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Biomedical subjects

M Stücker

Publications and source records attributed to M Stücker.

At least 55 records · Page 3Linked to original sources
PubMed2001

[Generalized pustulous psoriasis: A novel extraintestinal manifestation of Crohn's disease?].

A 66-year-old female patient suffering for 10 years from Crohn's disease firstly presented with a parallel outbreak of generalized pustulous psoriasis and Crohn's disease. A second synchronous exacerbation of both disorders occurred after discontinuation of treatment with prednisolone, methotrexate, and mesalazine. As to their pathogenetic concepts, both disease entities reveal similar immunologic alterations, i. e. comparable patterns of cytokines, chemokines, and inflammatory cells (T cells and neutrophils). Generalized pustulous psoriasis, therefore, might develop as hitherto undescribed, more rare extraintestinal manifestation of Crohn's disease.

Aged↗
PubMed2001

Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis.

BACKGROUND: There are already many effective topical therapies available for use in the treatment of chronic plaque psoriasis. Unfortunately, these treatments are often associated with a rather significant risk of undesirable effects. OBJECTIVE AND METHODS: In this randomized, prospective clinical trial, the effects of the vitamin D(3) analog calcipotriol were evaluated against those of a recently developed vitamin B(12) cream containing avocado oil in an intraindividual right/left-side comparison. The trial population consisted of 13 patients, 10 men and 3 women, with chronic plaque psoriasis. The observation period was 12 weeks; the effects of therapy were assessed on the basis of a PASI score adapted to the right/left-side comparison technique, the subjective evaluations of the investigator and patients and the results of 20-MHz sonography. RESULTS: There was a more rapid development of beneficial effects with the use of calcipotriol in the initial 8 weeks, although differences in effects were significant only at the time point of therapy week 8 (p < 0.05). After 12 weeks, neither the PASI score nor 20-MHz sonography showed significant differences between the two treatments. While the efficacy of the calcipotriol preparation reached a maximum in the first 4 weeks and then began to subside, the effects of the vitamin B(12) cream containing avocado oil remained at a constant level over the whole observation period. This would indicate that the vitamin B(12) preparation containing avocado oil may be suitable for use in long-term therapy, a hypothesis further supported by the fact that the investigator and the patients assessed the tolerability of the vitamin B(12) cream containing avocado oil as significantly better in comparison with that of calcipotriol. CONCLUSION: The results of this clinical trial provide evidence that the recently developed vitamin B(12) cream containing avocado oil has considerable potential as a well-tolerated, long-term topical therapy of psoriasis.

Adult↗
PubMed2001

Interpapillary lines--the variable part of the human fingerprint.

The dermatoglyphic pattern of human palms and soles is individually unique and unchanging. Their prints show the course of the papillary ridges as papillary lines. Case reports and a few older studies of repeatedly taken fingerprints could, however, show that so-called interpapillary lines can develop between the papillary lines. The questions of this study were: How often do interpapillary lines occur? Can the differences between papillary and interpapillary ridges be quantified? Five-hundred and two ink prints of the palms and fingers from the archive of the Bochum Police Department were examined retrospectively. In 121 volunteers, the appearance of interpapillary lines was examined prospectively. From the later collective, the fingerprints of 13 people with interpapillary lines and nine people without were examined further by taking two silicon prints and measuring them with laser profilometry In 215 of the 502 ink prints (42.8%) interpapillary lines could be demonstrated. In those subjects younger than 20 years they were less frequently observed (34.1%) than in those above the age of 20 (51.8%). In all cases using laser profilometry the interpapillary lines could be related to a corresponding interpapillary ridge. The interpapillary ridge heights were 24.9 +/- 10.0 microm, significantly lower than the papillary ridges, which measured 59.0 +/- 19.2 microm. Interpapillary ridge widths were with 194.8 +/- 65.1 microm significantly narrower as compared to 435.5 +/- 57.4 microm in the papillary ridge. Those papillary ridges, between which interpapillary ridges were found, were significantly further apart from each other (610.5 +/- 78.9 microm) than those without interpapillary ridges (484.9 +/- 70.6 microm). During the course of a lifetime new ridges between the regular papillary ridges can develop or manifest. The fact that interpapillary lines are more frequently found on the right hands in men and those with increasing age is consistent with the theory that they correspond to degenerative changes and with sensitivity of touch.

