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Biomedical subjects

J Ring

Publications and source records attributed to J Ring.

At least 199 records · Page 11Linked to original sources
PubMed2000

Traffic-related air pollution is associated with atopy in children living in urban areas.

Traffic emissions are a major source of air pollution in Western industrialized countries. To investigate the association between traffic-related air pollution and parameters of atopy, we studied 317 children 9 years of age living near major roads in two urban areas and one suburban area of a city in West Germany. Atopic sensitization was analyzed by skin-prick testing and determination of allergen-specific serum immunoglobulin E. Parents recorded allergic symptoms in a symptom diary, and physicians assessed allergic diseases. Personal NO2 exposure and NO2 concentrations in front of each child's home were measured. Outdoor NO2 was a good predictor for traffic exposure but a poor predictor for NO2 exposure at the personal level. Atopy was found to be related to outdoor NO2 (odds ratio for the association between symptoms of allergic rhinitis and outdoor NO2 = 1.81; 95% confidence interval = 1.02-3.21) but not to personal NO2 (odds ratio for the association between symptoms of allergic rhinitis and personal NO2 = 0.99; 95% confidence interval = 0.55-1.79). When the analysis was restricted to urban areas, we found that hay fever, symptoms of allergic rhinitis, wheezing, sensitization against pollen, house dust mites or cats, and milk or eggs were associated with outdoor NO2. The results indicate that traffic-related air pollution leads to increased prevalence of atopic sensitizations, allergic symptoms, and diseases.

Child↗
PubMed2000

An unusual cutaneous T cell lymphoma presenting as leonine facies.

We report an unusual case of a cutaneous T cell lymphoma with the clinical picture of leonine facies as the only skin symptom appearing during the first years of the disease. Small atypical lymphocytes with partly pleomorphic, partly indented cerebriform nuclei are present in the facial skin as well as in the peripheral blood and in the bone marrow. The lymphoma shows an indolent clinical behaviour without rapid progression of the disease. It shares features with both pleomorphic small/medium-sized T cell lymphoma and mycosis fungoides, but cannot be classified according to the criteria of the European Organization for Research and Treatment of Cancer (EORTC) Classification for Primary Cutaneous Lymphomas. At present the lymphoma has to be ranged among the group of so-called unspecified peripheral T cell lymphomas according to the proposal of the International Lymphoma Study Group.

Biopsy↗
PubMed1999

Indoor risk factors for atopic eczema in school children from East Germany.

This study aimed to investigate the relation between environmental influences such as arsenic, cadmium, lead, and mercury, as well as environmental tobacco smoke, pet keeping, and heating systems on the prevalence of atopic eczema. Therefore, a multicenter cross-sectional study of school children aged 5-14 years, including a standardized questionnaire, blood and urine analyses, and a dermatological examination, was undertaken. A cases-control approach was chosen in order to identify relevant risk factors. A total of 2200 school children (response 79.1%) of two areas (Bitterfeld, Hettstedt) polluted by industrial activities and an agricultural control region (Zerbst) of the former German Democratic Republic were examined. Atopic eczema as identified by dermatological examination and history was the outcome variable of interest. Body burden of arsenic and heavy metals and questionnaire data on environmental tobacco smoke exposure, pet keeping, and heating system were investigated as potential risk factors. The overall prevalence of atopic eczema was 2.6%, with higher prevalences in the industrial areas (2.5 and 2.9%) compared to the control area (1.6%, not significant). Bivariate analyses did not reveal statistically significant associations between atopic eczema and tobacco smoke exposure or the body burden of arsenic and heavy metals. According to multiple logistic regression analysis, atopic eczema was significantly more frequent in predisposed families and those who reported keeping guinea pigs (OR=4.37, CI 2.15-8.91), but not other pets, like dogs, cats, and hamsters. In comparison to a distant heating system, a decreased risk was observed in households with central heating system (OR=0.30, CI 0.10-0.90), whereas the presence of a gas heater with an exhaust pipe connection to the wall was associated with a significantly elevated risk for eczema (OR=8.22, CI 2.44-27.66). The heating system and exposure to certain animal allergens are related to the manifestation of atopic eczema. Further studies are needed to clarify how far a causal relationship is reflected by these findings.

