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O Clemmensen

Publications and source records attributed to O Clemmensen.

18 recordsLinked to original sources

Diagnostic value of PCR for detection of Borrelia burgdorferi DNA in clinical specimens from patients with erythema migrans and Lyme neuroborreliosis.

BACKGROUND: The aim of the study is to evaluate the diagnostic sensitivity of a 16S ribosomal RNA-based PCR on clinical specimens from patients with erythema migrans (EM) and neuroborreliosis and to compare the sensitivities with those obtained by in vitro culture and serological testing. A semiquantitative detection system, representing the input amount of specific DNA and thus the density of spirochetes in clinical specimens, indicated the preferred clinical sample to obtain for PCR testing. METHODS AND RESULTS: Skin biopsy and urine samples from 31 patients with EM and cerebrospinal fluid (CSF) and urine samples from 30 patients with neuroborreliosis were investigated. Borrelia burgdorferi DNA was detected in 71% of the skin biopsy specimens and 13% of the urine samples from patients with EM. Forty-one percent of the patients with EM were found to have B burgdorferi-specific antibodies in serum, and B burgdorferi was cultured in 29% of the EM specimens. For patients with neuroborreliosis, the diagnostic sensitivities in CSF and urine samples were 17% and 7%, respectively. Specific intrathecal antibody production was found in 90% of the patients, and 87% showed elevated B burgdorferi antibodies in serum. In general, PCR of skin biopsy samples yielded very high amounts of amplicons versus low amounts for CSF and urine samples. CONCLUSIONS: PCR of skin biopsy specimens is currently the most sensitive and specific test for the diagnosis of patients with EM, superior to culture and serological testing. For B burgdorferi-specific CSF disgnosis in patients with neuroborreliosis, the measurement of specific intrathecal antibody synthesis is superior to PCR. However, in patients with a short duration of disease (<14 days), PCR may be a useful diagnostic supplement. PCR of urine samples cannot be recommended at the present time for routine diagnosis of patients with EM or neuroborreliosis.

Adolescent↗

Comparison of in vitro culture, immunohistochemical staining, and PCR for detection of Borrelia burgdorferi in tissue from experimentally infected animals.

An avidin-biotin-amplified immunophosphatase staining method with a purified polyclonal rabbit anti-Borrelia burgdorferi hyperimmune serum was developed for identification of B. burgdorferi in tissue specimens. The diagnostic efficacy was compared with those of in vitro culture and PCR with fresh and fixed, paraffin-embedded tissues. A nested PCR assay was developed for identification of a 276-bp fragment of the B. burgdorferi flagellin gene. The diagnostic sensitivities of the different techniques were evaluated with spleen, renal, and urinary bladder tissues from eight experimentally infected gerbils. A systemic infection was verified by positivity of 23 of 24 (96%) organ cultures. B. burgdorferi was visualized immunohistochemically in 9 of 23 (39%) of the specimens. Among these nine specimens, an average of 33% of the 15 sections examined were positive. The spirochetes accumulated in discrete clusters and were associated with focal lymphocytic infiltration. The diagnostic sensitivity obtained by PCR with fixed, paraffin-embedded tissue was 21%, considerably lower than that with fresh tissue (71%). Thus, the reliable demonstration of B. burgdorferi by immunohistochemical staining is possible but extremely laborious, and considering the fact that the density of B. burgdorferi in human tissue is even lower than that in experimentally infected animals, the method is not useful in a clinical setting. It may, however, still be valuable in pathogenetic research. Detection of B. burgdorferi DNA by PCR should be performed with fresh tissue specimens and not with fixed, paraffin-embedded specimens.

Animals↗

Abnormalities of lymphocyte function and phenotypic pattern in a case of toxic epidermal necrolysis.

We examined the blood lymphocyte function and phenotypic pattern in a patient with toxic epidermal necrolysis after taking salazopyrin. We studied cell surface markers, natural killer cell activity and mitogen-induced lymphocyte transformation. Our results point to temporary immunosuppression as evidenced by lymphopenia with a large "null cell" population, reduced natural killer cell activity, and impaired lymphocyte response to mitogens.

Acute Disease↗

Adenocarcinoma arising in a foregut cyst of the mediastinum.

A case of malignant transformation in a mediastinal cyst of the esophageal reduplication type is presented. The cyst had been recognized 39 years previously, but remained asymptomatic until sudden growth occurred. It was resected totally from the esophagus and the patient recovered well. A review of the literature showed that malignancy in mediastinal foregut cysts is extremely rare.

Adenocarcinoma↗

Antigen-presenting activity of non-Langerhans epidermal cells in contact hypersensitivity reactions.

Despite the critical role of the Langerhans cells in the induction of contact hypersensitivity reactions, non-Langerhans antigen-presenting cells in already sensitized individuals may play a role in the elicitation phase of a contact hypersensitivity reaction. Following epicutaneous challenge with antigens, the number of CD1+DR+ epidermal Langerhans cells increased in a time-dependent way and, concomitantly, CD1-OKM5+DR+ epidermal non-Langerhans cells appeared. In parallel with this, the capacity of epidermal cells to present both alloantigens and auto/nominal antigens increased, and 4 days after initiation of the contact hypersensitivity reactions 33-53% of the epidermal antigen-presenting capacity was due to CD1- non-Langerhans antigen-presenting cells. Thus, contact hypersensitivity skin reactions are accompanied by the appearance of non-Langerhans antigen-presenting cells capable of presenting both alloantigens and auto/nominal antigens.

Allergens↗

Herpes gestationis.

