UV Radiation and the Skin

UV radiation (UV) is classified as a “complete carcinogen” because it is both a mutagen and a non-specific damaging agent and has properties of both a tumor initiator and a tumor promoter. In environmental abundance, UV is the most important modifiable risk factor for skin cancer and many other environmentally-influenced skin disorders. However, UV also benefits human health by mediating natural synthesis of vitamin D and endorphins in the skin, therefore UV has complex and mixed effects on human health. Nonetheless, excessive exposure to UV carries profound health risks, including atrophy, pigmentary changes, wrinkling and malignancy. UV is epidemiologically and molecularly linked to the three most common types of skin cancer, basal cell carcinoma, squamous cell carcinoma and malignant melanoma, which together affect more than a million Americans annually. Genetic factors also influence risk of UV-mediated skin disease. Polymorphisms of the melanocortin 1 receptor (MC1R) gene, in particular, correlate with fairness of skin, UV sensitivity, and enhanced cancer risk. We are interested in developing UV-protective approaches based on a detailed understanding of molecular events that occur after UV exposure, focusing particularly on epidermal melanization and the role of the MC1R in genome maintenance.     

Hearing aid outcome measures for children

The provision of appropriate amplification for a young hearing-impaired child is critical as the aided speech signal will be used for the development of speech and language. The purpose of this paper is to provide an overview of the complex issues surrounding the documentation of hearing aid outcomes in the pediatric population. In the first two sections of the paper, the unique characteristics and needs of the pediatric population and factors complicating the measurement of outcome are described in detail. The third section provides a review of literature on existing outcome measures for children and the fourth section is devoted to a discussion of alternative approaches. The final section is an overview of clinical and research needs in the area of hearing aid outcome measures for children.     

Subjective effects of peak clipping and compression limiting in normal and hearing-impaired children and adults

Despite many advances in hearing-aid signal processing, compression limiting and peak clipping are still used. To date, perceptual studies have been conducted only with adults. The current study was designed to investigate the clarity of peak-clipped and compressed speech for both adults and children. Subjects were 30 normal-hearing and 30 hearing-impaired individuals in three age ranges (7-9, 10-12, and 16-50 years). Stimuli were processed at 60, 70, 75, and 80 dB SPL using peak clipping and at 80 dB SPL using compression limiting. Paired-comparison measures were used to assess the clarity of sentences, and a signal-to-distortion ratio (SDR) based on a measure of coherence between input and output was computed for each condition. For the peak-clipping conditions, there was a decrease in perceived clarity as the input increased from 60 to 80 dB SPL. This perceptual continuum was most apparent for the normal-hearing adults. The normal-hearing 10-12 year olds and the hearing-impaired adults showed a similar, but less pronounced, pattern. In contrast, the remaining three subject groups showed minimal differences in perceived clarity across conditions. Surprisingly, only the two oldest normal-hearing groups showed a clear preference for compression limiting over peak clipping at the highest input level, and only their results were consistent with the pattern of coherence across stimuli. Judgments of clarity by the normal-hearing subjects correlated best with the SDR in the 500-2000-Hz range, while clarity judgments of the hearing-impaired subjects correlated best with the SDR below 1000 Hz.     

Characterisation of a chromatographically produced anti-D immunoglobulin product

A chromatographic fractionation method has been developed for the production of a liquid-stable anti-D immunoglobulin product for intravenous and intramuscular use. An immunoglobulin fraction, highly enriched with anti-D immunoglobulins, was isolated by cation-exchange column chromatography and further polished, first by anion-exchange chromatography, followed by an aluminium hydroxide gel treatment. The process includes two specific steps for virus inactivation and removal, namely S/D treatment and nanofiltration. The overall anti-D process yield is about 56%. The final product is stabilised with human albumin and glycine and placed in ready-to-use syringes. The anti-D product was shown to be stable in liquid state for at least 30 months at 4 degrees C.     

Treatment for infertility and risk of invasive epithelial ovarian cancer

The relationship between the use of fertility drugs and the risk of ovarian cancer was analysed using data from an Italian case-control study. The study comprised 971 women below the age of 75 years with histologically confirmed invasive epithelial ovarian cancer diagnosed within the year before the interview. The controls were 2758 women admitted to the same network of hospitals where the cases of ovarian cancer had been identified. Five cases (0.5%) and 11 controls (0.4%) reported use of fertility drugs. In comparison with women who had never used fertility drugs, the multivariate odds ratio (OR) for women who had taken fertility drugs was 1.1 [95% confidence interval (CI) 0.4-3.3]. The OR were 0.7 (95% CI 0.1-7.9) and 1.0 (95% CI 0.2-3.8) for women who had used fertility drugs for <6 and > or =6 cycles respectively. Considering the 14 cases and 45 controls reporting difficulty in conception, the risk of ovarian cancer was 0.5 (95% CI 0.1-3.6) for women who reported use of fertility drugs. Considering nulliparous women only, the estimated OR of ovarian cancer for any fertility drug use was 0.6 (95% CI 0.1-3.5). Although the present results have limitations in terms of statistical power and available information, they provide reassuring evidence of the absence of a strong association between fertility drugs and subsequent risk of developing epithelial ovarian cancer.     

Experience in organizing surgical care during the combat operations in the Chechen Republic

In the article the final analysis of organization of surgical care during the local military conflict in northern Caucasus was presented. The real possibilities of different medical units such as single medical company and medical squadron of special assignment was described. Also concrete contents of emergency specialized surgical care and its role in improvement of outcomes in patients with combined combat injuries was reflected. Mortality in this patients was decreased from 25.2 to 12.8%. The defects of surgical care were analyzed and the main ways of improvement of surgical care in local military conflict were presented. In the result of using the principle of moving the medical care closer to the wounded in the whole system of consecutive care the mortality was decreased up to 1.3%.     

X-ray photoelectron spectroscopy analysis of whole cells and isolated cell walls of gram-positive bacteria: comparison with biochemical analysis

The surface chemical composition of whole cells and isolated cell walls of four coryneform bacteria and of a Bacillus brevis strain has been determined by X-ray photoelectron spectroscopy (XPS). The XPS data were converted into concentrations of model compounds: peptides, polysaccharides, and hydrocarbonlike compounds. The composition of the surface of B. brevis differed markedly from that of coryneforms: the peptide concentration was about twice higher in the former case, which is attributed to the presence of an S-layer at the cell surface; in contrast, the surface of coryneforms was rich in hydrocarbonlike compounds (about 40%), which was concomitant with a high water contact angle. The peptide surface concentration of the isolated cell walls of the five strains deduced from XPS data fitted well with the total peptide content determined by biochemical analysis, which supports the validity of XPS to determine the overall macromolecular composition of the bacterial cell surface. Compared to biochemical analysis of isolated cell walls, XPS analysis of whole cells provides information which concerns directly the cell surface (2- to 5-nm-thick layer) and is less subject to alteration via losses of cell wall constituents or contamination by intracellular compounds.     

Identification of C1 presympathetic neurons in rat rostral ventrolateral medulla by juxtacellular labeling in vivo

The rostral ventrolateral medulla (RVLM) contains barosensitive, bulbospinal neurons that provide the main supraspinal excitatory input to sympathetic vasomotor preganglionic neurons. However, the phenotype of the critical RVLM cells has not been conclusively determined. The goal of the current study was to identify the proportion of electrophysiologically defined, putative, presympathetic RVLM neurons that are C1 cells. We used a juxtacellular labeling technique to individually fill spontaneously active, barosensitive, bulbospinal RVLM neurons with biotinamide following electrophysiological characterization in chloralose-anesthetized rats. To determine whether these neurons could be classified as C1 cells, the biotinamide-labeled cells were processed for detection of tyrosine hydroxylase. The majority of barosensitive bulbospinal RVLM neurons were tyrosine hydroxylase immunoreactive (TH-ir; 28 of 39). All of the barosensitive bulbospinal RVLM neurons with axonal conduction velocities in the C fiber range (<1 m/second) were TH-ir (n = 16), whereas faster conducting cells (1 to 7 m/second) were either lightly TH-ir (n = 12) or not detectably TH-ir (n = 11). Adjacent respiratory-related RVLM units labeled with biotinamide were not detectably TH-ir (n = 10). To verify that TH-ir cells were indeed adrenergic, a subset of barosensitive bulbospinal cells labeled with biotinamide were examined for phenylethanolamine N-methyltransferase immunoreactivity (PNMT-ir). Three slowly conducting cells had detectable PNMT-ir, and two fast-conducting cells had no detectable PNMT-ir. These results indicate that the majority of bulbospinal RVLM neurons with putative sympathoexcitatory function are C1 cells.     

Interpersonal problems, personality pathology, and social adjustment after cognitive therapy for depression.

The authors examined the level and structure- of the Inventory of Interpersonal Problems--Circumplex version (IIP-C; L. M. Horowitz. L. E. Alden, J. S. Wiggins, & A. L. Pincus, 2000) before and after 20 sessions of acute-phase cognitive therapy for depression (N=118), as well as associations with the Schedule for Nonadaptive and Adaptive Personality (L. A. Clark, 1993b) and the Social Adjustment Scale--Self-Report version (M. M. Weissman & S. Bothwell, 1976). Interpersonal problems had a 3-factor structure (Interpersonal Distress, Love, and Dominance), with the latter 2 factors approximating a circumplex, both before and after therapy. Interpersonal Distress decreased and social adjustment increased with therapy, but the Love and Dominance dimensions were relatively stable, similar to personality constructs. Social adjustment related negatively to Interpersonal Distress but not to Love or Dominance. Personality pathology related broadly to Interpersonal Distress and discriminantly to Love and Dominance. These findings support the reliability and validity of the IIP-C and are discussed in the context of personality theory and measurement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mesh inguinal herniorrhaphy: a ten-year review

Inguinal herniorrhaphy remains one of the most common surgical operations, with approximately 10 to 20 per cent performed for recurrence. Reviews by specialized hernia centers show mesh repair has a recurrence rate of 0.2 per cent. Detractors of this repair include increased cost, technical difficulty, and risk for infection. The purpose of this study was to compare mesh versus nonmesh inguinal herniorrhaphy at a large teaching institution. From 1985 to 1994, 892 patients underwent primary repair for inguinal hernia at the Veterans Administration Hospital at Memphis, TN. Patients were stratified by repair [Lichtenstein (Mesh), open anterior (Bassini, Marcy, McVay, and Shouldice), laparoscopic (Lap), and preperitoneal (Post)]. Operative time for Mesh repair (111 +/- 2 minutes) was longer than for Bassini or McVay (91 +/- 2 and 98 +/- 2 minutes; P < 0.05), and Lap repairs were longer than all others (192 +/- 16 minutes; P < 0.05). Hospital stay averaged 2.2 +/- 0.1 days for Mesh versus 2.6 +/- 0.1 days for all repairs combined (P = not significant). Mesh patients developed four wound infections (1.0%), none requiring mesh removal, versus nine infections (1.8%) in other groups (P = not significant). One Mesh patient (0.3%) developed recurrence, compared with 16 (3.5%) with open anterior repair (P < 0.01). Inguinal herniorrhaphy using an open mesh repair technique provides superior recurrence rates without increasing risk for infection, length of stay, or technical difficulty.