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Biomedical subjects

M Binder

Publications and source records attributed to M Binder.

At least 163 records · Page 9Linked to original sources
PubMed1995

An epidemiological study of trichotillomania in Israeli adolescents.

OBJECTIVE: To determine the prevalence of trichotillomania and comorbid psychopathology in nonreferred adolescents. METHOD: Using a questionnaire and interview, 794 Israeli 17-year-olds were screened for current and past hair-pulling and comorbid psychopathology. RESULTS: Eight current or past hair-pullers (5 male, 3 female) were identified, yielding a lifetime prevalence of hair-pulling of 1%. Four subjects reported current hair-pulling (point prevalence of 0.5%). None of these reported alopecia, distress, or tension before pulling; only two reported relief after pulling. Thus, none met the full DSM-III-R criteria for trichotillomania. Four subjects reported past but not current hair-pulling, with bald spots in two cases. Three of the four current hair-pullers had significant obsessive-compulsive symptoms, a significantly elevated rate compared to the entire screened population. Two subjects with obsessive-compulsive disorder also had generalized anxiety disorder and, in one case, chronic simple vocal tics. Hair-pullers did not differ significantly from non-hair-pullers in IQ, physical fitness, and overall competency, or prevalence of other comorbid disorders. CONCLUSIONS: In a community adolescent sample, only 25% of hair-pullers reported resulting bare spots and none endorsed both rising tension and subsequent relief. The prevalence of obsessive-compulsive symptoms was significantly elevated in these nonreferred hair-pullers.

Adolescent↗
PubMed1995

New treatment of atrophic acne scars by iontophoresis with estriol and tretinoin.

BACKGROUND: Common treatment of atrophic acne scars consists of invasive methods such as dermabrasion, chemopeeling, or implantation of bovine collagen. In our study a new noninvasive treatment method consisting of local iontophoresis is demonstrated. Local iontophoresis was performed with either estriol--a mainly topically active estrogen--or with tretinoin. PATIENTS AND METHODS: Eighteen women were treated with estriol iontophoresis twice weekly for a period of 3 months. In addition to photographic and clinical documentation of the skin, venous blood for determination of serum levels of prolactin and estradiol according to standard radioimmunoassay methods was obtained monthly. Tretinoin iontophoresis was performed according to the same time schedule in 28 patients (19 women and 9 men) with atrophic acne scars. RESULTS: Improvement of acne scars was observed in 93% of patients treated with tretinoin iontophoresis and in 100% of the group treated with estriol iontophoresis. No hormonal changes were noted in the estrogen group. Side effects involving the skin appeared in the tretinoin group in 4 cases and consisted of increased dryness and of retinoid dermatitis. CONCLUSION: Both treatments were shown to be clinically effective in decreasing acne scars and persistence of effects. This promising new therapeutic approach may thus replace invasive treatment methods in many patients.

Acne Vulgaris↗
PubMed1995

Near infrared spectroscopy during and after cardiac arrest--preliminary results.

OBJECTIVE: To evaluate if regional cerebrovascular oxygen saturation (rSO2) is linked to systemic oxygenation and if impaired regional cerebral oxygenation affects outcome in cardiac arrest patients. DESIGN: Prospective, observational study. SETTING: Emergency department of a University Hospital. SUBJECTS: Patients during cardiac arrest or after restoration of spontaneous circulation. INTERVENTIONS: To measure rSO2 an infrared light-emitting probe was applied to the patient's forehead after arrival in the emergency department. Data were collected continuously together with blood pressure and pulse oximetry. Each variable measured immediately after arrival was used for calculation. ENDPOINTS: Best outcome (cerebral performance category) or death within one week. MEASUREMENTS AND MAIN RESULTS: Regional SO2 was measured in 18 consecutive patients. Six patients presented with cardiac arrest on arrival and rSO2 was measured during chest compression. Twelve patients had achieved restoration of spontaneous circulation before they arrived in the emergency department. No association was found between rSO2 and pulse oximetry or rSO2 and blood pressure. All patients surviving for one week (n = 9) achieved a significantly higher median rSO2 on arrival than nonsurvivors (n = 9) (63% and 46%, respectively; p = 0.003). Median rSO2 was lower in the group arriving without spontaneous circulation (n = 6) than in patients after restoration of spontaneous circulation (n = 12) (44% and 63%, respectively; p = 0.009). This difference was not found in pulse oximetry readings. Patients with restoration of spontaneous circulation surviving the first week after cardiac arrest (n = 8) had a higher rSO2 than patients with restoration of spontaneous circulation who did not survive (n = 4) (65% and 48%, respectively). Time from restoration of spontaneous circulation to arrival was not different between the two groups. CONCLUSION: By showing that low rSO2 readings after cardiac arrest are associated with a higher mortality, this new, non-invasive and easily applicable technique might help to prognosticate outcome and offers new insights into monitoring cerebral oxygenation after cardiac arrest.

