Androgenetic Alopecia in Gender Minority Patients.

Androgenetic alopecia (AGA) is the most common type of hair loss in adults and may be particularly distressing for gender minority patients, given the close relation between hair and gender expression. Furthermore, use of gender affirming hormones such as testosterone in transmen and estrogen/antiandrogens in transwomen has a direct effect on hair growth distribution and density. Clinicians should thus be knowledgeable about the effects of sex hormones on the hair growth cycle to comfortably diagnose and treat AGA in gender minority patients.

Low-intensity laser for harvesting palatal graft for the treatment of gingival recession: A systematic review.

The aim of the present study was to assess the efficacy of low-intensity laser therapy (LILT) for harvesting palatal connective tissue graft (PCTG) in the treatment of gingival recession. Databases were searched up to May 2018. The addressed focused question was: Is adjunctive LILT effective in the healing of donor palatine area after harvesting PCTG? Screening of the initially identified studies resulted in four clinical studies. All studies showed that LILT was effective in improving clinical outcomes, such as tissue thickness, postoperative discomfort, remaining wound area, and visual analog score at follow up. Upon comparison with the control group, two studies showed significantly greater improvements in the clinical parameters and patient-centered outcomes for LILT than control groups at follow up. Due to the low number of included clinical studies, it remains debatable whether LILT improves clinical and patient-centered outcomes of PCTG procedures. Further randomized controlled trials are needed to evaluate the outcomes of LILT on the healing of donor palatine area after harvesting PCTG.

Avaliação tomográfica da espessura da mucosa palatina em indivíduos com biótipos fino e espesso / Tomographic evaluation of palatine mucosa thickness in individuals with thin and thick biotypes

INTRODUÇÃO: O palato é a principal área doadora de enxerto nas cirurgias periodontais e peri-implantares. O volume de tecido disponível depende da espessura da mucosa palatina e variações intra e interindividuais podem estar relacionadas ao tipo de biótipo do paciente. OBJETIVO: Investigar a diferença da espessura da mucosa palatina em indivíduos com biótipos fino e espesso, avaliada em diferentes regiões. METODOLOGIA: Foram analisadas 30 tomografias de feixe cônico adquiridas no tomógrafo CS8100 3D® e analisadas no software CS 3D Imaging® . O biótipo periodontal foi categorizado em fino (<1,5mm) ou espesso (≥1,5mm) e definido de duas formas: primeiro, o biótipo encontrado nos incisivos centrais foi considerado para os demais dentes. Em seguida, cada dente foi avaliado individualmente. Por fim, a espessura da mucosa palatina foi medida nos caninos, 1º e 2º pré-molares e 1º molares à 3mm, 6mm, 9mm e 12mm a partir da margem gengival. Os testes de Mann-Whitney, Wilcoxon e Friedman foram utilizados para avaliar as diferenças na espessura da mucosa palatina entre os grupos, entre os dentes e nas diferentes regiões, respectivamente. RESULTADOS: Não houve diferença estatística nas espessuras das mucosas palatinas entre os grupos (p> 0,05); em todos os dentes, quanto mais distante da margem gengival, maior a espessura da mucosa palatina (p< 0,0001). Entre os dentes, observou-se menor espessura nas localizações "b" e "c" no primeiro molar (p< 0,05) em todas as avaliações; nessas mesmas localizações, o segundo pré-molar (2PbX1Pb: p<0,0001) e o canino (CcX1Pc: p=0,022 e CcX2Pc: p=0,004) mostraram mucosa mais fina apenas quando categorizados com base no biótipo dos incisivos centrais. CONCLUSÃO: a espessura da mucosa palatina não mostrou relação com o biótipo do paciente, sendo mais fina na região do primeiro molar. Independentemente do dente, áreas mais distantes da margem gengival apresentam maior espessura tecidual (AU).

