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Biomedical subjects

A Gillissen

Publications and source records attributed to A Gillissen.

At least 55 records · Page 3Linked to original sources
PubMed2002

[Pulmonary and pleural metastasis of a malignant granular cell tumor].

HISTORY AND CLINICAL FINDINGS: A 72-year-old woman, who suffered from increasing dyspnea and productive cough was admitted to hospital. Clinical examination revealed a reduced respiratory sounds over the left lung and a painless and unmovable tumor in the area of the left hip. CLINICAL AND LABORATORY TESTS: Apart from hypoxemia (pO2 7.81 kPa) the laboratory values did not indicate any pathological findings. The X-ray and CT-scan of the chest showed a few spotty shadows and pleura effusion on the left. No tumor cells were detected in the pleural effusion. In biopsies of the visceral and parietal pleura as well as biopsy within the tumor in the area of the left hip there were clusters of tumor cells of a granular cell tumor. DIAGNOSIS, TREATMENT AND CLINICAL COURSE: Because the same tumor cell type was detected in the visceral and parietal pleura and wihtin the tumor at the left gluteus area, we diagnosed a malignant granular cell tumor. The CT-scan was suspicious of lung metastasis. The primary tumor was located in the area of left hip. The patient was in a poor general condition and she suffered from an extensive metastastic disease; curative treatment was not possible. A pleurodesis was performed. The patient died nine months after initial diagnosis. CONCLUSION: A rare malignant granular cell tumor was discovered by detecting tumor tissue of granular cell tumor in the pleura and within a tumor in the left gluteus area. Another indication of a metastatic disease were multifocal lesions in the lung detected by CT-scan. Curative treatment was not possible.

Aged↗
PubMed2002

[Spirometry, pulse oximetry, brochospasmolytic test. The pillars of COPD diagnosis].

In addition to case history and clinical examination, the basic diagnostic work-up of chronic obstructive pulmonary disease comprises in particular lung function testing by means of spirometry. In the event of an uncertain diagnosis, or in a search for underlying causes, an additional EKG, chest X-ray and bronchospasmolytic testing to determine the reversibility of the airways obstruction are employed. In COPD patients younger than 50, as well as in those with pulmonary edema largely confined to the basal fields, determination of the alpha-1-antitrypsin should be carried out. In the case of an exacerbation of the clinical presentation, the sputum should be cultured to determine the possible presence of pathogenic bacteria. Recurrent exacerbations or a rapid worsening of dyspnea necessitate hospitalization.

Adrenergic beta-Agonists↗
PubMed2002

[Inhaled steroids in COPD. Do they modify the disease?].

The use of inhaled steroids in the treatment of chronic obstructive lung disease is controversial. It is becoming ever more clear that a differentiated approach to treatment determined by the clinical presentation and the specific cell profile is needed. More inflammation, poorer lung function and more frequent exacerbation benefit from steroids, while early stages of the disease with few symptoms, and patients with predominance of emphysema but little bronchitis are unlikely to benefit from this form of treatment. Particular attention must be paid to mixed types with an asthma-like component. While the combination of long-acting beta-mimetic drugs and inhalative steroids might appear to be of benefit, the outcome of currently ongoing studies must be awaited.

Administration, Inhalation↗
PubMed2001

[Synergistic effects of combined therapy of inhalational glucocorticosteroids with long-acting beta 2-receptor agonists in treatment of bronchial asthma].

BACKGROUND: Due to the potent anti-inflammatory strength, glucocorticosteroids are the basis of long-term (controller) therapy in asthma. They inhibit transcription of pro-inflammatory cytokines and block humoral as well as cellular derived inflammation in the bronchi. beta 2 sympathomimetics are well known to cause dilatation of the bronchi but also to modulate certain anti-inflammatory responses. SYNERGISM: Just recently it could be demonstrated that beta 2 agonists may also be able to activate glucocorticosteroid receptors, independently of existing glucocorticosteroids. Thus, beta 2 agonists lead to augmentation of glucocorticosteroid receptor concentration, and consequently cause better efficacy of glucocorticosteroids within the cell. Vice versa glucocorticosteroids enhance the transcription rate of beta 2 receptors, causing higher beta 2 receptor number, and thus may contribute to better beta 2 agonist efficacy. These synergies of beta 2 agonists and glucocorticosteroids on molecular level explain additive efficiency in the therapy of asthma--particularly through improving lung function--when using both substances in combination.

Administration, Inhalation↗
PubMed2001

[Pleural mesothelioma. I: History, epidemiology, clinical aspects (symptoms, diagnosis)].

EPIDEMIOLOGY: Although production and processing of asbestos have been prohibited for years, the incidence of mesothelioma of the pleura will rise in Western Europe. The incidence of mesothelioma will peak between the years 2010 and 2020. It will cause an estimated 250,000 deaths within the next 35 years. PATHOGENESIS: The fact that exposure to asbestos fibers may result in mesothelioma was first described in 1960. The risk of developing mesothelioma depends mainly on the type of asbestos fibers and the way asbestos is manufactured. Environmental eronite fibers in Central Turkey are the cause of endemic mesothelioma. The pathogenetic role of infection with simian virus 40 is still not determined. Thoracic radiation is of minor importance in the etiology of pleural mesothelioma. DIAGNOSIS: Between first symptoms of disease and diagnosis of mesothelioma often more than 6 months pass as clinical symptoms are rarely typical. Detection of early stages by invasive procedures and imaging is often very difficult. Histopathological distinction between adenocarcinoma and mesothelioma requires experienced pathologists. This implies that management of mesothelioma should only be performed in multidisciplinary cooperation in specialized centers.

Asbestos↗
PubMed2001

[Diagnosis and differential diagnosis of bronchial asthma].

Asthma and COPD (chronic obstructive pulmonary disease) are the most important obstructive pulmonary diseases. Patient's history and physical evaluation give major hints of the underlying disease. Further diagnostic measures comprise lung function analysis including spirometry, plethysmography and--in severe cases--blood gas analysis. Bronchial hyperreactivity may be quantified with an unspecific inhalative provocation test. In many cases allergic diseases are accompanied by asthma. Thus, allergy tests--particularly skin prick tests--have to be carried out. To further define an underlying allergy, in some cases even specific inhalative provocation tests have to be performed. X-ray of the thorax and other imaging techniques, detailed blood analysis, further diagnosis of the upper respiratory tract and the cardiac system may have to be carried out a) to quantify the effects of a severe form of asthma or COPD on other organs, and b) for differential diagnostic examinations.

Asthma↗