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Biomedical subjects

R Knobler

Publications and source records attributed to R Knobler.

At least 55 records · Page 3Linked to original sources
PubMed1993

Results and tissue healing after copper-vapour laser (at 578 nm) treatment of port wine stains and facial telangiectasias.

Twenty-four patients with port wine stains (PWS), and 33 patients with facial telangiectasias were treated with a copper-vapour laser (CVL) operating at 578 nm. Good to excellent results were obtained in 52% of PWS and 69% of facial telangiectasias. Enzyme histochemistry revealed vessel-selective damage with energy densities up to 12 J/cm2, but a non-specific coagulation necrosis with higher fluences (> or = 15 J/cm2). With vessel-selective fluences only moderate blanching was obtained in two PWS. All other evaluated patients were treated using non-selective energy densities. Tissue healing was comparable with that after argon laser treatment. The theoretically correct wavelength (578 nm) alone appeared to be no guarantee of vessel-selective damage. The laser employed lacked adequate power (only 1.3 W maximum) to transmit sufficient energy into the tissues in a short exposure time. However, the clinical results confirm the value of the CVL in the treatment of superficial cutaneous angiodysplasias.

Adolescent↗
PubMed1993

[Interferon-alpha in cutaneous T-cell lymphoma].

There exists a variety of treatment modalities for cutaneous T-cell lymphoma (CTCL) which are used according to localization and extension of the disease. Additionally, in the last years it has been demonstrated by several groups that interferon-alpha (IFN-alpha) therapy dependent on stage of the disease results in response rates of 40 to 50%. We could demonstrate that the combination of low dose IFN with retinoids is able to induce long term remissions with low incidence of side effects. Other combinations of IFN-alpha with standard therapies and/or experimental therapies (Pentostatin) seem to contribute-according to preliminary data-to an improvement of remission rates in CTCL.

Clinical Trials as Topic↗
PubMed1992

High incidence of asymptomatic urogenital infection in patients with uveitis anterior.

Acute anterior uveitis (AAU) may be associated with systemic infectious or inflammatory disease. We examined 92 patients with the first attack of acute anterior uveitis; all patients were free of any extraocular symptoms. A thorough clinical examination did not reveal any systemic underlying disease. In the course of microbiological examination, however, a high incidence of asymptomatic infection of the urethra and/or cervix with ureaplasma urealyticum, chlamydia trachomatis and mycoplasma hominis was found. Infections with ureaplasma were significantly more frequent in patients with AAU when compared with a sex- and age-matched control group. There was no statistically valid association of these infections with the HLA-B27 phenotype in the patients. The higher rate of urogenital infections in patients with AAU may reflect a higher rate of sexual promiscuity. Transmission of infectious agents seems to be one possible factor in the pathogenesis of AAU.

Acute Disease↗
PubMed1992

Treatment of traumatic tattoos with various sterile brushes.

BACKGROUND: Various types of brushes are efficient for the removal of foreign material accidentally projected into the skin by explosive or abrasive trauma. OBJECTIVE: To evaluate how different times between injury and treatment influenced esthetic results, we retrospectively evaluated 14 patients subjected to the brushing technique. METHODS: Two groups were identified. Group I had been treated within 24 hours of injury. In group II debridement had been performed later. RESULTS: Cosmetic results were strikingly better in group I. CONCLUSION: Our results demonstrate that debridement of traumatic tattoos should be carried out as soon as possible to achieve favorable cosmetic results.

Adult↗
PubMed1992

Correlations of unique clinical, immunotypic, and histologic findings in cutaneous gamma/delta T-cell lymphoma.

Cutaneous T-cell lymphoma is a malignancy of T cells that express a clone-specific heterodimer T-cell receptor for antigen. The second recognized case of an epidermotropic malignancy of T-cells expressing gamma/delta T-cell receptor-expressing cells is reported. The immunophenotype of the malignant T-cells was CD3+, CD2+, CD7+, gamma/delta T-cell receptor+, CD4-, CD8-, and alpha/beta T-cell receptor-. The clinical features were remarkable for extreme epidermotropism with a scant dermal lymphomatous infiltrate. Profound keratinocyte necrosis occurred in areas of malignant skin infiltrates. Despite cutaneous lesions covering more than 50% of the skin surface of the patient, no adenopathy or splenomegaly was detected. The intense epidermotropism of this patient's gamma/delta T-cell receptor-expressing cells and the putative cytolytic properties of CD4- CD8- gamma/delta contributed to the destruction of epidermis. Remission was induced with a combination of electron beam and extracorporeal photochemotherapy.

Antigens, CD↗
PubMed1992

Treatment of erythrodermic cutaneous T-cell lymphoma with extracorporeal photochemotherapy.

