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Biomedical subjects

R L Moy

Publications and source records attributed to R L Moy.

88 records · Page 5Linked to original sources

The presence of human papillomavirus type 16 in squamous cell carcinoma of the proximal finger and reconstruction with a bilobed transposition flap.

In a 71 year old white female a clinically diagnosed keratoacanthoma on the dorsum of the right third finger was removed using Mohs micrographic surgery and histologically diagnosed as a squamous cell carcinoma. It was shown by dot blot hybridization to have HPV type 16 DNA in the tumor. The wound was reconstructed with a bilobed transposition flap.

Aged↗

Stratospheric ozone depletion and its relationship to skin cancer.

Several articles have appeared in the literature regarding the impact of stratospheric ozone depletion on the prevalence of skin cancer due to increasing ultraviolet radiation. While it has been shown that UVB radiation is related to carcinogenesis of both melanoma and non-melanoma skin cancer, it has not definitively been shown that stratospheric ozone depletion is translating into increased penetrating ultraviolet radiation. Estimates of increasing skin cancer in the future are dependent on calculations of UVB increases drawn from data on ozone depletion. The present article describes the history of stratospheric ozone depletion, how it may affect UVB penetration and skin cancer rates, and what is currently being done to prevent man's further detrimental effects on our atmosphere.

Air Pollutants↗

Sunscreens. Update and review.

The awareness of sun-induced skin damage has increased in both the lay public and physician. Coincidentally, there has been progress in the development of new ultraviolet-(UV) radiation protecting sunscreens. In this review and update on sunscreens, sunscreen classification, UVB and UVA protection, sunscreen vehicle, and substantivity will be addressed.

Humans↗

Commonly used suture materials in skin surgery.

The ideal suture is strong, handles easily and forms secure knots. It causes minimal tissue inflammation and does not promote infection. It stretches, accommodates wound edema and recoils to its original length with wound contraction. Ideally, it is also inexpensive. Although no single suture material possesses all of these features, proper selection of sutures helps achieve better results in skin surgery. Among the absorbable sutures are catgut and treated catgut (both are used infrequently) and the synthetic sutures, which are designed for good tensile strength, easy handling and low tissue reactivity. Nonabsorbable sutures include silk (now infrequently used) and several synthetic materials designed for elasticity, easy handling, good knot security and minimal tissue irritation.

Absorption↗

Commonly used suturing techniques in skin surgery.

Proper suturing technique is essential for obtaining good cosmetic results and avoiding infection, scarring and poor wound healing. Techniques that must be mastered include good eversion of skin edges, avoiding suture marks, maintaining uniform tensile strength along the skin edges and precise approximation of skin edges. Vertical mattress sutures have the advantage of good wound eversion and closure of dead space. Running continuous sutures can be quickly placed and divide tension equally along the skin edge. Interrupted sutures are more time-consuming but allow more precise wound edge approximation, while subcuticular sutures are useful for avoiding suture marks in conspicuous areas.

Dermatologic Surgical Procedures↗

Systemic isotretinoin: effects on dermal wound healing in a rabbit ear model in vivo.

Clinical observations have suggested that wound healing may be altered in patients treated with systemic isotretinoin. In this study, we examined the effects of systemic isotretinoin on dermal wound healing and connective tissue metabolism in a rabbit ear model. Forty 6-mm punch-biopsy wounds were created in the ears of two control rabbits as well as two experimental animals fed isotretinoin, 4 mg/kg per day. Clinical inspection and histologic examination revealed no difference between the control and isotretinoin-treated rabbits in terms of the time required for complete wound healing or the appearance of the final scar. The tissue removed from the wound site at days 0, 7, 14, and 21 after wounding was subjected to analysis of a collagen production and collagen gene expression. Collagen production, determined by the synthesis of [3H]hydroxyproline after incubation of tissue slices with [3H]proline in vitro or by the measurement of the steady-state levels of types I and III procollagen mRNAs, was not significantly different between the two groups. The results indicate that systemic administration of isotretinoin does not affect collagen synthesis in the rabbit ear model of wound healing.

