The Bare Necessities: Uncovering Essential and Condition‐Critical Genes with Transposon Sequencing

Summary

Querying gene function in bacteria has been greatly accelerated by the advent of transposon sequencing (Tn‐seq) technologies (related Tn‐seq strategies are known as TraDIS, INSeq, RB‐TnSeq and HITS). Pooled populations of transposon mutants are cultured in an environment and next‐generation sequencing tools are used to determine areas of the genome that are important for bacterial fitness. In this review we provide an overview of Tn‐seq methodologies and discuss how Tn‐seq has been applied, or could be applied, to the study of oral microbiology. These applications include studying the essential genome as a means to rationally design therapeutic agents. Tn‐seq has also contributed to our understanding of well‐studied biological processes in oral bacteria. Other important applications include in vivo pathogenesis studies and use of Tn‐seq to probe the molecular basis of microbial interactions. We also highlight recent advancements in techniques that act in synergy with Tn‐seq such as CRISPR interference and microfluidic chip platforms.

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http://bit.ly/2DpnJDG

Papular Spreaded Necrobiosis Lipoidica: a rare clinical presentation of this pathology

Abstract

A 69‐year‐old Caucasian woman suffering from long‐term diabetes mellitus type II was referred to our dermatology department with cutaneous lesions that appeared 3 years before. They were itchy and non‐tender, and spreaded progressively, with no history of previous trauma. Examination revealed multiple erythematous to yellowish papules on the lower legs, which merged in plaques, of varying shapes and sizes (Fig.1).

This article is protected by copyright. All rights reserved.

http://bit.ly/2TGpKSN

A Brief History of Circannual Time

Abstract

The tenet of this review is that innate circannual timing is an ancestral trait that first evolved in free‐living eukaryotic cells some 2000My ago. Marine algae of the genus Allexandrium provide a living unicellular model. This species shows the primitive trait of 'alternation of generations' where the organism alternates between fast replicating vegetative cells in summer, and a dormant cystic cell over winter. The resistant cysts sink into the cold ocean sediments. Remarkably, excystment in spring is governed by an endogenous circannual timing mechanism. Thus, a tiny, short‐lived unicell can utilize a circannual clock as part of the species' life history program. Innate timing allows for major adjustments in physiology and behavior in anticipation of the seasons, and provides an internalized sense of seasonal time for the many species where standard environmental cues are weak or ambiguous. This is a highly adaptive strategy irrespective of the organism's size and longevity. Circannual rhythms are expressed by a diverse range of organisms from flowering plants,to mammals, interwoven into each species life‐history program – the consequence of fore‐ever living in a periodic world. In complex vertebrates, the early division of the zygote potentially carries circannual timer genes into all progeny cells and into all tissues. This supports the concept of a 'clock shop' where cell‐autonomous long‐term rhythms are generated in each tissue, orchestrated by a central circannual pacemaker system. This is analogous to the organization of the circadian timing system. For the circannual time‐scale, specialized thyrotrope cells located in the pars tuberalis (PT) of the pituitary gland and adjacent tanycyte cells located in the ependymal wall of the third cerebral ventricle (3rdV) of the brain act as putative central circannual pacemakers. At a molecular level epigenetically regulated, cyclical remodeling of chromatin, that determines whether specific circannual timer genes are transcriptionary active, or not, is thought to drive the oscillation between the summer and winter phenotypes.

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http://bit.ly/2Spza8H

Multifocal Stroke From Ozone Gas Emboli

Abstract: A 34-year-old man with chronic neck pain was treated with regular cervical paravertebral ozone injections. After his last injection, he experienced a syncopal episode and, upon awakening, was found to have ataxia, aphasia, hemiparesis, and left sixth nerve palsy. Computed tomographic angiography demonstrated intra-arterial gas in the right vertebral artery; multiple posterior circulation infarcts were seen on brain MRI. This case illustrates the potential dangers of paravertebral injections of ozone. Address correspondence to Paul R. Freund, MD, 801 Eglinton Avenue W, Suite 301, Toronto, Ontario M5N 1E3, Canada; E-mail: pfreund@ualberta.ca The authors report no conflicts of interest. © 2019 by North American Neuro-Ophthalmology Society

http://bit.ly/2UMa2Wd

Big Data Research in Neuro-Ophthalmology: Promises and Pitfalls

Background: Big data clinical research involves application of large data sets to the study of disease. It is of interest to neuro-ophthalmologists but also may be a challenge because of the relative rarity of many of the diseases treated. Evidence Acquisition: Evidence for this review was gathered from the authors' experiences performing analysis of large data sets and review of the literature. Results: Big data sets are heterogeneous, and include prospective surveys, medical administrative and claims data and registries compiled from medical records. High-quality studies must pay careful attention to aspects of data set selection, including potential bias, and data management issues, such as missing data, variable definition, and statistical modeling to generate appropriate conclusions. There are many studies of neuro-ophthalmic diseases that use big data approaches. Conclusions: Big data clinical research studies complement other research methodologies to advance our understanding of human disease. A rigorous and careful approach to data set selection, data management, data analysis, and data interpretation characterizes high-quality studies. Address correspondence to Heather E. Moss, MD, PhD, Department of Ophthalmology, Stanford University, Spencer Center for Vision Research, 2370 Watson Court, MC 5349, Palo Alto, CA 94303; E-mail: hemoss@stanford.edu National Institutes of Health (Bethesda, MD) grants R21 EY027447 (to S. Roth), K23 EY 024345 (to Moss), P30 EY 026877 to the Department of Ophthalmology at Stanford University, P30 EY001792 to the Department of Ophthalmology at the University of Illinois at Chicago, unrestricted grants from Research to Prevent Blindness, Inc. (New York, NY) to the Stanford Department of Ophthalmology and to the University of Illinois at Chicago Department of Ophthalmology and Visual Sciences, and by the Michael Reese Foundation (Chicago, IL) Pioneers Award to Dr. Roth. The authors report no conflicts of interest. © 2019 by North American Neuro-Ophthalmology Society

http://bit.ly/2G7MMxL

Neuro-Ophthalmology Virtual Education Library (NOVEL) 2019 Update: North American Neuro-Ophthalmology Society's Neuro-Ophthalmology Examination Techniques (NExT) and Illustrated Curriculum are Online

No abstract available

http://bit.ly/2G7MNSl

Neuro-Ophthalmology in Canada

No abstract available

http://bit.ly/2FRqcu0

Acute Posterior Multifocal Placoid Pigment Epitheliopathy Complicated by Fatal Cerebral Vasculitis

Abstract: A 21-year-old man experienced unilateral vision loss associated with multiple atrophic chorioretinal lesions. He was treated for a presumptive diagnosis of acute retinal necrosis, but his vision did not improve with antiviral therapy. Over the course of several weeks, his symptoms progressed to involve both eyes. The fellow eye showed characteristic yellow-white placoid lesions, prompting treatment with oral corticosteroids for acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Despite high-dose therapy with prednisone 80 mg daily, the patient developed the acute onset of mental status changes within the next several days. Neuroimaging revealed multifocal large-vessel strokes associated with cerebral edema; these infarcts led to herniation and death. Postmortem histopathologic examination confirmed granulomatous inflammation in both ocular and cerebral vasculatures. Together with findings from multimodal imaging obtained throughout this patient's clinical course, our findings support the notion that granulomatous choroiditis is the mechanism of the ocular lesions seen in APMPPE. This granulomatous inflammation can also affect cerebral vessels, leading to strokes. Address correspondence to Gregory P. Van Stavern, MD, Washington University in St. Louis, St. Louis, MO; E-mail: vanstaverng@wustl.edu The authors report no conflicts of interest. R. N. Maamari and L. Stunkel contributed equally to this work. © 2019 by North American Neuro-Ophthalmology Society

http://bit.ly/2CKTnee

Petroclival Meningioma Presenting With an Ipsilateral Sixth Nerve Palsy and a Contralateral Homonymous Quadrantanopia: A Unique and Topographically Localizing Syndrome

