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Biomedical subjects

W C Marsch

Publications and source records attributed to W C Marsch.

At least 37 records · Page 2Linked to original sources
PubMed2002

Urticarial intolerance reaction to cetirizine.

The paradoxical acute exacerbation of pre-existing chronic idiopathic urticaria accompanied by intense generalized pruritus, facial oedema, and dyspnoea in a 36-year-old-woman 3-4 h after a single oral dose of 10 mg cetirizine (Zyrtec tablets), suggested the presence of an underlying intolerance reaction. However, a type I hypersensitivity reaction also had to be excluded. Detailed allergy testing supported the view that the patient had suffered an intolerance reaction to cetirizine. This is the third known case of most probably a nonallergic generalized urticaria following the administration of cetirizine, a drug with extensive usage worldwide. However a type I sensitization to cetirizine is indeed possible, as has been demonstrated in this research with the verification of cetirizine-specific IgE antibodies in one of the control sera.

Acute Disease↗
PubMed2001

Noninvasive characterization of human stratum corneum of undiseased skin of patients with atopic dermatitis and psoriasis as studied by Fourier transform Raman spectroscopy.

Etiopathogenetic regulatory disorders of epidermal metabolism and the subsequent changes in the molecular pattern of the stratum corneum play an important role in the clinical differentiation of particular dermatoses (e.g., psoriasis, atopic dermatitis). In this study we present in vitro Fourier transform Raman spectra of the stratum corneum from healthy skin, as well as from clinically undiseased skin of the right heel of atopic and psoriatic volunteers. Differences in the averaged spectra were detected, particularly in the spectral ranges of 1112-1142 (lipid band), 1185-1220, and 1394-1429 cm(-1). By using the first derivative of the averaged spectra and/or a statistical evaluation of the spectroscopic data it was possible to distinguish the skin types examined.

Adolescent↗
PubMed2001

Isolation and in vitro characterization of human dermal microvascular pericytes.

Pericytes cover the abluminal surface of capillaries and venules and are thought to play an important role in microvascular regulation and pathology. The purpose of this study was to isolate and characterize human dermal microvascular pericytes (HDMPC), a minor cell type in the skin but a relatively easily obtainable human source of tissue. We developed and compared two procedures that differed in the preselection method. Isolation of dermal microvessel fragments from neonatal foreskins by trypsin digestion was followed by mechanical release of subepidermal tissue, collagenase treatment, and sieving through 100- and 30-microm meshes. After subcultivation, pericytes were preselected either by isolation of outgrowing capillary fragments or by 3G5-coupled magnetic beads. Pericytes were selected finally by cultivation of single cells in endothelial cell-conditioned media. Cultured HDMPC were seen to be large and well spread with irregular edges and prominent stress fibers. They lack contact inhibition, are positive for 3G5 antigen, alpha-smooth muscle actin, and vimentin, and are negative for the endothelial cell marker CD31, diI-acetylated low-density lipoprotein uptake, cytokeratin 5, 6, and 18, and S100 protein. Using both preselection methods, we could establish purified cell cultures of HDMPC. The results of these studies represent the first report of HDMPC isolation.

Cell Separation↗
PubMed2001

[Merkel cell carcinoma: a diagnostic and therapeutic challenge].

Merkel cell carcinoma (cutaneous neuroendocrine carcinoma) is a highly malignant, neuroendocrine skin tumor. It mostly occurs in elderly patients in the sun-exposed skin of the head and neck and the extremities. Merkel cell carcinomas develop as fast-growing dermal tumors. They are characterized by a high frequency of lymph-node metastases (50%) and local recurrences (25-77%). The 5-year survival rate is 30-74%. Histology reveals uniform, round cells with a small cytoplasmic rim expressing cytokeratin 20, neurofilament, synaptophysin, chromogranin, and neuron-specific enolase. Ultrastructurally, 100-200 nm electron dense granules are typical findings. Wide surgical excision, followed by radiotherapy, is the treatment of choice. Regional lymph-node metastases should be treated by radical lymph-node excision and radiotherapy. In advanced metastatic Merkel cell carcinoma, a remission can be achieved by different chemotherapy schedules or the somatostatin analogue octreotide. However, the prognosis remains poor. The current knowledge about this disease and guidelines for effective diagnosis and treatment are given.

Biomarkers, Tumor↗
PubMed2001

[Postoperative pyoderma gangrenosum].

Post-traumatic pyoderma gangrenosum is an ulceronecrotizing dermatosis that is rare and therefore often misinterpreted. After excision of an orbit pseudotumor by otorhinolaryngological surgeons, a 77-year-old woman developed a multifocal ulcerous wound dehiscence. Although the case history, development and clinical picture were characteristic, the correct diagnosis was established and successfully treated 6 months later by a consulting dermatologist. Postoperative pyoderma gangrenosum should be taken into consideration if a sterile, painful, chronically progressive, ulcerative and sludgy defect develops after surgery. The preoperative investigation should include pyoderma gangrenosum in the personal history and take associated diseases into account (e.g., inflammatory bowel diseases, blood diseases, rheumatological diseases and vasculitis) to provide prophylactic immunosuppressive pharmacotherapy. In minimally invasive or cosmetic surgery these aspects may have a forensic impact, as pyoderma gangrenosum heals with atrophic scars. The purpose of this paper was to describe the clinical characteristics of pyoderma gangrenosum, its prevention and its therapy.

