Fluorescence remission spectroscopy of psoriatic lesions and the effect of topical anthralin therapy.

BACKGROUND: Psoriatic lesions are characterized by induration, scaling and erythema. Erythema is a result of inflammation and increased microvascular blood flow. Anthralin is the strongest topical antipsoriatic drug that causes clearing of psoriatic lesions and temporary remission. OBJECTIVE: The objective evaluation of skin perfusion might be a suitable way to gain a better insight in the pathophysiological process of this disease and to evaluate the response to antipsoriatic anthralin therapy. METHODS: We evaluated 21 psoriatic lesions (plaques, patches and pinpoint lesions) including 4 lesions in remission with anthralin induced erythema and 4 controls of healthy, uninvolved skin. We performed the measurements with a combined fluorescence and remission imaging (FRIS). The FRIS sensor is coupled with a touch screen industrial computer. The equipment consists of a white-light halogen lamp (20 W), two VIS-spectrometer modules (Zeiss) for remission detection and references. Imaging is realized by CCD-colour camera module and white light ring-lighting. Fluorescence emission was realized using an ultraviolet LED with a wavelength of 370 nm. The fluorescence detector is a highly sensitive MCS CCD (Zeiss) with an integration time of 2.5 sec. RESULTS: Spectral remission of psoriatic skin is characterized by a pronounced decrease (60-80%) of the haemoglobin double-peak compared to uninvolved skin. The NADH-fluorescence is diminished in lesional psoriatic skin including anthralin-treated areas with clinical remission. CONCLUSIONS: Vascular perfusion is increased in psoriatic lesions as demonstrated by remission spectroscopy. NADH-fluorescence is reduced in lesional psoriatic skin and in anthralin-induced erythema. FRIS is a suitable tool for objective evaluation of the cutaneous response to antipsoriatic treatment.

[Thermal irritation of the organ of equilibrium by means of heat radiation (NIR)]. / Thermische Reizung des Gleichgewichtsorganes mittels Wärmestrahlung (NIR).

BACKGROUND AND OBJECTIVE: Convection and conduction are the main factors involved in caloric response. Heat radiation has also been discussed as an important factor. The present work tests whether heat radiation is an essential part of the caloric response and whether caloric irritation of the semicircular canals is possible using two sources with a different near infrared (NIR) spectrum. In addition, we tested whether it is possible to induce a detectable nystagmus reaction using either NIR-radiation sources. RESULTS: NIR is able to penetrate bone tissue. The temperature elevation in dry and wet bones was almost immediately registered. With high optical power, specific temperature maxima could be seen by focal and selective broad spectrum and monochromatic NIR irritation of the three semicircular canals. Nystagmus could be generated after using both NIR emission sources in five probands. CONCLUSIONS: NIR generates temperature differences and nystagmus. By using a broad scale as well as a monochromatic NIR-emission source, it is possible to generate a nystagmus. The procedure of NIR-irritation occurs without physical contact, is painless and quiet.

[Near infrared stimulation of the equilibrium organ--first clinical experiences]. / Nahinfrarotreizung des Gleichgewichtsorgans--erste klinische Erfahrungen.

