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Biomedical subjects

G Burg

Publications and source records attributed to G Burg.

At least 307 records · Page 17Linked to original sources
PubMed1993

[Malignant lymphoma of the skin].

Extranodal non-Hodgkin lymphomas preferentially involve the skin. Among them, 65% are T-cell lymphomas, 25% B-cell lymphomas and about 10% rare variants or nonclassifiable lymphomas. Mycosis fungoides is the most common form of low-grade malignant peripheral cutaneous T-cell lymphoma (CTCL): Lymphomas originating from follicular center cells are the most common types of cutaneous B-cell lymphomas (CBCL). Only 15 to 25% of cutaneous lymphomas show extracutaneous manifestations at time of diagnosis. The prognosis is relatively good, since the average survival time from diagnosis is 12 to 14 years. For making the diagnosis, clinical, histo- and cytomorphological parameters often have to be supplemented by phenotypic, genotypic and molecular biologic techniques in order to establish the correct diagnosis. An important problem still is the early diagnosis and early evaluation of prognostic parameters in CTCL. The therapeutic approach is control of the disease according to stage and prognostic parameters.

Combined Modality Therapy↗
PubMed1993

[Soluble interleukin 2 receptor as activity parameter in serum of systemic and discoid lupus erythematosus].

The evaluation of disease activity in systemic lupus erythematosus (SLE) is important for selection of the appropriate therapeutic regimen. In addition to the clinical picture, various laboratory parameters are taken into account. However, no validated criteria for the evaluation of the disease activity in SLE have yet been established. Recently, serum levels of soluble interleukin-2 receptor (sIL-2R) have been proposed as a potential parameter for disease activity in SLE. However, the studies reported on this subject so far have focused mainly on certain subsets of the disease, and the evaluation of the disease activity was based on a very limited number of parameters. In the present study, we determined serum levels of sIL-2R in 23 patients with SLE and 30 patients with discoid LE (DLE). Evaluation of disease activity in SLE was based on a comprehensive scale which considered numerous clinical signs and laboratory parameters. In SLE, serum levels of sIL-2R showed a better correlation with disease activity than all the other parameters investigated, including proteinuria, erythrocyte sedimentation rate, serum globulin concentration, titre of antibodies against double-stranded DNA, serum albumin concentration, serum complement levels and white blood cell count. For the first time, we report on elevated serum levels of sIL-2R in DLE, which also correlated with disease activity.

Adolescent↗
PubMed1993

[Amyloidosis cutis nodularis atrophicans (Gottron)].

We report an exceptionally severe case of amyloidosis cutis nodularis atrophicans (Gottron) of the lower limbs in a 49-year-old female patient. The diagnosis was made on clinical and histological grounds and was confirmed by immunohistochemical evidence of amyloid of the A-lambda type. For the first time, cutaneous microcirculation in the region of the nodules was investigated by means of fluorescence video microscopy. Pronounced microangiopathy characterized by avascular fields, enlarged and tortuous capillaries and increased transcapillary diffusion of sodium fluorescein, was clearly demonstrable in the area of the nodules. The pathogenetic role of these vascular changes is discussed.

Amyloid↗
PubMed1993

[Lupus erythematosus discoid-like dermatosis in a carrier of septic granulomatosis].

We present a clinically atypical case of discoid lupus erythematosus in the mother of a boy with chronic granulomatous disease. In this disorder, the phagocytes are unable to produce superoxide anion to degrade incorporated microorganisms. In addition to a discoid lupus erythematosus-like skin disease, recurrent stomatitis aphthosa, hidradenitis suppurativa and Raynaud phenomenon are markedly associated with heterozygote carriers of chronic granulomatous disease. Based on this conspicuous association, diverse models concerning the pathogenesis of lupus erythematosus are discussed.

Adult↗
PubMed1993

[Pseudomonas aeruginosa folliculitis after epilation].

We report on a rare case of Pseudomonas aeruginosa folliculitis following depilation of the legs in a 33-year-old woman. Recently attention has been drawn to Pseudomonas-folliculitis acquired from whirlpools. The possibility of P. aeruginosa folliculitis occurring after skin depilation is less well known. The source of infection may be contaminated cosmetics or the hospital environment. The conditions favouring Pseudomonas invasion of the skin, and the clinical picture, course and of treatment P. aeruginosa folliculitis are discussed.

