Human nails as a biomarker of arsenic exposure from well water in Inner Mongolia: comparing atomic fluorescence spectrometry and neutron activation analysis.

Arsenic (As) is found naturally in the geological strata within the Ba Men Region of Inner Mongolia, China. A study was conducted to compare the total As measurements from two analytical techniques: instrumental neutron activation analysis (INAA) and atomic fluorescence spectrometry (AFS), and to verify nails as an exposure biomarker in this population. In 1999, nail and water samples were collected in a pilot study. Fingernails and toenails were pooled from 32 participants and analysed for total As by both INAA and AFS. Mean nail As values were 14.8+/-2.4 and 19.4+/-2.8 microg g-1 (+/-SEM) for INAA and AFS, respectively. Results from these two methods were significantly correlated (r=0.93, p<0.0001). In 2000, a second study was conducted and INAA was used to measure total As in toenails from 314 Ba Men residents. Well water samples were collected from 121 households and analysed by AFS. A significant correlation was observed between toenail and well water As (r=0.84, p<0.0001). Based on the results, INAA was significantly correlated with AFS and proved to be a reliable measure of nail As levels. In this population, toenail samples are a useful internal As exposure biomarker from drinking water sources.     

甲板甲床部分切除联合苯酚烧灼术治疗嵌甲症的临床研究

目的:探讨甲板甲床部分切除联合苯酚烧灼术治疗嵌甲症的临床疗效。方法:选择武汉市中心医院2004年10月至2013年5月收治的115例148趾拇趾嵌甲进行研究。以2004年10月至2007年12月的患者53例(67趾)作为对照组行单纯甲板甲床部分切除术治疗,2008年1月至2013年5月的患者62例(81趾)作为观察组行甲板甲床部分切除联合苯酚烧灼术治疗。对比两组患者的出血、疼痛缓解和康复时间,了解一年后患者复发情况及满意度。结果:148趾手术伤口均一期愈合,观察组病例术后出血时间、疼痛缓解时间(1.85±0.42天、13.25±2.17小时)较对照组(2.69±0.53天、21.54±2.56小时)低,但术后恢复时间(11.32±2.37天)较对照组(8.93±2.06天)长,差异均有统计学意义(P0.05),观察组和对照组的复发率及总体满意率分别为6.15%、12.5%及97.06%、91.07%,两组差异并无统计学意义(P0.05)。结论:甲板甲床部分切除联合苯酚烧灼术治疗嵌甲症与单纯甲板甲床部分切除术的疗效相当,但可显著减少患者痛苦。     

Analysis of myosmine,cotinine and nicotine in human toenail,plasma and saliva

Myosmine is a minor tobacco alkaloid with widespread occurrence in the human diet. Myosmine is genotoxic in human cells and is readily nitrosated and peroxidated yielding reactive intermediates with carcinogenic potential. For biomonitoring of short-term and long-term exposure, analytical methods were established for determination of myosmine together with nicotine and cotinine in plasma, saliva and toenail by gas chromatography–mass spectrometry (GC/MS). Validation of the method with samples of 14 smokers and 10 non-smokers showed smoking-dependent differences of myosmine in toenails (66?±?56 vs 21?±?15?ng?g^?1, p?<0.01) as well as saliva (2.54?±?2.68 vs 0.73?±?0.65?ng ml^?1, p <0.01). However, these differences were much smaller than those with nicotine (1971?±?818 vs 132?±?82?ng g^?1, p <0.0001) and cotinine (1237?±?818 vs <35?ng?g^?1) in toenail and those of cotinine (97.43?±?84.54 vs 1.85?±?4.50?ng ml^?1, p <0.0001) in saliva. These results were confirmed in plasma samples from 84 patients undergoing gastro-oesophageal endoscopy. Differences between 25 smokers and 59 non-smokers are again much lower for myosmine (0.30?±?0.35 vs 0.16?±?0.18?ng?ml^?1, p <0.05) than for cotinine (54.67?±?29.63 vs 0.61?±?1.82?ng ml^?1, p <0.0001). In conclusion, sources other than tobacco contribute considerably to the human body burden of myosmine.     

