bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical class I corticosteroids in 10 patients with bullous pemphigoid: correlation of the outcome with the severity degree of the disease and review of the literature
Authors: Stockman A , Beele H , Vanderhaeghen Y , Naeyaert JM 
Published: February 2004

ABSTRACTBackground  Treatment of bullous pemphigoid (BP) with systemic immunosuppressive agents, in particular with systemic corticosteroids, has many long‐term side‐effects. A dozen reports were published regarding the efficacy of topical corticosteroids in the treatment of bullous pemphigoid.Objective  To evaluate the efficacy of potent class I topical corticosteroids in relation to the affected body surface area (BSA) in patients with bullous pemphigoid and to review the literature.Methods  An open prospective trial with 10 patients with BP with measurement of the affected BSA. Treatment protocol consisted of three steps: potent class I topical corticosteroid treatment, systemic tetracyclines and systemic corticosteroids. Follow‐up period was between 24 and 72 months.Results  Our study suggests a correlation between the success rate of topical corticosteroid treatment and the body surface area initially affected: all patients with an affected BSA of less than 20% healed with topical treatment only. The patients with more than 40% affected BSA needed systemic treatment with steroids.Conclusion  Topical class I corticosteroids seem to be effective in healing lesions of BP, especially if less than 20% of the BSA is affected. This study comprises only 10 patients, making further studies necessary to draw definite conclusions.
Cryopreserved and lyophilized cultured epidermal allografts in the treatment of leg ulcers: a pilot study
Authors: Navrátilová Z , Slonková V , Semrádová V , Adler J 
Published: February 2004

ABSTRACTBackground  In the conservative therapy of venous leg ulcers modern types of dressings are used most frequently. In the past 20 years ‘active wound dressings’ − cultured epidermal keratinocytes as autografts and allografts − were also introduced in the management of leg ulcers.Methods  The aim of our study was to compare the effect of cryopreserved and lyophilized cultured epidermal allografts in the treatment of venous leg ulcers. Evaluation of the therapy was documented as photodocumentation, planimetry, healing time and evaluation of pain relief over a 3‐month period after application. Fifty patients with venous leg ulcers were selected. Twenty‐five patients (group I) were treated with cryopreserved keratinocytes and 25 (group II) with lyophilized keratinocytes.Results  The final evaluation 3 months after the application of allografts showed 84% of healed ulcers in group I and 80% in group II. The number of healed ulcers and the healing rate both showed no statistically significant differences. The size of the ulcer was reduced by half during the first week in both groups. The size differences during the first week are statistically significant in both groups and they are comparable (P < 0.001). The intensity of the pain was statistically significantly reduced during the first week after application in both groups (P < 0.001).Conclusions  The cryopreserved and lyophilized cultured allografts are comparable in healing rate, course of healing and relief of pain, and also in planimetric changes during the healing of venous leg ulcers. Lyophilized allografts are more convenient for routine use than cryopreserved allografts as they can be stored at room temperature. These results could give rise to the more frequent use of lyophilized allografts in slow‐healing venous leg ulcers.
Effect of infection with Trichophyton mentagrophytes varietas interdigitale on phagocytosis in humans
Authors: Gregurek‐Novak T 
Published: February 2004

ABSTRACTBackground and aim  Phagocytosis by polymorphonuclear leucocytes (PMNLs) and macrophages is important in the defence of human organisms, especially in mycotic infections of the skin. The aim of this study was to examine the relationship between phagocytosis and a chronic type of infection with Trichophyton mentagrophytes varietas interdigitale (T. m. var. interdig.).Materials and methods  A group of 256 patients was investigated from 1990 to 2000. They were all treated with terbinafine. The parameters for phagocytosis were analysed by the Hersy method.Results  The immunological status of all of the patients was altered. Ingestion, digestion and random mobility decreased significantly (P < 0.001). Out of 256 patients treated with terbinafine, 196 (76%) were cured completely and the values for phagocytosis became normal.Conclusion  This investigation confirms the defect in the function of phagocytes of patients chronically infected by T. m. var. interdig. Terbinafine was shown to be an effective antimycotic drug, both fungicidal and immunostimulative.
Safety of long‐term treatment with cyclosporin A in resistant chronic plaque psoriasis: a retrospective case series
Authors: García‐Bustínduy M , Escoda M , Guimerá FJ , Sáez M , Dorta S , Fagundo E , Sánchez‐González R , Noda‐Cabrera A , García‐Montelongo R 
Published: February 2004