INTRODUCTION: The palate is the main donor site in periodontal and periimplant surgeries. The volume of tissue available depends on the thickness of the mucosa and intra and interindividual variations may be related to the patient's biotype. PURPOSE: To investigate the difference of the palatal mucosa thickness in individuals with thin and thick biotypes, evaluated in different regions. METHODS: 30 CBCT scans were acquired in the CS8100 3D® tomograph and analyzed in CS 3D Imaging® software. The periodontal biotype was categorized into thin (<1.5mm) or thick (≥1.5mm) and defined in two ways. First, the biotype found in the central incisors was considered for the remaining teeth. Then, each tooth was categorized individually. Finally, the thickness of the palatal mucosa was measured in the canine, 1st and 2nd premolars and 1st molar at 3mm, 6mm, 9mm and 12mm from the gingival margin. The Mann-Whitney, Wilcoxon and Friedman tests were used to evaluate differences in palatal mucosa between groups, among teeth and in different regions, respectively. RESULTS: There was no statistical difference in the palatal mucosal thickness between the groups (p> 0.05); in all analyzed teeth, the furthest from the gingival margin, the palatal mucosa thickness (p <0.0001) was higher. Among the teeth, the locations "b" and "c" in first molar was thinner (p <0.05) in all evaluations. The second pre-molar (2PbX1Pb: p <0.0001) and the canine (CcX1Pc: p = 0.022 and CcX2Pc: p = 0.004) showed a thinner mucosa only when categorized based on the central incisor biotype. CONCLUSIONS: the palatal mucosa thickness was not related to the patient biotype and was thinner at the first molar region. Regardless of the tooth, areas more distant from the gingival margin had a thicker tissue (AU).

Fat Graft Survival After Recipient Site Pretreatment With Fractional Carbon Dioxide Laser.

BACKGROUND: Fat grafting is a commonly performed procedure not only for augmenting the soft tissue but also for regeneration in esthetic and reconstructive plastic surgery.However, unpredictable fat survival rate because of high resorption rate is remained as the main problem. The purpose of this study was to investigate the effect of pretreatment of the recipient site to the fat survival using fractional carbon dioxide (CO2) laser. METHODS: The rats were divided to 2 groups. Inguinal fat pads of rats were transplanted to the dorsum without pretreatment in the control group. The study group was preconditioned by fractional CO2 laser to the recipient site 1 week before fat graft.The pulse energy was set to 100 mJ. Transplanted fat tissues were harvested at postoperative days 1, 3, 7, 14, and 28 and were analyzed morphologically, histologically, and immunohistochemically. RESULTS: Weight and volume in the control group was more decreased than in the study group at postoperative day 28. Histological evaluation showed less inflammation, less fibrosis, less vacuolization, and better integrity of adipocytes. Immunohistologically, microvessel density in the study group was higher than in the control group (P < 0.05) at postoperative day 1. Survival rate in the study group was higher than in the control group at postoperative days 1, 3, 7, and 14 (P < 0.05). CONCLUSIONS: Pretreatment of recipient site using fractional CO2 laser helped vascularization in the early stage in fat graft and solved the ischemic condition, so it improved fat survival rate.

Restorative Tissue Transplantation Options for Osteochondral Lesions of the Talus: A Review.

Symptomatic osteochondral lesions of the talus remain a challenging problem due to inability for cartilage lesions to heal. Numerous treatment options exist, including nonoperative management, marrow stimulating techniques, and autograft-allograft. Arthroscopic marrow stimulation forms fibrocartilage that has been shown to be biomechanically weaker than hyaline cartilage. Restorative tissue transplantation options are being used more for larger and cystic lesions. Newer biologics and particulated juvenile cartilage are currently under investigation for possible clinical efficacy. This article provides an evidenced-based summary of available literature on the use of biologics for treatment of osteochondral lesions of the talus.

Requirements for Clinical Trials with Gene Therapy and Transplant Products in Switzerland.

