Swelling-activated chloride and potassium conductance in primary cultures of mouse proximal tubules. Implication of KCNE1 protein

Volume-sensitive chloride and potassium currents were studied, using the whole-cell clamp technique, in cultured wild-type mouse proximal convoluted tubule (PCT) epithelial cells and compared with those measured in PCT cells from null mutant kcne1 -/- mice. In wild-type PCT cells in primary culture, a Cl- conductance activated by cell swelling was identified. The initial current exhibited an outwardly rectifying current-voltage (I-V) relationship, whereas steady-state current showed decay at depolarized membrane potentials. The ion selectivity was I- > Br- > Cl- > > gluconate. This conductance was sensitive to 1 mM 4,4'-Diisothiocyanostilbene-2,2'-disulfonic acid (DIDS), 0.1 mM 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB) and 1 mM diphenylamine-2-carboxylate (DPC). Osmotic stress also activated K+ currents. These currents are time-independent, activated at depolarized potentials, and inhibited by 0.5 mM quinidine, 5 mM barium, and 10 microM clofilium but are insensitive to 1 mM tetraethylammonium (TEA), 10 nM charybdotoxin (CTX), and 10 microM 293B. In contrast, the null mutation of kcne1 completely impaired volume-sensitive chloride and potassium currents in PCT. The transitory transfection of kcne1 restores both Cl- and K+ swelling-activated currents, confirming the implication of KCNE1 protein in the cell-volume regulation in PCT cells in primary cultures.

CFTR modulates programmed cell death by decreasing intracellular pH in Chinese hamster lung fibroblasts

To study the potential influence of cystic fibrosis conductance regulator (CFTR) on intracellular pH regulation during apoptosis induction, we used PS120 Chinese hamster lung fibroblasts devoid of the Na(+)/H(+) exchanger (NHE1 isoform) transfected with constructs, allowing the expression of CFTR and/or NHE1. Kinetics of lovastatin-induced apoptosis were measured by orcein staining, double staining with Hoechst-33258, propidium iodide, DNA fragmentation, and annexin V labeling. In PS120 control cells, the percentage of apoptotic cells after 40 h of lovastatin treatment was 23 +/- 3%, whereas in PS120 CFTR-transfected cells, this percentage was 40 +/- 4%. In PS120 NHE1 cells, the transfection with CFTR did not modify the percentage of apoptotic cells after 40 h (control: 19 +/- 3%, n = 8; CFTR: 17 +/- 1%, n = 8), indicating that blocking intracellular acidification by overexpressing the Na(+)/H(+) exchanger inhibited the enhancement of apoptosis induced by CFTR. In all cell lines, the initial pH values were identical (pH = 7.46 +/- 0.04, n = 9), and treatment with lovastatin led to intracellular acidification. However, the pH value after 40 h was lower in PS120 CFTR-transfected cells (pH = 6.85 +/- 0.02, n = 10) than in PS120 cells (pH = 7.15 +/- 0.03, n = 10). To further investigate the origin of this increased intracellular acidification observed in CFTR-transfected cells, the activity of the DIDS-inhibitable Cl(-)/HCO exchanger was studied. 8-Bromoadenosine 3',5'-cyclic monophosphate incubation resulted in Cl(-)/HCO exchanger activation in PS120 CFTR-transfected cells but had no effect on PS120 cells. Together, our results suggest that CFTR can enhance apoptosis in Chinese hamster lung fibroblasts, probably due to the modulation of the Cl(-)/HCO exchanger, resulting in a more efficient intracellular acidification.

