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The recent experimental observations of designer Dirac fermions and topological phases in molecular graphene are addressed theoretically. Using scattering theory, we calculate the electronic structure of finite lattices of scattering centers dual to the honeycomb lattice. In good agreement with experimental observations, we obtain a V-shaped electron density of states around the Fermi energy. By varying the lattice parameter we simulate electron and hole doping of the structure, and by adding and removing scattering centers we simulate, respectively, vacancy and impurity defects. Specifically, for the vacancy defect we verify the emergence of a sharp resonance near the Fermi energy for increasing strength of the scattering potential. [ABSTRACT FROM AUTHOR]

A method is presented for the simultaneous assay of buccal enzymes by measuring reduced nicotinamide adenine dinucleotide and adenosine triphosphate with the aid of the bioluminescence of luciferase extracts. The activity of glucose-6-phosphate dehydrogenase (G6PDH) was shown earlier to he increased in homogeneous leukoplakias of the oral mucosa. Since smoking has been implicated as an etiologic factor of leukoplakia, G6PDH was measured in the normal buccal epithelium of cigarette smokers. No difference was found in the activity of G6PDH between smokers and nonsmokers when related to the activity of pyruvate kinase, which is known to be invariable in healthy and leukoplakic oral mucosa. A new compact kinetic luminescence analyzer is briefly described. [ABSTRACT FROM AUTHOR]

Three rapid methods for the detection of Chlamydia trachomatis were compared: one immunofluorescence test and two enzyme immunoassays. Cervical and urethral specimens were obtained from 75 women in an outpatient clinic for therapeutic abortions and from 50 women in a sexually transmitted disease clinic. Urethral specimens were also obtained from 154 men in the same clinic. One hundred and nineteen cervical and 272 urethral specimens of a total 391 specimens were tested by the three methods. The direct immunofluorescence test detected Chlamydia trachomatis in 8 % and the two enzyme immunoassays in 10 % and 12 % of the patients. The sensitivity of the immunofluorescence test was 76 % compared to 91 % and 80 % for the two enzyme immunoassay tests. All three tests had a specificity of 99 %. Dilution experiments confirmed that one immunoassay test, Chlamydiazyme, detected most of the positive specimens. The rapid and easily automated enzyme immunoassays are a valuable complement to the culture technique. [ABSTRACT FROM AUTHOR]

Phenylethanolamine N-methyltransferase (PNMT)-like immunoreactivity has been found in psoriatic skin and in this study, PNMT-like immunoreactivity was investigated in the involved and uninvolved skin of six patients with lichen planus and four patients with lichen simplex. No PNMT immunoreactivity was observed in these diseases. Studies were carried out using cultured fibroblasts from two patients with psoriasis from uninvolved and involved areas of skin and from two controls using antibodies to PNMT, as well as antibodies to the chemical messengers somatostatin, substance P, parathyroid hormone and peptide histidine isoleucine amide. No immunoreactivity to these substances was found, and fibroblasts are unlikely to be the cellular origin of the PNMT-like immunoreactivity as seen in psoriatic skin. [ABSTRACT FROM AUTHOR]

A new polymorphism of the complement factor C3 in human plasma was demonstrated by isotachophoresis in agarose gels followed by immunodetection with rabbit anti-human C3c and C3d immunoglobulins. Four bands were detected in the immunoprint of freshly drawn EDTA-plasma, which were C3s1, C3s2, C3f1 and C3f2. At least four additional C3b1 components in Mg2+-zymosan activated plasma were present, which were C3b1 to C3b4. The different forms of C3 in frozen and thawed heparin-plasma from 20 patients with psoriasis and 20 healthy individuals were studied from the immunoprint. The total content of C3 components was 29% greater in the patients with psoriasis than controls. The major difference was in the C3b components which were increased by 46%. In psoriatic patients, the two slow C3 components C3s1 and C3s2 were increased by 24 and 56% respectively, when compared with controls. The two fast C3 components C3f1 and C3f2 were decreased to 29 and 37%. The results suggest a direct involvement of the complement factor C3 in psoriasis. [ABSTRACT FROM AUTHOR]

