Establishment of a C57BL/6 mouse model simulating transurethral thulium laser vaporization prostatectomy / 中华泌尿外科杂志

Objective:To construct a C57BL/6 mouse model of simulating transurethral thulium laser vaporization prostatectomy.Methods:Twelve male C57BL/6 mice were selected to undergo transvesical vaporization resection of the urothelium covering the urethra of the prostate using thulium laser. The urethral tissue of the prostate was retrieved on the 1st, 3rd, 5th, and 7th days after the surgery. HE staining was used to observe the process of re-epithelialization of the urethral wound of the prostate. Immunohistochemical (IHC) staining was used to detect whether the re-epithelialized cells of the urethral wound of the prostate expressed urothelin Ⅲ (UPⅢ).Results:On the first day after surgery, HE staining showed complete destruction to the urothelium covering the urethra of the prostate, with a large amount of coagulative necrotic tissue on the wound surface, and IHC staining showed no expression of UPⅢ on the wound surface. On the 3rd day after surgery, HE staining showed that there were still no regenerated epithelial cells on the wound surface, with coagulation necrosis tissue significantly reduced, and the urethral cavity was clearly visible. And IHC staining showed no expression of UPⅢ on the wound surface. On the 5th day after surgery, HE staining showed 1-2 layers of regenerated epithelial cells lacking cell polarity on the wound surface, and IHC staining showed that the regenerated epithelial cells expressed UPⅢ. On the 7th day after surgery, HE staining showed 4-6 layers of polar regenerated epithelial cells on the wound surface, and IHC staining showed the multiple layers of regenerated epithelial cells expressing UPⅢ.Conclusions:Based on the simulation of transurethral thulium laser vaporization resection of the prostate, the thulium laser and ultra micro endoscope system were used to vaporize the urothelium covering the urethra of the prostate, and the process of urethral re-epithelialization of the prostate can be observed after surgery. The establishment of the C57BL/6 mouse model simulating thulium laser vaporization prostatectomy provides a new research platform for studying the mechanism of wound repair after prostatectomy.

Sinais clínicos para diagnóstico diferencial entre queimaduras de espessura parcial e total em crianças / Clinical signs for differential diagnosis between partial and full thickness burns in children

OBJETIVO: Analisar a acurácia do método clínico no diagnóstico diferencial entre queimadura de espessura parcial e total, correlacionando o diagnóstico inicial das lesões com a confirmação do diagnóstico em até 21 dias. MÉTODO: Estudo prospectivo, descritivo e longitudinal, baseado na análise de parâmetros diagnósticos (sensibilidade, umidade, retorno de preenchimento capilar e coloração da área) em pacientes pediátricos, internados por queimaduras, no Hospital Joana de Gusmão em Florianópolis, SC. O diagnóstico inicial da profundidade da queimadura foi realizado no momento da internação hospitalar e comparado ao evolutivo em até 21 dias, sendo considerado diagnóstico final de espessura parcial a presença de reepitelização espontânea, e de espessura total na sua ausência, com necessidade de cirurgia para cobertura cutânea. RESULTADOS: Dos 81 diagnósticos avaliados, 55 (67,9%) corresponderam ao diagnóstico final de queimadura de espessura parcial e 26 (32,1%) ao diagnóstico final de queimadura de espessura total, sendo que a sensibilidade álgica e o retorno capilar foram as duas características mais presentes na queimadura parcial. A acurácia do exame médico baseado na presença ou ausência dos parâmetros na diferenciação entre as espessuras da queimadura foi de 80,24%. CONCLUSÕES: A presença de perfusão na área queimada foi a variável de maior acerto no diagnóstico de queimadura de espessura parcial, seguida pela presença de sensibilidade álgica. As duas variáveis também apresentaram alta sensibilidade diagnóstica na caracterização da queimadura de espessura parcial.

OBJECTIVE: To analyze the accuracy of the clinical method for differential diagnosis between partial and full-thickness burn, correlating the initial diagnosis of the injuries with its confirmation within 21 days. METHODS: A prospective longitudinal descriptive study, based on the analysis of diagnostic parameters (sensory sensitivity, humidity, return of hair growth and area coloration) in pediatric patients hospitalized for burn injury at Hospital Joana de Gusmão in Florianópolis, Santa Catarina state. The initial of the depth of the burn was done at the time of hospitalization and compared to the follow up in 21 days, in which the presence of spontaneous reepithelialization was considered final diagnosis of partial thickness burn and, its absence, of full-thickness burn, requiring surgery for skin coverage. RESULTS: Of the 81 diagnoses evaluated, 55 (67.9%) corresponded to the final diagnosis of partial-thickness burn while 26 (32.1%) to the final diagnosis of full-thickness burn and pain sensitivity as well as venous return were the two most common characteristics in partial-thickness burn. The accuracy of the medical examination based on the presence or absence of the parameters in order to differentiate burn thicknesses was 80.24%. CONCLUSIONS: The presence of venous return in the burned area was the most accurate variable in the diagnosis of partial thickness burn, followed by the presence of pain sensitivity. Both variables also showed high diagnostic sensitivity in the characterization of partial-thickness burn.

