Synthesis and application of gelatin-based controlled-release antibacterial films containing oregano essential oil/ß-cyclodextrin microcapsules for chilling preservation of grass carp fillets.

This work aimed to synthesize oregano essential oil/ß-cyclodextrin microcapsules (OEO/ß-CDs) and then prepare gelatin-based controlled-release antibacterial films with different OEO/ß-CDs contents (0%-2%) for chilling preservation of grass carp fillets. The results of FTIR, XRD, DSC and accelerated release ratio showed that OEO was successfully encapsulated in OEO/ß-CDs and its thermal stability was effectively improved. Moreover, at 2% of addition amount of OEO/ß-CDs, the tensile strength of the films increased from 14.43 MPa to 18.72 MPa. In addition, the films showed significant antibacterial activity against Pseudomonas (61.52%), Aeromonas (62.87%), and Shewanella putrefaciens (66.67%). Preservation experiments showed that the films effectively prevented the increase of TVB-N, and TBA value of the refrigerated fillets and significantly suppressed the growth of spoilage organisms, thus extending the shelf life by 2-3 days. Therefore, the synthesized film has promising potential as an active packaging material for the preservation of grass carp.

Seasonal characteristics of groundwater discharge controlled by precipitation and its environmental effects in a coal mining subsidence lake, eastern China.

Many regions have formed subsidence lakes due to underground mining in the world. However, seasonal variations of lacustrine groundwater discharge (LGD) rate and solute fluxes in the coal mining subsidence were rarely reported. In this study, we conducted four seasonal samplings in a coal mining subsidence, during which samples for stable water (δ18O) and radioactive (222Rn) isotopes were collected to quantify the seasonal dynamics of LGD rates. The LGD rates estimated from the 222Rn mass balance model were 10.2 ± 8.7, 5.5 ± 3.2, 11.5 ± 7.8, and 7.8 ± 4.5 mm d-1 in summer, autumn, winter and spring, respectively. According to the 18O mass balance model, the corresponding LGD rates were 15.1, 7.3, 15.6, and 11.3 mm d-1 in summer, autumn, winter and spring, respectively. We found a significant correlation between precipitation and LGD rates, suggesting precipitation was recognized as the main control factor for seasonal variations of LGD rates. Based on this correlation, the extrapolated LGD rates over a year ranged from 3.1 to 12.7 mm d-1 with an average of 8.8 mm d-1. Moreover, the fluxes of dissolved silicon (DSi), iron (Fe), and manganese (Mn) from LGD in autumn were (1.6 ± 0.9) × 105, (1.9 ± 1.1) × 104, and (1.1 ± 0.6) × 104 mol a-1, respectively. Correspondingly, in winter they were (3.5 ± 2.4) × 105, (4.1 ± 2.8) × 103, and (2.8 ± 1.9) × 103 mol a-1, respectively. This study demonstrated significantly seasonal variations of LGD, with precipitation being the main control factor of LGD in the coal mining subsidence lake. The fluxes of dissolved substance (DSi, Fe, Mn) from LGD need to be emphasized because they may have important impacts on the ecological stability in coal mining subsidence lakes.

Geochemical characteristics and migration patterns of rare earth elements in coal mining subsidence lakes under the influence of multiple factors.

