Changes in the T-wave of the electrocardiograph in urticaria

A series of cases is presented, in which non-specific primary changes in the T-waves were observed in electrocardiographs of patients with urticaria, the latter caused by drugs or other substances. In all these patients, no other abnormality was found and they were completely asymptomatic as regards cardiac involvement. A definite ‘cause and effect’ type of relationship was found between the T-wave changes and the urticaria. The mechanism of the T-wave changes remains to be investigated. Since this phenomenon disappears simultaneously with the urticaria, treatment should be determined by the urticaria, and bed rest is not indicated.     

Botulinum toxin A in the treatment of the wrinkles in the upper third of the face

The practice of botulinum toxin injections is unavoidable in the correction of facial aging. In effect botulinum toxin allows to erase dynamic wrinkles, by transient and reversible muscular relaxation. This is the best wrinkle treatment for the upper part of the face: glabellar lines, horizontal forehead lines and crow's feet. This technique requires a good understanding of facial muscular anatomy, in order to correctly apply the basics of injection. Every patient is unique and only a big experience will allow to refine and personalise injections.     

Ultrastructure of the Fibrous Substance in the Keratinocytes of the Epidermis in Healthy Individuals

The present findings in the epidermis of healthy individuals suggest that the fibrous substance in the keratinocytes is subjected to an individual differentiation as the cells move from stratum basale through strata spinosum and intermedium to stratum coreum. In the basal cells the fibrous substance consists of opaque tonofilaments, mostly aggregated in dense tonofibrils, but also occurring randomly scattered and in loose tonofibrils (fibrous substance of basal-cell type). In most cells the fibrous substance undergoes differentiation: a) in stratum spinosum into compact tonofibrils with no individual tonofilaments visible (fibrous substance of spinous-cell type), b) in stratum inter-medium into compact tonofibrils with intensely stained regions or keratohyalin (fibrous substance of intermediate-cell type), and c) in stratum corneum into tonofibrils with a keratin pattern (fibrous substance of horny-cell type). There are also keratinocytes in which the fibrous substance undergoes only an incomplete differentiation, with the appearance of horny cells with a fibrous substance of spinous-cell type, intermediate-cell type or horny-cell type with keratohyalin. Finally, there are keratinocytes in which the fibrous substance does not undergo any differentiation at all, but which display a fibrous substance of basal-cell type throughout the entire epidermis.     

Transient immune deposits in the papillary dermis and in the epidermis

Summary To have a further insight into the localizations of immune deposits in the skin the reversed passive and the passive Arthus reactions were carried out in the foot-pads skin of guinea-pigs using horseradish peroxidase as antigen. The transient localizations of immune deposits in the papillary dermis and in the epidermal cell layer were observed in the skin of the reversed passive Arthus reaction, but not in the skin of the passive Arthus reaction. Following the immune deposits in the papillae including the capillary walls and the dermo-epidermal junction, the papillary dermis became widened, swollen, and edematous, being infiltrated by PMN's. In the epidermal layer, the immune deposits were found as fine granular aggregates adhering to the epidermal cells or to the dendritic cells. Although the immune deposits disappeared promptly from the papillae and the inflammatory reactions were slightly and transient, the epidermal cell layer became thickened, and several mitotic figures of the epidermal cells were observed.     

Measles Virus was Present in the Inner Cell of the Acrosyringium in the Skin Rash

Abstract: A case of measles in a 26-year-old Japanese man is reported. A skin specimen taken on the third eruptive day from a maculopapular eruption on his chest was immunohistopathologically and electron microscopically examined using a rabbit polyclonal antibody against the nucleocapsid protein of the measles virus. The measles virus antigen was found in the inner cells of the acrosyringium and hair follicles. The measles virus nucleocapsid was electron microscopically identified in the nuclei of the inner cells of the acrosyringium. The findings suggest that the sweat from skin lesions might contain the measles virus.     

Assessing the secular trends in the transmission of HIV in Greece

OBJECTIVE: To evaluate the current trends in HIV transmission in Greece. METHODS: A retrospective study of HIV infected individuals reported to the Hellenic Center for Infectious Diseases Control (HCIDC) was conducted. RESULTS: Since the beginning of the epidemic in Greece and until early 1990s most cases concerned men who have sex with men (MSM). After the mid-1990s the proportion of homosexual males among HIV positive individuals decreased slightly, then was stabilised but they still remain the dominant population among HIV positive people. On the other hand, heterosexual transmission increased steadily and has become a frequent route for the spread of HIV/AIDS in recent years. Individuals originating from or travelling to countries where this mode of transmission prevails were the most frequent cases in this category. A significant proportion of cases classified as "undetermined" were also recorded and were partially attributed to the increased heterosexual transmission among people (especially women) without obvious high risk behaviours. CONCLUSIONS: The HIV/AIDS surveillance system must evolve in order to find the new unreported risk information and identify the population groups at higher risk. This will help to implement preventive policies and information campaigns addressed to target populations with special attention paid to immigrants, women, and marginalized communities.     

