The histopathology of fiberglass dermatitis in relation to von Hebra''s concept of eczema

A group of 36 normal control persons was patch-tested with glass fibers. The tested filaments had a length of about 3 to 5 mm and a diameter of 9 to 13 microns. The glass fibers were obtained from the normal production process. They were coated with cured epoxy resin. A group of 29 normal control persons was tested with the same type of fibers from which the epoxy finish had been burned off. Another group of 36 persons was patch-tested with ultrasmall glass globes with a diameter of 10 to 15 microns. Coated and uncoated glass globules were tested. On every person 5 patch tests with the same material were done. They were removed after 1, 5, 24, 48 and 72 h. On coated fiber, 12 of 36 tested people reacted with either a + or a ++ reaction. On the uncoated fibers a reaction could be noted in 10 out of 29 persons. The patch tests with coated as well as uncoated glass globules were all negative. A total of 60 biopsies was performed in those cases where + or ++ reactions were noted. The histological examination of the biopsies showed no differences between the reactions on coated and uncoated fibers. The skin reactions to glass fiber showed, besides microtraumatic changes, several histological characteristics of an eczematous reaction, like spongiosis and perivascular lymphocytic infiltration. The importance of these findings is discussed. It is emphasized that histological alterations are only one of the six points which must be taken into account when the diagnosis of eczema is considered.     

Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. a study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry

OBJECTIVE: Endovascular treatment of thoracic aortic disease may be associated with severe neurologic complications. The current study used the data of a multicenter registry to assess of the incidence and the risk factors for paraplegia or paraparesis and intracranial stroke. METHODS: The European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) database prospectively enrolled 606 patients. Thoracic pathologies with urgent or elective presentation, which included degenerative aneurysm in 291, aortic dissection in 215, traumatic rupture in 67, anastomotic false aneurysm in 24, and infectious or nonspecified disorders in 9. Study end points included evidence of perioperative spinal cord ischemia (SCI) or stroke. Univariate analysis and multivariate regression models were used to assess the significance of clinical factors that potentially influenced the occurrence of neurological sequelae. RESULTS: Paraplegia or paraparesis developed in 15 patients (2.5%) and stroke in 19 (3.1%); two patients had both complications. At multivariate regression analysis, independent correlation with SCI was observed for four factors: (1) left subclavian artery covering without revascularization (odds ratio [OR], 3.9; P = .027), (2) renal failure (OR, 3.6; P = .02), (3) concomitant open abdominal aorta surgery (OR, 5.5; P = .037) and (4) three or more stent grafts used (OR, 3.5; P = .043). In patients with perioperative stroke, two correlating factors were identified: (1) duration of the intervention (OR, 6.4; P = .0045) and (2) female sex (OR, 3.3; P = .023). A neurologic complication (paraplegia or stroke) developed in 8.4% of the patients in whom left subclavian covering was required compared with 0% of patients with prophylactic revascularization (P = .049). CONCLUSION: Perioperative paraplegia or paraparesis was significantly associated with blockage of the left subclavian artery without revascularization. The clinical significance of this source of collateral perfusion of the spinal cord had not been confirmed previously. Intracranial stroke was associated with lengthy manipulation of wires, catheters, and introducer sheaths within the aortic arch, reflected by a longer duration of the procedure.     

Retinal blood flow changes in diabetic retinopathy measured with the Heidelberg scanning laser Doppler flowmeter

Background: Investigation of retinal blood flow in patients with and without diabetic retinopathy (DR). Retinal blood flow is measured with the non-invasive Heidelberg Retinal Flowmeter (HRF). The clinical suitability of the HRF in patients with diabetes mellitus is investigated, and measured blood flow is compared with blood flow in a group of non- diabetic persons. Methods: Cross- sectional study of retinal capillary perfusion in eighty diabetic patients and forty-nine control persons, non-invasively measured with the Heidelberg scanning laser Doppler flowmeter. Results: In the control group, HRF measurements could be performed in all subjects. In the diabetes group some patients had media opacities or were not able to maintain stable fixation. Therefore HRF measurement was only possible in 79%, 75% and 60% of the subjects for the nasal, papillo-macular and foveal areas respectively. Retinal blood flow as measured in the perifoveal and nasal areas was associated with the level of diabetic retinopathy. In patients with proliferative DR (levels 4 and 5) the blood flow was reduced, in comparison with that of the patients with exudative or non-proliferative DR (levels 1 and 2) and preproliferative DR (level 3). Blood flow was not correlated with age, systemic blood pressure, intra-ocular pressure and perfusion pressure in either group. A significant negative correlation with the actual blood glucose level was found in the perifoveal area (R=–0.585, P=0.0001). Conclusions: The HRF offers an interesting non-invasive method for measurement of retinal blood flow. In this cross-sectional study variations in retinal blood flow could be detected in various stages of DR in relation to clinically visible funduscopic changes. Received: 19 April 2000 Revised: 10 July 2000 Accepted: 10 July 2000     

Sustained Virological Response in Chronic Hepatitis C Patients after a 6- and a 36-Month Interferon-a2b Treatment Schedule. A Multicenter,Randomized, Controlled Study

With the introduction of medical treatment (chenodeoxycholic acid therapy) of cholesterol gallstones, the prediction of the gallstone type, cholesterol — non-cholesterol stones (i.e. cholesterol predominating or not), has become important. In 24 consecutive patients admitted for surgery because of gallstones, the value of various criteria for differentiation between the two types of stones was assessed. It is concluded that the combined requirements of radiolucency of the stones and a cholesterol saturation index in duodenal bile above 1.00 constitutes a fairly reliable method for selection of patients for dissolution therapy with chenodeoxycholic acid.     

