Unusual combined sensitization to palladium and other metals.
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Adult↗
Biomedical subjects
H Hackel
Publications and source records attributed to H Hackel.
Vulvitis granulomatosa and anoperineitis granulomatosa.
We present the case of a 77-year-old female with a rare genital and anoperineal granulomatous cutaneous manifestation resembling cheilitis granulomatosa Miescher. The typical histological findings of epithelioid cell granulomas were localized in the vulva and anoperineal region; the latter manifestation has not yet been described. Based on our personal observations and a review of the literature, the clinical and histological features of vulvitis granulomatosa are described.
Aged↗
[The value of Gardnerella-vaginalis-culture in bacterial-vaginitis- score-confirmed bacterial vaginosis].
The relative value of a semiquantitative Gardnerella vaginalis culture for the diagnosis of bacterial vaginosis (BV) was studied in 113 women attending a STD clinic. The standard diagnosis of BV was based on the BV score, which is a 10-point grading system to evaluate gram-stained vaginal samples objectively and reproducibly. The sensitivity of G. vaginalis culture for the diagnosis of BV was 28%, while the specificity was 89%. The positive and the negative predictive values were 50% and 76% for G. vaginalis culture in our population. Our data suggest that G. vaginalis culture cannot be recommended for the routine diagnosis of BV. However, G. vaginalis culture will detect asymptomatic women with high vaginal colonization with G. vaginalis. Further studies are needed to find whether these women are at risk of developing BV.
Bacteriological Techniques↗
Prevalence of Ureaplasma urealyticum in the urethra of men without urethritis in relation to clinical diagnosis.
Ureaplasma urealyticum is one of the microorganisms possibly causing nongonococcal urethritis. In a prospective study, 606 men without urethritis presented to an STD clinic in a rural West German region were investigated for the prevalence of U. urealyticum in the urethra. The overall isolation rate of the organism was 21.3%. Analyzing patients grouped by clinical diagnoses, the isolation rate of U. urealyticum was significantly higher in the genital warts group (25%) and in the partner's control group (35%) than in the group of patients suffering from fertility disorder (15.2%) or balanitis (14%). These findings stress the importance and the difficulty to select the appropriate controls in clinical studies concerning the role of U. urealyticum in the male urethra.
Adult↗
[Unusual manifestation of scleroderma of the trunk].
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.
Aged↗
[Keratoacanthoma centrifugum marginatum].
Keratoacanthoma centrifugum marginatum (KCM) is a rare distinct variant of keratoacanthoma. Based on three personal observations and a review of the literature, the authors describe the clinical and histological features of this neoplasm. Clinically KCM is characterized by the lack of a tendency for spontaneous remission and by continuous centrifugal spread. Histologically there is a subclinical, iceberg-like growth pattern. Like keratoacanthoma, KCM is a highly differentiated, biologically benign, non-metastasizing tumour. The treatment of choice is early excision of the tumour.
Aged↗
Effect of the application of an anionic detergent combined with FABRY's tincture and its components on human skin resident flora. Part 1: Dermofug solution combined with either FABRY's tincture or 50 v/v% isopropanol.
The aim of the study was to investigate the antimicrobial longterm efficacy of the combined application of an anionic detergent (Dermofug) either with 50 v/v% isopropanol or FABRY's tincture (3 w/v% salicylic acid, 1 v/v% liquefied phenol containing 50 v/v% isopropanol) on the resident flora of the human forehead skin after repeated applications using the forehead skin test. The test results show that both combinations tested are able to penetrate the infrainfundibulum of the sebaceous glands. The combined application of 10 v/v% Dermofug solution (D) and FABRY's tincture (F) showed better antibacterial efficacy than the combination of D and 50 v/v% isopropanol (I) against the coagulase-negative-staphylococci in the stratum corneum/acroinfundibulum as well as in the infrainfundibulum of the sebaceous glands. Against Propionibacterium spp., D and F showed better efficacy than D and I in the stratum corneum/acroinfundibulum, and equal efficacy in the infrainfundibulum of the sebaceous glands. It remains to be clarified in further investigations, which of the components of FABRY's tincture leads to the better antibacterial efficacy of the combined application of D and F in comparison to D and I, the salicylic acid or the phenol acid component.
1-Propanol↗
Effect of the application of an anionic detergent combined with FABRY's tincture and its components on human skin resident flora. Part 2: Dermofug solution combined with either salicylic acid tincture or phenol acid tincture.
Using the forehead skin test, we investigated the combined application of 10 v/v% Dermofug solution and 3 w/v% salicylic acid tincture or 1 v/v% phenol acid tincture. The former combination showed better antibacterial efficacy against the coagulase-negative staphylococci and Propionibacterium spp. in the stratum corneum/acroinfundibulum as well as in the infrainfundibulum of the sebaceous glands. No antibacterial efficacy could be determined against Propionibacterium spp. in the infrainfundibulum of the sebaceous glands after the combined application of Dermofug solution and 1 v/v% phenol acid tincture. In contrast, the combined application of Dermofug solution and 3 w/v% salicylic acid tincture led to a long-term reduction of the cfu-counts of Propionibacterium spp. in the infrainfundibulum of the sebaceous glands. The following conclusions can be drawn from our study and applied to external therapy: a detergent like Dermofug should be used instead of an alcohol to enhance the penetration of a drug into the infrainfundibulum of the sebaceous glands, since the former can block the growth of Propionibacterium spp. in the infrainfundibulum. Secondly, it should be kept in mind that the addition of salicylic acid to a topical antibiotic ointment does not only enhance the penetration of the antibiotic into the infrainfundibulum of the sebacous glands, but that the antibacterial effect of the salicylic acid itself may be the reason for the better clinical antibacterial efficacy of such combinations.