Abstract: An 84-year-old woman reported onset of headaches, diplopia, and blurred vision. On examination, she was found to have a left sixth nerve palsy and an incongruous right homonymous hemianopia. Brain MRI demonstrated a left petroclival meningioma, causing this unusual combination of clinical findings. The patient was treated with radiation therapy and has remained stable over 4 years of follow-up. Address correspondence to Andrew G. Lee, MD, Blanton Eye Institute, Houston Methodist Hospital, 6560 Fannin Street Suite 450, Houston, TX 77030; E-mail: aglee@houstonmethodist.org The authors report no conflicts of interest. © 2019 by North American Neuro-Ophthalmology Society

http://bit.ly/2FJvwyJ

Myasthenia Gravis Associated With Orbital Marginal Zone Lymphoma

No abstract available

http://bit.ly/2srXaZg

Ocular Tilt Reaction in Compensated Vestibular Schwannoma

No abstract available

http://bit.ly/2RHT9yg

A Tough NUT to Crack: A 47-Year-Old With Diplopia From a Rare Malignancy

No abstract available

http://bit.ly/2HaFN9u

Peripapillary Vessel Density Measured by Optical Coherence Tomography Angiography in Idiopathic Intracranial Hypertension

Background: Although alterations in the peripapillary retinal nerve fiber layer (RNFL) in patients with idiopathic intracranial hypertension (IIH) have been characterized using optical coherence tomography (OCT), there are little data regarding the peripapillary vasculature in this patient population. Our aim was to evaluate findings of OCT angiography (OCT-A) in the peripapillary region in addition to the RNFL measurements on OCT in patients with IIH. Methods: Thirty-eight eyes of 19 patients with IIH and 42 eyes of 21 healthy controls were enrolled in our study. Papilledema was graded according to the Frisen scale. Peripapillary RNFL and vessel density were evaluated with OCT and OCT-A, respectively. Results: RNFL thickness was found to be increased with OCT, but this was statistically significant only in the inferior location in IIH patients when compared with the control group. There was a significant decrease in mean peripapillary vessel density measured with OCT-A in IIH patients with papilledema when compared with the control group (P

http://bit.ly/2CLmHmp

Minocycline-Induced Vasculitis Presenting as a Third Nerve Palsy

No abstract available

http://bit.ly/2GBt8wb

Monocular Single Saccadic Pulses

No abstract available

http://bit.ly/2RlOAcR

Do Most Patients With a Spontaneous Cerebrospinal Fluid Leak Have Idiopathic Intracranial Hypertension?

Background: The association between cerebrospinal fluid (CSF) leaks at the skull base and raised intracranial pressure (ICP) has been reported since the 1960s. It has been suggested that spontaneous CSF leaks might represent a variant of idiopathic intracranial hypertension (IIH). We review the evidence regarding the association between spontaneous CSF leaks and IIH, and the role of ICP in the pathophysiology of nontraumatic skull base defects. We also discuss the management of ICP in the setting of CSF leaks and IIH. Evidence Acquisition: References were identified by searches of PubMed from 1955 to September 2018 with the terms "idiopathic intracranial hypertension" and "cerebrospinal fluid leak." Additional references were identified using the terms "pseudotumor cerebri," "intracranial hypertension," "benign intracranial hypertension," and by hand search of relevant articles. Results: A CSF leak entails the egress of CSF from the subarachnoid spaces of the skull base into the surrounding cavitary structures. Striking overlaps exist regarding demographic, clinical, and radiological characteristics between IIH patients and those with spontaneous CSF leaks, suggesting that some (if not most) of these patients have IIH. However, determining whether a patient with spontaneous CSF leak may have IIH may be difficult, as signs and symptoms of raised ICP may be obviated by the leak. The pathophysiology is unknown but might stem from progressive erosion of the thin bone of the skull base by persistent pulsatile high CSF pressure. Currently, there is no consensus regarding the management of ICP after spontaneous CSF leak repair when IIH is suspected. Conclusions: IIH is becoming more widely recognized as a cause of spontaneous CSF leaks, but the causal relationship remains poorly characterized. Systematic evaluation and follow-up of patients with spontaneous CSF leaks by neuro-ophthalmologists will help clarify the relation between IIH and spontaneous CSF leaks. Address correspondence to Valérie Biousse, MD, Neuro-Ophthalmology Unit, Emory Eye Center, The Emory Clinic, 1365-B Clifton Road NE, Atlanta, GA 30322; E-mail: vbiouss@emory.edu Supported in part by an unrestricted departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc., New York, and by NIH/NEI core grant P30-EY06360 (Department of Ophthalmology). N. J. Newman received the Research to Prevent Blindness Lew R. Wasserman Merit Award. J. M. Levy is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1TR002378 and KL2TR002381. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors report no conflicts of interest. © 2019 by North American Neuro-Ophthalmology Society

http://bit.ly/2tfQaiK

Unrecognized Pseudohypoparathyroidism Type 1A as a Cause of Hypocalcemia and Seizures in a 64-Year-Old Woman.

Related Articles

Unrecognized Pseudohypoparathyroidism Type 1A as a Cause of Hypocalcemia and Seizures in a 64-Year-Old Woman.

Case Rep Endocrinol. 2019;2019:8456239

Authors: Del Monte P, Cuttica CM, Marugo A, Foppiani L, Audenino D, Godowicz TT, Elli FM, Mantovani G, Di Maria E

Abstract
Pseudohypoparathyroidism type 1A (PHP1A) is usually diagnosed in childhood or early adulthood. We describe the case of a 64-year-old woman admitted to the Neurological Unit for recurrent episodes of loss of consciousness and seizures. Glycemia and ECG were normal, while hypocalcemia was noted. Clinical history revealed carpo-pedal spasm since the age of 30 years, cognitive impairment, hypothyroidism since early adulthood, and menopause at 30 years. She was taking oral calcium and cholecalciferol for chronic hypocalcemia. Physical features suggested Albright's osteodystrophy. Blood calcium was confirmed low, with increased parathyroid hormone, moderate 25OH-vitamin D deficiency, and normal creatinine. Brain CT scan revealed calcifications of the basal ganglia, cortical and subcortical white matter, and cerebellum. Therapy was switched to oral calcitriol, with normalization of calcium levels; levetiracetam was started and no further seizures occurred. The clinical diagnosis of PHP1A was confirmed by molecular analysis, which demonstrated the heterozygous c.568_571del mutation of the GNAS gene. Our report illustrates the natural history of a patient with PHP1A, which went undiagnosed until the age of 64 years, with multi-hormonal resistance and clinical sequelae evolving throughout life, and underlines the importance of diagnosing this rare disease, which has a great impact on patients and their family life.

PMID: 30729047 [PubMed]

http://bit.ly/2SmrDYi

Diabetic Ketoacidosis Revealing a Severe Hypertriglyceridemia and Acute Pancreatitis in Type 1 Diabetes Mellitus.

Related Articles

Diabetic Ketoacidosis Revealing a Severe Hypertriglyceridemia and Acute Pancreatitis in Type 1 Diabetes Mellitus.