Islet neogenesis is stimulated by brief occlusion of the main pancreatic duct.

OBJECTIVE: Current models of islet neogenesis either cause substantial pancreatic damage or continuously stimulate the pancreas, making these models unsuitable for the study of early events that occur in the neogenic process. We aimed to develop a method where the initial events that culminate in increased pancreatic endocrine mass can be studied. DESIGN AND METHODS: Ten 12-week-old female Wistar rats were subjected to a midline laparotomy, the pancreas was isolated and the main pancreatic duct was occluded for 60 seconds. The pancreas was released and carefully relocated within the abdomen. Ten age-, strain- and sex-matched control rats were subjected to a sham operation. The animals were killed 56 days post occlusion, and the pancreata excised and fixed for histological analysis. Body, pancreatic and hepatic weights were noted at termination and serum was taken for analysis. The endocrine-to-exocrine ratio was calculated and the number of endocrine cells in each islet from the sectioned pancreata was counted. RESULTS: Occlusion of the main pancreatic duct for 60 seconds results in an increase in endocrine mass by 80% 56 days post occlusion. This constitutes an increase in endocrine units (1-6 cells), and in small (7-30 cells), medium (31-60 cells) and large (> 60 cells) islets by 85%, 96%, 95% and 71% respectively. CONCLUSION: Brief occlusion of the main pancreatic duct results in an increase in pancreatic endocrine mass. An increase in endocrine units and small islets is indicative of islet neogenesis. Therefore, owing to the briefness of the stimulation, this model can therefore be used to study the initial events that occur during the neogenic process.     

Trans‐sodium crocetinate provides neuroprotection against cerebral ischemia and reperfusion in obese mice

Trans‐sodium crocetinate (TSC) is a novel synthetic carotenoid compound that improves diffusion of small molecules, including oxygen, in solutions. TSC provides neuroprotection in healthy rats and rabbits. This study seeks to determine whether TSC is neuroprotective in obese mice. Sixteen‐week‐old CD‐1 male mice that had been fed a high‐fat diet for 10 weeks were subjected to a 90‐min middle cerebral arterial occlusion (MCAO). They received TSC by two boluses through a tail vein 10 min after the onset of MCAO and reperfusion, respectively, with doses of 0.14, 0.28, and 0.7 mg/kg or by a bolus–infusion–bolus strategy with a dose of 0.14 mg/kg during MCAO. The neurological outcome was evaluated 72 hr after MCAO. Brain tissues were harvested 24 hr after MCAO to measure nitrotyrosine‐containing proteins, 4‐hydroxy‐2‐nonenal, matrix metalloproteinase (MMP)‐2 and ‐9 activity and expression, and inflammatory cytokines. TSC given in the two‐bolus strategy did not improve the neurological outcome. The bolus–infusion–bolus strategy significantly reduced brain edema, infarct volume, and hemorrhagic transformation and improved neurological functions. TSC reduced nitrotyrosine‐containing proteins, MMP‐9 activity and expression, and inflammatory cytokines in ischemic brain tissues. Our results indicate that TSC delivered by the bolus–infusion–bolus strategy provides neuroprotection in obese mice. This protection may occur through reduction of oxidative stress, MMP‐9 activity, or inflammatory cytokines in the ischemic brain tissues. © 2014 Wiley Periodicals, Inc.     

Look-Back of Anti-HCV ELISA-Positive, HCV-RNA PCR-Negative Donors and Recipients of Their Blood Products

Background and objectives: To establish the infectivity of anti-HCV ELISA-positive, but cDNA-PCR-negative blood components transfused before the introduction of routine anti-HCV blood donor screening, we enrolled recipients of such blood products in a look-back programme. Materials and methods: The blood components were donated by (A) RIBA?-2-indeterminate and cDNA-PCR-negative donors, and (B) RIBA-2 and cDNA-PCR-negative donors. The look-back comprised 214 blood products from group A donors and 278 from group B. Results: Of 211 recipients of group A components, 66 (31.3%) were available for testing. All other recipients could not be traced, had died, or refused collaboration. Of these 66, 3 patients had independent risk factors for HCV infection and were excluded. All remaining 63 recipients were anti-HCV ELISA-negative. Of 274 recipients of group B components, 84 (30.7%) were available for testing. All others could not be traced, had died, or refused collaboration. Of these 84, six patients had an independent risk factor for HCV infection and were excluded. All remaining 78 recipients were anti-HCV ELISA-negative. None of the recipients of blood products from previous donations of anti-HCV ELISA-positive, cDNA-PCR-negative, and RIBA-2-indeterminate or negative donors were HCV-infected. Conclusions: Donors and patients with such reactivities in anti-HCV ELISA, RIBA-2, and cDNA-PCR can be assured that they are not infected with HCV. The donors involved can re-enter the donor pool, provided that future donations are anti-HCV ELISA-negative.