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Biomedical subjects

C Seebacher

Publications and source records attributed to C Seebacher.

At least 37 records · Page 2Linked to original sources
PubMed1999

Infections and melanoma risk: results of a multicentre EORTC case-control study. European Organization for Research and Treatment of Cancer.

Immune function plays a prominent role in the defence against cutaneous malignant melanoma and the increased risk of melanoma development during immunosuppression. Since the immune system is challenged beyond its routine activity by an infection, the effect of previous infectious diseases on the risk of melanoma may also be crucial. In a European Organization for Research and Treatment of Cancer (EORTC) case-control study performed in six European countries and Israel, we compared the history of severe infections in 603 melanoma patients with that in 627 population controls. We calculated adjusted odds ratios (ORs) to estimate the effect of infectious diseases on melanoma risk. The ORs for melanoma risk were below 1 for nearly all types of infections (except two) if body temperature was not taken into consideration, and for all infections with a body temperature above 38.5 degrees C. In the latter category significantly lowered ORs were found for pulmonary tuberculosis (0.16; 95% confidence interval [CI] 0.01-0.98), Staphylococcus aureus infections (0.54; 95% CI 0.31-0.94), sepsis (0.23; 95% CI 0.06-0.70), influenza and related infections (0.65; 95% CI 0.48-0.86) and pneumonia (0.45; 95% CI 0.27-0.73). Analysis of the cumulative influence revealed a consistent pattern of results pointing to a reduction in melanoma risk with increasing numbers of recorded infections and fever height. This apparent dose-response relationship suggests a causal association. Speculations on the underlying mechanism include a Shwartzman-like phenomenon when melanoma formation precedes the infection and/or an infection-related Th1-cell activation preventing the establishment of the tumour.

Adult↗
PubMed1999

Fungal colonization of the paranasal sinuses.

Fungal infection of the paranasal sinuses occur in four primary types: acute invasive (1), chronic invasive (2), chronic fungus ball (3) and allergic fungal sinusitis (4). The first and second form can be fatal and is often found in immunosuppressed patients. The present paper concerns a group of immunocompetent patients with non-invasive chronic sinusitis caused by moulds. Over the period from 1994 to 1998, 132 tissue samples from the paranasal sinuses obtained by endoscopic operation from 117 patients was examined for mycotic infections. The mycological examination was carried out if granulomatous and crumbly material was seen in the sinus by endoscopy (91 times maxillary sinus, 23 times ethmoid sinus, 11 times frontal sinus, 7 times sphenoid sinus). Out of 117 patients 29 were positive (24.9%). From 132 surgical specimens fungi were proved in 34 times (25.7%). The following fungal species were isolated: Aspergillus fumigatus 17 times, other Aspergillus spp 6 times, Alternaria alternata 2, Penicillium rugulosum 1, and moulds without differentiation 5 times. In the histological examination an invasive mycelial growth in the mucous membrane or in the bones was never observable. Our findings represented a commensal colonization of the paranasal sinuses, but not a mycosis. The colonization is evidently assisted by a chronic hypertrophic sinusitis with increased mucus production which impedes the mucociliary clearance. For immunosuppressed patients, however, this situation causes a danger of invasion with fatal consequences.

Alternaria↗
PubMed1998

[Limits of brief treatment of onychomycoses].

New antifungals for oral therapy have improved the chances of healing onychomycoses. Nevertheless, in daily practice the failure rate is 20-30% both with itraconazole and terbinafine. In our investigations for the fungicidal effects of terbinafine, we could show that the same strain of Trichophyton rubrum or T. mentagrophytes in the rest period needs 1000 times higher concentration of terbinafine (2.0 to 0.002 microgram/ml) for complete fungal killing as in the growth phase. Thus resting fungi in the nail are not harmed, and if the concentration of terbinafine is lower than the MIC for the fungi, they can cause a relapse. Itraconazole is a fungistatic agent. Its concentration in the nail plate must be higher than the MIC for the causative fungi for a long time-10 to 12 months. The usual short-term treatment of onychomycosis over 3 months can be insufficient in individual cases such as patients with disorders, e.g. circulatory disorders or slowed nail growth.

Administration, Oral↗
PubMed1998

[Candida infections in infancy and early childhood].

Candida infections in infancy can manifest themselves as skin, mucosal or systemic candidiasis. Eighty to nintey percent of all candida infections in this age group are caused by Candida albicans. Whereas in neonates, infections mostly occur sub partu, in older children predisposing underlying diseases get an increasing etiological importance. The diagnosis is based on microscopic and cultural detection of yeast as well as on the course of the titers of Candida antigen and antibodies. For topical antifungal treatment of skin and mucosa infections, different preparations of the polyenes nystatin and amphotericin B have been proven to be most effective. In systemic candidiasis the combination of amphotericin B and 5-flucytosin is the treatment of choice. In view of the potential severe side effects of this combination therapy, fluconazol as a sole treatment represents an effective alternative. Prophylaxis against Candida infections comprises sticking to hygienic regimes, mycological surveillance of risk groups and oral application of antimycotics.

