A Split-Face Comparison Study of Pulsed 532-nm KTP Laser and 595-nm Pulsed Dye Laser in the Treatment of Facial Telangiectasias and Diffuse Telangiectatic Facial Erythema

BACKGROUND AND OBJECTIVES: Pulsed 595 nm and 532 nm lasers can effectively diminish or eliminate facial telangiectasia. We performed a split-face, single-blind, controlled, comparison study in an effort to determine their individual and comparative efficacy. STUDY DESIGN/MATERIALS AND METHODS: Fifteen patients were treated using a 595-nm PDL on one side of the face and a pulsed 532-nm potassium-titanyl-phosphate (KTP) laser on the other. Each subject was evaluated at 3 weeks after three treatments. RESULTS: Both devices improved telangiectasia. The 532-nm device, however, was at least as effective or more effective than the 595-nm laser in all subjects. On average, the KTP laser achieved 62% clearing after the first treatment and 85% clearing 3 weeks after the third treatment, compared to 49% and 75% for the PDL, respectively. Seventy-nine percent of KTP laser-treated patients continued to have swelling for greater than 1 day versus 71% of PDL-treated patients. Of those patients who noted persistent erythema for at least 1 day after treatment, 58% noted more erythema on the KTP laser-treated side compared to 8% on the PDL-treated side. CONCLUSIONS: Both the 595-nm and the 532-nm pulsed lasers are highly effective in the treatment of facial telangiectasia and redness. The 532-nm KTP laser appears to be more effective but causes more swelling and erythema.     

Influence of external cardiac pacing on cerebral oxygenation measured by near‐infrared spectroscopy in children after cardiac surgery

Background: The brain of children in the early period after repair of congenital heart defects with cardiopulmonary bypass (CPB) may be more vulnerable to hemodynamic changes because of impaired cerebral autoregulation. During postoperative testing of the external temporary safety pacer, we performed desynchronizing ventricular pacing (VVI) while monitoring cerebral oxygenation using near‐infrared spectroscopy (NIRS). Methods: We prospectively investigated 11 children (6 girls, 5 boys). Mean age was 6.1 months (±3.8 months) and mean weight: 5.3 kg (±1.5 kg). We performed measurements at four study steps: baseline I, VVI pacing, baseline II and atrial pacing (AOO) to exclude effects of higher heart rate. We continuously measured the effects on hemodynamic and respiratory parameters as well as on cerebral tissue oxygenation index (TOI). Hemoglobin difference (HbD) was calculated as a parameter for cerebral blood flow (CBF). Results: Ventricular pacing leads to a significant decrease in arterial blood pressure and central venous saturation accompanied by an immediate and significant decrease in TOI (63.3% ± 7.6% to 61.5% ± 8.4% [P < 0.05]) and HbD (0.51 ± 1.8 μmol·l⁻¹ to −2.9 ± 4.7 μmol·l⁻¹ [P < 0.05]). Conclusion: Cardiac desynchronization after CPB seems to reduce CBF and cerebral oxygenation in children.     

Evidence of validity in a new method for measurement of dexterity in children and adolescents

Aim Many everyday activities involve manipulation of objects with the fingertips. Impaired performance in manipulative tasks is common in neurodevelopmental disorders. Thus accurate assessment of an individual’s ability to coordinate fingertip forces is important for planning treatment. We evaluated a recently developed assessment tool (the Strength–Dexterity Test), which is based on manipulation of unstable objects, in a paediatric population. Method A Rasch model was used to examine the validity and reliability of the Strength–Dexterity Test in a sample of 56 typically developing children and adolescents (30 males, 26 females; age range 4y 10mo–17y 3mo; mean age 9y 8mo, SD 3y 8mo). In addition, we examined how performance on this test relates to widely used tests for assessment of gross manual dexterity (assessed with the Box and Blocks Test) and finger strength measured with a pinch meter. Results The constructs measured with the 78‐item Strength–Dexterity Test include dexterity and strength, and form a unique unidimensional latent trait, named fingertip force coordination, that improves with age. The test has internal scale validity when applied to a typical paediatric population. Positive correlations (significant at p<0.001) were found among all three tests. Interpretation We provide preliminary evidence of construct validity in the Strength–Dexterity Test. Our findings suggest that this test has the potential to be developed into a promising tool for assessing dexterity in children.     

REACTIVE ARTHRITIS: UROGENTTAL SWAB CULTURE IS THE ONLY USEFUL DIAGNOSTIC METHOD FOR THE DETECTION OF THE ARTHRITOGENIC INFECTION IN EXTRA-ARTICULARLY ASYMPTOMATIC PATIENTS WITH UNDIFFERENTIATED OLIGOARTHRITIS

Reactive arthritis (ReA) is a scronegative oligoarthritis triggeredby a preceding extra-articular infection. While evidence ofa microbial infection is mandatory for establishing the diagnosisof ReA, the sensitivity of bacteriological and serological testshas not been determined in patients without symptoms of infection.In a retrospective study, we evaluated the usefulness of urogenitalswab cultures, serology and stool culture to identify infectionsin 234 patients with undifferentiated oligoarthritis. One hundredand forty-four patients complaining about joint pain who hadno sign or history of inflammatory arthritis served as controls.Urogenital swab cultures showed a microbial infection in 44%of the patients with oligoarthritis (15% Chlamydia, 14% Mycoplasma,28% Ureaplasma), whereas in the control group only 26% had apositive result (4% Chlamydia, 7% Mycoplasma, 21% Ureaplasma)(P < 0.001). A Chlamydia IgG-antibody titre     

