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Biomedical subjects

M Goos

Publications and source records attributed to M Goos.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Comparative study of the therapy of Candida esophagitis in HIV-1-infected patients with fluconazole or amphotericin B and flucytosine].

In 20 HIV-patients (17 male homosexuals, 1 male and 1 female i.v. drug abuser and 1 female patient with M. Willebrand-Jürgens) Candida esophagitis was diagnosed by esophagogastroduodenoscopy. Clinically they presented retrosternal pain or an exacerbation of oral candidosis under local antimycotics. The diagnosis of Candida esophagitis was based on histopathologic examination and culture studies of biopsy specimen from macroscopically suspect lesions. Candida antigen was found in the serum of 30% of the patients, immunofluorescence was positive for Candida antibodies in 25%. A CMV- or HSV-esophagitis could be ruled out by direct immunofluorescence, in situ hybridoma experiments and by virus culture assays. In 11/20 patients the Candida esophagitis was the first manifestation of full blown AIDS. 10 patients were treated daily with a combination of amphotericin B 0.4 mg/kg KG and flucytosine 150 mg/kg/KG and 10 patients by oral administration of fluconazole 400 mg/d each for 8 days. Secondary prophylaxis was carried out with 2.4 g/d (24 ml) amphotericin B as oral suspension in the amphotericin group and with 50 mg/d fluconazole p.o. in the fluconazole group. Both therapy regimens showed a complete remission in a control esophagogastroduodenoscopy after 10 days. Side effects were only moderate. After an observation period between 7-24 months there were three relapses in the amphotericin group and four in the fluconazole group. After 24 months 10 patients had died, a rate comparable to that after Pneumocystis carinii pneumonia. In total, there is no difference between both therapy regimens, the oral administration of fluconazole once a day allowed treatment as an outpatient and was appreciated by the patients.

Amphotericin B↗
PubMed1990

A family study of atopic dermatitis. Clinical and genetic characteristics of 188 patients and 2,151 family members.

The history of 188 caucasian patients with atopic dermatitis (AD) and of 2,151 family members has been analyzed. Of the AD patients 48% suffered from respiratory atopy (36% rhinitis, 28% asthma, and 15% both). AD showed by far the earliest onset of all atopic diseases: 50% of our patients had skin lesions before the age of 2 years and 60% before the age of 5 years. In contrast, symptoms of allergic asthma developed in 40% of AD patients before the age of 5 years in comparison with only 25% who had allergic rhinitis. AD affects females more frequently than males (male to female ratio 1:1.5), regardless of whether additional respiratory atopies are present or not. In contrast, respiratory atopies develop more frequently in males than in females (male to female ratio 1.5:1). Mothers with respiratory atopy more often have atopic children (26%) than do fathers with respiratory atopy (13%). Finally, risk figures for genetic counselling are given. In short, the general risk of developing AD (3%) and atopy (7%) increases by a factor of two with each first-degree family member already suffering from atopy.

Adolescent↗
PubMed1990

[Cutaneous manifestation of fungal infection].

A 50-year-old patient with an aplastic syndrome developed disseminated purpuric, necrotic lesions on his skin. Histological examination revealed fungal sepsis. The clinical appearance, the course of the disease are described and the importance of histological examination is pointed out.

Agranulocytosis↗
PubMed1990

Comparative effects of rifampin and/or probenecid on the pharmacokinetics of temazepam and nitrazepam.

The pharmacokinetics of nitrazepam and temazepam were investigated in 16 healthy volunteers before and after seven days of the administration of rifampin 600 mg/d and/or probenecid 500 mg/d. In order to determine the endoplasmatic reticulum enzyme function, 6-beta-hydroxycortisol excretion and antipyrine pharmacokinetic parameters were evaluated. After the administration of rifampin, the total body clearance of antipyrine and nitrazepam increased by 87% and 83%, respectively. After the combined treatment with rifampin and probenecid, the elimination of the two drugs was also increased, even though to a lesser extent (33%, 31%). After the administration of probenecid only, the total clearances of antipyrine and nitrazepam were decreased by 22% and 25%, respectively. The urinary clearance of the antipyrine metabolites also decreased. In norantipyrine and 4-OH-antipyrine, this was due to a significant reduction of glucuronide fraction (211 +/- 32 to 159 +/- 26 mg, and 259 +/- 39 to 191 +/- 25 mg). The sulphate fraction of norantipyrine increased by 18% and that of 4-OH-antipyrine by 21%. Apart from a reduced excretion of the glucuronide fraction, the pharmacokinetics of temazepam were neither altered significantly by probenecid nor by rifampin. According to the outcome of this investigation, probenecid seems to bring about not merely an inhibition of phase II but also an inhibition of phase I metabolization.

