Comparison study of a Q‐switched alexandrite laser delivered with versus without compression in the treatment of dermal pigmented lesions

Background: The Q‐switched laser is the treatment of choice when attempting to improve dermal pigmented lesions. However, purpura and dyspigmentation are frequently observed after treatment. Objective: To compare the efficacy and complications of the Q‐switched alexandrite laser when delivered with versus without compression in the treatment of dermal pigmented lesions. Methods: Ten patients with dermal lesions were enrolled in the study. Each patient had a lesion treated with the Q‐switched alexandrite laser delivered with compression. Each patient also had a lesion treated with the Q‐switched alexandrite laser delivered without compression with the same fluence and spot size. The patients were evaluated for efficacy and treatment‐related side effects. Results: There was no significant difference in efficacy, but purpura and dyspigmentation were more likely when pigmented lesions were treated without compression. Conclusion: Purpura from Q‐switched laser treatment in darkly pigmented skin is due to mechanical injury of blood vessels. It is well known that pressure ‘diascopy’ eliminates blood from cutaneous vessels by coapting the vessel lumen. In this study, we used pressure applied by a glass window on the Q‐switched laser handpiece to remove cutaneous blood during laser exposure, making it possible to reduce purpura and dyspigmentation.     

Clinical impact of endoscopy position detecting unit(UPD-3) for a non-sedated colonoscopy

AIM:To evaluate whether an endoscopy position detecting unit(UPD-3) can improve cecal intubation rates, cecal intubation times and visual analog scale(VAS) pain scores, regardless of the colonoscopist's level of experience.METHODS:A total of 260 patients(170 men and 90women)who underwent a colonoscopy were divided into the UPD-3-guided group or the conventional group(no UPD-3 guidance).Colonoscopies were performed by experts(experience of more than 1000colonoscopies)or trainees(experience of less than 100colonoscopies).Cecal intubation rates,cecal intubation times,insertion methods(straight insertion:shortening the colonic fold through the bending technique;roping insertion:right turn shortening technique)and patient discomfort were assessed.Patient discomfort during the endoscope insertion was scored by the VAS that was divided into 6 degrees of pain.RESULTS:The cecum intubation rates,cecal intubation times,number of cecal intubations that were performed in15 min and insertion methods were not significantly different between the conventional group and the UPD-3-guided group.The number of patients who experienced pain during the insertion was markedly less in the UPD-3-guided group than in the conventional group.Univariate and multivariate analysis showed that the following factors were associated with lower VAS pain scores during endoscope insertion:insertion method(straight insertion)and UPD-3guidance in the trainee group.For the experts group,univariate analysis showed that only the insertion method(straight insertion)was associated with lower VAS pain scores.CONCLUSION:Although UPD-3 guidance did not shorten intubation times,it resulted in less patient painduring endoscope insertion compared with conventional endoscopy for the procedures performed by trainees.     

Establishment of tyrosinase sequence database in normally pigmented Indians and Japanese for rapid determination of novel mutations

BACKGROUND: Many mutations of the tyrosinase gene have been reported in oculocutaneous albinism type I (OCA1) patient. In the future, a greater number of novel mutations will be found as the search for pathological mutations in the tyrosinase genes of OCA patients from various ethnic origins. For rapid determination in future whether an observed mutation is a polymorphism or a novel pathological one, sequence databases of the gene of various ethnic people are needed. OBJECTIVE: We established a sequence database of the tyrosinase gene of Japanese as well as Indian people. METHOD: We collected DNA from 109 Japanese and 103 Indians with normal pigmentation and analyzed their tyrosinase gene using a direct sequencing method. RESULT: The database shows an apparent difference between the two ethnic groups in polymorphisms of the tyrosinase gene namely, Q402 allele, Y192 allele and IV2+24 insT were found in the Indian population, but not in the Japanese. On the other hand, some Japanese had IV2-21 insT but none of the Indians did. The database supports the notion that the tyrosinase gene evolved and extended separately in the two ethnic groups. And the developing database confirmed that the reported mutations causing Indian and Japanese OCA were not among the polymorphisms in the database, which conversely gives genetical proof of the "genuine" pathological mutations. CONCLUSION: Eventually, the sequence database we established will contribute to demonstrating novel mutations of albinism in Indians and Japanese.     

