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J Ring

Publications and source records attributed to J Ring.

At least 127 records · Page 7Linked to original sources
PubMed2001

Adverse reactions to foods.

Allergic reactions to foods represent a prominent, actual and increasing problem in clinical medicine. Symptoms of food allergy comprise skin reactions (urticaria, angioedema, eczema) respiratory (bronchoconstriction, rhinitis), gastrointestinal (cramping, diarrhea) and cardiovascular symptoms with the maximal manifestation of anaphylactic shock. They can be elicited by minute amounts of allergens. The diagnosis of food allergy is done by history, skin test, in vitro allergy diagnosis and--if necessary--oral provocation tests, if possible placebo-controlled. Avoidance of respective allergens for the allergic patient, however, is often complicated or impossible due to deficits in declaration regulations in many countries. Increasing numbers of cases including fatalities, due to inadvertent intake of food allergens are reported. It is therefore necessary to improve declaration laws and develop methods for allergen detection in foods. Allergens can be detected by serological methods (enzyme immunoassays, in vitro basophil histamine release or in vivo skin test procedures in sensitized individuals). The problem of diagnosis of food allergy is further complicated by cross-reactivity between allergens in foods and aeroallergens (pollen, animal epithelia, latex etc.). Elicitors of pseudo-allergic reactions with similar clinical symptomatology comprise low-molecular-mass chemicals (preservatives, colorings, flavor substances etc.). For some of them (e.g. sulfites) detection assays are available. In some patients classic allergic contact eczema can be elicited systemically after oral intake of low-molecular-mass contact allergens such as nickel sulfate or flavorings such as vanillin in foods. The role of xenobiotic components in foods (e.g. pesticides) is not known at the moment. In order to improve the situation of the food allergic patient, research programs to elucidate the pathophysiology and improve allergen detection strategies have to be implemented together with reinforced declaration regulations on a quantitative basis.

Food Hypersensitivity↗
PubMed2001

[Allergy research: news in epidemiology, diagnosis and therapy. What applies to general practice?].

In the last few decades, the prevalence of allergic diseases has increased appreciably--for reasons that have not yet been identified. Currently research is concentrated on genetic basics, on the role of cytokines, T-helper and suppressor cells in the allergic sensitization process, and on the involvement of enzymes and chemokines in the triggering of an allergic reaction in the sensitized organism. New information provided by the results of research of relevance for the doctor's office concern the diagnosis of allergies, the avoidance of allergens, and prevention and immunotherapy. Today, improved methods of detecting IgE are available, and the atopy patch test has been shown to be superior to the prick and radio-allergo-sorbent tests. The measurement of allergens with strip tests in the domestic setting of the patient has improved the chances of avoiding allergen contact and prevention. Therapeutic innovations are to be found in particular in climatotherapy, the development of new antihistaminic agents as well as new allergen extracts and adjuvants for specific hyposensitization. In addition, initial results obtained with monoclonal IgE antibodies and an interleukin-4 receptor antagonist are very promising.

Adult↗
PubMed2001

[Properly classifying skin changes. Exanthema--what is what?].

Exanthema is characterized by extensive generalized eruptions of the skin and mucosa that show a typical temporal spread. Potential noxae include medications, foodstuffs, infections (viral, bacterial, mycotic, parasitic), and malignancies, but unexplained causes may also present. A knowledge of the cutaneous changes may contribute decisively to ensuring that specific diagnostic and therapeutic measures are initiated without delay.

Adult↗
PubMed2001

[Symptomatic therapy of exanthema. Finding the proper externum].

In the treatment of exanthems, the first step is the elimination of the causal agent. Of great importance also is the symptomatic treatment of the cutaneous changes and such associated symptoms as itching and pain. The choice of the appropriate external medication and its vehicle will depend on the clinical findings, skin type, and the location of the skin lesions. The most important therapeutic principles are discussed taking drug-induced exanthema, acute urticaria and (herpes) zoster as examples.

Adult↗
PubMed2001

The interaction of human peripheral blood eosinophils with bacterial lipopolysaccharide is CD14 dependent.

Bacterial lipopolysaccharide (LPS, endotoxin) is a ubiquitous component of dust and air pollution and is suspected to contribute after inhalation to an activation of eosinophils in bronchial tissues of asthmatic patients, provoking inflammatory and allergic processes. We were therefore interested in the interaction of eosinophil granulocytes with LPS and have examined the activation of and uptake to human peripheral blood eosinophils by LPS. Eosinophils were stimulated by LPS and the endotoxic component lipid A and the release of tumor necrosis factor alpha (TNF-alpha) and of the eosinophil-specific granule protein eosinophil cationic protein (ECP) was estimated. The results show induction of TNF-alpha and ECP-release by LPS and lipid A in a dose-dependent manner. Anti-CD14 monoclonal antibody (moAb) (clone MEM-18) and the synthetic lipid A partial structure 406 blocked the release of TNF-alpha and ECP by LPS-stimulated eosinophils. Studies with radioactively labeled LPS showed dose-dependent uptake of (3)H-LPS to eosinophils. The (3)H-LPS uptake was found to be specific because preincubation with unlabeled LPS, compound 406 and also anti-CD14 antibodies inhibited uptake of (3)H-LPS to eosinophil granulocytes. By flow cytometry using anti-CD14 moAb and by reverse transcriptase-polymerase chain reaction (RT-PCR) technique, CD14 expression was detectable. Furthermore, messenger RNA (mRNA) expression of Toll-like receptors (TLR) 2 and TLR 4 was detected, indicating the presence of these CD14 coreceptors. The results indicate that eosinophils can take up LPS and can be stimulated by LPS in a CD14-dependent manner. Hence, in addition to allergens, eosinophils interact with endotoxin, a process that possibly exacerbates ongoing inflammatory and allergic processes.

