Search Results (59)

Background and Objectives: Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. A standard surgical approach is often not possible due to the different degrees and etiologies of penile tissue loss. The continuing growth and the presence of various congenital anomalies in children require a different penile reconstruction approach than in adults. We aimed to share our experience and surgical results with children in whom we performed penile reconstruction with different techniques due to penile tissue loss. Materials and Methods: Ten cases that underwent penile reconstruction between 2018 and 2023 were evaluated retrospectively. Age at initial operation, associated anomalies, surgical technique, and other related surgical attempts, as well as functional and cosmetic results, were recorded. Results: Ten boys aged between 6 months and 17 years underwent phalloplasty due to penile tissue absence. In six cases, penile tissue loss was due to acquired causes, and in four cases, congenital anomalies were the reason. The most common cause of penile tissue loss was circumcision complications. In four cases, penile reconstruction was achieved by mobilization of the remaining corpus cavernosum tissues, in two cases, the cavernous tissue was adequate and repaired with glansplasty and penile skin graft. Phalloplasty was performed by tubularization of a skin and subcutaneous fat flap, removed from the pubic region and scrotal region, in two cases. A microvascular radial forearm flap was performed in a 17-year-old patient with penile tissue loss because of trauma, and a free skin flap taken from the forearm was used for penile reconstruction. Thirty percent of patients required a second surgery. Urinary continence was present in eight of the cases. Although four cases were classified as cosmetically unsatisfactory in our evaluation, all patients and their families reported being satisfied with the cosmetic results. Conclusions: Penile reconstruction for penile tissue loss in children should be performed in clinics where different scenarios can be applied. With maximum preservation and mobilization of existing cavernous tissues, temporary penile reconstruction with local flaps should be performed in young children at an early stage to minimize the psychological effects of penile absence. Although an esthetically perfect result cannot be guaranteed, patients and families are generally satisfied with the outcome. Full article

Aim of the study: Several previous experimental studies simulated ancient Egyptian mummification of human bodies using the embalming protocol described by Herodotus. Besides two human experiments, several animal studies have been performed with very different species, mostly over short observation periods. We used a human-sized piglet model that matches closely to humans and undertook a long-term experiment with two detailed examination time points over 13 years. This was conducted to test the efficacy of the Herodotus embalming method in the long term. Material and Methods: An 88 kg piglet, 1.30 m body length, obtained from a veterinary practice was chosen as the skin is similar to humans. Using the described formula, the carcass was cleaned, eviscerated, filled with spices and natron sachets, and then covered with 240 kg of natron for 40 days. It was then reopened, and most of the sachets were removed. The surface was cleaned with wine, the body cavity partly refilled with sachets and spices, the surface treated with oils, wax, honey and bitumen, and finally sealed with linen bandages. The body weight was regularly monitored over the 13-year period. At 7 and 13 years, re-examination, with a protocol including CT scanning, histology and microbiology, was performed. Results: The monitoring of the body weight showed a rapid loss of weight within the first year, gradually slowing, reaching more than 66% of its weight. In the final 6 years, the body weight was reduced by only 1.7 kg. The CT scans at 7 years and 13 years showed that the structures of the heart, muscle, skin, and soft tissue were well preserved, and the body significantly shrunken; only the musculature showed air inclusions. Histology and microbiology (examined at baseline, 7 years and 13 years) revealed excellently conserved tissue with anaerobic microbe spores, very limited tissue destruction, and no significant fungal or parasitic invasion. However, the preserved kidneys and internal genitalia had disappeared. Conclusions: This ongoing long-term project confirmed excellent mummification with near-perfect body conservation at 13 years, supporting the efficacy of the described Herodotus technique. This model is suitable for the assessment of special preservation techniques recently suggested for individual soft tissue organs. Full article

