bluuebunny/crossref_metadata_2025 huggingface dataset:
Rosacea-like Angiosarcoma of the Face
Authors: Panizzon Renato , Schneider Barbara V , Schnyder Urs W
Published: October 2009

We present an 84-year-old white male patient who, during a 2-year period, developed successively tumor infiltrations of an angiosarcoma in his face. The tumor started at the right lower eyelid, later appeared on the nose, the front, the cheeks and the earlobes. The first clinical impression was that of a rosacea. The tumors where successfully treated by soft X-rays, the total doses ranging from 4,800 to 5,600 cGy.
Desmoplastic Trichoepithelioma Nosology
Authors: Blanc D. , Zahouani H. , Rochefort A. , Faivre B.
Published: October 2009

We report the case of a 51-year-old woman who presented with a progressive elevation of the border of an old varicella scar. The lesion which was clinically diagnosed as a basal cell carcinoma turned out to be a typical desmoplastic trichoepithelioma. The development of desmoplastic trichoepithelioma in an area of scarring has not been previously reported. The nosology of this tumor is discussed with particular emphasis on its possible relationship to morphoeic basal cell carcinoma, thus questioning it as a true tumor sui generis.
Factor-XIIIa-Positive Dendrocytes and the Dermal Microvascular Unit
Authors: Estrada Arrese , Piérard G.E.
Published: October 2009

We present an immunohistochemical study with factor XIIIa antibody performed in a variety of cutaneous diseases. Our observations suggest that factor-XIIIa-positive dendrocytes, in noninflammatory conditions, may be resident phagocytic cells intimately associated with the microvascular units of the skin.
Familial Lichen planus
Authors: Katzenelson (Weissman) Varda , Lotem Michal , Sandbank Miriam
Published: October 2009

Familial lichen planus (FLP) was observed to have developed within a period of 3 years in 2 sisters as well as in the son of one of the women. In contrast to typical FLP, the eruption was generalized in only 1 of these patients; no atypical forms were observed; the response to topical treatment with steroids was rapid, and the relapses were few and mild. Previous reports of familial cases of lichen planus as well as the long interval between onset of the disease in the affected members of the family speak in favor of a genetic predisposition. HLA typing revealed HLA DR in all 3 patients. There was no increased incidence of HLA B7, HLA A3 or HLA A28.
Intraepidermal Sebaceous Carcinoma: Case Report
Authors: Oka K. , Katsumata M.
Published: October 2009

We report a rare case of intraepidermal sebaceous carcinoma which occurred on the left upper arm of an old woman. Light-microscopic findings revealed that almost all the histopathological lesions were in the epidermis and showed pagetoid spread. The tumor was well differentiated and consisted of germinative, transitional and sebaceous cells. Mitosis and mild and moderate pleomorphism were observed. Ultrastructural findings revealed lipid droplets in the tumor cells although Sudan III staining failed to show any positive materials.
Dermatomyositis and Malignancy
Authors: Bonnetblanc J.M. , Bernard P. , Fayol J.
Published: October 2009

A retrospective analysis of 118 cases of dermatomyositis (DM) collected in 22 departments of dermatology over a 5-year period is presented. 34 cases (28%) were associated with a cancer that was diagnosed more than 1 year prior to (7 cases) concomitantly (22 cases) or more than 1 year after (5 cases) the occurrence of DM. There was a clear correlation between the evolution of DM and a cancer paraneoplastic evolution in 8 cases only (22%). In most of the cases, no extensive diagnostic procedures were necessary for identifying the tumors. 58% of the patients with cancer-associated DM died 20 (8–29) months after the diagnosis of DM. This multicenter study based on a short period of time confirms and extends previous observations based on retrospective single-center analyses.
Acute Reactions to Coelenterates
Authors: Letot B. , Piérard-Franchimont C. , Piérard G.E.
Published: October 2009

Many coelenterates can injure human skin by means of their nematocytes. Our study was based upon clinico-pathological confrontations and was also conducted in vitro with sea anemones. Most acute reactions were toxic in nature and induced sublethal and lethal alterations of the keratinocytes with swelling of their cytoplasms and pyknosis. Another reaction found in 1 patient revealed an acantholytic disruption of the epidermis associated with intercellular deposits of IgG. These lesions were different from the late or recurrent reactions to coelenterates.
Disseminated Syringomas of the Upper Extremities
Authors: Metze Dieter , Jurecka Wolfgang , Gebhart Walter
Published: October 2009

A case of disseminated syringomas with unusual distribution and high age of onset is reported. The 66-year-old male patient presented with multiple lesions confined to dorsum of both hands and flexor side of both forearms. Morphological and immunohistochemical studies using keratin, S-100, carcinoembryonic antigen, and epithelial membrane antigen antibodies were performed both at light microscopical and ultrastructural level. These investigations revealed the presence of keratin filament containing colloid bodies near syringomatous epithelia. Reactivity for carcinoembryonic antigen could be demonstrated on the membranes of intracytoplasmic vesicles as well as within luminal debris. Absence of S-100 and epithelial membrane antigen in the tumor and ultrastructural features indicate ductal origin of syringoma.
Proliferation Antigens in Cutaneous Melanocytic Tumors – an Immunohistochemical Study Comparing the Transferrin Receptor and the Ki 67 Antigen
Authors: Soyer Hans Peter , Smolle Josef , Smolle-Juettner Freyja-Maria , Kerl Helmut
Published: October 2009

