Circulating intercellular adhesion molecule-1 in melanoma patients: induction by interleukin-2 therapy.

Intercellular adhesion molecule-1 (ICAM-1, CD54), a molecule bound to the cell surface membrane, mediates various cell-cell interactions in inflammation and immunosurveillance. By means of a new specific enzyme-linked immunosorbent assay (ELISA) for soluble ICAM-1, free circulating ICAM-1 was measured in serum from five healthy volunteers, 10 melanoma patients at different stages of their disease, and eight patients receiving high-dose interleukin-2 (IL-2) for metastatic melanoma. No correlation between the concentration of circulating ICAM-1 and the tumor burden could be detected. In melanoma patients receiving high-dose IL-2, we observed an increase of circulating ICAM-1 of up to 200%, compared to the concentration prior to therapy, ranging between 4 and 13 ng/ml. The increase in circulating ICAM-1 was associated with the induction of tumor necrosis factor-alpha and interferon-gamma.

MCP-1 mRNA expression in basal keratinocytes of psoriatic lesions.

In addition to hyperproliferation of keratinocytes, psoriasis is characterized by pronounced leukocytic infiltration. In contrast to the epidermal localization of neutrophils and T lymphocytes, macrophages are almost exclusively restricted to the dermal compartment. By immunohistologic analysis, these dermal macrophages were mainly encountered in the papillary dermis and arranged along the rete ridges in close proximity to proliferating keratinocytes. Monocyte chemoattractant protein (MCP-1) anti-sense RNA probes yielded abundant signals over the proliferating basal keratinocytes of the tips of the rete ridges, and, to a lesser extent, in cells in the papillae. Thus, the strongest MCP-1 message in psoriatic lesions is found above the dermal-epidermal junction and this may explain the characteristic sub-basal distribution of dermal macrophages. These results suggest that MCP-1 is important in regulating the interaction between proliferating keratinocytes and dermal macrophages in psoriasis pathogenesis.

A comparison of the effect of povidone-iodine and 60% n-propanol on the resident flora using a new test method.

The efficacy and safety of povidone-iodine (PVP-I) and 60% v/v% n-propanol on the forehead of patient's were examined using a newly developed method. Significantly higher reduction factors (RFs) of the total resident flora were obtained using PVP-I immediately after and 3-6 h after application (1.4, 1.4, 1.4) than with isopropanol (0.6, 0.6, 0.8) using the detergent scrub method. No significant difference was found using the cyanoacrylate method. Propionibacter spp. showed similar results. With Staphylococcus epidermidis, RFs of 1.8 were obtained with both bath agents using the detergent scrub method, but using the cyanoacrylate method significantly higher RFs were obtained with isopropanol immediately and 3 h after application (1.3, 1.3) than with PVP-I (0.4, 0.5). This phenomenon seems to be due to the limit of complete elimination of the resident bacterial counts in vivo.

Staphylococci of the normal human skin flora. Variety of biotypes and antibiograms without direct correlations.

352 strains of Staphylococci of the normal human skin flora were sampled from one volunteer by single scrabbing in a ca. 3 cm2 measuring area. They were biotyped by the scheme of Pelzer et al.(1973)--a modified Baird-Parker-Scheme (1963)--and the resistance to antibiotics was investigated by the method of Bauer et al. (1966). All the nine biotypes of Staphylococci were found in variable quantities. It seems problematic to call one biotype as the main type. Morphologically identical colonies of Staphylococci from the indigenous flora of the human skin were not identical in their biotypes as previously described by Pelzer (1976). Only the investigation of all Staphylococci colonies from the culture plate can evaluate all biotypes of Staphylococci of the normal human skin flora, and can give the right quantitative correlation. Staphylococci were found to be sensitive and resistant up to four antibiotics, and one biotype did not show one type of antibiogram.

[Restriction of washing and its effect to the normal human skin flora. Quantitative and qualitative investigations of the aerobic skin flora (author's transl)]. / Waschverbot und Verhalten der Hautflora. Quantitative und qualitative Untersuchungen der aeroben Hautflora.

