bluuebunny/crossref_metadata_2025 huggingface dataset:
Attenuated Gastric Mucosal Blood Flow Predicts Non-Healing of Benign Gastric Ulcers
Authors: Clarke D.L. , Thomson S.R.
Published: April 2003

Background: A subset of benign gastric ulcers do not respond to therapy and may require surgery. A predictor of non-healing may allow modification of therapy. Gastric mucosal blood flow plays an important role in gastric ulcer pathogenesis and healing. Aims: Mucosal blood flow was measured with Laser Doppler flowmetry at initiation of and during therapy to assess the variability of mucosal blood flow in healing and non-healing ulcers as a possible predictor of healing. Methods and Subjects: Mucosal blood flow was measured at the mid-antrum in 105 normal human stomachs and on the circumference of 26 benign gastric ulcers. The gastric ulcers were followed up with repeat endoscopy and repeat measurements were made. Results: The ulcers that healed had significantly higher mucosal blood flow than normal stomachs at both initial and follow-up measurement (59.8 ± 26.1 vs. 75.7 ± 17.5 and 69.8 ± 13.7). The refractory ulcers persistently had significantly lower mucosal blood flow than normal stomachs and healing ulcers (59.8 ± 26.1 vs. 45.2 ± 21.9 and 39.2 ± 6.7). Conclusions: Gastric mucosal blood flow seems to increase in response to mucosal injury and healing. Attenuation of this response is associated with delayed healing. Attenuated peri-ulcer mucosal blood flow may predict non-healing of a benign gastric ulcer.
Iron Deficiency Anaemia: An Unusual Complication of Meckel’s Diverticulum
Authors: Al-Onaizi Iman , Al-Awadi Fatma , Al-Dawood Abdul-Latif
Published: April 2003

Objectives: To describe a case of Meckel’s diverticulum with an unusual complication of iron deficiency anaemia due to chronic intestinal bleeding. Clinical Presentation and Intervention: A 12-year-old boy presented with bloody diarrhoea and abdominal pain in association with a long-standing history of black stools and progressive pallor. Biochemical tests revealed low serum iron (1.2 mmol/l) indicating iron deficiency anaemia and low serum albumin (29 g/l). The other tests were normal. Colonoscopy performed on the 8th day of hospitalization was normal. A technetium-99m pertechnetate scan showed an ectopic gastric mucosa in the Meckel’s diverticulum confirmed at surgery in the region of the antimesentric border and on histopathology. Conclusion: Findings indicated that the patient had a bleeding Meckel’s diverticulum, complicated by iron deficiency anaemia.
TORCH Agents in Pregnant Saudi Women
Authors: Ghazi Hani O. , Telmesani Abdulwahab M. , Mahomed Mahomed F.
Published: April 2003

Objective: To determine the seroprevalence rates of IgG to common TORCH agents in pregnant Saudi women using indirect enzyme-linked immunosorbent assay. Subjects and Methods: A total of 926 samples of sera were tested for antibodies to TORCH agents known to cause serious congenital infections: Toxoplasma gondii, rubella, cytomegalovirus (CMV), herpes simplex viruses (HSV-1 and HSV-2), varicella zoster virus (VZV) and human immunodeficiency virus (HIV-1 and HIV-2). Results: Toxoplasma IgG antibodies were detected in 35.6%, CMV total IgG antibodies were found in 92.1%, rubella IgG antibodies in 93.3%, HSV-1 IgG antibodies in 90.9%, HSV-2 IgG in 27.1%, and VZV IgG antibodies in 74.4%. A 0% seroprevalence rate for HIV-1 and -2 was found. Conclusion: Pregnant Saudi women commonly have IgG antibodies to rubella, CMV, HSV-1 and -2, VZV, and T. gondii. Serological evidence of HIV infection was not observed.
Primary Antituberculosis Drug Resistance at Turkish Military Chest Diseases Hospital in Istanbul
Authors: Kartaloglu Zafer , Bozkanat Erkan , Ozturkeri Hakan , Okutan Oguzhan , Ilvan Ahmet
Published: April 2003

Objective: The aim of this study was to investigate the prevalence of primary drug resistance to tuberculosis. Methods: We evaluated the clinical data, radiological features and sputum samples from 365 newly diagnosed patients with a positive culture of pulmonary tuberculosis at the Turkish Military Chest Diseases Hospital, Istanbul, Turkey. No patients had taken antituberculosis drugs previously. The Bactec method was used to perform drug susceptibility testing for isoniazid, rifampicin, ethambutol, and streptomycin. Results: Primary resistance to one or more drugs was detected in 87 (23.8%) patients; resistance to isoniazid was most common (54 patients) followed by resistance to ethambutol (n = 39), rifampicin (n = 11), and streptomycin (n = 9). One-drug resistance was detected in 69 patients; two-drug resistance in 11, three-drug resistance in 6, and four-drug resistance in 1. Multidrug resistance (resistance to at least isoniazid and rifampicin) was detected in 10 patients. In logistic-regression analysis, primary drug resistance was associated with radiological advanced tuberculosis (p < 0.001). Conclusion: Primary resistance to one or more drugs used in treating tuberculosis is relatively high. It is necessary to regularly screen for and treat drug resistance among those who live in close quarters, such as army barracks, school dormitories and prisons. Regular surveillance of drug sensitivity patterns should be maintained to determine appropriate alternate drug regimens and detect the spread of resistant stains in the population.
Idiopathic Chronic Ulcerative Enteritis – The Role of Radical Surgical Resection
Authors: Sutton C.D. , White S.A. , Marshall L.J. , Dennison A.R. , Thomas W.M.
Published: April 2003

