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  • 1
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    Berlin : Springer
    Call number: QZ365WR500:171
    Keywords: Skin Neoplasms
    Pages: x, 136 p. : ill.
    ISBN: 9783642247019
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  • 2
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Purpura Schönlein-Henoch ; Therapie ; Dapson ; Key words Schönlein-Henoch-Purpura ; Therapy ; Dapsone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 26-year old patient who suffered from purpura for four years evolved into the complete clinical picture of Henoch-Schönlein-purpura in the past two years. A causative agent was never found. Multiple therapeutic approaches including systemic steroids, azathioprine as well as pentoxyfylline failed to control the arthralgias, intestinal symptoms and skin lesions. Therefore dapsone therapy was initiated at a dosage of 100 mg daily after checking the glucose-6-phosphate-dehydrogenase and with regular control of the blood methemoglobin level. Within two weeks, the patient’s symptoms completetly cleared, he has now been in remission for the past six months. As noted elsewhere, dapsone is an effective therapy for severe cases of Henoch-Schönlein- purpura.
    Notes: Zusammenfassung Wir berichten über einen 26jährigen Patienten mit seit 4 Jahren bestehender, seit 2 Jahren das Vollbild einer Purpura Schönlein-Henoch zeigender Purpura, für die trotz wiederholter, sorgfältiger Abklärung ein Auslöser nicht festzustellen war. Nachdem es unter verschiedenen therapeutischen Maßnahmen, die u.a. die systemische Gabe von Glukokortikoiden und Azathioprin sowie Pentoxifyllin-Infusion beinhalteten, nicht gelungen war, die Gelenkschmerzen, die Magen-Darm-Symptomatik und die Hautveränderungen zu kontrollieren, wurde nach Kontrolle der Glukose-6-Phosphatdehydrogenase und unter Überwachung des Methämoglobinspiegels eine Behandlung mit Dapson in einer Dosierung von 100 mg täglich durchgeführt. Hierunter kam es innerhalb von 2 Wochen zu Symptomfreiheit, die bis jetzt über 6 Monate andauert. Dapson stellt somit bei therapieresistenter Purpura Schönlein-Henoch eine Therapiealternative dar.
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  • 3
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Melanom ; MIA ; Adhäsion ; Attachment ; Key words Melanoma ; MIA ; Adhesion ; Attachment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The protein MIA was identified and isolated from the tissue culture supernatant of melanoma cells in vitro by its ability to inhibit thymidine incorporation by melanoma cell lines. After purification and partial sequencing of the peptide, a fragment of the MIA cDNA was cloned by RT-PCR. This cDNA fragment was used to screen phage libraries and subsequently fully encoding human and murine MIA cDNA and genomic DNA clones were obtained. The MIA gene spans a region of approximately 2 kb and is divided into 4 exons. Mapping the MIA gene revealed that the human gene is located on chromosome 19 and the murine gene on chromosome 7. The MIA open reading frame spans 131 (human) or 130 (murine) amino acids. The first 24 (human) or 23 (murine) amino acids represent a signal sequence directing the secretion of MIA into the extracellular compartment. The mature, secreted MIA consists of 107 amino acids and its MW is approximately 11 kDa. Preliminary structural data suggests that MIA is a small globular protein stabilized by two intramolecular disulfide bonds. Expression studies of protein und mRNA levels indicate that MIA is expressed specifically by malignant melanoma cells and chondrocytes. This points to a highly restricted expression pattern which is controlled by the MIA promoter. In addition, MIA provides a clinically useful parameter in patients with malignant melanoma. Enhanced values were measured in the serum of all patients with metastatic melanoma (stage III and IV). In vitro and in vivo experiments using recombinant MIA protein revealed that MIA specifically inhibits attachment of melanoma cells to fibronectin and laminin. Further analysis indicated a direct binding between MIA and the matrix proteins. This finding provides an explanation for the capability of MIA to inhibit proliferation of melanoma cells in vitro. Our studies suggest a putative function of MIA in regulated detachment of melanoma cells from the extracellular matrix which is an important step in metastasis.
