Histopathological changes in an intraocular retinoblastoma-like tumour following photodynamic therapy

The histopathological effect of photodynamic therapy (PDT) was investigated in an intraocular retinoblastoma-like tumour in vivo. Eighty-two tumours were studied by light microscopy and 8 by electron microscopy. Damage of the vascular endothelium with dilation of the organelles was evident 1 h after treatment, followed by leakage of the blood vessels, tissue hemorrhages, and vascular collapse. Histopathological examination showed an overall pattern of shrinkage of the cytoplasm and pycnosis of the nuclei in most of the tumour cells 3-5 days after treatment. The tumour recurrence often developed from the periphery of the tumours and in a few cases from small islets of viable tissue. Use of high doses of Photofrin II or light energy was associated with damage in the light irradiated area both to the conjunctiva or cornea in the form of leucocyte infiltration or ulcers, and to the retina, which often developed edema and appeared severely disorganized, with damage of the photoreceptors.     

Treatment of giant papillary conjunctivitis with cromolyn sodium.

We evaluated the efficacy of cromolyn sodium in the management of contact lens patients with GPC. Fourteen of 20 patients (70%) with moderate to severe giant papillary conjunctivitis (GPC) were able to continue wearing contact lenses with the use of 4% sodium cromolyn eye drops. These patients had all failed to stay symptom free with our standard method of treatment (i.e., discontinuing contact lens wear for 1-2 weeks; improving lens care; and refitting with different lens designs and/or polymers). This study examined the indications, therapeutic regimen, complications, and patient response to the use of sodium cromolyn in contact lens patients with GPC.     

Electroencephalographic sleep studies in depressed outpatients treated with interpersonal psychotherapy: I. Baseline studies in responders and nonresponders.

Electroencephalographic (EEG) sleep measures have been examined as predictors of therapeutic response in patients with major depression. Although some studies have reported that EEG sleep measures are predictive of a favorable outcome with medications, two recent studies found no differences in the baseline sleep characteristics of responders and nonresponders to psychotherapy. To clarify this issue, we compared baseline EEG sleep in a group of patients with recurrent depression who responded to interpersonal psychotherapy (n = 19) and a comparable group who did not respond (n = 18). Baseline ratings of depression severity did not differ in the groups, but some differences in baseline sleep were noted. Psychotherapy nonresponders had longer sleep latencies, lower sleep efficiency, and increased automated measures of phasic rapid eye movement (REM) activity. In addition, the two groups had different EEG sleep adaptation patterns for REM latency and phasic REM density measures across the two study nights. These preliminary results suggest that baseline EEG sleep patterns, as well as the pattern of laboratory adaptation, may differ for depressed patients who respond to psychotherapy and those who do not.     

Congenital telangiectatic erythema (Bloom syndrome)

"Congenital telangiectatic erythema" (Bloom's syndrome) is very rare; it is linked to a group of hereditary diseases and a common feature is cellular hypersensitivity to a variety of physical or chemical agents. The mode of transmission is autosomal-recessive. Characteristic criteria for Bloom syndrome are: consanguinity of the parents; androtropia; low birth weight, short stature (proportional); and persistent telangiectatic erythema in sun-exposed areas, sometimes with blistering. The syndrome is also associated with a facultative lack of antibodies. Of great importance is the high leukaemia morbidity among individuals with this syndrome; chromosomal aberrations and breakages play a significant role. Histological changes comprise an increase in dilated vessels in the upper dermis and damage and loss of elastic fibers. We give a review of Bloom's syndrome and present a case report.     

Two roads to rapid eye movement latency

Although considerable attention has been paid to the accumulated body of data on sleep-related "markers" of affective illness, there has been ongoing controversy with respect to the application of these sleep measures. This report attempts to reexamine the data on the electroencephalographic sleep features of individuals with depressive illness from a different theoretical perspective. Our focus on rapid eye movement latency is intended to provide both a new interpretation of the available data and directions for future research.     