The behaviour of the aerobic skin flora of the flexor sides of the forearms, under a three-week restriction of washing, was investigated in twenty-four patients for its quantitative and qualitative aspects. The combined scrabbing-washing method was used as described by Burtenshaw with Ringer's solution. After a three-week restriction of washing, using the Wilcoxon-Test, statistically no significant changes in the total number of microorganisms were found in areas investigated in the intermittent sampling of the skin flora. A three-week restriction of washing in the region of the flexor sides of the forearms does not induce significant changes in the composition of the normal aerobic skin flora. The percentage of differences in the total number of bacteria fluctuates up to the mark in wide limits; statements about standard deviations are not permitted because of the technical and experimental conditions. There was no shifting of the Resident flora to other groups of bacteria in the patients under study. Pathogenic microorganisms could not be found in higher numbers after the second sampling.

[Shower-bath and its influence on the behaviour of the aerobic resident flora of the human skin. Half-side comparisons between a single shower bath with and without bath supplements (author's transl)]. / Duschbaden und sein Einfluss auf die aerobe Residentflora der menschlichen Haut. Halbseitenvergleiche unter Duschen mit und ohne Duschzusätze bei einmaliger Anwendung.

A method for the in vivo investigation of shower-bath supplements and their influences on the human skin flora is presented. The shower-bath supplement is added in a constant dosis directly to the shower-jet to obtain constant conditions of shower-bathing on the human skin. Different concentrations of the shower-bath supplement in neighboured areas of the skin can be avoided and this allows to make comparative investigations of the effect of shower-bath supplements to the normal human skin flora. The reproducibility of the results and the accuracy of the method were investigated in half-side comparisons of the aerobic resident flora of the flexor sides of the forearms in three groups of volunteers, 60 persons in total. A marketable product in two slightly differing modificatons was used as shower-bath supplement. Half-side comparisons between each of the two supplements against water alone and between the shower-bath supplements directly were performed. The detergent washing method was used for sampling the skin flora. Statistically significant changes of the aerobic resident flora in the half-side comparison between the two supplements were obvious only 24 h after a single bath. It could be proved that the results can be reproduced at different times and with different groups of vlunteers. Further more, that a half-side comparison between th two shower-bath supplements detects more sensible differences in the effect on the human skin flora of the two marketable products than the comparison of each supplement with water alone.

[Daily bath and its effect on the normal human skin flora quantitative and qualitative investigations of the aerobic skin flora (author's transl)]. / Tägliches Baden und Verhalten der Hautflora. Quantitative und qualitative Untersuchungen der aeroben Hautflora.

The behaviour of the aerobic skin flora of the flexor sides of the forearm, under a daily repeated bath during 21 days, using two marketable bath-supplements, was investigated in 24 volunteers for its quantitative and qualitative aspects. The combined scrubbing-washing-method was used as described by Burtenshaw with Ringer's solution. After the daily baths, using Wilcoxon-test, statistically no significant changes in the total number of microorganizations and in the number of the single groups of bacteria were found in the areas investigated by intermittent samplings of the skin flora. In the analysis of the composition of the normal aerobic skin flora, however, changes were obvious in 4 volunteers. There were no clinical changes of the skin surface in any of the volunteers.

[Restriction of washing and its effect to the normal human skin flora. Quantitative and qualitative investigations of the aerobic skin flora (author's transl)]. / Waschverbot und Verhalten der Hautflora. Quantitative und qualitative Untersuchungen der aeroben Hautflora.

The behaviour of the aerobic skin flora of the flexor sides of the forearms, under a three-week restriction of washing, was investigated in twenty-four patients for its quantitative and qualitative aspects. The combined scrabbing-washing method was used as described by Burtenshaw with Ringer's solution. After a three-week restriction of washing, using the Wilcoxon Test, statistically no significant changes in the total number of microorganisms were found in areas investigated in the intermittent sampling of the skin flora. A three-week restriction of washing in the region of the flexor sides of the forearms does not induce significant changes in the composition of the normal aerobic skin flora. The percentage of differences in the total number of bacteria fluctuates up to the mark in wide limits; statements about standard deviations are not permitted because of the technical and experimental conditions. There was no shifting of the Resident flora to other groups of bacteria in the patients under study. Pathogenic microorganisms could not be found in higher numbers after the second sampling.

Effect of occlusion on resident flora, skin-moisture and skin-pH.

