Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Autologous Cultured Melanocytes in Vitiligo Treatment

BACKGROUND Surgical treatment of vitiligo is indicated when lesions are localized in poorly responding areas. OBJECTIVES The objectives were: (1) to establish the melanocyte culture obtained from the epidermis of vitiligo patients for future treatment; (2) to estimate the influence of selected factors on the formation of suction blisters and the results of culture; and (3) to compare the results of treatment of vitiliginous macules localized in the dorsum of the hands and lower limbs by transplantation of cultured autologous melanocytes plus psoralen and ultraviolet A (PUVA) therapy (CMP), suction blister transplantation plus PUVA therapy (SBP), cryotherapy plus PUVA-therapy (CP), and only PUVA therapy (OP). METHODS Forty patients were qualified for the study. The roofs of the suction blisters were used as a melanocyte source for culture establishment or were directly transplanted. RESULTS The CMP procedure was successfully performed on only 10 of 20 patients because of the difficulties in cell culture establishment. The SBP method was carried out on all 20 patients. A total lack of effectiveness was found in CP and OP methods. CONCLUSIONS The effectiveness of culture depends on time of suction blister forming, phototype, and previous PUVA therapy. This study demonstrated the advantage of the SBP over the CMP method. [source]

A Painless Subungual Osteoid Osteoma

Pelin Ekmekci MD
Background. Osteoid osteoma is a benign bone tumor. Its etiology is not fully understood and the role of trauma is still elusive. Objective. Osteoid osteoma mostly presents with a poorly localized pain that is worst at night and characteristically relieved by salicylates. It usually occurs on the weight-bearing bones of the lower extremities, but toe location is quite rare. Here, we present a case of painless osteoid osteoma located subungually on the dorsum of the great toe. Result. A 29-year-old woman presented with a painless subungual mass on the dorsum of her great toe. Subungual exotosis, osteochondroma, and osteoma were considered in the differential diagnosis and the lesion was totally excised. Histopathologic examination showed characteristic findings of osteoid osteoma. Conclusion. A painless osteoid osteoma is rarely seen and it can be easily misdiagnosed if it occurs in an atypical location such as the subungual area. [source]

Dermoscopy provides useful information for the management of melanonychia striata

Luc Thomas
ABSTRACT:, The diagnosis of melanonychia striata is often difficult, and a biopsy of the nail matrix is required in doubtful cases. However, dermoscopic examination of the nail plate offers interesting information in order to better select the cases in which pathologic examination is indicated. In the case of brown longitudinal pigmentation with parallel regular lines, the diagnosis of nail apparatus melanocytic nevus could be made. On the other hand, the presence of a brown pigmentation overlaid by longitudinal lines irregular in their thickness, spacing, color, or parallelism is highly in favor of a melanoma. Gray homogeneous lines are observed in case of lentigo, lentiginoses, ethnic or drug-induced pigmentations, and in post-traumatic pigmentations. Blood spots are characterized by their round-shaped proximal edge and their filamentous distal edge and are highly suggestive of subungual hemorrhages. Dermoscopic examination of the free edge of the nail plate gives information on the lesion location; pigmentation of the dorsum of the nail plate is in favor of a proximal nail matrix lesion, whereas pigmentation the lower part of the nail edge is in favor of a lesion of the distal matrix. [source]

Association of Coronary Sinus Diameter with Pulmonary Hypertension

Yilmaz Gunes M.D.
Background: Impaired venous drainage secondary to increased right atrial pressure (RAP) may result in coronary sinus (CS) dilatation.,Methods: Two hundred fifteen patients referred for transthoracic echocardiography were included in the study. CS diameters were measured from apical four-chamber view with the transducer being slightly tilted posteriorly to the level of the dorsum of the heart. Pulmonary artery systolic pressure (PASP) is estimated by measurement of tricuspid regurgitation velocity (v) and estimate RAP based on size and collapsibility of inferior vena cava (VCI) with the formula PASP: 4v2+RAP. Patients with PASP >35 mmHg were considered to have pulmonary hypertension (PH).,Results: CS diameter was measured in 80.3% of the patients with normal PASP (8.1 ± 2.4 mm) and 93.1% of the patients having PH (12.3 ± 2.5 mm). PASP was significantly correlated with CS diameter (r = 0.647, P < 0.001), RA volume index (r = 0.631, P < 0.001), RV volume index (r = 0.475, P < 0.001), VCI diameter (r = 0.365, P < 0.001), and left ventricular ejection fraction (LVEF) (r =,0.270, P < 0.001). CS diameter was also correlated significantly with estimated RAP (r = 0.557, P < 0.001), RA volume index (r = 0.520, P < 0.001), RV volume index (r = 0.386, P < 0.001), LVEF (r =,0.327, P < 0.001), and VCI diameter (r = 0.313, P < 0.001). Multivariate analyses, testing for independent predictive information of CS size, VCI diameter, RA and RV volume indexes, and estimated RAP for the presence of PH revealed that estimated RAP (beta = 0.465, P < 0.001) and CS size (beta = 0.402, P = 0.003) were the significant predictors.,Conclusions: Coronary sinus is dilated in patients with pulmonary hypertension. Coronary sinus diameter significantly correlates with PASP, RAP, right heart chamber volumes, LVEF, and VCI diameter. [source]

Assortative mating between adjacent populations of threespine stickleback (Gasterosteus aculeatus)

R. J. Scott
Abstract,,, The idea that sexual selection can lead to rapid evolution of premating isolation among independent populations (speciation) has been controversial, but is rapidly gaining acceptance among many evolutionary biologists as empirical examples accumulate. A survey of male signals and female preferences (mate recognition systems, MRSs) across the contact zone between divergent populations of threespine stickleback (Gasterosteus aculeatus) in Conner Creek, WA, revealed a spatial pattern of MRSs that is consistent with speciation via sexual selection. Females from locations that possessed melanic males preferred melanic males whereas females from populations possessing typical mosaic males (red chin, blue iris, and blue-green dorsum) preferred mosaic males. I argue that sensory drive sexual selection, acting through geographically varying spectral properties, is responsible for the observed population differences and premating isolation between the adjacent populations. [source]