Administration, Topical↗
PubMed1993

[Pemphigus foliaceus caused by penicillamine].

We report the case of an 80-year-old woman who developed pemphigus foliaceus while taking penicillamine for rheumatoid arthritis. On the basis of this new case, we discuss fresh insights into the pathogenesis of drug-induced pemphigus. In addition, having reviewed the literature, we give a list of drugs that have been reported to induce this disease.

Aged↗
PubMed1993

[Unilateral "nevoid" spider nevi].

A case of unilateral spider telangiectasia on the left side of the face initiating at puberty is reported. With respect to its therapy and prognosis this alteration must be distinguished from other telangiectasias. With unilateral nevoid telangiectasia it shares the unilateral distribution of the lesions and the predilection for the female sex during hormonal instability periods. Both of these types of acquired telangiectasia seem to occur in relation with endocrine influences. Unilateral nevoid telangiectasia may also show typical spider telangiectasia but occurs in combination with other telangiectatic alterations. Unilateral "nevoid" spider telangiectasia consists exclusively of spider telangiectasia. Pathogenesis and further differential diagnosis of this peculiar type of primary telangiectasia are outlined.

Adolescent↗
PubMed1993

Peripheral blood mononuclear cells in patients with nonleukemic cutaneous T-cell lymphoma. Reduced proliferation and preferential secretion of a T helper-2-like cytokine pattern on stimulation.

BACKGROUND AND DESIGN: Since patients with cutaneous T-cell lymphoma (CTCL) demonstrate several immunologic abnormalities such as elevated serum immunoglobulin levels or reduced natural killer cell activity, we analyzed functional properties of the peripheral blood mononuclear cells in patients with nonleukemic CTCL and healthy donors. RESULTS: After priming with phytohemagglutinin for 3 days, a reduced proliferation in the presence of interleukin 2 and interleukin 4 was found. Limiting dilution technique revealed a diminished number of peripheral blood mononuclear cells from patients with CTCL that were capable of proliferating on interleukin 2 but not on interleukin 4 stimulation. Phytohemagglutinin induced a significantly higher release of interleukin 4 (mean +/- SD, 196 +/- 149.8 pg/mL [n = 19] vs 76.4 +/- 16.4 pg/mL [n = 248]) and a significantly lower secretion of interferon-gamma (24.9 +/- 30.7 U/mL [n = 17] vs 47.5 +/- 43.5 U/mL [n = 18]) in the peripheral blood mononuclear cells of patients with CTCL compared with the peripheral blood mononuclear cells of healthy donors (P < or = .02, U test). CONCLUSION: These functional characteristics can be explained by an imbalanced T helper-1/T helper-2 system and allow speculations concerning clinical features such as elevated immunoglobulin serum levels and reduced cytotoxic activity in patients with CTCL.

Adult↗
PubMed1992

[Controversial aspects of stage I skin melanomas].

Melanoma is still the most frequent cause of death for diseases arising in the skin. The mortality rate is approximately 25%, tumor thickness, sex and localization being the most important prognostic factors. It is still unclear whether the margin of excision, type of anaesthesia and the pattern of follow-up should be taken into consideration in relation to the individual prognostic groups.

Anesthesia↗
PubMed1992

[The pathogenesis of psoriasis--new results].

A great deal of new immunological, biochemical, and cell biological information has been published on the pathogenesis of psoriasis. Many of these findings must be considered to be epi-phenomena of the inflammatory reaction (clinical correlate--erythema) and hyperproliferation of keratinocytes (scaling). The mechanisms of the psoriatic inflammatory reaction and of the specific neutrophil infiltration can now be more readily understood following the discovery of adhesion molecules, and the identification of new mediators--in particular NAP-1/IL-8. Proliferation-promoting factors for keratinocytes in vitro, that is, possible mediators of psoriatic scaling, are listed, and currently known changes in expression and concentration in psoriatic lesions are discussed.

Acute-Phase Proteins↗
PubMed1992

[Current treatment methods in skin tumors].

