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Specific extraction of antigen in vivo by extracorporeal circulation over antibody immobilized in collodion-charcoal.

A novel extracorporeal immunoadsorbent is described in which anti-bovine serum albumin (anti-BSA) was entrapped in collodion membranes adherent to activated charcoal particles. This immunoadsorbent was capable of specifically removing circulating BSA in vitro and in vivo in an extracorporeal system in dogs. In preparation of the immunoadsorbent, up to 81.2% of added anti-BSA was retained on collodion-charcoal. In vitro circulation studies demonstrated that anti-BSA collodion-charcoal removed 812% more 125I-BSA than control colloidon-charcoal. For in vivo studies, an extracorporeal circulation system was established and arterial blood was passaged through a continuous flow celltrifuge wherein plasma which was separated from formed elements of the blood was circulated over anti-BSA and control rabbit gamma-globulin collodion-charcoal. 125I-BSA was passively infused into mongrel dogs, and plasma was then circulated over extracorpeal immunoadsorbents for 2 hr. Results showed up to 896% greater uptake of circulating 125I-BSA on the charcoal containing immobilized anti-BSA compared to control charcoal. There was no evidence of release of anti-BSA from the immunoadsorbent since 125I-anti-BSA cpm on the charcoal before and after the experiments were unchanged. In addition, there were no significant alterations in hematocrit, leukocyte counts, serum sodium, potassium, calcium, magnesium, or creatinine levels before and after in vivo procedures. These data suggest that this immunoadsorbent consisting of anti-BSA immobilized in collodion membranes adherent to charcoal particles may specifically withdraw circulating antigens in vivo with minimal release of entrapped antibodies and no significant alteration in the host hematologic and biochemical status.

Animals

Specific removal of antibody by extracorporeal circulation over antigen immobilized in collodion-charcoal.

Studies were undertaken to determine whether BSA immobilized in collodion membranes adherent to activated charcoal particles, would be capable of specifically removing circulating BSA antibody in vitro and in vivo in an extracorporeal system in dogs. Up to 59-8 mg of BSA were retained in collodion membranes adherent to small particles. In vitro studies demonstrated that immobilized BSA could specifically reduce BSA binding activity from circulating antisera. For in vivo studies, an extracorporeal circulation system was established and arterial blood was circualted through a continuous flow celltrifuge in which plasma was separated from formed elements of the blood. Only plasma was circulated over the BSA collodion-charcoal immunoadsorbent. Anti-BSA and anti-HSA atibodies were passively infused into dogs and, after an equlibration period of 12 or 15 min, plasma was passed over the BSA collodion-charcoal immunoadsorben. Plasma exhibited a sharp reduction in BSA binding over the next 30-60 min with only slight reduction in anti-HSA binding the same period. Dogs, actively immunized to BSA and HSA, were also treated by extracorporeal plasma perfusion over BSA collodion-charcoal. A specific decline in BSA binding of sera, was again observed with minimal changes in HSA binding. A post-perfusion rebound of BSA binding was observed which reached pre-perfusion levels after 6-8 days. A second treatment during the rebound period also resulted in a specific decline in BSA binding with a similar pattern of antibody rebound. There were no significant changes in I-labelled BSA recorded on the charcoal before and after in vivo procedures and no signifcant alterations in haematocrit, serum sodium, potassium, calcium, magnesium or creatinine levels before and after the procedures. These data suggests that antigen-coated charcoal may specifically withdraw circulating antibodies in vivo with minimal release of the entrapped antigen and little alteration in the host's haematological and biochemical status.

Animals

Self-healing collodion baby: evidence for autosomal recessive inheritance.

Five spontaneously healing collodion babies were recorded in a large Swiss kindred. They all had consanguineous parents. Their distribution in the family indicates autosomal recessive inheritance. At birth they had the typical features of collodion babies. The collodion-like membrane was shed within the first month, leaving a slightly scaly skin for a few weeks. Thereafter the skin remained normal without any evidence of a disorder of cornification.

Child

Collodion baby.

The study of 198 collodion babies, 29 personal cases and 169 from the literature was undertaken. The collodion membrane with spontaneously desquamate between the 15th day and 3rd month of life. During the neonatal period one third of the infants die due to pulmonary complications or infection. The collodion membrane seems to have an increased permeability. The desquamation is followed by a relapse which leads to different keratinization disorders, most frequently nonbullous congenital ichthyosiform erythroderma.

Humans

[Collodion baby. Clinical course based on 29 cases].

Study of 29 cases of collodion baby and 169 cases previously published led to several conclusions. In the short-term, the child is threatened by pulmonary infections. The increased skin permeability may result in the loss of water or intoxication by cutaneous absorption of a substance applied to the skin. In the long-term the condition progresses to one of a congenital disturbances in keratinisation. In 2/3 of cases, the problem is that of congenital non-bullous ichthyosiform erythrodermia. Profression to lamellar ichthyosis, ichthyosis vulgaris, circumflex linear ichthyosos and Conradi's syndrome is established. Ichthyosis related to sex in our cases did not seem to be a feature of the collodion baby, the opinion in the literature being divergent. Congenital bullous ichthyosiform erythrodermia never begins as collodion baby syndrome.

Adolescent

Collodion as a safe, cost-effective dressing for central venous catheters.

Catheter-related sepsis continues to be a major problem with the use of central venous catheters. Controversy exists with respect to dressing material and frequency of dressing changes. Collodion is a solution of pyroxylin in a solution of 75% ether and 25% alcohol. Camphor and castor oil are added to create a flexible noncontracting dressing when applied to the skin. We retrospectively reviewed the charts of 34 patients requiring central venous catheters between 1986 and 1988. All catheters were placed via the subclavian approach. Collodion was used as a dressing on all patients. Dressings were not routinely changed. The catheters remained in position an average of 16.5 days. No insertion site became infected; one episode of catheter-related sepsis occurred, and two catheters were inadvertently dislodged. The overall incidence of catheter-related sepsis was 2.9%.