BACKGROUND: A new method for the stimulation of the organ of equilibrium by means of a broad-scale and monochromatic near infrared emission was developed. This method should be examined within the framework of a pilot study, evaluated and its clinical possible applications examined. PATIENTS AND METHODS: Healthy probands (n = 15), patients with a radical cave of the ear (n = 5), patients with a defect of the tympanic membrane (n = 5) and spontaneous nystagmus (n = 5) were examined. In healthy probands an irritation with broad-scale as well as monochromatic near infrared (NIR) was performed and compared with a water irrigation (44 degrees, 50 ml in 30 seconds). The subjective, local feelings during the application and the appearance of giddiness according to irritation were recorded and the nystagmus was registered by means of videonystagmography. In patients with radical cave of the ear and tympanic membrane defects, a broad-scale NIR-irritation before a comparative irritation with warm air (44 degrees) was performed exclusively. RESULTS: In all healthy probands, a nystagmus reaction could be seen with broad-scale and monochromatic NIR. Compared to the hot water irritation slow phase velocity (SPV) was decreased however registrable by means of Frenzel glasses and electronystagmography during the culmination stage. In patients with radical cave (n = 4) and tympanic membrane defects (n = 3) showing paradoxical nystagmus reaction during hot air irritation, a nystagmus to the site of stimulation resulted by means of light calorisation. In patients with a spontaneous nystagmus an attenuation (n = 1) or inversion (n = 2) could be achieved by NIR-radiation. CONCLUSIONS: The method of the NIR-radiation is suitable in clinical practice for the caloric test proofing warm reaction. Vaporization cold does not occur. The application of heat charm is better proportionable and steerable than during air irritation. The procedure is sterile, noiseless and non-contact. Difficulties in interpretation of results of vestibular tests because of evaporation coldness do not occur.

[Testing for general knowledge of dog owners--requirements for courses and examinations]. / Sachkundenachweis für Hundehalter--Anforderungen an Lehrgang und Prüfung.

The expert group of the German Veterinary Chamber has established a frame-work of basic knowledge for education and examination of normal dog owners together with other groups. The most important topics of the theoretical part are: Ethology (social-behaviour, communication dog-human and dog-dog, education, dog-training, learning, psychology, fear, aggression), keeping and caring (prevention, first aid, handling), nutrition and health (diets, vaccination, parasites, diseases), breeding (sexual differences, knowledge about dog-breeds and their needs), dogs in public and family (laws, interaction, obedience, control. The practical part concentrates on the ability of the owner to influence and control his dog, practical handling and the dogs' obedience. Minimum age of owners is 18 years, the dog should be between 18 and 24 months old. The owner has to pass the theoretical exam only once in his/her life, the practical-part has to be repeated with every new dog older than 18 months.

Laser therapy of spider leg veins.

BACKGROUND: Spider leg veins are a common aesthetic problem in females. The standard treatment is sclerotherapy but lasers have been used for decades to solve this problem as well. AIM: To review recent advances in laser physics and its tissue interactions with skin vessels. The different laser types used to treat spider leg veins are discussed, including their advantages, limitations and possible adverse effects. METHOD: The international literature on laser therapy for spider leg veins has been reviewed with particular emphasis on the last decade. RESULTS: Recent developments in laser technology allow a more selective and well-tolerated therapy. Efficacy has also improved. Most studies report a greater than 75% improvement in spider leg veins as a realistic goal for laser therapy. Clinic response depends upon wavelength, fluence, pulse width and pulse duration, cooling and the diameter and colour of spider leg veins. CONCLUSIONS: Sclerotherapy remains the gold standard treatment for spider leg veins. Nevertheless, laser therapy has become increasingly efficacious and convenient. Laser selectivity has been improved by technological progress. The ideal laser, however, has yet to be invented.

Response of spider leg veins to pulsed diode laser (810 nm): a clinical, histological and remission spectroscopy study.

