Biomedical subjects

K Konrad

Publications and source records attributed to K Konrad.

At least 19 recordsLinked to original sources

PubMed1992

Controlled trial of balneotherapy in treatment of low back pain.

Three treatments for non-specific lumbar pain--balneotherapy, underwater traction bath, and underwater massage--were assessed in a randomised prospective controlled trial in 158 outpatients. Each group was treated for four weeks and patients were reviewed at the end of this period and at 12 months after entry to the trial. The prescription of analgesics and the pain score were significantly reduced in all three treated groups, but there was no difference between the three groups. No significant change occurred in spinal motion and the straight leg raising test. After one year only the analgesic consumption was significantly lower than in the control group.

Adult↗

PubMed1992

Hyperkeratosis lenticularis perstans (Flegel's disease). Ultrastructural study of lesional and perilesional skin and therapeutic trial of topical tretinoin versus 5-fluorouracil.

Lesional and perilesional skin samples from a 57-year-old man who had hyperkeratosis lenticularis perstans (HLP) (Flegel's disease) were studied by light and electron microscopic examination. Keratohyalin granules were diminished at the center of a fully-developed lesion. In contrast, keratohyalin appeared normal and membrane-coating granules were found in reduced numbers at the edges of the HLP lesion and were easily detected in normal numbers in clinically normal, perilesional skin. The inflammatory infiltrate in the HLP lesion was composed of small lymphocytes, which often displayed nuclei with deep infoldings resembling Sézary cells, and larger histiocytic cells, many of which were in close contact with the lymphocytes. Peripheral blood mononuclear cells did not show an abnormal ultrastructural appearance. Treatment with topical 5-fluorouracil cream led to the disappearance of the HLP lesions, whereas topical tretinoin was ineffective.

Administration, Cutaneous↗

PubMed1992

Middermal elastolysis in an elderly man with evidence of elastic fiber phagocytosis.

BACKGROUND: Middermal elastolysis is a clinically and histologically distinct entity. This idiopathic loss of dermal elastic fibers has mostly been reported in younger adults. To our knowledge, the present case, which has been followed up for 4 years, is the first to occur in an elderly man. OBSERVATIONS: Two years after the onset of progressive wrinkling of the upper aspect of the thorax, the patient underwent a biopsy. Histologic examination of the specimens confirmed previous findings of middermal elastolysis. Examination of extracutaneous elastic tissue showed normal findings. Electron microscopy demonstrated elastic fibers embraced by macrophages, which is suggestive of elastic fiber phagocytosis. For the following 4 years, the patient has remained in stable clinical condition. CONCLUSIONS: Middermal elastolysis is probably more common than has been assumed so far. It does not affect nondermal elastic tissue. After progressive loss of dermal elasticity in a circumscribed area, a benign course follows, with a stable condition over several years. Electron microscopic findings indicate that elastic fiber phagocytosis is operative in the disappearance of the middermal elastic tissue.

Aged↗

PubMed1991

Merkel cell carcinoma of the head and neck associated with Bowen's disease.

The Merkel cell carcinoma occurs primarily in the skin of the head and neck, and develops in the dermis with a trabecular growth pattern. Immunohistochemistry reveals positive staining for neuron-specific enolase, neurofilaments, cytokeratin and chromogranin A. Electron microscopically, the tumor cells contain dense-core granules, spinous cytoplasmic processes, desmosomes, zonulae adherentes and paranuclear filament aggregates besides frequent mitoses, focal necroses and lymphocyte and plasma cell infiltrates. The Merkel cell carcinoma is often co-existent with other malignancies such as squamous cell carcinoma or, as in the present study, with Bowen's disease. The definite diagnosis of the Merkel cell carcinoma can be effected only by electron microscopic examination of the tumor.

Aged↗

PubMed1991

[Collodion baby with transition to mild lamellar ichthyosis.Clinical course, histopathology and ultrastructural findings].

The case of a collodion baby in whom the condition evolved into a mild form of lamellar ichthyosis is presented. The clinical course was impressive: the hard, collodion-like horny membrane started to crack soon after the birth and had detached completely at the 9th day of life; after a few more days, almost complete clearing of the skin had occurred. At the age of 10 months, the child had only a very mild lamellar ichthyosis. Whereas light microscopy revealed only compact hyperkeratosis on the 1st day of life, electron microscopy suggested a favourable prognosis even at this early stage, which has been corroborated by the ensuing clinical course.

Dermatologic Agents↗

PubMed1990

Restenosis after transluminal coronary angioplasty: a risk factor analysis.

