From the Department of Dermatology of the University of Tübingen, Director: Professor Wilhelm Schneider, MD Can hair colour and sebaceous gland secretion be influenced by oral Pantogar® medication? Inaugural dissertation for conferral of a doctorate in dentistry Submitted to the Faculty of Clinical Medicine of the Eberhard-Karls University of Tübingen by Martin Kauffmann from Stuttgart 1973 Dean: Prof. Dr. E. Körber First referee: Prof. Dr. H. Tronnier Second referee: Prof. Dr. W. Schneider Dedicated in gratitude to my parents Introduction Hair has always had something magical about it. From the beginnings of human existence, hair has played an important role among the peoples of the world. The ancient Germans used to cut off the hair as a sign of subservience. The Greeks used to make hair sacrifices for the granting of citizenship, at the beginning of wedding ceremonies and as a form of honour for the dead. In the Old Testament, Samson viewed his long hair as a sign of vitality and consecration (Judges Chapter 16, verse 17). Hair and skin care have taken on ever increasing importance in today’s society. The influence of the hair on your head is not to be underestimated from a professional and psychological point of view. Apart from decorative and preparative cosmetic measures, the treatment of disorders of scalp hair – which are caused either by a defect in the extrafollicular part of the hair shaft or by a dysfunction of the hair-forming parts of the skin – involves dermatological therapy. External preparations such as shampoo and hair tonic can be used, which have local disinfectant, hyperaemic, keratolytic and antiseborrhoeic effects (24). However, keratin and follicle production is primarily dependent on the haematogenic nutritional status, which can be influenced by medication. Pfitzer reports on the effect of an oral Pantogar® treatment on hair quality (23). The parameters used were measuring procedures for investigating tensile strength, extension, tearing, swelling, and dye affinity (32, 33). His results showed a marked improvement in hair quality. The objective of the present paper was to determine any possible change in hair colour and sebaceous gland secretion as a result of Pantogar® medication. The medication was administered to 12 persons at a dose of 3 x 4 sugar-coated tablets daily for 3 months. One Pantogar®*) sugar-coated tablet contains: Aneurinum hydrochloricum Calcium-D pantothenate Medicinal yeast mixture of Saccharomyces Carlsbergensis (50 %) and Saaccharomyces cerevisiae (50 %) L-cystine Keratin Acidum para-aminobenzoicum Excip. pro compr. obduct. 0.015 g 0.015 g 0.025 g 0.005 g 0.005 g 0.005 g Influence on hair growth and hair colour The objective here is only to go into the possible influencing factors of the substances contained in Pantogar® and of certain vitamins. The spectrum of factors that affect hair growth is quite diverse. It ranges from genetic determinants, environmental influences and diseases to the effects of direct sunlight, hormone metabolism, vitamin availability and nutrition. Thus, heavy protein intake leads to lengthening of the hair and inhibition of the medullary cells; a low-protein diet promotes the formation of the medullary cord (25). SCHWEMMLER confirmed a favourable influence of vitamin A on hair and nail growth (29); high doses have a negative effect in this respect (34). An increase in hair growth with doses of vitamin D2 was determined by BEUTNAGEL and FRIEDERICH (3, 28). The blood cholesterol levels, which correlate with the skin cholesterol secreted with the sebum, apparently increase (15, 5). This skin cholesterol is also attributed a hair growth stimulating action (13). Vitamin B deficiency leads to the nails becoming brittle in pellagra; rats show symmetrical hair loss. Pantothenic acid, also termed vitamin B5, occupies the dominant position as the “hair vitamin” and “antigreying factor”. It is supposed to be effective against dandruff, greying and lack of glossiness (8, 4, 12, 22). According to the investigations of JUON, the progression of