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1

Oral burn contractures in children.  

PubMed

Oral burn contractures in children present major reconstructive problem. Only few reports in literature discussed oral burns in children. Electrical, chemical, and thermal agents are the main causative agents for oral burns. Oral contractures can be classified into anterior, posterior, and total. Anterior contractures are usually caused by electrical burns and involve the oral commissure, lips, anterior buccal sulcus and surrounding mucosa, and anterior tongue. Posterior oral contractures are caused by caustic ingestion and involve the posterior buccal mucosa, posterior tongue, retro-molar area and oro-pharynx. Total oral contractures involve the lips, tongue, oral cavity, and oro-pharyngeal mucosa and are caused by lye caustic ingestion. This report reviews three children; one with posterior, two with total oral cavity contracture. All cases were managed by linear release of scar contracture and skin grafting followed by a prolonged intra-oral splinting with a fixed mouth-block and commissural splint. A successful outcome was observed in all cases. PMID:14595182

Hashem, Fuad K; Al Khayal, Zikra

2003-11-01

2

An extraordinary case of axillary contracture: trapped healthy skin and its adnexes under contracted scar.  

PubMed

Abstract Although striking improvements have been achieved in overall management of burn injury, postburn contractures are still an ongoing challenge to burn surgeons. Axillary adduction contracture is one of the most common types of these disabling postburn complications that usually result from suboptimal treatment after acute burns. An unusual and complicated case of axillary contracture in which the unburned, healthy axillary dome skin was trapped as a cystic mass under the scarred area was reconstructed by transfer of a big (17 × 13-cm) thoracodorsal artery perforator flap after contracture release. The result was satisfactory in terms of function and acceptable cosmetically. The underlying reasons for the inadequate treatment the patient received after surviving a severe electrical injury were discussed. PMID:25058781

Nisanci, Mustafa; Sahin, Ismail; Guzey, Serbulent

2014-01-01

3

Scar contracture of anterior tonsillar pillar leading to difficult intubation  

PubMed Central

Unanticipated difficult intubations on the operation table have often tested all the anesthetists’ intubation skill. The understanding of the causative factor and accordingly using the correct instrument from the difficult intubation kit requires experience and thorough knowledge on the part of the anesthetist. We describe a case of difficult intubation due to scar contracture of anterior tonsillar pillar formed after a previous surgery.

Kapoor, Hemlata; Mokashi, Suhas

2014-01-01

4

The effect of myofibroblast on contracture of hypertrophic scar.  

PubMed

Wound contraction in humans has both positive and negative effects. It is beneficial to wound healing by narrowing the wound margins, but the formation of undesirable scar contracture brings cosmetic and even functional problems. The entire mechanism of wound healing and scar contracture is not clear yet, but it is at least considered that both the fibroblasts and the myofibroblasts are responsible for contraction in healing wounds. The myofibroblast is a cell that possesses all the morphologic and biochemical characteristics of both a fibroblast and a smooth muscle cell. Normally, the myofibroblasts appear in the initial wound healing processes and generate contractile forces to pull both edges of an open wound until it disappears by apoptosis. But as an altered regulation of myofibroblast disappearance, they remain in the dermis and continuously contract the scar, eventually causing scar contracture. In this research, to compare and directly evaluate the influence on scar contracture of the myofibroblast versus the fibroblast, dermal tissues were taken from 10 patients who had highly contracted hypertrophic scars. The myofibroblasts were isolated and concentrated from the fibroblasts using the magnetic activating cell-sorting column to obtain the myofibroblast group, which contained about 28 to 41 percent of the myofibroblasts, and the fibroblast group, which contained less than 0.9 percent of the myofibroblasts. Each group was cultured in the fibroblast-populated collagen lattice for 13 days, and the contraction of the collagen gel was measured every other day. In addition, they were selectively treated with tranilast [N-(3',4'-dimethoxycinnamoyl) anthranilic acid] to evaluate the influence on the contraction of the collagen gel lattice. During the culture, the myofibroblast group, compared with the fibroblast group, showed statistically significant contraction of the collagen gel lattice day by day, except on the first day, and only the myofibroblast group was affected by tranilast treatment, showing significant inhibition of gel contraction. By utilizing an in vitro model, the authors have demonstrated that myofibroblasts play a more important role in the contracture of the hypertrophic scar. PMID:14758226

Shin, Dongmin; Minn, Kyung Won

2004-02-01

5

Pentoxifylline inhibits mature burn scar fibroblasts in culture.  

PubMed

Fibroblasts are thought to be (in part) responsible for the persisting contractile forces that result in burn contractures. Using monolayer and fibroblast populated collagen lattice (FPCL) models we subjected burn scar fibroblasts to the anti-fibrinolytic agent Pentoxifylline (PFX) in an attempt to reduce proliferation and contraction of these cells. Fibroblasts were isolated from mature burn scars at reconstructive surgery. Fibroblasts were grown in monolayer or incorporated into FPCL's and exposed to PFX. Fibroblast numbers and FPCL surface areas were calculated using digital photography and image analysis. PFX showed a dose-dependent inhibition of contraction and reduced proliferation of burn scar fibroblasts. In monolayer, cell number proliferation was markedly reduced. FPCL's containing 0, 0.25, 0.5, 1, and 2 mg/ml of PFX had relative surface areas of 31, 40, 43, 59, and 85%, respectively. One and 2 mg/ml FPCL's contracted significantly less than controls (p < 0.0001). This is the first study to show the dose-dependent effects of Pentoxifylline on the proliferation and contraction of burn scar fibroblasts. This study suggests that Pentoxifylline has a direct effect on inhibiting burn scar fibroblasts. Further study of PFX on burn scars will provide opportunities to reduce burn scar contractures in vivo. PMID:16384653

Rawlins, J M; Lam, W L; Karoo, R O; Naylor, I L; Sharpe, D T

2006-02-01

6

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

PubMed Central

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

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

2008-01-01

7

Burns, hypertrophic scar and galactorrhea  

PubMed Central

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

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

2013-01-01

8

Free jejunal patch to reconstruct oral scar contracture following caustic ingestion.  

PubMed

Reconstruction of oral scar contracture is often a challenging problem due to the complex structures and functions of the oral cavity. This report describes the treatment of a patient who sustained extensive oral scar contracture following caustic liquid soda ingestion. Surgical release of the scar contracture formed an S-shaped, thin, long defect that was difficult to cover with a conventional flap or skin graft. A jejunal segment was transferred microsurgically as a patch to reconstruct the defect. It sustained a sufficient oral space to provide full opening of the mouth and good movement of the tongue. A free jejunal flap, used occasionally for reconstruction following oral cancer resection, has significant advantages for restoration of function after release of an oral scar contracture. PMID:10402992

Ichioka, S; Nakatsuka, T; Yoshimura, K; Kaji, N; Harii, K

1999-07-01

9

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

PubMed Central

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

Seo, Dong-Kook; Kym, Dohern

2014-01-01

10

The Supraclavicular Flap for Reconstruction of Post-Burn Mentosternal Contractures  

PubMed Central

Background The thin and pliable skin of the neck is a region with multidirectional activity, and postburn scar contractures tend to form there easily. The supraclavicular flap is used to correct neck scar contractures. Its main vascular supply is the supraclavicular artery, and it can be harvested as either a skin pedicle flap or an island flap (vascular pedicle flap). Objective In this article, a total of 41 flaps are studied retrospectively and their efficacy in reconstruction of post-burn neck scar contractures is discussed. Also donor-site morbidity, patient satisfaction, and complications were evaluated. Patients and Methods Between November of 2004 and January of 2009, 41 supraclavicular flaps were used for reconstructions in 32 patients at the authors’ hospital. Twenty-four of these flaps were skin pedicle flaps, and 17 were island flaps. The range of flap size was 18 ± 6 cm in length, and 9 ± 3 cm in width. Pre-expansion was performed in 14 flaps. Primary closure of donor site was performed in 35 flaps. Results Thirty-seven of the 41 flaps survived completely, but there were three cases of distal necrosis (10-30%), and one case of complete flap necrosis. Twenty-nine of the 32 patients were satisfied with both the functional and aesthetic results. Conclusions Scarring of the neck produces problems with function, and appearance. In our view, the supraclavicular flap, a thin flap of good texture, is an excellent and highly reliable flap for covering defects of the anterior neck. This flap is easy to harvest, with good functional and aesthetic results. PMID:24083000

Loghmani, Shahriar; Eidy, Mohammad; Mohammadzadeh, Mahdi; Loghmani, Alireza; Raigan, Fahimeh

2013-01-01

11

Postburn contractures of the hand.  

PubMed

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

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

2014-09-01

12

Topical tamoxifen therapy in hypertrophic scars or keloids in burns  

Microsoft Academic Search

As acute burn patients have experienced increasing survival rates, the number of patients who need specific care due to aberrant\\u000a scarring is also increasing. The burned skin often responds with fibrotic tissue proliferation, which can lead to a hypertrophic\\u000a scar or a keloid. Non-physiologic scars are mostly not acceptable for the burn patient. Intradermal and topical therapy in\\u000a burns comprise

Alfredo Gragnani; Mario Warde; Fabianne Furtado; Lydia Masako Ferreira

2010-01-01

13

Prevention and surgical management of postburn contractures of the hand.  

PubMed

In addition to burn surgeons, skilled nurses, and therapists, hand surgeons are a key part of the multidisciplinary team caring for patients following thermal injury to the hand. Despite appropriate initial treatment and compressive therapy, contractures are common after deep burn. The most common and functionally limiting are web space and hand contractures. Web space contractures can be managed with excision followed by local soft tissue rearrangement or skin grafting. The classic burn claw hand deformity includes extension contracture of the metacarpophalangeal joints and flexion contractures of the proximal interphalangeal joints. The mainstay of management of these postburn contractures includes complete surgical release of scar tissue and replacement by full-thickness skin graft. In cases in which scar contracture release results in major exposure of the tendons or joints, distant tissue transfer is required. This review focuses on prevention and management of late sequelae of thermal injury to the hand focusing on contractures of the webspaces and hand. PMID:24288147

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

2014-03-01

14

Burn Scar Near the Hanford Nuclear Reservation  

NASA Technical Reports Server (NTRS)

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

2002-01-01

15

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

PubMed Central

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

Huang, Chenyu

2014-01-01

16

Drought and Burn Scars in Southeastern Australia  

NASA Technical Reports Server (NTRS)

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.

2003-01-01

17

Topical tamoxifen therapy in hypertrophic scars or keloids in burns.  

PubMed

As acute burn patients have experienced increasing survival rates, the number of patients who need specific care due to aberrant scarring is also increasing. The burned skin often responds with fibrotic tissue proliferation, which can lead to a hypertrophic scar or a keloid. Non-physiologic scars are mostly not acceptable for the burn patient. Intradermal and topical therapy in burns comprise the treatment of the skin injury and its possible texture, elasticity and color alterations with the aid of active substances that result in fibroblastic modulation. An alteration of cytokine levels may mediate these effects, and evidences suggest that keloid scar formation may be mediated, in part, by deranged growth factor activity, including that of transforming growth factor (TGF)-beta(1). The addition of tamoxifen, a non-steroidal anti-estrogen, usually used in breast cancer, to standard treatment may lead to improved wound healing in keloids by decreasing the expression of TGF-beta(1), with the consequent inhibitions of both fibroblast proliferation and collagen production. Topical tamoxifen citrate chemical treatment has been shown to improve scarring. However, prospective studies must be undertaken to validate the inclusion of tamoxifen into standard clinical practice. PMID:19636578

Gragnani, Alfredo; Warde, Mario; Furtado, Fabianne; Ferreira, Lydia Masako

2010-01-01

18

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

PubMed Central

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%.

Saaiq, Muhammad; Ashraf, Bushra

2014-01-01

19

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

PubMed

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

Saaiq, Muhammad; Ashraf, Bushra

2014-10-16

20

Release of the postburn contractures on the lower abdomen and inguinal regions using modified abdominoplasty.  

