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1.
Orthod Craniofac Res ; 2023 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-38058228

RESUMEN

OBJECTIVE: This study aims to evaluate the potential impact of port wine stains on the development of permanent teeth in mixed dentition and provide insights for managing tooth abnormalities in patients with port wine stains. MATERIALS AND METHODS: A retrospective analysis was conducted on 21 patients with mixed dentition and unilateral maxillary port wine stains. Two researchers concurrently utilized Nolla Analysis to assess the developmental stage of bilateral maxillary and permanent mandibular teeth based on panoramic radiographs. The cumulative developmental values of upper and lower permanent teeth on both sides were calculated, and a comparison was made between the developmental stages of the upper and lower jaws. RESULTS: Port wine stains can influence the maturity of permanent upper teeth, within the unilateral maxillary port wine stains range, with an early developmental completion observed on the affected side compared to the unaffected side. While the developmental stages of the lower teeth on both sides showed similarities. CONCLUSIONS: Port wine stains can accelerate the maturity of teeth on the affected side, leading to alterations in the order of tooth eruption and subsequent abnormal occlusion in children with mixed dentition. These findings provide a basis for developing appropriate management strategies for addressing tooth abnormalities in patients with port wine stains.

2.
Artículo en Inglés | MEDLINE | ID: mdl-36688881

RESUMEN

Kaposiform hemangioendothelioma is a locally invasive tumor and we were unable to find any previous reports of multifocal progression. Sirolimus, a mammalian target of rapamycin inhibitor, has been widely used to treat kaposiform hemangioendothelioma. Herein, we report a case of multifocal progressive kaposiform hemangioendothelioma, wherein sirolimus treatment caused severe thrombocytopenia. A 12-year-old East Asian girl presented with indurated dark-purple masses on her back. The patient had received three surgical interventions following the first appearance of the masses in 2012 and subsequent reappearances in 2014 and 2016. Kaposiform hemangioendothelioma was diagnosed based on radiological and pathological findings. Two more masses appeared in the following year. The patient was treated with oral sirolimus (2.5 mg/ m2/day) and developed grade 3 thrombocytopenia 8 days later. The patient was uneventfully relieved 5 days later after the withdrawal of sirolimus and the administration of appropriate medications. This rare case indicated that kaposiform hemangioendothelioma could be progressive with local metastatic characteristics in children. Besides, the severe sirolimus-induced complication highlights the importance of serum drug level monitoring during treatment. Physicians should be extremely cautious while treating kaposiform hemangioendothelioma patients with sirolimus.


Asunto(s)
Anemia , Hemangioendotelioma , Síndrome de Kasabach-Merritt , Sarcoma de Kaposi , Niño , Femenino , Humanos , Anemia/inducido químicamente , Hemangioendotelioma/diagnóstico , Hemangioendotelioma/tratamiento farmacológico , Síndrome de Kasabach-Merritt/diagnóstico , Síndrome de Kasabach-Merritt/tratamiento farmacológico , Sarcoma de Kaposi/inducido químicamente , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/tratamiento farmacológico , Sirolimus/efectos adversos
3.
J Invest Dermatol ; 143(4): 566-577.e12, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36243122

RESUMEN

Infantile hemangioma (IH), the most common benign tumor in infancy, is generally sensitive to propranolol treatment. However, the challenge remains because resistance or recurrence could occur in some patients, and the mechanism or target of propranolol remains unknown. Therefore, advancement in the drug development is needed. In this study, we explored whether apelin receptor (APJ) can become a candidate target. We found that APJ is expressed only in endothelial cells of IH (HemECs) but not in other vascular anomalies, and its antagonist, ML221, can negatively regulate cellular viability and functions of HemECs. This inhibitory effect could be replicated in a murine hemangioma model. Importantly, in vitro experiments also indicated that ML221 failed to affect the proliferation or angiogenesis of normal endothelial cells or APJ-knockout HemECs. Through analysis of the phosphoantibody microarray data, ML221 was revealed to have an inhibitory effect on HemECs by suppressing the activation of mitogen-activated protein kinase/extracellular signal-regulated kinase pathway. These results verified the distinctive expression of APJ in IH and specific inhibition of HemEC activity caused by ML221. In addition, APJ was also detected in propranolol-resistant IH. Collectively, we propose that APJ can act as a specific marker and a promising therapeutic target for IH, which will facilitate further drug development.


