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Biomedical subjects

R Bergman

Publications and source records attributed to R Bergman.

At least 37 records · Page 2Linked to original sources
PubMed1994

Epithelial markers in malignant melanoma. A study of primary lesions and their metastases.

In order to determine epithelial markers in malignant melanoma in routinely processed paraffin sections and to compare the staining of primary (cutaneous) malignant melanomas and their metastases, we stained formalin-fixed paraffin sections of 13 primary and 18 metastatic malignant melanomas using the streptavidin-biotin peroxidase method by antibodies to S-100, vimentin, HMB-45, polyclonal carcinoembryonic antigen (CEA), monoclonal CEA, cytokeratins (CAM 5.2 and broad-spectrum CKKES), and epithelial membrane antigen (EMA). All primary and most metastatic malignant melanomas showed positive staining with anti-S-100, HMB-45, and anti-vimentin. Reactivity with polyclonal CEA was observed in 15 (48%) of the 31 lesions; 14 of them were metastatic. No lesion was reactive with monoclonal CEA. Significant cytokeratin (CK) staining was evident in only three (9.7%) lesions (all metastatic), which also stained specifically with anti-CK 18. EMA was observed only focally in two (6.5%) lesions. There was no correlation between epithelial markers staining of the primary tumours and their metastases. All lesions with CK or EMA staining showed concomitant extensive staining for S-100, HMB-45, and vimentin. We conclude that (a) polyclonal CEA staining in malignant melanoma is not rare and is probably due to CEA-related molecules; (b) significant CK reactivity is rare and related to simple CK, such as CK 18; (c) epithelial marker reactivity is more common in metastases of malignant melanomas and is not correlated to the reactivity in their primary tumors. Considering our results and reports of positive S-100, vimentin, and HMB-45 in epithelial tumors, a wide panel of antibodies is recommended for the study of undifferentiated tumors.

Adult↗
PubMed1992

[Treatment of onychomycosis using 40% urea with 1% bifonazole].

The rate of success in treating onychomycosis with 40% urea ointment containing 1% bifonazole, with and without oral griseofulvin, was evaluated. Most patients had onychomycosis of the toes. 11 patients (group A: 5 men and 6 women, average age 48.5) were treated locally under occlusion with the ointment until dissolution of most of the nail, and then with 1% bifonazole cream for a total of 6 months. 11 others (group B: 3 men and 8 women, average age 42.5) received, in addition, griseofulvin 500 mg/day orally during that period. Treatment with the ointment alone did not give higher cure rates than the average of reported cure rates for griseofulvin alone. However, the results of treatment with 40% urea and 1% bifonazole ointment concomitantly with oral griseofulvin seemed superior to those of either of these agents alone, with full cure, partial cure and failure in group A of 22.2, 33.3 and 44.5%, respectively, and in group B, 45.4, 27.3 and 27.3%. This therapeutic experiment should be repeated in larger series of patients.

Administration, Oral↗
PubMed1992

Malignant melanomas with histologic diameters less than 6 mm.

BACKGROUND: Malignant melanomas (MMs) with a small diameter (less than 6 mm) are rarely removed surgically; therefore there is a need for more data to characterize them. OBJECTIVE: The purpose of this study was to further elucidate the clinical and histopathologic features of small melanomas. METHODS: The greatest diameters of 112 consecutively submitted MMs were measured histologically. Those lesions with diameters of less than 6 mm were further studied clinically and histopathologically. RESULTS: Four MMs (3.5%) were found to have small histologic diameters. Their clinical features differed from the classic clinical ABCD's, although their histopathologic features resembled those of large MMs. Their depth of dermal invasion was relatively superficial, and their clinical outcome was favorable. CONCLUSION: Histopathologically, small MMs tend to resemble large MMs, but clinically they may require other diagnostic criteria. Because they tend to show a relatively superficial depth of invasion, their increased recognition and removal may have an impact on overall mortality from MM.

Adult↗
PubMed1992

A study of keratin expression in benign familial chronic pemphigus.

