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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  26. Fortbildungswoche für praktische Dermatologie und Venerologie; 20180724-20180728; München; DOCP20 /20180716/
    Publication Date: 2018-07-17
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Abstract: Pachydermodactyly describes a rare condition of localized fibromatosis, usually symmetrically affecting the interphalangeal joints of both hands. We describe a case of a new subtype of pachydermodactyly in a 14-year-old boy, which we term 'unilateral pachydermodactyly transgrediens'. This atypical pattern is caused by specific localized mechanical manipulation of the hands. This condition contributes to the completely indolent spectrum of pachydermodactyly, and usually does not need therapy. Therefore it is essential not to misinterpret it as an inflammatory state such as juvenile idiopathic arthritis. The correct diagnosis of pachydermodactyly and its rare subtypes, as we describe in this case, often spares the affected patients unnecessary invasive diagnostic procedures and immunosuppressive therapy.
    Type of Publication: Journal article published
    PubMed ID: 25893660
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  • 3
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  • 4
    Abstract: BACKGROUND: The incidence of skin cancer continues to increase. However, little is known about the dermatosurgical characteristics of the patients. PATIENTS AND METHODS: In this single center, retrospective study, dermatosurgical reports of all patients treated because of basal cell carcinomas (BCC), squamous cell carcinomas (SCC), and malignant melanoma (MM) between 2004 and 2013 were analyzed. RESULTS: During the observed period, the number of operated BCC rose by a factor of 1.86 and the number of MM by a factor of 2.3. In comparison to BCC/MM, there was a disproportionately high increase of SCC by a factor of 4.02. The average age was 71.5 +/- 13.4 years (minimum: 14 years; maximum: 104 years), whereupon a significant increase of male age and a significant decrease of female age occurred. Almost 70% of all tumors were located in the head and neck area. The nose was most commonly treated. CONCLUSIONS: During the last 10 years, the cohort of dermatosurgical patients changed in the tumor center. This should be verified in multicenter studies.
    Type of Publication: Journal article published
    PubMed ID: 28361252
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  • 5
    Abstract: BACKGROUND: Direct wound closure, flaps or grafts are considered to be gold standards for the reconstruction of defects. However, these techniques may not be applicable in all cases, especially for the challenging closure of large defects. OBJECTIVE: We developed a technique to close large defects, of varying size and shape, using serial tightening loop sutures. In 64 consecutive patients, loop sutures were applied to defects from 3 cm(2) up to 173 cm(2) for a maximum of 42 days with tightening every 2-7 days. RESULTS: The median size of the defects was 20 cm(2). In 58 patients (91%) the defects were closed by direct approximation of the wound edges within a median time of 11 days (range: 4-42 days). Two patients received a skin transplant after a significant reduction of the defect size and four remaining defects healed by secondary intention. The skin stretching of defects located on the trunk was faster compared with defects on the extremities. Defects located on the scalp were closed hair bearing with little scarring. Overall, aesthetic results were satisfying. CONCLUSION: The use of loop sutures allows the delayed closure of large defects avoiding the need for skin flaps or grafts in most cases.
    Type of Publication: Journal article published
    PubMed ID: 23458729
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  • 6
    ISSN: 1432-0584
    Keywords: Colorectal carcinoma ; Acquired B-antigen ; Pseudo-B-antigen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient who had been admitted to hospital for surgical treatment of inguinal hernias was found to have a blood group phenotype of A1B in the presence of a non-auto-anti-B. No previous records of the patient's blood group were available. The serological workup including absorption and saliva inhibiton studies yielded a high probability for an acquired B-antigen which is known to be often associated with carcinoma of the colon. Subsequent coloscopy revealed the presence of a carcinoma of the sigmoid, unaccessable to palpation. To our knowledge this is the first report in the literature that the serological diagnosis of an acquired B-antigen led to the detection of a hitherto undetected carcinoma.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0584
    Keywords: CML ; Busulfan ; Hydroxyurea ; Interferon-alpha ; Duration of chronic phase ; Prospective study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary For palliative therapy during the chronic phase of CML busulfan has proved to be the drug of choice. During the past years hydroxyurea and also interferon-alpha have gained increasing significance since they might prolong the duration of the chronic phase. In a multicenter study it is being determined, whether the use of hydroxyurea or of interferon-alpha instead of busulfan prolongs the duration of the chronic phase of Philadelphia positive CML. Additional goals are the examination of whether the types of disease evolution and the terminal phases differ between the treatment groups, and the prospective recognition of prognostic criteria for the duration of the chronic phase of CML. By December 31, 1987, 326 CML-patients had been randomized, 150 for busulfan, 150 for hydroxyurea and 26 for interferon-alpha. The average age is 50 years. 59 patients reached the end of the chronic phase, 55 died. The mean observation time of all patients is 1.34 years. At present no significant difference in survival is recognizable between the busulfan and hydroxyurea groups. Fewer adverse effects have been observed in the hydroxyurea group. Philadelphia chromosome negative patients show a higher average age and tend to have lower white blood cell and platelet counts. The number of patients having received interferon-alpha is still too small to allow evaluation. This report intends to document organization and progress of this study which to our knowledge is, at present, the largest ongoing prospective multicenter study on the therapy of CML.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0428
