bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic relationships between ferralsols, podzols and white kaolin in Amazonia
Authors: Ishida D. A. , Montes C. R. , Lucas Y. , Pereira O. J. R. , Merdy P. , Melfi A. J.
Published: July 2014

White kaolin has frequently been observed to be associated with ferralsol‐podzol soil systems in Amazonia. In order to evaluate whether such systems favour kaolin genesis and to identify the associated genetic processes, we studied soil organization, mineralogy and groundwater properties of a ferralsol‐podzol soil system with white kaolin located in the High Rio Negro Basin, Brazil. We found that the kaolin was situated near the ferralsol‐podzol transition and that its thickness was related to the depth of landscape incision by regressive erosion. The kaolin was characterized by silicon, iron and titanium (Ti) leaching and aluminium (Al) absolute accumulation. The groundwater that percolates from the podzol to the kaolin can enhance kaolinite precipitation, by supplying Al originating from kaolinite dissolution in the overlying Bh, and kaolin bleaching, by low pH and Eh of the percolating waters favouring iron reduction. The system dynamics imply that the quartz dissolution rate in the kaolin is of at least the same order of magnitude as the kaolinite dissolution rate in the overlying Bh. Within the whole system, Ti appeared to be very mobile.
Self‐harm in people with epilepsy: A retrospective cohort study
Authors: Meyer Nicholas , Voysey Merryn , Holmes Jane , Casey Deborah , Hawton Keith
Published: July 2014

Objectives

Little is known about self‐harm in people with epilepsy, despite suicide being recognized as a leading cause of mortality in this population. This study aimed to investigate the characteristics of self‐harm in people with epilepsy, and associated demographic and psychosocial factors.

Methods

Patients presenting to hospital following self‐harm between 1994 and 2008 were identified from the Oxford Monitoring System for Self‐Harm. Epilepsy diagnosis was confirmed through review of medical records. Demographic features, patient, and self‐harm characteristics of 132 people with epilepsy and 9,778 self‐harm patients without epilepsy were compared using a regression model, adjusting for age, sex, and repetition. Patients presenting between 1998 and 2008 were followed up for all‐cause mortality to the end of 2011.

Results

The rate of self‐harm per individual with epilepsy was 2.04 (95% confidence interval [CI] 1.85–2.25) times that of the comparison group, and time between first and second self‐harm events was shorter (hazard ratio 1.86; 1.46–2.38). People with epilepsy were significantly more likely to use antiepileptic medication in overdose, although overall methods of self‐harm were similar in the two groups. No significant differences in suicide intent scores or the proportion of patients who died by suicide were found. Previous outpatient psychiatric treatment, longer duration of unemployment, experience of violence, and housing problems were associated with self‐harm in people with epilepsy.

Significance

People with epilepsy who self‐harm do so more frequently than other self‐harm patients. Clinicians should be aware of this and pay attention to contributory factors as these may enhance risk in this population.

A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
Cerebral glucose hypometabolism is associated with mitochondrial dysfunction in patients with intractable epilepsy and cortical dysplasia
Authors: Tenney Jeffrey R. , Rozhkov Leonid , Horn Paul , Miles Lili , Miles Michael V.
Published: July 2014

Objectives

Metabolic imaging studies, such as positron emission tomography (PET), allow for an assessment of physiologic functioning of the brain, and [18F]fluoro‐2‐deoxyglucose (FDG)–PET is now a commonly used technique in presurgical epilepsy evaluations. Focal interictal decreases in glucose consumption are often but inconsistently concordant with the ictal onset area, and the underlying mechanisms are poorly understood. The current study tests the hypothesis that areas of glucose hypometabolism, determined by FDG‐PET, are associated with mitochondrial dysfunction in patients with medically intractable epilepsy associated with isolated focal cortical dysplasia (FCD).

Methods

Measures of electron transport chain (ETC) functioning and mitochondrial abnormalities (ETC complex biochemistry, protein kinase B subtype 1 (Akt1), glial fibrillary acidic protein (GFAP)) were assessed in surgical resection specimens that had hypometabolic abnormalities and those that were normal on FDG‐PET. Determination of FDG‐PET abnormalities was based on coregistration of statistical parametric mapping (SPM) results with postsurgical images.

Results

Twenty‐two patients (11 male, 11 female; mean age at the time of surgery 10.5 ± 4.4 years), with pathologically confirmed FCD, were included in this retrospective review. Complex IV function was found to be significantly reduced in areas of hypometabolism (p = 0.014), whereas there was a trend toward a significant reduction in complex II and III function in areas of hypometabolism (p = 0.08, p = 0.059, respectively). These decreases were independent of cortical dysplasia severity (p = 0.321) and other clinical epilepsy measures.

