The effect of biopolymer gel derived from sugarcane on healing of traumatic oral ulcers: an experimental study

Purpose: The extracellular polysaccharide (EPS) is produced by the bacterium Zoogloea sp. and plays a positive role in tissue repair. The purpose of this study was to clinically and histologically compare the effects of EPS in the healing of traumatic oral ulcers in rats with the effects of triamcinolone. Methods: Ulcers were induced in the oral mucous of 45 male Wistar rats, divided into three groups: control group, treated with triamcinolone, and treated with biopolymer gel. In the clinical evaluation, we considered the weight variation of the animals and the size of the lesion area, at baseline and on treatment days 1, 3 and 7. The histological parameters evaluated were the type and intensity of the inflammatory infiltration, the presence of necrosis and foreign body granuloma and the degree of re-epithelialization of the lesion. Results: The reduction of the lesion area was greater in the animals treated with EPS, with no difference in the intensity of the inflammatory infiltration between the groups on days 3 and 7 of treatment. Conclusions: The results suggest that topical application of EPS in traumatic oral ulcers of rats promotes faster repair than triamcinolone ointment, without increasing the intensity of inflammatory infiltration under the lesion.

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.

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.

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.

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.

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.

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.

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.

Effects of radiofrequency on the healing of skin wounds in rats: analysis using digital planigraphy and histological evaluation / Efeitos da radiofrequência na cicatrização de feridas cutâneas em ratos: análise por planigrafia digital e avaliação histológica

Introduction: Given the extensive use of plastic surgery and the search for better aesthetic and functional results, it is necessary to research ways to improve healing and scarring. The objective is to evaluate the effects of three radiofrequency (RF) sessions in healing the skin of mice. Methods: Forty-eight rats were divided into four groups by day of sacrifice and treatment (RF group: RG; control group: CG). Dissection of the excisional wound of 2 cm x 2 cm (4 cm²) was performed and a 6-mm punch was used to hold two excisional wounds 0.6 cm in diameter. After 24 h, radiofrequency was performed using Spectra® directly on the wound in the dorsal region for 7 minutes at 38°C. This was repeated three times on alternate days. For the control group, the radiofrequency protocol was performed with the device switched off. Results: A larger area of the square wound was measured on postoperative day three in RG (RG7: 3.3 cm² ± 0.7 cm² vs. CG7: 2.4 cm² ± 0.4 cm²; p = 0.009). On day 14, the square wound in RG was greater than in CG (RG14: 1.9 cm² ± 0.5 cm² vs. CG14: 1.0 cm² ± 0.3 cm²; p = 0.001). There was a 90% closure of wounds in CG14. In RG14, 60% of the wounds were re-epithelized while 40% remained ulcerated. In CG7, 70% of the remaining wounds were ulcerated and 30% were re-epithelized. In RG7, 8% were re-epithelized and 92% remained ulcerated. Conclusion: Radiofrequency has a negative influence on the healing process, as indicated by mice that received radiofrequency having a persistent ulcerated wound.

