Similarities between interstitial cystitis/bladder pain syndrome and vulvodynia: implications for patient management

Interstitial cystitis/bladder pain syndrome (IC/BPS) and vulvodynia are chronic pain syndromes that appear to be intertwined from the perspectives of embryology, pathology and epidemiology. These associations may account for similar responses to various therapies.     

Dry skin in dermatology: a complex physiopathology

Dry skin (xerosis) is a common dermatosis affecting people of varying skin types and ages and various areas of the body. It is associated with both skin thickening and skin thinning and is triggered by both exogenous (e.g. climate, environment, lifestyle) and endogenous (e.g. medication, hormone fluctuations, organ diseases) factors. Skin requires a water content of 10–15% to remain supple and intact. This water is either ‘static’ (i.e. bound) or ‘dynamic’. The predominance of hydrophobic substances in intercellular constituents is a means of regulating the humidity of the skin. Emollients, highly effective treatment adjuncts in the management of all dry skin disorders, help to restore damaged intercorneocyte lipid structures and increase the water content of the skin, helping to reduce scaling and improving its barrier function.     

Head-to-head comparison of retropubic, perineal and laparoscopic radical prostatectomy

OBJECTIVE: As more patients are diagnosed with prostate cancer at an early stage, it is becoming increasingly important to refine the technique of surgical excision. For this purpose we have generated objective data comparing three different surgical approaches used by three experienced surgeons. METHODS: We prospectively compared three contemporary personal series of 50 consecutive radical prostatectomy (RP) patients. The health-related quality of life was evaluated preoperatively and in months 1, 3, 6, 12 and 24. RESULTS: Considering in turn the patients undergoing retropubic, perineal and laparoscopic RP, the median procedure time was 2 h and 27 min, 1 h and 50 min and 4 h, with a transfusion rate of 2, 0 and 8%, respectively. In the perineal group there were more wound infections. Median catheter drainage was 7, 10 and 7 days and zero, 13 and one patients needed reinsertion of a catheter. Early continence varied considerably, with 57.4, 11.4 and 6.3% of patients pad-free after 1 month, but there were no differences in social continence (zero or one pad) with 97.8, 97.8 and 91.9% after 2 years. The Litwin score for incontinence (preoperative minus postoperative) was -24, -41 and -63% after 1 month and -13, +3 and -29% after 2 years. Twenty-nine, five and 15 patients had a preoperative five-item version of International Index of Erectile Function (IIEF-5) score of > or = 17 points and a nerve-sparing procedure. After 2 years, 48.1, 0 and 0% had an IIEF-5 score of > or = 17 points without the use of phosphodiesterase type 5 (PDE-5) inhibitors, but when including patients using inhibitors there were no significant differences. CONCLUSIONS: A comparison of morbidity, short-term convalescence and long-term side-effects of different surgical techniques is strongly biased by both the preoperative status of patients and the skill of the surgeons. Overall, we found some differences in the short-term results (e.g. early continence) and comparable long-term results.     

