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Biomedical subjects

J Lauharanta

Publications and source records attributed to J Lauharanta.

At least 73 records · Page 4Linked to original sources

Light and electron microscopy of psoriatic skin before and during retinoid (Ro 10-9359) and retinoid-PUVA treatment.

Eight patients with psoriasis (pustular, erythrodermic or severe plaque type) were treated successfully with retinoid (Ro 10-9359) or with retinoid followed by PUVA (RePUVA). The histological changes in recovering skin were examined during 14 weeks. Treatment resulted in normalization of keratinocyte differentiation with fine structural changes suggesting decreased metabolic activity and a reduction of mitoses. There was an increase in the number of keratohyalin granules and of tonofilaments and desmosomes and a decrease in leukocytes in the epidermis. The different cell organelles were studied in detail, but the exact mechanism of retinoid action remains unsolved. Although the treatments were clinically highly effective, total normalization of the histological and electron microscopical picture was not achieved.

Animals↗

Ultrahistopathology of balanitis circinata.

Penile lesions from six patients with balanitis circinata were examined with the light and electron microscopes. The epithelium showed slight parakeratosis, acanthosis, and elongation of rete ridges. Neutrophil pustules occupied the upper epidermis. Prickle cells formed a spongiform net around the pustules. The most prominent features detected by the electron microscope were the small-to-medium-sized pustules in the upper epidermis. The thin flattened keratinocytes formed a sponge-like trabecular network. Neutrophils were not found inside the keratinocytes. Chlamydia were not present in the lesions, which indicates that balanitis circinata is due to some reactive mechanism. The fine structure of balanitis circinata resembles that of pustular psoriasis.

Adult↗

The effect of etretinate on fibronectin in psoriatic skin.

The distribution of fibronectin in psoriatic skin was studied in 6 patients during treatment with oral etretinate using indirect immunofluorescence technique. In untreated lesions fibronectin was clearly visualized in the dermo-epidermal junction (DEJ) and in the walls of papillary capillaries, and showed a reticular or fibrillar pattern in the dermis. In the horny layer there was some fluorescence which we regarded largely as unspecific. In all patients a transient accentuation of fibronectin accumulation in DEJ was seen after 3-7 days of treatment. Except for some decrease in the amount and intensity of capillary fluorescence, no other notable changes occurred in the fibronectin distribution during 4 weeks of treatment.

Adult↗

A clinical evaluation of the effects of an aromatic retinoid (Tigason), combination of retinoid and PUVA, and PUVA alone in severe psoriasis.

Eighty ambulatory adult patients with severe psoriasis were included in our 14-week study to compare the clinical effects of treatment with an aromatic retinoid (Tigason), combination treatment with aromatic retinoid plus PUVA (RePUVA), and PUVA alone. RePUVA was given by two different modifications: either 4 weeks of pretreatment with retinoid followed by 6 weeks of PUVA treatment, or 10 weeks of retinoid treatment with concomitant PUVA treatment during the last 6 weeks. The latter modification of RePUVA proved to be significantly more effective than the other treatments (P less than 0.01) as regards complete remission. With respect to the number of patients with good or excellent improvement (75-100% improvement) there was no marked difference between RePUVA and PUVA treatments. Retinoid alone proved to be the least effective, showing, however, a good to excellent result in 65% of patients. Besides the increase in efficacy, another advantage achieved by RePUVA was a highly significant (P less than 0.001) reduction of total UVA doses to about one third as compared to PUVA therapy.

Adult↗

Reduction of increased polyamine levels in psoriatic lesions by retinoid and PUVA treatments.

Treatment with an oral aromatic retinoid (etretinate) and with PUVA significantly reduced the elevated levels of putrescine, spermidine and spermine in psoriatic lesions. Both treatments also significantly reduced the spermidine/spermine ratio, which is considered to be an indicator of proliferation activity. Although both regimens produced a roughly parallel reduction of epidermal polyamines the initial fall of putrescine was much more rapid in patients receiving retinoid. This may indicate that one of the primary targets of retinoids could be ornithine decarboxylase.