As far as history tells, people have set efforts both to improve the conditions and to change the visual outfit of the skin, nails, and hair. The first information on nail cosmetics is found in ancient China and Egypt, where various nature-derived compositions were used for changing the colour of the nails. Nowadays more mechanically and chemically durable systems for nail polishes are elaborated. This review focuses on the latest achievements in the field of UV-curable nail polishes. Herein, the polymerization mechanisms of various systems (acrylates, as well as epoxides and thiols) occurring in nail polishes are described. Besides plausible side reactions of the polymerization process are characterized. Thus, the main drawbacks for forming a uniform, perfect layer are illuminated. For effective curing, the choice of photoinitiators may be crucial; thus, various types of photoinitiators as well as their main advantages and disadvantages are characterized. Ensuring effective adhesion between the substrate (human nail) and the polymer film is one of the challenges for the nail polish industry—thus the plausible interactions between the adhesion promoters and the keratin are described. Regarding the film-forming agents, a comprehensive overview of the composition of the traditional UV-curing nail polishes is provided, but the main emphasis is devoted to alternative, nature-derived film-forming agents that could introduce renewable resources into nail cosmetics. Additionally, this review gives short insight into the latest innovations in UV-curing nail cosmetics, like (1) nail polishes with improved pealability, (2) covalently polymer-bonded dyes and photoinitiators, thus reducing the release of the low-molecular compounds or their degradation products, and (3) UV-curing nail polishes as delivery systems for nail treatment medicine. Full article

The imbalance in the production of reactive oxygen species (ROS) with endogenous antioxidant capacity leads to oxidative stress, which drives many disorders, especially in the skin. In such conditions, supplementing exogenous antioxidants may help the body prevent the negative effect of ROS. However, the skin, as the outermost barrier of the body, provides a perfect barricade, making the antioxidant delivery complicated. Several strategies have been developed to enhance the penetration of antioxidants through the skin, one of which is nanotechnology. This review focuses on utilizing several nanocarrier systems, including nanoemulsions, liposomes, solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), and polymeric nanoparticles, for transporting antioxidants into the skin. We also reveal ROS formation in the skin and the role of antioxidant therapy, as well as the natural sources of antioxidants. Furthermore, we discuss the clinical application of topical antioxidant therapy concomitantly with the current status of using nanotechnology to deliver topical antioxidants. This review will accelerate the advancement of topical antioxidant therapy. Full article

Background/Objectives: Youthful, smooth skin is highly desired in modern society. Individuals invest in cosmetics, plastic surgeons, and dermatologists in pursuit of perfect skin. However, many do not seek out dietary changes to improve skin health. Although research has been conducted on the role of nutrition and select nutrients and phytonutrients on skin health, there is a lack of healthy food recommendations for clear skin. Methods: The literature was assessed to determine which nutrients and phytonutrients play a significant role in the protection and maintenance of skin health. Key compounds were highlighted as there is evidence to suggest they have a significant role in skin health: vitamin A, vitamin C, vitamin D, vitamin E, zinc, omega-6 and omega-3 fatty acids, polyphenols/flavonoids, copper, selenium, and silicon. USDA FoodData Central and FooDB (food database), were utilized to select foods and food groups containing the key nutrients and phytonutrients. Results: A skin-healthy dietary pattern is proposed in addition to a scoring system to assess diet. A sample skin-healthy daily diet was designed, using only whole foods, that met the Daily Values for vitamins and minerals and contained key compounds for skin health. Conclusions: There is a clear link between nutrition and skin health, or nutritional dermatology; however, more research needs to be done to find the intersection between both disciplines. Full article