Evaluation of the alcoholic extract of Dipteryx alata Vogel almonds and bark in skin wound healing in C57BL6 mice / [Avaliação do extrato alcoólico da casca e da semente da Dipteryx alata Vogel na cicatrização da pele de camundongos C57BL/6]

The aim of this study was to evaluate the topical application of alcoholic extracts of Dipteryx alata Vogel almonds and bark in skin wound healing in mice. Fifty-four C57BL/6 mice were equally distributed into three groups: Control, Almond, and Bark. A 9 mm skin fragment was resected from the dorsal region of the animals' thorax. The wounds were submitted to topical application of base cream (vehicle), 10% hydroalcoholic almond extract, or bark extract twice a day. Macroscopic, histological, and immunohistochemical evaluations were conducted on the 7th, 14th, and 21st postoperative days. No significant difference was observed regarding skin wound area among groups, with the parameter presenting only a temporal effect on healing (p>0.05). The almond and control groups exhibited more intense collagenization than the bark group (p<0.05). Dipteryx alata Vogel showed to be inert in the wound healing process in mice.(AU)

O objetivo deste estudo foi avaliar a aplicação tópica do extrato alcoólico da semente e da casca da Dipteryx alata Vogel na cicatrização de feridas cutâneas, em camundongos. Um total de 54 camundongos C57BL/6 foram utilizados neste estudo, distribuídos em três grupos de 18 animais (controle, semente e casca). Em todos os animais, um fragmento de pele foi ressecado da região dorsal do tórax utilizando-se instrumento de punção de 9mm de diâmetro, após o qual foi realizada aplicação tópica de creme base (veículo), extrato hidroalcoólico 10% de semente ou casca, duas vezes ao dia. As avaliações macroscópica, histológica e imuno-histoquímica foram realizadas no sétimo, 14º e 21º dias de pós-operatório. Não foi observada diferença significativa quanto à área da ferida cutânea entre os grupos, apenas um efeito temporal na cicatrização (P>0,05), indicando estágio possivelmente mais avançado desse processo. Porém, na avaliação histológica, os grupos semente e controle apresentaram colagenização mais intensa que o grupo casca (P<0,05). Dipteryx alata Vogel mostrou-se inerte no processo de cicatrização de feridas em camundongos.(AU)

Efecto epitelizante y analgésico del sevoflurano tópico en el tratamiento de las úlceras por presión grado I-III no infectadas Hospital Obrero N°1 de La Paz Bolivia / Epithelializing and analgesic effect of topical sevoflurane in the treatment by pressure of uninfected grade I-III ulcers Hospital Obrero (workers´ Hospital) N°1 of La Paz Bolivia

INTRODUCCIÓN: las úlceras por presión constituyen un importante problema de salud por su frecuencia, carácter crónico, costes económicos y una merma en la calidad de vida en pacientes internados en las unidades de cuidados especiales. MATERIAL Y MÉTODOS: el objetivo del estudio fue evaluar el efecto epitelizante y analgésico del sevoflurano aplicado tópicamente en úlceras por presión grado I-III no infectadas de pacientes internados. El tipo de estudio fue Ensayo clínico aleatorizado. Un total de 16 pacientes fueron incluidos en el estudio y fueron divididos aleatoriamente en 2 grupos: grupo A (8 pacientes), en los que se realizó la curación con sevoflurano tópico más povidona yodada y, grupo B (8 pacientes) curación solo con yodopovidona. La valoración de la evolución de la úlcera se realizó mediante la Escala PUSH, que valora superficie, cantidad de exudado y tipo de tejido del lecho. RESULTADOS: durante la realización de la curación, el dolor manifestado por los integrantes del Grupo A (1.6 ± 0.7), fue mucho menor que el observado el Grupo B (7.2 ± 1). No se encontró diferencias significativas en la superficie de la úlcera y en la cantidad de exudado; si se encontró una diferencia significativa en el tipo de tejido existente en el lecho ulceroso, en los pacientes del Grupo A se evidenció la presencia de tejido de granulación y epitelial a partir de la tercera semana de tratamiento, lo cual, en los pacientes del Grupo B, se observó a partir de la cuarta semana.

