Biomedical subjects

J Fewkes

Publications and source records attributed to J Fewkes.

5 recordsLinked to original sources

PubMed1999

Acute excisional wounds treated with a tissue-engineered skin (Apligraf).

BACKGROUND: Tissue-engineered products are usually composed of living cells and their supporting matrices that have been grown in vitro, using a combination of engineering and life sciences principles. Apligraf is a bilayered product composed of neonatal-derived dermal fibroblasts and keratinocytes, and Type I bovine collagen. OBJECTIVE: To evaluate in a prospective, multicentered open study, the effects of tissue therapy with a tissue-engineered skin (Apligraf) with partial or full-thickness excisional wounds. METHODS: One hundred and seven patients participated in this study. The tissue-engineered skin was applied once, immediately after excisional surgery, usually for skin cancer, and patients were followed for up to one year. RESULTS: The safety results were impressive, with no clinical or laboratory evidence of rejection. Clinically, graft persistence was good to excellent in 77 of 105 (73.3%) of patients at one week, falling to 56.6% and 53.6% at two weeks and one month respectively. CONCLUSION: To date, this is the largest experience with a tissue-engineered skin product in acute wounds, and this study suggests that tissue therapy may be safe and useful.

Animals↗

PubMed1997

Correlation of histologic subtypes of primary basal cell carcinoma and number of Mohs stages required to achieve a tumor-free plane.

BACKGROUND: Certain histologic subtypes of basal cell carcinoma (BCC) behave more aggressively and require more aggressive treatment. OBJECTIVE: The aim of this study was to see whether certain subtypes of BCC require more Mohs stages to achieve tumor-free margins. METHODS: A retrospective study of 342 primary BCCs treated with Mohs micrographic surgery (MMS) was performed identifying the histologic subtype of BCC present and the number of stages required to clear the tumor. RESULTS: The aggressive subtypes (infiltrative, morpheaform, micronodular, and mixed) were most frequently found when high numbers of Mohs stages were required for cure. CONCLUSION: The more aggressive subtypes of BCC require more MMS stages to achieve tumor-free margins, which is consistent with the concept that these subtypes usually require more aggressive treatment from the start.

Aged↗

PubMed1995

Wound healing.

Wound healing is a dynamic biologic process of repairing insults to the integumentary system. It is commonly divided into three phases: inflammatory, proliferative, and maturation. Each phase has unique cellular and substance constituents without which it cannot progress normally. A large variety of factors may influence any part of wound healing, including local factors such as bacteria, oxygen tension, and bleeding, and systemic factors such as the mental and physical health of the patient. There are also extrinsic factors that can be influenced by the caretakers of the wound to enhance wound healing. Areas of intervention include using antiseptic technique when one is dealing with the wound, using good surgical technique, choosing the appropriate wounding method and repair for the individual patient, and using antibiotics and special wound dressings. Modern science and technology are giving us new insights into wound healing and leading us to exciting new ways of influencing it, including the topical use of growth factors, artificial skins, cultured epithelium with and without dermal components, and electrical stimulation. The future of wound healing holds a better understanding of the complexities of the physiologic events that occur and a translation of that into a biologically active and interactive wound care.

Cell Division↗

PubMed1990

Metastatic lentigo maligna melanoma.

An elderly woman presented with an advanced and ultimately lethal lentigo maligna melanoma after ignoring a precursor lesion present for several decades. Lentigo maligna melanoma can be lethal in the elderly. Early detection and treatment are warranted.

Aged↗

PubMed1986

Immunologic detection of markers of keratinocyte differentiation. Its use in neoplastic and preneoplastic lesions of skin.

We examined seven invasive squamous cell carcinomas, five squamous cell carcinomas in situ, four keratoacanthomas, two actinic keratoses, and two seborrheic keratoses by indirect immunofluorescence. We used a panel of three antibodies: one directed against filaggrin, one against involucrin, and one against peptidylarginine deiminase. Anti-involucrin stained all the lesions studied, but the pattern within a given category of lesions was variable and consistent differences between the categories were not observed. Similarly, the antibodies against peptidylarginine deiminase and filaggrin were not able to distinguish differences between the various types of tumors. We conclude that in tumors of epidermis, benign or malignant, products of differentiation are expressed independently of histologic atypia or clinical aggressiveness. Therefore, markers of differentiation do not appear to be reliable indexes for distinguishing benign from malignant lesions.

Carcinoma, Squamous Cell↗