We studied keratin expression in the involved and uninvolved skin of six benign familial chronic pemphigus (BFCP) patients, using monoclonal antibodies specific for various keratin polypeptides and immunohistopathologic techniques. Normal and psoriatic (i.e., hyperproliferative) skin specimens served as controls. The uninvolved BFCP epidermis showed keratin profiles identical to that of normal epidermis. In the acantholytic epidermal segments of the involved BFCP skin, some of the lower suprabasal acantholytic cells failed to express keratin polypeptides 10 and 11 (Moll's catalog). This delay in expression of suprabasal keratins was not accompanied by an expression of hyperproliferative keratin polypeptide 16. Also, some of the lower suprabasal acantholytic cells of the involved BFCP epidermis retained staining by the antikeratin KS-1A3 antibody, which in the normal, psoriatic, and uninvolved epidermis was limited to the basal cell layer. Staining for keratin polypeptide 18 was negative in the epidermis of all four types of specimens. We believe that the delay in suprabasal keratin expression in the involved BFCP epidermis was more likely secondary to the acantholysis (i.e., "arrest of differentiation" due to acantholysis) rather than due to a primary defect in keratin expression.

Adult↗
PubMed1992

Porokeratotic eccrine ostial and dermal duct nevus. An abnormally keratinizing epidermal invagination or a dilated, porokeratotically plugged acrosyringium and dermal duct?

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) has been said to represent a widely dilated, keratin-plugged acrosyringium and dermal duct. We have observed in a case of congenital PEODDN a normal-appearing, acrosyringium-like duct that traverses vertically the entire length of the parakeratotic column. Also, in its lower course, it stained positively for carcinoembryonic antigen, while the inner borders of the invagination from which the parakeratotic column arose stained negatively. This leads us to suggest that the epithelial structure in PEODDN is an abnormally keratinizing epidermal invagination through which an acrosyringium-like duct traverses, rather than an abnormally dilated, parakeratotically plugged acrosyringium and dermal duct.

Adult↗
PubMed1992

The Gulf War: reaction and action in institutions for the aged in Israel.

In order to learn how geriatric centres were coping during the Gulf War (1991), questionnaires were distributed to 116 unit head nurses in 16 institutions in Israel. Additional information was obtained from the directors of nursing and national supervisors in a meeting 3 1/2 months after the cease-fire. Questions focused on organization of work, behaviour of staff, patients and their families, main problems, solutions and recommendations. Data showed a very high level of commitment by staff, flexibility, initiative and creativity in meeting the emotional, physical and safety needs of the aged. Stress level was highest in the 'Scud' areas and among the aged who are mentally alert. Families visited less but increased contact by telephone. Management was supportive with guidance, transport, child care facilities, etc. They also provided beds and food for spouses of the aged residents. Major problems related to safety measures (sealing rooms, moving patients during attacks), physical exhaustion and emotional stress of staff, and reorganization of care programmes. Recommendations included development of a master plan for non-conventional attacks, preparation of buildings with structural improvements, recruitment and training of volunteers, clarification of roles of staff and education for them.

Adaptation, Psychological↗
PubMed1992

Implementation of a tool to improve quality of care in psychogeriatric units.

The examples of change that occurred in the units show that in most instances the impetus came from the top and middle levels, but then became total staff projects. The most important tactic introduced to cause change was re-education and ensuing discovery, using the tool as a guide. In at least one unit, much thought and effort were devoted to developing trust and confidence, as proposed by Bennis et al. (1976). Acceptance by the peer group (Mauksch and Miller, 1981) was achieved through the group decision-making process in the units and the interagency meetings of the head nurses and supervisors. Termination of the relationship between the units and project will probably take place at a later date, to be replaced by a special interest group made up of practice, education, and research psychogeriatric nurses. Only a few of the experiences of the units in utilizing the instrument to improve quality of care have been presented. Some were very successful; others had little impact. The overall impression is that of awakened desire by staff and administration to improve care; increased valuing of patients, their families, and staff; readiness to utilize the help available in the instrument and the project team; and recognition of the professional challenge and status inherent in psychogeriatric nursing.

Aged↗
PubMed1991

Neutral lipid storage disease with ichthyosis: serum apolipoprotein levels and cholesterol metabolism in monocyte-derived macrophages.

