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Biomedical subjects

P Lenane

Publications and source records attributed to P Lenane.

10 recordsLinked to original sources
PubMed2003

Mucor mycosis infection presenting as a non-healing ulcer in an immunocompromised patient.

Mucor mycosis is an uncommon saprophytic opportunistic fungus causing localized cutaneous infection associated with high morbidity and, on dissemination, high mortality. We report the case of an immunocompromised patient with an aggressively progressing, painful non-traumatic ulceration, unresponsive to standard treatment. Deep biopsies for haematoxylin and eosin staining and fungal culture revealed the characteristic broad non-septate irregular hyphae of mucor allowing introduction of the appropriate treatment. Infection with mucor mycosis must be considered in today's medical environment as the number of immunocompromised patients increases.

Humans↗
PubMed2002

The expression of p53, p21, Bax and induction of apoptosis in normal volunteers in response to different doses of ultraviolet radiation.

BACKGROUND: Ultraviolet radiation (UVR) damages keratinocytes. Direct DNA damage may undergo enzymatic repair followed by resumption of the normal cell cycle. Cells may also be eliminated without inflammation by the error-free process of programmed cell death or apoptosis. Necrosis of cells can occur after overwhelming damage. Failure of apoptosis leads to retention of cells with persistent mutations. OBJECTIVES: This study investigates p53-dependent apoptotic responses in normal skin following solar-simulated radiation (SSR). METHODS: Sun-protected buttock skin from normal volunteers with no history or clinical evidence of skin cancer was exposed to graded doses of SSR, 0.5, 1, 2 and 3 times the minimal erythema dose (MED). Biopsies taken at a range of time points (4.5, 9, 24, 33, 48 and 72 h) after UVR, quantified the time course and dose-response of apoptosis and the expression of the relevant proteins, p53, p21waf1/Cip1 and Bax, by single and double labelling techniques. RESULTS: Apoptosis was upregulated in a dose-dependent manner as was the expression of p53, p21waf1/Cip1 and Bax in response to SSR. Following exposure to 3 MEDs it was found that: (i) the maximum number of apoptotic cells occurred at 48 h; (ii) p53 protein expression was upregulated from 4 to 72 h preceding peak p21waf1/Cip1 protein expression (9-48 h) and peak Bax protein expression (33 h). CONCLUSIONS: These results suggest that, following SSR, normal human skin induces apoptosis by the p53, p21waf1/Cip1, Bax pathway in vivo. In addition, induction of apoptosis and expression of p53, p21waf1/Cip1 and Bax occurs in a dose-dependent manner.

Aged↗
PubMed2002

Comparison of the expression of p53, p21, Bax and the induction of apoptosis between patients with basal cell carcinoma and normal controls in response to ultraviolet irradiation.

AIM: Ultraviolet light (UV) is known to cause DNA damage in the epidermis. The damaged DNA is repaired or deleted by apoptosis to prevent the generation of cancer. It has been suggested that a deficient apoptotic mechanism may predispose individuals to skin cancer. Therefore, the response of normal controls and patients with basal cell carcinoma (BCC) to UV irradiation was investigated. METHODS: The buttock skin from normal volunteers and patients with BCC was irradiated using solar simulated radiation (SSR). SSR mimics the effect of natural sunlight. Skin biopsies were excised and examined for p53, p21, and Bax protein expression and for the induction of apoptosis. RESULTS: At 33 hours after UV irradiation, the induction of apoptosis was significantly higher (p = 0.04) in patients with BCC than in normal volunteers (Mann Whitney test). A trend towards higher p21 expression was found at 33 hours in patients with BCC (mean, 18.69 positive cells/field) than in normal volunteers (mean, 9.89), although this difference was not significant (p = 0.05 positive cells/field). CONCLUSION: These results may imply that patients with BCC have enhanced sensitivity to UV irradiation or that there is some defect in the cell arrest or repair pathways, which results in damaged cells been pushed into apoptosis rather than repair.

Apoptosis↗
PubMed2001

The Laugier-Hunziker syndrome.

Laugier and Hunziker described a syndrome consisting of asymptomatic benign areas of hyperpigmentation affecting the lips, buccal mucosa and, in 50%, the fingernails. We report a 67-year-old woman with the clinical features of Laugier-Hunziker syndrome in association with vulval pigmentation. Histology, immunohistochemistry and electron microscopy from the various areas of pigmentation on the body confirmed the benign nature of the pigmentation. We review potential causes of oral and genital pigmentation, and suggest an expansion of the original syndrome described by Laugier and Hunziker to include more widespread areas of benign hyperpigmentation, which may associated.

Aged↗
PubMed2001

Sunscreens and the photodermatoses.