This chapter aims to describe and summarize the regulation of gene and cell therapy products in Switzerland and its legal basis. Product types are briefly described, as are Swiss-specific terminologies such as the term "transplant product," which means products manufactured from cells, tissues, or even whole organs. Although some parts of this chapter may show a guideline character, they are not legally binding, but represent the current thinking of Swissmedic, the Swiss Agency for Therapeutic Products. As so far the experience with marketing approval of gene therapy and cell therapy products in Switzerland is limited, this chapter focuses on the regulation of clinical trials conducted with these products. Quality, nonclinical, and clinical aspects are summarized separately for gene therapy products and transplant products.

Inhibition of cytomegalovirus infection and photothermolysis of infected cells using bioconjugated gold nanoparticles.

Human cytomegalovirus (CMV) is a herpesvirus that causes major health problems in neonates as well as in immunocompromised individuals. At present, a vaccine is not available for CMV infection and the available antiviral drugs suffer from toxicity, poor efficacy and resistance. Here, we chemically conjugated a monoclonal antibody raised against CMV surface glycoprotein (gB) with gold nanoparticles (GNP) and characterized the potential of this gB-GNP conjugate for antiviral activity against CMV. The gB-GNP blocks viral replication, virus-induced cytopathogenic effects and virus spread in cell culture without inducing cytotoxicity. High concentrations of gB-GNP that coat the surface of virus particles block virus entry, whereas lower concentrations block a later stage of virus life cycle. Also, cells treated with gB-GNP gain resistance to CMV infection. In addition, infected cells when bound to gB-GNP can be selectively lysed after exposing them to specific wavelength of laser (nanophotothermolysis). Thus, we have not only designed a potential antiviral strategy that specifically blocks CMV infection at multiple stages of virus life cycle, but we have also characterized a technique that can potentially be useful in eliminating CMV infected cells from donor tissue during transplant or transfusion.

Fecal microbiota transplantation in treating Clostridium difficile infection.

Clostridium difficile infection (CDI) is an increasingly common and severe international health problem. Customary treatment of this infection, usually with antibiotics, is often ineffective and its recurrence is common. In recent years the treatment of recurrent or refractory CDI by the transfer of stool from an uninfected person, so called fecal "microbiota transplantation" has become recognized as effective and generally safe. The effectiveness of this novel treatment is incompletely defined but is likely to be due to its correction of the intestinal dysbiosis that characterizes the disease. Practical methods for the administration of the transplantation have been described. This review summarizes the current reported experiences with fecal microbiota transplantation in the treatment for CDI.

Enxerto de tecido conjuntivo para aumento em espessura na correção de discromia radicular / Connective tissue graft to increase gingival thickness in correcting the root dyschromia

A cirurgia plástica periodontal tem sido cada vez mais utilizada para o tratamento de alterações nos tecidos de proteção, de acordo com as exigências estéticas da sociedade atual. Este relato de caso clínico demonstra a utilização do enxerto de tecido conjuntivo subepitelial para aumento de espessura na zona estética, pela Técnica de Bruno, como alternativa terapêutica no tratamento da discromia radicular. De acordo com os resultados obtidos, considerou-se que, com a correta indicação clínica, a cirurgia plástica periodontal pode ser uma escolha viável para aumento de espessura gengival, de forma a mascarar a discromia radicular.

Development and implementation of a computerized system for collection, processing, and administration of cellular therapy products.

Great strides have been made in computerization of ordering processes for general medications and chemotherapy agents. However, systems for ordering, processing, and administration of cellular therapies continue to be largely paper-based, without the safety features of computerized order entry. To address this deficit, Partners Healthcare System Information Services (PHS-IS; Boston, MA) has worked with oncologists and staff in the cell processing laboratory at the Dana-Farber Cancer Institute (Boston, MA) to develop and implement a novel, comprehensive computerized system for physician ordering and management of cellular products. A multidisciplinary team was formed to accomplish the task of developing a cellular product management system. This team identified the unique characteristics of cellular therapies and sought to develop a comprehensive computerized system that addressed these needs. The biotherapy order entry system developed and implemented by PHS-IS includes a suite of three interrelated applications that addresses all requirements of a traditional computerized provider order entry system, as well as features unique to cellular therapies. The biotherapy suite of applications has addressed patient safety concerns, streamlined the ordering of cellular therapy products, and has reduced opportunities for error and delay in product administration.

