SummaryChanges in forehead skin blood flow were determined in 17 healthy, term newborns, using a fiberless diode laser Doppler flow meter (Diodopp). Measurements were carried out three times on each infant, at postnatal ages of 16.8 f 7.4 h, 58.9 f 6.2 h and 121.5 -C 14.2 h (mean + SD.), respectively. Skin blood flow, respiration, heart rate and skin temperature were recorded simultaneously, while the newborns were asleep. During the recordings, the behavioural state of the newborns was observed and environmental temperature and humidity were kept constant. Postocclusive hyperaemia of the skin blood flow was obtained by pressing the laser Doppler probe against the skull for 30 or 60 s. The following parameters changed significantly between the first and third measurements (t-test for paired samples): the basal skin blood flow during active and quiet sleep decreased, the average decrease being 29.4% (P = 0.002) and 25.9% (P = O.Ol), respectively; skin blood flow during postocclusive hyperaemia also changed: the time taken to reach maximum hyperaemia increased from 17.3 to 22.7 s (P = O.Ol), while the halftime recovery increased from 46.1 to 57.1 s (P = 0.02). The changes in skin blood flow between the first and gecond measurements and between the second and third measurements did not reach the level of statistical significance. skin blood flow; laser Doppler; reactive hyperaemia; newborn.Correspondence to: J.G Aarnoudse. 0378-3782/90/%03.50 0

Objective: Marfan syndrome (MFS) is a connective tissue disorder associated with severe cardiovascular morbidity and mortality. It is unknown if aorta complications in MFS are associated with progressive pulmonary artery (PA) dilatation. Methods: We measured the PA diameter on routine magnetic resonance imaging in a population of MFS patients seen in our specialised centre with follow up of diameters as well as the outcome. Results: PA dilatation was defined as an increase in diameter of 2 mm or more, and 71 patients (44%) of our total cohort (n = 162) met this criterion; mean follow up between two scans was 8.6 years (standard deviation (SD) ± 2.7 years). Furthermore, 28 patients suffered from dissections, of which 14 had a type A dissection, 10 had a type B dissection, and 4 patients suffered from both. Of those who suffered from dissection, 64% (18 out of 28) had a dilatation of the PA, versus 39% (53 out of 134) in the patient group without a dissection (p < 0.05). There was a significant association between type B dissection and descending aorta diameter (OR 1.14; 95% CI 1.05–1.24 p < 0.01) and PA dilatation (OR 1.69; 95% CI 1.03–2.77 p = 0.04). In the multivariable analysis the final model for type B dissection, only systolic blood pressure (OR 1.06; 95% CI 1.01–1.11 p = 0.02) and PA dilatation were statistically significant (OR 1.85; 95% CI 1.10–3.12 p = 0.02) while descending aorta diameter was not. Conclusions: We report an association between progressive PA dilatation and type B dissection. Our findings encourage a renewed interest in PA dimensions in MFS.

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