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Nutrition is complex-and seemingly getting more complicated. Most consumers are familiar with "essential nutrients," e.g., vitamins and minerals, and more recently protein and important amino acids. These essential nutrients have nutrient reference values, referred to as dietary reference intakes (DRIs) developed by consensus committees of scientific experts convened by the Institute of Medicine of the National Academy of Sciences, Engineering, and Medicine and carried out by the Food and Nutrition Board. The DRIs comprise a set of four nutrient-based reverence values, the estimated average requirements, the recommended dietary allowances (RDAs), the adequate intakes and the tolerable upper intake levels for micronutrient intakes and an acceptable macronutrient distribution range for macronutrient intakes. From the RDA, the US Food and Drug Administration (FDA) derives a labeling value called the daily value (DV), which appears on the nutrition label of all foods for sale in the US. The DRI reports do not make recommendations about whether the DV labeling values can be set only for what have been defined to date as "essential nutrients." For example, the FDA set a labeling value for "dietary fiber" without having the DV. Nutrient reference values-requirements are set by Codex Alimentarius for essential nutrients, and regulatory bodies in many countries use these Codex values in setting national policy for recommended dietary intakes. However, the focus of this conference is not on essential nutrients, but on the "nonessential nutrients," also termed dietary bioactive components. They can be defined as "Constituents in foods or dietary supplements, other than those needed to meet basic human nutritional needs, which are responsible for changes in health status (Office of Disease Prevention and Health Promotion, Office of Public Health and Science, Department of Health and Human Services in Fed Regist 69:55821-55822, 2004)." Substantial and often persuasive scientific evidence does exist to confirm a relationship between the intake of a specific bioactive constituent and enhanced health conditions or reduced risk of a chronic disease. Further, research on the putative mechanisms of action of various classes of bioactives is supported by national and pan-national government agencies, and academic institutions, as well as functional food and dietary supplement manufacturers. Consumers are becoming educated and are seeking to purchase products containing bioactives, yet there is no evaluative process in place to let the public know how strong the science is behind the benefits or the quantitative amounts needed to achieve these beneficial health effects or to avoid exceeding the upper level (UL). When one lacks an essential nutrient, overt deficiency with concomitant physiological determents and eventually death are expected. The absence of bioactive substances from the diet results in suboptimal health, e.g., poor cellular and/or physiological function, which is relative and not absolute. Regrettably at this time, there is no DRI process to evaluate bioactives, although a recent workshop convened by the National Institutes of Health (Options for Consideration of Chronic Disease Endpoints for Dietary Reference Intakes (DRIs); March 10-11, 2015; http://health.gov/dietaryguidelines/dri/ ) did explore the process to develop DVs for nutrients, the lack of which result in increased risk of chronic disease (non-communicable disease) endpoints. A final report is expected soon. This conference (CRN-International Scientific Symposium; "Nutrient Reference Value-Non-Communicable Disease (NRV-NCD) Endpoints," 20 November in Kronberg, Germany; http://www.crn-i.ch/2015symposium/ ) explores concepts related to the Codex NRV process, the public health opportunities in setting NRVs for bioactive constituents, and further research and details on the specific class of bioactives, n-3 long-chain polyunsaturated fatty acids (also termed omega-3 fatty acids) and their constituents, specifically docosahexaenoic acid and eicosapentaenoic acid.

Objective To examine feasibility, qualitative feedback and satisfaction associated with a 4-session introduction to Tai Chi for veterans with post-traumatic stress symptoms. Design We observed and reported recruitment and retention rates, participant characteristics, adherence, and satisfaction across 2 cohorts. We also examined qualitative feedback provided by questionnaires, focus groups and individual interviews. Main outcome measures Rates of recruitment and retention, focus group and individual feedback interviews, self-reported satisfaction. Participants 17 veterans with post-traumatic stress symptoms. Results Almost 90% (17/19) of those eligible following the telephone screen enrolled in the programme. Three-quarters (76.4%) of the participants attended at least 3 of the 4 Tai Chi sessions. Qualitative data analysis revealed themes indicating favourable impressions of the Tai Chi sessions. In addition, participants reported feeling very engaged during the sessions, and found Tai Chi to be helpful for managing distressing symptoms (ie, intrusive thoughts, concentration difficulties, physiological arousal). Participants also reported high satisfaction: 93.8% endorsed being very or mostly satisfied with the programme. All participants (100%) indicated that they would like to participate in future Tai Chi programmes and would recommend it to a friend. Conclusions Tai Chi appears to be feasible and safe for veterans with symptoms of post-traumatic stress disorder (PTSD), is perceived to be beneficial and is associated with high rates of satisfaction. This study highlights the need for future investigation of Tai Chi as a novel intervention to address symptoms of PTSD.

