The effect of wet-wrap dressing on epidermal barrier in patients with atopic dermatitis

BACKGROUND: Wet-wrap dressing has been shown to be effective for atopic dermatitis; however, the therapeutic mechanism of wet-wrap dressing is only the hypothesis based on the recovery of decreased epidermal barrier function. OBJECTIVES: To examine the therapeutic efficacy as well as the mechanism of wet-wrap dressing in atopic dermatitis patients. METHODS: To examine the difference of non-lesional and lesional atopic skin and to evaluate the change between epidermal barrier function before and after the treatment, SCORAD, epidermal water content, transepidermal water loss, the lipid amount of skin surface, immunohistochemical staining of filaggrin and loricrin, transmission electron microscopic examination, and calcium ion capture cytochemistry method were done in 10 severe form atopic dermatitis patients. RESULTS: In atopic dermatitis patients, SCORAD was clearly decreased, epidermal water content was increased, and transepidermal water loss was decreased after wet-wrap dressing. After wet-wrap dressing, increased release of lamellar body and the recovery of the damaged lamellar structure of intercellular lipid were observed; nevertheless, neither the change in keratinocyte differentiation nor the change of calcium ion gradient was detected. A week after the termination of wet-wrap dressing, increased water content and decreased transepidermal water loss were still maintained. CONCLUSION: We confirmed the abnormality of the epidermal barrier in atopic dermatitis, and the effects of wet-wrap were associated with the recovery of epidermal barrier. In atopic lesions, wet-wrap dressing induced clinical improvement by the release of lamellar body and the restoration of intercellular lipid lamellar structure.     

Concurrent chemoradiation for oesophageal cancer: Factors influencing myelotoxicity

Concurrent chemotherapy and radiation (CT/RT) for localized oesophageal cancer can cause life-threatening myelo-suppression. This non-randomized study examines 95 patients from three Australasian centres treated on the Trans-Tasman Radiation Oncology ‘definitivechemoradiation ‘ study. Duration of fluorouracil infusion and patient age were independently predictive of myelotoxicity after the first cycle of CT/RT. Overall rates of grade III and IV neutropaenia were 23% and of thrombocytopaenia 8% following the first cycle of chemotherapy. Five neutropaenic septic episodes followed the first cycle and six the second. All five patients recovered after the first cycle but there were four treatment-related deaths occurring after the second cycle of CT/RT. Recommendations are made concerning initial dosing, dose reductions and delays to minimize adverse patient outcomes from myelosuppression.     

Deletion and differential expression of p16INK4a in mouse lung tumors

Recent allelotyping of chemical-induced lung tumors in hybrid mice has detected loss of heterozygosity on chromosome 4 in a region involving the interferon-alpha (IFN-alpha gene cluster that is syntenic to human chromosome 9p21-22, the location of the p16INK4a (p16) and p15INK4b (p15) tumor suppressor genes. The purpose of the current investigation was to characterize the expression of p16 and p15 in lung tumors and tumor-derived cell lines induced in A/J mice by exposure to the tobacco- specific nitrosamine, 4-methylnitrosamino-1-(3-pyridyl)-1-butanone (NNK). Expression of p16 and p15 was detected in all primary lung tumors; however, levels of expression of p16 differed by up to 15-fold between tumors. This is the first study to note a marked difference in the expression of the p16 gene in primary lung tumors. The apparent low levels of expression seen in approximately half of the tumors was not attributed to deletion, mutation or methylation of the p16 gene. Conversely, the high levels of p16 expression were not the result of effects on the retinoblastoma gene (Rb) or cyclin D1 proteins but most likely in response to a dysfunction elsewhere within this pathway. In contrast to the detection of p16 expression in primary tumors, this gene was deleted in all four cell lines. Three of four cell lines also showed loss of the p15 gene. Mapping of these homozygous deletions on chromosome 4 revealed that the p16 gene resides near the D4MIT77 marker, which is located approximately 12 cM proximal to the IFN-alpha gene cluster, thereby implicating the p16 gene as one of the targets within the allelic deletions detected previously in primary lung tumors from hybrid mice.      