Extracellular adenosine modulates a volume-sensitive-like chloride conductance in immortalized rabbit DC1 cells

Cl(-) currents induced by cell swelling were characterized in an immortalized cell line (DC1) derived from rabbit distal bright convoluted tubule by the whole cell patch-clamp techniques and by (125)I(-) efflux experiments. Exposure of cells to a hypotonic shock induced outwardly rectifying Cl(-) currents that could be blocked by 0.1 mM 5-nitro-2-(3-phenylpropyl-amino)benzoic acid, 1 mM DIDS, and by 1 mM diphenylamine-2-carboxylate. (125)I(-) efflux experiments showed that exposure of the monolayer to a hypotonic medium increased (125)I(-) loss. Preincubation of cells with LaCl(3) or GdCl(3) prevented the development of the response. The addition of 10 microM adenosine to the bath medium activated outwardly rectifying whole cell currents similar to those recorded after hypotonic shock. This conductance was inhibited by the A(1)-receptor antagonist 8-cyclopentyl-1,3-diproxylxanthine (DPCPX), LaCl(3), or GdCl(3) and was activated by GTPgammaS. The selective A(1)-receptor agonist N(6)-cyclopentyladenosine (CPA) mimicked the effect of hypotonicity on (125)I(-) efflux. The CPA-induced increase of (125)I(-) efflux was inhibited by DPCPX and external application of LaCl(3) or GdCl(3). Adenosine also enhanced Mn(2+) influx across the apical membrane. Overall, the data show that DC1 cells possess swelling- and adenosine-activated Cl(-) conductances that share identical characteristics. The activation of both conductances involved Ca(2+) entry into the cell, probably via mechanosensitive Ca(2+) channels. The effects of adenosine are mediated via A(1) receptors that could mediate the purinergic regulation of the volume-sensitive Cl(-) conductance.

Absence of fodrin (spectrin-like protein) under the pseudopod membrane in stimulated thyroid cells

A fodrin-like protein purified from porcine thyroid cells and characterized by its properties identical to those of pig brain spectrin (F. Regnouf et al., Eur. J. Biochem. 153, 313-319 (1985)) has been localized by immunofluorescence and electron immunocytochemistry in porcine and rat thyroid. Fodrin-like polypeptides were detected in subplasmalemmal meshworks of microfilaments attached to isolated or in situ plasma membranes. In resting cells, fodrin was found under apical and basolateral membrane domains, whereas it was always absent under the pseudopod membrane domain induced by acute TSH stimulation in vitro, using monolayers of porcine cultured cells attached to collagen permeable substrates, as well as in vivo, using rats intravenously treated with TSH. Thyroid fodrin could be involved in exocytosis and membrane stabilization which occurs during the formation of pseudopods induced by TSH stimulation.

Cholesterol-rich microdomains in rat and porcine thyroid membranes involved in TSH-induced endocytotic processes

Filipin, a polyene antibiotic, was used to detect cholesterol in thyroid membranes in vivo and in culture during TSH stimulation. We found that apical and basolateral plasma membranes were heterogeneously modified by filipin which induced abundant lesions in apical membranes, whereas Golgi apparatus, endoplasmic reticulum, nuclear membranes were unmodified. Small apical vesicles and colloid droplets were generally highly enriched in these complexes, suggesting a high cholesterol concentration in their membranes. Pseudopod membranes, known to be highly specialized domains in the apical plasma membrane, appeared enriched in cholesterol. Consequently, we suggest that an increased cholesterol content may be involved in the stabilization of thyroid membranes during endocytotic processes.

Roxithromycin in skin and soft tissue infections

In a double blind randomised investigation in 76 patients, roxithromycin (150 mg bd) and doxycycline (200 mg once daily) were compared in two groups of patients who were well-matched for age, sex, body weight, diagnosis, duration and severity of disease and associated pathological conditions, with infected skin conditions. Clinical effectiveness was 92% for roxithromycin and 82% for doxycycline, and bacteriological effectiveness also 92% and 82% respectively, the differences not being statistically significant.

Longitudinal melanonychia with spreading pigmentation in Laugier-Hunziker syndrome: a report of two cases

We present two cases of Laugier-Hunziker syndrome with longitudinal melanonychia and Hutchinson's sign, associated with essential melanotic pigmentation of the mouth and lips.

Skin lesions from hypersensitivity to cold during chronic myelomonocytic leukaemia

A patient with chilblain lupus and chronic myelomonocytic leukaemia (CMML) is reported. The possible mechanisms of this association which appears specific to CMML are briefly discussed.