Idiopathic chronic ulcerative enteritis is uncommon. It is a term that describes ulceration of the small bowel in the absence of a recognisable cause. Patients mainly present with a surgical abdomen and their management often proves to be a therapeutic challenge. Our series describes three such cases: the first patient presented with a tender left iliac fossa mass and rectal bleeding, the second with peritonitis and pneumoperitoneum, the third with severe acute colitis. All three patients needed urgent surgical intervention with further laparotomies due to recurrent ulceration, perforation and fistula formation in addition to intensive supportive measures such as inotropes and total parenteral nutrition. The importance and challenges of idiopathic chronic ulcerative enteritis are therefore discussed.
Spontaneous Necrosis of Hepatocellular Carcinoma: A Case Report
Authors: Morimoto Yoshikazu , Tanaka Yasuhiro , Itoh Toshinori , Yamamoto Shigetaka , Mizuno Hitoshi , Fushimi Hiroaki
Published: April 2003

Background: Spontaneous regression of a malignant tumor is a rare phenomenon. So far, 13 cases of spontaneous regression of hepatocellular carcinoma (HCC) have been described in the English literature. We report a case of HCC, with spontaneous complete necrosis demonstrated by histological examination. Methods: A 73-year-old male was admitted to our hospital complaining of general fatigue. CT and US revealed a huge mass measuring 9.5 cm at the left lobe. Angiographies showed hypovascular tumor stains. The levels of alpha-fetoprotein (AFP) and PIVKA-2 on admission were high, at 55 ng/ml and 62,300 mAU/ml, respectively. We diagnosed hypovascular HCC and performed a left lobectomy on October 16, 2000. Results: In the histological examination, no viable cells were found. The levels of AFP and PIVKA-2 had already decreased to 14 ng/ml and 1,420 mAU/ml, before laparotomy. Conclusion: Changes in tumor markers and histological findings reveal that this phenomenon occurred without specific treatment.
The Abdominal Cocoon: A Case Report
Authors: Hamaloglu Erhan , Altun Hasan , Ozdemir Arif , Ozenc Ahmet
Published: April 2003

The abdominal cocoon is a rare disease that is characterized by a total or partial encasement of the small bowel by a thick and fibrotic membrane. Thirty-five cases were reported since it was first described. It occurs primarily in females. Preoperative diagnosis is a matter of challenge and usually made at laparotomy. We report a patient with partial intestinal obstruction and abdominal cocoon which was diagnosed peri-operatively. We review the literature and discuss the etiology of this disease.
Does Seeding of Intraluminal Tumour Cells Cause Anastomotic Recurrence after Oesophageal Resection?
Authors: Spillenaar Bilgen E.J. , Reuvers C.B. , Klinkenbijl J.H.G. , Meijer J.W.R.
Published: April 2003

Background: Recurrence at the cervical anastomosis of a tumour of the oesophagogastric junction after resection of the oesophagus with gastric tube reconstruction is a peculiar phenomenon in view of the distance of the primary tumour from the proximal anastomosis. It is hypothesised that contamination with tumour cells from the nasogastric tube or the gastric reconstruction tube could be responsible for this phenomenon. Method: Fifteen patients with a tumour of the oesophagus or gastric cardia were included. During the operation the nasogastric tube was left in the resected specimen. Debris from the tube was washed out for cytological examination. Also the gastric reconstruction tube was washed out and the debris examined for malignant cells. Results: In all of the patients with a tumour extending intraluminally malignant cells were found in the nasogastric tube or the gastric reconstruction tube or both. In 92% of these patients malignant cells were found in the nasogastric tube, while 60% of the gastric reconstruction tubes were contaminated with tumour cells. Conclusion: The presence of intraluminal malignant cells during oesophageal resection and gastric tube reconstruction is very high, possibly leading to anastomotic recurrence. Measures should be taken to minimise local contamination with tumour cells.
Intermediate Results following Laparoscopic Adjustable Gastric Banding for Morbid Obesity
Authors: Victorzon Mikael , Tolonen Pekka
Published: April 2003

Background/Aims: Morbid obesity is a rapidly increasing health risk in most industrialized countries. Unfortunately, conservative treatment methods will fail in the long run in almost 100% of patients. Today, long-lasting success can only be achieved by operative treatments. Laparoscopic gastric banding has the general benefits of minimally invasive techniques is relatively easy to perform and can be reversed or changed to any other operation aiming at weight loss, if necessary. We report here our primary and intermediate outcome of Laparoscopic Adjustable Gastric Banding (LAGB). Methods: Since 1996–2001 we have treated 110 (87 women, 23 men) morbidly obese patients with the Swedish Adjustable Gastric Band (SAGB). Median age (range) of the patients was 42 years (21–64), and preoperative median body mass index (BMI, kg/m2) (range) was 44 (35–66). Most of the patients suffered from obesity related co-morbidities. Results: At a median follow-up of 27 months, mean weight loss was 30 kg, mean excess weight loss (range) 52% (11–108%), and median (range) BMI 34 (24–46). Reoperations due to band slippage (3 patients), band erosion (2 patients), infection (1 patient), and leakage of the band or the filling system (5 patients) have been necessary in 11 (10%) patients so far. Median postoperative hospital stay (range) was 3 days (2–53). There was no mortality. Immediate postoperative morbidity was 9%. More than 50% of the patients had signs of mild erosive gastroesophageal reflux disease during routine endoscopic follow-up 3 years after the operation. Conclusion: Weight loss following LAGB is generally good and complications few, at least in the short term. However, technical problems with the band causes morbidity and reoperations in a number of patients. Despite this fact, we think the LAGB operation is the best ‘first’ operation in the treatment of morbid obesity, although long-term results are not yet available.
Prevention Campaign against Skin Cancer
Authors: Heinzerling L.M. , Dummer R. , Panizzon R.G. , Bloch P.H. , Barbezat R. , Burg G.
Published: April 2003

