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J Hercogová

Publications and source records attributed to J Hercogová.

16 recordsLinked to original sources
PubMed2006

Lyme borreliosis infection as a cause of dilated cardiomyopathy.

The relatively low percent of patients affected with the cardiac form of Lyme borreliosis is difficult to diagnose, especially if the disease manifests itself in ways other than atrio-ventricular blockade. The advanced stage of Lyme carditis manifesting as dilated cardiomyopathy is a special case of this affliction. The authors of this report present clinical experience with an attempt to support the working hypothesis about involvement of Lyme borreliosis infection in the development of dilated cardiomyopathy. The patients were clinically examined thoroughly with special attention to the cardiovascular system. In addition to the basic clinical methods, the following procedures have been employed: dynamic Holter's electrocardiography, exercise ECG test, coronarography, and myocardial biopsy. From laboratory methods pertaining to the detection of Borrelia, ELISA method, Western blot, PCR, electron microscopy and histopathological analysis were used. In all three cases, clinical and laboratory findings provided the evidence of the borreliosis infection involvement in the development of dilated cardiomyopathy.

Adult↗
PubMed2005

[Combined immunosuppressive therapy in patients with pemphigus vulgaris and its side effects].

Pemhigus vulgaris is an autoimmune bullous disease of the integument. When not treated, it has a high mortality, the treatment with corticosteroids and immunosuppressives has serious side effects. Our casuistry gives a case of patients with histologically verified diagnosis of pemphigus vulgaris. In this case the stabilization of the disease was difficult and side effects of the combined immunosuppressive therapy developed very early.

Adrenal Cortex Hormones↗
PubMed2004

Agminated histiocytomas in a 23-year-old patient.

A 23-year-old patient presented with a group of 17 reddish-brown papules and nodules on the left shoulder lasting for 4 years. The histopathologic examination after a punch biopsy was repetitively consistent with the diagnosis of fibrous histiocytoma (FH). We use the term agminate histiocytomas for the first time to stress the presence of grouped lesions in one skin segment. Intralesional corticosteroids and cryotherapy were partially successful in this patient.

Administration, Topical↗
PubMed2004

Annular elastolytic giant cell granuloma causes an irreversible disappearance of the elastic fibres.

A 67-year-old man presented with grouped red papules with a smooth surface coalescing to relatively well-demarcated plaques on his left thigh, in the axillae and on the lateral parts of the trunk. The plaques were growing slowly, and the older ones had a frilled surface. A skin biopsy showed a zone of disappearance of the elastic fibres with a rim of giant multinuclear cells with fragments of the elastic fibres in their cytoplasm. This finding is typical of annular elastolytic giant cell granuloma (AEGCG). After corticosteroid therapy, the inflammation resolved, causing the frilled surface of the lesions due to the disappearance of the elastic fibres. Remission of the skin lesions lasted for 1.5 years. A second skin biopsy taken from the site of the previous lesion showed the absence of the elastic fibres, thus their phagocytosis was irreversible.

Aged↗
PubMed2004

Multiple granular cell tumour.

Myoblastic myoma was first described in 1926. Immunohistochemical methods have proven the neuroectodermal origin of this tumour. It most frequently affects individuals between 30 and 60 years of age, with a significant female predominance. In most cases it is a benign solitary tumour, with multiple lesions found in 25% of cases. The malignant variant of the tumour is diagnosed in less than 3% of cases. This case report of a 30-year-old woman describes the appearance of a solid resistance between her breasts following delivery of her child, with similar findings on the neck and wrists. Histopathological examination confirmed the presence of a benign variant of myoblastic myoma.

Adult↗
PubMed2004

[Gonorrheal proctitis imitating proctalgia fugax].

Proctalgia fugax is usually a source of many diagnostic and therapeutic problems. It is often very difficult to find the cause of the pain. Case-report of a 27-year-old patient who was examined by surgeons on cramp-like pain localized to the rectum. The careful history and laboratory examination confirmed gonorrheal proctitis. She was then successfully treated with ceftriaxon.

Adult↗
PubMed2002

[Syphilis in the third millenium].

