[Erythemogenic UV rays].

The UV-index is an international standard measurement of the strength of erythemogenic ultraviolet radiation. It is often published in the media and then refers to the highest expected UV radiation for that day. The highest UV-index value measured in Iceland is seven. Although this is similar to the maximum values from southern Scandinavia, the average UV-index is lower in Iceland compared to other Nordic countries. Around solar noon the UV index is roughly equivalent to the Standard Erythema Dose (SED). During a bright summer day in Iceland the number of Standard Erythema doses can go as high as 32, but is on average in June around twenty. The typical Icelander gets red after 4-6 SED and it is obvious that during solar noon it is easy to sunburn in Iceland if you stay outside without sun protection.Útfjólublár stuðull er alþjóðleg skilgreining sem segir til um styrk útfjólublárra geisla. Gildi hans er oft birt í fjölmiðlum og segir þá til um hæsta gildi sem búist er við þann daginn. Hæsta gildi sem mælst hefur á Íslandi er rúmlega sjö. Þrátt fyrir að þetta sé svipað og í Danmörku er útfjólublár stuðull þó að jafnaði lægri á Íslandi. Um hádegisbil er útfjólublár stuðull nánast jafn fjölda staðlaðra roðaskammta á klukkustund. Á heiðskírum íslenskum sumardegi hafa mælst allt að 32 staðlaðir roðaskammtar, en í júní er meðalgildið 20 á dag. Húð flestra Íslendinga roðnar við fjóra til sex staðlaða roðaskammta þannig að mjög stuttan tíma þarf til þess að húðin roðni ef verið er úti án þess að nota sólvörn, sérstaklega í kringum hádegið

Distribution of 3H-8-MOP and its Metabolites in Rat Organs after a Single Oral Administration

Concentrations of 3H-8-metboxypsoralen (MOP), its lipid and water soluble metabolites and tritiated water have been measured in rat serum, liver, kidney and skin, using liquid scintillation, thin-layer chromatography and other techniques.Radioactivity in whole blood, plasma, ovary, adrenals and pancreas has also been measured.The radioactivity has been measured up to 1week after medication, whilst 3H-8-MOP and metabolite concentrations have been measured from 10mm to 24hr after medication with a single dose of 1mg 3 H-8-MOP in solution/kg bodyweight.Maximum 8-MOP concentrations were seen from 10 to 30min after dosing. The concentrations in μg/kg 10 min, 2hr, and 24hr after medication were as follows: serum—686, 57, 2.1; liver—489, 45, 3.3; kidney—1708, 139, 4.3; and skin—55, 16, 3.8. The concentrations of water soluble metabolites were very high in the liver and only slightly lower in the kidney. The concentrations of these metabolites might accumulate after doses repeated 4 times a week. 3H-8-MOP and its other metabolites would not show similar accumulation. Most of the radioactivity present after 1week is due to tritiated water

Identifying the psychosocial predictors of ultraviolet exposure to the face in patients with xeroderma pigmentosum:A study of the behavioural factors affecting clinical outcomes in this genetic disease

BACKGROUND: For patients with xeroderma pigmentosum (XP), the main means of preventing skin and eye cancers is extreme protection against ultraviolet radiation (UVR), particularly for the face. We have recently developed a methodology for objectively measuring photoprotection behaviour (‘UVR dose to facial skin’) and have found that the degree of photoprotection varies greatly between patients with XP. We have previously identified factors affecting photoprotection behaviour in XP using a subjective measure of photoprotection. Here, we have used this objective methodology to identify the factors which determine photoprotection behaviour in XP. METHODS: We studied 29 psychological, social, demographic and clinical variables in 36 patients with XP. We have previously objectively measured UVR protection (by measuring the dose of UVR reaching the skin of the face over a 3-week period) in these patients. Here, we use linear mixed-effects model analysis to identify the factors which lead to the differences in degree of photoprotection observed in these patients. RESULTS: Psychosocial factors accounted for as much of the interindividual variation in photoprotection behaviour (29%) as demographic and clinical factors (24%). Psychosocial factors significantly associated with worse UVR protection included: automaticity of the behaviours, and a group of beliefs and perceptions about XP and photoprotection known to associate with poor treatment adherence in other diseases. CONCLUSIONS: We have identified factors contributing to poor photoprotection in XP. Identifying these potentially reversible psychosocial features has enabled us to design an intervention to improve photoprotection in patients with XP, aiming to prevent skin and eye cancers in these patients

