bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of desquamation – the Achilles heel of the reconstructed epidermis
Authors: Ponec M. , Kempenaar J. , Weerheim A. 
Published: March 2003

SynopsisThe use of human skin equivalents for screening tests aiming to assess repetitive application of various test agents is hampered by the lack of desquamation in vitro. The present study was undertaken to examine whether the desquamation can be induced by various treatments including mechanical stress, application of various agents that should decrease the surface pH and calcium level, activate the enzymes involved in desquamation process or UV irradiation. In addition, the effect of α‐hydroxyacids, known to enhance desquamation and to improve the stratum corneum barrier function in vivo, was examined as well. Human epidermis reconstructed on de‐epidermized dermis or on fibroblast‐populated collagen matrices during a 2‐week culture at the air–liquid interface underwent various treatments during an additional 3‐week period. The effects of treatments were evaluated on the basis of tissue morphology and lipid composition. The results of the present study revealed that cell shedding could only be induced by a mild repetitive mechanical treatment. The lack of desquamation, under most in vitro conditions, has a practical consequence, since it may hamper the use of reconstructed epidermis for various screening studies aiming to examine the repetitive exposure to topical agents or UV irradiation. The gradual thickening of the stratum corneum will lead to its higher resistance to the environmental stimuli and in this way affect the outcome of the tests. Furthermore, from the results obtained in the present study, it became evident that one should be careful in selecting endpoints when, for example, the effects of agents known to modulate melanogenesis are examined.
Dietary sphingomyelin and other sphingolipids in health and disease
Authors: Schmelz Eva M. 
Published: March 2003

SummarySphingolipids are found in all eukaryotic and some prokaryotic cells and therefore most foods contain varying amounts. They are digested in the intestinal tract, and the bioactive metabolites (i.e. ceramide, sphingosine) are released. In mouse models, the supplementation of the diet with complex sphingolipids significantly reduced early stages in colon carcinogenesis and tumour formation, providing an insight into the association between diet and cancer.
The genetic epidemiology of thinness
Authors: Bulik C. M. , Allison D. B. 
Published: March 2003

SummaryMost genetic research in the area of human obesity asks the question ‘Why are certain people obese?’ Considerably less attention has been paid to the question of why certain people are not obese, particularly given the obesogenic environment that permeates the western culture. We present data from human and animal studies and evolutionary arguments supporting the notion that genetic studies of thinness or obesity resistance may yield important and complementary findings to genetic studies of obesity. We offer strategies for further refining the definition of thinness, weigh the advantages and disadvantages of potential sampling strategies and suggest candidate genes for thinness or obesity resistance.
Euthanasia: from the perspective of HIV infected persons in Europe
Authors: Andraghetti R , Foran S , Colebunders R , Tomlinson D , Vyras P , Borleffs Cj , Fleerackers Y , Schrooten W , Borchert M 
Published: March 2003

1

Institute of Tropical Medicine, Antwerp, Belgium,

2

St Mary's Hospital, London, UK,

3

General Hospital of Athens, Athens, Greece and

4

University Hospital Utrecht, Utrecht, the Netherlands
Background  In the debate about legalization of euthanasia very little attention has so far been given to the opinion of the patient.Objective  To assess the opinion of persons with HIV infection in Europe.Methods  A cross‐sectional survey of persons with HIV infection attending HIV/AIDS treatment centres or HIV support organizations in 11 European Union Member States was performed. A total of 2751 anonymous patient self‐administered questionnaires were distributed between August 1996 and September 1997. The questionnaire contained 108 questions concerning a variety of topics about HIV care, including five questions on euthanasia.Results  One thousand three hundred and seventy‐one people with HIV infection completed the questionnaire, of whom 1341 (98%) responded to the questions concerning euthanasia. Seventy‐eight percent of respondents agreed with the legalization of euthanasia in case of severe physical suffering, 47% if there was severe psychological suffering and 24% simply at the patient's request. For physical suffering and at a clear patient's request, accepted practices were: alleviation of pain with double effect (81%), medical euthanasia (62%) and physician assisted suicide (45%). Fifty percent would consider euthanasia for themselves if all treatment options were exhausted. Social indicators such as educational level and employment seemed to play a more significant role in determining attitudes towards legalization, and personal interest in, euthanasia than indicators related to disease status.Conclusion  In this study a majority of HIV infected persons in Europe favoured the legalization of euthanasia.
Pulmonary pathology in patients with AIDS: an autopsy study from Mumbai
Authors: Lanjewar DN , Duggal R 
Published: March 2003