Characteristics of skin aging in Korean men and women

J. H. Chung
Introduction Korea is located between Japan and Mainland China. The people of these three countries have similar appearances and it is difficult to differentiate between them. Although the population of Asia is more than half of the total population of the Earth, the inherent characteristics of Asian skin have not been well investigated. Commercial markets for cosmetics and drugs for photoaged skin are rapidly expanding in many Asian countries. Therefore, many investigators in the field of dermatology and cosmetology have become interested in brown Asian skin. Clinical characteristics of skin aging and photoaging in Asians Skin aging can be divided into two basic processes: intrinsic aging and photoaging [1]. Intrinsic aging is characterized by smooth, dry, pale, and finely wrinkled skin, whereas photoaging, which indicates premature skin aging in chronically photodamaged skin, is characterized by severe wrinkling and irregular pigmentation. The pattern of wrinkling in Asians seems to differ from that in Caucasians. Asians have coarser, thicker and deep wrinkles, particularly in the forehead, perioral and Crow's foot areas. In contrast, Caucasians usually have relatively fine cheek and Crow's foot wrinkles. The reasons for these differences are not known and need further investigation. There are racial, ethnic and genetic differences, and differences of skin structure and function, between the brown skin of Asians and the white skin of Caucasians. As Asian skin is more pigmented, acute and chronic cutaneous responses to UV irradiation differ from those in white skin. Many people believe, based on clinical impressions, that the main process of photoaging in Asians involves pigmentary changes, rather than wrinkling. However, no study has been performed to confirm this belief. Risk factors for skin wrinkles and their relative risks in Korean skin [2] Various factors such as age, sun-exposure, and smoking are known to be important risk factors for wrinkles. However, the relative risks of each factor on wrinkles in the brown skin of Asians have not been investigated, and they could differ from those in Caucasians. An evaluation system for skin wrinkling is necessary for Asian skin [3]. Thus, we developed an eight-point photographic scale for assessing wrinkles in both Korean genders [2]. This scale can probably be applied to the populations of other Asian countries, at least to the Japanese and Chinese. The pattern of wrinkles in both genders appears to be similar. Age Age is an important risk factor for wrinkling in Asians, as in Caucasians. Korean subjects in their 60s showed a 12-fold increased risk of wrinkling, while subjects in their 70s have a 56-fold increased risk compared with young age group. UV light It is well known that the UV component in sunlight can cause and accelerate photoaging. The pigmented skin of Asian may better protect skin from acute and chronic UV damage. However, we found a strong association between sun-exposure and the development of wrinkling in Koreans. It was found that sun exposure of more than 5 h per day was associated with a 4.8-fold increased risk in wrinkling versus less than 2 h of sun-exposure in Koreans. Estrogen deficiency Korean females have more wrinkles than men, after controlling for age, sun exposure, and smoking, it was found that they have a 3.6-fold increased risk of developing wrinkles than their male counterparts [2]. It has also been reported, that the relative risk for wrinkling in women is higher than in men as for in white Caucasians [4]. The reason why women show more wrinkles remains to be determined. It is possible that a reduction in skin collagen because of estrogen deficiency in postmenopausal woman may aggravate wrinkling severity. Korean women with more than 10 years since menopause showed a 3.9-fold higher risk of wrinkling than the women 5 years of beyond menopause [5]. We demonstrated that women with a history of HRT have a significantly lower risk, more specifically, one fifth of the risk of facial wrinkling relative to those who had no history of HRT. Interestingly, we found that wrinkle severity significantly increased with an increasing number of full term pregnancies. The relative risk for severe wrinkling is increased by approximately 1.8-fold per full term pregnancy. Smoking It is known that smoking causes skin wrinkling in Caucasians, and that it plays no role in Blacks [6, 7]. Koreans with have a smoking history of more than 30 pack years showed a more than 2.8-fold increased risk of wrinkles [2]. The relative risks of wrinkles associated with a 30,50 pack-years history of smoking were 2.8- and 5.5-fold, respectively. Dyspigmentation in Asian skin To follow pigmentary changes, six photographic standards for both genders were developed for Korean skin, to produce a 6-point scale [2, 8]. Hyperpigmented spots, mostly lentigines, were prominent among women, while seborrheic keratosis tended to be more prominent in men. Seborrheic keratosis in Korean men Seborrheic keratoses (SKs) are benign cutaneous tumors. They have diverse clinical and histopathological appearances and are very common in the elderly (over 50 years old). The etiology of SKs is not well understood, although patients with a great number of lesionsshow a familial trait with an autosomal dominant pattern, and human papilloma virus has been suggested as possible cause because of verrucous appearance of the lesions. Exposure to sunlight has been suggested to be a risk factor for SKs. However, there is still some debate in terms of the role of sunlight. Recently, we have investigated the clinical characteristics of SKs and relationship between SKs and sunlight exposure in Korean males [9]. The prevalence of SKs in Koreans increases with age; it rose from 78.9% at 40 years, to 93.9% at 50 years and 98.7% in those over 60 years. Exposed areas, i.e. the face, neck and dorsum of the hands, demonstrate a significant increase in the prevalence of SKs by decade, whereas partly exposed areas, although SKs tended to increase in prevalence with age, this trend was not significant. When the estimated body surface area (BSA) is taken into account, the number of SKs on both the face and dorsum of the hands (0.51 ± 0.08 per 1% BSA) was over-represented compared with the trunk. SKs were also concentrated on the neck (0.38 ± 0.07 per 1% BSA) and in the V-area (0.47 ± 0.09 per 1% BSA). Outer forearms also showed 3-fold more SKs per unit area than neighboring arms and inner forearms, which are classified as partly exposed area (0.09 ± 0.02, 0.03 ± 0.01, respectively). The total area covered by SKs on exposed area also became significantly larger with aging than on intermittently exposed areas. These results indicate that exposure to sunlight might be related to SK growth. Our results indicated that excessive sun exposure is an independent risk factor of SKs. After controlling for age, smoking, and skin type, subjects with a sun exposure history of more than 6 hours per day showed a 2.28-fold increased risk of having severe SKs (n , 6) compared with those exposed for less that 3 h per day. These findings indicated that sun-exposure may play an important role in SK development. In summary, SKs are very common in Korean males and represent one of the major pigmentary problems. SKs concentrate on exposed skin, especially on the face and dorsum of the hands. Both age and lifetime cumulative sunlight exposure are important contributing factors and may work in a synergistic manner. Conclusion Many people tend to believe that wrinkles are not a prominent feature of Asian photoaged skin, and that dyspigmentation is a major manifestation in Asian skin. Contrary to this impression, wrinkling is also a major problem in the photoaged skin of Asians, and Korean people showing severe pigmentary changes usually tend to have severe wrinkles. In conclusion, the wrinkling patterns and pigmentary changes of photoaged skin in East Asians differ from those of Caucasians, and the relative risks of aggravating factors may be different from those of Caucasian skin. References 1.,Gilchrest, B.A. Skin aging and photoaging: an overview. J. Am. Acad. Dermatol. 21, 610,613 (1989). 2.,Chung, J.H. et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch. Dermatol. 137, 1043,1051 (2001). 3.,Griffiths, C.E. et al. A photonumeric scale for the assessment of cutaneous photodamage. Arch. Dermatol. 128, 347,351 (1992). 4.,Ernster, V.L. et al. Facial wrinkling in men and women, by smoking status. Am. J. Public Health. 85, 78,82 (1995). 5.,Youn, C.S. et al. Effect of pregnancy and menopause on facial wrinkling in women. Acta Derm. Venereol. 83, 419,424 (2003). 6.,Kadunce, D.P. et al. Cigarette smoking: risk factor for premature facial wrinkling. Ann. Intern. Med. 114, 840,844 (1991). 7.,Allen, H.B., Johnson, B.L. and Diamond, S.M. Smoker's wrinkles? JAMA. 225, 1067,1069 (1973). 8.,Chung, J.H. Photoaging in Asians. Photodermatol. Photoimmunol. Photomed. 19, 109,121 (2003). 9.,Kwon, O.S. et al. Seborrheic keratosis in the Korean males: causative role of sunlight. Photodermatol. Photoimmunol. Photomed. 19, 73,80 (2003). [source]