Mining activities cause surface subsidence and the formation of subsidence lakes, which dynamically change with the continuous coal mining activities. Under the combined influence of various human activities such as agriculture, aquaculture, and floating photovoltaic (FPV), the lake environment undergoes continuous changes, thereby altering the geochemical characteristics of rare earth elements (REEs) in the sediment. This study focused on the subsidence lakes in the Huainan coalfield in eastern China to examine the REEs content in the sediment, elucidated the temporal variations and geochemical characteristics of REEs distribution, explored the main controlling factors of REEs in the sediment, and revealed the migration and transformation behavior of REEs during dynamic subsidence processes. The study revealed that the migration pattern of REEs in the sediment was closely related to the duration of subsidence. The average content of REEs in lake sediments with subsidence duration <5 years increased from 219 µg·g-1 to 248 µg·g-1 compared to the soil, showing an enrichment model primarily driven by rainwater runoff, groundwater input retention, and mineral dissolution. With further subsidence, the processes of reduction dissolution of Fe-Mn oxides/hydroxides, organic colloid adsorption, and hydraulic disturbance gradually replaced the aforementioned enrichment behavior as the main migration pathways, resulting in a decrease in the average REEs content in the sediment to 179 µg·g-1 for subsidence durations exceeding 10 years. There was no strong correlation between REEs fractionation and subsidence duration. Artificial activities, such as FPV, are important factors causing Cerium and Erbium anomalies in some subsidence lake sediments. This study was not only of significant importance for understanding the migration, distribution, and environmental behavior of pollutants in aquatic environments under the interference of human activities but also provided a solid theoretical foundation for the future management of coal mining subsidence lakes.

Water chemistry and stable isotope characteristics of subsidence lakes in coal mining areas, Eastern China.

Many subsidence lakes have formed in eastern China as a result of underground coal mining. These coal mining-related subsidence lakes vary in their formation time and connectivity with rivers. These factors may influence the water chemistry and hydrogen and oxygen stable isotope characteristics of the lake water. This study collected and tested subsidence lake water, atmospheric precipitation, river water, and shallow groundwater in the study area. The results showed that the water chemical types of the subsidence lake water and river water are Cl-Na and HCO3·Cl-Na and that the water chemical types of the shallow groundwater are mainly HCO3·Cl-Na and HCO3·Cl-Ca. There are no significant differences in the water chemical characteristics of subsidence lakes with different subsidence ages and types. The major ions in each water body mainly come from evaporite dissolution and silicate weathering, and ion exchange occurs. Reverse ion exchange occurs in some shallow groundwater samples. The stable isotopes of hydrogen and oxygen in the subsidence lake water, river water, and shallow groundwater are distributed along a straight line with a slope less than that of the LMWL, indicating that these water bodies have a common source, namely, precipitation. With increases in the formation time of the subsidence lakes, the heavy isotopes in the lake water gradually become depleted, and the d value gradually increases, mainly driven by precipitation dilution, weakening evaporation, river recharge, and groundwater recharge. The isotopic values of different types of lakes with the same subsidence time differ little. The research results may provide scientific guidance for the rational development and utilization of water resources in coal mining subsidence areas, enrich the study of the hydrological cycle in the area, and are of great significance for the protection of the local water balance and water environment.

Metabolic Profiling Revealed Prediction Biomarkers for Infantile Hemangioma in Umbilical Cord Blood Sera: A Prospective Study.

Infantile hemangioma (IH), the most common benign tumor in infancy, mostly arises and has rapid growth before 3 months of age. Because irreversible skin changes occur in the early proliferative stage, early medical treatment is essential to reduce the permanent sequelae caused by IH. Yet there are still no early screening biomarkers for IH before its visible emergence. This study aimed to explore prediction biomarkers using noninvasive umbilical cord blood (UCB). A prospective study of the metabolic profiling approach was performed on UCB sera from 28 infants with IH and 132 matched healthy controls from a UCB population comprising over 1500 infants (PeptideAtlas: PASS01675) using liquid chromatography-mass spectrometry. The metabolic profiling results exhibited the characteristic metabolic aberrance of IH. Machine learning suggested a panel of biomarkers to predict the occurrence of IH, with the area under curve (AUC) values in the receiver operating characteristic analysis all >0.943. Phenylacetic acid had potential to predict infants with large IH (diameter >2 cm) from those with small IH (diameter <2 cm), with an AUC of 0.756. The novel biomarkers in noninvasive UCB sera for predicting IH before its emergence might lead to a revolutionary clinical utility.

Aesthetic outcome of intralesional injection of lauromacrogol as a single-agent treatment for uncomplicated infantile hemangiomas: A long-term follow-up study.

