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We use the spectral kinetic theory of soliton gas to investigate the likelihood of extreme events in integrable turbulence described by the one-dimensional focusing nonlinear Schrödinger equation (fNLSE). This is done by invoking a stochastic interpretation of the inverse scattering transform for fNLSE and analytically evaluating the kurtosis of the emerging random nonlinear wave field in terms of the spectral density of states of the corresponding soliton gas. We then apply the general result to two fundamental scenarios of the generation of integrable turbulence: (i) the asymptotic development of the spontaneous modulational instability of a plane wave, and (ii) the long-time evolution of strongly nonlinear, partially coherent waves. In both cases, involving the bound state soliton gas dynamics, the analytically obtained values of the kurtosis are in perfect agreement with those inferred from direct numerical simulations of the fNLSE, providing the long-awaited theoretical explanation of the respective rogue wave statistics. Additionally, the evolution of a particular nonbound state gas is considered, providing important insights related to the validity of the so-called virial theorem.
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We study the (1+1) focusing nonlinear Schrödinger equation for an initial condition with compactly supported parabolic profile and phase depending quadratically on the spatial coordinate. In the absence of dispersion, using the natural class of self-similar solutions, we provide a criterion for blowup in finite time, generalizing a result by Talanov et al. In the presence of dispersion, we numerically show that the same criterion determines, even beyond the semiclassical regime, whether the solution relaxes or develops a high-order rogue wave, whose onset time is predicted by the corresponding dispersionless catastrophe time. The sign of the chirp appears to determine the prevailing scenario among two competing mechanisms for rogue wave formation. For negative values, the numerical simulations are suggestive of the dispersive regularization of a gradient catastrophe described by Bertola and Tovbis for a different class of smooth, bell-shaped initial data. As the chirp becomes positive, the rogue wave seems to result from the interaction of counterpropagating dispersive dam break flows, as in the box problem recently studied by El, Khamis, and Tovbis. As the chirp and amplitude of the initial profile are relatively easy to manipulate in optical devices and water tank wave generators, we expect our observation to be relevant for experiments in nonlinear optics and fluid dynamics.
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We consider large-scale dynamics of non-equilibrium dense soliton gas for the Korteweg-de Vries (KdV) equation in the special "condensate" limit. We prove that in this limit the integro-differential kinetic equation for the spectral density of states reduces to the N-phase KdV-Whitham modulation equations derived by Flaschka et al. (Commun Pure Appl Math 33(6):739-784, 1980) and Lax and Levermore (Commun Pure Appl Math 36(5):571-593, 1983). We consider Riemann problems for soliton condensates and construct explicit solutions of the kinetic equation describing generalized rarefaction and dispersive shock waves. We then present numerical results for "diluted" soliton condensates exhibiting rich incoherent behaviors associated with integrable turbulence.
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PurposeTo determine the mean 24-h intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) characteristics of newly diagnosed, previously untreated, Caucasian, normal tension glaucoma (NTG) patients and to identify relationships between these features and visual field (VF) loss at diagnosis.MethodsConsecutive newly diagnosed NTG patients underwent 24-h habitual IOP and blood pressure (BP) monitoring. Parameters from pooled measurements obtained in the sitting (0800-2200 hours) and supine (1200-0600 hours) positions were compared and associations were sought with VF mean deviation (MD) and pattern standard deviation (PSD).ResultsSixty-two Caucasian NTG patients (24 men and 38 women) successfully completed circadian IOP and BP monitoring. In habitual position, 8 subjects (12.9%) exhibited a diurnal acrophase, 42 subjects (67.7%) demonstrated a nocturnal acrophase, one subject (1.6%) showed a flat rhythm and 11 patients (17.7%) revealed a biphasic/polyphasic rhythm. Nighttime MOPP values (supine position) were significantly greater than diurnal values (sitting position); (P<0.001). No association could be demonstrated between glaucomatous damage, as indicated by VF parameters, and either mean habitual 24-h IOP (P=0.20 and P=0.12 for MD and PSD, respectively), or habitual 24-h MOPP (P=0.96 and 0.29, for MD and PSD, respectively).ConclusionsIn this cohort of Caucasian NTG patients, most patients exhibited a nocturnal IOP acrophase when evaluated in a habitual position. No association was found between 24-h IOP or MOPP and VF damage.
