Ultraviolet-B treatment for cutaneous lichen planus: our experience with 50 patients

Background: Previous small reports suggested the role of ultraviolet (UV)‐B in the management of cutaneous lichen planus. Objective: To summarize our experience with UVB in a relatively large study group looking specifically into predictive factors for complete response and the long‐term relapse rates. Methods: A retrospective analysis of 50 patients with generalized cutaneous lichen planus, treated by broad or narrow band UVB. Results: Seven and 43 patients were treated by broad and narrow band UVB, respectively. Complete response was achieved in 70% and 85% of those were still in remission after a median of 34.7 months. The complete response rate and the need for higher cumulative exposure doses were not influenced by sex, age, skin type, presence of additional diseases, failure of previous treatment or disease duration. Limitations: This is a retrospective non‐randomized analysis of a usually self‐limiting disease. Conclusion: UVB is a safe and efficient treatment option for generalized cutaneous lichen planus.     

A contrast-enhanced-CT-based classification tree model for classifying malignancy of solid lung tumors in a Chinese clinical population

BackgroundTo develop and validate a contrast-enhanced CT based classification tree model for classifying solid lung tumors in clinical patients into malignant or benign.MethodsBetween January 2015 and October 2017, 827 pathologically confirmed solid lung tumors (487 malignant, 340 benign; median size, 27.0 mm, IQR 18.0–39.0 mm) from 827 patients from a dedicated Chinese cancer hospital were identified. Nodules were divided randomly into two groups, a training group (575 cases) and a testing group (252 cases). CT characteristics were collected by two radiologists, and analyzed using a classification and regression tree (CART) model. For validation, we used the decision analysis threshold to evaluate the classification performance of the CART model and radiologist’s diagnosis (benign; malignant) in the testing group.ResultsThree out of 19 characteristics [margin (smooth; slightly lobulated/lobulated/spiculated), and shape (round/oval; irregular), subjective enhancement (no/uniform enhancement; heterogeneous enhancement)] were automatically generated by the CART model for classifying solid lung tumors. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the CART model is 98.5%, 58.1%, 80.6%, 98.6%, 79.8%, and 90.4%, 54.7%, 82.4% 98.5%, 74.2% for the radiologist’s diagnosis by using three-threshold decision analysis.ConclusionsTumor margin and shape, and subjective tumor enhancement were the most important CT characteristics in the CART model for classifying solid lung tumors as malignant. The CART model had higher discriminatory power than radiologist’s diagnosis. The CART model could help radiologists making recommendations regarding follow-up or surgery in clinical patients with a solid lung tumor.     

Kinetics and peculiarities of phase separation in the formation of semi-interpenetrating polymer networks

The initial stages of phase separation in the formation of semi-interpenetrating polymer networks (semi-IPN's) based on copolymer from styrene with divinylbenzene (DVB)/poly(butyl methacrylate) (PBMA) were studied using an optical laser diffractometer. It was found that phase separation obeys the mechanism of spinodal decomposition. The peculiarity of phase separation in the system studied is due to the existence of a two-stage process. Each stage exhibits different interdiffusion coefficients, sizes of microheterogeneity areas and activation energies.     

Determination of growth hormone releasing peptides metabolites in human urine after nasal administration of GHRP‐1, GHRP‐2, GHRP‐6, Hexarelin,and Ipamorelin

Growth hormone releasing peptides (GHRPs) stimulate secretion of endogenous growth hormone and are listed on the World Anti‐Doping Agency (WADA) Prohibited List. To develop an effective method for GHRPs anti‐doping control we have investigated metabolites of GHRP‐1, GHRP‐2, GHRP‐6, Hexarelin, and Ipamorelin in urine after nasal administration. Each compound was administrated to one volunteer. Samples were collected for 2 days after administration, processed by solid‐phase extraction on weak cation exchange cartridges and analyzed by means of nano‐liquid chromatography ‐ high resolution mass spectrometry. Six metabolites of GHRP‐1 were identified. GHRP‐1 in the parent form was not detected. GHRP‐1 (2‐4) free acid was detected in urine up to 27 h. GHRP‐2, GHRP‐2 free acid and GHRP‐2 (1‐3) free acid were detected in urine up to 47 h after administration. GHRP‐6 was mostly excreted unchanged and detected in urine 23 h after administration, its metabolites were detectable for 12 h only. Hexarelin and Ipamorelin metabolized intensively and were excreted as a set of parent compounds with metabolites. Hexarelin (1‐3) free acid and Ipamorelin (1‐4) free acid were detected in urine samples after complete withdrawal of parent substances. GHRPs and their most prominent metabolites were included into routine ultra‐pressure liquid chromatography‐tandem mass spectrometry procedure. The method was fully validated, calibration curves of targeted analytes were obtained and excretion curves of GHRPs and their metabolites were plotted. Our results confirm that the detection window after GHRPs administration depends on individual metabolism, drug preparation form and the way of administration. Copyright © 2015 John Wiley & Sons, Ltd.     

