Impact of systemic alitretinoin treatment on skin barrier gene and protein expression in patients with chronic hand eczema.

BACKGROUND: Chronic hand eczema (CHE) is a common inflammatory skin disease that affects approximately 10% of the population. Systemic alitretinoin has been shown to be effective in patients with CHE who are refractory to topical corticosteroids. OBJECTIVES: To analyse the impact of alitretinoin on the skin barrier genes and protein expression in the skin lesions of patients with CHE. MATERIALS AND METHODS: Fifteen patients with CHE were treated with 30 mg daily of alitretinoin for up to 27 weeks. Disease severity was assessed using a clinical score. Skin biopsies from all the patients were evaluated before and after therapy for the expression of Ki-67, various skin barrier genes and thymic stromal lymphopoietin (TSLP) by real-time quantitative polymerase chain reaction and immunohistochemistry. RESULTS: After alitretinoin application, an improvement in the clinical severity of CHE was observed in the majority of patients. Analysis of skin biopsies before treatment showed a significant increase in Ki-67-positive cells in the suprabasal layer and a dysregulated expression of various skin barrier genes, such as claudin 1, loricrin, filaggrin and cytokeratin 10, which were normalized after treatment. TSLP was significantly upregulated in patients with CHE and also normalized after alitretinoin treatment and negatively correlated with filaggrin. CONCLUSIONS: Our data indicate that the expression of barrier genes and proteins was normalized following treatment with alitretinoin in patients with CHE. The change in expression levels of these genes correlated with the clinical efficacy, suggesting that alitretinoin exhibits a disease-modifying activity. TSLP is upregulated in CHE and seems to counteract filaggrin expression in the skin.

Investigation of friction and perceived skin feel after application of suspensions of various cosmetic powders.

The perceived skin feel during and after application of skin care products is highly important to the consumer and therefore to cosmetic formulators. Powder particles are commonly incorporated in cosmetic formulations to improve their sensory properties. Although a large variety of cosmetic powders is available, it is presently uncertain how the particles' properties affect the perceived skin feel. Well-trained panellists usually assess the perceived skin feel; however, these tests are time-consuming and by nature subjective. To address this complexity, the authors have systematically investigated various suspensions of cosmetic powders with regard to the perceived skin feel after application. Furthermore, an in vitro friction measurement set-up was developed which features a tribological contact similar to the mechanical properties and the topography of the contact between finger tip and human skin. A correlation was found between the friction coefficients determined in vitro and the perceived skin feel after sample application (as assessed by a descriptive panel). The results indicate that cosmetic powder particles should be small with a rather irregular shape to better lubricate the tribological contact between finger tip and skin surface, which leads to a more 'powdery' skin feel. It is suggested to carry out further tests with different powder particles or other skin care formulations to fully understand the underlying mechanisms of skin feel improvement and to validate or even partly replace the results of panel testing.

Cosmetic powder suspensions in compliant, fingerprintlike contacts.

Cosmetic powders are regularly employed in skin creams and cosmetic formulations to improve performance and enhance skin feel. A previous study investigated the effect of particle concentration and size on the lubricating properties of powder suspensions in smooth, compliant contacts [Timm et al., Tribol. Int. (2011)]. In this paper the tribological properties of cosmetic powder suspensions are investigated in compliant contacts having model fingerprintlike surface topography. Friction coefficients were measured for a series of powder suspensions with varying particle size and concentration in a polydimethylsiloxane (PDMS)/PDMS contact. A commercial tribometer (MTM, PCS Instruments) was employed to measure friction as a function of rubbing time (20 min), under pure sliding (50 mm/s) and low load (0.5 N) conditions. Compared to results using smooth surfaces, it was clear that surface topography has a pronounced affect on the time-dependent tribological behavior of the cosmetic powder suspensions studied. A two-stage friction coefficient versus time curve was observed. By varying the particle size and concentration it was shown that the duration and magnitude of each stage can be controlled.

Sequential magnetic resonance imaging changes after suspected global brain ischaemia in a dog.

Sequential magnetic resonance imaging studies over a period of 18 months were performed in a two-year-old pug dog after suspected global brain ischaemia following an anaesthetic accident. The dog was presented with seizures and neurological deficits consistent with a left brainstem and multifocal/diffuse forebrain lesion after an asymptomatic interval of 72 hours following the ischaemic event. Magnetic resonance imaging scans were performed three hours, six weeks, seven and 18 months after the incident. In the acute stage, signal hyperintensity was evident in the occipital and parietal regions of the cerebral cortex and in both rostral caudate nuclei. Slight involvement of the white matter was also noticed. In the chronic phase, the signal hyperintensity in the affected areas of the cortex was diminished and smaller in size, whereas the white matter did not appear to be compromised anymore.

Use of cloprostenol as an abortifacient in the llama (Lama glama).