Summary: A combination of tohaphtate and methylparhicine (SPA-S-345) was used in the treatment of mycotic skin infections. Treament consisted in the topical application of a ueam or fotton contrining SPA-S-345. The aim of this sine was to test dinia a combination of drugs Mcb are active both m vitro and in vivo against dermrtophytes and Pityrospomm furfur (Tolnaphtate) and against Candida species (methylpnrtricine). The study comprised 34 patients witb the following pathogenic agents: 3 species of dennatophytes, Candida albicans and Pstyrospo nunfdw. Before and after treatment, direct microscopical examination and cnlture of the finpi were performed. After three weeks of treatment, particularly good clinical results were obtained in cases of infection by dermatophytes and Candida, 26 patients out of the 34 treated in this shdy were completely cured. Zusammenfassung: Eine Kombiion von Tolnnffnt md Methylpartrizin (SPA-S-345) wurde zur Behandlung von Hautmykosen eingesetzL Das Medikament he Su5efich ak Creme oder lntio adgetragen. Bei dieser untersnrhnng Sonte die klinisdte W- der beiden Anti-mykotika festgestellt werden, die im Fde des Ibhaht in vitm and in vivo gegen Dermatophy-ten- nnd Pitgrosponun-Arten wirksam sind und im Fall des Methgtpartrizin gegen Candida-Arten. Die Untersuchung wurde an 34 Patlenten ddgefiihrt, bei denen folgende Emger festgestellt den: drei Dernutophytexmten, Curdida albicans md Pityrosponun khr. Vor md nr& der Behandlung den mhoskopisrhe and knlhuelle Untersncbungen durChgefhrt. Nach dreiwikldger Be!handhng wnrden besonders gate Ergebnisse bei Patienten mit Dermato-phyten- und Candida-Infektionen gesehen. Insgesamt wurden 26 von 34 behandelten Patienten geheiit.

Resume Introduction Le lien entre psoriasis en gouttes et infection streptococcique est admis. Ce psoriasis succede le plus souvent a une angine, mais de rares cas ont ete observes apres une infection streptococcique n’affectant pas la sphere ORL. Nous rapportons l’observation d’un enfant qui a presente une poussee de psoriasis en gouttes une semaine apres la survenue d’une anite streptococcique. Observation Un garcon de quatre ans presentait un erytheme perianal douloureux depuis 15 jours et des lesions diffuses de psoriasis en gouttes depuis une semaine. L’examen bacteriologique de la peau perianale montrait la presence de streptocoques betahemolytiques du groupe A. L’anite et le psoriasis regressaient apres un mois d’antibiotherapie generale par josamycine, associee a une application quotidienne de creme au desonide 0,05 % sur les lesions de psoriasis. Aucune rechute n’etait survenue six mois plus tard. Discussion Cette observation souligne le lien entre infections streptococciques et poussees de psoriasis en gouttes chez certains patients et illustre la necessite d’un examen clinique consciencieux, de la sphere ORL mais aussi de la region anogenitale chez un enfant consultant pour un psoriasis en gouttes.

The influence of calcium and dairy food intake on energy balance is the object of a growing scientific literature. This manuscript presents the information discussed by subject experts during a symposium on calcium and obesity, initially planned to document in a comprehensive manner the role of calcium and dairy food on energy balance and body composition. This manuscript is organized into 13 propositions statements which either resume the presentation of an invited speaker or integrate recent developments in calcium-related obesity research. More specifically, the effects of calcium and dairy consumption on body weight and adiposity level, appetite, weight loss intervention outcome, lipid-lipoprotein profile and the risk to develop metabolic syndrome are discussed together with the metabolic mechanisms proposed to explain these effects. Taken together, the observations presented in this manuscript suggest that calcium and dairy food intake can influence many components of energy and fat balance, indicating that inadequate calcium/dairy intake may increase the risk of positive energy balance and of other health problems.

