bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Scalp Laxity, Elasticity, and Glidability and Donor Strip Scar Width in Hair Transplantation and a New Elasticity Measuring Method
Authors: Park Jae Hyun 
Published: December 2016

BACKGROUND
Hair transplantation requires precise evaluation of donor site laxity, elasticity, and glidability.

OBJECTIVE
The purpose of this study was to examine the relationship between donor strip scar width and preoperative laxity, elasticity, and glidability.

MATERIALS AND METHODS
Preoperative measurements of scalp laxity, elasticity, and glidability and of donor site scar width 10 months postoperatively were evaluated in 88 patients who underwent hair transplantation with strip harvesting. Elasticity was measured by firmly pressing the scalp with the fingertips of one hand at 2 points to restrict dermis movement while stretching the skin with the other hand. Glidability was calculated as laxity minus elasticity.

RESULTS
Scar width positively correlated with laxity (p < .01) and elasticity (p < .05) but had no relationship with glidability. There was a significant difference between patients in the upper 30th percentile of elasticity (≥10 mm) versus others (<10 mm) in scar width.

CONCLUSION
Scalp laxity, elasticity, and glidability are of great clinical importance in hair transplantation. The authors’ novel method of measuring elasticity will assist surgeons in predicting donor site scar width.
A 12-Month Follow-up, Randomized Comparison of Effectiveness and Safety of Two Hyaluronic Acid Fillers for Treatment of Severe Nasolabial Folds
Authors: Ascher Benjamin , Bayerl Christiane , Kestemont Philippe , Rzany Berthold , Edwartz Carolina , Podda Maurizio 
Published: December 2016

BACKGROUND
Hyaluronic acid (HA) filler injection is an increasingly popular aesthetic procedure.

OBJECTIVE
To compare the effectiveness and safety of two HA fillers (HAED and HAPER) for the treatment of severe nasolabial folds (NLFs).

MATERIALS AND METHODS
This was an evaluator-blinded and subject-blinded split-face study. At baseline, HAED or HAPER was randomly assigned to the left or right NLF. The follow-up period was 12 months. Effectiveness was assessed using the wrinkle severity rating scale (WSRS) and subject preference. Safety was assessed by adverse events and local tolerability symptoms recorded by subjects during 3 weeks after the treatment.

RESULTS
At 6 months, HAED was noninferior to HAPER (assessed by mean change from baseline in WSRS score). There was a significant difference in mean WSRS score change from baseline in favor of HAED at 3 to 12 months, and a majority of subjects preferred HAED over HAPER at 12 months. However, the overall responder rate was similar between products, and it remained high throughout the study. At 12 months, approximately 80% of subjects were still responders. Both products were well tolerated and associated with a few treatment-related adverse events.

CONCLUSION
To conclude, HAED was at least as effective and well tolerated for the treatment of severe NLFs as HAPER.
Roscovitine Protects From Arterial Injury by Regulating the Expressions of c-Jun and p27 and Inhibiting Vascular Smooth Muscle Cell Proliferation
Authors: Liu Yu , Li Yun-feng , Chang Hong , Zhao Jing-shan , Hou Jian-ming , Yu Kun , Sun Jia-huan , Wang Hong , Li Ai-ying 
Published: December 2016

Purpose:
Roscovitine (Rosc) is a selective inhibitor of cyclin-dependent kinases (CDKs) and a promising therapy for various cancers. However, limited information is available on the biological significance of Rosc in vascular smooth muscle cells (VSMCs), the cell type critical for the development of proliferative vascular diseases. In this study, we address the effects of Rosc in regulating VSMC proliferation, both in vitro and in vivo, exploring the underlying molecular mechanisms.

Methods:
The proliferations and cell-cycle distributions of in vitro cultured VSMCs, as well as several other cancer cell lines, were examined by cell-counting assay and flow cytometry, respectively. Molecular changes in various CDKs, cyclins, and other regulatory molecules were examined by reverse transcription polymerase chain reaction, Western blot, or immunocytochemistry. The in vivo effects of Rosc were examined on a carotid arterial balloon-injury model.

