Biomedical subjects
Publications and source records attributed to R Schröter.
We report on a 7-year-old boy suffering from two rare genetic diseases, namely hyalinosis cutis et mucosae and Ehlers-Danlos syndrome. The diagnosis was finally established after 7 years, by means of light and electron microscopy and immunohistology. Therefore, this report deals with the typical clinical and morphological features of both genetic disorders.
In a patient with lichen ruber, skin lesions appeared exclusively on sun-exposed sections of the body. This localization is atypical in Europe. In tropical and subtropical countries lichen ruber actinicus can be observed in up to 30% of the population.
Three cases of acquired immune deficiency with unusual dermatological symptoms of early syphilis are reported. All three patients were promiscuous homosexual men with confirmed HIV infections and signs of an impaired immune status. One patient was apparently healthy, one had the AIDS-related complex and one was suspected of having LAS. Although none showed serious symptoms as regards their general well-being, the syphilitic skin manifestations corresponded to earlier reports of malignant syphilis.
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A prophylactic vaccine represents a major hope for the control of sexually transmitted diseases. The current general vaccine strategies and the status of vaccine development against infections with Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis and Herpes simplex virus are described. Vaccines consisting of whole infectious agents are replaced by protective subunits. A subunit vaccine has the advantage to be free from other components, which are not relevant for protection and which may confer unwanted side effects. At the present time vaccine development against infections with Neisseria gonorrhoeae and Herpes simplex virus seems to be the most progressed. With monoclonal antibodies several surface components could be identified, which are of importance for the pathomechanism. With Treponema pallidum and Chlamydia trachomatis the development is delayed by unsolved problems of immunity. For the production of vaccines molecular-biologic methods, like protein synthesis or gene-cloning will be used. Genetically modified live vaccines or polytope hybrid vaccines will gain importance in the future.
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In 1981/82 the first representative health survey (SOMIPOPS "Socio-medical indicators for the population of Switzerland") was conducted 1) to gain representative data on health status (perceived morbidity), use of health services, 2) to analyse the demand for health care, and 3) to develop reliable health and use indicators. In order to validate questionnaire and interview data (primary data sources), two additional (secondary sources) were used: income and wealth data for the whole of the original SOMIPOPS sample (N = 5,860), and health insurance records for 80% consenting members of the interviewed sample. The integration of different data sources on an individual level greatly enhances the analytic potential of health survey.
A report is presented of a patient with tertiary syphilis of the skin with biologically false negative 19S-(IgM-)FTA-ABS-test. This possibility of failure in this otherwise highly reliable test for the detection of specific 19S-(IgM-)antibodies is still little known.
In 72 patients with chronic pancreatitis results of tbe secretin-cholecystokinin test were compared with those of several indirect test of pancreatic function (faecal fat content, chymotrypsin activity in faeces, peptide-PABA test, fluorescein-dilaurate test and weight of faeces). In 46 patients with markedly impaired pancreatic secretion the indirect tests were abnormal in 56-83% of cases. In 26 patients with normal or upper-limit-of-normal excretory function the same tests were abnormal in 15-77%. These results indicate that indirect tests of pancreatic function are of only limited value in the early diagnosis of pancreatic insufficiency.
The proposed role of parathyroid hormone as an important agent for the development of certain uremic complications could not be confirmed in studies correlating, in dialysis patients, the nerve conduction velocity and the serum lipids with four different immunochemically defined forms of circulating parathyroid hormone. To a certain extent the data invalidate suggestions which favor parathyroid hormone as a leading uremic toxin.
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Five female patients with benign gonococcal sepsis were seen during the second half of 1974. All cases presented the typical clinical triad of fever, arthralgias and characteristic skin lesions, the macroscopic and microscopic appearance of which could be best classified as superficial vasculitis. Skin biopsies were taken from 3 patients and the histopathological findings are discussed in detail. Genital symptoms were slight or absent, and only very few gonococci could be detected in stained smears from genital sites. However, Neisseria gonorrhoeae could be cultured without difficulty from the genitourinary tract in all cases, while cultures from blood and skin lesions were sterile. In fresh pustules gonococci could be demonstrated by immunofluorescence in 2 cases. The complement-fixation-test is regarded as a useful supplementary diagnostic procedure.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.