Surgical approach in the management of ear keloids: our experience with 30 patients.

BACKGROUND: Ear keloids are benign, fibrous proliferations due to excessive collagen synthesis and deposition. It is a popular practice to pierce earlobes for decorative earrings and adornment; this might trigger the keloid process. Although there are varied treatment modalities, it is unsatisfactory and has always been a challenge. The aim is to evaluate the efficacy of surgical treatment with intralesional therapy in auricular keloids. METHODS: We included 30 patients with 45 keloids over the ear. Patients were evaluated (including detailed history, complete physical and local examination), and photographs and written informed consent were taken. They were treated with: excision and closure, intralesional and/or surface cryotherapy, ablative laser, intralesional steroids, and 5-fluorouracil. Excision and closure, and intralesional cryotherapy were done under local anesthesia. Closure was done after intramarginal excision with or without raising auto flaps, followed by intraoperative intralesional steroids to margins. Recurrence was assessed at 3 weeks, 3 months, 6 months, and 1 year. RESULTS: The age group of patients ranged from 14 to 57 years. A total of 32 out of 45 (71.1%) keloids were excised and were combined with intraoperative and postoperative intralesional steroid injection, with sessions depending on the patient's response. Eight (17.7%) and five (11.1%) keloids were treated using intralesional cryotherapy and only intralesional steroids, respectively. A total of 16.6% of patients had recurrence with one patient having recurrence of bilateral earlobes keloid. CONCLUSION: Keloidectomy with intraoperative and postoperative intralesional steroid injections has been very effective in the treatment of ear keloids. Different treatment modalities act synergistically, but excision surgery gives good results as it aims at maintaining ear architecture.

Time-reversal asymmetry without local moments via directional scalar spin chirality.

Invariably, time-reversal symmetry (TRS) violation in a state of matter is identified with static magnetism in it. Here, a directional scalar spin chiral order (DSSCO) phase is introduced that disobeys this basic principle: it breaks TRS but has no density of static moments. It can be obtained by melting the spin moments in a magnetically ordered phase but retaining residual broken TRS. Orbital moments are then precluded by the spatial symmetries of the spin rotation symmetric state. It is allowed in one, two and three dimensions under different conditions of temperature and disorder. Recently, polar Kerr effect experiments in the mysterious pseudogap phase of the underdoped cuprates hinted at a strange form of broken TRS below a temperature T K, that exhibits a hysteretic 'memory effect' above T K and begs reconciliation with nuclear magnetic resonance (which sees no moments), x-ray diffraction (which finds charge ordering tendencies) and the Nernst effect (which detects nematicity). Remarkably, the DSSCO provides a phenomenological route for reconciling all these observations, and it is conceivable that it onsets at the pseudogap temperature ∼T*. A six-spin interaction mediated by enhanced fluctuations of velocity asymmetry between left- and right-movers above the onset of charge ordering in the cuprates is proposed as the driving force behind DSSCO formation. A testable prediction of the existence of the DSSCO in the cuprates is a Kerr signal above T K triggered and trainable by a current driven along one of the in-plane axes, but not by a current along the other.

MIR142 Loss-of-Function Mutations Derepress ASH1L to Increase HOXA Gene Expression and Promote Leukemogenesis.

Point mutations in the seed sequence of miR-142-3p are present in a subset of acute myelogenous leukemia (AML) and in several subtypes of B-cell lymphoma. Here, we show that mutations associated with AML result both in loss of miR-142-3p function and in decreased miR-142-5p expression. Mir142 loss altered the hematopoietic differentiation of multipotent hematopoietic progenitors, enhancing their myeloid potential while suppressing their lymphoid potential. During hematopoietic maturation, loss of Mir142 increased ASH1L protein expression and consequently resulted in the aberrant maintenance of Hoxa gene expression in myeloid-committed hematopoietic progenitors. Mir142 loss also enhanced the disease-initiating activity of IDH2-mutant hematopoietic cells in mice. Together these data suggest a novel model in which miR-142, through repression of ASH1L activity, plays a key role in suppressing HOXA9/A10 expression during normal myeloid differentiation. AML-associated loss-of-function mutations of MIR142 disrupt this negative signaling pathway, resulting in sustained HOXA9/A10 expression in myeloid progenitors/myeloblasts and ultimately contributing to leukemic transformation.Significance: These findings provide mechanistic insights into the role of miRNAs in leukemogenesis and hematopoietic stem cell function. Cancer Res; 78(13); 3510-21. ©2018 AACR.

Aspergillus galactomannan detection in exhaled breath condensate compared to bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in immunocompromised patients.

