Active Suppression of Quantum Dephasing in Resonantly Driven Ensembles

We have used quantum control to suppress the impact of random atom positions on coherent population transfer within atom pairs, enabling the observation of dipole-dipole driven Rabi oscillations in a Rydberg gas with hundreds of atoms. The method exploits the reduced coupling-strength sensitivity of the off-resonant Rabi frequency, and coherently amplifies the achievable population transfer in analogy to quasi-phase-matching in nonlinear optics. Simulations reproduce the experimental results and demonstrate the potential benefits of the technique to other many-body quantum control applications.

Residential Proximity to Dioxin-emitting Facilities and Risk of Non-Hodgkin Lymphoma in the NIH-AARP Diet and Health Study

Purpose: Few studies have investigated the relationship between risk of non-Hodgkin lymphoma (NHL) and residential proximity to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) emitted from industrial combustion and manufacturing sources. Methods: We evaluated this relationship among participants of the NIH-AARP Diet and Health Study, a prospective cohort (N = 548,845) in 6 states and 2 cities in the U.S. We linked geocoded enrollment addresses (1995–1996) with a U.S. Environmental Protection Agency database of 4,478 historical PCDD/F sources, which contained toxic equivalency quotient (TEQ) emissions estimates from 1995. Exposure metrics indicated presence/absence of any facility within 3 and 5km of participant homes, overall and by type of facility (e.g., coal-fired power plants, waste incinerators), which vary in emissions levels and constituency. We also calculated exposure as a distance- and toxicity-weighted average emissions index (AEI [g TEQ]). We used Cox regression to estimate associations (hazard ratios; HR and 95% confidence intervals; CI) with NHL and major subtypes, adjusting for and by strata of sociodemographic and lifestyle characteristics. Results: With 6,747 incident cases through 2011, we found no association between living near any or specific types of PCDD/F-emitting facilities and NHL risk. However, participants with an AEI >95th percentile within 5km had increased risk of NHL compared to unexposed (HR = 1.28; CI = 1.05–1.55; p-trend = 0.01). Specifically, we observed increased risk for lymphoplasmacytic lymphoma (HR = 2.98, CI = 1.16–7.63; p-trend = 0.03) and diffuse large B-cell lymphoma (HR = 1.65, CI = 1.11–2.46; p-trend = 0.01). Non-Hispanic blacks were nearly three times as likely as whites to live <5 km of a facility, although we had limited power to evaluate heterogeneity in associations by race/ethnicity. Associations did not vary by age, smoking status, body mass index, or urbanicity of residence. Conclusions: Using an exposure metric accounting for distance and the toxicity of emissions, we found significant positive associations between residential exposure to high PCDD/F emissions and risk of NHL and two subtypes. Our results underscore the hazard for populations living near sources of these persistent organic pollutants.

Identifying Spatial Variation Along the HIV Care Continuum: The Role of Distance to Care on Retention and Viral Suppression

Distance to HIV care may be associated with retention in care (RIC) and viral suppression (VS). RIC (≥ 2 HIV visits or labs ≥ 90 days apart in 12 months), prescribed antiretroviral therapy (ART), VS (< 200 copies/mL at last visit) and distance to care were estimated among 3623 DC Cohort participants receiving HIV care in 13 outpatient clinics in Washington, DC in 2015. Logistic regression models and geospatial statistics were computed. RIC was 73%; 97% were on ART, among whom 77% had VS. ZIP code-level clusters of low RIC and high VS were found in Northwest DC, and low VS in Southeast DC. Those traveling ≥ 5 miles had 30% lower RIC (adjusted odds ratio (aOR) 0.71, 95% CI 0.58, 0.86) and lower VS (OR 0.70, 95% CI 0.52, 0.94). Geospatial clustering of RIC and VS was observed, and distance may be a barrier to optimal HIV care outcomes.

