bluuebunny/crossref_metadata_2025 huggingface dataset:
An improved dynamic model of photosynthesis for estimation of carbon gain in sunfleck light regimes
Authors: PEARCY R. W. , GROSS L. J. , HE D.
Published: November 2003

A dynamic model of leaf photosynthesis for C3 plants has been developed for examination of the role of the dynamic properties of the photosynthetic apparatus in regulating CO2 assimilation in variable light regimes. The model is modified from the Farquhar‐von Caemmerer‐Berry model by explicitly including metabolite pools and the effects of light activation and deactivation of Calvin cycle enzymes. It is coupled to a dynamic stomatal conductance model, with the assimilation rate at any time being determined by the joint effects of the dynamic biochemical model and the stomatal conductance model on the intercellular CO2 pressure. When parametrized for each species, the model was shown to exhibit responses to step changes in photon flux density that agreed closely with the observed responses for both the understory plant Alocasia macrorrhiza and the crop plant Glycine max. Comparisons of measured and simulated photosynthesis under simulated light regimes having natural patterns of lightfleck frequencies and durations showed that the simulated total for Alocasia was within ±4% of the measured total assimilation, but that both were 12–50% less than the predictions from a steady–state solution of the model. Agreement was within ±10% for Glycine max, and only small differences were apparent between the dynamic and steady–state predictions. The model may therefore be parametrized for quite different species, and is shown to reflect more accurately the dynamics of photosynthesis than earlier dynamic models.
Cytological and structural changes in Pinus pines L. needles following the application of an anionic surfactant
Authors: BUSSOTTI F. , BOTTACCI A. , GROSSONI P. , MORI B. , TANI C.
Published: November 2003

In many coastal areas, synthetic surfactants are present as pollutants in the chemical composition of sea spray. Their phytotoxic action in synergism with sea salt is well known. This paper examines the early effects of an anionic surfactant (sodium alkylbenzene sulphonate = ABS) on the anatomy and ultrastructure of Pinus pinea L. needles. Three successive treatments in the open field on Pinus pinea trees about 2 m in height were carried out in the month of August. The crowns of the trees were sprayed with an aqueous solution containing 1000 g m−3, and subsequently the current‐year needles were observed by light microscopy, as well as by scanning and transimission electron microscopy. A few days after the treatment the needles had turned yellow. The results of the microscopical analysis show that the surfactant is absorbed prevalently through the stomata and that it causes deterioration of the epistomatal wax structures and induces alterations in the stomatal guard cell walls. Lastly, it causes degeneration of the protoplasm in cells of the mesophyll, beginning with the cells closest to the stomatal openings. The efficiency of both photosynthesis and gaseous exchange processes may be affected.
Elevated atmospheric CO2 differentially affects needle chloroplast ultrastructure and phloem anatomy in Pinus palustris: interactions with soil resource availability
Authors: PRITCHARD S. G. , PETERSON C. M. , PRIOR S. A. , ROGERS H. H.
Published: November 2003

The response of forest species to increasing atmospheric CO2, particularly under resource limitations, will require study in order to predict probable changes which may occur at the plant, community and ecosystem levels. Longleaf pine (Pinus palustris Mill.) seedlings were grown for 20 months at two levels of CO2 (365 and 720 μol mol1) in two levels of soil nitrogen (4 and 40 g m−2), and with two levels of soil moisture (–0·5 and –1·5 MPa xylem pressure potential). Leaf tissue was collected in the spring (12 months exposure) and autumn (20 months exposure) and examined using transmission electron microscopy (TEM) and light microscopy. During early spring, elevated CO2 magnified effects of N and water treatment on starch accumulation and in some cases contributed to altered organization of mesophyll chloroplasts. Disruption of chloroplast integrity was pronounced under elevated CO2, low N and water stress. In autumn, needles contained little starch; however, chloroplasts grown under high CO2 exhibited stress symptoms including increased plastoglobuli and shorter grana. A trend for reduced needle phloem cross‐sectional area resulting from fewer sieve cells was also observed under elevated CO2. These results suggest that, in nature, longleaf pine seedlings may not benefit from a doubling of CO2, especially when soil resources are limiting.
Pityriasis lichenoides et varioliformis acuta in HIV‐1 + patients: a marker of early stage disease
Authors: Smith Kathleen J. , Nelson Ann , Skelton Henry , Yeager Josef , Wagner Kenneth R ,   The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR)
Published: November 2003

Background

The high incidernce of cutaneous disease in HIV‐1 + patients may be a marker of the chronic state of immune activation. In addition, specific cutaneous diseases may be related to the pattern and degree of immune dysregulation present in the patients at the time of the eruption. We have observed that HIV‐1 + patients with pityriasis lichenoides et varioliformis acuta (PLEVA) were in the early to midstage of HIV‐1 disease.

Materials and methods

To determine if there was a correlation between the phenotype of the lymphoid infiltrate and surface markers of the epidermis and the known changes in early or late‐stage HIV‐1 disease, we studied five HIV‐1 + patients with PLEVA. Cutaneous biopsy specimens were obtained and immunohistochemical stains were used to determine the expression of ELAM‐1, ICAM‐1, and HLA‐DR and the phenotype of the lymphoid infiltrate.

Results

The HIV‐1 + patients showed increased expression of HLA‐DR on keratinocytes as well as on the mononuclear and dendritic cell populations in the epidermis and dermis. The majority of T cells were activated CD8+ cells.

