Face Transplant Surgery Can Improve Speech in Victims of Severe Face Trauma

A new case study out of New York University’s Steinhardt School of Culture, Education, and Human Development suggests that face transplant surgery in patients who have experienced severe facial trauma can improve speech production.

“Our findings provide a window into the complex recovery process following major facial reconstruction and serve as an important foundation from which we can begin to understand how facial transplant can improve speech production preoperatively to postoperatively,” said Maria I. Grigos, the study’s lead author and associate professor of communicative sciences and disorders at NYU Steinhardt.

“Among the many remarkable patterns observed, we found that the patient displayed more flexible control of facial movement as he adapted to the transplanted structures.”

Read the full press release at www.sciencedaily.com

UCI-Led Study Reveals How Blood Cells Help Wounds Heal Scar-Free

The natural scar-free skin repair process relies partially on assistance from circulating blood cells. Results from a study published recently in Nature Communications point the way toward possible treatments for scar-free wound healing that target the body’s own blood cells.

Maksim Plikus, an associate professor in developmental and cell biology at the UCI School of Biological Sciences, and colleagues, led the study, along with George Cotsarelis from University of Pennsylvania.

Skin injuries activate rapid wound repair, which often culminates with the formation of scars. Unlike normal skin, scars are devoid of hair follicles and fat cells, and creating new hair and fat is necessary for regenerating an equivalent of normal skin. In a 2017 paper published in Science, Plikus and colleagues identified that adult mice can naturally regenerate nearly normal-looking skin when new hair follicles and fat cells form in healing wounds.

New fat cells regenerate from myofibroblasts, a type of wound fibroblast that was previously not thought to be capable of converting into other cell types. This discovery brought renewed attention to wound fibroblasts as attractive targets for anti-scarring therapies.

In the recent study, the research team sought to further characterize wound fibroblasts and determine if they’re all the same and equally capable of regenerating new fat cells.

Using a panel of single-cell tools as a type of “computational microscope” that examines thousands of individual cells at once, the research team observed an unexpectedly high degree of fibroblast diversity.

“We saw that wound fibroblasts are surprisingly very diverse and that there are as many as twelve different cell sub-types. We understand their molecular signatures and are beginning to learn about their unique biology. For example, we already know that distinct fibroblast sub-types ‘prefer’ only certain parts of the wound. This suggests that they play specific roles in different locations within the wound, and possibly at different times during the repair process,” said Christian Guerrero-Juarez, a postdoctoral fellow at UCI and first author on the project, in a media release from Newswise.

After a closer look at wound fibroblasts, the team noted that a sizable group of cells had the molecular telltale signs of having originated from blood.

“Molecular profiling of wound fibroblasts strongly suggests that as many as 13% of them at some point in their past were blood cells that converted into collagen-producing fibroblasts, but kept residual blood-specific genes still turned on,” said Plikus.

Indeed, blood cell-derived fibroblasts have been reported by others in the past, including located in wound scars. “What is truly novel about our observation is that these fibroblast-making blood cells, which are called myeloid cells, can reprogram into new fat cells,” Plikus said. “In essence, we observed that for wounds to achieve scar-less regeneration, the body must mobilize multiple cellular resources, which includes remotely circulating blood progenitors.”

Because myeloid cells can be fairly easy to harvest and enrich using existing techniques, the new findings open the exciting possibility that the skin’s healing ability can be enhanced via delivery of regeneration-competent blood-derived progenitors to the site of the wound. As an immediate next step, an information-rich catalog of diverse wound fibroblasts will help form a platform for the team to begin identifying new sub-types of cells that enhance scarring, or promote repair toward scar-less skin regeneration.

[Source(s): University of California Irvine, Newswise]

Is the Monetary Value of Rhinoplasty Associated with Perceived Attractiveness?

What is the monetary value of changes in attractiveness achieved through rhinoplasty, as perceived by society? Researchers posed this question in a study published recently in JAMA Plastic Surgery.

To aid them in answering this question, Researchers performed a cross-sectional survey administered via public online forums to 228 casual observers.

Survey results suggest that there is an association, according to the researchers.

For one standard deviation increase in attractiveness, a rhinoplasty was valued at $6123.75, and for two standard deviations increase in attractiveness, it was valued at $9223.05.

Findings thus suggest contingent valuation, or willingness to pay, to be a well-established economic concept that could be used for the valuation of cosmetic facial procedures.

[Source: MDLinx Otolaryngology]

Treatment Options for Congenital Birthmarks Explored in Study


Combination surgical excision/laser treatment shows better clinical outcomes and patient satisfaction, according to a study published recently in Lasers in Surgery and Medicine, the official journal of the American Society for Laser Medicine and Surgery Inc (ASLMS).

