Oral itraconazole for the treatment of severe seborrhoeic dermatitis

Background:

Seborrheic dermatitis (SD) is an inflammatory skin disorder in which colonies of Malassezia furfur have been found in affected areas.

Aim:

The aim of this study was to evaluate the efficacy of itraconazole in the treatment of severe SD.

Materials and Methods:

Itraconazole was given to 30 patients of SD in a dose of 100 mg twice daily for 1 week followed by 200 mg/day for first 2 days of the following 2 months. The response was noted on day 15, 30, 60, and 90. The clinical response was graded as markedly effective, effective, or ineffective.

Results:

Clinical improvement (evaluated as markedly effective or effective) was observed in 83.3% cases.

Conclusion:

The anti-inflammatory activity of oral itraconazole suggests that it should be the first-line therapy in severe SD.     

Enhanced tumor growth in brain dopamine-depleted mice following 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) treatment

Brain dopamine influences immune functions and the role of immune functions in tumor growth is well established. Therefore, a study has been carried out to evaluate the correlation, if any, between brain dopamine and tumor growth. MPTP selectively destroys dopaminergic neurons in the brain. In the present study, Ehrlich carcinoma growth was evaluated in MPTP-treated mice. Results showed a correlation between depletion of striatal dopamine and enhanced tumor growth. Since in the present study striatal dopamine depletion in mice was associated with significantly decreased immune responses, the suggested correlation between brain dopamine and tumor growth was possibly mediated by the immune system.     

Parapharyngeal metastasis from papillary microcarcinoma of thyroid: report of a case diagnosed by peroral fine needle aspiration

A parapharyngeal metastasis from primary thyroid carcinoma is rare and a search of relevant publications disclosed only seven previous reported cases. We describe a 46-year-old man who presented with a left parapharyngeal mass that was subsequently diagnosed by peroral fine-needle aspiration as a metastasis originating from a papillary carcinoma of the thyroid gland. Metastatic thyroid cancer should be considered in the differential diagnosis of a parapharyngeal mass. Fine-needle aspiration cytology is a simple, speedy, and cost-effective method of diagnosis of parapharyngeal masses.     

Effect of human chorionic gonadotropin (hCG) on expression of vascular endothelial growth factor a (VEGF-a) in human mid-secretory endometrial cells in three-dimensional primary culture

Several lines of evidence suggest that human uterine endometrial cells can bind human chorionic gonadotropin (hCG) which, in turn, influences the physiology of implantation stage endometrium. Vascular endothelial growth factor (VEGF) appears to be a candidate mediator in this process. However, our knowledge about hCG action on VEGF in human endometrial cells is very thin. In the present study, we have examined microscopically hCG binding to dissociated human endometrial cells collected from mid-luteal phase and maintained in three-dimensional primary co-culture on rat-tail collagen type I biomatrix and examined the effect of different concentrations (0, 1, 10, 100 and 1000 IU/ML) of hCG on VEGF expression and secretion by endometrial cells maintained in the above system. We report that both cytokeratin positive epithelial cells as well as vimetin positive stromal cells from human mid luteal phase endometrium could bind hCG and that their number increased (P < 0.01) steadily with time. Administration of hCG enhanced (P < 0.05) immunoreactive VEGF protein expression in dose dependent manner in endometrial cells retrieved from mid-luteal phase of cycle, and co-cultured in a three-dimensional cell culture system, but with no marked change in VEGF secretion. Collectively, it appears that hCG influences VEGF protein synthesis in human midluteal phase endometrial cells, but has little effect on post-translational regulation and secretion. From physiological homeostasis point of view, it is likely that synthesis and secretion of VEGF exhibits a modular and factorial regulation to achieve a fine tuning of this potent vasotropic agent in receptive stage endometrium.     

In vitro action of leukemia inhibitory factor (LIF) on mid-secretory stage endometrial stromal cells collected from hormone-simulated, ovariectomized monkey and maintained in three-dimensional primary culture

Leukemia inhibitory factor (LIF) is a pleiotropic cytokine that is known to play an important role in blastocyst implantation. The putative action of LIF in the regulation of uterine function has been examined using mid-secretory stage monkey endometrial stromal cells cultured on rat-tail collagen type I and treated with recombinant human LIF (rhLIF) or immunoneutralized LIF (in LIF) under serum-free condition. Long-term ovariectomized rhesus monkeys (n=8) underwent simulation of their menstrual cycles with steroid hormones and endometrial tissue samples were collected on cycle day 18; stromal cells were isolated and grown in primary culture on three-dimensional collagen matrix. Significant decline in cellular protein synthesis (P < 0.01) and cell proliferation index (P < 0.05) was observed in cells with increasing doses (0-1000 ng/ml) of rhLIF under serum-free in vitro condition. JAK1 expression in cultured cells increased (P < 0.01) in response to rhLIF as revealed from Western blot and confocal laser scanning microscopic examination, STAT1 and STAT2 expressions were unchanged, while pSTAT3 expression increased (P < 0.01) with increased concentration of rhLIF in culture medium. Autophosphorylation of JAK1 in endometrial stromal cells showed no change with increasing concentration (0.01 to 100 ng/ml) of rhLIF in vitro, but significant (P < 0.05) increase was observed with the time of exposure to rhLIF. Immunoneutralization of LIF or no addition of rhLIF to cultured cells led to significant (P < 0.01) increase in stromal cell proliferation index and significant (P < 0.01) decrease in the level of JAK1 and its autophosphorylation as compared to cells exposed to rhLIF alone. From the present set of experiments we conclude that rhLIF affects the physiological behaviour of monkey mid secretory stage endometrial stromal cells in vitro via the JAK-STAT signaling pathway.     