    Keywords: Secretin ; pancreozymin ; exocrine pancreatic insufficiency ; insulin ; free fatty acids ; glucose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'effet des hormones intestinales sécrétine et pancréozymine sur la sécrétion d'insuline, sur la glycémie, les acides gras et le glycérol a été étudié chez onze malades sans diabète mais ayant une insuffisance pancréatique exocrine d'après des résultats cliniques et chimiques. Un groupe de 30 sujets normaux a été utilisé comme témoins. Les hormones intestinales n'ont causé aucune augmentation d'insuline dans le sérum des malades ayant une insuffisance pancréatique exocrine. La sécrétion d'insuline après l'injection intraveineuse de glucose était normale. Il semble que la présence du tissu exocrine du pancréas soit nécessaire pour obtenir une stimulation de la sécrétion d'insuline par la sécrétine et la pancréozymine. Comme il était prévu, il n'y a pas eu chez ces malades — contrairement à ce qui se passe chez les personnes normales — de sécrétion d'insuline différente après l'application de glucose oral et intraveineux. Ces résultats montrent que la similitude des modifications de l'insuline plasmatique après administration de glucose par voie orale et parentérale peut signifier un mauvais fonctionnement du pancréas exocrine. On peut en déduire qu'un récepteur du glucose de la cellule bêta ou de la membrane superficielle peut opérer indépendamment du tissu pancréatique exocrine et des hormones intestinales. D'autre part, il est proposé comme conclusion qu'un «entérorécepteur» de la cellule bêta est sensible à l'action des hormones intestinales et qu'il est dépendant, plus ou moins, d'un tissu pancréatique exocrine.
    Abstract: Zusammenfassung Bei 11 nicht-diabetischen Patienten mit klinisch und laborchemisch nachgewiesener chronischer exkretorischen Pankreasinsuffizienz wurde die Wirkung der intestinalen Hormone Sekretin und Pankreozymin auf die Insulinsekretion, den Blutzucker, die freien Fettsäuren und das Glycerin untersucht und verglichen mit den an 30 normalen Versuchspersonen gewonnenen Befunden. — Bei den Patienten mit exkretorischer Pankreasinsuffizienz bewirkten die oben genannten intestinalen Hormone keine Erhöhung des Seruminsulins, obwohl die Insulinsekretion nach der i.v. Verabreichung von Glucose nicht beeinträchtigt war. Offensichtlich ist für eine Insulinausschüttung nach Sekretin und Pankreozymin beim Menschen ein intaktes exkretorisches Pankreas erforderlich. Erwartungsgemäß konnte bei diesen Patienten, im Gegensatz zu Normalpersonen, kein Unterschied in der Insulinausschüttung nach oraler und intravenöser Verabreichung von Glucose festgestellt werden. Aus diesen Ergebnissen ist zu schließen, daß die Ähnlichkeit der Plasmainsulin-Veränderungen nach oraler und parenteraler Gabe von Glucose bereits auf einen frühen Schaden der exokrinen Pankreasfunktion hinweisen könnte. Man kann daraus die Folgerung ziehen, daß ein (hypothetischer) „Glucose receptor“ derβ-Zelle oder ihrer Oberflächenmembran mehr oder weniger unabhängig von exokrinem Pankreasgewebe und intestinalen Hormonen funktioniert. Andererseits scheint der „Entero-Rezeptor“ derβ-Zelle, der auf die insulinstimulierende Wirkung der intestinalen Hormone reagiert, mehr oder weniger abhängig zu sein von ausreichendem Vorhandensein intakten exokrinen Pankreasgewebes.
    Notes: Summary In 11 non-diabetic patients with clinical and laboratory evidence of chronic exocrine pancreatic insufficiency, the effect of intestinal hormones secretin and pancreozymin upon insulin secretion, blood sugar, free fatty acids and glycerol was studied and compared with the findings obtained in 30 normal volunteers. — In the patients suffering from exocrine pancreatic insufficiency the above mentioned enterohormones did not elicit any increase in serum insulin although insulin secretion after i.v. glucose loads was perfectly undisturbed. Obviously, the mediator inducing insulin release following secretin and pancreozymin in man depends on intact exocrine pancreatic tissue. As had been expected, no differences in the serum-insulin responses to oral and intravenous glucose, as found in normals, were established in these patients. From theses results it is inferred that similarity of plasma insulin changes after oral and parenteral glucose loads might hint at an early impairment of exocrine pancreatic tissue function. That implies, that a (hypothetical) “Glucose receptor” of theβ-cell or its surface works more or less independently of both the exocrine pancreatic tissue and the intestinal hormones. On the other hand, the “Entero-receptor” of theβ-cell responding to the insulin-stimulating action of intestinal hormones, such as secretin and pancreozymin, is likely to be more or less dependent upon sufficient amounts of intact exocrine pancreatic tissue.
    Type of Medium: Electronic Resource
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