85 results on '"K. Hoffmann"'
Search Results
2. [The German Sonderweg of § 64 of the German Penal Code-Authoritarian state deprivation of the right to decision of therapeutic option?]
- Author
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Hoffmann K
- Subjects
- Humans, Germany, Commitment of Persons with Psychiatric Disorders, Prisoners
- Published
- 2023
- Full Text
- View/download PDF
3. [Suicidality in schizophrenic psychosis: a current overview].
- Author
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Knorr R and Hoffmann K
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- Humans, Risk Factors, Suicide, Attempted, Psychotic Disorders diagnosis, Psychotic Disorders therapy, Schizophrenia diagnosis, Schizophrenia therapy, Suicide Prevention
- Abstract
Background: Suicidality in schizophrenic psychosis is an important topic but stands in clinical everyday work behind the perception of suicide especially in affective disorders. Schizophrenic psychosis is recognized as an independent risk factor for suicide attempts and suicides, whereas it poses particular challenges to the clinical professional due to the frequent unpredictability, abruptness and brutality of the methods used. For this reason, the suicide of a psychotic patient often leaves the professional and non-professional environment disturbed., Aims: An overview of the existing relevant literature on suicide in psychosis is given. Explanations on the psychodynamics, indications on pharmacotherapy and psychotherapy and considerations on prevention round off this article and provide an up to date overview of this topic for clinicians., Material and Methods: A search was carried out in PubMed and Google scholar using the terms "suicide", "suicidality", "schizophrenia", "suicide AND schizophrenia", "suicide AND psychosis", "suicidality AND schizophrenia", "suicidality AND psychosis", "suicidality AND psychosis AND prevention", "suicide AND psychosis AND prevention", "suicidality AND schizophrenia AND prevention", "suicide AND schizophrenia AND prevention"., Conclusion: Clinicians must have knowledge of the specific risk factors for suicide in psychotic patients, the characteristics of suicide in terms of design and temporal connection with treatment. The exploration and assessment of suicidality is often more difficult in psychotic patients than in affective or personality disorder patients, as there are often impulsive suicide attempts that can be explained by (suddenly occurring) psychotic symptoms and are therefore difficult or even impossible to foresee., (© 2020. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2021
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4. A Choosing Wisely top-5 list to support general practitioners in Austria.
- Author
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Glechner A, Rabady S, Bachler H, Dachs C, Flamm M, Glehr R, Hoffmann K, Hoffmann-Dorninger R, Kamenski G, Lutz M, Poggenburg S, Tschiggerl W, and Horvath K
- Subjects
- Austria, Child, Humans, Male, Medical Overuse, General Practice, General Practitioners
- Abstract
From a pool of 147 reliable recommendations, ten experts from the Austrian Society of General Practice and Family Medicine selected 21 relevant recommendations as the basis for the Delphi process. In two Delphi rounds, eleven experts established a top‑5 list of recommendations designed for Austrian family practice to reduce medical overuse. Three of the chosen recommendations address the issue of antibiotic usage in patients with viral upper respiratory tract infections, in children with mild otitis media, and in patients with asymptomatic bacteriuria. The other two "do not do" recommendations concern imaging studies for nonspecific low back pain and routine screening to detect prostate cancer. A subsequent survey identified the reasons for selecting these top‑5 recommendations: the frequency of the issue, potential harms, costs, and patients' expectations. Experts hope the campaign will save time in educating patients and provide legal protection for omitting measures., (© 2021. The Author(s).)
- Published
- 2021
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5. [Identical oncological results with lower perioperative morbidity after laparoscopic liver resection : Results of a matched pair analysis].
- Author
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Schön MR, Kouladouros K, Hoffmann K, Gärtner D, Tournas I, and Justinger C
- Subjects
- Humans, Length of Stay, Matched-Pair Analysis, Retrospective Studies, Treatment Outcome, Hepatectomy methods, Laparoscopy, Liver Neoplasms surgery
- Abstract
Background: Laparoscopic liver resection belongs to the standard repertoire in hepatobiliary surgery. The advantages and disadvantages are still the subject of controversial discussion., Objective: The aim of the study was to compare the perioperative and long-term outcomes of laparoscopic and open liver resections., Material and Methods: All patients who underwent liver resection in the Department of Surgery at the certified liver center of the municipal hospital Karlsruhe were analyzed. From a total of 268 hepatic resections 65 laparoscopic liver resections were identified and matched 1:1 with 65 open resections, based primarily on the extent of the resection and secondarily on diagnosis, age and gender of the patients. The demographic data, comorbidities, perioperative and long-term outcomes were compared., Results: Both groups had comparable demographic parameters and comorbidities. Operation time, duration of intensive care stay and percentage of negative resection margins were comparable in both groups. The 30-day mortality was 0% and 90-day mortality 1.5% in both groups. The laparoscopic group showed lower intraoperative and postoperative transfusion rates (p < 0.001), shorter hospital stay (p < 0.001) and lower overall morbidity (p < 0.001). The 1-, 3- and 5-year overall and tumor-free survival of patients with colorectal liver metastases was comparable (p = 0.984; p = 0.947). The same applied for patients with hepatocellular carcinomas (p = 0.803; p = 0.935)., Conclusion: Laparoscopic liver resections have identical long-term outcomes with lower overall morbidity. Laparoscopic liver resections offer advantages regarding transfusion rates, length of hospital stay and postoperative complications.
- Published
- 2018
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6. [The Indian Ayurveda medicine-a meaningful supplement to psychiatric treatment?]
- Author
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Juckel G and Hoffmann K
- Subjects
- Dietary Supplements, Germany, India, Medicine, Ayurvedic standards, Mental Disorders therapy, Plants, Medicinal
- Abstract
Ayurveda is a traditional Indian system of medicine that is more than 3000 years old, consisting mostly of a specific diet, oily infusions mainly in the area of the head, enemas, medicinal plants and yoga. It is based on a naturopathic and anthropological belief in association with the hinduistic religion. Ayurveda has been practiced very successfully in India but so far it has only been insufficiently appreciated by western medicine, especially psychiatry. An exception is Scharfetter from Zürich who wrote a review article on this topic in 1976. Nevertheless, it is probable that particularly the immunological mechanisms of psychotic and affective disorders can be influenced by the application of ayurvedic methods; however, the empirical data source, particularly with respect to randomized controlled trials and meta-analyses regarding psychiatric disorder symptoms is limited. Even if Ayurveda is applied in a highly individualized manner, this should be rapidly improved for further evidential assessment. First positive experiences in the neuropsychiatric field in Germany are already available.
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- 2018
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7. [Delusions: current psychodynamic and neurocognitive approaches].
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Knorr R and Hoffmann K
- Subjects
- Capgras Syndrome diagnosis, Capgras Syndrome psychology, Capgras Syndrome therapy, Delusions diagnosis, Delusions therapy, Diagnosis, Differential, Diagnostic and Statistical Manual of Mental Disorders, Early Diagnosis, Early Medical Intervention, Gestalt Theory, Humans, International Classification of Diseases, Neurocognitive Disorders diagnosis, Neurocognitive Disorders therapy, Psychopathology, Psychotic Disorders diagnosis, Psychotic Disorders psychology, Psychotic Disorders therapy, Schizophrenic Psychology, Social Adjustment, Theory of Mind, Delusions psychology, Neurocognitive Disorders psychology, Psychoanalytic Theory
- Abstract
Background: The symptom "delusions" is a central psychopathological symptom in psychiatric diseases. Since the beginning of psychiatry various disciplines have attempted to explain and understand delusions but even now no generally accepted definition of this phenomenon exists., Aim: A comprehensive review of current psychopathological and neurobiological theories of delusions is given., Material and Methods: PubMed and Google scholar searches were performed using the keywords "delusion", "psychodynamic" and "neurobiology", both in English and German. Relevant German textbooks of psychiatry were also included., Discussion: A differentiated perspective of the phenomenon of delusions appears to be necessary to approach this complex and fascinating symptom. A one-dimensional approach does not do justice to the complexity of delusions. The various explanatory approaches can increasingly be linked to each other and are no longer considered to be mutually exclusive.
- Published
- 2018
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8. [Therapy drop-out as a predictor of re-delinquency : Legal probation of substance addicted patients according to §64 of the German Legal Code].
- Author
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Querengässer J, Bulla J, Hoffmann K, and Ross T
- Subjects
- Adult, Female, Follow-Up Studies, Forensic Psychiatry legislation & jurisprudence, Germany, Humans, Male, Prospective Studies, Psychotropic Drugs, Recurrence, Risk Factors, Substance-Related Disorders psychology, Crime legislation & jurisprudence, Crime psychology, Patient Dropouts psychology, Prisoners legislation & jurisprudence, Prisoners psychology, Psychotherapy legislation & jurisprudence, Substance-Related Disorders rehabilitation
- Abstract
Background: Recidivism rates in substance-addicted patients placed in institutions according to §64 of the German legal code are approximately 50%, 3 years after discharge from inpatient treatment. The recidivism rates of patients with premature termination of inpatient treatment who had then been referred back to prison and were finally discharged into the community are unknown., Research Question: Is premature termination of treatment a risk factor for recidivism?, Methods: Patients released from forensic treatment according to § 64 of the German legal code were followed up for violent and non-violent recidivism. Full data were acquired for Baden-Württemberg patients released in 2010 and 2011 with regular vs. premature termination of treatment., Results: All measures revealed highly significant group differences: 48% of the patients discharged after subsequent prison sentences recidivated within the first year and 73% within 3 years after discharge. Among recidivists, the severity of offences was much higher (odds ratio > 3.8 each). Regularly discharged patients also re-offended to a remarkable extent (50%)., Discussion: Patients serving prison sentences after unsuccessful forensic treatment are a high-risk group for recidivism. Alternative concepts of clinical and legal treatment of this group should be developed.
