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Biomedical subjects

R U Peter

Publications and source records attributed to R U Peter.

At least 91 records · Page 5Linked to original sources
PubMed1999

Mycophenolate mofetil: a new therapeutic option in the treatment of blistering autoimmune diseases.

BACKGROUND: Mycophenolate mofetil (MMF), an ester of mycophenolic acid (MPA), was approved by the Food and Drug Administration in 1995 and is currently primarily indicated for the prophylaxis of rejection in renal transplant patients. The drug seems also to be of value in the treatment of psoriasis and rheumatic arthritis. Recently there have been 6 reported cases of successful treatment of blistering autoimmune diseases with MMF in combination with high dose prednisone therapy. OBJECTIVE: On the basis of these reports we administered this new treatment regimen to several patients with blistering autoimmune diseases. Besides using a combination of MMF and high-dose prednisone we wanted to evaluate whether MMF monotherapy is also effective in the treatment of blistering autoimmune diseases. METHODS: We administered MMF to 5 patients who had severe pemphigus vulgaris or bullous pemphigoid. Two patients received MMF in combination with high-dose prednisone therapy and 3 patients received MMF monotherapy. To our knowledge, this is the first report of successful treatment of pemphigus vulgaris and bullous pemphigoid with MMF monotherapy. RESULTS: All patients were completely free of symptoms within 8 to 11 weeks of therapy. Patients who had received MMF monotherapy responded as well to treatment as those who received a combination of MMF and high-dose prednisone. CONCLUSION: Our experiences strongly suggest that MMF monotherapy may be effective for patients even with severe pemphigus vulgaris and bullous pemphigoid. In addition, MMF monotherapy, at least over the short term, offers the advantage of fewer side effects in comparison to immunosuppressive combination therapy and was well tolerated by our patients.

Aged↗
PubMed1999

Phototherapy for atopic eczema with narrow-band UVB.

Management of atopic dermatitis has been less than satisfactory. Conventional therapy has not been particularly successful, and prolonged use of topical corticosteroids and systemic immunosuppressant drugs (eg, corticosteroids, cyclosporine, azathioprine) can result in severe cutaneous and systemic effects. We decided to evaluate the effect of UVB at 311 nm to treat 5 patients with moderate to severe atopic dermatitis. In each patient a mean cumulative dose of 9.2 J/cm2 was applied over a mean of 19 irradiations. Narrow-band UVB notably reduced atopic dermatitis after 3 weeks in all patients.

Adult↗
PubMed1999

S-100 protein in peripheral blood: a marker for melanoma metastases: a prospective 2-center study of 570 patients with melanoma.

BACKGROUND: S-100 protein, commonly used in the immunohistochemical diagnosis of malignant melanoma and melanoma metastases, has recently been introduced as a tumor marker in peripheral blood. OBJECTIVE: This prospective, observational, 2-center study evaluates S-100 in peripheral blood of patients with melanoma as a marker for metastasis. METHODS: With application of an immunoluminometric assay, S-100 levels in 1396 samples of 570 patients with melanoma and 53 control subjects were measured in a blinded manner. RESULTS: The cut-off level for patients with melanoma without medical history of metastases versus patients with newly occurring lymph node, visceral, and/or brain metastases was 0.114 microg/L, with a sensitivity of 94% (95% confidence interval, 86.4%-98.5%) and a specificity of 91% (95% confidence interval, 87.7%-93.6%). False-negative results included patients with unknown primary melanoma and those with amelanotic melanoma metastases. CONCLUSION: The data suggest that S-100 in the peripheral blood of patients with melanoma could serve as a marker indicating new melanoma metastases and could help to monitor the course of the disease.

Adolescent↗
PubMed1999

[Long-term radiation damage to the skin and eye after combined beta- and gamma- radiation exposure during the reactor accident in Chernobyl].

