Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simp...Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simple technique by direct melanocytes transplant by spade needle technique in treatment of vitiligo. Patients and Methods: This interventional, therapeutic, comparative study was done in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from April 2014-March 2015. Twenty patients with localized, generalized and segmental vitiligo were included. Full history and examination for each patient was done with 4 (20%) males and 16 (80%) females and their ages ranged from 9 - 40 (23.15 ± 11.44) years. Forty one patches in 20 patients treated by spade grafting technique and the donor and recipient sites were demarcated and anesthesia done by xylocaine 2% with adrenalin 1:100,000. Transplantation was started by using disposable needle gauge 18 (the sharp end of needle was cut by a scissor to make it a spade like) with medical syringe 5 ml supplied with normal saline. The micro-pieces were taken from donor site and transplanted directly, easily and rapidly into dermis of recipient site and followed by pushing normal saline and the procedure was repeated to cover all recipient sites with 5 mm distance between injection points. The surface area of the lesions was calculated and the reduction rate was estimated every month till the end of the 4th month period of the treatment. Results: Including 41 patches in 20 patients with the surface area of the patches ranged from 1.5 - 90 cm<sup>2</sup> (13.78 ± 17.57) cm<sup>2</sup>. The mean ±SD of surface area of lesions was decreased from 13.78 ± 17.57 cm<sup>2</sup> at baseline visit to 13.61 ± 17.48 cm<sup>2</sup> at the second visit (after 2 weeks ) which was statistically significant (p value ≤ 0.001). The mean surface area continued to be reduced till reaching 12.20 ± 15.68 cm<sup>2</sup> at the third visit and 12.01 ± 15.55 cm<sup>2</sup> at the fourth visit. All were statistically significant when compared to baseline visit. There was reduction in surface area 1.1% at two weeks, 9.93%, and 12.5% at the 2nd, 4th months respectively. Conclusions: Intradermal injection of melanocytes in patients with vitiligo by spade like needle was very quick and simple non-costly technique, and gave 12.5% reduction which could be repeated at different times until satisfactory re-pigmentation of vitiligenous skin is achieved.展开更多
针对针式末端执行器夹持移栽后穴孔内基质残留较多的问题,设计了一种指铲式末端执行器,通过增大指铲与苗钵基质的接触面积,减少穴孔内基质的残留。通过静力学分析找出末端执行器提取苗钵后基质残留的原因:基质间的最大内聚力小于由基质...针对针式末端执行器夹持移栽后穴孔内基质残留较多的问题,设计了一种指铲式末端执行器,通过增大指铲与苗钵基质的接触面积,减少穴孔内基质的残留。通过静力学分析找出末端执行器提取苗钵后基质残留的原因:基质间的最大内聚力小于由基质与穴盘间的粘附力和苗钵重力合成的总阻力时,苗钵出现破裂,基质塌陷。基于离散单元法,通过EDEM(Enhanced discrete element method)仿真分析了指铲式末端执行器对土壤基质的抓取过程,发现随着土壤基质内聚力的提高基质残留的现象得到改善;将基质配比和含水率条件作为主要影响因素,通过组合测盘试验测量在不同基质配比和含水率试验条件下的粘附力和内聚力变化,寻找内聚力大于粘附力的基质配比和含水率条件。试验表明,当相对含水率为60%、基质配比为6∶3∶1(泥炭∶蛭石∶珍珠岩)时,内聚压强和粘附压强的差值最大,在该条件下,指铲式末端执行器对劣质苗钵穴孔基质的平均剔净率达到70.8%,优于其他作业条件,可剔除穴孔内大部分基质。展开更多
文摘Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simple technique by direct melanocytes transplant by spade needle technique in treatment of vitiligo. Patients and Methods: This interventional, therapeutic, comparative study was done in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from April 2014-March 2015. Twenty patients with localized, generalized and segmental vitiligo were included. Full history and examination for each patient was done with 4 (20%) males and 16 (80%) females and their ages ranged from 9 - 40 (23.15 ± 11.44) years. Forty one patches in 20 patients treated by spade grafting technique and the donor and recipient sites were demarcated and anesthesia done by xylocaine 2% with adrenalin 1:100,000. Transplantation was started by using disposable needle gauge 18 (the sharp end of needle was cut by a scissor to make it a spade like) with medical syringe 5 ml supplied with normal saline. The micro-pieces were taken from donor site and transplanted directly, easily and rapidly into dermis of recipient site and followed by pushing normal saline and the procedure was repeated to cover all recipient sites with 5 mm distance between injection points. The surface area of the lesions was calculated and the reduction rate was estimated every month till the end of the 4th month period of the treatment. Results: Including 41 patches in 20 patients with the surface area of the patches ranged from 1.5 - 90 cm<sup>2</sup> (13.78 ± 17.57) cm<sup>2</sup>. The mean ±SD of surface area of lesions was decreased from 13.78 ± 17.57 cm<sup>2</sup> at baseline visit to 13.61 ± 17.48 cm<sup>2</sup> at the second visit (after 2 weeks ) which was statistically significant (p value ≤ 0.001). The mean surface area continued to be reduced till reaching 12.20 ± 15.68 cm<sup>2</sup> at the third visit and 12.01 ± 15.55 cm<sup>2</sup> at the fourth visit. All were statistically significant when compared to baseline visit. There was reduction in surface area 1.1% at two weeks, 9.93%, and 12.5% at the 2nd, 4th months respectively. Conclusions: Intradermal injection of melanocytes in patients with vitiligo by spade like needle was very quick and simple non-costly technique, and gave 12.5% reduction which could be repeated at different times until satisfactory re-pigmentation of vitiligenous skin is achieved.
文摘针对针式末端执行器夹持移栽后穴孔内基质残留较多的问题,设计了一种指铲式末端执行器,通过增大指铲与苗钵基质的接触面积,减少穴孔内基质的残留。通过静力学分析找出末端执行器提取苗钵后基质残留的原因:基质间的最大内聚力小于由基质与穴盘间的粘附力和苗钵重力合成的总阻力时,苗钵出现破裂,基质塌陷。基于离散单元法,通过EDEM(Enhanced discrete element method)仿真分析了指铲式末端执行器对土壤基质的抓取过程,发现随着土壤基质内聚力的提高基质残留的现象得到改善;将基质配比和含水率条件作为主要影响因素,通过组合测盘试验测量在不同基质配比和含水率试验条件下的粘附力和内聚力变化,寻找内聚力大于粘附力的基质配比和含水率条件。试验表明,当相对含水率为60%、基质配比为6∶3∶1(泥炭∶蛭石∶珍珠岩)时,内聚压强和粘附压强的差值最大,在该条件下,指铲式末端执行器对劣质苗钵穴孔基质的平均剔净率达到70.8%,优于其他作业条件,可剔除穴孔内大部分基质。
