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Biomedical subjects

H C Korting

Publications and source records attributed to H C Korting.

At least 163 records · Page 9Linked to original sources
PubMed1990

[A clinical trial of desired and unwanted effects of topically applied glucocorticosteroids in the human].

Several methods are available for testing the clinical efficacy of topical glucocorticosteroids, some of which only check single parameters relevant to the inhibition of inflammation. These methods include the vasoconstriction assay, the erythema inhibition assays, the psoriasis-plaque assay and the contact sensitization inhibition assay. The methods of testing side-effects include the Duhring chamber assay, the ammonium hydroxide blister assay and the corticoid stratum corneum assay. Provided the most appropriate of these methods are carefully selected, reliable data on the efficacy of topical glucocorticosteroids can be obtained.

Administration, Topical↗
PubMed1989

Plasmid content, serotypes, and antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in Munich in 1987-88.

Eighty-four strains of Neisseria gonorrhoeae isolated in Munich between January 1987 and June 1988 were characterized in terms of their plasmid content, protein I serovar and susceptibility or resistance to four antimicrobial agents. Eighty two percent of the strains belonged to serogroup 1B, the three most prevalent serovars being 1B-1, 1B-2 and 1B-6. Among the serogroup 1A strains, 1A-2 was the commonest serovar. Fourteen strains (16.7%) lacked the 2.6 Md cryptic plasmid, although two of these strains contained the conjugative gonococcal plasmid. Although some degree of resistance to penicillin and tetracycline was noted, all the strains were sensitive to spectinomycin and cefotiam.

Anti-Bacterial Agents↗
PubMed1989

[Multi-step increase in resistance of Neisseria gonorrhoeae isolates after repeated in-vitro subinhibitory concentrations of second-generation quinolones].

Five recent gonococcal isolates were exposed to subinhibitory concentrations of several antibiotics in vitro 25 times. In the presence of rifampicin all strains quickly became resistant. In the presence of penicillin, enoxacin and ciprofloxacin, antimicrobial susceptibility also decreased. Here development of resistance, however, corresponded to the multi- and not to the one-step type. It seems remarkable that even at the end of the experiments no strain grew at concentrations of ciprofloxacin exceeding 0.064 mg/l. In conclusion, quick development of resistance need not be expected after the introduction of newer quinolones into the therapy of gonorrhoea on a large scale.

Anti-Infective Agents↗
PubMed1989

Liposome preparations: a step forward in topical drug therapy for skin disease? A review.

The production of liposomes, which was described in 1961, soon was claimed to be a useful technology for drug encapsulation. The first preparation (containing a topical antifungal agent), however, was registered only recently. Additional preparations, including some for topical therapy of skin disease, are under clinical investigation. Moreover, a variety of cosmetic products that contain liposomes is available today. In this article we review the literature on liposomes as it pertains to dermatology, including the basic principles of liposome structures and preparations, pharmacokinetics of liposomes and liposome-encapsulated drugs, and the influence on drug activity. Moreover, future applications of liposome preparations are discussed.

Absorption↗
PubMed1989

Skin blister fluid levels of ketoconazole during repetitive administration in healthy man.

Ketoconazole administered orally is used in the treatment of superficial and deep mycoses. To evaluate its active concentrations in skin tissue, serum, suction blister fluid (SBF), and cantharides blister fluid (CBF) levels of total and non-protein bound ketoconazole were determined. In general, only the free drug is considered to be the active one. Six healthy subjects received 200 mg once daily for 5 days. Total ketoconazole concentrations were determined by HPLC. The unbound fractions of ketoconazole in SBF (2.3%) and CBF (1.2%) were calculated from plasma protein binding (99.0%). Before the ultimate dose, levels of unbound ketoconazole in SBF and CBF were 0.64 +/- 0.16 and 0.70 +/- 0.25 ng/ml and were thus in accordance with free ketoconazole serum levels (0.52 +/- 0.24 ng/ml; p greater than 0.05). Furthermore, following the ultimate dose, the areas under the blister fluid level-time curves of unbound ketoconazole did not differ from the respective areas under the serum level time curves, thus distribution equilibrium between serum and skin blister fluid was obtained. Peak concentrations of free ketoconazole were (SBF) 8.6 +/- 2.9 ng/ml and (CBF) 8.9 +/- 2.3 ng/ml. Free concentrations in SBF and CBF were far below the MIC values for dermatophytes and Candida ssp. reported in the literature, leaving the concentration-effect relationship of ketoconazole still open for discussion.

Adult↗
PubMed1989

Clinical spectrum of oral candidosis and its role in HIV-infected patients.

