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Sample records for burn scar contracture

  1. The post-burn elbow medial flexion scar contracture treatment with trapeze-flap plasty.

    PubMed

    Grishkevich, Viktor M

    2009-03-01

    A medial flexion elbow contracture is characterized by the presence of a fold which has a semi-lunar shape, the sheets of which are scars. The shortage in skin length and the excess in width occurs in the sheets. To estimate the size and form of length deficiency in the fold is the section from the top of the fold to the rotation axis of the joint. As a rule, the wound receives a trapeze form. To convert the sheets of the fold into trapeze-shaped flaps, several radial cross-sections from the tops of the fold to joint rotation axis are used. The flaps are mobilized with the full fat layer, and then transposed toward one another causing tension, therefore, covering the wound on the flexion surface of the joint. Flaps and the adjacent skin, displaced forward from lateral and back surfaces of the joint, participate in wound coverage. Trapezoid flaps have a wide end, stable blood circulation; they do not undergo rotation, therefore, do not undergo necrosis. Contractures are eliminated in full without relapse. As a rule, in all 35 patients the functional outcome was perfect. PMID:18848399

  2. [Burn scars: rehabilitation and skin care].

    PubMed

    Rochet, Jean-Michel; Zaoui, Affif

    2002-12-15

    Burn rehabilitation main goal is to minimize the consequences of hypertrophic scars and concomitant contractures. The treatment principles rely on the association of joint posture, continuous pressure completed with range of motion to prevent joint fusion (which happens to adults but not to children). Throughout the different treatment phases and wound evolution, reassessment is necessary to review rehabilitation goals and activities. During the acute phase the alternance of positioning is prioritized in order to keep the affected extremities in antideformity position using splint or other devices. At the rehabilitation phase, treatment is focussed on active/passive range of motion (skin posture) strengthening exercises and use of dynamic splint is introduced to correct contractures. After their discharge home, patients benefit from outpatient rehab until scar maturation (approximately 18 months). The treatment consists mainly on active/passive range of motion, scar massage, strengthening exercise and endurance retraining. Also modalities (such as thermal bath and high pressure water spray) are used to address itching problems and for scar softening. Finally, reconstructive surgery can be performed to correct excessive scarring or joint contracture for better functional or cosmetic outcome. PMID:12621946

  3. Post Burn Contracture Neck: Clinical Profile and Management

    PubMed Central

    Bankar, Sanket S.; Patil, Avinash

    2014-01-01

    Background: Morbidity related to hypertrophic scars and contractures which are well known sequel after burns remains high and in fact has increased as more severely burned patients are surviving. This study was undertaken in order to assess the varied clinical presentation, precipitating factors, preventive measures, treatment modalities of neck contractures and evaluate the results after surgical procedures. Materials and Methods: This hospital based study was conducted on patients admitted in our institution with proven cases of Post burn neck contracture from 1st August 2009 to 31st July 2011. Twenty two patients of post burn neck contracture who underwent operative treatment were included. Observation: 10 of 22 cases were in the middle age group i.e. between 21-30 years. There were 5 males and 17 females. Accidental flame burn was the commonest aetiology. Fourteen patients were treated within 1 year of burns for functional disability. Excisional release was performed in 13 and incisional release in 9 of our patients. Resurfacing with STSG (split thickness skin graft) was carried out in 19 cases and a local or regional flap with or without a graft in 3 patients. Hypertrophy and recontracture were the commonest late complications and occurred in 3 cases. Good to fair results were obtained in 19 patients Conclusion: Local flaps have many advantages and are to be used whenever possible. It is preferable to place the grafts if used in the area surrounding the neck (donor site of flap) or at least in the non-visible area of the neck (submental area). When a combination of flap & graft is used, it’s preferable to place the flap in a horizontal intersecting fashion in between the two patches of the graft. A follow up program for reasonable period is highly desired. PMID:25478392

  4. Burn Scar Neoplasm

    PubMed Central

    Kadir, A.R.

    2007-01-01

    Summary Marjolin's ulcer is a rare and aggressive cutaneous malignancy that occurs in previously traumatized and chronically inflamed skin, especially after burns. The majority of burn scar carcinomas are seen after a lag period in burns that were not grafted following injury. Between 2000 and 2006, 48 patients with Marjolin's ulcer were treated in our centre (Sulaimani Teaching Hospital and Emergency Hospital). All the lesions were secondary to burns from various causes. The medical records of these 48 patients were reviewed prospectively. The mean age at tumour diagnosis was 40 yr and the ratio of male to female was 2:1 (67% males and 33% female). Upon histological examination, all the cases were diagnosed as well-differentiated squamous cell carcinoma. The scalp was most frequently affected (16 patients = 33.3%), followed by the lower limb (14 patients = 29.1%). Treatment of the neoplasm consisted of excision and grafting in 36 patients (75.0%), excision and reconstruction with flaps in eight patients (16.6%), and amputation in three patients (6.2%). A chemotherapy combination of the above treatments was used in two patients (4.1%). Local recurrence was noted in 16 patients (33.3%) out of the 48, and all died from these recurrences. PMID:21991095

  5. Postburn neck anterior contracture treatment in children with scar-fascial local trapezoid flaps: a new approach.

    PubMed

    Grishkevich, Viktor M; Grishkevich, Max; Menzul, Vasiliy

    2015-01-01

    One of the dramatic consequences of burns is scar contracture and deformities of the neck. Cervical contracture in children is especially dangerous, leading to face disfigurement and kyphosis; therefore, early reconstruction is indicated. Despite the existence of many various surgical techniques, the successful neck contracture treatment in pediatric patients remains a challenge for surgeons. Eleven children (aged 5 to 14 years) with postburn neck anterior contractures were studied to develop a new approach for reconstruction that would employ the use of local scar-fascial flaps. The new approach and technique for postburn pediatric contracture treatment was developed which is especially effective in the treatment of children who cannot undergo complex and long surgical procedures that are aimed at both contracture elimination and neck skin restoration. The technique consists of two trapezoid scar-fascial flaps mobilization which includes all the anterior neck surfaces and consists of scars, fat layer, platysma, and deep cervical fascia. Counter transposition of flaps with tension elongated neck anterior surface was 100 to 200%. The contracture was fully eliminated, and neck contours, mentocervical angle, and head movement were restored. In case of severe contracture, residual wound in submandibular region and above clavicles were skin-grafted. The full range of head motion (functional results) was achieved in all the 11 patients. The flaps continued to grow and the skin grafts shrinkage was moderate. Local trapeze-flap plasty allows neck contracture elimination in children in the cases when a more complex technique is impossible or undesirable to use. Early surgical intervention prevents secondary complications, allotting enough time for patients to mature and be ready for more complex procedures. PMID:25522154

  6. Dupuytren’s contracture following burn injury of the hand: A case report and review of literature

    PubMed Central

    Balakrishnan, Chenicheri; Sugg, Kristoffer B; Huettner, William; Jarrahnejad, Payam

    2008-01-01

    In burn patients, scar contractures adjacent to or across the joints lead to disabling deformities. In Dupuytren’s disease, the proliferative process involves the fascia of the palm and fingers, resulting in disabling flexion contractures of the fingers and the palm. A single insult involving the hand or even a more proximal injury may lead to Dupuytren’s disease. PMID:19554166

  7. Burns, hypertrophic scar and galactorrhea

    PubMed Central

    Karimi, Hamid; Nourizad, Samad; Momeni, Mahnoush; Rahbar, Hosein; Momeni, Mazdak; Farhadi, Khosro

    2013-01-01

    Abstract: An 18-year old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs. At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected. She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients. PMID:23456048

  8. Treatment of scars with flexion contracture using carbon dioxide laser and fractional photothermolysis.

    PubMed

    Cho, Sung Bin; Lee, Sang Ju; Kang, Jin Moon; Kim, Young Koo; Kim, Dong Hyun

    2010-07-01

    Scars with flexion contracture of various origins are challenging problems which may cause not only cosmetic concerns, but also severe functional restriction. In this report, we describe a case presenting scars with flexion contracture: a 23-year-old Korean female with surgical scars on both axillae, which were treated by laser-cision (incision using carbon dioxide laser) with second intention wound healing followed by a non-ablative fractional photothermolysis system. PMID:19598038

  9. Airway management in patients with burn contractures of the neck.

    PubMed

    Prakash, Smita; Mullick, Parul

    2015-12-01

    Airway management of patients with burn contracture of the neck (PBC neck) is a challenge to the anesthesiologist. Patient evaluation includes history, physical and airway examination. A safe approach in the airway management of a patient with moderate to severe PBC neck is to secure the airway with the patient awake. The anesthesiologist should have a pre-planned strategy for intubation of the difficult airway. The choices advocated for airway management of such patients include awake fiberoptic-guided intubation, use of intubating laryngeal mask airway, intubation without neuromuscular blocking agents, intubation with neuromuscular blocking agents after testing the ability to ventilate by mask, pre-induction neck scar release under local anesthesia and ketamine or sedation followed by direct laryngoscopy and intubation and video-laryngoscope guided intubation, amongst others. Preparation of the patient includes an explanation of the proposed procedure, sedation, administration of antisialogogues and regional anesthesia of the airway. The various options for intubation of patients with PBC neck, intraoperative concerns and safe extubation are described. Back-up plans, airway rescue strategies and a review of literature on this subject are presented. PMID:25868969

  10. Management of neck contractures by single-stage dermal substitutes and skin grafting in extensive burn patients

    PubMed Central

    Seo, Dong-Kook; Kym, Dohern

    2014-01-01

    Purpose Severe neck contracture is a problem that must be resolved by priority. We consider the best contracture treatment to be the full-thickness skin graft. However, clinicians often encounter patients, especially extensive burn patients, who have insufficient donor sites for the full-thickness skin graft. We treated extensive burn patients with neck scar contractures with a split-thickness skin graft (STSG) combined with dermal substitutes. The purpose of this study was to evaluate clinical outcomes of neck contracture treatment in extensive burn patients performing STSG with dermal substitutes as adjuvant treatment. Methods We analyzed the retrospective clinical and photographic records of 28 patients with severe neck contracture who were admitted to Hallym University Hangang Sacred Heart Hospital, Seoul, Korea, from January 2012 to December 2012. We performed STSG in combination with dermal substitutes to minimize the degree of contracture. Results The overall take rate of skin to dermal substitutes was 95.9%, and no grafts failed to affect recontracture except in one patient with a partial loss of artificial dermis who underwent a follow-up skin graft without any problems. Excellent/good outcomes were shown in 27 out of 28 patients. Conclusion In extensive burn patients, skin grafting in combination with dermal substitutes can be an alternative to STSG alone for contracture release. PMID:25368851

  11. [Evaluation of Cepan Cream after 15 years of treatment of burn scars].

    PubMed

    Stozkowska, Wies?awa

    2002-01-01

    Cepan Cream is used for the topical treatment of scars and keloids resulting from burns, post-operative scars, and contractures. Cepan Cream makes scars more elastic, softer and paler. Plant extracts, heparin and allantoin in Cepan act on the biochemical processes in the developing connective tissue, preventing the formation of hyperplastic scars. These active ingredients enhance swelling, softening and loosening of connective tissue. It exerts softening and smoothing action on indurated and hyperplastic scar tissue, improving collagen structure. It promotes tissue regeneration and reduces exuberant granulation. Cepan is well tolerated. PMID:12731382

  12. Management of complex pediatric burn scars in a humanitarian collaboration

    PubMed Central

    Bassetto, F.; Staffieri, A.; Reho, F.; Facchin, F.; Shehata, J.; Maged, D.; Tiengo, C.

    2015-01-01

    Summary Burn scars still represent a challenge to the reconstructive surgeon. Their management requires a specific expertise and set up involving the possibility of long term rehabilitation and follow up. Cases encountered in humanitarian missions present additional issues. Often the local environment is not suitable for an appropriate treatment plan, requiring the case to be transferred to a foreign country for surgical care as part of an integrated international and multidisciplinary management. We present the case of a three year-old patient injured in a bomb explosion during the Arab Spring and suffering from severe scar contracture limiting thoracic and upper limb movement. After initial consultation at distance, transfer to our country was organized and an intensive surgical and rehabilitative program was carried out over three months. After five months, the patient returned to his home country where a supportive network had been set up for continued rehabilitation, ensuring follow up for over a year and ultimate success. PMID:26668562

  13. Management of complex pediatric burn scars in a humanitarian collaboration.

    PubMed

    Bassetto, F; Staffieri, A; Reho, F; Facchin, F; Shehata, J; Maged, D; Tiengo, C

    2015-03-31

    Burn scars still represent a challenge to the reconstructive surgeon. Their management requires a specific expertise and set up involving the possibility of long term rehabilitation and follow up. Cases encountered in humanitarian missions present additional issues. Often the local environment is not suitable for an appropriate treatment plan, requiring the case to be transferred to a foreign country for surgical care as part of an integrated international and multidisciplinary management. We present the case of a three year-old patient injured in a bomb explosion during the Arab Spring and suffering from severe scar contracture limiting thoracic and upper limb movement. After initial consultation at distance, transfer to our country was organized and an intensive surgical and rehabilitative program was carried out over three months. After five months, the patient returned to his home country where a supportive network had been set up for continued rehabilitation, ensuring follow up for over a year and ultimate success. PMID:26668562

  14. Linear Hand Burn Contracture Release under Local Anesthesia without Tourniquet.

    PubMed

    Prasetyono, Theddeus O H; Koswara, Astrid F

    2015-10-01

    The objective of this report is to present a case of hand burn linear contracture release performed under local anesthesia. It also introduces the one-per-mil tumescent solution consisted of 0.2% lidocaine and 1:1.000.000 epinephrine as a local anesthesia formula, which has the potential of providing adequate anesthesia as well as hemostatic effect during surgery of the hand without tourniquet. The surgery was performed on a 19 year-old male patient with multiple thumb and fingers flexion linear contracture for 105 minutes without any obstacle. The patient did not complain any pain and discomfort during the procedure; while bloodless operative field was successfully achieved. At four-month follow up, the patient could fully extend his thumb, middle and ring finger, while the index was limited by 10° at the DIP joint. Overall, the patient was satisfied with the outcome. PMID:26388018

  15. An idiosyncratic history of burn scars.

    PubMed

    Petro, Jane A

    2015-03-01

    The history of burn scars can best be found in military medical history. The care of wounded soldiers documented in the Illiad reflected the trauma of the weapons of war, arrow, spear, sword, and ax. The introduction of gunpowder in the 14th century, increasingly sophisticated explosives, and in modern times, petroleum-driven vehicles, including airplanes, created a new subset of wounds requiring attention and post-survival scars challenging the quality of survival. This article selects from among a myriad of examples of modern military treatments as they relate to those survivors. Larrey, with Napolean's Grand Army, Sir Harold Gilles during and following World War I, and the Boston area preparation and response to the Cocoanut Grove Fire in 1942 are the principle topics examined. Recent modern interventions, related to the survival of horrific blast and burn injuries, with modern wound care and scar manipulation techniques provide context to the current ability to modify healing and scars. PMID:25922950

  16. Postburn contractures of the hand.

    PubMed

    Fufa, Duretti T; Chuang, Shiow-Shuh; Yang, Jui-Yung

    2014-09-01

    Several functionally limiting sequelae can follow deep thermal injury to the hand. Despite appropriate initial management, contractures are common. Whereas acute burn care is often managed by multidisciplinary, specialized burn units, postburn contractures may be referred to hand surgeons, who should be familiar with the patterns of burn contracture and nonsurgical and operative options to improve function and expected outcomes. The most common and functionally limiting sequelae are contractures of the webspace, hand, and digits. Webspace contractures and postburn syndactyly are managed with scar excision and local soft tissue rearrangement or skin grafting. The burn claw hand presents as extension contracture of the metacarpophalangeal joints and flexion contractures of the proximal interphalangeal joints. The mainstays of management of these contractures include complete surgical excision of scar tissue and resurfacing of the resultant soft tissue defect, most commonly with full-thickness skin grafts. If scar contracture release results in major exposure of the tendons or joints, distant tissue transfer may be required. Early motion and rehabilitative modalities are essential to prevent initial contracture formation and recontracture after surgical release. PMID:25154575

  17. Distally based venous flap for proximal phalangeal soft tissue burn defect and web space burn contracture.

    PubMed

    Cil, Yakup; Yapici, Abdul Kerim; Kocman, Atacan Emre; Ozturk, Serdar

    2009-01-01

    Flap choices for the coverage of the proximal phalangeal soft tissue defects of the finger and web space burn contractures are limited. A unipedicled distally based venous flap was raised from the third or fourth metacarpal area of the hand for proximal phalangeal soft tissue defects of the finger and web space burn contracture. For clinical use, we operated seven male patients using this venous flap. Superficial necrosis involving two flaps did not interfere with flap survival. Mild edema and venous congestion occurred in all flaps. All flaps survived completely. The mean follow-up period of the flaps was 6 months, ranging from 3 to 14 months. A well-planned distally based venous flap is an useful option for the coverage of the proximal phalangeal soft tissue burn defects of the finger and web space burn contracture of the hand. PMID:19506495

  18. A novel immune competent murine hypertrophic scar contracture model: A tool to elucidate disease mechanism and develop new therapies

    PubMed Central

    Ibrahim, Mohamed Magdy; Bond, Jennifer; Bergeron, Andrew; Miller, Kyle J; Ehanire, Tosan; Quiles, Carlos; Lorden, Elizabeth R; Medina, Manuel A; Fisher, Mark; Klitzman, Bruce; Selim, M Angelica; Leong, Kam W; Levinson, Howard

    2014-01-01

    Hypertrophic scar (HSc) contraction following burn injury causes contractures. Contractures are painful and disfiguring. Current therapies are marginally effective. To study pathogenesis and develop new therapies, a murine model is needed. We have created a validated immune-competent murine HSc model. A third-degree burn was created on dorsum of C57BL/6 mice. Three days postburn, tissue was excised and grafted with ear skin. Graft contraction was analyzed and tissue harvested on different time points. Outcomes were compared with human condition to validate the model. To confirm graft survival, green fluorescent protein (GFP) mice were used, and histologic analysis was performed to differentiate between ear and back skin. Role of panniculus carnosus in contraction was analyzed. Cellularity was assessed with 4?,6-diamidino-2-phenylindole. Collagen maturation was assessed with Picro-sirius red. Mast cells were stained with Toluidine blue. Macrophages were detected with F4/80 immune. Vascularity was assessed with CD31 immune. RNA for contractile proteins was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Elastic moduli of skin and scar tissue were analyzed using a microstrain analyzer. Grafts contracted to ?45% of their original size by day 14 and maintained their size. Grafting of GFP mouse skin onto wild-type mice, and analysis of dermal thickness and hair follicle density, confirmed graft survival. Interestingly, hair follicles disappeared after grafting and regenerated in ear skin configuration by day 30. Radiological analysis revealed that panniculus carnosus doesn't contribute to contraction. Microscopic analyses showed that grafts show increase in cellularity. Granulation tissue formed after day 3. Collagen analysis revealed increases in collagen maturation over time. CD31 stain revealed increased vascularity. Macrophages and mast cells were increased. qRT-PCR showed up-regulation of transforming growth factor beta, alpha smooth muscle actin, and rho-associated protein kinase 2 in HSc. Tensile testing revealed that human skin and scar tissues are tougher than mouse skin and scar tissues. PMID:25327261

  19. Burn Scar Near the Hanford Nuclear Reservation

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This Multi-angle Imaging Spectroradiometer (MISR) image pair shows 'before and after' views of the area around the Hanford Nuclear Reservation near Richland, Washington. On June 27, 2000, a fire in the dry sagebrush was sparked by an automobile crash. The flames were fanned by hot summer winds. By the day after the accident, about 100,000 acres had burned, and the fire's spread forced the closure of highways and loss of homes. These images were obtained by MISR's vertical-viewing (nadir) camera. Compare the area just above and to the right of the line of cumulus clouds in the May 15 image with the same area imaged on August 3. The darkened burn scar measures approximately 35 kilometers across. The Columbia River is seen wending its way around Hanford. Image courtesy NASA/GSFC/JPL, MISR Science Team

  20. The Use of CO2 Fractional Photothermolysis for the Treatment of Burn Scars.

    PubMed

    Levi, Benjamin; Ibrahim, Amir; Mathews, Katie; Wojcik, Brandon; Gomez, Jason; Fagan, Shawn; Austen, William Gerald; Goverman, Jeremy

    2016-01-01

    A recent advancement in the treatment of burn scars has been the use of the carbon dioxide (CO2) laser to perform fractional photothermolysis. In this analysis, we describe our results and patient-reported outcomes with the use of fractional CO2 laser for the treatment of burn-related scarring. We performed a retrospective study of all patients who underwent CO2 laser procedures for treatment of symptomatic burn scars and skin grafts at one accredited regional burn center. Burn injury and laser treatment demographics, as well as complications, are reported. A questionnaire was administered to all patients and included patient-reported outcome measures aimed at understanding the patient experience and their subjective response to treatment. A total of 387 CO2 laser procedures were performed on 131 patients for the treatment of symptomatic burn scars and skin grafts between October 1, 2011, and May 1, 2014 (average, 2.95 procedures/patient; range, 1-11). Average time between injury and first laser was 597.35 days (range, 60-13,475). Average time between laser treatments (when multiple) was 117.73 days (range, 22-514). There were no infections requiring treatment with oral antibiotics. Overall patient satisfaction with laser therapy was 96.7%. Patients reported reductions in neuropathic pain, tightness (contracture), and pruritus (54.0, 50.6, and 49.0%, respectively). Fractional photothermolysis utilizing the CO2 laser is a safe and effective modality for the treatment of symptomatic burn scars, donor sites, and skin grafts. Patient satisfaction with this procedure is high, and complications are low. Significant improvements in scar appearance, pliability, tightness, neuropathic pain, and pruritus were commonly reported. PMID:26536539

  1. Extensive Burn Scars in Russia's Amur Region

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Vast areas of southeastern Russia have been scorched by fires over the last few weeks. All across Siberia fires have been raging, and this Moderate Resolution Imaging Spectroradiometer (MODIS) image from May 15, 2002, shows extensive, dark burn scars along with actively burning fires (red dots) on the north side of the Amur River, which separates Russia (north) and China (south). The southern Amur region is largely devoted to farming and other agriculture, and these fires may have been set intentionally to prepare the land for the growing season. Fire is often used to clear land of unwanted vegetation, and to return the nutrients stored in vegetation back to the soil. However, fires that are too frequent or severe can devastate the soil, eventually making it unsuitable for farming or grazing. Fires can also escape control and spread into protected areas. In this image, fires are mostly concentrated in a lowland area within the drainage basin of the Zeya River, which drains from the frozen lake at the top of the image. Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC

  2. A simple and effective procedure for treating burn contractures: releasing incision and quadra Z technique.

    PubMed

    Sen, Cenk; Karacalar, Ahmet; Agir, Hakan; Dinar, Serkan; Isil, Eda; Iscen, Deniz

    2007-03-01

    Burn contractures particularly involving the joints are challenging problems which might cause severe functional impairments. Many surgical techniques have been described for use, however, an ideal method yet to be found. Releasing incision is the most common and effective way to release the wide and severe contractures but it has some drawbacks. We propose a releasing incision technique combined with four Z plasty incisions to overcome the disadvantages of traditional releasing incision technique. We successfully used our releasing incision and quadra Z technique on seven consecutive patients with burn contractures between 2003 and 2005. We modified the classical releasing incision technique by adding four Z plasties; two of them with a common base on each corner of the incision line. In this technique, limitation of the webbing following the incision is made possible by the transposed flaps and unnecessary lateral extension of the incision and the defect was avoided, i.e. maximum release gain with minimal defect was provided. Satisfactory results were achieved in seven patients treated with this technique due to significant burn contractures between 2003 and 2005 with no significant complication. We propose this technique is suitable in all patients with severe burn contractures who require releasing incision and grafting. PMID:17118561

  3. Three-dimensional Reconstruction of Scar Contracture-bearing Axilla and Digital Webs Using the Square Flap Method

    PubMed Central

    Huang, Chenyu

    2014-01-01

    Background: Joint scar contractures are characterized by tight bands of soft tissue that bridge the 2 ends of the joint like a web. Classical treatment methods such as Z-plasties are mainly based on 2-dimensional designs. Our square flap method is an alternative surgical method that restores the span of the web in a stereometric fashion, thereby reconstructing joint function. Methods: In total, 20 Japanese patients with joint scar contractures on the axillary (n = 10) or first digital web (n = 10) underwent square flap surgery. The maximum range of motion and commissure length were measured before and after surgery. A theoretical stereometric geometrical model of the square flap was established to compare it to the classical single (60 degree), 4-flap (45 degree), and 5-flap (60 degree) Z-plasties in terms of theoretical web reconstruction efficacy. Results: All cases achieved 100% contracture release. The maximum range of motion and web space improved after square flap surgery (P = 0.001). Stereometric geometrical modeling revealed that the standard square flap (? = 45 degree; ? = 90 degree) yields a larger flap area, length/width ratio, and postsurgical commissure length than the Z-plasties. It can also be adapted by varying angles ? and ?, although certain angle thresholds must be met to obtain the stereometric advantages of this method. Conclusions: When used to treat joint scar contractures, the square flap method can fully span the web space in a stereometric manner, thus yielding a close-to-original shape and function. Compared with the classical Z-plasties, it also provides sufficient anatomical blood supply while imposing the least physiological tension on the adjacent skin. PMID:25289342

  4. Hypertrophic scar contracture is mediated by the TRPC3 mechanical force transducer via NFkB activation

    PubMed Central

    Ishise, Hisako; Larson, Barrett; Hirata, Yutaka; Fujiwara, Toshihiro; Nishimoto, Soh; Kubo, Tateki; Matsuda, Ken; Kanazawa, Shigeyuki; Sotsuka, Yohei; Fujita, Kazutoshi; Kakibuchi, Masao; Kawai, Kenichiro

    2015-01-01

    Wound healing process is a complex and highly orchestrated process that ultimately results in the formation of scar tissue. Hypertrophic scar contracture is considered to be a pathologic and exaggerated wound healing response that is known to be triggered by repetitive mechanical forces. We now show that Transient Receptor Potential (TRP) C3 regulates the expression of fibronectin, a key regulatory molecule involved in the wound healing process, in response to mechanical strain via the NFkB pathway. TRPC3 is highly expressed in human hypertrophic scar tissue and mechanical stimuli are known to upregulate TRPC3 expression in human skin fibroblasts in vitro. TRPC3 overexpressing fibroblasts subjected to repetitive stretching forces showed robust expression levels of fibronectin. Furthermore, mechanical stretching of TRPC3 overexpressing fibroblasts induced the activation of nuclear factor-kappa B (NF?B), a regulator fibronectin expression, which was able to be attenuated by pharmacologic blockade of either TRPC3 or NF?B. Finally, transplantation of TRPC3 overexpressing fibroblasts into mice promoted wound contraction and increased fibronectin levels in vivo. These observations demonstrate that mechanical stretching drives fibronectin expression via the TRPC3-NFkB axis, leading to intractable wound contracture. This model explains how mechanical strain on cutaneous wounds might contribute to pathologic scarring. PMID:26108359

  5. The menace of post-burn contractures: a developing country’s perspective

    PubMed Central

    Saaiq, M.; Zaib, S.; Ahmad, S.

    2012-01-01

    Summary A study was carried out regarding 213 patients of either gender and all ages who presented with post-burn contractures. The commonest site of contracture was the neck. 92 patients (43.19%) had received their initial burn injury management in general surgery units in tertiary care hospitals compared to 43 patients (20.18%) in district headquarter hospitals. Only 26 patients (12.20%) were managed in plastic surgery/burn wards, and 52 patients (24.41%) received no regular treatment from any hospital. The majority of patients (n=197) had a history of conservative management, with only 16 patients (7.51%) having a split thickness skin graft for part of their initial burns. None of the patients had the appropriate anti-deformity splintage in the affected parts or any physiotherapy during the acute phase of their burns. PMID:23466805

  6. Free thin anterolateral thigh flap for post-burn neck contractures - a functional and aesthetic solution.

    PubMed

    Sarkar, A; Raghavendra, S; Jeelani Naiyer, M G; Bhattacharya, D; Dutta, G; Bain, J; Asha, J

    2014-12-31

    Neck contractures after burn injuries produce restrictions in motion and unacceptable aesthetic outcomes. Although different methods of reconstruction have been used in the treatment of this ailment, a limited and unsatisfactory outcome often results. Free thin anterolateral flaps have been found to be a good single stage option for reconstruction of post-burn contractures of the neck. In our study, 11 patients with post flame burn contractures of the neck underwent surgical release and coverage by a free thin anterolateral thigh flap. Patients were followed up for an average of five years and various aspects of functional and aesthetic rehabilitation were assessed. Our findings revealed that the free thin anterolateral flaps covered the defects over anterior and lateral aspects of the neck with good colour match and contour. Furthermore, none of the flaps had any significant early or delayed complications. Two cases had to be reoperated for partial loss of flaps and all patients were satisfied with functional and aesthetic outcomes. We therefore consider free thin anterolateral thigh flaps to provide a good single stage reconstruction for post-burn cervical contractures with good functional and aesthetic outcomes. PMID:26336369

  7. Drought and Burn Scars in Southeastern Australia

    NASA Technical Reports Server (NTRS)

    2003-01-01

    More than 2 million acres were consumed by hundreds of fires between December 2002 and February 2003 in southeastern Australia's national parks, forests, foothills and city suburbs. These images were acquired on February 14, 2002 (left) and February 17, 2003 (right) by the Multi-angle Imaging SpectroRadiometer (MISR) instrument onboard NASA's Terra satellite. The year 2002 was one of Australia's hottest and driest on record, and the acreage burnt during the summer 2002-2003 fire season in Victoria, the Australian Capital Territory and southern New South Wales, is the largest since 1938-1939, when more than 3 million acres were scorched.

    The extent of the burnt area and the dry conditions as of February 2003 are indicated by these contrasting false-color views. Both image panels display data from the near-infrared, red and blue spectral bands of MISR's downward-viewing (nadir) camera, as red, green and blue, respectively. This display technique causes healthy vegetation to appear red and burnt areas to show as dark brown. The data displayed from the two dates were processed identically to preserve relative brightness variations. Vegetation changes related to the dry conditions (not related to the brown burn scars) are also indicated in the February 2003 panel, where many previously red areas exhibit instead the pale yellow-brown of the underlying soils and geology. Significant reduction in the surface area of several large and important water bodies are also apparent. The diminished extent of Lake Hume (along the left-hand edge) in the later date provides a good example.

    The Multi-angle Imaging SpectroRadiometer observes the daylit Earth continuously and every 9 days views the entire globe between 82 degrees north and 82 degrees south latitude. These data products were generated from a portion of the imagery acquired during Terra orbits 14999 and 16858. The panels cover an area of about 208 kilometers x 286 kilometers, and utilize data from blocks 118 to 121 within World Reference System-2 path 91.

    MISR was built and is managed by NASA's Jet Propulsion Laboratory,Pasadena, CA, for NASA's Office of Earth Science, Washington, DC. The Terra satellite is managed by NASA's Goddard Space Flight Center, Greenbelt, MD. JPL is a division of the California Institute of Technology.

  8. Postburn Neck Lateral Contracture Anatomy and Treatment: A New Approach.

    PubMed

    Grishkevich, Viktor M; Grishkevich, Max

    2015-01-01

    Lateral contracture of the neck is a rare and insufficiently researched burn consequent. Contracture restricts head motion, can cause a secondary face deformity, presents severe cosmetic defects, and, therefore, requires surgical reconstruction. Literature does not sufficiently address the issue; therefore, anatomy not researched and treatment techniques not developed. The anatomy of postburn lateral cervical flexion contracture was studied in 21 operated patients. Using obtained data, new approaches were investigated, which were directed toward maximal efficacy of the local tissues use. Follow-up results were observed from 6 months to 9 years. Lateral cervical contractures were divided into two types based on their anatomy: edge and medial. Edge contractures were caused by burns and scars located on the posterior neck surface and were characterized by the presence of the fold in central lateral zone. In the fold, only one (posterior) sheet is scars that cause the contracture. Medial contractures were caused by scars located on the lateral cervical surface and were characterized by the presence of the fold in which both sheets were scars. In both types, contracture was caused by scar sheet surface deficiency in length, which has a trapezoid form (contracture cause). In all cases, there was surface surplus in the fold's sheets allowed contracture release with local tissue. The technique that allows the maximum local tissue use and ensures full contracture elimination is the trapeze-flap plasty. Two anatomic types of lateral cervical scar contractures were identified: edge and medial. An anatomically justified efficacy reconstructive technique for both types is trapeze-flap plasty. PMID:25501780

  9. Long-Term Followup of Dermal Substitution with Acellular Dermal Implant in Burns and Postburn Scar Corrections

    PubMed Central

    Juhasz, I.; Kiss, B.; Lukacs, L.; Erdei, I.; Peter, Z.; Remenyik, E.

    2010-01-01

    Full-thickness burn and other types of deep skin loss will result in scar formation. For at least partial replacement of the lost dermal layer, there are several options to use biotechnologically derived extracellular matrix components or tissue scaffolds of cadaver skin origin. In a survey, we have collected data on 18 pts who have previously received acellular dermal implant Alloderm. The age of these patients at the injury varied between 16 months and 84 years. The average area of the implants was 185 cm2. Among those, 15 implant sites of 14 patients were assessed at an average of 50 months after surgery. The scar function was assessed by using the modified Vancouver Scar Scale. We have found that the overall scar quality and function was significantly better over the implanted areas than over the surrounding skin. Also these areas received a better score for scar height and pliability. Our findings suggest that acellular dermal implants are especially useful tools in the treatment of full-thickness burns as well as postburn scar contractures. PMID:21234359

  10. Remote sensing and hydrological modeling of burn scars

    NASA Astrophysics Data System (ADS)

    Miller, Mary Ellen

    This study examined the potential usefulness of combining remote sensing data with hydrologic models and mapping tools available from Geographic Information Systems (GIS), to evaluate the effects of wildfire. Four subprojects addressed this issue: (1) validation of burn scar maps derived from the Advanced Very High Resolution Radiometer (AVHRR) with the National Fire Occurrence Database; (2) testing the potential of thermal MODIS (Moderate Resolution Imaging Spectroradiometer) data for near-real time burn scar and fire severity mapping; (3) evaluation of Landsat derived burn severity maps within WEPP through the Geo-spatial interface for the Water Erosion Prediction Project (GeoWEPP), and (4) predicting potential post-fire erosion for western U.S. forests utilizing existing datasets and models. Wildfire poses incredibly complex management problems in all of its stages. Today's land managers have the option of trying to mitigate the effects of a severe fire before it occurs by fuel management practices. This process is expensive especially considering the uncertainty of when and where the next fire in a given region will occur. When a wildfire does occur, deciding when to let it burn and when to suppress it may lead to controversial decisions. In addition to the threat to life and property from the fire itself, smoke emissions from large fires can cause air quality problems in distant airsheds. Even after the fire is extinguished, erosion and water quality problems may pose difficult management questions. Contributions stemming from these studies include improved burn scar maps for studying historical fire extent and demonstration of the feasibility of using thermal satellite data to predict burn scar extent when clouds and smoke obscure visible bands. The incorporation of Landsat derived burn severity maps was shown to improve post-fire erosion modeling results. Finally the potential post-fire burn severity and erosion risk maps generated for western US forests will be used for planning pre-fire fuel reduction treatments.

  11. Marjolin's ulcers in the post-burned lesions and scars.

    PubMed

    Saaiq, Muhammad; Ashraf, Bushra

    2014-10-16

    Marjolin's ulcer (MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention, or burn wounds which never healed completely over years and the unstable post-burned scars. In the majority of cases, the MU is a squamous cell carcinoma (SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%. PMID:25325060

  12. Bipedicled “Superthin” Free Perforator Flaps for Facial Burn Scar Reconstruction: Expanded Scope of Superthin Flaps: A Case Series

    PubMed Central

    Van Anh, Tran; Tien, Nguyen Gia; Hyakusoku, Hiko; Ogawa, Rei

    2015-01-01

    Background: “Superthin flap” is a distinctively thin flap that is thinned primarily to the point that the subdermal vascular network can be seen through a minimal fat layer. Reconstruction of severely disfigured neck and face can be performed using the occipito-cervico-dorsal superthin flap that is harvested from the dorsal region and supercharged by the circumflex scapular vessels. We used bipedicled superthin free perforator flaps to reconstruct scar contractures on half of the face, whole face, or the whole chin-neck area in 17 postburn patients. Methods: This case series report includes all 17 cases. Flaps in the dorsal area were designed. In all cases, one pedicle consisted of the circumflex scapular vessels. In 11, 5, and 1 flaps, the second pedicle consisted of contralateral posterior intercostal perforators (type 1), ipsilateral posterior intercostal perforators (type 2), and ipsilateral circumflex scapular vessels (type 3), respectively. Four patients underwent whole-face reconstruction after acid burn with type 1 or type 3 perforator. The recipient vessels were the superficial temporal vessels and contralateral or ipsilateral facial vessels. Intraoperatively, all adipose tissue in the flap, including between the 2 pedicles, was thinned by scissors before the pedicles were detached from the donor sites. Maximum flap size was 35?×?15?cm. Donor sites were covered by a split full-thickness skin graft. Flap survival and functional and cosmetic results were assessed retrospectively. Results: Fifteen of the 17 flaps survived completely. Two developed partial necrosis due to perforator thrombosis. Some patients developed hypertrophic scars around the flap, but these improved naturally over time. All patients were satisfied with both the cosmetic and functional outcomes of the reconstruction. Conclusion: Bipedicled superthin free perforator flaps may be an excellent choice for reconstruction of severe neck scar contracture. This report expands the scope of previously used “superthin flaps.” PMID:26495206

  13. Advances in Research in Animal Models of Burn-Related Hypertrophic Scarring.

    PubMed

    Domergue, Sophie; Jorgensen, Christian; Noël, Danièle

    2015-01-01

    Skin burn injuries affect approximately 500,000 people per year in France. After deep burns, functional sequelae associated with hypertrophic and retractile scars are an important public health problem. To understand the pathophysiology of sequelae and evaluate new therapeutic approaches, the use of animal models that should be standard tools is necessary. Some pre-clinical models of hypertrophic scars after burns have been described, but the choice of the appropriate and relevant experimental model is crucial to accurately investigate any therapeutic approach. A variety of hypertrophic scar animal models have been described after burn lesions; none of which being totally satisfactory. The most frequently used is the hypertrophic scar model after skin excision of the ear rabbit, but this model does not reflect burn injuries. The red Duroc pig seems to be the more relevant model of human hypertrophic scarring after burns; however, because of costs and the lack of studies evaluating burn injuries in this species, the domestic pig is most commonly used in burn research. Elevated hypertrophic scars are obtained, but they spontaneously resolve within a year. Although mortality in small animals is higher and creates technical difficulties, many models on nude mice are used in research. Indeed, transplantation of human hypertrophic scar tissue or human skin grafts may induce hypertrophic scarring that can last more than a year permitting additional manipulation and experimentation. PMID:25356852

  14. Paediatric post-burn scar management in the UK: a national survey.

    PubMed

    Liuzzi, Francesca; Chadwick, Sarah; Shah, Mamta

    2015-03-01

    Thermal injuries affect 250,000 people annually in the United Kingdom. As burn survival improves, good scar management is paramount to help individuals living with the resultant scars lead a life without restrictions. Post-burn hypertrophic scars can limit growth in children, interfere with function and cause psychological problems. In the current literature there is great variation in post-burn scar management across the world and in the evidence available for the efficacy of these management modalities. The aim of this study was to investigate the variances if any, in the management of post-burn scarring in children across the UK. A telephone survey of UK paediatric burn services was conducted to obtain information on post-burn scar management and advice given to patients/carers. Of the 19 burn services that participated, all advised moisturising of scars but with variable emphasis on massaging. Silicones and pressure therapy were used by 18 services but commencement of use varied from soon after healing to onset of hypertrophic scarring. Laser therapy, ultrasound therapy and steroid therapy were used sporadically. This study highlights the common modalities of post-burn scar management in children across the UK. However, there is marked variation in timing and selection of the commonly used modalities. Although this study did not investigate the outcomes of scar management, it clearly identifies the need for a well-designed multi-centred study to establish evidence-based best practice in the management of post-burn scarring in children as these modalities are time consuming and not without potential complications. Evidence based practice could potentially lead to significant financial savings to the health service. PMID:25468478

  15. Is 20 years of immobilization, not sufficient to render metacarpophalangeal joints completely useless?--Correction of a 20-year old post-burn palmar contracture: a case report.

    PubMed

    Saraiya, H

    2001-03-01

    This report presents a case of post-burn palmar contracture with flexion contracture of thumb of 20-year duration. The contracture was released and the raw area was covered with split thickness skin graft. Only one 'K' wire in soft tissue was needed to keep all the fingers straight and immobilized, suggestive of intermetacarpal ligamentous contracture. A static night splint was given to maintain the correction. Complete range of movement was achieved in a month with the combination of dynamic splinting and physiotherapy. It was interesting to note that even 20 years of contracted position did not render the metacarpophalangeal joints completely stiff and useless. Probable reasons are discussed. PMID:11226662

  16. Study of Burn Scar Extraction Automatically Based on Level Set Method using Remote Sensing Data

    PubMed Central

    Liu, Yang; Dai, Qin; Liu, JianBo; Liu, ShiBin; Yang, Jin

    2014-01-01

    Burn scar extraction using remote sensing data is an efficient way to precisely evaluate burn area and measure vegetation recovery. Traditional burn scar extraction methodologies have no well effect on burn scar image with blurred and irregular edges. To address these issues, this paper proposes an automatic method to extract burn scar based on Level Set Method (LSM). This method utilizes the advantages of the different features in remote sensing images, as well as considers the practical needs of extracting the burn scar rapidly and automatically. This approach integrates Change Vector Analysis (CVA), Normalized Difference Vegetation Index (NDVI) and the Normalized Burn Ratio (NBR) to obtain difference image and modifies conventional Level Set Method Chan-Vese (C-V) model with a new initial curve which results from a binary image applying K-means method on fitting errors of two near-infrared band images. Landsat 5 TM and Landsat 8 OLI data sets are used to validate the proposed method. Comparison with conventional C-V model, OSTU algorithm, Fuzzy C-mean (FCM) algorithm are made to show that the proposed approach can extract the outline curve of fire burn scar effectively and exactly. The method has higher extraction accuracy and less algorithm complexity than that of the conventional C-V model. PMID:24503563

  17. Study of burn scar extraction automatically based on level set method using remote sensing data.

    PubMed

    Liu, Yang; Dai, Qin; Liu, Jianbo; Liu, ShiBin; Yang, Jin

    2014-01-01

    Burn scar extraction using remote sensing data is an efficient way to precisely evaluate burn area and measure vegetation recovery. Traditional burn scar extraction methodologies have no well effect on burn scar image with blurred and irregular edges. To address these issues, this paper proposes an automatic method to extract burn scar based on Level Set Method (LSM). This method utilizes the advantages of the different features in remote sensing images, as well as considers the practical needs of extracting the burn scar rapidly and automatically. This approach integrates Change Vector Analysis (CVA), Normalized Difference Vegetation Index (NDVI) and the Normalized Burn Ratio (NBR) to obtain difference image and modifies conventional Level Set Method Chan-Vese (C-V) model with a new initial curve which results from a binary image applying K-means method on fitting errors of two near-infrared band images. Landsat 5 TM and Landsat 8 OLI data sets are used to validate the proposed method. Comparison with conventional C-V model, OSTU algorithm, Fuzzy C-mean (FCM) algorithm are made to show that the proposed approach can extract the outline curve of fire burn scar effectively and exactly. The method has higher extraction accuracy and less algorithm complexity than that of the conventional C-V model. PMID:24503563

  18. Scar revision - series (image)

    MedlinePLUS

    ... can cause loss of a large area of skin and may form hypertrophic scars. A hypertrophic scar can cause restricted movement of muscles, joints, and tendons (contracture). Surgical repair includes removing excessive scar tissue and a series ...

  19. Fat Grafting in Burn Scar Alleviates Neuropathic Pain via Anti-Inflammation Effect in Scar and Spinal Cord

    PubMed Central

    Huang, Shu-Hung; Wu, Sheng-Hua; Lee, Su-Shin; Chang, Kao-Ping; Chai, Chee-Yin; Yeh, Jwu-Lai; Lin, Sin-Daw; Kwan, Aij-Lie; David Wang, Hui-Min; Lai, Chung-Sheng

    2015-01-01

    Burn-induced neuropathic pain is complex, and fat grafting has reportedly improved neuropathic pain. However, the mechanism of fat grafting in improving neuropathic pain is unclear. Previous investigations have found that neuroinflammation causes neuropathic pain, and anti-inflammatory targeting may provide potential therapeutic opportunities in neuropathic pain. We hypothesized that fat grafting in burn scars improves the neuropathic pain through anti-inflammation. Burn-induced scar pain was confirmed using a mechanical response test 4 weeks after burn injuries, and autologous fat grafting in the scar area was performed simultaneously. After 4 weeks, the animals were sacrificed, and specimens were collected for the inflammation test, including COX-2, iNOS, and nNOS in the injured skin and spinal cord dorsal horns through immunohistochemistry and Western assays. Furthermore, pro-inflammatory cytokines (IL-1 ? and TNF-?) in the spinal cord were collected. Double immunofluorescent staining images for measuring p-I?B, p-NF?B, p-JNK, and TUNEL as well as Western blots of AKT, Bax/Bcl-2 for the inflammatory process, and apoptosis were analyzed. Fat grafting significantly reduced COX2, nNOS, and iNOS in the skin and spinal cord dorsal horns, as well as IL-1? and TNF-?, compared with the burn group. Moreover, regarding the anti-inflammatory effect, the apoptosis cells in the spinal cord significantly decreased after the fat grafting in the burn injury group. Fat grafting was effective in treating burn-induced neuropathic pain through the alleviation of neuroinflammation and ameliorated spinal neuronal apoptosis. PMID:26368011

  20. Visible scars and self-esteem in pediatric patients with burns.

    PubMed

    Abdullah, A; Blakeney, P; Hunt, R; Broemeling, L; Phillips, L; Herndon, D N; Robson, M C

    1994-01-01

    The supposition of often made that visible scarring is more psychologically damaging than are "hidden" burn scars, but little evidence exists to support that idea. We compared the self-evaluations of 28 male and 21 female pediatric patients with burns to the amount and visibility of scars. Males were 6 to 18 years old at the time of burn and sustained 15% to 99% total body surface area burns. They were evaluated 1 to 6 years after their burn injury. Females constituted a similar group. They were 5 to 18 years old at the time of burn, sustained 15% to 94% total body surface area burns, and were evaluated 1 to 7 years after their burn injury. All of the children underwent evaluation with the Piers-Harris Children's Concept Scale, evaluating themselves on intellectual and school status, physical appearance, anxiety, happiness and satisfaction, and behavior and popularity. Scores from these parameters were compared against each child's "visible" scars as seen on the face, head, neck, and hands. Also, comparisons were made with the numbers of reconstructive needs in these areas. Significant inverse correlations were found in the males. As the number of scars increased in these areas, the patient's scores for "physical appearance" and "happiness and satisfaction" decreased (p < 0.001). Other psychologic parameters were not affected. There was no effect by age of patient, and no significant correlations were found for the female group. The results emphasize the importance of the burn team's awareness that pediatric survivors of burns may appear superficially to be adjusting well, while harboring grave self-deprecating feelings. Those with "visible" scars will need special support to enhance self-esteem. PMID:8195258

  1. Shine on: Review of Laser- and Light-Based Therapies for the Treatment of Burn Scars

    PubMed Central

    Hultman, C. Scott; Edkins, Renee E.; Lee, Clara N.; Calvert, Catherine T.; Cairns, Bruce A.

    2012-01-01

    Restoration of form and function after burn injury remains challenging, but emerging laser and pulsed light technologies now offer hope for patients with hypertrophic scars, which may be associated with persistent hyperemia, chronic folliculitis, intense pruritis, and neuropathic pain. In addition to impairing body image, these scars may limit functional recovery, compromise activities of daily living, and prevent return to work. Three different platforms are now poised to alter our reconstructive algorithm: (1) vascular-specific pulsed dye laser (PDL) to reduce hyperemia, (2) ablative fractional CO2 laser to improve texture and pliability of the burn scar, and (3) intense pulsed light (IPL) to correct burn scar dyschromia and alleviate chronic folliculitis. In this paper, we will provide an overview of our work in this area, which includes a systematic review, a retrospective analysis of our preliminary experience, and interim data from our on-going, prospective, before-after cohort trial. We will demonstrate that laser- and light-based therapies can be combined with each other safely to yield superior results, often at lower cost, by reducing the need for reconstructive surgery. Modulating the burn scar, through minimally invasive modalities, may replace conventional methods of burn scar excision and yield outcomes not previously possible or conceivable. PMID:22778719

  2. Semi-stochastic cell-level computational modelling of cellular forces: application to contractures in burns and cyclic loading.

    PubMed

    Vermolen, F J; Gefen, A

    2015-11-01

    A phenomenological model is formulated to model cellular forces on extracellular material. The model is capable of modelling both expansion and contractile forces. This work is based on the assumption of linear elasticity, which allows a superposition argument to arrive at fundamental expressions for cellular forces. It is also shown how the cellular forces can be implemented using different strategies, as well as an extension to cellular point sources. Illustrations are given for modelling a (permanent) contraction (e.g. a contracture) of burns and for cyclic loading by the cells. PMID:25776519

  3. [Post-burn scar contractures in children in the lower limb].

    PubMed

    Sankale, A A; Manyacka Ma Nyemb, P; Coulibaly, N F; Ndiaye, A; Ndoye, M

    2010-06-30

    Il s'agit d'une étude faisant ressortir les aspects épidémiologiques, cliniques et thérapeutiques des séquelles de brûlures du membre inférieur chez l'enfant, à propos de 42 cas colligés au service de chirurgie infantile de l'Hôpital Aristide Le Dantec (Sénégal). L'âge moyen retrouvé est de 5 ans et 3 mois, et le sex-ratio garçons/filles de 1,8/1. La brûlure thermique est causée par une flamme dans 33% des cas, par un liquide chaud dans 21% des cas, et par des braises dans 21% des cas. Les cicatrices rétractiles intéressent le genou et le creux poplité dans 47% des cas et le pied dans 45% des cas. Elles sont bilatérales dans 21% des cas, et concernent une autre localisation associée dans 21% des cas. Quant aux brides, 21% ont bénéficié d'une chirurgie, avec un délai moyen de 3 ans et 2 mois après la brûlure. Cette procédure chirurgicale consiste en une plastie en Z dans 91% des cas, à laquelle est associée une greffe de peau dans 54% des cas. Une rééducation fonctionnelle est pratiquée chez 54% des opérés. Parallèlement aux données de la littérature, nos résultats montrent que l'optimisation de la prise en charge passe par une meilleure prévention des accidents domestiques et une bonne codification thérapeutique. PMID:21991202

  4. Evidence based management for paediatric burn: new approaches and improved scar outcomes.

    PubMed

    Kishikova, Lyudmila; Smith, Matthew D; Cubison, Tania C S

    2014-12-01

    Little evidence has been produced on the best practice for managing paediatric burns. We set out to develop a formal approach based on the finding that hypertrophic scarring is related to healing-time, with durations under 21 days associated with improved scar outcome. Incorporating new advances in burn care, we compared outcomes under the new approach to a cohort treated previously. Our study was a retrospective cross-sectional case note study, with demographic, treatment and outcome information collected. The management and outcome of each case was assessed and compared against another paediatric burns cohort from 2006. 181 burns presenting across a six month period were analysed (2010 cohort) and compared to 337 children from a previous cohort from 2006. Comparison of patients between cohorts showed an overall shift towards shorter healing-times in the 2010 cohort. A lower overall rate of hypertrophic scarring was seen in the 2010 cohort, and for corresponding healing-times after injury, hypertrophic scarring rates were halved in comparison to the 2006 cohort. We demonstrate that the use of a structured approach for paediatric burns has improved outcomes with regards to healing-time and hypertrophic scarring rate. This approach allows maximisation of healing potential and implements aggressive prophylactic measures. PMID:24630818

  5. Suppression of scar formation in a murine burn wound model by the application of non-thermal plasma

    NASA Astrophysics Data System (ADS)

    Hoon Lee, Dae; Lee, Jae-Ok; Jeon, Wonju; Choi, Ihn-Geun; Kim, Jun-Sub; Hoon Jeong, Je; Kang, Tae-Cheon; Hoon Seo, Cheong

    2011-11-01

    Suppression of hypertrophic scar generation in an animal model by treatment with plasma is reported. Contact burn following mechanical stretching was used to induce scar formation in mice. Exposure to the plasma tended to reduce the scar area more rapidly without affecting vitality. The treatment resulted in decreased vascularization in the scar tissue. Plasma-treated scars showed mild decrease in the thickness of hypertrophic tissues as shown by histological assessment. Finally, we showed that plasma treatment induced cell death and reactive oxygen species generation in hypertrophic scar fibroblast. All of the results support that plasma treatment can control scar generation.

  6. Multiple Marjolin's ulcers arising from irradiated post-burn hypertrophic scars: a case report.

    PubMed

    Zuo, Kevin J; Tredget, Edward E

    2014-06-01

    Marjolin's ulcer is an aggressive ulcerating cutaneous malignancy that may arise in chronically inflamed or traumatized skin. Frequently overlooked, this rare condition is classically associated with burn scars, with the process of malignant degeneration typically occurring over two to three decades. The most common histopathological pattern is squamous cell carcinoma; however, compared to typical squamous cell carcinomas, Marjolin's ulcers have an increased rate of metastasis. The correlation between radiotherapy for benign hypertrophic scarring and carcinogenesis is controversial, with few reports in the literature. We present a unique case of a 61 year old Caucasian male who was burned by scald at age 4, received radiotherapy for his post-burn hypertrophic scars, and later developed multiple Marjolin's ulcers on his left arm, chest, and right temporal scalp. PMID:24290855

  7. Wildfires, smoke, and burn scars, near Yakutsk, Russia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The Lena River in central Siberia is hidden beneath a veil of smoke from multiple wildfires burning around the city of Yakutsk, Russia. Fires have been burning in the region off and on since late May 2002, and may be agricultural in cause. This image was acquired by the Moderate Resolution Imaging Spectroradiometer (MODIS) on the Terra satellite on July 23, 2002. In the false=-color image, vegetation is bright green, smoke is blueish-white, and burned areas are reddish-brown. In both images, fire detections are marked with red outlines. Credit: Jacques Descloitres, MODIS Land Rapid Response Team, NASA/GSFC

  8. Palm oil thorn-induced squamous cell carcinoma with underlying burns scar

    PubMed Central

    Qi Qi, Choo; Ajit Singh, Vivek

    2012-01-01

    Marjolin's ulcers are malignancies that arise from previously traumatised, chronically inflamed or scarred skin. We present a case with childhood burns, who had repeated irritation of his forearm skin with palm oil thorns that eventually led to malignant change. PMID:22865804

  9. The role of the TGF-β family in wound healing, burns and scarring: a review

    PubMed Central

    Penn, Jack W; Grobbelaar, Adriaan O; Rolfe, Kerstin J

    2012-01-01

    It is estimated worldwide that over 6 million people per annum experience a burn injury. Despite advances in management and improved survival rates, the incidence of hypertrophic scarring remains high. These scars are particularly common after burns and are often raised, red, hard and may cause abnormal sensations. Such pathological scarring can lead to severe functional impairment, psychological morbidity, and costly long term healthcare. Wound healing is an inherent process which restores the integrity of the skin after injury and although scarring is a frequent by-product, the scarless wound healing observed in early human gestational fetuses suggests that it is not an essential component of the response. This has lead to a large body of research attempting to understand the mechanisms behind scarring and in turn prevent it. One of the main focuses of recent research has been the role played by the growth factor TGF-β in the process of both wound healing and scar formation. The three isoforms (TGF-β1, TGF-β2 and TGF-β3) appear to have overlapping functions and predominantly mediate their effects through the intracellular SMAD pathway. Initial research suggested that TGF-β1 was responsible for the fibrotic scarring response whereas the scarless wound healing seen in fetal wounds was due to increased levels of TGF-β3. However, the reality appears to be far more complex and it is unlikely that simply altering the ratio of TGF-β isoforms will lead to scarless wound healing. Other aspects of the TGF-β system that appear promising include the downstream mediator CTGF, the proteoglycan decorin and the binding protein p311. Other putative mechanisms which may underlie the pathogenesis of hypertrophic scars include excessive inflammation, excessive angiogenesis, altered levels of matrix metalloproteinases, growth factors, and delayed apoptosis of fibrotic myofibroblasts either due to p53 genetic alterations or tensile forces across the wound. If an effective treatment for hypertrophic scars following burns injury is to be developed then further work must be carried out to understand the basic mechanisms of pathological scarring. PMID:22928164

  10. Prevention and management of hypertrophic scars and keloids after burns in children.

    PubMed

    Berman, Brian; Viera, Martha H; Amini, Sadegh; Huo, Ran; Jones, Isaac S

    2008-07-01

    Hypertrophic scars and keloids are challenging to manage, particularly as sequelae of burns in children in whom the psychologic burden and skin characteristics differ substantially from adults. Prevention of hypertrophic scars and keloids after burns is currently the best strategy in their management to avoid permanent functional and aesthetical alterations. Several actions can be taken to prevent their occurrence, including parental and children education regarding handling sources of fire and flammable materials, among others. Combination of therapies is the mainstay of current burn scar management, including surgical reconstruction, pressure therapy, silicon gels and sheets, and temporary garments. Other adjuvant therapies such as topical imiquimod, tacrolimus, and retinoids, as well as intralesional corticosteroids, 5-fluorouracil, interferons, and bleomycin, have been used with relative success. Cryosurgery and lasers have also been reported as alternatives. Newer treatments aimed at molecular targets such as cytokines, growth factors, and gene therapy, currently in developing stages, are considered the future of the treatment of postburn hypertrophic scars and keloids in children. PMID:18650721

  11. Reconstructive Surgery of Extensive Face and Neck Burn Scars Using Tissue Expanders

    PubMed Central

    Ashab Yamin, Mohammad Reza; Mozafari, Naser; Mozafari, Mohadase; Razi, Zahra

    2015-01-01

    BACKGROUND Neck reconstruction is considered as one of the most important surgeries in cosmetic and reconstructive surgery. The present study aimed to assess the results of reconstructive surgery of extensive face and neck burning scars using tissue expanders. METHODS This descriptive prospective study was conducted on 36 patients with extensive burning scars on the neck and face. Operation for tissue expander insertion was performed and tissue distension started two or three weeks later, depending on the patients’ incisions. After sufficient time for tissue expansion, while removing the expander and excision of the lesion, the expanded flap was used to cover the lesion. Overall, 43 cosmetic surgeries were done. RESULTS Rectangular expanders were employed in most patients (73.81%) and were located in the neck in most of them (60.78%). Complications were detected in five patients (13.89%), with exposure of the prosthesis being the most common one. Scar tissues at the reconstruction site and the flap donor site were acceptable in 94.44% and 98.18% of the cases, respectively. Overall, most of the patients (77.78%) were satisfied with the operation results.  CONCLUSION Using tissue expanders in tissue reconstruction of extensive neck and facial burning scars results in highly desirable outcomes. PMID:25606476

  12. Marjolin’s ulcers in the post-burned lesions and scars

    PubMed Central

    Saaiq, Muhammad; Ashraf, Bushra

    2014-01-01

    Marjolin’s ulcer (MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention, or burn wounds which never healed completely over years and the unstable post-burned scars. In the majority of cases, the MU is a squamous cell carcinoma (SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%. PMID:25325060

  13. Using MODIS imagery to assign dates to maps of burn scars in Portugal

    NASA Astrophysics Data System (ADS)

    DaCamara, C. C.; Libonati, R.; Barros, A.; Gaspar, G.; Calado, T. J.

    2012-04-01

    In the European context, Portugal presents the highest number of fire occurrences and has the largest area affected by wildfires. Like other southern regions of Europe, Portugal has experienced a dramatic increase in fire incidence during the last few decades that has been attributed to modifications in land-use as well as to climatic changes and associated occurrence of weather extremes. Wildfire activity also presents a large inter-annual variability that has been related to changes in the frequency of occurrence of atmospheric conditions favorable to the onset and spreading of large-fires. Since 1990, the Portuguese Authority for Forests (AFN) has been producing yearly maps of fire perimeters under a protocol with the Department of Forest Engineering of the Institute of Agronomy (DEF/ISA). The AFN fire atlas uses end of fire season Landsat TM/ETM imagery to map all fire perimeters with area larger than 5ha. Because it relies on end-of-season imagery, the atlas provides a spatial snapshot of the yearly area burned, and dates of burn for individual events cannot be estimated. Such information is nevertheless crucial to understand the fire regime and fire seasonality and to disentangle the complex interactions among fire, land cover and meteorology. The aim of the present work is to develop an automated procedure that allows using time series of moderate resolution imagery, such as the one provided by the MODIS instrument on-board TERRA and AQUA, to assign dates of burning to scars larger than 500 ha in the Landsat based fire atlas. The procedure relies on the so-called (V,W) burned index that uses daily reflectance obtained from the 1km MODIS Level 1B calibrated radiance from bands 2 (NIR) and 20 (MIR). The algorithm detects persistent changes in the (V,W) burned index time series, within each Landsat burned scar. The day of maximum change is then identified by means of a discrimination index, together with thresholds from the (V,W) time series. A spatial filter is finally applied to remove the outliers. An assessment of the temporal accuracy of the algorithm was conducted for the year 2005. For this year, Landsat based fire scars larger than 500ha have an associated detection date, based on field information provided by the AFN. The detection date is here assumed as ignition date of each scar. It is also assumed that each scar corresponds to a single fire event. Using 78 fire scars, we computed the time difference, in days, between the detection date and the date of burn, estimated by the algorithm. Our results show that 70% of all scars were correctly dated by the algorithm with differences to the AFN detection date up to three days. These correspond to 83% of the overall burned area used in the accuracy assessment.

  14. Increased expression of three types of transient receptor potential channels (TRPA1, TRPV4 and TRPV3) in burn scars with post-burn pruritus.

    PubMed

    Yang, Yoon Seok; Cho, Soo Ick; Choi, Min Gyu; Choi, Young Hee; Kwak, In Suk; Park, Chun Wook; Kim, Hye One

    2015-01-01

    Post-burn pruritus is a common distressing consequence of burn wounds. Empirical treatment often fails to have a satisfactory outcome on post-burn pruritus, as the mechanism of post-burn pruritus has not been fully elucidated. The aim of this study was to evaluate the manifestation of transient receptor potential (TRP) channels in post-burn pruritus. Fifty-one burn patients with (n=33) or without (n=18) pruritus were investigated, including skin biopsies. Not unexpectedly, the scarred body area was larger in the former group. In immunohistochemistry, TPRV3 was significantly elevated in the epidermis of burn scars with pruritus. Furthermore, real time- PCR showed that mRNA of TRPA1 and TRPV4 was increased in itching burn scars. Staining for substance P and CGRP did not differ between the 2 grouped, but the former neuropeptide was increased in burn scars. These results may help determine a specific therapeutic approach for post-burn pruritus. PMID:24695993

  15. Interrater and intrarater reliability of the Semmes Weinstein aesthesiometer to assess touch pressure threshold in burn scars.

    PubMed

    Meirte, J; Moortgat, P; Truijen, S; Maertens, K; Lafaire, C; De Cuyper, L; Hubens, G; Van Daele, U

    2015-09-01

    Burn scars are frequently accompanied with sensory deficits often remaining present months or even years after injury. Clinimetric properties of assessment tools remain understudied within burn literature. Tactile sense of touch can be examined with the touch pressure threshold (TPT) method using the Semmes Weinstein monofilament test (SWMT). There is in recent research no consensus on the exact measurement procedure when using the SWMT. The aim of this paper was to determine the interrater and intrarater reliability of TPT within burn scars and healthy controls using the 'ascending descending' measurement procedure. We used the newly developed guidelines for reporting reliability and agreement studies (GRRAS) as a basis to report this reliability study. In total 36 individuals were tested; a healthy control group and a scar group. The interrater reliability was excellent in the scar group (ICC=0.908/SEM=0.21) and fair to good in the control group (ICC=0.731/SEM=0.12). In the scar group intrarater ICC value was excellent (ICC=0.822/SEM=0.33). Within the control group also an excellent intrarater reliability (ICC=0.807/SEM=0.27) was found. In conclusion this study shows that the SWMT with the 'ascending descending' measurement procedure is a feasible and reliable objective measure to evaluate TPT in (older) upper extremities burn scars as well as in healthy skin. PMID:25703663

  16. Predicting severity of pathological scarring due to burn injuries: a clinical decision making tool using Bayesian networks.

    PubMed

    Berchialla, Paola; Gangemi, Ezio Nicola; Foltran, Francesca; Haxhiaj, Arber; Buja, Alessandra; Lazzarato, Fulvio; Stella, Maurizio; Gregori, Dario

    2014-06-01

    It is important for clinicians to understand which are the clinical signs, the patient characteristics and the procedures that are related with the occurrence of hypertrophic burn scars in order to carry out a possible prognostic assessment. Providing clinicians with an easy-to- use tool for predicting the risk of pathological scars. A total of 703 patients with 2440 anatomical burn sites who were admitted to the Department of Plastic and Reconstructive Surgery, Burn Center of the Traumatological Hospital in Torino between January 1994 and May 2006 were included in the analysis. A Bayesian network (BN) model was implemented. The probability of developing a hypertrophic scar was evaluated on a number of scenarios. The error rate of the BN model was assessed internally and it was equal to 24·83%. While classical statistical method as logistic models can infer only which variables are related to the final outcome, the BN approach displays a set of relationships between the final outcome (scar type) and the explanatory covariates (patient's age and gender, burn surface area, full-thickness burn surface area, burn anatomical area and wound-healing time; burn treatment options such as advanced dressings, type of surgical approach, number of surgical procedures, type of skin graft, excision and coverage timing). A web-based interface to handle the BN model was developed on the website www.pubchild.org (burns header). Clinicians who registered at the website could submit their data in order to get from the BN model the predicted probability of observing a pathological scar type. PMID:22958613

  17. Dupuytren contracture

    MedlinePLUS

    ... your doctor may recommend exercises, warm water baths, stretching, or splints. Your doctor may recommend treatment that ... Minimally invasive options in Dupuytren's contracture: aponeurotomy, enzymes, stretching, and fat grafting. Plast Reconstr Surg . 2014;134: ...