Toenail mercury concentration as a biomarker of methylmercury exposure

The aim of the study was to assess the value of toenail mercury as an alternative biomarker of methylmercury exposure compared with blood and hair. Blood, hair and toenail total mercury concentrations were determined simultaneously in a southern urban sea n = 35 and an eastern rural lake n = 37 group and separately in a central Finnish rural lake n = 39 group. A questionnaire based index was used for estimating frequency of exposure taking into account high vs low mercury fish. Total mercury concentration was determined by cold vapour atomic absorption spectrophotometry. The mean Fish Consumption Frequency Index varied from 4.7 to 9.9 on a scale of 1-20. The blood, hair and toenail mercury mean concentrations ranged from 2.9 to 14.6 g l-1, 0.45 to 1.57 mg kg-1 and 0.20 to 0.54 mg kg-1, respectively. In the combined southern and eastern groups n = 72 sampled simultaneously, the correlations between blood and hair mercury were r = 0.92 and that of blood and toenails r = 0.78 p 0.0001 . In the central Finnish group the correlations were more moderate. In the three groups all three biomarkers correlated highly with the fish consumption index, r = 0.43-0.76 p 0.0001 . Men consumed high mercury fish more frequently than women, 8.6 vs 6.6 n.s. The mean mercury levels of blood and hair were two fold, but toenail mercury levels were only 30 higher in men compared with those of the women. The relative sensitivity slope of the sources decreased in the order, blood hair toenails. In conclusion, toenails, an easily accessible tissue for the estimation of methylmercury exposure, have been shown to be closely correlated with the well established samples for biomarkers, viz. blood and hair mercury.     

Toenail mercury concentration as a biomarker of methylmercury exposure

The aim of the study was to assess the value of toenail mercury as an alternative biomarker of methylmercury exposure compared with blood and hair. Blood, hair and toenail total mercury concentrations were determined simultaneously in a southern urban sea n = 35 and an eastern rural lake n = 37 group and separately in a central Finnish rural lake n = 39 group. A questionnaire based index was used for estimating frequency of exposure taking into account high vs low mercury fish. Total mercury concentration was determined by cold vapour atomic absorption spectrophotometry. The mean Fish Consumption Frequency Index varied from 4.7 to 9.9 on a scale of 1-20. The blood, hair and toenail mercury mean concentrations ranged from 2.9 to 14.6 g l-1, 0.45 to 1.57 mg kg-1 and 0.20 to 0.54 mg kg-1, respectively. In the combined southern and eastern groups n = 72 sampled simultaneously, the correlations between blood and hair mercury were r = 0.92 and that of blood and toenails r = 0.78 p 0.0001 . In the central Finnish group the correlations were more moderate. In the three groups all three biomarkers correlated highly with the fish consumption index, r = 0.43-0.76 p 0.0001 . Men consumed high mercury fish more frequently than women, 8.6 vs 6.6 n.s. . The mean mercury levels of blood and hair were two fold, but toenail mercury levels were only 30 higher in men compared with those of the women. The relative sensitivity slope of the sources decreased in the order, blood hair toenails. In conclusion, toenails, an easily accessible tissue for the estimation of methylmercury exposure, have been shown to be closely correlated with the well established samples for biomarkers, viz. blood and hair mercury.     

