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Biomedical subjects

J S Weiss

Publications and source records attributed to J S Weiss.

At least 55 records · Page 3Linked to original sources
PubMed1990

Changes in photo-aged human skin following topical application of all-trans retinoic acid.

Although topical applications of retinoids on rodents and humans have been shown to cause epidermal hyperplasia, a detailed study of the influence of retinoids on epidermal differentiation in vivo has not been performed. In order to assess the pharmacologic effects of chronic topical tretinoin application used to improve the appearance of patients with photoaged skin, cutaneous biopsies from 25 patients in a controlled clinical study were examined histologically and immunocytochemically. Chronic application of tretinoin causes epidermal thickening (25 of 25 samples), stratum granulosum thickening (15 of 25), parakeratosis (13 of 25), a marked increase in the number of cell layers expressing epidermal transglutaminase (13 of 25), and focal expression of two keratins, K6 (12 of 25) and K13 (8 of 25), not normally expressed in the epidermis. The morphologic changes correlated with immunohistochemical abnormalities; neither of these correlated with the subjective cosmetic response. Three major epidermal differentiation products, keratins K1, K10, and K14 were not altered, within the limits of the methods used. Thus, chronic topical tretinoin reprograms some, but not all, aspects of human epidermal differentiation in vivo.

Administration, Topical↗
PubMed1990

Clinical features of photodamage and treatment with topical tretinoin.

Photodamage constitutes a skin disease that merits therapy. Immediate cosmetic improvement of photodamaged skin can be achieved most dramatically by surgical means. Medical intervention has been limited until the recent advent of topical retinoic acid products for photoaging. These medications have been shown to enhance cosmesis and to produce long-lasting physiologic changes. The clinical features of photodamage and treatment with topical tretinoin are discussed.

Administration, Cutaneous↗
PubMed1990

Immunofluorescent characteristics of the diabetic cornea.

In view of the increasing awareness of corneal abnormalities in diabetes, five diabetic and five nondiabetic post-mortem corneas were investigated. Indirect fluorescent antibody techniques were used for the detection of immunoglobulin, complement components, fibrinogen, and fibronectin, as some of these had already been found in the kidney, pancreas, and skin of diabetic patients. There was no obvious difference in the deposition of IgG, IgA, IgM, fibrinogen, or fibronectin between diabetic and control corneal specimens. Five diabetic specimens versus three control specimens demonstrated positive staining at 1:50 dilution for complement components Clq, C3, and C4. This staining was primarily present in the epithelium. Of greater interest was the finding that complement components were present in the basement membrane of two diabetic patients, but were not found in nondiabetic patients. In conclusion, diabetic corneas demonstrate unusual staining for complement components in the epithelial basement membrane.

Adult↗
PubMed1990

Tretinoin therapy: practical aspects of evaluation and treatment.

Tretinoin has previously been used for the treatment of acne. Recent studies, however, demonstrating the efficacy of topical tretinoin in the treatment of photodamaged skin have led to its widespread use for this entirely new indication. When prescribing tretinoin for photodamaged skin rather than acne, physicians must take into consideration a new set of issues. Patients must be selected based on their commitment to a total sun-avoidance regimen. Evaluation of photodamage must be careful and thorough prior to initiating topical tretinoin therapy. Global assessment of a patient's photodamaged skin should be made before therapy and at all follow-up visits. The patient population treated for photodamage tends to be older than that using topical tretinoin for acne; therefore, the treatment regimen must account for the different clinical and physiological characteristics of older patients' skin.

Humans↗
PubMed1989

Topical tretinoin therapy: its use in photoaged skin.

Tretinoin cream has been used extensively to reverse the changes of photoaging. It is the first topical therapy to undergo controlled clinical testing and proved to be efficacious. These results have been substantiated with photography, histopathologic examination, and skin surface replicas. The mechanism of action of retinoic acid is unknown, but it may bind to a specific receptor that alters the gene expression of the cell. Therapy is most successful when a liberal amount of tretinoin 0.1% cream is applied to the skin daily. Tretinoin cream has an excellent safety record; a local cutaneous hypervitaminosis A reaction is the only common problem.

