Biomedical subjects
Publications and source records attributed to H Hamm.
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19 IDDM patients (m/f 9/10; ages 7-25 y.; duration of diabetes 3-20 y., mean 10 y.) have been compared to 15 healthy controls (m/f 11/4; ages 11-24 y., mean 14 y.) in respect to HRTS (heart rate response to standing), SDB (single deep breath) and Valsalva maneuvre. In the diabetics the results have been correlated to MNCV (motor nerve conduction velocities), quality of diabetic control and duration of diabetes. A questionnaire did not uncover signs or symptoms of autonomic dysfunction. Resting heart rates were significantly higher in diabetics but were unrelated to age, duration of diabetes, quality of diabetic control or MNCV. HRTS, SDB and the Valsalva maneuvre did not display statistically significant differences between diabetics and controls. Diabetic autonomic dysfunction seems to be rare in young diabetics. Routinely testing for this sequela would therefore not be justified at this stage of diabetes. On the other hand diabetic autonomic dysfunction might be harmful for the patient as regards sudden and unexpected cardiorespiratory arrest eg. during anaesthesia or bronchopneumonia. If therefore symptoms and/or signs of possible peripheral or autonomic dysfunction are present special investigations (eg. HRTS) are indicated.
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The pineal gland of birds contains one or more circadian oscillators that play a major role in overall temporal organization. We have developed a flow-through culture system for the isolated pineal by which we can measure the release of melatonin continuously from superfused glands over long periods of time. Chicken pineals release melatonin rhythmically, and these rhythms persist in vitro with a circadian oscillation. In light cycles the release of melatonin is strongly rhythmic; however, in constant conditions the amplitude of the rhythm is lower and appears to be damping. Light has at least two effects upon the isolated pineal: cyclic light input synchronizes the rhythm, and acute light exposure at night rapidly inhibits melatonin release. The cultured avian pineal clearly offers great potential as a model system for the study of vertebrate circadian oscillators and may open the way for an analysis of mechanism.
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The cutaneous signs of anorexia nervosa (AN) and bulimia nervosa (BN) have been described previously in adult patients. For the first time, we present here dermatologic findings in children and adolescents suffering from eating disorders. Thirty consecutive young anorexic and bulimic inpatients (8 to 17 years of age, mean 15.1 years) underwent a standardized dermatologic examination. Patients were checked for abnormalities of the skin including atopic stigmata, dermographism, hair, nails, and oral cavity. Serum was obtained for hemoglobin, iron, zinc, GPT, thyroid, and sex-hormone levels. In 13 patients, the total serum IgE was determined, and a prick test was carried out with defined type I allergens. Findings in order of frequency included xerosis of the skin, white dermographism, diffuse hypertrichosis, acrocyanosis, scars, diffuse effluvium, artifacts, brittle nails, and onychophagia. Significant co-relations were found between the presence of hypertrichosis and the existence of amenorrhea or a body mass index of less than 16. In 22 patients a low T3 level was found. In summary, children and adolescents suffering from AN or BN show dermatologic features similar to those reported in older patients. Special findings in this age group are extensive lanugo hair and signs of autoaggressive behavior.
BACKGROUND: Drug-related skin reactions often present as macular, maculopapular or urticarial rashes. Severe drug eruptions are rare, with life-threatening events occurring in about 4 per one million persons a year. In pediatric patients the estimated incidence of Stevens-Johnsons-syndrome (SJS) and toxic epidermal necrolysis (TEN) is even lower. They are often caused by antiepileptic drugs like carbamazepine. CASE REPORT: A 10 (5)/ (12) year old boy of dark complexion suddenly developed a severe bullous skin disease six weeks after starting carbamazepine therapy due to focal epilepsy. Within few hours a life-threatening systemic inflammatory reaction occurred with subsequent respiratory failure. The clinical course was complicated by bacterial sepsis, bilateral thrombosis of the external iliacal veins and bilateral ocular symblephara. The skin healed with considerable pigmentary disturbance. We report the differential diagnostic and therapeutical features of toxic epidermal necrolysis and give a review of the literature.
Lichen striatus (LS) is an uncommon disease of unknown origin characterised by a linear inflammatory papular eruption with spontaneous regression. We here review a series of 12 consecutive cases of LS. Diagnosis was supported by histological examination. Ten of our 12 patients were children aged 6 months to 12 years. The male gender predominated by 9:3. The lower limb was involved more often than the upper limb and trunk. The duration of the disease until regression ranged from 4 months to 4 years (median, 12 months). Postinflammatory hypopigmentation was noted in 5, and hyperpigmentation in 4 patients. Two patients showed nail involvement (onychodystrophy, longitudinal ridging) which appeared simultaneously with the skin lesions and resolved completely. A personal history of atopic disorders was found in 7 of 12 patients. From this series we can confirm that LS mainly affects children. Both skin and nail lesions disappear completely even if they last longer than one year. Compared with other studies, our series showed differences with regard to sex ratio, predilection sites and after effects.
Surfactant protein A (SP-A) appears to have an important function in the assembly and maintenance of the alveolar surfactant monolayer. SP-A has also been implicated in modulating the activity of immunoactive cells, such as increasing the bactericidal capacity of alveolar macrophages. In this immunocytochemical study the SP-A content of alveolar macrophages from seven patients with hypersensitivity pneumonitis was compared with the results obtained from six healthy controls. A polyclonal rabbit antibody against human SP-A was used for detection of SP-A in the cytoplasm of alveolar macrophages, applying the immunoperoxidase adhesive slide assay. In hypersensitivity pneumonitis a significant increase in the percentage of SP-A+ alveolar macrophages was observed as compared with the percentage in healthy controls. The intensity of the staining reaction was also increased in the alveolar macrophages of hypersensitivity pneumonitis. We conclude that the observed abnormalities in SP-A content in alveolar macrophages may play a role in the pathogenesis of hypersensitivity pneumonitis.