Significance

This study suggests an association between glucose hypometabolism and reduced mitochondrial complex IV functioning, which is independent of the degree of cortical dysplasia. This supports the role of cellular energy failure as a potential mechanism for intractable epilepsy.
The Effect of Human Presence and Human Activity on Risk Assessment and Flight Initiation Distance in Skinks
Authors: McGowan Marilyn M. , Patel Priya D. , Stroh Jolie D. , Blumstein Daniel T.
Published: July 2014

Antipredator behavior and risk assessment of many species are affected by the presence of humans and their activities. Previous studies have largely been conducted on birds and mammals and relatively less is known about human impacts on reptiles. We used flight initiation distance (FID) as a measure of risk assessment in inland blue‐tailed skinks (Emoia impar) and tested the direct and indirect effects of humans on risk assessment. We first examined the effects of varying levels and types of human disturbance and activity on skink FID. We found that skinks flushed at significantly longer distances in areas with the least human activity. We then tested the degree to which skinks are able to discriminate different numbers of humans by comparing FID across three different types of approaches. Skinks did not significantly differentiate between a single approacher and a single approacher coming from a group of two other people, but did flush at greater distances when approached by three people simultaneously. Although skinks are not directly harvested or harassed by humans, they have refined human discrimination abilities. Overall, skinks habituate to a variety of human activities and perceive a larger threat when the number of human approachers is greater.
Preventive DNA repair by sanitizing the cellular (deoxy)nucleoside triphosphate pool
Authors: Nagy Gergely N. , Leveles Ibolya , Vértessy Beáta G.
Published: July 2014

The occurrence of modified bases in DNA is attributed to some major factors: incorporation of altered nucleotide building blocks and chemical reactions or radiation effects on bases within the DNA structure. Several enzyme families are involved in preventing the incorporation of noncanonical bases playing a ‘sanitizing’ role. The catalytic mechanism of action of these enzymes has been revealed for a number of representatives in clear structural and kinetic detail. In this review, we focus in detail on those examples where clear evidence has been produced using high‐resolution structural studies. Comparing the protein fold and architecture of the enzyme active sites, two main classes of sanitizing deoxyribonucleoside triphosphate pyrophosphatases can be assigned that are distinguished by the site of nucleophilic attack. In enzymes associated with attack at the α‐phosphorus, it is shown that coordination of the γ‐phosphate group is also ensured by multiple interactions. By contrast, enzymes catalyzing attack at the β‐phosphorus atom mainly coordinate the α‐ and the β‐phosphate only. Characteristic differences are also observed with respect to the role of the metal ion cofactor (Mg2+) and the coordination of nucleophilic water. Using different catalytic mechanisms embedded in different protein folds, these enzymes present a clear example of convergent evolution.
The development of scales to measure childhood cancer survivors' readiness for transition to long‐term follow‐up care as adults
Authors: Klassen Anne F. , Rosenberg‐Yunger Zahava R.S. , D'Agostino Norma M. , Cano Stefan J. , Barr Ronald , Syed Iqra , Granek Leeat , Greenberg Mark L. , Dix David , Nathan Paul C.
Published: July 2014

Purpose

To develop and validate scales to measure constructs that survivors of childhood cancer report as barriers and/or facilitators to the process of transitioning from paediatric to adult‐oriented long‐term follow‐up (LTFU) care.

Methods

Qualitative interviews provided a dataset that were used to develop items for three new scales that measure cancer worry, self‐management skills and expectations about adult care. These scales were field‐tested in a sample of 250 survivors aged 15–26 years recruited from three Canadian hospitals between July 2011 and January 2012. Rasch Measurement Theory (RMT) analysis was used to identify the items that represent the best indicators of each scale using tests of validity (i.e. thresholds for item response options, item fit statistics, item locations, differential item function) and reliability (Person Separation Index). Traditional psychometric tests of measurement performance were also conducted.

Results

RMT led to the refinement of a 6‐item Cancer Worry scale (focused on worry about cancer‐related issues such as late effects), a 15‐item Self‐Management Skills scale (focused on skills an adolescent needs to acquire to manage their own health care), and a 12‐item Expectations scale (about the nature of adult LTFU care). Our study provides preliminary evidence about the reliability and validity of these new scales (e.g. Person Separation Index ≥ 0.81; Cronbach's α ≥ 0.81; test–retest reliability ≥ 0.85).

Conclusion

There is limited knowledge about the transition experience of childhood cancer survivors. These scales can be used to investigate barriers survivors face in the process of transition from paediatric to adult care.
Metastability in the MgAl2O4–Al2O3 System
Authors: Wilkerson Kelley R. , Smith Jeffrey D. , Hemrick James G.
Published: July 2014

Aluminum oxide must take a spinel form (γ‐Al2O3) at increased temperatures in order for extensive solid solution to form between MgAl2O4 and α‐Al2O3. The solvus line between MgAl2O4 and Al2O3 has been defined at 79.6 wt% Al2O3 at 1500°C, 83.0 wt% Al2O3 at 1600°C, and 86.5 wt% Al2O3 at 1700°C. A metastable region has been defined at temperatures up to 1700°C which could have significant implications for material processing and properties. Additionally, initial processing could have major implications on final chemistry.
Community pharmacy type 2 diabetes risk assessment: demographics and risk results
Authors: Twigg Michael J , Wright David J , Thornley Tracey , Haynes Lisa
Published: July 2014

Objectives

To determine the demographics and risk results of patients accessing a community pharmacy diabetes risk assessment service.

Method

Participating patients underwent an assessment using a validated questionnaire to determine their 10-year risk of developing type 2 diabetes. Patients were given appropriate lifestyle advice or referred to their general practitioner if necessary.

Key findings

In total, 21 302 risk assessments were performed. Nearly one-third (29%) of 3427 risk assessments analysed yielded a result of moderate or high chance of developing the condition.

