Warfarin-induced skin necrosis is an infrequent complication occurring in individuals under warfarin treatment who have a thrombophilic history or after administration of large loading doses of warfarin particularly without simultaneous initial use of heparin. A 62-year-old lady developed skin necrosis 4 days after initiating warfarin therapy of 5 mg daily without initial co-administration of heparin. The patient had a normal clotting profile. Skin necrosis progressed to eschar formation after cessation of warfarin and heparinization stopped expanding. Warfarin was reintroduced at 2 mg daily, initially together with low molecular weight heparin. Autolytic debridement of the necrotic tissue was followed by healing of the cutaneous deficit by secondary intention. Prompt diagnosis and discontinuation of warfarin are crucial for the prognosis. PMID:24648693
Papanas, Nikolaos; Karadimas, Efthimios; Polychronidis, Alexandros
A patient with a history of deep vein thrombosis presented with painful bruising and blistering on his left leg 7–10?days after warfarin treatment. A complicated 2-month treatment followed, where vasculitis was originally diagnosed from histological findings before the final diagnosis of warfarin-induced skin necrosis (WISN) was made on clinical grounds. Warfarin was stopped, reversed and low molecular weight heparin started but, the lesions had progressed to full thickness necrosis. This was originally treated with conventional surgical debridement before introducing maggot debridement therapy (MDT) in an effort to try to salvage the limb. PMID:23362073
Biscoe, Anna Louise; Bedlow, Alison
Skin necrosis must be considered as a syndrome, because it is a clinical manifestation of different diseases. An early diagnosis is very important to choose the appropriate treatment. Therefore, its causes should be suspected and confirmed quickly. We report eleven patients with skin necrosis seen at our Department, caused by different etiologies: Warfarin-induced skin necrosis, loxoscelism, diabetic microangiopathy, ecthyma gangrenosum, disseminated intravascular coagulation, necrotizing vasculitis, paraneoplastic extensive necrotizing vasculitis, livedoid vasculopathy, necrotizing fasciitis, necrosis secondary to the use of vasoactive drugs and necrosis secondary to the use of cocaine. We also report the results of our literature review on the subject. PMID:24861125
Molgó, Montserrat N; Arriagada, Camila E; Salomone, Claudia B; Vera, Cristián K; Giesen, Laura F; Solar, Antonieta G; González, Sergio B
Erythroderma is a potentially serious and life-threatening skin disease with a number of possible aetiologies. Drug reactions are well-documented causes, with carbamazepine, penicillin and allopurinol being the most commonly implicated. This case describes a unique presentation of warfarin-induced erythroderma in a 78-year-old female patient. PMID:24592901
Rowe, Casey J; Robertson, Ivan; James, Daniel; McMeniman, Erin
Oral anticoagulants acting via vitamin K antagonists have long been employed in the clinical practice. However, difficulties related to the management of treatment regimens and complications still persist. Among the complications, bleeding disorders are widely known, but oth- ers should also be taken into consideration, such as warfarin-induced skin necrosis. The pathophysiology of this rare but severe complication is still
Jose Manoel da Silva; Fernando Thomazinho; Wander Eduardo Sardinha; Igor Schincariol Perozin; Domingos de Morais Filho
The efficacy shown by biological therapy with tumor necrosis factor (TNF) antagonists has led in the recent years to its increased and extended use in different inflammatory arthopathies. Initially, safety studies of these drugs were mainly focused on the risk of infection and the development of malignancies. Recently, several cases of skin lesions induced by anti-TNF drugs have been reported with an increased incidence, highlighting the importance of the skin as a major target of the side effects of these drugs. In addition to skin lesions directly related to drug administration there is a wide spectrum of skin lesions of different morphology and etiology, especially the development of cutaneous immune-mediated conditions, an emergent phenomenon associated with this treatment. We describe the main skin lesions associated with treatment with anti-TNF drugs according to an extensive review of the literature. PMID:22766431
Hernández, Maria Victoria; Meineri, Melina; Sanmartí, Raimon
Thromboprophylaxis are routinely given to prevent venous thromboembolism (VTE) in patients after total hip and knee replacement surgeries. Low molecular weight heparin (LMWH) (fractioned heparin) is effective in the prevention and treatment of VTE. The predicable effect of LMWH has popularized it for routine clinical use. Although LMWH has lesser complication rate, compared to unfractioned heparin (UFH), sporadic clinical complication has been reported. We report a rare case of skin necrosis secondary to use of LMWH tinzaparin used for routine thromboprophylaxis after total knee replacement. PMID:24804131
Karuppiah, S. V.; Johnstone, A. J.
Thromboprophylaxis are routinely given to prevent venous thromboembolism (VTE) in patients after total hip and knee replacement surgeries. Low molecular weight heparin (LMWH) (fractioned heparin) is effective in the prevention and treatment of VTE. The predicable effect of LMWH has popularized it for routine clinical use. Although LMWH has lesser complication rate, compared to unfractioned heparin (UFH), sporadic clinical complication has been reported. We report a rare case of skin necrosis secondary to use of LMWH tinzaparin used for routine thromboprophylaxis after total knee replacement. PMID:24804131
Karuppiah, S V; Johnstone, A J
The great selectivity and the lack of side effects of Photodynamic Therapy make it more advantageous than radiotherapy or chemotherapy. The application of PDT to skin diseases is particularly appropriate, due to the accessibility of this tissue. Common disorders like nonmelanoma skin cancer, that includes basocelullar or squamous cell carcinomas, can be treated with PDT. Conventional procedures, like surgery or radiotherapy, are not so efficient and do not, in general, obtain the same favourable results. PDT in dermatology medical praxis uses fixed protocols depending on the photosensitizer and the optical source used. These protocols are usually provided by the photosensitizer laboratory, and every lesion is treated with the same parameters. In this work we present a photo-chemical model of PDT applied to skin disorders treated with topical photosensitizers. Optical propagation inside the tissue is calculated by means of a 3D diffusion equation, solved via a finite difference numerical method. The photosensitizer degradation or photobleaching is taken into account, as the drug looses efficiency with the irradiation time. With these data the necrosis area is estimated, so this model could be used as a predictive tool to adjust the optical power and exposition time for the particular disease under treatment.
Fanjul-Vélez, F.; Romanov, O. G.; López-Escobar, M.; Ortega-Quijano, N.; Arce-Diego, J. L.
Summary Background: Coumadin is the standard oral anticoagulant used in a variety of clinical conditions. Coumadin inhibits the vitamin-K dependent gamma-carboxylation of coagulation factors II, VII, IX, X and the anticoagulant proteins C and S. Rarely, skin necrosis occurs when the resultant initial procoagulant state in the first few days of starting coumadin leads to thrombosis and formation of blood clots tin the dermal capillaries. This in turn causes skin necrosis due to interruption in blood supply to the skin. Case Report: We are presenting the case of a 64 year-old female admitted for acute respiratory distress secondary to newly-diagnosed pulmonary embolism. The patient was started on therapeutic doses of low molecular weight heparin (LMWH) and coumadin. After 5 days of treatment, the patient started complaining of pain and numbness in both upper extremities. Overnight, this rapidly progressed to manifest hemorrhagic bullae with necrotic areas. This was immediately recognized as coumadin-induced skin necrosis. Coumadin was stopped immediately. Vitamin K was administered and local wound care was provided. Therapeutic LMWH was continued. The skin lesions began to show improvement after 3 days. Conclusions: In coumadin-induced skin necrosis, the patient initially presents with pain and erythema, followed by petechial lesions which progress to become purpuric. Hemorrhagic bullae with necrosis and eschar formation may soon develop. Once it is suspected, coumadin should be stopped and the patient should be given Vitamin K and FFP to reverse the effects of coumadin. PMID:23569516
Kumar, Mehandar; Abrina, Vanessa Mae; Chittimireddy, Sasikala
Warfarin-Induced Artery Calcification Is Accelerated by Growth and Vitamin D Paul A. Price, Samuel A. Faus, Matthew K. Williamson Abstract--The present studies demonstrate that growth and vitamin D. The second set of experiments examined the possible synergy between vitamin D and Warfarin in artery
Price, Paul A.
We report a case of skin necrosis as a result of the use of a negative pressure device for erectile dysfunction. To our knowledge this is the first report of such a complication. The patient was paraplegic with hypesthesia and analgesia of the genital area. PMID:2398575
Meinhardt, W; Kropman, R F; Lycklama à Nijeholt, A A; Zwartendijk, J
Mesenchymal stem cells (MSCs), multipotential cells that reside within the bone marrow, can be induced to differentiate into various cells, such as osteoblasts, adipocytes, chondrocytes, vascular endothelial progenitor cells, and other cell types. MSCs are being widely studied as potential cell therapy agents due to their angiogenic properties, which have been well established by in vitro and in vivo researches. Within this context, MSCs therapy appears to hold substantial promise, particularly in the treatment of conditions involving skin grafts, pedicle flaps, as well as free flaps described in literatures. The purpose of this review is to report the new advances and mechanisms underlying MSCs therapy against skin flaps necrosis. PMID:25258671
Zhang, Fu-Gui; Tang, Xiu-Fa
Objective Accumulating experimental evidence implicates ?-catenin signaling and enzyme transglutaminase 2 (TG2) in the progression of vascular calcification, and our previous studies have shown that TG2 can activate ?-catenin signaling in vascular smooth muscle cells (VSMCs). Here we investigated the role of the TG2/?-catenin signaling axis in vascular calcification induced by warfarin. Methods and Results Warfarin-induced calcification in rat A10 VSMCs is associated with the activation of ?-catenin signaling and is independent from oxidative stress. The canonical ?-catenin inhibitor Dkk1, but not the Wnt antagonist Wif-1,prevents warfarin-induced activation of ?-catenin, calcification, and osteogenic trans-differentiation in VSMCs. TG2 expression and activity are increased in warfarin-treated cells, in contrast to canonical Wnt ligands. Vascular cells with genetically or pharmacologically reduced TG2 activity fail to activate ?-catenin in response to warfarin. Moreover, warfarin-induced calcification is significantly reduced on the background of attenuated TG2 both in vitro and in vivo. Conclusions TG2 is a critical mediator of warfarin-induced vascular calcification that acts through the activation of ?-catenin signaling in VSMCs. Inhibition of canonical ?-catenin pathway or TG2 activity prevents warfarin-regulated calcification, identifying the TG2/?-catenin axis as a novel therapeutic target in vascular calcification. PMID:22034513
Beazley, Kelly E.; Deasey, Stephanie; Lima, Florence; Nurminskaya, Maria V.
In recent years, perforator flaps have become an indispensable tool for the reconstruction process. Most recently, "propeller" perforator flaps allow each perforator vessels to become a flap donor site. Once the perforator of interest is identified by acoustic Doppler, the cutaneous or fascio-cutaneous island is designed and then customized according to the principle of "perforasome". So, the flap can be rotated such a propeller, up to 180°. Ideally the donor site is self-closing, otherwise it can be grafted at the same time. Through a skin necrosis secondary to a contrast medium extravasation of the cubital fossa in a 47-year-old man, we describe the use of propeller perforator flap based on a perforator of the radial collateral artery (RCAP). The perforator was identified preoperatively by acoustic Doppler then the flap was adapted bespoke to cover the loss of substance. Ultimately, the result was very satisfying. Well experienced for lower-extremity reconstruction, perforator-based propeller flap are still few reported for upper limb. It is likely that in the future, propeller flap supersede in many indication not only free flaps and locoregional flaps but also, leaving no room for uncertainties of the vascular network, the classic random flaps. PMID:23891106
Chaput, B; Gandolfi, S; Ho Quoc, C; Chavoin, J-P; Garrido, I; Grolleau, J-L
This case study describes an atypical case of refractory, sodium warfarin-induced necrotizing fasciitis and myonecrosis. This patient did not initially receive surgical debridement and systemic antibiotics, the standard treatment for necrotizing fasciitis of bacterial origin. This patient's wound care regimen began with silver sulfadiazine and wet-to-dry dressings, modified to initial cleansing with a zinc-saline solution, followed with application of a zinc-saline wet dressing, impregnated with an aluminum hydroxide ointment. The patient experienced pain relief after the first application. After 4 weeks, the necrotic tissue sloughed off, the early signs of healing appeared making surgical debridement possible. Therapy with the zinc-saline dressings was continued and restoration of all tissues was documented within 225 days. If aggressive surgical therapy is not an option, the prevention of secondary complications such as infection becomes the goal of treatment until the necrotic process stops and healing begins. For this goal, a moist environment may be the optimal choice for topical therapy. PMID:7779233
Piczon, O Y; Manahan, F J; Udomsak, P; Villasin, J J; Clark, M G
Human scalp skin and hair follicles (HFs) are extra-pituitary sources of prolactin (PRL). However, the intracutaneous regulation of PRL remains poorly understood. Therefore we investigated whether well-recognized regulators of pituitary PRL expression, which also impact on human skin physiology and pathology, regulate expression of PRL and its receptor (PRLR) in situ. This was studied in serum-free organ cultures of microdissected human scalp HFs and skin, i.e. excluding pituitary, neural and vascular inputs. Prolactin expression was confirmed at the gene and protein level in human truncal skin, where its expression significantly increased (p?=?0.049) during organ culture. There was, however, no evidence of PRL secretion into the culture medium as measured by ELISA. PRL immunoreactivity (IR) in female human epidermis was decreased by substance P (p?=?0.009), while neither the classical pituitary PRL inhibitor, dopamine, nor corticotropin-releasing hormone significantly modulated PRL IR in HFs or skin respectively. Interferon (IFN) ? increased PRL IR in the epithelium of human HFs (p?=?0.044) while tumour necrosis factor (TNF) ? decreased both PRL and PRLR IR. This study identifies substance P, TNF? and IFN? as novel modulators of PRL and PRLR expression in human skin, and suggests that intracutaneous PRL expression is not under dopaminergic control. Given the importance of PRL in human hair growth regulation and its possible role in the pathogenesis of several common skin diseases, targeting intracutaneous PRL production via these newly identified regulatory pathways may point towards novel therapeutic options for inflammatory dermatoses. PMID:23626671
Langan, Ewan A.; Vidali, Silvia; Pigat, Natascha; Funk, Wolfgang; Lisztes, Erika; Bíró, Tamás; Goffin, Vincent; Griffiths, Christopher E. M.; Paus, Ralf
Background: Anti-tumor necrosis factor (TNF) agents are increasingly being used for a rapidly expanding number of rheumatic and systemic diseases. As a result of this use, and of the longer follow-up periods of treatment, there are a growing number of reports of the development of autoimmune processes related to anti-TNF agents. The use of anti-TNF agents has been associated with
L. Boussemart; S. Jacobelli; F. Batteux; C. Goulvestre; P. Grange; A. Carlotti; J. P. Morini; I. Gorin; J. M. Ziza; M. F. Avril; N. Dupin
Vacuum-assisted closure (VAC) is a relatively new technique for wound management in dogs and cats. It was successfully used in this cat to treat severe urine-induced skin and thigh muscle necrosis, resulting from a traumatic urethral rupture. No complications were encountered with application of the VAC technique and production of a healthy granulation bed, suitable for wound reconstruction, was achieved after only five days of VAC treatment. The marked wound contraction (40.3%) obtained after eight days of treatment, was sufficient to allow closure of the defect using a simple, rotational subdermal plexus flap. This was a safe, effective and efficient treatment for a challenging wound in a difficult anatomical location. PMID:19750293
Owen, L; Hotston-Moore, A; Holt, P
AIM: To investigate the correlation between the appearance of skin lesions and concentration of interleukin (IL)-17A, IL-23 and interferon-? (IFN-?) in Crohn’s disease (CD) patients during anti-tumor necrosis factor-? (TNF-?) therapy METHODS: A prospective study included 30 adult patients with CD of Caucasian origin (19 men and 11 women; mean age ± SD 32.0 ± 8.6 years) during biological therapy with anti-TNF-? antibodies from January 2012 to March 2013. Eighteen patients were treated with infliximab, seven with adalimumab and five with certolizumab. Inclusion criteria were exacerbation of the underlying disease, Crohn’s Disease Activity Index over 300 and the ineffectiveness of previously used non-biological therapies. Patients with a history of psoriasis, atopic dermatitis and other autoimmune skin lesions were excluded from the study. The control group consisted of 12 healthy subjects. A diagnostic survey was carried out, blood tests and careful skin examination were performed, and the serum levels of IL-17, IL-23 and IFN-? were measured using an enzyme-linked immunosorbent assays technique. Dermatoses that have developed in the course of biological therapy in patients who had no pre-existing skin lesions of similar character were qualified as skin lesions induced by anti-TNF-? therapy. RESULTS: Skin manifestations occurred in 18 of CD patients during the anti-TNF-? therapy (60%), in the average time of 10.16 ± 3.42 mo following the beginning of the 52-wk treatment cycle. Skin lesions observed in CD patients during biological therapy included psoriasiform lesions (44.4%), and eczema forms lesions (22.2%). In CD patients with drug induced skin lesions significantly higher levels of hemoglobin (13.3 ± 1.5 g/dL vs 10.8 ± 1.9 g/dL, P = 0.018) and hematocrit (39.9% ± 4.5% vs 34.3% ± 5.4%, P = 0.01), as well as a significantly lower level of platelets (268 ± 62 × 103/?L vs 408 ± 239 × 103/?L, P = 0.046) was observed compared with CD patients without skin manifestations. The concentrations of IL-17A and IL-23 in CD patients with skin lesions developed under anti-TNF-? therapy were significantly higher compared to those in patients without lesions (IL-17A: 39.01 ± 7.03 pg/mL vs 25.71 ± 4.90 pg/mL, P = 0.00004; IL-23: 408.78 ± 94.13 pg/mL vs 312.15 ± 76.24 pg/mL, P = 0.00556). CONCLUSION: Skin lesions in CD patients during biological therapy may result from significantly increased concentrations of IL-17A and IL-23, which are strongly associated with TNF-?/Th1 immune pathways. PMID:24944497
W?odarczyk, Marcin; Sobolewska, Aleksandra; Wójcik, Bartosz; Loga, Karolina; Fichna, Jakub; Wi?niewska-Jarosi?ska, Maria
Haemophilus ducreyi (H. ducreyi) strains, representing both reference strains and low-passage isolates, were investigated in terms of surface structures and enzymatic equipment. The interaction of these factors with host tissue was analysed using new in vitro- and in vivo-models. By electron microscopy studies there was no evidence of an extracellular capsule or surface appendages such as pili or flagella. Interaction of all isolates tested with the lectin Phaseolus vulgaris suggests N-acetyl-D-glucosamine units as common structural features of H. ducreyi cell envelope polysaccharide. In attachment to epithelial cells more than one hemagglutinin might be implicated as different haemagglutination patterns could be observed whereby the activity was not heat-labile, but was abolished by formaldehyde. Hydrophobic interactions might be of importance as well as strains showed a wide range of reactions from hydrophobic to hydrophilic, low hydrophobicity being more marked with the older strains. No elaboration of degradative enzymes based on the measurement of enzymatic activity using insoluble dye-protein complexes could be detected in case of H. ducreyi, using Azocoll and Remazol Brilliantblue hide powder for detection of proteolytic activity and elastinorcein for detection of elastase activity. In vitro studies using human keratinocytes and Vero cells did not show any morphological changes when incubated with H. ducreyi culture filtrates. In vivo studies with a new mouse model for H. ducreyi infection could confirm the results of the in vitro studies. Mere contact to undamaged skin both of whole cell organisms, live or heat-killed, and of culture filtrates did not lead to any reaction or even damage of mouse skin. However, when the outer epidermal layer was overcome by intradermal injection of shaved mice ulcers developed. Tissue necrosis production was not bound to live organisms as dead ones showed the same effect. There is great evidence that this tissue necrosis is associated with H. ducreyi lipopolysaccharide (LPS) because intradermal injection of purified H. ducreyi LPS lead to the same reaction pattern. For the first time a cell mediated immune response could be demonstrated in case of H. ducreyi infection as different antigen preparations of H. ducreyi isolates induced proliferation of lymphocytes isolated from healthy unexposed individuals and from a chancroid-sensitized male. In the latter case measured cell responses were much stronger. The dose-dependent phenomenon was associated with interleukin-2 production. In summary, H. ducreyi isolates do not exhibit cytotoxic effects on the epithelial cells of the skin.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1636361
Abeck, D; Korting, H C
. Retinoic acid (RA) and glycolic acid (GA) are frequently used in the treatment of acne and skin aging, as well as improving\\u000a skin healing after dermabrasion and in photoaged skin. Examples of histologic alterations caused by these substances are vascularization\\u000a increase and interference with inflammatory as well as regenerative skin processes. The objective of this study was to evaluate
Alan Landecker; Marta Lúcia Silva Katayama; Angelica Kolody Mammana; Regina Maria Cubero Leitao; Theresa Sachetta; Rolf Gemperli; Rogério Izar Neves
Levamisole-induced vasculitis is a relatively new entity in people who use cocaine. We describe a 44-year-old woman with a history of cocaine use who presented with a complaint of a painful rash of 2-3 month’s duration on her extremities, cheeks, nose, and earlobes. She had not experienced fever, weight loss, alopecia, dry eyes, oral ulcers, photosensitivity, or arthralgia. Examination revealed tender purpuric eruptions with central necrosis on her nose, cheeks, earlobes, and extremities. Laboratory investigations revealed neutropenia, an elevated erythrocyte sedimentation rate (ESR), presence of lupus anticoagulant, low complement component 3 (C3), and presence of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA). A urine toxicology screen was positive for cocaine, and gas chromatography–mass spectrometry was positive for levamisole. Skin biopsy showed leukocytoclastic vasculitis and small vessel thrombosis. Necrotic lesions of the nose led to its self-amputation. Large bullae on the lower extremities ruptured, leading to wound infection and extensive necrosis that required multiple surgical debridements. When necrosis progressed despite debridement, bilateral above-knee amputation of the legs was performed. Once new lesions stopped appearing, the patient was discharged home. Two months later, she had a recurrence related to cocaine use. To the best of our knowledge, this is only the second reported case of levamisole-induced vasculitis that required above-knee amputation. PMID:23186390
Cancer patients receiving epidermal growth factor receptor (EGFR) antibody therapy often experience an acneiform rash of uncertain etiology in skin regions rich in pilosebaceous units. Currently, this condition is treated symptomatically with very limited, often anecdotal success. Here, we show that a monoclonal antibody targeting murine EGFR, ME1, caused a neutrophil-rich hair follicle inflammation in mice, similar to that reported in patients. This effect was preceded by the appearance of lipid-filled hair follicle distensions adjacent to enlarged sebaceous glands. The cytokine tumor necrosis factor-alpha (TNFalpha), localized immunohistochemically to this affected region of the pilosebaceous unit, was specifically up-regulated by ME1 in skin but not in other tissues examined. Moreover, skin inflammation was reduced by cotreatment with the TNFalpha signaling inhibitor, etanercept, indicating the involvement of TNFalpha in this inflammatory process. Interleukin-1, a cytokine that frequently acts in concert with TNFalpha, is also involved in this process given the efficacy of the interleukin-1 antagonist Kineret. Our results provide a mechanistic framework to develop evidence-based trials for EGFR antibody-induced skin rash in patients with cancer. PMID:19584274
Surguladze, David; Deevi, Dhanvanthri; Claros, Nidia; Corcoran, Erik; Wang, Su; Plym, Mary Jane; Wu, Yan; Doody, Jacqueline; Mauro, David J; Witte, Larry; Busam, Klaus J; Pytowski, Bronek; Rodeck, Ulrich; Tonra, James R
Venous thromboembolism is an important cause for maternal morbidity and mortality in postpartum period. Though catheter-directed thrombolysis (CDT) is now considered as a safe and effective therapy for the management of deep venous thrombosis (DVT) but still it is not indicated in postpartum DVT. We are presenting a case of 22-year-old female patient who presented with post-partum lower limb DVT and managed successfully with CDT by using injection streptokinase and temporary inferior vena caval filter was inserted as prophylactic for pulmonary embolism as she had extensive DVT extending into inferior vena cava (IVC). During follow-up, she developed large skin necrosis in left lower limb which was managed by adding injection low-molecular-weight heparin. IVC filter also could not be retrieved even after trying all manoeuvres during follow-up after 2 weeks. PMID:23887994
Srinivas, B C; Patra, Soumya; Agrawal, Navin; Manjunath, C N
Tumor necrosis factor (TNF)-? induces matrix metalloproteinases (MMPs) that may disrupt skin integrity. We have investigated the effects and mechanisms of exogenous TNF-? on collagen degradation by incubating human skin explants in defined serum-free media with or without TNF-? (10 ng/ml) in the absence or presence of the nonselective MMP inhibitor GM6001 for 8 days. The basal culture conditions promoted type I collagen catabolism that was accelerated by TNF-? (p < 0.005) and accomplished by MMPs (p < 0.005). Levels of the collagenases MMP-8 and MMP-13 were insignificant and neither MMP-2 nor MMP-14 were associated with increased collagen degradation. TNF-? increased secretion of MMP-1 (p < 0.01) but had no impact on MMP-1 quantities in the tissue. Immunohistochemical analysis confirmed similar tissue MMP-1 expression with or without TNF-? with epidermis being the major source of MMP-1. Increased tissue-derived collagenolytic activity with TNF-? exposure was blocked by neutralizing MMP-1 monoclonal antibody and was not due to down-regulation of tissue inhibitor of metalloproteinase-1. TNF-? increased production (p < 0.01), tissue levels (p < 0.005) and catalytic activity of the endogenous MMP-1 activator MMP-3. Type I collagen degradation correlated with MMP-3 tissue levels (rs = 0.68, p < 0.05) and was attenuated with selective MMP-3 inhibitor. Type I collagen formation was down-regulated in cultured compared with native skin explants but was not reduced further by TNF-?. TNF-? had no significant effect on epidermal apoptosis. Our data indicate that TNF-? augments collagenolytic activity of MMP-1, possibly through up-regulation of MMP-3 leading to gradual loss of type I collagen in human skin. PMID:25457675
Ågren, Magnus S.; Schnabel, Reinhild; Christensen, Lise H.; Mirastschijski, Ursula
Background Anti-tumor necrosis factor alpha (anti-TNF) drugs are very effective for the treatment of rheumatoid arthritis but may increase the risk of serious bacterial infections. We assessed the association between the risk of serious skin and soft tissue infections (SSSTI) and the use of these agents in rheumatoid arthritis patients (RA). Methods We conducted a nested case–control study among rheumatoid arthritis patients in the Veterans Integrated Service Network 20 from 2000–2008. We identified rheumatoid arthritis patients with SSSTI, matched them to three sets of RA controls and used conditional logistic regression to compare the risk of SSSTI between patients treated and those not treated with an anti-TNF drug, after adjusting for known confounders and important covariates. Limited by the design, we could not assess (absolute) risk but only relative risk in terms of association. Results Among the 97 cases and 291 controls, 90 percent were male, 62 percent white, with a mean age of 63 years. Twenty percent received anti-TNF drugs during the study period. Thirty-nine percent of cases and 15 percent of controls died, (OR 3.5, 95% CI: 2.033, 6.11, p <0.01). Diabetes mellitus (37%), kidney disease (16%) and a history of skin infections (27%) were common among cases. Based on conditional logistic regression, anti-TNF use was not significantly associated with skin and soft tissue infections (OR 1.1, 95% CI: 0.61-2.03, p = 0.92). However, patients with diabetes mellitus (OR 2.5, 95% CI: 1.53-4.13, p = 0.01) or a prior history of skin infection (OR 5.7, 95% CI: 2.87-11.43, p <0.01) were more likely to have skin and soft tissue infections. Conclusion Use of anti-TNF therapy among RA patients was not associated with an increased risk of SSSTI, but patients with diabetes mellitus and those with a history of prior skin infection were significantly more likely to have SSSTI and mortality was higher among cases than controls in this veteran cohort. PMID:24498926
Type 1 neurofibromatosis is a relatively common inherited disease of the nervous system, with a frequency of almost 1 in 3000. It is associated with neurofibromas of various sites. Our case report is about the surgical management of a giant neurofibroma of the right gluteal fold in a 46-year-old male with NF1. The patient presented with increasing edema and accelerated growth of the mass; he underwent percutaneous embolization of lesion vessels that induced necrosis of the neurofibroma. The patient was taken to the operating room, where surgical resection of the bulk of the lesion was undertaken. The postoperative course was complicated by delayed wound closure managed with antibiotics and vacuum-assisted wound closure. Giant neurofibromas similar to this tumor require complex preoperative, intraoperative and postoperative management strategies. Surgical debulk is best managed with preoperative percutaneous embolization that help to avoid surgical bleeding. Postoperative delayed wound closure was managed with the application of negative pressure in a closed environment that triggers granulation and tissue formation. PMID:22958807
Cavallaro, G; Pedullà, G; Crocetti, D; D'Ermo, G; Giustini, S; Calvieri, S; De Toma, G
Among the several cytokines involved in the psoriasis pathogenesis, tumor necrosis factor (TNF)-alpha and interleukin (IL)-17 play a central role. Many biomolecular steps remain unknown due to difficulty to obtain psoriatic models. To investigate the effect of TNF-alpha and IL-17 on the ultrastructure, immunophenotype, and number of epidermal Langerhans cells (LCs), human skin explants (n=7) were cultured air-liquid interface in a Transwell system. Four different conditions were used: medium alone (control), medium added with 100ng/ml TNF-alpha or 50ng/ml IL-17 or a combination of both cytokines. Samples were harvested 24 and 48h after cytokine addition and were frozen. Samples harvested at 24h were also processed for transmission electron microscopy (TEM). By immunofluorescence analysis with anti-human Langerin antibody (three experiments/sample) we calculated the percentage of LCs/mm(2) of living epidermis after 24 and 48h of incubation (considering control as 100%). At 24h LC number was significantly higher in samples treated with both cytokines (216.71+15.10%; p<0.001) and in TNF-alpha (125.74+26.24%; p<0.05). No differences were observed in IL-17-treated samples (100.14+38.42%). After 48h, the number of epidermal Langerin-positive cells in IL-17- and TNF-alpha treated samples slightly decreased (94.99+36.79% and 101.37+23% vs. their controls, respectively). With the combination of both cytokines epidermal LCs strongly decreased (120+13.36%). By TEM, upon TNF-alpha stimulus LCs appeared with few organelles, mostly mitochondria, lysosomes, and scattered peripherical BGs. Upon IL-17 stimulus, LCs showed a cytoplasm with many mitochondria and numerous BGs close to the perinuclear space and Golgi apparatus, but also at the periphery, at the beginning of the dendrites. The addition of both cytokines did not affect LC ultrastructure. Our study showed that IL-17 induced significant changes in LC ultrastructure, while the combination of both cytokines seems to have a strong chemo-attractant effect on epidermal LCs, supporting the relevance of investigating the interplay between LCs and pro-inflammatory cytokines in the ongoing of the disease. PMID:25596626
Prignano, Francesca; Arnaboldi, Francesca; Cornaghi, Laura; Landoni, Federica; Tripo, Lara; Preis, Franz William Baruffaldi; Donetti, Elena
Introduction Anti-tumour necrosis factor (TNF) therapy is a mainstay of treatment in rheumatoid arthritis (RA). In 2001, BSRBR was established to evaluate the safety of these agents. This paper addresses the safety of anti-TNF therapy in RA with specific reference to serious skin and soft tissue infections (SSSI) and shingles. Methods A cohort of anti-TNF-treated patients was recruited alongside a comparator group with active RA treated with non-biological disease-modifying antirheumatic drugs (nbDMARD). 11 881 anti-TNF and 3673 nbDMARD patients were analysed. Follow-up was by 6-monthly questionnaires to patients and clinicians. Analyses considered SSSI and shingles separately. Incidence rates (IR) were calculated and then compared using survival analyses. Results The crude IR for SSSI were: anti-TNF 1.6/100 patient-years (95% CI 1.4 to 1.8); nbDMARD 0.7/100 patient-years (95% CI 0.5 to 1.0) and shingles: anti-TNF 1.6/100 patient-years (95% CI 1.3 to 2.0); nbDMARD 0.8/100 patient-years (95% CI 0.6 to 1.1). Adjusted HR were SSSI 1.4 (95% CI 0.9 to 2.4), shingles 1.8 (95% CI 1.2 to 2.8). For SSSI, no significant differences were seen between anti-TNF agents. For shingles, the lowest risk was observed for adalimumab (adjusted HR vs nbDMARD) 1.5 (95% CI 1.1 to 2.0) and highest for infliximab (HR 2.2; 95% CI 1.4 to 3.4)). Conclusion A significantly increased risk of shingles was observed in the anti-TNF-treated cohort. The risk of SSSI tended towards being greater with anti-TNF treatment but was not statistically significant. As with any observational dataset cause and effect cannot be established with certainty as residual confounding may remain. This finding would support the evaluation of zoster vaccination in this population. PMID:22532633
Galloway, James B; Mercer, Louise K; Moseley, Alison; Dixon, William G; Ustianowski, Andrew P; Helbert, Matthew; Watson, Kath D; Lunt, Mark; Hyrich, Kimme L; Symmons, Deborah PM
Caffeic acid (3,4-dihydroxycinnamic acid, CA) has been reported to have anti-inflammatory activity in animal models. However, the mechanisms underlying the anti-inflammatory effects of CA in skin inflammation are only partially understood. The present study was designed to investigate the effects and mechanisms of CA on acute and chronic skin inflammation in mice and the effect of CA in keratinocytes in vitro. The results showed that topical treatment with CA inhibited 12-O-tetradecanoyl-phorbol-13-acetate (TPA)-induced skin edema in a dose-dependent manner, leading to substantial reductions in skin thickness and tissue weight, neutrophil-mediated myeloperoxidase activity, and various histopathological indicators. The CA treatment also significantly reduced the mRNA and protein levels of tumor necrosis factor alpha (TNF-?), interleukin-6 (IL-6) and IL-1? at the application site, and the TNF-? production, the TNF-?-induced IL-6 and IL-1? production, and TNF-?-induced nuclear factor-kappa B (NF-?B) activation in human keratinocytes in vitro. Furthermore, CA was effective at reducing inflammatory damage induced by chronic TPA exposure. These results demonstrate that CA has anti-inflammatory activities in both acute and chronic contact dermatitis models via blockade of the mRNA and protein synthesis of these cytokines and neutrophil-mediated myeloperoxidase activity, and can target inflammatory mediators specifically in the keratinocytes. Taken together, the present results suggest that CA might be a therapeutic agent against inflammatory skin diseases. PMID:24583856
Zhang, Mengjun; Zhou, Juan; Wang, Li; Li, Bin; Guo, Jiawei; Guan, Xiao; Han, Qingjuan; Zhang, Huijing
Tumor Necrosis Factor-?-induced Proteolytic Activation of Pro-matrix Metalloproteinase-9 by Human Skin Is Controlled by Down-regulating Tissue Inhibitor of Metalloproteinase-1 and Mediated by Tissue-associated Chymotrypsin-like Proteinase*
The proteolytic activation of pro-matrix metalloproteinase (MMP)-9 by conversion of the 92-kDa precursor into an 82-kDa active form has been observed in chronic wounds, tumor metastasis, and many inflammation-associated diseases, yet the mechanistic pathway to control this process has not been identified. In this report, we show that the massive expression and activation of MMP-9 in skin tissue from patients with chronically unhealed wounds could be reconstituted in vitro with cultured normal human skin by stimulation with transforming growth factor-? and tumor necrosis factor (TNF)-?. We dissected the mechanistic pathway for TNF-? induced activation of pro-MMP-9 in human skin. We found that proteolytic activation of pro-MMP-9 was mediated by a tissue-associated chymotrypsin-like proteinase, designated here as pro-MMP-9 activator (pM9A). This unidentified activator specifically converted pro-MMP-9 but not pro-MMP-2, another member of the gelatinase family. The tissue-bound pM9A was steadily expressed and not regulated by TNF-?, which indicated that the cytokine-mediated activation of pro-MMP-9 might be regulated at the inhibitor level. Indeed, the skin constantly secreted tissue inhibitor of metalloproteinase-1 at the basal state. TNF-?, but not transforming growth factor-?, down-regulated this inhibitor. The TNF-?-mediated activation of pro-MMP-9 was tightly associated with down-regulation of tissue inhibitor of metalloproteinase-1 in a dose-dependent manner. To establish this linkage, we demonstrate that the recombinant tissue inhibitor of metalloproteinase-1 could block the activation of pro-MMP-9 by either the intact skin or skin fractions. Thus, these studies suggest a novel regulation for the proteolytic activation of MMP-9 in human tissue, which is mediated by tissue-bound activator and controlled by down-regulation of a specific inhibitor. PMID:12004062
Han, Yuan-Ping; Nien, Yih-Dar; Garner, Warren L.
... Tumors Ewing Sarcoma Eye Cancer Germ Cell Tumors Kidney/Wilms Tumor Liver Cancer Neuroblastoma Osteosarcoma Rhabdomyosarcoma Skin Cancer Soft ... Leukemia Brain Tumors Ewing Sarcoma Germ Cell Tumors Kidney/Wilms Tumor Liver Cancer Lymphoma (non-Hodgkin) Lymphoma (Hodgkin) Neuroblastoma ...
Four cases of Japanese patients with psoriatic arthritis in whom effective treatments by anti-tumor necrosis factor-? drugs were evaluated by magnetic resonance imaging together with improvement of skin lesions.
Because psoriatic skin lesions of psoriatic arthritis (PsA) usually precede the onset of joint symptom, dermatologists are in an ideal position to screen and find individuals with PsA early in the disease course. There have been no reports from the dermatology field evaluating the effect of anti-tumor necrosis factor (TNF)-? drugs on joint disorders using magnetic resonance imaging (MRI) in PsA patients. The purpose of this study was to elucidate the effectiveness of MRI in the evaluation of anti-TNF-? drugs on joint disease of Japanese PsA patients. Data were collected from four adult Japanese male PsA patients. MRI of the affected hand was performed at baseline and 1-7 months after infliximab or adalimumab treatment. T1 -weighted gadolinium-enhanced images with fat suppression were acquired in the coronal, sagittal and/or axial planes. We determined the apparent improvement of synovitis, periarticular inflammation, tenosynovitis and/or bone marrow edema by MRI after anti-TNF-? treatments in all the patients together with the improvement of skin lesions. We also determined in one patient that these symptoms detected by MRI before treatment were alleviated within 1 month and had disappeared 6 months after treatment, suggesting the potentially early detection of the effect of anti-TNF-? drugs on joint disease. We present four cases of Japanese patients with PsA in whom effective treatments by anti-TNF-? drugs were evaluated by contrast-enhanced MRI. This imaging enables dermatologists and radiologists to assess and monitor early inflammatory changes, and to grant PsA patients earlier access to modern treatment such as biologics. PMID:25425546
Yonenaga, Takenori; Saeki, Hidehisa; Nakagawa, Hidemi; Fukuchi, Osamu; Umezawa, Yoshinori; Hayashi, Mitsuha; Ito, Toshihiro; Yanaba, Koichi; Tojyo, Shinjiro; Fukuda, Kunihiko
The processes that course with intraabdominal fat necrosis often manifest with acute or subacute abdominal pain; these clinical findings can be caused by various conditions, including epiploic appendagitis, omental infarction, encapsulated fat necrosis, mesenteric panniculitis, appendicitis, diverticulitis, and certain neoplasms. In this context, although the anatomic location of the pain and accompanying symptomatology can help orient the diagnosis, there is a risk of unnecessary surgery. Imaging tests like ultrasonography and especially computed tomography are essential for diagnosing intraabdominal fat necrosis. Radiologists must be familiar with the characteristic findings for all the conditions that can cause acute or subacute abdominal pain to ensure appropriate management and prevent unnecessary surgery. PMID:22019421
Aguilar-García, J J; Alcaide-León, P; Vargas-Serrano, B
Contact hypersensitivity (CHS) is a typical inflammatory response against contact allergens. Inflammatory cytokines, including IL-1 and tumor necrosis factor (TNF)-a, are implicated in the reaction, although the precise roles of each cytokine have not been completely elucidated. In this report, we dissected the functional roles of IL-1 and TNF-a during CHS. CHS induced by 2,4,6- trinitorochlorobenzene as well as oxazolone
Susumu Nakae; Yutaka Komiyama; Shosaku Narumi; Katsuko Sudo; Reiko Horai; Yoh-ichi Tagawa; Kenji Sekikawa; Koji Matsushima; Masahide Asano; Yoichiro Iwakura
Nicolau syndrome is an uncommon complication of intramuscular injection leading to variable degrees of necrosis of skin and the underlying tissues. We report here two cases of this syndrome. Our first case was a 25 year-old male who developed intense pain and purplish discoloration of the skin in the right hip after intramuscular diclofenac injection. The second case was a 60 year-old male who developed intense pain and discoloration of skin, not only at the injection site, but also on the left scapular area and left elbow after receiving chlorpheniramine maleate injection intramuscularly. These cases highlight the need for awareness about this condition and the need to exercise utmost care during the administration of any parenteral injections by dermatologists. PMID:20808597
Nischal, KC; Basavaraj, HB; Swaroop, MR; Agrawal, DP; Sathyanarayana, BD; Umashankar, NP
We report a case of a 6-year-old girl with severe protein S deficiency due to a homozygous mutation and recurrent episodes of skin necrosis. She developed purpura fulminans at birth and a catheter-related venous thrombosis complicated by massive pulmonary embolism at the sixth day of life. Long-term oral anticoagulant therapy with a vitamin K-antagonist was started with a therapeutic range of the international normalized ratio of prothrombin time between 2.0 and 3.0. Unfortunately, this common range was not sufficient because recurrent episodes of warfarin-induced skin necrosis developed if the international normalized ratio was <4.0. Vitamin K antagonists decrease plasma level of vitamin K-dependent coagulation proteins, including the natural anticoagulant protein C. In our patient, the hypercoagulable state due to warfarin-induced reduction of protein C, other than severe protein S deficiency, outweighed the anticoagulant efficacy of the inhibition of procoagulant factors II, VII, IX, and X. The switch of anticoagulant therapy from warfarin to rivaroxaban, a direct inhibitor of activated factor X that does not inhibit other vitamin K-dependent proteins, resulted in the disappearance of skin necrosis at 1 year of follow-up. Rivaroxaban may be considered as a valid anticoagulant alternative in patients with severe inherited protein S deficiency and warfarin-induced skin necrosis. PMID:24144709
Martinelli, Ida; Bucciarelli, Paolo; Artoni, Andrea; Fossali, Emilio F; Passamonti, Serena M; Tripodi, Armando; Peyvandi, Flora
In this communication we discuss preliminary evidence suggesting a very strong synergism between tumour necrosis factor (TNF) and lipopolysaccharide (LPS) or between TNF and other bacteria in causing haemorrhagic necrosis and lethal shock. We found that TNF by itself does not cause haemorrhagic necrosis when injected into normal skin. TNF also had a rather low systemic toxicity when injected into disease-free, germfree-derived, defined-flora animals. On the other hand the addition of small amounts of LPS markedly raised the lethality of intravenous TNF treatments, and LPS injected into normal skin 'prepared' the site of injection for subsequent induction of haemorrhagic necrosis by locally injected TNF. Similar synergism was observed between TNF and mycoplasma. We suggest that the synergism between TNF and bacterial endotoxin (or other bacteria or bacterial products) may be part of an important defence mechanism against infections which is independent of specific immunity mediated by B and T cells. This synergism may be useful in increasing the therapeutic effects of TNF on tumours if the development of systemic toxicity in this treatment can be prevented. PMID:3330008
Rothstein, J L; Schreiber, H
It has been suggested that the ultimate depth of burn necrosis might be minimized by prevention or reversal of the progressive capillary stasis which occurs in the early postburn hours. To study the role of wound dehydration in determining burn depth, 5% body surface area, 75 C, 10 second burns (in which the zone of stasis included the full thickness of skin) were inflicted on the backs of guinea pigs and subsequent mechanical trauma was prevented. At various times postburn, water content, (and after India ink perfusion) depth of capillary stasis and histological structure of burn were studied in the following groups: 1) blister intact; 2) blister removed; and 3) blister replaced by several different types of dressing. Reversal of capillary stasis was least and necrosis full-thickness in depth in undressed wounds with blister removed. Reversal of capillary stasis was complete and necrosis absent with blister replaced by fresh split-thickness porcine skin and correlated with prevention of wound dehydration. Similar, though less complete, prevention of necrosis occurred with blister intact or replaced by sialastic film. Other dressings were associated with deep necrosis or gross infection. These and other data suggest that in the zone of stasis, capillary stasis may be reversed and necrosis avoided by appropriate prevention of wound dehydration. Clinical correlations are suggested. ImagesFig. 1.Fig. 2. PMID:4835963
Zawacki, Bruce E.
IL-1-induced tumor necrosis factor-alpha elicits inflammatory cell infiltration in the skin by inducing IFN-gamma-inducible protein 10 in the elicitation phase of the contact hypersensitivity response.
Contact hypersensitivity (CHS) is a typical inflammatory response against contact allergens. Inflammatory cytokines, including IL-1 and tumor necrosis factor (TNF)-alpha, are implicated in the reaction, although the precise roles of each cytokine have not been completely elucidated. In this report, we dissected the functional roles of IL-1 and TNF-alpha during CHS. CHS induced by 2,4,6-trinitorochlorobenzene as well as oxazolone was suppressed in both IL-1alpha/beta(-/-) and TNF-alpha(-/-) mice. Hapten-specific T cell activation, as examined by T cell proliferation, OX40 expression and IL-17 production, was reduced in IL-1alpha/beta(-/-) mice, but not in TNF-alpha(-/-) mice, suggesting that IL-1 but not TNF-alpha is required for hapten-specific T cell priming in the sensitization phase. On the other hand, TNF-alpha, induced by IL-1, was necessary for the induction of local inflammation during the elicitation phase. We also found that the expression of IFN-gamma-inducible protein 10 (IP-10) was augmented at the inflammatory site. Although IP-10 mRNA expression was abrogated in TNF-alpha(-/-) mice, both CHS development and TNF-alpha mRNA expression occurred normally in IFN-gamma(-/-) mice, indicating that the induction of IP-10 during CHS was primarily controlled by TNF-alpha. Interestingly, CHS was suppressed by treatment with anti-IP-10 mAb, suggesting a critical role for IP-10 in CHS. Reduced CHS in TNF-alpha(-/-) mice was reversed by IP-10 injection during the elicitation phase. Thus, it was shown that the roles for IL-1 and TNF-alpha are different, although both cytokines are crucial for the development of CHS. PMID:12578855
Nakae, Susumu; Komiyama, Yutaka; Narumi, Shosaku; Sudo, Katsuko; Horai, Reiko; Tagawa, Yoh-Ichi; Sekikawa, Kenji; Matsushima, Koji; Asano, Masahide; Iwakura, Yoichiro
The skin microcirculation performs a range of vital functions, such as maintaining nutritional perfusion to the tissues and overall thermoregulation. Not only does impairment to the skin blood supply lead to tissue necrosis ...