Conclusions

Immunophenotyping of the inflammatory infiltrate in these patients is consistent with a pattern of immune dysregulation seen only in earlier stages of HIV‐1 disease. Thus, PLEVA may be useful as a marker of early to midstages of HIV‐1 disease.
Group therapy: a useful and supportive treatment for psoriasis patients
Authors: Seng Tan Kang , Nee Tham Siew
Published: November 2003

Background

Because of the social and psychologic effects of psoriasis, many patients with the disease experience considerable emotional stress which in turn can aggravate the disease. This study was undertaken to determine the usefulness of group therapy in helping psoriasis patients cope with their condition.

Methods

A structured program consisting of seven sessions was carried out with 10 psoriasis patients under the guidance of a social worker. The program covered knowledge of psoriasis, feelings of acceptance, stress management, and coping with daily living. An evaluation was carried out at the end of the program.

Results

Most patients found that the program enhanced their knowledge of psoriasis and helped them to cope better, and that they also learned from each other how to handle stress and gained self‐confidence.

Conclusion

Group therapy is a useful adjuvant therapy for psoriasis patients in coping with their illness.
A 2‐year study of liquid nitrogen therapy in cutaneous leishmaniasis
Authors: Al‐Majali Osama , Routh Hirak Behari , Abuloham Obad , Bhowmik Kazal Rekha , Muhsen Muhammed , Hebeheba Haider
Published: November 2003

Background Among the different modalities for treatment of cutaneous leislnmaniasis, liquid nitrogen is considered an effective therapy with very mild side‐effects.

Methods A study was conducted using liquid nitrogen topically for the treatment of cutaneous leishmaniasis in the King Hussain Medical Centre, Amman‐Jordan. Among 468 patients of cutaneous leishmaniasis, 293 were treated with liquid nitrogen and the rest were treated with other known treatment modalities.

Results Of the patients treated with cryo surgery liquid nitrogen, 215 of 293 permitted appropriate follow‐up; the clinical response was significant and effective. No systemic adverse effects were noted. Mild cutaneous complications were infrequent, and included hypopigmentation, hyperpigmentation, and scar formation.

Conclusions From the results of this study, liquid nitrogen therapy may be considered an effective treatment for cutaneous leishmaniasis.
Clothing as protection from ultraviolet radiation: which fabric is most effective?
Authors: Davis Sandra , Capjack Linda , Kerr Nancy , Fedosejcvs Robert
Published: November 2003

Background

With increasing levels of solar ultraviolet radiation (UVR) in the earth's near environment and evidence that exposure to UVR contributes to skin cancer, cataracts, and photoaging, protection of the skin is imperative during exposure to the sun. The purpose of this study was to examine the effectiveness of various fabrics in screening UVR and to determine if specific characteristics of fabric are directly related to the amount of protection provided.

Methods

Transmission of UVR was measured using spectrophotometric techniques. This transmission, as a function of wavelength over the range 250–400 nm, was weighted with solar and biological spectral data to determine a “sun protection factor” (SPF) for each fabric.

Results

The transmission of UVR through fabric depends on the wavelength and varies with factors such as type of fiber, fabric mass, cover, and color.

Conclusions

Of 28 white fabrics tested, 19 offered less protection than a sunscreen with SPF 15, Polyester fabrics offered increased protection over cotton. The presence of dyes increased protection considerably.
Onychomycosis in Hong Kong
Authors: Kam Kai Man , Au Wai Fan , Wong Pui Yu , Cheung May May
Published: November 2003

Background Onychomycosis in temperate countries has been studied extensively, but few data are available on its epidemiology in tropical countries. We performed a survey of patients seen in Hong Kong for the 8‐year period from January 1987 to December 1994.

Methods A retrospective study of the mycology laboratory records of patients attending the Government Dermatology Clinics was carried out. Nail samples examined included clippings, scrapings, and drillings. Microscopy was performed on all specimens. Sabouraud dextrose agar was used for culture.

Results Out of a total of 2382 nail samples (1024 (43.0%) toe, 1148 (48.2%) finger, and 210 (8.8%) unspecified site) examined, 340 (14.3%) were microscopy positive; 165 (48.5%) of these were culture positive, including 160 (97%) with dermatophyte and/or yeast, and 5 (3%) with molds. Men were affected more in the –19 and >50 years age groups, whereas women were affected more in the 20–50 years age group. Women were affected significantly more than men with yeasts, dermatophytes occurred more during adolescence. Dermatophytes showed a high peak in late spring, although both dermatophyte and yeast cases peaked in the summer months. Dermatophytes (29.1%) occurred more commonly than yeasts (19.4%) in microscopy‐positive onychomycosis cases in Hong Kong. Trichophyton rubrum was the commonest dermatophyte, and Candida spp., other than C albicans, were the commonest yeasts. Mixed infections (5%) were uncommon.

Conclusions Dermatophytes are more important than yeasts as a cause of onychomycosis in Hong Kong. Changes in climatic conditions affect the prevalence of dermatophytes more than yeasts.
Extracorporeal photochemotherapy in progressive systemic sclerosis: a follow‐up study
Authors: Schwartz Joseph , Gonzalez Joselyn , Palangio Mark , Klainer Albert S. , Bisaccia Emil
Published: November 2003

Background

Extracorporeal photochemotherapy (photopheresis), an immune‐modulating therapy, has been demonstrated to elicit a therapeutic response in the treatment of several autoimmune disorders. We evaluated the use of photopheresis in the treatment of patients with progressive systemic sclerosis (PSS; scleroderma).

