Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial

Publication date: Available online 25 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): KE Hietanen, TA Järvinen, H Huhtala, TT Tolonen, HO Kuokkanen, IS Kaartinen
Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid -resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months.There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p<0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p<0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels before and after treatment decreased in the TAC group, but not in the 5-FU group (p<0.05). Fibroblast proliferation evaluated by Ki-67 staining decreased in the TAC group (p<0.05) but increased in the 5-FU group (p<0.05).TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas.

Abnormal soft palate movements in patients with microtia

Publication date: Available online 25 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): M.N. Kolodzynski, BTJA van Hoorn, M. Kon, C.C. Breugem
IntroductionMicrotia is a congenital malformation of the auricle, ranging in severity. It can be isolated or associated with (craniofacial) anomalies. Most of these anomalies together are described as being part of the oculo-auriculo-vertebral spectrum (OAVS). Velar abnormalities have been described to occur in patients with OAVS, however the incidence in patients with microtia without OAVS is largely unknown. The primary purpose of this study was to examine the prevalence of velar palsy in patients with isolated microtia, and in patients with microtia and signs of OAVS. The secondary purpose was to identify possible risk factors associated with the presence of velar palsy.MethodsAll patients with microtia presented to our department between January 2015 and March 2017 were retrospectively reviewed. Medical images, information of the palate and demographics were subtracted from the patients' medical files.ResultsVelar palsy was present in 18 out of 42 patients with isolated microtia (43%; no signs of OAVS), and in 33 out of 41 patients with microtia and signs of OAVS (80%). Patients with signs of OAVS were found to be independently associated with a higher prevalence of velar palsy (OR: 4.8; 95% CI: 1.7 to 13).ConclusionThis study demonstrates a clear relationship of abnormal velar movement and microtia. We believe that isolated microtia should not be seen as a separate entity but as a part of OAVS. Abnormal velar movement can lead to velopharyngeal insufficiency (VPI), which can affect children's speech development. Physicians should exam the palate in all microtia patients, not only those with speech difficulties.

Volume change in the rectus abdominis muscle after deep inferior epigastric perforator flap harvest

Publication date: Available online 25 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Hyun Ho Han, Min Kyu Kang, Sin Young Song, Hyung Chul Lee, Eun Key Kim, Jin Sup Eom
Deep inferior epigastric perforator flap has less donor site morbidity than that of transverse rectus abdominis myocutaneous flap. However, abdominal muscle atrophy and donor site complications caused by denervation during pedicle dissection cannot be avoided. This retrospective study investigated the change in rectus abdominis muscle volume after deep inferior epigastric perforator flap harvest. Of 395 patients who underwent unilateral deep inferior epigastric perforator flap breast reconstruction between August 2007 and July 2017, 25 patients with >2-year postoperative abdominal computed tomography data were evaluated. Preoperative and postoperative images of the abdominal muscle after pedicle dissection and of the nonoperated side were compared. The volume of the muscles from the lower margin to the umbilicus was determined by using OsiriX image analysis. The volume on the side of pedicle dissection decreased from 72.63 ± 23.29 cm³ preoperatively to 53.09 ± 16.93 cm³ postoperatively(p < 0.001). The corresponding volumes on the side without dissection were 73.29 ± 19.25 cm³ and 60.89 ± 18.79 cm³ (p < 0.001). The percentage of postoperatively retained volume relative to the preoperative volume was 75.65% ± 19.18% on the pedicle dissection side and 84.65% ± 19.00% on the contralateral side. The 9% difference was not statistically significant (p = 0.10). No major abdominal complications were observed. Despite nerve injury during deep inferior epigastric perforator flap surgery, the volume loss of the involved and contralateral muscle did not differ. More than 75% of the abdominal muscle volume was retained. Muscle integrity was well maintained without any postoperative complications.

Comparing Transversus Abdominus Release and Anterior Component Separation Techniques in Reconstructing Midline Hernias – A Cadaveric Study

Publication date: Available online 25 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Charles Yuen Yung Loh, Metin Nizamoglu, R Raja Shanmugakrishnan, Alethea Tan, Cecilia Brassett, Bryony Lovett, Makarand Tare, Naguib El-Muttardi

Exploration of intrinsic brain activity in migraine with and without comorbid depression

Major depressive disorder is a common comorbidity in migraineurs. Depression may affect the progression and prognosis of migraine. Few studies have examined the brain function in migraineurs that may cause thi...

Upper cervical two-point discrimination thresholds in migraine patients and headache-free controls

Chronic pain including migraine is associated with structural and functional changes in the somatosensory cortex. Previous reports proposed two-point discrimination (TPD) as a measurement for cortical alterati...

Abnormal brain white matter in patients with right trigeminal neuralgia: a diffusion tensor imaging study

Idiopathic or classical trigeminal neuralgia (TN) is a chronic painful condition characterized by intermittent pain attacks. Enough evidence demonstrates classical TN is related to neurovascular compression (N...

OnabotulinumtoxinA in the treatment of refractory chronic cluster headache

Cluster headache (CH) is a clinically well-defined primary headache disorder, approximately 20% of cluster headache sufferers experience recurrent attacks without periods of significant remission. For the trea...

