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Selected AbstractsParadoxical Hypertrichosis After Laser Therapy: A ReviewDERMATOLOGIC SURGERY, Issue 3 2010SHRADDHA DESAI MD BACKGROUND Laser hair removal is a safe and effective procedure for the treatment of unwanted body hair but is not exempt from side effects. A rare but significant adverse effect with this treatment modality is paradoxical hypertrichosis. OBJECTIVE To evaluate the potential etiologies, risk factors, related laser types, and treatment options for the development of excess hair after laser therapy. MATERIALS AND METHODS An analysis of previously published case studies and review articles along with our own experience was used to gather information regarding this phenomenon. RESULTS Paradoxical hypertrichosis has a low incidence, ranging from 0.6% to 10%, and most commonly occurs on the face and neck. All laser and light sources have the potential to cause hair induction, especially in individuals with darker skin types (III,VI); with dark, thick hair; and with underlying hormonal conditions. Possible causes include the effect of inflammatory mediators and subtherapeutic thermal injury causing induction of the hair cycle. Treatment for paradoxical hypertrichosis is laser therapy of the affected area. CONCLUSIONS Paradoxical hypertrichosis is a rare side effect of laser hair removal; the pathogenesis of this event remains widely unknown. We recommend further large-scale studies to investigate this effect. The authors have indicated no significant interest with commercial supporters. [source] Botanical Extracts Used in the Treatment of CelluliteDERMATOLOGIC SURGERY, Issue 2005Doris Hexsel MD Background. Cellulite is defined as skin relief alterations that give the skin an orange peel or mattress appearance. The lesions tend to be asymptomatic and may be considered the anatomic expressions of the structures in the affected area, such as the fat and subcutaneous septa. Objective. The present article reviews the most important botanical extracts used as active ingredients in the treatment of cellulite, as well as the steps to obtain these botanicals as raw material and their standardization and quality control, which are important to guarantee their therapeutic action. Methods. The current literature was reviewed, and we also obtained information from the manufacturers of the prducts that contained botanicals because of the few publications about this subject. Conclusions. The reduction in fat deposits through the continuous use of anticellulite products depends on the availability of the active ingredient at the action site, the concentration of the ingredient in the formulation, and the physiochemical characteristics particular to each active ingredient. The botanicals used in topical products must have standardized extracts, which would permit each phytomedicine to have the same effect anywhere in the world. New scientific research is necessary to verify the efficacy and ideal concentrations of such substances. DORIS HEXSEL, MD, CECILIA ORLANDI, MD, AND DEBORA ZECHMEISTER DO PRADO, PHARM, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Treatment of Facial Telangiectasia With Variable-Pulse High-Fluence Pulsed-Dye Laser: Comparison of Efficacy with Fluences Immediately Above and Below the Purpura ThresholdDERMATOLOGIC SURGERY, Issue 7 2003Murad Alam MD Background. Pulsed-dye laser treatment has been shown to be highly effective for the treatment of facial telangiectasia. Posttreatment purpura after such treatment has limited patient acceptance of the procedure. Objective. To determine whether purpura-free treatment with recently introduced variable-pulsed pulsed-dye lasers can effectively reduce facial telangiectasia. Methods. This was a prospective, randomized, controlled, nonblinded trial. Eleven patients received variable-pulse pulsed-dye laser treatment with and without induction of purpura. Telangiectasia were graded on a "telangiectasia density scale," on which a 1 signified extremely fine, sparsely distributed telangiectasia, and 5 referred to thick, ropelike telangiectasia covering the affected area. For each subject, two areas on either side of the facial midline with equivalent telangiectasia density ratings were randomized to the purpura and purpura-free treatment groups, respectively. All treatments used a 7-mm spot size and a 10-ms pulse duration. The fluence associated with the purpura threshold for each patient was determined in test areas. Purpura-free treatment entailed a fluence 1.0 J/cm2 less than the purpura threshold, and purpura-level treatment entailed a fluence 0.5 J/cm2 greater than the threshold. Results. Six weeks after a single purpura-free treatment, mean telangiectasia ratings were reduced from 2.7 to 2.4. Purpura-level treatments resulted in a decrease to 1.4 from the same baseline. Thicker, denser telangiectasia appeared to benefit more from purpura-level treatment (a mean telangiectasia density scale reduction of 1.7) than finer, sparser telangiectasia (a mean reduction of 0.8). In 81% of cases, both investigators and patients rated the side treated with purpura as undergoing a greater reduction in telangiectasia density. Conclusion. Although facial telangiectasia do improve after a single purpura-free treatment with the variable-pulse pulsed-dye laser, they improve more after purpura is induced. Purpura-free and purpura-level treatments may be close to equivalent for treating fine telangiectasia, but