Cutaneous sensory nerve fibers are decreased in number after peripheral and central nerve damage.

Two dermatologic patients displaying peripheral and central nerve damage, respectively, are described. Cutaneous nerve fibers in both patients were studied in skin biopsy specimens taken from neuropathic areas and from the contralateral side, immunocytochemistry being applied to a pan-neuronal marker, a protein gene-product (PGP 9.5). One of the patients, suffering from compression of the ulnar nerve, had dyshidrotic eczema of the hands that was absent on areas of skin that were neuropathic. The cutaneous innervation (most of which was sensory) was reduced by 50% in the neuropathic area as compared with the contralateral side. The other patient had unilateral pruritus on the parethic side after a stroke. The cutaneous innervation of that side was reduced by 80% as compared with the other side. It seems that peripheral sensory innervation is a prerequisite for inflammation, whereas spontaneous itching may emanate from a central nervous system disorder such as a stroke and continue on in partly denervated skin.     

Trichochromuria in melanosis of melanoma

Two patients with metastasizing melanoma and diffuse melanosis have previously been reported to excrete large quantities of trichochromes in the urine. The present study describes 2 further melanoma patients with diffuse melanosis and trichochromuria. The hair of one of the patients which had been red in childhood and turned brown in adult age returned to red with the appearance of melanosis. Normal excretion of a methylated melanocytic metabolite, 6-hydroxy-5-methoxyindole-2-carboxylic acid, was observed in this patient, possibly indicating exhaustion of the methylating system. The other patients excreted large quantities of 6-hydroxy-5-methoxyindole-2-carboxylic acid. Both patients showed highly increased excretion of 5-S-cysteinyldopa. Both patients with melanosis exhibited fine electrone-dense granules in lysosomes of dermal histiocytes. The findings support the concept that trichochromes or similar pigments in dermal histiocytes are responsible for diffuse melanosis in melanoma patients.     

Comparison of the carcinogenic potential of trioxsalen bath PUVA and oral methoxsalen PUVA. A preliminary report.

BACKGROUND AND DESIGN--There is an increasing concern about the long-term carcinogenic effect of oral psoralen with long-wave UV radiation in the A range (PUVA). Most follow-up investigations indicate a definite risk of squamous cell carcinoma of the skin with long-term PUVA treatment. In a recently published study of 4799 Swedish patients who had received PUVA, it was noted that 833 patients who had received trioxsalen bath or oral trioxsalen did not show any increased risk of skin cancer in contrast to oral methoxsalen. This finding has been further investigated in this study. We compared four dermatologic university clinics in Sweden with regard to the carcinogenic potential of the PUVA regimen used. One clinic used trioxsalen bath PUVA exclusively and the other three used oral methoxsalen. Information on their PUVA-treated patients was collected and linked with information from the Swedish Cancer Registry to identify individuals with squamous cell carcinoma of the skin. RESULTS--A total of 18 squamous cell carcinomas of the skin were reported in 2975 PUVA-treated patients until 1987. The expected number was 3.1. The center using bath PUVA only had no increased risk of squamous cell carcinoma of the skin in contrast to the three centers using oral methoxsalen-PUVA. The increased risk for male subjects from those centers varied from six to 13 times that in the general population, but for female subjects a significant increased relative risk was found only at one center. CONCLUSION--In this preliminary report, PUVA treatment with trioxsalen bath seems to be less carcinogenic than the oral dosage. However, differences in the patient populations might also have affected the outcome of the study. More information on this field is needed.     