BACKGROUND: Spider leg veins are common. Their treatment with laser or intensed light therapy shows generally variable success rates and often adverse side effects such as hyper- or hypopigmentation. This study was performed to investigate whether pulsed diode laser (810 nm) treatment is effective and safe. METHODS: Thirty-five female patients with spider leg veins were included in this prospective trial. They were treated twice with a pulsed diode laser (810 nm; spot size 12 mm, frequency 2-4 Hz, pulse width 60 msec, fluence 80-100 Jcm(-2)). Laser therapy was performed on day 0 and day 14. Clinical assessments were carried out before and immediately after the first laser therapy, after 2 weeks, 8 weeks, and one year. Skin biopsies were taken before and immediately after the first laser treatment, and after 10 weeks. Contact-free remittance spectroscopy was performed before laser treatment, immediately after the first treatment, after 2 weeks and 8 weeks. RESULTS: After the first treatment 15 patients showed a complete disappearance (CR) of spider leg veins; in the remaining 20 patients a remarkable improvement (RI) was noted (n=35). After six months of follow-up CR was seen in 6 patients, RI in 6, a stable situation in 9, and scar formation in 1 patient (n=21). The effect was almost completely stable during one year of follow-up. The examination of histological specimens before and after laser treatment showed no cellular inflammatory reaction. The mean vascular area was significantly reduced after the first (p<0.05) and after the second (p<0.05) laser treatment. Spectral analysis showed a marked decrease of peaks for oxygenized haemoglobin immediately after laser treatment and during the follow-up. Safety profile was excellent without purpuric reaction or pigmentary changes. Mild scarring was observed in two patients at the end of follow-up. CONCLUSIONS: Pulsed diode laser therapy (810 nm) is an effective and safe treatment option for spider leg veins. The effects can be seen immediately. Objective monitoring by non-invasive remission spectroscopy and histology of biopsy specimens demonstrates selectivity of the laser action.

Effects of long versus short bout exercise on fitness and weight loss in overweight females.

OBJECTIVE: The specific aim of this study was to determine if three 10 minute bouts of exercise per day (3 x 10) and two 15 minute bouts per day (2 x 15) were as effective as one 30 minute bout per day (1 x 30) for improving VO2 max and weight loss. METHODS: Overweight, female college students (body mass index > or = 28 kg/m2) were recruited and assessed at baseline and post-treatment for aerobic fitness (Astrand maximal cycle test), weight, skinfold thickness (7-site), and circumference measures (4-site). Following measurement of resting energy expenditure (REE), subjects were asked to follow a self-monitored calorie restricted diet (80% of REE) for the twelve week duration of the study and were assigned (non-random) to one of four treatment groups: 1) a nonexercising control group (control, n = 8), 2) a 30 minutes continuous exercise group (1 x 30, n = 12), 3) a 30 minutes accumulated exercise group (2 x 15, n = 10) and 4) a second 30 minutes accumulated exercise group (3 x 10, n = 8). The exercising subjects participated in aerobic exercise training at 75% of heart rate reserve three to five days per week with all exercise monitored. RESULTS: VO2 max increased significantly while weight, body mass index, sum of skinfolds, and sum of circumferences decreased significantly from baseline to post-treatment in the 1 x 30, 2 x 15 and the 3 x 10 groups, but not in the control group. A tertiary finding was that exercise participation did not differ among the exercising groups with regard to the average number of days per week. CONCLUSIONS: These results support the hypothesis that exercise accumulated in several short bouts has similar effects as one continuous bout with regard to aerobic fitness and weight loss during caloric restriction in overweight, young women.

Contact-free spectroscopy of leg ulcers: principle, technique, and calculation of spectroscopic wound scores.

Objective wound monitoring is an essential tool for evidence-based medicine in leg ulcers and other chronic wounds. Non-invasive and contact-free optical remittance spectroscopy seems to be a useful approach as it can provide additional information with respect to more traditional techniques of wound scoring. Twenty-three patients with chronic venous, arterial, and mixed leg ulcers were enrolled in this study. The clinical state of the ulcers was documented by a clinical wound score (quantity, color, and consistency of granulation tissue). The spectroscopic readings were performed with a novel diode-array spectrometer system in the visible and near-infrared range of the spectrum (400-1600 nm) with a resolution of 5 nm. The wound spectra mainly depend on the absorption of hemoglobin and water. The maximum correlation coefficients of mean remittance spectra with the clinical wound scores did not exceed +/- 0.5. Discriminant and cluster analysis were applied for spectral classification of wound scores. By using cross-validation the percentage of correct predicted wound scores was about 69%. Our results indicate that the application of optical visible and near-infrared spectroscopy could be a valuable remedy for the clinician.

In vivo spectroscopy in dermatology: methods and new fields of application.