Case Rep Endocrinol. 2019;2019:8974619

Authors: Zaher FZ, Boubagura I, Rafi S, Elmghari G, Elansari N

Abstract
Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication occurring in patients with diabetes, especially in patients with type 1 diabetes (T1D), due to an insulin deficiency. Moderate hypertriglyceridemia is commonly observed in DKA but severe hypertriglyceridemia with a triglyceride level exceeding 10g/L is very rarely reported. We report a case of a 14-year-old boy who had type 1 diabetes for 4 years treated with insulin therapy, also having adrenal insufficiency treated with hydrocortisone who presented with ketoacidosis and excruciating abdominal pain. Investigations revealed hypertriglyceridemia at 64g/L, lipasemia at 1000 U/L, and stage E pancreatitis on abdominal CT. The patient was treated with intravenous insulin, rehydration, and fenofibrate with good clinical and biological evolution. Severe hypertriglyceridemia causing pancreatitis in type 1 diabetes mellitus is a rare but very serious complication of DKA in children.

PMID: 30723557 [PubMed]

http://bit.ly/2GegRge

Randomized, Controlled, Multicentered, Double-Blind Investigation of Injectable Poly-L-Lactic Acid for Improving Skin Quality

BACKGROUND Poly-L-lactic acid (PLLA) is an injectable filler used for restoring facial fat volume loss. OBJECTIVE To evaluate the effect of repeated PLLA injections on skin quality. METHODS Forty healthy women were enrolled in this randomized, controlled, double-blind, multicenter study. Eligible subjects received 3 treatments every 4 weeks with either PLLA (treatment group) or saline (control group) injections, into both sides of the face. Follow-up visits were at 6, 9, and 12 after the last treatment. Assessments included biophysical measuring instruments, live ratings, patient questionnaires, and rating of standardized pictures by a blinded evaluator. RESULTS At the 12-month follow-up, there was a statistically significant increase of skin elasticity and hydration in PLLA-treated subjects and a decrease in transepidermal water loss in both groups. Pigmentation, erythema, and pore size were significantly decreased, whereas radiance and smoothness were significantly increased at 12 months per blinded investigator rating in this group. No treatment-related adverse events occurred. CONCLUSION Repeated PLLA treatments may improve skin quality in a time-dependent manner. Address correspondence and reprint requests to: Neil S. Sadick, MD, Sadick Dermatology, 911 Park Avenue, New York, NY 10075, or e-mail: nssderm@sadickdermatology.com Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://bit.ly/2bw6lgr). The authors received funding for this research from Galderma who also provided the PLL. The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2ULn3PK

Treatment of Facial Telangiectases With Glycerin Sclerotherapy

BACKGROUND Sclerotherapy is used to treat varicosities and telangiectases. Glycerin is a sclerosing agent that has been used off-label for years with a favorable adverse effect profile. However, the treatment of facial telangiectases with sclerotherapy is controversial given the potential for necrosis and embolization in relation to the complex vascular anatomy of the face. OBJECTIVE To determine the safety and efficacy of glycerin sclerotherapy for the treatment of facial telangiectases. MATERIALS AND METHODS The authors report a series of 8 patients with facial telangiectases treated with glycerin sclerotherapy. Glycerin mixed with lidocaine and epinephrine was used. The telangiectases were measured and identified as targets for treatment. RESULTS The patients ranged in age from 45 to 88 years. Between 0.5 and 1 mL was used to treat telangiectases of the nose and malar cheek area per session. Five of the patients achieved satisfactory results after 1 treatment, whereas patients with more extensive telangiectases required up to 3 sessions with 4-week intervals between each session. Injection site pain was the only reported adverse effect, and no evidence of necrosis or blindness was observed. CONCLUSION Glycerin sclerotherapy seems to be a safe and effective modality for the treatment of facial telangiectases. Address correspondence and reprint requests to: Sean McGregor, DO, PharmD, Department of Dermatology, Wake Forest Baptist Health, 4618 Country Club Road, Winston-Salem, NC 27104, or e-mail: smcgrego@wakehealth.edu The authors have indicated no significant interest with commercial supporters. Use of this product as discussed has not been approved by the Food and Drug Administration. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2UNxdPX

Efficacy of Microneedling and Photodynamic Therapy in Vitiligo

No abstract available

http://bit.ly/2te88C1

The Frequency of Auricular Cartilage Invasion by Nonmelanoma Skin Cancer

No abstract available

http://bit.ly/2UOM7Wb

How We Do It: Use of Reinforced Adhesive Skin Closures as a “Ripstop” Medium for Suturing Fragile Skin: A Video Demonstration of Technique

No abstract available

http://bit.ly/2te884Z

Cellular Dermatofibroma: Clinicopathologic Review of 218 Cases of Cellular Dermatofibroma to Determine Clinical Recurrence Rate

BACKGROUND Cellular dermatofibromas, a variant of dermatofibroma, are reported to recur at rates of 26% to 50%. OBJECTIVE To determine whether there are distinct clinical or histological differences between cellular dermatofibromas that recur versus those that do not. To determine recurrence rates in a real-world clinical setting. MATERIALS AND METHODS A retrospective analysis of the medical records and skin biopsies of cellular dermatofibroma in the University of Utah Health system between December 2011 and 2016. Clinical and dermatopathological features were evaluated to find distinct differences between the cellular dermatofibromas that recurred compared with those that did not. RESULTS There were no significant differences in histology between the primary lesions in recurrent and nonrecurrent cases. One factor that seemed to be associated with a greater likelihood of recurrence was an initial lesion size greater than 1 cm. The authors' data suggest that if the margins are involved on initial biopsy, there is a 10% chance of recurrence. This percentage is far less than the 26% to 50% reported in the past literature. CONCLUSION If a patient presents with a cellular dermatofibroma larger than 1 cm and positive margins at initial biopsy, a careful discussion should be had between the provider and patient about the low risk of local recurrence. Address correspondence and reprint requests to: Keith Duffy, MD, Department of Dermatology, 30 N 1900 East, 4A330, Salt Lake City, UT 84132, or e-mail: keith.duffy@hsc.utah.edu The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2UOMMa7

Suture Treatment for Pincer Nail Deformity: An Inexpensive and Simple Technique

No abstract available

http://bit.ly/2tdptLp

Use of Insulin Syringes for Precision Filler in Periocular and Rhinoplasty Procedures

No abstract available

http://bit.ly/2USH4US

A Diagnostic Challenge: Changes in Histopathologic Tumor Diagnosis of Atypical Squamous Proliferations After Surgical Removal

BACKGROUND Biopsy-proven "atypical squamous proliferations" (ASPs) may prove difficult to diagnose histologically because of partial sampling, lack of complete criteria for definitive diagnosis, or overlap of histopathological features with other neoplasms. There are no guidelines concerning the management of ASPs. OBJECTIVE To retrospectively clarify the diagnosis of biopsy-proven ASPs after surgical removal, specifically, to ascertain what fraction represent malignant tumors. METHODS Medical records of patients who underwent surgical removal of biopsy-proven ASPs in an academic dermatologic surgical unit from June 2008 to July 2013 were examined. The resultant histopathologic diagnosis of these lesions after surgical removal, along with other demographic data, was obtained. RESULTS Of the 71 biopsy-proven ASPs that were treated by surgical removal in the study period, 54.9% exhibited resultant pathologic diagnosis of nonmelanoma skin cancer (NMSC). CONCLUSION Biopsy-proven ASPs present a therapeutic challenge. The authors' data illustrate the importance of subsequent tissue sampling, as these lesions often represent NMSCs. Address correspondence and reprint requests to: Ashley G. Rubin, MD, 2683 Via De La Valle STE G-710, Del Mar, CA 92014, or e-mail: Rubindermatology@gmail.com The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2tcJKRr

Assessment of Skin Physiology Change and Safety After Intradermal Injections With Botulinum Toxin: A Randomized, Double-Blind, Placebo-Controlled, Split-Face Pilot Study in Rosacea Patients With Facial Erythema

