bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visualization of cutaneous hemoglobin oxygenation and skin hydration using near‐infrared spectroscopic imaging
Authors: Attas Michael , Hewko Mark , Payette Jeri , Posthumus Trevor , Sowa Michael , Mantsch Henry 
Published: March 2003

Background/aims: The visualization of skin hemodynamics and tissue water content has important implications in a number of areas of dermatology, plastic surgery, and clinical skin evaluation. The aim of this study was to develop instrumentation and techniques for infrared spectroscopic imaging, and to evaluate whether they can be used to make objective assessments of skin health, perhaps even before clinical signs are evident.Methods: A liquid‐crystal tunable filter was mounted on the front of the objective lens of an infrared‐sensitive charge‐coupled device digital camera. Sets of narrow‐band images of skin were acquired in vivo at wavelength intervals of 10 nm from 650 to 1050 nm, under computer control. The data processing techniques used to extract interpretable clinical information from the raw image sets included normalization, ratios, and multivariate analysis.Results: To highlight the capabilities of these techniques, results are presented of two studies that generated spectroscopic images. One examined a volunteer’s forearm subjected to short interruptions of blood flow, and the other followed changes in a skin flap elevated on a rat model. The data sets were processed in different ways to determine several skin and blood parameters, in particular hemoglobin oxygen saturation, blood volume, and skin hydration. Variations in these parameters were followed non‐invasively as a function of time and location to study the skin’s response to blood flow changes, and to predict the viability of the skin.Conclusion: Near‐infrared reflectance spectroscopic imaging is demonstrated to be a powerful augmentation to the standard clinical assessment of skin.
Water, salts and skin barrier of normal skin
Authors: Yoshizawa Yusuke , Kitamura Keijiro , Kawana Seiji , Maibach Howard I. 
Published: March 2003

Background: We recently reported that open application of seawater for 20 min ameliorated experimental irritant contact dermatitis induced by sodium lauryl sulphate (SLS) cumulative irritation. The efficacy was overall contributed by 500 mm of sodium chloride (NaCI) and 10 mm of potassium chloride (KCl), which are consistent with the each concentration in seawater. Although the usefulness of mineral water with 500 mm NaCl and 10 mm KCl to treat atopic dermatitis (AD) or irritated skin was considered, seawater or its components would induce a feel of stinging in patients with AD. Furthermore, 20 min application was thought to be too long to use everyday as a treatment.Objective: We report the effects of 3 types of mineral water with NaCl and KCl to check the further efficacy with lesser stinging by 2 min application.Results: A mineral water with 250 mm NaCl and 50 mm KCl was the most effective water to prevent disruption of skin barrier and stratum corneum water content after cumulating irritation by SLS. Moreover, improvement of skin dryness and pruritus were shown 2 weeks after the application of the mineral water to a 6‐year‐old boy with atopic dermatitis.Conclusion: Our results suggested the possible usefulness of the mineral water with 250 mm NaCl and 50 mm KCl as the therapy of atopic dermatitis of other chronic dermatitis. Although the mineral water would not cure those skin diseases, it could be an adjunctive therapy. Further controlled clinical trials with evaluation by TEWL and capacitance are required to declare the efficacy of the mineral water in the treatment of patients with AD or other chronic dermatitis.
The use of different concentrations of betaine as a reducing irritation agent in soaps monitored visually and non‐invasively
Authors: Nicander Ingrid , Åberg Peter , Ollmar Stig 
Published: March 2003

Background/aims: Products containing detergents can damage the skin and give rise to irritant contact dermatitis. Therefore, attempts have been made to find less irritating detergents as well as substances decreasing undesired side‐effects of detergents, and a novel approach is offered by betaine. The aim of the study has been to determine the irritating properties of some liquid soaps for personal hygiene and to map the effect of different concentrations of betaine using electrical impedance, trans‐epidermal water loss and visual inspection.Methods: Twenty‐eight healthy subjects were patch tested with different commercial soaps with and without betaine and sodium lauryl sulphate on both volar forearms for 24 h. A site with distilled water and an unoccluded area were used as references. Responses of the skin reactions were evaluated by visual inspection and by measuring trans‐epidermal water loss and electrical impedance before application and 24 h after removal of the chambers.Results/conclusions: Significant skin reactions were found for all soaps tested but the soaps containing betaine were the least irritating. However, the skin irritation did not decrease with increasing concentrations of betaine in the tested range. On the whole the differences between the products were not large. The non‐invasive methods used were more sensitive than visual assessment for evaluation of invisible or barely visible skin responses.
Short‐term exposure to alcohol increases the permeability of human oral mucosa
Authors: Howie NM , Trigkas TK , Cruchley AT , Wertz PW , Squier CA , Williams DM 
Published: March 2003

