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Biomedical subjects

W Bräuninger

Publications and source records attributed to W Bräuninger.

At least 19 recordsLinked to original sources
PubMed2002

[Umbilical metastasis of a gallbladder carcinoma: "Sister Mary Joseph's nodule"].

UNLABELLED: HISTOLOGY AND CLINICAL FINDINGS: A 63-year-old man presented with a firm and crusting umbilical mass which had developed within several weeks. The tumor was 1.5 cm in diameter. There were no other diseases in the patient's history. Physical examination was normal except the umbilical tumor. INVESTIGATIONS: Histologic examination revealed a malignant epithelial tumor corresponding to a metastasis of an adenocarcinoma which could be a carcinoma of the gallbladder or the pancreas. Initially the following clinical examination of the patient showed no pathological findings: gastroscopy and coloscopy gave no hint for a primary carcinoma. Computed tomography of the abdomen revealed a thickened gallbladder wall with an irregular intraluminal contour suspicious of a gallbladder carcinoma. During surgery the gallbladder showed a clearly thickened wall. There were numerous carcinomatous lesions on the peritoneum. A cholecystectomy was performed and the umbilical metastasis was excised. DIAGNOSIS, TREATMENT AND COURSE: Histologic examination revealed a metastatic adenocarcinoma of the gallbladder with tumorous infiltration of the liver tissue and a solitary metastasis in the skin (>>Sister Mary Joseph's nodule<<). During wound healing there were no complications and the patient was demitted 10 days after surgery. Following a recovery phase at home a palliative chemotherapy was planned. Because the patient's general condition worsened he was readmitted to the hospital. He presented with a considerable anemia and an icterus. Sonography revealed a hilar tumor measuring 4 cm in diameter. The intrahepatic bile ducts were congested. A stent was inserted by endoscopic retrograde pancreaticocholangiography. During the following weeks the patient's general condition worsened rapidly and he died 9 months after the skin metastasis had occurred. CONCLUSION: A rapidly developing umbilical mass (>>Sister Mary Joseph's nodule<<) is suspicious of an underlying metastatic adenocarcinoma. The necessary examination and therapy including excision of the umbilical metastasis is warranted without delay.

Adenocarcinoma↗
PubMed2001

[Follicular mycosis fungoides (FMF): a rare disease].

Follicular mycosis Fungoides (FMF) was first described in 1924. Since the first description, 22 patients with this special form of mycosis fungoides have been published. Clinical features include epidermal cysts as well as follicular papules, nodules and hyperkeratoses. FMF can be confused with acneiform dermatoses. In most cases, infiltrated plaques typical for cutaneous T cell lymphoma are also present. Histology shows a monomorphic CD4+ T cell infiltrate. Treatment and prognosis are similar of those of classical mycosis fungoides. We present one patient with FMF and review the literature of all published cases.

Acitretin↗
PubMed1995

[Granuloma anulare disseminatum as a rare side effect of allopurinol].

During long-term therapy of hyperuricaemia with allopurinol (300 mg/d) two patients developed generalized granuloma annulare. The diagnoses were confirmed by histology; concomitant diseases, especially diabetes mellitus, were not detectable. Following discontinuation of allopurinol therapy, cutaneous granulomas healed without relapse. Hyperuricaemia could be controlled by low-purine diet and medication avoiding allopurinol. The clinical history of our two patients suggested a causal connection between allopurinol therapy and generalized granuloma annulare. For this reason we rate the development of this disease in both cases as a rare but significant side effect of allopurinol. This should give rise to critical assessment of concomitant drug therapy during development of generalized granuloma annulare.

Aged↗
PubMed1994

[Clinical aspects and therapy of early lepromatous leprosy with a case example].

Taking into account the increase in worldwide human migration, leprosy is of growing importance in the differential diagnosis of dermatological diseases encountered in Central Europe. We report on the case of a young man from Ghana who developed hypopigmented maculae and plaques on his trunk and proximal limbs. The diagnosis of lepromatous leprosy could be made in consideration of the histological pattern of infiltrating leucocytes and detection of numerous acid-fast mycobacteria on skin biopsy. The results of the physical examination as well as routine laboratory and immunological parameters were consistent with this form of leprosy. Due to glucose-6-phosphate-dehydrogenase deficiency, treatment with dapsone was contraindicated. With high-dose rifampicin and clofazimine therapy, the skin changes cleared over the course of 11 months following a leprosy reaction type II (erythema nodosum leprosum) that developed during a phase of discontinued therapy due to low patient compliance.

Adult↗
PubMed1992

[Botryomycosis caused by fusobacteria].

In the Anglo-American literature botrymycosis is described as a chronic cutaneous granulomatous reaction to bacterial infection, containing granules resembling the sulphur granules seen in actinomycosis. The diagnostic and therapeutic aspects are discussed with reference to a recently observed patient. Fusobacterium nucleatum was isolated as the bacterial cause of the pathologic disorder.