ABSTRACTBackground  An intermittent short course of cyclosporin A (CyA) therapy is a good choice in the treatment of severe psoriasis. Nevertheless, some severe or resistant patients might benefit from long‐term treatment. Adverse effects of long‐term use of CyA are investigated and the results are compared with the literature.Patients and methods  A retrospective study of adverse effects of CyA treatment in a group of 53 patients suffering from psoriasis. The mean treatment time was 31.4 ± 23.2 months with a minimum of 4 months to a maximum of 95 months, with very few short interruptions of treatment (from 2 to 5 months in five patients).Results  The group consisted of 29 women and 24 men, ranging in age from 18 to 65 years, with an average age of 44.49 years. Arterial hypertension appeared in 45.3% of patients during treatment. Pharmacological treatment was required in 32% of these patients to control the condition. Serum creatinine levels were transiently elevated in 11.3% of the cases, but withdrawal of treatment was required in none of them.Discussion  Long‐term CyA treatment might be necessary in some patients and this study shows that it could be sustained with a close follow‐up. This involves regular visits depending on each patient, as well as common test protocol and clinical evaluation. In conclusion, this retrospective study seems to confirm the relative safety of long‐term CyA treatment when patients are adequately monitored.
Mycosis fungoides mimicking inflammatory linear verrucous epidermal nevus
Authors: Jang J‐G , Sim H‐J , Kim S‐H , Doh K‐S , Jang M‐S , Suh K‐S , Kim S‐T 
Published: February 2004

ABSTRACTWe experienced an unusual case of mycosis fungoides with the clinical and histological features mimicking inflammatory linear verrucous epidermal nevus (ILVEN) in an 11‐year‐old boy. Localized linear multiple pruritic verrucous confluent papules and plaques appeared on the his left elbow, forearm and hand for 7 months. Skin biopsies showed characteristic findings of mycosis fungoides (e.g. Pautrier's microabscesses, follicular epitheliotropism, wiry bundles of collagen, etc.). T‐cell receptor gene rearrangement analysis in the lesional skin demonstrated rearrangement of the gamma chain. RePUVA (systemic PUVA with retinoic acid) therapy improved his skin lesions and pruritus, but these progressed after discontinuation of treatment. Thus, lesions mimicking ILVEN can be an unusual and potentially misleading presentation of mycosis fungoides.
The risk and risk factors of a second non‐melanoma skin cancer: a study in a Mediterranean population
Authors: Graells J 
Published: February 2004

ABSTRACTBackground  Non‐melanoma skin cancer (NMSC) patients often develop second primary skin tumours. Studies assessing the risk and risk factors on the appearance of a second NMSC are scarce, especially in European countries.Objectives  To assess the 5‐year risk of a second NMSC in a Mediterranean population, and to find patient characteristics predicting second tumours.Methods  NMSC patients at our institution were studied retrospectively. In situ tumours, recurrences, follow‐up shorter than 2 months and mucosal lesions were excluded. Data analysed included age, gender, anatomical site, histological subtype, number of tumours and months of follow‐up. Disease‐free interval was defined as time from histological documentation of the first NMSC to the date of the last follow‐up or to the date of histological documentation of the second NMSC. Survival analysis was conducted with the life‐table analysis. Cox's proportional hazards regression model was used to assess risk factors.Results  The study group comprised 535 cases. Of these, 120 patients presented a second NMSC (22.4%). Hazard rates remained high in all yearly intervals. Multivariate analysis showed older age, multiple tumours and male sex as significant prognostic factors. When the second NMSC was diagnosed in the first year of follow‐up, a trend to a high risk of further NMSCs was observed.Conclusions  The risk of a second NMSC is similar to other studies, although in the lower range. Prognostic factors are also similar to other studies. Yearly hazard rates not falling suggests that long‐term follow‐up is needed. Prospective studies including whole‐body examination could define the exact risk of a second NMSC.
Involvement of UV‐irradiation in pemphigus foliaceus
Authors: Igawa K , Matsunaga T , Nishioka K 
Published: February 2004