Ionization of excited atoms by intense single-cycle THz pulses

We have employed intense, single-cycle THz pulses to explore strong-field ionization of low-lying Na Rydberg states in the low-frequency limit. At the largest fields used, F≃430  kV/cm, electrons with energies up to 60 eV are created. The field ionization threshold is greater than expected for adiabatic "over-the-barrier" ionization and is found to scale as n-3. In addition, for a given field amplitude, higher energy electrons are produced during the ionization of the most tightly bound states. These observations can be attributed to the suppression of scattering from the nonhydrogenic ion core, the long times required for Rydberg electrons to escape over the barrier in the field-dressed Coulomb potential, and the failure, in the single-cycle limit, of the standard prediction for electron energy transfer in an oscillating field. The latter, in particular, holds important implications for future strong-field experiments involving the interaction of ground-state atoms and molecules with true single-cycle laser fields.

Terahertz-induced field-free orientation of rotationally excited molecules

We have used picosecond THz pulses to induce transient field-free orientation of OCS molecules. Coherent optical Raman excitation prepares the molecules in rotational superposition states prior to THz irradiation, substantially enhancing the degree of orientation. The time-dependent alignment and orientation are characterized via Coulomb explosion in an intense probe laser. The degree of OCS orientation is an order of magnitude larger than previously observed following THz irradiation and is achieved with a significantly smaller THz field.The field-free orientation level is comparable to that generated using pulsed, two-color laser fields but is obtained with negligible target ionization.

Time-dependent electron interactions in double Rydberg wave packets

We investigate the time-dependent evolution of a nonstationary three-body Coulomb system at energies just below the threshold for three-body breakup. Experimentally, short-pulse lasers excite two electrons in Ba to radially localized Rydberg wave packets with well-defined energy and angular momentum. Time-dependent interactions between the two electrons are probed using half-cycle electric field pulses. The measurements indicate that substantial energy exchange between the two electrons is nearly immediate upon the launch of the second wave packet. Fully quantum and classical calculations support this observation, predicting extremely rapid autoionization under the experimental conditions. The calculations also show very fast angular momentum exchange and sensitivity to the relative binding energies of the two electrons.

Probing electronic coherence in a gas of dipole-dipole coupled Rydberg atoms

We demonstrate a novel time-domain method to probe electronic coherence in ensembles of cold Rydberg atoms coupled via nearly resonant dipole-dipole interactions. Short laser pulses create coherent superpositions of few-electron eigenstates which evolve under the influence of pulsed electric fields. The pulses steer the dynamics, enhancing the probability for finding atoms in np, rather than initially excited ns states. The enhancement reflects the underlying electronic coherence which persists for >10  μs, 2 orders of magnitude longer than previously measured dephasing times in the same system. Simulations suggest that atom motion is responsible for the eventual decoherence.

Phase-dependent electron-ion recombination in a microwave field

Using picosecond laser photoionization of Li in a microwave field we have observed phase-dependent reccombination of the photoelectrons with their parent Li+ ions. Recombination occurs at phases of the microwave field such that energy is removed from the photoelectron in the first microwave cycle after excitation, and there are two maxima in the recombination in each microwave cycle. These observations are consistent with observations made using an attosecond pulse train phase locked to an infrared pulse and with the "simpleman's" model, modified to account for the fact that the photoelectrons are produced in a Coulomb potential.

Directional emission of multiply charged ions during dissociative ionization in asymmetric two-color laser fields

Intense, asymmetric 1ω+2ω laser fields are used to affect the directional ejection of multiply charged ion fragments from a variety of molecules, including N2, O2, CO, HBr, and CO2. By tuning the relative phase, ϕ, between the two fields, we observe large forward-backward dissociation asymmetries. The largest asymmetries are obtained at the same values of ϕ for all species, suggesting a common dynamical mechanism. Following an independent phase calibration, the sign of the asymmetry appears to be opposite that expected from the standard enhanced ionization model.

