Surviving child from tubal pregnancy.
A case report of a 1150 g child surviving from a tubal pregnancy in the 30th week of gestation, delivered by cesarean laparotomy, is described. A review of the literature disclosed nine other cases.
Adult↗
Biomedical subjects
H Søgaard
Publications and source records attributed to H Søgaard.
Serum aminoterminal propeptide of type III procollagen in psoriasis and psoriatic arthritis: relation to liver fibrosis and arthritis.
Levels of serum aminoterminal propeptide of type III procollagen were measured in 170 patients with psoriasis (49% with coexistent psoriatic arthritis) who had liver biopsies performed during or before treatment with methotrexate or, in some cases, with retinoids. Psoriasis patients with fibrosis or cirrhosis in their liver biopsy specimens had a significantly higher mean serum aminoterminal propeptide of type III procollagen than did patients without fibrosis and without arthritis. Only 4% of patients without cirrhosis or fibrosis and no arthritis had an elevated serum aminoterminal propeptide of type III procollagen. In contrast, 38% of patients with psoriatic arthritis had an increased aminoterminal propeptide of type III procollagen in the absence of detectable liver fibrosis. It is concluded that the number of liver biopsies performed on methotrexate-treated psoriasis patients with or without arthritis may be reduced to a minimum as long as serum aminoterminal propeptide of type III procollagen is normal. Increased serum aminoterminal propeptide of type III procollagen in the absence of arthritis is a strong indicator of liver fibrogenesis and suggests the need for liver biopsy to monitor possible methotrexate-induced toxicity. In patients with psoriatic arthritis an increased aminoterminal propeptide of type III procollagen may be related to the joint disease. Patients with psoriatic arthritis and increased levels of aminoterminal propeptide of type III procollagen should therefore follow the established guidelines for the use of methotrexate in psoriasis.
Alkaline Phosphatase↗
Long-term efficacy and tolerability of topical calcipotriol in psoriasis. Results of an open study.
Calcipotriol is a non-calcaemic vitamin D3 analogue. In short-term studies, topically applied calcipotriol is both efficacious and safe for the treatment of psoriasis vulgaris. The purpose of the present study was to determine the efficacy and safety of calcipotriol ointment in patients treated for approximately 6 months. Fifteen patients with plaque-type psoriasis were treated daily with calcipotriol ointment 50 micrograms/g. After treatment for 6 weeks there was a significant alleviation of erythema, infiltration and scaling. This degree of improvement was maintained throughout the study, except in one patient, who was withdrawn at week 15 because of minimal improvement. At the end of treatment, 80% of the patients showed a moderate improvement at least. Local adverse events occurred in 3 patients. These were mild and transient. Hypercalcaemia or other laboratory abnormalities did not develop in any patient. Morphometric examination of biopsies taken from perilesional skin (i.e. skin exposed to calcipotriol) at the end of treatment did not show signs of epidermal or dermal atrophy compared with uninvolved psoriatic skin. Although only a limited number of patients participated in the study, these results indicate that calcipotriol ointment 50 mu/g is both efficacious and safe for the long-term treatment of psoriasis.
Administration, Cutaneous↗
[Mycosis fungoides. A review of the clinical picture, treatment and course in 107 patients].
During the period 1972 till the end of 1987, 107 patients with the diagnosis of mycosis fungoides or cutaneous T-cell lymphoma were examined and treated in the Department of Dermatology, Marselisborg Hospital. This disease belongs to the group of non-Hodgkin T-cell lymphomata. The diagnosis is based on the occurrence of red, scaly plaques in the skin associated with itching or tumours in the skin and, simultaneously, of a pleomorphic infiltrate consisting of CD4-positive T-lymphocytes which show characteristically exocytoses in the epidermis with subsequent formation of Pautrier's microabscesses. The disease may progress with spread to the regional lymph nodes where lymphomata develop. Treatment is initially local with employment of chlormethin ("nitrogen mustard gas") and this treatment can maintain the patients in remission for prolonged periods. In cases with spread to lymph glands or in particularly aggressive forms with tumour formation in the skin, combined chemotherapy is administered (prednisone, cyclophosphamide, etretinate and bleomycin). Thirty-eight of the patients were in stage I in which a clinical suspicion of mycosis fungoides was present but where the histological changes were insufficient to confirm the diagnosis. IVa and ten in stage IVb. The age at the onset of the symptoms was from 59 to 64 years (median values) for the various stages. Stages I and II had approximately 80% five-year survival, while the stages with more extensive spread had approximately 50% survival. The etiology of the disease is unknown but, during recent years, certain evidence has been found suggesting that activation of a retrovirus in the epidermis may be a contributory factor.
Antineoplastic Combined Chemotherapy Protocols↗
Kidney biopsies in methotrexate-treated psoriatics.