PubMed

To return the patient to normal function while maximizing aesthetic appearance is the most important issue in burn management. Although many techniques such as pressure garments and silicone dressings are used in the initial scar management to optimize final appearance, avoiding residual scarring is impossible after extensive burns. The changes in appearance and limitations imposed by the burn scar contribute to a negative body image. Burn patients frequently require numerous procedures over many years to achieve optimum function, but aesthetic needs are often overlooked in these patients. By assessing such patients with regard to their body image and aesthetic needs, patients who will benefit from a combined aesthetic procedure with burn contracture release are easily identified. The author presents a female patient who underwent modified abdominoplasty for releasing burn scar contractures, providing the dual benefit of improved body contour and burn scar release. PMID:22113321

Ergün, Selma Sönmez

2012-01-01

21

Anaesthetic management of post-burn contractures, a recurrent challenge from oil pipeline vandalization in Nigeria: a case report  

PubMed Central

A 13 year- old girl presented to the department with sternomental contractures as a result of facial burns from kerosene explosion. Difficult airway was envisaged. Over the period of time she developed sub-mental contracture with keloids; and was scheduled for release of contractures and flap closure. Anaesthesia was induced with halothane and 100% oxygen. A size 3 laryngeal mask airway (LMA) was inserted and anaesthesia maintained with oxygen/nitrous oxide/halothane/muscle relaxant technique. The successful placement of LMA at 2nd attempt was aided by a surgical incision on the submental contracture. Blood loss was 600 mls and a unit of packed red blood cells was transfused. She made full recovery and was discharged home after 1 month. PMID:20062658

2009-01-01

22

Health professionals' and consumers' opinion: what is considered important when rating burn scars from photographs?  

PubMed

With advances in wound care technology, there is a trend toward patients undertaking specialist burns treatment in an outpatient capacity. Photographic scar evaluation is a part of this trend in some health services because it permits scar assessment by different health professionals, both within and across outpatient services, to assess the impact of scar management strategies. The aim of this study was to explore the parameters considered integral to scar assessment when completing photographic scar evaluation. First, opinions were sought from 38 burn health professionals in 2 tertiary pediatric hospitals who participated in focus groups where in-person and in-photograph scar rating were completed using three burn scar rating scales (modified Vancouver scar scale, Manchester scar scale, and patient and observer scar assessment scale) presented with a standard format and instructions. Second, 36 occupational therapists and physiotherapists from Australia and New Zealand completed questionnaires. Third, 10 healthcare consumers from 1 tertiary pediatric hospital participated in face-to-face or telephone interviews. Parameters believed to be assessed using photographic evaluation of burns scarring were vascularity, surface area, color, contour, height, and overall opinion. However, surface area was considered questionable as an indicator of scar maturity. These parameters mostly differ from those considered important in a burn scar outcome measure when rating scars in-person: height/thickness, vascularity, color, pliability, joint function, and patient/client opinion. A categorical scale with visual descriptors, as well as specific strategies to improve photographic technique, may go some way to addressing the perceived difficulty in rating these parameters using burn scar photographs. PMID:21233729

Simons, Megan; Tyack, Zephanie

2011-01-01

23

Perforator Plus Fasciocutaneous Flaps in the Reconstruction of Post-Burn Flexion Contractures of the Knee Joint  

PubMed Central

Background: A post-burn flexion contracture of the knee joint is a disabling condition which interferes with an upright posture and a bipedal locomotion. Islanded perforator flaps have been used to resurface the tissue defect which is produced as a result of the contracture release. Despite their various advantages, they are limited by an increased tendency to undergo venous congestion. Perforator-plus flaps can be used to overcome this limitation, while retaining the merits of the islanded perforator flaps. Methods: Ninteen patients with post flame burn flexion contractures of the knee joints underwent surgical releases and coverages by various local fasciocutaneous perforator-plus flaps. The patients were followed up for 6 months and the various aspects of the functional and the aesthetic rehabilitations were assessed. Results: All the local fasciocutaneous perforator-plus flaps resurfaced the tissue defect over popliteal fossa with good colour and texture match and maintenance of the contour. None of the flaps had any significant early or delayed complications (which included venous congestions) which necessitated reoperations. All the patients were satisfied with the functional and aesthetic outcomes. Conclusion: Local fasciocutaneous perforator-plus flaps can be considered as one of the primary treatment modalities for the surgical release and reconstruction of post burn flexion contractures of the knee. PMID:23814737

Gupta, Madhumita; Pai, Ashwin A.; Setty, Ravi R.; Sawarappa, Raghavendra; Majumdar, Bijay Kumar; Banerjee, Tibar; Kanoi, Aditya; Bhattacharya, Abhimanyu

2013-01-01

24

A Vision-Based Technique for Objective Assessment of Burn Scars  

Microsoft Academic Search

In this paper a method for the objective assessment of burn scars is proposed. The quantitative measures developed in this research provide an objective way to calculate elastic properties of burn scars relative to the surrounding areas. The approach combines range data and the mechanics and motion dynamics of human tissues. Active contours are employed to locate regions of interest

Leonid V. Tsap; Dmitry B. Goldgof; Sudeep Sarkar; Pauline S. Powers

1998-01-01

25

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

PubMed Central

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

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

2012-01-01

26

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

PubMed

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 CO(2) 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

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

2012-01-01

27

Non-Operative Treatment of Hypertrophic Scars and Keloids After Burns in Children  

PubMed Central

Summary Scars are a consequence of the natural way of wound healing and replacement of the damaged part of the skin. Hypertrophic scars and keloids are formed as a result of the process of abnormal wound healing, causing aesthetic and functional deformities, discomfort, and disturbance of children's normal growth. The prophylaxis and treatment of these scars, i.e. burns sequelae, are a significant moment in the treatment of children with burns. The objectives of the present study are methods for the prophylaxis and non-operative treatment of hypertrophic scars and keloids in children with burns. Altogether, 547 children with 485 burns sequelae - fresh scars in the period of healing and old hypertrophic scars (377) and keloids (108) - were treated in our Clinic of Children's Burns for a period of five years. The age of the patients varied between 0 and 18 years. Non-operative treatment was applied in 276 children. The patients were divided into two groups according to the treatment applied. Compression, intralesional application of triamcinolone acetonide, and silicone sheets were employed in the first group (84.06%), while only silicone sheets were applied to children in the second group (15.94%). Unaffected areas and areas adjacent to the scar were used as control areas. The sequelae monitored in both groups were assessed using the Vancouver Scar Scale. The children were monitored in an out-patient department. The results obtained are regardless of age, anatomical location, and scar aetiology. In old scars, and especially in keloids, the treatment proved to have variable results, according to the assessment parameters. We were satisfied with the improvement of the parameters during the course of treatment and with the good final results, which we consider a therapeutic success. Analysis of the results shows that the parameters improved slowly during the course of treatment, the process being most active during the first few weeks. The use of compressive therapy, the intralesional application of triamcinolone acetonide, and silicone sheets may prevent and minimize the formation of hypertrophic scars and keloids. The methods of non-operative treatment of these abnormal scars continue to be discussed and developed. PMID:21991030

Argirova, M.; Hadjiski, O.; Victorova, A.

2006-01-01

28

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

PubMed

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

Zuo, Kevin J; Tredget, Edward E

2014-06-01

29

Burn scar of the Rodeo-Chediski Complex Fire, Arizona  

NASA Technical Reports Server (NTRS)

The Rodeo Fire in east-central Arizona is burning within the Fort Apache Indian Reservation about 100 miles east-northeast of Phoenix (seen southwest of the fire as a large area of grayish pixels surrounded by scattered spots of dark green vegetation). The fire was about 48,000 acres as of June 20, 2002, and was 0 percent contained. These images from the Moderate Resolution Imaging Spectroradiometer (MODIS) on the Terra satellite was captured on June 19, 2002. In the false-color image the vegetation is green, and burned areas are red.

2002-01-01

30

Release of severe post-burn contracture of the first web space using the reverse posterior interosseous flap: Our experience with 12 cases.  

PubMed

We retrospectively assessed outcomes after treating severe contractures of the first web space from burns with the reverse posterior interosseous flaps (RPIF). Twelve consecutive patients (ages 18-58 years) with burns from 10% to 70% (mean, 30.1%) total body surface area and severe contractures of the first web space of the hand (initial thumb to index angles from 10° to 35° [mean, 23°]) underwent contracture release using the RPIF. Seventeen RPIFs were used, with sizes from 9cm×6cm to 14cm×10cm (mean area, 83.6cm(2)). The patients were followed for 5-26 months. All flaps survived completely, rapidly adapted to the recipient beds, and achieved good color and texture harmony. No early complications occurred. Fifteen donor sites were closed with skin grafts. Two donor sites were closed by direct suture. No paralysis of the posterior interosseous nerve was observed in these cases. At last follow-up the mean thumb to index angle was 78°, increasing the web length 260%. All patients regained fundamental hand functions. The RPIF is reliable and safe for releasing severe contractures of the first web space of the hand after burn, with distinct advantages over currently used alternative methods. PMID:23523223

Kai, Shi; Zhao, Jingchun; Jin, Zhenghua; Wu, Weiwei; Yang, Ming; Wang, Yan; Xie, Chunhui; Yu, Jiaao

2013-09-01

31

Exploring reliability of scar rating scales using photographs of burns from children aged up to 15 years.  

PubMed

Assessing burn scars from photographs is a common practice given the growing trend to support health service delivery via electronic media (eg, email, videoconferencing). Scar rating scales, originally designed for in-person assessment, have been used to rate scars from photographic images. Evidence for the reliability of this practice is lacking. Five raters completed three scar rating scales (Patient and Observer Scar Scale, Manchester Scar Scale, modified Vancouver Scar Scale), both in-person and using photographs on 12 participants (seven male, five female) with 18 scar areas (3?×?3?cm). Interrater reliability for the scar parameters of vascularity, color, contour, pliability, and overall opinion achieved intraclass correlation coefficient values of between 0.71 and 0.87 (in-person) and 0.72 and 0.77 (using photographs) for multiple raters. The level of agreement between in-person and photographic assessment was below acceptable levels, which brings into question construct validity when scar rating scales are used in a way for which they were not designed. Reliability estimates in this study were likely reduced by the underrepresentation of scars in the more severe range. This limitation needs to be addressed in future research. Advances are required in the development and refinement of burn scar rating scales, specifically for photographic use, given their routine use in clinical care. PMID:23271058

Simons, Megan; Ziviani, Jenny; Thorley, Michelle; McNee, Jessamine; Tyack, Zephanie

2013-01-01

32

Characterization of T-cell subsets infiltrating post-burn hypertrophic scar tissues.  

PubMed

In this study, skin-infiltrating cells were characterized in both the active and remission phases of post-burn hypertrophic scar biopsies. Immunohistochemistry examination of active phase samples showed an abundant presence of Langerhans cells, T cells, macrophages, a low presence of natural killer cells and the lack of B lymphocytes. In active hypertrophic scars T lymphocytes infiltrate deep into the superficial dermis and are also observed in the epidermis: CD3+ cells were present at about 222 +/- 107 per 0.25 mm2. In particular the analysis of lymphocyte subpopulations showed that CD4+ T cells predominate in the dermis as well as in the epidermis of active hypertrophic scars whereas CD8+ cells were less well represented (CD4/CD8 ratio is 2.06). This distribution was also shown in remission phase samples and in normotrophic scar specimens, although the lymphocyte number was significantly lower. Approximately 70 per cent of T lymphocytes present in the tissue involved in active phase hypertrophic scar samples were activated (positive with anti-HLA-DR and IL-2 receptor antibodies) which is significantly higher than remission phase hypertrophic and normotrophic scars, in which positivity was 40 and 38 per cent, respectively. Upon activation, the lesional lymphocytes release several cytokines, locally and transiently, that interact with specific receptors in response to different stimulation. Central to the immune hypothesis of hypertrophic scars is that some of the T-cell lymphokines act on keratinocytes, fibroblasts and other cell types to induce changes characteristic of these scars. The presence and close proximity of activated T lymphocytes and antigen-presenting cells of various phenotypes in both the epidermis and dermis of hypertrophic tissues provides strong circumstantial evidence of a local immune response. However, the manner in which T cells achieve and maintain their activated state in hypertrophic tissues is not yet known, and both antigen-dependent and independent mechanisms may contribute. PMID:9568325

Castagnoli, C; Trombotto, C; Ondei, S; Stella, M; Calcagni, M; Magliacani, G; Alasia, S T

1997-01-01

33

Resurfacing severe facial burn scars: an algorithm based on three different types of prefabricated expanded flaps.  

