bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychobiological Aspects of Atopic Dermatitis: An Overview
Authors: Buske-Kirschbaum Angelika , Geiben Andrea , Hellhammer Dirk
Published: April 2003

Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease with increasing incidence characterized by eczematous inflammation of the skin, a chronically relapsing course and severe pruritus. In the last decade, there has been growing evidence indicating that psychological factors such as personality and stress may play an important role in the pathogenesis of AD. While there is only little consensus on an AD-specific personality profile and its etiological significance, a growing number of reports support the role of psychosocial stress in the onset and the course of AD symptomatology. However, although a close association between psychosocial stress and skin condition in AD patients has been demonstrated by several investigators, pathological models that integrate stress and its effect on atopy-relevant biological processes, e.g. immune processes, are still missing. This overview summarizes the role of immunological and psychological factors in AD pathogenesis and discusses potential psychobiological pathways of stress-related modulation of AD symptoms.
Psychiatric Disorders in Burn Patients: A Follow-Up Study
Authors: Madianos Michael G. , Papaghelis Michael , Ioannovich John , Dafni Rani
Published: April 2003

Background: We report on a prospective study of 45 patients with burn injuries admitted to a major burn unit in the greater Athens area. The study aimed to explore the prevalence of psychological and psychiatric disorders among burn survivors. Methods: The sample comprised all consecutive cases of adult burn patients in a 6-month period. Personal interviews were conducted by the administration of the Langner scale and the DSM-III-R Structured Clinical Interview. Twelve months later, 30 patients of the baseline sample were reexamined. Results: Psychological impairment was found to be 45.5 and 40% at the baseline and follow-up assessments, respectively. The extent of burns was found to be associated with psychological impairment. The prevalence of psychiatric disorders (any DSM-III nosological entity) reached 46.6% at both baseline and follow-up examinations. Posttraumatic stress disorder was diagnosed in 17.8 and 20.0% of burn survivors at the baseline and the 12-month follow-up assessments, respectively. Logistic regression analysis revealed that face disfigurement was the only burn characteristic significantly associated with the presence of psychiatric morbidity. Conclusions: The results of the study suggest that the extent of burns is not so important when compared to the possibility of disfigurement from the point of risk of developing a psychiatric disorder.
Anxiety Is a Good Indicator for Somatic Symptom Reduction through Behavioral Medicine Intervention in a Mind/Body Medicine Clinic
Authors: Nakao Mutsuhiro , Fricchione Gregory , Myers Patricia , Zuttermeister Patricia C. , Baim Margaret , Mandle Carol Lynn , Medich Cynthia , Wells-Federman Carol L. , Arcari Patricia Martin , Ennis Margaret , Barsky Arthur J. , Benson Herbert
Published: April 2003

Background: This study examined the effect of anxiety on symptom reduction through a behavioral medicine intervention in a Mind/Body Medicine Clinic. Method: Participants were 1,312 outpatients attending a 10-week behavioral medicine intervention which included training in the relaxation response, cognitive restructuring, exercise and nutrition. All of the patients had physical symptoms and were referred to the clinic by their physician. The Medical Symptom Checklist (12 major symptoms), Symptom Checklist 90 Revised (SCL-90R), Stress Perception Scale and the Health-Promoting Lifestyle Profile were administered before and after the program. Results: Of the sample, 1,012 patients completed the program, and 911 completed the posttreatment assessment. Self-reported frequency of medical symptoms, degree of discomfort and interference with daily activities were significantly reduced as a result of the program. Anxiety and other psychological distress as measured by the SCL-90R and stress perception scales also showed significant reductions. Furthermore, health-promoting lifestyle functioning significantly improved. High levels of pretreatment anxiety predicted a decrease in the total number of medical symptoms endorsed. Conclusions: Behavioral medicine interventions are effective in reducing medical symptoms coinciding with improvement in anxiety. High anxiety at program entry may predict better outcome.
Perceived Difficult Temperament, Hostile Maternal Child-Rearing Attitudes and Insulin Resistance Syndrome Precursors among Children: A 3-Year Follow-Up Study
Authors: Ravaja Niklas , Katainen Saara , Keltikangas-Järvinen Liisa
Published: April 2003

Background: We prospectively examined the relationship between latent constructs of perceived difficult temperament and hostile maternal child-rearing attitudes on the one hand, and the cluster of multiple cardiovascular risk factors comprising the insulin resistance syndrome (IRS) on the other. Methods: A 3-year follow-up study of 451 randomly selected healthy children was used. The temperament of the children and maternal child-rearing attitudes were self-rated by the mothers. The physiological parameters measured were serum insulin, high-density lipoprotein cholesterol (HDL-C), triglycerides, systolic blood pressure, body-mass index and subscapular skinfold thickness. We analyzed the data using structural equation models that involved specific paths allowing separation, and tests of both unique and common (latent) aspects of measured variables. Results: Among boys we found a cross-lagged effect between the latent constructs of perceived difficult temperament and IRS, as well as 1 specific effect from hostile maternal child-rearing attitudes to HDL-C. Among girls there were 6 specific effects from specific measures of perceived temperamental difficultness or hostile maternal child-rearing attitudes that influenced the IRS or its components. Conclusions: The findings suggest that temperament and maternal child-rearing attitudes may contribute to the early development of the IRS in a gender-specific way among children, thereby potentially increasing the risk of coronary heart disease later in life.
Intact Physiological Response to Arousal with Impaired Emotional Recognition in Alexithymia
Authors: Stone Linda A. , Nielson Kristy A.
Published: April 2003