Finger pebbles in a diabetic patient: Huntley's papules

Claudio Guarneri MD
A 60-year-old obese man was referred to our department from the internal medicine unit. He had a 20-year history of poorly controlled diabetes (no other cases in the family), and was admitted to hospital because of respiratory and consequent heart failure. Skin examination showed diffuse xerosis and a rough, sandpaper-like appearance of the skin of the finger, of approximately 15 years' duration, consisting of multiple, minute, hyperkeratotic papules grouped in a miniature "cobblestone" pattern on the dorsum of the distal phalanges (Fig. 1), more dense over the knuckles and the interphalangeal joints. No pruritus was present. Figure 1. Pebbly pattern of the skin on the dorsum of the second digit He was a pensioner, who had been physically inactive for months previously, and this condition had occurred progressively in the absence of any known trauma. No other cutaneous manifestations were evident. Histologic examination was performed using hematoxylin and eosin staining of a biopsy specimen taken from the left second finger; it displayed a hyperorthokeratotic epidermis with enlarged dermal papillae, thickened and vertically oriented collagen bundles, few elastic fibers, and a mild perivascular inflammatory infiltrate (Fig. 2). Figure 2. Histologic view of a biopsy specimen of the skin of the finger: the epidermis is hyperkeratotic, the dermal papillae are enlarged and there are thickened vertical collagen bundles, elastic fibers, and a mild perivascular inflammatory infiltrate (hematoxylin and eosin stain; original magnification, ×100) [source]

Effects of sevoflurane on collagen production and growth factor expression in rats with an excision wound

Background: Sevoflurane is a widely used inhalation anesthetic, but there are no studies on its effect on the wound-healing process. This study was undertaken to evaluate the effect of exposure time to sevoflurane on wound healing. Method: Male Sprague,Dawley rats were used. Two circular full-thickness skin defects 8 mm in diameter were made on the dorsum of the rats. The animals were divided into six groups according to exposed gas type and time: S1 (sevoflurane, 1 h), S4 (sevoflurane, 4 h), S8 (sevoflurane, 8 h), O1 (oxygen, 1 h), O4 (oxygen, 4 h), and O8 (oxygen, 8 h). The surface area of the wounds was measured 0, 1, 3, and 7 days after surgery. Separately, the mean blood pressures (MBP) and arterial oxygen pressures (PaO2) were monitored during the sevoflurane exposure. Collagen type I production and transforming growth factor-,1 (TGF-,1) and basic fibroblast growth factor (bFGF) expression on the wound surface were analyzed. Routine histological analysis was also performed. Result: Exposure duration to sevoflurane had no influence on MBP and PaO2. The reduction in wound size and collagen type I production was delayed in S8. The expression of TGF-,1 and bFGF on the wound surface in S8 was significantly attenuated in S8. The histology of the S8 demonstrated a delayed healing status. Conclusions: Prolonged exposure to sevoflurane might alter the inflammatory phase of the wound-healing process by attenuation of growth factor expression such as TGF-,1 and bFGF and subsequently by reduced collagen production. [source]

A unique variant of Darier's disease

Christopher M. Peterson MD
A 45-year-old black woman presented with a chief complaint of an increasing number of ,,light spots'' on her face, upper trunk, and legs. She had a 4-year history of a pruritic eruption on the dorsum of her hands. The eruption was particularly pruritic in the summer months. Other family members, including her sister and her daughters, reportedly had a similar dermatologic problem. The patient had been previously evaluated and biopsied by another dermatologist. The earlier biopsy was nondiagnostic, however, and she presented for further evaluation of this problem. On physical examination, the patient had hypopigmented macules along her jawline (Fig. 1), lateral neck, and upper chest. She had similar hypopigmented macules on her thighs. She had hyperkeratosis of the palmoplantar surface of her hands and feet. The dorsum of her hands had numerous coalescing, shiny, flat-topped, hypopigmented papules (Fig. 2), and several of her fingernails had distal, V-shaped notching. Figure 1. Hypopigmented macules on the cheek and along the jawline Figure 2. Coalescing, hypopigmented papules on the dorsal aspect of the fingers and hand, with distal notching of the fingernails A punch biopsy from a papule on the dorsum of her hand was obtained. The epidermis had corps ronds present with focal areas of acantholysis above the basal layer (Fig. 3). The dermis had sparse, superficial, perivascular infiltrates composed of lymphocytes and histiocytes. These changes were consistent with our clinical diagnosis of Darier's disease (keratosis follicularis). Figure 3. Corps ronds (large arrow) and focal acantholysis with suprabasal clefts (small arrow) are present in the epidermis (hematoxylin and eosin; original magnification, ×,40) [source]

Mucous membrane pemphigoid, thymoma, and myasthenia gravis

Haideh Yazdani Sabet
In November 1997, approximately 1 year before being evaluated at the Mayo Clinic, Rochester, a 63-year-old woman presented with erosive tongue lesions that were diagnosed by her physician as oral lichen planus. The lesions responded well to 3 months of treatment with systemic and topical corticosteroids and topical antiyeast medication. She stopped taking the medications and had a relapse. A few months after the oral lesions developed, her left eyelid became ptotic. Results of magnetic resonance imaging of her brain were normal, and the ptosis resolved spontaneously after 2 weeks. One year later, her right eyelid began to droop, and the results of edrophonium testing were positive. She was prescribed prednisone, 30 mg daily, and pyridostigmine, as needed. The ptosis improved, but never fully resolved. Radiography revealed a left ,,thyroid nodule,'' but computed tomography did not show a mediastinal mass. She was advised to have the ,,nodule'' removed surgically and came to the Mayo Clinic, Rochester, for a second opinion. Her medical history was significant for the following: tinnitus, glaucoma, early bilateral cataracts, and long-standing hypertension, for which she took losartan, 50 mg twice daily. Other medications included: prednisone, 30 mg daily; pyridostigmine as needed; famotidine, 40 mg daily; and eyedrops for glaucoma. She denied any history of hyperthyroidism or hypothyroidism, head and neck irradiation, family history of thyroid disease, or diplopia. Hepatitis serologic studies revealed hepatitis B exposure and recovery, hepatitis C immunity, and a previous hepatitis A viral infection. On examination at the Mayo Clinic, Rochester, an erosive hypertrophic plaque was noted on the posterior dorsal half of the tongue, and vesicles and erythematous erosions on the hard and soft palates ( Fig. 1a). A lace-like white pattern was seen on the buccal mucosa bilaterally, and a small erosive patch on the left buccal mucosa ( Fig. 1b). Ocular and nasal mucous membranes were normal in appearance, and there were no pertinent skin findings. Dermatopathologic examination of an excisional biopsy specimen from the left dorsum of the tongue demonstrated an ulcer with epitheliomatous hyperplasia and a granulomatous reaction, presumably due to yeast infection. Silver staining showed hyphae and yeast at the base of the tongue ulcer. The results of the direct immunofluorescence study were negative and revealed no lichenoid changes on hematoxylin and eosin staining. Indirect immunofluorescence testing of the serum revealed a 1 : 80 titer of basement membrane zone antibodies, reflecting pemphigoid. This test was positive on repeat study. Salt-split skin on monkey esophagus revealed an epidermal pattern of basement membrane zone antibodies. Treatment included fluocinonide gel applied to the involved areas four times daily and oral antiyeast therapy (fluconazole, 200 mg once daily by mouth) while the rest of the evaluation was being completed. Figure 1(a). Erosive hypertrophic tongue plaque. Figure (b) ,. Erosive patch on the buccal mucosa. As part of the evaluation of the ptosis, a myasthenia gravis antibody panel was performed. It revealed the following abnormalities: striated muscle antibody at 1 : 480 (reference range, <1 : 60), acetylcholine receptor binding antibody at 6.33 nmol/L (reference range, ,,0.02 nmol/L), acetylcholine receptor blocking antibody at 31% (reference range, 0,25%), and acetylcholine receptor modulating antibody at 100% (reference range, 0,20%), suggesting thymoma. Treatment included pyridostigmine, 30,45 mg 3,4 times daily, to control the myasthenia symptoms, while the ill-defined neck mass was being evaluated. A mildly enlarged thyroid was noted on physical examination. Hematology panel revealed thyroid-stimulating hormone (TSH) levels in the low normal range; the thyroid microsomal antibody was normal. Chest radiography showed minor tracheal deviation, and a previous computed tomogram showed what appeared to be a 3-cm enlarged mass in the thyroid. Ultrasonographically guided thyroid biopsy did not show malignancy, but a benign mesenchymal-type tumor was found and surgical excision was planned. Intraoperatively, a thymoma of the left cervical thymic tongue was found. At 6 months' follow-up, the ptosis and oral mucosal lesions had improved significantly, although she continued topical corticosteroid therapy intermittently for minor erosive oral disease. [source]

