Fractional carbon dioxide laser versus low-dose UVA-1 phototherapy for treatment of localized scleroderma: a clinical and immunohistochemical randomized controlled study.

Morphea is a rare fibrosing skin disorder that occurs as a result of abnormal homogenized collagen synthesis. Fractional ablative laser resurfacing has been used effectively in scar treatment via abnormal collagen degradation and induction of healthy collagen synthesis. Therefore, fractional ablative laser can provide an effective modality in treatment of morphea. The study aimed at evaluating the efficacy of fractional carbon dioxide laser as a new modality for the treatment of localized scleroderma and to compare its results with the well-established method of UVA-1 phototherapy. Seventeen patients with plaque and linear morphea were included in this parallel intra-individual comparative randomized controlled clinical trial. Each with two comparable morphea lesions that were randomly assigned to either 30 sessions of low-dose (30 J/cm2) UVA-1 phototherapy (340-400 nm) or 3 sessions of fractional CO2 laser (10,600 nm-power 25 W). The response to therapy was then evaluated clinically and histopathologically via validated scoring systems. Immunohistochemical analysis of TGF-ß1 and MMP1 was done. Patient satisfaction was also assessed. Wilcoxon signed rank test for paired (matched) samples and Spearman rank correlation equation were used as indicated. Comparing the two groups, there was an obvious improvement with fractional CO2 laser that was superior to that of low-dose UVA-1 phototherapy. Statistically, there was a significant difference in the clinical scores (p = 0.001), collagen homogenization scores (p = 0.012), and patient satisfaction scores (p = 0.001). In conclusion, fractional carbon dioxide laser is a promising treatment modality for cases of localized morphea, with proved efficacy of this treatment on clinical and histopathological levels.

Are normolipidaemic patients with xanthelasma prone to atherosclerosis?

BACKGROUND: When patients with xanthelasma are found to have normal lipid levels, dermatologists usually proceed with their treatment without further investigations. However, there is some evidence that normolipidaemic patients with xanthelasma (NPX) have a similar cardiovascular risk to hyperlipidaemic patients with xanthelasma (HPX). AIM: To evaluate the risk of atherosclerosis in Egyptian NPX compared with HPX and controls. METHODS: In total, 20 NPX, 20 HPX and 40 normolipidaemic controls were enrolled. All participants were matched for age and sex. Diabetes was an exclusion factor. Carotid ultrasonography was used to measure intima-media thickness (IMT). Other risk factors of atherosclerosis such as high blood pressure, obesity and smoking were also assessed, as well as atherosclerotic markers, including total leucocytic count (TLC), C-reactive protein and lipoprotein a. RESULTS: Although still within the normal range, total cholesterol and triglycerides were significantly higher in NPX compared with controls. IMT was significantly higher in NPX compared with controls, but lower than that of HPX. The increased IMT in NPX was not related to any of the studied risk factors. Apart from significantly higher body mass index and TLC, NPX showed no significant differences from controls for other risk factors of atherosclerosis or for atherosclerotic markers. CONCLUSION: NPX seem to have a higher risk of atherosclerosis independent of lipid concentrations, and should therefore be fully investigated in order to allow detection and early management of such risk.

Treatment of phosphogypsum waste produced from phosphate ore processing.

Phosphogypsum (PG), primary byproduct from phosphoric acid production, is accumulated in large stockpiles and occupies vast areas of land. Phosphogypsum is a technologically enhanced naturally occurring radioactive material (TE-NORM) that contains radionuclides from (238)U and (232)Th decay series which are of most radio-toxicity. The reduction in concentration of radionuclides content from PG was based on leaching of (226)Ra, (210)Pb, (238)U and (40)K using tri-butyl phosphate (TBP) and tri-octyl phosphine oxide (TOPO) in kerosene. The factors which affect the leaching process such as contact time, concentration of the solvent and temperature were optimized. Based on the experimental results, about 92.1, 88.9, 83.4, 94.6% of (226)Ra, (210)Pb, (238)U and (40)K respectively were successfully removed from the PG. The reduction in the concentration of radionuclides was accompanied by reduction in the concentration of rare earth elements (∑REE) equals to 80.1%. Using the desired organic extractant under optimum conditions for treatment of the PG waste leads to obtain a decontaminated product that can be safely used in many industrial applications.

DNA polymorphisms and tissue cyclooxygenase-2 expression in oral lichen planus: a case-control study.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disorder defined as a precancerous condition. Special attention has been paid to the expression of cyclooxygenase-2 (COX-2) and its potential role in development of oral squamous cell carcinoma. The identification of single nucleotide polymorphisms that affect gene function or expression and contribute to disease predisposition has become a major area of investigation toward understanding the mechanisms for cancer. OBJECTIVE: The objective of this study is to investigate the association between the COX-2 765G>C gene polymorphism, tissue COX-2 expression and the development of OLP as a chronic inflammatory condition. METHODS: This study was done on 50 patients with OLP and 50 healthy controls. COX-2 activity was assessed by measuring tissue prostaglandin E (PGE)2 levels by enzyme immunometric assay kit. COX-2 765G>C gene polymorphism was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR) followed by restricted fragment length polymorphism (RFLP). RESULTS: OLP patients showed statistically significant higher mean PGE2 than the control group. We did not observe any statistically significant differences in genotype distribution or allele frequency between the patients and the control group (P > 0.05). Odds ratio showed no statistically significant association between COX-2 765G>C polymorphism and lichen planus. CONCLUSION: The present evidence thus indicates that variation in the COX-2 gene is unlikely to be of relevance to the aetiology of OLP. As this is the first report concerning the COX-2 -765G>C gene polymorphism and the risk of OLP, additional studies with larger sample size will be required to confirm these findings.

