Clinics in dermatology
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Clinics in dermatology · Jul 2004
ReviewHow do we get fat? An epidemiologic and metabolic approach.
Obesity results when the energy intake exceeds expenditure for a long period. The first law of thermodynamics, which describes this relationship, does not provide insight into the failures to couple energy intake and expenditure. ⋯ Perhaps the greatest impact has resulted from the cloning of genes corresponding to the five mouse monogenic obesity syndromes and the subsequent characterization of the human counterparts to these syndromes. Extensive molecular and reverse genetic studies (mouse knockouts) have helped establish other critical pathways that regulate body fat and food intake, and also have either validated or refuted the importance of previously identified pathways.
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Clinics in dermatology · May 2004
ReviewCurrent technologies for the in vivo diagnosis of cutaneous melanomas.
The rising incidence of cutaneous malignant melanoma has been observed in the past decades. Currently, there is no cure for metastatic melanoma; only early diagnosis followed by prompt excision of cutaneous lesions ensures a good prognosis. The clinical ABCD rule is created as a framework for differentiating melanomas from benign pigmented skin lesions, and it serves as the basis for current clinical diagnosis. ⋯ Although it is valuable, it has its limitations. Currently, the diagnostic accuracy for physicians is about 65%. This statistic implies that 1) melanomas with subtle signs are missed as benign lesions, and 2) benign lesions are over diagnosed as melanomas, which lead to unnecessary biopsies.
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Clinics in dermatology · Jan 2004
ReviewAnatomy of the sweat glands, pharmacology of botulinum toxin, and distinctive syndromes associated with hyperhidrosis.
For a long period the therapeutic modalities to treat focal hyperhidrosis (HH) were very limited. Due to this the problem of focal HH was delt with stepmotherly. Nowadays we can consider BTX as the therapy of choice for axillary HH after topical treatment with aluminium salts have failed. ⋯ The structural architecture of BTX comprises three domains-L, H(N) and H(C)-each with a specific function in the mechanism of cell intoxication. The heavy chain is responsible for binding to the nerve cell, whereas the light chain catalyzes the proteolysis of one of the three SNARE proteins (Snap-25, Vamp or Syntaxin) depending to the serotype of BTX (7 serotypes A-G). Once cleaved by BTX, the SNARE proteins cannot become part of the complex capable of mediating the vesicle membrane fusion and therefore prevents the release of ACh and hence transmission of the nerve impulse.