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Biomedical subjects

P Jipp

Publications and source records attributed to P Jipp.

At least 19 recordsLinked to original sources
PubMed2000

[Risk factors for the development of vision disorders in polymyalgia rheumatica with giant cell arteritis].

BACKGROUND AND OBJECTIVE: Visual disorders, even blindness, are serious complications of polymyalgia rheumatica (PMR) associated with temporal arteritis. Their early recognition in patients at high risk is essential to avoid the development of such visual disorders. It was the aim of this study to identify these risk factors. PATIENTS AND METHODS: Clinical and laboratory data and biopsy findings in 131 patients (94 women, 37 men; mean age 74 years) with PMR and concomitant temporal arteritis were analysed retrospectively. RESULTS: Visual disorders occurred in 61 of the 131 patients. Temporal artery biopsy was not sufficient to detect those at high risk. But this was possible by identifying a typical clinical pattern in that most patients with visual disorders had severe cerebral symptoms, while they had only minor forms of PMR and few generalized symptoms. There was no correlation between any of the laboratory tests and high risk. CONCLUSIONS: A typical pattern of clinical manifestations can provide early identification of those patients who have PMR associated with temporal arteritis and are at high risk of developing visual disorders.

Aged↗
PubMed1999

[The rare differential diagnosis of a mediastinal space-occupying lesion].

HISTORY AND CLINICAL FINDINGS: Two months before admission a 31-year-old man first noted a painless swelling on the right side of his neck without any associated symptoms. Physical examination revealed a painless right cervical node 4 cm in diameter. INVESTIGATIONS: Magnetic resonance imaging demonstrated a large right-sided cervical tumour which extended into a mediastinal mass 11 cm in diameter. The excised cervical node showed a Hodgkin's lymphoma. Further tests to stage the disease revealed a 1.5 cm tumour in the right testis. Removal of the latter showed a mixed testicular tumour. Mediastinoscopic biopsy confirmed Hodgkin's lymphoma of the mediastinal mass. TREATMENT AND COURSE: Standard chemotherapy of the Hodgkin's lymphoma was undertaken, followed by "extended field" radiation which has so far secured a remission of two years. CONCLUSION: Histological diagnosis is always essential in the case of an unusual tumour location so that a synchronous second tumour may be revealed. If there is a second tumour, exact histological classification with definitive staging of the tumours is necessary to ensure adequate treatment.

Adult↗
PubMed1997

[The synchronous occurrence of acute myeloid leukemia and kidney carcinoma].

HISTORY AND CLINICAL FINDINGS: During the past year a 52-year-old man had developed quarterly bouts of fever, up to 38.5 degrees C, associated with fatigue and arthralgia. The fourth bout continued as undulating periods of fever with markedly impaired general state. Physical examination was unremarkable except for mild generalised lymphadenopathy. INVESTIGATIONS: Extensive imaging and serological studies failed to find an infectious or autoimmunological cause. But computed tomography and angiography revealed a space-occupying lesion in the left kidney, yet the suspected diagnosis of renal carcinoma insufficiently explained the clinical picture. DIAGNOSIS TREATMENT AND COURSE: Haematological tests having shown anaemia (Hb 8.1 g/dl) and blast cells (10%) in the peripheral blood a bone marrow biopsy was performed which indicated acute myeloid leukaemia. Three courses of intensive chemotherapy brought about only partial remission and the patient died 6 months later from a cerebral haemorrhage. An autopsy confirmed both the acute myeloid leukaemia and a renal carcinoma. CONCLUSION: The possibility of synchronous occurrence of two malignancies should always be kept in mind especially if the initially diagnosed tumor cannot explain the clinical symptoms.

Acute Disease↗
PubMed1997

Successful treatment of stage-IIIB seminoma with single-agent carboplatin therapy.

Single-agent carboplatin chemotherapy has recently been introduced into the therapy of limited seminoma. Because of poor compliance due to Down's syndrome we successfully treated a 32-year-old man with relapsed stage-IIIB seminoma with a dose-modified carboplatin monotherapy schedule leading to complete remission even after a follow-up of 4 years.