purpura-level treatments have a distinct advantage for treating thicker telangiectasia. Significantly, the variable-pulse pulsed-dye laser offers patients the option of effective treatment of some telangiectasia without bruising. [source] Multi-scale system reliability analysis of lifeline networks under earthquake hazardsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 3 2010Junho Song Abstract Recent earthquake events evidenced that damage of structural components in a lifeline network may cause prolonged disruption of lifeline services, which eventually results in significant socio-economic losses in the affected area. Despite recent advances in network reliability analysis, the complexity of the problem and various uncertainties still make it a challenging task to evaluate the post-hazard performance and connectivity of lifeline networks efficiently and accurately. In order to overcome such challenges and take advantage of merits of multi-scale analysis, this paper develops a multi-scale system reliability analysis method by integrating a network decomposition approach with the matrix-based system reliability (MSR) method. In addition to facilitating system reliability analysis of large-size networks, the multi-scale approach enables optimizing the level of computational effort on subsystems; identifying the relative importance of components and subsystems at multiple scales; and providing a collaborative risk management framework. The MSR method is uniformly applied for system reliability analyses at both the lower-scale (for link failure) and the higher-scale (for system connectivity) to obtain the probability of general system events, various conditional probabilities, component importance measures, statistical correlation between subsystem failures and parameter sensitivities. The proposed multi-scale analysis method is demonstrated by its application to a gas distribution network in Shelby County of Tennessee. A parametric study is performed to determine the number of segments during the lower-scale MSR analysis of each pipeline based on the strength of the spatial correlation of seismic intensity. It is shown that the spatial correlation should be considered at both scales for accurate reliability evaluation. The proposed multi-scale analysis approach provides an effective framework of risk assessment and decision support for lifeline networks under earthquake hazards. Copyright © 2009 John Wiley & Sons, Ltd. [source] A case of suspected contact dermatitis in a juvenile cynomolgus monkey (Macaca fascicularis)JOURNAL OF MEDICAL PRIMATOLOGY, Issue 2008Joanne Morris Abstract Background, A 2-year-old male cynomolgus monkey (Macaca fascicularis) presented with vesicular dermatitis exhibiting freshly ruptured blisters, crusts, and papules on the extremities and face. Methods, Complete blood count, serum chemistry, skin biopsy, skin scrape, and culture of a fresh blister were initially submitted for diagnostics. Results, Skin biopsy of the affected area revealed a non-suppurative eosinophilic dermatitis with mild thickening of the epidermis. Serum chemistry showed a marked eosinophilia (1.74 × 103/,l, 17.4%). All other results were within normal limits. Initial differentials included contact dermatitis, immune-mediated disease such as pemphigus or psoriasis. Repeated blood work and skin biopsies were collected as well as serum for allergen-specific IgE latex and food allergy testing. Herpes B virus was added to the differential list after an oral lesion was noted upon repeated physical examination and samples were collected for testing. Repeat blood work maintained a marked eosinophilia and food allergy testing was within normal limits. Serum IgE for latex was equivocal and a follow-up latex sensitivity test was performed and was within normal limits. Repeated skin biopsies were consistent with acute eosinophilic spongiotic dermatitis with vesicles most likely due to contact dermatitis. No therapy was initiated during the diagnostic period and no etiology was confirmed. Conclusions, Over time the dermatitis and eosinophilia resolved spontaneously. The animal is currently free of any lesions and maintains an eosinophil count within normal limits. [source] Estimating the growth models of news stories on disastersJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 9 2009Jiuchang Wei Understanding the growth models of news stories on disasters is a key issue for efficient disaster management. This article proposes a method to identify three growth models: the Damped Exponential Model, the Normal Model, and the Fluctuating Model. This method is proven to be valid using the 112 disasters occurring between 2003 and 2008. The factors that influence the likelihood of the growth models include disaster types, newsworthy material, disaster severity, and economic development of the affected area. This article suggests that disaster decision-makers can identify the respective likelihood of the three growth models of news stories when a disaster happens, and thereby implement effective measures in response to the disaster situation. [source] Large recurrent plexiform neurofibroma of the foot and ankleMICROSURGERY, Issue 1 2004Lee L.Q. Pu M.D., Ph.D. Plexiform neurofibroma often causes significant pain, deformity, and functional problems in the affected part of the body. Surgical management of the condition can be challenging, and local recurrence is common because of inadequate resection of the tumor. One patient