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- 2018
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9. [Healthcare research in forensic commitment or poking around in the dark : Consensus paper on the necessity for more uniform and better data].
- Author
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Querengässer J, Bezzel A, Hoffmann K, Mache W, and Schiffer B
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- Commitment of Persons with Psychiatric Disorders legislation & jurisprudence, Data Collection legislation & jurisprudence, Forecasting, Germany, Health Services Needs and Demand legislation & jurisprudence, Health Services Research legislation & jurisprudence, Humans, Surveys and Questionnaires, Commitment of Persons with Psychiatric Disorders trends, Data Collection trends, Health Services Needs and Demand trends, Health Services Research trends
- Abstract
Complex trends in occupancy determined by many influencing factors, clear state-specific differences in imprisonment practices as well as recently implemented statutory alterations to the appropriate paragraphs in criminal law, underline the necessity for qualitative high-grade concomitant research of German forensic commitment; however, neither the structural prerequisites nor an adequate data situation are currently present in order to do justification to this aim. Not even the total number of patients currently accommodated in forensic commitment can be elucidated from the publicized (partial) statistics. This consensus paper, which was formulated by three research institutes active at the state level, describes the limited possibilities for current forensic healthcare research and raises the demand for a nationwide uniform data situation on patients in forensic commitment. Furthermore, how the appropriate elicitation instrument should be organizationally and structurally achieved, is sketched from a scientific perspective. This article aims at initiating a discussion on a sustainable improvement in the prerequisites for healthcare research in German forensic commitment and targets a sensitization of decision makers in politics and administration for this topic.
- Published
- 2017
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10. [Standards for treatment in forensic committment according to § 63 and § 64 of the German criminal code : Interdisciplinary task force of the DGPPN].
- Author
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Müller JL, Saimeh N, Briken P, Eucker S, Hoffmann K, Koller M, Wolf T, Dudeck M, Hartl C, Jakovljevic AK, Klein V, Knecht G, Müller-Isberner R, Muysers J, Schiltz K, Seifert D, Simon A, Steinböck H, Stuckmann W, Weissbeck W, Wiesemann C, and Zeidler R
- Subjects
- Ambulatory Care ethics, Ambulatory Care legislation & jurisprudence, Ambulatory Care standards, Commitment of Persons with Psychiatric Disorders ethics, Ethics, Medical, Germany, Humans, National Health Programs ethics, Patient Admission legislation & jurisprudence, Patient Admission standards, Prisoners legislation & jurisprudence, Prisoners psychology, Prognosis, Commitment of Persons with Psychiatric Disorders legislation & jurisprudence, Commitment of Persons with Psychiatric Disorders standards, Interdisciplinary Communication, Intersectoral Collaboration, Mental Disorders rehabilitation, National Health Programs legislation & jurisprudence, Substance-Related Disorders rehabilitation
- Abstract
People who have been convicted of a crime due to a severe mental disorder and continue to be dangerous as a result of this disorder may be placed in a forensic psychiatric facility for improvement and safeguarding according to § 63 and § 64 of the German Criminal Code (StGB). In Germany, approximately 9000 patients are treated in clinics for forensic psychiatry and psychotherapy on the basis of § 63 of the StGB and in withdrawal centers on the basis of § 64 StGB. The laws for treatment of patients in forensic commitment are passed by the individual States, with the result that even the basic conditions differ in the individual States. While minimum requirements have already been published for the preparation of expert opinions on liability and legal prognosis, consensus standards for the treatment in forensic psychiatry have not yet been published. Against this background, in 2014 the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) commissioned an interdisciplinary task force to develop professional standards for treatment in forensic psychiatry. Legal, ethical, structural, therapeutic and prognostic standards for forensic psychiatric treatment should be described according to the current state of science. After 3 years of work the results of the interdisciplinary working group were presented in early 2017 and approved by the board of the DGPPN. The standards for the treatment in the forensic psychiatric commitment aim to initiate a discussion in order to standardize the treatment conditions and to establish evidence-based recommendations.
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- 2017
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11. [Molecular diagnosis of autoimmune dermatoses].
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Hoffmann K, Hertl M, and Sitaru C
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- Autoantibodies immunology, Humans, Autoimmune Diseases diagnosis, Autoimmune Diseases immunology, Immunoassay methods, Molecular Diagnostic Techniques methods, Skin Diseases diagnosis, Skin Diseases immunology
- Abstract
Bullous autoimmune diseases are organ-specific disorders characterized by an autoantibody-mediated blistering of skin and mucous membranes. The detection of tissue-bound and serum autoantibodies is prerequisite for the diagnosis of autoimmune blistering diseases. The individual entities of this group may be difficult to differentiate on clinical grounds alone. An accurate diagnosis is however important for prognosis and therapy. A preliminary diagnostic step includes direct and indirect immunofluorescence microscopy, which provide information about the binding pattern and isotype of autoantibodies and allow the diagnosis of the autoimmune blistering disease. Subsequent characterization of the molecular specificity of autoantibodies is necessary for the exact classification of autoimmune bullous dermatoses. The quantitative measurement of autoantibodies against structural proteins of the skin may be often used to assess disease severity at follow-up.
- Published
- 2016
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12. [Molecular diagnosis of collagen vascular diseases and vasculitides].
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Hoffmann K, Hertl M, and Sitaru C
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- Collagen Diseases immunology, Evidence-Based Medicine, Humans, Vasculitis immunology, Collagen Diseases diagnosis, Fluorescent Antibody Technique methods, Immunoassay methods, Molecular Diagnostic Techniques methods, Vasculitis diagnosis
- Abstract
Collagen vascular diseases and vasculitides comprise various diseases, which may affect virtually every organ system. Therefore, their diagnosis and management is often an interdisciplinary challenge. Because of the heterogeneous symptoms, these diseases have significant overlap, which interferes with the clinical diagnosis and may require additional investigation. Therefore, a rational and comprehensive diagnostic work-up should be performed at the initial presentation before initiation of therapy. The detection of antinuclear (ANA) or anticell antibodies by indirect immunofluorescence microscopy on Hep2 cells is used to screen for autoantibodies in collagen vascular diseases. The molecular specificity of autoantibodies should be further characterized using immunoassays with recombinant or purified protein. When systemic autoimmune disease is suspected, the function of the frequently affected organs should be evaluated. The immunopathological findings should always be interpreted in the context of clinical, histological, and imaging data. The detection of autoantibodies is helpful for the initial diagnosis, provides prognostic information, may indicate involvement of organs or systems and some parameters may also be used for disease monitoring. The clinical significance of autoantibodies is emphasized by the fact that their detection constitutes diagnostic criteria for most collagen vascular diseases and several vasculitides. The screening for ANCA may be performed using immunoassays with recombinant myeloperoxidase and proteinase 3 or by indirect immunofluorescence microscopy on granulocytes. In this article, the current diagnostic tools and their relevance for the diagnosis and monitoring of systemic autoimmune diseases with primary skin involvement are reviewed.
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- 2016
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13. [Methotrexate-associated photosensitization].
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Hoffmann K, Casetti F, and Schempp C
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- Adult, Arthritis, Psoriatic therapy, Combined Modality Therapy, Humans, Male, Methotrexate therapeutic use, Neoplasms, Radiation-Induced chemically induced, Neoplasms, Radiation-Induced diagnosis, Neoplasms, Radiation-Induced therapy, Photosensitivity Disorders therapy, Radiodermatitis chemically induced, Radiodermatitis diagnosis, Radiodermatitis therapy, Risk Factors, Skin Neoplasms chemically induced, Skin Neoplasms diagnosis, Skin Neoplasms therapy, Methotrexate adverse effects, Photosensitivity Disorders chemically induced, Photosensitivity Disorders diagnosis, Psoriasis therapy, Ultraviolet Therapy adverse effects
- Abstract
Background: Methotrexate (MTX), alongside fumaric acid esters, is the most commonly used drug in the systemic therapy of psoriasis in Germany. It is sometimes used in combination with topical therapy and/or phototherapy due to synergistic effects., Case Report: Here we describe a case of phototoxic dermatitis during treatment with MTX. Other cutaneous side effects of MTX include so-called UV recall, radiation recall, and skin tumor formation.
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- 2015
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14. Dual regulation of β2-adrenoceptor messenger RNA expression in human lung fibroblasts by β2-cAMP signaling; delayed upregulated inhibitors oppose a rapid in onset, direct stimulation of gene expression.