Conclusions

Community pharmacies can identify a significant number of patients at risk of developing type 2 diabetes in the next 10 years. Further follow-up work needs to be done to determine the cost-effectiveness of such a service and the consequences of receiving a risk assessment.
The sensory neurone membrane protein SNMP1 contributes to the sensitivity of a pheromone detection system
Authors: Pregitzer P. , Greschista M. , Breer H. , Krieger J.
Published: July 2014

Male moths detect female‐released sex pheromones with extraordinary sensitivity. The remarkable sensory ability is based on a cooperative interplay of pheromone binding proteins in the lymph of hair‐like sensilla trichodea and pheromone receptors in the dendrites of sensory neurones. Here we examined whether in Heliothis virescens the so‐called ‘sensory neurone membrane protein 1’ (SNMP1) may contribute to responsiveness to the pheromone component, (Z)‐11‐hexadecenal (Z11‐16:Ald). By means of immunohistochemistry and in situ hybridization we demonstrated that SNMP1 is in fact present in cells expressing the Z11‐16:Ald receptor HR13 and the dendrites of sensory neurones. To assess a possible function of SNMP1 we monitored the responsiveness of cell lines that expressed HR13 alone or the combination SNMP1/HR13 to stimulation with Z11‐16:Ald by calcium imaging. It was found that SNMP1/HR13 cells were 1000‐fold more sensitive to pheromone stimulation compared with HR13 cells. In contrast, cells that expressed HR13 and the non‐neuronal SNMP2‐type showed no change in pheromone sensitivity. Overall, our reconstitution experiments demonstrate that the presence of SNMP1 significantly increases the HR13‐based responsiveness of cells to Z11‐16:Ald, suggesting that SNMP1 also contributes to the response of the antennal neurones and thus to the remarkable sensitivity of the pheromone detection system.
Dental fear and expected effectiveness of destructive coping as predictors of children's uncooperative intentions in dental settings
Authors: Crego Antonio , Carrillo‐Diaz María , Armfield Jason M. , Romero Martín
Published: July 2014

Aim

To explore the mechanisms by which some children select disruptive behaviours to cope with stressful dental events. In particular, the relationships between dental fear, expected effectiveness of destructive coping, and intentions of displaying uncooperative behaviours were analysed.

Design

Participants were 170 children who filled out a questionnaire survey. Descriptive statistics by gender and group age as well as comparisons of means were calculated. Spearman's rho correlation coefficients and binary logistic regression analysis were used to test hypotheses of the relationships among variables.

Results

Both dental fear and the expected effectiveness of destructive coping strategies were significantly associated with children's uncooperative intentions at the dentist. In addition, children who strongly endorsed the effectiveness of destructive coping strategies had a higher probability of uncooperative intentions as dental fear increased. In contrast, this relationship was not statistically significant among children who did not expect negative behaviours to be effective.

Conclusions

Children's expectations about the effectiveness of destructive coping behaviours can help explain variations in the use of these strategies in stressful dental situations. Dental fear as well as children's inadequate expectancies about coping alternatives should be explored and targeted to prevent and modify uncooperative behaviour intentions at the dentist.
Comparison of Calcipotriol and Coal Tar in Conjunction with Sun Exposure in Chronic Plaque Psoriasis: A Pilot Study
Authors: Kaur Inderjeet , Saraswat Abir , Kumar Bhushan
Published: July 2014

This study was a left‐right comparison of the efficacy of 0.005% calcipotriol ointment and 5% coal tar ointment in conjunction with sun exposure in 10 patients with stable plaque psoriasis. After four weeks of therapy, the calcipotriol treated site showed a significantly faster fall in PASI compared to the coal tar treated site. At eight weeks, this difference was not significant with both sides showing comparable improvement in lesions, as shown by PASI values. There were no significant side effects from either therapy. We conclude that both calcipotriol and coal tar ointments have comparable efficacy in treating stable plaque psoriasis when used simultaneously with sun exposure, although the initial response to calcipotriol is faster.
Vitiligo: A Retrospective Comparative Analysis of Treatment Modalities in 500 Patients
Authors: Handa Sanjeev , Pandhi Roma , Kaur Inderjeet
Published: July 2014

The major non‐surgical re‐pigmenting therapies for vitiligo include psoralens and corticosteroids, used both topically and systemically. In an attempt to determine the best therapeutic option, we compared the efficacy of various treatment regimens used in our department for the treatment of vitiligo. We report herein our results with six different regimens used in our clinic. Data from five hundred vitiligo patients who attended the pigmentary disorders clinic at the Nehru Hospital, PGI, Chandigarh, was analysed. For the purpose of analysis, patients were arbitrarily divided into two groups based upon the body surface area (BSA) involved: Group A (<10% BSA involved) and B (>10% BSA involved). Group A was further divided into three subgoups of patients depending upon what treatment they received: R‐I {topical clobetasol propionate+sun exposure}; R‐II {topical psoralen+sun exposure (topical PUVASOL)}; R‐III {topical psoralen+UVA (topical PUVA)}. Group B was also subdivided into three subgroups of patients who received: R‐IV {oral dexamethasone pulse therapy + sun exposure}; R‐V {systemic psoralen + sun exposure (systemic PUVASOL)}; R‐VI {systemic psoralen + UVA (systemic PUVA)}. Patients who had undergone, one of the above mentioned regimens and had a regular monthly follow up until total re‐pigmentation or for at least one year, whichever was earlier, were included in the final assessment of the therapeutic efficacy of that regimen. At the end of the study in Group A, 207 (89%) patients out of 232 on R‐I; 73 (93%) out of 78 on R‐II, and 15 (79%) out of 19 patients on R‐III showed moderate to excellent re‐pigmentation, respectively. In group B, 45 (81%) patients out of 55 on R‐IV, 48 (84%) out of 57 on R‐V, and 22 (84%) patients out of 26 on R‐VI showed moderate to excellent re‐pigmentation. Statistically, in Group A, R‐I & II were significantly better than R‐III. However in Group B, there was no significant difference in the responses to R‐IV, V, and VI. A positive family history of vitiligo did not seem to affect the response rate. Potent topical steroids used along with sun exposure and topical PUVASOL were the most effective forms of therapy for localised vitiligo. For the generalised form of the disease, we concluded that all the systemic modalities, oral steroids, PUVASOL and PUVA, are equally efficacious over a period of one year. Phototoxic reactions were, however, more common with PUVASOL.
Treating Ingrown Toenails by Nail Splinting with a Flexible Tube: An Indian Experience
Authors: Gupta Somesh , Sahoo Bijaylaxmi , Kumar Bhushan
Published: July 2014

