full-thickness

全厚度
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    囊性纤维化(CF)患者经历严重的肺部疾病,包括持续性感染,炎症,和气道的不可逆纤维化重塑。尽管使用跨膜传导调节剂(CFTR)蛋白调节剂的治疗在CFTR挽救方面达到最佳效果,肺移植仍然是CF晚期患者的最佳治疗方法。的确,慢性炎症和组织重塑仍然是治疗过程中的绊脚石,和潜在的机制仍不清楚。如今,动物模型不能完全复制人类疾病的临床特征,并且常规体外模型缺乏经历纤维化重塑的基质区室。为了解决这个差距,我们显示了CF的3D全厚度模型的开发,该模型具有在结缔组织上分化的人支气管上皮。我们证明,上皮细胞不仅经历了粘膜纤毛分化,而且在结缔组织中迁移并形成腺样结构。结缔组织的存在刺激了上皮的促炎行为,它激活了嵌入到自己的细胞外基质(ECM)中的成纤维细胞。通过改变CF上皮细胞和CF或健康结缔组织的模型组成,有可能复制CF疾病的不同时刻,如在不同条件下CF上皮转录组的差异所证明的。通过全厚度模型忠实地表示CF中上皮和结缔组织之间的串扰的可能性,伴随着炎症和基质激活,使模型适合更好地理解疾病发生的机制,programming,和对治疗的反应。
    Patients with cystic fibrosis (CF) experience severe lung disease, including persistent infections, inflammation, and irreversible fibrotic remodeling of the airways. Although therapy with transmembrane conductance regulator (CFTR) protein modulators reached optimal results in terms of CFTR rescue, lung transplant remains the best line of care for patients in an advanced stage of CF. Indeed, chronic inflammation and tissue remodeling still represent stumbling blocks during treatment, and underlying mechanisms are still unclear. Nowadays, animal models are not able to fully replicate clinical features of the human disease and the conventional in vitro models lack a stromal compartment undergoing fibrotic remodeling. To address this gap, we show the development of a 3D full-thickness model of CF with a human bronchial epithelium differentiated on a connective airway tissue. We demonstrated that the epithelial cells not only underwent mucociliary differentiation but also migrated in the connective tissue and formed gland-like structures. The presence of the connective tissue stimulated the pro-inflammatory behaviour of the epithelium, which activated the fibroblasts embedded into their own extracellular matrix (ECM). By varying the composition of the model with CF epithelial cells and a CF or healthy connective tissue, it was possible to replicate different moments of CF disease, as demonstrated by the differences in the transcriptome of the CF epithelium in the different conditions. The possibility to faithfully represent the crosstalk between epithelial and connective in CF through the full thickness model, along with inflammation and stromal activation, makes the model suitable to better understand mechanisms of disease genesis, progression, and response to therapy.
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  • 文章类型: Journal Article
    背景:改良的Meek技术在马伤口处理中并不常用,尽管与其他嫁接技术相比具有一致的可靠和优越的结果。主要缺点是需要专业化,昂贵的设备和全身麻醉。
    目的:描述改进的Meek技术的调整,使其能够在不需要完整设备的情况下用于站立马。这意味着使用从胸区手动收获的全厚度皮肤移植物并手动切成微型移植物。移植物接受;愈合进展;最终的功能和美容结果是结果参数。
    方法:描述性案例系列。
    方法:八匹马背部有外伤,治愈第二种意图,被治疗。根据数码照片后处理和接受百分比确定原始伤口面积和移植物接受和排斥面积,计算伤口收缩和上皮化。
    结果:初始平均创伤面积为55.4cm2。移植物接受率为95.3±2.5%。伤口闭合是由于46.0±25.6%的伤口收缩和54.0±25.6%的上皮化,并导致移植后28.0±8.5天的初始伤口面积减少96.8±1.9%。伤疤是平的,灵活和功能,通常有稀疏和规则的头发生长。适应的程序快速有效,具有增加的手动工作的学习曲线。
    结论:小研究人群。
    结论:这种经过调整的改进的Meek技术可以成功地在站立的马匹上进行,并且消除了对全部昂贵设备和全身麻醉的需要。全厚度移植物的接受度极好,导致快速和令人满意的愈合。
    BACKGROUND: The modified Meek technique is not commonly used in equine wound management, despite the consistent reliable and superior results compared with other grafting techniques. Major drawbacks are the need for specialised, expensive equipment and general anaesthesia.