Methods

Five patients with early‐onset, diffuse PSS were treated with photopheresis on 2 successive days monthly for an average of 59 months (range 54–69 months). We initially reported the response this group of patients had to photopheresis treatment at an average of 11 months (range 6–21 months).

Results

An improvement or stabilization was noted in most patients in skin thickening, joint mobility, pulmonary function studies, oral aperture, functional index, as well as symptoms including Raynaud's phenomenon, dyspnea, fatigue, dysphagia, arthralgias, and cutaneous ulcers. Renal function tests remained within normal range. A total of 296 monthly treatments were administered without significant toxicity.

Conclusions

This study suggests that extended use of extracorporeal photochemotherapy in the management of early‐onset, diffuse PSS is well tolerated and may provide an increasingly beneficial clinical outcome.
Autoimmune progesterone dermatitis: effective prophylactic treatment with danazol
Authors: Shahar Eduardo , Bergman Reuven , Pollack Shimon
Published: November 2003

Background Autoimmune progesterone dermatitis is a rare condition appearing during the perimenstrual period or following progesterone treatment. Various treatment modalities have been suggested, but most have proved to be ineffective.

Methods We used the anabolic androgen danazol as a preventive treatment for recurrent episodes of autoimmune progesterone dermatitis in two young women. The treatment regimen consisted of 200 mg danazol twice daily, starting 1–2 days before the expected date of each menses and continuing for 3 days thereafter.

Results This treatment regimen proved to be highly effective in preventing the eruptions in these two patients.

Conclusions Patients with autoimmune progesterone dermatitis may benefit from prophylactic treatment with danazol.
Primary localized cutaneous amyloidosis: a clinicopathologic study from Saudi Arabia
Authors: Al‐Ratrout Jehad T. , Satti Mohamed B.
Published: November 2003

Background Primary localized cutaneous amyloidosis (PLCA) refers to deposition of amyloid in apparently previously normal skin with no evidence of deposits in internal organs. Certain ethnic groups are particularly predisposed. The objective of this study was to investigate the occurrence of PLCA in a hospital‐based set‐up and to review the clinicopathologic findings of histologically confirmed cases.

Methods Methods included a retrospective evaluation of the records and paraffin sections of skin biopsies of all patients, diagnosed clinically as cutaneous amyloidosis in a tertiary care teaching hospital during the period 1987–95.

Results Twenty‐one out of 42 suspected cases were histologically confirmed as PLCA; the total number of biopsied patients during the whole period was 920. Eleven were cases of lichen amyloidosis (LA) and 10 were of macular amyloidosis (MA). All were adults, and women dominated in MA. The mean duration of symptoms was shorter for the latter subtype. Histologically epidermal changes were the main differentiating feature between LA and MA.

Conclusions PLCA is a rare chronic progressive skin disorder affecting adults, with a prevalence of 0.15 among patients attending the dermatology clinic in a tertiary care teaching hospital in Saudi Arabia. There were few differences in demographic profile or histochemical characteristics between LA and MA. Meticulous histologic examination of sections and even sequential biopsies may be needed to confirm the diagnosis in clinically suspected cases.
Linear IgA bullous dermatosis in South India
Authors: Ajithkumar Kidangazhiyathmana , Kurian Susy , Jacob Mary , Pulimood Susanne
Published: November 2003

Background A study of five cases of linear IgA dermatosis (LABD) in a referral hospital in South India is presented.

Methods A dermatologic examination, skin biopsy, and direct immunofluorescence were carried out on all patients. Patients were then followed up.

Results All five cases showed linear IgA deposits at the dermo‐epidermal junction. One case in addition showed IgG and C3 deposits. All cases responded to treatment with dapsone. The treatment duration varied from 14 to 16 months and the fifth patient is still on treatment after 37 months.

Conclusions Linear IgA bullous dermatosis is a self‐limiting bullous disorder. To the best of our knowledge this is the first report of LABD from India.
Laser treatment for further depigmentation in vitiligo
Authors: Thissen Monique , Westerhof Wiete
Published: November 2003

Background

In patients with vitiligo, sometimes the greatest part of the skin has already lost its melanocytes. The remaining pigmented patches can be removed by using strong bleaching creams, but many adverse events have been reported with this treatment. Anew depigmentation therapy could be treatment with a Ruby laser.

Methods

Before treatment, the patients filled out a questionnaire about their vitiligo history. Eight patients with remaining pigmentation of the arms, hands, and face were treated once with a Ruby laser. Patients were monitored for developing repigmentation during the 9 months after treatment.

Results

In patients with a positive Koebner phenomenon, a permanent state of depigmentation was reached after laser therapy. None of the treated patients showed severe side‐effects.

Conclusions

Ruby laser treatment can be an effective, fast, and safe method for removing cosmetically disturbing remnants of normal pigmentation in vitiligo patients with a positive Koebner phenomenon.
The effect of toenail onychomycosis on patient quality of life
Authors: Elewski Boni E.
Published: November 2003

Background Onychomycosis is a common fungal infection of the toenails which has historically been regarded as a cosmetic problem. A previous study has suggested that this is not the case and that toenail and fingernail onychomycosis adversely impacts patient quality of life (QOL).