Levels of SP-A-anti-SP-A immune complexes in neonatal respiratory distress syndrome correlate with subsequent development of bronchopulmonary dysplasia

As part of a double-blind, randomized, placebo-controlled study of human surfactant therapy for neonatal respiratory distress syndrome (NRDS), we measured circulating immune complexes between surfactant protein-A and anti-surfactant protein-A antibodies (SAS). Plasma from almost all infants contained detectable immune complexes. Immune complex levels in surfactant-treated infants were comparable with those of placebo-treated controls. Despite the relatively small sample size, maximum SAS immune complex values between 2 and 4 weeks after birth correlated significantly with subsequent development of BPD. Levels of these immune complexes correlated with eventual BPD independently of, and more strongly than, gestational age and birth weight. Thus, plasma SAS immune complex measurements may be useful in analyzing the course and outcome of NRDS, in particular the likelihood of subsequent development of BPD. This assay may also help to identify infants at risk for BPD and to target preventative therapy to them.     

Application of autologous peripheral blood stem cell transplantation in children with malignant tumor

Objective To investigate if low dose total body irradiation (TBI, 6.0-9.0 Gy) combined with intensified chemotherapy followed by autologous peripheral blood stem cell transplantation results in better survival in children with refractory leukemia or solid tumors. Methods Twenty-one children with malignant tumors were included in this study.There w ere 14 males and 7 females aged 3.5-12 years.Underlying disease included high -risk acute lymphoblastic leukemia (ALL, CR(1) in 3 children and CR(2) in 5 ch ildren), acute myeloblastic leukemia (AML, 9 children), non-Hodgkin’s lymphoma stage Ⅳ ( 2 children), and neuroblastoma stage Ⅳ (2 children).The peripheral hematopoi etic stem cells were collected six to eleven months after complete response, mob ilized with high dose chemotherapy alone or combined with GM-CSF or G-CSF.Th e conditioning regimen consisted of chemotherapy with two to three combinations of the following drugs: cyclophosphamide, arabinosylcytosine, McNU, etopside, an d Idarubicin on the basis ofTBI (6.0-9.0 Gy).A mean of (1.8±0.5) ×10(8)/kg autologous mononuclear cells were transplanted.The patients were followed up after transplantation. Results Severe bone marrow suppression occurred in all patients around day +7.Peripher al white blood cell count decreased to 0 in all patients at day +4.8±2.9, and platelet count decreased to less than 20×10(9)/L at day +9.0±2.6.Succ essful engraftment was achieved in 21 patients, but four died of infection at da y +17, +20, +31 and +67, respectively.Recovery of white blood cell (WBC) to 10×10(9)/L, absolute neutrophil count to 0.5×10(9)/L, platelet count to 20 ×10(9)/L occurred on 21±12, 26±13, and 27±10 days, respectively.During the follow up period, three patients relapsed at +5 months, +1.5 years, and +2 yea rs 10 months, respectively.One patient died of intracranial hemorrhage at +8 m onths.Thirteen patients had event-free survival for 2-12 years, with a mean o f 6.7±3.4 years.Conclusion Our preliminary data suggest that myeloablative therapy with low dose TBI (6.0 -9.0 Gy) combined with intensified chemotherapy followed by autologous periphe ral blood stem cell transplantation might be associated with favorable results i n children with refractory leukemia or solid tumors.     

The formation of a spheroid of primary hepatocytes and the expression of liver-specific functions depend on the characteristics of polyurethane foam

Rapid formation of spherical multicellular aggregates (spheroids) of hepatocytes and expression of liver-specific functions are important in developing a hybrid artificial liver. The relation between these points and the surface characteristics of the culture substratum are investigated in this article. Polyurethane foam (PUF) was used as a culture substratum for hepatocytes. Rat, dog, and porcine primary hepatocytes spontaneously formed a spheroid within 1.5 days in the pores of a hydrophilic PUF with a contact angle of 53.4±2.7°. Rat and dog primary hepatocytes formed a spheroid within 3 and 7 days of culture, respectively, in hydrophobic PUF with a contact angle of about 100°. The rates of albumin secretion and ammonia metabolism at 5 days of culture of porcine hepatocytes were 31 μg of albumin/10⁶ nuclei/day and 0.018 μmol of NH₃/10⁶ nuclei/h, respectively, about 2 times higher than the values with hydrophobic PUF. It is very important to control the hydrophilicity of the PUF surface to develop an effective artificial liver module.