PubMed

Background?In the reconstruction of facial burn scars, large, thin, color-matching flaps are desirable due to aesthetic and functional demands. There have been many reports using prefabricated flaps to resurface facial skin lesions. However, an algorithm to select the most suitable treatment option for the individual patient is lacking. Methods?An algorithm for facial resurfacing based on three types of prefabricated flaps from the cervical, periclavicular, and lateral thoracic area was setup, and 15 were patients treated accordingly. Results?All 15 prefabricated flaps survived. Minor necrosis at the distal flap edge developed in three cases. After a follow-up of at least 6 months, all patients showed satisfactory aesthetic and functional outcomes. Conclusion?By individual selection of the most suitable option among these three types of prefabricated flaps, satisfactory resurfacing can be achieved for most facial burn scars. PMID:25025508

Xie, Feng; Zhu, Hainan; Gu, Bin; Zan, Tao; Liu, Kai; Li, Qingfeng

2014-11-01

34

Clinical application of split skin graft from scar tissue for plastic reconstruction in post-extensive burn patients  

Microsoft Academic Search

We evaluated the use of autologous split-thickness skin taken from scars on the backs of patients with extensive burns, without sufficient normal donor skin. Between 1998 and 2008, a total of 15 patients underwent 47 operations using split-thickness skin grafts from scar tissue. Split-thickness skin was harvested from scars on the patient's back. In each operation, two thirds of donor

Jie Xin Zheng; Qin Zhang; Yi Wen Niu; Jian Liu

2010-01-01

35

Psychopathology and psychological problems in patients with burn scars: epidemiology and management.  

PubMed

Burn injury is often a devastating event with long-term physical and psychosocial effects. Burn scars after deep dermal injury are cosmetically disfiguring and force the scarred person to deal with an alteration in body appearance. In addition, the traumatic nature of the burn accident and the painful treatment may induce psychopathological responses. Depression and post-traumatic stress disorder (PTSD), which are prevalent in 13-23% and 13-45% of cases, respectively, have been the most common areas of research in burn patients. Risk factors related to depression are pre-burn depression and female gender in combination with facial disfigurement. Risk factors related to PTSD are pre-burn depression, type and severity of baseline symptoms, anxiety related to pain, and visibility of burn injury. Neuropsychological problems are also described, mostly associated with electrical injuries. Social problems include difficulties in sexual life and social interactions. Quality of life initially seems to be lower in burn patients compared with the general population. Problems in the mental area are more troublesome than physical problems. Over a period of many years, quality of life was reported to be rather good. Mediating variables such as low social support, emotion and avoidant coping styles, and personality traits such as neuroticism and low extraversion, negatively affect adjustment after burn injury. Few studies of psychological treatments in burn patients are available. From general trauma literature, it is concluded that cognitive (behavioral) and pharmacological (selective serotonin reuptake inhibitors) interventions have a positive effect on depression. With respect to PTSD, exposure therapy and eye movement reprocessing and desensitization are successful. Psychological debriefing aiming to prevent chronic post-trauma reactions has not, thus far, shown a positive effect in burn patients. Treatment of problems in the social area includes cognitive-behavioral therapy, social skills training, and community interventions. Sexual health promotion and counseling may decrease problems in sexual life.In conclusion, psychopathology and psychological problems are identified in a significant minority of burn patients. Symptoms of mood and anxiety disorders (of which PTSD is one) should be the subject of screening in the post-burn phase and treated if indicated. A profile of the patient at risk, based on pre-injury factors such as pre-morbid psychiatric disorder and personality characteristics, peri-traumatic factors and post-burn factors, is presented. Finally, objective characteristics of disfigurement appear to play a minor role, although other factors, such as proneness to shame, body image problems, and lack of self-esteem, may be of significance. PMID:12680803

Van Loey, Nancy E E; Van Son, Maarten J M

2003-01-01

36

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

NASA Astrophysics Data System (ADS)

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.

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

2012-04-01

37

A comparison of two laser-based methods for determination of burn scar perfusion: Laser Doppler versus laser speckle imaging  

Microsoft Academic Search

Laser Doppler perfusion imaging (LDI) is an established technique for early assessment of burn depth to help determine a course of treatment. Laser speckle perfusion imaging (LSPI) is an alternative laser based, non-invasive perfusion monitoring technique that offers rapid and high resolution images of tissue. We have evaluated the ability of the LSPI instrument in determining and monitoring burn scar

C. J. Stewart; R. Frank; K. R. Forrester; J. Tulip; R. Lindsay; R. C. Bray

2005-01-01

38

Randomized crossover comparison of the laryngeal mask airway classic with i-gel laryngeal mask airway in the management of difficult airway in post burn neck contracture patients  

PubMed Central

Purpose: The objective of the study was to compare the performance of i-gel supraglottic airway with cLMA in difficult airway management in post burn neck contracture patients and assess the feasibility of i-gel use for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening. Methods: Prospective, crossover, randomized controlled trial was performed amongst forty eight post burn neck contracture patients with limited mouth opening and neck movement. i-gel and cLMA were placed in random order in each patient. Primary outcome was overall success rate. Other measurements were time to successful ventilation, airway leak pressure, fiberoptic glottic view, visualization of square wave pattern. Results: Success rate for the i-gel was 91.7% versus 79.2% for the cLMA. i-gel required shorter insertion time (19.3 seconds vs. 23.5 seconds, P=0.000). Airway leak pressure difference was statistically significant (i-gel 21.2 cm H20; cLMA 16.9 cm H20; P=0.00). Fiberoptic view through the i-gel showed there were less epiglottic downfolding and better fiberoptic view of the glottis than cLMA. Overall agreement in insertion outcome for i-gel was 22/24 (91.7%) successes and 2/24(8.3%) failure and for cLMA, 19/24 (79.16%) successes and 5/24 (16.7%) failure in the first attempt. Conclusion: The i-gel is cheap, effective airway device which is easier to insert and has better clinical performance in the difficult airway management of the airway in the post burn contracture of the neck. Our study shows that i-gel is feasible for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening in post burn neck. PMID:23087456

Singh, Jeevan; Yadav, Manohar Kumar; Marahatta, Sujan Babu; Shrestha, Bikash Lal

2012-01-01

39

The use of skin grafts in postburn contracture release: a 10-year review.  

PubMed

Postburn scarring and contracture affecting function remain the most frustrating late complications of burn injury. Various techniques are used to release contractures; the choice depends on their location and/or the availability of unaffected skin adjacent to the contracture or elsewhere. A retrospective review was carried out of the case notes of patients who had skin grafting for the release of postburn contracture at the Burns Unit, City Hospital, Nottingham between May of 1984 and August of 1994 to evaluate the experience over this period. Information was obtained about the burn injury, contracture site, interval between burn and release of contracture, indication, age at first release, intervals between releases, operative details (donor and graft sites), complications and nonoperative treatment, and follow-up to the end of the study period. A total of 129 patients underwent skin grafting for release of contractures as opposed to any other method of correction. Full-thickness skin grafts were used in 81 patients (63 percent) and split-thickness skin grafts in 26 (20 percent). Twenty-two patients (17 percent) had both types used on different occasions. Flame burns (41 percent) were the most common causes, followed by scalds (38 percent). Two hundred thirty-nine sites of contracture were released, with the axilla (59) and the hand/wrist (59) being the most common sites involved, followed by the head/neck region (42). It was found that for the same site, release with split-thickness skin grafts was associated with more rereleases of the contracture than with full-thickness skin grafts. Also, the interval between the initial release and first rerelease was shorter than with full-thickness skin grafts (p < 0.048). It was also noted that children required more procedures during growth spurts, reflecting the differential effect of the growth of normal skin and contracture tissue. Patients reported more satisfaction with texture and color match with the full-thickness skin grafts. There was comparable donor-site and graft morbidity with both graft types. The use of skin grafts is simple, reliable, and safe. Whenever possible, the authors recommend the use of full-thickness skin grafts in preference to split-thickness skin grafts in postburn contracture release. PMID:10088507

Iwuagwu, F C; Wilson, D; Bailie, F

1999-04-01

40

Spatial and temporal corroboration of a fire-scar-based fire history in a frequently burned ponderosa pine forest.  

PubMed

Fire scars are used widely to reconstruct historical fire regime parameters in forests around the world. Because fire scars provide incomplete records of past fire occurrence at discrete points in space, inferences must be made to reconstruct fire frequency and extent across landscapes using spatial networks of fire-scar samples. Assessing the relative accuracy of fire-scar fire history reconstructions has been hampered due to a lack of empirical comparisons with independent fire history data sources. We carried out such a comparison in a 2780-ha ponderosa pine forest on Mica Mountain in southern Arizona (USA) for the time period 1937-2000. Using documentary records of fire perimeter maps and ignition locations, we compared reconstructions of key spatial and temporal fire regime parameters developed from documentary fire maps and independently collected fire-scar data (n = 60 plots). We found that fire-scar data provided spatially representative and complete inventories of all major fire years (> 100 ha) in the study area but failed to detect most small fires. There was a strong linear relationship between the percentage of samples recording fire scars in a given year (i.e., fire-scar synchrony) and total area burned for that year (y = 0.0003x + 0.0087, r2 = 0.96). There was also strong spatial coherence between cumulative fire frequency maps interpolated from fire-scar data and ground-mapped fire perimeters. Widely reported fire frequency summary statistics varied little between fire history data sets: fire-scar natural fire rotations (NFR) differed by < 3 yr from documentary records (29.6 yr); mean fire return intervals (MFI) for large-fire years (i.e., > or = 25% of study area burned) were identical between data sets (25.5 yr); fire-scar MFIs for all fire years differed by 1.2 yr from documentary records. The known seasonal timing of past fires based on documentary records was furthermore reconstructed accurately by observing intra-annual ring position of fire scars and using knowledge of tree-ring growth phenology in the Southwest. Our results demonstrate clearly that representative landscape-scale fire histories can be reconstructed accurately from spatially distributed fire-scar samples. PMID:20945762

Farris, Calvin A; Baisan, Christopher H; Falk, Donald A; Yool, Stephen R; Swetnam, Thomas W

2010-09-01

41

Treatment of split-thickness skin graft-related forearm scar contractures with a carbon dioxide laser protocol: 3 case reports.  

PubMed

Split-thickness skin grafts in the forearm can lead to motion restriction and disability through the dense scarring of the skin and formation of graft-tendon adhesions. Three patients were referred for laser treatment of motion-limiting scar-associated split-thickness skin grafts to the forearm. All patients had reached a plateau in range of motion despite aggressive hand therapy and underwent serial laser scar treatments at 6- to 8-week intervals. Treatments were performed in a clinic setting and were initiated 2 to 5 months after reconstructive surgery. Rapid subjective functional and objective improvements in range of motion were noted after laser therapy. Results were cumulative and durable at final follow-up ranging from 10 to 15 months after the initial treatment. No complications were noted. Fractionated carbon dioxide laser therapy is a promising adjunct to hand therapy when the main restraint to motion is superficial skin scarring and skin-tendon adhesions. PMID:24021742

Kroonen, Leo; Shumaker, Peter R; Kwan, Julia M; Uebelhoer, Nathan; Hofmeister, Eric

2013-11-01

42

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

PubMed Central

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

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

2011-01-01

43

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

NASA Astrophysics Data System (ADS)

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.

Ballhorn, U.; Siegert, F.

2009-04-01

44

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

PubMed

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

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

2009-12-15

45

Clinical application of split skin graft from scar tissue for plastic reconstruction in post-extensive burn patients.  

PubMed

We evaluated the use of autologous split-thickness skin taken from scars on the backs of patients with extensive burns, without sufficient normal donor skin. Between 1998 and 2008, a total of 15 patients underwent 47 operations using split-thickness skin grafts from scar tissue. Split-thickness skin was harvested from scars on the patient's back. In each operation, two thirds of donor skin was used at the recipient site and the remaining part was used to cover the donor site. All skin grafts survived. The skin function and appearance at the reconstruction site was improved in all cases, and reconstruction had therapeutic effects similar to those achieved by graft procedures using normal autologous split skin. Moreover, 6 months later, the skin graft procedure could be repeated at the donor site. Therefore, we concluded that split-thickness skin from scars on patients' backs is a valuable source of skin graft material that can be used repeatedly for plastic reconstruction in extensively burned patients. PMID:20971386

Zheng, Jie Xin; Zhang, Qin; Niu, Yi Wen; Liu, Jian

2010-12-01

46

Contracture deformity  

MedlinePLUS

Brain and nervous system disorders, such as cerebral palsy or stroke Inherited disorders (such as muscular dystrophy ) Nerve damage Reduced use (for example, from lack of mobility) Scarring after traumatic injury or ...

47

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

PubMed

????????????????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

Hayashida, Kenji; Akita, Sadanori

2012-08-01

48

The propeller flap for postburn elbow contractures  

Microsoft Academic Search

Flexion contracture of the elbow is a common sequela of burn injury. Numerous methods have been suggested for release, including grafting, Z-plasty, Y-V flaps, local or distant fasciocutaneous flaps, muscle or myocutaneous flaps, free flaps, tissue expanders and non-surgical orthotics. In this article the authors present their experience with the propeller flap method in seven cases of elbow flexion contracture.

