Cm2 Of Skin Research Articles

Comparison of Two Human Skin Cell Isolation Protocols and Their Influence on Keratinocyte and Fibroblast Culture.

For the development of advanced therapies, the use of primary cells instead of cell lines is preferred. The manufacture of human tissue-engineered skin substitutes requires efficient isolation and culture protocols allowing a massive expansion of the cells in culture from an initial specimen of a minimal size. This study compared two skin cell isolation protocols, routinely applied in two clinical laboratories. Epithelial (keratinocytes) and dermal (fibroblasts) cells were isolated and cultured from three human skin biopsies (N = 3). The two-step digestion protocol (LOEX-Protocol) firstly used thermolysin to enzymatically disrupt the dermal-epidermal junction while, for the one-step digestion protocol (UPCIT-Protocol), mechanical detachment with scissors was applied. Then, the epidermal and dermal layers were digested, respectively, to achieve cell isolation. The cell size, viability, yield and growth were analyzed over five passages (P). The colony-forming efficiency (CFE) and Keratin 19 (K19) expression of epithelial cells were also assessed after P0 and P1. Regarding the dermal cells, no significant differences were observed in the tested parameters of isolation and culture. However, for the epithelial cells, viability was higher (93% vs. 85%) and the number of cells extracted per cm2 of skin was 3.4 times higher using the LOEX-Protocol compared to the UPCIT-Protocol. No significant difference was observed for any parameter once the keratinocytes were cultured from P1 to P4. The CFE and K19 expression decreased from P0 to P1 in both protocols, probably due to the culture process. This study shows that both protocols enable the efficient isolation of skin dermal and epithelial cells and subsequent culture to produce grafts destined for the treatment of patients.

Isostearic acid is an active component of imiquimod formulations used to induce psoriaform disease models.

Topical imiquimod based creams are indicated as immune stimulants for papillomas and various skin neoplasms. Imiquimod is considered a TLR7 ligand. These creams are also used in research to induce skin inflammation in mice as a model for psoriasis. We observed that this inflammatory response was not strictly imiquimod dependent and we set out to establish which components drive the proinflammatory effects. To this end, we examined the induction response in a BALB/cJRj mouse model, in which 50mg of cream is applied to 2 cm2 of skin (125mg/kg imiquimod-5% W/V, and/or 625mg/kg isostearic acid-25% W/V). Comparing cream formulations containing isostearic acid, imiquimod and the combination, we observed that isostearic acid causes skin inflammation within 2days, whereas imiquimod requires up to 5days for initial signs. Isostearic acid activated an inflammasome response, stimulated release of proinflammatory cytokines and upregulated the IL-23/17 axis. Animals treated with isostearic acid had enlarged livers (+ 40% weight), which was not observed with imiquimod alone. Imiquimod was readily metabolized and cleared from plasma and liver, but was maintained at high levels in the skin throughout the body (200mM at area of application; 200µM in untreated skin). Imiquimod application was associated with splenomegaly, cytokine induction/release and initial body weight loss over 3days. Despite high imiquimod skin levels throughout the animal, inflammation was only apparent in the treated areas and was less severe than in isostearic acid groups. As the concentrations in these areas are well above the 10µM required for TLR7 responses in vitro, there is an implication that skin inflammation following imiquimod is due to effects other than TLR7 agonism (e.g., adenosine receptor agonism). In brain, isostearic caused no major changes in cytokine expression while imiquimod alone sightly stimulated expression of IL-1β and CCL9. However, the combination of both caused brain induction of CCL3, -9, CXCL10, -13, IL-1β and TNFα. The implication of these data is that isostearic acid facilitates the entry of imiquimod or peripherally secreted cytokines into the brain. Our data suggest that psoriaform skin responses in mice are more driven by isostearic acid, than generally reported and that the dose and route used in the model, leads to profound systemic effects, which may complicate the interpretation of drug effects in this model.