Morphological study of the lingual papillae of the giant panda (Ailuropoda melanoleuca) by scanning electron microscopy

J. F. Pastor
Abstract Due to the scarcity of giant pandas, there are few descriptions of their morphology and even fewer of their microscopic anatomy and the ultrastructure of their organs. In this study of the complete tongue of an adult male giant panda, we describe the morphology of its lingual surface, the different types of papillae, their characteristics and topographic distribution. It was seen that there are four main types of lingual papillae: filiform, conical, fungiform and vallate. There was no sign of foliate papillae, tuberculum intermolare or sublingua. Papilla distribution was not limited to the dorsum of the tongue, but was also seen on the anterior and ventral surfaces of the tongue. In the anterior third of the midline there is a smooth area with no papillae at all. Morphology of the microgrooves and pores is similar to that observed in other mammals. The papillae share characteristics encountered in Carnivora and herbivorous species of mammals. A narrow bamboo-based diet and specialized manner of eating have together resulted in modification of the tongue of a carnivoran, giving it some characteristics typical of an herbivore. [source]

Respiratory hypersensitivity to trimellitic anhydride in Brown Norway Rats: a comparison of endpoints

Jürgen Pauluhn
Abstract A rat bioassay has been developed to provide an objective approach for the identification and classification of respiratory allergy using trimellitic anhydride (TMA), which is a known respiratory tract irritant and asthmagen. Particular emphasis was placed on the study of route-of-induction-dependent effects and their progression upon inhalation challenge with TMA (,23 mg m,3 for a duration of 30 min), which included analysis of specific and non-specific airway hyperreactivity and pulmonary inflammation initiated and sustained by immunological processes. Refinement of the bioassay focused on procedures to probe changes occurring upon challenge with TMA or methacholine aerosols using physiological, biochemical and immunological procedures. Following challenge with TMA, the rats sensitized to TMA showed marked changes in peak inspiratory and expiratory air flows and respiratory minute volume. In these animals, a sustained pulmonary inflammation occurred, characterized by specific endpoints determined in bronchoalveolar lavage (lactate dehydrogenase, protein, nitrite, eosinophil peroxidase, myeloperoxidase). When compared with the naive controls, lung weights were increased significantly, as were the weights of lung-associated lymph nodes following inhalation induction and auricular lymph nodes following topical induction. The extent of changes observed was equal or more pronounced in animals sensitized epicutaneously (day 0 : 150 µl vehicle/50% TMA on each flank, day 7; booster administration to the skin of the dorsum of both ears using half the concentration and volume used on day 0) when compared with rats sensitized by 5 × 3 h day,1 inhalation exposures (low dose: 25 mg TMA m,3, high dose: 120 mg TMA m,3). In summary, the findings support the conclusion that the Brown Norway rat model is suitable for identifying TMA as an agent that causes both an immediate-type change of breathing patterns and a delayed-type sustained pulmonary inflammatory response. However, it remains unresolved whether the marked effects observed in the topically sensitized rats are more related to a route-of-induction or dose-dependent phenomenon. Copyright © 2002 John Wiley & Sons, Ltd. [source]

In vivo antimicrobial effectiveness of an essential oil-containing mouth rinse 12 h after a single use and 14 days' use

D. H. Fine
Abstract Objectives: Two studies were conducted to determine the antimicrobial effect of rinsing with an essential oil-containing mouth rinse 12 h after a single rinse and 12 h after 2 weeks of twice daily rinsing, during the daytime and overnight. Materials and Methods: These studies utilized a randomized, double-blind, controlled crossover design. Following baseline sampling of bacteria from supragingival plaque and the dorsum of the tongue, subjects began twice-daily rinsing with either an essential oil mouth rinse containing 0.09% zinc chloride (Tartar Control Listerine® Antiseptic) or a negative control rinse. Bacterial sampling was repeated 12 h after the first rinse, and again 12 h after the final rinse 14 days later. The sampling schedule was adjusted according to whether the study was investigating daytime or overnight activity. Samples were plated on Schaedlers medium (total anaerobes), Schaedlers Nalidixic/Vancomycin medium (Gram-negative anaerobes), and OOPS medium (volatile sulphur compound (VSC)-producing organisms). Inter-group log10 transformed colony-forming units /ml counts from samples of supragingival plaque and tongue swabs on each of the three media were compared by analysis of covariance. Results: The mean bacterial counts in subjects using the essential oil mouth rinse were significantly lower (p0.005) than mean counts in subjects using the control rinse in all the comparisons, i.e., tongue and supragingival plaque samples on each of three media at two sampling periods in the daytime and overnight study, respectively. Mean bacterial count percent reductions for plaque samples ranged from 56.3 to 95.3; percent reductions for tongue samples ranged from 61.1 to 96.1. There was a trend to higher reductions after 14 days' rinsing than after the initial rinse. Conclusion: Rinsing with the essential oil mouth rinse can have long-lasting effects in reducing anaerobic bacteria overall as well as Gram-negative anaerobes and VSC-producing bacteria. The significant reductions in numbers of these bacteria produced by the essential oil mouth rinse, both in plaque and on the dorsum of the tongue, can play a key role in explaining the essential oil mouth rinse's effectiveness in reducing supragingival plaque and gingivitis as well as its effectiveness in controlling intrinsic oral malodor over prolonged periods. [source]

Tongue coating and salivary bacterial counts in healthy/gingivitis subjects and periodontitis patients

