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Biomedical subjects

R K Winkelmann

Publications and source records attributed to R K Winkelmann.

At least 307 records · Page 17Linked to original sources
PubMed1978

Migraine and systemic scleroderma.

Scleroderma with typical migraine headaches occurred in 16 well-documented cases observed over a 25-year period. Although the number of cases is within the expected range of coincidence of both diseases, in 13 of the 16 patients the scleroderma developed after 15 years or more of therapy with ergot or methysergide preparations. Eleven of the 13 patients had Raynaud's vasospastic phenomenon as part of their systemic scleroderma. The vascular pathology of scleroderma, Raynaud's phenomenon, and ergotism is similar enough to suggest caution in the administration of these drugs to patients with migraine and extra caution in observing for signs of Raynaud's phenomenon or early vascular scleroderma.

Adult↗
PubMed1978

Langerhans cells in contact dermatitis of the guinea pig.

In the guinea pig, the epidermal Langerhans cells studied by adenosine triphosphatase and electron microscopic techniques in dinitrochlorobenzene-induced contact dermatitis showed early cellular vacuolar and granular changes and intraepidermal contact with mononuclear cells. At later periods of up to 48 hours, the Langerhans cells migrated to the surface of a thickened epidermis and were lost in the parakeratotic horny layer that was shed. Thus, the Langerhans cell probably has a macrophage-type role in the epidermal reaction of contact dermatitis, and as the sponglosis and the inflammatory reaction develop, these cells are shed with the degenerating keratinocytes.

Animals↗
PubMed1978

Concurrent localized scleroderma and discoid lupus erythematosus. Cutaneous 'mixed' or 'overlap' syndrome.

Four patients with concurrent, chronic, progessive, localized scleroderma and discoid lupus erythematosus were studied; the condition originated as linear scleroderma in three of them. Three of the four patients were young females at the onset of the first skin disease. Dermatopathologic study confirmed the scleroderma and lupus erythematosus (LE). Direct immunofluorescence showed a positive band test in three cases. Unusual serological results included a positive LE clot test in three cases, a positive extractable nuclear antigen test in one case, and a negative antinuclear antibody test on repeated occasions in all four cases. Rare cutaneous disease similar to systemic, "mixed," or "overlap" connective tissue disease exists and offers an opportunity to study unusual immunologic and pathological events in both scleroderma and LE.

Adolescent↗
PubMed1977

Atypical fibroxanthoma of the skin: an ultrastructural study of two cases.

The ultrastructure of two atypical" fibroxanthomas of the skin was studied. The first lesion was a spindle cell tumor on light microscopy, which electron microscopy revealed was composed of undifferentiated mesenchymal cells. The second lesion had a highly pheomorphic appearance on both light and electron microscopy. It was formed by atypical histiocytic cells and abundant "typical" Langerhans cells. The second lesion was considered to be a proliferation either of atypical Langerhans cells or of histiocytes related to Langerhans cells. Thus, atypical fibroxanthoma of skin may not be a homogeneous entity but could be a group of mesenchymal proliferative lesion in a similar clinical setting.

Aged↗
PubMed1977

The human cutaneous basement membrane--anchoring fibril complex: preparation and ultrastructure.

The human cutaneous basement membrane (CBM) has been isolated together with the anchoring fibrils (AF) of the dermis. These structures are removed from the dermis as a single complex, the CBM-AF complex. The epidermis is first removed from the dermis by immersion of whole, defatted skin in cold 2 n NaSCN for 5 to 6 hr. Subsequently, removal of the CBM-AF complex is effected by focusing high-intensity ultrasonic energy against the dermal surface. Purification of the preparation is achieved by low-speed sedimentation. All stages of the process were monitored by electron microscopy, which demonstrated that the morphology of the CBM-AF complex was well preserved and that this complex represents the principal mass component in the system. In addition, our report describes an ultrasound-induced variation in collagen fibril morphology, which we have called 'disordered collagen.' This altered type of fibril lacks periodicity or recognizable banding and has a frayed appearance. Finally, the experiments provide the basis for an analysis of the relative strengths of certain bonds at the dermal--epidermal junction. The strongest of these appears to be the bond between basement membrane and anchoring fibril.

Basement Membrane↗
PubMed1977

The Merkel cell system and a comparison between it and the neurosecretory or APUD cell system.

The Merkel cell, a neural crest migrant to the skin, possesses a characteristic intranuclear rodlet, cytoplasmic membrane-bound granules, and horn projections and is usually associated with nerve terminations. It is also associated with all types of known organizations of sensory nerve endings in the skin and possesses characteristic enzyme reactions in relation to the ending. The Merkel cell is found in the skin and the oral mucous membranes, and similar cells are observed in the taste buds and pulmonary tissue. A comparison between the Merkel cell and the APUD cell system of polypeptide hormone and amine-producing cells reveals many structural and chemical similarities.

Animals↗
PubMed1977

Direct immunofluorescence in the diagnosis of scleroderma syndromes.

Immunofluorescent study of the skin of nine patients with mesenchymal, inflammatory scleroderma (mixed connective tissue disease) revealed immunoglobulin and complement deposition at the basement membrane or within blood vessel walls. The skin specimens of ten patients with systemic scleroderma were negative for immunofluorescence. It is proposed that basement membrane or vascular (or both) immunofluorescence is an excellent means of identifying the infrequent patient who has scleroderma and myositis or lupus erythematosus in whom a corticosteroid response may occur.

Adolescent↗
PubMed1977

Granuloma annulare and sarcoidosis.