The Establishment of a High Standard Skin Bank in Taiwan as a Burn Care Pioneer

Introduction: The establishment of skin banks is especially important in providing crucial cadaveric skin for burn treatments. Although the 2015 Formosa Fun Coast Explosion Disaster resulted in tragic casualties, it raised public awareness of the importance of having a well-functioning skin bank and led to the initiation of a skin bank development project, as well as the establishment of the first high standard skin bank in Taiwan. Methods: We standardized the size of our procured skin to avoid broken or disrupted skin graft, fit properly on a Zimmer Dermacarrier® for mesh expansion, and to be convenient for storage. We also integrated gamma radiation with the glycerol stored skin method for our skin preservation which effectively eradicates all contamination. Results: From 2016 to 2020, 453,100 cm2 of skin were procured from 62 donors and stored in the NTUH skin bank; 254,000 cm2 of which were utilized in the treatment of 75 patients. Between 2016 and 2017, 141 microbiological examinations were administered with six were positive. Since the introduction of gamma radiation, no contamination has been observed hereafter in our examinations. Conclusions: We report the success of establishing a high standard and well-functioning skin bank at NTUH that supply sufficient skin allografts in Taiwan. It is the first interhospital supply of charitable skin allografts across Taiwan. Being humanitarian, our skin bank is passing great love forward.

Comparative evaluation of the application of modern ectoparasiticides

Despite the success achieved in the control of parasitic animal diseases, there are still some issues that need to be scientifically sound. The issue of prevention and treatment of animals affected by ectoparasites is especially relevant. The study aimed to establish and experimentally confirm the effectiveness of innovative ectoparasiticides for dogs and cats for prevention and therapy in parasitic infections. Innovative antiparasitic drugs with the main active ingredient imidacloprid were used in the experiments: ‘MegaStop for dogs’ (drops for external use, spot application), ‘Golden Defence for dogs spot-on’, ‘MegaStop for cats’ (drops for external use, spot application), ‘Golden Defence for cats spot-on’. Following the objectives of the study, we used visual and microscopic methods in accordance with existing practical manuals and current guidelines. According to the results of the research, a stable infection of experimental dogs with fleas was established at the mean intensity of 7.5 ± 2.0 parasite individuals per 10 cm² of animal skin, and otodectosis, sarcoptosis, and notoedrosis were diagnosed separately in some animals. Experimental cats were diagnosed with otodectosis, notoedrosis, sarcoptosis, demodicosis by clinical signs. Parasitism of fleas on the animal bodies was detected, and in one animal heartworm disease was diagnosed. The mean intensity of flea infection in cats ranged from 8 to 12 parasite individuals per 10 cm2 of skin, and the mean intensity of mite infection was 2–3 mites in the field of view of the microscope. High activity of ‘MegaStop for dogs’, ‘Golden Defence for dogs spot-on’, ‘MegaStop for cats’, ‘Golden Defence for cats spot-on’ as agents with a broad spectrum of action against fleas (Ctenocephalides spp.), acariform mites (Otodectes cynotis, Notoedres cati, Sarcoptes sapis), mites of the genus Demodex; heartworm (effective against L3 and L4 larvae of Dirofilaria immitis) has been established

The Scientific and Clinical Case for Reviewing Diagnostic Radiopharmaceutical Extravasation Long-Standing Assumptions.

Background: The patient benefit from a diagnostic nuclear medicine procedure far outweighs the associated radiation risk. This benefit/risk ratio assumes a properly administered radiopharmaceutical. However, a significant diagnostic radiopharmaceutical extravasation can confound the procedure in many ways. We identified three current extravasation hypotheses espoused by medical societies, advisory committees, and hundreds of individual members of the nuclear medicine community: diagnostic extravasations do not cause harm, do not result in high absorbed dose to tissue, and require complex dosimetry methods that are not readily available in nuclear medicine centers. We tested these hypotheses against a framework of current knowledge, recent developments, and original research. We conducted a literature review, searched regulatory databases, examined five clinical cases of extravasated patients, and performed dosimetry on those extravasations to test these globally accepted hypotheses.Results: A literature review found 58 peer-reviewed documents suggesting patient harm. Adverse event/vigilance report database reviews for extravasations were conducted and revealed 38 adverse events which listed diagnostic radiopharmaceutical extravasation as a factor, despite a regulatory exemption for required reporting. In our own case material, assessment of care was evaluated for five extravasated patients who underwent repeat imaging. Findings reflected results of literature review and included mis- or non-identification of lesions, underestimation of Standardized Uptake Values (SUVs) by 19–73%, classification of scans as non-diagnostic, and the need to repeat imaging with the associated additional radiation exposure, inconvenience, or delays in care. Dosimetry was performed for the same five cases of diagnostic radiopharmaceutical extravasation. Absorbed doses to 5 cm3 of tissue were between 1.1 and 8.7 Gy, and shallow dose equivalent for 10 cm2 of skin was as high as 4.2 Sv.Conclusions: Our findings suggest that significant extravasations can or have caused patient harm and can irradiate patients' tissue with doses that exceed medical event reporting limits and deterministic effect thresholds. Therefore, diagnostic radiopharmaceutical injections should be monitored, and dosimetry of extravasated tissue should be performed in certain cases where thresholds are thought to have been exceeded. Process improvement efforts should be implemented to reduce the frequency of extravasation in nuclear medicine.

