Search

Human mesenchymal stem cells (hMSCs) have tremendous potential in regenerative medicine, making it desirable to cryopreserve and bank them to increase their access and availability.This research is part of a clinical trial performed on six patients that aimed to use advanced therapy medicinal products (ATMPs) based on hMSCs in patients undergoing repeated total hip replacement.To compare the characteristics of fresh and frozen hMSCs, we used the trypan blue exclusion test (cell viability), flow cytometry (cell viability and phenotyping), sterility determinations and the clonogenic assay of cell proliferation.Cryopreserved hMSCs showed good quality parameters after thawing in comparison with fresh hMSCs in suspension. When using a medium containing dimethyl sulfoxide (DMSO), the viability was higher than 90% in all cases. The cell purity determined by flow cytometry was also acceptable.These initial results show that the prepared cryopreserved ATMP exhibited good viability and phenotype characteristics.

Nonstationary signals are naturally found and exploited in various applications, such as radar, sonar, radio astronomy, seismology, and electroencephalogram (EEG) [1]–[6]. Time-frequency (TF) analysis of nonstationary signals is a key enabling technology for radar-based human-machine interface through gesture recognition using hands and arms [7], [8]. Many nonstationary signals can be described as frequency modulated (FM) signals and characterized by their time-varying instantaneous frequencies (IFs). Compared to single-domain signal representations with respect to either time or frequency, joint TF-domain representations are better suited for the analyses and classification of such signals as they provide a time-varying spectrum [1], [2].

Unmet medical needs are not infrequent in oncology, and these needs are usually of higher magnitude in rare cancers. The field of neuroendocrine neoplasms (NENs) has evolved rapidly during the last decade, and, currently, a new WHO classification is being implemented and several treatment options are available in the metastatic setting after the results of prospective phase III clinical trials. However, several questions are still unanswered, and decisions in our daily clinical practice should be made with limited evidence. In the 2016 meeting of the advisory board of the European Neuroendocrine Tumor Society (ENETS), the main unmet medical needs in the metastatic NENs setting were deeply discussed, and several proposals to try to solve them are presented in this article, including biomarkers, imaging, and therapy.

BACKGROUND: Fluoroquinolones are frequently used in hospital for many indications. However, overuse or incorrect utilisation may cause resistance to these antibiotics. Furthermore, we had to analyse the consequences of a recently ofloxacine suppression from our hospital antibiotic list. PURPOSE: We wanted to know the level of relevance of fluoroquinolone prescription including: indication, fluoroquinolone molecule choice, dosage (including CKD-EPI based dose reduction), duration, route, eventual association, compliance with the antibiogram, drug interaction and catch of fluoroquinolone from 6 months before. MATERIAL AND METHODS: We carried out a 3 month transversal retrospective study. Between February and April 2017 each nominal prescription of fluoroquinolone was included using our pharmacy validation software. All services were included except intensives care units and emergencies. Then an intern in the pharmacy processed analyses of the relevance of the previous parameters with the help of senior infectious disease staff. The reference guideline used for relevance and analysis was the 2015 French Spoken Infectious Diseases Society (SPILF) recommendations. RESULTS: Two hundred and six patients were included. The most recovered fluoroquinolone was levofloxacine 47.1% (95% CI: 40.3 to 53. 9). The average duration of treatment was 12 days (95% CI: 10.3 to 13.6). The most used route was oral 81.7% (95% CI: 76.2 to 87.2). In a large majority of fluoroquinolone prescription was probabilistic 60% (95% CI: 53.4 to 67.7). Analysis of relevance showed that indication was respected in 84.7% (95% CI: 79.5 to 89.8) of cases. The association of correct duration, dosage, molecule used and route was observed in 63.7% (95% CI: 53.8 to 73.6). 70.8% (95% CI: 58 to 83.7) of renal insufficiency patients (CKD-EPI

