Laser circumcision

Circumcision is one of the most commonly performed surgical procedures. A large variety of techniques have been used, but unfortunately, complications such as pain, bleeding, swelling, stitch granuloma, scab formation, and removal of improper proportions of skin/mucous membrane occur in significant numbers. The authors present a technique using the carbon dioxide laser to excise the prepuce and weld the cut edges together, thus providing a completely bloodless operation. Suturing is optional as the laser can also be used to unite the cut edges. The technique allows exact proportions of skin and mucous membrane to be removed. This method has been used in a total of 1,154 patients ranging in age from infancy to 10 years. A detailed analysis of postooperative recovery and follow-up indicates that minor complications occurred in only 4 patients, none of whom required hospital admission.     

Laser treatment of Coats' disease

A 9-year-old boy presented with an exudative retinal detachment, vascular telangiectasias, subretinal lipid, and retinal macrocyst formation. He underwent three sessions of large-spot diode laser for the treatment of Coats' disease. Serial examinations and fundus photography documented an excellent involutional response with an improvement in visual acuity.     

Laser resection of posterior urethral valves

 Laser resection (LR) of posterior urethral valves during infancy as early as possible after diagnosis appears to represent a safe and reliable method. In contrast to other procedures, LR allows valve ablation with thin cystoscopes and carries little risk, even in premature and newborn infants. Its application in seven children in the course of 2 years principally confirmed its suitability for use: it could be applied in all cases without any problems and led to extensive resection of the valve tissue and removal of the obstruction in all patients. The encouraging clinical findings were confirmed by control cystoscopies and micturating cystourethrograms. Complications arising from the method were not observed. Accepted: 9 March 2000     

Laser treatment of congenital vascular birthmarks

Congenital vascular birthmarks, classified as either hemangioma or vascular malformations (portwine stains), can now be cleared successfully using certain lasers. Since their introduction into medicine in the mid-1960s, several types of lasers including the argon, carbon dioxide, neodymium yttrium aluminum garnet (Nd:YAG) and pulsed tunable dye lasers have been used to treat benign cutaneous vascular lesions such as portwine stains. After extensive research examining the effects of specific laser parameters on tissue, a set of parameters was identified which together selectively destroyed blood vessels in the skin. Application of this laser technique for the treatment of benign cutaneous vascular lesions, such as portwine stains, meant that it was possible to destroy only the abnormally ectatic vessels which are inherent in these birthmarks. Because of the specificity of the laser injury, only the abnormal blood vessels are destroyed and healthy adjacent structures such as epidermal pigment and dermal collagen are left intact. Thus, unwanted adverse effects such as scar formation and pigmentary abnormalities at the laser-exposed site have been minimized. Skin treated using this combination of laser parameters normalizes in color, texture and its markings, and adnexae are maintained at the treated site. Not only has this new laser treatment provided a way of removing these disfiguring birthmarks with the return of normal-appearing skin at the treated site, but the lack of adverse effects following this treatment has meant that not only adults but children of all ages can now be treated using this technique.(ABSTRACT TRUNCATED AT 250 WORDS)     

Radiological investigation of abdominal masses

Intra-abdominal masses are a presenting feature of disease in a significant percentage of patients in the pediatric age group. The present article is an attempt at an analysis of roentgenological findings in thirtyfive such cases using simple techniques viz. straight x-ray abdomen, IVP, retrograde pyelography, barium meal and barium enema examinations. Certain characteristic signs are often revealed during the procedures e.g. the compressed, splayed appearance of the calyces of the kidney in Wilm's tumour, the relative displacement of the kidney by extra-renal masses and the crescentic calyceal pattern in cases of hydronephrosis (observed in IVP). Based on such signs, an etiological diagnosis is often possible.     

Radiologic investigation of rheumatic diseases

This article reviews the current use of the wide variety of imaging modalities now available, presenting the imaging features of common and important causes of acute and chronic rheumatic disorders including juvenile idiopathic arthritis, spondyloarthropathies/enthesitis-related arthritis, sepsis, autoimmune diseases, vasculitis, and osteoporosis.