Li, Vivian V. (Vivian Victoria)
Quantitative dosimetry in the treatment of skin disorders with (laser) light requires information on propagation of light in the skin related to the optical properties of the individual skin layers. This involves the solution of the integro-differential equation of radiative transfer in a model representing skin geometry, as well as experimental methods to determine the optical properties of each skin
M. J. C. Van Gemert; S. L. Jacques; H. J. C. M. Sterenborg; W. M. Star
Acute retinal necrosis (ARN) is a rare disease that is usually caused by one of the three neurotropic human herpesviruses - herpes simplex virus type 1(HSV-1), HSV-2 and varicella-zoster virus (VZV). Although much is known about the clinical course of the disease and its treatment and about the viruses that cause it, comparatively little is known about its pathogenesis. This article will review the history of ARN, the typical clinical findings, and methods of diagnosis. Information from studies of the mouse model of ARN including development of anterior chamber-associated immune deviation (ACAID) and routes of spread will be reconsidered, and the combined information from human and mouse studies will be discussed to suggest mechanisms that contribute to the pathogenesis of ARN in human patients. Finally, puzzles and questions about the disease will be considered. PMID:17264500
Kezuka, Takeshi; Atherton, Sally S
Polyarteritis nodosa (PAN) is a systemic vasculitis which may result in thrombosis or aneurysm formation in any organ of the body. We report a case polyarteritis nodosa (PAN) resulting in bilateral asynchronous testicular necrosis. A 55-year-old male developed acute onset of left testicular pain resulting in a left orchiectomy and right orchidopexy for an ischemic left testicle without evidence of torsion. Three weeks later, the patient developed acute right-sided scrotal pain, and surgical exploration revealed a right necrotic testicle resulting in a right orchiectomy. Pathologic evaluations demonstrated benign testes with acute interstitial hemorrhage and focal atrophy. The patient also experienced abdominal skin necrosis, penile pain and swelling, and temporary loss of vision. This is a unique case of PAN and the only case of asynchronous testicular necrosis in the medical literature. PMID:22606613
Toepfer, Nicholas J.; Lountzis, Nektarios I.; Ugoeke, Joseph C.; Ferringer, Tammie C.
Skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Skin grafts are used in a variety of clinical situations, such as traumatic wounds, defects after oncologic resection, burn reconstruction, scar contracture release, congenital skin deficiencies, hair restoration, vitiligo, and nipple-areola reconstruction. Skin grafts are generally avoided in the management of more complex wounds. Conditions with deep spaces and exposed bones normally require the use of skin flaps or muscle flaps. In the present review, we describe how to perform skin grafting successfully, and some variation of skin grafting. PMID:22570780
Shimizu, Ruka; Kishi, Kazuo
Cellulitis, a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin, is a common lesion in children, usually responsive to systemic antibiotic therapy. However, an unusual course of healing or some nontypical features should call the treating physician to consider and investigate for other diagnoses that might prevent unnecessary treatment and alleviate parental stress. We present a case of posttraumatic fat necrosis, demonstrating some pitfalls in the process of diagnosis. PMID:23050184
Haikin Herzberger, Einat; Aviner, Shraga; Cherniavsky, Evgenia
We find a strong synergism between tumor necrosis factor (TNF) and bacteria or their products. Endotoxin-"free" recombinant TNF, even at very high doses (160 micrograms), did not alone cause hemorrhagic necrosis (HN) in the skin of normal mice. Similarly, TNF alone had a low systemic toxicity in tumor- and pathogen-free mice. However, TNF given intravenously with nanogram quantities of the endotoxin lipopolysaccharide caused lethal shock. Furthermore, subcutaneous injection of lipopolysaccharide made skin susceptible to subsequent induction of HN by TNF injected in the same site 24 hr later. Mycoplasma-infected cells or corynebacteria also synergized with TNF to cause HN or lethal shock. In addition, we find that lymphotoxin, a cytokine functionally and genetically related to TNF, also synergized with the bacteria to cause HN, whereas interleukin 1 alpha or interferon gamma did not. Together, the results indicate that a synergy between TNF and bacteria or their products causes HN and lethal shock in normal mice. PMID:3422444
Rothstein, J L; Schreiber, H
Porcine ear necrosis was investigated in 23 conveniently chosen farms, consisting of 14 case farms and 9 control farms. Biopsies of lesions and oral swabs from pigs on 11 case farms were examined by histology and bacterial culture. All farms were visited for observations and a survey on management, housing, and the presence of other clinical signs or behavioral vices. Histological examination revealed that the lesions began on the surface and progressed to deeper layers, and that vascular damage did not appear to be the initiating cause. Spirochetes were only rarely observed in histological examination and were not cultured from biopsies and oral swabs. Staphylococcus aureus and Staphylococcus hyicus were cultured from 91% and 66% of samples, respectively. Ear biting and a humid environment were associated with ear necrosis. On some farms large numbers of pigs were affected and lesions were sometimes extensive. The condition appears to be an infectious disease beginning on the surface of the skin; contributing environmental and management factors are likely. PMID:24155434
Park, Jeonghwa; Friendship, Robert M.; Poljak, Zvonimir; DeLay, Josepha; Slavic, Durda; Dewey, Catherine E.
Necrosis of the penis glans is commonly described after circumcision or strangulation. We report the case of a patient, opioid abuser, who presented an isolated glans necrosis after an injection of buprenorphin. The buprenorphin (Subutex) is a sublingual partial mu-opioid agonist used for the treatment of heroin dependance. Its intravenous or subcutaneous abuse is associated with local infection. The patient require a surgical intervention. After the failure of a mucosal graft, a soft skin graft was done. PMID:19269730
Hornez, E; Laroche, J; Monchal, T; Bourgouin, S; Riviere, P; Fournier, R; Dantzer, E
Necrosis of the skin was produced by the injection of measured quantities of electrolytes and of amino compounds into the dermis, and the relative ability of these substances to produce it was determined. Inflammation characterized by edema and accumulation of leucocytes accompanied necrosis. The ability of electrolytes to produce necrosis was found to increase with the valence of their basic ion, and in this respect was in accord with their ability to denature proteins. The quantity of different electrolytes needed to produce necrosis varied in the same order as the molar concentration of these electrolytes, that is isotonic with liver or kidney cells. Necrosis caused by amino compounds occurred with similar relation to the isotonicity of liver cells. In this as in other relations the cells acted as osmometers. The foregoing relations indicate that denaturation of proteins, necrosis of living tissue, and osmotic activity of liver or kidney cells are determined by molecular weight, valence, and ion-dissociation of electrolytes, that is, by the factors that determine the colligative properties of electrolytes. Agents such as turpentine, mustard, or croton oil and some halogen substitution compounds of methyl that are insoluble in water and soluble in lipoids have produced skin necrosis and inflammation. PMID:14482110
OPIE, E L
Necrosis of the femoral head represents a special form of aseptic bone necrosis because it develops in the high load-bearing region of the hip joint. The incidence of the disease is not precisely known. Characteristic macroscopic findings include articular cartilage detachment in the load-bearing zone immediately below the subchondral osseous lamella, the bordering necrosis of the marrow space and bone cells, incursion of the spongiosa, and the gradual loss of roundness of the femoral head. The cause of the disease is a disorder in circulation supplying the proximal femur. The disease frequently occurs in disorders of lipometabolism, after steroid medication, in sickle cell anemia and chronic alcoholism, and after fractures of the femoral neck. Histopathological classification should distinguish between arthropathy with secondary femoral head necrosis and primary forms. Differential diagnosis based on histological findings should distinguish between primary coxarthrosis with secondary femoral head necrosis, metastases, and a few bone tumors in the epiphyses. Clear cell chondrosarcoma is particularly important in the context. PMID:17450348
... to flares, and treat symptoms when they occur. Rosacea © 2008 Logical Images, Inc. Rosacea — Frequent redness (flushing) of the face; small red ... and thicker skin. Your physician can usually diagnose rosacea with a thorough medical history and physical exam. ...
an Concentrates. Blood Transfusion. 2009;7:325–334. Westernadverse event of blood transfusion. Vox Sanguinis. 2005;89:blood or plasmapheresis, FFP must be ABO matched to the patient before transfusion
Zareh, Meena; Davis, Andrew J; Henderson, Sean O
In a relatively short timespan, a wealth of new skin substitutes made of synthetic and biologically derived materials have arisen for the purpose of wound healing of various etiologies. This review article focuses on providing an overview of skin substitutes including their indications, contraindications, benefits, and limitations. The result of this overview was an appreciation of the vast array of options available for clinicians, many of which did not exist a short time ago. Yet, despite the rapid expansion this field has undergone, no ideal skin substitute is currently available. More research in the field of skin substitutes and wound healing is required not only for the development of new products made of increasingly complex biomolecular material, but also to compare the existing skin substitutes. PMID:25371771
Howe, Nicole; Cohen, George
Infected pancreatic necrosis is a challenging complication that worsens prognosis in acute pancreatitis. For years, open necrosectomy has been the mainstay treatment option in infected pancreatic necrosis, although surgical debridement still results in high morbidity and mortality rates. Recently, many reports on minimally invasive treatment in infected pancreatic necrosis have been published. This paper presents a review of minimally invasive techniques and attempts to define their role in the management of infected pancreatic necrosis.
Cebulski, W?odzimierz; S?odkowski, Maciej; Krasnod?bski, Ireneusz W.
Skin cancers in skin of color often present atypically or with advanced stage in comparison to Caucasian patients. Health care providers must maintain a high index of suspicion when examining skin lesions in skin of color. PMID:19691228
Bradford, Porcia T.
... their way into the skin. Diseases such as hemochromatosis or hemosiderosis or some drugs and chemicals that ... C. Schalock, MD VIEW STUDENT STORIES Pronunciations bilirubin hemochromatosis hemosiderosis hypopigmentation malaria melanin melanocytes siderosis tinea versicolor ...
Aseptic necrosis after intramuscular injection (Nicolau syndrome) occurred in 38 patients. Symptoms were severe immediate pain, swelling and livid discoloration of the skin with development of gangrene of skin and muscle tissue. It was the result of an unintentional intra-arterial injection of toxic substances: to assume an allergic reaction is unwarranted. Since irreversible tissue damage occurs within a short time, treatment results are unsatisfactory. For this reason prevention is essential. Using proper precautions, intra-arterial injections can be largely avoided. Since the greater proportion of these severe complications occurs after the administration of antirheumatic drugs, there should be a fundamental reconsideration of the need for intramuscular application of such drugs, as pharmacologically it is not essential. PMID:6723533
The cutaneous surface is continually influenced by aging and environmental factors. A longer life span is accompanied by an increase in the frequency of problems associated with aging skin. Although most of these changes and lesions are not life threatening, the premalignant lesions must be recognized and treated. The common aging and actinic skin changes are discussed and appropriate management is described. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:20469067
In assigning health priorities, skin diseases are sometimes thought of, in planning terms, as small-time players in the global league of illness compared with diseases that cause signif- icant mortality, such as HIV\\/AIDS, community-acquired pneu- monias, and tuberculosis. However, skin problems are generally among the most common diseases seen in primary care settings in tropical areas, and in some regions
Roderick Hay; Sandra E. Bendeck; Suephy Chen; Roberto Estrada; Anne Haddix; Tonya McLeod; Antoine Mahé
Local control, cosmesis and functional results were evaluated in 315 cases of skin cancer in 247 patients treated with radiation therapy. The initial recurrence rate for basal cell carcinoma was 7.8% and for squamous cell carcinoma was 14.9%. Ultimate local control was achieved in 98.7% of the cases of basal cell carcinoma and in 94.0% of the cases of squamous cell carcinoma with use of further irradiation or other therapeutic modalities. Ultimate local control rates were comparable to other therapeutic modalities. Cosmetic and functional results were excellent. Cartilage necrosis was not a significant problem. Radiation therapy may offer advantages in certain clinical situations and should be considered as a mode of therapy in the treatment of skin cancer.
Fischbach, A.J.; Sause, W.T.; Plenk, H.P.
This Web site is the online companion to Unmasking Skin, a feature article in the November 2000 issue of National Geographic Magazine, which offers an in-depth look at the body's largest organ. Visitors are invited to "go skin deep and beyond" with a photo gallery, a multimedia interview with the story's photographer, and related Web sites. The site also includes a portion of the feature article, a related Online Extra article, and a short piece about goosebumps. While not as comprehensive as the print article itself, this Web site provides an intriguing look at a part of the body that's often taken for granted.
Pulsed carbon-dioxide laser skin resurfacing is a purportedly 'non-thermal' procedure enjoying wide application as a cosmetic treatment for skin wrinkles. Treatment success has been based on clinical assessments of skin smoothness. Skin lesions (1 cm2) created by one, two or three superimposed carbon-dioxide laser passes were placed on the backs of 28 'fuzzy' Harlan Sprague Dawley rats. The variable laser irradiation parameters included measured energies ranging from 112 to 387/pulse with pulse widths of 65 and 125 microseconds and a repetition rate of 8 Hz. The square, flat laser beam measured 3 mm2 at the focal point. The lesions were collected from 0 to 10 days after treatment for qualitative and quantitative histopathology. Thermal damage and treatment effect tended to increase in severity and, to a lesser extent, depth with increased delivery parameters. In acute lesions, the vacuolated and fragmented, desiccated and thermally coagulated epidermis was partially removed exposing the underlying thermally coagulated dermal collagen and cells. Epidermal and dermal necrosis and slough occurred between 24 to 72 hours after treatment. Epithelial regeneration originated from the adnexa and the lesion edges. Dermal fibrous scar formation began at 5 days below the regenerated epidermis and became more prominent at 7 and 10 days.
Thomsen, Sharon L.; Baldwin, Bonnie; Chi, Eric; Ellard, Jeff; Schwartz, Jon A.
Radiation necrosis is a well-described toxicity following radiation therapy in the brain. There is little data regarding the incidence of radiation necrosis in pediatric patients. We retrospectively reviewed our experience with 101 children with solid brain tumors. Radiation necrosis was diagnosed by examination of magnetic resonance imaging. Median follow-up for all patients was 13 months (range 3-51). Radiation necrosis occurred in 5% (5/101) of cases with a median time to onset of 1.2 months. In three of these children, the child was symptomatic, requiring management with steroids and bevacizumab. Radiation necrosis did not correlate with the administration of chemotherapy, age at treatment, or planning treatment volume. Our experience with pediatric patients treated with radiotherapy for solid brain tumor suggests that children may have an increased likelihood to develop radiation necrosis compared to adults. PMID:23647507
Plimpton, S Reed; Stence, Nicholas; Hemenway, Molly; Hankinson, Todd C; Foreman, Nicholas; Liu, Arthur K
Let M be a hyperbolic $3$ -manifold with nonempty totally geodesic boundary. We prove that there are upper and lower bounds on the diameter of the skinning map of M that depend only on the volume of the hyperbolic structure with totally geodesic boundary, answering a question of Minsky. This is proved via a filling theorem, which states that as
Richard Peabody Kent
In this activity, learners explore the concept of permeability to better understand why amphibians are extremely sensitive to pollution. Learners soak one regular hard-boiled egg and one peeled hard-boiled egg in dyed water and then record how the eggs' circumference and appearance change after 24 hours. Learners investigate how the peeled egg represents amphibian skin and how amphibians are affected by pollution.
Aquarium, Omaha'S H.
A 63-year-old man developed delayed cerebral radiation necrosis following radiotherapy to a nasopharyngeal carcinoma. Complete resolution of his neurological deficit resulted from corticosteroid therapy alone. Serial CT scans showed the disappearance of the patients' mass lesion. The literature on cerebral necrosis following radiotherapy of extracranial neoplasms is reviewed with particular emphasis on management. Images PMID:6512555
Shaw, P J; Bates, D
Summary This report deals with a pancreatic tumor associated with metastatic fat necrosis. Our patient displayed the full gamut of nodular panniculitis, polyarthritis, fever, eosinophilia, hyperlipasemia, lytic bones lesions, and marrow fat necrosis. The rheumatologic features are reviewed. Elevated serum lipase is a most helpful laboratory confirmation. The tumor in our patient presented a difficult problem in classification. Although the
Armin E. Good; Bertram Schnitzer; Hidenori Kawanishi; Kyriakos C. Demetropoulos; Robert Rapp
Peripheral vascular disease is a rare feature of pheochromocytoma. This potentially catastrophic but curable tumor should be suspected in combination of distal necrosis with hypertension and palpable pulses. We report such an unusual case of pheochromocytoma presenting as toe necrosis. PMID:23776872
Bandawar, Mayur S.; Ansari, Mohammad S.; Behera, Arunanshu; Bhadada, Sanjay K.
Pulmonary manifestations of pyoderma gangrenosum are relatively rare. We report the case of a 45-year-old patient with multiple pulmonary nodules with central necrosis as assessed by CT scan. The patient had a 4-year history of pyoderma gangrenosum with only minor skin manifestations. A CT-guided, fine-needle biopsy of the lung revealed a nonspecific, inflammatory, aseptic necrotic process, which was comparable to the skin biopsy of one pyoderma lesion. Following the initiation of oral prednisolone therapy, a rapid resolution of the pulmonary nodules occurred. We conclude that pulmonary nodules represent a rare pulmonary manifestation of pyoderma gangrenosum. PMID:11243990
Krüger, S; Piroth, W; Amo Takyi, B; Breuer, C; Schwarz, E R
Bullae and sweat gland necrosis remain rare cutaneous manifestation, and these conditions can be misdiagnosed as Vibrio vulnificus infections or other soft tissue infections because of their low index of suspicion. A 46-yr-old man with a history of continued alcohol consumption presented with erythematous and hemorrhagic bullous lesions on his left arm. The patient reported that after the ingestion of clams, he slept for 12 hr in a heavily intoxicated state. Then the skin lesions started as a reddish patch that subsequently became hemorrhagic bullae. V. vulnificus infection, cellulitis, and necrotizing fasciitis were considered in initial differential diagnosis. However, on the basis of sweat gland necrosis on histopathologic examinations and negative results on bacterial cultures, we made the diagnosis of bullae and sweat gland necrosis. Therefore, bullae and sweat gland necrosis should also be considered in chronic alcoholic patients who present with bullae and a previous history of unconsciousness. PMID:21394318
Kim, Gun-Wook; Park, Hyun-Je; Kim, Hoon-Soo; Kim, Su-Han; Ko, Hyun-Chang; Kim, Moon-Bum
The varieties of luetic clinical variants are countless in nature. In this regard, an autopsy case of a 72-year-old homeless man who accidentally succumbed to carbon-monoxide poisoning is here presented and reviewed. The autopsy revealed the highly unusual finding of asymptomatic syphilitic necrosis of spleen followed by luetic mesaortitis, a solitary skin gumma, and syphilitic arthritis. The spleen was 8×4×3 cm in size; the capsule was completely calcified and firm, 3 to 5?mm thick. Only in the region of the hilus was a small part of preserved tissue found. After puncturing the capsule, a brown-yellowish pus-like mass was found which filled the entire space inside. When reviewing the relevant literature, this case and its finding of pan splenic necrosis accompanied by a calcified capsule seem to be unique in nature. In terms of the final diagnosis, a Treponema pallidum haemagglutination assay confirmed it to be syphilis. Since it was a late stage of the disease, it is estimated that it may have been present for more than 20 or 30 years in the deceased. PMID:23970621
Radojevic, Nemanja; Vukmirovic, Filip; Curovic, Ivana; Soc, Miodrag
The /sup 99m/Tc-DTPA renogram is a well extabished noninvasive method for evaluating and following transplanted kidneys. The examination is useful in distinguishing rejection from acute tubular necrosis as well as demonstrating several less common complications such as vascular occlusion, urinary extravasation, obstruction, and lymphocele. A previously unreported condition involving a transplant kidney (i.e., renal cortical necrosis) is described which was diagnosed with renal scintigraphy in combination with sonography.
Blumhardt, R.; Growcock, G.; Lasher, J.C.
. The etiology of avascular necrosis (AVN) is multifactorial. Independent of its etiology and localization it shows typical\\u000a pathologies and radiological images. In the early stages localized subchondral edema is characteristic. In 50 % of all cases\\u000a accompanying joint effusion may be found. Due to necrosis of the cells of bone marrow and bone fibrovascular, reactions with\\u000a hyperemia can be
H. Imhof; M. Breitenseher; S. Trattnig; J. Kramer; S. Hofmann; H. Plenk; W. Schneider; A. Engel
Histological slices of skin samples with the subcutaneous adipose tissue after photothermal/photodynamic treatment are analyzed. In the case of subcutaneous indocyanine green injection and 808-nm diode laser exposure of the rat skin site in vivo, the greatest changes in tissue condition were observed. Processes were characterized by dystrophy, necrosis, and desquamation of the epithelial cells, swelling and necrosis of the connective tissue, and widespread necrosis of the subcutaneous adipose tissue. The obtained data are useful for safe layer-by-layer dosimetry of laser illumination of ICG-stained adipose tissue for treatment of obesity and cellulite.
Yanina, Irina Yu.; Tuchin, Valery V.; Navolokin, Nikita A.; Matveeva, Olga V.; Bucharskaya, Alla B.; Maslyakova, Galina N.; Altshuler, Gregory B.
Extracellular adenosine triphosphate (ATP), present in thermally injured tissue, modulates the inflammatory response and causes significant tissue damage. The authors hypothesize that neutrophil infiltration and ensuing tissue necrosis would be mitigated by removing ATP-dependent signaling at the burn site. Mice were subjected to 30% TBSA partial-thickness scald burn by dorsal skin immersion in a water bath at 60 or 20°C (nonburn controls). In the treatment arm, an ATP hydrolyzing enzyme, apyrase, was applied directly to the site immediately after injury. Skin was harvested after 24 hours and 5 days for hematoxylin and eosin stain, elastase, and Ki-67 staining. Tumor necrosis factor (TNF)-? and interferon (IFN)-? expression were measured through quantitative real-time polymerase chain reaction. At 24 hours, the amount of neutrophil infiltration was different between the burn and burn + apyrase groups (P < .001). Necrosis was less extensive in the apyrase group when compared with the burn group at 24 hours and 5 days. TNF-? and IFN-? expression at 24 hours in the apyrase group was lower than in the burn group (P < .05). However, Ki-67 signaling was not significantly different among the groups. The results of this study support the role of extracellular ATP in neutrophil activity. The authors demonstrate that ATP hydrolysis at the burn site allays the neutrophil response to thermal injury and reduces tissue necrosis. This decrease in inflammation and tissue necrosis is at least partially because of TNF-? and IFN-? signaling. Apyrase could be used as topical inflammatory regulators to quell the injury caused by inflammation. PMID:23877144
Bayliss, Jill; Delarosa, Sara; Wu, Jianfeng; Peterson, Jonathan R; Eboda, Oluwatobi N; Su, Grace L; Hemmila, Mark; Krebsbach, Paul H; Cederna, Paul S; Wang, Stewart C; Xi, Chuanwu; Levi, Benjamin
\\u000a Skin cancer is the most common malignancy in the United States.1 While skin cancer is less common in people with skin of color,\\u000a it is more often associated with an increased incidence of morbidity and mortality as compared to white counterparts.2,3 This\\u000a imbalance has significant public health concerns. Current skin cancer campaigns focus on Caucasian patients in high-risk groups.\\u000a There
Brooke A. Jackson
Quantitative immunohistochemistry is needed in order to reliably and accurately assess the expression of cellular proteins in tissue. Skin is a difficult tissue for automated image analysis due to its heterogeneous composition and its architecture. In the present study we used a psoriatic skin model to compare the expression of p53 and bcl-2 before and after treatment with anti-tumor necrosis
Georgios Kokolakis; Lambros Panagis; Efstathios Stathopoulos; Elpida Giannikaki; Androniki Tosca; Sabine Krüger-Krasagakis
Summary The case is a 34-year-old woman with long-standing type 1 diabetes mellitus with existing follow-up in the outpatient clinic at the Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, UHCW. She had maintained good glycaemic control and glycaemic stability with basal bolus regimen for many years. She had not developed any diabetes-related complications and had no other co-morbidities. Six months ago, she presented to A&E with sudden-onset, well-localised and severe pain in the right iliac fossa, just lateral to the para-umbilical area. Her biochemistry was normal. Ultrasound scan, however, revealed a right-sided ovarian cyst, which was thought to have caused pain to her. She was discharged from A&E with simple analgesia. On subsequent gynaecological follow-up 4 weeks later, her pain remained severe and examination revealed an exquisitely tender subcutaneous nodule at the same location measuring 2?cm in diameter. Magnetic resonance imaging (MRI) scan at the time revealed a 1?cm mass in the subcutaneous adipose tissue, which co-localised to her pain. The mass demonstrated a central fat signal surrounded by a peripheral ring: observations consistent with fat necrosis. There were other smaller subcutaneous nodules also observed in the left para-umbilical area. Subsequent surgical resection of the main area of fat necrosis was performed. The patient made an excellent recovery and her pain resolved post-operatively. Histology confirmed the presence of fat necrosis. Fat necrosis is a rare complication of s.c. insulin injection. This case illustrates the importance of considering this diagnosis in patients who inject insulin and develop localised injection-site pain. Learning points Fat necrosis is a rare complication of insulin injections that can manifest with severe, persistent and well-localised pain.Fat necrosis can masquerade as other pathologies causing diagnostic confusion.The imaging modality of choice for accurate diagnosis of fat necrosis is MRI.Histological confirmation of fat necrosis is important.Appropriate management of localised fat necrosis is surgical excision, with avoidance of further insulin injections into the affected area. PMID:25298886
Pandit, M; Menon, V; Roberts, S; Barber, T M
Staphylococcus sciuri (S. sciuri) is a rare pathogen in humans, but it can cause a wide array of human infections. Recently a S. sciuri isolate (HBXX06) was reported to cause fatal exudative epidermitis (EE) in piglets and thus considered as a potential zoonotic agent. To investigate the pathogenicity of this bacterium, we cloned exfoliative toxin C (ExhC), a major toxin of the S. sciuri isolate and performed functional analysis of the recombinant ExhC-his (rExhC) protein using in vitro cell cultures and newborn mice as models. We found that rExhC could induce necrosis in multiple cell lines and peritoneal macrophages as well as skin lesions in newborn mice, and that the rExhC-induced necrosis in cells or skin lesions in newborn mice could be completely abolished if amino acids 79-128 of rExhC were deleted or blocked with a monoclonal antibody (3E4), indicating aa 79-128 portion as an essential necrosis-inducing domain. This information contributes to further understandings of the mechanisms underlying S. sciuri infection. PMID:21829591
Li, Haihua; Wang, Yongqiang; Ding, Lin; Zheng, Shijun J
Pigmentation means coloring. Skin pigmentation disorders affect the color of your skin. Your skin gets its color from a pigment called melanin. Special cells in ... damaged or unhealthy, it affects melanin production. Some pigmentation disorders affect just patches of skin. Others affect ...
The defining event in apoptosis is mitochondrial outer membrane permeabilization (MOMP), allowing apoptogen release. In contrast, the triggering event in primary necrosis is early opening of the inner membrane mitochondrial permeability transition pore (mPTP), precipitating mitochondrial dysfunction and cessation of ATP synthesis. Bcl-2 proteins Bax and Bak are the principal activators of MOMP and apoptosis. Unexpectedly, we find that deletion of Bax and Bak dramatically reduces necrotic injury during myocardial infarction in vivo. Triple knockout mice lacking Bax/Bak and cyclophilin D, a key regulator of necrosis, fail to show further reduction in infarct size over those deficient in Bax/Bak. Absence of Bax/Bak renders cells resistant to mPTP opening and necrosis, effects confirmed in isolated mitochondria. Reconstitution of these cells or mitochondria with wild-type Bax, or an oligomerization-deficient mutant that cannot support MOMP and apoptosis, restores mPTP opening and necrosis, implicating distinct mechanisms for Bax-regulated necrosis and apoptosis. Both forms of Bax restore mitochondrial fusion in Bax/Bak-null cells, which otherwise exhibit fragmented mitochondria. Cells lacking mitofusin 2 (Mfn2), which exhibit similar fusion defects, are protected to the same extent as Bax/Bak-null cells. Conversely, restoration of fused mitochondria through inhibition of fission potentiates mPTP opening in the absence of Bax/Bak or Mfn2, indicating that the fused state itself is critical. These data demonstrate that Bax-driven fusion lowers the threshold for mPTP opening and necrosis. Thus, Bax and Bak play wider roles in cell death than previously appreciated and may be optimal therapeutic targets for diseases that involve both forms of cell death. PMID:22493254
Whelan, Russell S.; Konstantinidis, Klitos; Wei, An-Chi; Chen, Yun; Reyna, Denis E.; Jha, Saurabh; Yang, Ying; Calvert, John W.; Lindsten, Tullia; Thompson, Craig B.; Crow, Michael T.; Gavathiotis, Evripidis; Dorn, Gerald W.; O'Rourke, Brian; Kitsis, Richard N.
Retiform purpura (RPP) is a livedoid pattern of cutaneous haemorrhage that may result from vasculitis, occlusion or altered coagulation. When this pattern presents as palpable plaques, vascular inflammation is present, and the differential diagnosis includes calciphylaxis, warfarin-induced skin necrosis, antiphospholipid antibody syndrome and heparin-induced skin necrosis. These diseases are clinically aggressive and may result in significant morbidity and mortality. Early recognition is essential to make the necessary medication changes and to begin intervention. Our morphological approach to diagnosis differs from traditional methods and can expedite management. Biopsy results and laboratory findings are then used to verify the diagnosis and determine the specific cause. This approach may allow the development of a treatment plan prior to availability of all ancillary data. Clinical and histological cases are presented for these four syndromes presenting as RPP. PMID:17489989
Jones, A; Walling, H
Objective Extracellular ATP, present in thermally-injured tissue, modulates the inflammatory response and causes significant tissue damage. We hypothesize that neutrophil infiltration and ensuing tissue necrosis would be mitigated by removing ATP-dependent signaling at the burn site. Methods Mice were subjected to 30% total-body- surface-area partial-thickness scald burn by dorsal skin immersion in a water bath at 60°C or 20°C (non-burn controls). In the treatment arm, an ATP hydrolyzing enzyme, apyrase, was applied directly to the site immediately after injury. Skin was harvested after 24 hours and 5 days for hematoxylin and eosin stain (H&E), elastase, and Ki-67 staining. TNF-? and IFN-? expression were measured through qRT-PCR. Results At 24 hours, the amount of neutrophil infiltration was different between the burn and burn + apyrase groups (p<0.001). Necrosis was less extensive in the apyrase group when compared to the burn group at 24 hours and 5 days. TNF-? and IFN-? expression at 24 hours in the apyrase group was lower than in the burn group (p <0.05). However, Ki-67 signaling was not significantly different among the groups. Conclusions Our results support the role of extracellular ATP in neutrophil activity. We demonstrate that ATP hydrolysis at the burn site allays the neutrophil response to thermal injury and reduces tissue necrosis. This decrease in inflammation and tissue necrosis is at least partially due to TNF-? and IFN-? signaling. Apyrase could be used as topical inflammatory regulators to quell the injury caused by inflammation. PMID:23877144
Bayliss, Jill; DeLaRosa, Sara; Wu, Jianfeng; Peterson, Jonathan R; Eboda, Oluwatobi N.; Su, Grace L; Hemmila, Mark; Krebsbach, Paul H.; Cederna, Paul S.; Wang, Stewart C; Xi, Chuanwu; Levi, Benjamin
Acute esophageal necrosis (AEN) is extremely rare and the pathogenesis of this is still unknown. We report a case of AEN caused by alcohol abuse. In our case, the main pathogenesis could be accounted for low systemic perfusion caused by severe alcoholic lactic acidosis. After the healing of AEN, balloon dilatation was effective to manage the stricture. PMID:16222758
Endo, Tetsu; Sakamoto, Juichi; Sato, Ken; Takimoto, Miyako; Shimaya, Koji; Mikami, Tatsuya; Munakata, Akihiro; Shimoyama, Tadashi; Fukuda, Shinsaku
Ten varieties of Triticum aestivum and three synthetic T. durum + Aegilops squarrosaThe + sign indicates an amphiploid. hexaploids were crossed with an Ae. bicornis + Ae. squarrosa amphiploid. 55 hybrid plants involving 9 different combinations developed necrosis and died before maturity. The two plants which survived were both from the F1 with a synthetic hexaploid, T. durum var. Carleton
K. A. Siddiqui; J. K. Jones
Infected pancreatic necrosis carries a high morbidity and mortality from sepsis and multisystem organ failure. Following confirmation of the infection by CT-guided fine needle aspiration, treatment consists of broad spectrum antibiotics (imipenim-cilastin) followed by emergency open (laparotomy) digital necrosectomy and insertion of drains for postoperative lavage with hyperosmolar dialysate as advocated by Beger et al. This video shows an alternative
G. D. Adamson; A. Cuschieri
Summary Viral pathogenesis relies upon modulation of host cytokine activation as well as cell death pathways. Infection by murine cytomegalovirus induces a novel receptor-interacting protein (RIP)3-dependent necrosis. RIP3 kinase activity and homotypic interaction motif (RHIM)-dependent interactions control virus-associated necrosis as occurs in TNF?-induced necroptosis; however, the virus-induced death pathway proceeds independent of RIP1, and is therefore distinct from the TNF?-dependent death pathway. The viral inhibitor of RIP activation (vIRA, encoded by the viral M45 gene) suppresses either pathway, disrupting RHIM-dependent RIP3-RIP1 interaction that is critical for TNF?-induced necroptosis as well as a RIP3 RHIM-dependent step in virus-induced necrosis. Importantly, the attenuation of vIRA-deficient virus in wild type mice is completely normalized in a RIP3-deficient genetic background. Thus, vIRA function validates necrosis as central to the elimination of infected cells in host defense and highlights the benefit of multiple virus-encoded cell death suppressors that subvert not only apoptotic, but also necrotic mechanisms of virus clearance. PMID:20413098
Upton, Jason W.; Kaiser, William J.; Mocarski, Edward S.
A photodynamic therapy experiment on 118 inbred white mice with transplanted Ehrlich's tumor (mouse mammary gland adenocarcinoma) is performed to reveal mechanisms of necrosis formation. In 7-10 days the tumor of 1-1.5 cm diameter is formed under skin at the injection point, and PDT procedure is applied. There were used a chlorine type photosensitizer RadachlorineTM and 662 nm wavelength diode laser. The drug is injected by intravenously at the dose of 40 mg/kg; the irradiation is executed in 2-2.5 hours at the surface dose of about 200 J/cm2. Each of the mice had a photochemical reaction in form of destructive changes at the irradiation region with subsequent development of dry coagulation necrosis. After rejection of the necrosis there occurred epithelization of defect tissues in a tumor place. Histological investigations were conducted in different follow-up periods, in 5 and 30 min, 1, 3, 6, and 12 hours, 1, 3, 7 and 28 days after irradiation. They included optical microscopy, immune marker analysis, morphometry with measurements of volume density of epithelium, tumor stroma and necroses, vascular bed. The investigations showed that an important role in damaging mechanisms of photodynamic action belongs to hypoxic injuries of tumor mediated by micro vascular disorders and blood circulatory disturbances. The injuries are formed in a few stages: microcirculation angiospasm causing vessel paresis, irreversible stases in capillaries, diapedetic hemorrhages, thromboses, and thrombovasculitis. It is marked mucoid swelling and fibrinoid necrosis of vascular tissue. Progressive vasculitises result in total vessel obliteration and tumor necrosis.
Privalov, Valeriy A.; Lappa, Alexander V.; Bigbov, Elmir N.
Investigative activities enabling students to explore the many purposes of our skin can create meaningful understanding of its functions. These activities can also help children construct an understanding of the skin as an always present but constantly ch
Sunal, Cynthia S.; Walters, Jeffrey J.
Skin is a highly dynamic, autoregulated, living system that responds to mechanical stretch through a net gain in skin surface area. Tissue expansion uses the concept of controlled overstretch to grow extra skin for defect repair in situ. While the short-term mechanics of stretched skin have been studied intensely by testing explanted tissue samples ex vivo, we know very little about the long-term biomechanics and mechanobiology of living skin in vivo. redHere we explore the long-term effects of mechanical stretch on the characteristics of living skin using a mathematical model for skin growth. We review the molecular mechanisms by which skin responds to mechanical loading and model their effects collectively in a single scalar-valued internal variable, the surface area growth. redThis allows us to adopt a continuum model for growing skin based on the multiplicative decomposition of the deformation gradient into a reversible elastic and an irreversible growth part.redTo demonstrate the inherent modularity of this approach, we implement growth as a user-defined constitutive subroutine into the general purpose implicit finite element program Abaqus/Standard. To illustrate the features of the model, we simulate the controlled area growth of skin in response to tissue expansion with multiple filling points in time. Our results demonstrate that the field theories of continuum mechanics can reliably predict the manipulation of thin biological membranes through mechanical overstretch. Our model could serve as a valuable tool to rationalize clinical process parameters such as expander geometry, expander size, filling volume, filling pressure, and inflation timing to minimize tissue necrosis and maximize patient comfort in plastic and reconstructive surgery. While initially developed for growing skin, our model can easily be generalized to arbitrary biological structures to explore the physiology and pathology of stretch-induced growth of other living systems such as hearts, arteries, bladders, intestines, ureters, muscles, and nerves. PMID:23623569
Zöllner, Alexander M.; Holland, Maria A.; Honda, Kord S.; Gosain, Arun K.; Kuhl, Ellen
Skin is a highly dynamic, autoregulated, living system that responds to mechanical stretch through a net gain in skin surface area. Tissue expansion uses the concept of controlled overstretch to grow extra skin for defect repair in situ. While the short-term mechanics of stretched skin have been studied intensely by testing explanted tissue samples ex vivo, we know very little about the long-term biomechanics and mechanobiology of living skin in vivo. Here we explore the long-term effects of mechanical stretch on the characteristics of living skin using a mathematical model for skin growth. We review the molecular mechanisms by which skin responds to mechanical loading and model their effects collectively in a single scalar-valued internal variable, the surface area growth. This allows us to adopt a continuum model for growing skin based on the multiplicative decomposition of the deformation gradient into a reversible elastic and an irreversible growth part. To demonstrate the inherent modularity of this approach, we implement growth as a user-defined constitutive subroutine into the general purpose implicit finite element program Abaqus/Standard. To illustrate the features of the model, we simulate the controlled area growth of skin in response to tissue expansion with multiple filling points in time. Our results demonstrate that the field theories of continuum mechanics can reliably predict the manipulation of thin biological membranes through mechanical overstretch. Our model could serve as a valuable tool to rationalize clinical process parameters such as expander geometry, expander size, filling volume, filling pressure, and inflation timing to minimize tissue necrosis and maximize patient comfort in plastic and reconstructive surgery. While initially developed for growing skin, our model can easily be generalized to arbitrary biological structures to explore the physiology and pathology of stretch-induced growth of other living systems such as hearts, arteries, bladders, intestines, ureters, muscles, and nerves. PMID:23623569
Zöllner, Alexander M; Holland, Maria A; Honda, Kord S; Gosain, Arun K; Kuhl, Ellen
... releases Press kits Sign in Account Home Skin health tips Caring for tattooed skin Caring for tattooed skin ... getting a piercing or tattoo. Risks Explains common health risks associated with tattoos and piercings. Safety tips What you should know before getting a piercing ...
We topically applied 20 nucleotide phosphorothioate intercellular adhesion molecule-1 anti-sense oligodeoxynucleotide in a cream formulation. It effectively inhibited tumor necrosis factor-?-induced expression of intercellular adhesion molecule-1 in human skin transplanted on severe compromised immunodeficient mice. The effects were concentration dependent, sequence specific, and resulted from reduction of intercellular adhesion molecule-1 mRNA levels in the skin. Intravenous administration of the drug
Rahul C. Mehta; Kimberly K. Stecker; Scott R. Cooper; Michael V. Templin; Yali J. Tsai; Thomas P. Condon; C. Frank Bennett; Gregory E. Hardee
Venous congestion after skin flap transplantation usually slows blood flow velocity and induces skin flap necrosis and surgical failure. Adipose tissue-derived stromal cells (ADSCs) can promote neovascularization and have been extensively applied in cell transplantation therapy and tissue regeneration. However, their function has not been reported in venous-congested skin flaps. In this study, rabbit ADSCs were isolated and identified. We established a rabbit ear venous-congested skin flap model and injected ADSCs into points along the midlines of skin flaps. The survival conditions of venous-congested skin flaps on postoperative day 7 showed that there was obvious swelling, hemorrhage, or necrosis in skin flaps of the control group, while the skin flap survival rate in the ADSC treatment group significantly increased. Hematoxylin and eosin (HE) staining results indicated that compared with the control group, thrombosis was significantly relieved and neovascularization was observed in the ADSC treatment group. Immunofluorescence revealed that the CD34 expression level and the number of capillaries significantly increased in the ADSC treatment group. In summary, ADSC transplantation promotes neovascularization in venous-congested skin flaps and skin flap survival. Therefore, ADSC transplantation may be an effective measure for promoting the survival of venous-congested skin flaps. PMID:25190589
Xu, Nan; Guo, Shu; Wang, Yuxin; Sun, Qiang; Wang, Chenchao
Over the last several years, there have been refinements in the understanding and nomenclature regarding the natural history of acute pancreatitis. Patients with acute pancreatitis frequently develop acute pancreatic collections that, over time, may evolve into pancreatic pseudocysts or walled-off necrosis. Endoscopic management of these local complications of acute pancreatitis continues to evolve. Treatment strategies range from simple drainage of liquefied contents to repeated direct endoscopic necrosectomy of a complex necrotic collection. In patients with chronic pancreatitis, pancreatic pseudocysts may arise as a consequence of pancreatic ductal obstruction that then leads to pancreatic ductal disruption. In this review, we focus on the indications, techniques and outcomes for endoscopic therapy of pancreatic pseudocysts and walled-off necrosis. PMID:25222140
Law, Ryan; Baron, Todd H
A 47-year-old man hospitalized for disk surgery received a preoperative injection of hydroxyzine hydrochloride in the upper outer quadrant of the gluteal region. The immediate pain decreased after 3 days but later became incapacitating. Substantial tissue necrosis in the region of the injection was confirmed 4 weeks after the injection, and 100 g of necrotic tissue was excised, leaving the patient with lost muscle mass and a definite limp 2 years later. During the injection of hydroxyzine, the needle penetrated through the gluteal muscle and entered the gluteal artery, causing thrombosis of the artery and necrosis of the gluteus maximus muscle. This case and other reported cases indicate that the use of intramuscular hydroxyzine is contraindicated. PMID:8557552
Tokodi, G; Huber, F C
Objective: Several devices exist today to assist the intraoperative determination of skin flap perfusion. Laser-Assisted Indocyanine Green Dye Angiography (LAICGA) has been shown to accurately predict mastectomy skin flap necrosis using quantitative perfusion values. The laser properties of the latest LAICGA device (SPY Elite) differ significantly from its predecessor system (SPY 2001), preventing direct translation of previous published data. The purpose of this study was to establish a mathematical relationship of perfusion values between these 2 devices. Methods: Breast reconstruction patients were prospectively enrolled into a clinical trial where skin flap evaluation and excision was based on quantitative SPY Q values previously established in the literature. Initial study patients underwent mastectomy skin flap evaluation using both SPY systems simultaneously. Absolute perfusion unit (APU) values at identical locations on the breast were then compared graphically. Results: 210 data points were identified on the same patients (n = 4) using both SPY systems. A linear relationship (y = 2.9883x + 12.726) was identified with a high level or correlation (R2 = 0.744). Previously published values using SPY 2001 (APU 3.7) provided a value of 23.8 APU on the SPY Elite. In addition, postoperative necrosis in these patients correlated to regions of skin identified with the SPY Elite with APU less than 23.8. Conclusion: Intraoperative comparison of LAICGA systems has provided direct correlation of perfusion values predictive of necrosis that were previously established in the literature. An APU value of 3.7 from the SPY 2001 correlates to a SPY Elite APU value of 23.8. PMID:25525483
Fourman, Mitchell S.; Rivara, Andrew; Dagum, Alexander B.; Huston, Tara L.; Ganz, Jason C.; Bui, Duc T.; Khan, Sami U.
