Fluorescence spectroscopy of an in vitro model of human cervical neoplasia identifies graded spectral shape changes with neoplastic phenotype and a differential effect of acetic acid.

BACKGROUND: The clinical utility of spectroscopic methods for the diagnosis of cervical cancer is limited by significant inter-patient variation in the spectroscopic properties of the cervix. Improved understanding of the contributions of the components of cervical tissue to the observed spectra would therefore be helpful in the development of spectroscopic approaches to the study of cervical disease in vivo. METHODS: In this study, we used organotypic epithelial raft culture as an in vitro model system to analyse the fluorescence properties of the surface squamous epithelium specifically. The spectrum of cervical dysplasia was modelled by producing rafts lined by primary human keratinocytes (PHKs) and the HaCaT, SiHa and CaSki human keratinocyte cell lines and fluorescence emission spectra were recorded at a wide range of excitation wavelengths. RESULTS: Statistically significant differences in spectral shape were identified between the different rafts at excitation wavelengths between 250nm and 310nm. A graded, differential effect of acetic acid on fluorescence intensity was also observed, consistent with the visible effects of acetic acid on clinical examination at colposcopy. CONCLUSION: These data suggest that the development of neoplastic changes in the squamous epithelium of the cervix are associated with alterations in its fluorescence properties and that the application of acetic acid has a demonstrable effect on these properties. Identification of these alterations may aid the discrimination of cervical lesions in vivo.

A LED-LED-based photoplethysmography sensor.

A high sensitivity, low power and low cost sensor has been developed for photoplethysmography (PPG) measurement. It uses standard light emitting diodes (LEDs) as both light emitter and detector, pulse-based signal conversion techniques instead of the classical analogue-to-digital convertors (ADCs) and a general purpose microcontroller for the implementation of measurement protocol. The main advantages of the proposed approach are that it leads to better spectral sensitivity, increased and adjustable resolution, reduction in cost, dimensions and power consumption, and it avoids the need for expensive and precise operation amplifiers, ADCs and other external components. The basic sensing configuration presented uses only two I/O pins and two LEDs and is capable of detecting the PPG signal from a finger or toe. It is then very simple to extract the vital signs such as heart rate and heart rate variability from such a signal. The basic configuration can easily be expanded to include a pulse oximeter for the determination of oxygen saturation (SpO(2)) by the addition of only two more LEDs. The proposed technique is also suitable for a wide range of other photometric applications.

Confocal endoscopy via structured illumination.

We describe a simple modification to a rigid endoscope so as to provide both high-quality conventional and confocal images of reasonably accessible regions of the body. This versatile system uses a structured illumination approach together with a conventional incoherent illumination source. Images taken in fluorescence are presented using this combined conventional and confocal endoscope.

Persistent erythema multiforme: a report of three cases.

Three cases of persistent erythema multiforme, two of unknown aetiology and one precipitated by influenza are reported. Lesions were widespread, mostly atypical in appearance and regressed in response to immunosuppressants (systemic steroids and/or azathioprine) or, in one case, to dapsone. One patient developed erythroderma responding eventually to etretinate. Histology in all patients was consistent with the mixed, epidermodermal pattern of erythema multiforme. There were no significant laboratory abnormalities nor marked symptomatology apart from itching. The persistent form appears to belong to the spectrum of erythema multiforme being heterogeneous with respect to inducing stimuli, including viral antigens, neoplastic or inflammatory disease or unknown causes. Whenever it is possible, treatment should be adjusted depending on the causative agent.

Skin lesions--an indicator of disease activity in systemic lupus erythematosus?

Cutaneous manifestations have great diagnostic value for systemic lupus erythematosus (SLE). In this study we tried to establish a correlation between lupus erythematosus LE-specific and LE-nonspecific cutaneous lesions and disease activity measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Sixty-six patients with SLE were evaluated. They were divided into three groups having: (1) only LE-specific lesions (38 or 58.46%); (2) only LE-nonspecific lesions (4 or 6.15%); and (3) both types of lesions (23 or 35.38%). Results were analyzed using the Student t-test. Patients with LE-nonspecific skin manifestations had significantly increased disease activity compared to those with only LE-specific lesions. The number of different skin lesion types also correlated with disease activity. It was significantly increased in a group with three different types of lesion, either specific or nonspecific. Patients with only one type of lesion had mild disease. An intermediate disease activity was found in the group with two different lesion types. Lupus-specific skin manifestations serve primarily as an important diagnostic clue. In conclusion, patients with LE-nonspecific lesions have significantly more active SLE than those with LE-specific lesions and may therefore require more intensive therapy and disease monitoring.