Resume Introduction Les principales manifestations de la syphilis sont cutanees et muqueuses. Toutefois, il s’agit d’une maladie pouvant entrainer des atteintes multiviscerales. L’objectif de ce travail etait de decrire les atteintes extra-cutaneomuqueuses rencontrees chez des malades atteints de syphilis secondaire. Malades et methodes Etude observationnelle monocentrique des malades chez qui une syphilis a ete diagnostiquee entre janvier 2000 et decembre 2006. Au sein de cette cohorte, nous nous sommes interesses aux patients ayant une syphilis secondaire avec presence de signes cliniques cutanes ou muqueux typiques et un titre de VDRL superieur ou egal a un quart au moment de l’inclusion (ou une augmentation d’un facteur 4 en presence d’un VDRL anterieur dans le dossier). Resultats Quatre-vingts episodes de syphilis secondaire ont ete observes chez 77 malades, dont 50 episodes chez des sujets seropositifs pour le VIH. Vingt-et-un malades (26,3 %) ont presente un point d’appel neurologique (cephalees, signes ophtalmiques ou otorhinolaryngologiques) amenant a mettre en evidence trois (3,8 %) uveites, quatre (5 %) papillites, deux (2,5 %) retinites, une (1,25 %) otosyphilis confirmee par l’examen ORL. Quatorze de ces 21 malades (67 %) ont eu une ponction lombaire, confirmant six neurosyphilis certaines et un probable. Trois malades (3,8 %) ont eu des episodes de diarrhee, quatre (5 %) des episodes de douleur abdominale, six (7,5 %) une hepatomegalie, sept (11,5 %) des ALAT superieur a deux fois la normale et deux (3,3 %) des ALAT superieur a dix fois la normale. Trois patients (3,8 %) ont fait part de douleurs osseuses, dont un (1,25 %) osteite confirmee par une scintigraphie osseuse au gallium et au technetium (osteolyse). Conclusion Les localisations extra-cutaneomuqueuses de la syphilis meritent d’etre recherchees systematiquement, compte tenu de leur gravite potentielle, afin d’adapter le suivi et le traitement de la maladie, notamment dans les formes neurologiques.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can be exacerbated by exposure to ultraviolet radiation (UVR). The number and phenotype of antigen presenting cells in the skin play a role in cutaneous immune response generation. Although antimalarials are widely used in SLE treatment, their mode of action is not completely elucidated. The aim of our study was to determine the effect of chloroquine treatment on HLA-DR+ and CD1a+ cell number in locally irradiated (three minimal erythema doses of UVB) and normal appearing skin in SLE patients and healthy subjects. A significantly higher number of HLA-DR+ and CD1a+ cells were found in both locations in SLE patients compared with controls. Following three months of daily chloroquine treatment (250 mg), the HLA-DR+ and CD1a+ cell counts were significantly reduced in both irradiated and unirradiated sites of SLE patients, although still higher than in controls. Chloroquine treatment reduces the number of antigen presenting cells in the skin of SLE patients, and this effect may explain the antimalarials beneficial immunoregulatory and anti-inflammatory properties.

Tumor-to-tumor metastasis is a very rare event. We report three cases of tumor metastasizing in a clear cell renal cell carcinoma: two breast carcinomas and a sigmoid carcinoma. So we objectified a prevalence of 1.5% of renal tumors in our series. It's a rare situation but to be considered in daily practice because it changes oncological management offered to the patient. According to the literature, clear cell renal cell carcinoma is the most common tumor recipient of metastasis. Several physiopathological mechanisms can explain this phenomenon, but many of them are still unknown. A better understanding of this phenomenon makes it possible to improve the diagnosis and thus the management of patients with several cancers.