BACKGROUND Botulinum toxin (BTX) has been used cosmetically with good clinical efficacy and tolerable safety. OBJECTIVE This randomized, double-blind, split-face clinical study aimed to investigate the efficacy and safety of intradermal BTX in patients with rosacea. MATERIALS AND METHODS Twenty-four participants were enrolled and randomly given intradermal injections of BTX and normal saline in both cheeks. Clinician Erythema Assessment (CEA) score, Global Aesthetic Improvement Scale (GAIS) score, skin hydration, transepidermal water loss (TEWL), melanin content, erythema index, elasticity, and sebum secretions were evaluated at baseline and 2, 4, 8, and 12 weeks. RESULTS On the BTX-treated side, the CEA score significantly decreased and the GAIS score significantly increased. The erythema index decreased at Weeks 4 and 8. Skin elasticity was improved at Weeks 2 and 4 and skin hydration, at Weeks 2, 4, and 8. However, TEWL and sebum secretion did not show significant differences. CONCLUSION Intradermal BTX injections significantly reduced the erythema on both cheeks and improved skin elasticity and hydration, but not TEWL and sebum secretion. Intradermal BTX injections reduced erythema and rejuvenated the skin effectively and safely in patients with rosacea. Address correspondence and reprint requests to: Yang W. Lee, MD, PhD, Department of Dermatology, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea, or e-mail: 20050078@kuh.ac.kr Supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF) and funded by the Ministry of Science, ICT, and Future Planning (NRF-2016R1D1A1A09918488). Daewoong Pharmaceutical provided the research funds and drugs used in this clinical trial (prabotulinumtoxinA; NABOTA, Daewoong Pharmaceutical, Seoul, Korea). This study protocol was approved by the International Review Board of Konkuk University Hospital, Seoul, South Korea (KUH 1120075), and informed consent was obtained from all subjects before study enrollment. Assessment of Skin Physiology Change and Safety After Intradermal Injections With Botulinum Toxin: A Single-Center, Randomized, Double-Blind, Placebo-Controlled, Split-Face Pilot Study in Rosacea Patients With Facial Erythema. The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2UQIi2O

Objective and Subjective Evaluation of Lipoinjection for Correction of Temporal Depression

BACKGROUND Temporal depression is commonly found among people. OBJECTIVE Objective and subjective evaluation of lipoinjection for correction of temporal depression. METHODS From November 2012 to January 2018, 34 healthy female subjects underwent temporal augmentation by lipoinjection on both sides. Efficacy was assessed by objective and subjective parameters. The quantitative measurement of the temporal defect was obtained using molded plasticine preoperatively and 12 months after treatment. The subjective assessment consisted of excellent, good, fair, and poor results based on the patients' self-evaluations. The adverse events were recorded. RESULTS The follow-up period ranged from 12 to 36 months. It was found that a statistically significant difference existed between the preoperative and postoperative defect on both temples. Regarding the patients' self-evaluations, 17 patients (50.0%) reported feeling excellent, 15 patients (44.1%) as good, and 2 patients (5.9%) as fair, and no patient as poor. After the statistical analysis, it was found that the volumetric restoration rate of the grafted fat decreased as the temporal defect generally increased during the aging process. Injection-site swelling and bruising were commonly found complications; other complications were not found. CONCLUSION Autologous fat is inexpensive and readily available. Fat grafting is an alternative for correction of temporal depression. Address correspondence and reprint requests to: Xiaogen Hu, MD, Plastic Surgery Department, China Japan Friendship Hospital, Beijing 100029, China, or e-mail: huxiaogeng78@qq.com The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2tniKih

Cutaneous Metastasis of Malignant Peripheral Nerve Sheath Tumor Arising From the Pancreas: A Rarity

No abstract available

http://bit.ly/2UQIhvM

Novel Classifications for Muscular Contraction of the Lower Face and Neck

BACKGROUND Currently, there are no scales that address lower-face muscular contraction patterns, and there is only one that addresses platysmal bands. OBJECTIVE The goal of this article is to create scales to classify the strength and contraction patterns of the lower face and neck based on (1) the muscular anatomy and contraction patterns of the platysma and (2) the strength of the depressor anguli oris (DAO). METHODS Three hundred sixty patients participated in the study. Standardized photogarphs were taken in an effort to characterize muscle contraction patterns. RESULTS A novel classification measuring the strength of the DAO is presented. For the DAO, 4 different contraction patterns were observed: Type 1 (38%), Type 0 (26.3%), Type 2 (25.2%), and Type 3 (8.6%). The remainder (1.9%) used asymmetric contraction. For platysmal bands, 3 different contraction patterns were observed: complete contraction (64.53%), lateral contraction (19.83%), and central contraction pattern (11.73%). A small percentage of patients (3.91%) had an asymmetric contraction pattern. CONCLUSION Categorization of contraction of the DAO and platysmal bands into these proposed classifications provides objective measurements that can be helpful for designing treatment protocols and assessing response to treatment. Address correspondence and reprint requests to: Berta E. Alcalá, MD, Roger de flor 2907, 512 Las Condes, Santiago, Chile 7550201, or e-mail: berta.alcala@gmail.com The authors have indicated no significant interest with commercial supporters. B.S.F. Bravo is a speaker for Allergan. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2tbRfrG

Repair of a Large Dorsal Hand Defect After Mohs Micrographic Surgery

No abstract available

http://bit.ly/2UOMeB5

Institution of a Double-Dosing Protocol Using Cyanoacrylate Glue for the Larger Diameter Refluxing Superficial Truncal Vein

No abstract available

http://bit.ly/2tfSRRm

Satellite and In-Transit Metastatic Disease in Melanoma Skin Cancer: A Retrospective Review of Disease Presentation, Treatment, and Outcomes

BACKGROUND Satellitosis and in-transit metastases (SITM) are uncommon in cutaneous melanoma and are associated with poor prognosis. However, the disease- and treatment-specific variables that predict outcomes among patients with SITM are poorly defined. OBJECTIVE To identify factors that predict prognosis among patients with SITM. MATERIALS AND METHODS Retrospective chart review of patients treated for melanoma at a large academic medical center in central Pennsylvania between 2000 and 2012. Patients with pathology reports containing "satellite lesions" or "in-transit metastases" were selected for analysis. Data were collected regarding tumor stage, the timing of SITM discovery, treatment, recurrence-free survival after SITM discovery, and overall survival (OS). RESULTS We identified SITM in 32 (1.9%) of 1,650 patients with pathology-diagnosed melanoma over the study period. Reduced recurrence-free survival after SITM discovery was associated with higher pathologic stage, metastatic disease, lymph node dissection, and use of adjuvant chemotherapy. Reduced OS was associated with higher T, N, M, and overall prognostic stage; positive surgical margins; disease recurrence; and SITM on initial presentation. CONCLUSION Our data support previous findings that higher stage disease confers a worse prognosis among patients with SITM. Patients with SITM on initial presentation had worse outcomes, suggesting SITM is indicative of more aggressive disease. Address correspondence and reprint requests to: Genevieve Andrews, MD, Department of Surgery, Division of Otolaryngology—Head and Neck Surgery, Milton S. Hershey Medical Center, The Pennsylvania State University, 500 University Drive, Mail Code H091, Hershey, PA 17033-0850, or e-mail: gigi.andrews76@gmail.com The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2UKb598

Squamous Cell Carcinoma of the Nail Unit: A Clinical Histopathologic Study and a Proposal for Classification