Adult↗

Vitamin A transport complex during treatment with an oral aromatic retinoid (RO 10-9359).

No significant changes were noted in the serum levels or molar ratios of vitamin A, retinol-binding protein (RBP) and prealbumin even during long-term (up to 15 months) treatment with RO 10-9359 in 19 patients with normal renal function. Nor did any significant alteration occur in the highly significant correlations between vitamin A and RBP, and between RBP and prealbumin. In 3 patients with slightly elevated serum creatinine, some tendency towards an elevation of vitamin A and RBP levels was seen.

Adult↗

One-week treatment of chlamydia-positive urethritis with doxycycline and tetracycline chloride in males.

65 patients with chlamydia-positive urethritis were treated with doxycycline and 59 with tetracycline chloride 1 g/day for one week. All steady sexual partners of these patients were treated with the same regimen during the same period. At control visits 2 and 3 weeks after the beginning of the treatment, all re-examined doxycycline-treated patients and all except 4 tetracycline-treated patients showed clinical cure and were free from signs of urethritis in the microscopical examination of Gram-stained smears from the urethra. Isolation of C. trachomatis was positive in 7 of the doxycycline-treated and 10 of the tetracycline-treated patients at the first control visit and in one more tetracycline-treated patient at the second control visit. The study stresses the importance of attempts to isolate C. trachomatis in cases without clinical or microscopical evidence of nongonococcal urethritis at control visits after short-term treatment with tetracyclines. The present investigation indicates that this is true also in cases in which all steady sexual partners are treated simultaneously.

Adult↗

Fine structure of the intercellular space of psoriatic epidermis during retinoid (RO 10-9359) and retinoid-PUVA treatment.

The enlarged intercellular space in the lower malpighian layers of untreated psoriasis contains a fine granular and a coarse granular substance. Both types of this substance increase in amount during 2-6 weeks of retinoid (RO 10-9359) therapy. Retinoid stimulates the formation of these substances, which previously have been termed "mucus". After glutaraldehyde-osmium tetroxide fixation their mucoid nature cannot be ascertained more specific cytochemical techniques being needed for this. A darker, more homogeneous substance in the upper spinous intercellular spaces increases in amount during retinoid therapy. Large amounts of keratinosome-derived lamellae are observed at the boundary of the stratum intermedium and the stratum corneum. Even after 14 weeks of treatment with retinoid or retinoid plus PUVA, at clinical remission, the histological and electron microscopical pictures still show some psoriatic changes, i.e. enlarged intercellular spaces with fine or coarse granular substance.

Adult↗

Treatment of Darier's disease with an oral aromatic retinoid (Ro 10-9359): a clinical and light and electron microscopic study.

An aromatic retinoid (Ro 10-9359) cleared 6 of 8 patients with Darier's disease in 4-6 weeks. After discontinuing the treatment, remission was maintained for up to 5 months. In 2 severe cases continuous treatment proved necessary in order to maintain the improved state. Acantholysis, various types of dyskeratosis and acanthosis with downward proliferation of rete ridges were seen by light microscopy before treatment. Electron microscopy revealed a decreased number of desmosomes and other cellular attachments and conspicuous microvillous changes of cell surface in separated basal cells. Keratinization in epidermal cells was premature and characterized by abnormal aggregations of keratinization products. Under the influence of retinoid there seemed to appear a new generation of basal cells better able to form intercellular attachments, after which the progress of keratinization in the entire epidermis shifted towards normal, and acanthosis decreased.

Administration, Oral↗

Treatment of pityriasis rubra pilaris with an oral aromatic retinoid (RO 10--9359).

A patient with widespread PRP was first treated with an oral aromatic retinoid (RO 10--9359) and PUVA in successive periods. Retinoid treatment resulted in marked improvement but during PUVA treatment the disease became re-activated. The patient was finally treated with aromatic retinoid alone, which brought the disease to remission in 6 weeks.

Administration, Oral↗

Photochemotherapy.

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Clinical Trials as Topic↗