The cellular reactivities with the monoclonal antibodies OKT9 and Ki 67 have been demonstrated to be closely related to proliferation in various malignant neoplasms. In this study a total of 25 melanocytic skin tumors was examined immunohistochemically with both antibodies and the results were evaluated semiquantitatively for OKT9 and quantitatively for Ki 67 by stereological methods. All cases of primary and metastatic malignant melanoma expressed a strong stainability for OKT9, whereas benign melanocytic nevi were almost completely negative. Our results with the monoclonal antibody Ki 67 revealed highly significant differences in the numerical density of Ki-67-positive cells between metastatic malignant melanoma (number of positive cells: 47.0 ± 9.2 × 103/mm3), primary malignant melanoma (6.3 ± 1.9 × 103/mm3) and benign melanocytic nevi (2.2 ± 0.7 × 103/mm3). Correlation analysis between mean percentage of OKT9-positive cells and numerical density of Ki-67-positive cells revealed a significant correlation of both parameters (r = 0.58; p ≤ 0.05), indicating a positive relationship of OKT9 and Ki 67 expression. Especially in primary malignant melanoma, however, the amount of OKT9-positive cells considerably exceeds that of Ki-67-positive cells. The monoclonal antibodies OKT9 and Ki 67 reflect ‘proliferative activity’ in melanocytic skin tumors, as both are expressed in significantly higher amounts in primary and metastatic malignant melanomas. The combined application of these antibodies in cutaneous melanocytic lesions might be of diagnostic and prognostic value.
A Monoclonal Antibody Which Identifies an Epitope in Eccrine Duct and Acrosyringium
Authors: Penneys Neal S. , Matsuo Shinobu
Published: October 2009

A mouse monoclonal antibody obtained after immunization of BALB/c mice with large molecular weight salivary mucins decorated an epitope in eccrine duct and acrosyringium in sections from formalin-fixed, paraffin-embedded tissues. Eccrine coil, apocrine gland and other cutaneous structures were not decorated by the monoclonal antibody.This antibody was used to study the histogenesis of a number of adnexal neoplasms.
HLA and Allopurinol Drug Eruption
Authors: Chan S.H. , Tan Tulip
Published: October 2009

Strong HLA associations were found in Southern Chinese patients with skin eruptions due to allopurinol. The positive associations were with AW33 (Pc = 1.7 × 10-5; relative risk [RR] = 15.0, 95% confidence limit 5.2–42.9) with B17/BW58 (Pc = 2.9 × 10-9; RR = 46.3, 95% confidence limit 10.3–209.2). The negative association was with A2 (Pc = 8.3 × 10-5, RR = 0).The findings suggested a genetic predisposition to cutaneous drug reactions.
Psoriatic Lesions Do Not Respond to Oral Administration of Lobenzarit Disodium, an Inhibitor of Interleukin 1 Production
Authors: Takematsu Hideaki , Ohkochi Kyoko , Terui Tadashi , Tagami Hachiro
Published: October 2009

Interleukin 1 (IL-1) has been implicated in the production of characteristic changes in psoriatic lesions such as epidermal hyperprohferation and accumulation of polymorphonuclear leukocytes within the epidermis. Because lobenzarit disodium, an immunomodulator, inhibits the production of IL-1 in peripheral and peritoneal macrophages, we studied the clinical effects of this compound on psoriatic lesions. A 12-week course of oral lobenzarit disodium treatment did not induce any remarkable changes in psoriasis lesions. This does not support the major pathogenic role of IL-1 in the development of psoriasis.
Acute Pancreatitis: A Fatal Complication of Treatment of Bullous Pemphigoid with Systemic Corticosteroids
Authors: Keefe Martin , Munro Fraser
Published: October 2009

Acute pancreatitis may be a rare complication of systemic corticosteroids, although this is disputed. We describe a patient with bullous pemphigoid whose treatment was complicated by fatal acute pancreatitis.The question of a cause and effect relationship is discussed with reference to the literature. We emphasise the way that corticosteroids modified the presentation of acute pancreatitis in this case.
Solitary Plexiform Neurofibroma
Authors: Aloi Filippo G. , Massobrio Roberta
Published: October 2009

A 35-year-old man with a solitary subcutaneous cord running on the abdomen wall is reported. Histologic examination of the lesion permitted a diagnosis of plexiform neurofibroma. In this patient and in his family no other signs of von Recklinghausen’s disease were found. The plexiform neurofibroma considered as pathognomonic of neurofibromatosis may occur in a solitary form.
Lymphadenosis benigna cutis: Multinodular Aggregated Variant
Authors: Büchner S.A. , Rufli T.
Published: October 2009

A 67-year-old man presented with multiple brownish-red nodules on the left lower leg. Histologically, a dense peri vascular and diffuse infiltrate of lymphocytes, histiocytes, plasma cells and eosinophils was present in the dermis and subcutaneous tissue. Serologic examination revealed a highly elevated titer of IgG antibodies against Borrelia burgdorferi spirochetes. Our case report illustrates the wide range of clinical features of B. burgdorferi-induced lymphadenosis benigna cutis (LABC) demonstrating multiple nodules on the lower leg. LABC should thus be considered in the differential diagnosis of nodular lesions on the lower extremities.
Adénome papillaire eccrine digital agressif
Authors: Bourlond A. , Frankart M. , Vanwijck R. , Calteux N. , Fiévez C.
Published: October 2009

A typical example of digital aggressive eccrine papillary adenoma is reported. The specific histological features are stressed, once again: cribriform pattern; cavities with secretory cells and papillary projections. This tumor, found in 80% of the cases on the digits and toes, has to be resected very carefully because of its propensity to diffuse within the connective tissue and to recur.
Psoriasis and Lichen planus: Coexistence in a Single Patient
Authors: Shiohara T. , Hayakawa J. , Nagashima M.
Published: October 2009