certain hair disorders that are regarded as incurable, such as alopecia seborrhoica in men or pseudopelade of Brocq, can at least be interrupted, if not stopped altogether (14, 9). According to BEIGLBOCK and CLATTEN, after intravenous administration of pantothenic acidified calcium, the sugar metabolism is characterised by an increase in blood sugar levels and the lipid metabolism by an increase in cholesterol values and decrease in ester fractions and fatty acids (2). Beside copper (15), p-amino benzoic acid is regarded as an activator of pigmentation. A darkening of the hair was also described by ZARAFONETIS after intensive treatment with p-amino benzoic acid (35). It was also capable of lightening nutrition-related greying in mice (1). Hormonal factors to be mentioned in relation to pigmentation are MSH, thyroid hormones and NNR hormones (6, 12, 25). The secretion of sebum Sebaceous glands develop in the second foetal month (16). They can occur freely or bound to hair follicles. Their mode of secretion is holo- and merocrine (6, 10). Little is known about the physiology of sebum secretion; the fat available on the skin is probably a major determinant. The secretion of sebum is dependent on age, air temperature and sex (7). The cutaneous fat contains 20 – 40 % free fatty acids with chain lengths of C7 to C22. In first place are the chains C14, C16 and C18; free and esterified fatty acids make up 2/3 of the cutaneous fat. It also contains wax alcohols, sterols (cholesterol and dihydrocholesterol) and carbohydrates (7.5 % of total cutaneous fat; 2/3 of this is made up of squalene, an intermediate product of cholesterol synthesis) (2, 18, 21, 30). The physiological importance of the fatty film is to be seen, among other things, in the fact that it is needed to wet the hydrophobic keratins of the skin (27). Methodology M Methodology for determining hair colour measurements 1) The principle of hair colour measurement The method described here was used to test how the human hair changes in colour intensity after the intake of Pantogar®. It should be mentioned that this is not a colour measurement in the true sense. This would namely require a measurement dependent on the wavelength. Rather, a difference in colour intensity of the individual hair was to be measured, in other words it is not a question of a shift into another spectral range, as occurs when hair is dyed. This colour intensity, as an expression of percentage light absorption is simply measured with a microscope with a photoelectric cell inserted into its beam path. The hair must be arranged in such a way that it completely covers the receptor field of the photoelectric cell. The photoelectric current produced is read by an ammeter. This means that it can be used as an objective measure of the light absorption of individual hairs. 2) Material Since hairs have a great variability in colour, cross-section and thickness, even in a single individual, they were sampled as test material from the various test subjects close to the scalp and always from the same area of the scalp (above the ear). This ensured a true basis for comparison before and after medication. 3) The microscopic specimen At least 10 hairs (13 – 15 were usually used) from one subject were fixed to a strip of sticking plaster with the 2-mm long scalp end of the hair, with a separation of 2 mm between each hair. The plaster was stuck to a microscope slide. After ensuring that the hairs were parallel and flat, a second strip of plaster was stuck over them, with a separation of about 3.5 cm. The hairs were measured at approx. 0.5 cm and approx. 2.5 cm from the scalp. Fig. 1: Sampling of the hairs with the microscope at a separation of 0.5 cm and 2.5 cm. 4) Experimental design The measurement of hair colour was conducted according to the method of TRONNIER and KUHNBUSSIUS (33). A “Dialux” universal microscope (Leitz) with an attached micro-photoelectric system was used. The light is first passed through the eyepiece. A crosshair becomes visible in a square. The human hair is adjusted so that it completely fills the square; after switching to the photoelectric cell, this field corresponds to the photosensitive area. 5) Calibration and measurement description The transformer and ammeter are switched on and allowed to warm up for 15 minutes. 