with a large recurrent plexiform neurofibroma of the foot and ankle was treated successfully with a complete resection of the tumor, followed by a free latissimus dorsi muscle transfer with a skin graft for soft-tissue reconstruction. The patient has regained good contour of the foot and ankle, and has been symptom-free with no evidence of local recurrence in the affected area for 18 months. The authors believe that thorough preoperative planning and state-of-the-art reconstructions, as described here, are the keys to their success. © 2003 Wiley-Liss, Inc. [source] Determination of corneal volume from anterior topography and topographic pachymetry: application to healthy and keratoconic eyesOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2009Alejandro Cervińo Abstract Purpose:, To describe a method to measure corneal volume from topography and pachymetry, and test its clinical use on a sample of healthy human subjects and a case of circumscribed posterior keratoconus. Methods:, Corneal curvature (PCT 200® corneal topography system; Optopol Technology SA, Zawiercie, Poland) and ultrasonic topographic pachometry on 25 points (Ophthasonic® A-Scan/Pachometer III; Teknar Inc., St Louis, MO, USA) were measured on each of 12 young healthy corneas and one cornea suffering from circumscribed posterior keratoconus. Topography and pachymetry data were used to calculate the coordinates for the corresponding points on the posterior surface of the cornea. TableCurve 3D software (Systat Software Inc., Chicago, IL, USA) was used to fit a surface to those points measured. Integration of the surface fitted to the data points, corresponding to the anterior and posterior corneal surfaces, was used to calculate the volume underneath each of them. Subtraction of volumes underneath anterior and posterior surfaces, taking into account an axial offset equal to the central corneal thickness, rendered corneal volume for the central 6 mm of the cornea. Results:, Central corneal thickness ranged from 520 to 630 ,m for the healthy corneas. Corneal volumes for this sample analyzed averaged 18.66 ± 1.15 mm3 (range 17.25,20.53 mm3). For the posterior keratoconic cornea, the affected area was located at about 1.5,2 mm from the corneal center on the 135° hemimeridian of the right eye, observed through topographic pachymetry. Calculated corneal volume for the central 6 mm was 16.072 mm3, noticeably lower than those found in the sample without pathology, but within the range for corneas presenting with keratoconus. Conclusions:, Corneal volume is a useful parameter for characterising dystrophic corneas and can aid in the detection of rare anomalies which are hardly detected with corneal topography and/or central corneal thickness evaluation. A potentially useful measure of corneal volume can be calculated from anterior corneal topography and topographic pachymetry data. Values obtained are in good agreement with previous studies using corneal tomography techniques. The methodology has been shown to have potential for retrospective analysis of data, or where no access is available to tomographical techniques. [source] Use of Botulinum Toxin Type A Injection for Neuropathic Pain after Trigeminal Nerve InjuryPAIN MEDICINE, Issue 4 2010Seung Hyun Yoon DDS Abstract Objective., To present a case that neuropathic pain following traumatic injury of the inferior alveolar nerve, which was relieved by the injection of BTX-A. Design., Case report. Setting., Tertiary care University hospital. Subject., A 62-year-old female was referred by her general dentist to our clinic due to numbness and pain over the left side of her lower lip and chin region. Intervention., Botulinum toxin type A injected into the middle of chin area subcutaneously. Results., At 1 month after BTX-A injection, the affected area had decreased in size. And at 2 months, the patient reported a slight decreased in pain, and CPT differences being sustained at a reduced level. Conclusions., This case report suggests an effective new modality for treating neuropathic pain after trigeminal nerve injury. A further randomized controlled study involving a large number of patients is needed. [source] MULTIDISCIPLINARY PAIN ABSTRACTS: 34PAIN PRACTICE, Issue 1 2004Article first published online: 15 MAR 200 Because recent studies emphasized the role of peripherally distributed N-methyl-D-aspartate (NMDA) receptors in processing the nociceptive information, the authors investigated whether peripheral application of the ointment containing ketoconazole (KET) is able to attenuate the symptoms of local neuropathic pain. They applied ointment containing KET (0.25%,1.5%) to the affected area on limbs in five patients with complex regional pain syndrome type I (CRPS I) and in two patients with type II (CRPS II). One to 2 weeks later, they observed improvement of the report of pain intensity, measured by the visual analog scale, in four patients with acute early dystrophic stage of CRPS I. Swelling of the affected limbs subsided as well. No apparent changes were noticed in one patient with chronic atrophic stage of CRPS I and in both patients with CRPS II. The authors concluded that topical application of KET appears to be beneficial for the patients with acute early dystrophic stage of CRPS I because of either its local anesthetic effect or NMDA receptor antagonist action. Patients with chronic atrophic stage of CRPS I and CRPS II patients do not appear to respond to this treatment. [source] Congenital