- Author
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Kämpfer N, Lamyel F, Schütz I, Warnken M, Hoffmann K, von Kügelgen I, and Racké K
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- Cell Line, Humans, Lung cytology, Signal Transduction, Up-Regulation, Cyclic AMP metabolism, Fibroblasts metabolism, RNA, Messenger metabolism, Receptors, Adrenergic, beta-2 genetics, Receptors, Adrenergic, beta-2 metabolism
- Abstract
Based on their bronchodilatory effect, β2-adrenoceptor agonists constitute essential elements in the treatment of bronchial asthma and COPD. As treatment with β2-adrenoceptor agonists has been associated with worsening of airway hyper-reactivity, possibly because of loss of β-adrenoceptor function, molecular mechanism of the regulation of β2-adrenoceptor expression were studied. MRC-5 human lung fibroblasts were cultured in absence or presence of test substances followed by β2-adrenoceptor messenger RNA (mRNA) determination by qPCR. After inhibition of mRNA synthesis by actinomycin D, β2-adrenoceptor mRNA decreased with a half-life of 23 min, whereas inhibition of protein synthesis by cycloheximide caused an about 5- and 6-fold increase within 1.5 and 4 h, respectively. β2-Adrenoceptor mRNA was increased by about 100 % after 1 h exposure to formoterol or olodaterol but decreased by about 60 % after 4 h agonist exposure. Both effects of β2-adrenoceptor agonists were mimicked by forskolin, a direct activator of adenylyl cyclase and cholera toxin, which stimulates adenylyl cyclase by permanent activation of Gs. β2-Adrenoceptor agonist-induced upregulation of β2-adrenoceptor mRNA was blocked by the β2-adrenoceptor antagonist ICI 118551 and prevented by actinomycin D, but not by cycloheximide. Moreover, in presence of cycloheximide, β2-adrenoceptor agonist-induced reduction in β2-adrenoceptor mRNA was converted into stimulation, resulting in a more than 10-fold increase. In conclusion, expression of β2-adrenoceptors in human lung fibroblasts is highly regulated at transcriptional level. The β2-adrenoceptor gene is under strong inhibitory control of short-living suppressor proteins. β2-Adrenoceptor activation induces via adenylyl cyclase - cyclic adenosine monophosphate (cAMP) signaling a rapid in onset direct stimulation of the β2-adrenoceptor gene transcription, an effect opposed by a delayed upregulation of inhibitory factors.
- Published
- 2014
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15. Differences in access points to the ambulatory health care system across Austrian federal states.
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Hoffmann K, Stein KV, and Dorner TE
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- Adolescent, Adult, Aged, Austria, Cross-Sectional Studies, Female, General Practice statistics & numerical data, Health Services Research statistics & numerical data, Healthcare Disparities statistics & numerical data, Humans, Male, Medicine statistics & numerical data, Middle Aged, Referral and Consultation statistics & numerical data, Surveys and Questionnaires, Utilization Review statistics & numerical data, Young Adult, Ambulatory Care statistics & numerical data, Delivery of Health Care statistics & numerical data, Health Services Accessibility statistics & numerical data, National Health Programs statistics & numerical data
- Abstract
Background: The nine Austrian regions differ according to demographic parameter, health status, and health care structure. It was the aim of this study to analyse whether there are also differences in access points towards the level of ambulatory care., Method: The Austrian Health Interview Survey (2006-2007) data with 15,474 participants were used for this cross-sectional analysis. Statistical analyses included descriptive statistics as well as multivariate logistic regression models and correlations., Results: There were significant differences in patients with direct utilisation of specialists without having consulted a general practitioner (GP) in the same period in the Austrian regions, with highest proportions for women in Vorarlberg (20.3%) and men in Vienna (21.5%) and lowest in Burgenland (7.0 and 6.6%, respectively). The specialist/GP ratio correlated significantly with the direct specialist utilisation (Spearman correlation coefficient: 0.717)., Conclusion: There are spatial differences in the health care utilisation within the Austrian regions, which partly can be explained by the disposal of health care structure. These findings are of special importance according to the ongoing debate concerning the topic strengthening the primary health care sector in Austria.
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- 2014
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16. [Transarterial ablation of hepatocellular carcinoma. Status and developments].
- Author
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Radeleff BA, Stampfl U, Sommer CM, Bellemann N, Hoffmann K, Ganten T, Ehehalt R, and Kauczor HU
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- Humans, Infusions, Intra-Arterial, Carcinoma, Hepatocellular therapy, Embolization, Therapeutic methods, Embolization, Therapeutic trends, Hemostatics administration & dosage, Hepatic Artery, Liver Neoplasms therapy
- Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and represents the main cause of death among European patients with liver cirrhosis. Only 30-40% of patients diagnosed with HCC are candidates for curative treatment options (e.g. surgical resection, liver transplantation or ablation). The remaining majority of patients must undergo local regional and palliative therapies. Transvascular ablation of HCC takes advantage of the fact that the hypervascularized HCC receives most of its blood supply from the hepatic artery. In this context transvascular ablation describes different therapy regimens which can be assigned to four groups: cTACE (conventional transarterial chemoembolization), bland embolization (transarterial embolization TAE), DEB-TACE (TACE with drug-eluting beads, DEB) and SIRT (selective internal radiation therapy, radioembolization). Conventional TACE is the most common type of transvascular ablation and represents a combination of intra-arterial chemotherapy and embolization with occlusion of the arterial blood supply. However, there is no standardized regimen with respect to the chemotherapeutic drug, the embolic agent, the usage of lipiodol and the interval between the TACE procedures. Even the exact course of a cTACE procedure (order of chemotherapy or embolization) is not standardized. It remains unclear whether or not intra-arterial chemotherapy is definitely required as bland embolization using very small, tightly calibrated spherical particles (without intra-arterial administration of a chemotherapeutic drug) shows tumor necrosis comparable to cTACE. For DEB-TACE microparticles loaded with a chemotherapeutic drug combine the advantages of cTACE and bland embolization. Thereby, a continuing chemotherapeutic effect within the tumor might cause a further increase in intratumoral cytotoxicity and at the same time a decrease in systemic toxicity.
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- 2012
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17. [Karl Wilmanns' theoretical contributions and his clinical practice. What does it mean for contemporary psychiatry?].
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Mundt CH, Hoffmann K, and Wilmanns J
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- Germany, History, 19th Century, History, 20th Century, Forensic Psychiatry history, Military Medicine history, Models, Psychological, Psychoanalysis history, Schools, Medical history
- Abstract
Karl Wilmanns (1873-1945) is widely known as the founder of the Heidelberg school of psychopathology. His important contributions to criminology and forensic psychiatry and his encouragement of psychoanalysis in the inpatient setting are less known today. During the First World War, he worked as director of the military hospitals in the German county of Baden and as director of the Reichenau Mental Hospital at Lake Constance. Thus, he was familiar with the needs of everyday psychiatric practice under difficult circumstances. In Heidelberg he dealt intensively with criminology, social psychiatry and psychoanalysis. Wilmanns remained sceptical towards deterministic positions including the biological psychiatry of his days, but he fought for psychiatry open to social and political questions and open to different scientific methods. In 1933, the Nazis expelled him from office. Wilmanns remained as a private practitioner in Germany and died shortly after the liberation in 1945.
- Published
- 2011
- Full Text
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18. [Recommendations for the administration of conventional and new antithrombotic agents from the perspective of anesthesiology].
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Gogarten W, Hoffmann K, and Van Aken H
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- Drug Interactions, Humans, Anesthetics, Local administration & dosage, Anticoagulants administration & dosage, Postoperative Complications prevention & control, Thromboembolism etiology, Thromboembolism prevention & control, Wounds and Injuries complications, Wounds and Injuries surgery
- Abstract
Neuraxial blockade confers benefits to surgical patients not only due to the high analgesic quality but also through a reduction in postoperative complications, such as respiratory insufficiency and a shortening of postoperative paralytic ileus. In orthopedic surgery peripheral and neuraxial blockades are extensively used to enhance postoperative mobilization. The most serious complication of neuraxial blockade is spinal epidural hematoma, which may lead to permanent paraplegia if left untreated. The risk is enhanced in patients receiving thromboembolism prophylaxis. Most national societies have issued guidelines with specific time intervals between application of antithrombotic drugs and subsequent neuraxial blockade to minimize this risk. From the viewpoint of an anesthesiologist it is preferable to start with chemical thromboembolism prophylaxis postoperatively as opposed to preoperatively, to administer all drugs in the evening and to limit the number of available drugs at each site. The safety of neuraxial blockade in the presence of the new oral anticoagulant rivaroxaban is currently unknown due to limited experience and dabigatran is considered contraindicated with indwelling epidural catheters according to the manufacturer.
- Published
- 2010
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19. [Injection lipolysis].
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Hoffmann K
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- Adipocytes drug effects, Adipocytes pathology, Embolism, Fat drug therapy, Germany, Humans, Injections, Subcutaneous, Lipoma drug therapy, Minimally Invasive Surgical Procedures methods, Necrosis, Off-Label Use, Phosphatidylcholines adverse effects, Soft Tissue Neoplasms drug therapy, Deoxycholic Acid administration & dosage, Esthetics, Lipolysis drug effects, Phosphatidylcholines administration & dosage, Plastic Surgery Procedures methods
- Abstract
A new treatment variation in the spectrum of aesthetic medicine has been investigated worldwide since 2004: so-called injection lipolysis. Advances in knowledge regarding the efficacy and mechanism of action have been achieved especially in Germany because most users are found in Germany when compared on an international level. The reason for this is that the combination of phosphatidylcholine and deoxycholic acid as active substances has been approved for i.v. treatment of fat embolisms. It is thus readily available, but the subcutaneous injection of the drug Lipostabil N® is considered as off-label use. Meanwhile injection lipolysis has become an integral component for many in the practice of aesthetic medicine. The international association of physicians performing lipolysis in the so-called NETWORK-Lipolysis (with more than 2,000 members worldwide) has in particular called for the development of internationally recognized treatment standards and protocols. When the indication for its use adheres to strict criteria and the physicians applying the method have participated in intensive training, subcutaneous injection of phosphatidylcholine/deoxycholic acid represents a meaningful addition to the scope of minimally invasive aesthetic medicine.