Adolescent↗
PubMed2001

[Acute generalized cat scratch disease in myelodysplastic syndrome].

In patients with normal immunity, cat scratch disease typically develop a papule at the portal of entry and no other cutaneous features. A 73 year old male patient with a myelodysplastic syndrome developed generalized petechial, papular and, vasculitic skin lesions in association with cat scratch disease. After the diagnosis was established by identifying the causative organism in a lymph node biopsy, the patient was treated with erythromycin for three weeks resulting in progressive clearance of the skin lesions. Apart from the soluble IL-2 receptor, no other serologic inflammatory parameters were elevated. IgG antibodies against Bartonella henselae and Bartonella quintana increased only slightly during acute exacerbation of the disease, but significantly increased some months later. The diagnosis was established by the positive staining of the lymph node biopsy using the Warthin-Starry stain.

Administration, Oral↗
PubMed2000

Macroangiopathy of the upper extremities in progressive systemic sclerosis.

BACKGROUND: Raynaud's phenomenon is a hallmark of progressive systemic sclerosis (SSc). While nailfold capillary changes are well known, morphological changes in larger arteries have less been focused on. OBJECTIVE AND METHODS: In the study presented we examined how often in digital subtraction angiography organic changes of the arteries of the fingers, hands and forearms were observed, whether they showed a typical picture like the changes in nailfold capillaries and whether they correlated with cutaneous sclerosis, Raynaud's phenomenon and serological findings. 29 patients were examined, 14 with acroscleroderma and 15 with proximal ascending sclerosis. RESULTS: In 27 of those 29 patients a stenosis of the arteries of the upper extremity was found. The frequency of arterial occlusions decreased from the fingers (26 patients) to the forearms (9 patients with occlusion of the ulnar artery, none with occlusion of the radial artery). The arteries of 47% of patients with proximal ascending sclerosis showed no reactivity towards the alpha-sympatholyticum tolazoline hydrochloride due to severe organic changes while in patients with acroscleroderma only 14% of patients did not respond to tolazoline hydrochloride. The severity of Raynaud's phenomenon did not correlate with the severity of the angiographic findings. In patients with stenoses refractory to tolazoline hydrochloride and in those with occlusions Scl-70 autoantibodies were more frequently positive than in other patients with SSc (44% compared to 23%). CONCLUSION: As in SSc the severity of the organic arterial changes is in close correlation with the extent of the cutaneous sclerosis and with the serological findings the arterial system should gain much more importance in the diagnosis and therapy of SSc.

Aged↗
PubMed2000

Blood cytokine response of low-dose molgramostim (rhGM-CSF)-treated patients.

We examined leukocyte counts and ex vivo cytokine response of whole blood to lipopolysaccharide (LPS) or lipoteichoic acid (LTA) in patients under low-dose molgramostim therapy. Patients were injected subcutaneously daily for ten days with 1 microg/kg (n=9) or 2 microg/kg (n=14) molgramostim. Leukocytosis was observed in all patients, but only the eosinophil fraction was significantly increased in relation to other leukocyte populations. Ex vivo IFN-gamma release was decreased and IL-10 and IL-1ra secretion were increased in response to LPS or LTA. Thus, in non-neutropenic patients, leukocytosis can already be initiated by low doses of molgramostim. The ex vivo cytokine data suggest that these doses prime blood towards a systemic anti-inflammatory response.

Adult↗
PubMed2000

Local oxygen content in the skin is increased in chronic venous incompetence.