The combined effects of extracts containing carotenoids and vitamins E and C on growth and pigmentation of cultured human melanocytes.Smit N, Vicanova J, Cramers P, Vrolijk H, Pavel S.Department of Clinical Chemistry, Leiden University Medical Centre, Leiden, The Netherlands. N.Smit@lumc.nlIn the present study, we investigated the effects of tomato extract (TE) containing lycopene and palm fruit extract (PE) rich in carotenoids on the growth and pigmentation of melanocyte cultures of Caucasian origin. The extracts were tested at different concentrations and in combination with vitamins E and C. Melanocytes with basic and increased (tyrosine-induced) pigmentation were treated in short-term and long-term experiments. Prevention of UVA-induced DNA damage was studied by using the comet assay. Melanocytes with stimulated melanin production showed reduced growth. Incubation of the cells with TE/PE (20/4 microg/ml) in combination with 35 microM vitamin E and 100 microM vitamin C (COMB 20/4) reduced this growth inhibition, especially in the long-term cultures. Increased production of melanin pigment was obtained when the cells were treated with 2.5 x and 10 x higher concentrations of the TE/PE and the same concentration of vitamins E and C (COMB 50/10 and 200/40). Reduced DNA damage was found after UVA irradiation in cells preincubated with COMB 50/10. The results indicate that the presence of carotenoids from TE and PE in combination with vitamins E and C may influence growth and pigmentation in melanocyte monocultures. Depending on the concentration of the carotenoid mixtures, their presence may provide some protection against the melanogenic intermediates and/or exogenous DNA damage. 2004 S. Karger AG, Basel

Introduction Alors que les infections systemiques a mycobacteries atypiques ( Mycobacterium avium complex MAC en particulier) sont devenues plus rares dans la pathologie VIH, nous rapportons une observation de mycobacteriose atypique mimant histologiquement une maladie de Whipple et qui s’est compliquee d’hypercalcemie et d’insuffisance renale resolutives. Observation Une femme de 32 ans est hospitalisee en janvier 2016 pour exantheme maculo-papuleux febrile et douleurs abdominales. Cette patiente est seropositive pour le VIH depuis 2002 et non observante (CD4 a 80/mm 3 et charge virale VIH a 5 520 000 copies). L’eruption cutanee disparait sans diagnostic dermatologique. Par contre, la fievre et les douleurs abdominales persistent tandis qu’un syndrome inflammatoire s’installe, accompagne de sueurs nocturnes et de selles liquides. La coproculture et l’examen parasitologique des selles sont negatifs. Le scanner thoraco-abdomino-pelvien montre une hepatosplenomegalie homogene moderee, des adenomegalies mesenteriques non necrotiques et une stase liquidienne du grele. Sur les biopsies duodenales, le chorion est infiltre par des macrophages PAS+ avec bâtonnets prenant la coloration de Ziehl. Parallelement, un tubage gastrique et une expectoration montrent la presence de BAAR (PCR BK negative). Une quadritherapie anti-VIH est reintroduite associee a un traitement antibiotique a spectre large actif sur les mycobacteries. Les PCR Whipple sont negatives dans le sang, les selles et la salive. Alors que la patiente devient apyretique et que la semiologie abdominale regresse, une hypercalcemie (calcemie corrigee a 3,62 mmol/L) et une insuffisance renale organique (DFG a 39 mL/min) surviennent. La 25OHD3 est abaissee a 15,3 ng/mL, l’angiotensine convertase serique est tres augmentee a 131 U/L. Grâce a une hydratation intraveineuse, la patiente sortira avec une calcemie et une fonction renale normalisees. Discussion A cote du classique Wasting syndrome existent des formes cliniques moins severes de mycobacterioses systemiques associant a des degres divers fievre, sueurs nocturnes, douleurs abdominales, diarrhee. Les mycobacteries colonisent en premier lieu le tractus digestif et se retrouvent dans des vacuoles au sein des macrophages de la lamina propria. Elles peuvent ensuite franchir la sous-muqueuse et se disseminer par voie hematogene. Cette physiopathologie rend compte de la semiologie radiologique observee : epaississement des parois du grele, adenopathies mesenteriques (rarement necrotiques) et hepatosplenomegalie. Endoscopiquement des nodules (5 a 10 mm) sont frequents au niveau du duodenum. La fibroscopie gastrique peut etre normale. Histologiquement, les villosites duodenales sont preservees, la lamina propria est distendue, parsemee de macrophages dont le cytoplasme regorge d’inclusions PAS+ qui prennent ; contrairement au Whipple, la coloration de Ziehl. L’analyse en PCR et la culture de ces biopsies permettent d’identifier et de tester la sensibilite de la mycobacterie en cause. L’existence d’une hypercalcemie est rapportee dans quelques observations de mycobacterioses atypiques. Elle peut preceder la survenue des symptomes mais peut aussi apparaitre apres quelques jours de traitement. Le mecanisme invoque, comme dans les granulomatoses, consiste en une conversion inappropriee de la 25OHD3 en 1-25diOHD3 sous l’effet de la 1-alpha hydroxylase presente dans les macrophages actives. Conclusion L’enterite a MAC constitue un diagnostic differentiel de la maladie de Whipple. Les deux affections possedent une presentation clinique, radiologique (syndrome grelique), endoscopique (nodules blanchâtres duodenaux) et histologique (histiocytes spumeux inclusions PAS+ dans le chorion) tres voisine. La coloration de Ziehl sur les biopsies intestinales doit donc etre systematique notamment en cas d’immunodeficience. La survenue possible d’une hypercalcemie incite a controler la calcemie en debut et en cours de traitement antimycobacterien et doit rendre prudent dans les apports de vitamine D.

