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Biomedical subjects

A Lindmaier

Publications and source records attributed to A Lindmaier.

At least 19 recordsLinked to original sources
PubMed1992

Extracorporeal photochemotherapy for the treatment of systemic lupus erythematosus. A pilot study.

OBJECTIVE: To investigate the effectiveness and feasibility of extracorporeal photochemotherapy (ECP) in the treatment of an autoimmune disease with known cutaneous photosensitivity. METHODS: Ten patients with systemic lupus erythematosus (SLE) were treated with ECP in an open clinical trial. The efficacy of treatment was analyzed by means of established disease activity scores. RESULTS: Eight patients completed the trial. In 7 of the 8, there was a significant response to the treatment, with no or minor side effects. The clinical activity score in the group of 8 patients decreased from a median of 7 (range 4-9) to a median of 1 (range 0-5) (P less than 0.05). Laboratory abnormalities did not change significantly, but were mild at the outset. CONCLUSION: ECP led to clinical improvement of SLE without side effects. The effectiveness of this method should be investigated further in controlled clinical trials.

Adult↗
PubMed1992

[Polymorphous photodermatitis. Morphology and temporal course].

From 1985 to 1990 we saw 318 patients with polymorphous light eruption (PLE). Papular (47.4%) and papular-vesicular (27.2%) skin lesions were predominant. A monomorphous picture was seen in 31%. The first lesions appeared within a median period of 19 h after sun exposure, and in 38% of cases within 5 h. In most patients (78.7%) the skin eruptions faded within 1 week of appearance (median 4 days). There seems to be a correlation between the course of light exposure and the resulting clinical morphology. Terminological and methodical problems in the classification of PLE are discussed.

Diagnosis, Differential↗
PubMed1991

Hormonal parameters in androgenetic hair loss in the male.

Alopecia in the male is considered as a genetically determined disorder. Increased local androgen metabolism and androgen receptor binding in the balding areas confirm the importance of the target organ hair follicle as regulative of androgen influences. In our study the hormonal parameters of 65 male patients with male pattern hair loss with a mean age of 24.31 years were compared with those of 58 age-matched controls. Determinations of the androgens, sex-hormone-binding globulin, the hypophyseal hormones luteinizing hormone, follicle-stimulating hormone and prolactin, 17 beta-estradiol and cortisol were performed by standard radioimmunoassay. Significant differences in serum levels of androstenedione, cortisol, 17 beta-estradiol and luteinizing hormone were noted between hair loss patients and control subjects. Suprarenal stimulation as well as hypophyseal feedback mechanisms therefore seem to be involved in male pattern alopecia.

17-alpha-Hydroxyprogesterone↗
PubMed1991

Hormone studies in females with androgenic hairloss.

Reports on hormone analysis in androgenic hairloss in the female show partly contradicting results. Elevated as well as normal-range androgen levels have been found. The present study aimed at the investigation of a possibly more differentiated hormonal constellation by hormone analysis and additional determination of the hypophyseal level by the thyrotropin-releasing hormone (TRH) test. In 46 female patients with androgenic hairloss blood sampling for hormone analysis was performed. Determination of the androgens testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), 17-hydroxy-progesterone acetate (17-OHP) and free testosterone (FT), of sex-hormone-binding globulin (SHBG), estradiol (E2), cortisol (F) and the hypophyseal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was performed by standard radioimmunoassay methods. The TRH-test is based on feedback mechanisms between the hypothalamic TRH which stimulates hypophyseal TSH and PRL release. Thus, even mild forms of hypothyroidism or hyperprolactinaemia can be detected. The control group for the TRH test consisted of 45 volunteer females without hairloss or any other hormonal or menstrual disturbances. Statistical analysis was performed according to the Wilcoxon two-sample test. The results of the study show no significant elevation of androgens in females with androgenic hairloss, but a more complex condition with involvement of the glandula suprarenalis and the hypophyseal level. Significantly elevated TSH levels prior to and after TRH stimulation in the hairloss group indicate that hypothyroidism may be an important hormonal disturbance in androgenic hairloss. Interactions between hypothyroidism and androgen metabolism are possible at various links.(ABSTRACT TRUNCATED AT 250 WORDS)

17-alpha-Hydroxyprogesterone↗
PubMed1991

[Hyperprolactinemia and hypophyseal hypothyroidism as cofactors in hirsutism and androgen-induced alopecia in women].