In skin lesions of chronic venous incompetence (CVI) transcutaneous oxygen pressure (tcpO(2)) at the ankle is often reduced. However, in some CVI patients the tcpO(2) during suprasystolic occlusion remains significantly higher than in healthy subjects. The aim of the present study was to investigate which kind of CVI patients develop this phenomenon and whether the higher tcpO(2) during occlusion is caused by a smaller oxygen consumption of the skin or by an increased local oxygen content. The oxygen consumption of the skin was measured by the pO(2) decrease (DeltatcpO(2)/Deltat) after stopping the arterial oxygen supply when the hemoglobin was saturated by oxygen inhalation, i.e., at tcpO(2) values above 120-130 mmHg. By multiplying the tcpO(2) with the mean oxygen solubility coefficient of the skin the content of physically dissolved oxygen is obtained. The decrease of tcpO(2) in the 55- to 45-mmHg range indicates the consumption of oxygen physically dissolved and chemically bound to hemoglobin. It gave a parameter for estimating the local hemoglobin content of the skin. These values and the minimal tcpO(2) after a 5-min arterial occlusion were measured in 14 healthy subjects, in 13 patients with varicose veins, but no skin lesions, in 10 patients with CVI lesions like white atrophy and lipodermatosclerosis and in 16 CVI patients with open venous ulcers. During suprasystolic occlusion tcpO(2) at the ankle remained significantly higher in CVI patients with skin lesions than in the healthy control subjects (25.6 +/- 18.9 versus 8.0 +/- 7.0 mmHg). The steepness of the tcpO(2) decrease caused by cutaneous oxygen consumption in healthy subjects was not significantly different from the CVI patients. In contrast, the decrease of tcpO(2) at the ankle between 55 and 45 mmHg was 1.9 +/- 2.0 mmHg/s in the control group and 0.7 +/- 0.5 mmHg/s in the group with open venous ulcers. These results indicate a higher hemoglobin content in the skin of the CVI patients than in healthy subjects. Obviously, the hemoglobin bound oxygen content in the skin of CVI patients is increased. Thus, a lack of oxygen is unlikely to be the primary reason for the development of skin lesions in CVI.

Administration, Inhalation↗
PubMed2000

[Implicit personality theories in dermatology. An empirical study on the image that physicians have of patients of diverse dermatologic diagnosis groups].

BACKGROUND AND OBJECTIVE: Studies about the personality of dermatological patients are numerous. The results are inconsistent and peculiarities of the personality are rarely confirmed. Contrary to the usual procedure, this study asks for the impressions physicians have about their patients. PATIENTS/METHODS: To elicit associations dependent on a dermatological diagnosis, 27 physicians filled in a three-dimensional differential asking for their impressions about patients with atopic dermatitis, leg ulcer, malignant melanoma, or psoriasis vulgaris in order to quantify these impressions. RESULTS: The dimension valence (good-bad) did not differ between the groups. The dimensions of excitation (active-passive) and potency (strong-weak) showed the biggest differences between patients with atopic dermatitis and ulcus cruris. The latter get significantly lower values on both dimensions. The correlations between the impression and the duration of employment in dermatology were low. CONCLUSIONS: In our opinion it is necessary to raise the impression of medical personal about their patients because these impressions affect the interaction of the personal with the patient.

Dermatitis, Atopic↗
PubMed2000

[Follicular dyskeratosis: successful treatment with local retinoid].

Therapy of Darier disease is rarely satisfactory. Oral retinoids can improve the skin lesions. Because of previous positive results with topical retinoids, which were often not practical because of marked skin irritation, two patients were treated with the new, topical acetylene-retinoid tazarotene in a 0.01% gel preparation. In both patients skin cleared within 2 to 4 weeks. After stopping the medication patients did not develop any new skin lesions for 12 months. In a third patient, healing with tazarotene gel 0.025% was faster than with a topical preparation containing 10% urea. Tazarotene is an important addition to the therapeutic possibilities in Darier disease.

Administration, Topical↗
PubMed2000

The histomorphologic changes at the saphenofemoral junction in varicosis of the greater saphenous vein.