Asunto(s)
Células Endoteliales , Hemangioma , Humanos , Animales , Ratones , Células Endoteliales/metabolismo , Propranolol/farmacología , Propranolol/uso terapéutico , Receptores de Apelina/metabolismo , Receptores de Apelina/uso terapéutico , Proliferación Celular , Hemangioma/tratamiento farmacológico
4.
Photobiomodul Photomed Laser Surg ; 39(12): 795-798, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33493015

RESUMEN

Objective: Recurrence or redarkening of port-wine stain (PWS) after laser treatment occurs frequently. Background: Vascular-targeted photodynamic therapy (PDT) is an alternative adjuvant treatment for PWS. Methods: We report the first case of PWS recurrence after PDT with a 22-year follow-up. Results: Histological analysis was performed to indicate the possible mechanisms of PWS recurrence. Conclusions: This case demonstrates the possibility of PWS recurrence and suggests that patients be notified of this possibility before treatment.


Asunto(s)
Fotoquimioterapia , Mancha Vino de Oporto , Estudios de Seguimiento , Humanos , Mancha Vino de Oporto/tratamiento farmacológico
5.
J Am Acad Dermatol ; 84(5): 1371-1377, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32032694

RESUMEN

BACKGROUND: Congenital hemangiomas present fully grown at birth and share a remarkably similar lack of disproportionate or accelerated postnatal proliferation. OBJECTIVE: We report a series of unusual congenital hemangiomas that arise prenatally and initially exhibit a proportional growth pattern similar to that of noninvoluting congenital hemangioma. However, a tardive expansion of the lesion, similar to the proliferation phase of infantile hemangioma, occurs later during childhood. METHODS: A total of 11 unusual congenital hemangiomas were reviewed in regard to clinical presentation, imaging, and pathologic characteristics. RESULTS: The infants included 9 boys and 2 girls. The tumors were located in the head and neck (n=10) and abdominal wall (n=1). Spontaneous expansion began at the age of 12 months to 61 months, as determined from clinic notes and paired follow-up photographs. Uniform parenchymal masses and fast-flow vessels were confirmed by imaging examination. There are both histopathological overlap and distinction between these lesions and other congenital hemangiomas. LIMITATIONS: Only a small number of cases were identified. CONCLUSION: We propose that these lesions be denominated "tardive expansion congenital hemangioma (TECH)" to indicate their specific clinical and histological distinctiveness. Recognition of these distinct lesions will contribute to a better understanding of congenital hemangiomas.


Asunto(s)
Hemangioma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Piel/patología , Preescolar , Femenino , Hemangioma/congénito , Hemangioma/patología , Hemangioma/cirugía , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Piel/diagnóstico por imagen , Neoplasias Cutáneas/congénito , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía
6.
Lasers Surg Med ; 53(4): 435-442, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32896932

RESUMEN

BACKGROUND AND OBJECTIVES: Many types of lasers have been used to treat café-au-lait macules (CALMs) since the introduction of the selective photothermolysis theory. However, the efficacy and safety of picosecond lasers, compared with those of nanosecond lasers, have not been researched. To compare the efficacy and safety of 755 nm picosecond laser (PS-755 nm), Q-switched (QS) Alexandrite 755 nm nanosecond laser (QS-755 nm), and QS Nd:YAG 532 nm nanosecond laser (QS-532 nm) for treating CALMs. STUDY DESIGN/MATERIALS AND METHODS: Forty-one patients received several treatments at 3-month intervals. Lesions were divided into two or three approximately equal parts, which were randomly treated with PS-755 nm, QS-755 nm, and QS-532 nm. The safety and efficacy of three lasers were determined based on blinded visual assessments and self-reports of patients three months after the comparative trial. RESULTS: Visual assessment 3 months after the comparative trial revealed that there was no statistically significant difference among the sites treated by QS-755 nm (2.84 ± 1.11), QS-532 nm (2.63 ± 1.06), and PS-755 nm (2.74 ± 1.05) lasers. Five (26.32%) of 19 patients showed lesion recurrence. Adverse effects included acneiform miliaris, hypopigmentation, and hyperpigmentation, which were resolved within 12 months. Five (26.32%) of 19 patients who showed lesion recurrence 1-5 months after laser treatment had lightened or cleared at least 50% of the lesion. 46.67% of patients were satisfied or very satisfied with the outcome of the overall treatment. CONCLUSIONS: PS-755 nm, QS-755 nm, and QS-532 nm laser treatments were equally effective in treating and improving CALMs. PS-755 nm caused fewer adverse effects. Individuals can react differently to different types of lasers. Patch tests should be conducted before the treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.


