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Biomedical subjects

C S Munro

Publications and source records attributed to C S Munro.

At least 73 records · Page 4Linked to original sources
PubMed1992

The route of rapid access of drugs to the distal nail plate.

It has recently been shown that antimycotic drugs have unexpectedly rapid access to distal nail, which we have suggested occurs through the site of continuous ventral nail formation along the nail bed. To exclude the alternative possibility of diffusion through the nail plate, we have measured the effect of topical terbinafine cream in onychomycosis. Sustained outward movement of the fungally affected distal segment was seen in only 2 of 10 measured nails, and there was no change in the mean severity of clinical involvement in 53 nails under study. This excludes significant diffusion of drugs through the nail plate, and we conclude that the route of rapid access is indeed through the nail bed.

Administration, Oral↗
PubMed1992

The unexpectedly rapid response of fungal nail infection to short duration therapy.

To test our hypothesis that, by laying down a fungicidal barrier in the growing nail, a short course of antifungal therapy should be effective against onychomycosis, we treated 8 subjects with Trichophyton rubrum nail infection with terbinafine 125 mg b.d. for 14 days. All but one patient showed marked improvement, and 80% of fingernails and 37% of toenails were clinically cured after 6 months. Although this confirmed our prediction, the onset of response measured by outward movement of affected nail and negative cultures from distal nail clippings occurred after as little as 4 weeks. This was too soon for a fungicidal barrier to have grown out and indicates that the drug must have been carried directly into the diseased distal nail, presumably from newly formed ventral nail beneath it. The findings show that 1) short duration therapy, perhaps even a single dose, is possible in fungal nail infections; 2) the ventral nail provides unexpectedly rapid access of drugs to the site of distal disease.

Adult↗
PubMed1992

Mapping of the Darier's disease gene by serogenetic markers: results in two large British kindreds.

The authors have carried out genetic linkage studies in 57 subjects from two large kindreds of Darier's disease, using a range of serological and biochemical polymorphisms of known chromosomal location. In these kindreds, about 7% of the genome has been excluded for close linkage to the Darier's disease gene. However, one family showed positive lod scores for linkage with the Duffy blood locus (1p13); lod scores were negative in the other family, but in the combined families the total score for this marker was still positive and does not completely exclude linkage.

Chromosome Mapping↗
PubMed1991

The incidence and distribution of oral lesions in patients with Darier's disease.

Darier's disease is an uncommon autosomal dominant genodermatosis that may be accompanied by oral lesions. The incidence and distribution of oral manifestations was studied in 24 patients with cutaneous Darier's disease. Oral lesions comprising whitish papules of varying severity were present in 12 patients, with the palate being the most common site affected, followed by gingiva, buccal mucosa and tongue. Generally, the severity of the oral lesions paralleled that of the skin condition. Seven patients (30%), six of whom also had oral mucosal involvement, reported intermittent parotid swelling. Parotid sialograms of two patients revealed strictures in the main ducts, suggesting an obstructive aetiology.

Adolescent↗
PubMed1991

Cyclosporin A in atopic dermatitis: therapeutic response is dissociated from effects on allergic reactions.

Fourteen patients with severe chronic atopic dermatitis were treated with cyclosporin A (CyA, Sandimmun; 5 mg/kg/day) for 7-16 weeks. All showed a marked clinical improvement and half could omit topical corticosteroid treatment during therapy. Adverse effects were minor, but two patients relapsed despite continued treatment. In the others, the disease recurred soon after stopping CyA. Serum IgE levels and prick-test responses were unchanged by CyA. Immediate and late-phase cutaneous responses to intradermal house dust mite antigen (HDM) were significantly increased during treatment; but a delayed response, present at 24 and 48 h, was unaffected. Four of six patients challenged with HDM patch tests to tape-stripped skin during treatment showed eczematous reactions at 48 h. Thus, cyclosporin A has a powerful therapeutic effect in atopic dermatitis but does not reduce allergic responses to inhalant antigens.

Adolescent↗
PubMed1991

[Cyclosporin A in atopic dermatitis: therapeutic effect and effect on allergic reactions are dissociated from each other].

Fourteen patients with severe chronic atopic dermatitis were treated with cyclosporin A (CyA, Sandimmun; 5 mg/kg/day) for 7-16 weeks. All showed a marked clinical improvement and half could omit topical corticosteroid treatment during therapy. Adverse effects were minor, but two patients relapsed despite continued treatment. In the others, the disease recurred soon after stopping CyA. Serum IgE levels and prick-test responses were unchanged by CyA. Immediate and late-phase cutaneous responses to intradermal house dust mite antigen (HDM) were significantly increased during treatment; but a delayed response, present at 24 and 48 h, was unaffected. Four of six patients challenged with HDM patch tests to tape-stripped skin during treatment showed eczematous reactions at 48 h. Thus, cyclosporin A has a powerful therapeutic effect in atopic dermatitis but does not reduce allergic responses to inhalant antigens.

Adolescent↗
PubMed1989

Symptomatic zinc deficiency in breast-fed premature infants.

We report two breast-fed premature infants who developed transient symptomatic zinc deficiency with scaly erythema of cheeks and napkin area, 9-13 weeks after birth. Serum zinc concentrations were 3.6 and 4.8 mumols/l, and the lesions healed rapidly in response to oral zinc supplements. Both mothers had low breast-milk zinc levels (2.3 and 3.2 mumols/l at 21 and 15 weeks respectively). The infants were both initially misdiagnosed as having eczema and infection. Premature infants are in negative zinc balance and though the additional factor of a low maternal breast milk zinc concentration may be necessary to provoke symptoms, rashes developing in such infants in the months following premature birth should raise the suspicion of zinc deficiency.

