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Biomedical subjects

P Altmeyer

Publications and source records attributed to P Altmeyer.

At least 181 records · Page 10Linked to original sources
PubMed1999

Femtosecond two-photon excited fluorescence of melanin.

Fluorescence of synthetic melanin in dimethyl sulfoxide has been excited by two-photon absorption at 800 nm, using 120 fs pulses with photon flux densities > or = 10(27) cm-2 s-1. The shortest main component of the three-exponential decay of fluorescence is 200 +/- 2 ps. The overall spectral shape is red-shifted with respect to the 400 nm excited fluorescence. Two-photon excited melanin fluorescence also has been measured from excised samples of healthy human skin tissue. Because of the selectivity of melanin excitation via resonant two-photon absorption, it is hypothesized that fluorescence excited in this way may yield information on malignant transformation.

Humans↗
PubMed1998

[Ficus benjamina--the hidden allergen in the house].

The weeping fig, Ficus benjamina (Fb), is a relatively common indoor allergen. Many cases of perennial allergic rhinoconjunctivitis and allergic asthma caused by Fb hypersensitivity are not detected. These patients typically have proven sensitization to housedust mites and do not improve after avoidance of exposure (encasing) and specific immunotherapy. The number of Fb sensitizations is increasing in Germany, which can partly be explained by the cross-reactivity between Hevea brasiliensis (Hb) latex and Fb and the rapidly increasing number of mostly occupational latex allergies. But Fb itself is a potential sensitizer which is widely spread as ornamental plant in homes and offices. As relevant indoor allergen Fb ranks third after housedust mites and pets but before molds among our allergy patients. For diagnosis, prick-tests with Fb-latex seem to be more sensitive than in vitro-methods (RAST, CAPRAST). Fb plants should not be kept in the homes of atopic individuals or persons with latex (Hb) allergy.

Adult↗
PubMed1998

[Sun protection by optimally designed fabrics].

A rising incidence worldwide of skin cancer has been observed for years. A high cumulative exposure to UV radiation is a major factor in the development of such neoplasms. Suitable protective measures are therefore becoming increasingly important. Textiles provide simple, effective and medically safe protection against UV radiation. At present, however, in Europe--in contrast to Australia--the UV protection factor (UPF) for summer textiles is not stated. It is a largely unknown fact that by far not all textiles offer sufficient protection. Our goal was to study the factors which determine the UV transmission of fabrics and, based on these findings, to design materials which provide enhanced protection. A spectrophotometric method was used to determine the UV transmission by fabrics made of cotton, silk, polyester and viscose. The UV protection factors of the fabrics were computed on the basis of the transmission data. The UV protection factor is dependent on the type of fibre, yarn and surface design, weight per square metre, moisture content, colour, finishing method and degree of wear. To optimize the UV protection via textiles, a viscose yarn with a low UV transmission was used. This yarn makes it possible to design light-weight summer fabrics with optimized UV protection. This development will make it possible to offer clothing with high UV protection on the European marked. This clothing will not be more expensive than normal products, so that effective prevention should be more available.

Clothing↗
PubMed1998

[Mometasone and calcipotriol optimize the initial therapeutic effect of dithranol in chronic persistent psoriasis].

In a randomized study 30 patients with chronic stationary psoriasis were treated with 3 different topical schemes. Group 1 (n = 10) received monotherapy (dithranol (D) twice a day, D/D), group 2 (n = 10) calcipotriol mornings/dithranol evenings (calcipotriol (C)/dithranol (D) C/D) and 3 (mometasone (M) mornings/dithranol (D) evenings, M/D). During the therapy period of 4 weeks we documented the PASI-Score as well as infiltration, erythema and desquamation weekly. The M/D group revealed in the first week a significantly faster reduction of the PASI-score (5.3) than in the D/D group (PASI 13.22). The C/D group (PASI 10.5) show a not significantly faster reduction. After 4 weeks of treatment and after a follow period of 6 weeks there were similar PASI-Scores in all groups. There were less side-effects in the M/D group than in the others. The beginning, more anti-psoriatic effectiveness was achieved by the mometasone/dithranol combination than the other schemes. In the long term, the effects were similar.

