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Biomedical subjects

A Steiner

Publications and source records attributed to A Steiner.

At least 217 records · Page 12Linked to original sources

[Diagnostic value of atrial natriuretic peptide in hypertension and heart insufficiency].

Serum ANP levels were measured by radioreceptor assay in 40 patients with various forms of secondary hypertension and 6 patients with heart failure. In addition, serum ANP was determined in 4 patients with renal artery stenosis before and after dilatation, as well as in 5 anephric patients before and after haemodialysis. Our results showed elevated serum ANP level in most patients with various forms of secondary hypertension and chronic heart failure. A distinction between these two groups and a control group of healthy individuals was not possible due to the wide range and occasional normal levels in the first two groups. ANP levels in patients with renal stenosis decreased after dilatation but there was no correlation with the success of this procedure. A positive correlation between ANP and plasma renin level was detectable in patients with renal artery stenosis, but was also elevated in anephric patients with absent renin production. In summary, our results show that measurements of serum-ANP are of little significance in the diagnosis of hypertension and chronic cardiac failure.

Atrial Natriuretic Factor↗

Comparison of the effects of three different treatment regimens of recombinant interferons (r-IFN alpha, r-IFN gamma, and r-IFN alpha + cimetidine) in disseminated malignant melanoma.

A total of 30 patients with progressively growing visceral and/or cutaneous malignant melanoma metastases were entered in a prospective phase II trial comparing three different therapeutic regimens of recombinant interferons (r-IFN). The first group of 12 patients received r-IFN alpha A 9-36 IU/day i.m. on 5 consecutive days/week. A second group of 11 patients was treated with r-IFN alpha A and oral cimetidine, 1000 mg/day. The third group of 7 patients had i.v. infusions of r-IFN gamma 0.25-0.5 mg/m2 on 3 days/week. Of the 12 r-IFN alpha A-treated patients, 1 responded (complete response, CR), 5 patients exhibited no change (NC), 3 patients had progressive disease (PD), and 3 patients could not be evaluated after therapy. In the group treated with r-IFN alpha A plus cimetidine 3 patients responded (1 CR, 2 partial responses) and 3 exhibited NC. The remaining patients showed PD. Treatment responses were found exclusively in patients with cutaneous and/or lymph node metastases. In contrast, none of the r-IFN gamma-treated patients responded to therapy. Known IFN side effects of varying degrees, sometimes severe, were observed in all patients. Despite the small numbers of patients treated, our preliminary data indicate that r-IFN alpha A therapy seems (1) to be of some therapeutic value in the treatment of cutaneous melanoma metastases, (2) to be superior to r-IFN gamma therapy, and (3) that overall response rates improve with the addition of oral cimetidine to r-IFN alpha A treatment.

Cimetidine↗

Antibodies of the IgE and IgG isotype, serum IgE and circulating immune complexes in schistosomiasis intercalatum.

Individuals in an advanced phase of infection by Schistosoma intercalatum in whom viable ova are still present in the rectal mucosa but not excreted in detectable quantity, can be distinguished clinically from a younger group of individuals excreting S. intercalatum ova in their faeces. This clear-cut distinction is underlined by findings in parameters of humoral response. The ratio of anticercarial to anti-adult worm antibodies was higher in the group excreting eggs with probably more recent infection. Levels of total serum immunoglobulin were higher in this group, with the exception of serum IgA, which was lower as long as eggs were being excreted. In a later stage of the disease, relatively more IgG seems to be bound in circulating immune complexes. It is postulated that these stage specific patterns of humoral immune response represent the evolution of the host-parasite relationship during the infection.

Adolescent↗

Vegetating cicatricial pemphigoid. A new subset of the cicatricial pemphigoid spectrum.

A case with widespread vegetating-pustular skin lesions, oral erosions, ulcerations and scarring, and conjunctival synechiae is reported. Clinically, histopathologically, and by immunofluorescence and electron microscopy this patient combined the features of pemphigoid vegetans, as described by Winkelmann and Su, and the mucocutaneous type of cicatricial pemphigoid. This observation suggests that a third subset of cicatricial pemphigoid can now be added to the two existing ones, the mucocutaneous and Brunsting-Perry types, and the designation vegetating cicatricial pemphigoid is proposed for this heretofore undescribed condition.

Aged↗

In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions.

The importance of recognizing early melanoma is generally accepted. Because not all pigmented skin lesions can be diagnosed correctly by their clinical appearance, additional criteria are required for the clinical diagnosis of such lesions. In vivo epiluminescence microscopy provides for a more detailed inspection of the surface of pigmented skin lesions, and, by using the oil immersion technic, which renders the epidermis translucent, opens a new dimension of skin morphology by including the dermoepidermal junction into the macroscopic evaluation of a lesion. In an epiluminescence microscopy study of more than 3000 pigmented skin lesions we have defined morphologic criteria that are not readily apparent to the naked eye but that are detected easily by epiluminescence microscopy and represent relatively reliable markers of benign and malignant pigmented skin lesions. These features include specific patterns, colors, and intensities of pigmentation, as well as the configuration, regularity, and other characteristics of both the margin and the surface of pigmented skin lesions. Pattern analysis of these features permits a distinction between different types of pigmented skin lesions and, in particular, between benign and malignant growth patterns. Epiluminescence microscopy is thus a valuable addition to the diagnostic armamentarium of pigmented skin lesions at a clinical level.

Basal Cell Carcinoma↗

In vivo epiluminescence microscopy of pigmented skin lesions. II. Diagnosis of small pigmented skin lesions and early detection of malignant melanoma.