0-point calibration: The switch is set to 100-fold magnification. The dark current is then compensated for and the 0-point of the scale is adjusted. 100-point calibration: The 100 scale graduations of the ammeter were used for the brightness value 100 without an object. For adjusting this point, the lens for oil immersion and the slide with oil are placed in the beam path in the same arrangement as when the individual hairs are measured, except that there is no hair in the beam path; this is best achieved by pushing the slide until the hair disappears from the field of vision and adjusting 100 scale graduations with a screen in the beam path. Once calibration has been performed, a hair is pushed into the beam path and the photoelectric current is measured on the magneto-electric instrument as a measure of transparency. This method offers the following advantages: • All 100 scale graduations are available for the hair colour intensity, since the absorption of the slide and oil are not included in the measurement. Oil was used to prevent the different fat levels of the hair having any effect on the measurement. • By pushing the hair out of the field of vision, re-calibration can be performed at any time, without removing the slide. Precisely such constant calibration control is necessary for sensitive equipment. • The calibration points are reproducible; this is necessary to make it possible to compare measurements at different times. When kept constant, this method provides objective results. Methodology for determining hair colour measurements The method of STRAUSS and POCHI for the quantitative determination of sebaceous gland secretion in human skin (31) is commonly used and modified. Here, cigarette paper is pressed onto the forehead and the fat absorbed by the paper is extracted and weighed. SCHAEFER and KUHN-BUSSIUS described another method (26). It exploits the effect that greased milk glass is more transparent than fat-free glass. Milk glass platelets roughened on one side, measuring 12 x 15 mm, are used for measurement. 1) Test description The glass platelets were cleaned in the solvent series distilled water – ethanol – acetone – ether for 10 minutes each. The transmission of each platelet was then determined in a Zeiss spectrophotometer at 460 nm. This yielded a blank value for each platelet. The smooth side of four platelets was stuck to a strip of sticky tape, after their blank value had been determined. The strip was turned the other way around, with the rough side of the platelets to the skin, weighted down with 1000 g and left in place for 30 seconds. The transmission of the greased platelets was now determined. The transmission difference, blank value minus fat value, corresponded to the fat secretion. 2) The measurement process Zero adjustment Darken receiver (cuvette slide to black) Wavelength adjustment (460 nm) Measurement Place the reference cuvette in the light path Set 100 scale graduation display Place the sample in the light path Read off degree of transmission 3) Calibration The zero adjustment is done by closing the monochromator gap (cuvette slide to black). The left-hand rotary switch is set with the pointer at 45° upwards to the right. At the zero point corrector, the scale is set to 0. For 100-point adjustment, the rotary switch is set with the pointer at 45° upwards to the right. Since the unit measures samples against an optical blank or less dense standard, the platelets greased with Vaseline were inserted into the last cuvette compartment and set to 100 scale graduations on the right-hand regulation switch. In a preliminary experiment, I tested the Vaseline-treated platelets, which were intended for adjusting the second calibration point, against the optically blank standard (nothing in the beam path = 100 scale graduations). The different Vaseline-treated platelets differed considerably in their transparency. One and the same platelet changed its transmission from approx. 