bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexamethasone pulse therapy in pemphigus
Authors: Tóth Gg , Van De Meer Jb , Jonkman Mf 
Published: March 2003

ABSTRACTPulse therapy with high‐dose glucocorticoids was introduced 20 years ago as a treatment modality for autoimmune disease and transplant rejection. The most popular dermatological indication for pulse therapy is severe pemphigus. We reviewed the sequelae of 14 patients with pemphigus who were treated by pulse therapy. Seven of them reached complete remission, although three of them needed a new pulse course due to disease flare‐up. Adverse events were minor and confined to 60% of all patients: temporary facial flushing during pulse administration, sleep disturbances during the first night after pulse administration, and mood changes occurred during the week of pulse therapy. The study showed the possibility of oral instead of an intravenous route of dexamethasone pulse administration, which makes double‐blind placebo‐controlled trials ethically feasible. Fifty per cent of the patients reached complete remission. This retrospective study does not allow claims on the steroid‐sparing effect.
Scleroderma ‘en coup de sabre’ and progressive facial hemiatrophy. Is it possible to differentiate them?
Authors: Orozco‐Covarrubias L , Guzmán‐Meza A , Ridaura‐Sanz C , Carrasco Daza D , Sosa‐De‐Martinez C , Ruiz‐Maldonado R 
Published: March 2003

AbstractThe aim was to be able to evaluate the diagnosis of two diseases by a consensus of clinical opinion used in the Department of Dermatology of the National Institute of Paediatrics in Mexico City. To differentiate between scleroderma ‘en coup de sabre’ (SCS) and progressive facial hemiatrophy (PFH), colour slides of 13 patients diagnosed as SCS and nine as PFH were examined by two dermatologists and microscopic slides by two pathologists. In both cases, the slides were randomly presented and no clinical information was given. The clinical and histopathological findings were statistically compared with two‐tailed tests and α = 0.05. κ coefficients were obtained to evaluate the concordance between dermatologists, pathologists, and in terms of the consensus diagnosis. The usefulness of photographic assessment is limited by the inability to palpate the consistency of lesions. The most important clinical feature that differentiated both conditions was cutaneous sclerosis present in eight of 13 patients with SCS and in none of the PFH patients (P < 0.005). Other clinical features more frequently found in SCS were cutaneous hyperpigmentation and alopecia. The more frequent clinical features in PFH were total hemifacial involvement and ocular changes. Statistically significant histopathological features were: connective tissue fibrosis present in all cases with SCS and two of nine patients with PFH (P < 0.0002); adnexal atrophy present in 11 of 13 patients with SCS, and in three of nine with PFH (P < 0.02), and mononuclear cell infiltrates in all patients with SCS cf. six with PFH (P < 0.05). Our results suggest that in most cases it is possible to differentiate SCS from PFH based on clinicopathological findings.
Alternative treatment of psoriasis with balneotherapy using Leopoldine spa water
Authors: Tsoureli‐Nikita E , Menchini G , Ghersetich I , Hercogova J 
Published: March 2003