As part of a larger project investigating the development and heritability of choanal atresia glama), it was necessary to develop a protocol for aborting llamas at various stages of gestation. Twenty-seven animals between 4 and 7 mo of gestation were successfully aborted a total of 53 times following two 250 microg intramuscular injections of cloprostenol at 24 h intervals. Abortion was induced once in 10 animals and multiple times (range 2 to 5) in 17 animals. Twenty-four animals (45.2%) aborted 3 d following the first injection, with 20 animals (37.7%) aborting 4 d post prostaglandin administration. Other animals aborted at 2 d (n=6, 11.3%), 5 d (n=2, 3.8%), and 7 d (n=1, 1.9%) following drug administration. Forty-nine (92.5%) of the abortions occurred following a single series of injections, while 4 animals (7.5%) aborted following a second series of injections. No confirmed pregnant animals failed to abort following the second series of cloprostenol injections. Conception rates in animals rebred 2 to 4 wk following an abortion were comparable to those of untreated animals in the research herd. Unlike the severe hypertension and death that has been reported following dinoprost tromethamine administration in the llama, no adverse reactions were observed in this study following cloprostenol administration. The results demonstrate that llamas can be safely and effectively aborted up to 7 mo of gestation (normal full term gestation = 342 +/- 10 days) without adverse effects on subsequent fertility.

Long term follow-up of combined radiochemotherapy for locally advanced bladder carcinoma.

BACKGROUND: The 5- and 10-year survival rates and the toxicity of combined radiochemotherapy for 53 consecutive patients with locally advanced bladder carcinoma were studied in a noncomparative trial. METHODS: Between November 1986 and October 1987, 53 consecutive patients (mean age, 68 years) with muscle invasive and/or locally advanced bladder carcinoma were treated by simultaneous chemotherapy and hyperfractionated irradiation. Radiation was administered during the first to fourth week and during the ninth to tenth week as an interrupted treatment protocol. Cisplatin and epirubicin were used as radiosensitizers before radiation. The maximum dose of irradiation was 57.6 grays. RESULTS: Of 53 patients, 45 completed the planned treatment course. Causes for discontinuing therapy in 8 patients were pronounced myelosuppression (n = 2), severe gastrointestinal symptoms (n = 2), nephrotoxicity (n = 1), and severe radioproctitis (n = 1). Two additional patients stopped therapy due to vascular diseases independent of treatment-related toxicity. The overall survival for all 53 patients was 23% after 5 years and 8% after 10 years. Cause specific survival was 36% after 5 years and 29% after 10 years. Four patients are still alive after 10 years without disease progression. One of them received incomplete therapy due to toxicity. All four patients underwent transurethral resections for superficial, local tumor recurrences. CONCLUSIONS: The poor prognosis group of patients with invasive and/or locally advanced bladder carcinoma was found to have a limited disease specific survival after combined radiochemotherapy.

Radiographic contrast gastrointestinal study of the neonatal llama.

This is a description of the radiographic appearance of the normal gastrointestinal tract of neonatal crias with survey and contrast radiography, including transit times for the various segments of the gastrointestinal tract. Radiographs of the abdomen of six healthy neonatal llama crias positioned in right lateral and dorsal recombency were obtained initially then at various intervals post barium administration. Portions of the gastrointestinal tract that could be identified included the stomach with first, second and third compartments, the duodenal ampulla, small intestine, proximal loop of the ascending colon, spiral colon and descending colon. Barium given by orogastric intubation rapidly entered all three compartments of the stomach and the proximal small intestine. Overall the transit time through the intestinal tract of the crias was longer than expected with no emptying of the ascending colon and beyond though studies were carried to 48-72 hours. Recommendations are made for frequency of radiographs.

Sacroiliac joint dysfunction in elite rowers.

STUDY DESIGN: Cross-sectional, descriptive study. OBJECTIVES: To examine the occurrence of sacroiliac joint dysfunction (SIJD) in a group of elite rowers. BACKGROUND: Sacroiliac joint dysfunction is a common problem for elite athletes, but is largely unstudied in the medical literature. METHODS AND MEASURES: The United States Senior National Rowing Teams at the Pan American Games and the World Rowing Championships in 1995 were tested for SIJD through the standing flexion test followed by palpatory examination of anatomic landmarks. RESULTS: Sacroiliac joint dysfunction occurred in 54.1% of team members. Sacroiliac joint dysfunction was prevalent in both sweep rowers (66%) and scullers (34%). Prevalence of SIJD did not differ among the specific types of SIJD, the side of involvement, or for the handedness of sweep rowing. CONCLUSIONS: Sacroiliac joint dysfunction is an important orthopaedic problem in rowers. This information may be useful for clinicians who treat rowers and elite athletes.

Randomized controlled trial of Protonics on patellar pain, position, and function.

