Photodynamic Therapy in Pigmented Basal Cell Carcinoma-A Review

This review summarizes the effectiveness of photodynamic therapy (PDT) in the treatment of the pigmented subtype of basal cell carcinoma (BCC) based on the current literature. PDT is a light-activated treatment, non-invasive, that selectively destroys tumor cells and tissues via the interaction of a photosensitizer, light, and molecular oxygen. It can induce cancer cell death through direct tumor vascular damage or via the induction of immune response. However, human skin is also an absorption and scattering medium since it contains hemoglobin and melanin that act as chromophores. Eumelanin can be considered a light-absorber and an intracellular antioxidant that can neutralize PDT-induced ROS and, therefore, decrease PDT success. Various factors, including tumor depth, the degree of pigmentation in malignant cells, and the individual's skin phototype, can impact the outcome of this intricate biochemical process. It has been widely recognized that PDT exhibits limited efficacy in the treatment of pigmented lesions. However, new combination techniques such as curettage or debulking before PDT show promising results in the treatment of pigmented BCC.

Fungal Planet description sheets: 1550-1613

Novel species of fungi described in this study include those from various countries as follows: Argentina, Neocamarosporium halophilum in leaf spots of Atriplex undulata. Australia, Aschersonia merianiae on scale insect (Coccoidea), Curvularia huamulaniae isolated from air, Hevansia mainiae on dead spider, Ophiocordyceps poecilometigena on Poecilometis sp. Bolivia, Lecanora menthoides on sandstone, in open semi-desert montane areas, Sticta monlueckiorum corticolous in a forest, Trichonectria epimegalosporae on apothecia of corticolous Megalospora sulphurata var. sulphurata, Trichonectria puncteliae on the thallus of Punctelia borreri. Brazil, Catenomargarita pseudocercosporicola (incl. Catenomargarita gen. nov.) hyperparasitic on Pseudocercospora fijiensis on leaves of Musa acuminata, Tulasnella restingae on protocorms and roots of Epidendrum fulgens. Bulgaria, Anthracoidea umbrosae on Carex spp. Croatia, Hymenoscyphus radicis from surface-sterilised, asymptomatic roots of Microthlaspi erraticum, Orbilia multiserpentina on wood of decorticated branches of Quercus pubescens. France, Calosporella punctatispora on dead corticated twigs of Aceropalus. French West Indies (Martinique), Eutypella lechatii on dead corticated palm stem. Germany, Arrhenia alcalinophila on loamy soil. Iceland, Cistella blauvikensis on dead grass (Poaceae). India, Fulvifomes maritimus on living Peltophorum pterocarpum, Fulvifomes natarajanii on dead wood of Prosopis juliflora, Fulvifomes subazonatus on trunk of Azadirachta indica, Macrolepiota bharadwajii on moist soil near the forest, Narcissea delicata on decaying elephant dung, Paramyrothecium