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Andreas Blum

Publications and source records attributed to Andreas Blum.

At least 19 recordsLinked to original sources
PubMed2006

Ossifying fibromyxoid tumor of the nasal septum.

The fibromyxoid tumor is quite a rare soft tissue tumor and typically presents as an ossifying fibromyxoid tumor (OFMT) in the subcutis of the extremities of adults. Most authors favour schwannian or chondroid origin of this lesion with somehow uncertain biologic dignity. Local recurrence is seen in 27% of patients after primary excision. We present a case of a fibromyxoid tumor of the nasal septum in a 49-year-old female who complained of nasal airway obstruction and enlargement of the right contour of the nose. Endonasal, endoscopic tumor excision was performed. The tumor contained spindle-shaped and polygonal cells, mucoid pseudocysts and a fibromyxoid stroma with local calcifications. The clinical behaviour of OFMT in general is benign but some reports have documented atypical tumors with histologic signs of malignancy. Complete local resection is the treatment of choice. Because of the high rate of local recurrence, clinical follow-up examinations are necessary.

Airway Obstruction↗
PubMed2006

Clear differences in hand-held dermoscopes.

In order to correctly evaluate melanocytic and non-melanocytic skin tumors using a hand-held dermoscope, it is essential to have adequate magnification and illumination to allow the differential structures to be clearly seen. One example of a dysplastic compound melanocytic nevus and a thin malignant melanoma were examined with five different handheld dermoscopes (Heine Delta 10, Heine Delta 20, Dermogenius and Dermlite Foto 37 with and without glass plate) in order to assess the image quality. The magnification was identical in all dermoscopes. In the newer dermoscopes (Heine Delta 20, Dermogenius and Dermlite Foto 37 with and without glass plate) the light sources were clearly improved, as now 6 or 24 LEDs, respectively, are employed. This distinctly improved the image quality with regard to color and visible differential structures compared to the dermoscope (Heine Delta 10) with only one light source. Clear differences is assessing differential structures were seen in one dermoscope (Dermlite Foto 37 without glass plate). Using this dermoscope without any glass plate or liquid between the dermoscope and the skin, exophytic tumors were better visualized in a three-dimensional fashion but fewer differential structures were seen.

Adult↗
PubMed2006

Ultrasound mapping of lymph node and subcutaneous metastases in patients with cutaneous melanoma: results of a prospective multicenter study.

BACKGROUND: Ultrasound (sonography, B-mode sonography, ultrasonography) examination improves the sensitivity in more than 25% compared to the clinical palpation, especially after surgery on the regional lymph node area. OBJECTIVE: To evaluate the distribution of metastases during follow-up in the draining lymph node areas from the scar of primary to regional lymph nodes (head and neck, supraclavicular, axilla, infraclavicular, groin) in patients with cutaneous melanoma with or without sentinel lymph node biopsy (SLNB) or former elective or consecutive complete lymph node dissection in case of positive sentinel lymph node (CLND). cv: Prospective multicenter study of the Departments of Dermatology of the Universities of Homburg/Saar, Tubingen and Munich (Germany) in which the distribution of lymph node and subcutaneous metastases were mapped from the scar of primary to the lymphatic drainage region in 53 melanoma patients (23 women, 30 men; median age: 64 years; median tumor thickness: 1.99 mm) with known primary, visible lymph nodes or subcutaneous metastases proven by ultrasound and histopathology during the follow-up. RESULTS: Especially in the axilla, infraclavicular region and groin the metastases were not limited to the anatomic lymph node regions. In 5 patients (9.4%) (4 of them were in stage IV) lymph node metastases were not located in the corresponding lymph node area. 32 patients without former SLNB had a time range between melanoma excision and lymph node metastases of 31 months (median), 21 patients with SLNB had 18 months (p < 0.005). In 11 patients with positive SLNB the time range was 17 months, in 10 patients with negative SLNB 21 months (p < 0.005); in 32 patients with CLND the time range was 31 months and in 21 patients without CLND 18 months (p<0.005). In thinner melanomas lymph node metastases occurred later (p<0.05). CONCLUSIONS: After surgery of cutaneous melanoma, SLNB and CLND the lymphatic drainage can show significant changes which should be considered in clinical and ultrasound follow-up examinations. Especially for high-risk melanoma patients follow-up examinations should be performed at intervals of 3 months in the first years. Patients at stage IV should be examined in all regional lynph node areas clinically and by ultrasound.

