Prognostic significance of the patient's sex,tumor site,and mitotic rate in thin (≤1.5 mm) melanoma

Summary Patients who died of a melanoma thinner than 1.5mm within 96 months (group 1, n=60) were compared with those having a tumor of the same thickness who had not died in this time period (Group 2, n=300). Both groups were investigated with respect to differences in patients sex and age and to thickness, diameter, exophytic growth, and site of the melanoma as well as the number of mitoses/mm² of tumor area. Relatively speaking, more men than women died of a thin melanoma: in Group 1 (deceased) there were 32 men and 28 women, in Group 2 (alive) 58 men and 242 women. The better survival rate of females did not depend on the difference in the predominating melanoma locations (face and legs; trunk): in both sites, on the legs and on the trunk, women had a significantly higher 8-year survival rate than men with equally thick tumors. Furthermore, melanomas on the arms and legs of females had a better prognosis than those on the trunk and face. Both the patient's sex and the tumor site seem to influence the survival of melanoma patients. Only in men was the median of mitoses/mm² of tumor area found to be higher in the first group (2.2) than in the second group (0.75). In women, no marked difference in the mitotic count was found (Group 1:1.1; Group 2:1.15).Supported by the Deutsche Forschungsgemeinschaft     

How tubular epithelial cells dictate the rate of renal fibrogenesis?

The main threat to a kidney injury,whatever its cause and regardless of whether it is acute or chronic,is the initiation of a process of renal fibrogenesis,since fibrosis can auto-perpetuate and is of high prognostic significance in individual patients.In the clinic,a decrease in glomerular filtration rate correlates better with tubulointerstitial damage than with glomerular injury.Accumulation of the extracellular matrix should not be isolated from other significant cellular changes occurring in the kidney,such as infiltration by inflammatory cells,proliferation of myofibroblasts,obliteration of peritubular capillaries and atrophy of tubules.The aim of this review is to focus on tubular epithelial cells(TEC),which,necessarily involved in the repair process,eventually contribute to accelerating fibrogenesis.In the context of injury,TEC rapidly exhibit phenotypic and functional changes that recall their mesenchymal origin,and produce several growth factors known to activate myofibroblasts.Because they are high-demanding energy cells,TEC will subsequently suffer from the local hypoxia that progressively arises in a microenvironment where the matrix increases and capillaries become rarified.The combination of hypoxia and metabolic acidosis may induce a vicious cycle of sustained inflammation,at the center of which TEC dictate the rate of renal fibrogenesis.     

Does psychiatric illness affect the recurrence rate of genital herpes?

The progress of 58 patients with first attacks of genital herpes was monitored for up to 30 weeks. The effects of sex (gender), age, social class, and non-psychotic psychiatric illness (as measured by the "general health questionnaire," GHQ) on the recurrence rate of herpes was studied. The recurrence rates, measured by the actuarial percentage recurrence-free curves, showed that the 29 patients with GHQ scores above 11 had a significantly higher recurrence rate than those who scored less than 11 (P = 0.002). There were no important differences between recurrence rates according according to sex, age, or social class. These findings suggest that non-psychotic states, such as anxiety or obsessionality resulting in GHQ scores above 12, may possibly cause an excess production of adrenergic substances which encourages reactivation of latent genital herpes. Thus, to lessen the recurrence rate in such patients, a psychological or chemical approach to treatment could be used to modify the autonomic sympathetic response.     

Melanoma's high C>T mutation rate: is deamination playing a role?

The majority of melanoma mutations are C>T transitions, and most bear UV signatures. However, other process may contribute to the high C>T mutation rate. Okura et al., have demonstrated immunohistochemical evidence of deaminating enzymes, activation‐induced cytidine deaminase (AID) and apolipoprotein B mRNA‐editing enzyme catalytic polypeptide‐like 3B (APOBEC3B) in melanoma. Both have been implicated in cancer. While further validation is necessary, these findings warrant consideration of a role for deamination in melanomagenesis. Deamination primarily drives C>T transitions. Compared with trunk/extremity melanomas, acral melanomas display a significantly higher percentage of ‘spontaneous’ and ‘AID’ mutation signature events suggesting deamination may be particularly important in this subgroup.     