Antibodies, Monoclonal↗
PubMed2001

[Development of the German Scale for Assessing Quality of Life in Skin Diseases].

BACKGROUND AND OBJECTIVE: A German dermatological quality-of-life (QoL) instrument was developed on the basis of a representative and standardised patient population. PATIENTS/METHODS: Qualitative interviews were performed in 633 patients. Based on the answers of 20 patients from each of the 10 most frequent diagnostic groups, items were identified and a questionnaire developed. This was used in 704 patients and eventually the number of items was reduced. RESULTS: The long version of the instrument has 72 items. The median of the total score of the questionnaire was 75 and significantly different between diagnostic groups (herpes/shingles 110, verruca 26; p < 0.001). Significant differences occurred also between questionnaire domains with categories "psychological, physical, and treatment" showing the highest results. In contrast to the total group, patients with urticaria scored highest in dimensions "social, leisure, and work" (p < 0.001). By factor analysis the number of items was reduced to 36. CONCLUSIONS: The DIELH was developed on the basis of a standardised and representative patient population. The long version proved to have a good discriminant validity with respect to diagnostic groups and dimensions.

Activities of Daily Living↗
PubMed2001

[Cylindrospiradenomas in Brooke-Spiegler syndrome].

Brooke-Spiegler syndrome is a rare autosomal-dominant inherited disease, characterized by the development of multiple cylindromas and trichoepitheliomas. We report a case in which tumors were found on the head showing histological features of both cylindromas and spiradenomas. These changes were in continuity within the same lesions. Since cylindromas are thought to be apocrine in nature, whereas spiradenomas are eccrine, a contiguous growth within the same neoplasm indicates a conflict concerning their histogenesis. The available histological, ultrastructural and immunohistochemical studies have not produced any criteria to allow an unequivocal classification, suggesting instead that both tumors arise from similarly differentiated cells, perhaps from pluripotent epithelial cells. In our opinion, it seems impractical to strictly classify cylindromas and spiradenomas into tumors of apocrine or eccrine differentiation. Moreover, at least for those cases of Brooke-Spiegler syndrome, where both tumors are found in immediate vicinity to each other, we propose the term cylindrospiradenoma.

Adenoma↗
PubMed2001

[German instrument for the assessment of quality of life in skin diseases (DIELH). Internal consistency, reliability, convergent and discriminant validity and responsiveness].

BACKGROUND AND OBJECTIVE: Performance and psychometric testing of the German Instrument for the Assessment of Quality of Life in Skin Diseases (DIELH). PATIENTS/METHODS: The instrument consisting of 36 questions (maximum skore 180, 7 domains) was used in 836 outpatients and quality assessments (validity, reliability, responsiveness) were performed. RESULTS: The total skore had a mean of 54 pts. (STD 31, range 0-157) and was normally distributed. Women reported a higher impact on quality of life (median 56 vs. 49, p < 0.001). In terms of discriminant validity significant differences between diagnostic groups were observed with high scorings for patients with eczema, psoriasis, urticaria, and acne (p < 0.001). Tests for internal consistency (Cronbach's alpha 0.71-0.92) and reliability (r = 0.73-0.86) revealed valid results. The DIELH correlated well with the DLQI (r = 0.78, p < 0.001) and moderately with 3 domains of the SF 36 (r = 0.25-0.30, p < 0.01). Changes in the quality of life after 4 weeks were consistent with the corresponding changes of the skin condition and partially significant. CONCLUSIONS: In the use within a large patient sample the DIELH proved to be feasible, valid, reliable, and responsive.

Adolescent↗
PubMed2001

[Skin allergies].

Explore the source record for details and available documents.

Dermatitis, Allergic Contact↗
PubMed2001

Immunohistochemical characterization of the perivascular infiltrate cells in tissues adjacent to stainless steel implants compared with titanium implants.

Metallic orthopaedics implants are composed of elements that are known to be skin sensitizers in the general population. In this study, we analyzed the cells of perivascular infiltration in the tissue adjacent to titanium (n = 23) and steel (n = 8) implants after explantation of the metals by immunohistochemical methods. The following panel of monoclonal antibodies were used as parameters: CD 1a (Langerhans cells), CD 4 (T-helper cells), CD 8 (T-suppressor cells), CD 11c (monocytes and macrophages), CD 45 RO (memory cells), CD 45 RA (naive cells), eosinophil cationic proteins (ECP), neutrophil elastase, and HLA-DR. The number of perivascular total cells did not differ significantly. All cells were identified in both metal subgroups, but a statistical difference was not seen in the above-mentioned parameters. We conclude that sensitization to metals is possible in the tissue adjacent to steel and titanium implants, because all cells which play an important role in allergic delayed-type hypersensitivity (type IV) reactions are present. This phenomenon may be called a 'pre-sensitization' phase, because no sensitization or allergic reactions were seen in our cases. Second, in the present study, a statistical difference was not seen in the number of infiltrate cells in the tissue adjacent to steel compared with titanium implants.

