Mesenchymal hamartoma of the chest wall in infants: Report of three cases and literature review

Mesenchymal hamartoma of the chest wall in infants is a rare abnormality. We present a report of three cases and a brief review of the literature, emphasizing the role of the radiologist in diagnosis and management.     

Efficacy and safety of long-term treatment with cyclosporin A for atopic dermatitis

Background Cyclosporin A (CsA) is being increasingly used in the treatment of severe refractory atopic dermatitis. Clinical efficacy and safety of short‐term cyclosporin A treatment in atopic dermatitis patients has been proven, however, data on long‐term treatment are limited. Objective The aim of this study was to investigate the efficacy, safety and the effect of discontinuation of cyclosporin A treatment in atopic dermatitis patients, with a particular focus on patients treated with cyclosporin A for more than 6 months. Methods We performed a retrospective study of clinical and adverse effects of cyclosporin A treatment in 73 atopic dermatitis patients, with an average duration of cyclosporin A treatment of 1.3 years. Results We included 73 patients (31 women and 42 men, with a mean age of 33.8 years) with severe atopic dermatitis refractory to conventional therapy that was treated with cyclosporin A. Treatment was successful in 56/73 patients. Increases in serum creatinine levels > 30% compared to baseline were reported in 7/73 patients. Arterial hypertension appeared in 11/73 patients during treatment. After discontinuation of treatment, 40/73 patients experienced a relapse and 33/73 patients experienced clinical remission for at least 3 months. No correlation between treatment duration and nephrotoxicity or hypertension was found. Strikingly, 6/73 patients experienced a rebound phenomenon. Conclusions We conclude that CsA is an effective and safe treatment for patients with severe AD refractory to conventional treatment, provided that the recommended guidelines for its administration are strictly observed. However, in contrast to previous reports, we found that 8% (6/73) of patients experienced a rebound phenomenon after discontinuation of treatment.     

O9 Creation of oral care flavours to deliver breath freshening benefits – an in vitro method

Flavours conventionally help to deliver breath freshening in oral care products via sensory masking. The aim of this study was to determine whether flavours could additionally inhibit formation of malodorous compounds by bacteria. Oral malodour is in large part related to the production of volatile sulphur compounds (VSCs) by Gram-negative organisms. We therefore developed a quantitative in vitro assay for hydrogen sulphide production by Klebsiella pneumoniae . The entire Quest dental flavour palette was screened for inhibition of H₂S production. A database of flavour ingredient effects was created, and used to create VSC-inhibitory flavours. These flavours were assessed in the in vitro assay to confirm that the compounded flavour performed as expected. The best performing flavours developed in this way were selected for testing in the Quest Breath Freshness Panel (see poster, P21). Rules based on the performance of dental flavour ingredients, singly or in combination, were also used to develop a patent position. Flavours formulated using these rules (termed Q-fresh flavours) have been incorporated into a range of oral care products including toothpastes, mouthwashes, chewing gums and breath films. These products have been tested in the Quest Breath freshness panel, and have been shown to deliver significant breath freshening benefits. An in vitro VSC-inhibition method has allowed reliable development of flavours with breath-freshening benefits.     

050The Angiogenesis Inhibitor Endostatin Impairs Wound Healing at Tumor‐inhibiting Doses

Effective blockade of the pluripotent cytokine TGF‐beta as a means of cutaneous scar reduction is a strategy with great potential. This desired effect may be achieved through the overexpression of mutant TGF beta receptors within the wound milieu. Our goal was to examine the effects of dominant negative mutant TGF‐beta receptor II (dnTGFRII) protein expression in a well‐established rabbit ear model of hypertrophic scarring. Serial injections of a retroviral construct encoding a truncated TGFβRII and the marker green fusion protein (pMSCV‐rIIdn‐GFP) were performed in 7mm punch wounds at day 10 and day 14 (two‐day injection group) or day 8, 10, 12 (three‐day injection group) post wounding. Delivery of a null vector (pMSCV‐GFP) at the same time points served as a negative control. Histomorphometric analysis of wounds harvested at day 28 revealed a statistically significant reduction (33%) in the scar elevation index in 2‐day treated and a more modest reduction in SEI (17.5%) in the 3‐day treated arm compared to null‐treated controls. Confocal microscopy confirmed stable transfection of the construct in both peri‐wound tissue as well as rabbit dermal fibroblasts transfected in vitro. Optimization of this novel application in retroviral gene therapy could lead to effective anti‐scarring strategies.     

Hydroxy-methylglutaryl-coenzyme A reductase inhibition improves endothelial dysfunction in type-1 diabetes.

OBJECTIVE: We hypothesize that treatment with Pravastatin, a HMG CoA reductase inhibitor would improve flow-mediated dilation (FMD), a nitric oxide dependent phenomenon and the earliest detectable marker of endothelial dysfunction, in asymptomatic patients with type-1 diabetes. MATERIALS AND METHODS: FMD of the brachial artery in response to reactive hyperaemia was measured using high-resolution ultrasonography. Young male patients with type-1 diabetes (n=9) were compared with age matched non-diabetic controls (n=8). RESULTS: The FMD response in the control group was a median increase in diameter of 7.9 (range 3.8-12.6)%. In the diabetic group the FMD response was impaired when compared with controls with a median increase only of 4.4 (range 3.7-5.8)% (p<0.01). Following Pravastatin, 40 mg per day for one month in the diabetic group, there was a significant diameter change in response to reactive hyperaemia with a median of 8.4 (range 6.9-12.6)% (p<0.01). CONCLUSIONS: These data confirm the presence of endothelial dysfunction in young patients with type-1 diabetes. We have shown that 1-month of Pravastatin treatment normalizes FMD. This suggests that HMG CoA reductase inhibitors may have a role in the management of diabetes mellitus, even in the presence of normal serum cholesterol levels.