Objective Although India has a high prevalence of HIV/AIDS, the associated pathologies responsible for morbidity have not been evaluated previously in a representative study. Hence, an autopsy study was carried out to analyse the spectrum of pulmonary lesions in patients with HIV/AIDS.Methods A retrospective and prospective autopsy study was carried out during 1988–2000 at Mumbai, India. Lungs from 143 adults, with at least 10 sections from each case, were examined using routine and special stains.Results The risk factors for 97 men (68%) and 38 women (27%) included: heterosexual sex with multiple partners (135 cases, 95%); blood transfusions (three cases; 2%); sex between men (two cases; 1%); and unknown risk factors (three cases, 2%). Pulmonary pathology was observed in 126 (88%) cases. The lesions identified were tuberculosis (85 cases, 59%), bacterial pneumonia (26 cases, 18%), cytomegalovirus (CMV) infection (10 cases, 7%), cryptococcosis (eight cases, 6%), Pneumocystis carinii pneumonia (seven cases, 5%), aspergillosis (four cases, 3%), toxoplasmosis (two cases, 1%), Kaposi's sarcoma (one case, 1%), squamous cell carcinoma (one case, 1%). Two or more infections were observed in 18 (13%) cases.Conclusions Pulmonary diseases and risk factors among patients with AIDS in India differ from those reported in industrialized countries. Tuberculosis was the most frequently observed pulmonary infection, followed by bacterial pneumonia and CMV pneumonitis. In contrast with industrialized countries, PCP remains less common in our patients. The information on opportunistic infections obtained in this study will be useful for managing HIV/AIDS cases at district level hospitals where diagnosing specific HIV‐associated diseases is not always possible.
Body composition changes in protease inhibitor‐naive HIV‐infected patients treated with two nucleoside reverse transcriptase inhibitors
Authors: Tsekes G , Chrysos G , Douskas G , Paraskeva D , Mangafas N , Giannakopoulos D , Papanikolaou M , Georgiou E , Lazanas MC 
Published: March 2003

ObjectivesIn the era of highly active antiretroviral treatment (HAART), there are insufficient data regarding lipodystrophy syndromes in HIV‐1‐infected patients treated with regimens that do not include protease inhibitors (PIs). We studied changes in body composition in HIV‐1‐infected patients before and 2 years after starting a non‐PI‐containing antiretroviral treatment regimen.MethodsWe studied retrospectively the whole body dual energy X‐ray absorptiometry (DEXA) scans of 23 PI‐naive HIV‐1‐infected patients (17 males, six females), aged 37.4 ± 9.3 years with mean CD4 count 401 ± 130 cells/µL. Thirteen patients were on zidovudine (ZDV) + lamivudine (3TC) and 10 on ZDV + didanosine (ddI). Subjects were evaluated before the beginning of antiretroviral treatment and approximately 24 months later. For each patient body weight, CD4 T‐cell counts, bone mineral content (BMC), bone mineral density (BMD) and whole body as well as regional fat and lean body mass were evaluated.ResultsA significant decrease in BMC was observed, although the T scores remained within the normal limits. Our patients also exhibited a significant decrease in body weight due almost exclusively to fat loss, while lean mass was minimally affected. Fat loss was statistically significant in the arms and legs, but not in the trunk. The above changes were most prominent in the ZDV + 3TC treatment group; in this group of patients, fat loss was also evident in the trunk. Patients on ZDV + ddI, on the other hand, only showed a significant increase in their legs' lean mass; they preserved their total fat mass and exhibited no other significant changes between the two assessments.ConclusionsDual NRTI therapy contributes to fat loss and reduction of bone mineral content in otherwise healthy, clinically stable, PI‐naive HIV‐infected adults. Compared with patients on ZDV + ddI, patients on ZDV + 3TC had a more prominent fat loss in all body regions.
Endogenous cytokine production protects T cells from spontaneous apoptosis during highly active antiretroviral therapy
Authors: Ensoli F , Fiorelli V , De Cristofaro M , Collacchi B , Santini Muratori D , Alario C , Sacco G , Iebba F , Aiuti F 
Published: March 2003