OBJECTIVES: The aim of this study was to evaluate the effect of short‐term exposure to ethanol on the permeability barrier properties of human oral mucosa.MATERIALS AND METHODS: Permeability constants (Kp× 10−4 cm min−1) to tritiated water were determined, for untreated human ventral tongue, and following treatment with phosphate‐buffered saline (PBS), 5, 15 or 40% ethanol using an in vitro perfusion chamber system. Some samples were also exposed to fluorescent‐labelled albumin and examined by fluorescence microscopy. Permeability barrier lipid composition was assessed in treated and untreated mucosa by heat separation, solvent extraction and thin layer chromatography.RESULTS: Fifteen per cent ethanol significantly increased mucosal permeability (5.8 ± 0.44; P < 0.05) compared with untreated, PBS and 5% ethanol treated mucosa (4.69 ± 0.26, 4.48 ± 0.3 and 4.13 ± 0.27, respectively). Albumin was restricted to the epithelial surface in control tissue, but extended further through the epithelium and, in some cases, into the connective tissue after treatment with ethanol. Biochemical analysis revealed no significant difference in the epithelial lipid composition of treated and untreated mucosa.CONCLUSIONS: These results suggest that short‐term exposure to ethanol may act as a permeability enhancer, possibly by causing molecular rearrangement of the permeability barrier, not as a result of lipid extraction.
Opportunistic infections associated with HIV infection in Africa
Authors: Maartens G 
Published: March 2003

HIV‐associated infections in sub‐Saharan Africa differ markedly in their incidence from those in industrialized countries. Tuberculosis is the commonest cause of morbidity and mortality. Enteric pathogens such as microsporidiosis commonly cause disease as access to safe water is limited. Pneumocystis carinii pneumonia, which is the commonest opportunistic infection in industrialized countries, is uncommon in adults with HIV infection. This remains unexplained because P. carinii pneumonia is common in Black African HIV‐infected children. Cytomegalovirus and Mycobacterium avium complex, which only occur in severely immune‐suppressed individuals, are seldom found. One reason may be that survival after conversion to AIDS is relatively short in Africa. Patients often die before they develop severe immune suppression. Recently, prophylactic cotrimoxazole treatment was shown to be effective in symptomatic HIV‐infected adults in Africa. Tuberculosis preventive therapy is also effective in Africa, at least in the medium term. It is hoped that these two affordable interventions will become available to large numbers of patients identified in voluntary counselling and testing centres.
Enhancement of transmucosal permeation of cyclosporine by benzalkonium chloride
Authors: Van Der Bijl P , Van Eyk AD , Gareis AA , Thompson IOC 
Published: March 2003

OBJECTIVES: Permeation of cyclosporin A (CsA) through intact and de‐epithelialized human vaginal mucosa in the presence and absence of benzalkonium chloride (BZCl) was tested.MATERIALS AND METHODS: Human vaginal mucosa (snap‐frozen in liquid nitrogen, stored at −85°C) had been used for permeability experiments. CsA permeation through thawed frozen intact and de‐epithelialized vaginal mucosa was determined using a flow‐through diffusion apparatus (20°C, 24 h). Flux rates for CsA across these two mucosae were determined in the presence and absence of 0.01% BZCl. ANOVA and Duncan's multiple range test were used to test for steady‐state and an unpaired t‐test with Welch's correction was used to test for differences between the mean flux values at each time point (significance level of 5%). A piece of thawed tissue from each patient, before and after de‐epithelialization, was placed in formalin and histologically examined.RESULTS: Flux rates of CsA across intact vaginal mucosa tended to increase by 28–46% in the presence of 0.01% BZCl, and CsA across de‐epithelialized mucosa by approximately 28%. The latter differences were statistically significantly higher after 10 h. Flux rates across de‐epithelialized mucosa were 52–140% higher in the presence of 0.01% BZCl (statistically significantly higher after 12 h).CONCLUSIONS: The permeation of CsA through intact and de‐epithelialized human vaginal mucosa can be enhanced by 0.01% BZCl.
Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease
Authors: Katz J , Shenkman A , Stavropoulos F , Melzer E 
Published: March 2003