Background: The purpose of the present study was to clarify the relationship between the recognition of emotion and physiological response to emotion (i.e. arousal) in alexithymia. Methods: This study investigated differences in physiological arousal state, as measured by continuous heart rate, electrodermal activity (EDA) and self-reported emotional intensity before and after exposure to an emotionally arousing or neutral videotape among 41 high- or low-alexithymic young adult participants. Results: Across subjects, emotionally negative stimuli produced increased physiological arousal. However, high-alexithymic participants exposed to the arousing videotape did not report increased subjective emotional intensity, as did low-alexithymic participants. In addition, the baseline EDA of high-alexithymic participants was significantly higher than that of the low-alexithymic participants. Conclusions: Results support the prediction that alexithymia leads to a decoupling between subjective and physiological arousal when exposed to emotionally negative stimuli. This decoupling may increase alexithymic individuals’ risks for stress-related illness.
Short-Term Group Therapy for Patients with Chronic Fatigue Syndrome
Authors: Söderberg Stina , Evengård Birgitta
Published: April 2003

Background: This study presents experiences of focused short-term group therapy for patients with chronic fatigue syndrome (CFS). Methods: Fourteen women diagnosed as CFS patients were randomly placed into two groups. The control group received group therapy 5 months after the first group. The project consisted of 10 group sessions of 1.5 h per week. Sense of coherence (SOC) was used for measuring coping resources, and self-rating scales of quality of life and of fatigue were compared before and after group therapy. Results: The most valuable aspect was the sharing of experiences. More than half of the patients also felt that the sessions had improved psychological well-being through adjustment of ambitions and improved coping with symptoms. Conclusion: The study encourages further research. If group therapy is chosen as treatment for these patients, a longer period is recommended. A possible alternative is individualized short-term therapy adapted to each patient’s needs, problems and circumstances.
Over-the-Counter Drug Use in Gymnasiums: An Underrecognized Substance Abuse Problem?
Authors: Kanayama Gen , Gruber Amanda J. , Pope Jr. Harrison G. , Borowiecki John J. , Hudson James I.
Published: April 2003

Objective: Many individuals, attempting to gain muscle or lose fat, use ‘dietary supplements’. Though widely available over the counter or by mail order in America and Europe, some of these ‘supplements’ are actually potent drugs such as androstenedione and ephedrine. We sought to estimate the prevalence of these forms of drug use in American gymnasiums. Methods: We distributed anonymous questionnaires to 511 clients entering five gymnasiums, asking about use of both supplements and anabolic steroids. Results: Among men, 18% reported use of androstenedione and/or other adrenal hormones, 25% reported ephedrine use, and 5% reported anabolic steroid use within the last 3 years; among women these rates were 3, 13 and 0%. Extrapolating from these figures to the United States as a whole, we estimated that possibly 1.5 million American gymnasium clients have used adrenal hormones and 2.8 million have used ephedrine within the last 3 years. Conclusions: Millions of men and women are currently using potent drugs, widely sold over the counter as ‘supplements’, despite their known adverse effects, unknown long-term risks, and possible potential for causing abuse or dependence.
Diagnostic Accuracy in the First 5 minof a Psychiatric Interview
Authors: Herrán Andrés , Sierra-Biddle Deirdre , de Santiago Ana , Artal Jesús , Díez-Manrique Juan Francisco , Vázquez-Barquero José Luis
Published: April 2003

Background: There is little if any research on the explicit contents delivered by patients in the first minutes of a psychiatric interview. Methods: In order to study the impact of the first minutes of a psychiatric interview on final diagnosis, we gathered information from the speech during the first 5 min in 162 new psychiatric patients with a checklist including symptoms extracted from the SCAN interview. Results: The area reported most frequently was life events (51.2%). The average of psychiatric symptoms cited was 2.3. An initial suspected diagnosis was done in 126 patients, and in 73 patients (57.9% of those with a suspected diagnosis, 45.1% of the total sample) the initial diagnosis was coincident with the final diagnosis. The initial clinical impression was more accurate in adjustment and ‘neurotic’ disorders, and less in mood disorders. Those patients who cited more symptoms received a less accurate initial diagnosis. Conclusion: Psychiatric patients spontaneously report a low number of symptoms. The accuracy of psychiatric diagnosis in the first minutes of an interview is unacceptably low. However, the role of short psychiatric interviewing as a screening method deserves to be further investigated.
Outcome Predictors in Anorectic Patients after 6 Months of Multimodal Treatment
Authors: Fassino S. , Abbate Daga G. , Amianto F. , Leombruni P. , Fornas B. , Garzaro L. , D’Ambrosio G. , Rovera G.G.
Published: April 2003

