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Biomedical subjects

S M John

Publications and source records attributed to S M John.

At least 19 recordsLinked to original sources

The tripeptide phenylalanine-(D) glutamate-(D) glycine modulates leukocyte infiltration and oxidative damage in rat injured spinal cord.

The tripeptide, phenylalanine-glutamate-glycine (FEG) and its d-isomeric form phenylalanine-(D) glutamate-(D) glycine (feG), derived from submandibular gland peptide-T, significantly reduce the allergic inflammatory response and leukocyte trafficking and neutrophil migration into intestine, heart and lungs. Due to these actions, we hypothesized that feG would attenuate the early inflammatory response to spinal cord injury, reduce free radical production and improve neurological outcomes, like other leukocyte-limiting strategies we have used previously. We tested this using a clip compression model of spinal cord injury in rats. Following spinal cord injury at the 4th thoracic cord segment, we quantified leukocyte infiltration, free radical formation and oxidative damage at the lesion site after feG or control peptide phenylalanine-(D) aspartate-(D) glycine treatment. In rats treated with feG at 2 and 12 h, or 6 and 12 h after spinal cord injury, mean myeloperoxidase activity and ED-1 expression were significantly lower ( approximately 40%) than in controls at 24 h. Free radical formation generated in injured spinal cord was detected using 2',7'-dichlorofluorescin-diacetate as a fluorescent probe. Free radical production in the injured cord increased significantly after spinal cord injury and feG treatment significantly reduced this free radical production. Oxidative enzymes, lipid peroxidation and cell death were also significantly ( approximately 40%), gp91 ( approximately 30%), thiobarbituric acid reactive substance levels ( approximately 35%), 4-hydroxynonenal-bound protein ( approximately 35%) and caspase-3 ( approximately 32%). Early administration of feG decreases infiltration of inflammatory cells into the injured spinal cord and intraspinal free radical formation, thereby reducing oxidative damage and secondary cell death after spinal cord injury.

Animals↗

[New forms of management in dermatology. Integrated in-patient-out-patient prevention of severe occupational dermatoses: cornerstones for an effective integrated management in clinics and practices].

Occupational dermatoses (OD) are the most frequent occupational diseases in Germany and amount to more than 25% of all suspected occupational diseases. Preventive measures have proven to be very effective in recent years, especially measures of primary and secondary prevention as components of a complex hierarchical prevention concept in wet work occupations. If employees are in danger of loosing their job due to a severe OD, intensive interdisciplinary measures of tertiary individual prevention (TIP) are required. TIP comprises 2-3 weeks of in-patient treatment plus intensive health-pedagogic counselling, followed by 3 consecutive weeks (or longer) of out-patient treatment by the local dermatologists ("Osnabrueck model"). Each patient will stay off work for a total of at least 6 weeks to allow full barrier-recovery. It could be shown that 2/3 of the patients successfully remained in their workplaces because of TIP. TIP reveals remarkable pertinent options for interdisciplinary disease management in severe OD in all risk professions. In Germany recently, a multi-centre study was started which will further standardise such preventive measures and evaluate their long-term success.

Ambulatory Care↗

[New dermatologist's procedure. Research plans for improving secondary prevention of occupational dermatoses].

The dermatologist's procedure was introduced in 1972 by employers' liability insurance funds in the industrial, agricultural, and public sectors of Germany's statutory occupational accident insurance as a "procedure for early detection of occupational skin diseases." So far, it is still the most relevant tool for secondary prevention in occupational dermatology in Germany. According to the intention of this procedure, insured persons with a skin disease in which an occupational etiology is suspected must be offered preventive measures and, if necessary, given appropriate treatment to avoid job-loss. To improve the efficiency of the "classic" dermatologist's procedure, in 1999, on the initiative of the Central Federation of Industrial Professional Associations, a study group was founded in cooperation with the Task Force on Occupational and Environmental Dermatology of the German Dermatological Society and the Professional Organisation of German Dermatologists. In October 2002, a controlled intervention study started in North-western Germany to scientifically evaluate the "optimised" dermatologist's procedure, which was proposed by the study group and compare it to the standard ("classic") procedure. The study results should allow detailed suggestions for an improved dermatologist's procedure before it is introduced nationwide.

Cross-Sectional Studies↗

Early secondary prevention of occupational skin disease in Germany: the dermatologist's procedure in perspective.