Adult↗
PubMed2006

Axonemal localization of the dynein component DNAH5 is not altered in secondary ciliary dyskinesia.

Primary ciliary dyskinesia (PCD) is a heterogeneous genetic disorder characterized by recurrent airway infections and situs inversus in half of affected individuals. Diagnosis currently relies on demonstration of abnormal ciliary ultrastructure or altered ciliary beat. Alterations encountered in secondary ciliary dyskinesia (SCD) caused by inflammation often complicate the diagnostic workup. We have recently shown that in respiratory epithelial cells from PCD patients with outer dynein arm defects the dynein protein DNAH5 is mislocalized and either completely or partially absent from the ciliary axoneme. In this study, we addressed the question whether SCD might affect axonemal DNAH5 localization in respiratory cells. To induce SCD in vitro, we treated primary human respiratory epithelial cell cultures with interleukin-13 (IL-13). Ciliary function and ultrastructure were assessed by high-speed videomicroscopy and transmission electron microscopy, respectively. For in vivo localization of DNAH5, we performed nasal brushing biopsies in patients with evidence of SCD. Expression of DNAH5 was analyzed by immunofluorescence microscopy. IL-13-treated cells showed evidence of SCD. Ciliary beat frequency was significantly reduced and ultrastructural analyses showed axonemal disorganization compared with control cells. High-resolution immunofluorescence studies of respiratory epithelial cells with SCD identified in vitro and in vivo normal axonemal DNAH5 localization. DNAH5 localization is not altered by SCD, indicating a high potential for immunofluorescence analysis as a novel diagnostic tool in PCD.

Axonemal Dyneins↗
PubMed2006

Power output during stage racing in professional road cycling.

PURPOSE: The aim of the study was to evaluate the power output during a multistage professional road race using direct power measurements and to compare these results with the performance measurements using competition heart rate recordings. METHODS: Six professional road cyclists performed an incremental cycling test during which peak power output, power output, and heart rate at the lactate threshold (LT) and at a lactate increase of 1 mM above the LT (LT + 1) were assessed. During a six-stage road race competition, power output was measured directly (SRM crankset). To analyze the time spent at different intensities during competition, the amount of competition time spent below LT (zone 1), between the LT and LT + 1 (zone 2), and above LT + 1 (zone 3) determined during laboratory testing were calculated for power output and heart rate. RESULTS: During the five mass start stages, a mean power output of 220 +/- 22 W (3.1 +/- 0.2 W x kg(-1)) with a mean heart rate of 142 +/- 5 bpm was measured. Average power output during an uphill time trial was 392 +/- 60 W (5.5 +/- 0.4 W x kg(-1)) with a mean heart rate of 169 +/- 3 bpm. For the mass start stages, the average distribution of exercise time spent in different intensities calculated for power output and heart rate was 58 versus 38% for zone 1, 14 versus 38% for zone 2, and 28 versus 24% for zone 3. CONCLUSION: Most of the competition time during the mass start stages was spent at intensities near the LT. Compared with power output, heart rate measurement underestimated the time spent at intensity zones 1 and 3, and overestimated the time spent in zone 2.

Adult↗
PubMed2005

The performance of SolarScan: an automated dermoscopy image analysis instrument for the diagnosis of primary melanoma.