- Published
- 2010
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20. Clinical and immunological responses in metastatic melanoma patients vaccinated with a high-dose poly-epitope vaccine.
- Author
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Dangoor A, Lorigan P, Keilholz U, Schadendorf D, Harris A, Ottensmeier C, Smyth J, Hoffmann K, Anderson R, Cripps M, Schneider J, and Hawkins R
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- Adult, Aged, Antigens, Neoplasm genetics, Antigens, Neoplasm immunology, CD8-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes metabolism, CD8-Positive T-Lymphocytes pathology, Disease Progression, Epitopes, T-Lymphocyte genetics, Epitopes, T-Lymphocyte immunology, Female, HLA-A2 Antigen metabolism, Humans, Immunization, Secondary, Interferon-gamma metabolism, Lymphocyte Activation, MART-1 Antigen, Male, Melanoma mortality, Melanoma physiopathology, Middle Aged, Neoplasm Metastasis, Neoplasm Proteins genetics, Neoplasm Proteins immunology, Neoplasm Staging, Survival Analysis, Antigens, Neoplasm metabolism, Cancer Vaccines, Epitopes, T-Lymphocyte metabolism, Melanoma immunology, Melanoma pathology, Melanoma therapy, Neoplasm Proteins metabolism, Vaccinia virus genetics
- Abstract
Background: Safety and cellular immunogenicity of rising doses and varying regimens of a poly-epitope vaccine were evaluated in advanced metastatic melanoma. The vaccine comprised plasmid DNA and recombinant modified vaccinia virus Ankara (MVA) both expressing a string (Mel3) of seven HLA.A2/A1 epitopes from five melanoma antigens., Methods: Forty-one HLA-A2 positive patients with stage III/IV melanoma were enrolled. Patient groups received one or two doses of DNA.Mel3 followed by escalating doses of MVA.Mel3. Immunisations then continued eight weekly in the absence of disease progression. Epitope-specific CD8+ T cell responses were evaluated using ex-vivo tetramer and IFN-gamma ELISPOT assays. Safety and clinical responses were monitored., Results: Prime-boost DNA/MVA induced Melan-A-specific CD8+ T cell responses in 22/31 (71%) patients detected by tetramer assay. ELISPOT detected a response to at least one epitope in 10/31 (32%) patients. T cell responder rates were <50% with low-dose DNA/MVA, or MVA alone, rising to 91% with high-dose DNA/MVA. Among eight patients showing evidence of clinical benefit-one PR (24 months+), five SD (5 months+) and two mixed responses-seven had associated immune responses. Melan-A-tetramer+ immunity was associated with a median 8-week increase in time-to-progression (P = 0.037) and 71 week increase in survival (P = 0.0002) compared to non-immunity. High-dose vaccine was well tolerated. The only significant toxicities were flu-like symptoms and injection-site reactions., Conclusions: DNA.Mel3 and MVA.Mel3 in a prime-boost protocol generated high rates of immune response to melanoma antigen epitopes. The treatment was well tolerated and the correlation of immune responses with patient outcomes encourages further investigation.
- Published
- 2010
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21. Scent of a queen-cuticular hydrocarbons specific for female reproductives in lower termites.
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Weil T, Hoffmann K, Kroiss J, Strohm E, and Korb J
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- Animals, Female, Hydrocarbons isolation & purification, Nesting Behavior, Social Behavior, Wood parasitology, Hydrocarbons analysis, Isoptera physiology, Reproduction physiology
- Abstract
In social insects, it is assumed that signals of the queen inform nestmates about her reproductive status. Thus, workers forego their own reproduction if the queen signals high fertility. In hemimetabolous termites, little is known about reproductive inhibition, but evidence exists for a royal-pair control. Workers of lower termites exhibit a high developmental flexibility and are potentially able to become reproductives, but the presence of a fertile reproductive restrains them from reaching sexual maturity. The nature of this control, however, remains unknown. Here, we report on qualitative differences in cuticular hydrocarbon profiles between queens and workers of the basal drywood termite Cryptotermes secundus. Queens were characterized by a shift to long-chained and branched hydrocarbons. Most remarkably, similar chemical patterns are regarded as fertility cues of reproductives in social Hymenoptera. This might suggest that both groups of social insects convergently evolved similar chemical signatures. The present study provides deeper insights into how termites might have socially exploited these signatures from sexual communication in their cockroach-like ancestor.
- Published
- 2009
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22. A German genome-wide linkage scan for type 2 diabetes supports the existence of a metabolic syndrome locus on chromosome 1p36.13 and a type 2 diabetes locus on chromosome 16p12.2.
- Author
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Hoffmann K, Mattheisen M, Dahm S, Nürnberg P, Roe C, Johnson J, Cox NJ, Wichmann HE, Wienker TF, Schulze J, Schwarz PE, and Lindner TH
- Subjects
- Chromosome Mapping, Female, Genetic Predisposition to Disease, Genome, Human, Germany, Humans, Male, Odds Ratio, Polymorphism, Genetic, Chromosomes, Human, Pair 1, Chromosomes, Human, Pair 16, Diabetes Mellitus, Type 2 genetics, Genetic Linkage, Genomics, Metabolic Syndrome genetics
- Abstract
Aims/hypothesis: The aim was to identify type 2 diabetes susceptibility regions in 250 German families., Subjects and Methods: We conducted a genome-wide linkage scan using 439 short tandem repeat polymorphisms at an average resolution of 7.76 +/- 3.80 cM (Marshfield). In an affected-only-design (affected sib pairs), we performed nonparametric multipoint linkage analyses. Conditional analyses were applied where linkage signals were found in the baseline analyses., Results: We identified two loci with nominal evidence for linkage on chromosomes 1p36.13 and 16p12.2 (D1S3669, 37.05 cM, logarithmic odds ratio [LOD] = 1.49, p = 0.004; D16S403, 43.89 cM, LOD = 1.85, p = 0.002). D16S403 crossed the empirically obtained threshold of genome-wide suggestive significance of LOD = 1.51. Positive findings in those regions have been reported by the following other linkage studies on: (1) symptomatic/clinical gall bladder disease with type 2 diabetes in Mexican Americans from the San Antonio Family Diabetes/Gallbladder Study (LOD = 3.7, D1S1597-D1S407, 29.93-33.75 cM); (2) body size-adiposity in another Mexican American population (D1S1597, LOD = 2.53, 29.93 cM); (3) lipid abnormalities (LOD = 3.1, D1S2826-D1S513, 41.92-60.01 cM); and (4) hypertension in Australian sib pairs (LOD = 3.1, D1S2834-D1S2728, 31.02-33.75 cM); as well as (5) a meta-analysis of four European type 2 diabetes-related genome scans (LOD = 1.09, D16S412, 42.81 cM). In linkage analyses conditional on evidence for linkage at D16S403 we identified a LOD increase (Delta LOD) of 1.55 (p = 0.0075) at D17S2180. Similar conditioning on D17S2180 revealed evidence for interaction with D1S3669 (Delta LOD = 1.67, p = 0.0055), D16S403 (Delta LOD = 1.48, p = 0.0091) and another locus on chromosome 1 where several genome scans have reported evidence for linkage ( approximately 200 cM, Delta LOD = 1.60, p = 0.0066)., Conclusions/interpretation: Our results and the findings of other studies are consistent with the presence of a locus for a complex metabolic syndrome on chromosome 1p36.13.
- Published
- 2007
- Full Text
- View/download PDF
23. [Migrant patients in forensic psychiatry. An epidemiological survey from Baden-Württemberg].
- Author
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Hoffmann K
- Subjects
- Crime psychology, Female, Germany epidemiology, Humans, Male, Mental Disorders psychology, Prevalence, Risk Factors, Transients and Migrants psychology, Crime statistics & numerical data, Forensic Psychiatry statistics & numerical data, Mental Disorders epidemiology, Risk Assessment methods, Transients and Migrants statistics & numerical data
- Abstract
The treatment of mentally ill migrants is being increasingly discussed in general psychiatry and psychotherapy. Most studies show that this group under-utilizes the mental health system. This first epidemiological survey of the German forensic system shows a higher percentage of migrant patients than in the general population. Reasons for this development are discussed. In clinical practice, the migrant patients require special therapeutic and pedagogic options including specific legal advice.
