Possible role of proenkephalin in psoriasis.

BACKGROUND: Psoriasis is a common chronic skin disease that can also affect the mucous membranes and joints. It is multifactorial in origin, occurring in genetically predisposed individuals, and triggered by various endogenous and exogenous factors. Proenkephalin (PENK) is an endogenous opioid polypeptide hormone that acts on specific opiate receptors found on nerve and mucosal cells, and on various cells in the immune system. PENK receptors are expressed on skin cells, and their activation can regulate keratinocyte and melanocyte activities. PENK expression has been found to be increased in keratinocytes in psoriatic skin, and together with its inflammatory basis, this suggests that PENK may be regulated by inflammatory stimuli. AIM: To assess the possible role of PENK in the pathogenesis of psoriasis and to assess if it is related to the severity of psoriatic lesions. METHODS: Serum and tissue PENK levels were estimated in 20 patients with psoriasis vulgaris, and compared with those of 20 healthy controls (HCs). RESULTS: PENK levels were found to be significantly increased both in serum and in psoriatic lesions in patients compared with HCs. No significant correlation was found between PENK levels and patient age, disease duration or disease severity (Psoriasis Area and Severity Index). CONCLUSION: Our results support the role of PENK in the aetiopathogenesis of psoriasis, and indicate that giving anti-PENK drugs in addition to current antipsoriatic therapies might be of value in treating this common chronic skin disease.

Trans- and cis-urocanic acid, biogenic amine and amino acid contents in ikan pekasam (fermented fish) produced from Javanese carp (Puntius gonionotus) and black tilapia (Oreochromis mossambicus).

Ikan pekasam is a fermented fish product produced in Malaysia and is usually made from freshwater fish with ground roasted uncooked rice as the main source of carbohydrate. In this study, the amino acid, biogenic amine, and trans- and cis-urocanic acid (UCA) contents of fifteen commercial samples of Ikan pekasam made from Javanese carp and black tilapia, that had undergone either natural or acid-assisted fermentation, were quantified. The latter includes either tamarind (Tamarindus indica) pulp or dried slices of Garcinia atroviridis fruit in the fermentation process. Results showed that there are no significant differences in most of the biogenic amines including histamine, while there are significant differences in total UCA content, and trans- and cis-UCA contents between the two samples. Differences in the amino acid contents were largely fish-dependent.

Left ventricular pseudoaneurysm associated with mitral regurgitation.

A patient with a large posterolateral left ventricular pseudoaneurysm flush with the posterior papillary muscle and associated with mitral regurgitation was successfully treated surgically. The operation consisted of opening the sac of the aneurysm, dissecting the wall of the left ventricle from the fibrous wall of the sac, leaving a cuff of fibrous tissue suitable to hold sutures, and closing the defect with a Dacron patch.

Modification of flip-flap technique for correction of distal penile hypospadias.

Flip-flap is a popular technique used for correction of distal penile hypospadias. When the flap length is more than 2 cm, meatal stenosis may develop postoperatively. This stenosis is probably due to the ischemia at the tip of the flap. We have used flaps with wide base to ensure good blood supply to avoid this complication. The results were excellent in all of the cases in which this modification was used.