[Synechia in the area of the foreskin].
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Biomedical subjects
Publications and source records attributed to W P Herrmann.
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In Lyme's disease (LD) as well as in the European form of erythema chronicum migrans (ECM), the etiologic agents are spirochetes. As fas as we know by now, these microbes are closely related but not identical. Consequently, LD and ECM should be regarded as closely related but not as identical diseases. The sera of our 21 patients suffering from acrodermatitis chronica atrophicans (ACA) contained elevated antibody titers directed against the etiological agent found in ECM. These findings strongly suggest that ACA is also induced by spirochetes-possibly by the same microbes found in ECM.
Using indirect immunofluorescence, IgG antibodies against the recently detected Ixodes-ricinus-spirochaeta, which causes erythema chronicum migrans could be demonstrated in all 21 persons with acrodermatitis chronica atrophicans. Titers were from 1 : 64 to 1 : 1024, specific IgM antibodies were demonstrable in only 5 patients in a titer of 1 : 64. Even after treatment with penicillin high IgG antibody titers of up to 1 : 1024 were found. Fourfold decreases could be found only once for each IgG and IgM antibodies.l Serology indicates that acrodermatitis chronica atrophicans as well as erythema chronicum migrans is caused by the Ixodes-ricinus-spirocheta.
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Three cases of penicillin-resistant gonorrhoea were detected at Bremen during a period of 3 months: in a tourist and 2 sailors. The infections had been acquired in Thailand, Africa, and USA, respectively. In all 3 cases penicillinase-producing strains of gonococci were isolated, resistant to penicillin in concentrations of 20 micrograms/ml and more. Patients were successfully treated with spectinomycin. The identification of penicillinase-producing strains of gonococci is of major epidemiological importance. Therefore, bacteriological investigations including sensitivity tests and, if necessary, penicillinase-tests should be done in each case of penicillin-resistant gonorrhoea. Relevant cases should be reported to the Venereal Diseases and Treponematoses Unit at Geneva, Switzerland.
Necrotizing fasciitis is a rare and little known infectious disease of the skin with a mortality, despite modern antibiotic treatment, of 25--50%. A case of the disease in a 63-year-old woman is described. Treatment consisted of wide incision and drainage of the subcutaneous abscess, with regression of the clinical signs and symptoms. There has been no recurrence. Determination of the anti-DN-ase-B titre was of diagnostic value in this instance.
Serum levels of sialyltransferase and sialic acid were measured in patients with malignant melanomas (n = 49), healthy control persons (n = 20), and patients with non-malignant skin disorders (n = 30). Both parameters were found to be higher in malignant melanoma patients than in healthy control persons, but they were not significantly higher in melanoma patients than in patients with benign skin disorders, unless widespread dissemination of metastases had occurred. The highest values were measured in patients with liver and lung metastases. No general correlation was found between sialyltransferase activities and sialic acid concentrations. Sialic acid concentrations seem to be a better index for tumor spreading than sialyltransferase activities. In early stages of the disease, shedding from tumor cells is not the major source of elevated serum levels of sialyltransferase and sialic acid, respectively.
Lymphocyte blast transformation of 23 melanoma patients was compared to that of 22 healthy persons after stimulation with the mitogens PHA, ConA, and PWM. Transformation rate of lymphocytes in microcultures was measured following 3H-Thymidin uptake in a Liquid-Scintillation-Counter. Calculations were based on analyses of variance. There was no significant difference in blastogenetic response between the 2 groups (patients and controls), but there were differences between the used mitogens.
Classical topical therapy has been largely displaced by the development of up-to-date drugs and advances in the galenic field. Serious objections have even been leveled against some older drugs and others are no longer current in spite of their good efficacy (e.g. dyes) because less discriminatory drugs can be substituted for them. The fundamental principles of classical topical therapy are still as valid as ever (inherent action of the base). However, many of the active principles of the prechemotherapeutic era have meanwhile been superseded as for example boric acid, mercury, desquamative pastes, sulfur among others. In contrast to this, topical applications such as dithranol, salicylic acid, coal tar and a few others still belong to the permanent stock of dermatological topical therapy.
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Electrophoretic and immunological studies revealed that normal and pathologically altered epidermis contains an arylamidase with the electrophoretic mobility of an x-globulin. This enzyme seems to be immunologically identical with an arylamidase secreted by the prostate gland. In psoriasis scales the arylamidase migrates with the electrophoretic mobility of a beta-globulin. Presumably, this enzyme contains fewer neuraminic acid groups than the arylamidase of normal epidermis. It may well be that in psoriasis the synthesis of arylamidase is incomplete.
Histiocytomas display a remarkably strong proteolytic activity. Electrophoretic and immunological studies reveald that this proteolytic activity is due, at least partially, to the presence of an arylamidase, previously described as "aminopeptidase I". This enzyme has been identified in various tissues of ectodermal, mesodermal and entodermal origin.
Proteins present in the eccrine sweat collected from the skin surface of male volunteers were studied. The protein content ranged from 0.154--0.774 g per liter. A total 2282 ml sweat was concentrated until a final protein content of 25 mg/ml was reached. Paper electrophoresis revealed 3 fractions migrating like alpha-, beta-, and gamma-globulins. Eight different proteins were demonstrated by immunoelectrophoretic analyses using rabbit antisera directed against human sweat proteins. Three of these proteins were identified as blood serum proteins. One of the remaining 5 proteins could be of epidermal origin; another one which occurs in comedones as well as in sweat seems to be eluted from the sebum film present on the skin surface.