Development and characterisation of in vitro human oral mucosal equivalents derived from immortalised oral keratinocytes.

Tissue engineered oral mucosal equivalents (OME) are being increasingly used to measure toxicity, drug delivery, and to model oral diseases. Current OME are mainly comprised of normal oral keratinocytes (NOK) cultured on top of a normal oral fibroblasts (NOF)-containing matrix. However, the commercial supply of NOK is limited, restricting widespread use of these mucosal models. In addition, NOK suffer from poor longevity and donor-to-donor variability. Therefore, we constructed, characterised and tested the functionality of oral mucosal equivalents based on commercial TERT2-immortalised oral keratinocytes (FNB6) in order to produce a more readily available alternative to NOK-based OME. FNB6 OME cultured at an air-to-liquid interface for 14 days exhibited expression of differentiation markers cytokeratin 13 in the suprabasal layers and cytokeratin 14 in basal layer of the epithelium. Proliferating cells were restricted to the basal epithelium and there was immuno-positive expression of E-cadherin confirming the presence of established cell-to-cell contacts. The histology and expression of these structural markers paralleled those observed in the normal oral mucosa and NOK-based models. Upon stimulation with TNFα & IL-1, FNB6 OME displayed a similar global gene expression profile to NOK-based OME with increased expression of many common pro-inflammatory molecules such as chemokines (CXCL8), cytokines (IL-6) and adhesion molecules (ICAM-1) when analysed by gene array and qPCR. Similarly, pathway analysis showed that both FNB6 and NOK models initiated similar intracellular signalling upon stimulation. Gene expression in FNB6 OME was more consistent than NOK-based OME that suffered from donor variation in response to stimuli. Mucosal equivalents based on immortalised FNB6 cells are accessible, reproducible and will provide an alternative animal experimental system for studying mucosal drug delivery systems, host-pathogen interactions and drug-induced toxicity

No benefit of an adjunctive phototherapy protocol in treatment of periodontitis: A split-mouth randomized controlled trial

Aim: To assess the efficacy of a commercially available adjunctive phototherapy protocol (“Perio-1”) in treatment of periodontitis. Materials and Methods: In an examiner-blind, randomized, controlled, split-mouth, multicentre study, 60 periodontitis patients received root surface debridement (RSD) in sextants either alone (control sextants) or with the adjunctive phototherapy protocol (test sextants). Re-evaluation was performed at 6, 12 and 24 weeks. Results: No statistically significant differences in mean (± standard deviation) clinical attachment level (CAL) change from baseline to week 24 were observed between test (−1.00 ± 1.16 mm) and control sextants (−0.87 ± 0.79 mm) at sites with probing pocket depths (PPDs) ≥5 mm (“deep sites”) at baseline (p =.212). Comparisons between test and control sextants for all other parameters (CAL change at all sites, PPD change at deep sites/all sites, bleeding on probing, plaque scores), and for all change intervals, failed to identify any statistically significant differences. Conclusions: The phototherapy protocol did not provide any additional clinical benefits over those achieved by RSD alone. (German Clinical Trials Register DRKS00011229)

Social Control in Transnational Families: Somali Women and Dignity in Johannesburg

Transnational mobility often separates families and distances individuals from the kinship and social structures by which they organized their lives prior to migration. Myriad forms of insecurity have been the impetus for Somali movement into the diaspora, with people fleeing the realities of conflict that have marked Somalia for decades while physically dividing families as individuals settle in different countries around the world. Mobility has altered the dynamics of households, families, and communities post-migration, reshaping social constructions as individuals move on without the familial support that sustained them in Somalia. While outcomes of these hardships are variable and often uneven in different settlement spaces, migration can offer new opportunities for people to pursue avenues from which they were previously excluded, such as by assuming roles and responsibilities their relatives once filled. These changes precipitate shifting identities and are challenging for women who find themselves self-reliant in the diaspora, particularly in the absence of (supportive) husbands and close kin.Drawing on ethnographic research in Johannesburg’s Somali community, this chapter explores the assumption that migration provides an opening for women to challenge subordinating gender norms. Settlement often grants women greater freedom to make choices in their lives, such as in employment and personal relationships, and yet they remain constrained by networks that limit their autonomy. Even with transnational migration and protracted separation, women are family representatives who must uphold cultural notions of respectability despite realities that position them as guardians and family providers. Women remain under the watchful eye of their extended families through expansive networks and the ease of modern communication, which facilitate a new form of social control as women’s behavior is carefully monitored and reported to relatives afar. These actualities raise questions about the degree to which transnational movement is a liberating force for women or rather a reconfiguration of social control. I argue that despite women’s changing position in their households and families, they remain limited by social control within their extended families and communities

De-epithelialized fasciocutaneous turnover flap for recurrent calcaneal wound with osteomyelitis.

Recurrent ulcerations of the foot and ankle almost always present a challenge to lower extremity surgeons. Recalcitrant heel ulcerations with osteomyelitis are especially difficult to treat because of the lack of soft tissue coverage. The turnover flap is a simple, fast, and effective treatment method for lower extremity wounds. It is a de-epithelialized fasciocutaneous flap harvested from the adjacent area of the wound. We believe it is an underused technique for advanced wound closure in the lower extremity. It offers several advantages compared with traditional, more difficult to perform, flaps. We have seen an excellent result 18 months after using the turnover flap in a patient with recurrent posterior heel ulceration with calcaneal osteomyelitis