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  • 1
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Malignes Melanom ; Epidemiologische Entwicklungen ; Aktuelle Therapie ; Key words Malignant melanoma ; Epidemiological trends ; Present therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The Central Malignant Melanoma Registry of the German Dermatological Society was founded in 1983 and has meanwhile developed into a major continuously updated multicentre project. Up to June 1994, 19250 reports of cutaneous melanoma had been received, from 41 departments of dermatology in the former Federal Republic of Germany, from 14 departments in the former German Democratic Republic, from 2 departments in Austria, and from 1 department in Switzerland. Analysis of the data revealed some epidemiological trends over time during the years 1983 to 1993. (1) During the last 10 years the percentage of male patients has steadily increased, from an average of 38% in the year 1983 to 46% in 1993. (2) Early diagnosis of malignant melanoma improved during the period of time investigated. The percentage of diagnoses of primary tumour alone increased between 1983 and 1993. The mean tumour thickness (Breslow) decreased in the West Germany from 1.8 mm to 1.3 mm and in East Germany from 2.5 mm to 1.7 mm. The proportion of nodular melanoma decreased correspondingly from 29% to 14% in the former Federal Republic of Germany and from 40.6% to 22.6% in the former Germany Democratic Republic. During the years 1990 and 1993, 64% of melanoma patients with the primary tumour alone were operated on in two consecutive sessions in the former Federal Republic of Germany and 34.2% of those in the former Germany Democratic Republic. During this period 73.7% of all melanoma patients were operated on under local anaesthesia. In recent years surgical operations were more often performed in two consecutive sessions, mostly under local anaesthesia and with decreasing safety margins, in keeping with the decrease in tumour thickness. The present analysis shows that the Central Malignant Melanoma Registry is an important instrument for investigating trends in clinical epidemiology and treatment of malignant melanoma in the German-speaking countries.
    Notes: Zusammenfassung Das Zentralregister Malignes Melanom der Deutschen Dermatologischen Gesellschaft hat seine Arbeit 1983 aufgenommen und sich seitdem zu einem kontinuierlich fortgeführten multizentrischen Projekt entwickelt. Insgesamt wurden bis Juni 1994 die Daten von 19.250 Patienten aus 41 Kliniken der alten Bundesländer, 14 Kliniken der neuen Bundesländer, zwei Kliniken aus Österreich und einer Klinik aus der Schweiz gemeldet. Die Auswertung der Daten läßt mehrere epidemiologische Trends im Zeitraum von 1983–1993 erkennen. a) Es fand sich eine kontinuierliche Zunahme des Anteils der Männer an den Melanom-Patienten, der im Mittel von 38% im Jahre 1983 auf 46% im Jahre 1993 anstieg. b) Die Früherkennung maligner Melanome wurde im untersuchten Zeitraum verbessert. Die Diagnosen im Stadium des Primärtumors stiegen im untersuchten Zeitraum an. Die mittlere Tumordicke nach Breslow nahm in den alten Bundesländern von 1,8 mm auf 1,3 mm und in den neuen Bundesländern von 2,5 mm auf 1,7 mm ab. Entsprechend verringerte sich der Anteil nodulärer Melanome in den alten Bundesländern im Mittel von 29,3% auf 14,1% und in den neuen Bundesländern von 40,6% auf 22,6%. In den Jahren 1990–1993 wurden in den alten Bundesländern 64% und in den neuen Bundesländern 34,2% aller primären malignen Melanome zweizeitig operiert. Insgesamt wurden 73,7% der Patienten in Lokalanästhesie operiert. In den letzten Jahren wurde vermehrt in Lokalanästhesie und zweizeitig operiert, wobei entsprechend der Abnahme der Tumordicke die endgültige Versorgung häufiger mit kleinerem Sicherheitsabstand erfolgte. Die vorliegende Analyse zeigt, daß das Zentralregister Malignes Melanom ein wichtiges Instrument zur Untersuchung von Entwicklungen der klinischen Epidemiologie und der Therapie des malignen Melanoms im deutschsprachigen Raum ist.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Chronische Veneninsuffizienz ; Arthrogenes Stauungssyndrom ; Gelenkbeweglichkeit ; Vibrationsreiz ; Biomechanische Stimulationstherapie (BMS) ; Mechanische Schwingungen ; Key words Chronic venous insufficiency ; Arthrogenic congestive syndrome ; Flexibility training ; Muscular strength ; Vibratory stimulation ; Biomechanical stimulation method (BMS)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We report about a new type of physical therapy which can be used in patients with joint immobility secondary to by chronic venous insufficiency. Biomechanical stimulation therapy (BMS) uses mechanical vibration of standardised frequencies from 18–35 Hz spectrum to expose the feet and legs to longitudinal mechanical stimuli. Therapeutic benefit and clinical improvement can be achieved after a short period of treatment. We describe a 76 year old female patient suffering from both impaired motion and recurrent venous ulceration due to chronic venous insufficiency. After 10 days treatment with BMS, mobility of upper ankle joints improved by 16 degrees and 19 degrees and was accompained by healing of venous ulcerations after skin flap transplantation. Biomechanical stimulation methods were developed in the former Sowiet Union where they were used in sports medicine to improve relaxation of strained muscle structures and to increase the stretching ability of capsules and tendons. We have successfuly treated 6 patients with impaired mobility and chronic venous insufficiency. We believe that BMS is lialy to become a valuable therapeutic tool in patients with this problem in the near future.