indicum on living leaves of Hibiscus hispidissimus, Trichoglossum syamviswanathii on moist soil near the base of a bamboo plantation. Iran, Vacuiphoma astragalicola from stem canker of Astragalus sarcocolla. Malaysia, Neoeriomycopsis fissistigmae (incl. Neoeriomycopsidaceae fam. nov.) on leaf spots on flower Fissistigma sp. Namibia, Exophiala lichenicola lichenicolous on Acarospora cf. luederitzensis. Netherlands, Entoloma occultatum on soil, Extremus caricis on dead leaves of Carex sp., Inocybe pseudomytiliodora on loamy soil. Norway, Inocybe guldeniae on calcareous soil, Inocybe rupestroides on gravelly soil. Pakistan, Hymenagaricus brunneodiscus on soil. Philippines, Ophiocordyceps philippinensis parasitic on Asilus sp. Poland, Hawksworthiomyces ciconiae isolated from Ciconia ciconia nest, Plectosphaerella vigrensis from leaf spots on Impatiens noli-tangere, Xenoramularia epitaxicola from sooty mould community on Taxus baccata. Portugal, Inocybe dagamae on clay soil. Saudi Arabia, Diaporthe jazanensis on branches of Coffea arabica. South Africa, Alternaria moraeae on dead leaves of Moraea sp., Bonitomyces buffels-kloofinus (incl. Bonitomyces gen. nov.) on dead twigs of unknown tree, Constrictochalara koukolii on living leaves of Itea rhamnoides colonised by a Meliola sp., Cylindromonium lichenophilum on Parmelina tiliacea, Gamszarella buffelskloofina (incl. Gamszarella gen. nov.) on dead insect, Isthmosporiella africana (incl. Isthmosporiella gen. nov.) on dead twigs of unknown tree, Nothoeucasphaeria buffelskloofina (incl. Nothoeucasphaeria gen. nov.), on dead twigs of unknown tree, Nothomicrothyrium beaucarneae (incl. Nothomicrothyrium gen. nov.) on dead leaves of Beaucarnea stricta, Paramycosphaerella proteae on living leaves of Protea caffra, Querciphoma foliicola on leaf litter, Rachicladosporium conostomii on dead twigs of Conostomium natalense var. glabrum, Rhamphoriopsis synnematosa on dead twig of unknown tree, Waltergamsia mpumalanga on dead leaves of unknown tree. Spain, Amanita fulvogrisea on limestone soil, in mixed forest, Amanita herculis in open Quercus forest, Vuilleminia beltraniae on Cistus symphytifolius. Sweden, Pachyella pulchella on decaying wood on sand-silt riverbank. Thailand, Deniquelata cassiae on dead stem of Cassia fistula, Stomiopeltis thailandica on dead twigs of Magnolia champaca. Ukraine, Circinaria podoliana on natural limestone outcrops, Neonematogonum carpinicola (incl. Neonematogonum gen. nov.) on dead branches of Carpinus betulus. USA, Exophiala wilsonii water from cooling tower, Hygrophorus aesculeticola on soil in mixed forest, and Neocelosporium aereum from air in a house attic. Morphological and culture characteristics are supported by DNA barcodes. Citation: Crous PW, Costa MM, Kandemir H, et al. 2023. Fungal Planet description sheets: 1550-1613. Persoonia 51: 280-417. doi: 10.3767/persoonia.2023.51.08.