Administration, Topical↗
PubMed1998

[Balanitis/balanoposthitis chronica circumscripta benigna plasmacellularis--entity or fiction?].

During the years 1985 up to 1995 53 patients between 18 and 80 years of age (mean age 54.7 years) with histologically and clinically proven Zoon's balanitis were treated by circumcision. The majority of patients had symptoms for more than 12 months. In five cases they had lasted for 8, 10, 16, 17 and 47 (!) years. 30 patients were investigated by means of physical examination and questionnaire in this retrospective study. Lesions involved glans in all patients, while in 17 of 30 patients both glans and prepuce were involved. None of the patients showed lesions of the prepuce only. In most cases Zoon's balanitis was successfully treated by circumcision in a period of two to four weeks. In four cases, psoriatic lesions, and in one case lichen ruber was diagnosed. In the remaining patient, whose circumcision was inadequate, a small area of balanitis persisted in the sulcus coronarius still covered by the foreskin. The curative effect of adequate circumcision in 100% of patients suggests that Zoon's balanitis is a relatively non-specific reactive balanitis caused by a disturbed "preputial-ecology". It is remarkable that other distinct inflammatory diseases of glans and prepuce can show features which are identical to those Zoon's balanitis.

Adolescent↗
PubMed1998

[Bleomycin-induced PSS-like pseudoscleroderma. Case report and review of the literature].

Although the association between administration of the antitumor agent bleomycin and the development of cutaneous fibrosis is established, there are only a small number of cases of bleomycin-induced scleroderma described in the literature. We report the development of generalised scleroderma with wide spread hyperpigmentation in a 52-year-old male patient, who received a total dose of 360 mg bleomycin in combination with cisplatin and etoposid for therapy of a malignant testicular seminoma. The clinical cutaneous alterations as well as the histological findings were indistinguishable from those encountered in progressive systemic sclerosis (PSS). In contrast to PSS however, Raynaud's phenomenon, cutaneous calcinosis, teleangiectasia, arthritis and involvement of additional organs were all absent. PSS-typical auto-antibodies were negative. Even 18 months after discontinuation of the drug and treatment with UVA1 phototherapy (3-4 times per week with 20 J/cm2) as well as physiotherapy, the skin changes had still not resolved. Based on our case and a detailed review of the literature, we discuss characteristics of bleomycin-induced scleroderma including pathogenesis, treatment modalities and course.

Antibiotics, Antineoplastic↗
PubMed1998

Kinetics of photosensitivity in bath-PUVA photochemotherapy.

BACKGROUND: Bath-PUVA is used to treat a variety of dermatoses. However, the kinetics of 8-methoxypsoralen during treatment are not completely clarified. OBJECTIVE: The purpose of this study was to investigate the intensity of the phototoxic response and the persistence of phototoxicity after bath-PUVA. METHODS: Twelve volunteers were exposed to UVA doses ranging from 0.5 to 40 J/cm2 from 10 to 240 minutes after bath-PUVA treatment. The resulting phototoxic response of the skin was determined. RESULTS: Irradiation 10 minutes after the psoralen bath led to the lowest assessed minimal phototoxic dose (MPD) of 1.42 J/cm2 (mean, SD +/- 0.29). Thereafter, the MPD increased significantly and sharply every hour. At 4 hours after the psoralen bath, UVA doses up to 40 J/cm2 failed to induce any phototoxic erythema (MPD). CONCLUSION: For optimal effects, UVA irradiation has to be administered immediately after the psoralen bath; no restrictive behavior is necessary after bath-PUVA treatment.

Adult↗
PubMed1998

Low-dose UVA phototherapy for treatment of localized scleroderma.

BACKGROUND: For treatment of localized scleroderma numerous treatments, including ones with potentially hazardous side effects, are currently used with only limited success. OBJECTIVE: We attempted to determine the efficacy of low-dose UVA1 irradiation in patients with severe localized scleroderma. METHODS: Patients were irradiated with 20 J/cm2 UVA1 for 12 weeks (total number of treatments: 30; cumulative UVA1 dose: 600 J/cm2). RESULTS: Low-dose UVA1 irradiation induced significant clinical improvement (clearance of > 80% of lesions) in 18 of 20 patients. Clearance was documented by clinical score as well as by 20 MHz ultrasound and histopathologic analysis. CONCLUSION: Low-dose UVA1 phototherapy can be highly effective for sclerotic plaques, even in patients with advanced localized scleroderma and with lesions rapidly evolving despite conventional therapy.

