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Biomedical subjects

N Haas

Publications and source records attributed to N Haas.

At least 109 records · Page 6Linked to original sources
PubMed1994

Foreign-body granuloma and IgE-pseudolymphoma after multiple bee stings.

We report a patient with an unusual combination of an eosinophilic foreign-body granuloma and a pseudolymphoma, with recurrent severe oedema on the forehead, after multiple bee stings. On immunohistology the foreign-body granuloma and lymphoid follicles reacted with monoclonal antibodies against the high- and low-affinity IgE receptors, and against IgE. Prick and intradermal tests with whole-body bee extracts showed positive immediate-type reactions. The eosinophilic granuloma formation and lymphoid follicles may have been induced by a combination of immune complex and cell-mediated hypersensitivity following antigen persistence. Although bee stings are common, as far as we are aware, this complex reaction pattern has not been reported previously.

Animals↗
PubMed1994

Methadone maintenance outcome as a function of detoxification phobia.

OBJECTIVE: Methadone maintenance outcome as a function of detoxification phobia was examined. METHOD: Opiate addicts (N = 271) in a 1983 random sample of methadone maintenance patients from three diverse populations were studied. Subjects from an individually assessed follow-up sample (N = 102) were compared on detoxification phobia. Logistic regression analysis yielded best predictors of the phobia. RESULTS: Phobic patients were more likely to be white, female, and abstinent; to have had fewer detoxification attempts and longer periods on maintenance; to show persistence of the phobia; to meet diagnostic criteria for depressive or anxiety disorders; and to have Addiction Severity Index scores above the 75th percentile for psychological problems. CONCLUSIONS: Detoxification phobia has a complex relationship to methadone maintenance outcome. It is associated with greater abstinence for patients in methadone maintenance treatment. However, for rehabilitated phobic patients it presents a barrier to successful detoxification and a drug-free adjustment that is often associated with other psychopathology but could be ameliorated by targeted assessment and treatment.

Adult↗
PubMed1994

Ifosfamide, carboplatin, and etoposide plus granulocyte-macrophage colony-stimulating factor: a phase I study with apparent activity in non-small-cell lung cancer.

PURPOSE: A phase I trial was performed to evaluate the feasibility of escalating the dose of etoposide in dose-intensive ifosfamide, carboplatin, and etoposide (ICE) with granulocyte-macrophage colony-stimulating factor (GM-CSF). PATIENTS AND METHODS: Twenty-four patients were entered between November 1990 and November 1991. Patients received ifosfamide 5 g/m2 by continuous infusion over 48 hours, carboplatin 400 mg/m2 by intravenous bolus, and GM-CSF 5 micrograms/kg/d subcutaneously from day 4 until neutrophil recovery. The etoposide dose was escalated, with six patients receiving 300 mg/m2 total dose (level 1), six receiving 600 mg/m2 (level 2), three receiving 900 mg/m2 (level 3), and five receiving 1,200 mg/m2 (level 4). Level 4B consisted of three patients who received etoposide 1,200 mg/m2 and GM-CSF 10 micrograms/kg/d. Cycles were repeated every 21 days. The maximum-tolerated dose (MTD) was prospectively defined as the dose level at which the next higher level produced greater than 7 days of grade 4 myelosuppression in two or more of six patients. RESULTS: Twenty-three patients were assessable. The median duration of neutropenia was < or = 7 days on cycle 1 at all dose levels. The initial criteria for determination of the MTD was never achieved. However, seven of eight patients treated at levels 4 and 4B required hospitalization for neutropenic fever on cycle 1 of therapy, with three of four septic events occurring at these levels. Cumulative thrombocytopenia occurred at all dose levels, with > or = 50% of patients requiring platelet transfusions on cycle 3. This became the dose-limiting toxicity above level 3. The overall response rate was 48%, with 11 of 23 objective responses, including two complete responses (CRs). Seven of 11 (64%) patients with non-small-cell lung cancer (NSCLC) responded, including one CR. Two of four (50%) heavily pretreated non-Hodgkin's lymphoma (NHL) patients responded, with one CR. CONCLUSION: The addition of GM-CSF to a dose-intensive ICE regimen permitted dose escalation of etoposide to 900 mg/m2, with cumulative thrombocytopenia as the dose-limiting toxicity. Carboplatin dosing by the area under the curve (AUC) may minimize thrombocytopenia. This appears to be an active regimen for patients with NSCLC and refractory NHL.