Photodynamic Therapy is an Effective Treatment of Facial Pigmented Actinic Keratosis

BACKGROUND

Actinic keratosis (AK), or solar keratosis, is a precancerous condition of the skin, mainly caused by excessive and chronic exposure to ultraviolet radiation. Pigmented AK (pAK) is a rare variant of AK. Photodynamic therapy (PDT) is widely used to treat the classical variant of AK, but very limited data are available on the use of PDT in patients with pAK. The objective of this study was to assess the usefulness of PDT in the treatment of pAK.

METHODS

The study included 16 patients with 20 pAK lesions treated with PDT. All skin lesions were clinically and dermatoscopically assessed for typical features characteristic of pAK. Reflectance confocal microscopy (RCM) was also used to assess keratinocyte atypia, confirm pAK diagnosis, and rule out other disease entities.

RESULTS

After three PDT sessions, the complete resolution of all clinical features of pAK was observed in 80% of the studied lesions. Dermatoscopically, 65% of the lesions achieved 100% response and no cellular atypia was seen in the follow-up RCM images of 85% of lesions.

CONCLUSIONS

Photodynamic therapy is an effective treatment modality for pAK in fair-skinned individuals.

YY1 Is a Key Player in Melanoma Immunotherapy/Targeted Treatment Resistance

Malignant melanoma, with its increasing incidence and high potential to form metastases, is one of the most aggressive types of skin malignancies responsible for a significant number of deaths worldwide. However, melanoma also demonstrates a high potential for induction of a specific adaptive anti-tumor immune response being one of the most immunogenic malignancies. Yin Yang 1 (YY1) transcription factor is essential to numerous cellular processes and the regulation of transcriptional and posttranslational modifications of various genes. It regulates programmed cell death 1 (PD1) and lymphocyte-activation gene 3 (LAG3) by binding to its promoters, as well as suppresses both Fas and TRAIL by negatively regulating DR5 transcription and expression and interaction with the silencer region of the Fas promoter, rendering cells resistant to apoptosis. Moreover, YY1 is considered a master regulator in various stages of embryogenesis, especially in neural crest stem cells (NCSCs) survival and proliferation as it acts as transcriptional repressor on cancer stem cells-related transcription factors. In addition, YY1 increases the metastatic potential of melanoma through negative regulation of microRNA-9 (miR-9) expression, acts as a cofactor of transcription factor EB (TFEB) and contributes to autophagy regulation, mainly due to increased transcription of genes related to autophagy and lysosome biogenesis. Therefore, focusing on the detailed biology and administration of therapies that directly target YY1 or crosstalk pathways in malignant melanoma could facilitate the development of new and more effective treatment strategies and improve patients’ outcomes.

Pridopidine in the treatment of Huntington's disease

Huntington's disease (HD) is a highly common inherited monogenic neurodegenerative disease, and the gene responsible for its development is located in the 4p16.3 chromosome. The product of that gene mutation is an abnormal huntingtin (Htt) protein that disrupts the neural conduction, thus leading to motor and cognitive disorders. The disease progresses to irreversible changes in the central nervous system (CNS). Although only a few drugs are available to symptomatic treatment, 'dopamine stabilizers' (as represented by the pridopidine) may be the new treatment options. The underlying causes of HD are dopaminergic conduction disorders. Initially, the disease is hyperkinetic (chorea) until it eventually reaches the hypokinetic phase. Studies confirmed a correlation between the amount of dopamine in the CNS and the stage of the disease. Pridopidine has the capacity to be a dopamine buffer, which could increase or decrease the dopamine content depending on the disease phase. A research carried out on animal models demonstrated the protective effect of pridopidine on nerve cells thanks to its ability to alter the cortical glutamatergic signaling through the N-methyl-D-aspartate (NMDA) receptors. Studies on dopamine stabilizers also reported that pridopidine has a 100-fold greater affinity for the sigma-1 receptor than for the D2 receptor. Disturbances in the activity of sigma-1 receptors occur in neurodegenerative diseases, including HD. Their interaction with pridopidine results in the neuroprotective effect, which is manifested as an increase in the plasticity of synaptic neurons and prevention of their atrophy within the striatum. To determine the effectiveness of pridopidine in the treatment of HD, large multicenter randomized studies such as HART, MermaiHD, and PRIDE-HD were carried out.

Resveratrol in the treatment of neuroblastoma: a review

Resveratrol, polyphenol naturally occurring in grapes or nuts, has anti-cancer properties in the treatment of neuroblastoma - the most common childhood solid tumor. It affects cancer cells by increasing apoptosis, inducing cell necrosis and reducing tumor mass. Mechanism of action - (1) converting procaspases, mainly procaspases three and nine into active forms - caspases, (2) blocking kinases, and also (3) leading the cell to the S-cell cycle, where it is most effective while increasing the concentration of cyclin E and lowering the concentration of p21 protein. In vitro, as well as, rodent animal models studies are available and show promising results. Therapeutic doses, currently within 10-100 μmol/L, are also being tested, as well as other forms of resveratrol, such as its trans-4,4'-dihydroxystilbene analog and polyphenol lipoconjugates. In our review, we presented the known molecular mechanisms of polyphenol anti-tumor activity against neuroblastoma and discussed the studies confirming its effectiveness.