Methods A survey was used to self‐assess the physical symptoms and psychosocial dimensions of toenail onychomycosis in 93 patients. Positive responses scored one point each, and points were summed for each patient.

Results Ninety‐two per cent of patients reported experiencing negative psychosocial and/or physical effects. Forty‐four per cent indicated that their toenails had a negative effect on their self‐image, and 41% reported experiencing pain or discomfort as a result of onychomycosis.

Conclusions Toenail onychomycosis has a significant impact on the overall QOL of patients, and should be evaluated further to develop guidelines for total patient care.
Intradermal antigen tests and the Koebner phenomenon in psoriasis
Authors: Dogan Bilal , Harmanyeri Yavuz
Published: November 2003

Background Psoriasis is one of several dermatologic conditions in which nonspecific irritation may elicit the disease where it was not previously present. In this study we aimed to assess the cutaneous cellular immune reaction with intradermal antigen tests and the relation between Koebner's phenomenon and intradermal antigens.

Methods Thirty psoriasis patients and 20 control subjects were tested with 0.1 mL intradermal injections of purified protein derivative (PPD), Candida (C), mumps (M), mixed respiratory vaccine (MRV), and saline control solutions. Koebner status was also determined in the psoriatic patients. Injection sites were evaluated at 72 h and on the eighth, 12th, 16th, and 20th days for erythema, induration, and local development of psoriasis.

ResultsTwo patients were Koebner positive and developed psoriasis at all five injection sites. However, local psoriasis development was observed at one or more injection sites in five Koebner‐negative patients. In addition, intensity of delayed hypersensitivity reaction and resolution times demonstrate no significant difference between psoriatic and nonpsoriatic subjects statistically (P > 0.05).

Conclusions These findings may indicate that intradermal antigens used in this study were more effective in inducing the Koebner phenomenon than injury alone. Furthermore, we observed that there is no meaningful difference between psoriatic and nonpsoriatic subjects in developing cutaneous cellular immune reactions.
Head louse infestations: epidemiologic survey and treatment evaluation in Argentinian schoolchildren
Authors: Chouela Edgardo , Abeldaño Alejandra , Cirigliano Marcela , Ducard Mariana , Neglia Vicenta , Forgia Marta L. , Colombo Alejandra
Published: November 2003

Background Our aim was to demonstrate that the treatment of individual cases is effective, but not sufficient, to control endemic Pediculus capitis, and that eradication of the epidemiologic school focus may lower significantly the prevalence of infestation. Statistical data on the degree of infestation relating to socio‐economic and cultural variables were also updated. Therapeutic effects and educational impact were evaluated.

Methods An educational and motivational program was designed for pupils, parents, and teachers: 326 children and 15 adults were subjected to clinical and parasitologic evaluation. The recorded parameters included the age, sex, hair style and length, presence of other dermatologic diseases, degree of infestation, clinical remission, parasitologic remission, dwelling type and features, need to share a bed with co‐dwellers, availability of home tap water supply, level of family income, and periodic medical controls. The entire population received treatment with neutral shampoo and rinsing cream containing 1% permethrin. Exclusion criteria were the presence of acute scalp inflammation and a history of pyrethrin and/or pyrethroid sensitivity. Statistical analysis was performed as required on data expressed as frequencies, percentages, means, and standard deviations by chi‐square and Fisher exact tests.

Results The overall infestation prevalence rate was 81.5%, the highest values corresponding to children from 6 to 11 years of age, with a slight predominance in males (55.4% vs. 44.6%). A significantly greater rate of clinical remission was observed in subjects enjoying home tap water supplies (p<0.01).

Conclusions The model of research plus action adopted allows the following conclusions to be drawn; (i) individual and isolated treatments for pediculosis are useful, but will not by themselves allow for the epidemiologic control of this parasitosis; (ii) massive, complete, and simultaneous treatments lead to a significant decrease in infestation prevalence; (iii) educational measures tending to foster collective awareness enable greater epidemiologic surveillance to be achieved; (iv) careful inspection of the entire scalp is essential with the use of a powerful light source and lenses with high magnification, as the parasite has no predilection for any given area; (iv) socio‐economic and cultural conditions are not relevant for infestation, although a good home tap water supply is essential for treatment.
Intralesional therapy of American cutaneous leishmaniasis with pentavalent antimony in Rio de Janeiro, Brazil – an area of Leishmania (V.) braziliensis transmission
Authors: Oliveira‐Neto Manuel P. , Schubach Armando , Mattos Marise , Gonçalves da Costa Sylvio C. , Pirmez Claude
Published: November 2003

Background The drug of choice for leishmaniasis is pentavalent antimony and different regimens are under continuous evaluation. The ideal therapy should be simple, effective, and with no or minor side‐effects, in this paper we have studied the efficacy of intralesionally applied antimony in New World cutaneous leishmaniasis.

Methods Seventy‐four patients from Rio de Janeiro state, Brazil, and presenting with single ulcerative cutaneous lesions mainly located on the trunk or extremities were enrolled in the study. The drug employed was N‐methyl glucamine (425 mg of Sbv in each 5 ml ampoule). Each lesion was infiltrated with the drug at the four cardinal points in order to achieve complete blanching.

Results Of the 74 patients, 59 (80%) were healed after a 12–week interval. Extensive follow‐up (up to 10 years) disclosed no relapses or the development of mucosal lesions.

