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α-Gal syndrome results from sensitization to the carbohydrate epitope galactose-α-1,3-galactose (α‑gal). The allergen occurs in mammalian meat and innards, but also in other foods and medical products of animal origin. Allergic reactions generally occur delayed after allergen intake with a latency period, depending on the individual tolerance threshold and the influence of cofactors. Details in the patient's medical history can help to establish the suspected diagnosis of α‑gal syndrome. Confirmation of the diagnosis requires the expertise of specialists, experienced with the implementation and interpretation of in vitro and in vivo diagnostic tests. Whereas skin prick testing with commercial whole-meat extracts often does not provide reliable results, allergen-specific IgE (α-gal) is generally detectable in affected patients. Cell-based tests such as the basophil activation test are currently only employed in an experimental setting. To evaluate, whether a sensitization is clinically relevant, an in-patient oral food challenge should be performed, using for example cooked pork or porcine kidney in addition to suspected cofactors.

Teledermoscopy is a promising modern technique to complement or to substitute dermatologic examination.In this pilot study, we compared the outcomes of teledermoscopic consultations with clinical examinations and histologic results.Conventional and dermatoscopic photos of single lesions were taken in 26 patients using a mobile phone and an attached handyscope optical system. Five resident physicians performed a clinical examination including dermoscopy while the teledermatologic and teledermoscopic photos were assessed by an experienced dermatologist. Examination results were compared regarding diagnosis, differential diagnoses, recommended further management, as well as subjective and objective accuracy of diagnosis. In addition, 23% of the lesions were excised and histologically examined.The most frequent diagnosis was "nevus cell nevus", followed by "subungual hematoma" and "basal cell carcinoma". The concordance of diagnoses was 92.3%; the concordance of recommended further management was 76.9%. Of the 6 histologically proven diagnoses, 66.7% were given the same diagnosis by teledermatoscopy and conventional clinical assessment. Concerning accuracy of diagnosis, teledermoscopy showed no disadvantage.Teledermatologic photos of single lesions combined with teledermatoscopic photos can be reliably and safely assessed. Especially when access to dermatologic examination is difficult, mobile teledermoscopy is a good and reliable alternative.

SummaryBackground Plaque psoriasis is an inflammatory disease affecting approximately 2% of the population. The clinical hallmarks of psoriasis are sharply demarcated, erythematous plaques with thick scales. Photochemotherapy (psoralen plus ultraviolet A, PUVA) is one of the most effective therapies of psoriasis. The photosensitizer 8-methoxypsoralen (8-MOP) can be applied either orally (system PUVA) or topically in a warm water bath (bath PUVA). Objectives To compare bath PUVA and system PUVA in the treatment of plaque psoriasis. Methods This was a randomized, open, prospective, multicentre trial. We included 74 patients with moderate-to-severe plaque psoriasis during a 6-week treatment and a 4-week follow-up period. Of the patients enrolled in the study, 38 received bath PUVA and 36 system PUVA. Results Both treatment modalities significantly reduced the median Psoriasis Area and Severity Index (PASI) score in the intention-to-treat population. Within 6 weeks bath PUVA reduced the median PASI by 74% (16·4 to 4·2) while system PUVA did so by 62% (15·3 to 5·8). The difference between the two modalities was not significant with regard to treatment efficacy (P = 0·389). Conclusion There is no difference between bath PUVA and system PUVA in the treatment of psoriasis.

Zellulare In-vitro-Testsysteme zur Soforttypallergie-Diagnostik nutzen den Nachweis von Mediatoren (Histaminfreisetzungstest, Leukotrienfreisetzungstest) oder zellularen Antigenen (Basophilenaktivierungstest) der basophilen Granulozyten nach Allergenstimulation. Sie eignen sich fur patientenbezogene diagnostische Fragestellungen v. a. im Bereich der Insektengiftallergie und bei Nahrungsmittelallergien sowie fur wissenschaftliche Forschungsansatze im Bereich IgE-vermittelter Reaktionen. Im Lymphozytentransformationstest (zellularer Allergenstimulationstest fur Typ-IV-Allergien) werden aus dem peripheren Blut isolierte Lymphozyten und Monozyten in vitro mehrere Tage in Gegenwart von Allergenen kultiviert. Die einsetzende Proliferationsantwort der das Antigen erkennenden Lymphozyten wird als Ausdruck der Sensibilisierung gemessen. Der Lymphozytentransformationstest kann zur Diagnostik bei Arzneimittelreaktionen und Kontaktallergien sowie fur wissenschaftliche Fragestellungen eingesetzt werden.