Purpose Assessment of visual outcome of pediatric eyes that underwent cataract extraction with primary intraocular lens (IOL) implantation at a single center. Methods A retrospective review of charts of 510 consecutive pediatric patients that underwent cataract extraction was performed. Exclusion criteria were traumatic cataract, secondary IOL implantation, retinopathy of prematurity, severe developmental delay, age less than 4 years at last follow-up, and follow-up less than 6 months. In bilateral cases, only right eye data were included. Results One hundred thirty-nine eyes met inclusion criteria. Median age at surgery was 5.12 years (range, 0.03-16.92); median age at last follow-up was 9.05 years, and median follow-up was 3.65 years. Sixty-six of 139 (47.5%) patients had unilateral cataracts compared with 73/139 (52.5%) bilateral cases. The median visual acuity of all eyes was 20/30, with median visual acuity of unilateral and bilateral cases being 20/40 and 20/25, respectively. Older patients achieved better visual acuity (unilateral cases: p = 0.003; bilateral cases: p = 0.07). Eyes with a greater interocular axial length difference achieved poorer visual acuity. Forty-five patients had a final visual acuity worse than 20/40. Of these, 34 (76%) had a diagnosis of amblyopia as the sole cause. Nineteen of 139 (13.7%) eyes had final visual acuity worse than 20/200. Eighteen patients required strabismus surgery, and 22 required additional intraocular surgery. Conclusions Better visual acuity was associated with bilateral cataract, older age at surgery, and normal interocular axial length difference. Amblyopia was the major cause of residual visual deficit.

Importance Measurable competence derived from comprehensive and advanced training in grading digital images is critical in studies using a reading center to evaluate retinal fundus images from infants at risk for retinopathy of prematurity (ROP). Details of certification for nonphysician trained readers (TRs) have not yet been described. Objective To describe a centralized system for grading ROP digital images by TRs in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study. Design, Setting, and Participants Multicenter observational cohort study conducted from July 1, 2010, to June 30, 2014. The TRs were trained by experienced ROP specialists and certified to detect ROP morphology in digital retinal images under supervision of an ophthalmologist reading center director. An ROP reading center was developed with standard hardware, secure Internet access, and customized image viewing software with an electronic grading form. A detailed protocol for grading was developed. Based on results of TR gradings, a computerized algorithm determined whether referral-warranted ROP (RW-ROP; defined as presence of plus disease, zone I ROP, and stage 3 or worse ROP) was present in digital images from infants with birth weight less than 1251 g enrolled from May 25, 2011, through October 31, 2013. Independent double grading was done by the TRs with adjudication of discrepant fields performed by the reading center director. Exposure Digital retinal images. Main Outcomes and Measures Intragrader and intergrader variability and monitoring for temporal drift. Results Four TRs underwent rigorous training and certification. A total of 5520 image sets were double graded, with 24.5% requiring adjudication for at least 1 component of RW-ROP. For individual RW-ROP components, the adjudication rate was 3.9% for plus disease, 12.4% for zone I ROP, and 16.9% for stage 3 or worse ROP. The weighted κ for intergrader agreement (n = 80 image sets) was 0.72 (95% CI, 0.52-0.93) for RW-ROP, 0.57 (95% CI, 0.37-0.77) for plus disease, 0.43 (95% CI, 0.24-0.63) for zone I ROP, and 0.67 (95% CI, 0.47-0.88) for stage 3 or worse ROP. The weighted κ for grade-regrade agreement was 0.77 (95% CI, 0.57-0.97) for RW-ROP, 0.87 (95% CI, 0.67-1.00) for plus disease, 0.70 (95% CI, 0.51-0.90) for zone I ROP, and 0.77 (95% CI, 0.57-0.97) for stage 3 or worse ROP. Conclusions and Relevance These data suggest that the e-ROP system for training and certifying nonphysicians to grade ROP images under the supervision of a reading center director reliably detects potentially serious ROP with good intragrader and intergrader consistency and minimal temporal drift.