Adolescent↗
PubMed1995

[Patch testing with the "Austrian standard series"--epidemiologic test values and results].

Patch testing for contact allergies is routinely performed by applying a "standard series" of the most frequently occurring contact allergens. Internationally "established" standard series have to be adapted to country- and population-specific factors (i.e., distribution of gender and age, occupational behavior, environmental factors etc.). In 1992 and 1993 altogether 11,690 patients were patch tested in 14 Austrian test centers with the "Austrian standard patch test series" as recommended by the working group "Contact Allergy" of the Austrian Society of Dermatology. Altogether data on 11,544 patients were complete and are analyzed in this study. 71.5% of the test population were female with an average age of 39 years, whereas the male patients had an average age of 40 years. 38.1% of the patients were younger than 30 years, 47.8% were in the group ranging from 31 to 60 years and 14% of the tested patients were older than 60 years. Cutaneous sensitization was found in 51% of the people tested with the "Austrian standard series". This proportion varied between 40.8 and 61.4% from center to center (with more than 100 tested persons). 15 (60%) of the 25 test substances in 1992 and 17 (68%) in 1993 surpassed the limit of a sensitization frequency of 1%. The "hit list" of substances did not differ qualitatively from those of other international studies, with only one remarkable, well described "Austrian-specific" exception, namely the mercury-containing thiomersal (second place).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

The minimum basic data set as the core of the Freiburg University Hospital information system.

At the University Hospital Freiburg (1,927 beds; 53,000 inpatients/year), we developed and ran a Medical Information, Retrieval, and Archives System (MIRA) by integrating the Minimum Basic Data Set into the self developed patient administration system and all the other parts of our hospital information system. Especially for the physicians, MIRA offers access to basic medical data of all patients treated in all medical departments and separate buildings since 1986. MIRA is mainly used in cases of readmission and for scientific and managerial purposes. The privacy controlled access to the central patient data bases (records of 450,000 patients) of MIRA is possible via 610 online PCs and dialog terminals. Because of the many easy-to-use standard functions and special extensions for different clinical departments, MIRA became one of the best accepted edp systems for physicians, nurses and administrators.

Germany↗
PubMed1994

[Profilometry. A method for documenting skin structure].

Profilometry is a novel procedure allowing precise analysis of skin surface structure. With the help of a synthetic material a negative image of a defined area of the skin is taken. During the subsequent analytical procedure the roughness is determined by means of a profilometer. A commercially available statistics software program is used for statistical analysis of the results. This procedure was applied to check for to evaluate positive effects of oestrogen creams on the structure of the skin surface on the face.

Administration, Topical↗
PubMed1994

Endomyocardial HLA expression is increased to the same extent in idiopathic and secondary dilated cardiomyopathy.