[Prognosis of generalized scleroderma. A retrospective study of 78 cases]

From 1960 to 1984, 78 new patients with progressive systemic sclerosis were followed up: 60 women and 18 men whose ages ranged from 20 to 83 years, with a mean age of 58 years. Twenty nine are known to be dead and 3 were lost of follow-up. Forty six have been followed up to the present time for a mean period of 5 years. The cumulative survival rates were 88 +/- 7 p. 100 at one year, 62,5 +/- 11,5 p. 100 at five years and 50,5 +/- 15 p. 100 at ten years. These figures are significantly different from those found in a matched group from the French general population. Nine features at the time of diagnosis which might influence prognosis were studied. Seven factors apparently have not affected prognosis: sex, age, time elapsed between initial symptom and definitive diagnosis, location of scleroderma, blood pressure, erythrocyte sedimentation rate and creatinine clearance. On the other hand, survival declined significantly faster in the 28 patients with anemia than in the 50 patients without anemia (P less than 0,001). Similarly, the 47 patients with radiological pulmonary involvement or pulmonary function abnormalities were at significantly higher risk for death than the 31 patients without interstitial pulmonary fibrosis. Anemia and pulmonary involvement are predictors of mortality and important prognostic tools in the management of the different drugs that have been recommended for the treatment of patients with systemic sclerosis.

Plasma zinc is decreased only in generalized pustular psoriasis

Plasma and cutaneous zinc were studied in 22 psoriatic patients and 14 controls. The psoriatics were divided into three groups: 10 extensive psoriasis vulgaris, 5 palmoplantar psoriasis and 7 extensive pustular psoriasis. Low plasma zinc and decreased in vitro chemotaxis of polymorphonuclear leukocytes were found only in extensive pustular psoriasis, whereas zinc was not decreased but rather elevated in skin. This explains why conflicting results on plasma zinc have been previously reported in psoriasis and confirms that cutaneous zinc depletion is not a feature of psoriasis.

[The role of the argon laser in the treatment of condylomata acuminata of the anal margin and canal]

Condyloma acuminata of the anal margin or anal canal raise therapeutic problems as soon as they become important. In this study, we report the results obtained by 24 patients after Argon-ion laser therapy. This laser, the beam of which is mainly absorbed by haemoglobin allowed us to cure 91,7 percent of our patients. This results was obtained in one (14 patients) or two sessions (10 patients) with at least 3 months as follow-up. Furthermore we can notice the excellent quality of cicatrization and the complete lack of incidents during or after the treatment. So argon laser could be a new kind of treatment used preferentially in extensive genital warts.

A study of intermediate filaments (cytokeratin, vimentin, neurofilament) in two cases of Merkel cell tumor

In two cases of Merkel cell tumor, the study of intermediate filaments, using monoclonal antibodies (vimentin, cytokeratin, neurofilaments), confirmed the double differentiation (neuroendocrine and epithelial) of this tumor as previously observed in histological, electron microscopical and histochemical analyses. Labelling of the tumor cells was positive with monoclonal antibodies against neurofilament proteins and cytokeratin.

[Migration of polynuclear neutrophils in vivo. Standardization of the technic]

The migration of neutrophils across a skin barrier is a commonly employed method for the study of the inflammatory response. This report aims at comparing the leukocyte migration in the presence of two different chemoattractants : autologous serum and pool of serum. The reproducibility of this method has proved to be increasing by using duplicate skin chambers in 30 healty volunteers. The neutrophil migration with the pool of serum appears more homogeneous than with autologous serum. These results permit to obtain a standard curve of the neutrophil migration using a pool of serum.

The benefit of chilling in argon-laser treatment of port-wine stains

The authors compare results obtained in argon laser treatment of port-wine stains with and without preliminary chilling, noting that the success rate is considerably greater with the former procedure (68.6 percent) than with the latter (37.5 percent) (X2 = 4.37 p less than 0.05). The effect of chilling has been studied with special reference to the vitropressure test. Different hypotheses are presented to account for the difference and possible complications of the treatment are considered.

