3D Whole-body skin imaging for automated melanoma detection.

BACKGROUND: Existing artificial intelligence for melanoma detection has relied on analysing images of lesions of clinical interest, which may lead to missed melanomas. Tools analysing the entire skin surface are lacking. OBJECTIVES: To determine if melanoma can be distinguished from other skin lesions using data from automated analysis of 3D-images. METHODS: Single-centre, retrospective, observational convenience sample of patients diagnosed with melanoma at a tertiary care cancer hospital. Eligible participants were those with a whole-body 3D-image captured within 90 days prior to the diagnostic skin biopsy. 3D-images were obtained as standard of care using VECTRA WB360 Whole Body 3-dimensional Imaging System (Canfield Scientific). Automated data from image processing (i.e. lesion size, colour, border) for all eligible participants were exported from VECTRA DermaGraphix research software for analysis. The main outcome was the area under the receiver operating characteristic curve (AUC). RESULTS: A total of 35 patients contributed 23,538 automatically identified skin lesions >2 mm in largest diameter (102-3021 lesions per participant). All were White patients and 23 (66%) were males. The median (range) age was 64 years (26-89). There were 49 lesions of melanoma and 22,489 lesions that were not melanoma. The AUC for the prediction model was 0.94 (95% CI: 0.92-0.96). Considering all lesions in a patient-level analysis, 14 (28%) melanoma lesions had the highest predicted score or were in the 99th percentile among all lesions for an individual patient. CONCLUSIONS: In this proof-of-concept pilot study, we demonstrated that automated analysis of whole-body 3D-images using simple image processing techniques can discriminate melanoma from other skin lesions with high accuracy. Further studies with larger, higher quality, and more representative 3D-imaging datasets would be needed to improve and validate these results.

Salmonella enterica Serovars Dublin and Enteritidis Comparative Proteomics Reveals Differential Expression of Proteins Involved in Stress Resistance, Virulence, and Anaerobic Metabolism.

The Enteritidis and Dublin serovars of Salmonella enterica are phylogenetically closely related yet differ significantly in host range and virulence. S Enteritidis is a broad-host-range serovar that commonly causes self-limited gastroenteritis in humans, whereas S Dublin is a cattle-adapted serovar that can infect humans, often resulting in invasive extraintestinal disease. The mechanism underlying the higher invasiveness of S Dublin remains undetermined. In this work, we quantitatively compared the proteomes of clinical isolates of each serovar grown under gut-mimicking conditions. Compared to S Enteritidis, the S Dublin proteome was enriched in proteins linked to response to several stress conditions, such as those encountered during host infection, as well as to virulence. The S Enteritidis proteome contained several proteins related to central anaerobic metabolism pathways that were undetected in S Dublin. In contrast to what has been observed in other extraintestinal serovars, most of the coding genes for these pathways are not degraded in S Dublin. Thus, we provide evidence that S Dublin metabolic functions may be much more affected than previously reported based on genomic studies. Single and double null mutants in stress response proteins Dps, YciF, and YgaU demonstrate their relevance to S Dublin invasiveness in a murine model of invasive salmonellosis. All in all, this work provides a basis for understanding interserovar differences in invasiveness and niche adaptation, underscoring the relevance of using proteomic approaches to complement genomic studies.

Quantifying dyspigmentation in facial skin ageing: an explorative study.

OBJECTIVE: The skin melanin system is affected by ageing, resulting in dyspigmentation with associated clinical and psychosocial consequences. In dark skinned phenotypes, broad evidence is available, whereas little is known about pigmentary changes in fair-skinned Caucasians. The objective of this study was to investigate age-related changes in facial pigmentation and dyspigmentation in subjects of skin phototypes II-III and to develop and test parameters for quantifying dyspigmentation. METHODS: Twenty-four skin healthy female subjects were recruited in three distinct age groups (30-40, 50-60, 70-80 years). Skin colour was measured by Mexameter and Chromameter. Skin dyspigmentation was measured by clinical evaluation and newly developed image-processing parameters on the cheeks and the forehead. The reliability of the clinical evaluation was investigated by intraclass correlation coefficients between three raters, and the validity of the dyspigmentation parameters was analysed by bivariate correlations with related measures. RESULTS: Skin lightness decreased with increasing age. Clinical dyspigmentation scores showed positive associations with chronological age ranging between 0.452 and 0.606. RBX(®) -Brown transformation-based hyperpigmentation and hypopigmentation indices increased with age, whereas the overall pigmentation intensity decreased with age at the cheeks. The image analysis-based parameters showed strong associations with the clinical scores and related measurements. CONCLUSION: We demonstrated age-related changes in the facial colour and dyspigmentation of fair-skinned Caucasian females. An increase in dyspigmentation was found by clinical scoring and the RBX(®) -Brown transformation-based pigmentation indices. The validity of hyper- and hypopigmentation indices and overall pigmentation intensity was supported. The RBX(®) transformation-based pigmentation indices might be applied in future studies to complement or substitute clinical evaluation.

Bioengineering in the oral cavity: our experience.

