1. Int J Radiat Oncol Biol Phys. 2010 Oct 23. [Epub ahead of print]

Three-Year Outcomes of a Canadian Multicenter Study of Accelerated Partial Breast
Irradiation Using Conformal Radiation Therapy.

Berrang TS, Olivotto I, Kim DH, Nichol A, John Cho BC, Mohamed IG, Parhar T,
Wright JR, Truong P, Tyldesley S, Sussman J, Wai E, Whelan T.

British Columbia Cancer Agency-Vancouver Island; University of British Columbia, 
BC, Canada.

PURPOSE: To report 3-year toxicity, cosmesis, and efficacy of a multicenter study
of external beam, accelerated partial breast irradiation (APBI) for early-stage
breast cancer. METHODS AND MATERIALS: Between March 2005 and August 2006, 127
women aged ?40 years with ductal carcinoma in situ or node-negative invasive
breast cancer ?3 cm in diameter, treated with breast-conserving surgery achieving
negative margins, were accrued to a prospective study involving five Canadian
cancer centers. Women meeting predefined dose constraints were treated with APBI 
using 3 to 5 photon beams, delivering 35 to 38.5 Gy in 10 fractions, twice a day,
over 1 week. Patients were assessed for treatment-related toxicities, cosmesis,
and efficacy before APBI and at specified time points for as long as 3 years
after APBI. RESULTS: 104 women had planning computed tomography scans showing
visible seromas, met dosimetric constraints, and were treated with APBI to doses 
of 35 Gy (n = 9), 36 Gy (n = 33), or 38.5 Gy (n = 62). Eighty-seven patients were
evaluated with minimum 3-year follow-up after APBI. Radiation dermatitis, breast 
edema, breast induration, and fatigue decreased from baseline levels or
stabilized by the 3-year follow-up. Hypopigmentation, hyperpigmentation, breast
pain, and telangiectasia slightly increased from baseline levels. Most toxicities
at 3 years were Grade 1. Only 1 patient had a Grade 3 toxicity with
telangiectasia in a skin fold inside the 95% isodose. Cosmesis was good to
excellent in 86% (89/104) of women at baseline and 82% (70/85) at 3 years. The
3-year disease-free survival was 97%, with only one local recurrence that
occurred in a different quadrant away from the treated site and two distant
recurrences. CONCLUSIONS: At 3 years, toxicity and cosmesis were acceptable, and 
local control and disease-free survival were excellent, supporting continued
accrual to randomized APBI trials.


PMID: 20971571 [PubMed - as supplied by publisher]


2. J Am Acad Dermatol. 2010 Dec;63(6):1088-91. Epub 2010 Mar 11.

Epidermotropic metastasis from vulvar squamous cell carcinoma: a rare cutaneous
manifestation.

Wang AR, O'Brien M, Ross R, Long T, Robinson-Bostom L.

Department of Dermatology, Warren Alpert Medical School of Brown University,
Providence, Rhode Island 02903, USA.

Cutaneous metastases occur in 0.7% to 9% of all malignancies. In women, cutaneous
metastases occur most often in breast cancer, followed in order by colorectal
carcinoma, melanoma and ovarian carcinoma. Of the squamous cell carcinomas (SCC) 
that do metastasize, many are exceedingly difficult to differentiate from primary
SCC of the skin and are often found in the advanced stages with well-established 
primary tumor and lymph node involvement. This is an important distinction
because metastatic cutaneous SCC is associated with a much poorer prognosis than 
primary SCC. Cutaneous metastases from vulvar cancers are even less common and
have been reported in only 8 cases. We report a rare case of epidermotropic
metastatic squamous cell vulvar cancer in a 77-year-old woman.


PMID: 20226566 [PubMed - indexed for MEDLINE]


3. Melanoma Res. 2010 Apr;20(2):147-52.

Behavioral factors of patients before and after diagnosis with melanoma: a cohort
study - are sun-protection measures being implemented?

Soto E, Lee H, Saladi RN, Gerson Y, Manginani S, Lam K, Persaud AN, Wong R,
Alexandrescu DT, Fox JL.

New Age Skin Research Foundation New York, USA.