[Cutaneous paraneoplastic syndromes]

The authors list the really significant paraneoplastic cutaneous syndromes: acanthosis nigricans, paraneoplastic acrokeratosis, acquired ichthyosis (and eventually the "explosive" onset of seborrheic warts) and a special type of desquamative circinate erythema (erythema gyratum repens). The possible paraneoplastic character of other conditions is also discussed: dermatomyositis, necrosing vasculitis, autoimmune bullous conditions and pruritus "sine materia".

[Systemic mastocytosis and intestinal malabsorption]

With reference to an observation, thirty-four cases of systemic mastocytosis with intestinal malabsorption are reviewed. The most characteristic intestinal anomalies are the steatorrhea, partial villous atrophy and deficiency in secretory IgA. Routine investigations for mastocytosis may be warranted in patients with malabsorption. A markedly telangiectatic and angiomatous aspect of cutaneous lesions may be suggestive of the association.

[Alcoholic neuroacropathy. Recent diagnostic and pathogenic attainments]

The authors report the results of a prospective study of 28 patients with alcoholic neuroacropathy or the Bureau and Barrière syndrome. The investigations included biochemical analysis of the alcoholism, electrophysiological studies and, in 4 cases, electron microscopy of the musculocutaneous nerve biopsy. Bone scintigraphy with foot and hand scans was carried out in all cases for a more exact and above all, earlier diagnosis of the neurological osteoarthropathy. The clinical syndrome was attributed to a polyneuropathy with a large sensory component of the alcoholic "dying back" variety in all cases. High VGM levels associated with high serum IgA levels appears to be a biochemical diagnostic criteria of this condition. The latter parameter was not closely related to the hepatocytic status of the patient but suggests a direct or indirect effect of the neuropathy on humoral immunity. All cases had characteristic bone scans with high uptake at points of mechanical stress of the anterior part of the foot (first metatarsophalangeal joint). This finding, which is also observed in alcoholic sensory neuropathy without trophic disturbances prompts the authors to define a preacropathic state and an evolutive and pathogenic outline of the disease.

[Functional anomalies of polymorphonuclears in Papillon-Lefèver disease (author's transl)]

Polymorphonuclear functions were studied in 3 patients of the same brotherhood with Papillon-Lefèvre disease (hyperkeratosis palmaris and plantaris and acute periodontosis resulting in loss of teeth) who developed severe and recurrent infections. Chemotaxis, oxygen consumption and production of H2 O2 were investigated by polarography, O2 production by quantitative reduction of nitroblue tetrazolium and iodination by the Pinus and Klebanoff technique. functional anomalies of polymorphonuclears involving chemotaxis, induced O2 consumption and H2 O2 production were detected in all three patients. This study confirms the presence of polymorphonuclear functional anomalies in patients with Papillon-Lefèvre disease. Analysis of the family tree of the patients, which went back to 1761, showed that this was probably not a chance association.

[Angiomatous cutaneous lesions revealing arteriovenous fistulas (author's transl)]

Reports of Bluefarb-Stewart syndrome have been infrequent. Two observations of this condition are described. Both patients are young men who presented with extensive angiomatous lesions of the feet, revealing distal arteriovenous fistulas. Surgical treatment was successful in one patient. Diagnostic criteria are discussed. As to pathogenesis the most likely hypothesis is that the arteriovenous fistulas are congenital. Bluefarb-Stewart syndrome can therefore be classified as one of the angiodysplasias.

[Clinical trial of isaxonine in the ulcerous mutilating acropathy of chronic alcoholics (author's transl)]

The ulcerous mutilating acropathy accompanying impairment of the peripheral nervous system, as evidenced by the electrophysiology of chronic alcoholics, formed the subject of a double-blind (isaxonine) survey carried out with a placebo in the case of such patients. The withdrawal of alcoholic beverages was a therapeutic rule in both groups. Healing of perforating plantar ulcers was clearly more frequent in the treated group than in the control group. The improvement was accompanied by an improvement in sensory disorders, particularly superficial tactile sensibility.

