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A critical study of 69 cases of collodion baby observed between 1976 and 1984 is compared with the study conducted in 1976. These 69 cases are divided into 32 examined by the authors personally and 37 published in the literature. The total number of collodion babies is 267. A collodion baby is a high risk newborn who must be nursed in a specialized intensive care unit during the neonatal period. The vital prognosis has been improved by the prevention of metabolic disorders (dehydration with hypernatraemia) and of percutaneous intoxication with topical products, and by the early treatment of infections. The mortality rate, which was 33 p. 100 in 1976, had fallen to 11 p. 100 in 1984. Skin infection with systemic spread remains the major complication (the present situation is summarized in table II). The collodion baby is the neonatal expression of different disorders of keratinization and as such, constitutes a syndrome. Several conclusions can be drawn from a comparison of the keratinization disorders observed in our two series (table VI). Congenital ichthyosiform erythroderma and lamellar ichthyosis are responsible for 60 p. 100 of collodion babies. These two lesions may be the first signs of an ichthyosis transmitted as an autosomal dominant trait in 9.7 p. 100 of the cases. Trichothiodystrophy may be heralded by a collodion baby syndrome. In 9.7 p. 100 of the cases this syndrome disappears without sequelae. Sex-linked ichthyosis never begins with a collodion baby syndrome.
Lam, Gow T. (Jefferson Medical College, Philadelphia, Pa.), Francis J. Sweeney, Jr., Charlotte M. Witmer, and Robert I. Wise. Abscess-forming factor(s) produced by Staphylococcus aureus. I. Collodion bag implantation technique. J. Bacteriol. 86:611-615. 1963.-A collodion bag with a pore size sufficiently large to permit the diffusion of the staphylococcal extracellular products, but small enough to retain bacterial cells, was developed from a mixture of collodion and flexible collodion. These collodion bags were filled with various staphylococcal components and bacterial cells, and then implanted for 5 days into the peritoneal cavities of Swiss albino mice and four strains of inbred mice. It was found that live organisms, cell wall, and extracellular products promote an abscesslike formation around the collodion bags. The bags were surrounded with a thick layer of fibrous tissue and infiltrated with leukocytes. The exudate was free from bacterial cells. In contrast, no encapsulation occurred when the bags were filled with sterile culture medium, saline, or extracellular products which were free from coagulase after filtration through a Millipore filter.
A procedure for the efficient transfer of cell monolayers, cultured on glass coverslips, to microscopy slides has been developed. This technique involves the coating of the upper surface of an ethanol-fixed cultured cell layer with a film of collodion dissolved in n-amyl acetate. The dry collodion-coated cell layer can then be detached by rehydrating it for 1 h under water or phosphate-buffered saline and then carefully peeling it away from the coverslip using a pair of tweezers. Once a cell layer has been so mounted, it can be subjected to rough treatment such as proteolytic degradation (which greatly improves the signal-to-noise ratio in procedures like in situ hybridization [ISH] or primed in situ synthesis [PRINS]) without running the risk of cell detachment because of the partial or total degradation of the extracellular matrix. As an example of its application, we show a PRINS of telomeres from mouse fibroblasts. The high mechanical strength of collodion ensures that the structural integrity and morphology of the cell layer is maintained under experimental conditions where the collodion itself is insoluble. In addition to its use on cell layers, collodion can be used for the production of support films for (i) attaching suspension cell cultures, (ii) immobilizing cells normally cultured in suspension (such as tobacco BY2 cells or germinating tobacco pollen grains) or (iii) planting cryostat sections to microscopy slides. The value of this technique lies in its ease of use and the large number of different applications, in both the plant and animal fields of research, to which it may be applied.
A novel extracorporeal immunoadsorbent is described in which anti-bovine serum albumin (anti-BSA) was entrapped in collodion membranes adherent to activated charcoal particles. This immunoadsorbent was capable of specifically removing circulating BSA in vitro and in vivo in an extracorporeal system in dogs. In preparation of the immunoadsorbent, up to 81.2% of added anti-BSA was retained on collodion-charcoal. In vitro circulation studies demonstrated that anti-BSA collodion-charcoal removed 812% more 125I-BSA than control colloidon-charcoal. For in vivo studies, an extracorporeal circulation system was established and arterial blood was passaged through a continuous flow celltrifuge wherein plasma which was separated from formed elements of the blood was circulated over anti-BSA and control rabbit gamma-globulin collodion-charcoal. 125I-BSA was passively infused into mongrel dogs, and plasma was then circulated over extracorpeal immunoadsorbents for 2 hr. Results showed up to 896% greater uptake of circulating 125I-BSA on the charcoal containing immobilized anti-BSA compared to control charcoal. There was no evidence of release of anti-BSA from the immunoadsorbent since 125I-anti-BSA cpm on the charcoal before and after the experiments were unchanged. In addition, there were no significant alterations in hematocrit, leukocyte counts, serum sodium, potassium, calcium, magnesium, or creatinine levels before and after in vivo procedures. These data suggest that this immunoadsorbent consisting of anti-BSA immobilized in collodion membranes adherent to charcoal particles may specifically withdraw circulating antigens in vivo with minimal release of entrapped antibodies and no significant alteration in the host hematologic and biochemical status.