Adolescent↗
PubMed1998

Treatment of psoriasis with fumaric acid esters: results of a prospective multicentre study. German Multicentre Study.

Systemic treatment of psoriasis with fumaric acid esters (FAE) has been found effective by empirical means. In recent years clinical studies have confirmed the antipsoriatic activity of a defined mixture of different FAE. The aim of the present prospective multicentre study was to investigate further the efficacy and safety of FAE therapy in a large number of patients with severe psoriasis vulgaris. From 101 patients included in the study 70 completed the treatment period of 4 months. Discontinuation was due to adverse events in seven, lack of efficacy in two, and other reasons, such as non-attendance for scheduled visits, in 22 patients. Evaluation of overall efficacy showed a decrease in psoriasis area and severity index of 80% after 4 months of FAE therapy. Laboratory investigations revealed a slight overall decrease of lymphocytes during the treatment period which was more than 50% below baseline in 10 patients. During weeks 4 and 8 mean eosinophil counts were above the normal range. At the end of FAE therapy elevated eosinophil counts had returned to normal values. None of the patients showed changes in renal function parameters throughout the study. Adverse events were reported in 69% of the patients mainly consisting of gastrointestinal complaints (56%) and flushing (31%). In five patients gastrointestinal complaints and in two patients flushing led to withdrawal from the study. Taken together the results of this multicentre study showed in a large number of patients that systemic FAE treatment is effective in severe psoriasis vulgaris. Transient eosinophilia seems to be a characteristic feature of FAE therapy, while lymphocytopenia is usually mild. Adverse effects are dose-related and consist mainly of gastrointestinal complaints and flushing.

Adult↗
PubMed1998

[100 MHz ultrasound of psoriasis vulgaris plaque].

PURPOSE: 20 MHz sonography of inflammatory diseases has concentrated on the evaluation of the echo-poor area in the upper dermis. With regard to higher resolution, this study focuses on the alterations of the epidermis and upper dermis skin using 100 MHz sonography. METHOD: 70 fully developed psoriasis vulgaris plaques of 20 patients were examined using our 100 MHz ultrasound equipment after application of salicylic acid in petrolatum for 24 h. After informing the patient about the aims of the study, a small knife biopsy was taken from 11 plaques. RESULTS: All psoriasis plaques exhibited, in comparison with normal skin, a significant widening of the skin entry echo (p < 0.001). Focally, this echo-rich line broke up into two thinner lines. Correlating histology exhibited in these areas an orthohyperkeratosis and focal parakeratosis. The upper dermis showed an echo-poor, band-shaped area which corresponded histologically to an acanthosis, elongation of rete ridges, and widening of the stratum papillare. The mean grey level of the echo-poor area and of the dermis beneath was significantly lower (p < 0.001) than the normal adjacent dermis. The thickness of the echo-poor area correlated with the thickness of the sum of the acanthosis and the inflammatory infiltrate in the histological sections (r = 0.94). CONCLUSION: Using 100 MHz sonography changes of the skin entry echo and the upper dermis can be visualized and quantified.

Adult↗
PubMed1998

Rhythmical variations of haemoglobin oxygenation in cutaneous capillaries.

The consequences of rhythmical arteriolar vasomotion for nutrition and the tissue oxygen supply to human skin are largely unknown. In the study presented here, the periodic variations of haemoglobin oxygenation in the small cutaneous vessels have been evaluated with a new reflection spectrophotometer. For the assessment of spatial variations, we examined 24 different sites in 20 healthy volunteers. For quantification of the relatively long duration of periodic variations, a Digital Fourier Transformation with a specially programmed filter was used. In 265 out of 480 spectra (55.2%), periodic variations of the haemoglobin oxygenation were found. The average of the main frequency of waves was 7.0 +/- 2.5 cycles per minute. The occurrence of variations of haemoglobin oxygenation depended on the measuring site. In the gluteal region, variations were observed in 17 out of 20 subjects, on the palms in 16 out of 20, at the foot plantar in 18 out of 20 in comparison to the cheek (8/20), the lip (5/20) and the eyelid (6/20). On the head we observed significantly more variations per minute than in the lower extremities. Because these variations, with duration of up to 30 s, have a relatively slow dynamic compared with heart rate and breathing frequency, consequences for the cutaneous diffusion and metabolism of other substrates are very likely.

