Search PubMedSearch

Biomedical subjects

K Konrad

Publications and source records attributed to K Konrad.

At least 19 recordsLinked to original sources

Controlled trial of balneotherapy in treatment of low back pain.

Three treatments for non-specific lumbar pain--balneotherapy, underwater traction bath, and underwater massage--were assessed in a randomised prospective controlled trial in 158 outpatients. Each group was treated for four weeks and patients were reviewed at the end of this period and at 12 months after entry to the trial. The prescription of analgesics and the pain score were significantly reduced in all three treated groups, but there was no difference between the three groups. No significant change occurred in spinal motion and the straight leg raising test. After one year only the analgesic consumption was significantly lower than in the control group.

Adult

Hyperkeratosis lenticularis perstans (Flegel's disease). Ultrastructural study of lesional and perilesional skin and therapeutic trial of topical tretinoin versus 5-fluorouracil.

Lesional and perilesional skin samples from a 57-year-old man who had hyperkeratosis lenticularis perstans (HLP) (Flegel's disease) were studied by light and electron microscopic examination. Keratohyalin granules were diminished at the center of a fully-developed lesion. In contrast, keratohyalin appeared normal and membrane-coating granules were found in reduced numbers at the edges of the HLP lesion and were easily detected in normal numbers in clinically normal, perilesional skin. The inflammatory infiltrate in the HLP lesion was composed of small lymphocytes, which often displayed nuclei with deep infoldings resembling Sézary cells, and larger histiocytic cells, many of which were in close contact with the lymphocytes. Peripheral blood mononuclear cells did not show an abnormal ultrastructural appearance. Treatment with topical 5-fluorouracil cream led to the disappearance of the HLP lesions, whereas topical tretinoin was ineffective.

Administration, Cutaneous

Middermal elastolysis in an elderly man with evidence of elastic fiber phagocytosis.

BACKGROUND: Middermal elastolysis is a clinically and histologically distinct entity. This idiopathic loss of dermal elastic fibers has mostly been reported in younger adults. To our knowledge, the present case, which has been followed up for 4 years, is the first to occur in an elderly man. OBSERVATIONS: Two years after the onset of progressive wrinkling of the upper aspect of the thorax, the patient underwent a biopsy. Histologic examination of the specimens confirmed previous findings of middermal elastolysis. Examination of extracutaneous elastic tissue showed normal findings. Electron microscopy demonstrated elastic fibers embraced by macrophages, which is suggestive of elastic fiber phagocytosis. For the following 4 years, the patient has remained in stable clinical condition. CONCLUSIONS: Middermal elastolysis is probably more common than has been assumed so far. It does not affect nondermal elastic tissue. After progressive loss of dermal elasticity in a circumscribed area, a benign course follows, with a stable condition over several years. Electron microscopic findings indicate that elastic fiber phagocytosis is operative in the disappearance of the middermal elastic tissue.

Aged

Merkel cell carcinoma of the head and neck associated with Bowen's disease.

The Merkel cell carcinoma occurs primarily in the skin of the head and neck, and develops in the dermis with a trabecular growth pattern. Immunohistochemistry reveals positive staining for neuron-specific enolase, neurofilaments, cytokeratin and chromogranin A. Electron microscopically, the tumor cells contain dense-core granules, spinous cytoplasmic processes, desmosomes, zonulae adherentes and paranuclear filament aggregates besides frequent mitoses, focal necroses and lymphocyte and plasma cell infiltrates. The Merkel cell carcinoma is often co-existent with other malignancies such as squamous cell carcinoma or, as in the present study, with Bowen's disease. The definite diagnosis of the Merkel cell carcinoma can be effected only by electron microscopic examination of the tumor.

Aged

[Mycosis fungoides bullosa--a case report (author's transl)].

An extremely rare variant of mycosis fungoides, presenting with bullous lesions, is reported. Histopathological examination of the skin revealed subepidermal blister formation, a diffuse mononuclear infiltrate in the uppermost parts of the dermis and the characteristic intraepithelial Pautrier microabscesses. Lutzner cells were found at the ultrastructural level. The mechanism of blister formation in mycosis fungoides is outlined.