BACKGROUND: Insufficiency of the greater saphenous vein starts at its junction with the femoral vein, so that the histomorphologic changes at the saphenofemoral junction are of special interest. METHOD: In this study we examined which histologic changes occur in the vein walls 5 cm distal to the junction of the greater saphenous vein into the femoral vein and whether these changes correlate to the clinical severity of venous disease. For this the morphologic changes of 28 venous specimens were described qualitatively and the two layers of the media were measured at their thickest and thinnest points. RESULTS: The three-layered structure of the vessel wall with intima, media and adventitia was destroyed in 21% of the cases, the intima and media were fused into one another due to loss of the membrana elastica interna. In 93% the intima was thickened at circumscribed areas. Sprouting of capillaries into the intima was found only if varicosis lasted for longer than 15 years. Aneurysms were found in 29% of the specimen. In part of severe aneurysms the media was completely missing. The thickness of the circular muscle layer of the media varied more than that of the longitudinal muscle layer (difference between minimal and maximal thickness 400 +/- 130 microM compared to 190 +/- 90 microM). With increasing clinical severity of the chronic venous insufficiency the difference between minimal and maximal thickness of the circular muscle layer increased (330 +/- 90 microM at stage I according to Widmer, 490 +/- 130 at stage III). CONCLUSION: The coexistence of muscular hypertrophy and atrophy in varicose veins is regarded by us as a reaction to altered perfusion and pressure in the veins. Considering the frequently severe damage to the veins, indication for a vein sparing therapy has to be viewed with care.

Adult↗
PubMed2000

UVA1 irradiation induces deoxyribonuclease dependent apoptosis in cutaneous T-cell lymphoma in vivo.

Cutaneous T-cell lymphoma (CTCL) is a malignancy of mature T-cells, predominantly of the helper phenotype, that primarily invade the skin. Different photo- and chemotherapeutic treatments are known to be beneficial in early-stage CTCL. This observation has initiated prospective investigations into the efficacy of phototherapeutic regimens. The purpose of our study was to investigate the ability of medium-dose UVA1 phototherapy (60 J/cm2) to induce apoptosis (programmed cell death) in skin infiltrating T-cells of CTCL in vivo. We describe the results of three different staining methods for formalin-fixed, paraffin-embedded tissue sections. The in situ end-labeling (ISEL) procedure, nuclear staining using the DNA-binding fluorochrome Hoechst 33342, and immunohistochemistry using polyclonal antibodies against recombinant mouse deoxyribonuclease I (DNase I) demonstrated that UVA1 irradiation was able to induce marked apoptosis in CTCL. Thereby, ISEL and Hoechst staining clearly revealed DNA-condensation and nuclear fragmentation, accompanied by the formation of typical "apoptotic bodies". The accumulation of DNase I immunoreactivity in the cytoplasm of lymphocytes in UVA1 irradiated skin indicated that DNase I or DNase I-related endonucleases may have acted as apoptotic endonuclease(s) which were synthesized after UVA1 irradiation prior to their apoptotic elimination.

Aged↗
PubMed2000

Superior vena cava syndrome presenting as persistent erythematous oedema of the face.

The superior vena cava syndrome occurs when extrinsic compression or intraluminal occlusion impedes blood flow through this vessel. Detecting the characteristic cutaneous features can lead to an early diagnosis of this condition. We report a 73-year-old patient with a 4-year-history of erythematous oedema of the face. The underlying cause was a large retrosternal goitre obstructing the superior vena cava. Subtotal thyroidectomy led to dramatic improvement of all dermatologic symptoms.

Aged↗
PubMed2000

The transepidermal oxygen flux from the environment is in balance with the capillary oxygen supply.