BACKGROUND: This original cohort of patients with erythrodermic cutaneous T-cell lymphoma (CTCL) was reported to have clinical improvement with photopheresis during the 12 months of the original study. No long-term follow-up data have been available to examine the impact of this therapy on the disease. OBJECTIVE: Our purpose was to provide long-term follow-up on the original 29 erythrodermic CTCL patients treated with photopheresis and to compare these results with historical controls. METHODS: Files of patients from the original photopheresis study centers were reviewed and their current status was documented. RESULTS: The median survival of the treated patients was 60.33 months from the date of diagnosis and 47.9 months from the date of the start of photopheresis therapy. A complete remission has been maintained in four of the six patients who achieved complete responses in the original study. The best responses were seen in patients with a lower CD4/CD8 ratio in the peripheral blood at the start of therapy. CONCLUSION: Photopheresis can influence the natural history of erythrodermic CTCL by inducing remissions and prolonging survival with minimal toxicity.

CD4-CD8 Ratio↗
PubMed1992

Reactive lentiginous hyperpigmentation after cryosurgery for lentigo maligna.

BACKGROUND: Twenty patients treated for lentigo maligna of the face with cryosurgery developed benign lentiginous hyperpigmentation mimicking a recurrence. OBJECTIVE: When cryosurgery is used in the treatment of lentigo maligna, it is important to know whether repigmentation of the scar represents true recurrence or a benign process. METHODS: Twenty patients were treated with cryosurgery for lentigo maligna of the face. Within a follow-up period of 7 to 80 months, frequent clinical observations were made. RESULTS: Lentiginous hyperpigmentation developed within the treatment area in eight patients. Histologic investigation revealed recurrence of lentigo maligna in three and benign hyperpigmentation in five. CONCLUSION: Genetic factors and UV exposure after cryosurgery may favor the development of benign lentiginous hyperpigmentation. Because recurrence of lentigo maligna must be considered, histologic evaluation of repigmentation is mandatory.

Aged↗
PubMed1992

Neuropsychological and structural brain lesions in multiple sclerosis: a regional analysis.

Quantified lesion scores derived from MRI correlate significantly with neuropsychological testing in patients with multiple sclerosis (MS). Variables used to reflect disease severity include total lesion area (TLA), ventricular-brain ratio, and size of the corpus callosum. We used these general measures of cerebral lesion involvement as well as specific ratings of lesion involvement by frontal, temporal, and parieto-occipital regions to quantify the topographic distribution of lesions and consequent effects upon cognitive function. Lesions were heavily distributed in the parieto-occipital regions bilaterally. Neuropsychological tests were highly related to all generalized measures of cerebral involvement, with TLA being the best predictor of neuropsychological deficit. Mean TLA for the cognitively impaired group was 28.30 cm2 versus 7.41 cm2 for the cognitively intact group (p less than 0.0001). Multiple regression analyses revealed that left frontal lobe involvement best predicted impaired abstract problem solving, memory, and word fluency. Left parieto-occipital lesion involvement best predicted deficits in verbal learning and complex visual-integrative skills. Analysis of regional cerebral lesion load may assist in understanding the particular pattern and course of cognitive deficits in MS.

Adult↗
PubMed1990

[Relevance of routine diagnosis of Chlamydia and HIV infections in Vienna prostitutes].

At the Control Center for Veneral Diseases of the Vienna Health Office, 5000 examinations for Chlamydia infection were performed on registered and non-registered prostitutes between 1980 and 1988. During this period, we observed a continuous decrease of the rate of infections from 20.4% to 4% among registered prostitutes and from 31.4% to 12.4% among non-registered prostitutes. Between 1985 and 1988, the cumulative number of HIV infections only rose from 7 to 8 cases among registered prostitutes and from 2 to 3 cases among non-registered prostitutes. All these HIV carriers were associated with i.v. drug abuse. The correlations between these two infections as well as the implications regarding health politics are discussed.

Antibodies, Bacterial↗
PubMed1987

Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy. Preliminary results.

Systemically disseminated cutaneous T-cell lymphoma is generally resistant to chemotherapy and radiotherapy. We tested a treatment involving the extracorporeal photoactivation of biologically inert methoxsalen (8-methoxypsoralen) by ultraviolet A energy to a form that covalently cross-links DNA. After oral administration of methoxsalen, a lymphocyte-enriched blood fraction was exposed to ultraviolet A (1 to 2 J per square centimeter) and then returned to the patient. The combination of ultraviolet A and methoxsalen caused an 88 +/- 5 percent loss of viability of target lymphocytes, whereas the drug alone was inactive. Twenty-seven of 37 patients with otherwise resistant cutaneous T-cell lymphoma responded to the treatment, with an average 64 percent decrease in cutaneous involvement after 22 +/- 10 weeks (mean +/- SD). The responding group included 8 of 10 patients with lymph-node involvement, 24 of 29 with exfoliative erythroderma, and 20 of 28 whose disease was resistant to standard chemotherapy. Side effects that often occur with standard chemotherapy, such as bone marrow suppression, gastrointestinal erosions, and hair loss, did not occur. Although the mechanism of the beneficial effect is uncertain, an immune reaction to the infused damaged cells may have restricted the activity of the abnormal T cells. This preliminary study suggests that extracorporeal photochemotherapy is a promising treatment for widespread cutaneous T-cell lymphoma.

Administration, Oral↗
PubMed1986

Tumor-associated antigen is expressed on lymphocytes from patients with acquired immunodeficiency syndrome.