Bacterial Infections

Ingrown toenail treated with cotton collodion insert.

Separating the distal anterior tip and lateral edges of an ingrown toenail from the adjacent soft tissue with a wisp of absorbent cotton coated with collodion gives immediate relief of pain and provides a firm runway for further growth of the nail. The collodion coating fixes the cotton in place, waterproofs, and permits bathing. This simple office method was successfully used on 86 private patients. It is not applicable in patients with infected acute paronychia.

Collodion

Allergic contact dermatitis to colophony included in the formulation of flexible collodion BP, the vehicle of a salicylic and lactic acid wart paint.

The authors describe two cases of allergic contact dermatitis to colophony included in the formulation of flexible collodion BP, the vehicle of a wart paint. Patch and repeated open application tests confirmed absence of contact allergy to other constituents. The patients were known to be allergic to various adhesive plasters. The use of flexible collodion USP, which does not contain colophony, is highly advisable whenever possible.

Adult

The keratinization disorder in collodion babies evolving into lamellar ichthyosis. Its possible relevance for determining the primary defect in lamellar ichthyosis.

Two collodion baby girls with disorder evolving into lamellar ichthyosis were followed by light and electron microscopy. Light microscopically, the neonatal colloidion skin was characterized by a thick compact stratum corneum which was PAS positive in its upper two thirds, by a thin stratum granulosum and by a non-acanthotic stratum spinosum with normal mitotic activity. Electron microscopically, the upper stratum corneum appeared pathological, whereas the lower part was normal except for some minor parakeratosis. The main alterations in the underlying stratum granulosum were diminished tonofibrils and keratohyalin. Biopsy specimens taken at the age of 2 weeks were typical for lamellar ichthyosis and showed hyperkeratosis with focal parakeratosis, a thickened stratum granulosum in which the cellular content of keratohyalin and tonofibrils was moderately diminished, and acanthosis with increased mitotic activity. It appears that the ultrastructural changes of the stratum granulosum, seen in lamellar ichthyosis, are already present in the collodion skin of the newborn, at a time when the epidermis does not yet show an increase in mitotic activity.

Female

[Collodion baby with transition to mild lamellar ichthyosis.Clinical course, histopathology and ultrastructural findings].

The case of a collodion baby in whom the condition evolved into a mild form of lamellar ichthyosis is presented. The clinical course was impressive: the hard, collodion-like horny membrane started to crack soon after the birth and had detached completely at the 9th day of life; after a few more days, almost complete clearing of the skin had occurred. At the age of 10 months, the child had only a very mild lamellar ichthyosis. Whereas light microscopy revealed only compact hyperkeratosis on the 1st day of life, electron microscopy suggested a favourable prognosis even at this early stage, which has been corroborated by the ensuing clinical course.

Dermatologic Agents

[Collodion baby. Apropos of a case with eye manifestations].

We report a case of a male collodion baby, born at term of a consanguineous couple of Afghan origin. The new-born baby displayed a pseudo-dysmorphic syndrome predominant of the face, with a marked ectropion of the upper and lower eye-lids and chemosis, without corneal involvement. The condition improved with time but complete regression was not obtained. Collodion baby syndrome is a pathologic skin condition observable during the neonatal period. Long term evolution is towards ichthyosis in 90% of cases, and resolution in 10%.

Ectropion

Epnzymatric recycling of coenzymes by a multi-enzyme system immobilized within semipermeable collodion microcapsules.

Hexokinase (ATP:D-glucose 6-phosphotransferase EC 2.7.1.2) and pyruvate kinase (ATP:pyruvate 2-0-phosphotransferase EC 2.7.1.40) were co-immobilized within semipermeable collodion microcapsules. The resulting microcapsules displayed excellent hexokinase and pyruvate kinase activities, with the measured pyruvate kinase activity considerably greater than that measured for hexokinase. The co-immobilized enzymes, when used sequentially were capable of recycling both ATP and ADP when exposed to the appropriate conditions. Furthermore, when exposed to limiting amounts of coenzyme, the cycles were capable of reusing the total amount of coenzyme supplied at least three times in 90 min. The use of microencapsulation to produce partially "self sufficient" enzyme systems is discussed.

Adenosine Triphosphate

[Correlation of structural and ultrastructural modifications of the renal cortex with water, sodium and protein excretion in rats rendered hypertensive by perinephritic constriction by collodion].

Water, sodium and proteins renal excretion in with collodion Page's method hypertensive rats is compared with that of same Wistar strained control rats. Blood pressure of treated animals (n = 16) is 193.1 Hg mm (138 in control rats). Urinary flow increases from 19.5 to 33.7 ml/24 h (+ 72.8%), sodium excretion from 29.6 to 37.5 mg/24 h (+ 26.7%) and total proteins excretion from 23.5 to 63 mg/24 h (+ 169%. This data are correlated with the renal cortex morphological changes with photon and electron microscope. Severe damages are seen in Bowman's capsule and in glomerular copruscules, especially at the epithelial layer level. Important proteic pools occur within tubular lumen. Proximal tubular epithelium seems normal. On the other hand, distal tubular epithelium seriously scales. So, important water, sodium and proteins excretion increase in our experimental hypertension model can be explained. It is also discussed about functional and structural modifications analogy in our model's rats and in spontaneously hypertensive rats (SHB).

Blood Pressure

Hypernatremia in two collodion babies.

Two cases of collodion babies with hypernatremia are presented, and the importance of this electrolyte abnormality in skin disorders is also stressed.

Female