Gurcan Aslan; Dogan Tuncali; Bulent Cigsar; Ayse Yuksel Barutcu; Ahmet Terzioglu

2006-01-01

49

Post-traumatic stress disorder due to devastitang burns overcome by a single session of eye movement desensitization  

Microsoft Academic Search

Summary - This article reports on the effective use of a single session of eye movement desensitization (EMD) in the treatment of an exceptionally severe case of post-traumatic stress disorder (PTSD). The patient was the survivor of burns that left him with massive scarring, total deafness, bilateral amputations of the upper extremities above the elbow, severe contractures, and severely damaged

DAVID L. MCCANN

1992-01-01

50

Pseudoangiosarcomatous squamous cell carcinoma developing on a burn scar: A case report and review of the literature.  

PubMed

Pseudoangiosarcomatous squamous cell carcinoma, also known as pseudovascular, pseudovascular adenoid and pseudoangiomatous squamous cell carcinoma, is an exceedingly rare, aggressive variant of cutaneous squamous cell carcinoma with extreme acantholysis resulting in angiosarcoma-like areas. Histologically, a pseudoangiosarcomatous pattern includes complex anastomosing channels and spaces lined with neoplastic cells. The neoplastic cells exhibit cytokeratin and vimentin positivity but yield negative results with CD31 and CD34. This case report describes pseudoangiosarcomatous squamous cell carcinoma developing on a burn scar on the ankle. In this report, we emphasize the importance of establishing a diagnosis with histological and immunohistochemical examination, and we review the described incidence of the age and sites with the prognosis for the treatment of pseudoangiosarcomatous squamous cell carcinoma of the skin. PMID:24768344

Koh, Sung Hoon; Oh, Suk Joon; Chun, Huan; Kim, Seon Gyu

2014-11-01

51

Increased Types I and III Collagen and Transforming Growth Factor-?1 mRNA and Protein in Hypertrophic Burn Scar  

Microsoft Academic Search

Hypertrophic scar is the result of abnormal healing that often follows thermal injury. Hypertrophic scar is characterized by excessive dermal fibrosis and scarring. Five cases of human hypertrophic scar were compared with normal skin using in situ hybridization to localize mRNAs for procollagen types I and III and transforming growth factor-?1. Expression of type I procollagen and TGF-?1 were also

Kai Zhang; Warren Garner; Leslie Cohen; Jorge Rodriguez; Sem Phan

1995-01-01

52

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

PubMed Central

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

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

2013-01-01

53

An automatic method for burn scar mapping using support vector X. CAO{{, J. CHEN*{, B. MATSUSHITA, H. IMURA" and L. WANG{{  

E-print Network

the potential to be applied to near real-time burn scar mapping in grassland areas. *Corresponding author. Email:[UniversityatBuffalo,theStateUniversityofNewYork(SUNY)]At:20:5915September2009 #12;1. Introduction Wildfire is a natural process that disturbs ecosystem

Wang, Le

54

Comparing parent and child perceptions of stigmatizing behavior experienced by children with burn scars.  

PubMed

This study examined perceptions of stigmatization in a sample of 85 pediatric burn survivors and their parents. Survivors and a parent independently completed the Perceived Stigmatization Questionnaire (PSQ) rating the frequency that the child experienced three types of stigmatizing behaviors: absence of friendly behavior, confused and staring behavior, and hostile behavior. The sample was divided into a high (top 25%) and low (bottom 75%) perceived stigmatization groups. The mean ratings of parents did not significantly differ from that of children reporting low stigmatization. The mean PSQ parent ratings were significantly lower than those of children reporting high stigmatization. Additionally, the concordance on PSQ subscale scores within child-parent dyads was significantly lower in children reporting high stigmatization relative to child-parent dyads of children reporting low stigmatization. Children surviving burns may experience stigmatization that is under-perceived by their parents. Clinicians should be alert to this potential discrepancy. PMID:21074503

Lawrence, John W; Rosenberg, Laura; Mason, Shawn; Fauerbach, James A

2011-01-01

55

Resurfacing of total penile full-thickness burn managed with the Versajet hydrosurgery system.  

PubMed

Reconstruction of penile skin loss resulting from various causes is a challenge for clinician. Especially in a potent man, functional and cosmetic outcomes are demanded. Conservative treatment with topical agents is not enough for the full-thickness burn although hypertrophic scar and secondary contracture usually occurs. Resurfacing of total penile full-thickness burn after wound management with the Versajet hydrosurgery system (a water-jet powered debrider) is described for the first use in our hospital. PMID:20182375

Yeh, Chin-Choon; Lin, Yu-San; Huang, Kuo-Feng

2010-01-01

56

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

NASA Astrophysics Data System (ADS)

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.

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

2013-04-01

57

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

PubMed

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

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

2014-01-01

58

Congenital contractural arachnodactyly (Beals syndrome)  

Microsoft Academic Search

Congenital contractural arachnodactyly (Beals syndrome) is an autosomal dominantly inherited connective tissue disorder characterized by multiple flexion contractures, arachnodactyly, severe kyphoscoliosis, abnormal pinnae and muscular hypoplasia. It is caused by a mutation in FBN2 gene on chromosome 5q23. Although the clinical features can be similar to Marfan syndrome (MFS), multiple joint contractures (especially elbow, knee and finger joints), and crumpled

Ergül Tunçbilek; Yasemin Alanay

2006-01-01

59

Pedicled Anterior Lateral Thigh Flap in Managing a Bilateral Groin Contracture  

PubMed Central

A fifteen-year-old female patient presented with a severe bilateral groin contracture for the last 8 years. She had sustained burns at the age of seven years. Three attempts to release the contracture with split thickness skin grafts had been done without success. A pedicled anterior lateral thigh flap was raised and advanced into the defect after the contracture had been released. Postoperatively the patient healed well without any complications and was able to achieve hip abduction of about 130 degrees.

Biribwa, Peter; Khainga, Stanley

2014-01-01

60

Isolated Chemical Burns to the Genitalia  

PubMed Central

Summary Perineal or genital burns are mostly part of large body surface injuries, and isolated burns to the genitalia are not common. Nevertheless, they are of major concern to the patient and clinician. Highly concentrated solutions of sulphuric acid are available to unclog drains. We have noted a substantial number of both accidental and intentional cutaneous burns caused by these agents and we therefore conducted a study on the incidence and treatment of isolated chemical burns in the genitalia. The study was performed in the Burns Unit, King Saud Hospital, Al-Qassim, Kingdom Saudi Arabia, from April 2001 to December 2004. During this period we received 12 patients with isolated chemical burns in the genitalia, representing 3.4% of all cases of burns treated between 2001 and 2004 (350 patients with different causes and variable percentages of burns). Of these 12 patients, 11 were males and one female. The patients' ages ranged from 9 to 75 yr. The mean burn size was 2% of the total body surface area. The cause of the burn injury was sulphuric acid, which is famous in this area for water closet cleaning. Eight patients (66.7%) required skin grafting, one healed with minimal scarring, and three (25%) healed with minimal contractures treated with multiple Z-plasty. We concluded that conservative management of perineal and genital chemical burns was recommended until the demarcation zone became clear. Split-thickness skin grafts were durable, safe, and technically easy, with satisfactory cosmetic and functional results. PMID:21991041

Abdel-Razek, S.M.

2006-01-01

61

Barnacle scars  

NSDL National Science Digital Library

The nearly circular scars of barnacle encrustation are noticeable even when the barnacle shells are broken off. A scallop with barnacle scars from the Yorktown Formation was the first described and illustrated fossil in North America.

2001-03-01

62

Validation of a vertical progression porcine burn model.  

PubMed

A major potential goal of burn therapy is to limit progression of partial- to full-thickness burns. To better test therapies, the authors developed and validated a vertical progression porcine burn model in which partial-thickness burns treated with an occlusive dressing convert to full-thickness burns that heal with scarring and wound contraction. Forty contact burns were created on the backs and flanks of two young swine using a 150 g aluminum bar preheated to 70°C, 80°C, or 90°C for 20 or 30 seconds. The necrotic epidermis was removed and the burns were covered with a polyurethane occlusive dressing. Burns were photographed at 1, 24, and 48 hours as well as at 7, 14, 21, and 28 days postinjury. Full-thickness biopsies were obtained at 1, 4, 24, and 48 hours as well as at 7 and 28 days. The primary outcomes were presence of deep contracted scars and wound area 28 days after injury. Secondary outcomes were depth of injury, reepithelialization, and depth of scars. Data were compared across burn conditions using analysis of variance and ?(2) tests. Eight replicate burns were created with the aluminum bar using the following temperature/contact-time combinations: 70/20, 70/30, 80/20, 80/30, and 90/20. The percentage of burns healing with contracted scars were 70/20, 0%; 70/30, 25%; 80/20, 50%; 80/30, 75%; and 90/20, 100% (P = .05). Wound areas at 28 days by injury conditions were 70/20, 8.1 cm(2); 70/30, 7.8 cm(2); 80/20, 6.6 cm(2); 80/30, 4.9 cm(2); and 90/20, 4.8 cm(2) (P = .007). Depth of injury judged by depth of endothelial damage for the 80/20 and 80/30 burns at 1 hour was 36% and 60% of the dermal thickness, respectively. The depth of injury to the endothelial cells 1 hour after injury was inversely correlated with the degree of scar area (Pearson's correlation r = -.71, P < .001). Exposure of porcine skin to an aluminum bar preheated to 80°C for 20 or 30 seconds results initially in a partial-thickness burn that when treated with an occlusive dressing progresses to a full-thickness injury and heals with significant scarring and wound contracture. PMID:21841494

Singer, Adam J; Hirth, Douglas; McClain, Steve A; Crawford, Laurie; Lin, Fubao; Clark, Richard A F

2011-01-01

63

Dupuytren's Contracture: Fibroblast Contraction?  

PubMed Central

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

Gabbiani, Giulio; Majno, Guido

1972-01-01

64

Congenital contractural arachnodactyly (Beals syndrome).  

PubMed

Congenital contractural arachnodactyly (CCA, Beals syndrome) is an autosomal dominant disorder that is phenotypically similar to Marfan syndrome. CCA is characterized by arachnodactyly, dolichostenomelia, scoliosis, multiple congenital contractures and abnormalities of the external ears. We report here 28 patients with CCA, in whom a wide range of phenotypic expression is observed. These individuals usually have abnormally formed ears, limited extension of fingers and toes, arachnodactyly, clinodactyly, delay of developmental milestones and psychomotor retardation. Limited extensions of elbows, knees and hips are not constant features. With time, those affected individuals experience spontaneous improvement of their contractures but the kyphosis, unlike the joint contractures, tends to be progressive. No ocular problems were found in all patients, but congenital heart defects were detected in 32.2% of them. Atrial septal defect and ventricular septal defect are common components in our patients. Within the only one family with two multiply affected siblings there is little phenotypic variation between the patients. PMID:10927940

Su, P H; Hou, J W; Hwu, W L; Wu, M H; Wang, J K; Wang, T R

2000-01-01

65

Management of severe burn injuries with topical heparin: the first evidence-based study in Ghana  

PubMed Central

Conventional therapy for burns has always produced a nightmarish illness for patients. The lack of the ability to prevent contractures often produces dysfunctional limbs and the ugly scars resulting from severe burns are an ongoing reminder of this lengthy painful illness. This study is to determine the effectiveness of topical heparin in burns management among some patients at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Patients for this prospective study were burns victims who were transported to the Accident and Emergency Center of KATH. Complete clerking of the patients and related information were taken. Six patients with ages ranging from 5-35 years, TBSA 5-42% and a combination of 2° and 3° burns were enrolled in the case study. Anatomical locations of the burns included: face, neck, trunk and limbs. Using topical heparin produced smooth skin in two patients: Patients 3 and 5 who reported on Post-burn Day 85 and 116 at the BICU. Five out of the six patients assessed the degree of pain; before treatment with heparin, all five patients stated they were experiencing severe pains, however, three (60.0%) of the patients stated they experienced no pain at all while two (40.0%) were experiencing mild pain after topical heparin application. Heparin was observed to be very effective in the management of burn injuries in the patients studied. It was effective in reduction of pain and prevention of scars and contractures. However, due to the small number of patients and lack of control for the wound healing, a firm recommendation for the use of heparin therapy in burns cannot be made and further studies would be required to establish its use especially in the African population. PMID:23386983

Agbenorku, Pius; Fugar, Setri; Akpaloo, Joseph; Hoyte-Williams, Paa E; Alhassan, Zainab; Agyei, Fareeda

2013-01-01

66

Congenital contractural arachnodactyly (Beals syndrome).  