Introduction La decouverte d’une artere sous-claviere droite aberrante (ASDA) n’est pas exceptionnelle ; elle est rencontree dans 0,5 a 1,8 % de la population. Plus de neuf fois sur dix, cette particularite de l’embryogenese est asymptomatique. Nous rapportons trois observations de dysphagie en rapport avec une ASDA retro-œsophagienne ou arteria lusoria. Le cas princeps remonte a 1794 et a ete decrit par Bayford sous le vocable de dysphagia lusoria. Observation Observation n o 1 : patiente de 58 ans hypertendue en surpoids adressee en juillet 2011 pour douleur thoracique anterieure depuis 4 mois associee a des episodes de blocage œsophagien quasi-quotidiens. Sur l’echographie cervicale etait notee l’existence d’un kyste du tractus thyreoglosse. L’endoscopie œsogastrique s’averait rassurante. La TDM thoracique completee d’une angioIRM retrouvait une arteria lusoria associee a un tronc commun a l’origine des 2 carotides primitives. Le transit œsogastroduodenal confirmait l’existence d’une compression extrinseque de l’œsophage chiffree a 90 % avec stase du produit de contraste en amont. En septembre 2011, la patiente beneficiait d’une fermeture intramediastinale de l’ASDA (sternotomie) avec reimplantation dans la carotide primitive droite (cervicotomie). Les suites operatoires etaient simples avec disparition des troubles de la deglutition a distance. Observation n o 2 : patient de 52 ans sans passe ethylo-tabagique, hospitalise en decembre 2014 pour une dysphagie et une dysphonie avec amaigrissement de 3 kg en une annee. La biologie etait non contributive. La fibroscopie gastrique retrouvait une compression extrinseque a 25 cm des arcades dentaires et l’examen ORL mettait en evidence une paralysie complete de l’hemilarynx gauche sans lesion suspecte associee. Le scanner TAP n’objectivait aucune anomalie mediastinale en dehors d’une arteria lusoria naissant de la partie descendante de la crosse aortique avec compression de l’œsophage. Le patient est adresse aux chirurgiens vasculaires. Observation n o 3 : patiente de 57 ans fumeuse (20 paquets-annees) hospitalisee en fevrier 2015 pour douleur cervicothoracique migratrice depuis 3 mois accompagnee d’une dysphagie aux solides et d’un amaigrissement de 12 kg. L’endoscopie gastrique n’objectivait qu’une hernie hiatale non compliquee. La laryngoscopie en suspension sous anesthesie etait sans particularite, le bilan thyroidien normal. Le TDM cervicothoracique ne retrouvait rien d’anormal au niveau mediastinopulmonaire mais mettait en evidence une arteria lusoria de 13 mm de diametre. Le transit baryte confirmait une empreinte extrinseque sur le tiers superieur de l’œsophage. La patiente est confiee en chirurgie vasculaire. Discussion A partir d’une recente revue de la litterature [1] regroupant 141 observations d’ASDA (126 cas cliniquement documentes et 15 cas anatomiquement confirmes), il apparait que l’âge moyen de mise en evidence est de 50 ans (45 ans chez l’homme et 54 ans chez la femme). L’anomalie est plus frequemment rencontree chez la femme que l’homme (55 % versus 44 %). L’incidence est plus elevee lorsque coexiste une tetralogie de Fallot, une atresie pulmonaire un syndrome de Down ou de Di George. Chez l’adulte, les symptomes rapportes sont essentiellement une dysphagie et des douleurs thoraciques atypiques sources d’errance diagnostique comme dans nos observations 1 et 3. Une dysphonie est rapportee de maniere tout a fait exceptionnelle (observation 2). Chez l’enfant du fait du caractere compressible de la trachee se surajoutent des signes respiratoires (stridor, wheezing , cyanose, pneumopathies iteratives). La rigidite accrue de la trachee et de l’œsophage (qui s’accentuent avec l’âge), la formation d’un anevrisme proximal sur l’ASDA (diverticule de Kommerell) l’atherosclerose, la coexistence d’un truncus bicaroticus (origine commune des arteres carotides droite et gauche a partir de la crosse aortique comme dans l’observation 1) constituent des facteurs de risque pour rendre symptomatique l’arteria lusoria. Le traitement chirurgical est reserve aux patients tres symptomatiques ou lorsqu’il existe un anevrisme menacant. Diverses modalites sont proposees : chirurgie conventionnelle (ligature proximale ASDA, reimplantation dans la carotide interne droite), technique endovasculaire pure, therapeutique hybride. Conclusion La dysphagia lusoria est une cause rare de dysphagie de l’adulte. La decouverte d’une arteria lusoria en tomodensitometrie est bien souvent fortuite. Avant de rattacher la dysphagie a une arteria lusoria, une analyse rigoureuse et exhaustive reste indispensable.

