Skin barrier and microbiome in acne

Abstract

Acne is an immune-mediated chronic inflammatory disease. Although several factors are involved in its pathophysiology, this process is not completely understood. Androgen hormone activity increases sebum production inside the pilosebaceous follicle, adjusting the environment for the development of Propionibacterium acnes which triggers inflammation. Knowing how others factors such as the skin barrier and microbiome are involved in acne, can help in understanding more about the disease and may help to conduct a better treatment.

Buccal Mucosal Epithelial Cells Downregulate CTGF Expression in Buccal Submucosal Fibrosis Fibroblasts

Abstract

Introduction

Oral submucosal fibrosis (OSMF) is a chronic debilitating fibrotic disease of the oral cavity and is a serious health hazard in south Asia and, increasingly, the rest of the world. The molecular basis behind various treatment modalities to treat OSMF still remains unclear. In this study, we have investigated the in vitro ability of the buccal mucosal cells to reduce the proliferation of the fibroblasts of the fibrotic area in co-culture of cells and also at the molecular levels to reduce the level of connective tissue growth factor (CTGF) in the OSMF fibroblasts (SMF-F).

Materials and Methods

The study compares isolation, morphological and proliferation kinetics of SMF-F and BMF cells with and without co-culturing with BMEs. In addition, we have compared the mRNA expression levels of CTGF in SMF-F co-cultured BME and non-co-cultured SMF-F cells using validated real-time quantitative PCR (RT-qPCR) method.

Results

The basic morphological characteristics of SMF-F were similar to BMF, but the former cells had higher proliferation rate in early passages compared to late passage state. We also observed that the CTGF expression levels in SMF-F under co-culture conditions of BME were consistently and significantly downregulated in all four different SMF-F-derived cells from four different patients.

Conclusion

Rapid proliferation and collagen synthesis in SMF-F as against BMF cells are the factors that confirm the innate nature of fibrosis fibroblasts (SMF-F). Further, the CTGF expression level in SMF-F was significantly suppressed by BME in co-culture conditions against controls (BMF). Considered together, this suggests that the cell therapeutic candidate of BME could be used in treating OSMF.

Can Arterial Spin-Labeling with Multiple Postlabeling Delays Predict Cerebrovascular Reserve? [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The effect of delayed transit time is the main source of error in the quantitative measurement of CBF in arterial spin-labeling. In the present study, we evaluated the usefulness of the transit time–corrected CBF and arterial transit time delay from multiple postlabeling delays arterial spin-labeling compared with basal/acetazolamide stress technetium Tc99m-hexamethylpropylene amineoxime (Tc99m-HMPAO) SPECT in predicting impairment in the cerebrovascular reserve.

MATERIALS AND METHODS:

Transit time–corrected CBF maps and arterial transit time maps were acquired in 30 consecutive patients with unilateral ICA or MCA steno-occlusive disease (severe stenosis or occlusion). Internal carotid artery territory–based ROIs were applied to both perfusion maps. Additionally, impairment in the cerebrovascular reserve was evaluated according to both qualitative and quantitative analyses of the ROIs on basal/acetazolamide stress Tc99m-HMPAO SPECT using a previously described method. The area under the receiver operating characteristic curve was used to evaluate the diagnostic accuracy of arterial spin-labeling in depicting impairment of the cerebrovascular reserve. The correlation between arterial spin-labeling and cerebrovascular reserve was evaluated.

RESULTS:

The affected hemisphere had a decreased transit time–corrected CBF and increased arterial transit time compared with the corresponding values of the contralateral normal hemisphere, which were statistically significant (P < .001). The percentage change of transit time–corrected CBF and the percentage change of arterial transit time were independently differentiating variables (P < .001) for predicting cerebrovascular reserve impairment. The correlation coefficient between the arterial transit time and cerebrovascular reserve index ratio was –0.511.

CONCLUSIONS:

Our results demonstrate that the transit time–corrected CBF and arterial transit time based on arterial spin-labeling perfusion MR imaging can predict cerebrovascular reserve impairment.

Role of MR Neurography for the Diagnosis of Peripheral Trigeminal Nerve Injuries in Patients with Prior Molar Tooth Extraction [PERIPHERAL NERVOUS SYSTEM]

BACKGROUND AND PURPOSE:

Clinical neurosensory testing is an imperfect reference standard to evaluate molar tooth extraction related peripheral trigeminal neuropathy. The purpose was to evaluate the diagnostic accuracy of MR neurography in this domain and correlation with neurosensory testing and surgery.