In order to determine the relationship of restenosis following percutaneous transluminal coronary angioplasty (PTCA) to risk factors such as hypercholesterolemia, hyperglycemia, smoking, and weight, we performed a univariate analysis to test the association of these variables with restenosis in 723 patients who had percutaneous transluminal coronary angioplasty and follow-up catheterization. Cholesterol levels were higher in younger and female subjects (less than 0.0001). Initial cholesterol did not predict restenosis, and follow-up cholesterol levels showed an inverse relationship with restenosis (P less than .02). There was a trend (P less than .09) toward decreased restenosis in those who were active smokers at the time of follow-up catheterization. No differences were seen in diabetics with hyperglycemia, in both treated and untreated groups (P = NS). A stepwise multiple logistic regression was used to simultaneously test the association of the above risk factor variables to restenosis. None of the interactions were found to be significant, except cholesterol at follow-up (P = .001). Therefore, the status of serum cholesterol, blood sugar, smoking, and weight during the time of PTCA and at follow-up catheterization may be unimportant in predicting restenosis. Thus, we conclude 1) that to better determine the effect of these variables on restenosis, they should be estimated at times other than follow-up and 2) that the pathophysiological mechanism of restenosis may have different risk factors than progression of atherosclerotic coronary artery disease.

Angioplasty, Balloon, Coronary↗

PubMed1990

The ultrastructure of dysplastic naevi: comparison with superficial spreading melanoma and common naevocellular naevi.

Eleven dysplastic melanocytic naevi with various degrees of dysplasia, as judged by light microscopy, were studied by transmission electron microscopy, and their intra-epidermal melanocytes compared with those of five superficial spreading melanomas and seven common benign naevocellular naevi. Intra-epidermal melanocytes in dysplastic naevi exhibited signs of cellular atypia, which were most pronounced in the dysplastic naevi with histological high-grade dysplasia. A correlation between the degree of dysplasia at the light microscopic level and the degree of cytological atypia at the ultrastructural level was noted, and melanocytes in dysplastic naevi with a high degree of dysplasia had ultrastructural features similar to the melanocytes in superficial spreading melanomas. Our observations support the concept that dysplastic naevi fill the biological gap between benign naevocellular naevi and malignant melanomas and suggest that at least some of the dysplastic naevi must be regarded as potential precursor lesions of malignant melanoma, particularly those exhibiting a high degree of histological dysplasia.

Adult↗

PubMed1990

Polypous clear cell acanthoma.

We report on two cases of polypous clear cell acanthoma. This growth pattern is unusual for the tumor and has not been reported in the literature. Histologically, these two tumors fulfill the criteria of clear cell acanthoma.

Female↗

PubMed1990

Keratitis, ichthyosis and deafness (KID)-syndrome: report of three cases and a review of the literature.

We report three patients with keratitis, ichthyosis and deafness (KID)-syndrome. All had characteristic hyperkeratotic skin lesions and neurosensory hearing defects. Two had ophthalmologic symptoms. The third patient did not have eye involvement at the age of 3 years, but exhibited the other typical signs of the syndrome. In none of the three cases were any of the patients' relatives affected, and a spontaneous new mutation is the most likely explanation for the occurrence of this rare syndrome. Histopathological and electron microscopic studies revealed orthohyperkeratosis but no other pathology and no abnormal deposits of glycogen were found. Treatment with the aromatic retinoid etretinate proved to be of little value in any of the patients. The necessity for early audiologic and ophthalmologic evaluation and the need for life-long medical care for patients with KID-syndrome is emphasized.

Adult↗

PubMed1990

Congenital melanocytic nevi with halo phenomenon: report of two cases and a review of the literature.

Verrucous congenital nevocellular nevi surrounded by a depigmented halo occurring in a 7-year-old boy and a 13-year-old girl were excised and the wounds closed primarily. Histopathologic studies revealed a striking arrangement of the inflammatory infiltrate in these halo nevi. A dense, band-like, lymphohistiocytic infiltrate was found only around and intermingled with A- and B-type nevomelanocytes in the upper dermis, whereas inflammatory infiltrates were completely absent from type C-nevomelanocytes in the lower parts of the reticular dermis. The literature is reviewed with particular consideration of congenital halo nevi.

Adolescent↗

PubMed1990

[Histology of the skin and mucous membrane manifestations of AIDS].

The dermatopathologist must be aware of the wide spectrum of non-specific cutaneous manifestations, cutaneous infections and skin tumors associated with AIDS. We present the histological criteria essential for the diagnosis of early Kaposi's sarcoma, its differential diagnosis including epithelioid angiomatosis, as well as the diagnosis of oral hairy leucoplakia.

Acquired Immunodeficiency Syndrome↗

PubMed1989

[Hyalinosis cutis et mucosae of the ear-nose-throat].

Hyalinosis cutis et mucosae (HCM) is a rare autosomal recessive disease of unknown aetiology and pathogenesis. In the skin and mucous membranes there is characteristically a deposition of hyaline-like material in the papillary dermis, around the small blood vessels and around skin appendages. Besides the manifold skin lesions, the mucous membranes affected are found in the nasal and oral cavities, pharynx and larynx. The latter causes the most characteristic symptom, namely, hoarseness, from birth. The lesions of the vessel walls are the most significant histopathological alterations. Ultrastructurally, massive deposits of amorphous, hyaline-like material in the dermis, reduction in number and size of the collagen fibrils and, finally, thickening of the basal laminae could be observed. The findings suggest an abnormal production of noncollagenous proteins as well as the alteration of the lysosomal systems of fibroblasts, endothelial cells and pericytes in the pathogenesis of hyalinosis.

