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Objective: To compare the efficacy and safety of double-pass pulsed dye laser (DWL) and single-pass PDL (SWL) in treating virgin port wine stain (PWS). Background: The increase in the extent of vascular damage attributed to the use of double-pass techniques for PWS remains inconclusive. A prospective, side-by-side comparison with a histological study for virgin PWS is still lacking. Materials and methods: Twenty-one patients (11 flat PWS, 10 hypertrophic PWS) with untreated PWS underwent 3 treatments at 2-month intervals. Each PWS was divided into three treatment sites: SWL, DWL, and untreated control. Chromametric and visual evaluation of the efficacy and evaluation of side effects were conducted 3 months after final treatment. Biopsies were taken at the treated sites immediately posttreatment. Results: Chromametric and visual evaluation suggested that DWL sites showed no significant improvement compared with SWL (p > 0.05) in treating PWS. The mean depth of photothermal damage to the vessels was limited to a maximum of 0.36–0.41 mm in both SWL and DWL sides. Permanent side effects were not observed in any patients. Conclusions: Double-pass PDL does not enhance PWS clearance. To improve the clearance of PWS lesions, either the depth of laser penetration should be increased or greater photothermal damage to vessels should be generated. [ABSTRACT FROM AUTHOR]

EMLA cream was developed to reduce pain during pulsed-dye laser (PDL) treatment; however, no standard assessment for the therapeutic outcomes of PDL with EMLA creams thus far available. This comparative, prospective clinical trial evaluates laser efficacy and pain reduction during PDL treatment with EMLA cream for local topical anesthesia. Nineteen patients with untreated port-wine stain (PWS) were treated using PDL and examined in this study. Treatment specifications included Vbeam® PDL (Candela Corp.), 595-nm wavelength, 9 J/cm2 radiant exposure, 0.45 ms pulse duration, 10 mm spot size, and cryogen spray cooling (40 ms cooling plus a 20 ms delay). A topical anesthetic (EMLA cream: 2.5% lidocaine and 2.5% prilocaine) and a placebo were applied to two respective testing areas on all patients prior to treatment. The visual analog scale (VAS) was used for pain assessment. Clinical therapeutic outcomes were evaluated by visual evaluation and with the use of a chromameter 2 months after 3PDL treatments. The average VAS scores were 3.15 ± 0.95 and 8 ± 0.57 for the EMLA cream site and the placebo site, respectively, at a significance level p < 0.001. The EMLA cream site and the placebo site had clearance or fading rates of 45.08 and 44.12%, respectively (p < 0.05). No serious side effects were reported. Patients reported a consistent decrease in pain during PDL treatment when the topical anesthetic EMLA cream was administered. Treatment of PWS by PDL with EMLA cream does not lead to a decrease in efficacy or an increase in side effects; instead, it significantly reduces pain during treatment. EMLA cream is a safe and effective local topical anesthetic for PWS treatment by PDL. [ABSTRACT FROM AUTHOR]

Objective: To compare the safety and efficacy of pulsed dye laser (PDL) at different intervals for the treatment of East Asians with Port-Wine Stain (PWS). Background: The population of East Asians around the world is about 1.6 billion, and they are considered to have more melanin in their skin compared with Caucasians. Nevertheless, no studies about the optimal treatment intervals for East Asians with PWS have been carried out. Methods: We prospectively investigated 39 East Asian patients with untreated PWS. Half of the PWS lesion was randomly allocated to be treated at 3 weeks and the other half at 6 weeks. Both halves of the PWS were treated three times in total. The efficacy outcome 2 months post final treatment was evaluated by visual and chromameter evaluation. Results: The average blanching rate was 40.27% and 44.17% for PDL treatments at the 3- and 6-week interval sites, respectively ( p > 0.05). No patient developed scarring or permanent pigmentation change. Limitations: There was no age criteria involved in the enrollment of patients in this study. Additionally, there is no comparison with long-term treatments at different intervals. Conclusions: PDL treatment at 3-week interval proved to be safe for East Asians with PWS. This can reduce the total duration of the course of treatments and had no increase in side effects compared with the standard interval treatments. [ABSTRACT FROM AUTHOR]

Objective: Pulsed dye laser (PDL) with 7 and 10 mm spot sizes is widely used on a regular basis for the treatment of port-wine stain (PWS). Background data: No studies have reported on the differences in efficacy outcomes resulting from the use of different laser spot sizes in the treatment of PWS by PDL. Thus, an in vivo investigation into the differences in safety and efficacy of treatment between two spot sizes (7 vs. 10 mm) of PWS by PDL was conducted. Materials and methods: A total of 35 PWS patients underwent three treatment sessions by using a 595 nm wavelength PDL (Vbeam®, Candela Corp) with two laser settings: (1) 7 mm spot size, radiant exposure of 12 J/cm2 and (2) 10 mm spot size, radiant exposure of 10 J/cm2. Cryogen spray cooling and 1.5 msec pulse duration were applied. Therapeutic outcomes were evaluated by visual and chromametric evaluation 3 months after the final treatment. Results: Average blanching rates were 34.03% and 36.51% at sites treated by PDL with 7 and 10 mm laser spot sizes, respectively ( p < 0.05). Conclusions: On the basis of the laser setting, the therapeutic outcomes of PDL with 7 and 10 mm spot sizes were similar. PDL with a 10 mm laser spot size is more efficacious with lower radiant exposure than PDL with a 7 mm spot size; it can also reduce the treatment time. [ABSTRACT FROM AUTHOR]

Background Few specific reports have addressed propranolol as a treatment for parotid hemangioma, and its mechanism remains unclear. Methods Eighty-seven patients were recruited in this prospective study. Ten patients underwent detailed color Doppler examination. The depths, vessel densities, and resistant indices of 10 lesions were recorded and analyzed before treatment and at 1 and 3 months after treatment. Results The overall responses were 'bad' in 2 cases, 'stable' in 4 cases, 'good' in 53 cases, and 'excellent' in 28 cases. Hemangioma regrowth was observed in 11 cases (12.6%). The parents of 18 patients (20.7%) complained that their children experienced minor discomfort during therapy. The lesion depths, vessel densities, and resistant indices were altered after propranolol treatment. Conclusion Propranolol can significantly reduce the sizes of parotid hemangiomas with minor side effects. Hemodynamic changes might play an important role in the course of propranolol treatment. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1730-E1736, 2016 [ABSTRACT FROM AUTHOR]

The abnormal deposition of the amyloid β-protein (Aβ) in the brain appears crucial to the pathogenesis of Alzheimer's disease (AD). Recent studies have suggested that highly amyloidogenic Aβ 1- 42 is a cause of neuronal damage leading to AD pathogenesis and that monomeric Aβ1- 40 has less neurotoxicity than Aβ 1- 42. We found that mouse and human brain homogenates exhibit an enzyme activity converting Aβ 1- 42 to Aβ 1- 40 and that the major part of this converting activity is mediated by the angiotensin-converting enzyme (ACE). Purified human ACE converts Aβ 1- 42 to Aβ 1- 40 as well as decreases Aβ 1- 42/Aβ 1- 40 ratio and degrades Aβ 1- 42 and Aβ 1- 40. Importantly, the treatment of Tg2576 mice with an ACE inhibitor, captopril, promotes predominant Aβ 1- 42 deposition in the brain, suggesting that ACE regulates Aβ 1- 42/Aβ 1- 40 ratio in vivo by converting secreted Aβ 1- 42 to Aβ 1- 40 and degrading Aβs. The upregulation of ACE activity can be a novel therapeutic strategy for AD. [ABSTRACT FROM AUTHOR]