    OBJECTIVE: To describe adjustments of the modified Meek technique enabling use in the standing horse without the need for the full equipment. This implied the use of full-thickness skin grafts manually harvested from the pectoral area and manually cut into micrografts. Graft acceptance; healing progress; and final functional and cosmetic result were outcome parameters.
    METHODS: Descriptive case series.
    METHODS: Eight horses with traumatic wounds at the dorsal side of the carpus or tarsus, healing by second intention, were treated. Original wound areas and areas of graft acceptance and rejection were determined from post-processing of digital photographs and percentage acceptance, wound contraction and epithelialisation were calculated.
    RESULTS: The initial mean wound area was 55.4 cm2 . Graft acceptance was 95.3 ± 2.5%. Wound closure was due to 46.0 ± 25.6% wound contraction and 54.0 ± 25.6% epithelialisation and resulted in 96.8 ± 1.9% reduction of the initial wound area 28.0 ± 8.5 days after grafting. The scar was flat, flexible and functional, usually with thin and regular hair growth. The adapted procedure was fast and efficient, with a learning curve for the increased manual work.
    CONCLUSIONS: Small study population.
    CONCLUSIONS: This adapted modified Meek technique can successfully be performed in the standing horse and obviates the need for the full expensive equipment and general anaesthesia. The acceptance of the full-thickness grafts is excellent resulting in fast and satisfactory healing.
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  • 文章类型: Journal Article
    这项工作回顾了有关特发性全厚度黄斑裂孔(FTMHs)自发闭合的文献。
    通过OvidMEDLINE对自发性特发性FTMH关闭患者的文献进行了综述,EMBASE,和PubMed至2020年7月16日。共纳入66篇已确定的文章中的27篇。
    共有68只眼自发闭合。在患者中,62.7%为女性,平均年龄为67.5岁。视敏度从Snellen20/78提高到闭合后的20/33。平均孔径为176.8μm;最大孔径为350μm。大多数是根据Gass的第2阶段,而根据国际玻璃体牵引研究组(IVTS)的分期,尺寸较小。最近文献中的主要分类系统是IVTS分期。光学相干断层扫描观察到的平均闭合时间为4.5个月。
    关于审查,报告的所有特发性FTMH的自发闭合率范围为3%至15%,并且没有人口统计学子群更有可能封闭。≤250µm的孔的闭合率(22.2%)高于>250至400µm(13.3%)和≥400µm(0%)的孔。闭合与良好的视觉结果相关,和视网膜桥接通过神经胶质细胞可能是关键的关闭。这些决定是基于有限的数字;需要前瞻性研究来进一步确定比率,机制,和特点。IVTS分期提供了可靠的报告,并了解了手术前是否可以观察到FTMH。
    UNASSIGNED: This work reviews the literature regarding spontaneous closure of idiopathic full-thickness macular holes (FTMHs).
    UNASSIGNED: Literature on patients with spontaneous idiopathic FTMH closure was reviewed via Ovid MEDLINE, EMBASE, and PubMed through July 16, 2020. A total of 27 of 66 identified articles were included.
    UNASSIGNED: A total of 68 eyes had spontaneous closure. Of the patients, 62.7% were women and the average age was 67.5 years. Visual acuity improved from Snellen 20/78 to 20/33 post closure. The average hole diameter was 176.8 μm; the largest was 350 μm. Most were stage 2 according to Gass and of small size according to International Vitreomacular Traction Study Group (IVTS) staging. The predominant classification system in recent literature is IVTS staging. The average optical coherence tomography-observed closure time was 4.5 months.