We explore the limitations and validity of semiclassically formulated spin equations of motion. Using a single-molecule magnet as a test model, we employ three qualitatively different approximation schemes. From a microscopic model, we derive a generalized spin equation of motion in which the parameters have a nonlocal time dependence. This dynamical equation is simplified to the Landau-Lifshitz-Gilbert equation with (i) time-dependent and (ii) time-independent parameters. We show that transient dynamics is essentially nonexisting in the latter approximation, while the former breaks down in the regime of strong coupling between the spin and the itinerant electrons. [ABSTRACT FROM AUTHOR]

In single-molecule magnets, the exchange between a localized spin moment and the electronic background provides a suitable laboratory for studies of dynamical aspects of both local spin and transport properties. Here we address the time evolution of a localized spin moment coupled to an electronic level in a molecular quantum dot embedded in a tunnel junction between metallic leads. The interactions between the localized spin moment and the electronic level generate an effective interaction between the spin moment at different instances in time. Therefore, we show that, despite being a single-spin system, there are effective contributions of isotropic Heisenberg and anisotropic Ising and Dzyaloshinski-Moriya character acting on the spin moment. The interactions can be controlled by gate voltage, voltage bias, the spin polarization in the leads, in addition to external magnetic fields. Signatures of the spin dynamics are found in the transport properties of the tunneling system, and we demonstrate that measurements of the spin current may be used for readout of the local spin moment orientation. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic fractures, encompassing a spectrum from minor to life-threatening injuries, pose challenges in trauma management. This study focuses on short-term outcomes, exploring morbidity and mortality within 30 days postoperative, among pelvic fracture patients at a tertiary care hospital in Karachi, Pakistan. The majority of pelvic injuries result from intense blunt trauma, with associated risks of concomitant injuries. Pelvic fractures are linked to early complications such as hemorrhage, thromboembolism, and infections, influencing mortality rates., Methodology: A prospective cohort study involving 53 surgically managed pelvic fracture patients was conducted at Aga Khan University Hospital, Karachi. Variables such as age, gender, comorbidities, mechanism of injury, associated injuries, and presenting vitals were documented. Thirty-day morbidity included surgical site infections, hemorrhagic shock, nerve injuries, and others. Statistical analyses assessed associations between patient characteristics and morbidity., Results: The study revealed a median age of 37 years, with 77% male patients. Most fractures result from motor vehicle accidents. Morbidity occurred in 31.6% of cases, primarily associated with the presence of associated injuries. Postoperative complications included neurological deficits (15.1%) and pulmonary complications (9.4%). No 30-day mortality was reported., Discussion: The study highlights the importance of a multidisciplinary approach in managing pelvic fractures, emphasizing the association between associated injuries and postoperative morbidity. Comorbidities did not significantly impact morbidity, emphasizing the traumatic nature's independent contribution. Timely presentation (median 20 hours) and efficient trauma systems are crucial for optimal outcomes., Conclusion: This research contributes insights into short-term outcomes following pelvic fracture fixation in a Pakistani tertiary care setting. By exploring a range of parameters, the study emphasizes the need for comprehensive management strategies to minimize complications and improve patient outcomes. Bridging critical knowledge gaps, this research informs clinical decision-making for pelvic fracture patients in this region., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Review Committee, AKUH issued approval 2022-0525-22307. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Shahid et al.)

The genome of the soil Bacteroidota Chitinophaga pinensis encodes a large number of glycoside hydrolases (GHs) with noteworthy features and potentially novel functions. Several are predicted to be active on polysaccharide components of fungal and oomycete cell walls, such as chitin, β-1,3-glucan and β-1,6-glucan. While several fungal β-1,6-glucanase enzymes are known, relatively few bacterial examples have been characterised to date. We have previously demonstrated that C. pinensis shows strong growth using β-1,6-glucan as the sole carbon source, with the efficient release of oligosaccharides from the polymer. We here characterise the capacity of the C. pinensis secretome to hydrolyse the β-1,6-glucan pustulan and describe three distinct enzymes encoded by its genome, all of which show different levels of β-1,6-glucanase activity and which are classified into different GH families. Our data show that C. pinensis has multiple tools to deconstruct pustulan, allowing the species' broad utility of this substrate, with potential implications for bacterial biocontrol of pathogens via cell wall disruption. Oligosaccharides derived from fungal β-1,6-glucans are valuable in biomedical research and drug synthesis, and these enzymes could be useful tools for releasing such molecules from microbial biomass, an underexploited source of complex carbohydrates., (© 2023 The Authors. The FEBS Journal published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies.)