Prediction of fecundity of livestock by the level of adaptability in the ecological and climatic conditions of the Southern Urals

The article presents the results of studies on the natural resistance of castrated bull calves of Simmental breed in the Southern Urals and half-blood Holstein crossbreeds. The aim of the present study was to determine the adaptability of purebred and cross-breeding animals to a sharply continental climate when keeping them in an open feeding area. Assessment of the body’s response to the influence of negative air temperatures was carried out according to the indicators of the natural resistance of the humoral and cellular parts of the immune system and hair condition – regularity of its shift, length, density and fractional composition. Significant differences in the determined indicators were revealed both depending on the genotype and on the season of the year. Simmentals exceeded their cross-breed peers in hair density from 1 cm2 of skin, weight, and hair length. These differences are most pronounced in winter. Assessment of the humoral link of natural resistance showed significant intergroup differences. Simmental bull calves exceeded cross-breed peers in bactericidal blood activity depending on the season of the year by 1.28–2.87 %, in terms of lysozyme content – by 2.9–7.1 %. Intergroup differences were also revealed in the assessment of cellular factors of natural resistance. In spring, the activity of neutrophils increased in comparison with autumn and winter months in Simmental bull calves 6.4 and 7.3 times. The highest value of the phagocytic index was noted in winter period – 11.4–11.9 %. In summer, it decreases slightly. Intergroup differences in these indicators are slightly expressed.

CHARACTERISTICS OF THE DISTRIBUTION OF DEMODECOSIS OF SHEEP IN SUBSISTANCE FARMINGSOF KABARDINO-BALKARIA

New data were obtained when studying the distribution of sheep demodеcosis in Kabardino-Balkaria. Peculiarities of sheep epizootological were studied from April to November 2018 in household plots. Sheep demodecosis was diagnosed on the basis of epizootological, clinical data and microscopic examination of the contents of demodectic nodules or skin scrapings in which live or dead mites of Demodex ovis were found. A total amount of 210 animals were examined. The prevalence of demodecosis of sheep in Kabardino-Balkaria belongs to epizootic ectoparasites, which manifest themselves with different intensity of invasion. Sheep demodecosis manifests itself enzootic and epizootic with high extensiveness and intensity of invasion with EI – 31,91% and II – 687,67±44,10 spec./100 cm2 of the skin. In the farms of the Baksan, Zolsky and Urvansky districts, the EI of sheep demodecosis was high and amounted to, respectively, 35.71; 28.57; 31.43% with II – 778.4±47.8 spec.; 603.0±40, 4 spec.; 681.6±44, 6 spec. per 100 cm2 of skin. The contamination of sheep with demodicosis in the household farms of the Baksansky district was comparatively more than other areas, due to the long range grazing. In the household farms of Kabardino-Balkaria, sheep demodicosis manifests itself epizootically with high extensiveness and intensity of invasion with EI – 31.91% and II – 687.67±44, 10 spec./100 cm2 of the skin, which requires urgent development of effective measures to prevent invasion.

Subcutaneous spacer injection to reduce skin toxicity in breast brachytherapy: A pilot study on mastectomy specimens

PurposeAccelerated partial breast irradiation is a treatment option for selected patients with early-stage breast cancer. Some accelerated partial breast irradiation techniques lead to skin toxicity with the skin dose as a main risk factor. Biodegradable spacers are effective and safe in prostate brachytherapy to protect the rectum. We hypothesize that a subcutaneous spacer injection reduces the skin dose in breast brachytherapy. Methods and MaterialsUltrasound-guided spacer injections, either hyaluronic acid (HA) or iodined polyethylene glycol (PEG), were performed on fresh mastectomy specimens. Success was defined as a spacer thickness of ≥5 mm in the high-dose skin area. Usability was scored using the system usability scale. Pre and postinjection CT scans were used to generate low-dose-rate seed brachytherapy treatment plans after defining a clinical target volume. Maximum dose to small skin volumes (D0.2cc) and existence of hotspots (isodose ≥90% on 1 cm2 of skin) were calculated as skin toxicity indicators. ResultsWe collected 22 mastectomy specimens; half had HA and half had PEG injection. Intervention success was 100% for HA and 90.9% for PEG (p = NS). Hydrodissection was feasible in 81.8% with HA and 63.6% with PEG. Median system usability scale score was 97.5 for HA and 82.5 for PEG (p < 0.001). Mean D0.2cc was 80.8 Gy without spacer and 53.7 Gy with spacer (p < 0.001). Skin hotspots were present in 40.9% without spacer but none with spacer (p < 0.001). ConclusionsA spacer injection in mastectomy specimens is feasible. An extra 5 mm space is always achieved, thereby potentially reducing the skin dose dramatically in low-dose-rate seed breast brachytherapy.

