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The cutaneous corticosteroid vasoconstriction assay: a reflectance spectroscopic and laser-Doppler flowmetric study.

Cutaneous vasoconstriction induced by topical corticosteroids was investigated using non-invasive bioengineering techniques. Corticosteroids of different potency in alcoholic solution were applied topically, under occlusion, and cutaneous blanching was investigated using visual scoring, reflectance spectroscopy (RS) and laser-Doppler flowmetry (LDF). The RS technique allowed separation of cutaneous haemoglobin content into arterial oxygenated (OH) and venous deoxygenated haemoglobin (DOH) components. Application of alcohol decreased total haemoglobin by 10%, with a corresponding 8% increase in blood flow (BF). Clobetasol propionate was the most potent vasoconstrictor, inducing significant visible blanching and decreasing DOH (30%), OH (33%) and BF (18%) (P < 0.01). Fluocinolone acetonide, betamethasone-17-valerate and dexamethasone also caused visible blanching (P < 0.01). There was no significant decrease in BF, but reflectance spectroscopy showed a decrease in DOH (P < 0.01). Tixocortol, CMJ and hydrocortisone acetate did not produce significant blanching, although DOH was decreased compared with the alcohol control. Measured by reflectance spectroscopy, corticosteroid-induced blanching was predominantly venoconstriction and only the most potent corticosteroid caused a significant decrease in OH and blood flow. This may explain why previous attempts to improve cutaneous vasoconstriction assays using laser-Doppler flowmetry have been unsuccessful.

Adrenal Cortex Hormones↗

Fruit acids and sodium hydroxide in the food industry and their combined effect with sodium lauryl sulphate: controlled in vivo tandem irritation study.

BACKGROUND: Cutaneous exposure to a variety of irritants has been extensively studied in recent years. Nevertheless, knowledge of the induction of irritant dermatitis, especially by mild irritants at low doses and for a short duration of exposure, is still incomplete. OBJECTIVES: To quantify the irritant effects and barrier disruption properties of ascorbic acid (ASC), acetic acid (ACA) and sodium hydroxide (NaOH), particularly in combination with an anionic detergent, sodium lauryl sulphate (SLS). METHODS: In a tandem repeated irritation test, the irritants were applied for 30 min twice daily for 4 days to the skin of the mid-back of 19 healthy volunteers of both sexes. We used bioengineering techniques for measurement of transepidermal water loss (TEWL) and skin colour reflectance, as well as visual scoring. RESULTS: Repeated application of ASC and ACA caused a moderate increase in TEWL and erythema. The sequential application of ASC or ACA and SLS enhanced these effects. NaOH induced a strong reaction when applied both occlusively and nonocclusively as well as in combination with SLS, with an early onset of the inflammatory signs, leading to discontinuation of the application on the third day in most of the test fields. Notably, the irritant effect of NaOH was not as marked when applied sequentially with SLS. CONCLUSIONS: Our results demonstrate that concurrent application of an anionic detergent and a mild acidic irritant can lead to disruption of the barrier function which, although not additive, is still considerable. The combined application of SLS and mild acids does not prevent SLS-induced irritation. Furthermore, we showed that NaOH in low concentrations may also act as a potent irritant but that its effect is not enhanced by SLS. The necessity of adequate skin protection and reduction of contact with substances that are potentially barrier disruptive and irritant, e.g. in the food industry, is emphasized, not only when handling detergents, but also when processing food products.

Acetic Acid↗

The objective severity assessment of atopic dermatitis (OSAAD) score: validity, reliability and sensitivity in adult patients with atopic dermatitis.

BACKGROUND: The Objective Severity Assessment of Atopic Dermatitis (OSAAD) score is a recently developed scale for evaluation of severity of atopic dermatitis, constructed from the assessment of epidermal barrier function, and properties using noninvasive bioengineering methods and computer-assisted estimates of disease extent. The method has been validated for use in infants and children with atopic dermatitis and compared with a referent scoring system. OBJECTIVES: The aim of the present study was to test the validity, reliability and sensitivity of the OSAAD score as an objective tool for the assessment of the severity of atopic dermatitis in adult patients. METHODS: Thirty-two adult patients with atopic dermatitis were included in the study. To assess the validity of the OSAAD score we tested it against the Severity Scoring of Atopic Dermatitis (SCORAD) index of the European Task Force on Atopic Dermatitis as a referent clinical severity scale, and the serum levels of interleukin (IL)-16 as a laboratory variable for monitoring the activity of atopic dermatitis. Responsiveness to change was assessed in a longitudinal study comparing OSAAD, SCORAD and serum levels of IL-16 before and after treatment. To test the reliability of the OSAAD score we studied the interobserver variability of the score recorded by three independent board-certified dermatologists in 16 patients and compared it with SCORAD. RESULTS: We report a significant correlation between the OSAAD and the SCORAD index as an acknowledged referent severity scale. The OSAAD score correlated significantly with the serum levels of IL-16 in the acute stage of atopic dermatitis. In a longitudinal study, the OSAAD score decreased significantly, parallel with improvement of the skin findings and a significant decrease in the SCORAD score and IL-16 serum levels. We report improved interobserver variability for the OSAAD score compared with SCORAD. CONCLUSIONS: This is the first study validating the OSAAD score as a sensitive and reliable tool for the assessment of the severity of atopic dermatitis in adult patients.

