Biomedical subjects
Publications and source records attributed to M Widmer.
We report the case of a 55-year-old patient with recurrent episodes of generalized pustulosis and febrile temperatures. Histological examination revealed subcorneal and spongiform pustules. After a 4 years' course acute exanthematous generalized pustulosis, induced by acetylsalicylic acid was diagnosed. Clinical features, differential diagnosis and causative agents of this rare drug reaction are discussed.
We report an exceptionally severe case of amyloidosis cutis nodularis atrophicans (Gottron) of the lower limbs in a 49-year-old female patient. The diagnosis was made on clinical and histological grounds and was confirmed by immunohistochemical evidence of amyloid of the A-lambda type. For the first time, cutaneous microcirculation in the region of the nodules was investigated by means of fluorescence video microscopy. Pronounced microangiopathy characterized by avascular fields, enlarged and tortuous capillaries and increased transcapillary diffusion of sodium fluorescein, was clearly demonstrable in the area of the nodules. The pathogenetic role of these vascular changes is discussed.
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The cloned murine interleukin 3 (IL 3)-dependent cell lines FD.C/1, 32Dc1-23, and KP3 can each be switched to interleukin 2 (IL 2)-dependent growth states. Replication-defective retroviral vectors have been used to introduce the v-src oncogene into each of these cell lines maintained in either an IL 3- or an IL 2-dependent growth state. These cell lines maintained in an IL 3-dependent growth state were converted to lymphokine-independent growth after infection with v-src. These same cells maintained in an IL 2-dependent growth state and infected with v-src maintained strict lymphokine dependence for growth. Another cloned murine IL 3-dependent cell line, GM, can be switched to a granulocyte-macrophage colony-stimulating factor (GM-CSF)-dependent growth state. GM cells maintained as IL 3- or GM-CSF-dependent cells readily converted to a lymphokine-independent growth state when infected with v-src. These experiments indicate that either there exist differences in the biochemical mechanisms of signal transduction through the IL 3- and IL 2-specific receptors, or developmental processes associated with the switching of cells to an IL 2-dependent growth state influence expression of the v-src gene product. These cell lines offer new ways not only for analyzing biochemical pathways that regulate cell growth, but also for analyzing the control of oncogene expression.
A prospective, controlled, double-blind, randomized multicentre trial in Switzerland has been conducted to investigate the effectiveness of 5 g mezlocillin given during induction of anesthesia for prevention of infectious complications in biliary tract surgery. All adults undergoing elective or emergency surgery were included. Single-dose prevention reduces the incidence of wound infections from 10% to 4%, but does not reduce other kinds of infectious complications. The incidence of wound infections in the control group in Switzerland is only about half that in other countries. It is concluded that administration of single-dose mezlocillin to all patients in this type of surgery is justified. On the basis of risk factors it is impossible to predict reliably the patients who do not need protection.
A prospective, controlled, double-blind, randomized multicenter trial including 12 Swiss hospitals with 358 patients was carried out. The aim of the study was to investigate whether a single-dose prophylaxis with 5 g mezlocillin given immediately before surgery can reduce not only the incidence of wound infections but other bacterial complications as well. Of the 324 correct protocols, 165 belonged to the placebo and 159 to the mezlocillin group. The two groups are comparable in all regards. The incidence of wound infections was 10% in the control and 4% in the treated group (p less than 0.05). The number of other infectious complications could not be reduced. No side effects due to the prevention were observed. Single-dose prevention with mezlocillin is proposed for all patients undergoing biliary tract surgery.
We have evaluated the case histories of all patients who underwent surgery of the biliary tract in 1979. In that year every surgeon was able to administer antibiotics postoperatively whenever he considered it necessary. Of the 71 patients, 39% received postoperative antibiotic treatment. In 1980, 50 patients over the age of 50 received a 36-hour course of mezlocillin prophylaxis when they underwent surgery of the biliary tract, either as an elective or emergency operation. Only 8% of these patients required antibiotics postoperatively. In comparison to the 39% from 1979, this difference is highly significant statistically. This pilot study justifies further investigations to determine whether single-dose mezlocillin prophylaxis is able to reduce the incidence of infectious complications, the duration of the hospital stay and the total amount of antibiotics administered.
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Monocytopoietic proliferation activity was investigated in patients with untreated Hodgkin's disease, Hodgkin's disease in long-term complete remission, and untreated non-Hodgkin's lymphoma of the lymphosarcoma and reticulosarcoma type. Untreated Hodgkin's disease was found to be associated with a rise in medullary monocyte production which returned to normal during long-term complete remissions. In contrast, monocyte production was increased in only 5 out of 14 patients with lymphosarcoma and reticulum cell sarcoma, normal in 3, and reduced in 6. In neither of these lymphomas was any relation between monocyte production and stage or histology of the disease detectable.
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