The increasing incidence of and resulting deaths associated with malignant skin tumors are a public health problem that can be minimized if detection strategies are improved. Currently, diagnosis is heavily based on physicians’ judgment and experience, which can occasionally lead to the worsening of the lesion or needless biopsies. Several non-invasive imaging modalities, e.g., confocal scanning laser microscopy or multiphoton laser scanning microscopy, have been explored for skin cancer assessment, which have been aligned with different artificial intelligence (AI) strategies to assist in the diagnostic task, based on several image features, thus making the process more reliable and faster. This systematic review concerns the implementation of AI methods for skin tumor classification with different imaging modalities, following the PRISMA guidelines. In total, 206 records were retrieved and qualitatively analyzed. Diagnostic potential was found for several techniques, particularly for dermoscopy images, with strategies yielding classification results close to perfection. Learning approaches based on support vector machines and artificial neural networks seem to be preferred, with a recent focus on convolutional neural networks. Still, detailed descriptions of training/testing conditions are lacking in some reports, hampering reproduction. The use of AI methods in skin cancer diagnosis is an expanding field, with future work aiming to construct optimal learning approaches and strategies. Ultimately, early detection could be optimized, improving patient outcomes, even in areas where healthcare is scarce. Full article

Hybrid positron emission tomography/magnetic resonance imaging (PET/MR) opens new possibilities in multimodal multiparametric (m2p) image analyses. But even the simultaneous acquisition of positron emission tomography (PET) and magnetic resonance imaging (MRI) does not guarantee perfect voxel-by-voxel co-registration due to organs and distortions, especially in diffusion-weighted imaging (DWI), which would be, however, crucial to derive biologically meaningful information. Thus, our aim was to optimize fusion and voxel-wise analyses of DWI and standardized uptake values (SUVs) using a novel software for m2p analyses. Using research software, we evaluated the precision of image co-registration and voxel-wise analyses including the rigid and elastic 3D registration of DWI and [18F]-Fluorodeoxyglucose (FDG)-PET from an integrated PET/MR system. We analyzed DWI distortions with a volume-preserving constraint in three different 3D-printed phantom models. A total of 12 PET/MR-DWI clinical datasets (bronchial carcinoma patients) were referenced to the T1 weighted-DIXON sequence. Back mapping of scatterplots and voxel-wise registration was performed and compared to the non-optimized datasets. Fusion was rated using a 5-point Likert scale. Using the 3D-elastic co-registration algorithm, geometric shapes were restored in phantom measurements; the measured ADC values did not change significantly (F = 1.12, p = 0.34). Reader assessment showed a significant improvement in fusion precision for DWI and morphological landmarks in the 3D-registered datasets (4.3 ± 0.2 vs. 4.6 ± 0.2, p = 0.009). Most pronounced differences were noted for the chest wall (p = 0.006), tumor (p = 0.007), and skin contour (p = 0.014). Co-registration increased the number of plausible ADC and SUV combinations by 25%. The volume-preserving elastic 3D registration of DWI significantly improved the precision of fusion with anatomical sequences in phantom and clinical datasets. The research software allowed for a voxel-wise analysis and visualization of [18F]FDG-PET/MR data as a “combined diffusivity–metabolic index” (cDMI). The clinical value of the optimized PET/MR biomarker can thus be tested in future PET/MR studies. Full article

Background: In the contemporary world, a cult of perfection is being created, and deviations from such an ideal image are becoming socially unacceptable. A particular situation arises when a defect or symptoms of a disease appear on the skin, which, in the case of people suffering from psoriasis, are a source of stress, dissatisfaction with the disease, and a reduction in quality of life. The aim of this study was to assess whether the quality of life related to the occurrence of psoriasis and the level of acceptance of the disease affect coping strategies in stressful situations. Methods: The study involved 111 people with common psoriasis (46.8% women and 53.2% men). Inclusion criteria were as follows: a diagnosis of common psoriasis for at least 0.5 years, no other types of psoriasis, no mental illnesses, and an informed consent of the respondent to participate in the study. In order to compile the research input, a proprietary questionnaire was used along with the following standardised tools: the Dermatology Life Quality Index (DLQI), the Acceptance of Illness Scale (AIS), and the Coping Inventory for Stressful Situations (CISS). Results: The duration of the disease in the studied population varied and ranged from 0.5 years to over 50 years. Most respondents showed relatively low DLQI scores, with an average value of 10.8 points. In stressful situations (CISS), the respondents primarily used a strategy based on rational thinking (Task-oriented coping), with approximately 54 points on average; followed by an avoidant style (Avoidance-oriented coping), with approximately 50 points on average; and least often an emotional style (Emotion-oriented coping), with approximately 46 points on average. The average level of disease acceptance (AIS) in the studied group equalled approximately 26 points. Conclusions: Psoriatic lesions on the torso caused less rational behaviour in stressful situations (a decrease in the Task-oriented coping) in women but had the opposite result in men, whereas psoriatic lesions on the head stimulated the use of Task-oriented coping in women but had the opposite result in men. The higher the acceptance of the disease (AIS) presented by the respondents, the less often they used an emotional strategy (Emotion-oriented coping) in stressful situations. The higher the quality of life (DLQI) was, the lower the values of Emotion-oriented coping were noted. Full article