    Notes: Zusammenfassung Vorgestellt wird anhand einer Kasuistik ein neuartiges physikalisches Therapieverfahren, das bei Patienten mit arthrogenem Stauungssyndrom infolge einer chronischen Venenerkrankung zum Einsatz kommen kann. Die biomechanische Stimulationstherapie (BMS) stellt dabei eine technische Erweiterung physiotherapeutischer Möglichkeiten durch den Einsatz kontrollierter mechanischer Schwingungen dar und führt zu raschen und klinisch günstigen Therapieerfolgen. Vom BMS-Gerät werden im Rahmen der Behandlung definierte longitudinale Schwingungen im Frequenzbereich zwischen 18 und 36 Hz auf Fuß und Unterschenkel übertragen und damit eine Relaxation der beteiligten Muskulatur sowie eine verbesserte Dehnbarkeit des Kapselbandapparates ermöglicht. Bei der vorgestellten 76jährigen Patientin mit langjährig vorbestehenden Bewegungseinschränkungen im oberen Sprunggelenk, Ulcera cruris venosa bei postthrombotischem Syndrom, konnte der Bewegungsumfang im Sprunggelenk durch eine 10tägige Behandlungsphase mit der biomechanischen Stimulationstherapie (BMS) im Sprunggelenk um je 16 Grad bzw. 19 Grad an beiden Beinen verbessert und der Erfolg dermatochirurgischer Maßnahmen bei der Ulcussanierung gesichert werden. Das BMS-Verfahren stammt aus der ehemaligen Sowjetunion. Hier wurde es im Leistungssportbereich zur Muskelrelaxation und Dehnung eingesetzt. Beim arthrogenen Stauungssyndrom wurde es von uns erstmals klinisch erfolgreich zum Einsatz gebracht. Aufgrund vorliegender Ergebnisse bei bislang 6 Patienten mit arthrogenem Stauungssyndrom bewerten wir das BMS-Verfahren als wichtige neuartige physikalische Therapieform des arthrogenen Stauungssyndroms.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Disialoganglioside antigens GD2 and GD3 are expressed on most melanoma cells. On melanoma surrounding T-cells in immunohostological sections, disialogangliosides can also be found, as well as in a small % of T-lymphocytes in peripheral blood from healthy persons. In order to find out if there is a difference in ganglioside expression on peripheral T-lymphocytes between melanoma patients and healthy persons, we examined the expression of CD3 as T-lymphocytic antigen and GD2 or GD3 antigens, respectively, by flow cytometry. We used peripheral mononuclear blood cells of 12 patients with advanced disseminated malignant melanoma and of 12 healthy control donors. For immunostaining, murine monoclonal antibodies Leu-4, 14G2a and MB3.6 were used, recognizing CD3, GD2 and GD3. GD2 expression was found on only a low proportion of T-lymphocytes in patients and healthy persons (pat.: mean = 1.2%± 0.7%, co.: mean = 0.4%± 0.4%). Disialoganglioside antigen GD3, however, could be demonstrated on an average of 8.4%± 4.6% of patients' and on 4.0%± 2.1% of healthy persons' T-cells. There is a statistically significant difference (P 〈 0.01) between the data of patients' and control group. We conclude that there is a correlation between advanced malignant melanoma and expression of GD3 antigen on patients' peripheral T-lymphocytes. The immunological relevance of our findings is discussed.