INTRODUCTION: pressure ulcers constitute an important health problem due to their frequency, chronic nature, economic costs and a reduction in the quality of life in patients hospitalized in special care units. MATERIAL AND METHODS: the aim of the study was to evaluate the epithelializing and analgesic effect of sevoflurane applied topically in uninfected grade I-III pressure ulcers of hospitalized patients. The type of study was Randomized Clinical Trial. A total of 16 patients were included in the study and were randomly divided into 2 groups: group A (8 patients), in which the cure was performed with topical sevoflurane plus povidone iodine, and group B (8 patients) only with povidone iodine. The evaluation of the evolution of the ulcer was performed using the PUSH Scale, which assesses surface area, amount of exudate and type of bed tissue. RESULTS: during the healing, the pain manifested by the members of Group A (1.6 ± 0.7), was much lower than that observed in Group B (7.2 ± 1). No significant differences were found on the surface of the ulcer and in the amount of exudate; If a significant difference was found in the type of tissue existing in the ulcer bed, in Group A patients the presence of epithelial and granulation tissue was evidenced starting the third week of treatment, which, in Group A patients B, was observed starting the fourth week.

Effects of canine adipose-derived mesenchymal stem cells on the epithelialization of rabbits' skin autograft (Oryctolagus cuniculus) / Efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães na epitelização de autoenxertos de pele em coelhos (Oryctolagus cuniculus)

The present study aimed to evaluate the effects of mesenchymal stem cells derived from canine adipose tissue in the healing process of full-thickness mesh skin grafts in rabbits. The stem cells were collected from young dogs; and, after characterization, remained in cryopreservation, in independent doses containing 2 x 106 cells. The mesh distal limb graft technique was performed in 60 rabbits, divided into three groups, CG (Control Group), GT1 (Intralesional Stem Cell Treated Group), and GT2 (Intravenous Stem Cell Treated Group), containing 20 animals each. After grafting, each group was randomly divided into four subgroups according to euthanasia time 3, 7, 14, and 30 days, containing five animals in each group. Animals of GT1_14, GT1_30, and GT2_14, GT2_30 subgroups received a second dose of xenogeneic cells on the seventh day. Meanwhile, animals from GT1_30 and GT2_30 received the third dose of xenogeneic cells on day 14. The groups treated with xenogeneic stem cells positively affected type III collagen re-epithelialization and deposition, and possibly GT1 had a controlled inflammatory response. However, no effect on angiogenesis. Thus, it was possible to demonstrate tolerance and therapeutic action of mesenchymal stem cells from canine adipose tissue in skin grafts in rabbits.(AU)

O presente estudo teve como principal objetivo avaliar os efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães no processo de cicatrização de autoenxertos de pele de espessura total em malha em coelhos. As células-tronco foram coletadas de cães jovens, após a caracterização estas permaneceram em criopreservação, em doses individuais contendo 2 x 106 células. A técnica de enxerto em malha na região distal do membro foi realizada em 60 coelhos, divididos em três grupos, GC (Grupo Controle), GT1 (Grupo tratado com células-tronco intralesional) e GT2 (Grupo tratado com células-tronco via endovenosa), contendo 20 animais cada. Imediatamente após a enxertia, cada grupo foi dividido aleatoriamente em quatro subgrupos, de acordo com o tempo de eutanásia 3, 7, 14 e 30 dias contendo cinco animais cada. Animais dos subgrupos GT1_14, GT1_30 e GT2_14, GT2_30 receberam uma segunda dose de células xenógenas no sétimo dia. Ademais, animais do GT1_30 e do GT2_30 receberam a terceira dose de células xenógenas no dia 14. Os grupos tratados com células-tronco xenógenas tiveram um efeito positivo na reepitelização e deposição de colágeno tipo III, e possivelmente, o GT1 teve uma resposta inflamatória controlada, entretanto o efeito na angiogênese não foi observado. Dessa forma, foi possível demonstrar que houve tolerância e ação terapêutica das células-tronco mesenquimais derivadas do tecido adiposo de cães em enxertos de pele em coelhos.(AU)

Molecular mechanisms in the process of re-epithelization in wound healing and the action of honey in keratinocytes / Mecanismos moleculares en el proceso de re-epitelización en cicatrización de heridas y la acción de la miel en queratinocitos

SUMMARY: The treatment of chronic wounds has become a public health issue in recent years mainly due to comorbidities associated with an older population and bacterial resistance. Honey has emerged as an alternative treatment for chronic wounds but lack of knowledge of its mechanism of actionin the treated tissue and low quality of evidence in clinical triads has distanced the medical community from honey as a possible treatment. One of the main processes that is altered in chronic wounds is re-epithelialization mediated by keratinocytes, where proliferation and migration processes are altered. Markers of proliferation, migration and activation of keratinocytes, such as adhesion molecules, growth factors, membrane receptors, signal translating proteins, transcription factors, microRNAs, among others are deregulated in this process. In general, honeys from different floral origins have a positive effect on markers of proliferation and migration in keratinocytes. In conclusion there are still few studies that focus on the molecular action of honey in keratinocytes and fail to report details on the honey used not allowing to achieve the same results.