Infantile hemangiomas (IH) are at risk of incomplete regression with remnant permanent sequelae, ranging from passive waiting for spontaneous regression to active systemic administration. The application of traditional therapy involving injection of a sclerosing agent is limited due to the difficulty in achieving cosmetic improvement. This study aimed to explore a new injection method that could not only promote tumor regression but also achieve cosmetic improvement. A total of 122 IH (from 109 children) injected intralesionally with lauromacrogol in the Plastic Surgery Department of Fujian Medical University Union Hospital between 1 January 2012 and 1 June 2019 were enrolled in this study. The mean follow-up time was 2.9 years. Of 122 lesions studied, 111 (91.0%) achieved complete regression, 10 (8.2%) achieved significant regression and one (0.8%) achieved moderate regression. In terms of aesthetic appearance, 70 (57.4%) IH had no sequelae and the A score was 5/5. Twenty-one (17.2%) IH had minimal hyperpigmentation, hypopigmentation or telangiectasia and the A score was 4/5. Thirty-one (25.4%) IH had left mild or relatively obvious sequelae and the A score was 1-3/5. None of the 122 IH involved had rebound growth after terminating the treatment. Hyper- or hypopigmentation gradually faded over time and part of the IH had already returned to normal appearance by the time of long-term follow up. The results indicated that this new type of injection therapy significantly promoted the regression of uncomplicated IH and helped achieve the expected cosmetic appearance.

Induction of telomere-mediated chromosomal truncation and behavior of truncated chromosomes in Brassica napus.

Engineered minichromosomes could be stably inherited and serve as a platform for simultaneously transferring and stably expressing multiple genes. Chromosomal truncation mediated by repeats of telomeric sequences is a promising approach for the generation of minichromosomes. In the present work, direct repetitive sequences of Arabidopsis telomere were used to study telomere-mediated truncation of chromosomes in Brassica napus. Transgenes containing alien Arabidopsis telomere were successfully obtained, and Southern blotting and fluorescence in situ hybridization (FISH) results show that the transgenes resulted in successful chromosomal truncation in B. napus. In addition, truncated chromosomes were inherited at rates lower than that predicted by Mendelian rules. To determine the potential manipulations and applications of the engineered chromosomes, such as the stacking of multiple transgenes and the Cre/lox and FRT/FLP recombination systems, both amenable to genetic manipulations through site-specific recombination in somatic cells, were tested for their ability to undergo recombination in B. napus. These results demonstrate that alien Arabidopsis telomere is able to mediate chromosomal truncation in B. napus. This technology would be feasible for chromosomal engineering and for studies on chromosome structure and function in B. napus.

The pigment epithelium-derived factor (PEDF): an important potential therapeutic agent for infantile hemangioma.

In previous studies, the expression and the role of proangiogenic factors in infantile hemangiomas have been well studied. However, the role of angiogenic inhibitors has been revealed rarely. The expression of PEDF, as the strongest and safe endogenous inhibitor, is still unrecognized until the current study. In order to investigate the expression and significance of the pigment epithelium-derived factor (PEDF) in the proliferating and regressing phases of infantile hemangiomas, the expression of PEDF, VEGF, Ki-67, and CD34 protein in hemangioma tissues was examined with immunohistochemical polymer HRP method in 42 cases during the proliferative phase, 40 cases during the regressing phase, and 11 cases of non-involuting congenital hemangiomas (NICHs). Meanwhile, the mRNA expression of these factors was detected with quantitative realtime RT-PCR. We found the protein and mRNA expression of PEDF in regressing phase was significantly higher than those in proliferative phase and NICHs (P < 0.001), while the protein and mRNA expression of VEGF were much lower (P < 0.001). The microvessel density (MVD), Ki-67 changes, and the expression of PEDF and VEGF were found significantly correlated. These results indicated that the reduction of VEGF and increase in PEDF are causative to the evolution of infantile hemangioma. PEDF may play a key role in the spontaneous regression of infantile hemangioma and may become an important potential therapeutic agent for infantile hemangioma.