Acute Disease↗

Effects of oil and water baths on the hydration state of the epidermis.

The effects of bath-oil and tap-water baths were studied by non-invasive bioengineering methods. Measurements of water evaporation, electrical conductance and capacitance demonstrated an increase in cutaneous hydration for 20 min after both types of bath, with the larger increase occurring within the first 10 min. A small but significantly greater amount of water (12-27%) was bound in the skin following use of bath oil. However, measurements of evaporation, conductance and capacitance indicated no clear difference in the skin surface hydration following bath-oil and tap-water baths. Thus, the increase in the water-holding capacity of the skin resulting from bath oil is slight and of no real importance for skin-surface hydration immediately after bathing. There was no difference between 5-min and 20-min baths. Oil baths resulted in an increase in skin-surface lipids lasting at least 3 h, comparable to the effect of traditional moisturizing lotions. This lipidization of the skin surface may have protracted effects. In conclusion, the value of bath oil lies mainly in the general lipidization of the skin with potential improvement in dryness and scaling, i.e. effects which are complex and protracted. The direct hydration of the skin is of short duration and comparable to a tap-water bath. In comparison with lotions, use of an oil bath has the disadvantage that it is not practical for repeated daily treatment over the long period which is necessary for therapy to be effective. The present study on normal skin does not take into account other effects of bathing with or without the addition of oil.

Adult↗

UVA1 and UVB irradiated skin investigated by optical coherence tomography in vivo: a preliminary study.

In histological studies, it has frequently been demonstrated that ultraviolet (UV) exposure, in particular UVB, can induce significant thickening of the viable epidermis and/or stratum corneum. Since skin biopsy alters the original skin morphology and always requires an iatrogenic trauma, we aimed to introduce optical coherence tomography (OCT) in vivo for the investigation of changes of epidermal thickness (ET) following UVA1 and UVB irradiation. Twelve healthy subjects received daily 60 J/cm2 of UVA1 and 1.5 minimal erythema doses UVB on their upper back over 3 consecutive days. Twenty-four hours after the last irradiation, OCT assessments were performed on UV exposed and adjacent nonirradiated control sites. Data of ET as expressed by comparison of the averaged A-scans differed significantly between nonirradiated (94.2 +/- 15.7 microm), UVA1 (105.4 +/- 12.8 microm) and UVB (125.7 +/- 22.1 microm) exposed sites. In comparison to the nonirradiated sites, UVA1 exposed skin showed significant (P = 0.022) increase of ET of 11% and UVB exposed sites a significant (P < 0.001) increase of 25%. ET of UVA1 and UVB exposed skin sites differed significantly (P =0.005). Our results obtained from OCT in vivo measurements confirm data of previous histological studies indicating that not only erythemogenic doses of UVB, but also suberythemogenic doses of UVA1 may have a significant impact on ET. OCT appears to be a promising bioengineering technique for photobiological studies. However, further studies are needed to establish its measurement precision and validity, and to investigate in vivo spectral dependence on UV induced skin changes such as skin thickening.

Adult↗

Spontaneously occurring mutations in the cyclobutane pyrimidine dimer photolyase gene cause different sensitivities to ultraviolet-B in rice.

