Adipose-derived stem cells: true or false? A different point of view

SPECIAL EDITORIA

A propeller flap for single-stage nose reconstruction in selected patients: supratrochlear artery axial propeller flap

The paramedian forehead flap is the gold standard technique for nose reconstruction. It requires two different surgical operations which prolonged the postoperative dressing and care. We present our 5-year experience with a propeller flap based on the supratrochlear artery, which allows one-stage transfer of the forehead skin to the nose without the need for pedicle division. This technique is indicated in a selected group of patients who are not suitable for multiple-stage reconstructions because they have concurrent medical conditions, reduced mobility, or live far away from specialized medical centers. We have renamed this procedure as supratrochlear artery axial propeller flap, from the acronym STAAP flap, to stress the axial, well known and constant, vascularization of the flap. In the past 5 years, we have been performing 25 STAAP flaps; full-thickness nasal reconstruction was performed in 11 cases. The patients were 16 males and 9 females, with a mean age of 79.5 years. All patients had multiple comorbidities. Complete flap survival was observed in 23 cases and healing was complete in 7 days. In two cases, there was a partial distal necrosis of the flap treated conservatively. Cosmetic results were good and the patient's satisfaction was significant. These results indicate that the STAAP flap is a reliable and useful technique in selected cases, as old or noncompliant patients who benefit from a one-stage technique of nose reconstructio

A difficult case of necrotizing fasciitis caused by Acinetobacter baumannii

This study reports the case of a 55-year-old woman with diabetes with a necrotizing fasciitis of the right lower limb and the perineum, first admitted at the emergency department for septic shock with cardiac arrest, and later transferred to the department of surgery. Microbiological and histopathological examination confirmed the diagnosis of necrotizing fasciitis caused by Acinetobacter baumannii. A broad-spectrum antibiotic therapy was administered and later readjusted according to the results of microbiological culture. Intensive hemodynamic support was required. Wounds were dressed daily with a 3 percent boric acid solution and a silver sulfadiazine-impregnated dressing. An extensive surgical debridement was promptly performed and repeated until complete control of the infection. Wounds were finally covered with split-thickness skin grafts. The infection was overcome 35 days after admission. The graft take was 100%. Postoperative rehabilitation was required because of the functional limitation of lower limb movements. Follow-up at 6 months showed no functional deficit and an acceptable aesthetic result. Necrotizing fasciitis is a life-threatening disorder, especially in patients with diabetes, whose clinical diagnosis may sometimes be challenging. Early recognition and treatment represent the most important factors influencing surviva

e+e- Pairs: a clock and a thermometer of heavy ion collisions

Recently, there is growing evidence that a new state of matter is formed in sqrt(s_NN)= 200 GeV Au+Au collisions at RHIC: a strongly coupled Quark Gluon Plasma of partonic degrees of freedom which develops a collective motion. Dilepton spectra are not affected by strong interaction and can therefore probe the whole time evolution of the collision. Thus they may be sensitive to onset of deconfinement, chiral symmetry restoration, as well as the production of thermal photons. The PHENIX experiment measured the production of e+e- pairs in p+p and Au+Au collisions at sqrt(s_NN)= 200 GeV. An enhanced dilepton yield in the mass range 150<m_ee<750 MeV/c^2 is measured. The excess increases faster with centrality than the number of participating nucleons and is concentrated at p_T<1GeV/c. At higher p_T the excess below 300 MeV/c^2 has been related to an enhanced production of direct photons possibly of thermal origin.Comment: Proceedings of Quark Matter 2008, 8 pages, 7 figure

Injectable xyloglucan hydrogels incorporating spheroids of adipose stem cells for bone and cartilage regeneration