Removal of dissolved sulfides in aqueous solution by activated sludge: mechanism and characteristics.

Activated sludge recycling has been developed as a novel technique to directly prevent volatile sulfides emission from wastewater influents. In this study, mechanisms and characteristics of dissolved sulfides removal in aqueous solution by activated sludge were investigated. When DO content in water was 0.49mg/L, 70% of removed dissolved sulfides were released back from the activated sludge by lowering pH to 1. The SEM/EDS result revealed that removed sulfur was fixed in activated sludge and the XPS result showed that fixed sulfur had an oxidation state of -2. FTIR results showed that primary amine group (R-NH2) could be one of the radical groups bonding sulfides. All these results verified that sulfides removal by activated sludge is primarily attributed to adsorption, rather than biodegradation, under low DO conditions in 40min. The equilibrium isotherm data fit the Langmuir isotherm model well. The maximum adsorption capacity (q0) ranged in 25-38mg/g at temperatures of 10-40°C. The adsorption kinetic data fit the pseudo-second-order model well. The amounts of adsorbed sulfides at equilibrium (qe) were positively proportional to temperature, initial sulfides concentration and agitation speed. These results indicate that sulfides adsorption could be a chemical sorption or ion exchange process.

Rapid Identification of Candidate Genes for Seed Weight Using the SLAF-Seq Method in Brassica napus.

Seed weight is a critical and direct trait for oilseed crop seed yield. Understanding its genetic mechanism is of great importance for yield improvement in Brassica napus breeding. Two hundred and fifty doubled haploid lines derived by microspore culture were developed from a cross between a large-seed line G-42 and a small-seed line 7-9. According to the 1000-seed weight (TSW) data, the individual DNA of the heaviest 46 lines and the lightest 47 lines were respectively selected to establish two bulked DNA pools. A new high-throughput sequencing technology, Specific Locus Amplified Fragment Sequencing (SLAF-seq), was used to identify candidate genes of TSW in association analysis combined with bulked segregant analysis (BSA). A total of 1,933 high quality polymorphic SLAF markers were developed and 4 associated markers of TSW were procured. A hot region of ~0.58 Mb at nucleotides 25,401,885-25,985,931 on ChrA09 containing 91 candidate genes was identified as tightly associated with the TSW trait. From annotation information, four genes (GSBRNA2T00037136001, GSBRNA2T00037157001, GSBRNA2T00037129001 and GSBRNA2T00069389001) might be interesting candidate genes that are highly related to seed weight.

[Chinese expert consensus on the use of topical timolol maleate treatment of infantile hemangiomas].

Non-selective ß-blocker propranolol has been proved by FDA as the first-line agent for infantile hemangioma (IH) with dramatic response. To reduce the side effects caused by systemic administration of propranolol, timolol maleate treatment has been increasingly used as an alternative to systemic ß-blockers and watchful waiting for many IH patients in recent years. However, the appropriate indications, drug dosage, dosing regimen, time for initiation, optimal duration, monitoring for side effects still remains controversial. To standardize the use of topical timolol in treating IH, avoid overtreatment or under-treatment, as well as minimize complications, a Chinese expert consensus on the use of topical timolol treatment of IH has been approved and written by a multidisciplinary experts group based on an up-to-date literature review and repeated discussion, which can be used to reduce inappropriate variations in clinical practice and to promote the delivery of high quality, evidence-based health care for IH patients.

Inhibition or promotion of biodegradation of nitrate by Paracoccus sp. in the presence of nanoscale zero-valent iron.