Whole-body ultraviolet (UV)A1 (340-400 nm) phototherapy was first introduced 30 years ago, but is currently available in the UK in only three dermatology departments. A workshop to discuss UVA1 was held by the British Photodermatology Group in May 2009, the aim of which was to provide an overview of UVA1 phototherapy and its role in practice, and to identify areas in which further studies are required. The conclusions were that UVA1 phototherapy is an effective treatment in several inflammatory skin diseases, including localized scleroderma and atopic eczema (AE); however, deficiencies and limitations exist in the published evidence base. For most diseases, such as AE, other treatments also exist, which are generally more effective than UVA1. However, for some diseases, particularly morphoea, the evidence of efficacy is stronger for UVA1 than for other treatments. Acute adverse effects of UVA1 are minimal. The risk of long-term adverse effects, particularly skin cancer, is unknown. Medium to high doses of UVA1 are needed for efficacy in most situations, but the equipment to deliver such doses is large, expensive and difficult to install. UVA1 is currently underprovided, and the recommendation of the workshop is that more tertiary centres should have access to UVA1 phototherapy in the UK.

Allergien konnen sich am Hautorgan nicht nur mit den unterschiedlichsten Krankheitsbildern manifestieren, auch konnen sie durch unterschiedliche allergische Reaktionstypen ausgelost werden. Der hiermit vorliegende Beitrag beschreibt die pathogenetischen Vorgange und die Klassifikation der zu Grunde liegenden allergischen Reaktionen. Zusatzlich wird die klinische Symptomatik, Diagnostik und Therapie der haufigsten allergisch bedingten Hauterkrankungen von der Urtikaria, dem Ekzem, uber die Purpura bis zum Arzneimittelekzem dargestellt.

Dissociation of a 240 MeV/u beam of He-6, incident on carbon and lead targets, has been studied in kinematically complete experiments to investigate low-lying excitation modes in the halo nucleus He-6. It is shown that alignment effects characterize the inelastic scattering and allow an unambiguous assignment of the spin of a narrow resonance observed in the excitation energy spectrum. The differential cross sections for the He-6 inelastic scattering on carbon and lead targets were deduced from the measured moments of the two neutrons and the a-particle. An analysis of these distributions shows that quadrupole and, possibly, monopole excitations characterize the hadronic interaction, while the dipole mode is dominating in Coulomb dissociation. Neither theoretically predicted new resonance states in He-6 nor nuclear excitation of a dipole mode were found. Direct evidence has been obtained for strong suppression of Coulornb post-acceleration in direct Coulomb breakup in a lead target.

This work demonstrates the feasibility of in-beam γ-spectroscopy employing radioactive ion beam species at relativistic energies of E = 210 ∼ 280 A· MeV. Neutron-rich nuclei below 48Ca with neutron number between the two magic numbers 20 and 28 have been investigated. Using a Pb target, single step inelastic excitation originating mainly from Coulomb interaction takes place populating preferentially low-lying low-spin states and enabling the extraction of B(E2) values. On a C target, nucleon removal reactions are dominating and medium-spin states are populated thus offering spectroscopic information in neighboring nuclei. Cross sections of inelastic excitation are determined and compared to coupled-channels calculations. Two new states of the very neutron-rich nucleus 44Ar at 1.78(8) MeV and 2.61(16) MeV are deduced from γ-transitions.

4 pages, 3 figures.-- PACS nrs.: 27.20.+n, 24.70.+s, 25.60.Gc., Peripheral fragmentation of a 287 MeV/nucleon beam of the halo nucleus Li-11 incident on a carbon target has been studied in a fragment-neutron coincidence experiment. The momentum distribution of the Li-10 fragments gives access to the momentum distribution of the removed neutron in Li-11. From the shape of the distribution, the (1s(1/2))(2) contribution to the mixture of (1s(1/2))(2) and (0p(1/2))(2) components in the ground-state wave function was determined to he (45 ± 10)%. The angular correlation between the knocked out neutron and the one from the decay of Li-10 shows a skew distribution signaling interference of these two different parity states., This work was supported by the BMBF under Contracts No. 06 DA 820, No. 06 OF 112, and No. 06 MZ 476, and by GSI via Hochschulzusammenarbeitsvereinbarungen under Contracts No. DA RICK, No. OF ELZ, and No. MZ KRK, and partly supported by the Polish Committee of Scientific Research under Contract No. PBZ/PB03/113/09, EC under Contract No. ERBCHGE-CT92-0003, CICYT under Contract No. AEN92-0788-C02-02(M. J.G.B.), and WTZ under Contract No. RUS 609-96. One of us (B. J.) acknowledges support from an Alexander von Humboldt Research Award.

