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Photodynamic therapy (PDT) with topical application of 5-aminolaevulinic acid (ALA, 20% w/w) was used to treat superficial basal cell carcinoma (BCC, 16 patients), Morbus Bowen (one patient), basal cell naevus syndrome (BCNS, three patients), actinic keratosis (AK, two patients), chronic inflammation (CI, one patient), and metastasized BCC (one patient). The interval between ALA application and illumination was 3–6 h. The incident light dose was 50–100 J cm−2, mostly 75 J cm−2, at 633 nm wavelength. This was based on the fluorescence excitation spectrum, measured on the skin of human volunteers. In a few cases, 514.5 nm light was used. A complete response (CR) rate of 79% (median follow-up 13 months) was obtained with 42 BCC lesions. The treatment of five areas with AK, two areas with CI and one area with M. Bowen yielded three CR for AK and five partial remissions (PR). Photodynamic therapy of metastasized BCC, after either topical or oral ALA, was not successful. Treatment of BCNS was satisfactory with 100% CR in one patient (22 lesions), PR in a second patient (20 lesions), and good palliation in a third patient (>250 lesions). The treatment was well tolerated, although the illumination had to be interrupted occasionally due to pain. Healing usually occurred in 2 weeks. Cosmetic results were good to excellent. 5-Aminolaevulinic acid application over 16–19 h and repeated treatments made it possible to obtain CR of non-superficial lesions. The selective tumour fluorescence was then lost, however, due to fluorescence of normal skin, but the cosmetic outcome did not deteriorate. 5-Aminolaevulinic acid PDT may be a good alternative outpatient treatment, especially in elderly patients and for large treatment areas. The excellent cosmetic outcome warrants further study in younger patients. More work is necessary to establish optimal ALA-treatment schemes.

The value of DNA-flow cytometry and clinico-pathological prognostic factors for the prediction of local recurrences after breast-conserving therapy (BCT) were evaluated in a retrospective study. Thirty-one patients with a local recurrence were compared with 31 matched patients without a local recurrence. Morphology and DNA-indices of the local recurrences and their corresponding primary tumours were compared. Ductal carcinoma in situ was present significantly more often in the group with a primary recurring tumour, than in the matched group (P less than 0.001), and the same holds for lobular carcinoma (n = 5). Half of the tumours that recurred had macroscopically positive surgical margins compared to about one-fourth of the matched group. Fifty-six per cent of the DNA-aneuploid stemlines in cases with local recurrence were present in the corresponding primary tumour as well (confidence limits 45%-75%), an indication that the majority of local recurrences are true recurrences and not independently developed tumours. The lack of similarity of DNA stemlines between some primary DNA-aneuploid tumours and their local recurrences indicates that these tumours had developed independently. The percentage of DNA-aneuploid cases in the group with local recurrence (89%) did not differ significantly from that in the matched group (70%). However, the findings suggest a selective recurrence of DNA-diploid stemlines. This might indicate increased resistance of DNA-diploid tumour cells to radiotherapy as compared with the resistance level in DNA-aneuploid cells.

In organized screening programmes for cervical cancer, pre-cancerous lesions are detected by cervical smears. However, during follow-up after a positive smear these pre-cancerous lesions are not always found. The purpose of the study is to analyse positive diagnostic values of smears of at least mild dysplasia, made under the organized screening programmes in the Rotterdam area (1979-1991), and detection ratios of histologically confirmed CIN > or =3, among women participating in these screening programmes.

The occurrence of continuous and obscure pains about the face and head for which the usual methods of relief, both medical and surgical, have as a rule failed has been the subject of considerable investigation since 1920. The patients whose records are here analyzed have run the gantlet of numerous physicians, both local and foreign, 1 patient (who is a physician) having visited 126 physicians in America and on the Continent. Useless and meddlesome surgical procedures have been performed not only on the trigeminal tract but on the nasal sinuses, the abdomen and the pelvis, and there has been wholesale extraction of teeth as well. Peculiarly enough, not only have these operations failed to accomplish their purpose, but in practically all cases the pain has been much worse thereafter.Though many of these patients complain bitterly of pain during the examination, their facies rarely indicate such severity. This is in

Experimental results for the pyroelectric coefficient, Curie temperature, dielectric constant, and loss tangent of (ND2CD2COOD)3D2SO4 were obtained and compared with (ND2CH2COOD)3D2SO4 and (NH2CH2COOH)3H2SO4. It is shown that complete deuteration of TGS does not result in an improved pyroelectric detector material since further substitution of deuterium for hydrogen in the -CH2- radical does not apparently contribute to the spontaneous polarization of deuterated TGS.

We describe a patient with quiet systemic lupus erythematosus who developed a hypereosinophilic syndrome. The patient presented with gastrointestinal eosinophilia which caused diarrhoea, malabsorption and anaemia due to deficiencies of vitamins. The hypereosiniphilic syndrome completely resolved after treatment with prednisone.