British Association of Dermatologists guidelines for the management of people with cutaneous lupus erythematosus (CLE) 2021

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of cutaneous lupus erythematosus (CLE) in the presence or absence of systemic lupus erythematosus (SLE) in adults, young people and children. The document aims to: offer an appraisal of all relevant literature up to December 2020, focusing on any key developments address important, practical clinical questions relating to the primary guideline objective. provide guideline recommendations and if appropriate research recommendations.

Localized bullous pemphigoid in a patient with primary lymphoedema tarda

We report a case of localized bullous pemphigoid (BP) in a woman patient with primary lymphoedema tarda. There is only one previous case reported of localized pemphigoid in an area of lymphoedema, this being of the cicatricial variant. Slow circulation in the lymphatic vessels, increased capillary permeability with preferential localization of antibodies in the area, and potential cleavage of the epidermal junction due to increased hydrostatic pressure leading to autoimmunity, have all been advocated as possible pathogenic mechanisms. Nevertheless, we consider that the mechanism by which localized pemphigoid arises on lymphoedema remains elusive, based on a previous case of generalized BP sparing an area of postsurgical lymphoedema.

Space radiation measurements on-board ISS--the DOSMAP experiment

The experiment 'Dosimetric Mapping' conducted as part of the science program of NASA's Human Research Facility (HRF) between March and August 2001 was designed to measure integrated total absorbed doses (ionising radiation and neutrons), heavy ion fluxes and its energy, mass and linear energy transfer (LET) spectra, time-dependent count rates of charged particles and their corresponding dose rates at different locations inside the US Lab at the International Space Station. Owing to the variety of particles and energies, a dosimetry package consisting of thermoluminescence dosemeter (TLD) chips and nuclear track detectors with and without converters (NTDPs), a silicon dosimetry telescope (DOSTEL), four mobile silicon detector units (MDUs) and a TLD reader unit (PILLE) with 12 TLD bulbs as dosemeters was used. Dose rates of the ionising part of the radiation field measured with TLD bulbs applying the PILLE readout system at different locations varied between 153 and 231 microGy d(-1). The dose rate received by the active devices fits excellent to the TLD measurements and is significantly lower compared with measurements for the Shuttle (STS) to MIR missions. The comparison of the absorbed doses from passive and active devices showed an agreement within +/- 10%. The DOSTEL measurements in the HRF location yielded a mean dose equivalent rate of 535 microSv d(-1). DOSTEL measurements were also obtained during the Solar Particle Event on 15 April 2001.

Radiation measurements aboard NASA ER-2 high altitude aircraft with the Liulin-4J portable spectrometer

The risks to aircrew health posed by prolonged exposure to low levels of ionizing radiation at aircraft altitudes have recently received renewed attention. Civil and military aircraft currently on the drawing board are expected to operate at higher altitudes (>12 km) and fly longer ranges than do existing aircraft, thereby exposing their crews to higher levels of ionizing radiation, for longer periods of time. We are currently carrying out dosimetric measurements of the ionizing radiation environment at approximately 20 km altitude using portable Si detectors aboard NASA's two ER-2 high altitude research aircraft. The instruments, Liulin-4J, have been extensively calibrated at several particle accelerators. With these instruments, we can measure not only absorbed dose, but also variation of the absorbed dose as a function of time. We report radiation dose measurements as function of time, altitude, and latitude for several ER-2 missions.

Expression of the c-erbB-3/HER-3 and c-erbB-4/HER-4 growth factor receptors and their ligands, neuregulin-1 alpha, neuregulin-1 beta, and betacellulin, in normal endometrium and endometrial cancer

The objective of this study was to determine the immunohistochemical expression of the c-erbB-3 and c-erbB-4 growth factor receptors and their principal ligands, the neuregulins and betacellulin, in normal endometrium and determine whether there was evidence of under- or overexpression in endometrial adenocarcinoma. Immunohistochemistry was performed using well-characterized antibodies against each of the five proteins analyzed on formalin-fixed, paraffin-embedded archival material. Forty-three normal endometrial samples (16 proliferative, 19 secretory, and 8 hyperplastic) and 41 endometrial adenocarcinoma cases were analyzed. There was variable expression of the growth factor receptors and the ligands in the two principal phases of the menstrual cycle as well as in endometrial adenocarcinoma. In normal endometrium, the c-erbB-3 receptor was weakly expressed in both phases. The c-erbB-4 receptor and all of the ligands examined, neuregulin alpha, neuregulin beta, and betacellulin, were expressed at significantly higher levels in the secretory as compared with the proliferative phase of the menstrual cycle, suggesting a role for these proteins in endometrial maturation. In endometrial adenocarcinoma, overexpression of c-erbB-3, c-erbB-4, and betacellulin with underexpression of neuregulin a as compared with normal controls was observed. Neuregulin beta expression was not found to be significantly different in the two groups. These results suggest that signaling through the c-erbB-3 and c-erbB-4 receptors and the ligands neuregulin alpha, neuregulin beta, and betacellulin are important in endometrial carcinogenesis.

Right cerebral hemisphere damage: incidence of language problems

While dysphasia is rare after right cerebral hemisphere damage (RHD), there is now a body of evidence to suggest that language and communication problems can occur. This paper reports the findings of a pilot study that estimated the incidence of non-dysphasic language and communication problems following RHD. Eleven subjects completed language assessments within 2 weeks of onset and again 3 months later. The results show that language impairment can follow a unilateral RHD for 50% of the sample, and that there are marked difficulties for 20%. Furthermore these problems do not resolve spontaneously over a 3 month period. The case for speech and language therapy intervention for this patient group is discussed.