105Changes in Nitric Oxide Levels After Deep Dermal injury in the Female,Red Duroc Pig (FRDP)

Introduction : Hypertrophic scar is a devastating sequel to burns and other tangential skin injuries. It follows deep dermal injuries and does not occur after superficial injuries. Nitric oxide (NO) plays many important roles in wound healing from inflammation to scar remodeling. Studies have shown that expression of nitric oxide synthase and nitric oxide production are decreased in human hypertrophic scar. However little is known about NO involvement in the early stages of hypertrophic scarring, because of the lack of an animal model. It was recently reported that the female red Duroc pig (FRDP) makes thick scar, which is similar to human hypertrophic scar. We hypothesized that NO production in wounds on the female, red Duroc pig is similar to that of human hypertrophic scar and that NO involvement in deep wounds is different from that in superficial wounds. Methods : Superficial (0.015” to 0.030”) and deep (0.045” to 0.060”) wounds were created on the backs of four FRDPs. Biopsies were collected at weeks 1.5, 4, 8 and 21 post wounding including samples of uninjured skin. Nitric oxide levels were measured with the Griess reaction assay and normalized with tissue protein level. Results : Superficial wounds healed with an invisible scar whereas the deep wounds healed with scar resembling mild hypertrophic scar. The thickness of the scars from the deep wounds was significantly greater than uninjured skin and healed superficial wounds (p < 0.01). NO levels were increased at 1.5 weeks in deep wounds compared to superficial wounds and uninjured skin (p < 0.05). At 8 weeks, NO levels in deep wounds had returned to the level of uninjured tissue and superficial wounds. By 21 weeks, NO levels had decreased significantly when compared to superficial wounds (p < 0.01). There were no differences in NO levels between uninjured skin and superficial wounds at any time point (p > 0.05). Conclusions : NO production is similar in late, deep wounds on the female, red Duroc pig to that reported in the literature for human hypertrophic scar further validating this animal model. NO production is quite different after deep wounds as compared to superficial wounds in the FRDP. Early elevation in nitric oxide production might account for excessive inflammation in deep wounds that become thick scars in the FRDP. Nitric oxide regulators and effects at early stages of scar formation should be elucidated further and the FRDP appears to be a useful model.     

TREATMENT OF PALMOPLANTER HYPERHIDROSIS BY IONTOPHORESIS

Twenty-seven patients with idiopathic palmoplanter hyperhidrosis were treated with Iontotherapy over a one year period. In twenty-four cases there was a good response but maintenance therapy was required every 3-4 weeks.KEY WORDS: Iontophoresis, Palmoplanter hyperhidrosis     

Differences in breast carcinoma characteristics in newly diagnosed African-American and Caucasian patients: a single-institution compilation compared with the National Cancer Institute's Surveillance, Epidemiology, and End Results database

BACKGROUND: Breast carcinomas in African-American patients appear to be more aggressive than in Caucasian patients due to multifactorial differences. METHODS: The authors compiled pathology data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database regarding stage, histologic grade, and estrogen receptor (ER) expression in breast carcinomas diagnosed in 197,274 African-American and Caucasian patients between 1990 and 2000, and the same information, along with nuclear grade, Ki-67, c-erb-B2, and p53 expression, in 2230 African-American and Caucasian patients diagnosed at Thomas Jefferson University Hospital between 1995 and 2002. Immunohistochemical markers were assayed in paraffin-embedded, formalin-fixed tissue stained with hematoxylin and eosin using antibodies to these proteins, with differences in expression analyzed by the chisquare test. RESULTS: In both databases, more African-American patients presented with advanced stage tumors and higher histologic (P < .001) and nuclear grade (P < .001) than Caucasian patients. African-American patients had less ER positivity (51.9% vs 63.1%; P < .001) but significantly higher Ki-67 (42.4% vs 28.7%; P < .001) and p53 expression (19.4% vs 13.1%; P < .05) than Caucasian patients with all stages of disease. In addition, the basal or "triple-negative" breast cancer phenotype was more common in African-American patients than in Caucasian patients (20.8% vs 10.4%; P < .0001), and was associated with higher histologic and nuclear grade (P < .0001). CONCLUSIONS: African-American patients with breast carcinomas are more likely than Caucasian patients to present with tumors that are of a later stage and higher grade, with higher Ki-67 expression and more ER negativity, thereby highlighting a greater need for early screening among African-American women. Molecular studies that may explain these differences, and correlations with survival, have been proposed to identify therapeutic targets.     