Adolescent↗
PubMed1999

Training phonological awareness with and without explicit attention to articulation.

One hundred twenty-two second- to fifth-grade (7- to 11-year-old) children with reading difficulties studied phonological awareness with or without explicit attention to articulation and with or without manipulation of sounds. They all studied identical phonics and read stories on the computer with speech and decoding support for difficult words. Regular-instruction controls received regularly scheduled language-arts or reading activities. After 40 h of training, children in all three trained conditions outperformed controls on all tests except math. Conditions that manipulated sounds showed advantages over the condition without explicit practice manipulating sounds, but only on the two measures of phonological awareness. Articulatory awareness training yielded no unique benefits during this training period. Individual differences in response to treatment related to initial levels of phonological awareness, naming speed, IQ, and grade. The similar outcomes of the three conditions suggest that specific variations in good phonological training may be less important than once thought for most children with reading difficulties.

Attention↗
PubMed1999

[Squamous epithelial carcinoma-associated necrolytic migratory erythema].

A 59-year-old Caucasian man suffered from persistent disseminated necrolytic skin lesions for 8 months. They failed to respond to a variety of therapeutic regimens but then cleared spontaneously within a few days. After one week an invasive squamous cell carcinoma of the hypopharynx became clinically apparent. At autopsy, the expected glucagonoma often associated with necrolytic migratory erythema was not found.

Carcinoma, Squamous Cell↗
PubMed1999

[Systemic therapy in the treatment concept of atopic eczema. Reliable treatment methods and experimental developments].

Our therapeutic approach to atopic eczema consists of a continuous topical dermatological basic therapy in combination with an antiinflammatory therapy in phases of exacerbations. In the treatment of exacerbated atopic eczema, systemic agents are added to achieve effective control more rapidly or to induce remissions in cases refractory to standard therapy. Antihistamines to control the pruritus, as well as antibiotics and acyclovir for antimicrobial superinfections are often used. In many patients exacerbations can be successfully controlled with phototherapy, especially with UVA1 light. The use of systemic immunosuppressants, like glucocorticosteroids, cyclosporine or azathioprine generally can be avoided and is a therapeutic alternative only in few selected cases. In the last years promising new experimental treatments have evolved, which could become therapeutic alternatives for the future.

Administration, Oral↗
PubMed1999

[Treatment of acute exacerbated atopic eczema with emollient-antiseptic preparations using the "wet wrap" ("wet pajama") technique].

Six patients (3 children and 3 adults) with acute exacerbated atopic eczema were treated with basic emollients in combination with chlorhexidine-soaked dressings over a period of three days using the "wet-pyjama" technique. Improvement of eczema was documented with the severity score "Scoring of Atopic Dermatitis" (SCORAD); most pronounced changes were found for the subjective parameters itch and sleep loss. Paralleling skin improvement a reduction of Staphylococcus aureus colonisation was noted. Improvement of skin changes lasted beyond the active treatment period. Wet-wrap dressings are an effective treatment modality for atopic eczema without use of corticosteroids and can be used easily on an outpatient basis when manufactured dressings are used.

Acute Disease↗
PubMed1999

[Henoch-Schönlein purpura: successful treatment with Dapsone].

A 26-year old patient who suffered from purpura for four years evolved into the complete clinical picture of Henoch-Schönlein-purpura in the past two years. A causative agent was never found. Multiple therapeutic approaches including systemic steroids, azathioprine as well as pentoxyfylline failed to control the arthralgias, intestinal symptoms and skin lesions. Therefore dapsone therapy was initiated at a dosage of 100 mg daily after checking the glucose-6-phosphate-dehydrogenase and with regular control of the blood methemoglobin level. Within two weeks, the patient's symptoms completely cleared, he has now been in remission for the past six months. As noted elsewhere, dapsone is an effective therapy for severe cases of Henoch-Schönlein- purpura.

Adult↗
PubMed1999

Association between severity of atopic eczema and degree of sensitization to aeroallergens in schoolchildren.