Bullous delayed pressure urticaria; pressure testing may produce a systemic reaction.

We report a patient with bullous delayed pressure urticaria (DPU) and chronic idiopathic urticaria (CIU) in whom a systemic reaction occurred. The reaction occurred 18 h after a pressure test had been performed on the right forearm. Blood histamine levels were more elevated in the sample taken from the forearm on which the test had be applied. Skin biopsy revealed both intraepidermal and subepidermal bullae with a sparse dermal inflammatory infiltrate and direct immunofluorescence showed linear deposition of fibrinogen along the epidermodermal basement membrane. As far as we are aware this is only the third case of bullous DPU reported and the first associated with generalized urticaria and angioedema and severe broncho-obstruction. Possible pathophysiological mechanisms are discussed.

[Contact thermometry of lesions in alopecia areata]. / Kontaktna termometrija lezija alopecije areate.

The contact thermometry has been performed at the center of lesions, at the periphery and at the adjoining healthy skin in 10 patients with alopecia areata (AA) of the scalp. The lowest temperature was recorded in the center of lesions (approximately 33.55 degrees C), slightly higher in the periphery (approximately 33.71 degrees C) and the highest in the adjoining healthy skin (approximately 34.01 degrees C). The authors suggest the skin temperature to be the result of the degree of vascularization. The obtained results were examined in reference to the results published elsewhere on the light and electronic microscopy of AA lesions where the changes in capillaries were found. Based on all the above, the authors consider the topical use of drugs that improve the peripheral circulation to be justified in the treatment of AA.

[Clinical and laboratory studies of cholinergic urticaria]. / Klinicka i laboratorijska studija holinergijske urtikarije.

The clinical and laboratory study of 80 patients (75 males, 5 females) with cholinergic urticaria (CHU), treated from 1971 to 1996 is presented. The mean age at CHU occurrence was 22.3 years (10-50). The disease lasted at the time of examination from 3 months to 14 years, on an average 2 years and 11 months. Among 30 studied patients, the disease ceased after 1-3 in 5 patients, and it lasted from 3 to 24 years, on an average 9 years, in the remaining 25 patients. Exercise-induced anaphylaxis occurred in 8 patients and simultaneously cold urticaria occurred in 7 patients. The increase of histamine level in blood, following the exercise and/or heat test was found in 12 examined patients. The higher increase was noticed after the exercise, than after the heat test, which was well correlated with the severity of clinical features and the duration of skin manifestations. Repeated heat and/or cold test, performed at the same day, showed the weaker or no reaction at all. The role of the sweat, acetylcholine and histamine in CHU occurrence was discussed.

[Vitamin E in the treatment of cutanea tarda porphyria]. / Vitamin E u lecenju kasne kozne porfirije.

The results of the treatment with vitamin E of seven patients with late skin porphyria are presented Vitamin E was given in the daily dose from 60 to 90 IU. The treatment resulted in the decrease of urine porphyrine and regression of skin changes. Side effects of vitamin E have not been observed and the pathophysiologic mechanism of its effect is reported.

[Lymphocytoma cutis]. / Lymphocytoma cutis.

Three patients with skin lymphocytoma and different histologic and clinical appearance of lesions (solitary, grouped, and in the third patient one lesion appeared on the forehead and one on the neck) are presented. By the histologic analysis and the use of immunohistochemical methods the differentiation of these lesions from skin lymphoma and other diseases which could resembe lymphocytoma was made. The method of immunoperoxidase has clearly shown formation of follicules and polyclonal lymphocytes which is the main histologic feature of this pseudolymphoma. By the method of indirect immunofluorescence, antibodies against Borrelia burgorferi were not found in the sera of two patients while in the third it was not performed.

[Ultrastructural changes in the dermal blood vessels in patients with psoriasis]. / Ultrastrukturne promene krvnih sudova derma u obolelih od psorijaze.

The ultrastructural analysis of psoriatic dermal lesions has shown the alteration of the dermal arterioles into specialized postcapillary venules, the so called high endothelial venules (HEV) which are characterized by the presence of tannic acid staining materials (TASM) located among the endothelial cells. This type of venules seen in the lymphatic nodes and other lymphoid organs is considered to be an important site of lymphocyte recirculation. Similar venules are seen in the lymphatic nodes too. In correlation with the immunologic evidences in the lymphoid tissues and in psoriasis most probably in question are the identical surface antigen-lymphocyte receptors on the HVE which support selective binding of the definite subset of lymphocytes and migration from blood to tissues.