Correlation between complement-fixing pemphigoid antibody titres and disease activity.
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Biomedical subjects
Publications and source records attributed to S Kurihara.
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Eight cases of seborrheic keratosis (SK) and 7 cases of basal cell epithelioma (BCE) were studied comparatively by complement immunofluorescence using pemphigoid serum which was reactive not only to the basement membrane zone (BMZ) but also to the cell membrane or the intercellular space (CMICS) of basal cells in normal human epidermis. Positive immunofluorescence both at the BMZ and the CMICS of proliferating basaloid cells was observed in all cases of SK, whereas in BCE, immunofluorescence weaker than that in SK was observed only a the BMZ of tumor cell nests. These tumors were also examined by light and electron microscopy, and differences already described in the literature between SK and BCE were confirmed. These findings suggest that antigenic properties of the BMZ of the skin are affected by proliferating epithelial cells and that epithelial cells are involved in the formation of the BMZ.
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The fate of the contracted kidney in long-term hemodialysis patients was examined. Total kidney volume was measured by computer assisted tomography in 96 chronically hemodialyzed patients with chronic renal failure due to chronic glomerulonephritis. The presence of cysts and/or tumor in the renal parenchyma was evaluated. Kidney volume decreased progressively up to 3 years after the start of dialysis. However, after 4 years of dialysis, it then increased in a number of cases. Multiple cysts were found in 43.5% of patients on dialysis for less than 3 years and in 79.3% of patients who had been on dialysis for more than 3 years. They were found in 100% of those whose total kidney volume exceeded 50 ml despite more than 3 years dialysis. Bilateral nephrectomy was performed in 4 cases who had been dialyzed for more than 5 years and all showed acquired cystic disease of the kidney. Three out of 4 resected cases had adenocarcinoma and multiple adenomas in addition to acquired cystic disease of the kidneys. The other had intracystic epithelial hyperplasia. These results suggest that long-term hemodialysis is associated with a very high incidence of acquired cystic disease of the kidney. There is frequent enlargement of the contracted kidney, and a high incidence of renal adenocarcinoma in patients with glomerulonephritis leading to treatment with hemodialysis.
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Using complement immunofluorescence, the capability of complement fixation by bound antibodies in pemphigus lesional skin was compared with circulating intercellular antibodies of complement-fixing type in the same patient. Five lesional skin samples from 6 patients, containing bound IgG, gave positive binding of complement (C3) supplied from fresh guinea pig serum, while only one serum sample showed complement-fixing pemphigus antibodies in the circulation. These results support the view that complement-fixing pemphigus antibodies are rapidly localized to the skin and play a role on the production of acantholysis.
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Serum levels of carcinoembryonic antigen (CEA) were measured by a radioimmunoassay technique. The mean CEA level for 80 controls was 2.03 ng/ml with a standard deviation of 0.49 ng/ml. Hence, the upper limit of normal for serum CEA levels was considered to be 3.01 ng/ml, ie, two standard deviations above the mean. Serum CEA levels were measured in 86 patients with cervical squamous cell carcinoma, Stages 0 through IV. Thirty-five of the 74 patients with invasive cervical carcinoma were CEA-positive (serum levels above normal); patients with cervical dysplasia or carcinoma in situ were all CEA-negative. Study of the distribution of these patients together with the extent of their disease leads to the following conclusions: a) determination of serum CEA levels cannot serve as a test for the early diagnosis of cervical cancer or precancerous lesions; b) in patients with clinical Stage I or II cervical cancer, an elevated serum CEA level indicates a greater likelihood of parametrial invasion or lymph node metastasis; c) in patients with treated carcinoma of the cervix, continued normal levels of serum CEA affirm continued absence of the disease, whereas development of an elevated level is highly suspicious of occult residual or recurrent cancer. The authors urge periodic determinations of serum CEA levels in patients with treated cervical cancer.
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