A Bibliometrics of the Treatment of Alopecia Areata in the Past Twenty Years.

BACKGROUND: Alopecia areata (AA) is an autoimmune disorder characterized by hair loss on the scalp, face, and other body areas. Despite affecting approximately 2% of the global population, there has been no previous bibliometric analysis specifically focusing on AA treatment that can guide researchers in exploring promising treatment options and directing future research efforts. SUMMARY: This study conducted a bibliometric analysis of AA treatment research, encompassing publications from 2003 to 2022. A total of 1,323 papers from 65 countries, predominantly led by the USA and China, were included in the analysis. The number of publications related to AA treatment showed a notable increase over the years. Prominent research institutions included the University of Manchester, Icahn School of Medicine at Mount Sinai, University of Miami, and Columbia University. Among the journals, Dermatologic Therapy stood out as the most popular, while the Journal of the American Academy of Dermatology appeared as the most frequently co-cited publication.

Is vaginal mucosal graft the excellent substitute material for urethral reconstruction in female-to-male transsexuals?

PURPOSE: Construction of a neourethra is always considered to be a difficult part in phalloplasty, especially for the female-to-male (FTM) transsexual patients. We report our experience with prefabricated pars pendulans urethrae using vaginal mucosal graft for phalloplasty in FTM transsexuals. MATERIALS AND METHODS: We retrospectively reviewed notes on the 22 FTM patients treated with pedicled-flap phalloplasty with prefabricated pars pendulans urethrae using vaginal mucosal graft between January 2008 and December 2012. Surgical outcome, urological function, and complications were recorded. Histological difference between normal mucosa and skin, and pathological changes of vaginal mucosal graft were also observed. RESULTS: All the reconstructive penis survived, and patients could void in a standing position finally at a median follow-up of 25.4 ± 6.0 months. Urethral fistula and urethral stricture rates were 31.8 % (7/22 patients) and 4.5 % (1/22 patients), respectively. The occurrence of the urethral stricture was remarkably low compared with previous reports. Our histological results also showed a pronounced similarity between vaginal and buccal mucosa. Morphologically, they resembled urethral epithelium more closely than the forearm skin. Following the free transfer, the vaginal mucosal graft also showed a good revascularization and the inflammatory reaction and the extent of fibrosis of the mucosa decreased to the normal level after a 6-month prefabrication. CONCLUSION: With prefabrication of vaginal mucosal graft, we reconstruct a competent phallic neourethra in these FTM transsexuals. According to its histological similarities and source character, the vaginal mucosa is the excellent substitute material for promising urethral reconstruction in FTM transsexuals.

Laparoscope-assisted creation of a neovagina using pedicled ileum segment transfer.

BACKGROUND: To present our experience of vaginal reconstruction with the use of a pedicled ileum segment and laparoscope assistance, and to analyze its complications and long-term anatomic and functional results. METHODS: The abdominal and perineal approaches were performed simultaneously with the patient in a special position. Under the guidance of laparoscopy, the target ileal segment was harvested and transposed down to the perineum through an artificial tunnel between the bladder and the rectum. A silicon vaginal tutor was introduced into the vaginal cavity and maintained all day long for 2-3 months. The complications and the anatomical and functional results were summarized and analyzed. RESULTS: From February 2002 to June 2010, 82 patients underwent laparoscope-assisted total vaginal reconstruction with a pedicled ileum segment at our department. Complications developed in 16 of 82 patients, including rectum and/or bladder injury during operation, acute renal failure, delayed healing of the ileocutaneous anastomosis, introital stenosis, and partial or complete intestinal obstruction. The abdominal cutaneous scar was acceptable after the surgery. The vulva was not altered, which was especially significant for patients with congenital vaginal atresia. The neovagina was patent, soft, moist, and flexible. The mean width and depth of the neovagina at the latest postoperative visit measured 3.2 and 15 cm, respectively. CONCLUSIONS: The favorable long-term anatomical and functional results demonstrate that our technique is ideal for patients with congenital vaginal atresia or patients who need secondary vaginal reconstruction. For the primary male-to-female transsexuals or hermaphrodites, it can be an alternative method for vaginal construction.

Genomic Characteristics of Gender Dysphoria Patients and Identification of Rare Mutations in RYR3 Gene.

Gender dysphoria (GD) is characterized by an incongruence between the gender assigned at birth and the gender with which one identifies. The biological mechanisms of GD are unclear. While common genetic variants are associated with GD, positive findings have not always been replicated. To explore the role of rare variants in GD susceptibility within the Han Chinese population, whole-genome sequencing of 9 Han female-to-male transsexuals (FtMs) and whole-exome sequencing of 4 Han male-to-female transsexuals (MtFs) were analyzed using a pathway burden analysis in which variants are first collapsed at the gene level and then by Gene Ontology terms. Novel nonsynonymous variants in ion transport genes were significantly enriched in FtMs (P- value, 2.41E-10; Fold enrichment, 2.8) and MtFs (P- value, 1.04E-04; Fold enrichment, 2.3). Gene burden analysis comparing 13 GD cases and 100 controls implicated RYR3, with three heterozygous damaging mutations in unrelated FtMs and zero in controls (P = 0.001). Importantly, protein structure modeling of the RYR3 mutations indicated that the R1518H mutation made a large structural change in the RYR3 protein. Overall, our results provide information about the genetic basis of GD.

[Clinical application of Reading man flap].

OBJECTIVE: To investigate the effect of Reading man flap for the closure of round or elliptical-shaped defect. METHODS: Based on the asymmetric Z flaps, F1 (triangular flap) and F2 (rectangular flap) flaps were designed to cover the round or elliptical-shaped defects. The flaps size ranged from 0.8 cm x 0.8 cm to 9.0 cm x 8.0 cm. RESULTS: From 2008 to 2011, 32 cases were treated without infection or dog-ear deformity. Less than 5% of local necrosis happened in one flap, which healed spontaneously after dressing. Delayed healing happened in 5 cases. The scar after operation was inconspicuous. CONCLUSIONS: Reading man flap can be designed flexibly. It is a good option for the closure of round or elliptical-shaped defects.

[The reconstruction of erectile function with rabbit segmental gracilis musculocutaneous flap].

OBJECTIVE: To design an animal model for the reconstruction of penile erectile function with segmental gracilis musculocutaneous flap. METHODS: The rabbit gracilis muscle was split longitudinally into two approximately equal halves completely according to the principles of muscle compartmentalization. An animal model was designed for the reconstruction of erectile function with segmental musculocutaneous flap based on the anterior gracilis muscle bundle, with a silicone stick implanted as a supporter. A multi-channel physiological signal acquisition and processing system were used to stimulate the reconstructed penis and its CMAP was measured synchronously. RESULTS: When its nerve was electric stimulated, the muscle bundle contracted, which made the reconstructed penis moving accordingly. It satisfactorily simulated the way of a normal penis's erection. CONCLUSIONS: The reconstructed penis with rabbit segmental gracilis musculocutaneous flap according to the principles of muscle compartmentalization has achieved the erectile function satisfactorily. It has met the requirements of both improving reconstructive penis's appearance and retaining muscle' s contractive function.

[Laparoscopic small intestinal flap colpopoiesis].

OBJECTIVE: To investigate the possibility of Laparoscopic reconstruction of vagina using pedicled ileal autograft and provide a new procedure of colpopoiesis. METHODS: The abdominal and perineal approaches were performed simultaneously under a sufficiently deep general anaesthesia. Laparoscopically, a 15-18 cm segment of the ileum on its vascular pedicle, ileal branches of the superior mesenteric artery and its concomitant veins, was selected and isolated for transplantation using ultrasonically-powered instruments. The distal of the transferred ileal segment was 15cm apart from the ileocecal junction. The ileum continuity was restored immediately by end-to-end anastomosis and the distal oral of the transplant was closed using a curved intraluminal stapler. Meanwhile, a neovaginal tract was completed to dissect from the perineum into the peritoneum and the tract widened laterally. Then the ileum transplant was reversed to reach the perineum through the peritoneal incision at the top of the neovaginal tract without subjecting the mesenteric neurovascular pedicle to undue tension and subsequent necrosis. The oral edge of the ileum transplant was sutured to the perineal skin. RESULTS: Followed up for over 1-53 months postoperatively, 36 patients who received laparoscopic vaginoplasty by transferring ileal segment flaps got satisfactory neovaginal function similar to a normal vagina with mucus and moistness. CONCLUSIONS: The advantages of using a laparoscopic ileum colpopoiesis are that (1) satisfactory neovaginal function similar to a normal vagina with mucus and moistness, (2) no disturbance of bowel function, (minimal scarring in abdominal wall and less secondary deformity in perineum and (3) no need for frequent dilation or stent wearing to the reconstructed vagina. And so laparoscopic vaginoplasty was a preferable alternative of vaginoplasty.

[Effects of catecholamines on human preadipocyte proliferation and differentiation].

OBJECTIVE: To study the effects of catecholamines on human preadipocyte proliferation and differentiation. METHODS: Catecholamines (epinephrine, isoprenaline and noradrenaline) were added to the culture media of human preadipocytes. The proliferation of cells, the expression of GPDH and lipid droplet accumulation in cytoplasm were observed and recorded. The functions of alpha and beta receptors were examined with adding alpha and beta receptor blockers. RESULTS: Epinephrine and isoprenaline stimulated human preadipocyte proliferation and inhibited GPDH up-regulation during differentiation. The three types of catecholamines inhibited lipid accumulation in cell differentiation. The beta-adrenoceptors played a key role during the process. CONCLUSION: Human preadipocytes responded to catecholamine characteristically. The result would be applicable in the study of drugs for obesity.

[The dynamic expression of TNF-alpha mRNA of hypertrophic scars and its roles].

OBJECTIVE: To investigate the role of tumor necrosis factor alpha: TNF-alpha in the hypertrophic scar and find a valid way to treat the hypertrophic scars with gene therapy. METHODS: TNF-alpha mRNA expression was tested with a semiquantitative reverse polymerase chain reation (RT-PCR) method in the different period of a hypertrophic scar. RESULTS: There was a significant increase of TNF-alpha mRNA as the hypertrophic scar was getting mature (P < 0.01). However, the ratios of TNF-alpha mRNA was significantly in a lower level than the normal scar. CONCLUSIONS: The results suggest that TNF-alpha may play an important role in normal would healing, but the hypertrophic scar may result from the shortage of the TNF-alpha. This indicates that to increase the TNF-alpha with gene therapy may be a good way to treat the hyphertrophic scar.

[Autogenous costal cartilage with Medpor: a compound auricular framework applied to one-stage total ear reconstruction].

OBJECTIVE: To introduce a compound external ear framework characterized by few complications, simplicity and very low rate of implant exposure or absorption. METHODS: A compound auricular framework, being composed of the ninth autogenous costal cartilage as ear rim and Medpor ear base, was used in one-stage total ear reconstruction. All patients were followed up postoperatively. RESULTS: Nine cases have been performed clinically using this compound framework and all of them achieved satisfactory efficacies. The reforged ears looked natural and achieved superior cosmesis, and none of them experienced ear rim fracture or implant exposure or distortion. CONCLUSION: This compound auricular framework has advantages of practicability, simplicity and minimal complications. It may be an ideal framework for the reconstruction of total external ear at present.