[Stewart's malignant centrofacial granuloma (author's transl)]

Stewart's malignant centrofacial granuloma is a rare affection. The characteristic clinical features are extensive ulceronecrotic processes affecting the upper respiratory tract, these being always unilateral, with no lymph node adenopathy spread and no visceral dissemination (confirmed in all cases in which an autopsy was conducted). There are no specific biological changes that could supply objective confirmation of the affection. The histological appearance is that of a granuloma with non-specific inflammatory signs, but having a pseudo-malignant appearance in some cases which is difficult to interpret. The true etiopathogenic nature of the lesions remains obscure. The most admitted current hypothesis is that Stewart's malignant granuloma is an immune response, in a granulomatous mode, to an antigenic stimulation, the antigen being unknown.

[Tuberous sclerosis and lymphangiomyomatosis syndrome. Problem of their relationship (author's transl)]

Discussion of a case relating to a patient affected by a typical tuberous sclerosis, and a lymphangiomyomatosis syndrome, proliferation of unstriated muscles of lymphatic system. These symptoms induce pulmonary injuries, ascites and renal angiomyolipomas. The closeness of these localizations with the visceral manifestations of tuberous sclerosis leads to debate connections among the two diseases.

[Shulman's syndrome. A variant of scleroderma? Two cases (author's transl)]

Observations of two patients illustrating the problem of Shulman syndroma. The first had presented an oedema of the four limbs, without injury of the trunk, but with myalgias, histological fasciitis, eosinophilia and hypergammaglobulinemia. In spite of corticotherapy, evolution toward a generalized morphea. The second has presented the same oedema of the four limbs, with myalgias, but also Raynaud syndroma, histological fasciitis and eosinophilia. Evolution toward acrosclerosis in spite of corticotherapy. For the authors, Shulman's syndroma is apprehended as a particular clinical form of scleroderma.

[Eczematoid dermo-epidermitis]

A methodic study of 50 cases, had to the discussion of a real clinical well established entity. The lesions start from an initial site, located on the inferior limbs in 2/3rd of the cases; then within a variable period of time extend larger and larger by proliferating in numerous patches. These lesions present as polymorphic, erythemato-squamous or oozing. They often evolve towards recurrence. The disease is more frequently encountered among 50-year-old men. Several factors contribute to the onset of the lesions: chronic alcoholism--lack of sanitary conditions--microbial background--stasis--overweight. A disturbed system of cutaneous protection and a lack of immune defences versus an antigen, probably a bacteria, are at the origin of the pathogenesis of these disorders. Considering the treatment, we wish to underline the benefit of local coal tar applications.

[Scleroderma: peripheral vascular exploration by Doppler ultrasound (author's transl)]

In this preliminary study the authors consider the data that a Doppler investigation may provide for scleroderma. These data are on three levels. 1) At the diagnostic stage: in case of Raynaud phenomenon the Doppler investigation might allow to establish a diagnosis at an early stage in one of two directions:--whether a Raynaud disease, in case of a normal Doppler without taking into account its long-term future;--whether a Raynaud syndrome, in case of abnormal Doppler (thrombosis of the cubital artery or digital collaterals. Because of a recurring fact we must consider scleroderma first; 2) At the therapeutic stage, the Doppler investigation will perhaps allow to select at an early stage the patients who are able to respond to a cervical sympathectomy in a favorable way. 3) At the pathogenic stage, the Doppler investigation should allow a better selection of patients who are suspicious of being affected with a macroangiopathy has to be accurately diagnosed.

[Pyoderma gangrenosum and haemopathy. Report of three cases (author's transl)]

The authors report three personal cases of phagedenic pyoderma associated with hemopathy. Studying twenty-five other cases, described in the reviews, the question can be debated on three levels: 1) The clinical characteristics of hemopathic pyoderma remain non-specific. However blisters, pustules, and even vegetating lesions occur very often; 2) the etiology of hemopathy is subject to change; acute leukaemia or myeloproliferation syndrome. During the polyglobulars associated with pyoderma, anemia and myelofibrosis appear quite constantly; 3) finally on the pathogenic level, the recent works tend towards the hypothesis of a damage in the functioning of the polymorphonuclears hence displaying the increase in the inflammation during phagedenic pyoderma.