Ingrown toenail is a common problem, and currently available treatments are either quite invasive or associated with unacceptably high recurrence rate. Recently a new non‐invasive therapy, “Nail splinting”, has been introduced. In this procedure, the nail is splinted with a longitudinally incised plastic tube. We conducted the present study to evaluate the efficacy and safety of this procedure in fifty patients (68 nail edges in 61 nails) with ingrown toenails at all stages. The pain disappeared almost immediately, and inflammation subsided in about one week in all nail edges. Thirty‐nine patients came for regular follow‐up for six months after removal of the tube. Eight (20.5%) of these patients showed recurrence of the problem. No serious side effects were noted.
Comparative Efficacy of Ketoconazole and Fluconazole in the Treatment of Pityriasis Versicolor: A One Year Follow‐up Study
Authors: Bhogal Charanjeet Singh , Singal Archana , Baruah Manik Chander
Published: July 2014

Pityriasis versicolor can be treated by a single or multiple dosage regime of ketoconazole as well as by fluconazole. The therapeutic efficacy of these two drugs has not been compared. One hundred and eighty patients with moderate to extensive pityriasis versicolor confirmed by KOH and Wood's lamp examination were randomly assigned to one of the four oral antifungal regimes: Ketoconazole 400 mg single dose (Category I), Ketoconazole 200 mg daily for 10 days (Category II), Fluconazole 400 mg single dose (Category III) or Fluconazole 150 mg per week for 4 weeks (Category IV). Follow up was done at 2 and 4 weeks and then at 3, 6 and 12 months after the treatment in each group. KOH and Wood's lamp examinations were repeated each time. After four weeks of treatment, clinical cure was observed in 66.6% (Category I), 73.3% (Category II), 80% (Category III) and 59.9% (Category IV) of patients. Mycological cure after four weeks of treatment was observed in 53.3% (Category I), 73.3% (Category II), 82.2% (Category III) and 64.4% (Category IV) of patients. After twelve months of follow‐up, maximum relapses were observed with Category I. No relapse was seen in Category III patients. The time period of relapse varied from three to ten months. In conclusion, single dose 400 mg oral fluconazole provided the best clinical as well as mycological cure rate with no relapse during twelve months of follow‐up.
Clinical Spectrum of Behçet's Disease
Authors: Bang Dongsik
Published: July 2014

Behçet's disease is a chronic systemic inflammatory disease involving mucous membranes, skin, eyes, the gastrointestinal tract, joints, blood vessels, and the neurologic system. Behçet's disease occurs endemically in the Middle East and Mediterranean regions. It is also distributed in the Central and Far Eastern Asian countries including Korea, Japan, and China. With the volume of clinical information obtained from over 5,000 patients who visited the Behçet's Disease Specialty Clinic, Severance Hospital, Yonsei University College of Medicine, informative and educational viewpoints of Behçet's disease including dermatologic and other systemic manifestations were introduced.
Bullous Pemphigoid: End of the Century Overview
Authors: Liu Zhi , Diaz Luis A.
Published: July 2014

Bullous pemphigoid (BP) was first described by Lever in 1953 as a subepidermal blistering disease. Immunohistological features of BP include dermal‐epidermal junction separation with an inflammatory cell infiltrate in the upper dermis, and autoantibodies in patients' circulation and bound to the basement membrane zone (BMZ). These autoantibodies show a linear staining at the dermal‐epidermal junction (DEJ) and recognize two major hemidesmosomal proteins, the BP230 (BPAG1) and BP180 (BPAG2). An IgG passive transfer mouse model of BP was developed, that recapitulates the key features of human BP. Using this in vivo model system, key cellular and molecular events leading to BP disease phenotype are identified, including IgG binding to its target, complement activation, mast cell degranulation, neutrophil infiltration and activation. Proteinases and reactive oxygen species released by neutrophils work together to damage BMZ, causing DEJ separation. T cells from BP patients show a specific proliferative response to recombinant BP180 NC16A. These NC16A‐responding T lymphocytes express alpha/beta T cell receptors and CD4 memory T cell surface markers and exhibited a Th1/Th2 mixed cytokine profile. After almost a half‐century of studies, we have learned a great deal about IgG‐mediated tissue injury and begin to understand the autoimmune responses leading to pathogenic IgG production in BP.
Austria and Japan: Early Relations in Dermatology An “Imperial” Connection in Historical Perspective
Authors: Holubar Karl , Fatović‐Ferenčić Stella
Published: July 2014