Electromagnetic and nuclear breakup of the neutron-rich Oxygen isotopes ranging from A = 17 to A = 22 is studied experimentally in reactions at energies around 600 MeV/u. The beams were produced in fragmentation reactions and separated by the GSI Fragment Separator FRS. By measuring the four-momenta of all decay products after inelastic scattering and neutron decay of the projectile, the excitation energy is determined. From the differential cross sections dσ dE ∗ for electromagnetic excitation, the E1-strength distributions can be deduced. For 18,20,22O, low-lying dipole strength is observed, exhausting about 5% of the Thomas Reiche Kuhn sumrule for energies up to 5 MeV above the continuum threshold.

T. Aumann et al. ; 11 pags.; 6 figs.; 2 tabs. ; PACS number(s): 27.20.1n, 25.60.Gc, 25.70.De, 29.30.Hs

Ultraviolet (UV) B irradiation induces keratinocytes to produce among others the proinflammatory cytokines interleukin (IL) 1 and IL-6. The wavelength dependence of this UVB effect has not yet been assessed. We evaluated the potential of different UVB wavelength regions to release cytokines from the squamous carcinoma cell line SCL II and also assessed the effect of various putative inhibitors. Confluent monolayers of the cells were irradiated with 0.5-2.0 mJ/cm2 UVB at 280, 290, 300, 310 or 320 (each +/- 5) nm. In additional experiments dexamethasone (10-9-10-5 mol/L), ascorbic acid, d-alpha-tocopherol or indomethacin (each 10-7-10-4 mol/L) were added to the culture medium 24 h before, immediately after or combined before and after irradiation with 1 mJ/cm2 UVB at 280 +/- 5 nm. Supernatants of the cell cultures were recovered at 24 h after irradiation, and IL-1alpha or IL-6 were determined by an enzyme-linked immunosorbent assay (ELISA). IL-1alpha and IL-6 production were induced by UVB at 280, 290 and 300 nm, the production depended on the UV dose and decreased with increasing wavelengths. Irradiation at 310 or 320 nm did not induce cytokine production up to the maximum dose used. The production of IL-1 alpha/IL-6 was inhibited up to 80/89% (10-7-10-6 mol/L before and after irradiation) by dexamethasone in a concentration-dependent manner and with all conditions of incubation. Release of cytokines was also suppressed by indomethacin, d-alpha-tocopherol or ascorbic acid, but concentration dependence was not always evident. These results show that particularly shorter UVB radiation, which is expected to increase due to stratospheric ozone depletion, induces prominent production of proinflammatory cytokines, indicating major biological effects. Different pharmacological compounds can interfere with this effect and seem worth further evaluation with regard to their clinical effects.

13 pags, 5 figures.-- PACS nrs.: 24.60.−t; 25.70.Ef; 27.20.+n., Momentum distributions and invariant mass spectra from the breakup of He-6 ions with an energy of 240 MeV/u interacting with a carbon target have been studied. The data were used to extract information about the reaction mechanism which is influenced by the structure of He-6. It is found that the dominant reaction mechanism is a two-step process: knock out of one neutron followed by the decay of the He-5 resonance. The shape of the (α+n) two-body invariant mass spectrum is interpreted as mainly reflecting the 5He ground state which is a J(π) = 3/2(-) resonance. However, no evidence for correlations between cu particles and neutrons is observed in the momentum widths of the distributions. It is demonstrated that a combined analysis of the two-body invariant mass spectrum and an appropriate correlation function may be used to determine the properties of the intermediate resonance., This work was supported by the German Federal Minister for Education and Research (BMBF) under Contracts 06 DA 820, 06 OF 474 and 06 MZ 476 and by GSI via Hochschulzusammenarbeitsvereinbarungen under Contracts DARIK, OF ELK, MZ KRK and partly supported by the Polish Committee of Scientific Research under Contract PB2/P03B/113/09, EC under Contract ERBCHGE-CT92-0003 and CICYT under Contract AEN92-0788-C02-02 (MJGB) and by Deutsche Forschungsgemeinschaft (DFG) under Contract 436 RUS 130/127/1. One of us (B.J.)acknowledges the support through an Alexander von Humboldt Research Award.

A scintillating fibre detector for relativistic heavy ions with an active area of 50 × 50 cm 2 has been developed and was tested with various ion beams (1 ≤ Z ≤ 92). At count rates of up to 10 5 particles/s, the position resolution was found to be determined by the fibre width of 1 mm; depending on the nuclear charge of the beam, efficiencies between 89% and 100% and time resolutions between 800 and 200 ps (FWHM) were obtained.

