Efficacy of allogeneic cord blood platelet gel on wounds of dystrophic epidermolysis bullosa patients after pseudosyndactyly surgery

Epidermolysis bullosa (EB) is a rare genetic disorder characterized by the formation of blisters and wounds in skin and mucous membranes; it is classified into four types and has various methods of treatment. Management of previous wounds and prevention of formation of new lesions are the most important strategies in the course of therapy to improve patient's quality of life; lack of wound management can lead to further complications such as infection. The current study investigated the therapeutic effects of allogeneic platelet gel (prepared from umbilical cord blood) in a group of children diagnosed with dystrophic epidermolysis bullosa (DEB) eligible for surgical correction of pseudosyndactyly in the hand. The post‐surgical clinical outcome in this group was compared with the clinical outcomes of DEB patients receiving the standard treatment (paraffin gauze wound dressing and topical antibiotics) after corrective surgery. The current study results showed an increase in the rate of recovery and promotion of tissue granulation, complete wound healing, and a decrease in pain level and treatment period. The application of cord blood platelet gel topical dressing was not a conventional method of treatment in patients with DEB wounds and blisters. However, the current study results demonstrated that this gel dressing could effectively accelerate epithelialization and healing of the wounds and decrease patients' pain and post‐surgical recovery period, which altogether leads to improvements in patients' overall quality of life.     

Elevated IL-38 Serum Levels in Newly Diagnosed Multiple Sclerosis and Systemic Sclerosis Patients

ObjectiveInterleukin (IL)-38 is a newly discovered member of the IL-1 cytokine family with a proposed anti-inflammatory profile. We studied the probable role of this cytokine in the pathogenesis of two autoimmune diseases: multiple sclerosis (MS) and systemic sclerosis (SSc).Subjects and MethodsA total of 87 MS patients and 86 SSc patients (40 new and recently untreated cases and 46 treated cases) were selected for this study. Eighty-seven and 80 age- and sex-matched healthy subjects were included as controls for MS and SSc, respectively. Clinical and paraclinical features of the patients were recorded at the time of sampling. Serum IL-38 was measured by ELISA.ResultsLevels of serum IL-38 did not significantly differ between the total MS or SSc patients compared to controls. However, levels of IL-38 were significantly higher in newly diagnosed patients of MS (206.43 ± 38.97 pg/mL, p < 0.0001) than in those previously treated (158.04 ± 39.45 pg/mL). Similarly, new/recently untreated cases of SSc patients showed increased IL-38 levels (185.19 ± 36.27 pg/mL, p = 0.001) compared to treated patients (166.82 ± 33.08 pg/mL). IL-38 levels in newly diagnosed MS patients (p = 0.007) and new/recently untreated SSc patients (p = 0.032) were significantly higher than those in healthy controls.ConclusionThe higher serum levels of IL-38 in new or recently untreated cases of MS and SSc patients than in treated patients and healthy controls suggest the possible role of this cytokine in the development of these diseases or as part of a feedback loop to attenuate the inflammatory conditions in early stages of these diseases.     

Asymptomatic seminal infection of herpes simplex virus:impact on male infertility

In more than half of infertile men,the cause of their infertility is unknown.Several studies revealed the role of viral infections in male infertility.The aim of the present study was to determine the prevalence of herpes simplex virus-1 (HSV-1) and HSV-2 in semen from asymptomatic infertile male patients,and its association with altered semen parameters.A total of 70 semen samples were collected from infertile men who attended the Research and Clinical Center for Infertility in Yazd,Iran.Semen analysis and diagnostic real-time PCR using specific primers and probes for HSV-1 and HSV-2 DNA were performed.Comparison of semen parameters between virally infected and non-infected samples were performed with independent t-test and Mann-Whitney test.Semen analysis showed that infertile men fell into two groups,the male factor group and the unexplained group.HSV-1 and HSV-2 DNA was detected in 16 (22.9%) and 10 (14.3%) of 70 semen samples,respectively.All HSV-positive samples had abnormal semen parameters (the male factor group).Although HSV infection was not associated with sperm motility and morphological defects,it was correlated with lower sperm count in the seminal fluid.The findings suggest that asymptomatic seminal infection of HSV plays an important role in male infertility by adversely affecting sperm count.     