Hematological Profile of Sheep Experimentally Infested with Bovicola ovis

Changes in some haemotological parameters (erythrocyte count, hematocrit values and leukocyte counts) in animals with lice infestation had been reported previously. In this regards, information on the effect of Bovicola ovis (B. ovis) infestation on hematological values under experimental condition in Ethiopian sheep is not available. A total of 12 animals divided into two groups of six animals each were used in the experiment. Animals in one group were infested with 500 lice (Bovicola ovis) per sheep collected from different donor animals and the other group served as a non-infested control. Each group was observed for a period of eight consecutive weeks. The present findings demonstrated that the mean parasite burden/10 cm2 of skin was 16 in infested group whereas the control group did not have any lice. Packed cell volume was not significantly different between the two groups and values were in the normal range. On the other hand total RBC count was significantly lower for the infested group (P<0.05). Comparison of the leukocyte counts between the two groups indicated that the total count and eosinophil levels were significantly elevated in the infested group (P<0.05). In conclusion, B. ovis infestation results not only skin damage but also causes systemic changes that may significantly alter the physiological and health status of infested animals.

Ingenol Mebutate 0.06% Gel for Field Treatment of Actinic Keratosis on 250 cm2 of Skin on Trunk and Extremities: A Randomized Dose-Finding Trial

Background: Field treatment of actinic keratosis (AK) can eradicate clinical and sub-clinical lesions; treatments for extended skin areas are required.Methods: This randomized, double-blind, vehicle-controlled trial (NCT01998984) evaluated ingenol mebutate (IngMeb) 0.06% gel for AK treatment over extended areas. Adults with 5–20 AK lesions within a 250 cm2 area of skin on the trunk (except chest) or extremities were randomized to: 2 days vehicle, 2 days IngMeb (2D, n=55); 1 day vehicle, 3 days IngMeb (3D, n=59); 4 days IngMeb (4D, n=49); or 4 days vehicle (n=61). Week 8 primary endpoint was complete clearance of AK lesions; secondary endpoints included reduction in AK count and partial clearance. Adverse events (AEs) were recorded and local skin responses (LSRs) assessed. A hierarchical testing scheme, starting with 3D versus vehicle, was used.Results: In total, 224 patients were randomized. At Week 8, for 2D, 3D, 4D, and vehicle groups, complete clearance rates were 12.7%, 5.1%, 26.8%, and 0.0% (3D vs. vehicle, p=0.18); reductions in AK count were 63.0%, 66.8%, 73.6%, and 11.9%, respectively. LSR scores peaked at Day 5 (3D and 4D), and Days 5 and 10 (2D). Application-site pain and pruritus were common AEs. Of 15 neoplasm AEs, 14 were designated keratoacanthomas and one squamous cell carcinoma by central pathological review. The 4D group was closed based on pre-defined criteria.Conclusions: All three regimens were effective at reducing AK count on trunk/extremities. The 4D treatment was not well tolerated. Complete clearance was not significantly different to vehicle.

Extremity doses assessment of nuclear medicine staff involved in 99mTc-radiopharmaceuticals preparation: A multicentre study