Oral candidosis is a very frequent diseased state occurring mainly together with severe underlying disease. Clinical manifestation is variable. One can distinguish between oral thrush, denture stomatitis, angular cheilitis, leukoplakia and midline glossitis. Nowadays oral candidosis is also important in connection with HIV-infection. Here the clinical spectrum does not seem to be totally different. Apart from oral thrush (or pseudomembraneous type) a chronic atrophic type, a chronic hyperplastic type, papillary hyperplasia and angular cheilitis are distinguished. Oral candidosis is the most frequent opportunistic infection in HIV-infected patients. Frequency of overt disease is linked to the T4/T8 ratio. In patients with AIDS-related complex oral candidosis seems to be indicative of rapid progression. Candida albicans is the prevailing microorganism. There is, however, a change of biotypes during the course of HIV-infection. There seems to be a selection of certain phenotypes as can be judged from the increasing resistance to 5-fluorocytosine.

Candidiasis, Oral↗
PubMed1989

One-shot treatment of uncomplicated gonorrhoea with third-generation cephalosporins with differing serum half-life. Results of a controlled trial with ceftriaxone and cefotaxime.

The highest minimum inhibitory concentrations of ceftriaxone and cefotaxime in 89 analysed Neisseria gonorrhoeae isolates amounted to 0.008 and 0.031 micrograms/ml, respectively. In a randomized controlled trial the single intramuscular injection of ceftriaxone 250 mg and cefotaxime 500 mg cured bacteriologically 35 out of 35, and 29 out of 30 patients, respectively, with uncomplicated gonorrhoea. Facing the different phenotypes of the isolates grown before and after therapy in the case of the non-cured patient within the cefotaxime treatment group, reinfection rather than failure has to be presumed. Postgonococcal urethritis occurred about as often in both groups, the percentage amounting to 24.2 and 28.6%, respectively. If side effects were noted at all, they were considered minor: 4 patients belonging to the first and 3 belonging to the second treatment group complained temporarily about pain at the injection site. Due to the data presented here, ceftriaxone and cefotaxime appear equally effective and safe when used in the dose generally preferred, irrespective of differences in in vitro activity and pharmacokinetic behaviour.

Adult↗
PubMed1989

Bactericidal effect of cefodizime against beta-lactamase-producing Neisseria gonorrhoeae in vitro. A comparison of level profiles in serum and tissue after intramuscular and intravenous administration in man.

Serum and skin suction blister fluid (SBF) level profiles as well as the profile in the hypothetical peripheral compartment in man after the single intravenous application of 1 g of cefodizime and the corresponding serum level profile after intramuscular application were simulated in the presence of beta-lactamase-producing gonococci. A rapid reduction of bacterial density was observed under each of these conditions indicating clinical efficacy of both treatment protocols in uncomplicated gonorrhoea. Considering the different level profiles in more detail both serum level profiles after intravenous and intramuscular injection turned out similarly effective: while the time needed for a 99% reduction of gonococcal density (t99%) was slightly shorter with the intravenous profile (1.45 vs. 1.68 h), the maximum relative reduction was somewhat smaller, expressed by a higher kn value (0.00024 vs. 0.00010%). The drug level profile in the hypothetical peripheral compartment proved on the whole equally effective as the serum level profiles. The suction blister fluid level profile, however, showed an inferior antigonococcal activity (kn = 0.00076%, t99% = 2.08 h). This demonstrates the value of the determination of SBF levels and their inclusion in in-vitro simulation experiments.

Cefotaxime↗
PubMed1989

Influence of various concentrations of cefotiam and ceftizoxime on the phagocytosis of gonococci by polymorphonuclear granulocytes.

Both cefotiam and ceftizoxime stimulate the uptake of gonococci by polymorphonuclear granulocytes in vitro as can be seen by light microscopy. Although this already holds true of antibiotic concentrations lower than the minimum inhibitory concentration (MIC: 1/4 x) this effect is much more marked at concentrations highly exceeding the MIC (4000 x). As light microscopic investigation allows the analysis of large numbers of cells but no final judgement on actual bacterial engulfment definite phagocytosis is demonstrated by electron microscopy.

Cefotiam↗
PubMed1989

Efficacy and tolerability of combined topical treatment of acne vulgaris with tretinoin and erythromycin in general practice.

Efficacy and tolerability of a gel preparation with 0.025% tretinoin and 4% erythromycin in acne vulgaris was evaluated in an open multicentre study. A total of 1337 patients of either sex, aged 8 to 68 years, were enrolled in the study; 13 had to be excluded from analysis. Some 499 patients had received former acne treatment; this was described as non-efficient or poorly efficient in 90% of the patients. The treatment period lasted up to 14 weeks. Efficacy was determined by counting the acne lesions (comedones, papules and pustules) before drug administration and every second week during the treatment period. Lesions had diminished after 2 weeks in about 35% of the patients. At the end of the treatment period, comedones were eliminated in 47.0% and improved in another 41.4%. Papules were eliminated and improved in 58.2% and 32.6%, pustules in 74.3% and 18.3% respectively. Side-effects (erythema, burning, pruritus, scaling and dryness of the skin) occurred in 203 patients (15.3%). Treatment was stopped in 25 subjects (1.9%) due to intolerance reactions. The results of the present study thus confirm the high efficacy and tolerability of the fixed combination observed previously in more selected patients. The fixed combination of tretinoin and erythromycin makes retinoic acid treatment possible even by a general practitioner.