Effect of Mirabegron on the Body's Exercise Capacity: A Review

Mirabegron is a β3-agonist drug approved by the FDA for use in 2012 and administered in overactive bladder. Activating of adrenergic receptors leads to the relaxation of the detrusor muscle. According to the latest research and reports, it also has lipolytic activity, affecting the reduction of mainly brown adipose tissue (BAT) but also of white adipose tissue (WAT). This results in a decrease in body weight and triglyceride concentration and an increase in lipoprotein lipase activity, as well as in the level of free fatty acids or adipokines in the plasma. The drug indirectly participates in the regulation of carbohydrate metabolism, influencing the increase in insulin sensitivity, supporting cellular uptake of glucose. However, due to the elevation of blood pressure and pulse, as a supplement, the drug should be taken with care to avoid cardiovascular complications. In our review, below, we present a description and discussion of available studies in terms of mirabegron action on the exercise capacity of the body in the context of its potential use as a doping agent.

DELUSIONAL MISIDENTIFICATION SYNDROME: DISSOCIATION BETWEEN RECOGNITION AND IDENTIFICATION PROCESSES

Delusional misidentification syndrome (DMS) is an umbrella term for syndromes of intermetamorphosis, Fregoli, and Capgras. DMS) is thought to be related to dissociation between recognition and identification processes. DMS was described for the first time in 1932 as a variant of the Capgras syndrome and is currently on the DSM-V list of diseases as an independent disease entity. Patients affected by DMS believed that people around them, most often family, have changed physically (appearance) and mentally (character). Other symptoms include confabulation, derealization or depersonalization. In patients, aggressive behavior is often observed, aimed at alleged doppelgangers resulting from the sense of being cheated and manipulated. With the intermetamorphosis syndrome, for example, schizophrenia, depression, bipolar disorder or other misidentification syndromes (Fregoli's, Capgras) may coexist. There is also a reverse intermetamorphosis, where the object of the changed appearance or character becomes the patient himself. One of its forms may be lycanthropy. The etiology of the intermetamorphosis has not been fully understood, one of the reasons may be brain damage and changes in the parietal and/or temporal lobes of the right hemisphere. It may then damage long neuronal connections to the frontal areas of the brain, disturbances of working memory (WM) accountable for the keep and online management of data, so that it is available for further processing, and the patient's will be uncritical. The basic method of diagnosis of this delusion is a medical interview with the patient. Other diagnostic methods include computed tomography, magnetic resonance imaging, EEG and ERPs. Experimental methods include searching for the neuromarker of DMS. Currently, there are no treatment guidelines of this delusional disorder, and pharmacotherapy experimental, but the drugs from the group of neuroleptics and lithium seem effective. Some hope for the treatment is created by neurotherapy, but it is also experimental.

Predicted difficulties, educational needs, and interest in working in end of life care among nursing and medical students

BACKGROUND

The need to provide care for the dying patient and his/her family may occur in every medical setting. Newly graduated nurses and physicians should therefore be prepared to deliver it at a high-quality level.

OBJECTIVES

To explore (a) the primary difficulties participants anticipate they will encounter whilst working with dying patients, (b) their interest in developing competencies in caring for dying patients, and (c) their interest in working in palliative/hospice settings or with dying patients in the future.

DESIGN

A cross-sectional study.

SETTINGS

A medical university in Poland.

PARTICIPANTS

Convenience sample of nursing (=112) and medical students (=101) at the end of their undergraduate education.

METHODS

Questionnaire distributed online and in hard-copy format.

RESULTS

Half of the participants anticipated experiencing various emotional and professional difficulties in caring for dying individuals, especially medical students. These difficulties pertained mostly the reaction of family members to the patient's death, addressing the psychological needs of the dying person, and coping with his/her own emotions when dealing with the patient's death. Students reported that working with dying patients could cause occupational stress - more so among medical students. The majority of them showed an interest in improving knowledge regarding palliative care and also in this case this was mostly true of medical rather than nursing students. However, more than half of the participants preferred avoiding work in palliative/hospice settings, with no differences between the two groups. Participants attributed this attitude to two factors: (a) the desire to avoid negative emotions and stress that could be triggered by dealing with death and dying; and (b) because they felt they lacked the required skills and personal abilities to handle such situations.