In a total of 22 failing hearts from human transplant recipients, the expression of major histocompatibility complex (MHC) molecules, the CD phenotype of infiltrating mononuclear cells, and the number of fibroblasts were analyzed by immunohistochemistry. Compared with 10 non-failing control hearts, significantly higher morphometric area fractions of HLA-ABC and HLA-DR with a concomitant increase of CD3-, CD4- and CD8-positive cells were found to be comparable in 12 patients with idiopathic dilated cardiomyopathy and in 10 patients with secondary heart failure. Furthermore, the similarity of T-cell activation in idiopathic and secondary variants of the disease were substantiated by the following observations: (1) the site-specific distribution of MHC molecules and mononuclear cells in the myocardium was comparable in idiopathic and secondary dilated cardiomyopathy; (2) 6 individuals with lymphocytic aggregates in their myocardium in association with the highest levels of HLA-ABC expression were equally distributed among idiopathic and secondary patient subsets; and (3) expression of HLA-ABC and HLA-DR correlated with that of an endothelial cell marker, von Willebrand factor, in failing myocardia of both study groups. In conclusion, no difference was found in increased MHC molecule expression in failing myocardium of idiopathic and secondary variants of dilated cardiomyopathy, and these entities were not differentially associated with infiltration by increased numbers of T lymphocytes. Hence, we postulate that these immunopathological features are consequences rather than causative factors of myocardial degeneration and dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomyopathy, Dilated↗
PubMed1994

Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds. A pilot study.

A wide range of somatic symptoms of the perimenopausal female is due to the decrease of estrogen at that age. Minor attention has been paid hitherto to the involvement of estrogens in female skin ageing symptoms. In our study, the ageing skin of the face of perimenopausal females was treated with a 0.3% estriol cream (8 patients) or with a 0.01% estradiol cream (10 patients) for 6 months. Dermatologic follow-up was performed monthly. At each follow-up venous blood for radioimmuno assay determination of prolactin (PRL), follicle stimulating hormone (FSH) and estradiol (E2) was sampled. In addition, prior to and after 3 and 6 months of treatment, gynecological examinations for climacteric symptoms, mammary and colposcopic investigations and vaginal smears for cytology were performed. Both treatment groups showed improvement of the various skin ageing symptoms at the end of treatment. The effects of the group treated with topical estriol were slightly superior with regard to their extent and onset. No hormonal side effects were noted either clinically or by hormone monitoring. According to these preliminary results, local estrogen treatment appears to be a promising new approach for the treatment of skin ageing in perimenopausal females. However, for minimizing the risk of systemic hormonal side effects, concentrations and size of application field should be limited.

Administration, Cutaneous↗
PubMed1994

Application of an artificial neural network in epiluminescence microscopy pattern analysis of pigmented skin lesions: a pilot study.

In vivo epiluminescence microscopy (ELM) is a non-invasive technique which improves the clinical diagnosis of naevi and malignant melanoma by providing diagnostic criteria that cannot be appreciated by the naked eye. The present study investigated whether ELM criteria pattern analysis can be employed in an objective, observer-trained, computer-aided diagnostic system, and whether artificial neural networks (ANN) can be applied to the diagnosis of pigmented skin lesions (PSL). The ELM criteria patterns of 200 PSL oil immersion images (60 common naevi, 60 dysplastic naevi, and 80 malignant melanomas) were analysed using a standardized questionnaire. One hundred randomly assigned PSL were used as a training set for an ANN, the remaining 100 PSL serving as the test set. The ANN was trained by backward propagation according to the histological diagnosis, and its performance was compared with that of human investigators. Out of the test set the human investigators correctly diagnosed 88% of PSL and the ANN 86%. In a dichotomized model comparing common, compound, and dysplastic naevi vs. malignant melanoma, i.e. benign vs. malignant PSL, the sensitivity and specificity of human diagnosis was 95 and 90%, respectively, whereas the sensitivity and specificity of the ANN diagnosis was 95 and 88%. Our data indicate that artificial neural networks can be trained to diagnose PSL at a human expert level, based on patterns provided by ELM criteria. We suggest that this technique offers a new approach to the diagnosis of PSL.