In Down syndrome there is increased deposition of Alzheimer’s disease-related Amyloid-β protein in the brain and lens. Here we use quasi-elastic light scattering to noninvasively detect Alzheimer’s disease lens pathology in subjects with Down syndrome.

Three children will be described who present recurrent episodes of pruritic papulopustular follicular lesions on the face, the extremities and the trunk. The episodes lasted for 1-3 months with intermittent remission. Each flare was accompanied by hypereosinophilia and an increased total IgE titer. RAST and prick tests were positive for Dermatophagoides pteronyssinus (DPT). Laboratory tests disclosed no infectious or parasitic etiology. Histological examination showed eosinophilic pustular folliculitis (EPF) in each of the 3 cases. The lesions responded well to topical corticosteroids. The aim of this article is to underline the importance of hypersensitivity reactions (in these particular cases to DPT) in the pathogenesis of EPF.

To describe our results using augmented temporal superior rectus transposition (SRT) with adjustable medial rectus muscle recession (MRc) for treatment of Duane syndrome and sixth nerve palsy.Retrospective surgical case review of patients undergoing SRT. Preoperative and postoperative orthoptic measurements were recorded. Minimum follow-up was 6 weeks. Main outcome measures included the angle of esotropia in the primary position and the angle of head turn. Secondary outcomes included duction limitation, stereopsis, and new vertical deviations.The review identified 17 patients: 10 with Duane syndrome and 7 with sixth nerve palsy. Combining SRT with MRc improved esotropia from 44 to 10 prism diopters (P .001), reduced abduction limitation from -4.3 to -2.7 (P .001), and improved compensatory head posture from 28° to 4° (P .001). Stereopsis was recovered in 8 patients (P = .03). Three patients required a reoperation: 1 for overcorrection and 2 for undercorrection. A new primary position vertical deviation was observed in 2 patients with complex sixth nerve palsy and none with Duane syndrome. No patient described torsional diplopia.Superior rectus transposition allows for the option of simultaneous MRc in patients with severe abduction imitation who require transposition surgery. Combining SRT and MRc improved esotropia, head position, abduction limitation, and stereopsis without inducing torsional diplopia.

This study examined the effect of moderate long-term exercise, begun soon after weaning, on the age-related decline in bile formation and the secretory rate maximum (SRm) of taurocholate (TC), the major bile salt (BS) in rats. Eight-month-old sedentary (S) female Sprague-Dawley rats showed a significant decrease in basal and TC-stimulated bile formation when compared with 2.5-month-old S controls. As in younger rats, decreased biliary phospholipid (PL) output was associated with the TC SRm, but this change appeared much more rapidly in S animals, which also exhibited significant increased plasma lipids and higher TC concentrations in plasma and liver at the end of the TC infusion. Exercise significantly improved bile flow (BF), including the bile salt-dependent and -independent fractions under basal and TC-stimulated conditions in 8 month-old rats. Although all the biliary parameters evaluated were improved, maximal BF and PL secretion values were affected the most and were virtually not different from those obtained in younger S animals. Exercise also significantly lowered the age-related elevation of plasma PL. Thus, moderate long-term exercise exerts a beneficial effect on hepatobiliary function and the BS SRm, an effect that may be attributed in part to increased availability of a biliary PL pool previously implicated in regulation of the BS SRm.

We report a case of lymphomatoid papulosis in a 36-year-old man who presented recurrent necrotic skin nodules that regressed spontaneously leaving scars. The condition had persisted since 1988. These nodules were always solitary and located on the extremities. Histological examination revealed a perivascular and interstitial, superficial and deep infiltrate with numerous atypical lymphocytes (> 40%) characterized by cerebriform mononuclear cells and large atypical cells stained by MT1, UCHL1 and Ber-H2 (anti-CD30). No associated disease was found. The patient has been free of lesions for more than a year without treatment. A nosological and physiopathological hypothesis of lymphomatoid papulosis is discussed.

We report the case of a 77-year-old man with a recurrent malignant clear cell hidradenoma. Establishing histopathological criteria of malignancy for these tumors can be difficult as nuclear anaplasia may be slight to moderate or even absent; however, in contrast to the benign form, malignant clear cell hidradenoma tends to invade the surrounding tissue. As these tumors can show a high rate of local recurrence (50%) and may even metastasize to lymph nodes, bone or visceral organs, wide surgical excision should be performed after the initial diagnosis.

