The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions.

In most cases, patients with moderate to severe psoriasis are treated with narrow-band UVB phototherapy or with psoralen UVA (PUVA-) photochemotherapy. This UV-radiation is given to the whole skin, including unaffected skin. Normally, these two PUVA- and UVB-radiation procedures cannot be combined on account of the phototherapeutic side-effects on unaffected skin. The 308-nm excimer laser has been shown to be safe and effective in the treatment of localized mild-to-moderate plaque-type psoriasis whilst sparing healthy skin. Our aim was to compare the therapeutic response to PUVA plus up to 4 UVB308-nm radiations and PUVA monotherapy in patients with moderate-severe plaque-type psoriasis. 272 hospitalized adult patients were enrolled on this prospective random study. 256 patients completed the full course of treatment. PUVA treatment was given 4 times weekly to all patients. 123 patients received PUVA as a monotherapy. During the first two weeks, 149 patients were additionally treated up to four times with 308-nm excimer-derived UVB on the affected skin and treatment was evaluated for its efficacy, duration, number of times necessary for complete (CR) or partial remission (PASI reduction > 90 or > 50%, respectively), cumulative light dose, side effects of therapy and duration of remission after therapy. Statistically, there is no significant difference when comparing the efficacy of PUVA (CR 67.3%) and PUVA plus excimer (CR 63.6%). On average, patients treated by the combination method went into remission in half the treatment time (15 +/- 6 versus 27 +/- 7 days) and with half the cumulative UVA dose (22.9 +/- 5.8 versus 53.2 +/- 26.3), p < 0.05. In conclusion, skin heals considerably quicker when treated with a combination of photochemotherapy and a short course of UVB 308 nm laser treatment applied directly to the affected skin, resulting in a shorter hospital stay and quicker rehabilitation of patients with moderate-severe psoriasis.

Localized fibrous tumors (LFTs) of the pleura: clinical data, asbestos burden, and syntactic structure analysis applied to newly defined angiogenic/growth-regulatory effectors.

This study was performed to add clinical data, to introduce new markers, and to perform syntactic structural analysis on localized fibrous tumors (LFTs) of the pleura. The material comprised clinical data and processed sections obtained from 36 patients. The results achieved from quantitative imaging techniques and syntactic structure analysis were correlated with clinical data, including patients' habits (smoking), asbestos exposure, survival, and tumor recurrence. The disease caused increasing chest pain and dyspnea in 47% of patients. Exposure to asbestos was noted in 13 out of 36 patients, whereas smoking posed no major risk factor. Two patients developed a recurrent tumor after 8 and 42 months, respectively; none of the other patients died of this tumor disease within the follow-up period of maximal 212 months. The cases were clearly discriminated from mesotheliomas by the marker profile. Frequent expression of accessible ligands for endogenous lectins galectins-1 and -3, the expression of the angiogenic macrophage migration inhibitory factor (MIF), and the dense vascularization intimate a functional relationship. The proliferation index (Nv) was computed to be 1.6% in line with the balance of galectin expression. Abnormal p53 was expressed in only 19.4% of the cases. The diagnosis of LFT can be aided by quantitative assessment of vimentin, CD34, MIF, vascularization, and proliferation. Considering the galectin network, differential expression was noted with preference to effectors limiting growth and aggressiveness.