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  • 1
    Electronic Resource
    Electronic Resource
    Photosensitivity in lupus erythematosus, UV photoprovocation results compared with history of photosensitivity and clinical findings (1997)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 136 (1997), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Photosensitivity, one of the presenting symptoms in lupus erythematosus (LE), is still poorly defined and varying prevalence figures have been reported. The possibility of a coexisting photodermatosis, especially polymorphous light eruption (PLE), has often not been taken into account. We report the results of ultraviolet A (UVA) and B (UVB) photoprovocation tests in 67 clinically photosensitive patients who had confirmed discoid LE (DLE), systemic LE (SLE) or subacute cutaneous LE (SCLE). The results are compared with a detailed history of photosensitivity and with clinical and serological findings. A pathological photoprovocation reaction, graded as weak, moderate or strong, was induced with either UVA or UVB in 69% of patients with LE, in 100% of those with SCLE, in 70% of those with SLE and in 64% of those with DLE, but in none of 14 controls. Only 16% of the pathological reactions were strong and long-lasting, resembling LE lesions, while 48% were moderate or weak and transient, clinically like PLE. Fifty-three per cent of the provocation reactions which were biopsied showed a PLE-like histology or a non-specific inflammatory reaction, and most of them were clinically moderate or weak reactions of short duration. In the remaining, mostly clinically strong or long-lasting reactions, the histology was consistent with LE. A history of sunlight sensitivity did not predict a pathological photoprovocation result but a positive association between the presence of SSA/Ro or SSB/La antibodies and a pathological photoprovocation reaction was found. We have shown that PLE coexists with LE and that both PLE- and LE-like lesions can be induced with UV radiation in LE patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1997.6591644.x
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  • 2
    Electronic Resource
    Electronic Resource
    The treatment of port-wine stains with the pulsed dye laser at 600 nm (1997)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 136 (1997), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The standard wavelength in the treatment of port-wine stains (PWS) with the pulsed dye laser is 585 nm. In many cases, the response to therapy is not adequate despite many treatments, depending partly on vessels out of reach of the laser. Longer wavelengths penetrate deeper into the dermis, but are absorbed less by oxyhaemoglobin, and require higher fluences. In this study, 22 patients with PWS were treated with the flashlamp-pumped pulsed dye laser using two different wavelengths, 585 and 600 nm. Four adjacent sites with PWS were treated on one occasion with 585 nm, 600 nm and equal fluence, and with 1.5 and 2 times the 585 nm fluence. The test areas were examined blindly, by four evaluators, an average of 12.5 weeks later. There was significantly less lightening with 600 nm than with 585 nm (P〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:00070963:BJD360:les" location="les.gif"/〉0.001) when equal fluences were used. When 1.5 and 2 times the 585 nm fluence were applied, with 600nm the lightening was equal to that after 585 nm. However, in individual cases (11 of 22) 600 nm showed a superior lightening of at least 20% compared to 585 nm. There was slight hyperpigmentation and hypopigmentation, but no atrophy or scarring. In conclusion, 585 nm remains the wavelength of choice in treatment of PWS with the pulsed dye laser. However, in cases that do not respond satisfactorily with 585 nm, it may be worth trying 600 nm with a fluence that is at least 1.5–2 times the 585 nm fluence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1997.d01-1200.x
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  • 3
    Electronic Resource
    Electronic Resource
    Anaphylactoid reaction to celery (1979)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 5 (1979), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1979.tb04839.x
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  • 4
    Electronic Resource
    Electronic Resource