OBJECTIVE: An assessment of oral symptoms and signs in patients with inflammatory bowel disease (IBD). METHODS: Fifty‐four patients with IBD, 34 with Crohn's disease (CD) and 20 with ulcerative colitis (UC) participated in the study. Forty‐two patients without gastrointestinal disease or complaints attending the orthopedic clinic served as controls. Each patient completed a written questionnaire and was subjected to an oral examination. RESULTS: The main findings of this study were the higher prevalence of halitosis (50%vs 10%P < 0.0008), nausea (30%vs 7%, P < 0.017) and reflux (regurgitation) (45%vs 17%, P < 0.017) in patients with UC, and nausea (50%vs 7%, P < 0.026), dry mouth and halitosis (29%vs 10%, P < 0.026) and vomiting (41%vs 5%, P = 0.01) in patients with CD, compared with controls. Patients with active CD had a higher prevalence of dry mouth, nausea and vomiting compared with controls (46, 69 and 54%vs 10, 7 and 5%, respectively, P < 0.001) and of reflux compared with non‐active CD (46%vs 5%, P < 0.001). Patients with active UC had a higher prevalence of halitosis and regurgitation (50 and 60%vs 10 and 17%, P < 0.001) compared with controls. CONCLUSIONS: The present study demonstrates increased frequency of oral signs and symptoms in patients with IBD. Patients with active CD had more oral signs compared with non‐active CD patients. Manifestations such as nausea, vomiting, regurgitation and dry mouth may have detrimental effects on teeth and soft tissues of the oral cavity. Communication between gastroenterologists and dentists is imperative for success of the overall treatment of their patients.
Saliva and inhibition of HIV‐1 infection: molecular mechanisms
Authors: Shugars DC , Sweet SP , Malamud D , Kazmi SH , Page‐Shafer K , Challacombe SJ 
Published: March 2003

Oral fluids are rarely a vehicle for HIV‐1 infection in vivo, unlike other mucosal secretions. This unique property raises questions regarding (1) the molecular mechanisms responsible for the lack of salivary transmission, (2) the extent to which oral immunological responses mirror responses at other mucosal sites, (3) the use of promising salivary markers of HIV‐1 disease progression, (4) the relationship between oral and blood viral loads, (5) cofactors that influence oro‐genital transmission, and (6) the feasibility of oral‐based antibody testing for HIV‐1 diagnosis in the home. This paper discusses these questions and provides background summaries, findings from new studies, consensus opinions, practical relevance to developing countries, and suggestions for future research agenda on each of the key topics.
Adherence to Pressure Ulcer Prevention Guidelines: Implications for Nursing Home Quality
Authors: Saliba Debra , Rubenstein Lisa V. , Simon Barbara , Hickey Elaine , Ferrell Bruce , Czarnowski Elaine , Berlowitz Dan 
Published: March 2003

OBJECTIVES: This study aims to assess overall nursing home (NH) implementation of pressure ulcer (PU) prevention guidelines and variation in implementation rates among a geographically diverse sample of NHs.DESIGN: Review of NH medical records.SETTING: A geographically diverse sample of 35 Veterans Health Administration NHs.PARTICIPANTS: A nested random sample of 834 residents free of PU on admission.MEASUREMENTS: Adherence to explicit quality review criteria based on the Agency for Healthcare Research and Quality Practice Guidelines for PU prevention was measured. Medical record review was used to determine overall and facility‐specific adherence rates for 15 PU guideline recommendations and for a subset of six key recommendations judged as most critical.RESULTS: Six thousand two hundred eighty‐three instances were identified in which one of the 15 guideline recommendations was applicable to a study patient based on a specific indication or resident characteristic in the medical record. NH clinicians adhered to the appropriate recommendation in 41% of these instances. For the six key recommendations, clinicians adhered in 50% of instances. NHs varied significantly in adherence to indicated guideline recommendations, ranging from 29% to 51% overall adherence across all 15 recommendations (P < .001) and from 24% to 75% across the six key recommendations (P < .001). Adherence rates for specific indications also varied, ranging from 94% (skin inspection) to 1% (education of residents or families). Standardized assessment of PU risk was identified as one of the most important and measurable recommendations. Clinicians performed this assessment in only 61% of patients for whom it was indicated.CONCLUSIONS: NHs' overall adherence to PU prevention guidelines is relatively low and is characterized by large variations between homes in adherence to many recommendations. The low level of adherence and high level of variation to many best‐care practices for PU prevention indicate a continued need for quality improvement, particularly for some guidelines.
Malnutrition in Institutionalized Seniors: The Iatrogenic Component
Authors: Wendland Barbara E. , Greenwood Carol E. , Weinberg Iris , Young Karen W. H. 
Published: March 2003