The intracranial bridging veins: a comprehensive review of their history, anatomy, histology, pathology, and neurosurgical implications

Introduction

The intracranial bridging veins are pathways crucial for venous drainage of the brain. They are not only involved in pathological conditions but also serve as important landmarks within neurological surgery.

Methods

The medical literature on bridging veins was reviewed in regard to their historical aspects, embryology, histology, anatomy, and surgery.

Conclusion

Knowledge on the intracranial bridging veins and their dynamics has evolved over time and is of great significance to the neurosurgeon.     

Robert Liston (1794–1847): surgical anatomist and resurrectionist with an interest in hydrocephalus

Introduction

The Scottish surgeon Robert Liston was an accomplished anatomist of the nineteenth century. The study of anatomy during this day was often overshadowed by the so-called resurrectionists. Conclusions: The present historic paper reviews the life and contributions of Robert Liston and discusses his fascination with childhood hydrocephalus.     

Effects of hair removal alexandrite laser on biometric parameters of the skin

The effects of alexandrite laser (AL) on skin parameters such as melanin content, skin layer depth, elasticity, and density have not been investigated through biometric methods. We aim to assess the effect of AL on the skin parameters through biometric devices to determine whether it has positive effects on treated region. In this pretest-posttest study, we recruited patients who attended Laser Clinic of Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran, from January through December 2014. Patients had to be free of any dermatologic conditions and lesion at the site of treatment or any contraindication to laser therapy. Baseline measurements were performed and patients received four sessions of AL therapy (spot size, 12 mm; fluence, 12 J/cm²; and pulse width, 5 Hz) with 4-week intervals. Four weeks after the last treatment session, the same parameters were assessed that included skin color, transepidermal water loss (TEWL), dermis and epidermis density and depth (through skin ultrasonography), melanin content, erythema intensity, and skin elasticity. Biometric parameters of 33 patients (27 females [81.8 %]), with mean (SD) age of 35.7 (9.5)?years were evaluated. The mean percent changes of skin parameters were as follows: skin color, 5.88 % through Visioface and by 56.8 % through Colorimeter devices (became lighter); melanin content, ?15.95 %; TEWL, ?2.96 %; elasticity, +14.88 %; dermis depth ?19.01 %; and dermis density, +1580.11 % (P?<?0.001 for changes in each parameter). AL could decrease melanin content of the skin and make the skin thinner while it could increase elasticity and density of epidermis and dermis, which might indicate increased collagen content of skin.     

Proposal for the existence of a nasogastric reflex in humans, as a potential cause of upper gastrointestinal symptoms

The nose is a gateway of air from the environment to the body and with its rich innervation from the olfactory and trigeminal nerves plays a critical role as a sensor in both human beings and primitive animals. Irritation of the nasal or paranasal mucosa may initiate a severe bradycardia, apnea, and vasoconstriction and increase the pulmonary airflow resistance. However, the interaction between nasal mucosa and the upper gastrointestinal tract is more often than not neglected in the clinical literature. We propose that a nasogastric reflex might exist with its afferent and efferent loops being the trigeminal and vagus nerves, respectively. The central connection of these loops is located at the pontomedullary level. The sensory inputs from the nasal mucosa to the general somatic afferent component of the brainstem including the pontine and medullary trigeminal nucleuses may induce the neighboring nucleus of the solitary tract and dorsal motor nucleus of the vagus. This initiates, via the efferent fibers of the vagus nerve, the manifestations of the vagal stimulation. The presence of a nasogastric reflex may warrant considerations as diseases of nose and paranasal sinuses may be the cause upper gastrointestinal symptmatology.