Increase in primary liver cancer in the UK, 1979-94
Increase in primary liver cancer in the UK, 1979-94
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DOI：
10.1016/s0140-6736(05)63789-0
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发表时间：
1997-10-18
期刊：
影响因子：
168.9
通讯作者：
Thomas, HC
中科院分区：
文献类型：
--
作者：
TaylorRobinson, SD;Foster, GR;Thomas, HC
组织生物工程的进步，例如生物有用的细胞、组织和器官的开发，预计将彻底改变医学实践。 1 活体皮肤等效物 (LSE) 是一种生物工程皮肤，由 I 型牛胶原蛋白和从人类新生儿包皮中分离出的培养同种异体细胞（角质形成细胞和成纤维细胞）制成的表皮和真皮组成。在对照研究中，LSE 改善了静脉溃疡的愈合，而在开放研究中，它似乎可以改善热烧伤和皮肤癌切除造成的急性伤口的愈合。 3 我们报告了 SEL 分层自体皮片和聚氨酯膜 (PUF) 闭塞敷料治疗分层皮片供区的前瞻性、随机配对比较。在 11 名需要分层皮片移植的患者的大腿前部创建了 3 个 2·5 cm4·0 cm 供区。每个患者的供体部位均随机采用网状 LSE、网状自体移植物或 PUF 进行治疗。在第 7 天、此后每 2-3 天进行一次评估，直到所有三个供体部位均愈合，以及在第 1 个月和第 2 个月进行评估。终点是愈合时间、疼痛和美容效果（色素沉着、血管分布和身高）。 LSE 的平均愈合时间为 7·4 天 (SD 0·9)，自体移植物为 7·9 天 (1·5)，PUF 为 10·4 天 (1·7) (p= 0·0006)。除了快速愈合之外，LSE 和自体移植还减少了与供体部位愈合相关的疼痛。与 PUF 相比，LSE 或自体移植患者没有经历疼痛，PUF 十名患者中有六名伴有轻微疼痛。 LSE 和自体移植提供了更理想的美容效果。 2 个月时，所有部位色素沉着过度，但血管分布不同。 LSE 呈粉红色，自体移植物正常，PUF 呈紫色。 2 个月时，对 19 名患者中的 8 名进行了 PUF 部位评估。在参与本研究的患者中，临床服用发生率为 90%，并且没有毒性迹象或临床上可检测到的 LSE 排斥反应。我们的观察结果与使用 LSE 治疗莫氏手术后急性伤口的报道一致。 4
Advances in tissue bioengineering, such as the development of biologically useful cells, tissue, and organs, are expected to revolutionise the practice of medicine. 1 Living skin equivalent (LSE), a bioengineered skin, is composed of an epidermis and dermis made of type I bovine collagen and cultured allogeneic cells (keratinocytes and fibroblasts) isolated from human neonatal foreskin. In controlled studies, LSE improved healing in venous ulcers2 and in open studies it seemed to improve healing in thermal burns and acute wounds created by excision of skin cancer. 3 We report a prospective, randomised, paired comparison of SEL splitthickness autograft, and polyurethane film (PUF) occlusion dressing for the treatment of split-thickness skin graft donor sites.Three 2· 5 cm4· 0 cm donor sites were created on the anterior thigh of 11 patients who required split-thickness skin grafts. Each patient’s donor sites were randomly treated with meshed LSE, meshed autograft, or PUF. Evaluations were on day 7, every 2–3 days thereafter until healing of all three donor sites, and at 1 and 2 months. Endpoints were time to healing, pain, and cosmetic outcome (pigmentation, vascularity, and height). The mean time to healing was 7· 4 days (SD 0· 9) for LSE, 7· 9 days (1· 5) for autograft, and 10· 4 days (1· 7) for PUF (p= 0· 0006). In addition to rapid healing, LSE and autograft reduced the pain associated with healing donor sites. No patients experienced pain with LSE or with autograft compared with PUF which was associated with mild pain in six of ten patients. LSE and autograft afforded a more desirable cosmetic result. At 2 months all sites were hyperpigmented, but the vascularity was different. LSE was pink, autograft was normal, and PUF was purple. The PUF sites were evaluated in eight of 19 patients at 2 months. There was a 90% incidence of clinical take and no signs of toxicity or clinically detectable rejection to LSE in the patients enrolled in this study. Our observations are consistent with those reported using LSE for the treatment of acute wounds after Mohs surgery. 4