- Published
- 2006
- Full Text
- View/download PDF
24. Acute skin alterations following ultraviolet radiation investigated by optical coherence tomography and histology.
- Author
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Gambichler T, Boms S, Stücker M, Moussa G, Kreuter A, Sand M, Sand D, Altmeyer P, and Hoffmann K
- Subjects
- Adult, Aged, Aged, 80 and over, Humans, Light, Melanins analysis, Middle Aged, Scattering, Radiation, Skin chemistry, Skin pathology, Skin radiation effects, Tomography, Optical Coherence methods, Ultraviolet Rays
- Abstract
Optical coherence tomography (OCT) appears to be a promising technique to study skin in vivo. As part of an exploratory study to investigate UV induced effects non-invasively we aimed to evaluate the kinetics of acute UVB- as well as UVA1 induced skin alterations by means of OCT, and to correlate the results obtained with routine histology. Twelve healthy subjects received daily 60 J/cm2 of UVA1 and 1.5 minimal erythema doses of UVB on their upper back over three consecutive days. One day (24 h) after the last UV exposure, OCT measurements and skin biopsies were performed in four subjects (day 1) on the centre of the irradiated sites and an adjacent non-irradiated control site. The same procedure was performed in four subjects 3 days and 6 days after irradiation, respectively. Prior to OCT assessment two waterproof marks were drawn on the centre of UVB and UVA1 exposed sites and the control site. The OCT scanner, SkinDex 300, was used in the RI1D measurement modus in order to investigate morphological features, epidermal thickness, and scattering coefficients. Immediately after OCT assessment, 4 mm punch biopsies were taken from the previously marked sites. OCT as well as histological examinations performed on day 1, 3, and 6, revealed markedly higher values for epidermal thickness on UVB exposed skin sites, and slightly increased epidermal thickening in UVA1 exposed sites. UVB exposed sites showed disruption of the entrance signal in the B-scan of OCT resulting in a thickened layer with a signal-poor centre corresponding to hyperkeratosis and parakeratosis as confirmed by routine histology. Surprisingly, the mean scattering coefficients of the epidermis were slightly lower on UVA1 exposed sites, as compared to non-irradiated skin. By contrast, the scattering coefficient of the upper dermis of UVA1 irradiated skin was hardly altered. Moreover, the scattering coefficient of the upper dermis assessed on UVB exposed skin on day 1 was clearly smaller than the scattering coefficient observed on non-irradiated and UVA1 exposed skin. Conclusively, it was possible to demonstrate by means of OCT differences of epidermal thickness and pathological features of the stratum corneum following UV exposure. UVA1 induced epidermal pigmentation as well as UVB induced dermal inflammation may affect the light attenuation in the tissue indicated by a decrease of the scattering coefficient. OCT seems to be a useful tool to monitor UV induced effects in vivo.
- Published
- 2005
- Full Text
- View/download PDF
25. A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)--Potsdam Study cohort.
- Author
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Heidemann C, Hoffmann K, Spranger J, Klipstein-Grobusch K, Möhlig M, Pfeiffer AF, and Boeing H
- Subjects
- Adiponectin, Body Mass Index, C-Reactive Protein analysis, Case-Control Studies, Educational Status, Energy Intake, Female, Humans, Intercellular Signaling Peptides and Proteins blood, Leisure Activities, Male, Middle Aged, Reference Values, Smoking, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 prevention & control, Diet, Feeding Behavior
- Abstract
Aims/hypothesis: The aim of this study was to identify a dietary pattern associated with diabetes-related biomarkers and to investigate whether this pattern is associated with the incidence of type 2 diabetes., Methods: A nested case-control study of 192 cases of incident type 2 diabetes and 382 control subjects matched for sex and age was conducted. All subjects were participants in the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Dietary pattern score was derived using intake data on 48 food groups as exposure variables and the biomarkers HbA1c, HDL cholesterol, C-reactive protein and adiponectin as response variables in reduced rank regression. The association of the score with diabetes risk was estimated by conditional logistic regression analysis., Results: A high score for the identified dietary pattern was characterised by a high intake of fresh fruit and a low intake of high-caloric soft drinks, beer, red meat, poultry, processed meat, legumes and bread (excluding wholegrain bread). Subjects with high scores had high plasma concentrations of HDL cholesterol and adiponectin and low plasma concentrations of HbA1c and C-reactive protein. After multivariate adjustment, the odds ratios for type 2 diabetes across increasing quintiles of the dietary pattern score were 1.0, 0.59, 0.51, 0.26 and 0.27, respectively (p = 0.0006 for trend)., Conclusions/interpretation: A high score for the identified dietary pattern is associated with a more favourable biomarker profile and a substantially reduced incidence of type 2 diabetes.
- Published
- 2005
- Full Text
- View/download PDF
26. [Noninvasive diagnosis of skin functions].
- Author
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Hanau A, Stücker M, Gambichler T, Orlikov A, Hoffmann K, Altmeyer P, and Freitag M
- Subjects
- Aged, Calorimetry, Humans, Laser-Doppler Flowmetry, Microcirculation, Microscopy, Confocal, Sebum, Skin anatomy & histology, Skin blood supply, Skin Diseases physiopathology, Spectrophotometry, Surgical Flaps, Sweat metabolism, Thermography, Tomography, Optical Coherence, Cosmetics, Skin drug effects, Skin Diseases diagnosis, Skin Physiological Phenomena
- Abstract
Noninvasive investigation of skin functions is increasingly employed in dermatology and cosmetology. It enables one to study aspects of skin functions that cannot always be appreciated by sensory perception. Noninvasive methods permit objective and reproducible investigation of distinct biophysical parameters. In the age of evidence-based medicine this becomes more and more important. Biophysical data can be quantified, analyzed, and stored electronically. In an overview, selected noninvasive techniques of skin function testing are introduced and their relevance in dermatology, dermatopharmacology, and cosmetology is discussed.
- Published
- 2003
- Full Text
- View/download PDF
27. Premature keratinocyte death and expression of marker proteins of apoptosis in human skin after UVB exposure.
- Author
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Mass P, Hoffmann K, Gambichler T, Altmeyer P, and Mannherz HG
- Subjects
- Adult, Biomarkers analysis, Caspase 3, Caspases metabolism, Cell Death radiation effects, Deoxyribonuclease I metabolism, Humans, Keratinocytes metabolism, Male, Proto-Oncogene Proteins c-bcl-2 metabolism, Skin metabolism, Time Factors, Tumor Suppressor Protein p53 metabolism, Apoptosis physiology, Keratinocytes physiology, Skin Physiological Phenomena radiation effects, Ultraviolet Rays
- Abstract
Epidermal keratinocytes undergo a process of terminal differentiation or cornification that in many aspects resembles apoptosis. It is characterized by the elimination of cell nuclei within the granular layer, whereas the cytoplasm is transformed into horn cells. Premature death of keratinocytes can be induced by extrinsic factors such as UV irradiation. We investigated the time-dependent expression of apoptotic marker proteins in the skin of one healthy human volunteer after irradiation with a fourfold minimal erythema dose (MED) of UVB. The data were supplemented by including healthy skin areas of biopsies from patients UVB-irradiated for therapeutic reasons. Punch biopsies were analysed by in situ end-labelling (ISEL) for DNA strand breaks and by immunohistochemistry for expression of p53, bcl-2, active caspase-3 and its proform, and deoxyribonuclease I (DNase I). Keratinocytes with pyknotic nuclei were first detected 6 h after UVB exposure, and apoptotic keratinocytes (sunburn cells) 12 h after exposure. These aggregated to sunburn bodies after 24 h. In control skin, nuclei with DNA strand breaks were only occasionally detected in the granular layer but 6 h after UVB irradiation in the spinous layer. After 12 h, many sunburn cells were ISEL-positive and positively stained for active caspase-3, P53, and DNase I. Morphometric evaluation of the immunohistochemical data demonstrated that maximal upregulation of P53, DNase I and activation of caspase-3 occurred 12 h after irradiation and in advance of the peak of apoptotic cell death reached after 24 h as verified by ISEL. In contrast, strong Bcl-2 immunostaining appeared restricted to presumed melanocytes and basal cells but was not increased after UVB irradiation.
- Published
- 2003
- Full Text
- View/download PDF
28. [In vivo differentiation of pigmented skin tumors with laser Doppler perfusion imaging].
- Author
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Stücker M, Hoffmann M, Memmel U, von Bormann C, Hoffmann K, and Altmeyer P
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Basal Cell blood supply, Carcinoma, Basal Cell pathology, Diagnosis, Differential, Female, Humans, Male, Melanoma blood supply, Melanoma pathology, Microcirculation physiology, Middle Aged, Neovascularization, Pathologic pathology, Nevus, Pigmented blood supply, Nevus, Pigmented pathology, Sensitivity and Specificity, Skin blood supply, Skin pathology, Skin Neoplasms blood supply, Skin Neoplasms pathology, Carcinoma, Basal Cell diagnosis, Image Processing, Computer-Assisted instrumentation, Laser-Doppler Flowmetry instrumentation, Melanoma diagnosis, Neovascularization, Pathologic diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis
- Abstract
Background and Objective: Malignant melanomas show a higher heterogeneity in their architecture and a higher vessel density because of neovascularization compared to benign melanocytic skin tumours. In this study the validity of the newly developed Laser Doppler Perfusion Imager (LDPI) with a lateral resolution of 100 microns in the differential diagnosis of pigmented skin tumours was investigated., Patients/methods: The perfusion of 116 pigmented skin tumours was s measured with LDPI; 44 malignant melanomas, five melanoma metastases, 59 dysplastic nevi and eight basal cell carcinomas were studied before excision for precise histological diagnosis., Results: There is a significantly higher perfusion of the malignant melanomas (3.15 +/- 1.87 AU) compared to dysplastic nevi (1.14 +/- 0.97 AU) (p < 0.01). By calculating a ratio of the mean perfusion in the tumour and the mean perfusion in adjacent healthy skin, the potential source of error because of regional differences in perfusion is eliminated. The ratio of malignant melanomas (10.78 +/- 9.18) is significantly higher than these of melanoma metastases (4.20 +/- 1.66), basal cell carcinomas (3.24 +/- 1.32) and dysplastic nevi (2.85 +/- 1.32)., Conclusions: The high resolution LDPI has the potential to be a non-invasive screening method for preoperative differential diagnosis of pigmented skin tumours. Besides the epiluminescence microscopy and sonographic determination of the tumour thickness, we have now the possibility to get preoperative information about tumour vascularization.