[The 2009 performance report of the German cornea banks]. / Leistungsbericht der Deutschen Hornhautbanken 2009.

BACKGROUND: In Germany, human tissue for corneal and amniotic transplantation is supplied by 27 cornea banks. METHODS: The Section for Tissue Transplantation and Biotechnology of the German Ophthalmological Society records the cornea banks' activities by means of an annual questionnaire. RESULTS: In 2009, a total of 4,818 corneal grafts were processed by 21 responding cornea banks, and 57% were deemed suitable for transplantation. This ratio is slightly higher than the European average. In addition, German cornea banks released 1,257 amniotic grafts in 2009. DISCUSSION: German cornea banks are currently facing new regulatory issues due to updated legislation regarding tissue transplantation. Recent updates in European law have limited the cutoff time for postmortem blood sampling to 24 h, and this regulation may lead to a significant reduction in potential donors.

Efficacy of various durations of in vitro predegeneration on the cell count and purity of rat Schwann-cell cultures.

The efficacy of Schwann-cell cultivation can be enhanced by in vitro predegeneration of the harvested cells compared to immediate culture. The aim of this study was to improve Schwann-cell culture efficacy by comparing three different durations of predegeneration. The sciatic and median nerves of 6-8-week-old Lewis rats were harvested and subjected to either 2-day, 7-day, or 14-day predegeneration in Dulbecco's Modified Eagle's Medium supplemented with 10% fetal calf serum and 1% Penicillin/Streptomycin. Afterward, tissue was enzymatically dissociated and placed in a modified melanocyte growth medium. The cell count was determined immediately after dissociation while the cell purity was determined one subculture/trypsinization cycle later after cell attachment to the culture plate by means of optical microscopy and immunocytochemistry. Particular attention was then paid to the Schwann-cell-to-fibroblast relation. The cumulative cell count in the culture was 5.8 x 10(5) for 2-day, 1.12 x 10(6) for 7-day, and 1.48 x 10(6) for 14-day predegeneration. The culture purity was approximately equal for 2- and 7-day predegeneration (88% Schwann cells, 12% fibroblasts after 2 days; 85% Schwann cells, 15% fibroblasts after 7 days). After 14 days, however, cell cultures were significantly debased by fibroblast proliferation (57% Schwann cells, 43% fibroblasts). In vitro predegeneration is a particularly suitable procedural method to increase the cultural Schwann-cell yield. The number of cultivated rat Schwann cells is doubled by 7-day in vitro predegeneration in comparison to 2-day predegeneration. After 14-day predegeneration, however, the culture is significantly debased by fibroblasts. Therefore, 7-day in vitro predegeneration is an advisable predegeneration period.

Scaleable manufacture of HIV-1 entry inhibitor griffithsin and validation of its safety and efficacy as a topical microbicide component.

To prevent sexually transmitted HIV, the most desirable active ingredients of microbicides are antiretrovirals (ARVs) that directly target viral entry and avert infection at mucosal surfaces. However, most promising ARV entry inhibitors are biologicals, which are costly to manufacture and deliver to resource-poor areas where effective microbicides are urgently needed. Here, we report a manufacturing breakthrough for griffithsin (GRFT), one of the most potent HIV entry inhibitors. This red algal protein was produced in multigram quantities after extraction from Nicotiana benthamiana plants transduced with a tobacco mosaic virus vector expressing GRFT. Plant-produced GRFT (GRFT-P) was shown as active against HIV at picomolar concentrations, directly virucidal via binding to HIV envelope glycoproteins, and capable of blocking cell-to-cell HIV transmission. GRFT-P has broad-spectrum activity against HIV clades A, B, and C, with utility as a microbicide component for HIV prevention in established epidemics in sub-Saharan Africa, South Asia, China, and the industrialized West. Cognizant of the imperative that microbicides not induce epithelial damage or inflammatory responses, we also show that GRFT-P is nonirritating and noninflammatory in human cervical explants and in vivo in the rabbit vaginal irritation model. Moreover, GRFT-P is potently active in preventing infection of cervical explants by HIV-1 and has no mitogenic activity on cultured human lymphocytes.