    Photodynamic therapy of actinic keratosis at varying fluence rates: assessment of photobleaching, pain and primary clinical outcome (2004)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 151 (2004), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Although photodynamic therapy (PDT) is becoming an important treatment method for skin lesions such as actinic keratosis (AK) and superficial basal cell carcinoma, there are still discussions about which fluence rate and light dose are preferable. Recent studies in rodents have shown that a low fluence rate is preferable due to depletion of oxygen at high fluence rates. However, these results have not yet been verified in humans.Objectives  The objective was to investigate the impact of fluence rate and spectral range on primary treatment outcome and bleaching rate in AK using aminolaevulinic acid PDT. In addition, the pain experienced by the patients has been monitored during treatment.Patients/methods  Thirty-seven patients (mean age 71 years) with AK located on the head, neck and upper chest were treated with PDT, randomly allocated to four groups: two groups with narrow filter (580–650 nm) and fluence rates of 30 or 45 mW cm−2, and two groups with broad filter (580–690 nm) and fluence rates of 50 or 75 mW cm−2. The total cumulative light dose was 100 J cm−2 in all treatments. Photobleaching was monitored by fluorescence imaging, and pain experienced by the patients was registered by using a visual analogue scale graded from 0 (no pain) to 10 (unbearable pain). The primary treatment outcome was evaluated at a follow-up visit after 7 weeks.Results  Our data showed a significant correlation between fluence rate and initial treatment outcome, where lower fluence rate resulted in favourable treatment response. Moreover, the photobleaching dose (1/e) was found to be related to fluence rate, ranging from 4·5 ± 1·0 J cm−2 at 30 mW cm−2, to 7·3 ± 0·7 J cm−2 at 75 mW cm−2, indicating higher oxygen levels in tissue at lower fluence rates. After a cumulative light dose of 40 J cm−2 no further photobleaching took place, implying that higher doses are excessive. No significant difference in pain experienced by the patients during PDT was observed in varying the fluence rate from 30 to 75 mW cm−2. However, the pain was found to be most intense up to a cumulative light dose of 20 J cm−2.Conclusions  Our results imply that the photobleaching rate and primary treatment outcome are dependent on fluence rate, and that a low fluence rate (30 mW cm−2) seems preferable when performing PDT of AK using noncoherent light sources.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.2004.06211.x
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  • 5
    Electronic Resource
    Electronic Resource
    Flashlamp pulsed dye laser and argon-pumped dye laser in the treatment of port-wine stains: a clinical and histological comparison (2002)
    Oxford, UK : Blackwell Science, Ltd
    British journal of dermatology 146 (2002), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Port-wine stains (PWS) are congenital vascular malformations occurring in 0·3% of children. The pulsed dye laser is a well established treatment for PWS. Objectives To compare, clinically and histologically, the effects of the flashlamp pulsed dye laser with the argon-pumped dye laser in the treatment of PWS. Methods Thirty patients were treated on two to four test areas with both laser types using different energy fluences. A flashlamp pulsed dye laser with 0·45 ms pulse duration and a spot size of 5 mm was compared with an argon-pumped dye laser, with a spot size of 1 mm delivered with a robotic scanning laser handpiece (Hexascan) and 70–190 ms pulse duration. Both were tuned to 585 nm. Twelve weeks later the degree of lightening was evaluated and biopsies were taken. To count the vessels the skin sections were stained with CD34 using an immunohistochemical technique. The vessels were divided into three groups by diameter (d): d 〈 10 μm, 10 ≤ d 〈 20 μm, d ≥ 20 μm. Results The clinical results showed a significantly better lightening using the flashlamp pulsed dye laser than with the argon-pumped dye laser. The histological results showed a significant decrease in the number of vessels of diameter larger than 20 μm in treated compared with untreated lesions. We found no histological difference in the number of vessels between the two laser treatments. However, there was a tendency towards more small vessels (diameter 〈 10 μm) after one treatment with the flashlamp pulsed dye laser compared with untreated PWS. Conclusions The flashlamp pulsed dye laser is clinically superior to the argon-pumped dye laser in the treatment of PWS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2002.04470.x
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  • 6
    Electronic Resource
    Electronic Resource
    Expression of intercellular adhesion molecule-1 (ICAM-1) and OKM5 in UVA- and UVB-induced lesions in patients with lupus erythematosus and polymorphous light eruption (1993)
    Springer
    Archives of dermatological research 285 (1993), S. 328-333 
    Details
    ISSN: 1432-069X
    Keywords: Lupus erythematosus ; Polymorphous light eruption ; UVA ; UVB ; ICAM-1 ; OKM5