Onychomycosis: Multicentre epidemiological, clinical and mycological study

BackgroundOnychomycosis accounts for up to 50% of all nail disorders. They can be caused by: yeasts, dermatophytes and non-dermatophyte moulds.Objectives and methodsA multicentre study designed to determine the prevalence, mycological test results, aetiological agents, and clinical presentation of onychomycosis was carried out. All fingernail and toenail samples taken during a one year period at 9 diagnostic centres were included.ResultsA total of 5,961 samples were analysed, of which 82.3% were from toenails and 17.7% from fingernails. The mean age of the patients was 49.7 years, and 66% were females. Direct microscopic examination was positive in 61% of the samples. In adults, 61.2% of toenails were positive using potassium hydroxide (KOH), and 43.7% were positive in cultures. The prevailing aetiological agents belong to the dermatophyte group (82.8%), and distal subungual was the most common clinical form. In fingernails, direct examination showed 59.8% positive samples, and cultures were positive in 52.9%. The prevailing agents were yeasts belonging to Candida species, and onycholysis was the most common lesion.ConclusionsDirect mycological examinations were positive in 61%, a higher value than that found in other series. Dermatophytes were prevalent in toenails of both sexes, and in finger nails yeast were prevalent in females, and dermatophytes in males. Non-dermatophyte moulds corresponded to 4.8% of toenail and 2.05% of fingernails isolates.     

Level of trace elements in serum and toenail samples of patients with onychocryptosis (ingrown toenail) and onychomycosis

BackgroundOnychocryptosis (ingrown toenail) and onychomycosis are common pathologies of the toenail and affecting many people. Since levels of trace elements have been shown to vary in certain diseases, in the presented work, chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), selenium (Se), and zinc (Zn) levels of toenail and serum samples of healthy individuals and patients with onychocryptosis and onychomycosis were compared.MethodsSerum and toenail samples of 88 voluntary subjects (healthy n = 24; onychomycosis n = 24; onychocryptosis n = 40) aged between 19–80 years were collected. Levels of trace elements in the samples were analyzed by using an inductively coupled plasma-optical emission spectrophotometer (ICP-OES Thermo iCAP - 6000). The differences in medians between the groups for elements were evaluated with Kruskal -Wallis H test with post hoc for pairwise comparisons in SPSS 18.ResultsMg (p < 0.001) and Mn (p = 0.002) levels were significantly increased whereas Zn (p = 0.011) level was decreased in toenails of patients with onychomycosis compared to healthy subjects. Although Mg and Mn levels were higher in female subjects with onychomycosis (p = 0.001; p = 0.019), Mn was only increased in male subjects (p = 0.015). Mg was the only trace element found to be independent of sex, age, and smoking status in patients with onychomycosis. However, no significant difference has been found in serum trace element levels neither between any groups nor toenail trace element levels of patients with onychocryptosis and healthy subjects.ConclusionAs a response of the human body to pathogens like fungi in toenails, Mg, Mn and Zn levels vary. Especially the role of Mg ions in onychomycosis needs to be investigated more specifically.     

Adiponectin and leptin in African Americans

Objective: African Americans (AAs) have less visceral and more subcutaneous fat than whites, thus the relationship of adiponectin and leptin to body fat and insulin sensitivity in AA may be different from that in whites. Methods and Procedures: Sixty‐nine non‐diabetic AA (37 men and 32 women), aged 33 ± 1 year participated. The percent fat was determined by dual‐energy X‐ray absorptiometry, abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volume by computerized tomography (CT), and insulin sensitivity by homeostasis model assessment (HOMA). Results: VAT was greater in men (1,619 ± 177 cm³ vs. 1,022 ± 149 cm³; P = 0.01); women had a higher percentage of body fat (34.1 ± 1.4 vs. 24.0 ± 1.2; P < 0.0001), adiponectin (15.8 ± 1.2 μg/ml vs. 10.4 ± 0.8 μg/ml; P = 0.0004) and leptin (23.2 ± 15.8 ng/ml vs. 9.2 ± 7.2 ng/ml; P < 0.0001). SAT and HOMA did not differ because of the sex. Adiponectin negatively correlated with VAT (r = ?0.41, P < 0.05) in men, and with VAT (r = ?0.55, P < 0.01), and SAT (r = ?0.35, P < 0.05) in women. Adiponectin negatively correlated with HOMA in men (r = ?0.38, P < 0.05) and women (r = ?0.44, P < 0.05). In multiple regression, sex (P = 0.02), HOMA (P = 0.03) and VAT (P = 0.003) were significant predictors of adiponectin (adj R ² = 0.38, P < 0.0001). Leptin positively correlated with VAT, SAT, percent fat and HOMA in men (r = 0.79, r = 0.86, r = 0.89, and r = 0.53; P < 0.001) and women (r = 0.62, r = 0.75, r = 0.83, and r = 0.55; P < 0.01). In multiple regression VAT (P = 0.04), percent body fat (P < 0.0001) and sex (P = 0.01), but not HOMA were significant predictors of serum leptin (adj R ²= 0.82, P < 0.0001). Discussion: The relationship of adiponectin and leptin to body fat content and distribution in AA is dependent on sex. Although VAT and insulin sensitivity are significant determinants of adiponectin, VAT and percent body fat determine leptin.     