S. Mantilla Gómez
Abstract Background: The papillary structure of the dorsum of the tongue forms a unique ecological site that provides a large surface area favoring the accumulation of oral debris and microorganisms. These micro-organisms of the tongue may be of influence on the flora of the entire oral cavity. The normal appearance of the dorsum of the tongue is either pinkish or has a thin white coating. For the present study a scoring method was developed to describe the appearance of the dorsum of the tongue in relation to the extent of color and thickness of tongue coating. Aim: The purpose of this study was to investigate the discoloration and coating of the tongue in healthy/gingivitis subjects and periodontitis patients. Furthermore, to determine the relationship between the appearance of the tongue and the bacterial load in salivary samples. Material and Methods: 2 groups of patients were studied, 70 healthy/gingivitis subjects and 56 periodontitis patients. After scoring of the tongue a salivary sample of each patient was taken and analyzed using a phase-contrast microscope. Results: This investigation showed that most discoloration was found on the distal part of the tongue. The mean number of bacteria per ml sample in relation to a pink, white and yellow appearance of the tongue was 948, 855 and 900 (×106) respectively. The mean number of bacteria per ml sample in relation to no, thin and thick coating was 948, 863, and 895 (×106), respectively. Analysis did not reveal a relationship between discoloration, coating thickness and total bacterial load. The mean number of bacteria per ml in healthy/gingivitis subjects was 860 and in periodontitis patients 918 (×106). Conclusion: No relationship between the appearance of the tongue and salivary bacterial load could be detected. There was no difference in bacterial load between the healthy/gingivitis and the periodontitis group within the present study population. Zusammenfassung Hintergrund: Die papilläre Struktur des Zungenrückens bildet eine einheitliche ökologische Oberfläche, die eine große Oberfläche vermittelt, was die Akkumulation von oralem Belag und Mikroorganismen favorisiert. Diese Mikroorganismen der Zunge können die Flora der gesamten Mundhöhle beeinflussen. Die normale Erscheinung des Zungenrückens ist eher pinkfarben oder hat einen dünnen, weißen Belag. Für die vorliegende Studie wurde eine Meßmethode entwickelt, um die Erscheinung des Zungenrückens in Beziehung zum Ausmaß der Farbe und der Dicke des Zungenbelags zu beschrieben. Ziel: Der Zweck der Studie war die Untersuchung der Verfärbung und der Belagbildung auf der Zunge bei gesunden bzw. Gingivitis-Personen und Parodontitis-Patienten. Weiterhin sollte die Beziehung zwischen der Erscheinung der Zunge und dem bakteirellen Gehalt in Speichelproben bestimmt werden. Material und Methoden: 2 Gruppen von Patienten wurden untersucht, 70 gesunde bzw. Gingivitis-personen und 56 Parodontitis-Patienten. Nach der Beurteilung der Zunge wurde von jedem Patienten eine Speichelprobe genommen und mit einem Phasenkontrastmikroskop untersucht. Ergebnisse: Die Ergebnisse zeigten, daß die meiste Verfärbung der Zunge am distalen Teil gefunden wurde. Die mittlere Anzahl der Bakterien pro ml Speichel in Beziehung zu einer pinkfarbigen, weißen und gelben Erscheinung der Zunge was 948, 855 oder 900 (×106). Die mittlere Anzahl der Bakterien pro ml Speichel in Beziehung zu keinem, zu dünnem oder zu dickem Belag war 948, 863 oder 895 (×106). Die Analyse zeigte keine Beziehung zwischen Verfärbung, Belagsdicke und totalem Bakteriengehalt. Die mittlere Anzahl von Bakterien pro ml bei gesunden bzw. Gingivitis-Personen war 860 und bei Parodontitis-Patienten 918 (×106). Zusammenfassung: Es konnte kein Beziehung zwischen der Erscheinung der Zunge und dem bakteriellen Gehalt entdeckt werden. Es gab keine Differenzen im bakteriellen Gehalt zwischen den gesunden bzw. Gingivitis-Personen und den Parodontitis-Patienten innerhalb der vorliegenden Studienpopulation. Résumé Origine: La structure papillaire du dos de la langue forme un site écologique unique qui comporte une large surface favorisant l'accumulation de débris buccaux et de micro-organismes. Ces derniers peuvent avoir une influence sur la flore de l'ensemble de la cavité buccale. L'apparence normale du dos de la langue est rosée ou possède un très fin recouvrement blanc. Une méthode d'échellonnage a été développée afin de décrire l'apparence du dos de la langue en relation avec l'ampleur de la couleur et l'épaisseur du recouvrement de la langue. But: Le but de cette étude a été d'étudier la décoloration et le recouvrement de la langue chez des sujets sains/avec gingivite et parodontite. De plus la relation entre l'apparence de la langue et la charge bactérienne dans les échantillons salivaires a été déterminée. Matériaux et méthodes: 2 groupes de patients ont étéétudiés, 70 sujets sains ou avec gingivite et 56 patients avec parodontite. Après avoir évalué la langue, un échantillon salivaire de chaque patient a été prélevé et analysé en utilisant un microscope à contraste de phase. Résultats: Les résultats ont montré que la plupart de la décoloration était trouvée dans la partie distale de la langue. Le nombre moyen de bactéries par ml d'échantillon en relation avec la couleur rose, blanche ou jaune était respectivement de 948, 855 et 900 (×106). Le nombre moyen de bactéries par ml d'échantillon en relation avec un recouvrement inexistant, fin ou épais était respectivement de 948, 863 et 895 (×106). L'analyse n'a pas mis en évidence une relation entre la décoloration, l'épaisseur de recouvrement et la charge bactérienne totale. Le nombre moyen de bactéries par ml chez des sujets sains/gingivite était de 860 et chez les patients avec parodontite de 918 (×106). Conclusion: Aucune relation entre l'apparence de la langue et la charge bactérienne salivaire n'a donc pûêtre détectée. Il n'y avait aucune différence dans la charge bactérienne entre le groupe sain/gingivite et le groupe parodontite dans la population étudiée. [source]

Occurrence of Prevotella intermedia and Prevotella nigrescens in relation to gingivitis and gingival health

M. A. Lie
Abstract Aim: The occurrence of Prevotella intermedia (Pi) and Prevotella nigrescens (Pn) in relation to natural gingivitis, gingival health and 14-day experimental gingivitis was investigated in 25 non-dental students. Materials and Methods: Samples were taken from the dorsum of the tongue, the tonsils (or tonsillar area), and the supra- and subgingival plaque. Results: The microbiological results show that 73% of the samples were positive for the bacterial species presumed to be Pi and/or Pn. In natural gingivitis, gingival health and in experimental gingivitis 25, 23 and 25 subjects were found to be positive for Pi and/or Pn, respectively. The results of the 889 isolates that were succesfully purified and differentiated, show that almost all subjects were colonized with Pn whereas approximately half of the study population harboured Pi. These 2 species were isolated from both dental plaque and mucosal sites and were found to colonize the oral cavity simultaneously. Conclusion: In natural gingivitis, at the start and after 14 days of experimental gingivitis, Pn was the predominant micro-organism. [source]