- Published
- 2002
- Full Text
- View/download PDF
29. Role of clothes in sun protection.
- Author
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Gambichler T, Altmeyer P, and Hoffmann K
- Subjects
- Humans, Textiles, Protective Clothing, Sunlight adverse effects
- Abstract
Ultraviolet (UV) radiation is the carcinogenic factor in sunlight. Damage to skin cells from repeated UV exposure can lead to the development of skin cancer. Apart from avoidance of the sun, the most frequently used form of UV protection has been the application of sunscreens. The use of textiles as a means of sun protection has been underrated in previous educational campaigns, even though suitable clothing offers usually simple and effective broadband protection against the sun. Apart from skin cancer formation, exacerbation of photosensitive disorders and premature skin aging could be prevented by suitable UV-protective clothing. Nevertheless, several studies have recently shown that, contrary to popular opinion, some textiles provide only limited UV protection. It has been found that one-third of commercial summer clothing items provide a UV protection factor (UPF) less than 15. Given the increasing interest in sun protection, recreationally and occupationally, test methods and a rating scheme for clothing were needed that would ensure sufficient UV protection. Various textile parameters have an influence on the UPF of a finished garment. Important parameters are the fabric porosity, type, color, weight and thickness. The application of UV absorbers into the yarns significantly improves the UPF of a garment. Under the conditions of wear and use several factors can alter the UV-protective properties of a textile, e.g., stretch, wetness and laundering. The use of UV-blocking cloths can provide excellent protection against the hazards of sunlight; this is especially true for garments manufactured as UV-protective clothing. However, further educational efforts are necessary to change people's sun behavior and raise awareness for the use of adequate sun-protective clothing.
- Published
- 2002
- Full Text
- View/download PDF
30. Comparison of methods: determination of UV protection of clothing.
- Author
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Gambichler T, Altmeyer P, and Hoffmann K
- Subjects
- Radiation Dosage, Materials Testing methods, Protective Clothing standards, Textiles standards, Ultraviolet Rays adverse effects
- Abstract
Based on spectrophotometric measurements and mathematical calculations, the ultraviolet (UV) protection factor of a textile is determined in vitro. This technique is the most established test method for the determination of UV protection of a garment. However, the validity and practicality of the in vitro UV protection factor (UPF) determined in the laboratory has been a controversial issue with regard to its significance in the field. Several studies have verified the in vitro UPF by comparing it with various in vivo test protocols using solar-simulated radiation for the determination of the minimal erythema dose. The data inconsistency between these studies is certainly due to different methodology. Furthermore, UV dosimetry is a suitable method for quantifying UV transmission through a garment. Chemical dosimeters (e.g. polysulfone films) and biological UV detector films have been used in in vivo-simulated studies in the form of small portable badges monitoring solar UV transmittance through garments on manikins and mobile subjects. As sunlight consists to a considerable extent of diffuse radiation, which is more scattered and absorbed by the fabric than direct radiation, UPF values obtained by measurements in real exposure situations are usually higher than those obtained by conventional in vitro and in vivo testing with collimated radiation beams. Thus the discrepancy between laboratory-based testing and field-based measurements may be due to different radiation geometry of UV sources. Taken together, the in vitro method is the most practicable and inexpensive method for routine measurements of UPF, but dosimetry seems to be a highly useful method for determining the UPF in real exposure situations.
- Published
- 2002
- Full Text
- View/download PDF
31. [Correlation between histopathology and epiluminescent microscopy in nonmelanocytic skin lesions].
- Author
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Schulz C, Schulz H, Stücker M, Altmeyer P, and Hoffmann K
- Subjects
- Equipment Design, Humans, Microscopy, Electron, Image Processing, Computer-Assisted instrumentation, Microscopy, Confocal instrumentation, Microscopy, Video instrumentation, Skin Diseases pathology, Skin Neoplasms pathology
- Abstract
Epiluminescence microscopy techniques make surface and subsurface structures accessible to visual examination in vivo. The visualization of a multitude of special morphological features, such as blood vessels, adnexa and deposits of pigments in normal and pathologically changed skin allows a reproducible and topographical stratification. There is a chance of identifying the architecture of the stratum corneum, the epidermis and the papillary bodies. Changes in the amount of melanin can be individually assessed in the stratum corneum and the deeper layers extending into the upper dermis. It is possible to differentiate the orientation, size and color of the blood vessels of the cutaneous vascular plexus, involving the capillaries of the stratum papillare and the subpapillary plexus.
- Published
- 2001
- Full Text
- View/download PDF
32. [Comment on the contribution by H. Breuninger, C. Garbe and G. Rassner: Shave excision of melanocytic nevi of the skin--indications, technique, results].
- Author
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Gambichler T, Rotterdam S, Altmeyer P, and Hoffmann K
- Subjects
- Dermatologic Surgical Procedures, Humans, Nevus, Pigmented pathology, Skin pathology, Skin Neoplasms pathology, Nevus, Pigmented surgery, Skin Neoplasms surgery
- Published
- 2001
- Full Text
- View/download PDF
33. [Guidelines for quality assurance in ultrasound diagnosis in dermatology. Guideline of the Ultrasound in Dermatology Subgroup of the Physical procedures in Dermatology Subcommittee January 2000].
- Author
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Hoffmann K, Hölzle E, Ulrich J, Dill-Müller D, Blum A, and Gottlöber P
- Subjects
- Germany, Humans, Lymphatic Metastasis, Skin diagnostic imaging, Ultrasonography, Lymph Nodes diagnostic imaging, Quality Assurance, Health Care, Skin Diseases diagnostic imaging, Skin Neoplasms diagnostic imaging
- Published
- 2001
- Full Text
- View/download PDF
34. [Bilateral segmental neurofibromatosis simulating epidermal nevus].
- Author
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Gambichler T, Küster W, Wolter M, Rapp S, Altmeyer P, and Hoffmann K
- Subjects
- Adult, Biopsy, Diagnosis, Differential, Humans, Male, Neurofibromatoses pathology, Nevus pathology, Skin pathology, Skin Neoplasms pathology, Neurofibromatoses diagnosis, Nevus diagnosis, Skin Neoplasms diagnosis
- Abstract
Neurofibromatosis is a neuroectodermal systemic disease. A rare variant of this condition is bilateral segmental neurofibromatosis. A 29-year-old man presented with bilateral papillomatous plaques in the lumbar dermatomes. Clinically, the lesions were very similar to an epidermal nevus but histologic examination revealed superficial neurofibromas. Family history, ophthalmologic and neurologic investigations were unremarkable. The unusual morphologic presentation of bilateral segmental neurofibromas in this case points to the wide clinical spectrum of the disease and the significance of histologic examination in systematic nevoid lesions.
- Published
- 2000
- Full Text
- View/download PDF
35. [Current position of the Professional Group of Dermatologic Oncology on high dosage therapy with interferon-alpha-2b].
- Author
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Brockmeyer NH, Hoffmann K, and Altmeyer P
- Subjects
- Dose-Response Relationship, Drug, Humans, Interferon alpha-2, Interferon-alpha adverse effects, Melanoma mortality, Prospective Studies, Randomized Controlled Trials as Topic, Recombinant Proteins, Skin Neoplasms mortality, Survival Rate, Treatment Outcome, Interferon-alpha administration & dosage, Melanoma drug therapy, Skin Neoplasms drug therapy
- Published
- 2000
- Full Text
- View/download PDF
36. [Correlation between epiluminescence microscopy characteristics of malignant melanomas and Clark's level of invasion].
- Author
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Schulz C, Stücker M, Schulz H, Altmeyer P, and Hoffmann K
- Subjects
- Adult, Aged, Diagnosis, Differential, Female, Humans, Male, Melanoma classification, Melanoma pathology, Middle Aged, Neoplasm Invasiveness, Prognosis, Skin pathology, Skin Neoplasms pathology, Melanoma diagnosis, Microscopy, Video instrumentation, Skin Neoplasms diagnosis
- Abstract
Many epiluminescence microscopy (ELM) characteristics of malignant melanoma support the differential diagnosis of pigmented skin tumors. A preinvasive evaluation of level of invasion would be valuable for planning the excision margins. Since sonography for tumor thickness measurement is rarely available in a practice we searched for specific ELM criteria correlating with Clark's level of invasion. In our retrospective study of 120 malignant melanomas of 30 ELM features were studied for their correlation and the association was significant for 15 features.The following criteria were found only in level III-IV melanomas: intralesional horizontally elongated blood vessels, spontaneous microhemorrhages, plaster-of-Paris-like lacunae, grey-blue/yellowish-brown/reddish saccular pattern and eccentric nodes (reddish, livid, blue). 7 characteristics were predominantly found in level III-IV melanomas and seldom in "thin" melanomas (level I-II): deeply localized gray-blue/-brown fragmentary network, whitish-opaque septa, whitish- or bluish-opaque veil, negative pigmented network, areola with evenly arranged capillaries, polymorphic capillaries. Perivascular melanophages, eccentric dark blotches, pseudotrabeculae of melanophages and greyish-blue annular perifollicular pigmentations were the most significant association of ELM criteria in "thin" melanomas (level I-II). Epiluminescence microscopy is not only a tool for the differentiation of melanocytic lesions but also for a preinvasive evaluation of Clark's level of invasion.
- Published
- 1999
- Full Text
- View/download PDF
37. [Tazarotene increases the antipsoriatic effect of dithranol in chronic psoriasis].