Introduction the skin of the hands of the nuclear medicine’s staff involved in preparation and manipulation of unsealed radiopharmaceuticals is the organ at highest risk for irradiation. The dose limit, to be applied to the average of 1 cm2 of skin regardless the surface of the exposed area, is of difficult assessment. The ORAMED project identified the tip of the index of the non-dominant hand as the point of maximum exposure. Due to the high estimated proportion of workers liable to exceed the extremities annual dose limit (15–20%), the fingers dose monitoring is highly recommended especially in busy labs. Purpose To evaluate under routine operating conditions, in 3 nuclear medicine departments, the irradiation dose to the extremities of workers involved in the preparation of 99mTc-radiopharmaceuticals. Materials and methods Two operators for each centre were monitored by using 4 TLD (LiF: Mg, Cu, P) for 2 weeks. For each single task the operational time and the manipulated activities were recorded. Results The mean daily 99mTc activity manipulated was 56 GBq resulting in a mean dose equivalent values of: 38.5, 18.9, 5.4 and 63.7 microSv/GBq for the monitored hand positions: index tip of non-dominant, index base of non-dominant, wrist of non-dominant and index tip of dominant hand respectively. Conclusion Conversely to the ORAMED findings, the index fingertip of the dominant hand receives the highest dose. Based on the daily handled activities, the dose limit could be exceeded in 138 working days, thus confirming the concerns raised by many authors. the skin of the hands of the nuclear medicine’s staff involved in preparation and manipulation of unsealed radiopharmaceuticals is the organ at highest risk for irradiation. The dose limit, to be applied to the average of 1 cm2 of skin regardless the surface of the exposed area, is of difficult assessment. The ORAMED project identified the tip of the index of the non-dominant hand as the point of maximum exposure. Due to the high estimated proportion of workers liable to exceed the extremities annual dose limit (15–20%), the fingers dose monitoring is highly recommended especially in busy labs. To evaluate under routine operating conditions, in 3 nuclear medicine departments, the irradiation dose to the extremities of workers involved in the preparation of 99mTc-radiopharmaceuticals. Two operators for each centre were monitored by using 4 TLD (LiF: Mg, Cu, P) for 2 weeks. For each single task the operational time and the manipulated activities were recorded. The mean daily 99mTc activity manipulated was 56 GBq resulting in a mean dose equivalent values of: 38.5, 18.9, 5.4 and 63.7 microSv/GBq for the monitored hand positions: index tip of non-dominant, index base of non-dominant, wrist of non-dominant and index tip of dominant hand respectively. Conversely to the ORAMED findings, the index fingertip of the dominant hand receives the highest dose. Based on the daily handled activities, the dose limit could be exceeded in 138 working days, thus confirming the concerns raised by many authors.

Oxidative stability of chicken meat during storage influenced by the feeding of alfalfa meal

The aim of our experiment was to determine the effect of the alfalfa meal component in feed mixtures of Ross broiler chickens on oxidative stability of meat. Proportion of alfalfa meal in feed mixtures was 4 and 6%. The results were compared to the control group without alfalfa meal in feed mixtures. At the end of the experiment (day 38), 6 pcs of broiler chickens from each group with an average live body weight over 1 800 g were randomly selected. The samples for chemical analysis consisted of identical proportion of breast and thigh muscle, and about 1 cm2 of skin with subcutaneous fat. Fat from the meat was obtained after the samples drying. A fat was determined by extraction by means of laboratory instrument Det N Gras Selecta P. The oxidative stability of meat on the basis of acid number of fat was determided by chemical analysis. Chicken meat was stored at -18 °C for 12 months and 18 months. The acid number of fat of stored meat for 12 months was 7.38 mg KOH per g in the control group, 7.42 mg KOH per g in the group with a proportion of 4% alfalfa meal, and 11.18 mg KOH per g in the group with proportion 6% alfalfa meal. An acid number of fat of stored meat for 18 months was 5.90 mg KOH per g in the control group, 4.65 mg KOH per g in the group with a proportion of 4% alfalfa meal, and 7.07 mg KOH per g in the group with a proportion of 6% alfalfa meal. Chicken meat is notably sensitive to lipid oxidation because of its high content of polyunsaturated fatty acids. Legislation in Title 5 of Part 3 of the Codex Alimentarius of the Slovak Republic and the Government Regulation No. 286/2003 Coll. in the Annex 4 in Part B provide the requirements for animal fats and meat products. Regulation of the European Parliament and Council (EC) No. 853/2004 lays down specific hygiene rules for food of animal origin. In particular, determination of free fatty acids content of rendered animal fat (tallow, lard, other animal fat). Legislative regulation does not contain requirements for the quality of chicken meat, the acid number of fat of fresh or frozen chicken meat, respectively. A chicken meat is preferred over other kinds of meat. It is characterized by certain dietary and nutritional properties that consumer prefers. A price of this kind of meat remains attractive. In terms of human health, oxidative stability of chicken meat is important, especially of stored meat. In general terms, the various food additives are currently used to maintain the food stability. Great attention is currently paid to additives of natural origin. Similar focus is presented in our study. We can state, on the basis of the oxidative stability results of chicken meat, that natural feed component has its justification. This issue requires further research.

