Combination Of Other Modalities Research Articles

Effects of Stem Cell Therapy on Keloid Treatment: A Literature Review

Fibroblasts that produce excess collagen and growth factors play a role in the pathogenesis of keloid formation. In general, keloids are treated with intralesional corticosteroids alone or with a combination of other modalities, but the recurrence rate is still relatively high, so alternative treatments such as stem cells are being investigated, one of which is Mesenchymal Stem Cells (MSC), which have proven to be useful in healing keloids. Therefore, this literature review aims to discuss the effects of stem cell therapy in the treatment of keloids. In this literature review, 36 journals were used that discussed stem cell therapy in the treatment of keloids taken from various journal sources, namely Google Scholar, Pubmed, Medline, Ebsco, Hindawi, and Cochrane which were published within the last 10 years. According to the source, MSC is divided into 2 types, namely Adipose Mesenchymal Stem Cells (AMSC) and Bone Marrow Mesenchymal Stem Cells (BMMSC). In several studies, AMSC is known to reduce the expression of TGF-β1, COL-1, and COL-2 proteins, and has been shown to inhibit the proliferation of fibroblasts in keloid patients. Whereas in the BMMSC study that was applied with Hydroxybutyl chitosan (HBC) and Arg-Gly-Asp (RGD) hydrogels for 7 days, it was shown to significantly reduce nodular collagen fibers (p<0.05). Keloids occur due to excessive production of collagen and are influenced by various factors such as age, gender, skin color, and genetics. Stem cell therapy, such as MSC, has been proven in various studies to be an alternative treatment for keloids

Topical application of mitomycin C as an adjunct in treating subglottic stenosis

Topical application of mitomycin C is best used as an adjunct in airway surgeries together with combination of other modalities of endoscopic techniques such as excision, balloon dilatation and laser treatment in treating subglottic stenosis. We present a case of a 12-year-old boy who acquired Cotton–Myer grade 3 subglottic stenosis 6 months post endotracheal intubation. The stenotic segment was treated with cautery-assisted excision followed by balloon dilatation and topical application of mitomycin C at the raw area. The patient recovered well with improvement of airway diameter, no more symptoms, no more events of restenosis and without the need for multiple procedures.

A Retrospective Analysis of the Treatment of Melasma Using a Fractional Long-Pulsed Alexandrite Laser in Korean Patients.

Long-pulsed, 755-nm, alexandrite lasers have been shown to be effective and safe in the treatment of pigmentary lesions. Clinical outcomes and side effects in the treatment of melasma using a fractional, long-pulsed, alexandrite laser were assessed. Forty-eight patients with melasma received 2 to 4 treatment sessions of fractional, long-pulsed, alexandrite laser at 2 to 3 weeks intervals. The parameter of treatment was 60 to 80 J/cm without dynamic cooling device using 15-mm spot size of fractional hand piece, with a 0.5- to 1-millisecond pulse width. The mean modified melasma area and severity index score decreased significantly 2 months after the final treatment compared with baseline (16.5 ± 8.2 vs 11.5 ± 7.0; p = .002). The patients with epidermal type melasma were more effective compared to dermal type (p < .001). Long-pulsed alexandrite lasers using a fractional hand piece are moderately effective in the treatment of melasma with low risk of adverse effects, and it is suggested that fractional, long-pulsed, alexandrite laser with combination of other modalities can be an additional therapeutic option in patients with melasma.

Imaging Algorithm for Discitis, Epidural, and Paraspinal Infection

This article discusses imaging algorithms in early diagnosis of vertebral osteomyelitis-discitis, which, given its often vague clinical presentation, poses a diagnostic challenge. Magnetic resonance imaging, given its high sensitivity and specificity and capability to deliver exquisite anatomic details, plays a crucial role in its early diagnosis. A high accuracy can also be achieved by using a combination of other modalities, including a variety of nuclear medicine studies, which is especially important in patients who cannot tolerate magnetic resonance imaging. Computed tomography-guided biopsy is being increasingly recognized as a valuable tool in diagnostic work-up of vertebral osteomyelitis-discitis.