Administration, Topical↗
PubMed1989

Topical tretinoin and photoaged skin.

Topical tretinoin has been proposed for the treatment of photoaged skin in recent years. In both open and double-blind trials, it has been successful in reversing some of the histologically and clinically apparent changes of photoaging. Many patients will experience a dermatitis due to retinoids during therapy, but are usually able to tolerate the treatment. Although clinical improvement may be modest, most patients are pleased with the result. We have found that optimal improvement is achieved by using tretinoin 0.1 percent cream to the limit of tolerance. By carefully instructing the patient on the application of the medication, the occurrence of initial dermatitis with therapy, and the type of improvement to expect, compliance with and tolerance of tretinoin therapy are greatly enhanced.

Administration, Topical↗
PubMed1988

Optic neuropathy in chronic lymphocytic leukemia.

Ophthalmic and neurologic involvement in chronic lymphocytic leukemia is uncommon, and if it does occur, it is usually only late in the course of the disease. We report three cases in which progressive visual loss from optic nerve infiltration was an early clinical manifestation of chronic lymphocytic leukemia. Progressive optic atrophy with loss of acuity and visual field occurred in all cases, preceded in one patient by transient visual obscurations and disc edema. Surface marker studies of cerebrospinal fluid lymphocytes were useful in differentiating leukemic optic nerve infiltration from other causes of optic nerve damage. Optic nerve irradiation gave considerable clinical improvement in all three cases.

Aged↗
PubMed1988

Low heart rate variability and sudden cardiac death.

Our results indicate the following. 1. HRV is markedly depressed in inducible SCD survivors, a group at high risk of a subsequent episode of SCD. 2. Studies on patients who developed SCD during Holter monitoring indicate that HRV is depressed prior to SCD. 3. HRV is markedly depressed in inducible "asymptomatic ventricular ectopy" patients, with the degree of reduction paralleling that observed in inducible SCD survivors. In contrast, HRV of noninducible "asymptomatic ventricular ectopy" patients did not differ statistically from normal. 4. The findings provide additional evidence that cardiac parasympathetic function is depressed in patients prone to development of SCD and that altered autonomic function contributes to the development of electrical instability in such individuals. This accords with findings that such risk factors for sudden death as coronary artery disease, myocardial infarction, congestive failure, and hypertension all have been associated with reduced parasympathetic activity or attenuation of parasympathetically mediated reflexes. It is tempting to believe that diminished cardiac parasympathetic activity, perhaps by failing to counter excess sympathetic activity, contributes to SCD. 5. It may be inferred that HRV measurements have potential for serving as an independent predictor of inducibility in response to programmed ventricular stimulation and that they could represent a noninvasive screen for patients referred for evaluation of risk of SCD because of asymptomatic ventricular ectopy or other causes. In a larger sense, the data suggest that HRV measurements may provide information pertinent to the identification of individuals at increased risk of SCD that is independent of that provided by other risk factors. Given the human and economic stakes, further study is clearly warranted.

Death, Sudden↗
PubMed1988

Topical tretinoin in the treatment of aging skin.

We review the use of topical tretinoin (all-trans-retinoic acid) in the treatment of aging skin. We have found topical tretinoin capable of improving aged-appearing skin in both a double-blind, vehicle-controlled trial and our clinic patients. The most impressive improvement occurs after application of tretinoin 0.1% cream for 8 to 12 months. Side effects have been limited to a mild, transient, and clinically insignificant burning sensation in the eyes and mild irritation of tretinoin-exposed skin.

Administration, Topical↗
PubMed1988

Melanophages in inflammatory skin disease demonstrate the surface phenotype of OKM5+ antigen-presenting cells and activated macrophages.

