Cutaneous infections and disorders of inflammation

In 1908, the Nobel Prize in Physiology and Medicine was shared by Elie Metchnikoff and Paul Ehrlich. Their joint commendation acknowledged the vigorous debate which then existed and, in a sense, paved the way for our modern recognition that both cellular and humoral mechanisms might participate in immunity. Of Ehrlich's and Metchnikoff's many accomplishments, those concerning the basic nature of the inflammatory reaction suggested a clinical potential that has been realized only in the last decade. Central to their theories was the implication that normal inflammatory processes were of benefit to the host and that disordered inflammation was likely to lead to disease. Over the past decade or so, we have recognized an extensive set of diseases associated with primary or acquired deficiencies of inflammation, thus beginning to catch up to the genius of Ehrlich and Metchnikoff. Most, if not all, of these disorders demonstrate major cutaneous involvement in their clinical and biologic presentations. It is thus of essential importance that the dermatologist be familiar with this fascinating spectrum of disease, and it is to this end that this review is directed.

The effects of humoral factors on amplification of nonrecognizable erythrocytic and granulocytic precursors

These studies were to evaluate the effects of humoral factors on amplification of nonrecognizable erythrocytic and granulocytic precursors by the in vivo plasma clot diffusion chamber and the in vitro plasma clot culture methods. Changes in the plasma erythropoietin levels in the reticulocyte concentration and hematocrits of irradiated and nonirradiated Long-Evans rats exposed to hypoxia were also determined. While erythropoietin plasma concentrations appeared to affect BFU-E and CFU-E growth, results suggest erythropoietin may not be the sole regulator of red cell production and that inhibitors of chalone-like mechanisms may be involved. Measurements made on granulocyte precursors treated with colony stimulating factor (CSF) containing L-cell-conditioned medium revealed granulocytic colonies and burst-like formations similar to those seen for erythrocytic growth. There is strong evidence suggesting that CSF is a regulator of granulopoiesis; however, it is not the sole regulator and it appears that inhibitors may play an in vivo role. Growth of colonies with cell numbers not a power of 2 implies either asymmetric mitosis due to loss of genetic information required for continuing division, or differences in concentrations of, or ability to recognize, inhibitory factors. These possibilities are examined in the light of results from in vivo and in vitro culture techniques.

Conotruncal malformation complex: examples of possible monogenic inheritance

Two families are described in which there is possible monogenic inheritance of congenital cardiac defects within the spectrum of faulty conotruncal septation (CTS). Evidence for a genetic control of conotruncal septation arises from genetic and embryologic studies of similar defects in the Keeshond dog model, the excess of sibship pairs with conotruncal septation defects in sibship pairs with congenital heart diseases, and previously reported pedigrees of families with multiple affected individuals with conotruncal septation defects. It is suggested that in the small number of cases of congenital cardiac defects in which there is a strong family history for CTS defects, a higher recurrence risk should be considered rather than the usual polygenic recurrence risk of 3% that is usually given in such situations.

Comparison of microchromatography and electrophoresis with elution for hemoglobin A2 (Hb A2) quantitation

Microcolumns prepared in the authors' laboratory, two commercial microchromatography kits, and electrophoresis with elution were compared for Hb A2 quantitation. Day-to-day imprecision of microchromatographic methods was similar (CV 4.7--6.6%) and somewhat less than electrophoresis with elution (CV 8.0--9.1%). Both commercial kits showed variable imprecision in different lots; one lot of Kit B gave erratic results due to resin leakage. From 49 patient specimens, Kit A microcolumns and those of the authors identified the same 14 patients with an elevated percentage of Hb A2 and showed good correlation (P = 0.90), although Kit A showed constant bias toward higher values. Electrophoresis with elution resulted in a false-positive and a false-negative value, did not correlate well with microcolumns (P = 0.78 and 0.76), and showed proportional bias toward lower values for an elevated percentage of Hb A2. Commercial kits were convenient, relatively quick, and cost-effective. Frozen, stabilized hemolysates performed well for quality control.