  18. Neglected post burns contracture of hand in children: Analysis of contributory socio-cultural factors and the impact of neglect on outcome☆

    PubMed Central

    Gupta, Ravi Kumar; Jindal, Nipun; Kamboj, Kulbhushan

    2014-01-01

    Background No study has ever evaluated the causes and effect of neglect on the outcome of post burns contractures of hand in children. Methods 66 hands in 61 children (mean age 12.22 years) with a mean neglect of 11.6 years (range 5–17 years) were assessed for the causes of neglect and the outcome of surgery. Average follow up was 6.6 years. The results were assessed in two groups of 5–10 years neglect as group I and >10 years neglect as group II. Results In a total number of 134 contracted rays in 66 hands, the surgical procedures included local Z/V-Y flap (51 rays), cross finger flap (48 rays), full thickness graft (35 rays). Additional external fixator with a distracter was used in 3 patients treated at a delay of 14, 16 and 17 years. 50 (81.96%) patients belonged to rural and slum areas. The reasons for delayed treatment included poverty – 33 patients, lack of awareness of surgical treatment – 16 patients; and indifference of parents – 12 patients. 44 (72.13%) children were illiterates. With treatment the average DASH score improved from 65.10 to 36.90 (p < .000) and from 68.14 to 45.93 (p < .000) in group I and II respectively. The results were significantly superior in group I (p < .000). Conclusion The main factors for neglect in treatment of post burns contracture include poverty, lack of awareness and illiteracy. All the patients showed significant improvement in function after the surgery. Contractures with higher neglect had significantly inferior outcome. PMID:25983501

  19. Management of Hypertrophic Burn Scar: A Comparison between the Efficacy of Exercise-Physiotherapy and Pressure Garment-Silicone on Hypertrophic Scar

    PubMed Central

    Karimi, Hamid; Mobayen, Mohammadreza; Alijanpour, Aboulhasan

    2012-01-01

    Purpose Our study aims to investigate the effectiveness of other treatment methods for burn related scarring and to determine the possibility of their routine administration in similar clinical settings. Methods Through a prospective study, 66 patients were enrolled to receive either the conventional pressure garment therapy (PGT) and Silicone (control group) or exercise and physiotherapy (case group). Patients were visited regularly to be examined for the status of their scars’ regression, limbs’ dysfunction, and joint motion. Then, these two groups were compared to determine the efficacy of exercise and physiotherapy as an alternative to the conventional treatment with PGT. Results After about 20 months follow-up, decreased articular range of motion (ROM) was: 16 (51.5%) cases compared to 5 (15%) of controls had mild, 11 (35.5%) of the cases compared to 13 (39.5%) of the controls had moderate; and 4 (13%) of the cases compared to 15 (45.5%) of the controls had severe decreased ROM which revealed statistically significant difference (P<0.01). At the same time, Vancouver Scar Scale score was: 15 (48%) of the cases and 6 (18%) of the controls had mild Scar Scale, 12 (39%) of the cases and 14 (42.5%) of the controls had moderate score and 4 (3%) of the cases and 13 (39.5%) of the controls had severe score which revealed a statistically significant difference (P<0.05). Conclusion Our study showed that physical therapy andexercise are more effective than PGT, in management of burn hypertrophic scar, hence could be an alternative in cases that conventional therapy cannot be used for any reason. PMID:23785579

  20. Pirfenidone Nanoparticles Improve Corneal Wound Healing and Prevent Scarring Following Alkali Burn

    PubMed Central

    Chowdhury, Sushovan; Guha, Rajdeep; Trivedi, Ruchit; Kompella, Uday B.; Konar, Aditya; Hazra, Sarbani

    2013-01-01

    Purpose To evaluate the effects of pirfenidone nanoparticles on corneal re-epithelialization and scarring, major clinical challenges after alkali burn. Methods Effect of pirfenidone on collagen I and ?-smooth muscle actin (?-SMA) synthesis by TGF? induced primary corneal fibroblast cells was evaluated by immunoblotting and immunocytochemistry. Pirfenidone loaded poly (lactide-co-glycolide) (PLGA) nanoparticles were prepared, characterized and their cellular entry was examined in primary corneal fibroblast cells by fluorescence microscopy. Alkali burn was induced in one eye of Sprague Dawley rats followed by daily topical treatment with free pirfenidone, pirfenidone nanoparticles or vehicle. Corneal re-epithelialization was assessed daily by flourescein dye test; absence of stained area indicated complete re-epithelialization and the time for complete re-epithelialization was determined. Corneal haze was assessed daily for 7 days under slit lamp microscope and graded using a standard method. After 7 days, collagen I deposition in the superficial layer of cornea was examined by immunohistochemistry. Results Pirfenidone prevented (P<0.05) increase in TGF ? induced collagen I and ?-SMA synthesis by corneal fibroblasts in a dose dependent manner. Pirfenidone could be loaded successfully within PLGA nanoparticles, which entered the corneal fibroblasts within 5 minutes. Pirfenidone nanoparticles but not free pirfenidone significantly (P<0.05) reduced collagen I level, corneal haze and the time for corneal re-epithelialization following alkali burn. Conclusion Pirfenidone decreases collagen synthesis and prevents myofibroblast formation. Pirfenidone nanoparticles improve corneal wound healing and prevent fibrosis. Pirfenidone nanoparticles are of potential value in treating corneal chemical burns and other corneal fibrotic diseases. PMID:23940587

  1. Mechanical evaluation of the resistance and elastance of post-burn scars after topical treatment with tretinoin

    PubMed Central

    Dematte, Maria Fernanda; Gemperli, Rolf; Salles, Alessandra Grassi; Dolhnikoff, Marisa; Lanças, Tatiana; Saldiva, Paulo Hilário Nascimento; Ferreira, Marcus Castro

    2011-01-01

    OBJECTIVE: After burn injuries, scarred skin lacks elasticity, especially in hypertrophic scars. Topical treatment with tretinoin can improve the appearance and quality of the skin (i.e., texture, distensibility, color, and hydration). The objective of this prospective study was to examine the effects of treatment with 0.05% tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring. Setting: Tertiary, Institutional. METHOD: Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected. Skin biopsies were obtained initially and after one year of treatment. The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system. The density of collagen fibers, elastic fibers, and versican were determined using immunohistochemical analysis. RESULTS: Tretinoin treatment significantly lowered skin resistance and elastance, which is a result that indicates higher distensibility of the skin. However, tretinoin treatment did not significantly affect the density of collagen fibers, elastic fibers, or versican. CONCLUSION: Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients. PMID:22086527

  2. The effects of electroacupuncture on analgesia and peripheral sensory thresholds in patients with burn scar pain.

    PubMed

    Cuignet, Olivier; Pirlot, A; Ortiz, S; Rose, T

    2015-09-01

    The aim of this study is to observe if the effects of electro-acupuncture (EA) on analgesia and peripheral sensory thresholds are transposable from the model of heat pain in volunteers to the clinical setting of burn scar pain. After severe burns, pathological burn scars (PPBS) may occur with excruciating pain that respond poorly to treatment and prevent patients from wearing their pressure garments, thereby leading to unesthetic and function-limiting scars. EA might be of greater benefit in terms of analgesia and functional recovery, should it interrupt this vicious circle by counteracting the peripheral hyperalgesia characterizing PPBS. Therefore we enrolled 32 patients (22 males/10 females) aged of 46±11 years with clinical signs of PPBS and of neuropathic pain despite treatment. The study protocol consisted in 3 weekly 30-min sessions of standardized EA with extra individual needles in accordance to Traditional Chinese Medicine, in addition of previous treatments. We assessed VAS for pain and quantitative sensory testing (QST) twice: one week before and one after protocol. QST measured electrical thresholds for non-nociceptive A-beta fibers, nociceptive A-delta and C fibers in 2 dermatomes, respectively from the PPBS and from the contralateral pain-free areas. Based on heat pain studies, EA consisted in sessions at the extremity points of the main meridian flowing through PPBS (0.300s, 5Hz, sub noxious intensity, 15min) and at the bilateral paravertebral points corresponding to the same metameric level, 15min. VAS reduction of 3 points or below 3 on a 10 points scale was considered clinically relevant. Paired t-test compared thresholds (mean [SD]) and Wilcoxon test compared VAS (median [IQR]) pre and after treatment, significant p<0.05. The reduction of VAS for pain reached statistical but not clinical relevance (6.8 [3] vs. 4.5 [3.6]). This was due to a large subgroup of 14 non-responders whose VAS did not change after treatment (6.6 [2.7] vs. 7.2 [3.8]). That subgroup exhibited significant differences in sensory thresholds when compared to the 18 responders (VAS from 7 [3] to 3 [1]). First, responders' thresholds for A-delta and C fibers in the PPBS area were significantly lower than those in the pain-free area before treatment but corrected after acupuncture (from respectively 60 [30] and 63 [10]% to 91 [11] and 106 [36]%). That might account for a nociceptive hypersensitivity in the PPBS that corrected after treatment. On the contrary, in non-responders nociceptive thresholds were similar in both the PPBS and the pain-free areas before treatment and did not change after EA. However, absolute values for thresholds in the pain-free areas where significantly lower for non-responders than for responders. The fact that non-responders had significant pain scores while presenting with lowered nociceptive thresholds even in the pain-free areas might evoke the possibility of a generalized supra-spinal hyperalgesia. The fact that acupuncture did not correct the pain nor the nociceptive thresholds in this subgroup requires further investigation. We also observed a statistically and clinically relevant reduction in VAS for pruritus for all patients - even those from the subgroup of non-responders to pain - that is worth to be mentioned and requires further studies to be confirmed. This observational study is the first that confirms the effects of acupuncture on analgesia and nociceptive thresholds in the clinical setting of burn pain only for patients presenting with a burn-localized but not a generalized hyperalgesia. PMID:26188894

  3. Derivation of Burn Scar Depths with Airborne Light Detection and Ranging (LIDAR) in Indonesian Peatlands

    NASA Astrophysics Data System (ADS)

    Ballhorn, U.; Siegert, F.

    2009-04-01

    Tropical deforestation and forest degradation contribute to about 20% of the global greenhouse gas emissions and Indonesia is a leading emitter. Forests are certainly critical; but the peat soils beneath can store 30 times more carbon than the trees above. Indonesia has the fourth-largest area of peatland in the world, ranging from 30 to 45 million ha, which is approximately 10 - 12% of the global peatland resource. Fire has a long tradition in Indonesian land clearing, where almost all fires are related to human activities. The 1997 - 1998 fires throughout Indonesia caused significant haze and smoke-related health problems across Southeast Asia. Strong and weak El Niño events in 1998 and 2002 accelerated burning as soil was parched. Green house gas emissions from the fires were the source of 60% of all anomalies globally for 1997 - 2000, particularly from drained peatlands. In 2007/08 we participated in a study conducted by the World Wildlife Fund which focused on Sumatra's 8.3 million ha province of Riau, along the island's northeastern coastline. In this study CO2 emissions from deforestation and forest degradation, peat decomposition and burning over 17 years from 1990 - 2007 were estimated. Fire hotspot data for the years 1997 - 2000 from the NOAA AVHRR and MODIS sensors was used to identify burned peatland. Based on soil water availability the depths of peat burns were estimated. El Nino years with a water table of lower than 1.5 m propel intense burning so that a peat burn depth of 0.50 m was assumed, while normally only a peat burn depth of 0.15 m. Total emissions for the 1990 - 2007 period were estimated at 3.66 Gt CO2, composed of 1.17 Gt CO2 from deforestation, 0.32 Gt CO2 from forest degradation, 0.78 Gt CO2 from peat decomposition, and 1.39 Gt CO2 from peat burning. Average annual CO2 emissions were 0.22 Gt, equal to 58% of Australia's total CO2 annual emissions (including emissions/removals from LULUCF, in 2005); between 1990 and 2007, Riau produced more CO2 per year than the fourth-largest industrial nation, Germany, saved to achieve its Kyoto target. Since 1990, emissions from peat burning and peat decomposition have exceeded that of above ground biomass deforestation. These numbers show how important it is to have more accurate estimations for peat burn depth in the future. Until now few field measurements were made, which would require to know the fire affected area in advance or ignite peatland on purpose. Furthermore fire scars are quickly covered by regenerating vegetation. Another problem is the lack of a method without actually having to go into the field (e.g. through remote sensing techniques), due to the fact that many of the fire locations are remote and very difficult to access. We investigated if airborne light detection and ranging (LIDAR), an active laser pulse technology by which the height of objects can be precisely measured, can be used to determine the amount of peat burned during a fire event. From a LIDAR data set acquired in Central Kalimantan, Borneo, in 2007, one year after severe fires resulting from the 2006 El Niño drought, we calculated that the average depth of a burn scar was 0.30 ± 0.15 m .This was achieved through the construction of digital terrain models (DTMs) by interpolating the LIDAR ground return signals in burnt and adjacent unburned peatland. These calculated depths were compared to in situ measurements, which came to similar results. We believe that the method presented here to estimate burnt peat depth has the potential to considerably improve the accuracy of regional and global carbon emission models but would also be helpful for monitoring projects under the Kyoto Protocol like the Clean Development Mechanism (CDM) or the proposed Reducing Emissions from Deforestation and Degradation (REDD) mechanism.

  4. Derivation of burn scar depths and estimation of carbon emissions with LIDAR in Indonesian peatlands

    PubMed Central

    Ballhorn, Uwe; Siegert, Florian; Mason, Mike; Limin, Suwido

    2009-01-01

    During the 1997/98 El Niño-induced drought peatland fires in Indonesia may have released 13–40% of the mean annual global carbon emissions from fossil fuels. One major unknown in current peatland emission estimations is how much peat is combusted by fire. Using a light detection and ranging data set acquired in Central Kalimantan, Borneo, in 2007, one year after the severe peatland fires of 2006, we determined an average burn scar depth of 0.33 ± 0.18 m. Based on this result and the burned area determined from satellite imagery, we estimate that within the 2.79 million hectare study area 49.15 ± 26.81 megatons of carbon were released during the 2006 El Niño episode. This represents 10–33% of all carbon emissions from transport for the European Community in the year 2006. These emissions, originating from a comparatively small area (approximately 13% of the Indonesian peatland area), underline the importance of peat fires in the context of green house gas emissions and global warming. In the past decade severe peat fires occurred during El Niño-induced droughts in 1997, 2002, 2004, 2006, and 2009. Currently, this important source of carbon emissions is not included in IPCC carbon accounting or in regional and global carbon emission models. Precise spatial measurements of peat combusted and potential avoided emissions in tropical peat swamp forests will also be required for future emission trading schemes in the framework of Reduced Emissions from Deforestation and Degradation in developing countries. PMID:19940252

  5. Derivation of burn scar depths and estimation of carbon emissions with LIDAR in Indonesian peatlands.

    PubMed

    Ballhorn, Uwe; Siegert, Florian; Mason, Mike; Limin, Suwido

    2009-12-15

    During the 1997/98 El Niño-induced drought peatland fires in Indonesia may have released 13-40% of the mean annual global carbon emissions from fossil fuels. One major unknown in current peatland emission estimations is how much peat is combusted by fire. Using a light detection and ranging data set acquired in Central Kalimantan, Borneo, in 2007, one year after the severe peatland fires of 2006, we determined an average burn scar depth of 0.33 +/- 0.18 m. Based on this result and the burned area determined from satellite imagery, we estimate that within the 2.79 million hectare study area 49.15 +/- 26.81 megatons of carbon were released during the 2006 El Niño episode. This represents 10-33% of all carbon emissions from transport for the European Community in the year 2006. These emissions, originating from a comparatively small area (approximately 13% of the Indonesian peatland area), underline the importance of peat fires in the context of green house gas emissions and global warming. In the past decade severe peat fires occurred during El Niño-induced droughts in 1997, 2002, 2004, 2006, and 2009. Currently, this important source of carbon emissions is not included in IPCC carbon accounting or in regional and global carbon emission models. Precise spatial measurements of peat combusted and potential avoided emissions in tropical peat swamp forests will also be required for future emission trading schemes in the framework of Reduced Emissions from Deforestation and Degradation in developing countries. PMID:19940252

  6. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring

    PubMed Central

    Sood, Ravi F.; Arbabi, Saman; Honari, Shari; Gibran, Nicole S.

    2016-01-01

    Background Hypertrophic scarring (HTS) is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK) pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs) in MAPK-pathway genes would be associated with severity of post-burn HTS. Methods We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS) assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing. Results Our study population consisted of 538 adults (median age 40 years) who were predominantly White (76%) males (71%) admitted to our center from 2007–2014 with small-to-moderate-sized burns (median burn size 6% total body surface area). Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5%) was significantly associated with decreased severity of post-burn HTS (P = 1.3×10?6). In gene-based analysis, PTPN5 (P = 1.2×10?5) showed a significant association and BDNF (P = 9.5×10?4) a borderline-significant association with HTS severity. Conclusions We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology. PMID:26872063

  7. Use of an artificial dermis (Integra) for the reconstruction of extensive burn scars in children. About 22 grafts.

    PubMed

    Groos, N; Guillot, M; Zilliox, R; Braye, F M

    2005-06-01

    We used an artificial dermis (Integra) for the reconstruction of extensive burn scars in children. Integra was initially developed for the primary coverage of acute burns, but several authors report good experiences with Integra for reconstructive surgery. We present a group of 10 children who underwent Integra grafting at 22 different operational sites. Five children received several grafts with Integra. On average, 260 cm(2) per session were grafted. We compared the surface of Integra on the day of grafting and then again on the evaluation day to measure the secondary retraction of the grafts. Complications (infection of Integra, failure of the epidermal graft) were observed in 5 cases. At the final evaluation, 20 grafts were visible. The surface of the Integra graft represented less than 50% of the initial surface in 7 cases, 51-75% in 5 cases and more than 76% in 8 cases. The disadvantages of Integra in reconstructive surgery are that two operative procedures are necessary and the recurrence of contraction seems to be more significant than with full thickness auto grafts. However, Integra has many advantages: the immediate availability of large quantities, the simplicity and reliability of the technique, the pliability and the cosmetic aspect of the resulting coverage. In light of these preliminary results, Integra appears to offer a new alternative for the reconstruction of extensive burn scars in children. PMID:15999312

  8. Physical rehabilitation of pediatric burns

    PubMed Central

    Atiyeh, B.; Janom, H.H.

    2014-01-01

    Summary Significant improvements have been made in the acute treatment of pediatric burn injuries over the past 3 decades which have significantly decreased mortality. Each year, more burned children are necessitating serious medical attention during their convalescence. For children with serious consequences resulting from burns that can persist from childhood through adolescence into adulthood, the value of long-term rehabilitation cannot be over stated. Burn injury management should not focus only on the immediate treatment. Long-term functional outcome and the required rehabilitation that burn victims must go through should be given equal if not more attention. The present is a review of the available modalities utilized for the physical rehabilitation of convalescent pediatric burns in order to overcome the catabolic state, improve muscle power and fitness, reduce disfiguring scars and prevent contractures. PMID:25249846

  9. [The Treatment of Major Burn Injuries].

    PubMed

    Lin, Yu-Hsun; Lin, Hsiu-Hua; Shi, Li-Ping; Yeong, Eng-Kean

    2016-02-01

    Major burn injuries constitute a systemic disease. In addition to completely understanding the mechanisms of wound healing, precise burn depth and area assessment is critical to the successful management of burn injuries. The recent advancements in post-burn fluid resuscitation, tangential burn excision and grafting, effective enteral tube feeding, and aggressive sepsis treatment have helped greatly increase the survival rates for major burn injuries. However, the restricted joint motion that results from hypertrophic scar contracture remains the main challenge facing burn survivors. In conclusion, as the course of the treatment and rehabilitation is prolonged and multifaceted, a complete treatment plan is always necessary in addition to teamwork among physicians, nurses, social workers, physical therapists, and psychologists. Finally, social return is the final goal of treatment and may be achieved only through mutual support and understanding among the members of the burn treatment and rehabilitation team. PMID:26813057

  10. A histological study on the effect of pressure therapy on the activities of myofibroblasts and keratinocytes in hypertrophic scar tissues after burn.

    PubMed

    Li-Tsang, Cecilia W P; Feng, Beibei; Huang, Lin; Liu, Xusheng; Shu, Bin; Chan, Yvonne T Y; Cheung, Kwok-Kuen

    2015-08-01

    Although pressure therapy (PT) has been widely used as the first-line treatment for hypertrophic scars (HS), the histopathological changes involved have seldom been studied. This study aimed to examine the longitudinal effect of PT on the histopathological changes in HS. Ten scar samples were selected from six patients with HS after burn and they were given a standardized PT intervention for 3 months while 16 scar samples were obtained on those without PT. The scar biopsies were collected pre-treatment, 1 and 3 months post-intervention for both clinical and histopathological examinations. Clinical assessments demonstrated significant improvement in the thickness and redness of the scars after PT. Histological examination revealed that cell density in the dermal layer was markedly reduced in the 3-months post-pressurized scar tissues, while the arrangement of the collagen fiber was changed from nodular to wave-like pattern. The α-smooth muscle actin immunoreactivity was significantly decreased after 1-month pressure treatment. There was a significant reduction of myofibroblasts population and a concomitant increase in the apoptotic index in the dermal layer in the 3-months' post-pressurized scars. A significant negative correlation was found between the myofibroblasts population and the apoptotic index. The keratinocyte proliferation was found inhibited after PT. Results demonstrated that PT appeared to promote HS maturation by inhibiting the keratinocyte proliferation and suppressing myofibroblasts population, the latter possibly via apoptosis. PMID:25681960

  11. The Effects of Topical Agent (Kelo-Cote or Contractubex) Massage on the Thickness of Post-Burn Scar Tissue Formed in Rats

    PubMed Central

    Ko, Won Jin; Suh, Bum Sin; Kim, Hyeon A; Heo, Woo Hoe; Choi, Gum Ha; Lee, Seo Ul

    2013-01-01

    Background We conducted an experimental study to compare the effect of massage using topical agents (Kelo-cote or Contractubex) on scar formation by massaging the healed burn wound on the dorsal area of Sprague-Dawley (SD) rats. Methods Four areas of second degree contact burn were made on the dorsal area of each of 15 SD rats, using a soldering iron 15 mm in diameter. After gross epithelialization in the defect, 15 SD rats were randomly divided into four groups: the Kelo-cote group, Contractubex group, Vaseline group, and control group. Rats in three of the groups (all but the Control group) were massaged twice per day for 5 minutes each day, while those in the Control group were left unattended. For histologic analysis, we performed a biopsy and evaluated the thickness of scar tissue. Results In the Kelo-cote and Contractubex groups, scar tissue thicknesses showed a significant decrease, compared with the Vaseline and control groups. However, no significant differences were observed between the Kelo-cote and Contractubex groups. In the Vaseline group, scar tissue thicknesses showed a significant decrease, compared with the control groups. Conclusions The findings of this study suggest that massage using a topical agent is helpful in the prevention of scar formation and that massage only with lubricant (no use of a topical agent) also has a considerable effect, although not as much as the use of a topical agent. Thus, we recommend massage with a topical agent on the post-burn scar as an effective method for decreasing the scar thickness. PMID:24286041

  12. Quality of pediatric second-degree burn wound scars following the application of basic fibroblast growth factor: results of a randomized, controlled pilot study .

    PubMed

    Hayashida, Kenji; Akita, Sadanori

    2012-08-01

    Pediatric burn wounds present unique challenges. Second-degree burns may increase in size and depth, raising concerns about healing and long-term scarring. Results of a clinical study in adults with second-degree burn wounds suggest that application of basic fibroblast growth factor (bFGF) may reduce time to second-intention healing and result in a more cosmetically acceptable scar. To evaluate the effect of this treatment on pediatric patients with deep second- degree burn wounds, 20 pediatric patients ranging in age from 8 months to 3 years (average 1 year, 3 months [± 6 months]) with a total of 30 burn wounds from various causes were allocated either the growth factor (treatment, n = 15) or an impregnated gauze treatment (control, n = 15). Wounds still exudative (not healed) after 21 days were covered with a split-thickness skin graft. All wounds were clinically assessed until healed and after 1 year. A moisture meter was used to assess scars of wounds healing by secondary intention. A color meter was used to evaluate grafted wounds. Five wounds in each group required grafting. Skin/scar color match was significantly closer to 100% in the treatment than in the control group (P <0.01). Wounds not requiring grafting were no longer exudative after 13.8 (± 2.4) and 17.5 (± 3.1) days in the treatment (n = 10) and control group (n = 10), respectively (P <0.01). After 1 year, scar pigmentation, pliability, height, and vascularity were also significantly different (P <0.01) between the groups. Hypertrophic scars developed in 0 of 10 wounds in the treatment and in three of 10 wounds in the control group, and effective contact coefficient, transepidermal water loss, water content, and scar thickness were significantly greater in control group (P <0.01). Both the short- and long-term results of this treatment in pediatric burn patients are encouraging and warrant further research. PMID:22879314

  13. [I Am an Occupational Therapist. I Will Accompany You Through the Process of Burn Rehabilitation].

    PubMed

    Chen, Sheng-Sung

    2016-02-01

    Burn injuries nearly always occur by accident. Burn injuries that cover large areas of the body typically cause hypertrophic scarring and joint contractures that affect the ability of the burn patient to handle normal activities of daily living. Occupational therapists begin the related interventions as early as possible, and patients require rehabilitation continuously until scar maturation. The present article provides an overview of the approach that occupational therapists should take in treating burn patients. Key elements of this approach include creating a burn rehabilitation program and helping patients achieve independence in their activities of daily living by applying individual assistive devices. The goal of this program is to allow burn patients to return to the workplace and to a normal life. We hope that this article makes more specialists aware of the proper approach to occupational therapy for burn patients and reduces the incidence of post-burn-injury sequelae. PMID:26813062

  14. Rehabilitation of the burn patient

    PubMed Central

    Procter, Fiona

    2010-01-01

    Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ‘Burns Rehabilitation’ incorporates the physical, psychological and social aspects of care and it is common for burn patients to experience difficulties in one or all of these areas following a burn injury. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. The aims of burn rehabilitation are to minimise the adverse effects caused by the injury in terms of maintaining range of movement, minimising contracture development and impact of scarring, maximising functional ability, maximising psychological wellbeing, maximising social integration PMID:21321643

  15. A fully automatic processing chain to produce Burn Scar Mapping products, using the full Landsat archive over Greece

    NASA Astrophysics Data System (ADS)

    Kontoes, Charalampos; Papoutsis, Ioannis; Herekakis, Themistoklis; Michail, Dimitrios; Ieronymidi, Emmanuela

    2013-04-01

    Remote sensing tools for the accurate, robust and timely assessment of the damages inflicted by forest wildfires provide information that is of paramount importance to public environmental agencies and related stakeholders before, during and after the crisis. The Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens (IAASARS/NOA) has developed a fully automatic single and/or multi date processing chain that takes as input archived Landsat 4, 5 or 7 raw images and produces precise diachronic burnt area polygons and damage assessments over the Greek territory. The methodology consists of three fully automatic stages: 1) the pre-processing stage where the metadata of the raw images are extracted, followed by the application of the LEDAPS software platform for calibration and mask production and the Automated Precise Orthorectification Package, developed by NASA, for image geo-registration and orthorectification, 2) the core-BSM (Burn Scar Mapping) processing stage which incorporates a published classification algorithm based on a series of physical indexes, the application of two filters for noise removal using graph-based techniques and the grouping of pixels classified as burnt to form the appropriate pixels clusters before proceeding to conversion from raster to vector, and 3) the post-processing stage where the products are thematically refined and enriched using auxiliary GIS layers (underlying land cover/use, administrative boundaries, etc.) and human logic/evidence to suppress false alarms and omission errors. The established processing chain has been successfully applied to the entire archive of Landsat imagery over Greece spanning from 1984 to 2012, which has been collected and managed in IAASARS/NOA. The number of full Landsat frames that were subject of process in the framework of the study was 415. These burn scar mapping products are generated for the first time to such a temporal and spatial extent and are ideal to use in further environmental time series analyzes, production of statistical indexes (frequency, geographical distribution and number of fires per prefecture) and applications, including change detection and climate change models, urban planning, correlation with manmade activities, etc.

  16. Silk fibroin/gelatin electrospun nanofibrous dressing functionalized with astragaloside IV induces healing and anti-scar effects on burn wound.

    PubMed

    Shan, Ying-Hui; Peng, Li-Hua; Liu, Xin; Chen, Xi; Xiong, Jie; Gao, Jian-Qing

    2015-02-20

    Functional wound dressing has provided new challenges for researchers who focus on burn to improve skin graft quality, reduce scarring, and develop a pluristratified dermal or epidermal construct of a burn wound. This study aimed to investigate the effect of a silk fibroin/gelatin (SF/GT) electrospun nanofibrous dressing loaded with astragaloside IV (AS) on deep partial-thickness burn wound. AS-loaded SF/GT-blended nanofibrous dressing was prepared by electrospinning nanotechnology. The optimal ratio (25:75) of silk fibroin to gelatin was further optimized by evaluating ATR-FTIR characteristics, mechanical properties, porosity, swelling rate, degradation, and release profile of the AS-loaded SF/GT nanofibrous dressing. In contrast to the blank control, the AS-loaded SF/GT nanofibrous dressing promoted cell adhesion and proliferation with good biocompatibility in vitro (p<0.01). This dressing also accelerated wound healing and inhibited scar formation in vivo by stimulating wound closure (p<0.05), increasing angiogenesis, regulating newly formed types of collagen, and improving collagen organization. These results showed that SF/GT nanofibrous dressing is a promising topical drug delivery system. Furthermore, AS-functionalized SF/GT nanofibrous dressing is an excellent topical therapeutic that could be applied to promote healing and elicit anti-scar effects on partial-thickness burn wound. PMID:25556053

  17. Race and Melanocortin 1 Receptor Polymorphism R163Q Are Associated with Post-Burn Hypertrophic Scarring: A Prospective Cohort Study.

    PubMed

    Sood, Ravi F; Hocking, Anne M; Muffley, Lara A; Ga, Maricar; Honari, Shari; Reiner, Alexander P; Rowhani-Rahbar, Ali; Gibran, Nicole S

    2015-10-01

    The genetic determinants of post-burn hypertrophic scarring (HTS) are unknown, and melanocortin 1 receptor (MC1R) loss-of-function leads to fibrogenesis in experimental models. To examine the associations between self-identified race and MC1R single-nucleotide polymorphisms (SNPs) with severity of post-burn HTS, we conducted a prospective cohort study of burned adults admitted to our institution over 7 years. Subjects were evaluated using the Vancouver Scar Scale (VSS), asked to rate their itching, and genotyped for 8 MC1R SNPs. Testing for association with severe HTS (VSS>7) and itch severity (0-10) was based on multivariate regression with adjustment for known risk factors. Of 425 subjects analyzed, 77% identified as White. The prevalence of severe HTS (VSS>7) was 49%, and the mean itch score was 3.9. In multivariate analysis, Asian (prevalence ratio (PR) 1.54; 95% CI: 1.13-2.10), Black/African American (PR 1.86; 95% CI: 1.42-2.45), and Native American (PR 1.87; 95% CI: 1.48-2.35) race were independently associated with severe HTS. MC1R SNP R163Q was also significantly (P<0.001) associated with severe HTS. Asian race (linear regression coefficient 1.32; 95% CI: 0.23-2.40) but not MC1R SNP genotype was associated with increased itch score. We conclude that MC1R genotype may influence post-burn scarring. PMID:26030184

  18. Clinical outcomes from a foam wedge splinting program for axillary contracture prevention in the intensive care unit.

    PubMed

    Godleski, Matthew; Holden, Mary Sullivan; Luby, Darcie; Weitzenkamp, David; Boimbo, Sandra; Lindberg, Gordon

    2014-01-01

    Preventing scar contracture after burn injury is a critical goal during recovery. Although the need for intervention is well-understood, data on specific techniques are limited. The study's objective is to provide data for the use of a foam abduction wedge in terms of safety, effectiveness, and patient and caregiver satisfaction through a prospective, single-arm trial. All patients presenting with a burn injury that required grafting in the axillary region and placed them at risk for shoulder joint contracture were offered inclusion. Patient outcomes were recorded for the duration of their burn intensive care unit admission. Ten subjects completed the protocol with a mean duration of wedge use of 41.5 ± 32.5 days. At discharge, the mean shoulder abduction was 132° ± 38° on the left and 118° ± 22° on the right. The mean shoulder flexion was 132° ± 31° on the left and 123° ± 29° on the right. As much as 90% of the subjects had greater than 90° of shoulder abduction and flexion at discharge. There were no observations of worsening burn injury wounds, graft failure, or new pressure-related wounds. One patient was found to have an upper-extremity peripheral nerve injury that was not clearly associated with the splint. Patient and nursing surveys indicated areas of satisfaction as well as areas for potential improvement. This study illustrates the anticipated clinical outcomes and care issues associated with the use of a specific contracture prevention method used in the burn intensive care unit setting as well as identifying areas for future research. PMID:24918948

  19. California Burn Scars

    Atmospheric Science Data Center

    2014-05-15

    ... Imaging SpectroRadiometer (MISR). The images were created by displaying red, near-infrared and green spectral band data from ... Multi-angle Imaging SpectroRadiometer observes the daylit Earth continuously and every 9 days views the entire Earth between 82 degrees ...

  20. Management of an unusual extreme extension contracture of the wrist: role of a custom-designed exercise program in achieving a good range of movement and prevention of recontraction.

    PubMed

    Saraiya, Hemant

    2003-01-01

    An extreme extension contracture of wrist with dorsal contracture of fingers 15 years after burn injury is described. Shortening of extensor tendons, secondary lengthening of flexor tendons, contracted wrist joint capsule, unusual dislocation of carpals, dorsal dislocation of metacarpophalangeal joints of fingers, and provision of sufficient amount of good-quality skin were some of the issues that had to be addressed in treatment. The contracture was released, the carpals and metacarpophalangeal joint dislocations were corrected and fixed with K wires, and the resulting defect was covered with a sheet split-thickness skin graft. An exercise program was designed that consisted of isotonic, isokinetic, and isometric resistance exercises and passive, active, and active-assistive range of motion exercises. These exercises were pursued with the intention of increasing dynamic strength, endurance, and overall functional recovery of the flexor muscles by exploiting the immature nature of early scar tissue. The resultant enhanced flexor muscle power from exercises along with the dynamic splint helped in lengthening of extensor tendons, wrist joint capsule, and split-thickness skin graft. It also helped in resisting the recontracting tendency, with further recovery of good range of wrist and fingers movements, obviating the need of tendon-lengthening surgery and flap coverage. One and half years of follow up didn't show any sign of recontracture, and the patient was able to perform his routine activities. Postburn wrist contractures of such magnitude have been seldom described. Emphasis is put on simple contracture release and a postoperative exercise program. PMID:14610422

  1. [The treatment of a post-burn deformity and contracture of the neck, using extended flaps with axial type of blood supply].

    PubMed

    Zhernov, A A; Zhernov, An A

    2012-03-01

    Experience of treatment of 24 patients, suffering neck deformity and contracture, using stretched flaps with axial type of blood circulation, was summarized. In total 43 expanders were implanted. The cutaneo-fascial flaps stretching was performed in the neck and thorax. In all the flaps a nutrition artery was included. The neck-brachial flaps, including supraclavicular artery, were applied in 25 (58.1%) patients, the neck-thoracic flaps, using superficial neck artery--in 12 (27.91%), the occipital-neck flaps on a musculocutaneous perforating vessels of occipital artery--in 6 (13.95%). The methods of the expander implantation, the stretching, transposition regimes of plastic material and its fixation were elaborated. The donor sites were closed using stretched tissues, left in place after formation of flaps. Flaps were fixed, using mechanical method of the tissues connection with duplicature formation from deepidermized portion of cicatrix or with polypropylene mesh, which played a role of a dense framework. Then a strong connective tissue bolt was formed, securely fixing transposedstretched tissues. While application of a complex-component vascularized flaps a suppuration have occurred in 3 (6.97%), partial necrosis--in 2 (4.64%) observations. Inclusion of nutritive vessels permit to form large size flaps with a small risk of necrosis occurrence. The stretched perforant flaps application permits to achieve positive result in 95.3% of observations--in immediate and in 81.82%--in far remote period. PMID:22702123

  2. Scar revision

    MedlinePLUS

    ... revision is surgery to improve or reduce the appearance of scars. It also restores function, and corrects ... different. There are several ways to improve the appearance of scars: The scar may be removed completely ...

  3. Joint Contracture Orthosis (JCO)

    NASA Technical Reports Server (NTRS)

    Lunsford, Thomas R.; Parsons, Ken; Krouskop, Thomas; McGee, Kevin

    1997-01-01

    The purpose of this project was to develop an advanced orthosis which is effective in reducing upper and lower limb contractures in significantly less time than currently required with conventional methods. The team that developed the JCO consisted of an engineer, orthotist, therapist, and physician.

  4. OUTCOME OF PHYSICAL THERAPY AND SPLINTING IN HAND BURNS INJURY. OUR LAST FOUR YEARS’ EXPERIENCE

    PubMed Central

    Rrecaj, Shkurta; Hysenaj, Hajrie; Martinaj, Merita; Murtezani, Ardiana; Ibrahimi-Kacuri, Dafina; Haxhiu, Bekim; Buja, Zene

    2015-01-01

    Objective: Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to presents our experience of 38 children with hand burn injuries, admitted and treated at the Department of Plastic Surgery, UCCK-Pristina, Kosovo, during the years 2012-2015. Methods: Physical therapy is focused on active/passive range of motion in affected joints, management of cicatrix, strengthening exercise, coordination and use of splints for correction contractures. Patients were evaluated in three, six months and the definitive evaluation is done after 9 months of physical therapy and splinting. Results: We have improvement in range of motion (ROM), functionality, coordination, muscle force, decrease of keloids scars. Conclusion: This study shows the importance of physical therapy and splinting, achieving good results in preventing contracture, improving range of motion, muscle force and good cosmetic results. PMID:26889095

  5. Acne Scars

    MedlinePLUS

    ... treating acne scars include: Improved appearance Enhanced self-esteem Promotion of better skin health What you need to know There are two main types of acne scars: Hypertrophic or keloid scarring . These scars are caused when the body produces too much collagen as acne wounds heal, ...

  6. Scarring, stem cells, scaffolds and skin repair.

    PubMed

    Markeson, Daniel; Pleat, Jonathon M; Sharpe, Justin R; Harris, Adrian L; Seifalian, Alexander M; Watt, Suzanne M

    2015-06-01

    The treatment of full thickness skin loss, which can be extensive in the case of large burns, continues to represent a challenging clinical entity. This is due to an on-going inability to produce a suitable tissue engineered substrate that can satisfactorily replicate the epidermal and dermal in vivo niches to fulfil both aesthetic and functional demands. The current gold standard treatment of autologous skin grafting is inadequate because of poor textural durability, scarring and associated contracture, and because of a paucity of donor sites in larger burns. Tissue engineering has seen exponential growth in recent years with a number of 'off-the-shelf' dermal and epidermal substitutes now available. Each has its own limitations. In this review, we examine normal wound repair in relation to stem/progenitor cells that are intimately involved in this process within the dermal niche. Endothelial precursors, in particular, are examined closely and their phenotype, morphology and enrichment from multiple sources are described in an attempt to provide some clarity regarding the controversy surrounding their classification and role in vasculogenesis. We also review the role of the next generation of cellularized scaffolds and smart biomaterials that attempt to improve the revascularisation of artificial grafts, the rate of wound healing and the final cosmetic and functional outcome. PMID:24668923

  7. Avoiding unfavorable results in postburn contracture hand

    PubMed Central

    Bhattacharya, Sameek

    2013-01-01

    Deformities of the hands are a fairly common sequel of burn especially in the developing world. This is because of high incidence of burns, limited access to standard treatment and rehabilitation. The best outcome of a burnt hand is when deformities are prevented from developing. A good functional result is possible when due consideration is paid to hands during resuscitation, excisional surgery, reconstructive surgery and physiotherapy. The post-burns deformities of hand develop due direct thermal damage or secondary to intrinsic minus position due to oedema or vascular insufficiency. During the acute phase the concerns are, maintenance circulation minimize oedema prevent unphysiological positioning and wound closure with autogenous tissue as soon as possible. The rehabilitation program during the acute phase starts from day one and goes on till the hand has healed and has regained full range of motion. Full blown hand contractures are challenging to correct and become more difficult as time passes. Long-standing cases often land up with attenuation of extensor apparatus leading to swan neck and boutonniere deformity, muscle shortening and bony ankylosis. The major and most common pitfall after contracture release is relapse. The treatment protocol of contracture is solely directed towards countering this tendency. This article aims to guide a surgeon in obtaining optimal hand function and avoid pit falls at different stages of management of hand burns. The reasons of an unfavourable outcome of a burnt hand are possible lack of optimal care in the acute phase, while planning and performing reconstructive procedure and during aftercare and rehabilitation. PMID:24501479

  8. Study on Surgical Management of Post Burn Hand Deformities

    PubMed Central

    Ahmed, Firdos; Jash, Prabir Kumar; Gupta, Madhumita; Suba, Santanu

    2015-01-01

    Context Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer. Aim The aim of this study is to evaluate the different surgical procedures for resurfacing after release of post-burn hand contractures in terms of functional recovery and aesthetic outcome. Settings and Design It’s a prospective, non-randomised study of 50 patients admitted and undergoing surgical reconstructive procedures for post burn hand contractures in our plastic surgery department. Materials and Methods Resurfacing procedures were done according to type of contracture with individualisation for each case. All cases were followed up with physiotherapy and splinting advices. Functional and aesthetic outcome and recurrence of contracture for each procedure was noted at 6 months. Results Forty seven percent of the cases were reconstructed with skin grafting, 30% cases with Z plasties and 23% with flap coverage. Split thickness skin grafts (STSG) and full thickness graft (FTSG) reconstructed cases had good recovery of joint mobility in 43% and 75% of cases respectively. Reconstructive procedures were aesthetically acceptable to the patients in 63%, 75% and 94% of STSG, FTSG and Z plasty cases respectively. Recurrence was seen in 17% of STSG done cases. Conclusion Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z plasties with proper planning gives maximum length gain with no donor morbidity as other procedures. Postoperative physiotherapy and splinting is must for better outcome in all cases. PMID:26435994

  9. Burns.

    PubMed

    McLoughlin, E; Crawford, J D

    1985-02-01

    The authors present an extensive review of burn epidemiology. They review sources of burns, preventive tools, emergency behaviors to reduce severity, and rehabilitation. Ways are sketched in which the pediatrician can be an effective advocate against burn injuries. PMID:3975098

  10. Emerging Therapies for Scar Prevention

    PubMed Central

    Block, Lisa; Gosain, Ankush; King, Timothy W.

    2015-01-01

    Significance: There are ∼12 million traumatic lacerations treated in the United States emergency rooms each year, 250 million surgical incisions created worldwide every year, and 11 million burns severe enough to warrant medical treatment worldwide. In the United States, over $20 billion dollars per year are spent on the treatment and management of scars. Recent Advances: Investigations into the management of scar therapies over the last decade have advanced our understanding related to the care of cutaneous scars. Scar treatment methods are presented including topical, intralesional, and mechanical therapies in addition to cryotherapy, radiotherapy, and laser therapy. Critical Issues: Current treatment options for scars have significant limitations. This review presents the current and emerging therapies available for scar management and the scientific evidence for scar management is discussed. Future Directions: Based upon our new understanding of scar formation, innovative scar therapies are being developed. Additional research on the basic science of scar formation will lead to additional advances and novel therapies for the treatment of cutaneous scars. PMID:26487979

  11. Dupuytren's Contracture: Fibroblast Contraction?

    PubMed Central

    Gabbiani, Giulio; Majno, Guido

    1972-01-01

    In 6 cases of Dupuytren's disease and 1 of Ledderhose's disease, the nodules of the palmar and plantar aponeurosis were examined by light and electron microscopy. The cells composing these nodules, presumably fibroblasts, showed three significant ultrastructural features: (1) a fibrillar system similar to that of smooth muscle cells; (2) nuclear deformations such as are found in contracted cells, the severest being recognizable by light microscopy (cross-banded nuclei); (3) cell-to-cell and cell-to-stroma attachments. Based on these data and on recent information about the biology of the fibroblasts, it is suggested that these cells are fibroblasts that have modulated into contractile cells (myofibroblasts), and that their contraction plays a role in the pathogenesis of the contracture observed clinically. ImagesFig 10Fig 5Fig 11Fig 6 and 7Fig 8Fig 1Fig 2Fig 9Fig 3Fig 4 PMID:5009249

  12. Bladder neck contracture

    PubMed Central

    Simhan, Jay; Ramirez, Daniel; Morey, Allen F.

    2014-01-01

    Bladder neck contracture (BNC) is a well-described complication of the surgical treatment of benign and malignant prostate conditions. Nevertheless, etiologies of BNC development are highly dependent on the primary treatment modality undertaken with BNC also occurring after pelvic radiation. The treatment options for BNC can range from simple, office-based dilation procedures to more invasive, complex abdomino-perineal reconstructive surgery. Although numerous strategies have been described, a patient-specific approach is usually necessary in the management of these complex patients. In this review, we highlight various therapeutic maneuvers described for the management of BNC and further delineate a tailored approach utilized at our institution in these complicated patients. PMID:26816768

  13. Preliminary study of non-invasive shock wave treatment of capsular contracture after breast implant: animal model.

    PubMed

    Wu, Yu-Chiuan; Jao, Jo-Chi; Yang, Yu-Ting; Wang, Hsiang-Sheng; Wu, Chun-Hsien; Chen, Po-Chou

    2013-01-01

    The incidence rate of capsular contracture after breast implant is about 8% to 12%. Patients would feel extremely uncomfortable after scar formation. Administering oral medications (such as vitamin E and Zafirlukast tablets, etc.) or invasive breast capsulectomy surgery was commonly used for capsular contracture repair in clinical therapy. However, the therapeutic effect is still under investigation. Shock waves can be used to remove soft connective tissue in clinical applications. It has been widely used in orthopedics and rehabilitation. No related research paper about shock wave treatment of capsular contracture has been published yet. It might provide another choice for capsular contracture repair. In order to simulate breast implantation, two silica-gel bags filled with normal saline were implanted into New Zealand rabbit's thighs bilaterally as an animal model. Six weeks later, daily shock wave treatment on the right thigh was performed for six weeks after capsular contractures were formed, while the other thigh was used as a control. Then, magnetic resonance imaging (MRI) was used to compare the difference between treated and un-treated thighs. Afterwards, pathological sections were analyzed to confirm the findings. It has been demonstrated that shock wave treatments are capable of changing the structure and composition of capsular contractures. The structure of scar became myxoid changed or collagen deposition of scar decreased after shock wave treatment, hence, the formation of scars decreased. Increased myxoid and decreased collagen deposition has also been found. PMID:24109886

  14. Flooding after fire: Impacts of the 2013 Colorado Front Range floods on the High Park Fire burn scar

    NASA Astrophysics Data System (ADS)

    Kampf, S. K.; Schmeer, S.; MacDonald, L. H.; Brogan, D. J.; Nelson, P. A.

    2014-12-01

    In June 2012, the High Park Fire west of Fort Collins, CO burned 350 km2 of steep forested terrain, leading to elevated runoff and erosion in watersheds draining the burned area. Under the auspices of a NSF RAPID grant we began monitoring precipitation, hillslope-scale sediment production, stream stage, and channel geomorphic change in Skin Gulch and Hill Gulch, two 15 km2 watersheds within the High Park Fire. Short-duration summer thunderstorms are typically the dominant cause of post-fire runoff and erosion in the central and southern Rocky Mountains, but in September 2013 an extreme, long duration storm dropped more than 200 mm of rain in 48 hours. This storm provided a unique opportunity to compare the hydrologic and geomorphic effects of smaller summer thunderstorms to those of the long duration, high magnitude September event. Mean June-August 2013 precipitation in these watersheds was 125 mm, less than half the total for the September 2013 event, but this summer precipitation led to a mean sediment yield of 8 Mg ha-1, about double the mean sediment yield of the much larger September storm. Hillslope sediment production was highest during summer storms that were shorter duration but had higher 5-15 minute precipitation intensities than the September storm. These localized summer 2013 storms led to flashy pulses of flow in the channel network that caused relatively small amounts of channel aggradation or incision. In contrast, the September 2013 event produced sustained high flows that led to substantial geomorphic change throughout the channel network, with more than 2 m of aggradation at the outlet of Skin Gulch. These results indicate that the high intensity summer thunderstorms were most effective at mobilizing sediment from hillslopes, but the more spatially uniform rainfall during the September event produced much more dramatic downstream channel geomorphic change.

  15. [Scarring alopecias].

    PubMed

    Zinkernagel, M; Trüeb, R M

    2002-05-01

    The irreversibility and the possible important cosmetic consequences of scarring alopecia demand special diagnostic attention in order to promptly attain a precise diagnosis and specific treatment. Scarring alopecias are either due to permanent damage to essential parts of the hair follicle or destruction of the entire hair follicle. They are classified into the categories of primary scarring alopecias, where the hair follicle is the primary target of destruction, and secondary scarring alopecias, where the follicular damage results incidentally from events around impinging on the follicular unit. The differential diagnosis of the more common primary scarring alopecias, e.g. follicular lichen planus, chronic cutaneous lupus erythematosus and folliculitis decalvans, can be difficult when based only on anamnestic and clinical findings. The scalp biopsy is essential for appropriate nosologic classification and has prognostic relevance. The primary therapeutic goal is to halt progression of the irreversible process as early as possible by means of immunomodulatory, immunosuppressive or antiinfectious agents, respectively. PMID:12090122

  16. Burns

    MedlinePLUS

    ... doing so puts you in danger as well. Chemical and Electrical Burns For chemical and electrical burns, ... putting a child in the bathtub. Cover unused electric outlets with safety caps, and replace damaged, frayed ...

  17. Burns

    MedlinePLUS

    A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight or radiation. Scalds from hot ... and gases are the most common causes of burns. Another kind is an inhalation injury, caused by ...

  18. Burns

    MedlinePLUS

    ... complete destruction of the skin to its full depth and damage to underlying tissues. How does the body react to a severe burn? The swelling and blistering characteristic of burns is caused by the loss of fluid from damaged blood vessels. In severe cases, such fluid loss can cause shock . Burns often ...

  19. Dynamics associated with total aboveground biomass, C, nutrient pools, and biomass burning of primary forest and pasture in Rondo?nia, Brazil during SCAR-B

    NASA Astrophysics Data System (ADS)

    Guild, Liane S.; Kauffman, J. Boone; Ellingson, Lisa J.; Cummings, Dian L.; Castro, Elmar A.; Babbitt, Ron E.; Ward, Darold E.

    1998-12-01

    Burning of slashed tropical forests and pastures is among the most significant global sources of atmospheric emissions, yet the composition of the fuels and fires that creates these emissions is not well characterized. As part of the Smoke, Clouds, and Radiation-Brazil (SCAR-B) experiment, we measured total aboveground biomass (TAGB) as well as carbon, nitrogen, and sulfur pools in one cattle pasture and two slashed primary forests in Rondônia, Brazil. These pools were measured before and immediately after fires. From these data, we calculated the quantities of biomass and elements lost to the atmosphere during biomass burning. Prefire biomass in the pasture was 66 Mg ha-1; fire consumed 31% of this mass. Woody debris from the forest that occupied this site 12 years previously comprised 81% of the pasture prefire TAGB. Elemental inputs into the atmosphere (site losses) from the pasture fire were 9 Mg C ha-1, 88 kg N ha-1, and 5 kg S ha-1. Combining previous studies with this one, we calculate that the mean TAGB of Amazonian pastures is 74 Mg ha-1 with a mean combustion factor of 46%. Mean nutrient losses from pasture fires in Amazonia are 14 Mg C ha-1, 199 kg N ha-1, and 16 kg S ha-1. The TAGB of the two slashed primary forests before fire was 355 and 399 Mg ha-1 and following fire was 188 and 185 Mg ha-1 (i.e., a combustion factor of 47 and 54%), respectively. Combining this study with other studies of Amazon slashed primary forests, we calculate that the mean TAGB is 349 Mg ha-1 and the mean combustion factor is 48%. Total elemental losses arising from the primary forest slash fires in this study were notably higher than losses from the pasture site: 79 and 102 Mg C ha-1; 1019 and 1196 kg N ha-1; and 87 and 96 kg S ha-1. From this study combined with previous research in Rondônia and Pará, we calculate that mean nutrient losses from primary forest slash fires are 88 Mg C ha-1, 1181 kg N ha-1, and 107 kg S ha-1. As rates of deforestation are remaining high in the Brazilian Amazon and pastures are the most frequent end product, it can be expected that these will remain the dominant sources of atmospheric emissions from Amazonia in the future.

  20. Massage in hypertrophic scars.

    PubMed

    Patiño, O; Novick, C; Merlo, A; Benaim, F

    1999-01-01

    Various attempts have been made to intervene with the formation of hypertrophic scarring (HTS) or to ameliorate it once it has developed, but none have yet proved effective. Massage therapy is routinely used by therapists for the treatment of various conditions, and there have been reports of increased scar pliability and decreased scar banding with the use of massage. This study examines the use of friction massage over a 3-month period in a group of 30 pediatric patients with HTS. The patients were randomly assigned to receive either therapeutic massage sessions of 10 minutes per day in combination with treatment with pressure garments or they were treated with pressure garments alone. A modified Vancouver Burn Scar Assessment Scale was used to measure the characteristics of the identified scars (10 cm by 10 cm) before and after the implementation of massage therapy. The study failed to demonstrate any appreciable effects of massage therapy on the vascularity, pliability, and height of the HTS studied, although there were reports of a decrease in pruritus in some patients. Further studies, with prolonged treatment intervals, are necessary to conclusively demonstrate the ineffectiveness of this therapy for HTS. PMID:10342484

  1. Acne Scars

    MedlinePLUS

    ... guides Media Media resources Media contacts Public service advertisements Stats and facts Gold Triangle Awards Stories and ... that your skin is inflamed. Inflammation reduces the effectiveness of treatment for acne scars. To obtain the ...

  2. Scar Tissue.

    PubMed

    McLean, Haydn J

    2015-12-01

    Scar tissue is associated with physical wounds and their mending, but it is also descriptive in portraying the emotional scarring that occurs following adversity, resulting in potential psychological morbidity. Provided the adversity is not severe, such challenges to adaptability may provoke Andrew Solomon's process of forging meaning and building identity. Perceiving an emotional constitution as analogous to the immune system provides a metaphor for appreciating the benefits of emotional challenges, which may provoke greater emotional resilience or posttraumatic growth. PMID:26631526

  3. Chemical burns from assault: a review of seven cases seen in a Nigerian tertiary institution

    PubMed Central

    Tahir, C.; Ibrahim, B.M.; Terna-Yawe, E.H.

    2012-01-01

    Summary Chemical burns represent a major challenge for reconstructive surgeons. They are caused by exposure to acids, alkalis or other corrosive substances which result in various degrees of injury. This report highlights the challenges faced in managing such patients in a Nigerian teaching hospital. The medical records of seven patients (four females and three males) treated for chemical burns injury from January 2001 to December 2010 were retrospectively reviewed. All patients were younger than 30, with a mean age of 23.3. Most of them (85.7%) had sustained full thickness burns ranging from 8% to 33% of their body surface area. All cases were result of assaults. The male to female ratio was 1:1.3, and the average duration of hospital stay was 7.5 months. The face was affected in all patients. Patients presented with multiple deformities, like ectropion of eyelids, keratopathies, blindness, nasal deformities, microstomia, loss or deformities of the pinna, mentosternal contractures, and severe scarring of the face. Twenty-nine surgical procedures were performed, which included nasal and lip reconstruction, ectropion release, commissuroplasty, contracture release, and wound resurfacing. Management of chemical burns, especially in a developing country lacking specialised burn centres with appropriate facilities, is challenging. Prevention through public awareness campaigns, legislation for control of corrosive substances, and severe punishment for perpetrators of assaults using these substances will go a long way in reducing the incidence of chemical burns. PMID:23467188

  4. [Burns].

    PubMed

    Arai, Takao

    2016-02-01

    Burns extending deep into the skin and those affecting a wide surface area trigger various responses in the body and pose a serious threat to life. Therefore, the degree of severity needs to be determined accurately, and appropriate transfusion and local management should be provided accordingly. Systematic and meticulous management that considers not just the risk of death but also functional prognosis is essential from the early stage of burn injuries. Such management requires comprehensive care by a medical team concerning infections, nutrition and rehabilitation. This article outlines the current status of intensive care for severe burns. PMID:26915244

  5. Burns

    MedlinePLUS

    ... of burns from most to least common are: Fire/flame Scalding from steam or hot liquids Touching ... can be the result of: House and industrial fires Car accidents Playing with matches Faulty space heaters, ...

  6. Scar Management in the Pediatric and Adolescent Populations.

    PubMed

    Krakowski, Andrew C; Totri, Christine R; Donelan, Matthias B; Shumaker, Peter R

    2016-02-01

    For most children and adolescents who have developed symptomatic scars, cosmetic concerns are only a portion of the motivation that drives them and their caregivers to obtain treatment. In addition to the potential for cosmetic disfigurement, scars may be associated with a number of physical comorbidities including hypertrichosis, dyshidrosis, tenderness/pain, pruritus, dysesthesias, and functional impairments such as contractures, all of which may be compounded by psychosocial factors. Although a plethora of options for treating scars exists, specific management guidelines for the pediatric and adolescent populations do not, and evidence must be extrapolated from adult studies. New modalities such as the scar team approach, autologous fat transfer, and ablative fractional laser resurfacing suggest a promising future for children who suffer symptomatically from their scars. In this state-of-the-art review, we summarize cutting-edge scar treatment strategies as they relate to the pediatric and adolescent populations. PMID:26743819

  7. Evaluating an outreach service for paediatric burns follow up.

    PubMed

    Cubitt, Jonathan J; Chesney, Amy; Brown, Liz; Nguyen, Dai Q

    2015-09-01

    Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged. PMID:26036205

  8. Microsurgery in the burn population – a review of the literature

    PubMed Central

    Ibrahim, A.E.; Skoracki, R.; Goverman, J.G.; Sarhane, K.A.; Parham, C.S.; Abu-Sittah, G.; kaddoura, I.; Atiyeh, B.S.

    2015-01-01

    Summary The management of patients suffering from burn injury poses unique challenges for the reconstructive surgeon, both in the acute and delayed settings. Once resuscitative measures are optimized and hemodynamic stability is achieved, early burn debridement and coverage is performed. Traditionally, this consists of excision of devitalized tissue and subsequent coverage using split thickness skin grafts. However, in certain instances, and depending on the extent and nature of the burn injury, skin grafting (or even local tissue rearrangement) may not be a reasonable option. in these cases, free tissue transfer may provide a viable reconstructive alternative. While free flap reconstruction is rare in burn surgery, particularly in the acute setting, burn injuries that expose vital structures, such as tendon, nerve, bone, or deep vessels, require robust flap coverage. in the delayed setting, unsightly scar formation and contracture often occurs secondary to skin graft coverage. These significant patient morbidities are often amenable to free tissue transfer as well. This review article discusses the indications, applications, and problems with free flap surgery for burn injuries in both the acute and delayed setting, and summarizes the available literature on microsurgical free tissue transfer for burn management. PMID:26668561

  9. Chemical Burn Injury in Kumasi: The Trend and Complications following and Their Management

    PubMed Central

    Akpaloo, Joseph; Chirurgie, Facharzt; Aboah, Ken; Klutsey, Ellen; Hoyte-Williams, Paa Ekow; Farhat, Boutros; Turkson, Edmund; Yorke, Joseph; Chirurgie, Facharzt; Ametih, Richard; Hussey, Romeo

    2015-01-01

    Background: A chemical burn refers to irritation and destruction of human tissue caused by exposure to a chemical, usually by direct contact with the chemical or its fumes. The study investigated the trend and complications following chemical burns and their management. Methods: The study involved a retrospective review of Burns Registry at the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital on patients who were admitted for burns from May 1, 2009 to April 30, 2013. Results: Chemical burns admissions accounted for 3.5% (n = 17) out of the total 487 burns cases, consisting of 12 males (70.6%) and 5 females (29.4%). Mean total burns surface area was 21.9%; mean length of stay in Burns Intensive Care Unit was 9.5 days. The etiological agents for the chemical burns included the following: hot caustic soda 1 (5.9%); acid 9 (53.9%)—the most common; hot ethanol 3 (17.6%); and other chemicals such as other bases, oxidizers, solvents, etc. accounted for 4 (23.5%) etiological agents. Outcome included 11 discharges (64.7%), 6 transferred out to other wards (35.3%), and 0 deaths (0.0%). The complications included severe scar contractures in 5 patients (29.4%), loss of vision: partial/total = 2 (11.8%), gross keloidal/hypertrophic scars = 10 (58.8%). Conclusions: Chemical burns are severe and often cause severe debilitating sequelae including partial/total loss of vision. But the current study showed that only a small population (3.5%) were affected by chemical burns and no death was recorded; society has to be continually conscious of chemicals, especially caustic agents, and hence take the necessary precautions so as to prevent these avoidable complications. PMID:26579354

  10. Burns functional disabilities among burn survivors: a study in Komfo Anokye Teaching Hospital, Ghana

    PubMed Central

    Agbenorku, Pius

    2013-01-01

    Aim: To determine the types of functional disabilities in adult and paediatric burns survivors, with specific emphasis on potential risk and socio-economic factors of burn disabilities present in Ghana. Patients and Methods: The descriptive study was carried out in Komfo Anokye Teaching Hospital, Kumasi, Ghana from May 2011 to April 2012. Burn survivors who came for follow-up visits after been discharged home and had functional disability were the participants of the study. They were physically examined and interviewed using a pre-tested questionnaire after their informed consent/or that of their parents (in the cases of paediatrics burns survivors) was sought. Results: A total of 70 participants consented for the study. Their ages ranged from 8/12 – 78 years, with a mean age of 12±1.7 years. Majority (60.0%, N=42) of the participants had third degree burns. The nature of disabilities of participants were mostly scar contractures (42.9%, N=30) of which 36.7% (N=11) had impeded arm elevation; 23.3% (N=7) could not fold the palm or move the digits. From the multiple regression analysis risk factors for burn victim to have disability were paediatric age (OR=11.1, P=0.043), third degree of burn (OR=6.2, P=0.001) and anatomical part affected (OR=18.3, P=0.031). Socio-economic factors that affected burn disability victims were nuclear family compensation (OR=4.2, P=0.021), community mockery/stigmatization (OR=0.1, P=0.052) and caretakers time and finance (OR=5.2, P=0.033). Conclusion: The commonest functional disabilities recorded were scar contractions of the axilla region which had impeded the ability of the patients to lift the arm. Risk factors for burns disability included childhood age, third degree of burn incurred and anatomical part affected. Social factors influencing the lives of burn survivors with disability were good family and negative community interactions. Significant economical factors recorded were caretakers’ time and financial constrains. PMID:23638325

  11. Facial Scar Revision: Understanding Facial Scar Treatment

    MedlinePLUS

    ... the body heals by forming scar tissue. The appearance of the scar can range from nearly invisible ... more to fully heal and achieve maximum improved appearance. Facial plastic surgery makes it possible to correct ...

  12. Monitoring the influence of compression therapy on pathophysiology and structure of a swine scar model using multispectral imaging system

    NASA Astrophysics Data System (ADS)

    Ghassemi, Pejhman; Travis, Taryn E.; Shuppa, Jeffrey W.; Moffatt, Lauren T.; Ramella-Romana, Jessica C.

    2014-03-01

    Scar contractures can lead to significant reduction in function and inhibit patients from returning to work, participating in leisure activities and even render them unable to provide care for themselves. Compression therapy has long been a standard treatment for scar prevention but due to the lack of quantifiable metrics of scar formation scant evidence exists of its efficacy. We have recently introduced a multispectral imaging system to quantify pathophysiology (hemoglobin, blood oxygenation, melanin, etc) and structural features (roughness and collagen matrix) of scar. In this study, hypertrophic scars are monitored in-vivo in a porcine model using the imaging system to investigate influence of compression therapy on its quality.