Summary

The early relations in dermatology between imperial Japan of the beginning Meiji era and Imperial Austria‐Hungary are reviewed. Keizo Dohi, the pioneer of Western dermatology in Japan, trained in Austria under Moriz Kaposi in Vienna. Emphasis is also given to dermatological iconography, to early connections in medicine, and the Japanology in Austria, in general. Today, Japan has developed into one of three centers of investigative dermatology, (USA, Europe, Japan). The country has moved herself from the position of a pupil into that of a master.
Fulminant and Relentless Cutaneous Necrosis with Excruciating Pain Caused by Calciphylaxis Developing in a Patient Undergoing Peritoneal Dialysis
Authors: Sato Noriko , Teramura Tomoko , Ishiyama Takeshi , Tagami Hachiro
Published: July 2014

A 50‐year‐old Japanese female with chronic renal failure who had been on continuous ambulatory peritoneal dialysis developed fulminant systemic cutaneous necrosis that began as painful livedo reticularis‐like skin lesions on her thighs. Because of disseminated vascular calcification within the muscular layer of her lower limbs, we eventually diagnosed her with calciphylaxis. The skin necrosis progressed rapidly, and she died of sepsis and pneumonia on the 53rd hospital day. In addition to her long‐lasting severe hyperparathyroidism and extremely elevated serum phosphorus and calcium levels, mechanical, frictional stimulation inflicted on the local skin and administration of corticosteroids were suspected to have precipitated the calciphylaxis. Our lack of awareness of this disease in its early stages resulted in our missing the chance to do a parathyroidectomy that might have changed the course. It is important to know the clinical features of this rare disease in order to make a diagnosis as early as possible.
Effect of Biflavones of Ginkgo biloba against UVB‐induced Cytotoxicity In vitro
Authors: Kim Seong‐Jin
Published: July 2014

The effect of Ginkgo biloba extract on Ultraviolet B (UVB) irradiated fibroblasts was examined by using a neutral red dye uptake assay and a lactic dehydrogenase (LDH) release assay. Crude extract along with individual components, including flavone‐glycosides and biflavones, were applied to cultured normal human skin fibroblasts for 12 hours, and 0, 20, 40 and 80 mJ/cm2 of UVB were irradiated. Two synthetic flavonoids, quercetin and rutin, which have polyphenol structures close to the flavonoids in Ginkgo biloba extract, were used to compare any structure‐related activity under the same conditions. At the concentrations (from 0.25 to 2 mg/ml) treated with biflavone components (isoginkgetin/ginkgetin, sciadopitysin) and quercetin, high neutral red dye uptake was detected with gradual increases in UVB irradiation. The time‐course release of LDH was determined as the cytotoxicity index (%) during 24 hours following a high dose UVB irradiation (200 mJ/cm2), and the pattern of this cytotoxicity index was similar to that of the neutral red dye uptake results. Sciadopitysin, isoginkgetin/ginkgetin and quercetin treatments lowered cytotoxicity indices to 50.81, 67.81 and 62.19%, respectively, compared to 95.38% for the untreated control. The antioxidant potential of biflavones of Ginkgo biloba could be explained on the basis of structure‐related activity; hydroxy‐ and methyl‐substitutions on the basic structure of these flavonoids played a role, as other reports have suggested.
Hemilateral Distribution of Papular Lesions on the Buttock Histologically Resembling Granuloma Gluteale Infantum
Authors: Maekawa Yoshihiro , Kiyoi Kiho , Kunitake Yuko
Published: July 2014

Two Japanese girls had small grouped papules on the buttocks without diaper dermatitis or bacterial or fungal infection. These granulomas spontaneously regressed over two weeks, even though oral antibiotics were administered. We discuss this variant of granuloma gluteale infantum of Tappeiner et al.
Changes in the Seasonal Dependence of Atopic Dermatitis in Japan
Authors: Uenishi Toshiaki , Sugiura Hisashi , Uehara Masami
Published: July 2014

Although it has been generally accepted that seasonal aggravation of skin symptoms is a basic feature of atopic dermatitis, recent studies have suggested a decrease in the seasonal dependence of the dermatosis in European countries over the past several decades. We examined incidence of seasonal deterioration of atopic dermatitis in Japanse subjects. The study population consisted of 682 patients aged 3 to 30 years with atopic dermatitis, who visited our outpatient clinic from August 1998 through July 2000. Of these, 452 (66%) showed a seasonal aggravation of skin symptoms, and 230 (34%) had perennial deterioration. The overall incidences of exacerbation in spring, summer, autumn and winter were 25%, 19%, 11% and 36%, respectively. Further, 358 (52%) showed unpredictable and irregular exacerbations of skin symptoms every few days or weeks. These irregular worsenings were more frequent in patients who showed perennial deterioration than in those with seasonal aggravation. From a comparison of the present results with those reported in the 1960s, it became evident that a real decrease in the incidence of seasonal aggravation of atopic dermatitis has occurred over the past three decades in Japan and that the incidence of summer deterioration has greatly decreased during the same period of time.
Cutaneous Leiomyomatosis with Type 2 Segmental Involvement
Authors: Tsoitis George , Kanitakis Jean , Papadimitriou Christos , Hatzibougias Yannis , Asvesti Katerina , Happle Rudolf
Published: July 2014

