摘要:

AbstractThe European Academy of Dermatology and Venereology (EADV) prioritises the provision of high quality continuing medical education (CME) to its members.The European Union of Medical Specialists (LJEMS) is currently establishing European Boards of the individual medical specialities to monitor and ensure high professional standards of European medical specialists and harmonisation among member nations. Within the next Few years, national and supra‐national authorities in Europe are expected to request documentation of participation in continuing medical education from physicians in order to maintain their full specialist competence, analogous to the conditions now pertaining in the US. In Belgium, participation in CME is mandatory for standard appointments with the health insurance.The EADV has developed procedures for quality assurance of the CME activities for the 3rd EADV congress in Copenhagen 1993, and the Skin Therapy Update Symposium in Crete 1994, using participant evaluation of the scientific programme. Following these meetings the EADV has issued individual certificates to the participants, documenting their CME activities. The results of the programme evaluation indicate a high standard of CME at the above meetings.The EADV wishes to develop as a competent sponsor of CME activities, to offer extensive membership service in this field, and to administer recognition of EADV‐CME accreditation to other bod

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00528.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00529.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractObjectiveThe aim of this review is to provide a primer on polymerase chain reaction (PCR) technology for the clinical diagnosis ofChlamydia trachomatisinfections. Two main applications are reviewed: detection ofChlamydia trachomatisin clinical specimens For diagnosis, and genotyping ofChlamydia trachomatisfor epidemiological purposes.BackgroundChlamydia trachomatisis one of the major causes of sexually transmitted diseases throughout the world. Laboratory techniques to establish a definitive diagnosis have been hampered by a lack of sensitivity. This review describes the state of the art of the application of polymerase chain reaction based assays to the diagnosis and epidemiology ofChlamydia trachomatisinfections.ResultsThe basic principles of PCR assays are described. General guide‐lines for collecting specimens are reviewed. The application of home‐made PCR‐based assays and of the commercially available Amplieor assay in laboratory diagnosis is described. The first results of the application of LCR assays are mentioned. Comments arc made on the interpretation of the results and on the importance of quality assessment. Finally. PCR‐based techniques for genotyping of clinical isolates in epidemiological studies are described.ConclusionThe introduction of specific DNA amplification methods provides new ways to implement laboratory diagnosis and enhances our insights in the epidemiology ofChlamydia trachomatisinfections. At this moment PCR‐based assays are probably the most sensitive assays for detection ofChlamydia trachomatisavailable. Application of PCR‐based assays might yield higher prevalences ofChlamydia trachomatisinfections than currently recognized. Application of PCR‐based genotyping methods will reveal more useful epidemiological data and will unravel more precisely existing se

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00530.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractLC are dendritic cells localized in the supra‐basal layer of the epidermis and in mucous epithelia. Their density ranges from 200 to 900 cells/mm2. Their first function is to take an antigen, process it and present the processed antigen to the lymphocytes ([1] Misery L. La cellule de Langerhans. Editions Techniques, Encycl. Méd. Chir. Dermatologie 1994;12‐220‐B‐10). They are involved in numerous diseases.The origin of these cells has been debated but a consensus has now been reached. Langerhans cells (LC) were first described in 1868 by Paul Langerhans ([2] Über die Nerven der menschlichen Haut. Virch Arch A (Pathol Anat) 1868;44:325–337). He thought that it was a nerve cell. LC were first considered to be a component of the nervous system because their dendritic processes are similar so nerve fibers and because of their staining by gold chloride. Other authors have discussed a possible relationship with melanocytes. LC were regarded either as melanocytes, the progeny of melanocytes after division, or as melanocytes in an arrested stage of development ([3]Masson P. My conception of cellular naevi. Cancer 1951;4:9–15; [4] Fan J, Schoenfeld RJ, Hunter J. A study of the epidermal clear cells with special reference to their relationship to the cells of Langerhans. J Invest Dermatol 1959;32:445–450; [5]Zelickson AS. Granule formation in the Langerhans cell. J Invest Dermatol 1966;47:498–502). S100 protein is expressed on melanocytes, on nerve cells and on LC ([6] Cocchia D, Michetti F, Donato R. Immunochemical and immunocytochemical localization of S100 antigen in normal human skin. Nature 1981;294:85–87), but this does not imply that there is a common lineage. Subsequent research showed that this cell is in fact an immune cell.Electron microscopy has given us a new and very important insight into the nature of LC. Thus, there is no tonofilament, no desmosome and no melanosome ([7] Birbeck MS, Breathnach AS, Everall JD. An electron microscopy study of basal melanocyte and high level clear cell (Langerhans cell) in vitiligo. J Invest Dermatol 1961;37:51–63). The most important ultrastructural feature is the presence of Birbeck granules. Many experiments have pointed to a hone‐marrow origin of LC and their probable relationship with the phagocytic