PURPOSE: Patellofemoral pain (PFP) and abnormal patellofemoral congruence (PFC) are common athletic problems whose treatment remains controversial. This study examined the effects of a high volume of submaximal knee muscle exercise on objective measures of PFP and PFC under a test-retest design. METHODS: A sample of 100 subjects was randomly divided into two groups: control and treatment. All subjects of both groups were tested for PFC, using a Merchant x-ray view, function, via Kujala patellofemoral score (KPS), and pain, through a visual analog scale (VAS), initially and then 4 wk later. The treatment group exercised during activities of daily living (ADL) by wearing a Protonics device; the control group did not receive treatment. RESULTS: One-way analysis of variance tests found no difference between pre- and posttest results for the control group but found significant changes in PFC, KPS, and VAS (all P < 0.001). PFC and joint function improved, and PFP decreased in all subjects of the treatment group. CONCLUSIONS/CLINICAL RELEVANCE: It was concluded that the treatment reduced PFP and PFC as compared with the control. A high volume of submaximal knee exercise seems useful for clinical patients with PFP and abnormal PFC.

The isokinetic torque curve of shoulder instability in high school baseball pitchers.

Athletes with shoulder problems are commonly referred to orthopaedic and sports physical therapists for rehabilitation. Many of these problems include some form of shoulder instability. The purpose of this study was to generate an isokinetic torque curve that is representative of the shoulder impingement syndrome that may affect high school baseball pitchers. A sample of 241 subjects, each diagnosed with an impingement syndrome in the right shoulder, was tested using a Cybex II+ dynamometer configured to duplicate the orthopaedic loose-packed and plane of the scapula positions of the shoulder complex. The subjects were tested concentrically across five maximal repetitions of internal and external rotation at the speeds of 60, 120, 180, 240, and 300 degree/sec; graphic records were collected at 60 degrees/sec. Descriptively, testing revealed a distinct isokinetic torque curve for the impingement syndrome compared with the noninvolved shoulder. This information might serve as a useful complement to traditional clinical procedures for the diagnosis of the shoulder impingement syndrome.

Postrenal anuria after appendectomy in childhood.

An 11-year-old boy suffered from macroscopic haematuria and bilateral flank pain a few days after uneventful appendectomy for retrocaecal appendicitis phlegmonosa. Ultrasonography revealed a complete bilateral distal obstruction of the ureters. Renal failure due to postrenal anuria resolved completely after intravenous antibiotics.

The clinical and cost-effectiveness of two different programs for rehabilitation following ACL reconstruction.

Patient rehabilitation following anterior cruciate ligament reconstruction is a continuing challenge for physical therapists. This study compared the effectiveness of an established protocol to a new program which included Protonics exercise. Sixty patient (42 males and 18 females; mean age = 24.7 +/- 3.9 years; age range = 19-30 years) were randomly assigned into two groups: Group 1 received the established protocol and Group 2 received a Protonics exercise regimen. Both groups were measured for the time needed for return to unrestricted activity on the basis of objective, functional, and clinical exams; all tests were repeated at a 1-year follow-up exam. Group 2 completed treatment an average of 3.3 weeks sooner than Group 1 (mean = 19.8 vs. 23.1 weeks) at an average lower cost of $990.00 per subject. All subjects had good functional outcomes at the 1-year follow-up exam. It was concluded that the Protonics exercise program was more clinically and cost-effective than the other program, although both methods were successful for postsurgical anterior cruciate ligament rehabilitation.

Presence of enamel on the incisors of the llama (Lama glama) and alpaca (Lama pacos).

Attempts have been made to define the relationships among the South American camelids, the guanaco, llama, alpaca, and vicuna, by comparing the morphology of their incisors. The alpaca has been reported to have an incisor morphology similar to the vicuna, lacking enamel on the lingual surface. The llama and guanaco are said to have enamel on both the labial and lingual surface of their incisor teeth. These comparisons have been based on gross morphological observations and not on histologic analysis. This study was undertaken to determine whether or not alpaca teeth have enamel on the lingual surface. The cross-sectional histologic anatomy of the incisor teeth was compared in two closely related South American camelid species, the llama (Lama glama), and the alpaca (Lama pacos). Thick sections (300 microm) and scanning electron microscopy were the techniques utilized. The mandibular first, second, and third incisors were examined in four llamas and five alpacas. A substantial layer of enamel was present on all surfaces of all llama incisors. The enamel layer on the labial surface of the alpaca incisors closely resembled that found in the llama. The enamel layer on the lingual surface of the alpaca incisors, although greatly reduced, was distinctly present. Alpacas may be more closely related to guanacos and llamas than to vicunas. A histologic study of vicuna incisors would help to better define the relationships of the four camelids.

A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy.