ABSTRACTUltraviolet (UV) light has been implicated in inducing acantholysis in the uninvolved skin of pemphigus patients. This report presents the case of a 55‐year‐old man with pemphigus foliaceus in whom skin lesions were induced and exacerbated by UV‐irradiation.
Postoperative reduplicative paramnesia in a patient with a right frontotemporal lesion
Authors: YAMADA Makiko , MURAI Toshiya , OHIGASHI Yoshitaka 
Published: February 2004

AbstractReduplicative paramnesia (RP) is a well recognized neurological phenomenon, characterized by a false belief that a familiar person or place has been duplicated. In the development of RP, right‐dominant frontal lesions are commonly observed. We report a 73‐year‐old woman who developed reduplication of people and places 3 months after the surgical removal of a large right frontotemporal meningioma. About 1 year after the surgery, her RP diminished after a small dose of risperidone. Neuropsychological evaluation was performed before surgery, after surgery when RP was present and again after recovery of RP. In accordance with the literature, the present case study suggests that a right hemispheric lesion is the essential neuroanatomical substrate in the development of RP. However, no single neuropsychological factor can fully explain the development and resolution of RP. Multiple factors, including neuroanatomical, cognitive and environmental factors seem to be dynamically involved.
Analysis of psychogeriatric patients in the psychiatric emergency system
Authors: NIIZATO Kazuhiro , SUZUKI Miho , KAWADA Fukashi , OSHIMA Kenichi , MATSUSHITA Masaaki 
Published: February 2004

AbstractBackground:  To date, there have been few studies about elderly psychiatric patients using psychiatric emergency services. In the present study, we analyze data from the Tokyo metropolitan psychiatric emergency system and the Tokyo Metropolitan Matsuzawa Hospital to examine the clinical features and social factors of elderly psychiatric patients hospitalized in psychiatric emergency units.Methods:  Over a 4 year period, from April 1998 to March 2001, there were 7971 patients (4520 men, 3451 women) who used the Tokyo Metropolitan Government's psychiatric emergency system. Of these 584 patients (337 men, 247 women) were elderly, over 60 years. Of these geriatric patients, 72 (45 men, average age 74.4 years; 27 women, average age 76.0 years) were received at Tokyo Metropolitan Matsuzawa Hospital from January 1999 to December 2001. The present study examines the reasons for hospitalization, legally mandated admission, diagnosis, psychiatric symptoms at admission, inappropriate behaviors, family status and disease complications.Results:  Epidemiological data showed that the number of geriatric patients has increased annually and the distribution of elderly patients’ diagnoses is entirely different from that of younger or middle‐aged patients’. Almost all geriatric patients were under mandatory hospitalization by Law Related to Mental Health and Welfare of the Person with Mental Disorder. Psychiatric symptoms and inappropriate behaviors were considered to be highly severe, like those of younger patients.Conclusion:  The importance of psychiatric emergency care for geriatric patients is strongly recognized by the present study. It is necessary to improve the present psychiatric medical system to develop a suitable and desirable system to care for geriatric patients.
Tiapride for pathological jealousy (Othello syndrome) in elderly patients
Authors: MUKAI Taijiro 
Published: February 2004

AbstractPathological jealousy can be seen in all generations. It is known to be difficult to treat, especially in older patients. In middle‐aged patients, it is commonly treated with neuroleptics like pimozide but in elder patients treatment options are limited because of the adverse side‐effects of neuroleptics, such as extrapyramidal syndrome. The present study documents the successful treatment of a 98‐year‐old Japanese man who showed pathological jealousy using tiapride without any adverse side‐effects. Concluding that tiapride might be considered the medicine of choice in all kinds of monodelusional disorders among the elderly.
Prevalence and predominance of Alzheimer type dementia in rural Japan
Authors: NAKAMURA Shiori , SHIGETA Masahiro , IWAMOTO Makoto , TSUNO Norifumi , NIINA Rie , HOMMA Akira , KAWAMURO Yu 
Published: February 2004