We address the electronically induced anisotropy field acting on a spin moment in a vibrating magnetic molecule located in the junction between ferromagnetic metals. Under weak coupling between the electrons and molecular vibrations, the nature of the anisotropy can be changed from favoring a high spin (easy-axis) magnetic moment to a low spin (easy plane) by applying a temperature difference or a voltage bias across the junction. For unequal spin polarizations in ferromagnetic metals, it is shown that the character of the anisotropy is essentially determined by the properties of the weaker ferromagnet. By increasing the temperature in this metal or introducing a voltage bias, its influence can be suppressed such that the dominant contribution to the anisotropy is interchanged to the stronger ferromagnet. With increasing coupling strength between the molecular vibrations and the electrons, the nature of the anisotropy is locked into favoring easy-plane magnetism., Competing Interests: The authors declare no competing financial interest.

Molecular spintronics is made possible by the coupling between electronic configuration and magnetic polarization of the molecules. For control and application of the individual molecular states, it is necessary to both read and write their spin states. Conventionally, this is achieved by means of external magnetic fields or ferromagnetic contacts, which may change the intentional spin state and may present additional challenges when downsizing devices. Here, we predict that coupling magnetic molecules together opens up possibilities for all electrical control of both the molecular spin states as well as the current flow through the system. By tuning between the regimes of ferromagnetic and antiferromagnetic exchange interaction, the current can be at least an order of magnitude enhanced or reduced. The effect is susceptible to the tunnel coupling and molecular level alignment that can be used to achieve current rectification.

Background Drug related problems (DRPs) are frequent and cause suffering for patients and substantial costs for society. Multi-dose drug dispensing (MDDD) is a service by which patients receive their medication packed in bags with one unit for each dose occasion. The clinical decision support system (CDSS) electronic expert support (EES) analyses patients' prescriptions in the Swedish national e-prescription repository and provides alerts if potential DRPs are detected, i.e. drug-drug interactions, duplicate therapy, drug-disease contraindications, high dose, gender warnings, geriatric, and paediatric alerts. Objective To analyse potential DRPs in patients with MDDD, detected by means of EES. Setting A register study of all electronically stored prescriptions for patients with MDDD in Sweden (n = 180,059) March 5-June 5, 2013. Method Drug use and potential DRPs detected in the study population during the 3 month study period by EES were analysed. The potential DRPs were analysed in relation to patients' age, gender, number of drugs, and type of medication. Main outcome measure Prevalence of potential DRPs measured as EES alerts. Results The study population was on average 75.8 years of age (± 17.5, range 1-110) and had 10.0 different medications (± 4.7, range 1-53). EES alerted for potential DRPs in 76 % of the population with a mean of 2.2 alerts per patient (± 2.4, range 0-27). The older patients received a lower number of alerts compared to younger patients despite having a higher number of drugs. The most frequent alert categories were drug-drug interactions (37 % of all alerts), duplicate therapy (30 %), and geriatric warnings for high dose or inappropriate drugs (23 %). Psycholeptics, psychoanaleptics, antithrombotic agents, anti-epileptics, renin-angiotensin system agents, and analgesics represented 71 % of all drugs involved in alerts. Conclusions EES detected potential DRPs in the majority of patients with MDDD. The number of potential DRPs was associated with the number of drugs, age, gender, and type of medication. A CDSS such as EES might be a useful tool for physicians and pharmacists to assist in the important task of monitoring patients with MDDD for potential DRPs.

We investigate the effectiveness of different smoking policies on smokers' expectations to quit smoking using a choice experiment on a sample of smokers identified within the World Health Organization (WHO) MONICA Project. Our results indicate that restricted availability, increased cigarette prices, cessation subsidies and regulations at restaurants, bars and cafes increase the expected probability of smoking cessation. Regulations at work places do not seem to have any effect. The results also show the significant role of limited self-control; smokers who have the intent to quit smoking are more likely to quit smoking if a stricter regulation is implemented. Further, smokers who have received advice from their children to quit smoking or who perceive the health risks as considerable, are more likely to expect to quit smoking.

