bluuebunny/crossref_metadata_2025_split huggingface dataset:
India and Pakistan: Differing Security Perceptions
Authors: Rao R. Rama 
Published: July 2017

The two fragments into which Britain, before its withdrawal from the subcontinent, had split the Indian Empire, carried with them a legacy of mutual distrust. This could not but influence the course of subsequent events in the sub-continent. So have the attitudes of the erstwhile colonial and other powers towards the new states in the light of their respective regional interests. In the comparatively short period of thirty-seven years, short in the life of nations, the two states have been involved in hostilities on three occasions, not counting Pakistan's attack on India in the Kutch sector in April 1965. Time no doubt is a great healer but it takes same time for deep wounds to heal. The healing process would be aided and succeed only if the governments of both countries are convinced that not mutual hostility but at least co-existence, if not mutual amity, is good for both countries and strive to create conditions for peaceful co-existence. If only one side is anxious to maintain peace and the other wishes to maintain tension, the latter will prevail. Public opinion in the two countries, if mobilised far promoting coexistence rather than confrontation, would help. In democratic countries, at least in theory, public opinion is a force to reckon with and no government can for long afford to disregard public opinion. The media, again in theory, reflects public opinion and serves to consolidate and strengthen it, in the process compelling the government of the day to consider carefully the issues raised. In practice, however, governments, even in “liberal” democracies can influence prominent segments of the media to project issues in the manner desired by the former, i.e., the media can and regrettably are being used to misinform the public at home and abroad- Even so, in democracies, ultimately, governmental efforts not withstanding, at least some sections of the media discover facts and fearlessly expose governments' earlier efforts to misinform the public. This is the inherent strength of democracies. In dictatorships this is diffcult. But there are dictatorships and dictatorships! In Pakistan, for example, by all accounts the government of General Zia ul Haq, in its own way, has managed to secure tolerance if not the enthusiastic support of a majority of urban middle and lower middle classes for the martial law regime. A. section—even a large section—of politically conscious urban and rural groups are totally unreconciled to rule by generals for a number of reasons. Another section of the same strata of Pakistani society again for its own reasons, supports the regime. Thus General Zia is secure, provided he continues, with the dexterity he has so amply demonstrated during eight eventful years, to steer his country on a “least risk” course, and there is a good chance of preserving peace, precarious though it may be, in the sub-continent.
Operating Characteristics of the neurobehavioral cognitive Status Exam Using Neuropsychological Assessment as the Criterion
Authors: Karzmark Peter 
Published: July 2017

This study examined the performance characteristics of the Neurobehavioral Cognitive Status Exam (NCSE) using comprehensive neuropsychological assessment as the criterion. Sensitivity and specificity were assessed for the NCSE as a whole and for the individual subtests as measures of discrete cognitive abilities. The sample consisted of 50 consecutive outpatient referrals to the neuropsychological assessment service of a general medical hospital. Most of the patients in the sample had mild or moderate cognitive dysfunction. The sensitivity and specificity of the NCSE as a whole were .74 and .86, respectively. The sensitivity of the individual NCSE subtests was lower, ranging from .20 to .48. Specificity of subtests was high (.64 to .97). The results suggest that the operating characteristics of the NCSE depend significantly on the severity and nature of the sample assessed and the criterion used. They also indicate the need for caution in using NCSE subtest performance as a basis for concluding that specific cognitive abilities are normal.
Effect of Retinoic Acid on Apoptosis and DNA Repair in Human Keratinocytes after UVB Irradiation
Authors: Li Gang , Bush Jason A. , Ho Vincent C. 
Published: July 2017

Background: Skin cancer is extremely common. Epidemiological studies indicated that ultraviolet radiation (UV) is the primary cause for skin cancers, and that retinoic acid (RA) is able to inhibit this UV-induced skin carcinogenesis; however, the molecular mechanism of the anti-UV action of RA is unclear. Objective: The purpose of this study is to investigate if RA enhances the removal of UV-induced DNA damage. Methods: The effect of RA on UV-induced apoptosis and DNA repair was investigated by ELISA apoptosis assay and CAT assay. Results: Both all-trans-RA and 9-cis-RA did not promote UV-induced apoptosis nor the repair of UV-damaged DNA in human keratinocytes. Furthermore, RA did not induce the expression of p53. Conclusion: The inhibition of RA on skin carcinogenesis is not due to enhanced removal of UV-damaged DNA. Therefore, RA does not inhibit skin cancer development at the initiation stage, but possibly at the promotion and progression stages.
Wrinkling Due to Mid-Dermal Elastolysis: Two Cases and Literature Review
Authors: Rao Babar K. , Endzweig Carin H. , Kagen Mark H. , Kriegel David , Freeman Robert G. 
Published: July 2017

