bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Immune Status in vivo by the 2,4-Dinitro-1-Chlorobenzene Contact Allergy Time (DNCB-CAT)
Authors: Przybilla Bernhard , Burg Günter , Thieme Christian
Published: October 2009

The time interval from starting continuous application of 2,4-dinitro-1-chlorobenzene (DNCB) epicutaneously until the appearance of an allergic contact reaction, i.e. ‘contact allergy time’ (CAT), was determined. In 34 patients initially 2.0% DNCB ointment was administered for 2 days, then 0.05% DNCB ointment was applied daily (group I). In 39 patients only the 0.05% DNCB preparation was used (group II). The median of DNCB–CAT was 11.2 ± 0.8 days in group I and 22.3 ± 3.7 days in group II (p < 0.01). In patients older than 55 years DNCB–CAT was significantly longer than in younger patients. The medians of DNCB-CAT did not differ in male and female patients. In contrast to the conventional DNCB-sensitization procedures, the CAT method allows one to measure induction and elicitation phase quantitatively.
Tromantadine Hydrochloride in the Treatment of Herpes simplex
Authors: Hellgren L. , Hermann L.S.
Published: October 2009

In a randomised, double-blind trial on 20 patients with herpes simplex, tromantadine hydrochloride (TH) ointment had a significant therapeutic effect. No side effects were observed. 12 lesions were treated with the active drug and 13 with placebo. In an open study on 19 patients with recurrent herpes simplex, the prophylactic effect of the drug was good in most patients. During long-term treatment, 2 patients developed eczematous lesions. It is concluded that TH is a valuable topical agent for the treatment of herpes simplex.
Treatment of Onychomycosis by ODT Therapy with 20% Urea Ointment and 2% Tolnaftate Ointment
Authors: Ishii Masamitsu , Hamada Toshio , Asai Yoshie
Published: October 2009

20 patients with distal onychomycosis were given daily application of an ointment containing 2% tolnaftate and an ointment containing 20% urea under ODT. Following this, 17 of 20 patients developed onychomalacia and seven of these developed onycholysis 1 or 2 weeks later. The separated nails were cut as short as possible. Similarly to those patients with onychomalacia alone, occlusive dressing technique was continuously performed until the newly developed nails became macroscopically normal and no fungi were observed microscopically (responders). Following treatment, out of 20 patients, 14 responded. 5 patients who had a short course of treatment did not respond. Side-effects such as pain, hemorrhage and infection did not occur.
Inflammatory Linear Verrucous Epidermal Naevus
Authors: Landwehr A.J. , Starink T.M.
Published: October 2009

A case of inflammatory linear verrucous epidermal naevus is described. Unusual features were the widespread and bilateral distribution, nail involvement, and the abundance of capillaries in the dermis.
Immunhistochemische Untersuchungen an malignen Lymphomen und Pseudolymphomen der Haut
Authors: Rauch H.-J.
Published: October 2009

Biopsy material of 172 patients with malignant cutaneous lymphomas and pseudolymphomas was examined using the immunoperoxidase technique. It can be stated that this technique appears to be a valuable aid for the classification and differential diagnosis of cutaneous lymphoproliferative and histiocytic disorders. In addition, the method provides a better understanding of the etiopathology of certain entities.
Cyproterone Acetate in the Treatment of Acne vulgaris in Adult Females
Authors: Hansted Birgitte , Reymann Flemming
Published: October 2009

22 adult females with therapy-resistant acne vulgaris were treated for 12 months with Diane®1, a drug containing cyproterone acetate and ethinylestradiol. Treatment was withdrawn in 7 patients because of side-effects or lack of effect. In the remaining 15 patients, the treatment had extremely promising results, from 70 to 90% improvement of the acne. In a remarkably high number of patients, the androgen production, measured by the urinary excretion of fractional 17-ketosteroids, was elevated. None of these patients had signs of endocrinological diseases, in particular no cases of hirsutism of Stein-Leventhal syndrome were found. The current concept of the course of acne is that the conversion in the skin of testosterone to dehydrotestosterone is increased. The finding of an elevated urinary excretion of androgenic substances in this group of acne patients indicates that the pathogenesis is far more complicated.
Secondary Polymorphic Eruptions in Allergic Contact Dermatitis
Authors: Meneghini C.L. , Angelini G.
Published: October 2009

10 cases of secondary dissemination of allergic contact dermatitis in the form of erythema multiforme-like or purpura and vasculitis-like lesions are reported. The responsible contact allergens were various constituents of topical applications, such as pyrrolnitrin, sulfonamide, promethazine, balsam of Peru and vioform + ethylenediamine. The clinical patterns and histopathological features of the lesions are described and the possible pathogenetic mechanisms are discussed.
PUVA Treatment for Alopecia areata
Authors: Lassus A. , Kianto U. , Johansson E. , Juvakoski T.
Published: October 2009

41 patients with severe alopecia areata were treated with either local or oral 8-methoxypsoralen and UVA irradiations. In 26 cases (73%) a good to excellent result was obtained. The number of irradiations required for regrowth varied but 20–40 treatments were sufficient in most cases with a positive response. Patients with circumscribed or ophiasic alopecia responded better than patients with total or universal alopecia, atopy or a family history of alopecia did not seem to influence the outcome of the treatment. The age of onset of the disease seemed to be of importance as well as the duration of the treated attack. Patients over 20 years at the first attack of alopecia showed a better response than patients with an earlier onset of the disease. During a follow-up period of 6–12 months of 20 successfully treated patients only 2 had a recurrence.
Oral Retinoid (Ro 10-9359) in Children with Lamellar Ichthyosis, Epidermolytic Hyperkeratosis and Symmetrical Progressive Erythrokeratoderma
Authors: Tamayo Lourdes , Ruiz-Maldonado Ramón
Published: October 2009

