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Biomedical subjects

W Mall

Publications and source records attributed to W Mall.

At least 19 recordsLinked to original sources

Long-term survival of a patient with small-cell lung cancer (SCLC) following treatment with thalidomide and combination chemotherapy.

Thalidomide, an angiogenesis inhibitor is currently used in clinical trials in the US and Europe in combination with chemotherapy for the treatment of various solid tumors. The prognosis of patients suffering from small-cell lung cancer (SCLC) is poor. A 73-year-old female with extensive disease of SCLC was given six courses of chemotherapy with adriamycine, cyclophasphamide and oncovine, which led to complete remission of the disease. Following written informed consent, the patient has been treated with thalidomide 200 mg orally on a daily basis for 2 years and 5 months. There has been no sign of tumor recurrence during the follow-up. This case underlines the possible role of additional treatment with angiogenesis inhibitors in combination with traditional chemotherapy in the therapy of SCLC. Although there is no proof that thalidomide contributed to this good outcome and no conclusions can be drawn from this treatment in a single patient, further studies may determine the role of thalidomide as an adjuvant antiangiogenic agent in the therapy of SCLC.

Aged↗

Pulmonary metastasis from a basal-cell carcinoma of the retroauricular region.

Basal-cell carcinoma of the skin is a common facial neoplasm, usually regarded as benign. It is also called basalioma. Distant metastasis is very rare and may involve the brain, lung, and bones. We report a 74-year-old white male who was admitted to our hospital with cough and fever. Chest radiograph revealed an opacity of 2 x 1 cm in diameter in the upper lobe of the right lung. Bronchoscopy and thoracic fine-needle aspiration could not establish a diagnosis. Therefore the patient underwent right thoracotomy and wedge excision of the lesion. Histologic evaluation was consistent with pulmonary metastasis of a facial basal-cell carcinoma. The patient recovered uneventfully from surgery and is well 5 years after the operation. According to the English literature the median survival of patients with metastatic basal-cell carcinoma is 10 months. The clinical features, pathology, and treatment of this rare entity are discussed.

Aged↗

[Current status and analysis of diagnostic and therapeutic guidelines in the area of chronic obstructive respiratory tract diseases in adulthood].

UNLABELLED: GOAL OF THE INVESTIGATION: It was investigated (1) whether guidelines for the treatment of bronchial asthma and chronic obstructive pulmonary diseases (chronic obstructive bronchitis and lung emphysema) are distributed in Germany, (2) whether they are accepted by general practitioners and physicians for internal medicine without subspecialty, and (3) how much they are used. METHODS: (1) The mostly read medical journals have been screened. (2) 1200 physicians have been questioned with regard to the main criteria of these guidelines. (3) 600 physicians were asked to write a documentation for two patients each with bronchial asthma and chronic obstructive pulmonary disease. 344 of the questionnaires (28.7%) and 544 of the documentations could be analyzed (22.7%). RESULTS: Guidelines for the treatment of bronchial asthma are published in all leading journals. Substantially less references were found for the therapy of chronic obstructive bronchitis. The main concepts of training, diagnosis of the disease's severity, and physical therapy are all known by the practitioners. The training plays a sufficient role in only half of the questioned physicians. The self-measurement of the patient is not every where accepted. The treatment according to a stage by stage pharmacological therapy cannot be seen in one third of the questioned physicians. CONCLUSIONS: Differential diagnosis and therapy are not sufficiently emphasized in the current guidelines. Practitioners should participate in the development of guidelines, to include the aspects of realization.

Adult↗

[Abnormalities of the lung].

Inborn abnormalities of the lung are rarely seen by clinicians. This paper reports about the cases obeyed within a ten-years-space in a lung-clinic. Symptoms, diagnostic procedure, and treatment are described.

Adolescent↗

[Reliability of the Child Behavior Checklist in a population of 6 to 8-year-old special education students].

66 children attending first grade at a special school for educationally subnormal children were examined medically and psychologically. Classification was done according to ICD-10. In addition, the parents were asked to rate their children's behavior with the "Child Behavior Checklist" by Achenbach and Edelbrock. The most common symptoms rated in this group of 6- to 8-year-old children were lack of concentration, speech and language problems, hyperactivity, demand for attention and arguing. The mean total score (cut-off score: 30) and the number of crucial items (cut-off score: at least two crucial items) differed significantly between the children with and those without psychiatric disorders. No significant correlation was found between the mean total score or the number of crucial items and the sex of the children or the other axes of the Multi-axial Classification of Child Psychiatric Disorders.

Affective Symptoms↗

[Multiple diagnoses and stresses in children of primary school age].

The study was conducted to assess the consequences of multiple diagnoses and handicaps in children aged 6 to 8 years. Children were considered to be "multiply handicapped" if they suffered from two or more disorders or impairments included in the Multi-axial Classification Scheme. To this end children in special schools were compared with a random sample of children from three communities in Bavaria. As expected, all prevalences found in the population of children from special schools were substantially higher than those found in the random sample. Furthermore, the proportion of children with multiple handicaps in the special schools far exceeded what one would have expected based on the findings for the random sample. Most of the disturbances did not differ in respect to their comorbidity. But the mentally retarded children in the special schools were all "multiply handicapped". The importance of "multiple handicaps" for the assignment to special schools is discussed, as are the implications for the planning of services.

