Measurement of the Thermic Effect of Food in a Chinese Mixed Diet in Young People.

Objective: To determine the thermic effect of food (TEF) in a Chinese mixed diet in young people. Methods: During the study, the participants were weighed and examined for body composition every morning. The total energy expenditure (TEE) of the participants was measured by the doubly labeled water method for 7 days, and during this period, basal energy expenditure was measured by indirect calorimetry and physical activity energy expenditure was measured by an accelerometer. The value obtained by subtracting basal energy expenditure and physical activity energy expenditure from TEE was used to calculate TEF. Results: Twenty healthy young students (18-30 years; 10 male) participated in the study. The energy intake of the participants was not significantly different from the Chinese Dietary Reference Intake of energy ( P > 0.05). The percentage of energy from protein, fat and carbohydrate were all in the normal range. The intakes of fruits, milk and dietary fiber of the participants were significantly lower than those in the Chinese Dietary Guidelines ( P < 0.05). There was no significant difference in the body weight of the participants during the experiment ( P > 0.05). When adjusted for body weight, there was no significant difference in either TEE or basal energy expenditure between the male and female participants ( P > 0.05). In addition, there was no significant difference in physical activity energy expenditure and TEF between the male and female participants ( P > 0.05). The percentage of TEF in TEE was 8.73%. Conclusion: The percentage of TEF in TEE in a Chinese mixed diet in young people was significantly lower than 10% ( P < 0.001). A value of 10% is usually considered to be the TEF in mixed diets as a percentage of TEE.

Comparison of pulsed dye laser (PDL) and photodynamic therapy (PDT) for treatment of facial port-wine stain (PWS) birthmarks in pediatric patients.

BACKGROUND: Vascular-acting photodynamic therapy (PDT) might be an alternative approach for treating port wine stain (PWS) birthmarks, but the usefulness of PDT for pediatric patients has not been fully investigated. STUDY DESIGN: Medical records of pediatric patients (3-10 years old) with red and purple facial PWS were analyzed. Clinical outcomes after one session of PDL (585 nm, 4.8-6.5 J/cm(2)) and PDT (Hemoporfin - 3.5mg/kg, copper vapour laser - 120 J/cm(2)) were compared. RESULTS: The rate of excellent response in PDT group was significantly higher than that in PDL group (25.0% vs 10.9%). For red lesions there was no significant difference in overall response between PDL and PDT group, but for purple lesions the overall response rate of PDT group was significantly higher than that of PDL group (93.0% vs 75.6%). Lesions located at the forehead, cheek and jaw regions showed better responses to PDT. Incidences of pigmentation and scar formation in PDT group were significantly lower than PDL group (8.3% vs 21.1%). CONCLUSION: This study suggests that PDT is safe and effective for treating facial PWS of childhood patients.

Adverse effects associated with photodynamic therapy (PDT) of port-wine stain (PWS) birthmarks.

BACKGROUND: Several Chinese studies suggest that Hemoporfin-mediated photodynamic therapy (PDT) is an alternative treatment for port-wine stain (PWS) birthmarks. OBJECTIVE: To evaluate treatment responses and adverse effects associated with Hemoporfin PDT for the treatment of PWS and their management. METHOD: The medical records of 700 patients who underwent PDT treatment in our center were retrospectively examined. Treatment-related reactions and adverse effects were reviewed. RESULT: Different types of PWS lesions and different individuals showed different immediate responses (e.g. swelling, color change, pain). To certain extents these reactions were a useful indicator of the treatment endpoint. Edema and scabbing were the most common post-treatment responses. Short-term (e.g. blister, eczematous dermatitis, cutaneous photosensitivity) and long-term (e.g. pigmentation change, scar formation) adverse effects were generally caused by the phototoxicity associated with the combination of photosensitizer and light exposure. CONCLUSION: Although PDT is a safe treatment alternative for PWS birthmarks, treatment parameters must be selected for each individual patient and cutaneous changes must be monitored during light irradiation to minimize the risk of adverse effects. Over estimation of required light dosage or failure to recognize cutaneous changes associated with adverse effects can increase the risk of a poor outcome.

Photodynamic therapy of port-wine stains: long-term efficacy and complication in Chinese patients.

