Multiple Fibromas of Tendon Sheath: Unusual Presentation

Fibroma of the tendon sheath is an uncommon soft tissue tumor presenting as a solitary, slow-growing, firm, painless, small nodule, which shows strong attachment to the tendon or tendon sheath. It is usually localized on fingers and hand tendons in adults between the age of 20 and 40 years old. This case concerns a 61-year-old man presenting with a 5-year history of multiple cutaneous nodules on both palms and soles. Skin biopsy confirmed fibroma of the tendon sheath. Blood tests showed a high titer of rheumatoid factor and positivity to anti-nuclear antibody. No case of fibroma of the tendon sheath occurring multifocally on both palms and soles has been previously reported. Herein, we report on a very rare case of multiple fibromas of the tendon sheath arising from palms and soles, which supports the pathogenetic hypothesis that this tumor may be a reactive process rather than a true neoplasm

Pimecrolimus 1% cream for anogenital lichen sclerosus in childhood

BACKGROUND: Lichen sclerosus is a chronic inflammatory disease with a predilection of the anogenital region. Because of the potential side effects of repeated local application of potent glucocorticosteroids, equally-effective, safer therapeutic options are required, especially in the treatment of children. CASE PRESENTATIONS: We report on the efficacy of twice-daily application of pimecrolimus 1% cream in four prepubertal girls (range of age: 4 to 9 years) who suffered from anogenital lichen sclerosus. After three to four-month treatment, all patients had almost complete clinical remission including relief from itch, pain and inflammation. Only minor improvement was observed for the white sclerotic lesions. No significant side effects have been observed. CONCLUSIONS: Topical pimecrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. The clinical benefits observed in the four patient presented particularly include relief of pruritus, pain and inflammation. Vehicle-controlled studies on a larger number of patients are now warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital lichen sclerosus

Contact dermatitis and other skin conditions in instrumental musicians

BACKGROUND: The skin is important in the positioning and playing of a musical instrument. During practicing and performing there is a permanent more or less intense contact between the instrument and the musician's skin. Apart from aggravation of predisposed skin diseases (e.g., atopic eczema or psoriasis) due to music-making, specific dermatologic conditions may develop that are directly caused by playing a musical instrument. METHODS: To perform a systematic review on instrument-related skin diseases in musicians we searched the PubMed database without time limits. Furthermore we studied the online bibliography "Occupational diseases of performing artist. A performing arts medicine bibliography. October, 2003" and checked references of all selected articles for relevant papers. RESULTS: The most prevalent skin disorders of instrumental musicians, in particular string instrumentalists (e.g., violinists, cellists, guitarists), woodwind players (e.g., flautists, clarinetists), and brass instrumentalists (e.g., trumpeters), include a variety of allergic contact sensitizations (e.g., colophony, nickel, and exotic woods) and irritant (physical-chemical noxae) skin conditions whose clinical presentation and localization are usually specific for the instrument used (e.g., "fiddler's neck", "cellist's chest", "guitar nipple", "flautist's chin"). Apart from common callosities and "occupational marks" (e.g., "Garrod's pads") more or less severe skin injuries may occur in musical instrumentalists, in particular acute and chronic wounds including their complications. Skin infections such as herpes labialis seem to be a more common skin problem in woodwind and brass instrumentalists. CONCLUSIONS: Skin conditions may be a significant problem not only in professional instrumentalists, but also in musicians of all ages and ability. Although not life threatening they may lead to impaired performance and occupational hazard. Unfortunately, epidemiological investigations have exclusively been performed on orchestra musicians, though the prevalence of instrument-related skin conditions in other musician groups (e.g., jazz and rock musicians) is also of interest. The practicing clinician should be aware of the special dermatologic problems unique to the musical instrumentalist. Moreover awareness among musicians needs to be raised, as proper technique and conditioning may help to prevent affection of performance and occupational impairment

The effects of maternal childhood maltreatment on the cell composition in blood counts of maternal and umbilical cord blood

Background: Childhood abuse and neglect is associated with persevering psychological and physical consequences at the victim’s expense. The phenomenon of a biological memory taken into account, there might be biological means that enable childhood maltreatment experiences not only to persist throughout life but also to be passed on intergenerationally. Methods: This thesis investigated the effects of childhood maltreatment on blood cell counts. Women at the maternity ward were interviewed with respect to experiences of childhood maltreatment employing the Childhood Trauma Questionnaire- Short Form. Blood was drawn from those mothers and from their newborn`s umbilical cord. Results: Performing correlation analyses, it was found that the hematologic parameters of newborns are widely independent of their mothers’ in this explorative study. A significant positive association between former childhood maltreatment and the maternal mean thrombocyte volume was detected conducting regression analyses. Discussion: If this effect can be replicated in future studies, an adaption of the anticoagulant therapy of women in childbed with a history of childhood maltreatment experiences should be considered

Electrophysiology of Gαz protein as a mediator for seizure susceptibility

Seizures are marked by a state of irregular, recurrent neuronal activity in the brain. Seizures are typical across a wide range of disorders including epilepsy, autism, and they are high comorbidity with anxiety disorders. In the mouse model, increased levels of brain-derived neurotrophic factor (BDNF) have been linked to increased seizure susceptibility. Gαz, a member of the G-protein family, is important for the negative regulation of BDNF; Gαz-null show more BDNF-regulated axon growth. We postulated that since Gαz-null mice have increased levels of BDNF, Gαz might play a role in mediating seizure susceptibility. A previous study from our lab showed that Gαz -null mice were in fact more susceptible to seizures than wildtype (WT) mice. This study was conducted to characterize neuronal seizure activity and progression across different brain regions for this genetic model. Electrodes were implanted into the brains of WT and Gαz -null mice to record the local field potential (LFPs), proxy for relative activity, during induced seizure by the pilocarpine (180mg/kg) drug. LFP data was recorded simultaneously from 6 brain regions: amygdala, dorsal hippocampus, motor cortex, somatosensory cortex, ventral hippocampus, and thalamus. The Gαz -null mice had more severe seizure behavior and more robust electrographic activity in comparison to the WT group. The site of seizure onset and progression for the WT group closely matches the pattern from other studies, while the Gαz -null mice showed a novel pattern. The behavioral and electrographic results confirm the role of Gαz in mediating seizure severity and susceptibility; further studies will be needed to confirm the seizure progression pattern noted for the WT and Gαz-null groups.  Honors thesi

Rival American Allies: Turkey and Israel in the Eastern Mediterranean

The contemporary dynamics between Israel and Turkey have been confronta- tional at recent times though this doesn’t seem to affect the relations in other areas as the trade balance advancing towards the $8 million shows. This article focuses on the relations between Israel and Turkey within the context of the East Mediterranean geopolitics. Reviewing its shift from a quasi-alliance to a stiff geopolitical rivalry in the region, the article explores scenarios for near future