A more comprehensive hormonal diagnosis than has previously been performed shows that androgen-dependent diseases of hair growth are due to more varied hormonal disturbances than elevated androgen serum levels alone. In 46 female patients with androgenic hair loss and 27 patients with hirsutism, the levels of the androgens testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulphate and 17-hydroxyprogesterone and of sex hormone-binding globulin, cortisol, oestradiol and the hypophyseal hormones follicle-stimulating hormone and luteinizing hormone were determined and compared with the hormone levels of 27 female patients without endocrine disorders. Of the androgens, only androstenedione showed a slightly significant elevation in hirsutism. Cortisol was elevated significantly in androgenic hair loss, and with a low degree of significance in hirsutism. In view of the complex hormonal interactions of thyroxin, prolactin and androgens and thyroid hormones the thyrotropin-releasing hormone (TRH)-stimulation test was performed in 38 female patients with androgenic hair loss and 27 with hirsutism, and the results were compared with those recorded in 45 female control persons. The test is based on feedback mechanisms between hypothalamic TRH and hypophyseal TSH and prolactin and peripheral thyroid hormones. Baseline concentrations of TSH prior to stimulation were significantly elevated in hirsutism, while in androgenic hair loss both baseline and stimulated TSH levels were significantly elevated; thus, hypothyroidism is a significant finding in both clinical pictures. In the case of prolactin, both baseline and stimulated levels were highly significantly elevated in hirsutism, while in androgenic hair loss the stimulated levels were significantly elevated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[The patient with polymorphous light dermatosis. Skin type, hardening and other light-associated markers].

From 1985 to 1989 we interviewed 312 patients suffering from polymorphous light eruption (PLE). The interviews were based on a questionnaire dealing with the various light-dependent factors that exacerbate the disease. Of 90 patients who were tested with artificial UV-A and UV-B irradiation sources, 60 reacted with typical PLE lesions: (a) 27 patients to UV-A alone, (b) 12 to UV-B alone, and (c) 21 to both UV-A and UV-B. Using UV-A provocation tests we were able to determine the anamnestic criteria indicating a possible UV-A induction of PLE, e.g. occurrence in the shade, no protection from window glass, no benefit from conventional sunscreens, and occurrence in solaria. The period from experimental irradiation to induction of skin lesions was shorter in skin types I and II than in skin type III and IV. Hardening phenomenon was reported by 37% of our patients. Of the UV-A-positive patients, 38% showed the first presentation of PLE lesions at the height of summer, as against 64% of the total number of patients questioned. Additional lesions at non-irradiated skin sites occurred in 25% of our patients, the frequency rising with increasing duration of the tendency to PLE.

Adult↗
PubMed1990

Hormone receptors in pubic skin of premenopausal and postmenopausal females.

Various functions of the skin are hormone-dependent. Recently hormonal involvement in aging processes of the skin has attracted increasing interest. The rapid onset of aging of the skin from the climacterium on seems to be correlated with the decrease of estrogens. In order to evaluate hormonal stimulability of the skin a study of hormone receptors was performed in pre- and postclimacteric women. Pubic skin of a total of 106 females was obtained during gynecologic operations for determination of estrogen receptors (ER), androgen receptors (AR) and gestagen receptors (PgR) by saturation analysis. In the preclimacteric group consisting of 62 females with a mean age of 39.6 +/- (SD) 6.5 years the operations were performed in the luteal phase of the menstrual cycle. The results were compared with those of 44 postmenopausal females with a mean age of 63.2 +/- 9.4 years. AR concentrations were significantly lower in the skin of postmenopausal women. 47.4% positive findings with a mean receptor level of 15.3 +/- 33.3 fmol/mg protein were to be found against 85.2% positive AR with a mean level of 31.4 +/- 20.3 fmol/mg protein in the ovulatory cycling females. These findings were of high significance. In addition, diminished PgR in the postmenopausal group were noted for incidence and mean receptor levels. PgR were positive in 18.4% with a mean level of 34.2 +/- 72.8 fmol/mg protein versus 36.3% with a mean receptor level of 34.2 +/- 72.8 in the ovulatory group. In contrast, no significant differences between ER of premenopausal and postmenopausal skin became evident. Results of hormone receptor determinations in the premenopausal and postmenopausal group with regard to the aging process are interpreted.