Background: Anorexia nervosa is asevere disorder that often responds poorly to treatment. At this time, little is known about pretreatment predictors of response. Methods: A sample of 42 restrictor type anorectics was tested at the assessment phase and after 180 days retested using the Temperament and Character Inventory and Eating Disorder Inventory 2 along with other clinical evaluation instruments. After 180 days of treatment with multimodal ‘network’ therapy, the patients were divided into two groups. The first group included patients who showed relevant clinical improvement; the second group included patients considered ‘not yet responding’. Data collected from the not-yet-responding group were compared by the t test with the other group’s data to evaluate prognostic indexes. Results: Diagnosis of personality disorder, which afflicted about 50% of patients, seemed not to be a relevant prognostic factor. However, a lower novelty seeking was characteristic of the nonresponder group. Higher levels of asceticism and maturity fears also characterized the nonresponder group. Conclusion: Present data suggest some elements that could be useful to focus pharmacotherapy, psychotherapy and family counseling on the current psychopathology of each patient.
An Evaluation of the Absolute and Relative Stability of Alexithymia in Patients with Major Depression
Authors: Luminet Olivier , Bagby R. Michael , Taylor Graeme J.
Published: April 2003

Background: Previous studies demonstrating an association between alexithymia and depression have led to the proposal that alexithymia may be a state-dependent phenomenon rather than a stable and enduring personality trait. Several longitudinal studies have provided support for a trait view of alexithymia, but most of these studies evaluated absolute stability only (i.e., the extent to which alexithymia scores change over time) and did not examine the relative stability of alexithymia (i.e., the extent to which relative differences among individuals remain the same over time) in the context of changes in illness symptomatology. The present study evaluated both absolute stability and relative stability of alexithymia in depressed patients who experienced a marked reduction in the severity of depressive symptoms. Methods: Forty-six psychiatric outpatients with major depression were assessed for alexithymia and depression with the 20-item Toronto Alexithymia Scale and the Hamilton Rating Scale for Depression at the start of treatment (baseline) and after 14 weeks of treatment (follow-up) with antidepressant medication. Paired t tests and correlational analyses were performed to evaluate absolute stability and relative stability in alexithymia. Hierarchical regression analyses were then used to assess the degree to which the relative stability in alexithymia scores was related to the severity of depressive symptoms, and the degree to which changes in alexithymia scores could be attributed to changes in depression scores. Results: Alexithymia scores changed significantly from baseline to follow-up, indicating a general lack of absolute stability. There was, however, strong evidence of relative stability, as alexithymia scores at baseline correlated significantly with alexithymia scores at follow-up and were also a significant predictor of follow-up alexithymia scores, after partialling the effects of depression severity. Conclusions: Although alexithymia scores may change in the presence of large changes in the severity of depressive symptoms, the finding of relative stability of alexithymia supports the view that this construct is a stable personality trait rather a state-dependent phenomenon.
Sildenafil Citrate for the Sexual Dysfunction in Antidepressant-Treated Male Patients with Posttraumatic Stress Disorder
Authors: Reznik Ilya , Zemishlany Zvi , Kotler Moshe , Spivak Baruch , Weizman Abraham , Mester Roberto
Published: April 2003

Background: Previous studies have suggested that posttraumatic stress disorder (PTSD) may be associated with pervasive sexual dysfunction. Sildenafil citrate was established as a highly effective and well-tolerated oral agent for the treatment of sexual dysfunction of various etiologies. There are no studies that have examined the efficacy of oral sildenafil in PTSD patients with sexual dysfunction. Objective: The current study evaluated the impact of sildenafil added to an ongoing antidepressive treatment in male PTSD patients. Methods: Ten consecutive male PTSD patients who complained of sexual dysfunction were enrolled in an open-label 4-week fixed-dose study of sildenafil citrate 50 mg/day p.r.n. Patients were evaluated at baseline and after treatment with the Clinician-Administered PTSD Scale (CAPS); sexual function assessments were performed using the International Index of Erectile Function. Results: All patients completed the study and statistically significant improvement was observed in all evaluated domains of sexual functioning: erectile function (53.5%), orgasmic function (40.3%), sexual desire (53%), intercourse satisfaction (82%) and overall satisfaction (57.4%). Oral sildenafil treatment appeared to be well tolerated and no single patient stopped the treatment. Improvements in various CAPS subscales were also obtained; however, there was no significant correlation between improvement in sexual functioning and the changes in CAPS subscale scores. Conclusion: Sildenafil seems to be an efficacious, safe and well-tolerated treatment of sexual dysfunction in antidepressant-treated male PTSD patients.
Predictors of Tracheobronchial Invasion of Suprabifurcal Oesophageal Cancer
Authors: Riedel Martin , Stein Hubert J. , Mounyam Leonard , Busch Raymonde , Siewert Jörg R.
Published: April 2003

Background: Factors possibly predicting airway invasion of oesophageal cancer in the absence of frank oesophagotracheal fistulas have not been studied. Objectives: To identify possible predictors of airway invasion by oesophageal cancer that are readily accessible in the preoperative setting. Methods: We prospectively investigated 148 patients with newly diagnosed oesophageal cancer located at or above the level of the tracheal bifurcation and without any evidence of oesophago-respiratory fistulas or distant metastases. Demographic variables, respiratory parameters, results of bronchoscopy and other staging procedures (oesophagoscopy, swallow oesophagography, endosonography, CT and histology) and findings at surgery were compared between the patients with (n = 30) and without (n = 118) proven airway invasion and entered into a stepwise logistic regression model to evaluate their independent predictive roles. Results: Univariate analysis indicated that the incidence of airway invasion increased with the presence of suspect CT findings, the presence of respiratory symptoms, tumour length, T stage on endoscopic ultrasonography, and histopathologic grading of the primary cancer. A multivariate logistic regression model indicated that suspect CT findings (odds ratio, 4.4; 95% confidence interval 1.7–11.1, p = 0.002) and maximal tumour length >8 cm (odds ratio, 3.7; 95% confidence interval 1.4–9.6, p = 0.007) were associated independently with airway invasion. The accuracy of predicting airway invasion was 82.5% with both variables combined. Conclusions: The high incidence of airway involvement by oesophageal cancer and the difficulty to predict it accurately with clinical data or other staging procedures justifies the routine use of bronchoscopy in all patients with the tumour located at or above the level of the tracheal bifurcation. A particular effort to objectively prove or exclude airway invasion should be made in patients with tumours longer than 8 cm and/or with CT findings suggesting airway invasion.
Chemotherapy-Induced Noncardiogenic Pulmonary Edema Related to Gemcitabine plus Docetaxel Combination with Granulocyte Colony-Stimulating Factor Support
Authors: Briasoulis Evangelos , Froudarakis Marios , Milionis Haralambos J. , Peponis Ioannis , Constantopoulos Stavros , Pavlidis Nicholas
Published: April 2003