CONCLUSIONS

Undergraduate curricula that include strategies for coping with negative emotions associated with facing the process of death and dying should be developed. Interprofessional education should be encouraged, especially regarding the psychosocial aspects of end-of-life care.

Comparison of the effectiveness of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination in the detection of mild neurocognitive disorder in people over 60 years of age. Preliminary study

OBJECTIVES

Analysis of reliability of the Polish version of the MoCA 7.2 vs. the MMSE in mild NCD detecting, while taking into consideration the sensitivity and specificity of cut-off points for each type of education.

METHODS

Cross-sectional study was conducted at the Department of Geriatrics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun. The study was conducted between September 2014 and December 2015. The study involved 131 participants, including 54 people assigned to the group without NCD and 77 to the group with mild NCD. Recruitment for both groups was performed on the basis of specific inclusion and exclusion criteria.

RESULTS

Mean scores of the MoCA 7.2 and the MMSE showed a statistically significant difference between the groups with and without mild NCD. The optimal cut-off point on the MoCA scale for mild NCD was 24/25. The optimal cut-off point on the MMSE scale for mild NCD was 28/29. In the ROC curve analysis, area under the curve (AUC) for the MoCA was significantly greater than the AUC for the MMSE.

CONCLUSIONS

The MoCA 7.2 detect mild NCD with greater sensitivity than the MMSE. In the case of this tool, we propose the use of 24/25 cut-off point which has a higher sensitivity than the recommended 25/26 cut-off point. The MoCA 7.2 therefore can be used by primary healthcare and in the geriatric practice as a screening tool in detecting early cognitive impairment.

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis

OBJECTIVES

Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points.

METHODS

A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC).

RESULTS

ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767).

CONCLUSIONS

MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

Nonlinear spectra of ZnO: reverse saturable, two- and three-photon absorption

We present a broadband (460 - 980 nm) analysis of the nonlinear absorption processes in bulk ZnO, a large-bandgap material with potential blue-to-UV photonic device applications. Using an optical parametric amplifier we generated tunable 1-kHz repetition rate laser pulses and employed the Z-scan technique to investigate the nonlinear absorption spectrum of ZnO. For excitation wavelengths below 500 nm, we observed reverse saturable absorption due to one-photon excitation of the sample, agreeing with rate-equation modeling. Two- and three-photon absorption were observed from 540 to 980 nm. We also determined the spectral regions exhibiting mixture of nonlinear absorption mechanisms, which were confirmed by photoluminescence measurements.

Two-photon polymerization for fabricating structures containing the biopolymer chitosan

Two-photon polymerization is a powerful tool for fabricating three-dimensional micro/nano structures for applications ranging from nanophotonics to biology. To tailor such structure for specific purposes it is often important to dope them. In this paper we report on the fabrication of structures, with nanometric surface features (resolution of approximately 700 nm), using two-photon polymerization of an acrylic resin doped with the biocompatible polymer chitosan using a guest-host scheme. The fluorescence background in the Raman spectrum indicates the presence of chitosan throughout the structure. Mechanical characterization reveals that chitosan does not affect the mechanical properties of the host acrylic resin and, consequently, the structures exhibit excellent integrity. The approach presented in this work can be used in the fabrication of micro- and nanostructures containing biopolymers for biomedical applications.

Femtosecond laser waveguide micromachining of PMMA films with azoaromatic chromophores

We report on the femtosecond-laser micromachining of poly(methyl methacrylate) (PMMA) films doped with nonlinear azoaromatic chromophores: Disperse Red 1, Disperse Red 13 and Disperse Orange 3. We study the conditions for controlling chromophore degradation during the micromachining of PMMA doped with each chromophore. Furthermore, we successfully used fs-micromachining to fabricate optical waveguides within a bulk sample of PMMA doped with these azochromophores.