PubMed

Congenital contractural arachnodactyly (Beals syndrome) is an autosomal dominantly inherited connective tissue disorder characterized by multiple flexion contractures, arachnodactyly, severe kyphoscoliosis, abnormal pinnae and muscular hypoplasia. It is caused by a mutation in FBN2 gene on chromosome 5q23. Although the clinical features can be similar to Marfan syndrome (MFS), multiple joint contractures (especially elbow, knee and finger joints), and crumpled ears in the absence of significant aortic root dilatation are characteristic of Beals syndrome and rarely found in Marfan syndrome. The incidence of CCA is unknown and its prevalence is difficult to estimate considering the overlap in phenotype with MFS; the number of patients reported has increased following the identification of FBN2 mutation. Molecular prenatal diagnosis is possible. Ultrasound imaging may be used to demonstrate joint contractures and hypokinesia in suspected cases. Management of children with CCA is symptomatic. Spontaneous improvement in camptodactyly and contractures is observed but residual camptodactyly always remains. Early intervention for scoliosis can prevent morbidity later in life. Cardiac evaluation and ophthalmologic evaluations are recommended. PMID:16740166

Tunçbilek, Ergül; Alanay, Yasemin

2006-01-01

67

An insight into Dupuytren's contracture.  

PubMed

Dupuytren's contracture is a deforming, fibrotic condition of the palmar fascia which has confounded clinicians and scientists since the early descriptions by Guillaume Dupuytren in 1831. It predominantly affects elderly, male caucasians, has a hereditary predisposition and has strong associations with diabetes, alcohol consumption, cigarette smoking and HIV infection. The major morphological features are an increase in fibroblasts, particularly around narrowed fibroblasts; a finding consistent with localised ischaemia. During ischaemia, adenosine triphosphate (ATP) is converted to hypoxanthine and xanthine, and endothelial xanthine dehydrogenase to xanthine oxidase (alcohol also mediates this change, a finding of particular relevance given the association of Dupuytren's contracture with alcohol intake). Xanthine oxidase catalyses the oxidation of hypoxanthine to xanthine and uric acid with the release of superoxide free radicals (O2-), hydrogen peroxide (H2O2) and hydroxyl radicals (OH.). These free radicals are highly reactive, with half-lives in the order of milliseconds and are toxic in high concentrations. A potential for free radical generation in Dupuytren's contracture was elicited by finding a sixfold increase in hypoxanthine concentrations in Dupuytren's contracture compared with control palmar fascia. In vitro studies affirmed the toxic effects of oxygen free radicals to Dupuytren's contracture fibroblasts, but also showed that, at lower concentrations (concentrations similar to those likely to occur in Dupuytren's contracture), free radicals had a stimulatory effect on fibroblast proliferation. Cultured fibroblasts were found to release their own O2-. These endogenously released free radicals were also found to be important in fibroblast proliferation. The collagen changes of Dupuytren's contracture were examined. The results established that fibroblast origin was unimportant, but that inhibition of type I collagen production at high fibroblast density accounted for the increase in type III/I collagen ratios observed by previous investigators. These biochemical and morphological observations throw new light on Dupuytren's contracture. They suggest that age, genetic and environmental factors may contribute to micro vessel narrowing with consequent localised ischaemia and free radical generation. Endothelial xanthine oxidase derived free radicals may both damage the surrounding stroma and stimulate fibroblasts to proliferate. Proliferating fibroblasts lay down and contract collagen in lines of stress.Progressive fibroblast proliferation and deposition of collagen is likely to encourage further microvessel narrowing with a positive feedback effect consistent with the progressive nature of the condition. PMID:1616255

Murrell, G A

1992-05-01

68

Burn  

E-print Network

ravenous with color: sage, pine, sun-yellow, and canyon-brown, the rich carnelian of a Mexican sunset. Lean, leggy, pink tongue wet and lolling, she stares me straight in the eye. Silver moonlight on her back, wildfire burning in her eyes... 1 Burn By Vivian Kathleen Johnson...

Johnson, Vivian Kathleen

2008-01-01

69

The consensus of the surgical treatment of burn injuries in Belgium.  

PubMed

On the occasion of the twentieth anniversary of the 'Belgian Association of Burn Injuries' an inventory was made of all surgical techniques used in the five largest Belgian burn centres in order to draw up a consensus document. A questionnaire covering the whole treatment of severely burned patients was sent to the surgeons of each burn unit, ranging from emergency treatment, through diagnostic techniques, burn surgery and post-healing treatment (scars, contractures). During the past decade, several (often expensive) new techniques have been commercialised, resulting in a wide variety of treatment modalities in the different centres. For the majority of bums, however, a similar protocol is followed: the superficial burns are treated conservatively and the deep burns surgically. Nevertheless, burns of indeterminate depth are susceptible to variations in their treatment. There are also different therapeutic options for the deepest burns, from the use of donor skin to dermal substitutes as well as cultured keratinocytes. The writing of this consensus required intense communication on the different therapeutic modalities, as well as an increased exchange of experiences, which could lead to an improvement in the quality of burn treatment in Belgium. PMID:19241911

Brusselaers, N; Lafaire, C; Ortiz, S; Jacquemin, D; Monstrey, S

2008-01-01

70

Scar revision  

MedlinePLUS

... skin with a special wire brush called a burr or fraise. New skin grows over this area. Dermabrasion can be used to soften the surface of the skin or reduce irregularities. Massive injuries (such as burns) can cause loss of a large area of skin and ...

71

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

PubMed Central

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

Agbenorku, Pius

2013-01-01

72

Genital burns and vaginal delivery.  

PubMed

Obstetric complications may result from burn scarring in the genital area. Women in developing countries typically squat around cooking fires, and burns are common. This recent case in Nepal describes obstructed labor in a young woman whose genital area had extensive scarring from a cooking fire injury. Proper antenatal assessment by health care providers can reduce the risk to mothers and infants of the consequences of a birth canal damaged or obstructed by burn scarring. PMID:7556863

Pant, R; Manandhar, V; Wittgenstein, F; Fortney, J A; Fukushima, C

1995-07-01

73

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

NASA Astrophysics Data System (ADS)

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.

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

2014-03-01

74

TGF-? 2Activates Proliferative Scar Fibroblasts  

Microsoft Academic Search

Background.Cytokines, such as the transforming growth factor beta (TGF-?) isoforms, have been linked to the formation of proliferative scars. This study examines the stimulating effects of exogenous TGF-?2on cultured keloid, burn hypertrophic scar, and normal skin fibroblasts and whether such effects can be suppressed with TGF-?2antibody.Methods. In vitro,the fibroblast-populated collagen lattice (FPCL) is used in the evaluation of fibroblast activation

Paul Smith; Gerard Mosiello; Louis Deluca; Francis Ko; Sergio Maggi; Martin C. Robson

1999-01-01

75

Plantarflexion Contracture in the mdx Mouse  

PubMed Central

Objective Contractures are a major clinical issue for patients with muscular dystrophies. However, it is unknown whether contractures are present in the widely used mdx mouse model of Duchenne muscular dystrophy. Therefore, the objectives of this study were to develop methods to measure muscle contractures in mice, to determine whether plantarflexion contractures are present in mdx mice, and to analyze the composition of the major muscles involved. Design Hindlimbs of eight wild type and six mdx mice were assessed every 2 wks during the course of a 12-wk study. Assessments included range of motion and in vivo torques about the ankle. At the end of the study, mice were euthanized, and muscles were analyzed for composition. Results The mdx mice had ~10 degrees less dorsiflexion, increased passive torque moving the ankle into dorsiflexion, and an increased passive-to-active torque ratio relative to wild type mice. Gastrocnemius muscle composition alterations included increased wet mass, decreased protein content, and increased collagen. Conclusions The results indicate that mdx mice have plantarflexion contractures similar to those seen in children with Duchenne muscular dystrophy. In future studies, these measures can be used to assess strategies to slow the progression of contractures that occur with muscular dystrophies. PMID:21403594

Garlich, Michael W.; Baltgalvis, Kristen A.; Call, Jarrod A.; Dorsey, Lisa L.; Lowe, Dawn A.

2012-01-01

76

Genital burns and vaginal delivery  

Microsoft Academic Search

Obstetric complications may result from burn scarring in the genital area. Women in developing countries typically squat around cooking fires, and burns are common. This recent case in Nepal describes obstructed labor in a young woman whose genital area had extensive scarring from a cooking fire injury. Proper antenatal assessment by health care providers can reduce the risk to mothers

R. Pant; V. Manandhar; F. Wittgenstein; J. A. Fortney; C. Fukushima

1995-01-01

77

Relativistic Quantum Scars  

SciTech Connect

The concentrations of wave functions about classical periodic orbits, or quantum scars, are a fundamental phenomenon in physics. An open question is whether scarring can occur in relativistic quantum systems. To address this question, we investigate confinements made of graphene whose classical dynamics are chaotic and find unequivocal evidence of relativistic quantum scars. The scarred states can lead to strong conductance fluctuations in the corresponding open quantum dots via the mechanism of resonant transmission.

Huang, Liang [Department of Electrical Engineering, Arizona State University, Tempe, Arizona 85287 (United States); Lai Yingcheng [Department of Electrical Engineering, Arizona State University, Tempe, Arizona 85287 (United States); Department of Physics, Arizona State University, Tempe, Arizona 85287 (United States); Ferry, David K.; Goodnick, Stephen M. [Department of Electrical Engineering, Arizona State University, Tempe, Arizona 85287 (United States); Department of Physics, Arizona State University, Tempe, Arizona 85287 (United States); Center for Solid State Electronics Research, Arizona State University, Tempe, Arizona 85287 (United States); Akis, Richard [Department of Electrical Engineering, Arizona State University, Tempe, Arizona 85287 (United States); Center for Solid State Electronics Research, Arizona State University, Tempe, Arizona 85287 (United States)

2009-07-31

78

Soil respiration from a boreal forest fire scar chronosequence  

NASA Astrophysics Data System (ADS)

Climate change predictions suggest that warming is to be most pronounced at high latitudes, with a possibility of boreal forest warming of 4-6°C in the next 50-100 years. This has lead to the suggestion that changes in boreal forest soil carbon (C) storage could significantly alter the global soil C balance. Fire is the most significant factor controlling succession in the boreal forest biome and it is possible that climate change will lead to an increase in fire regime e.g. size, frequency, intensity, or any combination of these. Our research is investigating C flux dynamics in a Canadian boreal forest jack pine (Pinus banksiana Lamb.) dominated fire scar chronosequence. Fieldwork is carried out at Sharpsand Creek experimental burn site, near Thessalon, Ontario, Canada, where there are numerous fire scars of different ages. In June 2006 soil respiration (Rs), soil temperature (Ts) and soil moisture (Ms) were measured on three replicate scars selected from plot last burnt in 1948 and 1991. Rs values were later adjusted for Ts using a Q10 value of 2. There was no significant difference in mean adjusted Rs between the two scar age categories. It is likely that sample sizes were not large enough here to detect significant differences. In May 2007, large areas of the field site burnt as a result of wildfire; this provided an opportunity to take a large number of Rs measurements from recently burnt fire scars, as well as from those areas unaffected by the burn. Rs, Ts and Ms measurements were taken from 1948, 1975 and 1991 scar age categories (three replicate scars each) that were burnt in 2007, as well as a 1948 and 1991 fire scar that was unaffected by the wildfire. Soil samples were taken from three locations per fire scar surveyed and analysed in the laboratory for total C content. There was a significant difference in mean Rs adjusted for Ts and Ms (Rsadj) between the three pre-2007 fire scar age categories 1948, 1975 and 1991, that were all burnt in 2007. Mean Rsadj differed significantly between the 1948 and 1991 scars that were not burnt in 2007. A significant difference was apparent in mean Rsadj between the 1948 scar not burnt in 2007 and the three 1948 scars that were burnt in 2007. There was a significant difference in mean Rsadj between the 1991 scar not burnt in 2007 and the three 1991 scars burnt in 2007. Finally mean (Rsadj) differed significantly between the 1948 scar not burned in 2007, 1991 scar not burnt in 2007 and the 9 scars burnt in 2007. Our results indicate that Rs rates vary between fire scars of different ages and it seems that this is also apparent days after burning of scars that differ in their burn history. It appears that Rs from fire scars previously burnt in 1948 and subjected to fire in 2007, decreased as a direct result of the fire. In contrast, Rs from fire scars previously burnt in 1991 and subjected to fire in 2007, increased as a result of the fire. These results suggest that Rs is dominated by autotrophic components in mature forest (59 years post fire), but heterotrophic components in younger forest (16 years post fire). The possibility that Rs is increased directly after burning of younger fire scars is an important finding considering the view that climate change in boreal systems may increase the frequency of forest fires, and hence the proportion of younger forest. More research is needed in other boreal systems and in monitoring Rs for longer time periods after fire on scars with different burn histories.