Adult↗
PubMed2001

Influence of weather and climate on subjective symptom intensity in atopic eczema.

The frequent clinical observation that the course of atopic eczema, a skin disease involving a disturbed cutaneous barrier function, is influenced by climate and weather motivated us to analyse these relationships biometrically. In the Swiss high-mountain area of Davos the intensity of itching experienced by patients with atopic eczema was evaluated and compared to 15 single meteorological variables recorded daily during an entire 7-year observation period. By means of univariate analyses and multiple regressions, itch intensity was found to be correlated with some meteorological variables. A clear-cut inverse correlation exists with air temperature (coefficient of correlation: -0.235, P < 0.001), but the effects of water vapour pressure, air pressure and hours of sunshine are less pronounced. The results show that itching in atopic eczema is significantly dependent on meteorological conditions. The data suggest that, in patients with atopic eczema, a certain range of thermo-hygric atmospheric conditions with a balance of heat and water loss on the skin surface is essential for the skin to feel comfortable.

Adolescent↗
PubMed2001

Atopic eczema and allergy.

Although the pathomechanisms of respiratory atopy are well established, the role of IgE-mediated hypersensitivity in the elicitation and maintenance of eczematous skin lesions in atopic eczema (AE) is still controversial. There is, however, evidence for exogenous elicitation of AE by contact with aero- or food allergens (house dust mite, cat, and so forth). Recent investigations show that epidermal Langerhans' cells bind IgE via different receptors, especially the high-affinity receptor (Fc epsilon RI), which is significantly more strongly expressed in lesional skin of AE compared with other inflammatory skin diseases including allergic contact dermatitis. The clinical relevance of IgE-mediated sensitization in AE has been evaluated by the so-called atopy patch test (APT). The APT shows a much higher specificity compared with the skin prick test and radioallergosorbent test. However, allergic reactions do not play a decisive role in every case of AE. Other factors, such as nonspecific skin irritability or psychosomatic interactions, have to be considered. The concept of "extrinsic" versus "intrinsic" types of AE seems attractive. The concept of AE starting with TH2 inflammation, becoming TH1 inflammation in chronicity, and finally progressing to an autoimmune disease with IgE antibodies against autologous epidermal proteins is very attractive. Based on new knowledge, new methods in diagnosis, treatment, and prevention will develop, including more effective avoidance strategies, more potent anti-inflammatory treatment (e.g., immunomodulation or topical immunophyllins), and new ultraviolet modalities. The new findings have given rise to a possible new classification of eczema/dermatitis. The concept of "patient management," including all aspects from avoidance to therapy, has gained acceptance.

Animals↗
PubMed2001

Central activation by histamine-induced itch: analogies to pain processing: a correlational analysis of O-15 H2O positron emission tomography studies.

The aim of this study was to identify the functional cerebral network involved in the central processing of itch and to detect analogies and differences to previously identified cerebral activation patterns triggered by painful noxious stimuli. Repeated positron emission tomography regional cerebral blood flow (rCBF) measurements using O15-labeled water were performed in six healthy right-handed male subjects (mean age 32 +/- 2 years). Each subject underwent 12 sequential rCBF measurements. In all subjects a standardized skin prick test was performed on the right forearm 2 min before each rCBF measurement. For activation, histamine was applied in nine tests in logarithmically increasing concentrations from 0.03 to 8%. Three tests were performed with isotonic saline solution serving as a control condition. Itch intensity and unpleasantness were registered with a visual analogue scale during each test. Subtraction analysis between activation and control conditions as well as correlation analysis with covariates were performed. Itch induced a significant activation in the predominantly contralateral somatosensory cortex and in the ipsilateral and contralateral motor areas (supplementary motor area (SMA), premotor cortex, primary motor cortex). Additional significant activations were found in the prefrontal cortex and the cingulate gyrus, but not in subcortical structures nor in the secondary somatosensory cortex. In correlation analyses, several cortical areas showed a graded increase in rCBF with the logarithm of the histamine concentration (bilateral sensorimotor areas and cingulate cortex; contralateral insula, superior temporal cortex and prefrontal cortex) and with itch unpleasantness (contralateral sensorimotor cortex, prefrontal cortex and posterior insula; ipsilateral SMA). Induction of itch results in the activation of a distributed cerebral network. Itch and pain seem to share common pathways (a medial and a lateral processing pathway and a strong projection to the motor system). In contrast to pain activation studies, no subcortical (i.e. thalamic) activations were detected and correlation analyses suggest differences in subjective processing of the two sensations.

Adult↗