Several cancer therapeutic agents have been associated with pulmonary toxicity. Herein, we describe the case of a 73-year-old woman with breast cancer metastatic to the liver, who developed noncardiogenic pulmonary edema (NPE) while on treatment with gemcitabine plus docetaxel combination with granulocyte colony-stimulating factor (G-CSF) support. Gemcitabine, a deoxycytidine analogue, is reported to produce mild self-limiting and only occasionally severe pulmonary toxicity. The microtubule stabilizer docetaxel has been associated with water retention complications. The combination of these two agents has shown promising activity in several solid tumors and is in a phase of clinical development with prophylactic G-CSF in most of the trials due to the high rate of dose-limiting neutropenia observed with this combination. In our case pulmonary toxicity resolved rapidly following the administration of corticosteroids. A possible deleterious synergy of the compounds involved in this case is discussed and the medical literature on NPE related to cancer therapy is shortly reviewed. We conclude that NPE should always be considered in patients with respiratory function deterioration while on therapy with the gemcitabine-docetaxel combination and G-CSF. Corticosteroids can provide maximum benefit if started early upon diagnosis coupled with withdrawal of the causative drugs.
Increased Lung Uptake of Technetium-99m Hexamethylpropylene Amine Oxime in Systemic Lupus erythematosus
Authors: Shih C.-M. , Shiau Y.-C. , Wang J.J. , Ho S.-T. , Kao A.
Published: April 2003

Background: Systemic lupus erythematosus (SLE) can affect every organ. Involvement of the lungs in this disease is a significant cause of morbidity and mortality. Objectives: To assess pulmonary vascular endothelium damage in SLE by lung uptake of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO). Methods: Lung uptake of 99mTc-HMPAO was measured in 20 SLE patients and for comparison in 25 controls without SLE, referred for brain imaging due to dementia or stroke. Of the 20 SLE patients, 10 had significant clinical pulmonary manifestations. However, all SLE patients had normal chest X-ray findings. Anterior lung image, including a large part of the liver, was taken 10 min after intravenous injection of 20–25 mCi of 99mTc-HMPAO. Regions of interest were calculated over the liver and lung. Results: The mean lung/liver uptake ratio in patients without SLE was 0.36 ± 0.1. The mean lung/liver uptake ratio in SLE patients was 0.79 ± 0.58. The difference was significant. Conclusions: Our results indicated that determining the ratio of lung/liver uptake of 99mTc-HMPAO may be a useful complementary method to assess pulmonary injury in SLE patients.
A Case of Malignant Pleural Mesothelioma with Unexpectedly Long Survival without Active Treatment
Authors: Wong C.F. , Fung S.L. , Yew W.W. , Fu K.H.
Published: April 2003

Malignant pleural mesothelioma (MPM) is a disease with a very dismal prognosis. A median survival of 6–18 months is expected in most patients. Rarely, patients may survive unexpectedly long. We present the case of a patient with MPM who survived for more than 10 years without active treatment after the disease had been diagnosed.
Disseminated Mycobacterium intracellulare Infection in an HIV-Negative, Nonimmunosuppressed Patient with Multiple Endobronchial Polyps
Authors: Asano Takayuki , Itoh Go , Itoh Makoto
Published: April 2003

Endobronchial lesions caused by nontuberculous mycobacterial disease are extremely rare, but we recently encountered a case of disseminated disease due to Mycobacterium intracellulare presenting as multiple endobronchial polypoid lesions in an HIV-negative host. The patient was a 45-year-old Japanese female with fever, loss of body weight and cervical lymphadenopathy. Chest X-rays demonstrated a left hilar mass, and bronchoscopy revealed multiple polypoid lesions in the left main bronchus and bronchus of the left upper lobe. The infection later progressed, involving generalized lymphadenopathy, liver splenic and cutaneous abscesses, pulmonary infiltration, pleural effusion, and costal fracture. Finally, in two separate cutaneous abscesses M. intracellulare was identified by a DNA probe method. Antimycobacterial drugs were given, and the endobronchial lesions along with other symptoms and signs greatly improved.
Multiple Pulmonary Arterial Aneurysms in Behçet’s Disease: Clinical and Radiologic Remission after Cyclophosphamide and Corticosteroid Therapy
Authors: Aktogu Serir , Erer Onur Fevzi , Ürpek Gülcan , Soy Ömer , Tibet Gültekin
Published: April 2003

