Exposing the human nude phenotype.
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Alopecia↗
Biomedical subjects
H Baden
Publications and source records attributed to H Baden.
TGF-beta3, but not TGF-beta1, protects keratinocytes against 12-O-tetradecanoylphorbol-13-acetate-induced cell death in vitro and in vivo.
We have examined the role that individual TGF-beta isoforms, and in particular TGF-beta3, play in control of epidermal homeostasis. Mice with a knockout mutation of the TGF-beta3 gene die a few hours after birth. A full-thickness skin grafting approach was used to investigate the postnatal development and homeostatic control of the skin of these mice. Grafted skin of mice with a disruption of the TGF-beta3 gene developed similarly to grafts of wild type and TGF-beta1 knockout animals. However, a strikingly different response was observed after acute treatment with the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). When exposed to TPA, the grafted skin of wild type and TGF-beta1 knockout mice underwent a hyperplastic response similar to that of normal mouse skin. In marked contrast, TPA treatment of TGF-beta3 knockout grafts induced widespread areas of keratinocyte cell death. Analysis of cultured keratinocytes treated with purified TGF-beta isoforms revealed that TGF-beta3 plays a direct and specific function in protecting keratinocytes against TPA-induced cell death. The protective function of TGF-beta3 on TPA-induced cell death was not because of general suppression of the signaling pathways triggered by this agent, as ERK1/2 activation occurred to a similar if not greater extent in TGF-beta3-treated versus control keratinocytes. Instead, TGF-beta3 treatment led to a significant reduction in TPA-induced c-Jun N-terminal kinase activity, which was associated and possibly explained by specific counteracting effects of TGF-beta3 on TPA-induced disruption of keratinocyte focal adhesions.
Actins↗
Sea-blue histiocytosis and pancytopaenia associated with chronic total parenteral nutrition administration.
A 22-year-old female on chronic total parenteral nutrition for short bowel syndrome presented for investigation of pancytopaenia and hepatosplenomegaly. Bone marrow examination revealed an infiltrate of sea-blue histiocytes and cytochemistry confirmed these to be lipid laden macrophages. The total amount of fat in the feeding regimen was subsequently reduced, and there has been a partial haematological improvement. The occurrence of sea-blue histiocyte syndrome complicating the fat emulsion component of chronic total parenteral nutrition has been reported recently. To our knowledge this report is the first where reduction in the lipid content of the feeding regimem has resulted in an improvement in the degree of pancytopaenia.
Adult↗
[Retinal detachment despite preventive coagulation].
From 1974 to 1989 a total of 3447 cases of retinal detachments were treated surgically in three departments of ophthalmology in Hamburg. It was found that 245 (7.2%) of these eyes had previously been subjected to prophylactic coagulation because of lattice degeneration, tears, and retinoschisis. Retinal detachment followed the coagulation in 45% within 1 year in 45% of cases within 10 years in a further 45%, and after 11 years or longer in a further 5%. (In 5% the time of coagulation was unknown). The retinal defects responsible for detachment were within or at the border of the coagulation scars in 66% of cases. In this group the time interval between the coagulation and the occurrence of retinal detachment was half that in the eyes in which defects developed in the untreated retina. The obvious faults of the prophylactic coagulation are discussed.
Adolescent↗
Guidelines of care for androgenetic alopecia. American Academy of Dermatology.
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Alopecia↗
[Pancreaticoduodenectomy (Whipple's operation) for periampullary cancer].
This study evaluated the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients with periampullary adenocarcinoma. Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumour. The postoperative mortality rate after Whipple's operation was 8% (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15% (confidence limits, 5 to 25%). The five year survival rate for patients without tumour extension beyond the pancreas was 25% (confidence limits, 5 to 50%), and in patients with adenocarcinoma of the ampulla af Vater, 34% (confidence limits, 3 to 65%). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25% and a postoperative mortality rate of less than 5%.
Adenocarcinoma↗
[Liver resection of metastases from colorectal cancer].