Conclusions The aim of therapy in New World cutaneous leishmaniasis is the healing of the cutaneous lesion and the prevention of late mucosal damage. Both conditions were achieved with the treatment employed with no side‐effects and a considerable decrease in costs. In addition, the method is easy to apply in the field.
Embolia cutis medicamentosa
Authors: Koöhler Lars D. , Schwedler S. , Worret W.I.
Published: November 2003

A 35‐year‐old man presented with a painful skin necrosis after a deep ventrogluteal injection of diclofenac and dexamethasone for treatment of severe back pain. Immediately after the injection, the patient felt a strong pain just above the injection site. In the following days a remarkable necrosis developed in the upper gluteal region. Topical therapy with antiseptics and a topical corticosteroid cream plus analgesia with tramadole revealed no improvement of the symptoms. We excised the necrotic area. Within 1 day, the patient was without pain.
Two feet–one hand syndrome: a retrospective multicenter survey
Authors: Daniel C. Ralph , Gupta Aditya K. , Daniel Melissa P. , Daniel Carlton M.
Published: November 2003

Background The two feet‐one hand syndrome is not uncommon; however, there have only been a few reports on this condition. This study was undertaken to obtain a better understanding of the epidemiology of the two feet‐one hand syndrome.

Methods A retrospective chart review was conducted of all the patients seen in our practices over the past 15 years with the diagnosis of two feet‐one hand syndrome.

Results A total of 80 patients with mycologically confirmed disease were identified (men, 72 (90%); women, 8 (10%); 77 (96%) Caucasian; 3 (4%) African‐American; age (mean ± standard error (SE)), 55.9 ± 2.1 years). The mean age of the patients when the physician was first seen for the condition was 51.3 ± 2.0 years. The mean ages when the symptoms first developed on the feet and hand were 37.1 ± 2.4 years and 45.7 ± 2.2 years, respectively. Tinea pedis was found to occur at an earlier age than tinea manuum (t(65)=6.92, P<0.01). There was a significant relationship between the hand in which tinea manuum developed, the hand used to excoriate the soles of feet (Ch2(4)=14.82, P<0.01), and the hand used to pick toenails (χ2(4) = 14.82, P<0.01); however, there was no significant relationship between handedness and the development of tinea manuum in the dominant hand. The occupation of the patient at the time of development of the two feet‐one hand syndrome was categorized according to whether the intensity of hand use was high, moderate, or low. Patients with a high intensity of hand use in their jobs were significantly more likely to develop tinea pedis/onychomycosis (r=‐0.27, F(1,61)=4.77, P<0.05) and tinea manuum (r=‐0.30, F(1,62)=6.31, P<0.05) at an earlier age. The best multiple predictors of the age at which medical attention was sought were the age of onset of tinea manuum and a family history of tinea infection (r=0.86, F(2,59)=86.9, P<0.01). The age of onset of tinea manuum was the best single predictor, with a correlation of 0.85.

Conclusions In the two feet‐one hand syndrome, the development of tinea pedis/onychomycosis generally preceded the development of tinea manuum. Tinea manuum usually developed in the hand used to excoriate the feet or pick toenails. Patients whose occupation involved a high intensity of use of the hands were more likely to develop the disease at an earlier age. Patients were more likely to seek attention once tinea manuum had developed, particularly if there was a family history of tinea infection.
Dermatologists combat leprosy in Yemen
Authors: Al‐Qubati Yasin , Al‐Kubati Abdul Samad
Published: November 2003

Background Leprosy has been prevalent in Yemen for many years. The ostracization and stigmatization of leprosy patients are well documented in the Yemeni literature. No control activities were carried out until 1980.

Aim To document the development of leprosy control activities in the Republic of Yemen during the period from 1982 to 1996.

Materials and methods The dermatologists in Yemen used various methods, including the media, to fight the stigma of leprosy and thus to mobilize the community for the reintegration of leprosy patients. They sought support from international non‐governmentai organizations (NGOs) to start mobile teams all over the country.

Results The support of the German Leprosy Relief Association (GLRA) and the World Health Organization (WHO) enabled the National Leprosy Control Program (NLCP) to reach people in remote areas. The prevalence of leprosy has declined from 1.9 per 10,000 population in 1989 to 0.5 per 10,000 population in 1996.

Conclusions The stigma associated with leprosy also extends to other skin diseases. To combat this stigma, various methods, such as health education, training of medical personnel, and mass treatment for skin diseases, have been used.
Increased cutaneous toxicity to ionizing radiation in HIV‐positive patients
Authors: Smith COL Kathleen J. , Skelton CAPT Henry G. , Tuur Sylvana , Yeager Josef , Decker Catherine , Wagner Kenneth F.
Published: November 2003

Background There are reports of increased reactions in HIV‐1 + patients to ultraviolet light sometimes in association with medication. In addition, there are also reports of increased morbidity associated with radiation therapy in HIV‐1 + patients. Methods Three HIV‐1 + patients developed cutaneous toxic reactions to radiation therapy; two with Kaposi's sarcoma (KS) and one with non‐Hodgkin's lymphoma.

Conclusions Although the mechanisms which resulted in these reactions are not clear, they may be related to depletion of endogenous scavengers and may be accentuated by the pattern of immune dysregulation present in HIV‐1 disease.
Can school teachers improve the management and prevention of skin disease? A pilot study based on head louse infestations in Guerrero, Mexico
Authors: Paredes Sergio S. , Estrada Roberto , Alarcon H. , Chavez Guadalupe , Romero Marina , Hay Roderick
Published: November 2003

Background The effect of health education provided by teachers, in three primary schools of Guerrero, Mexico, on the prevalence of head louse infestation was compared. Methods A cross‐sectional survey and rapid appraisal methods were performed, including a child questionnaire and qualitative data from teachers and focus groups of mothers in the same schools.

