Surgical management of extensive gnathophyma

Rhinophyma is an uncommon disease of the nose characterized by irregular skin thickening and nodular deformation. The extensive growth causing 'whisky nose' is due to hyperplasia of the sebaceous glands and the surrounding connective tissue. Other facial regions may concomitantly be affected. We present a case of extensive gnathophyma accompanying minor lesions of the nose. Surgical treatment led to an excellent cosmetic result.     

Is growth hormone a radioprotective agent?

There is currently substantial clinical interest in growth hormone (GH) as a protective agent against radiation-related normal tissue injury. To further assess the potential radiation injury-preventive effects of GH, these effects were studied in rats by using a radiation-induced skin injury model. Group 1 received neither GH nor irradiation (control group). Group 2 received 30 Gy of gamma irradiation as a single dose to the right hind legs of the rats (radiation group). Group 3 and 4 received the same irradiation plus either 0.01 U/kg/day GH (RT + 0.01 GH group) or 0.02 U/kg/day GH (RT + 0.02 GH group) subcutaneously. Clinically and histopathologically, acute skin reactions were assessed by two independent experts in radiation oncology and pathology, respectively. Irradiation increased dermatitis in rats when compared with the control group. The severity of radiodermatitis in the rats in the RT + 0.01 GH and RT + 0.02 GH groups was significantly lower than that in the RT group; radiodermatitis developed earlier in the RT group than in the other groups. GH was efficacious in preventing epidermal atrophy, dermal degeneration such as oedema and collagen fibre loss, and hair follicle atrophy, but not better than in the control group. These results are preliminary to studies that will be performed with higher doses of GH in radiation-treated cancer patients, with the aim of reducing radiation-induced toxicity.     

The impact of changing dental needs on cost savings from fluoridation

Background:  Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia.
Methods:  Net costs were estimated as Costs_(programme) minus Costs_{(averted caries).} Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6–20, 21–45, 46–65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized.
Results:  With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal.
Conclusions:  Community water fluoridation remains a cost-effective preventive measure in Australia.     

Differences in constitutive and post-methotrexate folylpolyglutamate synthetase activity in B-lineage and T-lineage leukemia

Folylpolyglutamate synthetase (FPGS) is responsible for the metabolism of natural folates and a broad range of folate antagonists to polyglutamate derivatives. Recent studies indicated increased accumulation of methotrexate (MTX) polyglutamates (MTX-PG) in blast cells as a predictor of favorable treatment outcome in childhood acute lymphoblastic leukemia (ALL). We determined the expression of FPGS activity in blasts from children with ALL at diagnosis and after treatment with MTX as a single agent, before conventional remission induction therapy. The levels of enzyme activity in ALL blasts at diagnosis (median of 689 pmol/h/mg protein) were significantly higher (P = .003) than those found in acute nonlymphoblastic leukemia (ANLL) blasts (median of 181 pmol/h/mg protein). Comparable lineage differences in normal lymphoid versus nonlymphoid cells suggest a lineage-specific control of FPGS expression, FPGS activity increased in ALL blasts after in vivo exposure to MTX. The median increase in FPGS activity was significantly higher (P = .003) in B-lineage ALL (188%) than in T-lineage ALL (37%). Likewise, the percentage of intracellular long chain MTX-PG (Glu3-6) was significantly higher (P = .02) in B- lineage ALL (92%) than in T-lineage ALL (65%), consistent with higher FPGS activity in B-lineage blasts. This finding could explain, at least in part, the superior outcome in children with B-lineage ALL treated with antimetabolite therapy.     