Does the proximity of an amputation, length of time between foot ulcer development and amputation, or glycemic control at the time of amputation affect the mortality rate of people with diabetes who undergo an amputation?

OBJECTIVES: The main purpose of the authors' research was to compare the 3- and 5-year mortality rates of diabetic patients who have undergone a lower-extremity amputation, evaluating the proximity of the amputation in 3 groups (toe and foot amputation, BKA, and AKA), the timing of the amputation (within or after 2 years of the onset of the foot ulcer), and the effect of glycemic control at the time of amputation, regardless of the level of amputation. METHODS AND DESIGN: The subjects were 80 male inpatients at Illiana Veterans Health Care System who had diabetes, diabetic neuropathy, peripheral vascular disease, and a diabetic foot ulcer that resulted in an amputation. Of the 80 patients, 29 had a toe amputation, 30 had a BKA, and 21 had an AKA. The mean age in all 3 groups was 68.5 years+/-7.2 years. The authors used the hemoglobin A1C (Hgb A1C) level to assess glycemic control. MAIN OUTCOME MEASURES: Several chi tests were used to compare the 3- and 5-year mortality rates among the amputation groups. An Hgb A1C level of 8% or less defined good glycemic control; an Hgb A1C level of more than 8% defined poor glycemic control. A chi test was used to compare glycemic control, the level of amputation, and the mortality rate. A chi test was also used to evaluate the length of time between ulcer formation and amputation, the level of amputation, and the mortality. All statistics were done using SPSS 10.0 student version. CONCLUSIONS: The research revealed a statistically significant difference in mortality among the 3 groups at 3 and 5 years. No statistically significant difference in mortality in patients with good glycemic control and patients with bad glycemic control was found. At 3 years, a statistically significant difference in mortality existed between patients who had an amputation within 2 years of ulcer formation and those who had an amputation after 2 years. At 5 years, no statistically significant difference existed between these 2 groups.     

Kalk,Muzin, Myxödem,Sklerodermie, Calcinose

Ohne Zusammenfassung     

What is the best method for assessing the rate of wound healing? A comparison of 3 mathematical formulas

OBJECTIVE: To identify and evaluate current mathematical formulas used to assess the rate of wound healing. DATA SOURCES: MEDLINE, CINAHL, and Cochrane Systematic Review databases, from 1965 to 2004. STUDY SELECTION: Papers selected for the study met the following inclusion criteria: (1) participants had chronic venous, neuropathic, pressure, or ischemic wounds; (2) the wounds were objectively measured; and (3) the investigators described and used an objective measurement of wound healing rate, either as an absolute reduction in area over time, a percentage change, or a linear advancement of wound edge. Papers were excluded if they were (1) not written in English, (2) duplicated from other sources, or (3) unpublished. CONCLUSIONS: In clinical trials, measurement of the rate of wound healing over time by using the equation for the linear advancement of wound margins toward the center of the wound controls for confounding introduced by differing baseline ulcer sizes and shapes. Use of this assessment method after 4 weeks of healing may prove to be of value in predicting time to complete healing. Further research is required to develop standard healing rates for wounds of different etiologies.     