  13. Management of Radiation-induced Severe Anophthalmic Socket Contracture in Patients with Uveal Melanoma

    PubMed Central

    Nasser, Qasiem J.; Gombos, Dan S.; Williams, Michelle D.; Guadagnolo, B. Ashleigh; Morrison, William H.; Garden, Adam S.; Beadle, Beth M.; Canseco, Elvia; Esmaeli, Bita

    2012-01-01

    Purpose High-dose radiotherapy can cause contracture of the anophthalmic socket, but the incidence of this complication in patients with enucleation for uveal melanoma has not previously been reported. We reviewed the surgical management and outcomes in terms of successful prosthesis wear in patients with severe contracture of the anophthalmic socket treated with high-dose radiotherapy for high-risk uveal melanoma and estimated the relative risk of this complication. Methods The medical records of all consecutive patients enrolled in a prospective uveal-melanoma tissue-banking protocol at our institution who underwent enucleation between January 2003 and December 2010 were reviewed. Patients who underwent adjuvant radiotherapy of the enucleated socket were further studied. Results Of the 68 patients enrolled in the prospective tissue banking protocol, 12 had high-risk histologic features (e.g., extrascleral spread or vortex vein invasion) and were treated with 60 Gy of external-beam radiotherapy after enucleation. Five of these patients (41.7%) experienced severe socket contracture precluding prosthesis wear. The median time to onset of contracture following completion of radiotherapy was 20 months. Three patients underwent surgery, which entailed scar tissue release, oral mucous membrane grafting, and socket reconstruction; 2 patients declined surgery. All 3 patients who had surgery experienced significant improvement of socket contracture that enabled patients to wear a prosthesis again. Conclusion High-dose radiotherapy after enucleation in patients with uveal melanoma caused severe socket contracture and inability to wear a prosthesis in approximately 40% of patients. Surgical repair of the contracted socket using oral mucous membrane grafting can allow resumption of prosthesis wear. PMID:22581085

  14. Scars of torture: a Sri Lankan study.

    PubMed

    Perera, Priyanjith

    2007-04-01

    Interpretation of scars of torture is not an easy task as our understanding of evolution of scars of different methods of torture is still in its infancy. The objectives of this study were to produce the features of a typical scar of a few selected methods of torture and determine their characteristic distribution. To achieve this, 100 medico-legal records of victims of torture examined at the Judicial Medical Officer's Office, Colombo between 1998 and 2001 were perused. Scars caused by seven selected methods of torture were taken into consideration. They were, assault with both non-pliable and pliable blunt objects, cigarette burns, burns with heated solid objects and molten plastic, ligature application with different forms of suspension and cuts with sharp objects. Total number of scars analyzed in this study was 1846, which included 740 scars of non-pliable blunt weapons, 182 of pliable blunt weapons, 102 of ligature, 59 of molten polythene, 55 of heated objects and 82 of razor blades and knives. Typical scars of each method of torture and their characteristic distribution were determined. PMID:16919991

  15. Application of acellular dermal xenografts in full-thickness skin burns

    PubMed Central

    CHEN, XIAODONG; FENG, XIANGSHENG; XIE, JULIN; RUAN, SHUBIN; LIN, YAN; LIN, ZEPENG; SHEN, RUI; ZHANG, FENGGANG

    2013-01-01

    The aim of this study was to explore the clinical value of the porcine acellular dermal xenograft (ADX) in combination with autologous split-thickness skin and pure autologous split-thickness skin grafting applied in deep full-thickness burns and scar wounds. A total of 30 patients with deep burns were randomly divided into experimental and control groups following escharectomy. The patients were separately treated with porcine acellular dermal xenograft (ADX) in combination with autologous split-thickness skin and pure autologous split-thickness skin graft. The wound healing was observed routinely and the scores were evaluated using Vancouver scar scale at different times following transplant surgery. The samples of cograft regions and the control group (pure transplant split-thickness skin autograft) were observed using light microscopy and electron microscopy, and the follow-up results were recorded. No conspicuous rejections on the cograft wound surface were observed. Compared with the control group, the cograft wounds were smooth, presented no scar contracture and exhibited good skin elasticity and recovery of the joint function. The cografted skin combined well and displayed a clear and continuous basal membrane, as well as gradually combined skin structure, a mature stratum corneum, downward extended rete pegs, a mainly uniform dermal collagen fiber structure, regular alignment, and fewer blood capillaries. Clear desmosome cograft regions were identified among heckle cells, as well as a clear and continuous basal membrane. The cografted skin of the combined split-thickness autograft and the acellular heterologous (porcine) dermal matrix showed an improved shape and functional recovery compared with the pure split-thickness skin autograft. The combination of the meshed ADX and the split-thickness skin autograft applied in deep full-thickness burns and scar wounds may induce tissue regeneration via dermis aiming. This method also has superior shape and functional recovery, and has an extensive clinical application value. PMID:23935745

  16. Epidemiology and Outcome of Chemical Burn Patients Admitted in Burn Unit of JNMC Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India: A 5-year Experience

    PubMed Central

    Akhtar, Md Sohaib; Ahmad, Imran; Khurram, M. Fahud; Kanungo, Srikanta

    2015-01-01

    Aims and Objective: The objectives of this study were to evaluate the epidemiology, clinical variable of chemical burns, and their outcomes to prevent or reduce the frequency and morbidity of such injuries. Materials and Methods: A retrospective analysis was performed on all the patients with chemical burns admitted at author's center between November 2008 and December 2013. All the patients were evaluated in terms of age, sex, total body surface area, etiology, treatment given, morbidity, mortality, final outcome, and then educated regarding specific preventive measures. Results: A total of 96 patients (2.4% of total burn admissions) (42 males and 54 females) were admitted to our hospital with chemical burn injuries. Most of the patients were in the age group of 16–30 years. Incidence in females was slightly higher than in males. Acid was found to be the most common cause of injury. We found 55% patients admitted had <10% total body surface area (TBSA) involvement, 35% had burns involving between 11 and 20% TBSA, and 4% had burns involving 21–30% TBSA, and 6% had burns in >30% TBSA. Morbidity was noticed in the form of skin defect in 80% of cases, soft tissue defect with exposed tendon, bone, or vessels in 16% of cases, and 4% of patients developed contracture and hypertrophic scar. Eighty-six percent of patients required operative intervention. A total of three deaths (3%) were recorded. Conclusion: It was found that chemical burns, though not very common, are deeper burns and can be accidental or non-accidental, and the high-risk age group is 16–25 years. Chemical burns are largely preventable and if properly managed have a good outcome. PMID:25810999

  17. Can Acne Scars Be Removed?

    MedlinePLUS

    ... with a gradual dip or depression (sometimes called "rolling" scars) scars that are deep and narrow A ... bit sunburned for a couple of days. For "rolling" scars, doctors sometimes inject material under the scar ...

  18. Arthrogryposis Multiplex Congenita: Multiple Congenital Joint Contractures

    PubMed Central

    Sucuoglu, Hamza; Ornek, Nurettin Irem; Caglar, Cagkan

    2015-01-01

    Arthrogryposis multiplex congenita (AMC) is a syndrome characterized by nonprogressive multiple congenital joint contractures. The etiology of disease is multifactorial; it is most commonly suspected from absent fetal movements and genetic defects. AMC affects mainly limbs; also it might present with other organs involvement. It is crucial that the diagnosis of AMC should be kept in mind by musculoskeletal physicians in newborns with multiple joint contractures and patients must begin rehabilitation in early stage after accurate diagnosis in terms of functional independence. We present the diagnosis, types, clinical features, and treatment approaches of this disease in our case with literature reviews. PMID:26604929

  19. Models of Abnormal Scarring

    PubMed Central

    Seo, Bommie F.; Lee, Jun Yong; Jung, Sung-No

    2013-01-01

    Keloids and hypertrophic scars are thick, raised dermal scars, caused by derailing of the normal scarring process. Extensive research on such abnormal scarring has been done; however, these being refractory disorders specific to humans, it has been difficult to establish a universal animal model. A wide variety of animal models have been used. These include the athymic mouse, rats, rabbits, and pigs. Although these models have provided valuable insight into abnormal scarring, there is currently still no ideal model. This paper reviews the models that have been developed. PMID:24078916

  20. Pentazocine-induced contractures: Dilemma in management

    PubMed Central

    Kumar, Dileep; Gupta, Anil; Sharma, V. P.; Yadav, Ganesh; Singh, Arpita; Verma, Ajay Kumar

    2015-01-01

    Pentazocine is a commonly used synthetic opioid analgesic for moderate to severe pain secondary to various conditions. Complications of parenteral opioid abuse including localized ulcerations, abscess, indurations, and sclerosis are well-documented. We present a rare case of drug abuse due to pentazocine (Fortwin) in a 32-year-old female, who had severe myogenic contractures of her knee joints. PMID:26288482

  1. Osteogenesis imperfecta with joint contractures: bruck syndrome.

    PubMed

    Blacksin, M F; Pletcher, B A; David, M

    1998-02-01

    We describe an Egyptian boy with osteogenesis imperfecta who was born with thumb contractures and bilateral antecubital pterygia. He was seen at 16 months of age with femur and tibial fractures, thoracic vertebral compression fractures, scoliosis and Wormian bones. The findings are consistent with a diagnosis of Bruck syndrome. PMID:9472060

  2. Multidisciplinary, multimodal approach for a child with a traumatic facial scar.

    PubMed

    Admani, Shehla; Gertner, Jeffrey W; Grosman, Amanda; Shumaker, Peter R; Uebelhoer, Nathan S; Krakowski, Andrew C

    2015-03-01

    The treatment of disfiguring and disabling scars remains a field of active study, reinvigorated with recent advances in techniques and technologies. A variety of approaches can be utilized depending on scar characteristics, location, degree of tissue loss, and associated contractures. Just as traumatic scars can be complex and heterogeneous, the corresponding paradigm for treatment must also be flexible and multimodal for optimal improvement. This report describes a 3-year-old girl with a "mixed" (atrophic/hypertrophic), violaceous, contracted facial scar from a dog bite. It was treated with a novel approach utilizing a multidisciplinary pediatric scar team to combine autologous fat grafting, ablative fractional laser resurfacing, pulsed-dye laser, and laser-assisted delivery of a corticosteroid as concurrent, multimodal therapy to optimize the outcome. PMID:25922954

  3. A new flap design for release of parallel contracture bands: dual opposing five-flap z-plasty.

    PubMed

    Ersoy, Burak

    2014-12-01

    Skin contractures secondary to burn and other types of trauma can be encountered on almost every part of human body, best addressed by a custom treatment protocol tailored for each patient. Skin graft, local flap as well as distant flap options are available, each with intrinsic advantages and disadvantages. In the presence of weblike contracture the utilization of local tissue, when available, is a prefered approach for a relatively better appearance through a reasonably simpler surgical intervention, compared to skin graft applications and distant flap options. Among many other techniques and modalities utilized for this purpose, the dual opposing five-flap z-plasty method which is a novel method designed as a modification of the paired five-flap z-plasty technique promises to be a useful treatment option for the release of parallel contracture bands with satisfactory results in selected patients. PMID:24931824

  4. Laser Scar Management Technique

    PubMed Central

    Ohshiro, Toshio; Sasaki, Katsumi

    2013-01-01

    Background and Aims: Scars are common and cause functional problems and psychological morbidity. Recent advances in optical technologies have produced various laser systems capable of revising the appearance of scars from various etiologies to optimize their appearance. Methods: Laser treatment can commence as early as the time of the initial injury and as late as several years after the injury. Several optical technologies are currently available and combined laser/light treatments are required for treatment of scars. Since 2006, we have set up a scar management department in our clinic and more than 2000 patients have been treated by our combined laser irradiation techniques. Herein, we review several available light technologies for treatment of surgical, traumatic, and inflammatory scars, and discuss our combined laser treatment of scars, based upon our clinical experience. Results and Conclusions: Because scars have a variety of potential aetiologies and take a number of forms, no single approach can consistenty provide good scar treatment and management. The combination of laser and devices is essential, the choice of wavelength and approach being dictated by each patient as an individual. PMID:24511202

  5. Exploration of nonsurgical scar modification options: can the irregular surface of matured mesh graft scars be smoothed with microdermabrasion?

    PubMed

    Blome-Eberwein, Sigrid A; Roarabaugh, Chad; Gogal, Christina; Eid, Sherrine

    2012-01-01

    The purpose of this study was to determine, in principle, whether microdermabrasion can alter waffle-pattern (meshed split-thickness skin graft) burn scars after scar maturation. Matured waffle-pattern mesh-graft scars were treated with multiple microdermabrasion sessions over the course of a year (maximum 20). Before and after treatment, the treated scars and the control scar on the same patient were assessed with subjective and objective scar assessment tools (scar scales, cutometer [elasticity], laser Doppler flowmeter [vascularity], Semmes-Weinstein filaments [sensation], and high-resolution ultrasound [thickness]). The treatment resulted in continuous improvement of some physiologic skin functions like perfusion response (feedback), thickness, and elasticity when compared with nontreated scar, although no statistical significance was reached. Both Vancouver scar scale and patient assessment scales showed significant improvement. The study showed that even mature waffle pattern scars can be modified by minimally invasive interventions. Larger study groups and more economic treatment modalities need to be studied in the future. PMID:22079914

  6. Atrophic Acne Scarring

    PubMed Central

    Graber, Emmy M.

    2015-01-01

    Background: Scarring is an unfortunate and frequent complication of acne, resulting in significant psychological distress for patients. Fortunately, numerous treatment options exist for acne scarring. Objectives: To extensively review the literature on treatment options for atrophic acne scarring. Materials and methods: A comprehensive literature search was conducted on the following topics: dermabrasion, subcision, punch techniques, chemical peels, tissue augmentation, and lasers. Results: The literature supports the use of various treatment modalities; superior results may be achieved when multiple modalities are combined for a multi-step approach to scarring. Conclusion: The safety and efficacy of various treatment devices for acne scarring is well established, but there is a paucity of split-face trials comparing modalities. PMID:25610524

  7. Functional and mechanistic investigation of Shikonin in scarring.

    PubMed

    Xie, Yan; Fan, Chen; Dong, Ying; Lynam, Emily; Leavesley, David I; Li, Kun; Su, Yonghua; Yang, Yinxue; Upton, Zee

    2015-02-25

    Scarring is a significant medical burden; financially to the health care system and physically and psychologically for patients. Importantly, there have been numerous case reports describing the occurrence of cancer in burn scars. Currently available therapies are not satisfactory due to their undesirable side-effects, complex delivery routes, requirements for long-term use and/or expense. Radix Arnebiae (Zi Cao), a perennial herb, has been clinically applied to treat burns and manage scars for thousands of years in Asia. Shikonin, an active component extracted from Radix Arnebiae, has been demonstrated to induce apoptosis in cancer cells. Apoptosis is an essential process during scar tissue remodelling. It was therefore hypothesized that Shikonin may induce apoptosis in scar-associated cells. This investigation presents the first detailed in vitro study examining the functional responses of scar-associated cells to Shikonin, and investigates the mechanisms underlying these responses. The data obtained suggests that Shikonin inhibits cell viability and proliferation and reduces detectable collagen in scar-derived fibroblasts. Further investigation revealed that Shikonin induces apoptosis in scar fibroblasts by differentially regulating the expression of caspase 3, Bcl-2, phospho-Erk1/2 and phospho-p38. In addition, Shikonin down-regulates the expression of collagen I, collagen III and alpha-smooth muscle actin genes hence attenuating collagen synthesis in scar-derived fibroblasts. In summary, it is demonstrated that Shikonin induces apoptosis and decreases collagen production in scar-associated fibroblasts and may therefore hold potential as a novel scar remediation therapy. PMID:25591861

  8. Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

    PubMed Central

    Headon, Hannah; Kasem, Adbul

    2015-01-01

    Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer. PMID:26430623

  9. Capsular Contracture after Breast Augmentation: An Update for Clinical Practice.

    PubMed

    Headon, Hannah; Kasem, Adbul; Mokbel, Kefah

    2015-09-01

    Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer. PMID:26430623

  10. Leg contracture in mice: an assay of normal tissue response

    SciTech Connect

    Stone, H.B.

    1984-07-01

    Leg contracture, defined as the difference in extensibility of the control and irradiated hind legs of mice, was found to correlate with single doses of radiation from about 20 to 80 Gy. The time of development of the early phase of the response coincided with that reported for the appearance of the acute skin response, and in some cases, partially reversed as this reaction healed. The contracture then progressed again at a moderate rate through 90 days, and then more slowly through one year. Skin contraction, measured by decrease in intertattoo distance, was assayed in the same mice. It followed the same time course as leg contracture, but had a different dose-response relationship. To determine the contribution of skin contraction to the overall leg contracture response, mice were sacrificed and the leg contracture measured before and after the removal of the skin of the leg. After doses of up to 30 Gy, little contracture remained from skinning the leg, indicating that skin contraction was largely responsible for leg contracture in this dose range. After doses of about 45 Gy and above, some contracture remained in the skinned legs, although less than in intact legs. There was little or no enhancement of either skin contraction or leg contracture by the hypoxic cell sensitizers metronidazole or misonidazole.

  11. PREVENTION AND MANAGEMENT OF LIMB CONTRACTURES IN NEUROMUSCULAR DISEASES

    PubMed Central

    Skalsky, Andrew J.; McDonald, Craig M.

    2012-01-01

    Synopsis Limb contractures are a common impairment in neuromuscular diseases (NMD). They contribute to increased disability due to decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living (ADL), and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures in comparison to neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve ROM in NMD in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from the contractures. PMID:22938881

  12. Primary scarring alopecias.

    PubMed

    Rigopoulos, Dimitrios; Stamatios, Gregoriou; Ioannides, Dimitrios

    2015-01-01

    Scarring alopecia or cicatricial alopecia results from follicular damage that is sufficient to cause the destruction and replacement of pilosebaceous structures by scar tissue. Primary scarring alopecias represent a group of disorders that primarily affect the hair follicles, as opposed to secondary scarring alopecias, which affect the dermis and secondarily cause follicular destruction. Inflammation may predominantly involve lymphocytes or neutrophils. Cicatricial alopecias that mainly involve lymphocytic inflammation include discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, central centrifugal alopecia, and pseudopelade (Brocq). Cicatricial alopecias that are due to predominantly neutrophilic inflammation include folliculitis decalvans, tufted folliculitis, and dissecting cellulitis of the scalp. Folliculitis keloidalis is a cicatricial alopecia with a mixed inflammatory infiltrate. PMID:26370646

  13. Keloids and Hypertrophic Scars

    MedlinePLUS

    ... Rights Job Postings Sections of the JAOCD JAOCD Archive Published Members Online Dermatology Journals Edit This Favorite Name: Category: Share: Yes No, Keep Private Keloids And Hypertrophic Scars Share | Keloids are raised, ...

  14. A polarized multispectral imaging system for quantitative assessment of hypertrophic scars

    PubMed Central

    Ghassemi, Pejhman; Travis, Taryn E.; Moffatt, Lauren T.; Shupp, Jeffrey W.; Ramella-Roman, Jessica C.

    2014-01-01

    Hypertrophic scars (HTS) are a pathologic reaction of the skin and soft tissue to burn or other traumatic injury. Scar tissue can cause patients serious functional and cosmetic issues. Scar management strategies, specifically scar assessment techniques, are vital to improve clinical outcome. To date, no entirely objective method for scar assessment has been embraced by the medical community. In this study, we introduce for the first time, a novel polarized multispectral imaging system combining out-of-plane Stokes polarimetry and Spatial Frequency Domain Imaging (SFDI). This imaging system enables us to assess the pathophysiology (hemoglobin, blood oxygenation, water, and melanin) and structural features (cellularity and roughness) of HTS. To apply the proposed technique in an in vivo experiment, dermal wounds were created in a porcine model and allowed to form into scars. The developed scars were then measured at various time points using the imaging system. Results showed a good agreement with clinical Vancouver Scar Scale assessment and histological examinations. PMID:25360354

  15. A polarized multispectral imaging system for quantitative assessment of hypertrophic scars.

    PubMed

    Ghassemi, Pejhman; Travis, Taryn E; Moffatt, Lauren T; Shupp, Jeffrey W; Ramella-Roman, Jessica C

    2014-10-01

    Hypertrophic scars (HTS) are a pathologic reaction of the skin and soft tissue to burn or other traumatic injury. Scar tissue can cause patients serious functional and cosmetic issues. Scar management strategies, specifically scar assessment techniques, are vital to improve clinical outcome. To date, no entirely objective method for scar assessment has been embraced by the medical community. In this study, we introduce for the first time, a novel polarized multispectral imaging system combining out-of-plane Stokes polarimetry and Spatial Frequency Domain Imaging (SFDI). This imaging system enables us to assess the pathophysiology (hemoglobin, blood oxygenation, water, and melanin) and structural features (cellularity and roughness) of HTS. To apply the proposed technique in an in vivo experiment, dermal wounds were created in a porcine model and allowed to form into scars. The developed scars were then measured at various time points using the imaging system. Results showed a good agreement with clinical Vancouver Scar Scale assessment and histological examinations. PMID:25360354

  16. Posterior capsular contracture of the shoulder.

    PubMed

    Bach, H Gregory; Goldberg, Benjamin A

    2006-05-01

    Posterior capsular contracture is a common cause of shoulder pain in which the patient presents with restricted internal rotation and reproduction of pain. Increased anterosuperior translation of the humeral head occurs with forward flexion and can mimic the pain reported with impingement syndrome; however, the patient with impingement syndrome presents with normal range of motion. Initial management of posterior capsular contracture should be nonsurgical, emphasizing range-of-motion stretching with the goal of restoring normal motion. For patients who fail nonsurgical management, arthroscopic posterior capsule release can result in improved motion and pain relief. In the throwing athlete, repetitive forces on the posteroinferior capsule may cause posteroinferior capsular hypertrophy and limited internal rotation. This may be the initial pathologic event in the so-called dead arm syndrome, leading to a superior labrum anteroposterior lesion and, possibly, rotator cuff tear. Management involves regaining internal rotation such that the loss of internal rotation is not greater than the increase in external rotation. In the athlete who fails nonsurgical management, a selective posteroinferior capsulotomy can improve motion, reduce pain, and prevent further shoulder injury. PMID:16675620

  17. Nonsurgical scar management of the face: does early versus late intervention affect outcome?

    PubMed

    Parry, Ingrid; Sen, Soman; Palmieri, Tina; Greenhalgh, David

    2013-01-01

    Special emphasis is placed on the clinical management of facial scarring because of the profound physical and psychological impact of facial burns. Noninvasive methods of facial scar management include pressure therapy, silicone, massage, and facial exercises. Early implementation of these scar management techniques after a burn injury is typically accepted as standard burn rehabilitation practice, however, little data exist to support this practice. This study evaluated the timing of common noninvasive scar management interventions after facial skin grafting in children and the impact on outcome, as measured by scar assessment and need for facial reconstructive surgery. A retrospective review of 138 patients who underwent excision and grafting of the face and subsequent noninvasive scar management during a 10-year time frame was conducted. Regression analyses were used to show that earlier application of silicone was significantly related to lower Modified Vancouver Scar Scale scores, specifically in the subscales of vascularity and pigmentation. Early use of pressure therapy and implementation of facial exercises were also related to lower Modified Vancouver Scar Scale vascularity scores. No relationship was found between timing of the interventions and facial reconstructive outcome. Early use of silicone, pressure therapy, and exercise may improve scar outcome and accelerate time to scar maturity. PMID:23816994

  18. [Use of the Volkov-Oganesjan distraction-reposition apparatus in treatment of flexion contractures of the interphalangeal joints].

    PubMed

    Richtr, M; Rysavý, M

    1991-03-01

    In the submitted paper the authors present their experience with the treatment of flexion contractures by a Volkov-Oganesjan distraction reposition apparatus. The principle of treatment is continuous distension of shortened ligaments. The Volkov-Oganesjan apparatus makes systematic rehabilitation of the joint possible during gradual reposition of the contracture and at the same time prevents damage of the articular cartilage. The group comprised six patients who were treated and followed up. In four a post-traumatic condition was involved, once burns caused by electric current, and in one patient reoperation of a flexion contracture was involved. The mean grade of fixation of the PP joint before operation was 70 degrees. On average correction to 22 degrees was achieved. The mean period of treatment with the apparatus was 21 days. The therapeutic results was evaluated at least three months after removal of the apparatus. In all patients it proved possible to influence the flexion contracture by the method of an external fixation device. No complications of treatment were observed. The method and effect of therapy are consistent with the conclusions of work in vitro concerned with the role of traction in the shaping of ligaments. PMID:1872116

  19. Can Acne Scars Be Removed?

    MedlinePLUS

    ... Can I Help a Friend Who Cuts? Can Acne Scars Be Removed? KidsHealth > For Teens > Can Acne ... eliminarse las marcas de acne? Different Types of Acne Scars from acne can seem like double punishment — ...

  20. Surgical Scar Revision: An Overview

    PubMed Central

    Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

    2014-01-01

    Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods. PMID:24761092

  1. [Cesarean scar pregnancy].

    PubMed

    Matyszkiewicz, Anna; Jach, Robert; Nocu?, Agnieszka; Posadzka, Ewa; Huras, Hubert; Pity?ski, Kazimierz; Wolski, Hubert; Basta, Pawe?

    2015-10-01

    Pregnancy in the uterine scare after previous caesarean section is the rarest type of ectopic pregnancy Due to the possibility of life-threatening complications, cesarean scar pregnancy (CSP) needs rapid and proper diagnosis and management. Hereby we present 3 cases of women with CSP, diagnosed and treated at the Department of Gynecology and Obstetrics of Jagiellonian University Medical College, in Krakow, in 2013, as well as literature review. PMID:26677591

  2. Update on hypertrophic scar treatment

    PubMed Central

    Rabello, Felipe Bettini; Souza, Cleyton Dias; Júnior, Jayme Adriano Farina

    2014-01-01

    Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. PMID:25141117

  3. Basic fibroblast growth factor in Dupuytren's contracture.

    PubMed Central

    Gonzalez, A. M.; Buscaglia, M.; Fox, R.; Isacchi, A.; Sarmientos, P.; Farris, J.; Ong, M.; Martineau, D.; Lappi, D. A.; Baird, A.

    1992-01-01

    Lesions excised from nine patients undergoing surgery for Dupuytren's contracture (DC) and three normal fascia were examined for the presence of the angiogenic protein basic fibroblast growth factor (basic FGF). Endothelial cell proliferation assays established basic FGF-like activity in extracts of DC. Western blotting confirmed the presence of an 18,000-dalton protein which was localized in the lesions by immunohistochemical staining. All of the cells implicated in the progression of the disease (endothelial cells, fibroblasts, and myofibroblasts) contain the growth factor. Endothelial cells within the narrowed or occluded vessels, as well as fibroblasts surrounding these vessels, stained intensely positive. In situ hybridization using an antisense probe for human basic FGF and its receptor's (FGFR-1) mRNA established the major difference between normal and DC tissues: their levels are significantly higher than in the normal tissues. Thus the cells in DC also express both basic FGF and FGFR-1, suggesting a potential autocrine/paracrine role for basic FGF in the pathogenesis of DC. This finding is thus the first description of a nontumoral proliferative disease that can be directly associated with increased basic FGF mRNA. The possibility that therapies can be developed on the basis that basic FGF and its receptor are expressed in DC is discussed. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:1325742

  4. SCAR-B MAS

    Atmospheric Science Data Center

    2013-01-10

    ... properties. Study the impact of biomass burning and urban/industrial aerosol on the atmosphere and climate by measuring the properties of urban and industrial pollution dominated by sulfate particles. ...

  5. Purinergic signaling in scarring.

    PubMed

    Ferrari, Davide; Gambari, Roberto; Idzko, Marco; Müller, Tobias; Albanesi, Cristina; Pastore, Saveria; La Manna, Gaetano; Robson, Simon C; Cronstein, Bruce

    2016-01-01

    Adenosine (ADO) and nucleotides such as ATP, ADP, and uridine 5'-triphosphate (UTP), among others, may serve as extracellular signaling molecules. These mediators activate specific cell-surface receptors-namely, purinergic 1 and 2 (P1 and P2)-to modulate crucial pathophysiological responses. Regulation of this process is maintained by nucleoside and nucleotide transporters, as well as the ectonucleotidases ectonucleoside triphosphate diphosphohydrolase [ENTPD; cluster of differentiation (CD)39] and ecto-5'-nucleotidase (5'-NT; CD73), among others. Cells involved in tissue repair, healing, and scarring respond to both ADO and ATP. Our recent investigations have shown that modulation of purinergic signaling regulates matrix deposition during tissue repair and fibrosis in several organs. Cells release adenine nucleotides into the extracellular space, where these mediators are converted by CD39 and CD73 into ADO, which is anti-inflammatory in the short term but may also promote dermal, heart, liver, and lung fibrosis with repetitive signaling under defined circumstances. Extracellular ATP stimulates cardiac fibroblast proliferation, lung inflammation, and fibrosis. P2Y2 (UTP/ATP) and P2Y6 [ADP/UTP/uridine 5'-diphosphate (UDP)] have been shown to have profibrotic effects, as well. Modulation of purinergic signaling represents a novel approach to preventing or diminishing fibrosis. We provide an overview of the current understanding of purinergic signaling in scarring and discuss its potential to prevent or decrease fibrosis.-Ferrari, D., Gambari, R., Idzko, M., Müller, T., Albanesi, C., Pastore, S., La Manna, G., Robson, S. C., Cronstein, B. Purinergic signaling in scarring. PMID:26333425

  6. Cutaneous Scar Prevention and Management

    PubMed Central

    Al-Shaqsi, Sultan; Al-Bulushi, Taimoor

    2016-01-01

    Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management. PMID:26909210

  7. Dune Avalanche Scars

    NASA Technical Reports Server (NTRS)

    2004-01-01

    05 August 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows large, low albedo (dark) sand dunes in Kaiser Crater near 47.2oS, 340.4oW. The dunes are--ever so slowly--moving east to west (right to left) as sand avalanches down the steeper, slip face slopes of each. Avalanching sand in the Kaiser dune field has left deep scars on these slopes, suggesting that the sand is not loose but is instead weakly cemented. The image covers an area approximately 3 km (1.9 mi) wide and is illuminated by sunlight from the upper left.

  8. Involvement of impaired desmosome-related proteins in hypertrophic scar intraepidermal blister formation.

    PubMed

    Tan, Jianglin; He, Weifeng; Luo, Gaoxing; Wu, Jun

    2015-11-01

    Hypertrophic scar is one of the unique fibrotic diseases in human. Intraepidermal blister is a common clinical symptom following the hypertrophic scar formation. However, little is known about the reason of blister creation. In this study, we selected three patients with hypertrophic scar as manifested by raised, erythematous, pruritic, blister and thickened appearance undergoing scar resection. The first scar sample was 6 months after burn from the neck of a 3 years old male patient with 10 score by Vancouver Scar Scale (VSS). The second scar sample was 12 months after burn from the dorsal foot of a 16 years old female patient with 13 score by VSS. The third one was 9 months after burn from the elbow of a 34 years old male patients with 13 score by VSS. In order to understand the molecular mechanism of blister formation, we screened the different protein expression between hypertrophic scar and normal skin tissue by means of isobaric tags for relative and absolute quantitation (iTRAQ) labeling technology and high throughput 2D LC-MS/MS. There were 48 proteins found to be downregulated in hypertrophic scar. Among the downregulated ones, plakophilin1 (PKP1), plakophilin3 (PKP3) and desmoplakin (DSP) were the desmosome-related proteins which were validated by immunohistochemistry and western blotting assay. Transmission electron microscopy further showed the considerably reduced size and intensity of hemidesmosome and desmosome in hypertrophic scar tissue, compared to control normal skin. Our data indicted for the first time that downregulation of DSP, PKP1 and PKP3 in hypertrophic scar might be responsible for intraepidermal blister formation. PMID:25922301

  9. Extracorporeal Shock Wave Therapy: An Emerging Treatment Modality for Retracting Scars of the Hands.

    PubMed

    Saggini, Raoul; Saggini, Andrea; Spagnoli, Anna Maria; Dodaj, Ira; Cigna, Emanuele; Maruccia, Michele; Soda, Giuseppe; Bellomo, Rosa Grazia; Scuderi, Nicolò

    2016-01-01

    Prolonged and abnormal scarring after trauma, burns and surgical procedures often results in a pathologic scar. We evaluated the efficacy of unfocused shock wave treatment, alone or in combination with manual therapy, on retracting scars on the hands. Scar appearance was assessed by means of the modified Vancouver Scar Scale; functional hand mobility was evaluated using a range-of-motion scale, whereas a visual analogue score was implemented for detecting any improvements in referred pain. Additionally, biopsy specimens were collected for clinico-pathologic correlation. For each active treatment group, statistically significant improvements in modified Vancouver Scar Scale were recorded as early as five treatment sessions and confirmed 2 wk after the last treatment session. Analogous results were observed when assessing pain and range of movement. Histopathological examination revealed significant increases in dermal fibroblasts in each active treatment group, as well as in neoangiogenetic response and type-I collagen concentration. PMID:26454624

  10. Value of 17?-oestradiol in prevention of contracture formation *

    PubMed Central

    Akeson, Wayne H.; Woo, Savio L-Y.; Amiel, David; Doty, David H.; Rutherford, Ladd

    1976-01-01

    Akeson, W. H., Woo, S. L-Y., Amiel, D., Doty, D. H., and Rutherford, L. (1976).Annals of the Rheumatic Diseases, 35, 429-436. Value of 17?-oestradiol in prevention of contracture formation. Male and female rabbits were treated with 17?-oestradiol during the 9-week development of a contracture in the left hind limb. The right hind limb served as the paired control. Untreated (absolute control) animals received saline injections. After 9 weeks biochemical analyses of water, hexosamine, soluble and total collagen, as well as biomechanical measurements of joint stiffness, were performed on the dissected knees. In all cases 17?-oestradiol reduced the measured stiffness in the contractures by approximately 50% as compared to the contractures of the untreated animals. 17?-oestradiol, in addition, partially prevented the loss of water and hexosamine which occurs in untreated contractures. 17?-oestradiol administration also decreased the content of soluble collagen fractions in the periarticular connective tissue of both the control and experimental knees. The relationship of these biochemical findings to their mechanical consequences is discussed, and the results are related to a working hypothesis of stress- and motion-dependent homoeostasis within periarticular connective tissue. PMID:1234409

  11. Treatment of hypertrophic scars using a long-pulsed dye laser with cryogen-spray cooling.

    PubMed

    Kono, Taro; Erçöçen, Ali Rza; Nakazawa, Hiroaki; Nozaki, Motohiro

    2005-05-01

    Hypertrophic scars are common and cause functional and psychologic morbidity. The conventional pulsed dye laser (585 nm) has been shown previously to be effective in the treatment of a variety of traumatic and surgical scars, with improvement in scar texture, color, and pliability, with minimal side effects. This prospective study was performed to determine the effectiveness of the long-pulsed dye laser (595 nm) with cryogen-spray cooling device in the treatment of hypertrophic scars. Fifteen Asian patients with 22 hypertrophic scars were treated by the long-pulsed dye laser (595 nm) with cryogen-spray cooling device. In 5 patients, the scar area was divided into halves, one half of which was treated with the laser, whereas the other half was not treated and was used as a negative control. All patients received 2 treatments at 4-week intervals, and evaluations were done by photographic and clinical assessment and histologic evaluation before the treatment and 1 month after the last laser treatment. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. Symptoms such as pain, pruritus, and burning of the scar improved significantly. VGH scores improved in all treated sites, and there was a significant difference between the baseline and posttreatment scores, corresponding to an improvement of 51.4 +/- 14.7% (P < 0.01). Compared with the baseline, the mean percentage of scar flattening and erythema elimination was 40.7 +/- 20.7 and 65.3 +/- 25.5%, respectively (P < 0.01). The long-pulsed dye laser (595-nm) equipped with cryogen spray cooling device is an effective treatment of hypertrophic scars and can improve scar pliability and texture and decrease scar erythema and associated symptoms. PMID:15838209

  12. MiR-138/peroxisome proliferator-activated receptor ? signaling regulates human hypertrophic scar fibroblast proliferation and movement in vitro.

    PubMed

    Xiao, Ying-ying; Fan, Peng-ju; Lei, Shao-rong; Qi, Min; Yang, Xing-hua

    2015-05-01

    Excessive scars affect a patient's quality of life, both physically and psychologically, by causing pruritus, pain and contractures. Because there is a poor understanding of the complex mechanisms underlying the processes of hypertrophic scar formation, most therapeutic approaches remain clinically unsatisfactory. In this study, we found that miR-138 was downregulated and peroxisome proliferator-activated receptor (PPAR?) was inversely upregulated in hypertrophic scar tissues compared to in paired normal skin tissues. Using a dual-luciferase assay, we validated that miR138 directly targets PPAR? and regulates its expression at the transcriptional and translational levels. In gain-and-loss experiments, we found that miR-138/PPAR? signaling regulated human hypertrophic scar fibroblast proliferation and movement, and affected scarring-related protein expression, which suggests that miR-138/PPAR? signaling is important for hypertrophic scarring. Thus, our study provides evidence to help determine whether miR-138/PPAR? signaling may be a potential target for hypertrophic scarring management. PMID:25752881

  13. Pulmonary Nontuberculous Mycobacterial Infection in Congenital Contractural Arachnodactyly

    PubMed Central

    Paulson, Michelle L.; Olivier, Kenneth N.; Holland, Steven M.

    2013-01-01

    SUMMARY Congenital contractural arachnodactyly (CCA) is caused by mutations within fibrillin-2 (FBN2), which is crucial for microfibril structure. Affected individuals may have contractures, chest wall deformities, scoliosis, abnormal ear folding and elongated limbs. We describe a novel FBN2 mutation in a woman with CCA who also has pulmonary nontuberculous mycobacterial infection. The population with pulmonary nontuberculous mycobacterial infections shares phenotypic features with CCA, such as elongated body habitus, scoliosis and pectus deformities. While it is unlikely that FBN2 defects account for susceptibility to nontuberculous mycobacterial infection in the majority of cases, the overlap between these two diseases suggests some shared pathophysiology. PMID:22325249

  14. Assessment of burn depth and burn wound healing potential.

    PubMed

    Monstrey, Stan; Hoeksema, Henk; Verbelen, Jos; Pirayesh, Ali; Blondeel, Phillip

    2008-09-01

    The depth of a burn wound and/or its healing potential are the most important determinants of the therapeutic management and of the residual morbidity or scarring. Traditionally, burn surgeons divide burns into superficial which heal by rapid re-epithelialization with minimal scarring and deep burns requiring surgical therapy. Clinical assessment remains the most frequent technique to measure the depth of a burn wound although this has been shown to be accurate in only 60-75% of the cases, even when carried out by an experienced burn surgeon. In this article we review all current modalities useful to provide an objective assessment of the burn wound depth, from simple clinical evaluation to biopsy and histology and to various perfusion measurement techniques such as thermography, vital dyes, video angiography, video microscopy, and laser Doppler techniques. The different needs according to the different diagnostic situations are considered. It is concluded that for the initial emergency assessment, the use of telemetry and simple burn photographs are the best option, that for research purposes a wide range of different techniques can be used but that, most importantly, for the actual treatment decisions, laser Doppler imaging is the only technique that has been shown to accurately predict wound outcome with a large weight of evidence. Moreover this technique has been approved for burn depth assessment by regulatory bodies including the FDA. PMID:18511202

  15. Mapping Fire Scars in the Brazilian Cerrado Using AVHRR Imagery

    NASA Technical Reports Server (NTRS)

    Hlavka, C. A.; Ambrosia, V. G.; Brass, J. A.; Rezendez, A.; Alexander, S.; Guild, L. S.; Peterson, David L. (Technical Monitor)

    1995-01-01

    The Brazilian cerrado, or savanna, spans an area of 1,800,000 square kilometers on the great plateau of Central Brazil. Large fires covering hundreds of square kilometers, frequently occur in wildland areas of the cerrado, dominated by grasslands or grasslands mixed with shrubs and small trees, and also within area in the cerrado used for agricultural purposes, particularly for grazing. Smaller fires, typically extending over arm of a few square kilometers or less, are associated with the clewing of crops, such as dry land rice. A method for mapping fire scars and differentiating them from extensive areas of bare sod with AVHRR bands 1 (.55 -.68 micrometer) and 3 (3.5 - 3.9 micrometers) and measures of performance based on comparison with maps of fires with Landsat imagery will be presented. Methods of estimating total area burned from the AVHRR fire scar map will be discussed and related to land use and scar size.

  16. The treatment of flexion contracture of the knee in myelomeningocele.

    PubMed

    Abraham, E; Verinder, D G; Sharrard, W J

    1977-11-01

    A follow-up study, on average four years after operation, of seventy-six cildren with myelomeningocele who had surgical treatment for flexion contracture of the knee, is reported. After a single operation sixty-eight knees (55 per cent) had a contracture of less than 20 degrees, which was the main criterion of success. About half of the cases of transplantation of the hamstrings to the femur, division or elongation of the hamstrings, or supracondylar osteotomy had successful results. Transfer of the hamstring tendons to the patella was successful in nine of twelve instances, so giving the lowest rate of failure. Forty-five patients were active walkers at follow-up as compared to eighteen before operation. However, only one of the eleven patients over twelve years of age with a motor level above T.12 was an active walker at review. Several conclusions are drawn. A flexion contracture of the hip greater than 30 degress should be corrected before operation of the knee. Supracondylar osteotomy as a primary procedure should only be used to correct flexion contracture of the knee secondary to malunited fractures. Faradic stimulation is useful in the evaluation of muslce function before operation. An intelligence quotient below 65 and weakness of the arms are relative contraindications for correction of the deformity of the knee. PMID:925053

  17. Keloid scarring: bench and bedside.

    PubMed

    Seifert, Oliver; Mrowietz, Ulrich

    2009-04-01

    Wound healing is a fundamental complex-tissue reaction leading to skin reconstitution and thereby ensuring survival. While, fetal wounds heal without scarring, a normal "fine line" scar is the clinical outcome of an undisturbed wound healing in adults. Alterations in the orchestrated wound healing process result in hypertrophic or keloid scarring. Research in the past decades attempted to identify genetic, cellular, and molecular factors responsible for these alterations. These attempts lead to several new developments in treatments for keloids, such as, imiquimod, inhibition of transforming growth factor beta, and recombinant interleukin-10. The urgent need for better therapeutics is underlined by recent data substantiating an impaired quality of life in keloid and hypertrophic scar patients. Despite the increasing knowledge about the molecular regulation of scar formation no unifying theory explaining keloid development has been put forward until today. This review aims to give an overview about the genetic and molecular background of keloids and focus of the current research on keloid scarring with special emphasis on new forthcoming treatments. Clinical aspects and the spectrum of scarring are summarized. PMID:19360429

  18. Dupuytren's contracture and occupational exposure to hand-transmitted vibration

    PubMed Central

    Palmer, Keith T; D'Angelo, Stefania; Syddall, Holly; Griffin, Michael J; Cooper, Cyrus; Coggon, David

    2014-01-01

    Aims The relation between Dupuytren's contracture and occupational exposure to hand-transmitted vibration (HTV) has frequently been debated. We explored associations in a representative national sample of workers with well-characterised exposure to HTV. Methods We mailed a questionnaire to 21?201 subjects aged 16–64?years, selected at random from the age-sex registers of 34 general practices in Great Britain and to 993 subjects chosen randomly from military pay records, asking about occupational exposure to 39 sources of HTV and about fixed flexion contracture of the little or ring finger. Analysis was restricted to men at work in the previous week. Estimates were made of average daily vibration dose (A(8) root mean squared velocity (rms)) over that week. Associations with Dupuytren's contracture were estimated by Poisson regression, for lifetime exposure to HTV and for exposures in the past week >A(8) of 2.8?ms?2 rms. Estimates of relative risk (prevalence ratio (PR)) were adjusted for age, smoking status, social class and certain manual activities at work. Results In all 4969 eligible male respondents supplied full information on the study variables. These included 72 men with Dupuytren's contracture, 2287 with occupational exposure to HTV and 409 with A(8)>2.8?ms?2 in the past week. PRs for occupational exposure to HTV were elevated 1.5-fold. For men with an A(8)>2.8?ms?2 in the past week, the adjusted PR was 2.85 (95% CI 1.37 to 5.97). Conclusions Our findings suggest that risk of Dupuytren's contracture is more than doubled in men with high levels of weekly exposure to HTV. PMID:24449599

  19. Internet-based survey on current practice for evaluation, prevention, and treatment of scars, hypertrophic scars, and keloids.

    PubMed

    Lumenta, David B; Siepmann, Eva; Kamolz, Lars-Peter

    2014-01-01

    No universally accepted standard for evaluation, prevention, and treatment of scars, hypertrophic scars, and keloids exists. Following development of a questionnaire, we performed a closed Web-based survey among burn centers. Server-based data collection was performed over 4 weeks and closed thereafter. The poll revealed emerging new treatment schemes, but the majority of participants adhered to evaluation (Patient and Observer Scar Assessment Scale, Matching Assessment of Scars and Photographs, Vancouver Scar Scale, two-dimensional photography) and prevention (silicone gel sheets and compression garments) strategies that were in line with the currently available recommendations from the literature. We noted a low penetration for the use of objective evaluation tools in our poll and detected differences in surgical approaches to keloids. Based on the results of our survey and the power of currently available clinical recommendations, we expect future guidelines to gain more evidence-based power, especially when more high-quality clinical trials with objective evaluation support, clearly defined disease entities, and therapeutic outcome factors have become available. PMID:25041618

  20. Updated scar management practical guidelines: non-invasive and invasive measures.

    PubMed

    Monstrey, Stan; Middelkoop, Esther; Vranckx, Jan Jeroen; Bassetto, Franco; Ziegler, Ulrich E; Meaume, Sylvie; Téot, Luc

    2014-08-01

    Hypertrophic scars and keloids can be aesthetically displeasing and lead to severe psychosocial impairment. Many invasive and non-invasive options are available for the plastic (and any other) surgeon both to prevent and to treat abnormal scar formation. Recently, an updated set of practical evidence-based guidelines for the management of hypertrophic scars and keloids was developed by an international group of 24 experts from a wide range of specialities. An initial set of strategies to minimize the risk of scar formation is applicable to all types of scars and is indicated before, during and immediately after surgery. In addition to optimal surgical management, this includes measures to reduce skin tension, and to provide taping, hydration and ultraviolet (UV) protection of the early scar tissue. Silicone sheeting or gel is universally considered as the first-line prophylactic and treatment option for hypertrophic scars and keloids. The efficacy and safety of this gold-standard, non-invasive therapy has been demonstrated in many clinical studies. Other (more specialized) scar treatment options are available for high-risk patients and/or scars. Pressure garments may be indicated for more widespread scarring, especially after burns. At a later stage, more invasive or surgical procedures may be necessary for the correction of permanent unaesthetic scars and can be combined with adjuvant measures to achieve optimal outcomes. The choice of scar management measures for a particular patient should be based on the newly updated evidence-based recommendations taking individual patient and wound characteristics into consideration. PMID:24888226

  1. Fillers for the improvement in acne scars

    PubMed Central

    Wollina, Uwe; Goldman, Alberto

    2015-01-01

    Acne is a common inflammatory disease. Scarring is an unwanted end point of acne. Both atrophic and hypertrophic scar types occur. Soft-tissue augmentation aims to improve atrophic scars. In this review, we will focus on the use of dermal fillers for acne scar improvement. Therefore, various filler types are characterized, and available data on their use in acne scar improvement are analyzed. PMID:26491364

  2. Burn Institute

    MedlinePLUS

    ... Now Help keep local seniors safe from fire! Burn Survivor Support If you are reading this, chances ... year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute provides fire ...

  3. Scar remodeling after strabismus surgery.

    PubMed Central

    Ludwig, I H

    1999-01-01

    PURPOSE: Patients with overcorrected strabismus (and several patients with undercorrection after extraocular muscle resection) underwent exploration of previously operated muscles, with the intention of advancing their tendons to prevent the need for surgery on additional muscles. Unexpectedly, it was found that, in many cases, an elongated scar segment of variable length was interposed between the muscle and its insertion site on the sclera. Laboratory investigations were carried out to elucidate the underlying mechanism(s) and to create an animal model of the disorder. METHODS: Lengthened scars were repaired on 198 muscles during 134 procedures performed on 123 patients. The scars consisted of amorphous connective tissue interposed between the globe and normal tendon. Repair was accomplished by excision of the scar and reattachment of the muscle to sclera, using absorbable sutures in 64 cases and nonabsorbable sutures in 70 cases. Histopathologic examination was performed on 82 clinical specimens, and tissue culture studies were performed on 7 specimens. To develop an animal model, 10 New Zealand white rabbits underwent bilateral superior rectus resection. Half of the eyes received sub-Tenon's injections of collagenase over the operative site during weeks 2, 3, 5, and 6 postoperatively; the other half received saline solution injections on the same schedule. At 10 weeks, half the sites were studied histologically, and the other half underwent collagen creep analysis. In a second study, the use of absorbable versus nonabsorbable sutures was compared in the rabbit model. RESULTS: In the clinical cases, the mean length of the elongated scar segments was 4.2 mm. A total of 105 of the 134 repair procedures were judged successful. Thirty-one procedures resulted in recurrence of the original overcorrection; 7 of these had documented restretches. Factors that distinguished patients with stretched scars from patients with classic slipped muscles included minimal or no limitation of versions, less separation of the tendons from sclera, and thicker appearance of the scar segments. The use of nonabsorbable sutures in the repair procedure reduced the recurrence rate. Histologic examination of the clinical stretched scar specimens showed dense connective tissue that was less well organized compared with normal tendon. In the tissue culture studies, cells cultured from the stretched scar specimens grew rapidly and were irregularly shaped. A high-molecular-weight protein was identified in the culture medium. By contrast, cells cultured from normal tendon (controls) grew more slowly and regularly, stopped growing at 4 days, and produced less total protein than cultured stretched scar specimens. In the animal model studies, the collagenase-treated sites showed elongated scars with increased collagen between the muscle and the sclera, as well as increased collagen creep rates, compared with the saline-treated controls. The use of nonabsorbable sutures in collagenase-treated animal model surgery sites was associated with shorter, thicker scars compared with similar sites sutured with absorbable sutures. CONCLUSIONS: A lengthened or stretched, remodeled scar between an operated muscle tendon and sclera is a common occurrence and is a factor contributing to the variability of outcome after strabismus repair, even years later. This abnormality may be revealed by careful exploration of previously operated muscles. Definitive repair requires firm reattachment of tendon to sclera with nonabsorbable suture support. Images FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18 FIGURE 19 FIGURE 20 FIGURE 21 FIGURE 22 FIGURE 23 FIGURE 24 FIGURE 25 FIGURE 26 FIGURE 27 FIGURE 28 FIGURE 29 FIGURE 30 FIGURE 31 FIGURE 32 FIGURE 33 FIGURE 34 FIGURE 35 FIGURE 36 FIGURE 37 FIGURE 38 FIGURE 39 FIGURE 40 FIGURE 41 FIGURE 42 FIGURE 43 FIGURE 44 FIGURE 45 FIGURE 46 FIGURE 52 FIGURE 53 FIGURE 54 FIGURE 55 FIGURE 58 FIGURE 59 FIGURE 60 FIGURE 61 FIGURE 62 FIGURE 63 FIGURE 64 PMID:10703142

  4. Dermatan sulfate remodeling associated with advanced Dupuytren's contracture.

    PubMed

    Ko?ma, Ewa M; G?owacki, Andrzej; Olczyk, Krystyna; Ciecierska, Magdalena

    2007-01-01

    Dermatan sulfate (DS) widespread as a component of extracellular matrix proteoglycans, is characterized by great bio-reactivity and remarkable structural heterogeneity due to distinct degrees of sulfation and glucuronosyl epimerization and different polymerization degrees. However, DS metabolism under various biological conditions is poorly known. Dupuytren's contracture is a benign fibromatosis leading to complex remodeling of the palmar fascia structure and properties. However, it remains unclear whether the disease affects the structure of DS, which is the major tissue glycosaminoglycan. Thus the aim of the study was to examine the structure of the total DS in Dupuytren's fascia. DS chains were extracted from 5 samples of normal fascia and 7 specimens of Dupuytren's tissue by papain digestion followed by fractionation with cetylpyridinium chloride. Then, DS structure analysis was performed comprising the evaluation of its molecular masses and sensitivity to hyaluronidase and chondroitinase B. Dupuytren's contracture is associated with significant remodeling of DS chain structure revealed by (1) a distinct profile of chain molecular masses characterized by the appearance of long size components as well as the increase in the content of small size chains; (2) a different glucuronosyl epimerization pattern connected with the enhanced content of glucuronate disaccharide blocks; (3) chain oversulfation. These structural alterations in total DS may modify the GAG interactions especially affecting collagen fibrillogenesis and growth factor availability. Thus, Dupuytren's contracture associated DS remodeling may promote the phenomena typical for advanced disease: apoptosis and reduction in cell number as well as the appearance of dense pseudotendinous collagen matrix. PMID:18066404

  5. Generation and characterization of a novel shoulder contracture mouse model.

    PubMed

    Oki, Satoshi; Shirasawa, Hideyuki; Yoda, Masaki; Matsumura, Noboru; Tohmonda, Takahide; Yuasa, Kazuki; Nakamura, Masaya; Matsumoto, Morio; Horiuchi, Keisuke

    2015-11-01

    Frozen shoulder is a relatively common disorder that leads to severe pain and stiffness in the shoulder joint. Although this disorder is self-limiting in nature, the symptoms often persist for years, resulting in severe disability. Recent studies using human specimens and animal models have shown distinct changes in the gene expression patterns in frozen shoulder tissue, indicating that novel therapeutic intervention could be achieved by controlling the genes that are potentially involved in the development of frozen shoulder. To achieve this goal, it is imperative to develop a reliable animal joint contracture model in which gene expression can be manipulated by gene targeting and transgenic technologies. Here, we describe a novel shoulder contracture mouse model. We found that this model mimics the clinical presentation of human frozen shoulder and recapitulates the changes in the gene expression pattern and the histology of frozen shoulder and joint contracture in humans and other larger animal models. The model is highly reproducible, without any major complications. Therefore, the present model may serve as a useful tool for investigating frozen shoulder etiology and for identifying its potential target genes. PMID:26014262

  6. [Functional reconstruction of multiple severe deformities after extensive deep burn].

    PubMed

    Chen, Bi; Jia, Chi-yu; Hu, Da-hai; Zhu, Xiong-xiang; Han, Jun-tao; Yao, Qing-jun; Xu, Ming-da

    2008-10-01

    To explore new measures for functional reconstruction of multiple severe deformities as a result of extensive deep burn (total burn surface area > or = 90% TBSA, including deep burn > or = 70%TBSA) in late stage. Twelve severe burn patients with above-mentioned deformities were hospitalized in our ward during 1960--2005, the scars resulted from burns were distributed from head to foot with 173 deformities, including 27 scar ulcers. All patients lacked of self-care ability, among them some could not stand. Due to inadequate skin source, deformities were corrected by skin from matured scars expanded with subcutaneous balloon at late postburn stage. Following our former clinical experience, anatomic investigation and experimental research, we chose the following methods to correct deformities and restore functions: application of split-thickness scar skin after expansion (88 wounds); use of scar skin flap/scar-Achilles tendon flaps (59 wounds); combination of thin split-thickness skin grafts from scar and allogeneic acellular dermal matrix (composite skin, 40 wounds). All grafts survived, the appearance and function were improved obviously without complications. Follow-up 1-40 years, all patients could take care themselves with satisfactory function and appearance, and among them 8 patients returned to work (one had worked for 40 years), 2 patients married and had children. The above-mentioned measures are safe, reliable and effective for functional reconstruction of deformities. PMID:19103016

  7. MISR Views a Fire-Scarred Landscape

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This MISR image pair shows 'before and after' views of the area around the Hanford Nuclear Reservation near Richland, Washington. On June 27, 2000, a fire in the dry sagebrush was sparked by an automobile crash. The flames were fanned by hot summer winds. By the day after the accident, about 100,000 acres had burned, and the fire's spread forced the closure of highways and loss of homes.

    These images, from Terra orbits 2176 and 3341, were obtained by MISR's vertical-viewing (nadir) camera. Compare the area just above and to the right of the line of cumulus clouds in the May 15 image with the same area imaged on August 3. The darkened burn scar measures approximately 35 kilometers across. The Columbia River is seen wending its way around the area, and the Snake River branches off to the right.

    According to Idaho's National Interagency Fire Center, the US has been experiencing the worst fire season since 1996.

    MISR was built and is managed by NASA's Jet Propulsion Laboratory, Pasadena, CA, for NASA's Office of Earth Science, Washington, DC. The Terra satellite is managed by NASA's Goddard Space Flight Center, Greenbelt, MD. JPL is a division of the California Institute of Technology.

  8. Burning Issue: Handling Household Burns

    MedlinePLUS

    ... hot objects or liquid, fire, friction, the sun, electricity, or certain chemicals. Each year, about a half- ... infant or elderly. the burn was caused by electricity, which can lead to “invisible” burns. Burns Burns ...

  9. Biologicals and Fetal Cell Therapy for Wound and Scar Management

    PubMed Central

    Hirt-Burri, Nathalie; Ramelet, Albert-Adrien; Raffoul, Wassim; de Buys Roessingh, Anthony; Scaletta, Corinne; Pioletti, Dominique; Applegate, Lee Ann

    2011-01-01

    Few biopharmaceutical preparations developed from biologicals are available for tissue regeneration and scar management. When developing biological treatments with cellular therapy, selection of cell types and establishment of consistent cell banks are crucial steps in whole-cell bioprocessing. Various cell types have been used in treatment of wounds to reduce scar to date including autolog and allogenic skin cells, platelets, placenta, and amniotic extracts. Experience with fetal cells show that they may provide an interesting cell choice due to facility of outscaling and known properties for wound healing without scar. Differential gene profiling has helped to point to potential indicators of repair which include cell adhesion, extracellular matrix, cytokines, growth factors, and development. Safety has been evidenced in Phase I and II clinical fetal cell use for burn and wound treatments with different cell delivery systems. We present herein that fetal cells present technical and therapeutic advantages compared to other cell types for effective cell-based therapy for wound and scar management. PMID:22363853

  10. Fire scars and ancient sand dunes in southern Australia

    NASA Technical Reports Server (NTRS)

    1994-01-01

    The rectangular green areas in this view of southern Australia are protected areas of natural forest (national parks and biospheric reserves), and the lighter surrounding colors (tan-brown) are agricultural croplands occupying land which once must have looked as green as the nature reserves but are now cleared of forest. The major green patch has been recently burned, as shown by the irregular pattern of a large, multiple burn scar. The pattern of the fire scar indicates that the fires were driven by winds blowing from left to right. Close examination of the view shows that the forests are rooted in a soil made up of a widespread sheet of ancient dune sand. The dunes can be seen best within the area of the large fire scar where the characteristic wavy, scalloped pattern of crescent dunes can be detected. The crescents indicate that the sand was heaped up by winds blowing from right to left in this view, in the opposite direction to the winds which fanned the fires. A few straight dunes

  11. The in-vitro caffeine contracture test: influence of the muscle histochemical profile on test results.

    PubMed

    Brownell, A K; Szabo, M

    1982-05-01

    In vitro caffeine contracture tests were carried out on whole rat muscle composed primarily of either histochemical type I or type II fibers. Muscles composed primarily of type I fibers developed contractures at lower concentrations of caffeine and had lower caffeine specific concentrations than muscles composed primarily of type II fibers. These findings indicate that the histochemical profile of a muscle can influence the results of the in-vitro caffeine contracture test. PMID:7074401

  12. Postinfective skin contracture: a rare cause of fifth metatarsophalangeal joint subluxation.

    PubMed

    Prakash, Jatin; Mehtani, Anil

    2014-01-01

    Dislocation or subluxation of the metatarsophalangeal joint (MTP) is common and usually follows a traumatic event. Non-traumatic causes usually include inflammatory arthritis (rheumatoid arthritis), connective tissue disorders, crowded shoewear or flexor digitorum longus tendon contracture. We present a very unusual case of subluxation of the fifth MTP joint following a postboil skin contracture. The case was treated with the release of contracture by Z-plasty. It resulted in concentric reduction of the joint and normal skin healing. PMID:25199201

  13. Vegetation burning in the year 2000: Global burned area estimates from SPOT VEGETATION data

    NASA Astrophysics Data System (ADS)

    Tansey, Kevin; GréGoire, Jean-Marie; Stroppiana, Daniela; Sousa, AdéLia; Silva, JoãO.; Pereira, José M. C.; Boschetti, Luigi; Maggi, Marta; Brivio, Pietro Alessandro; Fraser, Robert; Flasse, StéPhane; Ershov, Dmitry; Binaghi, Elisabetta; Graetz, Dean; Peduzzi, Pascal

    2004-07-01

    The scientific community interested in atmospheric chemistry, gas emissions from vegetation fires, and carbon cycling is currently demanding information on the extent and timing of biomass burning at the global scale. In fact, the area and type of vegetation that is burned on a monthly or annual basis are two of the parameters that provide the greatest uncertainty in the calculation of gas and aerosol emissions and burned biomass. To address this need, an inventory of burned areas at monthly time periods for the year 2000 at a resolution of 1 km2 has been produced using satellite data and has been made freely available to the scientific community. In this paper, estimates of burned area and number of burn scars for four broad vegetation classes and reported at the country level for the year 2000 are presented using data taken from the inventory. Over 3.5 million km2 of burned areas were detected in the year 2000, of which approximately 80% occurred in areas described as woodlands and shrublands. Approximately 17% of the burned area occurred in grasslands and croplands, the remaining 3% occurred in forests. Almost 600,000 separate burn scars were detected. Descriptions of vegetation burning activity are given for ten regions. Finally, monthly burned area estimates are presented for the Central African Republic to illustrate the usefulness of these data for understanding, monitoring and managing vegetation burning activities.

  14. [Dermal subsitute with the collagen-elastin matrix Matriderm in burn injuries: a comprehensive review].

    PubMed

    Kolokythas, P; Aust, M C; Vogt, P M; Paulsen, F

    2008-12-01

    Matriderm is a dermal substitute consisting of a native (non-cross-linked) collagen matrix supplemented by a elastin hydrolysate. It is available in sheets of 1 mm and 2 mm thickness, and may be covered in a single step procedure with immediate split thickness skin grafting. Duration of the surgical procedures are only marginally increased. There is no diminished take of split thickness graft and only marginally prolonged healing time compared with the split thickness graft only. In experimental models the matrix reduces wound contracture, histologically collagen bundles in the scar are more randomly orientated. Clinical trials with a long-term clinical evaluation showed no difference in scar elasticity between the described dermal substitute and split thickness grafts alone. There is a lack of clinical data on the development of wound contracture. PMID:18629763

  15. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS § 11.3 Scar rule. The scar rule applies to all horses born on...

  16. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS § 11.3 Scar rule. The scar rule applies to all horses born on...

  17. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS § 11.3 Scar rule. The scar rule applies to all horses born on...

  18. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS § 11.3 Scar rule. The scar rule applies to all horses born on...

  19. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS § 11.3 Scar rule. The scar rule applies to all horses born on...

  20. A Second Trimester Caesarean Scar Pregnancy

    PubMed Central

    Sikka, Pooja; Suri, Vanita; Chopra, Seema; Aggarwal, Neelam

    2014-01-01

    Caesarean scar pregnancy, where conceptus is implanted on previous scar, is a rare entity. We present one such case of scar pregnancy presenting to us in the second trimester and was managed with methotrexate and uterine artery embolization, followed by hysterotomy. Uterus could be conserved and hysterectomy could be avoided. PMID:24782936

  1. Potassium Chloride Versus Voltage Clamp Contractures in Ventricular Muscle

    NASA Astrophysics Data System (ADS)

    Morad, M.; Reeck, S.; Rao, M.

    1981-01-01

    In frog ventricle, developed tension was markedly larger in response to depolarization caused by a voltage clamp step than to depolarization induced by high concentrations of potassium chloride. Measurement of extracellular potassium activity at the surface and at the depth of muscle during the development of contractures showed that the diffusion of potassium is much slower than the spread of depolarization through the cross section of muscle. These two observations suggest that competition between the depolarizing and the negative inotropic effects of an increase in the extracellular potassium ion concentration may determine the time course and magnitude of contractile tension in heart muscle.

  2. [Dupuytren contracture in North Germany. Epidemiological study of 500 cases].

    PubMed

    Brenner, P; Krause-Bergmann, A; Van, V H

    2001-04-01

    Dupuytren's disease is the "classical" hand illness of the north: it affects people of Celtic or Viking descent throughout the whole of northern Europe, whereas it is an unknown disease in the Mediterranean region. Dupuytren's contracture appears to be an extremity-related disease. Owing to the unclear etiology and a lack of up-to-date demographic data for northern Germany this study aims--together with the literature--to elucidate the role of associated illnesses in an attempt to discover pathogenic explanations. 566 patients suffering from Dupuytren's disease in the area around Hanover were analysed with respect to epidemiological features and their Tubiana contracture stage. 91.2% were of pure northern German stock, 12.5% had a family predisposition. The male-to-female ratio was 7:1. Men were afflicted on average at the age of 56 years. Intellectuals were scored 3.17, while manual workers scored 4.21. There were pre-existing ipsilateral lesions in 15% of cases. 55.1% had bilateral contracture. Ectopic penile and plantar fibrosis or knuckle pads were found in 6.7% of cases. The distribution of stages I-IV decreased by 2.4% from 59.1% among the 1,808 afflicted finger rays. With a score of 3.7-3.72, drinkers and smokers presented significantly more severe contractures, while the 8.2% of diabetics displayed a milder form. Among the epileptics--all of whom were affected bilaterally--the Tubiana stage of 3.71 exceeded the median manual score of 3.63 for the group as a whole. Thus Dupuytren's disease is a general but not an exclusively extremity-related sickness. The androtropy is pathognomic. Women develop the disease one decade later than men. In old age the male-to-female ratio equalizes. Drinkers, smokers and heavy manual workers present a more severe affliction, while diabetics suffer from a significantly less severe form. Although the ulnar type dominates, the radial type accounts for 14.4% of cases. 1.9 million Germans are chronically ill because of Dupuytren's disease. Despite a trauma history, Dupuytren's disease is not recognized as an occupational disease. PMID:11357696

  3. Biomass Burning

    Atmospheric Science Data Center

    2015-07-27

    Projects:  Biomass Burning Definition/Description:  Biomass Burning: This data set represents the geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ...

  4. Rhinoplasty with Cartilage and Alloplastic Materials, Nasal SMAS Management in Asian Rhinoplasty, Contracture Classification, and Secondary Rhinoplasty with Contracture.

