THE PUBERTY PROFILE OF FEMALE ADOLESCENTS IN CHERAS, MALAYSIA

@#Objectives: The objectives of our study were to determine the mean age of onset of thelarche and menarche, to determine the ages of each stage of puberty and to investigate if there are any ethnic differences in these ages amongst female adolescents in Kuala Lumpur, Malaysia. Methods: This was a cross-sectional study involving three secondary schools in Cheras, Kuala Lumpur. A total of 730 students were recruited via stratified random sampling. Self-administered survey forms on menstruation and puberty were used. Results: Out of 730 recruited respondents, 385 (52.74%) completed the survey and informed consents were obtained from their parents/legal guardians. Our respondents’ ages ranged between 13 to 17 years old with the median (IQR) age of 14.00(2.00) years. With regards to ethnicity, 329 (85.50%) were Malay, 46 (11.90%) were Chinese, 9 (2.30%) were Indian and 1(0.30%) was a Bajau. The mean age for breast development (thelarche) and menarche were 11.72 ±1.10 and 11.97±1.11 years respectively. The majority, 363 (94.30%), out of 385 respondents had attained menarche. There appeared to be a later onset of puberty amongst Malays comparatively. Conclusion: The mean ages of pubertal onset and menarche amongst female adolescents in the Cheras area are similar to those reported worldwide.

Design optimization of multi-pinhole micro-SPECT configurations by signal detection tasks and system performance evaluations for mouse cardiac imaging.

An optimized configuration of multi-pinhole aperture can improve the spatial resolution and the sensitivity of pinhole SPECT simultaneously. In this study, an optimization strategy of the multi-pinhole configuration with a small detector is proposed for mouse cardiac imaging. A 14 mm-diameter spherical field-of-view (FOV) is used to accommodate the mouse heart. To accelerate the optimization process, the analytic models are applied to rapidly obtain the projection areas of the FOV, the sensitivities and the spatial resolutions of numerous system designs. The candidates of optimal multi-pinhole configuration are then decided by the preliminary evaluations with the analytic models. Subsequently, the pinhole SPECT systems equipped with the designed multi-pinhole apertures are modeled in GATE to generate the imaging system matrices (H matrices) for the system performance assessments. The area under the ROC curves (AUC) of the designed systems is evaluated by signal-known-exactly/background-known-statistically detection tasks with their corresponding H matrices. In addition, the spatial resolutions are estimated by the Fourier crosstalk approach, and the sensitivities are calculated with the H matrices of designed systems, respectively. Furthermore, a series of OSEM reconstruction images of synthetic phantoms, including the hot-rod phantom, mouse heart phantom and Defrise phantom, are reconstructed with the H matrices of designed systems. To quantify the sensitivity and resolution competition in the optimization process, the AUC from the detection tasks and the resolution estimated by the Fourier crosstalk are used as the figure of merits. A trade-off function of AUC and resolution is introduced to find the optimal multi-pinhole configuration. According to the examining results, a 22.5° rotated detector plus a 4-pinhole aperture with 22.5° rotation, 20% multiplexing and 1.52X magnification is the optimized multi-pinhole configuration for the micro pinhole-SPECT applied to mouse cardiac imaging with a camera of 49  ×  49 mm(2) active area.

An eccrine angiomatous hamartoma with histopathological features of a papillary haemangioma in a neonate.

Eccrine angiomatous hamartoma (EAH) is a benign hamartomatous tumour characterized by a combination of proliferative eccrine and vascular elements. Papillary haemangioma (PH) is a distinct cutaneous haemangioma with predominantly intravascular capillary proliferation within dilated thin-walled blood vessels. EAHs have been reported in combination with various vascular components. We present the first case in the dermatological literature, to our knowledge, of a patient with congenital EAH with the histopathological features of a PH.

Synchronous infection with Mycobacterium chelonae and Paecilomyces in a heart transplant patient.

A 41-year-old male who was 3 years status post heart transplant presented with a 3-month history of painful erythematous nodules and ulcers on his lower legs and right hand. First, Mycobacterium chelonae infection was revealed through several biopsies with molecular sequence analysis, and combination treatment, including clarithromycin, was started. During the treatment, lesions of the legs showed an improvement, but a fluctuant erythematous nodule on the thumb did not respond. Repetitive biopsy from the thumb ultimately identified Paecilomyces species and the patient was treated with itraconazole and terbinafine sequentially. Our case is the first report, to our knowledge, of synchronous infection with non-tuberculous mycobacteria (NTM) and Paecilomyces in a solid organ transplant recipient. Our findings highlight the importance of recognizing cutaneous NTM infections or deep mycoses, as well as the importance of choosing an appropriate treatment.

A case of botryoid-type embryonal rhabdomyosarcoma.

We describe an infant with a congenital polypoid anal mass, diagnosed as botryoid-type embryonal rhabdomyosarcoma. Histological examination revealed myxoma-like appearance and cells with greater differentiation with elongated streaming eosinophilic cytoplasm and one or two nuclei, suggestive of rhabdomyoblasts. Tumour cells were strongly immunoreactive for desmin and 10% of cells displayed immunoreactivity for myoglobin. We present this case with a view to highlighting the benign clinical and histological appearance of botryoid-type embryonal rhabdomyosarcoma. Early biopsy is essential for improving prognosis.