The coexistence of psoriasis and lichen planus has been rarely reported, although both diseases are relatively common and have some features in common. A rare case of simultaneous occurrence of both diseases is presented. Spontaneous improvement of psoriasis occurred during the development of lichen planus and a subsequent disappearance of the lichen planus was associated with an exacerbation of the psoriasis. The clinical courses of the two diseases may not be independent of each other, but be affected by common factors. Immunohistochemical studies with lesional skin suggested local production of interferon-γ, which may in part explain the improvement of the psoriasis during the development of lichen planus. Based on these immunohistochemical findings, we discuss a putative role for these lymphokines in the pathogenesis of the two diseases.
Direct Mycological Examination in Dermatology: a Comparison of Different Methods
Authors: Monod M. , Baudraz-Rosselet F. , Ramelet A.A. , Frenk E.
Published: October 2009

Direct examination for fungi in skin and nail scrapings can be done by light microscopy with or without staining, or by fluorescence miroscopy using specific fluorochromes for the fungal cell wall constituants. The principal techniques described in the literature and two new methods (Congo red and Na2S-Blankophor P flüssig) were compared for their efficiency and rapidity.
Hereditary Angioedema Associated with Subacute Cutaneous Lupus Erythematosus
Authors: Gudat Werner , Bork Konrad
Published: October 2009

The increased occurrence of various autoimmune diseases has recently been reported in patients with hereditary angioedema (HAE). This is especially the case in different forms of lupus erythematosus, but also other autoimmune diseases. We report a 24-year-old female patient who 10 years ago developed the clinical symptoms of HAE which occurred at the same time as subacute cutaneous lupus erythematosus. The results of both immunological investigations and histocompatibility antigen genotyping gave no clear insight into the causal interrelationship of both diseases.
Investigations on the Development and Regression of Corticosteroid-Induced Thinning of the Skin in Various Parts of the Human Body during and after Topical Application of Amcinonide
Authors: Lubach Dietrich , Grüter Heide , Behl Michael , Nagel Cornelia
Published: October 2009

In 15 subjects 6 different parts of the body were treated with the potent topical corticosteroid (CS) amcinonide once a day for 21 days. The skin thickness of the treated areas was measured sonographically at intervals of 2 days. After completion of the CS application the regression of the CS-induced reduction in skin thickness was measured for a further 14 days. Aclear thinning of the skin could be measured after only 4 days and continued up to the 21st day of treatment. This thinning regressed completely in all areas after 10–12 days. The thinning and regression curves were very similar for all body areas. Differences in intensity of thinning were evident. No tachyphylaxis was detected.
In vivo Effects of Terbinafine and Ketoconazole on Testosterone Plasma Levels in Healthy Males
Authors: Effendy I. , Krause W.
Published: October 2009

Ten healthy male volunteers received daily 200 mg of ketoconazole or 500 mg of terbinafine (SF 86-327) for a period of 8 days according to a crossover double-blind design. Between the periods of treatment there was an interval of 3 weeks. Before and during the treatments, on 3 days in all, blood levels of testosterone were determined in the morning at 08.00 and 12.00 h. On the following day in each case, after taking a basal blood sample, 5,000 IU of hCG were injected intravenously and 2 h later a further blood sample for plasma testosterone determination was taken (short-term hCG stimulation test). Prior to treatment, the mean plasma testosterone levels at 12.00 h were slightly below the level at 08.00 h (6.5 ± 3.5 against 7.2 ± 3.1 ng/ml).The difference increased and was statistically significant with ketoconazole treatment (4.2 ± 3.2 against 7.7 ± 3.0 ng/ml), but did not alter during administration of terbinafine (7.8 ± 4.4 against 6.8 ± 3.0 ng/ml). The administration of testosterone levels by hCG stimulated 25.6% prior to treatment. The stimulation was suppressed to zero by ketoconazole but clearly intensified (41.7%) by terbinafine treatment. The results demonstrate once more the well-known effect of ketoconazole on testosterone production and confirm that terbinafine obviously does not have this effect.
Tinea of the Glans penis
Authors: Dekio Satoshi , Jidoi Joji
Published: October 2009

A 56-year-old Japanese man with tinea of the glans penis is described. He did not carry any other tinea lesions except that of the glans penis. Mycological examinations revealed that the causative organism was Trichophyton mentagrophytes.
Change of Epidemiological Characteristics of Malignant Melanoma during the Years 1962–1972 and 1983–1986 in the Federal Republic of Germany
Authors: Garbe Claus , Wiebelt H. , Orfanos C.E.
Published: October 2009

In the FRG data on more than 2,000 patients with malignant melanoma (MM) have been documented so far by the malignant melanoma cooperative group (MMCG 1962–1972) and by the central malignant melanoma registry of the German Dermatological Society (CMMR 1983–1988). In this study we compared the basic characteristics between these two multicenter data collections (CMMR until 1986) in order to detect any changes in clinical epidemiology of MM diagnosed within the past 20 years. The age distribution of the patients with MM at the time of first diagnosis did not reveal any change: a similar portion of patients was under 50 years of age (1962–72: males 44% females 45%; 1983–86: males 44%, females 47%). The percentage of males with MM, however, increased in the CMMR group (35–41%) and the portion of tumors localized on the trunk was found markedly increased in both sexes (males: 39–56%, females: 15–25%). Comparison of the tumor thickness indicated some significant advance in the early recognition of MM: the percentage of thick tumors (> 1.5 mm) decreased between both time periods (males: 72–41%; females: 60–37%) with a corresponding elevation of thinner tumors. Nevertheless, during both time periods the first diagnosis was metastasizing melanoma in about 10% of all patients. Also, the proportion of prognostically unfavorable, nodular malignant melanomas remained nearly constant (about 30% of all patients in both groups).
Chronic Urticaria Due to Dental Eugenol
Authors: Grade A.C. , Martens B.P.M.
Published: October 2009

