New concepts on the histogenesis of eccrine neoplasia from keratin expression in the normal eccrine gland, syringoma and poroma.

BACKGROUND: Peripheral and luminal layers of eccrine sweat gland ducts are self-renewing structures. Proliferation is restricted to the lowermost luminal layer, but randomly scattered in the peripheral layer. Each layer exhibits differential expression of keratins K5/K14 and K6/K16. Keratin K1 occurs only in peripheral cells and the novel keratin K77 is specific for luminal cells. OBJECTIVES: To investigate the expression of luminal (K77), peripheral (K1) and further discriminatory keratins in two eccrine sweat gland tumours: syringoma, thought to show differentiation towards luminal cells of intraepidermal sweat ducts and eccrine poroma, considered to arise from poroid cells, i.e. peripheral duct cells; and keratinocytes of the lower acrosyringium/sweat duct ridge differentiating towards cells of intradermal/intraepidermal duct segments. METHODS: Paraffin-embedded sections were examined by immunohistochemistry using several keratin, smooth muscle actin and Ki-67 antibodies. RESULTS: We confirmed the ductal nature of syringomas. Despite drastic morphological alterations in both layers, their keratin patterns remained almost undisturbed compared with normal ducts. In eccrine poroma epidermal keratins K5/K14 were ubiquitously expressed in all poroid cells. Cell islands deviating morphologically from poroid cells contained epidermal keratins K1/K10. K77 expression was limited to luminal cells of intact duct structures within the tumours. CONCLUSIONS: Syringomas are benign tumours of luminal cells of the lowermost intraglandular sweat duct. Poroid precursor cells of poromas do not comprise peripheral duct cells nor do poromas differentiate towards peripheral or luminal duct cells. Instead, poroid cells consist only of keratinocytes of the lowermost acrosyringium and the sweat duct ridge and poromas tend to differentiate towards the cells of the upper acrosyringium.

Characterization and expression analysis of the hair keratin associated protein KAP26.1.

BACKGROUND: Human hair follicle keratin-associated proteins (KAPs) comprise a large multigene family of proteins thought to be responsible for the bundling of keratin intermediate filaments. Recently, four new KAP family members KAP24.1, KAP25.1, KAP26.1 and KAP27.1 were identified from the genome, but the expression of only one, KAP24.1, was investigated and shown in hair follicles. OBJECTIVES: In the current study, the expression of the remaining members of the family were analysed. METHODS: Reverse transcriptase-polymerase chain reaction analysis of samples from numerous human organs was used. RESULTS: Only KAP26.1 showed expression, which was limited to the hair follicle. By in situ hybridization and immunohistochemistry using a specific antiserum, KAP26.1 was localized to the differentiated portion of the hair cuticle. CONCLUSIONS: As well as KAP24.1 in hair follicles, expression of KAP26.1 was shown and is found in the differentiated part of the hair cuticle.

[Medication in a physicians network: modern treatment with no increase in costs?]. / Arzneimittelverordnungen in einem Arztnetz: Modernere Therapie bei gleichen Kosten?

Practice networks are intended to improve drug treatment and render it more economical. To check whether these aims can be realized, two groups of physicians were observed over a period of two years. The first group stemmed from the Practice Network Nuremberg North (PNN), the other comprised a group of physicians in Augsburg similarly structured in terms of prescriptions, specialties and patients. A comparison was made of the application and costs of drugs for the following four different indications: bronchial asthma, diabetes mellitus, hypertension and osteoporosis. Within the practice network a mild increase in costswas observed forall four indications. This was in part explained by the increased used of modern, more expensive drugs, although savings were also achieved by a more liberal use of more economical, patent-free medications. No improvement in treatment outcome was seen, since prescription in accordance with recommended guidelines would have required the use of other drugs. Evaluation of treatment qualitywas not an aim of this study. Overall, the potentials in terms of improved and simultaneously more economical chemotherapy expected from the establishment of a practice network were not fully utilized. Perhaps the conclusion of a modified agreement Quality and Efficiency (QaE, 2003) might result in improved prescribing through evidence-based medicine, and greater savings.

Interface effects on mechanical properties of particle-reinforced composites.