The number of commercially available tumor necrosis factor (TNF)-? inhibitors has been increasing, including two new agents\\u000a licensed since 2008. In addition to an expanding number of agents, there are also increasing licensed and “off label” clinical\\u000a applications for the TNF inhibitors for the treatment of a variety of inflammatory or granulomatous disorders. Unfortunately,\\u000a use of the TNF inhibitors has
Jeannina A. Smith
The development of nonablative monopolar capacitive radiofrequency technology (ThermaCool System, Thermage, Inc., Hayward, California) has contributed to the noninvasive trend in facial skin rejuvenation. In contrast to traditional ablative resurfacing techniques, the ThermaCool System protects the skin surface from injury while selectively heating the underlying dermis. Preservation of epidermal integrity minimizes recovery and the risk of complications. Published clinical evidence documents the efficacy of monopolar capacitive radiofrequency skin tightening and supports its use for mild to moderate facial skin laxity and rhytides. Currently, monopolar capacitive radiofrequency represents the gold standard of treatments designed to tighten skin in a noninvasive fashion. PMID:17544932
Abraham, Manoj T; Mashkevich, Grigoriy
We evaluated ossicular chain reconstruction in patients with idiopathic incus necrosis who have conductive hearing loss and an intact ear drum. The study included four patients (3 women and 1 man; the ages of the patients were 22, 31, 35, and 56 years, respectively) with unilateral conductive hearing loss, no history of chronic serous otitis media, an intact ear drum, normal middle ear mucosa, and necrosis of the long processes of the incus. On preoperative pure tone audiometry, air-bone gaps were 24, 25, 38, and 33 dB. Bilateral tympanometry and temporal bone computed tomography results were normal. All 4 patients underwent an exploratory tympanotomy. During the operation, the mucosa of the middle ear was normal, with a mobile stapes foot plate and malleus. No evidence of any granulation tissue was found; however, necrosis of the incus long processes was seen. For ossicular reconstruction, we used tragal cartilage between the incus and the stapes in 1 patient; in the other 3 patients, glass ionomer bone cement was used (an interposition cartilage graft also was used in the patients who received the glass ionomer bone cement). In all patients, air-bone gaps under 20 dB were established in the first year after surgery. In the ossicular disorders within the middle ear, the incus is the most commonly affected ossicle. While, the most common cause of these disorders is chronic otitis media, it may be idiopathic rarely. Several ossicular reconstruction techniques have been used to repair incudostapedial discontinuity. PMID:23460219
Kansu, Leyla; Yilmaz, Ismail; Akdogan, Volkan; Avci, Suat; Ozluoglu, Levent
The etiology of avascular necrosis (AVN) is multifactorial. Independent of its etiology and localization it shows typical pathologies and radiological images. In the early stages localized subchondral edema is characteristic. In 50 % of all cases accompanying joint effusion may be found. Due to necrosis of the cells of bone marrow and bone fibrovascular, reactions with hyperemia can be delineated. These reactions allow us to visualize necrosis indirectly. The best imaging methods are MRI and, to a lesser extent, bone scintigraphy. In later stages calcification as well as new bone formation and microfractures are typically demonstrated and visualized best with plain X-rays and CT. Why reparations in many cases, particularly in the hip, are incomplete and may stop in any stage is unknown. Over years clinically complete silent AVNs are not an uncommon finding. Prognosis depends on the localization and size of the AVN. The number of repair mechanisms is best outlined with contrast-enhanced MRI and return of fatty marrow. PMID:9038111
Imhof, H; Breitenseher, M; Trattnig, S; Kramer, J; Hofmann, S; Plenk, H; Schneider, W; Engel, A
Large discrepancies in the available data on skin microbiology stimulated investigations of the number, interactions, and location of commensals and the true efficiency of disinfection by using skin biopsy, culture of frozen sections, and other methods.Most current procedures were less than 0·5% as sensitive as the biopsy method described. This gave mean bacterial counts ranging from 4,400\\/cm2 on the breast
Sydney Selwyn; Harold Ellis
The success of the ultrasonic pulse-echo technique for measurement of the depth of burn necrosis in porcine skin (Med. Phys. 4, 259--263 (1977)) has led to the present investigation of the specific acoustic impedance difference between the necrotic (burn) tissue and the underlying viable (nonburn) tissue. Experimental results show that the ultrasonic group velocities and mass densities are approximately the
John H. Cantrell; R. E. Goans; R. L. Roswell
Since the first application of CO2 laser in skin photosurgery, various techniques such as laser pulsing, beam scanning and computer-assisted laser pulse generator have been introduced for the purpose of reducing tissue carbonization and thermal necrosis. Using a quite simple XY optical scanner equipped with two galvanometric driven mirrors and an appropriate software to process the scanning data and control
Doru C. Dutu; Dan C. Dumitras; Ioan Nedelcu; Sergiu Ghetie
The motives of the work are to explore the effect of ribs in HIFU beam path on HIFU ablation goat liver. A model-JC Focused Ultrasound Tumor Therapeutic System was used. A 0.75 MHz focused transducer with 150mm aperture and 120mm focal length was used in all experiment. Acoustical power can be adjusted. 30 goats were divided into control group (HIFU beam through rib cage, HIFU alone), experiment group 1(HIFU beam through rib cage, HIFU combined with microbubble) and experiment group 2(Ribs in HIFU beam path were surgically removed, HIFU alone). 20 targeted regions at 5cm away from skin surface were applied for creating necrosis with linear scanning of 15mm length using HIFU in 3 groups. All animals were sacrificed two days later and exposed organs were dissected. After obtaining the maximal section, the volumes of the necrotic regions were measured, then to calculate Energy Efficiency Factor (EEF). Researched results showed that Ribs in HIFU beam path affected the formation of coagulative necrosis and enhanced EEF in control group. HIFU combined with microbubble could enhance the formation of coagulative necrosis and decrease EEF.
Li, Faqi; Gong, Xiaobo; Hu, Kai; Li, Chongyan; Wang, Zhibiao
Deep partial thickness burns are subject to delayed necrosis of initially viable tissues surrounding the primary zone of thermally induced coagulation, which results in an expansion of the burn wound, both in area and depth, within 48 hours postburn. Neutrophil sequestration and activation leading to microvascular damage is thought to mediate this secondary tissue damage. Resolvins, a class of endogenous mediators derived from omega-3 polyunsaturated fatty acids, have been shown to regulate the resolution of inflammation. We hypothesized that exogenous resolvins could mitigate the deleterious impact of the inflammatory response in burn wounds. Using two different mouse burn injury models involving significant partial thickness injuries, we found that a systemically administered single dose of resolvin D2 (RvD2) as low as 25?pg/g bw given within an interval of up to 4 hours postburn effectively prevented thrombosis of the deep dermal vascular network and subsequent dermal necrosis. By preserving the microvascular network, RvD2 enhanced neutrophil access to the dermis, but prevented neutrophil-mediated damage through other anti-inflammatory actions, including inhibition of tumor necrosis factor-?, interleukin-1?, and neutrophil platelet-endothelial cell adhesion molecule-1. In a clinical context, RvD2 may be therapeutically useful by reducing the need for surgical debridement and the area requiring skin grafting. PMID:23110665
Bohr, Stefan; Patel, Suraj J; Sarin, Dhruv; Irimia, Daniel; Yarmush, Martin L; Berthiaume, Francois
The skin is the human body’s largest organ, colonized by a diverse milieu of microorganisms, most of which are harmless or even beneficial to their host. Colonization is driven by the ecology of the skin surface, which is highly variable depending on topographical location, endogenous host factors and exogenous environmental factors. The cutaneous innate and adaptive immune responses can modulate the skin microbiota, but the microbiota also functions in educating the immune system. The development of molecular methods to identify microorganisms has led to an emerging view of the resident skin bacteria as highly diverse and variable. An enhanced understanding of the skin microbiome is necessary to gain insight into microbial involvement in human skin disorders and to enable novel promicrobial and antimicrobial therapeutic approaches for their treatment. PMID:21407241
Grice, Elizabeth A.; Segre, Julia A.
\\u000a We present a principled approach for general skin segmentation using graph cuts. We present the idea of a highly adaptive\\u000a universal seed thereby exploiting the positive training data only. We model the skin segmentation as a min-cut problem on\\u000a a graph defined by the image color characteristics. The prior graph cuts based approaches for skin segmentation do not provide\\u000a general
Rehanullah Khan; Allan Hanbury; Julian Stöttinger
Skin graft is the most common and simple procedure to cover superficial defect. Skin of variable thickness and size is completely detached from its origin (donor site) to cover a defect (recipient site). This simple procedure is the result of a long and eventful technical and theoretical evolvement. The aim of this article is to re-trace the history of skin grafting, from its discovery until today. PMID:19939539
Boudana, D; Wolber, A; Coeugniet, E; Martinot-Duquennoy, V; Pellerin, P
Restorative dentistry involves use of various intracoronal and intracanal medicaments. Commonly used endodontic medicaments include paraformaldehyde, sodium hypochlorite and hydrogen peroxide. These agents are caustic and in higher and in inappropriate concentrations can cause immediate damage to the surrounding hard and/or soft tissues. Proper knowledge of such agents and careful use of such intracanal medicaments is necessary to avoid iatrogenic injuries. This report presented a case of localized alveolar bone necrosis which is an iatrogenic damage occurred because of improper use of intracanal medicaments and improper management of carious tooth structure. Subsequent management of the case is also discussed in this case report. PMID:25214737
Reddy, K Krishna Mohana; Shankar, B Shiva; Reddy, K Amarendher; Reddy, S Nagalakshmi; Sudhakar, Jaradoddi; Reddy, P Sunil Kumar
Acute retinal necrosis (ARN) syndrome usually occurs as the result of secondary reactivation of latent, previously acquired, varicella-zoster or herpes simplex virus. The authors report four patients who developed a mild form of ARN within 1 month (5 to 28 days) after the onset of chickenpox. In contrast to typical cases of ARN, these cases were less severe, with retinitis limited to two quadrants or less (three patients), no retinal detachment (four patients), minimal vitreitis (four patients), and no loss of visual acuity (four patients). Thus, ARN may occur during the course of primary varicella-zoster infection. PMID:1666176
Culbertson, W W; Brod, R D; Flynn, H W; Taylor, B C; Brod, B A; Lightman, D A; Gordon, G
Tumor necrosis factor (TNF) is considered a major proinflammatory cytokine, affecting various aspects of the immune reaction. All five TNF inhibitors currently available on the market (i.e., etanercept, infliximab, adalimumab, certolizumab and golimumab) are top sellers, although indicated only in autoimmune diseases, including rheumatoid arthritis, Crohn's disease and psoriasis. This article briefly discusses the background and place for TNF inhibitors in modern therapy. The main safety aspects of TNF inhibitor administration are described in particular, with special consideration of the available meta-analyses. Finally, perspectives on the next-generation TNF inhibitors and their use in the clinic are given.
Lis, Krzysztof; Kuzawi?ska, Olga
Skin discolorations and skin lesions due to vascular pathologies are common clinical features in systemic lupus erythematosus. A variety of clinical manifestations such as Raynaud's phenomenon, acrocyanosis, livedo patterns, erythematous or violaceous macules and papules or necrosis are triggered by heterogeneous pathophysiological mechanisms such as vasospasm, vasculitis or thromboembolism. A standardized macro- and microvascular assessment is necessary to establish the correct diagnosis. We describe and illustrate common clinical features of vascular skin manifestations in systemic lupus erythematosus and present a diagnostic algorithm. PMID:20693202
Richter, J G; Sander, O; Schneider, M; Klein-Weigel, P
This lesson is part of the Skin Deep Project, which examines the science behind skin. Skin Deep is developed by AAAS and funded by NeutrogenaIn this lesson, students will examine the skin and how it functions as an organ and as part of a larger body system. By taking a closer look at the anatomy and function of the integumentary system, students will further their general knowledge of organ systems in general. Further, they will benefit from realizing that any part of a system may itself be considered as a systema subsystemwith its own internal parts and interactions. Additional links are given for further inquiry.
American Association for the Advancement of Science (; )
Dermatological conditions and treatment in antiquity can be assessed by studying ancient skin, artefacts illustrating medical disorders and literature from the classified period as well as Egyptian papyri, cuneiform tablets and the Bible. It is often more useful and informative to study naturally preserved skin rather than artificially mummified skin. Great care must be taken in making retrospective diagnosis. Skin manifestations of internal diseases are, and have always been, of the greatest clinical importance. Study of the past may give an insight into the epidemiological aspects of diseases such as TB, leprosy and syphilis which have spread across the world with serious social consequences. PMID:16521362
Hypericin has been widely studied as a potent photosensitizer for photodynamic therapy in both preclinical and clinical settings. Recently, hypericin has also been discovered to have a specific avidity for necrotic tissue. This affinity is also observed in a series of radiolabeled derivatives of hypericin, including [123I]iodohypericin, [124I]iodohypericin, and [131I]iodohypericin. Hypericin, along with other necrosis-avid contrast agents, has been investigated for use in noninvasively targeting necrotic tissues in numerous disorders. Potential clinical applications of hypericin include the identification of acute myocardial infarction, evaluation of tissue viability, assessment of therapeutic responses to treatments, and interventional procedures for solid tumors. The mechanisms of necrosis avidity in hypericin remain to be fully elucidated, although several hypotheses have been suggested. In particular, it has been proposed that the necrosis avidity of hypericin is compound specific; for instance, cholesterol, phosphatidylserine, or phosphatidylethanolamine components in the phospholipid bilayer of cellular membranes may be the major targets for its observed selectivity. Further investigations are needed to identify the specific binding moiety that is responsible for the necrosis avidity of hypericin. PMID:24052807
Jiang, Binghu; Wang, Jichen; Ni, Yicheng; Chen, Feng
We report the first case of acute renal failure secondary to prucalopride, a novel agent for the treatment of chronic constipation. The 75 years old male patient was initiated on prucalopride after many failed treatments for constipation following a Whipple's procedure for pancreatic cancer. Within four months of treatment his creatinine rose from 103 to 285 ?mol/L (eGFR 61 decrease to 19 mL/min per 1.73 m(2)). He was initially treated with prednisone for presumed acute interstitial nephritis as white blood casts were seen on urine microscopy. When no improvement was detected, a core biopsy was performed and revealed interstitial fibrosis and tubular atrophy. The presence of oxalate and calcium phosphate crystals were also noted. These findings suggest acute tubular necrosis which may have been secondary to acute interstitial nephritis or hemodynamic insult. The use of prednisone may have suppressed signs of inflammation and therefore the clinical diagnosis was deemed acute interstitial nephritis causing acute tubular necrosis. There are no previous reports of prucalopride associated with acute renal failure from the literature, including previous Phase II and III trials. PMID:25133152
Sivabalasundaram, Vithika; Habal, Flavio; Cherney, David
Although bile duct injuries are common among the complications of laparoscopic cholecystectomy, hepatic vascular injuries are not well described. Between January 1990 to December 1999, 83 patients with bile duct injuries have been referred to our clinic. Two of them had liver necrosis due to hepatic arterial occlusion. These two women had laparoscopic cholecystectomy for symptomatic cholelithiasis in district hospitals 4 and 15 days prior to their referral to our clinic. Serum aspartate aminotransferase and alanine aminotransferase levels were found to be 30 to 40-fold higher than normal levels. Ultrasonography, computed tomography and Doppler sonography showed necrosis in the right liver lobe and no flow in the right hepatic artery. Patients were also complicated with liver abscess and biliary peritonitis, respectively. Emergency right hepatectomy was performed in both cases and one of them needed Roux-Y-hepaticojejunostomy (to the left hepatic duct). One patient died of peritonitis in the postoperative period. The other one has no problem in her third postoperative year. The earliest and the simplest method for diagnosis or ruling out hepatic arterial occlusion is detecting the blood biochemistry and Doppler ultrasonography. In some cases emergency hepatectomy can be necessary. Postoperative complications should be expected higher than elective cases. PMID:11813609
Kayaalp, C; Nessar, G; Kaman, S; Akoglu, M
We report the first case of acute renal failure secondary to prucalopride, a novel agent for the treatment of chronic constipation. The 75 years old male patient was initiated on prucalopride after many failed treatments for constipation following a Whipple’s procedure for pancreatic cancer. Within four months of treatment his creatinine rose from 103 to 285 ?mol/L (eGFR 61 decrease to 19 mL/min per 1.73 m2). He was initially treated with prednisone for presumed acute interstitial nephritis as white blood casts were seen on urine microscopy. When no improvement was detected, a core biopsy was performed and revealed interstitial fibrosis and tubular atrophy. The presence of oxalate and calcium phosphate crystals were also noted. These findings suggest acute tubular necrosis which may have been secondary to acute interstitial nephritis or hemodynamic insult. The use of prednisone may have suppressed signs of inflammation and therefore the clinical diagnosis was deemed acute interstitial nephritis causing acute tubular necrosis. There are no previous reports of prucalopride associated with acute renal failure from the literature, including previous Phase II and III trials. PMID:25133152
Sivabalasundaram, Vithika; Habal, Flavio; Cherney, David
Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum. PMID:21603300
Lee, Hyo Hyeok; Jung, Sang Sig; Jung, Seung Mun; Choi, Soo Jung; Shin, Dae Hee
Elevated levels of polyamines have long been associated with skin tumorigenesis. Tightly regulated metabolism of polyamines is critical for cell survival and normal skin homeostasis, and these controls are dysregulated in skin tumorigenesis. A key enzyme in polyamine biosynthesis, ornithine decarboxylase (ODC) is upregulated in skin tumors compared to normal skin. Use of transgenic mouse models has demonstrated that polyamines
Susan K. Gilmour; Susan K
The skin is the human body's largest organ, colonized by a diverse milieu of microorganisms, most of which are harmless or even beneficial to their host. Colonization is driven by the ecology of the skin surface, which is highly variable depending on topographical location, endogenous host factors and exogenous environmental factors. The cutaneous innate and adaptive immune responses can modulate
Elizabeth A. Grice; Julia A. Segre
Hydrogels prepared from water solutions containing 10–20 mass% gelatine are generally accepted muscle tissue simulants in terminal ballistic research. They, however, do not have a surface layer which simulates the effect of human skin. The purpose of this research was to find a suitable skin simulant for enhancing the testing fidelity and the credibility of the results with gelatine-based materials
Jorma Jussila; Ari Leppäniemi; Mikael Paronen; Erkki Kulomäki
This paper deals with the theory of skin effect in semiconductor materials including the effect of displacement currents, which are generally neglected in the skin-effect theory for metallic conductors. In the case of flat plates, formulas are derived for the field distribution, the impedance and the eddy-current power losses, considering symmetrical electric as well as magnetic fields. Impedance as a
A. H. Frei; M. J. O. Strutt
Occupational skin diseases are the most commonly reported notifiable occupational diseases. In Germany, 23 596 out of a total of 71 263 reported occupational diseases in 2010 were classified as occupational skin diseases (BK No. 5101: "severe or recurrent skin diseases which have forced the person to discontinue all occupational activities that caused or could cause the development, worsening, or recurrence of the disease"). Contact dermatitis (allergic, irritant) of the hands is the most common skin disease and atopic skin diathesis is often an important co-factor. The number of work-related skin diseases is many times higher than the number of notified occupational dermatoses. This CME article explains the legal framework of occupational diseases, the tasks and obligations of the legal statutory work insurance. Typical allergens and irritants of high risk professions are also presented as are the important steps from diagnosis to compensation. Early prevention of occupational skin diseases is very important to avoid severe chronic hand eczema. Therefore the "dermatologist's report" is crucial. Other occupational dermatoses (outside of BK 5101) are briefly mentioned. In recent years the number of notifications of occupational skin cancer due to occupational UV-irradiation has increased. According to recent epidemiological findings, there is a significant and consistent positive association between occupational UV-irradiation and squamous cell carcinoma. Therefore, an important criterion for a new occupational disease is fulfilled. PMID:22455666
Diepgen, Thomas L
Context: Malignant melanoma is often lethal, and its incidence in the United States has increased rapidly over the past 2 decades. Nonmelanoma skin cancer is seldom lethal, but, if advanced, can cause severe disfigurement and morbidity. Early detection and treatment of melanoma might reduce mortality, while early detection and treatment of nonmelanoma skin cancer might prevent major disfigurement and to
Mark Helfand; Susan M Mahon; Karen B Eden; Paul S Frame; C. Tracy Orleans
Fisherman commonly experience a significant number of cutaneous problems, related to the exposure to environmental factors due to their working conditions. Among these factors, sun exposure is able to determine both acute and chronic skin damage, mostly linked to the effects of the ultraviolet (UV) radiation on epidermal and dermal structures. In particular, UV-A appears to play a major role in the deterioration of dermal structure leading to the photoaged appearance of the skin, while UV-B is mainly responsible for skin cancers. Peculiar clinical features of skin damage in fishermen include dryness, irregular pigmentation, wrinkling, stellate pseudoscars, elastosis, inelasticity, telangiectasia, comedones and sebaceous hyperplasia. Furtheremore, the high incidence of non-melanoma skin cancers, on sun-exposed areas, confirms the need for occupational health policies focusing on issues such as photoprotection. PMID:24303699
Cannavò, Serafinella Patrizia; Borgia, Francesco; Trifirò, Caterina; Aragona, Emanuela
The You and Your Skin interactive was developed by Science NetLinks with funding from Neutrogena as part of the Skin Deep project. This resource provides an introduction to the basic structure of the skin, information about how the skin protects us, and some information on how to care for the skin. There are four main sections to the resource: Function, Anatomy, Protection, and Care. When you click on one of the main sections, you'll be taken to an enlarged view of that section, which contains several subsections represented by the highlighted ring around the circle. Roll your mouse over the ring to see the subsections. To go to one of the subsections, simply click on it. To move from one of the main sections to another, simply click on one of the red arrows found by the ring.
Science NetLinks (AAAS; )
Levamisole is an immunomodulatory and antihelminthic drug, previously removed from the United States market, and now estimated to be present in the vast majority of cocaine distributed in the United States. Levamisole-adulterated cocaine (LAC) exposure can result in neutropenia, thrombocytopenia, and vasculitis with a predilection for subsites of the face. The objective of this review is to increase awareness among otolaryngologists of the manifestations of LAC exposure. We present the case of a 33-year-old woman with a history of cocaine use, consulted for purpuric, necrotic lesions of the nose, cheeks, and ears, with accompanying leukopenia, thrombocytopenia, and positive antineutrophil cytoplasmic antibodies (ANCA). The effects of levamisole are immune mediated, with antibodies directed against neutrophils causing neutropenia, and vasculitis caused by antibody deposition or secondary to induction of antiphospholipid antibodies causing thrombosis. LAC exposure can be differentiated from other similar appearing pathologies by evaluating serology for specific ANCA. The most important treatment is cessation of cocaine use, which most often results in complete resolution of symptoms. Awareness of the presentation, complications, and treatment of LAC exposure may be especially important for otolaryngologists, who may be one of the firsts to evaluate an affected patient.
Jiron, Jose L.; Lin, Ho-Sheng; Folbe, Adam J.
Toxic properties of recombinant human tumor necrosis factor (TNF-beta) were studied on noninbred albino mice. In the maximum tolerable doses the preparation induced a decrease in the body weight and temperature of the animals as well as development of glyco- and leukopenic reactions and damage of the internal organ structures. The preparation effects were observed early after the exposure and were mainly reversible. The most TNF-beta sensitive organs were the liver, lungs, adrenal gland, thymus and spleen. The major link in the pathological process development under the effect of the TNF-beta toxic doses was likely increased intravascular blood coagulability evident from a marked procoagulant activity of the preparation. PMID:9182503
Masycheva, V I; Danilenko, E D; Morozova, E N; Fedosova, L K; Sizova, L Iu; Gamale?, S G; Lebedev, L R; Pustoshilova, N M
The easier access to cocaine allows chronic and intensive consumption. Nasally inhaled cocaine causes important midfacial lesions called: Cocaine Induced Midline Destructive Lesions. These lesions are due to several factors, the anesthetic, vasoconstrictive, locally prothrombotic properties of cocaine and its components combined with cytotoxic effects and traumatic nasal injuries related to consumption mode. Functional signs are: nasal regurgitation, rhinolalia, rhinorrhea, and midfacial pain. The morphological modifications of the nasal pyramid feature the destruction of bone and cartilage structures. Endo-buccal examination, anterior rhinoscopy, and TDM reveal palatine necrosis of variable extension. Nasal fossae superinfection is always present. Sinus superinfection is frequent. Management is multidisciplinary. Weaning must be achieved before surgery. It is necessary to rehabilitate speech and swallowing functions by the means of various local or free flaps. PMID:20060991
Myon, L; Delforge, A; Raoul, G; Ferri, J
Acute esophageal necrosis (AEN), commonly referred to as “black esophagus”, is a rare clinical entity arising from a combination of ischemic insult seen in hemodynamic compromise and low-flow states, corrosive injury from gastric contents in the setting of esophago-gastroparesis and gastric outlet obstruction, and decreased function of mucosal barrier systems and reparative mechanisms present in malnourished and debilitated physical states. AEN may arise in the setting of multiorgan dysfunction, hypoperfusion, vasculopathy, sepsis, diabetic ketoacidosis, alcohol intoxication, gastric volvulus, traumatic transection of the thoracic aorta, thromboembolic phenomena, and malignancy. Clinical presentation is remarkable for upper gastrointestinal bleeding. Notable symptoms may include epigastric/abdominal pain, vomiting, dysphagia, fever, nausea, and syncope. Associated laboratory findings may reflect anemia and leukocytosis. The hallmark of this syndrome is the development of diffuse circumferential black mucosal discoloration in the distal esophagus that may extend proximally to involve variable length of the organ. Classic “black esophagus” abruptly stops at the gastroesophageal junction. Biopsy is recommended but not required for the diagnosis. Histologically, necrotic debris, absence of viable squamous epithelium, and necrosis of esophageal mucosa, with possible involvement of submucosa and muscularis propria, are present. Classification of the disease spectrum is best described by a staging system. Treatment is directed at correcting coexisting clinical conditions, restoring hemodynamic stability, nil-per-os restriction, supportive red blood cell transfusion, and intravenous acid suppression with proton pump inhibitors. Complications include perforation with mediastinal infection/abscess, esophageal stricture and stenosis, superinfection, and death. A high mortality of 32% seen in the setting of AEN syndrome is usually related to the underlying medical co-morbidities and diseases. PMID:20614476
Gurvits, Grigoriy E
Significance: During gestation, fetal skin progresses from a single layer derived from ectoderm to a complex, multi-layer tissue with the stratum corneum (SC) as the outermost layer. Innate immunity is a conferred complex process involving a balance of pro- and anti-inflammatory cytokines, structural proteins, and specific antigen-presenting cells. The SC is a part of the innate immune system as an impermeable physical barrier containing anti-microbial lipids and host defense proteins. Postnatally, the epidermis continually replenishes itself, provides a protective barrier, and repairs injuries. Recent Advances: Vernix caseosa protects the fetus during gestation and facilitates development of the SC in the aqueous uterine environment. The anti-infective, hydrating, acidification, and wound-healing properties post birth provide insights for the development of strategies that facilitate SC maturation and repair in the premature infant. Critical Issues: Reduction of infant mortality is a global health priority. Premature infants have an incompetent skin barrier putting them at risk for irritant exposure, skin compromise and life-threatening infections. Effective interventions to accelerate skin barrier maturation are compelling. Future Directions: Investigations to determine the ontogeny of barrier maturation, that is, SC structure, composition, cohesiveness, permeability, susceptibility to injury, and microflora, as a function of gestational age are essential. Clinicians need to know when the premature skin barrier becomes fully competent and comparable to healthy newborn skin. This will guide the development of innovative strategies for optimizing skin barrier development. PMID:24761361
Visscher, Marty; Narendran, Vivek
The recent era of exploring the human microbiome has provided valuable information on microbial inhabitants, beneficials and pathogens. Screening efforts based on DNA sequencing identified thousands of bacterial lineages associated with human skin but provided only incomplete and crude information on Archaea. Here, we report for the first time the quantification and visualization of Archaea from human skin. Based on 16 S rRNA gene copies Archaea comprised up to 4.2% of the prokaryotic skin microbiome. Most of the gene signatures analyzed belonged to the Thaumarchaeota, a group of Archaea we also found in hospitals and clean room facilities. The metabolic potential for ammonia oxidation of the skin-associated Archaea was supported by the successful detection of thaumarchaeal amoA genes in human skin samples. However, the activity and possible interaction with human epithelial cells of these associated Archaea remains an open question. Nevertheless, in this study we provide evidence that Archaea are part of the human skin microbiome and discuss their potential for ammonia turnover on human skin. PMID:23776475
Probst, Alexander J.; Auerbach, Anna K.; Moissl-Eichinger, Christine
It is estimated that total sun exposure occurs non-intentionally in three quarters of our lifetimes. Our skin is exposed to majority of UV radiation during outdoor activities, e.g. walking, practicing sports, running, hiking, etc. and not when we are intentionally exposed to the sun on the beach. We rarely use sunscreens during those activities, or at least not as much and as regular as we should and are commonly prone to acute and chronic sun damage of the skin. The only protection of our skin is endogenous (synthesis of melanin and enzymatic antioxidants) and exogenous (antioxidants, which we consume from the food, like vitamins A, C, E, etc.). UV-induced photoaging of the skin becomes clinically evident with age, when endogenous antioxidative mechanisms and repair processes are not effective any more and actinic damage to the skin prevails. At this point it would be reasonable to ingest additional antioxidants and/or to apply them on the skin in topical preparations. We review endogenous and exogenous skin protection with antioxidants. PMID:23384037
Poljsak, Borut; Dahmane, Raja; Godic, Aleksandar
Rats or mice developed centrolobular hepatic necrosis within 24 h after an intraperitoneal injection of 14C-bromobenzene or other radiolabeled halogenated aromatic hydrocarbons. The hepatic necrosis was preceded by the cova lent binding of substantial amounts of radiolabeled material to liver proteins, and autoradiograms revealed that most of the covalently bound material was localized within the necrotic centrolobular hepatocytes. Prior induction
Watson D. Reid; Gopal Krishna; James R. Gillette; Bernard Brodie
The current view of infectious pancreatic necrosis virus (IPNV) infection includes a necrotic process that relies primarily on the histological appearance of tissue after the degenerative process. We tested this view by examining the possibility that apoptosis is a component of double-stranded RNA virus (IPNV) that induces fish embryonic cell death. Four kinds of assays for apoptosis were used in analyzing IPNV-infected CHSE-214 cells: (1) assay with terminal deoxynucleotidyl transferase (TdT)-mediated end-labeling of DNA in nuclei of intact cells during virus infection, (2) assay for procoagulant activity, (3) assay for DNA ladders, and (4) electron microscopic assays for the ultrastructural changes in characteristic apoptotic cells. In all p.i. samples, both low and high m.o.i. groups contained apoptotic nuclei, according to TdT-mediated dUTP labeling of intact cells, but in control CHSE-214 cells, apoptotic nuclei were rare at all levels of incubation sampled by TdT-mediated dUTP labeling. Prenecrotic or postnecrotic cells were found to express phosphatidylserine on the surface by annexin V-FITC labeling, but normal cells did not. DNAs from both 4 h p.i. of high m.o.i. and 8 h p.i. of low m.o.i. were found to be cleaved into fragments indicative of preferential cleavage at internucleosomal sites. The IPNV-infected CHSE-214 cells were analyzed with an electron microscope and showed a pattern of ultrastructural change, indicating that apoptosis appears before pathological changes of necrosis, including condensed chromatin, fragmented nuclei, nuclei with chromatin marginations, and secondary necrosis from prenecrotic cells in IPNV-infected CHSE-214 cells. Together, these findings show that apoptosis precedes any detectable necrotic change in CHSE-214 cells that is currently viewed as necrosis. Thus, apoptosis characterizes the onset of pathology in host cells and is followed by necrotic processes. PMID:9770422
Hong, J R; Lin, T L; Hsu, Y L; Wu, J L
Cancers are often with spontaneous or therapeutic necrosis that could be utilized as a generic target for developing new treatments. The purpose of this study was to investigate the biodistribution and pharmacokinetics of radioiodinated hypericin (Hyp), a naturally occurring compound, after intravenous (i.v.) injection in a rat model of liver and muscle necrosis (n = 42), and evaluate its necrosis affinity. Hyp was labeled with (131)I with labeling efficiency >99%. After incubating in solution/rat plasma for 8 days, radiochemical purity of (131)I-Hyp remained 98.1 and 97.1%, respectively, indicating good in vitro stability. SPECT-CT images at 24 h after i.v. injection of (131)I-Hyp in rats with induced liver and muscle necrosis showed obvious tracer absorption in necrotic tissues. Biodistribution studies revealed that the percentage of the injected dose per gram of tissue (%ID/g) evolved from 1.9 %ID/g at 6 h, through a maximum 3.0 %ID/g at 12 h, to 1.0 %ID/g at 192 h in necrotic liver. Pharmacokinetics studies revealed that the terminal elimination half-life, total body clearance and area under the curve of (131)I-Hyp were 32.7 h, 9.2 L/h/kg and 1.6 MBq/L*h, respectively. These results demonstrated that (131)I-Hyp features a long blood circulation in animals and persistent retention in necrotic tissues. Therefore, (131)I-labeled Hyp could be a broad-spectrum anti-tumor agent with a cost much cheaper relative to the biological agents such as monoclonal antibodies. PMID:23627568
Kong, Ming; Zhang, Jian; Jiang, Cuihua; Jiang, Xiao; Li, Yue; Gao, Meng; Yao, Nan; Huang, Dejian; Wang, Xiaoning; Fang, Zhijun; Liu, Wei; Sun, Ziping; Ni, Yicheng
We determined the feasibility of using an anti-desmoglein (Dsg) mAb, Px44, to deliver a biologically active protein to keratinocytes. Recombinantly produced Px44-green fluorescent protein (GFP) injected into mice and skin organ culture delivered GFP to the cell surface of keratinocytes. We replaced GFP with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) to produce Px44-TRAIL. We chose TRAIL as a biological model because it inhibits activated lymphocytes and causes apoptosis of hyperproliferative keratinocytes, features of various skin diseases. Px44-TRAIL formed a trimer, the biologically active form of TRAIL. Standard assays of TRAIL activity showed that Px44-TRAIL caused apoptosis of Jurkat cells and inhibited IFN-? production by activated CD4+ T cells. Enzyme-linked immunoassay with Px44-TRAIL showed delivery of TRAIL to Dsg. Immunofluorescence with Px44-TRAIL incubated on skin sections and cultured keratinocytes or injected into mouse skin, human organ culture, or human xenografts detected TRAIL on keratinocytes. Px44-TRAIL caused apoptosis of the hyperproliferative, but not differentiating, cultured keratinocytes through binding to Dsg3. Foldon, a small trimerization domain, cloned into Px44-TRAIL maintained its stability and biological activity at 37°?C for at least 48 hours. These data suggest that such targeted therapy is feasible and may be useful for hyperproliferative and inflamed skin diseases. PMID:23439393
Kouno, Michiyoshi; Lin, Chenyan; Schechter, Norman M; Siegel, Don; Yang, Xiaoping; Seykora, John T; Stanley, John R
\\u000a Non-melanoma skin cancer (NMSC) is the most prevalent of all malignancies diagnosed in men and women in the US and its incidence\\u000a is rising rapidly. It has been estimated that between 900,000 and 1,200,000 new skin cancers arise in the Unites States each\\u000a year (1). The large majority of these are NMSC’s. Melanoma, with an estimated 44,200 new cases in
Meyer A. Horn; Gordon Kenneth B
Nicotinamide, an amide form of vitamin B3, boosts cellular energy and regulates poly-ADP-ribose-polymerase 1, an enzyme with important roles in DNA repair and the expression of inflammatory cytokines. Nicotinamide shows promise for the treatment of a wide range of dermatological conditions, including autoimmune blistering disorders, acne, rosacea, ageing skin and atopic dermatitis. In particular, recent studies have also shown it to be a potential agent for reducing actinic keratoses and preventing skin cancers. PMID:24635573
Chen, Andrew C; Damian, Diona L
. skin biopsy punch. Daily temperatures were recorded while animals were hospital- ized. Swabs taken from all sites where autografts failed to survive were cultured and antibiotic sensitivity was determined. Wounds were surgically produced... following transplantation. ~ Clinistix, Ames Co. , Inc. , Elkhart, Indiana Skin biopsies from the transplants were subjected to histo- pathological examination on the thirtieth day following transplantation. Biopsies were obtained by the use of a 6mm...
Boyd, Charles Leroy
Pregnancy is associated with complex of endocrinological, immunological, metabolic, and vascular changes that may influence the skin and other organs in various ways. Pregnancy is a period in which more than 90% women have significant and complex skin changes that may have great impact on the woman's life. The dermatoses of pregnancy represent a heterogeneous group of skin diseases related to pregnancy and/or the postpartum period. The dermatoses of pregnancy can be classified into the following three groups: Physiologic skin changes in pregnancy, pre-existing dermatoses affected by pregnancy, and specific dermatoses of pregnancy. Though most of these skin dermatoses are benign and resolve in postpartum period, a few can risk fetal life and require antenatal surveillance. Most of the dermatoses of pregnancy can be treated conservatively but a few require intervention in the form of termination of pregnancy. Correct diagnosis is essential for the treatment of these disorders. This article discusses the current knowledge of various skin changes during pregnancy and the evaluation of the patient with pregnancy dermatoses with special emphasis on clinical features, diagnostic tests, maternal and fetal prognosis, therapy, and management.
Vora, Rita V.; Gupta, Rajat; Mehta, Malay J.; Chaudhari, Arvind H.; Pilani, Abhishek P.; Patel, Nidhi
Necrotizing fasciitis (NF) is a fatal and rare disease, mainly located in extremity and body. Due to the good blood supply, the occurrence of this infective disease of skin and subcutaneous tissue/fascia is much rarer in the head and neck region. In this study, we represent periorbital necrotizing fasciitis case in a patient with normal immune system. The patient applied the emergency clinic with the complaints of swelling and redness on the left eye. It was found out that a skin incision occurred at 2?cm below the left eye with razor blade 2 days ago. After taking swab culture sample, patient was started on parenteral Vancomycin + Ampicillin-Sulbactam treatment. It was observed that necrosis spread within hours and an emergent deep surgical debridement was performed. Following the debridement, it was observed that periorbital edema began to regress prominently on the 1st day of the treatment. Treatment was carried on with daily wound care and parenteral antibiotherapy. The patient was discharged from the hospital with slightly cosmetic defect. PMID:25309766
Günel, Ceren; Ery?lmaz, Aylin; Ba?al, Ye?im; Toka, Ali
The sensory characteristics of fruit skins were determined for a range of produce including large fruit (apples, pears, and tomatoes) and small fruit (grapes, strawberries, blueberries, and cherry tomatoes). These results provided a context within which to study the sensory properties of skins from novel kiwifruit (Actinidia). The kiwifruit skins ranged from the edible skins of grape-sized Actinidia arguta through
Rachel L. Amos
The skin characteristics associated with thyroid hormone are classic. The name “myxedema” refers to the associated skin condition caused by increased glycosaminoglycan deposition in the skin. Generalized myxedema is still the classic cutaneous sign of hypothyroidism. It is caused by deposition of dermal acid mucopolysaccharides, notably hyaluronic acid. Despite its appearance, the skin does not pit with pressure. PMID:22110782
Moderate therapeutic hypothermia (MTH) significantly reduces the risk of death or long-term neurodevelopmental disability. Subcutaneous fat necrosis (SCFN) is a rare particular form of panniculitis in full-term newborns. It can occur in preterm infants with predisposing risk factors (birth asphyxia, gestational diabetes, etc.). A few cases of SCFN after MTH have been described. We report two original cases of SCFN after MTH in newborns of African origin. Ethnic origin has not yet been reported in the literature as a risk factor. We describe here the possibility of a new risk factor of SCFN. Dermatologists and pediatricians should be aware of this complication and recognize it early because of the risk of hypercalcemia, even late after skin remission. PMID:25482993
Martins, J; Maxaud, A; Bah, A-G; Prophette, B; Maillard, H; Bénéton, N
This report describes the development of lymphoedema in a patient with rheumatoid arthritis (RA) who was treated with tumour necrosis factor ? (TNF?) inhibitors. The patient was a 62-year-old woman with a long-standing history of RA that had been uncontrolled with steroids and methotrexate. Eight months after initiation of treatment with TNF? inhibitors she developed progressive symmetrical ascending non-pitting oedema of both legs with extensive keratinisation. A diagnosis of lymphoedema was made based on the clinical presentation and exclusion of alternative diagnoses. Skin biopsy showed dermatosclerosis consistent with lymphoedema. The temporal relationship suggested a link between the initiation of TNF? inhibitors and the development of lymphoedema. TNF? inhibitors are widely used to treat inflammatory diseases including lymphoedema. Paradoxically, there are reports suggesting the appearance of psoriasis, vasculitis and other inflammatory cutaneous conditions after the use of TNF? inhibitors. A review of literature is also presented. PMID:21686765
Tily, Hajra Ismail; Perl, Andras
Summary: The initial location of necrosis may affect the limb salvage rate. This study of 130 patients with chronic toe ulcers or gangrene was performed to assess whether the location of initial necrosis in the toes affected limb salvage prognosis. The patients were divided into 2 groups according to whether the initial necrosis was in the great toe or in other toes. Limb salvage prognosis was determined retrospectively. In the great toe group, the rates of total toe loss and major amputation were 50.0% and 24.4%, respectively. When the initial necrosis was in other toes, these rates were 27.3% and 9.3%, respectively. Great toe necrosis is associated with significantly higher rates of total toe loss (odds ratio = 3.10; P = 0.003; 95% confidence interval, 1.43?6.68) and major amputation (odds ratio = 3.66; P = 0.007; 95% confidence interval, 1.37?9.79). The great toe is supplied by 3 source arteries, whereas the lesser toes are fed by 1 or 2 arteries. Therefore, necrosis initiating from the great toe may reflect the presence of severe vascular disorders. The great toe is also anatomically connected to much of the foot via the tendons. Infection is more likely to spread along these tendons, which may reduce limb prognosis. Thus, the initial location of necrosis may be predictive of limb prognosis. PMID:25426399
Cells undergoing necrosis release endogenous danger signals that possess proinflammatory potential. In this study we show that mature IL-1beta and IL-18 are released by necrotic cells but not by apoptotic cells. We identify 7-bromoindirubin-3'-oxime, an indirubin oxime derivative that induces necrosis, as a potent inducer of caspase-1 activation and release of mature IL-1beta and IL-18. Inflammasome activation was triggered by other necrosis-inducing treatments but was not observed in response to apoptosis-inducing stimuli. Necrosis-induced inflammasome activation was mediated by the NLRP3 and ASC molecules. Release of IL-18 and IL-1beta in response to necrosis-inducing stimuli was observed in THP-1 macrophages and the MSTO-211H human mesothelioma cell line independently of LPS priming. Using the in vivo model of naphthalene-induced airway epithelial cell injury, we showed that necrosis activates the ASC inflammasome in vivo. Our study identifies a new mechanism through which necrosis generates proinflammatory molecules that contributes to the sterile inflammatory response. PMID:19596994
Li, Hanfen; Ambade, Aditya; Re, Fabio
Human recombinant tumor necrosis factor (TNF) was shown to be a weak direct stimulus of the neutrophil respiratory burst and degranulation. The stimulation, as measured by iodination, H/sub 2/O/sub 2/ production, and lysozyme release, was considerably increased by the presence of unopsonized zymosan in the reaction mixture, an effect which was associated with the increased ingestion of the zymosan. TNF does not act as an opsonin but, rather, reacts with the neutrophil to increase its phagocytic activity. TNF-dependent phagocytosis, as measured indirectly by iodination, is inhibited by monoclonal antibodies (Mab) 60.1 and 60.3, which recognize different epitopes on the C3bi receptor/adherence-promoting surface glycoprotein of neutrophils. Other neutrophil stimulants, namely N-formyl-methionyl-leucyl-phenylalanine, the Ca2+ ionophore A23187, and phorbol myristic acetate, also increase iodination in the presence of zymosan; as with TNF, the effect of these stimulants is inhibited by Mab 60.1 and 60.3, whereas, in contrast to that of TNF, their stimulation of iodination is unaffected by an Mab directed against TNF. TNF may be a natural stimulant of neutrophils which promotes adherence to endothelial cells and to particles, leading to increased phagocytosis, respiratory burst activity, and degranulation.
Klebanoff, S.J.; Vadas, M.A.; Harlan, J.M.; Sparks, L.H.; Gamble, J.R.; Agosti, J.M.; Waltersdorph, A.M.
Acute esophageal necrosis or black esophagus is an uncommon clinical entity, diagnosed at the upper gastrointestinal endoscopy with the presence of strikingly black necrotic esophagus. Very often no definite etiology will be identified even though a large list of potential associations has been postulated. Upper gastrointestinal bleeding is the most common clinical presentation, others being epigastric pain, retrosternal chest discomfort and dysphagia. Only about a hundred cases of acute esophageal necrosis have been described in medical literature till this date. We report a case of acute esophageal necrosis in an elderly female who had presented with hematemesis. PMID:25170416
Zacharia, George Sarin; Sandesh, K; Ramachandran, TM
Skin and skin disorders have had spiritual aspects since ancient times. Skin, hair, and nails are visible to self and others, and touchable by self and others. The skin is a major sensory organ. Skin also expresses emotions detectable by others through pallor, coldness, “goose bumps”, redness, warmth, or sweating. Spiritual and religious significances of skin are revealed through how much of the skin has been and continues to be covered with what types of coverings, scalp and beard hair cutting, shaving and styling, skin, nail, and hair coloring and decorating, tattooing, and intentional scarring of skin. Persons with visible skin disorders have often been stigmatized or even treated as outcasts. Shamans and other spiritual and religious healers have brought about healing of skin disorders through spiritual means. Spiritual and religious interactions with various skin disorders such as psoriasis, leprosy, and vitiligo are discussed. Religious aspects of skin and skin diseases are evaluated for several major religions, with a special focus on Judaism, both conventional and kabbalistic. PMID:25120377
Shenefelt, Philip D; Shenefelt, Debrah A
Infants exhibit many skin rashes. Erythema toxicum neonatorum presents as erythematous macules, papules, and pustules on the face, trunk, and extremities; it typically resolves spontaneously within 1 week. Neonatal acne presents as comedones or erythematous papules on the face, scalp, chest, and back. Infantile acne is similar but starts after the neonatal period. Both conditions typically resolve spontaneously; failure to resolve within 1 year warrants evaluation for androgen excess. Neonatal cephalic pustulosis is an acne variant caused by hypersensitivity to Malassezia furfur. It is typically self-limited, but severe cases are managed with topical ketoconazole. Miliaria and milia are caused by sweat retention and present as tiny vesicles or papules; they resolve spontaneously. Contact diaper dermatitis is managed by keeping the diaper area clean and with open air exposure. Diaper dermatitis due to Candida albicans is managed with topical antifungals. Seborrheic dermatitis causes scaling on the scalp. Management involves shampooing and removing scales with a soft brush after applying mineral oil or petrolatum; severe cases are managed with tar or ketoconazole shampoo. Atopic dermatitis is related to food allergy in approximately one-third of children. Food allergy can be confirmed with oral food challenges or skin prick tests. Management includes elimination of irritants and triggers and use of low-potency topical steroids. PMID:23600337
Zuniga, Ramiro; Nguyen, Tam
Skin diseases associated with photosensitivity are numerous and may be divided into three main groups: photo-aggravated dermatoses, genophotodermatoses and metabolic photodermatoses. Photo-aggravated dermatoses are autonomous skin diseases in which exposure to sunlight may make the disease worse or precipitate its onset and/or its progressiveness; this group includes lupus erythematosus, autoimmune bullous diseases, acantolytic dyskeratoses, acne vulgaris, rosacea and cutaneous lymphoid infiltrates. To these must be added photosensitive forms of autonomous dermatoses such as atopic dermatitis, psoriasis, herpes labialis, erythema multiforme, granuloma and disseminated superficial actinic porokeratosis. Genophotodermatoses are genodermatoses which are made photosensitive by a recognized or as yet unidentified deficiency of the natural photoprotection system. In this group are albinism, vitiligo, xeroderma pigmentosum and poikiloderma. Metabolic photodermatoses are diseases in which photosensitization reactions, often revealing, are due to the accumulation in the skin of an endogenous chromophore as a result of a congenital (porphyria) or acquired (pellagra) enzymatic disorder. PMID:1529248
Amblard, P; Leccia, M T
Fabricating a turbine component (50) by casting a core structure (30), forming an array of pits (24) in an outer surface (32) of the core structure, depositing a transient liquid phase (TLP) material (40) on the outer surface of the core structure, the TLP containing a melting-point depressant, depositing a skin (42) on the outer surface of the core structure over the TLP material, and heating the assembly, thus forming both a diffusion bond and a mechanical interlock between the skin and the core structure. The heating diffuses the melting-point depressant away from the interface. Subsurface cooling channels (35) may be formed by forming grooves (34) in the outer surface of the core structure, filling the grooves with a fugitive filler (36), depositing and bonding the skin (42), then removing the fugitive material.
Allen, David B
A skin friction balance uses a parallel linkage mechanism to avoid inaccuracies in skin friction measurement attributable to off-center normal forces. The parallel linkage mechanism includes a stationary plate mounted in a cage, and an upper and lower movable plate which are linked to each other and to the stationary plate throught three vertical links. Flexure pivots are provided for pivotally connecting the links and the plates. A sensing element connected to the upper plate moves in response to skin friction, and the lower plate moves in the opposite direction of the upper plate. A force motor maintains a null position of the sensing element by exerting a restoring force in response to a signal generated by a linear variable differential transformer (LVDT).
Ping, Tcheng (inventor); Supplee, Frank H., Jr. (inventor)
Skin diseases with an allergic background such as atopic dermatitis, allergic contact dermatitis, and urticaria are very common. Moreover, diseases arising from a dysfunction of immune cells and/or their products often manifest with skin symptoms. This review aims to summarize recently published articles in order to highlight novel research findings, clinical trial results, and current guidelines on disease management. In recent years, an immense progress has been made in understanding the link between skin barrier dysfunction and allergic sensitization initiating the atopic march. In consequence, new strategies for treatment and prevention have been developed. Novel pathogenic insights, for example, into urticaria, angioedema, mastocytosis, led to the development of new therapeutic approaches and their implementation in daily patient care. By understanding distinct pathomechanisms, for example, the role of IL-1, novel entities such as autoinflammatory diseases have been described. Considerable effort has been made to improve and harmonize patient management as documented in several guidelines and position papers. PMID:25283085
Schlapbach, C; Simon, D
Recently, we introduced a paradigm shift in light confinement strategy and introduced a class of extreme skin depth (e-skid) photonic structures (S. Jahani and Z. Jacob, "Transparent sub-diffraction optics: nanoscale light confinement without metal," Optica 1, 96-100 (2014)). Here, we analytically establish that figures of merit related to light confinement in dielectric waveguides are fundamentally tied to the skin depth of waves in the cladding. We contrast the propagation characteristics of the fundamental mode of e-skid waveguides and conventional waveguides to show that the decay constant in the cladding is dramatically larger in e-skid waveguides, which is the origin of sub-diffraction confinement. Finally, we propose an approach to verify the reduced skin depth in experiment using the decrease in the Goos-H\\"anchen phase shift.
We report on a systematic investigation of molecular conjugation of tumor necrosis factor-? (TNF) protein onto gold nanoparticles (AuNPs) and the subsequent binding behavior to its antibody (anti-TNF). We employ a combination of physical and spectroscopic characterization methods, including electrospray-differential mobility analysis, dynamic light scattering, polyacrylamide gel electrophoresis, attenuated total reflectance-Fourier transform infrared spectroscopy, fluorescence assay, and enzyme-linked immunosorbent assay. The native TNF used in this study exists in the active homotrimer configuration prior to conjugation. After binding to AuNPs, the maximum surface density of TNF is (0.09 +/- 0.02) nm-2 with a binding constant of 3 × 106 (mol L-1)-1. Dodecyl sulfate ions induce desorption of monomeric TNF from the AuNP surface, indicating a relatively weak intermolecular binding within the AuNP-bound TNF trimers. Anti-TNF binds to both TNF-conjugated and citrate-stabilized AuNPs, showing that non-specific binding is significant. Based on the number of anti-TNF molecules adsorbed, a substantially higher binding affinity was observed for the TNF-conjugated surface. The inclusion of thiolated polyethylene glycol (SH-PEG) on the AuNPs inhibits the binding of anti-TNF, and the amount of inhibition is related to the number ratio of surface bound SH-PEG to TNF and the way in which the ligands are introduced. This study highlights the challenges in quantitatively characterizing complex hybrid nanoscale conjugates, and provides insight on TNF-AuNP formation and activity.We report on a systematic investigation of molecular conjugation of tumor necrosis factor-? (TNF) protein onto gold nanoparticles (AuNPs) and the subsequent binding behavior to its antibody (anti-TNF). We employ a combination of physical and spectroscopic characterization methods, including electrospray-differential mobility analysis, dynamic light scattering, polyacrylamide gel electrophoresis, attenuated total reflectance-Fourier transform infrared spectroscopy, fluorescence assay, and enzyme-linked immunosorbent assay. The native TNF used in this study exists in the active homotrimer configuration prior to conjugation. After binding to AuNPs, the maximum surface density of TNF is (0.09 +/- 0.02) nm-2 with a binding constant of 3 × 106 (mol L-1)-1. Dodecyl sulfate ions induce desorption of monomeric TNF from the AuNP surface, indicating a relatively weak intermolecular binding within the AuNP-bound TNF trimers. Anti-TNF binds to both TNF-conjugated and citrate-stabilized AuNPs, showing that non-specific binding is significant. Based on the number of anti-TNF molecules adsorbed, a substantially higher binding affinity was observed for the TNF-conjugated surface. The inclusion of thiolated polyethylene glycol (SH-PEG) on the AuNPs inhibits the binding of anti-TNF, and the amount of inhibition is related to the number ratio of surface bound SH-PEG to TNF and the way in which the ligands are introduced. This study highlights the challenges in quantitatively characterizing complex hybrid nanoscale conjugates, and provides insight on TNF-AuNP formation and activity. Electronic supplementary information (ESI) available: Experimental procedures, instrumentation, materials and calculations. See DOI: 10.1039/c2nr30415e
Tsai, De-Hao; Elzey, Sherrie; Delrio, Frank W.; Keene, Athena M.; Tyner, Katherine M.; Clogston, Jeffrey D.; Maccuspie, Robert I.; Guha, Suvajyoti; Zachariah, Michael R.; Hackley, Vincent A.
While skin tears are common among the elderly in general, and residents of long-term care facilities in particular, there has been limited research into their treatment. Many facilities voluntarily track skin tears, and some states require facilities to report these events. Risk factors include age, xerosis (abnormal eye, skin, or mouth dryness), need for help in activities of daily living, presence of senile purpura, visual impairment, and poor nutrition. Plans to prevent skin tears that employ skin sleeves, padded side rails, gentle skin cleansers, moisturizing lotions, as well as staff education, can decrease by half the number of skin tears incurred in a long-term care facility. Although the treatment process seems simple, it is time consuming and can be painful for the patient. Residents with dementia or agitation often try to remove bulky dressings used to cover skin tears. Dressing changes may injure the fragile wound via skin stripping. PMID:18764669
Wick, Jeannette Y; Zanni, Guido R
Programmed necrosis or necroptosis is an inflammatory form of cell death driven by TNF-like death cytokines, toll-like receptors, and antigen receptors. Unlike necrosis induced by physical trauma, a dedicated pathway is involved in programmed necrosis. In particular, a kinase complex composed of the receptor interacting protein kinase 1 (RIPK1) and RIPK3 is a central step in necrotic cell death. Assembly and activation of this RIPK1–RIPK3 “necrosome” is critically controlled by protein ubiquitination, phosphorylation, and caspase-mediated cleavage events. The molecular signals cumulate in formation of intracellular vacuoles, organelle swelling, internal membrane leakage, and eventually plasma membrane rupture. These morphological changes can result in spillage of intracellular adjuvants to promote inflammation and further exacerbate tissue injury. Because of the inflammatory nature of necrosis, it is an attractive pathway for therapeutic intervention in acute inflammatory diseases. PMID:23125016
Chan, Francis Ka-Ming
in equine joints . Matrix metalloproteinases (MMPs) are an important group of zinc enzymesOriginal article Metalloproteinases and tumor necrosis factor-alpha activities in synovial fluids cartilage destruction. To further document cartilage matrix proteases production, synovial fluid
Paris-Sud XI, UniversitÃ© de
Complications after endoscopic injection therapy to control bleeding from peptic ulcers are uncommon and rarely fatal. We report a case of fatal gastroduodenal necrosis and postulate that accidental intra-arterial injection may be responsible for this event. PMID:8463616
Goldberg, P A; Krige, J E
The principle of stretching wound margins for primary wound closure is commonly practiced and used for various skin defects, leading at times to excessive tension and complications during wound closure. Different surgical techniques, skin stretching devices and tissue expanders have been utilized to address this issue. Previously designed skin stretching devices resulted in considerable morbidity. They were invasive by nature and associated with relatively high localized tissue pressure, frequently leading to necrosis, damage and tearing of skin at the wound margins. To assess the clinical effectiveness and performance and, to determine the safety of TopClosure® for gradual, controlled, temporary, noninvasive and invasive applications for skin stretching and secure wound closing, the TopClosure® device was applied to 20 patients for preoperative skin lesion removal and to secure closure of a variety of wound sizes. TopClosure® was reinforced with adhesives, staples and/or surgical sutures, depending on the circumstances of the wound and the surgeon's judgment. TopClosure® was used prior to, during and/or after surgery to reduce tension across wound edges. No significant complications or adverse events were associated with its use. TopClosure® was effectively used for preoperative skin expansion in preparation for dermal resection (e.g., congenital nevi). It aided closure of large wounds involving significant loss of skin and soft tissue by mobilizing skin and subcutaneous tissue, thus avoiding the need for skin grafts or flaps. Following surgery, it was used to secure closure of wounds under tension, thus improving wound aesthetics. A sample case study will be presented. We designed TopClosure®, an innovative device, to modify the currently practiced concept of wound closure by applying minimal stress to the skin, away from damaged wound edges, with flexible force vectors and versatile methods of attachment to the skin, in a noninvasive or invasive manner. PMID:22719176
Topaz, Moris; Carmel, Narin-Nard; Silberman, Adi; Li, Ming Sen; Li, Yong Zhong
In this lesson, students learn about the importance of proper protection from common skin conditions when they engage in sports-related activities. This lesson draws attention to fact that the body's own first line of defense against infectious agents is to keep them from entering or settling in the body. The students break into groups to provide a list of risk factors for each sports-related activity. They come together and compare notes. This sparks the lesson and instruction on how one should protect the skin when participating in sports. Links to other resources for further inquiry are given.
American Association for the Advancement of Science (; )
Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature. PMID:23983714
Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali; Ozer, Ender
Acute gastric dilatation with necrosis is a rare and severe complication associated with anorexia nervosa, bulimia, and psychogenic polyphagia. The Authors report an unusual case without underlying psychiatric context. Gastric necrosis was suspected based on imaging findings (plain radiograph and computed tomography). The detection of these imaging signs in an appropriate clinical setting, even without underlying psychiatric context, is important to avoid any delay in diagnosis and reduce mortality. PMID:15205657
Gomez, M-A; Blum, L; Scotto, B; Besson, M; Roger, R; Alison, D
A young female with Plasmodium vivax malaria presented with anemia, hyperbilirubinemia, thrombocytopenia, and advanced renal failure. She remained anuric for more than 3 weeks. Kidney biopsy confirmed the diagnosis of acute cortical necrosis. During follow-up, she became dialysis independent, but remained in stage 4 chronic kidney disease (CKD) at 3 month. P. vivax is supposed to be benign in nature, but can lead to rare and severe complication like renal cortical necrosis and progress to CKD. PMID:25484536
Kumar, R.; Bansal, N.; Jhorawat, R.; Kimmatkar, P. D.; Malhotra, V.
Penile necrosis is a very rare complication because of its rich collateral supply. Conservative management is apt to be ineffective; thus penectomy is usually performed. We present a case of penile necrosis and claudication of both legs with multiple atherosclerosis in a type II diabetes mellitus patient who was successfully treated with angioplasty, penoplasty, and additional intracavernous injections of prostaglandin E1. The treatment resulted in relief of the leg pain and healing of the penile ischemic lesions. PMID:24872955
Kim, Sung Dae; Huh, Jung Sik
The tumor necrosis factor receptors (TNFRs) play essential roles in innate and adaptive immunity. Depending on conditions, TNFR induces multiple cell fates including cell survival, cell apoptosis, and cell programmed necrosis. Here, we review recent progress in structural studies of the TNFR signaling pathway. The structural basis for the high order signal complexes, including the DISC, ripoptosome, necrosome, and RIP3/MLKL complex, may provide novel insights for understanding the biophysical principles of cell signaling cascades. PMID:25451008
Huang, Jing; Yu, Shaoning; Ji, Chaoneng; Li, Jixi
A young female with Plasmodium vivax malaria presented with anemia, hyperbilirubinemia, thrombocytopenia, and advanced renal failure. She remained anuric for more than 3 weeks. Kidney biopsy confirmed the diagnosis of acute cortical necrosis. During follow-up, she became dialysis independent, but remained in stage 4 chronic kidney disease (CKD) at 3 month. P. vivax is supposed to be benign in nature, but can lead to rare and severe complication like renal cortical necrosis and progress to CKD. PMID:25484536
Kumar, R; Bansal, N; Jhorawat, R; Kimmatkar, P D; Malhotra, V
Background Necrosis, a type of cell death accompanied by the rupture of the plasma membrane, promotes tumor progression and aggressiveness by releasing the pro-inflammatory and angiogenic cytokine high mobility group box 1. It is commonly found in the core region of solid tumors due to hypoxia and glucose depletion (GD) resulting from insufficient vascularization. Thus, metabolic stress-induced necrosis has important clinical implications for tumor development; however, its regulatory mechanisms have been poorly investigated. Methodology/Principal Findings Here, we show that the transcription factor Snail, a key regulator of epithelial-mesenchymal transition, is induced in a reactive oxygen species (ROS)-dependent manner in both two-dimensional culture of cancer cells, including A549, HepG2, and MDA-MB-231, in response to GD and the inner regions of a multicellular tumor spheroid system, an in vitro model of solid tumors and of human tumors. Snail short hairpin (sh) RNA inhibited metabolic stress-induced necrosis in two-dimensional cell culture and in multicellular tumor spheroid system. Snail shRNA-mediated necrosis inhibition appeared to be linked to its ability to suppress metabolic stress-induced mitochondrial ROS production, loss of mitochondrial membrane potential, and mitochondrial permeability transition, which are the primary events that trigger necrosis. Conclusions/Significance Taken together, our findings demonstrate that Snail is implicated in metabolic stress-induced necrosis, providing a new function for Snail in tumor progression. PMID:21448462
Ju, Min Kyung; Moon, Ji Young; Park, Hye Gyeong; Yoo, Mi-Ae; Choi, Byung Tae; Yook, Jong In; Lim, Sung-Chul; Han, Song Iy; Kang, Ho Sung
The response of the skin to ionizing radiation has important implications both for the treatment of malignant disease by radiation and for radiological protection. The structural organization of human skin is described and compared with that of the pig, with which it shows many similarities, in order that the response of the skin to ionizing radiation may be more fully understood. Acute radiation damage to the skin is primarily a consequence of changes in the epidermis; the timing of the peak of the reaction is related to the kinetic organization of this layer. The rate of development of damage is independent of the radiation dose, since this is related to the natural rate of loss of cells from the basal layer of the epidermis. Recovery of the epidermis occurs as a result of the proliferation of surviving clonogenic basal cells from within the irradiated area. The presence of clonogenic cells in the canal of the hair follicle is important, particularly after non-uniform irradiation from intermediate energy beta-emitters. The migration of viable cells from the edges of the irradiated site is also significant when small areas of skin are irradiated. Late damage to the skin is primarily a function of radiation effects on the vasculature; this produces a wave of dermal atrophy after 16-26 weeks. Dermal necrosis develops at this time after high doses. A second phase of dermal thinning is seen to develop after greater than 52 weeks, and this later phase of damage is associated with the appearance of telangiectasia. Highly localized irradiation of the skin, either to a specific layer (as may result from exposure to very low energy beta-emitters) or after exposure to small highly radioactive particles, 'hot particles', produces gross effects that become visibly manifest within 2 weeks of exposure. These changes result from the direct killing of the cells of the skin in interphase after doses greater than 100 Gy. Dose-effect curves have been established for the majority of these deterministic endpoints in the skin from the results of both experimental and clinical studies. These are of value in the establishment of safe radiation dose limits for the skin. PMID:1969905
Hopewell, J W
Although numerous epidemiological studies have shown that inorganic arsenicals are human skin carcinogens, there is currently no accepted mechanism for its action or an established animal model for its study. We observed increased mRNA transcripts and secretion of keratinocyte growth factors, including granulocyte macrophage-colony stimulating factor (GM-CSF) and transforming growth factor-? (TGF-?) and the proinflammatory cytokine tumor necrosis factor-? (TNF-?)
Dori R Germolec; Judson Spalding; Gary A Boorman; James L Wilmer; Takahiko Yoshida; Petia P Simeonova; Alessandra Bruccoleri; Fujio Kayama; Kevin Gaido; Raymond Tennant; Florence Burleson; Wumin Dong; Robert W Lang; Michael I Luster
Cephalopods, such as octopus and squid, can change their coloration in an instant, and even produce moving patterns on their skin. A new study describes these wavelike patterns in a colourful tropical cuttlefish, providing insights into the neural mechanisms that generate them. PMID:25093557
In this activity, students learn about their skin and the importance of protecting it. It is part of the My World activities from Baylor College of Medicine. Additional activities can be accessed at http://www.ccitonline.org/ceo/content.cfm?content_id=96.
Baylor College of Medicine (Baylor College of Medicine Human Genome Sequencing Center)
Chemokines are small molecules that induce chemotaxis and activation of certain subsets of leukocytes. The expression patterns of chemokines and chemokine receptors are specific to certain organs and cells. Therefore, chemokines are important to elucidate the mechanism of organ-specific human diseases. CCL17 expressed by Langerhans cells, blood endothelial cells, and fibroblasts plays a key role in attracting Th2 cells and tumor cells of adult T-cell leukemia/lymphoma and mycosis fungoides/Sézary syndrome into the skin, developing various Th2-type inflammatory skin diseases as well as cutaneous lymphoma. CCL11 and CCL26 expressed by skin-resident cells, such as fibroblasts, blood endothelial cells, and keratinocytes, induce infiltration of CCR3-expressing cells such as Th2 cells and eosinophils. CCL11 may also serve as an autocrine as well as a paracrine in anaplastic large cell lymphoma. CX3CL1 expressed on blood endothelial cells leads to infiltration of CX3CR1(+) immune cells, such as mast cells, neutrophils, and macrophages, playing important roles in wound healing, tumor immunity, and vasculitis. Biologics targeting chemokines and their receptors are promising strategies for various skin diseases that are resistant to the current therapy. PMID:25182982
Observations in humans and animal studies support the theory that immunologic surveillance plays an important role in limiting the development of skin malignancies. These immune responses undergo progressive diminution with age. In addition, other factors, such as bereavement, poor nutrition, and acute and chronic exposure to ultraviolet light, can further diminish immune mechanisms.
Smith, E.B.; Brysk, M.M.
Skin wound macrophages are key regulators of skin repair and their dysfunction causes chronic, non-healing skin wounds. Peroxisome proliferator-activated receptor gamma (PPAR?) regulates pleiotropic functions of macrophages, but its contribution in skin wound healing is poorly defined. We observed that macrophage PPAR? expression was upregulated during skin wound healing. Furthermore, macrophage PPAR? deficiency (PPAR?-knock out (KO)) mice exhibited impaired skin wound healing with reduced collagen deposition, angiogenesis and granulation formation. The tumor necrosis factor alpha (TNF-?) expression in wounds of PPAR?-KO mice was significantly increased and local restoration of TNF-? reversed the healing deficit in PPAR?-KO mice. Wound macrophages produced higher levels of TNF-? in PPAR?-KO mice compared with control. In vitro, the higher production of TNF-? by PPAR?-KO macrophages was associated with impaired apoptotic cell clearance. Correspondingly, increased apoptotic cell accumulation was found in skin wound of PPAR?-KO mice. Mechanically, peritoneal and skin wound macrophages expressed lower levels of various phagocytosis-related molecules. In addition, PPAR? agonist accelerated wound healing and reduced local TNF-? expression and wound apoptotic cells accumulation in wild type but not PPAR?-KO mice. Therefore, PPAR? has a pivotal role in controlling wound macrophage clearance of apoptotic cells to ensure efficient skin wound healing, suggesting a potential new therapeutic target for skin wound healing. PMID:25590807
Chen, H; Shi, R; Luo, B; Yang, X; Qiu, L; Xiong, J; Jiang, M; Liu, Y; Zhang, Z; Wu, Y
How does the beauty industry "narrate the skin"? What does it teach women from different cultural groups about the female body? How does skin function as a site where female subjection and abjection are produced and reproduced? In this paper we examine the skin industry pointing to its extreme commodification of the female body and to the…
Kenway, Jane; Bullen, Elizabeth
Apoptosis and necrosis are two different paths for cell death. One of differences between apoptosis and necrosis is the cell morphology. Apoptotic cells shrink without loosing the integrity of their plasma membrane and break into smaller pieces called apoptotic bodies that other body cells recognize and eat. In contrast, necrotic cells swell and their plasma membrane eventually ruptures. Since the cell membrane is closely related to the capacitance (or dielectric constant), we have fabricated a capacitance sensor, which can measure the capacitance of cells, and investigated its time dependence during apoptosis and necrosis for TE2 cells induced by TNF-related apoptosis inducing ligand (TRAIL) and ethanol. The capacitance decreases monotonically during apoptosis. For necrosis, however, step-like behaviors are observed and dips are found in the dC/dt-t curves. The time-lapse images of TE2 cells, which have been taken simultaneously with the capacitance measurements, show that the dips in the dC/dt-t curves are probably due to the rupture of cell membrane. These results suggest that apoptosis and necrosis are differentiated by the capacitance measurements. PMID:19233636
Lee, Ri Mi; Choi, Hyangtae; Shin, Jeon-Soo; Kim, Kunhong; Yoo, Kyung-Hwa
Nonmelanoma skin cancer (NMSC) represents the most common form of cancer in Caucasians, with continuing increase in incidence worldwide. Basal cell carcinoma (BCC) accounts for 75% of cases of NMSC, and squamous cell carcinoma (SCC) accounts for the remaining majority of NMSC cases. Whilst metastasis from BCC is extremely rare, metastasis from high-risk SCC may be fatal. In this article, we review the aetiology, diagnosis and management of NMSC. PMID:22557848
Samarasinghe, Venura; Madan, Vishal
\\u000a The consensus meeting on “educational needs for primary and secondary prevention of melanoma in Europe” by the EORTC Melanoma\\u000a group, published in 1991  as well as a consensus conference on “early melanoma” by the National Institutes of Health, USA, in 1992 and the consensus\\u000a meeting “How to decrease morbidity and mortality of skin cancer” by the “Commission of Early
E. W. Breitbart; M. Breitbart
In this two-minute radio program, a soil scientist introduces listeners to reasons why soil is crucial to the planet. The scientist lists functions of soil that include nutrient cycling and water filtration, and he also uses living skin as an analogy for soil. The program, part of the Pulse of the Planet radio show, is available here in text and audio formats. Copyright 2005 Eisenhower National Clearinghouse
Pulse of the Planet
The incidence of cancers of the skin is increasing, as is life expectancy among most of the population. Besides surgery, all skin cancers can be treated with radiotherapy, with excellent results. Unfortunately, both less training and less equipment are available than earlier, which means that dermatologists also have less experience in this field. We would like to propose radiotherapy for medium-sized or larger lesions, especially on the face in elderly people. Good indications are keratoacanthomas, extensive actinic keratoses, Bowen's disease including erythroplasia of Queyrat, basal cell and squamous cell carcinomas, but also lentigo maligna and lentigo maligna melanomas. These tumors can be treated in a curative way. Excellent results of palliative X-ray therapy are achieved in Kaposi's sarcoma and in lymphomas, and also in Merkel cell tumors. After 100 years of treatment of skin cancers by radiotherapy, dermatologists should not forget that if appropriate principles are followed and precautions are taken, X-ray treatment is still a safe and effective method. PMID:12079218
Panizzon, R G
Mycobacterial lesions and skin sites challenged with soluble mycobacterial antigen are very sensitive to the necrotizing effect of tumour necrosis factor (TNF). We have used a model that permits separate quantitative assessment of swelling and haemorrhage to show that when these reactions are elicited in mice that have not been deliberately immunized, pretreatment of the mice with lipopolysaccharide (LPS), or with a MoAb to CR3 which blocks emigration of myeloid cells into the tissues, will block both the swelling and the haemorrhage. On the other hand, treatment with an inhibitor of platelet-activating factor (PAF), or with misoprostol (a synthetic prostaglandin E1 analogue), or with cobra venom factor (CVF) which depletes complement, preferentially blocks the haemorrhagic component, while leaving the swelling relatively unaltered. As swelling occurs before the haemorrhage is seen, it is possible that these factors act at a late stage in the cascade of events leading to the tissue damage. However, LPS and CVF were able to inhibit swelling and haemorrhage in the massive reactions elicited in pre-immunized animals, whereas the PAF inhibitor had no detectable effect. PMID:1606738
al Attiyah, R; Rosen, H; Rook, G A
Oral Langerhans cells (LC) have better T-cell costimulatory capacity than skin LC. In this study factors affecting this capacity have been assessed in a mixed epithelial cell lymphocyte reaction (MELR) assay. Flow cytometry analysis of freshly recovered cells revealed major histocompatibility complex (MHC) class II molecule expression on 7.5% of the oral epithelial cells and 9.7% of the skin epithelial cells. Monoclonal anti class II antibodies significantly reduced the T-cell proliferation in the MELR. Pretreatment of skin epithelial cells with interleukin-1beta, tumour necrosis factor-alpha or interferon (IFN)-gamma did not affect the MELR proliferation, but incubation with IFNgamma significantly suppressed the T-cell response. Transfer of supernatants from cultures of skin epithelial cells and allogeneic T cells to cultures of oral epithelial cells and T cells resulted in a reduced T-cell proliferation while supernatants from oral epithelial cells and T cells did not reduce proliferation. The higher proliferation in cultures of T cells and oral epithelial cells than in cultures containing skin epithelial cells may be due to the presence of a suppressive factor in the skin epithelial cell suspensions. PMID:14871193
Hasséus, B; Jontell, M; Bergenholtz, G; Dahlgren, U I
The predominant definition of apoptosis considers that the elimination of the apoptosing cell is by heterolytic degradation following phagocytosis by an assisting scavenger (efferocytosis). However, an alternative and largely underestimated outcome of apoptosis is secondary necrosis, an autolytic process of cell disintegration with release of cell components that occurs when there is no intervention of scavengers and the full apoptotic program is completed. Secondary necrosis is the typical outcome of apoptosis in unicellular eukaryotes but, importantly, it may also occur in multicellular animals and has been implicated in the genesis of important human pathologies. Secondary necrosis is a mode of cell elimination with specific molecular and morphological features and should be considered the natural outcome of the complete apoptotic program. PMID:20974143
Silva, Manuel T
The Majority of Epidermal T Cells in Psoriasis Vulgaris Lesions can Produce Type 1 Cytokines, Interferon-?, Interleukin2, and Tumor Necrosis Factor-?, Defining TC1 (Cytotoxic T Lymphocyte) and TH1 Effector Populations:1 a Type 1 Differentiation Bias is also Measured in Circulating Blood T Cells in Psoriatic Patients
Psoriasis vulgaris is a skin disease potentially mediated by pro-inflammatory cytokines produced by type 1 lesional T cells. The capability of individual T cells to produce these cytokines in lesional skin is not known. In this study we measured the ability of lesional and peripheral blood T cells to produce intracellular interferon-?, tumor necrosis factor-?, interleukin-2, interleukin-4, and interleukin-10 proteins
Lisa M Austin; Maki Ozawa; Toyoko Kikuchi; Ian B Walters; James G Krueger
Summary Calciphylaxis, also referred to as calcific uremic arteriolopathy, is a relatively rare but well described syndrome that occurs most commonly in patients with late stage CKD. It is characterized by very painful placques or subcutaneous nodules and violaceous, mottled skin lesions that may progress to nonhealing ulcers, tissue necrosis, and gangrene with a 1-year mortality rate >50%. The pathogenesis of calciphylaxis is poorly understood. Risk factors include female sex, obesity, hyperphosphatemia, hypercalcemia, hyperparathyroidism, longer dialysis vintage, hypercoagulable states, and use of calcium-containing phosphate binders and warfarin. Treatment strategies for calciphylaxis are limited by inadequate understanding of its pathophysiology. Therapy is generally focused on correcting disturbances of calcium, phosphorus, and parathyroid hormone metabolism. Additional therapy focuses on decreasing inflammation and on dissolution of tissue calcium deposits with sodium thiosulfate and/or bisphosphonates. Successful treatment generally results in improvement of pain and healing of the lesions within 2–4 weeks, but the disorder generally takes many months to completely resolve. PMID:24202137
The receptor-interacting protein kinase 3 (RIP3/RIPK3) has emerged as a critical regulator of programmed necrosis/necroptosis, an inflammatory form of cell death with important functions in pathogen-induced and sterile inflammation. RIP3 activation is tightly regulated by phosphorylation, ubiquitination, and caspase-mediated cleavage. These post-translational modifications coordinately regulate the assembly of a macromolecular signaling complex termed the necrosome. Recently, several reports indicate that RIP3 can promote inflammation independent of its pronecrotic activity. Here, we review our current understanding of the mechanisms that drive RIP3-dependent necrosis and its role in different inflammatory diseases. PMID:23913919
Moriwaki, Kenta; Chan, Francis Ka-Ming
Hyperphagia and obesity are common features in individuals with Prader-Willi syndrome (PWS). Demographic and cause of death data from individuals with PWS were obtained through a national support organization. Four reports of unexpected mortality due to gastric rupture and necrosis were found in 152 reported deaths, accounting for 3% of the causes of mortality. Four additional individuals were suspected to have gastric rupture. Vomiting and abdominal pain, although rare in PWS, were frequent findings in this cohort. The physician should consider an emergent evaluation for gastric rupture and necrosis in individuals with PWS who present with vomiting and abdominal pain. PMID:17667731
Stevenson, David A.; Heinemann, Janalee; Angulo, Moris; Butler, Merlin G.; Loker, Jim; Rupe, Norma; Kendell, Patrick; Cassidy, Suzanne B.; Scheimann, Ann
Angiosarcoma of the kidney is an exceedingly rare and aggressive neoplasm. Very few cases have been reported in the English literature to date. We report a case of primary renal angiosarcoma with extensive necrosis and discuss its diagnostic difficulties. An 86-year-old male presented with a 12?cm necrotic renal mass and multiple pulmonary and hepatic nodules. A CT guided renal biopsy revealed extensive necrosis and few vascular channels lined by malignant endothelial cells. Diagnosis was given on a morphologic base and proven by an immunohistochemical study. Primary renal angiosarcoma should be included among the differential diagnosis of necrotic renal lesions. PMID:25133004
Parikh, Jignesh G.
Skin-to-skin contact has been implemented recently to facilitate maternal-infant bonding of preterm infants. The technique allows the removal of fragile preterm infants from an incubator to the bare chest of a parent or caretaker. When specific guidelines are followed, thermal stability can be maintained, parent-infant bonding can be facilitated, and parental satisfaction can be enhanced. We illustrate a case in which a preterm infant has skin-to-skin contact while being monitored for physiologic parameters, including heart and respiratory rate, oxyhemoglobin saturation, and nasal airflow. Improvements in breathing patterns in this infant during skin-to-skin care and maintenance of a normal temperature suggest that this technique may not only be safe and psychologically beneficial, but it may also promote physiologic improvement. PMID:9284613
Cleary, G M; Spinner, S S; Gibson, E; Greenspan, J S
Global climate appears to be changing at an unprecedented rate. Climate change can be caused by several factors that include variations in solar radiation received by earth, oceanic processes (such as oceanic circulation), plate tectonics, and volcanic eruptions, as well as human-induced alterations of the natural world. Many human activities, such as the use of fossil fuel and the consequent accumulation of greenhouse gases in the atmosphere, land consumption, deforestation, industrial processes, as well as some agriculture practices are contributing to global climate change. Indeed, many authors have reported on the current trend towards global warming (average surface temperature has augmented by 0.6 °C over the past 100 years), decreased precipitation, atmospheric humidity changes, and global rise in extreme climatic events. The magnitude and cause of these changes and their impact on human activity have become important matters of debate worldwide, representing climate change as one of the greatest challenges of the modern age. Although many articles have been written based on observations and various predictive models of how climate change could affect social, economic and health systems, only few studies exist about the effects of this change on skin physiology and diseases. However, the skin is the most exposed organ to environment; therefore, cutaneous diseases are inclined to have a high sensitivity to climate. For example, global warming, deforestation and changes in precipitation have been linked to variations in the geographical distribution of vectors of some infectious diseases (leishmaniasis, lyme disease, etc) by changing their spread, whereas warm and humid environment can also encourage the colonization of the skin by bacteria and fungi. The present review focuses on the wide and complex relationship between climate change and dermatology, showing the numerous factors that are contributing to modify the incidence and the clinical pattern of many dermatoses. PMID:23407083
Balato, N; Ayala, F; Megna, M; Balato, A; Patruno, C
An improved system for measuring aerodynamic skin friction which uses a dual-laser-beam oil-film interferometer was developed. Improvements in the optical hardware provided equal signal characteristics for each beam and reduced the cost and complexity of the system by replacing polarization rotation by a mirrored prism for separation of the two signals. An automated, objective, data-reduction procedure was implemented to eliminate tedious manual manipulation of the interferometry data records. The present system was intended for use in two-dimensional, incompressible flows over a smooth, level surface without pressure gradient, but the improvements discussed are not limited to this application.
Westphal, R. V.; Bachalo, W. D.; Houser, M. H.
In this lesson from Science NetLinks, students are asked to think about what they already know about how the body changes as people age. More specifically, they are asked to talk about acne and what they consider to be the most effective ways of treating it and preventing its spread. Using online resources, they discover that there are many misconceptions about the exact causes and best treatments for acne. After completing the lesson, they have a good understanding of how to prevent and treat acne, and take care of their skin in general.
There is a high incidence of skin disorders; these are also frequently encountered within Youth Healthcare (YHC). Some skin disorders are caused by an underlying disease, syndrome or child abuse. Therefore, detection of these causes in an early stage is important. Skin disorders can have a huge psychosocial impact on both child and parents. This is one of the reasons why prevention, detection, diagnosis, treatment, referral, and uniform advice and guidance are of great importance. The YHC Guideline examines counselling and advice, criteria for referral to primary or secondary healthcare, and skincare in general. It also describes the disorders that should be actively detected. The Guideline also looks at specific aspects of dark skins and ethnic diversity, and the impact of skin disorders on general wellbeing. The accompanying web-based tool includes argumentation and opinions from experts on more than 75 skin disorders, including illustrations and decision trees, to aid the drawing up of a treatment plan. PMID:23151335
Deurloo, Jacqueline A; van Gameren-Oosterom, Helma B M; Kamphuis, Mascha
The red mite of poultry, Dremanyssus gallinae, is the most important hematophagous ectoparasite of poultry. In this study, pathologic changes of its biting on the poultry skin have been investigated. Thirty-two (Control = 16 and Treatment = 16) four weeks old Ross broilers (308) were infested with the mite on skin of hock joins. Samples were collected after 1, 24, 72 hours and 10 days. The skin samples were fixed in 10% buffered formalin and histological sections were prepared using routine Hematoxylin & Eosin staining method. Results showed that in all cases, except within first hour of infestation, lymphocytic infiltration was always a constant pathologic feature. Necrosis of feather's follicles was a prominent pathologic feature ensued due to vascular disturbances and resulted in loss of feather. Hyperkeratosis, parakeratosis and acanthosis were observed after 72 hours. These findings reveal that mite biting induces local epidermal hyperplasia.
Hobbenaghi, Rahim; Tavassoli, Mousa; Alimehr, Manochehr; Shokrpoor, Sara; Ghorbanzadeghan, Mohammad
Skin of the newborn differs from that of an adult in several ways. It is more susceptible to trauma and infection and requires\\u000a special care. Certain principles of skin care have to be emphasized to the mother or caregiver such as gentle cleansing, adequate\\u000a hydration and moisturization of the skin, preventing friction and maceration in body folds, and protection from
Rashmi Sarkar; Srikanta Basu; R. K. Agrawal; Piyush Gupta
Skin tumors are supposed to develop through accumulations of genetic and/or epigenetic events in normal cells of the skin. Among them, we focus on common skin tumors, including benign, seborrheic keratosis, and malignant, squamous cell carcinoma and melanoma. Many important molecules have been detected on the molecular tumorigenesis of each of them to date, and some drugs targeted for their molecules have been already developed. We review updates on the molecular tumorigenesis of these tumors with our current works. PMID:24705742
Kubo, Yoshiaki; Matsudate, Yoshihiro; Fukui, Nozomi; Nakasuka, Ayaka; Sogawa, Maiko; Oshima, Mika; Mizutani, Tomoya; Otsu, Masanobu; Murao, Kazutoshi; Hashimoto, Ichiro
Objective: To study the local and systemic behavior of the tumor necrosis factor-? (TNF-?) in patients with active uveitis. Methods: TNF-? levels were measured in aqueous humor and peripheral blood samples using an enzyme-linked immunosorbent assay from 23 patients with uveitis and 16 control patients who had been operated on for uncomplicated cataracts. Results: Aqueous humor and sera of patients
Manuel Santos Lacomba; Carmen Marcos Martín; José María Gallardo Galera; Maria Amparo Gómez Vidal; Eduardo Collantes Estévez; Rafael Ramírez Chamond; M. M. Omar
Tumour necrosis factor ? (TNF?) antagonists are an established therapeutic option in Crohn's disease and rheumatoid arthritis. In recently published studies these agents have been used with great success, but little is known about any side effects or long term consequences. They increase the frequency of infections with mycobacteria, where TNF? is thought to be an important host defence factor.
S R Vavricka; T Wettstein; R Speich; A Gaspert; E B Bachli
We report two patients who developed varicella zoster virus (VZV) ophthalmicus complicated by ipsilateral keratouveitis, and within 4 weeks developed acute retinal necrosis (ARN) in the contralateral eye. The ipsilateral retina was spared in each case. One patient had systemic lupus erythematosus (SLE) and the other Hodgkin's disease. Both patients were in remission at the time of presentation. PMID:12439676
Matthews, B N; Erb, N; Gordon, C; Callear, A B; Murray, P I; Salmon, M
Endoscopic management of infected walled-off pancreatic necrosis is increasingly being performed. Although the role of the interventional endoscopist in treating necrotizing pancreatitis is growing, a multidisciplinary team including dedicated surgeons and interventional radiologists is a condition sine qua non for optimal patient management. Optimal management starts with a correct diagnosis with accurate description of the extent and nature of the inflammatory changes according to the recently updated criteria. This is important to consequently select the correct patients for the correct intervention at the correct interval after onset. When a decision is made to endoscopically intervene in a patient with (infected) pancreatic necrosis, the actual endoscopic technique does not differ much from the first retrospective series published a decade ago. Although endoscopic intervention for pancreatic necrosis is increasingly performed, evidence for superiority of endoscopic treatment over other techniques is still lacking. Dedicated endoscopic accessories for optimal drainage and necrosectomy are still lacking as well. This review provides an overview of current status, technique and recent innovations of endoscopic treatment of walled-off pancreatic necrosis. PMID:25345777
Voermans, Rogier P; Besselink, Marc G; Fockens, Paul
Cell death is an essential factor in many biological processes including development. Discusses two types of cell death: (1) necrosis (induced by sodium azide); and (2) apoptosis (induced by sodium chromate). Illustrates key features that differ between these two types of cells death including loss of membrane integrity and internucleosomal DNA…
Manning, Francis; Zuzel, Katherine
Tumor necrosis factor ? (TNF?) is a potent proinflammatory cytokine that plays an important role in immunity and inflammation, and in the control of cell proliferation, differentiation and apoptosis. TNF? is also the founding member of a still growing family of cytokines with diverse bioregulatory functions. Considerable progress has been made in understanding the molecular mechanisms that mediate TNF?-induced cellular
Véronique Baud; Michael Karin
Ziram as a dithiocarbamate fungicide is widely used throughout the world in agriculture and as an accelerating agent is used in latex production. In order to investigate ziram-induced apoptosis/necrosis and its underlying mechanism in human immune cells, a human monocyte-like cell line (U937) was treated with ziram at 0.0312-2 ?M for 2-24 h at 37 °C in a 5% CO? incubator. Apoptosis/necrosis induced by ziram was determined by analysis of FITC-Annexin-V/PI staining and the intracellular level of active caspase-3 by flow cytometry and DNA fragmentation analysis. We found that ziram induced apoptosis/necrosis in U937 in a time- and dose-dependent manner, as shown by FITC-Annexin-V/PI staining. DNA fragmentation was detected when cells were treated with 0.5, 1, or 2 ?M ziram for 24 h. Ziram also induced an increase in intracellular active caspase-3 in U937 cells in a dose-dependent manner, and a caspase-3 inhibitor, Z-DEVD-FMK, significantly inhibited the ziram-induced apoptosis. Moreover, it was found that ziram induced mitochondrial cytochrome c release in U937 cells. These findings indicate that ziram can induce apoptosis/necrosis in U937 cells, and this effect is partially mediated by activation of intracellular caspase-3 and mitochondrial cytochrome c release. PMID:20842346
Li, Qing; Kobayashi, Maiko; Kawada, Tomoyuki
Infectious hematopoietic necrosis virus (IHNV) is a rhabdoviral pathogen that infects wild and cultured salmonid fish throughout the Pacific Northwest of North America. IHNV causes severe epidemics in young fish and can cause disease or occur asymptomatically in adults. In a broad survey of 323 IHNV field isolates, sequence analysis of a 303 nucleotide variable region within the glycoprotein gene
Gael Kurath; Kyle A. Garver; Ryan M. Troyer; Eveline J. Emmenegger; Katja Einer-Jensen; Eric D. Anderson
Curcumin, contained in the rhizome of the plant Curcuma longa Linn, is a naturally occurring phytochemical that has been used widely in India and Indonesia for the treatment of inflammation. The pleiotropic cytokine tumor necrosis factor-? (TNF) induces the production of interleukin-1 ? (IL-1), and, together, they play significant roles in many acute and chronic inflammatory diseases. They have been
Marion Man-Ying Chan
Laser skin resurfacing (LSR) has evolved over the past 2 decades from traditional ablative to fractional nonablative and fractional ablative resurfacing. Traditional ablative LSR was highly effective in reducing rhytides, photoaging, and acne scarring but was associated with significant side effects and complications. In contrast, nonablative LSR was very safe but failed to deliver consistent clinical improvement. Fractional LSR has achieved the middle ground; it combined the efficacy of traditional LSR with the safety of nonablative modalities. The first fractional laser was a nonablative erbium-doped yttrium aluminum garnet (Er:YAG) laser that produced microscopic columns of thermal injury in the epidermis and upper dermis. Heralding an entirely new concept of laser energy delivery, it delivered the laser beam in microarrays. It resulted in microscopic columns of treated tissue and intervening areas of untreated skin, which yielded rapid reepithelialization. Fractional delivery was quickly applied to ablative wavelengths such as carbon dioxide, Er:YAG, and yttrium scandium gallium garnet (2,790 nm), providing more significant clinical outcomes. Adjustable laser parameters, including power, pitch, dwell time, and spot density, allowed for precise determination of percent surface area, affected penetration depth, and clinical recovery time and efficacy. Fractional LSR has been a significant advance to the laser field, striking the balance between safety and efficacy. PMID:23135075
Alexiades-Armenakas, Macrene R; Dover, Jeffrey S; Arndt, Kenneth A
Objectives: The present animal experiments were conducted to evaluate radioiodinated Hypericin (Hyp) for its regional distribution as well as theranostic potentials. Materials and Methods: Rat models of reperfused liver infarction (RLI) and hepatic rhabdomyosarcoma (R1) were surgically induced. R1 models received Combretastatin A4 phosphate (CA4P) intravenously at 10 mg/kg 24 h prior to radioiodinated Hyp. Three groups of 6 rats each containing 3 RLI and 3 R1 models received iv injections of 123I-Hyp at 37, 74, and 185 MBq/kg respectively and followed by 0.1 ml of 1% Evans blue solution were sacrificed at 4, 24 and 48 hour post injection immediately after in vivo examination of MRI and planar gamma scintigraphy. Besides, two groups of 6 R1 models that received either 300 MBq/kg of 131I-Hyp or vehicle intravenously were examined using MRI to compare tumor growth for 12 days. Autoradiography, gamma counting, and histopathology were performed for postmortem verifications and quantification. Results: Necrosis as seen in vivo on contrast-enhanced MRI corresponded well with the hot spots on planar scintigraphy. Autoradiography and gamma counting revealed intense accumulation of 123I-Hyp in necrotic liver (3.94 ± 1.60, 5.38 ± 1.04, and 6.03 ± 2.09 %ID/g ± SD) and necrotic tumor (4.27 ± 0.76, 5.57 ± 0.76, and 5.68 ± 1.33 %ID/g ± SD) relative to normal liver (1.76 ± 0.54, 0.41 ± 0.18, and 0.16 ± 0.07 %ID/g ± SD), with a high necrosis-to-liver ratio of 2.3, 14.0, and 37.0 at 4, 24 and 48 h respectively. Tumor volumes in R1 models that received 131I-Hyp and vehicle changed from 0.45 ± 0.09, and 0.47 ± 0.12 cm3 (p > 0.05) on day 0 to1.32 ± 0.76 and 3.63 ± 0.72 cm3 (p < 0.001) on day 12, with the corresponding necrosis ratios from 73 ± 12 %, and 76 ± 17 % to 47 ± 18% and 17 ± 13 % (p < 0.01), and with the tumor DT of 7.3 ± 1.0 and 4.2 ± 0.7 days, respectively. Conclusions: Radioiodinated Hyp as a necrosis avid tracer appears promising for non-invasive imaging diagnosis of necrosis-related pathologies. Its prominent targetability to necrosis allows targeted radiotherapy for malignancies on top of a prior necrosis-inducing treatment. PMID:23139728
Li, Junjie; Cona, Marlein Miranda; Chen, Feng; Feng, Yuanbo; Zhou, Lin; Yu, Jie; Nuyts, Johan; de Witte, Peter; Zhang, Jian; Himmelreich, Uwe; Verbruggen, Alfons; Ni, Yicheng
In this lesson, the students examine their skin types, similarities, differences, etc. and discuss the social implications of each group. They also examine the factors that influence variations in skin color in greater depth. The class is separated into groups and work on presentations, designed to foster peer-teaching with guidance from the instructor. The presentations to be worked on by the students are: Modern Human Variation: Overview, Skin Color Adaptation, and A new Light on Skin Color. All of the resources needed for the students presentations are included. Following each presentation, tips for review and discussion of the learning objectives are given.