A case is reported of a patient with chronic urticaria. The correlation between the symptoms and dental treatment gave rise to the supposition that a root canal cement was causing the trouble. A causal relationship with eugenol, a cement constituant, could only be established through provocative oral ingestion.There is a high probability that the oral provocation tests to eugenol are relevant. Nevertheless, caution is needed when dealing with chronic urticaria.
Polypeptide Neutrophil Chemoattractants in the Skin
Authors: Camp Richard D.R.
Published: October 2009

Extracts of stratum corneum samples from psoriatic skin lesions have been shown to contain a group of neutrophil chemoattractant polypeptides, a major portion of which is distinct from C5a (des arg). One of the components may be identical to the novel monocyte-derived neutrophil chemotactic peptide which has recently been purified, sequenced and cloned. Synthesis of this agent may be induced by interleukin 1, this process possibly explaining part of the pro-inflammatory activity of interleukin 1 in the skin. These compounds may be important in the pathogenesis of inflammatory skin disease.
Mechanisms for Hyperpigmentation in Postinflammatory Pigmentation, Urticaria pigmentosa and Sunburn
Authors: Tomita Yasushi , Maeda Kazuhisa , Tagami Hachiro
Published: October 2009

Our in vitro studies demonstrate that normal human epidermal melanocytes become swollen and more dendritic with an increase in amount of immunoreactive tyrosinase when they are cultured for several days with arachidonic acid metabolites vitamin D3 or histamine. From these data we propose the following possible mechanisms for hyperpigmentations noted at postinflammatory sites and suntanned areas as well as at skin lesions of urticaria pigmentosa. Arachidonic acid metabolites and histamine, which are found in increased amounts in inflammatory skin, are thought to play a key role in the induction of postinflammatory hyperpigmentation. In sunburnt skin the increased proinflammatory mediators, particularly arachidonic acid metabolites, are also thought to stimulate melanocytes in the production of hyperpigmentation. Thus tanning after sun exposure may be induced not only by the effect of vitamin D3 and direct UV irradiation on the melanocytes but also by the effect of various arachidonic acid metabolites which are increased in sunburnt skin. Mast cells massively proliferate in the skin lesions of urticaria pigmentosa. Thus hyperpigmentation in the skin lesions of urticaria pigmentosa is quite likely to be induced by the chemical mediators, including histamine and leukotrienes, that are released from these cells.
Normal Merkel Cells Express a Synaptophysin-Like Immunoreactivity
Authors: Ortonne J.P. , Petchot-Bacque J.P. , Verrando P. , Pisani A. , Pautrat G. , Bernerd F.
Published: October 2009

Synaptophysin (SY), a specific component of the membrane of presynaptic vesicles, has been reported as a novel marker for neurons, certain neuroendocrine cells and their neoplasms including neuroendocrine carcinomas of the skin. The origin of the Merkel cells (MC) being far from clear, this study was performed to establish if normal MC express SY. It is demonstrated by immunofluorescence and immunoelectron microscopy using a monoclonal antibody SY38 to this glycoprotein that normal MC in man, rabbit and pigs express an SY-like reactivity. Although immunoblotting identification of the immunoreactive material gave negative results, it is likely that normal MC contain SY. By immunoelectron microscopy, the staining was located at the surface of cytoplasmic vesicles. In view of the possible involvement of SY in the Ca2+-dependent neurotransmitter release, the observation of an SY-like immunoreactivity in MC supports the view that they are epithelial neuroendocrine cells and that they may possess a neurosecretory function.
Comparative Analysis of Oncogene Expression and Chromosome Abnormalities between Metastatic and Nonmetastatic B16 Melanoma Clones
Authors: Funasaka Yoko , Mishima Yutaka , Ichihashi Masamitsu , Sugiyama Taketoshi
Published: October 2009

We have established nonmetastatic mouse B16 melanoma clone, C1-2, and metastatic variant, C4-1, by subcloning the 30th passage of nonmetastatic W1-4 cells. We have investigated oncogene expression and chromosomal abnormalities to see whether there is some correlation with tumor progression and phenotypic diversification in melanoma cells. Not only metastatic C4-1 but also nonmetastatic C1-2 showed similarly high expression of c-Ha-ras and c-myc oncogenes by Northern blotting method. The chromosome numbers of both clones were distributed mainly within the range of 48–52. C1-2 had about 20 biarmed chromosomes and C4-1 had 13 or 14, which made real ploidy of C1-2 and C4-1, hypotetraploidy and triploidy, respectively. 21 marker chromosomes were commonly observed, while 9 marker chromosomes peculiar to C1-2 and 4 peculiar to C4-1 were constantly recognized. In partial accordance with a previous report, chromosomes 4, 5, 6, 8, 10, 13, 18, 19, and X were additionally observed in nonmetastatic C1-2 cells, compared with metastatic C4-1 cells. Furthermore, in our study, the increase of chromosomes 1, 15, and 16 was found to be greater in metastatic C4-1.
Histoid Leprosy: A Prospective Diagnostic Study in 38 Patients
Authors: Sehgal Virendra N. , Srivastava Govind
Published: October 2009