Background: Mid-dermal elastolysis is an acquired disorder of elastic tissue clinically characterized by diffuse fine wrinkling, most often of the trunk and arms. Histologically, a clear band of elastolysis is present in the mid-dermis. Objective: Although examples of diffuse elastolysis are well known, only a small number of patients with mid-dermal elastolysis have been reported to date. We present two patients with clinical and histological evidence of mid-dermal elastolysis, review the literature, and summarize the salient features of some common disorders of elastic tissue. Methods: The first patient presented with fine wrinkles and papules over the upper arms, upper chest, and axillae, and demonstrated increased laxity of the eyelids. The second patient had striking wrinkles extending in a band-like pattern on her arms, upper chest, back, and abdomen. Neither one of our patients had a previous history of skin inflammation, urticaria, or any other underlying diseases related to their skin changes. Skin biopsies were taken from lesional and perilesional skin of both patients, and were stained with hematoxylin and eosin, and with elastic tissue stain. In addition, a tissue sample from Patient 1 was fixed for electron-microscopy. Results: Hematoxylin and eosin stains did not demonstrate specific changes or diagnostic patterns. However, elastic tissue stains revealed a band-like loss of elastic tissue in the mid-dermis. Elastic tissue in the remaining superficial and deep dermis stained normally. Electron-microscopy was consistent with these findings and revealed significant loss of elastic tissue limited to the mid-dermis. Conclusion: We have presented two cases of mid-dermal elastolysis and reviewed the literature. To date, the pathophysiology of mid-dermal elastolysis had not been elucidated and no definitive therapy exists.
Teledermatology in New Zealand
Authors: Oakley Amanda M. M. 
Published: July 2017

Background: Teledermatology is the delivery of specialist dermatological services at a distance. It has become possible because of technological advances in digital imaging and telecommunications. Consultations may be “interactive” using video-conferencing equipment or “store-and-forward” using prerecorded text and images. The best method to deliver teledermatology services is unknown. Objective: Studies were designed to determine (a) if it was possible to diagnose and manage skin diseases using video-conferencing equipment, (b) if teledermatology was acceptable to patients and medical practitioners, and (c) whether it offered any economic advantages. We have also compared interactive and store-and-forward techniques. Method: The trials were conducted in collaboration with the Institute of Telemedicine & Telecare, Queen's University, Belfast, as part of the UK Teledermatology Trials. Remits: The trials have involved more than 300 teledermatology consultations. Having established that a diagnosis can be made in more than two-thirds of the cases, the majority of video consultations have resulted in satisfactory management, with only small numbers of patients requiring face-to-face review. Teledermatology is generally popular with patients and can save them considerable time and money. Routine clinics continue in three centers. We have found that effective store-and-forward teledermatology requires very good images and comprehensive historical referral data.
Disseminated Scleroderma of a Japanese Patient Successfully Treated with Bath PUVA Photochemotherapy
Authors: Aragane Yoshinori , Kawada Akira , Maeda Akira , Isogai Rieko , Isogai Noritaka , Tezuka Tadashi 
Published: July 2017

Background: Localized scleroderma is known to be resistant to therapies. Recently, it has been reported that bath PUVA photochemotherapy is effective for treating this dermatosis. Objectives: Although according in earlier reports mainly white populations have been treated successfully with bath PUVA therapy, there is little knowledge of whether it is effective in treating colored populations. We treated a 64-year-old Japanese woman suffering from disseminated scleroderma with bath PUVA photochemotherapy to see its effects. Conclusion: Although rather high cumulative UVA doses were required for this patient compared with those needed in earlier reports, no adverse effects were observed. The lesions were markedly improved, suggesting that this therapeutic modality is well-tolerated and useful for colored patients such as the Japanese. Furthermore, it turns out that the thermographical assessment is useful to estimate clinical improvement of this sclerosing skin disorder.
Primary Localized Cutaneous Amyloidosis in Association with Papillary Thyroid Carcinoma
Authors: Sangen Yoshiko , Kawada Akira , Maeda Akira , Aragane Yoshinori , Tezuka Tadashi 
Published: July 2017