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Ritmo Circadiano/fisiologia , Olho/irrigação sanguínea , Pressão Intraocular/fisiologia , Glaucoma de Baixa Tensão/fisiopatologia , Idoso , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Gonioscopia , Humanos , Glaucoma de Baixa Tensão/diagnóstico , Glaucoma de Baixa Tensão/etnologia , Masculino , Pessoa de Meia-Idade , Postura , Tonometria Ocular , Transtornos da Visão/diagnóstico , Campos Visuais/fisiologia , População Branca/etnologiaRESUMO
5-Iminodaunomycin, an anthracycline antitumor drug exhibiting an absorption peak at 595 nm, is shown to photosensitize in vitro cell kill. The photoactivation is performed irradiating the culture dishes during the incubation with the drug for 2 h with 34 mW/cm2 intensity, that is with light doses of up to 245 J/cm2. Long-term effects of administering 50 ng/ml and light for 2 h are studied in terms of growth curves. We show that photoactivation enhances the dark toxicity by a factor of about 10. Immediate cell death is produced by irradiating the cells in the presence of higher drug concentrations (e.g., 1000 ng/ml) which, however, are not toxic in the short term if administered in the dark. The viable cell percentage decreases at increasing light doses, being about 0.6% at the maximum dosage. Administering lower light doses, such as 30 J/cm2, which corresponds to an exposure duration of 15 min, has a short-term effect on the cell survival that strongly depends on the timing of the exposures within the incubation period.
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Sobrevivência Celular/efeitos dos fármacos , Animais , Antibióticos Antineoplásicos , Células Cultivadas , Daunorrubicina , Relação Dose-Resposta à Radiação , Técnicas In Vitro , Luz , Fotoquímica , Radiossensibilizantes , Ratos , Glândula Tireoide , Fatores de TempoRESUMO
The present study was undertaken in order to establish whether alterations in the endogenous opioid control of luteinizing hormone (LH) and ACTH/cortisol secretion occur in bulimic women with normal body weight and normal menstrual cycles. For this purpose, the capability of the opioid antagonist naloxone (4 mg injected as an intravenous bolus at time 0, plus 10 mg infused over 2 hr) to increase the circulating levels of LH and cortisol was tested in nine bulimic women and in nine age- and weight-matched normal controls. All women were tested on the 22nd day of a normal menstrual cycle. Two days later, a control test with normal saline (NaCl 0.9%) instead of naloxone was performed. The basal levels of LH and cortisol were similar in the bulimic and normal subjects and were not modified by the administration of normal saline. In contrast, the administration of naloxone significantly increased plasma LH and cortisol levels in all subjects, with peak LH responses at 30 min and peak cortisol responses at 60 min. The naloxone-induced LH and cortisol increases were significantly higher in the bulimic women than in the normal controls. These data indicate the presence of an increased opioid inhibitory tone in the control of LH and ACTH/cortisol secretion in normal weight bulimic women with normal menstrual cycles.
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Bulimia/sangue , Hidrocortisona/sangue , Hormônio Luteinizante/sangue , Naloxona/farmacologia , Adulto , Estradiol/sangue , Feminino , HumanosRESUMO
Newly synthesized daunomycin derivatives with red-shifted absorption compared to the parent molecule are shown to be able to photosensitize cells in vitro upon excitation with either argon or argon-pumped dye laser. Administering 86 J/cm2 total fluence (1 h irradiation) to Fisher rat thyroid cells during 2 h incubation with either daunomycin (excitation wavelength: 488 nm) or 5-iminodaunomycin (595 nm) produced cell killing at doses (about 2.7 X 10(-7) M for 50% cell survival) which were not toxic if administered in the dark. Greater photocytotoxicity (about 7 X 10(-8) M for 50% cell survival) was obtained with 4-demethoxydaunomycin as well as with its 6- and 11-amino derivatives (514 nm) while no cell killing as a result of photosensitization was observed for either Adriamycin or its 4'-iodo derivative. Our results suggest that the photosensitizing efficacy correlates with the absence of the methoxy group in the anthraquinone chromophore but is rather independent of the occurrence of triplet-mediated photoreactions. Finally, the fact that the imino- or amino-substituted 4-demethoxy compounds exhibit red-shifted absorption spectra compared to the parent molecule might be exploited for in vivo applications of the photoactivated cytotoxicity reported in this work.