Histoid leprosy is a fascinating expression of multibacillary leprosy, the incidence of which was 3.6%. It was seen predominantly in males of the younger age group, who were on inadequate and irregular dosage of diaminodiphenyl sulfone. Papules, cutaneous and/or subcutaneous nodules and plaques appearing over apparently normal skin were its exquisite prospective clinical features. It was invariably supported by enormous, uniformly solid staining discrete bacilli from the lesions, in contrast to their virtual absence from the surrounding normal-appearing skin. Encapsulated tumorous mass, formed primarily by spindle-shaped histocytes, displayed either in intertwining, criss-cross or whorled fashion in haematoxylin-eosin-stained sections, were supplementary. The morphology of acid-fast bacilli was, however, similar to skin-slit smears.
Eccrine-Pilar Angiomatous Nevus
Authors: Velasco J.A. , Almeida V.
Published: October 2009

A clinical and histological study was made of a congenital lesion on the knee of a 3-year-old boy showing a peculiar combination of eccrine, pilar and angiomatous structures with the characteristics of organoid nevus. A discussion is made of different questions related to eccrine hemartomas with respect to the clinical picture, the association of other hamartomatous components, the alterations that these induce in other cutaneous structures and their histogenesis.
Ulcerative Lesions and Hypervascularization of Glans penis
Authors: Aelbrecht M. , de Meyer J.M. , De Sy W. , Kint A.
Published: October 2009

We describe two patients with painful ulcerations on the penis after surgical vascular anastomosis for impotence.
HLA and Multiple Skin Carcinomas
Authors: Cerimele D. , Contu L. , Carcassi C. , Costa G.. , La Nasa G. , Sanna E. , Campus G.V.
Published: October 2009

The presence of HLA-associated genetic factors in patients with multiple skin carcinomas was investigated. 43 patients affected by multiple basal and squamous cell carcinomas and 220 healthy age-matched controls were typed for 72 HLA-A, B, C, DR antigens. A negative association of B-17 (mostly B-58) and a positive association of Cw-3 and DR-1 was observed in patients with multiple basal cell carcinomas; a similar negative association with B-58 and positive association with DR-1 was seen in patients with squamous cell carcinomas. The results of this study suggest the presence of resistance factors to the development of skin cancers associated with B-17 (B-58) antigen.
Arotinoid Acid (Ro 13-7410): A Pilot Study in Dermatology
Authors: Saurat J.-H. , Mérot Y. , Borsky M. , Abba Z. , Hirschel-Scholz S.
Published: October 2009

Ro 13-7410 was given to 29 patients (a total of 38 treatment courses) for 7.5 weeks (range 4–23). This compound is one of the most potent retinoids ever synthetized and has the highest affinity to human skin cellular retinoic-acid-binding protein. At therapeutically active doses, it did not induce the commonly seen mucocutaneous signs of retinoid toxicity such as scaling and cheilitis; over 0.5 μg/kg body weight/day, it very frequently induced an eczematous retinoid dermatitis. This pilot study provides some indications on what appears to be in several aspects a drug quite distinct from retinoids previously used in humans.
Clofazimine-Mediated Enhancement of Reactive Oxidant Production by Human Phagocytes as a Possible Therapeutic Mechanism
Authors: Anderson Ronald , Zeis Birgit M. , Anderson Ingram F.
Published: October 2009

Clofazimine, at concentrations within the therapeutic range (0.01–5 μg/ml), stimulated human polymorphonuclear leucocytes (PMNL) to generate increased amounts of reactive oxidants (RO) when activated with the tripeptide leucoattractant N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP), calcium ionophore, phorbol myristate acetate and opsonised zymosan. Clofazimine per se did not activate the membrane-associated oxidative metabolism of PMNL, but rather primed these cells to hyperreact to the various stimuli. To investigate the therapeutic significance of these observations clofazimine was administered to patients with various chronic inflammatory diseases (lichen planus, discoid lupus erythematosus and rheumatoid arthritis) and generation of RO by FMLP-activated phagocytes was measured before and during clofazimine administration. A statistically significant potentiation of RO generation by FMLP-activated phagocytes was observed during clofazimine administration. Since RO are immunosuppressive and antimicrobial the therapeutic mechanisms of clofazimine may be related to pro-oxidative interactions of this agent with phagocytes.
Palmoplantar Keratoderma with Amyotrophy
Authors: Jacyk W.K. , Bill P.L.
Published: October 2009

Four members of a South African Black family who have palmoplantar keratoderma with amyotrophy are reported. No neuromuscular defects have been found and the muscle thinning appears to result from disuse atrophy. Volar hyperhidrosis, nail abnormalities and in 2 cases knuckle pads, were additional features. The condition appears to be inherited as an autosomal dominant trait. We are not aware of a similar syndrome having been previously reported.
The Elderly Patient and Cardiac Surgery – A Mini-Review
Authors: Wiedemann Dominik , Bernhard David , Laufer Günther , Kocher Alfred
Published: October 2009

Introduction: Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care mean that more elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery and surgery of the ascending aorta are performed in elderly patients. Objective: In this review, we summarize the outcome of elderly patients undergoing various cardiac surgical procedures and give future perspectives for the treatment of elderly patients with cardiac surgery. Methods: A PubMed search for the period from 1980 to February 2009 was conducted with the following key words: ‘elderly patient’, ‘cardiac surgery’, ‘CABG aortic surgery’, ‘mitral valve surgery’ and ‘endocarditis’. Additional information concerning population demographics was obtained from the World Health Organization homepage. Results: More and more cardiac surgical procedures are offered to elderly patients. The short- and long-term survival rates of elderly patients are comparable to those of younger patients. Nevertheless, the risk for these patients is only acceptable in the absence of comorbidities. In particular, renal dysfunction, cerebrovascular disease and a poor clinical state are associated with a worse outcome in elderly patients. Conclusion: The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Careful patient selection, flawless surgery, meticulous hemostasis, perfect anesthesia and myoacardial protection are basic requirements for the success of cardiac surgery in elderly patients.
Pemphigus séborrhéique et surinfection herpétique
Authors: Camenzind M.
Published: October 2009