    PubMed

    Kim, Yong Kyu; Kania, Katarzyna; Nguyen, Anh H

    2015-11-01

    Rhinoplasty for Asians is quite different from that of Westerners. Most Asians desire a raised nasal bridge with a projected nasal tip, similar to that of Westerners. Nevertheless, most Asian nasal bones, and upper and lower lateral cartilages are inadequately developed. This largely necessitates the use of a nasal alloplastic material such as a silicone implant, most frequently utilized in nasal cosmetic surgery for Asians. Shaping of the silicone implant is rather easy and its removal is also simple, in the case of a complication or undesired result. The disadvantage of a nasal silicone implant, like that of silicone implants of the breast, is the fibrous capsular formation, which may lead to capsular contracture. The frequently employed types of nasal silicone implant include (1) the boat type in which the silicone implant descends down to the nasal tip, (2) the L-shape in which the silicone implant further extends to the anterior nasal spine (ANS) after passing the tip, and (3) the three-quarter type for which the silicone implant extends down to the upper lateral cartilage. In conjunction with the silicone implant, the cartilages of the ear and the nasal septum are commonly used to create or lengthen tip projection. Asians generally have cartilage with inadequate anatomical development. Instead, they often have an anatomically thick fibrous fatty layer including underdeveloped superficial musculoaponeurotic system (SMAS). Patients with a thick fibrous tissue layer have a bulbous tip. This nasal tip is the area where severe capsular contracture occurs after insertion of a silicone implant. It is imperative that the surgeon properly understands the nasal anatomical characteristics of Asians, and selects an appropriate implant together with a suitable donor cartilage to attain a safe and aesthetically pleasing nose. The same principle should apply to reoperation cases; the fibrofatty layer of SMAS along with the capsular contracture must be removed or released to gain a sufficient soft tissue volume. This provides further stability to the cartilage framework. PMID:26648805

  5. Congenital Heart Disease in Adolescents With Gluteal Muscle Contracture

    PubMed Central

    You, Tian; Zhang, Xin-tao; Zha, Zhen-gang; Zhang, Wen-tao

    2015-01-01

    Abstract Gluteal muscle contracture (GMC), presented with hip abduction and external rotation when crouching, is common in several ethnicities, particularly in Chinese. It remains unclear that the reasons why these children are weak and have no choice to accept repeated intramuscular injection. Here, we found some unique cases which may be useful to explain this question. We describe a series of special GMC patients, who are accompanied with congenital heart disease (CHD). These cases were first observed in preoperative examinations of a patient with atrial septal defect (ASD), which was proved by chest X-ray and cardiac ultrasound. From then on, we gradually identified additional 3 GMC patients with CHD. The original patient with ASD was sent to cardiosurgery department to repair atrial septal first and received arthroscopic surgery later. While the other 3 were cured postoperative of ventricular septal defect (VSD), tetralogy of fallot (TOF), patent ductus arteriosus (PDA), respectively, and had surgery directly. The study gives us 3 proposals: (1) as to CHD children, it is essential to decrease the use of intramuscular injection, (2) paying more attention to cardiac examination especially cardiac ultrasound in perioperative period, and (3) taking 3D-CT to reconstruct gluteal muscles for observing contracture bands clearly in preoperation. However, more larger series of patients are called for to confirm these findings. PMID:25654394

  6. Physiological Implications of Myocardial Scar Structure.

    PubMed

    Richardson, William J; Clarke, Samantha A; Quinn, T Alexander; Holmes, Jeffrey W

    2015-10-01

    Once myocardium dies during a heart attack, it is replaced by scar tissue over the course of several weeks. The size, location, composition, structure, and mechanical properties of the healing scar are all critical determinants of the fate of patients who survive the initial infarction. While the central importance of scar structure in determining pump function and remodeling has long been recognized, it has proven remarkably difficult to design therapies that improve heart function or limit remodeling by modifying scar structure. Many exciting new therapies are under development, but predicting their long-term effects requires a detailed understanding of how infarct scar forms, how its properties impact left ventricular function and remodeling, and how changes in scar structure and properties feed back to affect not only heart mechanics but also electrical conduction, reflex hemodynamic compensations, and the ongoing process of scar formation itself. In this article, we outline the scar formation process following a myocardial infarction, discuss interpretation of standard measures of heart function in the setting of a healing infarct, then present implications of infarct scar geometry and structure for both mechanical and electrical function of the heart and summarize experiences to date with therapeutic interventions that aim to modify scar geometry and structure. One important conclusion that emerges from the studies reviewed here is that computational modeling is an essential tool for integrating the wealth of information required to understand this complex system and predict the impact of novel therapies on scar healing, heart function, and remodeling following myocardial infarction. PMID:26426470

  7. Two dimensional unstable scar statistics.

    SciTech Connect

    Warne, Larry Kevin; Jorgenson, Roy Eberhardt; Kotulski, Joseph Daniel; Lee, Kelvin S. H. (ITT Industries/AES Los Angeles, CA)

    2006-12-01

    This report examines the localization of time harmonic high frequency modal fields in two dimensional cavities along periodic paths between opposing sides of the cavity. The cases where these orbits lead to unstable localized modes are known as scars. This paper examines the enhancements for these unstable orbits when the opposing mirrors are both convex and concave. In the latter case the construction includes the treatment of interior foci.

  8. Renal cortical scarring in acute pyelonephritis.

    PubMed

    Tsugaya, M; Hirao, N; Sakagami, H; Ohtaguro, K; Washida, H

    1992-03-01

    A series of 14 patients with acute pyelonephritis was evaluated for the formation of renal scarring by serial computed tomography (CT) and intravenous urography. Although the urography results were normal, CT showed renal parenchymal atrophy (cortical scarring) in 6 patients. Cortical scarring was observed to occur after 61 to 187 days, and it was slower to develop in the patients with recurrent fever lasting for 2 weeks or more in total than in those with fever for less than 2 weeks. Scarring was significantly more frequent in patients with severe renal involvement than in those with mild involvement, and scars developed at the sites of the most extensive lesions seen on the initial CT scans. Cortical scars were detected in 6 of the 7 patients in whom the lesions occupied 30% or more of the renal parenchyma. We conclude that the extent of the initial renal parenchymal involvement was the most important determinant of eventual scar formation. PMID:1568097

  9. Burn wound: How it differs from other wounds?

    PubMed Central

    Tiwari, V. K.

    2012-01-01

    Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds. PMID:23162236

  10. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    PubMed Central

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible. PMID:24707293

  11. The Mast Cell Stabilizer Ketotifen Fumarate Lessens Contracture Severity and Myofibroblast Hyperplasia: A Study of a Rabbit Model of Posttraumatic Joint Contractures

    PubMed Central

    Monument, Michael J.; Hart, David A.; Befus, A. Dean; Salo, Paul T.; Zhang, Mei; Hildebrand, Kevin A.

    2010-01-01

    Background The propensity of the elbow to become stiff after trauma is widely appreciated and in this setting, the joint capsule is commonly recognized as the major motion-limiting anatomical structure. Affected joint capsules become fibrotic, characterized by myofibroblast hyperplasia and excessive collagen deposition. Mast cell hyperplasia is common within fibrotic tissue and mast cells are known to synthesize many profibrotic mediators. We have hypothesized that mast cell inhibition after skeletal injury will lessen the degree of contracture severity and will reduce myofibroblast hyperplasia within the joint capsule. Methods Posttraumatic contractures of the knee were created using a combination of intra-articular injury coupled to internal immobilization in skeletally mature, New Zealand white rabbits. Four groups of animals were studied: a non-operative control group (CON), an operative contracture group (ORC) and two-operative groups treated with a mast cell stabilizer, Ketotifen fumarate at doses of 0.5mg/kg (KF0.5) and 1.0mg/kg (KF1.0) twice daily, respectively. After 8 weeks of immobilization, flexion contractures were measured biomechanically and the posterior joint capsule was harvested for quantification of myofibroblast and mast cell numbers. Results Flexion contractures developed in the ORC group (58 ± 14°) and the severity of contracture was significantly reduced in both groups treated with Ketotifen (KF0.5: 42 ± 17° and KF1.0: 45 ± 10°, p<0.02). Joint capsule myofibroblast and mast cell numbers were significantly increased within the operative contracture group (p<0.001). In both surgical groups treated with Ketotifen, myofibroblast and mast cell numbers were significantly reduced (p<0.001). Conclusions The use of a mast cell stabilizer, Ketotifen was effective in reducing the biomechanical and cellular manifestations of joint capsule fibrosis in a rabbit model of posttraumatic joint contracture. This is suggestive that an inflammatory pathway, mediated by mast cell activation is involved in the induction of joint capsule fibrosis after traumatic injury. Clinical Relevance These results suggest mast cell activation is an important event in the genesis of posttraumatic joint contractures. Further work is needed to determine if mast cell inhibition has a role in the prevention of posttraumatic joint contractures in humans. PMID:20516323

  12. Smoke, Clouds, and Radiation-Brazil (SCAR-B) Experiment

    NASA Technical Reports Server (NTRS)

    Kaufman, Y. J.; Hobbs, P. V.; Kirchoff, V. W. J. H.; Artaxo, P.; Remer, L. A.; Holben, B. N.; King, M. D.; Ward, D. E.; Prins, E. M.; Longo, K. M.; Mattos, L. F.; Nobre, C. A.; Spinhirne, J. D.; Ji, Q.; Thompson, A. M.; Gleason, J. F.; Christopher, S. A.; Tsay, S.-C.

    1998-01-01

    The Smoke, Clouds, and Radiation-Brazil (SCAR-B) field project took place in the Brazilian Amazon and cerrado regions in August-September 1995 as a collaboration between Brazilian and American scientists. SCAR-B, a comprehensive experiment to study biomass burning, emphasized measurements of surface biomass, fires, smoke aerosol and trace gases, clouds, and radiation. their climatic effects, and remote sensing from aircraft and satellites. It included aircraft and ground-based in situ measurements of smoke emission factors and the compositions, sizes, and optical properties of the smoke particles; studies of the formation of ozone; the transport and evolution of smoke; and smoke interactions with water vapor and clouds. This overview paper introduces SCAR-B and summarizes some of the main results obtained so far. (1) Fires: measurements of the size distribution of fires, using the 50 m resolution MODIS Airborne Simulator, show that most of the fires are small (e.g. 0.005 square km), but the satellite sensors (e.g., AVHRR and MODIS with I km resolution) can detect fires in Brazil which are responsible for 60-85% of the burned biomass: (2) Aerosol: smoke particles emitted from fires increase their radius by as much as 60%, during their first three days in the atmosphere due to condensation and coagulation, reaching a mass median radius of 0.13-0.17 microns: (3) Radiative forcing: estimates of the globally averaged direct radiative forcing due to smoke worldwide, based on the properties of smoke measured in SCAR-B (-O.l to -0.3 W m(exp -2)), are smaller than previously modeled due to a lower single-scattering albedo (0.8 to 0.9), smaller scattering efficiency (3 square meters g(exp -2) at 550 nm), and low humidification factor; and (4) Effect on clouds: a good relationship was found between cloud condensation nuclei and smoke volume concentrations, thus an increase in the smoke emission is expected to affect cloud properties. In SCAR-B, new techniques were developed for deriving the absorption and refractive index of smoke from ground-based remote sensing. Future spaceborne radiometers (e.g., MODIS on the Earth Observing System), simulated on aircraft, proved to be very useful for monitoring smoke properties, surface properties, and the impacts of smoke on radiation and climate.

  13. Scars

    MedlinePLUS

    ... subspecialty, ASDS member dermatologists perform medically necessary and cosmetic procedures to improve the health, function and beauty ... to frown lines… Performing more than 5 million cosmetic procedures each year, ASDS member dermatologists offer many ...

  14. Bilateral carpal contracture in a neonatal addax (Addax nasomaculatus).

    PubMed

    Watson, Megan K; Langan, Jennifer; Adkesson, Michael J

    2013-09-01

    A neonate male addax calf displayed an inability to extend its forelimbs bilaterally (range of motion restricted to 45 degrees-50 degrees on full extension) with resultant inability to stand. Based on examination and radiographs, the congenital defect was attributed to contracted soft tissue structures (joint capsule and/or intercarpal ligaments). Splinting, support of the limbs, and physical therapy resulted in moderate improvement of the angle of contraction (full flexion to approximately 120 degrees on extension at day 10). The animal was able to walk with splints but died at 10 days from acute head trauma, presumably related to a traumatic fall caused by challenges with ambulation. Postmortem examination confirmed soft-tissue contracture of the forelimbs. Malposition of the calf in utero was considered a possible cause of the defect. PMID:24063116

  15. [DIAGNOSTIC VARIATIONS OF X-LINKED MUSCULAR DYSTROPHY WITH CONTRACTURES].

    PubMed

    Kvirkvelia, N; Shakarishvili, R; Gugutsidze, D; Khizanishvili, N

    2015-01-01

    Case report with review describes X-linked muscular dystrophy with contractures in 28 years old man and his cousin. The disease revealed itself in an early stage (age 5-10), the process was progressing with apparent tendons retraction and contraction, limited movement in the areas of the neck and back of spine, atrophy of shoulder and pelvic yard and back muscles. Intellect was intact. Cardyomyopathy was exhibited. CK was normal. EMG showed classic myopathic features. Muscle biopsy showed different caliber groups of muscle fibers, growth of endo-perimesial connective tissue. Clinical manifestations together with electrophysiological and histological data suggest consistency with Rotthauwe-Mortier-Bayer X-linked muscular dystrophy. PMID:26177134

  16. In vitro contracture tests in patients with various neuromuscular diseases.

    PubMed

    Heytens, L; Martin, J J; Van de Kelft, E; Bossaert, L L

    1992-01-01

    In order to investigate the relationship between neuromuscular disease and malignant hyperthermia (MH) susceptibility, the caffeine and halothane in vitro contracture test (European Malignant Hyperthermia Group Protocol) were performed in 60 patients who underwent muscle biopsy for investigation of a clinically suspected neuromuscular disorder. Two test results were classified as MH susceptible, 10 as MH equivocal and 48 MH negative. The large number of equivocal results is thought to indicate the lack of specificity of the individual components of this test in patients with clinical or histological evidence of neuromuscular disease. The increased in vitro sensitivity to the drugs tested may nevertheless provide some explanation for several in vivo "MH-like reactions" reported frequently in these patients. These reactions, however, are likely to be based on pathophysiological mechanisms different from those responsible for a true MH crisis. PMID:1739572

  17. The management of fixed flexion contractures during total knee arthroplasty.

    PubMed

    Firestone, T P; Krackow, K A; Davis, J D; Teeny, S M; Hungerford, D S

    1992-11-01

    Fifty-one knees in 40 patients with joint surface degeneration accompanied by fixed flexion contractures (FFC) greater than 20 degrees were treated with total knee arthroplasty using a minimally constrained posterior cruciate ligament retaining prosthesis. Special techniques were employed in an attempt to achieve maximal correction at the time of surgery. The residual FFC measured 3.1 degrees at the completion of the arthroplasty, 10.1 degrees at three months, and 7 degrees at two years. At 55 months postoperatively, the FFC for the osteoarthrotic group had improved from 25.5 degrees to 3.6 degrees, whereas the rheumatoid group improved from 28.7 degrees to 8.6 degrees. The average knee score for the osteoarthrotic group was 89 compared with 81 for the rheumatoid group. Knees that were left with greater residual FFC at the completion of the arthroplasty were found to have greater residual FFC at the latest review. PMID:1395297

  18. Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments

    PubMed Central

    Wong, Kayleigh; Trudel, Guy; Laneuville, Odette

    2015-01-01

    Joint contractures, defined as the limitation in the passive range of motion of a mobile joint, can be classified as noninflammatory diseases of the musculoskeletal system. The pathophysiology is not well understood; limited information is available on causal factors, progression, the pathophysiology involved, and prediction of response to treatment. The clinical heterogeneity of joint contractures combined with the heterogeneous contribution of joint connective tissues to joint mobility presents challenges to the study of joint contractures. Furthermore, contractures are often a symptom of a wide variety of heterogeneous disorders that are in many cases multifactorial. Extended immobility has been identified as a causal factor and evidence is provided from both experimental and epidemiology studies. Of interest is the involvement of the joint capsule in the pathophysiology of joint contractures and lack of response to remobilization. While molecular pathways involved in the development of joint contractures are being investigated, current treatments focus on physiotherapy, which is ineffective on irreversible contractures. Future treatments may include early diagnosis and prevention. PMID:26247029

  19. Acne Scars: Pathogenesis, Classification and Treatment

    PubMed Central

    Fabbrocini, Gabriella; Annunziata, M. C.; D'Arco, V.; De Vita, V.; Lodi, G.; Mauriello, M. C.; Pastore, F.; Monfrecola, G.

    2010-01-01

    Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%–14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options. PMID:20981308

  20. Acne scars: pathogenesis, classification and treatment.

    PubMed

    Fabbrocini, Gabriella; Annunziata, M C; D'Arco, V; De Vita, V; Lodi, G; Mauriello, M C; Pastore, F; Monfrecola, G

    2010-01-01

    Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%-14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options. PMID:20981308

  1. A Case of Multiple Spontaneous Keloid Scars

    PubMed Central

    Jfri, Abdulhadi; Rajeh, Nawal; Karkashan, Eman

    2015-01-01

    Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body. PMID:26351423

  2. Dupuytren's disease or Cooper's contracture?: Kenneth Fitzpatrick Russell Memorial Lecture.

    PubMed

    Thurston, Alan

    2003-07-01

    In his position as curator of the Cowlishaw collection of historical medical books in the Library of the College, Kenneth Russell prepared the definitive catalogue of the collection. This catalogue is comprehensive and for almost all entries there is an annotation that demonstrates his meticulous attention to detail and the love of the book collection that he managed to secure for the College. It is from this catalogue that I have chosen two books in particular that bring together two great surgeons of the turn of the 19th century. Although he was a pupil of the great John Hunter, the young Astley Cooper possessed good manners and a gift of oratory of which the Scot, his teacher, was devoid. After his apprenticeship with Henry Cline senior, Cooper came to share the podium with Cline at Guy's and St Thomas' hospitals and the two dominated surgical teaching in London for some 22 years, until Cline's retirement in 1811. It was the latter who was first to recognize the true nature of the condition now known as Dupuytren's disease. Later, in 1822, Cooper wrote a detailed description of the contracture of the palmar aponeurosis and recommended fasciotomy as being curative. His book A Treatise on Dislocations and Fractures of the Joints, which contains this description of Dupuytren's contracture, is held in the Cowlishaw Collection. On the other side of the English Channel, M. le Baron Dupuytren repeatedly misquoted Cooper and stated that Cooper believed that the disease was incurable. In his famous lecture given to the staff of the Hôtel Dieu in Paris on 5th December 1931, he admitted to having seen 30 or 40 cases over 20 years of practice. It seems likely that he was not aware of the true cause of the condition before 1831 when he treated his first case. This lecture, along with others, are recorded in his Leçons Orales de Clinique Chirurgicale, a copy of which is also to be found in the Cowlishaw Collection. PMID:12864830

  3. [Surgical controversy. Limiting postoperative scarring].

    PubMed

    Lachkar, Y

    2005-06-01

    Postoperative follow-up of glaucoma surgery must be rigorous and carried out over the long term. Data acquired on the make-up of the filtering bleb justifies using postoperative anti-inflammatory drugs, even if the eye is clinically quiet. When using antimetabolites, the risk factors for failure must be well known and either 5-fluorouracile or mitomycin should be chosen depending on the level of risk of scarring. Their use in needle revision must be adapted case by case. anti-TGF-beta-2 antibody, currently being investigated, may prove advantageous in the very near future. PMID:16208245

  4. Scar Revision Surgery: The Patient's Perspective

    PubMed Central

    Allan, Anna Y; Butler, Daniel P; Cussons, Paul D

    2015-01-01

    Background Insufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria. Methods Patients (250) were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma), underlying issue (functional/symptomatic vs. cosmetic) and revision surgery details were also collected with the added use of a real-time, hospital database. Results Telephone contacting was achieved for 211 patients (214 scar revisions). Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016) and by females vs. males (85.52% vs. 75.36%, P<0.05), particularly in the elective group where males (36.17%) were more likely to report no change or worse outcomes versus females (16.04%) (P<0.01). Conclusions Successful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision. PMID:26618120

  5. Effective Treatments of Atrophic Acne Scars

    PubMed Central

    Zhou, Bingrong

    2015-01-01

    Atrophic scarring is often an unfortunate and permanent complication of acne vulgaris. It has high prevalence, significant impact on quality of life, and therapeutic challenge for dermatologists. The treatment of atrophic acne scars varies depending on the types of acne scars and the limitations of the treatment modalities in their ability to improve scars. Therefore, many options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, laser treatment, punch techniques, fat transplantation, other tissue augmenting agents, needling, subcision, and combined therapy. Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application. In order to optimally treat a patient’s scar, we need to consider which treatment offers the most satisfactory result. There are also promising procedures in the future, such as stem cell therapy. In this article, the authors review the different treatment options of atrophic acne scars. This may be useful for selecting the best therapeutic strategy, whether it be single or combined therapy, in the treatment of atrophic acne scars while reducing or avoiding the side effects and complications. PMID:26029333

  6. Bladder Contracture – A Rare and Serious Side Effect of Intravesical Bacillus Calmette-Guérin Therapy

    PubMed Central

    Garcia, Cindy; Jina, Hamesh; Bergersen, Philip; Chalasani, Venu

    2015-01-01

    Instillation of intravesical bacillus Calmette-Guérin (BCG) is an effective treatment for non-muscle invasive bladder cancer (NMIBC). The high incidence of side effects may limit its tolerability in patients. Local side effects including cystitis and hematuria are common but generally self-limiting. Bladder contractures are a rare but serious consequence of BCG treatment. In this case, an 82 year-old male developed BCG reactivation and subsequent bladder contractures following transurethral resection of the prostate (TURP) three years post-BCG. To our knowledge, this is the first reported case of BCG reactivation post-TURP leading to the rare but serious effect of bladder contractures. PMID:26793570

  7. The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants.

    PubMed

    Ajdic, Dragana; Zoghbi, Yasmina; Gerth, David; Panthaki, Zubin J; Thaller, Seth

    2016-03-01

    Capsular contracture is a common sequelae of implant-based breast augmentation. Despite its prevalence, the etiology of capsular contracture remains controversial. Numerous studies have identified microbial biofilms on various implantable materials, including breast implants. Furthermore, biofilms have been implicated in subclinical infections associated with other surgical implants. In this review, we discuss microbial biofilms as a potential etiology of capsular contracture. The review also outlines the key diagnostic modalities available to identify the possible infectious agents found in biofilm, as well as available preventative and treatment measures. PMID:26843099

  8. Scars after second intention healing.

    PubMed

    Donaldson, Matthew R; Coldiron, Brett M

    2012-10-01

    Second intention healing (SIH) is useful for many defects after skin cancer removal. SIH decreases intraoperative morbidity and reduces procedure costs. Granulating wounds are rarely infected, have minimal pain or bleeding, and care is simple. Location is the key determinant in cosmetic outcomes of SIH. Concavities of the face including the medial canthus and conchal bowl often heal imperceptibly. Defects on convex surfaces such as the nasal tip and malar cheek can heal poorly with depressed scars. Flat areas of the cheeks, forehead, and chin heal favorably but cosmesis can be unpredictable. These regions are often described by NEET (concavities of the nose, eyes, ears, and temple), NOCH (convexities of nose, oral lips, cheek, chin, and helix), and FAIR (flat areas of the forehead, antihelix of the ear, eyelids, and rest of the nose, lips, and cheeks). We review the limited literature describing SIH based on regional anatomy of the face. Complications of SIH include exuberant granulation tissue, hypopigmented or telangiectatic scars, and distortion of free lid margins. SIH should be an integral part of the surgeon's reconstructive algorithm after skin cancer removal. PMID:23027216

  9. [Present and future of cell therapy in burns].

    PubMed

    Bargues, L; Prat, M; Leclerc, T; Bey, E; Lataillade, J-J

    2011-06-01

    Severe burned patients need definitive and efficient wound coverage. Outcome of massive burns has been improved by using cultured epithelial autografts (CEA). Despite fragility, percentages of success take, cost of treatment and long-term tendency to contracture, this surgical technique has been developed in few burn centres. First improvements were to combine CEA and dermis-like substitute. Cultured skin substitutes provide earlier skin closure and satisfying functional result. These methods have been used successfully in massive burns. Second improvement was to allow skin regeneration by using epidermal stem cells. Stem cells have capacity to differentiate into keratinocytes, to promote wound repair and to regenerate skin appendages. Human mesenchymal stem cells contribute to wound healing and were evaluated in cutaneous radiation syndrome. Skin regeneration and tissue engineering methods remain a complex challenge and offer the possibility of new treatment for injured and burned patients. PMID:20167439

  10. Burns (image)

    MedlinePLUS

    ... degree burns damage the outer layer of skin (epidermis) and cause pain, redness and swelling (erythema). Second degree burns damage the epidermis and the inner layer, the dermis, causing erythema ...

  11. Pattern and outcome of children admitted for burns in Benin City, mid-western Nigeria

    PubMed Central

    Oludiran, O. O.; Umebese, P. F. A.

    2009-01-01

    Children are a vulnerable to burns, an injury, which is often preventable. A study of the profile of cases of children admitted for burns will provide background information to suggest locally doable preventive strategies as well as supply basic information for future reference. We studied the records of 62 children aged 0-16 years, admitted for burns, at the University of Benin Teaching Hospital, Benin City, between January 2002 and December 2006. There were 34 male and 28 female children. Children under three years constituted 56.5%. Whereas the leading cause of burns in all the children was flame burns from kerosene explosions (52%), scalds were responsible for 68.6% of cases in those under three. The extent of burn injury ranged from 6 to 50% and most of them presented late. 64.6% were discharged within three weeks. Wound sepsis and post burn contractures were the most frequently encountered complications (19.4% and 9.7% respectively). There were two deaths (3.2%) related to sepsis. Particular attention to burn safety precautions in children (especially, in the >3 years age group), safer storage and dispensing of combustible chemicals particularly petroleum products is advocated. Fire safety awareness, correct first aid measures and early presentation in the hospital will reduce morbidity and mortality. Early physiotherapy and splinting strategies will reduce contractures. There is the need locally for the establishment of specialized burn centres both to treat these children and to stimulate interest in burn management. PMID:20368855

  12. Controlled Burn

    USGS Multimedia Gallery

    GULF OF MEXICO — Dark clouds of smoke and fire emerge as oil burns during a controlled burn in the Gulf of Mexico. The U.S. Coast Guard working in partnership with BP PLC, local residents, and other Federal agencies conducted the controlled burn to aid in preventing the spread of oil following...

  13. Scald Burns

    MedlinePLUS

    Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

  14. Absence of capsular contracture in 319 consecutive augmentation mammaplasties: Dependent drains as a possible factor

    PubMed Central

    Fanous, Nabil; Salem, Iman; Tawilé, Carolyne; Bassas, AE

    2004-01-01

    Capsular contracture is one of the major complications of augmentation mammaplasty. A review of 638 augmented breasts in 319 consecutive patients who underwent primary augmentation, with an average follow-up of 17.2 months and without a single case of capsular contracture of any degree to date, is presented, along with a discussion of the surgical technique and complications, and an analysis of measures used to prevent capsular contraction. Each patient received a pair of smooth saline-filled implants (Mentor, USA) placed in the submuscular space through an inframammary incision. In all operated breasts, many of the known measures commonly used for capsular contracture prevention were implemented. As well, a dependent drain was used as the final hemostatic step to prevent blood accumulation in the pocket. Leaving a dependent drain in the dissected pocket overnight, as one of the sequence of measures aimed at eliminating blood accumulation, is believed to be a contributing factor in capsular contracture prevention. PMID:24115895

  15. Limb contractures in progressive neuromuscular disease and the role of stretching, orthotics, and surgery.

    PubMed

    McDonald, C M

    1998-02-01

    Contractures are exceedingly common impairments in selected progressive NMD conditions, particularly those with excessive fibrosis and fatty infiltration into muscle (i.e., dystrophic myopathies) and more severe NMD conditions, resulting in significant weakness and wheel-chair reliance, such as SMA. Less than antigravity strength produces an inability to achieve full active range of motion. Static positioning of limbs (generally in flexion) and lack of weight bearing results in fixed contractures. This article has reviewed the prevalence and distribution of contractures in specific NMD conditions. Aggressive rehabilitation strategies, including stretching, positioning, splinting, upright weight bearing, and orthopaedic surgical management may help minimize the degree of disability in NMD patients with contractures. PMID:9894140

  16. No relationship between fiber type and halothane contracture test results in malignant hyperthermia.

    PubMed

    Heiman-Patterson, T; Fletcher, J E; Rosenberg, H; Tahmoush, A J

    1987-07-01

    Previous studies in cat, rat, and swine have implicated fiber type as influencing the halothane and caffeine contracture test used to diagnose malignant hyperthermia (MH). The authors performed fiber type analysis using myosin ATPase stains on 31 fascicles of skeletal muscle from nine patients following contracture testing. There was no significant difference in fiber type composition between fascicles from MH negative (n = 5) and MH positive (n = 4) patients. Furthermore, examining each of the 31 fascicles, the authors found no correlation (P greater than .05) of contracture magnitude with percentage of either Type I or Type II fibers using the Pearson Product-Moment correlation calculation. The authors conclude that fiber type composition does not influence contracture test results in human biopsies. PMID:2440353

  17. [Use of a distraction apparatus in the treatment of flexion contractures in the interphalangeal joints].

    PubMed

    Richtr, M; Rysavý, M

    1992-04-01

    The use of a Volkov-Oganesjan distraction reposition apparatus in the treatment of flexion contractures of interphalangeal joints gives very satisfactory results. As compared with formerly used methods of conservative treatment, the apparatus makes reposition of the contractures possible, by its design it protects articular cartilages against damage by pressure and makes continuous rehabilitation of the joint possible throughout the period when the apparatus is used. PMID:1594996

  18. Global burned area and biomass burning emissions from small fires

    NASA Astrophysics Data System (ADS)

    Randerson, J. T.; Chen, Y.; van der Werf, G. R.; Rogers, B. M.; Morton, D. C.

    2012-12-01

    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity analyses of key model parameters caused estimates of global burned area increases from small fires to vary between 24% and 54%. Biomass burning carbon emissions increased by 35% at a global scale when small fires were included in GFED3, from 1.9 Pg C/yr to 2.5 Pg C/yr. The contribution of tropical forest fires to year-to-year variability in carbon fluxes increased because small fires amplified emissions from Central America, South America and Southeast Asia—regions where drought stress and burned area varied considerably from year to year in response to El Nino-Southern Oscillation and other climate modes.

  19. Global Burned Area and Biomass Burning Emissions from Small Fires

    NASA Technical Reports Server (NTRS)

    Randerson, J. T.; Chen, Y.; vanderWerf, G. R.; Rogers, B. M.; Morton, D. C.

    2012-01-01

    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity analyses of key model parameters caused estimates of global burned area increases from small fires to vary between 24% and 54%. Biomass burning carbon emissions increased by 35% at a global scale when small fires were included in GFED3, from 1.9 Pg C/yr to 2.5 Pg C/yr. The contribution of tropical forest fires to year-to-year variability in carbon fluxes increased because small fires amplified emissions from Central America, South America and Southeast Asia-regions where drought stress and burned area varied considerably from year to year in response to El Nino-Southern Oscillation and other climate modes.

  20. Novel Technology in the Treatment of Acne Scars: The Matrix-tunable Radiofrequency Technology

    PubMed Central

    Ramesh, M; Gopal, MG; Kumar, Sharath; Talwar, Ankur

    2010-01-01

    Background: Despite the many advances, scarring, particularly acne or pimple scarring, does not have a satisfactory treatment. A new armamentarium in this field is this recently devised matrix-tunable radiofrequency technology, which utilizes radiofrequency emission in the treatment of acne scars. Aims: To evaluate the efficiency of the new matrix-tunable radiofrequency technology in patients with acne scars of varying sizes. Settings and Design: A prospective study of 30 randomly selected patients with acne scars was carried out. Material and Methods: Thirty healthy patients with different types of acne scars – ice pick, box and rolling type – were randomly selected. The scars were either shallow or deep, varied in size from 2 to 20 mm and ranged in number from 10 to 50. These patients were first treated with broad-spectrum antibiotics and local exfoliating agents (topical tretinoin 0.025%) and then subjected to matrix-tunable radiofrequency technology. Each scar was treated at intervals of 1 month. A maximum of four such sittings were carried out. Patients were followed-up every 15 days. Results were noted at the end of 2 months and 6 months. Improvement was assessed by using the visual analog scale (VAS) at 2 months and 6 months, and results were noted in terms of percentage improvement of the whole face by calculating an average of percentage improvement on the basis of interviews of the patient and his/her accompanying relatives. The visual analog scaling was performed by means of high-resolution digital photographs taken at the baseline and at each subsequent visit. Results: The VAS improvement in scars ranged from 10 to 50% at the end of 2 months to 20 to 70% at the end of 6 months. Of the 30 patients of acne scars, the cosmetic result was excellent (>60% improvement) in four, good (35–60% improvement) in 18 and moderate to poor (<35% improvement) in eight. A few patients reported burning sensation and a mild sunburn-like sensation for about 1 h after treatment. The patients reported a pinkish tone for 2–3 days. Importantly, with the help of some slight make up, all the 30 patients could return to work the following day. Conclusion: Matrix-tunable radiofrequency technology is a safe and economically viable option for the dermatologists for the treatment of acne scars, because of the effective results coupled with a low downtime. PMID:21031069

  1. Ectopic pregnancy in previous Caesarean section scar.

    PubMed

    Hong, S C; Lau, M S K; Yam, P K L

    2011-06-01

    We report two cases of Caesarean scar pregnancies that were managed surgically. The first case was a 33-year-old woman who presented at 21 weeks of gestation with lower abdominal pain. An exploratory laparotomy was performed as she was hypotensive and had a drastic drop in haemoglobin level. Intraoperatively, a ruptured scar ectopic pregnancy with placenta percreta was found. A hysterectomy was performed in view of uncontrolled haemorrhage. The second case was a 30-year-old woman who presented with irregular per vaginal spotting without abdominal pain. Ultrasonography revealed a gestational sac at a previous Caesarean scar, with interval increase in size and development of a yolk sac. On laparoscopy, the diagnosis of scar pregnancy was confirmed, and the gestational sac and surrounding myometrium were excised. Our case report shows that early diagnosis of scar pregnancy is important, as timely intervention can prevent life-threatening complications and preserve fertility. PMID:21731980

  2. Scald Burns From Hair Braiding.

    PubMed

    Meizoso, Jonathan P; Ramaley, Stephen R; Ray, Juliet J; Allen, Casey J; Guarch, Gerardo A; Varas, Robin; Teisch, Laura F; Pizano, Louis R; Schulman, Carl I; Namias, Nicholas

    2016-01-01

    Only one previous case report has described scald burns secondary to hair braiding in pediatric patients. The present case study is the largest to date of scald burns as a result of hair braiding in children and adults. Charts of all 1609 female patients seen at a single burn center from 2008 to 2014 were retrospectively reviewed to identify patients with scald burns attributed to hair braiding. Demographics, injury severity, injury patterns, and complications were analyzed. Twenty-six patients (1.6%) had scald burns secondary to hair braiding with median TBSA 3%. Eighty-five percent of patients were pediatric with median age 8 years. Injury patterns were as follows: back (62%), shoulder (31%), chest (15%), buttocks (15%), abdomen (12%), arms (12%), neck (12%), and legs (4%). No patients required operative intervention. Three patients were admitted to the hospital. Two patients required time off from school for 6 and 10 days post burn for recovery. Complications included functional limitations (n = 2), hypertrophic scarring (n = 1), cellulitis requiring antibiotics (n = 1), and anxiety requiring medical/psychological therapy (n = 2). This peculiar mechanism of injury not only carries inherent morbidity that includes the risks of functional limitations, infection, and psychological repercussions but also increases usage of resources through hospital admissions and multiple clinic visits. Further work in the form of targeted outreach programs is necessary to educate the community regarding this preventable mechanism of injury. PMID:26594857

  3. Use of dermal matrix to prevent capsular contracture in aesthetic breast surgery.

    PubMed

    Hester, T Roderick; Ghazi, Bahair H; Moyer, Hunter R; Nahai, Farzad R; Wilton, Melissa; Stokes, Lou

    2012-11-01

    Capsular contracture remains a challenging complication of implant-based aesthetic breast surgery despite improvements in implant design. The lowering of capsular contracture rates noted with the past use of polyurethane foam-covered implants has increased awareness of the importance of the biologic response at the interface between the implant surface and breast tissue. Emerging evidence indicates that much like the polyurethane foam, acellular dermal matrices alter the biologic response at the surface interface, resulting in a more vascular and less constrictive pattern of collagen deposition. This study reports on the authors' clinical experience using Strattice Reconstructive Tissue Matrix (LifeCell Corporation, Branchburg, N.J.) for the treatment of capsular contracture in patients with established capsules and for prevention in patients undergoing primary augmentation or augmentation/mastopexy. Of 80 patients (154 breasts) in whom Strattice was used, clinically significant contracture (Baker grade III/IV) occurred in three breasts (3.75 percent), all of which were in the treatment of previous contracture group. In addition, the authors noted two seromas requiring implant removal (both patients developed capsules, as mentioned above) and two hematomas requiring revision, for an overall failure rate of 6.25 percent for Strattice-assisted surgery. The data confirm that the use of Strattice significantly lowers the incidence of capsular contracture in the first 3.5 years after implant placement. PMID:23096962

  4. Identification and function analysis of contrary genes in Dupuytren's contracture.

    PubMed

    Ji, Xianglu; Tian, Feng; Tian, Lijie

    2015-07-01

    The present study aimed to analyze the expression of genes involved in Dupuytren's contracture (DC), using bioinformatic methods. The profile of GSE21221 was downloaded from the gene expression ominibus, which included six samples, derived from fibroblasts and six healthy control samples, derived from carpal-tunnel fibroblasts. A Distributed Intrusion Detection System was used in order to identify differentially expressed genes. The term contrary genes is proposed. Contrary genes were the genes that exhibited opposite expression patterns in the positive and negative groups, and likely exhibited opposite functions. These were identified using Coexpress software. Gene ontology (GO) function analysis was conducted for the contrary genes. A network of GO terms was constructed using the reduce and visualize gene ontology database. Significantly expressed genes (801) and contrary genes (98) were screened. A significant association was observed between Chitinase-3-like protein 1 and ten genes in the positive gene set. Positive regulation of transcription and the activation of nuclear factor-?B (NF-?B)-inducing kinase activity exhibited the highest degree values in the network of GO terms. In the present study, the expression of genes involved in the development of DC was analyzed, and the concept of contrary genes proposed. The genes identified in the present study are involved in the positive regulation of transcription and activation of NF-?B-inducing kinase activity. The contrary genes and GO terms identified in the present study may potentially be used for DC diagnosis and treatment. PMID:25760233

  5. Effect of stretch on improvement of muscular contractures in rats

    PubMed Central

    Ishikura, Hideki; Ono, Takeya; Oki, Sadaaki; Saito, Yasukazu; Umei, Namiko; Tsumiyama, Wakako; Tasaka, Atsushi; Aihara, Kazuki; Sato, Yuta; Matsumoto, Tomohiro; Otsuka, Akira

    2015-01-01

    [Purpose] The purpose of this study was to investigate how a stretching torque affects muscular contractures. [Subjects] The subjects of this study were 48 male Wistar rats. [Methods] Subjects were divided into 4 groups as follows: Group 1 was the control; Group 2 had muscles in continuous fixation; Group 3 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 0.3N for a period of 30 minutes after continuous fixation; and Group 4 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 3.0N for a period of 30 minutes after continuous fixation. Joint fixation periods were for 2 and 4-weeks. Ankle joint range of motion and soleus flexibility were analyzed. [Results] For the 2-week joint fixation, soleus flexibility in Group 4 showed an increase compared with that of Group 3. For both fixation periods, range of motion in Group 4 showed an increase compared with that of Group 3. [Conclusion] For both fixation periods, stretching improved joint range of motion. In the 2-week joint fixation, soleus flexibility improved. However, soleus flexibility did not improve in the 4-week joint fixation. PMID:26504301

  6. Enlargement and Contracture of C2-Ceramide Channels

    PubMed Central

    Siskind, Leah J.; Davoody, Amirparviz; Lewin, Naomi; Marshall, Stephanie; Colombini, Marco

    2003-01-01

    Ceramides are known to play a major regulatory role in apoptosis by inducing cytochrome c release from mitochondria. We have previously reported that ceramide, but not dihydroceramide, forms large and stable channels in phospholipid membranes and outer membranes of isolated mitochondria. C2-ceramide channel formation is characterized by conductance increments ranging from <1 to >200 nS. These conductance increments often represent the enlargement and contracture of channels rather than the opening and closure of independent channels. Enlargement is supported by the observation that many small conductance increments can lead to a large decrement. Also the initial conductances favor cations, but this selectivity drops dramatically with increasing total conductance. La+3 causes rapid ceramide channel disassembly in a manner indicative of large conducting structures. These channels have a propensity to contract by a defined size (often multiples of 4 nS) indicating the formation of cylindrical channels with preferred diameters rather than a continuum of sizes. The results are consistent with ceramides forming barrel-stave channels whose size can change by loss or insertion of multiple ceramide columns. PMID:12944273

  7. Effect of stretch on improvement of muscular contractures in rats.

    PubMed

    Ishikura, Hideki; Ono, Takeya; Oki, Sadaaki; Saito, Yasukazu; Umei, Namiko; Tsumiyama, Wakako; Tasaka, Atsushi; Aihara, Kazuki; Sato, Yuta; Matsumoto, Tomohiro; Otsuka, Akira

    2015-09-01

    [Purpose] The purpose of this study was to investigate how a stretching torque affects muscular contractures. [Subjects] The subjects of this study were 48 male Wistar rats. [Methods] Subjects were divided into 4 groups as follows: Group 1 was the control; Group 2 had muscles in continuous fixation; Group 3 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 0.3N for a period of 30 minutes after continuous fixation; and Group 4 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 3.0N for a period of 30 minutes after continuous fixation. Joint fixation periods were for 2 and 4-weeks. Ankle joint range of motion and soleus flexibility were analyzed. [Results] For the 2-week joint fixation, soleus flexibility in Group 4 showed an increase compared with that of Group 3. For both fixation periods, range of motion in Group 4 showed an increase compared with that of Group 3. [Conclusion] For both fixation periods, stretching improved joint range of motion. In the 2-week joint fixation, soleus flexibility improved. However, soleus flexibility did not improve in the 4-week joint fixation. PMID:26504301

  8. MicroRNA 181b Regulates Decorin Production by Dermal Fibroblasts and May Be a Potential Therapy for Hypertrophic Scar

    PubMed Central

    Kwan, Peter; Ding, Jie; Tredget, Edward E.

    2015-01-01

    Hypertrophic scarring is a frequent fibroproliferative complication following deep dermal burns leading to impaired function and lifelong disfigurement. Decorin reduces fibrosis and induces regeneration in many tissues, and is significantly downregulated in hypertrophic scar and normal deep dermal fibroblasts. It was hypothesized that microRNAs in these fibroblasts downregulate decorin and blocking them would increase decorin and may prevent hypertrophic scarring. Lower decorin levels were found in hypertrophic scar as compared to normal skin, and in deep as compared to superficial dermis. A decorin 3’ un-translated region reporter assay demonstrated microRNA decreased decorin in deep dermal fibroblasts, and microRNA screening predicted miR- 24, 181b, 421, 526b, or 543 as candidates. After finding increased levels of mir-181b in deep dermal fibroblasts, it was demonstrated that TGF-?1 stimulation decreased miR-24 but increased miR-181b and that hypertrophic scar and deep dermis contained increased levels of miR-181b. By blocking miR-181b with an antagomiR, it was possible to increase decorin protein expression in dermal fibroblasts. This suggests miR-181b is involved in the differential expression of decorin in skin and wound healing. Furthermore, blocking miR-181b reversed TGF-?1 induced decorin downregulation and myofibroblast differentiation in hypertrophic scar fibroblasts, suggesting a potential therapy for hypertrophic scar. PMID:25837671

  9. A Quantitative Approach to Scar Analysis

    PubMed Central

    Khorasani, Hooman; Zheng, Zhong; Nguyen, Calvin; Zara, Janette; Zhang, Xinli; Wang, Joyce; Ting, Kang; Soo, Chia

    2011-01-01

    Analysis of collagen architecture is essential to wound healing research. However, to date no consistent methodologies exist for quantitatively assessing dermal collagen architecture in scars. In this study, we developed a standardized approach for quantitative analysis of scar collagen morphology by confocal microscopy using fractal dimension and lacunarity analysis. Full-thickness wounds were created on adult mice, closed by primary intention, and harvested at 14 days after wounding for morphometrics and standard Fourier transform-based scar analysis as well as fractal dimension and lacunarity analysis. In addition, transmission electron microscopy was used to evaluate collagen ultrastructure. We demonstrated that fractal dimension and lacunarity analysis were superior to Fourier transform analysis in discriminating scar versus unwounded tissue in a wild-type mouse model. To fully test the robustness of this scar analysis approach, a fibromodulin-null mouse model that heals with increased scar was also used. Fractal dimension and lacunarity analysis effectively discriminated unwounded fibromodulin-null versus wild-type skin as well as healing fibromodulin-null versus wild-type wounds, whereas Fourier transform analysis failed to do so. Furthermore, fractal dimension and lacunarity data also correlated well with transmission electron microscopy collagen ultrastructure analysis, adding to their validity. These results demonstrate that fractal dimension and lacunarity are more sensitive than Fourier transform analysis for quantification of scar morphology. PMID:21281794

  10. Microneedling Therapy for Atrophic Acne Scars

    PubMed Central

    Barakat, Manal; Awad, Sherif; Medhat, Walid; El-Fakahany, Hasan; Farag, Hanna

    2015-01-01

    Objective: Treatment of acne scarring is always a challenge. Microneedling therapy or percutaneous collagen induction is a new addition to the treatment modalities for such scars and has been reported to be simple and effective in atrophic acne scar treatment. The aim of this study is to evaluate the clinical effect and objectively quantify the histological changes of acne scarring in response to skin microneedling. Design: A prospective clinical study. Participants: Ten patients with different types of atrophic acne scars were subjected to three months of skin microneedling treatment (six sessions at two-week intervals). Measurements: Patients were photographed, and skin biopsies were obtained at baseline as well as one and three months from the start of treatment. Histometry for epidermal thickness and quantitative evaluation of total elastin; newly synthesized tropoelastin; collagen types I, III, and VII; and newly synthesized collagen were performed for all biopsies. Results: Compared to the baseline, patients’ evaluations revealed noticeable clinical improvement in atrophic post-acne scars in response to skin microneedling. There was a statistically significant increase (p<0.05) in the mean of collagen types I, III, and VII and newly synthesized collagen, while total elastin was significantly decreased (p<0.05) after the end of treatment. Conclusions: Multiple minimally invasive sessions of skin microneedling are an effective treatment for post-acne atrophic scars as it stimulates the repair processes with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time. PMID:26203319

  11. Treatment of Hypertrophic Scar in Human with Autologous Transplantation of Cultured Keratinocytes and Fibroblasts along with Fibrin Glue

    PubMed Central

    Taghiabadi, Ehsan; Mohammadi, Parvaneh; Aghdami, Nasser; Falah, Nasrin; Orouji, Zahra; Nazari, Abdoreza; Shafieyan, Saeed

    2015-01-01

    Objective Hypertrophic scar involves excessive amounts of collagen in dermal layer and may be painful. Nowadays, we can’t be sure about effectiveness of procedure for hypertrophic scar management. The application of stem cells with natural scaffold has been the best option for treatment of burn wounds and skin defect, in recent decades. Fibrin glue (FG) was among the first of the natural biomaterials applied to enhance skin deformity in burn patients. This study aimed to identify an efficient, minimally invasive and economical transplantation procedure using novel FG from human cord blood for treatment of hypertrophic scar and regulation collagen synthesis. Materials and Methods In this case series study, eight patients were selected with hypertrophic scar due to full-thickness burns. Human keratinocytes and fibroblasts derived from adult skin donors were isolated and cultured. They were tested for the expression of cytokeratin 14 and vimentin using immunocytochemistry. FG was prepared from pooled cord blood. Hypertrophic scars were extensively excised then grafted by simply placing the sheet of FG containing autologous fibroblast and keratinocytes. Histological analyses were performed using Hematoxylin and eosin (H&E) and Masson’s Trichrome (MT) staining of the biopsies after 8 weeks. Results Cultured keratinocytes showed a high level of cytokeratin 14 expression and also fibroblasts showed a high level of vimentin. Histological analyses of skin biopsies after 8 weeks of transplantation revealed re-epithelialization with reduction of hypertrophic scars in 2 patients. Conclusion These results suggest may be the use of FG from cord blood, which is not more efficient than previous biological transporters and increasing hypertrophic scar relapse, but could lead to decrease pain rate. PMID:25870834

  12. Collagenase Dupuytren Contracture: Achieving Single Treatment Success with a Hand Therapist-Based Protocol

    PubMed Central

    Malafa, Menyoli M.; Lehrman, Craig; Criley, Jerry W.

    2016-01-01

    Background: Surgery remains the gold standard in the treatment of Dupuytren contracture but is technically demanding, carries significant risk of complications, and requires prolonged recovery time. Collagenase injection is an efficacious alternative to surgery; however, contracture release often requires multiple treatments spaced a month apart. We report our experience with a new collagenase treatment protocol aimed to minimize the total treatment time per joint contracture. Methods: We performed a single institution retrospective review of patients with Dupuytren contracture treated with collagenase using our protocol from 2011 to 2013. Patients returned 24 hours after collagenase injection for cord manipulation by a certified hand therapist while under digital block. Treatment success was defined as reduction in contracture to 5 degrees or less. Successfully treated joints were evaluated for recurrence (>10 degrees contracture) at 30-day and 6-month follow-up appointments. Serious adverse events, including skin tears, were recorded. Results: Success was achieved in 36 of 47 treated joints (76.6%) after a single injection. There were 2 recurrences in 32 joints at 30-day follow-up (6.2%) and no recurrences in 17 joints available at 6-month follow-up. Skin tears were the only serious adverse event occurring in 18 of 47 cord ruptures (38.3%). All healed secondarily without complication. Conclusions: Our protocol preserves treatment efficacy while maximizing efficiency. Achieving successful cord rupture with a single injection allows earlier return of function, reduced cost of treatment, and increased convenience for the patient. Patients, particularly those with greater contractures, should be counseled regarding the risk of skin tear during cord manipulation. PMID:27014558

  13. Outcomes of outpatient management of pediatric burns.

    PubMed

    Brown, Matthew; Coffee, Tammy; Adenuga, Paul; Yowler, Charles J

    2014-01-01

    The literature surrounding pediatric burns has focused on inpatient management. The goal of this study is to characterize the population of burned children treated as outpatients and assess outcomes validating this method of burn care. A retrospective review of 953 patients treated the burn clinic and burn unit of a tertiary care center. Patient age, burn etiology, burn characteristics, burn mechanism, and referral pattern were recorded. The type of wound care and incidence of outcomes including subsequent hospital admission, infection, scarring, and surgery served as the primary outcome data. Eight hundred and thirty children were treated as outpatients with a mean time of 1.8 days for the evaluation of burn injury in our clinic. Scalds accounted for 53% of the burn mechanism, with burns to the hand/wrist being the most frequent area involved. The mean percentage of TBSA was 1.4% for the outpatient cohort and 8% for the inpatient cohort. Burns in the outpatient cohort healed with a mean time of 13.4 days. In the outpatient cohort, nine (1%) patients had subsequent admissions and three (0.4%) patients had concern for infection. Eight patients from the outpatient cohort were treated with excision and grafting. The vast majority of pediatric burns are small, although they may often involve more critical areas such as the face and hand. Outpatient wound care is an effective treatment strategy which results in low rates of complications and should become the standard of care for children with appropriate burn size and home support. PMID:25055004

  14. Cesarean scar endometrioma: Case series

    PubMed Central

    Çöl, Cavit; Yilmaz, Edip Erdal

    2014-01-01

    AIM: To evaluate endometrioma located at cesarean scatrix. METHODS: Medical data of 6 patients who presented to our institution with abdominal wall endometrioma were evaluated retrospectively and reviewed literature in this case series. The diagnostic approaches and treatment is discussed. RESULTS: All patients had a painful mass located at abdominal scars with history of cesarean section. The ages ranged from 31 to 34 and Doppler ultrasonography (US) detected hypoechoic mass with a mean diameter of 30 mm. Initial diagnosis was endometrioma in 4 and incisional hernia in 2 of 6 patients. Treatment was achieved with surgical excision in 5 patients, and one is followed by hormone suppression therapy with gonadotropin. CONCLUSION: Malignant or benign tumors of abdominal wall and incisional hernias should be kept in mind for diagnosis of endometrioma. Imaging methods like doppler US, computed tomography and magnetic resonance imaging should be used for differential diagnosis. Definitive diagnosis can only be made histopathologically. The treatment should be complete surgical excision and take care against intraoperative auto-inoculation of endometrial tissue in order to prevent recurrences. PMID:24868512

  15. Postburn galactorrhea with refractory hypertrophic scars: role of obesity under scrutiny.

    PubMed

    Saraiya, Hemant

    2003-01-01

    Postburn galactorrhea, although relatively uncommon, is a complex problem to treat. Three of 25 female premenopausal patients who were admitted during the years 1995 to 2001 with more than 40% TBSA burns developed this problem. All three patients were obese according to body mass index and other clinical criteria. It was observed that the additional disturbance of equilibrium of hypothalamus because of burn injury, which is already disturbed as per se in obese patients, precipitates sustained release of prolactin, leading to galactorrhea. Hyperinsulinemia because of obesity and associated reactive metabolic response of burn trauma contribute to the stimulation of prolactin secretion and sustained hyperprolactinemia. Interestingly, our patients who developed postburn galactorrhea also developed refractory hypertrophic scars not readily amenable to preventive and conservative therapeutic treatment methods. The responsible factor for its development can be a rise in prolactin levels with interplay of other hormones, such as melanocyte-stimulating hormone (MSH), from the anterior pituitary. Repeated serum prolactin measurements and early control of rising levels during the burn treatment, particularly in obese patients, are recommended. Early and vigorous measures to prevent scar hypertrophy also are advocated. In our study, we failed to correlate chest wall burns with galactorrhea. PMID:14610425

  16. Pressure therapy for hypertrophic scarrings: preliminary communication1

    PubMed Central

    Robertson, J C; Druett, J E; Hodgson, B; Druett, Jane

    1980-01-01

    A six-point programme for the prevention and pressure therapy of hypertrophic scarring started in 1975 at Odstock Hospital. The work reported here includes a pressure calibration of batches of the material chosen for pressure bandaging; a pressure study of the bandages on volunteers' limbs; and the formation of a pressure therapy clinic. The clinic results were similar to those reported by Thomson (1974) and were considered sufficiently favourable to justify continuing the clinic and instituting a policy of close review and early therapy for all burns patients. The programme proved the accuracy of the pressure sensor and attempted to develop an objective method of recording progress. Arguments for pressure versus occlusion as the therapeutic agent are discussed and supported by a case report. It is suggested that a controlled trial of pressure therapy should be carried out. PMID:7241460

  17. Lightning burns.

    PubMed

    Russell, Katie W; Cochran, Amalia L; Mehta, Sagar T; Morris, Stephen E; McDevitt, Marion C

    2014-01-01

    We present the case of a lightning-strike victim. This case illustrates the importance of in-field care, appropriate referral to a burn center, and the tendency of lightning burns to progress to full-thickness injury. PMID:23799482

  18. Answers to Common Questions about Scars

    MedlinePLUS

    ... Ideas Vehicle Donation Volunteer Efforts Answers to Common Questions About Scars skip to submenu Parents & Individuals Information ... 9044, Fax: (919) 933-9604 [Email] Have a question? Ask us! Thank you! We have received your ...

  19. SCAR-A Data and Information

    Atmospheric Science Data Center

    2015-11-19

    ... and Information Smoke/Sulfates, Clouds and Radiation - America (SCAR-A) data include physical and chemical components of ... Search and Order:  ASDC Order Tool Parameters:  Infrared Radiance Visible Radiance Order Data:  ...

  20. Proceedings of the SCAR Conference, Part 1

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The Supersonic Cruise Aircraft Research (SCAR) team analyzed six major topics: (1) aerodynamics, (2) stability and control, (3) propulsion, (4) environmental factor, (5) airframe structures and materials, and (6) design integration.

  1. Keratoacanthoma Centrifugum Marginatum with Atypical Scar

    PubMed Central

    Nag, Falguni; Biswas, Projna; Singha, Joydeep; Ghosh, Arghyaprasun; Surana, Trupti V.

    2012-01-01

    Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma (KA). It is characterized by a progressive peripheral expansion and central healing leaving atrophic scar. It is sometimes confused with squamous cell carcinoma (SCC) both clinically and histopathologically. We here report a case of KCM over the extensor aspect of the right forearm in a 57-year-old man with an abnormal looking scar. PMID:23259078

  2. Management of acid burns: experience from Bangladesh.

    PubMed

    Das, Kishore Kumar; Olga, Loren; Peck, Michael; Morselli, Paolo G; Salek, A J M

    2015-05-01

    Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial. PMID:25440856

  3. Frequency of placenta previa in previously scarred and non scarred uterus

    PubMed Central

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    Objective: To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. Methods: A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008– December 2011. Results: Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. Conclusion: A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus. PMID:26101491

  4. The incidence of burns among sex-trafficking victims in India.

    PubMed

    Rahman, Nadia; Sinha, Indranil; Husain, Fatima; Shah, Ajul; Patel, Anup

    2014-09-01

    Sex trafficking remains a flagrant violation of human rights, creating many public health concerns. During the initiation period, these victims experience acts of violence including gang rapes, subjecting them to traumatic injuries that include burns. Furthermore, lack of access to health care, particularly surgical, keeps them from receiving treatment for these functionally debilitating contractures caused by burns. This piece provides an overview of burns among sex-trafficked victims in India and the efforts by Cents of Relief to address the associated surgical burden of disease. PMID:25191142

  5. The Incidence of Burns Among Sex-Trafficking Victims in India

    PubMed Central

    Rahman, Nadia; Sinha, Indranil; Husain, Fatima; Shah, Ajul; Patel, Anup

    2014-01-01

    Sex trafficking remains a flagrant violation of human rights, creating many public health concerns. During the initiation period, these victims experience acts of violence including gang rapes, subjecting them to traumatic injuries that include burns. Furthermore, lack of access to health care, particularly surgical, keeps them from receiving treatment for these functionally debilitating contractures caused by burns. This piece provides an overview of burns among sex-trafficked victims in India and the efforts by Cents of Relief to address the associated surgical burden of disease. PMID:25191142

  6. The diagnostic management of newborns with congenital contractures: a nosologic study of 75 cases.

    PubMed

    Hageman, G; Ippel, E P; Beemer, F A; de Pater, J M; Lindhout, D; Willemse, J

    1988-08-01

    A prospective clinical study is presented of 75 patients with multiple congenital contractures. With the data from medical history, child neurologic examinations, laboratory tests including chromosome and dermatoglyphic analysis, and neuropathology in 23 cases with perinatal death, a nosological or syndromal diagnosis was made in 61 cases. These cases were classified by localization of causal pathology in the categories "cerebral dysgenesis", spinal cord defects, neuromuscular disorders and miscellaneous disorders without muscle weakness. Following this concept, the various modes of inheritance of specific disorders presenting with congenital contractures, as well as possibilities for prenatal diagnosis by ultrasonography are discussed. A guideline for the child neurologic evaluation of infants with congenital contractures is proposed. It is concluded that: 1) specification of the causal lesion and proper classification of disorders with congenital contractures is crucial for genetic counseling, (prenatal) diagnosis and management; 2) the analysis of dermatoglyphics in differential diagnosis of congenital contractures should be restudied; and 3) more study and experience is required in the observation of abnormal or decreased fetal movements by ultrasonography. PMID:3189411

  7. Increased CCT-eta expression is a marker of latent and active disease and a modulator of fibroblast contractility in Dupuytren's contracture.

    PubMed

    Satish, Latha; O'Gorman, David B; Johnson, Sandra; Raykha, Christina; Gan, Bing Siang; Wang, James H-C; Kathju, Sandeep

    2013-07-01

    Dupuytren's contracture (DC) is a fibroproliferative disorder of unknown etiology characterized by a scar-like contracture that develops in the palm and/or digits. We have previously reported that the eta subunit of the chaperonin containing T-complex polypeptide (CCT-eta) is increased in fibrotic wound healing, and is essential for the accumulation of ?-smooth muscle actin (?-SMA) in fibroblasts. The purpose of this study was to determine if CCT-eta is similarly implicated in the aberrant fibrosis seen in DC and to investigate the role of CCT-eta in the behavior of myo/fibroblasts in DC. Fibroblasts were obtained from DC-affected palmar fascia, from adjacent phenotypically normal palmar fascia in the same DC patients (PF), and from non-DC palmar fascial tissues in patients undergoing carpal tunnel (CT) release. Inherent contractility in these three populations was examined using fibroblast-populated collagen lattices (FPCLs) and by cell traction force microscopy. Expression of CCT-eta and ?-SMA protein was determined by Western blot. The effect of CCT-eta inhibition on the contractility of DC cells was determined by deploying an siRNA versus CCT-eta. DC cells were significantly more contractile than both matching palmar fascial (PF) cells and CT cells in both assays, with PF cells demonstrating an intermediate contractility in the FPCL assay. Whereas ?-SMA protein was significantly increased only in DC cells compared to PF and CT cells, CCT-eta protein was significantly increased in both PF and DC cells compared to CT cells. siRNA-mediated depletion of CCT-eta inhibited the accumulation of both CCT-eta and ?-SMA protein in DC cells, and also significantly decreased the contractility of treated DC cells. These observations suggest that increased expression of CCT-eta appears to be a marker for latent and active disease in these patients and to be essential for the increased contractility exhibited by these fibroblasts. PMID:23292503

  8. Presence of modified fibroblasts in ischemic contracture of the intrinsic musculature of the hand.

    PubMed

    Madden, J W; Carlson, E C; Hines, J

    1975-04-01

    Biopsies of fibrotic interosseous muscles were obtained from three patients with ischemic contracture of the intrinsic muscles of the hand. Control biopsies were taken from normal contralateral interossei and from normal interossei crushed three weeks earlier. Examination of the specimens from the affected muscles under the electron microscope demonstrated large numbers of modified fibroblasts with ultrastructural features of both fibroblasts and smooth muscle cells. The atypical fibroblasts observed resembled myofibroblasts seen in contracting wounds, Dupuytren's contracture, stenosing tenosynovitis, and idiopathic carpel tunnel syndrome. Biopsies from normal muscle and crushed normal muscle contained normal fibroblasts and smooth muscle cells but no modified fibroblasts. Active contraction of modified fibroblasts could be responsible for progressive muscle shortening seen in intrinsic contracture. PMID:1129660

  9. A randomized comparative study of two methods for controlling Tendo Achilles contracture in Duchenne muscular dystrophy.

    PubMed

    Hyde, S A; Fl?ytrup, I; Glent, S; Kroksmark, A K; Salling, B; Steffensen, B F; Werlauff, U; Erlandsen, M

    2000-06-01

    A 30-month prospective randomized study of 27 Scandinavian boys with confirmed diagnosis of Duchenne muscular dystrophy was done to compare the effect of passive stretching combined with the use of night splints (group A) or passive stretching (group B) on the evolution of Tendo Achilles contractures. Assessments were based on the methodology of Scott et al. (Muscle Nerve 1982;5:291-301)Analysis of the pattern and mechanism of dropout was done to eliminate bias between the two groups. Logistic regression showed that Tendo Achilles contracture was the most important variable (P=0.0020) for dropout. Methods of statistical analysis for longitudinal data avoiding induced serial correlations were used in the analysis. The expected annual change in Tendo Achilles contracture was found to be 23% less in group A than in group B after equalization for total muscle strength (%MRC). PMID:10838252

  10. Biomass Burning

    NASA Technical Reports Server (NTRS)

    Levine, Joel S.; Cofer, Wesley R., III; Pinto, Joseph P.

    1993-01-01

    Biomass burning may be the overwhelming regional or continental-scale source of methane (CH4) as in tropical Africa and a significant global source of CH4. Our best estimate of present methane emissions from biomass burning is about 51.9 Tg/yr, or 10% of the annual methane emissions to the atmosphere. Increased frequency of fires that may result as the Earth warms up may result in increases in this source of atmospheric methane.

  11. The Spectrum of Histopathological Lesions in Scarring Alopecia: A Prospective Study

    PubMed Central

    Kumar U., Mahesh; Yelikar, Balasaheb Ramling

    2013-01-01

    Introduction: The aim of the article was to study the histopathological features of various lesions of Scarring Alopecia (SA) and to classify Primary SA on the basis of the predominant type of inflammatory cell component. Scarring or cicatricial alopecias are those that are produced as a result of the malformation, damage or destruction of the pilosebaceous follicles, which are replaced by cicatricial tissue, in such a way that they cannot again produce hair. Material and Methods: This prospective study included 32 biopsy – proven cases of SA, who had attended our hospital. Primary SA was classified according to the North American Hair Research Society. The informed consents of the subjects and the institutional ethical clearance was obtained for the study. The SPSS, version 14 software was used to analyse the data. Frequencies and percentages were used to describe the data. Results: During the study period, 32 cases of scarring alopecia were diagnosed, of which 24 were primary SA and 8 were secondary SA. Among the primary SA, there were 23 cases of lymphocyte associated primary scarring alopecias, of which, 19 of lupus erythematosus, 3 of lichen planopilaris (LPP) and one case of non specific SA. 1 case of neutrophil associated primary scarring (folliculitis decalvans) was also noted and among the secondary SA, there were 4 cases of morphea and 1 case each of lupus vulgaris, congenital absence of skin, burn and sarcoidosis. Conclusion: To conclude, histopathology is a dependable tool for identifying the underlying cause in scarring alopecia, which is helpful for an early diagnosis and treatment. PMID:23998068

  12. Cooling of burns: Mechanisms and models.

    PubMed

    Wright, E H; Harris, A L; Furniss, D

    2015-08-01

    The role of cooling in the acute management of burns is widely accepted in clinical practice, and is a cornerstone of basic first aid in burns. This has been underlined in a number of animal models. The mechanism by which it delivers its benefit is poorly understood, but there is a reduction in burns progression over the first 48 h, reduced healing time, and some subjective improvements in scarring when cooling is administered after burning. Intradermal temperature normalises within a matter of seconds to a few minutes, yet the benefits of even delayed cooling persist, implying it is not simply the removal of thermal energy from the damaged tissues. Animal models have used oedema formation, preservation of dermal perfusion, healing time and hair retention as indicators of burns severity, and have shown cooling to improve these indices, but pharmacological or immunological blockade of humoural and cellular mediators of inflammation did not reproduce the benefit of cooling. More recently, some studies of tissue from human and animal burns have shown consistent, reproducible, temporal changes in gene expression in burned tissues. Here, we review the experimental evidence of the role and mechanism of cooling in burns management, and suggest future research directions that may eventually lead to improved treatment outcomes. PMID:25820085

  13. Evaluating the accuracy of a MODIS direct broadcast algorithm for mapping burned areas over Russia

    NASA Astrophysics Data System (ADS)

    Petkov, A.; Hao, W. M.; Nordgren, B.; Corley, R.; Urbanski, S. P.; Ponomarev, E. I.

    2012-12-01

    Emission inventories for open area biomass burning rely on burned area estimates as a key component. We have developed an automated algorithm based on MODerate resolution Imaging Spectroradiometer (MODIS) satellite instrument data for estimating burned area from biomass fires. The algorithm is based on active fire detections, burn scars from MODIS calibrated radiances (MOD02HKM), and MODIS land cover classification (MOD12Q1). Our burned area product combines active fires and burn scar detections using spatio-temporal criteria, and has a resolution of 500 x 500 meters. The algorithm has been used for smoke emission estimates over the western United States. We will present the assessed accuracy of our algorithm in different regions of Russia with intense wildfire activity by comparing our results with the burned area product from the Sukachev Institute of Forest (SIF) of the Russian Academy of Sciences in Krasnoyarsk, Russia, as well as burn scars extracted from Landsat imagery. Landsat burned area extraction was based on threshold classification using the Jenks Natural Breaks algorithm to the histogram for each singe scene Normalized Burn Ratio (NBR) image. The final evaluation consisted of a grid-based approach, where the burned area in each 3 km x 3 km grid cell was calculated and compared with the other two sources. A comparison between our burned area estimates and those from SIF showed strong correlation (R2=0.978), although our estimate is approximately 40% lower than the SIF burned areas. The linear fit between the burned area from Landsat scenes and our MODIS algorithm over 18,754 grid cells resulted with a slope of 0.998 and R2=0.7, indicating that our algorithm is suitable for mapping burned areas for fires in boreal forests and other ecosystems. The results of our burned area algorithm will be used for estimating emissions of trace gasses and aerosol particles (including black carbon) from biomass burning in Northern Eurasia for the period of 2002-2011.