Diagnosis, Computer-Assisted↗
PubMed1994

Role of somatostatin and its analogues in the treatment of acute and chronic pancreatitis.

Acute pancreatitis is caused by the activation of digestive enzymes in the pancreas and a possible treatment, therefore, is the inhibition of enzyme secretion. This approach is somewhat controversial, however, as it is not clear whether pancreatic secretion continues to occur during the course of acute pancreatitis. Animal studies show an appreciable reduction of secretion in the inflamed pancreas, but studies in humans are not conclusive. The use of somatostatin or its analogue, octreotide, has been investigated in several clinical studies. A meta analysis of six individual studies in which somatostatin was given for acute pancreatitis showed that somatostatin significantly reduces mortality. A trial in patients with moderate to severe acute pancreatitis showed a lower rate (although not statistically significant) of complications in patients treated with 3 x 200 and 3 x 500 micrograms/day octreotide, compared with controls and patients receiving a lower dose of octreotide. A further study showed a significant reduction in patient controlled analgesics in patients treated with octreotide compared with controls. Pain is the important clinical symptom of chronic pancreatitis, possibly resulting from an increased intraductal pressure during secretion. The effect on pain of the inhibition of pancreatic secretion by octreotide has been investigated in two studies. One showed no significant reduction in pain after treatment with octreotide for three days. In the other, in which octreotide was used for three weeks, significantly less pain and analgesic use was recorded during octreotide treatment than during placebo. The most common complication of chronic pancreatitis is the formation of pseudocysts. There is some evidence that octreotide may be useful in their treatment.

Acute Disease↗
PubMed1994

Potential role of somatostatin and octreotide in the management of acute pancreatitis.

The pathophysiology of acute pancreatitis remains controversial. Activation of digestive enzymes in the pancreas may play an important role in the course of this disease. Therefore, the inhibition of enzyme secretion may be a possible treatment concept. However, it is not clear whether pancreatic secretion continues during the course of acute pancreatitis. In the present paper experimental and clinical studies are reviewed to evaluate the effect of somatostatin and octreotide treatment in acute pancreatitis.

Acute Disease↗
PubMed1994

Octreotide in the treatment of acute pancreatitis: results of a unicenter prospective trial with three different octreotide dosages.

Acute necrotizing pancreatitis is still associated with high morbidity and mortality. In this prospective clinical trial, we analyzed the effect of octreotide in patients with acute pancreatitis. Eight patients received either 3 x 100, 3 x 200 or 3 x 500 micrograms octreotide subcutaneously per day over a period of 10 days. The complication rate was lower in the group of patients who received 3 x 200 or 3 x 500 micrograms octreotide than in the control group and the group of patients who received the dosis of 3 x 100 micrograms octreotide per day. The results of this study are promising and must be validated in a controlled clinical trial with octreotide in a larger patient population.

Acute Disease↗
PubMed1994

Epiluminescence microscopy: a new approach to the early detection of melanoma.

