Isolated primary osteoma cutis of the head: Case report

Osteoma cutis is a rare disease in which there is formation of bony tissue in the skin that causes deformities. The etiology remains unknown and its treatment is controversial. A rare case of primary osteoma cutis in the face and scalp, which was not associated with any syndrome, is described. The patient was treated with surgery and topical retinoic acid. The retinoic acid treatment resulted in an improvement of the frontal area, and stabilized the disease over a two-year follow-up period. Surgical resection was a simple treatment with a quick recovery, minimal scarring and no local recurrence. The patient was followed for two years and presented a satisfactory result.The treatment of osteoma cutis is quite variable, and surgery is the most frequently reported treatment. However, a combination of clinical and surgical treatments seems to be an efficient way to manage these patients.     

Sources of influence on infant feeding practices in Hong Kong

The breastfeeding rate in Hong Kong is low compared to the rates in Western countries. To understand the relative importance of different sources of influence on infant feeding practices, 714 Chinese mothers with infants aged 4 weeks to 6 months were studied. It was found that the bottlefeeding mothers were influenced more by the medical professionals who did not support breastfeeding. This influence was further reinforced by the mass media and particularly television advertisements on infant formulae. The successful breastfeeding mothers, on the other hand, were influenced more by their social networks through which they were told of the dangers of bottlefeeding. The failed breastfeeding mothers differed from the other groups in the lack of support they experienced from friends and relatives. Although they received professional encouragement to breastfeed, they were more sheltered from the influence of mass media and social networks. From these findings, it is suggested that different sources of influence are related to different feeding practices. However, to be able to continue with the practice that one has chosen, the availability of social support is essential. Implications of these findings are discussed and several recommendations to promote breastfeeding are made.     

Galanin is a potent in vivo modulator of mesencephalic serotonergic neurotransmission.

Neurochemical, molecular, immunohistochemical and behavioral methods were used to examine the in vivo effects of the neuropeptide galanin on central 5-HT neurotransmission and on 5-HT(1A) receptor-mediated responses. Intraventricularly infused galanin caused a long-lasting and dose-dependent reduction of basal extracellular 5-HT levels in the ventral hippocampus of awake rats as measured by microdialysis. Infusion of galanin into the dorsal raphe nucleus (DRN), but not intra-hippocampally, reduced 5-HT release. The effect of i.c.v. galanin on 5-HT release was blocked by the galanin receptor antagonist M35, acting most likely via galanin receptors at the level of the DRN. Galanin also reduced the levels of tryptophanhydroxylase mRNA in the DRN. Therefore, the effects of galanin on 5-HT(1A) receptor-mediated responses were further investigated. Surprisingly, galanin significantly attenuated the reduction of hippocampal 5-HT release induced by systemic injection of the 5-HT(1A) receptor agonist 8-OH-DPAT. Galanin also attenuated 8-OH-DPAT-induced hypothermia and locomotor activity in rats. These results indicate that galanin has important inhibitory actions on central 5-HT neurotransmission and on 5-HT(1A) receptor-mediated events.     

Evaluation of breastfeeding of very low birth weight infants: can we use the infant breastfeeding assessment tool?

The objective of this study was to evaluate the use of the Infant Breastfeeding Assessment Tool (IBFAT, Matthews, 1993) to assess breastfeeding in very low birth weight (VLBW, < 1.5 kg) infants. Thirty-four mothers of singleton VLBW infants completed the IBFAT and underwent a standardized feeding observation at 35 weeks corrected age. Median feeding duration was 14.5 minutes (range, 1-20), intake per feed was 6.0 mL (range, 0-60), and intake rate was 0.5 mL/minute (range, 0-3). IBFAT scores were correlated with feeding observation measures. The IBFAT summary score was significantly correlated with milk intake volume (r = 0.651, P < .001) and intake rate (r = 0.559, P = .001). The IBFAT sucking quality score was significantly associated with percent time sucking (r = 0.559, P = .001) and sucking bursts (r = 0.632, P< .001 on the feeding observation. The authors conclude that although IBFAT scores correlated with objective feeding measures, these data do not support use of the IBFAT to identify infants with adequate as compared to inadequate intakes. Further study is needed.     