Aged

Ultrastructure of blebbing phenomenon and phagocytosis of blebs in laryngeal carcinoma.

The epithelial-connective tissue junction of invasive squamous cell laryngeal carcinoma was examined electron microscopically. The pleomorphic cytoplasmic protrusions known as blebs were observed on the lateral and basal surfaces of malignant keratinocytes. These blebs were pinched off from the malignant epithelial cells and were then observed in the connective tissue or in the intercellular spaces. After the pinching-off process some blebs were seen to be closely surrounded by pseudopods of phagocytizing histiocytic cells in the lamina propria or by adjacent malignant keratinocytes in the intercellular spaces. Since blebs are believed to be intact parts of viable cells this engulfment can be interpreted as cytophagocytosis. During cytophagocytosis the zeiotic blebs exhibited varying degrees of enzymatic digestion. The process of blebbing was discussed in respect to cellular locomotion of malignant keratinocytes during tumor invasion. This phenomenon seems to occur only in the preliminary stages of malignant tumor growth in the larynx.

Carcinoma, Squamous Cell

Ultrastructural localization of immunoglobulin and fibrin in lichen planus.

To demonstrate the exact localization of immunoglobulin and fibrin deposits in skin lesions of lichen planus, we employed the peroxidase-antiperoxidase technique, both light and electron microscopically. IgM is shown to be deposited preferentially in and on the cytoid bodies all over their cut surface in a typical stippled pattern, partly obscuring the characteristic fibrillar substructure. All other structures such as the basal lamina are devoid of IgM deposits. Fibrin (F) is also present in cytoid bodies but in a lesser amount; it is characteristically deposited on and along the basal lamina and its reduplications in the uppermost strata of the dermis. Our results indicate that IgM deposition in cytoid bodies occurs at a very early stage during the formation of these structures and that fibrinogen exhibits a specific affinity not only to cytoid bodies but also to basal lamina material.

Fibrin

Juvenile dermatitis herpetiformis: an immunoelectron microscopic study.

Three children with persistent maculopapular and urticarial lesions and vesicles at the predilection sites of dermatitis herpetiformis (DH) were shown to exhibit typical granular, papillary IgA and C3 deposits in the tips of the dermal papillae, as demonstrated by direct immunofluorescence. By immunoelectron microscopy, the IgA deposits were associated with the microfibrils of the elastic fibres as has been described in DH of the adult. C3 deposits were scattered throughout the papillary dermis. Despite the similarity of the clinical appearance, history with regard to gluten sensitive enteropathy (GSE) varied in these three cases. In one child, the skin lesions appeared following faults in the gluten free diet on which he was kept for coeliac disease. Another child developed the skin lesions during a gluten free diet which was not strictly followed; no recurrences of gastrointestinal symptoms accompanied the eruption of DH. In the third case, no evidence for GSE in patient's history or in jejunal biopsies was present at the time of onset of DH.

Celiac Disease

[Sézary syndrome. Clinical, immunological and proliferative kinetics].

The development of Sézary syndrome was observed in a patient with mycosis fungoides. The Sézary cells in the peripheral blood were identified as a specific T-cell population with helper cell characteristics. Autoradiographic analysis showed that the Sézary cells obtained from skin biopsies proliferated much more rapidly than those from the peripheral blood. After transformation into a highly malignant T-cell lymphoma (immunoblastic) it came to an abrupt and fatal course of the disease.

Aged

[Immunopathology of Duhring's dermatitis herpetiformis].

Dermatitis herpetiformis and gluten-sensitive enteropathy and their mutual association are discussed. Clinical, histopathological, immunopathological and genetic findings are emphasized, particularly with regard to the pathogenesis and diagnosis of both disorders.

Antigen-Antibody Complex

[Ultrastructure of tumor-stroma junction of invasive laryngeal carcinoma (author's transl)].

