Shadow analysis via the C+K Visioline: A technical note.

BACKGROUND/PURPOSE: This research investigated the ability of shadow analysis (via the Courage + Khazaka Visioline and Image Pro Premiere 9.0 software) to accurately assess the differences in skin topography associated with photo aging. METHODS: Analyses were performed on impressions collected from a microfinish comparator scale (GAR Electroforming) as well a series of impressions collected from the crow's feet region of 9 women who represent each point on the Zerweck Crow's Feet classification scale. Analyses were performed using a Courage + Khazaka Visioline VL 650 as well as Image Pro Premiere 9.0 software. RESULTS: Shadow analysis showed an ability to accurately measure the groove depth when measuring impressions collected from grooves of known depth. Several shadow analysis parameters showed a correlation with the expert grader ratings of crow's feet when averaging measurements taken from the North and South directions. The Max Depth parameter in particular showed a strong correlation with the expert grader's ratings which improved when a more sophisticated analysis was performed using Image Pro Premiere. CONCLUSION: When used properly, shadow analysis is effective at accurately measuring skin surface impressions for differences in skin topography. Shadow analysis is shown to accurately assess the differences across a range of crow's feet severity correlating to a 0-8 grader scale. The Visioline VL 650 is a good tool for this measurement, with room for improvement in analysis which can be achieved through third party image analysis software.

Endovenous laser ablation of varicose veins with the 1470 nm diode laser using a radial fiber - 1-year follow-up.

BACKGROUND: Endovenous laser ablation is one of the most accepted treatment options for insufficient great and small saphenous veins. The aim of this study was to investigate the long-term efficacy and safety of the radial fiber (ELVeS-radial kit™) for the 1470 nm diode laser in a 1-year follow-up. METHODS: A total of 308 lower limbs with primary insufficiency of great and small saphenous veins or insufficient tributaries were included in the prospective observational cohort study. The primary efficacy endpoint of the study was ultrasonographic proven elimination of venous reflux after at least 1 year. Secondary efficacy and further safety end points after 1 year were as follows: (1) sonographic exclusion of recanalization of the treated vein segments, (2) deep vein thrombosis, clinical pulmonary embolism or superficial vein thrombosis as defined by objective testing, (3) death from any cause, (4) persistent clinical complaints such as pain and paresthesia, (5) recurrent varicose veins. Patient satisfaction was assessed using a CIVIQ-2 questionnaire after 1 year. RESULTS: Follow-up could be completed in 91.2% of the patients. Excellent efficacy numbers with 99.6% occlusion of the treated varicose veins as elimination of reflux could be demonstrated. After 1 year, 96% of the treated veins disappeared completely sonographically; one recanalization was observed. No deep vein thrombosis or pulmonary embolism occurred, three superficial vein thrombosis were diagnosed in follow-up examinations. Four patients died, not related to pulmonary embolism. No persistent pain or paresthesia occurred in the follow-up. Recurrent varicose veins were diagnosed in 10 patients (2.81%). CONCLUSION: One-year follow-up showed that endovenous laser treatment of varicose veins with 1470 nm diode laser using the radial fiber is highly effective, also regarding in a 1-year follow-up.

An RCT on the effects of topical CGP on surgical wound appearance and residual scarring in bilateral total-knee arthroplasty patients.

OBJECTIVE: To test the hypothesis that topically applied calcium glycerophosphate (CGP) would improve the appearance of the wound following bilateral knee replacement. METHOD: Healthy patients, aged 45-75 years, scheduled for bilateral total-knee replacement surgery were recruited into the study. One knee was randomly assigned to the treatment group, while the contralateral knee was designated the control (standard care). Subjects were instructed to apply a preparation of 10% CGP in an aqueous lotion to the treated knee once daily for 42 days, starting at the third postoperative day. Functional sealing and cosmetic appearance of the incision were evaluated by two surgeons by direct examination of the patient and then by two experienced assessors from photographs. The investigators qualitatively scored the intensity and extent of erythema along the incision and over the entire knee, the appearance of visible oedema along the incision and over the knee, and the overall clinical impression of wound healing. All four assessors were blinded to the subjects' allocation and the latter two assessors to the initial investigators' assessments. Subjects were also followed up for an additional 46 weeks, giving a total study duration of 12 months. RESULTS: Twenty patients completed the study. Statistical analysis showed that both the area and intensity of erythema along the incision were significantly reduced in the treated vs untreated knee over the entire study period. The analysis further showed that treatment significantly reduced oedema, both along the incision and across the entire knee. The differences were most marked at the seventh postoperative day and diminished with time. No adverse effects were observed for any patient, in either treated or untreated knees. CONCLUSION: These data demonstrate that postoperative application of 10% CGP could improve the appearance of the wound following total knee arthroplasty.

Methods for evaluating changes in skin condition due to the effects of antimicrobial hand cleansers: two studies comparing a new waterless chlorhexidine gluconate/ethanol-emollient antiseptic preparation with a conventional water-applied product.