Melanoma is the deadliest form of all skin cancers and is highly linked to
sun-related behavior in patients. However, sun-protection behavior to prevent
melanoma in this population has been shown to be inadequate to date. The
objective of this study was to compare changes in sun protection habit before and
after patients' diagnosis with malignant melanoma. The study also seeks patients'
advice on how to improve public education on melanoma prevention. A retrospective
survey study was conducted on 68 respondents of patients diagnosed with melanoma 
from six different dermatologic practices in various boroughs of New York and
Long Island in the state of New York by telephone interviews. There was a
significant positive change in patients' sun-protection behavior after they were 
diagnosed with melanoma. Various methods of sun protection, such as avoiding sun 
exposure, applying and reapplying sunscreen, and wearing protective clothing were
practiced more frequently after diagnosis. In addition, the frequency of
sunbathing decreased drastically. Most patients were aware about the dangers of
sun exposure before their diagnosis. They, however, did not feel the need to
adopt sun-protection measures before their diagnosis. Respondents advised that
education on dangers to excess sun exposure should be provided at an early age
through multiple venues. The study reflected that 71% of diagnosed patients who
completed the survey were informed about sun protection before their diagnosis.
Many patients did not follow strict guidelines to prevent sun damage as shown by 
their behaviors before diagnosis. Diagnosis of the disease was apparently the
main motivating factor to initiate challenging behavioral changes.


PMID: 20224304 [PubMed - indexed for MEDLINE]


4. J Craniofac Surg. 2010 Mar;21(2):301-5.

Free fibula osteocutaneous flap for primary reconstruction of T3-T4 gingival
carcinoma.

He Y, Zhang ZY, Zhu HG, Sader R, He J, Kovacs AF.

Department of Oral and Maxillofacial Surgery, Shanghai Jiao-tong University,
School of Medicine, Shanghai 9th People's Hospital, Shanghai, PR China.

Lower gingival squamous cell carcinoma (SCC) frequently invades the mandibular
bone and buccal or lingual oral mucosa. In the concept of en bloc surgery of
malignant tumors, it is advisable to prefer segmental mandibulectomy for T3-T4
lower gingival carcinoma that had radiologic bone involvement and resection of
soft tissue on the buccal or lingual side with negative border of margin.
Consequential defects of oral mucosa and mandible need immediate reconstruction
to provide the maximum probability of cure and quality of life with minimal donor
site morbidity. The aim of this study was to evaluate the fibula osteocutaneous
flap with skin island as a means to meet both hard and soft tissue
reconstructions needed in a one-stage procedure of gingival SCC. Data of 17
patients, with gingival SCC pathologically and who underwent en bloc operations
including segmental mandibulectomy and reconstruction of mandible and intraoral
mucosa with fibular flap, were retrospectively analyzed. The segmental mandibular
defects ranged from 8 to 17 cm, and intraoral soft tissue defects ranged from 4
degrees at 2.5 cm to 8.5 degrees at 4 cm. The flaps survived in all 17 patients
including 9 patients who received postoperative radiotherapy with good final
function of the lower leg. Of 17 patients, 11 had with no evidence of disease
with a mean follow-up period of 25 months. Our study results, together with
literature findings, revealed that the fibula that had a long length of
good-quality bone and sufficient blood supply were suitable for stable
osteosynthesis, with the overlying skin suitable in thickness and without
limitation of skin flap size for intraoral reconstruction especially after
ablative surgery. This method provides oral and maxillofacial surgeons with a
means to meet both hard and soft tissue needs in a one-stage procedure for
extensive resection of gingival SCC.


PMID: 20186097 [PubMed - indexed for MEDLINE]


5. Am J Public Health. 2010 Apr;100(4):735-41. Epub 2010 Feb 18.

A randomized trial of tailored skin cancer prevention messages for adults:
Project SCAPE.

Glanz K, Schoenfeld ER, Steffen A.

Department of Epidemiology and Biostatistics, University of Pennsylvania,
Philadelphia, PA 19104-6021, USA. kglanz@upenn.edu

OBJECTIVES: We evaluated the impact of a mailed, tailored intervention on skin
cancer prevention and skin self-examination behaviors of adults at moderate and
high risk for skin cancer.
METHODS: Adults at moderate and high risk for skin cancer were recruited in
primary health care settings in Honolulu, HI, and Long Island, NY. After
completing a baseline survey, participants were randomized to 2 groups. The
treatment group received tailored materials, including personalized risk
feedback, and the control group received general educational materials.
Multivariate analyses compared sun protection and skin self-examination between
groups, controlling for location, risk level, gender, and age.
RESULTS: A total of 596 adults completed the trial. The tailored materials had a 
significant effect on overall sun-protection habits, the use of hats, the use of 
sunglasses, and the recency of skin self-examination. Some effects were moderated
by location and risk level.
CONCLUSIONS: Tailored communications including personalized risk feedback can
improve sun-protection behaviors and skin self-examination among adults at
increased risk for skin cancer. These convenient, low-cost interventions can be
implemented in a variety of settings and should be tested further to assess their
long-term effectiveness.