MATERIALS AND METHODS:

In this retrospective study, nerve caliber, T2 signal intensity ratio, and contrast-to-noise ratios were recorded by 2 observers using MR neurography for bilateral branches of the peripheral trigeminal nerve, the inferior alveolar and lingual nerves. Patient demographics and correlation of the MR neurography findings with the Sunderland classification of nerve injury and intraoperative findings of surgical patients were obtained.

RESULTS:

Among 42 patients, the mean ± SD age for case and control patients were 35.8 ± 10.2 years and 43.2 ± 11.5 years, respectively, with male-to-female ratios of 1:1.4 and 1:5, respectively. Case subjects (peripheral trigeminal neuropathy or injury) had significantly larger differences in nerve thickness, T2 signal intensity ratio, and contrast-to-noise ratios than control patients for the inferior alveolar nerve and lingual nerve (P = .01 and .0001, .012 and .005, and .01 and .01, respectively). Receiver operating characteristic analysis showed a significant association among differences in nerve thickness, T2 signal intensity ratio, and contrast-to-noise ratios and nerve injury (area under the curve, 0.83–0.84 for the inferior alveolar nerve and 0.77–0.78 for the lingual nerve). Interobserver agreement was good for the inferior alveolar nerve (intraclass correlation coefficient, 0.70–0.79) and good to excellent for the lingual nerve (intraclass correlation coefficient, 0.75–0.85). MR neurography correlations with respect to clinical neurosensory testing and surgical classifications were moderate to good. Pearson correlation coefficients of 0.68 and 0.81 and of 0.60 and 0.77 were observed for differences in nerve thickness.

CONCLUSIONS:

MR neurography can be reliably used for the diagnosis of injuries to the peripheral trigeminal nerve related to molar tooth extractions, with good to excellent correlation of imaging with clinical findings and surgical results.

Dynamic Contrast-Enhanced MRI-Derived Intracellular Water Lifetime ({tau}i): A Prognostic Marker for Patients with Head and Neck Squamous Cell Carcinomas [HEAD & NECK]

BACKGROUND AND PURPOSE:

Shutter-speed model analysis of dynamic contrast-enhanced MR imaging allows estimation of mean intracellular water molecule lifetime (a measure of cellular energy metabolism) and volume transfer constant (a measure of hemodynamics). The purpose of this study was to investigate the prognostic utility of pretreatment mean intracellular water molecule lifetime and volume transfer constant in predicting overall survival in patients with squamous cell carcinomas of the head and neck and to stratify p16-positive patients based upon survival outcome.

MATERIALS AND METHODS:

A cohort of 60 patients underwent dynamic contrast-enhanced MR imaging before treatment. Median, mean intracellular water molecule lifetime and volume transfer constant values from metastatic nodes were computed from each patient. Kaplan-Meier analyses were performed to associate mean intracellular water molecule lifetime and volume transfer constant and their combination with overall survival for the first 2 years, 5 years, and beyond (median duration, >7 years).

RESULTS:

By the last date of observation, 18 patients had died, and median follow-up for surviving patients (n = 42) was 8.32 years. Patients with high mean intracellular water molecule lifetime (4 deaths) had significantly (P = .01) prolonged overall survival by 5 years compared with those with low mean intracellular water molecule lifetime (13 deaths). Similarly, patients with high mean intracellular water molecule lifetime (4 deaths) had significantly (P = .006) longer overall survival at long-term duration than those with low mean intracellular water molecule lifetime (14 deaths). However, volume transfer constant was a significant predictor for only the 5-year follow-up period. There was some evidence (P < .10) to suggest that mean intracellular water molecule lifetime and volume transfer constant were associated with overall survival for the first 2 years. Patients with high mean intracellular water molecule lifetime and high volume transfer constant were associated with significantly (P < .01) longer overall survival compared with other groups for all follow-up periods. In addition, p16-positive patients with high mean intracellular water molecule lifetime and high volume transfer constant demonstrated a trend toward the longest overall survival.

CONCLUSIONS:

A combined analysis of mean intracellular water molecule lifetime and volume transfer constant provided the best model to predict overall survival in patients with squamous cell carcinomas of the head and neck.