In this paper business owner expectations regarding revenue changes due to a general smoking ban are analyzed using a survey mailed out to all restaurants, bars, cafés and nightclubs in Gothenburg, Sweden. A reasonable interpretation of the survey responses is that as many as 74% of the establishments do not expect to be severely hurt by a general smoking ban applying to the entire restaurant sector. The econometric results show that the owners are more likely to expect a decrease in revenues the larger their share of smoking customers. Moreover, establishments that are smoke-free are less likely to expect negative economic effects compared to those that currently allow smoking. Also, establishments with a non-smoking section are less likely to expect negative economic effects from a general smoking ban. No strong effect of the type of establishment (café, bar, or restaurant) on expected changes in revenues is detected, although establishments with late night hours are more likely to expect financial losses.

The health risk of smoking is valued using the contingent valuation method, applied to a Swedish sample of smokers. The respondents were asked to put a value on newly developed cigarettes with no associated health risks. The average additional willingness to pay for the new cigarettes is estimated to be between 10 and 41 SEK per pack, where the variation is due to statistical method, discounting, and whether the open-ended or closed-ended question format is used. Using medical data on life shortening effects of smoking, the results indicate rather low values put on a lost life-year, compared to most existing estimates based on other methods. This may indicate that smokers do underestimate the health risk of smoking. There is also initial optimism-bias regarding people's own ability to quit smoking at will. However, there are remaining methodological questions and we found little or no sensitivity to scope., (Copyright 2003 John Wiley & Sons, Ltd.)

Epidermal-dermal interactions were studied in a skin equivalent model. Six combinations of keratinocytes and fibroblasts from healthy and psoriatic skin were used. TPA (12-O-tetradecanoylphorbol-13-acetate) was used to determine whether the expression of the IFN-gamma receptors in keratinocytes was related to epidermal differentiation and proliferation. These phenomena were assessed by immunohistochemistry. In all epidermal outgrowths, the epidermal growth factor receptor was expressed throughout the epidermis, cytokeratin 16 suprabasally, and filaggrin and involucrin in its superficial part. The IFN-gamma receptor was expressed throughout the epidermis, but was unevenly distributed. The expression of the IFN-gamma receptor was quantified by confocal laser scanning microscopy both in the whole of epidermis and in areas with the strongest intensity. The total amount varied to a minor degree in the epidermal outgrowths of different origins and was unaffected by TPA. In high-intensity areas interactions between keratinocytes and fibroblasts did influence the amount of IFN-gamma receptor expression and TPA decreased the expression by 13%. There was no correlation between the proliferation rate and the expression of the IFN-gamma receptor. Psoriatic and healthy keratinocytes were equally well differentiated in the skin equivalents. The interferon-gamma receptor was similarly expressed under these conditions. The growth rate, assessed by Ki-67-positive nuclei in the basal layer, was highest in healthy keratinocytes. Keratinocytes from psoriatic lesions increased their growth rate when cocultured with psoriatic fibroblasts compared with normal ones, indicating that fibroblasts may be of importance for epidermal hyperproliferation in psoriatic lesions.

Psoriatic keratinocytes have a reduced antiproliferative response to interferon (IFN)-gamma, and HLA-DR expression is usually not observed on keratinocytes in psoriatic plaques despite the presence of activated T cells. We have therefore compared the expression of IFN-gamma receptors in psoriatic skin with that of normal human skin. Using mouse monoclonal antibodies and immunoperoxidase staining on cryostat cut sections, we detected IFN-gamma receptors on keratinocytes throughout the epidermal layers except stratum corneum in normal skin (n = 11). Biopsy specimens from involved psoriatic skin (n = 17) consistently showed a staining pattern that differed from that of normal skin in that only the lower part of epidermis reacted with the antibodies to IFN-gamma receptors, whereas the upper layers showed no or minimal staining. Expression of IFN-gamma receptors in uninvolved psoriatic skin (n = 16) did not differ from that of healthy controls. Forty-five percent of the biopsies from lesional psoriatic skin displayed ICAM-1 positive keratinocytes, and only two specimens had a limited expression of HLA-DR reactive keratinocytes. The decreased binding of antibodies against the IFN-gamma receptors in the upper part of psoriatic epidermis might be secondary to abnormal maturation of psoriatic keratinocytes or a primary defect involving abnormal modulation of IFN-gamma receptors.