Results Nine hundred and forty‐four students and 33 teachers were interviewed; a focus group discussion with 6–8 mothers per school was performed. In the self‐diagnosis of pediculosis, the prevalence was 22% (range, 18%–33%) with a sensitivity of 68% and a specificity of 86%, In one school, 100% of the teachers applied a health program, whereas in the other two schools this percentage was only 20%. A child under 9 years of age who attended a school without information on health was 3.6 times more likely to have head louse infestation (OR=3.6, CI95%=2.1–6) than a child of the same age who attended a school where information was given. In older children the effect and potential impact were lower. The difference between the two age groups is unlikely to be explained by chance (X2 het=5.7, df=1, p=0.01).

Conclusions This study emphasizes the potential value of simple, but effective, health education provided by school teaching staff through liaison with patents in the amelioration of endemic disease.
The role of human papillomavirus in the development of pyogenic granulomas
Authors: Miller Anne M. , Sahl William J. , Brown Sarah A. , Young Stephen K. , Quinlan Christie M. , Patel Prashant R. , Benbrook Doris M. , Naylor Mark F.
Published: November 2003

Background Pyogenic granulomas (lobular capillary hemangiomas) and condyloma acuminata share similar locations and risk factors. Human papillomavirus (HPV) types 6 and 11 are commonly associated with condyloma acuminata, but their association with pyogenic granulomas has not been evaluated. The purpose of this study was to determine whether pyogenic granulomas contain evidence of infection with condyloma producing HPVs.

Methods Polymerase chain reaction assays for the E6 and E7 gene sequences of HPV types 6 and 11 and another assay for the E7 region of HPV types 16, 31, 33, 35, 42, and 58 were used to evaluate decxyribonucleic acid (DNA) extracted from archival pyogenic granuloma biopsies taken from cutaneous and oral epithelium.

Results Neither cutaneous nor oral pyogenic granulomas contain amplifiable E6 or E7 sequences from any of these viruses.

Conclusions Pyogenic granulomas are not caused by HPV 6, 11, 16, 31, 33, 35, 42, or 58. This study does not exclude the possibility that other viruses may be responsible for these tumors.
Effects of isotretinoin therapy on lipoprotein (a) serum Levels
Authors: Georgala Sofia , Schulpis Kleopatra H. , Potouridou Irene , Papadogeorgaki Helen
Published: November 2003

Background Increases in plasma concentrations of lipids, triglycerides, and liver enzymes have been reported in patients on isotretinoin therapy. Lipoprotein (a). (Lp (a)), a cholesterol‐rich plasma lipoprotein, influences the clotting system and is related to premature coronary heart disease and stroke.

Methods Blood (7 mL) was obtained from 30 patients with cystic acne before and 30 days after the initiation of oral isotretinoin (0.5 mg/kg/day).

Results An increase in liver enzymes and lipids, except high density lipoprotein, was found in our patients at the end of the study. The mean Lp (a) levels (initial value, 25.91±3.17 mg/dL) were statistically reduced (p < 0.0001) at the end of treatment (14.80±2.35 mg/dL).

Conclusions It is suggested that isotretinoin could be used as an Lp (a) lowering agent in the future.
Evaluating the efficacy of allopurinol for the treatment of cutaneous leishmaniasis
Authors: D'Oliveira Argemiro , Machado Paulo Roberto L. , Carvalho Edgar M.
Published: November 2003

This study was performed in Corte de Pedra, an area of L. braziliensis braziliensis transmission located 240 km southeast of Salvador, the capital of the state of Bahia in Brazil. This open controlled trial included 34 patients, aged 12 to 45 years, with leishmania‐positive skin test and a maximum of three ulcerated lesions (with a minimum lesion diameter of 10 mm and a maximum diameter of 50 mm) who had received no previous treatment. Exclusion criteria included chronic disease, use of other drugs, history of allergy to allopurinol, pregnancy, breast feeding, or forms of leishmaniasis other than cutaneous. Informed consent was obtained from all subjects after the nature of the procedures had been fully explained to them.

Randomly selected patients received 20 mg/kg of allopurinol orally, three times a day, or 10 mg/kg of intravenous antimoniate of meglumine, once a day. Both patient groups used the drugs for a period of 20 days. A clinical history was collected and a physical examination was performed on all patients before initiating the treatment. Lesions were photographed and biopsied, and the tissue was used for histopathologic study and inoculation in hamsters and appropriate culture media. Patients were re‐examined on days 10 and 20 and at monthly intervals for 1 year following the beginning of treatment. Blood samples for serologic and biochemical analysis (measurements of serum uric acid, urea, crsatinine, and transaminases) were collected at days 0, 10, and 22 following the beginning of treatment.

The definition of therapeutic failure included incompletion of the treatment protocol, use of a treatment different from the protocol, lesions not healed 3 months after the beginning of treatment, or relapse or development of new cutaneous or mucosal lesions caused by leishmaniasis within 1 year of treatment.