Kidney biopsies were studied in 19 psoriatics treated with methotrexate (MTX) from 1 month to 16 years. Only 3 of the patients had received the drug for less than 1 year. Four patients had been treated for more than 10 years. The total doses of MTX ranged from 30 to 14,340 mg. In 17 of the 19 patients the cumulative MTX dose was 500 mg or more. In 9 patients the cumulative doses were over 2 g. With the exception of 1 patient, which presented sequelae of acute renal failure unassociated with MTX treatment, all other biopsies showed renal structures which, assessed by routine judgement, were found normal. Semiquantitative evaluation of interstitial fibrosis and arteriolar hyalinosis as well as interstitial volume estimated by morphometry showed no significant changes. No patient showed clinical or laboratory signs of renal impairment.
Adult↗
Plutonium-induced mycosis fungoides and parapsoriasis en plaques--a new entity?
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Adult↗
Serum aminoterminal propeptide of type III procollagen. A non-invasive test for liver fibrogenesis in methotrexate-treated psoriatics.
Serum aminoterminal propeptide of type III procollagen (PIIINP) was studied in 73 psoriatics receiving methotrexate and in 11 selected for trial with methotrexate or etretinate. 72 of the patients on methotrexate were also investigated with liver biopsies. The highest PIIINP value was found in a patient with ascites and her PIIINP decreased after medication was discontinued. Psoriatics with fibrosis or cirrhosis in their liver biopsies had a significantly higher mean PIIINP than patients without fibrosis, who had the same mean value as psoriatics prior to treatment. Based upon the individual data together with data from serial PIIINP investigations of 11 patients studied during treatment, it is concluded that PIIINP can be utilized as a valuable non-invasive test for liver fibrogenesis in methotrexate-treated psoriatics. PIIINP is not specific for the liver, but the study indicates that the number of liver biopsies can be reduced in psoriatics on methotrexate who have normal levels of PIIINP.
Biomarkers↗
Improvement of psoriasis vulgaris after intralesional injections of 15-hydroxyeicosatetraenoic acid (15-HETE).
Psoriatic skin lesions are characterized by elevated levels of 5- and 12-lipoxygenase products (leukotrienes B4, C4, and D4, and 12-hydroxyeicosatetraenoic acid [12-HETE]), which can stimulate epidermal proliferation and induce skin inflammation. 15-Hydroxyeicosatetraenoic acid (15-HETE) has the potential to inhibit the activity of 5- and 12-lipoxygenases. The purpose of the present study was to determine the therapeutic effect of intralesional injections of 15-HETE. 15-HETE was formed by oxidation of arachidonic acid by soybean lipoxygenase, purified by reversed-phase high-performance liquid chromatography, and identified by mass spectrometric analysis. Thirteen patients took part in the investigation. Plaques with a diameter of approximately 1 cm were injected with 0.1 ml of 10 mumol/L 15-HETE, 0.1 ml of 1 mumol/L 15-HETE, or 0.1 ml of saline weekly. After 3 weeks the effect was evaluated clinically and histologically by an observer uniformed of the treatment given. We found that plaques injected with 10 mumol/L 15-HETE had cleared completely in four patients and improved considerably in seven. In one patient minimal improvement only was seen and in one patient no change was observed. Injection of 1 mumol/L 15-HETE was without effect in 11 patients and improvement was observed in two patients. Of the plaques injected with saline, minimal improvement was observed in one patient; otherwise the plaques had not changed. Injection of 0.1 ml of 10 mumol/L 15-HEPE (identical to 15-HETE except for five double bonds instead of four) induced only minimal improvement in one of four patients. The results imply that 15-HETE by a dose-dependent and stereospecific mechanism can improve psoriasis.(ABSTRACT TRUNCATED AT 250 WORDS)
Dose-Response Relationship, Drug↗
The red man syndrome. Exfoliative dermatitis of unknown etiology: a description and follow-up of 38 patients.
Thirty-eight patients with erythroderma of unknown etiology were diagnosed over a 15-year period, and represented 19% of all patients admitted to our department for erythroderma. The male:female ratio was 6.6:1, and the median disease duration was 2 years (range 1 to 23 years). Keratoderma of palms and/or soles was seen in 79%. Laboratory findings were normal, except for an increased IgE level in 69% of the patients studied. Lymph node histology showed dermatopathic lymphadenopathy. Bone marrow investigation results were normal in 48%, or showed eosinophilia (32%) or hyperplasia (20%). Initial skin biopsies showed nonspecific histology in most patients, but later biopsies revealed pleomorphic infiltration. During the observation period four patients progressed to mycosis fungoides and another nine patients were suspected of having mycosis. None developed Sézary's syndrome. Only one third of the patients went into complete remission; half of them died during the observation period. Patients with erythroderma of unknown etiology are predominantly men and seem to belong to a certain subgroup--herein called the red man syndrome.
Adult↗
Treatment of mycosis fungoides with recombinant interferon-alpha 2a2 alone and in combination with etretinate.