Results:
Rosc significantly inhibited VSMC proliferation in response to serum or angiotensin II and arrested these cells at the G0/G1 phase. These changes were associated with a specific and robust decrease in CDK4, cyclin E, c-Jun, and a dramatic increase in p27kip1 in VSMCs, which was also translated in vivo and correlated with the protection of Rosc on injury-induced neointimal hyperplasia.

Conclusions:
Acting on distinct molecular targets in VSMCs versus cancer cells, Rosc inhibits VSMC proliferation and protects from proliferative vascular diseases.
A Rare Case of Malignant Transformation of Oral Lichen Planus of the Mandible
Authors: Soo Joanne , Kokosis George , Ogilvie Michael , “Sara” Jiang Xiaoyin , Powers David B. , Rocke Daniel J. , Erdmann Detlev 
Published: December 2016

Summary:
Oral lichen planus (OLP) is an immune-mediated mucocutaneous disease associated with an increased risk in oral squamous cell carcinoma (OSCC). Nearly all cases of malignant transformation have been reported in patients >40 years old. We report the case of a 37-year-old woman with a 5-year history of erosive OLP who presented with malignant transformation to OSCC. Delineating the margins of the disease was impossible at presentation given her OLP, and she was initially treated with concurrent chemoradiation therapy. She then developed a recurrence of the mandibular alveolar ridge. The patient was successfully treated with a composite resection including a segmental mandibulectomy, buccal mucosa resection, partial glossectomy, and ipsilateral neck dissection. This was reconstructed with a free fibula osteo-septo-cutaneous flap. Mandibular OSCC is a rare complication of OLP with few reports on effective reconstructive interventions. The case represents the youngest reported patient with mandibular OSCC arising in the context of OLP and highlights the utility of the free vascularized fibula graft in the treatment of these patients.
Survival and Inflammatory Response in Adipose-derived Mesenchymal Stem Cell-enriched Mouse Fat Grafts
Authors: Begic Anadi , Isfoss Björn L. , Lønnerød Linn K. , Vigen Alexander , Moskaug Jan Ø. 
Published: December 2016

Background:
Adipose tissue-derived mesenchymal stem cells (ATMSCs) are currently used in grafting procedures in a number of clinical trials. The reconstructive role of such cells in fat graft enrichment is largely unclear. This study was undertaken to assess survival and inflammatory response in fat grafts enriched with ATMSCs in mice.

Methods:
ATMSC-enriched adipose tissue was grafted subcutaneously in a clinically relevant manner in mice, and survival and inflammatory response were determined by bioluminescence imaging of transgenic tissue constitutively expressing luciferase or driven by inflammation in wild-type animals.

Results:
Only a minor fraction of ATMSCs transplanted subcutaneously were found to survive long term, yet fat grafts enriched with ATMSCs showed improved survival for a limited period, compared with no enrichment. NF-κB activity was transiently increased in ATMSC-enriched grafts, and the grafts responded adequately to a proinflammatory stimulus. In one animal, cells originating from the subcutaneous graft were found at a site of inflammation distant from the site of engraftment.

Conclusion:
ATMSCs display limited subcutaneous survival. Still, ATMSC enrichment may improve the outcome of adipose tissue grafting procedures by facilitating short-term graft survival and adequate inflammatory responses. Migration of cells from grafted adipose tissue requires further investigation.
A Systematic Review of Metoidioplasty and Radial Forearm Flap Phalloplasty in Female-to-male Transgender Genital Reconstruction: Is the “Ideal” Neophallus an Achievable Goal?
Authors: Frey Jordan D. , Poudrier Grace , Chiodo Michael V. , Hazen Alexes 
Published: December 2016

Introduction:
The complex anatomy and function of the native penis is difficult to surgically replicate. Metoidioplasty and radial forearm flap phalloplasty (RFFP) are the 2 most commonly utilized procedures for transgender neophallus construction.

Methods:
A MEDLINE search for metoidioplasty and RFFP in female-to-male genital reconstruction was performed. Primary outcome measures were subsequently compared. A systematic review was planned in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyse guidelines. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was utilized to evaluate the quality of evidence.

