The type III restriction endonuclease EcoP15I was used in isolating fragments of 26 bp from defined positions of cDNAs. We call this substantially improved variant to the conventional serial analysis of gene expression (SAGE) procedure ''SuperSAGE.'' By applying Super-SAGE to Magnaporthe grisea (blast)-infected rice leaves, gene expression profiles of both the rice host and blast fungus were simultaneously monitored by making use of the fully sequenced genomes of both organisms, revealing that the hydrophobin gene is the most actively transcribed M. grisea gene in blast-infected rice leaves. Moreover, SuperSAGE was applied to study gene expression changes before the so-called hypersensitive response in INF1 elicitor-treated Nicotiana benthamiana, a ''nonmodel'' organism for which no DNA database is available. Again, SuperSAGE allowed rapid identification of genes up-or down-regulated by the elicitor. Surprisingly, many of the down-regulated genes coded for proteins involved in photosynthesis. SuperSAGE will be especially useful for transcriptome profiling of two or more interacting organisms like hosts and pathogens, and of organisms, for which no DNA database is available.

One-hundred-and-thirteen patients with cancer of the urinary bladder (cases) were examined with respect to the frequency of null genotypes of the polymorphic glutathione S-transferases GSTM1 and GSTT1. The allelic background in the German population of the area was evaluated by analysing 170 newborns (controls). The frequency of GSTM1 and GSTT1 null genotypes in this population, using methods based upon internal standard controlled polymerase chain reaction (PCR), was 0.54 and 0.18 respectively. An elevated relative bladder cancer risk of GSTM1 null genotype carriers was indicated by comparison of this background with the data of the bladder cancer cases (OR = 1.81; 95% CI [1.10, 2.98]; p = 0.019). The frequencies of the GSTT1 null genotype in the total group of bladder cancer cases versus controls did not differ statistically. However, a significantly higher relative risk of bladder cancer for the GSTT1 null genotype was detected in the cases-subgroup of non-smokers (OR = 3.84; 95% CI [1.21, 12.23]; p = 0.023). Thus, the GSTT1 null genotype might represent a minor risk factor for human bladder cancer which should be further investigated.

With great interest, we read the report by Skapek et al 1 in the September 1998 issue of the Journal of Clinical Oncology. This report detailed 10 cases of recurrent desmoid tumor in children treated with combination therapy of vinblastine and methotrexate. We report five additional cases successfully treated with a regimen similar to that of Skapek et al. Currently, none of our patients has evidence of regrowth of their tumor 7 to 76 months after elective cessation of chemotherapy.Between 1990 and 1997, five boys aged 7 to 17 years with biopsy-proven desmoid tumors were referred to us because the tumors were not amenable to surgical resection or because amputation was considered after multiple courses of surgery had failed. Although desmoid tumors do not show neoplastic features in histologic sections, the use of high-dose radiotherapy or aggressive polychemotherapy vinblastine [VBL], dactinomycin, and cyclophosphamide 2 is commonly advocated in these situations. Similar to Skapek et al, concerns about the toxicity profile and quality of life associated with these types of therapy, especially in prepubertal children, led us to a low-dose chemotherapeutic regimen of VBL and methotrexate (MTX), as previously reported in eight adults. 3 The apparent advantage of this regimen is the minimal risk for acute and long-term toxicities. We administered both VBL (6 mg/m 2 ) and MTX (30 mg/m 2 ) by intravenous push once a week. The total duration of treatment was 12 months, provided that the mass did not grow during that interval. Two patients experienced complete responses, one patient had a partial response, one patient had a minor response, and one patient had stable disease (Table 1). Follow-up after completion of therapy was 7 to 76 months. Tumor regression after VBL/MTX was slow (2 to 6 months) and was preceded by softening of the tumor, first notable after several weeks of treatment. These observations are consistent with the slow growth of the tumor; therefore, the presence of persistent disease immediately after VBL/MTX should not be misconstrued as an indicator of treatment failure. Side effects, including nausea, vomiting, and moderate hair loss, were minor and never required dosage reduction. Tumor recurrence observed in one patient (patient no. 4) was successfully re-treated with another course of VBL/MTX, and complete remission was achieved after 4 weeks.On the basis of our observations and those of Skapek et al, we agree that low-dose VBL/MTX should be considered in children with unresectable or multiply recurrent desmoid tumor who would otherwise require ablative surgery. At present, we do not know how many children will experience definitive cure with low-dose VBL/MTX chemotherapy. However, remission occurs for prolonged periods of time, and even recurrence can be successfully re-treated. In any event, the VBL/MTX combination offers the chance, as pointed out by Skapek et al, to treat young patients with minimal morbidity until they complete puberty. If recurrence occurs at that time, radiation can be expe...

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Perilesional sclerotherapy with foam is a safe and efficient therapy for patients with chronic venous leg ulcers even with postthrombotic syndrome and/ or ongoing anticoagulation.

BackgroundIt would be a benefit if time-saving, non-invasive methods could give hints for diagnosing systemic sclerosis. To investigate the skin of patients with systemic sclerosis using confocal laser scanning microscopy in vivo and to develop histometric parameters to describe characteristic cutaneous changes of systemic sclerosis observed by this new technique, we conducted an exploratory study.Materials and MethodsFifteen patients with systemic sclerosis treated with extracorporal photopheresis were compared with 15 healthy volunteers and 10 patients with other disorders also treated with extracorporal photopheresis. All subjects were investigated using confocal laser scanning microscopy in vivo.ResultsMicromorphologic characteristics of skin of patients with systemic sclerosis and measuring parameters for melanisation, epidermal hypotrophy, and fibrosis for dislocation of capillaries by collagen deposits in the papillary dermis were evaluated. An interesting finding was an increased thickness of the tissue in the dermal papillae superior to the first dermal papilla vessel. It was also possible to reproduce characteristic histologic features by confocal laser scanning microscopy in vivo. Histometric parameters for fibrosis and vascular features developed in this study showed significant differences in patients with systemic sclerosis compared to controls.ConclusionsAlthough the predominant histopathological features in systemic sclerosis are findings of the reticular dermis and the subcutis, and in histopathological investigation the epidermis seems to remain unaffected by the disease, we have demonstrate some characteristic differences in the epidermis and papillary dermis by confocal laser scanning microscopy in vivo. Some of them have not been described so far. However, to use this technique as a tool for diagnosis and/or staging of systemic sclerosis, further studies are needed investigating the sensitivity and specificity of the histometric parameters developed in this study.

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In childhood acute liver failure, treatment with single-pass albumin dialysis was generally well tolerated and seems to be effective in detoxification and in improving blood pressure, thus stabilizing the critical condition of children before liver transplantation and facilitating bridging to liver transplantation. It may be beneficial in avoiding severe neurologic sequelae after acute liver failure and thereby improve survival. Single-pass albumin dialysis is an inexpensive albumin-based detoxification system that is easy to set up and requires little training. Whether and to what extent single-pass albumin dialysis can support children with acute liver failure until native liver recovery remains unclear.