Posterior instrumentation through the pedicle is a common surgery. Understanding the morphometry of the pedicle and the anatomy of adjacent neural structures should help decrease the risk of postoperative complications. T1-L5 segments from 15 sets of human vertebrae were separated into individual vertebrae and the morphometric characteristics of the thoracic and lumbar spine and the safe zone of the pedicle were analyzed. T11-L5 segments from six human cadavers were dissected. Measurements were taken from the pedicle to the dura and nerve roots superiorly, inferiorly, medially, and laterally, and the transverse angles of the nerve roots were measured. Pedicles were widest in L5 and narrowest in T4 in the transverse plane, and widest in T11 or T12 and narrowest in T1 in the sagittal plane. In individual pedicle, the ranges of the safe zone width and height were 3.4-7.7 and 8.6-13.7 mm, respectively, in T1-T10; and 7.2-17.8 and 13.9-16.7 mm, respectively, in T11-L5. The transverse angle of the pedicle decreases progressively from T1 to T12, then increase from L1 to L5.In sagittal angle, the largest angle localized at T2 and the smallest at L5. The mean distances from pedicles to adjacent neural structures were greater superiorly and laterally than inferiorly and medially. The lateral distance between nerve root and the pedicle ranged from 2.4 to 9.6 mm in lumbar spine. This study provides potential safe zones for the application of through-pedicle procedures to help decrease the risk of postoperative complications.
Hypertrophic scarring is related to persistent activation of transforming growth factor-β (TGF-β)/Smad signaling. In the TGF-β/Smad signaling cascade, the TGF-β type I receptor (TGFBRI) phosphorylates Smad proteins to induce fibroblast proliferation and extracellular matrix deposition. In this study, we inhibited TGFBRI gene expression via TGFBRI small interfering RNA (siRNA) to reduce fibroblast proliferation and extracellular matrix deposition. Our results demonstrate that downregulating TGFBRI expression in cultured human hypertrophic scar fibroblasts significantly suppressed cell proliferation and reduced type I collagen, type III collagen, fibronectin, and connective tissue growth factor (CTGF) mRNA, and type I collagen and fibronectin protein expression. In addition, we applied TGFBRI siRNA to wound granulation tissue in a rabbit model of hypertrophic scarring. Downregulating TGFBRI expression reduced wound scarring, the extracellular matrix deposition of scar tissue, and decreased CTGF and α-smooth muscle actin mRNA expression in vivo. These results suggest that TGFBRI siRNA could be applied clinically to prevent hypertrophic scarring.
BackgroundTo treat skin color disorders, such as vitiligo or burns, melanocytes are transplanted for tissue regeneration. However, melanocyte distribution in the human body varies with age and location, making it difficult to select the optimal donor skin to achieve a desired color match. Determining the correlations with the desired skin color measurement based on CIELAB color, epidermal melanocyte numbers, and melanin content of individual melanocytes is critical for clinical application.MethodFifteen foreskin samples from Asian young adults were analyzed for skin color, melanocyte ratio (melanocyte proportion in the epidermis), and melanin concentration. Furthermore, an equation was developed based on CIELAB color with melanocyte ratio, melanin concentration, and the product of melanocyte ratio and melanin concentration. The equation was validated by seeding different ratios of keratinocytes and melanocytes in tissue-engineered skin substitutes, and the degree of fitness in expected skin color was confirmed.ResultsLinear regression analysis revealed a significant strong negative correlation (r = − 0.847, R2 = 0.717) between CIELAB L* value and the product of the epidermal melanocyte ratio and cell-based melanin concentration. Furthermore, the results showed that an optimal skin color match was achieved by the formula.DiscussionWe found that L* value was correlated with the value obtained from multiplying the epidermal melanocyte ratio (R) and melanin content (M) and that this correlation was more significant than either L* vs M or L* vs R. This suggests that more accurate prediction of skin color can be achieved by considering both R and M. Therefore, precise skin color match in treating vitiligo or burn patients would be potentially achievable based on extensive collection of skin data from people of Asian descent.
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