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Biomedical subjects

A B Lerner

Publications and source records attributed to A B Lerner.

At least 55 records · Page 3Linked to original sources
PubMed1982

Intralymphatic and regional surgical adjuvant immunotherapy in high-risk melanoma of the extremities.

A prospective, controlled study of surgical adjuvant immunotherapy with intralymphatic methanol-extractable residue (MER) of bacillus Calmette-Guerin (BCG) is preliminarily reported in 25 consecutive patients with high-risk malignant melanoma of the extremities. Patients were allocated on a random basis to receive preoperative intralymphatic immunotherapy with MER-BCG, surgical excision with regional lymphadenectomy and intraoperative infiltration of MER-BCG, and postoperative monthly intradermal vaccinations with BCG; or surgery and lymphadenectomy alone. Twenty patients followed for more than 1 year are the basis of this report. Fifteen patients accepted randomization, whereas four patients entered the immunotherapy group and one entered the control group at their own insistence. Immunotherapy improved the disease-free survival of patients in this trial. There was one recurrence with death in the 13 patients treated with preoperative intralymphatic MER-BCG; whereas four of seven patients in the control group had recurrence (P = 0.015), at all four of these patients died during the same interval.

Adjuvants, Immunologic↗
PubMed1981

Antibodies to melanocytes. Occurrence in patients with vitiligo and chronic mucocutaneous candidiasis.

The prevalence of antibodies to melanocytes was determined by an immunofluorescence complement fixation technique in 294 patients with vitiligo, other pigmentary disorders, and unrelated dermatoses. Antimelanocyte antibodies were present in the sera of five (29%) of 17 patients with chronic mucocutaneous candidiasis. Only two of the five patients with antibodies had vitiligo. No antibodies to melanocytes were found in the sera of 31 patients with common vitiligo or of 38 patients with vitiligo associated with autoimmune diseases or melanoma. Nor were antibodies to melanocytes found in 129 patients with other diseases of pigment-producing cells or in a control group of 79 patients with nonpigmentary dermatoses. These results suggest that complement fixing antibodies to melanocytes are associated wih chronic mucocutaneous candidiasis but are not involved in the pathogenesis of common vitiligo.

Autoantibodies↗
PubMed1981

The intermediate lobe of the pituitary gland: introduction and background.

Research from a number of laboratories using of systems has shown that cells from the anterior and intermediate lobes of the pituitary gland, from hypothalamic neurons and from the placenta produce a glycoprotein with the full sequences of corticotropin, beta-lipotropin and gamma-melanotropin. These peptides in turn contain the sequences of alpha- and beta-melanotropin, CLIP, gamma-lipotropin, alpha-, beta- and gamma-endorphins and methionine-enkephalin. The precursor molecule, here called protropin, is processed by the four types of cell to give rise to different ratios of corticotropin, CLIP, beta- and gamma-lipotropin, alpha-, beta- and gamma-endorphins and alpha-, beta- and gamma-melanotropins. The physiological roles of these peptides in neurotransmission, pre- and postnatal endocrinology, mental disorders and neoplasia are only now being established.

Animals↗
PubMed1981

The prevalence of vitiligo and poliosis in patients with uveitis.

Vitiligo is a disease of cutaneous pigment cells. Recently we reported that one third of patients with vitiligo had destructive lesions in the retinal pigment epithelium and/or the choroid which were visible by ophthalmologic examination. To determine whether abnormalities of the pigment system of the eye and skin are in fact associated, we examined for vitiligo the skin and hair of 107 patients with active uveitis. Thirty-four patients had an infectious or a known cause for their uveitis and none of these had vitiligo. In contrast, six of seventy-three patients (8%) with idiopathic uveitis had vitiligo or early graying of the hair. Seven other patients with active inflammatory diseases of the ocular pigment system were referred for evaluation of white spots on the skin. One of these patients was legally blind (correlated visual acuity less than 20/200 in both eyes) due to chorioretinal scars in the fovea. The finding that vitiligo is more common than expected in patients with uveitis is significant biologically and statistically. This observation supports our hypothesis that the same systemic factors, probably immunologic, are responsible for destroying pigment cells in the skin (vitiligo) and the eye (uveitis).

