Human cell-conditioned media produced under embryonic-like conditions result in improved healing time after laser resurfacing.

BACKGROUND: Laser resurfacing procedures are continuing to grow in popularity as patients select less invasive procedures for rejuvenation of photo-damaged and aging skin. However, although physicians have begun exploring options to aid in postlaser healing, currently available treatments have little clinical evidence to support their use for wounded skin. METHODS: When grown under conditions of very low oxygen and suspension, a simulation of the embryonic environment, neonatal cells have been found to produce proteins and growth factors in types and quantities similar to those of fetal cells. The human cell-conditioned media (hCCM) produced by the cells was extracted and formulated into a gel to evaluate its efficacy in the healing of postlaser wounds. RESULTS: A split-face clinical evaluation of the material was performed, with 42 subjects undergoing combination ablative and nonablative laser procedures. Three concentrations of the hCCM were tested (× 0.1, × 1.0, × 10.0), and a dose-response trend was seen in the blinded physician evaluation, particularly in the assessment of crusting. In addition, transepidermal water loss readings showed a significant difference (p ≤ 0.05), indicating a more rapid return to normal skin barrier function with the active treatment. Histopathologic evaluation of subject biopsies showed reduced inflammation and a more normal epidermal appearance in the active treatment sites. CONCLUSIONS: The results of this clinical evaluation support the use of the soluble hCCM produced under embryonic-like conditions to accelerate wound healing after laser resurfacing procedures. The utility of the × 10 concentration appears to promote more rapid, scarless wound healing after resurfacing procedures and more normal skin recovery.

Three dimensional ultrasound analysis of fascicle orientation in human tibialis anterior muscle enables analysis of macroscopic torque at the cellular level.

The purpose of this study was to test the hypothesis that the internal structure of the bipennate human tibialis anterior muscle is sufficiently homogenous throughout the muscle that the cellular stresses could be interpreted correctly from measurable anatomic properties and torque in the limb. This result is needed for facile comparison of extrinsic mechanical data and intrinsic energetic fluxes. Three-dimensional imaging of the fascicles of the human tibialis anterior muscle was made by capturing a series of ultrasound images while registering their location in space. Subsequent tracing of hundreds of structures in the ultrasound images with the use of custom software identified muscle boundaries, tendon surfaces, and fascicles as anatomic elements in 3-D space. The tendon was reconstructed as a mesh through the tracings identified as a component of the tendon. The angle of insertion of each identified fascicle at the tendon was calculated against the nearest normal in the mesh of the tendon. In three subjects the average angle of insertion of the fascicles onto the internal tendon was 11 degrees (coefficient of variation 40%). The angle decreased along the length of the muscle from approximately 15 degrees near the belly of the muscle to 6 degrees near the ankle in fascicles superior and inferior to the central tendon. The angle increased by several degrees during a voluntary contraction. Despite the differences in angles of insertion that can be measured, these distinctions have little significance for the distribution of forces along cellular axes within the muscle: the angles, their distribution within the muscle and change with contraction are small. For this bipennate muscle the cosine of the angle of insertion of the cellular bundles is always close to unity. Thus measurements of whole muscle mechanical data are simply related to mechanical stress of its cells.

[Reoperations after biliary-digestive system anastomosis]. / Reoperácie po biliodigestívnych anastomózach.

During the period from July 1997 to November 1999, five patients were electively surgically treated at the II Surgical Clinic due to stenosis of biliodigestive anastomoses. All patients were afflicted by stenosis of hepatojejunal anastomoses which were performed at various surgical clinics in order to correct iatrogenic lesions of biliary ducts. Re-operation was performed by use of the mucosa-to-mucosa anastomosis technique without transanastomotic drainage. There were two post-operational complications and no mortality. The authors discuss the safety and effectiveness of biliodigestive anastomoses carried out without transanastomotic drainage, and present the possibilities and indications of endoscopic therapy in these states.