Clinical results of immunoscintigraphy in a variety of malignant tumors with special reference to immunohistochemistry.

Radioimmunoscintigraphy was performed in 52 patients with a variety of malignant tumors (colorectal, melanoma, lung, testicular, ovarian, bladder, carcinoid). Respective antibodies or their F(ab')2 fragments against CEA (n = 23), melanoma antigen 225.28 S (n = 18), TPA (n = 4), beta HCG (n = 5) and HMFG2 (n = 2) were selected by immunohistochemistry of the primary tumor. Most patients were suspected of recurrence or of hitherto unknown distant or local metastases. Overall accuracy was 61% (32/52). False negatives amounted to 33% (17/52). Useful additional clinical information-not available by CT, ultrasonics or serum levels of tumor markers-was obtained in 17 out of 52 patients (= 33%). From these results it seems obvious that antibodies used for radioimmunoscintigraphy should be selected on the basis of immunohistochemistry.

Effect of diethyldithiocarbamate on the metabolic elimination of hexobarbital, phenazone, tolbutamide and four halogenated hydrocarbons.

The present study describes the inhibitory effects of diethyldithiocarbamate (dithiocarb) on the metabolic elimination of hexobarbital, phenazone, tolbutamide and four halogenated hydrocarbons. The plasma half-life for the beta-slopes of hexobarbital (25 mg/kg, i.v.) and phenazone (50 mg/kg, i.v.) were increased 2.5 and 3.5 fold respectively, when dithiocarb (100 mg/kg, i.p.) was administered simultaneously. The plasma half-life of tolbutamide was 2.27 h, when administered alone to rats; and 4.04 h, when administered with dithiocarb. Metabolic elimination of halothane, trichloroethylene, dichloroethane, and carbon tetrachloride, from the atmosphere of a closed exposure system was studied in rats. Treatment with dithiocarb (100 mg/kg, i.p.) immediately before exposure, prolonged the elimination half-life of: halothane (103 parts/10(6)) by a factor of 7.6, of trichloroethylene (25 parts/10(6)) by a factor of 5.3; dichloroethane (69 parts/10(6)) by 4.6; and carbon tetrachloride (38 parts/10(6)) by 2.4, respectively. The inhibitory actions of dithiocarb on the metabolism of the tested drugs and chemicals are explained as the consequences of a depressed microsomal mono-oxygenase activity due to a decrease in the cytochrome P 450 content.

[Dowling-Degos disease--an autosomal dominant genetic dermatosis]. / Morbus Dowling-Degos--eine autosomal dominante Genodermatosis.

We present 2 cases of Dowling-Degos disease out of a German family with 9 affected members and discuss the autosomally dominant inheritance and clinical features of this disease.

[Long-term therapy of multiple piloleiomyomas with nifedipine]. / Langzeittherapie multipler Piloleiomyome mit Nifedipin.

We report on a 46-year-old female patient suffering from painful disseminated cutaneous piloleiomyomata on her left leg. Treatment with nifedipine over 3 years resulted in suppressing the pain almost totally.

[Reactivity of conventional and immunologically standardized allergen extracts in the prick test]. / Reaktivität herkömmlicher und immunologisch standardisierter Allergenextrakte im Prick-Test.

In comparison with conventional allergen preparations immunologically characterized allergens were tested by skin-prick-tests for reactions. These results were compared with those of Rasttests.

[Neuron-specific enolase and beta 2-microglobulin in the serum of patients with melanoma]. / Neuronspezifische Enolase und beta 2-Mikroglobulin im Serum von Melanompatienten.

Both neuron-specific enolase (NSE) and beta 2-microglobulin were detected immunohistologically in malignant melanomas. In addition, serum NSE and beta 2-microglobulin were reported to be elevated in patients with malignant melanoma. The radioimmunoassay results presented did neither reveal any elevation of serum neuron-specific enolase nor of serum beta 2-microglobulin in more than 30 serum samples of patients with malignant melanoma in different tumour stages.

Serum selenium levels in patients with malignant melanoma.

The incidence of malignant melanoma of the skin has increased rapidly among white people during the last decade. Although the pathogenesis of malignant melanoma is not clear, epidemiologic data and experimental work indicates that ultraviolet (UV) radiation plays a critical role in tumorigenesis. Recent data implicate peroxidative reactions in UV-carcinogenesis and clearly demonstrate that selenium (Se) confers protection, in part by inducing cellular-free radical scavenging systems and by enhancing peroxide breakdown, thus enhancing the capacity of the cell to cope with oxidant stress. With this in mind, we investigated the Se status of 101 patients with malignant melanoma. Our study revealed significantly lower Se levels in the sera of melanoma patients than of controls. Although patients in all clinical stages had lower Se levels than the controls, patients in stage III (disseminated melanoma) had the lowest levels. Separate analysis of histogenetic subtypes of melanoma revealed that lentigo maligna melanoma (LMM) and superficial spreading melanoma (SSM) had the strongest association with depressed Se serum levels. Our results, showing for the first time that malignant melanoma is associated with low Se concentrations, are consistent with results of epidemiologic studies showing an inverse correlation between serum Se levels and certain cancers.