Groups A, B, C and G streptococci were cultured from 63 consecutive in-patients recruited between November 1987 and April 1988 and monitored until the end of July 1988. Chronic leg ulcers were present in 34 patients. Group G was found in 34 patients, 25 of whom had pyoderma and 3 had sepsis. Six of the patients had no signs of clinical infection, and treatment with antibiotics was therefore withheld. Recurrent phlegmon or erysipelas developed in 2 of 28 patients with clinical Group G infections. Erysipelas developed some 1-7 months later in 3 of the 6 patients who were not initially treated. No significant difference in severity or additional medical conditions was found between the patients with either Group G or Group A streptococci. In comparison, data on all streptococcal cultures at the Department indicated that Group G was isolated 2.6 times as often as Group A streptococci for the in-patients, compared with 1.1 for all patients seen. It is concluded that Group G streptococcal skin infections must be regarded with the same clinical vigilance as Group A infections.

Phenylethanolamine N-methyltransferase (PNMT)-like immunoreactivity has been found in psoriatic skin and in this study, PNMT-like immunoreactivity was investigated in the involved and uninvolved skin of six patients with lichen planus and four patients with lichen simplex. No PNMT immunoreactivity was observed in these diseases. Studies were carried out using cultured fibroblasts from two patients with psoriasis from uninvolved and involved areas of skin and from two controls using antibodies to PNMT, as well as antibodies to the chemical messengers somatostatin, substance P, parathyroid hormone and peptide histidine isoleucine amide. No immunoreactivity to these substances was found, and fibroblasts are unlikely to be the cellular origin of the PNMT-like immunoreactivity as seen in psoriatic skin.

Growth of keratinocytes in explant culture of mouse ear epidermis was studied. The addition of transferrin to the culture media improved growth. Transferrin fractionated from human and fetal calf serum increased outgrowths of the cultures when compared with commercially available transferrin. An acidic transferrin fraction was present in greater amount in human serum and in fetal calf serum than that found in commercial transferrin. This fraction was more abundant in serum from psoriatic patients than in serum of healthy subjects as shown by isotachophoresis. For the culture studies, preparation of this material was done by chromatography on DEAE-Sepharose 6B-CL columns. Further on, diferric transferrin was preferentially used in order to abolish variation due to iron saturation. Iron concentration higher than 5 microM was deleterious to cell growth. The basal culture medium contained transferrin depleted fetal calf serum in RPMI 1640 with 2 microM glutamine and antibiotics. Serum-free medium was used in some experiments. The additions were 1.7 microM insulin, 1.4 microM hydrocortisone, 10 microM ethanolamine and 10 microM phosphoethanolamine. A partially purified fraction of the acidic forms of transferrin (10-20 micrograms/ml medium) improved outgrowth when compared with a neutral fraction under these circumstances.

The activity of plasminogen activator has been measured in tissue sections with the aid of a modified Todd technique. Frozen skin biopsies were sectioned and the tissue covered with fibrin-plasminogen film. After incubation at 37 degrees C fibrinolysis was studied for a period of 30 min and was graded into six exponentially increasing steps. During this period, grades were linear with the llogarithm of time of incubation. The rate of fibrinolysis is a measure of the activity of the plasminogen activator and is expressed by the slope of the linear regression of grades versus the ogarithm of time; the value of the slope is proportional to the common logarithm of the activity of the plasminogen activator present in the section. Using urokinase as a specific plasminogen activator, the same linear expression was shown with time, indicating the validity of our grading and experimental system. Eleven healthy subjects served as controls to 6 patients with leukocytoclastic vasculitis and 4 patients with erysipelas and 4 with necrotizing fascilitis. The controls showed values similar to the non-involved skin in the patients. The activity was higher in the arm than in the thigh sites. The activity in the thighs was lower in women than in men. A decrease in the plasminogen activator activity was found in the three disorders.

A simple non-radioactive technique is described. The corneal layers were stained with 5% dansyl chloride ointment during 24-48 h of occlusion. The number of newly formed corneal layers were counted on sections from punch biopsies obtained at various intervals after the staining. The rate of formation is given as layers formed per 24 hours. The technique makes it possible to detect an increase in the turnover rate when it is more than 15-32% above normal. The biological material can also be utilized for comparative studies utilizing biochemical and histological methods. The average rate of formation was 1.15+-0.09 (S.E.M.) layers per 24 hours in a group of 10 subjects.