BACKGROUND: In April 1986, numerous reactor workers and firemen were exposed to high doses of ionizing radiation during the Chernobyl nuclear power plant accident. Apart from high ambient gamma-ray exposures they received inhomogeneous contamination with beta-rays from fission products, resulting in severe skin exposure. PATIENTS AND METHODS: Sixteen of these so called Liquidators were repeatedly examined between 1991 and 1996. Their doses ranged from 0.35 to 9 Gy, partly confirmed by determination of chromosomal aberrations. Ophthalmologic examination included non-subjective assessment of lenticular radiation damage with an electronic Scheimpflug camera system. Digital image analysis allowed the comparison of opacification units to previous and normal findings. RESULTS: Four Liquidators had posterior subcapsular opacifications in different degrees, one presented only after cataract extraction. One patient had dense corticonuclear cataracts and pseudoexfoliation-like changes. Three men had severe dry eye syndrome. Eight men had no ocular complications. Retinal radiation damages were absent. 15 Liquidators suffered from severe chronic cutaneous radiation damage, which led to amputations in 3 cases. CONCLUSIONS: A relation between ocular and dermatological findings was not expected and could, in fact, not be seen. The comparison of posterior subcapsular opacification and doses revealed no distinct relation, although it indicates a correlation that is here not quantified. The doses represent organ doses for the bone marrow which is primarily exposed to deeper penetrating gamma-radiation. Thus they need not be correlated with combined beta- and gamma-doses in organs such as skin and eye because the superficial exposure due to beta-radiation may differ greatly form the whole body exposure as reflected in bone marrow doses.

Accidents, Occupational↗
PubMed1999

Late-type allergy to the X-ray contrast medium Solutrast (iopamidol).

In the past few years, there have been an increasing number of publications on delayed intolerance reactions, including rashes, following the use of X-ray contrast media. We report a patient in whom infiltrated erythema of the face and generalized maculopapular rashes occurred on 2 occasions, within 1 day, following the use of the X-ray contrast medium Solutrast (iopamidol) for coronary angiography. The allergological investigations for clarification included prick tests and patch tests using a series of contrast media, as well as individual intravenous provocation tests. We found the cause to be a late-type allergy to the active substance iopamidol contained in the contrast medium Solutrast. We found a concomitant cross-reactivity to the contrast media iopromid and iomeprol. All 3 contrast media represent the monomeric, non-ionic type.

Allergens↗
PubMed1999

Treatment of severe recalcitrant dermatoses of the palms and soles with PUVA-bath versus PUVA-cream therapy.

PUVA-bath therapy developed into a first line topical PUVA therapy, and gel and cream preparations have been described as alternative modes of topical 8-MOP application. Because bath-PUVA can be difficult to manage, topical PUVA therapy using 8-MOP gel or cream preparations may become an important alternative when treating localised skin diseases. However, controlled comparisons of efficacy with this alternative topical PUVA therapy are lacking. We therefore compared the efficacy of PUVA-cream therapy with PUVA-bath therapy in 12 patients with recalcitrant dermatoses of the palms and soles using a left/right trial design. These patients responded well to both treatment modalities, meaning that both could be used successfully to treat recalcitrant dermatoses of the palms and soles.

Administration, Cutaneous↗
PubMed1999

Anaphylactic shock reaction to dibutyl-phthalate-containing capsules.

We report on a patient who was taking a Gelomyrtol forte capsule, a mucosecretolytic herbal product, to treat an infection of the upper respiratory tract. Itching, urticaria and respiratory distress occurred after 20 min which culminated in anaphylactic shock. Prick tests were carried out with the individual substances from Gelomyrtol forte capsules. Dibutyl phthalate produced a strong positive result. It is used as a plasticizer in films covering tablets, dragées and capsules. As a triggering agent of anaphylactic reactions to drugs, the auxiliary materials, e.g. dibutyl phthalate, should also be taken into consideration.

Adult↗
PubMed1999

Receptor tyrosine kinase and p16/CDKN2 expression in a case of tripe palms associated with non-small-cell lung cancer.