Pulse energy dependence of subcellular dissection by femtosecond laser pulses

Precise dissection of cells with ultrashort laser pulses requires a clear understanding of how the onset and extent of ablation (i.e., the removal of material) depends on pulse energy. We carried out a systematic study of the energy dependence of the plasma-mediated ablation of fluorescently-labeled subcellular structures in the cytoskeleton and nuclei of fixed endothelial cells using femtosecond, near-infrared laser pulses focused through a high-numerical aperture objective lens (1.4 NA). We find that the energy threshold for photobleaching lies between 0.9 and 1.7 nJ. By comparing the changes in fluorescence with the actual material loss determined by electron microscopy, we find that the threshold for true material ablation is about 20% higher than the photobleaching threshold. This information makes it possible to use the fluorescence to determine the onset of true material ablation without resorting to electron microscopy. We confirm the precision of this technique by severing a single microtubule without disrupting the neighboring microtubules, less than 1 micrometer away.

Inducing and probing non-thermal transitions in semiconductors using femtosecond laser pulses

Soon after it was discovered that intense laser pulses of nanosecond duration from a ruby laser could anneal the lattice of silicon, it was established that this so-called pulsed laser annealing is a thermal process. Although the radiation energy is transferred to the electrons, the electrons transfer their energy to the lattice on the timescale of the excitation. The electrons and the lattice remain in equilibrium and the laser simply 'heats' the solid to the melting temperature within the duration of the laser pulse. For ultrashort laser pulses in the femtosecond regime, however, thermal processes (which take several picoseconds) and equilibrium thermodynamics cannot account for the experimental data. On excitation with femtosecond laser pulses, the electrons and the lattice are driven far out of equilibrium and disordering of the lattice can occur because the interatomic forces are modified due to the excitation of a large (10% or more) fraction of the valence electrons to the conduction band. This review focuses on the nature of the non-thermal transitions in semiconductors under femtosecond laser excitation.

[The relation between Chlamydia pneumoniae infection and abdominal aortic aneurysm]

The aim of our study was to evaluate the frequency of C. pneumoniae infection in abdominal aortic aneurysm (AAA) patients by measuring C. pneumoniae specific serum IgG, IgM and IgA levels and the activation of their immune system by measuring the concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha in patients' serum. Microimmunofluorescence method was applied to evaluate the level of anti-C. pneumoniae IgG, IgA and IgM. The concentrations of cytokines were evaluated using ELISA method. Serologic markers of persistent C. pneumoniae infection have been detected in 25/28 (89.3%) patients and in 6/20 (30%) healthy controls. In 40% (10/25) of patients with serologic markers of persistent C. pneumoniae infection high titers of specific IgG and IgA indicated active infection--reinfection or exacerbation of chronic infection. Mean concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha indicated lack of protection against intracellular pathogens. Since all patients in this group were diagnosed as having symptomatic AAA, we suggest that active infection can exacerbate inflammation in the AAA wall and accelerate progression of the disease. In our opinion patients with active C. pneumoniae infection may be candidates to the antimicrobial treatment.

[Cytokines: regulations of immune response during infection]

The aim of this work is to review state-of-the-art knowledge about cytokines and their role as regulators of immune response during infections caused by different pathogens.

Ultrafast laser-induced phase transitions in amorphous GeSb films

Time-resolved measurements of the spectral dielectric function reveal new information about ultrafast phase transitions induced by femtosecond laser pulses in Sb-rich amorphous GeSb films. The excitation generates a nonthermal phase within 200 fs. The dielectric function of this phase differs from that of the crystalline phase, contrary to previous suggestions of a disorder-to-order transition. The observed dielectric function is close to that of the liquid phase, indicating an ultrafast transition from the amorphous phase to a different disordered state.