8 children with lamellar ichthyosis, 1 with epidermolytic hyperkeratosis and 5 with symmetrical progressive erythrokeratoderma were treated with a new aromatic retinoid (Ro 10-9359). Clinical improvement was dramatic. The children acquired an appearance never obtained before with other managements. The treatment had to be maintained to prevent recurrence. The tolerance to the drug was good. The side-effects were minimal and tended to disappear after several months of treatment. Our results suggest that because of its efficacy, good tolerance and easy administration, the oral retinoid Ro 10-9359 is at present the treatment of choice for the great ichthyotic disorders of children.
Basement Membrane Zone Deposits of Immunoglobulins and Complement in a Patient with Pemphigus vulgaris
Authors: Livden J.K.
Published: October 2009

A patient with pemphigus vulgaris is presented. In addition to the intercellular deposits of immunoglobulin and complement in the Malpighian layer which is consistent with pemphigus vulgaris, concomitant granular deposits of IgG and C3 were demonstrated at the dermal epidermal junction, similar to the findings in lupus erythematosus.
The Sensitizing Capacity of Compositae Plants
Authors: Hausen B.M.
Published: October 2009

25 patients known or suspected to be allergic to different Compositae plants were tested epicutaneously with ether extracts of different Compositae species. 14 persons revealed a chrysanthemum hypersensitivity, 2 were allergic to arnica and 2 to camomile. In 1 patient a positive reaction to tansy was obtained. In the case of the chrysanthemum allergy, this was induced occupationally. All other patients had sensitized themselves by non-occupational contact. Cross-reactions were seen to tansy [14], yarrow [11], camomile [10], arnica and sunflower [5]. The components which are responsible for the sensitization as well as for the cross-reactions are sesquiterpene lactones.
Über einen ungewöhnlichen Fall von Lyell-Syndrom (TEN)
Authors: Schuppli Rudolf
Published: October 2009

Report on a female patient with TEN, who has had four different carcinomas in her case history. In this instance, TEN may not be considered as a hyperergic reaction.
Immunological and Histopathological Studies in a Case of Pyodermia Vegetans Hallopeau
Authors: Kudejko Jan , Gajewska Malgorzata , Bednarzewska Elzbieta
Published: October 2009

In a case of pyodermia (pemphigus) vegetans Hallopeau, modern investigations were performed. Direct immunofluorescent (IF) study of specimens taken from verrucous vegetations failed to reveal the presence of IgG deposits in the intercellular spaces as well IgA and IgG deposits at the epidermal-dermal junction. Indirect IF examination of circulating pemphigus antibodies gave a negative result. Histopathological study did not show the presence of acantholysis. The studies which were carried out indicated that pemphigus vegetans Hallopeau should not be associated with the pemphigus group.
Leucocyte Migration Inhibition in Behçet’s Disease
Authors: Haim S. , Gilhar A. , Mekori T. , Segal R.
Published: October 2009

The leucocyte migration inhibition (LIF) was investigated in 16 patients with Behçet’s disease, 5 while in the active stage of the process, 3 both during relapse and remission, and 8 during remission of symptoms. In all patients skin tests with various antigens and with a needle prick and physiological saline were simultaneously performed. The results indicate a strong correlation between the activity of the disease, skin reactivity and the reactivity of LIF.
Two Primary Malignant Melanomas in a Patient with Plasmacytoma
Authors: Ruzicka T. , Goerz G. , Hofmann N. , Kratka J.
Published: October 2009

The occurrence of two primary malignant melanomas (superficial spreading melanoma, superficial spreading melanoma with nodular growth) in a patient with diffuse plasmacytoma treated with chemotherapy and radiation is described. Such an association does not appear to have been reported previously.
Dégénérescence muco-élastoïde localisée du derme après prednisone et azathioprine
Authors: Delacrétaz J.
Published: October 2009

A 68-year-old woman developed localized mucinous elastotic collar-like degeneration of the dermis after a 7-year course of therapy with prednisone and azathioprine for a posthepatitic micronodular cirrhosis.
Levuroses apparues en cas de brûlures graves
Authors: Male O. , Diem E.
Published: October 2009

The preconditions for the development of systemic mycoses, mainly levuroses, caused by opportunistic organisms are particularly favorable in the severely burned patients: on the one hand as a consequence of suppression of immunity, on the other hand by the overgrowth of these fungi in the digestive tract as a side-effect of the antibacterial chemotherapy which is necessary for the treatment of the original disease. Since such mycoses are usually very severe, mostly life endangering, their prophylaxis and early diagnosis are highly important. The aspects and measurements, most important in this connection, are discussed on the basis of our experience.
The Significance of Fetal and Neonatal Behavior Research in Japan
Authors: Kobayashi N.
Published: October 2009

This paper, including the results of our own studies and others, serves as an introduction to this special issue on fetal and neonatal behavior research in Japan. The social impact of these studies is discussed in relation to current problems in family and society. The scientific impact of this research in relation to behavioral development, particularly with respects to the theoretical aspects, is also discussed.
Psoriasis: Case Rate – HL-A Antigen Frequency Correlations
Authors: Thomas Robert J.
Published: October 2009