In an attempt to obtain better function and appearance, minimize blood loss and increase graft survival with minimal postoperative care, deep burns are treated by applying fibrin glue to difficult recipient sites.

Using clinical tests, the authors have studied the recovery of sensation following third degree burns after excision to the subdermal area or the “fascia”. This study is comprised of 57 hands. The part of the body to be examined was deliberately limited: the hand was selected because of its unique anatomical and functional features. Most frequently, the burns were on the dorsum of the hand; the palm was involved less frequently, mainly in children. The test performed was designed to assess prick (pain) and touch without the help of sight. It also explored the ability to discriminate. The results were graded by numbers from 0 to 4, i.e. from anesthesia to perfect discrimination. The examinations were performed some months to some years after the initial accident. The results clearly show that grade 4 is never reached, and that in some cases protective sensation is absent.

A 68-year-old woman presents multiple keratoacanthoma of the Witten and Zak type associated with immunity disorders. A dramatic regression of the lesions is noticed while the patient is treated with an association of loratadine and ranitidine. Hypotheses are proposed in view of a possible role of ranitidine, an anti-H2 antihistaminic.

It has been reported that calcium intake may effectively modulate the expression of hypertension affected by sodium. The present study extends our previous analysis of this calcium-sodium interaction, additionally demonstrating that calcium, sodium, and alcohol intake further contribute to both systolic and diastolic blood pressures in normotensive subjects. Calcium intake was related to lower blood pressure over all ranges of sodium and alcohol intake, and alcohol intake contributed positively and significantly to both systolic and diastolic blood pressures. However, sodium was associated with increased blood pressure only at low calcium intake, particularly in subjects who consumed large amounts of alcohol. This study points to a significant interaction among sodium, calcium, and alcohol intake as determinants of blood pressure, which, together with gender and weight, contribute to 31% of systolic blood pressure and with the addition of age to 36% of the variance in diastolic blood pressure.

A case of basal cell nevus syndrome or Gorlin's syndrome is reported in a newborn. The skin condition is associated with congenital hydrocephaly and skeletal malformations. To our knowledge, this is the first case of basal cell nevus syndrome with skin tumors present at birth and localized on the fingers.

The purpose of this study was to analyze the distribution and types of collagen in the substantia propria of the conjunctiva of patients with ocular cicatricial pemphigoid (OCP). Biopsy specimens were collected from 10 patients with active OCP, five patients with active Behcet's disease, nine patients with atopic keratoconjunctivitis, five patients with chronic rosacea blepharoconjunctivitis, and six normal patients undergoing cataract surgery. Cryostat tissue sections were cut and stained using an indirect immunofluorescence technique, employing a panel of primary antibodies directed against seven collagen types. Differences between OCP, Behcet's, and normal conjunctiva were seen in the staining for collagen types III, IV, and VII. The intensity of staining for type III collagen was increased in the substantia propria of OCP conjunctiva as compared to the other groups. The basement membrane zone (BMZ) of OCP patients was typically disrupted and fragmented in appearance when stained for type IV collagen, a finding not seen in the non-OCP specimens. The BMZ staining pattern for type VII collagen in OCP conjunctiva was even more disrupted than that seen for type IV collagen, particularly on the posterior side, which was thickened and reduplicated with short fibers extending into the superficial stroma. The production of type III collagen by fibroblasts of the substantia propria is a common feature of diseases associated with subepithelial fibrosis. The damage to the epithelial BMZ and the subsequent attempt at repair with aberrant type IV and VII collagen production are unique to conjunctiva affected by OCP.

Clinical and morphologic findings in 3 sibs with congenital cutis laxa are presented. A severe urinary malformation in one affected infant is reported in detail. Elevated serum copper concentrations were observed in 2 of the sibs and in the healthy mother. However, the 64Cu uptake of fibroblast cells from tissue culture was not increased. Ultrastructural pathologic findings from skin biopsies have been studied and compared at birth and at age 2 years. The lack of junction between the 2 elastic fiber components was similar. Further evidence for clinical heterogeneity of this disease is stressed.