Endoscopic en-face optical coherence tomography and fluorescence imaging using correlation-based probe tracking

Forward-viewing endoscopic optical coherence tomography (OCT) provides 3D imaging in vivo, and can be combined with widefield fluorescence imaging by use of a double-clad fiber. However, it is technically challenging to build a high-performance miniaturized 2D scanning system with a large field-of-view. In this paper we demonstrate how a 1D scanning probe, which produces cross-sectional OCT images (B-scans) and 1D fluorescence T-scans, can be transformed into a 2D scanning probe by manual scanning along the second axis. OCT volumes are assembled from the B-scans using speckle decorrelation measurements to estimate the out-of-plane motion along the manual scan direction. Motion within the plane of the B-scans is corrected using image registration by normalized cross correlation. En-face OCT slices and fluorescence images, corrected for probe motion in 3D, can be displayed in real-time during the scan. For a B-scan frame rate of 250 Hz, and an OCT lateral resolution of approximately 20μm , the approach can handle out-of-plane motion at speeds of up to 4 mm/s.     

Treatment of Complex Regional Pain Syndrome Type I With Oral Phenoxybenzamine: Rationale and Case Reports

▪ Abstract:   The nonselective α-adrenergic antagonist, phenoxybenzamine, has been used in the treatment of neuropathic pain syndromes, specifically, complex regional pain syndrome (CRPS) types I and II. This agent has also previously been used in intravenous regional peripheral blocks for treatment of CRPS I; however, an intravenous preparation of phenoxybenzamine is not currently available in the U.S.A. In this case series, systemic administration was more appropriate for three of the four patients, as their syndromes had spread beyond the initial area of surgery or trauma. We report an apparent clinical benefit in three of the four patients following oral administration. We postulate that this may be due to the noncompetitive (irreversible) blockade of α₁- and α₂-adrenergic receptors. We further hypothesize that this blockade could reduce stimulation of an increased population of adrenergic receptors in hyperalgesic skin, blunt the stimulation by norepinephrine of α₂-adrenergic receptors on macrophages, and ultimately reduce the release of proinflammatory cytokines from cellular elements. ▪     

Molecular mechanisms that control initiation and termination of physiological depolarization-evoked transmitter release

Ca(2+) is essential for physiological depolarization-evoked synchronous neurotransmitter release. But, whether Ca(2+) influx or another factor controls release initiation is still under debate. The time course of ACh release is controlled by a presynaptic inhibitory G protein-coupled autoreceptor (GPCR), whose agonist-binding affinity is voltage-sensitive. However, the relevance of this property for release control is not known. To resolve this question, we used pertussis toxin (PTX), which uncouples GPCR from its G(i/o) and in turn reduces the affinity of GPCR toward its agonist. We show that PTX enhances ACh and glutamate release (in mice and crayfish, respectively) and, most importantly, alters the time course of release without affecting Ca(2+) currents. These effects are not mediated by G(beta)gamma because its microinjection into the presynaptic terminal did not alter the time course of release. Also, PTX reduces the association of the GPCR with the exocytotic machinery, and this association is restored by the addition of agonist. We offer the following mechanism for control of initiation and termination of physiological depolarization-evoked transmitter release. At rest, release is under tonic block achieved by the transmitter-bound high-affinity presynaptic GPCR interacting with the exocytotic machinery. Upon depolarization, the GPCR uncouples from its G protein and consequently shifts to a low-affinity state toward the transmitter. The transmitter dissociates, the unbound GPCR detaches from the exocytotic machinery, and the tonic block is alleviated. The free machinery, together with Ca(2+) that had already entered, initiates release. Release terminates when the reverse occurs upon repolarization.     

Additional Drug Resistance of Multidrug-Resistant Tuberculosis in Patients in 9 Countries

Data from a large multicenter observational study of patients with multidrug-resistant tuberculosis (MDR TB) were analyzed to simulate the possible use of 2 new approaches to treatment of MDR TB: a short (9-month) regimen and a bedaquiline-containing regimen. Of 1,254 patients, 952 (75.9%) had no resistance to fluoroquinolones and second-line injectable drugs and thus would qualify as candidates for the 9-month regimen; 302 (24.1%) patients with resistance to a fluoroquinolone or second-line injectable drug would qualify as candidates for a bedaquiline-containing regimen in accordance with published guidelines. Among candidates for the 9-month regimen, standardized drug-susceptibility tests demonstrated susceptibility to a median of 5 (interquartile range 5–6) drugs. Among candidates for bedaquiline, drug-susceptibility tests demonstrated susceptibility to a median of 3 (interquartile range 2–4) drugs; 26% retained susceptibility to <2 drugs. These data may assist national TB programs in planning to implement new drugs and drug regimens.     

Base excision repair fidelity in normal and cancer cells

In mammalian cells, base excision repair (BER) is the major repair pathway involved in the removal of non-bulky damaged nucleotides. The fidelity of BER is dependent on the polymerization step, where the major BER DNA polymerase (Pol beta) must incorporate the correct Watson-Crick base paired nucleotide into the one nucleotide repair gap. Recent studies have indicated that expression of some Pol beta variants or changes in expression of wild-type Pol beta protein, frequently found in cancer cells, can lead to DNA repair synthesis errors and confers to cells a mutator phenotype.