Bipolar Radiofrequency Ablation of Spinal Tumors: The Effect of the Posterior Vertebral Cortex Defect on Temperature Distribution in the Spinal Canal [LETTERS]

Deep Brain Nuclei T1 Shortening after Gadobenate Dimeglumine in Children: Influence of Radiation and Chemotherapy [PATIENT SAFETY]

BACKGROUND AND PURPOSE:

Intrinsic T1-hyperintense signal has recently been reported in the deep gray nuclei on brain MR imaging after multiple doses of gadolinium-based contrast agents. Most reports have included adult patients and excluded those undergoing radiation or chemotherapy. We investigated whether T1 shortening is also observed in children and tried to determine whether radiochemotherapy is a risk factor for this phenomenon.

MATERIALS AND METHODS:

In this single-center retrospective study, we reviewed clinical charts and images of all patients 18 years of age or younger with ≥4 gadobenate dimeglumine–enhanced MRIs for 6 years. Seventy-six children (mean age, 9.3 years; 60 unconfounded by treatment, 16 with radiochemotherapy) met the selection criteria (>4 MR imaging examinations; mean, 8). T1 signal intensity ratios for the dentate to pons and globus pallidus to thalamus were calculated and correlated with number of injections, time interval, and therapy.

RESULTS:

Among the 60 children without radiochemotherapy, only 2 had elevated T1 signal intensity ratios (n = 20 and 16 injections). Twelve of the 16 children with radiochemotherapy showed elevated signal intensity ratios. Statistical analysis demonstrated a significant signal intensity ratio change for the number of injections (P < .001) and amount of gadolinium (P = .008), but not for the interscan time interval (P = .35). There was a significant difference in the average signal intensity ratio change between those with and without radiochemotherapy (P < .001). Chart review revealed no new neurologic deficits in any patients, related to their underlying conditions and prior surgeries.

CONCLUSIONS:

Compared with published adult series, children show a similar pattern of T1 hyperintense signal changes of the dentate and globus pallidus after multiple gadobenate dimeglumine injections. The T1 signal changes in children may have a later onset but are accelerated by radiochemotherapy.

Patient-reported outcome measures following gynecomastia correction: a systematic review

Abstract

Background

A patient's perspective is usually measured by patient-reported outcome instruments, which are becoming increasingly relevant to current research on clinical outcomes. The aims of our review were to identify studies that evaluated patient satisfaction after gynecomastia correction, analyze existing questionnaires, and summarize the development, psychometric properties and content of the questionnaires.

Methods

A multistep search of the web-based PubMed database was performed. Each potential study was examined by 2 independent reviewers for adherence to inclusion/exclusion criteria. The identified studies were categorized by title, authors, date, study type, number of patients, surgical procedures, complications, mean age, mean duration of follow-up, and outcome measurements. We summarized all the questionnaires used.

Results

Our search generated a total of 711 articles; we selected 28 studies for further appraisal. Eight studies were excluded based on the content of the abstracts, and an additional 8 studies were excluded based on the content of the complete article. Thus, we performed a systematic review of the 12 remaining studies. All studies identified from the literature review were assessed to determine the type of surgery used and whether or not the questionnaire used to analyze patient satisfaction had been validated. A total of 847 patients were included in these studies, which reported more than 100 complications.

Conclusions

The rate of patient satisfaction was high, although most studies did not use validated or quantifiable evaluation methods for assessment of satisfaction. A new self-assessment tool, which should include functional, psycho-relational, and cosmetic components, is needed to measure satisfaction and quality of life in patients who have undergone gynecomastia correction.

Level of Evidence: Level III, therapeutic study

Regulatory role of XynR (YagI) in catabolism of xylonate in Escherichia coli K-12

Abstract

The genome of Escherichia coli K-12 contains ten cryptic phages, altogether constituting about 3.6% of the genome in sequence. Among more than 200 predicted genes in these cryptic phages, 14 putative transcription factor (TF) genes exist, but their regulatory functions remain unidentified. As an initial attempt to make a breakthrough for understanding the regulatory roles of cryptic phage-encoded TFs, we tried to identify the regulatory function of CP4-6 cryptic prophage-encoded YagI with unknown function. After SELEX screening, YagI was found to bind mainly at a single site within the spacer of bidirectional transcription units, yagA (encoding another uncharacterized TF) and yagEF (encoding 2-keto-3-deoxy gluconate aldolase, and dehydratase, respectively) within this prophage region. YagEF enzymes are involved in the catabolism of xylose downstream from xylonate. We then designated YagI as XynR (regulator of xylonate catabolism), one of the rare single-target TFs. In agreement with this predicted regulatory function, the activity of XynR was suggested to be controlled by xylonate. Even though low-affinity binding sites of XynR were identified in the E. coli K-12 genome, they all were inside open reading frames, implying that the regulation network of XynR is still fixed within the CR4-6 prophage without significant influence over the host E. coli K-12.