Adult↗
PubMed1990

Endocrine parameters in acne vulgaris.

Hormonal parameters (see below) were determined in 78 male acne patients of both sexes (mean age 21.2 +/- 3.8 years; (mean +/- S.D.) and compared with 63 controls (25.0 +/- 4.2 years). In a female group consisting of 60 patients acne (23.2 +/- 5.0 years) and 28 controls (26.1 +/- 5.7 years) of age, blood sampling was performed in the luteal phase of the menstrual cycle. Testosterone (T), dehydroepiandrosterone-sulfate (DHEAS), androstenedione (A), free testosterone (FT) and 17-hydroxy-progesterone (17-OHP) were determined by standard radioimmunoassay methods. In addition, sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), 17 beta-estradiol (E2) and cortisol (F) were evaluated. Moreover, the counts of acne lesions in the face were performed in 34 males and females patients in order to investigate possible correlations between hormones and acne lesions. The results in the male group revealed a significant elevation only for F but not for the other hormones. However, the female acne group significantly elevated levels of T, DHEA and F and a decrease of E became apparent. In addition, the correlation between both free and total T and acne lesions were found in the total of males and females. In the female group, free T and total A were found to correlate with acne lesions. The evaluation of these results indicates that androgens play a more important role in female than in male acne at the hormonal and at the peripheral level in skin. Another interesting finding was the significant increase of F in both male and female acne subjects, thus stressing the role of suprarenal involvement.

17-alpha-Hydroxyprogesterone↗
PubMed1990

[2 cases of melanomatous erysipelas--differential diagnosis and terminology].

Erysipelas carcinomatosum can be differentiated on the one hand from other special forms of cutaneous metastasis, such as carcinoma teleangiectaticum, carcinoma en cuirasse or carcinoma eburné and on the other from secondary tumour-specific or non-tumour-specific erythematous lesions. Two cases of erysipelas melanomatosum and transitional forms of the different types of cutaneous metastasis will be discussed with special reference to melanoma.

Combined Modality Therapy↗
PubMed1990

[Relevance of routine diagnosis of Chlamydia and HIV infections in Vienna prostitutes].

At the Control Center for Veneral Diseases of the Vienna Health Office, 5000 examinations for Chlamydia infection were performed on registered and non-registered prostitutes between 1980 and 1988. During this period, we observed a continuous decrease of the rate of infections from 20.4% to 4% among registered prostitutes and from 31.4% to 12.4% among non-registered prostitutes. Between 1985 and 1988, the cumulative number of HIV infections only rose from 7 to 8 cases among registered prostitutes and from 2 to 3 cases among non-registered prostitutes. All these HIV carriers were associated with i.v. drug abuse. The correlations between these two infections as well as the implications regarding health politics are discussed.

Antibodies, Bacterial↗
PubMed1989

[Significance of the dose of josamycin in the treatment of chlamydia infected pregnant patients].

Erythromycin and josamycin are the antibiotics of choice in the treatment of pregnant women with Chlamydia infection. On the basis of differing recommendations in the literature regarding treatment period and dosage, two groups of pregnant women were treated with josamycin according to different dosage schedules: Group A: 170 patients treated with 2 x 500 mg daily for 12 days. Group B: 120 patients treated with 3 x 500 mg daily for 8 days. The diagnosis was confirmed by immunofluorescence with monoclonal antibodies. Non-responding patients were treated again with a similar dose. 17% of the patients in group A and 9.1% in group B were still positive for Chlamydia after the first course of treatment. After a second course, 13.6% of group A and none of group B showed positive controls. Failures of therapy after the first treatment course can be attributed to errors in dosage or re-infection, whereas failures after the second course must be due to bad compliance. Our results suggest that pregnant women with Chlamydia infection are most efficiently treated with high dosages of josamycin over a short period of time.