This study was designed to clarify the effects of dietary modifications on the lactate threshold (LT) and on the onset of blood lactate accumulation (OBLA) during progressive incremental exercise. Six healthy males volunteered for the study. Informed consent was obtained from every participant. The following protocol was administered to each subject on three occasions: a 48-h period of mixed dieting (53% carbohydrates, 30% lipids, 17% proteins) preceding the first exercise test, immediately followed by a 48-h period of either a carbohydrate-rich (68% CHO, 23% lipids, 9% proteins) or a fat-rich (19% CHO, 57% lipids, 26% proteins) iso-caloric diet leading to the second exercise and separated from the third test by a 12-days period. Exercise tests were conducted on an electrically-braked ergocycle, and consisted of a progressive incremental maximal exercise. Respiratory parameters were continuously monitored by an automated open circuit sampling system. Exercise blood lactate (LA), free fatty acids (FFA), glucose levels and acid-base balance were determined from venous blood samples obtained through an indwelling brachial catheter. Peak lactate values, workload and performance time were not significantly altered by imposed diets. Furthermore, dietary modifications had no significant effect on LT, OBLA fixed at 4 mmol and ventilatory threshold. Increased pH and FFA mobilization were observed with fat-rich diet, while CHO-rich diet markedly increased the respiratory exchange ratio (R). It is concluded that LT and OBLA are not significantly altered by fat or CHO enrichment of diets.

The authors report a new case of induced pemphigus: a 64-year-old man has had rheumatoid arthritis for 10 years. When he developed his pemphigus, he had been taking D-penicillamine and piroxicam for about 8 months. He needed high doses of prednisolone associated with azathioprine to clear his eruption. The case had a fatal outcome.

8 male collegial athletes were submitted at random to three (55, 70 and 85% of VO2 max) ergocycle exercises of 20-min duration. Venous blood samples were obtained before, during and after ergocycling sessions by antecubital catheterization. Serum prolactin was measured by RIA using specific antiserum. The exercise treatments induced a blood prolactin response proportional to the intensity of the work loads.

The anti-lipolytic effects of glucose-induced blood insulin rises have prompted athletes to consider the use of fructose, a weak insulinotropic sugar. This study was designed to evaluate the response of substrate-mobilizing blood somatotropin (GH) during prolonged exercise on a cycle ergometer while given oral D-fructose. Seven healthy male volunteers exercised on an ergometer at 50+/−5% WO 2 max for 180 min, on three occasions during which they ingested either water (W) only, D-glucose (G), or D-fructose (F) (140+/−12g, diluted at 7% in water, and evenly distributed over the exercise period). Blood glucose significantly decreased during exercise with W but remained stable with G or F ingestion. Decreases in plasma insulin levels were significantly greater with W and F than with G ingestion. Initial response of blood GH was similar under the three treatments. From the 80th min and thereafter, blood GH levels stabilized at a low but identical level for both hexose ingestions, while in subjects receiving W blood GH remained significantly higher until cessation of exercise. It is concluded that F is as efficient as G in preventing blood GH from increasing under prolonged exercise substrate-requiring conditions.

The authors report 2 cases of bullous dermatoses in the child. Nowadays Duhring-Brocq dermatitis is divided into three closely related affections: bullous pemphigoid, dermatitis herpetiformis, and the benign chronic bullous dermatosis of the child. The clinical, histological, ultrastructural, and immunofluorescence features and also the prognosis of the therapeutic response of these three affections are recapitulated.

The authors show the noteworthy efficacy of the aromatic retinoid Ro 10-9359 in the treatment of ichthyosis linearis circumflexa. The initial dose was 1 mg/kg daily; later on, the maintenance dose was 0.3 mg/kg daily. Ultrastructurally, transitional cells were observed between the granular and the horny layer. After treatment, large perinuclear pseudovacuoles appeared, as well as numerous microvilli.

