Biomedical subjects

S Born

Publications and source records attributed to S Born.

6 recordsLinked to original sources

PubMed2003

[Pyoderma gangrenosum and orbital pseudotumor].

Pyoderma gangrenosum belongs to the chronic, neutrophilic and necrotic dermatoses. These very painful, inflammable and purulent skin-ulcers often arise after injury or surgical intervention. About half of the patients suffer from systemic disease, for example hematological, gastrointestinal or rheumatic diseases. Our report includes a 77-year-old female with a multilocular emergence of pyoderma gangrenosum following surgery for an orbital pseudotumor. An additional lesion was detected on her anterior neck. Because the possibility of wound-infection was suspected, the lesion was treated locally and with a systemic antibiotic therapy. After this treatment the condition of the wound deteriorated. Upon dermatological examination, pyoderma gangrenosum was identified and a immunosuppressive therapy with corticosteroids and cyclosporin was initiated. As a result of this treatment the lesion healed slowly--with the formation of typical, atrophic and reticular scars. A connection between the pyoderma gangrenosum and the orbital pseudotumor can, on the basis of similar clinical and structural characteristics, not be excluded. A related disease was not diagnosed in this patient. Recurrence can be predicted in patients who have had skin injuries, therefore strict observation is required.

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PubMed2001

[Postoperative pyoderma gangrenosum].

Post-traumatic pyoderma gangrenosum is an ulceronecrotizing dermatosis that is rare and therefore often misinterpreted. After excision of an orbit pseudotumor by otorhinolaryngological surgeons, a 77-year-old woman developed a multifocal ulcerous wound dehiscence. Although the case history, development and clinical picture were characteristic, the correct diagnosis was established and successfully treated 6 months later by a consulting dermatologist. Postoperative pyoderma gangrenosum should be taken into consideration if a sterile, painful, chronically progressive, ulcerative and sludgy defect develops after surgery. The preoperative investigation should include pyoderma gangrenosum in the personal history and take associated diseases into account (e.g., inflammatory bowel diseases, blood diseases, rheumatological diseases and vasculitis) to provide prophylactic immunosuppressive pharmacotherapy. In minimally invasive or cosmetic surgery these aspects may have a forensic impact, as pyoderma gangrenosum heals with atrophic scars. The purpose of this paper was to describe the clinical characteristics of pyoderma gangrenosum, its prevention and its therapy.

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PubMed1998

Baroreflex sensitivity and heart rate variability in coronary disease compared to dilated cardiomyopathy.

This study was designed to compare baroreceptor sensitivity and heart rate variability as measures of cardiac autonomic tone in patients with coronary disease (CAD, n = 49) and idiopathic dilated cardiomyopathy (IDC, n = 130). Time domain heart rate variability, including SDNN, SDANN, and pNN50, was determined during 24-hour Holter ECG. Baroreflex sensitivity was analyzed nonivasively using the phenylephrine method. Baroreflex sensitivity and heart rate variability were comparable between patients with CAD versus IDC (baroreflex sensitivity: 6.1 +/- 3 vs 6.9 +/- 5 ms/mmHg; SDNN: 97 +/- 40 vs 114 +/- 41 ms; SDANN: 83 +/- 33 vs 99 +/- 41 ms; pNN50: 3.9 +/- 4 vs 9.6 +/- 13 ms, P = NS for all comparisons). Likewise, a subgroup analysis of patients with a left ventricular ejection fraction (LVEF) < or = 30% showed no significant difference in baroreceptor sensitivity and heart rate variability between IDC and CAD patients. Patients with CAD and an LVEF > 30% had a decreased heart rate variability but not a decreased baroreflex sensitivity compared to patients with IDC and LVEF > 30% (baroreflex sensitivity: 6.4 +/- 4 vs 8.3 +/- 6 ms/mmHg, P = NS; SDNN: 98 +/- 19 vs 128 +/- 42 ms, P < 0.05; SDANN: 86 +/- 21 vs 112 +/- 43 ms, P < 0.05; pNN50: 4.2 +/- 3 vs 12.3 +/- 8 ms, P < 0.05). Patients with a markedly depressed LVEF show comparable alterations in cardiac autonomic tone whether they have CAD or IDC. Patients with CAD and preserved LV function, however, have a decreased heart rate variability compared to patients with IDC and preserved LV function. The prognostic significance of these findings will be determined prospectively in a large patient cohort at our institution.

Baroreflex↗

PubMed1998

Noninvasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy: design and first results of the Marburg Cardiomyopathy Study.

