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Biomedical subjects

W Frank

Publications and source records attributed to W Frank.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Chylothorax as a complication of sarcoidosis].

This case report features a male patient of 45 years of age presenting with a right sided moderately compressive pleural effusion, that was clearly identified as chylothorax on thoracocentesis. Sarcoidosis with systemic involvement had already been diagnosed in 1995 by a parotid gland biopsy. Thoracoscopy revealed multiple discrete nodules parietally besides a number of more extensive yellowish lesions resembling malignant lymphoma. However visualization of a thoracic duct leakage was not possible. Histologically the biopsies taken represented exclusively non-caseating sarcoidosistype granulomas. Complete and permanent remission of the chylothorax was achieved within only ten days following talcum pleurodesis, alimentary measures and induction of systemic steroid therapy. The etiological classification of this extremely rare complication appears very clear. Pathogenetic and differential therapeutic aspects are discussed against the background of a review of the literature.

Biopsy↗
PubMed1996

[Asbestos concentrations in drinking water. Asbestos cement pipes and geogenic sources in Austria].

Sources of asbestos in drinking water may be natural deposits or the use of asbestos cement for water distribution. 50 water samples were selected in Austria to detect fibre contamination from either geology or asbestos cement by comparison with control areas and by comparison of raw and treated water. Standardized EPA/BGA methodology with transmission electron microscopy, energy dispersive X-ray analysis and selected area electron diffraction was used to quantify concentrations of different sized amphibole and chrysotile fibres. In 10 areas with asbestos deposits and in 14 areas with use of asbestos cement pipes asbestos concentrations in drinking water were low and not significantly different from 6 control areas (median 32,000 total asbestos fibres per litre). The relative highest concentration was found in an area with natural deposits at the source of the water supply (190,000 per litre). In areas without natural deposits the increase of asbestos concentrations from origin to consumer of water was not significant and unrelated to water aggressiveness, age and length of asbestos cement pipes. This could be mainly due to the fact that in areas with aggressive water asbestos cement pipes have been coated in Austria. A sample from a cistern, however, showed considerable asbestos contamination and raises concern about the use of surface water for room air humidification.

Asbestos↗
PubMed1995

[Modern examination methods in pneumology].

In addition to qualitative establishment of diagnosis the aim of modern investigational procedures is quantitative analysis of disease extension and of functional impairment. The most important endoscopic-bioptical techniques for establishment of diagnosis are bronchoscopy and thoracoscopy. In bronchology flexible bronchoscopy with a relative share of about 90% clearly holds now a dominant position versus the rigid technique. Suspected cancer is the most prominent indication (ca. 60%). Visible intrabronchial lesions can be diagnosed in more than 90%. In extrabronchial and peripheral bronchopulmonary disease technical aids like transbronchial needle aspiration (TBNA), bronchoalveolar lavage (BAL) or transbronchial biopsy (TBB) are required, resulting in a diagnostic yield, that may range between 30 and 90% depending on the particular disease entity. Thoracoscopy is the second most important endoscopic procedure and accounts for about 1/10 of the investigational frequency of bronchoscopy. Pleural - generally exsudative - effusion provides by far the most frequent indication with a relative incidence of 75%. Etiological diagnosis can be established in about 90% of pleural effusions. The maximum yield of 100% may be achieved in tuberculous effusions, in malignant effusion sensitivity comes close to 100%. Non-endoscopic bioptical techniques include guided perthoracic needle aspiration and "blind" pleural biopsy. Diagnostic escalation or tumor staging may require surgical procedures, which can be performed by conventional techniques (mediastinoscopy, minithoracotomy) or video-assisted thorascopy. Explorative thoracotomy is the most extensive investigation. For functional evaluation of number of "classical" techniques are available (spirometry, gas transfer analysis, spiroergometry) more recently expanded by radionuclide perfusion and ventilation studies. Besides grading of functional impairment they allow clinical diagnosis of diseases characterized by specific functional patterns (asthma, bronchitis, emphysema, sleep associated disorders) and serve preoperative assessment in surgery. Increasingly important modern imaging techniques like computed tomography (CT), nuclear magnetic resonance (NMR) or ultrasonic investigation are not featured in this clinically focused article.

Bacteriological Techniques↗
PubMed1995

Renal cell carcinoma: comparison of the TNM and Robson stage groupings.

This review compares the two major staging systems for renal cell carcinoma: the TNM and Robson systems. For purposes of worldwide clinical and scientific consistency, the TNM system is recommended. However, the primary tumor size cutoff of 2.5 cm. does not prognostically differentiate between stages I and II. A review of 337 patients with renal cell carcinoma, of whom 122 had stage I or II disease revealed that a 2.5-cm cutoff did not predict survival differences, while cutoffs of 5.0, 7.5, and 10.0 cm did. Because 7.5 cm most closely approximates the mean renal cell cancer diameter as noted by SEER data, it is recommended that the TNM primary tumor cutoff be changed to 7.5 cm.

Carcinoma, Renal Cell↗
PubMed1995

Influence of environmental factors on the infectivity of Echinococcus multilocularis eggs.

