Biomedical subjects
Publications and source records attributed to W Lechner.
Erythropoietin levels have been determined in 24 patients with different gynecologic malignancies, who were treated with cisplatinum and endoxan. A statistically highly significant decrease was demonstrated 2 h after starting treatment with a further significant decrease at 6 h. After 12 h the erythropoietin concentrations returned to values similar to those before treatment started.
We report on a 29-year old patient, who was treated as an inpatient in 95 different hospitals (altogether 173 times) within 7 years. The gynaecologist can suspect Münchausen's syndrome, if the following aspects are recorded: dramatic clinical admissions patterns, (frequently out of the normal consultation time); a history of several operations and many short stays in different hospitals. Special care in diagnostics should be taken to avoid further unnecessary surgical interventions.
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In an adjuvant clinical trial, 34 high-risk malignant melanoma patients were treated with natural interferon (IFN)-beta and recombinant IFN-gamma. Patients with tumor location on head, neck, and trunk received 3 million IU IFN-beta intravenously (IV) three times weekly for 24 weeks. Patients with tumor location on the extremities received subcutaneous (SC) injection of 2 million IU of IFN-beta distal the locoregional lymph nodes instead. All patients were given 50 micrograms IFN-gamma SC on 3 consecutive days every 4 weeks. Antibody formation was detected by coincubation of IFN and patients' serum and assessment of the inhibition of the cytopathic effect by a virus suspension. Soluble interleukin-2 receptors (sIL-2R) were determined by enzyme-linked immunosorbent assay (ELISA) technique. No antibodies against IFN-gamma were observed. The overall incidence of antibody formation to IFN-beta was 55.8% (19/34). Ninety-two percent of the SC-treated patients (13/14) and 30% (six of 20) of the IV-treated patients developed antibodies. Soluble interleukin-2 receptors were found to be significantly lower in antibody-positive patients than in antibody-negative patients. The authors conclude that IFN-beta antibody formation is frequent and might influence IFN induced sIL-2R elevation in vivo.
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Incontinentia pigmenti is a rare genodermatosis typically involving three stages: vesiculae, verrucous lesions, and hyperpigmentation. We clinically and pathologically documented a case from shortly after birth until the age of 17 years. Although the first two stages took a regular course, the third stage of the disease was characterized by hypopigmented streaks on the legs in addition to axillary hyperpigmentation. Similar hypopigmented areas were found in the patient's mother. Because pathological investigations of hypopigmented areas have been extremely rare, we performed light and electron microscopic studies and compared these with our findings in hyperpigmented regions. Light microscopy showed the hypopigmented streaks with slight epidermal atrophy and a reduced number of melanocytes and skin appendages. However, the main finding was round eosinophilic bodies in the upper dermis. Electron microscopic examination of these bodies demonstrated amorphous material that resembled colloid, suggesting degeneration of basal keratinocytes. Confirming previous reports, in hyperpigmented areas we found a reduction of pigment in those parts of the basal layer overlying melanophages located in the upper dermis.
41 samples of human milk from the region of Tyrol were investigated with regard to benzo(a)pyrene content. A complicated analytical preparatory method had to be worked out. The percentage recovery of benzo(a)pyrene was 85-90. Analysis was carried out by means of capillary gas chromatography and flame ionization detection or mass spectrometry. The limit of benzo(a)pyrene detection is 0.1-1 microgram/kg (single ion monitoring). None of the investigated samples of milk showed the presence of benzo(a)pyrene.
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Beta-endorphins are substances produced by the body to inhibit the perception of pain. Normally they exhibit a steep rise during birth. We have seen an impressive fall which also was statistically highly significant after the application of transcutaneous electric nerve stimulation in 20 parturient women.
Selenium content was investigated by atomic absorbtion spectroscopy in 32 normal pregnant women in the 38th-42, week of pregnancy. In congruence with other investigations from middle and northern Europe, selenium deficiency was stated in all of the patients.
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We present the case of an 81-year-old women with progressive systemic scleroderma. In addition to the typical manifestations of diffuse (truncal) scleroderma, including involvement of the esophagus, lungs and muscles, there were two unusual findings: large, non-sclerosing areas on the trunk simulating the disabling type of circumscribed scleroderma and high titers of anticentromere antibodies, while there were no anti-Scl-70 antibodies. The disease responded to treatment with griseofulvin.
A state of magnesium deficiency has been established in the population of highly industrialized countries in the last few years. This results among other disturbancies, in increasing prematurity. Therefore the tocolytic activity of magnesium was investigated in 29 uterine strips, which were obtained during cesarean section. A highly significant (p less than 0.001) reduction of the uterine activity from 100 to 0 (0-21), 0 (0-0) and 0 (0-0) (median, 20th and 80th percentile) 10, 20 and 60 min after the application of magnesium was observed.
In search for a new tocolytic agent we investigated felodipine, a calmodulin-antagonizing drug. Felodipine reduced the spontaneous activity of 22 uterine strips taken from the uterus in the course of a cesarean section to 52 +/- 12% (mean +/- SEM) after 10 min, to 20 +/- 7% after 20 min and to 12 +/- 4% after 60 min (P less than 0.001).
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