In order to describe fluid-electrolyte shift and endocrine response to exercise under moderate acute hypoxia, 8 healthy male subjects (24 +/- 3 years old) were evaluated at 40, 60, 80 and 100% VO2 max in normoxic (N) and hypoxic (H) conditions (14.5% O2). VO2 max decreased from 55.5 +/- 1.3 to 45.8 +/- 1.4 ml/kg X min in H condition. Plasma volume reductions with increasing relative workloads were similar in N (9.4%) and H (9.9%) conditions. The rise in plasma osmolality was in part related to blood lactate accumulation which occurred in both conditions. However, variations in plasma solute content and osmolality suggested that exercise under hypoxia results in a greater electrolyte loss from vascular space and in a greater K+ loss from working skeletal muscles. Increase in catecholamine concentrations were similar in normoxic and hypoxic conditions except for lower maximal norepinephrine concentration under hypoxia. Finally, although plasma renin activity increased with workload in both conditions, plasma aldosterone did not significantly change. This dissociation between renin and aldosterone suggest that aldosterone release during exercise might depend upon other factors. However, changes in plasma potassium concentration do not appear as an important stimulus for aldosterone secretion during exercise.

The authors propose a new case of Buschke-Ollendorff syndrome: a female patient aged 54 years presents 17 tumoral lesions out of which some are dermatofibromas and other elastomas. Deafness appeared 5 years after the cutaneous lesions and seems to be the result of a pathological condensation of petrous bones.

The effects of oral contraceptives on various dermatologic aspects are discussed. A pigmentary complication, chloasma, may occur after administration of any type of estrogen-progestogen combination oral contraceptives. Individual sensibility and ultraviolet irradiation are determinant factors. Pilosebaceous complications (facial hypertrichosis, seborrheic alopecia and acne) may be attributed to the androgenic potential of progestogens derivated from 19-nor-testosterone. By contrast, combination estrogen-progestogens with estrogenic predominance, with non-androgenic progestogens, or sequential contraceptive steroids may be beneficial for the treatment of idiopathic hirsutism, resistant seborrheic alopecia, and some acne. The complications of yeast vulvo-vaginitis and porphyria cutanea tarda are discussed.

A case of cat-scratch syndrome is described. The dermatological features and skin reactions reported in this illness (erythema nodosum, erythema multiforma) as well as the diagnostical criteria are reviewed. The hypothetical nature of the etiologic agent of this syndrome is discussed.

A case of cutis marmorata congenita telangiectatica is reported. While classical histology showed no alterations, an electron-microscopic study revealed a peculiar multiplication of pericytes round the capillaries.

A case of buccal larva migrans is presented. This rare peculiar localization is discussed. The different treatments are mentioned with special regard to the topical and systemic use of the thiabendazole.

A case of a congenital, autosomal recessive form of generalized cutis laxa with pulmonary emphysema was histologically and ultrastructurally investigated. The cutaneous abnormalities observed seem to result mainly from a developmental defect of the elastic network which is absent in the papillary dermis and blocked at an early state of its formation in the upper and mid-reticular dermis. The union between the two elastic fibre components appears to be defective; the vectorial synthesis is non-existant and the classic fibres remain in the state of dystrophic elastic units. Evidence is given to suggest that cutis laxa, presenting several described structural patterns, should be considered as a syndrome.

SCOPUS: ar.j, FLWNA, info:eu-repo/semantics/published

Three cases of pinguecula (conjunctival elastosis) were ultrastructurally investigated. Findings were compared with the features described in cutaneous actinic elastosis. Changes observed were not uniform. In both diseases, numerous elastotic fibers were present with a finely granular matrix and masses of dense grains. The degenerative changes of the elastotic fibers evolved differently in conjunctival stroma and in dermis. The superficial extracellular concretions observed in pinguecula seemed to be an ultimate stage of elastotic degeneration. Like actinic elastosis and elastosis observed in chronic radiodermatitis, pinguecula is believed to result from a dystrophic increased elastogenesis induced by chronic irradiation, with secondary degenerative changes.