HL-A antigen B17, associated with a high familial frequency of psoriasis, is significantly correlated (r = 0.8242) with psoriasis case rates in several countries but HL-A antigen B13 alone, associated with ‘early age onset’ cases of psoriasis, is not significantly correlated (r = 0.4299) with case rate. A sum of the B13 and B17 antigen frequencies, since either antigen has been associated to psoriasis, is correlated with case rate in the populations surveyed (r = 0.7405) and is statistically significant.
‘Atypical’ Blue Nevus – a Benign Variant of Cellular Blue Nevus
Authors: Avidor Irina , Kessler Elena
Published: October 2009

Three cases of ‘atypical’ blue nevus presented almost identical histological findings differing from both benign cellular blue nevus and malignant blue nevus or malignant melanoma, and suggesting malignancy. Long-term follow-up – in one case 19 years – indicates that this pigmented tumor is a benign variant of blue nevus.
Cutaneous Sarcoidosis Treated with Levamisole
Authors: Veien Niels K.
Published: October 2009

16 patients with cutaneous sarcoidosis were treated intermittently over a period of 6 months with levamisole in an open study. The skin lesions cleared in 2 of 13 patients completing the course of treatment. Aggravation of the sarcoidosis was noted in 2 other patients after a few weeks of treatment. Tuberculin sensitivity did not increase during the treatment period. Dinitrochlorobenzene sensitivity increased in 5 patients but the lesions did not clear in any of these patients. It is concluded that levamisole is not useful in the treatment of cutaneous sarcoidosis.
Untersuchungen zur Morphologie und Funktion der Sertoli-Zellen beim Menschen
Authors: Lüders G.
Published: October 2009

Ultrastructurally and enzyme histochemically two types of activities of Sertoli cells are to be proved. By means of closest membrane contact and intensive energetic changes of substances, the active cells participate largely in the ripening of spermatozoa. Steroid biosynthesis in Sertoli cells is possible according to their pattern of organelles and enzymes. The ultrastructure of Charcot-Böttcher’s crystalloids and the other characteristic inclusions in the cytoplasma of the Sertoli cells as well as implications to their function are described.
Biochemical and Physiological Parameters on the Healthy Skin Surface of Patients with Common Warts
Authors: Gloor Max , Baumann Christa , Friederich Hugo Constantin
Published: October 2009

Biochemical and physiological examinations were carried out on the healthy surface of the skin of 24 test persons who had had contracted common warts during the 2 years prior to examination and on a control group of 46 healthy persons of the same age and sex. The following significant results were obtained: (1) There was a significant reduction in the percentage amount of squalene in the lipids of the skin surface in the patients with common warts as compared with the healthy control persons. (2) The alkali neutralization time in the patients with common warts was significantly shortened as compared with the healthy control group. (3) The degree of moistening of the skin with water was significantly less in the patients with common warts than in the control persons. These results indicate important predisposing factors for common warts.
Hypersensitivity to Prilocaine
Authors: Göransson Kerstin
Published: October 2009

A case of anaphylactoid reaction with late onset to prilocaine and a positive intracutaneous test is reported.
Dermatopharmacology of Salicylic Acid
Authors: Weirich Erich
Published: October 2009

The history and the dermatotherapeutic activity spectrum of salicylic acid are briefly reviewed
Purine Phosphoribosyl Transferases in Human Hair Roots
Authors: de Bruyn C.H.M.M. , Oei T.L.
Published: October 2009

A method is presented for the simultaneous measurement of the two enzymes involved in purine salvage in human hair roots. Km values of hypoxanthine-guanine phosphoribosyl transferase (HG-PRT) for hypoxanthine and 5′-phosphoribosyl-1-pyrophosphate (PRPP) and of adenine phosphoribosyl transferase (A-PRT) for adenine and PRPP in human hair roots were similar to values reported for human erythrocytes. No differences were observed between hair root and erythrocyte enzymes with respect to the influence of magnesium and calcium ions. Heat inactivation experiments revealed comparable stability for HG-PRT, but A-PRT in hair roots is more labile than in erythrocytes.
Contact Allergic Investigations in 100 Patients with Ulcus Cruris
Authors: Malten K.E. , Kuiper J.P. , van der Staak W.B.J.M.
Published: October 2009

The incidence of contact-allergic reactions to some 10 substances out of 75 tested in 100 selected leg-ulcer patients is about 5 times as high as in eczematous patients. These substances are p-phenylenediamine, p-aminoazobenzene, Pellidol®, benzocaine, diaminodiphenylmethane, neomycin, coal tar, balsam of Peru, wool alcohols. Sesame oil was the tenth substance. It is used to clean the skin from rests of ointments. In Holland it figures as a constituent of the often-used, so-called pasta zinci oleosa, ung. diachylon, ung. simplex, and of emulgide cream. In our opinion, not only topical medicaments should be regarded as frequent contact sensitizers in leg-ulcer patients. A second class of important sensitizers in this group of patients appears to be the para-substituted substances such as p-phenylenediamine (and azo dyes) as inducers considered to be responsible for the cross-reaction of drugs such as benzocaine and sulfanilamide, and of the rubber additive, diaminodiphenylmethane. Stress is laid upon five preventive measures concerning contactants in leg-ulcer patients (stockings, bandages, topical medications) and upon the desirability of having non-sensitizing preservatives and stabilizers at one’s disposal–especially for topical medications in leg-ulcer patients who apparently are sensitized with greater ease than patients with other skin ailments.
Role of Keratinases in Dermatophytosis
Authors: Eleuterio M.K. , Grappel S.F. , Caustic C.A. , Blank F.
Published: October 2009

