INTRODUCTION AND OBJECTIVES: The benefits of using amniotic tissue in skin regeneration are well documented. Today, cryopreservation technology allows for better availability and maintenance of mesenchymal stem cells. This is of particular interest in treating the diabetic foot ulcer as this population has fewer mesenchymal stem cells. The objective of this case series investigation was to compare the efficacy of cryopreserved human amniotic stem cells in treating foot wounds of different etiologies. We will present data and case photos for a diabetic foot ulcer, venous leg ulcer, arterial ankle ulcer, and a pyoderma gangrenosum ulcer METHODS: Cryopreserved human amniotic stem cell grafts were applied to patients with chronic ulcers of different etiologies that had been subjected to at least 4 weeks of standard wound care and did not show adequate clinical progress. Wound area was recorded and photographed on weekly basis. Area reduction was charted over time and the results of each individual case were compared to one another. RESULTS: All ulcers displayed results that well exceeded the established parameters of weekly healing rates for effective wound treatment modalities. • Pyoderma gangrenosum displayed the poorest response to treatment. However, it is worth noting that the patient was not compliant in the prescribed adjunctive treatment regimen but managed to achieve 64% wound reduction. • All ulcers showed the largest appreciable amount of healing in both total area reduction and week-to- week closure percentage after the first application. CONCLUSIONS: Cryopreserved human amniotic stem cell grafts can aid in the decreasing the time to closure of various types of lower extremity ulcerations. The therapy is a clinically viable option for physicians to consider when formulating a treatment plan for a patient with an ulcer.

fracture radiographs by radiographers: the impact of a training programme. Br J Radiol (in press). Kleihauer testingNeed not be abandoned ED1ToR,-We recently conducted a survey of Kleihauer testing in the North Western region, and our findings are similar to those of Jennifer K M Duguid and Imelda Bromilow,' confirming the poor reproducibility and variability of the test as currently performed. We agree with Elizabeth A Letsky and Mahes de Silva that the reasons for the greater failure rate of prophylaxis with anti-D immunoglobulin in Britain compared with other countries require further investigation.' We do not automatically conclude, however, that the recommended standard dose of 500 IU for postpartum prophylaxis in Britain should be reviewed.Our study entailed a comparison of Kleihauer testing in hospital with analysis by flow cytometry for the investigation of fetomaternal haemorrhage when the perceived volume was over 4 ml of fetal red cells. Flow cytometry measured Rh D positive cells rather than fetal haemoglobin, which the Kleihauer test measures.Over 12 months we analysed 43 maternal