OBJECTIVES: To provide practitioners with benchmarks for micronutrient supplementation policies for older residents of long‐term care (LTC) facilities, based upon residents' usual energy intake.DESIGN: Retrospective secondary analysis of nutrient intake and delivery data, obtained from 21 consecutive collection days.SETTING: A fully accredited geriatric teaching facility, affiliated with the University of Toronto's Medical School, that includes a chronic care hospital and a home for the aged, housing more than 800 senior residents.PARTICIPANTS: Twenty‐three cognitively impaired residents who retained the ability to feed themselves.MEASUREMENTS: Average daily micronutrient (vitamin and mineral) content of two common diet types—unrestricted diet as tolerated and lactose‐free—were evaluated based upon all foods served during a 28‐day cycle of menus, providing an estimate of total possible micronutrient intake. Energy intake needed to meet recommended intakes for each of the micronutrients was then determined and compared with actual dietary intakes.RESULTS: Even if entirely consumed, neither diet (providing approximately 2,000 kcal/d) supplied sufficient quantities of vitamins (vitamin E, pantothenic acid) and minerals (calcium, zinc, copper and manganese) to enable residents to meet recommended intakes, making these deficiencies iatrogenic in nature. As projected intake levels fell to reflect ranges more consistently observed in LTC residents (1,000–1,500 kcal/d), the number and severity of risk nutrients increased. Similar predictions, based upon actual intake measurements, were made and confirmed.CONCLUSIONS: The traditional approach of developing LTC menus using resources such as Canada's Food Guide or the Food Guide Pyramid of the United States results in iatrogenic malnutrition. New guidelines are needed that are targeted toward the special needs of older adults who have low food intakes. In the interim, all older LTC residents require full‐spectrum vitamin and mineral supplements.
Development of a Scale to Predict Decline in Patients with Mild Alzheimer's Disease
Authors: Santillan Concepcion E. , Fritsch Thomas , Geldmacher David S. 
Published: March 2003

OBJECTIVES: To develop a scale that can assist in predicting likelihood of decline from mild dementia over 1 year in patients with Alzheimer's disease (AD).DESIGN: Retrospective cohort study.SETTING: University Memory and Aging Center.PARTICIPANTS: Patients with probable or possible AD and Clinical Dementia Rating (CDR) of 1 at baseline, divided into development and validation cohorts (n = 118 each).MEASUREMENTS: The CDR and neurological and neuropsychological assessments were given at baseline and 1 year later.RESULTS: In the development cohort, high education, low Mini‐Mental State Examination score, poor insight, psychotic symptoms, and greater activity of daily living impairment predicted decline in CDR from 1 to 2 or 3. Receiver operating characteristics (ROC) curve analysis identified cutoff scores that maximized sensitivity and specificity for each significant predictor of decline. Based on the cutoff, raw scores were recoded to reflect risk for decline, weighted, and summed to create a final scale score. ROC curve analysis established a cutoff to indicate risk for decline on the final scale score. Sensitivity, specificity, and area under the ROC were 0.76, 0.74, and 0.83 in the development cohort and 0.77, 0.69, and 0.80 in the validation cohort, respectively. Positive and negative predictive values were 0.71 and 0.78 in the development cohort and 0.68 and 0.78 in the validation cohort, respectively.CONCLUSIONS: Decline from mild to moderate or severe impairment represents significant clinical change, with implications for patient and caregiver quality of life and treatment options. The clinical scale developed uses data to enhance prediction about change from mild to moderate or severe stages of AD.
Rapid Stimulation of the PI3‐Kinase/Akt Signalling Pathway in Developing Midbrain Neurones by Oestrogen
Authors: Ivanova T. , Mendez P. , Garcia‐Segura L. M. , Beyer C. 
Published: March 2003