BACKGROUND: The human skin is an easily accessible organ on which non-invasive examination methods can be applied. Remittance spectroscopy uses registration of the proportion of reflected light from the skin surface. Optical characteristics of skin are determined by scattering, reflection and absorption. The remittance is influenced by various test conditions and topography. Spectroscopic methods are applied for determination of microcirculation, measuring of erythema and pigmentation and in pharmacology and toxicology of applied drugs. CONCLUSION: The standardization of spectroscopic measurement of human skin is essential to reduce error sources. In future a better investigation of skin structures and molecules, which are responsible for optical characteristics of skin and a more precise evaluation of spectroscopic signals are necessary to get more information about the state of skin and to develop new fields of applications, such as early diagnosis of skin diseases or monitoring of metabolic processes.

Cardiovascular disease risk factors are lower in African-American vegans compared to lacto-ovo-vegetarians.

OBJECTIVE: This study was undertaken to determine if African-American strict vegetarians (vegans) exhibit lower blood pressure (BP) and a more favorable serum lipid profile than their lacto-ovo vegetarian (LOV) counterparts, and if plasma ascorbic acid (AA) concentrations could explain any group differences in these cardiovascular disease (CVD) risk factors. METHODS: Habitual dietary intake, anthropometric characteristics, blood pressure, and blood lipids and ascorbic acid concentrations were determined in African-American study participants (male vegans, n = 14, age = 45.6 years; male LOV, n = 49, age = 49.8; female vegans, n = 31, age = 51.1, female LOV, n = 94, age = 52.1) recruited from Seventh-Day Adventist Churches in several cities in the northeastern United States. RESULTS: Body mass index (BMI) was significantly lower in the vegans (24.7 +/- 1.9 kg/m2) compared to LOV (26.4 +/- 0.45 kg/m2). There were no diet or gender differences in BP. Serum total cholesterol (3.75 +/- 0.12 vs. 4.51 +/- 0.10 mmol/L), LDL-cholesterol (2.06 +/- 0.13 vs. 2.65 +/- 0.09 mmol/l), and triglycerides (0.94 +/- 0.07 vs. 1.17 +/- 0.04 mmol/L) were significantly (p < 0.05) lower in vegans compared to LOV, but there were no dietary group differences in HDL-C. The ratio of total to HDL-cholesterol was significantly lower in vegans than in LOV (3.0 +/- 0.13 vs. 3.7 +/- 0.13). There were no dietary group differences in plasma AA concentrations. However, in the entire sample, plasma AA was inversely associated with BP (SBP: r = -0.46, p < 0.001, DBP: r = -0.32, p < 0.001), but unrelated to the serum lipid concentrations. CONCLUSION: African-American vegans exhibit a more favorable serum lipid profile than lacto-ovo-vegatarians and plasma AA is inversely related to BP in African-American vegetarians but does not explain any of the differences in CVD risk factors between vegans and lacto-ovo vegetarians.

Sexual risk-taking by Muscovite youth attending school.

Sexual behaviors of adolescents place them at a high risk for HIV and other sexually transmissible infections. Studies of sexual risk-taking and other health compromising practices by youth in countries other than the United States are relatively rare. Examination of health practices across cultures provides insights with respect to explaining international differences in disease rates, helps predict future trends in disease transmission, and identifies health education needs of particular populations or settings. Sexual behavioral risk factors were studied in a sample of 1,090 youth (mean age = 14 years) in Moscow using a translated version of the Youth Risk Behavior Surveillance (YRBS) survey developed by the U.S. Centers for Disease Control and Prevention. Only 26.3% of Muscovite youth report being taught about HIV/AIDS infection in school, and just 41.7% indicate discussion of HIV/AIDS occurred with parents or other familial adults. Overall, 15.7% of females and 23.7% of males report at least one sexual intercourse in their lifetime. About 8.8% of the sample reported participation in sexual intercourse before age 12, and 34.9% indicated having had sexual intercourse with four or more partners. Concomitant use of alcohol and other drugs is common (24.4%) prior to the most recent intercourse, and use of a condom occurs in fewer than half (41.7%) of recent sexual episodes.