A 77-year-old woman with pemphigus erythematosus developed a disseminated herpes hominis type I infection that mimicked a relapse of the pemphigus erythematosus. HPV superinfection of autoimmune bullous diseases might be more frequent than is usually appreciated.
Donovanose résistante à la doxycycline: à propos d’une observation
Authors: Masouyé I. , Bergues J.P. , Mérot Y. , Chavaz P. , Harms M.
Published: October 2009

We report of a case of donovanosis of the penis that was resistant to doxycycline and rapidly responded to trimethoprime-sulfamethoxazole.
Two Years of Follow-up of Oral Ketoconazole Therapy in 60 Cases of Pityriasis versicolor
Authors: Alteras I. , Sandbank Miriam , Segal Rina
Published: October 2009

In a series of 60 patients (42 males, 18 females) with widespread lesions of pityriasis versicolor, 200 mg of oral ketoconazole was administered daily for a period of 24 days. Routine laboratory examinations, including microscopic and Wood’s light examinations, were performed prior to initiation of treatment and twice during the treatment period as well as 3 and 6 months, and 1 and 2 years after completion of treatment. In 95% of the patients the clinical cure was maintained after 3 months but after 6 months it was still present in only 80% and after one year in only 57%. At the end of two years 60% showed relapse of the disorder. In 75% hypopigmented macules persisted after 6 months but without microscopic evidence of the fungus. No side effects were reported. It is evident that oral ketoconazole is effective in maintaining a clinical cure mainly during the first 3 months after treatment. The question as to whether side effects might appear with a more prolonged course of the drug should be given serious consideration before continuation of treatment is contemplated.
Progressive Replacement of Human Cultured Epithelial Allografts by Recipient Cells as Evidenced by HLA Class I Antigens Expression
Authors: Gielen Véronique , Faure Michel , Mauduit Gilles , Thivolet Jean
Published: October 2009

Human keratinocytes may be grown in vitro into living epithelia devoid of Langerhans cells and MHC class II antigens. These epithelia have been shown to be usable as epidermal allografts in patients with dermal wounds, without any apparent sign of rejection in the 12-month follow-up study. To evidence a progressive replacement by recipient cells of the grafted keratinocytes, we employed anti-MHC class I antigen monoclonal antibodies directed against tissue specificities expressed by either donors or recipients. At 2 and 4 weeks after grafting, some small epithelial cell islets from the recipient phenotype were clearly identified among cells from a donor origin by indirect immunofluorescence. At 6 months, all keratinocytes present at the grafted areas were labelled by antibodies directed toward recipient specificities only. This replacement may be related to the fact that, when placed on such superficial dermal wounds, the allografts are likely colonized by epithelial cells proliferating from residual recipient dermal appendages.
Immunophenotyping of the Eczematous Flare-Up Reaction in a Nickel-Sensitive Subject
Authors: Gawkrodger David J. , McVittie Eva , Hunter John A.A.
Published: October 2009

An eczematous flare-up reaction, occurring at a previously involved site, which followed oral challenge with 5.6 mg of nickel in a 29-year-old nickel-sensitive woman, was biopsied and studied by immunohistochemistry. The cellular infiltrate in the dermis and epidermis at 8 days was predominantly of Leu 3a phenotype (helper/inducer T lymphocytes), with smaller numbers of Leu-2a-reactive (suppressor/cytotoxic) T lymphocytes. Many infiltrating cells were DR-positive. No increase in epidermal Leu-6-positive Langerhans cells was seen but Leu-6-reactive cells were noted in the dermal infiltrate. Keratinocytes showed some expression of class II antigen (mainly DR). In comparison with the 48-hour allergic patch test reaction, the eczematous flare-up site showed no increase in epidermal Langerhans cell numbers nor infiltration with macrophages, but the responses were similar since both showed a superficial T cell reaction in the skin.
Methotrexate-Induced Liver Cirrhosis
Authors: Zachariae H. , Søgaard H.
Published: October 2009

Studies on serial liver biopsies from 25 patients with methotrexate-induced liver cirrhosis, taken from 1 to 13 years after cirrhosis was established, confirm that this type is not of aggressive nature. When evaluated blind no progression was found in most of the later biopsies. Alcohol and previous use of hepatotoxic drugs such as the combination of arsenics and vitamin A seem to have been contributing factors to cirrhosis formation.
Success of L-Lysine Therapy in Frequently Recurrent Herpes simplex Infection
Authors: Griffith Richard S. , Walsh David E. , Myrmel Kurt H. , Thompson Ronald W. , Behforooz Ali
Published: October 2009

A double-blind, placebo-controlled, multicenter trial of oral L-lysine monohydrochloride for the prevention and treatment of recurrent herpes simplex (HSV) infection was conducted. The treatment group was given L-Lysine monohydrochloride tablets (1,000 mg L-lysine per dose) 3 times a day for 6 months. A total of 27 (6 male and 21 female) subjects on L-lysine and 25 (6 male and 19 female) subjects on placebo completed the trial. The L-lysine treatment group had an average of 2.4 (p < 0.05) less HSV infections, symptoms were significantly (p < 0.05) diminished in severity and healing time was significantly reduced (p < 0.05). L-Lysine appears to be an effective agent for reduction of occurrence, severity and healing time for recurrent HSV infection.
Demodicidosis Mimicking Granulomatous Rosacea and Transient Acantholytic Dermatosis (Grover’s Disease)
Authors: Lindmaier A. , Jurecka W. , Lindemayr H.
Published: October 2009