    UNASSIGNED: On review, reported spontaneous closure rates of all idiopathic FTMH range from 3% to 15%, and no demographic subgroups are more likely to have closure. Holes ≤250 µm have higher closure rates (22.2%) than those in the range of >250 to 400 µm (13.3%) and ≥400 µm (0%). Closure is associated with favorable visual outcomes, and retinal bridging via glial cells is likely critical to closure. These determinations were based on limited numbers; prospective studies are needed to further ascertain rate, mechanism, and characteristics. IVTS staging provides reliable reporting and insight into whether FTMH can be observed before surgery.
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  • 文章类型: Journal Article
    传统上,使用1步或2步血管化皮瓣移植组合修复大的先天性眼睑瘤。然而,视觉轴阻塞数周是一个严重的问题,在小的孩子和最近的报道表明,皮瓣蒂不有助于血液灌注。最近在动物和人类中报道了一种“一步”替代大型盖子缺陷的方法,证明了单独的双层自体移植物的可行性。我们提出了一种替代的“一步”重建方法,该方法适用于6个月大的婴儿,该婴儿因先天性结肠缺损而位于中央的上眼睑缺损。从对侧上眼睑收获自由的全厚度双层自体移植物。随访时间为48个月。化妆品和功能效果良好,双层移植物存活下来,没有移植物缺血,坏死,或拒绝。这个男孩患上了马达罗病,盖子开槽,和轻微的轮廓不规则,但不需要再次手术,因为父母对手术结果感到满意。自由的双层眼睑自体移植似乎是重建大型结肠腺瘤性眼睑开口的“常规2步”和“现代1步”选项的出色替代方案,尤其是在不能耐受视轴阻塞的年轻婴儿中。这是一个简单的,实用,快,和有效的技术,也节省了医疗保健成本。
    Large congenital lid colobomas are traditionally repaired using 1- or 2-step vascularized flap-graft combinations. However, visual axis occlusion for weeks is a severe problem in small children and recent reports suggest that the flap pedicle does not contribute to blood perfusion. A \"one-step\" substitute for large lid defects has recently been reported in animals and humans, demonstrating the viability of a bilamellar autograft alone. We present an alternative \"one-step\" reconstructive approach in a 6-month-old infant who had a centrally-located large upper eyelid defect resulting from a congenital coloboma. The free full-thickness bilamellar autograft was harvested from the contralateral upper eyelid. The follow-up time was 48 months. Cosmetic and functional results were good, the bilamellar graft survived, and there was no graft ischemia, necrosis, or rejection. The boy developed madarosis, lid notching, and mild contour irregularity but needed no reoperation since the parent was satisfied with the surgical result. A free bilamellar eyelid autograft seems to be an outstanding alternative to both \"conventional 2-step\" and \"modern 1-step\" options for the reconstruction of large colobomatous eyelid openings, especially in young infants who cannot tolerate visual axis blockage. It is an easy, practical, fast, and effective technique that also saves cost in health care.
