Circulatory system in children with localized scleroderma.

The circulatory system was studied in 43 children (ages 3-18 years, mean 10.6 years; 32 girls, 11 boys) suffering from localized cutaneous forms of scleroderma. The following studies were undertaken: general pediatric examination, cardiologic examination including routine electrocardiogram (ECG), 24-h Holter ECG monitoring, echocardiography plus Doppler study, and a treadmill exercise test. Three children found to have congenital heart malformations were excluded from the study. Children with localized scleroderma were often lighter and shorter than their appropriate controls. The most common ECG abnormality was incomplete right bundle branch block, but other ECG and Holter abnormalities were found as well. Abnormal echocardiographic results were obtained in 16 cases. The abnormalities concerned valvar function (in all heart valves but predominantly in the mitral valve). It was found that the children suffering from scleroderma had different indices than controls for left ventricular mass index, mitral valve function and left ventricular filling. During the exercise test (conducted according to Bruce's protocol) we found no difference between patients and controls.

[Echocardiography examinations in children suffering from cutaneous forms of scleroderma]. / Badanie echokardiograficzne dzieci obarczonych skórnymi postaciami twardziny.

In 34 children suffering from so called cutaneous forms of scleroderma and in 30 healthy subjects echocardiographic cardiac assessment as well as doppler analysis of mitral valve function was performed. It was found that sclerodermic children suffered more frequently from cardiac valves regurgitation (especially insufficiency of mitral valve). However, these insufficiencies were usually negligible or corresponding to Io. Other changes detected in these children were as follows: significantly higher values of left ventricle shortening fraction, increased left ventricle mass index, and changes of mitral flow which may reflect impaired diasystolic function of left ventricle and, perhaps, impaired left atrium contraction. It is suggested that such changes could be corresponding to the beginning of cardiomyopathy.

Premictional volume and contractility of the urinary bladder in patients with systemic sclerosis.

Ultrasonographic measurements of the urinary bladder in 21 women with systemic sclerosis (SSc) revealed abnormal volume of the bladder in about 65% of patients; 6/21 had a smaller bladder and 7/21 had a larger bladder than the controls. The volume of the remaining urine after miction was higher in 7 patients. Fibrosis of the bladder wall leading to a small rigid bladder and ureteral obstruction resulting in a large bladder with low contractility are suggested as phenomena involved in disturbed function of the urinary bladder in SSc patients. Patients with symptoms lasting more than 14 yrs. were found to have larger premictional volume of the bladder than those with short-lasting disease. No correlation between age, number of deliveries and bladder volume was found.

Vitiligo associated with lichen planus. Is there a pathogenetic relationship?

We report the case of a 13-year-old boy with vitiligo who developed lichen planus involving both vitiliginous skin and normally pigmented skin. Biopsy of lichen planus surrounded by a depigmented halo revealed a dermal infiltrate composed of CD3 + T cells and macrophages. The association of these skin diseases may indicate a pathogenetic relationship.

[The circulatory system in children with cutaneous forms of scleroderma. The results of routine as well as 24-hour ECG and physical performance test]. / Uklad krazenia dzieci obarczonych skórnymi postaciami twardziny. Wyniki rutynowego i 24-godzinnego ekg oraz próby wysilkowej.

Thirty-four children suffering from so-called cutaneous forms of scleroderma were studied (physical examination, routine and 24-hour ECG, and physical performance test). Physical development was significantly impaired in 5 cases. Congenital heart malformations with left-to-right shunt were detected in 3 children. These children underwent surgery with good results. Heart murmur was found during physical examination in 14 cases. In 30 subjects routine ECG was described as abnormal or doubtful. Abnormal Holter monitoring results were found in 13 children. The authors were not able to detect inferior physical performance test results in the studied children as compared to the control group (when the children suffering from congenital heart malformations and resting tachycardia were excluded from the study). It is suggested that children suffering from so-called cutaneous forms of scleroderma should remain under constant cardiological care.

[Clinical evaluation of serious forms of acne treated with autovaccine]. / Ocena kliniczna ciezkich postaci tradzika leczonych autoszczepionka.

In this paper a clinical assessment of the treatment of serious forms of acne vulgaris with the use of autovaccines containing Propionibacterium strains was presented. It was shown that the associative therapy including parallel administration of both autovaccine and the antibiotic is remarkably efficacious.

[Influence of progressive systemic sclerosis on gastric emptying]. / Wplyw postepujacej twardziny ukladowej na opróznianie zoladka.