Electrical stimulation accelerates motor functional recovery in autograft-repaired 10 mm femoral nerve gap in rats.

Electrical stimulation has been shown to enhance peripheral nerve regeneration after nerve injury. However, the impact of electrical stimulation on motor functional recovery after nerve injuries, especially over long nerve gap lesions, has not been investigated in a comprehensive manner. In the present study, we aimed to determine whether electrical stimulation (1 h, 20 Hz) is beneficial for motor functional recovery after a 10 mm femoral nerve gap lesion in rats. The proximal nerve stump was electrically stimulated for 1 h at 20 Hz frequency prior to nerve repair with an autologous graft. The rate of motor functional recovery was evaluated by single frame motion analysis and electrophysiological studies, and the nerve regeneration was investigated by double labeling and histological analysis. We found that brief electrical stimulation significantly accelerated motor functional recovery and nerve regeneration. Although the final outcome, both in functional terms and morphological terms, was not improved by electrical stimulation, the observed acceleration of functional recovery and axon regeneration may be of therapeutic importance in clinical setting.

Evaluation of drug-metabolizing and functional competence of human hepatocytes incubated under hypothermia in different media for clinical infusion.

Hepatocyte transplantation has been proposed as a method to support patients with liver insufficiency. Key factors for clinical cell transplantation to progress is to prevent hepatocyte damage, loss of viability and cell functionality, factors that depend on the nature of the tissue used for isolation to a large extent. The main sources of tissue for hepatocyte isolation are marginal livers that are unsuitable for transplantation, and segments from reduced cadaveric grafts. Hepatocellular transplantation requires infusing human hepatocytes in suspension over a period of minutes to hours. The beneficial effect of hypothermic preservation of hepatocytes in infusion medium has been reported, but how critical issues towards the success of cell transplantation, such as the composition of infusion medium and duration of hepatocyte storage will affect hepatocyte quality for clinical cell infusion has not been systematically investigated. Infusion media composition is phosphate-buffered saline containing anticoagulants and human serum albumin. The supplementation of infusion media with glucose or N-acetyl-cystein, or with both components at the same time, has been investigated. After isolation, hepatocytes were suspended in each infusion medium and a sample at the 0 time point was harvested for cell viability and functional assessment. Thereafter, cells were incubated in different infusion media agitated on a rocker platform to simulate the clinical infusion technique. The time course of hepatocyte viability, funtionality (drug-metabolizing enzymes, ureogenic capability, ATP, glycogen, and GSH levels), apoptosis (caspase-3 activation), and attachment and monolayer formation were analyzed. The optimal preservation of cell viability, attaching capacity, and functionality, particularly GSH and glycogen levels, as well as drug-metabolizing cytochrome P450 enzymes, was found in infusion media supplemented with 2 mM N-acetyl-cystein and 15 mM glucose.

Modulation of dendritic spine remodeling in the motor cortex following spinal cord injury: effects of environmental enrichment and combinatorial treatment with transplants and neurotrophin-3.