The exact Fischer test was used to compare the treatment results between the two patient groups. Student's t‐test was used to compare the age of the patients and the duration of the illness. The Mann‐Whitney test was used to compare the diameter of the lesions at day 0 and 3 months after treatment completion in the two groups, and the Kruskal‐Wallis test was used to compare the number of lesions per patient and their localization.
Anti‐inflammatory activity of antifungal preparations
Authors: Rosen Ted , Schell Barbara J. , Orengo Ida
Published: November 2003

Background Although steroid/antifungal combination medications are used extensively, they are associated with potential disadvantages. Antifungal preparations possessing inherent anti‐inflammatory activity, leading to rapid symptomatic relief while providing mycologic cure, would be very useful.

Objective Our purpose was to investigate the anti‐inflammatory activity of proprietary antifungal preparations in an in vivo, human experimental model.

Methods Using a double‐blind, controlled protocol, we assessed the comparative ability of antifungal preparations to suppress the expected delayed erythema response following in vivo human exposure to ultraviolet B (UVB) irradiation generated by a solar stimulator.

Results Currently available allylamine preparations and ciclopirox olamine proved to be the most anti‐inflammatory, while ketoconazole was intermediate in anti‐inflammatory activity under these experimental conditions. These agents were superior to oxiconazole, econazole, and 2.5% hydrocortisone.

Conclusions Some antifungal preparations possess inherent anti inflammatory activity, although the exact mechanism remains uncertain.
Efficacy of a 2–mm spot size lens for the treatment of superficial vascular lesions with a flashlamp‐pumped dye laser
Authors: Grekin Roy C. , Flynn Timothy C. , Cooper David , Geisse John
Published: November 2003

Background The flashlamp‐pumped dye laser, using either a 3 or 5 mm spot size, is an excellent instrument for the treatment of port‐wine stains and other superficial cutaneous vascular lesions. Problems exist with patient acceptance due to prominent and prolonged blue‐black discoloration and the pain associated with the treatment.

Objective To assess the effectiveness of a flashlamp‐pumped dye laser equipped with a 2 mm spot size lens in the treatment of superficial vascular lesions.

Methods Twenty‐one patients with telangiectasias, cherry angiomas, and angiokeratomas were treated at a variety of fluences.

Results Three of 21 patients had complete clearing of their superficial vascular lesions. An improvement of greater than 75% was noted by 11 patients, and six patients noted a 50%–75% improvement. One patient had less than 50% improvement. Less post‐treatment discoloration and less pain were noted with the 2 mm spot size lens.

Conclusions The 2 mm spot size lens, used with the flashlamp‐pumped dye laser is an effective instrument for the treatment of superficial cutaneous vascular lesions.
The progression of nonsegmental vitiligo: clinical analysis of 318 patients
Authors: Chun Woo Hyung , Hann Seung‐Kyung
Published: November 2003

Background Vitiligo is an acquired disorder with destruction of melanocytes and is characterized by cutaneous depigmentation with a progressive clinical course. We attempted to evaluate whether there was a relationship between the initial site and ultimate progression of nonsegmental vitiligo.

Methods Three hundred and eighteen nonsegmental vitiligo patients were examined. Questionnaires regarding age, sex, duration of disease, family history, distribution of initial lesions, progression, and clinical type were recorded from personal interviews and case notes.

Results Two hundred and eighty nine (90.9%) of the 318 patients showed progression of vitiligo at the time of examination. When the initial sites were the posterior trunk, hands, or feet, there was more progression of vitiligo to other body areas. The progression pattern was usually contiguous to the initial site. When the hands were the initial site, however, vitiligo most commonly progressed to the face.

Conclusions There may be a possible relationship between the initial site and ultimate progression of nonsegmental vitiligo. The progression pattern is usually contiguous to the initial site.
Incorporation of Bovine Bone Marrow Stromal Cells into Porcine Foetal Tissues after Xenotransplantation
Authors: Troyer D. L. , Weiss M. L. , Mitchell K. E. , Martin P. L. , Davis D. L.
Published: November 2003

Bovine bone marrow stromal cells (BMSCs) were injected into the liver of foetal pigs at about 40 days of gestation to test whether these cells could populate developing tissue, and if so, which ones. Approximately 40 days after injection, the foetuses were harvested and tissue sections from many areas of the body were analysed for the presence of bovine cells using two different methods. First, using PCR, bovine repetitive DNA was found to be present in DNA extracted from foetal pig tissues. Secondly, using oligonucleotide primed in situ synthesis (PRINS), the in situ presence of bovine cells was found within porcine tissue sections. PRINS‐labelled cells were found within cartilage, perichondrium, connective tissue and smooth muscle. These data suggest that bovine BMSCs integrate throughout the foetal pig.
Morphogenic activity of fibroblast growth factor‐2 on primary neural precursor cells in three‐dimensional culture
Authors: Hiratochi Masahiro , Fujiwara Akiyori , Kitani Hiroshi , Iguchi Taisen , Sakakura Teruyo , Tomooka Yasuhiro
Published: November 2003

Mouse neural precursor cells (NPC) were dissociated from fetal heads at the 10th day of gestation. When clumps of NPC were cultured in collagen gel, they grew and reorganized neural tube‐like structures in medium containing fetal calf serum at 10% and supplemented with insulin, transferrin, cholera toxin and selenite. However, dissociated NPC died when they were cultured in collagen gel at low density in the same medium. Addition of fibroblast growth factor‐2 (FGF‐2) to this culture stimulated growth of NPC and formation of neural tube‐like structures. The requirement for FGF‐2 disappeared in high seeding density culture: they grew and formed neural tube‐like structures without FGF‐2. The structures formed in collagen gel were immunohistochemically positive against anti‐FGF‐2 antibody. The results show that the three‐dimensional culture system provides a useful tool to study the roles of FGF‐2 in morphogenesis of the central nervous system.
Retinopathy of prematurity in infants <29 weeks’ gestation at birth in New South Wales from 1986–92
Authors: TODD DA , KENNEDY J , CASSELL C , ROBERTS S , JOHN E
Published: November 2003

Objective:

To study the effect of increased survival of infants <29 weeks’ gestation on the incidence and severity of retinopathy of prematurity (ROP).