Adult↗
PubMed1998

Fumaric acid esters suppress peripheral CD4- and CD8-positive lymphocytes in psoriasis.

BACKGROUND: For severe forms of psoriasis vulgaris, the antipsoriatic fumaric acid esters (FAE) therapy has recently gained increasing acceptance and importance. Until today, there is little knowledge about the mode of action of FAE. However, some evidence exists indicating immunosuppressive effects. OBJECTIVE: The aim of this study was to examine the systemic, particularly the immunological changes in patients suffering from psoriasis treated with FAE over a long period of time, since we expect to see pharmacological effects of FAE at this point. METHODS: This study is based on continuously recorded clinical data and laboratory parameters of 10 patients, who were treated over a period of 12 months with FAE. A quantitative analysis of lymphocytes and their subtypes was carried out by means of flowcytometric methods. RESULTS: 3 months after starting treatment with FAE, a clinical effect with a remission index > 95% was achieved in all 10 patients examined. This remained constant until the end of this study. Focusing on leukopenia, and particularly on lymphopenia as important parameters, these effects were found in all patients. The lymphocyte subpopulations data demonstrated extensive proportionate reductions. Within the T cell fraction a stronger suppression of CD8+ lymphocytes was observed. CONCLUSION: Our investigations of systemic effects of fumaric acid esters demonstrate the suppressive character of this medication. Effects of cell count reduction in leukocyte and lymphocyte numbers over the entire period of 12 months could be observed. The lymphocytic cell count number is obviously linked to the clinical effect.

Administration, Oral↗
PubMed1998

Comparison of skin atrophy and vasoconstriction due to mometasone furoate, methylprednisolone and hydrocortisone.

BACKGROUND/AIMS: Topical glucocorticoids with improved benefit/risk ratio are of great interest in dermatology, but there are very few trials directly comparing the efficacy and side-effects of these new preparations. In our study the vasoconstrictor effect and side-effects of two of these new glucocorticoids were evaluated and blanching effect was determined by two-dimensional laser scanning. METHODS: In a randomised, double blind intra-individual comparative trial, 10 subjects were treated with various glucocorticoids or drug-free vehicle. The test drugs were mometasone furoate (MF), methylprednisolone aceponate (MP) and hydrocortisone (OH-C). The preparations were tested for a period of 3 weeks with occlusion on the flexor side of the forearm. Skin thickness and vasoconstriction were determined using 20 MHz ultrasound scanning, laser Doppler scanning (LDS) and chromometry. RESULTS: No adverse effects were observed during the observation period. Only partial vasoconstriction occurred in most cases during the observation period. MP and MF produced maximal blanching between days 3 and 5 of treatment, while with OH-C clinically visible blanching did not occur. Ultrasound evaluation of skin thickness showed similar behaviour for all three steroids tested: there were no signs of skin atrophy in any of the cases. LDS evidenced hypoperfusion of a test area on the perfusion image in only a few patients and there were no significant differences between the steroids tested. On evaluation of vasoconstriction caused by the steroids tested using chromometry there was a significant difference between MF and OH-C on the L*a*b* scale (P < 0.005). Only at day 3 was a blanching effect caused by MP and MF demonstrable (a-value, P < 0.05). CONCLUSION: In summary, the synthetic steroids MF and MP presented side-effects similar to those of OH-C but much greater vasoconstrictor effect; after an application period of over 5 days under occlusion a blanching effect in our model was not demonstrable by means of chromometry. Two-dimensional laser scanning offers no advantage in the evaluation of the blanching effect in comparison to one-dimensional laser fluxmetry (LDF).

Administration, Topical↗