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  • 文章类型: Journal Article
    在大全厚度小鼠皮肤再生模型中,伤口诱导的毛发新生(WIHN)发生在伤口中心。这意味着毛发再生的空间调节。对组织再生过程中机械转导的作用知之甚少。这里,我们创造了面积相等但形状不同的伤口,以了解扰动机械力是否会改变从头毛发再生的面积和数量。伤口刚度的原子力显微镜检查显示了整个伤口的刚度梯度,伤口中心比边缘更软。使用FAK或肌球蛋白II抑制剂减少机械转导信号显着增加WIHN,相反,用肌动蛋白稳定剂增强这些信号减少WIHN。这里,α-SMA在FAK抑制剂治疗的伤口中下调并降低伤口硬度。伤口中心上皮细胞相对于伤口边缘细胞表现出球形形态。FAK抑制剂处理的伤口RNAseq数据的差异基因表达分析显示,整合素-,基质相关基因下调,而毛囊新生,细胞增殖,和细胞信号基因上调。免疫组织化学染色显示,FAK抑制增加了再生伤口中心的pSTAT3核染色,暗示毛囊新生的信号增强。这些发现表明,控制伤口硬度可调节组织再生,包括上皮能力,组织图案化,和伤口愈合过程中的再生。
    In the large full-thickness mouse skin regeneration model, wound-induced hair neogenesis (WIHN) occurs in the wound center. This implies a spatial regulation of hair regeneration. The role of mechanotransduction during tissue regeneration is poorly understood. Here, we created wounds with equal area but different shapes to understand if perturbing mechanical forces change the area and quantity of de novo hair regeneration. Atomic force microscopy of wound stiffness demonstrated a stiffness gradient across the wound with the wound center softer than the margin. Reducing mechanotransduction signals using FAK or myosin II inhibitors significantly increased WIHN and, conversely, enhancing these signals with an actin stabilizer reduced WIHN. Here, α-SMA was downregulated in FAK inhibitor-treated wounds and lowered wound stiffness. Wound center epithelial cells exhibited a spherical morphology relative to wound margin cells. Differential gene expression analysis of FAK inhibitor-treated wound RNAseq data showed that cytoskeleton-, integrin-, and matrix-associated genes were downregulated, while hair follicular neogenesis, cell proliferation, and cell signaling genes were upregulated. Immunohistochemistry staining showed that FAK inhibition increased pSTAT3 nuclear staining in the regenerative wound center, implying enhanced signaling for hair follicular neogenesis. These findings suggest that controlling wound stiffness modulates tissue regeneration encompassing epithelial competence, tissue patterning, and regeneration during wound healing.
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  • 文章类型: Journal Article
    背景:全厚度肩袖撕裂(FTRCT)是一种常见的肩关节损伤,如果不治疗,可以在尺寸上进步,变得越来越痛苦,和抑制功能。这些病变通常通过手术修复,对于较大的眼泪,通常首选双排关节镜修复。已经开发了生物增强技术,以提高术后影像学再撕裂率,并增强FTRCT手术修复后患者报告的结果。这项研究试图证实,生物诱导性牛胶原蛋白植入物的增强修复可带来良好的再撕裂率和患者预后,随访2年。
    方法:进行了一项前瞻性多中心队列研究,以确定使用生物诱导性牛胶原蛋白植入物增强FTRCT单排或双排关节镜修复的有效性和安全性。在115名成年患者中,66(57.4%)具有中等(1-3cm)的撕裂,49(42.6%)具有大(3-5cm)的撕裂。进行磁共振成像和患者报告的结果(肩肘外科[ASES]肩关节评分和Constant-Murley评分[CMS]),并在基线记录,3个月,1年,和2年。
    结果:平均随访时间为2.1年(范围,1.5-2.9年)。在基线和2年随访之间,对于中等撕裂,冈上肌腱的平均总厚度增加了12.5%,对于大撕裂,增加了17.1%。在7/61可用的中等撕裂患者(11.5%)中发现了X线照相再撕裂,14/40患者(35.0%)伴有大泪液。在这两组中,这些眼泪主要发生在3个月随访前(13/21[61.9%]).采用补充的双排(DR)修复技术的射线照相再撕裂总体为13.2%(12/91DR患者;中等撕裂为11.3%,大撕裂为15.8%)。对于ASES和CMS,>90%的具有中等和大泪液的患者实现了最小的临床重要差异(MCID)。治疗外科医生将2例严重不良事件分类为可能与装置和/或手术有关(1例肿胀/引流和1例间歇性疼痛)。9例患者(7.8%;4例中等撕裂和5例大撕裂)需要再次手术索引肩袖手术。
    结论:本研究的最后2年数据证实,在关节镜下双排FTRT修复中使用该植入物可提供良好的影像学再撕裂率和实质性功能恢复。还进一步支持了装置的相对安全性。
    BACKGROUND: Full-thickness rotator cuff tears (FTRCTs) represent a common shoulder injury that, if untreated, can progress in size, become increasingly painful, and inhibit function. These lesions are often surgically repaired, with double-row arthroscopic repair often preferred for larger tears. Biological augmentation technologies have been developed to improve rates of postoperative radiographic re-tear and enhance patient-reported outcomes after surgical FTRCT repair. This study sought to confirm that augmented repair with a bioinductive bovine collagen implant results in favorable re-tear rates and patient outcomes with follow-up to 2 years.