The objective of this study was to compare the effect of ultraviolet radiation (UV) and oral vitamin D3 on the vitamin D status and parathyroid hormone (PTH) concentration in elderly nursing home patients. The design of the study was a randomized clinical trial. The setting was a psychogeriatric nursing home. Subjects included 45 female psychogeriatric patients with a mean age of 85 years. Exclusion criteria were going outdoors more than once a week and the presence of actinic or cancer skin lesions. Intervention was random allocation of UV-B irradiation at half the minimal erythemal dose of the lower back, three times per week during 12 weeks (UV-B), or oral vitamin D3 400 IU/day during 12 weeks (VIT-D), or no treatment (CONTR). Main outcome measures were change in fasting serum levels of vitamin D metabolites at 0, 2, 4, 8, and 12 weeks in the treatment groups, compared with the control group. PTH(1-84) was measured at 0 and 12 weeks. Baseline serum 25-hydroxyvitamin D (25(OH)D) was lower than 30 nmol/l in 95% of the participants. It increased to a median value of around 60 nmol/l after 12 weeks both in the UV-B and VIT-D groups, whereas there was no change in the CONTR group. Serum 1,25-dihydroxyvitamin D increased significantly in the UV-B group. Serum calcium increased significantly in both treatment groups. Serum PTH decreased more than 30% in both treatment groups (p < 0.001), whereas there was no significant change in the control group. Irradiation with UV-B in the very elderly for a few minutes per day leads to adequate improvement of the vitamin D status. It is as effective as oral vitamin D3 in increasing serum 25(OH)D and suppressing secondary hyperparathyroidism.