50 to 70 scale graduations and more within a few minutes. This is caused by the heating up of the Vaseline when exposed to light. Its surface becomes more smooth, the scattered light is reduced and consequently transmission is increased. For this reason, I took a tinted glass platelet as a reference basis that remains truly constant, which had a value of 63 scale graduations against the optical blank at 460 nm; this corresponded to the transmission value of an “average Vaseline platelet”. This platelet was set to the standard 100. The transmission of all other platelets before and after greasing was measured against this. This method yields precise measurement values, because it allows the fixation of the calibration points, their maintenance as a constant and their reproducibility. Fig. 2: Increase in transmission of a Vaseline-treated platelet from 50 to 70 at a standard of 100 in the optically blank field. Fig. 3: If this platelet is maintained as the standard 100, there is a flattening out of the calibration curve with an increase in its transmission; one measurement sample consequently yields differing values. Results R Tables 1- 3 show the results of the sebum secretion measurements. Measurements were made before Pantogar® intake, after one month and after three months. Tables 4 -16 show the results of the measurements of hair transparency. Measurements were made before Pantogar® intake, after one month’s and after three months’ intake. The change in transparency of the hair is presented as a graph in Figure 4. The measurement of cutaneous fat is presented as a graph in Fig. 5. Table 1: Measurement of sebaceous gland secretion; transmission was measured before and after greasing of the glass platelets Before P. intake After one month After three months Glass platelets Blank value Fat value Diff. Blank value Fat value Diff. Blank value Fat value Diff. 1 43.5 57.0 13.5 47.5 59.0 11.5 43.0 53.5 10.5 2 47.0 58.5 11.5 53.5 59.0 5.5 52.5 58.0 5.5 3 41.0 53.6 12.6 54.5 63.0 8.5 47.0 58.0 11.0 4 47.5 60.5 13.0 51.0 63.0 12.0 49.0 59.0 10.0 5 48.5 79.0 30.5 47.5 58.5 11.0 34.0 63.0 29.0 6 50.5 84.0 33.5 47.5 63.0 15.5 46.0 63.0 17.0 7 51.0 75.5 24.5 51.5 57.5 6.0 49.0 66.0 17.0 8 44.8 79.0 34.2 50.5 62.0 11.5 51.0 71.0 20.0 9 47.5 62.0 14.5 48.5 76.0 27.5 42.0 82.0 40.0 10 51.0 66.0 15.0 52.0 59.5 7.5 49.0 78.0 29.0 11 51.5 64.5 13.0 52.5 70.0 17.5 50.0 67.0 17.0 12 48.0 74.0 26.0 49.5 66.0 16.5 49.5 64.0 14.5 13 47.0 54.0 7.0 47.0 53.5 6.5 46.0 61.0 15.0 14 50.5 53.5 3.0 53.0 55.0 2.0 48.5 56.0 7.5 15 50.5 53.0 2.5 53.0 56.5 3.5 48.0 56.0 8.0 16 43.0 59.5 16.5 47.0 49.5 2.5 49.5 62.0 12.5 Table 2: Measurement of sebaceous gland secretion; transmission was measured before and after greasing of the glass platelets Before P. intake After one month After three months Glass platelets Blank value Fat value Diff. Blank value Fat value Diff. Blank value Fat value Diff. 17 44.0 101.5 57.5 48.5 80.0 31.5 47.5 64.0 16.5 18 43.5 106.5 63.0 48.5 90.0 41.5 51.0 85.0 34.0 19 45.5 101.5 56.0 52.5 93.5 41.0 47.5 77.5 30.0 20 48.5 106.0 57.5 52.0 70.0 18.0 51.0 83.0 32.0 21 46.0 55.5 9.5 53.0 75.0 22.0 41.0 78.0 37.0 22 50.5 57.5 7.0 48.5 79.0 30.5 45.0 85.0 40.0 23 50.2 53.0 2.8 52.0 72.0 20.0 49.0 75.0 26.0 24 48.5 61.5 13.0 53.0 71.5 18.5 50.0 80.0 30.0 25 48.0 56.5 8.5 50.5 61.0 10.5 49.0 56.0 7.0 26 51.0 60.0 9.0 53.0 66.0 13.0 48.5 59.0 10.5 27 49.5 50.5 1.0 52.5 68.0 15.5 48.5 65.0 16.5 28 50.0 56.5 6.5 51.5 65.0 13.5 49.5 62.0 12.5 29 48.0 65.0 17.0 48.5 49.0 0.5 48.5 52.0 3.5 30 49.4 64.0 14.6 53.0 54.0 1.0 51.0 54.0 3.0 31 51.2 66.0 14.8 53.5 56.0 2.5 50.0 55.0 5.0 32 49.0 71.5 22.5 56.5 64.0 7.5 49.5 52.0 2.5 Table 3: Measurement of sebaceous gland secretion; transmission was measured before and after greasing of the glass platelets Before P. intake After one month After three months Glass platelets Blank value Fat value Diff. Blank value Fat value Diff. Blank value Fat value Diff. 33 46.5 64.0 17.5 49.5 68.0 18.5 45.0 54.0 9.0 34 50.0 65.0 15.0 52.0 63.0 11.0 46.0 55.5 9.5 35 50.5 77.0 26.5 51.0 68.0 17.0 50.0 59.0 9.0 36 51.0 69.0 18.0 49.0 59.5 10.5 48.5 55.0 6.5 37 49.2 64.5 15.3 50.0 82.0 32.0 45.0 77.0 32.0 38 50.0 57.5 7.5 49.0 73.5 24.5 46.5 59.0 12.5 39 48.5 63.5 15.0 53.5 54.0 0.5 51.0 80.0 29.0 40 18.0 63.5 15.5 54.5 64.0 9.5 49.5 70.0 20.5 41 45.5 53.5 8.0 49.0 49.0 0.0 47.0 55.0 8.0 42 45.0 57.0 12.0 54.0 54.5 0.5 49.5 58.0 8.5 43 49.0 67.5 18.5 53.0 54.0 1.0 50.5 63.0 13.0 44 50.0 54.5 4.5 51.5 53.0 1.5 52.0 60.0 8.0 45 47.5 53.0 5.5 51.5 51.5 0.0 48.5 53.0 4.5 46 50.0 55.0 5.0 53.0 53.0 0.0 47.0 59.0 12.0 47 51.0 52.0 1.0 54.0 54.5 0.5 51.5 59.0 7.5 48 50.5 56.0 5.5 53.5 53.5 0.0 51.0 55.0 4.0 Table 4: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 29 34 31 36 45 44 2 36 42 34 48 65 54 3 32 44 33 37 45 48 4 39 36 59 55 43 37 5 45 41 38 40 61 55 6 33 18 54 42 38 37 7 34 36 53 53 48 43 8 33 35 34 48 51 44 9 47 33 42 45 60 55 10 40 47 42 46 55 54 11 38 46 56 50 47 41 12 Average 36.91 40.18 42.00 45.00 51.17 46.83 Table 5: Transparency of the hair Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 26 35 36 39 27 28 2 26 43 24 23 30 35 3 35 37 26 34 15 18 4 41 18 27 34 35 30 5 37 19 25 30 31 25 6 22 25 23 17 29 30 7 22 19 21 16 34 32 8 30 30 83 91 31 27 9 21 19 30 26 29 27 10 38 30 26 29 47 41 11 91 95 36 38 36 33 12 51 52 28 32 27 24 13 32 34 36 29 Average 36.31 35.08 31.31 29.15 32.08 32.42 Table 6: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 55 63 49 49 45 49 2 96 95 97 95 30 32 3 97 98 94 95 39 39 4 76 92 21 25 37 34 5 98 87 96 97 98 98 6 97 83 98 96 30 33 7 96 79 61 83 3 39 8 38 42 96 97 98 95 9 37 48 31 34 98 98 10 63 68 27 34 11 95 92 29 32 12 94 94 20 21 13 37 45 14 33 43 15 37 28 16 21 20 Average 78.50 78.42 71.44 74.56 44.81 46.25 Table 7: Transparency of the hair Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 92 91 96 94 29 36 2 95 96 34 30 32 36 3 34 37 97 96 44 50 4 93 98 95 96 59 62 5 96 98 50 43 98 96 6 91 94 40 39 37 47 7 49 56 29 36 38 44 8 76 86 40 37 33 37 9 52 56 27 24 40 38 10 97 96 30 28 32 38 11 31 30 33 28 95 94 12 36 36 18 22 31 42 13 47 38 45 50 28 39 14 53 46 Average 67.29 68.43 48.77 47.92 45.85 50.69 Table 8: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 51 59 46 30 32 34 2 54 52 51 38 31 30 3 58 74 40 34 66 42 4 51 52 47 36 29 29 5 57 56 31 28 43 36 6 72 65 56 58 57 62 7 45 53 44 388 37 29 8 54 64 29 34 53 47 9 28 35 40 27 51 47 10 54 48 39 42 27 26 11 63 56 45 27 12 32 27 51 47 13 47 47 14 49 47 15 56 56 16 34 32 17 37 31 Average 52.4 55.8 43.16 37.33 43.82 39.35 Table 9: Transparency of the hair Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 36 40 50 30 29 26 2 27 27 56 25 27 29 3 31 34 27 29 44 39 4 40 40 24 24 30 33 5 48 40 23 23 32 28 6 32 35 49 43 40 31 7 24 37 32 24 45 35 8 33 35 19 20 21 25 9 24 41 47 43 46 36 10 37 45 36 27 36 35 11 30 33 29 29 26 32 12 33 35 30 32 38 37 29 31 34.08 32.08 13 Average 34.58 36.83 35.17 29.08 Table 10: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 53 52 55 60 25 22 2 35 34 27 25 60 46 3 38 42 32 30 38 45 4 31 33 29 35 34 28 5 54 61 28 28 36 42 6 35 33 36 33 49 32 7 36 37 28 25 44 46 8 27 32 43 32 32 34 9 42 38 65 43 26 25 10 33 37 40 41 48 39 11 31 28 54 47 29 25 33 33 12 Average 37.73 38.82 39.73 36.27 37.83 34.75 Table 11: Transparency of the hair Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 25 23 43 36 21 24 2 39 32 16 15 17 19 3 25 32 14 15 22 19 4 51 55 19 25 21 25 5 40 38 19 19 30 18 6 64 50 25 29 25 29 7 26 22 28 26 44 42 8 24 20 21 21 62 50 9 23 25 30 35 16 15 10 20 18 34 30 23 16 11 42 43 27 21 27 20 12 31 30 22 24 13 12 Average 34.17 32.33 24.83 24.67 26.67 24.08 Table 12: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 48 46 43 46 48 44 2 46 32 44 48 44 42 3 37 35 26 27 45 41 4 43 37 36 23 45 42 5 39 30 38 40 47 49 6 40 38 43 37 48 49 7 46 40 38 40 47 42 8 42 39 44 62 25 28 9 32 44 47 47 32 30 10 36 52 33 39 45 50 11 62 49 40 22 54 53 12 51 53 53 46 52 41 13 Average 43.50 41.25 39.27 39.18 45.00 42.85 Table 13: Transparency of