In the collision of relativistic heavy ions with nuclear targets at the CERN SPS up to several hundred charged particles in the momentum range of 0.1–200 GeV/c are produced. These events have been recorded on film by the NA35 streamer chamber. A computer environment for the analysis of this data was developed and became operational at the University of Frankfurt. This Frankfurt Image Processing System (FIPS) is a modular und distributed system allowing the application of image processing and image understanding techniques to digitized streamer chamber images as well as the interactive computer-assisted measurement of photographic streamer chamber pictures on traditional film projection tables. Automatic track reconstruction software has been developed which in turn utilizes a multitude of image processing and image understanding techniques. The efficiency of the pattern recognition and track reconstruction processes is greater than 95% with a very good momentum resolution d P/P = ”(0.0009P) 2 + (0.0018) 2 . So far about 20 000 of these events have been processed. Currently approximately 50 events per day are automatically analysed.

Whole-body ultraviolet (UV)A1 (340-400 nm) phototherapy was first introduced 30 years ago, but is currently available in the UK in only three dermatology departments. A workshop to discuss UVA1 was held by the British Photodermatology Group in May 2009, the aim of which was to provide an overview of UVA1 phototherapy and its role in practice, and to identify areas in which further studies are required. The conclusions were that UVA1 phototherapy is an effective treatment in several inflammatory skin diseases, including localized scleroderma and atopic eczema (AE); however, deficiencies and limitations exist in the published evidence base. For most diseases, such as AE, other treatments also exist, which are generally more effective than UVA1. However, for some diseases, particularly morphoea, the evidence of efficacy is stronger for UVA1 than for other treatments. Acute adverse effects of UVA1 are minimal. The risk of long-term adverse effects, particularly skin cancer, is unknown. Medium to high doses of UVA1 are needed for efficacy in most situations, but the equipment to deliver such doses is large, expensive and difficult to install. UVA1 is currently underprovided, and the recommendation of the workshop is that more tertiary centres should have access to UVA1 phototherapy in the UK.

Polymorphous light eruption (PLE) is the most common chronic and idiopathic photodermatosis. PLE is assumed to represent an immunological hypersensitivity reaction to a radiation-induced cutaneous antigen involving reactive oxygen species (ROS) on the basis of a genetic predisposition. Among others, cellular protection against ROS is provided by glutathione S-transferases (GSTs). Different variants of the GST enzymes may influence the activity and efficiency of detoxification and biotransformation of unknown UV-induced skin-antigens and other factors that may play an important role in the pathogenesis of PLE.In this study the relationship between isoenzymes of the GST genes GSTM1, GSTT1 and GSTP1 and possible protective or predisposing effects on PLE was examined in 29 patients and 144 controls. Diagnosis of PLE was based on the presence of characteristic clinical features.No association between the functional polymorphisms of the GST gene family and PLE was found. Prevalence of certain GST isoenzymes or polymorphisms in patients with PLE did not differ from healthy controls.Our data do not support prevalence of GST isoenzymes or polymorphisms as a protective effect against PLE. Especially a higher carrier frequency of GSTP1 Val(105) as a protective factor against PLE which has been published before could not be proved. The GST genotypes GSTM1, GSTT1 and GSTP1 (including SNPs) seem to have no relevant association with PLE.

Ultraviolet radiation is capable of inducing numerous skin reactions. Considerable amounts of UVA radiation penetrate the epidermis and reach the microvascular endothelium of the papillary dermis. In order to investigate putative direct effects of UV radiation on endothelial cells, we studied adhesion molecule expression by immunostaining procedures and FACS analysis, following irradiation of normal human skin and cultured human dermal endothelial cells. Enhanced immunostaining for ICAM-1 and E-selectin was detected in biopsies taken after in vivo UVA and UVB irradiation, compared with non-irradiated control skin. On cultured human dermal endothelial cells, however, ICAM-1 and E-selectin were inducible by UVA but not UVB. The induction was dose-dependent, peaking at 20 J/cm2 for both adhesion molecules, and time-dependent, peaking after 6 and 24 h for E-selectin and ICAM-1, respectively. Expression of VCAM-1 and PECAM/EndoCAM/CD31 was unaffected by any UV-radiation modality. The functional integrity of irradiated cells was monitored by an exclusion assay of the fluorescent dye 7-AAD, and by staining for the cytoskeletal proteins actin and vimentin. Our results demonstrate that dermal microvascular endothelial cells are a critical and direct target of UVA, and suggest they may play a pivotal role in UV-induced inflammatory skin conditions.