BACKGROUND: To date, there are no studies reported in the literature on the possible use of bovine collagen, oxidized regenerated cellulose, or synthetic hyaluronic acid medications in the oral cavity. The aim of this paper is to report the use of bovine collagen, oxidized regenerated cellulose, and synthetic hyaluronic acid medications to improve wound healing in the oral cavity by stimulating granulomatous tissue. METHODS: From 2007 to 2011, 80 patients (median age 67 years) suffering from oral mucosal lesions participated in this double-blind study. The patients were divided into two groups, each consisting of 40 patients. One group received conventional medications, while the other group of patients were treated with the advanced medications. RESULTS: Advanced medications allowed re-epithelialization of the wound margin in 2-20 days, whereas patients receiving conventional medication showed a median healing duration of 45 days. CONCLUSION: The results of this study demonstrate that treating oral mucosal wounds with advanced medication has an advantage with regard to wound healing time, allowing patients to have a rapid, functional, and esthetic recovery.

[Benign insulinoma. Efficacy of preoperative treatment for persistent hyperinsulinemia using a synthetic somatostatin analog]. / Insulinoma benigno. Efficacia del trattamento preoperatorio sulla persistente iperinsulinemia con l'analogo sintetico della somatostatina.

We investigated the 24-hour mean blood glucose and serum insulin (IRI), C peptide (C pep) and glucagon concentrations before (pre) and after (post) continued treatment with octreotide (100 mcg three time daily by s.c. injection) in a woman, 68 years old, affected by a nine years long benign insulinoma. The blood pool to dose 24-hour mean glucose and all hormone concentrations was obtained by equal quantities of blood samples taken every 2-hour over 24-hour. The IRI, C pep, glucagon, glucose circadian pattern and IRI/glucose ratio were determined on remaining blood portions. After continued treatment with octreotide was significantly reduced the exaggerated and inappropriate insulin (pre = 77.08 +/- 23.6 microUI/ml; post = 15.19 +/- 2.3 microUI/ml; p < 0.001) and C pep secretion (pre = 4.17 +/- 0.4 ng/ml; post--1.64 +/- 0.04; p < 0.001), while the blood glucose levels were significantly elevated (pre = 40.46 +/- 3.1 mg/dl; post = 132.46 +/- 6.9 mg/dl; p < 0.001). Also glucagon levels were significantly inhibited (pre = 73.53 +/- 12.19 pg/ml; post = 46.80 +/- 9.1 pg/ml; p < 0.05). The long-acting somatostatin analogue has improved a lot IRI/glucose ratio (pre = 1.9 +/- 0.4; post = 0.12 +/- 0.04; p < 0.001). A significant positive correlation was found between IRI and C pep before (r = 0.93; p < 0.001) as well after octreotide treatment (r = 0.85; p < 0.001). A significant positive correlation (r = 0.69; p < 0.008) between IRI and glucose was observed only after octreotide treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Correlation between hormonal and metabolic profiles in women with polycystic ovary syndrome]. / Correlazioni tra assetto ormonale e metabolico in donne con sindrome dell'ovaio policistico.

To investigate the sex hormone status of women with polycystic ovary syndrome (PCO) and to relate this to serum levels of glucose, insulin, lipids and lipoproteins, 90 women with PCO (30 obese: BMI greater than 30 kg/m2; 30 overweight: BMI greater than 25- less than 30 kg/m2; 30 non obese: BMI less than 25 kg/m2) and 60 normal ovulatory women (20 obese; 20 overweight; 20 non obese) were studied. The women with PCO had significantly increased LH, FSH and androgen levels and significantly decreased SHBG levels compared to the normal women. Obese women with PCO had higher concentrations of fasting glucose, fasting insulin, incremental glucose area, incremental insulin area and lipid than overweight and non obese women with PCO and overweight and non obese control subjects, but were similar in obese normal women. There were decreases in high-density lipoproteins levels in both the obese groups (obese PCO and obese control women). Lipid and lipoprotein concentrations did not differ in the obese, overweight and non obese PCO women compared to the normal groups while HDL cholesterol were decreased in obese PCO and obese control women. The correlations between hormone, glucose, insulin, lipid and lipoprotein levels were different among the six groups. Non obese PCO women had: inverse correlations between free testosterone and incremental glucose area (r = -0.5128, P = 0.03); positive correlations between SHBG and alpha-lipoproteins (r = 0.9159, P = 0.001). Non obese normal women had: positive correlations between fasting insulin and total testosterone (r = 0.5272, P = 0.043) and between SHBG and beta-lipoproteins (r = 0.7445, P = 0.014) and LDL cholesterol (r = 0.7360, P = 0.010).(ABSTRACT TRUNCATED AT 250 WORDS)

Hypopituitarism following a direct bullet injury to the pituitary. A case report.

