[Stapes anomaly, Gorlin-Goltz and hand-foot-uterus syndrome as partial aspects of a generalized ectodermal-mesodermal abnormality syndrome with variable expression]. / Stapesanomalie, Gorlin-Goltz- und Hand-Fuss-Uterus-Syndrom als Teilaspekte eines Generalisierten Ektodermal-Mesodermalen Missbildungssyndromes mit wechselnder Expressivität.

A case of a Gorlin-Goltz-syndrome with anomalies of the stapes and incus of one ear is described for the first time. In the reported case, the hand-foot-uterus-syndrome could be recognised simultaneously. In the literature, about 250 cases of the syndrome are known, first published by Gorlin and Goltz in 1960. Malformations of the middle ear, however, have not yet been described in the Gorlin-Goltz-syndrome. As in the reported case both of the syndromes, the Gorlin-Goltz-syndrome and the hand-foot-uterus-syndrome, could be diagnosed, it must be discussed whether there are two independent syndromes or only one syndrome of polyvalent malformations characterised by variable expressivity.

[Quantitative analysis of skin surface lipids using a sebumeter method. Random lipid levels on the skin surface during therapy with 13-cis-retinoic acid, minocycline hydrochloride and UVA rays]. / Die quantitative Analyse der Hautoberflächenlipide mit Hilfe einer Sebumetermethode. Untersuchungen des Zufallfettspiegels an der Hautoberfläche unter 13-cis-Retinsäure, Minocyclinhydrochlorid und UV-A-Strahlen.

The Sebumeter method used in this study for quantitative analysis of skin surface lipids differs from previous techniques in simple handling and quick practicability and is therefore helpful in the clinical routine. Sebumetrical measurements carried out on healthy persons revealed symmetrical distribution of skin surface lipids. The highest levels were found on the forehead; young people generally showed higher values than older persons. During therapy with 13-cis retinoic acid on acne patients for 6 months (0.5 mg/kg daily), we found reduction of the random level in the first month, particularly in the forehead region. During therapy with minocycline on 3 acne patients for 3 months (2 X 50 mg daily), there was no variation of the random level observed. UVA irradiation on the face for 10 minutes daily (0.55 J/cm2/min) over a period of 3 weeks resulted in continuous reduction of the random level in most of the tested persons; a small part of them reacted by fluctuating values.

[Roaccutan in acne and rosacea]. / Roaccutan bei Akne und Rosacea.

Isotretinoin (Accutane) is a lately developed synthetic oral retinoid for treatment of severe forms of cystic acne resistant to therapy. Its pharmacological effect principally consists in decreased size of the sebaceous glands, reduced sebum production, as well as alteration of the bacterial micropopulation. At a dosage of 0.5 mg up to 1.0 mg/kg body weight daily, isotretinoin led to significant reduction of the inflammatory skin eruptions and long-lasting remission after discontinuation of the drug. With regard to 18 patients suffering from rosacea, the application of Accutane brought about satisfactory results, as well. Mucocutaneous side-effects were almost compulsory, but did never lead to discontinuation of the treatment. Because of its teratogenity, isotretinoin must not be applied in case of gravidity. Accutane offers new modes of therapy with respect to patients suffering from nodulocystic acne or severe rosacea which did not respond to common forms of treatment.

[Diagnosis and therapy of syphilitic changes of the skin and mucous membrane in the head and neck]. / Diagnostik und Therapie syphilitischer Haut- und Schleimhautveränderungen im Kopf- und Halsbereich.

Since the mid seventies the German Federal Board of Statistics has recorded a decrease in the incidence of the classical venereal diseases gonorrhoea and syphilis. This decrease is based only on a decline in the morbidity of gonorrhoea. Statistics on syphilis show an increase, from about 6000 to 8900 new cases each year, that is an increase of 48% between 1974 and 1978. Some cities such as Cologne, with a total of 401 new cases each year, show an increase, while numbers in rural regions remain unchanged or show a slight decline. Between 1978 and 1980 at the ENT and Dermatologic OPC of Cologne University many ulcers of uncertain aetiology in the head and neck region have been diagnosed as primary or secondary syphilis or as unusual presentations of this disease. In our Department a primary lesion of the head and neck was the presenting symptom in about 6% of all newly diagnosed cases. The differential diagnosis of early syphilitis lesions in the head and neck, the present position of serological diagnosis, and the current treatment of syphilis are illustrated by selected typical lesions.

[Determination of gold deposition with a new analytical technic (PIXE)]. / Bestimmung dermaler Goldablagerungen mit einer neuen Analysentechnik (PIXE).

By means of proton induced X-ray emission ( PIXE ) we have been able to identify gold deposits in the skin of two patients after gold therapy. There were measured very low concentration of 15 ppm and 6 ppm.

[Effectiveness of fusidic acid alone and in combination with hydrocortisone-17-butyrate in infected dermatoses]. / Zur Wirksamkeit von Fusidinsäure als Monopräparat und in Kombination mit Hydrokortison-17-butyrat bei infizierten Dermatosen.

In a double-blind controlled study with 27 indoor patients good results were achieved in the treatment of infected dermatoses by fusidic acid and by the combination of fusidic acid with hydrocortisone-17-butyrate.

[Improvement of the IgM-FTA-ABS Test--Short Communication (author's transl)]. / Verbesserung der Aussagefähigkeit des IgM-FTA-ABS-Testes.

With immobilized Protein A from Staph. aureus, treponema-specific IgG can be removed from patient's serum by affinity chromatography. The IgM-FTA-ABS-test can be improved decisively by eliminating competition at the antigen of treponema-specific IgM and IgG and thus false negative results.

[Etiology and diagnosis of necrotizing fasciitis (author's transl)]. / Zur Pathogenese und Diagnostik der Fasciitis necroticans.

This is the report of three cases of necrotizing fasciitis, an acute and progressive disease involving the connective tissue, which may appear after infection with beta-hemolytic streptococci of group A (S. pyogenes). Painless ulcerations and necrosis along the fascial tissue are pathognomonic. Treatment consists in immediate and wide incisions to terminate the toxic effects due to the cell wall constituents of the streptococci together with an adequate chemotherapy. The laboratory diagnosis and the pathogenic mechanisms are discussed.

Differences in the potassium dependence of the myocardial action of some semisynthetic cardiotonic steroids.

Experiments on guinea pig isolated papillary muscle indicated different dependence of the functional actions of cardiac aglycones and some semisynthetic derivatives on the external K+, concentration. Whereas toxicity of the aglycones and their acetates was increased by low K+, that of the "alkylating" compounds remained unchanged; drug-induced contractility was increased uniformly. These differences are explained on the basis of the ATPase reaction scheme, including a carrier-mediated transport of cardiac glycosides.