Acne Vulgaris↗
PubMed1989

[Disseminated herpes zoster in chronic lymphatic leukemia].

A 73-year-old woman suffering from chronic lymphatic leukemia presented a rare variant of zoster with disseminated eruptions. Ultrastructural negative staining revealed viruses of the herpes group. Herpes simplex was excluded by means of fluorescence-labelled monoclonal antibodies (HSV-1/HSV-2 direct specimen identification/typing test). It is proposed that the conventional classification of zoster into a segmental and a generalized variant should be supplemented.

Aged↗
PubMed1989

[Metabolism of drugs in the skin].

The principle metabolic pathways in the skin and their practical implications are still largely unknown. Some insight has already been gained from a few in vivo methods (application of radiolabelled substances in animal and man) and several in vitro methods (skin slice models, use of skin homogenates, skin perfusion models). Most of the drugs investigated with these methods have been glucocorticosteroids: cortisol (oxidation to cortisone, reduction at C-20 and delta 4), diflucortolonvalerate, fluocortinbutylester (ester cleavage). Estradiol (oxidation to estrone) and vidarabine-5-valerate (ester cleavage) are drugs of a different type that have been examined.

Animals↗
PubMed1989

[The etiopathogenesis of ulcus molle: current status of knowledge--approaches to future research].

Chancroid is a sexually transmitted disease characterized by genital ulceration. Although the pathology of chancroid lesions has been well described, we still know relatively little about the mechanism by which the causative agent, the bacterium Haemophilus ducreyi, produces disease. It is hoped that a better understanding of both the pathogenicity of H. ducreyi and the pathogenesis of chancroid will provide a rational basis for the development of improved strategies for the control of this disease.

Animals↗
PubMed1989

[Diagnosis and therapy of ulcus molle today. Case report and review of the literature].

Chancroid, an ulcerous disease of the genitalia caused by Haemophilus ducreyi, occurs rarely but regularly in Germany. Exact diagnosis is based on the clinical features and a direct smear, and in particular on cultivation of the organism, showing its unique macromorphological characteristics. The sensitivity of cultivation has increased due to the development of selective media for primary isolation. Resistance problems during the last decade meant that a change to new therapeutic strategies was unavoidable. The work presented here includes a case report and a review of the recent literature, it illustrates modern methods of diagnosis and treatment of Haemophilus ducreyi infections 100 years after the first description of the organism.

Administration, Topical↗
PubMed1989

[Intrafamilial transmission of Trichophyton verrucosum to a newborn].

At the age of 4 weeks a suckling developed discoid erythema with scales and a few pustules at the face. Previously, his father having contact with cattle as a farmer had fallen ill from tinea barbae. In both cases Trichophyton verrucosum could be detected by culture. Dermatophytosis in sucklings has recently more often been reported about in the literature. This, however, does not apply to Tr. verrucosum infections.

Family↗
PubMed1989

[Morphologic variants of genital ulcer caused by Haemophilus ducreyi].

The typical clinical picture, common variants and frequent complications of chancroid are presented in cases proven by culture. In general, the conventional view of the clinical spectrum of chancroid is substantiated. Certain types such as "chancre mou volant," however, could not be found in the present material. Their existence or association with Haemophilus ducreyi remains speculative.

Adult↗
PubMed1988

[In vitro effectiveness of ofloxacin and ciprofloxacin in genital Chlamydia trachomatis isolates measured by minimal inhibitory concentration and minimal bactericidal concentration].

Although Chlamydia trachomatis is usually susceptible to the most frequently applied chemotherapeutic agents in non-gonococcal urethritis in men and its counterpart in women--i.e., tetracycline and erythromycin--the clinical results are less satisfying than those in comparable gonococcal infections. Therefore, potent therapeutical alternatives are urgently called for. From this point of view, we investigated the in vitro susceptibility of 35 recent isolates of genital Chlamydia trachomatis from Munich to the new quinolones ciprofloxacin and ofloxacin. With both chemotherapeutics, the highest minimum inhibitory concentration amounted to 2.0 micrograms/ml; 1.0 micrograms/ml of ofloxacin inhibited 97% of the strains, ciprofloxacin but 57%. The highest minimum bactericidal concentration was 6.0 micrograms/ml. 5.0 micrograms/ml of ciprofloxacin killed all infectious particles in 91% of the strains, the corresponding figure for ofloxacin read 74%. Thus both quinolones of the second generation proved more or less equally effective in vitro. In view of the limited clinical experience gained so far with regard to these chemotherapeutic agents, we suggest further clinical study in this matter.

Chlamydia Infections↗