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Cosmetic outcomes of simple facial laceration suturing in the pediatric emergency department
Eyal Reiss,Yoav Gronovich,Eyal Heiman,Elad Sela,Giora Weiser 대한소아응급의학회 2024 대한소아응급의학회지 Vol.11 No.2
Purpose: The long-term cosmetic outcomes of simple facial lacerations have not been well addressed, specifically regarding those of suturing by pediatric emergency physicians (PEPs) and plastic surgery (PS) residents. Methods: A retrospective study was performed at the pediatric emergency department of Shaare Zedek Medical Center in Jerusalem, Israel. Cosmetic outcomes of simple facial lacerations sutured within 1 year of the study were reviewed using digital photographs taken by legal guardians of children sutured in the department. The photographs were reviewed and rated blindly using the Stony Brook scar score as measures of cosmetic outcomes by 2 plastic surgeons and 1 PEP, as well as the general numeric score (GNS) rated by the guardians and the 3 doctors. The scores were compared between children sutured by PEPs (PEP group) and those sutured by PS residents (PS group). A sample size of 50 children in each study group was calculated to have enough power to show a difference. Results: Among a total of 108 children who participated in the study (median age, 4.0 years [interquartile range, 3.0-7.0]), 57 and 51 were sutured by PEPs and PS residents, respectively. Guardian-rated median GNS showed no difference between the 2 groups (PEP, 90.0 [70.0-95.0] vs. PS, 90.0 [60.0-90.0]; P = 0.310). In contrast, doctor-rated median GNS was higher in the PEP group (PEP, 75.0 [63.3-86.7] vs. PS, 70.0 [53.3-83.3]; P = 0.046). A Stony Brook scar score of 3 or higher was similarly frequent in both groups (PEP, 87.7% vs. PS, 74.5%; P = 0.173) with a low interrater agreement (Kappa = 0.36). Conclusion: Cosmetic outcomes of simple facial lacerations in the pediatric emergency department were favorable regardless of the specialty or expertise of doctors. The guardians were more satisfied with the outcomes, compared to the doctors.
Biswas, D K,Dai, S C,Cruz, A,Weiser, B,Graner, E,Pardee, A B National Academy of Sciences 2001 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.98 No.18
<P>The effect of a kinase inhibitor Go6796 on growth of epidermal growth factor (EGF)-stimulated estrogen receptor negative (ER-) breast cancer cells in vivo and role of nuclear factor kappa B (NF-kappaB) on tumorogenesis have been investigated. This was studied in an animal model by implanting ER- mouse mammary epithelial tumor cells (CSMLO) in syngeneic A-J mice. (i) Local administration of Go6976 an inhibitor of protein kinases C alpha and beta inhibited growth of tumors and caused extensive necrotic degeneration and regression of the tumors without causing any microscopically detectable damage to the vital organs liver and lung. (ii) Stable expression of dominant-negative mutants of the beta subunit (dnIkkbeta) of the inhibitory kappa B (IkappaB) kinase (dnIkk) that selectively blocked activation of NF-kappaB caused loss of tumorigenic potential of CSMLO cells. Stable expression of dnIkkbeta also blocked phorbol 12-myristate 13-acetate (PMA)-induced activation of NF-kappaB and overexpression of cyclin D1, concomitantly with the loss or reduced tumorigenic potential of these cells. Thus, results from in vivo and in vitro experiments strongly suggest the involvement of NF-kappaB in ER- mammary epithelial cell-mediated tumorigenesis. We propose that blocking NF-kappaB activation not only inhibits cell proliferation, but also antagonizes the antiapoptotic role of this transcription factor in ER- breast cancer cells. Thus, NF-kappaB is a potential target for therapy of EGFR family receptor-overexpressing ER- breast cancers.</P>