OBJECTIVE: To describe the diagnostic performance of SolarScan (Polartechnics Ltd, Sydney, Australia), an automated instrument for the diagnosis of primary melanoma. DESIGN: Images from a data set of 2430 lesions (382 were melanomas; median Breslow thickness, 0.36 mm) were divided into a training set and an independent test set at a ratio of approximately 2:1. A diagnostic algorithm (absolute diagnosis of melanoma vs benign lesion and estimated probability of melanoma) was developed and its performance described on the test set. High-quality clinical and dermoscopy images with a detailed patient history for 78 lesions (13 of which were melanomas) from the test set were given to various clinicians to compare their diagnostic accuracy with that of SolarScan. SETTING: Seven specialist referral centers and 2 general practice skin cancer clinics from 3 continents. Comparison between clinician diagnosis and SolarScan diagnosis was by 3 dermoscopy experts, 4 dermatologists, 3 trainee dermatologists, and 3 general practitioners. PATIENTS: Images of the melanocytic lesions were obtained from patients who required either excision or digital monitoring to exclude malignancy. MAIN OUTCOME MEASURES: Sensitivity, specificity, the area under the receiver operator characteristic curve, median probability for the diagnosis of melanoma, a direct comparison of SolarScan with diagnoses performed by humans, and interinstrument and intrainstrument reproducibility. RESULTS: The melanocytic-only diagnostic model was highly reproducible in the test set and gave a sensitivity of 91% (95% confidence interval [CI], 86%-96%) and specificity of 68% (95% CI, 64%-72%) for melanoma. SolarScan had comparable or superior sensitivity and specificity (85% vs 65%) compared with those of experts (90% vs 59%), dermatologists (81% vs 60%), trainees (85% vs 36%; P =.06), and general practitioners (62% vs 63%). The intraclass correlation coefficient of intrainstrument repeatability was 0.86 (95% CI, 0.83-0.88), indicating an excellent repeatability. There was no significant interinstrument variation (P = .80). CONCLUSIONS: SolarScan is a robust diagnostic instrument for pigmented or partially pigmented melanocytic lesions of the skin. Preliminary data suggest that its performance is comparable or superior to that of a range of clinician groups. However, these findings should be confirmed in a formal clinical trial.

Algorithms↗
PubMed2005

Melanoma detection in British Columbia, Canada.

BACKGROUND: In several studies, delays in malignant melanoma (MM) diagnosis have been correlated with increased tumor thickness, increased morbidity, and increased mortality. OBJECTIVE: We sought to assess how MM is detected in British Columbia, Canada, and to understand the role of patient education and other factors on diagnostic delays. METHODS: A self-administered questionnaire was distributed to 176 consecutive patients with histologically confirmed MM. RESULTS: The total median delay was 4 months. There was no correlation between tumor thickness and delay times. Lesions found incidentally by physicians were less invasive (median Breslow thickness 0.59 vs 1.0 mm, P=.006) than those found by patients. The majority of patients had some knowledge of MM and recognized the importance of early detection. Nearly one fourth of respondents were unaware MM could develop from a melanocytic nevus. In general, MM knowledge did not affect total delay. CONCLUSION: Patients in British Columbia, Canada, report relatively short delays in diagnosis of MM. Delays were not correlated with increased tumor thickness or with patient knowledge regarding melanoma before diagnosis.

Adult↗
PubMed2005

Lipid-based Nose Ointment for Allergic Rhinitis.

OBJECTIVE: To assess the efficacy of a lipid-based nose ointment in treating allergic rhinitis. STUDY DESIGN AND SETTING: Prospective, open, randomized, controlled clinical study in the outpatient departments of 2 tertiary care centers. RESULTS: No specific adverse effects were observed. The nose ointment under investigation led to a significant improvement in sneezing and nasal itching (17 patients). There was no significant change for nasal congestion and rhinorrhea in the intention-to-treat sets. However, there was still a significant drop of the mean relative total symptom score derived from the individual scores. All scores remained unchanged in the untreated control group (16 patients). CONCLUSION: Topical application of the nose ointment as a supportive treatment leads to a significant improvement of symptoms in allergic rhinitis. SIGNIFICANCE: The prevalence of allergic rhinitis is about 10% to 20% in the population. Our study results are encouraging and should be assessed in further research because changes in the therapeutic guidelines may be suggested. EBM RATING: A.