Recent advances in the prevention and treatment of skin cancer using photodynamic therapy

Photodynamic therapy (PDT) is a noninvasive procedure that involves a photosensitizing drug and its subsequent activation by light to produce reactive oxygen species that specifically destroy target cells. Recently, PDT has been widely used in treating non-melanoma skin malignancies, the most common cancer in the USA, with superior cosmetic outcomes compared with conventional therapies. The topical ‘photosensitizers’ commonly used are 5-aminolevulinic acid (ALA) and its esterified derivative methyl 5-aminolevulinate, which are precursors of the endogenous photosensitizer protoporphyrin IX. After treatment with ALA or methyl 5-aminolevulinate, protoporphyrin IX preferentially accumulates in the lesion area of various skin diseases, which allows not only PDT treatment but also fluorescence diagnosis with ALA-induced porphyrins. Susceptible lesions include various forms of non-melanoma skin cancer such as actinic keratosis, basal cell carcinoma and squamous cell carcinoma. The most recent and promising developments in PDT include the discovery of new photosensitizers, the exploitation of new drug delivery systems and the combination of other modalities, which will all contribute to increasing PDT therapeutic efficacy and improving outcome. This article summarizes the main principles of PDT and its current clinical use in the management of non-melanoma skin cancers, as well as recent developments and possible future research directions.

Optimal skin prick wheal size for diagnosis of cat allergy

The skin prick test is the diagnostic procedure of choice for determination of immediate hypersensitivity. A wheal diameter of 3 mm or larger is generally accepted as the cutoff for a positive test result, although the validity of this assumption has not been rigorously demonstrated. To determine the skin prick wheal size that best identifies clinical allergy to cat. Forty-five patients referred for evaluation of rhinoconjunctivitis underwent determination of atopic status by skin testing using the Greer Dermapik device and a combination of other modalities, including history, in vitro determination of specific IgE level, and nasal challenge with standardized cat pelt extract. Parameters evaluated before and after nasal challenge included symptom score and nasal lavage tryptase and prostaglandin D (PGD2) levels. The widely accepted 3-mm wheal for a positive skin test result to cat is highly sensitive but only moderately specific for diagnosis of cat allergy as evaluated by history, specific IgE level, postchallenge symptom score, and tryptase and PGD2 levels. Optimal cutoffs for a positive skin test result to cat based on receiver operating characteristic analysis and 95% positive predictive value were 5.5 mm or greater for each of these parameters. When a true-positive result for cat allergy was defined as a combination of positive history, specific IgE level, postchallenge symptom score, and tryptase and PGD2 levels and a true-negative result as all of these parameters being negative, a 6-mm cutoff was able to distinguish cat allergic from cat nonallergic individuals. In a potentially allergic population undergoing skin prick testing with the Greer Dermapik using standardized extracts, a 3-mm skin prick wheal will overestimate the presence of cat allergy. A 6-mm wheal appears to distinguish those individuals who are cat allergic from those who are not.

Aggressive Fibromatosis, Aetiology, Diagnosis and Treatment

*@ Summary Aggressive fibromatosisrepresents (AF) a semimalignant tumour which has a locally destructive and invasive growth tendency but does not metastasize because of its high recurrence rate, the tumour remains a surgical problem. AF is rare group of fibroproletlative tumour started initially as painful masses developing slowly affecting mainly the limbs, neck, trunk, and the abdomen in that order. The disease process of (AF) regardless of the site of presentation, sex, or the age of the patient, endocrine, genetic and physical factors seem to play an important role in the development of the disease. Recent innovation in the field of molucular biology showed the abnormalities in (AF) is at the level of chromosomes in the form of gene mutation and chromosomal anomalies. Other studies showed that the pathogenesis of (AF) is related or modulates by hormone. Physical trauma seemed to have role in the development of the tumour. Whether (AF) is benign or malignant tumour is still in the field of theories. Many investigators put this type of tumour in the category of malignant lesion even in the absence of distal metastasis. The modalities of treatment of (AF) is widely different but surgery makes the major bulk, provided there is a good preoperative demonstration of the lesion by contrast solution and MR imaging, in the recurrent types of (AF) the combination of other modalities of treatment, radiotherapy, chemotherapy, cytotoxic and noncytotocix with and without surgery could be the most appropriate way of management. In this paper the character, pathogenesis, development method of detecting and the different modalities of treatment have been reviewed from literature.