A 21‐year‐old man had histologically‐confirmed diffuse cutaneous leiomyomatosis. The lesions showed a peculiar distribution in that they predominantly involved several segments of the right side of his body; in addition, less extensive, nonsegmental lesions were present on both sides of the body. Although this case was apparently sporadic, the genetic mechanism of loss of heterozygosity provides a plausible explanation for this unusual presentation. If the patient were heterozygous for the underlying mutation, at an early developmental stage a postzygotic event of loss of heterozygosity would have given rise to a type 2 segmental involvement, resulting in pronounced lesions superimposed on the disseminated tumors of the ordinary phenotype.
Six Cases of Metastatic Malignant Melanoma with Apparently Occult Primary Lesions
Authors: Honda Sakiko , Yamamoto Osamu , Suenaga Yoshinori , Asahi Masakazu , Nakayama Kanichiro
Published: July 2014

We report here six cases of malignant melanoma in which metastatic lesions were detected first. Of these, two cases showed some peculiar features: one exhibited widespread subcutaneous bleeding, probably due to venous rupture, and the other case had a rare primary lesion on the penis. In the Japanese literature, there have been 46 cases of malignant melanoma in which metastatic lesions were detected prior to the initial ones. The preferential site for metastasis was the lymph node (32 cases). The primary lesion was unknown in 35 patients. The outcomes were available for 36 of the 46 patients; 23 died, including 18 who died within two years.
Acute Hemorrhagic Edema in a Four‐year‐old Japanese Boy
Authors: Fujimura Taku , Funayama Michitaka , Tagami Hachiro
Published: July 2014

A case of acute hemorrhagic edema (AHE), a unique form of leukocytoclastic vasculitis limited only to the skin, was seen in a four‐year‐old boy. It was characterized by an abrupt onset of fever, peripheral edema, and rosette‐shaped purpuric plaques. Although the skin lesion might be confused clinically with other dermatoses such as Henoch‐Schönlein purpura, Sweet's disease and erythema multiforme, his laboratory data were normal, and the disorder follows a benign course with spontaneous resolution within one week.
Lupus Vulgaris Mimicking Lichen Simplex Chronicus
Authors: Pandhi Deepika , Reddy Belum Siva Nagi
Published: July 2014

Cutaneous tuberculosis is not an uncommon entity but it often remains undiagnosed and is inappropriately treated due to its varied presentation. We present a 42‐year‐old male with lupus vulgaris in the perianal area, who was treated as lichen simplex chronicus with steroids for two years. With four drug antitubercular treatment, the patient had a dramatic response. The case is being reported because in this HIV era with the resurgence of tuberculosis, not only will there be an increase in incidence but also more involvement of atypical sites.
Successful Treatment of a Patient with Lymphomatoid Papulosis by Methotrexate
Authors: Yazawa Noriko , Kondo Seiji , Kagaya Makiko , Yazawa Hitoshi , Minamitsuji Yasushi , Jimbow Kowichi
Published: July 2014

We report a case of lymphomatoid papulosis (LyP) that occurred in a 44‐year‐old Japanese male patient. Reddish papules with a small number of pustules and nodules were observed on the extremities, chest and upper back. Most lesions were also associated with central necrosis, ulceration and crusting, and regressed spontaneously within 4 to 6 weeks. Histopathological examination revealed wedge‐shaped dense cellular infiltrate in the dermis, which was mixed with large atypical lymphoid cells, small lymphocytes, eosinophils and neutrophils. These large atypical cells expressed CD30 on their cell membrane and cytoplasm. Rearrangement of the T‐cell receptor (TcR) β‐chain gene was detected in the skin lesion. Lymphadenopathy with histopathologic change similar to the skin lesions, but without TcR gene rearrangement, was found at the left inguinal area. Systemic administration of methotrexate (7.5–15.0 mg/week) was found to be dramatically effective in resolution of skin lesions and prevention of their recurrence.
Infantile Myofibromatosis with Visceral Involvement and Complete Spontaneous Regression
Authors: Hatzidaki Elefthezia , Korakaki Eftychia , Voloudaki Argyzi , Daskaloyannaki Mazia , Manoura Antonia , Giannakopoulou Christina
Published: July 2014

Infantile myofibromatosis is an unusual mesenchymal disorder characterized by the proliferation of tumors in the skin, muscle, bone, and viscera. Two types can be distinguished; the solitary type, defined by the presence of one nodule in the skin, muscle, bone or subcutaneous tissue; and the multicentric type which can be divided into two sub‐types. In the first sub‐type the lesions are multicentric but without visceral involvement, while in the second, visceral involvement is present. The prognosis of the disease depends on whether visceral involvement is present. Solitary and multicentric nodules without visceral involvement usually have excellent prognosis with spontaneous regression of lesions within 1 to 2 years of diagnosis. On the other hand, visceral lesions are associated with a significant morbidity and mortality, resulting from vital organ obstruction, failure to thrive, or infection. Death in these cases often occurs at birth, or soon after, and is usually due to cardio‐pulmonary or gastrointestinal complications. The case being reported here, is that of a female newborn who had multiple skin, subcutaneous tissue, skeletal muscle, bone, and lung lesions immediately after bith. At the age of three years, the child is in good health, her psychomotor development is in accordance with her age group, and the lesions have completely regressed. This is a case of the multicentic type of infantile myofibromatosis with visceral involvement, where all lesions have spontaneously regressed. This is a rarity since the prognosis in the majority of such cases is poor.
A Case of Cutaneous Low‐grade Myofibroblastic Sarcoma
Authors: Chang Sung‐Eun , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung , Lee Tae‐Jin , Ro Jae Y. , Silverman Jeffrey S.
Published: July 2014