NCB-02(standardized Curcumin preparation)protects dinitrochlorobenzene-induced colitis through down-regulation of NFκ-B and iNOS

AIM:To evaluate the efficacy and mechanism of action of NCB-02,a standardized Curcumin preparation,against 2,4-dinitrochlorobenzene(DNCB)-induced ulcerative colitis in rats.METHODS:Ulcerative colitis was induced in male rats by sensitizing with topical application of DNCB in acetone for 14 d and intra-colonol challenge with DNCB on day 15.A separate group of animals with vehicle treatment in similar fashion served as control group.Colitis rats were divided into different groups and treated with NCB-02 at doses of 25,50 and 100 mg/kg b.wt p.o.for 10 d.Sulfasalazine at a dose of 100 mg/kg b.wt for 10 d served as a reference group.On day 10 after respective assigned treatment,all the animals were euthanized and the length of the colon,weight of entire colon and distal 8 cm of the colon were recorded.The distal part of the colon was immediately observed under a stereomicroscope and the degree of damage was scored.Further distal 8 cm of the colon was subject to the determination of colonic myeloperoxidase(MPO),lipid peroxidation(LPO)and alkaline phosphatase (ALP)activities.A small piece of the sample from distal colon of each animal was fixed in 10% neutral buffered formalin and embedded in paraffin wax and sectioned for immunohistochemical examination of NFκ-B and iNOS expression.RESULTS:NCB-02 showed a dose dependent protection against DNCB-induced alteration in colon length and weight.NCB-02 treatment also showed a dose dependent protection against the elevated levels of MPO,LPO and ALP,induced by DNCB.NCB-02 demonstrated a significant effect at a dose of 100 mg/kg b.wt.,which was almost equipotent to 100 mg/kg b.wt.of sulfasalazine.Treatment with sulfasalazine and curcumin at a dose of 100 mg/kg b.wt.inhibited the DNCB-induced overexpression of NFκ-B and iNOS in the colon.CONCLUSION:Curcumin treatment ameliorates colonic damage in DNCB-induced colitic rats,an effect associated with an improvement in intestinal oxidative stress and downregulation of colonic NFκ-B and iNOS expression.     

Growth rate as a prognostic factor in localized invasive cutaneous melanoma

Background Melanoma is a tumour with a very variable progression. Whilst some melanomas grow slowly over many years, others can reach several millimetres in thickness in just a few weeks. Since melanoma is a visible superficial tumour, the information obtained from the clinical interview may be of use to calculate the speed of growth of the melanoma. Objective This study aims to assess the growth rate (GR) of melanomas and the association of this GR with various clinical and pathological factors and their usefulness as prognostic markers for localized invasive cutaneous melanomas. Methods The GR of melanomas was calculated as the ratio of tumour thickness to time of development, as obtained from the clinical history (in millimetres per month). Results Applying the GR calculation to patients with a localized melanoma showed a significant association between melanomas with a GR greater than 0.4 mm per month and an age of 65 years or over, male sex, nodular melanoma, tumour thickness, level of invasion, the presence of ulceration and a high mitotic index. As an independent prognostic factor for overall survival, the GR proved to be significant (P = 0.024). Conclusion The GR of localized cutaneous melanomas may be a possible prognostic factor for survival. Additionally, rapid GR is associated with male patients more advanced in age at diagnosis, which suggests the need to assess new strategies for the early detection of these melanomas.     

Oxygen consumption during sleep in atopic dermatitis

Measurements of oxygen consumption (VO2) were made during sleep in 10 patients with atopic dermatitis. Two groups of healthy children acted as controls. All subjects were studied in bed in an environmental temperature of 24-26 degrees C, and sleep was confirmed during continuous electroencephalographic monitoring. Mean (SD) values of VO2 in sleeping patients who were not scratching ranged from 4.0 (0.4) to 7.4 (0.7), which was not statistically significantly different from control values which ranged from 3.24 (0.3) to 5.56 (0.4). During scratching (while asleep), which occurred in nine out of 10 patients with atopic dermatitis, the mean values of VO2 ranged from 4.5 (0.04) to 10.4 (2.7), and this was significantly higher than the non-scratching patients and the control values. Scratching during sleep in children with atopic dermatitis is associated with increased VO2.