- Author
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Sander P, Happe M, Stücker M, Hermes N, Hoffmann K, and Altmeyer P
- Subjects
- Chronic Disease, Drug Combinations, Drug Synergism, Female, Gels therapeutic use, Humans, Male, Middle Aged, Prospective Studies, Retinoids therapeutic use, Anthralin therapeutic use, Dermatologic Agents therapeutic use, Nicotinic Acids therapeutic use, Psoriasis drug therapy
- Abstract
We examined whether it is possible to increase the antipsoriatic action by combining dithranol with a retinoid (tazarotene). In a randomized, open, prospective study with 50 psoriatic patients (22 females, 28 males, PASI>10) the antipsoriatic effectiveness of dithranol monotherapy to was compared combined therapy with dithranol and retinoid. The combination dithranol/retinoid (collective 2, reduction of the PASI from 17,2 to 2,8) revealed a significantly faster healing than the dithranol monotherapy (collective 1, reduction of the PASI from 18,5 to 4,8). The irritation of the combination therapy as evaluated with clinical score and laser doppler imaging was increased. Anti-psoriatic effectiveness of dithranol can be increased by combining it with tazarotene.
- Published
- 1999
- Full Text
- View/download PDF
38. [Prevalence of psychological symptoms in dermatologic patients of an acute clinic].
- Author
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Windemuth D, Stücker M, Hoffmann K, and Altmeyer P
- Subjects
- Adult, Aged, Anxiety Disorders diagnosis, Anxiety Disorders psychology, Anxiety Disorders therapy, Comorbidity, Cross-Sectional Studies, Depressive Disorder diagnosis, Depressive Disorder psychology, Depressive Disorder therapy, Female, Humans, Male, Middle Aged, Patient Care Team, Personality Inventory, Psychophysiologic Disorders diagnosis, Psychophysiologic Disorders therapy, Psychotherapy, Skin Diseases diagnosis, Skin Diseases therapy, Somatoform Disorders diagnosis, Somatoform Disorders therapy, Psychophysiologic Disorders psychology, Sick Role, Skin Diseases psychology, Somatoform Disorders psychology
- Abstract
There is a lot of information in the literature about psychological disturbances in somatic diseases. For dermatological patients such data are not available. In early spring 1998 we studied the psychological changes in 247 hospitalized patients in the dermatological department of the Ruhr University Bochum. We used the German version of the internationally accepted Hospital Anxiety and Depression Scale. We found the prevalence of psychological alterations ranged between 25.9% and 31%. The prevalence of psychological disturbances was a little higher than that seen in oncological, cardiological or neurological patient populations. Surprisingly skin cancer patients were less affected than patients with chronic inflammatory or angiological diseases. These results underline the necessity of improved psychological therapeutical strategies which must be standardized and evaluated.
- Published
- 1999
- Full Text
- View/download PDF
39. [Depression and suicidal intentions as a side effect of high dosage interferon-alpha therapy--two cases].
- Author
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Windemuth D, Bacharach-Buhles M, Hoffmann K, and Altmeyer P
- Subjects
- Adjuvants, Immunologic adverse effects, Adjuvants, Immunologic therapeutic use, Amnesia chemically induced, Amnesia diagnosis, Behavioral Symptoms chemically induced, Behavioral Symptoms diagnosis, Depression diagnosis, Female, Humans, Interferon-alpha therapeutic use, Male, Melanoma drug therapy, Middle Aged, Depression chemically induced, Interferon-alpha adverse effects, Suicide
- Abstract
Adjuvant therapy with interferon for malignant melanoma causes neurotoxic side effects such as depression. The biochemical mechanisms are unknown. We report two cases with both depression and amnesia. In one case, attempted suicide was accompanied by 7 h of amnesia. The diagnostic classification and possible explanations for the amnesia secondary to interferon therapy are reviewed.
- Published
- 1999
- Full Text
- View/download PDF
40. Treatment of patients with low-risk myelodysplastic syndromes using a combination of all-trans retinoic acid, interferon alpha, and granulocyte colony-stimulating factor.
- Author
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Hofmann WK, Ganser A, Seipelt G, Ottmann OG, Zander C, Geissler G, Hoffmann K, Höffken K, Fischer JT, Isele G, and Hoelzer D
- Subjects
- Adult, Aged, Aged, 80 and over, Anemia, Refractory drug therapy, Anemia, Refractory, with Excess of Blasts drug therapy, Drug Therapy, Combination, Female, Granulocyte Colony-Stimulating Factor administration & dosage, Granulocyte Colony-Stimulating Factor adverse effects, Humans, Interferon-alpha administration & dosage, Interferon-alpha adverse effects, Leukemia, Myelomonocytic, Chronic drug therapy, Leukocyte Count, Male, Middle Aged, Neutrophils, Remission Induction, Tretinoin administration & dosage, Tretinoin adverse effects, Granulocyte Colony-Stimulating Factor therapeutic use, Interferon-alpha therapeutic use, Myelodysplastic Syndromes drug therapy, Tretinoin therapeutic use
- Abstract
Used as single agents, ATRA, G-CSF, and IFN-alpha have shown a moderate benefit in patients with low-risk MDS, with a response rate of 10%. The aim of the present study was to evaluate the efficacy of a combination of these agents. The effect on hemoglobin (Hb), platelets, and absolute neutrophil count (ANC), as well as on transfusion frequency, was examined in 25 patients with MDS (11 RA, four RARS, eight RAEB, two CMML). The median age was 61 years (range 44-81), and the male/female ratio was 14/11. Treatment consisted of ATRA at 25 mg/m2/day p.o. for months 1, 3, 5, 7, 9, and 11, IFN-alpha at 1.5 MIU twice a week s.c. for 52 weeks, and, in patients with initial ANC <500/microl, G-CSF at 100-480 microg daily s.c. according to the degree of ANC. The duration of therapy was scheduled for 12 months. Two patients achieved ongoing CR (+19 months; +16 months), one patient with RA after 3 months and one with CMML after 7 months of treatment. In all patients, the mean ANC increased significantly from 1400+/-200/microl before the start of therapy to 3500+/-600/microl at the end of treatment (p=0.025). In two patients an increase of Hb was observed, and one patient ceased to require transfusions. In an additional patient with RA and 5q-syndrome, the platelet count normalized following administration of ATRA/IFN-alpha, increasing from 89,000/microl to 293,000/microl. The eight RAEB patients were nonresponders. We conclude that therapy with ATRA, IFNalpha, and G-CSF is effective in approximately 35% of low-risk MDS patients (in this study: six of 17) and may induce complete remission in individual cases.
- Published
- 1999
- Full Text
- View/download PDF
41. [Phototherapy in severe atopic dermatitis. Comparison between current UVA1 therapy, UVA1 cold light and combined UVA-UVB therapy].
- Author
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von Kobyletzki G, Freitag M, Herde M, Höxtermann S, Stücker M, Hoffmann K, and Altmeyer P
- Subjects
- Adolescent, Adult, Aged, Blood Proteins metabolism, Combined Modality Therapy, Dermatitis, Atopic diagnosis, Dermatitis, Atopic immunology, Eosinophil Granule Proteins, Female, Follow-Up Studies, Humans, Laser-Doppler Flowmetry, Male, Middle Aged, Prospective Studies, Radiotherapy Dosage, Receptors, Interleukin-2 blood, Skin blood supply, Dermatitis, Atopic radiotherapy, Ribonucleases, Ultraviolet Therapy methods
- Abstract
Severe atopic dermatitis, especially when involving the face, does not respond well to conventional therapy. In the present prospective randomized trial, we compared therapeutic efficiency of medium-dose UVA1, medium-dose cold light UVA1 (15 treatment courses with 50 J/cm2 each) and combined UVA-UVB phototherapy. Four (13.3%) of 30 UVA1 treated patients, one (3.4%) of 30 UVA1 cold light treated patients and three (30%) of 10 patients treated with combined UVA-UVB discontinued therapy course before finishing treatment protocol because skin status did not improve or even deteriorated. In the other patients treated over a period of three weeks, skin status improved significantly or even cleared completely in 80.8% of UVA1 treated and in 89.7% of UVA1 cold light treated patients resulting in a significant decrease of the SCORAD-Score (UVA1 group from 68.6 +/- SD 10.9 to 29.8 +/- SD 7.1 and UVA1 cold light group from 72.5 +/- SD 13.4 to 23.8 +/- SD 11.6; p < 0.05 each). In the UVA-UVB treated group, the SCORAD-Score also decreased (from 71.0 +/- SD 9.4 to 41.6 +/- 10.5), but significantly less than in both UVA1 treated groups (p < 0.05 each). Four weeks after completing therapy UVA1 treated patients showed a prolonged therapy benefit as compared to UVA-UVB treated patients. Plasma levels of eosinophil cationic protein and soluble interleukin-2 receptor significantly decreased under UVA1 phototherapy but not under UVA-UVB therapy. Compared to conventional UVA1 phototherapy, UVA1 cold light phototherapy showed advantages due to the absence of potentially proinflammatory effects based on temperature-induced increase of skin blood flow (quantified by Laser doppler scanning) and increased sweat production (determined by the patient using a visual analog scale).
- Published
- 1999
- Full Text
- View/download PDF
42. [A prospective comparison of octylcyanoacrylate tissue adhesive and conventional wound closure].
- Author
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Alamouti D, von Kobyletzki G, Allard P, and Hoffmann K
- Subjects
- Humans, Treatment Outcome, Wound Healing drug effects, Cyanoacrylates therapeutic use, Skin Neoplasms surgery, Tissue Adhesives
- Published
- 1999
- Full Text
- View/download PDF
43. [Mometasone and calcipotriol optimize the initial therapeutic effect of dithranol in chronic persistent psoriasis].