Port-wine stain (PWS) are congenital vascular malformations characterized by ectatic capillaries in the papillary layer of the dermis. They usually appear at birth and tend to become darker and thicker with age. Many clinicians consider the gold standard to treat PWS is pulsed dye laser (PDL) with wavelengths of 585 nm or 595 nm. But PDL is not suitable for patients with Fitzpatrick skin type V or nodular lesions. Vascular-targeted photodynamic therapy (PDT) might be an alternative approach in the treatment of such patients. The objective of this study was to assess the long-term outcomes and complications of PDT therapy of PWS in Chinese patients retrospectively. Patients with PWS who had received PDT therapy in a 5-year period were reviewed. 642 patients and a total of 3066 treatment sessions had been performed with an average of 2.6-8.2 sessions. Over 5% of patients had complete clearing, while 70% of patients had more than 25% of clearing. More than one-quarter of patients (29.8%) experienced a clearing of more than 50%. Ten percent of patients experienced complications (1.4% blistering, 1.2% hypopigmentation, 4.3% hyperpigmentation, 2.2% scabbing, <0.7% prolonged blistering that persisted for >2 months, 0.4% eczema dermatitis, 0.6% photoallergy). Sex, age, number of treatment sessions, average energy density and type of skin were not related to complication rate using the multiple regression analysis. Chinese patients were well responsive to and satisfied with vascular-targeted PDT (Patient Satisfaction Score 7.8). Dark-skinned patients and patients with vascular papules or nodules can be treated with alternative PDT to significant therapeutic effect in Chinese patients even though they experience few complications.

Combination of photodynamic therapy and immunomodulation for skin diseases--update of clinical aspects.

In dermatology, photodynamic therapy (PDT) has become a well established treatment modality which has been shown to be effective and safe for many skin and mucosal disorders. Pre-clinical and clinical studies demonstrate that, in addition to the direct local cytotoxicity and vascular effects, PDT can induce various host immune responses. Recent clinical data also show that improved clinical outcomes can be obtained through the sequential use of PDT and immunomodulation. This article will provide an update on the current status of such a combination in dermatological applications.

Successful combination therapy for severe infantile hemangiomas: case report and literature search.

Infantile hemangiomas are common benign vascular tumors of infancy. Although the majority of uncomplicated hemangiomas involute spontaneously, rapid-growth lesions with complications need early active intervention. On the other hand, severe and complicated lesions can be difficult to treat. Recently, we successfully treated two cases of giant severe infantile facial hemangiomas using local application of bleomycin and pulsed dye laser along with systemic application of dexamethasone. Our results suggest that the multiple modalities of bleomycin, laser, and corticosteroid are a safe and effective approach for early therapeutic intervention of severe facial hemangiomas.

Photodynamic therapy in treatment of port wine stain birthmarks--recent progress.

Port wine stain (PWS) birthmarks are congenital vascular malformations characterized by ectatic capillaries in the papillary layer of the dermis. They usually appear at birth and tend to become darker and thicker with age. Cosmetic and pathological changes can cause great depression in all ages. Laser-mediated selective photothermolysis is the treatment of choice but vascular-targeted photodynamic therapy (PDT) might be an alternative approach in the treatment of PWS. PDT has shown therapeutic benefit in pink and resistant lesions. In theory, vascular-targeted PDT may be more efficient in terms of better lightening and less treatment sessions than pulsed dye laser (PDL) irradiation. Chinese clinicians have gained profound knowledge and accumulated a large body of clinical experience in PWS PDT in the past years. The pursuing of regulatory approval on PWS PDT is currently underway. In this article we will report our experience in PWS PDT, discuss current PDT protocols and introduce the novel combination therapy, such as PDT+PDL and PDT+topical angiogenic inhibitor.

Comparison of photodynamic therapy and pulsed dye laser in patients with port wine stain birthmarks: a retrospective analysis.

BACKGROUND: Photodynamic therapy (PDT) might be an alternative approach for treating port wine stains (PWS). This study attempts to compare clinical outcomes of PDT versus conventional pulsed dye laser (PDL) in Chinese patients. METHODS: Retrospective analysis of medical records of a single hospital. PDL was delivered by a 585 nm laser. PDT was carried out by a combination of hematoporphyrin monomethyl ether (HMME) and copper vapour laser (510.6 and 578.2 nm). Clinical outcomes were graded based on photographs. RESULTS: The children group (3-10 years old) included 210 patients (PDL=112 and PDT=98) with pink flat PWS located in the cheek region. The overall fair to excellent response was 95.5% in PDL group and 88.8% PDT group (P=0.901), respectively. The excellent response rate of PDT group (23.5%) was higher than that of PDL group (16.1%). The adult group (18-30 years old) included 371 patients (PDL=163 and PDT=208) with purple flat PWS located in the temple, cheek or neck region. The overall fair to excellent response in PDL and PDT group was 88.4 and 94.2% (P<0.001), respectively. The excellent response rate of PDT group (37.5%) was significantly higher than that of PDL group (3.1%). The complication rate (pigmentary or textural change) in PDT group (10.2%) was lower than that in PDL group (24.7%). CONCLUSIONS: PDT is as effective as PDL for pink flat lesions and is more effective than PDL for purple flat lesions. The true value of PDT deserves further investigation.