American Association for the Advancement of Science (;)
Metagenomics, the direct exploitation of environmental microbial DNA, is complementary to traditional culture-based approaches for deciphering taxonomic and functional microbial diversity in a plethora of ecosystems, including those related to the human body such as the mouth, saliva, teeth, gut or skin. DNA extracted from human skin analyzed by sequencing the PCR-amplified rrs gene has already revealed the taxonomic diversity of microbial communities colonizing the human skin ("skin microbiome"). Each individual possesses his/her own skin microbial community structure, with marked taxonomic differences between different parts of the body and temporal evolution depending on physical and chemical conditions (sweat, washing etc.). However, technical limitations due to the low bacterial density at the surface of the human skin or contamination by human DNA still has inhibited extended use of the metagenomic approach for investigating the skin microbiome at a functional level. These difficulties have been overcome in part by the new generation of sequencing platforms that now provide sequences describing the genes and functions carried out by skin bacteria. These methodological advances should help us understand the mechanisms by which these microorganisms adapt to the specific chemical composition of each skin and thereby lead to a better understanding of bacteria/human host interdependence. This knowledge will pave the way for more systemic and individualized pharmaceutical and cosmetic applications. PMID:24361423
Mathieu, Alban; Vogel, Timothy M; Simonet, Pascal
Many phytochemicals are endowed with photoprotective properties, i.e., the capability to prevent the harmful effects of excessive exposure to ultraviolet (UV) light. These effects include photoaging and skin cancer, and immunosuppression. Photoprotection is endowed through two major modes of action: UV absorption or reflection/scattering; and tissue repair post-exposure. We and others have uncovered the photoprotective properties of an extract of the fern Polypodium leucotomos (commercial name Fernblock). Fernblock is an all-natural antioxidant extract, administered both topically (on the skin) or orally. It inhibits generation of reactive oxygen species (ROS) production induced by UV including superoxide anion. It also prevents damage to the DNA, inhibits UV-induced AP1 and NF-?B, and protects endogenous skin natural antioxidant systems, i.e., CAT, GSH, and GSSR. Its photoprotective effects at a cellular level include a marked decrease of UV-mediated cellular apoptosis and necrosis and a profound inhibition of extracellular matrix remodeling. These molecular and cellular effects translate into long-term inhibition of photoaging and carcinogenesis that, together with its lack of toxicity, postulate its use as a novel-generation photoprotective nutriceutical of phytochemical origin. PMID:22272084
Gonzalez, Salvador; Gilaberte, Yolanda; Philips, Neena; Juarranz, Angeles
...Industry on Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment...entitled ``Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment...to treat acute bacterial skin and skin structure infections (ABSSSI). This...
Clover yellow vein virus (ClYVV) elicits lethal tip necrosis in the pea line PI 118501. Pea line PI 118501 develops necrotic lesions and veinal necrosis\\u000a on inoculated leaves, followed by systemic necrosis, leading to plant death. To understand the genetic basis of this lethal\\u000a tip necrosis, we crossed lines PI 226564 and PI 250438, which develop mosaic symptoms in response
Gerald Ravelo; Uiko Kagaya; Tsuyoshi Inukai; Masanao Sato; Ichiro Uyeda
As people age, their skin undergoes changes which result in reduced elasticity, increased fragility and an altered immune response; in essence it becomes frail. As life expectancy is increasing the health of older skin is becoming a progressively more important facet of overall care. In addition to the consequences of ageing for otherwise healthy skin, the relative incidence of some dermatological conditions is age-dependent. In particular, xerosis (dry skin), cutaneous malignancies and skin injuries are more common in older people. In this review we describe the functional consequences of skin ageing and discuss the current evidence on how skin health may be maintained and dermatological conditions prevented in an ageing population. The future of dermatological health-care provision in the older population relies on the development of coordinated pathways of care, which start from a young age. Better quality research coordinated by the establishment of institutions dealing with skin health and ageing would be a method of addressing these needs. PMID:25213594
Al-Nuaimi, Yusur; Sherratt, Michael J; Griffiths, Christopher E M
Reconstructed skins have been developed to replace skin when the integrity of tissue has been compromised following severe injury, and to provide alternative methods validating the innocuousness and effectiveness of dermatological and cosmetic products. However the functional properties of tissue substitutes have not been well characterised, mainly since mechanical measurement devices have not been designed to test cell culture materials in vitro. From the mechanical standpoint, reconstructed skin is a heterogeneous multi-layer viscoelastic material. To characterise the time-dependent behaviour of reconstructed skin, spherical indentation load-relaxation tests were performed with a specific original device adapted to measure small soft tissue samples. Load-relaxation indentation tests were performed on a standard reconstructed skin model and on sub-components of the reconstructed skin (3D-scaffold alone and dermal equivalent). Generalised Maxwell and Kelvin-Voigt rheological models are proposed for analysing the mechanical behaviour of each biological tissue. The results indicated a modification of the rheological behaviour of the samples tested as a function of their biological structure. The 3D-scaffold was modelled using the one-branch Maxwell model, while the dermis equivalent and the reconstructed skin were modeled using a one-branch and a two-branch Kelvin-Voigt model, respectively. Finally, we demonstrated that skin cells contribute to global mechanical behaviour through an increase of the instantaneous relaxation function, while the 3D-scaffold alone influences the mechanical response of long relaxation times. PMID:24956159
Pailler-Mattei, C; Laquièze, L; Debret, R; Tupin, S; Aimond, G; Sommer, P; Zahouani, H
Background: Eating disorders are becoming an epidemic in Europe, particularly among young women, but European studies concerning this topic are few. In eating disorders, significant medical complications occur in all of the primary human organ systems, including the skin. Objective: The purpose of this study was to improve the knowledge of skin signs in anorexia nervosa (AN) and verify whether
R. Strumìa; E. Varotti; E. Manzato; M. Gualandi
Objective It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes. Methods A total of 403 diabetic patients, 31% type 1 and 69% type 2,
N T Foss; D P Polon; M H Takada; M C Foss-Freitas; M C Foss
Expert-reviewed information summary about the genetics of skin cancer — basal cell carcinoma, squamous cell carcinoma, and melanoma — including information about specific gene mutations and related cancer syndromes. The summary also contains information about interventions that may influence the risk of developing skin cancer in individuals who may be genetically susceptible to these syndromes.
Skin disease is the most common occupational disease, but the reported number is small in Korea due to a difficulty of detection and diagnosis in time. We described various official statistics and data from occupational skin disease surveillance system, epidemiological surveys and cases published in scientific journals. Until 1981, 2,222 cases of occupational skin disease were reported by Korean employee's regular medical check-up, accounting for 4.9% of the total occupational diseases. There was no subsequent official statistics to figure out occupational skin diseases till 1998. From 1999, the Korea Occupational Safety and Health Agency (KOSHA) published the number of occupational skin diseases through the statistics of Cause Investigation for Industrial Accidents. A total of 301 cases were reported from 1999 to 2007. Recent one study showed the figures of compensated occupational skin diseases. Many of them belonged to daily-paid workers in the public service, especially forestry workers. Also, it described the interesting cases such as vitiligo and trichloroethylene-induced Stevens-Johnson Syndrome. Skin diseases are still important though the number of cases has decreased, and therefore it is recommended to grasp the status of occupational skin diseases through continuous surveillance system and to make policy protecting high-risk group. PMID:21258591
Ahn, Yeon-Soon; Kim, Min-Gi
The skin is a complex organ involved in thermoregulation, gas exchange, protection against pathogens, and barrier function to maintain proper hydration. When dry, the ability for skin to execute these tasks becomes impaired. Dry skin affects almost everyone as we age, but it is also dependent on external factors, such as dry climate, colder temperatures, and repeated washing. In addition, increasing evidence has shown racial variability in the physiological properties of skin, which directly impacts water content of the stratum corneum and sensitivity to exogenously applied agents. A multitude of products have been developed to treat dry skin, and as a group, moisturizers have been designed to either impart or restore hydration in the stratum corneum. Given the large number of moisturizers presently available, depending on individual components, several different mechanisms may be employed to promote skin hydration. As there exists dramatic racial variability in skin properties, certain moisturizers may thus be more effective in some and less effective in others to treat the common condition of dry skin. PMID:25013536
Wong, Victor W.; Longaker, Michael T.; Yang, George P.
Hyaluronan (HA) is present in many tissues of the body and is essential to maintain moistness in the skin tissues, which contain approximately half the body's HA mass. Due to its viscosity and moisturizing effect, HA is widely distributed as a medicine, cosmetic, food, and, recently marketed in Japan as a popular dietary supplement to promote skin moisture. In a randomized, double-blind, placebo-controlled clinical study it was found that ingested HA increased skin moisture and improved treatment outcomes for patients with dry skin. HA is also reported to be absorbed by the body distributed, in part, to the skin. Ingested HA contributes to the increased synthesis of HA and promotes cell proliferation in fibroblasts. These effects show that ingestion of HA moisturizes the skin and is expected to improve the quality of life for people who suffer from dry skin. This review examines the moisturizing effects of dry skin by ingested HA and summarizes the series of mechanisms from absorption to pharmacological action. PMID:25014997
Kawada, Chinatsu; Yoshida, Takushi; Yoshida, Hideto; Matsuoka, Ryosuke; Sakamoto, Wakako; Odanaka, Wataru; Sato, Toshihide; Yamasaki, Takeshi; Kanemitsu, Tomoyuki; Masuda, Yasunobu; Urushibata, Osamu
The proinflammatory cytokines interleukin-1beta (IL-1?), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-?) hold important functions in the early and late courses of inflammation, trauma and wound healing. In the present study, human skin wounds due to sharp force (n=105) were collected during surgery and autopsy. The wound age mainly varied from several minutes to 5h, some specimens aged up to
Objective: The aim of this study is to present our clinical experience with rhomboid flaps. Materials and Methods: Twenty-four patients who were operated on between January 2006 and October 2010 were included in the study. All defects were reconstructed using rhomboid flaps. Results: Twenty-four patients were operated on for various reasons, and 26 rhomboid flaps were performed. Eleven of the 24 cases were male, and the median age of participants was 47.5 years. Eight cases were operated on under general anesthesia, and 13 were locally anesthetized; the remaining cases were operated on under regional anesthesia. In 17 cases, the defect was due to a benign or malignant tumor excision, and five cases were operated on due to burn contracture. There were no occurrences of partial or total flap necrosis or hematoma in our series. Conclusion: Our series indicates that rhomboid flaps can be safely used to reconstruct small to moderately sized skin defects.
Aydin, Osman Enver; Tan, Onder; Algan, Said; Kuduban, Selma Denktas; Cinal, Hakan; Barin, Ensar Zafer
Aseptic necrosis of the femoral head is a well-defined entity. The underlying diseases originate from very different types of pathological conditions. Alcoholism, cortisone therapy, gout or hyperuricemia, sickle cell anaemia and others all lead, through various pathways, to the impairment of the medullary blood flow. In many instances, a compartment syndrome can be demonstrated in the femoral head. Death of the osteocytes follows bone marrow necrosis. Revascularisation originates in the periphery of the necrotic segment. Vascular buds and fibroblasts invade the medullary space. New bone is laid over the necrotic trabeculae. Mechanical failure results from changes in the bony framework at three different levels. The subchondral boneplate may be weakened by the process of revascularisation, the necrotic trabeculae may fail because of diminished stiffness and strength, and overloading has been demonstrated at the junction between dead and living bone. Elevation of the intramedullary pressure is the first objective sign of impending or established bone necrosis. Scintigraphy with Technetium 99 m - Sulphur colloid can now show the early stages of marrow necrosis. Roentgenographic changes only appear in a later phase of the disease. Aseptic necrosis must be considered as involving both hips, unless proven otherwise. Attention given to the "silent hip" may allow salvage and prevent the occurrence of osteo-arthritic changes leaving merely unilateral disease. As long as the geometrical shape of the femoral head is maintained operation may well prove useful. The aim at this stage is to prevent collapse. It is impossible to know in the early stages whether mechanical failure will occur, but there is general agreement that the femoral head will eventually undergo deformation. A spherical epiphysis is therefore considered a success. All the conservative methods aim to decompress the medullary cavity. Core biopsy, curettage, bone grafting and intertrochanteric osteotomy all have their advocates. After fracture of the subchondral bone plate has occurred, there is evidence that grafts are unable to restore the strength of the necrotic area. Intertrochanteric osteotomy brings under the main load-bearing zone a vital part of the femoral head. Varus osteotomy can be successful if necrosis has spared sufficient of the lateral portion of the head. Rotation osteotomies, as proposed by Sugioka, are more radical and difficult operations. The published results are promising. Revascularisation of the weight-bearing area by pedicle grafts has been attempted, alone or in addition to osteotomy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6386708
Vasey, H M
Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., melasma); and hair, nail, and vascular changes. Preexisting skin conditions (e.g., atopic dermatitis, psoriasis, fungal infections, cutaneous tumors) may change during pregnancy. Pregnancy-specific skin conditions include pruritic urticarial papules and plaques of pregnancy, prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. Pruritic urticarial papules and plaques of pregnancy are the most common of these disorders. Most skin conditions resolve postpartum and only require symptomatic treatment. However, there are specific treatments for some conditions (e.g., melasma, intrahepatic cholestasis of pregnancy, impetigo herpetiformis, pruritic folliculitis of pregnancy). Antepartum surveillance is recommended for patients with intrahepatic cholestasis of pregnancy, impetigo herpetiformis, and pemphigoid gestationis. PMID:17263216
Tunzi, Marc; Gray, Gary R
Skin exerts a number of essential protective functions ensuring homeostasis of the whole body. In the present review barrier function of skin and its expression of antimicrobial peptides are discussed. Barrier function is provided by the dynamic stratum corneum structure composed of lipids and corneocytes. Stratum corneum is a conditio sine qua non for terrestrial life. Impairment of barrier function can be due to injury and inflammatory skin diseases. Therapeutic options are discussed with special emphasis of radiodermatitis and irritant contact dermatitis in patients with hearing device. The use of antimicrobial peptides is illustrated by facial inflammatory skin diseases. In wound healing new developments include biotechnological developments of matrix- and growth factors and tissue-engineered skin substitutes. In everyday wound care of chronic wounds the concept of wound bed preparation (TIME) constitutes the base of successful treatment. PMID:22073065
The effect of vinpocetine on flap survival, vascular endothelial growth factor (VEGF) expression, and superoxide dismutase (SOD) and malondialdehyde (MDA) contents were evaluated in this study. The McFarlane flap model was established in 20 rats and evaluated within two groups. Postoperative celiac injection was given for 7 days in the two groups: vinpocetine was applied in Group 1, and the same volume of saline was applied in Group 2. Flap necrosis was measured on day 7 by cellophane in all groups. VEGF expression was determined using immunohistochemical methods on tissue samples taken after 7 days of injections. SOD and MDA contents were examined according to the Kit (reagent instructions). Vinpocetine significantly reduced necrosis area in Group 1 (p < 0.05). VEGF expression and SOD contents were significantly increased in Group 1 compared with Group 2 (p < 0.01), whereas MDA level was reduced (p < 0.05). This experimental study demonstrates that vinpocetine improves survival of random skin flaps, promotes neovascularization, and increases VEGF expression. Meanwhile, vinpocetine has a protective effect against ischemia-reperfusion injury by improving SOD vitality and decreasing MDA value. PMID:23588551
Xiao-Xiao, Tao; Sen-Min, Wu; Ding-Sheng, Lin
Incidence of skin cancer has been increasing rapidly since the last few decades. Non-invasive optical diagnostic tools may improve the diagnostic accuracy. In this paper, skin structure, skin cancer statistics and subtypes of skin cancer are briefly reviewed. Among the subtypes, malignant melanoma is the most aggressive and dangerous; early detection dramatically improves the prognosis. Therefore, a non-invasive diagnostic tool for malignant melanoma is especially needed. In addition, in order for the diagnostic tool to be useful, it must be able to differentiate melanoma from common skin conditions such as seborrheic keratosis, a benign skin disease that resembles melanoma according to the well known clinical-assessment ABCD rule. The key diagnostic feature between these two diseases is surface roughness. Based on laser speckle contrast, our research team has recently developed a portable, optical, non-invasive, in-vivo diagnostic device for quantifying skin surface roughness. The methodology of our technique is described in details. Examining the preliminary data collected in a pilot clinical study for the prototype, we found that there was a difference in roughness between melanoma and seborrheic keratosis. In fact, there was a perfect cutoff value for the two diseases based on our initial data.
Lee, Tim K.; Tchvialeva, Lioudmila; Zeng, Haishan; McLean, David I.; Lui, Harvey
Dye enhanced laser welding has been recently proposed for skin closures to exploit the advantages of laser procedure (possible reduction of scar formation, no inflammatory reaction). In this preliminary study we used the diode laser-assisted technique to perform welding of rats' skin. In the pilot phase of the study we investigated the effect of the interaction between diode laser radiation and 20 full thickness skin wounds, performed on the shaved backs of 10 Wistar rats, using laser power in the range of 200 - 150 mW and, as the photoenhancing chromophore, Indocyanine Cardio-green (ICG) dye saturated solution in plasma. Ten wounds were sutured with 4.0 nylon thread, to provide a comparison with the traditional procedure. Wounds' samples were explanted on day 3 and 7 after the treatment, for histological evaluation. Clinical examination on the same days showed a high percentage of wounds dehiscence and presence of scales and crusts. Histologic examination demonstrated evidence of thermal injury and a heightened inflammation, superior to that of suture closures. In the second phase of the study, a lower laser power (150 - 80 mW), ICG-plasma-non saturated solution (ICG-sol) and ICG-plasma-saturated-sodium hyaluronate gel (ICG-gel), were used. Six wounds were filled with ICG-sol and six with ICG-gel, then irradiated at 150, 120 and 80 mW. Postoperative explants were performed on day 3 and 7. Clinical and histological results from this group were satisfactory: we recorded only one case of dehiscence, well healed wounds, no epidermal necrosis and a mild inflammatory reaction, reduced respect to that of traditional closure. We characterized the optimum range of parameters of diode laser-assisted technique to achieve an effective skin welding and the corresponding clinical and histologic pattern was described.
Reali, Umberto M.; Borgognoni, L.; Martini, L.; Chiarugi, C.; Gori, F.; Pini, Roberto; Toncelli, F.; Vanni, U.
The radial forearm flap transfer has proved to be the standard technique in penile reconstruction. However, this operation still leads to a residual scar on the forearm. In the reconstruction of partial penis necrosis, achieving a desirable appearance and functional recovery while minimizing donor-site damage remains an unsolved problem. In this study, we report our experience using penile elongation combined with glanuloplasty to rebuild the partially necrotic penis.A retrospective review of a consecutive series of 33 patients with partial penis necrosis after microwave thermotherapy (not from our hospital) from December 2008 to May 2012 was conducted at the Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital. These patients, with an age range from 20 to 36 years, first underwent a scrotal skin flap transfer to cover residual cavernosum. The penis was simultaneously elongated at the proximal end. Six months later, all patients received glanuloplasty using expanded polytetrafluoroethylene that was implanted at the distal end of transferred scrotal skin flap to create the neoglans.Anthropometric measurements of preoperative and postoperative penile length were performed with an average follow-up period of 28 months. The mean extended penile length average was 2.57 cm, ranging from 3.16 to 5.73 cm. Patients' satisfaction rate was 88%. In addition, preoperative and postoperative photographs were reviewed for objective and subjective assessment of outcome parameters such as appearance of neophallus, urination, and erogenous sensation. Most importantly, the rebuilt penis postoperatively showed almost normal shape and restoration of basic physiologic function in most of the patients, with an acceptable complication rate. These preliminary results may provide a useful strategy for the reconstruction of a partially necrotic penis using a novel, simple, and effective approach. PMID:24835865
Xiao, Kaiyan; Cheng, Kaixiang; Song, Nan
Exact Volume Preserving Skinning with Shape Control Damien ROHMER, Stefanie HAHMANN, Marie, Cani (Grenoble) Constant Volume Skinning SCA'09 1 / 22 #12;Classical character animation pipeline (Grenoble) Constant Volume Skinning SCA'09 2 / 22 #12;Motivations: character animation Fits
Objective To compare healing of free, full-thickness, meshed skin grafts under negative pressure wound therapy (NPWT) with bolster dressings in dogs. Study design Randomized, controlled experimental study, paired design. Animals Dogs (n =5) Methods Full-thickness skin wounds (4 cm ×1.5cm) were created bilaterally on the antebrachia of 5 dogs (n = 10). Excised skin was grafted to the contralateral limb. Grafts were randomized to NPWT or bolster dressings (control; CON). NPWT was applied continuously for 7 days. Grafts were evaluated on days 2, 4, 7, 10, 14 and 17, biopsied on days 0, 4, 7, and 14, and had microbial culture on day 7. Outcome variables were: time to first appearance of granulation tissue, percent graft necrosis, and percent open mesh. Significance was set at P<.05. Histologic findings, culture results, and graft appearance were reported. Results Granulation tissue appeared earlier in the NPWT grafts compared with CON grafts. Percent graft necrosis and remaining open mesh area were both greater in CON grafts compared with NPWT grafts at most time points. Histologic results showed no significant difference in all variables measured, and all cultures were negative. Conclusions Variables of graft acceptance were superior when NPWT was used in the first week post-grafting. Fibroplasia was enhanced, open meshes closed more rapidly and less graft necrosis occurred with NPWT application. More preclinical studies are required to evaluate histologic differences. PMID:23550662
STANLEY, BRYDEN J.; PITT, KATHRYN A.; WEDER, CHRISTIAN D.; FRITZ, MICHELE C.; HAUPTMAN, JOE G.; STEFICEK, BARBARA A.
The promotion and maintenance of skin integrity is one of the most common challenges for nurses in every sphere of practice, but particularly for those caring for patients with chronic inflammation of the skin (such as in eczema and psoriasis), and to those at risk of skin breakdown due to immobility, circulatory disease, or incontinence. A significant amount of nursing time is spent washing patients, or assisting them to wash. However, little attention has been given to a scientific appraisal or evidence of the effectiveness of these activities. PMID:15719795
A 52-year-old male presented with acute retinal necrosis in his left eye. Slit lamp examination revealed stellate keratic precipitates and cells in the anterior chamber and vitreous. Funduscopy of his left eye revealed multiple yellow deposits. Pathological examination of the vitreous showed both small, reactive lymphocytes and a few macrophages. IL-6 and IFN-? were elevated in the vitreous. Microdissected macrophages from the vitreous revealed DNAs from multiple viruses. The patient responded to oral valacyclovir. We conclude that multiple viral infections can be involved in the pathogenesis of acute retinal necrosis and that adequate anti-viral therapy has a beneficial effect on disease progression. However, retinal detachment can be a consequence for a poor visual outcome. PMID:25584358
Chen, Shida; Malik, Khurram J; Shen, Defen; Chan, Chi-Chao
Gentamicin nephrotoxicity limit its usage against gram negative bacteria. Most researches showed that antioxidant agents improved gentamicin nephrotoxicity. According to these investigations oxidative stress play a central role in the mechanism of gentamicin induced nephrotoxicity. Recently Rafieian-Kopaei and colleagues showed that erythropoietin significantly ameliorated serum creatinine, blood urea nitrogen and tubal necrosis in gentamicin induced nephrotoxicity in rat. One of the advantages of this study is treatment of rats for 10 days by erythropoietin after inducing gentamicin nephrotoxicity and besides co- treatment of gentamicin and erythropoietin at 10 days simultaneously. They showed that erythropoietin improved significantly serum creatinine and blood urea nitrogen in gentamicin injected rats simultaneously and even after gentamicin nephrotoxicity induction. This study also showed that erythropoietin ameliorates histopathological injuries especially tubular cell necrosis that induced by gentamicin. Although the detailed renoprotective mechanisms of erythropoietin cannot be fully explained by this study but histological and biochemical results are satisfactory. PMID:24475394
Bone marrow necrosis (BMN) is a rare finding in children with malignancy occurring most commonly in children with acute lymphoblastic leukemia. This article describes the first case of a girl who developed BMN during treatment for Hodgkin's disease. During the second cycle of chemotherapy, she experienced sudden profound bone pain in the lumbosacral region associated with elevated levels of lactate dehydrogenase (LDH), fibrin degradation products (D-Dimer), and alkaline phosphatase as well as pancytopenia and leukoerythroblastosis. MRI studies showed multiple confluent areas with low signal intensity and rim contrast enhancement in all vertebral bodies. Bone marrow biopsy revealed focal necrosis within hypocellular bone marrow. The patient responded quickly to symptomatic treatment with analgetics and heparin; however, elevations of LDH and D-Dimer persisted for 1.5 and 8 months, respectively. Clinicians should be aware of this rare condition to establish the diagnosis and to continue oncologic treatment as early as possible. PMID:22773298
Lackner, Herwig; Strenger, Volker; Sovinz, Petra; Beham-Schmid, Christine; Pilhatsch, Alexander; Benesch, Martin; Schwinger, Wolfgang; Ulreich, Raphael; Schmidt, Sandrin; Urban, Christian
In the middle cerebral artery occlusion model of ischemic injury, inflammation primarily occurs in the infarct and peripheral zones. In the ischemic zone, neurons undergo necrosis and apoptosis, and a large number of reactive microglia are present. In the present study, we investigated the pathological changes in a rat model of middle cerebral artery occlusion. Neuronal necrosis appeared 12 hours after middle cerebral artery occlusion, and the peak of neuronal apoptosis appeared 4 to 6 days after middle cerebral artery occlusion. Inflammatory cytokines and microglia play a role in damage and repair after middle cerebral artery occlusion. Serum intercellular cell adhesion molecule-1 levels were positively correlated with the permeability of the blood-brain barrier. These findings indicate that intercellular cell adhesion molecule-1 may be involved in blood-brain barrier injury, microglial activation, and neuronal apoptosis. Inhibiting blood-brain barrier leakage may alleviate neuronal injury following ischemia. PMID:25422636
Wu, Lingfeng; Zhang, Kunnan; Hu, Guozhu; Yan, Haiyu; Xie, Chen; Wu, Xiaomu
Nasopharyngeal necrosis resulting from narcotic insufflation is a recognized phenomenon, but cocaine use is more commonly associated with this pathology than opioid abuse. Physical exam findings associated with severe tissue destruction are not routinely seen on physical examination or available in the medical literature. We present a case of chronic oxycodone/acetaminophen insufflation and images of a defect in the soft palate. PMID:22415885
Rosenbaum, Christopher D; Boyle, Katherine L; Boyer, Edward W
TUMOUR necrosis factor-alpha (TNF-alpha) is a potent pro-inflammatory and immunomodulatory cytokine implicated in inflammatory conditions such as rheumatoid arthritis, Crohn's disease, multiple sclerosis and the cachexia associated with cancer or human immunodeficiency virus infection1. TNF-alpha is initially expressed as a 233-amino-acid membrane-anchored precursor which is proteolytically processed to yield the mature, 157-amino-acid cytokine2. The processing enzyme(s) which cleave TNF-alpha are
A. J. H. Gearing; P. Beckett; M. Christodoulou; M. Churchill; J. Clements; A. H. Davidson; A. H. Drummond; W. A. Galloway; R. Gilbert; J. L. Gordon; T. M. Leber; M. Mangan; K. Miller; P. Nayee; K. Owen; S. Patel; W. Thomas; G. Wells; L. M. Wood; K. Woolley
Summary Recent studies have shown that mucocutaneous leishmaniasis (MCL), a severe and debilitating form of American cutaneous leishmaniasis (ACL) caused by Leishmania braziliensis infection, is accompanied by high circulating levels of tumor necrosis factor (TNF)-oL. Analysis of TNF polymorphisms in Venezuelan ACL patients and endemic unaffected controls demonstrates a high relative risk (RR) of 7.5 (P <0.001) of MCL disease
Maira Cabrera; Marie-Anne Shaw; Claire Sharpies; Hazel Williams; Marianella Castes; Jacinto Convit; Jenefer M. Blackwell
Introduction Progressive outer retinal necrosis (PORN) is a rare but devastating infectious retinitis associated with varicella zoster virus (VZV) and responsible for severe visual loss. Case Report A 59-year-old man treated for generalized myasthenia with oral azathioprine and prednisone presented with severe unilateral necrotizing retinitis. Polymerase chain reaction of the aqueous and vitreous humors was diagnostic for VZV PORN. Conclusion VZV PORN is a severe potential ocular complication of immunosuppression, prompting urgent diagnosis and appropriate treatment. PMID:24926266
Coisy, Solène; Ebran, Jean-Marc; Milea, Dan
Approximately 20% of patients with acute pancreatitis develop pancreatic necrosis with significant mortality. Surgical debridement is the traditional management of necrotizing pancreatitis, but it is associated with significant morbidity and mortality. Endoscopic necrosectomy using repeats session of debridement and stent insertion has been more frequently used within the last decade and half. This technique continues to evolve as we attempt to optimize the post-procedural outcomes. PMID:22977825
In a previous study, we found that the extent of necrosis was the only radiological feature which correlated significantly\\u000a with survival in patients with glioblastoma. The aim of this paper was to evaluate the variability and prognostic value of\\u000a the extent of the necrotic area as seen on contrast-enhanced MRI and CT in a larger series. We studied 72 patients
A. Pierallini; M. Bonamini; P. Pantano; F. Palmeggiani; M. Raguso; M. F. Osti; G. Anaveri; L. Bozzao
A 27-year-old man developed delayed cerebral radiation necrosis following proton beam therapy to an arteriovenous malformation. Neuroimaging with technetium 99m diethylenetriamine penta-acetic acid and positron emission tomographic scanning with fludeoxyglucose F 18 aided in his evaluation. Significant improvement of his neurologic deficits resulted from corticosteroid therapy. Clinical resolution was corroborated by serial computed tomographic scans demonstrating regression of the abnormality
M. Kaufman; B. E. Swartz; M. Mandelkern; J. Ropchan; M. Gee; W. H. Blahd
The role of skin as a de novo source of glucocorticoids and the importance of cutaneous glucocorticoidogenesis as a homeostatic mechanism in human skin is highlighted by Slominski et al. in a recently published issue. Impairment of glucocorticoidogenesis through noxious stimuli, such as UVB, can explain pathophysiology of skin diseases (e.g. rosacea). In addition to keratinocytes, melanocytes and fibroblasts, cutaneous adnexes also play a significant role as targets and sources of glucocorticoids, because they express most of the enzymes required for steroidogenesis. Glucocorticoids are also involved in the pathogenesis of acne lesions, affecting sebum production in vivo and in vitro. Certain steroidogenic enzymes, such as 11?-hydroxysteroid dehydrogenase, are upregulated in acne lesions. On this background, the paper by Slominski et al. provides further insights into dermatoendocrinology, with emphasis on the importance of an impairment of the skin's own hypothalamic-pituitary-adrenal-like axis in the pathophysiology of several skin diseases. PMID:25056134
Nikolakis, Georgios; Zouboulis, Christos C
The limited availability of reconstruction materials can often make it difficult to treat defects in the esophagus caused by necrosis of the transplanted intestinal tissue after cervicothoracic esophagus reconstruction. We were forced to perform flap reconstruction on a patient who suffered necrosis due to impeded blood flow of the transplanted intestinal tract after twice conducting cervicothoracic esophagus reconstruction with an intestinal tract flap. The procedure we performed was esophagus reconstruction using a pectoralis major myocutaneous flap that had been expanded with a tissue expander due to the small volume of tissue available to perform the reconstruction. This case suggested that esophagus reconstruction with a skin flap using a tissue expander should be considered as a possible treatment choice when performing reconstruction of the cervicothoracic esophagus, which requires stable blood flow and a large amount of tissue. PMID:25468093
Kashimura, Tsutomu; Nakazawa, Hiroaki; Shimoda, Katsumi; Soejima, Kazutaka; Kochi, Mitsugu; Takayama, Tadatoshi
Fibrosis is a fundamental component of the adverse structural remodeling of myocardium present in the failing heart. Replacement fibrosis appears at sites of previous cardiomyocyte necrosis to preserve the structural integrity of the myocardium, but not without adverse functional consequences. The extensive nature of this microscopic scarring suggests cardiomyocyte necrosis is widespread and the loss of these contractile elements, combined with fibrous tissue deposition in the form of a stiff in-series and in-parallel elastic elements, contributes to the progressive failure of this normally efficient muscular pump. Cellular and molecular studies into the signal-transducer-effector pathway involved in cardiomyocyte necrosis have identified the crucial pathogenic role of intracellular Ca2+ overloading and subsequent induction of oxidative stress, predominantly confined within its mitochondria, to be followed by the opening of the mitochondrial permeability transition pore that leads to the destruction of these organelles and cells. It is now further recognized that Ca2+ overloading of cardiac myocytes and mitochondria serves as a prooxidant and which is counterbalanced by an intrinsically coupled Zn2+ entry serving as antioxidant. The prospect of raising antioxidant defenses by increasing intracellular Zn2+ with adjuvant nutriceuticals can, therefore, be preferentially exploited to uncouple this intrinsically coupled Ca2+–Zn2+ dyshomeostasis. Hence, novel yet simple cardioprotective strategies may be at hand that deserve to be further explored. PMID:20405318
Gandhi, Malay S.; Kamalov, German; Shahbaz, Atta U.; Bhattacharya, Syamal K.; Ahokas, Robert A.; Sun, Yao; Gerling, Ivan C.
It is traditionally thought that excitotoxic necrosis is a passive mechanism that does not require the activation of a cell death program. In this study, we examined the contribution of the cytochrome c-dependent mitochondrial death pathway to excitotoxic neuronal necrosis, induced by exposing cultured cortical neurons to 1 mM glutamate for 6 hrs and blocked by the NMDA antagonist, dizocilpine. Glutamate treatment induced early cytochrome c release, followed by activation of caspase-9 and caspase-3. Preincubation with the caspase-9 inhibitor z-LEHD-fmk, the caspase-3 inhibitor z-DEVD-fmk or the specific pan-caspase inhibitor Q-VD-oph decreased the percentage of propidium iodide-positive neurons (52.5 ± 3.1%, 39.4 ± 3.5%, 44.6 ± 3% respectively vs 65 ± 3% in glutamate + vehicle). EM studies showed mitochondrial release of cytochrome c in neurons in the early stages of necrosis, and cleaved caspase-3 immunoreactivity in morphologically necrotic neurons. These results suggest that an active mechanism contributes to the demise of a subpopulation of excitotoxic necrotic neurons. PMID:19235896
Seo, Dae-Won; Lopez-Meraz, Maria-Leonor; Allen, Suni; Wasterlain, Claude Guy; Niquet, Jerome
Dirty necrosis within glandular lumina is often considered as a characteristic of colorectal carcinomas (CRCs) that is a diagnostically useful feature of CRCs with DNA microsatellite instability (MSI). Multiphoton microscopy (MPM), which is based on the second-harmonic generation and two-photon excited fluorescence signals, was used to identify dirty necrosis. Our results demonstrated that MPM has the ability to exhibit the microstructure of dirty necrosis and the signal intensity as well as an emission spectrum that can help to differentiate dirty necrosis from cancer cells. These findings indicate that MPM may be helpful in distinguishing MSI colorectal carcinoma via the identification of dirty necrosis.
Li, Lianhuang; Jiang, Weizhong; Yang, Yinghong; Chen, Zhifen; Feng, Changyin; Li, Hongsheng; Guan, Guoxian; Chen, Jianxin
The varieties of normal skin color in humans range from people of "no color" (pale white) to "people of color" (light brown, dark brown, and black). Skin color is a blend resulting from the skin chromophores red (oxyhaemoglobin), blue (deoxygenated haemoglobin), yellow-orange (carotene, an exogenous pigment), and brown (melanin). Melanin, however, is the major component of skin color ; it is the presence or absence of melanin in the melanosomes in melanocytes and melanin in keratinocytes that is responsible for epidermal pigmentation, and the presence of melanin in macrophages or melanocytes in the dermis that is responsible for dermal pigmentation. Two groups of pigmentary disorders are commonly distinguished: the disorders of the quantitative and qualitative distribution of normal pigment and the abnormal presence of exogenous or endogenous pigments in the skin. The first group includes hyperpigmentations, which clinically manifest by darkening of the skin color, and leukodermia, which is characterized by lightening of the skin. Hypermelanosis corresponds to an overload of melanin or an abnormal distribution of melanin in the skin. Depending on the color, melanodermia (brown/black) and ceruloderma (blue/grey) are distinguished. Melanodermia correspond to epidermal hypermelanocytosis (an increased number of melanocytes) or epidermal hypermelanosis (an increase in the quantity of melanin in the epidermis with no modification of the number of melanocytes). Ceruloderma corresponds to dermal hypermelanocytosis (abnormal presence in the dermis of cells synthesizing melanins) ; leakage in the dermis of epidermal melanin also exists, a form of dermal hypermelanosis called pigmentary incontinence. Finally, dyschromia can be related to the abnormal presence in the skin of a pigment of exogenous or endogenous origin. PMID:23522626
Ortonne, J P
Specialty acrylates and methacrylates (SAM) comprise a large family of industrial monomers. In the late 1980s, the United States EPA and the industry SAM Panel collaborated to evaluate the potential effects, particularly carcinogenesis, of this family of chemicals. As part of this arrangement, the SAM Panel, with EPA input and approval, conducted four studies with a representative acrylate, triethyleneglycol diacrylate (TREGDA), and methacrylate, triethyleneglycol dimethacrylate (TREGDMA). All studies used unoccluded skin application to male mice as follows: Study 1, evaluation of skin irritation compared to cell proliferation in the basal epithelium (BE) following 7 or 14 days of treatment; Study 2, 14-day dose range-finding study; Study 3, 90-day subchronic toxicity study; and Study 4, chronic bioassays employing the EPAs draft guidelines for dermal chronic bioassays. BE cell proliferation was determined in subchronic and carcinogenicity studies (Studies 1, 3, and 4). Organ weight changes (Studies 3 and 4) and increased mortality (Study 4) were observed for the highest dose of TREGDMA. However, there was no related histopathology. Both chemicals induced cell proliferation (7 days through 78 weeks) that correlated with acute and chronic inflammation of the skin. No skin tumors were observed in this study. TREGDA resulted in skin lesions at doses approximately 20-fold lower than TREGDMA. Most of the skin lesions showed similar patterns of microscopic cutaneous alteration suggestive of nonspecific irritation for both chemicals. However, the high concentration TREGDA group in the 78-week study also had evidence of epidermal cell necrosis. In contrast to earlier studies with acrylates, dose selection was based on careful examination of skin irritation and cell proliferation to avoid excessive skin damage. Under these conditions, TREGDA and TREGDMA were not carcinogenic. PMID:12662909
Van Miller, J P; Garman, R H; Hermansky, S J; Mirsalis, J C; Frederick, C B
Despite an overall thinning of the epidermis and focal areas of cytologic atypia, there was no morphologic evidence that the protective function of this tissue was compromised by age. The characteristic morphologic markers associated with the keratinization process were not altered either in appearance or in amounts. A well-formed stratum corneum was present, suggestive that barrier ability is not compromised in senile skin. Whereas alterations in the aged epidermis are slight, the dermal-epidermal changes are marked and have greater physiologic consequences. The major change is a relatively flat dermal-epidermal junction because of retraction of the epidermal papillae as well as the microprojections of basal cells into the dermis. This flattening results in a more fragile tissue less resistant to shearing forces. Retraction of the epidermal downgrowths may also explain the loss in proliferative capacity associated with the aged epidermis. The major alterations in the aged dermis concern the architecture of the collagen and elastin networks. Both fibrous components appear more compact because of a decrease in the voids or spaces between the fibers; the spaces resulted from a loss of ground substance. Collagen bundles appear to unravel, and the individual elastic fibers show signs of elastolysis. The net effect of these fibrous rearrangements and alterations is a dermis that is less stretchable, less resilient, more lax, and prone to wrinkling. PMID:3521984
Lavker, R M; Zheng, P S; Dong, G
Despite an overall thinning of the epidermis and focal areas of cytologic atypia, there was no morphologic evidence that the protective function of this tissue was compromised by age. The characteristic morphologic markers associated with the keratinization process were not altered either in appearance or in amounts. A well-formed stratum corneum was present, suggestive that barrier ability is not compromised in senile skin. Whereas alterations in the aged epidermis are slight, the dermal-epidermal changes are marked and have greater physiologic consequences. The major change is a relatively flat dermal-epidermal junction because of retraction of the epidermal papillae as well as the microprojections of basal cells into the dermis. This flattening results in a more fragile tissue that is less resistant to shearing forces. Retraction of the epidermal downgrowths may also explain the loss in proliferative capacity associated with the aged epidermis. The major alterations in the aged dermis concern the architecture of the collagen and elastin networks. Both fibrous components appear more compact because of a decrease in the voids or spaces between the fibers; the spaces resulted from a loss of ground substance. Collagen bundles appear to unravel, and the individual elastic fibers show signs of elastolysis. The net effect of these fibrous rearrangements and alterations is a dermis that is less stretchable, less resilient, more lax, and prone to wrinkling. PMID:2646002
Lavker, R M; Zheng, P S; Dong, G
An inhibitor of tumor necrosis factor (TNF) has been isolated from the human histiocytic lymphoma cell line U-937 that is capable of inhibiting both TNF-alpha and TNF-beta. Protein sequencing has verified that it is distinct from a previously described TNF inhibitor that is a soluble fragment of a TNF receptor molecule (TNFrI). The cDNA sequence of this second TNF inhibitor
Tadahiko Kohno; Michael T. Brewer; Susan L. Baker; Phillip E. Schwartz; Michael W. King; Karin K. Hale; Charles H. Squires; Robert C. Thompson; James L. Vannice
The imbalance and/or the perturbation of the microbial populations that colonize the skin and that contribute to its defense may represent one of the causes of the development of noninfectious skin diseases. Atopic dermatitis, psoriasis, acne, and rosacea can be listed among these kinds of pathologies. In particular, considering that microbes have been long addressed as having a role in rosacea, this common dermatosis can be an interesting model to evaluate the correlation between microbiome alterations and the occurrence of clinical manifestations. Different microorganisms have been suggested to have a role in rosacea, but no direct correlation with the incidence of the pathology has been clearly defined. Skin microbiome composition is crucial for the correct skin immune functions and recent findings indicate an abnormal activation of innate immune system associated with the rosacea. The enhanced expression of toll-like receptor 2 in the epidermis of rosacea patients can represent a possible explanation for the amplified inflammatory response to external stimuli observed during the disease. In addition, significantly higher small intestinal bacterial overgrowth prevalence in rosacea subjects has been found and its eradication has been associated with a regression of the skin lesions. In conclusion, both skin and gut microbiome seem to have a role, even if synergistic with other factors, in the pathogenesis of rosacea. A deeper knowledge of human microbiome composition and microbe-host interactions will contribute to clarify the mechanism of development of rosacea and possibly will provide innovative therapeutic approaches. PMID:25291137
Picardo, Mauro; Ottaviani, Monica
Summary The investigation of nanoparticle interactions with tissues is complex. High levels of standardization, ideally testing of different material types in the same biological model, and combinations of sensitive imaging and detection methods are required. Here, we present our studies on nanoparticle interactions with skin, skin cells, and biological media. Silica, titanium dioxide and silver particles were chosen as representative examples for different types of skin exposure to nanomaterials, e.g., unintended environmental exposure (silica) versus intended exposure through application of sunscreen (titanium dioxide) or antiseptics (silver). Because each particle type exhibits specific physicochemical properties, we were able to apply different combinations of methods to examine skin penetration and cellular uptake, including optical microscopy, electron microscopy, X-ray microscopy on cells and tissue sections, flow cytometry of isolated skin cells as well as Raman microscopy on whole tissue blocks. In order to assess the biological relevance of such findings, cell viability and free radical production were monitored on cells and in whole tissue samples. The combination of technologies and the joint discussion of results enabled us to look at nanoparticle–skin interactions and the biological relevance of our findings from different angles.