AbstractBackground Leopoldine spa water is a hypotonic water rich in sulphate that has been used occasionally for balneological treatments in psoriatics. We evaluated the anti‐inflammatory effects of this salso‐sulphate water on the skin of subjects with psoriasis.Patients and methods We selected 10 volunteer subjects (23–58 years old), who presented symmetrical, bilateral psoriasis involving at least 40% of the body surface. All the subjects were subjected to the following treatment schedule: (i) immersion of both arms in water twice a day [the right arm was immersed in Leopoldine spa water at its natural source temperature (27.2 °C) for 30 min, and the left arm was immersed in double‐distilled water for 30 min at a constant temperature of 27 °C]; (ii) both arms were exposed to the sun for 60 min after each immersion; and (iii) vaseline containing moisturizing creams were applied liberally. The treatment was continued for 4 weeks and was well tolerated by all subjects. Response to treatment was assessed by means of the modified Psoriasis Area and Severity Index (PASI). Six of the 10 subjects volunteered to undergo a cutaneous biopsy of lesional skin both before and 4 weeks after treatment to allow for assessment of modifications of the cutaneous infiltrate in the areas treated.Results At the end of 4 weeks the average pretreatment PASI score of the left arms was 5.72 (range 4–9.6) while the right arms had a mean PASI of 5.56 (range of 3.2–9). At the end of the study the average PASI score was 0.78 for the arms treated with Leopoldine spa water and 2.83 for the arms treated with double‐distilled water. The mean PASI improvement score for the Leopoldine spa water treated arms was 85.9% while the double‐distilled water treated arms showed a PASI improvement score of 50.5%. An immunohistological study showed significant differences between the cutaneous samples taken 4 weeks after treatment and those taken before treatment with Leopoldine spa water. There were significant decreases in the numbers of epidermal CD4+ and CD8+ T lymphocytes and CD1a+ Langerhans cells (microscopic field at × 22 objective), as well as a decrease in the epidermal keratinocyte expression of intercellular adhesion molecule‐1 and interleukin‐8 and the dermal expression of CD4+ and CD8+ T lymphocytes.Conclusions These data show the potential anti‐inflammatory effects of Leopoldine mineral waters on human skin affected by psoriasis.
Assessment of depression in subjects with psoriasis vulgaris and lichen planus
Authors: Akay A , Pekcanlar A , Bozdag KE , Altintas L , Karaman A 
Published: March 2003

AbstractAim The aim of this study was to investigate the frequency of depressive symptoms in psoriasis vulgaris and lichen planus and to evaluate the relationship between the Beck depression scores and the Psoriasis Area and Severity Index (PASI) scores of subjects with psoriasis vulgaris.Subjects The study involved 120 subjects attending the dermatology clinic of Izmir Ataturk Training Hospital (Izmir, Turkey) and comprised 50 subjects with psoriasis vulgaris, 30 with lichen planus and 40 healthy control subjects.Results Subjects with psoriasis vulgaris, lichen planus and controls had depression scores of 58%, 53% and 20%, respectively. The Beck depression scores of patients with psoriasis vulgaris were significantly higher than those of the control group. The PASI scores showed a correlation with Beck depression scores. Smoking and drinking were very common in subjects with psoriasis vulgaris. There was no correlation between the duration of illness and depressive symptoms.Conclusions This study confirms the importance of depressive symptoms in two common dermatological diseases. It is important to recognize this association as it affects both clinical outlook and response to treatment.
Psychological features of androgenetic alopecia1
Authors: Camacho FM , García‐Hernández MJ 
Published: March 2003

AbstractObjective To evaluate the psychological features of subjects with male (MAGA) and female androgenetic alopecia (FAGA).Methods We performed a retrospective study of 100 patients with FAGA and the same number of patients with MAGA based on the features registered in the personal history of individuals who attended our Trichology Unit (Hospital Universitario Virgen Macarena, Sevilla, Spain) from January 1993 to January 1995.Results Depression was more frequent in FAGA than in MAGA (55:3), but anxiety (78:41) and aggressiveness or hostility were more frequent in MAGA than in FAGA (22:3), and three men were considered anxious and depressive. Treatment resulted in improvement in 89% of FAGA and 76% of MAGA, and the subjects continued attending with periodic check‐ups. There were requests for surgical treatment by 3% of FAGA and 12% of MAGA, and 6% of FAGA and 12% of MAGA did not return for follow‐up consultation. All of the MAGA showed aggressiveness and lack of willingness to follow the correct treatment.Conclusions In general, AGA patients tend to have elusive personalities and, although the individuals may go to the trichology centre accompanied they preferred to present alone to the desk or at least to the trichological examination room, except for subjects with depression who would often not agree to the physician removing hairs for the trichogram. Most subjects accepted the prescribed medical or surgical treatment, but several phoned before the second treatment session because the results of the first session were not as good as they had expected. The drop‐out rate was higher in men (1 in 2), who were probably subjects showing aggressiveness.
Mycosis fungoides presenting as Ofuji's papuloerythroderma
Authors: Hur J , Seong J‐Y , Choi T‐S , Jang J‐G , Jang M‐S , Suh K‐S , Kim S‐T 
Published: March 2003