BACKGROUND There is no consensus on the classification, grading, and the treatment of nail squamous cell carcinoma (NSCC). OBJECTIVE The aim of the study was to propose a possible classification of NSCC. MATERIALS AND METHODS Nail squamous cell carcinoma referred from January 2006 till December 2014 was included. On the basis of the clinical presentation, patients with NSCC were divided in 2 groups. Group A tumors presented as nodular or ulcerated masses of the nail bed, whereas Group B tumors presented as hyperkeratotic bands. In these 2 groups, differences in proportions (sex, histopathologic grading, and treatment performed) were evaluated with the chi-square test. RESULTS Forty-one NSCCs were included. The groups of NSCC differed regarding: (1) the age of the patients, (2) histopathology, and (3) surgical approach. CONCLUSION Nail squamous cell carcinomas may originate from 2 different epithelia, presenting a diverse clinical behavior. The correct identification and diagnosis of each subgroup of NSCC could be helpful in standardizing management of this tumor. Future studies considering human papillomavirus subtyping and including a major number of tumors should be performed to confirm or reject the authors' hypothesis. Limitations This is a retrospective study, presenting the data and the experience of a single institute. Address correspondence and reprint requests to: Emi Dika, MD, PhD, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138 Bologna, Italy, or e-mail: emi.dika3@unibo.it The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2thYPAU

Permanent Cutaneous Adverse Events After Injection With Deoxycholic Acid

No abstract available

http://bit.ly/2UMMznS

Cryolipolysis for Noninvasive Contouring of the Periumbilical Abdomen With a Nonvacuum Conformable-Surface Applicator

BACKGROUND Although most cryolipolysis treatments are performed with vacuum applicators, some patients may have areas of fibrous, nonpinchable fat or find vacuum suction to be uncomfortable. OBJECTIVE This study evaluates a nonvacuum conformable-surface applicator for cryolipolysis of the periumbilical abdomen. METHODS/MATERIALS Twenty subjects with periumbilical subcutaneous fat were treated with a nonvacuum cryolipolysis applicator in this prospective, single-center, open-label clinical trial. Each subject underwent a single treatment cycle with an optional second treatment 10 weeks later. Efficacy was evaluated by blinded review of digital photographs. Subject satisfaction was assessed at 10-week follow-up. RESULTS Twenty subjects completed one treatment, of which 6 underwent the optional retreatment. Independent review demonstrated 77% correct identification of baseline photographs after one treatment, which improved to 100% after a second treatment. Patient questionnaires after one treatment revealed 50% satisfaction, with 60% willing to recommend the procedure and 60% reporting visible fat reduction. After second treatment, however, 100% were satisfied, 83% were willing to recommend, and 100% reported visible fat reduction. CONCLUSION Cryolipolysis with a nonvacuum conformable-surface applicator is safe, effective, and well tolerated for noninvasive reduction of fibrous periumbilical abdominal fat. Efficacy and subject satisfaction is significantly greater with 2 treatments than with a single session. Address correspondence and reprint requests to: Daniel P. Friedmann, MD, FAAD, Westlake Dermatology Clinical Research Center, Westlake Dermatology and Cosmetic Surgery, 8825 Bee Cave Road, Austin, TX 78746, or e-mail: daniel@westlakedermatology.com Supported in part by a research grant from ZELTIQ Aesthetics. The author is a consultant and investigator for Allergan North America, Inc. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2tiGRhH

Cutaneous Sarcomatoid Squamous Cell Carcinoma of the Ear and the Use of Immunohistochemical Staining as a Diagnostic Aid

No abstract available

http://bit.ly/2UMMwbG

ICESP, a research hub within a total cancer care center

http://bit.ly/2Bi55gM

Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics

Idiopathic pulmonary fibrosis is a chronic disease of unknown etiology that usually has a progressive course and is commonly associated with a poor prognosis. The main symptoms of idiopathic pulmonary fibrosis, including progressive dyspnea and dry cough, are often nonspecific. Chest high-resolution computed tomography is the primary modality used in the initial assessment of patients with suspected idiopathic pulmonary fibrosis and may have considerable influence on subsequent management decisions. The main role of computed tomography is to distinguish chronic fibrosing lung diseases with a usual interstitial pneumonia pattern from those presenting with a non-usual interstitial pneumonia pattern, suggesting an alternative diagnosis when possible. A usual interstitial pneumonia pattern on chest tomography is characterized by the presence subpleural and basal predominance, reticular abnormality honeycombing with or without traction bronchiectasis, and the absence of features suggestive of an alternative diagnosis. Idiopathic pulmonary fibrosis can be diagnosed according to clinical and radiological criteria in approximately 66.6% of cases. Confirmation of an idiopathic pulmonary fibrosis diagnosis is challenging, requiring the exclusion of pulmonary fibroses with known causes, such as asbestosis, connective tissue diseases, drug exposure, chronic hypersensitivity pneumonitis, and other forms of idiopathic interstitial pneumonitis. The histopathological hallmark of usual interstitial pneumonia is a heterogeneous appearance, characterized by areas of fibrosis with scarring and honeycombing alternating with areas of less affected or normal parenchyma. The aim of this article was to review the clinical, radiological, and pathological features of idiopathic pulmonary fibrosis and of diseases that might mimic idiopathic pulmonary fibrosis presentation.

http://bit.ly/2Txp0PM

The effect of high UV radiation exposure environment on the novel PVC polymers

Abstract

Although plastic induces environmental damages, almost the consumption of poly(vinyl chloride) never stops increasing. Therefore, this work abstracted by two parts, first, synthesis of Schiff bases 1–4 compounds through the reaction of amino group with appropriate aromatic aldehyde, reaction of PVC with Schiff bases compounds 1–4 in THF to form a new modified PVC-1, PVC-2, PVC-3, and PVC-4. The structures of Schiff bases 1–4 and the modified PVC-1, PVC-2, PVC-3, and PVC-4 have been characterized by different spectroscopic analyses. Second, the influence of introducing 4-amino-1,2,4-triazole as a pendent groups into PVC chain investigated on photostability rules of tests. The modified polymers photostability investigated by observing indices (I_CO, I_po, and I_OH), weight loss, UV and morphological studies, and all results obtained indicated that PVC-1, PVC-2, PVC-3 and PVC-4 gave lower growth rate of I_CO, I_PO, and I_OH through UV exposure time. The photostability are given as PVC-4 < PVC-3 < PVC-2 < PVC-1 from different mechanisms which suggested building on existence of 4-amino-1,2,4-triazole moieties in the polymer chain.

http://bit.ly/2TC4nlC

Septocutaneous perforator mapping and clinical applications of the medial arm flap

The medial arm flap has a long history but remains underused despite providing multiple advantages. We reviewed our experience with using the medial arm flap in order to clarify the distribution of septocutaneous perforators and its relationship with pedicled flap design.

http://bit.ly/2tdU4bH

Digital Model Simulation Technology for Ear Reconstruction of Microtia with Craniofacial Asymmetry

Craniofacial asymmetry is often observed in microtia patients, duing to the accompanied craniofacial microsomia deformity, such as mandibular dysplasia and/or depression of the mastoid region, which makes it difficult to obtain symmetrical results in ear reconstruction [1]. In the process of reconstruction, both ear location and framework fabrication are interfered by the asymmetry. Mandibular hypoplasia and the heterotopic residual ear can not be regarded as an appropriate locating reference, which poses difficulties to the surgeon when determining the location for the reconstructed ear.

http://bit.ly/2UWkQBt

Post mastectomy upper limb lymphedema: combined vascularized lymph node transfer and scar release with fat graft expedites surgical and patients’ related outcomes. a retrospective comparative study

Lymphedema resulting from breast cancer treatment is a chronic condition which can significantly compromise quality of life. Several works have documented the efficacy of vascularized lymph node flap transfer (VLNT) for the treatment of advanced stage lymphedema. Given that the axillary scar may contribute to the patient's existing lymphedema, authors assumed that combining VLNT and scar release with fat graft could be an effective strategy of treatment. The purpose of this study is to compare the efficacy in limb's circumference reduction and health-related quality of life between a combined strategy, namely VLN and axillary scar release with fat grafting, and just VLN transfer for patients' affected by post mastectomy upper limb lymphedema.