Behçet’s disease (BD) with pulmonary arterial aneurysm is rare and often associated with a poor prognosis. But there is also a chance that the aneurysm may completely resolve with medical therapy. A 39-year-old man presented with fever, malaise, bilateral chest pain, recurrent oral ulcers, and hemoptysis. The chest radiograph showed a round opacity in the right hilum. Computed tomography and magnetic resonance angiography (MRA) further revealed multiple, bilateral pulmonary arterial aneurysms consistent with the diagnosis of BD. The patient was started on a course of cyclophosphamide and corticosteroid therapy that resulted in cessation of his symptoms and complete resolution of radiologic findings. The chest radiograph and MRA reverted to normal on long-term follow-up. He is still alive and symptom-free 20 months after diagnosis.
Diffuse Infiltrative Lung Disease Associated with Flecainide
Authors: Pesenti Sarah , Lauque Dominique , Daste Ghislaine , Boulay Vincent , Pujazon Marie-Christine , Carles Pierre
Published: April 2003

We present two patients who developed subacute diffuse infiltrative lung disease while receiving flecainide for supraventricular arrhythmia. They had bilateral subpleural lung opacities on computed tomography. Bronchoalveolar lavage revealed increased numbers of lymphocytes and eosinophils, and a low CD4/CD8 ratio. Nonspecific interstitial pneumonia was documented by open lung biopsy in patient 1. The outcome was favorable after flecainide withdrawal and prednisone treatment. Drug-induced pneumonitis should be suspected in patients treated with flecainide presenting with subacute diffuse infiltrative lung disease.
Effects of Skin Occlusion on Percutaneous Absorption: An Overview
Authors: Zhai Hongbo , Maibach Howard I.
Published: April 2003

Skin occlusion produces profound changes, including hydration status, barrier permeability, epidermal lipids, DNA synthesis, microbial flora, and numerous molecular and cellular processes. It often, but not always, increases percutaneous absorption of applied chemicals. This overview focuses on the effect of skin occlusion on percutaneous absorption.
Do Urea and Sodium Chloride together Increase the Efficacy of Moisturisers for Atopic Dermatitis Skin?
Authors: Hagströmer Lena , Nyrén Miruna , Emtestam Lennart
Published: April 2003

Urea has long been used to treat dry skin. In the present report, we compared two creams, identical with the exception that one contained both urea and sodium chloride and the other urea alone, in 22 patients with atopic dermatitis. Following a 2-week wash-out period, their clinically non-eczematous, rough or normal-appearing skin on the forearms was treated twice daily in a double-blind and randomised manner. We examined the treated areas by measuring transepidermal water loss, capacitance and electrical impedance. Our findings suggest that a moisturiser containing both urea and sodium chloride seems somewhat more effective than the same moisturiser without sodium chloride, at least concerning the ability to reverse impedance indices of atopic skin towards normal, an effect ascribed mainly to changes in hydration of the stratum corneum. However, the clinical significance of our impedance measurements is somewhat premature to decide.
Do Shake Lotions, Zinc Oil and Polyethylene Glycol Gels Produce Dehydration or Moisturization?
Authors: Gloor M. , Haus C. , Fluhr J.W. , Gehring W.
Published: April 2003

We carried out three studies to evaluate the effects of white zinc shake lotion (Zinkschüttelmixtur DAC), zinc oil ( Zinköl NRF 11.20), Lotio Cordes®, PEG ointment (Polyethylenglykolsalbe DAB) and PEG paste on nonmoisturized and moisturized skin. The aim of the study was a clear indication for these vehicles in the clinical practice. Studies 1 and 2 were performed on 20 healthy volunteers. Study 1 was carried out on nonmoisturized skin, while test areas in study 2 were treated with the study products after 1-hour moisturization with hydrophilic aqueous ointment (hydrophile wasserhaltige Salbe DAB), covered with a semiocclusive film dressing. Study 3, carried out on 10 subjects, differed from study 2 by a longer follow-up period. The water content of the horny layer before and after application of the different vehicles was estimated by the capacitance measurement (Corneometer CM 820) and the conductance measurement (Skikon). The glycerol-containing zinc shake lotion and both PEG gels (with or without zinc oxide) produced hydration under the conditions of study 1 and 2. Zinc oil and moisturizer-free Lotio Cordes had little impact on stratum corneum hydration under the conditions of studies 1–3. Therefore, zinc shake lotion and the two PEG ointments can be used in the treatment of dry atopic skin, but not in overhydrated skin, e.g. in intertriginous regions. Zinc oil and Lotio Cordes can be used in overhydrated skin but not in dry skin, for the missing water-binding capacity in the horny layer. On the other hand an effective dehydrating effect cannot be expected.
Scratching Behavior in Various Strains of Mice
Authors: Inagaki Naoki , Nagao Masafumi , Igeta Katsuhiro , Kawasaki Hirokazu , Kim Jhon Fan , Nagai Hiroichi
Published: April 2003

