Biomedical subjects
B Hentzer
Publications and source records attributed to B Hentzer.
Postinflammatory oedema in two patients with contact dermatitis. Effect of benzo-pyrones.
Two female patients with oedema of the arms and legs due to contact dermatitis complicated with recurrent infections were examined. The concentrations of plasma proteins of different molecular weight in the oedema fluid (collected from suction blisters) were highly increased. Albumin outflux as measured with radiolabelled albumin from the vessels of oedematous skin was markedly decreased corresponding to a decreased lymphatic function. Treatment with benzo-pyrones for 6 months did reduce the protein concentrations of the oedema fluid, but the clinical response was disappointing.
Calcification of cultured urticaria pigmentosa skin. An electron optical study of the calcium-apatite deposition.
Mast cells participate in experimental calcinosis. Skin from patients with urticaria pigmentosa (cutaneous mastocytosis) calcifies in vitro. In the present report, the nature of the calcium deposit was studied by electron optical techniques. The cultured mast cells of urticaria pigmentosa skin were surrounded by a large number of round bodies with an average diameter of 200-300 nm. Most of the round bodies were membrane bounded, while a few contained lamellar structures. These bodies may represent matrix vesicles as seen in calcifying hard tissues and/or may be remnants of mast cell granules. The calcified deposits were located on the round bodies, collagen fibrils and elastic matrix. Electron diffraction and X-ray microanalysis demonstrated that the deposits consisted of crystalline calcium apatite.
Deposits of immunoglobulin and complement in psoriatic lesions.
Biopsy specimens from 43 patients with psoriasis were studied by immunofluorescence microscopy. Deposits of complement C3 and/or immunoglobulins were seen in the vessel walls and/or in the dermal-epidermal junction of all of 21 patients with pustular psoriasis, acute guttate psoriasis, psoriatic arthropathy and erythroderma. similar deposits were seen in nine out of 22 patients with psoriasis vulgaris. Deposits were found in clinically uninvolved skin in only one of 37 patients. The results might suggest that the deposition of immune complexes in the vessel walls are of importance for the development of psoriatic lesions.
An epidemic of acute viral hepatitis in male homosexuals. Etiology and clinical characteristics.
Among 130 male patients admitted during a 30-month period with acute hepatitis in the Copenhagen Clinic for Infectious Diseases, 31 were homosexuals. Hepatitis B virus occurred in an endemic fashion in the homosexual subpopulation while hepatitis A infection caused a small epidemic among homosexuals during the winter 1977-78. The course of these infections showed no serological or clinical differences from the findings in 38 heterosexual male patients seen during the same period.
Viral hepatitis in a venereal clinic population. Relation to certain risk factors.
In the present survey 3 groups of patients were studied: 95 homosexual males, 117 heterosexual males and 68 females attending clinics for venereal diseases in Copenhagen. 10 cases of hepatitis B infection were found, all in homosexual males. Chronic carriership of hepatitis B surface antigen (HBsAg) and presence of hepatitis B e-antigen (HBeAg) was demonstrated in 8 and 5 cases, respectively and liver biopsy showed chronic liver disease in 5 out of the 8 former. The prevalence rate of hepatitis B antibody was significantly higher in all patient groups than in the general population in the area. Two patients had non-B hepatitis, 1 homosexual male and 1 female, but the prevalence rate of hepatitis A antibody (anti-HAV) was not increased in the venereal clinic population. The serological tests identified certain high risk groups regarding hepatitis B infection: (1) homosexual males > 25 years with anti-HAV and a high promiscuity; and (2) heterosexual males and females > 25 years with a past history of venereal disease and clinical hepatitis. The data are compatible with the hypothesis that sexual transmission plays an important role in the spread of hepatitis B infection. It is recommended that routine serological tests for hepatitis be taken in the high risk groups of venereal clinic populations.
Adult human skin maintained in organ culture. II. The ultrastructure of the cellular compartment of connective tissue.