Adult↗
PubMed1996

Acquired C 1-inhibitor deficiency with angioedema due to pleomorphic immunocytoma in a patient with three malignant tumors: long-term follow-up data and presentation of an additional case.

Two cases of lymphoma-associated acquired C 1-inhibitor deficiency are described. In both patients, C 1-inhibitor deficiency and related symptoms preceded the diagnosis of the underlying neoplasm by several months. C 1-inhibitor deficiency was most likely due to consumption following immunocomplex formation. In both patients, a close relationship between low levels of C 1-inhibitor and tumor relapse was observed during follow-up. These findings indicate that measurement of C 1-inhibitor and complement factor C4 can be used as markers of disease activity in affected patients.

Angioedema↗
PubMed1996

Color-coded Doppler sonography in the diagnosis of abdominal masses.

A man in his forties was operated on for testicular cancer on the right-side with subsequent radiotherapy. Two years later, another tumor was found on the opposite side and surgically removed, followed by polychemotherapy. In the follow-up period, CT scanning and ultrasound showed large abdominal masses which were suspected to be metastases. Before initiating four cycles of chemotherapy, we checked their nature by Doppler sonography and found them to be recently developed abdominal varices due to an alcoholic liver cirrhosis. We were able to demonstrate that Doppler sonography can provide further information and is easy to use.

Abdomen↗
PubMed1995

Successful interferon-alpha 2 a therapy for a patient with acute mumps orchitis.

Involvement of one or both gonads in postpuberty mumps is common and can often lead to infertility. Our report discusses the course of disease of a patient with acute mumps orchitis. Only 2 days after administration of interferon, clinical symptoms had drastically improved, and the infection subsided without any after-effects. We therefore recommend immediate interferon therapy, as soon as postpuberty mumps manifests, to prevent testicular atrophy and resulting infertility.

Acute Disease↗
PubMed1994

Role of human chorionic gonadotropin in patients with pure seminoma.

Human chorionic gonadotropin (beta-hCG) and alpha-fetoprotein (AFP) are widely established specific and sensitive tumor markers for nonseminomatous testicular cancer. In 106 patients with pure seminoma, a highly sensitive method detected beta-hCG both before and repeatedly during therapy. The low detection limit of the test (0.3 IU/l) coincided with the 95 percentile of a group of 60 healthy blood donors. Its 100 percentile of < 1.0 IU/l was applied as the upper limit of the normal range. In 30.2% of our patients with pure seminoma, elevated beta-hCG levels were noted prior to orchiectomy. The levels returned to normal in 76% of these patients thereafter, and in 34% after additional irradiation or chemotherapy. During an observation period of 2-84 months, all beta-hCG-positive patients were in complete remission. Prior to semicastration, 1 patient showed extremely high beta-hCG levels, while in another patient, beta-hCG and AFP were elevated simultaneously. In both cases, tumor marker levels did not seem to agree with the histology of 'pure seminoma' and rather suggested the presence of nonseminomatous tumor cells. Increased AFP levels contradict the presence of a pure seminoma and indicate a nonseminomatous testicular tumor. The same holds true for strongly elevated beta-hCG levels, whereas levels of up to 200 IU/l correlate with the diagnosis of pure seminoma.

Adult↗
PubMed1993

Intra- and perivesical tumor growth in preoperative staging of bladder cancer: the role of transrectal ultrasonography and high resolution magnetic resonance imaging.

Bladder tumors were staged preoperatively before and/or after M-VEC poly-chemotherapy using transrectal ultrasonography and magnetic resonance imaging in 46 patients. The resultant findings were each compared with histomorphologic results. The sensitivity of both methods compared with pathohistology was 88%. Using this technique, the degree of tumor invasion of the bladder wall could be evaluated and the appropriate therapy selected. Further applications included the monitoring of transurethral resection determine its adequacy as a treatment modality.

Adenocarcinoma↗
PubMed1992

[Herpes simplex-associated exacerbation of Crohn's disease. Successful treatment with acyclovir].