hyperinsulinism , a review of the disorder and a discussion of the anesthesia managementPEDIATRIC ANESTHESIA, Issue 7 2007OLGA T. HARDY MD Summary Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infants and children. In most affected infants, CHI is caused by a specific genetic defect that results in the altered expression of pancreatic beta cells causing unregulated oversecretion of insulin. Infants with CHI may have either focal or diffuse abnormalities of the pancreatic , -cells. Both forms of CHI manifest as hypoglycemia, usually in the early newborn period. Focal disease can be treated effectively with surgical resection of the affected area, resulting in a total cure or rendering the patient amenable to medical management. Most children with diffuse disease are unresponsive to medical therapy, and require near-total pancreatectomy. At The Children's Hospital of Philadelphia, we have developed a multidisciplinary program for diagnosis and treatment of CHI. Anesthesiologists have played an integral role in the perioperative care of these infants, which includes diagnostic procedures, partial or near-total pancreatectomy, and postoperative pain management. In this review, we describe the clinical features, diagnostic methods and anesthetic concerns in children with CHI. [source] Chronic Recurrent Multifocal Osteomyelitis (CRMO) and Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome with Associated Neutrophilic Dermatoses: A Report of Seven Cases and Review of the LiteraturePEDIATRIC DERMATOLOGY, Issue 5 2009Brook E. Tlougan M.D. Classically, patients present with swelling, pain, and impaired mobility of the affected area, with skin lesions developing concurrently or in the future. Bone biopsy reveals inflammatory changes consistent with infectious osteomyelitis, but cultures and histologic staining invariably fail to identify an infectious source. Patients are refractory to antibiotic therapy, but dramatically respond to systemic steroids and may need to be maintained on low-dose steroids to prevent relapse. Numerous authors have suggested that CRMO and synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome lie along the same clinical spectrum. In fact some believe that CRMO is the pediatric presentation of SAPHO. The two syndromes share numerous characteristics, including osteitis, a unifocal or multifocal presentation, hyperostosis, and pustulosis, which all occur in a generally healthy individual. Our seven patients, five of whom were diagnosed with CRMO, and two of whom were diagnosed with SAPHO syndrome further strengthen the idea that CRMO and SAPHO syndrome do indeed lie along the same clinical spectrum. In addition, we include two rare cases of pediatric Sweet's syndrome with evidence of pathergy. [source] Development of electric control catheter and tweezers for thrombosis sample in blood vessels using piezoelectric polymeric fibers,POLYMERS FOR ADVANCED TECHNOLOGIES, Issue 11-12 2006Yoshiro Tajitsu Abstract Poly- L -lactic acid (PLLA) has recently attracted attention as a polymer which exhibits a high shear piezoelectric constant. In this study, it was possible to control the piezoelectric motion of the PLLA fiber by applying d.c. voltage and a.c. voltage similar to a piezoelectric actuator. Then, on the basis of the experimental results, an electric control catheter and tweezers, using PLLA fibers (PLLA fiber catheter/tweezers) was developed. In the demonstration, it was assumed that thrombosis in blood vessels occurred and it was attempted to remove the thrombosis from the affected area using the PLLA fiber catheter and tweezers. This very delicate operation was attempted under a microscope. Using the PLLA fiber catheter and tweezers, the affected area was excised. A video movie of the test demonstration was recorded using a CCD video camera. All stages proceeded well in this study. Copyright © 2006 John Wiley & Sons, Ltd. [source] Indian Ocean tsunamis: environmental and socio-economic impacts in Langkawi, MalaysiaTHE GEOGRAPHICAL JOURNAL, Issue 2 2007MICHAEL BIRD We report the results of a study of the physical characteristics and socio-economic impacts of the Indian Ocean Tsunami of 26 December 2004 on the tourist island of Langkawi, Malaysia. In comparison with many other locations struck by the tsunami, the immediate physical and socio-economic impacts in Langkawi were relatively minor. A detailed survey of the watermark and ground elevations was undertaken in the worst affected area between Sungei Kuala Teriang and Sungei Kuala Melaka. Here, the tsunami reached a maximum elevation of 4.29 m as it crossed the coast, with a maximum flow depth of 2.0 m and a very consistent run-up elevation relative to mean sea level of 300 ± 10 cm. The tsunami inundated inshore areas for 300 m and penetrated inland along creeks for 500,1000 m. Structural damage to buildings was confined to within 50,150 m of the shoreline where about 10% of the houses were completely destroyed and 60,70% suffered significant structural damage. Damage was particularly severe in areas where there was no engineered coastal protection, but while coastal revetments did provide enhanced protection for houses at the waterfront, the coastline in the study area appeared to be more heavily impacted than elsewhere in Langkawi because wave energy was focused on the area by offshore breakwaters built to protect the Langkawi port and airport. Emergency response after the tsunami was rapid and efficient but would have been