Ultraviolet (UV) A1 phototherapy is an effective anti-inflammatory treatment modality that influences fibroblast functions.To document the effects of UVA1 treatment in patients with localized scleroderma (LS) in a retrospective study (at least 6 months after UVA1 treatment) and in a prospective study before and immediately after medium-dose UVA1 irradiation.In total, 30 patients (retrospective study n = 17, prospective study n = 13) with LS receiving UVA1 phototherapy five times weekly (for 3-6 weeks) were investigated. Improvement was documented using standardized questionnaires and clinical evaluation (using modified Rodnan skin score, Cutometer and 7.5-MHz ultrasound measurements). Levels of collagen I and collagen III metabolites were measured in serum and urine.In the retrospective study, medium-dose UVA1 phototherapy had been performed 6 months-3 years earlier (cumulative dose 750-1400 J cm(-2); mean + or - SD number of irradiations 19.3 + or - 3.8). Fourteen of 17 patients (82%) reported an improvement in symptoms following UVA1 therapy. In the prospective study, skin elasticity increased in 77% of the patients following medium-dose UVA1 phototherapy (cumulative dose 750-1250 J cm(-2); mean + or - SD number of irradiations 20.8 + or - 4.0). 7.5-MHz ultrasound measurements showed a mean reduction of lesional skin thickness of 13% compared with skin thickness before UVA1 phototherapy. The ratio of deoxypyridinoline to creatinine was significantly elevated in about two-thirds of the patients.This open study showed a positive short- and long-term efficacy of UVA1 phototherapy in patients with LS, with a reduction in sclerotic plaques, an increase in skin elasticity and a reduction of lesional skin thickness. UVA1 phototherapy had a significant effect on collagen metabolism. UVA1 phototherapy can be regarded as a safe treatment modality for patients with LS.

Investigation of the efficacy of ultraviolet (UV) A1 phototherapy on atopic eczema, scleroderma, granuloma annulare, urticaria pigmentosa, prurigo nodularis, lichen sclerosus et atrophicus, T-cell lymphoma, keratosis lichenoides chronica, chronic urticaria and some rare, sclerosing skin diseases.The data of 230 patients treated with low-dose, medium-dose and high-dose UVA1 therapy during 6 years were retrospectively analysed. The mean single dose (J/cm(2)), the mean number of irradiations and the mean total dose (J/cm(2)) were evaluated. The efficacy of phototherapy was assessed by a grading scale and the number of patients was given in percentage for each group.Good therapeutic effects of UVA1 therapy were shown in patients with atopic eczema, scleroderma, lichen sclerosus et atrophicus, keratosis lichenoides chronica, prurigo nodularis and with cutaneous T-cell lymphoma. Positive effects in some patients were seen in the urticaria pigmentosa and granuloma annulare group, no change to slight improvement was seen in most of the patients with rare, sclerosing skin diseases and no effect was seen in the chronic urticaria group.Besides topical and systemic therapy, UVA1 radiation is a good option of treatment in various skin diseases. It is one of the first-line treatments for several sclerotic diseases and it often improves pruritus considerably.

Summary Ultraviolet (UV) radiation-induced oxidative stress may result in acute and chronic photodamage. Based on the endogenous antioxidant system, the administration of antioxidants for scavenging reactive oxygen species might be a promising strategy in the prevention of UV-induced skin reactions. The relevance of the most common antioxidants, vitamins E and C, is reviewed focusing on topical and systemic photoprotective effects in animals and humans. Topically applied vitamin C induced significant photoprotective effects at concentrations of at least 10% in animals and humans, whereas a photoprotective effect has not been demonstrated by oral administration even at high doses in humans. Topical vitamin E reduced erythema, sunburn cells, chronic UV-B–induced skin damage, and photocarcinogenesis in the majority of the published studies, whereas only high doses of oral vitamin E may affect the response to UV-B in humans. Combination of vitamins C and E, partly with other photoprotective compounds, did increase the photoprotective effects dramatically compared to monotherapies. This synergistic interplay of several antioxidants should be taken into consideration in future research on cutaneous photoprotection.

The diagnosis of insect venom allergy and the indication for specific immunotherapy is based on history, skin tests and demonstration of hymenoptera venom-specific IgE-antibodies. Cellular tests can add useful information but the role of basophil activation tests for the different venoms has to be elucidated further. We evaluated positive reactions in a basophil activation test using CD63 expression as marker independently for bee or wasp venom in patients with hymenoptera allergy. Fifty-seven patients with a history of insect venom anaphylaxis were examined (12 x bee venom, 39 x wasp venom, 6 x bee plus wasp venom). Skin tests and determination of specific IgE-antibodies were performed. Basophil activation test (BAT) using CD63 expression was performed after stimulation with different concentrations of bee and wasp venom. The BAT is based on double staining with anti-IgE antibodies and anti-CD63 and subsequent determination of the percentage of activated basophils by flow cytometry. In patients with bee venom allergy, BAT was positive in 100% to bee venom and 75% to wasp venom. In patients with bee and wasp venom allergy, positive reactions for both venoms were found in 100%. In patients with wasp venom allergy, 97% reacted positive to wasp venom and only 56% to bee venom. These results show the reliability of the basophil activation test as a cellular test in the in vitro diagnosis in patients with bee and wasp venom allergy. They also show that positive reactions in the basophil activation test reflect both sensitization status and cross-reactivity between venom species.