A 28‐year‐old woman presented with a recurrent nodule on the lower margin of her left nostril after laser surgery. Histologically, the nodule had an indistinct margin and was composed of interlacing fascicles of plump, spindled or stellate tumor cells with mild cytologic atypia. The tumor cells were revealed to be myofibroblasts by positivity to smooth muscle actin and negativity to desmin. A diagnosis of low grade myofibroblastic sarcoma (LGMS) was made.
Protruding Tumorous Angiolymphoid Hyperplasia with Eosinophilia (ALHE) of the Scalp Accompanied by Arterial Occlusion
Authors: Kobayashi Hiromi , Moriya Takuya , Tagami Hachiro
Published: July 2014

We report a case of an extraordinarily large tumorous form of ALHE developing on the occiput of a 57‐year‐old Japanese male. Histologically, it was characterized by increased numbers of small blood vessels, fibrosis, and lymph follicle formations with massive eosinopilia in the dermis in addition to an occluded artery in the deep dermis.
A Case of Chronic Perianal Pyoderma Treated with the Recycled Skin Graft Method
Authors: Honda Tetsuya , Tachibana Takao , Kitoh Akihiko , Onodera Kazumasa Morita Hisashi , Miyachi Yoshiki
Published: July 2014

We present here a case of chronic perianal pyoderma (CPP), who was treated with a novel skin graft. The patient was a 28‐year‐old male who had suffered from painful abscesses and nodules on his buttocks for over 10 years. Although the abscesses and nodules were initially restricted to one buttock, they gradually spread over both buttocks. He visited our hospital in July of 2000. He was clinically diagnosed as CPP and treated with oral doses of antibiotics. When admitted to our hospital in September of 2000, an anal fistula was also found. The operations for CPP and anal fistula were simultaneously performed. After the anal fistula treatment, the lesions of CPP were totally resected. In this procedure, we removed the epidermis and upper dermis from the excised CPP lesions and grafted them on the defects of the excised lesion. There has been no recurrence of the CPP. This operation procedure, which we call the “recycled skin graft method” is less invasive, because a donor site for the skin graft is unnecessary. We considered it to be as one of the effective treatments for CPP.
Perforating Pilomatricoma: Transepithelial Elimination or Not
Authors: Honda Yoshihide , Oh‐I Tsunao , Koga Michiyuki , Tokuda Yasumoto
Published: July 2014

We present a 56‐year‐old woman with a perforating pilomatricoma in the left eyebrow region. Histologically, the tumor consisted mainly of basophilic cells and shadow cells, and the tumor components were being eliminated through an ulcer with damage to the epithelial structures. In past reports of perforating pilomatricoma, this elimination pattern has often been described as transepithelial elimination. In many patients with perforating pilomatricoma, elimination is accompanied by ulceration and epithelial damage. Mehregan recently stated that elimination accompanied by epidermal necrosis and superficial ulceration constituted one form of transepithelial elimination. Epidermal necrosis and ulceration generally constitute severe damage. However, when Mehregan first proposed the concept of transepithelial elimination, it was defined as a phenomenon with relatively little or no damage to the epithelial structures, differentiating it from other types of elimination. This original definition makes transepithelial elimination a unique and interesting phenomenon, and its most important feature is that there is relatively little or no damage to the epithelial structures. Therefore, the terms “epidermal necrosis” and “ulceration” should not be used in association with transepithelial elimination. Hence, in patients with perforating pilomatricoma, the elimination of tumor components from ulcers with damage to the epithelial structures, as seen in the present case, should not be described as transepithelial elimination.
Localized Linear Scleroderma with Cutaneous Calcinosis
Authors: Yamamoto Ai , Morita Akimichi , Shintani Yoichi , Sakakibara Shigeru , Tsuji Takuo
Published: July 2014

A 38‐year‐old woman developed sclerotic and atrophic changes of the left femur in the winter of 1976. In 1980, she was referred to our dermatology clinic and was diagnosed with localized linear scleroderma from the results of the physical examinations and the histological findings. Although several local and systemic treatments were employed over the following 10 years, the sclerotic lesion did not show any remarkable improvement. In 1991, several hard and white papules appeared in the lesion, and a biopsy specimen of these white papules revealed calcinosis.
Immunohistochemical Localization of Cathepsin L and Cystatin A in Normal Skin and Skin Tumors
Authors: Palungwachira Piti , Kakuta Mie , Yamazaki Masashi , Yaguchi Hitoshi , Tsuboi Ryoji , Takamori Kenji , Ogawa Hideoki
Published: July 2014

Cathepsin L, a cysteine proteinase, and cystatin A, an inhibitor of cysteine proteinases, are thought to regulate the invasion and metastasis of malignant cells. In this study, the expression of cathepsin L and cystatin A in skin tumors was investigated immunohistochemically in order to examine the relationship between these two enzymes in the pathophysiology of malignant cells. Formalin‐fixed and paraffin embedded specimens from normal skin, seborrheic keratoses, and squamous cell carcinomas were reacted with polyclonal antibodies against rat cathepsin L or cystatin α which cross‐react to human cathepsin L and cystatin A, respectively. The consequent immunostaining of these enzymes was observed to be strong in normal skin (4 cases) and seborrheic keratosis (6 cases). In well‐differentiated squamous cell carcinoma (SCC) (9 cases), staining for cathepsin L and cystatin A was moderately positive in differentiated tumor cells and negative in undifferentiated SCC (5 cases). The degree of staining of these enzymes was inversely correlated with the differentiation of the malignant cells. These results suggest that the immunohistochemical analysis of cathepsin L and cystatin A is a useful indicator for an aspect of malignancy in human epidermal keratinocytes.
Schnitzler's Syndrome with IgG κ Gammopathy
Authors: Akimoto Ruri , Yoshida Masami , Matsuda Rie , Miyasaka Keiichi , Itoh Masatoshi
Published: July 2014