RESUMEN: El tratamiento de heridas crónicas (HC) se ha vuelto un tema de salud pública en los últimos años, principalmente debido a comorbilidades asociadas a una población de mayor edad y a la resistencia bacteriana. La miel ha surgido como un tratamiento alternativo para HC pero la falta de conocimiento de su mecanismo de acción en el tejido tratado y de la baja calidad de la evidencia en triadas clínicas, ha distanciado a la comunidad médica de la miel como posible tratamiento. Uno de los principales procesos que se ve alterado en las HC es la re-epitelización mediada por queratinocitos, donde se ven alterados los procesos de proliferación y migración. Marcadores de proliferación, migración y activación de queratinocitos, como moléculas de adhesión, factores de crecimiento, receptores de membrana, proteínas traductores de señales, factores de transcripción, microARNs, entre otras, se ven desreguladas en éste proceso. De manera general las mieles de diferentes orígenes florales tienen un efecto positivo en marcadores de proliferación y migración en queratinocitos. En conclusión aún existen pocos estudios que se enfoquen en la acción molecular de la miel en queratinocitos y los pocos que existen fallan en la entrega de información en relación a la miel utilizada que pueda hacer reproducibles los resultados.

Vacuum sealing drainage enhances wound healing by up-regulating collagen type I/III ratio in rats / 中国组织工程研究

BACKGROUND: Vacuum sealing drainage can enhance acute and chronic wound healing. The ratio of collagen type I/III play a critical role in the structural stability of skin tissue and skin repair, but its change during vacuum sealing drainage accelerating wound healing remains unclear. OBJECTIVE: To observe the effect of vacuum sealing drainage on the ratio of collagen type I/III during wound healing and to explore the potential mechanism underlying acute wound repair in rats. METHODS: A full-thickness wound, with a diameter of 20 mm, was created on the back of healthy male rats. All model rats were then randomized into two groups: blank control and vacuum sealing drainage groups. The wound surface was photographed at three observational time points (1, 3, 7 days after operation), and wound closure rate was calculated and compared. The mRNA and protein expression levels of type I collagen and type III collagen and ratio of collagen type I/III were detected by RT-qPCR and immunohistochemistry. The structure of granulation tissue and length of re-epithelialization were histologically detected. RESULTS AND CONCLUSION: Compared with the blank control group, treatment with vacuum sealing drainage significantly increased the expression of type I collagen and type III collagen at mRNA and protein levels (P < 0.05), enhanced wound healing rate (P < 0.05) as well as increasing the ratio of collagen type I/III starting from the 3rd day after operation (P < 0.05). To conclude, the vacuum sealing drainage can accelerate wound healing by up-regulating the protein expression of type I collagen and type III collagen, the ratio of collagen type I/III and increasing wound tensile strength.

A novel wound healing accelerator: Effect of vitreous gel of cow eyeball on a chronic wound model

@#ss of wound healing after administration ofmitomycin-C, which inhibits granulation tissue formationand collagen synthesis, resulting in chronic wounds. Thevitreous gel of cow eyeballs contains a high level ofhyaluronic acid, which has a role in inflammation,granulation, re-epithelialization, and remodelling. This studyaims to understand the effect of 1% povidone iodine andvitreous gel of cow eyeballs on wound healing afteradministration of mitomycin-C.Methods: This was an invivostudy with quasi-experimentalmethods on 32 Wistar mice. Full-thickness wounds weremade and then treated with mitomicyn-C. The mice weredivided into 4 groups: a control group with NaCl 0.9%vitreous gel of cow eyeball (VGCE), 1% povidone-iodine, anda combination of VGCE and 1% povidone-iodine groups.Macroscopic and microscopic observations of the processof wound healing were performed on days 3, 7, and 14.Results: Vitreous gel administration produced significantwound healing rates within the first three days, andhistological analysis revealed an increased number offibroblasts and polymorphonuclear cells. However, thepovidone iodine group and the combination group withvitreous gel did not produce significant results.Conclusion: The single administration of VGCE canaccelerate the wound healing process, increase the numberof fibroblasts, and reduce inflammation in a chronic woundmodel.

The ocular surface after simple limbal epithelial transplant (SLET): A high-resolution OCT study of the early postoperative period

Simple limbal epithelial transplantation (SLET) is an emerging technique for treating unilateral limbal stem cell deficiency. We report the high-resolution, anterior segment optical coherence tomography (OCT) features of the first 2 weeks of a patient undergoing SLET for an old acid injury of the right eye, repeatedly from postoperative day 1 through day 14. Three out of 11 explants with the subjacent human amniotic membrane (hAM) and the overlaid bandage contact lens were imaged. The hAM was intact and of the same thickness throughout the study period; the sub-hAM space increased from day 3 to 9 and disappeared by day 10; the explants started thinning from day 3 with the fibrin around them starting to decrease from day 2 and completely disappeared by day 4. Epithelialization occurred between day 8 and 14 and proceeded more rapidly towards the limbus than centrally. There was no change of the corneal stromal thickness or reflectivity. This case report uses high-definition, spectral-domain OCT to document the events on the ocular surface after a successful SLET surgery and opens up an avenue to study epithelialization in a convenient and noninvasive manner.

