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Biomedical subjects

P Berdal

Publications and source records attributed to P Berdal.

13 recordsLinked to original sources

Immunoglobulin-producing cells in clinically normal, hyperplastic and inflamed human palatine tonsils.

Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT), or idopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal tonsils. Serum concentration of immunoglobulins, particularly IgG, were found to be increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes per tissue unit was reduced in the germinal centres of lymphoid follicles, in the extrafollicular areas, and in the reticular parts of the crypt epithelium. The overall percentage distribution of these cells was normally 65:30:3.5:1.2 for the IgG, IgA, IgM and IgD classes, respectively. In RT these figures were 53:39:4.7:4.4; in HT, 67:25:4.0:4.5; and in IHT, 50 : 33 : 7.2 : 10. Thus, there were only small alterations in the immunocyte class proportions, except for a significant relative increase in IgD-producing cells. The results indicate that there is a functional defect of the tonsils in association with disease. The relative accumulation of IgD cells is probably explained by an inadequate local maturational process in B-cell system, altough some influence of low age cannot be excluded in the HT and ITH groups.

Adolescent

Immunoglobulin systems of human tonsils. II. Patients with chronic tonsillitis or tonsillar hyperplasia: quantification of Ig-producing cells, tonsillar morphometry and serum Ig concentrations.

Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT) or idiopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal palatine tonsils. Serum concentrations of immunoglobulins, particularly IgG, were increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes was reduced per tonsillar tissue unit. The density of such cells was decreased in the germinal centres of the lymphoid follicles, in the extrafollicular areas and in the reticular parts of the crypt epithelium. However, only small changes in immunocyte class ratios were observed, excepting a significantly raised proportion of IgD-producing cells. The immunohistochemical results indicated a defect in the tonsillar immunological function associated with disease, perhaps as a result of inadequate stimulatory signals for local maturation of B-cell clones. An influence of low age on this result in the HT and ITH groups could not be excluded. In the RT group there was a significant negative correlation between the tonsillar density of IgA-producing cells and the rate of synthesis of serum IgA. This may indicate that compensatory mechanisms are reflected in inversely related levels of local and systemic IgA synthesis.

Adolescent

[Surgical correction of vocal cord synechia (author's transl)].

Anterior webs of the larynx, whether congenital or traumatic in origin, are conventionally treated by excision and subsequent interposition of a stent between the raw surfaces of the defect to prevent regrowth of the web. The present paper describes a new technique which does not require interposition of a stent. The web is divided through a laryngofissure and adjacent connective tissue is removed. The cut raw surfaces of the vocal cords are covered by the adjacent mucosa, which is carefully mobilized, adapted and sutured with interrupted silk sutures. The method described has been used in eight patients, with a good result obtained in seven of the patients. In the eighth patient, post-tranumatic scars with web formation were removed so that the condition was improved but not completely corrected.

Humans

Viral infection as a cause of acute peripheral facial palsy.

Among 51 patients with acute peripheral facial palsy, varicella-zoster virus was isolated from the cerebrospinal fluid (CSF) in one case, and Herpesvirus hominis from the nasopharynx in two cases. In 12 other cases, complement-fixing antibody or hemagglutination inhibition tests indicated a recent viral infection (varicella-zoster, seven; herpes simplex, one; cytomegalovirus, one; influenza type B virus, two; and mumps virus, one). One additional patient had clinical signs of herpes zoster oticus. About one third of these 16 virus-positive patients, but also one third of the remaining group, had increased levels of alpha 1-antitrypsin, orosomucoid, haptoglobin, and immunoglobulins. Evidently, an inflammatory reaction preceded or coincided with the facial palsy in both groups. In CSF, an increase of total proteins and gamma-globulins was frequently found among all 20 patients examined (eight were virus-positive).

Acute Disease

J chain in malignant human IgG immunocytes.

J chain was demonstrated directly by immunofluorescence in the cytoplasm of malignant IgG-producing human tumor cells. This was in contrast to IgG immunocytes accumulating in foci of chronic inflammation, which generally were devoid of J chain.

Aged

Simultaneous intermittent bleomycin and radiological treatment of laryngeal cancer.

Bleomycin has been shown to have a significant effect on squamous cell carcinomas, particularly on highly differentiated types. Applying combined bleomycin and x-rays simultaneously in an intermittent schedule, a synergistic effect was obtained. It was possible to lower the dosage of each and still achieve remarkable therapeutic responses. At the same time the side effects were reduced. The total dosages have been bleomycin 180 mg and x-rays 4.200 r skin dose, tumor dose approximately 2.500 r. Eighty-two laryngeal cases received such treatment. Altogether a complete regression was achieved in 62 per cent. Glottic tumors showed complete regression in 85 per cent. In six out of 10 inoperable cases, the tumor became surgically accessible by laryngectomy. In successfully treated patients characteristic histological changes were found, consisting in unusually large amounts of fully keratinized cells.

Aged

The role of viral infection in acute peripheral facial palsy.

Thirty-three patients with acute non-traumatic peripheral facial palsy were studied. In one patient, varicella-zoster virus was isolated from CSF. Antibody against the same virus was present in CSF, and rising titre was demonstrated in serum. In two cases, herpes virus hominis was isolated from the nasopharynx. CF-antibody tests indicated recent viral infection in 7 other cases. One additional patient had clinical signs of herpes zoster oticus. In most of these 11 patients, but also in the majority of the remaining 22 patients, an acute phase reaction was present, and serum and CSF immunoglobulins were increased. Thus, an active or recent infection (probably viral) seemed to precede or coincide with the facial palsy in most cases in both groups.

Adolescent

Immunodeficiency syndromes with otorhinolaryngological manifestations.

Among patients with recurrent, protracted or chronic infections of the respiratory tract involving the middle ear, 18 were found to have immunodeficiencies. In 10 of the patients, deficiency of immunoglobulins belonging to the IgG, IgA and IgM classes was found. Seven patients had an isolated IgA deficiency. One patient had a combined immunodeficiency with defects of the T-cell system and the B-cell system. One patient had an isolated T-cell deficiency.

Adolescent

Wegener's granulomatosis, immunosuppressive therapy.

We present a study of 11 patients with Wegener's granulomatosis. Seven of these were treated with Azathioprine (Imurel) combined with prednisone. Of these, 4 patients rapidly improved after the treatment was started. Atelectatic changes in the lungs disappeared. A rapidly progressive renal failure was reversed, and renal function returned to normal. Large lesions of the skin also improved. The treatment has now lasted 2 1/2-4 1/2 years without interruption. We have not had any serious side effects due to Imurel. We believe that the good effect of the treatment is due to immunosuppression by the drugs.

Adult