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00531.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractAimThis paper compares the effects of MC903 (calcipotriol) and 1,25‐dihydroxyvitamin D3[1,25(OH)2D3; calcitriol] on differentiation and proliferation of normal human keratinocytes cultured in serum‐free medium. In order to understand the inhibitory mechanism of MC903, we examined its effect on cell cycle kinetics and the phosphorylation of retinoblastoma gene product (pRB), a tumor suppressor gene products, in normal human keratinocytes.BackgroundThe hormonally active form of vitamin D3, 1,25‐dihydroxy vitamin D3[1,25(OH)2D3], regulates the differentiation and proliferation of epidermal keratinocytes in vitro. MC903 is a novel vitamin D3analogue which is at least 100 times less potent than 1,25(OH)2D3in its effects on calcium homeostasis.MethodsWe analyzed cell differentiation and cell cycle by flow cytometry using a FACScan, and pRB phosphorylation by Western blotting and densitometer.ResultsMC903 induced growth inhibition and differentiation of human keratinocytes. Cell cycle analysis demonstrated that 10‐6M of MC903 induced cell cycle arrest in both G1/G0 (62.4 ± 0.7% versus 56.5 ± 1.7% in control,p<0.01) and G2 + M (19.2 ± 0.3% versus 14.0 ± 0.9% in control,p<0.01) phase. 10‐6M of MC903 also increased the depnosphorylated pRB from 25% at 0 h to 84% at 48 h, as well as 1,25(OH)2D3.ConclusionsSince pRB phosphorylation is supposed to be essential for the progression from G1 to S phase, the inhibition of pRB phosphorylation could be responsible for the G1/G0 growth arrest induced by MC903 in normal human

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00532.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractAimTo study the suitability of the AgNOR technique for the determination of epidermal proliferative activity in hyperproliferative epidermal lesions.BackgroundNucleolus organizer regions are nuclear DNA segments of ribosomal genes, which can he visualized in histological sections by using a silver staining technique. Several studies in different tumors have demonstrated that the determination of AgNOR expression makes it possible to obtain precise information on cellular proliferative activity.MethodsWe investigated the epidermal AgNOR behavior in silver‐stained sections of different non‐neoplastic hyperproliferative epidermal lesions by image analysis.ResultsPsoriatic lesions showed the highest AgNOR expression, the lowest AgNOR status was found in senile atrophic epidermis. Acute‐exanthematic psoriasis could be distinguished significantly from chronic plaque‐type psoriasis. The AgNOR status of lichen planus and verrucous epidermal naevi corresponded to that of normal epidermis. We found a significant correlation with the values of PCNA expression. For analysis of AgNOR expression the count in the basal cell layer is sufficient.ConclusionsThe AgNOR technique is suitable for estimation of epidermal proliferative activity of hyperproliferative epidermal disorders. The method is easy and can he successfully used in paraffin‐embedde