AbstractWe report three patients presented with clinical features of Ofuji's papuloerythroderma (pruritic erythematous papules and extensive erythema sparing all skin folds), however, showing histopathological findings of mycosis fungoides (Pautrier's microabscess, haloed lymphocytes, disproportionate epidermotropism, and wiry collagen bundles). One case was associated with plaque stage of mycosis fungoides and follicular mucinosis. T‐cell receptor (TCR) gene rearrangement analysis in the lesional skin tissue demonstrated rearrangement of the gamma chain in all cases. HTLV‐1 serology was negative for two patients who conducted HTLV‐1 test. We think that Ofuji's papuloerythroderma might be a variant of early mycosis fungoides rather than secondary skin manifestations to certain cutaneous inflammatory diseases.
Skin necrosis from extravasation of Vinorelbine*
Authors: Moreno de Vega MJ , Dauden E , Abajo P , Bartolome B , Fraga J , Garcia‐Diez A 
Published: March 2003

AbstractSkin necrosis from intravenous infiltration of soft tissue is a rare but potentially devastating complication of intravenous therapy. Vinca alkaloids are among the intravenous drugs with the highest destructive power.We report two cases of skin necrosis from accidental extravasation of vinorelbine, a semisynthetic analogue of vinblastine, rarely described as being responsible for this event. Histopathologic study showed separation of the dermis from necrotic epidermis, associated with cytologic atypia, in both patients, and focal necrosis of eccrine glands in one of them.We consider that intravenous infusions of vinorelbine should be performed using the preventive measures and care applied for other chemotherapeutic agents with high potential for induction of skin necrosis due to extravasation.
Extracorporeal photochemotherapy in the treatment of eosinophilic fasciitis
Authors: Romano C , Rubegni P , De Aloe G , Stanghellini E , D’Ascenzo G , Andreassi L , Fimiani M 
Published: March 2003

ABSTRACTBackground Eosinophilic fasciitis (EF) is a rare connective tissue disorder characterized clinically by symmetrical swelling, induration and thickening of the skin and histologically by thickening of the fascia with chronic inflammatory infiltrate containing eosinophils. The disease is classified in the spectrum morphea/systemic sclerosis and treated with systemic steroids and other immunosuppressant drugs.Objective The purpose of this study was to use extracorporeal photochemotherapy (ECP) in patients with EF to evaluate the effectiveness of this therapy.Subjects and methods Three patients affected by EF were treated with ECP because they failed to respond or with contraindications to immunosuppressant treatment. The patients underwent ECP with a UVAR XTS apparatus. Subjects were treated on two consecutive days at 2‐week intervals for the first 3 months and thereafter every 4 weeks on the basis of clinical response. The patients were assessed before therapy and then monthly by means of a clinical score. Changes in affected areas were evaluated at predetermined points by computerized skin elastometry (Cutometer SEM 474).Result After 1 year of therapy we found considerable improvement of clinical parameters in two cases. There was less striking improvement in the other case. These clinical results were confirmed by the elastometry measurements. All patients reported improved quality of life, which enabled a reduction in the dose of immunosuppressants.Conclusion ECP emerged as a safe and effective therapy in association with low doses of immunosuppressants in our three patients. A randomized comparative multicentre study between ECP as single therapy and ECP plus immunosuppressants and conventional therapies is required to firmly establish photopheresis as a possible basic treatment to combine with conventional therapies for EF.
Leg ulcer in Klinefelter's syndrome
Authors: Igawa K , Nishioka K 
Published: March 2003

AbstractHypostatic ulceration of the legs is relatively uncommon in men. Recently, the hypothesis that recurrent ulceration in men may be associated with chromosomal abnormalities such as Klinefelter's syndrome is gradually being accepted. Herein, we describe a patient with Klinefelter's syndrome complicated by recurrent leg ulcers, in whom immunological disorders such as positive antinuclear factor, antiphospholipid antibodies and cryoglobulins without venous insufficiencies were demonstrated. Interestingly, these abnormalities of immune functions were normalized after the androgen replacement therapy for Klinefelter's syndrome, and his leg ulcers immediately recovered.
Ethics, an emerging subdiscipline of obstetric ultrasound, and its relevance to the routine obstetric scan
Authors: Chervenak F. A. , McCullough L. B. 
Published: March 2003