Adolescent↗
PubMed1981

Assay of melanotropic peptides in an in vitro mammalian system.

A reproducible and sensitive assay for melanotropic agents is described employing mouse melanoma cells in culture and measuring tyrosinase activity in terms of production of tritiated water from L-(ring-3,5-3H)-tyrosine. Molar concentrations of peptides inducing one-half maximal stimulation of tyrosinase activity were: beta-MSH, 1 +/- 2 x 10(-9); alpha-MSH and Beta h-LPH, 1 +/- 2 x 10(-8); ACTHp, 1 +/- 2 x 10(-7). Beta p 9-18-MSH and melanotropin potentiating factor, beta s 88-91-LPH exhibited no activity at concentrations as high as 10(-5)M.

Animals↗
PubMed1981

Anti-pigment-cell factors and mucocutaneous candidiasis.

Previous reports documented the fact that some patients with mucocutaneous candidiasis and vitiligo have a complement-fixing anti-pigment-cell factor in their serum. We examined sera from seven patients with mucocutaneous candidiasis without vitiligo. Three of the seven sera contained the anti-pigment-cell factor. We suggest that these anti-pigment-cell factors, which are most probably antibodies, are not cytotoxic for pigment cells and, thus, not the cause of vitiligo. The association of vitiligo and anti-pigment-cell factors with the syndrome of mucocutaneous candidiasis implicates the immune system are a causal factor of vitiligo.

Adult↗
PubMed1980

Halo nevi and the Vogt-Koyanagi-Harada syndrome. Manifestations of vitiligo.

A 10-year-old boy with Vogt-Koyanagi-Harada syndrome had loss of pigment cells in the skin, the halo nevi, the retina, and probably the leptomeninges. The amount of inflammation that accompanied destruction of pigment cells varied greatly and seemed to determine whether the patient had symptoms from his vitiligo. This patient exhibited symptoms associated with loss of pigment cells in his skin and leptomeninges, but not from the destruction of the pigment cells in his eyes. We suggest that vitiligo is a disease that can be manifested in any tissue containing pigment cells and has a variable clinical expression.

Child↗
PubMed1979

Psychological reaction to chronic skin disorders: a study of patients with vitiligo.

Diseases that cause physical handicaps can seriously interfere with the life of a patient. Some disorders such as vitiligo cosmetically disfigure patients without producing any physical disabilities. The effects of such diseases as vitiligo on the life of a patient have not been widely investigated. The investigation reported here utilized a questionnaire survey to focus on emotional disturbances caused by vitiligo and on the factors that differentiated patients who cope well from those who cope poorly with this stress. The results indicate that the cosmetic disfigurement of a seemingly inconsequential skin disease also can seriously disrupt the lives of a large number of patients. Those who cope well with their disfigurement have higher self-esteem than a matched control group without the disorder. Those who cope poorly have significantly lower self-esteem, which suggests that response to disfiguring diseases is affected by basic ego strength. Younger patients and those individuals in the lower socioeconomic groups show especially poor adjustment. A number of suggestions for better patient care are offered.

Adaptation, Psychological↗
PubMed1979

Ocular abnormalities occurring with vitiligo.

One hundred twelve patients with vitiligo were examined for ocular abnormalities. Discrete areas of depigmentation with associated pigment hyperplasia clinically appearing to involve the choroid and retinal pigment epithelium were observed in 44 patients, and active uveitis was seen in nine patients. The changes observed suggest that the spectrum of diseases that includes Harada's disease and the Vogt-Koyanagi syndrome may be broader than previously appreciated. Patients with these syndromes may represent the most severe examples of vitiligo and uveal inflammation. The occurrence of symptoms of night blindness in 12 patients and a family history of retinitis pigmentosa in two of these may signify a possible malfunction of the retinal pigment epithelium. Further evidence for a pigment epithelium disorder is suggested by the high incidence of an unusually prominent choroidal pattern in these patients.

Adolescent↗