PMCID: PMC2836338
PMID: 20167900 [PubMed - indexed for MEDLINE]


6. Br J Oral Maxillofac Surg. 2010 Jul;48(5):331-7. Epub 2009 Nov 12.

Indications for the scapular flap in reconstructions of the head and neck.

Brown J, Bekiroglu F, Shaw R.

Department of Oral and Maxillofacial Surgery, University Hospital Aintree, Lower 
Lane, Liverpool L9 7AL, United Kingdom. brownjs@doctors.org.uk

Composite free flaps that are available for reconstructions of the head and neck 
include those from the fibula, iliac crest, radial forearm, and scapula, but only
that from the scapula precludes two-team operating, and consequently adds a
further 2-3h to the operating time. Here we clarify the indications for the
subscapular system of composite flaps, and discuss their unique properties in
terms of reliability of the bony segment, their resistance to atherosclerosis,
and the diversity of the skin and muscular components that are available. We have
had favourable results in composite resections of the anterior mandible that
required substantial resections of the anterior tongue. In extensive
oropharyngeal resections that require a segmental resection of the mandible, the 
skin island is reliable and provides sufficient bulk to reduce the risk of
dehiscence and maintain a narrowed oropharynx to improve speech and swallowing.
In reconstructions of the midface a combination of the latissimus dorsi and the
scapula that is based on the angular branch of the thoracodorsal vessel
(thoracodorsal angular flap) allows for a long pedicle, and adequate muscle and
bone for high and low maxillectomy defects. We present a consecutive series of 46
patients who document the use of this option in routine head and neck practice.


PMID: 19913337 [PubMed - indexed for MEDLINE]


7. Foot Ankle Spec. 2008 Oct;1(5):297-9. Epub 2008 Jul 29.

A case of verrucous carcinoma (epithelioma cuniculatum) of the heel mimicking
infected epidermal cyst and gout.

Arefi M, Philipone E, Caprioli R, Haight J, Richardson H, Sheng Chen.

Department of Podiatric Surgery, Albert Einstein College of Medicine Long Island 
Jewish Medical Center, New Hyde Park, New York, USA. marefi4@yahoo.com

Verrucous carcinoma is a rare variant of well-differentiated squamous cell
carcinoma. It usually occurs in the oral cavity, genital area, and sole.
Verrucous carcinoma of the sole, also called epithelioma cuniculatum, often
presents a diagnostic challenge both clinically and histopathologically. The
authors report such a case that mimics infected epidermal cyst and gout
clinically.


PMID: 19825731 [PubMed - indexed for MEDLINE]


8. J Cutan Pathol. 2009 Oct;36 Suppl 1:42-5.

Cutaneous myoepithelioma with a plexiform pattern of growth: a case report.

Franklin G, Chen S, Sznyter LA, Morgenstern NJ.

Department of Pathologyy, North Shore-Long Island Jewish Health System, Long
Island Jewish Medical Center, The Long Island Campus of Albert Einstein College
of Medicine, New Hyde Park, NY 11040, USA.

Cutaneous myoepithelioma, a recently recognized, rare but well-characterized
entity, is comprised solely of myoepithelial cells. In this report, we describe a
cutaneous myoepithelioma with a plexiform pattern of growth in the scapular
region of a 58-year-old woman.


PMID: 19775394 [PubMed - indexed for MEDLINE]


9. J Plast Reconstr Aesthet Surg. 2010 Jul;63(7):1169-75. Epub 2009 Jul 1.

Inferior gluteal artery myocutaneous island transposition flap reconstruction of 
irradiated perineal defects.

Boccola MA, Rozen WM, Ek EW, Teh BM, Croxford M, Grinsell D.