AbstractBackground:  The aim of the present study was to estimate prevalence rates of dementia and its subtypes in the population aged 65 years or more in a rural area of Japan.Methods:  A survey was conducted in Itoigawa, a city with 33 120 inhabitants in Niigata Prefecture, Japan. There were 7847 persons aged 65 years or older, and they comprised 23.4% of the total population. The first phase survey included questions on medical history, activities of daily living, psychiatric and behavioral symptoms and MMSE. When the responses were examined 6394 valid replies were received (81.5%) and 914 subjects were identified who were suspected of having dementia. In addition, 200 samples were selected randomly as controls from the 5480 people who were not suspected of dementia. The second phase survey was applied to a total of 1114 subjects. Pairs of psychiatrists and nurses made house‐to‐house visits and examined the subjects in detail. Clinical diagnoses of the subtypes of dementia were based on the criteria set out by the Consortium to Establish a Registry for Alzheimer's Disease and DSM IV.Results:  The prevalence rate of dementia was estimated at 6.2% (men 4.5%, women 7.4%), which is higher than that found by previous reports in Japan. Alzheimer type dementia was the most frequent diagnosis, accounting for 4.0%, followed by vascular dementia (1.2%), other type of dementia (0.3%) and unknown dementia (0.8%). ‘Questionable dementia’, as defined by the Clinical Dementia Rating 0.5, was found in 4.4% of respondents (men 6.3%, women 3.0%).Conclusions:  The prevalence of dementia in a rural area was higher than that of previous Japanese reports, and the prevalence rate of Alzheimer type dementia was much higher than that of vascular dementia.
Destination after discharge from a senile dementia therapy ward before and after the implementation of long‐term care insurance in Japan
Authors: NAKAGAWA Yasushi , TSUKAMOTO Shinobu , MIYAZAKI Miho , NAKAGAWA Chiyuki , YAMANAKA Takeharu , YAMASHITA Norifumi , NOHTOMI Akito 
Published: February 2004

AbstractBackground:  In Japan a new long‐term care insurance (LTCI) system, the so‐called ‘Kaigo‐Hoken’, was started in April 2000. The present study analyzes the change in the type of destination after discharge from a senile dementia therapy ward before and after the implementation of LTCI at Fukuoka Prefectural Onga Hospital, Japan.Methods:  The present study examines data from 199 inpatients discharged from the Fukuoka Prefectural Onga Hospital that had been diagnosed with dementia and met the DSM IV criteria for Alzheimer's type, vascular dementia or other type of dementia. For the purposes of comparison two periods were defined, ‘the first period’ was defined as the period from 1 April 1999 to 31 March 2000, before LTCI was implemented, while ‘the second period’ was defined as the period from 1 April 2000 to 31 March 2001, after LTCI had started. Subject data was analyzed on the basis of where the subject had resided pre‐admission and their destination after discharge using the following classifications: nursing home or geriatric care facility, hospitalization, home and death.Results:  While the certification rate of inpatients regarding long‐term care increased slightly in the second period, no significant change was observed based on where the subject had resided pre‐admission and their destination after discharge between the first and second periods.Conclusions:  While LTCI is essential for Japan, it is necessary that people with dementia in senile dementia therapy wards are encouraged to return to their homes under the care and support of LTCI.
Efficacy of combination treatment of fluvoxamine and tiapride for repetitive behaviors in frontotemporal lobar degeneration
Authors: MASAKI Yoshihiro , IKEJIRI Yoshitaka , NISHIKAWA Takashi , HATTA Naoki , KAZUI Hiroaki , TAKEDA Masatoshi 
Published: February 2004

AbstractThe present study reports a 63‐year‐old right‐handed man with frontotemporal lobar degeneration (FTLD) who manifested severe repetitive and disinhibited behaviors. Combination treatment of fluvoxamine and tiapride decreased the frequency of these behaviors. The results indicate that these drugs are effective for the treatment of repetitive and disinhibited behaviors for patients with FTLD. The behaviors caused by FTLD are discussed in terms of obsessive–compulsive spectrum disorder.
Donepezil increases regional cerebral blood flow in a case of Korsakoff syndrome
Authors: OGINO Atsushi , NISHIKAWA Takashi , SUGITA Yoshiro , TAKEDA Masatoshi 
Published: February 2004

