Using biocompatible peptide hydrogel as a scaffold, we prepared three-dimensional synthetic skin that does not contain animal-derived materials or pathogens. The present study investigated preparation methods, proliferation, and functional expression of fibroblasts in the synthetic dermis and differentiation of keratinocytes in the epidermis. Synthetic dermis was prepared by mixing fibroblasts with peptide hydrogel, and synthetic skin was prepared by forming an epidermal layer using keratinocytes on the synthetic dermis. A fibroblast-rich foamy layer consisting of homogeneous peptide hydrogel subsequently formed in the synthetic dermis, with fibroblasts aggregating in clusters within the septum. The epidermis consisted of three to five keratinocyte layers. Immunohistochemical staining showed human type I collagen, indicating functional expression around fibroblasts in the synthetic dermis, keratinocyte differentiation in the epidermis, and expression of basement membrane proteins. The number of fibroblasts tended to increase until the second week and was maintained until the fourth week, but rapidly decreased in the fifth week. In the synthetic dermis medium, the human type I collagen concentration increased after the second week to the fifth week. These findings suggest that peptide hydrogel acts as a synthetic skin scaffold that offers a platform for the proliferation and functional expression of fibroblasts and keratinocytes.

Axillary osmidrosis is characterized by offensive odor resulting from bacterial decomposition of apocrine secretions in the axillae, and individuals with axillary osmidrosis suffer detrimental effects to their psychosocial functioning. We searched the literature in January 2019 for all English-language publications discussing axillary osmidrosis to identify previous reports, present trends, and emerging treatments. Studies were listed chronologically by the country of the first author's institution. Publications were also classified regarding the study type (literature review), pathophysiology, and treatments. We identified 133 publications on axillary osmidrosis, and of these, 120 were from East-Asian countries. Before 1990, there were only 9 publications, but after 2000, publications increased in number. One hundred of 133 reports discussed treatment, namely, 39 reports on suction curettage, 28 reports on open surgery, and 8 reports on subdermal laser. Other studies focused on the pathophysiology of axillary osmidrosis. This literature review revealed unique trends in the identified studies. Because control of axillary odor is a universal subject, the etiology and pathophysiology of axillary osmidrosis have been studied throughout the world and are clearly described. However, almost all studies of surgical treatments have been performed in East-Asian countries. After the year 2000, various surgical and nonsurgical treatments, namely, laser therapy and suction curettage, have been attempted. Emerging treatments for axillary osmidrosis include ethanol injections, microwave therapy, and microneedle radiofrequency technologies; however, further studies of these treatments are needed.

Le Fort III midfacial distraction using internal and external devices is a well-accepted procedure for the midfacial retrusion of craniosynostosis syndrome patients. The authors described 20 consecutive series of Le Fort III midfacial distraction using internal distraction devices. Two types of devices were utilized. One type was a zygoma-skull device (the anterior part of the device is attached to the zygoma, and the posterior part is attached to the skull), which was used in six cases. The other was a zygoma-zygoma device (the anterior and posterior parts of the device are attached to the osteotomized zygoma, respectively), which was used in 14 cases. Subject ages ranged 3-32 years. A 14-20-mm distraction length was obtained by 1 mm/day. Satisfactory distraction of the midface was obtained in 17/20 cases. In 3/6 cases in which a zygoma-skull device was used, an unsatisfactory result was obtained. In these three cases, a fracture of the zygomatico-maxillary suture was encountered, resulting in the Le Fort III portion being left behind. In all 14 cases in which a zygoma-zygoma device was used, a satisfactory result was obtained. During the distraction period, the connection of the distraction device was dislodged, resulting in re-connection in three cases. Slight asymmetry was noticed in two cases without any need for management. In order to obtain parallel setting of the bilateral distraction devices, a newly developed parallel bar was used and demonstrated to be effective.

We have been conducting medical collaboration programs for cleft lip and palate in the Republic of Madagascar for seven years, from 2011 to 2017. The purpose of this study was to investigate the incidence of stula after primary palatoplasty in the Republic of Madagascar, which is a developing country. A further objective was to determine if the group of patients in Madagascar had an increased incidence of palatal stula compared to a similar group of patients in Japan, and to examine the factors that might be involved in any increase. We conducted a survey of the cleft type, age at time of surgery, and stula incidence in 44 patients 28 males and 16 females in Madagascar. The age at the time of surgery was 11 months to 29 years average, 7 years and 8 months , and the cleft types were 0 class , 14 class , 18 class , and 12 class , by the Veau classication. We used a modi ed two-ap palatoplasty for palatal closure. In addition to the selection of surgical technique, the factors which are suggested to in uence the incidence of stula include the experience of the surgeon, and the extent of the cleft. The incidence of postoperative stula complication in these patients was zero. In medical collaboration settings in developing countries, there are factors which may delay wound healing, such as poor oral hygiene, poor nutrition, and instability of the ap blood ow. Understanding such factors in surgery is important to avoid palatal stula. We report that a palatal stula incidence rate of 0% can be achieved by avoiding those factors which contribute to stula formation.

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