Department of Plastic and Reconstructive Surgery, Western Hospital, Gordon St,
Footscray, 3011 Victoria, Australia. mboccola@yahoo.com

BACKGROUND: With the progressive use of more radical surgical resections and
pre-operative chemo-radiotherapy for locally advanced anorectal cancers, there
has become an increasing need for reconstructive options that import
well-vascularised tissue of sufficient bulk to the perineum. We present our
technique of inferior gluteal artery myocutaneous (IGAM) transposition flaps for 
reconstruction after extended abdomino-perineal excision (APE) for anorectal
cancer.
METHODS: Six consecutive male patients with T2/T3 rectal carcinoma underwent
neoadjuvant chemo-radiotherapy followed by extended APE and immediate
reconstruction with an islanded IGAM transposition flap. The operative technique 
and surgical outcomes were assessed with follow-up ranging from 3 to 18 months
(median 5 months).
RESULTS: In all cases, there were clear histological margins with no flap
failures or partial flap losses, and no post-operative hernias. There were no
major wound complications, with only one superficial breakdown associated with
high body mass index (BMI) and adhesive tape allergy, treated with dressings
alone. There was no donor site morbidity evident following flap harvest.
CONCLUSION: The IGAM island transposition flap provides excellent tissue bulk, a 
large reliable skin paddle and a long pedicle that permits flexible positioning
with tension free closure. Our successful results and high patient satisfaction
make it a favourable option that should be considered when faced with this
reconstructive challenge.


PMID: 19574116 [PubMed - indexed for MEDLINE]


10. Microsurgery. 2009;29(4):299-302.

Osteomyocutaneous deep circumflex iliac artery perforator flap in the
reconstruction of midface defect with facial skin loss: a case report.

Shaw RJ, Brown JS.

Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK.
richard.shaw@liverpool.ac.uk

We describe the value of the osteomyocutaneous deep circumflex iliac artery
perforator (DCIAP) flap in the complex midface defect requiring oronasal,
skeletal, and facial skin reconstruction. The skin island is thin and vascular
pedicle is long and flexible enough to allow reconstruction of a variety of
cutaneous defects. The DCIAP option offers an apparently excellent and complete
reconstruction and good potential for subsequent rehabilitation, however can be
raised synchronously with the ablative procedure and requires only one pair of
anastamoses.


PMID: 19274653 [PubMed - indexed for MEDLINE]


11. Oral Oncol. 2008 Nov;44(11):1014-8. Epub 2008 Jul 11.

The submental island flap for reconstruction of intraoral defects in oral cancer 
patients.

Sebastian P, Thomas S, Varghese BT, Iype EM, Balagopal PG, Mathew PC.

Head and Neck Service, Division of Surgical Oncology, Regional Cancer Centre,
Trivandrum 695 011, India.

The submental artery island flap (SIF) is gaining acceptance as a simple and
reliable option in selected oral oncologic reconstructions. The present study
aims to assess the usefulness of submental artery flap in oral reconstruction
with respect to flap reliability, cosmesis, function, donor site morbidity and
oncological safety. Thirty (30) patients who underwent ablative surgery and
reconstruction using the submental artery island flap for oral cancer at Regional
Cancer Centre, Trivandrum, India, between October 2004 and December 2006 were
prospectively studied for the flap viability, cosmesis, function (speech and
swallowing) and locoregional recurrence. The site and stage of the tumour, type
of resection, management of the neck and the technique of flap transfer were
recorded and the patients were followed up to assess the status of the flap and
its donor site and the oncologic outcomes. There were 19 men and 11 women, ages
of whom ranged from 30 years to 78 years with a mean+/-SD of 53+/-11 years. With 
the exception of one patient who had undergone neck dissection as part of a
previous surgery, all patients underwent neck dissection or at least a level I
clearance along with the wide excision of the primary lesion. The follow up
period ranged from 4 to 25 months with a median of 13.5 months. Six patients
either recurred locoregionally or had metachronous second primary constituting an
over all recurrence rate of 20%. The size of the skin paddle ranged from 3 x 3 cm
to 7 x 6 cm, with a mean size of 4.9 x 4 cm. One total and one partial flap loss 
were observed. One patient had intractable hair growth on the flap even 3 months 
after surgery. Donor site healing was excellent in all cases and the donor site
scar was well hidden. The long term cosmesis and functions were good in all the
patients. The submental artery island flap is a simple and reliable option for
oral cancer reconstruction in carefully selected cases, with acceptable cosmetic 
and functional results and reasonable oncological safety.


