The use of the steroid analyser in conjunction with a semi-automatic gas chromatograph in the routine analysis of urinary pregnanediol.
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Biomedical subjects
Publications and source records attributed to M Rogers.
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The work group identified a number of research areas where they felt there were significant data gaps where additional research was critical to better under standing of the origins of birth defects and to developing ways for their prevention. These included: 1. Studies designed to determine the role of growth and differentiation factors during pre- and postimplantation stages of development. These investigations could include descriptive studies involving the localization and timing of genes expressed and their products, but must also emphasize and include studies involving the function of these molecules and their interactions in normal and abnormal development. 2. Studies designed to develop and utilize models for investigating normal and abnormal development. These approaches could include in vivo and in vitro techniques, such as creation of genetically defined systems and cell, organ, and whole embryo cultures. These technologies should emphasize ways to study the functions of growth and differentiation factors and the effects of environmental factors. 3. Studies designed to identify environmental agents and their targets in embryonic, extraembryonic, and maternal tissues that may play a role in producing developmental abnormalities through peturbations of growth and differentiation factors. 4. Studies designed to determine cellular and molecular mechanisms for protection and recovery from environmental insults.
Pilomatrixomas are relatively common childhood tumors that usually occur in the head and neck region. The clinical diagnosis of these lesions may be difficult, especially if the examining physician is unfamiliar with them. Excision is usually recommended, as a foreign body reaction due to calcification of the lesion may occur and cause a vigorous inflammatory response with risk of scarring. A retrospective study was carried out by examining the preoperative ultrasound scans of 28 suspected pilomatrixomas in 25 children. The findings on sonography were correlated with the histologic results in 19 cases (18 pilomatrixomas and one ruptured epidermoid cyst). In the majority of patients, sonography either correctly supported or excluded the clinical diagnosis of pilomatrixoma and contributed to appropriate preoperative assessment and subsequent management of the lesion. We therefore found sonography of suspected pilomatrixomas in children to be a useful and noninvasive procedure, offering a significant improvement in the accurate diagnosis of these lesions.
Microcystic lymphatic malformations present with a wide variety of clinical manifestations that may make diagnosis difficult. We present four patients with microcystic lymphatic malformations that have been confirmed by both histology and ultrasound appearance. Five further cases of microcystic lymphatic malformations with unusual presentations, in which ultrasound was used to support the diagnoses, are then presented. The use of ultrasound as a tool to aid in the diagnosis of microcystic lymphatic malformations is then discussed and compared with other investigative techniques.
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We evaluated 130 prepubertal girls presenting with a vulvar complaint to determine the spectrum and frequency of conditions seen in this age group. Of the patients, 41 (33%) had atopic or irritant dermatitis, 23 (18%) had lichen sclerosus, 21 (17%) had psoriasis, 15 (12%) had vulvar lesions, most often hemangiomas and nevi, and 13 (10%) had streptococcal vulvovaginitis. Diagnoses less frequently seen were staphylococcal folliculitis (four patients), labial fusion (three patients), genital warts (two patients), molluscum contagiosum of the vulva only (one patient), vulvar bullous pemphigoid (two patients), scabies nodules (one patient), erythema annulare centrifugum (one patient), tinea (two patients), and vitiligo (one patient). We also encountered vulvar presentations of systemic diseases (varicella, staphylococcal scalded skin syndrome, and Henoch-Schönlein purpura, all one patient each). We did not see candidal vulvovaginitis in this age group nor did we encounter bacterial infection with pathogens other than Staphylococcus aureus and S. pyogenes.
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Our aim was to describe the types of psoriasis seen in a large series of patients presenting to a tertiary referral pediatric dermatology department using a classification system combining conventional terminology and additional categories based on the site and characteristics of the rash. A total of 1262 patients seen consecutively in the dermatology department of the Royal Alexandra Hospital for Children, Sydney, Australia, between 1981 and 1995 are described and classified according to the pattern of psoriasis at the time of presentation. Additional information recorded included family history, facial involvement, and history of a psoriatic type of diaper rash in infancy. The ages of the children ranged from 1 month to 15 years. There was an equal gender distribution and a high rate of positive family history at 71%. Twenty-six percent of children had a history of a psoriatic diaper rash and facial involvement occurred in 38% of children. Plaque psoriasis was the most common type overall, affecting 430 patients (34%). Three hundred forty-five children were less than 2 years of age, and this is the largest series of children with psoriasis in this age group presented to date. An entity defined by us as psoriatic diaper rash with dissemination was the most common type of psoriasis in the less than 2-year age group, affecting 155 (45%) patients. This large series offers information on the manifestations of psoriasis in childhood, but is particularly useful in examining the previously less well-described infant age group. The classification used is proposed as a practical way to describe psoriasis in children, particularly with respect to future descriptive studies.
PURPOSE: The purpose of this study was to report normative values of the amplitude of joint wrist motions and grip strength for older age groups. METHOD: Volunteers. (N = 147) were divided into four age groups, 60-69, 70-79, 80-89 and 90+ years, with a total of 62 men and 85 women. Maximum range motion values were obtained for wrist flexion, extension and ulnar deviation. In addition, grip strength measures were obtained for each participant. RESULTS: In general, the strength and ROM values for the oldest participants in this study were lower than those of the younger age group (age 60 to 69) and significantly lower than those published for subjects between 25 and 54 years of age. Furthermore, across all age groups males were significantly stronger than females. However, females tended to have greater ROM than males, particularly for wrist extension and ulnar deviations. Joint ROM and grip strength declined significantly with age for both males and females. Comparisons with published data for younger subjects (age 25-35) indicate that a 60-69 year old male, will on average experience a decline in wrist flexion, extension and ulnar deviation of 12%, 41%, and 22% respectively. By age 90, an individual may be expected to have ROM values that are only approximately 60% of an average 30 year old individual. CONCLUSION: The results suggest that the ageing population (particularly men) may face greater difficulty using an input device such as a mouse that relies on motions of the wrist. In addition, the reduced ROM of the wrist may put the elderly at greater risk of developing cumulative trauma disorders. The implications of these findings for the design of input devices are discussed.
Lichen striatus is a self-limiting inflammatory condition of unknown etiology in which the lesions follow the lines of Blaschko. We report a series of 61 cases of this condition in children, describing the clinical features, age distribution, and season of onset. The preponderance of cases in the preschool-age group and onset in the spring and summer months support the hypothesis of an environmental agent, possibly an infection, in the etiology of the condition.
Potent topical corticosteroid is recognized as the treatment of choice for vulvar lichen sclerosus in adults. A series of 11 children with vulvar lichen sclerosus were treated with the potent topical corticosteroid betamethasone dipropionate 0.05%, seven using an optimized vehicle preparation. There was an excellent response to therapy in all cases. No serious adverse effects or unwanted sequelae occurred. Eight of the 11 children experienced complete remission after 3 months of therapy. In these children no maintenance therapy has been necessary during follow-up periods ranging from 3 to 18 months. Three children required maintenance therapy with a mild topical corticosteroid. We conclude that in children, as in adults, potent topical corticosteroid is a safe and effective treatment for vulvar lichen sclerosus.
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