Psoriasis confined strictly to vitiligo areas – a Koebner‐like phenomenon?

Vitiligo and psoriasis are both common skin disorders. However, psoriasis strictly confined to pre-existing vitiligo areas is rare and suggests a causal relationship. We report here on two patients with a strict anatomical colocalization of vitiligo and psoriasis. The histopathological examinations showed typical changes for both diseases together with a dense infiltrate of CD4+ and CD8+ T cells. By immunohistochemistry, intracytoplasmatic granzyme B and tumour necrosis factor alpha (TNF-alpha) were detected within the T-cell population, suggesting the functional activity of these cells and the creation of a local T helper 1 (Th1)-cytokine milieu. Additionally, in one patient we could identify anti-melanocytic T cells by tetramer staining and enzyme-linked immunospot (ELISPOT) analysis. These skin-infiltrating lymphocytes might trigger, by the local production of Th-1 cytokines such as TNF-alpha and interferon-gamma (IFN-gamma), the eruption of psoriatic plaques in patients with a genetic predisposition for psoriasis.     

Differential expression of vasopressin receptor binding in the hypothalamus during lactation in golden hamsters

Vasopressin (AVP) receptor binding within hypothalamic sites was compared between cycling and lactating female golden hamsters. The density of AVP receptor binding was analyzed by quantitative autoradiography within the ventrolateral hypothalamus and dorsomedial hypothalamic nucleus. Lactation was correlated with a disappearance of AVP receptor binding within the ventrolateral hypothalamus. In contrast, lactation was associated with a two- to three-fold increase in the density of AVP receptor binding within the dorsomedial hypothalamic nucleus. These results suggest that AVP receptor binding within the ventrolateral hypothalamus is responsive to gonadal hormones in female golden hamsters. However, the increase in binding observed within the dorsomedial hypothalamus may be related to other neurobiological changes associated with lactation.     

Endoscopic surgery for early glottic carcinoma

Early glottic carcinoma, specifically stage I or II, can be treated with endoscopic excision, radiation therapy, or open partial laryngectomy. Over the past two decades, this topic has received intensive interest, and controversies have often focused on techniques and outcomes comparing the use of endoscopic excision versus radiation therapy. This article will discuss philosophy, techniques, and outcomes of resection using the endoscopic approach to early glottic carcinoma. Optimization through appropriate instrumentation, staging, and technical details are critical to postoperative oncologic and vocal outcomes. The reader must remember that over 90% of T1 lesions and approximately 75% of T2 lesions are curable, and therefore adherence to the principles described below is important to achieve these outcomes.     

Circannual variation in lymphocyte subsets, revisited

BACKGROUND: Circadian and circannual variations in lymphocyte subsets, especially CD8+ T-lymphocytes, have been reported. This study focuses on CD4+ T-lymphocyte seasonal variation over a 6-year 8-month period. STUDY DESIGN AND METHODS: Lymphocyte subsets were quantitated monthly for four healthy individuals from 1986 through 1992 as part of a flow cytometry quality-control program. RESULTS: In general, there were no significant seasonal changes in the total number of white cells or in total lymphocyte counts. The absolute numbers of CD4+ T-lymphocytes were lowest in summer when the CD8+ T-lymphocytes were highest. Mean CD4+ T-lymphocyte counts were 846, 967, 618, and 695 per microL for Subjects 1 through 4, respectively, in winter and 432, 670, 355, and 766 per microL, respectively, in summer. Two healthy subjects had CD4+ T-lymphocyte counts lower than 300 per microL on one or more occasions during the study period. In three of the four subjects, the percentage of B-lymphocytes in winter was almost double that in summer. In one of the four subjects, no circannual rhythm was observed in these lymphocyte subpopulations. CONCLUSION: The seasonal variation in CD4+ T- lymphocyte counts demonstrated in three healthy individuals over almost 7 years is again of interest in light of renewed consideration of using surrogate tests, such as CD4+ T-lymphocyte counts, to screen for AIDS- like diseases that may be in the blood supply.     

Respiratory symptoms and lung function in relation to passive smoking: a comparative study of American and French women

Results are reported from a parallel analysis of the association of passive smoking with respiratory symptoms and lung function (FEV1, FVC and FEV1/FVC) in 2220 US and 3855 French women from the general population examined over the same time period using similar methods. Age, city, educational level, occupational exposure and height (for lung function) were taken into account. In the US survey, being a never smoker married to a current or former smoker was significantly associated only with wheezing compared to being a true never smoker. A borderline significant association between passive smoking and dyspnoea was observed among women older than 40 in the French survey. No association was observed with cough or phlegm production. Passive smoking was significantly related to lower FVC and FEV1 values among French women 40 years or more, even among those without a history of wheeze or asthma. However, even among US women older than 40 years of age, there was no significant association between passive smoking and level of lung function. Better housing conditions, higher divorce rates, more frequent exposure to passive smoking in childhood, and different selection factors for active smoking in the US compared to France might explain the lack of association of current spousal smoking habits with lower lung function in American women.     

Optic disk neovascularization and retinal vessel diameter in diabetic retinopathy

We measured retinal vessel diameter before and after panretinal photocoagulation in 59 eyes with diabetic retinopathy and moderate to severe optic disk neovascularization. Treatment significantly reduced mean arteriolar and venular diameter. The diameter of the retinal arterioles after treatment correlated significantly with the amount of regression in disk neovascularization. Eyes with large diameter vessels after treatment usually had little or no regression of proliferative retinopathy, whereas regression was more frequently seen in eyes with smaller diameter vessels after treatment.