Background: The melanoma incidence has increased over recent decades. Educational campaigns aim to encourage protection from the sun and early detection of melanoma. Methods: During a campaign in Switzerland, information on risk factors, sun protection and melanoma prevention was distributed. 10,987 people completed a questionnaire regarding risk factors, and 2,746 people were examined by a dermatologist. Results: Men had a higher risk as assessed by skin type, ultraviolet exposure, family history, number of moles and sunburns during childhood. Changes in moles were reported significantly more often by people with: (1) a positive family history (p < 0.0001); (2) multiple moles (p < 0.0001), and (3) sunburns during childhood (p < 0.0001). A precancerous or cancerous condition was suspected in 16% of individuals examined. Conclusion: Early detection of melanoma can be achieved by this type of campaign. Primary prevention is a long-term approach and educational efforts targeting risk groups must be continued.
Permethrin 5% Cream versus Metronidazole 0.75% Gel for the Treatment of Papulopustular Rosacea
Authors: Kocak Mukadder , Yagli Salime , Vahapoğlu Güler , Ekşioğlu Meral
Published: April 2003

Background: Permethrin 5% cream used against human ectoparasites suggests that it may be effective in papulopustular rosacea. Methods: This study included 63 patients diagnosed as having papulopustular rosacea based on the clinical and histological findings. Patients were randomly assigned into permethrin (n = 23), metronidazole (n = 20) and placebo (n = 20) groups. Scores of erythema, telangiectasia, edema and rhinophyma and the numbers of papules, pustules, inflammatory nodules and Demodex folliculorum were determined. Twenty-three patients were given permethrin 5% cream (Zalvor 5% skin cream®), 20 patients metronidazole 0.75% gel (Roza gel®) and 20 patients placebo cream (Basis cream®), in packages looking identical to those of metronidazole and permethrin creams, and were recommended to apply them to their faces twice a day. All patients were also given SPF 20 cream for protection against sunlight. Two months of treatment were planned, and the patients were invited to the clinic for fortnightly controls. Scores of erythema, telangiectasia, edema and rhinophyma and the numbers of papules, pustules, inflammatory nodules and D. folliculorum were recorded at each visit. The mean scores of erythema and the mean numbers of papules, pustules and D. folliculorum were determined at baseline and on days 15, 30, 45 and 60. Side effects were also detected. Results: The effect of permethrin 5% cream on D. folliculorum was superior to that of metronidazole 0.75% gel. The effect of permethrin 5% cream on erythema and papules was found to be more effective than placebo and as effective as metronidazole 0.75% gel. However, it had no effect on telangiectasia, rhinophyma and pustules. Conclusion: It can be concluded that the application of permethrin 5% cream twice daily for 2 months can be as effective and reliable as metronidazole in the treatment of rosacea and a greater benefit can be gained when it is combined with other systemic and/or topical treatments.
Pimecrolimus Cream in the Long-Term Management of Atopic Dermatitis in Adults: A Six-Month Study
Authors: Meurer Michael , Fölster-Holst Regina , Wozel Gottfried , Weidinger Gottfried , Jünger Michael , Bräutigam Matthias , for the CASM-DE-01 Study Group f
Published: April 2003

Background: Pimecrolimus cream (Elidel®, SDZ ASM 981), a non-steroid inhibitor of inflammatory cytokines, is effective in the treatment of atopic dermatitis (AD). We assessed whether early treatment of AD signs/symptoms reduces the need for topical corticosteroids. Objective: To investigate the efficacy and safety of pimecrolimus cream 1% in the long-term management of adult AD. Methods: 192 adults with moderate to severe AD were randomised (1:1) for twice daily (b.i.d.) treatment of early signs or symptoms of AD with either pimecrolimus cream 1% or vehicle cream (control group) to prevent progression to flares. Treatment was given as needed for 24 weeks. In the event of flares, a moderately potent corticosteroid (prednicarbate 0.25% cream) was permitted as rescue medication in both groups. The percentage of days on which a topical corticosteroid was used to treat disease flares was the main outcome measure. Results: Corticosteroid medication was used on 14.2% (95% confidence interval, CI: 8.3–21.1) of the days of the 24-week treatment period in the pimecrolimus group and on 37.2% (95% CI: 30.4–44.0) of the days in the control group (p < 0.001). In total, 44.8% (43/96) of patients in the pimecrolimus group did not experience a flare compared with 18.8% (18/96) of patients in the control group. The median time to first flare was 144 days in the pimecrolimus group and 26 days in the control group (p < 0.001). Pimecrolimus treatment was also associated with improvement in signs and symptoms of AD, pruritus, patients’ self-assessment and quality of life. Conclusions: Pimecrolimus cream 1% b.i.d. is an effective, well-tolerated, long-term treatment for AD in adults, substantially reducing the number of flares compared to a conventional therapy and consequently reducing or eliminating the need for corticosteroid treatment.
Experimental Infection of Lacertids with Lizard Erythrocytic Viruses
Authors: Alves de Matos António Pedro , Paperna Ilan , Crespo Eduardo
Published: April 2003