Background: Lichen amyloidosis, a type of primary localized cutaneous amyloidosis, is characterized by pruritic brown or grayish pigmented papules. Objective: We report a case of lichen amyloidosis in which the skin lesion consisted of asymptomatic salmon-pink-colored papules on the back of the neck to the upper back. This was different from typical clinical pictures of lichen amyloidosis. Our patient proved to have thyroid papillary carcinoma. Conclusion: Our case may suggest that lichen amyloidosis could be a cutaneous manifestation of thyroid cancers.
Kasabach-Merritt Syndrome
Authors: Maguiness Sheilagh , Guenther Lyn 
Published: July 2017

Background: Kasabach-Merritt syndrome (KMS) is a consumptive coagulopathy associated with the presence of a large vascular lesion. It is often a frustrating condition to treat and it carries a high mortality rate. There are currently no known treatment guidelines. Kasabach-Merritt syndrome is associated with kaposiform hemangioendothelioma (KHE) and tufted angioma (TA); these lesions, when associated with KMS, are locally invasive, aggressive vascular tumors. Treatment options include supportive care, local therapies, and drug and surgical management. In most recent case reports, a multimodal approach to therapy is taken. Objective and Conclusion: The objective of this article is to provide a comprehensive review of KMS and give an up-to-date summary of treatment options. The clinical presentation, laboratory findings, vascular pathology, and pathophysiology will also be discussed.
Vulval Disease from the 1800s to the New Millennium
Authors: Lewis Fiona M. 
Published: July 2017

Background: The study of vulval disease has become important over the last few decades. Although several inflammatory dermatoses were described at the end of the 19th century, vulval involvement in these conditions was only realized some time later. Indeed, the vulva may be a site of predilection of some inflammatory dermatoses such as lichen sclerosus. Objective: There are now groups of interested dermatologists, gynecologists, and genitourinary physicians that have cooperated to study patients with vulval disease. Hopefully, this will increase our knowledge over the next century. Conclusion: This review article examines vulval disease from an historical viewpoint and highlights important developments that have increased our understanding of the disorders that specifically affect the vulva.
Foreign Body Granuloma: A New Manifestation of Immune Restoration Syndrome
Authors: Murray Christian A. , DeKoven Joel , Spaner David E. 
Published: July 2017

Background: People with human immunodeficiency virus may experience an immune restoration syndrome during the lymphocyte recovery period following effective highly active antiretroviral therapy. In this syndrome, antigens that previously were ignored by the immune system now induce an exaggerated response with obvious clinical effects. Most cases have been associated with infectious agents such as cytomegalovirus or mycobacterium avium intracellulare. However, the sudden onset of sarcoidal granulomatous reactions have also been described in this setting. Objective: We report a 66-year-old HIV-positive man who presented with exacerbation of multiple foreign body granulomas decades after the original injuries. The presentation coincided with a significant rise in CD4 count after beginning highly active antiretroviral therapy. Conclusion: We propose that this case demonstrates another manifestation of the immune restoration syndrome and postulate that an uncontrolled Th1 response is the causative mechanism.
Topical Treatment of Bowen's Disease with 5-Fluorouracil
Authors: Bargman Howard , Hochman Jacqueline 
Published: July 2017