[Profilometry, a method for the assessment of the therapeutic effectiveness of Kamillosan ointment]. / Profilometrie, eine Methode zur Beurteilung der therapeutischen Wirksamkeit von Kamillosan-Salbe.

Experimentally induced toxic contact dermatitis was topically treated with 3 different ointments (Kamillosan ointment, Kamillosan ointment base. 0.1% hydrocortisone acetate). The structural changes of the epidermal surface were studied by means of profilometry. According to our results, Kamillosan ointment is remarkably superior to other reference products with regard to its soothing effect on human skin.

[The influence of ethanol, dithiocarb, diethylmaleate and phenobarbital on the metabolic elimination of halothane in rats (author's transl)]. / Einfluss von Athanol, Dithiocarb, Diäthylmaleat und Phenobarbital auf die metabolische Elimination von Halothan bei Ratten.

Rats exposed to halothane (100 ppm) in a closed allglass-system eliminate halothane from the atmosphere of this system with a half-life (t0.5) of 0.99 h. In 24 h-fasted rats t0.5 was prolonged to 1.24 h. A single oral load of 4.8 g/kg ethanol as well as a 15% ethanol solution instead of drinking water for 28 days did not alter the metabolic elimination of halothane. On the other hand, ethanol (4.8 g/kg p.o.) applied 5 min before exposure to halothane markedly prolonged t0.5 to 3.79 h. Pretreatment with phenobarbital (80 mg/kg i.p. for 4 days) shortened t0.5 significantly to 0.79 h. Inhibition of the mixed-function oxidase system by dithiocarb (100 mg/kg i.p.) or diethyl maleate (1 ml/kg i.p.) markedly prolonged t0.5 to 7.53 and 1.57 h. respectively. The observed modifications of the halothane metabolism may be of interest in relation to the problem of halothane-induced hepatotoxicity.

Reactivity of human keratinocytes with the antimonocytic monoclonal antibody anti-Leu M2.

Skin biopsies from 49 patients with 21 different dermatoses and biopsies of normal skin were investigated with regard to the reactivity of keratinocytes with the monoclonal antimonocytic antibody anti-Leu M2 using the avidin-biotin-peroxidase complex method. In all excisates, a cytoplasmic reaction of keratinocytes was seen which was regularly weaker in the basal layers of the epidermis than in the upper layers. Marked differences in the labelling intensity were shown between the individual dermatoses. Keratinocytes have now been shown to react with several monoclonal antibodies directed against monocytic antigens; therefore the functional significance of this should be discussed.

[Value of Varady percutaneous microsurgical phlebologic extraction of varicose veins]. / Stellenwert der perkutanen mikrochirurgischen Phlebextraktion nach Varady in der Varizenchirurgie.

Varicectomy is a particularly useful procedure in the surgical treatment of varicose branch veins and perforating veins, since it allows selective estirpation without affecting the main trunk of the long saphenous vein (LSV). At the same time, there is usually no need of further sclerotherapy. The operation can be performed under local anaesthesia in the outpatient's department or, if a saphenofemoral junction insufficiency has to be simultaneously removed, during a short stay in hospital. The aesthetic results are remarkable. With the help of the new delicate instruments devised by Varady, the incisions are very small, making sutures unnecessary. All the varicose veins can be removed at once, there is no loss of blood and no need for prophylaxis against thrombosis and the postoperative ecchymosis is minimal. Thus the method can also be applied in elderly patients.

Improving skin function with CM-glucan, a biological response modifier from yeast.

Preparations from yeast have been used for a long time for cosmetic and pharmaceutical purposes. Studies have identified glucan from the cell wall of baker's yeast as an immunologically active agent. Glucan is a poly beta-( 1-3)-linked glucopyranose of high molecular weight and belongs to the class of compounds known as biological response modifiers. Glucan preparations are involved in the activation of the body's natural defence mechanisms and in the acceleration of the skin's wound healing processes. In the skin, Langerhans' cells and keratinocytes are the immunologically competent cells. Recent studies indicate that UV irradiation can deplete the number and viability of these cells (immunosuppression). The use of non-specific immune-stimulators, such as glucan, is a new approach for improving the function of stressed skin. We have developed a process to modify pure glucan from baker's yeast to carboxymethyl glucan (CM-glucan), a water soluble product suitable for topical formulations. The functional properties of this new compound have been investigated in vitro and in vivo. Cell culture experiments showed that CM-glucan protects skin cells against the depletion of antioxidant molecules upon UV-A irradiation and promotes the growth of keratinocytes. In placebo controlled studies with healthy volunteers, the pretreatment of skin with CM-glucan offered substantial protection against skin damage caused by a detergent challenge or UV-A irradiation. In addition, CM-glucan enhanced the renewal rate of the stratum corneum.

[Organoid nevus syndrome (Schimmelpenning-Feuerstein-Mims syndrome): case report and literature]. / Organoides Naevussyndrom (Schimmelpenning-Feuerstein-Mims-Syndrom): Kasuistik und Literatur.

