Changes in Seminal Quality Following Oral Zinc Therapy

33 subfertile men with idiopathic asthenozoospermia and/or oligozoospermia were treated with oral zinc sulphate. After treatment a significant improvement in the percentage progressive and total sperm motility was noted accompanied by a significant increase in seminal fluid zinc levels.     

Treatment of Fireworks Tattoos with the Q-Switched Ruby Laser

BACKGROUND: The best approach in managing patients with explosive traumatic tattoos is the immediate removal of particles during initial care. Delayed treatment makes the situation more difficult to manage. Under certain conditions, a Q-switched ruby laser can be considered an excellent alternative. METHODS: We report a new case of multiple facial fireworks tattooing managed successfully with a Q-switched ruby laser under low fluency pulses at 4.5 J/cm2. A pretreatment test zone was initially performed, and then three treatments were conducted at 6-week intervals. RESULTS: More than 75% of the lesions were removed without scarring. CONCLUSION: The Q-switched ruby laser can be a safe and excellent choice for the removal of explosive particles.     

创伤性文身的治疗现状及进展

创伤性文身（traumatic tattoos）又称为异物性文身,是指外伤后异物颗粒通过表皮,进入皮内及皮下组织,形成永久性色素斑块。根据致伤原因,创伤性文身可分为爆炸型（粉粒异物高速飞溅射入正常皮肤引起的各种色素沉着称之为爆炸粉粒沉着症；     

雪肤增感激光的美容应用

目的探讨雪肤增感激光非手术、无创美容技术。方法采用韩国MAX公司生产的SpectraVRMKQ开关Nd:YAG激光进行治疗。先将碳溶液涂到皮肤表面,20～30min后治疗。在Spectra模式激光能量被定向在靶组织上,2～3次的Q开关模式的激光使碳粉在很小的面积下爆破出来。每3次为一疗程,两次间隔为2～4周。结果本组12例均改善皮肤质地、缩小毛孔、改善细小皱纹、减少色素斑点。结论碳粉吸收激光的光和热产生很高的温度在表皮形成一个热量层,Q-switched模式短脉冲的激光使碳粉爆破,这就是“雪肤增感”。雪肤增感的优点:完成治疗方便,不结痂、不出血、不感染,不影响日常活动,不需要休息,适合所有的复杂皮肤的治疗。     

In Search of a Gold Standard Scoring System for the Subjective Evaluation of Cosmetic Outcomes Following Breast‐Conserving Therapy

The absence of a widely accepted method for aesthetic evaluation following breast‐conserving surgery for breast cancer limits the ability to evaluate cosmetic outcomes. In this study, two different panel scoring approaches were compared in an attempt to identify a gold standard scoring system for subjectively assessing cosmetic outcomes following breast‐conserving therapy. Standardized photographs of each participant were evaluated independently by twelve health care professionals involved in breast cancer diagnosis and treatment using the Danoff four‐point scale. Individual Danoff scores were combined using two methods, a random sample “three‐panel” score and an iterative “Delphi‐panel” score, in order to create a final cosmetic score for each patient. Agreement between these two aggregative approaches was assessed with a weighted kappa (wk) statistic. Patient and professional recruitment occurred at two separate tertiary care multi‐disciplinary breast health centers. Women with unilateral breast cancer who underwent breast‐conserving therapy (segmental mastectomy or lumpectomy and radiotherapy) and were at least 2 years after radiotherapy were asked to participate. Ninety‐seven women were evaluated. The Delphi approach required three rounds of evaluation to obtain greater than 50% agreement in all photographs. The wk statistic between scores generated from the “three‐panel” and “Delphi‐panel” approaches was 0.80 (95% CI: 0.71–0.89), thus demonstrating substantial agreement. Evaluation of cosmetic outcomes following breast‐conserving therapy using a “three‐panel” and “Delphi‐panel” score provide similar results, confirming the reliability of either approach for subjective evaluation. Simplicity of use and interpretation favors the “three‐panel” score. Future work should concentrate on the integration of the three‐panel score with objective and patient‐reported scales to generate a comprehensive cosmetic evaluation platform.     

Extensive Remineralization of Large Pelvic Lytic Lesions Following Total Therapy Treatment in Patients With Multiple Myeloma

Osteolytic bone lesions are a hallmark of multiple myeloma (MM) bone disease. Bone destruction is associated with severely imbalanced bone remodeling, secondary to increased osteoclastogenesis and significant osteoblast suppression. Lytic lesions of the pelvis are relatively common in MM patients and are known to contribute to the increased morbidity because of the high risk of fracture, which frequently demands extensive surgical intervention. After observing unexpected radiological improvement in serial large pelvic CT assessment in a patient treated in a total therapy protocol, the radiographic changes of pelvic osteolytic lesions by PET/CT scanning in patients who received Total Therapy 4 (TT4) treatment for myeloma were retrospectively analyzed. Sixty‐two (62) patients with lytic pelvic lesions >1 cm in diameter were identified at baseline PET/CT scanning. Follow‐up CT studies showed that 27 of 62 patients (43%) with large baseline pelvic lesions achieved significant reaccumulation of radiodense mineralization at the lytic cortical site. The average size of lytic lesions in which remineralization occurred was 4 cm (range, 1.3 to 10 cm). This study clearly demonstrates that mineral deposition in large pelvic lesions occurs in a significant proportion of MM patients treated with TT4, potentially affecting patient outcomes, quality of life, and future treatment strategies. © 2017 American Society for Bone and Mineral Research.     