Highly conserved gene expression profiles in humans with allergic rhinitis altered by immunotherapy

BACKGROUND: Atopic diseases, resulting from hypersensitivity to a wide variety of allergens, affect 10-20% of the population. Immunotherapy is an effective treatment for atopic diseases, but its mechanisms are not fully understood. OBJECTIVE: We studied gene expression profiles in the peripheral blood mononuclear cells (PBMC) and examined whether the individuals with allergic rhinitis (AR) have a unique gene expression profile and how the immunotherapy affect the gene expression profiles. METHODS: We used cDNA microarray and 'expression analysis systemic explorer' to examine the gene expression profiles in the PBMC of atopic subjects and other groups. RESULTS: We identified a highly conserved gene expression profile in atopic subjects that permitted their accurate segregation from control or autoimmune subjects. A major feature of this profile was the under-expression of a variety of genes that encode proteins required for apoptosis and over-expression of genes that encode proteins critical for stress responses and signal transduction. We also identified 563 genes that can segregate individuals with AR based upon receipt of immunotherapy. CONCLUSION: There is a highly conserved gene expression profile in the PBMC of individuals with AR. This profile can be used to identify individuals with AR and to evaluate responses to immunotherapy. Quantitative endpoints, such as gene expression, may assist clinicians faced with clinical decisions in the diagnosis of patients and the evaluation of response to therapy. The knowledge of the possible genetic basis for immunotherapy efficacy may also lead to novel therapeutic approaches for atopic diseases.     

5-S-cysteinyldopa excretion after treatment with 8-methoxypsoralen and UVA light

The excretion of the specific melanocytic metabolite 5-S-cysteinyldopa was studied in patients with psoriasis treated by 8-methoxypsoralen and UVA light. A pronounced increase was found after only 2 days treatment, although no increase in pigmentation could yet be observed. Peak values for urinary 5-S-cysteinyldopa were noted after 1 or 2 weeks treatment. Increase in pigmentation persisted after the excretion maxima for 5-S-cysteinyldopa.     

Antileukoprotease in patients with maxillary sinusitis

Antileukoprotease, an inhibitor of leukocyte elastase, was studied in paired sera from 12 patients with maxillary sinusitis. The serum concentration of antileukoprotease was increased at the day of admission to hospital, compared with the serum concentration in convalescence sera. In purulent maxillary sinus secretions antileukoprotease was found in complex with leukocyte elastase, as shown by gel filtration. The findings suggest a local protective function of antileukoprotease in maxillary sinus.     

Induction of UVA pigmentation in pressure areas by hydrogen peroxide

Heavy external pressure, caused by the weight of the body when lying on a hard transparent surface during UVA irradiation, prevents pigmentation in pressure exposed skin areas. After percutaneous H2O2 administration a delayed pigmentation appeared on the pressure sites. This finding provides evidence for the role of oxygen in delayed pigmentation by UVA.     

The influence of clothing on human intrathoracic pressure during airblast

Exposure to airblast can result in injury to the lungs and other gas-containing organs. The mechanism of lung injury is not clearly understood, but may be related to the rapid increase in intrathoracic pressure (ITP) which is produced when the blast wave strikes the chest wall. The purpose of this study was to determine if ITP during airblast would be influenced by several different types of protective clothing. Ten healthy young male volunteers were exposed to airblast while standing face-on and wearing 1) military fatigues (control condition); 2) fatigues with field jacket; 3) fatigues with ballistic armor vest; 4) fatigues with ceramic vest; 5) fatigues with ceramic vest over the ballistic vest. The incident blast waves simulated artillery muzzle blast. In each subject, an esophageal strain-gauge pressure transducer measured ITP during the blast. The pressure signal was analyzed for ITPmax, and maximum rate of rise of ITP (dP X dt max-1). In addition, the power density spectra of each ITP wave was computed and the peak frequency (fp) and centroid frequency (fc) were calculated. When the subjects wore the ballistic vest, the mean ITPmax was higher (p less than 0.05) than when they were exposed to airblast in fatigues alone. ITPmax was not influenced by the other clothing ensembles. The mean dP X dtmax-1 was not significantly different with any protective clothing ensemble. Clothing had no significant effect of fp, but with the ballistic vest, the mean calculated fc was higher (p less than 0.05) than that for the fatigues alone.(ABSTRACT TRUNCATED AT 250 WORDS)