Background: Bowen's disease is a common skin cancer. There are many different therapeutic approaches to treatment. Topical 5-Fluorouracil (5-FU) cream has been used for many years and there are many published papers attesting to its effectiveness. However, no papers have presented long-term followup results with biopsy confirmation of cure. Objectives: The purpose of this article is to present the long-term findings following the use of this cream in the treatment of Bowen's disease. Methods: Twenty-four patients with 26 biopsy-confirmed lesions of Bowen's disease were treated with topical 5-Fluorouracil cream and were followed for periods of up to 10 years. Posttreatment biopsies were performed in most cases. Results: Two of the 26 lesions treated topically recurred at some point. The rest were apparently cured. Conclusion: The results presented in this article confirm that treatment of Bowen's disease with topical 5-Fluorouracil cream is safe and effective treatment.
Skin Cancer Induced by Arsenic in the Water
Authors: Cabrera Hugo Néstor , Gómez María Luisa 
Published: July 2017

Background: Arsenic (As) is a well-recognized poison. Exposure may be of an acute nature, leading to high concentrations and acute arsenic poisoning. Chronic exposure may lead to benign skin changes, skin cancer, and internal malignancy. Objective: Our purpose was to study the nature, incidence, and sequelae of skin disorders in a group of Argentinean patients suffering from chronic arsenicism due to the intake of contaminated well water. Methods: All patients who presented with chronic arsenicism at the Dermatology Department of Hospital Posadas (Buenos Aires, Argentina) during a 10-year period (1988–1998) were included in this study. The patient group compromised 9 women and 14 men, the age range was 37–72 years. Diagnosis was based on the clinical triad (keratoderma, leucoderma and epiteliomatosis). We performed clinical, laboratory, and histopathologic studies to confirm diagnosis. We screened for possible internal diseases. Results: All patients included in this study had cutaneous lesions associated with long-term arsenic exposure. The mean age of the patients was 58.2 years. The estimated mean time of the beginning of the lesions was of 3.7 years. All patients were Argentinean from endemic areas of our country where the arsenic levels are higher than those accepted by the World Health Organization. Conclusion: This study allows us to conclude that the relationship between arsenic and cancer is frequent and it describes the principal characteristics of this entity in our group of patients.
Erdheim—Chester Disease
Authors: Lenahan Susan E. , Helm Klaus F. , Hopper Kenneth D. 
Published: July 2017

Background: Erdheim–Chester disease is a rare non-Langerhans' cell histiocytosis. Objective: This case report is presented to familiarize clinicians with Erdheim–Chester disease and its differential diagnosis. Results and Conclusion: Erdheim–Chester disease presents with unique clinical and pathologic findings. Its xanthoma-like lesions can cause significant morbidity and mortality.
Skin and Soft Tissue Necrosis following Hymenoptera Sting
Authors: Koçer Uğur , Tiftikcioğlu Yiğit Özer , Aksoy Hasan Mete , Karaaslan Önder 
Published: July 2017

Background: All kinds of bees, wasps, and hornets are members of the hymenoptera order. Local hypersensitivity reactions after bee stings are very common and well studied. However, tissue necroses following untreated bee stings are extremely rare and they are not well documented. Objective: Two extremely rare cases of extensive skin and soft tissue necrosis following hymenoptera stings are presented. Current literature and treatment options are discussed. Conclusions: Local skin reactions following bee stings may result in severe complications such as tissue necrosis if left untreated. Skin grafting following surgical debridement is an adequate and practical treatment modality for such cases.
Use of Infliximab, an Anti-Tumor Necrosis Alpha Antibody, for Inflammatory Dermatoses
Authors: Drosou Anna , Kirsner Robert S. , Welsh Esperanza , Sullivan Tory P. , Kerdel Francisco A. 
Published: July 2017

Background: Infliximab is a monoclonal antibody against tumor necrosis factor alpha currently approved by the U.S. FDA for the treatment of Crohn's disease and rheumatoid arthritis. Recently, a controlled trial reported its effectiveness for psoriasis. Objective: The object of our study was to evaluate the efficacy and safety of infliximab for inflammatory or autoimmune cutaneous disorders. Methods: A retrospective chart review was performed for patients who received infliximab at the University of Miami, Cedars Medical Center. Results: Patients with various disease, including panniculitis, pityriasis rubra pilaris, eosinophilic fasciitis, discoid lupus erythematosus, and necrobiosis lipoidica diabeticorum, received infliximab infusion at a dose of 5 mg/kg. All patients had refractory disease or adverse effects to previous therapy, which included cyclosporine, systemic steroids, azathioprin, clofazimine, mycophenolate mofetil, acitretin, UVB, and thalidomide. Six out of the seven patients improved after treatment. Conclusions: Infliximab was well tolerated in most patients and the majority benefited from the use of infliximab.
When is Recalcitrant Pyoderma Gangrenosum Truly Recalcitrant?
Authors: Barnabé Cheryl , Hurst Lorne , Alowami Salem 
Published: July 2017