Multiple Atrophies Following Tooth Extraction

Following a molar tooth extraction, the patient developed a depression and atrophy of the right ear, the right half of the mentum, and the tongue. These atrophy deformities were successfully corrected with dermografts.     

Occlusive Dressing versus Oxygen Mist Therapy Following CO2 Laser Resurfacing

BACKGROUND: Oxygen is an essential element for collagen synthesis and reepithelialization. The use of topical oxygen after CO2 laser resurfacing has not been studied. OBJECTIVE: To compare the rate and quality of healing in wounds treated with an oxygen mist to those treated with occlusive dressing following CO2 laser resurfacing. METHODS: Three patients underwent CO2 laser resurfacing to each half of the face 3 weeks apart. Postoperatively, half of the face was treated with an oxygen mist protocol for 5 days, while the other half was treated with occlusive dressing for 4 days. RESULTS: At postoperative day 5, significantly less crusting was observed on the half of the face treated with the oxygen mist protocol (p < 0.05). CONCLUSION: The oxygen mist postoperative protocol may offer patients similar overall healing rates and significantly less crusting compared to occlusive dressing.     

Surgery of Cosmetic Sequelae After Breast‐Conserving Therapy

Abstract: Although a considerable number of patients have an unfair cosmetic result after breast‐conserving therapy, which correlates with poor psychosocial functioning, surprisingly, really only very few patients undergo surgical correction. The purpose of this article was to report our experience in the surgical treatment of such patients and analyze a special subgroup which required bilateral reduction mammaplasty because of associated symptomatic macromastia and their desire to reduce their breast size. From July 2000 to November 2008, some 23 patients consulted for unsatisfactory cosmetic outcome after breast‐conserving therapy, fourteen of them accepting the surgical treatment proposed and these were operated upon. We used the following techniques: reduction mammaplasty of the contralateral breast for symmetrization (9), bilateral reduction mammaplasty (4), one mammaplasty and augmentation of contra‐lateral breast and one myocutaneous dorsi flap for surgical correction of ipsilateral breast. One patient had serious complications, having partial necrosis of the areola, fat and breast skin necrosis, and needed reoperation for surgical removal of necrotic tissue. Some factors such as obesity and heavy smoking habits could explain this. We were able to evaluate cosmetic outcome in ten patients; late cosmetic outcome was good in seven patients, fair in two and poor in one. Despite the fact that most patients treated by breast‐conserving therapy are satisfied with the fact that they have retained their breasts and minimized an unfair cosmetic outcome, cosmetic evaluation should be introduced as a matter of routine.     

A Review of Resistance Patterns and Phenotypic Changes in Gastrointestinal Stromal Tumors Following Imatinib Mesylate Therapy

Gastrointestinal stromal tumors are neoplastic lesions that arise from the interstitial cells of Cajal and are associated with somatic mutations in the tyrosine kinase receptor, KIT. The only known curative therapy is complete surgical resection. Unfortunately, postsurgical recurrence rates exceed 50% and most tumors are resistant to standard chemotherapy and radiation. Imatinib mesylate, a novel tyrosine kinase inhibitor, holds promise as a potential adjuvant therapy to prevent recurrence and improve long-term survival. However, as resistance data emerge, it appears that a potential “escape pathway” may originate from secondary mutations in the KIT receptor. This paper reviews the historical clinical experience with imatinib mesylate and discusses resistance patterns following targeted therapy. We highlight this review with an interesting case report that illustrates unique phenotypic tumoral changes associated with imatinib mesylate resistance. Drs. Bickenbach and Wilcox share joint first authorship     

Topical Imiquimod as an Adjuvant to Laser Removal of Mature Tattoos in an Animal Model

BACKGROUND: Lasers are a commonly employed method of tattoo removal; however, numerous treatments are often needed and laser treatment may fail to eliminate the tattoo completely. It has been shown in animal studies that topical application of imiquimod cream, alone, fades tattoos. It is suspected that the combination of both imiquimod and laser treatment will result in enhanced tattoo pigment clearance. OBJECTIVE: The objective was to evaluate the efficacy of topical imiquimod cream as an adjuvant to laser removal of mature tattoos. METHODS: Fourteen albino guinea pigs were tattooed with black ink, then randomly assigned into two groups: one underwent sequential laser treatments with a Q-switched alexandrite laser in conjunction with triweekly applications of 5% imiquimod cream, while the other group underwent laser therapy alone. Subjects were evaluated with clinical photographs and skin biopsies after six laser treatment sessions. RESULTS: The combination laser and imiquimod treated group was clinically and histologically rated as having less pigment than the tattoos that were treated with laser alone (p=.012 and p=.047, respectively). Adjuvant imiquimod treatment had greater inflammation (p=.002) and fibrosis (p=.002) on posttreatment skin biopsies. CONCLUSION: Imiquimod appears to be a useful adjuvant to experimental laser tattoo removal in guinea pigs.