Resting metabolic rate is influenced by anxiety in college men.

The effects of psychological parameters on resting metabolic rate (RMR) have been inadequately researched. The purpose of this study was to investigate relationships between anxiety and RMR. Seventy-nine male college students completed the trait portion (form Y-2) of the State-Trait Anxiety Inventory (C. D. Spielberger, R. L. Gorsuch, R. Lushene, P. R. Vagg, and G. A. Jacobs. Self-evaluation questionnaire (form Y). In: Manual for the State-Trait Anxiety Inventory. Palo Alto, CA, Consulting Psychologists Press, 1983) as a screening. Volunteers whose trait anxiety scores were > or = 1 SD above (52.7 +/- 2.7, n = 9) or below (26.5 +/- 3.0, n = 11) the male college student normal values (38 +/- 9) participated in the study. Fat-free weight was assessed using a seven-site skinfold equation (A. S. Jackson and M. L. Pollock. Phys. Sports Med. 13: 76-90, 1985). Resting metabolism was measured (Sensormedics metabolic cart model 2900) at two separate trials (1-2 wk apart) in the early morning after a 12-h fast and 36 h postexercise. An analysis of covariance with fat-free weight as the covariate revealed a significantly greater (P < 0.005) RMR in the high trait anxious group than in the low trait anxious group. State anxiety (form Y-1) assessments made before and after each RMR measurement revealed a significant main effect of group such that state anxiety was higher in the high trait anxious than in the low trait anxious group for both trials before and after RMR measurement. Moreover, a significant (P < 0.003) main effect for the time factor was found showing that state anxiety was reduced after the RMR procedure. The results of this study show that a statistically significant portion of the variance in RMR can be accounted for by individual differences in anxiety.

The effects of aerobic and anaerobic exercise conditioning on resting metabolic rate and the thermic effect of a meal.

This study examined resting metabolic rate (RMR) and thermic effect of a meal (TEM) among athletes who had participated in long-term anaerobic or aerobic exercise. Nine collegiate wrestlers were matched for age, weight, and fat-free weight with 9 collegiate swimmers. Preliminary testing included maximal oxygen consumption, maximal anaerobic capacity (MAnC) for both the arms and the legs, and percent body fat. On two separate occasions, RMR and TEM were measured using indirect calorimetry. VO2max was significantly higher in the swimmers while MAnC was significantly higher in the wrestlers for both the arms and the legs. RMR adjusted for fat-free weight was not significantly different between groups. The differences in total and percentage of TEM between the groups were not statistically significant, and there were no differences in baseline thyroid hormones. These data suggest that despite significant differences in VO2max and WAnT values following long-term aerobic and anaerobic exercise training, resting energy expenditure does not differ between these college athletes.

Two seasons of weight cycling does not lower resting metabolic rate in college wrestlers.

Over the course of 2 yr, we prospectively studied the effect on resting metabolic rate (RMR) of multiple cycles of weight loss followed by regain in six weight cycling collegiate wrestlers (WC) (mean age = 19.0 yr) compared with 12 weight stable, physically active, nonwrestling controls (C) (mean age = 20.9 yr), whose body composition was similar to the wrestlers. Furthermore, during the second year of the investigation, a group of six nonweight cycling collegiate wrestlers (NWC) (mean age = 18.8 yr) were included in the analyses. The WC had previously undergone at least three seasons of weight cycling and continued this pattern during each year of the study. For the WC, RMR was determined by indirect calorimetry before and after a 6-month season of weight cycling for each of two consecutive years. A similar time frame was followed for measurement of RMR in the C, while for the NWC, pre- and postseason RMRs were measured only during the second year. During the 2 yr, the WC had significantly higher (P < 0.05) pre- and postseason measures of RMR compared with the C. A separate analysis comparing all three groups during the second year showed that RMR was not different for WC and NWC, and that RMR was higher for both wrestling groups compared with C. In this prospective study, weight cycling did not increase the thermogenic efficiency of collegiate wrestlers compared with either nonweight cycling wrestlers or weight stable controls, who were not wrestlers.