[The clinical course of late cutaneous porphyria (author's transl)]

Study of the course of 23 patients, with late cutaneous porphyria, after 3 to 8 years. So, we remark: the clear improvement of the majority of the patients, from whom a quarter appear entirely cured, the more satisfactory affects of bleeding and alkali-therapy, the absence of reference with the course of chronic alcoholism the absence of visceral complication of porphyria.

[Household cleansers and nickel allergies]

Attention of authors has been drawn by the observation of patients presenting a nickel-dermatosis, instigating by the touch of jewelry (ear-rings, bracelets, necklaces...) and also a sensitization for housework cleansing agents. The chemical analysis of numerous housework cleansing agents exhibited the constant presence of nickel in these housework cleansings. These investigations enable the authors to affirm a close relationship between sensitization for nickel and sensitization for housework cleansings. Some patients present also sensitization for chromium or cobalt. The authors think this polysensitization is induced by metal's contamination.

[Study under scanning electron microscopy of scales of PUVA treated psoriasis (authors's transl)]

The authors recall an particular aspect of microvilli at the surface of horney cells in psoriasic disease. These microvilli are rounded, irregular size and spaced. The photochemotherapy involves parallely the disappearance of these microvilli and the recovery of the cutaneous lesions. The authors describe a "crumpled" aspect of the microvilli, appearing during the evolution towards the recovery.

[Malignant atrophying papulosis (Degos' disease) (author's transl)]

From 74 observations, 55 p. 100 of which caused death by intestinal lesions, the author searches, through the symptomatology of the disease, for possible factors of prognosis. No relation between the importance of cutaneous symptoms and the appearance of intestinal symptoms has been found. There is no constancy in the chronological evolution of the lesions. The interest of laparoscopy is emphasized. No biological constant seems specific of the disease. A few modest arguments are suggestive of an auto-immune disease. In spite of a varied range of therapeutic orientations, none of them could prove to be efficient, not even heparinotherapy.

[Stefansky's serodiagnosis and ulcerative and mutilating acropathy (author's transl)]

Systematic Stefansky's serodiagnostic test in the course of ulcero-mutilating acropathia reveals a frequent positivity (25/30 patients). Superinfection by atypical Mycobacterium of telluric extraction is considered. A delayed hypersensibility to several Mycobacterium antigens is proved to Mycobacterium kansasii, johnei, balnei. Perhaps, the same type of infection might exist in the course of chronic leg ulcers.

[Epithelioma occurring on chronic leg ulcers (author's transl)]

The authors report nine cases of epithelioma occuring on chronic leg ulcers of venous origin (6), or on fistula from chronic osteitis (3). Compared with the other trophic leg ulcers observed during the same period, the risk of malignant change approximatly is of 0,3 p. 100. It always concerns aged caucasian subjects (about 70 years old) and the evolution last long (5/20 years), except in one of the case. The first symptoms are hard, bleeding and exuberant granulation either on the edge of the ulcer, or on the ulcer itself. It is often necessary to repeat the biopsies to obtain histological corroboration of the diagnosis. Prognosis is severe (2 lung metastasis) and amputation seems to be the best treatment.

[Epitheliomatous degeneration of chronic leg ulcers. Apropos of 9 cases]

The authors report nine cases of epithelioma occurring on chronic leg ulcers of venous origin (6), or on fistula from chronic osteitis (3). Compared with the other trophic leg ulcers observed during the same period, the risk of malignant change approximately is of 0,3 p. 100. It always concerns aged caucasian subjects (about 70 years old) and the evolution lats long (5/20 years), except in one of the cases. The first symptoms are hard, bleeding and exuberant granulations either on the edge of the ulcer, or on the ulcer itself. It is often necessary to repeat the biopsies to obtain histological corroboration of the diagnosis. Prognosis is severe (2 lung metastasis) and amputation seems to be the best treatment.