Immunological Response of Guinea Pigs Sensitized With Homologous Antigens

ABSTRACT: The chemical composition of some “immunologically” pure antigens isolated from guinea pig testis and spermatozoa was correlated with their antigenic behavior. Their immunological responses were compared to select the best materials for a further isolation of chemically pure antigens. The glycoprotein extracted from the spermatozoa (T Gly) has the highest immunological potency and seems to be a T and B, depending antigen, able to induce high humoral and cell responses producing germinal cell damage, testicular lesions, and aspermatogenesis.     

Ultrastructural observations on uninvolved skin in dermatitis herpetiformis

Clinically normal skin from patients being treated for dermatitis herpetiformis was examined with the electron microscope. Cytoplasmic processes from the basal epidermal cells penetrated the dermis through discontinuities in the basal lamina which otherwise was normal in structure and thickness. The fibrous network of the dermis consisting of collagen, small reticular fibrils, anchoring fibrils and elastin, appeared normal. In patients receiving only dapsone, membrane-bound‘vacuoles’were found just below the basal lamina. They contained a fibrillar material of low electron density and were often associated with cell processes or complete cells, the classification of which was difficult. It is suggested that these vacuoles may be implicated in the reaction between reticulin and immunological complexes. In two specimens, early blister formation was also seen in the dermal papillae. The basal lamina remained applied to the stratum basale and was only absent where basal cell processes projected into the blister space which contained fibrin deposits. Vesiculated structures observed in the region of the blisters are interpreted as abnormal sensory nerve endings. This evidence supports the view that disruption of the basal lamina and blister formation in dermatitis herpetiformis are secondary to an earlier reaction.     

Relationship of Body Fat Distribution to Metabolic Complications in Obese Prepubertal Boys: Gender Related Differences

ABSTRACT. Our purpose was to assess the relationship of obesity and body fat distribution to serum glucose values, insulin concentration and insulin resistance in obese prepubertal boys. Thirteen obese and 15 control prepubertal boys were studied. Biceps, triceps, subscapular and supra-iliac skin fold thicknesses were measured. Percentage of body fat and total body fat were calculated. Body fat distribution was assessed by analyzing the central (supra-iliac, subscapu-lar)/peripheral (biceps, triceps) ratios. During an oral glucose tolerance test, serum glucose and insulin were measured and insulin/glucose was calculated. Body fat data and body fat distribution indices were significantly higher in the obese group. The obese population presented significantly elevated values of insulin and insulin/glucose. In the obese group insulin showed significant correlations with percentage of body fat, total body fat and subscapular skin fold thickness, whereas insulin/glucose had significant positive correlations with percentage of body fat, total body fat and supra-iliac skin fold thickness. In obese boys significant positive correlations were also shown by subscapular/supra-iliac with insulin and insulin/glucose, and by subscapular/triceps with insulin. In prepubertal boys obesity is centripetal and an upper central body fat distribution seems to be first associated with an abnormal glucose-insulin homeostasis.     

IgA and C3 complement in the uninvolved skin in dermatitis herpetiformis after gluten withdrawal

IgA deposits in the skin in 53 patients with dermatitis herpetiformis (DH) have been studied in relation to treatment. In 19 patients the disorder was controlled by a gluten-free diet (GFD) alone, in 13 patients by dapsone and GFD and in 18 by dapsone alone. In 3 patients the skin disorder became insignificant and required no treatment. Of the patients taking a GFD alone, six had been clear of skin lesions for 7 years, 5 for 3–5 years, and 8 for periods of 6 months-3 years. IgA deposits were found in all patients in an initial biopsy and in a second biopsy after treatment for periods varying from I to 7 years. There was no difference in the quantity of IgA, as assessed by the amount of fluorescence, whether patients were controlled with a GFD alone, GFD and dapsone, dapsone alone, or in those in clinical remission. The C₃ component of complement was present in the skin in 3 of the 19 patients (16%) controlled by a GFD alone, 6 of the 13 patients (46%) of those controlled by a GFD and dapsone, and in 12 of 18 (66%) of the patients taking dapsone alone, and in one of the patients in clinical remission.     

The cell cycle time in psoriasis

In the uninvolved epidermis of psoriasis and other conditions where an increased labelling index has been shown, the assumption is often made that this indicates a shortened cell cycle time producing accelerated cell replication. These studies on the uninvolved epidermis of six patients with psoriasis shows that this assumption may not always be correct. Employing the PLM curve method the mean S Phase duration (T_S) was found to be 11·4 h, similar to previous estimates of T_S in involved psoriatic epidermis, but too short to explain the wide ratio between labelled cells and mitoses (200:1) found in uninvolved psoriatic epidermis. The results imply that first, not all labelled cells are cycling S phase, cells and secondly if T_S is similar to that found in involved epidermis it does little to support the concept of a long cell cycle time in uninvolved epidermis. It is suggested that the increase in dividing cells and expansion of the epidermal compartment so characteristic of psoriasis may reflect alterations in growth fraction and not rapid cell replication.
     

OBSERVATIONS ON MITOSIS IN PSORIATIC EPIDERMIS

SUMMARY.— Mitotic counts in psoriatic epidermis removed from (a) the centre and edge of a single plaque in 17 patients, and (b) lesions at 3 different sites—the arm, leg and back—in 16 patients, have been compared.
Mitotic counts at the centre and edge of a plaque were similar for an individual patient, although there was variation in the group as a whole. There was no significant difference between the average centre and edge counts. The counts from the arm, leg and back were similar for an individual patient despite variation between patients. There was no evidence of any consistent variation between the 3 sites.
These results suggest that the factors influencing mitosis in psoriasis at any given time are similar for all lesions and each part of a lesion in an individual patient, although there are variations between patients.     