Smith, D.; Kaduk, J.; Balzter, H.; Wooster, M.; Mottram, G.

2007-12-01

79

Models of Abnormal Scarring  

PubMed Central

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

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

2013-01-01

80

Application of acellular dermal xenografts in full-thickness skin burns  

PubMed Central

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

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

2013-01-01

81

Contracturing granulomatous myositis: a separate entity.  

PubMed Central

Granulomatous muscle disease is most commonly seen in sarcoidosis, but may be seen in association with a wide variety of other disorders or in isolation. Patients with granulomatous myositis usually present with slowly progressive muscle pain and weakness affecting mainly proximal muscles. There are, however, a few reports of granulomatous muscle disease presenting with flexion contractures of the limbs. Two further patients with granulomatous muscle disease and flexion contractures of the limbs, but with no evidence of systemic granulomatous disease, is presented. It is suggested that such patients represent a separate clinical entity that is distinct from idiopathic granulomatous myositis presenting with muscle pain and weakness. The association of contracturing granulomatous myositis with a long-standing vasculitis in one patient suggests that the two conditions may be related. Images PMID:2283532

Simmonds, N J; Hoffbrand, B I

1990-01-01

82

Laser Scar Management Technique  

PubMed Central

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

Ohshiro, Toshio; Sasaki, Katsumi

2013-01-01

83

Post-burn duct carcinoma breast: An unusual case report  

PubMed Central

Malignancies arising from burn scars though rare are well documented in the literature; squamous cell carcinoma is the most common burn scar neoplasm, and adenocarcinoma is an extremely uncommon and rarely reported tumor in these scars. We hereby report a case of a young woman who presented with a rapidly growing lump in a scar in the mammary region that sustained severe burns 20 years back. It was diagnosed as duct carcinoma breast on cytology and later confirmed on histopathology and immunohistochemistry. The case mandates regular follow-up of patients with post-burn scars, and any lump arising in that region should be promptly investigated. PMID:23833406

Singh, Neha; Rao, Seema; Jain, Shyama

2013-01-01

84

Arthroscopic Gluteal Muscle Contracture Release With Radiofrequency Energy  

Microsoft Academic Search

Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to\\u000a require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would\\u000a decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal\\u000a muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior

Yu-Jie Liu; Yan Wang; Jing Xue; Pauline Po-Yee Lui; Kai-Ming Chan

2009-01-01

85

A polarized multispectral imaging system for quantitative assessment of hypertrophic scars  

PubMed Central

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

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

2014-01-01

86

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

PubMed

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

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

2014-10-01

87

Joint Capsule Matrix Turnover in a Rabbit Model of Chronic Joint Contractures: Correlation with Human Contractures  

PubMed Central

To evaluate changes in matrix molecules of the joint capsule, the right knees of 24 skeletally mature female NZW rabbits were immobilized while the contralateral limb served as an unoperated control. The immobilization was discontinued at 8 weeks and the rabbits were divided among four groups (n = 6) based on the number of weeks the right knees were remobilized: 0, 8, 16, or 32. Three rabbits (six knees) that did not have operations provided normal control joint capsules. The mRNA levels for collagen types I, II, and III, and MMP-1 and -13 were significantly increased in the joint capsules of the contracture knees in all groups when compared to normal and contralateral limb joint capsules. In contrast, the mRNA levels for TIMP-1, -2, and -3 were decreased in the joint capsules of the contracture knees in all groups when compared to normal and contralateral limb joint capsules. The mRNA levels for lumican and decorin were increased in the joint capsules of the contracture knees in all groups when compared to normal capsules. Many of the changes observed in this animal model are similar to those observed in human joint capsules from posttraumatic elbow contractures, supporting the value of this rabbit model. PMID:16596651

Hildebrand, Kevin A.; Zhang, Mei; Hart, David A.

2010-01-01

88

The scar mechanism revisited  

E-print Network

Unstable periodic orbits are known to originate scars on some eigenfunctions of classically chaotic systems through recurrences causing that some part of an initial distribution of quantum probability in its vicinity returns periodically close to the initial point. In the energy domain, these recurrences are seen to accumulate quantum density along the orbit by a constructive interference mechanism when the appropriate quantization (on the action of the scarring orbit) is fulfilled. Other quantized phase space circuits, such as those defined by homoclinic tori, are also important in the coherent transport of quantum density in chaotic systems. The relationship of this secondary quantum transport mechanism with the standard mechanism for scarring is here discussed and analyzed.

F. Borondo; D. A. Wisniacki; E. G. Vergini; R. M. Benito

2007-12-20

89

Central axis flap methods  

Microsoft Academic Search

Extensively burned patients often lack ample healthy skin for autotransplantation. Scar contractures are then frequent. Here, we reconstructed contractures using flaps of remaining healthy skin around the recipient sites. In this report, we present four original scar contracture repair methods using subcutaneous pedicled flaps: (1) Propeller flap, (2) multilobed propeller flap, (3) scar-band rotation flap and (4) pin–wheel flap. The

Hiko Hyakusoku; Itaru Iwakiri; Masahiro Murakami; Rei Ogawa

2006-01-01

90

Prenatal diagnosis in congenital contractural arachnodactyly.  

PubMed

Congenital contractural arachnodactyly (CCA) is a heritable connective tissue disorder caused by defects in the gene encoding fibrillin-2 (FBN2). People with CCA typically have a marfanoid habitus, flexion contractures, severe kyphoscoliosis, abnormal pinnae, and muscular hypoplasia. Because of the relative infrequency of the syndrome and its generally mild to moderate severity, prenatal diagnosis had not previously been sought. Here we report prenatal diagnosis in a family with CCA. Because the course of the disease in the proband was rather severe, she had requested genetic counseling as early as age 17. She delayed childbearing until prenatal diagnosis for CCA became possible. This decision was supported by her mother and later her husband. Because she shared the same genotype with her husband, genetic linkage analysis of this family did not alter the a priori 50% risk of having an affected child. The possibility of unambiguously ascertaining the affected status of a fetus homozygous for the tested FBN2 marker was sufficient for the family to pursue prenatal diagnosis. This case strongly points to the importance of informed decisions now that genetic testing is becoming commonplace. PMID:10464661

Belleh, S; Spooner, L; Allanson, J; Godfrey, M

91

Potassium-induced contractures in crab (Callinectes danae) muscle fibers.  

PubMed

The contractures induced by 20-200 mM [K+]o in single crab muscle fibers were resolved into two components. The first component, consisting of single twitches or brief tetanic contractions, was associated with electrogenic membrane responses. The second occurred after spiking subsided with an amplitude that increased linearly with the [K+]o between 20 and 90 mM. The amplitude and time course of the contractures elicited by a given [K+]o differed markedly between different fibers. Contracture reproducibility of a single fiber was best when 90 mM [K+]o was used. The K-induced contractures were abolished after brief (3 min) exposure of the fibers to a calcium-free solution and were greatly depressed by 8 mM procaine. The data suggest that the contractures require both Ca2+-influx across the sarcolemma and release of Ca2+ stored in the sarcoplasmic reticulum. PMID:6518341

Leal-Cardoso, J H; Suarez-Kurtz, G

1984-01-01

92

Engagement, Adolescents, and Scar Stories  

NSDL National Science Digital Library

One way to motivate young learners is to ask them to write about something thatâs theirs and theirs alone: their scars. Those scar stories can be a jumping off place for learning across the curriculum.

Nichols, Jennifer

2011-04-01

93

Scar-free healing: from embryonic mechanisms to adult therapeutic intervention  

Microsoft Academic Search

In man and domestic animals, scarring in the skin after trauma, surgery, burn or sports injury is a major medical problem, often resulting in adverse aesthetics, loss of function, restriction of tissue movement and\\/or growth and adverse psychological effects. Current treatments are empirical, unreliable and unpredictable: there are no prescription drugs for the prevention or treatment of dermal scarring. Skin

Mark W. J. Ferguson; Sharon O'Kane

2004-01-01

94

Multimodality Scar Management Program  

Microsoft Academic Search

Background   This trial was undertaken to assess the efficacy of a multimodality management regime used for the prevention of hypertrophic\\u000a scars. It follows previous research and experience (A.D. Widgerow et al, Aesthetic Plast Surg, 24(3):227–234, 2000) with a similar program but with the addition of active agents with specific effects against prolonged inflammation and enhanced\\u000a hydrative capacity. The modalities specifically

Alan D. Widgerow; Laurence A. Chait; Pieter J. Stals; Rene Stals; Geoffrey Candy

2009-01-01

95

Update on hypertrophic scar treatment.  

PubMed

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

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

2014-08-01

96

Update on hypertrophic scar treatment  

PubMed Central

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

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

2014-01-01

97

Pediatric cutaneous bleach burns.  

PubMed

Bleach is a common household product which can cause caustic injuries. Its effects on mucosal tissues and the eye have been well-described in the literature. However, there is little information published regarding the appearance and effect of bleach on a child's skin. We report three children who sustained chemical burns after contact with bleach. All three children sustained accidental bleach burns while at home, and each child had a distinct brown discoloration to the skin from the injury. All three children had treatment and follow-up for their burns. Two of the children sustained more severe burns, which were extensive and required more time to heal. There was also long-term scarring associated with the severe burns. Like most burns, pain control is required until the injury heals. PMID:23545350

Lang, Cathleen; Cox, Matthew

2013-07-01

98

Activated keratinocytes in the epidermis of hypertrophic scars.  

PubMed Central

The etiology of hypertrophic scarring, a pathological end point of wound healing, is unknown. The scars most commonly occur when epithelialization has been delayed during, for example, the healing of deep dermal burn wounds. Hypertrophic scars are conventionally described as a dermal pathology in which the epidermis has only a passive role. In this study, the expression of keratin intermediate filament proteins and filaggrin has been investigated in the epidermis of hypertrophic scars and site-matched controls from the same patients. Hypertrophic scar epidermis was found to express the hyperproliferative keratins K6 and K16 in interfollicular epidermis in association with K17 and precocious expression of filaggrin. K16 mRNA was localized by in situ hybridization using a highly specific cRNA probe. In contrast to the immunohistochemical location of K16 protein, the K16 mRNA was found to be expressed in the basal cell layer of normal skin. In hypertrophic scars the mRNA distribution corroborated the abnormal K16 protein distribution. These results suggest the keratinocytes in hypertrophic scar epidermis have entered an alternative differentiation pathway and are expressing an activated phenotype. Activated keratinocytes are a feature of the early stages of wound healing producing growth factors that influence fibroblasts, endothelial cells, and the inflammatory response. We propose that cellular mechanisms in the pathogenesis of hypertrophic scarring are more complex than isolated dermal phenomena. The persistence of activated keratinocytes in hypertrophic scar epidermis implicates abnormal epidermal-mesenchymal interactions. Images Figure 1 Figure 3 PMID:9588880

Machesney, M.; Tidman, N.; Waseem, A.; Kirby, L.; Leigh, I.

1998-01-01

99

Outcome studies for burn patients in Hong Kong: patient's satisfaction  

Microsoft Academic Search

With the recent advances in burns treatment, many more survive the burn to experience pain, scarring, physical deformity, loss of function and psychological trauma. Pressure therapy prescribed by occupational therapists for more than 20 years in Hong Kong has proved its effectiveness in treating the visible scars. However, the inconvenience and impaired appearance that is brought about by these garments

S. Cheng; A. Chan; S. Fong; M. Lam; A. Leung; P. Lee; J. Tsang; J. Wong; A. Wu

1996-01-01

100

Cones of skin occur where hypertrophic scar occurs.  

PubMed

Hypertrophic scarring is devastating for the patient, however the pathophysiology and treatment remain unknown after decades of research. The process follows deep dermal injury, occurs only on certain body parts, does not occur in the early fetus or in animals, and is a localized event. This suggests that an anatomic structure in human, deep dermis may be involved. The dermis is a matrix perforated by cones containing many structures including skin appendages and fat domes. We hypothesized that studying the cones might reveal a structure related to scarring. We examined tangential wounds from various body parts on human cadavers along with skin histology from various human body parts, the early fetus, partial thickness burns, hypertrophic scars, and two other species-rats and rabbits. We found that the cones may in fact be the structure. They exist where hypertrophic scar occurs-cheek, neck, chest, abdomen, back, buttock, arm, forearm, dorsal hand, thigh, leg, dorsal foot, helix and ear lobe. They do not exist where hypertrophic scar does not occur-scalp, forehead, concha, eyelid, palm, early fetus, and in rat, or rabbit. It also became apparent that the cones have been omitted from most considerations of skin histology. We suggest that the cones need to be studied in relation to hypertrophic scarring and restored to skin diagrams. PMID:11679135

Matsumura, H; Engrav, L H; Gibran, N S; Yang, T M; Grant, J H; Yunusov, M Y; Fang, P; Reichenbach, D D; Heimbach, D M; Isik, F F

2001-01-01

101

Raised Acne Scars: Treatment Can Ease Pain, Diminish Scars  

MedlinePLUS

... scars from returning after surgery. Lasers and Other Light Therapies More dermatologists are using lasers to treat raised ... scar. For people with lighter skin, intense pulsed light (IPL) also may be a treatment ... therapy may be used. Cryotherapy This treatment freezes the ...