International audience; OBJECTIVES: The aims of the study were to assess in patients with advanced HIV disease receiving antiretroviral therapy (ART) intensification with enfuvirtide (i) resistance at virological failure (VF), (ii) impact of baseline tropism on immunovirological response, and (iii) HIV-1 DNA tropism evolution during ART. METHODS: The ANRS 130 APOLLO randomized trial evaluated in naive patients the immunovirological impact of standard ART without (control arm) or with enfuvirtide. Tropism was determined on RNA and DNA by V3-loop sequencing interpreted using the Geno2Pheno algorithm. RESULTS: At baseline the median CD4 cell count was 30 cells/mm(3). Among the 170 patients assessable in this virological substudy, HIV-1 RNA tropism was as follows: 60% of viruses were R5 and 40% were R5X4/X4. HIV-1 DNA tropism was as follows: 54% were R5 and 46% were R5X4/X4. At week 24, 39% and 49% of patients experienced VF in the enfuvirtide and control arms, respectively. In the enfuvirtide arm, only resistance-associated mutations to enfuvirtide were detected. In the control arm, two patients displayed drug-resistant viruses at the time of VF. No impact of baseline tropism was observed on immunovirological response, regardless of the study arm. Among the 25 patients experiencing DNA tropism switch between baseline and week 24, 16 (64%) switched from R5 to R5X4/X4. These latter were mostly successfully suppressed patients receiving enfuvirtide and exhibiting poorer immunological response. CONCLUSIONS: Baseline RNA tropism had no impact on the immunovirological response. Drug resistance mutations were only detected for the fusion inhibitor. Finally, the mechanism of replenishment of the viral cellular reservoir with X4 viruses observed needs to be further analysed.

We used the single cell gel electrophoresis assay (comet assay) to study ultraviolet B (UVB)-induced DNA damage in pigment cells. This assay detects DNA damage, mainly DNA strand breaks and alkali labile sites in the DNA molecule. We studied the effect of biologically relevant doses (comparable to 2-3 MED (minimal erythemal dose) for in vivo irradiated full-thickness skin) of monochromatic UVB light of 302 nm on cultured melanocytes derived from foreskin, common melanocytic nevi, and dysplastic nevi. We were able to demonstrate a linear dose-response relationship between UV dose and the migration coefficient of the comet tail in all three types of pigment cells. Nevus cells originating from dysplastic nevi showed the highest sensitivity to UVB irradiation: 65% higher induction of DNA damage compared to the induction in foreskin melanocytes. Common melanocytic nevus cells were most resistant and showed a 30% lower induction of DNA damage in comparison to foreskin melanocytes. Differences in chromatin structure and cell cycle profile may influence the results of the comet assay. Control experiments with x-ray irradiation, which is well known to produce direct DNA strand breaks via radical formation, revealed only small differences between the three types of melanocytic cells. It is unlikely, therefore, that intrinsic nuclear characteristics may account for the observed differences.

Scleroderma is a fibrotic disorder of unknown etiology that is characterized by excessive collagen synthesis and its deposition in the skin and various internal organs.To examine whether an overproduction of extracellular matrix molecules is a result of either increased fibroblast proliferation or increased collagen synthesis. As results of clinical trials with 1,25-dihydroxyvitamin D3 (calcitriol) have suggested beneficial effect in the treatment of scleroderma patients, the effects of calcitriol on fibroblasts derived from scleroderma and normal skin has been examined as well.Cultures of fibroblasts were established from biopsies from involved and uninvolved skin of scleroderma patients and from skin of healthy subjects, and compared with respect to proliferation, collagen synthesis and collagen lattice contraction.No significant differences in cell proliferation and in the extent of fibroblast-induced collagen lattice contraction have been found between scleroderma patients exhibited a disorganized growth pattern in a monolayer culture in contrast to normal fibroblasts. Collagen synthesis tends to be higher in scleroderma fibroblasts as compared with controls. Calcitriol exerted an antiproliferative and antisynthetic effect on fibroblasts, which, however, did not discriminate healthy fibroblasts from fibroblasts derived from involved or uninvolved scleroderma plaques.Our findings suggest that collagen accumulation may not result from increased proliferation or altered dynamic properties of fibroblasts in a scleroderma lesion but from increased collagen biosynthesis. We additionally found that calcitriol does not selectively affect scleroderma fibroblasts.