Effects of serial dependency on the agreement between visual and statistical inference

Comparisons between visual and time-series inferences from behavioral data show that serial dependency in scores is likely to disrupt agreement between the two methods of analysis. If researchers follow an earlier recommendation that time-series analysis be used to supplement or confirm visual analysis, this study's findings suggest that the two methods will disagree most often when the data contain high levels of autocorrelation and when reliable behavorial changes are indicated by time-series analysis.

Interrupted time-series analysis and its application to behavioral data

This paper uses a question-and-answer format to present the technical aspects of interrupted time-series analysis (ITSA). Topics include the potential relevance of ITSA to behavioral researchers, serial dependency, time-series models, tests of significance, and sources of ITSA information.

Time-series analysis in operant research

A time-series method is presented, nontechnically, for analysis of data generated in individual-subject operant studies, and is recommended as a supplement to visual analysis of behavior change in reversal or multiple-baseline experiments. The method can be used to identify three kinds of statistically significant behavior change: (a) changes in score levels from one experimental phase to another, (b) reliable upward or downward trends in scores, and (c) changes in trends between phases. The detection of, and reliance on, serial dependency (autocorrelation among temporally adjacent scores) in individual-subject behavioral scores is emphasized. Examples of published data from the operant literature are used to illustrate the time-series method.

Multiphoton assisted recombination

We have observed multiphoton assisted recombination in the presence of a 38.8 GHz microwave field. Stimulated emission of up to ten microwave photons results in energy transfer from continuum electrons, enabling recombination. The maximum electron energy loss is far greater than the 2Up predicted by the standard "simpleman's" model. The data are well reproduced by both an approximate analytic expression and numerical simulations in which the combined Coulomb and radiation fields are taken into account.

Preserving coherence in Rydberg quantum bits

The effectiveness of decoherence suppression schemes is explored using quantum bits (qubits) stored in Li np Rydberg states. Following laser excitation, pulsed electric fields coherently control the electronic spin-orbit coupling, facilitating qubit creation, manipulation, and measurement. Spin-orbit coupling creates an approximate decoherence-free subspace for extending qubit storage times. However, sequences of fast NOT operations are found to be substantially more effective for preserving coherence.

Ionization of atoms by the spatial gradient of the pondermotive potential in a focused laser beam

Ionization of atoms by the spatial gradient of the pondermotive potential in a focused laser beam is investigated. Rydberg ions, formed during the interaction of noble gas atoms with an intense laser pulse, are used to probe the gradient field. Rydberg ion species with higher ionization potentials are produced at locations where the gradient field is largest. The measured Rydberg ion yields differ dramatically from estimates that ignore gradient-field ionization, but are in good agreement with predictions that include the effect.

Probing Two-Electron Dynamics of an Atom

Coherent short-pulse laser excitation has been used to control the approximate energy and relative proximity of two valence electrons within the same alkaline-earth atom, thereby providing insight into the dynamical evolution of a three-body Coulomb system. Our time-domain experiments enable direct experimental study of the electron dynamics at the classical limit of a two-electron atom. As an example, we look at the mechanism of autoionization for one two-electron configuration class and find that the doubly excited atom decays through a single violent electron-electron collision rather than a gradual exchange of energy between the electrons.

Time-domain investigation of electron recapture via post-collision interaction in a double photoionization continuum

Picosecond laser pulses have been used to sequentially photoionize both valence electrons from neutral Ba atoms, producing two radially localized continuum wave packets. The Coulomb interaction between the two outgoing electrons can result in the recapture of one of the electrons by the parent ion. The energy distribution of Rydberg ions formed via this "post-collision" interaction is measured as a function of the delay between the ionizing laser pulses. The experimental data are in agreement with the results of both a quantum sudden approximation and a classical simulation.