BACKGROUND: For several decades the clinical picture of all stages of syphilis has been assumed to be immutable. The aim of the study was to describe the real spectrum of cutaneous and mucosal manifestations and organ changes and to ascertain whether the incidence of the disease has an increasing trend. METHODS AND RESULTS: The studied group included 92 patients (44 males, 48 females, average was 31.3 years) diagnosed in years 1992 to 1998 at our clinics. The diagnose was confirmed by a microscopic and/or serologic examination. Number of patients with the primary syphilis increased more than twice (1992 versus 1997), incidence of newly registered manifestations of the secondary syphilis has also increased (1996 to 1998), number of hospitalised patients in the stadium of syphilis latens increased at least twice (1992 versus 1996). Higher was the number of proven cases in pregnant patients: number of dead births increased twice, inborn forms of syphilis were three times more frequent. Among the newly described clinical forms the specific gastritis and specific uveitis were diagnosed. In immunosuppressed patients forms of lues maligna and the blue toes syndrome were identified. However, those forms were not diagnosed among our group of studied patients. CONCLUSIONS: During the last 10 years a significant increase of incidence of syphilis was reported in the population of Czech Republic. Such dangerous and almost explosive rise of new cases has been accompanied with increased number of inborn forms and with the occurrence of new clinical manifestations, namely in immunosuppressed patients.

Adult↗
PubMed2001

Dendritic cells and their role in skin-induced immune responses.

This artide gives a brief review on dendritic cells (DC) with regard to their origin, life cyde and functions. The regulation of immune responses by DC functioning as antigen-presenting cells is discussed. Special attention is given to epidermal DC, e.g. Langerhans cells. The perspectives of DC-based therapy are also mentioned.

Cell Cycle↗
PubMed2001

Verrucous form of chilblain lupus erythematosus.

A 45-year-old woman had symmetrical livid plaques with yellowish hyperkeratoses for 5 years, which progressed on to the fingers and toes and on the soles of the feet. Two years later creamy, whitish areas and maceration appeared on the buccal mucosa and the lips. A skin biopsy revealed massive collagen hyaline degeneration in the perivascular area, hyperkeratosis and hypergranulosis, small lymphocyte infiltrates with several melanophages and extravasates of erythrocytes in the upper corium in perivascular areas and hydropic degeneration of basal keratinocytes. The findings using direct immunofluorescence were compatible with lupus erythematosus (LE). Laboratory investigation showed a slight leucopenia and thrombopenia, a slightly elevated erythrocyte sedimentation rate, hypocomplementaemia C3 and C4, a high titre of rheumatoid factor and antinuclear antibodies positivity of extractable nuclear antigen. The results reflected probably the development of a systemic form of the disease. The patient was successfully managed by methylprednisolone and hydroxychloroquine. After 1 year of therapy, a new skin biopsy revealed a substantial reduction of hyperkeratosis and hyaline degeneration of collagen tissue in the perivascular areas. The combination of the extensive hyperkeratosis and hyalinization thus seems to be features of the long-lasting, untreated lesions in chilblain LE.

Biopsy, Needle↗
PubMed2001

Lichen planus pigmentosus-inversus.

We examined seven patients with lichen planus pigmentosus (LPP) clinically and microscopically. Clinically, all patients had a striking predominance of lesions in an intertriginous location, with most of them in the axillae. Microscopically, two biopsies were of significance. Except for the regressive lichen planus, which is usual in LPP, the active inflammatory phase was also present. In these biopsies the very intensive hydropic degeneration of basal keratinocytes was combined with the absence of compensatory increased proliferation of keratinocytes, i.e. without acanthosis. The short duration of this process probably led to the quick transformation into a long noninflammatory regressive phase with incontinence of the pigment. These specific morphogenetic dynamics are possibly why most of the morphs of LPP present as brown, non-pruritic, small inflammatory macules. Because of the highly characteristic inverse location of the lesions in our patients we propose the designation LPP-inversus for this variant of the disease.

Aged↗
PubMed1994

Electron microscopy of Langerhans cells and Borrelia burgdorferi in Lyme disease patients.

