Biomedical subjects
Publications and source records attributed to B Berman.
T6-antigen-bearing Langerhans' cells were detected in a touch imprint of eosinophilic granuloma involving a thoracic vertebra of an 11-year-old boy. It is interesting to note that in this localized form of histiocytosis X, no T6-antigen-bearing Langerhans' cells were found in the peripheral blood. Immunofluorescence detection of T6 antigenicity has not been described in this disease and may serve as a rapid diagnostic test.
In a school-based immunization program in four states, 70% of the students were fully immunized by the end of the first year and 85% by the end of the second year. Because of student turnover, 20% of the immunization levels achieved by the end of a school year were not sustained into the subsequent year. Levels reported by the state immunization officers were higher than those recorded by school personnel. Completed immunization series for students requiring immunizations were 33% to 40% higher for students enrolled at the start of the year than for students who entered during the school year. Students who were unimmunized at the beginning of the year had a better change (P less than 0.001) of being immunized by the end of the year than those whose immunization status was unknown. To maintain high levels, a program must be sustained and continuing, provide immunizations, and have careful administrative monitoring of child-specific population-based data. Schools are uniquely able to provide all of these elements, which can augment the efforts of private practitioners.
In this study mass screenings identified more problems than did physical examinations, but more problems per 100 contacts were identified by physical examinations (51.6) than by screenings (4.7). When time necessary to accomplish the evaluation is considered, screenings are a more efficient way of identifying problems in the general diagnostic categories for which screenings can be provided, but most (85.8%) of the problems identified by physical examination were in categories for which screenings are not provided. Overall, 99.1% of the problems were identified without overlap between physical examinations and screenings. Eighty-three percent of the problems identified by physical examinations were previously unknown. By the end of the school year, 86.3% of the problems identified by physical examinations and 94.5% of those identified by screenings had been or were in the process of being resolved. The integration of physical examinations and screenings in a school setting, staffed by nurse practitioners supported by physicians, can maximize the identification and resolution of health problems.
Fingertip dermatoglyphic patterns of forty-five patients with atopic dermatitis were compared to those of sixty nonatopic dermatologic patients, twenty-one of whom had hand dermatitis. The average number of digits in which linear grooves were detected was significantly higher in the atopic group than in the nonatopic controls (p less than 0.005). Three or more digits with linear grooves were found in 95.2% of atopic patients with hand dermatitis and in 61.9% of controls with hand dermatitis (p less than 0.005). A greater number of digits displaying linear grooves was found in control patients with hand dermatitis than in control patients without hand dermatitis. However, atopic patients with hand dermatitis had, on the average, an even greater number of digits with linear grooves than did control patients with hand dermatitis (p less than 0.005). These findings suggest that linear grooves, although associated with hand dermatitis in general, are more commonly found in patients with atopic hand dermatitis. Although a significant increase in the whorl pattern was detected in female, but not in male, atopic patients when compared to sex-matched control groups (p less than 0.0025), this increase was significant only in Caucasian females when compared to sex- and race-matched controls (p less than 0.0005).
Langerhans cells (LC) have been implicated as antigen-presenting and target cells in contact allergic, cell-mediated reactions. We have examined the effects in guinea pigs, rats, and humans of in situ (epicutaneous) exposure to glucocorticosteroids (GCS) on the expression of epidermal LC markers. Reductions in the number of Fc-rosetting, C3b-rosetting, and immune-associated (Ia) antigen-bearing LC occurred in a dose-related fashion, with the degree of such reductions dependent upon the specific GCS employed. These reductions were determined to be reversible following cessation of exposure to GCS. T6 antigenicity, another cell surface marker of human LC, was little affected by GCS exposure. Simultaneous immunofluorescent staining for T6 and Ia antigenicity within human epidermis of amcinonide treated skin detected reduced numbers of T6+/Ia+ cells with a concomitant increase in T6+/Ia- cells. The data presented suggest a selective reduction in the expression of immunologically important receptors and antigens by LC which may be involved in steroid-responsive contact allergic reactions.
Langerhans cells play a role in cell-mediated immune reactions which are often depressed in sarcoidosis. We examined the epidermis of 17 anergic patients with sarcoidosis (Kveim-reactive and/or biopsy-proved) for the number of Langerhans cells in noninvolved skin and in any cutaneous sarcoidal lesions. Skin biopsies of 10 healthy volunteers served as controls. In comparison to controls, the epidermis overlying noninvolved (p less than 0.05), sarcoidal (p less than 0.0005), and Kveim-reactive (p less than 0.005) skin contained significantly fewer detectable Ia and T6 antigen-bearing Langerhans cells. The reductions within noninvolved skin were most pronounced in patients with multisystem disease. Lower epidermal Langerhans cell densities, in comparison to controls, were detected in both prednisone-treated and untreated patients. Epidermis overlying sarcoidal skin of untreated patients contained significantly fewer Ia and T6 antigen-bearing Langerhans cells (p less than 0.05, p less than 0.0025, respectively) than epidermis from noninvolved skin. Whether reduced numbers of cutaneous Langerhans cells are due to either a local and/or systemic effect of sarcoidosis, or reflect the anergic state of these patients is unknown.