Asunto(s)
Hiperpigmentación , Láseres de Estado Sólido , Terapia por Luz de Baja Intensidad , Manchas Café con Leche , Humanos , Láseres de Estado Sólido/uso terapéutico , Recurrencia , Resultado del Tratamiento
7.
Eur J Dermatol ; 30(5): 591-595, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33185527

RESUMEN

BACKGROUND: Infantile haemangiomas are the most common benign tumours affecting infants. Over time, the tumours may involute to some extent. However, sequelae, such as telangiectasia or fibrofatty tissue, often occur following this condition, which may cause disfigurement and influence patients' psychosocial development. OBJECTIVE: This prospective, randomized, self-controlled study aimed to assess the effects of topical timolol (0.5%) on involuting infantile haemangiomas. MATERIALS & METHODS: Each involuting superficial infantile haemangioma (n = 29) was randomly divided into two regions; one region was treated with topical timolol (0.5%) cream, three times daily, and the other region was untreated. The comparative treatments continued for three months. Five independent assessors, blinded to the treatment regimen, judged the treated and untreated regions by comparing photographs before and after treatment. RESULTS: The topical timolol-treated tumour sections showed no difference compared with the untreated sites (p = 0.355) after three months of treatment, and by the end of the treatment, the untreated lesions showed significant differences relative to pre-treatment (p<0.001). CONCLUSION: Topical timolol was not observed to have any effect on the regression of infantile haemangiomas in the involuting phase.


Asunto(s)
Antineoplásicos/administración & dosificación , Fármacos Dermatológicos/administración & dosificación , Hemangioma/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Timolol/administración & dosificación , Antineoplásicos/efectos adversos , Preescolar , Fármacos Dermatológicos/efectos adversos , Femenino , Humanos , Lactante , Masculino , Estudios Prospectivos , Crema para la Piel , Timolol/efectos adversos , Resultado del Tratamiento
8.
J Dermatol ; 47(4): 348-355, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32012364

RESUMEN

Pulsed dye laser-resistant port-wine stains present a therapeutic challenge. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy for treating these lesions. A total of 67 patients with pulsed dye laser-resistant cervicofacial port-wine stains were retrospectively assessed after undergoing photodynamic therapy mediated with a combination of hemoporfin and 532-nm light. For objective evaluation of photodynamic therapy efficacy, first, the colorimetric changes in the port-wine stain lesions were evaluated according to the L*a*b* color coordinate system, then the values of color changes (ΔE) and blanching rate were calculated. For subjective evaluation of improvement, photographs taken before and after photodynamic therapy were evaluated by three independent assessors blindly. Patient satisfaction was also used as a factor in the subjective evaluation. Adverse events were recorded after treatment. The median ΔE decreased significantly from the pretreatment value of 13.42 to 9.90 at the 2-month follow up (P < 0.001). The median blanching rate of port-wine stains was 28.04% after an average of 1.21 sessions of photodynamic therapy. Based on the overall visual assessment, 46.2% patients showed excellent or good levels of improvement (>50% color blanching). Adverse events were minimal, transient and self-limiting. In conclusion, photodynamic therapy serves as an alternative means to treat pulsed dye laser-resistant port-wine stains.


Asunto(s)
Hematoporfirinas/administración & dosificación , Láseres de Colorantes/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Fotoquimioterapia/métodos , Mancha Vino de Oporto/terapia , Adolescente , Adulto , Niño , Preescolar , Resistencia a la Enfermedad , Cara , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello , Satisfacción del Paciente , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
9.
Cell Res ; 29(11): 895-910, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31501519