The effects of a 3-day test of an occlusion dressing of the forearm on the resident flora of the skin, relative skin-moisture and skin-pH were studied in 26 male and female volunteers. The geometrical mean values of coagulase-negative Staphylococci and Corynebacterium species increased five and four logs and decreased 1 day post occlusion only two logs. Relative skin-moisture increased from 20% to 75% under occlusion and decreased to 5% 24h after removal. Skin-pH increased from 4.9 to 7.1 and decreased to pH 5.2. Investigations of the resident flora should be made, if the influence of external, not antimicrobial active agents, is to be examined, because changes in the substrate can cause secondary changes in the resident flora.

The interleukin-2 receptor in lesions and serum of bullous pemphigoid.

The interleukin-2 receptor (IL-2R) is mainly expressed on activated T cells. Depending on its rate of synthesis, a portion is released from the cell surface as soluble IL-2R (sIL-2R). Since the role of mononuclear cells in the pathology of bullous pemphigoid (BP) is not well understood, we determined the sIL-2R in both blister fluid and serum of 15 BP patients with generalized disease before initiating systemic treatment. In addition, we obtained both lesional and perilesional skin biopsies and examined the mononuclear infiltrate with a panel of monoclonal antibodies. In BP blisters, sIL-2R levels were significantly increased (2070 +/- 350 U/ml), (+/- SEM) compared with serum samples taken at the time of blister puncture (1340 +/- 290 U/ml). In six patients with blisters due to second-degree burns or friction and in five suction blister volunteers, sIL-2R levels were normal in both blisters and serum. In BP, elevated serum levels decreased to normal during therapy, correlating with disease activity. The immunohistology showed that 30% of mononuclear cells in the dermal infiltrate of lesional skin expressed the IL-2R, whereas only 15% were positive in perilesional skin. IL-2R-positive cells are the most likely source of the shed receptor in BP blisters. Our results indicate the presence of activated T cells in lesions and peripheral blood of BP and thus underline the importance of cell-mediated immune mechanisms in the pathology of this disease.

Annexins I to VI: quantitative determination in different human cell types and in plasma after myocardial infarction.

Concentrations of annexins I to VI were quantitatively determined in extracts of placenta and different human cell types. They were detectable in all extracts studied, but lymphocytes/monocytes, endothelial cells and fibroblasts had very high annexin contents. The results indicate cell type specific annexin-repertoires. Annexins are intracellular proteins lacking signal sequences but which are detectable in trace amounts in plasma of healthy humans. The majority of plasma samples drawn from 14 patients suffering from myocardial infarction had elevated annexin III, IV and V concentrations. Shortly after infarction increased annexin levels were detected, reaching maximal values 24 to 48 h later. In the course of the following days annexin concentrations returned towards normal plasma levels.

Acute disseminated histoplasmosis in infancy in Brazil: report of a case and review.

Although early age is an important risk factor for the occurrence of acute disseminated histoplasmosis in non immunosuppressed infants, cases of this condition have been rarely reported, even in highly endemic areas. This is a reason to add a new case, the first one diagnosed in the state of Rio Grande do Sul, and, also, to review and comment on the Brazilian literature of histoplasmosis in patients under three years of age.

Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature.

Eleven cases of involvement of the genital tract in paracoccidioidomycosis were collected in a retrospective study of the clinical records of 683 patients seen in Porto Alegre, Rio Grande do Sul, Brazil. These cases are herein summarily reported. Eighteen similar cases were gathered in review of the Brazilian literature. Obtained data are discussed.

[Gardnerella vaginalis infection. Clinical aspects, diagnosis and therapy]. / Gardnerella vaginalis-Infektion. Klinik, Diagnostik und Therapie.

The Gardnerella vaginalis-infection of the urogenital tract is of clinical importance in females and of epidemiological importance in males. Females suffer from Bacterial Vaginosis, with a foul-smelling grey vaginal discharge with a pH of 5.0-5.5 which contains "clue cells", and from Sepsis. The isolation and identification of G. vaginalis i necessary in man. If G. vaginalis-infection is suspected, simultaneous infections with further STD-agents such as N. gonorrhoeae, C. trachomatis etc should be excluded. Metronidazole (1 g/day for 5 days) is the drug of choice in G. vaginalis-infection.