A patient with rosacea-like lesions and transient acantholytic dermatosis (TAD; Grover’s disease), who showed follicle mites and perifollicular granulomas in involved skin, is presented. A possible relationship between the infestation with the follicle mite and TAD in this case is discussed.
Aging and Decision-Making: A Neurocognitive Perspective
Authors: Brand Matthias , Markowitsch Hans J.
Published: October 2009

Neuropsychological research contributes to a better understanding of cognitive mechanisms involved in making advantageous decisions, which is important for everyday life. Using laboratory gambling tasks, it has been demonstrated that both structural and functional brain changes can result in disadvantageous decision-making linked to reductions in executive functioning and feedback processing. However, relatively little is known about whether or not decision-making on these tasks is affected by normal aging. We argue that functions involved in decision-making – in particular categorization and monitoring processes – are most likely reduced in older adults. These reductions should lead to decision-making difficulties in older individuals. However, we also argue that the effects of age on decision-making depend on the type of decision situation (i.e. ambiguous or risky) in combination with the complexity of the decision-making task. In addition, we give a brief overview of methodological issues that should be taken into account in future studies on decision-making and aging.
Effects of Retinoids and Hydrocortisone on Keratinocyte Differentiation, Epidermal Growth Factor Binding and Lipid Metabolism
Authors: Ponec Maria , Boonstra Johannes
Published: October 2009

The relationship between keratinocyte differentiation capacity, lipid synthesis, plasma membrane composition and epidermal growth factor (EGF) binding has been studied in SCC-12F2 cells and normal keratinocytes. The differentiation capacity of the cells, i.e. ionophore-induced cornified envelope formation, was inhibited by various retinoids and stimulated by hydrocortisone. Retinoids that caused a significant reduction of cornified envelope formation, i.e. retinoic acid and 13-cis-retinoic acid, caused only minor changes in lipid synthesis and plasma membrane composition. Arotinoid ethyl sulfone, having a minor effect on cornified envelope formation, caused a drastic inhibition of cholesterol synthesis, resulting in changes in the plasma membrane composition. Hydrocortisone stimulated cornified envelope formation but had only minor effects on lipid synthesis and plasma membrane composition. Of all retinoids tested, only arotinoid ethyl sulfone caused a drastic increase of EGF binding, while hydrocortisone had no effect. The results presented in this study demonstrate that modulations in keratinocyte differentiation, as induced by retinoids or hydrocortisone, are not accompanied by comparable changes in EGF binding. It is concluded that EGF binding is most likely directly dependent upon the composition and properties of the plasma membrane. The effects of retinoids on EGF binding are thus caused by changes in the composition of the plasma membrane and not by modulation of capacity of cells to differentiate.
Mucocutaneous and Systemic Toxicity of Retinoids: Monitoring and Management
Authors: Shalita Alan R.
Published: October 2009

Oral retinoid therapy is associated with significant mucocutaneous and systemic toxicity similar to that found in hypervitaminosis A. Beside the well-known mucocutaneous adverse effects like cheilitis, xerosis, desquamation, dryness of mucous membranes, more troublesome findings are ocular effects, hair loss or hypergranulation tissue. The most unwanted systemic side effects under both retinoids (isotretinoin and etretinate) are teratogenicity, bone toxicity and serum lipid increments. Careful patient counselling and monitoring will enable the physician to modulate these effects and reduce their impact on patient compliance.
New Indications and New Retinoids
Authors: Gollnick H.
Published: October 2009

In addition to well-accepted indications, etretinate has a beneficial effect in a variety of other dermatoses such as the hyperkeratotic eczema of the palms and soles, prurigo nodularis, and other nonpsoriatic, sterile, pustular eruptions. Due to its influence on dermal inflammatory processes and immunomodulation of the tissue response, etretinate is effective in cutaneous lupus erythematosus, certain bullous disorders like pemphigus herpetiformis, the persistent variant of Grover’s disease, dermatitis herpetiformis, and bullous pemphigoid. Isotretinoin is reported to be effective in cutaneous sarcoidosis, disseminated granuloma annulare, systemic sclerosis and tumors of the cutaneous appendages. New synthetic retinoids have been developed. Etretin, the main metabolite of etretinate, was shown to be effective and to have a short elimination half-life of – 50 h. Arotinoid ethyl ester and arotinoid-free carboxylic acid are effective in minimal doses 500-fold lower than etretinate. Arotinoid ethyl ester was shown not to increase serum lipids. Arotinoid ethyl sulfone is the first retinoid without bone toxicity in animal experiments. Motretinide is the ethylamide of tretinoin and is reported to be effective in the local treatment of acne. Some of the new poly-aromatic retinoids appear to have sebosuppressive, antikeratinizing and/or anti-inflammatory effects via topical application.
Determinants of Surgical Outcome in Patients With Isolated Tricuspid Regurgitation
Authors: Kim Yong-Jin , Kwon Dong-A , Kim Hyung-Kwan , Park Jin-Shik , Hahn Seokyung , Kim Kyung-Hwan , Kim Ki-Bong , Sohn Dae-Won , Ahn Hyuk , Oh Byung-Hee , Park Young-Bae
Published: October 2009

Background—

We sought to identify preoperative predictors of clinical outcomes after surgery in patients with severe tricuspid regurgitation.