Sensitivity to ultraviolet-B (UVB) radiation (280-320 nm) varies widely among rice cultivars. We previously indicated that UV-resistant rice cultivars are better able to repair cyclobutane pyrimidine dimers (CPDs) through photorepair than are UV-sensitive cultivars. In this paper, we report that UVB sensitivity in rice, in part, is the result of defective CPD photolyase alleles. Surjamkhi (indica) exhibited greater sensitivity to UVB radiation and was more deficient in CPD photorepair ability compared with UV-resistant Sasanishiki (japonica). The deficiency in CPD photorepair in Surjamkhi resulted from changes in two nucleotides at positions 377 and 888 in the photolyase gene, causing alterations of two deduced amino acids at positions 126 and 296 in the photolyase enzyme. A linkage analysis in populations derived from Surjamkhi and Sasanishiki showed that UVB sensitivity is a quantitative inherited trait and that the CPD photolyase locus is tightly linked with a quantitative trait locus that explains a major portion of the genetic variation for this trait. These results suggest that spontaneously occurring mutations in the CPD photolyase gene cause different degrees of sensitivity to UVB in rice, and that the resistance of rice to UVB radiation could be increased by increasing the photolyase function through conventional breeding or bioengineering.

Amino Acid Sequence↗

Correlation of clinical features and skin barrier function in adolescent and adult patients with atopic dermatitis.

BACKGROUND: Xerotic changes in atopic skin are considered to be related to a decrease in the water permeability barrier. Whether abnormal skin barrier function is the main cause of atopic dermatitis (AD) or a secondary change of the disease is still controversial. Noninvasive bioengineering methods, including the measurement of the transepidermal water loss (TEWL) and water capacitance, have been commonly used to evaluate skin barrier function. AIM: To evaluate the correlation between the clinical features of each evaluation site (severity of AD) and skin barrier function. METHODS: TEWL, capacitance, and pH were checked on five evaluation sites: postauricle, forearm, abdomen, thigh, and popliteal fossa. The subjects included 25 patients, both adolescents and adults, with AD and 25 age-matched normal controls. The clinical severity, from 0 (no clinical manifestation) to 3 (severe), was also scored for erythema, induration/papulation, lichenification, and xerosis on each evaluation site of the AD patients. RESULTS: Based on the data, we found that the clinical severity score was correlated with TEWL and capacitance in more than one-half of the evaluation sites. Erythema and induration/papulation showed a statistically significant correlation with TEWL in most cases (P < 0.05, four sites). Lichenification and xerosis showed a significant correlation with capacitance in most cases (P < 0.05, four sites). In most cases, severity scoring of the clinical features did not show a significant correlation with skin pH. The patients showed higher TEWL and lower capacitance than normal controls (P < 0.05, all five sites). CONCLUSIONS: The results of our study suggest that skin barrier function, measured by TEWL and capacitance, and clinical severity show a statistically significant correlation in patients with AD.

Adolescent↗

Taking advantage of the positive side-effects of smallpox vaccination.

From the introduction of smallpox vaccination approximately 200 years ago right up to its discontinuation (1980), reports by physicians and scientists about positive side-effects such as healing of chronic skin rashes, reduced susceptibility to various infectious diseases, e.g. measles, scarlet fever and whooping cough, and even the prophylactic use of the vaccination, e.g. against syphilis, were published again and again. Comparison with the period after cessation of vaccination confirms the experiences of the above vaccinators. As early as 1956, targeted research on these observations led to evidence of the 'ring-zone phenomenon', i.e. the production of soluble antiviral substances in infected chicken embryos and cell cultures. With the help of modern immunological and bioengineering methods, it was later possible to demonstrate that these effects are based on the activation of lymphoreticular cells and the regulatory effect of certain cytokines within the context of the non-specific immune system. These findings led to the development of paramunization with paraspecific vaccines from highly attenuated animal pox viruses. During attenuation, deletions in the virus DNA occur. Attenuated animal pox strains are therefore suited for the production of vector vaccines. The fact that these vector vaccines demonstrate an especially high level of paraspecific efficacy and lack harmful effects is likewise the result of the attenuated animal pox viruses. Optimum regulation of the entire immune system leads to increased paramunity already in the first few days after vaccination and to enhanced antigen recognition and thus accelerated commencement of specific immunity.

Animals↗

Microsurgery in otolaryngology: the future.

Five areas of active clinical research development in otolaryngology have been selected to illustrate the specific applications of microsurgical principles and the potential future of associated bioengineering research. These are: (i) biocompatible microelectronic circuitry and cochlear electrode implant in total cochlear deafness, with preservation of auditory nerve function; (ii) microneural surgery of the facial nerve in hemifacial spasm and the techniques available for reinnervation of the paralysed larynx; (iii) laser microsurgery of the larynx--a new surgical modality dependent on high-precision control through the operating microscope; (iv) microvascular free tissue transfer in head and neck reconstruction and its potential value following combined irradiation therapy for carcinoma; and (v) human laryngeal transplantation--its current status.