Adult↗
PubMed1994

Giant spontaneous hematoma of the thoracic wall in a patient with REST syndrome.

We report on a 56-year-old patient with systemic sclerosis of one and a half year's duration who was admitted with an acute soft tissue swelling over the left scapula and a marked reduction of joint mobility of the left shoulder. Over the following days, the swelling extended distally and a hemorrhagic discoloration developed, reaching down to the scrotum. Nuclear magnetic resonance imaging revealed a giant intermuscular hematoma between the serratus anterior and the costal muscles. This is the first report of an extensive spontaneous hematoma of the thoracic wall in a patient with progressive systemic sclerosis. Its development and unusual localization may be explained by both the underlying systemic sclerosis and the patient's previous profession as a trapeze artist. Hemorrhagic complications of systemic sclerosis are rare but should be watched for in these patients.

CREST Syndrome↗
PubMed1994

Porokeratosis of Mibelli associated with active chronic hepatitis and vitiligo.

A patient with porokeratosis Mibelli is reported who suffered from long-standing chronic active hepatitis and rapidly expanding vitiligo of more recent onset. This type of disease association has never been reported before, although it is in line with several reports of porokeratosis in association with immunoregulatory disorders, mostly after drug-induced immunosuppression. The lesions of the present patient responded well to treatment with topical 5-fluorouracil.

Female↗
PubMed1994

[Injuries of the dens axis in childhood. Biomechanical analysis and surgical and conservative treatment of 2 cases].

Odontoid "fractures" in children are in fact typical lesions of the cartilaginous plate ("synchondrosis") separating the odontoid process from the body of the axis, 54 cases of which have been described in the literature so far. In our review we report about two 2-year-old children who were back-seat passengers restrained by four-point children's seat belts, in a car involved in a head-on motor vehicle accident. According to the accident research unit of our institution, trauma sustained in such circumstances is adequate for the causation of odontoid lesions in healthy children. Head-on collisions at a speed absorption of at least 40 km/h is described as a typical mechanism of such injury. Both children were immediately symptomatic, and the diagnosis was easily made from the X-rays. Neither child had neurologic deficits, which is in keeping with the literature, where neurologic injuries were found to have been reported exclusively in conjunction with head injuries. After closed reduction, conservative treatment was initiated in one child, in whom the extent of the anterior dislocation was smaller than the diameter of the odontoid shaft. In cases of major dislocation and more pronounced instability we recommend primarily open reduction and osteosynthesis with adequate implants. Our second case was treated with a halo fixator and a plaster vest for 12 weeks, but despite anatomic reduction there was no healing of the odontoid process. After temporary posterior fusion of C1/C2 we reamed the synchondrosis from an anterior approach and performed autogenous bone grafting. The posterior cerclage wire was removed after 5 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗
PubMed1994

[The mast cell].

Explore the source record for details and available documents.

Humans↗
PubMed1994

[The mast cell].

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Basophils↗
PubMed1993

Serum concentrations of granulocyte colony-stimulating factor in healthy term and preterm neonates and in those with various diseases including bacterial infections.