Lateral Drug Diffusion in Human Nails

The main objective of the current work is to demonstrate the process of passive lateral diffusion in the human nail plate and its effect on the passive transungual permeation of antifungal drug ciclopirox olamine (CPO). A water soluble dye, methyl red sodium salt (MR) was used to visualize the process of lateral diffusion using a novel suspended nail experiment. The decline in concentration of CPO correlates with that of concentration of MR from the proximal to the distal end of the nail in suspended nail study. Three toenails each were trimmed to 5 mm × 5 mm (25 mm²), 7 mm × 7 mm (49 mm²), and 9 mm × 9 mm (81 mm²) to study the extent and effect of lateral diffusion of the CPO on its in vitro transungual permeation. The permeation flux of CPO decreased as the surface area of the toenail increased. There was a positive correlation between the concentrations of CPO and MR in the area of application and in the peripheral area of the toenails of the three surface areas, confirming the findings in the suspended nail experiment. Profound lateral diffusion of CPO was demonstrated and shown to reduce the in vitro passive transungual drug permeation and prolong the lag-time in human toenails. The study data implies that during passive in vitro transungual permeation experiments, the peripheral nail around the area of drug application has to be kept to a minimum, in order to get reliable data which mimics the in vivo situation.KEY WORDS: ciclopirox olamine, lateral diffusion, passive, topical, transungual     

Quantification of manganese and mercury in toenail in vivo using portable X-ray fluorescence (XRF)

Background and objective: Toenail is an advantageous biomarker to assess exposure to metals such as manganese and mercury. Toenail Mn and Hg are in general analyzed by chemical methods such as inductively coupled plasma mass spectrometry and atomic absorption spectrophotometry. In this project, a practical and convenient technology—portable X-ray florescence (XRF)—is studied for the noninvasive in vivo quantification of manganese and mercury in toenail.

Material and methods: The portable XRF method has advantages in that it does not require toenail clipping and it can be done in 3?min, which will greatly benefit human studies involving the assessment of manganese and mercury exposures. This study mainly focused on the methodology development and validation which includes spectral analysis, system calibration, the effect of toenail thickness, and the detection limit of the system. Manganese- and mercury-doped toenail phantoms were made. Calibration lines were established for these measurements.

Results: The results show that the detection limit for manganese is 3.65?μg/g (ppm) and for mercury is 0.55?μg/g (ppm) using 1?mm thick nail phantoms with 10?mm soft tissue underneath.

Discussion and conclusion: We conclude that portable XRF is a valuable and sensitive technology to quantify toenail manganese and mercury in vivo.     