Hand recontouring with calcium hydroxylapatite (Radiesse)®

FAACS, Kenneth L Edelson MD
Summary The aging hand is a common area of concern for many patients. Until recently, adequate treatment options have been hampered by pain of injecting into the dorsum and, post-injection, by the absence of longevity of treatment. In this article, we describe the off-label use of the soft tissue filler calcium hydroxylapatite (CaHA; Radiesse) for hand rejuvenation. The product is inherently biocompatible and, when placed in soft tissue, induces neocollagenesis. An alternative injection mixture of CaHA combined with lidocaine is described, as well as the novel "bolus" injection technique. The CaHA-lidocaine emulsion reduces the pain of injection to nearly none at all, improves the rheology of the procedure, and allows for deposition of the product into the correct plane of tissue. The volume of CaHA injected as well as the amount of lidocaine used for the mixture vary according to physician preference. In our practice, 1.3 mL of CaHA combined with 0.5 mL lidocaine per hand usually appears to be sufficient to improve the appearance of the atrophic dorsum of the hand. Side-effects of CaHA (Radiesse), particularly in this off-label application, are minimal and of short duration. The aesthetic result is immediate and generally persists for longer than 6 months. As a treatment option, hand rejuvenation with CaHA (Radiesse) is a very gratifying procedure both to the patient and to the physician. [source]

Necrolytic acral erythema without hepatitis C infection

Yu-Hung Wu
Necrolytic acral erythema is a newly described entity characterized by sharply demarcated scaly plaques on the dorsum of the hands and feet. More than 30 patients have been reported since 1996, all of whom had anti-hepatitis C virus antibody. A 32-year-old Taiwanese woman had been diagnosed with and treated for systemic lupus erythematosus with lupus nephritis about 10 years earlier. Soon thereafter, she noted several well-demarcated keratotic plaques with erythematous borders on her feet, with sparing of the soles. Histopathology showed diffuse parakeratosis with a neutrophil infiltrate, hypogranulosis, pale upper keratinocytes, scattered and grouped dyskeratotic cells, psoriasiform hyperplasia and a mild lymphocytic infiltrate in the upper dermis. The diagnosis was made after three biopsies. The lesions regularly worsened just before and during menstruation, but patch and intradermal tests for progesterone and estrogen were negative. There was no evidence of either hepatitis B or hepatitis C infection. The lesions did not respond to treatment with zinc. The rash regressed spontaneously when corticosteroids were stopped and recurred when they were restarted, finally resolving completely after she was treated with high-dose pulse steroids for her lupus. [source]

Basal cell carcinoma with matrical differentiation in a transplant patient: A case report and review of the literature

Faizi Ali
Background:, Shadow cells, characterized by basaloid squamous cells with a distinct well-defined border and a central unstained area as a shadow of lost nuclei, are characteristic of pilomatricoma, a distinct neoplasm of hair matrix differentiation. The presence of shadow cells within tumor islands composed of follicular germinative cells of an otherwise classic basal cell carcinoma (BCC) has been considered as a distinct diagnostic category of BCC with matrical differentiation. We present a case of BCC with matrical differentiation in a transplant patient. To our knowledge, only 10 cases [Aloi et al. Am J Dermatopathol 1988; 10: 509; Ambrojo et al. Am J Dermatopathol 1992; 14: 293; Sagol et al. East J Med 1999; 4: 37; Kwittken J. Cutis 2002; 69: 57; Kim et al. Yonsei Med J 2003; 44: 523] of BCC showing matrical differentiation have been reported. None have been reported arising on the background of immunosuppression. Methods:, A 58-year-old male cardiac transplant patient with a nodule on the dorsum of left hand was studied. It arose and enlarged rapidly within a few months, causing irritation and bleeding. The nodule was surgically excised and submitted for histopathologic evaluation. The sections were prepared by hematoxylin and eosin (H&E) method. Results:, The H&E-stained sections of the hand lesion revealed multiple nodular masses of basaloid follicular germinative cells. In some areas, there was peripheral palisading and stromal retraction artifact typical of classic BCC. In these areas, the tumor nodules were connected to the epidermis, whereas in others, it extended deep into the reticular dermis to the subcutaneous fat junction. Elsewhere, the majority of the tumor contained a population of shadow cells, similar to those in pilomatricoma, with basaloid-appearing matrical cells in the periphery. Trichohyaline granules were identified in the cytoplasm of many of the peripheral basaloid cells. These granules are one of the characteristic features of follicular matrix differentiation. Mitoses were rare. Areas of cystic degeneration were present throughout the tumor. There was no evidence of an infiltrating growth pattern, lymphovascular invasion, or sarcomatoid growth pattern. Conclusion:, BCC with matrical differentiation is a distinct pathologic entity and a rare subtype of BCC featuring shadow and matrical cells, typically seen in pilomatricoma, a benign hair matrix neoplasm. This tumor has not yet been reported in an immunosuppressed transplant patient. [source]

Acral pseudolymphomatous angiokeratoma of children: immunohistochemical and clonal analyses of the infiltrating cells

Yoshitaka Hagari
Background:, Acral pseudolymphomatous angiokeratoma of children (APACHE) is a disorder characterized clinically by red nodules and histopathologically by a massive subepidermal lymphohistiocytic infiltrate. Although it was initially thought to be a vascular nevus, it has never been regarded as a pseudolymphoma. Case report: We report a 7-year-old-girl with small red nodules on the dorsum of the right foot and a 73-year-old man with asymptomatic brown-red nodules on the lower extremities. Results:, Histopathologic examination revealed a massive lymphohistiocytic infiltrate with plasma cells, some eosinophils, or a multinucleated giant cell immediately beneath the epidermis. Thick-walled vessels were observed in the infiltrate. These characteristics are identical to those of acral pseudolymphomatous angiokeratoma of children. The infiltrate was composed mainly of equal numbers of CD4+ or CD8+ T cells and equal numbers of B cells stained for , or , light chains. PCR amplification of rearranged immunoglobulin heavy chain genes or T-cell receptor , genes showed no evidence of clonality, suggesting that these infiltrates were polyclonal both for B and T cells. Conclusions:, Our data support the idea that this disorder represents a reactive process. The modified term ,papular angiolymphoid hyperplasia' would define this disorder more appropriately. [source]

Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects

Gye Song Cho
J Oral Pathol Med (2010) 39: 722,727 Background:, Zinc is known to play an important role for growth and development, the immune response, neurological function, and reproduction. Although the etiology of burning mouth syndrome (BMS) is unknown, zinc deficiency may be implicated in the pathogenesis of BMS. The aim of this study was to demonstrate a causal relationship between zinc deficiency and BMS and to assess whether zinc replacement is an effective therapy for BMS. Methods:, Serum zinc level was evaluated in 276 patients with BMS. To assess the therapeutic effect of zinc replacement, patients with zinc deficiency were administered a zinc supplement (14.1 mg/day). Pain intensity 6 months after zinc replacement was evaluated using an 11-point numerical scale. We also developed an animal model of zinc deficiency to assess the effects of zinc deficiency on the oral mucosa. Results:, Of the 276 patients with BMS, 74 (26.8%) had low serum zinc levels. Zinc replacement therapy lowered the mean numerical pain scale in these patients from 8.1 to 4.1, compared with a mean decrease from 7.7 to 6.7 in a control group (P = 0.004). In our animal model of zinc deficiency, the main pathologic findings were hyperkeratinization and increased mitosis on the dorsum of the tongue, although there were no gross oral mucosal lesions. Conclusions:, Zinc deficiency might play a role in some patients with BMS. In such patients, appropriate zinc replacement therapy is effective in relieving symptoms. [source]