The neonate is uniquely susceptible to severe and overwhelming bacterial infections. One of the most important deficits in the neonatal host defense system seems to be a quantitative and qualitative deficiency of the myeloid and the phagocytic system. Future optimal therapy of neonatal sepsis may include the use of adjuvant immunologic therapy. Granulocyte colony-stimulating factor (G-CSF) has been shown to induce neutrophilia and to enhance mature effector neutrophil function. To evaluate the role of G-CSF with respect to infection, we examined serum levels of G-CSF in term and preterm neonates, using an enzyme-linked immunosorbent assay method. G-CSF levels in healthy neonates showed peak levels up to 7 hours after birth, followed by an increase in total neutrophil cell (TNC) counts. Both G-CSF levels determined between 4 and 7 hours after birth and peak TNC counts correlated with the gestational age of the neonates. The state of nutrition, maternal treatment with glucocorticoids, maternal infection and hypertension, and the mode of delivery influenced peak G-CSF levels. Neonates with signs of infection between 4 and 7 hours after birth had higher levels of G-CSF than did healthy neonates (1,312 +/- 396 pg/mL v 176 +/- 19 pg/mL). In conclusion, the presented results of serum concentrations of G-CSF in relation to TNC counts and various diseases suggests an important role of G-CSF in the regulation of granulopoiesis during the neonatal period.

Bacterial Infections↗
PubMed1993

Ischemic neocortical protection with U74006F--a dose-response curve.

A dose-response curve for the lipid peroxidation inhibitor U74006F was established in a rat forebrain ischemia model. Transient forebrain ischemia was induced by bilateral carotid occlusion plus controlled hypotension (50 mmHg) for 10 min. U74006F was administered at doses of 0.3, 1, 3, 7, or 10 mg/kg 30 min prior to ischemia. Control animals received vehicle (0.02 M citrate buffer in 0.8% NaCl). Brains were perfusion-fixed on day 7 post-ischemia for histopathological examination. For both the hippocampus and striatum, neuronal injury was not significantly different between groups. Within the neocortex ischemic neuronal injury was significantly less (P < 0.05) in the 7 mg/kg U74006F-treated group compared to the control, 1 mg/kg, or 3 mg/kg U74006F-treated groups.

Animals↗
PubMed1993

A new solid unreamed tibial nail for shaft fractures with severe soft tissue injury.

In a prospective study, 51 tibial shaft fractures with severe open or closed soft tissue damage were treated with a new, thin (8 mm or 9 mm) solid locking nail, inserted without reaming. At 6 months or more after trauma, 43 cases were reviewed. Fractures were classified according to Müller with six type A, 25 type B, and 12 type C fractures. In 13 cases there was group II (n = 8) or group III (n = 5) closed soft tissue damage (Tscherne). Of 30 open fractures, 16 were group OII, six were group OIIIA and eight were group OIIIB (Gustilo). Postoperative treatment in 42 of 44 cases was possible without additional cast or brace. Full weight bearing was achieved in 26 cases within 12 weeks, and in 42 cases within 26 weeks. In 43 cases, fracture healing occurred with a mean of 21.9 weeks (range 12-40 weeks). There was one case with valgus of 6 degrees and three cases with anterecurvatum deformities of 5 degrees to 10 degrees. In four cases there was an external rotation malalignment between 10 degrees and 20 degrees. In three cases we found an internal rotation deformity of 10 degrees to 20 degrees. Shortening between 0.5 and 1.0 cm was found in five cases, and in one case shortening was 1.5 cm. None of the patients had an osteomyelitis.

Adolescent↗
PubMed1993

Amelanotic malignant melanoma presenting as malignant schwannoma.

A 78-year-old woman presented with a 14-month history of a nodule on the sole of her left foot. It had been increasing in size, and had become ulcerated. Histological, immunochemical and ultrastructural studies of the primary tumour revealed melanocytic and Schwannian characteristics, and posed diagnostic difficulties. The final diagnosis of a malignant melanoma with Schwannian differentiation was established on the basis of the clinical course, with the development of metastases in the subcutis, lymph nodes, liver and brain, as well as a shift in differentiation of the metastases towards cells containing giant melanosomes, typical of melanoma.