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Antibióticos Antineoplásicos/farmacologia , Fotoquimioterapia , Animais , Daunorrubicina/análogos & derivados , Daunorrubicina/farmacologia , Doxorrubicina/análogos & derivados , Doxorrubicina/farmacologia , Técnicas In Vitro , Ratos , Ratos Endogâmicos F344RESUMO
To study the cytologic profile and lineage involvement in acute myeloid leukemia (AML) with trisomy 11, cytologic, cytogenetic, and interphase cytogenetic studies were performed at presentation in two cases of acute myelomonocytic leukemia (AML-M4). Patient 1 had +11 as the sole chromosome aberration in 16/20 karyotypes whereas two related clones with +11 in all abnormal metaphases (14/18) were detected in patient 2. A proportion of interphase cells with three signals, comparable to the proportion of abnormal metaphases, was detected by fluorescent in situ hybridization (FISH) in these patients. Morphologic aberrations of the nonblast cell population affecting multiple cell lineages, along with a circulating minor megakaryoblastic component, were observed at diagnosis in both patients. By separation of bone marrow cells over a density gradient of Percoll two cell fractions were obtained, the former containing more than 80% erythroid precursors (collected at a density of 1065-1075 mg/ml), the latter containing more than 78% blast cells plus granulomonocytic precursors (collected at a density of 1060-1055 mg/ml). FISH documented the presence of a majority of interphase nuclei with three signals in the erythroblast-enriched cell fraction and in the blast-enriched cell fraction. It is concluded that cytologic features, as well as interphase cytogenetic findings on enriched cell fractions, suggest the occurrence of multipotent stem cell involvement in AML-M4 with +11.
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Cromossomos Humanos Par 11 , Eritroblastos/patologia , Leucemia Mielomonocítica Aguda/genética , Leucemia Mielomonocítica Aguda/patologia , Trissomia , Adulto , Medula Óssea/patologia , Granulócitos/patologia , Humanos , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-IdadeRESUMO
To better understand the role of trisomy 8 in myelodysplastic syndrome (MDS), we performed a multiparameter analysis combining conventional chromosome studies (CCS), fluorescence in situ hybridization (FISH), and bone marrow (BM) culture studies in two patients with MDS evolving into acute myeloid leukemia (AML). A mosaicism of a cytogenetically normal clone and a clone with trisomy 8 was detected in both patients throughout the course of the disease, a finding confirmed by FISH on BM cells. The relative size of the trisomic clone increased from 52% to 71% (p < 0.0001) and from 53% to 69% (p = 0.001) of all BM cells at the time of the leukemic switch in patients 1 and 2, respectively. Combined FISH and immunophenotyping of BM cells showed involvement of the granulomonocytic lineage in patient 1 and involvement of erythroid cells as well as of the granulomonocytic lineage in patient 2. Only disomic lymphocytes were detected in both patients. FISH on single hemopoietic colonies grown in semisolid media detected trisomic CFU-GM and disomic BFU-E in patient 1, whereas a proportion of CFU-GM and BFU-E deriving from the trisomic clone was detected in patient 2. However, the percent of trisomic colonies was lower than the percent of involved granulomonocyte precursors and involved erythroblasts, as detected by combined FISH and immunophenotyping on fresh BM samples. We have thus shown heterogeneity of lineage involvement by trisomy 8 in MDS undergoing transformation into AML. Although preferential growth of disomic clones may occur in vitro, the finding of an increased size of the trisomic clone at the time of leukemic switch suggests that these cells had proliferative advantage in vivo over cells without trisomy 8.