Introdução: Tendo em vista o número de cirurgias plásticas e a busca por melhores resultados estético-funcionais fazem-se necessárias pesquisas para encontrar meios para melhorar a cicatrização e as cicatrizes. O objetivo é avaliar os efeitos de três sessões de radiofrequência na cicatrização da pele de ratos. Métodos: Quarenta e oito ratos machos foram divididos em quatro grupos conforme ao grupo que pertenciam e o dia do sacrifício (grupo radiofrequência - GR - e grupo controle - GC). Realizada a dissecação da ferida excisional de 2 cm x 2 cm (4 cm²) e utilizou-se um punch de 6 mm para a realização de duas feridas excisionais de 0,6 cm de diâmetro. Após 24 h, foi realizada a radiofrequência com o equipamento Spectra® na região dorsal, diretamente sobre as feridas por 7 minutos, com temperatura de 38ºC. Repetida por três vezes, em dias alternados. No grupo controle foi realizada com o aparelho desligado. Resultados: Foi encontrada área maior na ferida quadrada, no 3º dia pós-operatório do GR (GR7 3,3 cm² ± 0,7 cm² vs. GC7 2,4 cm² ± 0,4 cm², p = 0,009). No 14º dia a ferida quadrada do GR foi maior do que no GC (GR14 1,9 cm² ± 0,5 cm² vs. GC14 1,0 cm² ± 0,3 cm², p = 0,001). Houve fechamento de 90% das feridas no GC14. No GR14, 60% das feridas foram reepitelizadas enquanto 40% permaneceram ulceradas. No GC7, 70% das feridas de permaneceram ulceradas e 30% foram reepitelizadas. Já no GR7, 8%, foram reepitelizadas e 92% permaneceram ulceradas. Conclusão: A radiofrequência tem influência negativa no processo cicatricial, mostrando que, nos ratos que receberam a radiofrequência, o quadrado permaneceu ulcerado.

Research progress of re-epithelialization in decellularized trachea matrix / 国际儿科学杂志

Long-segment tracheal defects are difficult to be managed by conventional surgical means,which often requires tracheal transplantation.Studies have confirmed that the capacity of tissue engineering techniques in restoration of extensive tracheal defects in animals and human.Decellularized tracheal matrix has attracted widespread attention for its advantages,such as excellent biocompatibility.Re-epithelialization of the tissue engineered trachea,which remains the major obstacle in tracheal transplantation,plays an important role in protecting the grafts from infection and restenosis.To date,some research focuses on the re-epithelialization of the tissue engineered trachea,but achievements are still far from desired,and further studies are needed to ensure the visibility of the application of tissue engineered trachea.

Effects of Polydeoxyribonucleotide in the Treatment of Pressure Ulcers

This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial, the effects of PDRN were compared over time between an experimental group (n=11) and a control group (n=12). The former was administered the same dose of PDRN intramuscularly (1 ampule, 3 mL, 5.625 mg, for 5 days) for 2 weeks and perilesionally (1 ampule, 3 mL, 5.625 mg, twice a week) for 4 weeks. The primary endpoint for determining efficacy was wound healing in the pressure ulcers, which was reflected by the wound surface area determined using VISITRAK Digital (Smith & Nephew, Largo, FL). The secondary endpoint was the pressure ulcer scale for healing score, determined using pressure ulcer scale for healing (PUSH Tool 3.0 developed by the National Pressure Ulcer Advisory Panel). After the 4-week treatment period, PDRN therapy was found to significantly reduce the wound size and PUSH score, without adverse effect during the treatment. The findings indicate that PDRN can positively modify the wound healing process in pressure ulcers, and its use could improve the clinical outcomes of patients and lower the need for additional therapies or hospital stay.

The application of human umbilical cord blood mononuclear cells in the management of deep partial thickness burn.

Background: Wound healing in burn is a complex process and early complete wound closure still enfaces many problems. Application of stem cells is found to be the future method of wound healing. Among the available sources of allogenic stem cells, umbilical cord blood is quite easy to be obtained, has less ethical issue, and contain multipotent stem cells, which are characterized by low immunogenicity. The study aims to evaluate the potential of human umbilical cord blood mononuclear cells (hUCBMNCs) treatment in the management of deep partial thickness burns. Methods: Twenty patients with deep partial thickness burns were treated with topical application of 2 x 107 hUCBMNCs and silver sulfadiazine (SSD) cream on the comparable wound size in the other sites. The treatments were applied for six times in every two consecutive days. Wound surface area was measured with Visitrak® on day 0, 7, and 11. Pain intensity was evaluated using Wong Baker’s faces scale on each wound dressing change. Histology examination was performed in some samples of collected skin biopsy of the newly re-epithelialized area of hUCBMNCs and SSD-treated wound at the end of treatment. HLA typing is used to evaluate the issue of safety. Wilcoxon signed rank test was used to compare the rate of wound healing. Results: Sixteen patients of hUCBMNCs-treated showed a significant wound closure in faster than SSD-treated; measured on day 7 (p = 0.041) and day 11 (p = 0.021). Number of patients with reduced pain intensity, from approximately scale 3 to 1/0 on day 7 and 11, were higher in hUCBMNCs-treated compared to SSD-treated wound. In spite of the HLA-mismatch, no allergic reaction, rejection, and infection found on hUCBMNCs-treated wound suggested the safety of this therapy. Histology examination found the formation of dermal-epidermal junction and rete ridges equal to the normal skin on hUCBMNCs-treated wounds. Conclusion: hUCBMNCs are effective and safe to promote re-epithelialization in deep partial thickness burns.