Abscess↗
PubMed1988

Increasing incidence of eczema herpeticum: analysis of seventy-five cases.

Clinicians at the Department of Dermatology at the University of Mainz saw 63 patients with 75 episodes of eczema herpeticum. An analysis of these cases shows an exceedingly high rate of increased incidence of the disease. From 1969 through 1981, 13 cases were registered, whereas in the years 1982 to 1986 the number of cases was 62. The mean age of the patients was 22.7 years, and 42 patients (56%) were between 15 and 24 years of age. This finding shows that the affected patients are not predominantly infants, as has been reported up to now. Of these patients 5 had one recurrence, two had two recurrences, and one had three recurrences. Acyclovir, used for treatment in 38 cases, led to rapid improvement, whereas therapy with immunoglobulins, antibiotics, and so-called immunostimulating agents did not clearly influence disease duration.

Acyclovir↗
PubMed1987

Dose-dependent influences on electrophysiological signs of attention in humans after neuropeptide ACTH 4-10.

The afferent humoral system exerts significant influences on brain activity. Central nervous actions of the adrenocorticotropic hormone (ACTH) are most likely to be mediated by information coded in a portion of this hormone structure corresponding to ACTH 4-10. Our previous research suggested an impairing effect of ACTH 4-10 on electrophysiological signs of selective attention in humans. The present experiments in 12 male subjects investigated the influences of ACTH 4-10 on different aspects of attention as indicated by auditory event-related potential (AERP) components. Furthermore, dose-response characteristics of these influences should be examined. Attention performance was tested in a dichotic listening paradigm, after 0, 0.1, 1.0, and 10 mg ACTH 4-10, administered intravenously 1 h prior to testing according to a double-blind latin-square design. Different aspects of attention were measured by brain electrical responses evoked either by frequent standard or rare target tone pips, which the subject had to attend to, or to ignore. The selective type of attention was reflected by the Nd determined as mean difference in amplitude between AERPs to tone pips when attended and when unattended, for a latency range between 0-460 ms post-stimulus. In addition, plasma cortisol, heart rate, blood pressure, and behavioral performance were measured. Results indicated a clear reduction of the Nd amplitude after all doses of ACTH 4-10. Other indicators of attention mechanisms such as mismatch processing were not affected by the peptide. The diminished Nd after ACTH 4-10 was due to an increased processing of unattended stimuli, but simultaneously attended tones were processed less intensively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Paraffin granuloma of the penis].

Granulomatous foreign-body reactions following paraffin injections can produce diagnostic difficulties, especially if the patient denies the injections. The paraffin injections serve to enlarge the penis and are mostly performed by psychiatrically patients. Undesired side effects that can occur are solid granulomatous infiltrations or penis deviation with impotentia coeundi. On the basis of a case report, the different motives of the patients and the therapeutic possibilities are presented.

Biopsy↗
PubMed1986

[Subungual keratoacanthoma].

Subungual keratoacanthoma is a very rare condition that varies in its clinical presentation from keratoacanthoma in other localizations. It is a painful lesion that fails to regress spontaneously and shows more vertical growth. On X-ray examination destruction of the underlying bone, caused by pressure, can be seen. It may be difficult to distinguish subungual keratoacanthoma from other subungual tumors, especially squamous cell carcinoma; therefore clinical and histological data should be taken into consideration.

Carcinoma, Squamous Cell↗
PubMed1985

[Pregnancy after malignant melanoma. A follow-up of 23 patients].

There is little known on the risks associated with pregnancy occurring after primary therapy of a malignant melanoma. Out of a total of 2850 melanoma patients there were 23 women (20 in stage I, 3 in stage II) in whom 33 pregnancies occurred in the course of the follow-up. No metastases developed in 18 patients with a total of 25 pregnancies whereas a relapse occurred in 3 patients in stage I and 2 patients in stage II. The induction of metastases by the pregnancy in 3 of these patients is unlikely owing to the absence of a temporal relationship or because of an existing stage II and only in 2 patients did the temporal relationship between spreading of the tumor and pregnancy suggest an influence of pregnancy on malignant melanoma.

Adolescent↗
PubMed1985

[Development of a squamous cell carcinoma in generalized morphea].

We report on a 65-year-old woman having suffered from generalized morphea since 28 years. Chronic leg ulcers within atrophic areas have been known since 1960. Since 10 months, the ground of one of these large ulcerated scars has increasingly turned to cauliflower-like vegetation with its edge progressively heaped up. Biopsies confirmed the diagnosis of squamous cell carcinoma. We discuss possible ways of carcinogenesis of squamous cell carcinoma in generalized morphea.

Aged↗