results, and after 2 years the patient remains totally cured. We discuss several embryological theories which may explain the mechanism of the vulval adenosis in this patient.

Adult

Hemodynamic effects of esmolol, an ultrashort-acting beta blocker.

The hemodynamic effects of esmolol were evaluated in 12 male patients at rest (mean age, 51 +/- 10 years) undergoing routine cardiac catheterization. Hemodynamic measurements were obtained during baseline (prior to esmolol), at steady state (during an intravenous infusion of esmolol 300 micrograms/kg/min), and at 30 minutes after stopping esmolol (postinfusion). Esmolol produced hemodynamic effects similar to the effects of other beta blockers. Significant reductions in rate-pressure product (mean decrease, 15%), cardiac index (mean decrease, 17%), stroke volume index (mean decrease, 13%), left ventricular stroke work index (mean decrease, 20%), and left ventricular ejection fraction (mean decrease, 18%) were observed. In contrast to other beta blockers, all hemodynamic effects of esmolol had returned to baseline values within 30 minutes after the infusion stopped. One patient exhibited hypotension during the esmolol infusion; this episode resolved without sequelae after discontinuation of esmolol. In summary, the effects of esmolol at rest on hemodynamic parameters and left ventricular function are similar to other beta-adrenergic blocking agents. Due to its ultrashort half-life, esmolol can be administered safely in critically ill patients whose disease status makes treatment with currently available beta blockers risky.

Adrenergic beta-Antagonists

Long-term therapy with disopyramide phosphate: side effects and effectiveness.

In this study, the safety and efficacy of long-term therapy with disopyramide phosphate were evaluated in 40 patients with documented, recurrent, symptomatic tachyarrhythmias. Twenty-one (53%) of the patients had organic heart disease, and nine of these patients had compensated congestive heart failure. The tachyarrhythmias which were treated were paroxysmal supraventricular tachycardia (21 patients), paroxysmal atrial fibrillation (six patients), and paroxysmal ventricular tachycardia (13 patients). In each patient there was evidence, from continuous ECG monitoring or electrophysiologic testing, that disopyramide would be effective therapy, and each patient was able to tolerate disopyramide (no side effects or tolerable side effects) during an initial trial period of 1 to 2 weeks. Dosages of disopyramide were 400 to 1600 mg/day (994 +/- 320 mm/day). During long-term therapy, side effects were reported by 28 (70%) of the patients. The side effects were usually anticholinergic, and were usually a continuation of side effects noted during the initial trial period. None of the patients had idiosyncratic reactions to disopyramide. Most of the patients found side effects to be tolerable; however, in seven patients it was necessary to discontinue disopyramide after 1 to 8 (6 +/- 3) months. Actuarial incidence of intolerable side effects was 21 +/- 7% at 12 months. Nine (22%) of the 40 patients had symptomatic recurrences of tachyarrhythmia after 3 to 32 (15 +/- 9) months of therapy. Actuarial incidence of drug ineffectiveness was 32 +/- 10% at 24 months. Disopyramide was both effective and tolerated in 24 (60%) of the patients, who were followed for 2 to 64 (23 +/- 16) months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Living-related kidney donors: a multicenter study of donor education, socioeconomic adjustment, and rehabilitation.

To determine the consequences of living-related kidney donation, a study was conducted of 536 donors whose nephrectomies had been performed at nine geographically dispersed centers during the past 12 years. The data demonstrated that greater than 84.0% of the donors thought they had been adequately informed regarding all aspects of donation, and less than 15.0% reported being pressured in their decision. Only two serious medical complications were directly attributable to the surgery, greater than 92.0% of the donors believed their health had not been adversely affected by donation, and 96.8% reaffirmed their decision regardless of the graft's success or the financial distress they experienced (P greater than .05). However, greater than 14.0% experienced direct pressure, particularly not to donate. Donation also appeared to stress previously troubled marriages, especially among donors without a religious affiliation, who were pressured to donate by their families, or who borrowed from family members (P less than .05). Substantial unreimbursed expenses (greater than or equal to $1,000) were incurred by 43 donors, and 23.2% of all donors reported that donation caused a financial hardship.

Adolescent

[Ultrastructural morphometric changes in spiral ganglion cells of the rat after broad band noise (author's transl)].

The comparison of ultrastructural and ultrastructural-morphometric findings in spiral ganglion cells subsequent to broad noise with 105 dB SPL over a period of 40 min demonstrates that there are morphometric changes of the cytoarchitecture of granular ganglion cells even without evident ultrastructural changes. Morphometric analyses shows a significant extension of the volume proportion of mitochondria per unit volume cytoplasm. The volume and the surface of the rough endoplasmic reticulum, the volume of the free ribosomes and the average single volume of the nucleoli increase per granular ganglion cell. The physiologic significance of these changes is discussed. The results show that changes of the cytoarchitecture of granular spiral ganglion cells are earlier detected by morphometry than by ultrastructural description.

Acoustic Stimulation

[Recurrent infectious parotiditis in the child (author's transl)].

On the basis of 18 cases of recurrent parotiditis in the child, the authors offer the current review of this condition: clinical features, radiological features, bacteriological features, course. They emphasize the importance of precise technique during sialography, which must include straight and lateral films. The progress of this condition is characterised by recurrences. These may be avoided by prolonged and appropriate antibiotic therapy. The improvement which takes place at puberty is of etiopathogenic significance. Bucco-dental septis, constantly present, is one of the causes favourising infectious parotiditis in child.

Bacterial Infections