Centrifugal electron-ion recombination

Transient electric-field pulses have been used to stimulate electron/ion recombination in a low density plasma in the presence of a static electric field. The measured recombination rates exhibit a strong dependence on the relative orientation of the pulsed and static fields. For weak pulses, the recombination rate is significantly higher for orthogonal as opposed to parallel or antiparallel field configurations. The enhanced recombination rate is attributed to the dynamic stabilization of high-m Rydberg levels that are populated during the pulse. Classical simulations confirm the importance of angular momentum rather than energy transfer.

Ratiometric comparison of intense field ionization of atoms and diatomic molecules

Intense-laser ionization rates for rare gas atoms and diatomic molecules have been precisely compared by making simultaneous measurements of ionization yield vs laser intensity for mixed atomic and molecular targets. At a given laser intensity, the N (2) and F (2) ionization yields are slightly greater than that of Ar. Conversely, comparison of O (2) and S (2) with Xe indicates significant ionization suppression in these molecules. Recent molecular ionization models that successfully describe ionization suppression in O (2) and its absence in N (2) fail to explain our observations in F (2) and S (2).

Necrobiotic cutaneous T-cell lymphoma

We report 3 patients with granulomatous cutaneous T-cell lymphoma (CTCL) who showed necrobiosis histologically with palisading granulomas. Although granulomatous change may be present in up to 4% of cases of CTCL, necrobiosis is rare. Misdiagnosis may occur if epidermotropism is minimal or if atypical cells are masked by the granulomatous infiltrate. T-cell receptor gene analysis confirmed the presence of clonal T-cell populations in lesional skin from all 3 cases.

Retrospective study of late febrile seizures

This retrospective study documents the clinical features, electroencephalographic data, and outcome of 50 children with a history of seizures with fever that occurred after 5 years of age. Children with afebrile seizures before the onset of febrile seizures were excluded. Outcome was based on a cross-sectional survey and the follow-up period was 1-13 years. Of the 50 children, 40 had two or fewer febrile seizures after 5 years of age, and febrile seizures did not occur after 10 years of age. Twenty had complex febrile seizures, and 16 had a first-degree relative with febrile seizures. Five developed afebrile seizures, and 18 had educational difficulties. Epileptiform electroencephalographic abnormalities were observed in 22 but were not predictive of later afebrile seizures. Febrile seizures that occur after 5 years of age recur infrequently and cease by 10 years of age. The risk of developing afebrile seizures in this group is small.

Corticotropin-releasing factor induces phosphorylation of phospholipase C-gamma at tyrosine residues via its receptor 2beta in human epidermoid A-431 cells

This laboratory previously reported that corticotropin-releasing factor (CRF) increased intracellular free calcium concentrations, cellular cAMP, inositol 1,4,5-trisphosphate, protein kinase C activity, and protein phosphorylation in human A-431 cells. The increase was blocked by CRF receptor antagonist. In this study, we identified the type of CRF receptors present and investigated whether CRF induced tyrosine phosphorylation of phospholipase C-gamma via CRF receptors. Using novel primers in reverse transcriptase-polymerase chain reaction, we determined the CRF receptor type to be that of 2beta. The levels of the CRF receptor type 2beta were not altered in cells treated with activators of protein kinase C, Ca2+ ionophore, or cells overexpressing heat shock protein 70 kDa. Cells treated with CRF displayed increases in protein tyrosine phosphorylation approximately at 150 kDa as detected by immunoblotting using an antibody against phosphotyrosine. Immunoprecipitation with antibodies directed against phospholipase C-beta3, -gamma1, or -gamma2 isoforms (which have molecular weights around 150 kDa) followed by Western blotting using an anti-phosphotyrosine antibody showed that only phospholipase C-gamma1 and -gamma2 were phosphorylated. The increase in phospholipase C-gamma phosphorylation was concentration-dependent with an EC50 of 4.2+/-0.1 pM. The maximal phosphorylation by CRF at 1 nM occurred by 5 min. The CRF-induced phosphorylation was inhibited by the protein tyrosine kinase inhibitors genistein and herbimycin A, suggesting that CRF activates protein tyrosine kinases. Treatment of cells with CRF receptor antagonist, but not pertussis toxin, prior to treatment with CRF inhibited the CRF-induced phosphorylation, suggesting it is mediated by the CRF receptor type 2beta that is not coupled to pertussis toxin-sensitive G-proteins. Treatment with 1,2-bis(2iminophenoxy)ethane-N,N,N',N'-tetraacetic acid attenuated the phospholipase C-gamma phosphorylation. In summary, CRF induces phospholipase C-gamma phosphorylation at tyrosine residues, which depends on Ca2+ and is mediated by activation of protein tyrosine kinases via the CRF receptor type 2beta.