PMID: 18620890 [PubMed - indexed for MEDLINE]


12. Unfallchirurg. 2008 May;111(5):323-30.

[Anterolateral thigh flaps for reconstruction of traumatological and oncological 
defects].

[Article in German]

Langer S, Steinsträsser L, Lehnhardt M, Strack N, Steinau HU, Daigeler A, Homann 
HH.

Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum,
Operatives Referenzzentrum für Extremitätentumore, Berufsgenossenschaftliches
Universitätsklinikum Bergmannsheil, Bochum, Germany. stefan.langer@rub.de

BACKGROUND: The anterolateral thigh flap (ALT) has become one of the most
preferred options for soft tissue defect reconstruction in Asia with an
increasing popularity in Europe. The article presents the authors' experience
using the ALT flap for various indications in the upper and lower extremities.
METHODS: Between January 2005 and March 2007, 60 free ALT flaps were operated for
reconstruction of various soft tissue defects. The causes of soft tissue defects 
included trauma (13), infection (26), and sarcoma resection (21). We operated on 
39 male and 19 female patients with an average age of 50.9 years (range: 16-84
years).
RESULTS: The flap survival rate was 95.0% percent (57 of 60 flaps); 5% of the
flaps died. The donor site was closed primarily in all cases. Donor site
complications were minimal. The average operative time was 282 min (69-544 min). 
Flap-related major complications occurred in 35.0% of patients including
reexploration of the anastomoses and partial flap necrosis. Minor complications, 
e.g., wound infection, hematoma, and swelling were seen in 23 cases.
CONCLUSIONS: Our experience indicates that the free ALT flap is a reliable method
for soft tissue defect reconstruction. The use of the ALT offers many advantages 
such as a long and large caliber vascular pedicle, a large skin island as well as
minimal donor site morbidity. The surgery can simultaneously performed by two
teams with the patient in a supine position.


PMID: 18443756 [PubMed - indexed for MEDLINE]


13. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Nov;42(11):849-51.

[Application of reversed pedicled submental island flap].

[Article in Chinese]

Chen XM, Mao CL, Chen H, Zhen ZN, Zhao M, Li JZ, Yang FW, Wang MX.

Department of Otorhinolaryngology Head and Neck Surgery, Fuzhou General Hospital 
of People's Liberation Army, Fuzhou 350025, China. fzchxming@sina.com

OBJECTIVE: To explore the clinical applications of reversed pedicled submental
island flap in the face and oropharynx.
METHODS: The clinical data of ten cases of reconstruction of defect in the area
of face or oropharynx following resection of tumors with reversed pedicled
submental island flaps between January of 2004 to December of 2006 were
retrospectively studied. The cases included six males and four females, aged from
24 to 76 (median 55 years). One of the cases suffered from upper lid melanoma,
two hard palate myoepthelioma, one maxillary ameloblastoma, four tonsil cancer
and two lingual carcinoma. The submental island flaps were dissected according to
the area of the defection, the distal facial vessel was used as the pedicle of
the flaps, and the flaps were transferred through under the skin of the face or
the mandible to the area of the defection. Radical neck dissection was performed 
in the four tonsil cancers and two lingual carcinomas simultaneously.
RESULTS: All the flaps showed pale, edema and/or congestion after the surgical
treatment, but swelling and congestion disappeared gradually 5 days later. One of
the cases suffered from severe congestion of the flap, but the flap survived by
stabing with needle and draining. The flap of another case separated from the
hard palate was sutured again, and healed. Lower lip palsy occurred in another
case, and recovered 3 months later by conservative therapy. None of the flaps
necrosed.
CONCLUSIONS: Because of the upper pedicel, reversed pedicled submental island
flap can be transferred to a long distance to reconstruct the defect in the upper
face or around the orbit, and radical neck dissection can be performed
simultaneously, it is a reasonable candidate in repairing the defect of the face 
and oropharynx.


PMID: 18300450 [PubMed - in process]


14. Dermatol Nurs. 2007 Oct;19(5):440-3, 447.

Literature review of theory-based empirical studies examining adolescent tanning 
practices.

Reynolds D.

Long Island University, Brooklyn, NY, USA.

Lifetime exposure to ultraviolet radiation is a major risk factor for all types
of skin cancer. The purpose of this manuscript is to examine theory-guided
empirical studies examining adolescent tanning practices.