Biofilms in the Edentulous Oral Cavity

Amit Sachdeo BDS, DMSc
Abstract Purpose: The oral cavity presents numerous surfaces for microbial colonization. These surfaces produce biofilms of differing complexities unique to each individual. Several studies have looked at biofilms in dentate patients. There has been limited research regarding biofilms on dentures or soft tissues of edentulous patients. The purpose of the present investigation was to provide meaningful data describing microbial ecological relationships in the oral cavity of edentulous patients and to evaluate the microbiota on hard and soft tissue surfaces and saliva in edentulous patients wearing complete dentures. Materials and Methods: Sixty-one edentulous subjects with complete maxillary and mandibular dentures were recruited. "Supragingival" biofilm samples were taken from 28 denture teeth for each subject. Biofilm samples were also taken from the dorsal, lateral, and ventral surfaces of the tongue, floor of mouth, buccal mucosa, hard palate, vestibule/lip, "attached gingiva," and saliva. Samples were individually analyzed for their content of 41 bacterial species using checkerboard DNA,DNA hybridization. Levels and proportions of each species were determined for every sample location. Results: Periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were clearly present in the samples from the edentulous subjects. Microbial profiles in samples from the soft tissue surfaces differed among site locations. Samples from the dorsum of the tongue exhibited the highest bacterial counts followed by the "attached gingiva" and the lateral surfaces of the tongue, while the lowest mean counts were found in samples from the buccal mucosa and labial vestibules. Using cluster analysis of the proportions of the test species, three clusters were formed. The first cluster comprised saliva, supragingival plaque, and the lateral and dorsal surfaces of the tongue. The second cluster comprised the other six soft tissue surfaces. Species on the denture palate formed a third cluster. Conclusions: One of the major findings in this study was the detection of periodontal pathogens, A. actinomycetemcomitans and P. gingivalis, in the edentulous subjects, as these species were thought to disappear after removal of all natural teeth. This finding has implications regarding future dental treatment and the general health of individuals. Distinct patterns of microbial colonization were seen on the different soft tissue surfaces. Thus, this investigation provided the first step in defining the organisms that are associated with edentulous patients on both soft (mucosa) and hard surfaces (denture). The study also provided meaningful data that described microbial ecological relationships in the oral cavity of edentulous subjects. The authors believe that this study is the first comprehensive assessment of the microbiota in the complete denture-wearing subject. [source]

Malignant seminoma with systemic metastases in a dog

M. Takiguchi
A three-year-old male crossbred dog was presented with multiple cutaneous nodules on the dorsum. Unilateral testicular enlargement ensued. Histopathological examination of testicular tissue and the skin lesions revealed a malignant seminoma. Despite the initiation of adjuvant chemotherapy, the dog died three months later due to systemic metastases of the seminoma to the skin, scrotum, eyes, liver, kidney and peritoneum. [source]

Skin hydration and transepidermal water loss in patients with a history of sulfur mustard contact: a case,control study

Seyyed Masoud Davoudi
Abstract Background,, Skin lesions are among the most common complications of contact with sulfur mustard. Objective,, This study was aimed to measure skin water content and transepidermal water loss (TEWL) in patients with a history of sulfur mustard contact. Methods,, Three hundred ten male participants were included in this study: 87 (28.1%) sulfur mustard,exposed patients with current skin lesions (group 1), 71 (22.9%) sulfur mustard,exposed patients without skin lesions (group 2), 78 (25.2%) patients with dermatitis (group 3) and 74 (23.8%) normal controls (group 4) The water content and TEWL of skin was measured at four different locations of the body: forehead, suprasternal, palm and dorsum of hand. Nonparametric statistical tests (Kruskal,Wallis) were used to compare the four groups, and P < 0.05 was considered statistically significant. Results,, The mean age of participants were 44.0 ± 6.7, 41.9 ± 5.9, 43.8 ± 9.3 and 44.8 ± 8.9 years in groups 1 to 4, respectively (P = 0.146). Xerosis, post-lesional hyperpigmentation and lichenification were significantly more common in either sulfur mustard,exposed participants or non-exposed participants with dermatitis (P < 0.05). Skin hydration was higher in subjects with sulfur mustard contact than in non-injured participants (P < 0.05) in the dorsum and palm of hands and forehead. TEWL was significantly higher in participants only in suprasternal area and dorsum of hand. Conclusion,, Contact with sulfur mustard agent can alter biophysical properties of the skin-especially the function of stratum corneum as a barrier to water loss-several years after exposure. Conflicts of interest None declared. [source]

The efficacy of excimer laser (308 nm) for vitiligo at different body sites

A Hofer
Abstract Background, The treatment with XeCl-excimer laser generated 308-nm UVB radiation has shown promising results in patients with vitiligo. Objective, In this controlled, prospective trial we studied the primary efficacy (start and grade of repigmentation) and patient's satisfaction of XeCl-excimer laser for treatment of vitiligo patches at different body sites and re-evaluated the achieved repigmentation 12 months after the end of therapy. Methods, Twenty-five patients with generalized or localized vitiligo with a total of 85 lesions at different body sites were enrolled in this study. Vitiligo patches were treated with 308-nm XeCl-excimer laser 3 times a week for 6 to 10 weeks. The overall repigmentation grade of each treated lesion was evaluated once a week on a 5 point scale rating from 0 (no repigmentation), 1 (1,5%), 2 (6,25%), 3 (26,50%), 4 (51,75%), to 5 (76,100%). Results, Twenty-four patients completed the study. Within 6 to 10 weeks of treatment 67% of the patients (16/24) developed follicular repigmentation of at least one of their vitiligo lesions. Lesion repigmentation started after a mean of 13 treatments in lesions located on the face, trunk, arm, and/or leg (high-responder location), and after a mean of 22 treatments in lesions located on the elbow, wrist, dorsum of the hand, knee, and/or dorsum of the foot (low-responder location). Untreated control lesions and lesions located on the fingers did not achieve any repigmentation. After 10 weeks of treatment repigmentation of more than 75% was found in 25% (7/28) of lesions of the high-responder location group versus 2% (1/43) of lesions of the low-responder location group. In most cases, laser-induced repigmentation was persistent, as determined 12 months after the end of treatment. Conclusions, 308-nm excimer laser is an effective modality for the treatment of vitiligo. However, similar to other non-surgical treatment modalities, the therapeutic effect is mainly dependent on the location of vitiligo lesions. [source]


