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Biomedical subjects

W Püschel

Publications and source records attributed to W Püschel.

At least 19 recordsLinked to original sources
PubMed2005

Development of ulcerative colitis after heart transplantation during immunosuppressive therapy.

BACKGROUND: Cardiac transplantation has become an accepted treatment modality for end-stage heart failure. Immunosuppressive agents, which are used after transplantation, are considered as therapeutic options for inflammatory bowel disease. CASE REPORT: We report on a 53-year-old patient who was treated for 2 years with cyclosporine A, azathioprine and prednisolone after heart transplantation. He developed a distal colitis with all features of ulcerative colitis. An infectious or ischemic etiology was carefully excluded. In spite of high-dose treatment with prednisolone the patient's abdominal symptoms worsened and he developed a progression of the inflammation in the entire colon and a colectomy with ileostomy was necessary. The histology was consistent with ulcerative colitis. After colectomy he recovered and remained in a good state of health. CONCLUSIONS: This report supports the concept that new onset inflammatory bowel disease can develop in a heart transplantation recipient in spite of immunosuppression.

Biopsy↗
PubMed2001

Intra-abdominal tuberculous peritonitis.

We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies.

Abdominal Abscess↗
PubMed2001

Localized lymphadenopathy due to leishmanial infection.

A 25-year-old female patient presented with an isolated cervical lymph node enlargement several months after having returned from Spain and Latin America. She had no other signs or symptoms of disease. Leishmania infantum/chagasi was identified as the causative agent. With extended travel activities localized lymph node enlargement due to leishmanial infection should be included in the differential diagnosis of lymphadenopathy of unknown origin.

Adult↗
PubMed1999

High rates of appendicectomy in a developing country: an attempt to contribute to a more rational use of surgical resources.

OBJECTIVE: In view of the high appendicectomy rate in a university teaching hospital in a developing country, we investigated the regional epidemiology of appendicitis. DESIGN: Prospective clinical and pathological study. SETTING: Teaching hospital, Madagascar. SUBJECTS: 165 patients who underwent appendicectomy during a two month period. INTERVENTIONS: Clinical investigation and histopathological examination of removed appendixes. MAIN OUTCOME MEASURES: Appendicitis score, local incidence of appendicectomy, appendicitis, perforation, and negative appendicectomy. RESULTS: There was a high incidence of primary appendicectomy (51.1/10,000 population/year) in relation to the incidence of histologically confirmed appendicitis (7.7/10,000), resulting in a negative appendicectomy rate of 85% (43/10,000). There were considerable sex related differences in the incidence of primary appendicectomy (81/10,000 women/year; 22/10,000 men), appendicectomy for appendicitis (12/10,000 women/year; 4/10,000 men) and non-perforating appendicitis (8/10,000 women/year; 2/10,000 men), but much less in that of perforating appendicitis (4/10,000 women/year; 2/10,000 men). CONCLUSION: There is potential for more economic use of medical resources by reducing the rate of negative appendicectomy. The incidence of non-perforating appendicitis depends on the number of appendicectomies done, which may explain the differences observed in the incidence of appendicitis between industrialised and developing countries.

Appendectomy↗
PubMed1999

[Implantation metastasis at the exit site after percutaneous endoscopic gastrostomy in esophageal carcinoma].

In patients with esophageal cancer causing obstruction percutaneous endoscopic gastrostomy (PEG) is a well-established procedure with a low complication rate to provide sufficient enteral nutrition. We report on a 68-year-old patient suffering from inoperable squamous cell cancer of the proximal esophagus, who underwent PEG insertion prior to a combined radiochemotherapy. Initially bougienage was performed because of subtotal esophageal stenosis. Four months later a metastasis was found at the PEG exit site with involvement of the gastric wall, most likely caused by spread of tumor cells during insertion of the PEG.

Aged↗
PubMed1998

Early-lethal pulmonary form of Niemann-Pick type C disease belonging to a second, rare genetic complementation group.

UNLABELLED: An infant with an unusual clinical presentation and course of Niemann-Pick disease type C (NPC) is described. The baby presented with severe pulmonary involvement and hepatosplenomegaly at the age of 3 months and died of respiratory failure at the age of 7 months. Cell hybridization studies revealed that the infant belonged to the rare genetic complementation group 2. To our knowledge, this is the third reported case with early-lethal pulmonary involvement in NPC. All three reported patients belong to the minor complementation group 2. An elder brother of the present case had also died at 6 weeks of age from NPC with severe pulmonary involvement. The two complementation groups cannot be distinguished from each other by clinical, cellular and biochemical criteria except for severe pulmonary involvement which may be characteristic of the second group. CONCLUSION: NPC may present in early infancy with severe pulmonary involvement mimicking interstitial pneumonia. Such manifestation may be characteristic of the rare genetic complementation group 2.

Biopsy, Needle↗
PubMed1998

[Diclofenac-associated acute cholestatis hepatitis].

Diclofenac is an anti-inflammatory analgesic which is widely used in the therapy of inflammatory joint pain. Diclofenac hepatotoxicity ranges from asymptomatic elevation of transaminase activity to significant liver disease. 31 cases of diclofenac-induced hepatitis with five associated deaths have been already reported in the English, French and Spanish literature. We report the case of a 64-year-old patient who was admitted to the hospital with an icteric hepatitis of sudden onset. The only drug that was taken before admission was diclofenac in a daily dose of 150-200 mg because of a spondylodiscitis. Work-up of the patient included ERCP, laparoscopy and liver biopsy and excluded other reasons of a cholestatic hepatitis. Discontinuation of diclofenac resulted in normalization of transaminase activity and bilirubin concentration within four months. The frequent use of diclofenac and the possibility of fatal liver damage highlights the need that diclofenac-toxicity should be considered in the differential diagnosis of acute cholestatic hepatitis.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1997

Cystadenoma of the parotid gland with unusual prominent lymphoid stroma.

A rare variant of the cystadenoma of salivary gland origin is presented, which occurred in the parotid of a 36-year-old, otherwise healthy female patient. The tumour showed a dense follicle-containing lymphoid stroma, resembling papillary cystadenoma lymphomatosum (Warthin's tumour). In contrast to that, the epithelial lining gave a more irregular impression and oncocytic metaplasia were completely absent. Light microscopic and immunohistochemical features of the tumour are described and compared with those of classical cystadenoma and papillary cystadenoma lymphomatosum (Warthin's tumour). Other relevant multicystic epithelial parotid lesions, which are commonly associated with a prominent lymphoid component are discussed.

Actins↗
PubMed1996

Investigations of breast tumors with fluorine-18-fluorodeoxyglucose and SPECT.

METHODS: We designed a prospective study to investigate the feasibility of combined FDG-SPECT and whole-body acquisition in the diagnostic work-up of breast tumors applying visual analysis. We studied 50 patients with breast tumors of unknown histology. RESULTS: All malignant diseases were accurately detected in tumors > 2.3 cm, while the smallest FDG-positive lesion was 1.4 cm. In a subgroup of these patients, quantitative evaluation (tumor-to-back-group ratios) was added, which improved the sensitivity. Lymph node metastases were accurately indicated in 9 of 13 patients, while the detection of distant metastases depended on the location and size. False-positive FDG scans were observed in inflamed tissue, in a rapidly growing phylloides tumor and in supposedly healthy breasts. CONCLUSION: These results are comparable with prior investigations of other groups using PET. Therefore, FDG-SPECT and whole-body acquisition may be an adequate and less expensive technique to meet the increasing demand of FDG examinations.

Breast Neoplasms↗
PubMed1994

[Intraosseous lipoma of the calcaneus].

This report presents one case of rare benign intraosseus lipoma of the os calcis, which is analysed under the clinical, histopathologic and radiologic view. Not only the radiographic but also the computed tomographic findings has shown a typical picture of an intraosseous lipoma including a central calcification. In order to exclude a malignant transformation and as a prophylaxis of a pathological fracture the operative removal and bone graft transplantation is considered as therapy of choice.

Bone Neoplasms↗
PubMed1991

Segmental renal hypoplasia of vascular origin causing renal hypertension in a 3-year-old girl.

A rare case of renal hypertension in a 3-year-old girl caused by segmental renal hypoplasia of vascular origin is presented. Resection of the hypoplastic segment of the kidney permitted successful treatment of the high blood pressure with preservation of renal function. Elevated plasma renin activity in the renal vein of the affected side and biochemical investigations demonstrated that the resected segment of the renal cortex was the source of the renin leading to hypertension by activation of the renin-angiotensin-aldosterone system.

Child, Preschool↗
PubMed1991

[Immunohistologic investigations of paraffin-embedded lymph nodes after bone marrow transplantation in autopsy samples].

A histological and immunohistochemical analysis of paraffin-embedded lymph nodes from 31 autopsies after bone marrow transplantation (BMT) was performed (20 allogeneic, 10 autologous, 1 syngeneic). Monoclonal antibodies against CD 45RB, CD 20, CD 21, CD 35. CD 43, CD 45RO, CD 76 and Ki-B3, and antisera for detection of S 100-protein and immunoglobulin isotypes were used. None of the lymph nodes showed a regular reconstitution. The lymphoid cells, scattered in a diffuse pattern, were mainly CD 43-positive. Most of them also expressed the CD 45RO antigen. CD 20- and Ki-B3 positive lymphoid cells were nearly absent within the first 100 days after BMT. After that time B cell follicles were detectable in a few cases. Surprisingly, in nearly all cases with infectious complications, numerous plasma cells could be found. The origin of this plasma cells is discussed.

Antibodies, Monoclonal↗
PubMed1991

[Erdheim-Chester disease].

Erdheim-Chester disease (ECD) is characterized by lipid granuloma in the long tubular bones, which leads to pathognomonic symmetrical sclerosis of their metaphyses and diaphyses. Lipid granuloma may also be present in numerous other mesenchymal tissues, especially lung, orbit and retroperitoneal space. The clinical course and prognosis of the disease depend on these lesions. Reviewing 30 cases published since 1931 and a personal case with S100 positive cells, we present the typical radiological and clinical findings. There is striking resemblance to chronic disseminated histiocytosis X.

Bone Diseases↗
PubMed1991

[Diagnosis and problems in follow-up of tumors with psammoma bodies].

Psammombodies are dystrophic calcifications with high density in CT being helpful to detect even small metastases. Examination should be done without oral administration of iodine to prevent mimicking metastases in contrasted bowel loops. In 3 cases with seropapillary carcinoma radiologic findings including scintigraphy and problems of diagnosis and follow-up are discussed.

Adult↗