Assessment of Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Obese Subjects

Our aim was to evaluate whether atrial electromechanical delay measured by tissue Doppler imaging (TDI), which is an early predictor of atrial fibrillation (AF) development, is prolonged in obese subjects. A total of 40 obese and 40 normal‐weight subjects with normal coronary angiograms were included in this study. P‐wave dispersion (PWD) was calculated on the 12‐lead electrocardiogram (ECG). Systolic and diastolic left ventricular (LV) functions, inter‐ and intra‐atrial electromechanical delay were measured by TDI and conventional echocardiography. Inter‐ and intra‐atrial electromechanical delay were significantly longer in the obese subjects compared with the controls (44.08 ± 10.06 vs. 19.35 ± 5.94 ms and 23.63 ± 6.41 vs. 5.13 ± 2.67 ms, P < 0.0001 for both, respectively). PWD was higher in obese subjects (53.40 ± 5.49 vs. 35.95 ± 5.93 ms, P < 0.0001). Left atrial (LA) diameter, LA volume index and LV diastolic parameters were significantly different between the groups. Interatrial electromechanical delay was correlated with PWD (r = 0.409, P = 0.009), high‐sensitivity C‐reactive protein (hsCRP) levels (r = 0.588, P < 0.0001). Interatrial electromechanical delay was positively correlated with LA diameter, LA volume index, and LV diastolic function parameters consisting of mitral early wave (E) deceleration time (DT) and isovolumetric relaxation time (IVRT; r = 0.323, P = 0.042; r = 0.387, P = 0.014; r = 0.339, P = 0.033; r = 0.325, P = 0.041; respectively) and, negatively correlated with mitral early (E) to late (A) wave ratio (E/A) (r = ?0.380, P = 0.016) and myocardial early‐to‐late diastolic wave ratio (E_m/A_m) (r = ?0.326, P = 0.040). This study showed that atrial electromechanical delay is prolonged in obese subjects. Prolonged atrial electromechanical delay is due to provoked low‐grade inflammation as well as LA enlargement and early LV diastolic dysfunction in obese subjects.     

Body composition of obese subjects by air displacement plethysmography: The influence of hydration

Objective: We investigated whether air displacement plethysmography (ADP) could detect small changes in body composition of obese subjects with alterations in hydration. Research Methods and Procedures: Ten obese subjects (mean BMI, 39.3 ± 2.8 kg/m²) entered the ADP chamber without and with oil (1, 2, or 4 liters), water (1, 2, or 4 liters), or mixed (1 liter oil + 1 liter water or 2 liters oil + 2 liters water) loads. Real and measured changes in body composition were compared by regression analysis and Bland‐Altman procedures. Results: The ADP‐measured changes in volume did not differ from the real values and were strongly correlated with them (r = 0.98). In all cases, loads of differing composition and similar volume led to different values of fat, fat‐free mass, and percentage fat. Water was detected as increased fat‐free mass only with loads of ≥2 liters, most of the water being falsely detected as increased fat mass. The observed changes were correlated with the real ones for fat mass (r = 0.68; p < 0.0001), fat‐free mass (r = 0.66; p < 0.0001), and percentage fat (r = 0.61; p < 0.0001), but fat mass changes were overestimated by ～1 kg, and fat‐free mass changes were underestimated by ～1 kg. This underestimation increased with the highest water loads, as shown by the Bland‐Altman plot (r = ?0.27; p < 0.05). Percentage fat changes were overestimated by 0.8% (p < 0.001); the magnitude of the error was correlated with the weight of the water load (r = 0.62; p < 0.0001). Discussion: ADP accurately measures changes in body volume, discriminating small changes in body composition. It overestimates changes in adiposity, as most of the increased hydration is detected as an enlarged fat mass.     