Psychological and perceptual factors associated with arrhythmias and benign palpitations

OBJECTIVE: Little is known about how patients who seek medical help for benign palpitations can be distinguished from those with clinically significant arrhythmias. This study tested whether patients with arrhythmia can be distinguished from those who are aware of sinus rhythm or extrasystoles on the basis of sex, prevalence of anxiety disorders, and heartbeat perception. METHODS: A consecutive sample of patients referred to a cardiology clinic participated in the study. Patients were diagnosed as having either arrhythmia (N = 62), extrasystoles (N = 75), or awareness of sinus rhythm (N = 47). They were assessed with use of the anxiety disorders and hypochondriasis modules of the Structured Clinical Interview for DSM-IV. Both patients and control subjects (N = 35) answered questionnaires measuring anxiety, fear of bodily sensations, and depression and underwent a heartbeat perception test. The present report focuses on patients who had palpitations but no comorbid cardiovascular disease. RESULTS: Patients with awareness of sinus rhythm could be distinguished from those with arrhythmia by several variables: female sex, higher prevalence of panic disorder, poor performance on the heartbeat perception test, report of palpitations when doing the test, higher heart rates, lower levels of physical activity, and (as trends) a greater prevalence of panic attacks, fear of bodily sensations, and depression. In contrast, patients with arrhythmias rarely reported palpitations when doing the test but were more likely to perceive their heartbeats accurately than patients with sinus rhythm and control subjects. Performance on the heartbeat perception test was intermediate in patients with extrasystoles; these patients also had an intermediate prevalence of panic disorder and intermediate depression scores. CONCLUSIONS: Measures of panic disorder and a simple heartbeat perception test could complement medical assessment in the diagnosis of patients who seek medical help for palpitations. The results also have implications for the treatment of patients with benign palpitations.     

Das zellkernmorphologische Geschlecht von Mamma- und Prostatacarcinomen

Ohne Zusammenfassung     

The effects of thermochemotherapy using cyclophosphamide plus hyperthermia on the malignant pleural mesothelioma in vivo

The human malignant pleural mesothelioma is related to the use of asbestos in the majority of cases. Though the use of asbestos has been prohibited since the 1990s, the incidence of pleural mesothelioma is still increasing because of a latency period of at least 20 years. This study investigated the benefit of single therapy with cyclophosphamide or hyperthermia or the combination of both on cells of a human pleural mesothelioma cell line, xenotransplanted subcutaneously in the paw of mice. A CONTROL group received the same volume of physiological saline. The oxygenation of tumours was measured, tumour growth was followed over 3 weeks, immunohistochemical studies and a light and electron microscopic evaluation were performed. Chemotherapy or hyperthermia alone was only temporarily effective. The greatest benefit was achieved using combined thermochemotherapy consisting of cyclophosphamide plus hyperthermia: 50% of this group had partial remissions, and 67% responded to this therapy. After 3 weeks tumours grew again. Superior effects could be achieved by performing additional cycles of chemotherapy or adding another drug or radiation for instance. This study shows promising results in the treatment of malignant pleural mesothelioma.     

Syncytial organization of acanthors of Polymorphus minutus (Palaeacanthocephala), Neoechinorhynchusrutili (Eoacanthocephala), and Moniliformis moniliformis (Archiacanthocephala) (Acanthocephala)

The fine structures of immature and of developed shelled acanthors of three species belonging to the three subgroups of the Acanthocephala were investigated. Acanthors are surrounded by four eggshells (embryonic envelopes) and are composed of three syncytia: a frontal syncytium, a central syncytium, and an epidermal syncytium. Neither a sense organ nor a nervous system has been found. The central syncytium shows a mass of condensed nuclei and 12 decondensed nuclei and gives rise to 10 anterior/posterior subepidermal myofibrillar systems and 2 oblique retractor muscles. Circular muscles are missing. A single decondensed nucleus can be assigned to each of the 12 muscular systems. The epidermal syncytium embeds the other two syncytia and forms the wrinkled epidermis, which shows an extracellular glycocalyx and intrasyncytial condensations. Prominent recurved hooks, which mark the anterior end of each acanthor, and body spines are intraepidermal differentiations. Partly branched tubular infoldings of the epidermal plasma membrane of the acanthor exist and represent precursors of the pore ducts typical of the adult epidermis. Autapomorphies in the ground pattern of the monophylum Acanthocephala are the four eggshells, the early development of three syncytia, the condensed nuclei in the central syncytium, and the differentiation of ten longitudinal muscle bands and two muscle retractors and of intraepidermal hooks and spines. The syncytial organization of the epidermis with intraepidermal skeletal condensations and infoldings of the apical plasma membrane are characteristics inherited from a stem species common to Acanthocephala, Seison, and Rotifera. Received: 25 September 1996 / Accepted: 10 October 1996     

How "blind" are double-blind studies?

Psychopharmacological studies usually attempt to eliminate "nonspecific" influences on outcome by double-blind designs. In a randomized, double-blind comparison of alprazolam, imipramine, and placebo, the great majority of panic disorder patients (N = 59) and their physicians were able to rate accurately whether active drug or placebo had been given. Moreover, physicians could distinguish between the two types of active drugs. Inasmuch as correct rating was possible halfway through treatment, concerns about the internal validity of the double-blind strategy arise.