Porphyria in animals

Porphyrins are found to be widely, although erratically, distributed throughout the animal kingdom. It would indeed have been surprising had it been otherwise since the tetrapyrrole ring system is a key material used in hemoproteins and essential for all biologic oxidative metabolism in the fabric of life. Those anaerobes, which possess no cytochromes or other hemoproteins, may be regarded as degenerate forms in which this biosynthetic ability has been lost. The porphyrins are stable chemical materials that have been detected in fossil shells from the post-Pleistocine and upper-Eocene deposits and are thus many millions of years old.^1,2 In the lower phyla, the black slug, Arion, contains great quantities of uroporphyrin. Among the higher forms of animal life, the group of birds known as the Turacos or plantain-eaters are unique in having utilized the copper complex of uroporphyrin III, called turacin,³ for the deep red areas of pigmentation in their flight feathers (Fig. 1) although there seems to be nothing otherwise unusual about the porphyrin metabolism of these birds.⁴ Other birds also have porphyrins in their feathers and down^5–7 and porphyrins are used in the coloration of eggs. Among the mammals, a few genera appear normally to produce much more porphyrin than others and these belong to the family of rodents. The rat excretes a relatively large quantity of protoporphyrin, which arises by synthesis in Harder's glands.⁸     

Bovine papillomaviruses

Bovine papillomaviruses have a major contribution to make in unravelling the mechanisms of oncogenesis by this group. Most papillomaviruses can exert their biologic effect only in vivo, but several of the bovine types transform fibroblasts in culture; the altered cells have measurable attributes such as anchorage independence, density inhibition, and tumorigenicity in nude mice. Another important feature is that subgenomic fractions of DNA can be transfected into cells and elicit transformation. It is, therefore, possible to undertake quantitative molecular biologic and genetic studies in a way which is impossible with most papillomaviruses. Large amounts of virus can be obtained from bovine tumors. The six currently characterized viruses have all been cloned by recombinant techniques, and are the subject of intensive comparative research in many laboratories.     

Cutaneous artifactual disease. A review, amplified by personal experience

Cutaneous artifactual disease is part of the general syndrome of contrived disease. While classical examples are easy to recognize, it can present in unusual ways. Difficulties in recognition include the unusual doctor-patient relationship, the doctor's fear of missing organic disease, and the reality of the disease to the patient's family and the family doctor. The diagnosis depends upon finding lesions whose morphology is consistent and an emotionally immature patient, whose personality shows, or has shown, hysterical and masochistic traits. Lesions "arrive" fully developed. Once there they begin to heal, so that a continuous supply of new ones is necessary if the illness is to continue. High intelligence is compatible with the diagnosis, but a mature personality is not. The differential diagnosis is extensive. Investigations prove negative or equivocal; in the latter case, the investigator is led even further into unfamiliar territory. It is suggested that the essence of management is to keep in contact with the patient.     

依达拉奉对心肺复苏后自主循环恢复患者S-100β蛋白水平的影响研究

目的观察依达拉奉对心肺复苏后自主循环恢复患者血清S-100β蛋白水平的影响。方法选取心肺复苏后自主循环恢复患者66例,随机分为常规治疗组32例和依达拉奉治疗组34例,其中常规治疗组患者仅给予常规心肺脑复苏治疗,依达拉奉治疗组在常规心肺脑复苏治疗的基础上给予依达拉奉30mg加入生理盐水250mL静脉滴注,每日2次,疗程14d。分别于自主循环恢复后即刻、脑复苏治疗3d、7d、14d采集两组患者静脉血,采用ELISA法测定血清S-100β蛋白水平并同时进行Glasgow评分。结果两组患者脑复苏治疗前血清S-100β蛋白水平差异无统计学意义,P〉0．05;依达拉奉治疗组患者不同治疗时间血清S-100B蛋白水平均较同期常规治疗组减低,P〈0．01,同时依达拉奉治疗组患者治疗后血清S-100β蛋白水平均较治疗前明显降低,P〈0．01,且随着治疗时间的延长,血清S-100β蛋白水平呈明显降低趋势,P〈0．01。两组患者脑复苏治疗前Glasgow评分差异无统计学意义,P〉0．05;依达拉奉治疗组患者Glasgow评分不同治疗时间均较同期常规治疗组升高,P〈0．01,且随着治疗时间的延长,Glasgow评分呈明显上升趋势,P〈0．01。复苏后第28d依达拉奉组神经功能恢复正常和轻度障碍的患者较常规治疗组显著增加,P〈0．05,而神经功能重度障碍、植物状态和死亡的患者比率较常规治疗组显著减少,P〈0．05。结论依达拉奉能够明显降低心肺复苏后自主循环恢复患者血清S-100β蛋白水平,具有良好的脑保护作用。     

Wound healing in dogs and cats

Dogs and cats suffer accidental wounds and surgical incisions in much the same manner as do humans. Ideally, the surgical incision and most accidental wounds are closed by sutures so that primary healing results. There are probably few differences in the healing processes in these sutured wounds in dogs and cats as compared with similar wounds in experimental animals such as rats, rabbits, and guinea pigs or in humans. Some surgical incisions and many accidental wounds must be left open, for various reasons, to heal as open wounds by contraction and epithelialization. It is in this mode of wound healing that similarities are seen between dogs and cats and the experimental animals such as rats, rabbits, and guinea pigs; however, major differences are seen between dogs and cats and humans.     

