Role of Plastic Surgery in Management of Cleft Lip

Plastic surgery is a very tiny subspecialty of surgery, having roots that date back over three millennia to India. In the US, there are about 6900 plastic surgeons in active practice, and there are about 230 residency spots available annually. Plastic surgery is perhaps one of the most diversified medical specialties, despite its tiny size. The most common congenital anomalies to occur repeatedly impacting the orofacial area are cleft lip and palate. It can happen on its own, in different combinations, or in addition to other congenital abnormalities, including congenital cardiac conditions. For a patient with an orofacial cleft malformation to be functionally and aesthetically well, treatment must be started at the appropriate age. Care for a newborn with a cleft lip and palate must be coordinated and supplied by several different specialists for the infant to be managed successfully. This study\u27s objective was to look into if plastic surgery has a crucial role in treating cleft lip, hence enhancing the quality of life for those who are born with this disease. Correcting cleft lip defects both aesthetically and functionally is mostly dependent on plastic surgery

Intraoperative use of enriched collagen and elastin matrices with freshly isolated adipose-derived stem/stromal cells : a potential clinical approach for soft tissue reconstruction

BACKGROUND: Adipose tissue contains a large number of multipotent cells, which are essential for stem cell-based therapies. The combination of this therapy with suitable commercial clinically used matrices, such as collagen and elastin matrices (i.e. dermal matrices), is a promising approach for soft tissue reconstruction. We previously demonstrated that the liposuction method affects the adherence behaviour of freshly isolated adipose-derived stem/stromal cells (ASCs) on collagen and elastin matrices. However, it remains unclear whether freshly isolated and uncultured ASCs could be directly transferred to matrices during a single transplantation operation without additional cell culture steps. METHODS: After each fat harvesting procedure, ASCs were isolated and directly seeded onto collagen and elastin matrices. Different time intervals (i.e. 1, 3 and 24 h) were investigated to determine the time interval needed for cellular attachment to the collagen and elastin matrices. Resazurin-based vitality assays were performed after seeding the cells onto the collagen and elastin matrices. In addition, the adhesion and migration of ASCs on the collagen and elastin matrices were visualised using histology and two-photon microscopy. RESULTS: A time-dependent increase in the number of viable ASCs attached to the collagen and elastin matrices was observed. This finding was supported by mitochondrial activity and histology results. Importantly, the ASCs attached and adhered to the collagen and elastin matrices after only 1 h of ex vivo enrichment. This finding was also supported by two-photon microscopy, which revealed the presence and attachment of viable cells on the upper layer of the construct. CONCLUSION: Freshly isolated uncultured ASCs can be safely seeded onto collagen and elastin matrices for ex vivo cellular enrichment of these constructs after liposuction. Although we observed a significant number of seeded cells on the matrices after a 3-h enrichment time, we also observed an adequate number of isolated cells after a 1-h enrichment time. However, this approach must be optimised for clinical use. Thus, in vivo studies and clinical trials are needed to investigate the feasibility of this approach

Sekundäre SCM-Myotomie zur Korrektur des dysmorphen Tracheostomas

Einleitung: Ein dysmorphes Tracheostoma behindert die Hilfemittelversorgung nach totaler Laryngektomie massiv. Häufig bilden die sternalen Ansätze des Musculus Sternocleidomastoideus (SCM) die prominentesten Hindernisse bei der Versorgung mit Pflastern und Kanülen. Auch wenn für die primäre intraoperative SCM-Myotomie keine signifikante Verbesserung der Tracheostomageometrie nachgewiesen werden konnte , so ist die SCM-Myotomie im ausgewählten Einzelfall dennoch ein effizientes Mittel zur Abflachung des Tracheostomas.Methoden: Ein 68-jähriger laryngektomierter Patient war aufgrund eines dysmorphen, extrem tief liegenden Tracheostomas mit einer Tracheostomaepithese versorgt worden. Trotz Tracheostomaepithese war kein luftdichter Abschluss des Tracheostomas zum Sprechen möglich. Wir führten daher eine sekundäre beidseitige Myotomie der sternalen Ansätze des SCM über kleine Hautinzisionen lateral des Tracheostomas durch. Ergebnisse: Bereits intraoperativ kam es zu einem Abflachen des Halsprofiles, so dass umgehend eine Tracheostomaversorgung mit einem herkömmlichen Tracheostomapflaster und einem HME-Filter erfolgen konnte. Die Wundheilung verlief stadiengerecht, ohne Schmerzen oder Funktionseinschränkungen. Das Sprechen war problemlos möglich.Schlussfolgerung: Ist die Versorgung eines dysmorphen Tracheostomas mit Standardhilfsmitteln nicht zu erreichen, kann die sekundäre SCM-Myotomie eine wirksame Maßnahme zur Korrektur des Tracheostomaprofils darstellen. Sie ist technisch einfach und kann auch in Lokalanästhesie erfolgen.Der Erstautor gibt keinen Interessenkonflikt an

GSK3 Deficiencies in Hematopoietic Stem Cells Initiate Pre-neoplastic State that Is Predictive of Clinical Outcomes of Human Acute Leukemia

Initial pathway alternations required for pathogenesis of human acute myeloid leukemia (AML) are poorly understood. Here we reveal that removal of glycogen synthase kinase-3\u3b1 (GSK-3\u3b1) and GSK-3\u3b2 dependency leads to aggressive AML. Although GSK-3\u3b1 deletion alone has no effect, GSK-3\u3b2 deletion in hematopoietic stem cells (HSCs) resulted in a pre-neoplastic state consistent with human myelodysplastic syndromes (MDSs). Transcriptome and functional studies reveal that each GSK-3\u3b2 and GSK-3\u3b1 uniquely contributes to AML by affecting Wnt/Akt/mTOR signaling and metabolism, respectively. The molecular signature of HSCs deleted for GSK-3\u3b2 provided a prognostic tool for disease progression and survival of MDS patients. Our study reveals that GSK-3\u3b1- and GSK-3\u3b2-regulated pathways can be responsible for stepwise transition to MDS and subsequent AML, thereby providing potential therapeutic targets of disease evolution. Guezguez et al. show that progressive removal of glycogen synthase kinase-3 (GSK-3) signaling by Gsk3b allelic deletion results in an MDS state that, when combined with Gsk3a deletion, leads to AML. A molecular signature derived from Gsk3b-null cells has prognostic potential for MDS patients