http://bit.ly/2tdU23z

Carbon dioxide laser treatment in burn-related scarring: a prospective randomised controlled trial

To investigate the effect of ablative fractional CO2 laser (AFCO2L) on burns scar appearance and dermal architecture at 6 weeks and up to 3-years post-treatment.

http://bit.ly/2UWkMld

“SCARLESS REVERSE UMBILICOPLASTY”: A NEW TECHNIQUE OF UMBILICAL TRANSPOSITION IN ABDOMNOPLASTY

The navel plays a major role in the aesthetics of the abdomen. A navel which is abnormally shaped, malpositioned or has evident scarring may compromise the outcome of an otherwise well executed full abdominoplasty. The aim of the technique in question is to recreate a navel that looks natural, with no visible scar and properly positioned.

http://bit.ly/2tftaQH

Revisiting the reconstructive surgery framework: the reconstruction supermarket

Plastic and reconstructive surgeons apply a variety of techniques throughout the body with analogies having evolved to provide a conceptual framework for the selection of techniques. Well-known examples include: the reconstructive ladder with increasingly complex rungs, the reconstructive elevator where the surgeon moves directly to the most suitable reconstruction, the reconstructive toolbox, and the reconstructive triangle.1,2 Extended models have been proposed to incorporate developments such as negative pressure wound therapy, and include the extended ladder,3 the reconstructive solar system,4 and the reconstructive clockwork.

http://bit.ly/2UJVcj0

Engagement can increase patient willingness to take medications

Abstract

DEAR EDITOR, Patients are often unduly afraid of rare or non‐existent but perceived risks of starting a new medication.¹ Developing and testing specific approaches to overcome such fears may help improve patients' treatment outcomes. We hypothesized that engaging patients in thinking about how to present reassuring information could be used to modify patients' perceptions of treatment. To test this, we queried subjects about their willingness to take ustekinumab, a drug that blocks interleukin (IL)‐23 signaling, for psoriasis.

This article is protected by copyright. All rights reserved.

http://bit.ly/2TESo6D

Long‐term, real world, efficacy of biologics for psoriasis: a single centre's experience

Abstract

Biologic therapies have revolutionised the management of moderate to severe chronic plaque psoriasis and have been life‐transforming for many patients. The first biologic to be licensed for psoriasis in the UK was efalizumab in 2004 and there are now nine licensed by the European Medicines Agency for the indication of moderate‐severe disease. A key determinant in choosing a biologic for an individual patient is the likelihood of long‐term efficacy and for some there is compelling evidence that monotherapy can result in long‐term disease control.

This article is protected by copyright. All rights reserved.

http://bit.ly/2BvassX

The nasal and skin microbiome are associated with disease severity in pediatric atopic dermatitis

Abstract

Background

Alterations of the skin microbiome have been associated with atopic dermatitis (AD) and its severity. The nasal microbiome in relation to AD severity is less well studied.

Objective

We aimed to characterize the nasal and skin microbiome in children with AD in relation to disease severity. Additionally, we explored differences and correlations between the nasal and skin communities.

Methods

We cross‐sectionally characterized the microbial composition of 90 nasal and 108 lesional skin samples from patients with AD, using 16S‐rRNA sequencing. Additional quantitative (q)PCR for Staphylococcus (S.) aureus and S. epidermidis was performed on the skin samples and AD severity was estimated using the self‐administered eczema area and severity index.

Results

We found an association between the microbial composition and AD severity in both the nose and skin samples (R²=2.6%; p=0.017 and R²=7.0%; p=0.004), strongly driven by staphylococci. However, other species also contributed, such as Moraxella in the nose. Skin lesions were positive for S. aureus in 50% of the children and the presence and load of S. aureus was not associated with AD severity. Although the nose and skin harbor distinct microbial communities (n=48 paired samples; p<0.001), we found that correlations exist between species in the nose and (other) species on the skin.

Conclusion

Our results indicate that both the nasal and skin microbiome are associated with AD severity in children and that next to staphylococci, other species contribute to this association.

This article is protected by copyright. All rights reserved.

http://bit.ly/2TBpHHM

PRISModegib: the use of the PRISM test to assess the Health‐Related Quality of Life of patients with Locally Advanced Basal Cell Carcinoma undergoing Hedgehog Pathway Inhibitor Therapy

Abstract

Vismodegib is an Hedgehog Pathway Inhibitor Therapy (HPIT) for patients affected by Locally Advanced Basal Cell Carcinoma (laBCC) and Metastatic Basal Cell Carcinoma (mBCC) not eligible for surgery and/or radiotherapy^1‐4. The efficacy of Vismodegib has been reported by several studies; likewise, treatment‐emergent adverse effects (AEs) have been reported for 95‐100% of the patients⁵. It has been observed that patients who achieved complete or partial response often discontinued HPIT because of a grade 1 or 2 AEs.

This article is protected by copyright. All rights reserved.

http://bit.ly/2BtjM0e

Ameliorative effect of zinc oxide nanoparticles against potassium bromate-mediated toxicity in Swiss albino rats

Abstract

Potassium bromate (PB) is a commonly used food additive, a prominent water disinfection by-product, and a class IIB carcinogen. It exerts a various degree of toxicity depending on its dose and exposure duration consumed with food and water in the living organisms. The present investigation aims to demonstrate the protective efficacy of zinc oxide nanoparticles (ZnO NPs) derived from Ochradenus arabicus (OA) leaf extract by green technology in PB-challenged Swiss albino rats. The rodents were randomly distributed, under the lab-standardized treatment strategy, into the following six treatment groups: control (group I), PB alone (group II), ZnO alone (group III), ZnO NP alone (group IV), PB + ZnO (group V), and PB + ZnO NPs (group VI). The rats were sacrificed after completion of the treatment, and their blood and liver samples were collected for further analysis. Group II showed extensive toxic effects with altered liver function markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyl transferase, glutathione-S-transferase, and thioredoxin reductase) and compromised redox status (SOD, CAT, GR, GPx, GSH, MDA, and total carbonyl content). The histopathological analysis and comet assay further supported the biochemical results of the same group. Besides, group III also showed moderate toxicity evidenced by an alteration in most of the studied parameters while group IV demonstrated mild toxicity after biochemical analysis indicating the excellent biocompatibility of the NPs. However, group VI exhibited attenuation of the PB-induced toxic insults to a significant level as compared to group II, whereas group V failed to show similar improvement in the studied parameters. All these findings entail that the ZnO NPs prepared by green synthesis have significant ameliorative property against PB-induced toxicity in vivo. Moreover, administration of the NPs improved the overall health of the treated animals profoundly. Hence, these NPs have significant therapeutic potential against the toxic effects of PB and similar compounds in vivo, and they are suitable to be used at the clinical and industrial levels.

http://bit.ly/2SGaasW

Influence of phytase enzyme on ruminal biogas production and fermentative digestion towards reducing environmental contamination

Abstract

Environmental impact of livestock production has received a considerable public scrutiny because of the adverse effects of nutrient run-offs, primarily N and P, from agricultural land harboring intensive energy livestock operations. Hence, this study was designed to determine the efficacy of dietary phytase supplementation on fermentation of a sorghum grain–based total mixed ration (TMR) using a ruminal in vitro digestion approach. Phytase was supplemented at three doses: 0 (control), 540 (P540), and 720 (P720) g/t dry matter, equivalent to 0, 2.7 × 10⁶, and 3.6 × 10⁶ CFU/t DM, respectively. Compared to P720 and the control, gas production was higher for P540 after 12 h (P = 0.02) and 24 h (P = 0.03) of fermentation suggesting a higher microbial activity in response to phytase supplementation at lower phytase levels. Correspondingly, dry matter degradability was found to have improved in P540 and P720 compared to the control by 13 and 11% after 24 h of incubation (P = 0.05). For ammonia nitrogen (NH₃-N), a tendency towards lower values was only observed for P540 at 24 h of fermentation (P = 0.07), while minimal treatment effects were observed at other fermentation times. The concentrations of total volatile fatty acids (VFA) were higher (P < 0.05) after 48 h of fermentation for P540 and P720 compared to the control (P = 0.03) by 10% and 14%, respectively. Ruminal acetate tended towards higher values in the presence of phytase after 12 h of fermentation (P = 0.10), but towards lower values after 24 h of fermentation (P = 0.02), irrespective of the phytase dose applied. A trend towards lower ruminal propionate levels was observed in the presence of phytase after 6 h (P = 0.10) and 12 h (P = 0.06) of fermentation, while no effects were found at other fermentation times. In conclusion, phytase supplementation has the potential to improve metabolic energy activity of rumen microorganisms and the use of feed constituents. Thus, phytase supplementation could help to reduce environmental contamination in areas of ruminant production.

http://bit.ly/2N1PbMc

Uptake and distribution of phenanthrene and pyrene in roots and shoots of maize ( Zea mays L.)

