[Giant nevus spilus with blue nevus. Apropos of a case].
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Biomedical subjects
Publications and source records attributed to N Haas.
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By means of a convenient and inexpensive incident light microscope, the mite of sarcoptes scabiei in vivo can be easily detected in the skin. This method simplifies the search for mites especially in children, because it allows to investigate many papules and probable burrows quickly and without pain.
In a 5-years' study, we investigated the correlation between clinical and histological diagnoses of blue nevi. In 24.7% of the cases, the clinical diagnosis turned out to be false; blue nevus was mostly confused with nevomelanocytic nevus (11.2%). Malignant melanoma was the primary differential diagnosis in 13 out of 89 cases. Differentiation of the histological subtypes identified 76.4% of the tumors as common blue nevi and 15.7% as cellular blue nevi. The remaining 7.9% were combined nevi. The average age of the patients with blue nevi at the time of excision was lower than that of the patients suffering from malignant melanoma during the same observation period. Comparison of the distribution of 89 blue nevi with 196 malignant melanomas revealed the different preferred areas of these tumors. We briefly refer to related dermal melanocytoses, such as Mongolian spot and Ota's nevus.
A therapeutic concept for the treatment of acute thoracolumbar spinal injury includes an early closed reduction as the first step. In cases with a surgical indication in the lower thoracic area as well as in the lumbar spine, the posterior approach is preferred. Following decompression of the spinal cord, a transpedicular lifting of the upper endplate is done and the fractured vertebra is filled with corticocancellous bone chips. Stabilization is achieved with an internal fixator usually over two motion segments only. Subsequently, autologous corticocancellous bone is added between lamina and between the transverse processes. In the thoracic spine proper, the anterior approach is more advantageous. Following spondylectomy (removal of the vertebral body whole or in part), an intercorporal spine arthrodesis is performed utilizing a solid bone graft and plates. Seventy-six patients with 78 fractures and subluxations of the thoracolumbar spine were reexamined for an average of 3 years and 4 months after their operation. Of the patients with an incomplete cord injury (Frankel B-D) 60% improved at least one Frankel grade and an additional nine patients improved within their group. Clinical deterioration did not occur. Irrespective of the localization, the radiologically determined loss of correction following an anterior approach was an average of 7 degrees whereas the settling after posterior approach averaged 9 degrees. The sagittal index of the affected vertebra improved from 0.59 preoperatively to 0.80 postoperatively. All spinal arthrodeses healed with osseous reorganization. Twelve postoperative computer tomographies were analyzed (11 after a posterior decompression), and showed a decrease of the spinal canal compromise from 65% preoperatively to 11% following surgery.
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The adoption of babies from third-world countries with endemic scabies by European and North American families is an ever increasing phenomenon. A brazilian baby was presented with papulopustules on both cheeks and an itchy, papular rash that developed four weeks upon arrival in Germany. Meanwhile the adoptive mother had contracted scabies.
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The infestation of a 3-month-old child with Sarcoptes scabiei by way of infested nipples during the breast-feeding period led initially to facial papules and later to generalized dermatitis. Scabies mites were not detected on the face; studies on ten infested babies in India supported this findings. Thus, direct antiscabies treatment to the face is not necessary in babies.
Structures within pigmented skin tumors, which are beyond the dissolving powers of the eye, may be analysed in vivo by macroscopy using incident lighting. Benign melanocytic nevi have a symmetric and distinct horizontal pattern of pigmentation, whereas in melanoma, intraepidermal tumor growth may show coexistence of net- and/or cluster-like and non-structural forms of pigmentation.
Experimental alteration in the restricted permeability of the blood-brain barrier to polar, blood-borne molecules is often quantitated in the rat with use of 14C-sucrose or 3H-mannitol delivered as a test substance into the circulation. The underlying principle is to relate the quantity of saccharide that has permeated into brain parenchyma, after an arbitrary time period, to some index of the circulating tracer level. This study indicates that to correct the radioactivity level in the brain tissue for intravascular tracer, it is an erroneous practice to estimate the latter as the product of tissue blood volume and the tracer concentration measured in a systematic blood sample. Dissected brain tissue was found to have a lower hematocrit and thereby larger plasma/tracer compartment per unit blood volume than femoral arterial blood. It is further shown that, although commercially supplied stocks of 14C-sucrose or 3H-mannitol may contain only small quantities of radioactive impurities, their inclusion in injectates and preferential uptake into brain may cause significant overestimation of permeability to the parent tracer. It is also confirmed that magnitude of permeability-area (PA) products for permeation of purified sucrose or mannitol into brain varies inversely with the length of time allotted for tracer circulation in the bloodstream. This finding is at variance with the assumptions of a two-compartment (plasma/brain) diffusion model underlying such measurements and supports a recently published model for blood-to-brain transfer based on multiple uptake compartments in brain parenchyma. The factors compromising PA measurement identified in this study may partly underlie variations in PA values published from several laboratories that had been attributed to genetic differences in laboratory rats.
Treatment with etretinate in a patient with multiple keratoacanthoma is described. Clinical improvement correlated with normalization of IL-2-production and mitogen induced lymphocyte proliferation. A causal relationship between reduced IL-2-production and eruption of keratoacanthoma is suggested.
DNA-cellulose chromatography and two-dimensional gel electrophoresis have been used to demonstrate the DNA-binding capacity of bacteriophage T4 gpunf/alc. The unf/alc protein does not bind to DNA via an association with RNA polymerase; gpunf/alc was shown to bind to DNA after separation from RNA polymerase and other large proteins by Sephadex chromatography.
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Histological details of 2 cases of 'Mondor's phlebitis' suggest that we are dealing with a process affecting lymphatic vessels. Fibrin thrombus formation with mycotic organization and capillary recanalization as well as fibromuscular hyperplasia of the vessel wall with infiltration of the surrounding fatty tissue determine the pathogenesis of the disease. 'Lymphangiofibrosis thrombotica occlusiva' is a more appropriate term.
One hundred sixty-seven femoral shaft fractures were treated with open intramedullary nailing and cerclage wires. Complications requiring surgical reintervention developed in 11 patients (6.6%). Delayed union or nonunion in five patients (3%), deep infection in four patients (2.4%), or unstable fixation in two patients (1.2%) required one or more additional procedures to achieve union. The time to weight-bearing averaged 32 days in patients with isolated injuries and 62 days in patients with associated injuries. One hundred forty-five patients were followed until fracture union occurred. Rotational malalignment in one patient, angulation of 10 degrees or more in two patients, and limb shortening of more than 2 cm in two patients were noted. Loss of hip or knee motion in excess of 20 degrees developed in 15 patients and was always associated with injuries of the pelvis or ipsilateral lower leg. Intramedullary nailing and cerclage wiring significantly expands the indication for intramedullary fixation of fractures of the femoral shaft.