To investigate dermal and epidermal involvement in the presence of Borrelia burgdorferi and to analyze the role of Langerhans cells and keratinocytes, 14 cases of erythema chronicum migrans and two controls were studied by means of electron microscopy, using negative staining and sectioning techniques. Using immunoelectron microscopy and histochemistry, positive results for B. burgdorferi were disclosed in 5 cases of erythema chronicum migrans and 3 cases of neuroborreliosis which were confirmed by cultivation. We cultured 4 stains of B. burgdorferi from the skin, 1 from blood and 2 from cerebrospinal fluid in BSK medium. Near to the centre of erythema chronicum migrans with focal necrosis were both a dissolved basal membrane and keratinocyte desmosomes surrounding damaged B. burgdorferi cells in the epidermis. Markedly oedematous keratinocytes and Langerhans cells with B. burgdorferi were released into lymphocyte infiltrates. At the periphery of all erythema chronicum migrans lesions, keratinocytes were well preserved while all dendritic cells seemed to be vacuolated. Above foci of B. burgdorferi located perivascular or among collagen fibers, Langerhans cells were frequent and more granulated. The possible role of Langerhans cells in the identification and elimination of B. burgdorferi is discussed.

Borrelia burgdorferi Group↗
PubMed1993

[Early-stage lyme borreliosis during pregnancy: treatment in 15 women with erythema migrans].

The authors treated and followed-up since July 1987 9 women with non-complicated erythema migrans and 4 women with erythema migrans associated with general signs and symptoms during pregnancy; two patients were treated only after delivery. For treatment antibiotics of the penicillin series were used. The course of gestation in 14 patients was without complications, one patient was followed-up on account of oedema of the lower extremities. The infants of 14 women were born in term, one infant was born during the 37th week of gestation. All infants were eutrophic. Umbilical blood for serological examination was collected from 8 infants, elevated IgG antibody levels against Borrelia burgdorferi were detected in one. The post-partum development of all infants was normal. During the subsequent follow-up for 6-26 months elevated antibodies against Borrelia burgdorferi were not found in any of the 4 infants subjected to serological examination. One child was operated at the age of one year on account of a patent ductus arteriosus, another child was treated at the age of two years on account of cryptorchism, two children were treated on account of hypoplastic enamel, in one infant at the age of 10 months the psychomotor development was retarded by two months. Transplacental transmission of Borrelia burgdorferi was not proved. With regard to the variety of the observed deviations and the small number of data the problem of a possible teratogenic action of this spirochete remains open.

Adult↗
PubMed1992

Contributions to the treatment of dermatologic manifestations of Lyme borreliosis.

Lyme borreliosis was identified in Czechoslovakia for the first time in 1985. Since then, more cases have gradually been identified. Since 1989, about 1,500 patients per ten million inhabitants have been reported every year. Having summarized the results of the therapy of 371 patients with dermatologic manifestations of lyme borreliosis (erythema migrans in 315, borrelial lymphocytoma in fifteen, and acrodermatitis chronica atrophicans in forty-one) we present the antibiotic regimens used by Czechoslovak dermatologists in clinical practice.

Acrodermatitis↗
PubMed1990

[Cutaneous forms of Lyme borreliosis in children].

Thirty-seven children with skin manifestations of Lyme borreliosis (31 with erythema chronicum migrans and six with lymphadenosis benigna cutis) were treated and followed up prospectivelly for 1-24 months (mean 7.58 months). The diagnosis was confirmed serologically by the finding of increased levels of antiborrelial antibodies assessed by the ELISA method, using antigen from Borrelia recurrentis, in a total of 87% patients with erythema chronicum migrans and in all patients with lymphadenosis benigna cutis. In nine patients the dermatoses were associated with general non-characteristic symptoms, after antibiotic treatment in five patients temporary fatigue, arthralgia and gastrointestinal complaints were observed. No extradermal organ complications were present. The authors discuss the clinical pictures of erythema chronicum migrans and lymphadenosis benigna cutis in children, mention diagnostic criteria and the recommended pattern of treatment.

Adolescent↗
PubMedDate not supplied

Long-term results in patients with Lyme arthritis following treatment with ceftriaxone.

A total of 35 patients with late stage Lyme borreliosis with involvement of the joints was followed up until 3 years after a 14 day course of 2 g ceftriaxone once daily i.v. Diagnosis was confirmed by indirect and direct microbiological methods as well as clinical signs and symptoms. Long term clinical results in 26 patients at 36 months were complete response or marked improvement in 19, relapse in six and new manifestations in four of the cases, respectively. Possible mechanisms for non-responding to therapy are discussed. Therapy was well tolerated; in no case discontinuation of treatment was necessary due to adverse drug reactions. The treatment results in this group of 35 patients with Lyme arthritis are considered successful. The data obtained are consistent with expectations based on the published experiences with ceftriaxone in this indication.

Adult↗