Scratching behavior was induced in 12 strains of mice and the frequency was compared. An injection of histamine at a dose of 50 nmol induced frequent scratching behavior only in ICR mice, although the same dose of serotonin induced frequent scratching behavior in all strains of mice except for A/J. Histamine (10 nmol), serotonin (1 nmol), substance P (50 nmol) and passive cutaneous anaphylaxis induced significant vascular permeability increase in BALB/c, ICR, ddY and NC/Nga mice. These four stimuli also induced frequent scratching behavior in ICR mice. However, they failed to induce substantial increase in the incidence of scratching in the other three strains, except for ddY, which exhibited a slight but significant increase against substance P injection. These results suggest that the ICR mouse is a good responder for scratching behavior against various stimuli, especially against histamine. Thus ICR mice may be suitable for studying mediators and/or mechanisms for itching.
Penetration Kinetics of 8-Methoxypsoralen after 8-Methoxypsoralen Bath Procedure with and without UVA Irradiation
Authors: Neumann Norbert J. , Grosse Oliver J. , Ruzicka Thomas , Lehmann Percy
Published: April 2003

Administration of 8-methoxypsoralen (8-MOP) in a dilute bath water solution is an effective therapeutic alternative for systemic application of 8-MOP, avoiding systemic side effects such as nausea and cataractogenesis. The aim of our study was to determine the epicutaneous penetration of 8-MOP in a dilute bath water solution with and without additional UVA irradiation in human skin under in vitro conditions. To simulate the PUVA bath procedure, 8 skin samples were exposed to radioactively labeled 8-MOP in a water solution. After 20 min, the test solution was removed and the skin surface was dried. Immediately after the bath procedure, 4 of the skin samples were irradiated with 0.5 J/cm2 UVA. During a test period of 15 h, the 8-MOP penetration was observed. In both test groups (with and without UVA irradiation) 8-MOP permeated through all skin layers between 30 min and 1 h after application. Compared to the unirradiated skin samples, the UVA-irradiated skin samples showed a significantly slower increase and a lower maximum of 8-MOP permeation. Following our results, UVA irradiation of 8-MOP-exposed skin samples led to a significantly decreased permeation rate. This might be due to UVA-induced links between 8-MOP molecules and human DNA. In addition, we investigated the levels of radioactivity emitted by tritium-labeled 8-MOP in stratum corneum, epidermis and dermis up to 30 min after 8-MOP bath in two further test groups with and without additional UVA irradiation. The statistical analysis revealed no significant differences between these two test groups. Thus, the levels of radioactivity remained constant in the epidermis and dermis during the test period of 30 min. Since the levels of radioactivity were constant up to 30 min after UVA irradiation, a previously supposed marked loss of 8-MOP concentration might not be responsible for the rapid extinction of observed in vivo photosensitivity within 1 h after PUVA bath observed in vivo in human skin.
Tacalcitol, an Active Vitamin D3, Induces Nerve Growth Factor Production in Human Epidermal Keratinocytes
Authors: Fukuoka Masami , Sakurai Katsutoshi , Ohta Tomohiro , Kiyoki Mamoru , Katayama Ichiro
Published: April 2003

The human epidermal keratinocyte cell line K-TL-1, developed from a benign epidermal tumor, was cultured in the presence of the synthetic vitamin D3 analogue tacalcitol [1α,24(R)-dihydroxyvitamin D3] to assess the effects on the production of nerve growth factor (NGF). Confluent K-TL-1 cells were cultured with 10–8M of tacalcitol. Supernatants and cell homogenates were collected and NGF concentrations were determined by enzyme-linked immunosorbent assay. The concentration of NGF in the supernatants of cultures treated with tacalcitol peaked within 24 h after the start of tacalcitol treatment and remained stable for 96 h. This NGF induction caused by tacalcitol was dose-dependent, showing an ED50 between 10–10 and 10–9M. Induction of NGF mRNA expression by tacalcitol was also observed by RT-PCR, indicating that tacalcitol induced NGF expression through transcriptional activation. These results suggest that active vitamin D3 could treat peripheral neuropathy by inducing NGF production in the skin.
Immunomodulation Induced by Avène Spring Water on Th1- and Th2-Dependent Cytokine Production in Healthy Subjects and Atopic Dermatitis Patients
Authors: Portalès P. , Ariès M.-F. , Licu D. , Pinton J. , Hernandez-Pion C. , Gall Y. , Dupuy P. , Charveron M. , Clot J.
Published: April 2003

Avène spring water (ASW) is commonly used in France for treating atopic dermatitis and psoriasis. Previous works demonstrated modulation of cell membrane fluidity by ASW. The aims of the present study were (a) to investigate a possible in vitro effect of ASW on Th1- and Th2-dependent cytokine production using peripheral blood mononuclear cells from healthy individuals and (b) to investigate both the in vitro effect of ASW on AD patients’ cells and the in vivo cellular and clinical modifications induced by a 3-week Avène Medical Spa water cure (AMSWC). The effect of ASW was tested on lymphocyte cultures, which were stimulated in vitro by various mitogens and a superantigen of staphylococcal origin. The lymphocyte proliferation and the production of the cytokines IL-2, IL-4 and IFN-γ were tested. The results showed that ASW-containing medium enhanced the lymphoproliferative response to some mitogens. IL-2 and IFN-γ production were also increased in stimulated culture supernatants. Conversely, ASW-containing medium induced a decrease in IL-4 production by normal peripheral blood lymphocytes. Furthermore, AMSWC was able to amend the clinical features as well as the immunological Th2 profile of atopic dermatitis.
Alternatively Activated Antigen-Presenting Cells: Molecular Repertoire, Immune Regulation, and Healing
Authors: Gratchev Alexei , Schledzewski Kai , Guillot Pierre , Goerdt Sergij
Published: April 2003