HHV8 and Kaposi's sarcoma: a time cohort study

AIMS

The recent finding that human herpes virus 8 (HHV8) is found in the majority of Kaposi's sarcoma (KS) cases supports the epidemiological observation that the tumour may be caused by an infectious agent. This study aimed to address when and how HHV8 evolved.

METHODS

A cohort of African endemic KS (49 samples from 45 patients) and European KS (18 samples from 13 patients), spanning 27 years, was assessed for the presence of HHV8 by both standard solution phase polymerase chain reaction (PCR) and the newly described technique of TaqMan PCR.

RESULTS

HHV8 was present in approximately 49% (24 of 49 tissue samples) of the African cases and in more than 90% (16 of 18 tissue samples) of the European cohort, in keeping with recent seroepidemiological data.

CONCLUSIONS

HHV8 is strongly linked to the development of KS; however, in some patients, other factors may operate. The utility and flexibility of TaqMan PCR in detecting low copy viral target in human tissues was demonstrated.

Diagnostic accuracy and appropriateness of general practitioner referrals to a dermatology out-patient clinic

A study was undertaken of new referrals by GPs to a dermatology clinic in a district general hospital over a 6-month period. Six hundred and eighty-six consecutive referrals to one consultant were analysed for diagnostic accuracy and requirement for referral. Only 47% of referral letters contained the correct diagnosis. Viral warts and psoriasis were best diagnosed (82 and 78%, respectively), but seborrhoeic warts and dermatofibromas caused difficulty (22 and 19%, respectively). Cutaneous malignancy was correctly diagnosed in 45% of referrals, and eczema, the commonest condition referred, in 54% of cases. Sixty-eight percent of referrals required hospital-based facilities for diagnosis (31%) or treatment/management (37%). Twenty-one per cent of patients referred attended for once-only visits, requiring no specialized diagnostic or therapeutic procedures. Such referrals should decrease with improved GP education. Eleven percent of referrals were for minor surgical procedures such as curettage, shave biopsy, or cryotherapy and would become unnecessary if such facilities were available in the community. Our data demonstrate the potential for management of up to one-third of current dermatological referrals within the community by improving education of GPs and providing appropriate facilities within the community. However, over two-thirds of patients required hospital facilities, a finding of considerable relevance to the future location of dermatological services.

An immunocytochemical assessment of 19 cases of cutaneous angiosarcoma

Four endothelial cell markers, two selective cytokeratin markers and a monoclonal smooth muscle antibody (SMA) were employed in the assessment of 19 cases of cutaneous angiosarcoma classified according to their degree of tumour differentiation. No labelling was seen for SMA or with cytokeratin markers MNF116 and CBL170. Expression of factor VIII-related antigen was seen in two tumours and positivity for CD34 (QBend 10 antibody) was found in four tumours. By contrast the pan-endothelial cell marker Ulex europeaus agglutinin 1 (UEA-1) and the CD31 marker JC70A labelled all cases of cutaneous angiosarcoma with the exception of one poorly differentiated tumour. These data confirm the endothelial cell origin of angiosarcoma, they demonstrate that CD31 and UEA1 are reliable markers in routinely processed tissue, and they suggest a lymphatic derivation for the tumour. This finding is in marked contrast to Kaposi's sarcoma where CD34 is the most reliable marker.

