Value of routine diagnostic criteria of bullous pemphigoid.

BACKGROUND AND DESIGN: The clinical, histologic, and direct (DIF) and indirect (IIF) immunofluorescence findings are used in a critical, although arbitrary, manner in the routine diagnostic process of bullous pemphigoid (BP). Our purpose was to estimate their relative value. In the present retrospective study, a follow-up of at least 18 months was used as a prerequisite for the final diagnosis of BP (63 patients) and controls (n=159). RESULTS: The clinical, histologic, DIF, and IIF diagnostic criteria of BP were found to vary independently of each other. Positive DIF was the most sensitive (90.5%) typical for BP histology and positive IIF were the most specific (99%). Immunopathologic tests were the most valuable, especially in the atypical varieties of BP. Nearly 25% of patients in this group would have been misdiagnosed if IF tests had not been performed. Atypical cases (40%) seemed to represent a clinical continuum over the whole spectrum of the disease. Patients with exclusively immunoglobulin G (IgG) and C3 basal membrane zone (BMZ) deposits were significantly more often seropositive than the rest of the DIF-positive cases; however, the class of BMZ immunoreactants varied according to the site of biopsy. C3 was almost invariably deposited at the BMZ of DIF-positive patients. When Igs were also present, they were only exceptionally (5% of cases) of greater fluorescence intensity than C3. CONCLUSIONS: The combination of clinical data plus one positive immunopathologic test provide the best combination of sensitivity and specificity (98%), and seem to be most appropriate in defining patient populations for study purposes. The relationship between the classes of immunoreactants should be better evaluated with reference to the site of skin biopsy. It may be suggested, however, that the likelihood of BP existence is very low when in vivo C3 is absent or of lower intensity of fluorescence than the concomitant Ig(s).

[Serum's immunoglobulins in dental caries with or not dental alloy]. / E epidrase tes teredonas ton dontion sta epipeda ton anososphairinon tou orou se schese me ton yparxe e ochi prosthetikes ergasias.

In 51 individuals with dental caries (mean age +/- SE, 30, 12 +/- 1, 43) were determined the serum's immunoglobulins IgA, IgG, IgM and the ration IgG/IgA. The levels of them were compared with the levels of immunoglobulins of 53 individuals (mean age +/- SE 36, 78 +/- 1, 86) with no significant difference (p greater than 0.1). Also, no significant difference (p greater than 0.1) was observed between the levels of immunoglobulins of the two subgroups, one with dental caries only (n = 32) and another with dental caries and alloy (n = 19). When in the two subgroups was taken care the dental caries degree the mean levels of the above parameters were differenciated. The mean level of IgG was significant lower in the subgroup with high caries degree without alloy (p less than 0.01) comparing with low caries degree. This difference was not observed between the subgroups where there was dental alloy. Also lower mean level of IgA was observed in the subgroup with high caries experience without prosthesis in contrast with the subgroup where there was dental alloy where the mean level of IgA was higher comparing these with the corresponding comparing subgroups. These differences were not significant (p greater than 0.1). The charge of the IgG/IgA ration was similarly lower in the subgroup with or without dental alloy. Also no significant was found between the levels of IgA, IgG, IgM, in relation to preexisting dental alloy or not. Our results show that the levels of IgA, IgG, IgM, can be affected not only of the dental caries degree but also of the preexisting dental alloy.

[Immunoglobulin estimation of saliva and serum according to dental caries degree]. / E ektimese ton anososphairinon sto salio kai ston analoga me to bathmo teredonismou.

In seven individuals without dental caries, thirteen with low degree caries (LDC) experience and twelve with high degree (HDC) were determined the mean levels of the serum's IgA, IgG and IgG/IgA and also the IgA of the saliva. In the group without dental caries the levels of IgG, IgA and IgG/IgA were higher than in the two other groups. The differences were not significant (p greater than 0.1) except the mean level of IgG (19.47 +/- 1.66) where it was significantly higher (p less than 0.05) in the group without dental caries (14.6 +/- 1.1). A reverse change of the immunoglobulins' levels were observed in relation to the dental caries degree (p greater than 0.1). In group LDC with dental alloy the ratio of IgG/IgA (4.69 +/- 0.39) were significantly lower (p less than 0.05) than in the LDCs without prosthesis (7.42 +/- 0.92). Also in the group HDC with prosthesis the IgA levels (3.17 +/- 0.15) were significantly higher (p less than 0.01) than in the HDCs without prosthesis (2.06 +/- 0.25). The estimation of immunoglobulins were made with radial immunodiffusion. The dental caries degree was characterized by the caries area of the existed teeth. The differentiation of the immunoglobulins' mean levels in relation to the degree of dental caries and the preexisting of dental alloy is discussed.

The electrical impedance of the human thorax as a guide in evaluation of intrathoracic fluid volume.

The modelling of the human thorax and the impedance characteristics of the thorax are presented. A two-dimensional model of the thorax was constructed by using more than four hundred reference points. The input impedance was calculated by solving the Helmholtz equation for zero charge density and low frequencies. Variation in the impedance corresponds to the fluid in the lung and the degree of inflation, which is related to a given degree of pulmonary oedema.