- Author
-
Sander P, Stücker M, Hermes N, Hoffmann K, and Altmeyer P
- Subjects
- Administration, Topical, Adult, Aged, Anthralin adverse effects, Anti-Inflammatory Agents adverse effects, Calcitriol administration & dosage, Calcitriol adverse effects, Dermatologic Agents adverse effects, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Therapy, Combination, Female, Glucocorticoids, Humans, Male, Middle Aged, Mometasone Furoate, Pregnadienediols adverse effects, Prospective Studies, Psoriasis diagnosis, Recurrence, Anthralin administration & dosage, Anti-Inflammatory Agents administration & dosage, Calcitriol analogs & derivatives, Dermatologic Agents administration & dosage, Pregnadienediols administration & dosage, Psoriasis drug therapy
- Abstract
In a randomized study 30 patients with chronic stationary psoriasis were treated with 3 different topical schemes. Group 1 (n = 10) received monotherapy (dithranol (D) twice a day, D/D), group 2 (n = 10) calcipotriol mornings/dithranol evenings (calcipotriol (C)/dithranol (D) C/D) and 3 (mometasone (M) mornings/dithranol (D) evenings, M/D). During the therapy period of 4 weeks we documented the PASI-Score as well as infiltration, erythema and desquamation weekly. The M/D group revealed in the first week a significantly faster reduction of the PASI-score (5.3) than in the D/D group (PASI 13.22). The C/D group (PASI 10.5) show a not significantly faster reduction. After 4 weeks of treatment and after a follow period of 6 weeks there were similar PASI-Scores in all groups. There were less side-effects in the M/D group than in the others. The beginning, more anti-psoriatic effectiveness was achieved by the mometasone/dithranol combination than the other schemes. In the long term, the effects were similar.
- Published
- 1998
- Full Text
- View/download PDF
44. [Sun protection by optimally designed fabrics].
- Author
-
Hoffmann K, Hoffmann A, Hanke D, Böhringer B, Schindling G, Schön U, Klotz ML, and Altmeyer P
- Subjects
- Europe, Humans, Neoplasms, Radiation-Induced etiology, Radiation Dosage, Skin Neoplasms etiology, Sunburn prevention & control, Clothing, Neoplasms, Radiation-Induced prevention & control, Skin Neoplasms prevention & control, Sunlight adverse effects, Textiles, Ultraviolet Rays adverse effects
- Abstract
A rising incidence worldwide of skin cancer has been observed for years. A high cumulative exposure to UV radiation is a major factor in the development of such neoplasms. Suitable protective measures are therefore becoming increasingly important. Textiles provide simple, effective and medically safe protection against UV radiation. At present, however, in Europe--in contrast to Australia--the UV protection factor (UPF) for summer textiles is not stated. It is a largely unknown fact that by far not all textiles offer sufficient protection. Our goal was to study the factors which determine the UV transmission of fabrics and, based on these findings, to design materials which provide enhanced protection. A spectrophotometric method was used to determine the UV transmission by fabrics made of cotton, silk, polyester and viscose. The UV protection factors of the fabrics were computed on the basis of the transmission data. The UV protection factor is dependent on the type of fibre, yarn and surface design, weight per square metre, moisture content, colour, finishing method and degree of wear. To optimize the UV protection via textiles, a viscose yarn with a low UV transmission was used. This yarn makes it possible to design light-weight summer fabrics with optimized UV protection. This development will make it possible to offer clothing with high UV protection on the European marked. This clothing will not be more expensive than normal products, so that effective prevention should be more available.
- Published
- 1998
- Full Text
- View/download PDF
45. [PUVA-bath photochemotherapy in Hallopeau's acrodermatitis continua suppurativa].
- Author
-
Behrens S, von Kobyletzki G, Hoffmann K, Altmeyer P, and Kerscher M
- Subjects
- Acrodermatitis diagnosis, Acrodermatitis pathology, Aged, Chronic Disease, Fingers pathology, Humans, Male, Remission Induction, Skin pathology, Acrodermatitis drug therapy, Baths, PUVA Therapy
- Abstract
A 73-year-old man presented with severe, relapsing acrodermatitis continua of Hallopeau, which had been resistant to prior local and systemic therapy for eight years. The patient was treated with selective hand PUVA-bath photochemotherapy. The cumulative dose of UVA used over 10 weeks of treatment was 54.6 J/cm2 on the palms and 26.8 J/cm2 on the dorsum of the hands. The single UVA doses ranged from 0.5 to 2.5 J/cm2 on the palms and 0.2 to 1.4 J/cm2 on the dorsum of the hands. After 16 treatment sessions, the acrodermatitis continua started to improve, and after 24 treatments, had cleared completely. In the four months following the PUVA therapy, there was no relapse. PUVA-bath photochemotherapy is an efficient therapeutic alternative in the treatment of acrodermatitis continua due to its clinical effectiveness and lack of any systemic side effects. It also possesses the advantage of allowing selective photosensitization of certain areas of the skin such as the hands.
- Published
- 1997
- Full Text
- View/download PDF
46. [Dermatology on the Internet].
- Author
-
Hoffmann K
- Subjects
- Computer Systems, Germany, Humans, Computer Communication Networks instrumentation, Dermatology instrumentation
- Published
- 1997
47. [Ultrasound in dermatology].
- Author
-
Hoffmann K and Happe M
- Subjects
- Curriculum, Dermatology education, Diagnosis, Differential, Humans, Lymph Nodes diagnostic imaging, Lymphatic Metastasis, Skin Diseases diagnostic imaging, Skin Neoplasms diagnostic imaging, Ultrasonography instrumentation
- Published
- 1997
48. [Keratosis palmoplantaris maculosa seu papulosa (Davies-Colley) simulating multiple cornua cutanea].
- Author
-
Schreiber D, Stücker M, Hoffmann K, Bacharach-Buhles M, and Altmeyer P
- Subjects
- Callosities genetics, Callosities pathology, Combined Modality Therapy, Humans, Keratoderma, Palmoplantar genetics, Keratoderma, Palmoplantar pathology, Male, Microscopy, Electron, Middle Aged, Skin pathology, Callosities diagnosis, Keratoderma, Palmoplantar diagnosis
- Abstract
Patient with extensive keratosis palmoplantaris maculosa seu papulosa (Davies-Colley) presented with multiple cutaneous horns. The clinical picture, the histology, the electro microscopic examination, the negative tumor screening and the viral classification in the tissue allowed the differentiation from other palmoplantar keratoses. The patient was treated successfully using a combination of acitretin with physical and chemical measures.
- Published
- 1997
- Full Text
- View/download PDF
49. [Balneophotochemotherapy with 8-methoxypsoralen in lichen sclerosis et atrophicus].
- Author
-
von Kobyletzki G, Freitag M, Hoffmann K, Altmeyer P, and Kerscher M
- Subjects
- Aged, Biopsy, Combined Modality Therapy, Female, Humans, Lichen Sclerosus et Atrophicus pathology, Skin pathology, Treatment Outcome, Balneology, Lichen Sclerosus et Atrophicus therapy, PUVA Therapy
- Abstract
A 66-year-old woman with longstanding lichen sclerosus et atrophicus improved strikingly with PUVA bath photochemotherapy over a period of 6 weeks. The cumulative UVA dose was 31.7 J/cm2; the single UVA dose ranged from 0.3 to 2.3 J/cm2. After 16 treatment sessions, the sclerotic lesions had softened greatly, while after 24 treatments, the skin lesions were almost completely cleared and pruritus was diminished. Histopathological analysis of biopsy specimens from previously affected sites as well as 20 MHz ultrasound examinations showed almost no residual sclerosis. Although long-term results are not yet available, PUVA bath photochemotherapy seems to be a promising and effective new treatment modality without systemic side effects for patients with disseminated lichen sclerosus et atrophicus.
- Published
- 1997
- Full Text
- View/download PDF
50. A 7-year-old child with primary tumour localisation in the distal duodenum--new imaging procedures for an improved diagnosis.
- Author
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Cholewa D, Waldschmidt J, Hoffmann K, Bäder M, Zimmer T, Scherübl H, Riecken EO, and Wiedenmann B
- Subjects
- Biomarkers, Tumor, Child, Duodenal Neoplasms physiopathology, Duodenal Neoplasms therapy, Female, Gastrinoma physiopathology, Gastrinoma therapy, Humans, Liver Neoplasms diagnostic imaging, Liver Neoplasms secondary, Lymphatic Metastasis diagnostic imaging, Receptors, Somatostatin analysis, Sensitivity and Specificity, Duodenal Neoplasms diagnostic imaging, Gastrinoma diagnostic imaging, Indium Radioisotopes, Somatostatin analogs & derivatives, Tomography, Emission-Computed, Single-Photon methods
- Abstract
Unlabelled: Duodenal gastrinomas in childhood are extremely rare and often missed at first medical consultation. We report on a 7-year-old child with sporadic gastrinoma of primary localisation in the distal duodenum. Small metastases in the liver and regional nodes were detected pre-operatively by somatostatin receptor scintigraphy (SRS) but not by other conventional imaging procedures. Diagnostic procedures include pre-operative SRS, endoscopic ultrasound and intra-operative endoscopic transillumination., Conclusion: Gastrinomas are rare abdominal tumours in childhood. Pre-operative tumour-specific diagnosis is possible by 111indium pentreotide SRS.
- Published
- 1997
- Full Text
- View/download PDF
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