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pathological skin reactions were induced with both UVA and UVB in 12 patients with lupus erythematosus (LE) and with UVA in 7 with polymorphous light eruption (PMLE) but in none of the controls. Biopsy specimens taken from UV-induced lesions showed that in dermal infiltrates of LE cases CD4-positive cells predominated, whereas in the majority of PMLE cases CD8-positive cells predominated. Keratinocytes expressed intercellular adhesion molecule-1 (ICAM-1) in 7 of the 12 UVA- and in eight of the ten UVB-induced LE lesions, and in three of the UVA-induced lesions of PMLE patients. Three different staining patterns were found. In subacute cutaneous LE (SCLE) cases staining throughout the epidermis resembled that seen in genuine SCLE lesions. In discoid LE (DLE) lesions, the staining was most prominent in and near the basal cell layer. In the one systemic LE case and in the PMLE cases, ICAM-1 expression was seen only in association with epidermal spongiosis and T-cell infiltration. Keratinocytes did not express ICAM-1 in the controls or in the non-irradiated skin of the LE patients. In five on the UVA-induced lesions, in eight of the UVB-induced LE lesions and in one of the PMLE cases, keratinocytes expressed CD36. In four of the six LE lesions with fewer CD1a-positive cells, dendritic CD36-positive cells were seen in the epidermis. In conclusion, the pattern of activated keratinocytes and immunocompetent cells in the dermis was similar to that seen in genuine LE and PMLE lesions, but dissimilar to each other and to the controls. Keratinocytes in both UVA- and UVB-induced lesions in LE patients and in UVA-induced lesions of PMLE expressed ICAM-1 with a staining pattern resembling that seen in genuine lesions. This may help to explain the pathomechanism of these skin lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00371832
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  • 7
    Electronic Resource
    Electronic Resource
    Technical and psychological complications of high-frequency jet ventilation (1987)
    Springer
    Intensive care medicine 13 (1987), S. 96-99 
    Details
    ISSN: 1432-1238
    Keywords: High-frequency jet ventilation ; Mechanical ventilation ; Acute respiratory failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The type and the incidence of complications during treatment with high-frequency jet ventilation were evaluated in 10 critically ill patients with acute respiratory failure. HFJV was used for 2 to 34 days for management of bronchopleural fistulae, tracheal rupture, laryngeal trauma or voluminous lung abscesses. The most significant technical problems observed were disconnection or kinking of the jet catheter, hypothermia and CO2 retention. Insufficient humidification could induce severe complications such as viscous bronchial secretions, desiccation of the tracheobronchial mucosa or total obturation of the endotracheal tube. Psychological tolerance of high-frequency jet ventilation was generally satisfactory but the ventilator noise was sometimes hardly tolerated. Patients could develop a psychological dependence to high-frequency jet ventilation, leading to weaning problems. Solutions are suggested to decrease the incidence and severity of the technical and psychological complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00254792
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  • 8
    Electronic Resource
    Electronic Resource
    Food-induced increase in bioavailability of 5-methoxypsoralen (1994)
    Springer
    European journal of clinical pharmacology 46 (1994), S. 375-377 
    Details
    ISSN: 1432-1041
    Keywords: 5-Methoxypsoralen ; Psoriasis ; food ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract 5-Methoxypsoralen (5-MOP) in combination with ultraviolet light exposure is used for the treatment of psoriasis. The effect of food on the pharmacokinetics of 5-MOP was evaluated in a randomized, crossover study in nine healthy subjects. Each subject received the tablets with a standardized breakfast or under fasting conditions. The food had a dramatic effect on the bioavailability of 5-MOP. Five of the subjects showed no measurable quantities (detection limit of the analytical technique 1 ng·ml-1) of 5-MOP when the drug was given under fasting conditions. However, plasma peak concentration within the range 37–144 ng·ml-1 (median 102 ng·ml-1) was measured when the drug was taken with food. The time for the plasma peak concentration was within the range 2.0–5.1 h (median 3.0 h) under non-fasting conditions. The elimination half-life was within the range 1.4–2.7 h (median 1.9 h). We conclude that it is imperative that 5-MOP tablets are administered together with food.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00194409
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