The capillary tube migration test was used for the ‘in vitro’ demonstration of delayed hypersensistivity to two keratinases isolated from T. Mentagrophytes var. granulosum. Both heat-inactivated keratinases, I and II, inhibited migration of peritoneal exudate cells from guinea pigs previously infected twice with this dermatophyte. Trichophytin did not cause any significant inhibition of migration.
Anti-Chromium Barrier Creams
Authors: Wahlberg J.E.
Published: October 2009

Disappearance measurements have been used for studying the inhibiting effect of barrier creams on chromate (51Cr) absorption in the guinea pig. The creams Bakosan, Dow (Silicones), Indulona, Ivosin, Kerodex 71 and petrolatum were applied in different volumes (0.05–0.15 ml/cm2) and the interval between application of cream and chromate was varied. Ivosin (ion exchanger) was the most effective absorption-inhibiting preparation. Only at 0.15 ml/cm2 was Dow equally effective. The protective effect of Bakosan, Indulona, Kercdex and petrolatum diminished when the volume was raised to 0.15 ml/cm3. Increasing the interval resulted in no change (Ivosin), a decrease (Bakosan, Indulona), and an increase in absorption for the other creams. Film thickness and interval before exposure have clinical implications.
Elektronenmikroskopische Untersuchungen an einem Fall von Elastosis perforans serpiginosa
Authors: Meves C. , Vogel A
Published: October 2009

A 27 year old female patient with elastosis perforans serpiginosa was investigated. The most significant findings were, as originally described by Miescher using light microscopy, hyperplasia of elastic fibres in the papillary dermis as well as probably newly formed smaller fibres. Collagen fibres were less affected.There were localised changes of the epidermal basement membrane, which was partly replaced by an electron-opaque, multi-layered substance made up of fine filaments but showing defects allowing processes of the basal layer cells to make direct contact with dermal cells and other dermal structures. The nature and derivation of this substance is uncertain. The localised hyperplasia of the elastic tissue is considered to be the primary event of the other connective tissue reactions. The nature of the disorder remains obscure.
The Induction of Delayed Sensitivity to 2.4-Dinitrophenyl Conjugates in Guinea Pigs Sensitized with DNCB
Authors: Nakagawa S. , Tanioku K.
Published: October 2009

Delayed reaction to DNP conjugate prepared in vitro from the extract of homologous epidermis could be clearly detected on intradermal injection in guinea pigs sensitized by epicutaneous application of DNCB and intradermal injection of Freund’s complete adjuvant to the previously applied area, but not to DNP guinea pig serum. The animals developed the most intense delayed reaction to DNP conjugate prepared from the subcellular small granule fraction of homologous epidermis. There was significant difference in the reactivity of this conjugate and DNP-soluble fraction of the epidermis. The animals also showed positive reactions to DNP conjugates prepared from the extracts of homologous heart, liver, kidney and heterologous (human) epidermis. This finding is explainable by cross-reactivity which exists between these conjugates and DNCB conjugated in vivo to autologous epidermis.
Scleroderma-Like Lesions in Multiple Myeloma
Authors: Jabłońska S. , Stachow A.
Published: October 2009

A case of IgG-χ multiple myeloma is reported with coexistent scleroderma-like skin lesions. Histological, histochemical, electron microscopic and immunohistochemical studies failed to reveal amyloid in the skin, muscles, intestine and kidney. No macroglossia or other features characteristic of systemic amyloi dosis have been revealed. Attention is called to disturbances of tryptophan metabolism (increased level of indoles) which may play some role in the pathomechanism of the indurations. The possible transformation of paraprotein to histochemically-detectable amyloid is discussed.
Le fibrokératome digital acquis
Authors: Geiser J.D.
Published: October 2009

On the basis of the study of cases already published and on two personal cases, the author describes the clinical and histological appearance of the acquired digital fibrokeratomas.
Dietary Phytosterols and Phytostanols Alter the Expression of Sterol-Regulatory Genes in SHRSP and WKY inbred Rats
Authors: Chen Qixuan , Gruber Heidi , Pakenham Catherine , Ratnayake Walisundera M.N. , Scoggan Kylie A.
Published: October 2009

Background/Aims: We elucidated the molecular mechanism(s) underlying sterol trafficking by investigating alterations in gene expression in response to increased retention of dietary phytosterols and phytostanols in stroke-prone spontaneously hypertensive (SHRSP) and normotensive Wistar Kyoto (WKY) inbred rats. Methods: SHRSP and WKY inbred rats were fed a control diet or a diet supplemented with phytosterols or phytostanols (2 g/kg diet). Results: Intake of phytosterols and phytostanols increased their incorporation in plasma, red blood cells, liver, aorta and kidney, but decreased cholesterol levels in liver and aorta in both rat strains. Phytosterol intake up-regulated mRNA expression of intestinal Npc1l1 and Abcg8, and hepatic Abcg5, Abca1, Cyp27a1 and Hmgcr. Phytostanol intake up-regulated Npc1l1 and Srebp2, but down-regulated Abcg5 mRNA expression in small intestine. Phytostanols also up-regulated Abca1 expression in SHRSP rats, but down-regulated Abca1 expression in WKY inbred rats. Compared to phytosterols, dietary phytostanols reduced phytosterol levels in plasma, red blood cells, and kidney, as well as altered mRNA levels of hepatic Abca1,Cyp27a1, and Hmgcr and intestinal Abcg5/8, Hmgcr and Srebp2. Conclusions: Altered expression of multiple sterol-regulatory genes may contribute to the incorporation and cholesterol-lowering actions of phytosterols and phytostanols. Phytosterols and phytostanols may act through different mechanism(s) on cholesterol and phytosterol/phytostanol trafficking.
Hypersensitivity to Chromium in a Light-blue Tattoo
Authors: Tazelaar D.J.
Published: October 2009

