[Diagnostics and therapy of idiopathic pulmonary hemosiderosis]

Idiopathic pulmonary hemosiderosis (IPH) is a rare clinical entity characterized by recurrent episodes of diffuse alveolar hemorrhage. The disease--also called Ceelen's syndrome--was subsequently defined as a clinical entity comprising the triade of hemoptysis, opacities in X-ray, and anemia, in which the etiology is still unknown. Intensive search for a specific etiology ends up negative, and there are no features, which are specifically pathognomonic for IPH. Therefore, the diagnosis relies solely on the exclusion of other disorders in which diffuse alveolar hemorrhage is a cardinal sign. Acute episodes may occur frequently, eventually leading to lung fibrosis in the chronic stage. Usually, the therapy consists of high doses of corticosteroids, which can be combined with immunosuppressive drugs. In addition to this review, a case having Ceelen's syndrome is presented. After a complicated clinical course, the patient could finally be stabilized with a combination therapy of prednisolone and azathioprine.

Tracheobronchopathia osteochondroplastica: A rare cause of chronic cough with haemoptysis

A case of tracheobronchopathia osteochondroplastic (TPO) was diagnosed in a 69-year old male with prolonged cough. TPO is a rare condition of unknown cause and only sporadic cases have been reported. The condition is benign, characterized by submucosal nodules growing from the submucosal layer of the airways, protruding into the bronchial lumen. The bronchscopic view together with bronchial cartilage with abnormal distributed mineralization of the histologic examination of theses nodules leads to the correct diagnosis. Mild cases are treated symptomatically, whereas we tried an inhaled corticosteroid. Prominent protrusions in the trachea or the bronchi must be removed. In most cases the disease is stable over years but progressive forms have been reported. TPO may cause chronic refractory cough, which eventually is the only prominent symptom of this disease.

[Musicotherapy--possible uses in social psychiatry (author's transl)]

The importance of musicotherapy as a type of treatment within the framework of psychiatry is examined. Musicotherapy, as used in the treatment of schizophrenia, is considered to be a communicative therapy with a tendency to regression. A plan for treating psychotics with a non-verbal and a verbal track is outlined. The special approach to patients offered via musicotherapy is seen as follows. The terapist-patient relationship is established on a preverbal communicative level in a zone which is free from anxiety. The shelter afforded by a common musical experience enables self-regulation of the balance between symbiosis and separation, and hence the development of a therapist-patient relationship. The feedback provided by establishing structured objects represents an integration aid for the self and the ego of the patient. Therapy practised as active group musicotherapy forms part of a social field within the group.