From 1978 to the end of 1991, 66 patients were operated on for liver metastases from colorectal cancer. All patients had had a curative resection of their colorectal cancer. Forty resections of the liver were major anatomic resections. This study was undertaken to determine the indications for and value of liver resection for metastases from colorectal cancer. Five patients died in the postoperative period. All resections were intended to be curative, but in 16 of the patients the resection became noncurative. None of these patients lived more than two years after liver resection. Fifty patients with a curative resection had a three-year survival rate of 36 percent, postoperative death included. Recurrence in the liver was observed in 30 patients (60 percent) from three to 33 (median 11) months after the liver resection. Four patients had repeated resections performed. Two of them are alive without recurrence at respectively 34 and 60 months after the first liver resection. The difference in survival between curative and noncurative liver resection was highly significant (p = 0.01). Sex, age, Dukes' stage of primary colorectal cancer, synchronous or metachronous appearance of metastases, or number of metastases could not predict long-term prognosis. The only factors of predictive value were tumour size, a free resection margin, and no extrahepatic tumour. If it is possible to perform a curative resection, there should be few contraindications against liver surgery as it is the only treatment that can demonstrate long-term survival for approximately one-third of the patients, and it is the only possibility of cure. Palliative resection is not recommended.
Adult↗
Resection of liver metastases from colorectal cancer. Indications and results.
PURPOSE: This study was undertaken to determine the indications for and value of liver resection for metastases from colorectal cancer. METHODS: From 1978 through 1991, 66 patients were operated on for liver metastases from colorectal cancer. All patients had had a curative resection of their colorectal cancer. Forty resections of the liver were major anatomic resections. RESULTS: Five patients died in the postoperative period. All resections were intended to be curative, but in 16 of the patients the resection became noncurative. None of these patients lived more than two years after liver resection. Fifty patients with a curative resection had a three-year survival rate of 36 percent, postoperative death included. Recurrence in the liver was observed in 30 patients (60 percent) from 3 to 33 (median, 11) months after the liver resection. Four patients had repeated resections performed. Two of them are alive without recurrences 34 and 60 months after the first liver resection, respectively. The difference in survival between curative and noncurative liver resection was highly significant (P = 0.01). CONCLUSIONS: Sex, age, Dukes stage of primary colorectal cancer, synchronous or metachronous appearance of metastases, or number of metastases could not predict long-term prognosis. The only factors of predictive value were tumor size less than 4 cm in diameter, a free resection margin, and no extrahepatic tumor. If it is possible to do a curative resection, there should be few contraindications against liver surgery as it is the only treatment that can demonstrate long-term survival for approximately one-third of the patients, and it is the only possibility of a cure.
Actuarial Analysis↗
Pancreaticoduodenectomy for periampullary adenocarcinoma.
BACKGROUND: This study evaluates the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients for treatment of periampullary adenocarcinoma. STUDY DESIGN: Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumor. Postoperative follow-up of clinical symptoms was done after one year. RESULTS: The postoperative mortality rate after Whipple's operation was 8 percent (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15 percent (confidence limits, 5 to 25 percent). The five year survival rate for patients without tumor extension beyond the pancreas was 25 percent (confidence limits, 5 to 50 percent), and in patients with adenocarcinoma of the ampulla of Vater, 34 percent (confidence limits, 3 to 65 percent). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Most patients surviving more than one year were doing well, although 60 percent needed exocrine pancreatic substitution therapy. CONCLUSIONS: Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25 percent and a postoperative mortality rate of less than 5 percent.
Adenocarcinoma↗
Phenotype of cranioectodermal dysplasia with different hair and bone abnormalities.
We report on a 3-year-old boy with hair abnormalities and a generalized bone dysplasia. He had very short, sparse hair and craniosynostosis. His stature, growth, and limb lengths were normal, as was his neurological development. While this phenotype has some resemblance to cranioectodermal dysplasia, the radiographic and hair abnormalities are different. Histological studies showed abnormalities in the internal root sheath of the hair follicle and the hair shaft. These findings define a new ectodermal dysplasia syndrome of unknown cause.
Child, Preschool↗
Morbidity after immediate and delayed opening of sigmoid end colostomy: a randomised trial.
OBJECTIVE: To see if sigmoid end colostomies that were opened immediately carried a higher early morbidity than those in which opening was delayed for 10 days. DESIGN: Randomised trial. SETTING: University department of surgical gastroenterology. SUBJECTS: All patients for whom a temporary or permanent end sigmoid colostomy was done between December 1986 and May 1989. INTERVENTIONS: 51 patients had their colostomies opened immediately, and in 49 opening was delayed. MAIN OUTCOME MEASURES: Presence of ischaemia, retraction, separation or infection, and length of stay in hospital. RESULTS: Two patients from each group died within the first week; none of the deaths was associated with complications of the colostomy. One patient whose colostomy had been opened immediately developed gangrene of the stoma, and one in whom the opening had been delayed developed retraction. There was no difference between the groups in length of stay in hospital. CONCLUSION: As we could find no differences in morbidity whether the colostomy was opened immediately or whether it was delayed, we now recommend that it should be done immediately. The question of late complications (stenosis and hernia), however, cannot be answered yet.