Objective: Lizard erythrocytic viruses (LEVs) produce inclusions in the cytoplasm of erythrocytes, but their impact on the infected host is poorly understood. This work reports on an experimental study of the infection process in Lacerta monticola and Lacerta schreiberi from Serra da Estrela Mountain, Portugal. Methods: A time sequence light microscope and transmission electron microscope (TEM) study of the infection process was performed in peripheral blood erythrocytes of experimentally infected lizards. Virions were searched for by TEM in visceral organs and bone marrow of the animals. Results: Infection was usually restricted to erythrocytes, but occasionally became systemic and induced disease. In the first case, a prevalence of infected erythrocytes of up to 98% followed by recovery was observed. In the latter, infection spread to leukocytes, leading to the death of the infected animals. Conclusions: The potential of LEVs to induce systemic infections was demonstrated. Sequential TEM examination of LEV-infected cells is described for the first time, demonstrating features such as dense inclusions related to virus nucleoid formation, intranuclear virions, intermediate structures in virion capsid morphogenesis and virus release by budding.
Effects of Triamcinolone Acetonide on Adult Human Lung Fibroblasts: Decrease in Proliferation, Surface Molecule Expression and Mediator Release
Authors: Oddera S. , Cagnoni F. , Mangraviti S. , Giron-Michel J. , Popova O. , Canonica G.W.
Published: April 2003

Background: Lung fibroblasts may have a pivotal role in airway inflammation as they are involved in continuous cycles of mediator secretion, proliferation, activation and cross-talk with recruited inflammatory cells. The role of fibroblasts as intermediate participants in the inflammatory network suggests that they could represent an important target for drugs commonly used in asthma; thus, we investigated the effects of triamcinolone acetonide (TAA) on primary human lung fibroblasts. Methods: The in vitro activity of increasing concentrations (10–9 to 10–7 M) of TAA in fibroblast cultures was evaluated as regards the following parameters: proliferation, extracellular matrix (ECM) release, cytokine/chemokine secretion and surface antigen expression. Results: All concentrations of TAA decreased fetal calf serum (FCS)-induced fibroblast proliferation, whereas in the presence of FCS plus basic fibroblast growth factor TAA was only effective at 10–8 and 10–7M. TAA failed to decrease ECM, whereas at 10–8 and 10–7M it decreased IL-6 and IL-8 secretion to different extents. In the presence of IFN-γ the drug was able to reduce VCAM-1 expression at all of the tested concentrations; on the other hand, in TGF-β1-driven cultures a decrease in CD54 expression was detected with TAA at 10–8 and 10–7M. Conclusions: TAA acts on some functional properties of human lung fibroblasts that make these cells active participants in the inflammatory network. The ability of TAA to inhibit lung fibroblast proliferation may prevent or even reverse some of the histological changes that characterize airway remodeling in chronic inflammatory diseases; moreover, IL-6, IL-8 and surface molecule decreases by TAA may suggest a direct anti-inflammatory effect of the drug by suppression of resident lung cell function.
Aberrant Fas Ligand Expression in Lymphocytes in Patients with Behçet’s Disease
Authors: Wakisaka Sueshige , Takeba Yuko , Mihara Shoji , Takeno Mitsuhiro , Yamamoto Shoso , Sakane Tsuyoshi , Suzuki Noboru
Published: April 2003

Background: Defects in immune responses have been reported in patients with Behçet’s disease (BD). To further characterize the immune dysfunction and its contribution to the pathogenesis, we have studied Fas ligand (FasL) expression in peripheral blood lymphocytes (PBL) and mononuclear cells in the skin lesions in patients with BD. Methods: FasL expression in PBL was studied with RT-PCR and immunoblotting with rabbit anti-human FasL antibody. We studied the expression of FasL in cryostat sections of biopsy specimens of erythema nodosum lesions from 4 patients with BD and of a genital ulcer lesion in another patient using immunohistochemical staining. Apoptotic cell death was detected with the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method. Results: We found that FasL mRNA and FasL protein expression was detected marginally in the unstimulated PBL, and was induced upon activation in normal individuals. PBL from patients with BD exhibited an enhanced expression of FasL mRNA and FasL protein without in vitro stimulation. Moreover, mitogen stimulation failed to augment FasL expression of their lymphocytes, suggesting a dysregulation of FasL expression of PBL in patients with BD. The skin biopsy specimens revealed that cells infiltrating into skin lesions expressed FasL and there were several TUNEL staining-positive cells in the lesions, suggesting that Fas/FasL-mediated apoptosis is involved in the development of the skin lesion and thus may be associated with the pathogenesis. Conclusions: We found an excessive expression of FasL in circulating as well as skin-infiltrating lymphocytes and the presence of apoptotic cells in the skin lesions, suggesting that lymphocytes expressing FasL aberrantly may play a role in the development and pathogenesis of BD.
Altered Control of the Hypothalamo-Pituitary-Adrenal Axis in Adult Male Rats Exposed Perinatally to Food Deprivation and/or Dehydration
Authors: Sebaai Naima , Lesage Jean , Vieau Didier , Alaoui Abdelilah , Dupouy Jean Paul , Deloof Sylvie
Published: April 2003

