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To the Editor: The recent article by Rockson, et al1 presents the results of a phase I trial of photodynamic therapy in patients with peripheral arterial disease. This report seems to be based on preliminary data that do not provide convincing evidence to support its conclusion, ie, that photoangioplasty holds promise as an alternative intervention for flow-limiting atherosclerosis. The lack of a control group and limiting the intervention to a single lesion that is not necessarily a flow-limiting stenosis are especially problematic. Smooth muscle cells constitute no more than 2% to 5% of the volume of the atherosclerotic plaque. Consequently, there is no basis for assuming that the cytotoxic effect of photodynamic therapy would reduce the plaque volume sufficiently to be hemodynamically significant. Even if these cells are killed and lysed, an explanation as to what happened afterward to the major extracellular components of the plaque (cholesterol deposits and fibrous and calcified material) seems necessary and important. Because there are …

In seven new cases of cervical intervertebral-disc calcification of unknown etiology, all but one patient (Case 4) had an acute episode of pain in the neck, limitation of motion, and torticollis. The similarity to calcific tendinitis is suggested. Trauma or infection may initiate the symptomatic episode. Three of our patients also had calcified material in the prevertebral tissues; this did not alter the favorable prognosis. Very rapid regression of the calcification was noted in most of our patients. This syndrome is probably a much more common entity than the few reports in the literature would suggest.