BACKGROUND: Hand-cleansing products that are milder to the skin of health care personnel are being developed, but the available methodologies to appropriately evaluate these products and quantify differences are not generally being applied in well-controlled studies. METHODS: Two randomized, blinded, bilateral comparison studies evaluated skin condition during use of 2 antiseptic hand preparation products: a new 1% chlorhexidine gluconate (CHG)/61% wt/wt ethanol antiseptic hand preparation in a unique emollient system for waterless/brushless application and a conventional 4% CHG antimicrobial product that is applied with water and a scrub brush. Trained technicians applied treatments 6 times (for a surgical scrub study) or 24 times (for a personnel handwash study) daily to the hands of healthy volunteers during 5 days of controlled washing. An expert grader evaluated skin for dryness, erythema, and roughness. Subjects completed a self-assessment questionnaire on skin condition. Transepidermal water loss was measured by an evaporimeter, and the skin surface hydration level was measured by an electrical conductance meter. RESULTS: Fifty-eight subjects were enrolled in the 2 studies and received both treatments. In general, skin treated with the waterless CHG/ethanol product scored significantly (P <.004) better on evaluations of visual dryness and erythema and showed greater improvement in the level of hydration (P <.003). In the health care personnel handwash study, transepidermal water loss was less than that for skin treated with the conventional CHG product (P <.002). Subject assessments showed similar results (total score, P <.007). CONCLUSIONS: All 3 approaches of expert grader evaluation, subject assessment, and instrumentation were in concordance, demonstrating that the waterless CHG/ethanol product was gentler to skin than the conventional CHG product.

A pilot study of noninvasive methods to assess healed acute and chronic wounds.

BACKGROUND: A variety of instruments are available that can objectively assess physical parameters of the skin such as strength, firmness, elasticity, hydration, and color, often undetected by clinical assessment. OBJECTIVE: To assess the physical properties of healed acute and chronic wounds using several noninvasive instruments. METHODS: Four patients with healed acute wounds and four patients with healed chronic wounds were studied using ballistometric, impedance, levarometric, and spectrophotometric measurements. RESULTS: In general, scars were harder, less elastic, dryer, and more erythematous than control skin. These differences were more pronounced in healed chronic wounds. CONCLUSION: A scar from an acute surgical wound becomes softer, more elastic, dryer, less erythematous, and less pigmented as it ages. In contrast, chronic wound scars become harder as they age. These different properties of healed acute wounds and healed chronic wounds may be a result of the different healing processes in each wound type.

A hand immersion test under laboratory-controlled usage conditions: the need for sensitive and controlled assessment methods.

Exaggerated test conditions were frequently used to investigate the cutaneous tolerance of detergent products in the past. As the sensitivity of newly designed biometric methods is steadily improving, the trend towards more realistic test conditions should be encouraged. A hand immersion test under laboratory-controlled usage conditions is presently described, fulfilling such principles. Panelists soaked their hands in 2 different hand dishwashing liquids, 2x daily for 10 min each (with successive in-solution/out-of-solution cycles) for 4 consecutive days. Products were at usual dilution for dishwashing liquids and were randomized between the dominant and non-dominant hands of panelists. Visual scoring of erythema and dryness developing on the whole hands (scoring scales including interdigital areas and joints) during the week did not allow discrimination between the 2 products. However the dominant hands were significantly more susceptible to alterations than the non-dominant hands, regardless of product attribution. In contrast, skin electrical measurements (Corneometer CM800 and Skicon 200) on the dorsum of the hands (muscle mass between thumb and index) and squamometry analysis of tape stripping (harvested from the same site) yielded significant differences between the 2 products. In conclusion, a hand immersion test under realistic conditions has been described, which discriminates between products when sensitive assessment methods are used to explore skin sites partially protected from daily-life skin aggressions.

Mediation of bradykinin-induced contraction in canine veins via thromboxane/prostaglandin endoperoxide receptor activation.

1. Canine jugular and femoral veins were studied to determine the possible importance of thromboxane (TXA2) and prostaglandin endoperoxides (prostaglandin H2, PGH2) in mediating bradykinin(BK)-induced contraction. 2. Isolated vein rings incubated in modified Krebs solution contracted to TXA2/PGH2 analogs SQ26655 and U44069 with potency of contraction exceeding that for BK. The potency ranking for both veins was SQ26655 greater than U44069 greater than BK greater than PGF2 alpha greater than TXB2 much greater than PGD2. 3. The cyclo-oxygenase inhibitors indomethacin (3 x 10(-7) M) and flufenamic acid (10(-5) M) reduced BK contractions without affecting those induced by noradrenaline (NA). 4. TXA2/PGH2 receptor antagonists SQ29548 (10(-8) M) and BM13177 (10(-6) M) strongly inhibited BK-induced tension. The action of antagonists was reversible with negligible influence on NA-elicited contraction. Selective removal of endothelium had no effect on BK-induced contraction or the action of the antagonists. 5. The thromboxane synthase inhibitors dazoxiben (10(-4) M) and CGS 12970 (10(-5) M) had no significant inhibitory effect on BK-induced tension. 6. These results suggest that in canine jugular and femoral vein, the action of BK is largely dependent upon stimulation of the cyclo-oxygenase pathway to produce PGH2 and possibly TXA2, which can activate a smooth muscle TXA2/PGH2 receptor to elicit vasoconstriction.