Preoperative Iodine Staining May Complicate the Demarcation of Esophageal Carcinoma

A 53-year-old man was suspected of having an esophageal neoplasm. An endoscopic examination including Lugol chromoendoscopy suggested an esophageal squamous cell neoplasm limited to the lamina propria. A targeted biopsy showed atypical squamous cells, and an endoscopic submucosal dissection was performed 22 days after the previous endoscopy. Although a single 40 mm unstained area was observed by preoperative Lugol chromoendoscopy, intraoperative endoscopy revealed a 25 mm iodine-unstained area, with small unstained areas scattered on the oral side. We included the small unstained areas in the extent of the resection through assessment by preoperative endoscopy. Histopathologically, the tumor extent appeared to coincide with the preoperative assessment. Tumor cells were found in the basal-parabasal layers of the mucosa, in which small unstained areas were scattered, although the superficial layers exhibited well-differentiated cells containing glycogen in the cytoplasm. Although Lugol chromoendoscopy, which can induce chemical esophagitis, is widely used, re-epithelialization after mucosal damage by preoperative iodine staining may complicate the intraoperative demarcation of tumors.

Topical 1% Nalbuphine on corneal sensivity and epitheilization after experimental lamellar keratectomy in rabbits / Nalbufina 1% tópica sobre a sensibilidade e a epitelização corneal após ceratectomia lamelar experimental

The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08) and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO) statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group) and on the right eye (Control Group). Two groups were formed (n=10) and corneas received either 30µl of 1% nalbuphine (NG) or 30µl of 0,9% saline (CG). Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT) was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P<0.05). Average ±SD time for corneal re-epithelialization was 7.40±0.47 days (NG) and 8.90±0.31 days (CG) (P=0.11). The results showed that the diameter of the keratectomized area and CTT did not change significantly between both groups (P>0.05); however, a higher area under the curve for both parameters was observed in the NG (2771), in comparison to CG (2164). Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.

Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC) e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08), de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO). Conceberam-se dois grupos (n=10) e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN) ou com 30µl de solução salina (Olho direito - GC), às 7, 11, 15 e 19 horas das ceratectomias unilaterais, até sua reepitelização. O limiar de sensibilidade corneal (LSC) foi avaliado 20 minutos após cada tratamento, 48 horas antes e depois da ceratectomia a intervalos regulares de 12 horas (7 e 19 horas) com estesiômetro de Cochet-Bonnet. Após a realização da cirurgia, diariamente, as córneas foram coradas com fluoresceína e registradas em fotos digitais para mensuração em software Image-J. A normalidade dos dados foi avaliada ao teste de Kolmogorov-Smirnov. O limiar de sensibilidade e a área ulcerada foram comparados ao teste de Bonferroni, após ANOVA de medias repetidas (P<0,05). O teste t-Student foi aplicado na avaliação das médias quanto ao tempo de reepitelização. Não houve diferença significativa quanto ao limiar de sensibilidade entre os grupos, em qualquer dos períodos avaliados (P>0,05), todavia, constatou-se maior área sob a curva, relativamente ao LSC, no GN (2771), comparativamente ao GC (2164). O tempo médio±DP de reepitelização no GN foi de 7,40±0,47 dias e de 8,90±0,31 dias no GC, não havendo diferença significativa entre os grupos (P=0,11). Como conclusão, tem-se que o uso tópico de nalbufina 1% não alterou significativamente o limiar de sensibilidade e a reepitelização corneais em coelhos submetidos a ceratectomia lamelar experimental.