A "Dysautonomic" Head-Up Tilt Test Pattern in Elderly Patients with Neurocardiogenic Syncope

The characteristics of neurocardiogenic syncope (NCS) in elderly patients remain unclear. We compared the hemodynamic profiles of young and older patients with consecutive and positive head-up tilt tests (HUT). Continuous, noninvasive, and reliable monitoring of arterial pressure (AP) and heart rate (HR) was done throughout 46 consecutive positive HUTs of symptomatic patients. The population (12-82 years old) was divided into two groups: younger patients, Y (n = 25, < or = 65 years), and older patients, O (n = 21). Changes in AP and HR after the first minute of tilting, during the stable orthostatic phase and during syncope were compared. Except for systolic pressure, baseline hemodynamic parameters were similar in Y and O. No difference appeared in the mean time elapsed before syncope (19+/-9 vs 22+/-2 min). Asymptomatic hypotension was observed, only in O, 1 minute after tilting, followed by a progressive fall in the mean AP before syncope (0+/-0.9 vs -1+/-0.7 mmHg/min) without HR increase (0.7+/-1 vs 0+/-0.6 beats/min). This pressure slope was strongly related to age (r = 0.54, P < 0.001). Hemodynamic recording during HUT identifies a dysautonomic pattern in elderly patients with NCS and the abnormal AP/HR responses to orthostasis may be a feature specific to this population. Although the central mechanism of NCS is common to all ages, the age-related characteristics of the trigger event may indicate the need for specific management at different ages.     

Results of a multi-componential psychosocial intervention programme for women with early-stage breast cancer in Spain: quality of life and mental adjustment

The effectiveness of a structured psychosocial intervention for women with breast cancer was studied in relation to a control group. The study was conducted in a hospital setting in Spain, and the aim of the intervention programme was to foster a higher quality of life and a more positive mental adjustment to the cancer. Three measures were used: baseline, post-treatment and 6-month follow-up for both groups. The dependent variables examined were quality of life and mental adjustment. The independent variable was the psychosocial intervention programme. Subjects were 188 women who had been operated for breast cancer and who satisfied a series of medical criteria, had no history of psychological problems and were between 25 and 65 years old. The results have shown that the psychosocial intervention programme was highly effective in improving the patients' quality of life, as compared with baseline measures, as well as compared with the control group. Additionally, the intervention increased the patients' fighting spirit and hopefulness/optimism, and reduced their anxious preoccupation as coping styles. These changes persevered at the 6-month follow-up.     

Clinical trial: the efficacy of alverine citrate/simeticone combination on abdominal pain/discomfort in irritable bowel syndrome ‐ a randomized,double‐blind,placebo‐controlled study

Aliment Pharmacol Ther 31 , 615–624

Summary

Background Alverine citrate and simeticone combination has been used for almost 20 years in irritable bowel syndrome (IBS), but supportive scientific evidence of efficacy was limited. Aim To evaluate the efficacy of alverine citrate and simeticone combination in patients with IBS‐related abdominal pain/discomfort. Methods A total of 412 IBS patients meeting ROME III criteria were included in this double‐blind randomized placebo‐controlled study if their abdominal pain/discomfort intensity was at least 60 mm on a 0–100 mm visual analogue scale (VAS) during a 2‐week run‐in treatment‐free period. Patients were randomly assigned through the use of Interactive Voice Response System to receive either alverine citrate 60 mg with simeticone 300 mg three times daily or matching placebo for 4 weeks. Results The full analysis set included 409 patients (71.4% female: mean age: 46.2 ± 13.9 years). At week 4, alverine citrate and simeticone group had lower VAS scores of abdominal pain/discomfort (median: 40 mm vs. 50 mm, P = 0.047) and higher responder rate (46.8% vs. 34.3%, OR = 1.3; P = 0.01) as compared with placebo group. Patient receiving alverine citrate and simeticone reported greater global symptom improvement compared with those receiving placebo (P = 0.0001). Reported adverse events were similar in both groups. Conclusion Alverine citrate/simeticone combination was significantly more effective than placebo in relieving abdominal pain/discomfort in patients with IBS.     

Pegfilgrastim and daily granulocyte colony-stimulating factor: patterns of use and neutropenia-related outcomes in cancer patients in Spain – results of the LEARN Study

Daily granulocyte colony-stimulating factors [(G-CSFs); e.g. filgrastim, lenograstim] are frequently used to reduce the duration of chemotherapy-induced neutropenia (CIN) and the incidence of febrile neutropenia (FN) in cancer patients. A pegylated formulation of filgrastim, pegfilgrastim, which is administered once per cycle, was introduced in Spain in 2003. LEARN was a multi-centre, retrospective, observational study in Spain comparing patterns of use of daily G-CSF and pegfilgrastim, and CIN-related outcomes in adults with non-myeloid malignancies receiving myelosuppressive chemotherapy. Outcome measures were the percentage of patients receiving G-CSF for primary prophylaxis versus secondary prophylaxis/treatment, duration of treatment with G-CSF and incidence of CIN-related complications. Medical records from consecutive patients with documented pegfilgrastim ( n  = 75) or daily G-CSF ( n  = 111) use during 2003 were included. The proportion of patients receiving primary or secondary prophylaxis was comparable between the pegfilgrastim (39 and 48% respectively) and daily G-CSF (40 and 48% respectively) groups. However, there was a trend towards less frequent use to treat a neutropenic event such as FN or neutropenia in the pegfilgrastim group (17 versus 30% with daily G-CSF). Chemotherapy-induced neutropenia-related complications were less frequent in patients receiving pegfilgrastim (e.g. FN 11 versus 24% with daily G-CSF). This is the first study to show the potential benefits of pegfilgrastim over daily G-CSF in Spanish clinical practice.