Effects of age on histological parameters of the sweat glands of Nellore cattle

The sweat glands are important in thermoregulation of cattle in a warm environment as they help dissipate heat through evaporation. Studies on gland histology are important to define its secretion potential and the capacity of perspiration and heat removal. The objective of this study was to determine, by histomorphometry, glandular epithelium height, the depth of the gland, length of the glandular portion and number of glands per cm2 of the sweat glands of the three age groups of Nellore cattle. Thirty females were used in this study. They were equally divided into calves, heifers and cows. Histological sections were obtained and analyzed by digital images in Trinocular BX40 Olympus microscope coupled to an Oly - 200 camera, connected to a computer. The images were obtained with microscope with 2x, 4x, 10x and 40x magnification objectives. The measurements were performed using HL Image 97 program. The height of glandular epithelium, depth of the glands, length and density of the glandular portion per cm2 , were all analyzed. The calves showed greater height of the glandular epithelium than heifers (P = 0.0024), and cows (P = 0.0191). The depth of the gland was not influenced by age. Cows had higher length of secretory portion than heifers (P = 0.0379) and calves (P = 0.0077). Heifers had a greater number of sweat glands per cm2 of skin than cows (P = 0.023). In cattle, the height of glandular epithelium and the density decreases as animals get older. On the other hand, the length of the secretor portion increases but with no changes in the depth of the sweat glands

Validity and interexaminer reliability of a new method to quantify skin neurofibromas of neurofibromatosis 1 using paper frames.

BackgroundSkin neurofibromas represent one of the main clinical manifestations of neurofibromatosis 1, and their number varies greatly between individuals. Quantifying their number is an important step in the methodology of many clinical studies, but counting neurofibromas one by one in individuals with thousands of tumors is arduous, time-consuming, and subject to intra and interexaminer variability. We aimed to evaluate the efficacy of a new methodology for skin neurofibromas quantification using paper frames.MethodsThe sample comprised 92 individuals with NF1. Paper frames, with a central square measuring 100 cm2, were placed on the back, abdomen and thigh. Images were taken, transferred to a computer and two independent examiners counted the neurofibromas. The average number of neurofibromas/100 cm2 of skin was obtained from the mean of the three values. The differences in the quantity of neurofibromas counted by two examiners were evaluated with Intraclass correlation coefficient (ICC), paired t-test, Bland-Altman and survival-agreement plots. To evaluate the predictive value of the method in obtaining the total number of neurofibromas, 49 participants also had their tumors counted one by one. Reproducibility was assessed with Pearson’s correlation coefficients and simple linear regression model.ResultsThere was excellent agreement between examiners (ICC range 0.992-0.997) and the total number of skin neurofibromas could be predicted by the adhesive frames technique using a specific formula (P < 0.0001).ConclusionsIn this article we describe a reliable, easy and rapid technique using paper frames to quantify skin neurofibromas that accurately predicts the total number of these tumors in patients with NF1. This method may be a useful tool in clinical practice and clinical research to help achieve an accurate quantitative phenotype of NF1.Electronic supplementary materialThe online version of this article (doi:10.1186/s13023-014-0202-9) contains supplementary material, which is available to authorized users.

Banking and use of glycerol preserved full-thickness skin allograft harvested from body contouring procedures

IntroductionThe use of glycerol preserved skin allograft (GPA) became a main stay in burn treatment. However, harvesting of cadaveric skin is not yet legalized in many countries including Egypt. ObjectivesTo estimate the feasibility of using skin harvested from body contouring procedures as a source of GPA and its clinical efficacy. Patients and methodsSkin harvested from body contouring procedures done in Al-Azhar university hospitals was preserved by glycerolization and used in management of burn and complicated wounds. ResultsIn the period between February 2012 and February 2013 skin was harvested from 24 abdomenoplasty cases, 6 bilateral breast reduction cases, and 1 case of thigh lift done in Al-Azhar university hospitals. This yielded about 22,000cm2 of skin preserved by glycerolization. This GPA was used in 15 excised burn wounds, in 9 cases of chronic burn wounds, and in 6 complicated wounds. Partial graft loss occurred in 3 cases and total graft loss occurred in 1 case. ConclusionThe glycerolized full-thickness skin harvested from body contouring procedures is clinically effective in burn and wound management. In the presence of regional coordination, it can serve as an abundant source for skin banking in where cadaveric skin use is not legalized.