Comparative Study Of Conventional Local Steroid Injections Only With Multi-Drugs Therapy And Steroid Injections In Oral Submucosal Fibrosis (OSMF)

Oral submucous fiosis (OSMF) is defined as the chronic inflammatory disease and progressive fiosis with localized collagen disorder involving oral mucosa. There are multiple pathophysiological changes that occur in this disease. The aim of this study is to establish that multidrugs needed for effective conservative treatment in oral submucous fiosis. A total number of 35 cases of OSMF managed in our ENT out patient department (OPD) over one year period ( March 2010 to Feuary 2011) were followed up until July 2011 and the results were analyzed retrospectively to find out any incidence of recurrence of this disease. All the cases received injection steroid and hyaluronidase with multivitamins (A,C and E in higher doses) for 10 weeks. At the end of treatment all the patients were relieved of burning sensation of mouth and got nearnormal mouth opening. The oral mucosa also changed from pale to pink. During follow-up no recurrence was detected. The study suggested that Vitamins A, C and E in higher doses are required to ensure best possible result apart from intralesional steroid and hyaluronidase as a standard conservative treatment protocol in oral submucous fiosis.

Effect of Liquid Paraffin Gauze Dressing In Burn Wounds: A Prospective Study

Introduction: Burn injury causes a considerable amount of disability, prolonged hospital stay, and burden on the public healthsector. Main requirement in burn wound management is an economical, easy to apply, readily available dressing, or method ofcoverage that will provide good pain relief, protect the wound from infection, promote healing, prevent heat and fluid loss, beelastic, non-antigenic, and adhere well to the wound while waiting for spontaneous epithelialization of superficial partial thicknessburns. The sterilized paraffin gauze dressing is non-adherent and non-allergenic and helps in speedy recovery of burn wounds.Materials and Methods: A prospective study of 90 patients with partial thickness burns who were salvageable (≤40% bodysurface area), admitted to Burn unit of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital,Rewa from June 1, 2017, to May 31, 2018. The autoclaved liquid paraffin gauze was applied over burn wound. Patients wereassessed on the basis of subsidence of pain, time of epithelialization if occurred after liquid paraffin gauze dressing. Patients’blood investigations were noted and the assessment of the effect of hemoglobin (anemia) and platelet counts in burn woundhealing in terms of mean epithelialization time were done.Results: Mean epithelialization time was 16 days. In 25% of cases epithelialization developed in 10–12 days. Post-burn painsubsided in 4–6 days in maximum in 54.44% cases. Mild and moderate anemia had no significant effect on wound healingtime (mean epithelialization time). Patient with less than normal platelet counts (<1.5 lakh/cumm) had more epithelializationtime and with normal platelet count had less epithelialization time. 15 patients developed complications and most commoncomplication was hyper granulation (11.11%).Conclusion: Burn wounds pose a great burden on health-care infrastructure and burn units. We can conclude that liquid paraffingauze dressing has good patient acceptability and less painful, it is easily available and relatively less expensive. In developingand resource-poor countries, most of the patients are from the rural background so these patients will need a dressing that isrelatively less expensive and easily available such as liquid paraffin gauze dressing.

Promotion of 640 nm red light on keratinocyte migration via CD26 / 上海交通大学学报（医学版）

Objective:To investigate the mechanism of 640 nm red light promoting keratinocyte migration preliminarily. Methods:Human keratinocytes were cultured in vitro and assigned to 4 groups according to different interventions, i.e. control group, sitagliptin group (CD26 expression inhibited), 640 nm red light group (8 J/cm2) and 640 nm red light+sitagliptin group. The levels of CD26 mRNA and protein in keratinocytes were measured with realtime-PCR and Western blotting, respectively. Cell migration was observed with Transwell assay and scratch assay. Results:The level of CD26 mRNA and the expression of CD26 protein in 640 nm red light group obviously increased compared with control group, while those of sitagliptin group significantly decreased. Migration ability of keratinocytes increased in 640 nm red light group and decreased in sitagliptin group observed by Transwell assay and scratch assay. Conclusion:The expression of CD26 in keratinocytes is promoted by the 640 nm red light, which can accelerate keratinocyte migration to facilitate re-epithelialization.

Características de los diabéticos tratados con Heberprot-p® en el municipio de Colón / Characteristics of the diabetics treated with Heberprot-p® in Colón municipality

Introducción: Una de las complicaciones vasculares más devastadora de la diabetes mellitus lo constituye el pie diabético y participan en su aparición y desarrollo, la neuropatía, la isquemia y la infección. Objetivo: Caracterizar a los pacientes diabéticos tratados con Heberprot-p®. Métodos: Estudio descriptivo-retrospectivo en 213 pacientes con úlceras de pie diabético en el municipio de Colón, provincia de Matanzas, en el período comprendido entre enero de 2013 a diciembre de 2015. Se analizaron las siguientes variables: edad, sexo, control metabólico, años de evolución de la enfermedad, factores de riesgo, grados de la clasificación de Wagner, tiempo de epitelización y número de amputaciones realizadas en el período de estudio. Se calcularon las frecuencias absolutas y relativas. Resultados: Se encontró un predominio de los mayores de 60 años (38,5 por ciento); del sexo femenino (n= 1 09; 51,2 por ciento) y de pacientes con más de 10 años de evolución (n= 120; 56,3 por ciento). Se constató que el 53,5 por ciento tenían un control metabólico adecuado. El 25,8 por ciento tenían, como factor de riesgo, un aumento de la presión plantar. Predominaron los grado 1 y 3 de la clasificación de Wagner. El 72,8 por ciento logró una epitelización completa en menos de 40 días y el 12,2 por ciento fue amputado. Conclusión: La aplicación del Heberprot-p® en el tratamiento de las úlceras de pie diabético redujo el tiempo de epitelización y el número de amputaciones de los miembros inferiores en los diabéticos del municipio de Colón(AU)

Introduction: One of the most devastating vascular complications of Diabetes Mellitus is the diabetic foot, and development, neuropathy, ischemia and infection are usually involved in its onset and development. Objective: To characterize diabetic patients treated with Heberprot-P ®. Methods: A descriptive and retrospective study was conducted in 213 patients with diabetic foot ulcers in Colón municipality, Matanzas province, in the period of January 2013 through December 2015. The following variables were analyzed: age, sex, metabolic control, years of progression of the disease, risk factors, Wagner classification, time of epithelization and number of amputations performed in the study period. Absolute and relative frequencies were calculated. Results: Patients older than 60 years (38.5 percent); women (n=109; 51.2 percent) and patients with more than 10 years having the disease (n = 120; 56.3 percent) predominated in the study. It was found that 53.5 percent had adequate metabolic control. The risk factor in 25.8 percent was foot pressure increase. Wagner´s classification I and II prevailed. In the group, 72.8 percent reached complete epithelization in less than 40 days and 1.2 percent underwent amputation(AU)

Epitelización de la interfase después de la técnica de LASIK / Interface epithelialization after surgery LASIK technique

La epitelización de la interfase es una de las complicaciones secundarias a la cirugía refractiva corneal mediante la técnica de LASIK y de SMILE, que pueden influir de forma negativa sobre la calidad visual de los pacientes operados. Se presenta una paciente femenina de 51 años de edad operada de astigmatismo hipermetrópico compuesto de ambos ojos, hace aproximadamente dos años, mediante la técnica de LASIK con microquerátomo pendular. Desde hace 5 meses aproximadamente comenzó con disminución de la visión del ojo derecho, agudeza visual sin corrección del ojo derecho de 0,1 y con corrección de 0,3. Al examen oftalmológico se observaron depósitos blanquecinos en la entrecara del flap corneal, correspondientes a la epitelización de la interfase. Se decidió levantar el flap corneal para eliminar el tejido epitelial de la entrecara; se realizó queratectomía fototerapéutica y se colocó mitomicina C al 0,02 por ciento. La evolución de la paciente fue satisfactoria. La agudeza visual posterior al mes sin corrección del ojo derecho mejoró a 0,5 y con corrección a 0,9, sin mostrar signos de recurrencia(AU)

Interface epithelialization is one of the secondary complications of LASIK and SMILE refractive corneal surgery which may negatively affect the visual quality of operated patients. A female 51-year-old patient presents who underwent surgery about two years ago for compound hyperopic astigmatism of both eyes by LASIK technique with a pendular microkeratome. Approximately five months ago the patient began experiencing gradual visual loss in her right eye. Visual acuity of the right eye was 0.1 without correction and 0.3 with correction. Ophthalmological examination found whitish deposits in the corneal flap interface revealing interface epithelialization. It was decided to lift the corneal flap to remove the epithelial tissue from the interface. Phototherapeutic keratectomy was performed and 0.02 percent mitomycin C applied on the area. The patient's evolution was satisfactory. At one month, visual acuity of the right eye had risen to 0.5 without correction and 0.9 with correction, and no signs of recurrence were observed(AU)

Topical Administration of the Recombinant Human Epidermal Growth Factor (EGF) Containing Ointment on the Tendon Exposed Skin Defect in Foot Digit: A Case Report

Contact burn is usually caused by prolonged contact to hot material and results in deep dermal injury. As a result, skin and soft tissue defects occur, and coverage of defect is required. When defect is located in the foot phalanxes, reconstruction becomes more challenging owing to anatomical features. If the patient has medical histories such as diabetes mellitus, peripheral arterial obstructive disease, or chronic kidney disease, peripheral circulation may be worsened, and reconstruction becomes more difficult. We present the case of a patient with contact burn wound on his foot phalanxes and dorsum, where extensor digitorum tendons were exposed. Initial trial of skin graft was failed and they were completely epithelialized through secondary-intention healing with the administration of ointment containing recombinant human epidermal growth factor.

Establishment of prostate urethral re-epithelialization model with Chinese rural canine by 2 μm laser vaporization resection / 中华泌尿外科杂志

Objective To establish a prostate urethral re-epithelialization model with Chinese rural canine by 2 μm laser vaporization resection.Methods We used 2 μm laser to vaporiz prostate of 15 uncastrated male Chinese rural canines from March to April in 2016.These canines mean age was (6.3 ± 0.6) years(ranging 5-7 years),and weight was (20.5 ± 1.3) kg(ranging 18-22 kg).We began to surgery in which we saw the protruding part of the prostate in urethra,and narrow prostate urethra after a successful anesthesia by intraperitoneal injection of chloral hydrate.The operation time,anesthesia time,survival rate,first time to drink water,first time to feed,first time to stand,first time to defecate,the time when canine bladders rinse became clear,wound healing time were recorded.After 3 days,1 week,2 weeks,3 weeks and 4 weeks,we randomly select 3 canines to observe regeneration of prostate urethra wound under cystoscope.After surgery,the bladder,prostate and prostate distale urethra were removed to make specimen and measure the diameter size of prostate.The HE staining and immunohistochemistry was performed in each sample.Results The experimental operation time was (70.5 ± 18.3) min (ramging 50-90 min).The average anesthesia time was (120.1 ± 21.1) min (ranging 95-145 min).The survival rate was 100％.In post surgery duration first standing time,first eating time,first drinking water time,first defecation time were (6.5 ± 1.8) h,(10.3 ± 2.1) h,(23.7 ± 5.6) h,(26.3 ± 3.1) h,respectively.The time when canine bladders rinse became clear and wound healing time were (5.2 ± 1.6) d,(8.7 ± 1.5) d respectively.Cystoscopy observated that the wound was covered by pale necrotic tissue 3 d and 1 week after operation,covered by epithelium 2 weeks after operation,covered by more thicker epithelium 3 weeks after operation,covered by epithelium which color was close to normal urothelium 4 weeks after operation.HE staining observated that the wound wasn't covered by epithelium 3 d after operation,partial wound was covered by flaky single or 2-3 cubic regenerated epithelial 1 week after operation,all wound was covered by epithelial which was lack of polar 2 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated a little umbrella cells on the surface 3 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated much umbrella cells on the surface 4 weeks after operation.Immunohistochemical staining observated that urinary spot protein from the wound or epithelium was negative 3 d,1 and 2 weeks after operation,urinary spot protein from the part of epithelium was positive 3 weeks after operation,and urinary spot protein from all epithelium was positive 4 weeks after operation.Conclusion It is feasible to establish prostate urethral re-epithelialization model in the Chinese rural canine by 2 μm laser vaporization resection of the prostate.

Epitelização de enxertos cutâneos em feridas recentes de coelhos tratados com membrana amniótica canina e/ou laserterapia / Skin graft epithelialization in rabbit fresh wounds treated with amniotic membrane and/or laser therapy

A enxertia cutânea é uma técnica cirúrgica simples e bastante útil para o reparo de feridas, principalmente aquelas onde existe dificuldade da aplicação do fechamento primário ou de outras técnicas reconstrutivas. Entretanto, para a sobrevivência do enxerto, é necessário que o leito da ferida esteja saudável e com presença de tecido de granulação exuberante. O objetivo do presente trabalho foi avaliar a aplicação da membrana amniótica e da laserterapia como potenciais estimulantes da cicatrização em enxertos aplicados em feridas sem tecido de granulação. Foram utilizados 42 coelhos, divididos em quatro grupos: grupo controle (GC), grupo membrana (GM), grupo laser (GL) e grupo membrana e laser (GML), submetidos a avaliações macro e microscópicas. Na avaliação macroscópica, foi possível notar que os pacientes dos grupos nos quais a membrana amniótica foi utilizada (GM e GML) apresentaram evidências associadas à acentuada reação inflamatória, à falha de integração do enxerto e à consequente necrose dele. Já os pacientes do GL apresentaram melhor aspecto do enxerto no último dia de avaliação. Na análise microscópica, observou-se intensa integração do enxerto à derme, reepitelização acentuada e escassas células inflamatórias no local do enxerto no GL. O contrário foi observado nos pacientes do GM e GML, nos quais aparentemente houve rejeição da membrana. A formação de colágeno não se correlacionou com outros fatores, como inflamação e necrose, em nenhum dos grupos de tratamento. Dessa forma, é possível afirmar que a laserterapia mostrou ser efetiva, contribuindo para o processo cicatricial e a integração do enxerto. Já a membrana amniótica canina não deve ser utilizada para esse fim, pois provoca intensa reação inflamatória, além de impedir a nutrição do enxerto.(AU)

Skin grafting is a simple surgical technique and useful to repair wounds, especially those where there is a difficulty to apply primary closure skin or other reconstructive techniques. However, for graft survival a healthy wound bed and the presence of an exuberant granulation tissue are necessary. This study aimed to evaluate the application of amniotic membrane and laser therapy as potential healing stimulants in grafts applied in wounds without granulation tissue. For this, we used 42 rabbits divided into four treatment groups, control group (CG), membrane group (MG), laser group (LG) and membrane and laser group (MLG), submitted to macroscopic and microscopic evaluation. The macroscopic examination showed that the patients of the groups where the amniotic membrane was used in order to stimulate re-epithelialization (MG and MLG) presented evidences associated with severe inflammatory reaction, graft integration failure and consequent necrosis. LG patients apparently had the best graph aspect in the last valuation date. Microscopic examination showed intense integration of the graft to the dermis, high re-epithelialization level, and scarce inflammatory cells in the graft site of LG patients. The opposite was observed in patients in the MG and MLG groups, where a rejection of the membrane was observed. Finally, collagen formation was not correlated with other factors such as inflammation and necrosis in any of the treatment groups. We can conclude that laser therapy was effective, contributing to the healing process and integration of the graft. Thus, canine amniotic membrane should not be used for this purpose because it causes intense inflammatory reaction besides avoiding graft nutrition.(AU)

Astaxanthin induces migration in human skin keratinocytes via Rac1 activation and RhoA inhibition

BACKGROUND/OBJECTIVES: Re-epithelialization has an important role in skin wound healing. Astaxanthin (ASX), a carotenoid found in crustaceans including shrimp, crab, and salmon, has been widely used for skin protection. Therefore, we investigated the effects of ASX on proliferation and migration of human skin keratinocyte cells and explored the mechanism associated with that migration. MATERIAL/METHOD: HaCaT keratinocyte cells were exposed to 0.25-1 µg/mL of ASX. Proliferation of keratinocytes was analyzed by using MTT assays and flow cytometry. Keratinocyte migration was determined by using a scratch wound-healing assay. A mechanism for regulation of migration was explored via immunocytochemistry and western blot analysis. RESULTS: Our results suggest that ASX produces no significant toxicity in human keratinocyte cells. Cell-cycle analysis on ASX-treated keratinocytes demonstrated a significant increase in keratinocyte cell proliferation at the S phase. In addition, ASX increased keratinocyte motility across the wound space in a time-dependent manner. The mechanism by which ASX increased keratinocyte migration was associated with induction of filopodia and formation of lamellipodia, as well as with increased Cdc42 and Rac1 activation and decreased RhoA activation. CONCLUSIONS: ASX stimulates the migration of keratinocytes through Cdc42, Rac1 activation and RhoA inhibition. ASX has a positive role in the re-epithelialization of wounds. Our results may encourage further in vivo and clinical study into the development of ASX as a potential agent for wound repair.

Substrate roughness induces the development of defective E-cadherin junctions in human gingival keratinocytes

PURPOSE: The entry of bacteria or harmful substances through the epithelial seal of human gingival keratinocytes (HGKs) in the junctional epithelium (JE) is blocked by specialized intercellular junctions such as E-cadherin junctions (ECJs). However, the influence of roughened substrates, which may occur due to apical migration of the JE, root planing, or peri-implantitis, on the development of the ECJs of HGKs remains largely unknown. METHODS: HGKs were cultured on substrates with varying levels of roughness, which were prepared by rubbing hydrophobic polystyrene dishes with silicon carbide papers. The activity of c-Jun N-terminal kinase (JNK) was inhibited with SP600125 or by transfection with JNK short hairpin RNA. The development of intercellular junctions was analyzed using scanning electron microscopy or confocal laser scanning microscopy after immunohistochemical staining of the cells for E-cadherin. The expression level of phospho-JNK was assessed by immunoblotting. RESULTS: HGKs developed tight intercellular junctions devoid of wide intercellular gaps on smooth substrates and on rough substrates with low-nanometer dimensions (average roughness [Ra]=121.3±13.4 nm), although the ECJs of HGKs on rough substrates with low-nanometer dimensions developed later than those of HGKs on smooth substrates. In contrast, HGKs developed short intercellular junctions with wide intercellular gaps on rough substrates with mid- or high-nanometer dimensions (Ra=505.3±115.3 nm, 867.0±168.6 nm). Notably, the stability of the ECJs was low on the rough substrates, as demonstrated by the rapid destruction of the cell junction following calcium depletion. Inhibition of JNK activity promoted ECJ development in HGKs. JNK was closely associated with cortical actin in the regulation of ECJs in HGKs. CONCLUSIONS: These results indicate that on rough substrates with nanometer dimensions, the ECJs of HGKs develop slowly or defectively, and that this effect can be reversed by inhibiting JNK.

The use of the buccal fat pad flap for oral reconstruction / 대한악안면성형재건외과학회지

Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.