[KIMS observational study of GH therapy in GH-deficient adults: 12-month follow-up analysis of the French cohort]. / Etude observationnelle KIMS du traitement par GH des patients adultes ayant un déficit somatotrope: analyse à 12 mois des données françaises.

KIMS study is an international, observational study initiated in 1994 in which France has been involved since 2003. Its aim is to collect on a widespread basis long-term data from GH-deficient adults treated or not treated with growth hormone in daily practice. Among 330 patients already enrolled by 128 centers in France at the data lock point for this first interim analysis, 122 patients were followed up for at least 12 months and their results are presented herein. After one year of treatment, IGF-1 level adjusted for age and sex was normalized for 77% of patients naive of GH-treatment, 71% of semi-naive patients and 85% of non naive patients. Lean mass increase was 5.1% and fat mass decrease 5.7%. Quality of life assessed through QoL-AGHDA questionnaire was improved with a median score decrease from 10 to 6. These are the first results available from French patients and suggest that growth hormone is an appropriate indication for adults with severe GH deficiency.

Educating children and parents about sun protection.

The incidence of skin cancer in the United States is rising at an alarming rate. Sun exposure in childhood is a risk factor for the development of skin cancer. The important role of the dermatology nurse in educating children about protecting themselves from the sun is reviewed.

Is dermatologic usage of coal tar carcinogenic? A review of the literature.

BACKGROUND: Coal tar ointments have been used for decades in the treatment of various dermatoses, most notably eczema and psoriasis. Occupational exposure to coal tar poses an increased risk of developing cutaneous malignancies. The evidence of an increased risk of skin cancer in humans, as a result of dermatologic usage of tar, however, is conflicting. OBJECTIVE: A consensus on the carcinogenicity of tar is sought. METHODS: The existing literature (in vitro, animal, and human studies) on this subject is reviewed. RESULTS: The carcinogenicity of coal tar has clearly been demonstrated by in vitro and animal studies, and appears to be potentiated by concomitant use of ultraviolet radiation. Systemic absorption of mutagens from topically applied tar has been demonstrated in humans. Epidemiologic studies in humans, however, have not definitively shown an increase in skin cancer with therapeutic use of tar. CONCLUSIONS: Conclusive evidence for the carcinogenicity of tar used in dermatologic practice is lacking. Further controlled studies are necessary.

Intrarenal renin-angiotensin system modulates glomerular angiotensin receptors in the rat.

The aim of this study was to test the hypothesis that the intrarenal renin-angiotensin system (RAS) modulates glomerular angiotensin II (ANG II) receptors. In one protocol ANG II receptors were measured 7 days after unilateral denervation of the left kidney in rats. There were 50% more receptors in the glomeruli from denervated compared with innervated kidneys (right, 1,037 +/- 108 vs. left, 1,556 +/- 143 fmol/mg; P less than 0.01), which was associated with a 63% reduction (P less than 0.01) in left renal vein renin. The differences in ANG II receptors between the left and right kidneys were no longer present when angiotensin-converting enzyme was inhibited with enalapril or when pharmacological amounts of ANG II (50 ng/min) were infused. In a second protocol, renal cortical renin content was raised in the left kidney by placing a 0.20-mm clip on the left renal artery (two-kidney, one-clip Goldblatt model). At 7 days, glomerular ANG II receptors were reduced by 72.3% in the clipped compared with the contralateral kidneys (right, 1,232 +/- 105 vs. left, 341 +/- 170 fmol/mg; P less than 0.01). The differences in ANG II receptors were no longer present after enalapril treatment. Pharmacological maneuvers that either blocked ANG II formation or increased circulating ANG II resulted in an equal number of ANG II receptors in the right and left kidneys. The data indicate that the intrarenal RAS modulates the density of glomerular ANG II receptors and is a more important receptor modulator than plasma ANG II.

Occupation and the risk of malignant melanoma.

BACKGROUND: The incidence of malignant melanoma is increasing rapidly. The risk for development of malignant melanoma has been reported to be higher in persons of higher socioeconomic status. METHODS: This case-control study explores the relation between occupation and malignant melanoma relative risk through analysis of data collected by the American Cancer Society. A total of 1.2 million people were enrolled in a study of lifestyles and environmental factors in relation to mortality from cancer and other diseases. A total of 2780 persons had a history of malignant melanoma when the study began or developed malignant melanoma during the 6-year study follow-up period. The controls were matched for age, sex, race, and geographic location on an approximately 1:3 basis to persons selected from the remaining people enrolled. RESULTS: In men, malignant melanoma risk was significantly higher in high-paying versus low-paying occupations (odds ratio [OR], = 1.58; P < 0.001) and in white-collar versus blue-collar occupations (OR = 1.33; P < 0.001). No significant conclusions could be drawn for women. No significant difference in risk was noted between those with indoor versus outdoor occupations. Among specific occupational exposures, only exposure to X-rays significantly raised malignant melanoma risk (OR = 1.37; P = 0.002). CONCLUSION: Upper pay scale and white-collar occupations significantly increase the risk for development of malignant melanoma.

Detection of substrates of keratinocyte transglutaminase in vitro and in vivo using a monoclonal antibody to dansylcadaverine.

A method providing more sensitive detection of transglutaminase substrates was developed to localize transglutaminase activity in tissue and to identify in vivo substrates in epidermal extracts. The enhanced sensitivity of this method was achieved via the generation of a monoclonal antibody (designated E7) made to dansylcadaverine. Transglutaminase substrates were visualized by western blot after a 1-min incubation with dansylcadaverine in contrast to the 2 h required when [14C]putrescine incorporation was measured by autoradiography of SDS-polyacrylamide gels. In addition, putative substrates not apparent using conventional methods were readily detected by western analysis. An ELISA assay to measure transglutaminase activity showed similar sensitivity to the traditional radiometric assay (Lorand et al., 1972). The correlation between the ELISA procedure and the radiometric assay was high (r2 = 0.924). Strips of neonatal human and mouse skin incubated in dansylcadaverine-supplemented culture medium were used to localize enzyme activity and to detect substrates in vivo. Transglutaminase activity was demonstrated at the cellular periphery in the upper spinous and granular cell layers of the epidermis. Substrates detected in epidermal extracts were similar to those detected using the in vitro assay. This technique allows for highly sensitive and nonradiometric analysis of both enzymatic activity and the substrates involved. The extension of this methodology to an in vivo system is the first demonstration of a system in which the dynamics of cornified envelope assembly may be further studied.

Teaching children about skin cancer: the draw-and-write technique as an evaluation tool.

Childhood exposure to sunlight is a risk factor for melanoma. To formulate a meaningful program to educate children about the ill effects of the sun, their extant knowledge base must be determined. We have used the "draw-and-write" technique to assess children's perceptions about the sun, suntans, and skin cancer. A total of 693 school children aged 4 to 13 years were asked to draw pictures and label them in response to a series of carefully worded questions. Awareness of the need to apply sunscreen increased from 44% in children aged 4 to 6 years to 95% in children aged 9 to 10 years. Ten percent of children aged 4 to 6 years already perceived a suntan as attractive. While almost all children were aware of the negative immediate effects of sun exposure, namely sunburn, just 30% of American children aged 11 to 13 were aware that sun exposure is a risk for skin cancer. No differences between boys and girls were seen. The "draw-and-write" technique allows assessment of the attitudes and perceptions of children regarding the sun and skin cancer. It also provides valuable information on which to base health education and evaluate its cost-effectiveness.