Plasma zinc response to a breakfast meal or fasting in elderly women

The aim of this study was to determine whether the postprandial decline in plasma zinc concentration is altered by aging. Eleven women, between the ages of 65 and 82 yr, participated in two separate experimental protocols: a high carbohydrate breakfast trial and a fasting trial. Plasma zinc concentrations were measured from blood samples obtained at 8∶00am (baseline fasting) and at 30-min intervals until 1∶00pm during each trial. Following the breakfast meal, plasma zinc concentrations declined 14% from 75±1 to 65±2 μg/dL (p<0.05), reaching a nadir 2.7±0.2 h after the meal. This decline was significantly (p<0.0001) greater than the 3.6% fall observed during the fasting trial. Postprandial changes in the plasma zinc concentrations were correlated with postprandial changes in serum glucose (r=−0.43,p<0.001), serum insulin (r=−0.17,p<0.01), and serum phosphorus(r=0.32,p<0.005). These data show that plasma zinc concentrations decline following food intake in elderly women in the same manner as previously described for younger adult women.     

Bioaccumulation of heavy metals in local edible plants near a municipal landfill and the related human health risk assessment

ABSTRACT

The increase in municipal solid waste generation, along with high concentrations of heavy metals in environments near municipal landfill, has led to human health hazards. This study investigated heavy metal contamination in water, sediment, and edible plants near a municipal landfill, including the bioaccumulation factor (BAF) and potential health risks. The heavy metal concentrations in the samples were analyzed using inductively coupled plasma optical emission spectrometry (ICP-OES). The concentrations of arsenic (As), lead (Pb), cadmium (Cd), and chromium (Cr) in water samples were not detected (ND), ND, 0.006 ± 0.01 mg/L, and ND, respectively, and in sediment samples, the concentrations were 1.19 ± 0.44, 3.20 ± 0.62, 0.46 ± 0.21, and 6.97 ± 0.34 mg/kg, respectively. The highest concentrations of As (5.03 ± 0.38), Pb (1.81 ± 0.37), and Cd (1.93 ± 0.13) were found in Marsilea crenata, whereas that of Cr (5.68 ± 0.79) was detected in Ipomoea aquatica. The Cr concentration in all plant species exceeded the standard for vegetables. The BAF values followed the heavy metal concentrations. All plant species have a low potential for accumulating Pb and Cr. The edible plants in this study area might cause health hazards to consumers from As, Pb, and Cd contamination.     

A Novel Apremilast Nail Lacquer Formulation for the Treatment of Nail Psoriasis

The objective was to prepare a novel nail lacquer formulation to improve the ungual and trans-ungual delivery of apremilast for the potential treatment of nail psoriasis. Nail lacquer formulation was prepared using Eudragit® S 100 as a film-forming polymer and the mixture of ethanol, ethyl acetate, and water as a solvent system. As a result of high-throughput screening studies, dexpanthenol and salicylic acid were found to be the potential penetration enhancers. After 7 days of in vitro studies, the cumulative amount of apremilast delivered by the nail lacquer formulation across the nail plate was found to be ~3-fold (0.52 ± 0.07 μg/cm²) more compared to control (nail lacquer formulation without enhancers) (0.19 ± 0.02 μg/cm²). The cumulative amount of apremilast retained in the nail plate in the case of nail lacquer formulation was 1.26 ± 0.18 μg/mg which was found to be ~2-fold more compared to control (0.57 ± 0.07 μg/mg). Human subject studies were performed on the nails of thumb and index finger of six volunteers for 15 days. As a result, the cumulative amount of apremilast retained in the free distal edge of the nail plate in the case of nail lacquer was found to be ~2-fold (0.93 ± 0.14 μg/mg) more related to control (0.41 ± 0.04 μg/mg). As a conclusion, nail lacquer formulation was found to be capable of delivering a substantial amount of apremilast into the nail apparatus; thus, it can be a potential option for the treatment of nail psoriasis.     

