By I. Tempeck. Barrington University.
The level of this section shows only a shrinking outer root sheath (trichilemma) which is surrounded by a thickened hyaline membrane order 50mg viagra soft erectile dysfunction female doctor, indicating catagen (hematoxylin and eosin stain buy viagra soft 50 mg low cost erectile dysfunction treatment houston, original magnication 200x) discount viagra soft 50 mg with visa erectile dysfunction drugs medications. Terminal Telogen Hair After catagen, the hair follicle enters telogen, where the hair follicle matures into a club hair. The hair follicle retracts to the level of the bulge at the site of insertion of the arector pili mus- cle into the follicle (Fig. Here the resting hair comprises a telogen germinal unit situated below the telogen club. The telogen germinal unit consists of trichilemma, which is somewhat convoluted and surrounded by palisading basaloid cells. The telogen germinal unit has a char- acteristic appearance and shows no obvious apoptosis (Fig. A telogen club comprises a central mass of trichilemmal keratin, star-shaped in horizontal section, surrounded by trichil- emmal and brous sheaths, connecting telogen germinal units and hair shafts (Fig. After 2 to 4 months of telogen, the telogen germinal cells envelops the dermal papilla and grows down the existing follicular tract or stela to form an anagen hair (Fig. Subsequent hair cycling will continue throughout life for as long as the hair follicle is viable. A certain proportion of the hair follicles undergo growth, regression, and rest, continuously and independently. This process involves orchestration of a complex yet delicate interplay of molecular signals. A thorough knowledge of the gross and microscopic follicular anatomy in vertical and horizontal sections is essential for the accurate interpretation of the biopsy, leading to the successful evaluation of the patient with hair disorder. Note that total brosis without a vascular supply indicates cicatricial alopecia and a lack of ability for further cycling. The Structure of the Human Hair Follicle: Light Microscopy of Vertical and Horizontal Sections of Scalp Biopsies. Transverse microscopic anatomy of the human scalp: a basis for morphometric approach to disorders of the hair follicle. Label-retaining cells reside in the bulge area of pilosebaceous unit: implications for follicular stem cells, hair cycle and skin carcinogenesis. A comparison of vertical versus transverse sections in the evaluation of alopecia biopsy specimens. Vertical and Transverse sections of alopecia biopsy specimens: Combining the two to maximize diagnostic yield. Diagnostic and predictive value of horizontal sections of scalp biopsy specimens in male pattern androgenetic alopecia. Morphology and properties of Asian and Caucasian hair J Cosm Sic 2006; 57:327 338. Difference is hair follicle dermal papilla volume are due to extracellular matrix volume and cell number: implications for the control of hair follicle size and androgen responses. Atrichia caused by mutations in the Vitamin D receptor gene is a phenocopy of generalized atrichia caused by mutations in the hairless gene. Hair cosmetics can be helpful in camouaging hair loss by optimizing the appearance of exist- ing hair; however, hair cosmetics may also be the cause of hair loss when improperly used or used to excess. The primary goal of this chapter is to help the reader understand how shampoos and conditioners can be incorporated into a treatment algorithm for patients undergoing hair disease treatment. The secondary goal of this chapter is to understand hair loss precipitated by hair coloring, permanent waving, and hair straightening. While these procedures can beautify the hair or appeal to fashion concerns, they can also permanently damage the hair protein and produce premature hair breakage and loss. Haircare is important because damage to the non- living ber is permanent until replaced by new growth, which is a time-consuming activity. Cleansing the hair is actually a complex task, since the average woman has 4 to 8 square meters of hair surface area to clean (2). Thus, the goal of a shampoo is to maintain scalp hygiene while beautify- ing the hair. A shampoo that has high detergent properties can remove the outer cuticle of the hair shaft rendering it frizzy and dull, while a well-designed conditioning shampoo can impart shine and improve manageability. Proper shampoo selection can be the difference between attractive and unattractive hair. Shampoo Formulation Shampoos cleanse by utilizing synthetic detergents, also known as surfactants, which are amphiphilic. The lipophilic site binds to sebum and oil-soluble dirt while the hydrophilic site binds to water allowing removal of the sebum with water rins- ing (4). There are four basic categories of shampoo detergents: anionics, cationics, amphoterics, and nonionics (5). Usually, a shampoo is a combination of two to four detergents with various abilities to remove sebum, produce foam, and condition the hair. Creating the perfect balance between hygiene and beautication is the goal of a successful shampoo. Anionic detergents are the most popular cleanser in general purpose shampoos and are named for their negatively charged hydrophilic polar group. Common anionic detergents include the