Amphotericin B↗
PubMed1998

[Diagnosis, differential diagnosis and therapy of onychomycosis].

Onychomycosis is a common infectious disease. The diagnosis always requires proof of the presence of fungi by culture. Nail psoriasis and onychodystrophy of another origin are clinically very similar to onychomycosis. There is a choice of topical and systemic antimycotics available for treatment. The modern antimycotic nail lacquars are well suited for the treatment of distal onychomycosis. If more than 2/3 of the nail plate and/or the nail matrix are infected, the treatment must be systemic. There is a choice of griseofulvin, terbinafine and itraconazole.

Administration, Topical↗
PubMed1997

[Autopsy findings in patients with repeated demonstration of Candida glabrata].

In our mycological laboratory we saw an increase of Candida glabrata isolates from 0.5% in 1993 to 22.2% in 1996, mainly isolates of high risk patients of intensive care units and oncological wards. We were interested to know whether this increase of C. glabrata is also corresponding to the number of endomycoses. Eighteen patients have been autopsied and examined histologically. During the hospital course we found repeatedly in all patients C. glabrata with or without C. albicans. Serological and culture results of this intensive care/oncological patients were indicative of an invasive endomycosis. In 12 of 18 patients there was no evidence of an invasive mycosis in autopsy tissues. Three patients had a typical aspergillosis of the lungs, which was not diagnosed during hospital course. In 5 patients, two of them with aspergillosis of the lungs, we found in kidney or lung tissue sporadic yeast cells, typified by size and missing pseudomycelium as C. glabrata. In no case a tissue reaction as an intravital defense reaction against these yeast cells was observed. Therefore, we interpreted the findings of C. glabrata in tissues as representing a transient fungemia and not as an endomycosis due to C. glabrata.

Adult↗
PubMed1997

[Tinea follicularis presenting as trichophytic Majocchi granuloma].

We report on a 75 year old patient with a bronchial asthma treated at least for 15 years with low dose prednisolone. Under this treatment he developed a tinea follicularis and was demonstrated in our clinic with papulopustular skin lesions on both forearms, left malleolus and left thigh. We saw tender to touch granulomata on erythematosquamous atrophic skin. A dermatomycosis was diagnosed by isolation and identification of Trichophyton rubrum. In addition the onychomycosis of all finger- and footnails was caused by T. rubrum. Clinical and accessory clinical findings (histology) agreed with a 1883 described disease, granuloma trichophyticum Majocchi. An internal treatment with terbinafine 250 mg/d and topical with tioconazole cream completely cured the skin lesions and the nails.

Aged↗
PubMed1996

[Mycophobia--a new disease?].

In the recent 18 months we analysed 13 patients with so-called therapy-resistant intestinal candidosis. Symptoms like flatulence, digestive trouble, intestinal inefficiency, arthralgia, heart trouble, etc., were declared. From four patients Candida albicans and in further three patients C. parapsilosis, C. lusitaniae, Trichosporon cutaneum, and Geotrichum candidum could be isolated. Serological tests were normal. In none of the 13 patients a mycosis which needed therapy was proven. Eight patients had signs of a depression or neurosis. In all 13 patients the occasional or repeated isolation of yeasts from faeces or the oral cavity was falsely interpreted as a fungal infection and thus became the inductor of a phobia.

Adult↗
PubMed1995

[Sterile eosinophilic pustulosis (Ofuji). A rare entity in Europe].

This case report refers to a German patient with sterile eosinophilic pustulosis of the Ofuji type (SEP), which is rarely described in non-Japanese humans. The distinctive histomorphology, with intraepidermal eosinophilic abscesses and eosinophilic folliculitis, is complemented in this patient by marked eosinophilia, evident eosinophilic bone marrow reaction and involvement of the oral mucosa with eosinophilic spongiosis, which is a feature that had not previously been reported. Possible transitions between cutaneous and internal hypereosinophilic syndromes are discussed. Despite the initial good effect of topical corticosteroids on the cutaneous changes, long-term follow-up to check for internal involvement is necessary.

Biopsy↗
PubMed1990

[Iron metabolism and chloroquine phosphate therapy in porphyria cutanea tarda].

The knowledge about the influence of chloroquine phosphate (CQ) on the iron metabolism in porphyria cutanea tarda (PCT) is still insufficient. In a study on 138 PCT patients treated with CQ, we observed decreasing serum iron concentration, transferrin saturation, and hepatic siderosis, as well as an increasing level of transferrin. After a one-year therapy with CQ, the patients showed normal porphyrinuria. Since there were no statistical correlations between the degree of hepatic siderosis and porphyrinuria, and since we repeatedly found remission of the PCT in spite of the continued existence of hepatic siderosis, the removal of iron cannot be regarded as the only principle of action in CQ therapy. In comparison with chloroquine, phlebotomy obviously has--even with regard to the iron deposits--no decisive advantages.

Adult↗
PubMed1990

[Results of treatment of malignant melanoma--a computer analysis of 772 patients].