Studies were undertaken to determine whether BSA immobilized in collodion membranes adherent to activated charcoal particles, would be capable of specifically removing circulating BSA antibody in vitro and in vivo in an extracorporeal system in dogs. Up to 59-8 mg of BSA were retained in collodion membranes adherent to small particles. In vitro studies demonstrated that immobilized BSA could specifically reduce BSA binding activity from circulating antisera. For in vivo studies, an extracorporeal circulation system was established and arterial blood was circualted through a continuous flow celltrifuge in which plasma was separated from formed elements of the blood. Only plasma was circulated over the BSA collodion-charcoal immunoadsorbent. Anti-BSA and anti-HSA atibodies were passively infused into dogs and, after an equlibration period of 12 or 15 min, plasma was passed over the BSA collodion-charcoal immunoadsorben. Plasma exhibited a sharp reduction in BSA binding over the next 30-60 min with only slight reduction in anti-HSA binding the same period. Dogs, actively immunized to BSA and HSA, were also treated by extracorporeal plasma perfusion over BSA collodion-charcoal. A specific decline in BSA binding of sera, was again observed with minimal changes in HSA binding. A post-perfusion rebound of BSA binding was observed which reached pre-perfusion levels after 6-8 days. A second treatment during the rebound period also resulted in a specific decline in BSA binding with a similar pattern of antibody rebound. There were no significant changes in I-labelled BSA recorded on the charcoal before and after in vivo procedures and no signifcant alterations in haematocrit, serum sodium, potassium, calcium, magnesium or creatinine levels before and after the procedures. These data suggests that antigen-coated charcoal may specifically withdraw circulating antibodies in vivo with minimal release of the entrapped antigen and little alteration in the host's haematological and biochemical status.
Lipid-impregnated collodion (nitrocellulose) films have been frequently used as a fusion substrate in the measurement and analysis of electrogenic activity in biological membranes and proteoliposomes. While the method of fusion of biological membranes or proteoliposomes with such films has found a wide application, little is known about the structures formed after the fusion. Yet, knowledge of this structure is important for the interpretation of the measured electric potential. To characterize structures formed after fusion of membrane vesicles (chromatophores) from the purple bacterium Rhodobacter sphaeroides with lipid-impregnated collodion films, we used near-field scanning optical microscopy. It is shown here that structures formed from chromatophores on the collodion film can be distinguished from the lipid-impregnated background by measuring the fluorescence originating either from endogenous fluorophores of the chromatophores or from fluorescent dyes trapped inside the chromatophores. The structures formed after fusion of chromatophores to the collodion film look like isolated (or sometimes aggregated, depending on the conditions) blisters, with diameters ranging from 0.3 to 10 microm (average approximately 1 microm) and heights from 0.01 to 1 microm (average approximately 0.03 microm). These large sizes indicate that the blisters are formed by the fusion of many chromatophores. Results with dyes trapped inside chromatophores reveal that chromatophores fused with lipid-impregnated films retain a distinct internal water phase.
Collodion baby is a rare congenital disorder resembling harlequin fetus but is milder in degree. Although it has been reported that harlequin fetus is associated with kidney abnormalities, malignant keratoma, micromelia, polydactyly, thymic atrophy and thyroid aplasia, there are few reports of collodion baby associated with congenital abnormality and/or disease in the literature. A newborn infant admitted with shedding of the skin and diagnosed as collodion baby concomitant with congenital hypothyroidism is presented here. This is the first case of collodion baby associated with congenital hypothyroidism in the literature to our knowledge.
Marked differences were noted among 14 antibiotics in their filterability through collodion (nitrated cellulose) membranes. The findings could not be attributed to differences in molecular weight or degree of serum protein binding, although the latter factor imposed an additional restraint on the passage of certain agents. Poorly filtered antibiotics appeared to be absorbed by the collodion. Some of these observations might be accounted for by the known ability of nitrated cellulose to interact with anions. However, the extreme differences in filterability among the various penicillins and the very restricted passage of certain cationic antibiotics appeared to be better explained by intrinsic differences in the diffusibility of these agents through water. Although differential filtration offers a means of assaying samples containing certain mixtures of antibiotics, the degree of separation exhibited by collodion membranes is not sufficient to make them useful for clinical purposes.
Seventeen cases of collodion baby are reported. Clinical aspects, complications, treatment, final outcome and family history were studied. We did not observe any clinical features in the collodion baby that could serve as a clue in predicting the final diagnosis. Infections were observed in nine, hypothermia in five and hypernatraemic dehydration in four cases. Skin infection mainly occurred in babies treated with emollients (petrolatum, lanolin and cetomacrogolis cream were used). We therefore recommend treating the collodion baby in a humidified incubator, if necessary with intravenous rehydration, but not to use emollients. The final outcome of these study patients was erythrodermic autosomal recessive lamellar ichthyosis in seven cases (41%), non-erythrodermic autosomal recessive lamellar ichthyosis in three cases (18%), Sjögren-Larsson in one case (6%), epidermolytic hyperkeratosis in one case (6%), acute neonatal variant of Gaucher disease in one case (6%) and normal skin in four cases (24%).
