PROLIFERATIVE ACTINIC KERATOSIS

Background. Solar/actìnic keratoses (AKS) are premalignant lesions, usually less than 1 cm in diameter, that appear on chronically sun-damaged skin. Methods. We describe four patients with a form of AK that enlarged and recurred despite standard treatment. Histologic examination revealed a single and multilayered sheet of anaplastic cells along the undersurface of the epidermis extending down hair follicles and present over a large area. Results. Three of the patients developed either a squamous cell carcinoma (sec) or basal cell carcinoma (see) within the area encompassed by the AK. Conclusions. These cases represent an insidious, proliferative form of AK with an increased tendency to develop into skin cancer.     

Fluoride content in toothpastes commercialized for children in Chile and discussion on professional recommendations of use

International Journal of Paediatric Dentistry 2013; 23: 77–83 Background. In Chile, no information is available regarding the soluble fluoride (F) content in the toothpastes commercialized for children and the country’s guidelines recommend the use of F in toothpastes in an age‐dependent concentration. No global consensus has been reached on this subject. Aim. To determine the soluble F concentration in dentifrices for children sold in Chile and to discuss Chilean guidelines and professional recommendations of use. Design. Three samples of twelve different dentifrices were purchased from drugstores. Toothpastes were analysed in duplicate using an ion‐specific electrode. The concentrations of total F (TF) and total soluble F (TSF) were determined (μg F/g). Results. Measured TF was consistent with that declared by the manufacturer in eight products. Two dentifrices showed lower TF and two higher F concentrations than declared. A toothpaste, marketed as low‐F (450 ppm), showed F concentration threefold higher. Most dentifrices exhibited TSF concentrations similar to the TF content, except one sample that displayed considerably lower TSF than TF. Recommendations on F toothpastes use in children widely vary from country to country. Conclusions. Most dentifrices for children match F content in the labelling, but recommendations are not supported by the best evidence available on the benefit/risk of F toothpastes use.     

The Effect of Dexamethasone on Integrin and Laminin Expression in Cultured Human Trabecular Meshwork Cells

Glucocorticoid treatment in vivo can produce a glaucoma similar in many ways to POAG. Treatment of trabecular meshwork cells in culture with dexamethasone allows the study of biochemical aspects of this disease process. The effects of dexamethasone on the expression of integrins and laminin in both normal and glaucomatous cultured human trabecular meshwork cells were evaluated. Human trabecular meshwork cell lines were cultured for 18 days in the presence or absence of 10⁻⁷mdexamethasone. Radioimmunoprecipitation was used to determine the relative expression of five αintegrin subunits. Laminin expression was evaluated with Western blots. Laminin was increased in all cell lines following dexamethasone treatment. α2, α5 and αV integrin chains showed consistent dexamethasone-induced changes in expression, while α3 and α4 subunits did not. There were no differences in the expression patterns for any of these integrin subunits between normal and glaucomatous cell lines. Increased laminin deposition as seen in this study with dexamethasone treatment may be partially responsible for the decreased outflow facility seen in both steroid-induced glaucoma and in POAG.     

KELOIDAL BLASTOMYCOSIS (LOBO'S DISEASE) WITH LYMPHATIC INVOLVEMENT: A CASE REPORT

ABSTRACT: Keloidal blastomycosis (Lobo's disease) is reported in a 34-year-old man from the Brazilian Amazon area. His left ear and posterior auricular region were involved. He is the eighth of 99 patients known to have lymph node involvement.     

CHRONIC TREATMENT WITH FINASTERIDE DAILY DOES NOT AFFECT SPERMATOGENESIS OR SEMEN PRODUCTION IN YOUNG MEN

PURPOSE: Finasteride, an oral type 2, 5alpha-reductase inhibitor, is used in 1 mg. daily doses for the treatment of male pattern hair loss. A dose of 5 mg. finasteride daily reduces ejaculate volume by approximately 25%, and reduces prostate volume by approximately 20% and serum prostate specific antigen (PSA) by approximately 50% in men with benign prostatic hyperplasia. To our knowledge no data exist on the effect of 1 mg. finasteride daily on ejaculate volume or other semen parameters, or on the prostate in young men. Therefore, we studied the potential effect and reversibility of effect of 1 mg. finasteride daily on spermatogenesis, semen production, the prostate and serum PSA in young men. MATERIALS AND METHODS: In this double-blind, placebo controlled multicenter study 181 men 19 to 41 years old were randomized to receive 1 mg. finasteride or placebo for 48 weeks followed by a 60-week off-drug period. Of the 181 men 79 were included in a subset for the collection and analysis of sequential semen samples. RESULTS: There were no significant effects of 1 mg. finasteride on sperm concentration, total sperm per ejaculate, sperm motility or morphology. Ejaculate volume in subjects on finasteride decreased 0.3 ml. (-11%) compared to a decrease of 0.2 ml. (-8%) for placebo, with a median between treatment group difference of -0.03 ml. (1%, 90% confidence interval -10.4 to 13.1, p = 0.915). There were significant but small decreases in prostate volume (-2.6%) and serum PSA (-0.2 ng./ml.) in the finasteride group, which reversed on discontinuation of the drug. CONCLUSIONS: Treatment with 1 mg. finasteride daily for 48 weeks did not affect spermatogenesis or semen production in young men. The effects of 1 mg. finasteride daily on prostate volume and serum PSA in young men without benign prostatic hyperplasia were small and reversible on discontinuation of the drug.     

Malignant Lymphoma in Manila --A Clinicopathologic Study at the University of the Philippines Philippine General Hospital Medical Center--

An analysis is presented of the histopathologic, clinical andprognostic features of malignant lymphomas (MLs) treated atthe University of the Philippines-Philippine General HospitalMedical Center, Manila, between 1975 and 1981. There were 434malignant lymphomas, constituting 3.86% of all cancers studiedat this institute during this period. Non-Hodgkin's lymphomasaccounted for 82%. Among these, nodular lymphomas constituted8% of the group and diffuse lymphomas 92%. In diffuse lymphomas,poorly differentiated lymphocytic lymphomas (31%) and histiocyticlymphomas (30%) were predominant. Pleomorphic lymphomas, whichare frequently observed in south western Japan and are now knownto be a peculiar type of adult T-cell lymphoma/leukemia, werenot found in this group. Hodgkin's disease constituted 18% ofall the malignant lymphomas, among which there were 52% mixedcellular type and 21% lymphocytic depletion type. These datawere correlated with those of other countries.     

RELATIONSHIP BETWEEN THE PASSAGE OF LOCAL ANAESTHETICS ACROSS THE BLOOD-BRAIN BARRIER AND THEIR EFFECTS ON THE CENTRAL NERVOUS SYSTEM

The transfer of procaine and lignocaine from blood to cerebrospinalfluid (c.s.f.) was studied in six patients and in twelve dogs.Local anaesthetics appeared very rapidly in the c.s.f. afterintravenous administration. Within 20 minutes, a c.s.f./plasmaultrafiltrate ratio around 0.9 was reached. Para-aminobenzoicacid, a procaine metabolite, appeared in c.s.f. later than procaine.This is explained by a different rate of drug entry into thec.s.f. and by the need for previous procaine splitting by plasmacholinesterase. The rapid transfer of local anaesthetics correspondswith their high lipid-solubility and low degree of ionic dissociationat the pH of the body. The free movement of drugs to and fromthe brain accounts for the controllability of general anaesthesiainduced by the intravenous administration of local anaesthetics. ^* Present address: Department of Pharmacology, Cornell UniversityMedical College, 1300 York avenue, New York, N.Y. 10021.