Results:
Using Population, Intervention, Comparison and Outcomes tool criteria, a total of 188 articles were identified; 7 articles related to metoidioplasty and 11 articles related to RFFP met inclusion criteria. The GRADE quality of evidence was low to very low for all included studies. In studies examining metoidioplasty, the average study size and length of follow-up were 54 patients and 4.6 years, respectively (1 study did not report [NR]). Eighty-eight percent underwent a single-stage reconstruction (0 NR), 87% reported an aesthetic neophallus (3 NR), and 100% reported erogenous sensation (2 NR). Fifty-one percent of patients reported successful intercourse (3 NR), and 89% of patients achieved standing micturition (3 NR). In studies examining RFFP, the average study size and follow-up were 60.4 patients and 6.23 years, respectively (6 NR). No patients underwent single-stage reconstructions (8 NR). Seventy percent of patients reported a satisfactorily aesthetic neophallus (4 NR), and 69% reported erogenous sensation (6 NR). Forty-three percent reported successful penetration of partner during intercourse (6 NR), and 89% achieved standing micturition (6 NR). Compared with RFFP, metoidioplasty was significantly more likely to be completed in a single stage (P < 0.0001), have an aesthetic result (P = 0.0002), maintain erogenous sensation (P < 0.0001), achieve standing micturition (P = 0.001), and have a lower overall complication rate (P = 0.02).

Conclusions:
Although the current literature suggests that metoidioplasty is more likely to yield an “ideal” neophallus compared with RFFP, any conclusion is severely limited by the low quality of available evidence.
Microvascular Fragment Transplantation Improves Rat Dorsal Skin Flap Survival
Authors: Stone Randolph , Rathbone Christopher R. 
Published: December 2016

Background:
The development of flap necrosis distally remains a concern during microsurgical flap transfers because, at least in part, of decreased perfusion. Microvascular fragments (MVFs) are microvessels isolated from adipose tissue that are capable of improving tissue perfusion in a variety of tissue defects. The aim of this study was to determine whether the transplantation of MVFs in a dorsal rat skin flap model can improve flap survival.

Methods:
A 10 × 3 cm flap was raised in a cranial to caudal fashion on the dorsal side of 16 Lewis rats, with the caudal side remaining intact. The rats were equally divided into a treatment group (MVFs) and a control group (sterile saline). At the time of surgery, sterile saline with or without MVFs was injected directly into the flap. Microvessel density was determined after harvesting flap tissue by counting vessels that positively stained for Griffonia simplicifolia lectin I-isolectin B4. Laser Doppler was used to measure blood flow before and after surgery and 7 and 14 days later. Flap survival was evaluated 7 and 14 days after surgery by evaluating the percentage of viable tissue of the flap with photodigital planimetry.

Results:
Despite the lack of a significant difference in microvessel density and tissue perfusion, flap survival increased 6.4% (P < 0.05) in MVF-treated animals compared with controls.

Conclusions:
The use of MVFs may be a means to improve flap survival. Future studies are required to delineate mechanisms whereby this occurs and to further optimize their application.
Accurate Measurements of the Skin Surface Area of the Healthy Auricle and Skin Deficiency in Microtia Patients
Authors: Otto Iris A , van Doremalen Rob F. M. , Melchels Ferry P. W. , Kolodzynski Michail N. , Pouran Behdad , Malda Jos , Kon Moshe , Breugem Corstiaan C. 
Published: December 2016

Background:
The limited cranial skin covering auricular implants is an important yet underrated factor in auricular reconstruction for both reconstruction surgery and tissue engineering strategies. We report exact measurements on skin deficiency in microtia patients and propose an accessible preoperative method for these measurements.

Methods:
Plaster ear models (n = 11; male:female = 2:1) of lobular-type microtia patients admitted to the University Medical Center Utrecht in The Netherlands were scanned using a micro-computed tomographic scanner or a cone-beam computed tomographic scanner. The resulting images were converted into mesh models from which the surface area could be calculated.

Results:
The mean total skin area of an adult-size healthy ear was 47.3 cm2, with 49.0 cm2 in men and 44.3 cm2 in women. Microtia ears averaged 14.5 cm2, with 15.6 cm2 in men and 12.6 cm2 in women. The amount of skin deficiency was 25.4 cm2, with 26.7 cm2 in men and 23.1 cm2 in women.