The skin, as the outer boundary of the body, plays the major role of protecting the organism against harmful exogenous influences. It is the interface between the organism and the environment and serves as a barrier ensuring the maintenance of the body functions. In irritable skin, this function is impaired and environmental factors that are normally not harmful to the skin can lead to a disturbance of the skin’s integrity. Due to a lack of objective parameters and a clear-cut definition of irritable skin, the condition of sensitive or irritable skin is difficult to assess with clinical or experimental methods. For the most part, the diagnosis is based on the patient’s history, which typically includes skin reactions following nonspecific stimulation of the skin with external triggering factors. In atopic eczema (AE), irritable skin is frequently found to be partly responsible for its dependence on environmental conditions and its exacerbation following exposure to certain nonallergenic external stimuli. Before discussing the impact of irritable skin on atopic eczema, it is therefore necessary to define the phenomenon of irritable skin in itself and objective methods of measurement.

The role of atopy in the pathophysiology of eczema is still under debate. The concept and analyses of the nonatopic and atopic subtypes of eczema have gained increasing interest in recent studies. The course of these subtypes and differences between boys and girls have not been investigated so far.To examine the course of nonatopic and atopic eczema in preschool children from Germany with regard to sex.Repeated cross-sectional studies were performed in 5-7-year-old preschool children from Germany between 1994 and 2000. Individuals with eczema were identified by a dermatological examination. In addition to a questionnaire, skin prick tests and analyses of serum IgE antibodies against seven and five environmental allergens, respectively, were performed. Atopy was defined by sensitization to at least one of five common aeroallergens (birch, grass and mugwort pollen, house dust mites, cat dander). In part of the study population investigations of spare time behaviour and skin function were carried out (including stratum corneum hydration and skin surface pH).A total of 2693 girls and 2783 boys underwent a full dermatological examination of the skin and determination of sensitization. Among the girls, 8.7% demonstrated eczema clinically at the day of investigation in contrast to 6.1% of the boys. In girls, early onset eczema (2 years of age) was strongly related to atopy at age 5-7 years [odds ratio (OR) 3.7; 95% confidence interval (CI) 2.7-5.1], whereas late-onset eczema (or = 2 years of age) was not (OR 1.0; 95% CI 0.7-1.5). Boys were more often atopic at the age of 5-7 years than girls (28.3% vs. 20.6%), and early and late-onset eczema were related to atopy without such a difference (OR 2.8, 95% CI 2.0-4.0; OR 1.9, 95% CI 1.3-2.8, respectively). The excess of current eczema in 5-7-year-old girls compared with boys was related to the nonatopic type. The higher susceptibility of girls in that age group to develop eczema was reflected by the skin physiological examination: even girls without eczema had significantly higher skin surface pH and lower stratum corneum hydration than boys. Additionally, questionnaire data revealed that girls more often than boys predominantly played indoors, which was associated with more eczema.Atopy and eczema develop differently in boys and girls. Boys are more often atopic, whereas girls suffer significantly more often from eczema without relation to atopy. The nonatopic type of eczema in preschool girls is noticed predominantly after their second birthday. Genetic and lifestyle factors may contribute to this difference.

The diagnosis of insect venom allergy and the indication for specific immunotherapy is based on history, skin tests and demonstration of hymenoptera venom specific IgE-antibodies. In cases with contradictory test results additional cellular tests are recommended.We evaluated the usefulness of a newly introduced test based on basophil CD63 expression as marker of activation in comparison with the basophil histamine release test (BHR) and the cellular antigen stimulation test (CAST) measuring leukotriene release.In 14 patients (10 males, 4 females; age; 12 to 67 years, mean: 42.5 +/- 15.1 years) with systemic reactions to hymenoptera stings in their history skin tests and determination of specific IgE-antibodies (CAP-RAST-FEIA) had shown inconsistent results: No demonstration of specific IgE-antibodies (n = 4), one sting by an unknown insect together with positive skin test and/or positive RAST to both bee and wasp venom (n = 4), several stings of partly unknown insects with positive skin test and/or demonstrable specific IgE-antibodies to more than one insect venom (n = 4), uncertain history and divergent results in skin test and/or RAST (n = 2). BHR, CAST and basophil activation test (BAT) were done according to the manufacturers with negative and positive controls and different concentrations of bee and wasp venom. The BAT is based on double staining with anti-IgE antibodies and anti-CD63 and subsequent determination of the percentage of activated basophils by flow cytometry.BAT and skin test were concordant in 42.9%, BAT and RAST in 57.1%. Concordance of all three cellular tests was seen in 57.1%, of BAT and BHR in 69.1%, of BAT and CAST in 78.6% and of BHR and CAST in 64.3%. In 6 cases where the three cellular tests (BHR, CAST, BAT) were not in accordance the addition of BAT led to a more reliable diagnostic result concerning the relevant insect in 3 cases and added no further information in 3 cases. BAT in controls always was negative. Correlation between CAST and BAT was higher than between CAST and BHR.In difficult cases of hymenoptera allergy, where history, skin tests and determination of specific antibodies do not allow a clear decision regarding the relevant insect species for immunotherapy, the additional performance of cellular tests (CAST and BAT) may be helpful.