Abstract

Polycyclic aromatic hydrocarbons as byproducts of carbon-based fuel combustion are an important group of pollutants with wide distribution in the environment. Polycyclic aromatic hydrocarbons are known as toxic compounds for almost all organisms. Different plant species can uptake polycyclic aromatic hydrocarbons by roots and translocate them to various aerial parts. The aim of this study is to investigate the uptake, translocation, and accumulation of pyrene and phenanthrene in maize under controlled conditions. Seeds were cultivated in perlite containing 25, 50, 75, and 100 ppm of phenanthrene and pyrene, and their concentrations in the roots and shoots of the plants were measured using high-performance liquid chromatography technique after 7, 14, and 21 days. The results revealed that phenanthrene naturally existed in maize and its concentration showed a time-dependent decrease in shoots and roots. In contrast, the concentration of pyrene was increased in the roots and reduced in the shoots. Although pyrene had higher uptake than phenanthrene in roots of maize, the translocation factor value for pyrene was lower than for phenanthrene. According to these findings, phenanthrene could be metabolized in maize in the shoot and root tissues, but pyrene had more tendency to be accumulated in roots.

http://bit.ly/2tcZfZt

Metastasis in the wild: investigating metastasis in non-laboratory animals

Abstract

Humans are not the only species to spontaneously develop metastatic cancer as cases of metastasis have been reported in a wide range of animals, including dinosaurs. Mouse models have been an invaluable tool in experimental and clinical metastasis research, with the use of genetically-engineered mouse models that spontaneously develop metastasis or ectopic/orthotopic transplantation of tumour cells to wildtype or immunodeficient mice being responsible for many key advances in our understanding of metastasis. However, are there other species that can also be relevant models? Similarities to humans in terms of environmental exposures, life-span, genetics, histopathology and available therapeutics are all factors that can be considered when looking at species other than the laboratory mouse. This review will explore the occurrence of metastasis in multiple species from a variety of domestic, captive and free-living veterinary cases to assist in identifying potential alternative experimental and clinical research models relevant to humans.

http://bit.ly/2SmLZ3l

Self-Related Processing and Future Thinking: Distinct Contributions of Ventromedial Prefrontal Cortex and the Medial Temporal Lobes

Publication date: Available online 8 February 2019

Source: Cortex

Author(s): Mieke Verfaellie, Aubrey A. Wank, Allison G. Reid, Elizabeth Race, Margaret M. Keane

Abstract

Episodic future thinking depends on a core network of regions that involves, in addition to the medial temporal lobes (MTL), the ventromedial prefrontal cortex (vmPFC). Neuroimaging studies suggest that vmPFC is particularly involved when future thinking requires consideration of self-relevant information, but lesion evidence for a special role of vmPFC in constructing self-relevant scenarios is limited. To clarify the involvement of vmPFC in future thinking, eight patients with vmPFC lesions were asked to imagine future events pertaining to the self or to another person, and their performance was contrasted with that of eight patients with MTL lesions. Patients with vmPFC lesions were no more detailed in their description of future events pertaining to the self than of events pertaining to another person. In contrast, like controls, patients with MTL lesions showed a self-benefit, despite impoverished performance overall. These findings accord with evidence from neuroimaging studies and elucidate the distinct contributions of vmPFC and MTL to future thinking.

http://bit.ly/2SDiQAo

Recruitment of CXCR3+ T cells into injured tissues in adult IgA vasculitis patients correlates with disease activity

Publication date: Available online 8 February 2019

Source: Journal of Autoimmunity

Author(s): Alexandra Audemard-Verger, Evangéline Pillebout, Agnès Jamin, Laureline Berthelot, Cédric Aufray, Bruno Martin, Aurélie Sannier, Eric Daugas, Julie Déchanet-Merville, Yolande Richard, Renato Monteiro, Bruno Lucas

Abstract

Objectives

Adult immunoglobulin A vasculitis (IgAV) is an immune complex small vessel vasculitis. So far, the involvement of T cells in this pathology has been poorly studied. The aim of this study was to analyze T-cell homeostasis as well as cytokine and chemokine concentrations in the blood and tissues of IgAV patients.

Methods

T cells, cytokine and chemokine concentrations were analyzed in peripheral blood using flow cytometry and multiplex assays. T-cell infiltrates in the kidney and the skin were characterized by immunohistochemistry. This study prospectively included 44 adult patients with biopsy-proven IgAV and 24 age- and sex-matched healthy controls.

Results

We observed reduced proportions of circulating CXCR5-and CXCR3-expressing memory CD4 T cells at diagnosis but normal values at remission. The plasma levels of Th1-related cytokines (IL-12, IL-27 and IFNγ) and of the TFH-related cytokine, IL-21, were paradoxically not reduced in patients. We observed increased plasma concentrations of the CXCR5 ligand, CXCL13, and of the CXCR3 ligands, CXCL10/11, suggesting a potential relocation of the corresponding T cells into inflamed tissues. We then confirmed the recruitment of CXCR3-expressing T cells into the skin and kidneys. In the skin, T-cell infiltrates mainly co-localized with damaged dermal small vessels. Finally, patients with the largest kidney T-cell infiltrates were also those with the highest proteinuria.

Conclusion

Altogether, our results strongly suggest that, in IgAV patients, CXCL10/11 orchestrate the recruitment of CXCR3-expressing T cells in injured tissues, contributing to tissue damage and disease activity.

http://bit.ly/2GCEOgi

Trends in Scholarly Productivity of Dermatology Faculty by Academic Status and Gender

Publication date: Available online 8 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Allen F. Shih, Wendy Sun, Cameron Yick, Suzanne Xu, Rance J.T. Fujiwara, Oscar R. Colegio

http://bit.ly/2SHzVZW

“Platelet-rich plasma and its utility in the treatment of acne scars - A systematic review”

Publication date: Available online 8 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Michael J. Hesseler, Nikhil Shyam

Abstract

The field of dermatology has seen numerous therapeutic innovations in the past decade with platelet-rich plasma recently garnering significant interest in acne scarring. This review consolidates the available evidence of platelet rich plasma for the practicing dermatologist and evaluates the current evidence up to May 31, 2018. A search was conducted in the PubMed database for "platelet rich plasma" or "platelet releasate" or "platelet gel" or "PRP" and "dermatology" or "skin" or "hair" or "cutaneous" with thirteen articles meeting the inclusion criteria. The quality of each individual study was evaluated and levels of evidence were assigned according to the Centre for Evidence-Based Medicine, Oxford. This review reveals that activated, leukocyte and platelet-rich plasma in combination with fractional ablative laser treatment, administered in 2-3 sequential sessions 1 month apart, improves the appearance of acne scars. The evidence for the use of platelet-rich plasma with microneedling is less supportive. Due to the heterogeneity of studies and widely variable outcome measures, comparison between platelet-rich plasma treatments and subsequent statistical analysis could not be performed. While these studies use various subjective and objective evaluation methods, the addition of platelet-rich plasma provides improvements in acne scarring, higher patient satisfaction and decreased post-procedure downtime.

http://bit.ly/2MXecrL

MRI estimates of brown adipose tissue in children – Associations to adiposity, osteocalcin, and thigh muscle volume

Publication date: Available online 8 February 2019

Source: Magnetic Resonance Imaging

Author(s): Jonathan Andersson, Josefine Roswall, Emma Kjellberg, Håkan Ahlström, Jovanna Dahlgren, Joel Kullberg

Abstract

Context

Brown adipose tissue is of metabolic interest. The tissue is however poorly explored in children.