RESUMEN

The response of endothelial cells to signaling stimulation is critical for vascular morphogenesis, homeostasis and function. Vascular endothelial growth factor-a (VEGFA) has been commonly recognized as a pro-angiogenic factor in vertebrate developmental, physiological and pathological conditions for decades. Here we report a novel finding that genetic ablation of CDP-diacylglycerol synthetase-2 (CDS2), a metabolic enzyme that controls phosphoinositide recycling, switches the output of VEGFA signaling from promoting angiogenesis to unexpectedly inducing vessel regression. Live imaging analysis uncovered the presence of reverse migration of the angiogenic endothelium in cds2 mutant zebrafish upon VEGFA stimulation, and endothelium regression also occurred in postnatal retina and implanted tumor models in mice. In tumor models, CDS2 deficiency enhanced the level of tumor-secreted VEGFA, which in-turn trapped tumors into a VEGFA-induced vessel regression situation, leading to suppression of tumor growth. Mechanistically, VEGFA stimulation reduced phosphatidylinositol (4,5)-bisphosphate (PIP2) availability in the absence of CDS2-controlled-phosphoinositide metabolism, subsequently causing phosphatidylinositol (3,4,5)-triphosphate (PIP3) deficiency and FOXO1 activation to trigger regression of CDS2-null endothelium. Thus, our data indicate that the effect of VEGFA on vasculature is context-dependent and can be converted from angiogenesis to vascular regression.


Asunto(s)
Diacilglicerol Colinafosfotransferasa/fisiología , Neoplasias/irrigación sanguínea , Neovascularización Patológica/genética , Neovascularización Fisiológica/genética , Nucleotidiltransferasas/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Proteínas de Pez Cebra/metabolismo , Animales , Línea Celular Tumoral , Diacilglicerol Colinafosfotransferasa/genética , Células Endoteliales/enzimología , Humanos , Melanoma Experimental , Ratones , Ratones Noqueados , Nucleotidiltransferasas/genética , Factor A de Crecimiento Endotelial Vascular/genética , Pez Cebra , Proteínas de Pez Cebra/genética
10.
J Dermatol ; 46(10): 835-842, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31373042

RESUMEN

Kaposiform hemangioendothelioma (KHE) and tufted angioma (TA) primarily occurring in infants are difficult to distinguish. This study evaluated ultrasonography (US) and magnetic resonance imaging (MRI) features of KHE and TA. Pathologically proven TA (n = 21) and KHE (n = 40 [11 KHE + Kasabach-Merritt phenomenon [KMP]]) occurring between January 2015 and December 2017 were reviewed. US (n = 61) and MRI (n = 50) findings were retrospectively evaluated. On US, KHE and TA lesions were subcutaneous, while 40% of KHE exhibited an infiltrative pattern extending into adjacent muscles. Of TA lesions, 42.9% were hyperechoic and 96.15% of KHE lesions exhibited mixed echogenicity. Of TA lesions, 76.2% exhibited well-defined margins and all KHE lesions exhibited ill-defined margins. The depth and vascular density of KHE and KHE + KMP were significantly increased compared with TA. The arterial peak systolic blood flow velocity of KHE + KMP was significantly higher than that in TA and KHE. KHE and KHE + KMP were significantly harder than TA on elastography. 3-D color Doppler revealed branch-shape blood flow for KHE and KHE + KMP lesions; for TA, it revealed a dot-like and striped pattern. Considering MRI findings, KHE and KHE + KMP were more likely to exhibit diffuse heterogeneous enhancement after contrast than TA. KHE was infiltrative and more likely to be thick, hypoechoic, ill-defined, richly vascular and hard than TA on US. KHE lesions were subcutaneous and reticular, with heterogeneous enhancement on MRI. Awareness of these features should prompt radiologists in the differential diagnosis of pediatric masses.


Asunto(s)
Hemangioendotelioma/diagnóstico por imagen , Hemangioma/diagnóstico por imagen , Síndrome de Kasabach-Merritt/diagnóstico por imagen , Sarcoma de Kaposi/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Adolescente , Adulto , Niño , Preescolar , Medios de Contraste/administración & dosificación , Diagnóstico Diferencial , Diagnóstico por Imagen de Elasticidad/métodos , Femenino , Gadolinio DTPA/administración & dosificación , Hemangioendotelioma/cirugía , Hemangioma/cirugía , Humanos , Imagenología Tridimensional , Lactante , Síndrome de Kasabach-Merritt/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Estudios Retrospectivos , Sarcoma de Kaposi/cirugía , Piel/irrigación sanguínea , Piel/diagnóstico por imagen , Neoplasias Cutáneas/cirugía , Ultrasonografía Doppler en Color , Adulto Joven
11.
Photobiomodul Photomed Laser Surg ; 37(6): 376-380, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31188091