    Notes: Zusammenfassung Das Protein MIA („melanoma inhibitory activity”) wurde aufgrund seiner antiproliferativen Eigenschaften auf Melanomzellen in vitro im Zellkulturüberstand von Melanomzellen nachgewiesen und isoliert. Nachdem das Protein in der Arbeitsgruppe von Prof. Bogdahn gereinigt und ansequenziert worden war, konnte durch die Verwendung degenerierter Primer über RT-PCR ein Teil der MIA-cDNA kloniert werden. Dieses cDNA-Fragment wurde als Sonde zum Screening von Genbibliotheken verwendet, was zur Klonierung der humanen und murinen cDNA und genomischen DNA führte. Das MIA-Gen umfaßt einen Bereich von ca. 2 kb und ist in 4 Exone unterteilt. Die cDNA wird durch ein einzelnes Gen auf dem humanen Chromosom 19 bzw. auf dem murinen Chromosom 7 kodiert. Das MIA-Protein umfaßt 131 (human) bzw. 130 (murin) Aminosäuren, wovon 24 (human) – bzw. 23 (murin)-Aminosäuren eine Signalsequenz für den Transport des Proteins in den Extrazellularraum darstellen, die nach der Sekretion abgespalten werden. Reifes MIA besteht somit aus 107 Aminosäuren und hat ein Molekulargewicht von ca. 11 kDa. Präliminäre Strukturanalysen deuten darauf hin, daß MIA ein kleines globuläres Protein ist, dessen Tertiärstruktur durch 2 Disulfidbrücken stabilisiert wird. Durch Expressionsstudien sowohl auf mRNA- als auch auf Proteinebene konnte gezeigt werden, daß MIA in vivo und in vitro von Melanomzellen und Chondrozyten exprimiert wird. Diese sehr stark auf spezifische Zelltypen limitierte Expression wird durch den MIA-Promoter kontrolliert. Eine bedeutende klinische Relevanz kommt der Bestimmung von MIA im Serum von Melanompatienten zu, da fast alle Patienten mit metastasiertem malignem Melanom (Stadium III und IV) stark erhöhte Werte im Serum aufweisen. Durch rekombinante Expression in Bakterien konnten große Mengen an MIA synthetisiert und für Versuche sowohl in vitro als auch in vivo verwendet werden. So konnte gezeigt werden, daß MIA das spezifische Attachment von Melanomzellen an Fibronektin und Laminin in vitro inhibiert. Weitere Analysen konnten eine direkte Bindung zwischen diesen Matrixproteinen und MIA nachweisen. Eine mögliche In-vivo-Funktion von MIA könnte daher das Ablösen der Zellen aus einem Gewebeverband sein, was einen entscheidenden Schritt in der Metastasierungskaskade darstellt.
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  • 4
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Malignes Melanom ; Tumorzentrum München ; Epidemiologie ; Key words Malignant melanoma ; Tumor registry Munich ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Since 1977, data of patients with malignant melanomas have been systematically documented in the tumor registry of the Tumor Center Munich. Analysis of data of 8071 patients revealed that tumor thickness has steadily declined over the years. While in 1977 the median tumor thickness was 1.45 mm, it is now 0.75 mm. This has been followed by a significant improvement in overall survival. Males and older patients tend to have thicker melanomas than females and younger patients. There has been a relative increase of melanomas of the trunk. At diagnosis, 95% of patients had local disease. Of these patients, 18.3% developed metastastes. At least two-thirds of these patients had progression at the primary tumor site or the regional lymph nodes, both of which can be assessed by clinical or ultrasound examinations. Overall survival of patients with thin melanomas is excellent and does not differ substantially from the overall survival of the general population comparable in sex and age.
    Notes: Zusammenfassung Seit 1977 werden im Bereich des Tumorzentrums München kontinuierlich klinisch-epidemiologische Daten von Patienten mit malignen Melanomen erfaßt und dokumentiert. Durch die 3 dermatologischen Kliniken im Tumorzentrum wurden bisher Daten von 8071 Patienten dokumentiert. Die Analyse der Tumordicke im Zeittrend zeigt eine kontinuierliche Abnahme der medianen Tumordicke (1977: 1,45 mm; seit 1992: 0,75 mm). Damit verbunden ist ein Anstieg der Überlebensrate für das Gesamtkollektiv. Bei dünnen Melanomen ist der Anteil junger Patienten deutlich höher als bei dicken Melanomen. Die Analyse der Tumorlokalisation im Zeittrend zeigt eine relative Zunahme der Melanome im Bereich des Stamms; 95% der Patienten hatten bei Diagnose eine klinisch lokal begrenzte Erkrankung, wobei 18,3% dieser Patienten im weiteren Verlauf eine Progression entwickelten. Bei mindestens 2/3 dieser Patienten erfolgt zunächst eine regionale Metastasierung, die durch klinische und sonographische Untersuchungen erfaßt werden kann. Patienten mit dünnen Melanomen haben eine exzellente Prognose.
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  • 5
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Maligner blauer Nävus ; Plaque-Typ ; Infiltrierendes Wachstum ; Gesicherter Präkursor ; Key words Malignant blue naevus ; Plaque-type ; Local invasiveness ; Documented precursor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We present, to the best of our knowledge, the first case of a malignant, primary plaque-type blue naevus in a 61-year-old male. Two biopsy specimens had been examined within 13 years, and revealed a common and cellular blue variant as a precursor. Locally invasive growth and regional lymph node swelling were present, but these alone could not confirm malignancy before evaluation of all clinical and histopathological features, as they are known to occur with benign cellular blue naevi. The recent literature and our case indicate that there is a malignant potential in every histological and clinical variant of blue naevus.