Modern aspects of treatment for malignant melanoma, basalioma and cutaneous lymphomas are reviewed. Cytokines have been proposed as immunostimulants in adjuvant therapy (destruction of residual tumor) for malignant melanoma or at high doses for treatment of metastatic melanoma. Basalioma is the most common tumor of the skin, prone to recurrence because of its iceberg-like subclinical growth-pattern. Micrographic surgery is best adapted to this growth behaviour by following the extent of the tumor in all directions by special histopathologic techniques thus permitting radical excision. Primary lymphomas of the skin although rare (1 in 100,000 per year) prevail and cumulate because of the long course over years and decades. New treatment avenues have opened by topical use of phospholipids and cytostatic drugs i. e. carmustine (BCNU).

Administration, Topical↗
PubMed1992

Influence of free radical scavengers on myeloperoxidase activity and lipid peroxidation in acute skin grafts.

Activated neutrophil granulocytes are an important source of oxygen free radicals in acute skin grafts. Lipid peroxidation and immigration of PMNs, indicating inflammatory mechanisms, affect each other to a variable extent. The effect of the scavengers allopurinol and alpha-D-tocopherol on both lipid peroxidation and neutrophilic infiltration was investigated. A possible mechanism for the superior effect of allopurinol compared to vitamin E was discussed.

Allopurinol↗
PubMed1992

The interleukin-2 receptor in lesions and serum of bullous pemphigoid.

The interleukin-2 receptor (IL-2R) is mainly expressed on activated T cells. Depending on its rate of synthesis, a portion is released from the cell surface as soluble IL-2R (sIL-2R). Since the role of mononuclear cells in the pathology of bullous pemphigoid (BP) is not well understood, we determined the sIL-2R in both blister fluid and serum of 15 BP patients with generalized disease before initiating systemic treatment. In addition, we obtained both lesional and perilesional skin biopsies and examined the mononuclear infiltrate with a panel of monoclonal antibodies. In BP blisters, sIL-2R levels were significantly increased (2070 +/- 350 U/ml), (+/- SEM) compared with serum samples taken at the time of blister puncture (1340 +/- 290 U/ml). In six patients with blisters due to second-degree burns or friction and in five suction blister volunteers, sIL-2R levels were normal in both blisters and serum. In BP, elevated serum levels decreased to normal during therapy, correlating with disease activity. The immunohistology showed that 30% of mononuclear cells in the dermal infiltrate of lesional skin expressed the IL-2R, whereas only 15% were positive in perilesional skin. IL-2R-positive cells are the most likely source of the shed receptor in BP blisters. Our results indicate the presence of activated T cells in lesions and peripheral blood of BP and thus underline the importance of cell-mediated immune mechanisms in the pathology of this disease.

Blister↗
PubMed1992

Gamma/delta receptor-expressing T-cell clones from a cutaneous T-cell lymphoma suppress hematopoiesis.

Recently we described a cutaneous T-cell lymphoma expressing the gamma/delta T-cell receptor [5]. The patient suffering from this lymphoma showed low numbers of myeloid and T cells in peripheral blood, while B and NK cells were relatively increased. In vitro culture of the patient's bone marrow (BM) cells revealed a significant suppression of myeloid/monocyte colony formation (GM-CFU) compared with normal controls. This was not due to infiltration of the BM with lymphoma cells. We speculated that a soluble factor either secreted or induced by the lymphoma cells might be responsible for the marked suppression of hematopoiesis in this patient. From a skin biopsy with infiltrating gamma/delta T-lymphoma cells we established T-cell clones bearing the gamma/delta T-cell receptor and resembling the phenotype of the lymphoma cells. The supernatant (SN) of these gamma/delta T-cell clones reduced the number of colonies in a CFU-GM assay (using normal control BM) in comparison to SN of alpha/beta T-cell clones established from the same biopsy. This suppression was seen mainly on day 7 of culture and was not neutralized by the addition of placenta-CM. The main mediator of this suppression seems to be IFN-gamma, since it was detectable in high amounts in the SN of these gamma/delta T-cell tumor clones as well as in the serum of the patient. In addition, anti-IFN-gamma antibodies can reverse the T-cell SN-mediated suppression of CFU-GM. We conclude that high serum levels of interferon-gamma, which is secreted in high amounts from gamma/delta T-cells grown from a biopsy of a cutaneous lymphoma, can suppress hematopoiesis.

