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Biomedical subjects

S Fronhoffs

Publications and source records attributed to S Fronhoffs.

5 recordsLinked to original sources

[Severe soft tissue infection with bulla formation, sepsis, multiple organ failure].

A 53-year old patient with diabetes mellitus presented with a painful swelling of the left thigh in an out-of-town hospital. Because of the slow progression associated with multiorgan dysfunction, a soft-tissue infection with sepsis was suspected. Strains of streptococcus of serogroup B were isolated from specimens, taken from certain areas of the affected skin. After transferring the patient to our hospital the diagnosis of a B-streptococcal associated necrotizing fasciitis was confirmed. Despite intensive medical treatment and several surgical interventions the patient deceased due to an acute severe liver failure as a consequence of a secondarily developed septic shock. In comparison to the well-known cases caused by streptococcus group A, the B-streptococcal associated necrotizing fasciitis is a rather rare occurring disease.

Diagnosis, Differential

[Recurrent respiratory tract infections].

On the occasion of a treatment of frequent infections of the upper respiratory tract an antibody deficiency syndrome was noticed in a 32-year-old female patient. Further investigations revealed a variable immunodeficiency syndrome, a disease belonging to the primary humoral immune defects and presenting with multiple clinical manifestations. Leading symptoms, however, are recurring respiratory infections that may lead to bronchiectasis. Therapy consists in the prevention of infections by periodical intravenous substitution with 7-S immunoglobulins and opportune prescription of antibiotics.

Adult

[Fever of unknown origin].

A 25-year-old patient presented with fever over a period of more than three months, night sweats, fatigue and a weight loss of more than 10 kg. A splenomegaly and an enlargement of cervical, thoracic and abdominal lymph nodes were found. The suspected malignant hematologic disorder could not be confirmed. Instead, epithelioid noncaseating granulomas in the bone marrow and a cervical lymph node as well as an elevated serum ACE and a lymphocytic alveolitis were found. These findings led us to the conclusion that the patient was suffering from sarcoidosis. Treatment with corticosteroids resulted in complete regression of all symptoms, including the splenomegaly and the enlargement of the lymph nodes. Sarcoidosis is an important consideration in differential diagnosis of fever of unknown origin, even in the absence of pathological changes on X-ray films of the chest.

Adult

[Polyuria, polydipsia].

A 24 year old patient with epigastric pain, polyuria, polydipsia and hypercalcemia was admitted to the hospital. Besides the frequent causes of hypercalcemia such as primary hyperparathyroidism and malignancy-related hypercalcemia we had to consider sarcoidosis because of massive splenomegaly. The interstitial lung disease shown on x-ray films of the chest, the epithelioid granulomas in lung tissue and the increased ACE confirmed the diagnosis of sarcoidosis. Hypercalcemia is found in less than 5% of all cases with sarcoidosis. After treatment with steroids, diphosphonates and diuretics all symptoms and the hypercalcemia improved.

Adult

Induction of immediate-early genes by angiotensin II and endothelin-1 in adult rat cardiomyocytes.

OBJECTIVE: Few molecular signals for induction of myocardial hypertrophy have been identified. This study was carried out to investigate the action of angiotensin II and endothelin on the growth- and differentiation-related genes Egr-1 (early growth response gene 1) and c-fos in isolated adult rat cardiomyocytes. METHODS: Cardiac myocytes from male Wistar-Kyoto rats were isolated and incubated with angiotensin II and endothelin-1 in Dulbecco's modified Eagle's medium. RNA was isolated and blotted, and densitometric analysis was performed. All experiments were repeated at least three times. RESULTS: Endothelin-1 (10(-7) mmol/l) induced a 20-25-fold rise in Egr-1 messenger RNA within 15 min. This effect was dose-dependent. c-fos was induced 10-20-fold within 15 min with similar dose-response characteristics. Angiotensin II also induced Egr-1 and c-fos with kinetics similar to endothelin but a cofactor from fetal calf serum was needed for full c-fos expression. The protein kinase C activator phorbol 12-myristate 13-acetate also induced Egr-1. CONCLUSIONS: The results identify Egr-1 and c-fos as target genes for the action of endothelin and angiotensin II in the adult myocardium suggesting that induction of the genes may be part of the signal transduction pathway for angiotensin II and endothelin in the myocardium.

Angiotensin II