Transdermal delivery of two antioxidants from different cosmetic formulations.

The efficacy of any cosmetic product containing a functional ingredient is determined by the skin delivery of the active molecule, which is influenced by the type of the vehicle and the molecule itself. This study was designed to compare the percutaneous absorption habits of the antioxidants carcinine and lipoic acid out of various formulations by means of the porcine skin model. Initial evaluation of the in vitro porcine skin model has demonstrated its feasibility for various substances and formulations [1, 2]. Increasing legal requirements for risk assessment in the cosmetic industry have led to the development of this alternative test method. The penetration properties are determined by the OECD Guideline TG 428: Skin Absorption: in vitro Method [3, 4], which allows the use of porcine skin for penetration studies. Porcine skin is used because of its similarity to human skin in terms of its morphology and the essential permeation characteristics [5]. The mass balances for each tested formulation type of the antioxidants show individual penetration behaviours with significant differences. The presented data plainly demonstrate that the lipophilic lipoic acid has a distinct higher penetration potential than the hydrophilic carcinine. The chosen vehicle can enhance or reduce the transdermal delivery of both tested antioxidants. Modern effective cosmetic formulations will work only, if the active ingredients penetrate into the epidermis. In conclusion, the correct selection of a suitable formulation plays an important role during product development.

Immunoglobulin G (IgG) and IgA, but also nonantibody factors, account for in vitro neutralization of human immunodeficiency virus (HIV) type 1 primary isolates by serum and plasma of HIV-infected patients.

The factors present in serum and plasma samples of human immunodeficiency virus (HIV)-infected patients that are responsible for the neutralization of four HIV type 1 (HIV-1) primary isolates in vitro have been analyzed. Purification of immunoglobulins (Ig) by affinity chromatography showed that the activities were mostly attributable to IgG and less frequently to IgA. For two samples, we have shown that the high-level and broad-spectrum inhibitory activity was essentially caused by non-Ig factors interfering with the measurement of antibody-specific neutralizing activity.

Cutaneous melanoma: patient surveillance and tumor progression.

BACKGROUND: The goal of surveillance examinations (SVE) in patients at high risk for cutaneous melanoma (CM) is to diagnose premetastatic tumors. OBJECTIVE: We attempted to determine whether SVE before CM diagnosis influences the histopathologic features of tumor progression. METHODS: A retrospective review was conducted of consecutive patients who presented with an intact primary CM during a 36 month period (1991 to 1994) in a university dermatology ambulatory setting. RESULTS: Thirty-nine intact CMs were diagnosed in 34 patients. Compared with 23 CMs in as many patients presenting at the first encounter, 16 CMs diagnosed in 11 patients during SVE had a smaller mean tumor diameter (P = .007) and tumor thickness (P = .002) and were more likely anatomic level I or II (P = .003) with microscopic thickness less than 0.76 mm (P = .01) and less than 0.50 mm (P = .002). CONCLUSION: Primary CMs are more likely to be smaller and thinner when diagnosed during SVE than at first encounter, features that are likely to have a positive impact on CM mortality.

Transepidermal elimination of elastic fibers after carbon dioxide laser resurfacing. A report of two cases.

BACKGROUND: Laser resurfacing for rhytides and dermatoheliosis is becoming more popular. As more procedures are performed, new side effects and complications are reported. METHODS: We report two cases of transepidermal elimination of elastic fibers after laser resurfacing with the carbon dioxide (CO2) laser for rhytides. Both patients presented with yellow to violaceous papules (one with papules near the lateral eyelid margins, and one with papules over the forehead and cheeks) at 18-22 days after laser resurfacing. Biopsy specimens were taken from both patients and revealed transepidermal elastic fiber elimination. CONCLUSION: To our knowledge, this has not been reported in the literature previously. We report these cases to make the clinician aware of this potential side effect after laser resurfacing and review the literature on side effects and complications of laser skin resurfacing as well as associations with transepidermal elimination of elastic fibers.

Widespread eruptive dermal and atypical melanocytic nevi in association with chronic myelocytic leukemia: case report and review of the literature.

Eruptive nevi have been associated with local skin trauma and immunosuppression, and atypical eruptive nevi preceding melanoma have been reported in immunocompromised transplant patients. We describe a 25-year-old man with widespread eruptive atypical and dermal melanocytic nevi in association with chronic myelocytic leukemia. Our patient's disease differs from earlier reports of eruptive nevi because his nevi appeared before induction chemotherapy. Eruptive nevi may have been a prodrome to leukemia in this patient. His nevi were histologically similar to eruptive atypical nevi observed in AIDS patients and may imply a link between systemic immunosuppression and melanocyte proliferation. We suggest that patients in whom eruptive nevi develop in association with immunosuppression should be carefully observed for the development of melanoma skin cancer.

