Basal cell carcinoma is the most common malignant tumor among fair-skinned individuals, and its incidence has been rising steadily in the past decades. In order to maintain the highest quality of ...patient care possible, the German S2k guidelines were updated following a systematic literature search and with the participation of all professional societies and associations involved in the management of the disease. Part 1 highlights new developments in genetics in particular as well as aspects regarding epidemiology, diagnosis, and histology.
Chlamydiales are familiar causes of acute and chronic infections in humans and animals. Human pulmonary emphysema is a component of chronic obstructive pulmonary disease (COPD) and a condition in ...which chronic inflammation manifested as bronchiolitis and intra-alveolar accumulation of macrophages is common. It is generally presumed to be of infectious origin. Previous investigations based on serology and immunohistochemistry indicated Chlamydophila pneumoniae infection in cases of COPD. Furthermore, immunofluorescence with genus-specific antibodies and electron microscopy suggested involvement of chlamydial infection in most cases of pulmonary emphysema, but these findings could not be verified by PCR. Therefore, we examined the possibility of other chlamydial species being present in these patients.
Tissue samples from patients having undergone lung volume reduction surgery for advanced alpha-1 antitrypsin deficiency (AATD, n = 6) or non-alpha-1 antitrypsin deficiency emphysema (n = 34) or wedge resection for hamartochondroma (n = 14) were examined by transmission electron microscopy and PCR.
In all cases of AATD and 79.4% of non-AATD, persistent chlamydial infection was detected by ultrastructural examination. Intra-alveolar accumulation of macrophages and acute as well as chronic bronchiolitis were seen in all positive cases. The presence of Chlamydia psittaci was demonstrated by PCR in lung tissue of 66.7% AATD vs. 29.0% non-AATD emphysema patients. Partial DNA sequencing of four positive samples confirmed the identity of the agent as Chlamydophila psittaci. In contrast, Chlamydophila pneumoniae was detected only in one AATD patient. Lung tissue of the control group of non-smokers with hamartochondroma was completely negative for chlamydial bodies by TEM or chlamydial DNA by PCR.
These data indicate a role of Chlamydophila psittaci in pulmonary emphysema by linking this chronic inflammatory process to a chronic infectious condition. This raises interesting questions on pathogenesis and source of infection.
Measurements of formaldehyde (CH2O) from a tunable diode laser absorption spectrometer (TDLAS) were acquired onboard the NASA DC‐8 aircraft during the summer 2004 INTEX‐NA campaign to test our ...understanding of convection and CH2O production mechanisms in the upper troposphere (UT, 6–12 km) over continental North America and the North Atlantic Ocean. The present study utilizes these TDLAS measurements and results from a box model to (1) establish sets of conditions by which to distinguish “background” UT CH2O levels from those perturbed by convection and other causes; (2) quantify the CH2O precursor budgets for both air mass types; (3) quantify the fraction of time that the UT CH2O measurements over North America and North Atlantic are perturbed during the summer of 2004; (4) provide estimates for the fraction of time that such perturbed CH2O levels are caused by direct convection of boundary layer CH2O and/or convection of CH2O precursors; (5) assess the ability of box models to reproduce the CH2O measurements; and (6) examine CH2O and HO2 relationships in the presence of enhanced NO. Multiple tracers were used to arrive at a set of UT CH2O background and perturbed air mass periods, and 46% of the TDLAS measurements fell within the latter category. In general, production of CH2O from CH4 was found to be the dominant source term, even in perturbed air masses. This was followed by production from methyl hydroperoxide, methanol, PAN‐type compounds, and ketones, in descending order of their contribution. At least 70% to 73% of the elevated UT observations were caused by enhanced production from CH2O precursors rather than direct transport of CH2O from the boundary layer. In the presence of elevated NO, there was a definite trend in the CH2O measurement–model discrepancy, and this was highly correlated with HO2 measurement–model discrepancies in the UT.