RESUMEN

Objective: To compare the efficacy and safety of the two generation photosensitizers, PsD-007 and hematoporphyrin monomethyl ether (HMME), for photodynamic therapy (PDT) of port-wine stain (PWS). Background: Vascular-targeted PDT has shown potentially beneficial results in treating PWS; however, the efficacy and safety of various photosensitizers have not been fully investigated. Materials and methods: We retrospectively analyzed 38 patients with PWS, who were treated with one session of PsD-007-mediated (n = 21) or HMME-mediated (n = 17) PDT. Clinical efficacy was assessed by a chromameter and visual assessment of color blanching of the PWS lesion. Adverse events were evaluated. Results: Neither visual nor chromameter optical evaluations showed significant differences between the PsD-007 and HMME groups (p = 0.337 and p = 0.191, respectively). The total response rate was 76.2% (n = 16) in the PsD-007 group and 88.2% (n = 15) in the HMME group. Good or excellent clearance was achieved in 42.9% patients in the PsD-007 group and 29.4% patients in the HMME group. The average ΔE (color expressed change or improvement) and mean blanching rate measured optically were higher in the PsD-007 group than in the HMME group without statistical differences (8.51 vs. 7.39, p = 0.649; 0.37 vs. 0.29, p = 0.191). Incidences of swelling, pruritus, scab formation, and other adverse reactions were similar for the two groups. There were no blisters, scarring, or hypopigmentation in either group. Conclusions: Both PsD-007- and HMME-mediated PDTs are effective and safe for treatment of PWS. However, HMME has a shorter photosensitivity period than does PsD-007, which might be more recommended.


Asunto(s)
Hematoporfirinas/uso terapéutico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Mancha Vino de Oporto/tratamiento farmacológico , Adolescente , Adulto , Femenino , Humanos , Masculino , Estudios Retrospectivos
12.
Pediatrics ; 141(Suppl 5): S425-S429, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29610165

RESUMEN

Kaposiform hemangioendothelioma (KHE) is a rare infiltrative vascular tumor that is potentially life-threatening when presenting with Kasabach-Merritt phenomenon (KMP). KMP is clinically characterized as severe thrombocytopenia and hypofibrinogenemia and therefore is associated with a high mortality rate. There is no standard of cure for KHE currently. Potential medications, including corticosteroids, propranolol, and chemotherapy drugs such as sirolimus, are often used for alleviating KHE symptoms. Although some case reports of sirolimus treatment have shown promising results with recovered coagulant parameters, the off-target effects may cause severe problems. Here we describe 2 cases of infant patients with KHE and KMP who were scheduled to receive sirolimus on a long-term basis. However, both patients developed paroxysmal cough and tachypnea shortly after the onset of sirolimus treatment and succumbed to infection thereafter. This report reveals a potential risk of infection in sirolimus-treated infant patients. The fatal complication highlights the importance of antibiotic prophylaxis and serum sirolimus level monitoring to ensure the safe use of sirolimus in the treatment of infant patients with KHE.


Asunto(s)
Antibióticos Antineoplásicos/efectos adversos , Bronconeumonía/diagnóstico , Hemangioendotelioma/tratamiento farmacológico , Inmunosupresores/efectos adversos , Síndrome de Kasabach-Merritt/tratamiento farmacológico , Sarcoma de Kaposi/tratamiento farmacológico , Sirolimus/efectos adversos , Bronconeumonía/microbiología , Resultado Fatal , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Mycoplasma pulmonis , Neumonía por Mycoplasma/diagnóstico , Sirolimus/uso terapéutico
13.
Pediatr Res ; 83(1-1): 175-182, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29019471

RESUMEN

BackgroundPropranolol is the first-choice treatment for severe infantile hemangioma (IH). However, 10- 30% of lesions relapse after propranolol treatment. The mechanisms underlying IH recurrence after propranolol treatment have not been completely elucidated.MethodsThis study combined an examination of hemodynamic changes with research regarding hemangioma stem cells (hscs) with differentially expressed microRNAs (miRNAs) to identify the factors affecting IH recurrence after propranolol treatment. Hemodynamic changes were monitored in 21 recurrent cases using high-frequency color Doppler ultrasound, and hscs were treated with different concentrations of propranolol. The levels of differentially expressed miRNAs and the activity of related pathways were then compared between 18 recurrent and 20 non-recurrent IH cases.ResultsDuring treatment, lesion depth and vessel density decreased, and the lesion resistance index increased. Obvious lesions and vessel signals were observed in recurrent cases compared with non-recurrent cases. Propranolol effectively inhibited hscs proliferation. Twenty-two differentially expressed miRNAs were found in the recurrent group compared with the non-recurrent group.ConclusionRecurrence may be attributed to a combination of events. Serum biomarkers and drug treatments for IH recurrence must be studied further.