Exosomes, small membrane-bound vesicles secreted by cells, have gained significant attention for their therapeutic potential. Measuring 30–100 nm in diameter and derived from various cell types, exosomes play a crucial role in intercellular communication by transferring proteins, lipids, and RNA between cells. This review analyzes existing literature on the clinical applications of exosomes. We conducted a comprehensive search of peer-reviewed articles and clinical trial data to evaluate the benefits, limitations, and challenges of exosome-based therapies. Key areas of focus included regenerative medicine, cancer therapy, gene therapy, and diagnostic biomarkers. This review highlights the vast clinical applications of exosomes. In regenerative medicine, exosomes facilitate tissue repair and regeneration. In cancer therapy, exosomes can deliver therapeutic agents directly to tumor cells. In gene therapy, exosomes serve as vectors for gene delivery. As diagnostic biomarkers, they are useful in diagnosing various diseases. Challenges such as the isolation, purification, and characterization of exosomes were identified. Current clinical trials demonstrate the potential of exosome-based therapies, though they also reveal significant hurdles. Regulatory issues, including the need for standardization and validation of exosome products, are critical for advancing these therapies. While significant progress has been made in understanding exosome biology, further research is essential to fully unlock their clinical potential. Addressing challenges in isolation, purification, and regulatory standardization is crucial for their successful application in clinical practice. This review provides a concise overview of the clinical applications of exosomes, emphasizing both their therapeutic promise and the obstacles that need to be overcome. Full article

The bioprinting of high-concentrated collagen bioinks is a promising technology for tissue engineering and regenerative medicine. Collagen is a widely used biomaterial for bioprinting because of its natural abundance in the extracellular matrix of many tissues and its biocompatibility. High-concentrated collagen hydrogels have shown great potential in tissue engineering due to their favorable mechanical and structural properties. However, achieving high cell proliferation rates within these hydrogels remains a challenge. In static cultivation, the volume of the culture medium is changed once every few days. Thus, perfect perfusion is not achieved due to the relative increase in metabolic concentration and no medium flow. Therefore, in our work, we developed a culture system in which printed collagen bioinks (collagen concentration in hydrogels of 20 and 30 mg/mL with a final concentration of 10 and 15 mg/mL in bioink) where samples flow freely in the culture medium, thus enhancing the elimination of nutrients and metabolites of cells. Cell viability, morphology, and metabolic activity (MTT tests) were analyzed on collagen hydrogels with a collagen concentration of 20 and 30 mg/mL in static culture groups without medium exchange and with active medium perfusion; the influence of pure growth culture medium and smooth muscle cells differentiation medium was next investigated. Collagen isolated from porcine skins was used; every batch was titrated to optimize the pH of the resulting collagen to minimize the difference in production batches and, therefore, the results. Active medium perfusion significantly improved cell viability and activity in the high-concentrated gel, which, to date, is the most limiting factor for using these hydrogels. In addition, based on SEM images and geometry analysis, the cells remodel collagen material to their extracellular matrix. Full article