Rancan, Fiorenza; Ahlberg, Sebastian; Nazemi, Berouz; Choe, Chun Sik; Darvin, Maxim E; Hadam, Sabrina; Blume-Peytavi, Ulrike; Loza, Kateryna; Diendorf, Jörg; Epple, Matthias; Graf, Christina; Rühl, Eckart; Meinke, Martina C; Lademann, Jürgen
Discusses such concerns as acne, syphilis, drug abuse, and tatoos. Indicates need for physician not only to treat skin diseases but to help adolescents to accept themselves and find constructive directions. (CJ)
Diabetes mellitus is one of the most common diseases in the Western industrialized countries with about 300 million affected patients worldwide. The hyperglycemic state of diabetes mellitus leads to changes in practically every cell type and organ of the human body. Skin changes are considered the most common manifestations of diabetes mellitus. As skin changes can manifest before onset of diabetes mellitus they may have a diagnostic relevance. Other changes and diseases of the skin develop during the course of diabetes mellitus and may be associated with complications in internal organs or may occur as an adverse effect of antidiabetic therapy. In particular the presence of the diabetic foot syndrome is associated with significantly increased morbidity and mortality of diabetes patients as well as with markedly elevated direct and indirect costs for the health care system. In this article the most common skin diseases of patients with diabetes mellitus as well as their pathophysiology and current treatment are reviewed. PMID:25262886
Gkogkolou, Paraskevi; Böhm, Markus
Skin and nipple-areola complex sparing mastectomy (SNSM) and primary reconstruction have been popular for breast cancer treatment in the last decade. An advantage of the SNSM technique is the removal of all breast tissue as a radical surgical procedure while preserving native breast integrity, nipple-areola complex (NAC), and submammary fold. This retrospective 15-year clinical study analyzes medical records from our breast surgery database collected at our department between 1997 and 2012. A total number of 3757 patients were treated for breast cancer; 411 (10.9%) patients had a skin-sparing mastectomy with the median (range) length follow-up of 63 months. This is the longest follow-up for SNSM in breast cancer patients; 3.7% of patients who underwent SNSM developed disease local recurrence, whereas occult NAC involvement with cancer occurred in 7.7% and local recurrence in the NAC in 1.2%. Partial necrosis of the NAC developed in 9.4% and total necrosis in 0.7% of operated breasts. All disease recurrences occurred in the first 10 years of the follow-up period. Local recurrence developed as first recurrence event has longer median cancer-specific survival time of 70 months than those with only distant metastases with 50 months and locoregional plus distant metastases with 35.5 months. The "Omega" pattern incision combines an oncological radical procedure with a lower incidence of skin flap necrosis. Patients reconstructed with autologous tissue were the group most satisfied. SNSM is an oncological safe procedure for breast cancer treatment with low recurrence in properly selected patients. PMID:24378808
Stanec, Zdenko; Žic, Rado; Budi, Sre?ko; Stanec, Sanda; Milanovi?, Rudolf; Vlaj?i?, Zlatko; Roje, Zeljka; Rudman, Franjo; Marti?, Krešimir; Held, Rebeka; Božo, Gorjanc
The increasing use of nano-sized materials in our environment, and in many consumer products, dictates new safety concerns. In particular, adequate experimental models are needed to evaluate skin toxicity of metal oxide ions, commonly found in cosmetic and dermatologic preparations. We have addressed the biological effects of topically applied copper oxide (CuO) nanoparticles in human skin organ cultures, using light and electron microscopy, and biochemical tests. Nanoparticles were more toxic than micro-sized particles, and their effects were stronger when supplied in growth medium than in topical application. Still topically applied CuO nanoparticles induced inflammatory cytokine secretion and necrosis, especially in epidermis deprived of its protective cornea. Since nanoparticle penetration was not seen, we propose that they may adhere to skin surface, react with the local acidic environment, and generate soluble ions that make their way to inner sites. This work illustrates the abilities of skin organ culture to evaluate the biological effects of topically-applied materials on skin in vitro. PMID:22954531
Cohen, Dror; Soroka, Yoram; Ma'or, Zeev; Oron, Miriam; Portugal-Cohen, Meital; Brégégère, François Menahem; Berhanu, Deborah; Valsami-Jones, Eugenia; Hai, Noam; Milner, Yoram
In this lesson, students become better aware of how their personal behavior and the environment can have a considerable impact on their health in general, particularly the health of their skin. In this exercise, students draw a model of a healthy and unhealthy person. This prompts a discussion on behavior and environmental behaviors that affect health. They also learn what good health is and the benefits of a healthy lifestyle. Finally, the students determine their skin types.
American Association for the Advancement of Science (American Association for the Advancement of Science;)
Immune reactions to drugs can cause a variety of diseases involving the skin, liver, kidney, lungs, and other organs. Beside\\u000a immediate, IgE-mediated reactions of varying degrees (urticaria to anaphylactic shock), many drug hypersensitivity reactions\\u000a appear delayed, namely hours to days after starting drug treatment, showing a variety of clinical manifestations from solely\\u000a skin involvement to fulminant systemic diseases which may
Oliver Hausmann; Benno Schnyder; Werner J. Pichler
Pathological skin picking (PSP) is a disabling disorder characterized by repetitive picking of the skin that causes tissue\\u000a damage. Estimated to affect 2% to 5.4% of the population, PSP is currently listed as an impulse control disorder not otherwise\\u000a specified. However, the repetitive and compulsive behaviors seen in PSP are phenomenologically and clinically similar to the\\u000a behaviors seen in obsessive-compulsive
Jon E. Grant; Brian L. Odlaug
The skin is the largest organ of the body and protects the organism against external physical, chemical and biological insults,\\u000a such as wounding, ultraviolet radiation and micro-organisms. The epidermis is the upper part of the skin that is continuously\\u000a renewed. The keratinocytes are the major cell type in the epidermis and undergo a specialized form of programmed cell death,\\u000a called
Saskia Lippens; Esther Hoste; Peter Vandenabeele; Patrizia Agostinis; Wim Declercq
Thyroid disorders have a high prevalence in medical practice; they are associated with a wide range of diseases with which they may or may not share etiological factors. One of the organs which best show this wide range of clinical signs is the skin. This review is an attempt to approach most of the dermopathies reflecting several degrees of harmfulness, coming directly or indirectly from thyroid abnormalities, as well as to update current knowledge on the relationship between the thyroid and skin. We have proposed a primary classification of skin disorders, regarding thyroid involvement, into two main groups: 1) dermopathies associated with thyroid abnormalities, mainly with autoimmune thyroid diseases, like melasma, vitiligo, Sjogren's syndrome, alopecia, idiopathic hirsutism, pre-menstrual acne, bullous diseases, connective tissue diseases, hamartoma syndrome, atopy, leprosy and DiGeorge anomaly; and 2) dermopathies depending on the nature of the thyroid disorder, in which the evolution and outcome of the skin disorder depend on the thyroidal treatment in most cases, such as trophism and skin blood flow, myxedema, alopecia, onychodystrophy, hypo- and hyperhidrosis, xanthomas, intraepidermal bullae, carotenodermia, pruritus, flushing, pyodermitis, palmoplantar keratoderma, ecchymosis, etc. In some other cases, the skin disease which developed as a consequence of the thyroid abnormality can remain unaltered despite functional treatment of the thyroid problem, such as pretibial myxedema, thyroid acropachy and some cutaneous manifestations of multiple endocrine neoplasia types 2A and 2B. PMID:11686547
Niepomniszcze, H; Amad, R H
Using smart materials and skins, one could design a smart structure with suitable feedback system architecture. This paper is designed to address some technical advances and applications of smart materials, smart skins and coatings covering a broad spectrum of electromagnetic fields. The Smart Skin Antenna Technology Program's objectives are to (1) use smart skin technologies to develop an antenna system architecture which is structurally integratable, wideband, and embedded/conformal; (2) design, develop, and fabricate a thin, wideband, conformal/arrayable radiator that is structurally integratable and which uses advanced Penn State dielectric and absorber materials to achieve wideband ground planes, and together with low RCS, wideband radomes; (3) implement a smart skin antenna system architecture. Traditional practice has been to design radome and antenna as separate entities and then resolve any interface problems during an integration phase. A structurally integratable conformal antenna, however, demands that the functional components be highly integrated both conceptually and in practice. Our concept is to use the lower skin of the radome as a substrate on which the radiator can be made using standard photolithography, thick film, or LTCC techniques.
Varadan, Vijay K.; Varadan, Vasundara V.
Traditional composite aircraft structures are designed for load bearing and then overdesigned for impact damage and hot humid environments. Seeking revolutionary improvement in the performance and weight of composite structures, Cessna Aircraft Company, with sponsorship from the NASA Fundamental Aeronautics Program/Subsonic Fixed Wing Project, has developed and tested a protective skin concept which would allow the primary composite structure to carry only load and would meet the impact, hot and humid, and other requirements through protective skins. A key requirement for the protective skins is to make any impact damage requiring repair visible. Testing from the first generation of skins helped identify the most promising materials which were used in a second generation of test articles. This report summarizes lessons learned from the first generation of protective skins, the design and construction of the second-generation test articles, test results from the second generation for impact, electromagnetic effects, aesthetics and smoothing, thermal, and acoustic (for the first time), and an assessment of the feasibility of the protective skin concept.
Johnson, Vicki S.; Boone, Richard L.; Jones, Shannon; Pendse, Vandana; Hayward, Greg
Skin detection consists in detecting human skin pixels from an image. Skin detection plays an important role in various applications such as face detection, searching and filtering image content on the web. In this paper we propose a novel skin detection algorithm based on tree distribution. A tree distribution that is more general then a bayesian network, can represent a
Sanaa EL FKIHI; Mohamed DAOUDI; Driss ABOUTAJDINE
Skin segmentation is widely used in many computer vision tasks to improve automated visualization. This paper presents a graph cuts algorithm to segment arbitrary skin regions from images. The detected face is used to determine the foreground skin seeds and the background non-skin seeds with the color probability distributions for the foreground represented by a single Gaussian model and for
Zhilan Hu; Guijin Wang; Xinggang Lin; Hong Yan
Previous studies have reached conflicting results regarding whether tumour necrosis is a predictor of survival in clear cell renal cell carcinoma. In addition, studies quantifying the extent of necrosis are limited.The aim of this study was to determine if quantifying tumour necrosis could improve its predictive value for survival in clear cell renal cell carcinoma.We reviewed the clinical pathological information contained in The Cancer Genome Atlas for clear cell renal cell carcinoma and correlated it with overall survival using a Cox proportional hazard model. Necrosis was quantified on a single frozen section slide taken at the time of tissue harvesting for molecular studies.For all tumours, the presence of tumour necrosis was a significant predictor of overall survival (p?0.001) on univariate analysis. When quantitated, >10% necrosis was associated with survival, but ?10% necrosis was not. On multivariate analysis, age (p?=?0.004), T3b stage (p?=?0.02), M1 stage (p?0.001), necrosis >30% (p?0.001), and elevated serum calcium (p?=?0.003) remained significant. For clinical stage 1-2 (T1-T2N0M0) tumours, necrosis >20% was significant on univariate analysis (p???0.005), and remained so on multivariate analysis (p?0.001).We conclude that quantitating the extent of tumour necrosis adds prognostic information in clear cell renal cell carcinomas, including organ confined tumours. PMID:25474516
Renshaw, Andrew A; Cheville, John C
Non-thermal plasmas are gaseous mixtures of molecules, radicals, and excited species with a small proportion of ions and energetic electrons. Non-thermal plasmas can be generated with any high electro-magnetic field. We studied here the pathological effects, and in particular cell death, induced by nanosecond-pulsed high voltage generated plasmas homogeneously applied on cell cultures and nude mouse skin. In vitro, Jurkat cells and HMEC exhibited apoptosis and necrosis, in dose-dependent manner. In vivo, on nude mouse skin, cell death occurred for doses above 113 J/cm2 for the epidermis, 281 J/cm2 for the dermis, and 394 J/cm2 for the hypodermis. Using electron microscopy, we characterized apoptosis for low doses and necrosis for high doses. We demonstrated that these effects were not related to thermal, photonic or pH variations, and were due to the production of free radicals. The ability of cold plasmas to generate apoptosis on cells in suspension and, without any sensitizer, on precise skin areas, opens new fields of application in dermatology for extracorporeal blood cell treatment and the eradication of superficial skin lesions. PMID:24358244
Bousquet, Guilhem; Gapihan, Guillaume; Starikovskaia, Svetlana M.; Rousseau, Antoine; Janin, Anne
Non-thermal plasmas are gaseous mixtures of molecules, radicals, and excited species with a small proportion of ions and energetic electrons. Non-thermal plasmas can be generated with any high electro-magnetic field. We studied here the pathological effects, and in particular cell death, induced by nanosecond-pulsed high voltage generated plasmas homogeneously applied on cell cultures and nude mouse skin. In vitro, Jurkat cells and HMEC exhibited apoptosis and necrosis, in dose-dependent manner. In vivo, on nude mouse skin, cell death occurred for doses above 113 J/cm(2) for the epidermis, 281 J/cm(2) for the dermis, and 394 J/cm(2) for the hypodermis. Using electron microscopy, we characterized apoptosis for low doses and necrosis for high doses. We demonstrated that these effects were not related to thermal, photonic or pH variations, and were due to the production of free radicals. The ability of cold plasmas to generate apoptosis on cells in suspension and, without any sensitizer, on precise skin areas, opens new fields of application in dermatology for extracorporeal blood cell treatment and the eradication of superficial skin lesions. PMID:24358244
Duval, Arnaud; Marinov, Ilya; Bousquet, Guilhem; Gapihan, Guillaume; Starikovskaia, Svetlana M; Rousseau, Antoine; Janin, Anne
In this study, aloe-emodin (AE) was less cytotoxic to human noncancerous skin cells (premalignant keratinocytic HaCaT and fibroblast Hs68) than to nonmelanoma cancer cells (epidermoid carcinoma A431 and head and neck squamous cell carcinoma SCC25). Notably, AE induced apoptosis by up-regulating tumor necrosis factor-alpha and Fas ligand and their cognate receptors, downstream adaptor TNF-R1-associated death domain and Fas-associated death domain, and activated caspase-8 in A431 and SCC25 cells. Moreover, AE up-regulated p53, increased intracellular reactive oxygen species levels, depleted intracellular-reduced GSH, up-regulated cytochrome c and Bax, down-regulated Bcl-2, and activated caspase-9 and -3. The combinatory use of AE and 5-fluorouracil (5-Fu) achieved significantly more cell death in A431 and SCC25 cells than only the use of AE or 5-Fu, likely via regulation of caspase-8, -9, and -3 expressions. Incorporating AE into the liposomal formulation accelerated cell death of A431 and SCC25 cells within a short time. Furthermore, skin permeation profiles of drug suggest that the liposomal formulation enhances transdermal delivery of AE. Experimental data demonstrate the feasibility of applying liposome to deliver AE in clinical therapy. PMID:19928967
Chou, Tzung-Han; Liang, Chia-Hua
Treatment of rats with the beta-adrenergic agonist isoproterenol results in cardiac hypertrophy, myocyte necrosis, and interstitial cell fibrosis. Our objectives in this study have been to examine whether hypertrophy and fibrosis occur in a compensatory and reparative response to myocyte loss or whether either process may be occurring independently of myocyte loss and thus be a reactive response to adrenergic hormone stimulation. We have examined this question by evaluating each of these responses in rats treated with different doses and forms of isoproterenol administration. Myocyte necrosis was evaluated using in vivo labeling with monoclonal antimyosin for identification of myocytes with permeable sarcolemma, which was indicative of irreversible injury. Myocardial fibrosis was evaluated by morphometric point counting of Gomori-stained tissue sections and by assessment of the stimulation of fibroblast proliferation by determination of increased levels of DNA synthesis. Stimulation of fibroblast DNA synthesis was determined from DNA specific radioactivities and radioautography after pulse labeling with [3H]thymidine. The evidence provided by this study suggests that the degree and timing of myocardial hypertrophy does not follow the course of myocyte loss and, thus, appears to be either a response to altered cardiac loading or a reactive response to beta-adrenergic hormone stimulation rather than a compensation for myocyte loss. Myocardial fibrosis, on the other hand, appears to be more closely related to myocyte necrosis with respect to collagen accumulation in the same areas of the heart, its dose-response relation to the amount of isoproterenol administered, and the timing of increased DNA synthesis, or fibroblast proliferation, after myocyte loss. PMID:2527639
Benjamin, I J; Jalil, J E; Tan, L B; Cho, K; Weber, K T; Clark, W A
Background The purpose of this paper was to present a case series of self-limiting, peripheral acute retinal necrosis and to demonstrate efficacy of treatment with valacyclovir in patients resistant to acyclovir. The diagnosis was made on ophthalmoscopic examination and positive serum tests for herpes viruses. Material/Methods Ten patients (6F and 4M) aged 19–55 years were diagnosed and treated for self-limiting acute retinal necrosis (ARN). The following endpoints were reported: visual outcomes, clinical features, disease progression, treatment, and complications. Patients received only symptomatic treatment because they did not consent to vitreous puncture. Results Peripheral, mild retinitis was diagnosed in all eyes at baseline. Initially, all patients were treated with systemic acyclovir (800 mg, 5 times a day), prednisone (typically 40–60 mg/day), and aspirin in an outpatient setting. In 6 patients, treatment was discontinued at 6 months due to complete resolution of the inflammatory process. Four patients with immune deficiency showed signs and symptoms of chronic inflammation. Two patients did not respond to acyclovir (2 non-responders); however, those patients were successfully treated with valacyclovir. Complete resolution of inflammatory lesions was observed in 8 patients. In 2 patients, the disease progressed despite treatment – 1 female patient after kidney transplant who stopped the prescribed medications, and 1 male patient with SLE and antiphospholipid syndrome who experienced breakthrough symptoms on-treatment. He died due to cerebral venous sinus thrombosis. Neurological complications (encephalitis and meningitis) were observed in 2 female patients. Prophylactic laser photocoagulation was performed in 1 subject. Conclusions A series of cases of self-limiting acute retinal necrosis (ARN) is presented. This clinical form of ARN can resemble toxoplasmic retinitis in some cases. Oral antiviral medications provide an effective alternative to intravenous formulations in patients with self-limiting ARN. Retinitis is associated with the risk of encephalitis. PMID:25356955
Brydak-Godowska, Joanna; Borkowski, Piotr; Szczepanik, Szymon; Moneta-Wielgo?, Joanna; K?cik, Dariusz
A historical note on the aetiology of phossy jaw shows that present-day knowledge is little greater than it was a century ago. The varied clinical course of the disease is described together with a report of 10 classical cases not previously reported. Six cases, not amounting to true necrosis but in which healing after dental extraction was delayed, and described, and mention is made of the noticeable differences in the oral state and appearances of tartar of healthy workmen exposed to phosphorus compared with healthy workmen not exposed. But no systematic differences of any kind were found in the incidence of general infections, fractures of bones, haematological findings, and biochemical studies of blood and urine in two groups of healthy men most exposed and least exposed to phosphorous in the same factory. An intensive study in hospital of a case of classical necrosis showed no departure from normal, except delayed healing following bone biopsy from the iliac crest, and a reversed polymorphonuclear/lymphocyte ratio. In the discussion the time of onset of necrosis after first exposure to phosphorus, clinical and radiological diagnosis, the organisms present, personal susceptibility, the appearance of the sequestra, and regeneration of bone are considered. An up-to-date note on prevention of the disease is given, although this has met with only partial success. Some persons are highly susceptible and, whilst complete protection is impossible in the light of our present knowledge, early diagnosis and modern treatment have robbed the disease of its terrible manifestations of Victorian times and turned it into a minor, although often uncomfortable complaint, with little or no resulting disability. Images PMID:14449812
Hughes, J. P. W.; Baron, R.; Buckland, D. H.; Cooke, M. A.; Craig, J. D.; Duffield, D. P.; Grosart, A. W.; Parkes, P. W. J.; Porter, A.
In this review, the authors provide evidences that imply the role of tumor necrosis factor-? (TNF-?) in the pathogenesis of diabetic complications, especially diabetic polyneuropathy. Under chronic hyperglycemia, endogenous TNF-? production is accelerated in microvascular and neural tissues, which may undergo an increased microvascular permeability, hypercoagulability, and nerve damage, thus initiating and promoting the development of characteristic lesions of diabetic microangiopathy and polyneuropathy. Enhanced TNF-? production may also promote atherosclerosis due to increased insulin resistance and the expression of adhesion molecules. Clinical application of specific agents that suppress production and/or activity of TNF-? may inhibit the development and exacerbation of chronic diabetic complications. PMID:14630568
Yagihashi, Soroku; Toyota, Takayoshi
Renal cortical necrosis (RCN) is a rare cause of acute renal failure (ARF). There is no clinical case report of RCN in a live kidney donor. A 48-year-old female kidney donor developed sudden anuria five hours postnephrectomy and remained anuric for more than three months on maintenance hemodialysis. Laboratory investigations revealed the features of hemolytic uremic syndrome. Contrast-enhanced computed tomography scan of abdomen showed hypoattenuated subcapsular rim of renal cortex favoring diagnosis of RCN. To the best of our knowledge, this is the first clinical case report of RCN in a live kidney donor in world literature. PMID:22279344
Prakash, J.; Srivastava, A.; Singh, S.; Ghosh, B.
Autologous fat transfer (AFT) is an increasingly popular cosmetic procedure practiced by dermatologic surgeons worldwide. As this is an office based procedure performed under local or tumescent anaesthesia with fat transferred within the same individual and limited associated down time its is considered relatively safe and risk free in the cosmetic surgery arena. We describe a case of AFT related fat necrosis causing significant facial dysmorphia and psychosocial distress. We also discuss the benefits and risks of AFT highlighting common causes of fat graft failure. PMID:25538442
Rai, Sweta; Marsland, Alexander M; Madan, Vishal
Tumour necrosis factor ? (TNF?) is likely to be involved in the pathogenesis of Wegener's granulomatosis. This paper reviews published clinical trials of the anti-TNF? agents etanercept and infliximab with regard to their efficacy and safety in the treatment of Wegener's granulomatosis. On the basis of the high rate of adverse events, particularly an increased incidence of cancers, the use of etanercept in the management of Wegener's granulomatosis is not justified. However, the potential role for infliximab or the as yet untested adalimumab cannot be discounted. The development of novel approaches focusing on blockade of specific molecules including TNF? in the treatment of Wegener's granulomatosis is awaited. PMID:16239383
Mukhtyar, C; Luqmani, R
A case of ruptured pheochromocytoma is presented, the pathophysiology discussed, and the literature reviewed. Evidence is presented that the use of alpha-adrenergic blockade in general, and phentolamine in particular, may predispose to this complication. Twelve cases of massive hemorrhagic necrosis with or without rupture were found in the literature, including the present case. Six had no operation; one survived. Six had immediate operation; 4 survived. An additional case of hemorrhage into a small pheochromocytoma following phentolamine is presented. This tumor was neither ruptured nor massively necrotic, but the case supports the hypothesis that alpha-adrenergic blockade may cause hemorrhage within the pheochromocytoma. Images Fig. 2. Fig. 3. PMID:938114
Van Way, C W; Faraci, R P; Cleveland, H C; Foster, J F; Scott, H W
Coal tar products, which are widely used in treating dermatologic disease, contain numerous polycyclic aromatic hydrocarbons, including 3,4-benzo[a]pyrene (BP). BP is among the most potent environmental chemical carcinogens and is known to evoke tumors in the skin of experimental animals and perhaps also of man. In this study the effect of cutaneous application of coal tar solution (U. S. Pharmacopeia) on aryl hydrocarbon hydroxylase (AHH) activity in the skin of patients usually treated with this drug was investigated. AHH, a cytochrome P-450 dependent carcinogen-metabolizing enzyme appears to play an important role in the activation of polycyclic hydrocarbons into reactive moieties that can bind to DNA and that may directly induce cancer. Application of coal tar solution to human skin caused a two to five-fold induction of cutaneous AHH in nine subjects. In further studies, the incubation of human skin with coal tar solution in vitro also caused variable induction of cutaneous AHH. Maximum responses in both systems occurred after 24 h and enzyme activity in vitro was time- and tissue- and substrate-concentration dependent. Studies in experimental animals showed that topical application of coal tar solution caused induction of AHH in skin and, after percutaneous absorption, in liver as well. Assay of several defined constituents of coal tar for AHH induction showed that BP was the most potent inducer of AHH tested. These studies indicate that topical application of coal tar solution in doses ordinarily used in treating dermatologic disease causes induction of AHH in human skin and suggest that such induced enzymatic activity could relate to carcinogenic responses to this agent in skin or, after percutaneous absorption, in other tissues as well. PMID:711851
Bickers, David R.; Kappas, Attallah
Experiments have been carried out on guinea pigs of two isogenic strains to elucidate the role of afferent lymphatic vessels in the rejection of orthotopic skin homografts. Graft beds were prepared in partially isolated skin flaps with an intact sustaining vascular "umbilical cord" in which a lymphatic connection with the host could be retained or abolished at will. In the absence of demonstrable lymphatic connections between flap and host, intra-flap homografts long outlived similar grafts transplanted to conventional sites in intact skin and, rather than being specifically rejected, died as a consequence of ischemic necrosis of the flap. When lymphatic drainage was retained, intra-flap homografts were rejected in the usual manner. Hosts of long-term intra-flap homografts did not develop sensitivity, as evidenced by the "first set" type rejection of subsequent test grafts, or by the long-term survival of a second skin graft transplanted to a new flap raised on the opposite side of the host's body. Intra-flap skin homografts were rejected if (a) the hosts had been presensitized, (b) they were grafted concomitantly with a skin homograft placed in a conventional site, or inoculated with a suspension of donor lymphoid cells, or (c) if the lymphatic drainage was restored by reimplantation of the hitherto partially isolated flap to an appropriate vascular bed. These findings and others indicate that an intact lymphatic drainage in its bed is essential for an orthotopic skin homograft to sensitize its host. Various experiments were carried out in which intra-flap homografts were used as "indicators" for the acquisition of specific active or adoptive immunity by their hosts. By transplanting skin homografts to conventional beds concomitantly with intra-flap grafts and then excising the former at various intervals, it has been found that a graft must be in residence for a minimum period of 4 days to evoke the development of a detectable level of sensitivity in the host. Furthermore, by replacing either freshly prepared or long-term skin flaps bearing skin homografts in vascular beds on the trunk and determining the subsequent survival times of the homografts, evidence has been obtained suggesting that reestablishment of a functional lymphatic system in a free skin graft may take as long as 9 days. Using intra-flap homografts as indicators of adoptive immunization of the host, we found that as few as 50 x 106 isologous peripheral blood leukocytes from a specifically sensitized animal will transfer an effective level of sensitivity. We also found that hyperimmune serum, in relatively large amount, exerts a weak but definite adverse effect upon either freshly or recently transplanted intra-flap grafts. PMID:4873840
Barker, Clyde F.; Billingham, R. E.
At least 1 million new cases of non-melanoma skin cancer (NMSC) are diagnosed in the United States each year, and the incidence is increasing. A higher incidence of non-melanoma skin cancer (NMSC) in organ transplant recipients on immunosuppression has been documented for some time, and recent studies indicate that patients with inflammatory bowel disease (IBD), particularly those treated with immunosuppressive medications, might also be at higher risk for this condition. In this review, we summarize recent data evaluating the associations between immunomodulators, anti-tumor necrosis factor-? (anti-TNF) biologic agents and NMSC in patients with IBD and other autoimmune conditions such as rheumatoid arthritis (RA). We also offer recommendations for prevention of NMSC in these populations. PMID:21053358
Long, Millie D.; Kappelman, Michael D.; Pipkin, Clare A.
Foot ulceration is a debilitating comorbidity of diabetes that may result in loss of mobility and amputation. Optical detection of cutaneous tissue changes due to inflammation and necrosis at the preulcer site could constitute a preventative strategy. A commercial hyperspectral oximetry system was used to measure tissue oxygenation on the feet of diabetic patients. A previously developed predictive index was used to differentiate preulcer tissue from surrounding healthy tissue with a sensitivity of 92% and specificity of 80%. To improve prediction accuracy, an optical skin model was developed treating skin as a two-layer medium and explicitly accounting for (i) melanin content and thickness of the epidermis, (ii) blood content and hemoglobin saturation of the dermis, and (iii) tissue scattering in both layers. Using this forward model, an iterative inverse method was used to determine the skin properties from hyperspectral images of preulcerative areas. The use of this information in lowering the false positive rate was discussed.
Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent
A method for imaging the superficial epidermal and papillary dermal layers of the skin is needed when assessing many skin lesions. We have developed an imaging modality using a video camera whose mechanism of contrast is the reflectance of polarized light from superficial skin. By selecting only polarized light to create the image, one rejects the 95% of diffusely reflected light from the deeper dermis. The specular reflectance (or glare) from the skin surface is also avoided in the setup. The resulting polarization picture maximally accents the details of the superficial layer of the skin and removes the effects of melanin pigmentation from the image. Fore example, freckles simply disappear and nevi lose their dark pigmentation to revel the details of abnormal cellular growth. An initial clinical study demonstrated that the polarization camera could identify the margins of sclerosing basal cell carcinoma while the eye of the doctor underestimated the margin estimate. The camera identified an 11-mm-diameter lesion while the unaided eye identified a 6-mm- diameter lesion.
Jacques, Steven L.; Lee, Kenneth
This research studies the effects of external parameters on the friction of porcine skin. A tribometer was used to evaluate the frictional behavior of the same. The effects of DI water and body oil on porcine skin against steel and glass balls were evaluated in terms of coefficient of friction (COF). The COF dropped rapidly when DI water/body oil was introduced into the sliding system and remained stable when the volume of the liquid exceeded a certain value. The COF increased with increasing sliding speed under dry conditions and decreased in wet. Under an increasing normal force, the COF decreased regardless of the presence of liquid. The ratio of the real contact area to the nominal contact area of the skin with the steel/glass ball was found to increase with a power law as the applied force was increased. These results reveal basic tribological properties of the skin in contact with a hard slider. These properties could be used as reference for the design and development of artificial skin in prosthetic applications. PMID:24373917
Xiao, Huaping; Ariyasinghe, Nethika; He, Xingliang; Liang, Hong
Skin preparation of the patient begins before arriving to the operating room; its purpose is to reduce the risk of post operative wound infection. The objective of this study was to assess the skin preparation for surgical procedures in 3 different hospitals of the General Organization for Teaching Hospitals & Institutes (GOTHI) and to determine their conformity to the existing protocol and make comparisons between them in their performance. A prospective study using the audit was done for 1 month, nearly for the same period in each of the 3 hospitals (A,B,C) to observe the skin preparation practices considering showering, hair removal and the 5 steps of patient skin preparation on table in the operating room. The global results revealed that the compliance rate in the three hospitals together as regards performing the 5 steps of skin preparation in the operating room was 36.2%. It was 50.6% in hospital A, 43.3% in hospital B and 18.7% in hospital C. As regards showering before surgery, it was 55%, removing hair appropriately (clipping) was 23.7% and removing hair by means was 44.6%. PMID:19302781
El Sayed, Iman A; Hashem, Samar A; El Sayed, Abdallah S; Gadoua, Iman M; Kamel, Ahlam E; Perse, Olivia K; Baghagho, Ehssan A; Terzaki, Soraya R
Background: Diabetes mellitus affects all systems of the body. Skin is also frequently involved. The aim of the study was to assess the frequency of various skin manifestations in patients with diabetes mellitus. Methods: This descriptive study was conducted at the out-patient diabetic clinics at Aga Khan University Hospital, Karachi. One hundred consecutive patients, both male and female suffering from either type-1 or type-2 diabetes mellitus were included. Results: Out of hundred patients, skin changes were present in 84% of patients. The most frequent finding was skin infections present in 29.7% of patients and the second most common finding was diabetic dermopathy found in 28.5% of patients. Other finding were: Acanthosis Nigricans in 19%, sweating complications in 14.2%, nail involvement in 10.7%, oral involvenient in 5.9%, diabetic foot in 5.9%, xanthelasma in 4.7%, yellow skin in 1.1%, generalized Pruritus in 1.1%, limited joint mobility in 1.1%. Conclusion: The cutaneous manifestations are very common in our diabetic patients (84%) and it is important that they are identified and appropriately treated in diabetes follow up clinics. PMID:25358216
Furqan, Saira; Kamani, Lubna; Jabbar, Abdul
Springtails, arthropods who live in soil, in decaying material, and on plants, have adapted to demanding conditions by evolving extremely effective and robust anti-adhesive skin patterns. However, details of these unique properties and their structural basis are still unknown. Here we demonstrate that collembolan skin can resist wetting by many organic liquids and at elevated pressures. We show that the combination of bristles and a comb-like hexagonal or rhombic mesh of interconnected nanoscopic granules distinguish the skin of springtails from anti-adhesive plant surfaces. Furthermore, the negative overhang in the profile of the ridges and granules were revealed to be a highly effective, but as yet neglected, design principle of collembolan skin. We suggest an explanation for the non-wetting characteristics of surfaces consisting of such profiles irrespective of the chemical composition. Many valuable opportunities arise from the translation of the described comb-like patterns and overhanging profiles of collembolan skin into man-made surfaces that combine stability against wear and friction with superior non-wetting and anti-adhesive characteristics. PMID:21980383
Helbig, Ralf; Nickerl, Julia; Neinhuis, Christoph; Werner, Carsten
Although Malassezia yeasts are a part of the normal microflora, under certain conditions they can cause superficial skin infection, such as pityriasis versicolor (PV) and Malassezia folliculitis. Moreover the yeasts of the genus Malassezia have been associated with seborrheic dermatitis and dandruff, atopic dermatitis, psoriasis, and, less commonly, with confluent and reticulated papillomatosis, onychomycosis, and transient acantholytic dermatosis. The study of the clinical role of Malassezia species has been surrounded by controversy due to the relative difficulty in isolation, cultivation, and identification. This review focuses on the clinical, mycologic, and immunologic aspects of the various skin diseases associated with Malassezia. Moreover, since there exists little information about the epidemiology and ecology of Malassezia species in the Italian population and the clinical significance of these species is not fully distinguished, we will report data about a study we carried out. The aim of our study was the isolation and the identification of Malassezia species in PV-affected skin and non-affected skin in patients with PV and in clinically healthy individuals without any Malassezia associated skin disease. PMID:24442041
Difonzo, E M; Faggi, E; Bassi, A; Campisi, E; Arunachalam, M; Pini, G; Scarfì, F; Galeone, M
Chemotherapy has long been considered as one of useful strategies for cancer treatment. It is primarily based on the apoptosis that can selectively kill cancer cells. However, cancer cells can progressively develop an acquired resistance to apoptotic cell death, rendering refractory to chemo- and radiotherapies. Although the mechanism by which cells attained resistance to drug remains to be clarified, it might be caused by either pumping out of them or interfering with apoptotic signal cascades in response to cancer drugs. In case that cancer cells are defective in some part of apoptotic machinery by repeated exposure to anticancer drugs, alternative cell death mechanistically distinct from apoptosis could be adopted to remove cancer cells refractory to apoptosis-inducing agents. This review will mainly deal with harnessing of necrotic cell death, specifically, programmed necrosis and practical uses. Here, we begin with various defects of apoptotic death machinery in cancer cells, and then provide new perspective on programmed necrosis as an alternative anticancer approach. PMID:25009696
Cho, Young Sik; Park, Seung Yeon
We demonstrate the capacity of an herbal anthraquinone aloe emodin to reduce the cytotoxicity of the proinflammatory cytokine tumor necrosis factor (TNF) towards L929 mouse fibrosarcoma and U251 human glioma cell lines. Aloe emodin inhibited both TNF-induced cell necrosis and apoptosis, but it did not reduce cell death induced by UV radiation or hydrogen peroxide. Aloe emodin inhibited both basal and TNF-triggered activation of extracellular signal-regulated kinase (ERK), and a selective blockade of ERK activation mimicked the cytoprotective action of the drug. On the other hand, aloe emodin did not affect TNF-induced activation of p38 mitogen-activated protein kinase or generation of reactive oxygen species. The combination of aloe emodin and TNF caused an intracellular appearance of acidified autophagic vesicles, and the inhibition of autophagy with bafilomycin or 3-methyladenine efficiently blocked the cytoprotective action of aloe emodin. These data indicate that aloe emodin could prevent TNF-triggered cell death through mechanisms involving induction of autophagy and blockade of ERK activation. PMID:17531219
Harhaji, Ljubica; Mijatovic, Sanja; Maksimovic-Ivanic, Danijela; Popadic, Dusan; Isakovic, Aleksandra; Todorovic-Markovic, Biljana; Trajkovic, Vladimir
Gossypol is a phenolic aldehyde extracted from plants and is known to be an antitumor agent to induce cancer cell apoptosis. In the present study, multiple myeloma cells were treated with gossypol, which resulted in an increase of cellular reactive oxygen species (ROS) and cell necrosis. Quantitative proteomic analysis was carried out to identify differentially expressed proteins between untreated and gossypol-treated cells. Proteomic analysis identified 4330 proteins, in which 202 proteins are upregulated and 383 proteins are downregulated in gossypol-treated cells as compared to the untreated cells. Importantly, proteomic and western blot analysis showed that apoptosis regulators BAK and Bax were upregulated in gossypol-treated cells, indicating that Bcl-2 associated death pathway was activated. Similarly, gossypol also induced upregulations of DNA mismatch repair proteins and DNA replication licensing factor, suggesting that gossypol caused significant DNA damage. Furthermore, upregulations of HLA class I and class II histocompatibility antigens and beta-2-microglobulin were observed in gossypol-treated cells, indicating that gossypol has a novel function to activate cellular immune responses. Our data demonstrate that the execution of necrosis is a complex process involving ROS, DNA damage, and Bcl-2 family proteins. Gossypol-activated immune responses are a potential new approach for multiple myeloma chemotherapy. PMID:25197664
Tian, Enbing; Tang, Haiping; Liu, Chongdong; Wang, Qingtao
Acute renal papillary necrosis occurred in five horses given normal therapeutic doses of phenylbutazone and deprived of water for 36 to 48 hours prior to euthanasia. Five horses given phenylbutazone alone and four horses subjected to water deprivation alone did not develop papillary necrosis. Urinalyses were normal prior to water deprivation, and also after water deprivation in the horses that did not receive phenylbutazone, but the water-deprived, phenylbutazone-treated horses had many red blood cells, transitional epithelial cells, and large numbers of oxalate crystals in their urine. Ulceration of the alimentary tract was seen in more than 50% of these horses. Tongue ulceration was present in one of five horses given phenylbutazone and one of five horses which had phenylbutazone and water deprivation. Ulceration of the gastric mucosa was seen in two of the five phenylbutazone-treated horses, four of five horses with phenylbutazone treatment and water deprivation, and one of four horses with water deprivation alone. Severe colonic ulceration with perforation and peritonitis was present in one horse given phenylbutazone for three months. No other significant changes in the small or large intestine were seen in the other 13 horses. PMID:6636467
Gunson, D E; Soma, L R
Gastric necrosis is a rare condition because of the rich blood supply and the extensive submucosal vascular network of the stomach. “Gas-bloat” syndrome is a well known Nissen fundoplication postoperative complication. It may cause severe gastric dilatation, but very rarely an ischemic compromise of the organ. Other factors, such as gastric outlet obstruction, may concur to cause an intraluminal pressure enough to blockade venous return and ultimately arterial blood supply and oxygen deliver, leading to ischaemia. We report a case of a 63-year-old women, who presented a total gastric necrosis following laparoscopic Nissen fundoplication and a pyloric phytobezoar which was the trigger event. No preexisting gastric motility disorders were present by the time of surgery, as demonstrated in the preoperative barium swallow, thus a poor mastication (patient needed no dentures) of a high fiber meal (cabbage) may have been predisposing factors for the development of a bezoar in an otherwise healthy women at the onset of old age. A total gastrectomy with esophagojejunostomy was performed and patient was discharged home after a 7-d hospital stay with no immediate complications. We also discuss some technical aspects of the procedure that might be important to reduce the incidence of this complication. PMID:25276288
Salinas, Javier; Georgiev, Tihomir; González-Sánchez, Juan Antonio; López-Ruiz, Elena; Rodríguez-Montes, José Antonio
A noninvasive photodynamic method has been developed to produce focal brain necrosis using porphyrin activated in vivo with laser light. After peripheral injection of the photosensitive porphyrin derivative, Photofrin I, mice were irradiated on the posterior lateral aspect of the head through the intact depilated scalp with 632 nm argon-dye laser light. Animals were studied at one, two and seven days after irradiation. Blood-brain barrier damage was detected by the intravenous injection of Evans blue, horseradish peroxidase and heterologous immunoglobulins. At one and two days after irradiation, the lesions were characterized by extravasation of immunoglobulin and Evans blue, and by edema, ischemia and infiltration by monocytes. On the seventh day after irradiation, the lesion was smaller than it had been two days after irradiation, and had reactive changes at its edges and coagulative necrosis at its center. Extravasation of Evans blue and immunoglobulin was markedly reduced by the seventh day after irradiation, but uptake of horseradish peroxidase by macrophages located at the periphery of the lesion was evident.
Stroop, W.G.; Battles, E.J.; Townsend, J.J.; Schaefer, D.C.; Baringer, J.R.; Straight, R.C. (VA Medical Center, Salt Lake City, UT (USA))
A fine balance between cell survival and cell death is required to sculpt the nervous system during development. However, an excess of cell death can occur following trauma, exposure to neurotoxins or alcohol, and some developmental and neurodegenerative diseases, such as Alzheimer's disease (AD). N-Methyl-D-aspartate receptors (NMDARs) support synaptic plasticity and survival of many neuronal populations whereas inappropriate activation may promote various forms of cell death, apoptosis, and necrosis representing the two extremes of a continuum of cell death processes both “in vitro” and “in vivo.” Hence, by identifying the switches controlling pro-survival vs. apoptosis and apoptosis vs. pro-excitotoxic outcome of NMDAR stimulation, NMDAR modulators could be developed that selectively block the cell death enhancing pro-survival signaling or synaptic plasticity mediated by NMDAR. Among these modulators, a role is emerging for the enzyme serine racemase (SR) that synthesizes D-serine, a key co-agonist with glutamate at NMDAR. This review summarizes the experimental evidence from “in vitro” neuronal cultures—with special emphasis on cerebellar granule neurons (CGNs)—and “in vivo” models of neurodegeneration, where the dual role of the SR/D-serine pathway as a master regulator of apoptosis and the apoptosis-necrosis shift will be discussed. PMID:24795622
Canu, Nadia; Ciotti, Maria Teresa; Pollegioni, Loredano
Polychlorinated biphenyls (PCBs) are structurally related to dioxins, widely used in the past in various industrial applications and daily used products. Although PCBs production was discontinued more than twenty years ago, their chemical stability and high lipophilicity make them persistent pollutants and dangerous occupational contaminants. Skeletal muscle is an important site of PCB accumulation. Our previous results about the effects of PCBs on L6C5 myoblasts, showed that "low concentrations" (< 10 microg/ml) of these compounds inhibit in vitro myogenic differentiation in a concentration-dependent fashion, while toxic effects only begin to be evident at PCB concentrations > or = 10 microg/ml. In the present paper we wondered if the observed cell mortality is due to necrosis or if it depends on the activation of programmed cell death mechanisms (apoptosis). Using different methods of analysis, we have observed that PCBs cause necrosis of myogenic cells and that such effect is related to the employed concentrations and to the time of exposure (EC50 approximately = 50 microg/ml). Our results may help to explain the creatin kinase elevation, observed in the blood of patients acutely exposed to high concentrations of PCBs, as the consequence of a necrotic damage of the skeletal muscle. It will be therefore interesting to evaluate the presence of muscular damages in the chronic exposures to PCBs. PMID:16124539
Cannavò, A; Cecil, P; Cortesi, M; Coletti, D; Adamo, S; Naro, F; Tomei, F
Recent studies have suggested an associationbetween tumor necrosis factor-a (TNF-a) andthe development and progression of acute liver failure.To investigate the role of TNF-a in the mechanism of massive hepatic necrosis, we studied a mousemodel of TNF-a and D-galactosamine (GalN)-inducedhepatic necrosis by ultrastructural analysis.Administration of GalN caused edema of hepatocellular microvilli and widening of sinusoidalendothelial fenestrae (SEF); administration ofTNF-a caused only
Kazuyuki Takenaka; Isao Sakaida; Mitsuru Yasunaga; Kiwamu Okita
Cancer cells escape apoptosis by intrinsic or acquired mechanisms of drug resistance. One alternative strategy to circumvent\\u000a resistance to apoptosis could be through re-direction into other death pathways, such as necrosis. However, necrosis is a\\u000a non-specific, non-targeted process resulting in cell lysis and inflammation of both cancer and normal cells and therefore,\\u000a not a viable alternative. However, if the necrosis
Richard D. Dinnen; Daniel P. Petrylak; Robert L. Fine
... t matter whether you consider your skin light, dark, or somewhere in between—anyone can get skin ... t matter whether you consider your skin light, dark, or somewhere in between— remember, anyone can get ...
The recent development of the cold spray technology has made possible the deposition of low porosity and oxide-free coatings with good adhesion and with almost no change in the microstructure of the coated parts. This focuses on the use of low-pressure cold spray process to repair damaged Al-based aircraft skin, aiming at obtaining dense coatings with strong adhesion to the Al2024-T3 alloy. In order to prove the feasibility of using of the cold spray process as a repair process for aircraft skin, series of characterisation/tests including microstructures, microhardness, adhesion strength, three-point bending, surface finish, fatigue test, and corrosion resistance were performed. The obtained results revealed that the low-pressure cold spray process is a suitable for the repair of aircraft skin.
Yandouzi, M.; Gaydos, S.; Guo, D.; Ghelichi, R.; Jodoin, B.
Autophagy is a major intracellular degradative process by which cytoplasmic materials are sequestered in double-membraned vesicles and degraded upon fusion with lysosomes. Under normal circumstances, basal autophagy is necessary to maintain cellular homeostasis by scavenging dysfunctional or damaged organelles or proteins. In addition to its vital homeostatic role, this degradation pathway has been implicated in many different cellular processes such as cell apoptosis, inflammation, pathogen clearance, and antigen presentation and thereby has been linked to a variety of human disorders, including metabolic conditions, neurodegenerative diseases, cancers, and infectious diseases. The skin, the largest organ of the body, serves as the first line of defense against many different environmental insults; however, only a few studies have examined the effect of autophagy on the pathogenesis of skin diseases. This review provides an overview of the mechanisms of autophagy and highlights recent findings relevant to the role of autophagy in skin diseases and strategies for therapeutic modulation. PMID:25404245
Yu, Teng; Zuber, Joshua; Li, Jinchao
The recent development of the cold spray technology has made possible the deposition of low porosity and oxide-free coatings with good adhesion and with almost no change in the microstructure of the coated parts. This focuses on the use of low-pressure cold spray process to repair damaged Al-based aircraft skin, aiming at obtaining dense coatings with strong adhesion to the Al2024-T3 alloy. In order to prove the feasibility of using of the cold spray process as a repair process for aircraft skin, series of characterisation/tests including microstructures, microhardness, adhesion strength, three-point bending, surface finish, fatigue test, and corrosion resistance were performed. The obtained results revealed that the low-pressure cold spray process is a suitable for the repair of aircraft skin.
Yandouzi, M.; Gaydos, S.; Guo, D.; Ghelichi, R.; Jodoin, B.