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: A variety of melanoma-associated antigens have been identified that mediate adhesion, growth, proteolysis, and modulation of immune response. However, the mechanisms by which human normal melanocytes become malignant are not clearly understood. Among the most consistent observations is the up-regulation of fibroblast growth factor-2 (FGF-2) and of the adhesion molecules β3 integrin and Mel-CAM during melanoma progression. To evaluate the potential role of FGF-2, β3 integrin and Mel-CAM in melanoma development we overexpressed FGF-2, β3 integrin and Mel-CAM in normal human melanocytes using replication-deficient adenoviruses as a gene delivery vehicle. Fibroblast growth factor-2 overexpressing melanocytes in monolayer culture displayed cytological atypia. Furthermore, in human skin reconstructs where the physiological milieu is recreated in vitro, FGF-2-overexpressing melanocytes exhibited marked proliferation, upwards migration, cluster formation and type IV collagen expression within the epidermal compartment, simulating early radial growth phase melanoma. In contrast, overexpression of β3 integrin and/or Mel-CAM in melanocytes did not affect their biological behaviour in human skin reconstructs. The described results of the current and previous studies emphasise the key role of FGF-2 in melanoma development and progression, underscoring the promise of FGF-2 as a target for therapy.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    International journal of dermatology 44 (2005), S. 0 
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 69-year-old woman presented to our clinic as an emergency with erythematous, well-circumscribed plaques, which were partly vesicular, on her extremities and in her armpits, and additionally hemorrhagic blisters on both her palms and her fingers (〈link href="#f1"〉Fig. 1a), which had developed 2 days after the first appearance of the skin lesions. The rapid onset of the lesions (within a few hours) and the pain associated with them were extremely troublesome to the patient. On admission she complained of fever, tiredness and being easily fatigued. Because of a urinary tract infection 1 month prior to admission, trospiumchloride was given. On clinical examination, body temperature was found to be above 38 °C and infraclavicular lymph nodes were enlarged but not tender.〈figure xml:id="f1"〉1〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD2287:IJD_2287_f1"/〉(a) Bullae on the patient's right hand. (b) Multiple partly confluent vesicles with neutrophilic granulocytes intraepidermally and a dense interstitial perivascular infiltration of neutrophilic granulocytes and lymphomononuclear cells (H&E, ×200)Normal or negative laboratory tests included blood counts, liver and kidney parameters, electrolytes and infection screen. Laboratory examination demonstrated minor leukocytosis and absolute neutrophilia (white blood cell count 10 440 cells/µL, neutrophils 8030 cells/µL). X-ray screening, abdominal ultrasound and laboratory investigations were all normal.There was no response to antibiotics when erythromycine was given. However, there was a good response to systemic corticosteroids. The patient was treated with a low dosage of prednisolone, beginning at 50 mg/day, which was then tapered off. Skin lesions resolved within 7 days.Histology from a lesion on the patient's left forearm showed a dense interstitial inflammatory infiltration consisting predominantly of neutrophilic granulocytes from the subepidermal layer to the middle of the reticular dermis. Inflammatory cells penetrated into both blood vessels and vessel walls; vasculitis was not prominent. In the lower dermis, perivascular infiltrations of lymphomononuclear cells were found. In addition, intraepidermally multiple partly confluent vesicles, with inclusions of neutrophilic granulocytes, were found, confirming the diagnosis of this rare variant of an acute febrile neutrophilic dermatosis (〈link href="#f1"〉Fig. 1b).