AbstractOestrogen promotes the differentiation of neurones in the central nervous system. In the rodent midbrain, the maturation of dopaminergic neurones appears to be under oestrogen control. This is supported by the fact that dopaminergic cells contain nuclear oestrogen receptors‐α/β (ER). Second, aromatase is transiently expressed in the developing midbrain. In previous studies, we have shown that oestrogen increases dopamine synthesis and plasticity of dopamine cells. These effects are transmitted through classical nuclear ER but require also the stimulation of nonclassical signalling pathways involving the activation of membrane receptors. This study attempted to identify nonclassical oestrogen‐dependent signalling cascades which might be stimulated downstream of membrane ERs. Using cultured mouse midbrain cells, we could demonstrate by Western blotting, that oestrogen rapidly phosphorylates Akt, a kinase which is implicated in the phosphatidylinositol 3 (PI3)‐kinase pathway. This effect was only seen in midbrain neurones but not astrocytes. Oestrogen‐induced Akt phosphorylation was time‐ and dose‐dependent, showing highest responses after 30 min and at a steroid concentration of 10−8 and 10−6 M. Immunocytochemistry for phosphorylated Akt (pAkt) demonstrated that pAkt is predominantly found in a nuclear/perinuclear position and that oestrogen exposure increased the number of pAkt‐positive cells. To investigate the mechanisms which are involved in transmitting oestrogen effects on the cellular level, cells were treated with antagonists for distinct signalling pathways. The application of the nuclear ER antagonist ICI 182 780 did not abolish the oestrogen‐induced Akt phosphorylation. In contrast, interrupting intracellular calcium signalling with BAPTA completely prevented this effect. The PI3‐kinase inhibitor LY294002 also inhibited the activation of Akt by oestrogen. Our study clearly indicates that oestrogen can rapidly stimulate the PI3‐kinase/Akt signalling cascade in differentiating midbrain neurones. This effect requires the intermediate activation of calcium‐dependent signalling pathways. In conclusion, oestrogen effects in the developing midbrain appear to be connected with the PI3‐kinase/Akt signalling mechanism.
Agonist‐Specific and Sexual Stage‐Dependent Inhibition of Gonadotropin‐Releasing Hormone‐Stimulated Gonadotropin and Growth Hormone Release by Ryanodine: Relationship to Sexual Stage‐Dependent Caffeine‐Sensitive Hormone Release
Authors: Johnson J. D. , Chang J. P. 
Published: March 2003

AbstractDifferential utilization of intracellular Ca2+ stores with specific functional characteristics could be a potential mechanism for coupling various stimuli to specific cellular responses. In the goldfish pituitary, both gonadotropes and somatotropes possess multiple intracellular Ca2+ stores that are differentially coupled to agonist‐evoked exocytosis. We investigated the role of ryanodine receptor/Ca2+‐release channels (RyR) in basal and gonadotropin‐releasing hormone (GnRH)‐evoked hormone secretion from cultured gonadotropes and somatotropes using radioimmunoassay for gonadotropin (GTH‐II) and growth hormone (GH). As is the case in vivo, the basal and evoked secretion of both hormones varied with seasonal reproductive status. GnRH‐stimulated hormone release was three‐fold higher in cells from sexually mature animals compared to those in a sexually regressed state. Nanomolar doses of ryanodine evoked significant GTH‐II and GH secretion, suggesting that ryanodine‐sensitive Ca2+ stores can couple to exocytosis in both cell types. In gonadotropes, 10 µM ryanodine abolished cGnRH‐II‐evoked GTH‐II release in both sexually mature and sexually regressed fish, while sGnRH signalling was mediated by ryanodine‐sensitive Ca2+ stores in cells from sexually regressed fish only. Ryanodine‐sensitive Ca2+ stores in somatotropes were only involved in cGnRH‐II‐stimulated GH release during gonadal regression. In contrast, sGnRH‐stimulated, but not cGnRH‐II‐stimulated, GH release was significantly reduced by 1 µM xestospongin C. Although hormone release stimulated by mobilizing caffeine‐sensitive Ca2+ pools was also markedly seasonal, it was largely independent of ryanodine‐sensitive Ca2+ stores. Ryanodine‐sensitive Ca2+ stores in both cell types are not active downstream of ionomycin, BayK 8644, protein kinase C or cyclic adenosine monophosphate signalling pathways, suggesting difference from a classical Ca2+‐induced Ca2+ release system. Ours study is the first to suggest that RyR2 may be involved in the seasonal plasticity of pituitary function, which may be related to cyclic changes observed in reproduction and growth.