Biomedical subjects
Publications and source records attributed to L Weinrauch.
In a severe case of the Papillon-Lefèvre syndrome, surgical correction of the disabling hyperkeratosis on the dorsa of the hands was first tested in a small area and, when that proved successful, the entire dorsa of both hands were resurfaced. The result was functionally gratifying and the cosmetic appearance was improved.
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An intractable and disabling case of Hailey-Hailey disease largely in the groins is reported. Conservative treatment was ineffective, but surgical excision and grafting had good results.
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Twenty-one insulin-dependent diabetics with azotemic nephropathy were evaluated for renal transplantation by selective coronary angiography and cine left ventriculography. All had hypertension, retinopathy, neuropathy, and required salt restriction plus diuretics for volume overload. There was no clinical or electrocardiographic evidence of ischemic coronary artery disease in twenty. Ten patients (five males, five females, mean age 29.3 years; mean duration of diabetes 21.9 years; mean serum cholesterol 239 mg%) had significant coronary artery disease, seven demonstrating focal abnormalities in left ventricular wall motion. Two patients (one male, one female; mean age 36.5 years; mean duration of diabetes 28.5 years; mean serum cholesterol 250 mg%) had no significant coronary artery disease, but demonstrated diffusely abnormal left ventricular wall motion with diminished ejection fraction. Thirty-eight percent had significant coronary artery disease unpredictable by electrocardiographic or clinical data. The finding of no significant coronary artery disease in 52% of a group with severe renal-hypertensive complications of diabetes is surprising. Two patients may have a demonstrated cardiomyopathy.
Two cases of Prinzmetal's variant angina are presented in which coronary spasm was documented by electrocardiographic evidence obtained in the coronary care unit during provocative testing with ergonovine maleate after the arteriographic demonstration of anatomically normal coronary arteries. The rationale and risks of provocative testing for spasm in patients with chest pain and anatomically normal coronary arteries are reviewed. The advantages of performing provocative testing in the coronary care unit after arteriography rather than in the catheterization laboratory during coronary arteriography are discussed.
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Thirty-nine patients with cutaneous leishmaniasis caused by Leishmania major were treated with rifampicin alone or in combination with isoniazid. No significant difference was found between these two therapeutic regimens, and about half of the patients were cured 2 months from the beginning of treatment. A review of rifampicin in cutaneous leishmaniasis is attached.
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