UV-based evaluation of ergosterol for monitoring the fungal exposure in Italian buffalo farms

Abstract

This study provided a reliable way to identify and estimate the ergosterol in farm environments, since it is renowned that it is a specific indicator for the occurrence of molds and yeasts. The quick valuation of exposure to airborne microorganisms is essential to assess the risk to which the health of employees is subjected in working places characterized by great humidity. From this view, it is worth estimating the total biomass of molds and yeast, including viable and non-viable forms, which may cause respiratory concerns to human. Air samples were collected with a passive method and the microbial growth was evaluated with a traditional counting method. At the same time, the ergosterol was quantified from yeasts and molds. In this way, the aerosol concentrations of molds and yeasts were compared by using the two methods, the cultivation on plates, as well as through ergosterol measurement by means of UV spectroscopy. Results showed, for the first time, a positive correlation between the amount of ergosterol and the yeast cells. Based on these outcomes, the ergosterol is a statistically significant biomarker to be used to control the air quality of indoor and outdoor farm spaces, by means of a simple and direct UV procedure.

Lesiones pruriginosas de meses de evolución en un paciente con antecedentes de micosis fungoide

Publication date: Available online 15 November 2017
Source:Piel
Author(s): Montserrat Molgó N., Paula Majluf C., Daniela Novoa C., Sergio González B.

Placas eritematosas arciformes como manifestación de hipotiroidismo

Publication date: Available online 15 November 2017
Source:Piel
Author(s): Claudia Quiroz Palominos, Julio Parra Cares, Roberto Bustos Macaya

Haartransplantation beim Mann

Zusammenfassung

Die Zahl der Haartransplantationen ist in den letzten Jahren weltweit kontinuierlich angestiegen. Der Anteil der Männer beträgt 85 %. Hauptindikation für eine Haartransplantation ist die androgenetische Alopezie. Eine qualifizierte ärztliche Beratung im Vorfeld einer Behandlung ist unabdingbar. Die Haartransplantation ist eine autologe Umverteilung Dihydrotestosteron-resistenter Haarwurzeln aus dem sog. Haarkranz in kahl gewordene Stellen. Es haben sich verschiedene Techniken etabliert. Die Resultate sind abhängig von der Ausgangssituation des Patienten und der Erfahrung des Operateurs mit seinem Team. Echte Komplikationen sind selten. Der Zufriedenheitsgrad der Patienten ist im Allgemeinen hoch.

Issue Information

A fully automatic end-to-end method for content-based image retrieval of CT scans with similar liver lesion annotations

Abstract

Purpose

The goal of medical content-based image retrieval (M-CBIR) is to assist radiologists in the decision-making process by retrieving medical cases similar to a given image. One of the key interests of radiologists is lesions and their annotations, since the patient treatment depends on the lesion diagnosis. Therefore, a key feature of M-CBIR systems is the retrieval of scans with the most similar lesion annotations. To be of value, M-CBIR systems should be fully automatic to handle large case databases.

Methods

We present a fully automatic end-to-end method for the retrieval of CT scans with similar liver lesion annotations. The input is a database of abdominal CT scans labeled with liver lesions, a query CT scan, and optionally one radiologist-specified lesion annotation of interest. The output is an ordered list of the database CT scans with the most similar liver lesion annotations. The method starts by automatically segmenting the liver in the scan. It then extracts a histogram-based features vector from the segmented region, learns the features' relative importance, and ranks the database scans according to the relative importance measure. The main advantages of our method are that it fully automates the end-to-end querying process, that it uses simple and efficient techniques that are scalable to large datasets, and that it produces quality retrieval results using an unannotated CT scan.

