Biomedical subjects
Publications and source records attributed to P Fritsch.
A tan induced by 8-methoxypsoralen-long wave ultraviolet light has proved an effective photoprotective sunscreen in 5 patients with long wave ultraviolet light-induced polymorphic light eruption.
This study describes a family of 30 people in which 14 members have hereditary epidermolytic palmoplantar keratoderma. Four patients were treated with an oral aromatic retinoid for up to 5 months. They responded in a uniform and dramatic way: 10-14 days after the onset of therapy, the hyperkeratotic horny layer was sequestered in large sheets resulting in normal appearing skin and restoration of normal surface sensitivity. Biopsies revealed that the underlying disorder of keratinization had remained unchanged. Treatment with the retinoid had to be discontinued as the sensitivity and vulnerability restricted normal function of hands and feet.
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Nineteen patients with mycosis fungoides (m.f.), without involvement of lymph nodes and/or internal organs, were treated with oral photochemotherapy (PUVA). After four to five weeks of PUVA therapy (four irradiations/week) complete remission of erythematous and infiltrative plaques occurred; tumorous m.f. lesions also responded to treatment but required longer treatment times. After complete resolution of m.f. lesions the patients were controlled regularly, the observation periods ranging from 6 to 27 months. When recurrences occurred the initial treatment schedule was resumed. Recurrences, more often seen in the tumorous m.f. stage, responded to PUVA equally well as the initial lesions. PUVA therapy of m.f. is thus more effective than conventional UVB-irradiation and less problematic than treatment with cytotoxic agents or ionizing radiation. Present experience indicates that PUVA represents the treatment of choice in early stage m.f.
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A case of contact sensitization to lead is described which presented as an acute bullous contact dermatitis after application of an ointment containing lead oxide (unguentum diachylon Hebra). In patch testing, the patient reacted strongly to lead oxide and lead acetate. Further examination revealed a chronic lead intoxication with neurologic and labyrinthine involvement. As a painter, the patient had had professional contact with the lead paints up to 25 years ago for a period of 30 years. He had never noticed any contact allergies to his working materials.
Experimental PUVA therapy in five different skin diseases showed excellent results in lichen planus and pityriasis lichenoides et varioliformis. Present experience indicates a favourable influence of PUVA also in pityriasis rubra pilaris and in lymphomatoid papulosis. In Darier's disease PUVA leads to acute exacerbation.
Oral aromatic retinoid (Ro 10-9359) in the treatment of a patient with hyperkeratotic Darier's disease yielded excellent results, which could be maintained over a period of 14 months by continuous administration of the drug. No serious side effects occurred which would have necessitated discontinuation of the therapy.
An experimentation of intoxication by stannous chloride has been realized in the rat. Two groups of animals have been fed ad libitum, during six months, with a diet containing respectively 0,4 and 0,8 g of tin (SnCl2) for 100 g of dry food. By gamma radioactivity measurements (with 113Sn used as a tracer), it results that this metal does not practically clear the digestive barrier. All the treated animals are characterized by a ponderal evolution obviously lower than temoins. At the end of treatment, tin entails a significative diminution of hematocrit, hemoglobin and serous iron, particularly at the highest dose studied. The essential impact remains that tin induces a total irritation of gastro-intestinal tract, proved by histological investigations.
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The essential clinical features of staphylococcal scalded skin syndrome (SSSS) and otherforms of toxic epidermal necrolysis (TEN) are contrasted. Whereas TEN is a devastating disease of multiple causes and of high fatality affecting all age groups, SSSS comprises many clinical entitles that occur primarily in early childhood and is caused by certain phage group 2 staphylococci. Because of the high cleavage plane, the barrier is only translently perturbed, and rapid recovery is the rule. Although the early stages of SSSS may resemble other widespread dermatoses clinically, the correct diagnosis is suggested, even prior to frank exfoliation, by the presence of cutaneous tenderness and a positive Nikolski sign. However, rapid bedside confirmation is now possible with exfoliative cytology and frozen sections. Recent availability of in vivo and in vitro animal models of SSSS have advanced the knowledge of the disease: the responsible epidermolytic toxin has been characterized, and the purely extracellular pathogenesis of SSSS has been established. The epidermolytic toxin is strikingly species and tissue specific, attacking only certain keratinizing epithelia of mice, hamsters, monkeys, and man. The lower incidence of SSSS in adults is primarily due to a supreior capacity to metabolize and excrete the toxin, as well as more efficient immune capabilities. The mechanisms of epidermolytic toxin action and the molecular site of action are still the focus of active investigation.
A toxicological, nutritional and histological study of rats on a diet containing 0.5 g of tin (Sn Cl2) per 100 g of dry food for one month has been made. By gamma radioactivity measurements (with 113Sn used as a tracer) it is shown that this metal does not practically clear the digestive barrier. Otherwise the classical coefficients of nitrogen nutrition and the urinary parameters (volume, glucose, pH) are not influenced; but the growth of treated animals is obviously slower than control animals because of their reduced ingestion of food. Moreover after one month of treatment a marked anaemia results since the hematocrit and hemoglobin levels are perceptibly reduced. Lastly the histological investigations give evidence of notable irritation of the total gastrointestinal tract. This study, as that of many authors, raises the question of present permissible levels of tin (up to 250 ppm) in foods.
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An improved bubble method was developed for applying an ultrathin layer of nuclear track emulsion on the surface of cells labeled with I125-MSH. The autoradiographs of I125-MSH binding indicate a nonrandom distribution of receptors on the surface of mouse melanoma cells. It is suggested that MSH receptors are displayed in clusters previous to and independently of their exposure to the hormone.
Binding of beta-melanotropin (betal-melanocyte stimulating hormone) to mouse melanoma cells occurs in a region on the cell surface overlying the Golgi complex. This association was demonstrated by labeling cells with fluorescein isothiocyanate hormone and by locating the Golgi complex with a histochemical test for thiamine pyrophosphatase activity. The biologically active fluorescent hormone appears on the surface and later in vesicles in the malanized cells, as judged by fluorescence microscopy. It is conceivable that internalization of the hormone is instrumental in the process of hormonally induced melanization. Because initial and late events of hormonally induced pigmentation are related to the Golgi complex, it is likely that instructions that follow the attachment of melanotropin to receptors are carried out in a compartmentalized manner.