the hair Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 37 35 45 47 18 18 2 28 36 39 29 34 26 3 51 53 24 29 30 45 4 43 40 38 34 31 32 5 34 36 44 30 20 17 6 31 25 18 20 34 33 7 46 31 25 31 23 20 8 37 63 43 36 31 28 9 47 44 38 25 24 27 10 69 64 52 53 25 25 11 49 64 20 20 Average 42.91 44.64 26.36 26.45 36.60 33.40 Table 14: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 43 40 32 28 50 52 2 58 48 42 49 36 29 3 50 49 33 31 33 33 4 49 53 33 41 45 38 5 34 35 44 35 42 45 6 40 43 33 35 35 31 7 51 58 39 59 43 37 8 39 39 30 34 43 45 9 35 43 26 25 33 42 10 56 48 42 47 43 45 11 55 52 26 31 12 66 66 31 35 13 50 55 Average 48.15 48.38 35.40 38.40 38.33 38.58 Table 15: Transparency of the hair Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 47 46 75 69 56 59 2 48 58 62 52 64 59 3 88 76 67 55 51 50 4 55 54 65 47 57 57 5 61 57 66 55 56 53 6 70 88 57 56 59 62 7 53 54 57 52 66 66 8 67 60 72 73 48 55 9 66 60 68 83 40 49 10 60 61 64 65 46 50 Average 61.50 61.40 65.30 60.70 54.30 56.00 Table 16: Transparency of the hair Measurement of hair colour Before P. intake After one month After three months Hair 0.5 cm 2.5 cm 0.5 cm 2.5 cm 0.5 cm 2.5 cm 1 62 50 61 57 44 43 2 61 66 55 59 60 44 3 58 59 34 38 59 61 4 55 52 29 30 44 41 5 40 41 26 31 38 34 6 43 45 33 35 32 30 7 52 52 38 37 54 48 8 40 49 36 30 54 48 9 65 67 32 33 38 34 10 50 54 39 41 11 52 56 22 32 Average 52.55 53.73 36.82 38.45 47.00 42.56 Testing of significance Testing the significance of sebum secretion A two-fold analysis of variance* was performed. The measurement value was the secretion of sebum. Model equation: where ␣ (time) = 3 points ß (person) = 12 persons j = 4 measurement values per cell Time is a fixed factor. The persons are chance factors. Results of the analysis of variance: 1. The persons as a whole show significant interindividual differences. 2. The interaction between time dependency and person shows significant differences 3. The various different time-points only show chance deviations * At this point, I would like to thank Prof. Dr. Geppert, Director of the Institute of Medical Biometrics/Tübingen, for planning the analysis of variance Table 17: x, s2, s, s x of the sebum secretion measurements Time-point I x = arithmetic mean 2 s = variance s = standard deviation s x = standard deviation of the means II III 1.711.041 120.625 1.589.583 22.247.329 11.919.813 11.644.636 1.491.553 1.091.778 1.079.103 215.287 157.584 155.755 Testing the significance of the transparency of the hair A four-fold analysis of variance with a hierarchical structure was performed. The measurement value was the transparency of the hair. Model equation: Since there was an unequal number of measurements per person and time-point, it was reduced to the same number per person using random numbers. There are two separations present (0.5 cm and 2.5 cm), three time-points (before intake, after one and three months of Pantogar®) and 13 persons with 9 to 13 hairs per person and time-point. Results of the analysis of variance: 1. The time-points show significant differences. In other words, there was a marked difference between at least one time-point and another. The transparency of the hair is thus not always the same. From the respective means, it can be seen that there is a drop in the transparency values from time-point one to time-points two and three. 2. The persons show significant interindividual differences. The same applies to the cells (repeat tests). 3. All other possible interactions, such as the separations, do not show any significant differences. Table 18: x, s 2, s, s x of the hair transparency measurements Time-point Separation I 0.5 cm II 2.5 cm 0.5 cm III 2.5 cm 0.5 cm 2.5 cm x 4.741.726 4.785.611 4.180.575 4.063.309 4.097.122 3.970.503 s2 37.421.593 37.558.784 35.740.402 37.282.817 26.076.728 24.838.338 s 1.934.466 1.938.008 1.890.513 1.930.875 1.614.829 1.576.018 sx 164.079 164.379 160.351 163.774 136.968 133.676 Fig. 4: Presentation of the “hair colour means” with standard deviation Fig. 5: Presentation of the means (M’, M’’, M’’’) of the cutaneous fat