Picosecond-Domain Fractional Laser Treatment Over Hyaluronic Acid Fillers: In Vivo and Clinical Studies.

BACKGROUND AND OBJECTIVES: Combined sequential treatments with multiple modalities such as lasers and soft-tissue fillers are commonly required for the treatment of atrophic acne scars. Recently, fractional treatment with picosecond-domain lasers has proven to be effective for skin rejuvenation and scar treatment. However, little is known about the effects of picosecond-domain fractional laser treatment over hyaluronic acid fillers (HAFs). We aimed to evaluate the in vivo tissue responses to 1064 nm picosecond-domain fractional neodymium:yttrium-aluminum-garnet (Nd:YAG) laser treatments using microlens array (MLA) applied over pre-injected HAF in rats. In addition, we evaluated the efficacy and safety of this combined same-day treatment for atrophic acne scars in patients. STUDY DESIGN/MATERIALS AND METHODS: Sprague-Dawley rats were subjected to 1064 nm picosecond-domain fractional Nd:YAG laser treatment immediately after HAF dermal injection. Skin specimens were histologically evaluated on days 0, 7, and 21. In a clinical study, 36 patients with acne scars were treated concurrently with 1064 nm MLA-type picosecond lasers and HAFs. The patients were scheduled to receive two consecutive treatments at 4-week intervals, with a follow-up visit at 12 weeks after the final treatment. Acne scar photographs were graded using the Goodman and Baron's qualitative and quantitative scales at baseline and 12 weeks post-procedure. RESULTS: Picosecond-domain fractional laser treatment immediately after the dermal injection of HAF into rats did not cause any histological changes in the filler or surrounding skin. In a clinical study, treated subjects (n = 36) achieved significant improvement in acne scars and patient satisfaction. No serious adverse events were observed. CONCLUSIONS: Combined picosecond laser and HAF treatment were proven to be safe and effective based on in vivo and clinical study results. Facial rejuvenation and scar treatment using a picosecond-domain fractional laser may be performed immediately after HAF injection. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Association between PD-L1 expression and initial brain metastasis in patients with non-small cell lung cancer and its clinical implications.

BACKGROUND: Brain metastases frequently occur in patients with non-small cell lung cancer (NSCLC) resulting in a poor prognosis. Here, we investigated the association between PD-L1 expression and brain metastasis in patients with NSCLC and its clinical significance. METHODS: A total of 270 patients diagnosed with metastatic NSCLC who underwent PD-L1 testing on their tumor tissue between January 2017 and March 2019 were retrospectively reviewed. The VENTANA PD-L1 (SP263) assay was used, and positive PD-L1 expression was defined as staining in ≥1% of tumor cells. RESULTS: Positive PD-L1 expression was observed in 181 (67.0%) patients, and 74 (27.4%) patients had brain metastasis at diagnosis. Synchronous brain metastases were more frequently observed in PD-L1-positive compared with PD-L1-negative patients (31.5% vs. 19.1%, p = 0.045). Multiple logistic regression analysis identified positive PD-L1 expression (odds ratio [OR]: 2.24, p = 0.012) as an independent factor associated with synchronous brain metastasis, along with the histological subtype of nonsquamous cell carcinoma (OR: 2.84, p = 0.003). However, the incidence of central nervous system (CNS) progression was not associated with PD-L1 positivity, with a two-year cumulative CNS progression rate of 26.3% and 28.4% in PD-L1-positive and PD-L1-negative patients, respectively (log rank p = 0.944). Furthermore, positive PD-L1 expression did not affect CNS progression or overall survival in patients with synchronous brain metastasis (long rank p = 0.513 and 0.592, respectively). CONCLUSIONS: Initial brain metastases are common in NSCLC patients with positive PD-L1 expression. Further studies are necessary to understand the relationship between early brain metastasis and cancer immunity.

Fixed prosthetics with a connective tissue and alloplastic bone graft ridge augmentation: a case report.

Augmentation of the partially edentulous ridge can significantly improve the final prosthodontic rehabilitation. For enhancing soft tissue contours in the anterior region, the subepithelial connective tissue graft is the treatment of choice. The combination of connective tissue grafts with alloplastic bone graft material can optimize the ridge augmentation and reduce post extraction defects. The aim of this clinical report is to describe the use of subepithelial connective tissue in conjunction with an alloplastic bone graft for augmentation of a maxillary anterior ridge prior to prosthetic rehabilitation.

Prurigo pigmentosa in Korea: clinicopathological study.

BACKGROUND: Prurigo pigmentosa (PP) is an inflammatory dermatosis characterized by recurrent pruritic erythematous papules, mainly located on the trunk. It was first described by Nagashima in 1971 in Japan. Since then, more than 300 cases have been reported in Japan, but reports from other parts of the world are quite rare. MATERIALS AND METHODS: We studied clinical and histopathological data from six patients with PP diagnosed in our hospital and 43 patients (18 reports) who were diagnosed with PP in Korea between 1988 and 2008. RESULTS: The number of Korean patients reported in recent years is higher than the number of other non-Japanese patients reported. Clinicopathological characteristics in Korean patients were not significantly different from those previously reported. Therapeutic results with minocycline were successful in our patients. CONCLUSIONS: We suspect that PP is not uncommon in Korea, and the disease may be underestimated. Strict restriction of diet as well as known associated factors like wet condition are suggested as one of the important factors contributing to the occurrence of PP in Korea.

A phase II study of irinotecan plus cisplatin for patients with advanced stage IIIB or IV NSCLC previously treated with nonplatinum-based chemotherapy.

BACKGROUND: Irinotecan (1) and cisplatin (P) are active chemotherapy agents with clinical synergy in non-small-cell lung cancer (NSCLC). We evaluated the efficacy of IP regimen as a salvage treatment of patients with NSCLC that progressed after nonplatinum-containing regimen(s). METHODS: Eligibility required histologically confirmed NSCLC, bidimensionally measurable disease, ECOG PS 0-2, and progressive disease after nonplatinum-based chemotherapy. Treatment consisted of I (65 mg/m2) and P (30 mg/m2) i.v. on Days 1 and 8 of a 21-day cycle, for a maximum of 6 cycles. An informed consent was obtained from all patients. RESULTS: Between August 2002 and May 2004, 32 patients with median age of 56 years (range, 42-74) were enrolled. Twenty-four (75%) patients were men, and 28 (88%) had ECOG PS 0 or 1. Twenty-five patients had adenocarcinoma and 6 had squamous-cell carcinoma. All patients were evaluated for response and toxicity, and the response rate was 40.6%. After a median follow-up of 18.5 months, the median survival time was found to be 9.3 months, with a 1-year survival rate of 43.8%. Toxicities were moderate and manageable, with 47% G3 and 9% G4 neutropenia, 19% G3 diarrhea, and 22% G3 asthenia. There was no G4 nonhematologic toxicity. CONCLUSIONS: The irinotecan and cisplatin combination is an active and well-tolerated regimen for the patients with advanced NSCLC that progressed after nonplatinum-containing regimen(s).