Scanning-integrating cytophotometric analyses of brain neuronal RNA and acetylcholinesterase in acute soman toxicated rats.

Cytophotometric analyses of RNA and acetylcholinesterase responses of caudate and cerebrocortical neurons of soman toxicated rats were conducted to characterize impairments in regulatory aspects of neuronal metabolism occurring in the acute phase of cholinesterase impairment. There was a severe and dose-dependent suppression (20-60%) in neuronal acetylcholinesterase activity in both a.m. and p.m.-treated rats; no diurnal differences were apparent in control acetylcholinesterase levels or neuronal acetylcholinesterase responsiveness to soman toxication. RNA levels, however, were markedly higher in p.m. than in a.m. saline-treated controls. Soman depressed caudate neuron RNA contents in the afternoon, but not in the morning. Cerebrocortical neuron RNA levels were suppressed in both a.m. and p.m.-toxicated rats, although this RNA depletion was more severe in the afternoon. These results indicate that soman can elicit marked alterations in neuronal transcriptional-translational capabilities and that there are diurnal variations in cellular metabolic responsiveness to soman toxication. Although functional relationships between soman-induced cholinesterase inhibition and RNA depletion remain to be elucidated, depressed RNA metabolism appears to be a maladaptive response preventing rapid regeneration of cholinesterase following poisoning.

Effects of environmental enrichment on old mice.

Fifteen male C57BL/6J mice, exposed to an enriched environment from age 600 to 750 days, were compared with 15 matched controls on 4 learning problems and an activity test. The enriched mice were significantly superior on an incidental learning and a food-seeking task, but did not differ significantly from controls on a brightness discrimination task, the Lashley III maze and an activity test. The relative abundance of high and low ribonucleic acid-containing cerebrocortical cells differed significantly between groups; the enriched mice had more cells with very high levels of RNA. The mammalian brain appears to remain responsive to environmental enrichment well into advanced age.

Feulgen-deoxyribonucleic acid analysis of rabbit aortic smooth muscle cells using scanning- integrating microdensitometry.

A procedure entailing the use of the Feulgen reaction is described for precise quantification of nuclear DNA levels in smooth muscle cells (SMC) of paraffin-processed microtome sections of the rabbit aorta. It was established that maximal, stable, and reproducible Feulgen-DNA (F-DNA) staining of SMC nuclei is achieved using 3.5 N HCl hydrolysis of 30-50 min prior to staining of aortic sections in Schiff reagent for 60 min at 22 degrees C. Scanning-integrating microdensitometry of Feulgen-stained SMC revealed that the tunica media is comprised of a relatively homogeneous population of cells with between 0.3 and 1% of the SMC nuclei yielding 3C or 4C (tetraploid) F-DNA levels, depending on location within the aortic wall. The nuclear chromatin in inner medial SMC was found to be in a more dispersed state than that of outer SMC (using nuclear area and nuclear susceptibility to acid hydrolysis as indices of chromatin dispersion). A linear correspondence was evidenced between nuclear area and nuclear F-DNA stainability throughout the tunica media. The observation that the lumenal portion of the tunica media contains a greater abundance of SMC with large, vesicular nuclei is interpreted as reflecting a greater metabolic reactivity of this compartment relative to that of SMC bordering the tunica adventitia.

Age-related changes in brain RNA of noise stressed mice.

Correlative data were obtained on RNA levels of cerebrocortical neurons, adrenal fasciculate cell RNA content and serum corticosterone levels in 10, 40 and 100 week old male C57BL/6J mice immediately following a 30 interval of continuous noise stimulation (100 dB re 2 x 10(-5) N/m2, 0.35-20 kHz) and at 1 hr and 4 hr recovery intervals. Quantification of cellular RNA levels entailed use of scanning-integrating microdensitometry of azure B stained tissue sections. Hormonal analyses were done by radioimmunoassay. Noise stimulation induced a mild to moderate adrenocortical activation and a moderate elevation of serum corticosterone levels in all age groups. Noise exposure also resulted in an increase in the RNA content of cerebrocortical neurons. However, maximal neuronal RNA levels proved to be considerably lower (32-36%) in 100 week old mice as compared to both 10 and 40 week old mice during the post-exposure intervals. The overall data support the existence of a lower neuronal capacity for sensory induced RNA synthesis in 100 week old mice. The data also suggest that age dependent differences in neuronal responsiveness are not directly related to the extent of adrenal RNA activation or to a lower availability of circulating glucocorticoids.