The excitation of the double-phonon giant dipole resonance was observed in heavy projectile nuclei impinging on targets of high nuclear charge with energies of 500‐700 MeV/nucleon. New experimental data are presented for 136 Xe and 238 U together with further analysis of earlier data on 208 Pb. Differential cross sections ds/dE* and ds/du for electromagnetic excitations were deduced. Depending on the isotope, cross sections appear to be enhanced in comparison to those expected from a purely harmonic nuclear dipole response. The cumulative effect of excitations of two-phonon states composed of one dipole and one quadrupole phonon, of predicted anharmonicities in the double-phonon dipole response, and of damping of the dipole resonance during the collision may account for the discrepancy. In addition, decay properties of two-phonon resonances were studied and compared to that of a statistical decay.

The cross section for the 6He+n channel as a function of the relative energy shows a structure, which is interpreted as being due to the 7He I π = 3/2− ground state resonance with about equal contribution from its I π = 1/2− spin-orbit partner at 1.2(2) MeV with a width Г = 1.0(2) MeV.

Dissociation of 227 MeV/u 8He in lead and carbon targets has been studied in kinematically complete experiments, the data are compared with corresponding results for 6He.

Genital leiomyomas of the scrotal skin are extremely rare benign tumors, originating from the tunica dartos of the scrotum. We describe a 55-year-old caucasian male with a 3-year history of a slowly growing asymptomatic scrotal knot which was first clinically regarded as a cyst and finally diagnosed histopathologically as leiomyoma. This typical case demonstrates that leiomyomas should be considered in the differential diagnosis of scrotal tumors.

14 pages, 1 table, 2 figures.-- PACS nrs.:27.20.+n; 24.70.+.-- Available online Oct 8, 2001., Dissociation of a 227 MeV/u He-8 beam in a lead target has been studied in a kinematically complete experiment. The results are compared with similar data from the well-known halo nucleus He-6. Coulomb-nuclear interference in the inelastic channel gives evidence for a I-π = 1- resonance in He-8 at E-x = 4.15 MeV. The deduced B(E1) value of 0.38 ± 0.07 e(2) fm(2) indicates a uniform distribution of the four neutrons around the α-particle core., This work was supported by the BMBF under Contracts 06 DA 820, 06 OF 112 and 06MZ 864 and by GSI under Contracts DARICK, OF ELZ,MZKRK and partly supported by the Polish Committee of Scientific Research under Contract PBZ/PB03/113/09, EC under contract ERBCHGE-CT92-0003, CICYT under Contract AEN92-0788-C02-02 (MJGB), WTZ under Contract RUS 674-98 and RFBR under Contract 01-02-16685. One of us (B.J.) acknowledges the support through an Alexander von Humboldt Research Award.

4 pages, 1 table, 4 figures.-- Printed version published Mar 11, 2002.-- PACS nrs: 24.30.Gd; 25.60.-t; 27.20.+n, Low-lying resonance states in He-7(He-6 + n), formed after fragmentation reactions of a 227 MeV/nucleon He-8 beam on a carbon target, have been studied. Coincidences between He-6 nuclei and neutrons, corresponding to the one-neutron knockout channel in He-8, were selected. The relative energy spectrum in the He-6 + n system shows a structure, which is interpreted as the He-7 (Iπ = 3/2(-)) ground state, unbound with 0.43(2) MeV relative to the He-6 + n system and a width of Γ = 0.15(8) MeV overlapping with an excited (Iπ = 1/2(-)) state observed at 1.0(1) MeV with a width of Γ = 0.75(8) MeV., This work was supported by the BMBF under Contracts No. 06 DA 915I, No. 06 OF 838, and No. 06 MZ 864 and by GSI under Contracts No. DA RICK, No. OF ELZK, and No. MZ KRAK and partly supported by the Polish Committee of Scientific Research under Contract No. KBN/2P03B/144/10, by the EC under Contract No. ERBCHGE-CT92-0003, by CICYT under Contract No. AEN92-0788-C02-02 (M. J.G. B.), by RFBR under Contract No. 01-02-16685, and by WTZ under Contract No. RUS 674-98. One of us (B. J.) acknowledges support by Alexander von Humboldt Research.