The dermatologist's procedure was introduced in 1972 as a "procedure of early detection of occupational skin disease" by industrial, agricultural and public-sector employers' liability insurance funds of Germany's statutory occupational accident insurance. To date, it represents the most relevant tool for secondary prevention in industrial dermatology in Germany. According to the intention of this procedure, insured parties who are likely to have an occupational skin disease have to be offered preventive measures and, if necessary, given appropriate treatment to avoid job-loss. In co-operation with the Central Federation of the Industrial Professional Associations, the Task Force on Occupational and Environmental Dermatology of the German Dermatological Society, and the Professional Organisation of German Dermatologists, a study group was constituted in 1999 to improve the traditional dermatologist's procedure. In October 2002 a controlled intervention study was started in North-western Germany to establish the definitive value of the "optimised" dermatologist's procedure. Past, present, and future of this specific procedure are discussed.

Dermatology↗

Patch test sensitization caused by para-tertiary-butylcatechol. Results of a prospective study with a dilution series.

Para-tertiary-butylcatechol (PTBC) has been patch tested in Europe at 1% in petrolatum (pet.) and is now suspected of induction of patch test sensitization. A prospective study was initiated to obtain detailed data on this undesirable risk. A dilution series of PTBC (1%, 0.5%, 0.25%, 0.1% pet.) was used. Patch tests were read on days (D) 1-3, 7, 14 and 21 after application. Patients who were unable to return for late readings were telephoned and asked to report any reaction at the patch test sites. 40 out of 46 patients included completed the study. Patch tests were negative in 35 patients. 4 patients showed a positive patch test at later readings only (D7-D21); 2 patients reacted to a concentration as low as 0.1%. Rechallenge was performed in 2 of these patients, revealing a clearly positive reaction as early as D2 after patch test application. PTBC clearly induced patch test sensitization in 10% of the patients. It cannot be excluded that patch testing with 0.25% PTBC or with even lower concentrations might induce patch test sensitization. The optimal patch test concentration still has to be determined but may be within the range of 0.01% to 0.25% PTBC.

Adult↗

The forensic pathology of nonagenarians and centenarians: do they die of old age? (The Auckland experience).

The aim of this study is to provide awareness of the common causes of death and their associated trends in the very aged. Forensic autopsies on patients aged >90 years were reviewed. The study lasted from January 1, 1988 to December 11, 1998 and was done in Auckland, New Zealand, the population of which is 1.3 million. Cases were divided into natural or unnatural deaths. Of the total of 319 cases, 272 (85%) deaths were natural. Of those, only 13 (5%) were "written off" as being attributed to old age or senile debility. The most common causes of death were ischemic heart disease (IHD), 74 cases (23%); bronchopneumonia, 37 cases (12%); fractures, 28 cases (9%); acute myocardial infarction, 25 cases (8%); cerebrovascular accident, 19 cases (6%); and ruptured aneurysm, 17 cases (5%); 61 (19%) deaths were multifactorial. Fractures, either as the primary cause of death or as a complicating factor, accounted for 29 cases, third only to IHD and bronchopneumonia. Forty-seven deaths (15%) were unnatural; of those, 43 were accidents, 3 were suicides, and 1 was a homicide. From these results it is clear that the very elderly succumb to disease; they do not often die of old age.

Aged↗

Relevance of multiparametric skin bioengineering in a prospectively-followed cohort of junior hairdressers.

There is conflicting evidence concerning predictors of individual susceptibility to develop irritant contact dermatitis in wet work. A cohort of initially 92 hairdresser apprentices was prospectively followed for 3 years. The association between anamnestic and clinical findings, and multiparametric skin bioengineering data (transepidermal water loss [TEWL], microcirculation, capacitance, pH, sebum, temperature) was investigated. The observation intervals were 3 months in the 1st year of training and 12 months thereafter. Of the 92 apprentices, 6 had already developed hand dermatitis on 1st examination, 20 dropped out or had occupational exposure longer than 7 weeks prior to investigation. Of the remaining 66 participants considered here, 19 (29%) developed moderate or severe dermatitis ("cases"), 32 minimal skin changes, 15 none within the observation period. Average incidence rate of hand dermatitis was 21.1 cases per 100 person years. Atopy score was not associated with the development of dermatitis, nor were the investigated basal bioengineering parameters, including TEWL, in a multivariable model. However, there was a significant increase in TEWL within the 1st year of training in presumptive "cases". The aim to develop an objective and predictive instrumentary for pre-employment counselling in wet work, by a combination of (a) clinical and (b) relevant non-invasive bioengineering parameters, has not yet been accomplished. Skin-provocation tests employing bioengineering seem to be required. Notwithstanding, work-related monitoring of basal biophysical skin-functions may become useful in the secondary prevention of occupational dermatitis.

Adolescent↗

Meningococcal disease and meningitis: a review of deaths proceeding to coroner directed autopsy in Auckland.