    Notes: Zusammenfassung Wir stellen, nach bestem Wissen, erstmalig die maligne Entartung eines primären blauen Nävus vom Plaque-Typ bei einem 61jährigen Patienten vor. Zwei Verlaufsbiopsien in 13 Jahren, histologisch als gewöhnliche und zellreiche Variante befundet, sicherten einen blauen Nävus als Präkursor. Die Phänomene des lokal infiltrierenden Wachstums und regionaler Lymphknotenschwellungen, die bei unserem Patienten vorlagen, bewiesen, für sich betrachtet, keineswegs einen malignen Verlauf, da sie auch bei benignen, zellulär-blauen Nävi beschrieben wurden. Neuere Literaturmitteilungen und unser Fall belegen, daß grundsätzlich jede histologische und klinische Variante eines blauen Nävus entarten kann.
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  • 6
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: AbstractBackground  Chronic idiopathic urticaria (CIU) is the most common type of chronic urticaria, and pruritus is the most prominent symptom. Antihistamines are the first-line treatment for CIU. Sedation and anticholinergic adverse effects are often experienced with the first-generation antihistamines and there is a risk of cardiovascular adverse effects and drug interactions with some second-generation agents. Hence, new treatment options are needed. Desloratadine is a new, potent, nonsedating antihistamine that has an excellent cardiovascular safety profile.Methods  This was a multicenter, randomized, double-blind, placebo-controlled study designed to determine the efficacy and safety of desloratadine in the treatment of moderate-to-severe CIU. A total of 190 patients, aged 12–79 years, with at least a 6-week history of CIU and who were currently experiencing a flare of at least moderate severity, were randomly assigned to therapy with desloratadine 5 mg or placebo once daily for 6 weeks. Twice daily, patients rated the severity of CIU symptoms (pruritus, number of hives, and size of largest hive), as well as the impact of CIU symptoms on sleep and daily activity. Patients and investigators jointly evaluated therapeutic response and overall condition. Safety evaluations included the incidence of treatment-emergent adverse events, discontinuations due to adverse events, and changes from baseline in vital signs, laboratory parameters, and ECG intervals.Results  Desloratadine was superior to placebo in controlling pruritus and total symptoms after the first dose and maintained this superiority to the end of the study. Measures of sleep, daily activity, therapeutic response, and global CIU status were also significantly better with desloratadine after the first dose; these clinical benefits were also maintained throughout the 6-week study. No significant adverse events occured.Conclusions  Desloratadine 5 mg daily is a safe and effective treatment for CIU with significant benefits within 24 h and maintained through the treatment period.
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  • 7
    ISSN: 1530-0358
    Keywords: Systemic sclerosis ; Anorectal manometry ; Fecal incontinence ; Rectoanal inhibitory reflex ; Esophageal manometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was designed to compare esophageal and anorectal function parameters in patients with systemic sclerosis and to define the role of anorectal manometry in the diagnosis of gastrointestinal involvement of systemic sclerosis. PATIENTS AND METHODS: Twenty-six consecutive patients (22 females) with systemic sclerosis originally referred for assessment of esophageal function were evaluated by esophageal and anorectal manometry. Anorectal function parameters were compared between patients with normal and those with disturbed esophageal function. RESULTS: A total of 17 of 26 patients (65 percent) had severe esophageal dysfunction with aperistalsis of the lower two-thirds of the esophagus, whereas 9 patients (35 percent) had normal esophageal manometry. Only three patients (11.5 percent) suffered from occasional fecal incontinence. Anorectal function parameters (resting pressure, maximum squeeze pressure, perception threshold) were not significantly different between patients with normal and those with disturbed esophageal motility. Rectoanal inhibitory reflex was excitable in nearly 90 percent of patients. CONCLUSION: In an unselected group of patients with systemic sclerosis, fecal incontinence and abnormal anorectal function are rather rare findings. Anorectal manometry cannot differentiate between patients with and without gastrointestinal involvement of systemic sclerosis.
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  • 8
    ISSN: 0021-9541
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Medicine
    Notes: Interferons have recently been recognized as potent mediators in inflammatory processes, exerting profound effects on fibroblasts. The influence of interferons γ and α on the chemotactic movement of fibroblasts toward various attractants was, therefore, investigated. Normal human adult and embryonal dermal fibroblasts, fibrosarcoma-derived fibroblasts and SV40-transformed fibroblasts were tested against conditioned medium from fibroblasts, the chemotactic peptide C-140 of fibronectin, platelet-derived growth factor, and leukotriene B4 as attractants in the presence or absence of the interferons. Interferons γ and α inhibited chemotaxis in a dose-dependent manner and at concentrations at least as low as 10-2 ng/ml. Inhibition was noticeable when the cells were exposed to interferon for as short a period as 60 minutes, and the effect was not readily reversible. Inhibition occurred when the cells came from sparse or dense cultures, but when platelet-derived growth factor was the attractant and the cells had been grown at low density there was no inhibition. It is concluded that this is a specific effect, not to be wholly explained by overall increase in membrane rigidity. Inhibition of fibroblast chemotaxis by interferons may be an important regulatory mechanism during wound healing or fibrosis and metastatic spread of tumor cells.
    Additional Material: 4 Ill.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1904
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Natural Sciences in General
    Type of Medium: Electronic Resource
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