Asunto(s)
Hemangioma/diagnóstico , Hemangioma/fisiopatología , Propranolol/uso terapéutico , Recurrencia , Biomarcadores/sangre , Femenino , Hemodinámica , Humanos , Lactante , Recién Nacido , Masculino , MicroARNs/metabolismo , Ultrasonografía Doppler , Vasoconstricción
14.
Photomed Laser Surg ; 35(9): 465-471, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28650740

RESUMEN

OBJECTIVE: Pulsed dye laser (PDL) with 7 and 10 mm spot sizes is widely used on a regular basis for the treatment of port-wine stain (PWS). BACKGROUND DATA: No studies have reported on the differences in efficacy outcomes resulting from the use of different laser spot sizes in the treatment of PWS by PDL. Thus, an in vivo investigation into the differences in safety and efficacy of treatment between two spot sizes (7 vs. 10 mm) of PWS by PDL was conducted. MATERIALS AND METHODS: A total of 35 PWS patients underwent three treatment sessions by using a 595 nm wavelength PDL (Vbeam®, Candela Corp) with two laser settings: (1) 7 mm spot size, radiant exposure of 12 J/cm2 and (2) 10 mm spot size, radiant exposure of 10 J/cm2. Cryogen spray cooling and 1.5 msec pulse duration were applied. Therapeutic outcomes were evaluated by visual and chromametric evaluation 3 months after the final treatment. RESULTS: Average blanching rates were 34.03% and 36.51% at sites treated by PDL with 7 and 10 mm laser spot sizes, respectively (p < 0.05). CONCLUSIONS: On the basis of the laser setting, the therapeutic outcomes of PDL with 7 and 10 mm spot sizes were similar. PDL with a 10 mm laser spot size is more efficacious with lower radiant exposure than PDL with a 7 mm spot size; it can also reduce the treatment time.


Asunto(s)
Láseres de Colorantes/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Seguridad del Paciente , Mancha Vino de Oporto/radioterapia , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Estudios de Cohortes , Estética , Dermatosis Facial/radioterapia , Femenino , Humanos , Lactante , Masculino , Mancha Vino de Oporto/diagnóstico , Estudios Prospectivos , Dosificación Radioterapéutica , Factores Sexuales , Resultado del Tratamiento , Adulto Joven
15.
Sci Rep ; 7: 43292, 2017 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-28225076

RESUMEN

There is no definitive conclusion regarding the optimal timing for terminating propranolol treatment for infantile hemangioma (IH). A total of 149 patients who underwent detailed color Doppler ultrasound examination were included in this study. The characteristics and propranolol treatment of all patients were summarized and analyzed. Patients were divided into two groups according to the lesion regression rate. Among the 149 patients, 38 were assigned to the complete regression group, and 111 were assigned to the partial regression group. The age at which propranolol treatment started, duration of follow-up after treatment discontinuation and rate of adverse events were not significantly different between the two groups. The duration of oral propranolol treatment was shorter in the complete regression group. The age at which propranolol was terminated was younger in the complete regression group, and this group had a lower recurrence rate. Propranolol is safe and effective for the treatment of IHs that require intervention, but it should be stopped at an appropriate time, which is determined primarily by the lesion regression rate after propranolol treatment. Ultrasound is helpful in determining when to stop propranolol for IH.