improved if the local police station had not been rendered inoperative by the first wave, and if a mechanism had been in place to ensure that informal advance warnings transmitted between Phuket (Thailand), Langkawi and Penang (Malaysia) by tourist operators could have been more widely disseminated. [source] Scalp dermoscopy of androgenetic alopecia in Asian peopleTHE JOURNAL OF DERMATOLOGY, Issue 2 2009Shigeki INUI ABSTRACT Although dermoscopy is used mainly for diagnosing pigmented skin lesions, this device has been reported to be useful in observing alopecia areata and frontal fibrosing alopecia. Herein, we investigated the dermoscopic features and their incidence of androgenetic alopecia (AGA; n = 50 men) and female AGA (FAGA; n = 10 women) in Asian people. More than 20% hair diameter diversity (HDD), which reportedly is an early sign of AGA and corresponds to hair follicle miniaturization, was observed in the affected area of all AGA and FAGA cases, suggesting that HDD is an essential feature to diagnose AGA and FAGA. Peripilar signs, corresponding to perifollicular pigmentation, were seen in 66% (33/50) of AGA and 20% (2/10) of FAGA women. This incidence in the present study was lower than previously reported in white subjects possibly because the Asian skin color conceals slight peripilar pigmentation. Yellow dots were observed in 26% (13/50) of AGA and 10% (1/10) of FAGA cases and the number of yellow dots in AGA and FAGA was limited to 10 on the overall hair loss area. Yellow dots possibly indicate the coincidence of AGA and enlargement of the sebaceous glands caused by common end-organ hypersensitivity to androgen. In conclusion, dermoscopy is useful to diagnose AGA and FAGA and provides insights into the pathogenesis of AGA. [source] Sources of water vapour contributing to the Elbe flood in August 2002,A tagging study in a mesoscale modelTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 638 2009H. Sodemann Abstract In this study we investigate the contribution of various moisture sources to the Elbe flood that occurred in Central Europe during August 2002. An 8-day simulation with the mesoscale numerical weather prediction model CHRM, including newly implemented water vapour tracers, has been performed. According to the simulation, rather than drawing moisture from one single dominant source region, water vapour from widely separated moisture sources contributed to the extreme precipitation in the most affected area, notably at distinct, subsequent periods of time, and each in significant amounts. These moisture sources include the Atlantic and Mediterranean ocean areas inside the model domain, evapotranspiration from land areas, and long-range advection from subtropical areas outside the model domain. The results highlight the importance of the concurrent upper-level circulation and the mesoscale flow structures associated with the cyclone for producing extreme precipitation in parts of Germany, Austria, and the Czech Republic during that period. Furthermore, the numerical and technical problems of implementing water vapour tracers into a limited-area model are discussed, including conservative tracer advection, initialization, boundary treatment, and the handling of precipitation parametrizations. An evaluation of the consistency of the method in terms of water vapour, cloud water, and precipitation is provided, with generally satisfying results. The model with its detailed water vapour tracer implementation can now be used for further case-studies and climatological simulations, and serve as a reference for evaluating the performance of other moisture tracking methods, such as those based on backward trajectories. Copyright © 2009 Royal Meteorological Society [source] Determination of arsenic species in a freshwater crustacean Procambarus clarkiiAPPLIED ORGANOMETALLIC CHEMISTRY, Issue 3 2002V. Devesa Abstract The arsenic species present in samples of the crayfish Procambarus clarkii caught in the area affected by the toxic mine-tailing spill at Aznalcóllar (Seville, Southern Spain) were analyzed. The total arsenic contents ranged between 1.2 and 8.5,µg g,1 dry mass (DM). With regard to the different species of arsenic, the highest concentrations were for inorganic arsenic (0.34,5.4,µg g,1 DM), whereas arsenobetaine, unlike the situation found in marine fish products, was not the major arsenic species (0.16,±,0.09,µg g,1 DM). Smaller concentrations were found of arsenosugars 1a (0.18,±,0.11,µg g,1 DM), 1b (0.077,±,0.049,µg g,1 DM), 1c (0.080,±,0.089,µg g,1 DM), and 1d (0.14,±,0.13,µg g,1 DM). The presence of two unknown arsenic species was revealed (U1: 0.058,±,0.058,µg g,1 DM; U2: 0.12,±,0.12,µg g,1 DM). No significant differences were seen with respect to the total arsenic contents between the sexes. However, significant differences in the total arsenic contents were revealed between the area affected by the spill and the area not affected, the contents being greater in the affected area. Copyright © 2002 John Wiley & Sons, Ltd. [source] Peripheral nerve field stimulation for pruritus relief in a patient with notalgia paraestheticaAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2010Bernadette Ricciardo ABSTRACT This case study is presented to exemplify the application of peripheral nerve field stimulation in the treatment of recalcitrant notalgia paraesthetica. The patient was a 60-year-old woman with severe and disabling notalgia paraesthetica. The itch persisted despite the use of several