Dehydration, a classic homeostatic stressor in rats, leads to a series of well characterized endocrine responses including stimulation of the hypothalamo-pituitary-adrenal (HPA) axis. In this study, the hypothesis to be tested was that a 50% maternal food restriction (FR50) in late gestation and lactation may have long-term repercussions on HPA axis responsiveness to dehydration in offspring. For this purpose, we studied HPA axis activity in 4-month-old control (C) and perinatally malnourished male rats after a 72-hour water deprivation period. Furthermore, we investigated the long-lasting effects of perinatal maternal malnutrition on the basal activity of the HPA axis. Under basal conditions, rats exposed to perinatal malnutrition showed reduced body weight, enhanced mineralocorticoid receptor (MR) mRNA levels in CA2 and CA3 hippocampal areas, but decreased glucocorticoid receptor (GR) mRNA levels in CA1, CA3 and dentate gyrus (DG) areas. In contrast, the levels of corticotropin-releasing hormone (CRH) and vasopressin (VP) mRNAs in the hypothalamic paraventricular nucleus (PVN) as well as of VP mRNA in the supraoptic nucleus (SON) were unaffected by maternal undernutrition. Expression of proopiomelanocortin (POMC) in the adenohypophysis was significantly enhanced, whereas prohormone convertase-1 (PC1) was not affected. Perinatal malnutrition reduced absolute adrenal weight but did not affect circulating levels of adrenocorticotropin (ACTH), corticosterone and free corticosterone as well as corticosteroid-binding globulin (CBG) binding capacity. Seventy-two hours of dehydration induced a decrease in body weight and CRH mRNA levels in PVN of controls as well as of FR50 rats, but also led to a rise in plasma corticosterone and free corticosterone without changing CBG binding capacity. Dehydration also induced an increase in adenopituitary POMC (C) and PC1 (FR50), PVN and SON VP (C) and GR in CA1 hippocampal area (FR50) mRNA levels and plasma ACTH (C), but a decrease in MR in DG (C) and GR in CA3 and DG (C) mRNA levels. We conclude that maternal food restriction during the perinatal period affects (1) the adult basal activity of the HPA axis with mainly opposite effects on hippocampal MR and GR gene expression and an increase in adenopituitary POMC gene expression, and (2) the responsiveness to water deprivation in adults. In the latter case, the rise in plasma ACTH levels, adenopituitary POMC gene expression, hypothalamic VP gene expression, and the decrease in hippocampal MR gene expression in DG and GR gene expression in CA3 and DG observed in controls are lacking in FR50 rats. In contrast, drastic adenopituitary PC1 gene expression occurred in FR50 rats but not in control animals.
Effect of Chlorhexidine Varnish and Gel on Mutans Streptococci in Margins of Restorations in Adults
Authors: Wallman C. , Birkhed D.
Published: April 2003

The aim of this study was to compare the effect of two different chlorhexidine regimens, varnish and gel, on mutans streptococci (MS) in the margins of restorations and in saliva. Eighteen subjects (mean age 44 years) with >250,000 MS/ml saliva and with many restored teeth were assigned to three groups, each comprising 6 individuals. They were treated with: (1) Cervitec® varnish, containing 1% chlorhexidine and 1% thymol; (2) placebo varnish, or (3) Corsodyl® gel, containing 1% chlorhexidine. The varnish was applied on two separate occasions to all tooth surfaces at an interval of 3–4 days. The gel was applied for 3×5 min in individual applicators on 2 consecutive days. Plaque samples from 8–9 margins of restorations per subject, mainly in the premolar and molar region, and stimulated saliva samples were collected at baseline and after 1, 4, 8 and 12 weeks. The general finding was that the Corsodyl gel gave the most pronounced reduction of MS followed by the Cervitec varnish. According to repeated measures ANOVA, no significant differences could be demonstrated either for MS in margins or in saliva among the three groups (p = 0.06 for margins and p = 0.07 for saliva). However, within the groups, the reduction of MS over time was statistically significant, both in margins and in saliva (p < 0.001 and p < 0.05, respectively). Student-Newman-Keuls test showed that MS in margins were significantly reduced at most sampling occasions in both chlorhexidine groups: the reduction was more pronounced in the Corsodyl gel group. The conclusion from this study is that the 1% chlorhexidine gel Corsodyl, administered 6 times during 2 days, is more effective in suppressing MS in the margins of restorations and in saliva than the 1% chlorhexidine varnish Cervitec, administered twice within 3–4 days.
Inhibition of Catalytic and Glucan-Binding Activities of a Streptococcal GTF Forming Insoluble Glucans
Authors: Wright W.G. , Thelwell C. , Svensson B. , Russell R.R.B.
Published: April 2003

The ability of a range of potential inhibitors to affect the catalytic activity or binding of dextran by a glucosyltransferase (GTF-I) that synthesises insoluble α1,3-linked glucan was tested. Acarbose, deoxynojirimycin, N-dodecyldeoxynojirimycin and Tris, which are thought to interfere with the active site of the enzyme of GTF and related glycosidases, inhibited glucan synthesis but not glucan binding. Tris was found to act as a competitive inhibitor of GTF-I. The effectiveness of the active site inhibitors was not altered by immobilisation of GTF-I on saliva-coated hydroxyapatite. In contrast, three amine hydrofluorides were markedly less effective against immobilised GTF than soluble GTF. The pH of the reaction mixture was found to have a strong influence on inhibition by acarbose, Tris and amine hydrofluorides, a finding that is of direct relevance to use of inhibitors in vivo.
Defluoridation of Drinking Water by Boiling with Brushite and Calcite
Authors: Larsen M.J. , Pearce E.I.F.
Published: April 2003