17-Hydroxycorticosteroids↗
PubMed1990

[Gardner syndrome with pilomatrixoma-like hair follicle cysts].

Gardner's syndrome is accompanied by numerous cutaneous neoplasias, cysts of hair follicles being the most frequent. We report a case of Gardner's syndrome with multiple hair follicle cysts. Histologically, parts of the cyst linings showed features of pilomatricomas. We discuss the histopathological findings and their significance as possible markers for the disease.

Adult↗
PubMed1989

Cimetidine and the immuno-response in healthy volunteers.

We compared the immunologic measurements from treatment of 12 healthy volunteers (six male, six female) with 800 and 1,600 mg cimetidine. In the first trial 800 mg cimetidine was administered daily to the volunteers over a period of 7 d; after an interruption of 2 months, 1,600 mg of cimetidine was applied daily for 21 d. The most striking result of our study was an increased mitogen-induced lymphocyte proliferation. This conclusion can be drawn from the fact that phytohaemagglutinin (PHA) (0.4 microgram/well) and pokeweed mitogen (PWM) (0.4 microgram/well) induced lymphocyte proliferation were found to be significantly increased in comparison to pretreatment values on day 7 in both cimetidine regimens (800 mg; PHA: mean proliferation 66,500 before treatment to 166,00 cpm, PWM: mean proliferation 8,800 before treatment to 34,000 cpm; 1,600 mg; PHA; mean proliferation 48,700 before treatment to 81,600 cpm; PWM: mean proliferation 6,300 before treatment to 16,200 cpm). Increased mitogen-induced proliferation following cimetidine intake is of special interest because the mechanisms of this activation process are incompletely known. Lymphocyte proliferation response is dependent on the availability of extracellular calcium. The function of the other bivalent cations is unknown. We found that the extent of mitogen-induced lymphocyte proliferation correlates with cellular intralymphocytic zinc and magnesium amounts (coefficients of correlation [r]) (800 mg: PHA/Mg r = 0.84; PHA/Zn r = 0.86; PWM/Mg r = 0.88; PWM/Zn r = 0.87). Though the application of both cimetidine doses causes enhanced mitogen-induced lymphocyte proliferation on day 7, T lymphocytes with different phenotypic properties appear to be influenced by cimetidine. In the first dose regimen (800 mg) the number of the CD8 lymphocytes decreased significantly from 16.1% (365 cell/microliters blood) to 12.7% (264 cells/microliters blood) after 7 d of cimetidine intake. After the period of high-dose (1,600 mg) cimetidine administration (at day 21) numbers of CD4 lymphocytes were significantly increased from 41.5% (860 cells/microliters blood) to 56.3% (1,210 cells/microliters blood). Our results show that although different cimetidine doses obviously influence different cell types of healthy volunteers, the cellular mechanisms are the same, namely, a proliferation and an increased incorporation of magnesium and zinc in lymphocytes.

Adult↗
PubMed1989

[Evoked potentials in neurologically asymptomatic persons during the early stages of HIV infection].

There are few reports on the relevance of evoked potentials in neurologically asymptomatic HIV seropositives. We studied 31 HIV infected males without AIDS or associated clinical neurological abnormalities. Visual evoked potentials by foveal checkerboard stimulation revealed a prolonged VEP latency in 37% of them. HIV seropositives with a pathologic VEP latency showed a significant reduction of their absolute numbers of peripheral blood T-helper cells. This increase of the mean VEP-latency was already significant in HIV seropositives with a T-helper cell count greater than 400/microliters. In 47% of the HIV seropositives the AEP peak I latency was prolonged in combination with a significant decrease of the AEP interpeak latency I-V suggesting endocochlear lesions at peripheral endings of the acoustic nerve or at the basal hair cells. HIV seropositives with a T-helper cell count less than 400/microliters revealed a significant prolongation of the mean AEP interpeak latency III-V indicating a central conduction defect in HIV-seropositives with an immune deficit. Somatosensory evoked potentials after median and tibial nerve stimulation were within the normal range. Since the VEP P100 latencies were significantly longer in HIV seropositives with a normal AEP peak I compared to those with prolonged AEP peak I latencies we postulate that there are different pathophysiological mechanisms underlying.