  14. Evaluating evidence for atrophic scarring treatment modalities

    PubMed Central

    McGrouther, Duncan; Chakrabarty, Kaushik

    2014-01-01

    Summary Introduction Atrophic scars cause significant patient morbidity. Whilst there is evidence to guide treatment, there does not appear to be a systematic review to analyse the efficacy of treatment options. Objectives To retrieve all evidence relating to atrophic scar treatment and evaluate using the Clinical Evidence GRADE score in order to allow clinicians to make evidence-based treatment choices. Method Searches were performed in Medline, EMBASE, CINHL and Cochrane to identify all English studies published evaluating treatment of atrophic scars on adults excluding journal letters. Each study was allocated a GRADE score based on type of study, quality, dose response, consistency of results and significance of results. The end score allowed categorisation of evidence into high, moderate, low or very low quality. Results A total of 41 studies were retrieved from searches including randomised controlled trials, observational studies, retrospective analyses and case reports of which 7% were allocated a high-quality score, 10% a moderate score, 7% a low score and 75% a very low score. Treatment modalities included ablative laser therapy, non-ablative laser therapy, autologous fat transfer, dermabrasion, chemical peels, injectables, subcision, tretinoin iontophoresis and combination therapy. Conclusion There is a paucity of good-quality clinical evidence evaluating treatment modalities for atrophic scarring. Evidence supports efficacy of laser, surgery and peel therapy. Further biomolecular research is required to identify targeted treatment options and more randomised controlled trials would make the evidence base for atrophic scar treatment more robust. PMID:25352991

  15. Observations of atmospheric methane and carbon monoxide in Brazil: SCAR-B mission

    NASA Astrophysics Data System (ADS)

    Alvala, Plinio C.; Kirchhoff, Volker W. J. H.

    1998-12-01

    Methane (CH4) concentrations have been measured in the lower atmosphere in Brazil on board a Brazilian research aircraft. Air samples were obtained at different heights by grab sampling, and taken for analysis by flame ionization detector (FID) gas chromatography at INPE (the Brazilian Institute for Space Research). The sampling region is the cerrado area of central Brazil, around the cities of Brasilia, Cuiaba, Alta Floresta, and Porto Nacional. Instead of concentrating on plume characteristics, an effort was made to describe the average mixed atmosphere, keeping a distance from direct burning sources. The measurements of atmospheric CH4 during the dry season have shown larger mixing ratios compared to the wet season. This finding has consistently been observed for different dry seasons, but especially for the Smoke, Clouds, and Radiation: Brazil (SCAR-B) field mission. For comparison, measurements near the ground in a region not directly affected by biomass burning (Natal, Brazil) show concentrations that are 39 parts per billion by volume (ppbv) less than the biomass burning results, which is 4 times the size of the seasonal amplitude at oceanic stations within about 10° of the equator, thus making the biomass burning values comparable to those observed at northern hemisphere midlatitudes. The vertical distribution for these regions seems to be well mixed, showing differences of about 40 ppbv between the different sampling areas of the SCAR-B experiment. The CH4 mixing ratio was in general well correlated with the CO mixing ratio.

  16. Early second trimester uterine scar rupture

    PubMed Central

    Bharatnur, Sunanda; Hebbar, Shripad; G, Shyamala

    2013-01-01

    Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19?weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as a differential diagnosis in pregnant women presenting with acute abdomen. In this case, although there was uterine rupture in the second trimester and a complete placental separation, fetus was alive which is quite unusual in patients presenting with rupture uterus. PMID:24326433

  17. Early second trimester uterine scar rupture.

    PubMed

    Bharatnur, Sunanda; Hebbar, Shripad; Shyamala, G

    2013-01-01

    Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19 weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as a differential diagnosis in pregnant women presenting with acute abdomen. In this case, although there was uterine rupture in the second trimester and a complete placental separation, fetus was alive which is quite unusual in patients presenting with rupture uterus. PMID:24326433

  18. Fraxelated radiofrequency device for acne scars

    NASA Astrophysics Data System (ADS)

    Rao, Babar K.; Khokher, Sairah

    2012-09-01

    Acne scars can be improved with various treatments such as topical creams, chemical peels, dermal fillers, microdermabrasion, laser, and radiofrequency devices. Some of these treatments especially lasers and deep chemical peels can have significant side effects such as post inflammatory hyperpigmentation in darker skin types. Fraxelated RF Laser devices have been reported to have lower incidence of side effects in all skin phototypes. Nine patients between ages 18 and 35 of various skin phototypes were selected from a private practice and treated with a RF fraxelated device (E-matrix) for acne scars. Outcomes were measured by physician observation, subjective feedback received by patients, and comparison of before and after photographs. In this small group of patients with various skin phototypes, fraxelated radiofrequency device improved acne scars with minimal side effects and downtime.

  19. Treatment of hypertrophic scars and keloids with a fractional CO2 laser: a personal experience.

    PubMed

    Scrimali, Luca; Lomeo, Giuseppe; Nolfo, Corrado; Pompili, Gianluca; Tamburino, Serena; Catalani, Alexei; Siragò, Paolo; Perrotta, Rosario Emanuele

    2010-10-01

    Keloids and hypertrophic scars are both abnormal wound responses in predisposed individuals but they differ in that keloids extend beyond the original wound and almost never regress, while hypertrophic scars remain within the original wound and tend to regress. How keloids grow is not totally clear because there is no animal model; in fact, keloids affect only humans. Different injuries can result in keloids, including burns, surgery, ear piercing, lacerations, abrasions, tattooing, vaccinations, injections, insect bites and any process causing skin inflammation (chicken pox, acne, folliculitis, zoster). Skin or wound tension is considered a critical factor in the formation of keloids and hypertrophic scars. This study is based on eight consecutive patients (four females and four males, F:M = 1:1) with a total of 12 keloids. All of whom were treated monthly with a MiXto SX CO(2) laser, using 13 W of power, 8 SX of index and 40% coverage (density) in combination with Same Plast Gel(®) twice a day. Each scar required 12 treatments, and all the patients, followed up for 1 year after the last treatment, had optimum results and no recurrence. PMID:20825256

  20. Inflammation and cutaneous nervous system involvement in hypertrophic scarring

    PubMed Central

    Li, Shao-hua; Yang, Heng-lian; Xiao, Hu; Wang, Yi-bing; Wang, De-chang; Huo, Ran

    2015-01-01

    This study aimed to use a mouse model of hypertrophic scarring by mechanical loading on the dorsum of mice to determine whether the nervous system of the skin and inflammation participates in hypertrophic scarring. Results of hematoxylin-eosin and immunohistochemical staining demonstrated that inflammation contributed to the formation of a hypertrophic scar and increased the nerve density in scar tissue.Western blot assay verified that interleukin-13 expression was increased in scar tissue. These findings suggest that inflammation and the cutaneous nervous system play a role in hypertrophic scar formation. PMID:26692869

  1. Ankle Plantar-Flexion Contracture Complication After Aesthetic Calf Volume Reduction Procedure.

    PubMed

    Han, Seung Hwan; Chung, Nam Su; Park, Do Young

    2015-07-01

    Minimally invasive, aesthetic calf volume reduction procedures are considered to be relatively safe. Published complications are mostly transient, with minimal functional loss. We hereby report debilitating ankle plantar-flexion contracture after aesthetic calf volume reduction procedure by selective neurectomy, with magnetic resonance imaging analysis and surgical treatment outcomes of this complication. From 2009 to 2010, 11 patients (17 lower legs) were surgically treated for this complication. The average preoperative ankle contracture angle of all involved lower legs was -22 degrees (range, -5 to -30 degrees). Magnetic resonance imaging performed in 14 lower legs showed lesions indicative of denervation atrophy, with fibrotic lesions causing longitudinal shortening of the gastrocnemius muscle. Of the 17 ankle contractures, 15 Silfverskiöld test-positive cases received miniopen gastrocnemius release, whereas 2 Silfverskiöld test-negative cases received Achilles tendon lengthening by percutaneous triple hemiresection. At last follow-up, the dorsiflexion angle of all ankles improved to an average of 25 degrees (range, 20-30 degrees) with full plantar flexion in all patients, whereas the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale scores improved from an average of 59.2 to 94.2. Surgeons and patients alike should be aware of debilitating ankle planter flexion contractures after aesthetic calf volume reduction procedures. Using minimally invasive gastrocnemius and Achilles tendon release, we were able to provide symptomatic and functional relief from this complication with minimal cosmetic sacrifice. PMID:24727446

  2. Kuskokwim syndrome, a recessive congenital contracture disorder, extends the phenotype of FKBP10 mutations

    PubMed Central

    Barnes, Aileen M.; Duncan, Geraldine; Weis, MaryAnn; Paton, William; Cabral, Wayne A.; Mertz, Edward L.; Makareeva, Elena; Gambello, Michael J.; Lacbawan, Felicitas L.; Leikin, Sergey; Fertala, Andrzej; Eyre, David R.; Bale, Sherri J.; Marini, Joan C.

    2013-01-01

    Recessive mutations in FKBP10 at 17q21.2, encoding FKBP65, cause both osteogenesis imperfecta (OI) and Bruck syndrome (OI plus congenital contractures). Contractures are a variable manifestation of null/missense FKBP10 mutations. Kuskokwim syndrome (KS) is an autosomal recessive congenital contracture disorder found among Yup’ik Eskimos. Linkage mapping of KS to chromosome 17q21, together with contractures as a feature of FKBP10 mutations, made FKBP10 a candidate gene. We identified a homozygous 3-nucleotide deletion in FKBP10 (c.877_879delTAC) in multiple Kuskokwim pedigrees; 3% of regional controls are carriers. The mutation deletes the highly conserved p.Tyr293 residue in FKBP65’s 3rd PPIase domain. FKBP10 transcripts are normal, but mutant FKBP65 is destabilized to a residual 5%. Collagen synthesized by KS fibroblasts has substantially decreased hydroxylation of the telopeptide lysine crucial for collagen cross-linking, with 2–10% hydroxylation in probands vs 60% in controls. Matrix deposited by KS fibroblasts has marked reduction in maturely cross-linked collagen. KS collagen is disorganized in matrix, and fibrils formed in vitro had subtle loosening of monomer packing. Our results imply that FKBP10 mutations affect collagen indirectly, by ablating FKBP65 support for collagen telopeptide hydroxylation by LH2, thus decreasing collagen crosslinks in tendon and bone matrix. FKBP10 mutations may also underlie other arthrogryposis syndromes. PMID:23712425

  3. Kuskokwim syndrome, a recessive congenital contracture disorder, extends the phenotype of FKBP10 mutations.

    PubMed

    Barnes, Aileen M; Duncan, Geraldine; Weis, Maryann; Paton, William; Cabral, Wayne A; Mertz, Edward L; Makareeva, Elena; Gambello, Michael J; Lacbawan, Felicitas L; Leikin, Sergey; Fertala, Andrzej; Eyre, David R; Bale, Sherri J; Marini, Joan C

    2013-09-01

    Recessive mutations in FKBP10 at 17q21.2, encoding FKBP65, cause both osteogenesis imperfecta (OI) and Bruck syndrome (OI plus congenital contractures). Contractures are a variable manifestation of null/missense FKBP10 mutations. Kuskokwim syndrome (KS) is an autosomal recessive congenital contracture disorder found among Yup'ik Eskimos. Linkage mapping of KS to chromosome 17q21, together with contractures as a feature of FKBP10 mutations, made FKBP10 a candidate gene. We identified a homozygous three-nucleotide deletion in FKBP10 (c.877_879delTAC) in multiple Kuskokwim pedigrees; 3% of regional controls are carriers. The mutation deletes the highly conserved p.Tyr293 residue in FKBP65's third peptidyl-prolyl cis-trans isomerase domain. FKBP10 transcripts are normal, but mutant FKBP65 is destabilized to a residual 5%. Collagen synthesized by KS fibroblasts has substantially decreased hydroxylation of the telopeptide lysine crucial for collagen cross-linking, with 2%-10% hydroxylation in probands versus 60% in controls. Matrix deposited by KS fibroblasts has marked reduction in maturely cross-linked collagen. KS collagen is disorganized in matrix, and fibrils formed in vitro had subtle loosening of monomer packing. Our results imply that FKBP10 mutations affect collagen indirectly, by ablating FKBP65 support for collagen telopeptide hydroxylation by lysyl hydroxylase 2, thus decreasing collagen cross-links in tendon and bone matrix. FKBP10 mutations may also underlie other arthrogryposis syndromes. PMID:23712425

  4. "Understanding burns": research project BurnCase 3D--overcome the limits of existing methods in burns documentation.

    PubMed

    Haller, H L; Dirnberger, J; Giretzlehner, M; Rodemund, C; Kamolz, L

    2009-05-01

    Understanding burns means knowing what is necessary for the successful treatment of burns. Nobody in science, economics, or quality control can comprehend this issue's complexity without thorough documentation of the work involved. BurnCase 3D is a non-profit research project whose aim, achieved through software of the same name, is a thorough and accurate burn-treatment documentation schema, facilitated by three-dimensional digital models tracked over time. Adapting these models on the basis of gender, height, weight, and body shape avoids systemic errors. Superimposing photos of the burned areas on the model prevents individual error and can be combined with methods of burn-depth evaluation. The program includes automatic encoding of diagnostic and therapeutic procedures. Model resolution is 1cm(2) and finer, so that even small scars' locations and extents can be documented, thus enabling registration of long-term results. The program's status as a multilingual data-collection tool brings together multiple international efforts in data collection, and makes it suitable for e-medicine and disaster relief. In its basic form, it provides essential functions in burn documentation, photo documentation, and reporting. The four-dimensional database allows registration of interactions over time and can demonstrate the influence of location, timing, and intervention on outcome. PMID:18950947

  5. Reclaiming body image: the hidden burn.

    PubMed

    Willis-Helmich, J J

    1992-01-01

    At the age of 4, I incurred a major burn injury that left 45% of my body with permanent scars. Normal clothing covers most of the scars. I was able to reclaim a positive body image through a gradual process of verbal and "body" disclosure. As an adult, I joined a burn survivors' self-help group; as a result of talking with other burn survivors, my self expectations increased. Later, I joined a facilitated group in which nudity and personal growth were the norm. In this group, I was the only person who had experienced a major physical trauma. I replaced my strongly held beliefs that others could not accept my unclothed, burn-injured body with the belief that some persons can, and I came to a personal understanding of why others could not. Fun, exercise, and relaxation led to a reclamation of positive feelings about my unclothed body and allowed my femininity and the character of my body image to emerge and become integrated. PMID:1572860

  6. Laparoscopic Treatment of Cesarean Scar Ectopic Pregnancy

    PubMed Central

    Felsingerová, Zuzana; Felsinger, Michal; Jandakova, Eva

    2014-01-01

    Abstract Background: An ectopic pregnancy within a Cesarean scar represents a rare type of extrauterine pregnancy in which the fertilized egg nidates in the myometrium of the uterine wall within a scar left from a previous Cesarean delivery. An unrecognized growing Cesarian scar pregnancy may result in uterine rupture, uncontrollable metrorrhagia, and bleeding into the abdominal cavity; therefore, early diagnosis and therapy are necessary to prevent the development of severe complications. Case: A 34-year-old woman after a previous Cesarean delivery presented with amenorrhoa of 7 weeks' duration. Transvaginal ultrasonography revealed an ectopic pregnancy in the Cesarean scar, and a laparoscopic removal of the gestational sac was performed with no complications. Results: Three months later, another laparoscopy with chromopertubation showed no signs of penetration in the suture, both the Fallopian tubes being bilaterally passable. The patient was advised that she could try to achieve pregnancy through spontaneous conception, after which monitoring of the gestational development and a careful assessment of the nidation site would be needed. Conclusions: Laparoscopic surgical management of a viable ectopic pregnancy is technically simple, and is followed by a good recovery. (J GYNECOL SURG 30:309) PMID:25336858

  7. Corneal heat scar caused by photodynamic therapy performed through an implanted corneal inlay.

    PubMed

    Mita, Mariko; Kanamori, Tomomi; Tomita, Minoru

    2013-11-01

    A 60-year-old man had a combination of laser in situ keratomileusis and Kamra corneal inlay implantation to correct presbyopia. Although the outcome was favorable postoperatively, central serous chorioretinopathy was observed in the left eye along with a decrease in the uncorrected (UDVA) and corrected (CDVA) distance visual acuities and the corrected near visual acuity (CNVA). Photodynamic therapy (PDT) was later performed in a university hospital. After PDT, the patient experienced a decline in the visual acuity and came to our clinic a month after the PDT. Degeneration and a scar were observed at the location of the inlay due to the heat and burning. Flattening of the corneal topography was also observed where the corneal scar was located, along with a significant decrease in CDVA in the left eye. Prior to any surgery in which the corneal inlay is an impediment, surgeons should take advantage of the reversibility of the Kamra inlay by explanting the inlay. PMID:24160386

  8. Burning Man

    ERIC Educational Resources Information Center

    Cech, Scott J.

    2006-01-01

    Former Baltimore cop and teacher Ed Burns isn't a masochist. The writer-producer for "The Wire," a critically applauded HBO series about life and death on the streets of Baltimore, is just feverishly trying to save public schools. He thinks American education is hopelessly screwed up, but that it's also the country's only hope. So it makes sense…

  9. Prescribed Burn

    USGS Multimedia Gallery

    Iowa State Grad students Devan McGranahan and Torre Hovick, along with DNR private land specialist Josh Rusk and ISU Research Technician Shannon Rusk ignite a prescribed fire on a patch-burn grazing research pasture in southern Iowa. The goals of the prescribed fire include reducing invasive eastern...

  10. Clinical effectiveness of dermal substitution in burns by topical negative pressure: a multicenter randomized controlled trial.

    PubMed

    Bloemen, Monica C T; van der Wal, Martijn B A; Verhaegen, Pauline D H M; Nieuwenhuis, Marianne K; van Baar, Margriet E; van Zuijlen, Paul P M; Middelkoop, Esther

    2012-01-01

    Previous research has shown clinical effectiveness of dermal substitution; however, in burn wounds, only limited effect has been shown. A problem in burn wounds is the reduced take of the autograft, when the substitute and graft are applied in one procedure. Recently, application of topical negative pressure (TNP) was shown to improve graft take. The aim of this study was to investigate if application of a dermal substitute in combination with TNP improves scar quality after burns. In a four-armed multicenter randomized controlled trial, a split-skin graft with or without a dermal substitute and with or without TNP was compared in patients with deep dermal or full-thickness burns requiring skin transplantation. Graft take and rate of wound epithelialization were evaluated. Three and 12 months postoperatively, scar parameters were measured. The results of 86 patients showed that graft take and epithelialization did not reveal significant differences. Significantly fewer wounds in the TNP group showed postoperative contamination, compared to other groups. Highest elasticity was measured in scars treated with the substitute and TNP, which was significantly better compared to scars treated with the substitute alone. Concluding, this randomized controlled trial shows the effectiveness of dermal substitution combined with TNP in burns, based on extensive wound and scar measurements. PMID:23110478

  11. A nude mouse model of hypertrophic scar shows morphologic and histologic characteristics of human hypertrophic scar.

    PubMed

    Momtazi, Moein; Kwan, Peter; Ding, Jie; Anderson, Colin C; Honardoust, Dariush; Goekjian, Serge; Tredget, Edward E

    2013-01-01

    Hypertrophic scar (HSc) is a fibroproliferative disorder that occurs following deep dermal injury. Lack of a relevant animal model is one barrier toward better understanding its pathophysiology. Our objective is to demonstrate that grafting split-thickness human skin onto nude mice results in survival of engrafted human skin and murine scars that are morphologically, histologically, and immunohistochemically consistent with human HSc. Twenty nude mice were xenografted with split-thickness human skin. Animals were euthanized at 30, 60, 120, and 180 days postoperatively. Eighteen controls were autografted with full-thickness nude mouse skin and euthanized at 30 and 60 days postoperatively. Scar biopsies were harvested at each time point. Blinded scar assessment was performed using a modified Manchester Scar Scale. Histologic analysis included hematoxylin and eosin, Masson's trichrome, toluidine blue, and picrosirius red staining. Immunohistochemistry included anti-human human leukocyte antigen-ABC, ?-smooth muscle actin, decorin, and biglycan staining. Xenografted mice developed red, shiny, elevated scars similar to human HSc and supported by blinded scar assessment. Autograft controls appeared morphologically and histologically similar to normal skin. Xenografts survived up to 180 days and showed increased thickness, loss of hair follicles, adnexal structures and rete pegs, hypercellularity, whorled collagen fibers parallel to the surface, myofibroblasts, decreased decorin and increased biglycan expression, and increased mast cell density. Grafting split-thickness human skin onto nude mice results in persistent scars that show morphologic, histologic, and immunohistochemical consistency with human HSc. Therefore, this model provides a promising technique to study HSc formation and to test novel treatment options. PMID:23126488

  12. Treatment modalities in severe mento-sternal synechia

    PubMed Central

    Ayhan, Meltem; Sevim, Kamuran Z; Gorgu, Metin

    2013-01-01

    Objective: Scar contracture of the neck after a burn-injury can cause both functional and aesthetic problems, and still presents a challenge for plastic surgeons. The anatomic area and adjacent structures such as the lower lip, trachea and neuro-vascular structures which are affected by the scar make treatment diffucult. Scarring and contracture of the neck region may severely limit function, cause alterations of normal posture and make intubation for surgery difficult. When a burn scar extends toward the face, eating and swallowing may be restricted and facial distortion may develop as the scar pulls the mouthdownwards even the lower eyelids. Method: Following the upper extremity, the neck is the most common site affected by burn contracture. The method chosen for contracture release, depends on the severity of scarring and extent of involvement. If the contracture area is limited, z-plasties, skin grafts or local skin flaps are adequate for the treatment but when the whole anterior neck is affected, the treatment modalities are limited and mostly skin grafts either meshed or unmeshed are used. Results: In this study we evaluated the usage of alternative teatment methods involving skin grafts and local flaps for severe neck contractures and tried to discuss oftenly encounered difficulties in treating these group of patients. Conclusion: Many techniques have been described for correction of neck contractures, including skin grafting, expanders, local regional flaps and free flaps. The treatment of choice should be modified for every patient. PMID:23638326

  13. [New concepts in local burn wound therapy].

    PubMed

    Behr, B; Megerle, K O; Germann, G; Kloeters, O

    2008-12-01

    Local burn wound care represents an integral part in the treatment of burn victims. A primary treatment goal is to prevent superficial infections, which can lead to life-threatening bacteraemia and sepsis. Secondary goals include improvement of functional and aesthetic outcome of the regenerating skin or scar tissue. Within the last few years numerous innovations have been evolved and some have already been incorporated into the clinical routine. In line with this, the first mid-term studies can be found in the literature. For instance, a hydrosurgical system can now be used for debridement and novel skin substitutes like Suprathel and Matriderm are commercially available. This review article summarises the most recent innovations in local burn wound care and puts them into a scientific perspective. PMID:19051160

  14. A Rat Excised Larynx Model of Vocal Fold Scar

    ERIC Educational Resources Information Center

    Welham, Nathan V.; Montequin, Douglas W.; Tateya, Ichiro; Tateya, Tomoko; Choi, Seong Hee; Bless, Diane M.

    2009-01-01

    Purpose: To develop and evaluate a rat excised larynx model for the measurement of acoustic, aerodynamic, and vocal fold vibratory changes resulting from vocal fold scar. Method: Twenty-four 4-month-old male Sprague-Dawley rats were assigned to 1 of 4 experimental groups: chronic vocal fold scar, chronic vocal fold scar treated with 100-ng basic…

  15. A Rat Excised Larynx Model of Vocal Fold Scar

    ERIC Educational Resources Information Center

    Welham, Nathan V.; Montequin, Douglas W.; Tateya, Ichiro; Tateya, Tomoko; Choi, Seong Hee; Bless, Diane M.

    2009-01-01

    Purpose: To develop and evaluate a rat excised larynx model for the measurement of acoustic, aerodynamic, and vocal fold vibratory changes resulting from vocal fold scar. Method: Twenty-four 4-month-old male Sprague-Dawley rats were assigned to 1 of 4 experimental groups: chronic vocal fold scar, chronic vocal fold scar treated with 100-ng basic…

  16. Scar formation and revision after the removal of orthodontic miniscrews

    PubMed Central

    Choi, Yoon Jeong; Lee, Dong-Won; Kim, Kyung-Ho

    2015-01-01

    Many clinicians expect complete healing after the removal of temporary anchorage devices, but clinical examination may reveal scar-like tissue. This report presents the typical features of scarring detected after the removal of miniscrews, and the clinical outcome of scar revision along with its pathologic features. PMID:26023543

  17. Combination Therapy in the Management of Atrophic Acne Scars

    PubMed Central

    Garg, Shilpa; Baveja, Sukriti

    2014-01-01

    Background: Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing. Objective: To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA) peel in the management of atrophic scars. Materials and Methods: Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed. Results: Out of 16 patients with Grade 4 scars, 10 (62.5%) patients improved to Grade 2 and 6 (37.5%) patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7%) patients were left with no scars, 2 (9.1%) patients improved to Grade 1and 15 (68.2%) patients improved to Grade 2. All 11 (100%) patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction. Conclusion: This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars. PMID:24761094

  18. The Use of Silicone Adhesives for Scar Reduction

    PubMed Central

    Bleasdale, Benjamin; Finnegan, Simon; Murray, Kathyryn; Kelly, Sean; Percival, Steven L.

    2015-01-01

    Significance: This article discusses the history and developments of silicone gel sheeting (SGS) scar therapy. Furthermore, we review a breadth of literature to gain an insight into how and why topical silicone gels remain the favored treatment of medical experts in scar management. We also analyze an ever increasing number of alternative therapies claiming to provide enhanced scar reduction performance. Recent Advances: Topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. SGS has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. Critical Issues: While the exact mechanisms by which SGS improves hypertrophic scars, keloid development and recovery are yet to be fully agreed upon, its ability to do so remains largely undisputed at present. However, there still is ongoing deliberation over the exact mechanism of action of silicone in improving a scar. At present it is likely that through occlusion of the scar site and hydration of the wound bed, the overactivity of scar-related cells is suppressed, and their activity normalized. Future Direction: The clinical support of topical silicone gel products, relative to all alternative scar therapies, is considered the internationally recommended first-line form of scar management, and favored by consensus among healthcare professionals. However, there still remains the need for further clinical evidence and a better understanding of the mechanism behind the benefit of silicone gel for use in the prevention of abnormal scarring. PMID:26155385

  19. Surgical correction of ear curling caused by scar tissue formation in a horse.

    PubMed

    Massoni, Sabrina; Vlaminck, Lieven E; Cokelaere, Stefan M; Martens, Ann M

    2005-10-01

    An 18-month-old Belgian Warmblood mare was evaluated because it had injured the outer convex aspect of the left auricle. Second intention healing of the wound area caused tissue contracture, which resulted in the tip of the ear curling backward. By use of a technique involving undermining of the skin and a flap of granulation tissue on the medial aspect of the wound area and multiple incisions of the auricular cartilage, the curling was relieved and the ear regained a more normal shape. A skin graft was applied to cover the existing wound defect in an attempt to accelerate wound healing; thermoplastic material was contoured to fit the inner concave surface of the ear for immobilization and fixation of the ear in its final shape after surgery. Thirty days after surgery, the graft had healed completely and the ear had a normal conformation. The successful outcome of this treatment suggests that correction of an ear deformity secondary to scar tissue formation by use of an adapted surgical technique and appropriate materials can be achieved with good cosmetic results in horses. PMID:16220675

  20. Different Surgical Reconstruction Modalities of the Post-Burn Mutilated Hand Based on a Prospective Review of a Cohort of Patients*

    PubMed Central

    Saleh, Y.; El-Shazly, M.; Adly, S.; El-Oteify, M.

    2008-01-01

    Summary This study covered 40 patients (22 females and 18 males) suffering from post-burn hand deformities admitted to Assiut University Hospital and Luxor International Hospital (Egypt) from June 2004 to May 2006. Their ages ranged between 4 and 45 yr (mean, 24.5 yr). They presented a variety of post-burn hand deformities, e.g. dorsal hand contracture (14 cases), volar contracture (10 cases), first web space contracture (3 cases), post-burn syndactyly (2 cases), wrist deformity (3 cases), skin and tendon affection (2 cases), and complex deformity (6 cases). All the patients underwent a variety of surgical procedures specific to the individual post-burn hand deformity. Post-operative splinting of the hand for 10 days was performed in patients with skin graft to prevent recontracture. The post-operative physiotherapy programme started in the second week in order to achieve good functional results. The follow-up period ranged from 6 to 20 months. The results were satisfactory in most of the cases as regards the quality of coverage, which was achieved in the majority of cases. In one case there was partial loss of the skin graft, which healed by secondary intention; full range of motion was achieved in most patients, but not those with joint affections. On the basis of our results, we can conclude that the management of post-burn hand deformities depends on several factors. Initial treatment of the burned hand is of great importance for the prevention of secondary deformities. In secondary burn management the first step is the release of the contracture, which should be complete and include all contracted structures. The second step is the proper selection of methods of coverage for resultant defects, using either skin grafts or flaps depending on the presence of exposed tendons, nerves, or joints. The third step in order to obtain a very good function is the activation of an intensive physiotherapy programme immediately after the operation. PMID:21991127

  1. Different Surgical Reconstruction Modalities of the Post-Burn Mutilated Hand Based on a Prospective Review of a Cohort of Patients

    PubMed Central

    Saleh, Y.; El-Shazly, M.; Adly, S.; El-Oteify, M.

    2008-01-01

    Summary This study covered 40 patients (22 females and 18 males) suffering from post-burn hand deformities admitted to Assiut University Hospital and Luxor International Hospital (Egypt) from June 2004 to May 2006. Their ages ranged between 4 and 45 yr (mean, 24.5 yr). They presented a variety of post-burn hand deformities, e.g. dorsal hand contracture (14 cases), volar contracture (10 cases), first web space contracture (3 cases), post-burn syndactyly (2 cases), wrist deformity (3 cases), skin and tendon affection (2 cases), and complex deformity (6 cases). All the patients underwent a variety of surgical procedures specific to the individual post-burn hand deformity. Post-operative splinting of the hand for 10 days was performed in patients with skin graft to prevent recontracture. The post-operative physiotherapy programme started in the second week in order to achieve good functional results. The follow-up period ranged from 6 to 20 months. The results were satisfactory in most of the cases as regards the quality of coverage, which was achieved in the majority of cases. In one case there was partial loss of the skin graft, which healed by secondary intention; full range of motion was achieved in most patients, but not those with joint affections. On the basis of our results, we can conclude that the management of post-burn hand deformities depends on several factors. Initial treatment of the burned hand is of great importance for the prevention of secondary deformities. In secondary burn management the first step is the release of the contracture, which should be complete and include all contracted structures. The second step is the proper selection of methods of coverage for resultant defects, using either skin grafts or flaps depending on the presence of exposed tendons, nerves, or joints. The third step in order to obtain a very good function is the activation of an intensive physiotherapy programme immediately after the operation. PMID:21991117

  2. Suppressed inflammatory gene expression during human hypertrophic scar compared to normotrophic scar formation.

    PubMed

    van den Broek, Lenie J; van der Veer, Willem M; de Jong, Etty H; Gibbs, Susan; Niessen, Frank B

    2015-08-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic scar (NTscar) tissue. Another drawback is that often only one time period after wounding is studied, while scar formation is a dynamic process over a period of several months. In this study, we compared the expression of genes involved in inflammation, angiogenesis and extracellular matrix (ECM) formation and also macrophage infiltration in biopsies obtained before and up to 52 weeks after standard surgery in five patients who developed HTscar and six patients who developed NTscar. It was found that HTscar formation coincided with a prolonged decreased expression of inflammatory genes (TNF?, IL-1?, IL-1RN, CCL2, CCL3, CXCL2, CXCR2, C3 and IL-10) and an extended increased expression of ECM-related genes (PLAU, Col3A1, TGF?3). This coincided with a delayed but prolonged infiltration of macrophages (type 2) in HTscar tissue compared to NTscar tissue. These findings were supported by immunohistochemical localization of proteins coding for select genes named above. Our study emphasizes that human cutaneous wound healing is a dynamic process that is needed to be studied over a period of time rather than a single point of time. Taken together, our results suggest innate immune stimulatory therapies may be a better option for improving scar quality than the currently used anti-inflammatory scar therapies. PMID:25939875

  3. Current treatment of severely burned patients.

    PubMed Central

    Nguyen, T T; Gilpin, D A; Meyer, N A; Herndon, D N

    1996-01-01

    OBJECTIVE: The authors provide an update on a multidisciplinary approach to the treatment of severely burned patients. A review of studies and clinical trials from the past to the present include fluid resuscitation, sepsis, immune function, hypermetabolism, early excision, wound healing, scar formation, and inhalation injury. SUMMARY BACKGROUND DATA: Advances in treating initial burn shock, infection control, early wound closure, and modulation of the hypermetabolic response have decreased morbidity and mortality in the last two decades. Specialized burn care centers, using a multidisciplinary approach, not only successfully treat large burns and their complications, but provide the necessary rehabilitation and psychological support required for readjustment back into society. CONCLUSIONS: Thermal injury results in a number of physiologic alterations that can be minimized by adequate fluid resuscitation to maintain tissue perfusion, early excision of burn wounds, and rapid wound coverage. These measures, in combination with antibiotic coverage and nutritional support in the form of early enteral tube feedings, will decrease the hypermetabolic response and the incidence of sepsis that can lead to hemodynamic instability and organ failure. Ongoing clinical trials using anabolic agents (e.g., recombinant human growth hormone) and pharmacologic agents that modulate inflammatory and endocrine mediators (e.g., ibuprofen and propranolol) show promise in the treatment of severe burn injuries. PMID:8554414

  4. Umbilical scarring in hatchling American alligators

    USGS Publications Warehouse

    Wiebe, J.J.; Sepulveda, M.S.; Buckland, J.E.; Anderson, S.R.; Gross, T.S.

    2004-01-01

    Umbilical scarring is the presence of excess scar tissue deposited between abdominal dermal layers at the site of yolk sac absorption in hatchling American alligators (Alligator mississippiensis). The presence of this dermal condition plays a key evaluatory role in the overall quality and subsequent value for various commercial leather products. Despite the prevalent nature of this condition, currently the industry has no standardized protocols for its quantification. The objectives of this study were to examine the relationship between hatchling weight and age and incidence of umbilical scarring and to develop a quantifiable and reproducible technique to measure this dermal condition in hatchling American alligators. Thirty eggs from each of nine clutches were incubated in two separate incubators at different facilities and hatchling umbilical scarring was measured at 2 and 10 days of age using digital calipers. Umbilical area was calculated by multiplying umbilical length times umbilical width. There was a significant effect of both age and clutch on umbilical area (overall decline of 64%) by 10 days post-hatch. However, only five of the nine clutches utilized expressed a noticeable decline in the size of this dermal condition (range 67-74%). We had hypothesized that larger hatchlings would have larger umbilical areas and a slower rate of improvement in this condition during the first few days post-hatch. The differences in umbilical area and percent decline with age across clutches, however, were not associated with differences in initial hatchling weights. Within clutches and time periods, hatchling weight had no significant effect on the size and/or rate of decline of this condition. ?? 2004 Published by Elsevier B.V.

  5. Microcystic adnexal carcinoma simulating scarring alopecia*

    PubMed Central

    Castanon, Maria Christina Marques Nogueira; Casali, Sandra Maria Gasparete; Lamim, Raul Fernando Binato; Nagahama, Marina Vieira; Silva, Camila Bastos Xavier Vassimon; de Carvalho, Rafael Guerra Nannetti

    2015-01-01

    The microcystic adnexal carcinoma is a rare, locally aggressive malignant adnexal neoplasm associated with signifi cant morbidity. It is often underdiagnosed due to clinical and histopathological resemblance with other cutaneous neoplasms and / or a combination of lack of familiarity associated with inadequate samples. We report a case with clinical hypothesis of scarring alopecia and histopathological diagnosis of microcystic adnexal carcinoma with favorable outcome in a follow-up of eleven years, after surgical treatment. PMID:26312669

  6. Induction of skeletal muscle contracture and calcium release from isolated sarcoplasmic reticulum vesicles by sanguinarine

    PubMed Central

    Hu, C M; Cheng, H W; Cheng, Y W; Kang, J J

    2000-01-01

    The benzophenanthrine alkaloid, sanguinarine, was studied for its effects on isolated mouse phrenic-nerve diaphragm preparations. Sanguinarine induced direct, dose-dependent effects on muscle contractility. Sanguinarine-induced contracture was partially inhibited when the extracellular Ca2+ was removed or when the diaphragm was pretreated with nifedipine. Depletion of sarcoplasmic reticulum (SR) internal calcium stores completely blocked the contracture. Sanguinarine induced Ca2+ release from the actively loaded SR vesicles was blocked by ruthenium red and dithiothreitol (DTT), consistent with the ryanodine receptor (RyR) as the site of sanguinarine action. Sanguinarine altered [3H]-ryanodine binding to the RyR of isolated SR vesicles, potentiating [3H]-ryanodine binding at lower concentrations and inhibiting binding at higher concentrations. All of these effects were reversed by DTT, suggesting that sanguinarine-induced Ca2+ release from SR occurs through oxidation of critical SH groups of the RyR SR calcium release channel. PMID:10807666

  7. Endoscopic extracapsular capsulectomy of the elbow: a neurovascularly safe technique for high-grade contractures.

    PubMed

    Kamineni, Srinath; Savoie, Felix H; ElAttrache, Neil

    2007-07-01

    Arthroscopic management of elbow contractures is rapidly becoming the primary operative form of treatment for many physicians. Safety concerns remain the primary limiting factor in its more widespread use. We use an extra-articular starting point in extremely difficult fixed contractures, and this technique is documented in this report. The ulnar nerve is initially identified and protected with a palpating finger, while a periosteal elevator is introduced through a proximal medial skin portal. A channel between the anterior humeral cortex and anterior musculature is created, and an arthroscope is introduced through a proximal lateral portal at the lateral aspect of the channel. The anterior capsule is dissected from the musculature/neurovasculature under direct vision and safely excised once the medial and lateral margins are safely identified. A useful technical tip is that retractors can be placed in auxiliary portals to deflect the muscles and fat pad to improve the ability to perform dissection under direct vision. PMID:17637419

  8. Digital imaging analysis to assess scar phenotype.

    PubMed

    Smith, Brian J; Nidey, Nichole; Miller, Steven F; Moreno Uribe, Lina M; Baum, Christian L; Hamilton, Grant S; Wehby, George L; Dunnwald, Martine

    2014-01-01

    In order to understand the link between the genetic background of patients and wound clinical outcomes, it is critical to have a reliable method to assess the phenotypic characteristics of healed wounds. In this study, we present a novel imaging method that provides reproducible, sensitive, and unbiased assessments of postsurgical scarring. We used this approach to investigate the possibility that genetic variants in orofacial clefting genes are associated with suboptimal healing. Red-green-blue digital images of postsurgical scars of 68 patients, following unilateral cleft lip repair, were captured using the 3dMD imaging system. Morphometric and colorimetric data of repaired regions of the philtrum and upper lip were acquired using ImageJ software, and the unaffected contralateral regions were used as patient-specific controls. Repeatability of the method was high with intraclass correlation coefficient score > 0.8. This method detected a very significant difference in all three colors, and for all patients, between the scarred and the contralateral unaffected philtrum (p ranging from 1.20(-05) to 1.95(-14) ). Physicians' clinical outcome ratings from the same images showed high interobserver variability (overall Pearson coefficient = 0.49) as well as low correlation with digital image analysis results. Finally, we identified genetic variants in TGFB3 and ARHGAP29 associated with suboptimal healing outcome. PMID:24635173

  9. Digital imaging analysis to assess scar phenotype

    PubMed Central

    Smith, Brian J.; Nidey, Nichole; Miller, Steven F.; Moreno, Lina M.; Baum, Christian L.; Hamilton, Grant S.; Wehby, George L.; Dunnwald, Martine

    2015-01-01

    In order to understand the link between the genetic background of patients and wound clinical outcomes, it is critical to have a reliable method to assess the phenotypic characteristics of healed wounds. In this study, we present a novel imaging method that provides reproducible, sensitive and unbiased assessments of post-surgical scarring. We used this approach to investigate the possibility that genetic variants in orofacial clefting genes are associated with suboptimal healing. Red-green-blue (RGB) digital images of post-surgical scars of 68 patients, following unilateral cleft lip repair, were captured using the 3dMD image system. Morphometric and colorimetric data of repaired regions of the philtrum and upper lip were acquired using ImageJ software and the unaffected contralateral regions were used as patient-specific controls. Repeatability of the method was high with interclass correlation coefficient score > 0.8. This method detected a very significant difference in all three colors, and for all patients, between the scarred and the contralateral unaffected philtrum (P ranging from 1.20?05 to 1.95?14). Physicians’ clinical outcome ratings from the same images showed high inter-observer variability (overall Pearson coefficient = 0.49) as well as low correlation with digital image analysis results. Finally, we identified genetic variants in TGFB3 and ARHGAP29 associated with suboptimal healing outcome. PMID:24635173

  10. [Pathogenetic aspects of complex treatment of Dupuytren's contracture in patients with chronic hepatitis].

    PubMed

    Iskra, N I; Hur'iev, S O; Kuz'min, V Iu; Kukuruz, Ia S

    2011-03-01

    The results of Dupuytren's contracture treatment in patients, suffering chronic hepatitis with the hand deformity grade II and III, in the injured persons and liquidators of the Chernobyl disaster consequences, conducted in 2000-2010 yrs., were adduced. Beginning from the third week, when an active movements had emerged, the patients were treated locally, including lidase and solution, which consisted of dimexid, isotonic saline and furazolidon. PMID:21695974

  11. Roles of TGF-?/Smad signaling pathway in pathogenesis and development of gluteal muscle contracture

    PubMed Central

    Zhang, Xintao; Ma, Yukun; You, Tian; Tian, Xiaopeng; Zhang, Honglei; Zhu, Qi

    2015-01-01

    Purpose of the study Gluteal muscle contracture (GMC) is a chronic fibrotic disease of gluteal muscles which is characterized by excessive deposition of collagen in the extracellular matrix. Transforming growth factor (TGF)-?s have been shown to play an important role in the progression of GMC. However, the underlying mechanisms are not entirely clear. We sought to explore the expression of TGF-?/Smad pathway proteins and their downstream targets in gluteal muscle contracture disease. Materials and methods The expression levels of collagens type I/III, TGF-?1, Smad2/3/4/7 and PAI-1 (plasminogen activator inhibitor type 1) in gluteal muscle contraction (GMC) patients were measured using immunohistochemistry, reverse transcription and polymerase chain reaction (RT-PCR) and western blot assays. Results The expressions of collagens type I/III and TGF-?1 were significantly increased in the contraction band compared with unaffected muscle. In addition, R-Smad phosphorylation and Smad4 protein expression in the contraction band were also elevated, while the expression of Smad7 was significantly decreased in the fibrotic muscle of the GMC patients compared to the unaffected adjacent muscle. The protein and mRNA levels of PAI-1 were also remarkably increased in the contraction band compared with adjacent muscle. Immunohistochemical analysis also demonstrated that the expression levels of TGF-?1 and PAI-1 were higher in contraction band than those in the adjacent muscle. Conclusion Our data confirm the stimulating effects of the TGF-?/Smad pathway in gluteal muscle contracture disease and reveal the internal changes of TGF-?/Smad pathway proteins and their corresponding targets in gluteal muscle contracture patients. PMID:25207745

  12. Bruck syndrome: a rare combination of bone fragility and multiple congenital joint contractures.

    PubMed

    Breslau-Siderius, E J; Engelbert, R H; Pals, G; van der Sluijs, J A

    1998-01-01

    Bruck syndrome manifests with combined features of arthrogryposis and osteogenesis imperfecta. It is a distinct autosomal recessive disorder with normal collagen I. The main features are osteoporosis, bowing of the long bones, scoliosis due to vertebral deformities, and congenital joint contractures. The presence of arthrogryposis differentiates this syndrome from "classical" osteogenesis imperfecta. A family with three affected children is presented with a review of the literature. PMID:9481655

  13. Perspectives on glenohumeral joint contractures and shoulder dysfunction in children with perinatal brachial plexus palsy.

    PubMed

    Gharbaoui, Idris S; Gogola, Gloria R; Aaron, Dorit H; Kozin, Scott H

    2015-01-01

    Shoulder joint deformities continue to be a challenging aspect of treating upper plexus lesions in children with perinatal brachial plexus palsy (PBPP). It is increasingly recognized that PBPP affects the glenohumeral joint specifically, and that abnormal scapulothoracic movements are a compensatory development. The pathophysiology and assessment of glenohumeral joint contractures, the progression of scapular dyskinesia and skeletal dysplasia, and current shoulder imaging techniques are reviewed. PMID:25835253

  14. The Scarbase Duo(®): Intra-rater and inter-rater reliability and validity of a compact dual scar assessment tool.

    PubMed

    Fell, Matthew; Meirte, Jill; Anthonissen, Mieke; Maertens, Koen; Pleat, Jonathon; Moortgat, Peter

    2016-03-01

    Objective scar assessment tools were designed to help identify problematic scars and direct clinical management. Their use has been restricted by their measurement of a single scar property and the bulky size of equipment. The Scarbase Duo(®) was designed to assess both trans-epidermal water loss (TEWL) and colour of a burn scar whilst being compact and easy to use. Twenty patients with a burn scar were recruited and measurements taken using the Scarbase Duo(®) by two observers. The Scarbase Duo(®) measures TEWL via an open-chamber system and undertakes colorimetry via narrow-band spectrophotometry, producing values for relative erythema and melanin pigmentation. Validity was assessed by comparing the Scarbase Duo(®) against the Dermalab(®) and the Minolta Chromameter(®) respectively for TEWL and colorimetry measurements. The intra-class correlation coefficient (ICC) was used to assess reliability with standard error of measurement (SEM) used to assess reproducibility of measurements. The Pearson correlation coefficient (r) was used to assess the convergent validity. The Scarbase Duo(®) TEWL mode had excellent reliability when used on scars for both intra- (ICC=0.95) and inter-rater (ICC=0.96) measurements with moderate SEM values. The erythema component of the colorimetry mode showed good reliability for use on scars for both intra-(ICC=0.81) and inter-rater (ICC=0.83) measurements with low SEM values. Pigmentation values showed excellent reliability on scar tissue for both intra- (ICC=0.97) and inter-rater (ICC=0.97) with moderate SEM values. The Scarbase Duo(®) TEWL function had excellent correlation with the Dermalab(®) (r=0.93) whilst the colorimetry erythema value had moderate correlation with the Minolta Chromameter (r=0.72). The Scarbase Duo(®) is a reliable and objective scar assessment tool, which is specifically designed for burn scars. However, for clinical use, standardised measurement conditions are recommended. PMID:26774602

  15. Rehabilitation instrument for prevent contracture of ankle using the pneumatic balloon actuator.

    PubMed

    Saga, Norihiko; Saito, Naoki

    2008-01-01

    A rehabilitation instrument for ankle contracture prevention is proposed. Its uses a tendon drive system using a pneumatic balloon. This instrument is intended to be carried and installed easily at the time of use in a place like a medical institution. This instrument is for use by people such as those with flaccid hemiplegia. The ankle is moved when it is worn; ankle contracture can be prevented. The device comprises an actuator, a power transfer mechanism, and ankle foot orthosis. A tendon drive system using a pneumatic balloon was adopted as the actuator of this instrument. It consists of a tendon and a silicone tube. Both ends of the silicone tube are closed and the tube expands like a balloon with the supply of air, which distends the silicone tube and pulls the tendon. The system is compact and has high power. Furthermore, it is very lightweight because of its composition material and structure. This paper describes a study of characteristics of the tendon drive system using a pneumatic balloon, along with the composition and operation of a rehabilitation instrument for prevention of ankle contracture. Results of operation tests on the instrument are also presented. PMID:19163662

  16. Fluid retention in Bioplasty Misti Gold II breast prostheses with development of capsular contracture.

    PubMed

    Benediktsson, K; Perbeck, L G

    2000-03-01

    We compared the incidence of capsular contracture in an implant (Bioplasty Misti Gold II) which has a textured surface and is filled with polyvinyl-pirrolidone (PVP)-hydrogel, with that in saline-filled implants with textured surfaces when the implants are placed subcutaneously during immediate reconstruction after subcutaneous mastectomy. In 41 patients, mean age 55 years (range 30-81), with breast cancer that was not suitable for breast conservation, 20 patients had 22 Misti Gold II prostheses inserted (two patients bilaterally) and 21 patients had saline-filled prostheses (one patient bilaterally). The development of capsular contracture was assessed using Baker's classification and applanation tonometry. Fourteen patients with Misti Gold II implants were classified one year postoperatively as Baker 2 and 3 compared with five with saline-filled implants (p = 0.01). On applanation tonometry 16 of the Misti Gold II group had an operative:postoperative ratio of < or = 0.75, compared with 50% in the saline-filled group (p = 0.096). In the 12 Misti Gold II prostheses that were removed because of capsular contracture between 13-40 months postoperatively, the volume in the prostheses had increased by 48%. The poor results obtained with the Misti Gold II prosthesis can be explained by the volume that they gained after implantation as a result of osmosis. PMID:10756578

  17. Beals-Hecht syndrome (congenital contractural arachnodactyly) with additional craniospinal abnormality: a case report.

    PubMed

    Meena, Jagdish P; Gupta, Ajay; Mishra, Devendra; Juneja, Monica

    2015-05-01

    Beals syndrome is an autosomal-dominant connective tissue disorder, characterized by multiple flexion contractures, arachnodactyly, severe kyphoscoliosis, crumpled ear, and muscular hypoplasia. It has similarities to Marfan syndrome (MFS) in many respects. It has much fewer incidences of eye and heart anomalies compared with MFS. Beals syndrome is caused by a mutation in the fibrillin-2 gene (FBN2) in 5q23; MFS is caused by mutations in fibrillin-1. With time, there is spontaneous improvement in joint contractures, but kyphosis tends to be progressive. The neonatal form results from new mutations and tends to be severe. Prenatal molecular diagnosis is possible. Ultrasound could be used to demonstrate hypokinesia and joint contractures in presumptive cases. We present a case of a patient with Beals syndrome who presented to the emergency department with pneumonia and was found to have narrowing of the foramen magnum, with partial fusion of C2-C3 vertebral bodies. To our knowledge, this has not been documented in the literature and could be characteristic in relation to Beals syndrome. PMID:25493702

  18. Using transurethral Ho:YAG-laser resection to treat urethral stricture and bladder neck contracture

    NASA Astrophysics Data System (ADS)

    Bo, Juanjie; Dai, Shengguo; Huang, Xuyuan; Zhu, Jing; Zhang, Huiguo; Shi, Hongmin

    2005-07-01

    Objective: Ho:YAG laser had been used to treat the common diseases of urinary system such as bladder cancer and benign prostatic hyperplasia in our hospital. This study is to assess the efficacy and safety of transurethral Ho:YAG-laser resection to treat the urethral stricture and bladder neck contracture. Methods: From May 1997 to August 2004, 26 cases of urethral stricture and 33 cases of bladder neck contracture were treated by transurethral Ho:YAG-laser resection. These patients were followed up at regular intervals after operation. The uroflow rate of these patients was detected before and one-month after operation. The blood loss and the energy consumption of holmium-laser during the operation as well as the complications and curative effect after operation were observed. Results: The therapeutic effects were considered successful, with less bleeding and no severe complications. The Qmax of one month postoperation increased obviously than that of preoperation. Of the 59 cases, restenosis appeared in 11 cases (19%) with the symptoms of dysuria and weak urinary stream in 3-24 months respectively. Conclusions: The Ho:YAG-laser demonstrated good effect to treat the obstructive diseases of lower urinary tract such as urethral stricture and bladder neck contracture. It was safe, minimal invasive and easy to operate.

  19. Detecting Moorland Wildfire Scars and their Persistence in the Landscape using Synthetic Aperture Radar (SAR) in the Peak District National Park, UK

    NASA Astrophysics Data System (ADS)

    Millin-chalabi, G. R.; McMorrow, J.; Agnew, C.

    2012-12-01

    The overall aim of this research is to assess the ability of SAR to detect moorland wildfire scars and their persistence in the landscape using the Peak District National Park (PDNP) in the UK as a case study. Spatially-robust data to monitor wildfire scar size and severity in UK moorlands is currently rare. Fires can burn deep into peat soils and contribute to the release of carbon dioxide into the atmosphere and may also affect the water quality of nearby streams. Information on fire extent would be useful for conservation organisations such as Moors For The Future who are trying to preserve the delicate peatland environment. Knowing the size and location of fire scars would help the Fire and Rescue Service to plan future response to moorland fires. Fire scar boundaries can be mapped in the field using Global Positioning Systems (GPS), however this is labour intensive. Indeed in the PDNP wildfire scar mapping is conducted by park rangers which provides essential ground truth data for assessing against the SAR data. Therefore this particular area provides a unique opportunity for testing an alternative SAR technique for monitoring wildfire scars in the moorland landscape. Previous research shows that SAR has been successfully applied for wildfire scar detection in other types of environments such as boreal (Bourgeau-Chavez et al, 1997) and the tropics (Huang and Siegert, 2004). This research presents some of the first results of the project which tests the capability of ERS 2; ASAR (C-band) and PALSAR (L-band) data to detect several wildfire scars from 2003 - 2008 of various spatial scales and fire severity. Some of the key areas of interest the paper will explore are at Bleaklow and the Kinder plateau. The Bleaklow peat fire of 18th April 2003 was larger (7km2) and more severe than at Kinder, which burned between 26-29th May 2008 and covered an area of 10 ha. All the wildfire scars were GPS, mapped just after the fire event. Archival time-series SAR imagery was supplied by the Landmap Service, originally sourced from the European Space Agency (ESA). C-band ASAR and ERS 2 data and L-band PALSAR data were pre-processed in SARscape 4.2. The results of this research will report on (a) the affect of land cover on backscatter and coherence results (b) the affect of precipitation on the backscatter signal (c) whether fire intensity and size affects the detectability of wildfire scars using SAR and InSAR (d) the degree that SAR and InSAR can be used to assess the persistence of wildfire scars in a UK moorland landscape.;

  20. Burning plasmas

    SciTech Connect

    Furth, H.P.; Goldston, R.J.; Zweben, S.J. . Plasma Physics Lab.); Sigmar, D.J. )

    1990-10-01

    The fraction of fusion-reaction energy that is released in energetic charged ions, such as the alpha particles of the D-T reaction, can be thermalized within the reacting plasma and used to maintain its temperature. This mechanism facilitates the achievement of very high energy-multiplication factors Q, but also raises a number of new issues of confinement physics. To ensure satisfactory reaction operation, three areas of energetic-ion interaction need to be addressed: single-ion transport in imperfectly symmetric magnetic fields or turbulent background plasmas; energetic-ion-driven (or stabilized) collective phenomena; and fusion-heat-driven collective phenomena. The first of these topics is already being explored in a number of tokamak experiments, and the second will begin to be addressed in the D-T-burning phase of TFTR and JET. Exploration of the third topic calls for high-Q operation, which is a goal of proposed next-generation plasma-burning projects. Planning for future experiments must take into consideration the full range of plasma-physics and engineering R D areas that need to be addressed on the way to a fusion power demonstration.

  1. Eliciting health state utilities for Dupuytren’s contracture using a discrete choice experiment

    PubMed Central

    2013-01-01

    Background and purpose An internet-based discrete choice experiment (DCE) was conducted to elicit preferences for a wide range of Dupuytren’s contracture (DC)-related health states. An algorithm was subsequently developed to convert these preferences into health state utilities that can be used to assess DC’s impact on quality of life and the value of its treatments. Methods Health state preferences for varying levels of DC hand severity were elicited via an internet survey from a sample of the UK adult population. Severity levels were defined using a combination of contractures (0, 45, or 90 degrees) in 8 proximal interphalangeal and metacarpophalangeal joints of the index, middle, ring, and little fingers. Right-handed, left-handed, and ambidextrous respondents indicated which hand was preferable in each of the 10 randomly-selected hand-pairings comparing different DC severity levels. For consistency across comparisons, anatomically precise digital hand drawings were used. To anchor preferences onto the traditional 0–1 utility scale used in health economic evaluations, unaffected hands were assigned a utility of 1.0 whereas the utility for a maximally affected hand (i.e., all 8 joints set at 90 degrees of contracture) was derived by asking respondents to indicate what combination of attributes and levels of the EQ-5D-5L profile most accurately reflects the impact of living with such hand. Conditional logistic models were used to estimate indirect utilities, then rescaled to the anchor points on the EQ-5D-5L. Results Estimated utilities based on the responses of 1,745 qualified respondents were 0.49, 0.57, and 0.63 for completely affected dominant hands, non-dominant hands, or ambidextrous hands, respectively. Utility for a dominant hand with 90-degree contracture in t h e metacarpophalangeal joints of the ring and little fingers was estimated to be 0.89. Separately, reducing the contracture of metacarpophalangeal joint for a little finger from 50 to 12 degrees would improve utility by 0.02. Interpretation DC is associated with substantial utility decre- ments. The algorithms presented herein provide a robust and flexible framework to assess utility for varying degrees of DC severity. PMID:24286567

  2. Burn due to misuse of an acetylene gas burner: a case report.

    PubMed

    Shimada, K; Aoki, Y; Ide, Y; Ishikura, N; Kawakami, S

    1999-11-01

    A rare case of deep penetrating burn injury caused by misuse of a high-pressure acetylene burner is reported. A 35 year old man was admitted with second and third degree burns involving the right arm cubital area and a subcutaneous burn on his right arm caused by a high-pressure acetylene gas flame. Early surgical debridement and secondary skin grafting using a preserved subcutaneous vascular network skin graft (PSVNSG) proved effective in this patient. Skin contracture was prevented and function was recovered. The basis of PSVNSG is that the vascular system existing in the graft is used as a permanent vascular system without degeneration. This case shows that, in this kind of burn injury, subcutaneous tissue damage should be suspected and that it is important to perform surgical debridement early after admission. PMID:10563697

  3. Static-electric field induction by a silicone cushion for the treatment of hypertrophic and keloid scars.

    PubMed

    Hirshowitz, B; Lindenbaum, E; Har-Shai, Y; Feitelberg, L; Tendler, M; Katz, D

    1998-04-01

    Silicone gel and silicone occlusive sheeting are widely used at present for the treatment of hypertrophic and keloid scars, without any scientific explanation as to their mode of action. In a recent paper the possibility was raised that static electricity generated by friction-activated silicone sheeting could be the reason for this effect, and that it can, with time, cause involution of hypertrophic and keloid scars. The objective of this study was to test this hypothesis and to observe whether a continuous and also an increased negatively charged static-electric field will shorten the treatment period. A device to implement these requirements gradually evolved over a 5-year period. A number of prototypes were tested until the final product was attained. Some of the patients in this study were treated initially with a silicone sponge inserted in the cushion. Later this version was changed to the final design described herein. A silicone cushion was developed with the purpose of increasing a negative static-electric charge to accelerate the regression process. The cushion is custom-made using a silicone occlusive sheeting envelope of 0.75-mm thickness, which does not deteriorate with use, and is partially filled with high viscosity silicone oil. Its edges are sealed, and its size is designed to extend a little beyond the scarred area. Static electricity readings, generated by activating the cushion by pumping action with the fingers, stretching or deforming the cushion, are invariably much higher when compared with those obtained with silicone occlusive sheeting and silicone gel sheeting. The interaction between the negatively charged ions of the cushion and the ionic charges of the tissue fluids may be the critical factor in achieving hypertrophic and keloid scars involution. Of the 30 patients enrolled in the study, 3 patients dropped out. Treatment with the silicone cushions yielded 63.3 percent cessation of itching and burning followed by pallor and flattening of the scar, some markedly so, over a few weeks to 6-month period. An additional 26.6 percent had their scars resolved in up to 12 months of treatment. Good contact of the cushion over the scar has been shown to be important in this clinical trial, and much creativity is needed for making elastic strap bindings that ensure this contact. The clinical trials extended over a 12-month period. Ten patients (33.3 percent) who had recalcitrant scars with little response to the use of the silicone cushion were given intralesional corticosteroid injections, in addition to the continued use of the cushion, resulting in a fairly rapid resolution of these scars over a period of months to a year. PMID:9529199

  4. Early postoperative treatment of thyroidectomy scars using botulinum toxin: a split-scar, double-blind randomized controlled trial.

    PubMed

    Kim, Youn Sung; Lee, Hyun Joo; Cho, Sang Hyun; Lee, Jeong Deuk; Kim, Hei Sung

    2014-01-01

    Operational scars, especially those located on the exposed parts of the body, can be distressing. Despite high demand for an early intervention to minimize surgical scars, there is yet no universal consensus on optimal treatment. A split-scar, double-blind randomized controlled trial was held to assess the safety and efficacy of early postoperative botulinum toxin type A (BTA) injection in surgical scars. A single session of treatment was performed where BTA was allocated to one half of the scar and 0.9% saline to the control half. Scars were assessed using the modified Stony Brook Scar Evaluation Scale (SBSES) with standardized photographs. Fifteen patients completed the study, and their data were analyzed. At 6 months' follow-up, a significant improvement in SBSES score was noted for the BTA-treated halves of the scars (p?scars and may be a promising option for scar prevention. PMID:24898579

  5. Burn surgery.

    PubMed

    Tenenhaus, Mayer; Rennekampff, Hans Oliver

    2007-10-01

    The challenges posed by thermal injury often are daunting emotionally and physically for the survivor, family, and staff. Morbidity and mortality have improved with advances in emergent and multidisciplinary care; the establishment of dedicated burn centers; and increased education, prevention, and experience. The role of surgery in the treatment of these complex injury patterns continues to evolve, incorporating refined concepts of tissue preservation, wound bed preparation, and early attention to functional and esthetic parameters. Societal reintegration, psychosocial support, and new pain control strategies have dramatically improved the quality of life for our patients during and after the acute course of care. With improved survivability and a changing demographic, fundamental reconstructive surgical principles have found increased applicability and are instituted at the time of admission whenever possible. PMID:17967624

  6. Effect of Ca2+ channel blockers on K+ contractures in twitch fibres of the frog (Rana pipiens).

    PubMed Central

    Gamboa-Aldeco, R; Huerta, M; Stefani, E

    1988-01-01

    1. The effects of Ca2+ channel blockers (nifedipine, nitrendipine and diltiazem) were tested on K+ contractures in single muscle fibres of the frog, Rana pipiens. 2. Nifedipine (1 microM) reduced the area under K+ contractures to 24 +/- 9% (4) (100 mM-K+) and 34 +/- 24% (4) (190 mM-K+). Nitrendipine (0.1 microM) reduced the area to 30 +/- 10% (4) (120 mM-K+). The blockade of the contractures was reversible. 3. Diltiazem (1 microM) shortened the first 190 mM-K+ contracture without affecting the peak amplitude. The first contractures, performed at 15-20 min after the removal of diltiazem, were greatly reduced to 29 +/- 14% (4). This effect was reversed after three to five contractures in the absence of the drug. Similar results were obtained with 60 and 100 mM-K+. 4. The resting potential in control saline and after a brief exposure to 120 mM-K+ was not affected by the dihydropyridines and diltiazem. 5. Slow and fast Ca2+ currents were not modified by 1 microM-diltiazem at any stimulation rate or with pre-pulse depolarizations. Diltiazem (50 microM) did not affect the fast Ca2+ current and reduced the slow one to 48 +/- 10% (4). 7. The reduction of K+ contractures by Ca2+ channel blocking agents was not related to a blockade of Ca2+ currents. This can be tentatively explained by interactions of these compounds on membranes sites which regulate the coupling between membrane depolarization and contraction. PMID:2457700

  7. Saturday night burns: an increasing problem?

    PubMed Central

    Bollero, D.; Malvasio, V.; Gangemi, E.N.; Giunta, G.; Collard, B.; Stella, M.

    2015-01-01

    Summary In Italy the economic crisis has caused changes in behavior in daily as well as leisure activities. For instance, night clubs have changed both their scenography and what they can offer. From simply providing a place to dance, they can now offer more complex scenography with spectacular fireworks and lit cocktails. While this can be amazing for all of us it can also be another cause of burn injuries. We conducted a retrospective study of all burns patients admitted to the Accident and Emergency Department at CTO Hospital in Turin from 2009 to 2013, after a night clubbing. A total of five patients were identified with an average age of 20 years old: four were burned by flaming cocktails and one was burned by a firework. Two received outpatient treatment, while orotracheal intubation and admission were needed for three, and two required surgical debridement and resurfacing with split skin graft. All patients had permanent sequelae caused by pathologic scarring and/or dyschromia. Our findings show that the risk of burn injuries is higher at weekends, mainly in summer, if all correct safety procedures are not followed. Meanwhile it is important to highlight that the promotion of inappropriate behavior at night clubs during firework displays and the passing of flaming cocktails should be avoided. PMID:26668565

  8. Saturday night burns: an increasing problem?

    PubMed

    Bollero, D; Malvasio, V; Gangemi, E N; Giunta, G; Collard, B; Stella, M

    2015-03-31

    In Italy the economic crisis has caused changes in behavior in daily as well as leisure activities. For instance, night clubs have changed both their scenography and what they can offer. From simply providing a place to dance, they can now offer more complex scenography with spectacular fireworks and lit cocktails. While this can be amazing for all of us it can also be another cause of burn injuries. We conducted a retrospective study of all burns patients admitted to the Accident and Emergency Department at CTO Hospital in Turin from 2009 to 2013, after a night clubbing. A total of five patients were identified with an average age of 20 years old: four were burned by flaming cocktails and one was burned by a firework. Two received outpatient treatment, while orotracheal intubation and admission were needed for three, and two required surgical debridement and resurfacing with split skin graft. All patients had permanent sequelae caused by pathologic scarring and/or dyschromia. Our findings show that the risk of burn injuries is higher at weekends, mainly in summer, if all correct safety procedures are not followed. Meanwhile it is important to highlight that the promotion of inappropriate behavior at night clubs during firework displays and the passing of flaming cocktails should be avoided. PMID:26668565

  9. Scarring due to an enuresis blanket.

    PubMed

    Diez, F; Berger, T G

    1988-02-01

    A 7-year-old boy was examined for cutaneous lesions that were localized to the side of the body on which he slept and occurred on skin in direct contact with an enuresis blanket. The painless skin lesions were similar to the punched-out skin ulcers and atrophic scars reported in the British literature as buzzer ulcers. Exposure of the child's skin to electrical current may have produced the lesions, which ceased to appear when use of the enuresis blanket was discontinued. PMID:3380764

  10. The Impact of Aerosols Generated from Biomass Burning, Dust Storms, and Volcanoes Upon the Earth's Radiative Energy Budget

    NASA Technical Reports Server (NTRS)

    Christopher, Sundar A.