Bacteria↗
Antibacterial efficacy of Fabry's tinctura on the resident flora of the skin at the forehead. Study of bacterial population dynamics in stratum corneum and infundibulum after single and repeated applications.
The in-vivo antibacterial activity of Fabry's tinctura (FT), a 3 w% salicylic acid, 1 w% phenoli liquefacti containing 50 v/v% isopropanol used in dermatology for the treatment of erythrasma, pityriasis versicolor, acne vulgaris a.o. on the human resident skin flora was assessed by a new test method in comparison to 60 v/v% isopropanol. The test method consists of a detergent scrub method (DSM) in combination with the cyanoacrylate method (CAM) thus allowing the quantitative determination of bacterial densities in two depth compartments of human skin, separately for bacterial genera. The most important innovation of this test method is that its arrangement, especially the separate evaluation of the genera of the resident flora, makes it possible to examine the ability of an antimicrobial agent to invade different depth compartments by its bioactivity against the resident flora and to measure short-and-long-term efficacies under physiological conditions. Our findings in 120 volunteers indicate that compared to 60% isopropanol FT is able to reduce bacterial density in superficial and deep skin compartments immediately after a single application equally well, but for a significantly longer period. In repeated applications, 60% isopropanol does not produce a cumulative or long-lasting effect, but it causes an abundant rebound growth of Propionibacterium spp. in the lower skin compartment. FT, however, shows a cumulative antibacterial effect at the surface and in the depth persisting up to four days after the last application. It is concluded that by its salicylic acid and phenolic content FT is an effective drug for the topical antimicrobial therapy of skin diseases.
1-Propanol↗
[Oral cephalexin therapy of osteomyelitis (author's transl)].
40 patients with chronic osteomyelitis were treated per os with the bactericidal beta-lactam-antibiotic cephalexin during 3 to 60 weeks. In 16 patients, who were operated simultaneously, bacterial spreading was prevented by a combination of cephalexin and parenteral cephaloridin during operation and in the postoperative period. In these patients no recurrence occurred during the follow up time (2 to 5 years). In 34 patients general and local signs of inflammation diminished under cephalexin therapy and a complaint-free interval of at least 6 months followed. No serious side effects forcing a stop of therapy were observed. According to the gained experiences oral cephalexin in combination with perenteral cephaloridin is indicated for prevention of bacterial spreading during operations in chronic bone infections and in patients with acute febrile recurrence of chronic osteomyelitis refusing a surgical intervention.
Administration, Oral↗
[Treatment of coxa magna in Perthes disease by pelvic osteotomy (author's transl)].
In M. Perthes a progressive deformation and flattening of the epiphysis is caused by the stress in the hip. In the beginning stages a varisation osteotomie gives a sufficient reduction of the joint pressure and a modelling of the enlarged head by the acetabulum is possible. In later stages a detoriation of the head deformity with fixed adduction contracture can be caused by varisation osteotomie. Enlarging the acetabulum laterally and ventrally and medializing the hip-joint by means of a Chiari pelvic-osteotomy reduces the joint pressure so far, that a restitution of the hip joint with round and congruent joint surfaces can be expected. A lateralisation of the deformed femoral head with a secondary insufficiency of the acetabulum should also be treated by an additional pelvic osteotomy, if in the arthrography the lateral part of the head does not enter the acetabulum in abduction position. In secondary osteochondritis in hip luxation the treatment should be equal. Even an advanced secondary osteoarthritis after M. Perthes could be stopped by pelvic osteotomy over years.
Adolescent↗
[Complete resection of a vertebral body (author's transl)].
The resection of one or more vertebral bodies is technically difficult and quite demanding for the patient. In cases of solitary metastases to a vertebral body such a procedure may be considered when the general condition of the patient is satisfactory. To mobilise the patient quickly the stabilisation of the spine with bone cement and plates is mandatory. Three of four cases have been treated by two consecutive operations, one patient received a prefabricated ceramic implant. Mobilisation was maintained until four months after surgery. An analysis of previously published reports on complete vertebral body resection shows advantages and disadvantages of several methods.
Braces↗
[Adaptation osteotomy in idiopathic femoral head necrosis].
Thirty-nine patients who suffered a segmental ischemic necrosis of the hip, fifteen of which affected on both sides, were treated with osteotomy of the femur. The re-examinations were carried out after an average period of 6.6 (2.5-12) years. While in twenty one cases, the hip necrosis was treated exclusively by varisation, in thirty three cases a combination of varisation and flexion was effected. 12 patients (equivalent to 22.2%), all of them with a necrotic angle of more than 115 degrees, were provided with a total hip arthroplasty in the interval. The patients with a necrotic angle smaller than 115 degrees showed a definite alleviation of the pain symptoms, an increased hip flexibility and an improved locomotory pattern.
Adult↗
[Indications and results of osteotomy of the pelvis using Chiari's method in advanced arthrosis].
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Adult↗