A Seventy‐year‐old man with a variant type of Schnitzler's syndrome is reported. Physical examination showed pruritic urticarial lesions on the extremities, arthralgia of knee joints, and intermittent fever. Laboratory investigations revealed a high level of IgG, an increased erythrocyte sedimentation rate, urinary Bence‐Jones protein, and an M‐bow in serum protein electrophoresis, which was shown to be a monoclonal IgG κ type. Histological examination showed perivascular neutrophil and lymphocytic infiltration into the upper dermis and diffuse neutrophilic infiltration in the middle dermis. One of the clinical features of typical Schnitzler's syndrome is IgM macroglobulinemia, and this is a very rare case of this syndrome with IgG gammopathy.
Primary Cutaneous T‐Cell‐Rich B‐Cell Lymphoma in a Zosteriform Distribution Associated with Epstein‐Barr Virus Infection
Authors: Watabe Hidenori , Kawakami Tamihiro , Soma Yoshinao , Baba Takako , Mizoguchi Masako
Published: July 2014

T‐cell‐rich B‐cell lymphoma (TRBL) is a lately recognized B‐cell lymphoma variant characterized by a minor population of neoplastic B cells existing in a background of predominant polyclonal T cells. We report an 86‐year‐old man with primary cutaneous TRBL associated with Epstein‐Barr (EB) virus infection. Clinically, palpable scaly erythemas were distributed in a zosteriform pattern on the right abdomen. Histologically, massive cellular infiltrates were located in the upper‐ and mid‐dermis. Higher magnification showed that the cellular infiltration was composed mainly of abnormal mononuclear, large lymphoid cells with clear cytoplasm and scattered mitoses and small lymphocytes, which represented in excess of 75% of all the infiltrating cells. Immunohistochemical staining revealed that the large cells were positive for the B cell marker, CD20, but negative for the T cell marker, CD3. On the other hand, the small cells were positive for CD3, but negative for CD20. Polymerase chain reaction (PCR) revealed EB virus DNA in the skin lesion. Primary cutaneous TRBL has only been reported in 15 cases worldwide. To our knowledge, this is the first case of primary cutaneous TRBL in a zosteriform distribution reported in the literature and the second case of primary cutaneous TRBL associated with the EB virus infection. We postulate that the EB virus may be a contributory pathogenetic event leading to monoclonal B‐cell proliferation.
Antiphospholipid Antibody Syndrome Complicated by Grave's Disease
Authors: Takahashi Ayumi , Tamura Atsushi , Ishikawa Osamu
Published: July 2014

The report describes a woman with primary antiphospholipid antibody syndrome complicated with Grave's disease. Developing symptoms included a small cutaneous nodule on her finger and subsequently ecchymotic purpura on the cheeks, ears, buttocks and lower legs. Histological examinations showed thrombosed vessels in the dermis without or with hemorrhage, respectively. Laboratory investigation revealed positive lupus anticoagulant and immunogenic hyperthyroidism due to Grave's disease. There is a close relationship between the cutaneous manifestation of antiphospholipid antibody syndrome and the activities of Grave's disease and a possible link of antiphospholipid antibody syndrome with Grave's disease was suggested both by the etiology of the disease as well as the disease activity.
Peripheral Vascular Diseases Resulting from Chronic Arsenical Poisoning
Authors: Yu Hsin‐Su , Lee Chih‐Hung , Chen Gwo‐Shing
Published: July 2014

Drinking water contaminated by arsenic remains a major public health problem. Long‐term arsenic exposure has been found to be associated with peripheral vascular diseases in a variety of studies. Reports of vascular effects of arsenic in drinking water, which span almost 100 years, have been published in Taiwan, Chile, Mexico, and China. This paper reviewed the association of peripheral vascular diseases resulting from arsenic exposure to drinking water from the clinical and pathological points of view. An endemic peripheral vascular disorder called “blackfoot disease” has been noticed in a limited area in Taiwan. This disease results in gangrene in the extremities. It has been associated with the ingestion of high concentrations of arsenic‐tainted artesian well water. Epidemiological studies confirmed a dose‐response relationship between long‐term arsenic exposure and the occurrence of blackfoot disease. Whereas arsenic has induced various clinical manifestations of vascular effects in Chile, Mexico and China, they do not compare in magnitude or severity to the blackfoot disease found in Taiwan. The pathogenesis of vascular effects induced by arsenic is still controversial. The possible mechanisms include endothelial cell destruction, arsenic‐associated atherogenesis, carotene and zinc deficiency, and/or some immunological mechanism. Microcirculatory assessments revealed that deficits of capillary blood flow and permeability exist in clinically normal skin of patients with chronic arsenical poisoning. The vascular effects of chronic arsenic poisoning may involve cardiovascular and cerebrovascular systems as well. In view of the increasing public health problems caused by arsenic exposure, vascular effects should be included in the future study of health effects of arsenic.