Library

Notes: Background Acne is usually perceived as a disease of teenagers, and most epidemiological studies have focused on adolescents.Objective The primary objective was to investigate the prevalence of acne in a representative sample of French females. Information about skin type, life-style factors influencing acne and quality of life were also recorded.Methods A self-administered questionnaire was sent to 4000 adult women aged 25–40 years, after a validation test by three dermatologists. A definition of acne severity, according to questionnaire answers, was established before the questionnaire was sent out.Results A total of 3394 women completed the questionnaire of which 3305 were useable. The data showed a prevalence of acne in 17% of the population, and physiological acne in 24%. Thus, the total acne prevalence was 41%. Forty-nine per cent of the acne patients had acne sequelae (scars and/or pigmented macules). Forty-one per cent of adult acne patients had not experienced acne during their adolescence. A premenstrual flare and stress was recorded as causing acne in 78% and 50%, respectively. Twenty-two per cent of acne subjects were currently receiving therapy. For most patients, acne did not severely impair their quality of life.Conclusion This study shows a prevalence of acne in 41% of women in the general population. A high proportion of these acne cases are late onset acne.

Notes: Background/aims: Skin atrophy is one of the main side effects of long-term topical corticosteroid therapy. It has already been studied through ultrasound skin-thickness measurement. In this study, the quantification of dermal echogenicity was introduced to provide new information on this phenomenon.Methods: Skin thinning induced by topical application (without occlusion) of the superpotent corticosteroid clobetasol propionate (0.05% lotion), was assessed by means of ultrasonography in terms of thickness and echogenicity. 15 healthy volunteers were treated for 6 weeks, 1 daily, 5 days a week on the forearms.Results: The thinning showed a biphasic pattern, with a 1st period of rapid change (about 15% of thinning in a week) followed by a period of slower but significant change. Skin thickness returned to baseline values 3 weeks after the end of treatment. Dermal echogenicity, which represents the mean intensity of the ultrasound signals reflected by the dermis, was found to follow the same variations, increasing strongly during the 1st week, then more slowly. The 2 parameters are correlated and probably reflect the same physiological modifications responsible for skin thinning, i.e., a reduction in glycosaminoglycan synthesis (leading to a drastic fall in dermal water content) and vasoconstriction.Conclusion: This sensitive and non invasive method enables us to identify the effects of clobetasol propionate on the healthy dermis in the absence of any clinical signs of thinning.

Notes: Abstract. Rhodamine 123 (Rh 123), a relatively new mitochondrial marker, little used in the study of plant cells, was tested on excized leaves of Elodea canadensis Michx. and on suspension-cultured cells of Ranunculus serbicus Vis. In both preparations, the dye accumulated rapidly and selectively in the mitochondria whose number, morphology and cell distribution could be easily observed. In the presence of Rh 123, cytoplasmic movements could also be perceived and the spatial arrangement of the mitochondria with respect to that of the auto-fluorescent chloroplasts was studied in connection with a normal or altered cytoskeletal framework. The specific uptake of Rh 123 by the organdies seemed to be potential-dependent since it was influenced by cations, ionophores and inhibitors of electron transport. Short exposures to the stain were practically non-toxic, whereas prolonged treatments (6–20 h) provoked specific alterations in structure of the mitochondria. The data reported here indicate that Rh 123 may be an excellent vital stain to study the morphology, function and dynamics of the mitochondria in living plant cells.

Notes: Abstract The objective of this study was to determine the clinical features of 44 patients with anticentromere antibody (ACA) positivity. We undertook a retrospective review of 44 ACA-positive patients (1 male and 43 females with a mean±SD age of 53.6±12.2 years). There were 25 patients with limited systemic sclerosis, 12 with Raynaud's disease, 2 with Sjögren's syndrome, 2 with systemic lupus erythematosus and 3 with polyarthritis. ACA was more frequently found in patients affected by limited systemic sclerosis with mild visceral involvement and in patients with Raynaud's disease. Moreover, ACA was detected in other connective tissue diseases that were characterized by an atypical autoantibody profile.