medications , topical and oral. Following a successful trial of peripheral nerve field stimulation with a temporary electrode, two subcutaneous electrodes were inserted into the affected area with a battery implanted subcutaneously in her right buttock. The patient was reviewed at 5 months post implantation. She reported a greater than 85% improvement in her itch. She also reported a major improvement in her quality of life, with particular improvement in her ability to sleep through the night. This case illustrates the possible utilization of peripheral nerve field stimulation in the treatment of notalgia paraesthetica, which is a common yet poorly understood and treated condition. Replication and controlled studies are required to determine the general applicability of this approach. [source] A boy born with multiple lesions of atrophodermaACTA PAEDIATRICA, Issue 3 2010Piero Pavone Abstract Aims:, The Atrophodermas include a large group of disorders appearing as localized or widespread depressed skin areas and characterized by underlying dermal atrophy. The present study aims to report a peculiar form of previously unreported focal dermal atrophy. Methods:, We studied over a period of 5 years a boy who manifested, since birth, multiple hypopigmented cutaneous atrophic lesions of the atrophoderma type in a mosaic distribution over the body and the legs. Results:, This boy did no develop other cutaneous or systemic stigmata except for an idiopathic thrombocytopenic purpura (ITP) manifested at age 2 years. Full serum, metabolic and infective analyses; full ophthalmological examination; ultrasound examination of the heart and internal organs; skeletal x-rays; brain magnetic resonance imaging; and DNA analysis of the PORCN (Focal Dermal Hypoplasia - FDH) gene in this boy yielded normal results. Pathological analysis of multiple skin specimens from an affected area revealed slightly reduced dermal thickness; hyperpigmentation of the basal layer; homogenized and disarrayed collagen bundles; perivascular chronic infiltrates of lymphocytes and histiocytes; and normal skin appendages. Currently, the child is healthy; he has mildly improved skin status with less-evident skin depression throughout the lesion areas and no further complication has been recorded. The histological and clinical appearance of the skin lesions and the course were against any known disorder in the group of the atrophodermas. Conclusions:, The cutaneous lesions seen in this boy represent a possibly new congenital skin disorder characterized by multiple, benign areas of focal dermal atrophy in a mosaic distribution. [source] Islam and CSR: a study of the compatibility between the tenets of Islam, the UN Global Compact and the development of social, human and natural capitalCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 4 2007John Zinkin Abstract Previous research has found that Muslims score elements that are assumed to matter in determining socially responsible business behaviour less highly than people of other religions. This paper looks at whether the tenets of Islam are the reason for this lower score by comparing and contrasting the UN Global Compact's ten principles with those of Islam in the affected areas. In so doing, the paper reconstructs the principles according to their impact on social, human and natural capital and explores whether Islam is supportive of responsible behaviour in these three areas. The paper concludes that, with the possible exception of Islam's focus on personal responsibility and non-recognition of the corporation as a legal person, which could undermine the concept of corporate responsibility, there is no divergence between the tenets of the religion and the principles of the UN Global Compact. Focusing on this convergence of values could help avert the threatened ,clash of civilizations'. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source] ,We All Knew that a Cyclone Was Coming': Disaster Preparedness and the Cyclone of 1999 in Orissa, IndiaDISASTERS, Issue 4 2004Frank Thomalla Imagine that a cyclone is coming, but that those living in the affected areas do nothing or too little to protect themselves. This is precisely what happened in the coastal state of Orissa, India. Individuals and communities living in regions where natural hazards are a part of daily life develop strategies to cope with and adapt to the impacts of extreme events. In October 1999, a cyclone killed 10,000 people according to government statistics, however, the unofficial death toll is much higher. This article examines why such a large loss of life occurred and looks at measures taken since then to initiate comprehensive disaster-preparedness programmes and to construct more cyclone shelters. The role of both governmental organisations and NGOs in this is critically analysed. The good news is that, based on an assessment of disaster preparedness during a small cyclone in November 2002, it can be seen that at community-level awareness was high and that many of the lessons learnt in 1999 were put into practice. Less positive, however, is the finding that at the state level collaboration continues to be problematic. [source] Bilateral degenerative suspensory desmitis with acute rupture in a Standardbred coltEQUINE VETERINARY EDUCATION, Issue 6 2010K. D. Miller Summary A 3-month-old Standardbred colt was examined for acute, bilateral hindlimb swelling and lameness. Serum chemistry demonstrated elevated muscle enzymes (AST, ALT, LDH and CK). Radiographs of the hindlimbs demonstrated intact proximal sesamoid bones that were displaced distally and subluxation of the pastern joints. Ultrasonography of the affected areas revealed large, diffuse hypoechoic areas in the bodies of both hind suspensory ligaments consistent with bilateral rupture. Histology of the lesions was consistent with degenerative suspensory desmitis with acute rupture. [source] Two Japanese cases of lichen planus pigmentosus-inversusINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2007Aki Kashima MD Case 1 was a 51-year-old Japanese woman. She presented with an asymptomatic brown macule located on the right axilla of 2 months' duration. The smooth macule was 2 cm in diameter with a sharp demarcation (Fig. 1A). Figure 1. Photographs of skin lesions in two patients. (A) Case 1. Well-circumscribed brown macule without an active red border in the central portion of the right axilla. (B) Case 2. Symmetric distribution of brown macules without an active red border in the popliteal fossae Case 2 was a 62-year-old Japanese man. He presented with asymptomatic, symmetric, gray,brown macules located on the groin, axillae, and popliteal region of 6 months' duration. The smooth macules were several millimeters to centimeters in diameter and sharply demarcated (Fig. 1B). Oral or nail lesions, previous inflammatory processes in affected areas, and internal malignancies were absent. A causal relationship with drugs, recent sun exposure, or trauma could not be identified. Findings for work-up, including blood cell count, fasting blood sugar levels, liver function, serum electrolyte levels, serum electrophoresis, urinalysis, antinuclear antibodies, and serological examinations for human hepatitis viruses and syphilis, were within normal limits or negative. The lesions gradually disappeared without medication within 6 months. Biopsy specimens showed a lymphocytic infiltrate with basal vacuolar changes and prominent melanin incontinence in the upper dermis (Fig. 2A). The band-like lymphocytic infiltrate was moderate in Case 1 and mild in Case 2. Immunohistochemistry showed infiltrative CD8+ T lymphocytes with keratinocytic damage, indicating cytotoxic injury of the keratinocytes (Fig. 2B). Both the epidermis and the upper dermis contained CD1a+ cells (Fig. 2C). The keratinocytes focally and weakly expressed HLA-DR (Fig. 2D). These findings were identical in samples from both patients. Figure 2. Light and immunohistochemical microphotographs. (A) Mild, band-like, lymphocytic infiltrate with basal vacuolar change and prominent melanin incontinence in the upper dermis with apoptosis or necrosis of keratinocytes. (B) Epidermal infiltrate of CD8+ T lymphocytes with keratinocytic damage. (C) CD1a+ cells in the upper dermis. (D) Keratinocytes focally and weakly express HLA-DR (original magnifications: A, ×200; B,D, ×400) [source] Clinical Features and Outcome of Heterobilharzia americana Infection in DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010C. Fabrick Background: Heterobilharzia americana (HA), the causative agent of canine schistosomiasis, is a flatworm with a freshwater snail as an intermediate host. Only case reports or small case series evaluating naturally infected dogs have been published. Objective: Describe clinical signs in dogs naturally infected with HA. Animals: Twenty-two dogs naturally infected with HA from 1985 to 2009. Methods: Retrospective study. All medical records were searched for HA and schistosomiasis. Only dogs with a diagnosis based on identification of ova on histopathology or fecal saline sedimentation were included. Results: The median age was 3.1 years (1,12). The median duration of clinical signs before diagnosis was 0.63 months (0.03,12). The most common clinical signs were lethargy (91%), weight loss (77%), hyporexia (68%), vomiting (59%), and diarrhea (55%). Eleven of the 22 dogs were hypercalcemic. Hypercalcemia did not resolve without definitive treatment with praziquantel. HA infection was an incidental diagnosis in 7/22 dogs. Diagnosis was obtained via necropsy (4), histopathology (9), and fecal examination (9). Definitive treatment included praziquantel and fenbendazole. Eighteen dogs were diagnosed antemortem and 17 were treated. Twelve dogs were alive for 6 months to 3 years after diagnosis. Conclusions and Clinical Importance: HA infection occurs in younger, larger breed, indoor dogs. Hypercalcemia does not resolve without praziquantel treatment. Prognosis is good and neither hypercalcemic-induced renal failure nor ascites appears to worsen prognosis. Dogs in affected areas or that have traveled to affected areas that present for weight loss, gastrointestinal or liver disease, and hypercalcemia, should be tested. [source] Bauten in deutschen Erdbebengebieten , zur Einführung der DIN 4149: 2005BAUTECHNIK, Issue 8 2005Jochen Schwarz Dr.