Daily Cosmetic Research Analysis

The 1-week photon radiotherapy schedule of 26 Gy in 5 fractions is as safe and effective as the standard 3-week schedule of 40 Gy in 15 fractions for adjuvant local radiotherapy in early stage breast cancer. Proton radiotherapy offers dosimetric advantages by reducing heart and lung dose but may be associated with increased acute skin toxicity, and the acute toxicity of ultra-hypofractionated proton therapy remains unknown. In this randomized trial, non-metastatic breast cancer patients were assigned to receive either proton or photon radiotherapy at a dose of 26 Gy in 5 fractions delivered on alternate days, with the aim of comparing acute skin toxicity between the two modalities. Of 140 eligible patients, 72 were included in this interim analysis, with 36 patients in each treatment arm. The highest observed toxicity was grade 2 radiation dermatitis, which occurred in one patient in the proton arm. The incidence of acute radiation dermatitis was significantly higher in the proton arm than in the photon arm (97.2% vs. 75%, P = 0.006), while no significant differences were observed in other acute toxicities. Patients treated with photon radiotherapy demonstrated better cosmetic outcomes (41.7% vs. 13.9%, P = 0.007) and higher satisfaction scores (80.6% vs. 58.3%, P = 0.04) compared with those treated with proton radiotherapy. At a median follow-up of 9 months (IQR: 6-11), no locoregional recurrence was observed in either treatment arm. This interim analysis indicates that ultra-hypofractionated proton therapy is associated with a higher incidence of mild acute radiation dermatitis, whereas photon radiotherapy results in superior cosmetic outcomes and patient satisfaction, with longer follow-up required to determine long-term outcomes.

BACKGROUND: Post-traumatic cubitus varus is a 3-dimensional deformity that may result in cosmetic dissatisfaction and, in a minority of patients, functional impairment. Translation step-cut osteotomy (TSCO) provides stable correction but may be associated with residual lateral condylar prominence. A modified spike translation step-cut configuration, referred to as the pentagonal osteotomy, has been proposed to enhance medial translation and improve cosmetic contour. This study prospectively compares the clinical, radiologic, and cosmetic outcomes of TSCO and pentagonal osteotomy in pediatric cubitus varus deformity. METHODS: This prospective comparative study included 24 children (<16y) with post-traumatic cubitus varus deformity, alternately allocated to TSCO (n=12) or pentagonal osteotomy (n=12). Patients were followed for at least 12 months. Clinical outcomes included elbow range of motion and carrying angle. Radiologic assessment comprised Baumann angle, humerus-elbow-wrist (HEW) angle, and lateral prominence index (LPI). Cosmetic outcomes were evaluated at final follow-up using the Barrett criteria, while overall functional results were graded using Oppenheim criteria. Complications were prospectively recorded. RESULTS: Both techniques achieved significant correction of deformity, restoring the physiological carrying angle and the HEW angle. Postoperative carrying angle was comparable between the TSCO (+6.5±9.08 degrees) and pentagonal groups (+7.91±1.97 degrees; P=0.603). Radiologic parameters, including the Baumann and HEW angles, improved significantly in both groups, with no significant intergroup differences. LPI improved in both cohorts, with a more negative mean value in the pentagonal group (-9.53±2.44 vs. -5.86±8.71), although this difference was not statistically significant (P=0.174). A statistically significant difference in postoperative extension deficit of 4 degrees was observed in favor of the TSCO group (P=0.046), while flexion and rotational correction were comparable. Excellent cosmetic satisfaction was reported by 83.3% of TSCO patients and 91.7% of patients undergoing pentagonal osteotomy (P=0.592). CONCLUSION: Both translation step-cut osteotomy (TSCO) and pentagonal osteotomy are safe and effective techniques for the correction of pediatric cubitus varus deformity, with comparable clinical, radiologic, and cosmetic outcomes. Further studies with larger cohorts and longer follow-up are required to determine the long-term advantages of the pentagonal osteotomy, if any. LEVEL OF EVIDENCE: Level II-prospective comparative study.

Hyaluronidases (HAase) offer a practical route to produce valued low molecular weight hyaluronic acid (LMW-HA) and HA oligosaccharides (o-HA), which are valued across medical, cosmetic, and biomaterials applications due to their enhanced bioactivity and tissue penetration. However, reliable production and scale-up of LMW‑HA and o‑HA remain complicated due to inefficient production method, potential pathogenic hosts, enzymes with limited catalytic proficiency and prone to thermal denaturation. Here, we employed a structure-guided multi-strategy engineering approach to express and optimize a PL8 family hyaluronidase in E. coli, aiming to overcome these industrial bottlenecks. Using the HA tetrasaccharide binding site mapping, residue conservation analysis, and binding energy calculations, we obtained two mutants (T204R and Y97R) with significantly improved catalytic activities of 1.56 × 10⁶ U/mg and 1.43 × 10⁶ U/mg, respectively. Building on the best-performing variant (T204R), stability-focused design yielded T204R/N206H, which extended the inactivation half-life at 45 °C by up to 1.4-fold without loss of activity. This engineered enzyme efficiently generates LMW-HA and o-HA with tunable size distributions under mild conditions. These findings expand the hyaluronidase toolbox with a recombinant PL8 enzyme, enabling controlled enzymatic production of LMW-HA and o-HA for biomedical and personal care applications.