PMID: 18286858 [PubMed - indexed for MEDLINE]


15. J Plast Reconstr Aesthet Surg. 2008;61(2):158-64. Epub 2007 Nov 26.

Clinical use of a pedicled anterolateral thigh flap.

Ng RW, Chan JY, Mok V, Li GK.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University
of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong
SAR, PR China. ngwmr@hkucc.hku.hk

BACKGROUND: Anterolateral thigh flap is a safe and reliable flap for soft tissue 
reconstruction. It has successfully been used as free flap reconstruction for
defects in the head and neck region, the upper extremities and lower extremities.
However, there were only a few reports in the literature concerning the clinical 
application of this flap for regional reconstruction.
METHODS: The authors describe their experience of using the pedicled island
anterolateral thigh flap for reconstruction of soft tissue defects in
neighbouring areas. Representative cases are presented for illustration.
RESULT: Between July 2005 and September 2006, seven patients underwent an
immediate reconstruction with pedicled anterolateral thigh flap. The patients
were between 49 and 69 years old. The size of the flaps measured from 5 x 8 cm to
15 x 15 cm. They were prepared as myocutaneous flaps in three cases and as
perforator flaps in four cases. One patient, who had the largest flap harvested, 
needed skin grafting of the donor site. Primary closure was performed for all
other cases. All flaps survived without any vascular compromise and the donor
site healed without complication.
CONCLUSION: Our study has shown that the pedicled anterolateral thigh flap is a
safe and reliable flap for repair of defects at the internal pelvis, lateral
thigh, groin, and genitoperineal region. The long vascular pedicle and having no 
restriction to the arc of rotation are keys to the successful transposition of
the flap for immediate reconstruction of soft tissue defects in neighbouring
areas.


PMID: 18023266 [PubMed - indexed for MEDLINE]


16. Am J Clin Dermatol. 2007;8(4):195-200.

The role of topical cyclo-oxygenase-2 inhibitors in skin cancer: treatment and
prevention.

Zhan H, Zheng H.

Department of Medicine, Long Island Jewish Medical Center, Albert Einstein
College of Medicine, New Hyde Park, New York 11040, USA. hczhanmd@yahoo.com

Cyclo-oxygenases (COXs) are rate-limiting enzymes in arachidonic acid metabolism 
and prostaglandin production. COX-2 is the main UV-responsive COX isoform in
human skin and is involved in UV-induced skin inflammation and apoptosis. The
topical NSAID diclofenac works as a nonspecific COX inhibitor and is an effective
and well tolerated treatment for actinic keratosis, which is a principal
precursor of cutaneous squamous cell carcinoma. Oral and topical COX-2 inhibitors
have chemopreventive activity against chemically and UV light-induced skin cancer
in animal models. The mechanism of action of COX inhibitors in skin tumorigenesis
is complex and not completely understood. Clinical trials to evaluate whether
topical administration of NSAIDs or specific COX-2 inhibitors can prevent skin
cancer in high-risk patients are warranted.


PMID: 17645375 [PubMed - indexed for MEDLINE]


17. Tissue Eng. 2007 Jun;13(6):1299-312.

Autologous bone marrow-derived cultured mesenchymal stem cells delivered in a
fibrin spray accelerate healing in murine and human cutaneous wounds.

Falanga V, Iwamoto S, Chartier M, Yufit T, Butmarc J, Kouttab N, Shrayer D,
Carson P.

Department of Dermatology, Roger Williams Medical Center, Providence, Rhode
Island 02908, USA. vfalanga@bu.edu