Seven years ago, a now 25-year-old man was found to have Crohn's disease of the terminal ileum as well as of the transverse and sigmoid colon. Despite treatment with both corticosteroids and mesalazine the disease progressed and led to almost complete stenosis of the lumen of the sigmoid colon so that surgical intervention was planned. But because immunohistological examination of the small and large intestinal mucosa had demonstrated herpes simplex virus (HSV I + II) DNA, additional treatment with acyclovir appeared worth-while. The morphological and clinical findings indeed changed decisively, obviating surgery. If a virus infection is found to be a pathogenetic co-factor in a case of Crohn's disease, a therapeutic trial with a suitable antiviral agent seems reasonable.

Acyclovir↗
PubMed1990

Rectal pseudotumor due to Chlamydia trachomatis in a male homosexual.

Chlamydia trachomatis causes a wide spectrum of human genital infections including lymphogranuloma venereum. We describe an unusual case of Chlamydia trachomatis proctitis in a homosexual man presenting with a large, solid tumor in the distal rectum, which was treated successfully by long-term oral doxycycline therapy.

Adult↗
PubMed1989

[Polychemotherapy using the M-VEC protocol (methotrexate, vinblastine, epirubicin, cisplatin) in advanced urinary bladder cancer--effectiveness and toxicity].

We report on preliminary experience with a modified M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) regimen in which adriamycin was replaced by the less toxic 4-epirubicin at equal doses (M-VEC). This study includes 58 patients suffering from advanced bladder cancer, with a minimum observation time of 12 months; each patient received at least two courses of M-VEC (mean follow-up 22 months, average 3.9 cycles). Most (22; 37.9%) of the tumors were T3-4 NO MO; 20 (34.4%) were T3-4 N1-2 MO; and 16 (27.7%) were T3-4 NO-2 M1. Microscopically, 52 (89.6%) were pure transitional cell carcinoma, 5 were (8.6%) squamous cell/carcinomatous transformation; 1 (1.8%) sarcoma was found. Chemotherapy was given as palliative treatment in 34 (58.6%) patients, as neo-adjuvant therapy in 19 (32.8%) cases and as adjuvant therapy in 5 (8.6%) patients. The overall response rate was 72.3% (CR = 51.7%), with a mean duration of response of 18+ months. The disease-free survival so far amounts to 24/58 (41.4%). Squamous cell carcinoma does not respond to M-VEC. Locally advanced bladder cancer (T3-4 NO-2 MO) responds significantly better than metastatic (M1) disease (78.5% vs 56.2%), resulting in an increased survival rate (57% versus 12.5%) after 22 months. The toxicity of M-VEC is considerably lower than has been reported for other regimens (M-VAC, CMV, CM). The toxic effects included mucositis (3%), nadir sepsis (2.4%) and drug-related death (2.4%).

Aged↗
PubMed1988

[Successful antibiotic treatment of a pulmonary infection with Nocardia asteroides (biovariety A3)].

An open lung biopsy in a 67-year-old man revealed nocardiosis as the cause of a treatment-resistant pulmonary infection. His resistance had been weakened by a non-Hodgkin lymphoma, polychemotherapy and long-term steroid medication. The nocardiosis was cured by a 26-day high-dosage regimen of imipenem and amikacin in combination. A six-month period of co-trimoxazole followed to ensure treatment success. Nocardia asteroides (biovariety A3) was found to be the causative organism, the second time that this has been described as cause of a human infection.

Aged↗
PubMed1986

[Immunocytoma with acquired C1-esterase inhibitor deficiency and recurrent angioneurotic edema].

Four attacks of mucosal angioneurotic oedema occurred in a 57-year-old woman, requiring tracheotomy for one episode. Decreased or non-measurable levels of complement components C1q, C-1-INH and C4 pointed to a complement consumption. The basic disease was a pleomorphic immunocytoma with the production of monoclonal IgM. Treatment with danazol, 600 mg daily, raised the serum level of C-1-INH, but not of C4.

Angioedema↗