The main symptom of the organoid nevus syndrome (Schimmelpenning-Feuerstein-Mims-Syndrom) is the nevus sebaceous, which is mostly linear and can be of variable expression. Malformations of the skeletal system and the eyes are usually associated, while malformations of the cardio-vascular system are less common. Neurological findings such as mental retardation and seizures are of clinical relevance. We describe a case and discuss this rare syndrome.

[Possible advantages of Excimer lasers in dermatology: an in vitro comparison of ArF and XeCl Excimer, Ar+ and Nd: YAG lasers]. / Mögliche Vorteile von Excimer-Lasern in der Dermatologie: Ein in vitro Vergleich mit ArF- und XeCl-Excimer, Ar+ und Nd: YAG-Lasern.

ArF and XeCl excimer lasers were compared with argon ion and Nd: YAG lasers regarding their respective cutting characteristics in human skin. Our light and SEM microscopic findings revealed that all lasers except the ArF excimer laser caused thermal damage to the skin.

[DTIC: effect on fibrinolysis and thrombocyte function]. / DTIC: Einfluss auf Fibrinolyse und Thrombozytenfunktion.

Pathogenesis of Budd-Chiari-syndrome, under treatment e.g. of malignant melanoma with DTIC (dacarbacin) is still unknown. In our investigations we could not find any hint for the hypothesis that Budd-Chiari-syndrome under DTIC is caused by hemostaseological impairment.

[Nuclear medicine kidney diagnosis in progressive systemic scleroderma]. / Nuklearmedizinische Nierendiagnostik bei der progressiven systemischen Sklerodermie (PSS).

Kidney involvement is one of the most frequent causes of death in progressive systemic scleroderma (PSS). It is therefore important to detect potential impairment of renal function in PSS very early. In 76 patients referred for nuclear medicine diagnostic procedures, 42 pathologic results were found with 131I-hippurate clearance, while only 14 abnormal results were detected by static 99mTc-DMSA scans. Hippurate clearance is thus a sensitive method of functional renal evaluation in PSS.

[Nuclear medicine diagnosis of heart involvement in progressive systemic scleroderma]. / Nuklearmedizinische Diagnostik der Herzbeteiligung bei progressiv systemischer Sklerodermie.

The frequency and extent of heart involvement in progressive systemic scleroderma (PSS) can be underestimated when current clinical diagnostic methods are used. We therefore studied 53 PSS patients with planar (201Tl) chloride myocardial scintigraphy, and 44 PSS patients with radionuclide ventriculography using red blood cells labeled in vitro with 99mTc. Comparison of maximal exercise and resting myocardial scans demonstrated pathologic findings in 18 of 38 patients. In 10% of the patients abnormal ejection fraction values (less than 50%) and Fourier analysis were found on radionuclide ventriculography. Myocardial scintigraphy in conjunction with other diagnostic modalities thus provides useful information for the evaluation of heart involvement in PSS.

[Scintigraphic detection of malignancies with radioactively labelled tumor antibodies. Clinical results based on immunohistochemical research]. / Szintigraphischer Malignomnachweis mit radioaktiv markierten Tumorantikörpern. Klinische Ergebnisse auf der Basis immunhistochemischer Untersuchungen.

69 patients with different tumors (colorectal, melanoma, testicle, ovary, bladder, carcinoid, lungs) were investigated by radioimmunoscintigraphy. The corresponding antibodies or their F(ab')2 fragments against CEA (n = 30), melanoma antigen (n = 25), TPA (n = 6), beta-HCG (n = 5), HMFG-2 (n = 2) and CEA/CA 19-9 (n = 1) were selected on the basis of immunohistochemical investigations of the primary tumors. The precision was 62%, and the number of false-negative findings was 32%. Additional clinical information (detection or exclusion of a suspected recurrence) could be obtained in 22 patients. From these results, it can be concluded that the corresponding tumor antibodies should be selected on the basis of immunohistochemical investigations of the primary tumor before performing radioimmunoscintigraphy to screen for recurrences or metastases.

[Risk factors for the development of malignant melanoma in West Germany. Results of a multicenter-case control study]. / Risikofaktoren für die Entwicklung maligner Melanome in der Bundesrepublik Deutschland. Ergebnises einer multizentrischen Fall-Kontroll-Studie.

In this multicenter case-control study (1,079 melanoma patients, 778 control persons), the significance of the well-known risk factors for the development of malignant melanoma (MM) was assessed for a German population. The multifactorial analysis of the data confirmed the total number of melanocytic nevi (MCN) as the most robust indicator for an increased melanoma risk. For persons with more than 50 MCN the relative risk was 4.8 times as high as for persons with fewer than 10 MCN. Hair color was found to be another valuable indicator. In persons with red hair the risk of MM was 4.7 that in individuals with black hair. Remarkably fair persons with skin type 1 (always sunburn, never tanning) had two times the risk of that in persons with skin type 4 (never sunburn, always tanning). The habit sun bathing for recreation showed no influence on the development of melanoma. A 2.7 x increased melanoma-risk was detected in persons with occupational sun exposure and out of doors work.