Background: The literature supports many different therapies used in recalcitrant pyoderma gangrenosum, which suggests that the pathophysiology is not yet understood. Our hypothesis is that certain patient demographic factors, including age or size of ulcer at presentation, may predict a poor clinical outcome. Objective: The goal of our study was to stimulate an analysis of pyoderma gangrenosum treatment failures to identify predisposing conditions that would increase the likelihood of failure. Conclusion: Patients older than 50 years of age or with an ulcer greater than 25 cm in diameter may have a poor outcome, but a systematic review of pyoderma gangrenosum treatment failures should be undertaken to support this hypothesis.
Basaloid Follicular Hamartoma with Trichoblastomatous Proliferations
Authors: Kaiser Adeel , Spence Robert J. , Parwani Anil , Tihan Tarik , Barrett Terry L. 
Published: July 2017

Background: Basaloid follicular hamartomas (BFH) are rare, benign, adnexal lesions with diverse clinical presentations. Previous studies documented BFHs with fibroepithelioma of Pinkus-like proliferations, or proliferations that resemble trichoepitheliomas. Objective: We report on a patient with linear, unilateral BFH and extensive trichoblastomatous proliferations involving the right arm, torso, and leg. An 18-year-old female presented with multiple, hyperkeratotic, linear nodules and plaques limited to her right side from the shoulder to the leg. The lesions had existed since birth and gradually increased over time. Results: The lesions contained hyperpigmented, exophytic nodules with acanthosis, pseudoepitheliomatous hyperplasia, focally associated with hyperkeratosis, and squamous eddies. Some areas contained trichoepithelioma-like proliferations, or large nodules of basaloid cells with numerous cystic spaces, marked hyperpigmentation, and melanophages. The diagnosis was linear, unilateral BFH with an unusual trichoblastomatous component. Conclusion: While trichoblastomatous proliferations could occur in a BFH, to our knowledge this finding has not been reported.
Carbon Dioxide Laser-Treatment of Resistant Verrucae Vulgaris: Retrospective Analysis
Authors: Sloan Kevin , Haberman Herbert , Lynde Charles W. 
Published: July 2017

Background: Verrucae are a very common dermatological problem that can be both painful and bothersome to the individual as well as costly to the health care system. In some cases Verrucae can be notoriously resistant to therapy. Objective: To determine the cure rate, side effect profile, and overall satisfaction with CO2 laser treatment of recalcitrant Verrucae vulgaris. Methods: A retrospective survey was sent to over 200 patients who had resistant Verrucae vulgaris treated with the carbon dioxide laser at The Toronto Hospital (Western Division) from 1989 to 1994. Results: Ninety-two complete responses were received. The overall cure rate was 64.1% at 12 months. There was no significant difference in cure rates between single compared to multiple warts (p = .824 Fisher's exact test). The duration of the wart being present showed no difference in cure rate (p = .801 Fisher's exact test). The location of the wart also had no influence on the cure rate (p = .433 Fisher's exact test). Overall, 71.7% of the patients were happy with the laser treatment and 85.7% would have it done again. Conclusion: The carbon dioxide laser is an effective treatment of resistant Verrucae vulgaris.
The Natural History of Strawberry Naevi
Authors: Jackson Robert 
Published: July 2017

Background: The field of dermatology was developed by clinicians with keen observational skills, who identified the natural history of clinical conditions through morphologic features. Objective: This article reviews the 1938 article published by Lister in which the natural history of hemangiomas are reviewed. Conclusion: Lister concluded “that drastic measures for the destruction of these naevi are inadvisable and treatment should be expectant and conservative.” With the advent of new laser treatments for hemangiomas, early aggressive treatment is suggested for a subgroup of these problems. However, it still holds true in 1997 that for many of these smaller lesions, treatment should be “expectant and conservative.”