Aged↗
PubMed2001

[Recurrent chancriform mucous membrane ulcer in plasmacytoma with secondary IgA deficiency. Pyoderma chancriforme of the tongue].

A 66 year old patient presented with a nine month history of recurrent oral ulcerations involving the tongue. We diagnosed chancriform pyoderma and a previously not identified multiple myeloma with secondary immunoglobulin deficiency. Clinically and histologically we excluded a necrotizing ulcerative stomatitis as found in individuals with cellular immunodeficiency as in late-stage HIV-infection. On culture only Neisseria catarrhalis was found. Chancriform pyoderma is often associated with local bacterial infections, especially Staphylococcus aureus. The most common sites are the genitalia and periorbital region; involvement of the oral mucosa is uncommon. To the best of our knowledge, this is the fourth reported case with tongue lesions. The multiple myeloma-associated immunoglobulin deficiency might have facilitated the oral manifestations of chancriform pyoderma.

Aged↗
PubMed2001

Skin function and skin disorders in Parkinson's disease.

Cutaneous symptoms (seborrhoea and hyperhidrosis) in Parkinson's disease were investigated. In 70 treated patients with Parkinson's disease and 22 control subjects, non-invasive bioengineering methods (sebumetry, corneometry, pH) were carried out on the forehead, sternum and forearm. In addition, concomitant dermatoses and medication were recorded. 18.6% of the patients had seborrhoea on the forehead (>220 microg/cm2), 51.4% showed normal sebum values (100-220 microg/cm2) and 30% a sebostasis (<100 microg/cm2). Males has significantly higher sebum values than females. No relationship between the seborrhoea and the therapy for Morbus Parkinson was found. Patients with hyperhidrosis (n = 36) had significantly lower pH values (p < 0.05) on the forehead than those without hyperhidrosis. 22 patients (31.9%) reported a cold/hot flush and a further 13 (18.8%) had clinical rosacea. Seborrhoea is rare in treated Parkinsonian patients but hyperhidrosis is frequently found. Furthermore, a particular lack of vasostability (flush) appears to be an autonomic dysregulation in the skin related to Morbus Parkinson, which has not been studied to any extent to date.

Aged↗
PubMed2001

Human dermal pericytes express 3G5 ganglioside--a new approach for microvessel histology in the skin.

BACKGROUND: Pericytes cover the abluminal surface of microvessels and play an important role in capillary regulation and pathology. Studies on pericytes have been hindered by the lack of specific markers with which to facilitate microscopic identification of this cell type. Expression of the cell surface 3G5 ganglioside antigen has been reported in cultured retinal and cardiac pericytes. The objective of this study was to determine the usefulness of monoclonal antibody 3G5 as a pericyte marker in human skin. METHODS: Cryosections of 21 skin biopsies were examined by direct fluorescence technique with anti-3G5, anti-von Willebrand factor, anti-alpha-smooth muscle actin or DNA fluorochrome. RESULTS: In human dermis, 3G5 expression is limited to pericytes discriminating this cell type from all other cells including smooth muscle cells, myofibroblasts and myoepithelial cells. We found a pericyte: endothelial cell ratio of 1:12.4 (+/-7.1), and a difference of alpha-smooth muscle actin expression between the subpapillary plexus and the microvessels of the Stratum reticulare. CONCLUSIONS: 3G5 mAB is an excellent and so far the only reported tool for identification of dermal pericytes by fluorescent light microscopy. Moreover, this is the first report of the application of 3G5 technique to the microvasculature in tissue sections at the light microscopic level.

Adolescent↗
PubMed2001

The NO release test as a functional reference standard for laser Doppler fluxmetry in cutaneous microangiology.

BACKGROUND/AIMS: The application of one-dimensional laser Doppler fluxmetry (LDF) to clinical research is widespread. Large intra- and interindividual fluctuations in perfusion impede the objective evaluation of studies and hinder a standardised reproducibility. Attempts are made to minimise these biological fluctuations of the measured values by means of functional tests, standardised measuring conditions and large study populations. An intraindividual fixed standard that also facilitates interindividual comparability as a reference parameter would be desirable. METHODS: By applying a nitric oxide (NO) release cream, a maximal vasodilatation is produced in a circumscribed skin area and optically registered by means of LDF. An LDF quotient is defined as a measure of the reproducibility. A total of 123 test subjects with dermatological diseases were measured at intervals of 60 min on the volar underarm on clinically normal skin with and without NO release cream. RESULTS: The LDF quotient of the NO release test represents a stable, readily reproducible individual parameter and is appropriate as a reference standard for resting flux measurements. Therefore, we define an LDF factor that includes the maximal vasodilatation as a specific assessment characteristic and thus allows a more powerful, functionally oriented assessment of the individual measurements. CONCLUSION: The NO release test is appropriate as a reference standard for laser Doppler fluxmetry and realises a high reproducibility of individual measurements.

Humans↗