OBJECTIVES: Exhaled breath condensate (EBC) is a noninvasive means of sampling the airways that has shown significant promise in the diagnosis of many disorders. There have been no reports of its usefulness in the detection of galactomannan (GM), a component of the cell wall of Aspergillus. The suitability of EBC for the detection of GM for the diagnosis of invasive aspergillosis (IA) using the Platelia Aspergillus enzyme-linked immunosorbent assay was investigated. METHODS: Prospective, cross-sectional study of lung transplant recipient and haemotologic malignancy patients at a university centre. EBC samples were compared to concomitant bronchoalveolar lavage (BAL) samples among lung transplant recipients and healthy controls. EBC was collected over 10 minutes using a refrigerated condenser according to the European Respiratory Society/American Thoracic Society recommendations, with the BAL performed immediately thereafter. RESULTS: A total of 476 EBC specimens with 444 matched BAL specimens collected from lung transplant recipients (n = 197) or haemotologic malignancy patients (n = 133) were examined. Both diluted and untreated EBC optical density (OD) values (0.0830, interquartile range (IQR) 0.0680-0.1040; and 0.1130, IQR 0.0940-0.1383), respectively, from all patients regardless of clinical syndrome were significantly higher than OD values in healthy control EBCs (0.0508, IQR 0.0597-0.0652; p < 0.0001). However, the OD index values did not correlate with the diagnosis of IA (44 samples were associated with IA). Furthermore, no significant correlation was found between EBC GM and the matched BAL specimen. CONCLUSIONS: GM is detectable in EBC; however, no correlation between OD index values and IA was noted in lung transplant recipients.

Investigation of the Possibility of Using Serum Ischemia Modified Albumin (IMA) as a Novel and Early Marker of the Extent of Oxidative Stress Induced by Various Tobacco Products.

BACKGROUND: Ischemia Modified Albumin (IMA) is an altered serum albumin that forms under the conditions of oxidative stress and is considered as a biomarker of cardiac ischemia. The objective of this study was to evaluate the ischemia modified albumin (IMA) in the serum of the individuals with different types of tobacco habits in order to investigate the possibility of using this as a biomarker for the oxidative stress induced by the tobacco products. MATERIALS AND METHODS: The study included 90 subjects, who were Grouped as control (30), Group I (betel quid chewers), Group II (gutkha chewers), Group III (smokers) and Group IV (mixed). Serum was collected from subjects of all Groups and IMA estimation was done using Albumin Cobalt binding assay. The results were tabulated and analysed statistically. RESULTS: The mean serum IMA levels in control, Group I, Group II, Group III and Group IV were 0.52547 ABSU, 0.68767 ABSU, 0.47433 ABSU,0.36540 ABSU and 0.54593 ABSU respectively. CONCLUSION: The results show that serum IMA levels were increased in betel quid chewers and mixed Group compared to the controls. From the results noted in this study we suggest that IMA can be used as an early marker for tobacco related oxidative stress.

Hemophagocytic lymphohistiocytosis secondary to infections: a tropical experience!

Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyper inflammatory condition, if not recognized and treated in time. A high index of suspicion can help identify the condition early. This condition can occur in the primary or secondary form. Secondary HLH or hemophagocytic syndrome (HPS) secondary to infections is an important clinical entity especially in tropical world. In this article, we share our experience with this entity and make an attempt to explore literature about ravenous macrophages which occurs secondary to infections. It is a series of six cases of HLH secondary to infectious disease in our center in a coastal city in South India over last one year with follow up.

Bilateral ultrasound-guided supraclavicular block in a patient with severe electrocution injuries of the upper extremities.

The performance of bilateral supraclavicular brachial plexus nerve blocks is controversial. We present the challenging case of a 29-year-old male who suffered bilateral high-voltage electrocution injuries to the upper extremities, resulting in severe tissue damage, sensory and motor deficits, and wounds in both axillae. This injury necessitated bilateral below-elbow amputations. His postoperative course was complicated by pain refractory to intravenous narcotics. The decision was made to attempt bilateral supraclavicular brachial plexus blocks. Our concerns with this approach included the risks of pneumothorax and respiratory failure due to phrenic nerve block. Initial attempts at brachial plexus blockade using nerve stimulation were unsuccessful; therefore, ultrasound guidance was employed. With vigilant monitoring in an intensive care unit setting, we were able to safely perform bilateral continuous supraclavicular brachial plexus nerve blocks with an excellent analgesic response and no noted complications.

Actividad antioxidante y polifenoles de las algas marinas halimeda opuntia y halimeda monile / No disponible

En este trabajo se estudió la actividad antioxidante de dos especies de algas marinas (H. opuntia y H. monile) mediante el ensayo de atrapamiento de radicales DPPH• y el sistema β-Caroteno-acido linoleico. Adicionalmente a las fracciones de ácidos fenolicos libres, ésteres solubles y ésteres insolubles de ácidos fenólicos se les determinó el contenido en fenoles totales mediante la técnica de Folin-Ciocalteu y posteriormente se identificaron y cuantificaron 8 ácidos fenólicos y cinámicos, resultando el componente mayoritario el ácido salicílico. En los ensayos utilizados se obtuvieron valores altos de actividad antioxidante para las diferentes fracciones. A partir de estos resultados se puede postular que la actividad antioxidante de los extractos polares de estas algas pudiera ser explicada, al menos parcialmente, por la presencia de los ácidos fenólicos y cinámicos. En el caso del alga Halimeda monile, de acuerdo con la literatura consultada, es el primer reporte de la actividad antioxidante(AU)