Notes: Abstract Transplantation activity is dependent upon organ procurement; although great efforts are made to enlarge the cadaver donors' pool, it still remains far too small to meet the recipients' need. Waiting time is a particular problem for paediatric patients, and mortality on the waiting list for liver transplantation is very high. The number of paediatric donors is far too small to satisfy the request. To enlarge the liver pool, the split-liver procedure was introduced in several Transplant Centers. In November 1997, the North Italy Transplant program (NITp) Working Group for Liver Transplantation decided to start an official Split-liver Program. A protocol was therefore defined and criteria for donor's and recipient's eligibility were established to minimize the risk. The Working Group also standardized the technical procedure and defined collaboration between centers. Out of 410 cadaver liver donors used in the NITp, from 1 November 1997 until 31 May 1999, 49 patients (37 males and 12 females) were chosen for the split-liver procedure. Mean age was 29.9 ± 17.5 years. Mean ICU stay of the donors was considerably short (2.5 ± 2.1 days), and the other conditions foreseen for donor eligibility were met. In all cases (except two) an “in situ” technique was performed. Forty-nine adult recipients and 43 children were transplanted by the split-liver technique in our Transplant Centers. One right lobe and five left liver lobes were sent to Transplant Centers outside the NITp. Adult recipient age ranged from 18 to 60 years (mean 46.4 ± 11.7 years), and the paediatric one from 2 to 144 months (mean 24.8). Mean patient follow-up was 8.3 ± 5.5 months. In the paediatric group, the graft was successful in 34 cases (79 %), five patients (10.2 %) died and four (9.3 %) were re-transplanted. In the adult group, graft survival was 67.3 %, 11 (22 %) patients died and 5 (10 %) were re-transplanted. On 1 November 1997, 30 paediatric patients were on the liver waiting list. In the preceding 19 months, 52 patients were newly enrolled, and 36 transplants were performed. The mean waiting time of paediatric patients was 259 days (range 1–919 says). From 1 November 1997 to 31 May 1999, 61 paediatric patients were newly enrolled. In this period 70 patients were transplanted. The mean waiting time was 185 days (1–1010 days). At present, the liver waiting list includes eight paediatric patients. Split-liver transplantation is a successful procedure, effective in reducing waiting time for paediatric patients. It should be established if this may be a tool to enlarge the organ pool also for adult liver transplantation.

Notes: Abstract The large imbalance between cadaver kidney supply and demand makes the implementation of equitable and effective organ allocation systems an urgent need. This has triggered a revision of the criteria used so far for cadaver kidney allocation within the North Italy Transplant program, not least in the light of the many changes that have occurred recently with respect to broader criteria for admission of patients to the waiting list, donor selection, tissue-typing methods, organ preservation and immunosuppressive protocols. We based the critical revision of our cadaver kidney allocation algorithm on univariate and multivariate analysis of a number of immunological, clinical, social and administrative factors that impacted on the transplant outcome in 2,917 patients transplanted in the 12 transplant centers operating within our organization from 1 January 1990 to 30 September 1997. This analysis indicated that younger donor age, absence of pretransplant transfusions, patient dialysis center and level of HLA match showed statistically significant positive associations with graft survival. Younger donor age and male donor gender showed a statistically significant association with excellent graft function at 4 years. The results of this analysis were used to develop a new computer-assisted version of our adult kidney allocation algorithm. It works in two steps (local pool first, then the entire waiting list) and four levels (0–1 HLA MM, PRA + ; 2 HLA MM, PRA + ; 0–1 MM, PRA–; 2–4 HLA MM, PRA–); within each level, selection takes into account waiting time and age difference from donor age. The evaluation of 731 transplants allocated in 19 months with the new algorithm, as against 698 transplants allocated in the preceding 19 months according to the previous algorithm, showed a significantly higher proportion of recipients who had been on the waiting list for more than 3 years (33.2 % versus 22.6 %). The use of the new algorithm was also associated with a significantly increased number of transplanted alloimmunized patients (18.8 % versus 9.2 % with the previous algorithm) and recipients with 0–1 HLA mismatches (22 % versus 14.3 %). Furthermore, the number of kidneys used locally has steadily increased. Differences in 6-month graft survival and percentage of patients with excellent function at 6 months were not statistically significant in recipients transplanted with the new versus the previous algorithm. Survivals were 93.7 % versus 91.8 %. Percentages of patients with excellent renal function were 69.9 % and 71.8 %, respectively. These preliminary data suggest that the new algorithm improves HLA match and reduces the number of patients on the waiting list for 3 or more years without determining significant modifications of 6-month graft survival and function. Moreover, it facilitates the achievement of a fair local balance between organs retrieved and transplanted, the compliance of operators with objective allocation rules and the documentation of the whole allocation process.