OBJECTIVES: Effective bonding between the filler and matrix components typically improves the mechanical properties of polymer composites containing inorganic fillers. The aim of this study was to test the hypothesis that composite flexural modulus, flexure strength, and toughness are directly proportional to filler-matrix interfacial shear strength. METHODS: The resin matrix component of the experimental composite consisted of a 60:40 blend of BisGMA:TEGDMA. Two levels of photoinitiator components were used: 0.15, and 0.5%. Raman spectroscopy was used to determine degree of cure, and thermogravimetry (TGA) was used to quantify the degree of silane, rubber, or polymer attachment to silica and glass particles. Filler-matrix interfacial shear strengths were measured using a microbond test. Composites containing glass particles with various surface treatments were prepared and the modulus, flexure strength, and fracture toughness of these materials obtained using standard methods. Mechanical properties were measured on dry and soaked specimens. RESULTS: The interfacial strength was greatest for the 5% MPS treated silica, and it increased for polymers prepared with 0.5% initiator compared with 0.15% initiator concentrations. For the mechanical properties measured, the authors found that: (1) the flexural modulus was independent of the type of filler surface treatment, though flexural strength and toughness were highest for the silanated glass; (2) rubber at the interface, whether bonded to the filler and matrix or not, did not improve toughness; (3) less grafting of resin to silanated filler particles was observed when the initiator concentration decreased. SIGNIFICANCE: These findings suggest that increasing the strength of the bond between filler and matrix will not result in improvements in the mechanical properties of particulate-reinforced composites in contrast to fiber-reinforced composites. Also, contraction stresses in the 0.5 vs 0.15% initiator concentration composites may be responsible for increases in interfacial shear strengths, moduli, and flexural strengths.

Filler-coupling agent-matrix interactions in silica/polymethylmethacrylate composites.

The interactions of the silane coupling agent methacryloxypropyltrimethoxysilane (MPS) with both fumed silica and a polymethylmethacrylate (PMMA) resin matrix were investigated using thermogravimetric analysis and Fourier transform infrared spectroscopy. OX 50 fumed silica was silanated with MPS at concentrations of 1% and 5% in aqueous ethanol (95%), acetone, and anhydrous toluene. Methyl methacrylate was polymerized with the silanated fumed silica (5% wt/wt) to form composites. The amount of MPS adsorption on the fumed silica and the amount of PMMA attached to the silanated fumed silica were determined by thermogravimetric analysis. MPS could be removed from the fumed silica after washing with methanol, but not after it underwent a drying process at 25 degrees C under vacuum. After vacuum drying at 25 degrees C, two types of adsorbed silane were found, i.e., firmly adsorbed and loosely adsorbed silane. The loosely adsorbed silane could desorb from silica and be incorporated into the polymer matrix through copolymerization with monomeric methyl methacrylate, resulting in crosslinking of the matrix. When the silanated silica was dried at 110 degrees C for 2 h, the loosely adsorbed silane was removed and the amount of firmly adsorbed silane increased. There was a positive correlation between the amount of firmly adsorbed MPS and the amount of PMMA attachment. The highest efficiency for PMMA attachment was found when MPS was adsorbed as a monolayer, because the loosely adsorbed silane did not contribute to the bonding of PMMA, and this suggested that not all of the double bonds of the MPS were accessible for reaction with the methacrylate monomer. Drying at 110 degrees C may also decrease the number of unsaturated double bonds of MPS.

Submicron-size particles of ultrahigh molecular weight polyethylene produced via nonsolvent and temperature-induced crystallization.

Submicrometer size particles of ultrahigh molecular weight polyethylene (UHMWPE) were produced by crystallization from dilute (0.1-1.0 wt % of UHMWPE) solvent/nonsolvent emulsions. The procedure consisted of mixing a hot solution of UHMWPE in decalin or decane with a nonsolvent (tetraglyme) at approximately 160 degrees C, followed by rapid cooling of the mixture to zero or subzero temperatures. The rapid cooling causes microphase separation between the two liquids, resulting in the formation of an emulsion, which consists of microdroplets of the supercooled UHMWPE solution dispersed in tetraglyme. The consequent crystallization of the polymer in the microdroplets produces a suspension of fine crystals of UHMWPE, which can easily be isolated. The particles were characterized using scanning electron microscopy, differential scanning calorimetry, and Raman spectroscopy. Their degree of crystallinity is between that of GUR 1050 original (powder) and processed (molded) polymer. By changing the polymer concentration, solvent to nonsolvent ratio, and temperature, the size (from 0.1-1.0 microm) and shape (spheroids or rods) of the particles can be controlled. These particles may be used for immunochemical investigations and the study of the influence of UHMWPE wear debris on cell response.