Driven by growing environmental concerns and regulations, cosmetic companies are seeking reliable methods to promptly assess the possibility of replacing high-impact ingredients with sustainable alternatives. In this work, we exploited rheological and texture analyses to evaluate the possibility of using natural and biodegradable raw materials for reformulating three commercial oil-in-water skin care emulsions from an eco-design perspective. Synthetic texturizers, like nylon-12 and PMMA, were replaced with starch, maltodextrin, and silica, while acrylic rheological modifiers were substituted with polysaccharide associations of sclerotium gum, xanthan gum, diutan gum, and carrageenan. Plant-based emollients and a biodegradable elastomer were used as alternatives to silicone oils. The flow and viscoelastic properties of the samples were characterized using rheological tests under continuous and oscillatory flow conditions. The immersion/de-immersion texture analysis allowed us to measure the mechanical properties of firmness, adhesiveness, and stringiness. A double-blind sensory test assessed the products’ application and sensory characteristics. The results revealed that rheology and texture analysis are complementary and correlated techniques, useful for predicting cosmetics’ sensory characteristics. While perfect replication of the original formulas might not be achievable, this protocol can aid formulators in selecting new eco-friendly ingredients ensuring the products’ desired application and sensory properties without compromising consumer experience. Full article

Cutaneous melanoma is one of the most lethal tumors among skin cancers, characterized by complex genetic and molecular alterations that result in uncontrolled cell proliferation and metastatic spread. Next-generation sequencing (NGS) enables the simultaneous examination of numerous genes, making this molecular technique essential for melanoma diagnosis, prognostic stratification, and therapy planning. Herein, we present the experience with our laboratory-designed NGS panel for the routine assessment of advanced-stage melanoma. A total of 260 specimens of advanced-stage melanomas were evaluated utilizing a laboratory-developed multi-gene NGS panel, which allowed the investigation of 229 amplicons in 25 oncogene/oncosuppressor genes. The NGS panel proved to be a reliable tool, failing to produce results in only 1.2% of the samples tested. BRAF and TERT were the two more commonly altered genes in 44.0% and 59.9% of samples, respectively. In 59.3% of the mutated cases, at least two concomitant variants were detected. In eight cases, both primary lesion and metastatic disease were analyzed by NGS. In all specimens (8/8, 100%), a perfect concordance in variants harbored by the primary and recurrence lesions was observed. Finally, this study described the validity of a laboratory-developed multi-gene NGS panel built specifically for advanced-stage melanomas in ordinary clinical practice. Full article

Melanoma is the most aggressive form of skin cancer that is known for its metastatic potential and has an increasing incidence worldwide. Breslow thickness, which determines the staging and surgical margin of the tumor, is unavailable at initial diagnosis. Novel imaging techniques for assessing Breslow thickness lack comparative data. This study evaluates optically guided high-frequency ultrasound (OG-HFUS) and multispectral imaging (MSI) for preoperative estimation of Breslow thickness and staging. We enrolled 101 patients with histologically confirmed primary melanoma and categorized them based on tumor thickness. Optically guided 33 MHz HFUS and MSI were utilized for the assessment. Our MSI-based algorithm categorized melanomas into three subgroups with a sensitivity of 62.6%, specificity of 81.3%, and fair agreement (κ = 0.440, CI: 0.298–0.583). In contrast, OG-HFUS demonstrated a sensitivity of 91.8%, specificity of 96.0%, and almost perfect agreement (κ = 0.858, CI: 0.763–0.952). OG-HFUS performed better than MSI in estimating Breslow thickness, emphasizing its potential as a valuable tool for melanoma diagnosis and patient management. OG-HFUS holds promise for enhancing preoperative staging and treatment decision-making in melanoma. Full article

