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Contact dermatitis is an umbrella expression for a group of dermatoses that are initiated by the pivotal event of the epidermis coming into contact with a triggering chemical For practical purposes, there are three main clinical forms: (1) irritant contact dermatitis (ICD); (2) contact urticaria (CU); and (3) allergic contact dermatitis (ACD) Approximately 80% of contact dermatitis cases are identified as ICD, because ICD represents a nonspecific inflammatory response to a chemical when the skin barrier function is impaired Wet work (immersing in detergents, water, or other activities that require frequent hand washing) predisposes an individual to these irritant-type reactions because of disruptions in skin barrier function (see 11) Irritancy can also occur after chronic exposure to an environment with low humidity,1 or chronic exposure to saliva (lip smacking), urine, or feces Another example of an inducible ICD is epidermal keratinocyte damage following a cosmetic peel (Fig 18-1) At the other end of the spectrum is CU, which accounts for approximately 05% of the contact dermatitides This type of reaction is IgE-mediated and represents an immediate-type hypersensitivity response Clinically, CU manifests classic wheals and flares (hives); with extreme cases the clinical symptoms may progress to severe respiratory compromise, anaphylaxis, and death A primary example is latex hypersensitivity The pathophysiology of ACD is remarkably different from the other types of contact dermatitis Like CU, ACD is an immunologic reaction; however, unlike CU, ACD is a consequence of lymphocyte activation (a T-cell mediated Type IV delayed-type hypersensitivity [DTH] reaction) To assist with the visualization of the sensitization process, it can be useful to consider the triggering of ACD as similar to serial vaccination, although scientifically it is important to note that they are different immunologic

12. How could you redesign the EMPLOYEES table to avoid the problem that the COMM column contains null values meaning not applicable Answer: By dropping that column from the EMPLOYEES table and by creating a separate SALESREPS table, with the following rows: EMPNO COMM -------- -------7499 300 7521 500 7654 1400 7844 0 In this table, the EMPNO column is not only the primary key, but it is also a foreign key referring to the EMPLOYEES table. 13. In Section 4.9, you saw the following statement: In SQL, NOT is not not. What is this statement trying to say Answer: In three-valued logic, the NOT operator is not the complement operator anymore: NOT TRUE is equivalent with FALSE not TRUE is equivalent with FALSE OR UNKNOWN 14. Referring to the brain-twister at the end of Section 4.9, what is the explanation of the result no rows selected in Listing 4-44 Answer: The following WHERE clause: 2 where evaluation not in (1,2,3,NULL)

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Before you access the Titler, position your playhead in the Timeline in the position you want your titles to begin The Titler is sort of hidden You can access it via the Project panel, in the series of small icons situated at the bottom of the panel Find and click the New Item icon (it looks like a page turning) In the New Item drop down, select Title The Titler opens, showing the frame where you positioned the playhead Click inside the frame to position your text tool The interface for the Titler is pretty simple

is logically equivalent with the following iterated AND condition: 2 3 4 5 where AND AND AND evaluation evaluation evaluation evaluation <> <> <> <> 1 2 3 NULL

CHAPTER 9:

FIGURE 18-1 Glycolic acid is an irritant that can result in keratinolysis In this gure, pink tender plaques occurred on the cheeks 1 day after a 30% glycolic acid peel processes That is, with each subsequent dose of a chemical the ability to remember that chemical for future interactions becomes more likely For example, with the hepatitis B vaccine, three shots are required for establishing long-lasting and effective immunity, or memory of that chemical; conversely, a tetanus vaccine must be boosted to guarantee memory Like the tetanus, the more potent chemicals may only require a single dose, such as poison ivy In most cases of ACD, however, the shots are mini-doses that taken sequentially over a given period of time result in the individual being sensitized to that chemical routinely exposed These chemicals usually have a molecular weight less than 500 Da allowing them to penetrate the skin or mucous membranes and activate an immunologic cascade2,3 Subsequent to entry into the skin these chemicals are taken up by epidermal immunologic cells (Langerhans cells) and further processed for presentation to na ve T lymphocytes This process of chemical capture and presentation is known as the induction phase of sensitization With induction there is clonal expansion of memory T cells, each inheriting the capability to mount an immune response upon reexposure to the allergenic chemical Upon reexposure, or challenge, the elicitation phase of sensitization ensues, which involves a complex interplay between immune cells (ie, Langerhans, lymphocytes, and keratinocytes) Each cell releases its respective cytokine repertoire leading

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