Gastric motility was measured with an isotopic method in patients with progressive systemic sclerosis (PSS). Twenty-six women aged 48 +/- 10 yr with PSS were investigated. The duration of PSS prior to the study ranged from 2 to 25 yr. Control values were obtained from 12 healthy female volunteers aged 34 +/- 8 yr. Endoscopic examination was carried out in all investigated individuals to exclude abnormalities that were non-related to PSS. Measurements were done at morning, after an overnight fast. Patients and controls received a test meal of 1650 kJ containing human albumin microspheres labelled with 7.4 MBq of 99mTc. Subjects were investigated with a gamma-camera. It was shown that gastric emptying (GE) t 1/2 was delayed in the patient with PSS (289 +/- 325 min) as compared to the controls (92 +/- 19 min), p < 0.001. Delayed t 1/2 over x + 2SD of the control group was found in 69% of patients with PSS while in the control group O. The mean transit time (MTT90) was in the PSS group significantly longer than in the control group, 42.3 +/- 1.4 and 40 +/- 0.9 min respectively (p < 0.001). There was no correlation found between GE t 1/2 and the time of PSS duration (r = 0.08), its type II or III as well as the titer of Scl-70 antibodies in blood serum (r = 0.29, p > 0.1).

[Volume of the functioning gallbladder and its emptying in patients with progressive systemic sclerosis]. / Objetosc miedzyposilkowa pecherzyka zólciowego oraz jego opróznianie u chorych na postepujaca twardzine ukladowa.

UNLABELLED: The aim of the study was to measure the gallbladder volume (GV) and its emptying after meal stimulus in patients with progressive systemic sclerosis (PSS). 18 women with PSS, aged 49.8 +/- 9.5 yr, participated in the study. Control values were obtained from 30 healthy women aged 26.5 +/- 3.5 yr. The duration of PSS symptoms ranged from 2 to 25 yr. Subjects with gallstones or cholecystitis as well those receiving drugs affecting the gastroduodenal motor function were excluded from the study. GV was measured according to Dodds et all (1985) with the real-time sonographic apparatus (Sonoline SL Siemens, Germany), after an overnight fast and after a test meal. Measurements were repeated in 10 min intervals through a 40 min duration of the study. Similar volumes of fasted gallbladder were found in the PSS group and in the control group: 25.4 cm3, SEM 3.0 (PSS), vs. 20.9 cm3, SEM 1.6 (control), p > 0.05. There was not any correlation between the fasted GV and duration of the disease symptoms. The test meal evoked in both groups a similar trend of the decrease in the GV during 40 min and the increase in the ejection fraction at this time. Although the changes observed were statistically not significant (p > 0.05) there were small differences in the gallbladder ejection fraction in two patients, not exceeding 14% and 18%, and being apparently below of any individual value in the control group. CONCLUSION: the gallbladder motor function is very rarely disturbed in patients with PSS.

[Use of Nd:YAG laser for treatment of basal-cell carcinomas and some premalignant conditions]. / Zastosowanie lasera Nd:YAG w leczeniu nabloniaków podstawnokomórkowych i niektórych stanów przednowotworowych.

In 51 patients, 29 female and 22 male of average 61 years old, 94 lesions were treated with Nd: YAG laser; 70 basal-cell carcinomas, 9 superficial basal-cell carcinomas, 12 actinic keratosis and 3 cutaneous horns. Size of changes varied from 7 to 24 mm. Quantity of energy used in laser-therapy was dependent on diagnosis, focus size, location and amounted from 50 to 240 J/cm2. Authors are of the opinion that Nd:YAG laser-therapy is a very good method for treatment of skin tumors. Moreover, the advantage of this method is its possibility of a single procedure in the conditions of outpatients clinic.

[Epidemiology of contact hypersensitivity to rubber components in manufacturers of automobile tires at the Stomil plant]. / Epidemiologia nadwrazliwosci kontaktowej na skladniki gumy u konfekcjonerów opon samochodowych w zakladach Stomil.

Dermatological examination and patch tests with 34 rubber components were carried out in 114 tire manufacturers, 78 women and 36 men aged 29 years on average, with a mean duration of work in the plant 7 years. For correct interpretation of the obtained results patch tests with the same components were done in two control groups that is in 120 healthy subjects and 120 patients with contact dermatitis. Patch tests with proper concentrations of the studied components were evaluated after 48, 72 and 96 hours. Positive patch tests were found most frequently with antioxidants--16.6% (including IPPD--8.6%), followed by vulcanization accelerators--10.6%, and other rubber components--11.4% in all. During about 3 years of follow-up in 4 manufacturers contact allergic eczema was noted and polyvalent hypersensitivity to antioxidants and vulcanization accelerators without clinical manifestations of this hypersensitivity was diagnosed in 3 other subjects.