Eleven patients with mycosis fungoides (MF) were treated with recombinant alpha-interferon (rIFN-alpha 2a2) in combination with etretinate (seven patients) or alone. One patient, who also received etretinate, went into complete remission and remained without signs of MF after 18 months. Six patients experienced partial remission; one of these was treated with rIFN-alpha 2a alone and was clinically in complete remission, but had still a pleomorphic skin infiltrate. Two patients were non-evaluable, and two stopped therapy due to progressive disease. Five patients discontinued therapy due to side-effects although three had partial remission of their disease. Only four patients received 12 months therapy. The study shows that rIFN-alpha 2a in combination with etretinate or alone can induce remission of MF.
Aged↗
Improvement of psoriasis by a topical vitamin D3 analogue (MC 903) in a double-blind study.
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Administration, Topical↗
Aminoterminal propeptide of type III procollagen in methotrexate-induced liver fibrosis and cirrhosis.
Twenty-four psoriatic patients on methotrexate were studied with liver biopsies and serum measurements of aminoterminal propeptide of type III procollagen (PIII NP). All but one of nine patients with serum levels of PIII NP above the normal range had liver fibrosis or cirrhosis and no normal liver biopsies were obtained in this group. In contrast, nine normal liver biopsies and two biopsies with minimal fibrosis were found among the 15 patients with normal serum levels of PIII NP. The study indicates that aminoterminal propeptide of type III procollagen can be utilized as a valuable non-invasive marker of fibrogenesis in the liver. This analysis is not specific for the liver, but it seems that the number of liver biopsies probably can be reduced in psoriatics on methotrexate who have normal levels of PIII NP.
Adult↗
Recombinant interferon alpha-2A (Roferon-A) in a case of Buschke-Löwenstein giant condyloma.
A case is presented of a 63-year-old female suffering from Buschke-Löwenstein giant condyloma acuminatum of more than 12 years' duration. The lesions had spread from portio and vagina to the bladder and the right ureter resulting in hydronephrosis of the right kidney leading to subsequent surgical procedures including the establishment of an ilealbladder and exstirpation of the right ureter and nephrectomy of the right kidney. Treatment with recombinant interferon alpha-2A 1.8 mU for 5 days a week resulted in steady regression of all tumor masses. After 6 months of treatment the tumors which had covered the whole of vagina and portio and filled out the whole vagina cavity were reduced to 5 small pin-size lesions at the introitus. Initial side effects of flu-like symptoms disappeared spontaneously without discontinuation of treatment.
Condylomata Acuminata↗
Development of cutaneous pseudolymphoma following ciclosporin therapy of actinic reticuloid.
The patient is a 57-year-old man with actinic reticuloid, who despite systemic prednisone, azathioprine, topical steroid, and sun-protective cream had to stay indoors in the summer of 1986. In February 1987 he was started on ciclosporin (CS), 5.5 mg per kg body weight, and skin symptoms did not develop as usual in spring and summer 1987. Following 4 months of successful therapy, he developed an indolent tumor on his right chin and parapsoriasis en plaque on the lower arms and legs. Histological examinations of the tumor showed an intense lymphoid infiltrate of a pseudolymphomatous type. The tumor regressed partly following discontinuation of CS, but additional radiation therapy had to be administered. His clinical symptoms of actinic reticuloid reappeared. Eight months after CS treatment he developed a malignant T cell lymphoma with metastasis in the regional lymph nodes on the neck. CS should not be used in diseases with potential premalignant features even though its therapeutic efficacy in actinic reticuloid was impressive.
Cyclosporins↗
Natural and Chang liver cell cytotoxic studies of methotrexate-treated psoriatic patients with liver cirrhosis.
Forty patients with psoriasis were investigated for unspecific and specific lymphocyte cytotoxicity in order to evaluate the significance for liver cell damage in methotrexate-treated (MTX) patients. We found no difference between psoriasis patients with regard to cytotoxicity. We also observed a normal proliferation of lymphocytes after stimulation with tuberculin and phytohemagglutinin.
Adolescent↗
[Partial mole with a fetus].
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Abortion, Induced↗
Reinke's oedema and thyroid function: a prospective study in 43 patients.
This study was designed to analyse thyroid function in patients with Reinke's oedema. Among 43 patients, 2 new cases of myxoedema as well as 2 patients with borderline myxoedema were found. However, the majority of patients showed no indication of thyroid hypofunction. In addition the alcian-blue staining intensity of vocal cord biopsies from patients with Reinke's oedema was compared with thyroid parameters, but a relation was not found.
Adult↗
Methotrexate-induced liver cirrhosis. A follow-up.
Studies on serial liver biopsies from 25 patients with methotrexate-induced liver cirrhosis, taken from 1 to 13 years after cirrhosis was established, confirm that this type is not of aggressive nature. When evaluated blind no progression was found in most of the later biopsies. Alcohol and previous use of hepatotoxic drugs such as the combination of arsenics and vitamin A seem to have been contributing factors to cirrhosis formation.
Adult↗