Biomedical subjects
Publications and source records attributed to A Brenke.
We report on four patients who developed thickened skin on the neck and back after a long history of insulin-dependent diabetes mellitus. Pathogenesis, histology and methods of treatment are discussed.
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The technique of 20-MHz B-scan sonography is non-invasive and allows quantification of the different compartments of the skin. Seven patients with atrophic linear circumscribed scleroderma and one patient with guttate circumscribed scleroderma were examined by ultrasound. All patients were found to have a total or subtotal loss of subcutaneous fatty tissue, whereas the thickness of the dermis remained almost unchanged. These findings should lead to further investigation of the pathophysiological mechanism involved in subcutaneous atrophy in circumscribed scleroderma.
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The aim of the study was to determine the pulmonary 67-gallium uptake, bronchoalveolar lavage (BAL) cell differentiation and the activity of BAL cells, measured as release of superoxide anion (O2-), and to investigate the results whether there are relations. In 11 nonsmoking systemic scleroderma (SS) patients and 11 systemic lupus erythematosus (SLE) patients with lung involvement double-sided BAL were performed, mainly in regions with increased 67-gallium uptake. Release of O2- was measured by INT-assey. BAL cell differentiation was in SS and SLE pathological in 68.2% without side-difference. In contrast to SS, O2(-)-release in SLE depends on BAL cell differentiation and is most increased in normal BAL cell differentiation. There is no correlation between 67-gallium uptake and both BAL cell differentiation and O2(-)-release. The results suggest, that in contrast to SS, BAL cells in SLE with pathological differentiation are less activated than BAL cells with normal differentiation probable due to autoimmunological factors. Pulmonary 67-gallium scan and BAL seem to be independent from each other.
The aim of the study was to determine the bronchoalveolar lavage (BAL) cell differentiation and the activity of beta-glucuronidase and N-acetyl-beta-D-glucosaminidase in alveolar macrophages. In 12 patients with systemic sclerosis (SS), 4 with systemic lupus erythematosus and 4 healthy controls BAL was performed. The activity of beta-glucuronidase and N-acetyl-beta-D-glucosaminidase was measured semiquantitative by means of cytochemical methods. Lymphocytes and neutrophils in BAL cell differentiation are increased, also the activity of beta-glucuronidase. The activity of N-acetyl-beta-D-glucosaminidase is decreased in SS and SLE in comparison with controls. The activity of beta-glucuronidase seems to be a marker of activity of alveolar macrophages in SS and SLE.
The purpose of the study was to determine the role of lymphocyte subsets (Ly) and reactive oxygen metabolites RSM, concerning the activity of BAL cells, in the pathogenesis of lung involvement in 12 patients with systemic sclerosis (SS) and 4 with systemic lupus erythematodes (SLE) in comparison with 10 control subjects. The cellular activity was measured by means of cytofluorometry (CFM) and chemiluminescence (CL). In SS/SLEY CD3+, CD4+, CD4/CD8-ratio, CD25 + T-Ly and luminol-dependent CL are increased (p less than 0.05). Correlations exist between CD3+, CD4+, CD8+ and CD25 + T-Ly and both luminol-dependent CL and neutrophils (p less than 0.01). The results suggest, that increased secretion of RSM by BAL-cells may be caused by local release of lymphokines by these activated T-Ly. Therefore CFM and CL seem to be useful in addition to BAL cell differentiation in characterizing the BAL cell activity in the diagnostic of lung involvement in SS and SLE.
Seven female systemic sclerosis patients (all from acrosclerosis type, with intestinal involvement, and marked Raynaud phenomenon) were treated with infrared A whole body irradiations (wavelengths between 800 and 1,400 nm, 12 W/dm2 maximally). The single exposure lasted for 30 minutes and resulted in an 0.9 degrees C rise of central body temperature. Acral skin rewarming became regular immediately after irradiation and kept improved, as compared with pre-treatment values, for at least 18 weeks. All the patients told about a comfortable feeling of warmth after each treatment lasting for one two days. Three out of the seven reported lower frequency and severity of Raynaud attacks.
The purpose of the study was to determine the role of reactive oxygen metabolites in the pathogenesis of interstitial lung involvement in 13 patients with collagen vascular diseases (CVD) in comparison with 10 control subjects. The cellular activity of bronchoalveolar lavage (BAL) cells was measured by means of chemiluminescence (CL), spontaneously and after challenge of the cells with opsonized zymosan (simultaneously luminol- and lucigenin-dependent). The findings show an increase of the spontaneous and stimulated CL of BAL cells in CVD, more pronounced in luminol-dependent CL. The luminol-dependent CL correlates with neutrophils in BAL cell differentiation. The results suggest that reactive oxygen metabolites take part in interstitial lung involvement in patients with CVD. Therefore the measurement CL of BAL cells is useful in addition to BAL cell differentiation in diagnostic of interstitial lung involvement in CVD.
Microcirculation in the hands of patients with progressive systemic sclerosis shows some peculiarities. For diagnostic purposes functional thermography and the acrale rewarming test may be used. Typical features of progressive systemic sclerosis are a general hypothermia of the hands and localized hypothermic areas and refractory hyperthermic areas. In the acrale rewarming test reactive vasodilatation after cold stimuli is often not inducible and the significantly retarded rewarming shows a marked local restrict dependence. The significance of these facts for a more intensive physical therapy is discussed.
Physiotherapy and spa-therapy occupy a high value in the treatment of the progressive sclerodermia. On the basis of 59 radon cures at Bad Brambach in patients with this disease is shown that a success of the cure lasting for a long time is to be expected particularly in patients with a relatively bad initial situation. Above all an amelioration of the subjective condition as well as the movability of the joints is achieved. The necessity of repeated cures at an interval of 1 to 2 years is discussed in selected patients. No evidence can be rendered concerning a possibly specific radon effect.
It is reported on a 48-year-old woman suffering from a multicentric reticulohistiocytosis. Most trouble in this case is caused by severe arthritis, which could not be stopped by various therapy schedules. The actual treatment is the combination of Prednisolone, Chloroquine, Ibuprofen and roentgenotherapy of the hands.
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