Cause of Death↗
Surgical treatment of morbid obesity. A survey of overall outcome 1968-1989.
This survey evaluates benefits and costs from a policy of employing surgical treatment in selected cases of morbid obesity. Between 1968 and 1978, we used end-to-side jejunoileal bypass. Despite many satisfied patients, complications were frequent and severe. For the next decade, we employed various types of gastric surgery. We eventually assessed a gastric balloon, but without success. Median duration of follow-up was 132 months in 145 patients with jejunoileostomy, 103 months in seven gastric bypass patients, and 36 months in 108 gastroplasty patients. Three patients were lost to follow-up. There have been four deaths after intestinal shunt and one after gastroplasty. The median re-admission rate was 1.6 per patient, while the median number of re-operations was 2.0 after intestinal shunt and 0.8 after gastric interventions. The median weight loss in our 260 patients was 32.1% of the preoperative weight. Outcome was good in 38.8%, acceptable in 40.4% and poor in 11.5% while there were 9.2% failures. Truly satisfactory outcomes, however, were rare, owing possibly to a negative relationship between weight loss and complications. Only 8.8% have obtained a stable normal weight without any side-effects.
Female↗
The use of minoxidil to attempt to prevent alopecia during chemotherapy for gynecologic malignancies.
Minoxidil 2% topical solution applied twice a day is known to induce hair growth and prevent hair loss in normal male pattern baldness. Based on this potential, this pilot study tested the effect of Minoxidil on hair loss during chemotherapy for gynecologic cancers. Ten women about to start alopecia-inducing chemotherapy protocols were entered into this non-randomized prospective trial. By study design, each patient served as her own control, as only a portion of the scalp was treated with Minoxidil. Four of the ten patients were unevaluable for failing to comply with the twice-a-day Minoxidil application schedule. Of the six evaluable patients, five experienced complete or severe symmetrically diffuse hair loss, all of which occurred within four weeks of initiating chemotherapy. One patient had no hair loss in either the treatment or control area. Application of the topical Minoxidil in all ten patients had no untoward side effects, skin changes or hypotension. Thus, in this pilot study, 2% Minoxidil was non-toxic but showed no benefit in the prevention of chemotherapy-induced alopecia.
Administration, Topical↗
[Iatrogenic biliary tract injuries].
From 1984 to 1986 The Medico-Legal Council was heard concerning four cases of iatrogenic lesions of the common bile duct during cholecystectomy. The Council's statements show that lesions of the common bile duct or the common hepatic duct during otherwise uncomplicated, elective cholecystectomy are considered surgical malpractice and not accidental mishaps.
Cholecystectomy↗
[Is clinical diagnosis alone unacceptable in acute appendicitis?].
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Acute Disease↗
Long-term survival after resection of ductal carcinoma in the body and tail of pancreas.
We report on a 62-year-old male, who had resection of a large ductal carcinoma in the body and tail of the pancreas. Four months later a metastasis was removed from the abdominal scar, and 14 months later another metastasis was removed from the anterior wall of the stomach. Moreover, he had a left mastectomy followed by radiation therapy for a primary ductal carcinoma and a transurethral resection of the prostate because of benign hyperplasia. A minor focus of primary highly differentiated adenocarcinoma was found in the chips. More than 6 years later, the patient is without any signs of recurrences.
Carcinoma, Intraductal, Noninfiltrating↗
Acute psychotic disorders treated with 5% zuclopenthixol acetate in 'Viscoleo' ('Cisordinol-Acutard'), a global assessment of the clinical effect: an open multi-centre study.
In an open clinical multi-centre trial carried out in five Danish psychiatric departments, patients suffering from acute psychosis including mania or exacerbation of chronic psychosis were given injections of 5% zuclopenthixol acetate in 'Viscoleo'. The object of the trial was to evaluate the treatment by means of a global assessment of the severity of the psychosis, the therapeutic effect and the side-effects. The results showed that the treatment was rapidly effective in reducing the severity of psychotic symptoms combined with an advantageous unspecific sedation. The side-effect profile was similar to that after other neuroleptics. Special attention should be paid, however, to a possible occurrence of acute dystonia which was observed particularly in young men with acute psychosis.
Acute Disease↗
Misdiagnosis of breast cancer in an out-patient breast clinic.
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Aged↗