lauryl sulfates, laureth sulfates, sarcosines, and sulfosuccinates. The second most popular detergents are the amphoter- ics, which contain both an anionic and a cationic group. This allows them to behave as cationic 60 Draelos detergents at low pH and as anionic detergents at high pH. Amphoteric detergents such as cocamidopropyl betaine and sodium lau- raminopropionate are found in baby shampoos. These detergents actually numb the tissues of the eyes, which accounts for the non-stinging characteristics of baby shampoo. Amphoteric detergents are also used in shampoos for ne and chemically treated hair because they foam moderately well while leaving the hair manageable. The main distinguishing characteristic between a bar cleanser and a shampoo is the addi- tion of a sequestering agent. Sequestering agents function to chelate magnesium and calcium ions thereby preventing the formation of insoluble soaps, known as scum. Without sequester- ing agents, shampoos would leave a lm on the hair, making it appear dull. Shampoo Diversity Even though all shampoos employ the same basic ingredients, the number of formulations on the market is diverse. This is because there are many different cleansing needs and hair types (Table 1). Shampoos designed for so-called normal hair thoroughly cleanse the scalp in persons with moderate sebum production and are best for chemically untreated hair. These shampoos are popular among men and use lauryl sulfate as the primary detergent, which provides good sebum removal and minimal conditioning. This is in contrast to dry-hair shampoos that provide mild cleansing and excellent conditioning.
The pro-oxidant actions only appear to be produced when the flavonoid doses are excessively high  buy viagra soft 100 mg low price impotence diagnosis code. Under this heading buy 100mg viagra soft with visa erectile dysfunction diagnosis code, we will present a brief review of the remaining antioxidants present in our diet viagra soft 100mg mastercard erectile dysfunction 30s, their activity, and the foods that supply them. Lycopene Lycopene is the carotenoid that imparts the red color to the tomato and watermelon and that it not converted into vitamin A in the human organism, which does not impede it from pos sessing very high antioxidant properties. High consumption of lyco pene has been related with the prevention of some cancer types, precisely that of the prostate. These minerals exercise their antioxidant function in diverse processes and metabolic steps in the organism [6, 26, 27]. It empowers the immune system, participates in the formation of enzymes, proteins, and brain neurotransmitters (cell renovation and stimulation of the nervous system) and is an anti-inflammatory and anti-infectious agent. Similarly, it facilitates the synthesis of collagen and elastin (necessary constituents of the good state of the blood vessels, lungs, and the skin). This mineral is incorporated into proteins in the form of selenoproteins and, in this manner, aids in the prevention of cell damage. Epidemiological studies related the lack of selenium in the diet with the incidence of lung, colorectal, and prostate cancer. The selenium content in the diet is directly related with the selenium content of the soil in which the food was grown. Thus, selenium-deficient soils give rise to a deficit of this ele ment in the population, as in the case of China. Iron Iron forms part of the organism s antioxidant system because it contributes to eliminat ing the peroxide groups. Co-enzyme Q Co-enzyme Q10 or ubiquinone is a liposoluble compound that can be carried in many foods, although it can also be synthesized in the human organism. Co-enzyme Q10 diminishes with age; thus, the metabolic processes in which it has been found implicated are also co- enzyme Q10-sensitive. Given its liposolubility, its absorption is very los, especially when the diet is poor in fats. It additionally acts as an immune system stimulant and through this stimulation also functions as an anticancerigen. In addition, it is capable of directly regenerating alpha- tocopherol [6, 26, 27]. Lipoic acid Lipoic acid or thioctic acid is also a compound that forms part of the antioxidant capital of the organism. It is synthesized by plants and animals, as well as by the human organism, although in the latter case, in very small amounts. Lipoic acid is considered a very good regenerator of po tent antioxidants such as vitamin C, vitamin E, glycation, and co-enzyme Q10. It is liposolu ble and hydrosoluble, which means that it can act on any part of the organism. Naringenine The hypolipidemic and anti-inflammatory activities in vivo as well as in vitro of the flavonoids of citric fruits have been widely demonstrated. Among the flavonoids, naringenine, one of the compounds that causes the bitter taste of grapefruit, has been studied extensively in recent years. Conclusion A good diet influences the development and treatment of diseases, it is increasingly evident. After that epidemiological studies have shown the association between moderate consump tion of certain foods and reduced incidence of various diseases at the rate of these observa tions has attracted considerable interest in studying the properties of substances inherent in the chemical composition of food. Among the characteristics of these substances is the anti oxidant activity, associated with the elimination of free radicals and therefore to the preven tion of early stages which can trigger degenerative diseases. In this regard it is important to continue the study of dietary antioxidants on the activity may have on human diseases, pay ing attention to the substances primarily natural antioxidants of food and synthetic way to assess its protective effect on the body. Olvera Hernndez, Telma Flores Cern and* Angelina lvarez Chvez *Address all correspondence to: chehue_alex@yahoo. Comisin Nacional de Formacin Continuada del Sistema Nacional de Sal ud, Madrid. Per spectivas del uso de antioxidantes como coadyuvantes en el tratamiento del asma. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Cuantificacin de cido Ascrbico (Vitamina C) en Nctares de Melocotn y Manzana Comercializados en Supermercados de la Ciudad Capi tal. Biologa, patobiologa y bioclnica de la actividad de oxidorreduccin de la vitamina C en la especie humana. Food and Nutrition Board, Institute of Medicine, National Academy Press 2000; Advance Copy, 3;6-7;97. Antiatherogenic properties of flavonoids: Implications for cardio vascular health. However, problems may arise when the electron flow becomes uncoupled (transfer of unpaired single electrons), generating free radicals . Antioxidants are important in living organisms as well as in food because they may delay or stop formation of free radical by giving hydrogen atoms or scavenging them. Oxidative stress is involved in the pathology of cancer, atherosclerosis, malaria and rheumatoid arthritis. An antioxidant can be defined in the broadest sense of the word, as any molecule capable of preventing or delaying oxidation (loss of one or more elec trons) from other molecules, usually biological substrates such as lipids, proteins or nucleic acids. The oxidation of such substrates may be initiated by two types of reactive species: free radicals and those species without free radicals are reactive enough to induce the oxidation of substrates such as those mentioned. Primary: Prevent the formation of new free radicals, converting them into less harmful molecules before they can react or preventing the formation of free radicals from other molecules. It also handles the classification based according to where they perform their activities, their background and their biochemical characteristics. So, antioxidants are also classified into two broad groups, depending on whether they are water soluble (hydrophilic) or lipid (hy drophobic). In general, water soluble antioxidants react with oxidants in the cell cytoplasm and blood plasma, whereas the liposoluble antioxidants protecting cell membranes against lipid peroxidation. In the metabolism it is a contradiction that while the vast majority of life requires oxygen for its existence, oxygen is a highly reactive molecule that damages living organisms by producing reactive oxygen species. Usually antioxidant sys tems prevent these reactive species are formed or removed before they can damage vital components of the cell. The hydroxyl radical is particularly unstable and reacts rapidly2 and non-specifically with most biological molecules. This species produces hydrogen perox ide redox reactions catalyzed by metals such as the Fenton reaction. The use of oxygen as part of the process for gen erating metabolic energy produces reactive oxygen species. In this process, the superoxide anion is produced as a byproduct of several steps in the electron transport chain.
Immune and vascular-mediated mechanisms contribute to the clinical manifestations viagra soft 50 mg without prescription erectile dysfunction normal age. These include anti-endothelial antibodies and antimyen- teric neuronal antibodies 100mg viagra soft erectile dysfunction doctor calgary. Immune complex formation with activation of complement is generally not part of the immunopathogenesis of scleroderma cheap viagra soft 100 mg without prescription impotence exercise, and it does not appear that anticentromere antibodies and antitopoisomerase antibodies are directly pathogenic as well. Autoantibody Formation in Inflammatory Muscle Disease The inflammatory muscle diseases comprise a group of heterogeneous diseases characterized by proximal muscle weakness and inflammation of skeletal muscle. Polymyositis and dermatomyositis, as well as the juvenile form of dermatomyositis, are immune-mediated diseases characterized by autoantibody formation. Antibodies to both 8 Part I / Introduction to Rheumatic Diseases and Related Topics nuclear and cytoplasmic antigens can be found in about 20% of patients with inflam- matory muscle disease (13). Antisynthetase antibodies are directed against cytoplasmic ribonucleoprotein antigens that are involved in protein synthesis and are characteristic of polymyositis and dermatomyositis. The antibodies are diagnostic markers, and their role in the immunopathogenesis of the diseases remains unclear. Like the other autonantibodies discussed, they do not appear to be directly pathogenic and do not appear to fix complement. Additionally, distinct vasculitis syndromes have been defined and comprise a heterogeneous group of disorders with overlapping clinical features. These vasculitis syndromes have been historically