Microscopic lesions in active psoriasis were identified after careful examination with a magnifying glass in areas free of macroscopic lesions and of hair follicles. Biopsies were excised without anesthesia, immediately frozen and cryostat-sectioned. Care was taken to preserve the horny layer which was stained to reveal corneocyte membranes and nuclei when present. The interlocking sheets of corneocyte layers made it feasible to outline and trace intercellular spaces parallel to the surface and count the number of corneocyte layers between pairs of these. It was assumed that the location of such a space in the horny layer indicates the period of time from its formation. This information was used to assess the rate of corneocyte layer formation at specified intervals of time. The result shows that adjacent areas of the horny layer could be compared and relative rates of corneocyte layer formation computed. In the parakeratotic part of the early lesions of psoriasis studied the rate of corneocyte layer formation was 15 times higher than that in the non-involved skin. The peak rate, coincident with parakeratosis, was preceded by a number of thickened corneocyte layers. These also showed an increased rate of formation, up to 6.6 times that in non-involved skin. There was no acanthosis in the lesions studied. A subepidermal cellular infiltrate was observed. Periods of rapid corneocyte formation with parakeratosis were often short (not more than one day). These were interrupted by periods with a lower rate. The relationship between corneocyte morphology and stratum corneum kinetics is a distinct feature in the early psoriatic lesion.

The clinical course of necrotizing fasciitis in 8 patients is compared with observations on 22 other patients with erysipelas. In necrotizing fasciitis the early erythematous areas turn into a dusky blue colour with later vesiculation and formation of bullae. An important finding is a non-pitting oedema extending outside the erythematous patches. The disease often progresses and involves further skin areas proximal to the initial ones. Gangrene tends to follow in multiple sites after the 1st week of illness. Group A streptococci in conjunction with widespread thrombosis and vascular necrosis of the involved skin are two major factors in the pathogenesis of the gangrene. Early debridement and excision of necrotic tissue in combination with large doses of penicillin and cloxacillin are confirmed as mandatory to remove toxaemia and inhibit further necrosis of the skin. In 3 of the 8 patients with necrotizing fasciitis the syndrome of disseminated intravascular coagulation complicated the course of the disease. A promising therapeutic result was seen in 2 further patients exhibiting alarming signs and symptoms of early necrotizing fasciitis; the combination of heparin, given intravenously in therapeutic doses guided by activated partial thromboplastin time studies, and of systemic antibiotics alleviated the symptoms, which vanished within 10 days of the start of treatment.

The age of microscopic lesions in psoriatic subjects was assessed from the stacking characteristics in the horny layer and related to type and density (cells/tissue volume) of mononuclear cells in the epidermis and the dermis determined by immunoperoxidase methods using monoclonal antibodies. Pan T cells (Lyt-2+, Lyt-3+, Leu-4+, OKT3+), T helper cells (Leu-3a+, OKT4+), T suppressor/cytotoxic cells (Leu-2a+, OKT8+), Ia+ cells and monocytes (OKM2+, BRL alpha mono+) were determined in epidermis and dermis. The psoriatic lesion was divided into regions underneath a parakeratotic and an orthohyperkeratotic/hypergranular portion of the horny layer and contrasted with perilesional and uninvolved psoriatic skin as well as with healthy skin. In the various regions and skin layers, the cell density was highest in parakeratosis and decreased toward normality with decreasing histologic abnormality. The relation between epidermal and dermal cell densities of the T-cell subsets was modified in the involved psoriatic skin with a selective preponderance of T suppressor/cytotoxic cells in the epidermis. The accumulation was present in the youngest lesion found (3 days) and cell densities were unchanged in older lesions. The findings suggests that the altered relationship in the subsets of T cells has an important role during the induction and progress of the psoriatic process in the skin.

Sixty-nine patients with mycosis fungoides, plaque stage, were treated in an open study with photochemotherapy (PUVA) or the combination of oral retinoids and PUVA (RePUVA). The response rate of Re-PUVA was equal to that of PUVA, with complete remission in 73% and 72%, respectively. Remissions were obtained with fewer PUVA sessions, and with a lower UVA dosage, if PUVA was combined with retinoids. A lower UVA dosage was needed if treatment was given four times weekly in stead of twice weekly. The duration of the remissions tended to be prolonged if retinoids were given as maintenance therapy.