Seroepidemiological study of infection with West Nile virus in Karachi, Pakistan, in 1983 and 1985

The prevalence of West Nile (WN) virus infection in Karachi, Pakistan, was unknown until 1982. It had been noticed that there were more than a few patients with encephalitides in Karachi, and it was supposed that Japanese encephalitis (JE) cases would be found among them. Therefore, a seroepidemiological study was conducted to define the prevalence of WN virus infection and the possible occurrence of JE virus infection in the Karachi area. Prevalences of haemagglutination inhibition (HI) and neutralization (NT) antibodies against WN virus were studied among 81 serum samples (in July, 33 samples; in September, 48) during 1983, and among 156 paired serum samples that were collected twice, in July and October of 1985. Nearly the same antibody-positive rates were obtained in July of both years (1983: HI 55%; 1985: HI 53%; NT 50%); the rates increased slightly during September/October (1983: HI 65%; 1985: HI 59%, NT 54%). Among 156 paired samples in 1985, 20 (13%) and 12 (8%) showed positive- or negative-antibody conversion between July and October. Two serum samples from each of 156 residents obtained in July had a significantly higher NT antibody titre against JE virus than against WN virus (in case 1, JE 1:80, WN less than 1:10; in case 2, JE 1:40, WN less than 1:10). This is the first report to show the prevalence of WN virus infection in Karachi, Pakistan.     

Intracellular nucleic acid sensors and autoimmunity

A collection of molecular sensors has been defined by studies in the last decade that can recognize a diverse array of pathogens and initiate protective immune and inflammatory responses. However, if the molecular signatures recognized are shared by both foreign and self-molecules, as is the case of nucleic acids, then the responses initiated by these sensors may have deleterious consequences. Notably, this adverse occurrence may be of primary importance in autoimmune disease pathogenesis. In this case, microbe-induced damage or mishandled physiologic processes could lead to the generation of microparticles containing self-nucleic acids. These particles may inappropriately gain access to the cytosol or endolysosomes and, hence, engage resident RNA and DNA sensors. Evidence, as reviewed here, strongly indicates that these sensors are primary contributors to autoimmune disease pathogenesis, spearheading efforts toward development of novel therapeutics for these disorders.     

An enzyme immunoassay for a metabolite of a new sleep inducer (450191-S), a ring-opened derivative of 1,4-benzodiazepine, in human serum

A competitive enzyme immunoassay was developed for metabolites of 450191-S, a ring-opened derivative of triazolobenzodiazepines, in human serum. Three kinds of labelled antigens, beta-D-galactosidase conjugates, and antisera from three kinds of immunogens, bovine serum albumin conjugates, were tested and the hapten heterologous assay was selected. B/F separation was performed using immobilized second antibody and the enzyme activity was measured using fluorescent substrate. One of the serum metabolites, the carboxyl form, was extracted from acidified serum and measured by the assay. The minimum detectable concentration was 1.5 ng/ml in serum, 15 pg/tube. The intra-assay and inter-assay variances were 5.5% and 7.7% at 6 ng/ml of serum, respectively. Standard curves of other related metabolites were assessed with various combinations of labelled antigens and antibodies.     

Modulation of tetrodotoxin-resistant sodium channels by dihydropyrazole insecticide RH-3421 in rat dorsal root ganglion neurons

The effects of the dihydropyrazole insecticide RH-3421 on the retrodotoxin-resistant (TTX-R) voltage-gated sodium channels in rat dorsal root ganglion (DRG) neurons were studied using the whole-cell patch clamp technique. RH-3421 at 10 nM to 1 microM completely blocked action potentials. The sodium currents were irreversibly suppressed by 1 microM RH-3421 in a time- and a dose-dependent manner and the IC50 value of RH-3421 was estimated to be 0.7 microM after 10 min of application. RH-3421 blocked the sodium currents to the same extent over the entire range of test potentials. The sodium conductance-voltage curve was not shifted along the voltage axis by 1 microM RH-3421 application In contrast, both fast and slow steady-state sodium channel inactivation curves were shifted in the hyperpolarizing direction in the presence of 1 microM RH-3421. It was concluded that RH-3421 bound to the resting and inactivated sodium channels to cause block with a higher affinity for the latter state.     

Gender difference in QTc prolongation of people with mental disorders

Background

We examined gender difference in QTc interval distribution and its related factors in people with mental disorders.

Methods

We retrospectively reviewed medical charts of patients discharged from a university psychiatric unit between November 1997 and December 2000. Subjects were 328 patients (145 males and 183 females) taking psychotropics at their admission. We examined patient characteristics, medical history, diagnosis, and medication before admission.

Results

Mean QTc interval was 0.408 (SD = 0.036). QTc intervals in females were significantly longer than those in males. QTc of females without comorbidity was significantly longer than that of males.

Conclusion

The influence of gender difference on QTc prolongation in people with mental disorders merits further research.