超分子水杨酸联合粉刺挤压治疗寻常型痤疮疗效观察1姚露,彭红霞,周文瑞,勒尔布哈,赵皓森,张琴,唐秀兰,阿衣子扎

目的 观察30%超分子水杨酸(博乐达)联合粉刺挤压治疗寻常型痤疮疗效。方法 将我院(2019年7月～2019年12月)收治的寻常型痤疮患者80例作为观察对象。随机分成观察组40例(30%超分子水杨酸治疗+粉刺挤压),对照组40例(粉刺挤压),两周1次,连续4次。分别于治疗前、治疗两次后、治疗四次后、治疗完成后4周对其评分。记录治疗后的临床疗效、安全性和患者满意度。结果 两组患者在治疗前GAGS评分比较无显著性差异(P 0.05)。在治疗两次后、治疗四次后、治疗完成后4周,观察组患者GAGS评分明显低于对照组,差异具有统计学意义(P 0.001)。观察组患者治疗后临床总有效率为97.50%,明显高于对照组的82.50%,差异具有统计学意义(P 0.05)。观察组患者在治疗过程中总计发生7例并发症(17.50%),对照组患者在治疗过程中总计发生4例并发症(10.00%),两组间差异无统计学意义(P 0.05)。实验组患者对治疗的总满意率为100.00%,明显高于对照组总满意率90.00%,差异具有统计学意义(P 0.05)。结论 在寻常型痤疮患者的治疗中,采取30%超分子水杨酸联合粉刺挤压治疗,可明显降低患者的痤疮整体分级评分,获得较好的临床治疗效果,获得较高的患者总满意率,效果理想。     

Atrichia, ichthyosis, follicular hyperkeratosis, chronic candidiasis, keratitis, seizures, mental retardation and inguinal hernia: a severe manifestation of IFAP syndrome?

A boy with congenital atrichia, ichthyosis follicular, keratitis, cutaneous infections and a huge inguinal hernia, but without deafness is reported. We believe it represents a new case of a rare X-linked recessive syndrome known as ichthyosis follicularis, alopecia, photophobia syndrome (IFAP). The differential diagnosis from keratitis ichthyosis deafness is discussed. The cutaneous infections seen in our case suggest the possibility of considering a genetic link between these syndromes.     

Naming acquired melanocytic nevi. Common and dysplastic, normal and atypical, or Unna, Miescher, Spitz, and Clark?

Acquired melanocytic nevi are among the commonest neoplasms in man, yet classification of them has proven elusive and elucidation unsatisfactory. From "active junctional nevus" to "dysplastic nevus," the brains of clinicians and histopathologists have been boggled and the psyches and skin of patients have been served badly. This essay advocates eponymic designations for acquired melanocytic nevi, all of which are common, as the surest route to comprehensive classification of them.     

盐酸氨基酮戊酸光动力疗法联合CO2点阵激光治疗重度痤疮3例1宋杰,纳猛,钟庆坤,邵丹,李霞,张娴,蔡汶高,李金桑

目的 观察盐酸氨基酮戊酸光动力疗法结合CO2点阵激光对重度痤疮进行联合治疗的疗效。方法 对3例重度痤疮患者在进行点阵激光治疗后随即给予光动力治疗。结果 3例患者较单纯光动力治疗取得了较好的疗效。结论 通过治疗达到杀灭痤疮丙酸杆菌、控制和减轻皮脂腺分泌、重建皮脂腺及表皮结构的效果,降低复发,有效预防疤痕,对重度痤疮有显著疗效。     

Adamantiades-Behçet's disease: serum IL-8 is a more reliable marker for disease activity than C-reactive protein and erythrocyte sedimentation rate

BACKGROUND: Interleukin 8 (IL-8) has recently been under focused investigation because of its possible participation in the evolution of Adamantiades-Beh?et's disease. OBJECTIVE: The reliability of IL-8 as a serological marker for the activity of the disease was investigated in a prospective consecutive trial of 34 cases. METHODS: The activity of the disease was clinically evaluated by the number of actively involved organ systems registered on the day of blood sampling and by the presence of oral aphthous ulcers. Serum IL-8 levels were compared to C-reactive protein (CRP) values and the erythrocyte sedimentation rate. RESULTS: An association of IL-8 levels with the activity of the disease was detected when compared with both the number of active clinical signs (p = 0.024) and the presence of oral aphthous ulcers (p = 0.002). In contrast, no association of CRP and sedimentation rate with the activity of the disease could be detected. A weak correlation of IL-8 levels with sedimentation rate values at 2 h was found (R = 0.37, p = 0.032). CONCLUSION: Our results confirm previous data concerning the significance of IL-8 and, in addition, they provide first evidence for the reliability of IL-8 as a serological marker for assessment of the activity of Adamantiades-Beh?et's disease in the follow-up of clinical and therapeutic studies.