Congenital melanocytic nevi (CMN) are nevi (birthmarks) that present at birth or arise within the first few weeks of life. For small to medium sized CMN, the current treatment of choice is staged surgical excision. Ablative lasers or pigment-specific lasers have also been recommended for lesions difficult for surgical removal or to avoid surgery.

In this study, researchers led by Jung Min Lim, MD, retrospectively analyzed the results of several treatment options for CMN to determine the optimal treatment method, according to a media release from ASLMS.

A total of 119 cases with small to medium sized CMN were retrospectively reviewed. Treatment options were categorized into four groups: (i) Excision only; (ii) Excision followed by scar laser; (iii) Excision followed by pigment specific laser; and (iv) Laser only.

For the treatment of small to medium sized CMN, treatment strategies including surgical methods are cosmetically superior to laser-only treatment. Also, the combination of surgical excision with scar laser has the potential for better clinical outcomes and patient satisfaction, per the release..

“This large-scale retrospective review about treatment options for small to medium congenital melanocytic nevi may give reassurance to clinicians seeking the best option for their patient, as large-scale assessments have never been made in this field,” says Lim, from the Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.

“It strongly supports the efficacy of surgical excision, which showed better cosmetic outcomes, while suggesting the need for improvement in laser-based treatment strategies. This review also promises the potential of combining scar lasers with surgical excision, which showed superior outcomes along with increased patient satisfaction.

“As various tools for treatment are constantly being developed, the comparison of different treatment strategies in a large scale will benefit the clinician in their daily practice,” Lim concludes, in the release.

[Source: American Society for Laser Medicine and Surgery Inc]

Study Links Psoriasis Treatment and Improvement in Heart Artery Disease

Treating psoriasis, a chronic inflammatory skin disease, with biologic drugs that target immune system activity can reduce the early plaque buildup that clogs arteries, restricts blood flow, and leads to heart attacks and stroke, researchers suggest.

The findings highlight how immunotherapies that treat inflammatory conditions might play a role in the reduction of cardiovascular disease risks. The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, appears online in the journal Cardiovascular Research.

“Classically a heart attack is caused by one of five risk factors: diabetes, hypertension, high cholesterol, family history, or smoking,” says Nehal N. Mehta, MD, head of the Lab of Inflammation and Cardiometabolic Diseases at NHLBI, in a media release from National Institutes of Health.

“Our study presents evidence that there is a sixth factor, inflammation; and that it is critical to both the development and the progression of atherosclerosis to heart attack.”

Now researchers provided first in-human evidence that treatment of a known inflammatory condition with biologic therapy, a type of drugs that suppresses the immune system, was associated with a reduction in coronary artery disease, in particular of rupture prone plaque which often leads to a heart attack.

Psoriasis, a common skin disease affecting 3-5 percent of the U.S. population, is associated with heightened systemic inflammation, which elevates risk of blood vessel disease and diabetes. Inflammation occurs when the body’s defensive mechanism kicks in to ward off infection or disease, but this mechanism can turn against itself when triggered, for instance, by excess low-density lipoproteins (LDLs) that seep into the lining of the arteries.

The resulting inflammatory response can cause blood clots, which block arteries and can lead to heart attack and stroke. Inflammation puts 20-30 percent of the U.S. population at risk for these kinds of events. People with inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, and psoriasis have a much higher rate of cardiovascular events.

Those high rates make worse already troubling numbers: More than 15 million Americans, and many more worldwide, suffer from atherosclerotic cardiovascular disease. Heart attack occurs in 750,000 individuals every year in the United States; globally, more than 7 million people had heart attacks in 2015.

The current findings came from an observational study of the NIH Psoriasis Atherosclerosis Cardiometabolic Initiative cohort, which had 290 psoriasis patients, 121 of whom suffered moderate to severe skin disease and qualified for the biologic therapy approved by the U.S. Food and Drug Administration, the release explains.

For a year, researchers followed the eligible patients, all of whom had low cardiovascular risk, and compared them to those who elected not to receive biologic therapy. Study results show that biologic therapy was associated with an 8 percent reduction in coronary artery plaque.

“The findings that intrigued us most were that coronary plaque sub-components changed over one year, including the necrotic core and non-calcified components, which are the culprits for most heart attacks,” Mehta said.

Prior research had linked psoriasis with premature development of high-risk coronary plaque. Now, Mehta’s team has shown beneficial changes in this plaque when psoriasis is treated with biologic therapy – even without changes in other cardiovascular risk factors such as cholesterol, glucose, and blood pressure.