    1997-01-01

    A new technique for detecting aerosols from biomass burning and dust is developed. The radiative forcing of aerosols is estimated over four major ecosystems in South America. A new smoke and fire detection scheme is developed for biomass burning aerosols over South America. Surface shortware irradiance calculations are developed in the presence of biomass burning aerosols during the SCAR-B experiment. This new approach utilizes ground based, aircraft, and satellite measurements.

  11. Analysis of state of vehicular scars on Arctic Tundra, Alaska

    NASA Technical Reports Server (NTRS)

    Lathram, E. H.

    1974-01-01

    Identification on ERTS images of severe vehicular scars in the northern Alaska tundra suggests that, if such scars are of an intensity or have spread to a dimension such that they can be resolved by ERTS sensors (20 meters), they can be identified and their state monitored by the use of ERTS images. Field review of the state of vehicular scars in the Umiat area indicates that all are revegetating at varying rates and are approaching a stable state.

  12. Pharmacological blockade of adenosine A2A receptors diminishes scarring

    PubMed Central

    Perez-Aso, Miguel; Chiriboga, Luis; Cronstein, Bruce N.

    2012-01-01

    Adenosine A2A receptor (A2AR) stimulation promotes wound healing and is required for the development of fibrosis in murine models of scleroderma and cirrhosis. Nonetheless, the role of A2AR in the formation of scars following skin trauma has not been explored. Here, we examined the effect of pharmacological blockade of A2AR, with the selective adenosine A2AR-antagonist ZM241385 (2.5 mg/ml), in a murine model of scarring that mimics human scarring. We found that application of the selective adenosine A2AR antagonist ZM241385 decreased scar size and enhanced the tensile strength of the scar. Within the scar itself, collagen alignment and composition (marked reduction in collagen 3), but not periostin, biglycan, or fibronectin accumulation, was improved by application of ZM241385. Moreover, A2AR blockade reduced the number of myofibroblasts and angiogenesis but not macrophage infiltration in the scar. Taken together, our work strongly suggests that pharmacological A2AR blockade can be used to diminish scarring while improving the collagen composition and tensile strength of the healed wound.—Perez-Aso, M., Chiriboga, L., Cronstein, B. N. Pharmacological blockade of adenosine A2A receptors diminishes scarring. PMID:22767233

  13. Intralesional Cryotherapy for the Treatment of Keloid Scars: Evaluating Effectiveness

    PubMed Central

    Bulstra, Anne Eva J.; Ket, Johannes C. F.; Ritt, Marco J. P. F.; van Leeuwen, Paul A. M.; Niessen, Frank B.

    2015-01-01

    Background: Intralesional (IL) cryotherapy is a novel treatment technique for keloid scars, in which the scar is frozen from inside. Over the past decade, several studies have been published with varying outcomes. A critical analysis of the current literature is, therefore, warranted to determine whether IL cryotherapy is an alternative to established keloid scar treatments. Methods: A comprehensive review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed and EMBASE were searched from inception. Studies and level of recommendation were graded according to the American Society of Plastic Surgeons criteria. Results: Eight studies meeting the inclusion criteria were selected. The average scar volume decrease ranged from 51% to 63%, but no complete scar eradication was achieved on average. Scar recurrence ranged from 0% to 24%. Hypopigmentation posttreatment was seen mostly in Fitzpatrick 4–6 skin type patients. Finally, complaints of pain and pruritus decreased significantly in most studies. Conclusions: IL cryotherapy for the treatment of keloid scars shows favorable results in terms of volume reduction and alleviated complaints of pain and pruritus. However, no complete scar eradication is established, and recurrences are seen. Also, persistent hypopigmentation proved a problem in Fitzpatrick 4–6 skin type patients. Summarized, the evidence proved limited and inconsistent resulting in an American Society of Plastic Surgeons grade C recommendation for this type of treatment of keloid scars. PMID:26180738

  14. Repair of acne scars with Dermicol-P35.

    PubMed

    Smith, Kevin C

    2009-01-01

    Acne vulgaris is a prevalent skin condition that can cause disfiguring residual scarring. While the complete removal of acne scars is unlikely, several treatments exist that can improve the appearance of acne scars. Dermal fillers offer a simple, nonsurgical corrective procedure that can provide improved skin texture. Dermicol-P35 (Evolence [Ortho Dermatologics, Skillman, NJ]) is a new, highly purified, ribose cross-linked, porcine collagen-based dermal filler that has demonstrated low immunogenicity and results that persist for at least 12 months. This article presents the aesthetic results of a male patient treated with Dermicol-P35 for severe facial acne scars. PMID:19577176

  15. Treating and Preventing Burns

    MedlinePLUS

    ... Text Size Email Print Share Treating and Preventing Burns Page Content Article Body Burns are divided into three categories , according to their severity. First-degree burns are the mildest and cause redness and perhaps ...

  16. Ram Burn Observations (RAMBO)

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Ram Burn Observations (RAMBO) is a Department of Defense experiment that observes shuttle Orbital Maneuvering System engine burns for the purpose of improving plume models. On STS-107 the appropriate sensors will observe selected rendezvous and orbit adjust burns.

  17. Burn and Scald Prevention

    MedlinePLUS

    Burn and Scald Prevention Approximately 450,000 burn injuries medical require treatment each year. NAamtieornicaalnBBurunrnRAepsososictioartyion (2011 report) Prevent burns and scalds in the kitchen: • Place objects so that they cannot be pulled ...

  18. [Diagnosis of susceptibility to malignant hyperthermia using the in vitro contracture test].

    PubMed

    Klein, W; Spiess-Kiefer, C; Küther, G; Pongratz, D; Lehmann-Horn, F

    1987-12-01

    Though a malignant hyperthermia (MH) crisis is still a critical event during general anesthesia, recent developments in prophylaxis and treatment should help in avoiding fatal episodes. The best means to avoid MH episodes would be early recognition of MH susceptibility. Today the only reliable test to identify MH susceptibility is the in vitro contracture test. Thus, to diagnose MH susceptibility we performed this test on muscle biopsies from 26 individuals who: (1) had an event during general anesthesia that may have been indicative of MH (4 patients); (2) had a family member with a medical history of MH (20 patients); or (3) had unexplained elevated CK levels (1 patient). The criteria according to which patients were submitted to the testing are shown in detail in Table 1. We used the standardized version of the contracture test that has been proposed by the European Malignant Hyperpyrexia Group. Muscle biopsies (20-30 mm long, 8 mm diameter) were dissected into 8-10 small bundles (2-3 mm diameter) and tested within 3 h post-biopsy in four independent tissue baths with various concentrations of caffeine or halothane. According to the concentration of caffeine or halothane necessary to elicit contractures exceeding a predefined force threshold (20 mN), it was possible to classify the patients as MHS (MH-susceptible), MHE (equivocal), or MHN (negative). In addition to the in vitro test, clinical, laboratory, and neurophysiological data were collected from these patients and correlated with the individual test results (Table 2). Thirteen patients were classified as MHS, five were MHE, and seven patients MHN (Fig. 3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2830805

  19. Interchangeable skin grafting to camouflage self-inflicted wound scars on the dorsal and volar forearm: a case report.

    PubMed

    Chou, Chang-Yi; Chang, Hsin An; Chiao, Hao-Yu; Wang, Chi-Yu; Sun, Yu-Shan; Chen, Shyi-Gen; Wang, Chih-Hsin

    2014-04-01

    Scars from self-inflicted wounds to the upper extremities are the hallmark of self-mutilation. They are easy to recognize and difficult to hide. Camouflaging these scars can be an onerous task. In this case study, a 23-year-old woman who has major depressive disorder with comorbid borderline personality disorder presented for scar repair of self-inflicted wounds on the volar and dorsal forearm (each approximately 10 cm2 x 15 cm2). Following a psychological and physical evaluation, split-thickness skin grafts (10/1,000 inches in thickness) were obtained from both areas and switched. The grafts were fixed with staples, immobilized with a short arm splint, and dressed daily with gauze and neomycin ointment. Staples were removed after 10 days; at the 6-month follow up, the wounds resembled burn wound scars. The patient was satisfied with this more socially acceptable result. This method might offer a simple camouflage option in appropriately selected cases. PMID:24706403

  20. Surgical Correction of Rigid Equinovarus Contracture Utilizing Extensive Soft Tissue Release.

    PubMed

    Reeves, Christopher L; Shane, Amber M; Zappasodi, Francesca; Payne, Trevor

    2016-01-01

    Although deforming contractures of the lower extremities after acute cerebrovascular events are well documented in the literature, there is limited literature regarding specific surgical considerations for the correction of these deformities, which are nonosseus in nature. The equinovarus foot, regardless of its origin, is a challenging pathologic condition for the foot and ankle surgeon. It is critical to have a firm understanding of the cause and symptoms behind an equinovarus deformity before treatment. The clinical presentation is discussed with special attention to deformities in adults with rigid equinovarus deformities after cerebrovascular-related accidents or peripheral ischemic events. PMID:26590731

  1. The Use of Dermal Substitutes in Burn Surgery: Acute Phase

    PubMed Central

    Shahrokhi, Shahriar; Anna, Arno; Jeschke, Marc G.

    2013-01-01

    Dermal substitutes are increasingly becoming an essential part of the burn care strategy. During the acute phase of burn treatment, dermal substitutes improve functional and cosmetic results long-term and thus increase quality of life. In the chronic wound setting, dermal substitutes are used to reconstruct and improve burn scars and other defects. Despite some successes in the use of dermal substitutes there are more needs and requirements to further improve outcomes and hence further research is required not only to strengthen scientific evidence regarding their effects but also to develop new technology and products. Dermal substitutes also emerge as pivotal research strategies to develop adequate scaffolds for stem cells, tissue engineering and regenerative medicine applications to obtain long-lasting and scarless artificial skin. This review discusses status-quo of dermal substitutes and novel strategies in the use of dermal substitutes with a focus on burn care. PMID:24393152

  2. Total obstetric brachial plexus palsy in children with internal rotation contracture of the shoulder, flexion contracture of the elbow, and poor hand function: improving the cosmetic appearance of the limb with rotation osteotomy of the humerus.

    PubMed

    Al-Qattan, Mohammad M

    2010-07-01

    Rotation osteotomy of the humerus has been described by several authors to treat the internal rotation contracture of the shoulder in Erb palsy. The main aim of the osteotomy in Erb patients is to bring the functioning hand to the face which greatly improves function. The author has performed the rotation humeral osteotomy in children with total obstetric brachial plexus palsy aiming for the improvement of the cosmetic appearance of the limb rather than improvement function. This article specifically reports on this group of patients.Over the last 15 years, the author has performed rotation humeral osteotomy in 13 children (mean age 6 years; range, 4.5-9 years) with total obstetric brachial plexus palsy aiming for improvement of the cosmetic appearance of the limb rather than improvement of function. All children had a triad of severe internal rotation contracture of the shoulder, severe flexion contracture of the elbow, and poor hand function.After a mean follow-up of 2 years following the humeral osteotomy, all patients/parents were satisfied with the result and a panel of plastic surgeons confirmed the significant improvement in aesthetics. Reasons for this improvement following the osteotomy were as follows: the child no longer needed to stand with shoulder slightly abducted, the antecubital fossa became visible in the standing position, and the forearm no longer appeared excessively pronated. Of more importance, was the improvement in elbow flexion contracture which had major contribution in improving limb appearance and the perception of length discrepancy between the affected and the contralateral normal limb.The humeral osteotomy improves the cosmetic appearance of children with total palsy and the triad of severe internal rotation contracture of the shoulder, severe flexion contracture of the elbow and poor hand function. PMID:20548233

  3. Bladder Contracture - A Rare and Serious Side Effect of Intravesical Bacillus Calmette-Guérin Therapy.

    PubMed

    Garcia, Cindy; Jina, Hamesh; Bergersen, Philip; Chalasani, Venu

    2016-01-01

    Instillation of intravesical bacillus Calmette-Guérin (BCG) is an effective treatment for non-muscle invasive bladder cancer (NMIBC). The high incidence of side effects may limit its tolerability in patients. Local side effects including cystitis and hematuria are common but generally self-limiting. Bladder contractures are a rare but serious consequence of BCG treatment. In this case, an 82 year-old male developed BCG reactivation and subsequent bladder contractures following transurethral resection of the prostate (TURP) three years post-BCG. To our knowledge, this is the first reported case of BCG reactivation post-TURP leading to the rare but serious effect of bladder contractures. PMID:26793570

  4. Improving global fire carbon emissions estimates by combining moderate resolution burned area and active fire observations

    NASA Astrophysics Data System (ADS)

    Randerson, J. T.; Chen, Y.; Giglio, L.; Rogers, B. M.; van der Werf, G.

    2011-12-01

    In several important biomes, including croplands and tropical forests, many small fires exist that have sizes that are well below the detection limit for the current generation of burned area products derived from moderate resolution spectroradiometers. These fires likely have important effects on greenhouse gas and aerosol emissions and regional air quality. Here we developed an approach for combining 1km thermal anomalies (active fires; MOD14A2) and 500m burned area observations (MCD64A1) to estimate the prevalence of these fires and their likely contribution to burned area and carbon emissions. We first estimated active fires within and outside of 500m burn scars in 0.5 degree grid cells during 2001-2010 for which MCD64A1 burned area observations were available. For these two sets of active fires we then examined mean fire radiative power (FRP) and changes in enhanced vegetation index (EVI) derived from 16-day intervals immediately before and after each active fire observation. To estimate the burned area associated with sub-500m fires, we first applied burned area to active fire ratios derived solely from within burned area perimeters to active fires outside of burn perimeters. In a second step, we further modified our sub-500m burned area estimates using EVI changes from active fires outside and within of burned areas (after subtracting EVI changes derived from control regions). We found that in northern and southern Africa savanna regions and in Central and South America dry forest regions, the number of active fires outside of MCD64A1 burned areas increased considerably towards the end of the fire season. EVI changes for active fires outside of burn perimeters were, on average, considerably smaller than EVI changes associated with active fires inside burn scars, providing evidence for burn scars that were substantially smaller than the 25 ha area of a single 500m pixel. FRP estimates also were lower for active fires outside of burn perimeters. In our analysis we quantified how including sub-500m burned area influenced global burned area, carbon emissions, and net ecosystem exchange (NEE) in different continental regions using the Global Fire Emissions Database (GFED) biogeochemical model. We conclude by discussing validation needs using higher resolution visible and thermal imagery.

  5. A case of spontaneous tubal pregnancy with caesarean scar pregnancy

    PubMed Central

    Zhu, Jie; Shen, Yue-Ying; Zhao, Yu-Qing; Lin, Ru; Fang, Fang

    2014-01-01

    Tubal pregnancy with caesarean scar pregnancy is rare. Early, accurate diagnosis and treatment for this kind of ectopic pregnancy can lead to a decrease of maternal morbidity and mortality. Here, we report a rare case of spontaneous tubal pregnancy co-existing with caesarean scar pregnancy. After timely emergency laparoscopy and curettage, the patient was cured. PMID:25356166

  6. Topical modalities for treatment and prevention of postsurgical hypertrophic scars.

    PubMed

    Foo, Chong Wee; Tristani-Firouzi, Payam

    2011-08-01

    There is no universally accepted treatment regimen and no evidence-based literature to guide management of hypertrophic scars. This article summarizes the existing literature regarding topical treatments such as silicone gel sheeting and ointment, onion extract, vitamin E, pressure garment therapy, massage therapy, and topical imiquimod 5% cream in the management of hypertrophic scars. PMID:21856542

  7. Regenerative healing, scar-free healing and scar formation across the species: current concepts and future perspectives.

    PubMed

    Ud-Din, Sara; Volk, Susan W; Bayat, Ardeshir

    2014-09-01

    All species have evolved mechanisms of repair to restore tissue function following injury. Skin scarring is an inevitable and permanent endpoint for many postnatal organisms except for non-amniote vertebrates such as amphibians, which are capable of tissue regeneration. Furthermore, mammalian foetuses through mid-gestation are capable of rapid wound repair in the absence of scar formation. Notably, excessive cutaneous scar formation, such as hypertrophic and keloid scars, is a species limited clinical entity as it occurs only in humans, although wounds on the distal limbs of horses are also prone to heal with fibroproliferative pathology known as equine exuberant granulation tissue. Currently, there are no reliable treatment options to eradicate or prevent scarring in humans and vertebrates. The limited number of vertebrate models for either hypertrophic or keloid scarring has been an impediment to mechanistic studies of these diseases and the development of therapies. In this viewpoint essay, we highlight the current concepts of regenerative, scar-free and scar-forming healing compared across a number of species and speculate on areas for future research. Furthermore, in-depth investigative research into the mechanisms of scarless repair may allow for the development of improved animal models and novel targets for scar prevention. As the ability to heal in both a scarless manner and propensity for healing with excessive scar formation is highly species dependent, understanding similarities and differences in healing across species as it relates to the regenerative process may hold the key to improve scarring and guide translational wound-healing studies. PMID:24863070

  8. SCAR-B fires in the tropics: Properties and remote sensing from EOS-MODIS

    NASA Astrophysics Data System (ADS)

    Kaufman, Yoram J.; Kleidman, Richard G.; King, Michael D.

    1998-12-01

    Two moderate resolution imaging spectroradiometer (MODIS) instruments are planned for launch in 1999 and 2000 on the NASA Earth Observing System (EOS) AM-1 and EOS PM-1 satellites. The MODIS instrument will sense fires with designated 3.9 and 11 ?m channels that saturate at high temperatures (450 and 400 K, respectively). MODIS data will be used to detect fires, to estimate the rate of emission of radiative energy from the fire, and to estimate the fraction of biomass burned in the smoldering phase. The rate of emission of radiative energy is a measure of the rate of combustion of biomass in the fires. In the Smoke, Clouds, and Radiation-Brazil (SCAR-B) experiment the NASA ER-2 aircraft flew the MODIS airborne simulator (MAS) to measure the fire thermal and mid-IR signature with a 50 m spatial resolution. These data are used to observe the thermal properties and sizes of fires in the cerrado grassland and Amazon forests of Brazil and to simulate the performance of the MODIS 1 km resolution fire observations. Although some fires saturated the MAS 3.9 ?m channel, all the fires were well within the MODIS instrument saturation levels. Analysis of MAS data over different ecosystems, shows that the fire size varied from single MAS pixels (50×50 m) to over 1 km2. The 1×1 km resolution MODIS instrument can observe only 30-40% of these fires, but the observed fires are responsible for 80 to nearly 100% of the emitted radiative energy and therefore for 80 to 100% of the rate of biomass burning in the region. The rate of emission of radiative energy from the fires correlated very well with the formation of fire burn scars (correlation coefficient = 0.97). This new remotely sensed quantity should be useful in regional estimates of biomass consumption.

  9. BKL maps, Poincaré sections, and quantum scars

    NASA Astrophysics Data System (ADS)

    Lecian, Orchidea Maria

    2013-11-01

    Cosmological billiards arise as a map of the solution to the Einstein equations, when the most general symmetry of the metric tensor is implemented, under the Belinskii, Khalatnikov and Lifshitz (BKL) paradigm, for which points are spatially decoupled in the asymptotical limit close to the cosmological singularity. Cosmological billiards in 4=3+1 dimensions for the case of pure gravity are analyzed for those features, for which the content of Weyl reflections in the BKL maps requires the definition of a three-dimensional restricted phase space. The role of Poincaré sections in these processes is outlined. The quantum regime is investigated within this framework: as a result, one-epoch BKL eras are found to be the most probable configuration at which the wave functions have to be evaluated; furthermore, BKL eras containing n?1 epochs are shown to be a less probable configuration for the wave functions. This description of the dynamics allows one to gain information about the connections between the statistical characterization of the maps which imply the different symmetry-quotienting mechanisms and the characterization of the semiclassical limit of the wave functions, for which evidence is produced for the phenomenon of “scars,” here for the first time outlined for the wave function of the universe in cosmological billiards, analyzed for the lowest silver ratios, and compared with the implications of a Farey map. The connections between the classical BKL probabilties and the quanum BKL probabilities for the “scarred” wave functions of the universe are provided and compared within different expansions according to different limits of the BKL statistics

  10. Two pregnancy cases of uterine scar dehiscence after laparoscopic myomectomy

    PubMed Central

    Song, Soo-Youn; Yoo, Hee-Jun; Kang, Byung-Hun; Ko, Young-Bok; Lee, Ki-Hwan

    2015-01-01

    Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies. PMID:26623418

  11. Two pregnancy cases of uterine scar dehiscence after laparoscopic myomectomy.

    PubMed

    Song, Soo-Youn; Yoo, Hee-Jun; Kang, Byung-Hun; Ko, Young-Bok; Lee, Ki-Hwan; Lee, Mina

    2015-11-01

    Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies. PMID:26623418

  12. Old-scar mass and changing surgical perspective: Sarcoidosis

    PubMed Central

    Aktimur, Recep; Aktimur, Sude Hatun; Çolak, Elif; Al?c?, Ömer; Demira?, Mehmet Derya

    2015-01-01

    Sarcoidosis is a systemic inflammatory disease of an unknown etiology. Skin is involved in 25% of all cases, and 29% of them present as a scar sarcoidosis. Asymptomatic old-scar masses are generally regarded as a foreign body reaction by surgeons and often result in excisional biopsy. We describe a case of a patient who developed sarcoidosis in a 34-year-old appendectomy scar and adjacent inguinal lymph nodes without any local or systemic symptom and radiologic finding. Surgeons should not underestimate the importance of such lesions as a simple condition. Scar sarcoidosis may resolve spontaneously, or the treatment with some topical agents is effective. Furthermore, scar sarcoidosis may be the initial manifestation of systemic sarcoidosis. PMID:25931946

  13. Special problems in burns.

    PubMed

    Sheridan, Robert L; Greenhalgh, David

    2014-08-01

    Burn units provide a unique set of resources to patients with complex wounds, sepsis, and organ failures. This resource set is useful in a number of traumatic, infectious, and medical conditions as well. Further, many burn patients have sustained simultaneous non-burn trauma which will be managed in burn programs. PMID:25085088

  14. Bruck syndrome - a rare syndrome of bone fragility and joint contracture and novel homozygous FKBP10 mutation.

    PubMed

    Moravej, Hossein; Karamifar, Hamdollah; Karamizadeh, Zohreh; Amirhakimi, Gholamhossein; Atashi, Sepideh; Nasirabadi, Shiva

    2015-01-01

    Bruck syndrome is an autosomal recessive syndrome consisting of bone fragility and congenital joint contractures. According to the genotype, it has been classified into types 1 and 2. Recently, mutations in FKBP10, localised to chromosome 17q21, have been identified in some patients of Bruck syndrome. Twenty-seven patients of this syndrome have been reported so far. We present a new patient of this syndrome, with frequent fractures, congenital joint contractures, kyphoscoliosis, bilateral clubfoot, and pectus carinatum. The clinical and genetic features of all previously reported cases are also reviewed. PMID:25931047

  15. Vicious Cycle of Multiple Invasive Treatments in a Hemophilic Inhibitor Positive Child with Resistant Knee Flexion Contracture, A Case Report

    PubMed Central

    Kachooei, Amir Reza; Badiei, Zahra; Zandinezhad, Mohammad E

    2013-01-01

    Uncontrolled recurrent hemarthrosis can end to contracture, deformity, pain, joint destruction and gait disorders which are disabling. We are going to report a challenge, a unilateral knee flexion contracture in a child with severe hemophilia A and inhibitor who underwent different treatment options with unsatisfactory improvement of knee range of motion. Mismanaging postoperatively, patient and parents irresponsibility in managing self-care, lack of access and affordability to treatment and unavailability of proper treatment can be the reasons of recurrence in addition to the tough nature of a patient with inhibitor. PMID:25207302

  16. In Vitro Contracture Test Results and Anaesthetic Management of a Patient with Emery-Dreifuss Muscular Dystrophy for Cardiac Transplantation

    PubMed Central

    Schuster, Frank; Wessig, Carsten; Schimmer, Christoph; Johannsen, Stephan; Lazarus, Marc; Aleksic, Ivan; Leyh, Rainer; Roewer, Norbert

    2012-01-01

    Emery-Dreifuss muscular dystrophy (EDMD) is a hereditary neuromuscular disorder characterized by slowly progressive muscle weakness, early contractures, and dilated cardiomyopathy. We reported an uneventful general anaesthesia using total intravenous anaesthesia (TIVA) for cardiac transplantation in a 19-year-old woman suffering from EDMD. In vitro contracture test results of two pectoralis major muscle bundles of the patient suggest that exposition to triggering agents does not induce a pathological sarcoplasmic calcium release in the lamin A/C phenotype. However, due to the lack of evidence in the literature, we would recommend TIVA for patients with EDMD if general anaesthesia is required. PMID:22973525

  17. An Autosomal Recessive Syndrome of Joint Contractures, Muscular Atrophy, Microcytic Anemia, and Panniculitis-Associated Lipodystrophy

    PubMed Central

    Garg, Abhimanyu; Hernandez, Maria Dolores; Sousa, Ana Berta; Subramanyam, Lalitha; Martínez de Villarreal, Laura; dos Santos, Heloísa G.; Barboza, Oralia

    2010-01-01

    Context: Genetic lipodystrophies are rare disorders characterized by partial or complete loss of adipose tissue and predisposition to insulin resistance and its complications such as diabetes mellitus, hypertriglyceridemia, hepatic steatosis, acanthosis nigricans, and polycystic ovarian syndrome. Objective: The objective of the study was to report a novel autosomal recessive lipodystrophy syndrome. Results: We report the detailed phenotype of two males and one female patient, 26–34 yr old, belonging to two pedigrees with an autosomal recessive syndrome presenting with childhood-onset lipodystrophy, muscle atrophy, severe joint contractures, erythematous skin lesions, and microcytic anemia. Other variable clinical features include hypergammaglobulinemia, hepatosplenomegaly, generalized seizures, and basal ganglia calcification. None of the patients had diabetes mellitus or acanthosis nigricans. Two had mild hypertriglyceridemia and all had low levels of high-density lipoprotein cholesterol. Skin biopsy of an erythematous nodular skin lesion from one of the patients revealed evidence of panniculitis. The lipodystrophy initially affected the upper body but later became generalized involving abdomen and lower extremities as well. Conclusions: We conclude that these patients represent a novel autoinflammatory syndrome resulting in joint contractures, muscle atrophy, microcytic anemia, and panniculitis-induced lipodystrophy. The molecular genetic basis of this disorder remains to be elucidated. PMID:20534754

  18. Contracture deformity

    MedlinePLUS

    ... TD Jr., eds. Essentials of Physical Medicine and Rehabilitation . 3rd ed. Philadelphia, PA: Saunders Elsevier; 2014:chap ... TM, Osterman AL, Fedorczyk J, Amadio P, eds. Rehabilitation of the Hand and Upper Extremity . 6th ed. ...

  19. Coin and currency burn.

    PubMed

    Bhatti, Asif Zubair; Chapman, William Thomas; Naveed, Masroor; McDiarmid, James R

    2006-01-01

    We describe a case of burns purposefully sustained in a patient performing a bizarre pub game while under the influence of alcohol. Full-thickness burns were sustained through contact with a 50-p UK currency coin essentially heated with burning paper. We discuss the nature and ease by which such burns can be sustained in the community and the increasing awareness of alcohol abuse as a factor in a significant proportion of such self-inflicted burns. PMID:16566547

  20. Inclusion of Scar/WAVE3 in a similar complex to Scar/WAVE1 and 2

    PubMed Central

    Stovold, Craig F; Millard, Thomas H; Machesky, Laura M

    2005-01-01

    Background The Scar/WAVE family of proteins mediates signals to actin assembly by direct activation of the Arp2/3 complex. These proteins have been characterised as major regulators of lamellipodia formation downstream of Rac activation and as members of large protein complexes. Results We have investigated the interactions of the three human Scar/WAVE isoforms with several previously described binding partners for Scar/WAVE 1 or 2. We find that all three Scar/WAVE isoforms behave similarly and are likely to participate in the same kinds of protein complexes that regulate actin assembly. Conclusion Differences between Scar/WAVE proteins are therefore likely to be at the level of tissue distribution or subtle differences in the affinity for specific binding partners. PMID:15752430

  1. Medicinal Plants for the Treatment of Hypertrophic Scars

    PubMed Central

    Ye, Qi; Wang, Su-Juan; Chen, Jian-Yu; Xin, Hai-Liang; Zhang, Hong

    2015-01-01

    Hypertrophic scar is a complication of wound healing and has a high recurrence rate which can lead to significant abnormity in aesthetics and functions. To date, no ideal treatment method has been established. Meanwhile, the underlying mechanism of hypertrophic scarring has not been clearly defined. Although a large amount of scientific research has been reported on the use of medicinal plants as a natural source of treatment for hypertrophic scarring, it is currently scattered across a wide range of publications. Therefore, a systematic summary and knowledge for future prospects are necessary to facilitate further medicinal plant research for their potential use as antihypertrophic scar agents. A bibliographic investigation was accomplished by focusing on medicinal plants which have been scientifically tested in vitro and/or in vivo and proved as potential agents for the treatment of hypertrophic scars. Although the chemical components and mechanisms of action of medicinal plants with antihypertrophic scarring potential have been investigated, many others remain unknown. More investigations and clinical trials are necessary to make use of these medical plants reasonably and phytotherapy is a promising therapeutic approach against hypertrophic scars. PMID:25861351

  2. The Use of Stem Cells in Burn Wound Healing: A Review

    PubMed Central

    Ghieh, Fadi; Jurjus, Rosalyn; Ibrahim, Amir; Geagea, Alice Gerges; Daouk, Hisham; El Baba, Bassel; Chams, Sana; Matar, Michel; Zein, Wadih; Jurjus, Abdo

    2015-01-01

    Burn wound healing involves a series of complex processes which are subject to intensive investigations to improve the outcomes, in particular, the healing time and the quality of the scar. Burn injuries, especially severe ones, are proving to have devastating effects on the affected patients. Stem cells have been recently applied in the field to promote superior healing of the wounds. Not only have stem cells been shown to promote better and faster healing of the burn wounds, but also they have decreased the inflammation levels with less scar progression and fibrosis. This review aims to highlight the beneficial therapeutic effect of stem cells in burn wound healing and to discuss the involved pathways and signaling molecules. The review covers various types of burn wound healing like skin and corneal burns, along with the alternative recent therapies being studied in the field of burn wound healing. The current reflection of the attitudes of people regarding the use of stem cells in burn wound healing is also stated. PMID:26236731

  3. External rhinoplasty for the Arabian nose: a columellar scar analysis.

    PubMed

    Foda, Hossam M T

    2004-01-01

    This study aimed to evaluate columellar scar problems after external rhinoplasty in the Arabian population, and to analyze the technical factors that help prevent such problems and maximize the scar cosmesis. The investigation was conducted in university and private practice settings of the author in Alexandria, Egypt. A total of 600 Arab patients who underwent external rhinoplasty were included in the study. All the patients underwent surgery using the external rhinoplasty approach, in which bilateral alar marginal incisions were connected by an inverted V-shaped transcolumellar incision. At completion of the procedure, a two-layer closure of the columellar incision was performed. At a minimum of 1 year postoperatively, the columellar scar was evaluated subjectively by means of a patient questionnaire, and objectively by clinical examination and comparison of the close-up pre- and postoperative basal view photographs. Objectively, anything less than a barely visible, leveled, thin, linear scar was considered unsatisfactory. Subjectively, 95.5% of the patients rated the scar as unnoticeable, 3% as noticeable but acceptable, and 1.5% as unacceptable. Objectively, the scar was unsatisfactory in 7% of the cases. This was because of scar widening with or without depression (5%), hyperpigmentation (1.5%), and columellar rim notching (0.5%). The use of a deep 6/0 polydioxanon (PDS) suture significantly decreased the incidence of scar widening (p < 0.005).The columellar incision can be used safely in the Arab population regardless of their thick, dark, and oily skin. Technical factors that contributed to the favorable outcome of the columellar scar included proper planning of location and design of the incision used, precise execution, meticulous multilayered closure, and good postoperative care. PMID:15666046

  4. Nonlinear optics for the study of human scar tissue

    NASA Astrophysics Data System (ADS)

    Ferro, D. P.; Vieira-Damiani, G.; Adam, R. L.; Cesar, C. L.; Metze, Konradin

    2012-03-01

    Collagen fibers are an essential component of the dynamic process of scarring, which accompanies various diseases. Scar tissue may reveal different morphologic expressions, such as hypertrophic scars or keloids. Collagen fibers can be visualized by fluorescent light when stained with eosin. Second Harmonic Generation (SHG) creates a non linear signal that occurs only in molecules without inversion symmetry and is particularly strong in the collagen fibers arranged in triple helices. The aim of this study was to describe the methodology for the analysis of the density and texture of collagen in keloids, hypertrophic scars and conventional scars. Samples were examined in the National Institute of Science and Technology on Photonics Applied to Cell Biology (INFABIC) at the State University of Campinas. The images were acquired in a multiphoton microscopy LSM 780-NLO Zeiss 40X. Both signals, two-photon fluorescence (TPEF) and SHG, were excited by a Mai-Tai Ti:Sapphire laser at 940 nm. We used a LP490/SP485 NDD filter for SHG, and a BP565-610 NDD filter for fluorescence In each case, ten images were acquired serially (512×512 ?m) in Z-stack and joined together to one patchwork-image . Image analysis was performed by a gliding-box-system with in-house made software. Keloids, hypertrophic scars and normal scar tissue show different collagen architecture. Inside an individual case differences of the scar process may be found between central and peripheral parts. In summary, the use of nonlinear optics is a helpful tool for the study of scars tissue.

  5. Control of scar formation in experimentally induced epilepsy.

    PubMed

    Hoeppner, T J; Morrell, F

    1986-12-01

    Penfield proposed that the meningocerebral scar that forms following trauma to the brain plays an important role in the development of posttraumatic epilepsy. Although the epileptogenic scar has come to be widely accepted as a cause of epilepsy, there is no direct evidence that scar formation contributes to epileptogenesis. This current study showed that procedures that control the development of collagen in a fibroblastic scar may modify the development of epilepsy. Epilepsy induced in the guinea pig by injection of metallic aluminum powder into the cerebral cortex was used as a model of posttraumatic epilepsy. Following application of aluminum and implantation of epidural electrodes, animals received either daily injections of prednisolone or an ascorbic acid-deficient diet to block scar formation. Control animals also had an injection of aluminum, but afterward received saline injections or a normal diet. Control animals developed epileptic spikes and often exhibited focal seizures. All manifestations of epileptogenesis were markedly reduced in animals treated with prednisolone or the ascorbic acid-deficient diet. The reduction in epileptiform activity corresponded to reduced collagenous scar formation in the treated animals. Although effective when given prophylactically, prednisolone did not inhibit the activity of an already established epileptic focus whether induced by aluminum or by amygdala kindling, nor did it block pentylenetetrazol-induced seizures. The finding that epileptogenesis is blocked by two procedures that inhibit scar formation but show no evidence of a direct anticonvulsant effect, suggests that scar formation is a significant factor in epileptogenesis induced by metallic aluminum. The collagenous component appears to be more significant than the glial component of the scar. PMID:3780905

  6. [Differential approach to the use of drug ultraphonophoresis for scars].

    PubMed

    Gerasimenko, M Iu; Zenger, V G; Iusova, Zh Iu

    2002-01-01

    A differential approach to administration of drug ultraphonophoresis (gel contractubex, collitin, elastolitin) in scarry deformations is proposed. The analysis of 82 treatment outcomes has shown that early after trauma (on day 6-12) it is more beneficial to use ultraphonophoresis (UPP) of heparin-containing compounds improving blood rheology, e.g. lidase. This prevents development of pathological scars. Later, when the scar tissues has already formed, more effective is UPP of enzyme medicines with fibrinolytic properties (collitin, elastolitin). Differentiated choice of UPP in scar therapy reduces the time of rehabilitation considerably. PMID:12132225

  7. The spatial and temporal distribution of crop residue burning in the contiguous United States.

    PubMed

    McCarty, Jessica L; Korontzi, Stefania; Justice, Christopher O; Loboda, Tatiana

    2009-10-15

    Burning crop residue before and/or after harvest is a common farming practice however; there is no baseline estimate for cropland burned area in the contiguous U.S. (CONUS). We present the results of a study, using five years of remotely sensed satellite data to map the location and areal extent of crop residue burning in the CONUS. Our burned area approach combines 500 m Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Burn Ratio (dNBR) data, with 1 km MODIS active fire counts calibrated using coincident high resolution satellite data to generate area estimates. Our results show that cropland burning is an extensive and recurring annual event in several states in the CONUS. On average, 1,239,000 ha of croplands burn annually, which is equivalent to 43% of the annual average area of wildland fires in the U.S., as reported by the United States Forest Service for the same period. Several states experience high levels (>30,000 ha yr(-1)) of crop residue burning, including Arkansas, California, Colorado, Florida, Idaho, Kansas, Louisiana, North Dakota, Oklahoma, Oregon, South Dakota, Texas, and Washington. Validation with high resolution burn scar imagery and GPS data collected during targeted field campaigns showed a moderate to high-level accuracy for our burned area estimates, ranging from 78 to 90%. Our approach provides a more consistent methodology for quantifying cropland burned area at regional scales than the previously available U.S. national and state-level statistics on crop residue burning. PMID:19647857

  8. Outcome of post-infectious renal scarring.

    PubMed

    Tullus, Kjell

    2015-09-01

    In this issue of Pediatric Nephrology, Gebäck et al. from Gothenburg, Sweden, show that after a mean follow-up after childhood urinary tract infection of 41 years, kidney function decreases from a mean of 93 ml/min/1.73m(2) to 81 ml/min/1.73m(2). This was found in women with severe bilateral renal scarring. They had experienced their UTI during childhood in the 1950s and 1960s and had been drawn from a population-based cohort of more than 1,000 children. A previous paper on this same group of women had shown a higher systolic blood pressure of 3 mmHg during the day and 5 mmHg during the night compared with a control group. This contrasted with a follow-up study published earlier by the same group on two different cohorts in which no impairment of kidney function or increase in hypertension could be found. The present follow-up time was 13 years longer than that of any previous studies. Data on the long-term outcome of children who have had one or several urine infections is very important, as the fear of long-term complications has been driving the extensive investigations to which these children have traditionally been subjected. Further population-based follow-up data can help us to outline modern guidance on imaging after UTI. PMID:26037738

  9. Congenital contractural arachnodactyly complicated with aortic dilatation and dissection: Case report and review of literature.

    PubMed

    Takeda, Norifumi; Morita, Hiroyuki; Fujita, Daishi; Inuzuka, Ryo; Taniguchi, Yuki; Imai, Yasushi; Hirata, Yasunobu; Komuro, Issei

    2015-10-01

    Congenital contractural arachnodactyly (CCA) is a connective tissue disease caused by mutations of the FBN2, which encodes fibrillin-2. CCA patients have a marfanoid habitus; however, aortic dilatation and/or dissection as observed in Marfan syndrome have been rarely documented. Here, we report on a Japanese familial case of CCA resulting from a FBN2 splicing mutation (IVS32+5g→a), which leads to exon 32 being skipped, and the patients developed aortic dilatation and type A dissection. Although CCA patients have been believed to have favorable prognoses, repetitive aortic imaging studies must be performed in some patients to detect possible aortic disease early, and genetic testing of FBN2 might be useful to identify such high-risk patients. PMID:25975422

  10. [Dupuytren contracture in Mosel wine dressers with arsenic-induced aftereffect damage].

    PubMed

    Grobe, J W

    1982-01-01

    Between 1972 and 1981 a total of 121 male and female wine-dressers with late after-effects from arsenic were medically examined and treated. Skin and liver were examined regularly every 3 months. With advancing years an increase in typically arsenic melanosis, precancerous, carcinomas and hyperkeratosis in palmae and plantae was observed. A significant increase in Dupuytren's contracture was found in the age groups between 50 and 80 with a growing progression of typically arsenic horned pearls on the palms of the hands and soles of the feet. The typically arsenic horned pearls and arsenical keratosis occurred most frequently in the Dupuytrenical changes of the skin. The liver parameters showed no pathological results such as cirrhosis of the liver as compared with the other patients. PMID:6218979

  11. Heparin Reduced Mortality and Sepsis in Severely Burned Children

    PubMed Central

    Zayas, G.J.; Bonilla, A.M.; Saliba, M.J

    2007-01-01

    Summary Objectives. In El Salvador, before 1999, morbidity and mortality in severely burned children were high. In 1998, all children with burns of 40% or larger size died and sepsis was found. With heparin use in 1999, some similarly burned children survived, and sepsis, pain, procedures, and scars were noted to be less. This retrospective study presents the details. Methods. A study was conducted at the National Children's Hospital in El Salvador of all children with burns over 20% size treated in 1998, when no heparin was used, and in 1999, when heparin was added to burns treatment, using an ethics committee approved protocol in use in twelve other countries. Sodium aqueous heparin solution USP from an intestinal source was infused intravenously and applied topically onto burn surfaces and within blisters for the first 1-3 days post-burn. Then heparin, in diminishing doses, was continued only topically until healing. The treatments in 1998 and 1999 were otherwise the same, except that fewer procedures were needed in 1999. Results. There were no significant differences in gender, age, weight, burn aetiology, or burn size between the burned children in 1998 and those in 1999. Burn pain was relieved and pain medicine was not needed in children treated with heparin in 1999. In 1998, one child survived who had a 35% size burn, and the eight children died who had burns of 40% and over. The survival rate was one out of nine (11%). The average burn size was 51.7%. With heparin use in 1999, six of the ten children survived burns of 50.7% average size. The increase in survival with heparin from 11% to 60% and, therefore, the decrease in mortality from 89% to 40% were significant (p < 0.04). Clinical symptoms and positive blood cultures documented bacterial sepsis in the nine children in 1998. In 1999, the blood cultures for sepsis were positive in the four children who died and negative in the six who survived. The nine versus four differences in the incidence of sepsis between 1998 and 1999 was significant (p < 0.008). The survivors had notably smooth skin. Conclusions. The use of heparin in this study relieved burn pain, significantly reduced mortality and sepsis with fewer procedures, and discernibly improved cosmetic results. PMID:21991064

  12. Identification of differentially expressed genes in fibroblasts derived from patients with Dupuytren's Contracture

    PubMed Central

    Satish, Latha; LaFramboise, William A; O'Gorman, David B; Johnson, Sandra; Janto, Benjamin; Gan, Bing Siang; Baratz, Mark E; Hu, Fen Z; Post, J Christopher; Ehrlich, Garth D; Kathju, Sandeep

    2008-01-01

    Dupuytren's contracture (DC) is the most common inherited connective tissue disease of humans and is hypothesized to be associated with aberrant wound healing of the palmar fascia. Fibroblasts and myofibroblasts are believed to play an important role in the genesis of DC and the fibroproliferation and contraction that are hallmarks of this disease. This study compares the gene expression profiles of fibroblasts isolated from DC patients and controls in an attempt to identify key genes whose regulation might be significantly altered in fibroblasts found within the palmar fascia of Dupuytren's patients. Total RNA isolated from diseased palmar fascia (DC) and normal palmar fascia (obtained during carpal tunnel release; 6 samples per group) was subjected to quantitative analyses using two different microarray platforms (GE Code Link™ and Illumina™) to identify and validate differentially expressed genes. The data obtained was analyzed using The Significance Analysis of Microarrays (SAM) software through which we identified 69 and 40 differentially regulated gene transcripts using the CodeLink™ and Illumina™ platforms, respectively. The CodeLink™ platform identified 18 upregulated and 51 downregulated genes. Using the Illumina™ platform, 40 genes were identified as downregulated, eleven of which were identified by both platforms. Quantitative RT-PCR confirmed the downregulation of three high-interest candidate genes which are all components of the extracellular matrix: proteoglycan 4 (PRG4), fibulin-1 (FBLN-1) transcript variant D, and type XV collagen alpha 1 chain. Overall, our study has identified a variety of candidate genes that may be involved in the pathophysiology of Dupuytren's contracture and may ultimately serve as attractive molecular targets for alternative therapies. PMID:18433489

  13. 15. Newfound Gap parking area with construction scar looking W. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Newfound Gap parking area with construction scar looking W. - Great Smoky Mountains National Park Roads & Bridges, Newfound Gap Road, Between Gatlinburg, TN & Cherokee, NC, Gatlinburg, Sevier County, TN

  14. First Aid: Burns

    MedlinePLUS

    ... You can get burned by heat, fire, radiation, sunlight, electricity, chemicals or hot or boiling water. There ... skin. The burned area will be sensitive to sunlight for up to one year, so you should ...

  15. American Burn Association

    MedlinePLUS

    ... and Activities Educational Resources Prevention Posters Awards FAQs Burn Awareness Week About IAC Accomplishments IAC Members Membership ... About Verification Verification Step by Step ACS Resources Burn Chapter Verification Criteria - Effective 1/1/2015 New! ...

  16. Burns and Fire Safety

    MedlinePLUS

    ... were seen in emergency rooms for fire and burn injuries in 2013. 1 Additional Statistics • Working smoke alarms ... Medical costs for hospital admissions for unintentional fire/burn injuries in children 19 and under average $14,498 ...

  17. A Nanomedicine Approach to Effectively Inhibit Contracture During Bladder Acellular Matrix Allograft-Induced Bladder Regeneration by Sustained Delivery of Vascular Endothelial Growth Factor

    PubMed Central

    Xiong, Qianwei; Lin, Houwei; Hua, Xiaolin; Liu, Li; Sun, Ping; Zhao, Zhen; Shen, Xiaowei; Cui, Daxiang; Xu, Maosheng

    2015-01-01

    Macroscopic evidence of contracture has been identified as a major issue during the regeneration process. We hypothesize that lack of angiogenesis is the primary cause of contracture and explore a nanomedicine approach to achieve sustained release of vascular endothelial growth factor (VEGF) to stimulate angiogenesis. We evaluate the efficacy of poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) for long-term (3 months) sustained release of VEGF in bladder acellular matrix allografts (BAMA) in a swine model. We anticipate that the sustained release of VEGF could stimulate angiogenesis along the regeneration process and thereby inhibit contracture. Bladder was replaced with BAMA (5×5?cm), modified with PLGA NPs encapsulated with VEGF in a pig model. The time points chosen for sampling were 1, 2, 4, and 12 weeks. The regenerated areas were then measured to obtain the contracture rate, and the extent of revascularization was calculated using histological and morphological features. In the control group of animals, the bladder was replaced with only BAMA. The in vivo release of VEGF was evident for ?3 months, achieving the goal of long-acting sustained release, and successfully promoted the regeneration of blood vessels and smooth muscle fibers. In addition, less collagen deposition was observed in the experimental group compared with control. Most importantly, the inhibition of contracture was highly significant, and the ultimate contracture rate decreased by ?57% in the experimental group compared with control. In isolated strips analysis, there were no significant differences between BAMA-regenerated (either VEGF added or not) and autogenous bladder. BAMA modified with VEGF-loaded PLGA-NPs can sustainably release VEGF in vivo (>3 months) to stimulate angiogenesis leading to the inhibition of contracture. This is the first study to report a viable nanomedicine-based strategy to overcome contracture during bladder regeneration induced by BAMA. Furthermore, this study also confirms that insufficient angiogenesis plays a crucial role in the onset of contracture. PMID:24947133

  18. Suppression of scarring in peripheral nerve implants by drug elution

    NASA Astrophysics Data System (ADS)

    FitzGerald, James J.

    2016-04-01

    Objective. Medical implants made of non-biological materials provoke a chronic inflammatory response, resulting in the deposition of a collagenous scar tissue (ST) layer on their surface, that gradually thickens over time. This is a critical problem for neural interfaces. Scar build-up on electrodes results in a progressive decline in signal level because the scar tissue gradually separates axons away from the recording contacts. In regenerative sieves and microchannel electrodes, progressive scar deposition will constrict and may eventually choke off the sieve hole or channel lumen. Interface designs need to address this issue if they are to be fit for long term use. This study examines a novel method of inhibiting the formation and thickening of the fibrous scar. Approach. Research to date has mainly focused on methods of preventing stimulation of the foreign body response by implant surface modification. In this paper a pharmacological approach using drug elution to suppress chronic inflammation is introduced. Microchannel implants made of silicone doped with the steroid drug dexamethasone were implanted in the rat sciatic nerve for periods of up to a year. Tissue from within the microchannels was compared to that from control devices that did not release any drug. Main results. In the drug eluting implants the scar layer was significantly thinner at all timepoints, and unlike the controls it did not continue to thicken after 6 months. Control implants supported axon regeneration well initially, but axon counts fell rapidly at later timepoints as scar thickened. Axon counts in drug eluting devices were initially much lower, but increased rather than declined and by one year were significantly higher than in controls. Significance. Drug elution offers a potential long term solution to the problem of performance degradation due to scarring around neural implants.

  19. Techniques to minimize skin incision scar for external dacryocystorhinostomy.

    PubMed

    Ng, Danny Siu-Chun; Chan, Edwin

    2016-02-01

    Although there has been a narrowing in the gap in successful functional outcomes between external and endonasal DCR, external DCR is still being frequently performed when cost, availability of additional surgical instruments and visual systems, surgeon's experience and preference are concerned. Nonetheless, skin incisions at the lateral nasal sidewall of the lower eyelid inevitably leave cutaneous scars. The purpose of this review is to evaluate the outcomes of current modified surgical practices that prevent a conspicuous scar in external DCR. PMID:26710168

  20. [Estimating Biomass Burned Areas from Multispectral Dataset Detected by Multiple-Satellite].

    PubMed

    Yu, Chao; Chen, Liang-fu; Li, Shen-shen; Tao, Jin-hua; Su, Lin

    2015-03-01

    Biomass burning makes up an important part of both trace gases and particulate matter emissions, which can efficiently degrade air quality and reduce visibility, destabilize the global climate system at regional to global scales. Burned area is one of the primary parameters necessary to estimate emissions, and considered to be the largest source of error in the emission inventory. Satellite-based fire observations can offer a reliable source of fire occurrence data on regional and global scales, a variety of sensors have been used to detect and map fires in two general approaches: burn scar mapping and active fire detection. However, both of the two approaches have limitations. In this article, we explore the relationship between hotspot data and burned area for the Southeastern United States, where a significant amount of biomass burnings from both prescribed and wild fire took place. MODIS (Moderate resolution imaging spectrometer) data, which has high temporal-resolution, can be used to monitor ground biomass. burning in time and provided hot spot data in this study. However, pixel size of MODIS hot spot can't stand for the real ground burned area. Through analysis of the variation of vegetation band reflectance between pre- and post-burn, we extracted the burned area from Landsat-5 TM (Thematic Mapper) images by using the differential normalized burn ratio (dNBR) which is based on TM band4 (0.84 ?m) and TM band 7(2.22 ?m) data. We combined MODIS fire hot spot data and Landsat-5 TM burned scars data to build the burned area estimation model, results showed that the linear correlation coefficient is 0.63 and the relationships vary as a function of vegetation cover. Based on the National Land Cover Database (NLCD), we built burned area estimation model over different vegetation cover, and got effective burned area per fire pixel, values for forest, grassland, shrub, cropland and wetland are 0.69, 1.27, 0.86, 0.72 and 0.94 km2 respectively. We validated the burned area estimates by using the ground survey data from National interagency Fire Center (NIFC), our results are more close to the ground survey data than burned area from Global Fire Emissions Database (GFED) and MODIS burned area product (MCD45), which omitted many small prescribed fires. We concluded that our model can provide more accurate burned area parameters for developing fire emission inventory, and be better for estimating emissions from biomass burning. PMID:26117890

  1. Extensive burns caused by the abusive use of photosensitizing agents.

    PubMed

    Braye, F; Latarjet, J; Foyatier, J L; Comparin, J P; Tranchand, P; Boucaud, C

    1997-01-01

    Psoralens are photosensitizing agents used in dermatology as reinforcements in psoralen ultraviolet A-range therapy. We report observations of 14 young women hospitalized for severe burns caused by abusive use of psoralens. The burns were of superficial and deep second-degree depth and covered more than 76% of the body surface on average. All patients needed fluid resuscitation. Hospital stay was 11 days on average. Healing was obtained without skin grafting in all cases. Among the six patients who responded to the mailed questionnaire, negative effects are now present in all patients as inflammatory peaks. Two patients have esthetic sequelae such as dyschromia and scars. The misuse of photosensitizing agents poses many problems. These accidents are very expensive. The largeness of the burned surface can involve a fatal prognosis. And finally, one can suspect that a much larger portion of the population regularly uses these products without any serious accident. In this case carcinogenesis can be expected. PMID:9261698

  2. Learn Not To Burn.

    ERIC Educational Resources Information Center

    English, Nancy; Hendricks, Charlotte M.

    1997-01-01

    Describes the "Learn Not to Burn Preschool Program," a low-cost fire safety awareness and burn prevention curriculum for young children. The program promotes eight burn prevention methods--including practicing an escape plan--using developmentally appropriate learning objectives to increase children's fire safety knowledge, skill, and…

  3. Economics of pediatric burns.

    PubMed

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures. PMID:18650705

  4. [Multiple trauma and burns].

    PubMed

    Carsin, H; Dutertre, G; Le Bever, H; Ainaud, P; Le Réveillé, R; Rives, J M

    1995-01-01

    In peace time, burn injury combined with traumatic, chemical or radioactive casualties is rarely encountered and often unrecognized; during disasters, burn injury is unlikely the only trauma. The authors try to bring out the main pathophysiological, diagnostic and therapeutic characteristics of changes induced by combined lesions on burn injury and vice-versa. PMID:7671090

  5. First Aid: Burns

    MedlinePLUS

    ... clothing stuck to the skin. Run cool (not cold) water over the burn until the pain eases. Lightly apply a gauze bandage. If your child is awake and alert, offer ibuprofen or acetaminophen for pain. Do not put any ointments, butter, or other remedies on the burn — these can make the burn ...

  6. Short and long-term cosmesis of cervical thyroidectomy scars.

    PubMed

    Dordea, M; Aspinall, S R

    2016-01-01

    Introduction Multiple surgical approaches to the thyroid gland have been described via cervical or extracervical routes. Improved cosmesis, patient satisfaction, reduced pain (procedure dependent) and early discharge have all been reported for minimally invasive approaches with similar safety profiles and long-term outcomes to conventional surgery. This review summarises the current evidence base for improved cosmesis with minimally invasive cervical approaches to the thyroid gland compared with conventional surgery. Methods A systematic review was undertaken. The MEDLINE(®), Embase™ and Cochrane databases were searched for relevant articles. Results A total of 57 papers thyroid papers were identified. Of those, 20 reported some form of cosmetic outcome assessment. There were 6 randomised controlled trials with 412 patients (evidence level 2B), 7 cohort studies with 3,073 patients (level 3B) and 7 non-comparative case series with 1,575 patients (level 4). There was significant heterogeneity between studies in terms of wound closure technique, timing of scar assessment and scar assessment scales (validated and non-validated). Most studies performed early scar assessments, some using non-validated scar assessment tools. Conclusions Assessment of cosmesis is complex and requires rigorous methodology. Evidence from healing/remodelling studies suggests scar maturation is a long-term process. This calls into question the value of early scar assessment. Current evidence does not support minimally invasive surgical approaches to the thyroid gland if improved long-term cosmesis is the goal. PMID:26688393

  7. Scar prevention by laser-assisted scar healing (LASH) using thermal post-conditioning

    NASA Astrophysics Data System (ADS)

    Gossé, Alban; Iarmarcovai, Gwen; Capon, Alexandre; Cornil, Alain; Mordon, Serge

    2009-02-01

    An 810-nm diode laser system was developed to accelerate and improve the healing process in surgical scars. Using thermal post-conditioning, the laser system provides a localised moderate heating whose maximum temperature is controlled to prevent tissue damage and stimulate the heat shock proteins (HSP) synthesis. The 810-nm wavelength allows a deep penetration of the light into the dermis, without damaging the epidermis. The time along which surgical incision is treated (continuous wave) must therefore be selected carefully with respect to the temperature precision achieved within the heated volume. A top-hat profile is preferred to a Gaussian profile in order to ensure the skin surface temperature is homogenised, as is the temperature of the heated volume. The spot shape will depend on the medical indication. The treatment should be made safe and controlled by means of a safety strip containing an RFID chip which will transmit the various operating settings to the laser device. A clinical trial aims at evaluating the 810 nm-diode laser in surgical incisions, with only one laser treatment immediately after skin closure, of patients with Fitzpatrick skin types I to IV. Surgical incisions were divided into two fields, with only portions randomly selected receiving laser treatment. At the final scar analysis (12 months) of the pilot study, the treated portion scored significantly better for both surgeon (P = 0.046) and patients (P = 0.025). Further studies may be warranted to better understand the cellular mechanisms leading to Laser-Assisted Skin Healing (LASH).

  8. Evaluation of Acne Scars: How to Assess Them and What to Tell the Patient.

    PubMed

    Fife, Douglas

    2016-04-01

    The prevalence and emotional impact of acne scarring are underestimated by the medical community. Dermatology providers should be able to evaluate the acne scar patient and discuss treatment options. Important aspects of the patient history include current treatments, prior acne scar procedures, and the patient's goals for treatment. During the physical examination, the scars are assessed and classified by scar morphology and overall severity of scarring. Finally, a treatment plan is developed in which the most appropriate procedures are matched with the scars that will work the best. Helping the patient understand likely expectations for improvement will increase overall satisfaction. PMID:27015781

  9. Shikonin reduces TGF-β1-induced collagen production and contraction in hypertrophic scar-derived human skin fibroblasts

    PubMed Central

    FAN, CHEN; DONG, YING; XIE, YAN; SU, YONGHUA; ZHANG, XUFANG; LEAVESLEY, DAVID; UPTON, ZEE

    2015-01-01

    Hypertrophic scarring/hypertrophic scars (HS) is a highly prevalent condition following burns and trauma wounds. Numerous studies have demonstrated that transforming growth factor-β1 (TGF-β1) plays an essential role in the wound healing process by regulating cell differentiation, collagen production and extracellular matrix degradation. The increased expression of TGF-β1 is believed to result in the formation of HS. Shikonin (SHI), an active component extracted from the Chinese herb, Radix Arnebiae, has previously been found to downregulate the expression of TGF-β1 in keratinocyte/fibroblast co-culture conditioned medium. In view of this, in this study, we aimed to further investigate the effects of SHI on TGF-β1-stimulated hypertrophic scar-derived human skin fibroblasts (HSFs) and examined the underlying mechanisms. Cell viability and proliferation were measured using alamarBlue and CyQUANT assays. The total amount of collagen and cell contraction were examined using Sirius red staining and the cell contraction assay kit. Gene expression and signalling pathway activation were detected using reverse transcription-quantitative polymerase chain reaction and western blot analysis. Our results revealed that SHI reduced TGF-β1-induced collagen production through the ERK/Smad signalling pathway and attenuated TGF-β1-induced cell contraction by downregulating α-smooth muscle actin (αSMA) expression in the HSFs. The data from this study provide evidence supporting the potential use of SHI as a novel treatment for HS. PMID:26239419

  10. Shikonin reduces TGF-?1-induced collagen production and contraction in hypertrophic scar-derived human skin fibroblasts.

    PubMed

    Fan, Chen; Dong, Ying; Xie, Yan; Su, Yonghua; Zhang, Xufang; Leavesley, David; Upton, Zee

    2015-10-01

    Hypertrophic scarring/hypertrophic scars (HS) is a highly prevalent condition following burns and trauma wounds. Numerous studies have demonstrated that transforming growth factor-?1 (TGF??1) plays an essential role in the wound healing process by regulating cell differentiation, collagen production and extracellular matrix degradation. The increased expression of TGF-?1 is believed to result in the formation of HS. Shikonin (SHI), an active component extracted from the Chinese herb, Radix Arnebiae, has previously been found to downregulate the expression of TGF-?1 in keratinocyte/fibroblast co-culture conditioned medium. In view of this, in this study, we aimed to further investigate the effects of SHI on TGF-?1-stimulated hypertrophic scar-derived human skin fibroblasts (HSFs) and examined the underlying mechanisms. Cell viability and proliferation were measured using alamarBlue and CyQUANT assays. The total amount of collagen and cell contraction were examined using Sirius red staining and the cell contraction assay kit. Gene expression and signalling pathway activation were detected using reverse transcription-quantitative polymerase chain reaction and western blot analysis. Our results revealed that SHI reduced TGF-?1?induced collagen production through the ERK/Smad signalling pathway and attenuated TGF-?1?induced cell contraction by downregulating ?-smooth muscle actin (?SMA) expression in the HSFs. The data from this study provide evidence supporting the potential use of SHI as a novel treatment for HS. PMID:26239419

  11. Timing constraints on remote sensing of wildland fire burned area in the southeastern US

    USGS Publications Warehouse

    Picotte, Joshua J.; Robertson, Kevin

    2011-01-01

    Remote sensing using Landsat Thematic Mapper (TM) satellite imagery is increasingly used for mapping wildland fire burned area and burn severity, owing to its frequency of collection, relatively high resolution, and availability free of charge. However, rapid response of vegetation following fire and frequent cloud cover pose challenges to this approach in the southeastern US. We assessed these timing constraints by using a series of Landsat TM images to determine how rapidly the remotely sensed burn scar signature fades following prescribed burns in wet flatwoods and depression swamp community types in the Apalachicola National Forest, Florida, USA during 2006. We used both the Normalized Burn Ratio (NBR) of reflectance bands sensitive to vegetation and exposed soil cover, as well as the change in NBR from before to after fire (dNBR), to estimate burned area. We also determined the average and maximum amount of time following fire required to obtain a cloud-free image for burns in each month of the year, as well as the predicted effect of this time lag on percent accuracy of burn scar estimates. Using both NBR and dNBR, the detectable area decreased linearly 9% per month on average over the first four months following fire. Our findings suggest that the NBR and dNBR methods for monitoring burned area in common southeastern US vegetation community types are limited to an average of 78–90% accuracy among months of the year, with individual burns having values as low as 38%, if restricted to use of Landsat 5 TM imagery. However, the majority of burns can still be mapped at accuracies similar to those in other regions of the US, and access to additional sources of satellite imagery would improve overall accuracy.

  12. Timing constraints on remote sensing of wildland fire burned area in the southeastern US

    USGS Publications Warehouse

    Picotte, J.J.; Robertson, K.

    2011-01-01

    Remote sensing using Landsat Thematic Mapper (TM) satellite imagery is increasingly used for mapping wildland fire burned area and burn severity, owing to its frequency of collection, relatively high resolution, and availability free of charge. However, rapid response of vegetation following fire and frequent cloud cover pose challenges to this approach in the southeastern US. We assessed these timing constraints by using a series of Landsat TM images to determine how rapidly the remotely sensed burn scar signature fades following prescribed burns in wet flatwoods and depression swamp community types in the Apalachicola National Forest, Florida, USA during 2006. We used both the Normalized Burn Ratio (NBR) of reflectance bands sensitive to vegetation and exposed soil cover, as well as the change in NBR from before to after fire (dNBR), to estimate burned area. We also determined the average and maximum amount of time following fire required to obtain a cloud-free image for burns in each month of the year, as well as the predicted effect of this time lag on percent accuracy of burn scar estimates. Using both NBR and dNBR, the detectable area decreased linearly 9% per month on average over the first four months following fire. Our findings suggest that the NBR and dNBR methods for monitoring burned area in common southeastern US vegetation community types are limited to an average of 78-90% accuracy among months of the year, with individual burns having values as low as 38%, if restricted to use of Landsat 5 TM imagery. However, the majority of burns can still be mapped at accuracies similar to those in other regions of the US, and access to additional sources of satellite imagery would improve overall accuracy. ?? 2011 by the authors.

  13. Facial Burns - Our Experience

    PubMed Central

    Zatriqi, Violeta; Arifi, Hysni; Zatriqi, Skender; Duci, Shkelzen; Rrecaj, Sh.; Martinaj, M.

    2013-01-01

    Facial burns are generally considered severe. This is due to the possibility of respiratory complications. First responders check the nostrils for singed hairs. In severe cases there may be soot around the nose and mouth and coughing may produce phlegm that includes ash. Facial and inhalational burns compromise airways. They pose difficulties in pre-hospital resuscitation and are challenge to clinicians managing surviving burn victims in the intensive care setting. Management problems – resuscitation, airway maintenance and clinical treatment of facial injuries are compounded if the victim is child. Inhalational burns reduce survivability, certainly in adult victim. In our retrospective study we found that facial burns dominated in male gender, liquids and scalds are the most common causes of facial burns in children whereas the flame and electricity were the most common causes of facial burns in adults. We came to the conclusion in our study that surgical treatment minimizes complications and duration of recovery. PMID:23687458

  14. Treatment of sandal burns of the feet in children in a moist environment.

    PubMed

    Shakirov, Babur M

    2014-05-01

    Burns to children's feet are often due to scalds, from hot tap water, as an infant's skin is thinner and hence more susceptible to a full-thickness injury. In Central Asia, and particularly in Uzbekistan, many episodes of burns take place at homes because of using sandal heaters. In the case of sandal burns of the foot, it usually is not only skin that is injured but also underlying tissues: subcutaneous fat, fasciae, muscles and even bones. Many controlled studies have confirmed that wounds heal more readily in a moist, physiological environment. After performing the toilet of burn wounds of the foot, we applied Dermazin cream on the affected areas and then the foot was placed onto a polyethylene packet of large size and fixed by a bandage. Measurement of wound water evaporation was performed every day post-burn. Surgery was usually performed 15-17 days after burn by applying a perforated skin graft or a 0.2-0.3-mm-thick non-perforated skin graft. The procedures helped to improve the general condition of patients, shortened their stay in hospital and also reduced expenses and lessened joint deformities and contracture deformities. PMID:24094987

  15. Double-muscle flap repair of the tethered tracheostomy scar.

    PubMed

    Aitken, Marguerite E; Hammond, Dennis C

    2002-09-01

    Whether for facial trauma, extensive cancer resection, or long-term pulmonary ventilation, the final result after prolonged placement of a tracheostomy is usually a widened, depressed scar that is adherent to the underlying trachea. This adherence creates an unsightly up-and-down movement to the scar with swallowing. This "tracheal tug" is distressful emotionally to many patients and may even be painful. Simple methods of repair do not separate the skin closure adequately from the trachea, leading to recurrence of the tracheal tug. Use of the surrounding strap muscles to cover the trachea in conjunction with allogeneic dura mater has been described as one method of repair. In an attempt to perform a repair without the need for an outside tissue source, the double-muscle flap technique was developed. During this procedure the retracted scar is released from the trachea, the strap muscles are used to cover the tracheal closure, and the medial edge of the platysma muscle on each side is dissected free and sutured together in the midline. This separates effectively the tracheal closure from the skin, allowing the trachea to move independently. The cutaneous scar is revised along skin tension lines to create a fine-line linear scar. This procedure has been used in 2 patients with tracheal tug after prolonged tracheostomy placement. In each patient, the tracheal tug was eliminated completely, and an imperceptible cutaneous scar was the only remaining evidence of what had been a long and arduous recovery for these patients. In each case, patient satisfaction was complete. The authors recommend this technique as a simple and effective method of closure for these troublesome scars. PMID:12351986

  16. Burn therapist contributions to the American Burn Association and the Journal of Burn Care and Research: a 45th anniversary review.

