Correlation between the efficacy of picosecond-domain laser treatment for solar lentigo and the vascularity in the upper dermis using optical coherence tomography angiography in Asian women.

OBJECTIVES: The purpose of this study was to noninvasively confirm the characteristics of the dermal vasculature in patients with solar lentigo (SL) and determine any association with the efficacy of picosecond-domain laser (PSL) treatment. METHODS: Thirteen facial SL lesions in 11 Asian female patients were included in this study and evaluated over 12 weeks. An Nd:YAG laser was used at 532 nm and 750 ps. Skin color and morphological structure were evaluated by ANTERA-3D® and optical coherence tomography (OCT), respectively. To analyze the vascularity in the upper dermis, an OCT angiography (OCTA) algorithm was applied to the OCT data. RESULTS: After PSL treatment, significant improvement in both hyperpigmentation and abnormally thickened epidermis was observed, but the efficacy varied for each lesion. There was a significant correlation between the change in the melanin index due to PSL treatment and preoperative vascular density in the upper dermis. CONCLUSIONS: To the best of our knowledge, this is the first report to demonstrate a correlation between the efficacy of PSL treatment of SL lesions and the vascularity in the upper dermis. Methods to evaluate the vasculature in the upper dermis may be useful for preoperative prediction of the efficacy of PSL treatment for SL lesions.

Three-Dimensional Analysis of Water Dynamics in Human Skin by Stimulated Raman Scattering.

The stratum corneum (SC), the outermost layer of the skin, has an important function to provide a barrier against dry environments. To evaluate the barrier function and the skin condition, it is crucial to investigate the ability of SC to absorb and retain water. In this study, we demonstrate stimulated Raman scattering (SRS) imaging of three-dimensional SC structure and water distribution when water is absorbed into dried SC sheets. Our results show that the process of water absorption and retention is dependent on the specific sample and can be spatially heterogeneous. We also found that acetone treatment leads to spatially homogeneous retention of water. These results suggest the great potential of SRS imaging in diagnosing skin conditions.

Tracking of cutaneous vascular structural changes post-UV irradiation using optical coherence tomography angiography.

BACKGROUND: Ultraviolet (UV) irradiation to skin induces biological responses to protect and heal the wounded tissue. Cutaneous blood vessels play an important role in maintaining skin homeostasis, by inducing angiogenesis and vasodilation. However, the vascular dynamics in vivo, such as morphological changes over time and their depth dependency, are not fully understood. METHODS: Ten Asian males were enrolled in this study and received UV (UVA + UVB) irradiation at two minimal erythema dose (MED) to the inner upper arm. Changes in epidermal thickness and vascular structures associated with UV irradiation were evaluated over time for 28 days by optical coherence tomography angiography (OCTA). This technique enables non-invasive visualization of three-dimensional vascular networks in human skin based on OCT assessment of skin structures with near-infrared light. RESULTS: Notable dilation of vascular structures and increases in epidermal thickness were observed after UV irradiation. Vessel density was markedly increased from the papillary dermis to the upper reticular dermis at a depth of 200 µm. These increases in vascular density showed significant persistence even at 28 days after UV irradiation. CONCLUSION: We visualized the vascular structural changes caused by UV irradiation and revealed that the effects of a single UV irradiation at 2 MED persisted for up to 28 days after exposure. The OCTA technique allows not only the in situ assessment of micro-vasculature in human skin but also its monitoring of vascular dynamics over time.

Effect of observation combined with motor imagery of a skilled hand-motor task on motor cortical excitability: difference between novice and expert.

We examined the effects of observation combined with motor imagery (MI) of a skilled hand-motor task on motor cortex excitability, which was assessed by transcranial magnetic stimulation (TMS). Novices and experts at 3-ball cascade juggling (3BCJ) participated in this study. In one trial, the subjects observed a video clip of 3BCJ while imagining performing it. In addition, the subjects also imagined performing 3BCJ without video clip observation. Motor evoked potentials (MEPs) were recorded from the hand muscles that were activated by the task during each trial. In the novices, the MEP amplitude was significantly increased by video clip observation combined with MI. In contrast, MI without video clip observation significantly increased the MEP amplitude of the experts. These results suggest that action observation of 3BCJ increases the ability of novices to make their MI performing the task. Meanwhile, experts use their own motor program to recall their MI of the task.

Clinical study on the efficacy of fluvoxamine for psychological distress in gynecologic cancer patients.