[Hypersensitivity to allergens from the panels standard I and II in automobile tire manufacturers at Stomil plant]. / Nadwrazliwosc na alergeny zestawów standard I i II u konfekcjonerów opon samochodowych zakladów Stomil.

Dermatological examination and patch tests were done in 114 manufacturers of tires, 78 women and 36 men, mean age 29 years, working in Stomil Plant. Patch tests included 15 substances in panels Standard I and II (excluding rubber components). The study demonstrated hypersensitivity to nickel and formalin (4.3% each), chromium and cobalt (3.5% each), and turpentine (2.6%), while hypersensitivity to other allergens was observed sporadically. A comparative analysis of the results of patch tests with antigens "Standard I and II" in confectioners and healthy and allergic persons showed that the per cent of positive tests in rubber industry workers was higher than in healthy subjects, and much lower than in patients with contact dermatitis.

[Evaluation of the results of surgical treatment of granuloma teleangiectodes]. / Ocena wyników leczenia chirurgicznego granuloma teleangiectodes.

In the clinic of dermatological surgery, I Department of Dermatology Silesian Medical Academy in Katowice 328 patients were treated surgically for granuloma teleangiectodes in the years 1973-1988. Two methods were used: excision of the lesion and curettage with electrocoagulation of the base of the lesion. After excision the wound was closed by approximation of its margins or local plastic procedure (285 cases) and by covering it with a free full-thickness skin graft (3 cases). Curettage and electrocoagulation was used in 43 cases, mainly due to the location of the lesion (in 90% on fingers). After granuloma excision no recurrences were observed, while after curettage and electrocoagulation recurrences developed in 20% of cases.

[Evaluation of surgical treatment of keratoacanthoma]. / Ocena chirurgicznego leczenia rogowiaka kolczystokomórkowego.

From 1973 to 1988 in the Dermatological Surgery Unit of the 1st Department of Dermatology of the Silesian School of Medicine in Katowice 82 patients were treated surgically for keratoacanthoma. In 76 patients the defect was closed by simple bringing closer the edges or by local plastic surgery, in 6 patients it was covered with free full-thickness skin grafts. The preparations of the excised tumors from various places were examined histologically. In three cases the texture of carcinoma spinocellulare was found in the base of the tumor. In 98% of the patients the wounds healed by first intention.

[Akne-Mycyna in the local treatment of acne]. / Akne-Mycyna w leczeniu miejscowym tradzika.

Akne-Mycyna, a new preparation for external treatment of acne containing 1% erythromycin, was used in 30 cases of acne: 12 cases of papulo-pustolous acne, 13 with pustulous acne, 5 with acne conglobata. The age of the patients ranged from 16 to 27 years, the mean duration of acne was 3.5 years. Selected lesions were smeared with Akne-Mycyna twice daily, mostly on one side of the face; symmetrical lesions were treated by conventional external methods. In the light of the study it is concluded that Akne-Mycyna is a very effective preparation for external treatment of papulo-pustulous acne and in milder cases of pustulous acne, with the duration of treatment at least 3 weeks. In deep forms of acne, particularly acne conglobata, Akne-Mycyna may be a valuable supplementation of systemic treatment.

[Phencarol in the treatment of allergic dermatoses of various pathological mechanisms]. / Fenkarol w leczeniu dermatoz alergicznych o róznym patomechanizmie.

Phencarol produced in the USSR is an antihistaminic drug highly effective in allergic dermatoses with the pathological mechanism of humoral and cellular type. The best results were obtained in acute allergic dermatoses and in acute recurrences of chronic allergic diseases. In comparative studies with difergan a greater efficiency of phencarol was noted, which was expressed as a higher proportion regression of lesions and more rapid action of the drug. The duration of phencarol treatment was about 3 weeks, the daily dose was 50-75 mg in adults. The drug was well tolerated.

[A case of superficial disseminated actinic porokeratosis treated with an aromatic retinoid]. / Przypadek porokeratosis actinica superficialis disseminata leczony aromatycznym retinoidem.

In 55-year-old woman with a history of 19 years of superficial disseminated actinic porokeratosis Tigason was used in doses from 0.7 to 0.5 mg/kg daily in two courses of therapy lasting about 3 months. The clinical improvement lasted for several months and their followed by less pronounced but progressive reappearance of clinical symptoms.

[Uncommon location of basal cell epithelioma]. / Nietypowe umiejscowienie nabloniaka podstawnokomórkowego.

The authors present three patients with the relatively rare location of basal-cell epithelioma in the axilla. The patients were surgically treated.