Adult↗

PubMed1989

Multiple apocrine hidrocystomas on the eyelids.

A 31-year-old man with multiple cystic tumors symmetrically distributed on his eyelids is presented. Histopathology and immunohistochemistry suggest the diagnosis of apocrine hidrocystomas. Apocrine hidrocystomas occur frequently on the face, but multiple and symmetrical occurrence on the eyelids has not been reported up to now.

Adult↗

PubMed1989

Photosensitivity and hyperpigmentation in amiodarone-treated patients: incidence, time course, and recovery.

Amiodarone (AD) induces photosensitivity in 75% of the patients treated with this drug. Phototoxic reactions can be experimentally elicited with UVA but not with UVB. The UVA-MED is significantly reduced after 12 months of treatment. The development of photosensitivity depends on the total dose of AD; 40 g is the minimal cumulative dose requirement. Under the regimens commonly used, photosensitivity can be expected after 4 months of continuous AD treatment and appears to be unrelated to the skin type. Photosensitivity gradually decreases and returns to normal between 4 and 12 months after the withdrawal of AD. AD-related hyperpigmentation develops after an average of 20 months of continuous AD treatment and a minimal total dose of 160 g AD in about 8% of the patients (mainly of skin type I). Electron microscopic examination of the sun-exposed skin of patients without AD discoloration shows pigment deposits similar to those already described in patients with AD hyperpigmentation in exposed and non-exposed skin. Light and electronmicroscopic examination of sun-exposed skin of both clinically photosensitive and non-photosensitive patients reveals perivascular inflammation even in the absence of a clinical rash. Reduplications of vascular basal laminae occur in sun-exposed skin of both patients with and without UVA photosensitivity but are absent from non-exposed skin. In one patient, followed for 33 months after drug withdrawal, massive AD-induced hyperpigmentation was found to be reversible.

Amiodarone↗

PubMed1989

[Staphylococcal scalded skin syndrome in 2 adults with acute kidney failure].

We report on two cases of staphylococcal scalded skin syndrome (SSSS) in adults. In contrast to the previously reported cases our patients were neither immunosuppressed nor haemodialysed, nor did they have cancer. In both cases, acute renal failure in the presence of a rather banal staphylococcal infection preceded the SSSS. The pathogenic role of acute renal failure in the development of SSSS is discussed.

Acute Kidney Injury↗

PubMed1989

[Cornu cutaneum].

We report on 62 cases of cornu cutaneum. In contrast to the general opinion that the majority of these lesions arise on the basis of an underlying actinic keratosis or a squamous cell carcinoma, on histological examination we found actinic keratoses in only 25% and squamous cell carcinomas in only 3.2% of cases; 58% of all lesions were identified as common warts. We therefore recommend removal of these skin lesions by the shaving technique followed by electrodesiccation of the base. This has the advantage of supplying the histopathologist with a representative specimen for histological examination and avoiding an unnecessarily large surgical excision. In the rare cases of histologically confirmed squamous cell carcinoma, these lesions can be excised in a second session.

Aged↗

PubMed1988

[Histology of cutaneous AIDS manifestations].

An increasing number of skin and mucous membrane biopsies from AIDS patients is submitted for histopathologic examination. The dermatopathologist must be aware about the wide spectrum of AIDS-associated non-specific cutaneous manifestations, of cutaneous infections and of skin neoplasms. The histological criteria essential for the diagnosis of early Kaposi's sarcoma and for oral hairy leukoplakia are presented.

Acquired Immunodeficiency Syndrome↗

PubMed1988

[Initial clinical experiences in a large Austrian patient sample with immunodeficiency syndrome (AIDS): I. Type and course of encountered infections].

This study presents a report on the first clinical experiences gained in 68 hospitalized HIV antibody-positive patients from Austria, covering a period of twelve months. 36 patients (52.9%) belonged to risk group I or Ib (homo- or bisexual), whereas 26 (38.2%) patients were i.v. drug abusers (risk group II). 5 (7.4%) patients fulfilled the criteria of stage II of the CDC classification of HIV-associated clinical symptoms, 10 (14.7%) were classified as stage III and the remaining 53 patients (78%) as stage IV. The most frequent and also the most serious problem was the development of opportunistic infections. Multiple infections were found in 45.7% of all cases. Kaposi's sarcoma was found in 9 patients who all belonged to risk group I. During the entire observation period 10 patients died as a consequence of HIV-1-induced immunodeficiency and the resulting opportunistic infections and/or neoplasms.

Acquired Immunodeficiency Syndrome↗