Valproic acid (VPA), a widely used anticonvulsant, inhibits glycogen synthase kinase 3β and activates the Wnt/β-catenin pathway, which is associated with hair growth cycle and anagen induction. To assess the efficacy of topical VPA for treating androgenetic alopecia (AGA), we performed a randomized, double-blind, placebo-controlled clinical trial. Male patients with moderate AGA underwent treatment with either VPA (sodium valproate, 8.3%) or placebo spray for 24 weeks. The primary end-point for efficacy was the change in hair count during treatment, which was assessed by phototrichogram analysis. Of the 40 patients enrolled in the study, 27 (n = 15, VPA group; n = 12, placebo group) completed the entire protocol with good compliance. No statistical differences in age, hair loss duration and total hair count at baseline were found between the groups. The mean change in total hair count was significantly higher in the VPA group than in the placebo group (P = 0.047). Both groups experienced mostly mild and self-limited adverse events, but their differences in prevalence rates were similar between the two groups (P = 0.72). A subject treated with topical VPA developed ventricular tachycardia, but it did not seem to be related to the VPA spray. Topical VPA increased the total hair counts of our patients; therefore, it is a potential treatment option for AGA.
IMPORTANCE There are limited data from randomized clinical trials comparing propranolol and steroid medication for treatment of infantile hemangioma (IH). OBJECTIVE To determine the efficacy and safety of propranolol compared with steroid as a first-line treatment for IH. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical noninferiority trial tested the efficacy and safety of propranolol vs steroid treatment for IH at a single academic hospital. All participants were diagnosed with IH between June 2013 and October 2014, had normal heart function, and had not been previously treated for IH. INTERVENTIONS The participants were randomly assigned to either the propranolol group or the steroid group. In the propranolol group, the patients were admitted, observed for adverse effects for 3 days after treatment initiation, and then released and treated as outpatients for 16 weeks (2 mg/kg/d). In the steroid group, the patients were seen as outpatients from the beginning and were also treated for 16 weeks (2 mg/kg/d). MAIN OUTCOMES AND MEASURES The primary efficacy variable was the response to treatment at 16 weeks, which was evaluated by the hemangioma volume using magnetic resonance imaging before and at 16 weeks after treatment initiation. While comparing the effect of medication between the groups, we monitored the adverse effects of both drugs. RESULTS A total of 34 patients (15 boys, 19 girls; mean age, 3.3 months; range, 0.3-8.2 months) were randomized to receive either propranolol or steroid treatment (17 in each treatment group). Guardians for 2 patients in the steroid group withdrew their consent, and 1 patient in the propranolol group did not complete the efficacy test. The intention-to-treat analysis, applying multiple imputations, found the treatment response rate in the propranolol group to be 95.65%, and that of the steroid group was 91.94%. Because the difference in response rate between the groups was 3.71%, propranolol was considered noninferior. We found that there was no difference between the groups in safety outcomes. CONCLUSIONS AND RELEVANCE Our trial demonstrated that propranolol was not inferior to steroid with respect to therapeutic effects in IH. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01908972
The interest in layered materials is largely based on the expectation that they will be beneficial for a variety of applications, from low-power-consuming, wearable electronics to energy harvesting. However, the properties of layered materials are highly dependent on thickness, and the difficulty of controlling thickness over a large area has been a bottleneck for commercial applications. Here, we report layer-by-layer growth of SnSe 2 , a layered semiconducting material, via van der Waals epitaxy. The films were fabricated on insulating mica substrates with substrate temperatures in the range of 210 °C-370 °C. The surface consists of a mixture of N and (N±1) layers, showing that the thickness of the film can be defined with monolayer accuracy (±0.6 nm). High-resolution transmission electron microscopy reveals a polycrystalline film with a grain size of ∼100 nm and clear Moiré patterns from overlapped grains with similar thickness. We also report field effect mobility values of 3.7 cm 2 V −1 s −1 and 6.7 cm 2 V −1 s −1 for 11 and 22 nm thick SnSe 2 , respectively. SnSe 2 films with customizable thickness can provide valuable platforms for industry and academic researchers to fully exploit the potential of layered materials.
LPNY may be considered as a safe treatment option for periorbital wrinkles in Asian patients. However, three treatment sessions are not enough for maintaining optimal clinical outcome.
Propranolol was highly effective and safe in the treatment of IHs. Effect of propranolol treatment started rapidly within 1 week, and was very promising regardless of patients' and lesions' characteristics. Based on the authors' observation, they suggest that treatment should be continued several months after the proliferative phase is considered to stop clinically.
BackgroundThe differential diagnosis of common pigmented skin lesions is important in cosmetic dermatology. The computer aided image analysis would be a potent ancillary diagnostic tool when patients are hesitant to undergo a skin biopsy.ObjectiveWe investigated the numerical parameters discriminating each pigmented skin lesion from another with statistical significance.MethodsFor each of the five magnified digital images containing clinically diagnosed nevus, lentigo and seborrheic keratosis, a total of 23 parameters describing the morphological, color, texture and topological features were calculated with the aid of a self-developed image analysis software. A novel concept of concentricity was proposed, which represents how closely the color segmentation resembles a concentric circle.ResultsMorphologically, seborrheic keratosis was bigger and spikier than nevus and lentigo. The color histogram revealed that nevus was the darkest and had the widest variation in tone. In the aspect of texture, the surface of the nevus showed the highest contrast and correlation. Finally, the color segmented pattern of the nevus and lentigo was far more concentric than that of seborrheic keratosis.ConclusionWe found that the subtle distinctions between nevus, lentigo and seborrheic keratosis, which are likely to be unrecognized by ocular inspection, are well emphasized and detected with the aid of software.
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