Ofuji's disease with unusual histological features

A 20-year-old lady presented with a 3-month history of an itchy eruption affecting her face and trunk. Erythematous annular plaques with follicular papules and pustules at the margins were present on her face consistent with Ofuji's disease. A perifollicular and perivascular eosinophil-rich infiltrate was seen histologically, with infiltration of the follicular epithelium by eosinophils and formation of eosinophilic microabscesses. An unusual feature was the presence of follicular mucinosis. Treatment with dapsone resulted in an improvement in the eruption after 2 weeks. Ofuji's eosinophilic pustular folliculitis is becoming increasingly frequently recognized, and may not be as rare as initial reports suggested. In 1965, Ise and Ofuji reported the case of a Japanese woman who had recurrent episodes of follicular pustules affecting her face and back accompanied by a peripheral eosinophilia. Following this, in 1970 Ofuji et al. reported three further cases and proposed the name eosinophilic pustular folliculitis. Although many of the early cases were in Japanese patients, reports of this disease affecting individuals from Europe and the United States have been increasing.

Distribution of airborne mouse allergen in a major mouse breeding facility

BACKGROUND

Occupational allergy to mice is a major cause of disability among workers in mouse breeding and research facilities. Efforts to prevent and treat allergy require a detailed knowledge of exposure levels to allergen.

OBJECTIVE

This study was designed to quantitate the level of major mouse allergen (Mus m I) in central room air and immediate breathing zones under a variety of working conditions.

METHODS

An Andersen sampler (Groseby Andersen, Spirotech Div., Atlanta, Ga.) was used to collect allergen in each room. A Gillian Personal sampler (Gillian Instrument Corp., West Caldwell, N.J.) collected particles in the worker breathing zone. ELISA was used to quantitate the concentration of Mus m I collected on the two collection devices.

RESULTS

Total Mus m I recovered from Andersen samplers ranged from 0.2 to 1.5 ng/m3 in rooms without mice and 0.5 to 15.1 ng/m3 in rooms with mice. Allergen recovered from the zone of worker activity ranged from 1.2 to 2.7 ng/m3 in rooms without mice and from 16.6 to 563.0 ng/m3 in rooms with mice. Direct mouse contact was associated with the highest levels of exposure to Mus m I. Analysis revealed the bulk of allergen to be in mid-particle size ranges (3.3 to 10 microns) for mouse-containing rooms and in small particle size range (0.43 to 3.3 microns) for non-mouse-containing rooms, suggesting that small particles were carried along corridors from rooms with mice into non-mouse-containing rooms. Ventilation characteristics of rooms and mouse population density were evaluated with a "mouse loading" index (number of mice per cubic meter of ventilated air per hour). Mouse loading correlated strongly with small particles (< 3.3 microns) in ambient air.

CONCLUSIONS

Mus m I is widely distributed within mouse breeding facilities. Direct worker contact with mice seems to be the major factor in high level exposure.

Tufted haemangioma responding to high-dose systemic steroids: a case report and review of the literature

Tufted haemangioma is a rare, acquired vascular tumour most commonly presenting in the first year of life. Some authors consider angioblastoma of Nakagawa and progressive capillary haemangioma to be the same condition, and include them in the lobular capillary haemangioma complex. There have been only a few case reports of tufted angioma in the literature, with little information on effective treatment. We describe a case of tufted angioma presenting in a 3-month-old girl. Because of the tumour's rapid growth, aggressive treatment was felt to be justified. There was no response to interferon alpha-2a but high-dose steroids were commenced with good results.

Comparison of cell adhesion molecule expression in cutaneous leucocytoclastic and lymphocytic vasculitis

AIMS

To compare the expression of the cell adhesion molecules intercellular adhesion molecule-1 (ICAM-1), ELAM-1 (E-selectin), and vascular cell adhesion molecule-1 (VCAM-1) in cutaneous leucocytoclastic and lymphocytic vasculitis.