It has been known since the nineteenth century that oxygen is taken up by the human skin. With a newly developed sensor it became possible to examine the influence of the vascular supply on the oxygen flux into the skin, tcJ(O2). tcJ(O2) was measured optically by determining the oxygen partial pressure difference, DeltapO2 across a diffusion test membrane, which itself was brought into close contact to the skin surface. Under these conditions DeltapO2 is proportional to the tcJ(O2). The skin perfusion was varied by the application of a hyperemizing ointment on the abdomen of 12 volunteers and by suprasystolic occlusion at the thigh of 20 volunteers. The tcJ(O2) was measured at a temperature of 33 degrees C of the humid skin. It was compared with the skin perfusion monitored by laser Doppler flow, and the capillary oxygen supply measured by transcutaneous partial pressure of oxygen, tcpO2, at an electrode temperature of 37 degrees C. The transcutaneous O2 flux produced a distinct DeltapO2 of 81.8 +/- 8.2 Torr (abdomen) and 72.8 +/- 12.3 Torr (ankle). In hyperemic skin on the abdomen the O2 flux was reduced (DeltapO2 = 57.7 +/- 10.6 Torr). The tcpO2 increased from 8.7 +/- 10.7 to 35.1 +/- 16.9 Torr. During suprasystolic occlusion, DeltapO2 increased by 6.4 +/- 2.3 Torr, whereas laser Doppler flow and tcpO2 decreased significantly. These results indicate that the total oxygen supply of the epidermis and the upper dermis is guaranteed even if the perfusion varies.

Adult↗
PubMed1999

[Phototherapy in severe atopic dermatitis. Comparison between current UVA1 therapy, UVA1 cold light and combined UVA-UVB therapy].

Severe atopic dermatitis, especially when involving the face, does not respond well to conventional therapy. In the present prospective randomized trial, we compared therapeutic efficiency of medium-dose UVA1, medium-dose cold light UVA1 (15 treatment courses with 50 J/cm2 each) and combined UVA-UVB phototherapy. Four (13.3%) of 30 UVA1 treated patients, one (3.4%) of 30 UVA1 cold light treated patients and three (30%) of 10 patients treated with combined UVA-UVB discontinued therapy course before finishing treatment protocol because skin status did not improve or even deteriorated. In the other patients treated over a period of three weeks, skin status improved significantly or even cleared completely in 80.8% of UVA1 treated and in 89.7% of UVA1 cold light treated patients resulting in a significant decrease of the SCORAD-Score (UVA1 group from 68.6 +/- SD 10.9 to 29.8 +/- SD 7.1 and UVA1 cold light group from 72.5 +/- SD 13.4 to 23.8 +/- SD 11.6; p < 0.05 each). In the UVA-UVB treated group, the SCORAD-Score also decreased (from 71.0 +/- SD 9.4 to 41.6 +/- 10.5), but significantly less than in both UVA1 treated groups (p < 0.05 each). Four weeks after completing therapy UVA1 treated patients showed a prolonged therapy benefit as compared to UVA-UVB treated patients. Plasma levels of eosinophil cationic protein and soluble interleukin-2 receptor significantly decreased under UVA1 phototherapy but not under UVA-UVB therapy. Compared to conventional UVA1 phototherapy, UVA1 cold light phototherapy showed advantages due to the absence of potentially proinflammatory effects based on temperature-induced increase of skin blood flow (quantified by Laser doppler scanning) and increased sweat production (determined by the patient using a visual analog scale).

Adolescent↗
PubMed1999

[Cyclical intravenous antibiosis as an effective therapy concept in chronic recurrent erysipelas].

The treatment of choice for prevention of recurrent erysipelas is the long-term therapy with intramuscular penicillin. The results are often unsatisfactory. Usually erysipelas recurs when the treatment is stopped. The aim of the present study was to evaluate a new treatment regimen, consisting of intravenous penicillin combined with lymphatic drainage. Fifteen patients who had suffered from three or more episodes of erysipelas within the last two years received 10 Mega I.U. of penicillin per day over ten days every third month over a one year period (patients who were allergic to penicillin received erythromycin). Use of intravenous penicillin was combined with lymphatic drainage performed by a sequential pneumatic compressing device. The treatment results were assessed by clinical examination and laboratory tests as well as by laser Doppler imaging every third month. During the one year treatment period and a further year of follow-up, 14 of 15 patients had no recurrent erysipelas. Only a 65 year old patient suffering from Parkinson heart failure, chronic lymphedema and an extensive stasis ulcers had recurrent erysipelas. The present treatment regimen appears to be an effective therapy for prevention of recurrent erysipelas.

Adult↗