The densities of T6 antigen-bearing Langerhans cells in 112 biopsies of human skin from sixteen surgical out-patients and four cadavers were determined for eight anatomical regions. The regional mean densities (+/- s.e.m.) of epidermal Langerhans cells per mm2 were: head and neck, 489 +/- 27; chest, 466 +/- 22; back, 466 +/- 11; upper extremities, 458 +/- 25; lower extremities, 431 +/- 30; buttocks, 411 +/- 11; genitalia, 298 +/- 45; soles, 58 +/- 12. No statistically significant differences were found between any of these Langerhans cell densities except for that of the soles which was lower than those of all other regions (P less than 0.002). No significant differences were detected between the mean densities of patients and cadavers, Caucasians and Hispanics or males and females.
This paper reports the first case of skin metastases from small-cell carcinoma of the lung with electron microscopic confirmation. The 2 to 3-cm cutaneous lesions present on the chest and limbs were hard, nontender, smooth-surfaced, freely moveable nodules with normal appearing overlying skin. Characteristic dense-core granules 1562 +/- 123 A (SEM) in diameter were detected by electron microscopy. The detection by electron microscopy of dense-core granules may assist in confirming the diagnosis of small-cell carcinoma in cutaneous lesions with equivocal histologic findings.
Cyclic hematopoiesis is a rare disease in man in which severe neutropenia recurs at 21-day intervals with associated illness. Because lithium carbonate therapy has been shown to eliminate cyclic hematopoiesis in grey collie dogs, we examined the effects of lithium treatment on five patients with this disease. With lithium levels maintained between 0.5 and 1.0 meq/liter, these patients showed no change in the fluctuations of their neutrophil counts. We conclude that lithium carbonate is not a simple cure for human cyclic hematopoiesis.
Recently, increasing numbers of young homosexual men with a fulminant form of Kaposi's sarcoma have been described. We report herein a case of a young homosexual man with Kaposi's sarcoma, chronic perianal and nasolabial ulcerating herpes simplex infection, oral candidiasis, and immunodeficiency, presumably acquired.
Explore the source record for details and available documents.
A noninvasive technique of pulsed ultrasound was used to determine the long-term changes in skin thickness resulting from intradermal injections of triamcinolone acetonide (TA). Injections of 0.1 ml of either saline or a suspension containing 5 mg/ml or 10 mg/ml of TA were made at selected sites on the forearms of two human volunteers. The corticosteroid-treated sites showed a maximal decrease of 30% to 40% of the original skin thickness at 4 to 8 weeks after a single injection. A transient thinning was observed at control sites injected with saline. A greater degree of thinning was seen at the site injected with 10 mg/ml of TA as compared to the site injected with 5 mg/ml of TA. The thinning at the corticosteroid injection sites persisted at least 18 weeks after the single corticosteroid injection but had approached normal thickness values by 44 weeks following treatment. Pulsed ultrasound may be useful as a noninvasive technique for monitoring the effects of intradermally injected corticosteroids on human skin thickness and may also be useful in assessing intrinsic atrophogenic potentials of different corticosteroid molecules in human skin and the duration of action of various injectable formulations of a corticosteroid.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The case histories of two elderly patients with cutaneous histiocytosis X treated topically with nitrogen mustard are presented. The cutaneous lesions cleared within 2 to 3 weeks, and remission was maintained with daily topical administration of nitrogen mustard. The clinical impression of improvement was substantiated by light and electron microscopic studies prior to and after therapy.
A discontinuous gradient of polyethylene glycol (PEG) with dimethyl sulfoxide (DMSO) was used to induced fusion between guinea pig epidermal cells (GPEC) enriched in Langerhans cells (LC) and cells of a human fibrosarcoma line (T-1080) deficient in hypoxanthine phosphoribosyl transferase (HPRT). The rapidly proliferating carrier T-1080 cells lack plasma membrane ATPase activity, Fc receptors, C3b receptors, guinea pig Ia-antigens, and nonspecific esterase activity, all characteristic of LC, and absent on other guinea pig epidermal cells. GPE/T-1080 hybrid cells were selected in hypoxanthine/aminopterin/thymidine (HAT) medium and by C3b and Fc rosette formation. A resultant continuous cell line was characterized karyotypically, histochemically, ultrastructurally and immunologically.
A population of guinea pig epidermal cells possessed the ability to form rosettes with IgM antibody-sensitized sheep erythrocytes coated with purified human C3b (SEAIgMC1-), but not with intermediates carrying C1, C4, or C2. This population of rosette-forming epidermal cells was identified as Langerhans cells (LC) ultrastructurally and by LC depletion and enrichment studies. In addition, these cells were able to bind fluid phase C3b, which inhibited any subsequent SEAIgMC1-3b rosette formation. Rosette formation was also inhibited after SEAIgMC1-3b pretreatment with beta 1H and C3b-inactivator. LC were shown to possess trypsin-resistant C3b and Fc receptors, and unlike the temperature-independent nature of LC Fc-rosette formation, the ability of LC to form C3 rosettes was a temperature-dependent process. The finding of C3b receptors on the surface of guinea pig epidermal LC supports the concept that they are of the phagocytic monocyte-macrophage family.