Pattern analysis by epiluminescence microscopy of pigmented skin lesions was tested in a study of 318 small pigmented skin lesions that were diagnostically equivocal when examined with the naked eye. An improvement of clinical diagnosis was achieved by epiluminescence microscopy for practically all lesions, both benign and malignant, and was equally impressive for melanocytic and nonmelanocytic lesions. Improvement in diagnostic accuracy was as follows: for small nodular melanomas, from 50% to 70%; for superficial spreading melanoma in situ, from 46% to 80%; for invasive superficial spreading melanoma, from 64% to 90%; and for early lentigo maligna and lentigo maligna melanoma, from 67% to 88%. Conversely, the diagnosis of pigmented Spitz nevi improved from 46% to 93% and of pigmented basal cell carcinomas from 60% to 90%, which appears equally important because most of these lesions had clinically been considered to represent melanomas. The use of epiluminescence microscopy also resulted in considerable improvement in the diagnosis of dysplastic nevi, which was particularly helpful in making therapeutic decisions. Epiluminescence microscopy greatly expands the diagnostic armamentarium available for pigmented skin lesions at a clinical level and thus increases the chances of detecting or ruling out melanoma in its earliest stages.

Basal Cell Carcinoma↗

Congenital absence of the anatomic common bile duct. Case report.

In congenital absence of the anatomic common bile duct, all bile from the liver drains into the gallbladder and thence to the duodenum via the cystic duct. A likely consequence of cholecystectomy then is discontinuity of hepatic drainage, since the gallbladder and cystic duct appear normal, and the anomaly is so rare that it is not considered.

Cholangiography↗

Late metastases of cutaneous malignant melanoma.

Although late recurrence of cutaneous malignant melanoma (CMM) is a known clinical phenomenon, only 12 adequately documented cases exist in the literature. We describe two female patients with CMM who developed melanoma metastases 18 years after radical excision of their primary tumours and presumed cure. Increasing numbers of reports of cases of delayed metastases of CMM might have implications for management and follow up of melanoma patients.

Adult↗

[Pemphigus vulgaris--malignant course].

A 42-year-old woman with extensive pemphigus vulgaris failed to respond to high-dosage systemic steroids, immunosuppressive drugs and plasmapheresis. The treatment resulted in severe depression of the immune system, without marked effect on the disease activity. Eleven weeks after onset of disease she died of pneumonia and sepsis.

Adult↗

[Modified Schanz screws for the external fixator].

In order to make a comparison with conventional implants, our recently developed 5/8 mm screws of Schanz were put in the lateral clamp of an external fixation unit applied to the femur. By using the modified 5/8 mm screws of Schanz, an increased stability and a reduced number of implants can be achieved. The results are not only applicable for the external fixation of the femur investigated by us, but also for unilateral fixation of the tibia.

Biomechanical Phenomena↗

Sulfone treatment of granuloma annulare.

Although spontaneous remission of granuloma annulare is not uncommon, most cases are chronic and resistant to a variety of therapeutic modalities. In our study we confirm the beneficial effect of dapsone treatment in patients with localized or generalized granuloma annulare. The results indicate that dapsone is a useful drug to control or at least to improve skin lesions in the majority of patients.

Adult↗

Botulism intoxication after surgery in the gut.

Botulism intoxication is described in a 45-year-old woman who was hospitalized with symptoms suggesting an intestinal obstruction. At intervention a 20-cm length of necrotic small intestine was excised and prophylactic antibiotics were given. Five days after surgery--during which time the patient was fed only parenterally--dryness of the mouth, difficulty in swallowing, general weakness, and difficulty with speech and in keeping her eyes open were noted. The patient was alert and well oriented. The clinical symptoms and the electrophysiological studies suggested the diagnosis of botulism. A serum sample caused death in mice upon inoculation and two samples of feces were positive for the presence of Clostridium botulinum organisms. Supportive treatment with botulinum antitoxin was given and the patient was discharged in good condition.

Anti-Bacterial Agents↗

[Pemphigus vegetans (Hallopeau) with eosinophilic spongiosis--successful retinoid therapy].

We present an unusual case of pemphigus vegetans (Hallopeau) with widespread, nonblistering gyrate erythematous lesions on the trunk and extremities in addition to typical vegetating lesions in the inguinocrural area. The histopathology which was characterized by eosinophilic spongiosis, as well as immunofluorescence and immunoelectron-microscopic studies indicated that the gyrate erythema (characterized by eosinophilic spongiosis) seen in our patient represented a manifestation of pemphigus. Treatment with retinoids resulted in the prompt disappearance of the gyrate erythemas, and the eosinophils returned to normal. A short-term, low-dose corticosteroid regimen also led to rapid healing of vegetating lesions.

Aged↗

Two-dimensional echocardiography in evaluating left ventricular function.

In 65 patients examined by mechanical sector and M-mode echocardiography, left ventricular volumes and ejection fraction were determined. Comparison with biplane ventriculography has shown that the above-mentioned parameters can be determined by sector relatively very reliably. Correlation coefficients for end-diastolic and end-systolic volumes were 0.74 and 0.85 respectively, for the ejection fraction 0.78. Substantially less close correlations were found for parameters obtained by one-dimensional echocardiography, especially in patients with segmental disturbances of kinetics and abnormal left ventricular geometry. The greatest contribution of this laborious and demanding method consists in the possibility of relatively reliable estimation of left ventricular volumes and ejection fraction by two-dimensional echocardiography also in these patients.

Adult↗