Serum dioxin-like compounds and aromatase (CYP19) expression in endometriotic tissues

Dioxin-like compounds (DLCs) are suspected etiological factors of endometriosis but their potential mechanisms of action remain elusive. Because endometriosis is an estrogen-dependent disease and since aromatase (CYP19), a key enzyme in estrogen biosynthesis, was recently demonstrated to be expressed in endometriotic lesions, we hypothesized that dioxin-like compounds could modulate local estrogen production through an up-regulation of aromatase. We tested this hypothesis by examining the correlation between serum DLC levels and CYP19 expression in endometriotic tissue obtained from 47 patients with peritoneal, ovarian endometriosis and/or deep endometriotic nodules of the rectovaginal septum. Aromatase expression was assessed by real-time RT-PCR in biopsied endometriotic tissues [peritoneal (n=19), ovarian (n=17) endometriosis and deep endometriotic nodules of the recto-vaginal septum (n=29)]. The relationship between aromatase expression and DLCs was traced by simple regression analysis. DLCs did not appear to be significant determinants of aromatase expression. CYP1A1 expression, measured as a positive control, was found associated with current smoking but not with DLCs. We conclude that DLCs do probably not facilitate the growth of endometriotic lesions by up-regulating the local expression of aromatase.     

Arteriovenous fistula of the internal maxillary artery: treatment with transarterial embolization

Six patients with arteriovenous fistulas of the internal maxillary artery were treated with transarterial embolization. The patients ranged in age from 19 to 47 years, with a mean of 26.5 years. Each had a lifelong history of symptoms suggestive of a congenital origin of symptoms. There was no history of trauma. The most common initial symptoms were bruit (83%), pulsatile mass (67%), and pain (50%). In one patient prior surgical ligation of the external carotid artery had been attempted, but it led to aggravation of headaches. All patients were treated with placement of a detachable balloon at the fistula site. In one patient the balloon migrated through the fistula, which was retreated with coils. Complete obliteration of the fistula was achieved in all patients. The follow-up ranged from 2 months to 10 years, with a mean of 5.2 years. Congenital arteriovenous fistulas of the internal maxillary artery are rare and can be treated effectively with transvascular techniques.     

Reproducibility of repeated measurements on healthy skin with Minolta Chromameter CR-300

Background/aims: In this report the reproducibility of measurements with the Minolta Chromameter CR-300 on healthy skin was investigated.
Methods: Intra- and inter-rater reproducibility, reproducibility with two instruments and repeated measurements with a 1 week time lapse were examined on healthy skin of 30 volunteers by means of intra-class correlation coefficients (ICC) and standard error of measurements (SEM).
Results: Results showed excellent values for ICC in all the four conditions.
Conclusions: On the basis of these results we concluded that the instrument provides reliable information and can be used in comparative clinical trials.     

Bowen's disease of the nail

We present a case of Bowen's disease of the nail bed in a 60-year-old male. This case should remind us to biopsy any chronic lesion of the nail in order to reduce the delay in diagnosis. Indeed Bowen's disease of the nail unit often presents as a clinically misleading 'benign' lesion. Early diagnosis is important as this precancerous lesion appears to have a more aggressive behavior when it affects the nail unit. Bowen's disease of the nail is therefore considered as a squamous cell carcinoma, and both entities are grouped under the term 'epidermoid carcinoma'. Surgical excision is the first treatment option for those tumors without bone involvement. Our patient was treated with Mohs' micrographic surgery which is considered the ideal surgical treatment as it ensures a complete eradication of the tumor in over 90% of the cases but also maximally preserves normal tissue and function. This case illustrates the challenge of Mohs' surgery on the nail unit due to its particular anatomy and histology.     

AIDS-MEDICOLEGAL ASPECTS

AIDS/HIV Positivity has been the most widely debated disease of this century. Reasons for this are manifold, viz-the non-availability of cure and consequent 100% mortality of a full blown case; its mode of transmission-homosexual and heterosexual activities; widespread occurrence amongst ‘main liners’; and patients receiving blood and blood products etc. These aspects have created a dreaded halo around AIDS as well as social stigma. Even the medical community is not exempt from these problems. Unfortunately, legislatures around the world, more so in India, have lagged behind in clarifying many legal issues involved by not enacting specific laws pertaining to AIDS. Consequently many legal & ethical doubts arise in the minds of doctors when confronted with a case of AIDS either in a live patient or in a dead body. In addition, the disease being incurable & 100% fatal, makes it essential to adopt effective preventive measures which in turn need thorough knowledge of social aspects of the epidemic. Certain medicolegal, and ethical aspects of the problem of AIDS are recapitulated in this article for the benefit of the medical community.KEY WORDS: Access, AIDS, Confidentiality     

Vascularization of the trapeziometacarpal joint and its clinical importance: anatomical study

Few studies have investigated the vascular anatomy of the trapeziometacarpal (TM) joint of the thumb. The aim of our study was to describe the supplying arteries of the trapezium and the TM joint since this knowledge is essential for trapezium osteotomies. Ten anatomical dissections in ten different cadavers using two different techniques (four macerations, six classic dissections) were performed. The arteries of the TM joint originated from the radial artery and the princeps pollicis artery. Four important branches were identified. The arteries formed a vascular network around the joint. The dorsoradial surface of the joint contained the richest arterial network. These findings present an important consideration when performing an osteotomy of the trapezium.     

Cross-Sectional Study of Prevalence,Characterization and Impact of Chronic Pain Disorders in Workers

Chronic pain prevention and treatment constitute a challenge for occupational health The aim of this study was to provide data on workers in a variety of jobs and multiple contexts to determine the prevalence and characteristics of different chronic pain disorders, in view to highlighting possible new targets for preventive actions. 1,008 participants working in 14 French IKEA stores were analyzed in this observational study on the basis of their responses to surveys on their sociodemographic characteristics, psychosocial factors, lifestyle, and pain disorders. The prevalence of chronic pain, moderate-to-severe chronic pain and high-impact chronic pain were 49%, 30%, and 11%, respectively. Chronic pain was predominantly located in the neck and back, and identified mostly as nociceptive, with, for some participants, a neuropathic component (mixed pain). The majority of chronic pain was reported as being due to professional activity, and causing at least one work stoppage during the past year in half of the participants. Jobs that were the most common sources of chronic pain were those with a higher proportion of repetitive gestures, no consecutive days of rest, stress at work, such as cash-register/catering jobs. Overall, this study highlighted profiles at risk of developing or suffering from chronic pain, and several associated factors: ≥40 years old, female sex, overweight/obesity, repetitive gestures, no consecutive days of rest, stress, catastrophism, workplace environment, poor quality of life, and mental state. In conclusion, these data give interesting information on the characteristics of workers with chronic pain and highlight profiles of participants.Perspective: This study provides important information about the features of chronic pain in a model of a working population of Western countries. This information can be used to propose preventive actions.