A case of clinically typical herpes gestationis is presented. The diagnosis was confirmed by light microscopy and immunofluorescence studies. The symptoms subsided at delivery, but recurred during subsequent oral contraceptive medication. The newborn infant was affected temporarily. The treatment, the fetal risk and the implications of the diagnosis on future pregnancies and contraceptive therapy are discussed.

Adult↗

Perioral contact urticaria from sorbic acid and benzoic acid in a salad dressing.

Contact urticaria was observed in a kindergarten in 18 of 20 children following the intake and accidental perioral application of a mayonnaise salad cream. In healthy adult controls, stinging tests and closed 20 minute patch test with the salad dressing were positive in 9 out of 12 and 4 out of 10 cases respectively. Twenty minute patch tests with the different components of the salad dressing were positive only so sorbic acid (SA) and benzoic acid (BA). Urticaria was provoked by inunction of the salad dressing periorally in two healthy boys. Serial 20 minute closed patch testing with varying concentrations of SA in 91 patients and BA in 41 patients gave almost identical results: positive reactions in two thirds of the patients with the highest concentrations. The response was only partially blocked by antihistamine applied locally before testing. Non-immunologic mechanisms are probably responsible for the transient reaction, and no restriction in the extensive use of SA or BA as preservatives in food should be considered.

Adolescent↗

Porphyria cutanea tarda and systemic lupus erythematosus.

Fifty-five patients with porphyria cutanea tarda (PCT) were examined for the simultaneous occurrence of systemic lupus erythematosus (SLE). The diagnostic criteria for SLE were those set up by the American Rheumatism Association (ARA). No patient fulfilled the ARA criteria for SLE. Clinical and laboratory features characteristically associated with SLE (although they were not ARA criteria) were simultaneously evaluated. A total of 120 items occurred in those cases but only 15 of these were ARA criteria. These findings, which may suggest the presence of SLE in patients with PCT, might be ascribed to the concomitant liver disease. The simultaneous occurrence of SLE and PCT is reviewed from the literature. The ARA criteria were fulfilled in one third of the reported cases. The coexistence of SLE and PCT might be less frequent than formerly believed.

Adult↗

Contact sensitivity to aluminium in a patient hyposensitized with aluminium precipitated grass pollen.

Standard patch testing of a patient with eczema revealed positive reactions to the aluminium discs used for testing. Patch tests with various aluminium allergens were positive in the patient and negative in 53 controls. The patient was having hyposensitization for hay-fever with an aluminium precipitated allergen. Intradermal testing with aluminium was positive in the patient and negative in nine controls. The eczema disappeared when hyposensitization was discontinued. The possibility of primary sensitization by the hyposensitization procedure is discussed.

Adolescent↗

A case of multiple neonatal haemangiomatosis successfully treated by systemic corticosteroids.

A case of multiple neonatal haemangiomatosis is reported. The disease entity is rare and probably always combined with haemangiomas of internal organs. When visceral involvement provokes clinical symptoms (cardiac, cerebral, gastrointestinal), the spontaneous course often proves fatal. The prognosis seems to improve substantially if treatment with systemic corticosteroids is instituted. The patient reported, who had concomitant cardiac and gastrointestinal symptoms, recovered completely following corticosteroid treatment. It is concluded that steroid treatment is indicated without hazards in complicated cases of multiple neonatal haemangiomatosis.

Angiomatosis↗

Cell-mediated immunity of Yersinia enterocolitica serotype 3 in patients with thyroid diseases.

The cellular immunity to Yersinia enterocolitica serotype 3 and crude human thyroid extract in 64 patients with thyroid diseases and 25 controls was studied by the leucocyte migration test. In the patient group as a whole and in patients with Graves' disease and nontoxic diffuse goitre a significantly reduced leucocyte migration towards Yersinia was found when compared with the controls. In controls the migration index was not related to the presence or titre of circulating yersinia antibodies, whereas the migration index of patients with yersinia antibodies was lower than the migration index of patients without yersinia antibodies as well as that of the controls. The leucocyte migration inhibition in two patients with recent yersinosis was normal during the recovery phase. In the presence of thyroid extract leucocyte migration inhibition differed only significantly in Graves' disease. However, a significantly positive correlation between inhibition of migration by thyroid extract and by Yersinia was found, while no correlation could be demonstrated in the controls. The cell-mediated immunity towards Yersinia in thyroid diseases thus demonstrated adds further evidence to the association between Yersinia and thyroid disease.

Adolescent↗

Sequential studies of lymphocytes, neutrophils and serum proteins during prednisone treatment.

Seven patients (6 with connective tissue diseases, 1 with bronchial asthma) have been studied before, during, and after prednisone therapy. Maximum dose was 15 mg daily, which was tapered off to zero within three months. All patients showed striking subjective improvement during therapy. The ESR reflected this improvement but the acute phase proteins did not. The serum concentration of prealbumin rose significantly during the period of most intensive steroid treatment. IgE decreased in the patient with bronchial asthma, but otherwise the immunoglobulins did not change, and positive serological tests remained unchanged. Contact sensitization to haptens was induced without impairment during therapy. Prednisone induced rises in blood lymphocyte and neutrophil concentrations. Lymphocyte transformation, both mitogen- and antigen-induced, was not influenced by therapy, but PPD-induced inhibition of leucocyte migration decreased. Neutrophil phagocytosis was unimparied, but bactericidal capacity, stimulated nitroblue tetrazolium reduction, and neutrophil and plasma lysozyme concentrations were all depressed during treatment with prednisone.

Adult↗