BACKGROUND: A subgroup of patients with atopic eczema exhibits aggravation through contact with aeroallergens. Little is known from population-based studies, however, about the association between the severity of eczematous skin disease and the degree of aeroallergen sensitization. OBJECTIVE: We sought to investigate the relationship between IgE-mediated allergic sensitization to aeroallergens and severity of atopic eczema in schoolchildren. METHODS: A nested case-control analysis on atopic eczema was performed on the basis of a cross-sectional study of 2201 East German schoolchildren aged 5 to 14 years. Atopic eczema and its severity was identified by dermatologic examination. Total and allergen-specific IgE antibodies to grass and birch pollen, Cladosporium herbarum, Dermatophagoides pteronyssinus, and cat epithelium in serum were determined, and additional information was obtained by means of standardized questionnaire. RESULTS: The overall prevalence of actual atopic eczema was 2.5%. Thirty-seven percent of the children were sensitized to at least one allergen. Children with atopic eczema were significantly more often sensitized than those without skin disease (75.0% vs 36.3%; odds ratio, 5.27; 95% confidence interval, 2.54-11.15). This was observed for each single allergen. The prevalence of atopic eczema increased significantly with increasing RAST class (chi(2) trend test for each allergen, P <.0001). Also, the prevalence of sensitization increased with the severity of the disease (chi(2) trend test for each allergen, P <.0001). This association was pronounced for house dust mite and cat allergen. Multiple linear regression analyses showed significant associations between the severity score of atopic eczema and concentrations of allergen-specific IgE to dust mite (P =.032) and cat (P =.014) allergens after adjustment for sex, age, location, and parental predisposition. CONCLUSIONS: The degree of sensitization is directly associated with the severity of atopic eczema. We speculate that early epicutaneous sensitization to aeroallergens may be enhanced by damage of the skin barrier function. The specific IgE response seems to contribute to the severity of the disease in a dose-dependent fashion.

Adolescent↗
PubMed1999

Evaluating the relevance of aeroallergen sensitization in atopic eczema with the atopy patch test: a randomized, double-blind multicenter study. Atopy Patch Test Study Group.

BACKGROUND: IgE-mediated sensitization of questionable clinical relevance is routinely demonstrated in patients with atopic eczema (AE) by skin prick test or radioallergosorbent test (RAST). We report the results of a randomized, double-blind multicenter study in patients with AE on the relevance and technical aspects of aeroallergen patch testing (atopy patch test, APT). METHODS: Two hundred fifty-three adult patients with AE in remission were tested in 7 study centers on clinically uninvolved, unabraded back skin with 3000 to 10,000 PNU/g of Dermatophagoides pteronyssinus, cat dander, grass, birch, and mugwort pollen allergen extracts in petrolatum. After skin prick and RAST and a detailed history on aeroallergen-induced eczema flares was obtained, reading was done at 48 to 72 hours. RESULTS: Previous eczema flares after contact with specific allergens were reported by 10% (mugwort pollen) to 52% (D pteronyssinus) of patients. The percentage of clear-cut positive APT reactions ranged from 44% with D pteronyssinus to 5% with mugwort. Positive skin prick (36% to 65%) and RAST (49% to 75%) results were more frequent. APT results showed significant concordances with history, skin prick, and RAST for D pteronyssinus, cat dander, and grass pollen (P < .001). Optimal test concentrations were 5000 (grass pollen) and 7000 PNU/g (D pteronyssinus, cat dander). The APT had a higher specificity (69% to 92% depending on allergen) with regard to clinical relevance of an allergen compared with skin prick test (44% to 53%) and RAST (42% to 64%). CONCLUSION: Aeroallergens are able to elicit eczematous skin reactions after epidermal application. The relevance of aeroallergens for AE flares may be evaluated by APT.

Adolescent↗
PubMed1999

The wide spectrum of clinical expression in Adams-Oliver syndrome: a report of two cases.

Two children are described with the combination of aplasia cutis congenita (ACC) and transverse limb defects known as Adams-Oliver syndrome. Whereas in the first child the typical features of ACC, syndactyly and transverse nail dystrophy were only mildly expressed and associated defects of the central nervous system and cardiac malformations were absent, the second child suffered from a very severe expression of the syndrome, with a combination of ACC, syndactyly, cutis marmorata telangiectatica congenita and multiple cardiac and central nervous system malformations which resulted in fatal central respiratory insufficiency.

Abnormalities, Multiple↗