A 29-year old man was referred for hypogonadism. At 14 years of age he was struck by a gun bullet in the head, receiving a frontomedial open fracture with leakage of cerebral tissue. The bullet could not be extracted at the operation. At 16 years of age he noticed a stop of pubertal development, weight gain and a fall in visus on the left eye. The clinical examination and the endocrinological data (low F-T4 and F-T3; low plasma cortisol and testosterone; normal plasma prolactin; sub-normal pituitary response to intravenous administration of insulin, GnRH, TRH and GRF) demonstrated that the patient was hypopituitaric. A radiological skull X-ray showed that the bullet was lodged in the sellar and parasellar region. This seems to be the seventh case of hypopituitarism following a direct injury to the pituitary region described in the literature so far.

Lack of nocturnal prolactin increase in patients with hypogonadotropic hypogonadism.

The circadian prolactin rhythm was studied in a group of 16 male adult volunteers: 10 healthy subjects and 6 patients affected by isolated hypogonadotropic hypogonadism (IHH). A significant nycto-hemeral prolactin rhythm (p = 0.0003, according to cosinor method) is detected in healthy subjects, but not in patients with IHH. In view of these results we may deem that the absence of nycto-hemeral variations of serum prolactin in subjects with IHH could be caused by failure of LH and FSH release.

Temporal relationship between circannual levels of luteinizing hormone and testosterone in prepubertal boys with constitutional short stature.

In the present study we refer the results of our researches on LH and testosterone circannual variations in 72 prepubertal boys with constitutional short stature, aged 6 to 10 years. They observed the following life schedule: nocturnal rest from 2200 to 0600, meals at 0800, 1300, 1900. Plasma samples were taken at 0800 and LH and testosterone were measured by RIA. The single independent data were fitted a cosine function to evidence any rhythm and describe its parameters. A significant circannual rhythm in the LH (annual crest time in December) and testosterone (annual crest tine in July) levels was detected, with a phase difference between the two from about 160 degree to 180 degree, i.e. an antiphase. Our data suggest that a temporal relationship may occur between the circannual secretion of LH and testosterone in prepubertal boys.

[Annual variations in plasma testosterone levels in prepuberal subjects]. / Variazioni circannuali dei livelli di testosterone plasmatico in soggetti prepuberi.

40 prepubertal boys, aged 6 to 10 years, were studied from 1977 to 1979 in order to evidence any circannual rhythm in the testosterone plasmatic levels. The patients observed in the following life schedule: nocturnal rest from 2200 to 0600 circa, meals at 0800, 1300, 1900. Plasma samples were taken at 0800 and testosterone was assayed by RIA. Testosterone data were fitted a cosine function, by least square method in order to describe any rhythm and to estimate its parameters:mesor, amplitude, acrophase. A significative circannual rhythm in the testosterone levels is present (P= 0.008) with Acrophase in July (-198.38 degrees +/- 18.26 ES). Our study suggests that a significative testosterone rhythm, with circannual periodicity, is present also in prepubertal age.

[Effect of sex on annual variations in GH response to insulin hypoglycemia in prepuberal subjects of small stature]. / Influenza del sesso sulle variazioni circannuali della risposta del GH all'ipoglicemia insulinica in soggetti prepuberi con bassa statura.

86 males and 66 females, aged 6 to 10 years, affected by short stature (SDs -2 according to Tanner), were investigated from 1977 to 1979 in order to evidence any circannual rhythm in the GH response to insulin test. The patients were hospitalized one week before the study starting and they observed the following life schedule:nocturnal rest from 2200 to 0600, meals at 0800, 1300, 1800. The insulin test (0,1 UI/Kg body weight) were administered at 0800. Plasma samples were taken before and after 20, 40, 60, 90 minutes. The single basal data and the peak were fitted a cosine function by least square method in order to describe amy rhythm and to estimate its parameters:mesor, amplitude, acrophase. A significative circannual rhythm in the GH response to insulin is present in the female subjects, with acrophase in December (-354.85 degrees +/- 21.93). Our study suggest that the sex may influence the circannual response of GH to insulin stimulus from prepubertal age.

[Effect of sex on annual variations in plasma LH and FSH levels in prepubertal subjects]. / Influenza del sesso sulle variazioni circannuali dei livelli plasmatici di lh ed fsh in soggetti prepuberi.

We studied, from 1977 to 1979, 61 females and 72 males (aged 6 to 10 years) in order to demonstrate the occurrence of FSH and LH circannual variations. The data were fitted a cosine function by least square method in order to describe any rhythm and to estimate its parameters:mesor, amplitude, acrophase. Our data suggest that in prepubertal age the behaviour of FSH secretion is different in two sexes, but without circannual rhythm. LH instead shows a statistically significant circannual rhythm in both groups, without differences in mean levels between the two sexes.

[Symptomatologic value of skin evaporimetry]. / Valore semeiologico dell'evaporimetria cutanea.

Skin significantly contributes to water turnover excreting 300-600 ml/Day, this aliquot being under the control of several factors, including psychologic factors. The cutaneous evaporimetry offers semeiological parameters useful to study water balance. Our work is an extension of the classic experiments of G.E. Nilsson and coworkers. In the present report evaporimetric measurements are related to 15 normal subjects at ours climatic conditions.