    METHODS: A prospective multicenter cohort study was undertaken to determine the efficacy and safety of augmenting single- or double-row arthroscopic repair of FTRCTs with a bioinductive bovine collagen implant. Of 115 adult patients participating, 66 (57.4%) had medium (1-3 cm) tears and 49 (42.6%) had large (3-5 cm) tears. Magnetic resonance imaging and patient-reported outcomes (Shoulder and Elbow Surgeons [ASES] Shoulder Score and Constant-Murley Score [CMS]) were performed and recorded at baseline, 3 months, 1 year, and 2 years.
    RESULTS: Mean duration of follow-up was 2.1 years (range, 1.5-2.9 years). Between baseline and 2-year follow-up, mean total thickness of the supraspinatus tendon increased by 12.5% for medium tears and by 17.1% for large tears. Radiographic re-tear was noted in 7/61 available patients (11.5%) with medium tears, and in 14/40 patients (35.0%) with large tears. In both groups, these tears primarily occurred before the 3-month follow-up visit (13/21 [61.9%]). Radiographic re-tear with the supplemented double-row (DR) repair technique was 13.2% overall (12/91 DR patients; 11.3% for medium tears and 15.8% for large tears). The minimal clinically important difference (MCID) was achieved by >90% of patients with both medium and large tears for both ASES and CMS. There were 2 serious adverse events classified by the treating surgeon as being possibly related to the device and/or procedure (1 case of swelling/drainage and 1 case of intermittent pain). Nine patients (7.8%; 4 medium tears and 5 large tears) required reoperation of the index rotator cuff surgery.
    CONCLUSIONS: Final 2-year data from this study confirm that using this implant in augmentation of arthroscopic double-row repair of FTRCTs provides favorable rates of radiographic re-tear and substantial functional recovery. The relative safety of the device is also further supported.
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  • 文章类型: Journal Article
    在治疗性候选药物的评价中,存在开发生理学相关体外皮肤模型以减少或替代动物试验的全球趋势。然而,只有商业重建的人表皮模型(RHEm)经过正式验证。尽管这些商业模型适用于广泛的应用,它们很昂贵,缺乏灵活性,用于生成它们的协议并不透明。在这项研究中,我们提出了一个开源的全厚度皮肤模型(FTSm),并评估了其用于药物测试的潜力.FTSm是使用内源性细胞外基质重建真皮隔室而开发的,避免动物衍生的水凝胶。并行评估了基于开源协议的RHEm。通过用洗涤剂挑战表面并测量细胞活力以及通过跨上皮电阻(TEER)测量来分析皮肤屏障的完整性。根据OECD指南进行皮肤刺激研究,并通过TEER测量评估对皮肤屏障的影响。使用Franz扩散池和无限剂量方法比较了染料通过开发的模型和商业膜(Strat-M®)的渗透。FTSm表现出与天然人皮肤相当的结构和屏障性质。尽管RHEm在药物测试中表现出更好的性能,与文献报道的商业模型相比,FTSm具有更好的阻隔性能。这些皮肤模型可以为加速动物试验替代品的开发和传播做出有价值的贡献。避免商业模式的局限性。
    There is a global trend towards the development of physiologically relevant in vitro skin models to reduce or replace animal testing in the evaluation of therapeutic drug candidates. However, only commercial reconstructed human epidermis models (RHEm) have undergone formal validation. Although these commercial models are suitable for a wide range of applications, they are costly, lack flexibility, and the protocols used to generate them are not transparent. In this study, we present an open-source full-thickness skin model (FTSm) and assess its potential for drug testing. The FTSm was developed using endogenous extracellular matrix to recreate the dermal compartment, avoiding animal-derived hydrogels. An RHEm based on an open-source protocol was evaluated in parallel. The integrity of the skin barrier was analyzed by challenging the surface with detergents and measuring cell viability as well as by trans-epithelial electrical resistance (TEER) measurements. Skin irritation studies were performed based on OECD guidelines and complemented with an evaluation of the impact on the skin barrier by TEER measurement. The permeation of a dye through the developed models and a commercial membrane (Strat-M®) was compared using Franz diffusion cells and an infinite dose approach. The FTSm demonstrated structural and barrier properties comparable to native human skin. Although the RHEm showed a better performance in drug testing, the FTSm presented better barrier properties than commercial models as reported in the literature. These skin models can be a valuable contribution to accelerating the development and dissemination of alternatives to animal testing, avoiding the limitations of commercial models.