Bacterial esophagitis associated with CD4+ T-lymphocytopenia without HIV infection. Possible role of corticosteroid treatment.

Although infectious esophagitis is usually due to infection with Candida, herpes virus, or cytomegalovirus, bacterial esophagitis is occasionally observed. Recently, patients have been reported with CD4+ T-lymphocytopenia without HIV infection. Bacterial esophagitis per se has not been reported in these patients. We report the case of an 80-year-old patient admitted with a COPD exacerbation after being on chronic steroids. The patient developed esophageal symptoms and was found to have bacterial esophagitis by biopsy. Her CD4+ counts were found to be low, but she denied HIV risk factors and HIV testing was negative. Her CD4+ counts rose into the normal range as her steroids were tapered, and her esophagitis improved on antibiotics. This case is reported to alert physicians to the possible association of bacterial esophagitis with CD4+ T-lymphocytopenia without HIV infection and to discuss the possible etiological role of corticosteroid treatment.

[Psychopathologic symptoms and personality traits in patients with florid acromegaly]. / Psychopathologische Symptomatik und Persönlichkeitszüge bei Patienten mit florider Akromegalie.

Important technical and clinical progress has been achieved in neuroendocrinological diagnostic investigations in recent years. Patients with active acromegaly and without a total loss of pituitary anterior lobe function can now be defined. With the help of neuroradiological investigations the intra-, supra- and parasellar extent of the adenoma can be determined. For the following study we selected patients with active acromegaly without a significant reduction of the other pituitary anterior lobe functions and with intrasellar adenomas. 31 patients with active acromegaly were examined before the operation. These patients have uniform psychopathological symptoms including loss of drive, affective disorders such as dejection, brooding, and irritability, and increase in appetite and loss of libido. The psychopathological symptoms are dependent neither on the level of the increased growth hormone nor on hyperprolactinemia. The higher cortical functions are intact. No disorders of intelligence or memory can be found. Disturbances of mental functions are manifested as disorders of concentration and fatigue. Personality traits were strikingly uniform. Their personalities are characterized by conscientiousness, reliability and industriousness. Some patients are also anxious and lacking in self-confidence. The personality traits of the patients become more pronounced as a result of the illness. The continuous development of the patients corresponds to the personality traits. Changes in personality, in particular those caused by organic brain disease were not found. Because we applied strict criteria to the selection of our patients we conclude that the uniform psychopathological symptoms and the uniform personality traits of the patients are an essential element of the clinical picture of active acromegaly.

Subclinical organic psychosyndromes on intrathecal injection of metrizamide for lumbar myelography.

Eighteen patients with symptoms and signs of possible lumbar disc herniation, who had no evidence of a preexisting organic psychosyndrome were included in the study. An organic psychosyndrome was found in six of them 10 h after lumbar myelography with metrizamide. The psychosyndrome, which was characterized by impaired memory and depression, could be demonstrated only by psychometric methods. In these patients metrizamide could be demonstrated within the basal cisterns by computed tomography 8 h after lumbar injection of the contrast medium. The organic psychosyndrome was completely reversible; five days after myelography it could not be detected any more by psychometric means. The development of an organic psychosyndrome in six of the 18 patients suggests a neurotoxic effect of metrizamide. This assumption is supported by hypo- and areflexia in four patients after intrathecal metrizamide as well as by EEG changes seen in three patients after myelography. There was no correlation between the EEG changes or reflex abnormalities and the organic psychosyndrome.

[Conventional-radiographic and computer-assisted cisternography of the posterior fossa with metrizamide (author's transl)]. / Konventionell-radiographische und computerassistierte Zisternographie der hinteren Schädelgrube mit Metrizamid. Untersuchungen zur Technik und erste Ergebnisse.

Conventional radiographic and computer-assisted (CT) cisternography of the posterior fossa using Metrizamide was carried out in 25 and 33 patients respectively. The contrast medium was injected by the lumbar or cervical route. During conventional cisternography, contrast medium distribution is most easily controlled by a lateral injection at the level of the first to second cervical vertebra. Because of its physical properties, Metrizamide results in good demonstration of detail. CT cisternography is usually able to demonstrate an extra-cerebral space-occupying lesion with a diameter greater than 1 cm. This procedure has fewer complications due to the contrast medium or the technique, since small amounts of Metrizamide achieve an adequate increase in the density of the CSF; it is therefore possible to inject this by a lumbar route and to carry out the entire examination with the patient supine. Both conventional and CT cisternography permit very accurate diagnosis in the region of the foramen magnum. Both procedures can be used on their own or as an addition to conventional Metrizamide myelography.