Plasma Adiponectin Levels Are Not Associated with Fat Oxidation in Humans

Objective: To test the hypothesis that low adiponectin is associated with low fat oxidation in humans. Research Methods and Procedures: We measured plasma adiponectin concentrations in 75 healthy, nondiabetic Pima Indians (age, 28 ± 7 years; 55 men and 20 women; body fat, 29.7 ± 7.5%) and 18 whites [(age, 33 ± 8 years; 14 men and 4 women; body fat, 28.2 ± 10.8% (means ± SD)] whose body composition was measured by DXA and 24-hour energy expenditure (24-hour EE) by a respiratory chamber. Respiratory quotient (an estimate of whole-body carbohydrate/lipid oxidation rate) was calculated over 24 hours (24-hour RQ). Results: Before correlational analyses, waist-to-thigh ratio (WTR) and percentage of body fat (PFAT) were adjusted for age, sex, and race; 24-hour EE was adjusted for fat mass and fat-free mass, and 24-hour RQ were adjusted for energy balance. Plasma adiponectin concentrations were negatively correlated with WTR (r = −0.42, p < 0.0001) and PFAT (r = −0.46, p < 0.0001). There was no correlation between plasma adiponectin concentrations and 24-hour RQ, (r = 0.09, p = 0.36) before or after adjustment for PFAT (r = 0.001, p = 0.99, respectively, partial correlation), and no correlation was found between plasma adiponectin concentrations and 24-hour EE (r = −0.12, p = 0.27). Discussion: Our cross-sectional data do not suggest physiological concentrations of fasting plasma adiponectin play a role in the regulation of whole-body fat oxidation or energy expenditure in resting conditions. Whether administration of adiponectin to individuals with low levels of this hormone will increase their fat oxidation rates/energy expenditure remains to be established.     

Comparison of spatial variation in otolith chemistry of two fish species and relationships with water chemistry and otolith growth

Spatial variation in the chemistry (Mg, Mn, Sr and Ba) of recently deposited otolith material (last 20–30 days of life) was compared between two demersal fish species; snapper Pagrus auratus (Sparidae) and sand flathead Platycephalus bassensis (Platycephalidae), that were collected simultaneously at 12 sites across three bays in Victoria, south-eastern Australia. Otolith chemistry was also compared with ambient water chemistry and among three sampling positions adjacent to the proximal otolith margin. For both species, variation in otolith chemistry among bays was significant for Ba, Mn and Sr; however, differences among bays were only similar between species for Ba and Mn. Only Ba showed significant variation at the site level. Across the 12 sites, mean otolith Ba levels were significantly positively correlated between species. Further, although incorporation rates differed, mean ambient Ba levels for both species were positively correlated with ambient Ba levels. Spatial variation in multi-element otolith chemistry was also broadly similar between species and with multi-element water chemistry. Partition coefficients clearly indicated species-specific incorporation of elements into otoliths. Mg and Mn were consistently higher in snapper than sand flathead otoliths (mean ±s .d ., Mg snapper 22·1 ± 3·8 and sand flathead 9·9 ± 1·5 μg g⁻¹, Mn snapper 4·4 ± 2·6 and sand flathead 0·5 ± 0·3 μg g⁻¹), Sr was generally higher in sand flathead otoliths (sand flathead 1570 ± 235 and snapper 1346 ± 104 μg g⁻¹) and Ba was generally higher in snapper otoliths (snapper 12·1 ± 12·8 and sand flathead 1·8 ± 1·4 μg g⁻¹). For both species, Mg and Mn were higher in the faster accreting regions of the otolith margin, Sr was lower in the slower accreting region and Ba showed negligible variation among the three sampling regions. This pattern was consistent with the higher Mg and Mn, and generally lower Sr observed in the faster accreting snapper otoliths. It is hypothesized that the differences between species in the incorporation of these elements may be at least partly related to differences in metabolic and otolith accretion rate. Although rates of elemental incorporation into otoliths appear species specific, for elements such as Ba where incorporation appears consistently related to ambient concentrations, spatial variation in otolith chemistry should show similarity among co-occurring species.     

Ingrowing toenails: an evaluation of two treatments.