Chlamydia Infections↗
PubMed1989

[Problems with dental prosthesis and dental filling materials: results of epicutaneous tests, consequences and follow-up].

Positive ECT results were found in 29 out of 70 patients (41%) tested for suspected denture sore mouth syndrome. 11 of them reacted to nickel (16%), 4 to benzoyl peroxide, 4 to mercury chloride, but only 3 out of 38 patients reacted to their own prosthetic material. A follow-up study covered a group of 31 patients with dentures. 20 of them had mechanical or material changes made, but only 4 because of ECT results (1 nickel, 1 benzoyl peroxide, 1 own prosthetic material). After elimination of the suspected allergen, these 4 patients showed improvement, but the symptoms did not completely clear. A similar beneficial effect was seen in 13 of the 20 patients, whose dentures were only mechanically adapted; but 6 out of 11 patients without any dental correction showed improvement, as well. Our results suggest that clinically relevant contact allergies are rare in patients with burning mouth syndrome. Mechanical, microbial, and psychic factors have to be taken into consideration, as well.

Aged↗
PubMed1989

Giant arteriovenous hemangioma (cirsoid aneurysm) of the nose.

We describe a 97-year-old woman who presented to our clinic with an unusually large pendulous asymptomatic soft tumor on the left side of her nose. History revealed a 40-year course, with accelerated growth in the last 9 years. Histology of this 7 x 3-cm large tumor revealed vascular structures composed of densely aggregated thick- and thin-walled vessels, separated by fibrous tissue. These features are characteristic for an arteriovenous hemangioma, also called cirsoid aneurysm. The distal part of the tumor showed nearly total fibrosis and at the proximal end of the tumor signs of incipient basal cell carcinoma were observed. In spite of the accelerated growth, unusual size, and the presence of a basal cell carcinoma at the base of this tumor, giant cirsoid aneurysms appear to be of a benign nature and thus conservative, nonradical surgical treatment can be performed. The tumor was removed by argon laser surgery with excellent results and no sign of recurrence after 1 year.

Aged↗
PubMed1989

[Pachydermoperiostosis. Clinical aspects, classification and pathogenesis].

There are 2 different forms of the rare disorder of connective tissue "pachydermoperiostosis": a primary form called Touraine-Solente-Gole (TSG) syndrome, and a secondary one, called Bamberger-Pierre-Marie syndrome (BPM). The manifestations of the two forms are very similar, but differential diagnosis is possible because BPM syndrome occurs in association with certain diseases of internal organs and effective treatment of these is followed by regression of the skin manifestations. Therefore, it seems reasonable merely to refer to primary and secondary forms of pachydermoperiostosis, rather than distinctly named syndromes. The pathogenesis of pachydermoperiostosis is unknown. Obviously a hereditary disturbance of metabolism in the connective tissue is involved, and manifestation of the disease can be either primary or secondary as a result of still unknown triggering factors.

Adult↗
PubMed1989

[Femorogluteal manifestation of lymphogranuloma venereum].

We report on a case of lymphogranuloma venereum in a 40-year-old man who acquired the disease while on vacation in Tunisia. After 4 years, a fibrosing, fistulating inflammation developed in an atypical distribution that involved the scrotum, perineum, and left gluteal and upper femoral regions; the disease progressed because of insufficient therapy. The diagnosis was established on serological examination, and treatment with doxycycline (2 x 100 mg for 4 weeks) improved the chronic inflammatory process.

Adult↗
PubMed1988

[Lichen ruber ulcerosus. Differentiation from Graham-Little syndrome. Pathogenesis and therapy].

A 61-year-old female patient having suffered for several years from typical Graham-Little's syndrome developed lichen ulcerosus after a period of 9 years. We discuss the relationship between these clinical manifestations with special reference to the pathogenesis and distribution of skin lesions in lichen rubber ulcerosus. Among the numerous therapeutic approaches, treatment with chloroquine or dapsone as well as skin grafting seem to be most promising.

Alopecia↗