grouped in a variety of ways: with respect to the predominant vessel size affected (small, medium, or large), by the histopathology of the affected vessel (e. Biopsy of clinically affected tissue is usually required for the diagnosis of most types of vasculitis. Vasculitis may be caused by the deposition of immune complexes within vessel walls resulting in focal complement activation, recruitment of inflammatory cells, and narrowing of the vessel lumen. Immune complexes, however, are not always detected in the serum of affected patients but may be more common with certain types of vasculitis. The specific trigger for each of the vasculitic processes is not clear, and different models have been proposed for individual diseases. The clinical presentation of the vasculitides in large part depends on the particular vessels involved. Diseases characterized by small vessel involvement may present with skin manifestations (purpura). Immune complex formation and deposition likely contributes to the pathogenesis of lupus vasculitis. Autoantibodies have also been seen with cryoglobulinemia, which can be seen with certain infections or other rheumatic diseases like lupus. Cryoglobulins are immun- globulins that precipitate in the cold, usually below 4 Celsius. They are categorized as type 1, 2, or 3, depending on the presence of a mononclonal component within the cryoglobulin itself. Both type 2 and 3 cryoglobulins contain a polyclonal component, but type 2 cryoglob- ulins also contain a monoclonal component. Type 2 and 3 cryoglobulins can be detected in the sera of patients with systemic vasculitis caused by hepatitis C. In hepatitis C- associated cryoglobulinemia, an untoward immune response to hepatitis C infection results in the formation of immune complexes that deposit in the vessel wall. The clinical manifestations of cryoglobulinemia caused by hepatitis C include skin disease with rash, and renal involvement owing to deposition of cryoglobulin complexes in the glomerulus, causing an abnormal urinalysis and renal function. Manifestations of cryoglobulinemia in lupus include skin and kidney disease, resulting from immune complex formation and activation of complement. Higher titers are generally associated with more destructive disease but titers do not correlate with disease activity; patients with higher titers may have a worse prognosis. One of the current prevailing theories regarding the development of autoimmune disease in general is that exposure to an unspecified antigen, in a genetically predisposed individual, results in disease. This interaction then leads to secretion of cytokines that help to promote the disease state. It remains one of the best examples of an association between a genetic marker and disease (18). Cytokines react with specific cellular receptors and exert their effects on multiple cell types, including the cells from which they are released. Interactions between cytokines and their receptors result in the activation of intracellular pathways that in turn lead to other biological processes. Functional classes of cytokines include immunoregulatory cytokines, proinflammatory cytokines, and anti-inflammatory cytokines. The identification of specific cytokines and their respective functions has helped scientists to piece together working models of the immunopathogenesis of some rheumatic diseases. Theories regarding the pathogenesis of this aberrant response include loss of tolerance, dysfunctional T-cell help, or molecular mimicry, in which shared features of the triggering antigen and self-antigen lead to an untoward immune response and resultant disease. Genetics influence the development of autoantibodies as well and many rheumatic diseases have multigenic processes at play. The products of this interaction include various cytokines, which then trigger further immune and inflammatory mediated pathways inherent in each disease. Preferential induction of autoantibody secretion in polyclonal activation by peptidoglycan and lipopolysaccharide: in vivo studies. Antinuclear antibodies: diagnostic markers for autoimmune diseases and probes for cell biology. Hepatitis C virus infection and vasculitis: Implications of antiviral and immunosuppressive therapies. Association of microsatellite markersnear the fibrillin 1 gene on human chromosome 15q and scleroderma in a Native American population. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Correlation between disease phenotype and genetic hetero- geneity in rheumatoid arthritis. Key Words: Anthropometric; biochemical; clinical; dietary; dietary status; environmental; functional assessment; nutritional assessment, nutritional status 1. It discusses the difference between dietary and nutri- tional status and provides some historical perspectives on nutritional status assessment. The six essential components of nutrition assessment are discussed, with specific attention to the arthritic and rheumatoid diseases. Distinction Between Dietary Status and Nutritional Status Dietary status refers to the assessment of intakes of nutrients from food, beverages, and supplements in relation to a reference standard, such as the dietary reference intakes. Malnutrition may result from inadequate intake, malabsorption, excess excretion of nutrients, and inborn errors of metabolism.