Rinofima severo / Severe rhinophyma

Rhinophyma is a progressively growing benign tumor that has the ability to distort the nasal form. Even though, it is considered a rare subtype of rosacea, it is of great importance for the ability to create: psychic, aesthetic and functional disorders. This report describes a severe case of rhinophyma in a 52 years old male patient, the medical treatment and the surgical technique used for removal.

El Rinofima es un tumor benigno de crecimiento progresivo con la capacidad de provocar severas alteraciones en la morfología nasal. Es considerado un subtipo de rosácea poco frecuente, sin embargo, es de gran relevancia por su capacidad de crear trastornos tanto estéticos como funcionales y psicológicos en las personas afectadas. Este reporte describe un caso severo de rinofima, en un paciente de género masculino de 52 años, el tratamiento médico y la técnica quirúrgica que se utilizó para su remoción.

Corneal Epithelial Separation and Corneal Wound Healing Effect between Alcohol and Mechanical Device for Epithelial Flap

PURPOSE: Laser epithelial keratomileusis (LASEK) is a refractive surgery technique in which the cornea is covered with the epithelial flap after keratectomy. However, there have been reports of tissue damage by the alcohol utilized in this procedure while preparing the epithelial flap, which has led to novel methods. One of these is the mechanical designing of the epithelial flap named epipolis laser assisted in situ keratomileusis (Epi-LASIK). This study evaluates the histologic features and wound healing process of the corneal flap using Epi-Tome, which is the epithelial cutter of the newly introduced Epi-Lasik. METHODS: Twenty-four eyes of 12 dogs were devided into two groups. In one group (n=12), 20% alcohol was used and, in the other group (n=12), Epi-Tome (Gebauer, Germany) was used to make a corneal flap. The size change of a fluorescein-stained epithelial defect was followed postoperatively at 6, 12, 24, and 36 hours. RESULTS: The maximum decrease in defect size were observed at 0 to 6 hours in the Epi-Tome group, and from 6 to 12 hours in the alcohol group; the value were 10.01+/-5.32 mm2 and 9.23+/-4.75 mm2 respectively. Histologic review revealed that there was less tissue damage and smoother cut edge in the Epi-Tome group compared to the alcohol group, and the adhesion between stroma and epithelium was faster in the Epi-Tome group. CONCLUSIONS: Mechanically detached corneal flaps had favorable chances of survival such that re-epithelialization occurred early in the postoperative phase. A few epithelial fragments at a corneal section plane prevent corneal opacification and minimize inflammatory reaction, thus reducing postoperative pain.

Effect of negative pressure on the rate of skin donor site re-epithelialization in pig model / 西安交通大学学报(医学版)

Objective To test the effect of negative pressure on the rate of skin donor site re-epithelialization in pig model.Methods Five pigs were selected for this study,and two split-thickness skin graft defects were harvested from the back of each animal.Half of the donor sites were treated with 120 mmHg negative pressure as the experimental group for 10 days and half were treated with vaseline gauze as the control.Changes in each wound were assessed every two days.Results The rate of re-epithelialization increased significantly.The donor sites healed after 4 to 6 days of negative pressure treatment, 2 to 4 days earlier than the control group.The level of inflammatory reaction occurring in wounds treated with negative pressure appeared less severe than that in wounds treated with vaseline gauze.Negative pressure could facilitate cell proliferation.The ratios of S,G2 and M phase increased significantly,and higher expression of PCNA was observed and detected in hair hollicle epithelium,regenerative basal cells and glandular epithelium on day 4 and 8 after negative pressure treatment.Conclusion Negative pressure could significantly increase the rate of skin donor site re-epithelialization