The professional literature contains relatively few randomized-control studies that have assessed the efficacy of physical therapy approaches to the management of patients with chronic low back pain (CLBP). The purposes of this study were: 1) to investigate the effects of physical agents, joint manipulation, low-tech exercise, and high-tech exercise on objective measures of CLBP; 2) to track the length of CLBP relief; and 3) to determine treatment cost-effectiveness. Two-hundred-fifty subjects (68 females, 182 males; ages 34-51 years) with CLBP following an L5 laminectomy were randomly assigned into five separate groups for a treatment period of 8 weeks. Chronic low back pain status was measured by modified-modified Schober, Cybex Liftask, and Oswestry procedures. Results revealed that: 1) only low-tech and high-tech exercise produced significant improvements (p < .05) in CLBP, 2) the mean period of CLBP relief ranged from 1.6 weeks (control) to 91.4 weeks (low-tech exercise), and 3) low-tech exercise was most cost-effective. It was concluded that: 1) low-tech and high-tech exercise were the only effective treatments for CLBP, 2) low-tech exercise produced the longest period of CLBP relief, and 3) low-tech exercise was the most cost-effective form of treatment. Clinically, low-tech exercise may be the treatment method of choice for the effective management of chronic low back pain.

The effects of supplementing diets with Saccharomyces cerevisiae var. boulardii on male poult performance and ileal morphology.

This study determined the effects of three levels of supplemental yeast of Saccharomyces cerevisiae var. boulardii (SCB) on commercial male poult performance and ileum morphology. One hundred and sixty Nicholas poults were randomly assigned to 16 battery cages (10 poults per cage, 4 cages per diet) from 1 to 21 d of age (DOA). Poults were fed diets (26% CP) consisting of corn-soybean (CS, control), CS + .01% SCB, CS + .02% SCB, and CS + .06% SCB. At 21 DOA, 30 poults fed the CS and CS + .02% SCB diets (from 1 to 21 DOA) were randomly selected within each diet, placed in 1 of 6 cages (5 poults per cage, 3 cages per diet), and fed their respective diet to 35 DOA. Body weights and feed consumptions (FC) were measured at 21 and 35 DOA and morphological comparisons of ileal tissues were conducted at 35 DOA. Increased BW (P < .004) at 7, 14, and 21 DOA were observed for poults fed diets containing SCB at .01, .02, and .06% of the diet. No dietary differences (P > .05) were observed in FC or feed:gain ratios from 1 to 21 DOA. Increased (P < .03) BW were maintained from 21 to 35 DOA for poults fed .02% SCB, whereas no dietary differences (P > .05) in FC or feed:gain were observed. Histological examination of ileal sections from poults (35 DOA) fed the CS and CS + .02% SCB diets revealed a decrease (P < .04) in the number of goblet cells per millimeter of villus height and a decreased (P < .02) crypt depth in poults receiving .02% SCB. No dietary differences (P > .05) were observed for either villus height or width.

Treatment of acute lead ingestion in a juvenile macaw.

A juvenile domestic green-winged macaw was admitted to the veterinary clinic within an hour of ingestion of lead drapery weights. Radiopaque objects were evident in the crop and ventriculus. The bird was anesthetized, and the crop was lavaged to remove lead fragments. Because lead fragments remained in the ventriculus after lavage, chelation treatment was instituted. Serial radiography was done on days 2, 5, 9, and 14 to determine passage of the lead. By day 14, lead fragments were not visible radiographically. The macaw did not have ill effects from the lead ingestion or from medical treatments. Because this bird had been observed ingesting the lead weights, treatment was for foreign body ingestion initially and for lead ingestion secondarily.

Third compartment ulcers in the llama.

The diagnosis of third compartment ulcers in the llama and alpaca is largely one of exclusion. Clinical signs may include mild to severe colic, inappetence, decreased fecal output, bruxism, and depression. Abdominocentesis results are usually unremarkable if C3 perforation has not occurred but reflective of a generalized peritonitis if full thickness ulceration has occurred. The H-2 receptor antagonists cimetidine and ranitidine do not suppress C3 acid production for a significant period of time and are of questionable efficacy in the management of C3 ulcers.

Upper extremity proprioceptive training.

Proprioception following lower extremity injuries is commonly recommended, but there is little information on proprioception training following upper extremity injuries. No studies have evaluated whether proprioception programs for athletes in open kinetic chain activities (throwing, shot putting) should be different than programs for athletes in closed kinetic chain activities (gymnastics, swimming, kayaking, or rowing). In this paper, we provide a rationale for proprioception training for upper extremity injuries in athletes and the importance of analyzing the athlete's sport and activity for specificity of proprioception exercises. We then discuss one popular proprioception exercise, rhythmic stabilization, and propose several additional upper extremity proprioception exercises, along with instructions for the athletic trainer on how to direct the athlete through these exercises.