Administration, Intranasal↗
PubMed2005

Lipid profile in spinal cord-injured women with different injury levels.

Background. In dependence on their injury level, male subjects with spinal cord injury (SCI) exhibit a less favorable lipoprotein profile than control persons. The impairment of the sympathetic nervous system and the fact that persons with spinal cord injury are subject to extreme physical inactivity may have an influence on their lipid profile and lipoprotein(a) concentration. It has been shown that sex-specific differences in hormonal regulation are responsible for differences in lipoprotein levels between nondisabled men and women. However, the role of hormones on lipoprotein levels has not been investigated in female subjects with spinal cord injury. Methods. Therefore, we performed a detailed investigation regarding the lipid profile in 32 premenopausal women with spinal cord injury ranging from tetraplegia to low paraplegia and in 36 control subjects. VO(2max) was determined by a wheelchair ergometry with stepwise increase in work load. Result. VO(2max) was significantly higher in paraplegics than in tetraplegics but significantly lower than in control subjects. Paraplegics had significantly higher low-density lipoprotein levels than both tetraplegics and control persons. The lipid profile of female tetraplegics was characterized by elevated triglycerides. An association between high-density lipoprotein levels and spinal cord injury or the level of the injury was not observed. No significant difference in lipoprotein(a) was found within SCI individuals as well as between SCI individuals and control persons indicating the predominant genetic determination of lipoprotein(a) and the thus related cardiovascular risk. Conclusion. Despite the extreme reduction of VO(2max), the assumed physical inactivity and low serum catecholamine levels due to the impairment of the sympathetic nervous system, female tetraplegic persons did not show an adverse lipoprotein profile with respect to high-density lipoprotein cholesterol levels. If the higher low-density lipoprotein cholesterol concentrations in female with spinal cord injury with low lesion levels or the elevated TG levels in female tetraplegics bare relevance with respect to an increased cardiovascular risk in this population needs to be clarified in further longitudinal investigations.

Adult↗
PubMed2005

Polymorphous vascular patterns in dermoscopy as a sign of malignant skin tumors. A case of an amelanotic melanoma and a porocarcinoma.

BACKGROUND: Using dermoscopy (dermatoscopy, epiluminescence microscopy), malignant skin tumors can be detected earlier and unnecessary excisions of benign tumors can be avoided. OBJECTIVE: Description of the dermoscopic vascular patterns of an amelanotic melanoma and a porocarcinoma. METHODS: Dermoscopy of an amelanotic melanoma and a porocarcinoma at 10-fold magnification. RESULTS: On dermoscopy polymorphous vascular patterns with pinpoint and hairpin-like vessels were seen. CONCLUSION: A reddish tumor without any pigmented network, globules or streaks but with polymorphous vascular patterns must be considered a malignant melanocytic or nonmelanocytic skin tumor.

Buttocks↗
PubMed2004

Wavelet analysis of cutaneous blood flow in melanocytic skin lesions.

Laser Doppler flowmetry (LDF) is frequently used to study the microcirculation. Usually LDF time series are analyzed by conventional linear methods, mainly Fourier analysis. The aim of this study was to observe dynamic blood perfusion of the skin in malignant and benign melanocytic skin lesions. Wavelet transformation was performed on each LDF time series in order to calculate a vasomotion field. First, the differences in vasomotion between healthy and pigmented skin were evaluated visually on six different time scales of the vasomotion field. In order to quantify the findings, vasomotion scale variance (VSV) was calculated for each scale plane of the vasomotion field. These VSV were compared using contrast DeltaVSV to determine the difference between healthy skin and a pigmented skin lesion in the same patient. After the measurements, the skin lesions were excised and examined histologically. We found that wavelet analysis of LDF time series is a specific, sensitive method for the in vivo identification of malignant melanoma. It is a non-invasive procedure and takes minimal time to be carried out.