and the standard deviation Discussion The means of the cutaneous fat measurement were much lower after one month’s Pantogar® intake than before. They increased again after three months’ intake (Fig. 5). The temperature was taken into account in the measurements. The glass platelet method described yields reliable results. The very large quantitative individual differences in cutaneous fat must be given particular attention. A possible decrease in cutaneous fat is completely overshadowed by the large spread. In order to make a precise statement about the change in sebum secretion, a relatively large number of subjects would have to be investigated, as a result of the large spread. Another possible way of making a statement about sebum secretion would be via re-greasing of the skin after prior de-greasing. It would be conceivable that the interindividual difference and thus the spread would be smaller. Figure 4 shows that the hair becomes darker under the influence of Pantogar®. The differences in the colour values are significant. They could be explained by the incorporation of a dye or by true pigmentation. An autoxidative colouration is known of some aromatic amines. p-aminobenzoic acid may also act in this way. Pantothenic acid also comes into question as a further cause of the deepening in colour. The true cause of the darkening of the hair cannot be stated within the context of this paper. The subsequent oxidative darkening of an incorporated substance would cause the hair to darken starting from the scalp and progressing to the tip of the hair. The measurement values at two separations on each hair did not produce any significant differences. This question could be decided by investigating hair from different persons with more or less the same colour at two separations. This would also make the spread smaller (Table 18), so that the small colour differences on two hair sections would lead to significant differences between each other. The varying effect of the medication on the hair and sebaceous glands is consistent with the current opinion that, in the case of seborrhoeic hair loss, at least hair loss and the sebum production rate are not causally connected in any way (8, 19). Conclusion C The present study investigated whether the transparency of human hair and the secretion of sebum change under the influence of Pantogar®. There are individual differences in both parameters. In the case of sebum secretion, a decrease could not be demonstrated. The transparency of the hair was already lower after one month’s Pantogar® intake than before. After three months, the hair became somewhat darker. The individual measurement data were analysed biometrically. The results are statistically verified. References (1) BAYER, H.: Hirzel-Vlg. (1967) 465 Lehrbuch der organischen Chemie (2) BEIGLBOCK, W. und R. CLATTEN: Stoffwechselwirkung der Pantothensäure beim Menschen und im Tierversuch Dtsch. Ges. für Innere Medizin; angewandte Chemie 67 (1955) 353 (3) BEUTNAGEL, J. und H.C. FRIEDERICH: Beeinflußung pathologisch gestörten Haarwachstums durch Vitamin D2 in hohem Dosen Neue Med. Welt 1, N.F. (1950) 779-781 (4) BIANCO, O.: Das Haar und seine Krankheiten Roß-Vlg., Köln (1954) (5) BOCK, H.E. und G. SCHETTLER: Indikationen und Gefahren des Vigantolstoßes bei Erwachsenen Ärztl. Forschung 3 (1949) 22 (6) BUCHER, O.: Histologie und mikroskopische Anatomie des Menschen Huber-Vlg., Bern (1962) (7) ERNST, G. und J. SÖLTZ-SZÖTS: Neue Methodik zur Behandlung des seborrhoischen Haarausfalls mit Vitamin B6 Med. Kosmetik 7 (1958) 201-209 (8) FRIEDERICH, H.C.: Krankheiten der Haare in: BODE-KORTING Handbuch d. Haut- u. Geschlechtskrankheiten Bd. II 10. Aufl. Fischer, Stuttgart (1970) 499-516 (9) FRIEDERICH, H.C.: Erkrankungen der Haare und des Haarbodens beim Menschen in: GOTTRON-SCHÖNFELD Dermatologie und Venerologie Bd. III, Teil 2 (1962) 799-898 (10) HORSTMANN, E.: Die Talgdrüsen in: GOTTRON-SCHÖNFELD Dermatologie und Venerologie Bd, I/1 69-71 Thieme-Vlg., Stuttgart (1961) (11) HESSE, E.: Angewandte Pharmakologie für Ärzte und Studierende der Medizin Urban u. Schwarzenberg-Vlg., Berlin (1947) 373-374 (12) HIRSCH, F.: Das Haar des Menschen K.F. Haug-Vlg., Ulm (1956) (13) JAFFÉ, R.: Cholesterinstoffwechsel und Haarwuchs Klin. Wschr. 