[Computer tomography of the cervical spinal canal following intrathecal enhancement: cervical CT myelography. Studies on technic and the initial results (author' transl)]. / Computertomographie des zervikalen Spinalkanals nach intrathekalem Enhancement: zervikale CT-Myelographie. Untersuchungen zur Technik und erste Ergebnisse.

Computer tomography of the cervical spinal canal was carried out in 54 patients after the intrathecal injection of metrizamide (CT myelography). In 43 patients this was done after conventional myelography, in eleven it was the primary examination. In 32 patients the examination proved normal and in 22 abnormal. Correlation between the CT findings and conventional myelography was excellent. Quite small intraspinal structures both normal and abnormal, could be demonstrated. CT myelography is particularly valuable for determining the special relationships within the vertebral canal. The procedure can supplement and confirm conventional myelography, for instance round the foramen magnum. Under certain circumstances it may be regarded as the method of choice, since it is simpler for the patient and less likely to produce complications due to the contrast medium.

[Unexplained tetraspasticity in adults (author's transl)]. / Ungeklärte Tetraspastik des Erwachsenen

1. Between 1965 and 1974 146 patients with unexplained tetraspasticity were admitted and examined. In 123 cases extended neuroradiologic examination with myelography of the cervical spinal canal was carried out. A space occupying lesion was found in 59 cases: narrow spinal canal, protruding discs. In 64 cases no pathologic processes were seen radiologically. Comparison of both groups: no differences in clinical signs, history or findings. 2. Tetraspasticity alone was the leading sign in 30 cases. The legs were always more severely involved than the upper limbs. In 70% spasticity was more severe on the right. Further clinical analysis depends on additional signs, particularly paresthesiae, pain, disturbed joint-sense. Among the patients with protruding discs heart-and circulatory insufficiency is a little more common, but in the group without protrusion exogenous/endogenous metabolic conditions(intoxication, malabsorption) and neoplasms. -Protein content of CSF is raised equally in both groups, particularly albumin. This is probably due to reduced circulation of CSF. In 6 patients an internal hydrocephalus was found. 3. No single active causative factor could be found nor any familial relationship. In spite of increasingly extended diagnostic techniques no underlying condition could be discovered. Tetraspastic is a "polygenetic" reaction of the central nervous system without a final common path. The cases show that mechanical factors (cervical myelopathy) predispose locally to non-mechanical injuries.

Production of gibberellic Acid using a dairy waste as the Basal medium.

Filtered whey has been shown to be a feasible basal medium for the production of gibberellic acid. A maximum yield of 750 mg/liter has been obtained, and the only supplement required was Mg ion at a final concentration of 10 mg/liter.

[Mild course of botulinus intoxication (author's transl)]. / Leichte Verlaufsform einer Botulinusintoxikation

Botulinus poisoning generally ends fatally after an only short course, mild forms being rare. In four members of a family who had eaten deep-frozen grilled sausages symptoms of botulinus poisoning developed, predominantly marked by disturbances of the autonomic nervous system. The course was so mild that hospitalization was not necessary nor was specific antitoxin administration. All clinical symptoms had disappeared after nine weeks. But special clinical and neurophysiological studies (electromyography, pupillography, electroencephalography) demonstrated abnormalities for very much longer. Botulinus poisoning was proven in animal tests and neutralization tests with botulinus antitoxin. The epidemiology, source of infection, and clinical symptoms suggest botulinus type B poisoning.

[Metabolic myelosis (author's transl)]. / Funikuläre Myelosen

102 patients suffering from metabolic myelosis were studied clinically. Among the early signs and symptoms, pins and needles, freezing or burning feet, and impaired kinaesthesia were the most frequent ones. With the syndrome progressing, motor disturbances of supramotoneuronal character developed. Every third patient had neurogenic ischuria. Examinations of the cerebrospinal fluid did not reveal any deviation characteristic or "typical" of myelosis. Different pathogenic factors were detected by analysis according to the rules of internal medicine. However, no single factor defining myelosis aetiologically could be discovered. The majority of cases suggested that the metabolic steady state decompensated by the coincidence of more than one factor, thus initiating myelosis. The following pathogenic factors were observed frequently: Malabsorption, abuse or intoxication, liver cell damage, neoplasm. The great variety of pathogenic factors emphasizes that metabolic myelosis must be counted among the polygenetic identical reactions of the central nervous system. These are the organism alarming signals and they require comprehensive general examinations.