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00533.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackgroundPUVA has become a preferred method of treatment for vitiligo and psoriasis. However, 8‐methoxypsoralen (8‐MOP) as well as a high galactose diet may cause liver and kidney function damage and enhance cataract formation.Patients and MethodsTwenty one patients aged 32 ± 2.6 yrs with vitiligo (N= 11) or psoriasis (N= 10) underwent eye‐examination, liver and kidney function tests and galactose + galactose 1‐phosphate (gal + gal P) blood evaluation using Porton‐Cambridge Ltd reagents, before and after the 12th PUVA treatment during a 35–40 day study.ResultsAll these functional tests including eye‐examination were normal before and after commencing therapy. However, the mean gal + gal P blood levels (1.29 ± 0.41 mg/dl) were statistically elevated (2.95 ± 0.42 mg/dl) at the end of the study. It is suggested that 8‐MOP either impairs liver function or acts as an inhibitor of the enzymes responsible for galactose metabolism. We propose gal + gal P blood estimation in all patients before and, at intervals, after the initiation of PUVA therapy in order to prevent as early as possible an additional risk factor for liver or kidney dysfunction as well as

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00534.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractObjectiveThe use of radiation for the treatment of keloids has been the topic of debate for years.MethodsIn this study, 46 symptomatic cases were treated with90Sr‐90Y β‐rays. Patients were given four fractions of 5 Gy per fraction either as weekly or twice weekly schedules.ResultsRadiation dose of 20 Gy given twice weekly in four fractions showed response in 92% of the cases as compared to 81% in those receiving four fractions of 5 Gy weekly.ConclusionFurther studies with numerous dose fractionation schedules would open up new dimensions in the radiotherapy of kel

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00535.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackgroundOn the basis of experimental and clinical data, interferon α might improve pathological alterations in atopic eczema. Systemic treatment with this drug is however cumbersome and fraught with side effects.ObjectiveSince most patients with atopic eczema have only localized disease, we have decided to study the effect of topically applied interferon α in this disease.DesignA pilot study was performed on 10 patients, using a single‐blind, within‐patient comparison. An interferon‐α2a gel formulation (150000 IU/g) was studied against triamcinolone acetonide liquor carbonis detergens and bland cremes or gels with a twice daily application to the anticubital fossae over 10 days. Biopsies were taken from 3 patients for evaluation of treatment‐induced histopathological changes.ResultsImprovement of eczema occurred most rapidly with triamcinolone whereas interferon α was as effective as other treatments and vehicle alone. No effect on pruritus was noted with any patient. Only two patients considered interferon α better than liquor carbonis detergens or bland cremes respectively. Mast cell numbers were elevated in all patient biopsies and were lower on the triamcinolone‐treated site in only one patient.ConclusionShort‐term treatment with topically applied interferon α is thus ineffective

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00536.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractObjectivesTo evaluate the efficacy of treatment of plaque‐type psoriasis with a moderate and a strong corticosteroid under continuous hydrocolloid occlusion, with weekly change of dressing, compared with treatment with the same corticosteroids alone, and the acceptance by the patients of his type of treatment.SettingDermatological Departments of two University Hospitals and four General Hospitals.DesignOpen parallel study divided in two parts depending on the two different corticosteroid preparations applied. Each part was an intrasubject half‐side study with left‐right comparison.SubjectsFifty five patients with symmetrical, stable psoriasis plaques on elbows or knees.MethodsTwenty nine patients were treated with clobetason butyrate cream (EmovatcR) twice daily as well as once weekly covered with a hydrocolloid dressing (ContreetR) for four weeks. Twenty six patients were treated with clobetasol propionate cream (DermovateR) twice daily as well as once weekly covered by the hydrocolloid dressing for 2 weeks. Induration, erythema and scaling were assessed using a four‐point scale. Plaque size was measured by multiplying the largest and the smallest diameter. Healing was defined as score 0 for scaling and induration and score 0 or 1 for erythema. Acceptance was evaluated by questions related to the wearing of the dressings: comfort of wearing, pain, itching, adhesiveness and sticking to clothing, and the performance of daily activities.Statistics analysisSign test for the score values, parametric paired Studentt‐test for plaque size, chi‐square test for healing.ResultsWith occlusion a statistically significant increased reduction of severity was obtained compared to treatment without occlusion; this effect was more pronounced with the application of the strong corticosteroid. The questions related to the wearing of the dressing were answered positively by the majority of the patients.ConclusionsTreatment of psoriasis plaques with, especially strong, corticosteroid creams under occlusion with a hydrocolloid dressing with a high adherence is rapid and effective. The acceptance of this type of treatment by the patients is high, and it permits normal daily

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1995.tb00537.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY