The etiology and pathogenesis of idiopathic guttate hypomelanosis (IGH) are largely unknown. To investigate whether the pathologic alteration in IGH involves changes in melanocytic differentiation, ...cell number, or both, we studied nine lesions of IGH by immunoperoxidase, using monoclonal antibodies against the KIT receptor and a panel of melanocyte differentiation antigens (tyrosinase‐related protein‐1, tyrosinase, and gp100/pme117). In each case, compared with grossly normal non‐lesional skin, IGH lesions showed markedly reduced numbers both of KIT+ cells and of cells expressing melanocyte differentiation antigens (p < 0.0001). Double immunofluorescence labeling of lesions revealed only scattered cells with a less‐differentiated phenotype, i.e. cells positive for KIT but having low or undetectable TRP‐1. These results indicate that the pathogenesis of IGH involves an absolute decrease in the number of melanocytes; a block in melanocyte differentiation does not appear to be a major component of the process.
We study the onset of rigidity near the glass transition (GT) in a short-chain polymer melt modelled by a bead-spring model, where all beads interact with Lennard-Jones potentials. The properties of ...the system are examined above and below the GT. In order to minimize high-cooling-rate effects and computational times, equilibrium configurations are reached via isothermal compression. We monitor quantities such as the heat capacity CP, the short-time diffusion constants D, the viscosity eta , and the shear modulus; the time-dependent shear modulus Gt is compared with the shear modulus mu obtained from an externally applied instantaneous shear. We give a detailed analysis of the effects of such shearing on the system, both locally and globally. It is found that the polymeric glass displays long-time rigid behavior only below a temperature T1 , where T1 < TG. Furthermore, the linear and nonlinear relaxation regimes under applied shear are discussed.
Cutaneous metastases arising from breast carcinoma are quite common. A standard panel of immunohistochemical markers including estrogen receptor (ER), progesterone receptor (PR), and BRST-2 are ...frequently used in surgical pathology to identify neoplasms with breast differentiation. It is well known that as the grade of a tumor increases, and as tumors lose their differentiation, immunohistochemistry results become more unpredictable in determining possible primary sites of origin. Although previous studies have identified a decrease of ER sensitivity in breast metastases, a possible sensitivity differential of cutaneous metastases of invasive lobular versus invasive ductal carcinoma by using the standard immunohistochemical panel has not been previously reported. With the standard panel, we compared the staining sensitivity of metastatic invasive ductal carcinoma (10 cases) to metastatic invasive lobular carcinoma (four cases) to the skin. ER positivity was identified in one case of metastatic ductal carcinoma and none of the four lobular carcinomas. PR positivity was noted in all cases of metastatic ductal and lobular carcinoma. BRST-2 positivity was found in only two of 10 cases of metastatic ductal carcinoma and all four of four cases of metastatic lobular carcinoma. These results indicate that a differential sensitivity exists for the BRST-2 marker when comparing cutaneous metastases of invasive lobular with invasive ductal carcinoma.
A case of myospherulosis, a condition first reported in 1969, is reported following the extraction of mandibular third molars and subsequent placement of Terra-Cortril and Gelfoam into the extraction ...sites. The lesions were discovered during a periodontal surgical procedure and to the best of our knowledge this is the first such report in the periodontal literature.
The efficacy of an indirect & a direct-indirect intervention approach is compared in a young dysfluent child aged 4:6. During the first treatment period, indirect methods such as clinical modeling of ..."easy speech" & "stretched speech" were used. During the second treatment period, sessions were conducted in the child's or the clinician's home rather than in a clinic setting, & the child was encouraged to directly use the modeled techniques. Conversational speech samples were analyzed for pre- & posttreatment periods to obtain behavioral frequency data. A higher degree of fluency, as well as more permanent results, was observed after the second treatment period. Results support the use of a combined direct-indirect intervention approach with young children. 2 Tables, 38 References. Modified HA
Pseudomonas aeruginosa infection can cause a wide array of skin manifestations. While some infections are mild, as are the cases with hot tub folliculitis and toe web or nail infection, others are a ...result of sepsis and can be fatal without prompt treatment. The classic skin finding of P. aeruginosa sepsis is Ecthyma gangrenosum, but other signs such as papules, petechiae, and hemorrhagic bullae can also be seen. Suppurative panniculitis can also be caused by P. aeruginosa sepsis and clinically manifests as solitary or multiple subcutaneous nodules. Reports in the literature describe these nodules in the setting of clinical sepsis or with positive blood cultures. We report a case of localized subcutaneous nodules on the leg caused by P. aeruginosa in a patient without sepsis or positive blood cultures. The source of the infection was thought to be from a traumatic inoculation. This raises the possibility that P. aeruginosa can cause subcutaneous nodules from a localized infection, perhaps via lymphangitic spread without the manifestations of sepsis.
Structural properties of settlement systems have typically been identified & calibrated in relatively homogeneous agricultural regions. As a result, social scientists are somewhat uncertain about the ...properties of settlement systems in regions characterized by an uneven distribution of resources, economic activities, & population. Examined here is the allocation of 10 different business types among 22 Ariz communities with populations of 3,000-15,000. The traditional regression model for estimating the number of establishments (of a given business type) in a community is shown to be unsatisfactory for the Ariz case. However, a generalized edition of this model -- one that includes numerous demographics, SE, & locational variables -- is demonstrated to generate satisfactory estimates. In addition, this new model allows both community-level & region-level entry thresholds to be specified for different business types. 2 Tables, 1 Figure. HA
Objective
To assess the efficacy and safety of rilonacept, an interleukin‐1 inhibitor, in a randomized, double‐blind, placebo‐controlled trial.
Methods
An initial 4‐week double‐blind placebo phase ...was incorporated into a 24‐week randomized multicenter design, followed by an open‐label phase. Seventy‐one children who had active arthritis in ≥2 joints were randomized (1:1) to the 2 arms of the study. Patients in the rilonacept arm received rilonacept (loading dose 4.4 mg/kg followed by 2.2 mg/kg weekly, subcutaneously) beginning on day 0. Patients in the placebo arm received placebo for 4 weeks followed by a loading dose of rilonacept at week 4 followed by weekly maintenance doses. The primary end point was time to response, using the adapted American College of Rheumatology Pediatric 30 criteria coupled with the absence of fever and taper of the dosage of systemic corticosteroids, using prespecified criteria.
Results
The time to response was shorter in the rilonacept arm than in the placebo arm (χ2 = 7.235, P = 0.007). The secondary analysis, which used the same response criteria, showed that 20 (57%) of 35 patients in the rilonacept arm had a response at week 4 compared with 9 (27%) of 33 patients in the placebo arm (P = 0.016). Exacerbation of systemic juvenile idiopathic arthritis (JIA) was the most common severe adverse event. More patients in the rilonacept arm had elevated liver transaminase levels (including levels more than 3 times the upper limit of normal) compared with those in the placebo arm. Adverse events were similar in the 2 arms of the study.
Conclusion
Rilonacept was generally well tolerated and demonstrated efficacy in active systemic JIA.
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