Mechanisms that play a role in the maintenance of the calcium gradient in the epidermis

BACKGROUND/PURPOSE: Calcium regulates the proliferation and differentiation of keratinocytes and plays a role in restoration of the epidermal barrier function. The factors that maintain the calcium gradient in vivo are still unknown. A numerical model may give more insight into transport processes that maintain the epidermal calcium gradient. METHODS: In this study, transport of free calcium in the epidermis is described with diffusion, convection and electrophoresis. Binding and release of calcium results in equilibrium between free and bound calcium. The physiological epidermal calcium gradient as well as the calcium concentration in a damaged epidermis are modeled. RESULTS: The typical shape of the calcium gradient in the epidermis, as found in experimental studies, was maintained when separate formulations were used for free and bound calcium. Application of damage results in a decrease of the calcium concentration, especially in the upper living epidermis. Using this model, an estimate could be made about the fraction bound calcium in the epidermis. CONCLUSION: The typical shape of the gradient is predominantly determined by the bound calcium concentration. For both a normal and a damaged epidermis, the concentration of free calcium is mainly determined by electrophoresis in the living epidermis, whereas in the largest part of the stratum corneum diffusion is the most important factor. The convection that was determined by the transepidermal water loss did not have an effect on the calcium concentration.     

Development of the hair in the rat: in vivo and in transplanted tissue

Differentiation of the hair was examined in the head skin of rat embryos aged from days 12.5 to 18.5 of gestation. In 12.5-day-old embryos, the skin consisted of single layered epidermis and underlying loose connective tissue. On day 17.5 of gestation, the epidermis appeared to have a two or three layered epithelium, and the subepidermal connective tissue gave rise to an overlying dense tissue, into which blood capillaries arose from the deeper layer. The epidermis showed partial thickenings, where basal cells were arranged perpendicular to the surface of the epidermis. Beneath the epidermal thickenings, a number of connective tissue cells appeared to have accumulated and occasionally were accompanied by blood capillaries. In sequential development of the skin, the thickenings protruded as cords to the underlying dermal tissue and formed hair follicles covered with a connective tissue sheath. Skin obtained from 12.5-day-old embryos was transplanted singly or with cerebral cortex into the third ventricle of adult male rats. Thirty days after the transplantation, hairs and sebaceous glands had developed from the grafted skin. Hair growth tended to be more prominent in the cotransplanted skin grafts. However, no nerve fibers immunoreactive for substance P or calcitonin gene-related peptide (CGRP) were found in the grafted skin, although these fibers appeared in the dermis at the end of gestation in vivo. These results showed that the skin of 12.5-day-old embryos was able to induce hair growth in the third ventricle without accompanying peripheral neuronal fibers or blood capillaries, although the effects of connective tissue cells could not be ruled out.     

AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s

BACKGROUND: The mortality associated with AIDS among men may have had an influence on primary and secondary syphilis trends among men in the United States, through the loss of men at high risk for acquisition or transmission of syphilis in this population and/or by prompting safer sexual behaviors in response to the threat of AIDS. GOAL: The goal of this study was to examine the association between AIDS mortality rates and primary and secondary syphilis incidence rates among men in the United States from 1984 to 1997. STUDY DESIGN: We used a fixed-effects regression analysis of state-level AIDS mortality rates and primary and secondary syphilis incidence rates for men. RESULTS: Our analysis showed a significant association between higher AIDS mortality and lower rates of syphilis incidence, after we controlled for confounding factors. Our model estimates suggested that every 20 AIDS deaths per 100,000 adult men are associated with declines of about 7% to 12% in syphilis incidence rates among men. CONCLUSION: Increases in AIDS-associated mortality may have accounted for one-third to one-half of the decline in syphilis rates among men in the early 1990s. Recent declines in AIDS mortality in the United States may have contributed to the recent outbreaks of syphilis, particularly among men who have sex with men. Our findings underscore the importance of providing STD prevention services to men with HIV infection and the need for STD surveillance in communities at risk for syphilis outbreaks.     

Experience in the use of ditrastic in the therapy of psoriasis

Forty-six patients suffering from psoriasis have been treated with ditrastic, a new drug for external application, manufactured by Orion, Finland. The drug is manufactured in the form of sticks weighing 2.4 g, containing 1.5 or 3% of dithranol, paraffin, and microcrystalline sulfur. These sticks are applied to psoriatic plaques once daily. The treatment has been effective.     

Leiomyoma of the breast in the male

A macroscopically not sure classifiable solitary tumour on the nipple was observed in a 68 year old man. Histologically a pure leiomyoma was found. Therapy of choice is the tumour resection, if requested.     

Sarcomas of the skin in the elderly

Malignant mesenchymal neoplasms of skin and soft tissues are characterized by an extreme clinicopathologic heterogeneity. Although all sarcomas of deep soft tissues may also arise in superficial locations, there are important clinicopathologic differences. Lipogenic sarcomas represent the most frequent type of sarcomas in deep soft tissues, but purely dermal liposarcomas are exceedingly rare. Vascular and fibroblastic or myofibroblastic sarcomas, however, are much more frequent in dermal location. In contrast with most deep-seated sarcomas, morphologic grading of dermal sarcomas has only a limited importance because most types of dermal sarcoma have a rather favorable clinical prognosis. Important exceptions to this rule are epithelioid sarcoma and cutaneous angiosarcoma, which are aggressive sarcomas with an increased rate of distant metastases and tumor-associated death. Dermal sarcomas arising in elderly patients show some important differences in their incidence and prognosis. Whereas cutaneous angiosarcoma, myxofibrosarcoma, undifferentiated pleomorphic sarcoma of the skin showing morphologic similarities to atypical fibroxanthoma, and cutaneous leiomyosarcoma arise predominantly in elderly patients, dermatofibrosarcoma protuberans, epithelioid sarcoma, and superficially located clear cell sarcoma are seen more often in younger patients.