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0851
    Keywords: Melanoma ; 13-cis-Retinoic acid ; Interferon α
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of 13-cis-retinoic acid and highly purified human leukocyte interferon α (Alphaferon) therapy for metastatic melanoma was studied. A group of 17 patients with disseminated malignant melanoma were treated over a 6-month period. They received 60 mg 13-cis-retinoic acid/day continuously and ten cycles of interferon α (IFNα). IFN was administered by subcutaneous injection, at a daily dose of 6×106 IU Alphaferon. The 5-day treament period was followed by an IFN-free interval of 2 weeks. We were able to observe an overall response rate of 30% with 12% complete responses (2 out of 17 patients). Sites of response included the skin, lung, liver and lymph nodes. All responses have now lasted over 6 months. Therapy was generally well tolerated and could be performed on an outpatient basis. Side-effects of this combination therapy did not exceed the established side-effects of the two substances. We also studied 2′-5′-oligoadenylate synthetase, β2-microglobulin and neopterin levels during the whole treatment course. All patients were within the normal range before treatment and a sharp rise occurred during each IFN cycle. The maximum being observed 24 h after the third injection. This indicates a high biological activity of IFNα administered cyclicly during the whole treatment course. This finding also corresponds well with the absence of neutralizing antibodies before and after the whole treatment period.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0851
    Keywords: Melanoma ; Interferon β ; Antibodies ; Adjuvant trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The incidence and clinical significance of therapy-induced neutralizing interferon β (IFNß) antibodies was studied in a group of 21 melanoma patients treated with natural IFNß and 7 patients treated with recombinant IFNß. They were treated subcutaneously with 3×106 IU three times per week in an adjuvant open trial for 24 weeks after surgical removal of all detectable metastases. Of the 21 patients treated with natural IFNß, 95% developed significant levels of neutralizing antibodies after 24 weeks. In comparison, 28% of the 7 patients treated with recombinant IFNß developed neutralizing IFNß antibodies. Cross-reactivity of the antibodies could be demonstrated. Persistence of antibody titers was seen in 80% of the patients 24 weeks after cessation of treatment with natural IFNß. No correlation between the maximum antibody titers and the antibody persistence after cessation of therapy could be established. We detected a clear correlation between the formation of neutralizing antibodies and the decrease in β2-microglobulin and 2′,5′-oligoadenylate synthease and therefore the drop in biological activity. In this adjuvant trial there was no difference in relapse rate and time until relapse between antibody-positive and antibody-negative patients. No difference in clinical outcome could be established between the patients treated with natural IFNß and recombinant IFNß.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0851
    Keywords: Key words: Melanoma – Interferon β– Antibodies – Adjuvant trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The incidence and clinical significance of therapy-induced neutralizing interferon β (IFNβ) antibodies was studied in a group of 21 melanoma patients treated with natural IFNβ and 7 patients treated with recombinant IFNβ. They were treated subcutaneously with 3×106 IU three times per week in an adjuvant open trial for 24 weeks after surgical removal of all detectable metastases. Of the 21 patients treated with natural IFNβ, 95% developed significant levels of neutralizing antibodies after 24 weeks. In comparison, 28% of the 7 patients treated with recombinant IFNβ developed neutralizing IFNβ antibodies. Cross-reactivity of the antibodies could be demonstrated. Persistence of antibody titers was seen in 80% of the patients 24 weeks after cessation of treatment with natural IFNβ. No correlation between the maximum antibody titers and the antibody persistence after cessation of therapy could be established. We detected a clear correlation between the formation of neutralizing antibodies and the decrease in β2-microglobulin and 2′,5′-oligoadenylate synthetase and therefore the drop in biological activity. In this adjuvant trial there was no difference in relapse rate and time until relapse between antibody-positive and antibody-negative patients. No difference in clinical outcome could be established between the patients treated with natural IFNβ and recombinant IFNβ
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0851
    Keywords: Key words Melanoma ; 13-cis-Retinoic acid ; Interferon α
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The effect of 13-cis-retinoic acid and highly purified human leukocyte interferon α (Alphaferon) therapy for metastatic melanoma was studied. A group of 17 patients with disseminated malignant melanoma were treated over a 6-month period. They received 60 mg 13-cis-retinoic acid/day continuously and ten cycles of interferon α (IFNα). IFN was administered by subcutaneous injection, at a daily dose of 6×106 IU Alphaferon. The 5-day treatment period was followed by an IFN-free interval of 2 weeks. We were able to observe an overall response rate of 30% with 12% complete responses (2 out of 17 patients). Sites of response included the skin, lung, liver and lymph nodes. All responses have now lasted over 6 months. Therapy was generally well tolerated and could be performed on an outpatient basis. Side-effects of this combination therapy did not exceed the established side-effects of the two substances. We also studied 2′-5′-oligoadenylate synthetase, β2-microglobulin and neopterin levels during the whole treatment course. All patients were within the normal range before treatment and a sharp rise occurred during each IFN cycle. The maximum being observed 24 h after the third injection. This indicates a high biological activity of IFNα administered cyclicly during the whole treatment course. This finding also corresponds well with the absence of neutralizing antibodies before and after the whole treatment period.
    Type of Medium: Electronic Resource
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