The nonhematopoietic component of bone marrow includes multipotent mesenchymal
stem cells (MSC) capable of differentiating into fat, bone, muscle, cartilage,
and endothelium. In this report, we describe the cell culture and
characterization, delivery system, and successful use of topically applied
autologous MSC to accelerate the healing of human and experimental murine wounds.
A single bone marrow aspirate of 35-50 mL was obtained from patients with acute
wounds (n = 5) from skin cancer surgery and from patients with chronic,
long-standing, nonhealing lower extremity wounds (n = 8). Cells were grown in
vitro under conditions favoring the propagation of MSC, and flow cytometry and
immunostaining showed a profile (CD29+, CD44+, CD105+, CD166+, CD34-, CD45-)
highly consistent with published reports of human MSC. Functional induction
studies confirmed that the MSC could differentiate into bone, cartilage, and
adipose tissue. The cultured autologous MSC were applied up to four times to the 
wounds using a fibrin polymer spray system with a double-barreled syringe. Both
fibrinogen (containing the MSC) and thrombin were diluted to optimally deliver a 
polymerized gel that immediately adhered to the wound, without run-off, and yet
allowing the MSC to remain viable and migrate from the gel. Sequential adjacent
sections from biopsy specimens of the wound bed after MSC application showed
elongated spindle cells, similar to their in vitro counterparts, which
immunostained for MSC markers. Generation of new elastic fibers was evident by
both special stains and antibodies to human elastin. The application of cultured 
cells was safe, without treatment-related adverse events. A strong direct
correlation was found between the number of cells applied (greater than 1 x 10(6)
cells per cm2 of wound area) and the subsequent decrease in chronic wound size (p
= 0.0058). Topical application of autologous MSC also stimulated closure of
full-thickness wounds in diabetic mice (db/db). Tracking of green fluorescent
protein (GFP)+ MSC in mouse wounds showed GFP+ blood vessels, suggesting that the
applied cells may persist as well as act to stimulate the wound repair process.
These findings indicate that autologous bone marrow-derived MSC can be safely and
effectively delivered to wounds using a fibrin spray system.


PMID: 17518741 [PubMed - indexed for MEDLINE]


18. J Invest Dermatol. 2007 Oct;127(10):2307-14. Epub 2007 May 10.

Epigenetic control of the S100A6 (calcyclin) gene expression.

Le?niak W, S?omnicki ?P, Ku?nicki J.

Department of Molecular and Cellular Neurobiology, Nencki Institute of
Experimental Biology, Warsaw, Poland. w.lesniak@nencki.gov.pl

S100A6 (calcyclin) is a calcium-binding protein of cell-specific expression whose
gene is clustered with other S100 genes within the epidermal differentiation
complex, on human chromosome 1q21. Many S100 proteins, including S100A6, are
expressed in human epidermis at various stages of differentiation and their
expression is often deregulated in skin and epithelial cancers. To gain insight
into the mechanism of regulation of S100A6 expression, we examined epigenetic
marks, that is DNA methylation and histone modifications along the S100A6 gene.
Sequencing of bisulfite-modified DNA within a 3,247 bp long genomic region
encompassing the promoter/first exon CpG island, the coding sequence of the
S100A6 gene and a downstream region showed that it is almost entirely
methylation-free in S100A6 expressing human epidermoid carcinoma (Hep-2) cells
and lymphocytes and methylated in S100A6-negative embryonic epithelial (HEK293)
cells. Chromatin immunoprecipitation revealed profound differences in the level
of histone H3 acetylation and methylation and in the in vivo binding of upstream 
regulatory factor (USF), to the S100A6 gene promoter in S100A6-negative and
-positive cells. These data demonstrate that cell-specific S100A6 expression is
under control of epigenetic mechanisms.


PMID: 17495951 [PubMed - indexed for MEDLINE]


19. Am J Dermatopathol. 2007 Apr;29(2):169-71.

A metastatic melanoma with an unusual immunophenotypic profile.

Gao Z, Stanek A, Chen S.

Department of Pathology, Albert Einstein College of Medicine North Shore Long
Island Jewish Health System, New Hyde Park, NY 11040, USA.

The most commonly used melanocytic markers are S100, HMB45, Melan-A, or MART-1
and tyrosinase. Melanoma with complete, concordant loss of these markers has not 
been reported. We report a case of metastatic melanoma with complete loss of
staining for S100, HMB45, Melan-A, and tyrosinase. Interestingly, both the
primary melanoma and its metastasis were strongly positive for CD99.


PMID: 17414440 [PubMed - indexed for MEDLINE]


20. Am J Dermatopathol. 2007 Feb;29(1):56-8.

Plexiform epithelioid schwannoma: a case report.

Gao Z, Palleschi SM, Chen S.

Department of Pathology, Albert Einstein College of Medicine, Long Island Jewish 
Medical Center, New Hyde Park, NY, USA.

Epithelioid schwannoma is rare but may pose a challenge in histopathologic
diagnosis. In the present report, we describe a plexiform variant of epithelioid 
schwannoma in the skin of the breast of a 47-year-old woman.


PMID: 17284962 [PubMed - indexed for MEDLINE]