Child↗

[Thoracoscopic pericardial fenestration--diagnostic and therapeutic aspects].

This article reports on four tumour patients with extensive, but cytologically innocuous pericardial effusion. In three cases, a tumour-cell-negative pleural effusion, on the left, was also present. Thoracoscopy showed that the pleura were unremarkable, whereupon, with the aid of the biopsy forceps--in one case the Nd:YAG laser--the pericardium was opened. The procedure provided diagnostically high-yielding material; in addition, pericardial tamponade was "permanently" eliminated (period of observation up to 4 years). This shows that, in addition to its diagnostic value, thoracoscopic pericardial fenestration also can be therapeutic. It represents an alternative to the surgical approach.

Humans↗

[Adjuvant therapy of non-small cell bronchial cancer with mopidamol].

Between January 1982 and April 1986 a double-blind randomized placebo controlled study of mopidamol, employed as adjunct therapy to surgery in patients with non-small cell bronchial carcinoma, was performed at 7 hospitals. The main criteria were occurrence of metastases and survival. Mopidamol was given perioperatively at a dose of 2 x mg i.v. daily, and postoperatively orally at a dose of 3 x 500 mg daily. The treatment period was scheduled to at least 2 years and in some of the patients was prolonged to 3 years. The standard therapy of each individual center was given as basic therapy. A total of 270 patients were included in the study, 147 in the placebo and 123 in the mopidamol group. By the end of the study 52 deaths from metastases had occurred in the placebo group (35%) compared with only 32 (26%) in the mopidamol group. This difference is statistically significant at p less than 0.05 with the one-sided test. A comparison of life-tables according to Kaplan-Meier shows a statistically significant difference in favour of the group treated with mopidamol (savage p less than 0.05). Cox's multivariate analysis confirmed the statistically significant difference in favour of the group treated with mopidamol, the inclusion of the risk factors tumour stage and histology in the evaluation results in a p-value of 0.02. With respect to the incidence of metastases there were no appreciable differences between the treatment groups. The incidence of side effects or undesired events was equal in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Castleman's lymphoma (author's transl)].

Intrathoracic angiofollicular lymph node hyperplasia (Castleman's lymphoma) was found in a 32-year-old woman. The diagnosis could be established already preoperatively by endoscopic biopsy. It was a coincidental discovery as there were no clinical symptoms. Histologically the tumour was of the hyaline-vascular type. After uncomplicated surgical removal follow-up at 6 weeks was unremarkable. Aetiology and pathology of this rare disease are unknown.

Adult↗

Transbronchoscopic lung biopsy in sarcoidosis.

In a prospective study in our department, 63 consecutive patients with suspected sarcoidosis underwent combined bronchial and transbronchial biopsy during bronchoscopy with rigid instruments under general anaesthesia. Lung tissue was obtained in all cases. In 19 cases noncaseous granulomas were found only by transbronchial lung biopsy. In 9 cases they were found only by bronchial biopsy. In 30 patients noncaseating granulomas were found by both technics, that is, the lesions were found in both lung parenchyma and bronchial wall. In 5 patients, diagnosis of sarcoidosis could not be confirmed by bronchological methods, but was obtained by other biopsy procedures. From our findings, we conclude that the combination of bronchial and transbronchial biopsies during bronchoscopy with rigid instruments is a valuable procedure for establishing the diagnosis of sarcoidosis and that the bronchological methods could replace mediastinoscopy in most cases of sarcoidosis.

Bronchi↗

[Tracheobronchopathia osteochondroplastica--a rare condition in lower respiratory tract (author's transl)].

In a 55 years old male patient bronchoscopy was carried out because of suspected bronchial carcinoma. Chest X-ray showed a lesion in the periphery of left lung, an episode of hemoptysis was reported 4 weeks prior to the examination. During bronchoscopy we found numerous small tumours on the mucosa of distal trachea and left main bronchus. The findings suggested a widespread malignant process, whereas histological examination of biopsies showed tracheobronchopathia osteochondroplastica. In the case described we could not find amyloidosis of tracheal wall or disorders in somatotropine secretion. Pathogenesis and clinical features of the disease, which is in a high percentage detected by chance or post mortem, are discussed.

Bronchial Diseases↗

Chondrosarcoma of the pulmonary artery.

Primary sarcomas of the large vessels are rare. They are observed most commonly in the pulmonary artery. Up to now 28 cases of primary sarcoma of the pulmonary artery have been described in the literature. The clinical features of this disease which presents considerable diagnostic difficulties are dominated by signs of cor pulmonale. In the present paper a primary chondrosarcoma of the pulmonary artery is presented.

Adult↗