BackgroundThe availability of therapeutic regimens that effectively interfere with HIV‐1 replication provides novel opportunities to investigate mechanisms of T‐cell depletion as well as repopulation in infected individuals.MethodsNineteen HIV‐1‐infected individuals were investigated during one‐year follow‐up of highly active retroviral therapy (HAART). The frequencies of apoptotic T cells, as determined by propidium iodide, staining, TUNEL assay and analysis of annexin V, were assessed either in the absence or in the presence of anti‐interleukin (IL)2 and anti‐IL‐4 neutralizing Ab. Spontaneous and lectin‐induced cytokine production were assessed by ELISA.ResultsIncrements of both naive and memory CD4 and CD8 T cells during HAART are accompanied by a decrease of T‐cell apoptosis that, after 12 months of HAART, reaches normal levels. This is associated with increments of both spontaneous and activation‐induced production of IL‐2 and IL‐4 by peripheral blood mononuclear cells (PBMCs), though only the latter was found defective at enrolment. During HAART, blocking of either IL‐2 or IL‐4 production by PBMCs using neutralizing Ab restores levels of T‐cell apoptosis consistent with those determined at enrolment. These data suggest that both IL‐2 and IL‐4 produced by PBMCs during HAART provide anti‐apoptotic signals that can contribute to an increased survival of T cells and may thus play a part in long‐term immune reconstitution.ConclusionsAn effective viral suppression and, possibly, effects of PI on molecular targets other than viral components, can support a progressive normalization of T‐cell survival that, at least in part, depends upon the restoration of proper soluble signals. These results provide evidence of a supporting role of endogenous cytokine production in peripheral T‐cell repopulation during an effective and prolonged viral suppression. This may be relevant for the definition of immune‐intervention targets aimed at immune reconstitution in HIV‐1‐infected patients.
Photodynamic therapy with violet light and topical δ‐aminolaevulinic acid in the treatment of actinic keratosis, Bowen’s disease and basal cell carcinoma
Authors: Dijkstra AT , Majoie IML , Van Dongen JWF , Van Weelden H , Van Vloten WA 
Published: March 2003

AbstractBackground Most clinical studies using photodynamic therapy (PDT) with topical application of δ‐aminolaevulinic acid (δ‐ALA) use red light because it allows greater depth of penetration. However, given the porphyrin‐like spectrum of δ‐ALA‐induced photosensitivity, violet light provides a maximal overlap with the excitation spectrum of protoporphyrin IX, meaning that PDT with violet light uses less light energy to induce the phototoxic reaction.Aim To study the efficacy of violet light in combination with topical δ‐ALA PDT in the treatment of premalignant and malignant skin lesions.Methods Eight hours after 20%δ‐ALA was applied topically, photoirradiation was performed with an incoherent light source (Philips HPM‐10, 400 W) emitting predominantly violet light (400–450 nm). Lesions received 10–20 J/cm2 during an exposure time of 30 min. The 38 subjects treated included three with basal cell naevus syndrome with multiple (> 30) superficial and nodular basal cell carcinomas (BCCs), one subject had multiple lesions of Bowen’s disease, involving 50% of the scalp, and the remaining 34 subjects presented a total of 35 superficial BCCs, 10 nodular BCCs, four large solar keratoses and five solitary lesions of Bowen’s disease.Results Complete remission both clinically and histologically was seen after a single treatment in 82% of the superficial BCCs (100% after a second treatment), 50% of the nodular BCCs, one of the four solar keratosis lesions (partial remission in the other three) and 90–100% of the solitary lesions of Bowen’s disease.Conclusions δ‐ALA PDT using violet light appears to be a well tolerated and effective alternative treatment for premalignant and malignant skin lesions, especially when there are multiple lesions or large patches comprising a large area of skin.
An epidemiological study of acne in female adults: results of a survey conducted in France
Authors: Poli F , Dreno B , Verschoore M 
Published: March 2003

