THE EPIDERMAL-DERMAL JUNCTION OF NORMAL HUMAN SKIN AS SEEN IN FREEZE-ETCH PREPARATIONS

SUMMARY.— The epidermal–dermal junction has been examined by the replication of freeze-fractured human skin.
A basement zone about 150 nm. in depth has been observed which continuously separates epidermis from dermis. This relatively broad region has been interpreted as the hydrated form of the basement membrane.
The convoluted nature of the epidermal–dermal junction and the plasmalemmae of the basal cells is more easily followed by this method of examination, which also brings out the complexity of these appositions.
No hemidesmosomes have been observed in the contacts between the basal cells and basement membrane. Desmosomal contacts between basal cells differ in appearance from those seen in thin sections and possibly involve portions of the basement zone.     

Preponderance of lysosomal bodies in cultured fibroblasts from patients with recessive epidermolysis bullosa dystrophica

Fibroblasts of skin explants from three normal men and six patients with recessive epidermolysis bullosa dystrophica (EBD-R) were cultured in Dulbecco's medium, grown to confluence, sectioned and studied with the electron microscope. The normal control fibroblasts from the 6th to 13th passage (secretory phase) showed irregular or lobed nuclei with centrally scattered chromatin. They also had prominent RER, Golgi complexes, variously shaped mitochondria and cytoskeletal microfibrils. Their peripheral cytoplasm exhibited many vacuoles and a small number of these were autophagic lysosomes. In addition to the ultrastructural features described in the control fibroblasts, the EBD-R cells from the 6th passage contained remarkable numbers of strongly electron dense lysosomal bodies through their entire cytoplasm with very few empty vacuoles. It is speculated that the accumulation of these lysosomes may be connected with a primary metabolic cellular defect in the dermal fibroblasts of patients with EBD-R akin to that described in mucopolysaccharide storage diseases.     

HLA antigen frequencies in allergic bronchopulmonary aspergillosis

The frequency of HLA antigens in twenty-two Caucasian patients with allergic broncho-pulmonary aspergillosis (ABPA) and sixty-nine unrelated Caucasian controls was determined. The results indicated that there was no increased frequency of a specific HLA antigen in patients with ABPA. Moreover, studies in thirteen families of ABPA patients also demonstrated that, within families, there was no consistent association between a specific haplotype and asthma, allergies or hay fever.     

Successful treatment of pure red cell aplasia associated with systemic lupus erythematosus with oral danazol and steroid

We describe a middle-aged Chinese systemic lupus erythematosus (SLE) patient developing steroid refractory and transfusion dependent red cell aplasia. Oral danazol 200 mg twice per day was started together with low-dose prednisolone therapy. There was no further recurrence of anemia 1 month after this combined therapy.     

Diet and cancer prevention: the fiber first diet

Diet can play a major role in cancer prevention. The international differences in cancer incidence are largely accounted for by lifestyle practices that include nutrition, exercise, and alcohol and tobacco use. About 50% of cancer incidence and 35% of cancer mortality in the U.S., represented by cancers of the breast, prostate, pancreas, ovary, endometrium, and colon, are associated with Western dietary habits. Cancer of the stomach, currently a major disease in the Far East, relates to distinct, specific nutritional elements such as excessive salt intake. For these cancers, information is available on possible initiating genotoxic factors, promoting elements, and prophylactic agents. In general, the typical diet in the United States contains low levels of the potent carcinogenic agents, heterocyclic amines, formed during the cooking of meats. It provides only about half the potent appropriate fiber intake and is high in calories. About twice as many calories as would be desirable come from fat, certain kinds of which enhance the development of cancers. Other foods with functional properties, such as soy products and tea, can be beneficial. To achieve reduction in risk of certain cancers, diet must be optimized, primarily to reduce caloric intake and the fat component. The latter should be 20% or less of total caloric intake and fiber should be increased to 25- 35 g per day for adults. One approach to achieving these goals is the Fiber First Diet, a diet designed around adequate fiber intake from grains, especially cereals, vegetables, legumes, and fruits, which thereby reduces both calorie and fat intake. Such dietary improvements will not only reduce cancer and other chronic disease risks, but will contribute to a healthy life to an advanced age. A corollary benefit is a lower cost of medical care.      