Methods

Sixty-three 7-year old subjects from the Swedish birth-cohort Halland Health and Growth Study were recruited. Care was taken to include both normal weight and overweight children, but the subjects were otherwise healthy. Only children born full term were included.

Water-fat separated whole-body MRI scans, anthropometric measurements, and measurements of fasting glucose and levels of energy homeostasis related hormones, including the insulin-sensitizer osteocalcin, were performed. The fat fraction (FF) and effective transverse relaxation time (T₂*) of suspected brown adipose tissue in the cervical-supraclavicular-axillary fat depot (sBAT) and the FFs of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) were measured. Volumes of sBAT, abdominal VAT and SAT, and thigh muscle volumes were measured.

Results

The FF in the sBAT depot was lower than in VAT and SAT for all children. In linear correlations including sex and age as explanatory variables, sBAT FF correlated positively with all measures of adiposity (p < 0.01), except for VAT FF and weight, positively with sBAT T₂* (p = 0.036), and negatively with osteocalcin (p = 0.017). When adding measures of adiposity as explanatory variables, sBAT FF also correlated negatively with thigh muscle volume (p < 0.01).

Conclusions

Whole-body water-fat MRI of children allows for measurements of sBAT. The FF of sBAT was lower than that of VAT and SAT, indicating presence of BAT. Future studies could confirm whether the observed correlations corresponds to a hormonally active BAT.

http://bit.ly/2SCVkmX

Plaque‐like myofibroblastic tumor, a rare entity of childhood: possible pitfalls in differential diagnosis

Plaque‐like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occuring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology and immunohistochemistry is necessary for the correct diagnosis.

This article is protected by copyright. All rights reserved.

http://bit.ly/2UNKFDq

Clinical Factors Associated with Cutaneous Histopathologic Findings in Dermatomyositis

Background

Common histopathologic findings in cutaneous dermatomyositis include vacuolar interface with dyskeratosis, mucin, and perivascular inflammation. Data examining the relationships between these and other histologic abnormalities, or their dependence on biopsy site, and medications is limited.

Methods

Using 228 dermatomyositis skin biopsies and statistical analyses including Chi‐squared analyses, calculations of relative risk, and adjusted GEE regressions we investigated relationships between 14 histopathologic findings and the impact of clinical factors on these findings.

Results

In biopsies taken from sites of visible rash interface dermatitis was seen in 91% and 95% had at least one of perivascular inflammation, mucin or basal vacuolization. Vascular abnormalities were not closely associated with epidermal or inflammatory findings. Concomitant prednisone significantly decreased the odds of basal vacuolization (OR 0.34, 95% CI 0.12‐0.98, p‐value = 0.05), perivascular inflammation (OR 0.19, 95% CI 0.07‐0.53, p‐value = 0.002) and vessel damage (OR 0.81, 95% CI 0.68‐0.96, p‐value = 0.02).

Conclusions

Vasculopathy and classic findings of interface dermatitis may be driven by unique pathways in dermatomyositis. Corticosteroid use may impact skin biopsy findings. There is a need for clinicopathologic correlation when diagnosing dermatomyositis.

This article is protected by copyright. All rights reserved.

http://bit.ly/2tbW3xf

Efficacy of mesotherapy with tranexamic acid and ascorbic acid with and without glutathione in treatment of melasma: A split face comparative trial

Abstract

Introduction

Melasma is a prevalent annoying skin hyperpigmentation disorder that commonly involves reproductive‐aged females. Variety of treatments with controversial results has been recommended. The aim of the current study was to evaluate combination therapy of tranexamic acid (TA) and vitamin C with and without glutathione with mesotherapy technique for treatment of melasma.

Methods and Materials

This is a randomized clinical trial study conducted on 30 patients referred to Dermatology Clinics. Patients were examined under wood lamp in order of melasma type (epidermal, dermal, or mixed) determination. Then, patients underwent melasma therapy using Cocktail A (TA 4 mg/mL; vitamin C 3% and glutathione 2%) on their right half of the face and Cocktail B (TA 4 mg/mL and vitamin C 3%) on their left half of the face, with mesotherapy technique. This procedure was done for six times with 2‐week intervals. Patients' modified Melasma Area and Severity Scoring (mMASI) was assessed at initiation and end of the study.

Results

According to mMASI score changes 12 weeks after intervention, both cocktails had significant efficacy in reduction of mMASI score in each side. Mean of mMASI in left side had decrease of 1.82 ± 0.88 (P‐value < 0.001) and in right side had decrease of 3.046 ± 1.25 (P‐value < 0.001) from base line. Comparison between two groups 12 weeks after treatment showed significantly more reduction (1.28 ± 0.64) of mMASI score with cocktail A than B (P‐value < 0.001). Erythema, edema, and ecchymosis was not significantly different among two cocktails (P‐value > 0.05).

Conclusion

Use of combination mesotherapy in treatment of melasma was accompanied with appropriate outcomes regardless of type of agents but treatment with glutathione containing cocktail A presented superior results compared with cocktail of TA and vitamin C but not glutathione.

http://bit.ly/2tfo4UG

Multiple pilomatrixomata as a presentation of myotonic dystrophy

Abstract

A 38‐year‐old male patient presented to our dermatology department for excision of an inflamed nodule in the right postauricular region (Figure 1). Histology showed proliferating basaloid cells undergoing matrical differentiation. Multiple ghost cells were seen with a foreign body‐type reaction in the stroma with numerous histiocytes including multiple multinucleated giant cells and dermal fibrosis (Figure 2). These findings were consistent with a pilomatrixoma.

This article is protected by copyright. All rights reserved.

http://bit.ly/2SnUYBB

CD8 resident memory T cells with IL‐17A‐producing potential are accumulated in disease‐naïve non‐lesional sites of psoriasis possibly in correlation with disease duration

Abstract

Human skin is populated by non‐recirculating resident memory T cells (T_RM) which are characterized by the expression of surface molecules such as CD49a, CD69 and CD103^1,2. In psoriasis, CD8 T_RM in lesional (L) and resolved skin demonstrate IL‐17‐skewed phenotype^3‐6. A skin‐grafted mouse model also proved the importance of CD8 T cells in disease initiation⁷.

This article is protected by copyright. All rights reserved.

http://bit.ly/2BrdONG

Association analysis within MHC region of psoriasis vulgaris accounting for familial history

Abstract

Psoriasis vulgaris (PsV) is the most common subtype of psoriasis which only involved the skin and without joint symptoms, and both environmental and genetic factors were involved in its etiology ¹. Some patients have familial genetic predisposition, more than 80 susceptibility genes/loci have been identified². Human leukocyte antigen system (HLA) has been identified to be significantly associated with psoriasis and explained vital part of the genetic factors in pathogenesis of psoriasis³.

This article is protected by copyright. All rights reserved.

http://bit.ly/2TDYqV5