Evaluation of long-term toxicity in patients after cisplatin-based chemotherapy for non-seminomatous testicular cancer.

BACKGROUND: Because of the increasing number of long-term survivors of metastatic testicular germ-cell cancer, a general concern has been secondary morbidities, especially cardiovascular risk factors. PATIENTS AND METHODS: Thirty-two patients treated with cisplatin- and doxorubicin-containing chemotherapy > or = 13 years before the time of analyses were evaluated for neuro-, oto-, pulmonary-, vascular- and gonadal toxicity including evaluation of myocardial damage and cardiovascular risk factors and analysis of microcirculation. RESULTS: Thirty percent of the patients showed abnormal left ventricle function. Elevated follicle stimulating hormone (FSH) and luteinising hormone (LH) levels in 75% of patients were often associated with low testosterone levels. Elevated total cholesterol levels were found in 82% and higher triglyceride levels in 44% of patients, most of them were overweight. About 25% of the patients developed diastolic arterial hypertension after chemotherapy. Reduced hearing was confirmed in 23% of patients, especially at frequencies higher than 3000 Hz. Moreover, 53% of patients presented transient evoked otoacoustic emissions. In 38% of patients non-symptomatic neuropathy was detected, in 28% symptomatic neuropathy, and in 6% disabling polyneuropathy. In 80% of patients with neuropathic symptoms additional morphological and functional abnormalities were found by nailfold capillary videomicroscopy, compared to only 57% of the patients without neuropathic symptoms. CONCLUSIONS: Patients cured by cisplatin-based chemotherapy for metastatic testicular cancer have to be cognizant of their unfavorable cardiovascular risk profile, that might be a greater risk than developing a relapse or second malignancy.

[Excessive weight loss caused by dysphagia in superior laryngeal nerve neuralgia--a case report]. / Exzessiver Gewichtsverlust durch Dysphagie bei Laryngeus-superior-Neuralgie--eine Falldarstellung.

BACKGROUND: Superior laryngeal nerve neuralgia is a very rare disease typically associated with paroxysmal and lancinating pain mostly localised on one side of the laryngeal region and sometimes radiating into the homolateral jaw or ear. The condition is usually idiopathic and treated successfully with carbamazepine. Even if the symptoms are unusual or not typical for superior laryngeal nerve neuralgia, the condition should be considered as a possible diagnosis if there are no other pathological findings. CASE REPORT: In October 1999, a 44-year old man presented a progressive dysphagia. Complaining about increasing problems in swallowing, he started refusing solid food and lost about 50 kg in two and a half years. In addition, he complained about persistent pain in the right laryngeal region, intensified by chewing or swallowing. Extensive investigations produced no pathological findings, especially no neoplastic process or other consuming diseases. After an injection of local anaesthetic near to the right hypothyroid membrane, the symptoms improved dramatically for a few hours and the diagnosis of superior laryngeal neuralgia was made. To confirm the diagnosis we injected sodium chloride as a placebo without any effect. The condition was successfully treated with 200 mg of carbamazepine three times daily without any major side effects. CONCLUSIONS: Even if the symptoms are not typical and dysphagia and weight loss are the outstanding symptoms, superior laryngeal nerve neuralgia should be considered as the possible diagnosis, especially if no other pathological findings are revealed. Injection of local anesthetic is a valuable tool for diagnosing the disease.

[Hearing ability after cholesteatoma surgery]. / Hörvermögen nach Cholesteatom-Chirurgie.

Five years after cholesteatoma surgery (primary operation in 1981 and 1982) we examined 112 patients to determine the hearing and clinical results in follow-up. In 12 (10.7%) patients Cholesteatoma recurred. During the period of follow-up 28 (25%) ears underwent second surgery. Comparing the open (50.9%) with the closed (49.1%) technique a better air bone gap was gained for the closed technique procedures. This was confirmed when the different types of tympanoplasty were compared between the two groups. In 69.5% of the closed procedures the air bone gap was less than 20 dB, whereas the value for the open technique was 51.1%. In 30 patients a second-look operation was recommended, which was performed in 15 persons; 8 recurrent cholesteatoma were detected. Reducing the application of the closed procedures from a rate of 78.1% in the years 1971/1972 to 49.1% in 1981/1982, we saw a distinct reduction of cholesteatoma recurrence from 25% in 1971/1972 to 10.7% in the present study. The data show that the advice for a second-look operation should be seriously considered. Furthermore, the study indicates that due to modern tympanoplastic techniques also in longterm follow-up good hearing results can be obtained.

[A fermenter dialysis cultivation technic for encapsulated pathogenic bacteria. II. Group B streptococci]. / Einsatz der Fermenter-Dialyse-Kultur zur Züchtung kapseltragender Bakterien mit klinischer Bedeutung.

For mass cultivation of group B streptococci (B-III and B-variant streptococci), a fermenter dialysis culture technique is described and compared to conventional shaking culture and fermenter batch culture techniques. The influence of two kinds of cultivation media on the bacterial yield is demonstrated. The growth rate of the bacteria and the yield of the microbes is higher in modified POPE medium than that observed with Nährbouillon I. The type-specific polysaccharide of B-III-streptococci prepared by phenol-water extraction followed by gel-chromatography can be used as a screening antigen for the production of monoclonal antibodies against B-III-streptococci.

[Isolation of group-specific polysaccharide complexes from group B streptococci by phenol-water extraction]. / Einsatz der Phenol-Wasser-Extraktion zur Isolierung des gruppenspezifischen Polysaccharidkomplexes aus B-Streptokokken.

The group specific polysaccharide of Group B streptococci was isolated either by means of phenol-water extraction or by Lancefield extraction procedures. Two groups of rabbits were immunized with these substances to induce polyclonal antibodies. The phenol-water extract induced antisera had a significantly higher titer against B streptococci than against A-, D- and G streptococci in the agglutination reaction. The B-specific titers in rabbits immunized with phenol-water extract were significantly higher than those obtained in the rabbits immunized with Lancefield extract. In counter immunoelectrophoresis, only the antisera prepared by immunization with phenol-water extract reacted with standard antigen from group B streptococci. The serological specificity of the phenol-water extract antigen isolated from B streptococci was confirmed by counterimmunoelectrophoresis. The antigen was a heterologous fraction with a molecular mass of 8 x 10(4)-2 x 10(6) Dalton.