Effects of sildenafil and calcitonin gene-related peptide on brainstem glutamate levels: a pharmacological proton magnetic resonance spectroscopy study at 3.0 T

Studies involving human pharmacological migraine models have predominantly focused on the vasoactive effects of headache-inducing drugs, including sildenafil and calcitonin gene-related peptide (CGRP). However...

Itching at night: A review on reducing nocturnal pruritus in children

Pediatric Dermatology, EarlyView.

Dermatoscopic features of lichen nitidus

Pediatric Dermatology, EarlyView.

Quantifying Direct DNA Damage in the Basal Layer of Skin Exposed to UV Radiation from Sunbeds

Photochemistry and Photobiology, EarlyView.

Composite cutaneous lymphoma of diffuse large B‐cell lymphoma‐leg type and subcutaneous panniculitis‐like T‐cell lymphoma

Journal of Cutaneous Pathology, EarlyView.

The assessment of changes to the nontuberculous mycobacterial metabolome in response to anti-TB drugs

Abstract

Mycobacterium species can cause a range of nontuberculous infections of healthy and immunocompromised people as well as infect people during and after surgical procedures. The similarity of nontuberculous mycobacteria (NTM) to the tuberculosis bacilli (TB) could ultimately enable the use of anti-TB drugs for the genus. Hence, three NTM (M. smegmatis, M. phlei and M. avium) were cultured under different lab conditions, causing two mycobacterial phenotypes (active and dormant), and treated with isoniazid (INH) and ethambutol (EMB) independently or in combination. Metabolite profiling was applied to facilitate the investigation and characterisation of intracellular targets affected by the antibiotics. Aliquots of the cell culture were taken over the treatment period and the metabolite profile of the cells analysed by GC/MS. Comparative analysis of the metabolite levels to untreated mycobacteria confirmed the successful action of the antibiotics on the metabolism of all three species. Furthermore, single metabolites and metabolite pathways affected by the antibiotics could be identified and included, besides the known target sites for INH and EMB on mycobacterial cells, changes in e.g. nucleotide and saccharide levels. The combined treatment highlighted the property of EMB to enhance the effects of INH even under hypoxic culture conditions.

Effect of gpd box copy numbers in the gpdA promoter of Aspergillus nidulans on its transcription efficiency in A. niger

Abstract

In this study, we characterised PgpdA, PgpdA2B, PgpdA3B, and PgpdA4B promoters, containing 1–4 copies of gpd box by modifying the gpdA promoter, and constructed pSZHGX-xynB expression vectors, which were introduced into Aspergillus niger CICC2462 through Agrobacterium-mediated transformation. Thus, An (PgpdA-xynB), An (PgpdA2B-xynB), An (PgpdA3B-xynB), and An (PgpdA4B-xynB) homozygous recombinant strains were obtained. The xylanase activity of homozygous recombinant strains was measured. The enzymatic activities of An (PgpdA-xynB), An (PgpdA2B-xynB), An (PgpdA3B-xynB), and An (PgpdA4B-xynB) peaked on the 7th day of fermentation, at 1578.67, 2333.88, 3588.38, and 3183.51 U·mL⁻¹, respectively. SDS-PAGE and qRT-PCR analysis indicated that An (PgpdA3B-xynB), containing three copies of gpd box demonstrated the highest levels of protein expression and transcription. These results suggested that the PgpdA3B promoter promotes highly efficient transcription and may serve as a strong constitutive promoter for efficient recombinant protein expression. Additionally, a number of constitutive promoters with various transcription efficiencies were identified for the metabolic engineering of A. niger. Accordingly, this study provides a new approach for obtaining promoters with different transcription efficiencies.

Environmentally friendly remediation of lead/cadmium co-contaminated loess soil in northwestern China using a humificated straw solution

Abstract

The remediation of heavy metal-contaminated soils is a great challenge and an important issue for global environmental sciences and engineering. Soil washing technology is popularly used for soil remediation, but there are issues that must be solved. These include selecting an environmentally friendly washing solution and preventing damage to the soil during the washing process. The aim of the present work is to reveal the effects of operational conditions on soil remediation contaminated by lead/cadmium, and the effects on soil physicochemical properties caused by the washing reaction. A loess soil sample was collected from northwestern China, and a humificated straw solution was used as the washing solution. The remediation efficiency was investigated using a small-scale experimental device. The remediation efficiency could be improved by optimizing the operational conditions, and we found that the Elovich equation fits better the reaction process compared to the double-constant equation and the first-order kinetics equation. The washing rate of cadmium was slightly faster than that of lead. Compared to the topsoil in the column, the concentration of lead/cadmium was higher in the bottom soil, and the content of lead/cadmium in the inner layer soil was lower than that in the outer layer soil. The washing process had little influence on the surface characteristics and functional groups of soil. The humificated straw solution could be used effectively to remove lead/cadmium and preserve nutrients in loess soil.

Sun sensitivity and sun protective behaviors during sun exposure among indoor office workers in the American Midwest

Photodermatology, Photoimmunology &Photomedicine, EarlyView.

Chronic hand eczema: A prospective analysis of the Swiss CARPE registry focusing on factors associated with clinical and quality of life improvement

Contact Dermatitis, EarlyView.

Regulation of contact sensitivity in non‐obese diabetic (NOD) mice by innate immunity

Contact Dermatitis, EarlyView.

Allergic contact dermatitis caused by benzyl salicylate in hair products

Contact Dermatitis, EarlyView.