The aim of the presented prospective study was to use a digital dermatoscopic system to follow-up patients with multiple melanocytic naevi, and to evaluate the frequency and character of dermatoscopic changes.We monitored selected melanocytic lesions with the use of a 6-month follow-up interval between check-ups. We searched for changes in size, shape, symmetry, structure and colour. We defined the criteria for surgical excision and histopathological examination of changing lesions. We created a small group of excised unchanged atypical melanocytic naevi.We completed dermatoscopic monitoring of 1027 melanocytic lesions in 121 patients at risk of developing malignant melanoma. The average total follow-up interval was 21.0 months. We noticed a substantial enlargement of monitored lesions in 4.5% of cases, and there was a change of shape in 1.3% and change of asymmetry in 2.0%. The appearance of new structures, frequently being associated with malignant melanoma, was observed in 10 lesions, and it was predictive for the histopathological confirmation of this diagnosis in all cases. About 80% of monitored lesions remained unchanged. We excised 38 monitored lesions (seven melanomas in situ, four thin invasive melanomas and 27 melanocytic naevi). There was no melanoma excised in the group of unchanged atypical melanocytic lesions.Digital dermatoscopic follow-up facilitates the recognition of thin malignant melanomas and helps to reduce the number of unnecessary excisions.

An effective prophylactic treatment of patients with polymorphic light eruption (PLE) consists of repeated low, gradually increasing exposures to UVB radiation. This so-called UV(B) hardening induces better tolerance of the skin to sunlight.SunshowerMedical company (Amsterdam) has developed an UV (B) source that can be used during taking shower. The low UV fluence of this apparatus makes it an interesting device for UV hardening. In a group of PLE patients, we compared the effectiveness of the irradiation with SunshowerMedical at home with that of the UVB treatment in the hospital.The PLE patients were randomized for one of the treatments. The hospital treatment consisted of irradiations with broad-band UVB (Waldmann 85/UV21 lamps) twice a week during 6 weeks. The home UV-device was used each day with the maximal irradiation time of 6 min. The outcome assessment was based on the information obtained from patients' dermatological quality of life (DLQI) questionnaires, the ability of both phototherapies to reduce the provocation reaction and from the patients' evaluation of the long-term benefits of their phototherapies.Sixteen patients completed treatment with SunshowerMedical and thirteen completed treatment in hospital. Both types of phototherapy were effective. There was a highly significant improvement in DLQI with either treatment. In most cases, the hardening reduced or even completely suppressed clinical UV provocation of PLE. The patients using SunshowerMedical at home were, however, much more content with the treatment procedure than the patients visiting the dermatological units.Both treatments were equally effective in the induction of skin tolerance to sunlight in PLE patients. However, the home treatment was much better accepted than the treatment in the hospital.

Micronutrients can inhibit oxidation reactions due to micro-organisms in human tissues. In this randomized, double-blind and placebo-controlled pilot study, it was examined whether suppletion of a mixture of selected micronutrients could affect the outcome of conservative treatment of periodontitis. A group of 16 for periodontitis treated patients received a mixture of micronutrients consisting of alpha-tocopherol acetate, ascorbic acid, cholecalcipherol and an extract from green tea, whereas a group of 16 similar patients received a placebo. At baseline and after 3 and 6 months, in every patient the number of teeth with periodontitis, the number of gingival bleedings on probing, and the pocket depths were registered. An evident improvement was defined as 40% reduction of the number of gingival bleedings on probing or of the summated pocket depth. After 6 months, the number of gingival bleedings on probing was significantly more reduced in the experimental group when compared with the placebo group. Also evident improvement was significantly more observed in the experimental group when compared with the placebo group.

This paper presents design and assembly of mixed electronic circuitry for measured signal processing of the capacitive difference pressure sensor, as well as analysis of the obtained results. The smart pressure sensor provides values of measured pressure via 4-20 mA current loop output. The loop current is also used for sensor circuitry supplying. This means that current consumption of the whole sensor electronics should be less than 3.5 mA even in extended industrial temperature range from -40 to +125degC.

A new sensitive method for the determination of catechol O-methyltransferase activity has been developed. The method is based on the O-methylation of the indolic intermediates of melanin metabolism. The substrate, 5,6-dihydroxyindole-2-carboxylic acid, is converted by the enzyme to two O-methylated products, which can be separated by high-performance liquid chromatography and measured with fluorimetric detection. The physiological presence of both substrate and products could be detected in crude melanoma cell extracts. The limit of sensitivity for detection of the O-methylated products is less than 0.5 pmol per injection. The method was compared with an earlier described HPLC method which makes use of uv detection of O-methylated products of 3,4-dihydroxybenzoic acid. The described method will be used to study the importance of catechol O-methyltransferase as a protective enzyme in (malignant) melanocytes.