“This appears to be an anti-inflammatory effect. In the absence of improvement in other cardiovascular risk factors, and without adding new cholesterol medications, patients’ soft-plaque still improved. The only change was the severity of their skin disease,” said Mehta.

Researchers say continued research will need to be done to confirm whether this is so, or whether the positive effect is a result of treating the underlying inflammatory disease.

“Our data are observational so the next steps should be randomized, controlled trials,” Mehta concludes.

[Source: National Institutes of Health]

Mandibular Contour Surgery Training System Beneficial

An intraoral mandibular contour surgery (MCS) training system is effective for improving clinical surgery time and accuracy, according to a study published recently in JAMA Facial Plastic Surgery.

Jia Qiao, M.D., from the Chinese Academy of Medical Sciences in Beijing, and colleagues enrolled 90 consecutive MCS patients and 15 craniofacial surgery fellow physicians (five per group) in a prospective observational study. Participants were randomly assigned to either an intervention group (groups A and B) or a control group (group C).

The intervention groups completed five training sessions on the intraoral MCS training models, constructed by three-dimensional skull models covered with elastic head cloths, before each clinical case. Intraoral MCS training models were provided to groups A and B; group A also had surgical templates provided in training sessions and clinical surgeries.

The researchers found that all patients were satisfied with their postoperative mandible contours. Groups A and B had improvement in clinical surgery time (mean, 147.2, 184.47, and 219.3 minutes for groups A, B, and C, respectively) and surgical accuracy (mean, 0.68, 1.22, and 1.88 mm, respectively), with greater improvements in group A. Improvements were also noted in learning curves and operators’ confidence and surgical skill.

“The overriding goal of this project was to establish a better way to achieve optimal results in training plastic surgery resident physicians and fellow physicians,” the authors write. “It is simple, economical, and can significantly improve the training quality of surgical trainees.”

[Source: MedicalXPress, HealthDay]

Many Women Get Unnecessary Mammograms Before Breast Reduction Surgery

Getting a mammogram before breast reduction surgery is not required or recommended. But thousands of younger women with no known breast cancer risk still get them, a new study suggests.

Although the pre-surgical screening has been a longtime practice among physicians, no professional society recommends routine screening until a woman turns 40.

Erika D. Sears, MD, MS, a Michigan Medicine plastic surgeon who studies appropriateness and efficiency in health care, wondered how often the practice takes place.

Her new study, published in JAMA Surgery, found that nearly one-third of women younger than 40 underwent mammography before breast reduction surgery. Health services researchers culled the records of 52,486 women of all ages being evaluated for breast reduction between 2009 and 2015.

Few may realize the unnecessary screenings come at a price — and not just a monetary one that adds to the nation’s health care bill, Sears says.

“Altering screening mammography for patients younger than 40 years in the setting of evaluation for breast surgery has a risk for subsequent tests and invasive procedures,” says Sears, also an assistant professor of surgery at the University of Michigan.

The study showed 30 percent of women ages 30 to 39 had mammograms before breast reduction surgery, a rate five times higher than that of other women their age.

About 4 percent of women ages 29 and younger received mammograms as they considered breast reduction — compared with 0.2 percent of the population of millennial women.

When performing the analysis, researchers had excluded women whose medical records indicated a personal or family history of breast cancer, genetic predisposition or prior benign breast disease — although there’s a chance the risk existed but wasn’t noted in their records, explains a media release from Michigan Medicine – University of Michigan.

Among the women in their 30s who had mammograms before breast reduction surgery, 14 percent went on to have an MRI, ultrasonography, or a biopsy in which breast tissue or fluid is removed for laboratory testing.

Cancer was found in only 0.5 percent of the women, the study showed.

That finding could help shift the conversation on both sides.

“I think that if there’s more awareness among patients, they may be motivated to have a conversation with their doctor about whether screening mammography is right for them,” Sears says. “It’s also about education on the provider’s part about the downstream impact of future testing that women may experience.”

[Source(s): Michigan Medicine – University of Michigan, Science Daily]

Phase 2 Trial of Thykamine for Atopic Dermatitis Progressing as Planned, Per Update

Devonian Health Group Inc, a clinical stage botanical pharmaceutical corporation focused on developing a unique portfolio of botanical prescription drugs and cosmeceutical products, recently provided an update on its phase 2 clinical trial in adult patients suffering from atopic dermatitis.

The phase 2 clinical trial of Thykamin in adult patients with Mild-to-Moderate Atopic Dermatitis is progressing as planned. In order to accelerate the recruitment of patients, Devonian is expanding the number of sites from 6 to 12 clinics across Canada. The study should be completed later this year, according to a news release.