METHODS

Immunohistochemical analysis was performed on early lesional skin biopsy specimens of leucocytoclastic vasculitis (n = 14), lymphocytic vasculitis (n = 10), non-lesional skin (n = 12), and normal skin (n = 5). A standard immunoperoxidase technique was used to detect expression of ICAM-1, E-selectin, VCAM-1, and the cell markers CD11a, CD11b, CD11c, von Willebrand factor, CD3, CD68, and neutrophil elastase (NP57).

RESULTS

Basal keratinocyte intercellular adhesion molecule-1 was expressed in eight (80%) cases of lymphocytic and in only one (7%) case of leucocytoclastic vasculitis, and not in non-lesional skin or control biopsy specimens from normal subjects. E-selectin was expressed on vascular endothelium in eight (57%) cases of leucocytoclastic and in seven (70%) cases of lymphocytic vasculitis. Endothelial vascular cell adhesion molecule-1 expression was seen in three (21%) biopsy specimens of leucocytoclastic and five (50%) of lymphocytic vasculitis. There were increased numbers of cells in the dermal infiltrate stained for NP57, CD11b, and CD11c in leucocytoclastic compared with lymphocytic vasculitis (p < 0.001, p = 0.013, p = 0.009, respectively); immunoreactive positive cells for CD3 and CD11a were increased in lymphocytic compared with leucocytoclastic vasculitis (p < 0.001, p = 0.011, respectively).

CONCLUSIONS

These observations indicate that upregulation of adhesion molecule expression occurs in both leucocytoclastic and lymphocytic vasculitis. The different patterns of adhesion molecule expression in the two groups of vasculitis may reflect differences in the local release of cytokines. In particular, detection of intercellular adhesion molecule-1 expression by keratinocytes in lymphocytic vasculitis is consistent with an active role for mediators derived from T lymphocytes in the pathogenesis of the lesion.

Angioimmunoblastic lymphadenopathy with dysproteinemia and dermal T-cell lymphoma

BACKGROUND

T-cell receptor (TCR)-gamma gene rearrangements provide a specific clonal marker for T-cell malignancies of both the alpha beta and gamma delta varieties. A polymerase chain reaction (PCR)-based method was used in this study for investigation of clonal TCR-gamma gene rearrangements in a patient with a classical presentation of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) that subsequently progressed into an indolent form of dermal T-cell lymphoma.

METHODS

TCR gene rearrangements in patients with cutaneous T-cell lymphoma (CTCL) were examined using conventional Southern blot analysis and a newly developed PCR-based technique for clonal TCR gene rearrangements. The oligoprimers amplified rearranged V gamma and J gamma segments (including the N region) of the TCR-gamma gene, and PCR products were resolved using high resolution nondenaturing polyacrylamide gel electrophoresis.

RESULTS

The authors' results demonstrated good correlation between the two techniques in 10 patients with CTCL (9 patients with C beta and 1 patient with delta 2 rearrangements) and 10 control subjects. The PCR-based technique allowed the authors to detect the presence of an identical T-cell clone in all skin nodules, but not in the original lymph node affected by AILD.

CONCLUSIONS

This PCR-based method for detecting clonal TCR rearrangements is a highly sensitive and specific technique for detecting T-cell clones in fresh and paraffin embedded tissues. The presence of a T-cell clone in all skin nodules of this patient, but not in the original lymph node affected by AILD, confirms previous findings that in some cases of AILD, clonal T-cell expansion may not be detectable until a later stage of the disease.

A trial of oral zinc supplementation in psoriasis

A controlled double-blind study of oral zinc supplementation was performed in twenty-five patients with chronic plaque psoriasis over twelve weeks to assess changes in both psoriasis (using the psoriasis area and severity index) and neutrophil zinc content. There were no statistically significant differences in the psoriasis area and severity index during the trial between the placebo- and zinc-treated group, nor in the zinc levels. There was therefore no evidence of a benefit from zinc supplementation in patients with this disease.