To evaluate small fiber function in Friedreich's Ataxia (FA), we performed in 7 patients pin-prick, thermal thresholds, and sweat test. All tests were performed in four different sites: hand dorsum, anterior thigh, lateral distal leg, and foot dorsum. The same subjects underwent 3 mm punch skin biopsy from fingertip, anterior thigh, and lateral distal leg. We used a thin needle mounted on a calibrated nylon wire for the pin-prick test, and a Medoc 2001 TSA system for thermal threshold assessment. Sweat test was performed using a silicon mold after stimulation with pilocarpine by iontophoresis. Skin specimens, cut into 100-,m-thick sections, were double-stained using primary antibodies specific for collagen and nervous fibers and secondary antibodies labeled with Cy3 and Cy5 fluorophores. Tridimensional digitized images were obtained from z-series of 2-,m-thick optical sections acquired with a confocal microscope. We found in all patients in the more distal sites definite signs of functional impairment of the small fibers. These data correlated with the skin innervation morphological findings that showed, in the same sites, a sensible loss of small fibers regarding both the epidermal free endings and the subepidermal neural plexus. Less severe morphological abnormalities were found in the proximal sites. The large fiber neuropathy in FA is well documented. Our data show a length-dependent involvement of small fibers in the pathological process. [source]

Comparison of red and green laser doppler imaging of blood flow

Andrea K. Murray PhD
Abstract Background and Objectives Laser Doppler imaging (LDI) of perfusion has been performed with a novel green wavelength (532 nm) for comparison with a HeNe laser (633 nm), the aim being validation of the green laser wavelength as a research tool. Study Design/Materials and Methods The effect of wavelength and power on images was investigated and perfusion response following both finger occlusion and local heating of the dorsum were examined as reproducible stimuli for clinical studies. Results The most striking difference between red and green LDI is the absence of veins on green LDI, which are seen with red LDI. Differences have been quantified using vein LDI profiles. Differences were found between blood flow responses imaged by red and green LDI (3 and 5 mW, respectively) for occlusion and heat stimuli. Results are discussed in the context of light penetration. Conclusions Red and green wavelengths appear to image different components of the microcirculation. Lasers Surg. Med. 35:191,200, 2004. © 2004 Wiley-Liss, Inc. [source]

Feeding and survival of Culicoides sonorensis on cattle treated with permethrin or pirimiphos-methyl

B. A. Mullens
Summary The persistence of permethrin (5% a.i.) and pirimiphos-methyl (27% a.i.), applied to the dorsum of calves in the field against Culicoides sonorensis Wirth and Jones (Diptera: Ceratopogonidae), was estimated using a hair-blood-feeding bioassay in the laboratory. Hair clippings were taken before treatment and 3, 7, 14, 21, 28, 42 and 56 days after treatment from the dorsum, side and belly of treated and control calves. Laboratory-reared insects were allowed to feed through thin hair layers and a parafilm membrane on sheep blood warmed using a water-jacketed feeder. Some intoxication after exposure to hair was noted up to 28 days after treatment with permethrin and up to 14 days after treatment with pirimiphos-methyl. Hair from the dorsum caused more intoxication for a longer period than hair from other body regions. Permethrin and pirimiphos-methyl applied to the back did not significantly reduce overall engorgement (body regions pooled) after treatment. Permethrin residues on hair remained far higher on the back than other body regions and were related to insect intoxication and reduction in engorgement in the laboratory. Residues on belly hair never exceeded 12 p.p.m. and did not result in significantly reduced feeding at any time. Engorged insects that exhibited sublethal intoxication from feeding through permethrin-treated hair did recover and matured numbers of eggs comparable to controls. Field trials using treated and control calves and enclosure nets showed that dorsal applications of 5% permethrin were not effective in reducing engorgement, despite some intoxication. Vacuum samples from a calf showed that C. sonorensis fed primarily on the belly. A 0.2% permethrin application on the belly (250 ml) did result in >,80% reduction of C. sonorensis in the enclosure nets at 3 and 7 days after treatment, but activity had subsided by 10 days after treatment. The utility of insecticidal treatments for suppression of this vector is discussed. [source]

The thoracodorsal vascular tree-based combined fascial flaps

MICROSURGERY, Issue 2 2009
Meisei Takeishi M.D.
In this study, combined fascial flaps pedicled on the thoracodorsal artery and vein were raised and used for thin coverage of dorsal surfaces of the fingers and the dorsum of hand and foot with favorable results. The combined fascial flaps consist of the serratus anterior fascia and the axillary fascia at the entrance of the latissimus dorsi. These flaps were used for reconstruction of the hand, fingers, or foot in nine patients. Reconstruction was performed for burn or burn scar contracture, after resection of malignant tumors, posttraumatic skin defects, and chronic regional pain syndrome. The sites of reconstruction were dorsal surfaces of fingers, dorsum of hand, wrist and palm, forearm, lower leg, and foot. The flaps were used in various configurations including two independent fascial flaps, two-lobed fascial flap with separate feeding vessels, and composite fascial and thoracodorsal artery perforator flap. The fascial and skin flaps survived in all nine patients, with favorable results both functionally and esthetically. Good coverage of soft tissue defects and good recovery of range of motion in resurfaced joints were achieved. There were no complications. The scars at the sites of harvest were not noticeable. The advantage of this method is that not only a single flap but flaps of a variety of configurations can be harvested for different purposes. The thoracodorsal vascular tree-based combined fascial flaps are useful for the reconstruction of soft tissue defects in the extremities. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source]

Extremity salvage with a free musculocutaneous latissimus dorsi flap and free tendon transfer after resection of a large congenital fibro sarcoma in a 15-week-old infant.

MICROSURGERY, Issue 6 2006
A case report
A case of complex microsurgical reconstruction of the dorsum of the foot, including tendon transfer following tumor resection, in a 15-week-old male infant is presented. After birth, a 5.5 × 4 cm large tumor was observed on the dorsum of the right foot. Biopsy showed a congenital malignant fibro sarcoma. After initial chemotherapy a radical excision of the tumor at the age of 14 weeks was followed. To cover the defect a musculocutaneous latissimus dorsi flap was taken, the cutaneous part being large enough to cover the defect. Extensor tendons were reconstructed with free tendon transplants. Amputation is usually indicated in these cases. To the best of our knowledge, microsurgical reconstruction in infants at this age with congenital malignant tumors has not yet been reported. The case shows that Plastic surgery can play an important role in pediatric oncology and should routinely be integrated into the multi-modal treatment concepts. © 2006 Wiley-Liss, Inc. Microsurgery, 2006. [source]

Cross-leg free anterolateral thigh perforator flap: A case report

MICROSURGERY, Issue 3 2006
Serel M.D.
The purpose of this report is to introduce the cross-leg anterolateral thigh perforator flap for closure of a defect on the dorsum of the foot, and to show that the anterolateral thigh perforator flap is a safe option for a cross-bridge microvascular anastomosis in defects of the extremity. The free anterolateral thigh perforator flap was used for a patient with an unhealed wound on the dorsum of the foot. The flap was revascularized by end-to-side anastomosis between the flap's artery and the posterior tibial artery of the other leg, since there was no available recipient artery on the same leg. After a 4-week neovascularization period, the pedicle was cut. To the best of our knowledge, this is the first report of the use of a free anterolateral thigh perforator flap for a cross-bridge microvascular anastomosis. © 2006 Wiley-Liss, Inc. Microsurgery, 2006. [source]