Cochlear Implants↗

Skin capacitance mapping of psoriasis.

BACKGROUND: The pathobiological dynamics of psoriatic lesions are complex and difficult to perceive by clinical inspection alone. Non-invasive bioengineering methods may prove to be useful in this field. OBJECTIVE: To identify some subtle capacitance variations in the stratum corneum of chronic psoriasis lesions. METHOD: The newly developed method of skin capacitance imaging was used to provide non-optical images of the hydration of the superficial layers of the stratum corneum. RESULTS: Compared to the uninvolved skin, psoriatic lesions usually showed an overall lowered capacitance, admixed with foci of moderately higher capacitance. Still other sharply circumscribed blotches with higher capacitance were present. The latter aspect corresponded to inflammatory areas. Sweating appeared markedly impaired inside the lesions. The fingerprint of some patients was altered, thus potentially interfering with the current biometric security procedures using the same method. CONCLUSION: Skin capacitance imaging is a non-invasive, non-optical method that distinguishes three contrasting levels of stratum corneum hydration in psoriatic lesions. The lowest capacitance level probably corresponded to xerotic orthokeratosis. The medium capacitance level presumably identified foci of parakeratosis and clumps of neutrophils. The highest capacitance level suggested exsudation at the site of prominent vessel dilation and dermal inflammation. Impaired sweating in the psoriatic lesions may potentially interfere with body thermoregulation.

Dermatoglyphics↗

How to build and rebuild a lens.

Evolution has used many different strategies to build eyes and lenses. However, the genetic regulation involved seems to be quite conserved. Likewise, the regeneration of eye structures is remarkable, especially in salamanders. This review outlines the basic mechanisms of lens regeneration and its induction and the possibility of creating lenses by transdifferentiation of the pigment epithelial cells, by stem cells or by bioengineering.

Animals↗

Dermal fillers.

The new bioengineered human collagen products and the various hyaluronic acid (HA) fillers are all safe and effective agents for soft tissue augmentation. There is no one best filler for all purposes and optimal results are achieved by using these products in various combinations. In my opinion, HA-containing products provide volume while collagen products are better suited to provide structural support. Less downtime is associated with the collagen products, due to the platelet-aggregating effects of collagen and the eosinophil-stabilizing effects of lidocaine. Using collagen in combination with HA, during the same office visit, may help reduce some of the bruising and swelling seen with HA alone.

Journal Article↗

Capillaroscopy and videocapillaroscopy assessment of skin microcirculation: dermatologic and cosmetic approaches.

BACKGROUND: Different noninvasive bioengineering techniques exist to study the microvasculature of the skin and the dynamics of the microcirculation. The goal of these techniques is to visualize the skin capillary circulation easily and directly. Indeed, this information is irreplaceable to study the physiology and physiopathology of the skin capillary circulation efficiently. AIMS: Capillaroscopy and video-capillaroscopy techniques are presented with different methods to study the capillary structure of the skin. METHODS: The methods presented in this work include image processing analysis combining morphology, statistics, geometry, and neural network detection designed to quantify the microcirculation and to follow its evolution. To illustrate the combination of these techniques and methods, different examples of their application are described, in dermatology (hypertension, venous insufficiency, age-related changes) as well as in cosmetology (rosacea and erythrosis assessment). CONCLUSION: The determination of structural or dynamic changes in the cutaneous microcirculation belongs to the noninvasive techniques of the biometrological domain. Thus, every capillary modification resulting from topical cosmetic products, or chemical agents can be observed. In pathology, numerous conditions can be better examined with this system. Associated with the potential of numerical image analysis, capillaroscopy techniques will probably extend their application fields to the assessment of the influence of arterial and venous diseases on the skin nutritional circulation.

Journal Article↗

Growth regulation of endothelial cells by tissue fragments: analysis on mechanism of rapid endothelialization of tissue-seeded vascular prosthesis in a three-dimensional culture system.

Rapid endothelialization of the inner surface was reported in an autologous tissue-seeded vascular prosthesis. We applied a three-dimensional in vitro culture system to elucidate the precise mechanism of rapid endothelial coverage of a tissue-seeded vascular prosthesis. Human venous, omental, adipose and striated muscle tissue fragments were harvested from surgical specimens. They were embedded in collagen gel, and 2.0 x 10(5) bovine aortic endothelial cells (BAECs) were seeded on the gel. The number of BAECs was counted on Days 2 and 7. Growth rate of BAECs was facilitated on the collagen gel with omental and striated muscle tissue fragments (p < 0.05). Factor VIII-negative spindle cells migrated around tissue fragments, especially around the omental and striated muscle tissue fragments. Rapid endothelialization of a tissue-seeded vascular prosthesis may result from facilitation of EC proliferation by viable tissue fragments and migrated cells. These results confirm tissue fragments regulate EC growth, and are useful as bioengineering tools.