    PubMed

    Richard, Reginald

    2014-01-01

    The year 2013 marked the 45th anniversary of American Burn Association (ABA) annual meetings. At this significant juncture, a review of contributions of its members is appropriate to celebrate this milestone. Since the first ABA annual meeting and the initiation of the Journal of Burn Care and Research (JBCR), burn therapists, including both occupational and physical therapists, have grown to become integral members of the ABA, and their contributions among all members are highlighted. A systematic manual review of both ABA annual meeting proceedings and the JBCR was performed. The contributions of burn therapists to the ABA as a whole were classified, cataloged, and hand counted. Areas included: 1) quantifying ABA abstract and JBCR articles on authorship and subject matter, 2) representation on ABA committees; 3) participation in special activities; and 4) other recognitions. Burn therapists comprise 9.7% of ABA members overall. During the course of the first 44 ABA meetings, 8381 abstracts have been presented. Of this number, 634 (7.6%) have been delivered by burn therapists as lead authors. Through the end of 2011, no less than 3207 publications by all disciplines have appeared in JBCR. The vast majority of articles have been written by physicians, followed by doctorate-trained professionals. One hundred-forty therapists have 249 publications (7.8%) to their credit. For both abstracts and articles, the top three subject matter topics have been: scarring, splints and casts, and outcomes. Numerous burn therapists have served as faculty and moderators at ABA annual meetings and on ABA committees including JBCR. Burn therapists have made significant contributions to the JBCR and in support of the ABA and its annual meetings over the past 45 years from the clinical, scientific, and Association perspectives. PMID:24823340

  17. The reported effects of bullying on burn-surviving children.

    PubMed

    Rimmer, Ruth B; Foster, Kevin N; Bay, Curtis R; Floros, Jim; Rutter, Cindy; Bosch, Jim; Wadsworth, Michelle M; Caruso, Daniel M

    2007-01-01

    There is a trend of increasing childhood aggression in America, which has been tied to bullying. Although there is growing research concerning bullying in the general pediatric population, there are limited data on bullying and its effects on children with disfigurements and physical limitations. This study was conducted to assess burned children's experience with bullying. A pretest was administered regarding experience with bullying and teasing. A curriculum regarding bullying, which incorporated the Harry Potter and the Sorcerer's Stone movie, was presented. After reviewing bullying depicted in the film and participating in a class regarding bullying, children were invited to complete a survey regarding their experience with bullying. A total of 61% of these children reported being bullied at school; 25% reported experiencing headaches or stomachaches due to bullying, and 12% reported staying home from school. Nearly 25% reported bullying as a big problem. Of those with visible scars (55%), a full 68% reported bullying as a problem, versus 54% with hidden scars (P < .05). However, those with visible scars were no more likely to tell an adult (54%) than those without (56%). Children were much more willing to disclose personal bullying experiences after participating in the class (57%) than before (45%) (P < .01). This study revealed that bullying impacts many burn-injured children and has negative effects on their physical and mental well-being. Many children (with visible or hidden scars) did not seek adult intervention for the problem. Participation in a bullying course appears to give children a forum that increases their willingness to disclose personal bullying experiences and can provide them with prevention information and a safe place to seek help. PMID:17438488

  18. Preclinical Study of Novel Gene Silencer Pyrrole-Imidazole Polyamide Targeting Human TGF-β1 Promoter for Hypertrophic Scars in a Common Marmoset Primate Model

    PubMed Central

    Igarashi, Jun; Fukuda, Noboru; Inoue, Takashi; Nakai, Shigeki; Saito, Kosuke; Fujiwara, Kyoko; Matsuda, Hiroyuki; Ueno, Takahiro; Matsumoto, Yoshiaki; Watanabe, Takayoshi; Nagase, Hiroki; Bando, Toshikazu; Sugiyama, Hiroshi; Itoh, Toshio; Soma, Masayoshi

    2015-01-01

    We report a preclinical study of a pyrrole-imidazole (PI) polyamide that targets the human transforming growth factor (hTGF)-β1 gene as a novel transcriptional gene silencer in a common marmoset primate model. We designed and then synthesized PI polyamides to target the hTGF-β1 promoter. We examined effects of seven PI polyamides (GB1101-1107) on the expression of hTGF-β1 mRNA stimulated with phorbol 12-myristate 13-acetate (PMA) in human vascular smooth muscle cells. GB1101, GB1105 and GB1106 significantly inhibited hTGF-β1 mRNA expression. We examined GB1101 as a PI polyamide to hTGF-β1 for hypertrophic scars in marmosets in vivo. Injection of GB1101 completely inhibited hypertrophic scar formation at 35 days post-incision and inhibited cellular infiltration, TGF-β1 and vimentin staining, and epidermal thickness. Mismatch polyamide did not affect hypertrophic scarring or histological changes. Epidermis was significantly thinner with GB1101 than with water and mismatch PI polyamides. We developed the PI polyamides for practical ointment medicines for the treatment of hypertrophic scars. FITC-labeled GB1101 with solbase most efficiently distributed in the nuclei of epidermal keratinocytes, completely suppressed hypertropic scarring at 42 days after incision, and considerably inhibited epidermal thickness and vimentin-positive fibroblasts. PI polyamides targeting hTGF-β1 promoter with solbase ointment will be practical medicines for treating hypertrophic scars after surgical operations and skin burns. PMID:25938472

  19. Bizarre paediatric facial burns.

    PubMed

    Ho, W S; Ying, S Y; Wong, T W

    2000-08-01

    Child abuse and neglect account for a significant number of paediatric burn injuries. It is of great importance because of the high mortality, high frequency of repeated abuse, as well as the physical, psychological and social sequelae that it causes. Burn abuse is often under-recognized and under-reported because it is difficult to define non-accidental injury. On the other hand, false accusation of burn abuse is extremely damaging to the family. Bizarre and unusual burn injuries can be caused by accident and should not automatically be assumed to be deliberate injury. Three boys of age 1-7 years with bizarre facial burns were admitted to the Burns Unit at the Prince of Wales Hospital between February 1995 and July 1999. One was burned by his baby-sitter with hot water steam and the other two were burned by their mothers with hot boiled eggs. The unusual causes of their burns raised the suspicion of child abuse and formal investigations were carried out by the Social Services Department. Detail assessment including a developmental history of the child and the psychosocial assessment of the family revealed that these three boys were burned because of poor medical advice and innocent cultural belief. PMID:10812279

  20. Study on changes in skin extensibility during the development of joint contracture due to joint immobilization in rats

    PubMed Central

    Tasaka, Atsushi; Ono, Takeya; Oki, Sadaaki; Umei, Namiko; Ishikura, Hideki; Aihara, Kazuki; Sato, Yuta; Matsumoto, Tomohiro

    2015-01-01

    [Purpose] The purpose of this study was to elucidate whether skin extensibility decreases when a contracture develops as a result of joint immobilization. [Subjects] This study was conducted on six female Wistar rats. [Methods] The rats were divided into two experimental groups. In the immobilized group, the right ankle joints were immobilized in complete plantar flexion by plaster casts for two weeks. In the control group, the left ankle joints had no intervention. On the final day, skin extensibility was determined from a length-tension curve by collecting skin from the posterior aspect of the ankle joint and using a tensile strength tester. [Results] Compared with the control group, the immobilized group showed a significant decrease in skin extensibility. [Conclusion] The results demonstrated that the extensibility of the skin itself decreases when joint contracture develops. PMID:26504268

  1. Classification of equinus in ambulatory children with cerebral palsy-discrimination between dynamic tightness and fixed contracture.

    PubMed

    Zwick, Ernst B; Leistritz, Lutz; Milleit, Berko; Saraph, Vinay; Zwick, Gertrude; Galicki, Miroslaw; Witte, Herbert; Steinwender, Gerhardt

    2004-12-01

    In this study a generalised dynamic neural network (GDNN) was designed to process gait analysis parameters to evaluate equinus deformity in ambulatory children with cerebral palsy. The aim was to differentiate dynamic calf muscle tightness from fixed muscle contracture. Patients underwent clinical examination and had instrumented gait analysis before evaluating their equinus under anaesthesia and muscle relaxation at the time of surgery to improve gait. The performance of the clinical examination, the subjective interpretation of gait analysis results, and the application of the neural network to assess ankle function were compared to the examination under anaesthesia. Evaluation of equinus by a Neural Network showed high sensitivity and specificity values with a likelihood ratio of +14.63. The results indicate that dynamic calf muscle tightness can be differentiated from fixed calf muscle contracture with considerable precision that might facilitate clinical decision-making. PMID:15531174

  2. Hypertrophic scars and keloids in surgery: current concepts.

    PubMed

    Song, Colin

    2014-09-01

    Hypertrophic scars and keloids remain a challenge in surgery. We appreciate that our understanding of the process at cellular and molecular level, profound as it is, when it comes to the clinical evidence much is left to be desired. Although the bench to bedside conundrum remains, the science of translational research calls for an even higher level of cooperation between the scientist and the clinician for the impetus to succeed.The clinicians alerted us to the possible theories in the pathogenesis of keloid formation, inter alia, the ischemia theory, mast cell theory, immune theory, transforming growth factor ? interaction, mechanical theory, and the melanocyte stimulating hormone theory. All of the above presupposed a stimulus that would result in an uncontrolled upregulation of collagen and extracellular matrix expression in the pathogenesis of the keloid. This bedside to bench initiative, as in true science, realized more ponderables than possibilities.By the same token, research into the epidermal-mesenchymal signaling, molecular biology, genomics, and stem cell research holds much promise in the bench top arena. To assess efficacy, many scar assessment scores exist in the literature. The clinical measurement of scar maturity can aid in determining end points for therapeutics. Tissue oxygen tension and color assessment of scars by standardized photography proved to be useful.In surgery, the use of dermal substitutes holds some promise as we surmise that quality scars that arise from dermal elements, molecular and enzyme behavior, and balance. Although a systematic review shows some benefit for earlier closure and healing of wounds, no such review exists at this point in time for the use of dermal substitutes in scars.Adipose-derived stem cell, as it pertains to scars, will hopefully realize the potential of skin regeneration rather than by repair in which we are familiar with as well as the undesirable scarring as a result of healing through the inflammatory response.Translational research will bear the fruit of coordinating bench to bedside and vice versa in the interest of progress into the field of regenerative healing that will benefit the patient who otherwise suffers the myriad of scar complications. PMID:25115371

  3. Burnt Scar Mapping from High Resolution Optical Remote Sensing

    NASA Astrophysics Data System (ADS)

    Sedano, Fernando; Kempeneers, Pieter; Kucera, Jan; San Miguel-Ayanz, Jesus

    2010-05-01

    Existing remote sensing-based Burnt scar mapping methodologies are mainly based on medium spatial resolution sensors. These methodologies cannot accurately detect burnt areas smaller than 200 ha. However, smaller burnt areas can represent a significant number of the total burnt areas. They play an important ecological roll, and also have relevant socio-economic consequences. Within this framework, a new methodology for burnt scar mapping from high resolution optical remote sensing data is being developed by the Institute for Environment and sustainability of the Joint Research Center of the European Commission. This methodology aims to map burnt patches larger than 10 ha, which represent more than 90% o fires over Europe A two stage approach is implemented. The first stage applies a classifier for the identification of burnt scar seeds. The second stage applies a region growing routine using the previously identified seeds as initial points. Together with standard burnt area detection approaches (i.e. thresholding of original bands, spectral indices and combination of both, Gaussian classifiers), several more algorithms such as neural networks, classification trees and bagging techniques are tested for the identification of burnt scar seeds. This combined approach allows conservative estimate of the initial seeds which reduces the overestimation of burnt areas, while the region growing stage produces a precise delineation of the burnt polygons. The methodology is tested for images from the Advanced Wide Field Sensor (AWIFS) over fires in Portugal. Training data was obtained from MODIS-based polygons generated by the Rapid Damage Assessment (RDA) module of the European Forest Fire Information System (EFFIS). The method has been validated using burnt area polygons were derived from visual interpretation of ETM scenes at the end of the fire season. These polygons were provided by the Department of Forestry of the University of Lisbon. In a later stage, a digital elevation model-based post processing is implemented in order to minimize the potential overestimation of burnt scars. In general the validation exercise shows a very high accuracy and precision in the identification of burnt scars and delineation of burnt scar borders. The two-stage methodology also proves to be robust over number different environments. The importance of proper training data during the seed identification stage is highlighted. The tests also show that non-parametric algorithms (neural networks and classification trees) outperform classic approaches in the identification of burnt scar seeds. Given the promising performance of the proposed methodology, the next goal will be the production of the first high resolution burnt scar map at pan-European level.

  4. Pretranscriptional regulation of Tgf-beta1 by PI polyamide prevents scarring and accelerates wound healing of the cornea after exposure to alkali.

    PubMed

    Chen, Min; Matsuda, Hiroyuki; Wang, Linghua; Watanabe, Takayoshi; Kimura, Makoto T; Igarashi, Jun; Wang, Xiaofei; Sakimoto, Tohru; Fukuda, Noboru; Sawa, Mitsuru; Nagase, Hiroki

    2010-03-01

    Corneal alkali burns are a serious clinical problem that often leads to permanent visual impairment. In this process, transforming growth factor (Tgf)-beta1 is upregulated and involved in the response to corneal injury and the process of corneal stromal scarring. To develop an efficient compound to inhibit Tgf-beta1 in the cornea, we designed GB1201, a pyrrole-imidazole (PI) polyamide targeting rat Tgf-beta1 gene promoter to the activator protein-1 (AP-1) binding site. GB1201 showed a high binding affinity to the target DNA sequence in the gel mobility shift and Biacore assays. GB1201 significantly inhibited the rat Tgf-beta1 gene promoter activity in HEK (human embryonic kidney) 293 cells in a concentration-dependent manner. Topically administrated GB1201 was distributed immediately to the nuclei of all cell layers of the cornea and remained for 24 hours. A corneal alkali burn model in rats was used to evaluate the therapeutic efficacy of GB1201. GB1201 suppressed the upregulation of Tgf-beta1 in the burned cornea, both in the mRNA and protein levels. Moreover, daily treatment with GB1201 for a week significantly improved the corneal tissue wound healing, reduced corneal stromal scarring, and prevented corneal haze formation. Our data suggest that PI polyamide may open new opportunities for therapeutic intervention in the treatment of chemically burned corneas. PMID:19920805

  5. Transmitter-mediated local contracture of the endplate region of the focally innervated mouse diaphragm treated with anticholinesterase.

    PubMed

    Hong, S J; Chang, C C

    1993-08-01

    1. Local contraction of the endplate region in response to nerve stimulation was studied in isolated mouse diaphragms. In normal preparations, muscle contractions involved the whole length of the muscle fibre with rise and decay times in the order of tens of ms whether evoked with a single or train of pulses. 2. When acetylcholinesterase was inhibited with neostigmine, tetanic stimulation produced a twitch-like phasic contraction and a delayed tonic contracture. A brief train of pulse (10 ms, 300 Hz) was enough to trigger a full size tonic contracture which reached an amplitude about one tenth that of control tetanus and had a duration of about 4 s. 3. Tetanic stimulation evoked a non-propagating prolonged depolarization at the endplate region lasting for about 1 s following a few muscle action potentials. 4. mu-Conotoxin, a specific inhibitor of muscle Na+ channel, selectively abolished the phasic contraction and the muscle action potentials leaving the tonic contracture and the prolonged depolarization unaffected. 5. Both the tonic contracture and the prolonged depolarization were highly sensitive to blockade by tubocurarine (IC50 0.05-0.1 microM) and vesamicol (1 microM, an inhibitor of packaging acetylcholine into synaptic vesicles), were attenuated by increasing Ca2+ concentration and were prolonged by decreasing Ca2+. 6. The results suggest that prolonged activation of endplate nicotinic receptors by endogenously released transmitter can produce substantial contractions of the endplate region when acetylcholinesterase are inhibited. The source of Ca2+ for the contraction seems to come mainly from intracellular stores. PMID:8104646

  6. Transmitter-mediated local contracture of the endplate region of the focally innervated mouse diaphragm treated with anticholinesterase.

    PubMed Central

    Hong, S. J.; Chang, C. C.

    1993-01-01

    1. Local contraction of the endplate region in response to nerve stimulation was studied in isolated mouse diaphragms. In normal preparations, muscle contractions involved the whole length of the muscle fibre with rise and decay times in the order of tens of ms whether evoked with a single or train of pulses. 2. When acetylcholinesterase was inhibited with neostigmine, tetanic stimulation produced a twitch-like phasic contraction and a delayed tonic contracture. A brief train of pulse (10 ms, 300 Hz) was enough to trigger a full size tonic contracture which reached an amplitude about one tenth that of control tetanus and had a duration of about 4 s. 3. Tetanic stimulation evoked a non-propagating prolonged depolarization at the endplate region lasting for about 1 s following a few muscle action potentials. 4. mu-Conotoxin, a specific inhibitor of muscle Na+ channel, selectively abolished the phasic contraction and the muscle action potentials leaving the tonic contracture and the prolonged depolarization unaffected. 5. Both the tonic contracture and the prolonged depolarization were highly sensitive to blockade by tubocurarine (IC50 0.05-0.1 microM) and vesamicol (1 microM, an inhibitor of packaging acetylcholine into synaptic vesicles), were attenuated by increasing Ca2+ concentration and were prolonged by decreasing Ca2+. 6. The results suggest that prolonged activation of endplate nicotinic receptors by endogenously released transmitter can produce substantial contractions of the endplate region when acetylcholinesterase are inhibited. The source of Ca2+ for the contraction seems to come mainly from intracellular stores. PMID:8104646

  7. Sciatic nerve regeneration in the rat. Validity of walking track assessment in the presence of chronic contractures.

    PubMed

    Dellon, A L; Mackinnon, S E

    1989-01-01

    The ability of the walking track assessment of sciatic nerve function to correlate with results of a nerve repair has been well documented following acute nerve injury and after recovery of the nerve following nerve repair. The long-term effects of partial denervation upon the lower extremity of the rat include the development of chronic contractures due to residual partial muscle paralysis and imbalance. The present study evaluated the ability of the walking track technique to portray accurately the walking pattern in animals following chronic contracture as a result of sciatic nerve repair. Animals 18 months and 24 months after sciatic nerve repair were found to have morphometric analysis distal to the repair that was not statistically significantly different from normal. However, the walking track assessment was inadequate at twenty-four months due to the development of clawing, interphalangeal joint contractures, and ankle inversion or eversion with or without dorsiflexion. The presence of these chronic deformities invalidated the walking track as an appropriate assessment technique for long-term assessment of nerve function following nerve repair. PMID:2796718

  8. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture.

    PubMed

    Ribuffo, Diego; Lo Torto, Federico; Giannitelli, Sara M; Urbini, Marco; Tortora, Luca; Mozetic, Pamela; Trombetta, Marcella; Basoli, Francesco; Licoccia, Silvia; Tombolini, Vincenzo; Cassese, Raffaele; Scuderi, Nicolò; Rainer, Alberto

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. PMID:26354273

  9. Secondary breast reconstruction with deepithelialized free flaps from the lower abdomen for intractable capsular contracture and maintenance of breast volume.

    PubMed

    Gurunluoglu, Raffi; Shafighi, Maziar; Schwabegger, Anton; Ninkovic, Milomir

    2005-01-01

    Although surgical techniques and the quality of mammary prostheses have been improved significantly in recent years, capsular contracture attendant on prosthetic mammary reconstruction remains a major flaw. Although rarely, some patients are confronted with recurrent and intractable capsular contractures with resultant breast deformity, even after multiple attempts at capsulectomies and implant exchange. Patients with recurrent capsular contracture often do not want replacement with a new prosthesis, but desire the maintenance of their breast volume with a safe alternative. In an attempt to maintain breast volume and to improve the aesthetic appearance, secondary breast reconstruction using bilateral deepithelialized free flaps from the lower abdomen was performed in a series of seven patients. Three bilateral muscle-sparing TRAM flaps, two bilateral DIEP flaps, one bilateral SIEA flap, one unilateral SIEA flap, and one unilateral DIEP flap (a total number of 14 flaps) were used following implant removal, total capsulectomy, and prophylactic subcutaneous mastectomy. The early postoperative course was uneventful, and all flaps survived completely with no complications. There were no donor-site problems, except in one patient (case 5), who had partial skin necrosis of the abdominal flap. The long-term results (mean follow-up: 4.8 years) demonstrated an aesthetically satisfactory appearance of the breasts, with no major donor-site problems. Several advantages, as well as drawbacks, are highlighted with this technique. PMID:15672318

  10. Ultrasonographic Evaluation of Uterine Scar Niche before and after Laparoscopic Surgical Repair: A Case Report

    PubMed Central

    Drouin, Olivier; Bergeron, Tessa; Beaudry, Ariane; Demers, Suzanne; Roberge, Stéphanie; Bujold, Emmanuel

    2014-01-01

    Context?Uterine scar defects or scar niche are relatively common after cesarean delivery. An association has been observed between the severity of scar defect, also known as isthmocele, some gynecologic symptoms, and the risk of uterine scar dehiscence at the next delivery. It has been suggested that surgical repair of scar defect could improve the gynecological symptoms, but it remains unclear whether such surgery mends the uterine scar itself. Case Report?We report the case of a woman with uterine scar defect in whom laparoscopic repair significantly improved the gynecological symptoms without affecting the uterine scar, evaluated by hysterosonography. Conclusion?This case highlights the significant dearth of knowledge surrounding the diagnosis, consequences, and benefits of surgical repair of uterine scar defect after cesarean. PMID:25452883

  11. Analysis of Brush Fire Scars in Semi-Arid Urban Environments: Implications for Future Fire and Flood Hazards Using Field and Satellite Data

    NASA Astrophysics Data System (ADS)

    Misner, T.; Ramsey, M.; Arrowsmith, R.

    2002-12-01

    The number of forest fires has increased dramatically over the past five years in the western United States, due to both human and natural causes. These fires commonly expand rapidly as a function of vegetation, climate as well as past and present fire fighting practices. Many urban areas, such as Phoenix, AZ have experienced extreme population growth rates over the past 50 years. A majority of the development now occurring is in desert areas that have once burned, or are currently threatened by the potential of brush fires. These regions northeast of the city of Phoenix have experienced numerous fires over the past two decades that have been expensive to fight, and caused a considerable amount of property damage. This region is also currently targeted as one of the prime suburban growth corridors in a metropolitan area. As people expand into these environments there is an increased risk of fire, and the potential of subsequent flooding focused within the scars. Therefore, the ability to predict and control fires is increasingly important in these rapidly growing areas. Remote sensing together with detailed field data has been used to characterize areas scarred by past fires with the goal of assessing the risk for burning in the future. Space and airborne data from ASTER, Landsat ETM, SIR-C, TIMS and balloon-based cameras have been combined within a GIS model to characterize existing fire scars northeast of Phoenix, AZ. These data sets were used to quantify the relationship of fire scar age to vegetative recovery, and to determine the control of local topography on fire behavior. In addition, detailed field topographic surveys were combined with sediment trap data to contrast erosion rates in several burned and unburned catchments. Initial results imply a slightly higher erosion rate in the scars and therefore increased flooding risks. The combination of remote sensing data analyses with a GIS database, constrained by careful geomorphic and sedimentological investigations, may permit city officials and urban planners to better calculate potential risks for both future fire and flood hazards within the region. By examining the spatial variability of numerous scars in one location, and given the potential to evaluate their relative ages automatically, it should be possible to establish fire recurrence intervals around any urban area. This can be compared with lightning frequency, climate, vegetation, and terrain characteristics to vastly improve the characterization of hazards associated with semi-arid environment brush fires.

  12. Outpatient burn management.

    PubMed

    Warner, Petra M; Coffee, Tammy L; Yowler, Charles J

    2014-08-01

    Most burn patients have injuries that may be treated on an outpatient basis. Newer silver-based dressings and improved medications for the treatment of pain and pruritus have led to further growth of outpatient care. The final barrier of distance from the burn center will decrease with the growth of telemedicine. It is incumbent for burn centers to develop outpatient guidelines to facilitate this growth of outpatient care. PMID:25085094

  13. A multidisciplinary approach to scars: a narrative review

    PubMed Central

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

    The purpose of this article is to carry out a narrative review regarding the approach to scars through complementary and alternative medicine focusing on osteopathy, naturopathy, and other minor methods and traditional rehabilitative medicines, such as physiotherapy and manual therapies. We analyzed the existing literature regarding the possible influences of techniques relaxing the diaphragm – both manual and psychophysical relaxing techniques – and the consequent local response to events leading to scar tissue healing. The objective of the study is to become a useful instrument of knowledge for those manual therapists and professionals who deal with patients affected by discontinuity of the skin surface due to trauma or surgery. This article also intends to stimulate research in order to find and propose new methods of scar treatment, taking into consideration the information gained so far from other complementary and alternative disciplines. PMID:26316774

  14. Burn Wound Infections

    PubMed Central

    Church, Deirdre; Elsayed, Sameer; Reid, Owen; Winston, Brent; Lindsay, Robert

    2006-01-01

    Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices. PMID:16614255

  15. Burns and Diabetes

    PubMed Central

    Shalom, A.; Friedman, T.; Wong, L.

    2005-01-01

    Summary Diabetes is often considered a risk factor for poor wound healing and increased complication rates for plastic surgery procedures. Burn injury in diabetic patients may have implications for the length of stay and number of operations required. We therefore we examined the characteristics of diabetic patients admitted to our burn unit and the impact of their condition on their hospital course. Charts of all patients with diabetes admitted to the burn unit from 1995 to 2000 were reviewed (n = 73). Demographic data, percent body surface area burned, anatomical location of the burn, number of surgical procedures required, length and cost of stay, and outcome were noted. The control population included 150 consecutive patients without diabetes treated during the same period. Diabetic patients were older and underwent a higher number of surgical procedures, with increased length of stay and increased mortality, despite an equivalent body surface area burned. They had a higher incidence of scald burns in the lower extremities than the non-diabetic population. This work shows that diabetic patients constitute a unique group. They are significantly older, have an increased rate of surgical interventions, increased hospital stay, and significantly increased mortality compared to a control group with similar surface area burns. This group is also more likely to have scald burns in the lower extremities, mostly due to diabetic neuropathy. This work emphasizes the importance of education and prevention programmes directed towards this group of patients, in order to decrease morbidity, mortality, and hospital costs. PMID:21990975

  16. Reduced satellite cell number in situ in muscular contractures from children with cerebral palsy.

    PubMed

    Dayanidhi, Sudarshan; Dykstra, Peter B; Lyubasyuk, Vera; McKay, Bryon R; Chambers, Henry G; Lieber, Richard L

    2015-07-01

    Satellite cells (SC) are quiescent adult muscle stem cells critical for postnatal development. Children with cerebral palsy have impaired muscular growth and develop contractures. While flow cytometry previously demonstrated a reduced SC population, extracellular matrix abnormalities may influence the cell isolation methods used, systematically isolating fewer cells from CP muscle and creating a biased result. Consequently, the purpose of this study was to use immunohistochemistry on serial muscle sections to quantify SC in situ. Serial cross-sections from human gracilis muscle biopsies (n?=?11) were labeled with fluorescent antibodies for Pax7 (SC transcriptional marker), laminin (basal lamina), and 4',6-diamidino-2-phenylindole (nuclei). Fluorescence microscopy under high magnification was used to identify SC based on labeling and location. Mean SC/100 myofibers was reduced by ?70% (p?

  17. High Resolution Muscle Measurements Provide Insights into Equinus Contractures in Patients with Cerebral Palsy

    PubMed Central

    Mathewson, Margie A.; Ward, Samuel R.; Chambers, Henry G.; Lieber, Richard L.

    2015-01-01

    Muscle contractures that occur after upper motor neuron lesion are often surgically released or lengthened. However, surgical manipulation of muscle length changes a muscle’s sarcomere length (Ls), which can affect force production. To predict effects of surgery, both macro- (fascicle length (Lf)) and micro- (Ls) level structural measurements are needed. Therefore, the purpose of this study was to quantify both Ls and Lf in patients with cerebral palsy (CP) as well as typically developing (TD) children. Soleus ultrasound images were obtained from children with CP and TD children. Lf was determined and, with the joint in the same position, CP biopsies were obtained, formalin fixed and Ls measured by laser diffraction. Since soleus Ls values were not measurable in TD children, TD Ls values were obtained using three independent methods. While average Lf did not differ between groups (CP=3.6±1.2 cm, TD=3.5±0.9 cm; p>0.6), Ls was dramatically longer in children with CP (4.07±0.45 μm vs. TD=2.17±0.24 μm; p<0.0001). While Lf values were similar between children with CP and TD children, this was due to highly stretched sarcomeres within the soleus muscle. Surgical manipulation of muscle-tendon unit length will thus alter muscle sarcomere length and change force generating capacity of the muscle. PMID:25242618

  18. ZBTB42 mutation defines a novel lethal congenital contracture syndrome (LCCS6)

    PubMed Central

    Patel, Nisha; Smith, Laura L.; Faqeih, Eissa; Mohamed, Jawahir; Gupta, Vandana A.; Alkuraya, Fowzan S.

    2014-01-01

    Lethal congenital contracture syndrome (LCCS) is a lethal autosomal recessive form of arthrogryposis multiplex congenita (AMC). LCCS is genetically heterogeneous with mutations in five genes identified to date, all with a role in the innervation or contractile apparatus of skeletal muscles. In a consanguineous Saudi family with multiple stillbirths presenting with LCCS, we excluded linkage to all known LCCS loci and combined autozygome analysis and whole-exome sequencing to identify a novel homozygous variant in ZBTB42, which had been shown to be enriched in skeletal muscles, especially at the neuromuscular junction. Knockdown experiments of zbtb42 in zebrafish consistently resulted in grossly abnormal skeletal muscle development and myofibrillar disorganization at the microscopic level. This severe muscular phenotype is successfully rescued with overexpression of the human wild-type ZBTB42 gene, but not with the mutant form of ZBTB42 that models the human missense change. Our data assign a novel muscular developmental phenotype to ZBTB42 in vertebrates and establish a new LCCS6 type caused by ZBTB42 mutation. PMID:25055871

  19. Defective collagen fibril formation and mineralization in osteogenesis imperfecta with congenital joint contractures (Bruck syndrome).

    PubMed

    Brenner, R E; Vetter, U; Stöss, H; Müller, P K; Teller, W M

    1993-06-01

    We describe a male patient with osteogenesis imperfecta (OI) who was born with contractures of the knee, elbow and ankle joints. During the first 4 years he suffered from recurrent fractures. He has white sclerae, mild dentinogenesis imperfecta, multiple wormian bones, severe scoliosis and short stature. Morphological analysis of cortical bone revealed typical characteristics of OI including varying width of the osteoid, swollen mitochondria and a dilated endoplasmic reticulum of the osteoblasts. Collagen fibrils of the osteoid had a varying diameter, a feature not found in typical OI patients. Analysis of compact bone showed that the size of apatite crystals and the extractability of collagen with pepsin were markedly elevated compared to controls and other OI type III and IV patients. Lysyl hydroxylation of collagen from the organic bone matrix and the electrophoretic mobility of collagen alpha 1(I)- and alpha 2(I)-chains were normal. Our results provide evidence that this patient belongs to a subtype of OI. The biochemical studies indicate that the underlying defect involves defective fibril-formation of collagen type I leading to an altered mineralization of bone. PMID:8335019

  20. Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies

    PubMed Central

    Steiert, Andreas E; Boyce, Maria; Sorg, Heiko

    2013-01-01

    The most common implanted material in the human body consists of silicone. Breast augmentation and breast reconstruction using silicone-based implants are procedures frequently performed by reconstructive and aesthetic surgeons. A main complication of this procedure continues to be the development of capsular contracture (CC), displaying the result of a fibrotic foreign body reaction after the implantation of silicone. For many years, experimental and clinical trials have attempted to analyze the problem of its etiology, treatment, and prophylaxis. Different theories of CC formation are known; however, the reason why different individuals develop CC in days or a month, or only after years, is unknown. Therefore, we hypothesize that CC formation, might primarily be induced by immunological mechanisms along with other reasons. This article attempts to review CC formation, with special attention paid to immunological and inflammatory reasons, as well as actual prophylactic strategies. In this context, the word “biocompatibility” has been frequently used to describe the overall biological innocuousness of silicone in the respective studies, although without clear-cut definitions of this important feature. We have therefore developed a new five-point scale with distinct key points of biocompatibility. Hence, this article might provide the basis for ongoing discussion in this field to reduce single-publication definitions as well as increase the understanding of biocompatibility. PMID:24324348

  1. ZBTB42 mutation defines a novel lethal congenital contracture syndrome (LCCS6).

    PubMed

    Patel, Nisha; Smith, Laura L; Faqeih, Eissa; Mohamed, Jawahir; Gupta, Vandana A; Alkuraya, Fowzan S

    2014-12-15

    Lethal congenital contracture syndrome (LCCS) is a lethal autosomal recessive form of arthrogryposis multiplex congenita (AMC). LCCS is genetically heterogeneous with mutations in five genes identified to date, all with a role in the innervation or contractile apparatus of skeletal muscles. In a consanguineous Saudi family with multiple stillbirths presenting with LCCS, we excluded linkage to all known LCCS loci and combined autozygome analysis and whole-exome sequencing to identify a novel homozygous variant in ZBTB42, which had been shown to be enriched in skeletal muscles, especially at the neuromuscular junction. Knockdown experiments of zbtb42 in zebrafish consistently resulted in grossly abnormal skeletal muscle development and myofibrillar disorganization at the microscopic level. This severe muscular phenotype is successfully rescued with overexpression of the human wild-type ZBTB42 gene, but not with the mutant form of ZBTB42 that models the human missense change. Our data assign a novel muscular developmental phenotype to ZBTB42 in vertebrates and establish a new LCCS6 type caused by ZBTB42 mutation. PMID:25055871

  2. Recontouring, resurfacing, and scar revision in skin cancer reconstruction.

    PubMed

    Brenner, Michael J; Perro, Christopher A

    2009-08-01

    Residual disfigurement is a common problem for patients who have undergone skin cancer reconstruction. Restoring form and function in these patients is an artistic and technical endeavor. The efficacy of surgical scar revision, dermabrasion, chemical peels, and laser resurfacing is predicated upon the skin's innate ability to regenerate over time in response to mechanical, chemical, and thermal or ablative stresses. The patient and surgeon should be accepting of a process that is often gradual and may proceed in stages. Achieving proficiency with the secondary procedures for improving scars and local flaps may allow the motivated surgeon to mold an initially passable surgical result into an excellent one. PMID:19698924

  3. Mineral analysis in experimental corneal scars. An EDAX study

    SciTech Connect

    Bonafonte, S.; Fernandez del Cotero, J.N.; Aguirre Vila-Coro, A.

    1988-01-01

    Central penetrating excisional wounds were made in the corneas of 12 rabbits and 10 trout. The scar tissue and the surrounding cornea were compared using a new method for assessing inorganic elements in the cornea: the scanning electron microscopy and energy dispersive analysis of x-ray (EDAX). Semiquantitative determination of inorganic elements within the range of atomic numbers 9-93 in the periodic system was performed, comparing the relative concentration of those elements in the scar tissue to the surrounding cornea. Results showed that calcium was the only element higher in the healing wound than in the surrounding cornea.

  4. Caesarean scar pregnancy: a precursor of placenta percreta/accreta.

    PubMed

    Sinha, P; Mishra, M

    2012-10-01

    In the last decade, diagnosis of caesarean scar (CS) pregnancy and abnormal placental invasion has gone up significantly. It appears that the history of previous caesarean section is the predisposing factor common to both conditions. Until now, these are treated as a separate entity and therefore managed differently. Recent available evidence suggests that these are not a separate entity but rather a continuum of the same condition. If the caesarean scar pregnancy is managed expectantly in the 1st trimester, most likely it evolves into placenta accreta. This leads invariably to peripartum hysterectomy for postpartum haemorrhage (PPH) and severe maternal morbidity. Early diagnosis and intervention may give a favourable outcome. PMID:22943704

  5. Burns and military clothing.

    PubMed

    McLean, A D

    2001-02-01

    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under high heat loads in the laboratory, combat clothing can ignite, but there is little evidence that clothing ignition is a common occurrence in military burn casualties. Thermoplastic materials have many benefits in civil and military clothing. There is little objective evidence that they exacerbate burns, or complicate burn management. Their use in military clothing must be based on objective evidence, not hearsay. PMID:11307683

  6. Comparison of the Postoperative Incidence Rate of Capsular Contracture among Different Breast Implants: A Cumulative Meta-Analysis

    PubMed Central

    Liu, Xing; Zhou, Liang; Pan, Fuqiang; Gao, Yang; Yuan, Xi; Fan, Dongli

    2015-01-01

    Background A large number of clinical studies have reported that the different materials used in breast implants were a possible cause of the different incidence rates of capsular contracture observed in patients after implantation. However, this theory lacks comprehensive support from evidence-based medicine, and considerable controversy remains. Objectives In this study, a cumulative systematic review examined breast augmentation that used implants with textured or smooth surfaces to analyze the effects of these two types of implants on the occurrence of postoperative capsular contracture. Methods We conducted a comprehensive search of literature databases, including PubMed and EMBASE, for clinical reports on the incidence of capsular contracture after the implantation of breast prostheses. We performed a cumulative meta-analysis on the incidence of capsular contracture in order from small to large sample sizes and conducted subgroup analyses according to the prosthetic material used, the implant pocket placement, the incision type and the duration of follow-up. Relative risks (RR) and 95% confidence intervals (CI) were used as the final pooled statistics. Results This meta-analysis included 16 randomized controlled trials (RCTs) and two retrospective studies. The cumulative comparison of textured and smooth breast implants showed statistical significance at 2.13 (95% CI, 1.18-3.86) when the fourth study was entered into the analysis. With the inclusion of more reports, the final results indicated that smooth breast implants were more likely to be associated with capsular contracture, with statistical significance at 3.10 (95% CI, 2.23-4.33). In the subgroup analyses, the subgroups based on implant materials included the silicone implant group and the saline implant group, with significant pooled statistical levels of 4.05 (95% CI, 1.97-8.31) and 3.12 (95% CI, 2.19-4.42), respectively. According to implant pocket placement, a subglandular group and a submuscular group were included in the analyses, and only the subglandular group had a statistically significant pooled result of 3.59 (95% CI, 2.43-5.30). Four subgroups were included in the analyses according to incision type: the inframammary incision group, the periareolar incision group, the transaxillary incision group and the mastectomy incision group. Among these groups, only the pooled results of the inframammary and mastectomy incision groups were statistically significant, at 2.82 (95% CI, 1.30-6.11) and 2.30 (95% CI, 1.17-4.50), respectively. Three follow-up duration subgroups were included in the analyses: the one-year group, the two- to three-year group and the ?five-year group. These subgroups had statistically significant results of 4.67 (95% CI, 2.35-9.28), 3.42 (95% CI, 2.26-5.16) and 2.71 (95% CI, 1.64-4.49), respectively. Conclusion In mammaplasty, the use of textured implants reduces the incidence of postoperative capsular contracture. Differences in implant pocket placement and incision type are also likely to affect the incidence of capsular contracture; however, this conclusion awaits further study. PMID:25680100

  7. The Healing Effect of Curcumin on Burn Wounds in Rat

    PubMed Central

    Mehrabani, Davood; Farjam, Mojtaba; Geramizadeh, Bita; Tanideh, Nader; Amini, Masood; Panjehshahin, Mohammad Reza

    2015-01-01

    BACKGROUND Burns are still considered one of the most devastating conditions in emergency medicine affecting both genders and all age groups in developed and developing countries, resulting into physical and psychological scars and cause chronic disabilities. This study was performed to determine the healing effect of curcumin on burn wounds in rat. METHODS Seventy female Sprague-Dawley 180-220 g rats were randomly divided into 5 equal groups. Groups of A-C received 0.1, 0.5 and 2% curcumin respectively and Group D, silver sulfadiazine ointment. Group E was considered as control group and received eucerin. After 7, 14 and 21 days of therapy, the animals were sacrificed and burn areas were macroscopically examined and histologically were scored. RESULTS Administration of curcumin resulted into a decrease in size of the burn wounds and a reduction in inflammation after 14th days. Reepithelialization was prominent in groups A-C while more distinguishable in group C. In group C, epidermis exhibited well structured layers without any crusting. There were spindle shaped fibroblasts in fascicular pattern, oriented parallel to the epithelial surface with eosinophilic collagen matrix. CONCLUSION Curcumin as an available and inexpensive herbal was shown be a suitable substitute in healing of burn wounds especially when 2% concentration was applied. PMID:25606474

  8. Burns (For Parents)

    MedlinePLUS

    ... fluid can be used) or hold a clean, cold compress on the burn for approximately 3-5 minutes ( do not use ice, as it may cause more destruction to the injured skin ). Do not apply butter, grease, powder, or any other remedies to the burn, as these can make the ...

  9. Scar-free cutaneous wound healing in the leopard gecko, Eublepharis macularius.

    PubMed

    Peacock, Hanna M; Gilbert, Emily A B; Vickaryous, Matthew K

    2015-11-01

    Cutaneous wounds heal with two possible outcomes: scarification or near-perfect integumentary restoration. Whereas scar formation has been intensively investigated, less is known about the tissue-level events characterising wounds that spontaneously heal scar-free, particularly in non-foetal amniotes. Here, a spatiotemporal investigation of scar-free cutaneous wound healing following full-thickness excisional biopsies to the tail and body of leopard geckos (Eublepharis macularius) is provided. All injuries healed without scarring. Cutaneous repair involves the development of a cell-rich aggregate within the wound bed, similar to scarring wounds. Unlike scar formation, scar-free healing involves a more rapid closure of the wound epithelium, and a delay in blood vessel development and collagen deposition within the wound bed. It was found that, while granulation tissue of scarring wounds is hypervascular, scar-free wound healing conspicuously does not involve a period of exuberant blood vessel formation. In addition, during scar-free wound healing the newly formed blood vessels are typically perivascular cell-supported. Immunohistochemistry revealed widespread expression of both the pro-angiogenic factor vascular endothelial growth factor A and the anti-angiogenic factor thrombospondin-1 within the healing wound. It was found that scar-free wound healing is an intrinsic property of leopard gecko integument, and involves a modulation of the cutaneous scar repair program. This proportional revascularisation is an important factor in scar-free wound healing. PMID:26360824

  10. Hand chemical burns.

    PubMed

    Robinson, Elliot P; Chhabra, A Bobby

    2015-03-01

    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes. PMID:25653184

  11. Burning Mouth Syndrome

    PubMed Central

    Kamala, KA; Sankethguddad, S; Sujith, SG; Tantradi, Praveena

    2016-01-01

    Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS. PMID:26962284

  12. Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol

    PubMed Central

    Müller, Martin; Bartoszek, Gabriele; Beutner, Katrin; Klingshirn, Hanna; Saal, Susanne; Stephan, Anna-Janina; Strobl, Ralf; Grill, Eva; Meyer, Gabriele

    2015-01-01

    Background: Joint contractures are common problems in frail older people in nursing homes. Irrespective of the exact extent of older individuals in geriatric care settings living with joint contractures, they appear to be a relevant problem. Also, the new emphasis on the syndrome of joint contractures, e. g. by the German statutory long term care insurance, led to an increase in assessment and documentation efforts and preventive interventions in clinical care. However, more attention should be paid to the actual situation of older individuals in nursing homes with prevalent joint contractures, particularly their experience of related activity limitations and participation restrictions. Thus, the aim of this study is 1) to develop a tailored intervention to improve functioning, and especially participation and quality of life in older residents with joint contractures in nursing homes and 2) to test the feasibility of the intervention accompanied by a rigorous process evaluation. Methods: The complex intervention, which will be developed in this project follows the UK Medical Research Council (MRC) framework and integrates the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development process will comprise a systematic literature review, reanalysis of existing data and the integration of the knowledge of the affected individuals and experts. The developed intervention including a comprehensive process evaluation will be pilot tested with residents with joint contractures in three nursing homes. Discussion: The projected study will provide a tailored intervention to improve functioning, participation and quality of life in older residents with joint contractures in nursing homes. With this focus, the intervention will support patient relevant outcomes. The pilot study including process evaluation will offer a first opportunity to indicate the size of the intervention’s effect and prepare further studies. PMID:26195926

  13. Physical and quality of life outcomes of patients with isolated hand burns--a prospective audit.

    PubMed

    Williams, Nicola; Stiller, Kathy; Greenwood, John; Calvert, Philip; Masters, Margot; Kavanagh, Sheila

    2012-01-01

    Hand burns can have major implications on function, appearance, and quality of life. Our clinical practice has changed over the last 10 years, with a steady increase in the proportion of hand burns receiving early and aggressive surgical management using Biobrane® sheets/gloves and a concomitant fall in the proportion requiring excision and split skin grafting. The aim of this study was to measure a comprehensive range of outcomes for patients admitted with isolated hand burns to review our outcomes and provide us with the "expected" patterns of recovery. A prospective audit was performed over a 14-month period, with outcomes measured during hospital admission and at 2 weeks, 1, 3, 6, and 12 months postinjury (depending on the method of management). Outcomes comprised pain, the Burns Specific Health Scale (abbreviated version B), return to work/leisure, total active range of motion, grip strength, the Michigan Hand Questionnaire, and scar appearance using Matching Assessment with Photographs of Scars. A total of 52 patients (35 male, mean age 39 years) with 57 burned hands participated. Patients whose burn injuries were such that they were able to be managed conservatively or with Biobrane® showed rapid recovery in all outcomes, with normal or near-normal values achieved within 2 weeks to 1 month postinjury. The patients whose burn injuries required excision and split skin grafting demonstrated more marked initial deterioration, a slower rate of improvement, but eventual good recovery. In conclusion, for this sample of patients with isolated hand burns, recovery was good and rapid for those whose burn injuries were such that they were managed conservatively or with Biobrane®. PMID:22210079

  14. Electrospun Poly(L-Lactide) Fiber with Ginsenoside Rg3 for Inhibiting Scar Hyperplasia of Skin

    PubMed Central

    Hu, Changmin; Li, Haiyan; Zhang, Yuguang; Chang, Jiang

    2013-01-01

    Hypertrophic scarring (HS) has been considered as a great concern for patients and a challenging problem for clinicians as it can be cosmetically disfiguring and functionally debilitating. In this study, Ginsenoside Rg3/Poly(l-lactide) (G-Rg3/PLLA) electrospun fibrous scaffolds covering on the full-thickness skin excisions location was designed to suppress the hypertrophic scar formation in vivo. SEM and XRD results indicated that the crystal G-Rg3 carried in PLLA electrospun fibers was in amorphous state, which facilitates the solubility of G-Rg3 in the PLLA electrospun fibrous scaffolds, and solubility of G-Rg3 in PBS is increased from 3.2 µg/ml for pure G-Rg3 powders to 19.4 µg/ml for incorporated in PLLA-10% fibers. The released G-Rg3 content in the physiological medium could be further altered from 324 to 3445 µg in a 40-day release period by adjusting the G-Rg3 incorporation amount in PLLA electrospun fibers. In vitro results demonstrated that electrospun G-Rg3/PLLA fibrous scaffold could significantly inhibit fibroblast cell growth and proliferation. In vivo results confirmed that the G-Rg3/PLLA electrospun fibrous scaffold showed significant improvements in terms of dermis layer thickness, fibroblast proliferation, collagen fibers and microvessels, revealing that the incorporation of the G-Rg3 in the fibers prevented the HS formation. The above results demonstrate the potential use of G-Rg3/PLLA electrospun fibrous scaffolds to rapidly minimize fibroblast growth and restore the structural and functional properties of wounded skin for patients with deep trauma, severe burn injury, and surgical incision. PMID:23874757

  15. 4. VIEW OF DOWNSTREAM FACE OF DAM, WITH SCARS FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. VIEW OF DOWNSTREAM FACE OF DAM, WITH SCARS FROM EARTH MOVING TO CONSTRUCT DAM IN FOREGROUND, LOOKING NORTHWEST - High Mountain Dams in Upalco Unit, Five Point Lake Dam, Ashley National Forest, 12 miles Northwest of Swift Creek Campground, Mountain Home, Duchesne County, UT

  16. 8. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH MOVING TO CONSTRUCT DAM, LOOKING NORTH - High Mountain Dams in Upalco Unit, East Timothy Lake Dam, Ashley National Forest, 8.4 miles North of Swift Creek Campground, Mountain Home, Duchesne County, UT

  17. 9. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH MOVING TO CONSTRUCT DAM, LOOKING EAST - High Mountain Dams in Upalco Unit, East Timothy Lake Dam, Ashley National Forest, 8.4 miles North of Swift Creek Campground, Mountain Home, Duchesne County, UT

  18. [Nonablative fractional lasers: Acne scars and other indications].

    PubMed

    Degitz, K

    2015-10-01

    Nonablative photothermolysis has become an established technique in laser dermatology. It is mainly used for restructuring dermal connective tissue in order to treat, for example, acne scars or solar elastosis. It is also applied to the treatment of melasma and other benign cutaneous pigment disorders. This article discusses various indications in light of published observations and with regard to practical considerations. PMID:26253115

  19. Ectopic Pregnancy in caesarean section scar: A case report.

    PubMed

    Aich, Rajarshi; Solanki, Narayan; Kakadiya, Ketan; Bansal, Ashank; Joshi, Manisha; Nawale, Ajita

    2015-12-01

    We report a rare case of ectopic pregnancy occurring in the scar of a previous caesarean section, diagnosed by ultrasonography and confirmed by 3.0-T magnetic resonance imaging of pelvis. We present the clinical details and imaging findings, followed by discussion of the etiology, pathogenesis, and imaging of this condition. PMID:26649124

  20. Ectopic Pregnancy in caesarean section scar: A case report

    PubMed Central

    Aich, Rajarshi; Solanki, Narayan; Kakadiya, Ketan; Bansal, Ashank; Joshi, Manisha; Nawale, Ajita

    2015-01-01

    We report a rare case of ectopic pregnancy occurring in the scar of a previous caesarean section, diagnosed by ultrasonography and confirmed by 3.0-T magnetic resonance imaging of pelvis. We present the clinical details and imaging findings, followed by discussion of the etiology, pathogenesis, and imaging of this condition. PMID:26649124

  1. Photodynamic therapy for a hypertrophic scarring: a promising choice.

    PubMed

    Bruscino, Nicola; Lotti, Torello; Rossi, Riccardo

    2011-12-01

    The case we report is about a female patient, 69 years old, who had a hypertrophic scarring on the right cheek because of a bite by her dog. She had attempted many types of topical and intralesional treatments but without success. The patient underwent photodynamic therapy (PDT), employing a methyl ester of 5-aminolevulinic acid (MAL) as topical photosensitizer and a non-coherent red light at a wavelength of 632 nm. This session was then repeated three more times at 2-week intervals. A month after the last session, the scarred area significantly softened, becoming more flexible, less erythematous, smoother and reduced in volume. The patient was greatly satisfied with the clinical and cosmetic result, she had no more than rough scarring on the cheek, and her skin in the area around the lesion was very smooth, wrinkle-free. She did not show any recurrence of her hypertrophic scarring after 1 year of follow-up. PDT revealed to be the most effective approach if compared with previous therapeutic options received by the patient, but further studies are necessary to evaluate protocols to be used for the best results in this kind of application. PMID:22092740

  2. Prediction of scar integrity and vaginal birth after caesarean delivery.

    PubMed

    Valentin, Lil

    2013-04-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has been published. A thin lower uterine segment at 35-40 weeks, as measured by ultrasound in women with a caesarean hysterotomy scar, increases the risk of uterine rupture or dehiscence. No cut-off for lower uterine segment thickness, however, can be suggested because of study heterogeneity, and because prospective validation is lacking. Large caesarean hysterotomy scar defects in non-pregnant women seen at ultrasound examination increase the risk of uterine rupture or dehiscence in subsequent pregnancy, but the strength of the association is unknown. To sum up, we currently lack a method that can provide a reliable estimate of the risk of uterine rupture or dehiscence during a trial of labour in women with caesarean hysterotomy scar(s). PMID:23103207

  3. Histologic features of alopecias: part II: scarring alopecias.

    PubMed

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-05-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder. PMID:25439143

  4. Occlusion Regulates Epidermal Cytokine Production and Inhibits Scar Formation

    PubMed Central

    Gallant-Behm, Corrie L; Mustoe, Thomas A

    2010-01-01

    Hypertrophic scars are a major clinical problem, yet there are few therapeutics available to prevent or treat scar formation. One of the oldest known and most effective treatments is occlusion with silicone gel. However, little is known about its mode of action. It is hypothesized that occlusion increases the hydration state of the epidermis, and that this affects the epidermal and dermal cell behavior. This study investigated that possibility. Using the rabbit hypertrophic scar model, we determined that occlusion was able to increase the hydration state of the epidermis in a dose dependent manner, and significantly reduced the scar hypertrophy. Quantitative RT-PCR and immunohistochemistry demonstrated that occlusion altered the keratinocyte behavior, including keratin expression. Furthermore, occlusion significantly decreased the epidermal expression of the pro-fibrotic cytokine IL-1? and increased the epidermal expression of the anti-fibrotic cytokine TNF-?. Those alterations in epidermal gene expression resulted in concomitant changes in the expression of TGF-? family members by cells in the dermis, resulting in a decrease in pro-fibrotic signaling within the dermis. In summary, the results of this study indicate that occlusive therapy was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and anti-fibrotic signals produced following injury. PMID:20419876

  5. Phoenix Society for Burn Survivors

    MedlinePLUS

    ... Our Programs Phoenix SOAR Phoenix Online Community Phoenix World Burn Congress Phoenix Kids & Teens Online Learning Phoenix ... Phoenix Education Grant Burn Support Magazine Collaborators Phoenix World Burn Congress Location & Registration Attendee Scholarships Youth and ...

  6. Hysteroscopy and suction evacuation of cesarean scar pregnancies: a case report and review.

    PubMed

    Fylstra, Donald L

    2014-03-01

    Implantation of a pregnancy into the scar of a prior cesarean is an uncommon type of ectopic pregnancy. The incidence of cesarean scar pregnancy is thought to be one in 1800-2216 pregnancies. The increase in the incidence of cesarean scar pregnancy is thought to be a consequence of the increasing rates of cesarean delivery. The natural history of cesarean scar pregnancy is unknown. However, if such a pregnancy is allowed to continue, uterine scar rupture with hemorrhage and possible hysterectomy seem likely. Two early diagnosed cesarean scar pregnancies were treated with hysteroscopy and suction curettage removal. One required intramuscular methotrexate to resolve a persistent cesarean scar ectopic pregnancy. It would seem reasonable that simple suction evacuation would frequently leave chorionic villi imbedded within the cesarean scar, as the pregnancy is not within the endometrial cavity. PMID:24320609

  7. Screening of candidate genes in fibroblasts derived from patients with Dupuytren's contracture using bioinformatics analysis.

    PubMed

    Liu, Haoyu; Yin, Weitian; Liu, Biao; Liu, Yan; Guo, Baofeng; Wei, Zhuang

    2015-08-01

    Our study aimed to identify candidate genes associated with Dupuytren's contracture (DC) and elucidate their roles in DC development. The microarray data of GSE21221 were downloaded from Gene Expression Omnibus database, including six samples from carpal tunnel-derived fibroblasts and six samples from DC-derived fibroblasts. The differentially expressed genes (DEGs) in DC samples were screened using limma package. GO annotation and KEGG pathway analyses were performed by DAVID online tool. Protein-protein interaction network and expression correlation network were constructed to identify crucial relationships between DEGs. Finally, candidate DC-associated genes were predicted based on comparative toxicogenomics database. A total of 529 DEGs (138 up- and 391 down-regulated) in DC-derived fibroblasts were screened and compared with carpal tunnel-derived fibroblasts. Only ten DC-associated genes, such as neurotrophin 3 (NTF3) and protein kinase C, epsilon (PRKCE), were further screened. In addition, NTF3 was significantly enriched in MAPK signaling pathway, in which other DEGs, such as nuclear receptor subfamily 4, group A, member 1 (NR4A1), fibroblast growth factor 22 (FGF22) and BDNF, were enriched. Besides, NTF3 could co-express with fibrillin 2 (FBN2), and PRKCE could co-express with zinc finger protein 516 (ZNF516), solute carrier organic anion transporter family, member 2A1 (SLCO2A1), chromosome 10 open reading frame 10 (C10orf10) and Kelch domain containing 7A (KLHDC7A). Our study indicates that these DEGs, including NTF3, FBN2, NR4A1, FGF22, BDNF, PRKCE, ZNF516, SLCO2A1, C10orf10 and KLHDC7A, may play important roles in DC development and serve as candidate molecular targets for treating DC. PMID:25963801

  8. CD44 and hyaluronan expression in human cutaneous scar fibroblasts.

    PubMed Central

    Messadi, D. V.; Bertolami, C. N.

    1993-01-01

    Fibrotic disorders of skin and other organs are typically associated with an abnormal accumulation of extracellular matrix. This study focuses on a matrix constituent, hyaluronan-which is known to be altered in fibrotic disorders of skin- and on CD44, a cell adhesion molecule and putative receptor for hyaluronan. Tissue samples were obtained from biopsies of human normal skin, normal cutaneous scar; and hypertrophic cutaneous scar. After culturing, cells were studied by single- and double-labeling immunohistochemistry using the two anti-CD44 monoclonal antibodies, BU-52 and J173, and a biotinylated hyaluronan binding complex probe, b-HABR. Certain cultures were pretreated with Streptomyces hyaluronidase to assess the dependency of CD44 expression on the presence of endogenous hyaluronan. CD44 expression, both in the presence and the absence of exogenous hyaluronan, was quantitated by radioimmunobinding assay. Overall glycosaminoglycan synthesis and identification of hyaluronan were accomplished by precursor incorporation assays and by quantitative cellulose acetate electrophoresis. CD44 was found to be a normal human adult fibroblastic antigen whose expression is markedly increased for hypertrophic scar fibroblasts compared with normal skin fibroblasts. Although hyaluronan was found to be the predominant glycosaminoglycan constituent of the pericellular matrix for these fibroblasts, CD44 attachment to the cell surface is neither mediated by hyaluronan nor is the presence of hyaluronan a prerequisite for CD44 expression. Exogenous hyaluronan induced a decline in measurable CD44 expression for normal skin fibroblasts but not for hypertrophic scar fibroblasts. These observations are compatible with current understanding of the way cells manage the hyaluronan economy of the extracellular matrix and emphasize phenotypic heterogeneities between fibroblasts derived from normal versus scar tissues. Images Figure 1 Figure 4 PMID:8475990

  9. Molecular mechanisms of scar-sourced axon growth inhibitors.

    PubMed

    Ohtake, Yosuke; Li, Shuxin

    2015-09-01

    Astrogliosis is a defense response of the CNS to minimize primary damage and to repair injured tissues, but it ultimately generates harmful effects by upregulating inhibitory molecules to suppress neuronal elongation and forming potent barriers to axon regeneration. Chondroitin sulfate proteoglycans (CSPGs) are highly expressed by reactive scars and are potent contributors to the non-permissive environment in mature CNS. Surmounting strong inhibition by CSPG-rich scar is an important therapeutic goal for achieving functional recovery after CNS injuries. Currently, enzymatic digestion of CSPGs with locally applied chondroitinase ABC is the main in vivo approach to overcome scar inhibition, but several disadvantages may prevent using this bacterial enzyme as a therapeutic option for patients. A better understanding of molecular mechanisms underlying CSPG function may facilitate development of new effective therapies to overcome scar-mediated inhibition. Previous studies support that CSPGs act by non-specifically hindering the binding of matrix molecules to their cell surface receptors through steric interactions, but two members of the leukocyte common antigen related (LAR) phosphatase subfamily, protein tyrosine phosphatase σ and LAR, are functional receptors that bind CSPGs with high affinity and mediate CSPG inhibition. CSPGs may also act by binding two receptors for myelin-associated growth inhibitors, Nogo receptors 1 and 3. Thus, CSPGs inhibit axon growth through multiple mechanisms, making them especially potent and difficult therapeutic targets. Identification of CSPG receptors is not only important for understanding the scar-mediated growth suppression, but also for developing novel and selective therapies to promote axon sprouting and/or regeneration after CNS injuries. This article is part of a Special Issue entitled SI: Spinal cord injury. PMID:25192646

  10. Sequential treatment with intradermal incision (intracision) and 2,940-nm Er:YAG laser for chicken pox scars.

    PubMed

    Lee, Sang Ju; Kim, Young Koo; Choi, Sun Young; Park, Kui Young; Seo, Seong Jun

    2014-01-01

    Boxcar scars, such as chicken pox scars, are round to oval depressions with sharply defined vertical edges. Subcision is a simple and safe procedure for treatment of atrophic and depressed scars, but boxcar scars are generally not eliminated by subcision. Intradermal incision technique (intracision) can treat chicken pox scars by untethering fibrotic strands, raising collagen synthesis, and having additional intradermal blood pocket formation. We have found that chicken pox scars further improve when intracision is followed by laser skin resurfacing. PMID:24502307

  11. 'Therapeutic' burns (Maqua).

    PubMed

    Baruchin, A M

    1984-12-01

    Cauterization of the skin by a red-hot iron, a pinch of hot cinder or a burning coal, is a form of 'treatment' used by lay healers in some parts of Africa and the Middle East. The burns are limited to small circular areas, and are usually full-thickness skin loss. Most frequently, the patients do not seek medical treatment and the burns heal by secondary intention. Sometimes, however, disastrous complications such as infectious osteomyelitis, septicaemia and death may occur. PMID:6525537

  12. [Keloid scars (part I): Clinical presentation, epidemiology, histology and pathogenesis].

    PubMed

    Philandrianos, C; Kerfant, N; Jaloux, C; Martinet, L; Bertrand, B; Casanova, D

    2016-04-01

    Keloid scars are a dysregulated response to cutaneous wound healing and are characterized by excessive deposition of collagen. Clinical and histological aspects are typical but they are often confused with hypertrophic scars. Principal pathogenesis is abnormal regulation of the collagen equilibrium because of TGFβ. In this first part, clinical characteristics, physiopathology and histology of keloid scars are explained. PMID:26545809

  13. Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity.

    PubMed

    Hägglund, Gunnar; Andersson, Sofia; Düppe, Henrik; Lauge-Pedersen, Henrik; Pedertsen, Henrik Lauge; Nordmark, Eva; Westbom, Lena

    2005-07-01

    During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CP register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P = 0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated. PMID:15931031

  14. Reliability of biomass burning estimates from savanna fires: Biomass burning in northern Australia during the 1999 Biomass Burning and Lightning Experiment B field campaign

    NASA Astrophysics Data System (ADS)

    Russell-Smith, Jeremy; Edwards, Andrew C.; Cook, Garry D.

    2003-02-01

    This paper estimates the two-daily extent of savanna burning and consumption of fine (grass and litter) fuels from an extensive 230,000 km2 region of northern Australia during August-September 1999 encompassing the Australian continental component of the Biomass Burning and Lightning Experiment B (BIBLE B) campaign [, 2002]. The extent of burning for the study region was derived from fire scar mapping of imagery from the advanced very high resolution radiometer (AVHRR) on board the National Oceanic and Atmospheric Administration (NOAA) satellite. The mapping was calibrated and verified with reference to one Landsat scene and associated aerial transect validation data. Fine fuel loads were estimated using published fuel accumulation relationships for major regional fuel types. It is estimated that more than 43,000 km2 was burnt during the 25 day study period, with about 19 Mt of fine (grass and litter) fuels. This paper examines assumptions and errors associated with these estimates. It is estimated from uncalibrated fire mapping derived from AVHRR imagery that 417,500 km2 of the northern Australian savanna was burnt in 1999, of which 136,405 km2, or 30%, occurred in the Northern Territory study region. Using generalized fuel accumulation equations, such biomass burning consumed an estimated 212.3 Mt of fine fuels, but no data are available for consumption of coarse fuels. This figure exceeds a recent estimate, based on fine fuels only, for the combined Australian savanna and temperate grassland biomass burning over the period 1990-1999 but is lower than past estimates derived from classification approaches. We conclude that (1) fire maps derived from coarse-resolution optical imagery can be applied relatively reliably to estimate the extent of savanna fires, generally with 70-80% confidence using the approach adopted here, over the major burning period in northern Australia and (2) substantial further field assessment and associated modeling of fuel accumulation, especially of coarse fuels, is required.

  15. ["Raw and charred flesh": the experience of burned women in Northeast Brazil].