Dermal cells maintained in cultured human skin explants for up to 10 weeks were studied by electron microscopy. Common findings in the cell organelles were: 1) altered nuclear shapes and numerous nuclear bodies; 2) reduced rough endoplasmic reticulum; 3) a prominent Golgi complex; and 4) an increasing number of free ribosomes, mitochondria, glycogen granules, lysosomes and lipid droplets. The individual types of dermal cells showed various cytoplasmic changes according to duration of the culture. The fibroblasts displayed a moderately developed rough endoplasmic reticulum. The macrophages were filled up with lysosomes and residual bodies. The mast cells showed typical as well as atypical granules. The smooth muscle cells had a variable content of myofilaments. The pericytes and the smooth muscle cells, both surrounded by a basal lamina, became increasingly difficult to discern from each other as a consequence of the decreasing number of myofilaments in the latter. The endothelial cells were recognized because of the preserved blood vessel architecture. Besides the above-mentioned cell types, two other types appeared with the culture time. The unidentifiable cells were characterized by dense zones of the cell membrane and an adjacent extracellular basal lamina-like material. This cell type may be derived from the pericytes of the small blood vessels. The primitive cells had a large rounded nucleus and a cytoplasm with few organelles. This cell type is assumed to represent a precursor cell common to various cell types.
Dermatomyositis with universal calcinosis. A histopathological and electron optic study.
Biopsies from a 5-year-old girl with dermatomyositis and universal calcinosis were studied histopathologically and by means of electron optical techniques. The dermis was infiltrated by fibroblasts, lymphocytes and plasma cells. In the lower part of the dermis, dense basophilic areas were present. In the vicinity of these areas irregular elastic fibers appeared. In the electron microscope these elastic fibers appeared mineralized to varying degrees. The mineral part was identified as calcium apatite (either calcium-hydroxy-apatite or calcium fluoroapatite) by X-ray microanalysis and selected area diffraction. No calcification was observed outside the elastic fibers.
Chronic hepatitis B infection in male homosexuals.
Ten cases of hepatitis B virus infection were identified among asymptomatic male homosexuals. These patients shared a number of characteristics: A subclinical origin and course of infection; Persistence of HGsAg for periods exceeding six to 25 months; Persistent GPT elevation of two to five times upper normal limit; Morphological changes in the liver with portal and parenchymal inflammation (chronic persistent hepatitis, six cases; non-specific reactive hepatitis, 2 cases; cirrhosis and acute hepatitis with signs of chronicity, one case each). HBeAg was found in six cases, anti-HBe in none. These results indicate that screening for hepatitis B should be performed whenever these individuals come under medical attention in order to detect asymptomatic chronic liver diseases and to detect these silent vectors of an infection that presently shows an increased frequency among homosexuals.
Adult human skin maintained in organ culture: I. The ultrastructure of the acellular compartment of connective tissue.
Collagenolytic enzymes are produced by cultured skin explants. During cultivation the acellular compartment of the dermal connective tissues is digested away. The ultrastructure of the connective tissue resorption has been studied in human skin maintained in organ culture for 2--10 weeks. The connective tissue changes are: (1) Collagen fibrils with normal axial periodicity but decreasing diameters. On cross sections these fibrils have irregular outlines, while the longitudinal sections show fibrils separated into thin bundles of filaments 40--80 A thick with preserved normal axial periodicity. (2) Cross-banded filamentous aggregations (CBFA) consisting of fine parallel filaments 25 A thick and without axial periodicity. The CBFA has 350 A thick bands at 525 A intervals. At the end of the cultivation, the CBFA are replaced by solitary filaments 25 A thick. (3) The elastic fibres show no marked changes of the amorphous matrix, while the fibrils disappear. The loss of collagen and elastic fibrils during cultivation of the skin gives direct evidence of connective tissue degradation. The described changes are discussed in relation to previous ultrastructural studies on connective tissue resorption of various tissues.
Intracellular collagen fibrils in cultured human skin.
During cultivation, the collagen fibrils of skin explants are broken down. The cells of the explants participate in this resorption. The ultrastructure of the intracellular degradation of collagen fibrils of cultured human skin has been examined. Intracellular collagen fibrils occur in fibroblasts, macrophages, smooth muscle cells and unidentifiable cells. Normal collagen fibrils are engulfed and appear within membrane-bounded tubes of the cytoplasm. Primary lysosomes fuse with the tubes. Degraded intracellular collagen fibrils are frequently present in secondary lysosomes and show decreasing diameters, filamentous splitting, loss of axial periodicity, variable stainability and cross-banded filamentous aggregates. The changes in the intracellular collagen fibrils are identical with those seen in the extracellular space. The present study demonstrates that various cell types in dermis are involved in collagen fibril degradation and that the lysosomes play an important part in the intracellular resorption.
Fibrodysplasia (myositis) ossificans progressiva treated with disodium etidronate.