Incomplete spinal cord injury (SCI) elicits structural plasticity of the spared motor system, including the motor cortex, which may underlie some of the spontaneous recovery of motor function seen after injury. Promoting structural plasticity may become an important component of future strategies to improve functional outcomes. We have recently observed dynamic changes in the density and morphology of dendritic spines in the motor cortex following SCI. The present study sought to test whether SCI-induced changes in spine density and morphology could be modulated by potential strategies to enhance functional recovery. We examined the effects of enriched environment, transplants, and neurotrophin-3 on the plasticity of synaptic structures in the motor cortex following SCI. Housing rats in an enriched environment increased spine density in the motor cortex regardless of injury. SCI led to a more slender and elongated spine morphology. Enriched housing mitigated the SCI-induced morphological alterations, suggesting that the environmental modification facilitates maturation of synaptic structures. Transplantation of embryonic spinal cord tissue and delivery of neurotrophin-3 at the injury site further increased spine density when combined with enriched housing. This combinatorial treatment completely abolished the injury-induced changes, restoring a preinjury pattern of spine morphology. These results demonstrated that remodeling of dendritic spines in the motor cortex after SCI can be modulated by enriched housing, and the combinatorial treatment with embryonic transplants and neurotrophin-3 can potentiate the effects of enriched housing. We suggest that synaptic remodeling processes in the motor cortex can be targeted for an intervention to enhance functional recovery after SCI.

Removal of alpha-Gal Epitopes in Aortic Valve and Pericardium ofPig Using Green Coffee Bean alpha-Galactosidase / 대한흉부외과학회지

BACKGROUND: It is currently thought that tissue valve degeneration is related to an animal's immune response, which is mainly due to cell surface alpha-Gal epitopes. Cell surface alpha-Gal epitopes are known to be degraded by the enzyme called green coffee bean alpha-galactosidase. It is also well known that alpha-Gal epitopes are immunologically stained by Griffonia Simplicifolia isolectin type B4. We know that many commercially available tissue valves are made of aortic valves and pericardial tissue of pig. So, we investigated whether alpha-Gal epitopes of the aortic valve and pericardial tissue of a pig can be removed by green coffee bean alpha-galactosidase, and we did so by comparing immunologic staining of the tissues before and after the enzyme treatment. MATERIAL AND METHOD: After treating fresh porcine aortic valve and pericardial tissue with green coffee bean alpha-galactosidase at concentrations of 0.5 unit/mL, 1.0 unit/mL, 2.0 unit/mL, respectively, under the condition of pH 6.5, temperature 4degrees C and 24 hours of incubation, each sample was stained with Griffonia Simplicifolia isolectin type B4 immunofluorescent labeling. We then examined whether the alpha-Gal epitopes were reduced or abolished in each consecutive concentration of green coffee bean alpha-galactosidase by comparing the degree of the Griffonia Simplicifolia isolectin B4 staining in each sample. RESULT: In the pig aortic valve tissue, a 1.0 unit/mL concentration of green coffee bean alpha-galactosidase at pH 6.5, 4degrees C and reaction for 24 hours was enough for complete removal of alpha-Gal epitopes from the cell surface on the immunostaining with Griffonia Simplicifolia isolectin B4. On the other hand, more alpha-Gal epitopes were present in the pig pericardial tissue on Griffonia Simplicifolia isolectin B4 staining before the enzyme treatment, and 1.0 unit/mL of galactosidase was not sufficient for complete removal of alpha-Gal from the tissue. 2.0 units/mL of green coffee bean alpha-galactosidase was needed to completely remove the alpha-Gal epitopes from the pericardial tissue on immunostaining. CONCLUSION: The alpha-Gal epitopes of the pig's aortic valve and pericardial tissue were successfully stained with Griffonia Simplicifolia isolectin B4. We could remove nearly all the alpha-Gal epitopes using green coffee bean alpha-galactosidase at the concentration of 1.0 unit/mL in the aortic valve of pig, and 2.0 unit/mL was need to nearly completely remove all the alpha-Gal epitopes in the pericardial tissue of pig under the condition of pH 6.5, 4degrees C and 24 hours of reaction time. In the near future, removal of alpha-Gal epitopes in the pig's aortic valve and pericardial tissue will become a powerful tool for the improvement of the tissue valve durability. It needs to be determined if alpha-galactosidase treated pig tissue is immune to human anti-Gal antibody or anti-Gal monoclonal antibodies.