HYPOXAEMIA AFTER INHALATION OF 50% NITROUS OXIDE AND OXYGEN

We have investigated, in volunteers, the effect of inhaling50% nitrous oxide in oxygen on subsequent oxygenation. Subjectsbreathed either 50% nitrous oxide in oxygen or 50% nitrogenin oxygen during hyperventilation and normal ventilation. Arterialoxygen saturation and end-expired oxygen concentrations werelower after 50% nitrous oxide in oxygen than after the othermixture with both patterns of ventilation and were lowest afterhyperventilation with 50% nitrous oxide in oxygen.     

Increased fibrovascular invasion of subcutaneous polyvinyl alcohol sponges in SPARC-null mice

The expression of SPARC (secreted protein acidic and rich in cysteine/osteonectin/BM-40) is elevated in endothelial cells participating in angiogenesis in vitro and in vivo. SPARC acts on endothelial cells to elicit changes in cell shape and to inhibit cell cycle progression. In addition, SPARC binds to and diminishes the mitotic activity of vascular endothelial growth factor. To determine the effect(s) of SPARC on angiogenic responses in vivo, we implanted polyvinyl alcohol sponges subcutaneously into wild-type and SPARC-null mice. On days 12 and 20 following implantation, SPARC-null mice showed increased cellular invasion of the sponges in comparison to wild-type mice. Areas of the sponge with the highest cell density exhibited the highest numbers of vascular profiles in both wild-type and SPARC-null animals. The endothelial component of the vessels was substantiated by immunoreactivity with three different markers specific for endothelial cells. Although sponges from SPARC-null relative to wild-type mice were populated by significantly more cells and blood vessels, an increase in the ratio of vascular to nonvascular cells was not apparent. No differences in the percentage of proliferating cells within the sponge were detected between wild-type and SPARC-null sections. However, elevated levels of vascular endothelial growth factor were associated with sponges from SPARC-null versus wild-type mice. An increase in vascular endothelial growth factor production was also observed in SPARC-null primary dermal fibroblasts relative to those of wild-type cells. In conclusion, we have shown that the fibrovascular invasion of polyvinyl alcohol sponges is enhanced in mice lacking SPARC, and we propose that increased levels of vascular endothelial growth factor account, at least in part, for this response.     

The Behavioural Status Index: therapeutic assessment of risk, insight, communication and social skills

An overview is given of the Behavioural Status Index (BSI), a developing classification instrument offering practical approaches to assessment and therapy surrounding social 'risk'. The approach hypothesizes that social 'risk' presented by a patient tends to correlate inversely with his/her degree of personal insight and capacity to perform well in key communicative and social skills, though no causal claims are made. Evidence exists to suggest that personal insight and communicative and social skills deserve serious consideration in a therapeutic approach to violent and dangerous behaviours. 'Risky' behaviours, as operationalized in the 'risk' subscale of the BSI, insight into the self and its activities, and communicative and social skills, may provide three critical foci for treatment planning in high security psychiatric care. A hypothetical linked factorial structure is proposed.     

Nursing Implementation of Single-Room Maternity Care

For five generations, infants were born at St. Mary's Hospital in Minneapolis, Minnesota, in a conventional setting. Mothers labored in one room, delivered in another, recovered in yet another, and spent the remainder of the hospital stay in a postpartum room. Five generations of nurses were taught and practiced in the compartmentalized manner that the physical structure of this traditional unit mandated. In March 1984, tradition gave way to a new era with the opening of an 18-bed, single-room maternity care system--The Birthplace. With the opening of this new unit, the changes in nursing care delivery were dramatic. New roles were developed for nursing staff. The transition to this contemporary practice was not without its labor pains.