Biomedical subjects
Publications and source records attributed to G Hesse.
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This report concerns a multicentric skin tumor of dendritic cells. Skin-colored to reddish-brown papules and nodules erupted on the right arm of a 68-year-old man and, during the following years, spread to the upper extremities, shoulders, legs and face. Immunohistochemically the large, histiocyte-like tumor cells are Leu-6 (CD1), Leu-3a (CD4), HLA-DR/DQ and S-100 protein positive, but on thorough ultrastructural investigation were found to lack Birbeck granules. Thus, this disease represents a skin tumor of the interdigitating dendritic cell, an accessory cell which, in this case, was associated with a high content of T-lymphocytes within the cutaneous cellular infiltrate. The clinical course is characterized by periodic progression with intermittent, spontaneous regression. During a 7-year follow-up it was not possible to ascertain involvement of either lymph nodes or internal organs.
There have been many publications about enlarged summation potentials with Meniere patients. The phenomenon was interpreted as being due to endolymphatic hydrops. 50 patients were examined electrocochleographically who were suffering from the symptoms low-frequency hearing loss, vertigo, tinnitus and pressure in the ear. As in other previous studies a significantly enlarged negative summating potential was found in 70% of the patients. With 10 patients electrocochleography was performed before and three hours after glycerol ingestion. In 8 patients the SP became smaller, although the subjective hearing threshold improved in only 4 cases. The study shows that enlarged SP is a common finding in Meniere patients; it underlines the diagnostic value of electrocochleography in this disease.
A long-term study on 98 psoriatic patients with an average observation time of seven years proved that PUVA therapy with low doses of UV-A is sufficient to induce complete remission of psoriasis vulgaris (chronic stationary type). After a maintenance therapy of about 7.3 irradiations over 6.5 weeks, the patients were without symptoms for 64 weeks on an average. With regard to patients showing skin type II, III, or IV, we give detailed information on the increase of UV-A doses during the first eleven days of treatment.
A case of T-accessory cell tumor of the skin in a 67-year-old man is reported. The limbs, shoulders, and face were affected, but no visceral involvement is evident 6 years after onset. Tumor cells are nonphagocytic mononuclear cells with folded irregular nuclei. Immunologically, cells were positive for S100 protein, HLA-DR, Ki-M1, Leu 3a (CD4), Leu 6 (CD1); that is, they are identical to the phenotype of Langerhans or interdigitating reticulum cells (IDCs). Birbeck granules were absent. The clinical course appears to be less aggressive than that of the reported IDC sarcomas in other anatomical sites. The similarity of our case to some cases of so-called "non-X histiocytosis" of the skin is discussed. It is suspected that the "non-X histiocytosis of the skin" reported in the literature might have included T-accessory cell tumors, especially those of IDC origin. More immunological studies on the histiocytic disorders of the skin are necessary to clarify their cytogenesis.
Early diagnosis of possible atherosclerosis as a cause of ulcers in the lower leg is necessary for adequate therapy whether it is conservative, invasive, or operative. Percutaneous transluminal treatment of arteriosclerotic obstructions offer good and long-lasting results, particularly for the inoperable patient. Sometimes it is the prerequisite for the necessary venous treatment.
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We report 2 cases of Cogan's syndrome. One female patient had a typical interstitial keratitis and bilateral hearing impairment, the other had dramatically progressive deafness, combined with failure of the left vestibule and severe conjunctivitis resistant to treatment and otitis externa. The typical Cogan's syndrome with interstitial keratitis developed only a few weeks later. The disease is caused by an auto-immune response. The hearing impairment is mainly due to endolymphatic hydrops. Corticosteroids are the treatment of choice.
Pre-operative information about cochlear mechanical function is a pre-requisite for intra-cochlear implants. In more than 300 pre-operative examinations we demonstrated cochlear microphonics in many patients suffering from complete inner ear deafness; we interpret this phenomenon as evidence of mechanical function of the cochlea. A summation potential in patients with sensorineural deafness is more certain proof. We have now performed thorough electrocochleography on 43 deaf patients whose acoustic nerve was intact, i.e. whose promontory test was positive. After stimulation firstly with rarefaction tonebursts and later with condensation tonebursts and consecutive, off-line addition and subtraction we found small amplitude microphonics in 32 patients. Of these patients, 16 showed a negative potential that we interpreted as a summation potential. If these findings are verified by further investigations it will be possible to examine patients with inner ear deafness electrophysiologically. Furthermore this investigation is a very sensitive indicator of residual mechanical function of the cochlear basilar membrane.