    PubMed

    Arruda, Cristiani Nobre de; Braide, Andrea Stopglia Guedes; Nations, Marilyn

    2014-10-01

    In Northeast Brazil, death from burns is a widespread, pervasive threat to poor women. This anthropological study describes the experience of personal suffering among female burn patients. In 2009, six "information-rich" cases were investigated at the Burn Center in Fortaleza, Ceará State, Brazil. Open ethnographic interviews with key informants, narratives of lived experiences, and participant observation at the clinic and patients' home were conducted. The methods included content analysis, systems of signs, meanings, and actions, and contextualized semantic interpretation. The emerging metaphors are embued with the cultural meaning of "monstrosity" and gender violence by fire - inscribed mercilessly in the woman's body. "Accidents" caused by flammable liquids (alcohol) hide the cruel reality of "raw and charred flesh". The scars can disfigure the victims as "non-persons", destroying their moral reputation and leading to social rejection. In the Brazilian Northeast, the social vulnerability caused by sequelae from burns demands a policy for humanized care. PMID:25388309

  16. A case report of a chemical burn due to the misuse of glacial acetic acid.

    PubMed

    Yoo, Jun-Ho; Roh, Si-Gyun; Lee, Nae-Ho; Yang, Kyung-Moo; Moon, Ji-Hyun

    2010-12-01

    As young and elastic skin is what everyone dreams of, various measures have been implemented including chemical, laser resurfacing and dermabrasion to improve the condition of ageing skin. However, the high cost of these procedures prevents the poor from having access to treatment. Glacial acetic acid is widely used as a substitute for chemical peeling because it is readily easily available and affordable. However, its use can result in a number of serious complications. A 28-year-old female patient was admitted to our hospital with deep second-degree chemical burns on her face caused by the application of a mixture of glacial acetic acid and flour for chemical peeling. During a 6-month follow-up, hypertrophic scarring developed on the both nasolabial folds despite scar management. Glacial acetic acid is a concentrated form of the organic acid, which gives vinegar its sour taste and pungent smell, and it is also an important reagent during the production of organic compounds. Unfortunately, misleading information regarding the use of glacial acetic acid for chemical peeling is causing serious chemical burns. Furthermore, there is high possibility of a poor prognosis, which includes inflammation, hypertrophic scar formation and pigmentation associated with its misuse. Therefore, we report a case of facial chemical burning, due to the misuse of glacial acetic acid, and hope that this report leads to a better understanding regarding the use of this reagent. PMID:20708991

  17. Clinical and impression cytology findings of amniotic membrane and oral mucosal membrane transplantation for the management of socket contracture

    PubMed Central

    Kurtul, Bengi Ece; Erdener, Ugur; Mocan, Mehmet Cem; Irkec, Murat; Orhan, Mehmet

    2014-01-01

    AIM To investigate and compare the cytopathological and clinical effects of amniotic membrane transplantation (AMT) and oral mucosal membrane transplantation (OMMT) in socket contraction. METHODS Twelve patients who could not be fitted with ocular prosthesis due to socket contracture were included in this study. Seven patients underwent AMT and 5 patients underwent OMMT. Thirteen patients who had healthy sockets were included as control group. Depth of inferior fornix, degree of inflammation, extent of the socket contracture and socket volume were measured in the preoperative period and at sixth and twelfth weeks postoperatively. Impression cytology of conjunctival fornices and tear transforming growth factor beta-1 (TGF?1) levels were determined. RESULTS In the AMT group, socket volume and lower fornix depth values were significantly higher (P=0.030 and P=0.004 respectively) and inflammation levels and impression cytology stages (P=0.037 and P=0.022 respectively) were significantly lower in postoperative period compared to preoperative period. In the OMMT group, no statistical differences were found in terms of clinical parameters, inflammation levels and impression cytology stages of preoperative versus postoperative values. Preoperative tear TGF?1 levels were higher in AMT and OMMT groups compared to the control group (25.5 ng/mL, 26.3 ng/mL and 21.7 ng/mL respectively). Decreased tear TGF?1 levels were observed in both the AMT and OMMT groups postoperatively (median decrease value=2.1 ng/mL and 2.7 ng/mL respectively). CONCLUSION AMT is associated with postoperative improvement in inferior fornix depth, socket volume, inflammation and impression cytology levels and may be a more proper alternative method than OMMT in the management of socket contracture. PMID:24790882

  18. Review of X-linked syndromes with arthrogryposis or early contractures-aid to diagnosis and pathway identification.

    PubMed

    Hunter, Jesse M; Kiefer, Jeff; Balak, Christopher D; Jooma, Sonya; Ahearn, Mary Ellen; Hall, Judith G; Baumbach-Reardon, Lisa

    2015-05-01

    The following is a review of 50 X-linked syndromes and conditions associated with either arthrogryposis or other types of early contractures. These entities are categorized as those with known responsible gene mutations, those which are definitely X-linked, but the responsible gene has not been identified, and those suspected from family history to be X-linked. Several important ontology pathways for known disease genes have been identified and are discussed in relevance to clinical characteristics. Tables are included which help to identify distinguishing clinical features of each of the conditions. PMID:25790323

  19. [Value and place of tenolysis of the flexors of the fingers in the complex treatment of tenogenic contractures].

    PubMed

    Kolonta?, Iu Iu; Bely?, S I

    1989-07-01

    Having analysed their experience in the treatment of 102 patients with tendogenic contractures of the hand fingers the authors have proposed a test for prognosis of the recovery of the slipping function of the flexor tendons after suturing and tendoplasty. In cases of ineffective conservative therapy it is recommended to make tenolysis at the early stages of rehabilitation. Indications and contraindications, the operative technique including application of microsurgical technique and the authors' devices have been determined. The principles of postoperative management of this category of patients have been elucidated. It has been noted that tenolysis at the early stages allows to considerably reduce the terms of rehabilitation. PMID:2682432

  20. Bruck syndrome (osteogenesis imperfecta with congenital joint contractures): review and report on the first North American case.

    PubMed

    McPherson, E; Clemens, M

    1997-05-01

    We describe a patient who was born with flexion contractures and pterygia at the elbows, clubfeet, torticollis, and several rib fractures. During infancy and childhood, multiple fractures of the lower limbs occurred with minimal trauma and led to disabling deformities. When evaluated at age 19 years, he was normally intelligent, but extremely short, with severe kyphoscoliosis compromising his pulmonary function. Pterygia limited elbow extension to 90 degrees, and severe lower limb deformities prevented ambulation. He did not have blue sclerae, dentinogenesis imperfecta, or hearing loss. X-ray studies showed demineralized bones, severe deformity and cystic change at old fracture sites, and vertebral wedging. Collagen studies on skin fibroblasts were normal. PMID:9129737

  1. New Fashioned Book Burning.

    ERIC Educational Resources Information Center

    Gardner, Robert

    1997-01-01

    Reports on results of a teacher's experiment in book burning as a lesson accompanying the teaching of Ray Bradbury's "Fahrenheit 451." Discusses student reactions and the purpose of or justification for the experimental lesson. (TB)

  2. Minor burns - aftercare

    MedlinePLUS

    ... put a thin layer of ointment, such as petroleum jelly or aloe vera, on the burn. The ointment ... and pressure with a sterile non-stick gauze (petrolatum or Adaptic-type) lightly taped or wrapped over ...

  3. 'Burns Cliff' Beckons

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This approximate true-color image taken by the panoramic camera on the Mars Exploration Rover Opportunity highlights a feature called 'Burns Cliff' within the impact crater known as 'Endurance.' Scientists are eager to explore this layered ridge for clues to the red planet's past. The only problem is its location: Burns Cliff is a vertical drop, which poses an interesting challenge for rover planners. Burns Cliff was named after the late scientist Roger Burns, who was one of the first to correctly propose the importance of sulfate and jarosite to the study of Mars' geologic history.

    This image is a portion of a larger mosaic taken with the panoramic camera's 480-, 530- and 750-nanometer filters on sols 97 and 98.

  4. IL-6 Trans-signaling-STAT3 Pathway Mediates ECM and Cellular Proliferation in Fibroblasts from Hypertrophic Scar

    PubMed Central

    Ray, Sutapa; Ju, Xiaoxi; Sun, Hong; Finnerty, Celeste C; Herndon, David N; Brasier, Allan R

    2012-01-01

    The molecular mechanisms behind the pathogenesis of post-burn hypertrophic scar (HS) remain unclear. Here, we investigate the role of interleukin-6 (IL-6) trans-signaling-STAT3 pathway in HS fibroblasts (HSF) derived from burned-induced HS skin. HSF showed increased Tyr 705 STAT3 phosphorylation over normal fibroblast (NF) after IL-6•IL-6R? stimulation by immunoassays. The endogenous STAT3 target gene, SOCS3, was upregulated in HSF and showed increased STAT3 binding on its promoter relative to NF in Chromatin Immunoprecipitation assay. We observed that the cell surface signaling transducer glycoprotein 130 is upregulated in HSF using Q-RT-PCR and flow cytometry. The production of excessive extracellular matrix (ECM), including the expression of alpha2 (1) procollagen (Col1A2) and fibronectin 1 (FN) were seen in HSFs. A STAT3 peptide inhibitor abrogated FN and Col1A2 gene expression in HSF indicating involvement of STAT3 in ECM production. The cellular proliferation markers Cyclin D1, Bcl-Xl and c-Myc were also upregulated in HSF and knockdown of STAT3 by siRNA attenuated c-Myc expression indicating the essential role of STAT3 in fibroblast proliferation. Taken together, our results suggest that the IL-6-trans-signaling-STAT3 pathway may play an integral role in HS pathogenesis and disruption of this pathway could be a potential therapeutic strategy for the treatment of burn-induced HS. PMID:23303450

  5. Spinal osteotomy in the presence of massive lumbar epidural scarring.

    PubMed

    Arlet, Vincent

    2015-01-01

    The combination of Massive epidural scarring and spinal deformity represents the ultimate challenge for the spinal deformity surgeon. This is observed more and more as the population is aging and the number of spine surgery is increasing. In assessing the patient with spinal deformity and epidural scarring, one should carry out a thorough medical work up including Dexa scan, comorbidities, and in most cases a Myelo-CT scan that will identify the extent of the previous fusion, the fixed or semi-rigid nature of the deformity with complete anterior fusion or only bone bridges, the evaluation of the previous instrumentation (if present) with possible screw misplacement, or halo around the screws, the extent of the previous laminectomy, the spinal stenosis and possible arachnoiditis and or meningocele. Once the requirement of deformity correction has been established with specific attention to the pelvic incidence and amount of lordosis required two basic choices can be made. The first one is to perform the spine realignment outside the massive epidural scarring whether this will be performed through simple posterior osteotomies, TLIF combined with Smith-Petersen osteotomies or Pedicle subtraction osteotomies. One should not forget about all the possibilities of an anterior or lateral approach to the spine that can also judiciously realign the spine at the level or at distance of the massive epidural scarring. These anterior realignments have to be supplemented with posterior fixation and or osteotomies. The other alternative is to perform the spine osteotomy at the level of the massive epidural scarring preferably at the junction of normal dura and epidural scar. Working around the dura that will require to be thinned down before the osteotomy is performed represents another challenge where incidental durotomies are not infrequent. During the closing of the osteotomy the dura may not be as giving as a normal dura and too aggressive closure of the osteotomy may not be possible. Instead a closing/opening osteotomy may be preferable, but will require an additional anterior column support. Attention to anterior column reconstruction and solid posterior instrumentation (iliac screws, four rods) should be given to all these revisions to have a long-lasting result. PMID:25427670

  6. Burns of the foot.

    PubMed

    Achauer, B M; Bartlett, R H; Wilson, L F

    1976-01-01

    The most severe trauma a patient can sustain is a major burn. When a person is seriously burned, initial care begins with maintaining an adequate airway and adequate blood volume and urinary output by intravenous fluids. After the patient has been stabilized, the wound is of primary importance, and postage stamp split thickness grafts are used for skin coverage. When these are secure and a maximal range of motion has been obtained, reconstructive procedures should be started. PMID:16053

  7. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the company used technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications

  8. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the companyused technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications.

  9. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the company used technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications.

  10. Preventing tap water burns.

    PubMed Central

    Baptiste, M S; Feck, G

    1980-01-01

    Based on a 1974-1975 survey of hospital records in upstate New York, we estimate that 347 tap water burns will require inpatient treatment annually, with children and the elderly at increased risk. The number and severity of burns from tap water makes them an important prevention priority. Reducing the temperature of household hot water supplies could be a practical and effective prevention measure. PMID:7386711

  11. Release of insulin from PLGA-alginate dressing stimulates regenerative healing of burn wounds in rats.

    PubMed

    Dhall, Sandeep; Silva, João P; Liu, Yan; Hrynyk, Michael; Garcia, Monika; Chan, Alex; Lyubovitsky, Julia; Neufeld, Ronald J; Martins-Green, Manuela

    2015-12-01

    Burn wound healing involves a complex set of overlapping processes in an environment conducive to ischaemia, inflammation and infection costing $7.5 billion/year in the U.S.A. alone, in addition to the morbidity and mortality that occur when the burns are extensive. We previously showed that insulin, when topically applied to skin excision wounds, accelerates re-epithelialization and stimulates angiogenesis. More recently, we developed an alginate sponge dressing (ASD) containing insulin encapsulated in PLGA [poly(D,L-lactic-co-glycolic acid)] microparticles that provides a sustained release of bioactive insulin for >20 days in a moist and protective environment. We hypothesized that insulin-containing ASD accelerates burn healing and stimulates a more regenerative, less scarring healing. Using heat-induced burn injury in rats, we show that burns treated with dressings containing 0.04 mg insulin/cm(2) every 3 days for 9 days have faster closure, a higher rate of disintegration of dead tissue and decreased oxidative stress. In addition, in insulin-treated wounds, the pattern of neutrophil inflammatory response suggests faster clearing of the burned dead tissue. We also observe faster resolution of the pro-inflammatory macrophages. We also found that insulin stimulates collagen deposition and maturation with the fibres organized more like a basket weave (normal skin) than aligned and cross-linked (scar tissue). In summary, application of ASD-containing insulin-loaded PLGA particles on burns every 3 days stimulates faster and more regenerative healing. These results suggest insulin as a potential therapeutic agent in burn healing and, because of its long history of safe use in humans, insulin could become one of the treatments of choice when repair and regeneration are critical for proper tissue function. PMID:26310669

  12. Infrared imaging of burn wounds to determine burn depth

    NASA Astrophysics Data System (ADS)

    Hargroder, Andrew G.; Davidson, James E., Sr.; Luther, Donald G.; Head, Jonathan F.

    1999-07-01

    Determination of burn wound depth is at present left to the surgeons visual examination. Many burn wounds are obviously, by visual inspection, superficial 2 degree burns or true 3 degree burns. However, those burn wounds that fall between the obvious depth burns are difficult to assess visually, and therefore wound depth determination often requires waiting 5 to 7 days postburn. Initially, 10 burn patients underwent IR imaging at various times during the evaluation of their burn wounds. These patients were followed to either healing or skin grafting. The IR images were then reviewed to determine their accuracy in determining the depth of the wound. IR imaging of burn wounds with focal plane staring array midrange IR systems appears promising in determination of burn depth one to two days postburn. This will allow clinical decision regarding operative or nonoperative intervention to be made earlier, thus decreasing hospital stays and time to healing.

  13. Ball lightning burn.

    PubMed

    Selvaggi, Gennaro; Monstrey, Stan; von Heimburg, Dennis; Hamdi, Mustapha; Van Landuyt, Koen; Blondeel, Phillip

    2003-05-01

    Ball lightning is a rare physical phenomenon, which is not yet completely explained. It is similar to lightning but with different, peculiar characteristics. It can be considered a mix of fire and electricity, concentrated in a fireball with a diameter of 20-cm that most commonly appears suddenly, even in indoor conditions, during a thunderstorm. It moves quickly for several meters, can change direction, and ultimately disappears. During a great storm, a 28-year-old man and his 5-year-old daughter sustained burn wounds after ball lightning came from the outdoors through a chimney. These two patients demonstrated signs of fire and electrical injuries. The father, who lost consciousness, sustained superficial second-degree burn wounds bilaterally on the zygomatic area and deep second-degree burn wounds on his right hand (total body surface area, 4%). His daughter demonstrated superficial second-degree burn wounds on the left part of the face and deep second-degree and third-degree burn wounds (total body surface area, 30%) on the left neck, both upper arms, and the back. In this article, the authors report the first two cases of burn injuries resulting from ball lightning contact indoors. The literature on this rare phenomenon is reviewed to elucidate the nature of ball lightning. Emphasis is placed on the nature of injuries after ball lightning contact, the therapy used, and the long-term complications. PMID:12792547

  14. Use of makeup, hairstyles, glasses, and prosthetics as adjuncts to scar camouflage.

    PubMed

    Sidle, Douglas M; Decker, Jennifer R

    2011-08-01

    Scars after facial trauma or surgery can be a source of distress for patients, and facial plastic surgeons are frequently called upon to help manage them. Although no technique can remove a scar, numerous treatment modalities have been developed to improve facial scar appearance with varying levels of invasiveness. This article reviews techniques that camouflage scars without surgical intervention. Topical scar treatments, camouflage cosmetics, use of hairstyling and glasses, and facial prosthetics are discussed. In addition, professional counseling is provided on selection and application of topical cosmetics for use as part of an office practice. PMID:21856536

  15. PBXN-110 Burn Rate Estimate

    SciTech Connect

    Glascoe, E

    2008-08-11

    It is estimated that PBXN-110 will burn laminarly with a burn function of B = (0.6-1.3)*P{sup 1.0} (B is the burn rate in mm/s and P is pressure in MPa). This paper provides a brief discussion of how this burn behavior was estimated.

  16. Multispectral Imaging Of Burn Wounds

    NASA Astrophysics Data System (ADS)

    Afromowitz, Martin A.; Callis, James B.; Heimbach, David M.; DeSoto, Larry A.; Norton, Mary K.

    1988-06-01

    This research program successfully developed a real-time video imaging system (the Imaging Burn Depth Indicator, or IBDI) which can discriminate areas of burn wounds expected to heal in three weeks or less from the day of injury from those areas not expected to heal in that time period. The analysis can be performed on or about the third day post-burn on debrided burn wounds. Early evaluation of burn healing probability is a crucial factor in the decision to tangentially excise the burn wound. The IBDI measures the reflectivity of the burn wound in the red, green, and near infrared wavelength bands, which data correlate with burn healing probability. The instrument uses an algorithm established in an earlier study to translate the optical data into burn healing probabilities. The IBDI produces two types of images: a true-color image of the burn and a false-color image of the burn. The false-color image consists of up to four colors, each of which indicates a distinct range of probability that the area of the burn so colored will heal within 21 days. Over 100 burn wound sites were studied. Burn sites were evaluated on day three post-burn by our instrument and by the attending physician. Of 55 sites considered to be of intermediate depth, the IBDI predicted the healing outcome accurately in 84% of the cases. By comparison, the predictions of burn surgeons supervising the care of these patients were accurate in 62% of the cases.

  17. Bladder neck contracture–incidence and management following contemporary robot assisted radical prostatectomy technique

    PubMed Central

    Parihar, Jaspreet Singh; Ha, Yun-Sok; Kim, Isaac Yi

    2014-01-01

    Purpose: Bladder neck contracture (BNC) is a well-recognized complication following robot-assisted radical prostatectomy (RARP) for treatment of localized prostate cancer with a reported incidence of up to 1.4%. In this series, we report our institutional experience and management results. Methods: A prospectively collected database of patients who underwent RARP by a single surgeon from 2006 to 2012 was reviewed. Watertight bladder neck to urethral anastomosis was performed over 18-French foley catheter. BNC was diagnosed by flexible cystoscopy in patients who developed symptoms of bladder outlet obstruction. Subsequently, these patients underwent cold knife bladder neck incisions. Patients then followed a strict self regimen of clean intermittent catheterization (CIC). We identify the patient demographics, incidence of BNC, associated risk factors and success of subsequent management. Results: Total of 930 patients who underwent RARP for localized prostate cancer was identified. BNC was identified in 15 patients, 1.6% incidence. Mean patient age and preoperative prostate-specific antigen was 58.8 years old and 7.83 ng/mL (range, 2.5–14.55 ng/mL) respectively. Mean estimated blood loss was 361±193 mL (range, 50–650 mL). Follow-up was mean of 23.4 months. Average time to BNC diagnosis was 5.5 months. In three patients, a foreign body was identified at bladder neck. On multivariate analysis, estimated blood loss was significantly associated with development of BNC. All patients underwent cystoscopy and bladder neck incision with a 3-month CIC regimen. Out of 15 index patients, none had a BNC recurrence over the follow-up period. Conclusions: BNC was identified in 1.6% of patients in our series following RARP. Intraoperative blood loss was a significant risk factor for BNC. In 20% of BNC patients a migrated foreign body was noted at vesicourethral anastomosis. Primary management of patients with BNC following RARP should be bladder neck incision and self CIC regimen. PMID:24693529

  18. Incidence of bladder neck contracture after robot-assisted laparoscopic and open radical prostatectomy

    PubMed Central

    Breyer, Benjamin N.; Davis, Cole B.; Cowan, Janet E.; Kane, Christopher J.; Carroll, Peter R.

    2013-01-01

    OBJECTIVE To evaluate the incidence and risk factors for bladder neck contracture (BNC) in men treated with robot-assisted laparoscopic radical prostatectomy (RALP) and open radical prostatectomy (ORP), as BNC is a well-described complication of ORP and may be partially attributable to technique. PATIENTS AND METHODS The University of California San Francisco Urologic Oncology Database was queried for patients undergoing RALP or ORP from 2002 to 2008. Patient demographics, prostate cancer-specific information, surgical data, and follow-up were collected. For each surgical approach, multivariate Cox proportional hazards regression was performed to evaluate associations of demographics and clinical characteristics with BNC. Time to BNC after RP was evaluated using life table and Kaplan–Meier methods. RESULTS From 2002 to 2008, 988 patients underwent RP as primary treatment and had at least 12 months of follow-up. Of these men, 695 underwent ORP and 293 underwent RALP. The mean (SD) age was 59.3 (6.80) years and 91% of men were Caucasian. D’Amico risk groups at diagnosis were low (38%), intermediate (38%), and high (24%). The BNC incidence was 2.2% (22 cases) overall, 1.4% (four) for RALP, and 2.6% (18) for ORP (P = 0.12). Patients with BNC were diagnosed a median (range) of 4.7 (1–15) months after surgery. At 18 months after surgery, the BNC-free rate was 97% for ORP and 99% for RALP (log-rank P = 0.13). The most common presenting complaint was slow stream, followed by urinary retention. In Cox proportional hazards regression analysis, earlier year of surgery, older age at diagnosis and higher PSA level at diagnosis were significantly associated with BNC among ORP patients. In the RALP group, none of the covariates were associated with BNC. CONCLUSIONS The overall incidence of BNC was low in both RALP and ORP groups. Technical factors such as enhanced magnification and a running bladder anastomosis may explain the lower BNC incidence in the RALP group. PMID:20438567

  19. The media glorifying burns: a hindrance to burn prevention.

    PubMed

    Greenhalgh, David G; Palmieri, Tina L

    2003-01-01

    The media have a profound influence on the actions of children and adults. Burns and burn prevention tend to be ignored or even mocked. The purpose of this presentation is to reveal the callousness of the media in its dealings with burns and burn prevention. Printed materials with a relationship to burns, risk of burning, or disrespect for the consequences of burns were collected. The materials were tabulated into four categories: comics, advertisements (ads), articles that made light of burns, and television shows that portrayed behavior that would risk burn injury. Most burn-related materials were found in comics or advertisements. Several comics made light of high-risk behavior with flames, scald injury, contact injury, or burns. In addition, several advertisements showed people on fire or actions that could easily lead to burns. Several articles and televisions shows portrayed high-risk behavior that, in some instances, led to copycat injuries. Flames are frequently used to sell items that target adolescent boys or young men. The high incidence injuries that frequent this population parallel the high-risk behaviors portrayed by the media. The media portrays flames and high-risk behavior for burn injury as being cool, funny, and without consequence. The use of flames on clothing and recreational equipment (skateboards, hot rods) particularly targets the high-risk adolescent male. The burn community should make the media aware of the harm it causes with its callous depiction and glorification of burns. PMID:12792237

  20. Manifestation of scarring in a driven system with wave chaos.

    PubMed

    Virovlyansky, A L; Zaslavsky, G M

    2005-06-01

    We consider wave propagation in a model of a deep ocean acoustic wave guide with a periodic range dependence. It is assumed that the wave field is governed by the parabolic equation. Formally the mathematical model of the wave guide coincides with that of a quantum system with time-dependent Hamiltonian. From the analysis of Floquet modes of the wave guide it is shown that there exists a "scarring" effect similar to that observed in quantum systems. It turns out that the segments of an unstable periodic ray trajectory may be distinguished in the spatial distribution of the wave field intensity at a finite wavelength. Besides the scarring effect, it is found that the so-called "stable islands" in the phase space of ray dynamics reveal themselves in the coarse-grained Wigner functions of the Floquet modes. PMID:16035888

  1. [Indications for surgical treatment of hard scarring gastric ulcers].

    PubMed

    Durleshter, V M; Korochanskaia, N V; Serikova, S N

    2014-01-01

    It was done the comparative analysis of the morphofunctional state of the upper gastrointestinal tract between 350 patients with effective conservative treatment and 104 patients with hard scarring gastric ulcers. The analysis identified the predictors of ineffective medical treatment and led to deliver the indications for timely surgical treatment. It was identified the next indications for planned organ-preserving surgical treatment of patients with hard scarring gastric ulcers: penetrating and non-healing ulcers with large or gigantic size in case of the adequate medical therapy, high-grade dysplasia and colonic metaplasia of the gastric epithelium in the borders or fundus of the ulcer,ulcers combination with fixed cardio-fundal or fundo-corporal hiatal hernias; hypotonic-hypokinetic type of the gastric and duodenal activity with the development of gastrostasis and pronounced duodenogastric reflux. PMID:24781063

  2. Skin, fascias, and scars: symptoms and systemic connections

    PubMed Central

    Bordoni, Bruno; Zanier, Emiliano

    2014-01-01

    Every element or cell in the human body produces substances that communicate and respond in an autocrine or paracrine mode, consequently affecting organs and structures that are seemingly far from each other. The same also applies to the skin. In fact, when the integrity of the skin has been altered, or when its healing process is disturbed, it becomes a source of symptoms that are not merely cutaneous. The skin is an organ, and similar to any other structure, it has different functions in addition to connections with the central and peripheral nervous system. This article examines pathological responses produced by scars, analyzing definitions and differences. At the same time, it considers the subcutaneous fascias, as this connective structure is altered when there is a discontinuous cutaneous surface. The consequence is an ample symptomatology, which is not limited to the body area where the scar is located, such as a postural or trigeminal disorder. PMID:24403836

  3. Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)

    PubMed Central

    Ponticorvo, Adrien; Burmeister, David M.; Yang, Bruce; Choi, Bernard; Christy, Robert J.; Durkin, Anthony J.

    2014-01-01

    Accurate and timely assessment of burn wound severity is a critical component of wound management and has implications related to course of treatment. While most superficial burns and full thickness burns are easily diagnosed through visual inspection, burns that fall between these extremes are challenging to classify based on clinical appearance. Because of this, appropriate burn management may be delayed, increasing the risk of scarring and infection. Here we present an investigation that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn severity. We used SFDI and LSI to investigate controlled burn wounds of graded severity in a Yorkshire pig model. Burn wounds were imaged starting at one hour after the initial injury and daily at approximately 24, 48 and 72 hours post burn. Biopsies were taken on each day in order to correlate the imaging data to the extent of burn damage as indicated via histological analysis. Changes in reduced scattering coefficient and blood flow could be used to categorize burn severity as soon as one hour after the burn injury. The results of this study suggest that SFDI and LSI information have the potential to provide useful metrics for quantifying the extent and severity of burn injuries. PMID:25360365

  4. Sprayed cultured mucosal epithelial cell for deep dermal burns.

    PubMed

    Ueda, Minoru

    2010-11-01

    Mucosal epithelial cells have various advantages compared with epidermal cells, such as their high proliferation ability and long biologic activity. The objective of this study was to assess the clinical results after sprayed application of cultured mucosal epithelial autograft (CMEA) suspensions onto deep dermal burn wounds. Ten patients with deep dermal burns were included in a prospective study. The average total-body-surface-area burn was 17.7% (8%-45%). The average Abbreviated Burn Severity Index was 6.3 points (4-9 points). The application of sprayed CMEA suspension was performed onto an average body surface area of 2.05% (0.5%-5%; median, 2%). Eight patients were recruited for clinical follow-up after an average of 10 months (3-18 months). The average Vancouver Scar Scale score at follow-up was 1.5 points (range, 0-5 points). The average period of epithelialization in wound surface was 12.5 days. Our data show that enzymatic and careful surgical debridement and consecutive application of CMEA suspensions using a spray technique result in excellent cosmetic outcomes compared with any other methods. PMID:21119409

  5. Effect of pERK2 on extracellular matrix turnover of the fibrotic joint capsule in a post-traumatic joint contracture model

    PubMed Central

    SUN, YANGBAI; LI, FENGFENG; FAN, CUNYI

    2016-01-01

    Lentivirus (LV)-mediated extracellular signal-regulated kinase (ERK)2 small interfering RNA (siRNA) has previously been demonstrated to reduce post-traumatic joint contractures: In the present study, the effect of ERK2 siRNA on extracellular matrix turnover within fibrotic joint capsules in post-traumatic joint contractures was examined. Rats were randomly assigned to one of three groups as follows: The non-operated control (CON), operated contracture (ORC) and contracture-treatment (CNT) groups. Representative post-traumatic joint contracture was created through 8 weeks of immobilization following intra-articular injury. In the CNT group, LV-mediated ERK2 siRNA was injected into the model knee at days 3 and 7 after surgery. The posterior joint capsule was examined by western blotting, histology and immunohistochemistry to evaluate alterations in ERK2, phosphorylated (p)ERK2, total collagen, collagen I, collagen III, matrix metalloproteinase (MMP)-1, MMP-13 and tissue inhibitor of metalloproteinase (TIMP)-13. In the ORC group, pERK2 was elevated and total collagen, collagen I, MMP-1 and MMP-13 were significantly increased (P<0.01 vs. CON group); however, these were significantly decreased in the CNT group, and pERK2 was downregulated (P<0.01 vs. ORC group). Collagen III and TIMP-13 were markedly decreased in the ORC group (P<0.01 vs. CON group), but elevated in the CNT group (P<0.01 vs. ORC group). The present res4ults demonstrate unique pathological changes of the fibrotic joint capsule that are responsible for joint contracture following traumatic injury, and reveal that extracellular matrix turnover can be affected by pERK2. PMID:26893645

  6. Clinimetric properties and clinical utility in rehabilitation of postsurgical scar rating scales: a systematic review.

    PubMed

    Vercelli, Stefano; Ferriero, Giorgio; Sartorio, Francesco; Cisari, Carlo; Bravini, Elisabetta

    2015-12-01

    The aim of this study was to review and critically assess the most used and clinimetrically sound outcome measures currently available for postsurgical scar assessment in rehabilitation. We performed a systematic review of the Medline and Embase databases to June 2015. All published peer-reviewed studies referring to the development, validation, or clinical use of scales or questionnaires in patients with linear scars were screened. Of 922 articles initially identified in the literature search, 48 full-text articles were retrieved for assessment. Of these, 16 fulfilled the inclusion criteria for data collection. Data were collected pertaining to instrument item domains, validity, reliability, and Rasch analysis. The eight outcome measures identified were as follows: Vancouver Scar Scale, Dermatology Life Quality Index, Manchester Scar Scale, Patient and Observer Scar Assessment Scale, Bock Quality of Life (Bock QoL) questionnaire, Stony Brook Scar Evaluation Scale, Patient-Reported Impact of Scars Measure, and Patient Scar Assessment Questionnaire. Scales were examined for their clinimetric properties, and recommendations for their clinical or research use and selection were made. There is currently no absolute gold standard to be used in rehabilitation for the assessment of postsurgical scars, although the Patient and Observer Scar Assessment Scale and the Patient-Reported Impact of Scars Measure emerged as the most robust scales. PMID:26426285

  7. Retinoic acid and glycolic acid combination in the treatment of acne scars

    PubMed Central

    Chandrashekar, BS; Ashwini, KR; Vasanth, Vani; Navale, Shreya

    2015-01-01

    Introduction: Acne is a prevalent condition in society affecting nearly 80-90% of adolescents often resulting in secondary damage in the form of scarring. Retinoic acid (RA) is said to improve acne scars and reduce postinflammatory hyperpigmentation while glycolic acid (GA) is known for its keratolytic properties and its ability to reduce atrophic acne scars. There are studies exploring the combined effect of retinaldehyde and GA combination with positive results while the efficacy of retinoic acid and GA (RAGA) combination remains unexplored. Aim: The aim of this study remains to retrospectively assess the efficacy of RAGA combination on acne scars in patients previously treated for active acne. Materials and Methods: A retrospective assessment of 35 patients using topical RAGA combination on acne scars was done. The subjects were 17-34 years old and previously treated for active acne. Case records and photographs of each patient were assessed and the acne scars were graded as per Goodman and Baron's global scarring grading system (GSGS), before the start and after 12 weeks of RAGA treatment. The differences in the scar grades were noted to assess the improvement. Results: At the end of 12 weeks, significant improvement in acne scars was noticed in 91.4% of the patients. Conclusion: The RAGA combination shows efficacy in treating acne scars in the majority of patients, minimizing the need of procedural treatment for acne scars. PMID:25821727

  8. Cross-leg fillet flap for the reconstruction of severe bilateral leg burns.

    PubMed

    Fujimura, Taiju; Tomizuka, Yosuke; Fujita, Masato

    2009-10-01

    For a patient with fourth-degree burns involving both legs, we performed an amputation of the right leg at the thigh and covered the left knee joint with the posterior part of the right leg as a cross-leg fillet flap. It is reasonable to use tissue from one leg for reconstruction of the other leg in order to avoid bilateral leg amputation in the treatment of bilateral severe leg injury. We could transfer a sufficient amount of tissue by using this flap without donor site morbidity. Generally, hip or knee joint contracture is a major problem with the cross-leg flap. The long pedicle of this flap allowed the patient some leg movement and there was no contracture at his knee or hip joints. We cannot use this flap as a sensory flap because of pedicle cutting, but inappropriate sensation of the lower extremity is uncomfortable and reduces a patient's quality of life. The cross-leg fillet flap described here avoids donor site morbidity without the use of microsurgery. This flap will become a treatment option for severe bilateral leg injuries when one leg requires amputation. PMID:18617453

  9. The Use of Chemotherapeutics for the Treatment of Keloid Scars.

    PubMed

    Jones, Christopher David; Guiot, Luke; Samy, Mike; Gorman, Mark; Tehrani, Hamid

    2015-05-21

    Keloid scars are pathological scars, which develop as a result of exaggerated dermal tissue proliferation following cutaneous injury and often cause physical, psychological and cosmetic problems. Various theories regarding keloidogenesis exist, however the precise pathophysiological events remain unclear. Many different treatment modalities have been implicated in their management, but currently there is no entirely satisfactory method for treating all keloid lesions. We review a number of different chemotherapeutic agents which have been proposed for the treatment of keloid and hypertrophic scars while giving insight into some of the novel chemotherapeutic drugs which are currently being investigated. Non-randomized trials evaluating the influence of different chemotherapeutic agents, such as 5-fluorouracil (5-FU); mitomycin C; bleomycin and steroid injection, either alone or in combination with other chemotherapeutic agents or alternative treatment modalities, for the treatment of keloids were identified using a predefined PubMed search strategy. Twenty seven papers were identified. Scar improvement ?50% was found in the majority of cases treated with 5-FU, with similar results found for mitomycin C, bleomycin and steroid injection. Combined intralesional 5-FU and steroid injection produced statistically significant improvements when compared to monotherapy. Monotherapy recurrence rates ranged from 0-47% for 5-FU, 0-15% for bleomycin and 0-50% for steroid injection. However, combined therapy in the form of surgical excision and adjuvant 5-FU or steroid injections demonstrated lower recurrence rates; 19% and 6% respectively. Currently, most of the literature supports the use of combination therapy (usually surgery and adjuvant chemotherapy) as the mainstay treatment of keloids, however further investigation is necessary to determine success rates over longer time frames. Furthermore, there is the potential for novel therapies, but further investigation is required to elucidate their true efficacy. PMID:26236447

  10. Slippery Scar: A New Mushroom Disease in Auricularia polytricha

    PubMed Central

    Sun, Jie

    2012-01-01

    A new disease, the slippery scar, was investigated in cultivated bags of Auricularia polytricha. This fungus was isolated from the infected mycelia of cultivated bags. Based on morphological observation, rDNA-internal transcribed spacer and 18S sequence analysis, this pathogen was identified as the Ascomycete Scytalidium lignicola. According to Koch's Postulation, the pathogenicity of S. lignicola to the mycelia of A. polytricha was confirmed. The parasitism of this fungus on mushroom mycelia in China has not been reported before. PMID:22870056

  11. Heterotopic cesarean scar pregnancy: diagnosis, treatment, and prognosis.

    PubMed

    OuYang, Zhenbo; Yin, Qian; Xu, Yujing; Ma, Yunyan; Zhang, Qiushi; Yu, Yanhong

    2014-09-01

    Heterotopic cesarean scar pregnancy is a rare, life-threatening form of ectopic pregnancy. To provide information regarding the clinical manifestations, diagnosis, management, and prognosis of this condition, we reviewed all cases reported in the English literature. All literature on heterotopic cesarean scar pregnancy was retrieved by searching the PubMed database and tracking references of the relevant literature. Full texts were reviewed, and clinical manifestations, diagnostic methods, and the relationship between the treatment and prognosis were summarized. A total of 14 patients with heterotopic cesarean scar pregnancies were identified, including 6 spontaneous pregnancies and 8 following in vitro fertilization-embryo transfer. Gestational ages at diagnosis ranged from 5 weeks to 8 weeks 4 days. Only 5 cases presented with vaginal bleeding, and the others were asymptomatic. All 14 cases were diagnosed by transvaginal sonography. One patient with no future fertility requirements underwent pregnancy termination by methotrexate. Of the remaining 13 patients who desired to preserve their intrauterine gestations, 10 were treated by sonographically guided selective embryo reduction in situ (by embryo aspiration, drug injection, or both); 2 underwent laparoscopic and hysteroscopic excision of the ectopic pregnancy masses; and 1 was treated by expectant management. All operations were successful and maintained a living intrauterine gestation. Twelve cases resulted in live births by cesarean delivery (3 at term and 9 preterm). One patient underwent pregnancy termination at 12 weeks because of a fetal malformation confirmed by sonography. The possibility of heterotopic cesarean scar pregnancy after cesarean delivery should be considered, especially when pregnancy follows assisted reproductive technology. Transvaginal sonography is an important tool for diagnosis and management. Despite the many options, the best treatment for this condition remains unclear. Selective embryo reduction in situ with sonographic guidance is the main treatment modality and can result in a successful intrauterine gestation, albeit at high risk. PMID:25154932

  12. Photoletter to the editor: Topical 0.5% brimonidine gel to camouflage redness of immature scars.

    PubMed

    Reinholz, Markus; Heppt, Markus; Tietze, Julia K; Ruzicka, Thomas; Gauglitz, Gerd G; Schauber, Jürgen

    2015-09-30

    Cutaneous scars develop as a result of a defective wound healing process. Scars are commonly visible as erythematous, sometimes disfiguring lesions which might be stigmatizing for the affected patient. Only a few therapies to improve the appearance of scars are available. Recently, brimonidine - a selective ?2-receptor-agonist which causes vasoconstriction of small cutaneous vessels - was approved for the treatment of erythemato-telangiectatic rosacea. Topical brimonidine might also be helpful to improve redness of immature scars. Here we report on the effect of brimonidine 0.5% gel on a flat, erythematous scar in a 25-year-old female patient. Whitening of the scar could be observed immediately after application of brimonidine 0.5% gel and a good clinical result was observed within one hour. This effect lasted for up to three hours. We conclude that brimonidine 0.5% gel is a suitable topical therapy to reduce erythema in visible cutaneous scars. PMID:26512307

  13. Comparison of different laser systems in the treatment of hypertrophic and atrophic scars and keloids

    NASA Astrophysics Data System (ADS)

    Scharschmidt, D.; Algermissen, Bernd; Willms-Jones, J.-C.; Philipp, Carsten M.; Berlien, Hans-Peter

    1997-12-01

    Different laser systems and techniques are used for the treatment of hypertrophic scars, keloids and acne scars. Significant criteria in selecting a suitable laser system are the scar's vascularization, age and diameter. Flashlamp- pumped dye-lasers, CO2-lasers with scanner, Argon and Nd:YAG-lasers are used. Telangiectatic scars respond well to argon lasers, erythematous scars and keloids to dye-laser treatment. Using interstitial Nd:YAG-laser vaporization, scars with a cross-section over 1 cm can generally be reduced. For the treatment of atrophic and acne scars good cosmetic results are achieved with a CO2-laser/scanner system, which allows a precise ablation of the upper dermis with low risk of side-effects.

  14. Three-Dimensional Electromagnetic High Frequency Axisymmetric Cavity Scars.

    SciTech Connect

    Warne, Larry K.; Jorgenson, Roy E.

    2014-10-01

    This report examines the localization of high frequency electromagnetic fi elds in three-dimensional axisymmetric cavities along periodic paths between opposing sides of the cavity. The cases where these orbits lead to unstable localized modes are known as scars. This report treats both the case where the opposing sides, or mirrors, are convex, where there are no interior foci, and the case where they are concave, leading to interior foci. The scalar problem is treated fi rst but the approximations required to treat the vector fi eld components are also examined. Particular att ention is focused on the normalization through the electromagnetic energy theorem. Both projections of the fi eld along the scarred orbit as well as point statistics are examined. Statistical comparisons are m ade with a numerical calculation of the scars run with an axisymmetric simulation. This axisymmetric cas eformstheoppositeextreme(wherethetwomirror radii at each end of the ray orbit are equal) from the two -dimensional solution examined previously (where one mirror radius is vastly di ff erent from the other). The enhancement of the fi eldontheorbitaxiscanbe larger here than in the two-dimensional case. Intentionally Left Blank

  15. A novel mutation in two Hmong families broadens the range of STRA6-related malformations to include contractures and camptodactyly.

    PubMed

    Marcadier, Julien L; Mears, Alan J; Woods, Elizabeth A; Fisher, Jamie; Airheart, Cory; Qin, Wen; Beaulieu, Chandree L; Dyment, David A; Innes, A Micheil; Curry, Cynthia J

    2016-01-01

    PDAC (also termed Matthew Wood) syndrome is a rare, autosomal recessive disorder characterized by pulmonary hypoplasia/aplasia, diaphragmatic defects, bilateral anophthalmia, and cardiac malformations. The disorder is caused by mutations in STRA6, an important regulator of vitamin A and retinoic acid metabolism. We describe six cases from four families of Hmong ancestry, seen over a 30 years period in California. These include: (i) consanguineous siblings with a combination of bilateral anophthalmia, diaphragmatic abnormalities, truncus arteriosus, and/or pulmonary agenesis/hypoplasia; (ii) a singleton fetus with bilateral anophthalmia, pulmonary agenesis, cardiac malformation, and renal hypoplasia; (iii) a sibling pair with a combination of antenatal contractures, camptodactyly, fused palpebral fissures, pulmonary agenesis, and/or truncus arteriosus; (iv) a fetus with bilateral anophthalmia, bushy eyebrows, pulmonary agenesis, heart malformation, and abnormal hand positioning. The phenotypic spectrum of PDAC syndrome has until now not included contractures or camptodactyly. Sequencing of STRA6 in unrelated members of families three and four identified a novel, shared homozygous splice site alteration (c.113?+?3_4delAA) that is predicted to be pathogenic. We hypothesize this may represent a unique disease allele in the Hmong. We also provide a focused review of all published PDAC syndrome cases with confirmed or inferred STRA6 mutations, illustrating the phenotypic and molecular variability that characterizes this disorder. © 2015 Wiley Periodicals, Inc. PMID:26373900

  16. Texture analysis of collagen second-harmonic generation images based on local difference local binary pattern and wavelets differentiates human skin abnormal scars from normal scars

    NASA Astrophysics Data System (ADS)

    Liu, Yao; Zhu, Xiaoqin; Huang, Zufang; Cai, Jianyong; Chen, Rong; Xiong, Shuyuan; Chen, Guannan; Zeng, Haishan

    2015-01-01

    Quantitative methods for noninvasive diagnosis of scars are a challenging issue in medicine. This work aims to implement a texture analysis method for quantitatively discriminating abnormal scars from normal scars based on second-harmonic generation (SHG) images. A local difference local binary pattern (LD-LBP) operator combined with a wavelet transform was explored to extract diagnosis features from scar SHG images that were related to the alteration in collagen morphology. Based on the quantitative parameters including the homogeneity, directional and coarse features in SHG images, the scar collagen SHG images were classified into normal or abnormal scars by a support vector machine classifier in a leave-one-out cross-validation procedure. Our experiments and data analyses demonstrated apparent differences between normal and abnormal scars in terms of their morphological structure of collagen. By comparing with gray level co-occurrence matrix, wavelet transform, and combined basic local binary pattern and wavelet transform with respect to the accuracy and receiver operating characteristic analysis, the method proposed herein was demonstrated to achieve higher accuracy and more reliable classification of SHG images. This result indicated that the extracted texture features with the proposed method were effective in the classification of scars. It could provide assistance for physicians in the diagnostic process.

  17. Aesthetic restoration of the severely disfigured face in burn victims: a comprehensive strategy.

    PubMed

    Rose, E H

    1995-12-01

    Although highly specialized burn centers have significantly reduced mortality rates following extensive total body surface area burns, survivors are often left with grotesque facial disfigurement. The strategy of modern facial restoration emphasizes enhancement of aesthetic appearance as significantly as mitigation of functional impairment. Criteria for success are (1) an undistracted "normal" look at conversational distance, (2) facial balance and symmetry, (3) distinct aesthetic units fused by inconspicuous scars, (4) "doughy" skin texture appropriate for corrective makeup, and (5) dynamic facial expression. Since 1985, the author has successfully restored 17 severely disfigured burned faces by replacement of entire aesthetic units with microvascular "prepatterned" composite flaps blended into the facial canvas by cosmetic camouflage techniques. The series includes hemiface (2), neck/jaw (5), chin/lower lip (3), cheek/malar (5), peri-orbital (2), nose (3), upper lip (4), and ear reconstructions (4). Flaps represented are free preauricular (1), radial forearm (6), ulnar forearm (1), free scapular (6), ilio-osteocutaneous (2), temporoparietal (8), vascularized forehead island (3), supraclavicular (1), and SMAS (1). Important to outcome is extensive initial intraoperative "sculpting" to simulate normal planes and contours. Seams are placed at junctions of facial components. Three-dimensional imaging is used to assess architectural asymmetries, and bone grafts are aided by computer-generated acrylic models. Adjunctive procedures include tensor fasciae latae slings, intraoperative tissue expansion, suction-assisted lipectomy, and scar management. After restoration of facial form and texture, flesh color make-up and/or tattooing of beard, lips, scars, eyebrows, etc., aid to hide scars and pigment the skin to harmonize with the rest of the face. In all cases, facial integrity has been aesthetically restored and, in most instances, with makeup, is near normal in social settings at conversational distances. Facial animation is retained and color matches are excellent. One flap was lost early in the series. PMID:7480277

  18. Global burned-land estimation in Latin America using MODIS composite data.

    PubMed

    Chuvieco, Emilio; Opazo, Sergio; Sione, Walter; Del Valle, Hector; Anaya, Jesús; Di Bella, Carlos; Cruz, Isabel; Manzo, Lilia; López, Gerardo; Mari, Nicolas; González-Alonso, Federico; Morelli, Fabiano; Setzer, Alberto; Csiszar, Ivan; Kanpandegi, Jon Ander; Bastarrika, Aitor; Libonati, Renata

    2008-01-01

    This paper presents results of the AQL2004 project, which has been develope within the GOFC-GOLD Latin American network of remote sensing and forest fires (RedLatif). The project intended to obtain monthly burned-land maps of the entire region, from Mexico to Patagonia, using MODIS (moderate-resolution imaging spectroradiometer) reflectance data. The project has been organized in three different phases: acquisition and preprocessing of satellite data; discrimination of burned pixels; and validation of results. In the first phase, input data consisting of 32-day composites of MODIS 500-m reflectance data generated by the Global Land Cover Facility (GLCF) of the University of Maryland (College Park, Maryland, U.S.A.) were collected and processed. The discrimination of burned areas was addressed in two steps: searching for "burned core" pixels using postfire spectral indices and multitemporal change detection and mapping of burned scars using contextual techniques. The validation phase was based on visual analysis of Landsat and CBERS (China-Brazil Earth Resources Satellite) images. Validation of the burned-land category showed an agreement ranging from 30% to 60%, depending on the ecosystem and vegetation species present. The total burned area for the entire year was estimated to be 153 215 km2. The most affected countries in relation to their territory were Cuba, Colombia, Bolivia, and Venezuela. Burned areas were found in most land covers; herbaceous vegetation (savannas and grasslands) presented the highest proportions of burned area, while perennial forest had the lowest proportions. The importance of croplands in the total burned area should be taken with reserve, since this cover presented the highest commission errors. The importance of generating systematic products of burned land areas for different ecological processes is emphasized. PMID:18372556

  19. Burning trees and bridges

    NASA Technical Reports Server (NTRS)

    Levine, Joel S.

    1990-01-01

    Most burning of biomass is the result of human activity, and on a global scale it is increasing. Tropospheric concentrations of CO2, CO, CH4, non-methane hydrocarbons, and ozone are all increasing with time; global biomass burning may make an important contribution to this increase and thus to potential global climate change. The nitrogen cycle also can have important climatic effects. Nitrous oxide put into the atmosphere by biomass burning is a greenhouse gas 250 times more powerful (molecule for molecule) than carbon dioxide. Nitric oxide, as well as being a photochemical precursor of ozone, a major pollutant in the troposphere, produces nitric acid, the fastest-growing component of acid rain. Hence, the new bridge in the nitrogen cycle is of more than mere technical interest.

  20. [Prehospital management of burns].

    PubMed

    Marichy, J; Chahir, N; Peres-Tassart, C; Abeguile, R

    2002-03-01

    The optimal assessment of the burn victim in the prehospital setting needs a clear understanding of the pathophysiological changes occurring locally and systemically after injury. For the mobile emergency unit it is essential to dispose of an appropriate protocol for the prevention of hypovolemia, hypothermia, hypoxemia. In the immediate survey, immediate life-threatening conditions should be clearly identified and treated as well as a through head-to-toe evaluation should be undertaken. Two phases of transport can be identified: the first from the scene of accident to the proximal emergency unit, specialized or not in burn care. The second is the transportation from the non-specialized proximal emergency unit to a burn intensive care unit according to the decision of the dispatching Centre 15. PMID:11933837

  1. Ripple burn control

    SciTech Connect

    Bhadra, D.K.; Petrie, T.W.; Peuron, U.A.; Rawls, J.M.

    1980-05-01

    The ripple contribution to the ion thermal conductivity is ideally suited in magnitude, temperature dependence, and spatial dependence to serve as a burn control mechanism. Furthermore, a considerable measure of automatic burn control results because of the radial shift of the plasma to a region of higher ripple. Unfortunately, the window in ripple values consistent with both ignition and a burn equilibrium is uncomfortably narrow, given the current lack of contact between the theoretical models of ripple transport and experimental observations. A survey is made of the techniques to vary the ripple and thus broaden the design window. One new technique is discussed in some detail: the use of ferromagnetic materials in the shield with magnetic properties which are sensitive functions of the operating temperature.

  2. Burning mouth syndrome

    PubMed Central

    Jimson, Sudha; Rajesh, E.; Krupaa, R. Jayasri; Kasthuri, M.

    2015-01-01

    Burning mouth syndrome (BMS) is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a result, a multidisciplinary approach is required for better control of the symptoms. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms. PMID:26015707

  3. Burning mouth syndrome.

    PubMed

    Jimson, Sudha; Rajesh, E; Krupaa, R Jayasri; Kasthuri, M

    2015-04-01

    Burning mouth syndrome (BMS) is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a result, a multidisciplinary approach is required for better control of the symptoms. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms. PMID:26015707

  4. Fast burning propellants

    SciTech Connect

    Colgate, S.A.; Roos, G.E.

    1987-07-21

    A solid or semisolid propellant is described comprising grains of propellant or propellant components bonded together to create voids within the propellant volume. The grains are of near-uniform size and have less than about a 20% size variation between the largest and smallest grains, the voids comprising from about 10% to about 50% of the propellant volume. The grains are bonded together with sufficient strength to substantially delay the fluidization of the propellant by the onset of Taylor unstable burning. The propellant has a rapid burn rate of from about 10 cm sec/sup -1/ to about 10/sup 4/cm sec/sup -1/.

  5. Non-invasive evaluation of therapeutic response in keloid scar using diffuse reflectance spectroscopy

    PubMed Central

    Hsu, Chao-Kai; Tzeng, Shih-Yu; Yang, Chao-Chun; Lee, Julia Yu-Yun; Huang, Lynn Ling-Huei; Chen, Wan-Rung; Hughes, Michael; Chen, Yu-Wen; Liao, Yu-Kai; Tseng, Sheng-Hao

    2015-01-01

    The pathogenesis and ideal treatment of keloid are still largely unknown, and it is essential to develop an objective assessment of keloid severity to evaluate the therapeutic response. We previously reported that our diffuse reflectance spectroscopy (DRS) system could assist clinicians in understanding the functional and structural condition of keloid scars. The purpose of this study was to understand clinical applicability of our DRS system on evaluating the scar severity and therapeutic response of keloid. We analyzed 228 spectral data from 71 subjects with keloid scars. The scars were classified into mild (0-3), moderate (4-7) and severe (8-11) according to the Vancouver scar scale. We found that as the severity of the scar increased, collagen concentration and water content increased, and the reduced scattering coefficient at 800 nm and oxygen saturation (SaO2) decreased. Using the DRS system, we found that collagen bundles aligned in a specific direction in keloid scars, but not in normal scars. Water content and SaO2 may be utilized as reliable parameters for evaluating the therapeutic response of keloid. In conclusion, the results obtained here suggest that the DRS has potential as an objective technique with which to evaluate keloid scar severity. In addition, it may be useful as a tool with which to track longitudinal response of scars in response to various therapeutic interventions. PMID:25780731

  6. Probability mapping of scarred myocardium using texture and intensity features in CMR images

    PubMed Central

    2013-01-01

    Background The myocardium exhibits heterogeneous nature due to scarring after Myocardial Infarction (MI). In Cardiac Magnetic Resonance (CMR) imaging, Late Gadolinium (LG) contrast agent enhances the intensity of scarred area in the myocardium. Methods In this paper, we propose a probability mapping technique using Texture and Intensity features to describe heterogeneous nature of the scarred myocardium in Cardiac Magnetic Resonance (CMR) images after Myocardial Infarction (MI). Scarred tissue and non-scarred tissue are represented with high and low probabilities, respectively. Intermediate values possibly indicate areas where the scarred and healthy tissues are interwoven. The probability map of scarred myocardium is calculated by using a probability function based on Bayes rule. Any set of features can be used in the probability function. Results In the present study, we demonstrate the use of two different types of features. One is based on the mean intensity of pixel and the other on underlying texture information of the scarred and non-scarred myocardium. Examples of probability maps computed using the mean intensity of pixel and the underlying texture information are presented. We hypothesize that the probability mapping of myocardium offers alternate visualization, possibly showing the details with physiological significance difficult to detect visually in the original CMR image. Conclusion The probability mapping obtained from the two features provides a way to define different cardiac segments which offer a way to identify areas in the myocardium of diagnostic importance (like core and border areas in scarred myocardium). PMID:24053280

  7. β2-Adrenoceptor Activation Modulates Skin Wound Healing Processes to Reduce Scarring

    PubMed Central

    Le Provost, Gabrielle S; Pullar, Christine E

    2015-01-01

    During wound healing, excessive inflammation, angiogenesis, and differentiated human dermal fibroblast (HDF ) function contribute to scarring, whereas hyperpigmentation negatively affects scar quality. Over 100 million patients heal with a scar every year. To investigate the role of the beta 2 adrenergic receptor (β2AR) in wound scarring, the ability of beta 2 adrenergic receptor agonist (β2ARag) to alter HDF differentiation and function, wound inflammation, angiogenesis, and wound scarring was explored in HDFs, zebrafish, chick chorioallantoic membrane assay (CAM), and a porcine skin wound model, respectively. Here we identify a β2AR-mediated mechanism for scar reduction. β2ARag significantly reduced HDF differentiation, via multiple cAMP and/or fibroblast growth factor 2 or basic FGF (FGF2)-dependent mechanisms, in the presence of transforming growth factor betaβ1, reduced contractile function, and inhibited mRNA expression of a number of profibrotic markers. β2ARag also reduced inflammation and angiogenesis in zebrafish and CAMs in vivo, respectively. In Red Duroc pig full-thickness wounds, β2ARag reduced both scar area and hyperpigmentation by almost 50% and significantly improved scar quality. Indeed, mechanisms delineated in vitro and in other in vivo models were evident in the β2ARag-treated porcine scars in vivo. Both macrophage infiltration and angiogenesis were initially decreased, whereas DF function was impaired in the β2ARag-treated porcine wound bed. These data collectively reveal the potential of β2ARag to improve skin scarring. PMID:25050597

  8. Clinical study of cultured epithelial autografts in liquid suspension in severe burn patients.

    PubMed

    Yim, Haejun; Yang, Hyeong Tae; Cho, Yong Suk; Seo, Cheong Hoon; Lee, Boung Chul; Ko, Jang Hyu; Kwak, In Suk; Kim, Dohern; Hur, Jun; Kim, Jong Hyun; Chun, Wook

    2011-09-01

    We address the clinical application of the suspension type cultured epithelial autografts (CEAs), Keraheal™ (MCTT, Seoul, Korea), along with the effects, application method, merits and demerits thereof. From February 2007 to June 2010, 29 burn patients with extensive burns, participated in the suspension type of CEA clinical test. A widely meshed autograft (1:4-6 ratio) was applied to the wound bed and the suspension type CEA was sprayed with a Tissomat cell sprayer, followed by a Tissucol spray, a fibrin sealant. The patients' (men/women=26/3) median (interquartile ranges) age was 42 (30-49) years old, the burned TBSA was 55 (44-60) %, and the full thickness burn area was 40 (30-46.5) %. The area of Keraheal™ applied was 800 (400-1200) cm(2). The take rate was 96 (90.5-99) % and 100 (98.5-100) % at 2 and 4 weeks after treatment with Keraheal™, respectively. The Vancouver burn scar scale was 5 (4-6.5), 4 (3-6), and 3 (2-4) at 8, 12 and 24 weeks after the Keraheal™ application. Widely meshed autograft must be applied in massive burns but it's take rate is greatly reduced. The CEAs enhance the take rate of a wide meshed autograft in massive burns and allow for grafting wide meshed autograft together with acellular dermal matrix in some cases. PMID:21531079

  9. Fat burn X: burning more than fat.

    PubMed

    Hannabass, Kyle; Olsen, Kevin Robert

    2016-01-01

    A 50-year-old man presented with a 2-day history of bilateral lower extremity cramping and dark urine. The patient was found to have a creatine phosphokinase (CPK) elevated of up to 2306?U/L, a serum uric acid of 9.7?mg/dL and 101 red blood cell's per high-powered field on urinalysis. On questioning, the patient endorsed daily exercise with free weights. There were no changes in his regular exercise and medication regimen, no muscle trauma, no recent drug use and no illness. The patient did mention using a new fat burner known as 'Fat Burn X', which he had begun taking 2?days prior to the onset of his muscle cramps. The patient was given normal saline intravenous fluid resuscitation for 48?h with resultant normalisation of his CPK and creatinine, and was discharged with primary care follow-up. PMID:26811412

  10. Co-delivery of VEGF and bFGF via a PLGA nanoparticle-modified BAM for effective contracture inhibition of regenerated bladder tissue in rabbits

    NASA Astrophysics Data System (ADS)

    Jiang, Xincheng; Lin, Houwei; Jiang, Dapeng; Xu, Guofeng; Fang, Xiaoliang; He, Lei; Xu, Maosheng; Tang, Bingqiang; Wang, Zhiyong; Cui, Daxiang; Chen, Fang; Geng, Hongquan

    2016-02-01

    Graft contracture is a common problem associated with the regeneration processes of tissue-engineered bladders. Currently, most strategies used for incorporating bioactive molecules into biomaterial designs do not work during all phases of tissue regeneration. In this study, we used a growth factor-PLGA nanoparticle thermo-sensitive gel system (i.e., BAM with incorporated VEGF and bFGF-loaded PLGA nanoparticles and mixed with a hydrophilic gel) to promote bladder tissue regeneration in a rabbit model. At 4 and 12 weeks after surgery, contracture rate assessment and histological examination were conducted to evaluate bladder tissue regeneration. The results indicated that the functional composite scaffold continuously and effectively released VEGF and bFGF and promoted bladder reconstruction with a significant decrease in graft contracture. In addition, the number and arrangement of regenerated urothelial cells and smooth muscle cells as well as microvascular density and maturity were improved in the VEGF/bFGF nanoparticle group compared with the single factor VEGF or bFGF nanoparticle group and BAM alone. The nanoparticle thermo-sensitive gel system, which exhibited favourable performance, may effectively inhibit graft contracture and promote bladder tissue regeneration in rabbits.

  11. Co-delivery of VEGF and bFGF via a PLGA nanoparticle-modified BAM for effective contracture inhibition of regenerated bladder tissue in rabbits

    PubMed Central

    Jiang, Xincheng; Lin, Houwei; Jiang, Dapeng; Xu, Guofeng; Fang, Xiaoliang; He, Lei; Xu, Maosheng; Tang, Bingqiang; Wang, Zhiyong; Cui, Daxiang; Chen, Fang; Geng, Hongquan

    2016-01-01

    Graft contracture is a common problem associated with the regeneration processes of tissue-engineered bladders. Currently, most strategies used for incorporating bioactive molecules into biomaterial designs do not work during all phases of tissue regeneration. In this study, we used a growth factor-PLGA nanoparticle thermo-sensitive gel system (i.e., BAM with incorporated VEGF and bFGF-loaded PLGA nanoparticles and mixed with a hydrophilic gel) to promote bladder tissue regeneration in a rabbit model. At 4 and 12 weeks after surgery, contracture rate assessment and histological examination were conducted to evaluate bladder tissue regeneration. The results indicated that the functional composite scaffold continuously and effectively released VEGF and bFGF and promoted bladder reconstruction with a significant decrease in graft contracture. In addition, the number and arrangement of regenerated urothelial cells and smooth muscle cells as well as microvascular density and maturity were improved in the VEGF/bFGF nanoparticle group compared with the single factor VEGF or bFGF nanoparticle group and BAM alone. The nanoparticle thermo-sensitive gel system, which exhibited favourable performance, may effectively inhibit graft contracture and promote bladder tissue regeneration in rabbits. PMID:26854200

  12. Pseudoankylosis of the mandible as a result of methyl methacrylate-induced inflammatory cicatricial contracture of the temporal muscle after cranioplasty.

    PubMed

    Yoshii, T; Hamamoto, Y; Muraoka, S; Teranobu, O; Kuwamura, K; Komori, T

    2001-10-01

    Pseudoankylosis of the mandible after intracranial surgical procedure has been widely reported, and is usually caused by fibrosis of the temporal muscle as a result of injury during the operation. We present an unusual case of mandibular pseudoankylosis as a result of methyl methacrylate-induced aseptic inflammatory cicatricial contracture of the temporal muscle after cranioplasty. PMID:11601819

  13. Co-delivery of VEGF and bFGF via a PLGA nanoparticle-modified BAM for effective contracture inhibition of regenerated bladder tissue in rabbits.

    PubMed

    Jiang, Xincheng; Lin, Houwei; Jiang, Dapeng; Xu, Guofeng; Fang, Xiaoliang; He, Lei; Xu, Maosheng; Tang, Bingqiang; Wang, Zhiyong; Cui, Daxiang; Chen, Fang; Geng, Hongquan

    2016-01-01

    Graft contracture is a common problem associated with the regeneration processes of tissue-engineered bladders. Currently, most strategies used for incorporating bioactive molecules into biomaterial designs do not work during all phases of tissue regeneration. In this study, we used a growth factor-PLGA nanoparticle thermo-sensitive gel system (i.e., BAM with incorporated VEGF and bFGF-loaded PLGA nanoparticles and mixed with a hydrophilic gel) to promote bladder tissue regeneration in a rabbit model. At 4 and 12 weeks after surgery, contracture rate assessment and histological examination were conducted to evaluate bladder tissue regeneration. The results indicated that the functional composite scaffold continuously and effectively released VEGF and bFGF and promoted bladder reconstruction with a significant decrease in graft contracture. In addition, the number and arrangement of regenerated urothelial cells and smooth muscle cells as well as microvascular density and maturity were improved in the VEGF/bFGF nanoparticle group compared with the single factor VEGF or bFGF nanoparticle group and BAM alone. The nanoparticle thermo-sensitive gel system, which exhibited favourable performance, may effectively inhibit graft contracture and promote bladder tissue regeneration in rabbits. PMID:26854200

  14. Hot spring burns.

    PubMed

    Baruchin, A M

    1996-03-01

    This case report describes a woman who, while visiting a hot spring, received partial- and full-thickness immersion scald burns of both ankles and heels. The prevention of such accidents is most important; efforts should be made to educate guides and tourists about the potential hazards inherent in these resorts. PMID:8634128

  15. The Earth Could Burn.

    ERIC Educational Resources Information Center

    Yarrow, Ruth

    1982-01-01

    Environmental educators are worried about the ultimate ecological threat--nuclear war, which could burn thousands of square miles, sterilize the soil, destroy 70 percent of the ozone layer letting in lethal ultraviolet rays, and cause severe radiation sickness. Educators must inform themselves, teach others, contact government representatives, and…

  16. Gas Hydrates Burning

    USGS Multimedia Gallery

    An image of gas hydrates burning. Gas hydrates are naturally-occurring “ice-like” combinations of natural gas and water that have the potential to provide an immense resource of natural gas from the world’s oceans and polar regions....

  17. Burning Your Own CDs.

    ERIC Educational Resources Information Center

    Ekhaml, Leticia

    2001-01-01

    Discusses the use of CDs (Compact Disks) for backing up data as an alternative to using floppy disks and explains how to burn, or record, a CD. Topics include differences between CD-R (CD-Recordable) and CD-RW (CD-Rewritable); advantages of CD-R and CD-RW; selecting a CD burner; technology trends; and care of CDs. (LRW)

  18. TIRES, OPEN BURNING

    EPA Science Inventory

    The chapter describes available information on the health effects from open burning of rubber tires. It concentrates on the three known sources of detailed measurements: (1) a small-scale emissions characterization study performed by the U.S. EPA in a facility designed to simulat...

  19. TRIAL BURNS: METHODS PERSPECTIVE

    EPA Science Inventory

    When conducting a trial burn, it is necessary to make a number of measurements in order to adequately define the performance of the incinerator. n addition to flue gas emissions for particulate matter, HCl, and selected organics, it is also necessary to measure selected organics ...

  20. The Earth Could Burn.

    ERIC Educational Resources Information Center

    Yarrow, Ruth

    1982-01-01

    Environmental educators are worried about the ultimate ecological threat--nuclear war, which could burn thousands of square miles, sterilize the soil, destroy 70 percent of the ozone layer letting in lethal ultraviolet rays, and cause severe radiation sickness. Educators must inform themselves, teach others, contact government representatives, and…