Despite numerous warnings regarding the dangers of exposure to the sun, the number of skin cancer patients continues to increase rapidly. Dermatologists speak of a 'skin cancer epidemic' and estimate that the number of patients is substantially higher than the number estimated on the basis of cancer registry data. According to the Netherlands and Eindhoven cancer registries, 35.500 Dutch people were newly diagnosed with 'skin cancer' in 2006. Many skin cancer patients develop multiple skin tumours, therefore the total number of skin tumours is much higher than this. One in 6 Dutch people will develop skin cancer in their lifetime, 1 in 50 will develop a melanoma. Despite the good prognosis for most skin tumours, there is a high level of morbidity as a result of treatment. The large number of skin tumours and patients puts a great deal of pressure on the health care system. PMID:20025791
de Vries, Esther; Nijsten, Tamar; Louwman, Marieke W J; Coebergh, Jan Willem W
Rheumatoid arthritis (RA) is a systemic autoimmune disease in which inflammation of the joints is one of the dominant clinical abnormalities resulting in serious morbidity. Over the past decade, tumour necrosis factor (TNF) antagonist has revolutionized the treatment of RA. However, the subsequent increased risk of developing tuberculosis is one of the major drawbacks of this otherwise effective treatment. Latent tuberculosis infection (LTBI) is an asymptomatic form of tuberculosis that is confined by the host's immune system. Active tuberculosis may develop when the immune status weakens. This risk is much higher in patients receiving TNF antagonist. Traditionally, tuberculin skin test (TST) is used to diagnose LTBI. Unfortunately, TST cannot distinguish bacillus Calmette-Guérin (BCG) vaccination from tuberculosis making it difficult to use as a reliable diagnostic tool. In addition, possible anergy and interaction of the altered autoimmune status in rheumatological diseases further complicate the interpretation of TST results. Although interferon-gamma release assay (IGRA) has improved the diagnosis of LTBI in immunocompetent individuals, its respective sensitivity/specificity values are unknown in patients with autoimmune disease due to variable pretest probability and lack of confirmatory test for LTBI. Thus, the use of IGRA for screening LTBI is variable among different countries. This review explores the prevalence of tuberculosis in patients receiving TNF antagonist in countries with different tuberculosis disease burdens and the potential mechanisms for variation in the incidence of tuberculosis with different TNF antagonists, the current practice guidelines for assessing the risk of LTBI in different countries, and the possible solutions for improving diagnosis, monitoring and management of LTBI. PMID:23627398
To, Kin Wang; Reino, Juan J Gomez; Yoo, Dae Hyun; Tam, Lai Shan
Background Polymorphisms in the proinflammatory cytokine genes tumor necrosis factor-? (TNF) and lymphotoxin-? (LTA, also called TNF-?) have been associated with asthma and atopy in some studies. Parental smoking is a consistent risk factor for childhood asthma. Secondhand smoke and ozone both stimulate TNF production. Objectives Our goal was to investigate whether genetic variation in TNF and LTA is associated with asthma and atopy and whether the association is modified by parental smoking in a Mexican population with high ozone exposure. Methods We genotyped six tagging single nucleotide polymorphisms (SNPs) in TNF and LTA, including functional variants, in 596 nuclear families consisting of asthmatics 4–17 years of age and their parents in Mexico City. Atopy was determined by skin prick tests. Results The A allele of the TNF-308 SNP was associated with increased risk of asthma [relative risk (RR) = 1.54; 95% confidence interval (CI), 1.04–2.28], especially among children of non-smoking parents (RR = 2.06; 95% CI, 1.19–3.55; p for interaction = 0.09). Similarly, the A allele of the TNF-238 SNP was associated with increased asthma risk among children of nonsmoking parents (RR = 2.21; 95% CI, 1.14–4.30; p for interaction = 0.01). LTA SNPs were not associated with asthma. Haplotype analyses reflected the single SNP findings in magnitude and direction. TNF and LTA SNPs were not associated with the degree of atopy. Conclusions Our results suggest that genetic variation in TNF may contribute to childhood asthma and that associations may be modified by parental smoking. PMID:17450233
Wu, Hao; Romieu, Isabelle; Sienra-Monge, Juan-Jose; del Rio-Navarro, Blanca Estela; Anderson, Daniel M.; Dunn, Erin W.; Steiner, Lori L.; del Carmen Lara-Sanchez, Irma; London, Stephanie J.
The shape of shark skin - riblet - reduces the skin friction up to 8% in a turbulent boundary layer, as compared to a smooth surface. The sailfish is the fastest sea animal, reaching its maximum speed of 110km/h. On the sailfish skin, we observe a number of V-shaped protrusions pointing downstream. So, we investigate the possibility of skin-friction reduction using this shape. We perform an extensive parametric study by varying the width and height of V-shaped protrusion, the spanwise and streamwise spacings between adjacent ones, and the overall distribution pattern (parallel, staggered and random), respectively. For all the cases considered, drag is either increased or unchanged. Each surface protrusion generates a pair of streamwise vortices, producing low and high shear stresses at the center and side of the protrusion, respectively, but total skin friction is nearly same as or higher than that of a smooth surface. Since this shape is very similar to but opposite in direction to that used in Sirovich & Karlsson (Nature 1997), we perform another experiment on the V-shaped protrusions pointing upstream following their study. Unlike their result, we do not obtain any drag reduction even with random distribution of these V-shaped protrusions.
Sagong, Woong; Choi, Sangho; Kim, Chulkyu; Jeon, Woo-Pyung; Choi, Haecheon
For many years people with colostomies, ileostomies and urinary diversions have had to live in a shadow due to ill-fitting appliances. This has lead to odor problems, skin excoriation, depression, and even withdrawal from society. Dr. Rupert Turnbull from the Cleveland Clinic in Ohio saw the need for an enterostomal therapy service some ten years ago. Patients rehabilitated in self-care by an enterostomal therapist, pre and post-operatively, now rarely have any skin problems. During the last ten years new and better appliances have been developed, and with a well constructed stoma in a suitable site, any ostomate can return to a normal life. PMID:21301501
A Caucasian woman in her 60s with a history of rheumatoid arthritis presented to our institution complaining of skin ulceration. Her initial course was complicated by superinfection and sepsis until a diagnosis of cryofibrinogenaemia was finally established. Cryofibrinogenaemia remains as an under-recognised entity in part, because it can mimic other causes of skin ulcerations. In addition, its diagnosis can be challenging because of the particular handling techniques required of lab specimens. This case exemplifies some of the diagnostic and treatment challenges encountered while managing the patient with cryofibrinogenaemia. PMID:23429017
Sandouk, Zahrae; Alirhayim, Zaid; Hassan, Syed; Qureshi, Waqas
Topical steroids, commonly used for a wide range of skin disorders, are associated with side effects both systemic and cutaneous. This article aims at bringing awareness among practitioners, about the cutaneous side effects of easily available, over the counter, topical steroids. This makes it important for us as dermatologists to weigh the usefulness of topical steroids versus their side effects, and to make an informed decision regarding their use in each individual based on other factors such as age, site involved and type of skin disorder. PMID:25284849
Abraham, Anil; Roga, Gillian
Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic and exogenous or extrinsic factors. Because of the fact that skin health and beauty is considered one of the principal factors representing overall “well-being” and the perception of “health” in humans, several anti-aging strategies have been developed during the last years. It is the intention of this article to review the most important anti-aging strategies that dermatologists have nowadays in hand, including including preventive measurements, cosmetological strategies, topical and systemic therapeutic agents and invasive procedures. PMID:23467476
Ganceviciene, Ruta; Liakou, Aikaterini I.; Theodoridis, Athanasios; Makrantonaki, Evgenia; Zouboulis, Christos C.
Facial skin lesions present routinely to clinic and are largely dermatological in origin. Odontogenic infections are an unusual cause of facial lesion and are well-described in the dental literature; however they are regularly overlooked and mismanaged, often to considerable aesthetic detriment. We present such a case and highlight important avoidable pitfalls. PMID:22542730
Herd, M K; Aldridge, T; Colbert, S D; Brennan, P A
Fluorescent contact chemical allergens provoke sensitization after application on both syngeneic and allogeneic skin grafts in mice. We attempted to determine whether the functional activity in a contact sensitization response of human skin graft was affected at the level of antigen uptake and migration. After xenogeneic skin transplantation, we examined the effect of topical exposure of the graft to rhodamine B isothiocyanate (RITC). This paper describes the migration of RITC-carrying cells and human major histocompatibility complex (MHC) class II DR (HLA-DR)+ cells, from the graft to mouse draining lymph nodes. As demonstrated by immunohistochemistry, grafting resulted in a time-dependent decrease of human HLA-DR+ and CD1a+ cells, and an increase of mouse MHC class II (Ia)+ cells within the graft. Application of RITC on a 3-week-old human skin graft showed optimal migration capability compared to 6- or 9-week-old grafts. In addition, the time-dependent increase of frequencies of RITC+ and HLA-DR+ cells in the draining lymph nodes, and the time-dependent decrease of HLA-DR+ cells in the 3-week-old human skin graft, were concurrent. Supporting these data, human cytokine interleukin-1 alpha (IL-1 alpha), IL-1 beta and tumour necrosis factor-alpha (TNF-alpha), analysis in situ revealed that cytokine production by keratinocytes, a property associated with dendritic cell migration, was preserved in the human skin graft. Thus, like dendritic cells in contact sensitization in allografted skin, dendritic cells from human xenografted skin onto nude mice are capable of migration to mouse draining lymph nodes after allergen application. Induction of contact hypersensitivity is possible in a human skin graft onto nude mice model, although the use of this ex vivo model to analyze contact sensitivity is probably limited to 3 weeks after transplantation. PMID:7490132
Hoefakker, S; Balk, H P; Boersma, W J; van Joost, T; Notten, W R; Claassen, E
Background The advent of skin-sparing mastectomy has allowed for the reconstruction of the breast and nipple with improved cosmesis. However, the nipple-areolar complex (NAC) in Asian patients is more pigmented and scars easily. Therefore, commonly described incisions tend to result in poor aesthetic outcomes in Asian patients with breast cancer. Methods We describe an algorithmic approach to skin-sparing mastectomy incisions in Asian patients on the basis of the location of the biopsy scar and the tumor site and size. Four incision types are described: peri-areolar, a peri-areolar incision with a second distant skin paddle, "racquet handle," and peri-areolar with adjacent skin excision. Results 281 immediate breast reconstructions were performed between May 2001 and February 2012 after skin-sparing mastectomy. The mastectomy incisions used included the peri-areolar design (n=124, 44%), peri-areolar design with a second distant skin paddle (n=39, 14%), "racquet handle" (n=21, 7.5%), and peri-areolar design with adjacent skin excision (n=42, 14%). The traditional elliptical incision and other variants where the NAC outline was not preserved were performed in the remaining 55 patients. The average follow-up was 44.7 months during which there was 1 case of total flap loss and 7 cases of partial flap necrosis; all remaining flaps survived. 24% of the patients (68/281) underwent subsequent nipple reconstruction. Conclusions Our algorithm avoids breast incisions that are randomly placed or excessively long and prevents the unnecessary sacrifice of normal breast skin. This allows skin-sparing mastectomy and immediate breast reconstruction to be performed with a consistently achievable aesthetic result in Asian women without neglecting oncological safety. PMID:25075359
Chim, Harvey; Ng, Zhi Yang; Ong, Kong Wee
White mustard (Sinapis alba L.), a traditional Chinese medicine, is widely used in China for clinical prevention and treatment of the common winter diseases of asthma and bronchitis by percutaneous administration in the summer. The present study is to investigate the skin penetration behavior of white mustard extract to elucidate the possible mechanism underlying its immune regulation activity. The principle active compound of the extract, sinapine thiocyanate (ST), was used as a marker. The skin penetration of ST in white mustard extract was examined in vitro and in vivo. In vitro study on excised guinea pig hairless skin using Franz diffusion cell revealed ST can permeate through the skin and also accumulate in the skin. In vivo study was carried out on the guinea pig hairless skin for 24 h, and then skin was excised for frozen section, ST from the sections were extracted to quantify the amount of drug in different skin layers. The detailed distribution of ST showed that it accumulated in the epidermis, especially in the stratum corneum. After treatment with white mustard extract for 24h, the skin was stained with ATPase, and the morphometric parameters of epidermal LCs were compared to the untreated control through image-analysis system. A statistically significant reduction in LC density and increase in shape factor were observed. Cytokines related to LCs migration including interleukin 1? (IL-1?) and tumor necrosis factor ? (TNF-?) were also measured after white mustard extract treated at different time points. Compared to the untreated group, white mustard extract significantly enhanced the release of IL-1? and TNF?. The morphometric changes of LCs and the local cytokine release after topical white mustard treatment may explain the activity of the white mustard extract against asthma and bronchitis. PMID:24076395
Guo, Xiucai; Lu, Haoyang; Lin, Yuanyuan; Chen, Bao; Wu, Chuanbin; Cui, Zhengrong; Wang, Yinping; Xu, Yuehong
"Skin Cancer- What to Look For" Rochester Recreation Club for the Deaf May 20, 2010 #12;Supporters for the Deaf ("REAP") #12;Overview Skin Overview What is skin cancer? Who is at risk? How common is skin cancer? Signs of skin cancer Prevention Treatments #12;Skin Overview Skin is the largest organ in your body
Goldman, Steven A.
Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft. PMID:24665420
Lim, Hyoseob; Han, Dae Hee; Lee, Il Jae
Despite all modern surgical techniques, skin flap that is considered as the main method in most reconstructive surgeries puts the skin tissue at danger of necrosis and apoptosis derived from ischemia. Therefore, finding a treatment for decreasing the apoptosis derived from flap ischemia will be useful in clinic. In present study, we evaluated the effect of azelaic acid 20% and finasteride on expression of BCL-2 and bax proteins after the skin flap surgery. For this purpose, 21 rats were entered in three groups including control, azelaic acid 20% and finasteride, all experienced skin flap surgery and then flap tissue was assessed for determining the expression of proteins in 5 slices prepared from each rat that were graded between - to +++ scales. Both azelaic acid and finasteride increased the expression of BCL-2 protein (p < 0.05) and decrease the expression of bax protein (p < 0.05). These results suggested an antiapoptotic role for finasteride and azelaic acid in preserving the flap after the ischemia reperfusion insult. PMID:24250563
Ayatollahi, Seyyed Abdulmajid; Ajami, Marjan; Reyhanfard, Hamed; Asadi, Yasin; Nassiri-Kashani, Mansour; Rashighi Firoozabadi, Mehdi; Davoodi, Sayed Hossein; Habibi, Esmaeil; Pazoki-Toroudi, Hamidreza
The ability of essential fatty acids (EFAs) to modulate radiation-induced normal tissue injury was assessed in pig skin. Female Large White pigs (approximately 25 Kg) received 3 ml/day orally of either an 'active' oil [So-1100, containing 9% gamma-linolenic acid (GLA)] or a 'placebo' oil (So-1129) for just 4 weeks before or for 4 weeks before and for 16 weeks after irradiation; localised irradiation of skin was with single doses of beta-rays from 22.5 mm diameter 90Sr/90Y plaques. The severity of the acute reaction, assessed in terms of erythema or moist desquamation, was significantly less in those pigs that received So-1100 both before and after irradiation, as compared with those receiving that oil only prior to irradiation and the 'placebo' groups. Dose modification factors (DMFs) of between 1.13-1.24 were obtained. A similar reduction in the severity of acute skin injury was seen in pigs receiving So-1100 for only 10 weeks after irradiation. Late skin damage, assessed in terms of late erythema or dermal necrosis, was also reduced with So-1100, with DMFs of 1.14-1.51. No such modification was observed if So-1100 was only administered for 4 weeks prior to irradiation. No adverse side-effects were apparent as a result of EFA administration. So-1100 may represent a safe and valuable method of increasing the therapeutic gain in radiotherapy. PMID:8391301
Hopewell, J. W.; Robbins, M. E.; van den Aardweg, G. J.; Morris, G. M.; Ross, G. A.; Whitehouse, E.; Horrobin, D. F.; Scott, C. A.
The association between tissue damage, chronic inflammation and cancer is well known. However, the underlying mechanisms are unclear. Here we characterize a mouse model in which constitutive epidermal extracellular-signal-regulated kinase-MAP-kinase signalling results in epidermal inflammation, and skin wounding induces tumours. We show that tumour incidence correlates with wound size and inflammatory infiltrate. Ablation of tumour necrosis factor receptor (TNFR)-1/-2, Myeloid Differentiation primary response gene 88 or Toll-like receptor (TLR)-5, the bacterial flagellin receptor, but not other innate immune sensors, in radiosensitive leukocytes protects against tumour formation. Antibiotic treatment inhibits, whereas injection of flagellin induces, tumours in a TLR-5-dependent manner. TLR-5 is also involved in chemical-induced skin carcinogenesis in wild-type mice. Leukocytic TLR-5 signalling mediates upregulation of the alarmin HMGB1 (High Mobility Group Box 1) in wound-induced papillomas. HMGB1 is elevated in tumours of patients with Recessive Dystrophic Epidermolysis Bullosa, a disease characterized by chronic skin damage. We conclude that in our experimental model the combination of bacteria, chronic inflammation and wounding cooperate to trigger skin cancer. PMID:25575023
Hoste, Esther; Arwert, Esther N; Lal, Rohit; South, Andrew P; Salas-Alanis, Julio C; Murrell, Dedee F; Donati, Giacomo; Watt, Fiona M
Surfactants in skin cleansers interact with the skin in several manners. In addition to the desired benefit of providing skin hygiene, surfactants also extract skin components during cleansing and remain in the stratum corneum (SC) after rinsing. These side effects disrupt SC structure and degrade its barrier properties. Recent applications of vibrational spectroscopy and two-photon microscopy in skin research have provided molecular-level information to facilitate our understanding of the interaction between skin and surfactant. In the arena of commercial skin cleansers, technologies have been developed to produce cleansers that both cleanse and respect skin barrier. The main approach is to minimize surfactant interaction with skin through altering its solution properties. Recently, hydrophobically modified polymers (HMPs) have been introduced to create skin compatible cleansing systems. At the presence of HMP, surfactants assemble into larger, more stable structures. These structures are less likely to penetrate the skin, thereby resulting in less aggressive cleansers and the integrity of the skin barrier is maintained. In this paper, we reviewed our recent findings on surfactant and SC interactions at molecular level and provided an overview of the HM technology for developing cleansers that respect skin barrier. PMID:22927835
Walters, Russel M.; Mao, Guangru; Gunn, Euen T.; Hornby, Sidney
Dry skin is estimated to be present in about 75% of people aged 75 and over. It has been known for many years that this condition is more frequent in winter, in cold and dry weather conditions. With technological progress, people are now mostly exposed to multiple indoor and outdoor pollutants and environment parameters (air-conditioning, chemicals, noise) which can interact
S. Mac-Mary; J. M. Sainthillier; P. Humbert
Langerhans cells (LCs) are resident dendritic cells (DCs) of the skin possessing intracellular Birbeck granules (BGs). Langerin, a surface protein unique to LCs, can be internalized resulting in BG formation. The standard for characterizing DCs as Langerhans cells is expression of the protein, lange...
Medical science has vastly improved on the means and methods available for the treatment of wounds in the clinic. The production and use of various types of skin substitutes has led to dramatic improvements in the odds of survival for severely burned patients, but they have also shown promise for many other applications, including cases involving chronic wounds that are
F. A. Auger; D. Lacroix; L. Germain
Estee Lauder uses digital image analyzer and software based on NASA lunar research in evaluation of cosmetic products for skincare. Digital image processing brings out subtleties otherwise undetectable, and allows better determination of product's effectiveness. Technique allows Estee Lauder to quantify changes in skin surface form and structure caused by application of cosmetic preparations.
The "skin, scale, feather, and fur" program was designed to provide children in the New York City public schools with knowledge about various animal species and their place in the animal world. Teacher and paraprofessional staff along with the Staten Island Zoo Personnel developed activities and instructed children at the zoo. They also conducted…
Human papillomavirus (HPV) appears to be the most ubiquitous of the human viruses. Over 100 HPV types have been identified. A minority of HPV cause cutaneous warts and mucosal condylomata. The HPV that cause mucosal condylomata put the patient at various degrees of risk for developing cancers, particularly cervical cancer. The majority of HPV infect the skin of normal and
Alfred B. Jenson; Stanley Geyer; John P. Sundberg; Shin-je Ghim
The judiciary needs forensic medicine to determine the difference between an entry hole and an exit hole in human skin caused by firearms for civilian use. This important information would be most useful if a practical and accurate method could be done with low-cost and minimal technological resources. Both macroscopic and microscopic analyses were performed on skin lesions caused by firearm projectiles, to establish histological features of 14 entry holes and 14 exit holes. Microscopically, in the abrasion area macroscopically observed, there were signs of burns (sub-epidermal cracks and keratinocyte necrosis) in the entrance holes in all cases. These signs were not found in three exit holes which showed an abrasion collar, nor in other exit holes. Some other microscopic features not found in every case were limited either to entry holes, such as cotton fibres, grease deposits, or tattooing in the dermis, or to exit holes, such as adipose tissue, bone or muscle tissue in the dermis. Coagulative necrosis of keratinocytes and sub-epidermal cracks are characteristic of entry holes. Despite the small sample size, it can be safely inferred that this is an important microscopic finding, among others less consistently found, to define an entry hole in questionable cases. PMID:24931861
Baptista, Marcus Vinícius; d'Ávila, Solange C G P; d'Ávila, Antônio Miguel M P
Tumor necrosis factor-? (TNF-?) is a pleiotropic cytokine that becomes elevated in chronic inflammatory states such as hypertension and diabetes and has been found to mediate both increases and decreases in blood pressure. High levels of TNF-? decrease blood pressure, whereas moderate increases in TNF-? have been associated with increased NaCl retention and hypertension. The explanation for these disparate effects is not clear but could simply be due to different concentrations of TNF-? within the kidney, the physiological status of the subject, or the type of stimulus initiating the inflammatory response. TNF-? alters renal hemodynamics and nephron transport, affecting both activity and expression of transporters. It also mediates organ damage by stimulating immune cell infiltration and cell death. Here we will summarize the available findings and attempt to provide plausible explanations for such discrepancies. PMID:23515717
Garvin, Jeffrey L.
There is no consensus on the optimal antiviral regimen in the management of acute retinal necrosis, a disease caused by herpetic viruses with devastating consequences for the eye. The current gold standard is based on retrospective case series. Because the incidence of disease is low, few well-designed, randomized trials have evaluated treatment dosage and duration. Newer oral antiviral agents are emerging as alternatives to high-dose intravenous acyclovir, avoiding the need for inpatient intravenous treatment. Drug resistance is uncommon but may also be difficult to identify. Antiviral drugs have few side effects, but special attention needs to be paid to patients who have underlying renal disease, are pregnant or are immunocompromised. PMID:20169044
Tam, Patrick MK; Hooper, Claire Y; Lightman, Susan
A minute dose of bacterial endotoxin is known to cause lethal shock in BCG (Bacillus Calmette Guérin)-sensitized mice and rats. To gain insight into the mechanism of this hypersensitivity to endotoxin, serum (tumor necrosis serum: TNS) was prepared from BCG-sensitized Lewis rats following endotoxin challenge and injected intravenously into Lewis rats 2 days after their partial hepatectomy. TNS injection caused lethal shock in Hpx (partially hepatectomized) rats but not in normally fed, fasted, or sham-operated rats. Hpx rats survived injection of serum prepared by either BCG sensitization or endotoxin challenge alone. Biochemical and histological examination of the Hpx rats injected with TNS indicated that profound hypoglycemia, hepatic and renal injury, and dysfunction of the coagulation system accompanied by hemorrhage were involved in the lethal shock. These experiments also suggested that serum component(s), probably monokine(s) derived from activated macrophages, might participate in the endotoxin shock in BCG-sensitized rats. PMID:3056630
Fukushima, H; Ikeuchi, J; Tohkin, M; Matsubara, T; Harada, M
Condom catheters are often used in the management of male urinary incontinence, and are considered to be safe. As condom catheters are placed on the male genitalia, sometimes adequate care is not taken after placement owing to poor medical care of debilitated patients and feelings of embarrassment and shame. Similarly, sometimes the correct size of penile sheath is not used. Strangulation of penis due to condom catheter is a rare condition; only few such cases have been reported in the literature. Proper application and routine care of condom catheters are important in preventing this devastating complication especially in a neurologically debilitated population. We present a case of penile necrosis due to condom catheter. We will also discuss proper catheter care and treatment of possible complications. PMID:23758994
Ozkan, Heval S; Irkoren, Saime; Sivrio?lu, Nazan
Tumor necrosis factor-? (TNF, cachectin), a protein secreted by activated macrophages, participates in inflammatory responses and in infectious and neoplastic disease states. The mechanisms by which TNF exerts cytotoxic, hormonal, and other specific effects are obscure. Structural studies of the TNF trimer have revealed a central pore-like region. Although several amino acid side chains appear to preclude an open channel, the ability of TNF to insert into lipid vesicles raised the possibility that opening might occur in a bilayer milieu. Acidification of TNF promoted conformational changes concordant with increased surface hydrophobicity and membrane insertion. Furthermore, TNF formed pH-dependent, voltage-dependent, ion-permeable channels in planar lipid bilayer membranes and increased the sodium permeability of human U937 histiocytic lymphoma cells. Thus, some of the physiological effects of TNF may be elicited through its intrinsic ion channel-forming activity.
Kagan, Bruce L.; Baldwin, Rae Lynn; Munoz, David; Wisnieski, Bernadine J.
Lewis lung carcinoma and EMT6 sarcoma growing as solid tumors in mice caused a gradual increase in the susceptibility of the animals to lethal toxicity of endotoxins (lipopolysaccharides [LPS]). By day 15 following inoculation of the tumors, the 50% lethal dose of LPS, which in normal mice was approximately 400 micrograms, decreased to 2 micrograms for the sarcoma-bearing mice and 0.1 microgram for the carcinoma-bearing mice. This sensitization to endotoxin was paralleled by a high sensitization to tumor necrosis factor (TNF). Human recombinant TNF given to normal mice was lethal at about 500 micrograms. It was lethal for 50% of the animals bearing EMT6 or Lewis lung carcinoma tumors in amounts of 4 and 0.01 micrograms, respectively, on day 15 following tumor inoculation. The sensitization of tumor-bearing animals to LPS and TNF was paralleled by marked granulocytosis. PMID:3623699
Bartholeyns, J; Freudenberg, M; Galanos, C
Acute gastric dilatation can have multiple etiologies which may lead to ischemia of the stomach. Without proper timely diagnosis and treatment, potentially fatal events such as gastric perforation, haemorrhage, and other serious complications can occur. Here we present a 36-year-old man who came to the casualty with pain abdomen and distension for 2 days. Clinically, abdomen was asymmetrically distended more in the left hypochondrium and epigastrium region. Straight X-ray abdomen showed opacified left hypochondrium with nonspecific gaseous distension of bowel. Exploratory laparotomy revealed dilated stomach with patchy gangrene over lesser curvature and fundic area. About 4 litres of brownish fluid along with semisolid undigested food particles was sucked out (mainly undigested pieces of meat). Limited resection of gangrenous areas and primary repair were done along with feeding jejunostomy. Necrosis of the stomach was confirmed on histopathology. The patient recovered well and was discharged on the tenth postoperative day. PMID:24222883
Sahoo, Manash Ranjan; Kumar, Anil T.; Jaiswal, Sunil; Bhujabal, Siba Narayan
Progressive outer retinal necrosis syndrome (PORN) is a variant of necrotizing herpetic retinopathy and the majority of the described cases were related to acquired immunodeficiency syndrome. We present a patient who is HIV negative with nephrotic syndrome and prednisolone use for 4 months who showed clinical features of PORN. Low CD4 counts and lymphocytopenia suggested immunosuppression. In the left eye, tractional retinal detachment at the posterior pole followed by incomplete posterior vitreous detachment developed. In addition to intravenous administration of acyclovir, vitreous surgeries including stripping of the posterior hyaloid and silicone-oil tamponade were successfully performed to repair the retinal detachment in the left eye and to prevent it in the right eye. PMID:11195746
Shinoda, K; Inoue, M; Ishida, S; Kawashima, S; Wakabayashi, T; Suzuki, S; Katsura, H
Sarcoidosis is a chronic multisystem disease of unknown etiology, characterized by noncaseating granulomatous infiltration of virtually any organ system. Treatment is often undertaken in an attempt to resolve symptoms or prevent progression to organ failure. Previous studies have suggested a prominent role for tumor necrosis factor-alpha (TNF-?) in the inflammatory process seen in sarcoidosis. TNF-? and interleukin-1 are released by alveolar macrophages in patients with active lung disease. Corticosteroids have proved to be efficacious in the treatment of sarcoidosis, possibly by suppressing the production of TNF-? and other cytokines. Three agents are currently available as specific TNF antagonists: etanercept, infliximab, and adalimumab. Although data from noncomparative trials suggest that all three have comparable therapeutic effects in rheumatoid arthritis, their effects in a granulomatous disease such as sarcoidosis are less consistent. In this review, current data on the effectiveness are summarized. PMID:19337437
Callejas-Rubio, José Luis; López-Pérez, Lourdes; Ortego-Centeno, Norberto
The recent effort leads to reliable imaging techniques which can help to a surgeon during operations. The fluorescence spectroscopy was selected as very useful online in vivo imaging method to organics and biological materials analysis. The presented work scopes to a laser induced fluorescence spectroscopy technique to detect tissue local necrosis in small intestine surgery. In first experiments, we tested tissue auto-fluorescence technique but a signal-to-noise ratio didn't express significant results. Then we applied a contrast dye - IndoCyanine Green (ICG) which absorbs and emits wavelengths in the near IR. We arranged the pilot experimental setup based on highly coherent extended cavity diode laser (ECDL) used for stimulating of some critical areas of the small intestine tissue with injected ICG dye. We demonstrated the distribution of the ICG exciter with the first file of shots of small intestine tissue of a rabbit that was captured by high sensitivity fluorescent cam.
Cip, Ondrej; Buchta, Zdenek; Lesundak, Adam; Randula, Antonin; Mikel, Bretislav; Lazar, Josef; Veverkova, Lenka
Infected pancreatic necrosis carries a high morbidity and mortality from sepsis and multisystem organ failure. Following confirmation of the infection by CT-guided fine needle aspiration, treatment consists of broad spectrum antibiotics (imipenim-cilastin) followed by emergency open (laparotomy) digital necrosectomy and insertion of drains for postoperative lavage with hyperosmolar dialysate as advocated by Beger et al. This video shows an alternative laparoscopic technique to open necrosectomy and has been used in Dundee since 1994. After elevation of the transverse colon, the lesser sac is opened through the root of the transverse colon between the middle and left colic vessels. The necrosectomy is accomplished from inside the lesser sac under vision with a combination of pulsed irrigation and graspers. On completion of the necrosectomy, two large drains are inserted into the lesser sac for postoperative irrigation. The experience with this technique has been favorable with a patient survival of 85%. PMID:14973724
Adamson, G D; Cuschieri, A
Case Report: We report here on a 58-year-old patient with abnormal findings in the left breast on screening mammography (October 2012). In May 2008 the patient was diagnosed with rectal cancer, subsequently treated by surgical resection followed by radiochemotherapy. In September 2011 the patient was diagnosed with peritoneal cancer. Extravasation of folinic acid occurred during palliative chemotherapy, which was delivered through a surgically implanted port, placed prepectorally on the left side. The patient had not previously undergone breast surgery. The abnormal finding in the left breast was located at the 1–2 o?clock position. The mammogram showed extensive hyperdense nodules with predominantly round, fine granular calcifications. On sonography, the findings presented as a hypoechogenic, inhomogenous, partially diffuse, partly solid, partly cystic mass with individual calcifications and reduced echogenicity in the dorsal aspect. Strong densification of the left breast was found at the corresponding position on palpation. On computed tomography (CT) done during follow-up for rectal cancer, new streaky/pitted densifications were noted in the left breast. Based on the patient?s previous history and the results of the breast diagnostics a diagnosis of extensive fat necrosis after folinic acid extravasation was made. No further measures were taken. The patient will continue to be screened using mammography. Conclusion: A good knowledge of the mammographic and sonographic features of fat necrosis can reduce the number of unnecessary biopsies. Careful consideration of the patient?s prior medical history is very important in breast diagnostics and may often be decisive for the correct diagnosis. PMID:24771912
Hammon, M.; Dilbat, G.; Schulz-Wendtland, R.
Necroptosis is a newly described form of regulated necrosis that contributes to neuronal death in experimental models of stroke and brain trauma. Although much work has been done elucidating initiating mechanisms, signaling events governing necroptosis remain largely unexplored. Akt is known to inhibit apoptotic neuronal cell death. Mechanistic target of rapamycin (mTOR) is a downstream effector of Akt that controls protein synthesis. We previously reported that dual inhibition of Akt and mTOR reduced acute cell death and improved long term cognitive deficits after controlled-cortical impact in mice. These findings raised the possibility that Akt/mTOR might regulate necroptosis. To test this hypothesis, we induced necroptosis in the hippocampal neuronal cell line HT22 using concomitant treatment with tumor necrosis factor ? (TNF?) and the pan-caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone. TNF?/zVAD treatment induced cell death within 4?h. Cell death was preceded by RIPK1-RIPK3-pAkt assembly, and phosphorylation of Thr-308 and Thr473 of AKT and its direct substrate glycogen synthase kinase-3?, as well as mTOR and its direct substrate S6 ribosomal protein (S6), suggesting activation of Akt/mTOR pathways. Pretreatment with Akt inhibitor viii and rapamycin inhibited Akt and S6 phosphorylation events, mitochondrial reactive oxygen species production, and necroptosis by over 50% without affecting RIPK1-RIPK3 complex assembly. These data were confirmed using small inhibitory ribonucleic acid-mediated knockdown of AKT1/2 and mTOR. All of the aforementioned biochemical events were inhibited by necrostatin-1, including Akt and mTOR phosphorylation, generation of oxidative stress, and RIPK1-RIPK3-pAkt complex assembly. The data suggest a novel, heretofore unexpected role for Akt and mTOR downstream of RIPK1 activation in neuronal cell death. PMID:24577082
Liu, Q; Qiu, J; Liang, M; Golinski, J; van Leyen, K; Jung, J E; You, Z; Lo, E H; Degterev, A; Whalen, M J
Necroptosis is a newly described form of regulated necrosis that contributes to neuronal death in experimental models of stroke and brain trauma. Although much work has been done elucidating initiating mechanisms, signaling events governing necroptosis remain largely unexplored. Akt is known to inhibit apoptotic neuronal cell death. Mechanistic target of rapamycin (mTOR) is a downstream effector of Akt that controls protein synthesis. We previously reported that dual inhibition of Akt and mTOR reduced acute cell death and improved long term cognitive deficits after controlled-cortical impact in mice. These findings raised the possibility that Akt/mTOR might regulate necroptosis. To test this hypothesis, we induced necroptosis in the hippocampal neuronal cell line HT22 using concomitant treatment with tumor necrosis factor ? (TNF?) and the pan-caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone. TNF?/zVAD treatment induced cell death within 4?h. Cell death was preceded by RIPK1–RIPK3–pAkt assembly, and phosphorylation of Thr-308 and Thr473 of AKT and its direct substrate glycogen synthase kinase-3?, as well as mTOR and its direct substrate S6 ribosomal protein (S6), suggesting activation of Akt/mTOR pathways. Pretreatment with Akt inhibitor viii and rapamycin inhibited Akt and S6 phosphorylation events, mitochondrial reactive oxygen species production, and necroptosis by over 50% without affecting RIPK1–RIPK3 complex assembly. These data were confirmed using small inhibitory ribonucleic acid-mediated knockdown of AKT1/2 and mTOR. All of the aforementioned biochemical events were inhibited by necrostatin-1, including Akt and mTOR phosphorylation, generation of oxidative stress, and RIPK1–RIPK3–pAkt complex assembly. The data suggest a novel, heretofore unexpected role for Akt and mTOR downstream of RIPK1 activation in neuronal cell death. PMID:24577082
Liu, Q; Qiu, J; Liang, M; Golinski, J; van Leyen, K; Jung, J E; You, Z; Lo, E H; Degterev, A; Whalen, M J
Papillomaviruses (HPVs) are small non-enveloped icosahedral viruses that infect the keratinocytes of skin and mucosa. The cutaneous HPV types are represented mainly by the beta and gamma genera, which are widely present in the skin of normal individuals. More than 40 beta-HPV types and 50 gamma-HPV types have been isolated, and these numbers are continuously growing. The main cause of non-melanoma skin cancer is exposure to ultraviolet radiation (UVR). However, cutaneous HPVs that belong to the beta genus may act as a co-carcinogen with UVR. The association between beta-HPVs and skin cancer was first reported in patients with epidermodysplasia verruciformis (EV), who frequently develop cutaneous squamous cell carcinoma (SCC) on sun-exposed areas. Isolation of HPVs from the lesions suggested that HPVs might act as a co-carcinogen with UVR in EV patients. Beta-HPVs may also play a role in cutaneous SCC in immunocompromised non-EV and in immunocompetent individuals. Several studies have reported an association of viral DNA and/or antibodies to beta HPV types with SCC. Interestingly, HPV prevalence and viral load decrease during skin carcinogenesis, being significantly higher in actinic keratosis than in SCC, suggesting that the virus may play a role in the early stages of tumour development (the "hit-and-run" hypothesis). Concordantly, in vivo and in vitro studies have shown that E6 and E7 from certain cutaneous HPV types display transforming activities, further confirming their potential role in carcinogenesis. PMID:25451638
Accardi, Rosita; Gheit, Tarik
Water pollution is known to play an important role in the pathogenesis of plastron, carapace and skin diseases of turtles. In this study, a total of 150 European pond turtles (Emys orbicularis) of different age and both sexes, originating from natural habitats in Serbia, were examined for morphological changes of the skin, plastron, carapace and skeletal system. The turtles were taken out from their natural habitats in Lake Ludas, Lake Palic and Lake Tresetiste. After artificial hibernation, they were subjected to detailed examination, sampled and treated, and finally returned into their natural habitat. Biopsies from the skin and shell were subjected to histopathological examination and microbiological analysis. X-ray scanning was also performed to detect changes in the skeletal system. Macroscopic changes of the skin, most frequently degenerative, inflammatory or neoplastic diseases, were diagnosed in 49.33% of the turtles examined. Dermatitis of different origin and form was the most prominent histopathological finding (28.00%). In the plastron, inflammatory and degenerative processes were frequently found. Osteopathy and mechanical injuries were the dominant findings. Macroscopic changes of the plastron, carapace and skeletal system were diagnosed in 67.33% of the turtles examined. Using X-ray scanning, generalised osteopathy, anomalies and malformations of different aetiology were also diagnosed on the tail and legs. Microbiological examinations showed the presence of a variety of bacterial and fungal agents, either primary pathogens or potential polluters, which invaded the skin and shell, or were present in cloacal swab samples. Bacterial infection was diagnosed in 76.66% of the turtles, first of all in those with skin and shell necrosis. Mycoses were diagnosed in 33.33% of the animals. PMID:24334084
Aleksi?-Kova?evi?, Sanja; Ozvegy, József; Krsti?, Nikola; Rusvai, Miklós; Jakab, Csaba; Stanimirovi?, Zoran; Becskei, Zsolt
SKIN MOLE MATCHING INCORPORATING TEMPLATE NORMALIZED COORDINATES HENGAMEH MIRZAALIAN1 , GHASSAN. Dermatology and Skin Science, University of British Columbia, BC, Canada Abstract: Density of moles propose using an automatic graph- based approach for finding corresponding moles. We evaluate our proposed
Steady conduction heat transfer between the body core and the skin is modeled to find temperature distribution through a subskin layer. The effect of varying the outside heat transfer coefficient on the skin temperature and heat loss is predicted.
Krane, Matthew J.
Electron probe x-ray microanalysis was used to study elemental distribution in uninvolved and involved skin from patients with psoriasis, and in skin from healthy controls. Significant differences were found between the involved and uninvolved psoriatic skin. In the involved skin, the concentrations of Mg, P, and K were higher in the stratum germinativum, spinosum, and granulosum, compared to the corresponding strata in uninvolved skin. Neither involved nor uninvolved psoriatic stratum germinativum differed markedly from nonpsoriatic control stratum germinativum. In uninvolved psoriatic skin only a lower level of K was noted. In comparison to uninvolved psoriatic skin, the elemental composition of the various strata of involved psoriatic skin shows a pattern typical for highly proliferative, nonneoplastic cells.
Grundin, T.G.; Roomans, G.M.; Forslind, B.; Lindberg, M.; Werner, Y.
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4660 Skin marker. (a) Identification. A skin marker is a pen-like...
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4660 Skin marker. (a) Identification. A skin marker is a pen-like...
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4660 Skin marker. (a) Identification. A skin marker is a pen-like...
Glioblastoma (GBM) has explosive biologic properties with rapid clinical progression leading to death. Its distinguishing pathologic features, necrosis with surrounding pseudopalisades and microvascular hyperplasia, are believed to be instrumental to its accelerated growth. Microvascular hyperplasia arises in response to the secretion of proangiogenic factors by hypoxic pseudopalisades and allows for peripheral neoplastic expansion. Mechanisms underlying necrosis and hypoxia remain obscure,
Daniel J Brat; Erwin G Van Meir
Block copolymer nanotemplating of tobacco mosaic and tobacco necrosis viruses q Arthur V. Cresce This paper examines the interaction between a block copolymer and a virus. A poly(styrene-b-4-vinylpyridine of tobacco mosaic virus (TMV) and tobacco necrosis virus on microphase-separated PS/P4VPÂ Ni was examined
Rubloff, Gary W.
Conjunctival necrosis is a rare complication following periocular/intraocular triamcinolone acetonide injection and has been reported extensively in adults. We describe a child who developed conjunctival necrosis following subconjunctival injection of triamcinolone acetonide for severe chronic anterior uveitis. Prompt diagnosis and management of this uncommon condition is vital.
Ying-Jiun, Chong; Chee-Kuen, Wong; Shatriah, Ismail
This paper describes a case of wide mandibular bone necrosis associated with significant soft tissues injury after using an arsenical endodontic preparation in the right lower second molar for endodontic purpose. Authors debate about the hazardous effects of the arsenic paste and the usefulness of piezosurgery for treatment of this drug related bone necrosis. PMID:24062957
Giudice, A.; Cristofaro, M. G.; Barca, I.; Novembre, D.; Giudice, M.
During ischemic brain injury, glutamate accumulation leads to overstimulation of postsynaptic glutamate receptors with intracellular Ca2+ overload and neuronal cell death. Here we show that glutamate can induce either early necrosis or delayed apoptosis in cultures of cerebellar granule cells. During and shortly after exposure to glutamate, a subpopulation of neurons died by necrosis. In these cells, mitochondrial membrane potential
Maria Ankarcrona; Jeannette M. Dypbukt; Emanuela Bonfoco; Boris Zhivotovsky; Sten Orrenius; Stuart A. Lipton; Pierluigi Nicotera
Human atherosclerotic plaques express the metalloprotease tumor necrosis factor (TNF)-? converting enzyme (TACE/ADAM-17), which cleaves several transmembrane proteins including TNF and its receptors (TNFR-1 and TNFR-2). Plaques also harbor submicron vesicles (microparticles, MPs) released from plasma membranes after cell activation or apoptosis. We sought to examine whether TACE/ADAM17 is present on human plaque MPs and whether these MPs would affect TNF and TNFR-1 cellular shedding. Flow cytometry analysis detected 12,867 ± 2007 TACE/ADAM17+ MPs/mg of plaques isolated from 25 patients undergoing endarterectomy but none in healthy human internal mammary arteries. Plaque MPs harbored mainly mature active TACE/ADAM17 and dose dependently cleaved a pro-TNF mimetic peptide, whereas a preferential TACE/ADAM17 inhibitor (TMI-2) and recombinant TIMP-3 prevented this cleavage. Plaque MPs increased TNF shedding from the human cell line ECV-304 overexpressing TNF (ECV-304TNF), as well as TNFR-1 shedding from activated human umbilical vein endothelial cells or ECV-304TNF cells, without affecting TNF or TNFR-1 synthesis. MPs also activated the shedding of the endothelial protein C receptor from human umbilical vein endothelial cells. All these effects were inhibited by TMI-2. The present study shows that human plaque MPs carry catalytically active TACE/ADAM17 and significantly enhance the cell surface processing of the TACE/ADAM17 substrates TNF, TNFR-1, and endothelial protein C receptor, suggesting that TACE/ADAM17+ MPs could regulate the inflammatory balance in the culprit lesion. PMID:17872973
Canault, Matthias; Leroyer, Aurélie S.; Peiretti, Franck; Lesèche, Guy; Tedgui, Alain; Bonardo, Bernadette; Alessi, Marie-Christine; Boulanger, Chantal M.; Nalbone, Gilles
The results of a series of four clinical studies demonstrated that disposable baby wipes were milder to the skin than use of a cotton washcloth and water, recognized as a "gold standard" for skin mildness. Importantly, the baby wipes caused no significant change from the baseline value in any of the skin parameters examined. This observation verified that the test wipes are minimally disruptive to the epidermal barrier and thus suitable for use on intact or compromised, irritated skin. PMID:11917305
Odio, M; Streicher-Scott, J; Hansen, R C
Human skin is a complex organ that provides protection and regulates our interaction with the outside environment. The skin\\u000a is composed of three layers, which include the epidermis, dermis, and hypodermis. Skin appendages include hair follicles,\\u000a sebaceous glands, and sweat glands. These appendages are unevenly distributed on the skin. The stratum corneum is the outer\\u000a protective layer of the epidermis
G. James; E. Swogger; E. deLancey-Pulcini
Recently developed immunohistochemical methods permit the visualization of intraepiderma! nerve fibers (ENFs) in punch skin biopsies and skin blisters. ENF density has been shown to be diminished in diabetic neuropathy as well as other focal and generalized sensory-predominant neuropathies, including the neuropathy associated with anti-retroviral therapy, idiopathic small-fiber sensory neuropathy, Fabry disease, and diabetic truncal radiculopathy. ENF depletion is often found prior to the development of clinical or eleo trodiagnostic abnormalities, making this procedure arguably the most sensitive diagnostic test for sensory neuropathies, particularly those with predominant involvement of unmyelinated fibers. Characteristic morphologic changes of epidermal nerves and the subepidermal neural plexus are often seen in these conditions as well. The fibers visualized by this technique are thought to be polymodal heat and mechanical nociceptors. We review the history, clinical applications, and methodology of this exciting technique. PMID:19078588
Kennedy, W R; Wendelschafer-Crabb, G; Walk, D
This paper presents a contribution in the field of image processing for dermatological of skin lesions. Psoriasis skin lesion's images were digitally captured under controlled environment. These images were processed to produce color histograms to obtain color variegation metric. This paper shows that certain normalization technique can be employed to distinguish three types of psoriasis skin diseases infecting the Malaysian
Rozita Jailani; H. Hashim; M. Nasir Taib
Nonmelanoma skin cancer is the most common human malignancy. An estimated 2.75 million patients worldwide are diagnosed with skin cancer each year, with more than one million in the United States alone. Treatment for skin cancer includes methods such as cryosurgery, curettage and electrodessication, local excision, and Mohs micrographic surgery. Regardless of the method used, the goal is to provide
Margaret L. Anthony
Today skin cancer is mainly treated by surgical interventions. New findings concerning molecular biology and the signaling pathways in epithelial skin cancers such as basal cell carcinoma, squamous cell carcinoma or melanoma, and mesenchymal skin cancers such as angiosarcoma and dermatofibrosarcoma protuberans (DFSP) have identified new molecular targets for a systemic or local treatment approach. For DFSP there is an
M. B. Karpova; M. J. Barysch; M. C. Zipser; N. Schönewolf; L. E. French; R. Dummer
...United States Standards for Grades of Potatoes 1 Skinning § 51.1549 Skinning...provide a basis for describing lots of potatoes as to the degree of skinning whenever...means that not more than 5 percent of the potatoes in the lot have more than one-tenth...