-Ing. Die Einführung der DIN 4149: 2005 bildet eine wichtige Voraussetzung, um im Kontext der Harmonisierung europäischer Baubestimmungen ein erdbebensicheres und wirtschaftliches Bauen in den Erdbebengebieten Deutschlands zu ermöglichen. Verschiedene Phasen der Erarbeitung werden in einer chronologischen Form beleuchtet und mit einem Ausblick auf die weitere Normenentwicklung abgeschlossen. Es werden interdisziplinäre Forschungsarbeiten gewürdigt, die wesentlich dazu beigetragen haben, das Regelwerk der seismischen Lastannahmen für Bauwerke neu zu konzipieren. Insbesondere durch die Festlegung geologie- und untergrundbezogener Bemessungsspektren wird eine differenzierte Beschreibung seismischer Einwirkungen und auf die regionalen Besonderheiten deutscher Erdbebengebiete ausgerichtete Bauwerksbemessung gewährleistet. Der erreichte Grad der Harmonisierung europäischer Erdbebenbaunormen wird anhand aktueller Zonenkarten sowie der Festlegungen zu Bemessungsbeschleunigungen entlang der nationalen Grenzen beispielhaft nachvollzogen. Da die neue Gefährdungszonenkarte eine veränderte regionale Verteilung der Erdbebenzonen bedingt, wird auf die Notwendigkeit einer Bewertung der Erdbebentauglichkeit der vorherrschenden Bauweisen und die Identifikation der im Katastrophenfall bedeutenden Anlagen und Einrichtungen hingewiesen. Buildings in German seismic regions , to the introduction of the revised German Seismic Code DIN 4149: 2005. The introduction of the revised Seismic Code DIN 4149: 2005 can be regarded as an important step towards earthquake resistant and economic building design in German earthquake regions. Different stages of its elaboration are described chronologically, concluding in an outlook on the ongoing development in European code standardization. Interdisciplinary research projects, which influenced the redrafting of the general rules and the implementation of new approaches, substantially, are recognized for their contributions. In particular, the concept of geology- and subsoil-dependent response spectra enables a refined description of seismic action and building design while reflecting the existing site conditions realistically. The attained state of harmonisation of national regulations is discussed exemplary by comparing peak ground and derived design accelerations alongside the borders with neighbouring countries like Belgium, France and Switzerland. With respect to the new zoning map and the modifications of affected areas, the need of practical implementation is directed towards two tasks: evaluation of the existing building stock and the predominant building types and identification of those structures and facilities which are of high importance in cases of catastrophic events. [source] Subconjunctival injection of bevacizumab (Avastin®) for corneal neovascularizationACTA OPHTHALMOLOGICA, Issue 2009MF DE LA PAZ Purpose to study the effects of subconjunctival injection of Bevacizumab on corneal neovascularization. Methods Prospective interventional case series on 7 eyes of 7 patients who underwent subconjunctival injection with Bevacizumab. The following parameters were studied pre-op, at 1 week, 30, 60 and 90 days post-op: UCVA, BCVA, pachymetry with OCT, slit lamp examination and photographic imaging. Conjunctival impression cytology pre-op at 1 week and 9o days was done and complications were also noted. Results Pre-op diagnoses were: herpetic leucoma (4 eyes), chemical burn (2 eyes), neurotrofic keratopathy (1 eye). An informed off-label consent form prior to procedure was signed. 1.25 mg of subconjunctival Bevacizumab was injected nearest the area affected. Mean preoperative UCVA and BCVA were 0.86 and 0.44 LogMar units, improved to 0.61 and 0.26 LogMar units at 90 days post-op, respectively. Central and peripheral pachymetry improved from 532 and 623 microns pre-op, to 529 and 619 microns at 90 days post-op, respectively. All slit lamp findings and photographic imaging showed a clear regression of superficial and deep stromal corneal vascularization, with clearing of lipid deposits around the affected areas. No toxic effects were noted on conjunctival impression cytology. Conclusion Subconjunctival injection of Bevacizumab is a safe and effective procedure for the regression of superficial and deep corneal neovascularization. It may be a good alternative for patients prior to performing an optical keratoplasty or for those who are poor candidates for the same. [source] Chemical and Biogeophysical Impact of Four-Dimensional (4D) Seismic Exploration in Sub-Saharan Africa, and Restoration of Dysfunctionalized Mangrove Forests in the Prospect AreasCHEMISTRY & BIODIVERSITY, Issue 9 2007Abstract Four-dimensional (4D) seismic exploration, an improved geophysical technique for hydrocarbon-data acquisition, was applied for the first time in the Nembe Creek prospect area of Nigeria. The affected soils were slightly alkaline in situ when wet (pH,7.2), but extremely acidic when dry (pH,3.0). The organic carbon content (4.6,26.8%) and other physicochemical properties of soils and water (N, P, and heavy-metal contents, etc.) were higher than the baseline values obtained in 2001 before seismic profiling. Most values also exceeded the baseline compliance standards of the Department of Petroleum Resources (DPR), the World Health Organization (WHO), and the Federal Environmental Protection Agency (FEPA). Rehabilitation of the affected areas was achieved by stabilizing the mangrove floor by liming and appropriate application of nutrients, followed by replanting the cut seismic lines over a distance of 1,372,km with different mangrove species, including juvenile Rhizophora racemosa, R. mangle, and Avicennia species, which were transferred from nursery points. Quicker post-operational intervention is recommended for future 4D surveys, because the time lag between the end of seismic activity and post-impact investigation is critical in determining the relationship between activity and impact: the longer the intervening period, the more mooted the interaction. [source] | ||||||||||||||||||||||||||||||||||