Conclusions:
This study proposes a novel method to provide quantitative data on the skin surface area of the healthy adult auricle and the amount of skin deficiency in microtia patients. We demonstrate that the microtia ear has less than 50% of skin available compared with healthy ears. Limited skin availability in microtia patients can lead to healing problems after auricular reconstruction and poses a significant challenge in the development of tissue-engineered cartilage implants. The results of this study could be used to evaluate outcomes and investigate new techniques with regard to tissue-engineered auricular constructs.
The Number of Perforators Included in Reversed Flow Posterior Interosseous Artery Flap: Does It Affect the Incidence of Venous Congestion?
Authors: Reyad Khaled A. , Shaker Ayman A. , Elbarbary Amir S. , Sayed Mohamed A. , Elghareeb Mohamed A. 
Published: December 2016

Background:
The purpose of this study is to decrease the incidence of venous congestion occurring in the reversed flow posterior interosseous artery flap used for coverage of hand defects.

Methods:
This may be achieved by studying the incidence of venous congestion in flaps including only 1 perforator and comparing the results with others including more than 1 perforator both in small and large sized flaps.

Results:
This study showed that inclusion of only 1 perforator in the flap decreased the incidence of venous congestion with complete flap loss in flaps to 5%. Also, it decreased the incidence of venous congestion with partial flap loss in flaps to 10%.

Conclusions:
The small sized reversed flow posterior interosseous artery flap should be less than 40 cm2 and should include only 1 perforator to decrease the incidence of venous congestion with partial and complete loss of the flap. The level of evidence for this study is the type II prospective comparative study.
Comparison of Peripheral Nerve Regeneration with Side-to-side, End-to-side, and End-to-end Repairs: An Experimental Study
Authors: Rönkkö Henrikki , Göransson Harry , Taskinen Hanna-Stiina , Paavilainen Pasi , Vahlberg Tero , Röyttä Matias 
Published: December 2016

Background:
The present study was conducted to find out a tool to enable improved functional recovery with proximal nerve injury. In this experimental study, nerve regeneration was compared between side-to-side (STS), end-to-side (ETS), and end-to-end repairs.

Methods:
The walk track analysis was used as an outcome of functional recovery. Nerve regeneration was studied with morphometry and histology 6 or 26 weeks postoperatively.

Results:
All 3 repair techniques showed regeneration of the nerve. From 12 weeks onward, the functional results of the 3 intervention groups were significantly better compared with the unrepaired control group. End-to-end repair was significantly better when compared with the STS and ETS groups. At 26 weeks, the functional and morphometric results and histologic findings did not differ between the STS and ETS groups. The functional results correlated with the morphometric findings in all groups.

Conclusions:
STS neurorrhaphy showed nerve regeneration, and the end results did not differ from clinically widely used ETS repair. Further studies are warranted to optimize the neurorrhaphy technique and examine possible applications of STS repair in peripheral nerve surgery.
Effect of Axonal Trauma on Nerve Regeneration in Side-to-side Neurorrhaphy: An Experimental Study
Authors: Rönkkö Henrikki , Göransson Harry , Taskinen Hanna-Stiina , Paavilainen Pasi , Vahlberg Tero , Röyttä Matias 
Published: December 2016

Background:
Side-to-side (STS) neurorrhaphy can be performed distally to ensure timely end-organ innervation. It leaves the distal end of the injured nerve intact for further reconstruction. Despite encouraging clinical results, only few experimental studies have been published to enhance the regeneration results of the procedure. We examined the influence of different size epineural windows and degree of axonal injury of STS repair on nerve regeneration and donor nerve morbidity.

Methods:
Three clinically relevant repair techniques of the transected common peroneal nerve (CPN) were compared. Group A: 10-mm long epineural STS windows; group B: 2-mm long windows and partial axotomy to the donor tibial nerve; and group C: 2-mm long windows with axotomies to both nerves. Regeneration was followed by the walk track analysis, nerve morphometry, histology, and wet muscle mass calculations.

Results:
The results of the walk track analysis were significantly better in groups B and C compared with group A. The nerve fiber count, total fiber area, fiber density, and percentage of the fiber area values of CPN of the group C were significantly higher when compared with group A. The wet mass ratio of the CPN-innervated anterior tibial muscle was significantly higher in group C compared with group A. The wet mass ratio of the tibial nerve–innervated gastrocnemial muscle was higher in group A compared with the other groups.