Monoclonal antibody BE2 recognizes an antigen found on malignant T4+ lymphocytes from cutaneous T-cell lymphoma patients (CTCL). Normal peripheral blood lymphocytes do not express detectable levels of BE2 antigen. Forty-eight percent of patients with the acquired immunodeficiency syndrome (AIDS) had lymphocyte populations that were reactive with monoclonal antibody BE2. Peripheral blood lymphocytes from healthy homosexuals, patients with classical Kaposi's sarcoma or viral syndromes, and healthy normal controls were BE2-. Double-labeling studies demonstrated that BE2+ cells were T lymphocytes. This observation demonstrates that some AIDS patients as well as CTCL patients have circulating cells that express a common lymphocyte abnormality.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Sebum suppression by benzoylperoxide.

Sebum excretion rate (SER) was determined by thin-layer chromatography and based on densitometric data in 9 male and 5 female patients suffering from acne during treatment with 10% benzoylperoxide (BPO). BPO was applied to the forehead (treatment area), whereas gel only was applied to the chest (control area) for 6 weeks. SER decreased in 10/14 subjects, no change was found in 1 subject and 3 patients exhibited an increase in SER. Suppression varied between 12 and 86%. Concomitant SER reduction in control and treatment areas was noted in 6 patients. When treatment and control areas of individual patients were considered for data evaluation, SER decrease was noted in only 4 out of 14 subjects. Similar results were obtained when free fatty acids, triglycerides and squalene data were analyzed. Combined, these data suggest that BPO may affect SER in some patients. The present experiments indicate the importance of adequate controls in such studies.

Acne Vulgaris↗
PubMed1984

Computer-assisted volumetric analysis of cutaneous malignant melanomas.

The total number of neoplastic cells seems to be an important factor in interactions between host and neoplasm. Studies of patients with leukemia indicate that cure of the disease occurs after reduction of leukemic cells below 10(6). With this concept in mind, a calculation of the number of neoplastic cells in cutaneous malignant melanoma was performed by computerized volumetric analysis. Serial sections of three entire lesions were assessed by a system of Videoplan Morphometry. The results were compared with conventional prognostic variables (level, thickness, mitotic index). This method of assessing volume did not improve the prognostic accuracy afforded by simpler methods.

Computers↗
PubMed1983

[External erythromycin therapy of acne].

24 patients suffering from papulo-pustular acne were treated with mono-therapy with 2% erythromycin-containing alcoholic solution for eight weeks. Pustular lesions responded promptly, followed by inflammatory papules. Microbiological investigations revealed a lack of propionibacteria as well as reduction of pathogenic staphylococci. Patients after extended local erythromycin treatment did not show any erythromycin serum levels.

Acne Vulgaris↗
PubMed1983

[The leopard syndrome, a cardio-cutaneous syndrome].

A patient with the "leopard" syndrome presented with cardiomyopathy and a large arteriovenous shunt of the left renal vessels. The skin manifestations included multiple lentigines, junctional naevi, blue naevi, and one malignant lentigo. This syndrome is a rare entity, but in all patients with multiple lentigines the possibility of associated cardiovascular changes should be considered. In addition, regular monitoring of the pigmented lesions should be performed because of the increased risk of development of malignant melanoma.

Adult↗
PubMed1983

Serial determination of serum ferritin levels in patients with malignant melanoma.

In a pilot study, serum ferritin levels of patients with malignant melanoma were found to be increased in stage III of the disease. Therefore, serial determinations were carried out up to 24 months in patients at various stages of the disease undergoing either chemo- or immunotherapy. Serum ferritin was determined by a two-site IRMA technique. Serum samples of 91 patients in different clinical stages of histologically verified malignant melanoma were included in these investigations. 80 healthy individuals were also investigated to determine normal ranges of serum ferritin. In stage III serum ferritin levels were significantly elevated (p less than 0,0005), whereas in stages I and II the values were within the normal range. Repeated serum ferritin levels of 10 patients in stage I and 13 patients in stages II and III without evidence of tumor progression were within the normal range. In 9 patients in stage III the increases in serum ferritin concentration correlated with the degree of dissemination of metastasis. Because of the occurrence of increased ferritin levels only in melanoma patients with progressive metastatic disease, the measurement of serum ferritin might have limited utility in clinical evaluation of melanoma patients as well as in the prediction of recurrence and in monitoring response to therapy.

Female↗
PubMed1982

Sex steroid hormone receptor analysis in malignant melanoma.

Melanomas, as well as benign pigmented nevi, long-term cell cultures of melanoma cells and sixty-six normal skin biopsies, were evaluated for oestrogen and androgen receptor activity by a dextran-coated charcoal method. Oestrogen-binding was observed in 16% and androgen-binding in 40% of all investigated tumours. Normal skin showed 4% oestrogen and 41% androgen receptor activity; melanoma cell cultures expressed the same sex steroid hormone binding as tumour material. The quantitative receptor expression was found to be significantly higher in female than in male melanoma patients. Even though the study shows that to a certain extent malignant melanoma is a hormone dependent tumour, it seems that sex steroid hormones are not exclusively related to the biological behaviour of this tumour. In future, investigations should be expanded to other hormonal influences.

Adolescent↗