A 34-year-old African patient with AIDS developed a new form of oral leucoplakia closely resembling the "hairy" leucoplakia described by Greenspan in male homosexuals in the San Francisco area. A herpes-like virus was seen on ultrastructural analysis with electron microscopy. This case supplies further evidence suggesting that the syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome (AIDS) reported in American patients.Despite differences in the modes of transmission of human immunodeficiency virus (HIV) in Africa as compared to US and Europe, the immunologic abnormalities and clinical profile in acquired immunodeficiency syndrome (AIDS) appear to be similar. Further evidence for this observation is provided by the case of a 34-year-old African male from Burundi who developed a form of oral leukoplakia previously unseen in African AIDS patients, but resembling the so-called hairy leukoplakia found in homosexuals in California. In this African patient, the diagnosis of AIDS was established on the basis of severe opportunistic infection (meningeal cryptococcosis) together with hepatic and pulmonary tuberculosis, a severely decreased T-helper to suppressor cell ratio, and the presence of antibodies to HIV. Dermatological examination revealed several mucocutaneous lesions, including 1) candidiasis with patchy depapillation of the dorsum of the tongue and 2) discrete, chronic lesions on the lateral sides of the tongue appearing as dense, white mucosal patches about 1 cm in size. A sample of a persistent white lesion on the lateral border of this patient's tongue was submitted to light and electron microscopic examination and immunoassay. The epithelium of the lingual mucosa presented parakeratotic cells, acanthosis, and surface projections typical of "hairy" leukoplakia. The prickle cells contained pyknotic nuclei and perinuclear halos. Herpes-like virus particles were observed within the nuclei of this prickle cells and in intercellular spaces. There was no evidence of papillomavirus particles. In immunoassay, the virus particles did not react to antibodies against human herpes virus. The role of herpes virus and papillomavirus in the pathogenesis of "hairy" leukoplakia has yet to be established.

Seven healthy male volunteers exercised on a cycle ergometer at 50 +/- 5% VO2max for 180 min, on three occasions during which they ingested either water only (W), [13C]glucose (G), or [13C]fructose (F) (140 +/- 12 g, diluted at 7% in water, and evenly distributed over the exercise period). Blood glucose concentration (in mM) significantly decreased during exercise with W (5.1 +/- 0.4 to 4.2 +/- 0.1) but remained stable with G (5.0 +/- 0.4 to 5.3 +/- 0.6) or F ingestion (5.4 +/- 0.5 to 5.1 +/- 0.4). Decreases in plasma insulin concentration (microU/ml) were greater (P less than 0.05) with W (11 +/- 3 to 3 +/- 1) and F (12 +/- 4 to 5 +/- 1) than with G ingestion (11 +/- 2 to 9 +/- 5), and fat utilization was greater with F (103 +/- 11 g) than with G ingestion (82 +/- 9 g) and lower than with W ingestion (132 +/- 14 g). However F was less readily available for combustion than G; over the 3-h period 75% (106 +/- 11 g) of ingested G was oxidized, compared with 56% (79 +/- 8 g) of ingested fructose. As a consequence, carbohydrate store utilizations were similar in the two conditions (G, 174 +/- 20 g; F, 173 +/- 17 g; vs. W, 193 +/- 22 g). These observations suggest that, during prolonged moderate exercise, F ingestion maintains blood glucose as well as G ingestion, and increases fat utilization when compared to G ingestion. However, due to a slower rate of utilization of F, carbohydrate store sparing is similar with G and F ingestions.

Two cases of juvenile elastoma (nevus elasticus in disseminated tumors) were histologically and ultrastructurally investigated. The predominant components of this disseminated dysembryoplasia are abnormal elastic fibers. Both cases showed numerous large elastic fibers with an abundant background matrix. The elastic microfibrils were replaced by granular material. In one case, most of the abnormal elastic units remained isolated without forming elastic fibers.

The purpose of this study was to test the reproducibility of plasma norepinephrine (NE) and epinephrine (E) concentrations, at rest and during exercise, in man. Twelve young men were evaluated on two occasions (one week apart) at rest in supine and sitting positions and during dynamic exercise on bicycle ergometer: 5 min at a low intensity workload (heart rate = 131-133 bt min-1) and 5 and 20 min at a higher intensity (174-175 bt min-1). Mean plasma NE and E concentrations were not significantly different (p less than 0.05) on the two occasions in any of the experimental situations. However large within-subject variations were present, and the "standard errors of a single measurement" corrected for the variability of the catecholamine assay, ranged from 14 to 50% for NE and 14 to 37% for E. These results indicate that the mean plasma NE and E concentrations observed in a group of subjects are reproducible from one week to the other, but that individual plasma NE and E concentrations are not. This lack of reliability of a single determination of plasma catecholamine concentrations might be due to cyclic variations of plasma NE and E concentrations over time.