Cartilage or bone regeneration approaches based on the direct injection of mesenchymal stem cells (MSCs) at the lesion site encounter several challenges, related to uncontrolled cell spreading and differentiation, reduced cell viability and poor engrafting. This work presents a simple and versatile strategy based on the synergic combination of in-situ forming hydrogels and spheroids of adipose stem cells (SASCs) with great potential for minimally invasive regenerative interventions aimed to threat bone and cartilage defects. Aqueous dispersions of partially degalactosylated xyloglucan (dXG) are mixed with SASCs derived from liposuction and either a chondroinductive or an osteoinductive medium. The dispersions rapidly set into hydrogels when temperature is brought to 37 °C. The physico-chemical and mechanical properties of the hydrogels are controlled by polymer concentration. The hydrogels, during 21 day incubation at 37 °C, undergo significant structural rearrangements that support cell proliferation and spreading. In formulations containing 1%w dXG cell viability increases up to 300% for SASCs-derived osteoblasts and up to 1000% for SASCs-derived chondrocytes if compared with control 2D cultures. The successful differentiation into the target cells is supported by the expression of lineage-specific genes. Cell-cell and cell-matrix interactions are also investigated. All formulations resulted injectable, and the incorporated cells are fully viable after injection

Hydrogel scaffolds blends to host Spheroids from human adipose stem cells

INTRODUCTION Adipose stem cells represent a reliable source of stem cells for their widely demonstrated potential in regenerative medicine and tissue engineering applications. New recent insights show that 3D models may properly mimic the native tissue properties; in fact Spheroids from Adipose derived Stem Cells (S-ASCs) displayed enhanced regenerative abilities if compared to 2D models. Stem cell therapy success is determined by "cell-quality" thus the involvement of stress signals and cellular aging need to be deeply investigated. The development of 3D cell-laden hydrogels has enabled to mimic the peculiar scenario of a native tissue. We studied SASCs-cell quality and tested their viability and differentiation abilities in new hydrogels. METHODS S-ASCs were obtained from liposuction of healthy patients. Analysis of aging, telomeric length and stress-oxidative genes was performed through Real-Time PCR. Physico-chemical, morphological and mechanical properties of k-Carrageenan (k-C, 2%w) and degalactosylated xyloglucan (Deg-XG, 2%w) hydrogels were defined. S-ASCs compatibility with hydrogels was evaluated by viability test and mesenchymal differentiation abilities. RESULTS Gene expression of genes linked with stemness, senescence and stress-oxidative was evaluated and correlated with SASCs-cell quality. Indeed, aging-related p16INK4a mRNA is downregulated while anti-aging Sirtuin1 is upregulated in 3D-SASCs. Furthermore, vegetal-origin hydrogels have guaranteed an optimal environment for S-ASCs in stemness and mesenchymal differentiation conditions. CONCLUSION Bio-instructive scaffolds are critical for exploiting stem cells therapeutic potential in tissue engineering. This study provides a versatile approach to investigate the interactions between cells in controlled settings, opening up novel 3D in vitro approaches to mimic the tissues complexity

Freestyle-Like V-Y Flaps of the Eyebrow: A New Outlook and Indication of an Historical Technique

The eyebrow region is of utmost importance for facial movement, symmetry, and the overall cosmetic appearance of the face. Trauma or tumor resection often leave scars that may dislocate the eyebrow producing an alteration both in static symmetry of the face and in the dynamic expressivity. The authors present a technique for eyebrow's defects repair using the remaining eyebrow advancement by means of a "freestyle-like" V-Y flap. In the past two years a total of eight consecutive patients underwent excision of skin lesions in the superciliary region and immediate reconstruction with this technique. On histology, six patients were affected from basal cell carcinomas, one from squamous cell carcinoma, and one from congenital intradermal melanocytic nevus. The pedicle of the flap included perforators from the supratrochlear, supraorbital, or superficial temporalis artery. Advancement of the entire aesthetic subunit that includes the eyebrow using a V-Y perforator flap was performed successfully in all cases achieving full, tension-free closure of defects up to 3.0\u2009cm. "Freestyle-like" V-Y flaps should be considered as a first-line choice for partial defects of the eyebrow. The greater mobility compared to random subcutaneous flaps allows to reconstruct large defects providing an excellent cosmetic result