Bone Marrow Cells↗
PubMed1992

The prognosis of primary and metastasising melanoma. An evaluation of the TNM classification in 2,495 patients.

The prognostic value of the TNM classifications of the UICC dated 1978 and 1987, was investigated in a population of 2,495 patients who were followed up over the long term. In the case of primary melanoma, Breslow's tumour thickness proved to be the most powerful predictor of patient survival in multivariate analysis, while the significance of Clark's level ranged after that of both localisation of the primary tumour and the sex of the patient. The continuous proportional relationship between tumour thickness and risk of death makes it possible to regrade thickness groups. Grading cutoffs at 1, 2 and 4 millimetres, with no account being taken of depth of invasion, proved to be particularly favourable for a classification in accordance with prognostic criteria. In advanced stages of the disease, the outcome of locoregional and distant metastasis is significantly different; and furthermore in the case of locoregional metastasis, in-transit and satellite metastases exert a significantly better prognosis than regional lymph node involvement. Isolated juxtaregional lymph node metastases occurred primarily or during the course of the observation period in only 19 patients of our group, and, in comparison with visceral metastases, proved to have only an insignificantly better prognosis. For this reason, it would appear meaningful to assign them to a common stage. On the basis of these results, proposals are made for modifications of the TNM classification.

Evaluation Studies as Topic↗
PubMed1992

[Recurrent eyelid tumor in necrotizing panniculitis].

To our knowledge, necrotizing lid tumors occurring in the context of a necrotizing lobular panniculitis have not yet been described in the literature. Our patient, a 75-year-old male, presented with indolent, nonmoveable subcutaneous lumps that were centrally ulcerating. They appeared first on his upper lid, then on his lower lid and thereafter on the neck, back, upper extremity and abdomen, especially in the area of his cholecystectomy scar. A thorough work-up, which included repeated histopathological examinations performed by several laboratories, led to the diagnosis of an idiopathic necrotizing lobular panniculitis. A serum level determination performed later revealed no alpha 1-antitrypsin deficiency. As the eye-lid's subcutaneous tissue lacks fat, the association between the necrotizing lid tumors and the necrotizing panniculitis appears to be a paradox. In spite of the normal alpha 1-antitrypsin serum levels--determined when the patient's lesions had long ago healed--we think in retrospect that the differential diagnosis should have included the possibility of a decreased alpha 1-antitrypsin serum level (e.g. heterozygous MZ-phenotype). An alpha 1-antitrypsin level deficiency--with resulting decreased inhibition of collagenase and elastase--could account for the necrotizing process that also occurred in the eyelid's subcutaneous tissue. In the Van Gieson stain of this patient's eyelid biopsy, fragmentation of all visible collagen and elastic fibers was noted. In our opinion, the differential diagnosis does include lid involvement with secondary panniculitis caused by partially decreased alpha 1-antitrypsin serum levels and--by exclusion--idiopathic necrotizing lobular panniculitis. Therapeutic possibilities are briefly discussed.

Aged↗
PubMed1992

Circulating intercellular adhesion molecule-1 in melanoma patients: induction by interleukin-2 therapy.

Intercellular adhesion molecule-1 (ICAM-1, CD54), a molecule bound to the cell surface membrane, mediates various cell-cell interactions in inflammation and immunosurveillance. By means of a new specific enzyme-linked immunosorbent assay (ELISA) for soluble ICAM-1, free circulating ICAM-1 was measured in serum from five healthy volunteers, 10 melanoma patients at different stages of their disease, and eight patients receiving high-dose interleukin-2 (IL-2) for metastatic melanoma. No correlation between the concentration of circulating ICAM-1 and the tumor burden could be detected. In melanoma patients receiving high-dose IL-2, we observed an increase of circulating ICAM-1 of up to 200%, compared to the concentration prior to therapy, ranging between 4 and 13 ng/ml. The increase in circulating ICAM-1 was associated with the induction of tumor necrosis factor-alpha and interferon-gamma.

Cell Adhesion Molecules↗