[Chronic Chlamydia pneumoniae infection in patients with asthma]

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in 41 asthma patients. They have been assigned to 3 groups, according to disease severity. Control group consisted of 35 age matched healthy volunteers (without cardiac and pulmonary diseases). The levels of specific IgG, IgA and IgM in patients' serum have been estimated using indirect microimmunofluorescence. According to serologic criteria, 23(56.1%) asthma patients and 4(11.4%) healthy controls have appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Acute Chlamydia pneumoniae infection was present in 3(7.3%) asthma patients and in 2(5.7%) healthy controls. Taking in account asthma severity, persistent Chlamydia pneumoniae infection has occurred more frequently in patients with moderate and severe asthma than in ones with mild asthma. Acute Chlamydia pneumoniae infection was present in 9.1% and 12.5% of patients with mild and severe asthma respectively.

[Chronic Chlamydia pneumonia infection in patients with chronic obstructive pulmonary disease]

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in COPD patients. Microimmunofluorescence method has been applied Chlamydia pneumoniae Micro-IF test (Labsystems) has been used. The levels of specific IgG, IgA and IgM have been estimated in patients' serum. According to serologic criteria, 64.1% of COPD patients and 20.5% of healthy controls appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Taking in account COPD severity, persistent Chlamydia pneumoniae infection has been present in 68.2%, 57.1%, and 50% of patients with severe, moderate and mild COPD, respectively. Our study has revealed that chronic Chlamydia pneumoniae infection occurs more frequently in COPD patients than in healthy controls and in patients with severe COPD than in ones with mild and moderate disease. It is possible that persistent Chlamydia pneumoniae infection can initiate or amplify inflammatory reactions in the respiratory tract. The results suggest a need to diagnose chronic Chlamydia pneumoniae infection in COPD patients and, if confirmed, to take an attempt of antimicrobial therapy.

Micromachining bulk glass by use of femtosecond laser pulses with nanojoule energy

Using tightly focused femtosecond laser pulses of just 5 nJ, we produce optical breakdown and structural change in bulk transparent materials and demonstrate micromachining of transparent materials by use of unamplified lasers. We present measurements of the threshold for structural change in Corning 0211 glass as well as a study of the morphology of the structures produced by single and multiple laser pulses. At a high repetition rate, multiple pulses produce a structural change dominated by cumulative heating of the material by successive laser pulses. Using this cumulative heating effect, we write single-mode optical waveguides inside bulk glass, using only a laser oscillator.

Dorsal thoracic cord compression from a spinal angiolipoma: case report and brief comment

Angiolipomas are benign tumors usually found in the forearms of young adults. To the best of our knowledge only 63 cases of spinal angiolipomas have been reported in the literature up until 1999 (MEDLINE 1966-1999). We report a case of a spinal angiolipoma causing dorsal cord compression in a 44-year-old woman presenting with subacute lower limb paresthesias, in the absence of sensory or motor findings, which mimicked multiple sclerosis by history. Operative intervention was curative.

Cognitive moderators of children's adjustment to stressful divorce events: the role of negative cognitive errors and positive illusions

This study examined whether children's cognitive appraisal biases moderate the impact of stressful divorce-related events on psychological adjustment in 355 children ages 9 to 12, whose families had experienced divorce within the past 2 years. Multiple regression indicated that endorsement of negative cognitive errors for hypothetical divorce events moderates the relations between stressful divorce events and self- and maternal reports of internalizing and externalizing symptoms, but only for older children. Positive illusions buffer the effects of stressful divorce events on child-reported depression and mother-reported externalizing problems. Implications of these results for theories of stress and coping, as well as for interventions for children of divorced families, are discussed.

Minimally disruptive laser-induced breakdown in water

We produce minimally disruptive breakdown in water by using tightly focused 100-fs laser pulses and demonstrate the potential use of this technique in microsurgery of the eye. Using time-resolved imaging and piezoelectric pressure detection, we measure the magnitude and speed of propagation of the pressure wave produced in the breakdown. Compared with breakdown with longer pulses, here there is a much lower energy threshold for breakdown of 0.2microJ , a smaller shock zone diameter (11microm for 1-microJ pulses), and consistent energy deposition.