Devonian also announces that its Cosmeceutical R&D initiative is progressing as expected. Devonian’s Cosmeceutical R&D program is focused on external Exposome associated with skin aging namely sun radiation (UVA/UVB, Infrared A and Blue Light), Blue light radiation from other sources than sun and pollution.

Blue light emission, which is also called high-energy visible light (HEV), stems from the sun and also from digital screens of computers, smartphones, televisions, tablets and from LED lamps.  The negative impact of Blue light on ocular health and on circadian system ( sleep pattern) has been reported in several scientific manuscripts. There is also evidence that it has adverse effects on different dermal cells, that it generates Reactive Oxygen Species (oxidants) and is inducing skin aging.

Devonian has completed the formulation of a new Blue light photoprotection product. The product has been developed as a day cream with, as one of the main ingredients, Devonian’s patented R-Spinasome. The product will be tested in human during 2019 and is expected to be ready for commercialisation in 2020, the release continues.

“This is the first product emerging from our Cosmeceutical R&D program focused on Exposome. Blue light is around us all the time, and consumers are now aware of the increased risks of daily exposition to this radiation. We are therefore developing this new product in order to offer consumers an effective product with protective attributes against the negative impacts of Blue light may have on their skin.

“As all our products, the efficacy and safety of our Blue light protection cream will be assessed through a double-blind, placebo controlled clinical study. Our team is currently selecting skin biomarkers to be included in this study which should be completed by year-end.” says Devonian’s resident & CEO, Dr Andre P. Boulet, in the release.

[Source(s): Devonian Health Group Inc, Business Wire]

Can a Wearable Blue-Light Device Clear Psoriasis?

The U.S. Food and Drug Administration (FDA) has approved a wearable, blue-light device for treating mild psoriasis at home. It offers a gentle treatment that’s easy to use. You simply strap it onto your arm or leg where you have mild psoriasis.

Because blue light is UV-free, the device isn’t known to cause skin cancer or signs of premature skin aging, such as wrinkles or age spots.

Here’s what the results from studies show, regarding how well it works.

Read the full article at www.aad.org

Artificial Skin Could Give Superhuman Perception, Study Notes

A new type of sensor could lead to artificial skin that someday helps burn victims “feel” and safeguards the rest of us, University of Connecticut researchers suggest, in Advanced Materials.

Our skin’s ability to perceive pressure, heat, cold, and vibration is a critical safety function that most people take for granted. But burn victims, those with prosthetic limbs, and others who have lost skin sensitivity for one reason or another, can’t take it for granted, and often injure themselves unintentionally.

Chemists Islam Mosa from UConn, and James Rusling from UConn and UConn Health, along with University of Toronto engineer Abdelsalam Ahmed, wanted to create a sensor that can mimic the sensing properties of skin. Such a sensor would need to be able to detect pressure, temperature, and vibration. But perhaps it could do other things too, the researchers thought.

“It would be very cool if it had abilities human skin does not; for example, the ability to detect magnetic fields, sound waves, and abnormal behaviors,” Mosa says, in a media release from University of Connecticut.

Mosa and his colleagues created such a sensor with a silicone tube wrapped in a copper wire and filled with a special fluid made of tiny particles of iron oxide just one billionth of a meter long, called nanoparticles. The nanoparticles rub around the inside of the silicone tube and create an electric current. The copper wire surrounding the silicone tube picks up the current as a signal.

When this tube is bumped by something experiencing pressure, the nanoparticles move and the electric signal changes. Sound waves also create waves in the nanoparticle fluid, and the electric signal changes in a different way than when the tube is bumped.

The researchers found that magnetic fields alter the signal too, in a way distinct from pressure or sound waves. Even a person moving around while carrying the sensor changes the electrical current, and the team found they could distinguish between the electrical signals caused by walking, running, jumping, and swimming.

Metal skin might sound like a superhero power, but this skin wouldn’t make the wearer Colossus from the X-men. Rather, Mosa and his colleagues hope it could help burn victims “feel” again, and perhaps act as an early warning for workers exposed to dangerously high magnetic fields. Because the rubber exterior is completely sealed and waterproof, it could also serve as a wearable monitor to alert parents if their child fell into deep water in a pool, for example, the release continues.

“The inspiration was to make something durable that would last for a very long time, and could detect multiple hazards,” Mosa states. The team has yet to test the sensor for its response to heat and cold, but they suspect it will work for those as well. The next step is to make the sensor in a flat configuration, more like skin, and see if it still works.

[Source(s): University of Connecticut, Science Daily]