Results

Our experimental results on 9 CT queries on a dataset of 41 volumetric CT scans from the 2014 Image CLEF Liver Annotation Task yield an average retrieval accuracy (Normalized Discounted Cumulative Gain index) of 0.77 and 0.84 without/with annotation, respectively.

Conclusions

Fully automatic end-to-end retrieval of similar cases based on image information alone, rather that on disease diagnosis, may help radiologists to better diagnose liver lesions.

Executive summary of the 12th HHT international scientific conference

Abstract

Hereditary hemorrhagic telangiectasia is an autosomal dominant trait affecting approximately 1 in 5000 people. A pathogenic DNA sequence variant in the ENG, ACVRL1 or SMAD4 genes, can be found in the majority of patients. The 12th International Scientific HHT Conference was held on June 8–11, 2017 in Dubrovnik, Croatia to present and discuss the latest scientific achievements, and was attended by over 200 scientific and clinical researchers. In total 174 abstracts were accepted of which 58 were selected for oral presentations. This article covers the basic science and clinical talks, and discussions from three theme-based workshops. We focus on significant emergent themes and unanswered questions. Understanding these topics and answering these questions will help to define the future of HHT research and therapeutics, and ultimately bring us closer to a cure.

Harnessing the Power of Data in Facial Plastic and Reconstructive Surgery

The widespread use of electronic health records (EHRs) has created unprecedented opportunities to apply meaningful clinical data for quality improvement. Through machine learning, large data sets of patient clinical information gathered through routine clinical encounters can be analyzed for risk prediction and treatment algorithms. Although randomized clinical trials remain the criterion standard study type to show causality, the use of big data is showing promise as an alternative for discovery. This alternative is of particular significance in surgery, where randomized clinical trials are not feasible or likely.

Recreational Activity and Facial Trauma Among Older Adults

This database analysis uses the National Electronic Injury Surveillance System to collect data to evaluate the incidence of recreational activity–associated facial fractures among older adults and to further delineate injury characteristics including demographics, fracture location, and activities.

Teaching Rhinoplasty

Rhinoplasty is considered by many to be the most challenging operation that otolaryngologists do. Teaching rhinoplasty is even more challenging. In this issue of JAMA Facial Plastic Surgery, Robitschek and colleagues provide a combination of rhinoplasty analysis, science, and teaching our younger colleagues. Their study is a well-designed, prospective look at the effect of a simple teaching tool (a 10-minute slide presentation) and the thoroughness with which otolaryngology residents analyze the nose from patient photographs. The study concludes that 10 weeks after the teaching session, residents continue to perform better at rhinoplasty analysis, especially in terms of describing the position of the caudal septum.

In Memoriam: Gary Burget, MD (1941-2017)

Facial plastic surgery recently lost a dear friend, teacher, and colleague on May 31, 2017, with the passing of Gary Burget, MD. Dr Burget was born in Toledo, Ohio, on April 20, 1941, the second child of Dean E. and Marie A. Burget. His parents were schoolteachers who had grown up on small working farms in southern Ohio near West Virginia near the Appalachian foothills. His parents obtained schoolteaching jobs in the Toledo, Ohio, public school system after graduating from Bowling Green State University at the height of the Great Depression. Dr Burget attended Thomas A. DeVilbiss High School and served as president of the student council his senior year. He attended Yale University and graduated with a BA in English and then followed his older brother, Dean, to Yale Medical School, which he completed in 1967. During his fourth year of medical school, he arranged a surgical clerkship in Edinburgh, Scotland, under the direction of Andrew Logan, MD, which increased his interest in surgery. Following medical school, he pursued an internship at Columbia University College of Physicians and Surgeons in New York City and spent much of his time at Harlem Hospital. He then went to Jackson Memorial Hospital at the University of Miami as a resident in general surgery, followed by a residency in plastic surgery under D. Ralph Millard, Jr, MD. He was influenced by his older brother, Dean, who preceded him into a career in plastic surgery. Following completion of his plastic surgery residency, he was invited to join Dr Millard as an associate partner in his private practice. While honored, Dr Burget decided to enter private practice with Walter Garst, MD. After several years, Dr Burget struck out on his own and opened a practice in Miami. Henry W. Menn, MD, an early Mohs surgeon, referred a large number of patients with difficult facial defects to Dr Burget. It was during these years that Dr Burget realized the importance of the aesthetic units of the face and the need to sometimes remove additional tissue to move scars into favorable positions.