The Marburg Cardiomyopathy Study (MACAS) is a prospective, observational study designed to determine the value of the following potential noninvasive arrhythmia risk predictors in at least 200 patients with idiopathic dilated cardiomyopathy (IDC) over a 5-year follow-up period: NYHA-class, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, left bundle branch block and atrial fibrillation on ECG, QT/JT dispersion on 12-lead ECG, signal-averaged ECG, ventricular arrhythmias and heart rate variability (HRV) on 24-hour Holter ECG, baroreflex sensitivity, and microvolt T wave alternans during exercise. This article describes the findings among the first 159 patients with IDCs enrolled in MACAS until May 1998 (40 women, 119 men; age: 49 +/- 12 years; LVEF: 32 +/- 10%). Twenty-nine patients (18%) had atrial fibrillation and 130 patients (82%) were in sinus rhythm. Patients with sinus rhythm were further stratified according to LVEF < 30% (n = 54) versus LVEF > or = 30% (n = 76). Compared to patients with LVEF > or = 30%, patients with LVEF < 30% more often had left bundle branch block (43% vs 25%, P < 0.05), nonsustained VT (44% vs 22%, P < 0.05), decreased HRV (SDNN: 95 +/- 39 vs 128 +/- 42 ms, P < 0.01), decreased baroreflex sensitivity (5.6 +/- 4 vs 8.3 +/- 6 ms/mmHg, P < 0.01), and T wave alternans (59% vs 37%, P < 0.05). The prognostic significance of these findings will be determined by multivariate Cox analysis at the end of a 5-year follow-up. Primary endpoints in MACAS are overall mortality and arrhythmic events (i.e., sustained VT or VF, or sudden cardiac death).

Arrhythmias, Cardiac↗

PubMed1982

Blood oxygen affinity in high- and low-altitude populations of the deer mouse.

There is little solid evidence for specific genetic adaptations in animal populations native to high altitude. There is also continuing debate over what oxygen transport characteristics are truly adaptive at high altitude. We have attempted to elucidate both problems through population genetic and physiological studies of the deer mouse, Peromyscus maniculatus. That species is noteworthy because it inhabits the widest range of altitudes of any North American mammal, and it shows a high degree of genetic variation in hemoglobins. Deer mice were collected from 35 populations representing ten nominal subspecies covering a broad geographical range of the United States. The mice were acclimated to low altitude (340 m); then a mixing method was used to determine P50 and other blood gas parameters on samples pooled from individuals of representative hemoglobin genotypes. When the data from all subspecies wee combined, there was a highly significant negative correlation between P50 and the native altitude of the population. Tests on progeny reared at low altitude indicated that the differences in P50 were primarily genetic. Part of the clinal variation in P50 could be attributed to 2,3-DPG effects; high-altitude populations showed lower baseline DPG/Hb ratios. Surprisingly, within those subspecies which inhabit a wide range of altitudes, there was no correlation between P50 and native altitude. Our tentative conclusion from these data and data presented elsewhere is that deer mouse populations do show genetic adaptations to high altitude. However, because of gene exchange between populations, the genetic characteristics of a population reflect the average altitude over a relatively broad geographic area.

2,3-Diphosphoglycerate↗

PubMedDate not supplied

Metastasising malignant lymphoma mimicking necrotising and hyperplastic gingivostomatitis.

This paper presents the case of a 65 year-old woman suffering from recurrent oral aphthoid ulcers which rapidly evolved towards hyperplastic and ulcerated lesions over the entire floor of the mouth. The initial lesions were interpreted as non-specific aphthoid ulcers. Later, a tentative diagnosis of necrotising stomatitis with secondary reactive proliferating epithelial hyperplasia was made. The clinical symptoms and the immuno-phenotyping of lymphocytes circulating in the peripheral blood suggested the diagnosis of CD30-positive large cell anaplastic lymphoma. The biopsy showed only a pseudoepitheliomatous hyperplasia, reactive infiltrates and no lymphoma cells. The disease ran a fulminant course leading to death within 4 weeks due to acute gastro-intestinal bleeding. Autopsy revealed infiltrates of CD30+ large cell anaplastic lymphoma in a submandibular lymph node, in a thrombus stenosing the right subclavian vein, in the spleen, the anterior and posterior gastric wall as well as in the depth of the tumour on the floor of the mouth. The clinical and histopathological spectrum of CD30+ large cell anaplastic lymphoma is considerably variable. The particular feature of pseudoepitheliomatous hyperplasia has been reported especially in CD30+ anaplastic large cell lymphomas. An early correct diagnosis is rendered difficult in insufficient biopsy size, becauses this type of lymphoma often simulates other inflammatory or neoplastic skin diseases. Thus, with a necrotising and hyperplastic gingivostomatitis, the diagnosis of a CD30+ anaplastic large cell lymphoma should be considered.

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