AbstractEthics is an emerging subdiscipline of obstetric ultrasound because there are clinical dimensions of obstetric ultrasound that only ethics can identify and address. These dimensions concern the ethical obligations of physicians to their patients. Ethics is defined as the disciplined study of morality. Two fundamental principles of ethics are described, beneficence and respect for autonomy. How ethics can bring to light clinical dimensions of obstetric ultrasound that are insufficiently appreciated is illustrated with the example of the routine use of obstetric ultrasound in the second trimester. The authors conclude that prenatal informed consent for sonogram should be an integral part of obstetric care in countries, such as the United States, in which routine ultrasound is not endorsed. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Conservative treatment of ectopic pregnancies using a single echo‐guided injection of methotrexate into the gestational sac
Authors: Venezia R. , Zangara C. , Comparetto G. , Cittadini E. 
Published: March 2003

AbstractThe authors describe the possibility of the conservative treatment of five early ectopic pregnancies. A single injection of methotrexate into the tubal gestational sac was performed under vaginal ultrasound guidance. In all five cases, a clear ectopic gestational sac could be visualized. The pregnancies dated from the 5th to the 7th week of amenorrhea. Strict ultrasound follow‐up following injection showed a gradual reduction in the size of the tubal gestational sac. At the same time, plasma β‐hCG gradually decreased to zero after a maximum time period of 25 days. Subsequent hysterosalpingography performed on all of the women demonstrated bilateral normal patent tubes.It is concluded that, in selected patients, transvaginal injection provides an alternative relatively non‐invasive approach to the management of ectopic pregnancy. It is proposed that the adoption of a policy of earlier diagnosis and treatment may lead to a reduction in the incidence of some tubal causes of infertility. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonography of the uterine cavity following curettage for early pregnancy failure
Authors: Haines C. J. , Shand K. L. , Leung D. Y. L. 
Published: March 2003

AbstractIn a study of 50 women presenting with sonographically confirmed early pregnancy failure, the uterine contents were measured in both sagittal and transverse planes before proceeding with evacuation of the retained products of conception. A repeat sonographic study of the empty uterine cavity was performed on the day after curettage and similar measurements were made, the subjects having been divided into four groups according to gestational age. There was no significant difference between the groups in the postoperative measurements of either uterine cavity width or area, nor was the size of the empty uterine cavity influenced by the volume of tissue within the uterus before evacuation. Whilst the measurement of width was similar both before and after evacuation of the uterus in all groups, the sagittal area was significantly smaller postoperatively. There was no evidence of retained tissue at any of the postoperative sonographic examinations, nor did any of the subjects in the study develop subsequent complications. Assuming the dimensions of the uterine cavity following curettage are representative of an empty uterus, this will form the basis of a prospective study to determine whether spontaneous abortion can be safely managed without curettage in selected cases, if the preoperative sonographic measurements fall within a specified range. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Changes in inferior vena cava blood flow velocity and diameter during breathing movements in the human fetus
Authors: Huisman T. W. A. , van den Eijnde S. M. , Stewart P. A. , Wladimiroff J. W. 
Published: March 2003

AbstractBreathing movements in the human fetus cause distinct changes in Doppler flow velocity measurements at arterial, venous and cardiac levels. In adults, breathing movements result in a momentary inspiratory collapse of the inferior vena cava vessel wall. The study objective was to quantify the inferior vena cava flow velocity modulation during fetal breathing movements and to evaluate possible inferior vena cava vessel diameter changes in normal third‐trimester pregnancies.We studied 57 women after oral administration of dextrose (50 g). In 40 fetuses (n = 19, 27–32 weeks and n = 21, 36–39 weeks), fetal inferior vena cava waveforms were obtained during apnea and fetal breathing activity. In 30 fetuses (27–39 weeks) inferior vena cava vessel diameter changes were studied using the M‐mode during apnea and breathing movements. Peak and time‐averaged velocities of inferior vena cava flow velocity waveforms showed a gestational age‐independent increase of 60–160% during breathing activity. A temporary inferior vena cava vessel wall collapse (range, 50–83%) was recorded, which was significantly different from vessel diameter changes during apnea (range, 11–19%). The marked increase of inferior vena cava flow velocities is due to a raised thoraco‐abdominal pressure gradient, which may cause a reduction in vessel size and additional volume flow into the right atrium. The significance of the caval index for recognition of elevated right atrial pressure in abnormal human fetal development needs further investigation. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Trends in sonographic fetal organ visualization
Authors: Wolfe H. M. , Zador I. E. , Bottoms S. F. , Treadwell M. C. , Sokol R. J. 
Published: March 2003

