The effects of cyclosporin A on T lymphocyte and dendritic cell sub-populations in psoriasis

Sequential skin biopsies from six patients with severe psoriasis were studied during treatment with cyclosporin. Four of the patients cleared completely and the remaining two showed a marked improvement. A subset of dendritic cells, HLA-DR+ but lacking the T6 antigen characteristically expressed by Langerhans cells (DR+ 6-), was observed in lesional epidermis. They disappeared during treatment, before clinical improvement was apparent and at a rate which correlated with clearance of psoriasis. These cells were not found in normal or uninvolved psoriatic epidermis and their number in lesional skin appeared to be related to the clinical severity of the disease. Total numbers of CD4 and CD8, and HLA-DR+ CD8 T cells were substantially reduced in both epidermis and dermis prior to clinical improvement. In contrast, there was generally no decrease in the number of HLA-DR+ CD4 T cells in the epidermis during resolution, whereas these cells were reduced by an average of 68% in the dermis. The beneficial effects of cyclosporin in psoriasis further support the hypothesis that T cells play a central role in the pathogenesis of psoriasis. The cellular changes observed in the skin during cyclosporin treatment may help to elucidate the effects of this drug on immunoregulatory mechanisms in man.

A new variant of the alpha subunit of spectrin in hereditary elliptocytosis

A kindred is described in which two brothers with a poikilocytic variant of hereditary elliptocytosis (HE) were found to have a defect of spectrin dimer association and a decreased spectrin-band 3 ratio. Two-dimensional gel electrophoresis of limited tryptic digests of their spectrin revealed decreased amounts of the alpha I domain when compared with control digests and the appearance of two major peptides with mol wts of 43,000 and 42,000 and isoelectric points (5.75 to 5.85) more basic than the alpha I domain. Tryptic digests of spectrin from the asymptomatic mother of the two brothers were normal. Immunoblots of the two-dimensional gels using an antiserum to the alpha I domain revealed that the 43,000- and 42,000-dalton peptides were derived from the alpha I domain, along with a series of lower mol wt peptides, some of which were below the detection limits of Coomassie blue-stained gels. Limit chymotryptic maps of 125I-labeled tryptic peptides confirmed that the 43,000- and 42,000-dalton peptides were derived from the alpha I domain. This kindred represents a new structural variant of spectrin in HE in that the major abnormal tryptic peptides derived from the alpha I domain have lower mol wts and more basic isoelectric points than hitherto described.

Homosexuality and alcohol: observations and research after the psychoanalytic era

There is very little literature in the area of homosexuals and alcohol but since the 1960s some work on the alcohol use of homosexuals has begun to surface. Most studies focus on the male but there are some studies of lesbians. The gay bar seems to be the best starting point for such studies as it is so central to gay society. How sex, drugs, and acquired immune deficiency relate to alcohol use are discussed. Ideas relating to intervention into the alcohol problems of gays are put forward.

Studies on the structural polymorphism of the alpha-II domain of human erythrocyte spectrin

Following restricted tryptic digestion at 4 degrees C, a structural polymorphism affecting the alpha-chain of human spectrin, the major erythrocyte membrane skeleton protein, has recently been described in American blacks (Knowles, W.J., Bologna, M.L., Chasis, J.A., Marchesi, S.L. and Marchesi, V.T. (1984) J. Clin. Invest 73, 973-979). Four variants affecting the alpha-II domain or its tryptic products have been characterized, depending on changes in molecular weight and/or isoelectric point. One variant of the alpha-II domain (Type 2) shows an increase in apparent molecular weight and basic shift in pI. It contains a limit chymotryptic peptide showing a change in chromatographic mobility on two-dimensional electrophoresis which is thought to reflect a sequence alteration associated with the increase in apparent molecular weight. We find that this altered limit chymotryptic peptide is not unique to the Type 2 variant, but is also present in a variant (Type 4) showing only the same basic shift in pI as the Type 2 variant. It is not found in a variant (Type 3) showing only an increase in apparent molecular weight. The most likely explanation for these findings is that the altered limit chymotryptic peptide common to both the Type 2 and Type 4 variants is responsible for the change in isoelectric point which is common to both these variants. An as yet unidentified change elsewhere in the polypeptide chain must be responsible for the observed alteration in molecular weight of the Types 2 and 3 variants.

Developmental follow-up of long-term infant tracheostomy: a preliminary report

In a retrospective study, medical records of a randomly selected sample of all infants less than 13 months old with tracheostomy of at least 1 month's duration were reviewed with respect to medical, demographic, and perinatal variables. Standardized outcome measures were used to document physical, cognitive, linguistic, and emotional development in a cross-sectional follow-up of all tracheostomized infants who were without primary mental retardation or neurological and physical handicap. The total sample of tracheostomized infants tended to be white, male, and premature, with moderate to severe medical illness in the perinatal period. There was a high rate of mortality and morbidity, with the majority of survivors presenting with multiple physical and mental handicaps. Follow-up of survivors without other major handicapping conditions suggested that long-term infant tracheostomy may be associated with impaired physical and emotional development, even when cognitive and language development are within normal limits. Pediatricians should be aware of the complex nature of this handicapping condition in order to coordinate appropriate interdisciplinary management.

The surface roughness and gloss of composites

The contrast gloss and the average roughness were measured for four commercial composite filling materials. Using a factorial design, each material was subjected to four available finishing methods. A significant difference was found in the contrast gloss among finishing methods, and a significant linear regression is given which relates the inverse of the contrast gloss to the average roughness. Surface gloss is proposed as playing a major role in the esthetic appearance of composite restorations.

Poppers, a new recreational drug craze

The study was conducted to obtain information on the recreational use of the vasodilators (RVs) amyl nitrite and butyl nitrite in Toronto. The results of 70 interviews (40 complete) indicate that sniffing these RVs gives a 'high' lasting from a few seconds to a few minutes with headache being the most common side effect. None of the more serious side effects mentioned in the literature were reported. RVs are used chiefly in conjunction with sexual activities and dancing. Their use is currently a craze amongst the male homosexual population.

Effects of cardiac surgery with extracorporeal circulation on intellectual function in children

The effect of extracorporeal circulation during open heart surgery on changes in intellectual function was studied in 18 children. A group of patients undergoing such surgery was compared to a control group undergoing cardiac surgery without extracorporeal circulation. The Wechsler Intelligence Scale for Children was used to evaluate the patients. No significant differences were found in either the performance IQs, verbal IQs, or full scale IQs by comparing the postoperative scores to the preoperative scores either within each group or between the groups. Extracorporeal circulation during open heart surgery does not appear to alter intellectual functioning in the pediatric age group.