Scabies with Clinical Features and Positive Darier Sign Mimicking Mastocytosis

Abstract:  Scabies is a common human parasitic infection in infants and children. But diagnosis pitfalls are frequent in infants, in whom the clinical presentation is usually atypical and different from adults. We report a misleading case of a 5-month-old child, who presented with pruritic brown–red macules of the trunk showing a positive Darier's sign, suggestive of an urticaria pigmentosa.     

Non-mammalian “big” neurophysins — complete amino acid sequence of a two-domain MSEL-neurophysin from goose

Vasotocin-associated neurophysin (MSEL-neurophysin) has been purified from goose neurohypophysis through molecular sieving and high-pressure reverse-phase liquid chromatography (HPLC). The protein has a molecular mass (measured by SDS-polyacrylamide gel electrophoresis) of 17kDa in contrast to 10kDa found for the mammalian MSEL-neurophysins. Complete amino acid sequence (131 residues) has been determined mainly through tryptic or staphylococcal proteinase peptides derived from carboxyamido-methylated neurophysin, isolated by HPLC and microsequenced. N- and C-terminal sequences have been established by Edman degradation or action of carboxypeptidase Y, respectively, applied on the native protein. Goose MSEL-neurophysin is homologous to the two-domain “big” MSEL-neurophysin previously identified in the frog. It appears that in non-mammalian tetrapods, namely birds and amphibians, the proteolytic processing of the pro-vasotocin involves only one cleavage, releasing the hormone moiety and a “big” neurophysin with two domains homologous to mammalian MSEL-neurophysin and copeptin, respectively. Comparison of the avian protein with its mammalian and amphibian counterparts reveals that the first half of the polypeptide chain is evolutionarily much less variable than the second and that the goose protein resembles the frog protein much more than the mammalian one.     

Centre for behavioural research in cancer

The Centre for Behavioural Research in Cancer (CBRC) is one of two research centres housed at the Anti-Cancer Council of Victoria, the other being an epidemiological research centre. The CBRC's main focus for research is in smoking behaviour. A feature of the Centre is its close organisational and professional links with Victoria's large publicly funded smoking prevention programme. This provides opportunities to conduct programme-related research, to influence the nature of tobacco reduction interventions and to evaluate outcomes.     

PLASMA CONCENTRATIONS OF NORADRENALINE AND ADRENALINE AND PLASMA RENIN ACTIVITY DURING EXTRADURAL BLOCKADE IN DOGS

Anaesthetized dogs (pentobarbitone 25 mg kg^–1+ 3 mg kg^–1h^–1) with a Teflon catheter inserted to the femoral arteryfor pressure and heart rate measurement and blood sampling werestudied. Eitradural puncture was carried out at L7-S1 underx-ray control and 2% lignocaine (1 ml min^–1) infused forapproximately 10 min. During extradural block a decrease inarterial pressure was accompanied by a simultaneous decreasein plasma noradrenaline concentration (NA) and a compensatoryincrease in plasma renin activity (PRA), which became significant15 min after commencing the block when the arterial pressurewas at the minimum. Dihydroergotamine (DHE) led to a rapid reversalof the hypotension with no change in heart rate and a decreasein PRA. Hypovolaemia (blood loss 5 ml kg^–1) was inducedbefore and during block, respectively, in two further experimentalgroups. Increased NA and PRA were found under hypovolaemia withoutextradural block, but only PRA increased with hypovolaemia anda block. The effects of DHE in the later studies were comparableto those observed in the initial study.     

Membrane fractions of trypanosomes mimic the immunosuppressive and mitogenic effects of living parasites on the host

African trypanosomiasis in mice leads to profound changes in lymphoid tissues. In an attempt to define the nature of the trypanosome stimulus, we have studied the effect of radio-attenuated trypanosomes and their subcellular fractions in vivo. We find that relatively low doses of irradiated Trypanosoma brucei S42 injected into (CBA/H x C57B1/6)F1 mice mimicked the previously reported effects of infective parasites. 2 x 10(7) irradiated trypanosomes caused a greater than two-fold increase in spleen weight accompanied by a roughly 10-fold increase in background plaque forming cells (PFC) to sheep red blood cells (SRBC). The primary response to SRBC was significantly enhanced when priming was carried out on the day of trypanosome injection, but significantly suppressed when carried out 3 days later. Disruption of trypanosomes by freeze-thawing did not destroy their mitogenic or immunosuppressive activities. A membrane fraction collected by high speed centrifugation (150 000 x g) after removal of larger organelles at 12 000 x g retained both mitogenic and suppressive activities. The high speed supernatant lost the ability to enhance background PFC, but still caused partial immunosuppression with a much lower potency than the membrane pellet. Whether immunosuppression and enhanced PFC levels relate to the same parasite product is not clear as yet, but both effects can be ascribed to a membrane fraction of the parasite.