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Biomedical subjects

W Pohl

Publications and source records attributed to W Pohl.

At least 19 recordsLinked to original sources
PubMed1996

[A patient with idiopathic bronchiolitis obliterans with organizing pneumonia and idiopathic CD4+ T-lymphocytopenia].

Idiopathic bronchiolitis obliterans organizing pneumonia (idiopathic BOOP) and idiopathic CD4+ T lymphocytopenia are syndromes of unknown origins which have been characterized in recent years. An important feature of both syndromes is the good prognosis. The clinical and histological features of idiopathic BOOP are unspecific but characteristic, whereas the clinical features of idiopathic CD4+ T lymphocytopenia are not homogeneous. We present a report on the first patient in whom both syndromes were found simultaneously. Initially the chest x-ray showed bilateral patchy opacities and the peripheral blood showed a severe CD4+ T cell depletion. The diagnosis of BOOP was verified by open lung biopsy, which demonstrated the histological features of BOOP. No evidence was found of congenital or acquired reasons associated with CD4+ T cell depletion or with the histological features of BOOP, which implies the diagnosis of idiopathic CD4+ T lymphocytopenia and idiopathic BOOP. Within a follow-up period of 14 months the pulmonary opacities disappeared completely and the CD4+ T cells increased, but did not reach normal values.

Adult↗
PubMed1995

[Idiopathic CD4+ T-lymphocytopenia in 2 patients without indications for HIV infection].

We report on two patients with idiopathic CD4+ T cell depletion. A 26 year-old woman presented to us with acute respiratory failure requiring mechanical ventilation. Despite combined antibiotic therapy parenterally the opacities increased in the chest X-ray. An open lung biopsy was performed and led to the histological diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP). Respiratory function was improved impressively by high dose parenteral cortisone administration. This patient showed a general lymphocytopenia with severe CD4+ T cell depletion (60(37%)/mm3 blood). The CT4+ T cell concentration increased during a follow up period of 14 months, but did not reach normal values. The second patient was a 33 year-old homosexual. He was admitted with a mucocutaneous fungal infection which was successfully treated by antifungal drugs. This patient demonstrated a transient CD4+ T cell depletion (350(32%)/mm3 blood). In both patients HIV type 1 and 2 infections were excluded by antibody- and p 24-antigen testing, polymerase chain reaction and virus culture. CONCLUSION. Idiopathic CD4+ T lymphocytopenia differs from HIV infection in immunological profile, in the tendency to reversal of the CD4+ T cell depletion over time and in its better prognosis. It is unclear if this is a new syndrome and whether a transmissible agent, or possibly a genetically-determined reaction to noxious agents is responsible.

Adult↗
PubMed1993

[Serum magnesium, serum potassium and arrhythmia profile in patients with acute myocardial infarct].

In 176 patients with acute myocardial infarction (AMI) serum magnesium concentration (MGK) and serum potassium concentration (KK) were analysed during the first 48 hours after AMI. The patients rhythm was continuously recorded. In a subgroup of 70 patients a signal averaging-ECG was performed. 4.5% of the patients had a low, 55.7% a normal and 39.8% a high MGK. 14.8% of the patients had a low, 80.1% a normal and 5.1% a high KK. Ventricular arrhythmias > or = Lown IV b were found in 25% of the patients with low MGK, in 38.8% with normal and in 52.9% with high MGK. 50% of the patients with low, 62.2% with normal and 61.3% with high MGK had late potentials. There was no relation between hypomagnesemia and ventricular arrhythmias as between hypomagnesemia and late potentials. Thus, hypomagnesemia in AMI patients is rare and does not correlate with ventricular arrhythmia or delayed ventricular potentials.

Aged↗
PubMed1990

Urine excretion of inhaled technetium-99m-DTPA: an alternative method to assess lung epithelial transport.

Technetium-99m DTPA clearance (99mTc-DTPA) clearance measured by a gamma camera or a scintillation probe not only reflects epithelial transport, but is also influenced by an unknown amount of mucociliary clearance depending on particle size and aerosol deposition. This is confirmed by factor analysis of dynamic inhalation studies. Assessment of epithelial absorption by urinary excretion of inhaled 99mTc-DTPA is largely independent of aerosol lung deposition. Twenty-four-hour excretion reflects the amount of aerosol cleared by absorption, while two-hour excretion is a quantitative measure of the aerosol absorption rate from the epithelium into blood. Urinary 99mTc-DTPA excretion of two aerosols with different particle size correlated significantly (p less than 0.001) with analysis of lung clearance curves. A very similar regression in the form of a cumulative exponential function was found with both aerosols. Two-hour urine values of nonsmokers differed significantly from those of smokers or patients with active interstitial or infectious lung disease. This alternative procedure is suited as a bedside test and holds promise for patient monitoring and follow-up.

