[A patient with cicatricial parapemphigus of the larynx and hypopharynx].
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Biomedical subjects
Publications and source records attributed to E Stolz.
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In an open randomized study in a large Rotterdam male and female population (n = 1500), suffering from uncomplicated urogenital, rectal and oropharyngeal gonorrhoea treatment with cefotaxime 1.0 g proved to be more effective than with cefuroxime 1.5 g in all patients studied. However, statistically significant differences between the failure rates of the cefotaxime and the cefuroxime treatment were found only for all male and female patients, in urethral or urogenital and rectal infections in this group, for all male patients, and in urethral infections in men. Failure rates were low (1.7 and 5.6%, respectively for cefotaxime and cefuroxime). Oropharygeal gonorrhoea responded less well than urethral or urogenital and rectal gonorrhoea. Both drugs were very effective in the eradication of uncomplicated gonococcal infections caused by both non-beta-lactamase producing and beta-lactamase producing gonococci. High (greater than 30%) post-gonococcal urethritis rates were observed. Side-effects were minor.
A double blind pilot study was done to compare the efficacy and safety of treatment of uncomplicated gonorrhoea with two dosages of enoxacin. Eleven patients were treated with 600 mg enoxacin as a single oral dose and eleven patients were given 400 mg twice with an interval of 4 h. A cure rate of 100% was found with both dosages. No side effects were noted and there were no abnormalities in haematological tests or renal and hepatic function tests after treatment. MIC's of enoxacin and other relevant antibiotics were determined. A single oral dose of 600 mg enoxacin seems sufficient to cure uncomplicated gonorrhoea and warrants further investigation in more patients.
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Certain chemicals such as persulphates and formaldehyde are able to induce both immediate and delayed type reactions in the skin. The levels of delayed type response to persulphates (at 48 and 74 h), obtained by epicutaneous tests were subjected to comparative studies of shifts (48 versus 72 h) and statistical analysis. The 95% confidence limit of the mean value of shifts to persulphates was significantly higher than that of a standard routine battery as a whole and, with the exception of formaldehyde, also to that of other individual constituents of this battery. In the case of persulphates, this difference in shifts was due to an extremely low mean value of delayed-type response read at 48 h. The possible underlying mechanisms and the possible limiting rôle of vaso-active amines in the early evolution of delayed-type response is discussed.
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A case is described of malignant B-cell lymphoma with scleroderma-like manifestation. Using different monoclonals as B-cell markers the tumor appeared to be positive for surface immunoglobulins (SmIg) and for B2-antigen, but negative for intracytoplasmic immunoglobulin (CIg), BA2- and FMC7-antigens. Therefore, the tumor could be determined as a highly differentiated Sm-positive early B-cell type of B-cell lymphoma. In this clinically rare manifestation of cutaneous B-cell lymphoma aspects of the cell morphology and of cellular mediated immunity are briefly discussed.
We compared the survival of a laboratory strain of Chlamydia trachomatis serovar L-2 in different media and at different temperatures (room temperature, 4 degrees C, and -70 degrees C). At these temperatures the best storage medium was 2SP (0.2 mol/l sucrose in 0.02 mol/l phosphate buffer supplemented with 10% fetal calf serum). We used material obtained from patients to study the sensitivity of the culture method as a function of sample storage time and temperature. Compared with results on direct inoculation, material stored in 2SP for 48 hours gave 11% fewer positive cultures at 4 degrees C and 14% fewer at room temperature. Of samples which gave negative results on direct inoculation, 4% were positive after storage at 4 degrees C for 48 hours and 2% after storage at -70 degrees C for a week. As expected, the number of inclusion forming units in the original material proved to be important for the percentage of positive cultures among the stored samples.
We took blood samples from 128 prostitutes visiting the outpatient venereology department of the University Hospital, Rotterdam-Dijkzigt to test for the presence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs). The prevalence of anti-HBs was found to be significantly higher in the group of prostitutes than in "normal populations", and we concluded that more of the former had been in contact with the hepatitis B virus (HBV). We recommend that the advice on vaccination of the hepatitis B committee of the Health Council of The Netherlands should be followed by screening prostitutes for the presence of HBsAg and anti-HBs in the blood, and vaccinating those who have no anti-HBs.
Five patients with hand-, foot- and mouth disease, caused by infection with Coxsackievirus type A16, are described in an epidemic outbreak of this disease. Hand-, foot- and mouth disease, is characterized by a most distinctive enanthem-exanthemcomplex. In 65% of the cases a vesiculopapular exanthem is noted. Most cases are described in epidemic outbreaks. Although the vast majority of occurrences of the disease have been due to Coxsackie A16 viral infections, occasionally Coxsackie A5, A10 and enterovirus 71, seldom Coxsackievirus B1 or B3, have been etiologically incriminated. In this article attention is paid to the clinical characteristics, the epidemiology and the differential diagnostic aspects of hand-, foot- and mouth disease.
A solitary case of Trichorhinophalangeal syndrome type I is described. Scanning electron microscopic examination revealed alterations of the cuticular pattern and hair shaft structure. These alterations have not been previously described and differ from those seen in other syndromes belonging to the group of the ectodermal dysplasias e.g. the Trichoonytic Hidrotic ectodermal dysplasia, autosomal recessive Anhidrotic ectodermal dysplasia and X-linked Anhidrotic ectodermal dysplasia.
In two unusual cases of pemphigus, classified as pemphigus erythematosus (PE), the clinical and laboratory data are summarized and discussed. In case I, with characteristic immunologic features of PE, acantholysis was detectable only by the EM-technique. Case II with transitory pemphigus and features of SLE was diagnosed as "probable PE". In this case (case II) concomitant incidence was found of benign thymoma. In addition in both cases the patterns of T-cells and T-cell-subsets in blood and lesional skin are briefly discussed.
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Plasma levels of thromboxane B2 and 6-keto-prostaglandin F1 alpha were measured in six patients with systemic mastocytosis. Patients with systemic mastocytosis had significantly higher plasma thromboxane B2 levels (530 +/- 105 pg/ml, mean +/- SEM) than controls (118 +/- 8.2 pg/ml, P less than 0.001) and significantly lower 6-keto-prostaglandin F1 alpha levels (40 +/- 3.1 pg/ml, mean +/- SEM) than controls (49 +/- 1.6 pg/ml, P less than 0.05). The mechanism of the raised plasma thromboxane B2 levels is not clear. One possible explanation is that the high thromboxane levels are secondary to an increased production of leukotrienes C and D, which are constituents of slow reacting substances of anaphylaxis.