Primary pulmonary artery sarcoma masquerading as pulmonary thromboembolism: a rare diagnosis unveiled

Background

Primary pulmonary artery sarcomas are rare malignant vascular tumors and carry a very poor prognosis. Due to overlapping clinical and radiological features, the differentiation between pulmonary artery thromboembolism and pulmonary artery sarcoma can be challenging.

Case presentation

We herein present clinical, radiological and pathological features of primary pulmonary artery high grade sarcoma (angiosarcoma) in a 59-year-old male. The patient presented with a history of breathlessness on exertion of 2-months duration and was misdiagnosed as massive pulmonary thromboembolism on initial CT imaging.

Conclusion

Great similarity with significant degree of overlap in clinical and radiologic presentation makes differentiation of pulmonary artery sarcomas and thromboembolism a diagnostic challenge. Even though they are exceptionally rare, one should always consider it as differential diagnosis especially in cases with atypical clinical or imaging presentation.

     

Preventable hospitalization and medicaid managed care: does race matter?

This study examines the preventable hospitalization patterns of Medicaid patients by race/ethnicity to determine whether Medicaid managed care (MMC) has been more effective in some subgroups than others. It uses logistic models for three states, comparing preventable hospitalizations with marker admissions (urgent admissions, insensitive to primary care). Hospital discharge data from the Healthcare Cost and Utilization Project State Inpatient database of the Agency for Health Care Research and Quality for New York, Pennsylvania, and Wisconsin residents aged 20-64 years is used. In a more urban state, New York, MMC was effective for Whites but not for minorities. In a more rural state, Wisconsin, MMC was effective for minorities. Overall, the evidence is not strong that any particular racial group consistently benefited from MMC, or that any state consistently showed a favorable impact of MMC across racial groups. However, racial/ethnic disparity associated with the risk of preventable hospitalization is significantly lower among Medicaid patients than among private fee-for-service patients.     

Monochromatic aberrations in eyes with different intraocular lens optic designs

PURPOSE: To study the wavefront aberration profile of eyes with three different types of intraocular lenses (IOLs)--the Tecnis Z9000 (modified prolate surface design) (Pfizer, New York, NY), the Acrysof MA60BM (unequal biconvex optic) (Alcon, Ft Worth, Tex), and the Sensar Optiedge AR40e (equibiconvex optic) (AMO, Santa Ana, Calif)--in eyes following cataract surgery. METHODS: This study was conducted in two parts. The first part was a randomized open study of 32 eyes of 16 patients who underwent bilateral phacoemulsification with a foldable IOL in the capsular bag. A Tecnis Z9000 IOL was implanted in one eye and an Acrysof MA60BM IOL in the fellow eye. The ALLEGRETTO WAVE Analyzer (Wavelight Laser Technologies AG, Erlangen, Germany) was used to measure ocular aberrations 2 weeks after surgery. A paired t test was used to compare each Zernike term from Z3(-3) to Z6(6) between fellow eyes (pupil diameter = 6 mm). In the second part of the study, the wavefront aberrations of 16 eyes that underwent an identical surgical procedure as in the first part of the study but had a Sensar Optiedge AR40e IOL implanted were studied and compared with eyes with the Tecnis Z9000 and Acrysof MA60BM IOLs. RESULTS: The mean spherical aberration (Z4(0)) was statistically significantly lower in eyes with a Tecnis Z9000 IOL (Z4(0) = 0.07 +/- 0.12 microm) compared with eyes with an Acrysof MA60BM IOL (Z4(0) = 0.29 +/- 0.20 microm, P < .001) and with eyes with a Sensar Optiedge AR40e IOL (Z4(0) = 0.20 +/- 0.09 microm, P = .002). No statistically significant differences were noted in any of the Zernike terms between eyes with Acrysof MA60BM and Sensar Optiedge AR40e IOLs, or in the root-mean-square (RMS) of total higher order aberrations among the three IOL groups. CONCLUSIONS: The implantation of a Tecnis Z9000 IOL produces a significant reduction in spherical aberration of the eye. No significant differences were noted in the wavefront profile between eyes with Acrysof MA60BM and Sensar Optiedge AR40e IOLs. No significant differences were found in the RMS of total higher order aberrations among the three IOL groups.     

Effect of (Ala8,13,18)-magainin II amide on human trophoblast cells in vitro

Magainins are cationic peptides with anti-bacterial and anti-tumor properties. The anti-nidatory function of a synthetic analogue of magainin, (Ala8,13,18)-magainin II amide, has earlier been reported, and it has been indicated that placental trophoblast cells could be a target of magainin resulting in its contragestational action. The aim of the present study was to examine the effect of (Ala8,13,18)-magainin II amide (100 ng/ml and 1000 ng/ml) on attachment efficiency, viability, differentiation in terms of hCG secretion and invasive function of isolated first trimester, human placental trophoblast cells grown on rat-tail collagen type-I matrix in primary cell culture. In the present experimental model, magainin was not found to affect human trophoblast cell functions in vitro.