Energy expenditure following a bout of non-steady state resistance exercise.

Little is known about the effect of non-steady state resistive exercise on postexercise energy expenditure. Using a counterbalanced design, energy expenditure was measured by indirect calorimetry in six adult males (mean age +/- SD = 24.5 +/- 6.1) for 30 min before and 60 min after a single 42 min bout of weight lifting, and again on a separate day for 30 min before and 60 min after a 42 min control period of quiet sitting. For the exercise condition the subjects performed 4 sets of upper and 3 sets of lower body resistive exercises at weights equivalent to a 12 repetition maximum for each respective lift. Metabolic rate remained significantly elevated at the end of the 60 min recovery period compared to the control condition, although the excess postexercise oxygen consumption accounted for only approximately 19 additional kcal expended. These data suggest that while postexercise metabolic remains elevated for at least one hour following a moderate level of resistive exercise, the caloric cost of this elevation during a one hour recovery period is small and similar to that induced by steady-state exercise of moderate intensity.

Resting metabolic rate in weight-cycling collegiate wrestlers compared with physically active, noncycling control subjects.

To determine the effect of multiple cycles of weight loss and regain on resting metabolic rate (RMR), we compared RMR between 12 weight-cycling collegiate wrestlers (means age 19.4 y) with a minimum of three previous seasons of weight cycling and 13 weight-stable nonwrestlers of similar weight and body composition (means age 20.6 y). RMR was measured before, during, and after a 6-mo wrestling season. Wrestlers exhibited a significantly higher baseline RMR compared with the control subjects (p less than 0.05). During the season when wrestlers had lost weight for competition, RMR was reduced (p less than 0.05) but was not significantly lower than that of the weight-stable control subjects. After a season of weight cycling and the final weight regain, the wrestler's postseason RMR was similar to preseason values and higher than the postseason RMR of the control subjects (p less than 0.05). Participation in numerous cycles of weight loss and regain did not lower RMR in these competitive athletes, as has been previously suggested.

[Ground water improvement in the Ruhr--then and now]. / Grundwasseranreicherung an der Ruhr--einst und jetzt.

The waterworks founded during the second half of the last century obtained the raw water exclusively from the Ruhr-valley; they were responsible for the water supply of the industrial area situated on the right of the river Rhine. The rapidly growing water demand, limited possibilities in water catchment, the very bad quality of the Ruhr-water and epidemic typhoid fever required new methods in the water supply. Consequently, the Hygiene-Institute of Gelsenkirchen was founded and a new method of water production developed: the artificial ground water recharge. In 1913 two associations were founded: the Ruhrtalsperrenverein responsible for the provision of water quantity, and the Ruhrverband, responsible for the improvement of water quality. These associations formed the essential base for the rapid development of the so-called "Revier". In spite of the excellent elimination of bacteria by artificial ground water recharge-operating according to the principle of slow sand filtration-a disinfection of drinking water with chlorine became necessary; this disinfection was started in 1910 by the waterworks of the Ruhr. The construction of reservoirs and clarification plants ameliorated temporary the overall situation in water resources management. These improvements were, however, destroyed by consequences arising from the rapid economical growth before the second world war and the following break-down. After this period, great efforts were necessary to enlarge the reservoirs and increase the capacity of sewage plants. The waterworks pre-purified the water from the Ruhr before infiltration into the underground in order to increase the quantity and quality of the recharged water. Downstream, the number of sewage plants increased; a more and more refined method of analysis indicates now the pollution load of the raw ater and signalized trends which lead to further treatment measures or to the change of existing ones like substitution of chlorine by chlorine-dioxide. The artificial ground water recharge-because of its many advantages-should always be the nucleus of water treatment of the river Ruhr. For the sake of the natural character of water catchment and in order not to degrade the waterworks to mere "water-manufacturers", we are all requested to handle thoroughly and cautiously water-endangering substances.