The prevalence of allergic diseases has increased in modern Western countries during the last decades. Among the hypotheses for the reasons the idea that environmental pollutants may play a role is intensively discussed. In order to characterise the influence of these pollutants on the development, elicitation and chronification of allergic reactions (allergotoxicology) epidemiological, clinical and experimental data have to be considered. These investigations showed that among the pollutants with an enhancing effect on allergic diseases pollution types with nitrogen oxides (NOx), ozone (O3), tobacco smoke, particulate matter and diesel exhaust particles are of special interest.

19 pages, 3 tables, 6 figures.-- PACS nrs.: 27.20.+n; 24.70.+s; 25.06.-t.-- Available online Dec 4, 2000., Dissociation of 227 MeV/u 8He in a carbon target has been studied in kinematically complete experiments. The data include the relative energy spectrum, angular distributions in the neutron knock-out channel (6He+n) as well as diffractive dissociation and inelastic scattering into the (6He+2n) channel. The data are compared with corresponding results from the well-known halo nucleus 6He. In both cases it is found that neutron knock-out is the dominating reaction channel. The relative energy spectrum (6He+n) shows a structure, which is interpreted as being due to the Iπ=3/2− resonance in the 7He ground state with about equal contribution from its Iπ=1/2− spin–orbit partner., The 7He resonance shows a spin alignment similar to that observed in 5He, but with a smaller anisotropy indicating that the structure of the 8He ground state is more complicated than that of 6He., The data in the (6He+2n) channel were used to identify resonances in the excitation energy spectrum of 8He. If the spectrum is interpreted as two overlapping resonances, the spin-parity assignment for these is found to be 2+ and 1−, respectively., This work was supported by the BMBF under Contracts 06 DA 820, 06 OF 474 and 06 MZ 864 and by GSI via Hochschulzusammenarbeitsvereinbarungen under Contracts DA RICK, OF ELZ, MZ KRK and partly supported by the Polish Committee of Scientific Research under KBN grant No. 2 PO3B 14418, EC under contract ERBCHGE-CT92-0003, CICYT under contract AEN92-0788-C02-02 (MJGB) and WTZ under contract RUS 674-98. One of us (B.J.) acknowledges the support through an Alexander von Humboldt Research Award. The authors acknowledge fruitful discussions with Horst Lenske, Sergei Fayans and Leonid Grigorenko.

The possible influence of oxidative stress is discussed in the pathogenesis of polymorphous light eruption (PLE). A double-blind, placebo-controlled study of prophylactic treatment with systemic administration of vitamin C (3 g/d) and E (1500 IU/d) for 8 days was undertaken in 9 patients with PLE (verum, n=4; placebo, n=5). Evaluation of the maximal effects after photoprovocation before and after intake of the antioxidants revealed a reduction of most skin reactions (overall skin reaction, papules/vesicles) in both groups with marked differences in the placebo group. The antioxidants in the doses given and over the time period used did not influence the development of PLE, but might interfere with immunosuppressive effects of repeated photoprovocation tests.

Reduction in the size of the allergen-induced late-phase reaction (LPR) is seen as a consequence of successful allergen specific immunotherapy.It was the aim of this study to characterize the cellular infiltrate at the sites of cutaneous LPR that may occur following injection of a depot pollen allergoid (Allergovit(R)) during immunotherapy and thereby determine the immunological nature of the response.Punch biopsies were taken 24 h after subcutaneous injection of a depot pollen allergoid from eight patients that showed LPR and a further five patients that did not. Additional biopsies taken 24 h after injection of allergoid-free depot in the same patients served as controls. Immunoenzymatic labelling of the cryostat sections with different antibodies was performed with the APAAP technique. Results were expressed as cells/field (400 x magnification).Similar dermal cellular infiltrations were seen following depot allergoid injections in patients both with and without LPR. Patients with LPR showed statistically significant increases in total cells, CD4+ cells, CD11c+ cells, CD45RO+ cells, CD45RB+ cells and activated eosinophils at the reactions sites as compared with control sites. In patients without LPR CD11c+ cells, HLA-DR+ cells and CD45RA+ T cells increased significantly. CD8+, CD1a+, NP57+, CD23+ and CD25+ cells did not differ significantly in either group.These results indicate that activation of T cells, monocytes/macrophages and eosinophils at the sites of LPR following injection of depot allergoid are comparable with those following injection of allergen. Even in the absence of a cutaneous LPR, subsets of T cells and monocytes/macrophages increased. These cell activations may reflect events associated with the mechanisms of allergoid-based specific immunotherapy, and suggest that at least part of the late-phase reaction may be independent of IgE.