Five spontaneously healing collodion babies were recorded in a large Swiss kindred. They all had consanguineous parents. Their distribution in the family indicates autosomal recessive inheritance. At birth they had the typical features of collodion babies. The collodion-like membrane was shed within the first month, leaving a slightly scaly skin for a few weeks. Thereafter the skin remained normal without any evidence of a disorder of cornification.
The pathogenesis of 'collodion baby' has not been clarified yet, and this descriptive term is thought to include several heterogeneous conditions. We report a collodion baby whose clinical features had changed to those of lamellar ichthyosis (LI) as the patient got older. By electron microscopy, skin specimens at 3 days of age revealed the presence of lipid inclusions within the cornified cells, abnormal lamellar granules in the granular layer keratinocytes and a lack of extracellular lamellar structure between the first cornified cell and the granular cell though the cornified cell envelope appeared to be normally formed. Immunohistochemical labeling showed normal distribution of keratins 1, 5, 10, 14, filaggrin/profilaggrin and cornified cell envelope proteins (involucrin, small proline-rich proteins and loricrin). These observations suggested that a collodion baby might have a normal cornified cell envelope and show morphologic changes similar to those of harlequin ichthyosis at birth, even though its underlying disorder is LI.
The study of 198 collodion babies, 29 personal cases and 169 from the literature was undertaken. The collodion membrane with spontaneously desquamate between the 15th day and 3rd month of life. During the neonatal period one third of the infants die due to pulmonary complications or infection. The collodion membrane seems to have an increased permeability. The desquamation is followed by a relapse which leads to different keratinization disorders, most frequently nonbullous congenital ichthyosiform erythroderma.
Two cases of severe congenital ichthyosis are presented: "collodion baby" and "harlequin fetus". The collodion baby is no clinical entity, but a symptom occurring in several forms of ichthyosis. In our patient the collodion skin was a symptom of ichthyosis congaenita (lamellar ichthyosis). Treatment with orally administered steroids was life-saving. The harlequin fetus represents a distinct entity characterized by a lethal genotype. There is a molecular defect of keratinization.
Study of 29 cases of collodion baby and 169 cases previously published led to several conclusions. In the short-term, the child is threatened by pulmonary infections. The increased skin permeability may result in the loss of water or intoxication by cutaneous absorption of a substance applied to the skin. In the long-term the condition progresses to one of a congenital disturbances in keratinisation. In 2/3 of cases, the problem is that of congenital non-bullous ichthyosiform erythrodermia. Profression to lamellar ichthyosis, ichthyosis vulgaris, circumflex linear ichthyosos and Conradi's syndrome is established. Ichthyosis related to sex in our cases did not seem to be a feature of the collodion baby, the opinion in the literature being divergent. Congenital bullous ichthyosiform erythrodermia never begins as collodion baby syndrome.
About 10 Thai collodion babies were treated at the Department of Pediatrics, Faculty of Medicine, Chulalongkorn University from 1970 to 1990. Most of them were premature and small for gestational age infants. The sex incidence of males to female was 3:2. Only half of the cases had a family history of ichthyosis. The severity of thickness and tightness of the collodion membranes varied from mild to severe. The clinical and histopathologic findings revealed 5 cases of lamellar ichthyosis (50%), of which one case had episodes of pustular psoriasis. One case evolved to be ichthyosis vulgaris 10 per cent, one case had palmoplantar hyperkeratosis (10%), one case had been apparently normal up to 18 years old, one died of respiratory infection and another case was lost from follow-up. All cases of lamellar ichthyosis were associated with mental retardation with some degree of slow physical development. One severe collodion baby suffered from congenital absence of distal phalanges of toes with increased thickness of the finger nails.
Quantitative microscopic cytology of cells previously sorted by flow cytofluorometry has been hindered by the loss of cells from the microscope slide during staining procedures. The simple application of a semi-permeable membrane of collodion over fixed or unfixed cells sorted directly onto a microscope slide secured virtually 100% of the cells onto the slide. Cells covered with the collodion membrane studied with Papanicolaou's stain as well as routine clinical cervical cytologic preparations. In contrast, fewer than one half of the cells sorted onto uncoated or albumin coated slides were retained after staining.
A previous measurement showed that mass loss from collodion supported by thin carbon films was linear with electron exposure at liquid helium temperature. No other organic solid had shown a linear loss of mass at any temperature. When measurements of collodion were done using titanium supports, the loss of mass proceeded exponentially with exposure at liquid helium temperature. This result suggested that the differing electrical conductivities of these substrates might be the cause of the different mass loss effects. Carbon films, which are typically used at ambient temperatures, have much lower electrical conductivity at very low temperature than titanium films. This suggested that specimen preparation materials and techniques used routinely for room temperature studies may need to be modified when microscopy is done using superconducting objective lenses. For both substrates, the rate of mass loss is slowest at liquid helium temperature.