In this paper, the antioxidant activity displayed by two different green seaweed species (H. opuntia y H. monile) was studied using the β- carotene/ linoleic acid and the DPPH• scavenging.systems as different experimental in vitro antioxidant assessment models. Polar seaweed fractions containing free phenolic acids, soluble esters and insoluble esters of phenolic acids were chemically characterized in terms of their phenolic content and composition. In that direction, 8 phenolic acids were identified and quantified, and salycilic acid was shown to be the majoritary compound on the fractions from both species. In addition, the polar fractions were proved to exert antioxidant activity in the two used experimental systems with considerably low values of CI50. Thus, in view of these findings, the antioxidant activity of these polar Halimeda spp. extracts could be supported and at least partially related to the presence of phenolic acids. In case of Halimeda monile this is, at least to the extend of our knowledge, the first report of such biological activity(AU)

A critical role for CCR2/MCP-1 interactions in the development of idiopathic pneumonia syndrome after allogeneic bone marrow transplantation.

Idiopathic pneumonia syndrome (IPS) is a major complication after allogeneic bone marrow transplantation (allo-BMT) and involves the infiltration of donor leukocytes and the secretion of inflammatory cytokines. We hypothesized that leukocyte recruitment during IPS is dependent in part upon interactions between chemokine receptor 2 (CCR2) and its primary ligand monocyte chemoattractant protein-1 (MCP-1). To test this hypothesis, IPS was induced in a lethally irradiated parent --> F1 mouse BMT model. Compared with syngeneic controls, pulmonary expression of MCP-1 and CCR2 mRNA was significantly increased after allo-BMT. Transplantation of CCR2-deficient (CCR2-/-) donor cells resulted in a significant reduction in IPS severity compared with transplantation of wild-type (CCR2+/+) cells and in reduced bronchoalveolar lavage (BAL) fluid cellularity and BAL fluid levels of tumor necrosis factor-alpha (TNF-alpha) and soluble p55 TNF receptor (sTNFRI). In addition, neutralization of MCP-1 resulted in significantly decreased lung injury compared with control-treated allogeneic recipients. Experimental data correlated with preliminary clinical findings; patients with IPS have elevated levels of MCP-1 in the BAL fluid at the time of diagnosis. Collectively, these data demonstrate that CCR2/MCP-1 interactions significantly contribute to the development of experimental IPS and suggest that interventions blocking these receptor-ligand interactions may represent novel strategies to prevent or treat this lethal complication after allo-BMT.

Hypothyroidism induces type 2 iodothyronine deiodinase expression in mouse heart and testis.

In the present study we show the expression profiles of both type 1 and type 2 iodothyronine deiodinases (D1 and D2) in a wide spectrum of mouse tIssues, and D2 regulation by thyroid status. A characteristic tIssue-specific expression for each isoform was observed. D2 transcripts were detected in most tIssues with variable levels of expression. The observed D2 mRNA tIssue distribution was similar to that described in rats and is in agreement with the view of different patterns of expression between rodents and humans. However, it is interesting to note that despite the low levels of D2 transcripts in mouse heart and testis in the euthyroid state, the induction of hypothyroidism caused a significant increase in D2 activity in these tIssues. Similar results were also obtained in adult rats. These results suggest a previously unrecognized role for type 2 deiodinase in controlling intracellular triiodothyronine levels in rodent heart and testis during states of thyroid hormone deficiency.

A water-cooled spherical niobium target for the production of [18F]fluoride.

A new automated target system for the routine production of [18F]fluoride from (18)O-enriched water has been constructed. It consists of a small spherical niobium target chamber mounted into a special holder, which provides rapid cooling by water flow around the sphere. The target is irradiated with 21 MeV protons; the incident energy in the target chamber is 13 MeV. The system is operated without external over-pressure and has been tested for beam currents up to 50 microA. 95% of the theoretical yield of [18F]fluoride has been extracted and used for the synthesis of [18F]2-fluoro-2-deoxy-D-glucose.

The aging of man and society.

The author takes the main themes of an International Colloquium held in Toulouse on 15 June 1984 as a starting point to present some reflections on aging. In particular the need for aged societies to face important problems regarding dynamism is stressed, in order to maintain a confrontation with other, younger, societies and to provide people with the same levels of welfare. Moreover, in the future, towns will be more compact with less space so that within a limited environment the elderly individual--whose degree of mobility is ever-decreasing--can carry out his daily activities independently and with ease. From now on, collective savings--adequately invested in production--can assure economic development and a pension system worthy of a progressively aging society.