Neutral lipid storage disease with ichthyosis (NLSDI) is an inherited metabolic disorder characterized by accumulation of neutral lipids, in a wide variety of cells, by a still unknown mechanism. Previous studies have shown normal cholesterol content in NLSDI granulocytes, fibroblasts and skin cells. Monocyte-derived macrophages possess an additional pathway of cholesterol uptake, which is not shared by these cells and which is not regulated by intracellular cholesterol levels. This pathway is thought to play a rôle in the process of atherosclerosis. Three NLSDI patients were studied. The serum levels of triglycerides, cholesterol, high-density lipoprotein cholesterol, and apolipoproteins A-I and B were within normal limits in all three patients. The intracellular levels of free and esterified cholesterol were measured in the monocyte-derived macrophages of one patient and found to be normal, while the triglyceride concentrations were twice as high as normal. The cholesterol esterification rates, which serve as a sensitive indicator of intracellular changes in cholesteryl ester levels, were normal in the monocyte-derived macrophages of all three patients. These findings provide further evidence that cholesterol metabolism is not disturbed in NLSDI, and it may be inferred that in this respect these patients are not at increased risk for atherosclerosis.

Adult↗
PubMed1991

A comparative immunohistochemical study of adenoid cystic carcinoma of the skin and salivary glands.

We performed an immunohistochemical study that compared a primary adenoid cystic carcinoma (ACC) of the skin with two salivary gland ACC. All three tumors stained positively and in identical fashion for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), broad-spectrum keratins, and low-molecular-weight keratins. Both EMA and CEA were localized to the luminal surfaces and the secreted contents of the tubular structures and the ductlike structures of the cribriform formations. The staining reactions for both types of keratin were more intense in the cells lining the tubular structures and the ductlike structures of the cribriform formations. One of the two salivary ACCs stained positively for S-100 protein; the other was positive for vimentin. The cutaneous ACC was negative for both antigens. Leu-7 antigen was not detected in either type of ACC. These results show that primary cutaneous ACC and salivary ACC have similar immunohistochemical staining patterns for a number of antigens. We believe this similarity is due to the fact that these antigens are shared by the sweat glands and salivary glands, which are considered to be the respective sites of origin for these two types of tumors.

Adult↗
PubMed1990

Insulin resistance and acanthosis nigricans: evidence for a postbinding defect in vivo.

Acanthosis nigricans (AN) with insulin resistance has been traditionally attributed to insulin receptor abnormalities. To further clarify the postbinding defects of in vivo insulin action in this state, we applied the euglycemic insulin clamp technique, combined with the glucose trace infusion method, to 26 subjects: 12 AN patients (eight normoglycemic and four hyperglycemic), eight obese, and eight lean control subjects. The normoglycemic AN group exhibited fasting hyperinsulinemia (666% of control), 160% elevated hepatic glucose production (HGP), 425% increased posthepatic insulin delivery rate, and only slightly reduced (19%) insulin clearance rates, compared with controls. Except for the latter, all these abnormalities were statistically significant (P less than .05), and could not be accounted for by body overweight. AN patients with diabetes mellitus (AN + DM) exhibited a further decreased insulin responsiveness (30%) and clearance (38%), together with a major increase in HGP (320%). All AN patients showed a significant right-shift in the insulin dose-response curve, indicating a decrease in insulin sensitivity. In conclusion, AN is characterized by increased basal rates of HGP, and peripheral insulin resistance, which can be partially attributed to postbinding defects. In AN + DM, a worsening of these abnormalities may be responsible for unmasking the existence of diabetes.

Acanthosis Nigricans↗
PubMed1990

Anticardiolipin antibodies in Behçet's disease.

Twenty-six patients with Behçet's disease were studied for serum levels of anticardiolipin (ACL) antibody isotypes IgG and IgM. The frequency of elevated levels of ACL antibody isotype IgM was found to be significantly increased in these patients. This increased frequency, however, did not correlate statistically with a thrombotic tendency, colchicine intake, antinuclear antibodies, or a positive VDRL test.

Adult↗