Hypopigmented macules of photodamaged skin and their treatment with topical tretinoin.

Hypopigmented macules are frequently observed in the photodamaged skin of elderly people. We undertook to study and treat 2 types of hypomelanosis of photoaged skin. These lesions were: 1) idiopathic guttate hypomelanosis; and 2) macular hypomelanosis. Comparative studies included: 1) high-resolution photography using parallel polarized light, ultra-violet (UVA) and epiluminescence; 2) Silflo replicas for microtopography; and 3) suction device (Cutometer) for elasticity. Macular hypomelanosis was distinguishable from idiopathic guttate hypomelanosis because the macules were less white and less well demarcated. Glyphic markings were essentially absent in macular hypomelanosis, but variably effaced in idiopathic guttate hypomelanosis. Distensibility of the macules was characteristically low in proportion to the loss of glyphic markings. The chief histologic finding was the absence of melanin in basal keratinocytes. Macular hypomelanosis and idiopathic guttate hypomelanosis are probably related disorders along a spectrum of depigmentation. Treatment with tretinoin for 4 months restored the elasticity, the glyphic markings, with a partial restoration of pigmentation.     

Magnesium in treatment of acute myocardial infarction

Magnesium has properties of myocardial cytoprotection, the pathophysiological explanations of which in acute myocardial infarction include prevention of arrhythmia, antiplatelet effect, prevention of reperfusion injury, and coronary vasodilation. Although several studies have evaluated the role of magnesium administration in patients with acute myocardium infarction, the clinical impact of such a therapy in this condition has been controversial, largely as a result of conflicting data from randomized controlled trials. The data available to date do not favor the routine administration of intravenous magnesium in patients with myocardial infarction, but this should not preclude magnesium administration to replenish low serum magnesium concentrations or use of magnesium sulfate for treatment of torsade de pointes in patients with myocardial infarction.     

Left main coronary artery aneurysm

Left main coronary artery aneurysm is rare finding at coronary angiography. We report a case of a large left main coronary artery aneurysm in a 59-year-old male who had cardiac catheterization for effort angina and inducible myocardial ischemia.     

Supplementation of dietary vitamins,protein and probiotics on semen traits and immunohistochemical study of pituitary hormones in zinc-induced molted broiler breeders

The purpose of this study was to investigate the effect of dietary vitamin E and vitamin C, probiotics mixture and protein level and their combination on semen quality and immunohistochemical study of some pituitary hormones in male broiler breeders. One hundred and eighty male broiler breeders 65 weeks old were divided into six groups by completely randomized design. The birds were subjected to zinc-induced molt by mixing zinc oxide at the rate of 3000 mg/kg in the feed. After molting, one group was fed control diet (CP16%). The other groups were fed vitamin E (100 IU/kg), vitamin C (500 IU/kg), probiotics (50 mg/L of drinking water), protein (CP14%) and combination of these components. These treatments were given for five weeks. After the feeding period, semen samples were taken and analyzed for semen volume, sperm concentration, motility and dead sperm percentage. Pituitary samples were collected from three birds per replicate and were processed for immunohistochemical study. The results of semen quality parameters revealed that semen volume and sperm motility were significantly high in the vitamin E fed group, while the dead sperm percentage decreased significantly in the vitamin C group. The morphometric analysis revealed that compared to other groups, vitamin E caused a significant increase in the size and area of FSH, LH gonadotropes and lactotropes. These results showed that vitamin E alone may play some role in the enhancement of semen quality and growth of gonadotropes and lactotropes.     

Irreversible delayed complete heart block secondary to jailed first septal perforator following PCI of the left anterior descending coronary artery

Permanent complete heart block (CHB) secondary to the loss of first septal perforator after percutaneous coronary intervention (PCI) of the left descending artery (LAD) is an extremely rare complication. We describe a case report where a patient underwent PCI of proximal LAD, complicated by loss of first septal perforator, septal infarction, and bifasicular block, which progressed to symptomatic delayed CHB. One week later, the patient required implantation of a permanent pacemaker following failure to wean off the transvenous temporary pacing maker.     

Orthognathic treatment of asymmetry: two cases of "waferless" stereotactic maxillary positioning

We present 2 cases in which navigation-guided surgery was used to correct complex facial asymmetry. The merits and challenges of using stereotactic technology to allow “waferless” positioning of the maxilla in orthognathic surgery are illustrated by patients who were operated on without the use of acrylic wafers to achieve three-dimensional correction of the maxillary deformity. Biometric assessment was made clinically and recorded with computed tomographic (CT) scanning. The operation was planned using Voxim^® software and the operation done with the aid of the Voxim^® navigation system.