Weibull models of fracture strengths and fatigue behavior of dental resins in flexure and shear.

In estimating lifetimes of dental restorative materials, it is useful to have available data on the fatigue behavior of these materials. Current efforts at estimation include several untested assumptions related to the equivalence of flaw distributions sampled by shear, tensile, and compressive stresses. Environmental influences on material properties are not accounted for, and it is unclear if fatigue limits exist. In this study, the shear and flexural strengths of three resins used as matrices in dental restorative composite materials were characterized by Weibull parameters. It was found that shear strengths were lower than flexural strengths, liquid sorption had a profound effect on characteristic strengths, and the Weibull shape parameter obtained from shear data differed for some materials from that obtained in flexure. In shear and flexural fatigue, a power law relationship applied for up to 250,000 cycles; no fatigue limits were found, and the data thus imply only one flaw population is responsible for failure. Again, liquid sorption adversely affected strength levels in most materials (decreasing shear strengths and flexural strengths by factors of 2-3) and to a greater extent than did the degree of cure or material chemistry.

Indentation cracking of composite matrix materials.

Composite restorative materials wear by a fatigue mechanism in the occlusal contact area. Here, tooth cusps and food debris cyclically indent the restoration. Modeling this phenomenon requires an understanding of material response to indentation. The question in this study was whether material response depends on indenter size and geometry, and also, whether polymers used in restorative materials should be considered elastic and brittle, or plastic and ductile for modeling purposes. Three resins used as matrices in proprietary restorative composites were the experimental materials. To ascertain the influence of glass transition temperature, liquid sorption, and small amounts of filler on indentation response, we prepared materials with various degrees of cure; some samples were soaked in a 50/50 water/ethanol solution, and 3 vol% silica was added in some cases. Indentation experiments revealed that no cracking occurred in any material after indentation by Vickers pyramid or spherical indenters with diameters equal to or smaller than 0.254 mm. Larger spherical indenters induced subsurface median and surface radial and/or ring cracks. Critical loads causing subsurface cracks were measured. Indentation with suitably large spherical indenters provoked an elastoplastic response in polymers, and degree of cure and Tg had less influence on critical load than soaking in solution. Crack morphology was correlated with yield strain. Commonly held assumptions regarding the brittle elastic behavior of composite matrix materials may be incorrect.

Determination of the degree of cure of dental resins using Raman and FT-Raman spectroscopy.

FT-IR spectroscopy has traditionally been used to determine the degree of conversion of dental resins. FT-Raman scattering provided an alternate method of obtaining degrees of conversion for these systems and was particularly useful for measuring spectra of materials without any sample preparation. Raman and FT-Raman spectroscopy gave identical results, but the latter technique was preferred for the highly fluorescent samples often encountered in commercial composites. Linear calibration curves were obtained for the aromatic mixtures Bis-GMA/TEGDMA and Bisphenol-A/TEGDMA using C = C/phi, and for the wholly aliphatic mixture EGDMA/EGDA using C = C/C = O, over a wide range of mole ratios. If both the mole and intensity ratios [C = C/phi or C = C/C = O] were known for an uncured dental resin, then the degrees of conversion could be obtained for the cured materials using Raman spectroscopy. However, if the mole ratios for the uncured resin were unknown, then the degree of conversion depended on the calibration curve, since the Raman scattering cross section of the vibrational modes depended on the molecules to which they were attached.

Therapeutic choices made by patients with end-stage cancer.

The Oklahoma Children's Memorial Hospital Oncology Service has developed a new approach for its patients with end-stage cancer. The emphasis is on the patients' acknowledgement of the progression of the disease and the imminence of death, and informed choice between the use of research drugs and no further chemotherapy. Forty-three patients between 6 and 20 years of age participated in a conference of this type. The results demonstrated that they understood that their health was declining. They decided about further therapy autonomously or together with their family. The majority of children who chose supportive care without chemotherapy and lived for a period of time, participated in activities at home as far as their state of health permitted. Severe depression and severe behavioral problems occurred rarely. There was evidence that this open approach enabled patients and family members to communicate openly with each other.