A description is given of a case of hypersensitivity to chromium in a light-blue tattoo. The patient also exhibited a chromium eczema of the hands, just as in most cases of allergic reactions to chromium in green tattoos that have been reported.
Liver Regeneration: Focus on Cell Types and Topographic Differences
Authors: Kandilis Apostolos N. , Koskinas John , Tiniakos Dina G. , Nikiteas Nikolaos , Perrea Despina N.
Published: October 2009

Background/Aims: The liver has a remarkable capacity to regenerate after injury or resection. The aim of the current review is to outline the morphological changes at the cellular level and the intralobular differences during the regenerative response after partial hepatectomy. Methods: Relevant studies were reviewed using the Medline database. Results: At 24 h after partial hepatectomy, many alterations between the periportal and pericentral regions of the hepatic lobule occur, which coincide with the peak of hepatocellular proliferation in the periportal areas. Questions unanswered involve the precise role of Kupffer cells and whether the regenerative process is characterized by a net increase in the number of lobules or by an increase in the size of the existing lobules. Conclusions: Liver regeneration has been studied for many years, but further research is essential, since in-depth knowledge of the mechanisms that govern the regenerative process may expand the treatment options in patients with hepatic disease.
Prognostic Value of Circadian Blood Pressure Variation in Chronic Kidney Disease
Authors: Agarwal Rajiv , Kariyanna Shathabish S. , Light Robert P.
Published: October 2009

Background: Reduced circadian variation in blood pressure (BP) has been associated with cardiovascular morbidity, mortality and accelerated progression of kidney disease, but its independent prognostic value remains unknown. Methods: Using 2 definitions, one based on dipping and the other based on BP pattern (assessed by cosinor rhythmometry), we studied the prognosis of circadian BP variation among 322 patients, 179 (56%) of whom had chronic kidney disease (CKD). Results: During a follow-up period extending for up to 8.7 years, 116 (36%) patients died and 57 (32%) patients with CKD developed end-stage renal disease (ESRD). Compared to 106 patients (33%) who were dippers, the unadjusted hazard ratio (HR) for death among non-dippers was 2.03 (95% CI 1.30–3.16, p = 0.002). However, this HR became nonsignificant [1.39 (95% CI 0.89–2.19), p = 0.15] when adjusted for age and 24-hour average systolic BP. Although non-dipping was marginally associated with ESRD [HR 1.98 (95% CI 0.996–3.92), p = 0.051], even this association was weakened when adjusted for overall 24-hour systolic BP (HR 1.67, p = 0.15). Similar to the dipping definition, the BP pattern-based definition was significantly associated with mortality (p = 0.005) but not with ESRD (p = 0.68). Compared to those ‘in-phase,’ the HR for death among those ‘out-of-phase’ was 1.86 (95% CI 1.25–2.75, p = 0.002). Although this HR when adjusted for overall mean BP remained significant, when further adjusted for age, it too became nonsignificant. Conclusion: Among elderly veterans with or without CKD, circadian variation in BP is associated with mortality, but not ESRD. However, after accounting for common clinical risk factors, this association of circadian BP variation with mortality or ESRD is abolished.
Space, Gravity and the Physiology of Aging: Parallel or Convergent Disciplines? A Mini-Review
Authors: Vernikos Joan , Schneider Victor S.
Published: October 2009

The abnormal physiology that manifests itself in healthy humans during their adaptation to the microgravity of space has all the features of accelerated aging. The mechano-skeletal and vestibulo-neuromuscular stimuli which are below threshold in space, result in an overall greater than 10-fold more rapid onset and time course of muscle and bone atrophy in space and the development of balance and coordination problems on return to Earth than occur with aging. Similarly, the loss of functional capacity of the cardiovascular system that results in space and continuous bed rest is over 10 times faster than in the course of aging. Deconditioning in space from gravity deprivation has brought attention to the medical hazards of deconditioning on Earth from gravity withdrawal as in sedentary aging. Though seemingly reversible after periods of 6 months in space or its ground analog of bed rest, it remains to be seen whether that will be so after longer exposures. Both adaptation to space and aging do not merely parallel but converge as disorders of mechanotransduction. Like spaceflight, its analog bed rest telescopes the changes observed with aging and serves as a useful clinical model for the study of age-related deconditioning. The convergence of the disciplines of aging, along with gravitational and space physiology is advancing the understanding and prevention of modern lifestyle medical disorders.
Marked Improvement in Nail Psoriasis during Treatment with Adalimumab
Authors: Irla N. , Yawalkar N.
Published: October 2009