Three-dimensional optical storage inside transparent materials: errata

In our recent Letter1 a line of text was dropped in printing. On p. 2024 the beginning of the paragraph above Fig. 3 should read as follows: "Surprisingly, the 0.5-muJ pulse energy used in these microexplosions...".

Three-dimensional optical storage inside transparent materials

We present a novel method for three-dimensional optical data storage that has submicrometer size resolution, provides a large contrast in index of refraction, and is applicable to a wide range of transparent materials. Bits are recorded by use of a 0.65-N.A. objective to focus 100-fs laser pulses inside the material. The laser pulse produces a submicrometer-diameter structurally altered region with high contrast in index of refraction. We record binary information by writing such bits in multiple planes and read it out with a microscope objective with a short depth of field. We demonstrate data storage and retrieval with 2-microm in-plane bit spacing and 15-microm interplane spacing (17 Gbits/cm(3)). Scanning electron microscopy and atomic force microscopy show structural changes confined to an area 200 nm in diameter.

Informatics integration in a medical residency program: early experiences

In 1992, Informatics training was integrated into the medical residency program at Norwalk Hospital. The program objective was to familiarize the residents with clinical applications of information technology that could enhance their productivity in clinical practice. In its first year, the curriculum was theory oriented. Evaluation of the program at the end of the first year led to a significant restructuring of the program format and curriculum. The trainees did not find theory to be of immediate clinical value, in the second year the program emphasis was redirected toward the development of practical skills. Next year, in 1993, 'Informatics Clinics' were initiated to develop practical Informatics skills that would be useful in a clinical setting. This approach was more successful but did not offer a complete solution. The degree to which the concepts and methods learned are clinically utilized by residents will depend upon the degree of reinforcement provided in the clinical residency years. In addition, there is a need for the development of assessment standards for the evaluation of Informatics literacy levels. In the absence of assessment standards the level of Informatics literacy in medical graduates remains undetermined Consequently, it is difficult to determine whether the training received has transformed expectations into reality.

Negative cognitive errors and positive illusions for negative divorce events: predictors of children's psychological adjustment

This study examined the relations among negative cognitive errors regarding hypothetical negative divorce events, positive illusions about those same events, actual divorce events, and psychological adjustment in 38 8- to 12-year-old children whose parents had divorced within the previous 2 years. Children's scores on a scale of negative cognitive errors (catastrophizing, overgeneralizing, and personalizing) correlated significantly with self-reported symptoms of anxiety and self-esteem, and with maternal reports of behavior problems. Children's scores on a scale measuring positive illusions (high self-regard, illusion of personal control, and optimism for the future) correlated significantly with less self-reported aggression. Both appraisal types accounted for variance in some measures of symptomatology beyond that explained by actual events. There was no significant association between children's negative cognitive errors and positive illusions. The implications of these results for theories of negative cognitive errors and of positive illusions, as well as for future research, are discussed.

[Studies of susceptibility to antibiotics in strains of E. coli isolated from urine in the years 1986-1990]

From 1986 to 1990 research was conducted on E. coli strains isolated from patients with clinical symptoms of urinary tract infection. The paper-disk-plate technique was applied to determine their susceptibility to ampicillin, carbenicillin, azlocillin, cefamandole, cefotaxime, ceftriaxone, ceftazidime, cefoperazone, amikacin, netilmicin, gentamycin, vibramycin, and colistin. According to the authors' results the efficacy of ampicillin against the examined strains is as low as 3.4%. Aminoglycosides were traditionally recommended in therapy of urinary tract infections. Our research proves amikacin and netilmicin to be more effective against E. coli than gentamycin. The third-generation cephalosporins are recommended as alternative to aminoglycosides, especially since they are proved to be non-nephrotoxic. According to the results of the authors' research ceftazidime, cefotaxime and particularly ceftriaxone show the highest activity against the used strains of E. coli.