Gold therapy: dermatologic uses and toxicities.

Chrysotherapy is now an important approach to the management of pemphigus. The administration of gold compounds and their common toxicities are reviewed in this report.     

Hyperkeratosis of the nipple and areola

Hyperkeratosis of the nipple and areola is a rare condition. We report two cases of hyperkeratosis of the nipple and areola occurring in men with no underlying endocrinopathy or synthetic estrogenic drug therapy. Both patients demonstrated prompt resolution of the hyperkeratosis of the nipples with a keratolytic gel. Because our cases were not associated with ichthyosis or epidermal nevus, they best fit into the category of nevoid hyperkeratosis of the nipples.     

Black and white human skin differences

This review of black and white human skin differences emphasizes the alleged importance of factors other than the obvious, i.e., skin color. Physicochemical differences and differences in susceptibility to irritants and allergens suggest a more resistant black than white skin. Differences appear to exist in the frequency of which several skin diseases occur among blacks and whites. A striking feature in this literature is the disagreement between authors. Common for much of this information is difficulty of interpretation, because of socioeconomic influences and other environmental factors.     

HLA and genetic predisposition to lupus erythematosus and other dermatologic disorders

Human leukocyte antigen (HLA) associations with different clinical and serologic subsets of lupus erythematosus are providing important clues to genetic predisposition and pathogenesis. The evolving complexity of the HLA-D region is described, and currently recognized HLA-region associations with systemic lupus erythematosus, subacute cutaneous lupus erythematosus, homozygous C2-deficient lupus, Sj?gren's syndrome, and the neonatal lupus syndrome are reviewed. The striking relationship between the Ro/SSA-La/SSB antibody responses and HLA-DR2 and DR3 are emphasized. Other dermatologic conditions associated with HLA are also noted.     

Bactericidal activity and chemotaxis in pemphigus vulgaris and bullous pemphigoid

Host defense mechanisms were studied in six patients with pemphigus vulgaris (PV) and six patients with bullous pemphigoid (BP). Polymorphonuclear (PMN) leukocyte killing of Staphylococcus organisms was evaluated, and chemotaxis of PMN and mononuclear (MN) leukocytes in patients was compared with that in twenty age- and sex-matched controls. All patients had extensive widespread disease with the clinical diagnosis confirmed by immunopathologic studies. No statistically significant differences were observed in the PMN leukocyte bactericidal activity between PV patients and controls. In BP patients, PMN leukocyte bactericidal activity was very slightly reduced when normal cells and patient serum were used, but activity was normal when patient cells and patient serum were used. PMN leukocyte chemotaxis was normal in PV and BP patients. MN leukocyte chemotaxis was normal in PV patients and increased in BP patients when compared with that in controls. This study indicated that in spite of very severe and extensive disease, patients with PV and BP have intact neutrophil and monocyte functions. Drugs that compromise the patient's ability to fight infections should be used cautiously and judiciously.     

Herpes zoster and occult malignancy

Herpes zoster and malignancy have both been associated with conditions of immune suppression. It has been well documented that herpes zoster occurs more frequently in patients with a previously diagnosed malignancy, especially lymphoma. To determine whether there is an increased frequency of malignancy subsequent to the diagnosis of herpes zoster, we studied fifty outpatients with herpes zoster and compared them with fifty control patients with psoriasis. In a follow-up period ranging from 24 to 68 months, one individual in the herpes zoster group developed a subsequent malignancy, in comparison to none in the control population and to 1.5 cancer cases expected in the general population. These results support the view that herpes zoster is not a marker for an occult malignancy.     

Uncombable hair syndrome: observations on response to biotin and occurrence in siblings with ectodermal dysplasia

Three children are reported with uncombable hair syndrome, consisting of slow-growing, straw-colored scalp hair that could not be combed flat. The hairs appeared normal on light microscopy but on scanning electron microscopy were triangular in cross section, with canal-like longitudinal depressions. Oral biotin, 0.3 mg three times a day, produced significant improvement after 4 months in one patient, with increased growth rate and with strength and combability of the hair, although the triangular shape remained. The other two patients were unique in having associated ectodermal dysplasia. Their hair slowly improved in appearance and combability over 5 years without biotin therapy.