Animals↗

An evaluation of wound closure tapes.

Wound closure tapes are often used to decrease tension on wounds, to close wounds, and to reinforce wounds after suture removal. Seven different brands of wound closure tape, both with and without the additional application of the liquid adhesive Mastisol, were tested for their adhesion to the forearms of 8 volunteers when a 225-gram weight was applied. Steri-Strips with Mastisol had the longest time of adhesiveness, and the application of Mastisol markedly increased the adhesiveness of all 7 tapes evaluated. Only 2 of the 7 tapes, Proxi-Strip and Coverstrip II, showed any significant adhesiveness without Mastisol.

Adhesives↗

Human papillomavirus type 16 DNA in periungual squamous cell carcinomas.

Ten squamous cell carcinomas (in situ or invasive) of the fingernail region were analyzed for the presence of DNA sequences homologous to human papillomavirus (HPV) by dot blot hybridization. In most patients, the lesions were verrucae of long-term duration that were refractory to conventional treatment methods. Eight of the lesions contained HPV DNA sequences, and in six of these the sequences were related to HPV 16 as deduced from low-stringency nucleic acid hybridization followed by low- and high-stringency washes. Furthermore, the restriction endonuclease digestion pattern of DNA isolated from four of these lesions was diagnostic of episomal HPV 16. The high-frequency association of HPV 16 with periungual squamous cell carcinoma is similar to that reported for HPV 16 with squamous cell carcinomas on mucous membranes at other sites, notably the genital tract. Our findings suggest that HPV 16 may play an important role in the development of squamous cell carcinomas of the finger, most notably those lesions that are chronic and located in the periungual area.

Adult↗

Buried vertical mattress suture.

The buried vertical mattress suture combines the advantages of the vertical mattress suture and the buried intradermal suture. It provides prolonged wound support and eversion, while leaving no permanent suture marks on the skin.

Dermatologic Surgical Procedures↗

Selectively enhanced procollagen gene expression in sclerosing (morphea-like) basal cell carcinoma as reflected by elevated pro alpha 1(I) and pro alpha 1(III) procollagen messenger RNA steady-state levels.

Sclerosing or morphea-like variant of basal cell carcinoma (BCC) is characterized by an extensive connective tissue stroma, and histopathology has suggested that the extracellular matrix is largely composed of collagen. In addition, fibronectin deposition has been proposed to modulate tumor growth in BCC. In this study, we examined the expression of genes coding for type I, III, and IV procollagens, as well as for fibronectin, in tissue from 10 patients with sclerosing BCC. For comparison, tissues from 5 patients with nodular BCC and 4 controls were examined. Total RNA was isolated by CsCl density gradient centrifugation, and messenger RNA (mRNA) steady-state levels were determined by slot-blot hybridizations with human sequence specific complementary DNAs (cDNAs). The abundance of type I procollagen mRNA in sclerosing BCC tissue was increased to 233.6 +/- 36.7% of the controls (mean +/- SEM). The corresponding value for type III procollagen mRNA in sclerosing BCC was 281.8 +/- 54.8% of the controls. Consequently, the steady-state ratio of type I/III procollagen mRNAs in sclerosing BCCs (5.0 +/- 1.2; mean +/- SD) was within the control range. Thus, there is a coordinate increase in type I and type III procollagen mRNA levels in sclerosing BCC. In contrast, the values for type I and type III procollagen mRNAs in nodular BCC were not different from the controls. In addition, type IV procollagen and fibronectin mRNA levels were not different from the controls either in sclerosing or nodular BCCs, attesting to the selectivity of the increase in type I and III procollagen mRNA levels in sclerosing BCC. These observations may relate to the excessive deposition of the extracellular matrix stroma surrounding the tumor cells in sclerosing BCC.

Basal Cell Carcinoma↗

Lipoid proteinosis: ultrastructural and biochemical studies.