第994回千葉医学会例会・千葉大学医学部第二外科例会

BACKGROUND AND AIM:Ingenol mebutate (IngMeb) is an effective treatment for actinic keratosis. In this study, we hypothesized that repeated treatments with IngMeb may prevent progression of UV-induced photodamage, and that concurrent application of a corticosteroid may reduce IngMeb-induced local skin responses (LSR). METHODS:Hairless mice (n = 60; 3 groups of 20 mice) were irradiated with solar simulated ultraviolet radiation (UVR) throughout the study. Five single treatments with IngMeb were given at 4-week intervals (Days 21, 49, 77, 105, and 133). Clobetasol propionate (CP) was applied once daily for 5 days prior to each IngMeb application, as well as 6 h and 1 day post treatment. One week after IngMeb treatment No. 1, 3, and 5 (Days 28, 84, and 140), biopsies from four mice in each group were collected for histological evaluation of UV-damage on a standardized UV-damage scale (0-12). LSR (0-24) were assessed once daily (Days 1-7) after each IngMeb treatment. RESULTS:IngMeb prevented progression of photodamage in terms of keratosis grade, epidermal hypertrophy, dysplasia, and dermal actinic damage with a lower composite UV-damage score on day 140 (UVR 10.25 vs. UVR+IngMeb 6.00, p = 0.002) compared to UVR alone. IngMeb induced LSR, including erythema, flaking, crusting, bleeding, vesiculation, and ulceration. Concurrent CP increased LSR (max LSR Tx 1-5: UVR+IngMeb+CP 3.6-5.5 vs. UVR+IngMeb 2.6-4.3) and provided better prevention of photodamage compared to IngMeb alone (Day 140: UVR+IngMeb 6.00 vs. UVR+IngMeb+CP 3.00 p < 0.001). CONCLUSION:Repeated field-directed treatments with IngMeb prevent progression of cutaneous photodamage in hairless mice, while CP cannot be used to alleviate IngMeb-induced LSR. The findings suggest that IngMeb may potentially serve as a prophylactic treatment for UV-induced tumors

Gasdermin D-deficient mice are hypersensitive to acute kidney injury

Signaling pathways of regulated necrosis, such as necroptosis and ferroptosis, contribute to acute kidney injury (AKI), but the role of pyroptosis is unclear. Pyroptosis is mediated by the pore-forming protein gasdermin D (GSDMD). Here, we report a specific pattern of GSDMD-protein expression in the peritubular compartment of mice that underwent bilateral ischemia and reperfusion injury (IRI). Along similar lines, the GSDMD-protein expression in whole kidney lysates increased during the first 84 h following cisplatin-induced AKI. Importantly, unlike whole kidney lysates, no GSDMD-protein expression was detectable in isolated kidney tubules. In IRI and cisplatin-induced AKI, GSDMD-deficient mice exhibited hypersensitivity to injury as assessed by tubular damage, elevated markers of serum urea, and serum creatinine. This hypersensitivity was reversed by a combined deficiency of GSDMD and the necroptosis mediator mixed lineage kinase domain-like (MLKL). In conclusion, we demonstrate a non-cell autonomous role for GSDMD in protecting the tubular compartment from necroptosis-mediated damage in IRI

Treatment of Early Breast Cancer Patients: Evidence, Controversies, Consensus: Focusing on Systemic Therapy - German Experts' Opinions for the 16th International St. Gallen Consensus Conference (Vienna 2019)

A German working group of leading breast cancer experts have discussed the votes at the International St. Gallen Consensus Conference in Vienna for the treatment of primary breast cancer with regard to the German AGO (Ar-beitsgemeinschaft Gynakologische Onkologie) recommendations for clinical practice in Germany. Three of the German breast cancer experts were also members of this year's St. Gallen panel. Comparing the St. Gallen recommendations with the annually updated treatment recommendations of the Gynecological Oncology Working Group (AGO Mamma 2019) and the German S3 Guideline is useful, because the recommendations of the St. Gallen panel are based on expert opinions of different countries and disciplines. The focus of this article is on systemic therapy. The motto of this year's 16th St. Gallen Consensus Conference was Estimating the magnitude of clinical benefit. The rationale behind this motto is that, for every treatment decision, a benefit-risk assessment must be taken into consideration for each patient

An investigation of the predictors of photoprotection and UVR dose to the face in patients with XP : a protocol using observational mixed methods

INTRODUCTION: Xeroderma pigmentosum (XP) is a rare genetic condition caused by defective nucleotide excision repair and characterised by skin cancer, ocular and neurological involvement. Stringent ultraviolet protection is the only way to prevent skin cancer. Despite the risks, some patients' photoprotection is poor, with a potentially devastating impact on their prognosis. The aim of this research is to identify disease-specific and psychosocial predictors of photoprotection behaviour and ultraviolet radiation (UVR) dose to the face. METHODS AND ANALYSIS: Mixed methods research based on 45 UK patients will involve qualitative interviews to identify individuals' experience of XP and the influences on their photoprotection behaviours and a cross-sectional quantitative survey to assess biopsychosocial correlates of these behaviours at baseline. This will be followed by objective measurement of UVR exposure for 21 days by wrist-worn dosimeter and daily recording of photoprotection behaviours and psychological variables for up to 50 days in the summer months. This novel methodology will enable UVR dose reaching the face to be calculated and analysed as a clinically relevant endpoint. A range of qualitative and quantitative analytical approaches will be used, reflecting the mixed methods (eg, cross-sectional qualitative interviews, n-of-1 studies). Framework analysis will be used to analyse the qualitative interviews; mixed-effects longitudinal models will be used to examine the association of clinical and psychosocial factors with the average daily UVR dose; dynamic logistic regression models will be used to investigate participant-specific psychosocial factors associated with photoprotection behaviours. ETHICS AND DISSEMINATION: This research has been approved by Camden and King's Cross Research Ethics Committee 15/LO/1395. The findings will be published in peer-reviewed journals and presented at national and international scientific conferences