Use of alpha-tocopherol esters for topical vitamin E treatment: evaluation of their skin permeation and metabolism

The aim of this work was to investigate new pro-vitamins based on α-tocopherol (α-Toc) and fatty acids, and to compare their properties with those of α-tocopherol acetate (α-TAc). Skin levels of α-Toc-fatty acid ester conjugates, total α-Toc and endogenous α-Toc were measured in skin samples taken from separate groups of treated and untreated rats. Multiple and extensive treatment with α-Toc oleate and α-TAc was also carried out to assess the skin accumulation and safety of these esters. The in-vivo studies revealed that α-Toc-fatty acid conjugates penetrated into the skin quantitatively while being comparable with the permeation of α-TAc. Differences were found between the levels of total α-Toc and endogenous α-Toc after application of α-TAc, α-Toc oleate, α-Toc linoleate, α-Toc-α linolenate and α-Toc palmitate, indicating that α-Toc conjugates of these fatty acids, but not α-Toc γ-linolenate or α-Toc stearate, were hydrolysed to free α-Toc. In long-term and extensive treatment, α-TAc was found to be lethal to rats treated with 1.15 mg/kg of this agent, which had been spread over 16 cm(2) of skin. Similar treatment with α-Toc oleate did not produce any side effects. This study suggests that α-Toc conjugates with unsaturated fatty acids may be a good alternative as stable vitamin E derivatives, rather than the α-TAc ester.

Skin Cell Proliferation Stimulated by Microneedles

A classical wound may be defined as a disruption of tissue integrity. Wounds, caused by trauma from accidents or surgery, that close via secondary intention rely on the biological phases of healing, i.e., hemostasis, inflammation, proliferation, and remodeling (HIPR). Depending on the wound type and severity, the inflammation phase begins immediately after injury and may last for an average of 7–14 days. Concurrent with the inflammation phase or slightly delayed, cell proliferation is stimulated followed by the activation of the remodeling (maturation) phase. The latter phase can last as long as 1 year or more, and the final healed state is represented by a scar tissue, a cross-linked collagen formation that usually aligns collagen fibers in a single direction. One may assume that skin microneedling that involves the use of dozens or as many as 200 needles that limit penetration to 1.5 mm over 1 cm2 of skin would cause trauma and bleeding followed by the classical HIPR. However, this is not the case or at least the HIPR phases are significantly curtailed and healing never ends in a scar formation. Conversely dermabrasion used in aesthetic medicine for improving skin quality is based on “ablation” (destruction or wounding of superficial skin layers), which requires several weeks for healing that involves formation of new skin layers. Such procedures provoke an acute inflammatory response. We believe that a less intense inflammatory response occurs following microneedle perforation of the skin. However, the mechanism of action of microneedling appears to be different. Here we review the potential mechanisms by which microneedling of the skin facilitates skin repair without scarring after the treatment of superficial burns, acne, hyperpigmentation, and the non-advancing periwound skin surrounding the chronic ulcerations of the integument.

CORRECTION FACTORS APPLIED TO FINGER DOSIMETRY: A THEORETICAL ASSESSMENT OF APPROPRIATE VALUES FOR USE IN HANDLING RADIOPHARMACEUTICALS

United States Nuclear Regulatory Commission (USNRC) regulations limit the dose to the skin to 500 mSv per year. This is also the dose limit recommended by the International Commission on Radiological Protection (ICRP). The operational quantity recommended by ICRP for quantifying dose to the skin is the personal dose equivalent, Hp(0.07) and is identical to NRC's shallow dose equivalent, Hs, also measured at a skin depth of 7 mg cm-2. However, whereas ICRP recommends averaging the dose to the skin over an area of 1 cm regardless of the size of the exposed area of skin, USNRC requires the shallow dose equivalent to be averaged over 10 cm. To monitor dose to the skin of the hands of workers handling radioactive materials and particularly in radiopharmaceutical manufacturing facilities, which is the focus of this work, workers are frequently required to wear finger ring dosimeters. The dosimeters monitor the dose at the location of the sensitive element, but this is not the dose required to show compliance (i.e., the dose averaged over the highest exposed contiguous 10 cm of skin). Therefore, it may be necessary to apply a correction factor that enables estimation of the required skin dose from the dosimeter reading. This work explored the effects of finger ring placement and of the geometry of the radioactive materials being handled by the worker on the relationship between the dosimeter reading and the desired average dose. A mathematical model of the hand was developed for this purpose that is capable of positioning the fingers in any desired grasping configuration, thereby realistically modeling manipulation of any object. The model was then used with the radiation transport code MCNP to calculate the dose distribution on the skin of the hand when handling a variety of radioactive vials and syringes, as well as the dose to the dosimeter element. Correction factors were calculated using the results of these calculations and examined for any patterns that may be useful in establishing an appropriate correction factor for this type of work. It was determined that a correction factor of one applied to the dosimeter reading, with the dosimeter placed at the base of the middle finger, provides an adequate estimate of the required average dose during a monitoring period for most commonly encountered geometries. Different correction factors may be required for exceptional or unusual source geometries and must be considered on a case-by-case basis.