BACKGROUND: Diagnosis of cancer causes psychological distress. The present study investigated the safety and efficacy of fluvoxamine therapy in gynecologic cancer patients with either adjustment disorder or major depression after cancer was diagnosed. METHODS: Screening with the Hospital Anxiety and Depression Scale (HADS) was conducted at least 2 weeks after notification of the diagnosis of cancer in 214 gynecologic cancer patients hospitalized between January 2007 and December 2008. The HADS cutoff score was set at 11 points or greater. Informed consent to the study was obtained from 10 patients, and fluvoxamine was administered for 8 weeks. As primary end points, the safety and efficacy of fluvoxamine were evaluated using the HADS and the SF-36. As a secondary end point, the Clinical Global Impression was determined. RESULTS: The total HADS score, the anxiety score, and the depression score were significantly reduced after 6, 4, and 6 weeks of treatment, respectively. The SF-36 revealed significant improvement in vitality, mental health, and role (emotional) after 8 weeks of treatment. In the 5 patients with adjustment disorder, only the HADS anxiety score was significantly reduced after 4 weeks. In the 5 patients with major depression, the total HADS score, the anxiety score, and the depression score were significantly reduced after 6, 8, and 6 weeks, respectively. According to the SF-36, the adjustment-disorder groups showed significant improvement in mental health after 8 weeks of treatment, whereas the major-depression group showed significant improvement in vitality and role (emotional) after 8 weeks. No adverse events occurred in any subject. Assessment of the Clinical Global Impression suggested that fluvoxamine improved psychological distress in all 10 subjects. CONCLUSIONS: The present findings suggest that fluvoxamine is useful for alleviating psychological distress, including adjustment disorder and major depression, in gynecologic cancer patients. Management of psychological distress after diagnosis of cancer is important.

Psychological characteristics of Japanese gynecologic cancer patients after learning the diagnosis according to the hospital anxiety and depression scale.

AIM: Anxiety and depression are common in cancer patients, because diagnosis of cancer raises the fear of death. Although mental problems are often overlooked in cancer patients, it is important to control psychological distress, improve the quality of life, encourage patients to express requests about cancer therapy appropriately, and reduce the burden on family members. MATERIAL & METHODS: There were 214 patients admitted to the Department of Obstetrics and Gynecology of St. Marianna University Hospital for treatment of cancer between January 2007 and December 2008. At 2 weeks after learning the diagnosis of cancer, these patients completed a Hospital Anxiety and Depression Scale (HADS) questionnaire, and their psychological characteristics were investigated in relation to age, tumor type and time after learning the diagnosis. The cut-off value for intervention to manage maladjustment and major depression was set at a HADS score of 11. RESULTS: The HADS score was 11 in 118 of the 214 patients (55.1%). The HADS score for anxiety was higher in younger patients, while the HADS score for depression was higher in older patients. There were no significant correlations between the HADS score and the type of gynecologic cancer (cervical cancer, endometrial cancer and ovarian cancer) or the time after learning the diagnosis. CONCLUSION: Assessment based on the HADS score revealed a high prevalence of psychological problems after announcement of the diagnosis of gynecologic cancer. This emphasizes the importance of psychiatric intervention when patients are informed of their condition.

Increased excitability and reduced intracortical inhibition in the ipsilateral primary motor cortex during a fine-motor manipulation task.

The effects of a sensorimotor task on ipsilateral primary motor cortex (ipsi-M1) excitability mediated via the transcallosal pathway, including the changes in short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF), were examined in ten right-handed subjects. Transcranial magnetic stimulation (TMS) was delivered to evoke a motor evoked potential (MEP) from the first dorsal interosseous (FDI). The test-TMS intensity was adjusted to around 120% of the resting motor threshold (rMT). For the paired-pulse TMS paradigm, the conditioning-TMS intensity was set to 80% of the rMT, and the interstimulus interval was fixed at 3 ms for SICI and 12 ms for ICF. As a sensorimotor task, a fine-motor manipulation (FM) task (using chopsticks to pick up, transport, and release glass balls) was adopted. In addition, a pseudo-FM (pFM) task was also performed as a control task. These tasks were carried out using each hand separately. The MEPs evoked during the FM task were markedly increased compared with those evoked during the pFM task, and these effects were not dependent on the electromyographic activity of the FDI performing these tasks. SICI was significantly decreased during the FM task, indicating disinhibition of the ipsi-M1, and these effects were also noted when the subjects used their non-dominant hand. The present findings suggest that the differences between the effects of the FM and pFM tasks on ipsi-M1 excitability were caused by their property.

Spinal neuronal mechanisms explaining the modulation of soleus H-reflexes during sustained passive rotation of the hip joint.

OBJECTIVES: The aim of this study was to investigate the mechanism of modulation of soleus H-reflexes during sustained passive rotation of the hip joint. METHODS: Healthy men participated as subjects in this study. In the supine position, soleus maximum H-reflexes were recorded during rotation of the hip joint. To examine the roles of muscle spindles, we recorded H-reflexes while applying vibration to muscles around the hip joint. Furthermore, to assess the modulation of pre- and postsynaptic inputs to soleus motoneurons, H-reflexes were conditioned by common peroneal nerve stimulation or transcranial magnetic stimulation (TMS). RESULTS: The ratio of the maximum H-reflex to the maximum M-response was significantly reduced in externally rotated positions of the hip joint compared to neutral position. In these positions, presynaptic inhibition, assessed by D1 inhibition, was significantly increased. H-reflexes were reduced during vibration, irrespective of muscles involved and hip position. Facilitation of H-reflex induced by conditioning-TMS showed insignificant differences across all hip positions. CONCLUSIONS: These findings suggest that Ia afferents induced by rotation of the hip joint presumably inhibit soleus H-reflexes presynaptically. SIGNIFICANCE: Based on the results, therapists could efficiently modulate the spasticity of the lower legs of hemiplegic patients during rotation of the hip joint.