The tumor-stroma junction of invasive squamous cell carcinoma of the larynx was examined electron microscopically. Polymorphic cytoplasmic protrusions (blebs) with a diameter ranging from 2--4 micron to 8--10 micron were observed on the basal and lateral surfaces of the malignant keratinocytes. A system of cytoplasmic 6--8 nm microfilaments can be seen consistently at the base of the blebs. The microfilaments possibly serve as a contractile ring during the pinching-off process of the blebs from the malignant keratinocytes. The blebs were observed at various stages of development until the pinching-off process occurred. They have varying shapes, sizes, and electron density and are plasmamembrane bounded. They contain hyaline ectoplasm, ribosome particles, a fine filamentous and fine granular material as well as some lysosomes. The blebbing phenomenon is discussed in respect to the cellular locomotion of malignant keratinocytes and interpreted as a possible temporary invasion mechanism in the preliminary stages of the tumor growth.

Carcinoma, Squamous Cell

Non-inflammatory dermal elastolysis.

A 33-year-old woman is described who suffers from an idiopathic loss of mid-dermal elastic tissue which leads to wrinkling of the skin and to discrete perifollicular protrusions. In accordance with Sheley & Wood (1977) we conclude that these findings represent a new entity for which we propose the term 'non-inflammatory dermal elastolysis'.

Adult

Immunoelectron microscopy of skin in lupus erythematosus.

A multistep immunocytochemical method, utilizing horeradish peroxidase as an immunological bound marker enzyme, was employed to demonstrate in vivo fixed immunoglobulins (IgG, IgM) in the skin of three patients with CDLE and three patients with SLE. The immunoglobulin deposits were confined to the uppermost strata of the dermis, i.e. the area just below the basal lamina. Small amounts of immunoglobulin were visible within the lamina lucida and the basal lamina. Only quantitative differences were observed between deposits of immunoglobulins in CDLE and SLE. I CDLE, the reaction product covered a wider area of the superficial dermis and extended deeper down into the dermis. IgG and IgM deposits exhibited an identical fine structural morphology.

Complement C3

[Photochemotherapy in mycosis fungoides].

Nineteen patients with mycosis fungoides (m.f.), without involvement of lymph nodes and/or internal organs, were treated with oral photochemotherapy (PUVA). After four to five weeks of PUVA therapy (four irradiations/week) complete remission of erythematous and infiltrative plaques occurred; tumorous m.f. lesions also responded to treatment but required longer treatment times. After complete resolution of m.f. lesions the patients were controlled regularly, the observation periods ranging from 6 to 27 months. When recurrences occurred the initial treatment schedule was resumed. Recurrences, more often seen in the tumorous m.f. stage, responded to PUVA equally well as the initial lesions. PUVA therapy of m.f. is thus more effective than conventional UVB-irradiation and less problematic than treatment with cytotoxic agents or ionizing radiation. Present experience indicates that PUVA represents the treatment of choice in early stage m.f.

Adult

[Kaposi's sarcoma. Pharyngo-laryngeal manifestation, treatment (author's transl)].

Kaposi's sarcoma involvement of the ENT region develops normally years after the onset in the skin. Reports on Kaposi's sarcoma in the ENT literature are therefore very rare. Until now by no kind of treatment including X-ray irradiation satisfactory results could be obtained. The recently introduced longterm-treatment with vinblastine sulfate is very effective reducing the size and extension of the tumorous infiltrations. In the ENT-region the plate, the pharynx, the larynx and the trachea are most frequently involved. We report on a patient with extensive pharyngeal and laryngeal involvement who had to be tracheotomized. While still on treatment with vinblastine-sulfate the decanulement was possible, the patient could resume his profession as bassoonist. This successful treatment regimen has not been mentioned in the ENT-literature previously.

Humans

Systemic lupus erythematosus with multiple myeloma.

A 44-year-old white man presented with an erythemato-squamous rash in the supra-orbital and preauricular regions of the face. The diagnosis systemic lupus erythematosus was confirmed by histopathology, immunofluorescence (circulating antinuclear antibodies and a positive lupus band test), and by immunoelectron microscopy. Further examinations disclosed a multiple myeloma of the IgG type without cutaneous involvement. The coexistence of these two disorders has not been reported previously.

Adult