Background: Nail involvement is known as a common finding in psoriatic patients and represents a significant impact on patients’ quality of life. The treatment of nail psoriasis is often challenging, and there is a need for new therapeutic options. Biologicals effective in the treatment of moderate to severe chronic plaque psoriasis may represent a new therapeutic modality for this disease. Adalimumab is a fully human IgG1 monoclonal antibody that binds to tumor necrosis factor α with high affinity and specificity. Observations: We report two cases of rapid improvement in nail psoriasis under adalimumab monotherapy with maintained effectiveness despite intermittent treatment as well as long remission after therapy discontinuation. Conclusion: The marked improvement of our two cases indicates that adalimumab may also help ameliorate nail psoriasis and warrants further controlled studies to establish the effectiveness and therapeutic regimes.
The Effect of Aminolevulinic Acid Photodynamic Therapy on Microcomedones and Macrocomedones
Authors: Fabbrocini G. , Cacciapuoti S. , De Vita V. , Fardella N. , Pastore F. , Monfrecola G.
Published: October 2009

Background: Photodynamic therapy (PDT) with aminolevulinic acid (ALA) has been shown to be an effective treatment for acne. However, the effect of ALA PDT on comedo formation has never been objectively evaluated. Cyanoacrylate follicular biopsy (CFB), a noninvasive procedure, has been proposed as the most reliable tool for studying follicular casts. Objective: To determine the possible effect of ALA and red light (550–700 nm) on macro- and microcomedones in acne patients. Patients and Methods: 10 patients with mild-to-moderate facial and/or chest/back acne resistant to conventional therapies received ALA PDT at 2-week intervals in 3 sessions. The severity of acne had been estimated by a system of points, the Global Acne Grading System. The patients underwent PDT utilizing ALA 10% (face) or 15% (back/chest) and red light (15 J/cm2 each session). CFBs were performed. Results: Four weeks after their last PDT session, the patients showed an average global score reduction of 50%. CFBs demonstrated a reduction in the total area, the average area and the density of macrocomedones. Conclusion: The results obtained in this study using CFB evaluation demonstrate that ALA PDT exerts an action on the comedogenic phase as well.
Physical Activity Is a Determinant of Circadian Blood Pressure Variation in Chronic Kidney Disease
Authors: Agarwal Rajiv , Light Robert P.
Published: October 2009

Background: Circadian variation in blood pressure (BP), which is commonly blunted among patients with chronic kidney disease (CKD), has been associated with increased cardiovascular risk. The causes of this blunted circadian variation remain incompletely understood. Methods: We hypothesized that physical activity is a determinant of circadian BP variation. Accordingly, we studied 101 patients with CKD (mean age 69 years, mostly men) with 24-hour ambulatory BP monitoring and simultaneous monitoring of physical activity on 2 occasions 4 weeks apart. Results: Measured by wrist actigraphy, a higher level of physical activity was associated with lower overall mean BP. A higher level of activity also altered the circadian systolic BP rhythm; this alteration was characterized by both a higher amplitude of variation (and thus greater dipping) and restoration of acrophase (time at peak BP) to a less vulnerable period for cardiovascular events. Among the most sedentary participants, both systolic and pulse pressure acrophases were seen in the early hours of the morning which is also the most vulnerable period for cardiovascular events. Conclusion: Physical activity is an independent determinant of circadian variation in BP. We speculate that among patients with CKD, a sedentary lifestyle, rather than non-dipping, mediates increased cardiovascular risk.
‘Start the Conversation’: The New South Wales (Australia) Family Health History Campaign
Authors: Dunlop K. , Barlow-Stewart K.
Published: October 2009

Background: Evidence that family health history (FHH) informs recommendations for appropriate early detection strategies used for the prevention of many health conditions underscores the importance of optimizing a patient’s knowledge of his/her personal FHH. For some conditions, FHH also underpins identifying those at potentially high risk for whom genetic testing may be possible and suitable to further inform the advice. The Family Health History Campaign ‘Start the Conversation’ was conducted in New South Wales (Australia) in August 2006 as a small state-wide media campaign with the aim of encouraging individuals to discuss and gather their FHH information about several conditions and report it to their doctor. Campaign development included consultations with consumers and primary care practitioners (general practitioners – GPs), development of campaign resources, and establishment of partnerships. Methods: Evaluation methodologies included community poll surveys pre- and post-campaign, a GP mail survey, and website usage analysis. Results: While only 112/403 of the polled community reported hearing about the campaign in the media, 48% of those men and women were encouraged to start the conversation with their families. Limited findings from the GP survey respondents suggested they were engaged, made aware of the potential lack of patient knowledge about FHH and generated referral for several high-risk patients. Conclusion: Campaigns that use the media to encourage the community to take action and also engage the GPs can create a supportive environment that has the potential to increase the accuracy with reporting of FHH to maximize benefit for early detection and prevention.
Discrete Contributions of Elastic Fiber Components to Arterial Development and Mechanical Compliance
Authors: Carta Luca , Wagenseil Jessica E. , Knutsen Russell H. , Mariko Boubacar , Faury Gilles , Davis Elaine C. , Starcher Barry , Mecham Robert P. , Ramirez Francesco
Published: October 2009

Objective—

Even though elastin and fibrillin-1 are the major structural components of elastic fibers, mutations in elastin and fibrillin-1 lead to narrowing of large arteries in supravascular aortic stenosis and dilation of the ascending aorta in Marfan syndrome, respectively. A genetic approach was therefore used here to distinguish the differential contributions of elastin and fibrillin-1 to arterial development and compliance.