The photodermatoses are defined by their clinical features which result from exposure to ultraviolet radiation or visible light. Accurate diagnosis, which is often complicated, is essential to ensure appropriate treatment and protection from precipitating wavelengths. We review the acquired photodermatoses including polymorphic light eruption, hydroa vacciniforme and chronic actinic dermatitis. The genodermatoses including the DNA repair deficiency and melanin-deficient syndromes are discussed, and the best methods for protection of the cutaneous photodermatoses including relevant sunscreen use are elaborated.

Humans↗
PubMed2000

Partial lipodystrophy and renal disease.

Partial lipodystrophy is a rare disorder with both autosomal recessive and familial forms. The cutaneous findings, which are often subtle, consist of a gradual loss of subcutaneous fat from the face and upper body. Low levels of C3, occasionally low C5 and the presence of the nephritic factor help to identify these patients. Associated systemic abnormalities include the development of mesangiocapillary glomerulonephritis and an increased incidence of autoimmune diseases. Recognition of this unusual disorder is essential for diagnosis and treatment of underlying potentially life- threatening disease.

Adult↗
PubMed2000

Oral pigmentation.

Oral pigmentation may be physiological or pathological in nature. It may represent a localized anomaly of limited significance or the presentation of potentially life-threatening multisystem disease. Evaluation of a patient with oral pigmentation requires a systematic approach with resource to appropriate investigations in certain circumstances. A full history of evolution of the pigmentary changes, as well as inquiring into family history, drug ingestion and systemic symptoms of concurrent disease are clearly important in the assessment. The duration, pattern, hue and distribution of colour changes can provide useful diagnostic clues. Special attention is given to newly appearing lesions, or those that have changed significantly in appearance, and biopsy may be needed to validate the clinical impression. This review should enable the reader to increase their familiarity with the assessment of oral pigmentation, the common causes of oral pigmentary change and the rarer disorders of pigmentation seen in this area. The systemic diseases that may give rise to oral pigmentation are detailed and the early signs of oral melanoma are highlighted, as well as the drugs which may cause pigmentary changes in this area and the different pattern of pigmentation they may induce.

Biopsy, Needle↗
PubMed2000

Genital melanotic macules: clinical, histologic, immunohistochemical, and ultrastructural features.

BACKGROUND: Genital melanotic macules are poorly recognized lesions, which appear as isolated discrete macules. Their occurrence, usually as new pigmented lesions in adult life, can cause concern because they can mimic early melanoma. OBJECTIVE: Our purpose was to define the clinical, histologic, immunohistochemical, and electronmicroscopic features of genital melanotic macules. METHODS: History and clinical features of 10 patients (5 female, 5 male) were assessed in detail. Histologic findings were reviewed in 5 cases, and immunohistochemistry, with the use of the HMB-45 antibody, in 4 cases and electron microscopy in 3 cases. RESULTS: Clinically the lesions varied in color, tan to dark brown/black, and size (0.5-2 cm). Histologic findings showed increased basal pigmentation without atypical features. HMB45 antibody staining was negative. Electron microscopy showed normal morphology and number of melanocytes but increased melanosomes and dermal melanophages. CONCLUSION: Genital melanotic macules are benign, asymptomatic, discrete areas of hyperpigmentation that occur equally in men and women. Histologic, immunohistochemical, and electronmicroscopic study confirms their benign nature.

Adult↗
PubMed1993

Intraarticular analgesia following knee arthroscopy.

A randomized, double-blind, controlled study was conducted in patients undergoing elective knee arthroscopy to assess the analgesic effect of intraarticular morphine and bupivacaine, alone and in combination. Patients in group 1 (n = 10) received 5 mg of morphine in 25 mL of saline; patients in group 2 (n = 10) received 25 mL of 0.25% bupivacaine (62.5 mg); patients in group 3 (n = 10) received a combination of 5 mg of morphine and 62.5 mg of bupivacaine in 25 mL dilution; and patients in group 4 (n = 10) received 25 mL of saline. All the drugs were injected intraarticularly. Postoperative pain was assessed using the visual analogue scale at 1, 2, 4, 8, and 24 h after the intraarticular injection. The need for supplemental analgesia was recorded. Results showed that there was no significant difference in the pain scores or analgesic requirements between groups 1 and 3. Patients in groups 1 and 3 had significantly lower pain scores than those in groups 2 and 4. These low pain scores were associated with lower requirements of supplementary analgesics. The patients in group 4 showed the highest pain scores and analgesic requirements. We conclude that intraarticular morphine significantly reduces postoperative pain following knee arthroscopy and that there is no advantage of combining bupivacaine with morphine.

Adult↗