Animals↗

The importance of pulsatile and nonpulsatile flow in the design of blood pumps.

The traditional approach of total artificial heart (TAH) and ventricular assist device (VAD) development has been the mimicking of the native heart. Nonpulsatile flow using cardiopulmonary bypass has provided evidence of short-term physiologic tolerances. The design of nonpulsatile TAHs and VADs has eliminated the need for valves, flexing diaphragms, and large ventricular volumes. However, these devices require high efficiency power sources and reliable bearing seals or electromagnetic bearings while simultaneously attempting to avoid thromboemboli. The physiologic response to nonpulsatile flow is complex and variable. When compared to a pulsatile device, a nonpulsatile TAH or VAD needs to produce increased flow and higher mean intravascular pressures to maintain normal organ function. Despite its maintaining normal organ function, nonpulsatile flow does cause alterations in biochemical functions and organ specific blood flow. The combination of bioengineering superiority and the maintenance of physiologic homeostasis has directed future TAH and VAD research towards nonpulsatile systems.

Cardiopulmonary Bypass↗

Collagen fillers.

Collagen implants, both animal and human derived, have been used for soft tissue augmentation for many years. Bovine collagen fillers were the most popular injectable implants for nearly two decades in the United States. Since then, human bioengineered collagen products have been available in addition to hyaluronic acid-containing fillers. This article outlines the different types of injectable collagen implants, injection techniques, preferred methods of treatment, and possible adverse reactions to the injectable materials.

Biocompatible Materials↗

Effect of hormone replacement therapy for menopause on the mechanical properties of skin.

OBJECTIVE: To evaluate the effect of hormone replacement therapy (HRT) for menopause on the mechanical properties of the skin in healthy women. DESIGN: A group of 114 women, including 43 nonmenopausal controls, 46 menopausal women with HRT and 25 menopausal women without HRT, participated in the study. Mechanical properties of the skin were measured on the volar forearm using a computerized suction device. SETTING: University medical center. Research laboratory in bioengineering and biometrology. RESULTS: Computerized measurements of skin deformability and viscoelasticity revealed differences between the three groups of women. A steep increase in skin extensibility was evidenced during the perimenopause in untreated women. HRT appeared to limit the age-related increase in cutaneous extensibility, thereby exerting a preventive effect on skin slackness. No effect of HRT was found on other parameters of skin viscoelasticity. CONCLUSION: HRT has a beneficial effect on some mechanical properties of skin and thus may slow the progress of intrinsic cutaneous aging.

Adult↗

Soluble, insoluble and geometric signals sculpt the architecture of mineralized tissues.

Bone morphogenetic and osteogenic proteins (BMPs/OPs), members of the transforming growth factor-beta (TGF-beta) superfamily, are soluble mediators of tissue morphogenesis and induce de novo endochondral bone formation in heterotopic extraskeletal sites as a recapitulation of embryonic development. In the primate Papio ursinus, the induction of bone formation has been extended to the TGF-beta isoforms per se. In the primate and in the primate only, the TGF-beta isoforms are initiators of endochondral bone formation by induction and act in a species-, site- and tissue-specific mode with robust endochondral bone induction in heterotopic sites but with limited new bone formation in orthotopic bone defects. The limited inductive capacity orthotopically of TGF-beta isoforms is associated with expression of the inhibitory Smads, Smad6 and Smad7. In primates, bone formation can also be induced using biomimetic crystalline hydroxyapatite matrices with a specific surface geometry and without the exogenous application of osteogenic proteins of the TGF-beta superfamily, even when the biomimetic matrices are implanted heterotopically in the rectus abdominis muscle. The sequence of events that directs new bone formation upon the implantation of highly crystalline biomimetic matrices initiates with vascular invasion, mesenchymal cell migration, attachment and differentiation of osteoblast-like cells attached to the substratum, expression and synthesis of osteogenic proteins of the TGF-beta superfamily resulting in the induction of bone as a secondary response. The above findings in the primate indicate enormous potential for the bioengineering industry. Of particular interest is that biomimetic matrices with intrinsic osteoinductivity would be an affordable option in the local context.

Animals↗