Administration, Inhalation↗
PubMed1988

[Congenital cytomegalovirus infection with fatal outcome].

A 34-year-old woman had an essentially uneventful pregnancy until membrane rupture in the 30th week of pregnancy. She developed severe eclampsia necessitating delivery by section in the 36th week. The child was asphyxic at birth with petechial haemorrhages and hepatosplenomegaly, suggesting cytomegalovirus infection (CMV). He died on the fourth day. Virus could not be isolated from maternal urine, cervical smear and placental tissue, but was demonstrated in the child's urine and post-mortem in lung and liver tissue. The ELISA test on the child's serum was positive for CMV-specific IgM antibodies.

Adult↗
PubMed1987

Thoracic imaging with gallium-67.

In the past, gallium-67 imaging has undergone several ups and downs related to its clinical importance. After a period of initial enthusiasm, its role and indications are now established. At present, there are two fields of clinical interest for 67Ga-imaging: (1) mediastinal staging in bronchogenic carcinoma and the staging of malignant lymphoma; (2) assessment of activity in interstitial lung diseases, especially sarcoidosis and inflammatory lung disorders. The advantage of 67Ga-imaging is that it is highly sensitive for the detection of neoplastic and inflammatory processes, independent of anatomical barriers. Particularly with the challenge of AIDS, 67Ga-imaging will gain increasing importance in the future. The low specificity of gallium for detecting underlying disorders precludes its use as a primary diagnostic tool. Therefore, and because of the cost and radiation load, the indications for application will have to be selected very carefully.

Adenocarcinoma↗
PubMed1983

[Diagnosis in sarcoidosis. Sensitivity and specificity of 67-gallium scintigraphy, serum angiotensin converting enzyme levels, thoracic radiography and blood lymphocyte subpopulations].

In a prospective study in 73 patients (48 female, 25 male) with histologically proven sarcoidosis we examined the sensitivity and specificity of Gallium 67 scanning, S-ACE, chest X-ray and blood T-lymphocyte assays for assessment of activity in sarcoidosis. We found a positive correlation between 67Ga score and S-ACE (r = 0.54, p less than 0.001). S-ACE levels and 67Ga score were significantly higher (p less than 0.001) in active sarcoidosis compared to inactive sarcoidosis. However, patients characterized by bihilar active sarcoidosis proved to have higher mean S-ACE levels (p less than 0.025) and a higher 67Ga score (n. s.) compared to patients with other presentations of active sarcoidosis. 67Ga scanning had the highest sensitivity of all parameters (92%) to detect active sarcoidosis, followed by chest X-ray (79%) and S-ACE (70%). Blood T-lymphocyte assays without comparison to lavaged lung T-lymphocytes failed to give reliable results. In patients with inactive sarcoidosis S-ACE showed a higher specificity (85%) compared to 67 Ga scanning (77%). Among follow up assessments in 26 patients with recurrent sarcoidosis 67Ga scanning proved to be the most reliable means for all stages of sarcoidosis whereas in patients with interstitial pulmonary lesions chest X-ray as well as S-ACE sometimes failed to assess activity. For the clinical management of patients with pulmonary sarcoidosis we suggest the combined use of chest X-ray and S-ACE. In case of discrepant results, as well as interstitial pulmonary involvement or for difficult therapeutic decisions the use of 67Ga scanning or bronchoalveolar lavage should be considered.

Adolescent↗
PubMed1980

[Fractures of the axis organ in ankylosing spondylitis (author's transl)].

Fractures of the axis organ in ankylosing spondylitis display special features resulting from the peculiar underlying osteopathy. Depending on the localisation und extent of the vertebral ossification process, the mechanical load situations are different from case to case. Besides the disease-specific metaplastic-productive development, it is also possible that the peculiar destructive-absorptive component dominates in the overall pattern of the fracture, leading to false interpretations such as "non-typical fracture", "persistent pseudoarthrosis", specific spondylitis, stress fracture, suspected tumour, etc. Eight observations by the author demonstrate the risks, problems, differential diagnostic difficulties and the experience collected from observations of the course of the disease: four fractures of the cervical vertebral column (following mild traumas) were mainly flexion, luxation (compression) fractures at C 5/6 with partly extensive spondylodiscitic destruction, conservative treatment being sufficient in the absence of severe neurological symptoms (with one exception). A transvertebral fracture (after trauma) had occurred at the eleventh thoracic vertebral body with extremely protracted healing. Two stress fractures in which healing tendency was absent, were seen in a lumbar vertebral column sigment with spondylo-arthritically stiffened vertebral arch components, being probably a post-traumatic spondylolisthesis in segment L 5/S 1.

Adult↗