102

Helping Others Heal: Burn Survivors and Peer Support  

Microsoft Academic Search

Burns require psychosocial healing in addition to physical recovery as survivors face challenges such as scarring and altered appearance. An adjunct to interventions provided by social workers and other professionals is peer support from fellow burn survivors. But how do burn survivors view this intervention? This study examined a sample of burn survivors to learn about their views of peer

Karen Badger; David Royse

2010-01-01

103

Laser treatment of hypertrophic scars  

NASA Astrophysics Data System (ADS)

For prophylaxis and treatment, the pulsed solid state neodymium yttrium-aluminum garnet laser was used. It has been shown that this kind of radiation inhibits the proliferative process and prevents the scar hyperfibrotization. In this paper author's reports about the development of the method for improving the scar quality using Nd:YAG laser are presented.

Dobrjakova, Olga B.; Gulev, Valerii S.

2001-10-01

104

Laser CO2 versus radiotherapy in treatment of keloid scars.  

PubMed

Keloids and hypertrophic scars are quite common diseases that can occur after any kind of wound and skin inflammation in predisposed individuals. Despite their benign nature, they can be aesthetically disabling and they are often accompanied by unpleasant symptoms such pain, burning and itching. Several approaches have been tried but most of them with poor results. Ablative fractional CO(2) laser seems to be an encouraging approach in treatment of keloids and hypertrophic scars, not only for its efficacy, but also for its low harmfulness. Radiotherapy following surgical excision is commonly used to treat these scars, but an increased incidence of different kinds of cancer from radiation has been demonstrated in several cases. Compared to radiotherapy, the use of CO(2) laser after surgical excision of keloids has shown great results with no recurrence and without the risk of carcinogenesis. PMID:22384790

Scrimali, Luca; Lomeo, Giuseppe; Tamburino, Serena; Catalani, Alexei; Perrotta, Rosario

2012-04-01

105

[Clinical aspects of corneal burns].  

PubMed

Clinical aspects and prognosis of corneal burns mainly depend on the agent responsible for the trauma. The most severe burns are caustic burns, which should be classified as burns caused by basic agents, associated with deep and prolonged injuries, and burns caused by acidic agents, associated with more superficial injuries. At the acute stage, caustic burns induce epithelial defects, corneal edema, and ischemic necrosis of the limbus, conjunctiva, iris and ciliary body. At the early stage, reepithelialization occurs and is often associated with corneal vascularization and stromal infiltrates, followed by corneal scar formation. At the chronic stage, the following complications are possible: corneal scars, limbal stem cell insufficiency, lachrymal insufficiency, irregular astigmatism, ocular surface fibrosis, cataract, glaucoma, decreased intraocular pressure, and ocular atrophy. The Ropper-Hall classification is based on the extent of limbal ischemia. Thermal burns induce epithelial defects at the acute stage, with the more severe forms giving the same complications as caustic burns. Radiation-related burns can be caused by ultraviolet radiations (acute epithelial keratitis, pterygium, droplet-like keratitis), microwaves, infrared radiations, ionizing radiations or, laser radiations. Electrical burns are often a result of torture and give corneal stroma opacification. PMID:15687932

Borderie, V

2004-12-01

106

Pulmonary non-tuberculous mycobacterial infection in congenital contractural arachnodactyly.  

PubMed

Congenital contractural arachnodactyly (CCA) is caused by mutations within the fibrillin-2 gene (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 had pulmonary non-tuberculous mycobacteria (NTM) infection. The population with pulmonary NTM 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 NTM infection in the majority of cases, the overlap between these two diseases suggests some shared pathophysiology. PMID:22325249

Paulson, M L; Olivier, K N; Holland, S M

2012-04-01

107

Prenatal ultrasound findings in a fetus with congenital contractural arachnodactyly.  

PubMed

Congenital contractural arachnodactyly (CCA) or Beals-Hecht syndrome is an autosomal dominant disorder caused by mutations in the fibrillin-2 (FBN2) gene. The principal features of CCA are a marfanoid habitus, multiple congenital contractures, camptodactyly, arachnodactyly, kyphoscoliosis, muscular hypoplasia, and external ear malformations. Our case is the first that shows typical sonographic signs in a fetus at 25 weeks' gestation with molecular genetically verified CCA in a large family with many members affected over four generations. This demonstrates that CCA can be detected prenatally by non-invasive ultrasonography. The importance of confirmation of CCA by means of DNA sequence analysis of the FBN2 gene is stressed. PMID:12383326

Kölble, N; Wisser, J; Babcock, D; Maslen, C; Huch, R; Steinmann, B

2002-10-01

108

Secret scar free gracilis flap.  

PubMed

The gracilis free flap is a workhorse in plastic surgery. We present a modified technique that relies on a single horizontal thigh-lift-type approach, which (1) gives wide pedicle exposure, (2) provides material for skin grafting, and (3) allows for distal flap transection without an additional incision. Eighteen gracilis free flaps were performed from 2007 to 2009 for lower extremity reconstruction. Complete flap survival was observed in 17 patients with one partial necrosis distally. Our approach allowed access to divide the distal gracilis tendon without a second incision in all cases. The mean scar length was 16 ± 3 cm and no hypertrophic scars were observed. In 15 patients, no visible scar was observed in the upright position, and in three patients, the scar was visible dorsally (2 ± 1 cm). No sensory deficits were observed 6 months postoperatively. In addition, the split-thickness skin graft harvested from the skin paddle was sufficient to cover all defects. PMID:22588799

Tremp, Mathias; Wettstein, Reto; Raffoul, Wassim; Schaefer, Dirk J; Kalbermatten, Daniel F

2012-06-01

109

New Innovations in Scar Management  

Microsoft Academic Search

.   As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating\\u000a line between acceptable and unacceptable aesthetic results. With this in mind, a scar management program has been adopted\\u000a based on the modalities of wound support, hydration, and hastened maturity, all factors gleaned from scientific evidence published\\u000a over the past 25

Alan D. Widgerow; Laurence A. Chait; Rene Stals; Pieter J. Stals

2000-01-01

110

Leg contracture in mice: an assay of normal tissue response  

Microsoft Academic Search

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

Helen B. Stone

1984-01-01

111

Breast capsule contracture: Is fibroblast activity associated with severity?  

Microsoft Academic Search

Factors responsible for breast capsule contracture remain elusive. Using an in vitro model of wound contraction, the fibroblast-populated collagen lattice (FPCL), breast capsule fibroblasts and control dermal fibroblasts from ten patients were analyzed. Comparison was made to determine (1) if the activity of dermal fibroblasts on a collagen lattice correlated with the activity of breast capsule fibroblasts or if capsular

Sandra J. Piscatelli; Marshall Partington; Craig Hobar; Patrice Gregory; John W. Siebert

1994-01-01

112

Burn Institute  

MedlinePLUS

... do each year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute ... thousands of children and adults each year through fire and burn prevention education, burn survivor support programs ...

113

Scar remodeling after strabismus surgery.  

PubMed Central

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

Ludwig, I H

1999-01-01

114

The hair color-highlighting burn: a unique burn injury.  

PubMed

A unique, preventable, 2.8 x 3.7-cm, full-thickness scalp burn resulted after a woman underwent a professional color-highlighting procedure at a hair salon. The burn appeared to result from scalp contact with aluminum foil that had been overheated by a hair dryer during the procedure. The wound required debridement and skin grafting and 3 subsequent serial excisions to eliminate the resulting area of burn scar alopecia. The preventive aspects of this injury are discussed. PMID:10752740

Peters, W

2000-01-01

115

MISR Views a Fire-Scarred Landscape  

NASA Technical Reports Server (NTRS)

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.

2000-01-01

116

Hair bleaching and skin burning  

PubMed Central

Summary Hairdressing-related burns are preventable and therefore each case is one too many. We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond and placed under a dryer to accelerate the highlighting procedure. The wound on the nape of the neck required surgical debridement and skin grafting. The grafted area resulted in subsequent scar formation. PMID:23766754

Forster, K.; Lingitz, R.; Prattes, G.; Schneider, G.; Sutter, S.; Schintler, M.; Trop, M.

2012-01-01

117

Neonatal Volkmann Ischemic Contracture: Case Report and Review of Literature  

PubMed Central

Background?Neonatal Volkmann ischemic contracture in newborns is a devastating condition with lifelong consequences. Case Report?We report a neonate born with necrotic skin lesions and bullae on right dorsal thenar aspect of hand, who subsequently developed compartment syndrome requiring fasciotomy. Review and Conclusion?Necrotic skin lesions with/without swelling, bullae are invariably present at birth in these patients and should be recognized as a sentinel finding of underlying tissue ischemia/compartment syndrome. Early recognition and prompt surgical intervention can be limb saving. A range of radiologic abnormalities and contractures were noted in upto 84% of such patients followed long term. Hence, we recommend close follow-up until occurrence of epiphyseal fusion in these patients.

Agrawal, Hitesh; Dokania, Gunjan; Wu, Shou-Yien

2014-01-01

118

Two novel fibrillin-2 mutations in congenital contractural arachnodactyly.  

PubMed

Congenital contractural arachnodactyly (CCA) is an autosomal dominant connective tissue disorder, comprising marfanoid habitus, flexion contractures, severe kyphoscoliosis, abnormal pinnae, and muscular hypoplasia. It is now known that mutations in the gene encoding fibrillin-2 cause CCA. Interestingly, mutations described to date cluster in the fibrillin-2 region homologous to the so-called neonatal Marfan syndrome region of fibrillin-1. Thus, it has been hypothesized that the relative infrequency of CCA compared with the Marfan syndrome is due to the limited region of the gene targeted for mutations. In support of the above hypothesis, we report here the finding of two additional FBN2 mutations in CCA, C1141F (exon 26) and C1252W (exon 29). In addition, a new 3' UTR polymorphism is also described. PMID:10797416

Belleh, S; Zhou, G; Wang, M; Der Kaloustian, V M; Pagon, R A; Godfrey, M

2000-05-01

119

Overstretching of sarcomeres may not cause cerebral palsy muscle contracture  

Microsoft Academic Search

To answer the question whether the muscle contracture in patients with cerebral palsy is caused by overstretching of in-series sarcomeres we studied the active and passive force–length relationship of the flexor carpi ulnaris muscle (FCU) in relation to its operating length range in 14 such patients with a flexion deformity of the wrist.Force–length relationship was measured intra-operatively using electrical stimulation,

Mark J. C. Smeulders; Michiel Kreulen; J. Joris Hage; Peter A. Huijing; Chantal M. A. M. van der Horst

2004-01-01

120

Biologicals and Fetal Cell Therapy for Wound and Scar Management  

PubMed Central

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

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

2011-01-01

121

Modified Dovetail-Plasty in Scar Revision  

PubMed Central

Abstract Scar revision is one of the fundamental techniques in the field of plastic and reconstructive surgery. Local flaps, such as a Z-plasty, W-plasty, or geometric broken-line closure, have been used for scar revision. Camouflaging a scar during scar revision for marginal scars from skin grafts and flaps, trapdoor scars, and linear scars is difficult. We describe our experience with the use of modified dovetail-plasty for scar revision in these difficult areas. Our study group consisted of 28 cases among 22 patients (9 males and 13 females) with a mean age of 33.6 years (range, 6–61 years). The conspicuous scars were located on the face (50%) and extremities (50%). The authors designed Y-shaped incision lines to relax the skin tension lines on one side of the excision line and trapezoid incision lines on the other side. There were 16 follow-up operations performed over 6 months after the initial operation among a total of 22 patients. There were scar depressions (2 patients) and a hypertrophic scar (1 patient) at the interval area between the dovetail flaps. A diffuse hypertrophic scar occurred in 1 patient with a dorsal foot scar. The overall success rates of the procedure as assessed by the surgeons were as follows: excellent (75%), good (12.4%), fair (6.3%), and poor (6.3%). This new local flap can achieve an inconspicuous scar using a blurred scar line and reducing tension. The authors recommend a modified dovetail-plasty for the revision of trapdoor scars and scars under excessive tension. PMID:24577307

Oh, Suk Joon; Yang, Jihoon; Kim, Seon Gyu; Jung, Sung Won; Koh, Sung Hoon

2014-01-01

122

Post-Radical-Prostatectomy Urinary Incontinence: The Management of Concomitant Bladder Neck Contracture  

PubMed Central

Urinary incontinence postradical prostatectomy is a common problem which adversely affects quality of life. Concomitant bladder neck contracture in the setting of postprostatectomy incontinence represents a challenging clinical problem. Postprostatectomy bladder neck contracture is frequently recurrent and makes surgical management of incontinence difficult. The aetiology of bladder neck contracture and what constitutes the optimum management strategy are controversial. Here we review the literature and also present our approach. PMID:22611382

King, Thomas; Almallah, Y. Zaki

2012-01-01

123

A Second Trimester Caesarean Scar Pregnancy  

PubMed Central

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

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

2014-01-01

124

Two dimensional unstable scar statistics.  