Adult↗
PubMed1989

[Cutaneous metastatic Crohn disease].

A 27-year-old patient had firm, subcutaneous nodules on both legs. Histological examination revealed that they were epitheloid granulomas with necrotic areas. After the exclusion of infectious granulomas this finding suggested an association with Crohn's disease. Clinical investigations showed an acute form of Crohn's disease. We interpreted our findings as a cutaneous granulomatous reaction in Crohn's disease. In the literature this is referred to as metastatic Crohn's disease.

Adipose Tissue↗
PubMed1989

[Diagnosis of allergy in pregnancy].

Occasionally the allergist is required to examine a pregnant woman because of allergic symptoms. For legal and psychological reasons in particular, and not so much for medical reasons, in vivo allergy tests should be avoided during pregnancy. Consideration of the case history, in vitro tests and avoidance of the possible allergen are recommended for diagnosis at such times. In vivo testing is sometimes necessary if the test results will have substantial implications (for the treatment).

Allergens↗
PubMed1989

[Palmoplantar purpura in Duhring's herpetiform dermatitis].

Dermatitis herpetiformis Duhring (DHD) is characterized by polymorphism of its clinical picture. Haemorrhagic maculae on the palms and soles are rarely described. However, knowledge of this symptom is important because it may be the only clinical sign of DHD. We report two patients with DHD who presented with reddish-brown maculae on the flexure surface of their fingers and toes. The pertinent literature is reviewed.

Adult↗
PubMed1989

The immunomodulatory potency of cimetidine in healthy volunteers.

The effect of cimetidine, a histamine H2 receptor antagonist, was investigated in 12 healthy volunteers over a period of six weeks. Cimetidine was administered orally in a daily doses of 1,600 mg during the first three weeks of evaluation. Significant alterations in values of immunoglobulins (IgG, IgA), complement (C3), B-lymphocytes and T-helper cell counts were found after cimetidine intake. The in vitro lymphocyte proliferation response to plant mitogens was increased. In contrast to results obtained from a previous study with healthy volunteers who were given 800 mg cimetidine, we found no significant increase in the CD4/CD8 ratio and no decrease in the CD8 but a significant increase in the CD4 cell count. Whereas the peripheral blood immune system showed signs of immune system activation following 800 and 1,600 mg cimetidine intake, reactivity patterns of skin immune system, however, differed in both studies. The data suggests that cimetidine has a dose and time dependent effect on the immune system.

Adjuvants, Immunologic↗
PubMed1988

Immunomodulatory properties of cimetidine in ARC patients.

The immunomodulatory potency of cimetidine, a histamine H2 receptor antagonist, was investigated in 33 AIDS-related complex (ARC) patients performing detailed immunological and clinical evaluations. Cimetidine was administered orally in daily doses of 1200 mg for a period of 5 months with an interruption of therapy after the first 3 months for an interval of 3 weeks. Significant (P less than 0.05) elevations of immunoglobulins (IgG, IgA), complement C4, B-lymphocytes, and OKT4+ (helper/inducer) cells were found after cimetidine intake. The in vitro lymphocyte proliferative response to plant mitogens was significantly increased, and the in vivo cell-mediated hypersensitivity reaction assessed by intradermal application of seven recall antigens improved significantly. These effects were both reversible with the discontinuation of cimetidine and reproducible with repeated administration of the drug. Clinical data such as performance status, body weight, and fever were influenced favorably (P less than 0.05) by cimetidine. The frequency of diarrhea and the lymph node size were also diminished significantly. The data suggest that cimetidine may at least partially restore immunofunctions in AIDS-related complex.

AIDS-Related Complex↗