The Th1/Th2 paradigm has stimulated extensive research into the mechanisms underlying T-cell polarization; alternative activation of antigen-presenting cells (APCs) has turned out to be the corresponding concept APC polarization. Macrophages (Mφ) as well as dendritic cells (DCs) can undergo Th1- or Th2-like polarization; APC1 and APC2 thus acquire the capacity to drive the development of naive T cells and the reactivation of resting T cells towards either a Th1 or a Th2 phenotype, respectively. Among polarized APC, effector macrophages are classically activated by mediators such as IFN-γ, TNF-α or LPS (Mφ1), while Mφ2 are alternatively activated by IL-4, IL-10 or PGE2. Mφ2 exhibit a unique molecular repertoire including receptors of innate immunity with broad specificity for foreign antigen and anti-inflammatory cytokines such as IL-1 receptor antagonist and alternative macrophage activation-associated CC-chemokine (AMAC)-1. While DC1 are well characterized, contradictory results have been obtained for DC2 that may either represent immature myeloid DCs or lymphoid DCs. Altogether, APC2 have come to age; they mediate Th2 differentiation, tolerance induction, downregulation of inflammation and healing. Thus, APC2 represent a hitherto neglected, but indispensable major pathway of APC activation and function.
Diagnosis and Treatment of the Acute Porphyrias: An Interdisciplinary Challenge
Authors: Gutiérrez Pamela Poblete , Kunitz Oliver , Wolff Carlos , Frank Jorge
Published: April 2003

The porphyrias comprise a group of fascinating disorders resulting from predominantly inherited as well as acquired deficiencies of one of the eight enzymes along the pathway of heme biosynthesis. On the basis of clinical aspects, the different types of porphyrias can be classified in acute and non-acute forms. However, an exact classification is often difficult since the porphyrias might reveal unspecific clinical symptoms and/or overlapping biochemical features. In particular, this is true for the acute porphyrias which can present with life-threatening acute neurovisceral attacks that require immediate medical intervention. Due to the multiple facets of these disorders, the diagnosis and treatment of the acute porphyrias should always imply a close interdisciplinary collaboration to serve patients and their families most effectively.
Ultrastructure of the Human Stratum corneum
Authors: Corcuff P. , Fiat F. , Minondo A.-M.
Published: April 2003

The ultrastructural study of the intercellular spaces of the human stratum corneum was based on transmission electron microscopy of thin vertical sections and freeze-fracture replicas, field emission scanning electron microscopy and immunofluorescence confocal laser scanning microscopy. The maturation of the corneosomes and their enzymatic degradation could be depicted at strategic interfaces. These sharp and rapid metamorphoses are now relatively well understood from a morphological point of view. But morphology raises a lot of unsolved physiological problems.
Differences in Corneocyte Surface Area in Pre- and Post-Menopausal Women
Authors: Fluhr J.W. , Pelosi A. , Lazzerini S. , Dikstein S. , Berardesca E.
Published: April 2003

The differences between pre- and postmenopausal women and men on corneocyte surface area were investigated by a noninvasive exfoliation method. Surface corneocytes were collected with a modified detergent scrub technique. Separated corneocytes were analyzed by videomicroscopy and image analyses (NIH ImageTM 1.59). Additionally transepidermal water loss (TEWL) and stratum corneum hydration, water-holding capacity and moisture accumulation velocity were measured. 21 postmenopausal females without hormonal substitution (age 50.6 years), 33 premenopausal women (age 41.0 years) and 25 men matched for age (age 44.0 years) were included in this study. The smallest corneocyte surface area was seen in premenopausal women (368.0 pixels). For postmenopausal women and the male control population almost equal values could be detected (postmenopausal women 401.1 pixels; men 401.8 pixels). Significant differences were calculated with the ANOVA test (p = 0.0050) and post-hoc analyses (Dunn test); premenopausal vs. postmenopausal women (p < 0.05) and premenopausal women vs. men (p < 0.05), but not postmenopausal women vs. men (p > 0.05). No statistically significant differences could be detected for TEWL, stratum corneum hydration parameters. No correlation could be found between the corneocyte surface area and barrier or hydration parameters. The detected differences support the hypothesis that sexual hormones have an impact on corneocyte surface area, because sex hormone levels are higher in premenopausal women than in non-hormone-substituted postmenopausal women or men.
Iontophoretic Transport across the Skin
Authors: Guy R.H. , Delgado-Charro M.B. , Kalia Y.N.
Published: April 2003

There have been many attempts to define the key relationships between passive drug diffusion across the skin and the molecular and physicochemical properties of the permeant. At the present time, the importance of lipophilicity (or hydrogen bond donor and acceptor properties) and of molecular volume are well established, and useful predictive relationships for passive percutaneous permeability exist. With respect to iontophoresis, on the other hand, the situation is far less clear and the mechanisms involved have not been completely defined. The roles of electromigration and electroosmosis (current-induced convective solvent flow) are now beginning to be understood and experimentally separated. In turn, this allows the manner in which certain physicochemical parameters influence the efficiency of drug electrotransport to be deduced. An initial examination of a database drawn from the literature and from our own work (for which the experimental conditions employed were reasonably constant) suggests a rather sharp dependence of cationic drug delivery via electromigration upon molecular size. We suggest that the analysis reveals useful paths for further investigation.
On the Use of Micro-Imager® to Directly Visualize Drug Distribution in Human Skin
Authors: Gautier B. , Bernard B.A.
Published: April 2003