Existing methods for defluoridating drinking water involve expensive high technology or are slow, inefficient and/or unhygienic. A new method is now suggested, encompassing brushite and calcite suspension followed by boiling. Our aim was to examine the efficiency of the method and the chemical reactions involved. Brushite, 0.3–0.5 g, and an equal weight of calcite were suspended in 1 litre water containing 5–20 ppm fluoride. The suspensions were boiled in an electric kettle, left to cool and the calcium salts to sediment. Solution ion concentrations were determined and sediments were examined by X-ray diffraction. In distilled water initially containing 5, 10 and 20 ppm fluoride the concentration was reduced to 0.06, 0.4 and 5.9 ppm, respectively. Using Aarhus tap water which contained 2.6 mmol/l calcium the final concentrations were 1.2, 2.5 and 7.7 ppm, respectively, and runs without calcite gave results similar to those with calcite. Without boiling the fluoride concentration remained unaltered, as did the brushite and calcite salts, despite occasional agitation by hand. All solutions were supersaturated with respect to fluorapatite and hydroxyapatite and close to saturation with respect to brushite. Boiling produced well-crystallised apatite and traces of calcite, while boiling of brushite alone left a poorly crystallised apatite. We conclude that boiling a brushite/calcite suspension rapidly converts the two salts to apatite which incorporates fluoride if present in solution, and that this process may be exploited to defluoridate drinking water.
Comparative Histologic Effects of Daily Topical Application of Creams Containing All-trans-Retinoic Acid or All-trans-Retinoyl β-Glucuronide on Pig Skin
Authors: Gunning Desiree B. , Barua Arun B. , Myers Ronald K. , Ueltschy Amanda , Romans David , Olson James A.
Published: April 2003

The efficacy of all-trans-retinoic acid (tRA) and all-trans-retinoyl β-glucuronide (RAG), a water-soluble metabolite of vitamin A, in the topical treatment of acne is comparable. However, whereas 3.3 mM tRA shows side effects, 3.3 mM RAG does not. To assess the relative toxic and histologic effects (dermal and epidermal changes) of long-term (24-week) daily applications of tRA and RAG on the skin, separate skin patches were measured and marked dorsally on the skin of six 21-day-old, castrated male pigs. Each skin patch area was treated daily with a cream formulation containing either 3.3 mM RAG, 16.5 mM RAG, 33 mM RAG, 3.3 mM tRA, 16.5 mM tRA or blank cream. To serve as controls, one patch received no treatment, one patch received blank cream only and for 5.3 weeks one ‘washed’ patch was given daily application of 33 mM RAG with routine cleansing using a mild soap typical of skin care. The amount of cream used per square centimeter remained the same during the course of the study. Biopsy tissue was collected at –1, 0, 2, 4, 8, 12 and 24 weeks from 7 test patches. The ‘washed’ patch was biopsied once at the 5.3-week mark. Topically applied RAG cream (3.3 mM) resulted in significantly lower histologic scores when compared with scores from tissue treated with an equimolar concentration of tRA. The highest concentration of RAG tested (33.3 mM) resulted in a response comparable to that observed in the lowest tRA (3.3 mM) treated patch area. Daily cleansing of the test area receiving 33.3 mM RAG completely eliminated any clinical signs or negative histologic changes. In conclusion, long-term topical tRA treatment in young pigs, as in humans, showed dose-dependent adverse effects on the skin, whereas RAG treatment had significantly lower histologic changes and less irritation and/or inflammation.
Suppression of Spontaneous Scratching in Hairless Rats by Sedatives but Not by Antipruritics
Authors: Thomsen J.S. , Benfeldt E. , Serup J.
Published: April 2003

Experimental scratching in animals has hitherto been provoked by substances injected into the skin or central nervous system. We aimed to investigate if spontaneous scratching in the rat can be reduced by sedatives and antipruritics, and to assess if spontaneous scratching is elicited from the skin or the central nervous system. It may also be a complex behaviour related to the rat species, different from clinical itch. Eight male hairless rats were studied for 6 weeks. The animals were recorded on videotape in the middle of the day and at night, and the scratching activity was counted. The following substances were tested sequentially: midazolam, mepyramine, a eutectic mixture of lignocaine and prilocaine (EMLA®), betamethasone dipropionate and a vehicle. On days 1–3 of each sequence, the test material was applied to a 42-cm2 area on the rostral part of the back. Subsequent treatment of the whole body was made on day 4. Midazolam was injected intraperitoneally from day 1 to day 4. After 4 days of treatment, there was a wash-out phase of 3 days until the next sequence. We found a positive correlation between minutes awake and number of scratch episodes. Spontaneous scratching was lower after mepyramine on day 4 (p = 0.046) and after midazolam injections on days 1–3 (p = 0.009) and day 4 (p = 0.003). The local anaesthetic, EMLA, did not significantly influence spontaneous scratching. In conclusion, only the drugs with sedative properties suppressed spontaneous scratching, which is probably a cerebral phenomenon or otherwise explained general behaviour, rather than a reaction to skin stimuli. Thus, for testing of topically applied antipruritics, spontaneous scratching cannot be used as an animal model. Furthermore, evaluation of provocative scratching should eliminate/exclude spontaneous scratching.
Clinical Features and Treatment Prognosis of Infertile Males with Robertsonian Translocation
Authors: Kondoh Nobuyuki , Matsumiya Kiyomi , Nakamura Yoshihiro , Koga Minoru , Nishimura Kenji , Kitamura Masaya , Takeyama Masami , Okuyama Akihiko
Published: April 2003

Background: The principle of treating male infertility in those with chromosomal aberrations should change according to progress in treatment modalities. Methods: In this study, ten patients with Robertsonian translocation were assessed for their cytogenetic and clinical characteristics to establish guidelines for treating these patients. Results: In 8 of 10 cases, chromosomes 13 and 14 were involved. In 4 of 10 cases (40%), their wives became pregnant, including two spontaneously. All newborns were without any deformities including one boy who was shown to have a normal karyotype. Conclusion: Infertility treatment of patients with Robertsonian translocation should be optimistically performed on the basis of proper informed consent.
A Limited Study on the Perception and Change in Attitude about Circumcision among Health Care Professionals and Their Male Family Members
Authors: Verit Ayhan , Aksoy Sahin , Yeni Ercan , Unal Dogan , Ciftci Halil
Published: April 2003