Methods and Results—

We prospectively enrolled 61 consecutive patients (54 women, aged 57±9 years) with isolated severe tricuspid regurgitation undergoing corrective surgery. Twenty-one patients (34%) were in New York Heart Association functional class II, 35 (57%) in class III, and 5 (9%) in class IV. Fifty-seven patients (93%) had previous history of left-sided valve surgery. Preoperative echocardiography revealed pulmonary artery systolic pressure of 41.5±8.7 mm Hg, right ventricular (RV) end-diastolic area of 35.1±9.0 cm
2
, and RV fractional area change of 41.3±8.4%. The median follow-up duration after surgery was 32 months (range, 12 to 70). Six of the 61 patients died before discharge; thus, operative mortality was 10%. Three of the 55 patients who survived surgery died during follow-up, and 6 patients required readmission because of cardiovascular problems. Thus, 46 patients (75%) remained event free at the end of follow-up. In the 54 patients who underwent 6-month clinical and echocardiographic follow-up, RV end-diastolic area decreased by 29%, with a corresponding 26% reduction in RV fractional area change. Thirty-three patients (61%) showed improved functional capacity after surgery. On multivariable Cox regression analysis, preoperative hemoglobin level (
P
<0.001) and RV end-systolic area (
P
<0.001) emerged as independent determinants of clinical outcomes. On receiver operating characteristic curve analysis, we found that RV end-systolic area <20 cm
2
predicted event-free survival with a sensitivity of 73% and a specificity of 67%, and a hemoglobin level >11.3 g/dL predicted event-free survival with a sensitivity of 73% and a specificity of 83%.

Conclusions—

Timely correction of severe tricuspid regurgitation carries an acceptable risk and improves functional capacity. Surgery should be considered before the development of advanced RV systolic dysfunction and before the development of anemia.
NOS1AP
Is a Genetic Modifier of the Long-QT Syndrome
Authors: Crotti Lia , Monti Maria Cristina , Insolia Roberto , Peljto Anna , Goosen Althea , Brink Paul A. , Greenberg David A. , Schwartz Peter J. , George Alfred L.
Published: October 2009

Background—

In congenital long-QT syndrome (LQTS), a genetically heterogeneous disorder that predisposes to sudden cardiac death, genetic factors other than the primary mutation may modify the probability of life-threatening events. Recent evidence indicates that common variants in
NOS1AP
are associated with the QT-interval duration in the general population.

Methods and Results—

We tested the hypothesis that common variants in
NOS1AP
modify the risk of clinical manifestations and the degree of QT-interval prolongation in a South African LQTS population (500 subjects, 205 mutation carriers) segregating a founder mutation in
KCNQ1
(A341V) using a family-based association analysis.
NOS1AP
variants were significantly associated with the occurrence of symptoms (rs4657139,
P
=0.019; rs16847548,
P
=0.003), with clinical severity, as manifested by a greater probability for cardiac arrest and sudden death (rs4657139,
P
=0.028; rs16847548,
P
=0.014), and with greater likelihood of having a QT interval in the top 40% of values among all mutation carriers (rs4657139,
P
=0.03; rs16847548,
P
=0.03).

Conclusions—

These findings indicate that
NOS1AP
, a gene first identified as affecting the QTc interval in a general population, also influences sudden death risk in subjects with LQTS. The association of
NOS1AP
genetic variants with risk for life-threatening arrhythmias suggests that this gene is a genetic modifier of LQTS, and this knowledge may be clinically useful for risk stratification for patients with this disease, after validation in other LQTS populations.
Inhibition of the Adenosine
2A
Receptor-Epoxyeicosatrienoic Acid Pathway Renders Dahl Salt-Resistant Rats Hypertensive
Authors: Liclican Elvira L. , Doumad Anabel B. , Wang Jianjin , Li Jing , Falck John R. , Stier Charles T. , Carroll Mairéad A.
Published: October 2009

Adenosine-induced renovasodilation in Dahl rats is mediated via activation of adenosine
2A
receptors (A
2A
Rs) and stimulation of epoxyeicosatrienoic acid (EET) synthesis. Unlike Dahl salt-resistant rats, salt-sensitive rats exhibit an inability to upregulate the A
2A
R-EET pathway with salt loading; therefore, we examined the effect of in vivo inhibition of the A
2A
R-EET pathway on blood pressure and the natriuretic response to salt-loading in Dahl salt-resistant rats.
N
-Methylsulfonyl-6-(2-propargyloxyphenyl)hexanamide (MS-PPOH; 20 mg/kg per day), an epoxygenase inhibitor, or ZM241385 (ZM; 5 mg/kg per day), an A
2A
R antagonist, was given daily as an IV bolus dose for 3 days before and after placing rats on high salt intake (2% saline). After 3 days of high salt, systolic blood pressure per 24 hours increased from 108±2 mm Hg to 136±5 mm Hg and 140±4 mm Hg when treated with MS-PPOH or ZM, respectively (
P
<0.001). Plasma levels of EETs and dihydroxyeicosatrienoic acids during salt loading and MS-PPOH (29.3±1.8 ng/mL) or ZM treatment (9.8±0.5 ng/mL) did not increase to the same extent as in vehicle-treated rats (59.4±1.7 ng/mL;
P
<0.001), and renal levels of EETs+dihydroxyeicosatrienoic acids were 2-fold lower with MS-PPOH or ZM treatment. On day 3 of the high salt intake, MS-PPOH– and ZM-treated rats exhibited a positive Na
+
balance, and plasma Na
+
levels were significantly increased (163.3±1.2 and 158.1±4.5 mEq/L, respectively) compared with vehicle-treated rats (142.1±1 mEq/L), reflecting a diminished natriuretic capacity. These data support a role for the A
2A
R-EET pathway in the adaptive natriuretic response to modulate blood pressure during salt loading.