Knowledge of drug distribution into the skin has always been considered as a key parameter of both safety and efficiency. We describe here the use of a new and powerful device to directly visualize and quantify the skin distribution of a radioactively labelled compound on histological sections.
Apoptosis following Gamma Knife Radiosurgery in a Case of Acoustic Schwannoma
Authors: Fukuoka S. , Oka K. , Seo Y. , Tokanoshi M. , Sumi Y. , Nakamura H. , Nakamura J. , Ikawa F.
Published: April 2003

A 25-year-old woman with a large acoustic schwannoma underwent surgical excision 18 months after Gamma Knife radiosurgery because of transient expansion of the tumor causing ataxia. Histopathologial investigation by the TUNEL method revealed the presence of some apoptotic cells. The findings were compared with findings from a control group of 7 operated cases where radiosurgery had not been used. There was no apoptosis found in any of these cases. In addition, another case which resulted in a regrowing tumor following Gamma Knife treatment also showed no apoptosis. These findings suggest apoptosis may be a possible mechanism in reducing tumor size following Gamma Knife radiosurgery.
Gamma Knife Radiosurgery for the Treatment of Trigeminal Neuralgia
Authors: Young R.F. , Vermulen S. , Posewitz A.
Published: April 2003

One hundred and ten patients with trigeminal neuralgia were treated with the Gamma Knife using a single isocenter, the 4 mm secondary collimator helmet and a radiosurgical dose maximum of 70 or 80-Gy. The isocenter was placed at the trigeminal sensory root adjacent to the pons as identified on stereotactic MRI scans. Follow-up periods range from 4–49 months (mean 19.8 months). Initial pain relief was achieved in 95.5% of patients with typical trigeminal neuralgia symptoms, who had not had prior surgical intervention, and only 3.3% of these patients experienced recurrent pain during the follow-up period. Patients with atypical features to their pains or who had prior unsuccessful surgical attempts to relieve their pains achieved initial and long-term pain relief in 88 and 69%, respectively. Three patients (2.7%) developed delayed loss of facial sensation following treatment, but no other complications of any kind were noted. We believe that Gamma Knife radiosurgery is the safest and most effective form of treatment which is currently available for trigeminal neuralgia. We recommend early radiosurgical treatment of trigeminal neuralgia once the diagnosis is clearly established.
Effect of Gamma Knife on Secondary Trigeminal Neuralgia
Authors: Régis J. , Métellus P. , Lazorthes Y. , Porcheron D. , Peragut J.C.
Published: April 2003

The following study was conducted to evaluate the results of Gamma Knife stereotactic radiosurgery in the management of secondary trigeminal neuralgia. 53 patients suffering from secondary trigeminal neuralgia were studied and the results reported. We defined four therapeutic groups: group I correspond to essential trigeminal neuralgia. The primary aim was tumor control in group IV and pain cessation in group III and II (visualization of the fifth nerve root was possible in group II but not in group III). The target dose of the radiosurgery used in the current study varied from 20 to 40 Gy in group III and IV and from 70 to 90 Gy in group I and II. At short-term follow-up, 37 patients (74%) were pain-free, 9 patients (18%) were improved (50%–90% relief) and only 4 patients (8%) experienced treatment failure. Among the patients with early treatment success, 10 patients experienced a complete recurrence of pain in the four succeeding years, and 11 initially pain-free patients deteriorated to partial pain relief. The median time to pain relief was three months (range 1 day to 1 year). The mean follow-up was 32 months (range 7 to 60 months). No patient developed increased facial pain or deafferentation pain. Among the 53 patients, only two exhibit a slight facial hypesthesia and one patient described motor fasciculation related to Gamma Knife treatment. In our experience Gamma Knife surgery appears a safe and effective method for the treatment of secondary trigeminal neuralgia.
Pallidotomy with the Gamma Knife: A Positive Experience
Authors: Young R.F. , Vermeulen S. , Posewitz A. , Shumway-Cook A.
Published: April 2003

51 patients with medically refractory Parkinson’s disease underwent stereotactic posteromedial pallidotomy between August 1993 and February 1997 for treatment of bradykinesia, rigidity, and L-DOPA-induced dyskinesias. In 29 patients, the pallidotomies were performed with the Leksell Gamma Knife and in 22 they were performed with the standard radiofrequency (RF) method. Clinical assessment as well as blinded ratings of Unified Parkinson’s Disease Rating Scale (UPDRS) scores were carried out pre- and postoperatively. Mean follow-up time is 20.6 months (range 6–48) and all except 4 patients have been followed more than one year. 85 percent of patients with dyskinesias were relieved of symptoms, regardless of whether the pallidotomies were performed with the Gamma Knife or radiofrequency methods. About 2/3 of the patients in both Gamma Knife and radiofrequency groups showed improvements in bradykinesia and rigidity, although when considered as a group neither the Gamma Knife nor the radiofrequency group showed statistically significant improvements in UPDRS scores. One patient in the Gamma Knife group (3.4%) developed a homonymous hemianopsia 9 months following treatment and 5 patients (27.7%) in the radiofrequency group became transiently confused postoperatively. No other complications were seen. Gamma Knife pallidotomy is as effective as radiofrequency pallidotomy in controlling certain of the symptoms of Parkinson’s disease. It may be the only practical technique available in certain patients, such as those who take anticoagulants, have bleeding diatheses or serious systemic medical illnesses. It is a viable option for other patients as well.