Investigation of the Importance of Applying Various Methods of Calculation in Determining the Blood-Absorbed Dose for Patients with Differentiated Thyroid Carcinoma.

The objective was to compare estimated total blood-absorbed doses obtained by applying 4 methods to the same group of patients. In addition, these results were compared with those for the patients of other researchers, who used various other techniques over a period of more than 20 y. Methods: Twenty-seven patients (22 women and 5 men) with differentiated thyroid carcinoma were enrolled in the study. Whole-body measurements were performed as conjugate-view (anterior and posterior) counts by scintillation camera imaging. All patients received 3.7 GBq of 131I for thyroid ablation. Results: The mean total blood-absorbed doses by the first, second, third, and fourth methods in the 27 patients were estimated to be 0.46 ± 0.12, 0.45 ± 0.13, 0.46 ± 0.19, and 0.62 ± 0.23 Gy, respectively. The maximum values were 1.40, 0.81, 1.04. and 1.33 Gy, respectively. The difference between the mean values was 37.22%. In the comparison with the total blood-absorbed doses for the patients of other researchers, the difference was 50.77% (difference between the means of 0.65 and 0.32 Gy). Conclusion: None of the total absorbed doses to the blood by the 4 methods in my 27 patients was 2 Gy, the maximum permissible dose. The difference between the total absorbed doses to the blood obtained by different teams of researchers was 50.77%, whereas the difference between the values by the 4 different methods in the 27 patients was 37.22%.

Repair of complex ovine segmental mandibulectomy utilizing customized tissue engineered bony flaps.

Craniofacial defects require a treatment approach that provides both robust tissues to withstand the forces of mastication and high geometric fidelity that allows restoration of facial architecture. When the surrounding soft tissue is compromised either through lack of quantity (insufficient soft tissue to enclose a graft) or quality (insufficient vascularity or inducible cells), a vascularized construct is needed for reconstruction. Tissue engineering using customized 3D printed bioreactors enables the generation of mechanically robust, vascularized bony tissues of the desired geometry. While this approach has been shown to be effective when utilized for reconstruction of non-load bearing ovine angular defects and partial segmental defects, the two-stage approach to mandibular reconstruction requires testing in a large, load-bearing defect. In this study, 5 sheep underwent bioreactor implantation and the creation of a load-bearing mandibular defect. Two bioreactor geometries were tested: a larger complex bioreactor with a central groove, and a smaller rectangular bioreactor that were filled with a mix of xenograft and autograft (initial bone volume/total volume BV/TV of 31.8 ± 1.6%). At transfer, the tissues generated within large and small bioreactors were composed of a mix of lamellar and woven bone and had BV/TV of 55.3 ± 2.6% and 59.2 ± 6.3%, respectively. After transfer of the large bioreactors to the mandibular defect, the bioreactor tissues continued to remodel, reaching a final BV/TV of 64.5 ± 6.2%. Despite recalcitrant infections, viable osteoblasts were seen within the transferred tissues to the mandibular site at the end of the study, suggesting that a vascularized customized bony flap is a potentially effective reconstructive strategy when combined with an optimal stabilization strategy and local antibiotic delivery prior to development of a deep-seated infection.

Localized mandibular infection affects remote in vivo bioreactor bone generation.

Mandibular reconstruction requires functional and aesthetic repair and is further complicated by contamination from oral and skin flora. Antibiotic-releasing porous space maintainers have been developed for the local release of vancomycin and to promote soft tissue attachment. In this study, mandibular defects in six sheep were inoculated with 106 colony forming units of Staphylococcus aureus; three sheep were implanted with unloaded porous space maintainers and three sheep were implanted with vancomycin-loaded space maintainers within the defect site. During the same surgery, 3D-printed in vivo bioreactors containing autograft or xenograft were implanted adjacent to rib periosteum. After 9 weeks, animals were euthanized, and tissues were analyzed. Antibiotic-loaded space maintainers were able to prevent dehiscence of soft tissue overlying the space maintainer, reduce local inflammatory cells, eliminate the persistence of pathogens, and prevent the increase in mandibular size compared to unloaded space maintainers in this sheep model. Animals with an untreated mandibular infection formed bony tissues with greater density and maturity within the distal bioreactors. Additionally, tissues grown in autograft-filled bioreactors had higher compressive moduli and higher maximum screw pull-out forces than xenograft-filled bioreactors. In summary, we demonstrated that antibiotic-releasing space maintainers are an innovative approach to preserve a robust soft tissue pocket while clearing infection, and that local infections can increase local and remote bone growth.

An indirect high iodine (131 I) effective dose used for thyroid ablation in patients with thyroid cancer. Is the method of measurement important?

BACKGROUND: Radiation effective dose to the red bone-marrow, a critical organ in the therapy of differentiated thyroid carcinoma (DTC) with radioiodine-131 (131 I), cannot be measured directly. As radioiodine concentration is comparable in blood and most organs, and is believed to be similar in red marrow, the effective dose to the blood seems to be a good first-order approximation of the radiation effective dose to the hematopoietic system and a better means to quantifying exposure from therapy compared to the total amount of activity administered. PURPOSE: We applied four formulas (Lassmann et al (standard) [2008], Eur J Nucl Med Molecul Imaging, 35:1405-1412), (Thomas et al. [1993], Nucl Med Biol, 20:157-162), (Sisson et al. [2003], J Nucl Med, 44:898-903; Ha¨nscheid et al. [2009], Endocr Relat Cancer, 16:1283-1289) and (Ha¨nscheid et al. [2006], J Nucl Med, 47:648-654) and compared between the estimated values of the effective dose that were obtained by three formulas and those obtained by the standard one. MATERIALS AND METHODS: Twenty-seven patients, 22 women and 5 men, suffering from DTC were enrolled in this study. Whole-body probe measurements and blood collections (2 mL whole-blood samples) were conducted at 2, 6, 24, 48, 72-96 h after the administration of 131 I to obtain time-activity curves. Whole-body measurements were performed as conjugate view (anterior and posterior) counts by scintillation camera imaging. RESULTS: By comparing the values of blood effective dose that were obtained by applying Thomas et al. [1993], Nucl Med Biol, 20:157-162; Sisson et al. [2003], J Nucl Med, 44:898-903 and Ha¨nscheid et al. [2009], Endocr Relat Cancer, 16:1283-1289, and Ha¨nscheid et al. [2006], J Nucl Med, 47:648-654, techniques, with those obtained by (Lassmann et al (standard technique) [2008], Eur J Nucl Med Molecul Imaging, 35:1405-1412), we found that these values are, respectively, 15.0%, 40.0%, and 41.0% more than those obtained by using the standard method. To our knowledge no papers have been published previously that compare between these dosimetric approaches. CONCLUSION: Highly overestimated or highly underestimated results obtained by a certain method or technique, compared with those obtained by the standard method, are not desirable, they tend to exaggerate in applying radiation protection procedures, by increasing or decreasing, which, in both cases, become far from the realistic or recommended procedures. As an operating philosophy, the objective of radiation safety practices simply should not be to keep radiation doses within legal limits or maximum permissible doses (MPDs ), but to keep them "as low as reasonably achievable" (ALARA concept). MPDs should not be considered as thresholds below which exposure to radiation is of no concern, they are not assumed to be totally risk free, and any reasonable technique for reducing radiation dose may have potential benefits in the long run.

Massive Self-Induced Subcutaneous Cervicofacial, Pneumomediastinum, and Pneumopericardium Emphysema Sequelae to a Nondisplaced Maxillary Wall Fracture: A Case Report and Literature Review.

Iatrogenic cervicofacial subcutaneous emphysema is a well-reported entity in the field of dentistry and oral and maxillofacial surgery, especially with the use of air-driven headpieces. Cervicofacial subcutaneous emphysema sequelae after maxillofacial trauma, however, has been reported less and the self-induced variant is even rarer. We report a case of massive cervicofacial subcutaneous emphysema, pneumomediastinum, and pneumopericardium in a healthy 16-year-old boy after blunt trauma to the face, which caused a nondisplaced anterior maxillary wall fracture. The findings from the present case report will validate the common phrase "no nose blowing or holding your sneezes" that clinicians tell patients after maxillofacial trauma and sinus surgery.

Enhancing value of quality assurance rounds in improving radiotherapy management: a retrospective analysis from King Hussein Cancer Center in Jordan.

PURPOSE: The quality assurance (QA) chart rounds are multidisciplinary meetings to review radiation therapy (RT) treatment plans. This study focus on describing the changes in RT management based on QA round reviews in a single institution. MATERIALS AND METHODS: After 9 full years of implementation, a retrospective review of all patients whose charts passed through departmental QA chart rounds from 2007 to 2015. The reviewed cases were presented for RT plan review; subcategorized based on decision in QA rounds into: approved, minor modifications or major modifications. Major modification defined as any substantial change which required patient re-simulation or re-planning prior to commencement of RT. Minor modification included treatment plan changes which didn't necessarily require RT re-planning. RESULTS: Overall 7,149 RT treatment plans for different anatomical sites were reviewed at QA rounds. From these treatment plans, 6,654 (93%) were approved, 144 (2%) required minor modifications, while 351 (5%) required major modifications. Major modification included changes in: selected RT dose (96/351, 27%), target volume definition (127/351, 36%), organs-at-risk contouring (10/351, 3%), dose volume objectives/constraints criteria (90/351, 26%), and intent of treatment (28/351, 8%). The RT plans which required major modification according to the tumor subtype were as follows: head and neck (104/904, 12%), thoracic (12/199, 6%), gastrointestinal (33/687,5%), skin (5/106, 5%), genitourinary (16/359, 4%), breast (104/2387, 4%), central nervous system (36/846, 4%), sarcoma (11/277, 4%), pediatric (7/251, 3%), lymphoma (10/423, 2%), gynecological tumors (2/359, 1%), and others (11/351, 3%). CONCLUSION: Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/ or treatment decisions.

Six-year follow-up of vitiligo patients successfully treated with autologous non-cultured melanocyte-keratinocyte transplantation.

BACKGROUND: Although autologous non-cultured melanocyte-keratinocyte transplantation is a treatment option for stable vitiligo, there is lack of long-term maintenance data for this specific treatment. OBJECTIVE: To search for factors associated with long-term maintenance of patients with stable vitiligo successfully treated with melanocyte-keratinocyte transplantation. METHODS: This was a single-centre retrospective study including stable vitiligo patients who underwent successful melanocyte-keratinocyte transplantation in the National Center for Vitiligo, Riyadh, Saudi Arabia, between 1 January 2004 and 30 June 2015. Cox proportional hazard model was used to estimate factors associated with relapse at 6 years of followup. Co-variates included, gender, type of vitiligo, age at vitiligo onset, age at surgical procedure, disease duration, disease stability, affected body surface area, treated surface area, fingertip involvement, type of recipient area treatment and recurrence defined as the onset of new lesions on previously untreated areas. The risk of developing relapse defined as re-appearance of more than 10% depigmentation in a previously treated and repigmented site was considered as the main outcome. RESULTS: In total, 602 patients were included in the study of whom 410 (67%) were women. Mean age was 24.25 years [4.0-67.0]. Affected body surface area of less than 1% (adjusted HR = 0.37; P = 0.04) and mechanical dermabrasion (adjusted HR = 0.26; P = 0.03) were independently associated with lower rates of relapse. On the contrary, non-segmental type of vitiligo (adjusted HR = 2.11; P = 0.03) and fingertip involvement (adjusted HR = 3.75; P = 0.01) were independently associated with higher rates of relapse. CONCLUSIONS: Criteria for selecting patients with stable vitiligo for surgery should include careful assessment of vitiligo type including body surface area of vitiligo and involvement of fingertip before undergoing surgical procedure.

Notomelia and related neural tube defects in a baby born in Niger: case report and literature review.

INTRODUCTION: Notomelia associated with neural tube defects are rare diseases. CASE REPORT: A baby was born in Niger with multiple congenital embryonic malformations on the posterior midline. The most rostral malformation was an accessory limb (polymelia) at the level of the lumbar vertebrae composed of two long bones, a foot and three toes. Accessory male genitalia were present at the base of this malformed accessory limb which had no apparent motor or sensory innervation. The second malformation was a sacral vestigial appendage with an adjacent dermal sinus opening onto the posterior midline and extending internally to the dura through a defect of the vertebral arches. From the published literature and this particular case, we conclude that notomelia is a rare clinical sequela of a neural tube defect (NTD) and is correctly classified as a dysraphic appendage. CONCLUSION: The recent occurrence of three similar cases in the same ethnic group from Niger, three from consanguineous parents, suggests that genetic factors are likely to contribute significantly to the genesis of this syndrome, consistent with a recent report that mutation of the bovine NHLRC2 gene resulting in a V311A substitution at a highly conserved locus in the NHLRC2 protein is, when homozygous, causally associated with several forms of polymelia including notomelia, with heteropagus conjoined twinning and with other NTD-related embryonic malformations. Detailed genome-wide studies of children with dysraphic appendages are indicated.

Immediate Transoral Allogeneic Bone Grafting for Large Mandibular Defects. Less Morbidity, More Bone. A Paradigm in Benign Tumor Mandibular Reconstruction?

PURPOSE: Reconstruction of hard tissue continuity defects caused by ablative tumor surgery has been traditionally reconstructed with autogenous bone grafts or microvascular free flaps. Although results have been predictable from these 2 methods of reconstruction, the morbidity associated with bone harvest is quite serious for the patient. Predictable results have been obtained with using a combination of 100% cadaver bone, bone marrow aspirate concentrate (BMAC), and recombinant human bone morphogenic protein in immediate reconstruction for benign tumor extirpations through the extraoral approach. In light of these successful outcomes, the same combination was evaluated with an intraoral approach. This study evaluated the success of immediate mandibular reconstruction through the intraoral approach without any autogenous bone harvesting. PATIENTS AND METHODS: The aim of this retrospective study was to share the authors' experience with the use of 100% allogeneic bone in combination with bone morphogenic protein and BMAC through the transoral approach for immediate reconstruction of continuity defects that resulted from benign tumor surgery. A retrospective chart review was performed of all patients undergoing bone graft reconstruction at the University of Texas Health Sciences Center at Houston (UTHealth) Department of Oral and Maxillofacial Surgery from December 2014 through January 2016. Inclusion criteria were biopsy-proven benign tumors, American Society of Anesthesiologists I or II health status, and adequate intraoral soft tissue for primary closure determined during initial consultation. RESULTS: Five patients who underwent this procedure at the UTHealth Department of Oral and Maxillofacial Surgery from December 2014 through January 2016 are presented. The success rate was 100%. All patients showed excellent bone quality clinically and radiographically for endosseous dental implant placement. With the transoral approach and no autogenous bone harvesting, the average operating time was 3.4 hours and the hospital stay was 2.4 days. CONCLUSIONS: Composite allogeneic tissue engineering is an effective and predictable technique for immediate reconstruction of continuity defects from ablative benign tumor surgery. Overall, there was no donor site morbidity, the intraoperative time was shorter, there were fewer admission days, and total costs overall were lower compared with traditional methods.

Zinc transporter ZIP10 forms a heteromer with ZIP6 which regulates embryonic development and cell migration.

There is growing evidence that zinc and its transporters are involved in cell migration during development and in cancer. In the present study, we show that zinc transporter ZIP10 (SLC39A10) stimulates cell motility and proliferation, both in mammalian cells and in the zebrafish embryo. This is associated with inactivation of GSK (glycogen synthase kinase)-3α and -3ß and down-regulation of E-cadherin (CDH1). Morpholino-mediated knockdown of zip10 causes delayed epiboly and deformities of the head, eye, heart and tail. Furthermore, zip10 deficiency results in overexpression of cdh1, zip6 and stat3, the latter gene product driving transcription of both zip6 and zip10 The non-redundant requirement of Zip6 and Zip10 for epithelial to mesenchymal transition (EMT) is consistent with our finding that they exist as a heteromer. We postulate that a subset of ZIPs carrying prion protein (PrP)-like ectodomains, including ZIP6 and ZIP10, are integral to cellular pathways and plasticity programmes, such as EMT.

A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: the combined buccal fat pad flap and radical sinusotomy.

OBJECTIVE: Bisphosphonates and monoclonal antibodies directed at osteoclastic function are frequently used to treat postmenopausal and corticosteroid-induced osteoporosis. They are also used in the treatment of certain metastatic malignancies. However, osteonecrosis of the jaw has been reported after intravenous, subcutaneous, or oral use of these agents. More than 12 million Americans and another 20 million worldwide are thought to be taking a bisphosphonate. Exposed bone with oral-antral fistulas has been known to occur increasingly as a specific presentation of what is now termed medication-related osteonecrosis of the jaws (MRONJ) with a specific International Classification of Diseases, 10th revision (ICD-10) code. Oral-antral communications caused by bisphosphonate concomitant with secondary sinusitis represent a unique treatment challenge for the oral and maxillofacial surgeon. The purpose of this article is to demonstrate a simple but effective technique to treat oral-antral communications caused by MRONJ. STUDY DESIGN: With the review and approval of the University of Miami Internal Review Board, we identified 23 patients who had undergone this surgical procedure. RESULTS: We report a 100% resolution of osteonecrosis of the jaw (ONJ) and sinusitis with repneumatization. CONCLUSIONS: The buccal fat pad and radical sinustomy can be used as an effective and predictable technique for the resolution of oral-antral fistulas caused by MRONJ.

A case of cephalomelia discovered in a baby born in Niger.

INTRODUCTION: Subcutaneous tumors with extra limbs are very rare, and they are considered either as fetus in fetu or fetiform teratoma. CASE REPORT: We report here the case of a 6-day-old presenting a mass extending at the level of the occipital bone. This mass is developed in the extracranial region and contains two forelimbs including hands with digits. CT shows that the squamous part of the occipital bone is involved with several defects through which a part of the cerebellum herniates. The boy was operated on and the tumor was removed. The herniated region of the cerebellum has also been removed. After surgery, the boy develops normally. CONCLUSION: This type of tumor is extremely rare and is only the second case that has been reported at this exact location. This could be the so-called céphalomélie described by Isidore Geoffroy Saint-Hilaire in a duck in his famous Treatise of Teratology (1836). The cause of this malformation is still a matter for debate.

Unresectable pancreatic tumour? The issue is tissue.

The majority of tumours in the pancreas are adenocarcinomas for which therapeutic options are limited and which are associated with an unsatisfactory prognosis. However, alternative diagnoses may result in other therapeutic approaches with often a more favourable outcome. Hence, it is crucial to obtain a histological diagnosis before a definitive therapeutic plan can be devised. In this manuscript, a small series of pancreatic tumours other than adenocarcinoma are described.

Tumor necrosis factor-alpha polymorphisms in women with idiopathic recurrent miscarriage.

We investigated the association of tumor necrosis factor-alpha (TNFalpha) gene polymorphisms with idiopathic recurrent miscarriage (RM). TNFalpha -1031T/C, -863C/A, -857C/T, -376G/A, -308G/A, -238G/A, and +488G/A single nucleotide polymorphisms (SNPs) were investigated in 204 RM women and 248 age-matched parous women by PCR-restriction fragment length polymorphism. Significantly higher frequencies of -1031C and -376A alleles were seen in RM patients; significant differences were also noted in the distribution of -1031T/C, -376G/A, and -238G/A genotypes between case and control subjects. Haploview analysis revealed high linkage disequilibrium between -857C/T and +488G/A SNPs, but was lower between the other polymorphisms. Of the possible 52 seven-locus haplotypes constructed, 10 were common, and were included in subsequent analysis. Increased frequency of CCCGGGG and CCCGGAA haplotypes, and reduced frequency of TCCGGGG and TCCGGGA haplotypes were seen in RM patients than in controls. When the Bonferroni correction was applied, differences were significant for the CCCGGAA haplotype, which was higher (OR=4.14; 95% CI=1.84-8.95), and the TCCGGGA haplotype, which were lower among RM cases (OR=0.09; 95% CI=0.02-0.68), thereby conferring RM susceptibility and protection to these haplotypes, respectively. Multivariate analysis confirmed the positive association of only CCCGGAA haplotype with RM (P=0.010; aOR=2.03; 95% CI=1.18-4.47), after controlling for a number of covariates. These results demonstrate that the TNFalpha polymorphisms, in particular the -1031T/C variant, are significantly associated with idiopathic RM. Additional replication studies on other racial groups are needed to confirm our findings.

Long-term outcome of lesional posterior cortical epilepsy surgery in adults.

OBJECTIVE: The aim of this study was to evaluate the short- and long-term seizure outcome and to find predictors of outcome after epilepsy surgery in lesional posterior cortical epilepsies (PCEs). METHODS: The operative outcome in 80 consecutive adult patients with lesional PCEs who underwent resective surgery for intractable partial epilepsy between 1991 and 2006 was retrospectively studied. RESULTS: The probability of remaining in Engel Class I was 66.3% (95% CI 60 to 72) at 6 months, 52.5% (95% CI 47 to 57) at 2 years, 52.9% (CI 45 to 59) at 5 years and 47.1% (CI 42 to 52) at 10 years. Factors predicting poor outcome were the presence of a somatosensory aura, extraregional spikes, incomplete resection, interictal epileptiform discharge (IED) in EEG 6 months and 2 years postsurgery, history of generalised tonic-clonic seizure (GT-CS) and the presence of focal cortical dysplasia in the resected specimen. Factors predicting good outcome were childhood onset of epilepsy, short epilepsy duration, ipsilateral spikes, visual aura, presence of well-circumscribed lesion in preoperative MRI and a pathologically defined tumour. In the multivariate analysis, predictors were different in the long and short term as follows: incomplete resection as proven by postoperative MRI (hazard ratio (HR) 2.059 (CI 1.19 to 3.67)) predicts seizure relapse in short-term follow-up. The presence of IED in the EEG performed 6 months after surgery (HR 2.3 (CI 1.128 to 4.734)) predicts seizure relapse in the long-term fellow-up. However, the absence of a history of GT-CS independently predicts seizure remission in short- and long-term follow-up. CONCLUSIONS: Surgery in PCEs proved to be effective in short- and long-term follow-up. Lesional posterior cortical epilepsy may be a progressive process in a substantial number of cases.

Assessing patient readiness for the clinical adoption of personalized medicine.

BACKGROUND/AIMS: Although pharmacogenomics-based diagnostics and therapeutics are increasingly being translated into personalized medicine applications, relatively little evidence exists about how novel pharmacogenomics-based technologies will be accepted and adopted by patients. It is important to understand the characteristics of genomic diagnostics and targeted therapeutics that might impact utilization or serve as barriers to adoption of these novel technologies in order to formulate appropriate policies and procedures. The objective of this study was to investigate patients' understanding and knowledge of personalized medicine and the process of decision-making regarding pharmacogenomics testing and targeted therapeutics and to better understand how patients value receiving pharmacogenomics-based care. METHODS: We conducted 4 focus groups with 8-10 individuals in each group with patients recruited from out-patient clinics at The Methodist Hospital in Houston, Tex., USA. RESULTS: The use of genomic diagnostics and targeted therapeutics to facilitate personalized medicine has considerable support from patients. However, our data revealed that participants were concerned with issues surrounding privacy and confidentiality of genetic test results, particularly with respect to access of information by insurers, with potential costs of testing and issues related to accuracy of test results. Questions regarding willingness to pay revealed that patients would be more willing to pay out-of-pocket if the disease associated with pharmacogenomic testing for treatment was perceived to be high risk (e.g., colorectal cancer) versus a chronic condition that was perceived as lower risk (e.g., high cholesterol). CONCLUSION: As the personalized medicine approach is increasingly incorporated into health care, understanding patients' needs and their readiness to adopt these novel technologies will become progressively more important for the development of appropriate health policies.

Radioprotection using iodine-131 for thyroid cancer and hyperthyroidism: a review.

Radioiodine (iodine-131, or I-131) therapy has been used successfully for thyroid therapy for more than 50 years. Protocols for treatment with I-131 differ from country to country and even from hospital to hospital in the same country. Daily area surveys of hallways, stairwells, and rooms adjacent to isolation rooms must be conducted and documented to ensure that doses to any individuals in unrestricted areas do not exceed 20 mcSv (2 mrem) in one hour. Nursing and housekeeping staffs must realize that once therapy has begun, no items are to be removed from the room unless first cleared by nuclear medicine or radiation safety personnel. With proper education and instructions for patients and their family members, radiation exposure to healthcare professionals and the general public can be minimized. The objectives of this article are to review (a) practical radiation safety concerns associated with hospitalized patients receiving I-131 therapy, (b) preventive measures to minimize potential exposure and contamination problems, and (c) radiation safety precautions and preventive measures to minimize radiation exposure to family members and helpers living with patients receiving outpatient I-131 therapy.

Influence of external factors on the micellization process and aggregate structure of poly(oxy)styrene-poly(oxy)ethylene block copolymers.

Solutions of the polyoxystyrene-polyoxyethylene block copolymer SO(17)EO(65), where SO denotes polystyrene oxide block as the hydrophobic block and EO the polyethylene oxide block as the hydrophilic block, in mixtures of water (a selective solvent for the EO blocks) and 1,4-dioxane (a good solvent for both blocks) were studied by surface tension and light scattering measurements. Surface and micellar structural parameters have been analyzed as a function of solvent composition. The critical micelle concentration increases and the micellar aggregation number decreases, respectively, as the amount of 1,4-dioxane in the binary solvent increases as a consequence of the enhanced solubility of the SO blocks in the solvent mixture, causing the lowering of the interfacial tension between the hydrophobic blocks in the micellar core and the solvent; therefore, to achieve thermodynamic equilibrium, the micelle size decreases. In addition, static light scattering (SLS) has been proved to be a useful technique to detect the lower boundary of the transition between a dilute micellar solution (sol) to a local-ordered micellar solution (soft gel) resulting from a percolation mechanism. Comparison of the sol-soft gel boundaries obtained from SLS for copolymers SO(17)EO(65) and EO(67)SO(15)EO(67) with those previously derived by rheology is made. Finally, changes in the autocorrelation function of the solutions at the boundary obtained from dynamic light scattering are also analyzed.

Treatment of vitiligo lesions by ReCell vs. conventional melanocyte-keratinocyte transplantation: a pilot study.

BACKGROUND: Surgical procedures are indicated to treat stable vitiligo, refractory to medical treatment. In addition to conventional surgical techniques, noncultured cellular grafting is gaining wider acceptance among dermatologists. OBJECTIVES: To assess the efficacy of the ReCell kit (Clinical Cell Culture, Cambridge, U.K.) and to compare it with conventional melanocyte-keratinocyte transplantation (MKT) for the treatment of vitiligo. METHODS: Ten lesions in five patients at the same anatomical localization (left vs. right, or two separate lesions at the same anatomical location) were treated with ReCell and conventional MKT and repigmentation compared at 4 months post-transplantation. RESULTS: Of the five lesions treated with ReCell two lesions showed 100%, one 65% and one 40% repigmentation, and one lesion failed to repigment. Of the five lesions treated by conventional MKT three showed 100% and one 30% repigmentation and one failed to repigment. CONCLUSIONS: ReCell may be an effective method to treat vitiligo. Studies on larger series of patients are required to confirm its efficacy. Further research is required to establish the effective dilution of the cell suspension.