Lipoid proteinosis, a rare autosomal recessive disease, is histologically characterized by deposition of hyalinlike material in the dermis. In this study the pathologic processes of lipoid proteinosis were evaluated by ultrastructural and biochemical analysis of skin and cultured fibroblasts from a patient with classic features of the disease. Transmission electron microscopy revealed the presence of hyalinlike material with a granular appearance interspersed between collagen fibers. Immediately surrounding the blood vessel walls, there was reduplication of basal laminae in an "onionskin" arrangement. The fibroblastic cells in the affected dermis contained peculiar cytoplasmic inclusions. Biochemical studies with the cultured fibroblasts showed that the total synthesis of extracellular matrix components, as detected by the synthesis of radioactive hydroxyproline or the incorporation of 35SO4(2-) and [3H]glucosamine into macromolecules, was not altered in lipoid proteinosis. However, the relative expression of type I and type III procollagen genes, as detected by molecular hybridizations with pro-alpha 1(I) and pro-alpha 1(III) procollagen complementary deoxyribonucleic acid probes, was markedly altered in cultured fibroblasts. Specifically, the type I procollagen messenger ribonucleic acid (mRNA) levels were significantly reduced, resulting in a decreased type I/III procollagen mRNA ratio. Furthermore, the replicative capacity of lipoid proteinosis fibroblasts, as detected by the incorporation of radioactive thymidine, was reduced. Thus the skin fibroblasts from lipoid proteinosis demonstrate ultrastructural changes, as well as alterations in their phenotypic characteristics, and these changes may have relevance to the pathologic processes of this systemic disease affecting the skin and other organs.

Adult↗

alpha 1-Antitrypsin deficiency in severe psoriasis.

alpha 1-Antitrypsin phenotypes and trypsin-inhibitory capacities were measured in fifty-one patients with psoriasis. An increased number of variant phenotypes (MS, MZ, and SS) were found only in those patients with severe psoriasis (20% or more skin involvement) and not in those with lesser involvement. The psoriatic patients with variant phenotypes had an earlier disease onset than those psoriatic individuals (both mild and severe) without this association. Protease inhibitors may play a role in modifying disease activity in psoriasis.

Adult↗

Low skin temperatures produced by new skin refrigerants.

Temperatures produced by Cryosthesia -30 degrees C, Cryosthesia -60 degrees C, and Frigiderm were measured in minipigs. Cryosthesia -60 degrees C and Cryosthesia -30 degrees C were both found to rapidly lower skin temperatures to levels that have been shown to cause cell injury, necrosis, and loss of melanocytes. Use of these agents requires extreme caution in dermabrasion.

Animals↗

Isotretinoin vs etretinate therapy in generalized pustular and chronic psoriasis.

The clinical response to isotretinoin (13-cis-retinoic acid) in 11 patients with generalized pustular psoriasis was evaluated. Control of pustulation and systemic symptoms was achieved in ten cases, but additional therapy was required to produce complete clearing of all psoriatic lesions. Also, the efficacy of isotretinoin and etretinate in the treatment of chronic plaque psoriasis was compared in 29 patients. Isotretinoin was found to be less effective than etretinate in the treatment of chronic plaque psoriasis.

Adult↗

Immune complexes in pemphigus and bullous pemphigoid.

28 serum and 10 blister fluid specimens obtained from 28 pemphigus vulgaris (PV) patients were assayed for immune complexes using the polyethylene glycol (PEG)assay. 11% of sera and 30% of the blister fluids have elevated levels of immune complexes. Anti-intercellular cement substance (ICS) antibody could not be detected in PEG precipitates, but was present in the supernatants from the serum. However, anti-ICS antibody was found in 70 of the precipitated complexes from the blister fluid. 18 serum and 31 blister fluid specimens obtained from 18 bullous pemphigoid (BP) patients were assayed for immune complexes using the PEG assay. 17% of sera and 31% of the blister fluids have elevated levels of immune complexes. Antibasement membrane zone (BMZ) antibody could not be detected in the PEG precipitates, but was present in the supernatants obtained from the sera. Anti-BMZ antibody was found in 57% of the precipitated complexes from the blister fluids. This data further supports the hypothesis that the majority of the complexes in PV and BP are formed in situ.

Antigen-Antibody Complex↗