Breast Feeding↗
PubMed1989

Opsonic activity of a new intravenous immunoglobulin preparation: Pentaglobin compared with sandoglobulin.

Standard preparations of immunoglobulin for intravenous use consist predominantly of IgG (greater than 95%). We have compared the ability of a standard preparation (Sandoglobulin) with that of a new preparation (Pentaglobin, containing 12% IgM and 12% IgA) to improve the opsonic activity of antibody-deficient human sera in vitro. Panhypogammaglobulinaemic sera were poorly opsonic for five of six organisms tested, particularly Pseudomonas aeruginosa, Escherichia coli and Streptococcus pneumoniae, but opsonized Staphylococcus aureus almost normally. Both immunoglobulin preparations significantly improved the opsonic activity of the antibody-deficient sera for most organisms. The major difference between the two preparations was the ability of Pentaglobin to supply opsonins for P. aeruginosa, E. coli and Klebsiella pneumoniae, while Sandogloblin was significantly more potent in opsonins for Haemophilus influenzae. Pentaglobin demonstrates significant in vitro opsonic activity, particularly for enterobacteria (coliforms) and P. aeruginosa. Its content of IgM antibodies appears to confer special properties on Pentaglobin not seen with standard preparations of immunoglobulin for intravenous use. Its place in clinical practice remains to be determined but it may have a possible role in augmenting host defence mechanisms in Gram-negative septicaemia.

Agammaglobulinemia↗
PubMed1988

Suppression associated lymphocyte markers in lesions of sarcoidosis.

The presence within the epithelioid granulomas of sarcoidosis of lymphocytes of the "helper" (T4 positive) phenotype suggests that, as in granulomatous diseases of known aetiology, active cell mediated immunity plays a part in the disease. It has, however, been noted that T8 positive lymphocytes are also found on occasion in the granulomas. The presence of cells bearing markers associated with suppressor activity in various lesions of sarcoidosis has been investigated with a range of monoclonal antibodies. T4 positive cells were present in all granulomas; T8 positive lymphocytes were present within the epithelioid cell areas in proportions that varied from 5 to 55/100 of T4 cells. Other lymphocyte markers associated with suppression (Leu8 and SN130) were very rare on lymphocytes within granulomas but common on both T4 positive and T8 positive lymphocytes in the perigranulomatous mantle, which suggests that expression of these markers was down regulated in the granuloma or that cells bearing them are unable to migrate into the granuloma. Nevertheless, suppressor cell mechanisms could mediate the spontaneous resolution of most cases of sarcoidosis, and the presence or absence of cells bearing suppression associated phenotypes in the granuloma or its mantle may have prognostic importance.

Antibodies, Monoclonal↗
PubMed1987

An immunohistochemical analysis of human aortic fatty streaks.

Recent studies have shown both macrophages and lymphocytes in very early intimal lesions of experimental aortic atherosclerosis. The authors obtained fresh samples of human aortic wall, which had been removed in the course of aortocoronary bypass graft surgery. Intimal fatty streaks were identified macroscopically and six were studied immunohistochemically. The fatty streaks contained foam cells that were virtually all labeled by antibodies directed against members of the mononuclear phagocyte series (RFD-2 and RFD-7). Macrophages demonstrated acid phosphatase activity and marked expression of HLA-DR, suggesting activation. Other monoclonal antibodies (UCHT-1, OKT-4, and RFT-8) identified T lymphocytes, of both helper and suppressor phenotypes, within the fatty streaks. T lymphocytes of suppressor phenotype appeared to predominate over helper cells. B lymphocytes were not detected. The presence of activated macrophages and T lymphocytes in the fatty streaks indicates that components of a cell-mediated immune response are present. Such an immune process may be important in the pathogenesis of human atherosclerosis.

Aged↗
PubMed1987

Dendritic cells in cutaneous, lymph node and pulmonary lesions of sarcoidosis.

To determine whether dendritic cells (DC) are a consistent feature of lesions of sarcoidosis, we have used monoclonal antibodies to identify the HLA-DR-expressing populations of cells in cryostat sections of 15 lymph node, pulmonary and cutaneous lesions. The commonest HLA-DR positive cells in granulomas were epithelioid and giant cells, although lymphocytes within granulomas and tissue macrophages around them were also positive. Dendritic cells with Langerhans cells (NA1/34+ = OKT6+) and interdigitating cell (RFD1+) phenotype were consistently associated with granulomas only in skin lesions. In lymph nodes, interdigitating cells (NA1/34-/RFD1+/HLA-DR++) were confined to paracortical zones as in normal nodes, although a small area of NA1/34+/RFD1+ cells was found in one of three nodes. In lung lesions NA1/34+/RFD1+ dendritic cells were uncommon or absent, except in one chronic case. We conclude that while sometimes present in extracutaneous sites, DC are not an essential feature of sarcoid lesions, and that cells of the classical macrophage group are the most significant HLA-DR-expressing population. We suggest that the presence of DC in lesions of sarcoidosis may indicate an immunological response distinct from that causing granulomas to form. The variability of their involvement may have immunoregulatory significance.

Antibodies, Monoclonal↗