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Medula Óssea/química , Cromossomos Humanos Par 8 , DNA/análise , Heterogeneidade Genética , Síndromes Mielodisplásicas/genética , Trissomia/genética , Idoso , Medula Óssea/ultraestrutura , Células Cultivadas , Humanos , Imunofenotipagem , Hibridização in Situ Fluorescente , MasculinoRESUMO
Although the recognition of hybrid acute leukemia (HAL) is still controversial, several reports have described cytogenetic findings in these leukemias over the last 3 years. A distinct chromosomal profile appears to be associated with different immunologic subsets of HAL. The classical t(15;17), and inv(16) as well as abnormalities of the long arm of chromosome 5 and/or 7 are preferentially associated with acute myeloid leukemia (AML) with T-cell features; the t(8;21)(q22;q22), the Ph chromosome, and 11q23 rearrangements are more frequently found in AML with B-cell features; the Ph chromosome, t11q23 and 14q32 breaks without rearrangements of the immunoglobulin heavy chain gene may be associated with acute lymphoblastic leukemia (ALL) with myeloid markers. In addition, some chromosome aberrations may be encountered more frequently in acute leukemia with major phenotype deviations than in unselected cases of acute leukemia: namely the Ph chromosome, 11q23 rearrangements, and +13. These chromosome changes appear to be associated with a low complete remission (CR) rate. An association has been documented in some patients with ALL between the presence of the t(9;22) and a minor myeloid component consisting of 5-15% blast cells with myelomonocytic features, raising the possibility that a diagnosis of bilineal acute leukemia would be more appropriate in such cases. These patients appear to have a severe outcome with significantly lower CR rate than similar cases of Ph-positive ALL without a minor myeloid component.(ABSTRACT TRUNCATED AT 250 WORDS)
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Aberrações Cromossômicas/patologia , Leucemia/patologia , Doença Aguda , Transtornos Cromossômicos , Humanos , Imunofenotipagem , Leucemia/diagnóstico , Leucemia/genética , Fenótipo , Prognóstico , Translocação GenéticaRESUMO
We investigate the efficacy of daunomycin, some imino- and amino-substituted daunomycin analogues and the disubstituted aminoanthracenedione, mitoxantrone, in photosensitizing short-term cell kill upon irradiation in the long wavelength visible range, during incubation of Fisher rat thyroid cells with the drugs. While all compounds exhibit similar cytocidal effects on our cell line, in the absence of irradiation, administering 86 J/cm2 at wavelengths either coincident or close to drug absorption peaks causes greater enhancement in cell mortality for the 4-demethoxydaunomycin analogues than either the parent drug or its 5-imino-derivative. A lower enhancement is observed with mitoxantrone. In particular, C50 doses (i.e. concentrations that would kill 50% cells) as low as approximately 10(-9) M are found for both 6- and 11-amino 4-demethoxydaunomycin, compared with the values obtained in the absence of light, which are 2.59 x 10(-4) and 0.43 x 10(-4) M, respectively. Our previous studies of the photophysical and photochemical properties of the excited states of these drugs, and ESR and spin trapping studies of photosensitized generation of singlet oxygen, which were extended in this work to include mitoxantrone, indicate that the cytocidal effects proceed via type I rather than type II mechanisms.
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Sobrevivência Celular/efeitos da radiação , Daunorrubicina/análogos & derivados , Daunorrubicina/farmacologia , Lasers , Radiossensibilizantes , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Mitoxantrona/farmacologia , Ratos , Relação Estrutura-Atividade , Glândula TireoideRESUMO
We have compared the cytotoxicity of daunomycin in vitro to highly differentiated normal epithelial cells (Fisher rat thyroid cells, FRTL-5) and to two neoplastic cell lines, a thyroid carcinoma (TK-6) and its lung metastasis (MPTK-6). Whereas the cell lines are equally sensitive to the drug in the dark, if irradiated during incubation with daunomycin (86 J/cm2 at 488 nm), they become more and differently sensitive. Namely, the drug doses producing 50% mortality decrease by factors of about 22, 28 and 16 for FRTL-5, TK-6 and MPTK-6 cell lines, respectively. This result correlates with differences in drug uptake and resistance observed in the normal and neoplastic cell lines.
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Sobrevivência Celular/efeitos dos fármacos , Daunorrubicina/efeitos da radiação , Daunorrubicina/toxicidade , Animais , Transporte Biológico , Linhagem Celular , Sobrevivência Celular/efeitos da radiação , Escuridão , Daunorrubicina/metabolismo , Luz , Neoplasias Pulmonares/secundário , Ratos , Ratos Endogâmicos F344 , Glândula Tireoide , Neoplasias da Glândula Tireoide , Células Tumorais CultivadasRESUMO
Administering a light dose of 90 J/cm2 at 599 nm during incubation with hypericin to a highly differentiated normal epithelial cell line (FRTL-5), derived from Fisher rat thyroid, and to a neoplastic cell line (MPTK-6), derived from the lung metastases of a thyroid carcinoma induced in Fisher rats, produces cell kill at drug doses 1000 times lower than those necessary to cause the same mortality in the dark. The photocytocidal activity of this polycyclic quinone drug on neoplastic cells is superior to that of antitumor anthraquinone drugs, such as daunomycin and mitoxanthrone, and to the photosensitized antiviral activity previously reported for hypericin.
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Perileno/análogos & derivados , Fármacos Fotossensibilizantes/farmacologia , Animais , Antracenos , Morte Celular/efeitos dos fármacos , Morte Celular/efeitos da radiação , Linhagem Celular , Lasers , Perileno/farmacologia , Ratos , Células Tumorais Cultivadas/efeitos dos fármacos , Células Tumorais Cultivadas/efeitos da radiaçãoRESUMO
We describe a fluorometric technique for the measurement of transport parameters of fluorescent drugs through cellular membranes. Unlike other procedures, this method gives an accurate measure of drug accumulated in the cells and measures the fraction of free and bound drug in the cell. The kinetic parameters of transport through cellular membranes are determined using a simple three-compartment model combined with fluorescence measurements performed on the extracellular medium and on Triton-permeabilized cells during daunorubicin incorporation. With this technique we found that LoVo cells have a greater daunorubicin uptake, a similar input rate constant and a lower output rate constant than the drug-resistant LoVo/DX cells.
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Antibióticos Antineoplásicos/farmacocinética , Daunorrubicina/farmacocinética , Transporte Biológico Ativo , Resistência a Medicamentos , Humanos , Cinética , Modelos Biológicos , Células Tumorais CultivadasRESUMO
An apparatus for laser-induced time-resolved fluorescence measurements, in conjunction with pyrene derivatives endowed with long-lived excited singlet states, was employed for immunocytofluorometric measurements. N-(1-pyrene)maleimide, 1-pyrenesulfonyl chloride and 1-pyreneisothiocyanate were conjugated with immunoglobulin, antimouse-IgG, and the fluorescence decays of both free and conjugated forms were investigated. Bi-exponential decays were obtained in all cases with time constants of the short-lived component in the range 3-4.7 ns and the long-lived one in the range 20-55 ns. Only the spectral distribution of the two components is essentially affected upon conjugation. The persistence of the long-lived component, well above the lifetime of autofluorescence, and of the antibody specificity, as shown by immunodiffusion tests, upon conjugation indicates that this technique could be advantageously adopted in immunocytofluorometry.
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Corantes Fluorescentes , Imuno-Histoquímica/métodos , Pirenos , Espectrometria de Fluorescência/métodos , Animais , Imunoglobulina G , Isotiocianatos , Lasers , Maleimidas , Camundongos , Teoria Quântica , Relação Estrutura-Atividade , Ácidos SulfínicosRESUMO
Fluorometric measurements on extracellular medium are shown to allow kinetic parameters of in vitro anthracycline uptake by cells to be calculated. The method provides influx and efflux rates, as well as the time dependence of both influx and efflux. It is applied to a normal thyroid epithelial cell line (FRTL-5) and a cell line (MPTK-6) derived from the lung metastases of a thyroid carcinoma exposed to daunorubicin at concentrations within the range of 250 to 1000 ng/ml. The results show that the number of cells influences the dependence of the kinetics upon the extracellular drug concentration and that the MPTK-6 cells are endowed with very efficient efflux mechanisms.
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Daunorrubicina/farmacocinética , Doxorrubicina/farmacocinética , Animais , Antineoplásicos/farmacocinética , Células Cultivadas , Meios de Cultura , Células Epiteliais , Epitélio/metabolismo , Espaço Extracelular/metabolismo , Fluorometria , Lipoproteínas LDL/fisiologia , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/secundário , Neoplasias/tratamento farmacológico , Ratos , Espectrometria de Fluorescência , Glândula Tireoide/citologia , Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/patologiaRESUMO
The absorption, fluorescence and S1 state kinetics of anthracycline antitumour drugs (e.g. daunomycin, adriamycin) and several imino- and/or amino-substituted derivatives are investigated. The study, which includes all anthracyclines which possess photocytocidal activity, is extended to the disubstituted aminoanthracenedione, mitoxantrone, a red-light-absorbing antitumour drug whose activity, both in vitro and in vivo, is enhanced by photoactivation. The S1 state of the anthracycline imino and amino derivatives, in aqueous buffer at pH 7.4, is characterized by bi-exponential decay kinetics which indicates the presence of two ground state populations differing in the extent of hydrogen bonding. The ammonium group of the sugar moiety of anthracyclines contributes to the quenching of the S1 state population through a prototropic mechanism.