AbstractBackground Acne is usually perceived as a disease of teenagers, and most epidemiological studies have focused on adolescents.Objective The primary objective was to investigate the prevalence of acne in a representative sample of French females. Information about skin type, life‐style factors influencing acne and quality of life were also recorded.Methods A self‐administered questionnaire was sent to 4000 adult women aged 25–40 years, after a validation test by three dermatologists. A definition of acne severity, according to questionnaire answers, was established before the questionnaire was sent out.Results A total of 3394 women completed the questionnaire of which 3305 were useable. The data showed a prevalence of acne in 17% of the population, and physiological acne in 24%. Thus, the total acne prevalence was 41%. Forty‐nine per cent of the acne patients had acne sequelae (scars and/or pigmented macules). Forty‐one per cent of adult acne patients had not experienced acne during their adolescence. A premenstrual flare and stress was recorded as causing acne in 78% and 50%, respectively. Twenty‐two per cent of acne subjects were currently receiving therapy. For most patients, acne did not severely impair their quality of life.Conclusion This study shows a prevalence of acne in 41% of women in the general population. A high proportion of these acne cases are late onset acne.
Comparison of mastocytosis with onset in children and adults
Authors: Middelkamp Hup MA , Heide R , Tank B , Mulder PGH , Oranje AP 
Published: March 2003

AbstractObjective To compare the incidence, symptomatology and course of mastocytosis with onset in childhood and in adults.Design Retrospective study of 101 patients with mastocytosis who were referred from 1980 to 1998.Patients Medical records of 65 cases of mastocytosis with onset in childhood and 36 in adulthood were analysed. The clinical course was assessed in a subgroup consisting of 33 subjects with childhood onset who were followed up until at least adolescence and 12 subjects with adult onset who were followed up for at least 10 years.Results The onset of the disease occurred before the age of 2 years in 50% and between the ages of 2 and 15 years in 14% of cases (childhood onset). In 36% of patients onset occurred at the age of 16 years and older (adult onset). An incidence peak of 60% was noted in the first year of life. Mast cell‐mediated symptoms were not experienced by 21 of 36 adult onset mastocytosis patients nor by 27 of 65 childhood onset mastocytosis patients. Complete resolution was observed in five of 33 children. The majority of childhood onset cases (21 of 33) showed some improvement. Complete resolution was achieved in three of 12 adults. The majority of the remaining adults (eight of 12) showed no improvement.Conclusions We confirm the incidence of onset of mastocytosis previously reported in the literature. We conclude that childhood onset mastocytosis is much less transitory than generally is assumed, although improvement occurs in the majority of cases. Symptomatology and clinical course of adult onset mastocytosis is less severe than suggested in the literature.
Facial and periorbital cellulitis with orbital involvement
Authors: Reis M Duarte , Freitas JP , Sousa Coutinho V , Guerra Rodrigo F 
Published: March 2003

AbstractOrbital cellulitis is a rare, serious and potentially fatal condition, usually associated with trauma to the eyelids, external ocular infection, upper respiratory tract infection and, especially, sinusitis. It is distinct from the more common periorbital cellulitis because it involves all contents of the orbit and may threaten both the vision and the life of the patient. It occurs with greater frequency in children. We report the case of a 34‐year‐old woman with severe facial and right periorbital cellulitis who rapidly developed orbital involvement, as shown by computed tomography. Apart from a bilateral retroauricular dermatitis, present for several years, the woman had been always healthy. Systemic antibiotics were started without delay and she recovered very well, with no ocular sequelae. This case illustrates that a subset of bacterial skin infections is becoming more aggressive and should be recognized and treated early.
Cerebriform intradermal naevus (a rare form of secondary cutis verticis gyrata)
Authors: Geest AJ van , Berretty PJM , Klinkhamer PJJM , Neumann HAM 
Published: March 2003

AbstractBackground Acquired cerebriform intradermal naevus (CIN) is a rare form of pseudo cutis verticis gyrata.Case report A case of acquired CIN of the scalp in a 46‐year‐old male patient is presented. The clinical and histopathological presentations of CIN are described and the therapeutic possibilities are discussed.Conclusions In each individual case the physician must decide whether to do surgery or follow a wait‐and‐see policy. There is little risk of malignant change of CIN, and surgical excision of such lesions often involves evident mutilation.
Mycosis fungoides presenting with extensive pyoderma gangrenosum‐like ulcers
Authors: Carbia SG , Hochman A , Chaín M , Dei‐Cas I , Lagodín C , Devés A , Woscoff A 
Published: March 2003