Methods and Results—

Key parameters of cardiovascular function were compared among adult mice haploinsufficient for elastin (
Eln
+/−
), fibrillin-1 (
Fbn1
+/−
), or both proteins (
dHet
). Physiological and morphological comparisons correlate elastin haploinsufficiency with increased blood pressure and vessel length and tortuosity in
dHet
mice, and fibrillin-1 haploinsufficiency with increased aortic diameter in the same mutant animals. Mechanical tests confirm that elastin and fibrillin-1 impart elastic recoil and tensile strength to the aortic wall, respectively. Additional ex vivo analyses demonstrate additive and overlapping contributions of elastin and fibrillin-1 to the material properties of vascular tissues. Lastly, light and electron microscopy evidence implicates fibrillin-1 in the hypertension-promoted remodeling of the elastin-deficient aorta.

Conclusions—

These results demonstrate that elastin and fibrillin-1 have both differential and complementary roles in arterial wall formation and function, and advance our knowledge of the structural determinants of vascular physiology and disease.
Episodes of Acute Heart Failure Syndrome Are Associated With Increased Levels of Troponin and Extracellular Matrix Markers
Authors: Biolo Andreia , Fisch Mark , Balog Joshua , Chao Tania , Schulze P. Christian , Ooi Henry , Siwik Deborah , Colucci Wilson S.
Published: October 2009

Background—

Increased myocyte loss and extracellular matrix (ECM) turnover are central mechanisms that contribute to pathological myocardial remodeling in chronic heart failure (HF). We tested the hypothesis that episodes of acute HF syndrome (AHFS) are associated with transient increases in markers of myocyte injury and ECM turnover beyond those observed in chronic stable HF.

Methods and Results—

Markers of myocyte injury and ECM turnover were assessed in 80 patients prospectively divided into 3 groups: AHFS (n=39); chronic stable systolic HF (n=21); and control subjects without HF (n=20). Myocyte injury was assessed by measuring plasma troponin I. ECM turnover was assessed by measuring plasma matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases, and procollagen N-terminal type I and procollagen type III N-terminal peptides. In the AHFS group, biomarkers were obtained (1) at the time of hospital admission for an episode of HF decompensation, (2) at the time of hospital discharge, and (3) several weeks after discharge in patients who had returned to a chronic stable compensated state. In patients with stable HF (versus non-HF controls), there was a small increase in troponin I and little or no difference in any marker of ECM turnover. In patients with AHFS, troponin I and 3 markers of ECM turnover (matrix metalloproteinases-2, tissue inhibitors of matrix metalloproteinases-1, and procollagen type III N-terminal peptides) were elevated (versus chronic stable HF), and all fell toward chronic HF levels in patients who returned to a compensated state.

Conclusion—

Episodes of AHFS are associated with transient increases in markers of myocyte injury and ECM turnover that may reflect an acceleration of pathological myocardial remodeling during AHFS.
Higher Systolic Blood Pressure Is Associated With Increased Water Diffusivity in Normal-Appearing White Matter
Authors: MacLullich Alasdair M. J. , Ferguson Karen J. , Reid Louise M. , Deary Ian J. , Starr John M. , Seckl Jonathan R. , Bastin Mark E. , Wardlaw Joanna M.
Published: October 2009

Background and Purpose—

Hypertension is associated with the development of white matter lesions in older people. Diffusion tensor MRI can detect subtle, previsible white matter damage, but relationships between diffusion tensor MRI parameters and blood pressure (BP) remain unclear. We examined correlations among mean diffusivity (MD), fractional anisotropy and BP in 45 men aged 71 to 76 years.

Methods—

MD and fractional anisotropy were measured in 6 regions of interest in normal-appearing white matter. Visible white matter lesions were quantified using the Fazekas scale. Both were correlated with systolic and diastolic BP.

Results—

Systolic BP was positively and significantly correlated with MD in all 6 regions (
r
=0.31 to 0.45;
P
=0.037 to 0.002). MD was also correlated with diastolic BP in the genu of the corpus callosum (
r
=0.34,
P
=0.018). A summary factor derived from principal component analysis of the MD measurements accounted for 53.8% of the variance and correlated at
r
=0.51 (
P
<0.001) with systolic BP and
r
=0.33 (
P
=0.028) with diastolic BP. Fractional anisotropy did not correlate significantly with BP. Deep white matter Fazekas scores correlated with diastolic BP (ρ=0.35,
P
=0.019).

Conclusions—

The increase in MD without change in fractional anisotropy indicates that, in normal-appearing white matter, higher BP may be associated with increased extracellular fluid before any cytoarchitectural damage occurs.
Patient Dissatisfaction With Acute Stroke Care
Authors: Asplund Kjell , Jonsson Fredrik , Eriksson Marie , Stegmayr Birgitta , Appelros Peter , Norrving Bo , Terént Andreas , Åsberg Kerstin Hulter
Published: October 2009

Background and Purpose—

Riks-Stroke, the Swedish Stroke Register, was used to explore patient characteristics and stroke services as determinants of patient dissatisfaction with acute in-hospital care.

Methods—

All 79 hospitals in Sweden admitting acute stroke patients participate in Riks-Stroke. During 2001 to 2007, 104 876 patients (87% of survivors) responded to a follow-up questionnaire 3 months after acute stroke; this included questions on satisfaction with various aspects of stroke care.

Results—

The majority (>90%) were satisfied with acute in-hospital stroke care. Dissatisfaction was closely associated with outcome at 3 months. Patient who were dependent regarding activities of daily living, felt depressed, or had poor self-perceived general health were more likely to be dissatisfied. Dissatisfaction with global acute stroke care was linked to dissatisfaction with other aspects of care, including rehabilitation and support by community services. Patients treated in stroke units were less often dissatisfied than patients in general wards, as were patients who had been treated in a small hospital (vs medium or large hospitals) and patient who had participated in discharge planning. In multivariate analyses, the strongest predictor of dissatisfaction with acute care was poor outcome (dependency regarding activities of daily living, depressed mood, poor self-perceived health).