To investigate the effect of nanoscale zero-valent iron (nZVI) on the growth of Paracoccus sp. strain and biodenitrification under aerobic conditions, specific factors were studied, pH, concentration of nitrate, Fe (II) and carbon dioxide. Low concentration of nZVI (50mg/L) promoted both cell growth and biodegradation of nitrate which rose from 69.91% to 76.16%, while nitrate removal fell to 67.10% in the presence of high nZVI concentration (1000 mg/L). This may be attributed to the ions produced in nZVI corrosion being used as an electron source for the biodegradation of nitrate. However, the excess uptake of Fe (II) causes oxidative damage to the cells. To confirm this, nitrate was completely removed after 20 h when 100mg/L Fe (II) was added to the solution, which is much faster than the control (86.05%, without adding Fe (II)). However, nitrate removal reached only 45.64% after 20 h, with low cell density (OD 600=0.62) in the presence of 300 mg/L Fe (II). Characterization techniques indicated that nZVI adhered to microorganism cell membranes. These findings confirmed that nZVI could affect the activity of the strain and consequently change the biodenitrification.

Angiogenin: a potential serum marker of infantile hemangioma revealed by cDNA microarray analysis.

BACKGROUND: Hemangiomas are characterized by rapid growth but slow regression. Prognosis and treatment urgently require the identification of serum markers to determine the proliferative potential of hemangiomas. METHODS: Using four pairs of tissue from the proliferative and involution stages of the same hemangiomas, the authors performed cDNA microarray experiments to study differential expression of genes between proliferative hemangiomas and involuting hemangiomas. Among these genes, the authors searched for possible serum markers. A novel analysis process was used to screen for up-regulated genes encoding secreted proteins. Next, the mRNA and protein expression in hemangiomas and serum levels in patients with hemangiomas were validated by quantitative reverse-transcriptase polymerase chain reaction, immunohistochemistry, Western blotting, and enzyme-linked immunosorbent assay. RESULTS: Sixty-two up-regulated genes were detected in proliferative hemangiomas. Angiogenin, a key angiogenesis factor induced by hypoxia, was found to be a possible serum marker. Angiogenin mRNA and protein expression were validated by quantitative reverse-transcriptase polymerase chain reaction, immunohistochemistry, and Western blotting. An enzyme-linked immunosorbent assay confirmed that angiogenin serum levels correlate with the hemangioma stage. Moreover, receiver operating characteristic curve analysis indicates a high sensitivity and specificity of angiogenin for discriminating between proliferative hemangiomas and the control group and patients with venous malformations. CONCLUSIONS: The authors report for the first time that angiogenin may be a useful serum marker for hemangiomas, and report a novel analysis process that might efficiently screen for potential serum markers of tumors by cDNA microarray analysis.

Impact of iron-based nanoparticles on microbial denitrification by Paracoccus sp. strain YF1.

This study investigates the effects of Fe and Fe/Ni nanoparticles on biological denitrification when using Paracoccus sp. strain YF1. Results show that adding Fe and Fe/Ni nanoparticles to the cells decreased their growth and denitrification rate. Compared to that of free cells (control 89.47%), a decrease (64.33%) in the presence of 1000 mg/L Fe/Ni nanoparticles was observed, while a small decline in the denitrification rate (76.36%) was obtained when the concentration of Fe nanoparticles was 1000 mg/L. These were further confirmed by adding Fe(2+), Fe(3+), Fe3O4, Fe(2+)/Ni(2+) and Fe(3+)/Ni(2+) individually to the free cell system. Furthermore, Fe and Fe/Ni nanoparticles influenced the nitrate removal and bacterial growth under different pH and temperature conditions. SEM, XRD and EDS demonstrated that iron oxides formed as a result of nanoparticles corrosion in biological medium. Finally the presence of nanoparticles around some bacteria was observed.

Transcriptome profile analysis of young floral buds of fertile and sterile plants from the self-pollinated offspring of the hybrid between novel restorer line NR1 and Nsa CMS line in Brassica napus.

