A position paper in support of hand transplantation in the blind

Blind upper extremity amputees have historically been excluded from consideration for hand allotransplantation. Although no formal position statement regarding their exclusion has been published to date, functional, rehabilitative, and ethical concerns related to blind amputee candidacy for hand transplantation may be inferred. The authors provide a summary of these reservations and a counterargument to their assumptions, drawing on outcomes measures reported for hand transplantations completed to date. The authors therefore provide a rationale for the inclusion of blind amputees in hand transplantation protocols in the future.     

Nomenclature of precancerous lesions of the uterine cervix. A position paper

There is universal and almost unanimous belief that there is a need for a radical revision of the terminology relating to the epithelial abnormalities of the uterine cervix that precede invasive carcinoma. Although this belief has been held for some years, no generally accepted alternative system has, as yet, been devised. This position paper examines (1) the origin of the existing system of terminology, (2) the problems associated with this system and (3) the requirements of any new, alternative nomenclature. The various alternatives that have been suggested are considered with particular reference to their advantages and disadvantages. Only two such alternatives are considered to be acceptable, and it is suggested that neither is likely to gain universal acceptance at this time. However, it is possible that new diagnostic techniques, with their potential for a more accurate evaluation of cell abnormalities, may facilitate the development or application of an acceptable system of terminology.     

Koebner's phenomenon in vitiligo: European position paper

Koebner's phenomenon (KP) has been observed in a number of skin diseases, including vitiligo. Its clinical significance in vitiligo with respect to disease activity and course is still debatable, while its relevance for surgical techniques has been demonstrated in some reports. We present a literature review on the currently known facts about KP in vitiligo, including details of clinical, experimental, and histopathological changes. The consensus view is that there are still no methods to define and assess KP in vitiligo. A new classification is proposed to allow an evaluation of KP in daily practice or in experimental studies. However, many unanswered questions still remain after redefining KP in patients with vitiligo. Active research focusing on KP in vitiligo may not only provide unexpected clues in the pathogenesis of vitiligo but also help to tailor novel therapies against this chronic and often psychologically devastating skin disease.     

Teratology public affairs committee position paper: Iodine deficiency in pregnancy

Iodine deficiency is an important nutritional deficiency, with more than 2 billion people worldwide estimated to be at risk. The developing fetus and young children are particularly at risk. During pregnancy and lactation, iodine requirements increase, whether in iodine-poor or iodine-sufficient countries, making the mother and the developing fetus vulnerable. The American Thyroid Association (ATA) recommends 250 micrograms per day of iodine intake for pregnant and lactating women. The thyroid gland is able to adapt to the changes associated with pregnancy as long as sufficient iodine is present. Dietary intake is the sole source of iodine, which is essential to the synthesis of thyroid hormones. Iodine is found in multiple dietary sources including iodized salt, dairy products, seaweed, and fish. Prenatal vitamins containing iodine are a good source of iodine, but iodine content in multivitamin supplements is highly variable. Congenital hypothyroidism is associated with cretinism. Clinical hypothyroidism has been associated with increased risk of poor perinatal outcome including prematurity, low birth weight, miscarriage, preeclampsia, fetal death, and impaired fetal neurocognitive development. Subclinical hypothyroidism is also associated with poor pregnancy outcomes and potential fetal neurocognitive deficits, but the data are more variable than those for clinical hypothyroidism. We concur with the ATA recommendation that all pregnant and lactating women should ingest (through diet and supplements) 250 micrograms of iodine daily. To achieve this goal, we recommend that all pregnant and lactating women take daily iodine supplementation of 150 micrograms. Birth Defects Research (Part A) 94:677-682, 2012. ? 2012 Wiley Periodicals, Inc.     

Psychosocial implications of disfigurement and the future of human face transplantation

Although the first face transplants have been attempted, the social and psychological debates concerning the ethics and desirability of the procedure continue. Critics contend that these issues have not yet been sufficiently addressed. With this in mind, the present article seeks to elaborate on key psychological and social factors that will be central for addressing the ethical and psychosocial challenges necessary to move face transplantation into mainstream medicine. The goals of this article are to (1) discuss the psychosocial sequelae of facial disfiguration and how face transplantation may relieve those problems, and (2) delineate inclusion and exclusion criteria for the selection of research subjects for face transplantation. The article uses concepts from symbolic interaction theory in sociology to articulate a theoretically coherent scheme for comprehending the psychosocial difficulties of facial disfiguration and the advantages offered by facial transplantation. The authors conclude that the psychosocial implications of disfigurement warrant surgical intervention and that research in the area of face transplantation should continue.     

Timing of organogenesis support basal position of turtles in the amniote tree of life

Background  

The phylogenetic position of turtles is the most disputed aspect in the reconstruction of the land vertebrate tree of life. This controversy has arisen after many different kinds and revisions of investigations of molecular and morphological data. Three main hypotheses of living sister-groups of turtles have resulted from them: all reptiles, crocodiles + birds or squamates + tuatara. Although embryology has played a major role in morphological studies of vertebrate phylogeny, data on developmental timing have never been examined to explore and test the alternative phylogenetic hypotheses. We conducted a comprehensive study of published and new embryological data comprising 15 turtle and eight tetrapod species belonging to other taxa, integrating for the first time data on the side-necked turtle clade.     

