Sclerosis and blisters: An uncommon association revealing a new case of bullous morphea

Bullous morphea is a rare variant of localized scleroderma (morphea) characterized by subepidermal bullae developed over sclerotic plaques. The pathogenesis of bullae formation has been the subject of several debates, which arrived at the conclusion of a multifactorial mechanism. We report the case of a 67-year-old patient with bullous morphea of the trunk and thighs, who showed a good response to PUVA therapy combined with topical steroids. Our case report supports the efficiency of PUVA therapy associated with topical steroids as a safe regimen compared to other therapeutic approaches.

CCL27: Novel Cytokine with Potential Role in Pathogenesis of Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune and neurodegenerative disease of unknown etiology. Leukocyte infiltration of brain tissue and the subsequent inflammation, demyelination, axonal damage, and formation of sclerotic plaques is a hallmark of MS. Upregulation of proinflammatory cytokines has been suggested to play an essential role in regulating lymphocyte migration in MS. Here we present data on serum cytokine expression in MS cases. Increased serum levels of IL-17 and IL-23 were observed, suggesting activation of the Th17 population of immune effector cells. Additionally, increased levels of IL-22 were observed in the serum of those with acute phase MS. Unexpectedly, we observed an upregulation of the serum chemokine CCL27 in newly diagnosed and acute MS cases. CCL27 is an inflammatory chemokine associated with homing of memory T cells to sites of inflammation. Therefore, its upregulation in association with MS suggests a potential role in disease pathogenesis. Our data supports previous reports showing IL-17 and -23 upregulation in association with MS and potentially identify a previously unknown involvement for CCL27.

Influence of coexisting myringosclerosis on myringoplasty outcomes in children

Objective:To obtain information on the success rate of tympanoplasty with concomitant myringosclerosis.Methods:The medical records of 40 children with myringosclerosis (23 girls, 17 boys; age range six to 16 years, mean age 9.85 years) who had undergone primary tympanoplasty were retrospectively studied. Surgical success was defined as the perforation remaining closed 12 months post-operatively.Results:Sclerotic plaques occupied whole remnant eardrums in 17 patients, and were located in various parts of the eardrum in 23. Tympanosclerosis associated with myringosclerosis was present in six patients. The success rate of primary tympanoplasty was 92.5 per cent. All three surgical failures were observed in girls with marginal perforations. These children underwent successful revision procedures for their residual perforations, variously at four, eight and 10 months after the initial surgery.Conclusion:Appropriate freshening of the perforation edges, with removal of sclerotic plaques, can result in a high rate of successful closure of perforated tympanic membrane with coexisting myringosclerosis.

Injection of vapor into a porous medium saturated with gas and paraffin

The problem of injecting steam into a porous medium saturated with gas is considered. It is believed that the skeleton of a porous medium consists of two components, one of which has a melting point lower than the temperature of the injected vapor. Therefore, this component will undergo a phase transition with additional heat consumption. This type of problem occurs in processes associated with cleaning the porous media from sclerotic plaques, mining bitumen oils, regenerating porous catalysts.

Magnetic resonance imaging in the diagnosis of multiple sclerosis cerebral foci

The close attention to the problem of multiple sclerosis (MS) is by no means accidental. The widespread prevalence of the disease, the young age of the patients, the low effectiveness of therapy and the high percentage of disability among people of the most working age cause extreme concern [3, 7, 19]. MS is the most common demyelinating disease of the nervous system, which is characterized by a polysymptomatic and recurrent course [1, 4, 5, 59]. According to R. Detd. et al. (1977) and S.M. Poser et al. (1983), MS occurs in 4-10% of cases in different countries, more often in the south of Russia, Israel, the United States, Europe and Latin America. The pathogenesis of the disease is not fully understood, in particular, the role of genetic factors and autoimmune processes in the mechanisms of MS development has not been fully determined [2, 55, 70]. The basis of the disease is the process of demyelination with the formation of disseminated dense sclerotic foci in the white matter of the brain [31, 33]. These foci, resembling gliosis scars, are the result of a local inflammatory process, accompanied by the destruction of the myelin sheaths and axons of nerve cells [28]. The pathological feature of MS is considered to be a violation of the blood-brain barrier. In the acute phase of the disease, the disintegration of oligodendrocytes, which make up the myelin sheath of axons, and the migration of activated immune cells to the focus of antigenic conflict (into microglia and astrocytes) occur. In this case, there is muff-like adhesion of endothelial cells and leukocytes around venules and along the pathways with the subsequent formation of dense sclerotic plaques [8, 16]. In some cases, remyelination occurs, and then re-disintegration with the formation of plaques. In postmortem examination, MS foci are most often detected near the anterior and posterior parts of the lateral ventricles, in the region of the semi-oval center, subcortical nuclei, trunk, cerebellum, in the spinal cord, and also in the optic nerves.