Peroxisome proliferator-activated receptor gamma, a possible culprit in mycosis fungoides: an immunohistochemical study.

BACKGROUND: It still remains debatable whether peroxisome proliferator-activated receptor gamma (PPARγ) is pro- or antineoplastic, and its exact role in mycosis fungoides (MF) remains unclear. OBJECTIVE: This prospective comparative study aimed to investigate the expression of PPARγ in MF and compare it with psoriatics and controls in a trial to deduce its possible role in MF. Also, we tried to clarify the relation between PPARγ and Bcl-2 in MF. METHODS: Twenty MF patients, 20 psoriatic patients and 20 controls were included. All participants underwent a skin biopsy, and immunohistochemical staining for both PPARγ and Bcl-2 were performed. Western blot analysis was performed for detection of both PPARγ and Bcl-2. RESULTS: The mean area per cent of PPARγ measured in the MF patients (57.1217±9.502417) was significantly higher (P<0.001) when compared with that of both the psoriatics (2.989±1.723) and controls (35.9357±8.1789). The mean area per cent of Bcl-2 in MF patients (9.3763±6.6328) was significantly higher (P<0.001) than that of both the psoriatics (2.35±1.35) and the controls (0.73105±0.5302)]. Our results were confirmed using the western blot analysis. We detected a highly significant positive correlation between the PPARγ and Bcl-2 mean area per cents in all patients. In our MF patients, both parameters were also positively correlated with the age of the patient, duration and stage of MF (P<0.05). CONCLUSION: Our data suggest a possible role for PPARγ in the pathogenesis of MF possibly through several mechanisms, one of which might be conferring upon the lymphoma cells, a survival advantage at least partially through up regulating Bcl-2.

Treatment of phosphogypsum waste using suitable organic extractants.

Phosphogypsum (PG) is a residue of the phosphate fertilizer industry that has relatively high concentrations of harmful radioactive materials. The reduction in concentration of the radionuclides from PG was investigated. The removal process is based on leaching of radionuclides using suitable organic extractants. The studied radionuclides were 226Ra, 210Pb, 238U and 40K. The factors affect the leaching process such as type of leaching materials, contact time, concentration of the desired solvent, liquid to solid ratio, and temperature were studied. Based on the experimental results, about 71.1, 76.4, 62.4, and 75.7% of 226Ra, 210Pb, 238U and 40K respectively were successfully removed from the PG. The reduction in the concentration of radionuclides was accompanied by reduction in the concentration of rare earth elements (∑REE) equals to 69.8%. Using the desired organic extractant under optimum conditions for treatment of the PG waste leads to obtain a decontaminated product that can be safely used in many industrial applications.

Prevention and treatment of pregnancy-induced hypertension (preeclampsia) with progestogens.

Available data indicate that progesterone is able to treat pregnancy-induced hypertension (preeclampsia). Dydrogesterone and 17alpha-hydroxyprogesterone caproate might also be used for this purpose. Prevention of hypertensive disorders in preeclampsia also seems possible, but studies are needed to confirm this.

Radioimmunoassay of 5 alpha-pregnane-3,20-dione. A metabolite of placental progesterone.

A radioimmunoassay (RIA) procedure has been developed for the measurement of 5 alpha-pregnane-3,20-dione (DHP) in human plasma after ether extraction of the plasma-samples, followed by column chromatography. The antiserum was generated in rabbits with 6 alpha-carboxyethylmer-captoprogesterone-BSA conjugate. The high affinity (Ka = 3.72 X 10(9) l/mol) antiserum binds 40% of 40 picograms of tritiated 5 alpha-pregnane-3,20-dione at working dilutions of 1 : 2800. Negligible cross-reactivity of the antiserum was detected with 5 beta-pregnane-3,20-dione (1.8%). Other hydroxylated pregnanes showed minor cross-reactivity (5-40%). The cross-reacting steroids were all separated from pregnanedione by one chromatographic step. The plasma levels of 5 alpha-pregnane-3,20-dione were measured from 22nd to 42nd week of normal pregnancy and compared to published data.

Progesterone therapy in pregnancy induced hypertension therapeutic value and hormonal profile.

The study was carried on 25 primigravidae with severe pre-eclamptic toxaemia (PET) and 19 normal pregnancies as a control group. 15 cases of PET were treated by 600 mg. progesterone daily for variable duration between one and six weeks. Daily blood samples were assayed for progesterone, dihydroprogesterone, estriol, estradiol, placental lactogen and prolactin. Under progesterone therapy there was a significant decrease in both systolic and diastolic blood pressure, significant increase in urinary output, amelioration of the edema, slight reduction in weight gain, but no change in the proteinuria. Prolactin was the only hormone that showed significant rise in the group of PET when compared with normal pregnancy.