Previous studies in our laboratory revealed that ultraviolet light induces the appearance of epidermal melanophages that have potent antigen-presenting ability, that can activate autoreactive T cells, and that exhibit the immunophenotype OKM5+, OKM1-, T6-, and DR+. Therefore we undertook immunophenotyping of melanophages in selected inflammatory mucocutaneous lesions to determine whether the OKM5+, OKM1- phenotype was limited to ultraviolet-induced inflammation or whether the occurrence of melanophages expressing this antigen-presenting cell phenotype was a more generalized phenomenon. Ten of the eleven patients with chronic inflammatory skin lesions demonstrated melanophages expressing the OKM5+, OKM1-, T6-, DR+ immunophenotype. In addition, they often expressed Mo3e, a marker of activated macrophages. In contrast, melanophages of a patient with post-inflammatory hyperpigmentation, although DR+, failed to express OKM5. These results are taken to support an active role for OKM5+, OKM1-, T6-, DR+ melanophages in inflammatory skin disease because these cells demonstrate the phenotype of activated inflammation-producing monocytes and potent antigen-presenting cells.

Antibodies, Monoclonal↗
PubMed1988

The usefulness of routine alcian blue staining of corneal specimens.

To determine the diagnostic usefulness of routine staining of corneal buttons with alcian blue, we evaluated 150 consecutive corneal specimens with hematoxylin and eosin and alcian blue stains. Overall, 67% of specimens demonstrated deposition of acid mucopolysaccharide. More specifically, positive alcian blue staining was observed in 88% of specimens with pannus, 83% of specimens with stromal downgrowth, 71% of specimens with stromal scarring, and 67% of specimens with interstitial keratitis. In 80% of these cases, the positive alcian blue stain correlated to pathology noted on hematoxylin and eosin sections. In 20% of cases, we could not explain the reason for the presence of alcian blue staining. Except for macular dystrophy of the cornea, the presence, strength, and location of staining did not provide useful information in terms of making a specific clinical diagnosis. Consequently, alcian blue should be used only in those settings in which the pathologist needs to document or confirm the abnormal presence or absence of acid mucopolysaccharide deposition.

Alcian Blue↗
PubMed1987

Heart rate variability and sudden death secondary to coronary artery disease during ambulatory electrocardiographic monitoring.

Data are analyzed from 5 patients who died suddenly during ambulatory electrocardiographic monitoring. Three of the patients were also assessed in terms of 2 recently developed indexes of heart rate (HR) variability. One of these, the standard deviation of RR intervals during successive 5-minute segments averaged over 24 hours, has been reported to be a putative index of vagal tone. Comparisons were made with HR variability findings in 20 normal volunteers. Sudden death was due to ventricular tachycardia degenerating into ventricular fibrillation in all cases. Both early (3 patients) and late cycle (2 patients) ventricular premature complexes initiated the terminal dysrhythmia. An increased density of ventricular ectopic activity was noted in the hour before onset of ventricular fibrillation. HR variability as measured by the standard deviation was significantly (p less than 0.01) lower in the patients who died suddenly (30 +/- 10 ms) than in the normal subjects (76 +/- 14 ms). These findings support suggestions that HR variability analysis may be useful in identifying patients at a higher risk of sudden death.

Aged↗
PubMed1987

Specular microscopy in aniridia.

Aniridia and the iridocorneal endothelial (ICE) syndromes both are conditions which include abnormalities of the cornea, iris, and progressive iridocorneal adhesions which may result in glaucoma. In order to investigate the similarities between aniridia and the ICE syndromes, we performed specular microscopy of the corneal endothelium in nine patients with aniridia. Morphology and density of the corneal endothelium appeared normal for age. We found no evidence of the beaten metal appearance classically seen on specular microscopy in patients with ICE symptoms. This study did not support either an anatomic or pathogenic relationship between aniridia and the ICE syndromes.

Adolescent↗