Early Loss Experiences in Psychotherapists,Church of England Clergy,Patients Assessed for Psychotherapy,and Scientists and Engineers

An Inventory of Early Loss (IEL) has been developed for retrospective use with adults comprising loss events in childhood and unempathic parental responses to the child. Overall early loss is described by a severity score of mild, moderate, severe, or very severe. Four studies using the Inventory are described: (1) 100 Church of England clergy participating in a larger study of early loss, personality, and religious experience; (2) 114 psychotherapist members of the Society of Psychotherapy Research (UK) surveyed in a postal questionnaire; (3) 201 patients assessed for psychotherapy in Hertfordshire; and (4) 84 scientists and engineers from the faculty of Brunel University, Uxbridge. Among the clergy, 46% had overall early loss scores of very severe; for psychotherapists this figure was 27%; for NHS patients, 47%; and for scientists and engineers, only 4%. Implications for career choice in the helping professions are discussed.Ein Inventar zur Erfassung früher Verluste wurde entwickelt, um Erwachsene im Hinblick auf Verlustereignisse in der Kindheit und unempathische elterliche Reaktionen gegenüber dem kind retrospektiv zu befragen. Aus dem Inventar resultiert ein Indikator für den frühen Verlust, der sich mit einem Schwerescore (von gering bis sehr schwer) ausdrücken lässt. Vier Befragungen, die auf dem Inventar basieren, werden beschrieben: a) 100 Geistliche der Church of England, die an einer grösseren Studie zum Zusammenhang früher Verluste, Persönlichkeitsmerkmale und religiöser Erfahrungen teilnahmen; b) 114 Psychotherapeuten, Mitglieder der Society for Psychotherapy Research in Grossbritannien, die postalisch befragt wurden; c) 201 Patienten, die in Hertfordshire psychotherapeutisch untersucht wurden sowie d) 84 Wissenschaftler und Techniker aus der entsprechenden Fakultät der Brunel Universität in Uxbridge. Unter den Geistlichen gaben 46% schwere frühe Verlusterfahrungen an, bei den Psychotherapeuten waren es 27%, bei den Psycho-therapiepatienten 47%, dagegen bei den Wissenschaftlern und Technikern nur 4%. Implikationen für die Berufswahl unter den helfenden Berufen werden auf der Basis der Ergebnisse diskutiert.Un Inventaire de Perte Précoce (Inventory of Early Loss - IEL) a été développé pour l'utilisation rétrospective sur des adultes ayant eu à la fois des situations de perte pendant l'enfance et des réponses parentales non-empathiques envers les enfants. En générl, la perte précoce est décrite par un score de sévérité de léger, modéré, sévère ou trés sévère. Quatre études au moyen de l'Inventaire sont décrites. (a) 100 membres du clergé anglican participent à une large étude sur la perte précoce, la personnalité et l'expérience religieuse; (b) 114 psychothérapeutes membres de la Society of Psychotherapy Research (UK) enquêtés par un questionnaire postal, (c) 201 patients évalués pour psychothérapie à Hertfordshire; et (d) 84 scientifiques et ingénieurs de la faculté de l'Université Brunel, Uxbridge. Parmi les membres du clergé, 46% ont eu, en général, des scores de perte précoce de très sévères; pour les psychothérapeutes ce fait était 27%; les patients NHS, 47%; et les scientifiques et ingénieurs, seulement 4%. Les implications pour le choix de carrière en profession d'aide sont discutées.     

B19 parvovirus replicates in circulating cells of acutely infected patients

B19 parvovirus is the etiologic agent of fifth disease and transient aplastic crisis. In natural infections, B19 antigen and DNA have been detected in sera early in the course of aplastic crisis and only rarely in fifth disease. We have found B19 DNA in circulating cells of infected patients by DNA dot blot with a virus-specific probe: in four of four sickle cell patients with aplastic crisis, in one asymptomatic sibling, and in one normal adult with fifth disease. Only two of the sera showed B19 DNA. High-molecular weight intermediate forms were detected by Southern analysis of DNA extracted from cells, thus indicating active replication of virus in cells rather than passive adsorption to their surface membranes. Separation of cells into high- and low-density fractions resulted in a concentration of the virus DNA in the granulocytic fraction.