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Antibióticos Antineoplásicos/química , Radiossensibilizantes/química , Daunorrubicina/análogos & derivados , Daunorrubicina/química , Doxorrubicina/análogos & derivados , Doxorrubicina/química , Cinética , Estrutura Molecular , Espectrometria de Fluorescência , Espectrofotometria , Relação Estrutura-AtividadeRESUMO
The blue beam of an Argon laser (488 nm) has been focused on the cell membrane in the presence of phenol-red, an usual component of cell culture media, through a 100 x objective. At the site of the beam impact, due probably to local temperature changes, the cell membrane modifies its permeability. As a consequence of the hit, circular areas, whose radius may be apparently regulated by changing the irradiation time and/or the radiation intensity (energy), appear on the wall, last for a short time and fade spontaneously within 1-2 minutes. No evident sings of cell injury or hurt have been observed afterward. Plasmid DNA, purposely added to culture fluid, easily slips in the cytoplasm; utilizing such approach, thereafter indicated as "optoporation', we have successfully transfected two genes, namely beta-galactosidase and chloramphenicol-acetyl-transferase in murine NIH3T3 fibroblasts. Therefore optoporation represents an additional procedure for gene transfer with several advantages over already available methods: (1) it only takes advantage of the presence of phenol-red, a normal cell medium component, with no need of addition of extraneous substances; (2) it is a very mild treatment virtually suitable for any cell type and (3) it allows transfection of selected cells even in the presence of cells of different type (providing that they are morphologically distinguishable).
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Argônio , Corantes/química , DNA Bacteriano , Técnicas de Transferência de Genes , Fenolsulfonaftaleína/química , Células 3T3 , Animais , Cloranfenicol O-Acetiltransferase/genética , Eletroporação , Células Eucarióticas/metabolismo , Lasers , Camundongos , beta-Galactosidase/genéticaRESUMO
We have investigated the photoactivating effect of hypericin on two cancer cell lines: PC-3, a prostatic adenocarcinoma non-responsive to androgen therapy and LNCaP, a lymphonodal metastasis of prostate carcinoma responsive to androgen therapy. The two cell lines are incubated for 24 h with hypericin at concentrations ranging from 0.001 to 0.3 microg/ml in cell culture medium. The cells are irradiated at 599 nm (fluence = 11 J/cm2) using a dye laser pumped by an argon laser. Hypericin exerts phototoxic effects on both cell lines, while it does not produce toxic effects in the absence of irradiation. These results suggest that photodynamic therapy (PDT) with hypericin could be an alternative approach to the treatment of prostatic tumors, and could be beneficial in tumors that are non-responsive to androgen therapy.
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Adenocarcinoma/tratamento farmacológico , Antineoplásicos/farmacologia , Perileno/análogos & derivados , Fotoquimioterapia/métodos , Neoplasias da Próstata/tratamento farmacológico , Radiossensibilizantes/farmacologia , Adenocarcinoma/secundário , Antracenos , Antineoplásicos/uso terapêutico , Humanos , Masculino , Metástase Neoplásica , Perileno/farmacologia , Perileno/uso terapêutico , Radiossensibilizantes/uso terapêutico , Células Tumorais CultivadasRESUMO
Treatments currently employed for plantar warts are often painful (electrosurgery, cryotherapy) and not always effective (keratolytic agents). In this paper we investigate the effect of photodynamic therapy (PDT) with topical delta-aminolaevulinic acid (ALA) on plantar warts. In order to remove the superficial hyperkeratotic layer of the warts an ointment containing 10% urea and 10% salicylic acid was applied for 7 days. After gentle curettage, a cream containing 20% ALA was applied under an occlusive dressing for 5 h on 64 warts, while 57 warts (controls) received only the vehicle. Both the ALA-treated warts and the controls were irradiated using a visible light lamp (with a range of 400-700 nm, peaking at 630 nm). The light dose was 50 J/cm(2). Patients were followed-up for 22 months. Two months after the last irradiation session 48 (75.0%) out of 64 ALA-PDT treated warts had resolved. By contrast only 13 (22.8%) of the 57 control warts had done so. During the treatment a few patients complained of a mild burning sensation. The absorption of ALA by the verrucous tissue was demonstrated by in vivo fluorescence spectroscopy. This study shows that topical ALA-PDT can be an alternative treatment for plantar warts. Further studies will be necessary in order to optimize the concentration of ALA and duration of treatment.