Biomedical subjects
Publications and source records attributed to K J Misch.
We report a patient with multiple cutaneous and cerebral haemangiomas associated with angiokeratomas. As far as we are aware this patient is unique as the association of cutaneous and cerebral haemangiomas with angiokeratomas has not been previously described.
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Serum monoamine oxidase, diamine oxidase and lysyl oxidase-like activity were measured in patients with granuloma annulare (GA), necrobiosis lipoidica (NL) and diabetes mellitus. In diabetes, all enzyme measurements were raised by a factor of about 2 X 2, and in NL by a factor of about 1 X 5. The rise in patients with GA was small and only significant in the case of benzylamine monoamine oxidase. "Stiff' collagen would seem to link these three disorders and the present results suggest that these amine oxidases could be useful in monitoring collagen abnormality in diabetes and diabetes-associated disorders, particularly in the absence of chronic liver disease. A negative correlation was found between enzyme activity and blood glucose levels, thus collagen changes in these conditions may occur independently of elevated blood glucose levels. Possible involvement of these enzymes in angiopathy remains to be elucidated.
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The antiandrogen cyproterone acetate, which is known to suppress sebum production, but is not a standard therapy, was given in combination with tetracycline to 63 young unmarried men who had failed to respond to 6 months' tetracycline therapy alone. Fifty-seven patients responded and the mean time to clearance was 5.2 months' therapy. The main side effects were nodular sub-nipple breast swellings, which occurred in 13 cases (21%). Such side effects were reversible and cleared after 3-4 months following cessation of therapy. Eighty-eight percent of patients relapsed within 3 months of discontinuing therapy.
Human umbilical cord endothelial cells accumulate more intracellular sorbitol in response to increased glucose concentration during in vitro incubation. This accumulation of sorbitol by endothelial cells is both concentration and time dependent. Increased concentration of sorbitol in endothelial cells may be important in the pathogenesis of diabetic associated microangiopathy.
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Arachidonic acid and prostaglandins were measured in uninvolved psoriatic skin before and after treatment for up to 24 h with dithranol. Prior to treatment, skin exudate contained 2744 ng ml-1 arachidonic acid and 26.4 ng ml-1 PGE2. After treatment with dithranol, the arachidonic acid concentration increased to a maximum of 5556 ng ml-1 at 48 h whilst PGE2 increased to 93.4 ng ml-1 at 12 h and then declined. The erythemal response was apparent at 6-12 h and maximal at 72 h. These results suggest that PGE2 mediates the early development of dithranol erythema.
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The role of histamine in urticaria is reviewed with particular reference to experiments on cold contact urticaria. In this model, histamine release clearly has a central role, but the failure of drugs which suppress histamine release to alleviate symptoms, other than itching, suggests that other pharmacological agents must be involved. Evidence is presented that prostaglandin E may play a role in some of these patients. The discovery that human blood vessels possess H2 receptors as well as H1 receptors is discussed with particular reference to the role of combined H1 and H2 pharmacological blockade.
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