AbstractIn order to assess changes in sonographic visualization over the last 6 years, 7092 second‐ and third‐trimester ultrasound examinations from separate pregnancies in three individual years (1451 in 1985, 3016 in 1988, and 2625 in 1991) were compared. Overall, visualization across all gestational ages improved from 63.9% (1985) to 85.8% (1988) to 87.3% (1991), with the year in which the scan was performed explaining 19.6% of the variance in visualization. Maternal size (as determined by body mass index) remained the major determinant of ultrasound visualization in 1991 (r² = 11.2%), with gestational age explaining only 5.2% additional variance. Overall organ visualization was maximal at 21–23 weeks' gestation, with the decline in later gestation primarily accounted for by worsened visualization of fetal extremities and spine. Improved fetal visualization earlier in the second trimester and the advent of embryonic visualization in the first trimester may allow a continuum of prenatal sonographic diagnosis. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Fetal echocardiography: the identification of two of the pulmonary veins from the four‐chamber view during the second trimester of pregnancy
Authors: Anteby E. Y. , Shimonovitz S. , Yagel S. 
Published: March 2003

AbstractIdentification of two of the pulmonary veins as they enter the left atrium is important to the diagnosis of the visceroatrial situs for fetuses with normal and abnormal echocardiographic findings. In this study, we investigated the ability to demonstrate these veins in 734 fetuses varying in gestational age from 13 to 21 weeks.Transvaginal and transabdominal B‐mode ultrasound and color flow Doppler were used for the examination. With the use of the transvaginal route, the highest visualization rate, 85–95%, was achieved in fetuses of 14–15 weeks of gestation. With the use of the transabdominal route, the highest visualization rate, 95–97%, was achieved in fetuses of 20–21 weeks of gestation. This examination enabled the correct diagnosis to be made of complex cardiac anomaly.Visualization of the pulmonary veins with B‐mode ultrasound aided by color flow Doppler can be accomplished in the majority of fetuses, while the four‐chamber view is studied. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Arteriovenous malformation of the uterus associated with a missed abortion
Authors: Ginsberg N. A. , Hammer R. , Parihk S. , Tamura R. , Sabbagha R. E. 
Published: March 2003

AbstractArteriovenous malformation of the uterus is a rare uterine abnormality. This entity is generally associated with the presence of molar disease, choriocarcinoma and uterine surgery, but may be congenitally acquired. The presence of an arteriovenous malformation generally leads to unexplained profuse uterine bleeding. The diagnosis of this entity has traditionally been made by arteriography, and the treatment is usually hysterectomy. We present a patient with an arteriovenous malformation of the uterus whose prior delivery was by Cesarean section. The patient experienced episodes of heavy vaginal bleeding in the first month following the procedure of suction curettage for a first‐trimester pregnancy loss. Chorionic villus sampling performed prior to the procedure showed a chromosomally normal fetus. The diagnosis of an arteriovenous malformation was made by color Doppler velocimetry and confirmed with arteriography. The patient desired to maintain her fertility. Interventional radiological techniques were successfully utilized to obliterate the arteriovenous malformation with the use of polyvinyl alcoholparticles (250 µm) and gelfoam. Discussion includes the presenting signs and symptoms along with the method of both diagnosis and conservative management. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
First‐trimester diagnosis of hydrolethalus syndrome
Authors: Ämmälä P. , Salonen R. 
Published: March 2003

AbstractAt 12 weeks of gestation, a combination of atypical hydrocephalus with absent mid‐line structures and club foot was detected during transvaginal ultrasound examination. These findings were diagnostic of hydrolethalus syndrome and were confirmed after subsequent termination of the pregnancy. This is the first known case of first‐trimester prenatal diagnosis of hydrolethalus syndrome. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology