The role of TGF-ß and antimicrobial peptides in basal cell carcinoma: a systematic review.

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer in humans, occurring in more than 50% of Caucasians during their lifetime, with a frequency rate that is continually increasing. Material and methods: We present a systematic review summarizing the role of transforming growth factor ß (TGF-ß), cathelicidin, and human ß-defensins (HBDs) in the pathogenesis of BCC. The major online databases including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to extract studies regarding the levels of TGF-ß, HBD, and cathelicidin in BCC. Results: A total of 14 studies met the inclusion criteria and were included in this systematic review. There were 6 studies that included initially established levels of TGF-ß in BCCs. A total of 87 BCCs were analysed, and a common result was that the TGF-ß levels increase in the BCCs compared to the control groups. Analogously, 2 studies contained numerical data on HBD levels but with a different in methodology. The level of cathelicidin was established in 108 BCCs and was significantly higher in the BCC group than in the control group. Conclusions: The presented review shows evidence that proteins like TGF-ß, HBD, and cathelicidin play a role in developing BCC. Protein levels or their expression are elevated in patients with BCC. Furthermore, a critical review of the literature was presented and discussed, highlighting its shortcomings.

Growth rate of basal cell carcinoma: a meta-analysis and systematic review.

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer, especially in fair-skinned adults, and the lifetime risk of its incidence in this population is estimated to be approximately 30%. We present a meta-analysis and systematic review summarizing the size of the growth rate in BCC, depending also on its subtypes. Material and methods: To find all relevant studies, online medical databases such as PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched regarding the growth rate of BCC. Results: A total of 7 studies were included in this review. Five studies contained data on the growth rate of basal cell carcinomas. The mean growth rate for the longer axis of the BCC was established to be 0.71 mm/month (standard error: 0.22). Conclusions: The presented analysis shows that BCC is generally a slow-growing tumour, with a mean growth rate of about 0.7 mm/month. However, it was proven that this growth rate differs depending on the BCC subtype.

The adaptation of Polish version of Six-Item Carpal Tunnel Syndrome Symptoms Scale.

BACKGROUND: The Carpal Tunnel Syndrome is one of the most common peripheral neuropathy. The diagnosis could be made by taking the medical history from a patient or by physical examination or by performing electroneurography. The aims of the study were (1) to translate and adaptate the Polish version of the Six-Item Carpal Tunnel Syndrome Symptoms Scale (CTS-6 SS) and (2) to analyse the associations between different Patients-Reported Outcome Measures and nerve conduction studies (NCS). METHODS: One-hundred and fifty patients consistent with inclusion criteria filled the CTS-6 SS, Boston Carpal Tunnel Questionnaire (BCTQ), Disabilities of the Arm, Shoulder and the Hand (DASH) and Michigan Hand Outcomes Questionnaire (MHQ) during their first visit to the clinic. Then, they had the NCS done. After two weeks, 99 patients filled the CTS-6 SS for the second time. RESULTS: The Polish version of CTS-6 SS revealed good psychometric properties: high values of internal consistency, test-retest reliability and validity. The construct validity showed strong correlation with BCTQ - R = 0.87 (p < 0.05) for Symptoms Severity Scale (SSS) and R = 0.64 (p < 0.05) Functional Status Scale (FSS). Additionally CTS-6 SS has at least moderate correlation with DASH R = 0.53 (p < 0.05). CONCLUSIONS: The Polish version of translated scale was adapted and used together with NCS complete the overall picture of patients suffering from CTS. STUDY DESIGN: Prospective study.

Tissue Fillers for the Nasolabial Fold Area: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Tissue fillers injections remain to be one of the most commonly performed cosmetic procedures. The aim of this meta-analysis was to systematize and present available data on the aesthetic outcomes and safety of treating the nasolabial fold area with tissue fillers. We conducted a systematic review of randomized clinical trials that report outcomes concerning treatment of nasolabial fold area with tissue fillers. We searched the MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, Scopus, Cochrane Controlled Register of Trials, CNKI and Web of Science databases. Primary outcomes included aesthetic improvement measured using the Wrinkle Severity Rating Scale score and Global Aesthetic Improvement Scale. Secondary outcomes were incidence rates of complications occurring after the procedure. At baseline, the pooled mean WSRS score was 3.23 (95% CI: 3.20-3.26). One month after the procedure, the pooled WSRS score had reached 1.79 (95% CI: 1.74-1.83). After six months it was 2.02 (95% CI: 1.99-2.05) and after 12 months it was 2.46 (95% CI: 2.4-2.52). One month after the procedure, the pooled GAIS score had reached 2.21 (95% CI: 2.14-2.28). After six months, it was 2.32 (95% CI: 2.26-2.37), and after 12 months, it was 1.27 (95% CI: 1.12-1.42). Overall, the pooled incidence of all complications was 0.58 (95% CI: 0.46-0.7). Most common included lumpiness (43%), tenderness (41%), swelling (34%) and bruising (29%). Tissue fillers used for nasolabial fold area treatment allow achieving a satisfying and sustainable improvement. Most common complications include tenderness, lumpiness, swelling, and bruising. LEVEL OF EVIDENCE II: "This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 ."

Elevated serum levels of cathelicidin and ß-defensin 2 are associated with basal cell carcinoma.

Antimicrobial peptides (AMPs) are one of the primary mechanisms used by the skin in the early stages of immune defense. AMPs have a broad antibacterial activity and also show antifungal and antiviral attributes. Various studies have also shown that levels of antimicrobial peptides change with the development of neoplasia. The aim of this paper is to assess the associations between the presence of basal cell carcinoma (BCC) and the plasma concentrations of cathelicidin and ß-defensins (HBD1-3). We examined 108 patients (56 women, 52 men). The BCC group consisted of 49 patients with mean age 69.8 ±12.3 and the control group consisted of 59 participants with mean age 62.1 ±11.1. A statistical analysis of data was performed. The median serum concentration of cathelicidin was almost 3 times higher and the median concentration of HBD-2 more than 6 times higher in BCC patients than in the control group (p < 0.001). The logistic regression model revealed in univariate analysis that patients who had a detected cathelicidin level above ~1500 pg/ml had 9.9× higher likelihood of having BCC identified in the histopathology in comparison with the control group. In patients who had a HBD-2 level above ~1.2 ng/ml the OR of having BCC identified in the histopathology was 12.6 (p < 0.001). Elevated concentrations of cathelicidin and ß-defensin 2 are associated with the presence of basal cell carcinoma. Additionally, the specificity of cathelicidin and ß-defensin 2 in detecting basal cell carcinoma is high. However, it should be remembered that these factors are not specific only to this condition and further studies are needed.

Neurofibromatosis type 1 - social aspects of functioning and public attitude.

The neurofibromatosis type 1 (NF-1) is the most common phacomatosis. Its clinical picture is variable and the course of the disease is progressive. AIM: The aim of this paper is to present social aspects of living with neurofibromatosis type 1. MATERIALS AND METHODS: We examined 17 patients with NF-1 in the age between 22 to 61 years. In the group there were 11 women and 6 men. A special questionnaire was prepared for the study; it included questions concerning learning problems, difficulties in finding job, problems with getting into relationships and social reaction to NF-1. RESULTS: More than 20% of patients had learning problems and worse marks than other students. Most of respondents did not have problems with making social relationships and difficulties in finding job. However more than 70% of patients thinks that they are different and they were harmed by the nature. Almost 1/3 of respondents do not recognize themselves as good life partner. CONCLUSIONS: Neurofibromatosis type 1 decreases the self-confidence and self-esteem in patients with NF-1. The knowledge of this disease and its character is still poor in social audience. The patients' awareness of disease inheritance is high and their will to have children is small.

Clinical picture and treatment of cutaneous lesions in patients with neurofibromatosis type 1.

INTRODUCTION: The most common type of neurofibromatosis is Recklinghausen disease (NF-1). A major feature of NF1 is the development of localized cutaneous neurofibromas. Such types of lesions are manifested in > 99% of adults with NF1 and are responsible for major negative effects on quality of life. AIM: To present the clinical picture of patients with NF-1 and to report authors' own observations related to their surgical treatment. MATERIAL AND METHODS: A retrospective study aiming to present a group of patients with Recklinghausen disease was planned. The study was carried out in 39 patients with NF-1. RESULTS: All patients had cutaneous neurofibromas localized in different parts of the body. The three most frequent localizations were the abdomen, back, and face. Surgical treatment was performed in 31 patients. All patients had discomfort due to the presence of cutaneous nodules especially because their visibility and multiplicity. CONCLUSIONS: Due to the polymorphism of the clinical picture and unpredictable course of the disease, there is no one standard of treatment of patients with Recklinghausen disease. Excision of tumours in the early stage of their development gives better functional and aesthetic results.

Complications After Scalp Suturing Posttraumatic Avulsion.

Scalp avulsion is a rare but severe trauma. Most cases of this injury happened as a result of hair entrapment in a high-speed rotating machine. Treatment of scalp avulsion can be challenging. Nowadays, microsurgical scalp replantation has become the treatment of choice. However, there are situations in which replantation or even usage of scalp as composite grafts is not possible. The aim of this paper is to present 2 cases of scalp avulsion, which needed split-thickness skin graft for covering posttraumatic scalp loss. Closing large scalp defects after its avulsion by skin graft is still a viable option, especially when replantation and even usage of scalp as a composite graft is not achievable. Scalp shaving is mandatory before any surgical procedures.

Classification of congenital nasal deformities: a proposal to amend the existing classification.

Congenital nasal anomalies are rare malformations with a broad spectrum of defects. The only existing classification strictly relating to nasal anomalies was presented by Losee et al. (Plast Reconstr Surg 113(2):676-689, 2004). The aim of this paper is to propose some suggestions, based on our current knowledge and experience gained by treating our patients in the clinic, in creating a specification of patients with congenital nasal anomalies. All patients with congenital nose defects treated in our health center were selected for this study. The research was retrospective and included years from 1995 to 2015. Nasal anomaly associated with cleft lip and palate was excluded. Patients were classified into four categories of congenital nasal anomalies, according to Losee et al. CLASSIFICATION: In the period of 20 years, 191 patients with congenital nasal anomalies were treated in our health center. Type 1 defects were found in 124 patients, type 2 in 15, type 3 in 32 and type 4 in 20 patients. The nasal defect accompanying craniofacial syndrome is the most common type of nose malformation. The nose cleft is not always a part of craniofacial clefts; isolated forms of such malformations can occur. Vascular anomalies, due to different etiology, categorization and treatment, should not be recognized as nasal malformation.

A signature of circulating microRNAs differentiates takotsubo cardiomyopathy from acute myocardial infarction.

AIMS: Takotsubo cardiomyopathy (TTC) remains a potentially life-threatening disease, which is clinically indistinguishable from acute myocardial infarction (MI). Today, no established biomarkers are available for the early diagnosis of TTC and differentiation from MI. MicroRNAs (miRNAs/miRs) emerge as promising sensitive and specific biomarkers for cardiovascular disease. Thus, we sought to identify circulating miRNAs suitable for diagnosis of acute TTC and for distinguishing TTC from acute MI. METHODS AND RESULTS: After miRNA profiling, eight miRNAs were selected for verification by real-time quantitative reverse transcription polymerase chain reaction in patients with TTC (n = 36), ST-segment elevation acute myocardial infarction (STEMI, n = 27), and healthy controls (n = 28). We quantitatively confirmed up-regulation of miR-16 and miR-26a in patients with TTC compared with healthy subjects (both, P < 0.001), and up-regulation of miR-16, miR-26a, and let-7f compared with STEMI patients (P < 0.0001, P < 0.05, and P < 0.05, respectively). Consistent with previous publications, cardiac specific miR-1 and miR-133a were up-regulated in STEMI patients compared with healthy controls (both, P < 0.0001). Moreover, miR-133a was substantially increased in patients with STEMI compared with TTC (P < 0.05). A unique signature comprising miR-1, miR-16, miR-26a, and miR-133a differentiated TTC from healthy subjects [area under the curve (AUC) 0.835, 95% CI 0.733-0.937, P < 0.0001] and from STEMI patients (AUC 0.881, 95% CI 0.793-0.968, P < 0.0001). This signature yielded a sensitivity of 74.19% and a specificity of 78.57% for TTC vs. healthy subjects, and a sensitivity of 96.77% and a specificity of 70.37% for TTC vs. STEMI patients. Additionally, we noticed a decrease of the endothelin-1 (ET-1)-regulating miRNA-125a-5p in parallel with a robust increase of ET-1 plasma levels in TTC compared with healthy subjects (P < 0.05). CONCLUSION: The present study for the first time describes a signature of four circulating miRNAs as a robust biomarker to distinguish TTC from STEMI patients. The significant up-regulation of these stress- and depression-related miRNAs suggests a close connection of TTC with neuropsychiatric disorders. Moreover, decreased levels of miRNA125a-5p as well as increased plasma levels of its target ET-1 are in line with the microvascular spasm hypothesis of the TTC pathomechanism.

[Total upper and lower eyelid reconstruction using an expanded forehead flap supplied by the frontal branch of superficial temporal artery]. / Rekonstrukcja tkanek miekkich obu powiek za pomoca plata z czola opartego na galezi czolowej tetnicy skroniowej powierzchownej.

Eyelids form the protective eye apparatus. Loss of upper or lower eyelid can lead to infection, vision impairment or even blindness. Although there are many techniques for upper or lower eyelid reconstruction, there are only few articles to report simultaneous reconstruction of both eyelids. The aim of this study is to present a two-stage eyelid reconstruction method using the forehead flap. A 60-year-old woman was admitted to our Department with animal bite wounds in the left periorbital area. During the first operation, the eyelid defect was covered with forehead flap and in the second stage, horizontal incision was created in the flap above the eyeball to form a palpebral fissure. During this two-step surgical treatment, both eyelids of the left eye were reconstructed. The length and width of palpebral fissure were 30 mm and 14 mm, respectively. The patient was satisfied with the surgery outcomes. Reconstruction of both eyelids with forehead flap supplied by the frontal branch of the superficial temporal artery provides the elementary protection to the eyeball, enables vision preservation and offers good aesthetic result.

Surgical treatment of skin lesions in lupus erythematosus.

Lipodystrophies are a wide group of diseases with various etiology, mainly genetic, metabolic or autoimmune. The treatment of these diseases is chronic and not always effective. Major concerns for patients with lipodystrophies are also esthetic defects, especially deformities in the face, neck and upper limbs. There are many surgical methods that can be used to improve patient's appearance like fillers, autologous fat transfer and skin flaps. The aim of this paper is to present and discuss surgical techniques used for correction of lipoatrophy and other skin lesions present in lupus erythematosus. In the first presented patient, lipodermal grafts were performed in two stages (first - to both zygomatic areas, the second - to both nasolabial folds). Moreover, the patient was qualified for arm scar plasty. Deepithelialized skin in the affected area was covered with advanced local skin flaps. In the second patient, an extensive scarring lesion on the scalp was excised and the defect was closed with an expanded scalp flap. Patients with lipodystrophies may require aesthetic surgical procedures to improve their appearance. In patients with lupus erythematosus, autologous fat graft in the face area seems to be a safe and effective method of refilling the volume of atrophic tissues. On the basis of our experience, it is worth emphasizing that the process of fat graft resorption is typical. In patients with scalp scars, an effective method of their removal and hairline restoring is usage of the tissue expander.

The anatomy of the internal iliac artery: a meta-analysis.

BACKGROUND: The internal iliac artery (IIA) originates from the common iliac artery at the level of the sacroiliac joint and bifurcates between the L5 and S1 vertebrae. The aim of the present meta-analysis was to demonstrate the most up-to-date and evidence-based data regarding the general anatomy of the IIA, including their variations, length, and diameter. MATERIALS AND METHODS: Major online medical databases such as PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched in order to find all studies considering the anatomy of the IIA. Eligibility assessment and data extraction stages were performed. RESULTS: In the general population the pooled prevalence of Type I (The superior gluteal artery arises independently with the inferior gluteal and internal pudendal arteries arising from a common trunk which dividing inside (Type IA) or outside (Type IB) pelvic cavity) was found to be 56.57% (95% CI: 53.00-60.10%). The pooled mean length of the IIA was set to be 39.95 mm (SE = 1.79) in the overall population. The pooled mean diameter of the IIA was found to be 6.86 mm (SE = 0.27). CONCLUSIONS: The IIA is responsible for supplying the majority of the structures located in the pelvis. Hence, it is crucial to be aware of the possible variants of the said vessel. The results presented in our study may be highly significant in various surgical procedures performed in that region.

[Comparison of the prevalence of cleft lip and/or palate in children in Lodz province in the period of 1996-2010 in 5-years intervals]. / Porównanie czestosci wystepowania rozszczepów wargi i/lub podniebienia u dzieci w województwie lódzkim na przestrzeni lat 1996-2010 w okresach piecioletnich.

UNLABELLED: Clefts of lip and/or palate are the most common facial malformations. Taking into consideration complexity of this defect and necessity of multidisciplinary treatment the knowledge of actual scale of this phenomenon seems to be relevant. The aim of this paper it to describe and to compare the prevalence of cleft lip and/or palate in Lodz province in the period of 1996-2010 in 5 years intervals. MATERIAL AND METHODS; From Polish Register of Congenital Malformations we managed to obtain the data of the number of live born infants and birth of children with clefts in Lodz province in 2001-2010. On the basis of previously performed studies Department of Plastic, Reconstructive and Esthetic Surgery has the data of clefts' prevalence in Lodz province from year 1996 to 2000. RESULTS: The mean frequency of clefts was 1,67/1000 live born infants in 1996-2000, during years 2001-2005 - 1,47/1000, and 1,13/1000 in 2006-2010. CONCLUSIONS: Significant decrease of the prevalence of cleft lip and/or palate is observed in Lodz province in the period of 1996-2010. In boys the most frequent defect is cleft lip and palate, while in girls--isolated cleft palate.

Correlations between antimicrobial peptides and spectrophotometric skin color parameters in patients with basal cell carcinoma.

BACKGROUND: Antimicrobial peptides (AMPs) are active molecules in the human innate immune system, that participate in host defense and regulate the inflammation process. Previous reports have confirmed that antimicrobial peptides play a critical role in carcinogenesis. OBJECTIVE: The present study aimed to evaluate the correlations between plasma concentrations of AMPs and spectrophotometric parameters of skin color in patients with basal cell carcinoma and compare the results with those of healthy controls. METHODS: The plasma concentrations of cathelicidin and beta-defensin-2 in 100 patients (50 with skin cancer and 50 healthy control subjects) were measured, and skin color parameters were tested using a DermaSpectrophotometer. RESULTS: In patients with basal cell carcinoma, the concentrations of cathelicidin and beta-defensin-2 were significantly higher than those in healthy controls. In healthy control patients, when erythema increases, the levels of cathelicidin and beta-defensin-2 also increase. The direction of the relationship is opposite in people with basal cell carcinoma-the concentration of antimicrobial peptides decreases and the level of erythema increases. CONCLUSION: A significantly higher level of plasma concentrations of cathelicidin and HBD-2 are correspondent to the presence of basal cell carcinoma. Skin cancer modifies the relationship between intensity of skin erythema and the levels of cathelicidin and HBD-2. This can be related to inadequate immunological response in patients with skin cancers. New direction of research may be pioneered in searching for cytokine or mast cells disorders.

Skin cancer occurrence: single-center experiences from period 2020-2022.

<b><br>Introduction:</b> Skin cancers constitute a group of medical disorders remaining a field of interest for surgeons and dermatologists. Currently, this group is typically divided into malignant melanoma (MM) and keratinocyte cancers (KC).</br> <b><br>Aim:</b> The aim of this study is to analyze the cases of skin cancers treated in the Department of Plastic, Reconstructive, and Aesthetic Surgery in Lodz (Poland) during the COVID-19 pandemic (from 2020 to 2022) and then compare the results with the ones from the pre-pandemic period (from 2017 to 2019).</br> <b><br>Material and methods:</b> An analysis of histopathological files from the period between 2020 and 2022 was performed. It was based on the following criteria: sex, age, type of skin cancer, subtype of basal cell carcinoma (BCC), location, and dimensions of the tumor. The study sample consisted of 225 patients presenting 241 cases of skin cancers. There were 74 men and 151 women, with the mean age being 71.7.</br> <b><br>Results:</b> The most common skin cancer was BCC (175 cases, 72.6%) followed by SCC (59 cases, 24.5%), melanoma (5 cases, 2.1%), and other (2 cases, 0.8% - angiosarcoma and sweat gland carcinoma).</br> <b><br>Conclusions:</b> A marked reduction in the number of skin cancers detected during the pandemic period was reported on. Delay in the surgical treatment of skin tumors does not seem to affect the size of the removed lesion. Some models predicting that tumors would be larger after the confinement period are not applicable in reality. However, further investigations with larger samples from multiple centers are needed to confirm these findings and to work out standards on how to deal with healthcare crises in the future.</br>.

Biometric characteristics of the pelvis in female-to-male transsexuals.

The objective of the study was to evaluate the metric features of pelvises of 24 female-to-male (FtM) transsexuals as compared to control groups of 24 healthy males and 24 healthy females. The participants had their pelvises X-rayed with the same X-ray apparatus and in the same position. Seventeen measurements were taken on the basis of X-ray pictures of FtM transsexuals' pelvises and both comparison groups. Additionally, their body height was compared. The results showed that FtM transsexuals having female body height represent an intermediate size of three pelvic features and male values of five variables. In order to develop a model based on metric variables of the pelvis that would best discriminate the FtM transsexuals, the control females, and the control males, a discriminant analysis was applied. The model included four variables out of 17 metric features: the height of the pubic symphysis, the greatest pelvic breadth, the interischial distance, and the acetabular diameter. The model was found to be the best in discriminating males from females and FtM transsexuals, but considerably less effective in discriminating transsexuals from the two control groups. The results demonstrate that a number of FtM transsexuals' pelvic measurements reveal "masculinization," which confirms current results demonstrating a shift in the somatometric traits of transsexual females towards male traits. A discriminant analysis based only on pelvic metric features shows some differences between the size of the pelvis and chromosomal sex in FtM transsexuals, which might indicate a biological basis for gender identity disorder.