BACKGROUND: Tripe palms is a descriptive term for a cutaneous paraneoplastic keratoderma. Tripe palms are frequently associated with gastric and pulmonary carcinoma. The pathogenetic mechanism remains unknown. OBJECTIVE: To determine the influence of receptor tyrosine kinases, which are both expressed in pulmonary carcinomas and in human skin, we performed expression studies on epidermal growth factor receptor (EGFR), HER2, HER3 in a skin sample of tripe palms obtained from a patient with non-small-cell lung cancer with lymph node involvement. Two months after diagnosis, the patient had developed palmoplantar 'tripe palms'. Additionally, the expression of SRC, c-myc and p16/ CDKN2 were studied. METHOD: Conventional reverse-transcription polymerase chain reaction was performed on a tissue sample of tripe palms. RESULTS: Weak expression of HER2 and of p16/CDKN2 was found. EGFR, HER3, c-myc and SRC were not expressed. CONCLUSION: Receptor tyrosine kinases of subclass I, the tyrosine kinase SRC and the oncogene c-myc play no major role in the pathogenesis of this case of tripe palms.

Aged↗
PubMed1998

[Meningeal irritation--a complication of herpes zoster].

HISTORY AND CLINICAL FINDINGS: A previously healthy 26-year-old man complained of gradually increasing headache after an attack of flu. After 4 days an erythema with papules but no blisters was noted in the area of distribution of the left 10th thoracic nerve. As a child he had varicella (chickenpox) without complications. INVESTIGATIONS: Lymphocytic pleocytosis and evidence of an abnormal blood-brain barrier were noted in cerebrospinal fluid (CSF). Serology for varicella zoster virus revealed an IgG titre of > 7400 IU/l in serum and 21 IU/l in CSF. The corresponding IgM titres were negative. TREATMENT AND COURSE: The headaches and cutaneous changes regressed under i.v. treatment with acyclovir, 10 mg/kg body weight, 3 x daily for 10 days. Repeat CSF examination after 10 days showed merely minimal residual changes of inflammation. CONCLUSION: This case illustrates the risk of severe neurological complications of herpes zoster infection. A seemingly minor rash with headache must be correctly diagnosed and immediate high-dosage acyclovir treatment instituted to prevent life-threatening and severe complications of herpes zoster meningitis or encephalitis.

Acyclovir↗
PubMed1998

[Suppurative acrodermatitis continua of Hallopeau. A differential diagnosis of paronychia].

HISTORY AND CLINICAL FINDINGS: A 39-year-old man was admitted for treatment of bilateral inflammatory-pustular skin changes in the area of the large toes and soles of the feet. Antibiotic treatment and an Emmert wedge resection had already been unsuccessfully performed at another hospital for what was diagnosed as paronychia. On admission there were inflammatory, in part erosive, red areas with yellow and partly confluent pustules on the distal phalanges of both great toes. The entire right nail-bed and left medial nail-bed were missing. In the area of the capillitium, both lower arms and the sulcus coronarius there were erythematous squamous plaques. INVESTIGATIONS: Radiography of the great toes demonstrated dystrophic demineralisation, in part with subchondral cystic changes of the spongiosa. Histological examination of the nail-bed showed hyperplasia and papillomatosis, definite hyperkeratosis with a prominent granular layer, as well as ortho- and parahyperkeratosis. Laboratory tests for inflammatory disease were unremarkable and there was no association with HLA B27. DIAGNOSIS, TREATMENT AND COURSE: Suppurative acrodermatitis continua of Hallopeau was diagnosed and immunosuppressive treatment with cyclosporin A given (initially 4.4 mg/kg. stepwise reduction to 2.5 mg/kg within 6 weeks, this dosage then continued for a further 10 weeks). Nearly complete healing was achieved, but the condition recurred in a mild form 2 weeks after the end of treatment. CONCLUSION: Suppurative acrodermatitis continua of Hallopeau should be included in the differential diagnosis of inflammatory changes of the distal phalanges.

Acrodermatitis↗