Cryoscopy: a novel enhancing method of in vivo skin imaging

BACKGROUND: It is a common observation that superficial freezing of normal skin and skin tumors may create a transient superficial whitening effect. In this respect, cryoscopy refers to the direct observation by dermoscopy, with or without digital recording, of the visual alterations of the frozen tissues. AIMS: To define the optimal method of cryoscopy and to describe the cryoscopy patterns of normal skin and selected skin lesions. MATERIALS AND METHODS: The influence of (a) different cryogenic sources [solid carbon dioxide (-78.5 degrees C), liquid nitrogen (N(2), -196 degrees C), and a mixture of dimethyl ether and propane (-57 degrees C)], (b) various application methods (spraying, cotton chill tips, copper plate), and (c) freezing time was assessed with regard to clinical feasability, visualization quality, and persistance time of the whitening effect. Cryoscopy patterns of normal skin, callosities and of histologically proven seborrheic keratoses, verrucous hamartomas, molluscum contagiosum, keratoacanthomas, viral warts, condylomas, actinic keratoses, dermatofibromas, skin tags, basal cell carcinomas, angiomas, and melanocytic naevi were assessed. RESULTS: The cryoscopy images of skin highlighted the skin lines. They appeared similar regardless of the freezing source and the application method. The aspects differed according to the nature of the lesions. The cotton chill tip method provided a longer whitening period compared with the other cold sources, both in normal and lesional skin. Hence, it represented the most convenient way for performing digital recording cryoscopy. On normal skin, cryoapplication was limited to about 1.5 s due to pain, resulting in whitening times ranging from 6 to 9 s, which was too short for easy digital recording. On all studied skin tumors, a 10-s N(2) freezing time was not experienced as painful, and blanching time persisted for 20-34 s, allowing easy digital recording. The whitening time was longer with increasing freezing time on both normal and lesional skin. Every single examined normal skin site and all the skin lesions showed a strong whitening effect, except heavily cornified structures, including some keratoses, callosities, and viral warts. Increased contrast of the skin surface texture was observed in almost every studied lesion. CONCLUSION: The N(2) cotton chill tip technique appeared to be the most convenient technique for cryoscopy and provided longer whitening periods compared with the other freezing sources. Pain prevented its use on normal skin, but a series of exophytic skin lesions was conveniently accessible to cryoscopy. The differences in whitening periods of various epidermal components resulted in increased visual contrast, creating typical cryoscopy images for the different exophytic skin tumors. Cryoscopy represents a novel in vivo skin imaging technique that is rapid, non-invasive, cost-effective, and easily performed. It shows both investigative and diagnostic potentials. It is remarkable that cryoscopy pictures closely resemble those yielded by skin capacitance imaging.     

几种评价保湿产品无创性测试方法的相关性评价

目的:对测量皮肤角质层含水量和屏障功能的几种无创性皮肤测试方法进行相关性评价。方法:采用SKICON-200测定皮肤电导法、皮肤保水功能测定、TEWL测定、受试者主观评价的方法,比较某种保湿霜/精华素使用前、后皮肤角质层含水量和屏障功能的变化,并分析这些方法之间的相关性。结果:保湿霜的效果优于精华素,SKICON-200测定皮肤电导法、皮肤保水功能测定以及部分受试者临床症状和主观评价指标(如红斑、脱屑情况,皮肤滋润度的改善、皮肤细纹数量变化和皮肤弹性改善)有很好的平行关系。TEWL结果在本试验中变化不大,与上述指标没有平行关系。结论:SKICON-200测定皮肤电导法、皮肤保水功能测定适合用于保湿化妆品的功效评价。TEWL测定对于屏障功能受损的皮肤可能更敏感,对于健康皮肤使用前、后比较可作为参考指标。     

A New Method for Estimating Dermal Absorption from Chemical Exposure. 3. Compared with Steady-State Methods for Prediction and Data Analysis

Purpose. This paper compares unsteady-state and steady-state methods for estimating dermal absorption or analyzing dermal absorption data. The unsteady-state method accounts for the larger absorption rates during short exposure times as well as the hydrophilic barrier which the viable epidermis presents to lipophilic chemicals. Methods. Example calculations for dermal absorption from aqueous solutions are presented for five environmentally relevant chemicals with molecular weights between 50 and 410 and log₁₀K_ow between 0.91 and 6.8: chloromethane, chloroform, chlordane, 2,3,7,8-TCDD, and dibenz(a,h)anthracene. Also, the new method is used to evaluate experimental procedures and data analyses of in vivo and in vitro permeation measurements. Results. In the five example cases, we show that the steady-state approach significantly underestimated the dermal absorption. Also, calculating permeability values from cumulative absorption data measured for exposure periods less than 18 times the stratum corneum lag time will overestimate the actual permeability. Conclusions. In general, steady-state predictions of dermal absorption will underestimate dermal absorption predictions which consider unsteady-state conditions. Permeability values calculated from data sets which include unsteady-state data will be incorrect. Strategies for analyzing in vitro diffusion cell experiments and confirming steady state are described.     

尿道发育不良性阴茎弯曲的手术矫治

目的临床研究尿道发育不良性阴茎弯曲27例的手术方式和疗效。方法皮肤切口绕过菲薄尿道,脱蜕尿道表面阴茎皮肤,切断阴茎腹侧之深浅筋膜,伸直阴茎,手术不伤及尿道。结果27例阴茎下弯得以伸直,其中1例因留置橡胶导尿管导致阴茎部尿道狭窄,经尿扩治疗2年余,排尿尚通畅。结论采取保护菲薄尿道的切口脱蜕阴茎皮肤,切断增厚的阴茎筋膜能伸直Ⅰ型弯曲的阴茎。