Adhesively bonded, fixed orthodontic appliances--so-called multibracket appliances--on buccal or lingual tooth surfaces can make oral hygiene difficult. This increases the risk of caries and ...gingivitis, and patients require closely monitored prophylactic care. Oral hygiene indices serve to assess the oral hygiene situation and evaluate oral health status. The currently available indices do not adequately meet the special requirements of patients with multibracket appliances, since they evaluate only the smooth surfaces and/or approximal spaces of the teeth in terms of plaque accumulation and signs of inflammation of the marginal gingiva. The Orthodontic Plaque Index (OPI) is a special index for patients with fixed orthdontic appliances. The OPI focuses on the tooth area in the immediate vicinity of the bracket, since additional and relatively inaccessible plaque niches arise at these sites. To record the OPI, the dentition is divided into sextants. Plaque scores (0 to 4) are assigned. The plaque accumulation on each tooth surface adjacent to the bracket base is evaluated (mesial, distal, occlusal/incisal, and cervical). In addition, signs of gingival inflammation are recorded. The highest score per sextant is entered into a sextant table. Increased risk of caries and gingivitis is assumed as of score 3. The OPI can be used for both buccal and lingual multibracket appliances. In patients with fixed orthodontic apppliances, the OPI assesses oral hygiene in the bracket vicinity and thus provides differential findings. As a result, the OPI is recommended for clinical use.
An experimental study of aerogeneous challenge in pigs was conducted in order to reveal characteristic features of porcine respiratory chlamydiosis. Eight conventionally raised pigs were exposed to a ...pathogenic strain of
Chlamydia (C.) suis, four controls were mock infected. Besides pathological changes, the acute-phase and humoral immune responses, as well as the dissemination and transmission of the challenge strain was monitored in the course of infection. The data from clinical investigations, LPS-binding protein assay, antibody ELISAs, confocal laser scanning and light microscopy, immunohistochemical staining and PCR provided extensive evidence of the pathogenic potential of
C. suis for the porcine respiratory system. This model appears suitable for further pathophysiological and immunological investigations of chlamydial respiratory infections and can also be recommended for studies of
Chlamydia-associated infections of the human lung.
Une série d'inoculations par voie aérienne a été entreprise chez des porcs afin d'identifier les propriétés de la chlamydiose respiratoire porcine. Huit porcs élevés de manière conventionnelle ont été exposés à une souche pathogène de
Chlamydia (C.) suis, tandis que quatre porcs servant de contrôles négatifs ont reçu le milieu de culture seul. Les modifications pathologiques, les réponses en phase aiguë et immunitaire humorale, ainsi que la dissémination et la transmission de la souche inoculée ont été enregistrées tout au long de l'infection expérimentale. Les résultats des examens cliniques, du test mesurant la protéine qui se lie au lipopolysaccharide, des ELISAs permettant la détection d'anticorps, des microscopies optiques et confocales, des colorations immunohistochimiques et du test PCR, ont fourni de nombreuses preuves du caractère pathogène de
C. suis pour le système respiratoire porcin. Ce modèle semble convenir pour de futures études physiopathologiques et immunologiques des infections respiratoires à
Chlamydia. Il peut également être recommandé pour des études d'infections pulmonaires associées à
Chlamydia chez l'homme.
Vertical transmission of maternal cancer cells to the child is extremely rare, but melanoma represents the most common culprit. The aim of this study is to determine individual risks for ...materno-fetal transmission of melanoma cells and to establish standardized procedures for pregnant melanoma patients and their offspring.
In this retrospective multicenter study, data on women with stage III or IV melanoma that had been diagnosed before, during or up to 12 months after pregnancy, were analyzed for the occurrence of metastases in the placenta or the infant. In addition, a literature search for previously described materno-fetal transmission in case of maternal melanoma was conducted. A historical patient group was established from these cases and a statistical analysis was performed (SAS, p < 0.05 significant).
In total, 67 children born to women with stage III or IV melanoma were included. No placental or infant metastases were detected in any of the cases. The additional literature search revealed 37 cases with placental metastases and 14 cases with infant metastases (6 of them overlapping). Of the affected children, 10 (71.43%) died from their disease. Maternal death shortly after birth seems to be an unfavorable factor for transmission to the infant.
The risk of materno-fetal transmission of maternal melanoma metastases seems to be much lower than anticipated based on former studies. However, thorough placental screening and systematic follow-up of the children resulting from pregnancies of high-risk melanoma patients should be performed.
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