Case of dystrophic calcinosis cutis in epidermal cyst arising from verrucous epidermal nevus

Dystrophic calcinosis cutis is diagnosed when calcium is deposited into previously damaged tissue by connective tissue disease, panniculitis, pseudoxanthoma elasticum or trauma. We report a case of dystrophic calcinosis cutis arising from the lesion of an epidermal cyst on the verrucous epidermal nevus. A 20‐year‐old woman presented with a polypoid pinkish tumor on a brownish, verrucous plaque. Histopathological findings of the pinkish tumor showed calcium deposits as amorphous, basophilic material lining the true epidermis in the upper dermis, which were compatible with dystrophic calcinosis cutis and the plaque was diagnosed as a verrucous epidermal nevus.     

Improvement of juvenile dermatomyositis with calcinosis universalis after treatment with intravenous immunoglobulin

Juvenile dermatomyositis is a chronic multisystemic disease. It is believed to be of autoimmune aetiology and is characterized by the presence of vasculitis affecting striated muscle and skin. Calcinosis occurs in about 40% of cases. We report a case of a 10‐year‐old girl diagnosed with juvenile dermatomyositis who presented with difficulty in walking and inability to completely extend the four extremities due to calcinosis universalis. Calcinosis had progressed despite a 3‐year administration of diltiazem, hydroxychloroquine, aluminium hydroxide, cyclosporin, and probenecid. The introduction of monthly intravenous immunoglobulin therapy for 15 months lessened disease activity, and markedly regressed calcinosis, and improved functional outcome.     

CYSTICERCOSIS CELLULOSAE IN MAhT WITH SPECIAL REFERENCE TO INVOLVEMENT OF CENTRAL NERVOUS SYSTFM

In China human tapeworm infestation was known in ancient times, since the famous Pen Ts''ao, the Chinese Classical Herbal, written about 1,500 B.C., contains records of tapeworms and their treatment. In modern times a Report of the Research Committee of the China Missionary Medical Association published in igio(I) states that a medi- cal officer in Tsingtao saw during a period of eight years between 1899 and 1907 thirteen cases of Taenia solium and twenty-eight cases of T. saginaia among European residents. It is difficult to be certain that these casos were of local origin. The Same report contains records of tapeworms (species not specified) from other parts of China, one case from each of the provinces of Chihli (Hopei), Hunan and Chekiang, three cases from Peking (Peiping) and three cases from Hankow, and also the entry "tapeworms not common; variety T. soliunn" for Man- churia. In 1912 Clark (z) reported a case of T. solium in the province of Yunnan and remarked that taenia infestation was common in that province.     

Impact of oxidative stress on lung diseases

Reactive oxygen species (ROS) are products of normal cellular metabolism and are known to act as second messengers. Under physiological conditions, ROS participate in maintenance of cellular 'redox homeostasis' in order to protect cells against oxidative stress through various redox-regulatory mechanisms. Overproduction of ROS, most frequently due to excessive stimulation of either reduced nicotinamide adenine dinucleotide phosphate by cytokines or the mitochondrial electron transport chain and xanthine oxidase, results in oxidative stress. Oxidative stress is a deleterious process that leads to lung damage and consequently to various disease states. Knowledge of the mechanisms of ROS regulation could lead to the pharmacological manipulation of antioxidants in lung inflammation and injury.     

EFFECT OF TIME AND ADRENALINE ON THE FETOMATERNAL DISTRIBUTION OF BUPIVACAINE

Following lumbar extradural analgesia with 0.5% bupivacaine,the placental transfer of bupivacaine was examined in 40 womenundergoing elective and 40 women undergoing emergency Caesareansection. Within each group, the patients received randomly eitherplain bupivacaine or bupivacaine with adrenaline 1 in 200000.Plasma bupivacaine concentrations were measured in blood samplestaken simultaneously at delivery from the umbilical vein (UV),umbilical artery (UA) and maternal vein (MV). Bupivacaine concentrationsin MV, UV and UA were not significantly affected by the presenceof adrenaline, but were positively correlated with first doseto delivery interval (FDD) while MV and UV were inversely correlatedwith last dose to delivery interval (LDD). Mean ratio of UV:MVconcentrations of bupivacaine was 0.346 and for UA:MV it was0.305. There was no significant correlation between any fetal:maternal ratio and FDD or LDD. UA:UV ratio appeared to increasetowards unity 30–40 min after the last dose. The presenceof adrenaline was associated with an increase in UA:UV in theelective group (P <0.01). In eight patients who receivedadrenaline there was reverse placental transfer (UA:UV >1). There was no evidence of progressive fetal accumulationof bupivacaine beyond 30–40 min. ^* Present address: St Thomas' Hospital London SE1 7EH     