Conclusions:
All three variations of the STS repair technique showed nerve regeneration. Deliberate donor nerve axotomy enhanced nerve regeneration. A larger epineural window did not compensate the effect of axonal trauma on nerve regeneration.
Surgical Site Infiltration for Abdominal Surgery: A Novel Neuroanatomical-based Approach
Authors: Joshi Girish P. , Janis Jeffrey E. , Haas Eric M. , Ramshaw Bruce J. , Nihira Mikio A. , Dunkin Brian J. 
Published: December 2016

Background:
Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy.

Methods:
Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery. Also, studies identified by preceding search were reviewed for relevant publications and manually retrieved.

Results:
Based on neuroanatomy, an optimal surgical site infiltration technique would consist of systematic, extensive, meticulous administration of local anesthetic into the peritoneum (or preperitoneum), subfascial, and subdermal tissue planes. The volume of local anesthetic would depend on the size of the incision such that 1 to 1.5 mL is injected every 1 to 2 cm of surgical incision per layer. It is best to infiltrate with a 22-gauge, 1.5-inch needle. The needle is inserted approximately 0.5 to 1 cm into the tissue plane, and local anesthetic solution is injected while slowly withdrawing the needle, which should reduce the risk of intravascular injection.

Conclusions:
Meticulous, systematic, and extensive surgical site local anesthetic infiltration in the various tissue planes including the peritoneal, musculofascial, and subdermal tissues, where pain foci originate, provides excellent postoperative pain relief. This approach should be combined with use of other nonopioid analgesics with opioids reserved for rescue. Further well-designed studies are necessary to assess the analgesic efficacy of the proposed infiltration technique.
Bilateral Lymphatic Spread of Metastatic Basal Cell Carcinoma
Authors: Sleightholm Richard L. , Willcockson James R. , Watley Duncan C. , Durden Frederick L. , Foster Jason M. 
Published: December 2016

Summary:
Herein, we report a case of a patient with an abnormal skin lesion that remained unchecked by medical professionals for approximately 20 years. Upon physical examination in the emergency department for a fractured hip, an infiltrative mass was incidentally discovered. The neoplasm was noted to have progressed from an eraser-sized mass to a 3.5-cm invasive lesion. Initial surgical intervention was believed to have been successful in removal, as margins were clear with the exception of 1 indeterminate segment. However, subsequent 1-year follow-up revealed recurrence of the disease with bilateral axillary node and deep muscle involvement. This prompted a more extensive surgical approach complemented with radiation therapy. The patient had remained disease-free for a year.
The Use of Silgel STC-SE, a Topical Silicone Gel for the Treatment and Reduction of Hypertrophic and Keloid Scars
Authors: Stewart Sharon A. , Dougall Greig M. G. , Tafuro Erica M. 
Published: December 2016

Background:
A single-center study assessing the efficacy of Nagor’s Silgel STC-SE silicone gel to reduce the appearance of hypertrophic and keloid scars.

Methods:
A 16-week controlled study of 36 patients with hypertrophic or keloid scars. The subjects were divided between 2 cohorts: one assessing recently healed scars (<6 mo) and other assessing older scars (6 mo to 2 y). The efficacy of Silgel STC-SE on the scar was evaluated by skin hydration, skin moisture evaporation, skin elasticity, basic scar measurements, subjective patient questionnaire data, and image analysis. All subjects had data collected at baseline and weeks 1, 4, 8, 12, and 16. Photographs were taken for image analysis at baseline, week 8, and week 16. Statistical analysis was conducted on all data.

Results:
Twenty-nine patients completed the study (27 presented with hypertrophic scars and 2 with keloid scars), and 90% reported a marked improvement in their scar appearance. Patient questionnaire data showed great satisfaction with the product. Image analysis showed visual improvement with a statistically significant reduction of the “red” color of scars. Overall, scar dimensions were significantly reduced. There was a significant decrease from baseline levels in average scar length. Skin elasticity, skin hydration, and skin moisture evaporation did not change significantly from baseline.

Conclusions:
The results of this study indicate that Silgel STC-SE is an effective treatment in reducing the appearance and red color of hypertrophic scars up to 2 years old. Further study is required to draw significant conclusion in regard to the treatment of keloid scars.