\\u000a There are over 1 million cases of skin cancer diagnosed yearly in the United States. The majority of these are nonmelanoma\\u000a (NMSCs) and are associated with chronic exposure to ultraviolet light (UV). Actinic keratosis (AK) has been identified as\\u000a a precursor for SCC, but not for BCC. AKs are far more common than SCC, making them excellent targets for chemoprevention.
Janine G. Einspahr; G. Timothy Bowden; David S. Alberts
A diffusion model for the skin penetration of drug in the finite-dose system was developed considering the skin to be composed of two layers, the outermost layer (stratum corneum) and the lower layer (viable epidermis and dermis). Based on this skin model, the Laplace transforms of the equations for the drug amounts in the receptor, the vehicle, and the skin
Hirokazu Okamoto; Fumiyoshi Yamashita; Kyoko Saito; Mitsuru Hashida
The complexity of immune response-associated cells present in normal human skin was recently redefined as the skin immune system (SIS). In the present study, the exact immunophenotypes of lymphocyte subpopulations with their localizations in normal human skin were determined quantitatively. B cells were not found to be present in normal human skin. Lymphocytes were always of T-cell type, and 90%
Jan D. Bos; Ingrid Zonneveld; Pranab K. Das; Suze R. Krieg; Chris M. van der Loos; Martien L. Kapsenberg
It has been demonstrated that zinc exerts its beneficial influence on skin fibroblasts. Propolis, a complex mixture of plant-derived and bees' products, was reported to stimulate cicatrization processes in skin and prevent infections. The aim of this study was to find out how zinc and propolis influence human skin fibroblasts in cell culture and to compare the effect of individual compounds to the effect of a mixture of zinc and propolis. In this study, zinc, as zinc aspartate, at a concentration of 16 ?M, increased human fibroblasts proliferation in cell culture, whereas propolis at a concentration of 0.01% (w/v) revealed antiproliferative and cytotoxic action followed by mild cell necrosis. In culture, zinc was effectively transported into fibroblasts, and propolis inhibited the amount of zinc incorporated into the cells. An addition of propolis to the medium caused a decrease in the Zn(II) amount incorporated into fibroblasts. The obtained results also indicate an appreciable antioxidant property of propolis and revealed its potential as a supplement when applied at doses lower than 0.01% (w/v). In conclusion, the present study showed that zinc had a protective effect on human cultured fibroblasts' viability, although propolis revealed its antiproliferative action and caused mild necrosis. PMID:24913100
Tyszka-Czochara, Ma?gorzata; Pa?ko, Pawe?; Reczy?ski, Witold; Szlósarczyk, Marek; Bystrowska, Beata; Opoka, W?odzimierz
S100A6 is induced in myocardium post-infarction in vivo and in response to growth factors and inflammatory cytokines in vitro. Forced expression of S100A6 in cardiomyocytes inhibits regulation of cardiac specific gene expression in response to trophic stimulation. To define regulation and function of S100A6, we characterized the human S100A6 promoter and mapped upstream regulatory elements in rat neonatal cardiac myocytes, fibroblasts, and vascular smooth muscle cells and defined a functional role for S100A6 in tumor necrosis factor-?-induced myocyte apoptosis. The functional S100A6 promoter was localized to region -167/+134 containing 167 upstream base pairs. The S100A6 promoter is regulated by positive (-361/-167 and -588/-361) and negative (-1371/-1194) elements. Tumor necrosis factor-? induced the maximal S100A6 promoter and transcription factor NF-?B (p65 subunit). Electrophoretic mobility shift showed that tumor necrosis factor-? induced p65 binding to a potential NF-?B-binding site at -460/-451. Chromatin immunoprecipitation analysis revealed p65 is recruited to the S100A6 promoter upon tumor necrosis factor-? stimulation. The NF-?B inhibitor caffeic acid phenethyl ester and mutation of the NF-?B-binding site inhibited S100A6 promoter activation by tumor necrosis factor-?. Tumor necrosis factor-? induced cardiac myocyte apoptosis. Specific inhibition of S100A6 using a small interfering RNA directed against S100A6 potentiated tumor necrosis factor-?-induced myocyte apoptosis, whereas overexpression of S100A6 by gene transfer prevented tumor necrosis factor-?-induced myocyte apoptosis by interfering with p53 phosphorylation. These results demonstrate that S100A6 is induced by tumor necrosis factor-? via an NF-?B-dependent mechanism, serving a role in homeostasis to limit tumor necrosis factor-?-induced apoptosis by regulating p53 phosphorylation. PMID:18753141
Tsoporis, James N.; Izhar, Shehla; Parker, Thomas G.
Lewisite is a potent chemical warfare arsenical vesicant that can cause severe skin lesions. Today, lewisite exposure remains possible during demilitarization of old ammunitions and as a result of deliberate use. Although its cutaneous toxicity is not fully elucidated, a specific antidote exists, the British anti-lewisite (BAL, dimercaprol) but it is not without untoward effects. Analogs of BAL, less toxic, have been developed such as meso-2,3-dimercaptosuccinic acid (DMSA) and have been employed for the treatment of heavy metal poisoning. However, efficacy of DMSA against lewisite-induced skin lesions remains to be determined in comparison with BAL. We have thus evaluated in this study the therapeutic efficacy of BAL and DMSA in two administration modes against skin lesions induced by lewisite vapor on SKH-1 hairless mice. Our data demonstrate a strong protective efficacy of topical application of dimercapto-chelating agents in contrast to a subcutaneous administration 1 h after lewisite exposure, with attenuation of wound size, necrosis and impairment of skin barrier function. The histological evaluation also confirms the efficacy of topical application by showing that treatments were effective in reversing lewisite-induced neutrophil infiltration. This protective effect was associated with an epidermal hyperplasia. However, for all the parameters studied, BAL was more effective than DMSA in reducing lewisite-induced skin injury. Together, these findings support the use of a topical form of dimercaprol-chelating agent against lewisite-induced skin lesion within the first hour after exposure to increase the therapeutic management and that BAL, despite its side-effects, should not be abandoned. - Highlights: • Topically applied dimercapto-chelating agents reduce lewisite-induced skin damage. • One topical application of BAL or DMSA is sufficient to reverse lewisite effects. • Topical BAL is more effective than DMSA to counteract lewisite-induced skin damage.
Mouret, Stéphane, E-mail: firstname.lastname@example.org [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France); Wartelle, Julien; Emorine, Sandy; Bertoni, Marine; Nguon, Nina; Cléry-Barraud, Cécile [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France); Dorandeu, Frédéric [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France); Ecole du Val-de-Grâce, 1 place Alphonse Laveran, Paris (France); Boudry, Isabelle [Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées, Centre de Recherches du Service de Santé des Armées, 24 avenue Maquis du Grésivaudan, 38700 La Tronche (France)
Anyone Can Get Skin Cancer: Information for Hispanics. This article addresses myths about skin cancer and discusses how everyone can protect their skin. It also introduces an NCI publication for minorities: Anyone Can Get Skin Cancer.
An increasing progress on the role of Hedgehog (Hh) signaling for carcinogenesis has been achieved since the link of Hh pathway to human cancer was firstly established. In particular, the critical role of Hh signaling in the development of Basal cell carcinoma (BCC) has been convincingly demonstrated by genetic mutation analyses, mouse models of BCCs, and successful clinical trials of BCCs using Hh signaling inhibitors. In addition, the Hh pathway activity is also reported to be involved in the pathogenesis of Squamous Cell Carcinoma (SCC), melanoma and Merkel Cell Carcinoma. These findings have significant new paradigm on Hh signaling transduction, its mechanisms in skin cancer and even therapeutic approaches for BCC. In this review, we will summarize the major advances in the understanding of Hh signaling transduction, the roles of Hh signaling in skin cancer development, and the current implications of “mechanism-based” therapeutic strategies. PMID:21397013
Li, Chengxin; Chi, Sumin; Xie, Jingwu
Lithium plays an important role in the treatment and prophylaxis of affective psychoses. Taking lithium-containing drugs by mouth can cause side effects on the skin, although severe side effects are rare. Acneiform dermatoses have been most frequently described. In addition, when taking lithium continuously, psoriasis can be triggered or worsened and the psoriasis tends to be resistant to treatment. Maculo papular eruptions, ulcers, keratosis pilaris like folliculitis, exfoliative dermatitis, dermatitis herpetiformis like eruption, and hair loss have been described. Possibly the blood level of lithium plays a decisive role in developing a dermatosis. If the skin side effect is mild, the dermatosis should be treated topically. If the dermatoses under lithium treatment are severe, a reduction in the lithium dosage should possibly be discussed with the psychiatrist. Only rarely does lithium have to be entirely discontinued. PMID:3157663
To understand the development of bacterial resistance and multi-resistance following treatment with topical and systemic antibiotics is important for dermatologists. Furthermore the sensitization potential and toxicity of antibiotics applied to large skin areas must be considered. The advantage of many topical antibiotics is evident; extremely high concentrations can be achieved in the infected skin usually without any systemic side effects. When an antibiotic is used both systemically and topically, indications should be weighed carefully for topical use, in order to reduce the likelihood of sensitization to an potential systemic agent. Continuous monitoring of the resistance profile of important bacteria is also desirable, in order to preserve the utility of important "reserve antibiotics". In this review the most important topical antibiotics used in Germany are evaluated with regards to efficacy and safety profile. PMID:15765214
Thaçi, D; Schöfer, H
Skin Friction Versus Pile Movement. Test Pile 1 Loaded in Tension 17 10. Skin Friction-Soil Shear Strength Ratio Versus Pile Movement. Compression Test Pile 1 21 Skin Friction-Soil Sheer Strength Ratio Versus Pile Movement. Tension Test Pile 1 22... Data 35 16. 17. Mohr Envelope for Firm Saturated Sand. Mohr Envelope for Dense Saturated Sand. 37 LIST OF FIGURES (Continued) Figure Skin Friction-Soil Shear Strength Ratio Versus Pile Movement for Firm Saturated Sand 39 19. Skin F iction...
Sulaiman, Ibrahim Hikmat
Cumulative sun exposure has been linked to about 95 percent of all skin cancers. Farmers and their families, by nature of their occupations, are exposed to an abundance of sun over a long period of time and, therefore, are at an increased risk for skin cancer. Because education is known to be a primary means of health, Future Farmers of America (FFA) peer facilitators (teen educators) provided third graders in rural communities sun protection education with the hope that the message would reach the entire family. The FFA facilitators (n = 217) from 39 FFA organizations throughout Wisconsin were trained with skin cancer and sun protection information. The FFA facilitators then gave presentations on sun protection to third graders (n = 2,007) in their school districts. Control schools included 57 facilitators and 669 third graders. Evaluation involved pre-, post-, and six-month follow-up surveys testing knowledge gained by the third graders. Students who correctly responded to a question on the post-survey after incorrectly answering it on the pre-survey were said to have had a knowledge gain for that question. By using chi-square tests, the intervention group demonstrated a statistically significant (P < 0.001) higher proportion of students experiencing knowledge gain than did the control group from pre- to post-surveys for nine of the 10 questions. Summary statistics were used to describe the study population. In addition to skin cancer knowledge questions, the survey of facilitators included sun protection behavior and attitude questions. This intervention was able to use peer educators as instructors to demonstrate knowledge gain in the youths of the target population. The pilot project materials costs were +0.55 per third grade student and +3.50 per facilitator. Using a school-based organization such as FFA provided a cost-effective means of reaching the rural population. PMID:10162857
Reding, D J; Fischer, V; Gunderson, P; Lappe, K; Anderson, H; Calvert, G
Ultraviolet radiation is estimated to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. Athletes practicing outdoor sports receive considerable UV doses because of training and competition schedules with high sun exposure, and in alpine sports, by altitude-related increase of UV radiation and reflection from snow- and ice-covered surfaces. Extreme UV exposure in outdoor sports such as skiing, mountaineering, cycling, or triathlon has been documented in a series of dosimetric studies. Sweating because of physical exercise may contribute to UV-related skin damage as it increases the individual photosensitivity of the skin, facilitating the risk of sunburns. Large epidemiological studies showed that recreational activities such as sun exposure on the beach or during water sports were associated with an increased risk of basal cell carcinoma, whereas skiing has been shown to be at increased risk for squamous cell carcinoma. Risk factors of cutaneous melanoma such as the number of melanocytic nevi and solar lentigines have been found to be more frequent in subjects practicing endurance outdoor sports. An increased risk for cutaneous melanoma may be assumed for these athletes. In addition to the important sun exposure, exercise-induced immunosuppression may increase the risk for nonmelanoma skin cancer and cutaneous melanoma in athletes. Frequently, athletes seem to know little about the risk of sun exposure. Protective means such as avoiding training and competition with considerable sun exposure, choosing adequate clothing, and applying water-resistant sunscreen still need to be propagated in the community of outdoor sportsmen. PMID:18280899
\\u000a Contact allergy to ingredients of cosmetics is one of the most frequent causes of contact allergy. While patients may report\\u000a reactions to fragrance items, preservative allergy may not be suspected. The reaction typically resembles eczema on the face\\u000a or hands, although any body site may be affected. Products left on the skin are much more likely to cause allergic reactions
Jonathan M. L. White; Anton C. Groot; Ian R. White
Melanoma is a fatal cancer with a growing incident rate. However it could be cured if diagnosed in early stages. The first step in detecting melanoma is the separation of skin lesion from healthy skin. There are particular features associated with a malignant lesion whose successful detection relies upon accurately extracted borders. We propose a two step approach. First, we apply K-means clustering method (to 3D RGB space) that extracts relatively accurate borders. In the second step we perform an extra refining step for detecting the fading area around some lesions as accurately as possible. Our method has a number of novelties. Firstly as the clustering method is directly applied to the 3D color space, we do not overlook the dependencies between different color channels. In addition, it is capable of extracting fine lesion borders up to pixel level in spite of the difficulties associated with fading areas around the lesion. Performing clustering in different color spaces reveals that 3D RGB color space is preferred. The application of the proposed algorithm to an extensive data-base of skin lesions shows that its performance is superior to that of existing methods both in terms of accuracy and computational complexity.
Kamali, Mostafa; Samei, Golnoosh
A novel in vivo approach is described that provides large area mapping of the mechanical properties of the skin in human patients. Such information is important in the understanding of skin health, cosmetic surgery, aging, and impacts of sun exposure. Currently, several methods have been developed to estimate the local biomechanical properties of the skin, including the use of a physical biopsy of local areas of the skin (in vitro methods) [2, 3, and 4], and also the use of non-invasive methods (in vivo) [5, 6, and 7]. All such methods examine localized areas of the skin. Our approach examines the local elastic properties via the generation of field displacement maps of the skin created using time-sequence imaging  with 2D digital imaging correlation (DIC) . In this approach, large areas of the skin are reviewed rapidly, and skin displacement maps are generated showing the contour maps of skin deformation. These maps are then used to precisely register skin images for purposes of diagnostic comparison. This paper reports on our mapping and registration approach, and demonstrates its ability to accurately measure the skin deformation through a described nulling interpolation process. The result of local translational DIC alignment is compared using this interpolation process. The effectiveness of the approach is reported in terms of residual RMS, image entropy measures, and differential segmented regional errors.
Kacenjar, Steve; Chen, Suzie; Jafri, Madiha; Wall, Brian; Pedersen, Richard; Bezozo, Richard
Skin lightening preparations are widely used in dermatology by persons of all Fitzpatrick skin types. Fitzpatrick skin types I-III require local pigment lightening for the treatment of hormonally induced melasma and postinflammatory hyperpigmentation caused by acne and trauma. Fitzpatrick skin types IV and darker have an even greater need for skin lightening for social reasons, as well as pigmentary changes that occur around the eyes, in the intertriginous areas, following dermatitis, or with acne and trauma. The gold standard dermatologic agent for skin lightening was hydroquinone, until regulatory agencies in Japan, Europe, and most recently in the United States questioned the safety of this substance. This has encouraged research into alternative agents to inhibit skin pigmentation such as retinoids, mequinol, azelaic acid, arbutin, kojic acid, aleosin, licorice extract, ascorbic acid, soy proteins, and N-acetyl glucosamine. The efficacy and safety of each of these ingredients is examined as possible topical alternatives to hydroquinone. PMID:18045355
Draelos, Zoe Diana
The study of preserved porcine skin was done by using split-thickness skin grafts of pigs weighing approximately 25 to 30 kg. The harvesting of split-thickness skin grafts was performed under aseptic and antiseptic conditions. The povidone-iodine solution and 0.25% acidified sodium hypochlorite solution were used before immersion of the skin in 90% glycerine solution. Prepared skin graft was stored in the freezer compartment of a home refrigerator. Serial studies of the bacteriology and the histology of specimens were performed monthly for 12 months. No bacterial organisms were found during the study. The integrity of the skin lasted up to 5 months, however, the property of the preserved skin was as good as the other biological dressing even after 6 months. This simple, low-cost procedure is useful for restoring allografts or even autografts in a hospital without conveniences or adequate facilities. PMID:8512290
Visuthikosol, V; Punyahotra, N; Navykarn, T; Kruavit, A; Boonpucknavig, V
Electrolyzed reduced water (ERW), functional water, has various beneficial effects via antioxidant mechanism in vivo and in vitro. However there is no study about beneficial effects of ERW bathing. This study aimed to determine the effect of ERW bathing on the UVB-induced skin injury in hairless mice. For this purpose, mice were irradiated with UVB to cause skin injury, followed by individually taken a bath in ERW (ERW-bathing) and tap water (TW-bathing) for 21 d. We examined cytokines profile in acute period, and histological and ultrastructural observation of skin in chronic period. We found that UVB-mediated skin injury of ERW-bathing group was significantly low compared to TW control group in the early stage of experiment. Consistently, epidermal thickening as well as the number of dermal mast cell was significantly lowered in ERW-bathing group. Defection of corneocytes under the scanning electron microscope was less observed in ERW-bathing group than in TW-bathing group. Further, the level of interleukin (IL)-1?, tumor necrosis factor (TNF)-? and IL-12p70 in ERW group decreased whereas those of IL-10 increased. Collectively, our data indicate that ERW-bathing significantly reduces UVB-induced skin damage through influencing pro-/anti-inflammatory cytokine balance in hairless mice. This suggests that ERW-bathing has a positive effect on acute UVB-mediated skin disorders. This is the first report on bathing effects of ERW in UVB-induced skin injury. PMID:22040878
Yoon, Kyung Su; Huang, Xue Zhu; Yoon, Yang Suk; Kim, Soo-Ki; Song, Soon Bong; Chang, Byung Soo; Kim, Dong Heui; Lee, Kyu Jae
Coagulation necrosis is a peculiar type of ischemic necrosis that is characterized by firm, eosinophilic parenchyma with recognizable cell outlines without massive glial reactions. This is an autopsy report of coagulation necrosis 6 months after thrombolytic tissue plasminogen activator therapy against massive cerebral embolism in an 84-year-old man with atrial fibrillation. PMID:22000524
Suzuki, Miki; Uchihara, Toshiki; Toru, Shuta; Bae, Yuan; Igari, Toru; Kitagawa, Masanobu; Uchiyama, Shinichiro; Hirokawa, Katsuiku; Kobayashi, Takayoshi
Abstract Necrosis-avid agents are a class of compounds that selectively accumulate in the necrotic tissues after systemic administration, which can be used for in vivo necrosis imaging and targeted therapies. In order to search for a necrosis-avid tracer agent with improved drugability, we labelled iodine-131 on sennoside B (SB) as a naturally occurring median dianthrone compound. The necrosis targetability and clearance properties of (131)I-SB were evaluated in model rats with liver and muscle necrosis. On SPECT/CT images, a "hot spot" in the infarcted liver lobe and necrotic muscle was persistently observed at 24?h and 72?h post-injection (p.i.). Gamma counting of the tissues of interest revealed a radioactivity ratio of necrotic to viable liver at 4.6 and 3.4 and of necrotic to viable muscle at 7.0 and 8.8 at 24?h and 72?h p.i., respectively. The good match of autoradiographs and fluoromicroscopic images with corresponding histochemical staining suggested preferential uptake of (131)I-SB in necrotic tissue. Pharmacokinetic study revealed that (131)I-SB has an elimination half-life of 8.6?h. This study indicates that (131)I-SB shows not only prominent necrosis avidity but also favourable pharmacokinetics, which may serve as a potential necrosis-avid diagnostic agent for assessment of tissue viability. PMID:25330022
Zhang, Dongjian; Huang, Dejian; Ji, Yun; Jiang, Cuihua; Li, Yue; Gao, Meng; Yao, Nan; Liu, Xuejiao; Shao, Haibo; Jing, Su; Ni, Yicheng; Yin, Zhiqi; Zhang, Jian
Purpose: Diffuse pontine gliomas are a pediatric brain tumor that is fatal in nearly all patients. Given the poor prognosis for patients with this tumor, their quality of life is very important. Radiation therapy provides some palliation, but can result in radiation necrosis and associated neurologic decline. The typical treatment for this necrosis is steroid therapy. Although the steroids are effective, they have numerous side effects that can often significantly compromise quality of life. Bevacizumab, an antibody against vascular endothelial growth factor, has been suggested as a treatment for radiation necrosis. We report on our initial experience with bevacizumab therapy for radiation necrosis in pediatric pontine gliomas. Materials and Methods: Four children with pontine gliomas treated at the Children's Hospital in Denver and the University of Colorado Denver developed evidence of radiation necrosis both clinically and on imaging. Those 4 children then received bevacizumab as a treatment for the radiation necrosis. We reviewed the clinical outcome and imaging findings. Results: After bevacizumab therapy, 3 children had significant clinical improvement and were able to discontinue steroid use. One child continued to decline, and, in retrospect, had disease progression, not radiation necrosis. In all cases, bevacizumab was well tolerated. Conclusions: In children with pontine gliomas, bevacizumab may provide both therapeutic benefit and diagnostic information. More formal evaluation of bevacizumab in these children is needed.
Liu, Arthur K., E-mail: email@example.com [University of Colorado Denver, Department of Radiation Oncology, Aurora, CO (United States); Macy, Margaret E.; Foreman, Nicholas K. [Children's Hospital, Denver, Department of Neuro-Oncology, Aurora, CO (United States)
Neuronal necrosis induced by calcium overload causes devastating brain dysfunction in diseases such as stroke and brain trauma. It has been considered a stochastic event lacking genetic regulation, and pharmacological means to suppress neuronal necrosis are lacking. Using a Drosophila model of calcium overloading, we found JIL-1/mitogen- and stress-activated protein kinase 1/2 is a regulator of neuronal necrosis through phosphorylation of histone H3 serine 28 (H3S28ph). Further, we identified its downstream events including displacement of polycomb repressive complex 1 (PRC1) and activation of Trithorax (Trx). To test the role of JIL-1/PRC1/Trx cascade in mammals, we studied the necrosis induced by glutamate in rat cortical neuron cultures and rodent models of brain ischemia and found the cascade is activated in these conditions and inhibition of the cascade suppresses necrosis in vitro and in vivo. Together, our research demonstrates that neuronal necrosis is regulated by a chromatin-modifying cascade, and this discovery may provide potential therapeutic targets and biomarkers for neuronal necrosis. PMID:25201987
Liu, Kai; Ding, Lianggong; Li, Yuhong; Yang, Hui; Zhao, Chunyue; Lei, Ye; Han, Shuting; Tao, Wei; Miao, Dengshun; Steller, Hermann; Welsh, Michael J; Liu, Lei
Neuronal necrosis induced by calcium overload causes devastating brain dysfunction in diseases such as stroke and brain trauma. It has been considered a stochastic event lacking genetic regulation, and pharmacological means to suppress neuronal necrosis are lacking. Using a Drosophila model of calcium overloading, we found JIL-1/mitogen- and stress-activated protein kinase 1/2 is a regulator of neuronal necrosis through phosphorylation of histone H3 serine 28 (H3S28ph). Further, we identified its downstream events including displacement of polycomb repressive complex 1 (PRC1) and activation of Trithorax (Trx). To test the role of JIL-1/PRC1/Trx cascade in mammals, we studied the necrosis induced by glutamate in rat cortical neuron cultures and rodent models of brain ischemia and found the cascade is activated in these conditions and inhibition of the cascade suppresses necrosis in vitro and in vivo. Together, our research demonstrates that neuronal necrosis is regulated by a chromatin-modifying cascade, and this discovery may provide potential therapeutic targets and biomarkers for neuronal necrosis. PMID:25201987
Liu, Kai; Ding, Lianggong; Li, Yuhong; Yang, Hui; Zhao, Chunyue; Lei, Ye; Han, Shuting; Tao, Wei; Miao, Dengshun; Steller, Hermann; Welsh, Michael J.; Liu, Lei
The author demonstrates the development and treatment of 6 cases of necrosis of the slipped upper femoral epiphysis. In cases of gradual dislocation, the blood supply of the epiphysis remains normal at all stages. Necrosis does not occur spontaneously. In cases of sudden or so-called "traumatic" separation, the supply of blood to the epiphysis is often disturbed, and necrosis may occur spontaneously. Slight disturbance of the blood supply to the epiphysis may be only temporary and complete recovery may take place. Severe damage, however, leads to necrosis. Operative measures to treat the necrosis may lead to an improvement, but complete restoration of necrosis is not possible--as the examples in the article show. Osteoarthritis will follow at an early age in these cases. Thus, to avoid necrosis in cases of sudden dislocation of the epiphysis therapy must be carried out very gently. Closed or operative reduction should not be performed immediately after the slippage. The deformity should be corrected at a later stage. PMID:549327
Cell death overarches carcinogenesis and is a center of cancer researches, especially therapy studies. There have been many nomenclatures on cell death, but only three cell death modes are genuine, i.e. apoptosis, necrosis and stress-induced cell death (SICD). Like apoptosis, SICD is programmed. Like necrosis, SICD is a pathological event and may trigger regeneration and scar formation. Therefore, SICD has subtypes of stress-induced apoptosis-like cell death (SIaLCD) and stress-induced necrosis-like cell death (SInLCD). Whereas apoptosis removes redundant but healthy cells, SICD removes useful but ill or damaged cells. Many studies on cell death involve cancer tissues that resemble parasites in the host patients, which is a complicated system as it involves immune clearance of the alien cancer cells by the host. Cancer resembles an evolutionarily lower-level organism having a weaker apoptosis potential and poorer DNA repair mechanisms. Hence, targeting apoptosis for cancer therapy, i.e. killing via SIaLCD, will be less efficacious and more toxic. On the other hand, necrosis of cancer cells releases cellular debris and components to stimulate immune function, thus counteracting therapy-caused immune suppression and making necrosis better than SIaLCD for chemo drug development. PMID:25594039
Zhang, Ju; Lou, Xiaomin; Jin, Longyu; Zhou, Rongjia; Liu, Siqi; Xu, Ningzhi; Liao, D. Joshua
Macrophages are important in the induction of new blood vessel growth during wound repair, inflammation and tumour growth1-4. We show here that tumour necrosis factor-? (TNF-?), a secretory product of activated macrophages that is believed to mediate tumour cytotoxicity5-9, is a potent inducer of new blood vessel growth (angiogenesis). In vivo, TNF-? induces capillary blood vessel formation in the rat cornea and the developing chick chorioallantoic membrane at very low doses. In vitro, TNF-? stimulates chemotaxis of bovine adrenal capillary endothelial cells and induces cultures of these cells grown on type-1 collagen gels to form capillary-tube-like structures. The angiogenic activity produced by activated murine peritoneal macrophages is completely neutralized by a polyclonal antibody to TNF-?, suggesting immunological features are common to TNF-? and the protein responsible for macrophage-derived angiogenic activity. In inflammation and wound repair, TNF-? could augment repair by stimulating new blood vessel growth; in tumours, TNF-? might both stimulate tumour development by promoting vessel growth and participate in tumour destruction by direct cytotoxicity10-12.
Leibovich, S. Joseph; Polverini, Peter J.; Shepard, H. Michael; Wiseman, David M.; Shively, Vera; Nuseir, Nureddin
The complete genome sequence of chrysanthemum stem necrosis virus (CSNV) was determined using Roche 454 next-generation sequencing. CSNV is a tentative member of the genus Tospovirus within the family Bunyaviridae, whose members are arthropod-borne. This is the first report of the entire RNA genome sequence of a CSNV isolate. The large RNA of CSNV is 8955 nucleotides (nt) in size and contains a single open reading frame of 8625 nt in the antisense arrangement, coding for the putative RNA-dependent RNA polymerase (L protein) of 2874 aa with a predicted Mr of 331 kDa. Two untranslated regions of 397 and 33 nt are present at the 5' and 3' termini, respectively. The medium (M) and small (S) RNAs are 4830 and 2947 nt in size, respectively, and show 99 % identity to the corresponding genomic segments of previously partially characterized CSNV genomes. Protein sequences for the precursor of the Gn/Gc proteins, N and NSs, are identical in length in all of the analysed CSNV isolates. PMID:25398595
Dullemans, A M; Verhoeven, J Th J; Kormelink, R; van der Vlugt, R A A
Tumour necrosis factor (TNF) is a potent inflammatory cytokine that plays an important role in immunity to numerous bacterial infections, including Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis (TB) in humans. Infliximab, adalimumab, certolizumab pegol and etanercept are anti-TNF agents used to treat a range of inflammatory/autoimmune diseases, such as rheumatoid arthritis. The use of some of these drugs has been linked to reactivation TB. In addition to blocking TNF-mediated immune responses, some anti-TNF drugs have been found to interfere with innate immune responses, such as phagolysosomal maturation and monocyte apoptosis, as well as cell-mediated responses, including interferon-? secretion by memory T cells, complement-mediated lysis of Mtb-reactive CD8+ T cells and increased regulatory T cell activity. This review summarizes some of the reported effects of TNF blockers on immune cell responses in the context of the observed clinical data on TB reactivation in patients on anti-TNF therapy. PMID:20491796
Harris, J; Keane, J
Tumor necrosis inducing factor (TNF), a 140,000 molecular weight glycoprotein present in the serum of Corynebacterium parvum endotoxin-treated mice, was cytotoxic toward Friend virus-transformed erythroleukemic cells (FELC). These cells grow in culture as undifferentiated pro-erythroblasts but can be induced to differentiate in a limited fashion along the erythroid pathway to orthochromatic normoblasts by various agents such as dimethylsulfoxide (DMSO). Partially and highly purified preparations of TNF were cytotoxic toward logarithmically growing FELC whereas a comparable serum protein fraction from C. parvum treated mice or endotoxin from E. coli had no effect upon FELC viability. DMSO-induced cells were more sensitive to the action of TNF requiring only about half the concentration needed to produce 50% kill in noninduced cells. Inhibition of hemoglobin formation was TNF dose-related and could be decreased by 94%. TNF was also cytotoxic toward DMSO-induced cells in stationary phase and mitomycin C treated noninduced FELC. Neuraminidase modification of the surface of FELC increased the cytotoxicity of TNF by 50%. These results demonstrate that TNF destroys FELC whether they are nondividing, dividing or partially differentiated and suggest that TNF may accomplish this by affecting cell metabolism after internalization. PMID:3856542
Suyama, K; Goldstein, J; Green, S
Tumor necrosis factor (TNF) is a multifunctional cytokine that plays important roles in diverse cellular events such as cell survival, proliferation, differentiation, and death. As a pro-inflammatory cytokine, TNF is secreted by inflammatory cells, which may be involved in inflammation-associated carcinogenesis. TNF exerts its biological functions through activating distinct signaling pathways such as nuclear factor-kappaB (NF-kappaB) and c-Jun N-terminal kinase (JNK). NF-kappaB is a major cell survival signal that is anti-apoptotic, whereas sustained JNK activation contributes to cell death. The crosstalk between the NF-kappaB and JNK is involved in determining cellular outcomes in response to TNF. In regard to cancer, TNF is a double-dealer. On one hand, TNF could be an endogenous tumor promoter, because TNF stimulates the growth, proliferation, invasion and metastasis, and tumor angiogenesis of cancer cells. On the other hand, TNF could be a cancer killer. The property of TNF in inducing cancer cell death renders it a potential cancer therapeutic, although much work is needed to reduce its toxicity for systematic TNF administration. Recent studies have focused on sensitizing cancer cells to TNF-induced apoptosis through inhibiting survival signals such as NF-kappaB, by combined therapy. In this article we provide an overview of the roles of TNF-induced signaling pathways in cancer biology with specific emphasis on carcinogenesis and cancer therapy. PMID:18954521
Wang, Xia; Lin, Yong
B cell maturation antigen (BCMA) is a tumor necrosis family receptor (TNFR) member that is predominantly expressed on terminally differentiated B cells and, upon binding to its ligands B cell activator of the TNF family (BAFF) and a proliferation inducing ligand (APRIL), delivers pro-survival cell signals. Thus, BCMA is most known for its functional activity in mediating the survival of plasma cells that maintain long-term humoral immunity. The expression of BCMA has been also linked to a number of cancers, autoimmune disorders, and infectious diseases that suggest additional roles for BCMA activity. Despite the recent advances in our understanding of the roles for the related TNFR members BAFF-R and transmembrane activator and calcium-modulator and cyclophilin ligand interactor (TACI), the signaling pathway used by BCMA for mediating plasma cell survival as well as its putative function in certain disease states are not well understood. By examining the expression, regulation, and signaling targets of BCMA we may gain further insight into this receptor and how it operates within cells in both health and disease. This information is important for identifying new therapeutic targets that may be relevant in treating diseases that involve the BAFF/APRIL cytokine network. PMID:23237506
Coquery, Christine M.; Erickson, Loren D.
Avascular necrosis (AVN) of the hips is associated with significant disability, and the majority of established cases require major surgery. In a retrospective analysis of 185 patients with systemic lupus erythematosus (SLE) 13 (7%) were found to have AVN. Of these, six had Raynaud's phenomenon, all had been on corticosteroids, and one had digital vasculitis. The mean duration of corticosteroid therapy was two years (range four months to five years). Five patients developed AVN two to 10 years after discontinuing steroids. The mean duration of disease at the onset of AVN was 6.85 years (range 1-19 years), and the mean age at onset of AVN was 31 years. Ten patients had severe multisystem involvement. None of the patients abused alcohol. Surgery was performed on 11 hips. Three had total hip replacement for stages 3 and 4 and seven had core decompression for stages 1 and 2. AVN progressed in two (28%) of these patients. In another patient core decompression failed for technical reasons. She subsequently required total hip replacement. The early detection of AVN to avoid the need for major surgery is stressed. PMID:3740994
Kalla, A A; Learmonth, I D; Klemp, P
A variety of rheumatic disorders have been successfully treated with tumour necrosis factor (TNF) blockers. However, TNF blockade may be useful in a number of rare diseases. Preliminary data suggest that several forms of vasculitis appear responsive to TNF antagonists—Behçet's disease, Churg–Strauss vasculitis, polyarteritis nodosa, and giant cell arteritis, among others. Wegener's granulomatosis and sarcoidosis have been shown to improve with infliximab but not with etanercept. These results lend further support for the concept of differential mechanism(s) of action of the two antagonists with infliximab being more effective for the treatment of granulomatous diseases. Polymyositis/dermatomyositis may also be responsive to TNF blockade. TNF likely plays little role in Sjögren's syndrome as evidenced by the lack of efficacy of both TNF antagonists. Etanercept has been shown to be useful in the treatment of hepatitis C both in reducing the viral load and improving liver function. A number of other more rare disorders also may be responsive to TNF blockade. Further studies with larger numbers of well characterised patients and treatment regimens are necessary to provide more definitive evidence of the utility of the TNF antagonists in these serious and often life threatening diseases. PMID:15479879
We describe the serial magnetic resonance imaging (MRI) findings in a six-year-old girl with congenital adrenal hyperplasia, who presented with seizures and unconsciousness during a hypoadrenal crisis. Initial neuroimaging revealed the presence of brain edema with high signal changes in the fronto-parietal cortex on diffusion-weighted MRI. The brain edema worsened four days into admission, and by day 14 low-density areas were seen over the frontal lobes bilaterally using computed tomography (CT). Follow-up MRI at between one and two months of admission revealed extensive white matter lesions with high intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) images, which extended into deep cortical layers. Additionally, linear lesions with high signal change on T1-weighted imaging developed in the superficial cortical layers, with frontal predominance. This layer appeared isointense on T2WI and high intensity on FLAIR images, suggesting laminar cortical necrosis. Two months later, linear, cavitary lesions appeared in the middle cortical layers between the aforementioned superficial laminar abnormality and deep cortex/white matter lesions. The high-intensity signals in the deep cortical layers remained contiguous with the white matter lesions. This unique type of multi-layered cortical lesion may have resulted from a complex combination of hypoglycemia and hypoxia/ischemia in the setting of adrenal insufficiency. PMID:17590301
Saito, Yoshiaki; Ogawa, Toshihide; Nagaishi, Jun-ichi; Inoue, Takehiko; Maegaki, Yoshihiro; Ohno, Kousaku
Acute hepatopancreatic necrosis disease (AHPND), which has also been referred to as early mortality syndrome (EMS), initially emerged as a destructive disease of cultured shrimp species in Asia in 2009. The pathogen associated with the disease, Vibrio parahaemolyticus, subsequently spread to the Western Hemisphere and emerged in Mexico in early 2013. The spread to the Western Hemisphere is a major concern to shrimp producers in the region. To date, the only peer-reviewed published method for determining whether mortalities are due to AHPND is through histological examination. A novel PCR detection method was employed to assess samples from Mexico in order to confirm the presence of the pathogen in this country. This manuscript details the detection methods used to confirm the presence of AHPND in Mexico. Both immersion and per os challenge studies were used to expose the Penaeus vannamei to the bacteria in order to induce the disease. Histological analysis confirmed AHPND status following the challenge studies. Also provided are the details of the molecular test by PCR that was used for screening candidate V. parahaemolyticus isolates. A rapid PCR assay for detection of AHPND may help with early detection and help prevent the spread of AHPND to other countries. PMID:25144120
Nunan, Linda; Lightner, Donald; Pantoja, Carlos; Gomez-Jimenez, Silvia
Tumor necrosis factor alpha (TNF-?) is a proinflammatory cytokine that exerts both homeostatic and pathophysiological roles in the central nervous system. In pathological conditions, microglia release large amounts of TNF-?; this de novo production of TNF-? is an important component of the so-called neuroinflammatory response that is associated with several neurological disorders. In addition, TNF-? can potentiate glutamate-mediated cytotoxicity by two complementary mechanisms: indirectly, by inhibiting glutamate transport on astrocytes, and directly, by rapidly triggering the surface expression of Ca+2 permeable-AMPA receptors and NMDA receptors, while decreasing inhibitory GABAA receptors on neurons. Thus, the net effect of TNF-? is to alter the balance of excitation and inhibition resulting in a higher synaptic excitatory/inhibitory ratio. This review summarizes the current knowledge of the cellular and molecular mechanisms by which TNF-? links the neuroinflammatory and excitotoxic processes that occur in several neurodegenerative diseases, but with a special emphasis on amyotrophic lateral sclerosis (ALS). As microglial activation and upregulation of TNF-? expression is a common feature of several CNS diseases, as well as chronic opioid exposure and neuropathic pain, modulating TNF-? signaling may represent a valuable target for intervention. PMID:24966471
Olmos, Gabriel; Lladó, Jerònia
Two 13-amino-acid peptides were synthesized based on the putative feline tumor necrosis factor (FeTNF) sequence. The synthesized peptides were conjugated to keyhole limpet hemocyanin, emulsified in complete Freund's adjuvant, and injected into rabbits. The gene for FeTNF was cloned into the FLAG (International Biotechnologies Inc. [IBI], Kodak, New Haven, Conn.) fusion protein expression vector. The expressed fusion protein was purified by using the M-1 anti-FLAG octapeptide monoclonal antibody (IBI, Kodak). The fusion protein was emulsified in complete Freund's adjuvant and injected into chickens. The immune sera generated to the synthetic peptides and the fusion protein recognized the recombinant FeTNF fusion protein on Western or dot blot assay. The preimmune and immune sera were incubated with naturally occurring FeTNF (supernatants from lipopolysaccharide-stimulated cultured feline peritoneal exudate or peripheral mononuclear cells). The antibody raised to the recombinant FeTNF fusion protein and N-terminal synthetic peptide neutralized bioactivity of native FeTNF and recombinant human TNF. Preimmune sera did not have any neutralizing activity. The polyclonal antibodies were not specific for FeTNF, since both porcine and human recombinant TNF were neutralized by the fusion protein antibodies. The synthetic peptide antibodies recognized recombinant feline and equine TNF on a Western blot. PMID:9220170
Otto, C M; Niagro, F; McGraw, R A; Rawlings, C A
Given the difficulty in differentiating Radiation Induced Necrosis (RIN) and recurrent disease in glioma patients using conventional techniques (CT scans, MRI scans), researchers have looked for different imaging modalities. Among these different modalities are Diffusion Weighted Magnetic Resonance Imaging (DWMRI) and Magnetic Resonance Spectroscopy (MRS). In DWMRI, an Apparent Diffusion Coefficient (ADC) is calculated for a Region Of Interest (ROI), and then monitored over time (longitudinally). In the brain, different anatomical features can complicate the interpretation of ADCs. In particular, the density and spatial variation of the cerebral spinal fluid filled fissures known as sulci can influence how a change in an ADC is explained. We have used the covariance of pixel intensity in T1 weighted MRI scans to study how intra-patient and inter-patient sulci density varies, and will present these results. MRS uses the shift in the MR signal due to the local chemical environment to determine the concentration of brain metabolites like choline and creatin. The ratio of metabolites such as these has been shown to have the power to discriminate between RIN and recurrent disease in glioma patients. At our institution, we have initiated a protocol whereby we will use DWMRI and MRS to study how best to utilize these complimentary forms of imaging.
The mechanisms by which oncolytic vaccinia virus induces tumor cell death are poorly understood. We have evaluated cell death pathways following infection of ovarian cancer cells with both wild-type and thymidine kinase-deleted (dTK) Lister strain vaccinia. We show that death does not rely upon classical apoptosis despite the appearances of some limited apoptotic features, including phosphatidylserine externalization and appearance of sub-G1 DNA populations. Vaccinia infection induces marked lipidation of LC3 proteins, but there is no general activation of the autophagic process and cell death does not rely upon autophagy induction. We show that vaccinia induces necrotic morphology on transmission electron microscopy, accompanied by marked by reductions in intracellular adenosine triphosphate, altered mitochondrial metabolism, and release of high mobility group box 1 (HMGB1) protein. This necrotic cell death appears regulated, as infection induces formation of a receptor interacting protein (RIP1)/caspase-8 complex. In addition, pharmacological inhibition of both RIP1 and substrates downstream of RIP1, including MLKL, significantly attenuate cell death. Blockade of TNF-?, however, does not alter virus efficacy, suggesting that necrosis does not result from autocrine cytokine release. Overall, these results show that, in ovarian cancer cells, vaccinia virus causes necrotic cell death that is mediated through a programmed series of events. PMID:23985697
Whilding, Lynsey M; Archibald, Kyra M; Kulbe, Hagen; Balkwill, Frances R; Öberg, Daniel; McNeish, Iain A
The sailfish is the fastest sea animal, reaching its maximum speed of 110 km/h. On its skin, a number of V-shaped protrusions pointing downstream exist. Thus, in the present study, the possibility of reducing the skin friction using its shape is investigated in a turbulent boundary layer. We perform a parametric study by varying the height and width of the protrusion, the spanwise and streamwise spacings between adjacent ones, and their overall distribution pattern, respectively. Each protrusion induces a pair of streamwise vortices, producing low and high shear stresses at its center and side locations, respectively. These vortices also interact with those induced from adjacent protrusions. As a result, the drag is either increased or unchanged for most of the cases considered. Some of these cases show that the skin friction itself is reduced but the total drag including the form drag on the protrusion is larger than that of a smooth surface. In a few cases, the drag is decreased only slightly (˜1%) but this amount is within the experimental uncertainty. Since the shape of present protrusions is similar to that used by Sirovich and Karlsson [Nature (London) 388, 753 (1997)] where V-shaped protrusions pointing upstream were considered, we perform another set of experiments following their study. However, we do not obtain any drag reduction even with random distribution of those V-shaped protrusions.
Sagong, Woong; Kim, Chulkyu; Choi, Sangho; Jeon, Woo-Pyung; Choi, Haecheon
Inflammation is the clinical expression of chemical mediators such as the pro-inflammatory cytokine tumor necrosis factor (TNF-)-alpha produced by macrophages and other cells activated in the immune response. Hence, agents that can inhibit TNF-alpha may be useful in treating arthritis and other diseases resulting from uncontrolled inflammation. We now report that the cleavage of heparin by the enzyme heparinase I generates sulfated disaccharide (DS) molecules that can inhibit the production of TNF-alpha. Administration of nanogram amounts of the sulfated DS molecules to experimental animals inhibited delayed-type hypersensitivity to a skin sensitizer and arrested the joint swelling of immunologically induced adjuvant arthritis. Notably, the sulfated DS molecules showed a bell-shaped dose-response curve in vitro and in vivo: decreased effects were seen using amounts of the DS molecules higher than optimal. Thus, molecular regulators of inflammation can be released from the natural molecule heparin by the action of an enzyme. PMID:9352356
Cahalon, L; Lider, O; Schor, H; Avron, A; Gilat, D; Hershkoviz, R; Margalit, R; Eshel, A; Shoseyev, O; Cohen, I R
Thirty-year-old female with a previous history of a cutaneous ulcer suspicious of leishmaniasis 20 years ago presented with a new complaint of a depressed papular lesion 8 × 7?mm in the right lower extremity. The lesion was of 10-day duration. Because early cutaneous leishmaniasis (CL) lesions may have a non-ulcerated appearance, a Leishmania