Two patients with fibrodysplasia ossificans progressiva (FOP) were treated with disodium etidronate, a disodium salt of ethane-1-hydroxy-1, 1-diphosphonic acid (EHPD) for two years; both had multiple ectopic ossifications of connective tissue. Regular follow-up showed no improvement in joint movement whilst laboratory examination revealed an increase in the serum phosphorus level. Serum calcium and urinary phosphorus excretion remained within normal limits. The urinary calcium excretion varied with the dose of EHDP. X-ray examination showed significant reduction in size and density of the ectopic ossifications, while the density of bones during and after EHDP therapy remained normal. Development of new ossification was inhibited in the active phase of the disease. Suspected side-effects of the drug were occult blood in stools, skin petechiae, and amenorrhoea. Previous reports on the EHDP treatment of disorders with ectopic ossification are summarised.
A clinical study of 32 patients with oral discoid lupus erythematosus.
Thirty-two patients (26 females, six males) with discoid lupus erythematosus of the oral mucosa have been studied. Patients with signs of dissemination were classified according to accepted criteria. Four patients had systemic lupus erythematosus as well as oral discoid lesions. Twenty-one patients had discoid skin lesions. Eleven patients had oral discoid lesions without involvement of the skin. The time of onset of the oral discoid lesions rnaged from 6 to 75 years with a mean of 41 years. The mean druation of the oral lesions was 4.2 years. Symptoms from the oral discoid lesions were present in 75% of the patients. The clinical appearance varied and some lesions were difficult to differentiate from oral leukoplakia or from the lesions seen in oral lichen planus. The oral discoid lesions were most often seen on the buccal mucosa, the gingiva, labial mucosa and vermilion border. The oral lesions were infected by yeasts in more than half of thepatients.
Enzymatic liberation of viable cells of human skin.
To obtain viable cells from normal human skin, clostridial collagenase was used. Crude collagenase digestion of collagen fibres and basal lamina results in free dermal cells and sheets of epidermis. The collagenase was tested at various concentrations, solvents and incubation periods. The specimens digested were either split or full thickness skin of varying size. The optimal result was obtained by using small (3mm across) split skin pieces incubated in 2 mg/ml collagenase. The choice of solvent MEM, MEM supplemented with serum, and Tris buffer, was less important. 3 hours' incubation the epidermis was peeled off in sheets and finally dissociated by trypsin-EDTA. The corium was completely digested after 6 hours. After 6 hours' incubation no viable cells could be seen. The epidermal cells appeared mainly as polygonal cells of various sizes and a few little dendritic cells. The dermal cells had a heterogeneous morphology during the first weeks of cultivation. After 2 weeks the cells appeared as fibroblast-like cells.
Deposits of complement and immunoglobulins in dermal and synovial vessels in psoriasis.
Deposits of complement C3 and/or immunoglobulin were found in the vessel walls and/or at the dermal-epidermal junction in skin lesions of all of 11 patients with psoriatic arthritis and guttate psoriasis. Similar deposits were seen in 6 out of 15 patients with psoriasis vulgaris. Synovial tissue available from 2 patients revealed deposits in the vessel walls.
Salpeter-induced dermal changes electron-microscopically indistinguishable from pseudoxanthoma elasticum.
Salpeter-induced calcium deposits in ten patients showed a close clinical and histopathological similarity to the lesions of pseudoxanthoma elasticum. By electron microscopy and selected area diffraction analyses of the calcium deposits we find the changes indistinguishable from the changes previously described in involved skin of patients suffering from PXE. Clinically our patients were compared with the fourteen patients with traumatic calcification previously described.
In vitro calcification of connective tissue from uninvolved skin of patients with pseudoxanthoma elasticum.
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The ultrastructural changes of Leishmania tropica after treatment with pentamidine.
The effect of the antiprotozoal drug pentamidine on the ultrastructure of the amastigote stage of Leishmania tropica was studied. The most remarkable change introduced by the treatment occurred in the kinetoplast-mitochondrion complex. All mitochondria were extremely enlarged and most kinetoplasts disintegrated into a network of fine filaments. The flagellar pocket was frequently dilated and filled with various quantities of double-membrane bounded bodies ejected from the pocket wall. The multivesicular bodies and lipid droplets were enlarged. The number of ribosomal granules decreased. Many protozoa had an irregular shape and damaged internal structure. The drug-induced changes of L. tropica are discussed in relation to similar effects previously observed in trypanosomes.