OVERHEATING IN BED AS AN IMPORTANT FACTOR IN MANY COMMON DERMATOSES

Background. Extensive questioning of patients with a wide variety of skin disorders led to the impression that nocturnal overheating was probably an important factor in the initiation and the perpetuation of many skin disorders. Methods. In order to test the hypothesis, 12 “clean-skinned” subjects (6M/6F) aged 18 to 45 years were monitored electronically every 30 seconds during an 8 hour sleep period (2300 to 0700 hours), sleeping under a standard 10 tog duvet. Results. All the subjects were too hot by 3 to 4°C. All showed changes in their EEG patterns with reduced REM sleep, increased awakenings, and all showed changes in their sleep stage patterns. In addition, they all showed evidence of increased sweating in the “heat-sink” area. Conclusions. The mechanisms where by such changes could be implicated in the precipitation and perpetuation of skin disease are discussed. “Lifestyle” modification as a very effective, noninvasive, therapeutic regime is recommended. Further research along these lines would probably be very valuable and instructive.     

Unusual Cause of Methadone Poisoning

ABSTRACT. A child with respiratory distress was found to have been given an antibiotic which was reconstituted with methadone. A delay in standard emergency room management led to a delay in diagnosis and treatment.     

Assessment of Aortic Coarctation and Collateral Circulation By Biplane Transesophageal Echocardiography

Our experience in using biplane transesophageal echocardiography in the assessment of coarctation of the aorta is described.     

Use of a Novel Pulse Dye Laser for Rapid Single-Pass Purpura-Free Treatment of Telangiectases

BACKGROUND Purpura-free elimination of telangiectases with a single pass of a pulsed dye laser with a large spot has proved difficult.
OBJECTIVE The purpose of this report was to define parameters that achieve single-pass purpura-free telangiectasia reduction.
MATERIALS Thirty patients between the ages of 23 and 78 years were treated with a pulsed dye laser with a 10-mm spot and fluences ranging from 9 to 10 J/cm². The macropulse width was 20 ms. Each macropulse was composed of eight pulselets. Treatments were carried out over facial areas with discrete telangiectases.
RESULTS Smaller telangiectases (<600 μm) showed transient bluing followed by stenosis. Larger vessels (600–10,000 μm) showed bluing but inconsistent closure. A second pass typically resulted in closure.
CONCLUSION A modified pulsed dye laser was capable of single-pass purpura-free reduction with a 10-mm spot size.     

Expression of BCL-2 in the developing human fetal and infant breast

The expression of BCL-2 protein was analysed in 10 fetal and 45 infant breast specimens by immunocytochemical staining of methacarn-fixed, paraffin-embedded tissue. In the developing fetal breast bud, BCL-2 was expressed in the basal cell layer and in the surrounding mesenchyme. Basal cells of epithelial buds destined to become hair follicles also expressed BCL-2 while the basal cell layer of the epidermis was negative. In infant breasts studied (aged 0–2 years), there was heterogeneous staining of the luminal epithelial cells of the ducts and lobules and no staining of myoepithelial cells or fibroblasts. The intensity of staining had a strong positive correlation with the age of the infant. Although the function of the bcl -2 gene in epithelial cells is unknown, these findings suggest that bcl -2 has a role in the morphogenesis of the human breast, and may help to sustain active epithelial-mesenchymal interaction by inducing longevity of certain cells.