Subdural Empyema in a 12–Year–Old Girl: The Value of Magnetic Resonance Imaging

A 12–year–old girl presented with an acute history of fever, headaches, and focal neurological deficits. An initial computed tomography (CT) scan of the head was nondiagnostic whereas plain and gadolinium–enhanced magnetic resonance imaging (MRI) detected an extensive subdural empyema. The report emphasizes the hazard of relying on a nondiagnostic CT scan in a septic patient with deteriorating neurological function, and the need of MRI with contrast enhancement if subdural empyema is a serious clinical concern.     

Vitamin C and oxidative stress on cultured human keratinocytes

The aim of this research was to study the hypoxia-induced oxidative stress on cultured human keratinocytes. Control and cultured human keratinocytes were treated with vitamin C, and were then assessed by determining the concentration of malonyl dialdehyde (a final product of lipid peroxidation) existing in the cultured environment. Forty-eight flasks with culture of keratinocytes in confluent layer were divided into four groups: one control and one experimental group treated with vitamin C, and one control and one experimental group without vitamin C. All the cultures were sampled for malonyl dialdehyde assessment immediately after the end of a 30 min period of hypoxia. The statistical analysis of the results showed that vitamin C was not an effective protective agent against oxidative stress caused by hypoxia.     

Change in proptosis following extraocular muscle surgery: effects of muscle recession in thyroid-associated orbitopathy.

PURPOSE: To evaluate the effect of strabismus surgery on proptosis in patients with thyroid-associated orbitopathy. METHODS: The medical records of 22 consecutive patients with thyroid-associated orbitopathy undergoing strabismus surgery were reviewed. Data pertaining to the number of muscles operated on, amount of muscle recession, prior orbital decompression, and exophthalmometry were evaluated. RESULTS: Thirty-eight eyes in 22 patients with thyroid-associated orbitopathy were studied before and after strabismus surgery. The mean change in exophthalmometry following strabismus surgery in all eyes was +0.6 mm (p < 0.01). Eyes with prior decompression averaged a 0.9 mm increase following strabismus surgery (p < 0.01); those without decompression averaged a 0.2 mm decrease (p = 0.658). In eyes that underwent two rectus muscle recessions the increase in Hertel measurements averaged 1.2 mm; when only one muscle was recessed, the average increase was 0.2 mm. In the eyes with muscle recession < or =5 mm, the mean exophthalmometric increase was 0.7 mm. When a muscle recession of more than 5 mm was performed, the exophthalmometry showed a mean increase of 0.5 mm. CONCLUSIONS: Strabismus surgery on patients with thyroid-associated orbitopathy can worsen proptosis, especially in those with prior decompression. When planning for orbital decompression, the surgeon should consider this effect. Moreover, patients should be made aware of the possible changes to their appearance.     

Applied anatomy of the fasciocutaneous branch of the third perforator artery of the deep femoral artery

A study of the anatomy of the fasciocutaneous branch of the third perforator artery of the deep femoral artery was performed to help the elaboration of a fasciocutaneous flap for the reconstruction of skin and subcutaneous and deep fascia of the knee and popliteal region.Forty thighs in 27 fresh cadavers were dissected. In all of the thighs, the third perforator artery was found to arise from the deep femoral artery and reach the posterior aspect of the thigh after perforating the adductor magnus muscle. At that point it was also found that the third perforator artery gives off a branch that emerges through the intermuscular septum between the vast lateral muscle and the long head of the biceps femoral muscle, then crosses the posterior cutaneous nerve and moves directly on to perforate the deep fascia and then to bifurcate into two other branches: one ascending and one descending.The cutaneous area of the flap of the thigh’s posterior region, nourished by the fasciocutaneous branch, was evaluated through the injection of dye. Dying of the upper medial, middle medial, lower medial and lower lateral areas of the flap was not successful in all of the dissected thighs. Nevertheless, the upper lateral and the middle lateral areas were dyed successfully in all 40 dissected thighs of the 27 cadavers.