Granuloma annulare (GA) and sarcoidosis are two diseases of unknown cause which involve the skin and whose basic pathology is a mononuclear histiocytic cellular reaction. Biopsy plays the major role in the diagnosis of both diseases, and no other routine laboratory test for either disease is currently available. Sarcoidosis is generally considered to be an allergic or immune granuloma with inconstant defects in cell-mediated immunity (Broom & MacLaurin, 1973). There have been no immunological studies of GA. We recently studied 14 cases and found circulating lymphokines (macrophage migration inhibition factor) in 11 which correlated with circulating macrophage migration inhibition factor in sarcoidosis (9 of 10 cases) (Umbert, Belcher & Winkelmann, 1976). The co-existence of GA and sarcoidosis in 5 patients suggests to us that there are very similar immunological reactions as well as pathology in both diseases and that the elucidation of the pathogenesis of one disease should aid in understanding the other. To our knowledge, there are no prior reports of systemic sarcoidosis coexisting with or manifesting the histological picture of GA. In this report we have demonstrated by clinical and histological criteria that GA and sarcoidosis can co-exist.

Adult↗
PubMed1977

The Merkel cell in oral human mucosa.

A study of the mucosal Merkel cells from 10 patients showed that the cell contained an intranuclear rodlet, clear cell qualities, fine desmosomes, characteristic membrane-bound Merkel granules, and cellular "horns" and had a close relationship to terminal axons. The Merkel cell is an intraepithelial cell with features of neurons and of amine-storage cells.

Axons↗
PubMed1977

Serum IgE in dermatitis and dermatosis: an analysis of 497 cases.

Serum IgE values from 497 patients with various forms of dermatitis, dermatosis, and tinea pedis were analyzed statistically and compared with values from 95 normal controls. The median and geometric mean values were significantly elevated (except in acne without atopy, lichen planus, and tinea pedis), even after exclusion of patients with a history of atopy or of cutaneous reaction to food or drugs. Serum IgE levels and atopic dermatitis have a close correlation. A modest positive correlation (p approximately equal to .05) appeared between the log serum IgE level and peripheral blood absolute eosinophil count in 80 cases of atopic dermatitis. A unique group of adult nonatopic patients had acquired generalized dermatitis and markedly elevated serum IgE levels (greater than 12,000 ng/ml). Our results suggest that, in most common dermatologic disorders, elevated serum IgE is a secondary phenomenon rather than a primary causative factor.

Acne Vulgaris↗
PubMed1977

Immune complex disease of the skin.

The physician can now recognize clinically and histopathologically the cutaneous manifestations of immune complex disease. The usual clinical environment in which this type of reaction occurs has been very specifically delineated. Studies of immunoglobulins, complement components, and B cells in the blood may confirm the nature of the reaction. Special studies of cryoproteins of C1q precipitin or radioimmunoassay procedures may demonstrate directly the complexes in the blood. Biopsy of skin for immunofluorescence is confirmative of the skin disease and the presence of immune complexes. Biopsy of normal skin may be prognostic and indicate severity of the disease. Lesions may be induced by epinephrine, trauma, and controlled imflammation for clinical and pathologic study and confirmation of diagnosis. Treatment of the disease with corticosteroids, sulfapyridine, nicotinic acid, and antimalarial drugs may be useful. Clofazimine is an intriguing experimental drug. Plasmaphoresis has worked well with some patients.

Antigen-Antibody Complex↗
PubMed1977

[Treatment of inflammatory and proliferative skin diseases].

Treatment of inflammatory and proliferation dermatoses can now be accomplished with pharmacologic agents which inhibit production of mediators or their actions. The immune system can be stimulated by thymosin, imidazo drugs, BCG, corynebacterium parvum and idoxyuridine. Immune complex diseases may be treated with corticosteroids, clofazimine, sulfonamides, antimalarial drugs, and nicotinic acid. Low dose, safe immunosuppressive therapy can successfully control scleromyxedema, guttate parapsoriasis, histiocytosis X, Kaposi's sarcoma, and Sézary syndrome.

Adrenal Cortex Hormones↗
PubMed1977

Cutaneous manifestations of Wegener granulomatosis.

In a series of 19 patients (15 male and 4 female) who had Wegener granulomatosis with specific cutaneous histopathologic findings, the skin was only involved at onset in two. Four distinct histologic subgroups were defined as follows: necrotizing vasculitis (11 patients); necrotizing palisading granuloma (Churg-Strauss lesion) 2 patients); granulomatous vasculitis (2 patients); and lymphomatoid granulomatosis (4 patients). The 11 patients with necrotizing vasculitis had purpuric and hemorrhagic lesions, and the presence of vesicles and ulceration correlated with the severity of onset and extent of disease. The remaining eight patients had papular and nodular lesions. The patients with necrotizing vasculitis and lymphomatoid granulomatosis had a worse prognosis that did those with a predominant granulomatous reaction.

Adolescent↗
PubMed1977

Malignant melanoma in the resident population of Rochester, Minnesota.

The incidence of malignant melanoma in the population of Rochester, Minnesota, was studied through use of the countywide diagnostic indexing system at the Mayo Clinic. The average annual incidence of cutaneous melanoma (4.0/100,000 creude, 4.2 adjusted to the age structure of the US 1950 population) was similar to that reported by the Third National Cancer Survey for 1969 through 1971 for locations in the United States at the approximate latitude of Rochester. Unlike reports from other studies, no change in incidence rate during the 25 years 1950 through 1974 was detjected in Rochester. The crude annual incidence of malignant melanoma of the eye, also determined for the same period, was 1.3/100,000.

Age Factors↗