BACKGROUND: The fertile and sterile plants were derived from the self-pollinated offspring of the F1 hybrid between the novel restorer line NR1 and the Nsa CMS line in Brassica napus. To elucidate gene expression and regulation caused by the A and C subgenomes of B. napus, as well as the alien chromosome and cytoplasm from Sinapis arvensis during the development of young floral buds, we performed a genome-wide high-throughput transcriptomic sequencing for young floral buds of sterile and fertile plants. RESULTS: In this study, equal amounts of total RNAs taken from young floral buds of sterile and fertile plants were sequenced using the Illumina/Solexa platform. After filtered out low quality data, a total of 2,760,574 and 2,714,441 clean tags were remained in the two libraries, from which 242,163 (Ste) and 253,507 (Fer) distinct tags were obtained. All distinct sequencing tags were annotated using all possible CATG+17-nt sequences of the genome and transcriptome of Brassica rapa and those of Brassica oleracea as the reference sequences, respectively. In total, 3231 genes of B. rapa and 3371 genes of B. oleracea were detected with significant differential expression levels. GO and pathway-based analyses were performed to determine and further to understand the biological functions of those differentially expressed genes (DEGs). In addition, there were 1089 specially expressed unknown tags in Fer, which were neither mapped to B. oleracea nor to B. rapa, and these unique tags were presumed to arise basically from the added alien chromosome of S. arvensis. Fifteen genes were randomly selected and their expression levels were confirmed by quantitative RT-PCR, and fourteen of them showed consistent expression patterns with the digital gene expression (DGE) data. CONCLUSIONS: A number of genes were differentially expressed between the young floral buds of sterile and fertile plants. Some of these genes may be candidates for future research on CMS in Nsa line, fertility restoration and improved agronomic traits in NR1 line. Further study of the unknown tags which were specifically expressed in Fer will help to explore desirable agronomic traits from wild species.

[Transposition of orbital fat and orbicularis muscle flap over the orbital rim for correction of lower eyelid pouches complicated with lacrimal groove deformity].

OBJECTIVE: To introduce the experience in the treatment of lower eyelid pouches orbital rim. METHODS: An incision was made along the margin of lower eyelid and dissection was performed under the orbicularis muscle to expose the orbital septum and periosteum of lower orbital rim. The fat released from orbital septum was transposed just below the lower orbital rim and fixed on the periosteum. If lacrimal groove deformity was not corrected completely, the musculocutaneous flap, which may be excised beside the incision, was kept to correct the deformities further with only the muscle portion. RESULTS: 72 cases with lower eyelid pouches complicated with lacrimal groove deformities were treated with transposition of orbital fat and orbicularis muscular flaps. Satisfactory results were achieved in all the patients after a follow-up period of 3-6 months. CONCLUSION: It is an effective and feasible technique to correct lacrimal groove deformities with transposition of orbital fat and orbicularis muscular flaps.

Retrospective analysis of facial paralysis caused by ethanol sclerotherapy for facial venous malformation.

BACKGROUND: Absolute ethanol sclerotherapy provides a reliable treatment for facial venous malformation, although facial nerve injury may occur after sclerotherapy. This study is a retrospective review of facial nerve dysfunction after sclerotherapy. METHODS: A total of 91 patients with facial venous malformations accepted 288 ethanol sclerotherapy sessions. The facial nerve dysfunctions caused by the therapy were evaluated and analyzed. RESULTS: There were 9 instances of facial nerve injury. For 18 sessions of sclerotherapy in the temporal region, 5.6% of patients experienced injury to the temporal branch; for 12 sessions in the zygomatic region, 41.7% of patients experienced injury to the zygomatic branch. After patients were treated with medication, 8 of 9 instances of nerve injury recovered. CONCLUSIONS: The zygomatic and temporal branches of the facial nerve were the most vulnerable to injury after ethanol sclerotherapy. Surgeons are thus called on to pay more attention when performing ethanol sclerotherapy in those areas.

[A prospective study of propranolol as first-line treatment for problematic infantile hemangioma in China].