Most of the procedures used for treating ingrowing toenails cause considerable discomfort and have high failure rates. This study evaluated two methods of treatment: (a) a simple procedure, and (b) angular phenolisation. Patients were seen in a special toenail clinic and were assessed for severity and duration of symptoms. Those with no permanent deformity of the nail fold and with only minor infection were treated by the simple procedure. The nail was nicked and torn down to expose the infected nail fold. The patients were then taught to clean the area, spray it with povidone-iodine dry powder, and pack the nail fold with a twist of cotton-wool. Patients with recurrent or severe ingrowing toenails were treated by angular phenolisation. One hundred patients were treated by the simple procedure and 61 of these had had no recurrence after six months. A total of 280 phenolisations were carried out over 18 months and 272 were successful. The treatments described are simple, effective, and well tolerated and should be considered as alternatives to traditional treatment.     

Study of onychomycosis in Córdoba,Spain: Prevailing fungi and pattern of infection

From a total of 20 004 patients seen during two years, we carried out a mycologic nail investigation (direct microscopy and repeated cultures). Ninety-three (43.2%) of the nails were judged to be infected by their clinical appearance. They fulfilled the laboratory criteria required to start antifungal treatment (isolation of the same fungus in culture on two consecutive occasions), but only in 64 cases (29.7%) was there a clinical and mycological recovery once antifungal treatment and follow up were completed.Yeasts were isolated in two thirds of the cases of onychomycosis, mainly from fingernails. Candida albicans, C. parapsilosis or both were the most prevalent species. Dermatophytes were found in 18.8% of the samples, especially from toenails. Trichophyton rubrum was the predominant species. Non-dermatophytic filamentous fungi were cultured in 17.2%, Scopulariopsis brevicaulis being the most prevalent species.The highest prevalence of onychomycosis was found in patients between 50 and 70 years of age. Females were affected more frequently than males. Fingernails were affected more frequently than toenails. Proximal subungual onychomycosis, secondary to paronychia (PSOp), was the most prevalent clinical type, although primary distal and lateral subungual onychomycosis (DLSO) and total dystrophic onychomycosis (TDO) were also frequent. PSOp was only observed in fingernails, while DLSO was almost only seen in toenails and TDO in both fingernails and toenails. All the clinical types were more frequent in women except TDO, which showed a similar prevalence in both sexes.This revised version was published online in October 2005 with corrections to the Cover Date.     

Breath Condensate Hydrogen Peroxide Correlates with Both Airway Cytology and Epithelial Lining Fluid Ascorbic Acid Concentration in the Horse

The relationship between hydrogen peroxide (H²O²) concentration in expired breath condensate (EBC) and cytology of the respiratory tract obtained from tracheal wash (TW) or bronchoalveolar lavage (BAL), and epithelial lining fluid (ELF) antioxidant status is unknown. To examine this we analysed the concentration of H²O² in breath condensate from healthy horses and horses affected by recurrent airway obstruction (RAO), a condition considered to be an animal model of human asthma. The degree of airway inflammation was determined by assessing TW inflammation as mucus, cell density and neutrophil scores, and by BAL cytology. ELF antioxidant status was determined by measurement of ascorbic acid, dehydroascorbate, reduced and oxidised glutathione, uric acid and α-tocopherol concentrations. RAO-affected horses with marked airway inflammation had significantly higher concentrations of breath condensate H²O² than control horses and RAO-affected horses in the absence of inflammation (2.0±0.5?μmol/l, 0.4±0.2?μmol/l and 0.9±0.2?μmol/l H²O², respectively; p<0.0001). The concentration of breath condensate H²O² was related inversely to the concentration of ascorbic acid in ELF (r=-0.80; p<0.0001) and correlated positively with TW inflammation score (r=0.76, p<0.0001) and BAL neutrophil count (r=0.80, p<0.0001). We conclude that the concentration of H²O² in breath condensate influences the ELF ascorbic acid concentration and provides a non-invasive diagnostic indicator of the severity of neutrophilic airway inflammation.