EFFECT OF ANO-RECEPTIVE HOMOSEXUAL PRACTICE ON T LYMPHOCYTES AND DELAYED HYPERSENSITIVITY IN TRANSSEXUALS

To determine whether ano-receptive sexual intercourse adversely affects a person's cellular immunity, we compared several immunological parameters among 100 transsexual male prostitutes and 40 heterosexual male controls, and also among different durations of prostitution. The mean ratios of CD-4 (helper/inducer) lymphocytes to CD-8 (suppressor/cytotoxic) lymphocytes and the delayed-type cutaneous hypersensitivity (DTH) scores were significantly lower in transsexuals than they were in heterosexual controls; these parameters also showed a decreasing trend with increasing duration of prostitution. Transsexuals have a significantly higher CD-8 lymphocyte count than have heterosexuals. No significant differences between transsexuals and heterosexuals were found for lymphocyte counts, pan T cells, and CD-4 cell counts. We postulate that in these subjects cellular immunity is progressively reduced, probably through repeated and prolonged antigenic challenge via receptive anal intercourse. The impairment in cellular immunity is associated with the duration of prostitution, independent of the man's age.     

Cyclic peptides

In order to investigate the role of the L-2-hydroxy-3-methylbutanoic acid residue at position 2 of AM-toxin I (cyclic tetradepsipeptide) on necrotic activity for apple leaves, two analogs, [L-lactic acid²] AM-toxin I and [L-2-hydroxy-4-methylpentanoic acid²] AM-toxin I, were synthesized by the conventional method for peptide synthesis. The toxic activity of the former analog was much weaker than that of the natural AM-toxin I and the latter analog. CD spectra of AM-toxin I and these analogs were correlated to those toxic activities, indicating that bulkiness of the side chain at position 2 is important for the maintenance of active conformation and the induction of necrotic activity.     

Comparison of Outcome Assessments in Patients with Overactive Bladder Receiving Anticholinergics

Objectives: Patient‐reported outcomes (PRO) reflect treatment benefits from the patient's perspective, and are a subjective method of evaluating the efficacy of overactive bladder (OAB) treatment. We examined the changes in voiding diaries and health‐related quality of life (HRQL) according to patient‐perceived treatment benefits in patients with OAB receiving propiverine. Methods: Thirty‐two patients (mean age ± S.D: 55.1 ± 14.1 years) with OAB were treated with 20 mg propiverine once daily for 12 weeks. The 3‐day voiding diary and the Korean version of the Overactive Bladder Questionnaire (OABq), which includes an eight‐item bothersome symptom scale, as well as 25 HRQL items, were assessed at baseline and at 12 weeks. Finally, patient perception of treatment benefit was evaluated as “no benefit,”“little benefit,” or “much benefit” after treatment. Results: According to patients' perceptions of treatment benefits, 16 (50%) patients perceived “much benefit” from their treatment (group A) and 16 (50%) patients perceived “little benefit” or “no benefit” from their treatment (group B). In both groups, there were significant improvements in the micturation parameters, OABq bothersome symptoms, and total HRQL score after 12 weeks of treatment (P < 0.05). Although there were no significant differences in the voiding diary parameters between the two groups, patients in group A showed significant improvement of the OABq bothersome symptom and total HRQL score compared to group B (P < 0.05). Conclusion: Anticholinergic treatment improves both OAB symptoms and HRQL, and patients' perceptions of treatment benefits correlate better with the OABq than with the voiding diary parameters.     

Skin barrier function recovery after diamond microdermabrasion

Microdermabrasion is a popular method for facial rejuvenation and is performed worldwide. Despite its extensive usage, there are few publications on skin barrier change after microdermabrasion and none concerning diamond microdermabrasion. Our object was to see changes in transepidermal water loss (TEWL), hydration and erythema of the face following diamond microdermabrasion. Twenty-eight patients were included in this spilt face study. TEWL, stratum corneum hydration and the degree of erythema were measured from the right and left sides of the face (forehead and cheek) at baseline. One side of the face was treated with diamond microdermabrasion and the other side was left untreated. Measurements were taken right after the procedure and repeated at set time intervals. Diamond microdermabrasion was associated with a statistically significant increase in TEWL immediately after the procedure and at 24 h. However, on day 2, levels of TEWL were back to baseline. An increase in hydration and erythema was observed right after microdermabrasion, but both returned to baseline on day 1. The results show that skin barrier function of the forehead and cheek recovers within 2 days of diamond microdermabrasion. Diamond microdermabrasion performed on a weekly basis, as presently done, is expected to allow sufficient time for the damaged skin to recover its barrier function in most parts of the face.