OBJECTIVE: To prospectively assess the efficacy and safety or propranolol as a first-line treatment for problematic infantile haemangioma in China. METHODS: From Mar. 2009 to Feb. 2010, 78 patients with problematic infantile hemangioma were included in the prospective study. The characteristics of the tumor, including sex, age, site, complications, were recorded. The response to treatment at 1 week, at 1 month and at the end of treatment was evaluated. The efficacy of treatment was graded as no response, stabilization, or accelerated regression. The indications for treatment, side effects and relapse after treatment were documented. The mean follow-up period was 16.7 months (range, 12.1-23.6 months). RESULTS: Oral therapy was initiated at mean age of 3.7 months (range, 1.1-9.2 months) as first-line therapy. The mean age at the end of treatment was 11.2 months (range, 5.2-22.3 months). The treatment was lasted for 7.6 months (range, 2. 1-18.3 months). One week after treatment beginning, the hemangioma growth was controlled in all the patients. The accelerated regression was achieved in 88.5% (69/78) of patients after one week of treatment, and 98.7% (77/78) of patients after 1 month of treatment and at the end of treatment. Ulceration was occurred in 14 cases before treatment, which was healed after treatment for 2 months. Minor side effects were happened in 15.4% (12/78) of patients. Rebound growth of lesion was noticed in 35.9% (28/78) of patients. CONCLUSIONS: Propranolol is effective in the treatment of infantile hemangioma with minor side effect. We suggest it should be used as the first-line treatment.

A prospective self-controlled phase II study of imiquimod 5% cream in the treatment of infantile hemangioma.

Imiquimod has been reported to be efficacious in the topical treatment of uncomplicated infantile hemangiomas (IH). However, due to the natural tendency of IH to involute spontaneously, prior uncontrolled efficacy and safety studies have been called into question. We conducted a prospective self-controlled phase II study of imiquimod initially applied to uncomplicated, proliferative superficial or mixed IHs treating half of each IH once every other night for 16 weeks, leaving the other half untreated. After 16 weeks, an independent dermatologist evaluated the color, area, and volume of each half of the hemangioma. Of the 44 patients treated, the total effective rate was 80% (n = 35), with an overall resolution rated as excellent or good rate in 39% of lesions (n = 17/44). The relapse rate was 2% (n = 1). Side effects were noted in 61% (n = 27) including erythema or/and edema (n = 16%, 7), local itching (n = 7%, 3), peeling (n = 7%, 3), erosion (n = 5%, 2), crusting (n = 55%, 24), ulceration (n = 9%, 4), and scarring (n = 5%, 2). Some patients had two or more side effects. Most were judged to be mild to moderate and did not result in treatment being interrupted. Crusting or ulceration was noted to cause post-treatment skin reactions, such as texture change, whereas cases without crusting involuted to almost normal skin. No local infection or systemic reaction was observed. The difference in effective rate and side effect incidence between superficial and mixed IH was not statistically significant. Imiquimod 5% cream can be an effective and safe treatment option for superficial mixed IH in which the superficial component predominates. The recurrence rate is low, but local reactions including crusting can develop and result in post-treatment skin changes.

Reconstruction of the cheek after large port-wine stain lesion resection.

BACKGROUND: A laser is commonly used in treatment of port-wine stain (PWS). Although observable lightening of the stains can be achieved, complete removal is rare. A significant proportion of lesions are resistant to laser treatment, including hypertrophic lesions and scars developed after improper (unsuccessful) treatments. Alternatively, resection is used to eliminate such lesions, but the reconstruction of the aesthetic appearance of the cheek after large lesion resection remains a huge challenge. METHODS: Ten patients with a PWS larger than two-thirds of the cheek were selected for this study. In those patients, prefabricated induced expanded flaps carried by the superficial temporal vessels were prepared to cover the defect areas after resection of the PWS lesion. RESULTS: In eight patients, all the donor sites and defect areas were covered primarily with the expanded flaps, which then survived completely. All patients were satisfied with the cheek appearance after reconstruction with prefabricated induced expanded flaps, which provided a good match for color and texture, restored facial contour, placed scars in a concealed location, and achieved minimal donor-site morbidity. Two of the ten patients did not finish the original surgical plan due to infection or damage to the vascular pedicle. CONCLUSION: We show that the technique of using prefabricated expanded flaps based on the superficial temporal vessels can be an effective option for repairing large cheek defects after PWS resection.