AbstractCholinesterase inhibitors improve cognitive functions and regional cerebral blood flow (rCBF) in mild to moderate Alzheimer's disease (AD). Recently, the possibility has been suggested that in patients with dementia other than AD cholinesterase inhibitors are useful for the treatment of their cognitive impairment and behavioral symptoms. In the present study we report the effectiveness of donepezil for a patient with Korsakoff syndrome. The patient was a 65‐year‐old man who gradually showed disturbances in memory, attention and concentration. The etiology was considered to be alcoholism. He would indulge in drinking and repeatedly asked the same questions over and over. He also developed emotional fluttering and would not settle down. On admission, he showed a severe memory deficit, disorientation and momentary confabulation. It was obvious that the patient was inactive and not spontaneous. He also manifested disinhibited behaviors. The patient's confabulation gradually diminished in hospital. He had no focal neurological deficit. Cranial magnetic resonance imaging (MRI) did not reveal any abnormality. Single photon emission computed tomography (SPECT) with 99 m‐TC‐ hexamethyl propylamenamine oxide (HMPAO) indicated hypoperfusion in the left thalamus, left basal ganglia and bilateral medial temporal lobes. In order to improve his cognitive function, the patient was treated donepezil. An evaluation of the effects of donepezil on rCBF was performed with the images showing a remarkable improvement in cerebral perfusion in the right medial temporal, the left thalamus and basal ganglia. However, the patient's memory impairment, disorientation, disinhibition, and stereotypical behavior and utterance were not improved. As an explanation, it was speculated that his neural network might be damaged so severely that there was no room for improvement by the acetylcholinesterase inhibitors.
Nicergoline augmentation treatment of late onset depression
Authors: WATANABE Akira , IKEJIRI Yoshitaka , TAKEDA Masatoshi 
Published: February 2004

AbstractBackground:  Elderly patients with depression have more ischemic lesions on magnetic resonance imaging (MRI) of the brain than those without depression. Therefore, late onset depression might be associated with neurobiological etiology, especially vascular lesions of the brain. Recently nicergoline, which is an ergoline derivative and increases cerebral blood flow, has been reported to be effective for vascular depression. However, it remains unclear whether late onset depression without ischemic lesions or vascular risk factors can be improved by this compound.Methods:  The present study reports the case of a 69‐year‐old woman with depression, which consisted of mild depressive mood, severe loss of drive and appetite, and moderate cognitive impairment that developed over 8 months. Treatment with 150 mg of sulpiride, 40 mg of paroxetine hydrochloride, and 0.5 mg of etizolam everyday for 5 months had no effect on the patient. MRI of the brain showed mild cortical atrophy in the bilateral frontal and parietal lobes with no remarkable ischemic lesions. A mild decrease of relative cerebral blood flow (CBF) in the atrophic regions was shown by 99mTc‐HMPAO single photon emission computed tomography (SPECT). After sulpiride treatment was discontinued, the patient took 15 mg of nicergoline daily in addition to selective serotonin reuptake inhibitor (SSRI) treatment.Results:  The patient's symptoms were improved after 2 weeks and 99mTc‐HMPAO SPECT of the brain showed a slight improvement of relatively decreased CBF in the regions.Conclusion:  Nicergoline might have a therapeutic potential as an augmentation strategy for late onset depression.
Prediction of the press-fit curve in the assembly of a railway axle and wheel
Authors: Benuzzi D , Donzella G 
Published: February 2004

A methodology for the prediction of the press-fit curve in the assembly of a railway axle and wheel is described. It starts from friction measurements on samples taken directly from the two components. A new apparatus, adaptable to a common axial testing machine, was developed for this aim: it permits the contact pressure and sliding speed to be varied in order to change the lubrication condition of the contact surfaces. Two calculation models are then proposed to predict the press-fit curves. They take the results of the friction measurements as input data, together with the wheelset geometry, the design interference and the material characteristics. The first one is a finite element method (FEM) model, which is very accurate but difficult to use, which also allows the effect of the wheel seat chamfer and the oil injection grove to be assessed. The second one is a simplified analytical model based on the theory of axisymmetric bodies, which works on an approximate wheel geometry; nevertheless, it gives results in good agreement with those of the FEM model and with the experimental press-fit curves of the examined wheelsets. Moreover, the simplified model is very fast and easy to use, thus constituting a powerful and useful tool for the design of new wheelsets.
The making of local child daycare regimes: past and future
Authors: Randall Vicky 
Published: February 2004

English
The government's new child daycare policy, based on local ‘partnerships’, must reckon with tremendous local diversity of provision. This article draws on case studies of six English local authorities – Barnet, Kensington and Chelsea, Leeds, Manchester, Oxfordshire and North Tyneside – first to characterise more fully this variation of local daycare regimes and second, to explore the role played in shaping and modifying these regimes by local party and gender politics. The conclusion considers implications for local responses to recent national childcare initiatives.