ELM is a new approach to the diagnosis of pigmented skin lesions that holds considerable promise. It reveals a new dimension of in vivo morphology that can be used when the diagnostic criteria employed in routine visual diagnosis fail. It does not add to the diagnostic armamentarium available for unequivocal lesions, but has significant value for those equivocal, small, pigmented skin lesions that pose major diagnostic problems even for experienced clinicians. Prerequisites for a sensible approach to ELM include recognition of new morphologic ELM criteria and employment of these criteria in an analytic process called pattern analysis. As in clinical dermatology, ELM depends heavily on a learning process and, of course, on experience. ELM increases diagnostic accuracy for pigmented skin lesions in that it helps to distinguish between melanocytic and non-melanocytic pigmented lesions, and between benign and malignant growth patterns. Thus, ELM has the potential to overcome the diagnostic limitations encountered in clinical dermatology when small, early pigmented lesions are encountered that do not yet express the full complement of diagnostic features needed to arrive at a correct diagnosis. The fact that it is a noninvasive, in vivo method makes it even more attractive as a diagnostic tool in clinical practice. ELM already has proven to be of great practical value in several centers by increasing the probability that early melanoma will not be overlooked and by helping to prevent unnecessary major surgery in patients in whom a non-melanocytic or benign pigmentary lesion is suspected clinically to be a melanoma. It eventually may prove valuable for patients with dysplastic nevi by helping determine which lesions need to be removed. Of course, ELM also has limitations. It does not provide 100% diagnostic accuracy and is of little help in small lesions that are pigmented maximally and uniformly because these do not reveal the criteria necessary for ELM pattern analysis. At this stage, therefore, ELM does not replace histopathologic examination. Undoubtedly, ELM can be improved, and continued studies will reveal just how reliable the individual criteria discussed here eventually will prove to be in clinical practice. This requires continuing to accumulate and analyze data, and instituting teaching programs to familiarize dermatologists with ELM criteria and their use in pattern analysis. It is certain, however, that, just as clinicians have learned to employ the "ABCD" rules in visually recognizing and diagnosing melanoma, they will learn this new and more subtle approach to the previously unknown morphologic features that characterize benign and malignant pigmentary lesions on ELM.(ABSTRACT TRUNCATED AT 400 WORDS)

Diagnosis, Differential↗
PubMed1994

Estimation of the volume-weighted mean nuclear volume discriminates Spitz's nevi from nodular malignant melanomas.

BACKGROUND: Spitz's nevi are benign melanocytic skin tumors that are usually differentiated from nodular malignant melanomas by histopathologic criteria. Often, however, the architectural pattern and cytologic features of Spitz's nevi and nodular melanomas are similar. Hence, Spitz's nevi may be confused with nodular malignant melanomas at the histopathologic level. EXPERIMENTAL DESIGN: The determination of volume-weighted mean nuclear volume (Vv) uses a technique that permits an unbiased and efficient estimation of nuclear volumes in tissues. In this study, Vv was determined in 13 Spitz's nevi and 14 nodular malignant melanomas to investigate whether this stereologic approach may be of use in the differentiation of these two tumors. Vv was determined by computer-assisted image analysis (IBAS 20, Kontron, Germany) on Feulgen-stained sections using stereologic estimation of the Vv. RESULTS: The Vv (+/- SD) of Spitz's nevi was 491.6 micron3 (SD +/- 175.1), whereas nodular malignant melanomas exhibit a significantly higher (p < 0.001) Vv of 775.2 micron3 (SD +/- 205.4). This difference was even more pronounced when the deeper portions of the lesions (Spitz's nevi: 443.1 micron3, SD +/- 142.4; nodular malignant melanomas: 864.1, SD +/- 169.6) were investigated. In addition, we found that in relation to the depth of the lesions the mean Vv decreased in Spitz's nevi, whereas it increased in nodular melanomas. CONCLUSIONS: We found that (i) nodular malignant melanomas reveal a larger Vv than Spitz's nevi in general, and (ii) in contrast to malignant melanomas, the Vv of nevomelanocytes in Spitz's nevi decreases in the deeper portions of the dermis. Thus, Vv may be regarded as a helpful tool for the differential diagnosis of Spitz's nevi and nodular malignant melanomas.

Cell Nucleus↗
PubMed1993

[Antiphlogistic effect of salicylic acid and its derivatives].

An overview of the literature on the effects of salicylic acid and its derivatives with particular consideration being given to their antiinflammatory properties is presented. While acetylsalicylic acid, in common with most non-steroidal anti-inflammatory drugs, has a marked inhibitory effect on cyclooxygenase in vitro, salicylic acid only weakly inhibits this enzyme. Animal inflammation models, however, have shown that the two substances are comparable in terms of efficacy. It is therefore assumed that the antiinflammatory properties of salicylic acid and its derivatives are also based on prostaglandin-independent mechanisms. Both salicylates and salicylic acid are used for topical applications. Their penetration into deeper tissue layers, as also their efficacy after local application have been demonstrated in both animal studies and clinical trials.

Animals↗