Notes: Transepidermal water loss (TEWL), skin surface water loss (SSWL) and water content of the stratum corneum are utilized to assess the hydration effects of moisturizers and soaps. The relationship among these parameters may help differentiating hydration obtained via occlusion or by water-holding in the stratum corneum. Furthermore, skin function (hydration, dehydration, barrier damage) can be studied comparing the data obtained with these techniques. In this study, the effects of glycerol, petrolatum, soaps and commercial moisturizers on the skin are investigated and discussed.

Notes: Stratum corneum moisturization was measured by two instruments simultaneously on the same subjects at different body sites. One instrument is based on the 1 GHz focused mirowave dielectric measurement; the other instrument measures impedance at 16 Hz.A linear relationship r = 0.86 was observed between the measurements by the two above-mentioned instruments. The 1 GHz focused microwave measurement is more accurate in measuring water concentration in the stratum corneum, especially in the upper layers relevant to “moisturization”; it is, however, an expensive research instrument. The low frequency impedance measurement involves a much simpler, cheaper and portable instrument which can be used routinely to evaluate ‘moisturization’ for the purpose of skin classification under field conditions.Comparaison de divers appareils de mesure de I'hydratation de la couche cornee〈section xml:id="abs1-2"〉〈title type="main"〉ésuméL'hydratation de la couche cornée a été mesurée simultanément par deux appareils sur plusieurs sites de mêmes sujets: le front, la face et les membres. Un appareil est basé sur la mesure par micro ondes, I'autre mesure I'impédance à 16 Hz.On observe une relation linéaire, r= 0.86, entre les mesures effectuées par les deux appareils ci-dessus. L'appareil à micro ondes est plus précis pour la mesure de la concentration en eau de la couche cornée et plus spécialement dans les couches supérieures qui sont importantes pour I'hydratation, mais cet appareil est onéreux. La mesure des impédances à basse fréquence utilisé un appareil portable, simple et bon marché qui peut être utilisé en routine pour évaluer I'hydratation dans le but de classer des types de peaux sur le terrain.II n'est pas toujours possible de comparer des appareils diffeérents sur les mêmes personnes et dans le même temps et il est encore plus difficile d'obtenir des donneées sur un nombre de personnes de type diffeérent. Nous suggeérons d'utiliser à I'avenir une meéthode de comparaison diffeérente basée sur I'application d'un traitement standard bien défini, qui pourrait par example consister en I'application pendant une heure d'une solution à 2% de glycérine sur I'avant bras, avant la mesure.Ces données, avec la connaissance de la distribution des valeur du prétraitement pour les divers appareils, permettraient également la comparaison et la validation des différentes méthodes.

Notes: Dandruff is a common problem in approximately 30% of the world's population. Reports in the literature regarding treatment of this condition with various antidandruff shampoos usually report the level of active ingredient within the formulation. However, we propose that a more important parameter relating to antidandruff efficacy is the amount of active ingredient delivered to the scalp from the shampoo. This report describes the results from two studies designed to investigate the relationship between the level of zinc pyrithione (ZnPTO) deposited onto the scalp and the resultant scalp condition. A double-blind randomized vehicle-controlled clinical study comparing three shampoos – a vehicle, a low-depositing ZnPTO shampoo and a high-depositing ZnPTO shampoo – was carried out in the U.K. with 53 panelists with dandruff or mild-to-moderate seborrheic dermatitis of the scalp. Both shampoos containing ZnPTO were significantly superior in antidandruff efficacy to the vehicle. Furthermore, the high-depositing ZnPTO shampoo was significantly superior compared with the low-depositing ZnPTO shampoo in terms of both antidandruff efficacy and antimycotic activity. Antidandruff performance and antimycotic activity of ZnPTO-containing shampoos is highly dependent on the amount of active ingredient delivered to the scalp. Furthermore, careful manipulation of the formulation parameters of an antidandruff shampoo can result in enhanced levels of delivery of the active ingredient without having to increase the level of active ingredient within the formulation.

Notes: We present a patient who had a pleornorphic adenoma arising in the vulva. This tumour has rarely been reported in this site previously. The nature of the tumour is discussed.

Notes: Anaesthetists' ability to identify correctly a marked lumbar interspace was assessed in 100 patients undergoing spinal magnetic resonance imaging scans. Using ink, one anaesthetist marked an interspace on the lower spine and attempted to identify its level with the patient in the sitting position. A second anaesthetist attempted to identify the level with the patient in the flexed lateral position. A marker capsule was taped over the ink mark and a routine scan performed. The actual level of markers ranged from one space below to four spaces above the level at which the anaesthetist believed it to be. The marker was one space higher than assumed in 51% of cases and was identified correctly in only 29%. Accuracy was unaffected by patient position (sitting or lateral), although it was impaired by obesity (p = 0.001) and positioning of the markers high on the lower back (p 〈 0.001). The spinal cord terminated below L1 in 19% of patients. This, together with the risk of accidentally selecting a higher interspace than intended for intrathecal injection, implies that spinal cord trauma is more likely when higher interspaces are selected.

Notes: Background Previous studies suggest that sublingual immunotherapy (SLIT) represents a safer alternative to injection immunotherapy but equivalent efficacy is yet to be confirmed.Objective To evaluate the efficacy and safety of SLIT in grass pollen-induced seasonal rhinoconjunctivitis.Methods A randomized, placebo-controlled trial in 56 adults over 18 months. Outcome measures included diary scores of seasonal symptoms and medication use, overall assessments, conjunctival and intradermal provocation tests and serum antibody measurements. To investigate possible mechanisms, sublingual biopsies were taken for measurement of local T cells, antigen-presenting cells and IL-12 mRNA expression.Results There were no significant differences between the immunotherapy (IT) and placebo groups for diary symptom scores (P = 0.48) or rescue medication (P = 0.19). The patients' overall assessment of hayfever severity compared with previous years showed a highly significant improvement in favour of the IT group (P 〈 0.02). After treatment the late skin response was smaller (P = 0.003) and the ratio of serum allergen-specific IgG4/IgE was higher (P = 0.05) in the IT group. Both of these variables correlated with the clinical response to SLIT. There were no differences between groups in either the sublingual epithelium or lamina propria for numbers of CD3+ cells (epithelium: P = 0.9, lamina propria: P = 0.2), CD1a+ cells (P = 0.3, P = 0.25), CD68+ cells (P = 0.9, P = 1.0) or IL-12 mRNA+ cells (P = 0.6, P = 0.4). Local side-effects were minor and there were no serious treatment-related adverse events.Conclusion Grass pollen sublingual immunotherapy was well tolerated. Although there was no significant change in diary scores, the improvement in overall assessments, which correlated with inhibition of the late skin response and increases in serum IgG4 : IgE ratio, indicates the need for larger, dose-ranging studies.