The data of 772 patients with malignant melanoma, treated from 1.1.1972 to 30.6.1988 in the Regional Hospital Dresden-Friedrichstadt were analysed by computer. The probability of survival was estimated separately by the method of Kaplan and Meier in dependence on clinical stage in the time of the first treatment, pT and sex. The 10-year survival rate in clinical stage I amounts to pT1 = 100%; pT2 = 82.9% +/- 4.0%; pT3 = 67.1 +/- 4.3% and pT4 = 58.0 +/- 4.7%. There are significantly differences between women and men with melanomas of the category pT2 and pT3 in favour of women (pT2: 88.6%:70.0%; pT3: 75.8%: 53.4%). In the cases of pT4 melanoma there are no differences (61%:53%). The average time of survival from these patients who have died from melanoma shows also marked differences according to pT (pT2 = 46.6 month, pT3 = 36.6 month, pT4 = 30.2 month).

Female↗
PubMed1990

[Comparative analysis of narcosis and local anesthesia in surgery of malignant melanoma of the skin].

A nonrandomized trial was performed to compare the survival rate attained in patients with malignant melanoma who underwent their operations under general anaesthesia (g.a.) and in those who underwent surgery with only local anaesthesia (l.a.). All stage I patients were treated and followed up in our hospital exclusively. Data recorded in 190 patients operated on under g.a. from 1972 to 1980 and 376 patients operated on with l.a. from 1981 to 1987 were evaluated by computer. The 5-year survival rates calculated by the Kaplan-Meier method were as follows: Breslow's thickness up to 1.50 mm (pT1 and pT2): g.a. 91.4% l.a. 94.5%; 1.51-3.00 mm (pT3a) g.a. 64.1%, l.a. 84.5% (P less than 0.01); over 3.00 mm (pT3b and pT4) g.a. 57.9%, l.a. 62.2% (P greater than 0.05). Women with pT3a melanoma had more benefit from the operation in l.a. (93.1% to 69.7%) than did men (71.6% to 55.2%). The l.a. does not prejudice the prognosis, whether the l.a. improves the prognosis has to be stated. The available evidence that anaesthetic agents influence host defence could be an explanation for the better results with l.a.

Anesthesia, General↗
PubMed1989

[Treatment of fungus infections of the skin with tioconazole (Mykontral)].

73 patients with fungal infections due to dermatophytes (49), yeasts (16) and Malassezia furfur (8) could be cured clinically in 71% and mycologically in 88% of cases by the application of Mycontral-Lotion or -cream twice daily for 33 days on average. In 28% improvement could be reached, in one patient the therapy failed. Treatment is simple, clean and well acceptable. Side-effects occurred as slight redness, transient burning and pruritus on the eroded skin in the initial phase in 8 patients (11%). Mykontral contains 1% tioconazole as a modern imidazol compound. It has been characterized as an effective topical broad spectrum antimycotic agent. Its introduction and application in the GDR is to be recommended.

Administration, Topical↗
PubMed1986

Left ventricular function in well-controlled insulin-dependent (type I) diabetics--an echophonocardiographic study.

A high prevalence of left ventricular dysfunction in insulin-dependent (type-I) diabetics has been reported. However, the exact influence of metabolic control and/or the coexistence of early diabetic microangiopathy is unknown. Thus, we assessed left ventricular function by echophonocardiography in 50 type-I diabetics (mean age 26 +/- 7.9 years), who showed a fairly good metabolic long-term control (mean hemoglobin A1: 8.8%) after the introduction to intensified insulin therapy in comparison with 50 age- and sex-matched controls. Type-I diabetics did not differ from controls in their left ventricular internal diameters, mean wall thickness, ratio of pre-ejection period to left ventricular ejection time and systolic shortening fraction. Isovolumetric relaxation period reflecting an early diastolic event was slightly but significantly prolonged in diabetic subjects, independent of metabolic control status or existence of early microangiopathy. Isovolumetric relaxation period showed a statistically significant correlation to age in type-I diabetics, but not in controls. Possibly, the diabetic status--although well-controlled, but not normalized--may biochemically alter the myocardium and might influence its diastolic properties.

Adult↗
PubMed1986

[Therapeutic and pathogenetic aspects of porphyria cutanea tarda].

Seventy-three patients with porphyria cutanea tarda (PCT) were treated with chloroquine phosphate, which was administered in doses of 250 mg twice a week for more than 1 year on average. Of these patient, 49% did not have any associated ("inducing") factors. After treatment, serum transaminases and gamma-glutamyltransferase (gamma-GT) always returned to normal values. However, gamma-GT did not reach the normal range in the group without associated factors ("idiopathic group"). Of the 66 patients studied, 25 achieved an approximately physiological distribution of the pattern of urinary porphyrin fractions. Control biopsies were performed in 66 patients. Of them, 48 patients showed an improvement in liver damage. A statistically significant correlation was observed between a lasting increase in urinary prophyrin content and unchanged pathological liver morphology. A pathogenesis concept for PCT is discussed as a disease between inheritance (genetic enzyme defect) and environment ("inducing factors"). Even in the "idiopathic group" the improvement of pathological liver changes after therapeutic removal of the pathological prophyrin content in the liver cells shows that porphyrins could also cause liver damage.

Alcoholism↗