The sensitivity of eggs of Echinococcus multilocularis to environmental and controlled laboratory conditions was tested. Egg material was exposed and the infectivity was subsequently monitored by in vitro activation and by oral infection of the natural host, Microtus arvalis. To study the impact of environmental conditions in an endemic area of south-western Germany, eggs were sealed into bags of nylon mesh and exposed to the natural climate during various seasons. The maximal survival time of eggs was 240 days in an experiment performed in autumn and winter and 78 days in summer. A study of the tenacity of eggs under laboratory conditions revealed a high sensitivity to elevated temperatures and to desiccation. At 45 degrees C and 85-95% relative humidity the infectivity was lost after 3 h as well as after 4 h exposure to 43 degrees C suspended in water. Exposure to 27% relative humidity at 25 degrees C as well as exposure to 15% relative humidity at 43 degrees C resulted in a total loss of infectivity within 48 and 2 h, respectively. Temperatures of 4 degrees C and of -18 degrees C were well tolerated (478 days and 240 days survival, respectively), whereas exposure to -83 degrees C and to -196 degrees C quickly killed off the eggs (within 48 h and 20 h, respectively). Eggs of E. multilocularis were not killed off by exposure to various commercially available disinfectants applied according to the manufacturers' instructions and by exposure for 24 h to low concentrations of ethanol. Irradiation with 40 krad. from a 137Caesium source prevented the development of metacestodes but allowed seroconversion of infected rodents.

Animals↗
PubMed1994

Stage IV renal cell carcinoma.

Data from 104 patients with stage IV renal cell carcinoma were evaluated to investigate relationships between survival and gender, race, age, tumor size, lung versus bone metastasis, number of metastatic sites and nephrectomy. No statistically significant differences in survival were found between gender or racial groups, nor was there a statistically significant relationship between survival and patient age. Survival tended to decrease as tumor size increased. Survival was worse for patients with multiple metastatic sites compared to those with only 1 metastatic site, and for patients with bone and lung metastases compared to those with lung but no bone metastases and bone but no lung metastases. Although nephrectomy patients appeared to have somewhat better survival rates than those without nephrectomy, this difference was apparently due to better prognostic factors for nephrectomy patients.

Adolescent↗
PubMed1994

Value of tumor size in predicting survival from renal cell carcinoma among tumors, nodes and metastases stage 1 and stage 2 patients.

Results in the literature are inconsistent regarding the value of tumor size in predicting survival from renal cell carcinoma, and its use as a staging variable in the current tumors, nodes and metastases system has been questioned. In this study tumor size had no prognostic significance in Kaplan-Meier or Cox regression models examining survival differences between 93 patients with stage T1N0M0 and T2N0M0 renal cell carcinoma dichotomized by tumor size cutoffs at 2.5, 5, 7.5 or 10 cm. In multivariate Cox regression models for 122 patients with stage T1NallMall or T2MallMall renal cell carcinoma, metastatic disease was the strongest predictor of survival, and patients with smaller tumors had significantly longer survival than those with larger tumors at all cutoffs except 2.5 cm., for which differences were insignificant. A 5 cm. cutoff maximized the value of tumor size in predicting survival. If tumor size is to remain the variable by which tumors, nodes and metastases stages T1 and T2 disease are differentiated, a 5 cm. cutoff should replace the current 2.5 cm. definition.

Carcinoma, Renal Cell↗
PubMed1994

Skin growths in the aged. Treatment considerations.

Skin disorders are very common among elderly people. All physicians who care for this population should possess the ability to recognise common benign growths. Primary care physicians should also have the ability to recognise premalignant and malignant lesions, so that early diagnosis and treatment is possible. It is puzzling that the organ system most amenable to examination is so often overlooked in routine examinations. By simply taking the time to perform a skin examination, morbidity and mortality can be decreased. Through improvements in pharmacotherapy, particularly the development of more effective sunscreens, it may eventually be possible to markedly reduce the development of many benign and malignant skin lesions.

Age Factors↗
PubMed1994

[Diagnosis of familial Holt-Oram syndrome].

Presented is one rare case in a family affected by a Holt- Oram-Syndrome. This syndrome is associated with an upper limb malformation and a congenital heart disease. In our case we found radiusaplasia on both sides, thenaraplasia on the left hand, a hypoplastic thumb on the right hand. The heart was malformed as a Fallot tetralogy, the left kidney was absent. Four additional affected members of the family are described. By routine ultrasound examination we could not find this malformation syndrome. In families with affected history ultrasound screening examination should be done on a center for prenatal diagnosis.

Abnormalities, Multiple↗
PubMed1994

[Lung function reference values for students 6 to 16 years of age].

The diagnosis of lung function impairments in childhood is based on a variety of reference values. The assessment of "normal" function and growth of lung and airways in pediatric and environmental investigations is biased. The detection of small airway disease at an early stage is based on flow volume measurements, however, reference values in Europe relied on small and highly selected groups of children. We examined 18,106 children and adolescents aged 6 to 16 years at their schools by standardized methods. After exclusion of children with poor cooperation, respiratory signs or symptoms and active smokers, regression analysis was applied for FVC, FEV1, PEF, MEF75, MEF50, MEF25, and MMEF predicted from standing height, sex, age and weight. Means and standard deviations (SD) of lung function parameters of healthy Austrian school children are presented as a basis for reference. Individual lung function can thus be evaluated in SD-scores. Flow measures representing small airway functions were found higher in adolescent girls. MEF25 showed the highest variability unexplained by anthropometric characteristics. The new reference values improve available tools for early detection of respiratory diseases and dysfunctions in children and adolescents and they should help to evaluate environmental and other factors influencing function and growth of lung and airways.

Adolescent↗
PubMed1993

Renal cell carcinoma: the size variable.

Three hundred and thirty-seven renal cell carcinomas treated at University of Illinois Affiliated Hospitals were reviewed. There was an inverse correlation between tumor size and survival.

Carcinoma, Renal Cell↗