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As in cardio-vascular diseases certain risk factors are held responsible for the genesis of inner ear affections. We thoroughly examined 205 patients, suffering from various kinds of internal ear disorders. Examinations included audiometric tests, medical, neurological and ophthalomological consultations and laboratory findings. Evaluation showed a significant increase of certain risk factors in our patients compared to the normal population. 50.2% of our patients were overweight, 29.3% had a high blood cholesterol, 28.8% had anaemia, and 22.4% had hypertension. These lesions of the auditory system thus share the same risk factors as the coronary and cerebral circulations. In the second stage of the study we looked for correlations between individual parameters and certain variations of inner ear disturbances, eg. sudden hearing loss, progressive or non-progressive hearing loss, low or high frequency disorders. It was not possible to distinguish between the forms of inner ear disease mentioned on the basis of the prevalence of certain risk factors.
In strongly acidic medium (70% HClO4) streptothricins form a fluorophore (lambda ex = 312 nm; lambda em = 381 nm) with unknown structure. A fluorimetric determination of pure or crude products and cultures, respectively, was worked out based on this reaction. Concentrations for fluorescence measurements were in the range of 10(-8) - 2 X 10(-7) moles. Interferences of the assay are discussed, a statistical evaluation of results and a comparison between microbiological and fluorimetric findings are given.
The psychosocial services provided over a period of two years to 24 children and young people with chronic renal insufficiency in various disease stages were analyzed on the basis of patient files. A total of 1475 contacts (units) were classified according to the four dimensions: (1) type of care provided, (2) problems dealt with, (3) contact persons, (4) disease stage. Variety and multitude of the individual psychosocial problems present demonstrate the scope for psychosocial activity. Supportive services (1) pertaining to the so-called disease-context (2) and, more specifically, personal contacts with the patients (3) in the dialysis stage (4) were found to prevail among the functions of the attending psychologist. Psychosocial services focussing on specific individual and/or practical issues had plainly been far more important in the care of the chronically ill children and their families, than approaches based on classical clinical psychology and psychotherapy. These findings have resulted in increased staffing for supportive services "on site" (i.e. during dialysis time), which has entailed greater latitude in the time available for dealing with relevant preventive aspects in preparing patients for dialysis and transplantation.
To ascertain the effects of STS 557 (17 alpha-cyanomethyl-17 beta-hydroxy-estra-4, 9-dien-3-one) on the reproductive and endocrine functions, male rabbits were given the substance orally daily over 8 weeks. In doses of 10 and 20 mg STS 557 per animal per day fertility inhibition was accompanied by a decrease of spermatogenesis and sexual activity. At the chosen dose of 5 mg per day, STS 557 caused a decrease of sperm motility, semen fructose content and sterility of the bucks. On the other hand, libido, semen volume, sperm number, sialic acid content in semen, serum LH and testosterone remained unaffected. Concomitant injection of testosterone did not reverse the suppressive effect of STS 557 on fertility. Motility of human sperm was lowered markedly by STS 557 in vitro. The human sperm penetration and pronuclear formation were significantly reduced in the vitro fertilization assay with zona-free hamster eggs. Findings are discussed in view of the development of male contraceptives.
The toxicity of 17 alpha-cyanomethyl-17 beta-hydroxy-estra-4, 9-dien-3-one (STS 557) was studied by its oral administration of 0.1, 1.0 or 10.0 mg/kg/day to Wistar rats for six months, and of 0.01, 0.1 or 1.0 mg/kg/day to beagle dogs for six months, respectively. Levonorgestrel at a dose of 1.0 mg/kg/day was used as the standard in the dog study. With respect to the progestational activity of the compound the main target organs were the hypophysis, the reproductive organs and the adrenals. Mammary hyperplasia was observed in dogs treated with STS 557 or levonorgestrel at the dose of 1.0 mg/kg/day, but in no case mammary nodules could be detected. At the dose of 1.0 mg/kg/day STS 557 and levonorgestrel were found to increase the plasma insulin response to i.v. glucose in bitches, but neither the mean blood glucose levels nor the glucose utilization were affected. Moreover, during administration of both steroids to dogs temporary changes in serum concentrations of triglycerides and total cholesterol were noted. The results obtained in rats and dogs from functional and morphological investigations did not reveal any toxic side effects of STS 557 on the liver, the kidneys, the bone marrow or on blood coagulation. The effects on the reproductive organs observed following STS 557 especially in dogs are related to both the hormonal effects of the compound and the specific response of the dog to potent progestagens.
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