Aged↗
PubMed1993

Demonstration of the high-affinity IgE receptor on human Langerhans cells in normal and diseased skin.

Epidermal dendritic cells of normal adult foreskin, and of lesional skin from patients with atopic eczema, stasis eczema and urticaria pigmentosa are shown to be highly reactive with two different monoclonal antibodies (29C6 and 6F7) specific for extracellular domains of the alpha-chain of the high-affinity IgE receptor. By their distribution pattern, the reactive cells are Langerhans cells. This is confirmed by immunoelectron microscopic demonstration of Birbeck granules in the labelled epidermal cells. Very weak staining is observed on the same cells with an antibody (Tü1) against the low-affinity IgE receptor. Pre-incubation of the sections with IgE partially blocks binding of 6F7 antibody. Langerhans cells, together with dermal mast cells, can therefore bind IgE with high efficiency, and may in this way participate in IgE-mediated cutaneous diseases.

Adult↗
PubMed1993

Demonstration of the high-affinity IgE receptor (Fc epsilon RI) on Langerhans cells of oral mucosa.

Langerhans cells in the skin have recently been shown to bind IgE molecules via a high-affinity IgE receptor. Using two specific antibodies, 29C6 and 6F7, against the alpha-chain of the high-affinity IgE receptor, we here demonstrate that Langerhans cells express this receptor in oral mucosa. A specific antibody, Tü1, against the low-affinity IgE receptor showed only low expression of this receptor. High-affinity binding for IgE may be important for induction and support of Langerhans cell-dependent transepithelial IgE-mediated allergic reactions and inflammation.

Antibodies, Monoclonal↗
PubMed1993

Patterns of cell death: the significance of apoptosis for dermatology.

Development, function, remodelling, and senescence of multicellular organisms depend on the coordinated occurrence of physiological, actively induced cell death in two major patterns: terminal differentiation and programmed cell death (apoptosis). Apoptosis is a highly selective form of "cell suicide" with characteristic morphological and biochemical features: chromatin condensation, formation of apoptotic bodies, and DNA fragmentation by activation of endonucleases. Here, we outline the current understanding of apoptosis and its subtypes, discuss their biological functions, and delineate why apoptosis is relevant to the skin and its diseases. We distinguish apoptosis from necrosis, and discuss the regulation of apoptosis by selected genes, hormones, growth factors and cytokines. The epidermis and the regressing hair follicle offer interesting models for studying the as yet ill-understood biology of epithelial cell apoptosis. The selective manipulation of cell death programs may become part of the therapeutic arsenal of clinical dermatology.

Animals↗
PubMed1993

Primary leiomyosarcoma of the skin. A histological and immunohistochemical analysis.

We report a rare case of a cutaneous leiomyosarcoma on the extensor surface of the proximal part of the left arm of an 84-year-old man. The tumour exhibited a number of histological and immunohistochemical features which are characteristic of a leiomyosarcoma. Leiomyosarcomas are frequently misdiagnosed on clinical grounds. Therefore, clinical features, differential diagnosis, histological and immunohistochemical criteria, therapy and prognosis of this rare malignant tumour are summarized on the basis of the present case and previously published reports.

Aged↗
PubMed1993

[Extracorporeal membrane oxygenation (ECMO) in acute cardiovascular failure caused by myocarditis].

Main indication for extracorporeal membrane oxygenation (ECMO) is respiratory failure in the newborn. Less frequently ECMO is used for cardiac support. We report on a 4 months old boy, who suddenly fell ill with an acute viral myocarditis and heart failure (left-ventricular shortening fraction lowered to 17%). After failure of conventional management and resuscitation (twice) due to asystolic, veno-arterial ECMO was installed for a total time of 4 days. Under ECMO there was complete recovery of left-ventricular function; the infant was discharged 1 month after admission to hospital. ECMO-therapy should not only be considered in children with respiratory failure, but also in those with potentially reversible cardiac failure.

Echocardiography↗