Giant dermatofibroma with granular cell changes: side-effect of bee-venom acupuncture?

Dermatofibroma (DF) is a common benign fibrohistiocytic tumour with a predilection for the legs in middle-aged women. Giant DF, a rare clinical variant of DF, is characterized by its unusually large size. Granular cell change is typical of granular cell tumour, but can be observed in diverse cell lineages. Traumatic factors may be involved in the pathogenesis of giant DF and cellular granularity. We describe a 49-year-old Korean man with a giant DF showing granular cell differentiation, which may have been caused in part by multiple treatments with bee-venom acupuncture.

Focal myositis of the tongue presenting as macroglossia.

Focal myositis (FM) is a benign localized inflammatory process of unknown aetiology, which presents as a rapidly enlarging soft-tissue mass that evolves into a localized lesion. It is most often mistaken for a neoplasm. Histologically, it is characterized by marked myopathic changes of the muscle fibres, lymphocytic infiltration and interstitial fibrosis. We describe a case of focal myositis of the tongue and review this rare condition.

Argon laser photocoagulation for the treatment of polypoidal choroidal vasculopathy.

AIM: To evaluate the efficacy of conventional argon laser for the treatment of serosanguineous maculopathy secondary to polypoidal choroidal vasculopathy (PCV). METHODS: A retrospective audit of patients who had argon laser photocoagulation to angiographically determined polypoidal lesions and subsequently followed up at 1, 3, 6, and 12 months post treatment. RESULTS: Twenty-one eyes (75%) had stable or improved vision at 12 months. Twenty-three eyes had extrafoveal, two eyes had juxtafoveal, and three eyes had subfoveal polyps. In the extrafoveal group, 18 eyes (78%) had stable or improved vision at 12 months. Eighteen eyes (64.3%) showed clinical or angiographic resolution of maculopathy. Three eyes (10.7%) had recurrence of polyps subfoveally, three eyes (10.7%) had subsequent choroidal neovascularisation, and four eyes (14.3%) had persistent leakage with neurosensory detachment. CONCLUSION: In our study, 18 of the 23 eyes which had extrafoveal polyps had stable or improved best-corrected visual acuity and showed complete resolution of maculopathy at 12 months follow-up. Argon laser photocoagulation would appear to be most beneficial for extrafoveal PCV. However, in view of the retrospective nature of this study, the true efficacy of argon laser treatment would have to be evaluated with a larger, prospective and randomised controlled trial.

Photodynamic therapy with verteporfin for polypoidal choroidal vasculopathy.

BACKGROUND: To describe the efficacy of photodynamic therapy (PDT) with verteporfin for the treatment of polypoidal choroidal vasculopathy (PCV). METHODS: This is a retrospective interventional case series of 41 eyes of 40 patients with angiographic evidence of PCV, which had PDT with verteporfin. Pre-treatment best-corrected visual acuity (BCVA) was measured and patients were followed up for at least 12 months with BCVA recorded at each visit. RESULTS: The mean follow-up time was 23.7 months. Seven of 10 eyes (70%) with juxtafoveal lesions and 17 of 31 eyes (54.8%) with subfoveal lesions had stable or improved vision (loss of

Dengue vector surveillance in Hong Kong – 2007.

A dengue vector surveillance programme was implemented in the city and port areas in Hong Kong. Asa result of the surveillance, only Aedes albopictus was detected to be present in various areas in summer.Aedes aegypti was, however, not detected in any area under surveillance. Although a rather high indexof 70.9% was recorded in July, the activity of Ae. albopictus was immediately brought down through concerted efforts of varies agencies and the public. The swift response of concerned agencies werefacilitated by the use of Geographic Information System (GIS) in the dissemination of surveillance results. Users were able to access the system at any time for the latest results of the surveillance for takingimmediate remedial measures. The public was also informed of the results regularly through theInternet and press releases to arouse awareness to prevent and control the local dengue vector.

Heat stress induces alkaline phosphatase activity and heat shock protein 25 expression in cultured pulp cells.

AIM: To investigate the responses of cultured rat pulp cells to heat stress. METHODOLOGY: Pulp cells were obtained from rat incisors and cultured at 37 degrees C. The cells were cultured at 42 degrees C for 30 min and then cultured at 37 degrees C again. Morphology, alkaline phosphatase (ALP) activity and expression of heat shock protein 25 (HSP25) were investigated at 0, 1, 3, 5, 7, 10 and 14 days following stimulation. As a control, the cells were maintained at 37 degrees C. RESULTS: Although there were few cells of apoptosis immediately after heat stress, there were mitotic cells from day 1 after heat stress. ALP activity in the heat stress group significantly increased at days 7 and 14 compared with the control group (about 1.7-fold, P < 0.01, Friedman test). HSP25 expression increased in both groups, with HSP25 in the heat stress group being expressed earlier than in the control group, and nuclear localization of HSP25 was observed at days 0 and 1 in heat-stressed cells. CONCLUSION: These results suggest that heat stress not only induces HSP25 but also enhances ALP activity in pulp cells.