5 (1926) 507-508 (14) JUON, M.: Vergleichende klinische Untersuchung über die Wirkung von Pantothensäure und Ronicol bei Haarkrankheiten Med. Kosmetik 4 (1955) 257-260 (15) KIEL, H.L. und V.E. NELSON: The role of copper in haemoglobin regeneration and in reproduction J. biol. chem. 93 (1931) 49 (16 LANGMANN, L.: Medizinische Embryologie Thieme-Vlg., Stuttgart (1970) 353 (17) LINCKE, H.: Beiträge zur Chemie und Biologie des Hautoberflächenfettes Arch.Derm.Syph. 188 (1949) 453-481 (18) LINCKE, H.: Beiträge zur Chemie des Hautfettes Arch.Derm.Syph. 195 (1952) 540-548 (19) LUDWIG, E.: Der heutige Stand unseres Wissens über die Glatze Hautarzt 13 (1962) 337-339 (20) LUDWIG, E. und K. PATZWALK: Atlas der Schäden des Haares und der Kopfhaut Editio Cantor-Vlg., Aulendorf (1961) (21 NICOLAIDES, N. Preliminary and short reparts. Studies on chemical und S.T. ROTHMANN: compsition of human hair fat Squalene-cholestrol relation in Children and adults J. invest. Derm. 19 (1952) 389-391 (22) OESCH, F.: Versuche mit Pantothensäure am Menschen Schweiz. Med. Wschr. 76 (1946) 6-7 (23) PFITZER, H.: Methodische Untersuchungen über die Wirkung einer medikamentösen Behandlung auf die Haarqualität Inaug.-Diss., Tübingen (1971) (24) PUHAR, M.: Haarstatusuntersuchung unter Haarwasserbehandlung Inaug.-Diss., Tübingen (1971) (25) RICHTER, R.: Die Haare in: J. JADASSOHN, Handbuch d. Haut-u. Geschlechtskrankheiten; Erg. Werk I/3 1963: 282-522; Springer-Vlg., Berlin (26) SCHAEFER, H. und H. KUHN-BUSSIUS: Methodik zur qualitativen Bestimmung der menschlichen Talgsekretion Arch.klein.exp.Derm. 238 (1970) 429-435 (27) SCHNEIDER, W. und H. SCHULEIT: Fettmangel der Haut und seine Bedeutung für die Benetzung Arch:Derm.Syph. 193 (1951) 434-459 (28) SCHUCHARD, W.: Die Behandlung der Alopecia areata und des dyshidrotischen Ekzems mit milcheiweißgebundenem Vitamin D2 Dtsch.med.Wschr. 80 (1955) 417-418 (29) SCHWEMMLER, B.: Einfluß von Vitamin A auf Haar und Nagelwachstum Münch.med.Wschr. 86 (1939) 1226 (30) SOBEL, H.: Squalene in sebum and sebum-like materials J.inv.Derm. 13 (1949) 333-338 (31) STRAUSS, J.S. und P.E. FOCHI: The qualitative gravimetric determination of sebum production J.inv.Derm. 36 (1961) 293-298 (32) TRONNIER, H. und F. HÜSKE: Methodische Untersuchungen zur registrierbaren Schnellprüfung keratolytischer und keratinverfestigender Stoffe (33) TRONNIER, H. und H. KUHN-BUSSIUS: Experimentelle Untersuchungen über die Wirkung von UV-Strahlen auf Haare Ann.ital.Derm.clin.Sperimentale 16 (1961/62) 128-138 (34) WYATT, T.C., CARABELLO, C.A. und M.E. FLETCHER: Hypervitaminosis A Report of a case J.Amer.med.Ass. 144 (1950) 304 (35) ZARAFONETIS, C.J.D.: Darkening of gray hair during paraaminobenzoic acid J.inv.Derm. 15 (1950) 399-401 I would like to thank Professor Dr. W. Schneider, Director of the Department of Dermatology of the University of Tübingen, for allowing me to conduct the experimental part of this study in his department. I am extremely grateful to Professor Dr. H. Tronnier for entrusting me with this subject and for his valuable help and support. Curriculum vitae I, Martin Kauffmann, was born on 22 May 1947, as the only son of my father, August Kauffmann, and his wife Toni, née Hamm, in Stuttgart. After the primary school years (1954 to 1958) in Renningen, I attended the Albert-Schweitzer Grammar School in Leonberg from 1958 onwards; I passed my advanced school leaving certificate here in the autumn of 1966. I then completed 15 months of national service. In the summer semester of 1968, I started the study of dentistry. I passed the preliminary examination in the natural sciences on 20 March 1969 and the preliminary examination in dentistry on 6 October 1970. On 26 June 1973, I completed my studies with the state examinations and received my licence to practice dentistry.
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