Objectives: Millions of male children are circumcised throughout the world. We investigated the opinions and thoughts about the past and future aspects of circumcision by interviewing 100 male family members of the health care staff. Methods: 100 male volunteers answered a questionnaire comprising questions about their personal observations, feelings, festivities and opinions about their own circumcisions as well as their views about the circumcision phenomenon as a parent, and the legality of circumcision. Results: 81% of the volunteers in our study had been circumcised by traditional circumcisers. The rest had been circumcised by doctors (10%), barbers (7%) and sheikhs (2%). In 90% the circumcision took place at home, 7% in hospitals and in 3% in village squares. While 66% of the subjects do not remember anything, the remaining 33% reported some bad sensations like fear, pain and shame about their circumcisions, and 1 (1%) subject reported happiness. As a parent, they answered the questions on their preferences on the place and performer of the circumcision. 44% preferred to have circumcision performed in the hospital by a physician, 26% at home by a physician, and 30% at home by a circumciser. Conclusion: There are significant changes in the attitudes of people in Turkey on circumcision as a traditional culture, though its perception has remained unchanged.
Stratum corneum pH: Formation and Function of the ‘Acid Mantle’
Authors: Fluhr Joachim W. , Elias Peter M.
Published: April 2003

Although the acidic surface pH of the skin has been known for over a century, the stratum corneum (SC) pH gradient has been discovered only recently. After removal of SC layers with sequential tape strips, in humans, surface pH starts at 4.5–5.3, increasing by about 2–3 units until it reaches 6.8 in the lower SC. Both exogenous [free fatty acids (FFA) from sebaceous lipid, microbial metabolites, lactic acid from eccrine glands] and endogenous epidermal (enzymatic; membrane antiporters/pumps) mechanisms have been hypothesized to contribute to SC acidification. Three endogenous mechanisms have been identified to date that not only could influence SC pH, but also regulate one or more key SC functions: (1) the histidine-to-urocanic-acid pathway; (2) the phospholipid-to-FFA pathway, and (3) the sodium proton antiporter (NHE1). Additional factors that influence human surface pH have been detected. Endogenous factors, unrelated to pathological features, such as racial differences, topographical variation, gender differences, developmental and age-related changes have been reported. In contrast to adults, human newborn SC displays a near-neutral surface pH, which declines rapidly over the first postnatal month. Furthermore, endogenous factors have been described, as in atopic dermatitis, seborrheic dermatitis, diabetes, renal insufficiency and ichthyosis associated with an increased pH. Exogenous factors, like the use of detergents and cleansing products as well as SC hydration, can modify the surface pH. The consequences of SC acidification for several key SC functions are becoming clear, including (1) the role of an acidic pH for SC permeability barrier homeostasis, (2) the pH dependence of extracellular lipid processing and (3) SC integrity/cohesion. Integrity is defined as a measure of resistance to dissociation of adjacent corneocytes by tape stripping (cohesion is a related index defined as the amount of protein removed per stripping). (4) Proteolytic processes leading to desquamation are pH dependent, and (5) an acidic pH provides important antimicrobial resistance.
Androgenic Alopecia and Stress-Induced Premature Senescence by Cumulative Ultraviolet Light Exposure
Authors: Piérard-Franchimont C. , Uhoda I. , Saint-Léger D. , Piérard G.E.
Published: April 2003

Background: Ultraviolet light radiations (UVR) may be responsible for hair cycle synchronization and telogen effluvium in the animal and humans. The effect if any of cumulative UVR on chronic hair shedding and androgenic alopecia (AGA) is largely unknown. Objective: To compare the severity of AGA with the extent of solar elastosis. Method: The present study combining immunohistochemistry and computerized image analysis was undertaken in 140 men with AGA and 50 non-alopecic men. Solar elastosis was identified using the antibody to lysozyme, and collagen was revealed by Sirius red staining. The number and diameter of hair shafts were also assessed. Results: The scalp dermis was significantly thicker in AGA than in unaffected subjects. The difference was mainly due to a severer elastosis in baldness. The earliest signs of solar elastosis preceded hair thinning. When elastosis was thicker than 0.2 mm, a negative exponential correlation was found between hair diameter and severity of solar elastosis. Conclusion: Chronic UVR exposure of the scalp may affect the hair cycle and be one of the exogenous factors influencing negatively the progression of AGA. The induction of stress-induced premature senescence by reactive oxygen species and micro-inflammation might be operative at the level of the follicular stem cells.
Correlation of Instrumental Voice Evaluation with Perceptual Voice Analysis Using a Modified Visual Analog Scale
Authors: Yu Ping , Revis Joana , Wuyts Floris L. , Zanaret Michel , Giovanni Antoine
Published: April 2003

Various rating scales have been used for perceptual voice analysis including ordinal (ORD) scales and visual analog (VA) scales. The purpose of this study was to determine the most suitable scale for studies using perceptual voice analysis as a gold standard for validation of objective analysis protocols. The study was carried out on 74 female voice samples from 68 dysphonic patients and 6 controls. A panel of 4 raters with experience in perceptual analysis was asked to score voices according to the G component (overall quality) of the GRBAS system. Two rating scales were used. The first was a conventional 4-point ORD scale. The second was a modified VA (mVA) scale obtained by transforming the VA scale into an ORD scale using a weighted conversion scheme. Objective voice evaluation was performed using the EVA® workstation. Objective measurements included acoustic, aerodynamic, and physiologic parameters as well as parameters based on nonlinear mathematics (e.g., Lyapunov coefficient). Instrumental measurements were compared with results of perceptual analysis using either the conventional ORD scale or mVA scale. Results demonstrate that correlation between perceptual and objective voice judgments is better using a mVA scale than a conventional ORD scale (concordance, 88 vs. 64%). Data also indicate that the mVA scale described herein improves the correlation between objective and perceptual voice analysis.
HER-Targeted Tyrosine-Kinase Inhibitors
Authors: Baselga José , Hammond Lisa A.
Published: April 2003