Chemoprevention of coronary atherosclerosis: the role of lipid interventions. A position paper of the American Council on Science and Health

Atherosclerosis is not an inexorable part of aging. Addressing unhealthy lifestyle behaviors will go a long way toward reducing the current burden of atherosclerosis without widespread drug therapy. The question is whether this is possible, given the demand of our modern culture. It is not yet clearly established precisely where pharmaceutical lipid lowering or chemoprevention fits in the broader spectrum of prevention and treatment of atherosclerosis and its complications. Anatomic interventions, such as angioplasty or bypass surgery, targeted to obstructing but stable lesions, are likely to be only of limited effectiveness. On the other hand, cholesterol interventions, not only as a long-term means of dealing with atherosclerotic sequelae but as a short-term means of reducing plaque activity and events, are demonstrably effective. Aggressive cholesterol lowering will, moreover, substantially reduce the requirement for angioplasty and bypass procedures. Although more difficult to prove, earlier intervention can almost surely lower the risk of later, potentially lethal, coronary events.     

Mitochondrial genome data support the basal position of Acoelomorpha and the polyphyly of the Platyhelminthes

We determined 9.7, 5.2, and 6.8 kb, respectively, of the mitochondrial genomes of the acoel Paratomella rubra, the nemertodermatid Nemertoderma westbladi, and the free-living rhabditophoran platyhelminth Microstomum lineare. The identified gene arrangements are unique among metazoans, including each other, sharing no more than one or two single gene boundaries with a few distantly related taxa. Phylogenetic analysis of the amino acid sequences inferred from the sequenced genes confirms that the acoelomorph flatworms (acoels+nemertodermatids) do not belong to the Platyhelminthes, but are, instead, the most basal extant bilaterian group. Therefore, the Platyhelminthes, as traditionally constituted, is a polyphyletic phylum.     

Wood and bark anatomy of Hypocalyptus support its isolated taxonomic position in Leguminosae

The wood and bark anatomy of all three species of Hypocalyptus from the monotypic South African endemic tribe Hypocalypteae were studied. Despite large morphological differences (especially in habit) the species were found to be similar in wood and bark structure. Discontinuities are quantitative only, relating mainly to differences in growth form between H. oxalidifolius, a short-lived shrublet, and the two other species, H. coluteoides and H. sophoroides, both of which are erect shrubs or small trees of up to 6 m tall. Hypocalyptus wood has a mesomorphic structure with vessels solitary or in small groups, reflecting relatively moist habitats in fynbos vegetation. In contrast to many genera of Leguminosae for which data are available, crystals are absent from the wood. This is the first report of tanniniferous tubes in the wood of Leguminosae (previously reported only in Myristicaceae and a genus from Ulmaceae). The presence of tanniniferous tubes and the absence of crystals in all three species of Hypocalyptus underline the isolated position of the genus and support its tribal status.     

Aromatic residue position on the nonpolar face of class a amphipathic helical peptides determines biological activity

The apolipoprotein A-I mimetic peptide 4F (Ac-DWFKAFYDKVAEKFKEAF-NH(2)), with four Phe residues on the nonpolar face of the amphipathic alpha-helix, is strongly anti-inflammatory, whereas two 3F analogs (3F(3) and 3F(14)) are not. To understand how changes in helix nonpolar face structure affect function, two additional 3F analogs, Ac-DKLKAFYDKVFEWAKEAF-NH(2) (3F-1) and Ac-DKWKAVYDKFAEAFKEFL-NH(2) (3F-2), were designed using the same amino acid composition as 3F(3) and 3F(14). The aromatic residues in 3F-1 and 3F-2 are near the polar-nonpolar interface and at the center of the nonpolar face of the helix, respectively. Like 4F, but in contrast to 3F(3) and 3F(14), these peptides effectively inhibited lytic peptide-induced hemolysis, oxidized phospholipid-induced monocyte chemotaxis, and scavenged lipid hydroperoxides from low density lipoprotein. High pressure liquid chromatography retention times and monolayer exclusion pressures indicated that there is no direct correlation of peptide function with lipid affinity. Fluorescence studies suggested that, although the peptides bind phospholipids similarly, the Trp residue in 4F, 3F-1, and 3F-2 is less motionally restricted than in 3F(3) and 3F(14). Based on these results and molecular modeling studies, we propose that the arrangement of aromatic residues in class A amphipathic helical molecules regulates entry of reactive oxygen species into peptide-phospholipid complexes, thereby reducing the extent of monocyte chemotaxis, an important step in atherosclerosis.     

面部原发性皮肤隐球菌病1例

报道1例自身免疫功能正常的原发性皮肤隐球菌病。患者因"面部红斑进行性加重半年,破溃伴结痂2个月余"来我科就诊,皮肤科检查可见左侧面颊部3 cm×5 cm大小红斑,边界清楚,中央可见数片浅溃疡,覆盖灰褐色痂皮。病理检查示真皮浅层及深层可见大量炎性细胞浸润,PAS染色见大量紫红色孢子聚集在多核巨细胞内外;阿申蓝染色阳性;粘蛋白卡红染色阳性;免疫组化染色(抗体为兔抗隐球菌抗体)可见棕色圆形孢子。根据其临床症状、病理检查、特殊染色及免疫组化染色,确诊为原发性皮肤隐球菌病。经伊曲康唑治疗痊愈。