Conclusions—

Dissatisfaction with in-hospital acute stroke care is part of a more extensive complex comprising poor functional outcome, depressive mood, poor self-perceived general health, and dissatisfaction not only with acute care but also with health care and social services at large. Several aspects of stroke care organization are associated with a lower risk of dissatisfaction.
Dying old in the 21st century
Authors: Holloway Margaret
Published: October 2009

English

Dying in old age has become the majority dying of the developed world, yet older people are routinely denied palliative care, their dying characterized by failure to facilitate choice and recognize their needs. Social workers in all settings should embrace their contribution to quality end-of-life care for older people.

French

Mourir à un âge avancé est devenu la ‘forme majoritaire de la mort’ dans le monde développé, bien que l’on dénie couramment aux personnes âgées l’accès aux soins palliatifs, leur décès étant socialement caractérisé par l’incapacité à faciliter leurs choix et à reconnaître leurs besoins. Les travailleurs sociaux dans tous les dispositifs devraient apporter leur contribution à la qualité des soins de fin de vie pour les personnes âgées.

Spanish

Morirse de viejo se ha convertido en la forma mayoritaria de morir en el mundo desarrollado, sin embargo, a los ancianos se les niega sistemáticamente el cuidado paliativo. Sus muertes se caracterizan por el fallo de no ofrecer a los ancianos opciones y reconocer sus necesidades. Los trabajadores sociales de todas partes deben contribuir a la calidad del cuidado al final de la vida de los ancianos.
Facilitating the development of social work in the Hashemite Kingdom of Jordan
Authors: Cocks Alison J. , Al-Makhamreh Sahar S. , Abuieta Siham , Alaedein Jehad , Forrester Donald , Sullivan Mary Pat
Published: October 2009

English

This article reports on a collaboration between Jordan and the UK to develop social work as a profession in Jordan. Reflecting on some of the less anticipated outcomes of the project and the mutual benefits of engaging with cross-cultural alliances, the article is contextualized within debates around post-colonialism and the indigenization of practice.

French

Cet article présente une collaboration jordano-britannique visant le développement de la profession du travail social en Jordanie. Il apporte une réflexion sur certains des résultats les plus inattendus du projet ainsi que sur les bienfaits retirés de part et d’autre de cette alliance interculturelle. La présente réflexion se situe dans le contexte d’un débat touchant le post-colonialisme et l’adaptation des pratiques aux différents milieux d’exercice.

Spanish

Se informa sobre una colaboración entre Jordania y el Reino Unido en el desarrollo profesional del trabajo social. Se reflexiona sobre algunas consecuencias del proyecto que no fueron anticipadas, así como los beneficios mutuos de crear alianzas culturales. El ensayo toma en consideración el contexto de los debates acerca del post-colonialismo y las prácticas indígenas.
A Discussion on the Impact of CFC12 Emission Rate from XPS Insulation on Atmospheric Banks
Authors: Paquet Andrew N. , Mutton John , Lee Simon P.
Published: October 2009

This report presents new information regarding emissions of CFC12 used to make extruded polystyrene foam products. Earlier reports identified a significant difference in emission rates from extruded polystyrene foam that are used to estimate the amount of the chlorofluorocarbon yet to be released from these materials — the banked amount. Since the estimated atmospheric lifetime of CFC12 is ∼100 years, it is very important to use an accurate release rate from extruded polystyrene foam in actual use to corroborate laboratory measurements. This report will provide evidence that CFC12 is emitted from extruded polystyrene foam more than an order of magnitude slower than some earlier reported rates, resulting in a bank of CFC12, yet to be released from the foam, potentially larger than previously estimated.
Assertion Checking in J-Sim Simulation Models of Network Protocols
Authors: Sobeih Ahmed , d'Amorim Marcelo , Viswanathan Mahesh , Marinov Darko , Hou Jennifer C.
Published: October 2009

Verification and validation (V&V) is a critically important phase in the development life cycle of a simulation model. In the context of network simulation, traditional network simulators perform well in using a simulation model for evaluating the performance of a network protocol but lack the capability to check the “correctness” of the simulation model being used. To address this problem, we have extended J-Sim—an open-source component-based network simulator written entirely in Java—with a state space exploration (SSE) capability that explores the state space created by a network simulation model, up to a configurable maximum depth, in order to find an execution (if any) that violates an assertion, i.e. a property specifying an invariant that must always hold true in all states. In this paper, we elaborate on the SSE framework in J-Sim and present one of our fairly complex case studies, namely verifying the simulation model of the Ad-hoc On-demand Distance Vector (AODV) routing protocol for wireless ad-hoc networks. The SSE framework makes use of protocol-specific properties along two orthogonal dimensions: state similarity and state ranking. State similarity determines whether a state is “similar to” another in order to enable the implementation of stateful search. State ranking determines whether a state is “better than” another in order to enable the implementation of best-first search (BeFS). Specifically, we develop protocol-specific search heuristics to guide SSE towards finding assertion violations in less time. We evaluate the efficiency of our SSE framework by comparing its performance with that of a state-of-the-art model checker for Java programs, namely Java PathFinder (JPF). The results of the comparison show that the time needed to find an assertion violation by our SSE framework in J-Sim can be significantly less than that in JPF unless a substantial amount of programming effort is spent in JPF to make its performance close to that of our SSE framework.