Humans↗
PubMed2004

Human carbonyl reductase catalyzes reduction of 4-oxonon-2-enal.

4-Oxonon-2-enal (4ONE) was demonstrated to be a product of lipid peroxidation, and previous studies found that it was highly reactive toward DNA and protein. The present study sought to determine whether carbonyl reductase (CR) catalyzes reduction of 4ONE, representing a potential pathway for metabolism of the lipid peroxidation product. Recombinant CR was cloned from a human liver cDNA library, expressed in Escherichia coli, and purified by metal chelate chromatography. Both 4ONE and its glutathione conjugate were found to be substrates for CR, and kinetic parameters were calculated. TLC analysis of reaction products revealed the presence of three compounds, two of which were identified as 4-hydroxynon-2-enal (4HNE) and 1-hydroxynon-2-en-4-one (1HNO). GC/MS analysis confirmed 4HNE and 1HNO and identified the unknown reaction product as 4-oxononanal (4ONA). Analysis of oxime derivatives of the reaction products via LC/MS confirmed the unknown as 4ONA. The time course for CR-mediated, NADPH-dependent 4ONE reduction and appearance of 4HNE and 1HNO was determined using HPLC, demonstrating 4HNE to be a major product and 1HNO and 4ONA to be minor products. Simulated structures of 4ONE in the active site of CR/NADPH calculated via docking experiments predict the ketone positioned as primary hydride acceptor. Results of the present study demonstrate that 4ONE is a substrate for CR/NADPH and the enzyme may represent a pathway for biotransformation of the lipid. Furthermore, these findings reveal that CR catalyzes hydride transfer selectively to the ketone but also to the aldehyde and C=C of 4ONE, resulting in 4HNE, 1HNO, and 4ONA, respectively.

Alcohol Oxidoreductases↗
PubMed2004

[Skin and sports].

Explore the source record for details and available documents.

Athletic Injuries↗
PubMed2004

Is there a vasospasmolytic effect of acupuncture in patients with secondary Raynaud phenomenon?

BACKGROUND: Raynaud phenomenon (RP) is a vasospastic disorder of the digital arteries. Severe forms are found in patients with connective tissue diseases. Vasospasmolytic therapies are often limited by side effects such as orthostatic hypotension. PATIENTS/METHODS: We investigated therefore the effect of acupuncture in a double blind, placebo-controlled, randomized trial in patients with secondary RP. The study was performed during the winter season by licensed acupuncturists weekly for 8 weeks (points chosen for the verum group: L.I.4, S.J.5, St.36, P.6, Du.20, Ex.28). RESULTS: An improvement was detected in both groups but there was no significant effect on clinical symptoms - based on patient diaries (average number of attacks before and after treatment: verum 1.9 +/- 2.0 vs. 1.4 +/- 1.7 attacks/ day and placebo 2.8 +/- 1.8 vs. 1.9 +/- 1.1; duration of attacks: verum 15 +/- 12 vs. 12 +/- 9 min. and placebo 31 +/- 17 vs. 16 +/- 6; n.s.) or on skin microcirculation, measured by local cold testing. CONCLUSIONS: A specific vasospasmolytic effect of acupuncture could not be proven. This may be due to minor morphologic changes of supplying arteries or a severe local defect in endothelial function rather than a neurological disturbance which might be influenced by acupuncture. Much larger studies would be needed to identify the possible small benefit from acupuncture. If long-term relief is not obtained, it is unlikely to be cost-effective.

Acupuncture Therapy↗