Uterine malformation and fetal deformation

Beyond the enhanced miscarriage and prematurity associated with the structurally abnormal uterus, we have found 14 examples of fetal deformation secondary to uterine malformation with its consequent uterine constraint. In several instances the constellation of deformations had been misinterpreted as a multiple malformation disorder. One patient died of pulmonary hypoplasia, but all the survivors showed restoration toward normal form postnatally. Recognition of the basic problem allows for surgical reconstruction of the uterus, which is generally accompanied by an improved outlook for subsequent pregnancies.

Effects of alcohol on the storage and retrieval processes of heavy social drinkers

Two experiments investigated the effects of intoxication, expectation of intoxication, and state dependency on learning and relearning in male heavy social drinkers. In both studies, subjects participated in two daily sessions. On Day 1, intoxicated and sober subjects were presented with word lists for immediate free recall, followed by total free recall of all words. On Day 2, with or without a change in drug state, subjects were given a second total recall test, the same lists for immediate recall, and a third total recall test. In Experiment 1, 10 subjects served in each of four groups formed by crossing expectation with reception of alcohol on Day 1; all subjects were sober on Day 2. In Experiment 2, 12 subjects served in each of four groups formed by crossing drug state on Day 1 with drug state on Day 2 (sober-sober, sober-intoxicated, intoxicated-intoxicated, intoxicated-sober), and all expected alcohol. In both studies, intoxication produced a performance deficit, but retention loss on Day 2 was the same for change- and constant-state subjects. Expectation had no effect on performance. Results are discussed in terms of an alcohol-induced storage deficiency rather than a retrieval deficit.

Serum complement-like opsonic activities in human, animal, vegetable, and proprietary milks

Human, animal, proprietary, and soy milks are comparable to human serum C5 in opsonization of baker's yeast. Bovine milk and human serum opsonically reconstitute C5-deficient mouse serum. Such reconstitution is selectively inhibited by antiserum to human C5. Further characterization suggests that bovine milk contains material structurally and functionally similar, but not identical, to human C5.

Partial characterization of in vivo chemotactic activity: comparison to human C5a

Spontaneous eosinophil chemotactic activity (SECA) can mediate the directed movement of human eosinophils and neutrophils. Preliminary characterization of SECA has been carried out. SECA is nondialyzable and heat-stable (56 degrees C, 30 min). Chromatography on Sephadex G-75 demonstrated that SECA had elutional and functional properties similar to C5a (prepared from endotoxin-activated normal sera). Polyacrylamide gel electrophoresis (PAGE) with the use of 15% bisacrylamide gels of lyophilized, chemotactically active column fractions demonstrated a single protein band of identical electrophoretic mobility from either SECA or C5a preparations. Enzymatic hydrolysis with carboxypeptidase B, a known inhibitor of C5a activity, significantly decreased chemotactic activities of C5a and SECA. The addition of purified anti-C5 to either SECA or C5a significantly inhibited chemotactic activity. SECA is naturally occurring chemotactic activity identical to human C5a. Thus C5a may be an important source of in vivo chemotactic activity in various inflammatory disorders.

The effects of acute bleeding on acid-base balance erythropoietin (Ep) production and in vivo P50 in the rat

The mechanism of erythropoietin (Ep) production after acute haemorrhage has been thought to be due to a reduction in blood volume and tissue perfusion leading to tissue hypoxia. In the present study we have evaluated the effect of acute haemorrhage in the rat on the acid-base status, the red cell affinity for oxygen in vivo, and Ep production. Within a few hours after acute blood loss there was a respiratory alkalosis with an increase in blood pH, a decrease in pCO2 and an increase in the red cell affinity of Hb for oxygen in vivo that was temporally related to an increase in Ep production. Within 24 h after the acute haemorrhage, the blood pH AND PCO2, red cell affinity for oxygen in vivo, and Ep level returned towards normal. The decrease in in vivo red cell affinity for oxygen was associated with an increase in red cell 2,3-DPG levels and a decrease in Ep production.