AbstractMycosis fungoides (MF) may present with atypical clinical manifestations. Usually it mimics various chronic dermatoses, with the appearance of ulcers during the tumour stage. Infrequently, cutaneous ulcers are the main or initial sign of lymphoma. We report the case of a man who presented multiple skin lesions that clinically appeared to be pyoderma gangrenosum (PG). However, histological and immunohistochemical examination revealed MF. This case illustrates that PG‐like ulcers may be atypical cutaneous manifestations of MF and exceptionally the presenting sign of this disease.
Botulinum toxin A in anal fissures: a modified technique
Authors: Wollina U , Konrad H 
Published: March 2003

AbstractBackground Anal fissures are common and painful. Botulinum toxin A (BTXA) is considered to be the most potent non‐surgical treatment; however, no attention has been paid to associated hyperhidrosis.Aim To compare traditional BTXA treatment of muscular spasticity in anal fissures with combined treatment of spasticity and focal hyperhidrosis of the anal fold and perianal skin.Setting Outpatient department of a dermatological hospital.Patients and methods Ten patients with chronic anal fissures (of more than 6 months duration who failed to respond to conservative treatment and who had refused surgery) associated with focal hyperhidrosis as assessed by Minor's sweat test were investigated in an open, two‐armed trial. Intramuscular injections of 20–25 U BTXA (Botox®) were performed in group A (n = 5). In group B (n = 5) those injections were combined with intracutaneous injection of 30–50 U BTXA to treat focal hyperhidrosis. Mean follow‐up was 5 months.Results Five of five patients in group B but only two of five patients in group A experienced a complete remission despite the fact that relief of pain was evident in eight of 10 patients within 2 weeks. Patient satisfaction with treatment was high but slightly better in group B.Conclusions This open trial suggests that combined therapy of both muscular spasticity and focal hyperhidrosis may provide better results than intramuscular injections alone in anal fissure therapy with BTXA.
Eosinophilic pustular folliculitis
Authors: Majamaa H , Vaalasti A , Vaajalahti P , Reunala T 
Published: March 2003

AbstractEosinophilic pustular folliculitis is a rase dermatosis and the treatment is difficult because the underlying pathogenic mechanism is unknown. The authors report a case of eosinophilic pustular folliculitis (Ofuji's disease) in a 50‐year‐old man who died 9 years after onset of the disease.
Recurrent lentigo maligna as amelanotic lentigo maligna melanoma
Authors: Ara M , Maillo C , Martín R , Grasa MP , Carapeto FJ 
Published: March 2003

AbstractAmelanotic lentigo maligna and lentigo maligna melanoma are extremely rare tumours. Even rarer is a recurrent amelanotic lentigo maligna or amelanotic lentigo maligna melanoma at the site of a previously removed pigmented lentigo maligna. We describe two cases of recurrent amelanotic lentigo maligna melanoma manifesting as erythematous plaques evolved from previously excised pigmented lentigo maligna.
Lipomatous melanocytic nevomatosis
Authors: Cabrera H , Gómez Ml , García S 
Published: March 2003

AbstractGiant congenital melanocytic nevi (GCMN) are rare and occur in about one out of every 200 000–500 000 births. Their importance resides in the aesthetic alteration they produce and in the possibility of malignant transformation or in their association with nevi in the central nervous system as a distinctive syndrome: neurocutaneous melanoblastosis or nevomatosis, due to the fact that nervous system lesions are produced by infiltration of nevus cells. We present here a patient with a combination of GCMN with an outstanding lipomatosis located on the same area.
Three cases of androgen‐dependent disease associated with myotonic dystrophy
Authors: Cooper SM , Dawber RPR , Hilton‐Jones D 
Published: March 2003

ABSTRACTThree cases of androgen‐dependent disease in females with myotonic dystrophy are described. Serum androgens in individuals affected by myotonic dystrophy are known to be lower on average than in normal controls. Despite this these three females developed diseases that are androgen dependent, including acne, hidradenitis suppurativa, androgenetic alopecia and keratosis pilaris. These cases support the hypothesis that the peripheral response to androgens rather than absolute circulating levels of androgens is important in androgen‐dependent conditions.