Faculty Bibliography

OBJECTIVE: To determine whether certain patient demographics are associated with poorer specificity for the diagnosis of melanoma in nevi undergoing short-term sequential digital dermoscopic imaging. DESIGN: Retrospective cohort study performed from April 1, 1998, through May 31, 2007. SETTING: Sydney Melanoma Diagnostic Centre, a tertiary referral institution. PATIENTS: A total of 2497 benign melanocytic lesions in 1765 patients undergoing short-term sequential digital dermoscopic imaging during 2.5 to 4.5 months (42.3% male; mean [SD] age, 40 [14] years; age range, 1-86 years). MAIN OUTCOME MEASURES: Proportion of changed nevi as a function of age, sex, lesion diameter, and anatomical site. RESULTS: The only variable significantly associated with nevus change was age group (P = .002). When compared with the middle-aged (aged 36-50 years) group, the odds of change were significantly increased in the child and adolescent (aged 0-18 years: odds ratio, 2.60; 95% confidence interval, 1.30-5.22), young adult (aged 19-35 years: 1.50; 1.04-2.17), and elderly (> 65 years old: 2.04; 1.04-3.99) age groups. Within the changed benign lesions, a significant association was observed between histologic subtype and age group (P = .01). The proportion of changed lesions of the banal nevi type decreased and the proportion of the dysplastic nevi type increased with age. In the elderly group, 75.9% of changed lesions were of the dysplastic nevi type compared with 35.7% in the youngest group. CONCLUSION: A poorer specificity is observed for the diagnosis of melanoma for nevi undergoing short-term sequential digital dermoscopic imaging in children and adolescents (75.7%) and elderly patients (77.9%) compared with other patients (84.6%).

INTRODUCTION: Guillain-Barre syndrome is an immune-mediated polyneuropathy that is routinely initially treated with either intravenous immunoglobulin or plasmapheresis. To the best of our knowledge, no association between plasmapheresis treatment and acute onset of facial neuropathy has been reported. CASE PRESENTATION: A 35-year-old Caucasian man with no significant prior medical history developed ascending motor weakness and laboratory findings consistent with a diagnosis of Guillain-Barre syndrome. Plasmapheresis was initiated. Acute facial palsy developed during the plasma exchange that subsequently resolved and then acutely recurred during the subsequent plasma exchange. CONCLUSION: To the best of our knowledge, no prior cases of acute facial palsy developing during plasmapheresis treatment are known. Although facial nerve involvement is common in typical Guillain-Barre syndrome, the temporal association with treatment, near-complete resolution and later recurrence support the association. The possible mechanism of plasmapheresis-induced worsening of peripheral nerve function in Guillain-Barre syndrome is unknown.

Two-dimensional DNA lattices are grown under conditions that also are suitable for the magnesium-free growth of three-dimensional calcium carbonate crystals. These lattices are used to template morphology changes in calcium carbonate. The effects of DNA lattices, sub-assemblies, duplexes, single strands, dinucleotides, and mononucleotides on calcium carbonate morphology are studied. A "rotated" morphology of calcite is found to predominate when a critical concentration of any polynucleotide is reached in the templating solution.