Asunto(s)
Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Hemangioma/tratamiento farmacológico , Propranolol/administración & dosificación , Propranolol/efectos adversos , Administración Oral , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Femenino , Humanos , Lactante , Masculino , Factores de Tiempo , Resultado del Tratamiento
16.
J Dermatol ; 44(6): 660-665, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28191657

RESUMEN

Topical timolol and 595-nm pulsed dye laser (PDL) are both widely used in the treatment of superficial infantile hemangiomas (IH). However, to date, there is no reliable study comparing the therapeutic outcomes between the two treatment options. We designed the present study to evaluate and compare the efficacy and safety of timolol cream and PDL in the treatment of superficial proliferating IH. Twenty-one patients with superficial IH were included in the study. Each lesion was divided into two regions; one part was treated with 0.5% topical timolol cream four times daily, and the other part was treated monthly with PDL. Both treatments were continued for 2-6 months. Five independent and blinded assessors were asked to judge the results in both the topical timolol-treated and PDL-treated parts by comparing photographs taken before and after treatment. Both treatments resulted in significant clinical improvements after 3.39 sessions in the 2-month follow up. The average visual evaluation showed that PDL had significantly better results than topical timolol (6.55 ± 2.26 to 4.98 ± 2.92, P < 0.01). No patients experienced permanent side-effects during the treatment. Our short-term study revealed that PDL had better results compared with topical timolol cream application in the treatment of superficial proliferating IH. Further studies with longer follow-up time and larger sample size are required to validate our findings.


Asunto(s)
Antagonistas Adrenérgicos beta/administración & dosificación , Hemangioma/tratamiento farmacológico , Hemangioma/radioterapia , Láseres de Colorantes/uso terapéutico , Timolol/administración & dosificación , Administración Cutánea , Antagonistas Adrenérgicos beta/efectos adversos , Femenino , Humanos , Lactante , Terapia por Luz de Baja Intensidad , Masculino , Proyectos Piloto , Estudios Prospectivos , Timolol/efectos adversos
17.
Stem Cells Transl Med ; 5(3): 392-404, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26798059

RESUMEN

Tissue engineering strategies based on implanting cellularized biomaterials are promising therapeutic approaches for the reconstruction of large tissue defects. A major hurdle for the reliable establishment of such therapeutic approaches is the lack of rapid blood perfusion of the tissue construct to provide oxygen and nutrients. Numerous sources of mesenchymal stem cells (MSCs) displaying angiogenic potential have been characterized in the past years, including the adult dental pulp. Establishment of efficient strategies for improving angiogenesis in tissue constructs is nevertheless still an important challenge. Hypoxia was proposed as a priming treatment owing to its capacity to enhance the angiogenic potential of stem cells through vascular endothelial growth factor (VEGF) release. The present study aimed to characterize additional key factors regulating the angiogenic capacity of such MSCs, namely, dental pulp stem cells derived from deciduous teeth (SHED). We identified fibroblast growth factor-2 (FGF-2) as a potent inducer of the release of VEGF and hepatocyte growth factor (HGF) by SHED. We found that FGF-2 limited hypoxia-induced downregulation of HGF release. Using three-dimensional culture models of angiogenesis, we demonstrated that VEGF and HGF were both responsible for the high angiogenic potential of SHED through direct targeting of endothelial cells. In addition, FGF-2 treatment increased the fraction of Stro-1+/CD146+ progenitor cells. We then applied in vitro FGF-2 priming to SHED before encapsulation in hydrogels and in vivo subcutaneous implantation. Our results showed that FGF-2 priming is more efficient than hypoxia at increasing SHED-induced vascularization compared with nonprimed controls. Altogether, these data demonstrate that FGF-2 priming enhances the angiogenic potential of SHED through the secretion of both HGF and VEGF.


Asunto(s)
Factor 2 de Crecimiento de Fibroblastos/administración & dosificación , Factor de Crecimiento de Hepatocito/metabolismo , Células Madre Mesenquimatosas/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Hipoxia de la Célula/efectos de los fármacos , Pulpa Dental/citología , Factor 2 de Crecimiento de Fibroblastos/biosíntesis , Factor de Crecimiento de Hepatocito/biosíntesis , Humanos , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/efectos de los fármacos , Neovascularización Fisiológica/genética , Ingeniería de Tejidos , Factor A de Crecimiento Endotelial Vascular/biosíntesis
18.
Head Neck ; 38 Suppl 1: E1730-6, 2016 04.
Artículo en Inglés | MEDLINE | ID: mdl-26676449