Improved understanding of tumor biology has led to the identification of numerous growth factors that are involved in malignant transformation and tumor progression. Many of these factors induce cellular responses through receptors with intrinsic tyrosine kinase (TK) activity. Therefore, inhibiting receptor TK activity is a way to effectively block the tumorigenic effects that arise from these pathways. The HER family of TK receptors is overexpressed or dysregulated in many types of human cancer. As a result these receptors were identified as targets for cancer therapy. Several agents have been developed that reversibly, or irreversibly, inhibit one, two or all of the HER receptors. TarcevaTM and IressaTM are HER1-TK inhibitors that are advanced in development. Clinical data show that these agents as monotherapy have antitumor activity in patients with various types of solid tumor and are well tolerated; encouraging data are also produced when Tarceva or Iressa are combined with chemotherapeutic agents. Other dual or pan-HER, reversible or irreversible, TK inhibitors are being investigated in phase I trials. Early data show that they are generally well tolerated and have provided evidence of antitumor activity. HER-TK inhibitors are exciting agents that are likely to have a substantial impact on the way we treat patients with cancer.
Topical Retinoyl β-Glucuronide Is an Effective Treatment of Mild to Moderate Acne vulgaris in Asian-Indian Patients
Authors: Goswami Bhabesh C. , Baishya Bishnuram , Barua Arun B. , Olson James A.
Published: April 2003

Topical retinoyl β-glucuronide (RBG) is beneficial in the treatment of mild to moderate acne (acne vulgaris) in patients largely of North-European origin in the US. Because the skin types of people in India are different from those in the US, we investigated the effectiveness and toxicity of topical RBG in acne patients in India. Each day, 27 acne patients were treated topically with the vehicle, and 39 acne patients were treated topically with 0.16% RBG cream for 18 weeks in a double-blind study. A significant reduction (p < 0.001) in total lesions, inflammatory lesions and noninflammatory lesions in patients treated with RBG as compared with the vehicle only (86.8, 80.2 and 94.6% vs. 40.1, 34.3 and 50%, respectively) was observed. No side effects were associated with topical RBG treatment. Thus, topical 0.16% RBG is a rapid, effective and nontoxic treatment for mild to moderate acne in Asian-Indian patients.
Influence of Tacalcitol on Cell Cycle Kinetics of Human Keratinocytes following Standardized Injury
Authors: Mommers J.M. , ter Meulen A.C. , van Erp P.E.J. , van de Kerkhof P.C.M.
Published: April 2003

In the last few years, tacalcitol (1α,24-dihydroxy vitamin D3, TV-02) has become widely available for the topical treatment of psoriasis. Several studies documented its effect on epidermal differentiation, inflammation and proliferation. Especially the effect on epidermal proliferation has shown to be most substantial. This finding strongly suggests that the antipsoriatic effect of tacalcitol may be mediated by the normalization of epidermal cell cycle kinetics. Aim of the present study was to investigate the effect of tacalcitol ointment (4 µg/g) compared with the ointment base on epidermal proliferation following tape stripping. In particular, we addressed the question to what extent tacalcitol influences the recruitment of G₀ cells after standardized injury. In 15 healthy volunteers, SellotapeTM stripping of the epidermis was performed at two places on the lower back. Then, tacalcitol ointment (4 µg/g) and the ointment base were applied on the lesions and covered by a semiocclusive dressing. Punch biopsies of the lesions were obtained at 24, 32, 38, 44, 50, and 56 h after tape stripping. Using a flow cytometric staining procedure with parameters for epidermal proliferation (DNA content), differentiation (keratin 10 expression) and nonmesenchymal cells (vimentin expression), quantitative data were obtained. There was a statistically significant difference between the time intervals for tacalcitol and placebo with respect to the percentage of recruited basal cells in S phase: The peak of recruited basal cells in S phase was seen at 38 h for the placebo-treated lesions, whereas this peak was seen at 50 h for the tacalcitol-treated lesions. There was no significant difference in the total number of recruited cells between tacalcitol and placebo. The influence of tacalcitol on epidermal keratinization and on the percentage of nonkeratinocytes did not show any significance compared to placebo. We concluded that the mode of action of tacalcitol on proliferation is mainly through an extension of the cell cycle time of keratinocytes and/or an extension of the duration of the recruitment process of cycling cells, whereas the ability to suppress recruitment of resting keratinocytes is not different from placebo. Moreover, because of the limited effect of tacalcitol on epidermal keratinization, combination treatments with agents which interfere with keratinization and/or inflammation may be attractive.
Neurogenic Modifications Induced by Substance P in an Organ Culture of Human Skin
Authors: Branchet-Gumila M.C. , Boisnic S. , Le Charpentier Y. , Nonotte I. , Montastier C. , Breton L.
Published: April 2003

Neurogenic inflammation of the skin observed after topical application of an irritant substance or environmental stimulation induces vascular changes and the production of inflammatory mediators. Substance P (SP) is one of the main neuropeptides which trigger an inflammatory response in the skin. So, with the aim to develop an alternative method to study neurogenic inflammation of the skin, we used an organ culture of human skin. SP was added onto epidermis or directly to culture medium in an attempt to reproduce ex vivo the effects described in vivo. Even disconnected from systemic blood circulation, in skin fragments in culture, we observed dose-dependent edema, vasodilation and extravasation of lymphocytes and mast cells through the microvascular wall. Moreover, the release of proinflammatory mediators interleukin 1α and tumor necrosis factor α was evidenced.