ABSTRACT
To discuss the advantages and limitations of hair follicle-derived cell transplantation (FCT) in vitiligo, compared to the epidermal cell transplantation (ECT), and the knowledge gap which is required to be bridged. The papers relevant to the purpose was reviewed. Surgical approaches for treating vitiligo are based on the idea of replenishing lost melanocytes.Skin and hair follicles as the main sources of melanocytes have been applied for this purpose transferring the whole tissue or tissue-derived cell suspension to the vitiligo lesions. Considering the differences between hair follicle and epidermis in terms of the constituting cell populations, phenotype and function of melanocytes, and micro-environmental factors, different response of vitiligo patients to treatment with FCT or ECT would be expected theoretically. However, there is currently a lack of evidence on such a difference. However, ECT appears to be a more feasible, less time-consuming, and more comfortable treatment for both physicians and patients. Although the current evidence has not shown a significant difference between ECT and FCT in terms of efficacy, ECT appears to be more feasible specifically in the treatment of large lesions. However, further randomized controlled clinical trials with larger sample sizes and longer follow-up durations are required to be conducted to draw a definite conclusion on comparing FCT with ECT in terms of the safety, efficacy, durability of the therapeutic effects, and indications in vitiligo patients.
ABSTRACT
To discuss the advantages and limitations of hair follicle-derived cell transplantation (FCT) in vitiligo, compared to the epidermal cell transplantation (ECT), and the knowledge gap which is required to be bridged. The papers relevant to the purpose was reviewed. Surgical approaches for treating vitiligo are based on the idea of replenishing lost melanocytes.Skin and hair follicles as the main sources of melanocytes have been applied for this purpose transferring the whole tissue or tissue-derived cell suspension to the vitiligo lesions. Considering the differences between hair follicle and epidermis in terms of the constituting cell populations, phenotype and function of melanocytes, and micro-environmental factors, different response of vitiligo patients to treatment with FCT or ECT would be expected theoretically. However, there is currently a lack of evidence on such a difference. However, ECT appears to be a more feasible, less time-consuming, and more comfortable treatment for both physicians and patients. Although the current evidence has not shown a significant difference between ECT and FCT in terms of efficacy, ECT appears to be more feasible specifically in the treatment of large lesions. However, further randomized controlled clinical trials with larger sample sizes and longer follow-up durations are required to be conducted to draw a definite conclusion on comparing FCT with ECT in terms of the safety, efficacy, durability of the therapeutic effects, and indications in vitiligo patients.
ABSTRACT
Background: Opioid analgesics are the mainstay of the treatment of postoperative pain. Appropriate monitoring of patients receiving opioid analgesics is essential to detect those with side effects such as respiratory depression. The discovery of Acetaminophen as a COX-3 variant may represent a primary central mechanism by which acetaminophen decrease pain. The aim of this study was to assess the effect of intravenous acetaminophen on morphine requirement in post-operation pain after elective cesarean section
Materials and Methods: In a randomized clinical trial, patients' candidate for elective cesarean section. In experiment group, intravenous acetaminophen [1000 mg/6 hour] was administered and normal saline to control group. Visual analogue scale [VAS] was measured at 1, 3, 6, 12, and 24 hours post-operation. Besides, Morphine dose requirement were measured during next 24 hours
Results: 83 patients were enrolled in the study; which 44 patients assigned in placebo group and 39 in Acetaminophen. Mean Age of placebo group was 29.64 +/- 5.55 and Acetaminophen was 30.33 +/- 5.50 which was not significantly different [p=0.568]. Only at 1 and 3 hours, there was a significant difference between two groups of study. Total dose of morphine requirement was 5.73 +/- 2.78 mg/24 h in placebo group and 3.64 +/- 2.42 in Acetaminophen group which was significantly different [p=0.001]
Conclusion: Intravenous Acetaminophen could decrease post cesarean pain and decrease post operation total morphine requirement particularly at first 3 hours post operation
Subject(s)
Humans , Female , Adult , Administration, Intravenous , Postoperative Care , Pain, Postoperative , Narcotics , Cesarean Section , MorphineABSTRACT
Pulmonary alveolar proteinosis [PAP] is a rare disease in which surfactant accumulates abnormally in the pulmonary alveolar walls and causes respiratory symptoms. The only known effective treatment for PAP is pulmonary lavage. We have reported an 11- year-old girl with pulmonary alveolar proteinosis who underwent pulmonary lavage with normal saline under general anesthesia by a new method [using an univent tube for pulmonary blockage, ventilating one lung, and concurrently passing a catheter from out of the tube for lavage]. The general condition and vital signs of the patient were normal during lavage and in follow up. Three weeks later, her opposite lung was lavaged too. The results were favorable