Prognostic implication of NOTCH1 in early stage oral squamous cell cancer with occult metastases

Abstract

Objective

The objective of this study was to explore the prognostic value of cancer stem cell markers, namely CD133, NANOG, and NOTCH1, in early stage oral squamous cell carcinoma (OSCC).

Materials and methods

One hundred forty-four patients with early stage (cT1T2N0) OSCC were identified from a pre-existing database of patients with oral cancer. We examined the impact of the immunohistochemical expression of CD133, NANOG, and NOTCH1 in OSCC. Overall survival (OS) curves were calculated using the Kaplan–Meier method. Predictors of outcome were identified using multivariate analysis.

Results

We found that CD133, NANOG, and NOTCH1 were significantly associated with lymph node metastasis, and NOTCH1 was also significantly associated with depth of invasion and locoregional recurrence.

Conclusions

NOTCH1 was identified as an independent prognostic factor for OS.

Clinical relevance

NOTCH1 might prove to be a useful indicator for high-risk patients with occult metastases from early stage OSCC.

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Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement

Abstract

Background

Guidelines discourage the use of systemic corticosteroids for atopic dermatitis but their use remains widespread.

Objective

To reach consensus among an international group of atopic dermatitis experts on the use of systemic corticosteroids for atopic dermatitis.

Methods

A survey consisting of statements accompanied by visual analog scales ranging from "strongly disagree" to "neutral" to "strongly agree" was distributed to the International Eczema Council (IEC). Consensus was reached in agreement on a statement if <30% of respondents marked to the left of "neutral" towards "strongly disagree."

Results

Sixty of 77 (79%) IEC members participated. Consensus was reached on 12 statements, including that systemic corticosteroids should generally be avoided but can be used rarely for severe atopic dermatitis under certain circumstances, including a lack of other treatment options, as a bridge to other systemic therapies or phototherapy, during acute flares in need of immediate relief, in anticipation of a major life event or in the most severe cases. If used, treatment should be limited to short-term. Most respondents agreed that systemic corticosteroids should never be used in children, but consensus was not reached on that statement. The conclusions of our expert group are limited by a dearth of high-quality published evidence. If more stringent consensus criteria were applied (e.g., requiring <20% of respondents marking towards "strongly disagree," consensus would have been reached on fewer statements.

Conclusions

Based on expert opinion from the IEC, routine use of systemic corticosteroids for atopic dermatitis is generally discouraged and should be reserved for special circumstances.

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Laser Nd:YAG to treat primary pilonidal cysts: an alternative treatment

Abstract

A pilonidal cyst is an acquired inflammatory disease that affects young adults. Many treatments have been described, although no clear consensus has been reported. At present, surgical intervention is the first line of treatment. The main problem after treatment is the high recurrence of the pilonidal sinus (PNS).

We treated six patients with clinical PNS in the natal cleft (with different time of evolution) and 1.5 cm diameter approximately with Nd:YAG (1064nm). It took 3-4 treatments to resolve the sinus. It is important to remove the residual hairs into the cyst. All of our patients healed. Six lesions were eradicated, and no symptoms were described after the treatment. The mean follow-up period was 52 months (12 to 100 months) without any recurrences.

The early management of pilonidal cysts, with Nd:YAG (1064nm) could be an interesting way of treatment versus conventional surgery, because it causes few side effects and the clinical and aesthetic results are optimal.

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Sunburn and ambient temperature

Abstract

On days during the summer months when high temperatures are expected, weather forecasters frequently warn about the dangers of UV and high UV indices. It is not surprising, therefore, that it is a common belief that high ambient air temperatures are a major risk factor for burning. Although the UV index is generally higher on cloudless, hot days compared with cloudy, cool days, reliance should not be placed on ambient temperature alone as a guide to the need for sun protection.

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Acquired erythropoietic uroporphyria secondary to myelodysplastic syndrome with chromosome 3 alterations. A case report

Abstract

Congenital erythropoietic porphyria (CEP) is a rare, autosomal recessive disease caused by a deficiency of uroporphyrinogen III synthase (UROS), due to mutations in the UROS gene in chromosome 10. On occasion, patients show a mild late-onset disease, without germline UROS mutations, associated with hematologic malignancies. We report a 65-year-old patient with photosensitivity, porphyrins overexcretion and thrombocytopenia. Bone marrow analysis gave a diagnosis of myelodysplastic syndrome (MDS) with the presence of a derivative chromosome 3, possible due to an inversion including 3q21 and 3q26 breakpoints. After allogeneic stem cell transplantation a complete remission of MDS and uroporphyria was achieved. To our knowledge, this is the first reported case of acquired erythropoietic uroporphyria associated with MDS, with chromosome 3 alterations.

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Minimally-invasive and targeted therapeutic cell delivery to the skin using microneedle devices

Summary

Background

Translation of cell therapies to the clinic is accompanied by numerous challenges, including controlled and targeted delivery of the cells to their site of action, without compromising cell viability and functionality.

Objectives

To explore the use of hollow microneedle devices (to date only used for the delivery of drugs and vaccines into the skin and for the extraction of biological fluids) to deliver cells into skin in a minimally-invasive, user-friendly and targeted fashion.

Methods

Melanocyte, keratinocyte and mixed epidermal cell suspensions were passed through various types of microneedles and subsequently delivered into the skin.

Results

Cell viability and functionality is maintained after injection through hollow microneedles with a bore size ≥75 μm. Healthy cells are delivered into skin at clinically relevant depths.

Conclusions

Hollow microneedles provide an innovative and minimally-invasive method for delivering functional cells into the skin. Microneedle cell delivery represents a potential new treatment option for cell therapy approaches including skin re-pigmentation, wound repair, scar and burn remodelling, immune therapies, and cancer vaccines.

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Oral mucosa is a useful substrate for detecting autoantibodies of mucous membrane pemphigoid

Abstract

Mucous membrane pemphigoid (MMP) is a rare autoimmune blistering disease targeting various autoantigens, including the C-terminus of collagen XVII (COL17) and laminin332. Bullous pemphigoid (BP) is the most common autoimmune blistering disease, affecting the mucosae in 10-20% of cases. COL17, particularly, the non-collagenous (NC)16A domain is the pathogenic epitope for BP.

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