The usual presentation of secondary syphilis is with cutaneous and mucosal symptoms. However, systematic symptoms can also occur. The purpose of this study was to describe non-mucocutaneous manifestations of secondary syphilis.Patients from the Infectious Diseases Department of Tourcoing Hospital in whom secondary syphilis was diagnosed between January 2000 and December 2006 were enrolled in this study. Patients with secondary syphilis had the typical cutaneous and mucosal symptoms and a VDRLgreater than or equal to one quarter (or a fourfold increase in the VDRL if previously positive).Seventy-seven patients presenting a total of 80 cases of secondary syphilis were enrolled, 50 of whom were HIV-positive. Of these patients, 21 (26.3 p. 100) had neurological symptoms with three cases (3.8 p. 100) of uveitis, four (5 p. 100) of papillitis, two (2.5 p. 100) of retinitis and one (1.25 p. 100) of otosyphilis. In 14 of these 21 patients (67 p. 100), lumbar puncture was performed, confirming the diagnosis of neurosyphilis in six cases. Three patients (3.8 p. 100) had diarrhoea, four (5 p. 100) had abdominal pain and six (7.5 p. 100) had hepatomegaly. Seven (11.5 p. 100) patients had alanine aminotransferase levels above twice the normal upper limit and two above 10 times the normal upper limit. Three patients had bone pain and in one patient, osteitis was confirmed by technetium and gallium scintigraphy (osteolysis).In patients with secondary syphilis, clinicians should search for non-mucocutaneous symptoms. In the presence of these symptoms, appropriate syphilis treatment should be initiated.

Long-term treatment with minocycline is occasionally associated with the development of black thyroid syndrome in which thyroid cancer is frequently found. Here, we report a patient with cutaneous, pulmonary and thyroid sarcoidosis who developed papillary thyroid carcinoma in the presence of a black thyroid syndrome after being treated with minocycline for 2.5 years.

A new electroanalytical measurement system (micropotentiostat) for electrochemical analysis was designed onto a microchip. The microchip was fabricated in CMOS technology AMIS 0.7 and can store correction data in integrated PROM memory. The microchip was implemented on thick-film sensor to provide potentiometric measurements as cyclic voltammetry, amperommetry, etc. The measurement can be done at wide dynamic range with 8 orders of a current range.

SummaryPrevious studies have shown that low-dose ultraviolet-A (UVA-1) total body irradiations were capable of improving disease activity in patients with systemic lupus erythematosus (SLE). We hypothesized that UVA-1-induced suppression of immunoglobulin production by activated B cells in the dermal capillaries could be (partly) responsible for this effect. Our experiments with donor skin demonstrated that approximately 40% of UVA-1 could penetrate through the epidermis. Irradiation of peripheral blood mononuclear cells (PBMCs) with 2 J/cm2 of UVA-1 resulted in 20% cell death. This toxic effect could be prevented totally by preincubation of the cell cultures with catalase. This indicates that the generation of hydrogen peroxide plays a role in UVA-1 cytotoxicity. T cells and B cells appeared to be less susceptible to UVA-1 cytotoxicity than monocytes. With the use of a CD40–CD40L B cell activation method we measured immunoglobulin production after various doses of UVA-1 irradiation (0–2 J/cm2). The doses of 2 J/cm2 caused a significant decrease of IgM, IgG, IgA and IgE production under the conditions of interleukin (IL)-10 or IL-4 (IgE) stimulation. Although UVA-1 can cause apoptosis of B lymphocytes, we show that relatively low doses of UVA-1 radiation also affect the function of these cells. Both effects may be responsible for the observed improvement of disease activity in SLE patients.

Psoriasis is een veel voorkomende erythematosquameuze huidaandoening; ongeveer 2% van de bevolking heeft kenmerken van deze ziekte, die zich kan uiten van een scherp omschreven plaque tot een meer uitgebreide verdeling.