RESUMEN

BACKGROUND: Few specific reports have addressed propranolol as a treatment for parotid hemangioma, and its mechanism remains unclear. METHODS: Eighty-seven patients were recruited in this prospective study. Ten patients underwent detailed color Doppler examination. The depths, vessel densities, and resistant indices of 10 lesions were recorded and analyzed before treatment and at 1 and 3 months after treatment. RESULTS: The overall responses were "bad" in 2 cases, "stable" in 4 cases, "good" in 53 cases, and "excellent" in 28 cases. Hemangioma regrowth was observed in 11 cases (12.6%). The parents of 18 patients (20.7%) complained that their children experienced minor discomfort during therapy. The lesion depths, vessel densities, and resistant indices were altered after propranolol treatment. CONCLUSION: Propranolol can significantly reduce the sizes of parotid hemangiomas with minor side effects. Hemodynamic changes might play an important role in the course of propranolol treatment. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1730-E1736, 2016.


Asunto(s)
Hemangioma/tratamiento farmacológico , Neoplasias de la Parótida/tratamiento farmacológico , Propranolol/uso terapéutico , Administración Oral , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Recurrencia Local de Neoplasia , Estudios Prospectivos , Resultado del Tratamiento
19.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 32(4): 293-8, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30044576

RESUMEN

Objective: To establish a reliable method of isolation and culture of infantile hemangioma stem cells (HemSCs). Methods: Proliferating infantile hemangioma specimens were digested with collagenase to form a single cell suspension. The HemSCs were isolated with anti-CD133 MicroBeads, and were incubated in fibronectin coated 96-well plates with EBM-2 (10% FBS). HemSCs were identified by morphological characteristics, flow cytometry, cell tubule formation assay, osteoinductive and adipogenic differentiation assay, and subcutaneous tumor formation assay. Results: This method enables the rapid isolation of HemSCs which demonstrated typical mesenchymal stem cell morphology in culture.CD133 (+) HemSCs expressed CD29 (99.5%),CD44 (97.9%),CD90 (87.6%) and CD105 (98.5%),but barely expressed CD31 (0.2%),CD34 (0.1%),CD45 (0.1%) and CD144 (0.1%).These cells could differentiate into osteoblasts and adipocytes,and could form vascular wall like structure in vitro. When implanted into subcutaneous of the nude mice, the cells can develop into hemangioma like lesion histologically. Conclusions: This technique can effectively isolate HemSCs from the proliferative hemangioma. These cells could be further used to reveal the charaeteristics of HemSCs, as well as for further study of widespread application.


Asunto(s)
Técnicas de Cultivo de Célula , Diferenciación Celular , Proliferación Celular , Hemangioma Capilar/patología , Células Madre , Adipocitos/patología , Adipogénesis , Animales , Células Endoteliales , Citometría de Flujo , Hemangioma/patología , Humanos , Lactante , Células Madre Mesenquimatosas , Ratones , Ratones Desnudos
20.
Tumour Biol ; 37(2): 2765-71, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26408183

RESUMEN

Cutaneous squamous cell carcinoma (cSCC) is an epidermal keratinocyte-derived skin tumor, which is the second most common skin cancer in the general population. Recently, studies showed that microRNAs (miRNAs) played an important role in the development of cancer. In our study, we showed that the expression of SRCIN1 was lower in cSCC tissues than in the matched normal tissues. Moreover, there was significant inversed correlation between miR-346 and SRCIN1 in cSCC tissues. The luciferase reporter assay data showed that miR-346 can target the SRCIN1 message via the 3'-untranslated region (UTR) of SRCIN1. Overexpression of miR-346 inhibited the messenger RNA (mRNA) and protein expression of SRCIN1 in the A431 cells. In addition, ectopic expression of miR-346 promoted the A431 cell proliferation and migration. Meanwhile, SRCIN1 overexpression inhibited the A431 cell proliferation and migration. Rescue experiment has showed that SRCIN1 overexpression reduced the miR-346-induced A431 cell proliferation and migration. Herein, this study may provide miR-346 as a new therapeutic target for cSCC.


Asunto(s)
Carcinoma de Células Escamosas/genética , MicroARNs/genética , Oncogenes/genética , Neoplasias Cutáneas/genética , Regiones no Traducidas 3'/genética , Proteínas Adaptadoras del Transporte Vesicular/genética , Carcinoma de Células Escamosas/patología , Línea Celular Tumoral , Movimiento Celular/genética , Proliferación Celular/genética , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Queratinocitos/patología , ARN Mensajero/genética , Neoplasias Cutáneas/patología
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