AIMS: To assist the early diagnosis of meningitis, by finding trends and patient profiles, where delay or other factors may have lead to a fatal outcome. METHODS: All deaths from meningitis and meningococcal disease, confirmed at autopsy were reviewed. The study involved the Auckland area, in the period January 1988 November 1997. RESULTS: Cases were divided into those caused by N meningitidis and other meningitides. Death due to N meningitidis is often within 12-24 hours of the first symptomatology. Symptoms are often vague and may be indistinguishable from any other infection, often leading to fatal patient or doctor delay. A diagnosis of meningococcal disease cannot be excluded on: no rash (44%), no "meningitis" symptoms as sepsis without meningitis occurs (44%), age (50% were over 15 years old) or the presence of other abnormalities, eg bronchopneumonia or hydrocephalus. Non-N meningitidis menigitis is a disease of the very young or old, its time course is also swift with 30% suffering similar vague symptoms for less than 24 hours before death. CONCLUSIONS: For both categories, treat immediately and treat on suspicion, otherwise conformation of the diagnosis might be postmortem.

Adolescent↗

Topical immunotherapy in alopecia areata: anamnestic and clinical criteria of prognostic significance.

BACKGROUND: Topical immunotherapy of alopecia areata (AA) is an effective but time-consuming treatment with unknown long-term risks. OBJECTIVE: The purpose of this study was to identify criteria which allow a selection of patients with a good prognosis for topical immunotherapy with diphencyprone. METHODS: The anamnestic and clinical data of 50 successfully and 55 unsuccessfully treated patients were compared by the Mann-Whitney test. RESULTS: Five factors were found to be of prognostic significance: type of AA (p < or = 0.001), presence of nail changes (p < or = 0.001), duration of AA before treatment (p < or = 0.005), age at onset (p < or = 0.01) and association with atopic eczema (p < or = 0.02). CONCLUSION: A selection of AA patients who are likely to respond to topical immunotherapy is possible on the basis of anamnestic and clinical data.

Administration, Topical↗

Wartime evacuation and mortality from childhood leukaemia in England and Wales in 1945-9.

OBJECTIVE: To discover whether the wartime government evacuation of children from London and other population centres to rural districts was associated with any increase in childhood leukaemia. DESIGN: Observational study of mortality from leukaemia among the childhood population of England and Wales in relation to the unique population movements during the second world war. The 476 rural districts of England and Wales were ranked according to the ratio of government evacuees (two thirds of them children) to local children in September 1941. The districts were divided into three categories, each with similar numbers of children in 1947 but with different ratios of evacuees to local children ("low," "intermediate," "high"). Mortality from childhood leukaemia was examined in these three rural categories in 1945-9. Urban areas were also examined according to their exposure to evacuees. SETTING: Local authority areas of England and Wales. SUBJECTS: Children aged under 15. RESULTS: 47% excess of leukaemia at ages 0-14 years occurred in 1945-9 in the rural "high" category for evacuees relative to the "low" category, with a significant trend across the three categories. There were increases in both the 0-4 and 5-14 year age groups, but these were larger in the older age group. Rates 25% lower than average occurred in rural areas with few evacuees. CONCLUSION: These findings suggest that wartime evacuation increased the incidence of childhood leukaemia in rural areas and that other forms of population mixing may have contributed to the increases in past decades. Overall, they add to the appreciable evidence for an infective basis in childhood leukaemia.

Adolescent↗

Actinic comedonal plaque--a rare ectopic form of the Favre-Racouchot syndrome.

A 59-year-old woman with a single cuff-like plaque, consisting of multiple skin-coloured to bluish cysts and comedones on her right forearm is reported. The solitary lesion resembled, morphologically and histologically, the Favre-Racouchot syndrome. The above condition is another case of the previously described actinic comedonal plaque, which seems to be a rare entity within the spectrum of disease caused by actinic damage to the skin.

Dermatitis, Photoallergic↗

Stress-induced increase of extracellular levels of cyclic AMP in rat cortex.

Previous studies have suggested that stress may increase levels of cyclic AMP (cAMP) in the brain but these findings have been controversial due to the use of stressful procedures to inactivate brain enzymes. The present experiment therefore used a non-stressful technique, microdialysis, to assay extracellular levels of cAMP in the rat cortex after stress. Experiments were conducted 2 days after implantation of probes in the frontal cortex. Significant increases were found after the mild stressors of restraint or intraperitoneal injection of saline suggesting that increased tissue levels of cAMP had occurred. These responses were potentiated by local infusion of the phosphodiesterase (PDE) inhibitor, rolipram. It is concluded that one or more adenylate cyclase-coupled receptors in the cortex is activated by mild stress and that this activation can be detected in vivo by microdialysis.

Adenylyl Cyclases↗