Methodology:

Review of prospective records from 1986 to 1992 kept in the New South Wales (NSW) NICUS database on infants admitted to the neonatal intensive care units (NICU) in NSW. The survival rate and the incidence and severity of ROP on all infants <29 weeks’ gestation admitted to the NICUs in NSW from 1 July 1986 to 31 December 1987 were compared to a similar group of infants admitted from 1 January 1992 to 31 December 1992.

Results:

There was a significant difference in the survival rate of infants admitted between the two periods (235 of 376, 62.5% survival vs 255 of 336, 75.9% survival, respectively, P<0.0001). The odds ratio for survival adjusted for gestational age in the second period was 1.76 [1.24, 2.48 (95% confidence interval), P<0.002]. There was a slight increase in ROP in the second period (79 of 172 examined, 45.9% ROP vs 133 of 238 examined, 55.8% ROP, respectively). There was a rise in the number of infants with Stage 3 ROP in the second time period (14 of 172 examined, 8.1% ROP vs 41 of 238 examined, 17.2% ROP, respectively). However, fewer infants had detached retinas or ≥Stage 4 ROP in the second group [7 of 172, (4.1%) vs 3 of 238, (1.3%), respectively]. This may be a reflection of the increase in the use of cryo‐ or laser therapy for Stage 3 ROP with ‘plus’ disease [2 of 172 examined, (1.2%) vs 18 of 238 examined, (7.6%), respectively].

Conclusions:

With the increase in survival of the very preterm infant in recent years, there has been an increase in severe ROP (≥Stage 3) in NSW. Despite the increased survival of the highest at‐risk group (24‐ to 26‐week gestation infants), there have been fewer cases of retinal detachment. There was also a rise in the number of infants receiving cryo‐ or laser therapy intervention.
Should preterm infants born after 29 weeks’ gestation be screened for intraventricular haemorrhage?
Authors: HARDING D , KUSCHEL C , EVANS N
Published: November 2003

Objectives:

To determine whether the current incidence of intraventricular haemorrhage (IVH) of grade 2 or more is high enough in preterm infants born after 29 weeks gestation to justify the cost of screening with ultrasound and to explore clinical indicators for risk of IVH in the more mature preterm infant.

Methods:

This cohort study examined the incidence and severity of IVH in 800 preterm infants born between January 1992 and August 1996, of whom 436 were born after 29 weeks. Demographic and clinical details were collected from a prospectively maintained database. The Medicare schedule charge rate for cerebral ultrasound was used to calculate costs.

Results:

1.1% of preterm babies born after 29 weeks gestation who had routine ultrasound scans had an IVH of grade 2 or 3, no infant had a grade 4 IVH. Two infants had a grade 3 IVH, both of which were symptomatic. IVH was poorly predicted by other clinical criteria. Using the Medicare schedule to estimate costs, detecting the five grade 2 or 3 IVH cost A$42 000.

Conclusions:

The incidence of grade 2–4 IVH is low in infants born after 29 weeks gestation. Screening of this population is expensive and probably not justified. It may be most appropriate to scan these infants only if their condition raises concern.
Agammaglobulinaemia in a girl with a mosaic of ring 18 chromosome
Authors: LITZMAN J , BRYS˘OVÁ V , GAILLYOVÁ R , THON V , PIJÁC˘KOVÁ A , MICHALOVÁ K , ZEMANOVÁ Z , LOKAJ J
Published: November 2003

A patient with a mosaic karyotype 45,XX,‐18/46,XX,dic r(18)/46, XX, r(18) with multiple phenotypic abnormalities and immunodeficiency was presented at the age of 14 years. Immunological investigation revealed markedly decreased IgG, IgA and in two of three evaluations also IgM levels. Although selective IgA deficiency is frequent in patients with a ring chromosome 18, this is the third patient described with decreased levels of other immunoglobulin isotypes. The association of chromosome 18 partial deletions and immunoglobulin abnormalities suggests the presence of an as yet unrecognised gene with a pivotal role for immunoglobulin production on chromosome 18.
Streptococcus pneumoniae‐induced haemolytic uraemic syndrome
Authors: McTAGGART SJ , BURKE JR
Published: November 2003

Haemolytic uraemic syndrome secondary to infection with neuraminidase producing Streptococcus pneumoniae is well recognised, but was previously considered to be rare. This case report describes the course of a 9‐month‐old male with pneumococcal pneumonia, T activation and haemolytic uraemic syndrome. The clinical features of three other cases treated in Southeast Queensland in the past 2 years and 12 previously reported cases are summarised. The widespread availability of rapid diagnostic testing for this entity should allow for increased recognition, enabling appropriate use of low plasma volume blood products with improved patient outcome.