Treatment of Acquired Bilateral Nevus of Ota-Like Macules (Hori''s Nevus) with a Combination of the 532 nm Q-Switched Nd:YAG Laser Followed by the 1,064 nm Q-Switched Nd:YAG Is More Effective: Prospective Study

BACKGROUND: Acquired bilateral nevus of Ota-like macules (Hori's nevus) is a common dyschromatosis among Asian women. Q-switched lasers have been used successfully as a treatment modality. OBJECTIVE: The purpose of this study was to compare the efficacy of using the Q-switched 532 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser followed by the 1,064 nm laser versus the Q-switched 1,064 nm Nd:YAG laser alone in the treatment of Hori's nevus. METHODS: This is a prospective left-right comparative study. Ten women with bilateral Hori's nevus were recruited and treated with a combination of the Q-switched 532 and 1,064 nm Nd:YAG lasers on the right cheek and the Q-switched 1,064 nm Nd:YAG laser alone on the left cheek. Only one laser treatment session was performed. The degree of pigmentation was objectively recorded with a mexameter. Subjective assessment was made by both patients and two blinded, nontreating dermatologists. RESULTS: At 6 months, there was a statistically significant difference (p = .009) of 35.10 points using objective mexameter measurements between the two sides, favoring the side treated with a combination of 532 and 1,064 nm laser treatment. Subjective grading by the patients and blinded dermatologists also confirmed that combination therapy was more successful after one treatment. Although combination treatment had a higher incidence of mild postinflammatory changes, this disappeared within 2 months. CONCLUSIONS: Concurrent use of the Q-switched 532 nm Nd:YAG laser in combination with the 1,064 nm laser is more effective in pigment clearance than the Q-switched 1,064 nm Nd:YAG laser alone for Hori's nevi.     

An outbreak of Pneumocystis carinii pneumonia in children with malignancy

An outbreak of Pneumocystis carinii pneumonia (PCP) in three patients within a 6 week period was reported. Two patients had acute lymphoblastic leukaemia and one had brain-stem glioma. They shared common features of immuno-suppression and absence of cotrimoxazole prophylaxis and had been nursed in the same room. The severity of PCP and its response to treatment may be related to the degree of immunosuppression. Because of the morbidity and mortality of PCP, chemoprophylaxis should be given to all at-risk cases. Furthermore, isolation of patients with PCP should be considered in view of increasing evidence of nosocomial transmission.     

血清中白细胞介素6和白细胞介素8水平在肝病检测中的临床应用

目的:血清中IL-6和IL-8的含量是临床检验中的重要指标,本实验主要对肝癌患者血清的IL-6和IL-8的水平进行了统计分析,为进一步临床监测提供依据。方法:对86份肝癌患者血清进行检测,同时收集30份正常血清和35份肝硬化患者血清作为对照比较。结果:肝癌患者血清中IL-6水平[(0.197±0.041)ng/ml]显著高于对照组(正常组的0.159±0.038;肝硬化组0.185±0.026);肝癌患者血清中IL-8水平[(0.463±0.127)ng/ml],显著高于对照组(正常组的0.354±0.113;肝硬化组,0.386±0.102)。结论:血清中IL-6、IL-8水平可以作为肝癌的临床监测指标。     

老年股骨颈骨折围手术期的治疗分析

目的探讨老年人股骨颈骨折的治疗及围手术期的处理。方法回顾性分析2003年1月～2006年12月手术治疗的201例老年股骨颈骨折患者资料，其中男51例，女150例，年龄60～98岁，平均78．2岁。按Garden分型，Ⅱ型20例，Ⅲ型86例，Ⅳ型95例。采用多枚中空螺钉固定、Morre型人工股骨头置换术或双极人工股骨头置换手术进行治疗。结果本组患者平均住院10～14d，5～7d即能早期下床活动，住院期间及术后1年内无一例死亡。85％患者获得8个月～4年（平均2年）的随访，功能恢复按Harris评分，优良率为85％。结论老年人各脏器机能衰退，多同时合并各种内科疾病，手术治疗存在风险，但老年人股骨颈骨折的手术治疗仍能取得满意疗效。     

Serious complications associated with Dettol poisoning

Dettol is involved in 10percnt; of self-poisoning-related hospitaladmissions in Hong Kong. Although serious poisonings and evendeaths after ingesting this common household disinfectant havebeen reported, the frequency with which these complicationsmay occur is not known. In a retrospective study of 67 casesof Dettol poisoning, we found that serious complications wererelatively common (8%) and these included aspiration of Dettolwith gastric contents resulting in pneumonia, cardiopulmonaryarrest, bronchospasm, adult respiratory distress syndrome, andsevere laryngeal oedema with upper airways obstruction. It isparticularly important that the airways are adequately protectedbefore the patient is lavaged following Dettol poisoning, andthe immediate recognition of any upper airway obstruction requiringintubation will then be lifesaving.     

Chinese herbs and warfarin potentiation by 'Danshen'

Drug interactions with warfarin can be dangerous and although common drug interactions are now well recognized those with Chinese herbs are not widely appreciated. 'Danshen' is a herbal medicine often used for various complaints, particularly cardiovascular, in the Chinese community. We report a case of danshen-induced overcoagulation with severe and dangerous abnormalities of clotting in a patient with rheumatic heart disease.