Anti‐adhesive properties of culinary and medicinal plants against Staphylococcus aureus and Pseudomonas aeruginosa in ex vivo porcine skin model

Adhesion and survival of pathogens on skin can lead to serious infection. This is a particularly important in environments with high risk for cross‐infection. Pseudomonas aeruginosa and Staphylococcus aureus are the most common pathogenic bacteria responsible for infections transmitted from skin, especially since antibiotic resistant strains of these bacteria are becoming more prevalent. Non‐bactericidal compounds with anti‐adhesive activity can serve as an alternative to antibiotics and limit antibiotic resistance. Our objective was to screen 31 culinary and medicinal plants (CMP) used in traditional medicine for their anti‐adhesive properties against S. aureus and P. aeruginosa in an ex‐vivo porcine skin model. The low molecular weight fraction (LMWF) and high molecular weight fraction (HMWF) were isolated from CMP using standard protocols. The anti‐adhesive activity was tested on freshly excised porcine ear skin obtained from pigs slaughtered at a local abattoir. 4 cm2 of skin inoculated by spreading with 50 μl of 106cfu/ml of either S. aureus or P. aeruginosa were incubated in the presence and absence of LMWF and HMWF for 1 h and washed. Adherent bacteria were isolated in a stomacher and bacterial count was determined by plate count method. Our results indicate that in general HMWF were more effective in reducing the adhesion of S. aureus or P.aeruginosa. The HMWF from 11 samples proved to be effective against S. aureus, their anti‐adhesive activity ranged between 11‐46%. HMWF from 12 samples were effective against P. aeruginosa and their anti‐adhesive activity ranged between 6‐51%. Several CMP in our study had anti‐adhesive effects; the HMWF from these plants could be used as alternative therapy for preventing S. aureus and P.aeruginosa infections.

SU‐GG‐T‐539: Carbon Fiber Couch Effect On Skin Doses as a Function of Photon Energy

Purpose: To evaluate the dosimetric effect of a carbon fiber couch (CFC) on delivered skin dose as a function of photon energy. Method and Materials: A carbon fiber couch (BrainLab) was incorporated into a commercial TPS (Pinnacle) through auto‐contouring. A retrospective investigation on 2 lung and 2 prostate patient plans was performed. Targets and OARs, together with a skin contour of 0.3 cm thickness in contact with the CFC, were outlined in each plan. For each patient two sets of treatment plans were generated: 1) set of four plans with 4‐, 5‐, 7‐, and 9‐fields, all with 6MV beams, and 2) set of four plans, identical to the first set except that the CFC was intersected by 18MV beams. IMRT optimization was performed for each plan. Both sets of plans for each patient were normalized such that 95% of the PTV was covered by the same dose, escalated to the maximum allowed by the OAR constraints. CFC effect as function of beam energy was tallied by the highest dose to 2 cm2 of skin. The observed skin doses range from 20% to more then 87% of the prescription doses. Results: If 18MV rather than 6MV energies are used in the beams traversing the CFC the skin dose reduction ranges from 12% to more than 45%. An additional sparing for some OARs was also observed for the prostate cases, while the opposite was observed for the lung case. Conclusion: The results indicate that mixed energy 6MV/18MV (18MV for the beams passing through the CFC) IMRT plans would result in a substantial skin sparing of more than 45% compared to IMRT plans with only 6MV beams. The high skin doses in some cases (87% of the prescription) suggest that in hypofractionated SRS/SRT the CFC skin effect needs to be considered.