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  • 文章类型: Case Reports
    历史上,鼻子穿孔被认为是优雅的象征,有时也与地区仪式有关。在现代文明中,戴鼻环的趋势一直在减少,有些人要求关闭。在这里,我们报告了一个病例系列,其中3例患者成功进行了全层植皮以闭合鼻孔。
    Historically, nose piercing was considered as the symbol of elegance and sometimes also associated with regional ritual. In modern civilization, there has been a decreasing trend to wear nose rings and some people demand for its closure. Herein, we report a case series of three patients who were successfully managed with full-thickness skin grafting for the closure of nose piercing site.
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  • 文章类型: Journal Article
    背景:评估在实验动物(兔子)中使用同种异体冷冻干燥PRP进行全层伤口愈合过程。
    方法:本研究是一项仅使用后测设计的实验研究,一个简单的随机设计。将30只家兔随机分为6组(3个对照组和3个治疗组),每组由5名受试者组成。在每只兔子的背部进行皮肤厚的切割。对照组的伤口使用石蜡纱布治疗,治疗组给予同种异体冻干PRP;3日进行观察,9th,第14天采用两个随机样本的t检验和Mann-Whitney处理数据。结果在p<0.05时是显著的。
    结果:在第3天,对照组和治疗组的成纤维细胞平均数量存在显着差异(p=0.009),第9天(p=0.023),和第14天(p<0.001)。在第3天,对照组和治疗组之间的平均新生血管形成量也存在重大差异(p=0.034)。第9天(p<0.001),和第14天(p<0.001)。
    结论:证实应用同种异体冻干PRP能够增加兔全层创面愈合过程中的成纤维细胞数量和新生血管形成。
    BACKGROUND: To evaluate the use of allogenic freeze-dry PRP for the full-thickness wound healing process in experimental animals (rabbits).
    METHODS: This study is an experimental research using the posttest-only design, a simple randomized design. Thirty rabbits were randomly divided into six groups (three control groups and three treatment groups), and each group consisted of five subjects. Skin-thick cuts were made on the back of each rabbit. Wounds in the control group were treated using a paraffin gauze, and allogenic freeze-dried PRP was given to the treatment group; observations were made on the 3rd, 9th, and 14th days. The t-test on two random samples and Mann-Whitney were used to process data. The results were significant at p < 0.05.
    RESULTS: There were significant differences in the average number of fibroblasts the control groups and the treatment groups on day 3 (p = 0.009), day 9 (p = 0.023), and day 14 (p < 0.001). There were also major differences in the average amount of neovascularization between the control group and the treatment group on day 3 (p = 0.034), day 9 (p < 0.001), and day 14 (p < 0.001).
    CONCLUSIONS: The application of allogenic freeze-dried PRP was confirmed to be able to increase the number of fibroblasts and neovascularization in the full-thickness wound healing process in rabbits.
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