An open and a double-blind study were undertaken on patients with leg ulcers caused mainly by venous (VI) or arterial incompetence (AI). They were treated with intravenous infusions or injections of prostaglandin E1 (PGE1). Eight of 10 patients in the open study experienced relief of pain and a complete or almost complete healing of their ulcers. In the double-blind study (20 patients) 4 out of 5 patients with a history of leg ulcers due to VI for more than 5 year responded to the PGE1 treatment, compared with one of 5 treated with saline. In the saline group 3 more patients with VI of shorter duration improved. In 3 of 5 patients of PGE1 with ulcers due to AI the original ulcer area was reduced by 78--65% after 70 days, while in the 2 remaining cases healing occurred later on. No effect was noted in the 2 patients with ulcers due to AI who received saline infusions. The results indicate the beneficial effect of PGE1 on pain and healing in leg ulcers caused by peripheral vascular disease.

One hundred and seven psoriatics with palmoplantar involvement were clinically examined. They were selected from 921 patients filed in 1976 with the diagnosis psoriasis. Fifty per cent of the patients with palmoplantar psoriasis had flexural changes. The frequency of palmar involvement in patients with inverse psoriasis compared to patients with psoriasis vulgaris was increased 5.3 times. Pustulosis palmoplantaris (PPP) in addition to psoriasis was diagnosed in 18 patients (17%). A dermatophyte infection was observed in 1 of 48 patients examined for tinea infection. Positive patch tests were obtained in 8 of 47 patients, 7 of whom had more than one test reaction. The result gives no evidence of tinea infection and contact allergy as important factors in maintaining palmoplantar psoriasis.

Ear skin of adult mice was used as a source of explant cultures of epidermal cells and the requirements for growth were defined. Two growth phases were observed, the first more rapid than the second. All-trans-retinoic acid or n-hexadecane was applied topically for up to 9 days and the skin was then used for explant cultures. During both treatments the ear became red and swollen. The epidermis became hyperkeratotic or deprived of its horny layer. The thickness of the stratum Malpighii increased to up to nine layers, from the normal of two or three layers. The stratum granulosum became multilayered and keratohyalin granules were abundant. Explants of n-hexadecane-treated skin behaved exactly as their normal controls. All-trans-retinoic acid included an increase in migratory cell activity during the first growth phase. In the second growth phase the growth rate was similar or lower than that of the controls.

The activity of ICDH(NAD) was measured in subcorneal and basal epidermal layers in 8 patients with psoriasis and in 7 healthy controls treated once a day with 0.15% dithranol in white petrolatum for 2 weeks. Skin biopsies were taken before and on days 2, 6, and 14 of the treatment. Lowry's microtechniques were used in conjunction with a bioluminescent system (bacterial luciferase) for enzymatic assays. The enzymic activity could be related to the type of keratinization present in the stratum corneum overlying the epidermal areas under study. In orthokeratotic areas from the controls, in noninvolved, and in treated involved skin the activity was low. In parakeratotic areas, as found in treated noninvolved and in involved psoriatic skin, the enzymic activity was increased to a level at least twice that found in orthokeratosis. Since ICDH(NAD) activity reflects an aspect of mitochondrial function, the results suggest that mitochondrial activity may be important in control of keratinization.

Necrotizing fasciitis (NF) is a grave infection of the skin leading to gangrene of the integument and often having a complicated and prolonged course. Studies on blood coagulation and fibrinolysis were done in 15 patients with NF and compared with 5 cases of erysipelas (E). In both conditions local fibrin deposition occurred initially in their course, but it was quantitatively more pronounced in NF than in E. Fibrinolysis decreased and stayed low at the site of NF up to 5 months (median) after discharge from hospital. Fibrinogen and activities of several plasma serine proteinases modifying coagulation were increased during the course of both diseases and even at the follow-up. Factor XII was decreased during the first week in E but a transient drop was present in NF only on days 3 and 4. The treatment of NF consists of high doses of appropriate antibiotics instituted early in its course. A beneficial effect of 300-500 IU heparin/kg/day was suggested from this open study. The hard induration preceding the appearance of skin gangrene was inhibited, if heparin was given early in the course of NF. We conclude that the enhanced fibrin deposition and vascular occlusions in the skin are the basis for most complications present in NF.