Elevated face temperature due to mask wearing can cause discomfort and skin irritation, making mask mandates challenging. When thermal discomfort becomes intolerable, individuals instinctively or unknowingly loosen or remove their facemasks, compromising the mask’s protective efficacy. The objective of this study was to numerically quantify the microclimate under the mask and facial thermoregulation when wearing a surgical mask with different levels of misfit. An integrated ambient–mask–face–airway computational model was developed with gaps of varying sizes and locations and was validated against complementary experiments. The low Reynolds number (LRN) k-ω turbulence model with porous media was used to simulate transient respiratory flows. Both skin convective heat transfer and tissue heat generation were considered in thermoregulation under the facemask, besides the warm air exhaled from the body and the cool air inhaled from the ambient. The results of this study showed that when wearing a surgical mask with a perfect fit under normal breathing, the temperature at the philtrum increased by 4.3 °C compared to not wearing a mask. A small gap measuring 0.51 cm² (gap A) at the nose top resulted in 5.6% leakage but reduced the warming effect by 28% compared to zero gap. Meanwhile, a gap of 4.3 cm² (R1L1) caused 42% leakage and a 62% reduction in the warming effect. Unique temporospatial temperature profiles were observed at various sampling points and for different gap sizes, which correlated reasonably with the corresponding flow dynamics, particularly close to the gaps. The temperature change rate also exhibited patterns unique to the gap site and sampling point, with distinctive peaks occurring during the inspiratory–expiratory flow transitions. These results have the significant implications that by using the temporospatial temperature profiles at several landmark points, the gap location can potentially be pinpointed, and the gap size and leakage fractions can be quantified. Full article

Melatonin is widely present in Nature. It has pleiotropic activities, in part mediated by interactions with high-affinity G-protein-coupled melatonin type 1 and 2 (MT1 and MT2) receptors or under extreme conditions, e.g., ischemia/reperfusion. In pharmacological concentrations, it is given to counteract the massive damage caused by MT1- and MT2-independent mechanisms. The aryl hydrocarbon receptor (AhR) is a perfect candidate for mediating the latter effects because melatonin has structural similarity to its natural ligands, including tryptophan metabolites and indolic compounds. Using a cell-based Human AhR Reporter Assay System, we demonstrated that melatonin and its indolic and kynuric metabolites act as agonists on the AhR with EC₅₀’s between 10⁻⁴ and 10⁻⁶ M. This was further validated via the stimulation of the transcriptional activation of the CYP1A1 promoter. Furthermore, melatonin and its metabolites stimulated AhR translocation from the cytoplasm to the nucleus in human keratinocytes, as demonstrated by ImageStream II cytometry and Western blot (WB) analyses of cytoplasmic and nuclear fractions of human keratinocytes. These functional analyses are supported by in silico analyses. We also investigated the peroxisome proliferator-activated receptor (PPAR)γ as a potential target for melatonin and metabolites bioregulation. The binding studies using a TR-TFRET kit to assay the interaction of the ligand with the ligand-binding domain (LBD) of the PPARγ showed agonistic activities of melatonin, 6-hydroxymelatonin and N-acetyl-N-formyl-5-methoxykynuramine with EC₅₀’s in the 10⁻⁴ M range showing significantly lower affinities that those of rosiglitazone, e.g., a 10⁻⁸ M range. These interactions were substantiated by stimulation of the luciferase activity of the construct containing PPARE by melatonin and its metabolites at 10⁻⁴ M. As confirmed by the functional assays, binding mode predictions using a homology model of the AhR and a crystal structure of the PPARγ suggest that melatonin and its metabolites, including 6-hydroxymelatonin, 5-methoxytryptamine and N-acetyl-N-formyl-5-methoxykynuramine, are excellent candidates to act on the AhR and PPARγ with docking scores comparable to their corresponding natural ligands. Melatonin and its metabolites were modeled into the same ligand-binding pockets (LBDs) as their natural ligands. Thus, functional assays supported by molecular modeling have shown that melatonin and its indolic and kynuric metabolites can act as agonists on the AhR and they can interact with the PPARγ at high concentrations. This provides a mechanistic explanation for previously reported cytoprotective actions of melatonin and its metabolites that require high local concentrations of the ligands to reduce cellular damage under elevated oxidative stress conditions. It also identifies these compounds as therapeutic agents to be used at pharmacological doses in the prevention or therapy of skin diseases. Full article