SciTech Connect

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.

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

2006-12-01

125

A historical review of compartment syndrome and Volkmann's ischemic contracture.  

PubMed

Compartment syndrome has been a recognized disease entity since the mid-nineteenth century. Extensive research and clinical observation have allowed for a better understanding of this uniquely complex disease process. Outstanding contributions by clinicians over the past century have provided the basis for our current perspective on its pathogenesis, diagnosis, and treatment. Although Volkmann's early reference to increased "pressure" as the cause of this syndrome was made over 100 years ago, today's modern concept of treatment to prevent contracture based on increased intracompartment pressure has evolved only through the combined efforts of various committed clinicians during the past century. PMID:9742414

Trice, M; Colwell, C W

1998-08-01

126

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

PubMed

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

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

2001-04-01

127

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

PubMed

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

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

2008-12-01

128

Scar-free healing: from embryonic mechanisms to adult therapeutic intervention.  

PubMed Central

In man and domestic animals, scarring in the skin after trauma, surgery, burn or sports injury is a major medical problem, often resulting in adverse aesthetics, loss of function, restriction of tissue movement and/or growth and adverse psychological effects. Current treatments are empirical, unreliable and unpredictable: there are no prescription drugs for the prevention or treatment of dermal scarring. Skin wounds on early mammalian embryos heal perfectly with no scars whereas wounds to adult mammals scar. We investigated the cellular and molecular differences between scar-free healing in embryonic wounds and scar-forming healing in adult wounds. Important differences include the inflammatory response, which in embryonic wounds consists of lower numbers of less differentiated inflammatory cells. This, together with high levels of morphogenetic molecules involved in skin growth and morphogenesis, means that the growth factor profile in a healing embryonic wound is very different from that in an adult wound. Thus, embryonic wounds that heal without a scar have low levels of TGFbeta1 and TGFbeta2, low levels of platelet-derived growth factor and high levels of TGFbeta3. We have experimentally manipulated healing adult wounds in mice, rats and pigs to mimic the scar-free embryonic profile, e.g. neutralizing PDGF, neutralizing TGFbeta1 and TGFbeta2 or adding exogenous TGFbeta3. These experiments result in scar-free wound healing in the adult. Such experiments have allowed the identification of therapeutic targets to which we have developed novel pharmaceutical molecules, which markedly improve or completely prevent scarring during adult wound healing in experimental animals. Some of these new drugs have successfully completed safety and other studies, such that they have entered human clinical trials with approval from the appropriate regulatory authorities. Initial trials involve application of the drug or placebo in a double-blind randomized design, to experimental incision or punch biopsy wounds under the arms of human volunteers. Based on encouraging results from such human volunteer studies, the lead drugs have now entered human patient-based trials e.g. in skin graft donor sites. We consider the evolutionary context of wound healing, scarring and regeneration. We hypothesize that evolutionary pressures have been exerted on intermediate sized, widespread, dirty wounds with considerable tissue damage e.g. bites, bruises and contusions. Modem wounds (e.g. resulting from trauma or surgery) caused by sharp objects and healing in a clean or sterile environment with close tissue apposition are new occurrences, not previously encountered in nature and to which the evolutionary selected wound healing responses are somewhat inappropriate. We also demonstrate that both repair with scarring and regeneration can occur within the same animal, including man, and indeed within the same tissue, thereby suggesting that they share similar mechanisms and regulators. Consequently, by subtly altering the ratio of growth factors present during adult wound healing, we can induce adult wounds to heal perfectly with no scars, with accelerated healing and with no adverse effects, e.g. on wound strength or wound infection rates. This means that scarring may no longer be an inevitable consequence of modem injury or surgery and that a completely new pharmaceutical approach to the prevention of human scarring is now possible. Scarring after injury occurs in many tissues in addition to the skin. Thus scar-improving drugs could have widespread benefits and prevent complications in several tissues, e.g. prevention of blindness after scarring due to eye injury, facilitation of neuronal reconnections in the central and peripheral nervous system by the elimination of glial scarring, restitution of normal gut and reproductive function by preventing strictures and adhesions after injury to the gastrointestinal or reproductive systems, and restoration of locomotor function by preventing scarring in tendons and ligaments. PMID:15293811

Ferguson, Mark W J; O'Kane, Sharon

2004-01-01

129

Modulation of scar tissue formation using different dermal regeneration templates in the treatment of experimental full-thickness wounds  

Microsoft Academic Search

The recovery of skin function is the goal of each burn surgeon. Split-skin graft treatment of full-thickness skin defects leads to scar formation, which is often vulnerable and instable. Therefore, the aim of this study was to analyze wound healing and scar tissue formation in acute full-thickness wounds treated with clinically available biopolymer dermal regeneration templates. Full-thickness wounds (3 x

Daniel Druecke; Evert N. Lamme; Sonja Hermann; Jeroen Pieper; Paul S. May; Hans-Ulrich Steinau; Lars Steinstraesser

2004-01-01

130

Scars  

MedlinePLUS

... damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkled Skin Treatments and Procedures Ambulatory Phlebectomy Blepharoplasty ... damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkled Skin Treatments and Procedures Ambulatory Phlebectomy Blepharoplasty ...

131

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

NASA Technical Reports Server (NTRS)

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.

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

132

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol--Surgical Treatment of Neurological Hip Flexion Contracture  

PubMed Central

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

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

2014-01-01

133

Burns: Treatment and Outcomes  

PubMed Central

Burns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft tissues, and the methods used will depend very much on the extent of scarring locally and elsewhere in the body. In nearly all cases, a significant improvement in functional and aesthetic outcomes can be achieved, which, in conjunction with intensive psychosocial rehabilitation, can lead to high-quality patient outcomes. With the prospect of facial transplantation being a clinical reality, the reconstructive spectrum has opened up even further, and, with appropriate reconstruction and support, no patient should be left economically deprived or socially isolated after a burn injury. PMID:22550448

Burd, Andrew

2010-01-01

134

Acne Scars: Pathogenesis, Classification and Treatment  

PubMed Central

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

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

2010-01-01

135

Amniotic membrane transplantation for acute chemical or thermal burns  

Microsoft Academic Search

In acute burns, amniotic membrane transplantation can be considered as an early, if not immediate, surgical procedure to promote epithelialization and suppress inflammation so that scarring-induced sequelae can be prevented in the chronic stage. %Purpose: To determine whether preserved human amniotic membrane (AM) can be used to treat ocular burns in the acute stage.

Daniel Meller; Renato T. F Pires; Robert J. S Mack; Francisco Figueiredo; Arnd Heiligenhaus; Woo Chan Park; Pinnita Prabhasawat; Thomas John; Stephen D McLeod; Klaus P Steuhl; Scheffer C. G Tseng

2000-01-01

136

Focal adhesion kinase (FAK) siRNA inhibits human hypertrophic scar by suppressing integrin ?, TGF-? and ?-SMA.  

PubMed

The effect of focal adhesion kinase (FAK) on suppressing scarring and the potential molecular mechanism underlying it has been investigated. Ten samples of human hypertrophic scars (HS) tissue cultured in vitro were transfected with FAK siRNA mediated by liposome. Quantitative real-time PCR was used to detect the expression of integrin ?, transforming growth factor-? (TGF-?), FAK and ?-smooth muscle actin (?-SMA) after transfection. MTT assay was used as a measure of fibroblast proliferation. Flow cytometry and (3)H-proincorporation technique gave measurements of the cell cycle and the quantity of collagen synthesis, respectively. Expression of FAK was effectively blocked, accompanied by decreasing expression of integrin ?, TGF-? and ?-SMA in hypertrophic scars fibroblast (HSFB) cells. One to 4?h after transfection with FAK siRNA, proliferation of HSFB cells was strongly inhibited (P?contracture of the scar, making FAK iRNA therapy a potentially effective approach in HS treatment. PMID:24523242

Chen, Rui; Zhang, Zhiliang; Xue, Zhujia; Wang, Lin; Fu, Mingang; Lu, Yi; Bai, Ling; Zhang, Dongqing; Fan, Zhihong

2014-07-01

137

Burn wound: How it differs from other wounds?  

PubMed Central

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

Tiwari, V. K.

2012-01-01

138

Review of the female Duroc/Yorkshire pig model of human fibroproliferative scarring  

PubMed Central

Hypertrophic scarring after burns is an unsolved problem and remains as devastating today as it was in the 40s and it may be that the main reason for this is the lack of an accepted, useful animal model. The female, red Duroc pig was described as a model of hypertrophic scarring nearly 30 years ago but then vanished from the literature. This seemed strange since the authors reported that 12 of 12 pigs developed thick scar. In the mid 90s we explored the model and found that, indeed, the red Duroc pig does make thick scar. Other authors have established that the Yorkshire pig does not heal in this fashion so there is the possibility of a same species control. We have continued to explore the Duroc/Yorkshire model and herein describe our experiences. Is it a perfect model of hypertrophic scarring? No. Is it a useful model of hypertrophic scarring? Time will tell. We have now obtained gene expression data from the Duroc/Yorkshire model and analysis is underway. PMID:17727465

Zhu, Kathy Q.; Carrougher, Gretchen J.; Gibran, Nicole S.; Isik, F. Frank; Engrav, Loren H.

2010-01-01

139

[Dupuytren's contracture: percutaneous needle aponeurotomy is an alternative to surgery].  

PubMed

Dupuytren's contracture is a retractile fibrosis of the superficial palmar aponeurosis of the hand, resulting in a progressive and fixed flexion of the fingers that may result in severe limitation of hand function. It affects several millions of people in Europe and North America. Risk factors are genetic and sometimes related to mellitus diabetes. There is no spontaneous remission. Until recently, surgery was the only treatment, but now needle aponeurotomy emerges as a therapeutic alternative. It should be performed as first line treatment by a trained practitioner. Short and long-term results of needle aponeurotomy appear identical to those of surgery, with milder complications. It is indicated in palmar, palmo-digital, as well as in strictly digital forms of the disorder. The "table-test" is used to assess the loss of extension of the digit and to select the indication to needle aponeurotomy. A medico-surgical consensus should define the optimum treatment strategy in this affection. PMID:20828892

Manet, M-P; Roulot, E; Teyssedou, J-P; Lahalle, S; Ziza, J-M

2011-04-01

140

Unusual explosive growth of a squamous cell carcinoma of the scalp after electrical burn injury and subsequent coverage by sequential free flap vascular connection – a case report  

Microsoft Academic Search

BACKGROUND: Squamous cell carcinomos may arise from chronic ulcerating wounds in scars, most commonly postburn scars. Tumour growth usually takes place over months to years. Localization on the scalp is a relatively rare condition. CASE PRESENTATION: This report presents the case of a 63-year-old man with chronic ulceration of a postburn scar of the scalp due to an electrical burn

Raymund E Horch; G Bjoern Stark; Justus P Beier

2005-01-01

141

Knee flexion contracture in haemophilia: treatment with circular external fixator.  

PubMed

Haemophilia, a bleeding disorder, causes recurrent intra-articular bleeding of the joints result-ing in chronic haemophilic arthropathy with fixed knee flexion deformity. Mid-long-term results (between 2002 and 2006) of deformity correction in haemophilic patients with Ilizarov type circular external fixators were retrospectively evaluated. There were six patients (five haemophilia A and one haemophilia B). The mean age was 14.7 years (range, 8-22 years) at the time of initial surgery. The mean knee flexion contracture was 45 degrees (range, 30-75 degrees). The mean arc of motion was 58.3 degrees (range, 40-100) before the surgery. The mean duration of follow-up was 8 years (range, 5.5-10 years). The mean duration of external fixation was 4.4 months (range, 2.5-10.5 months). Full extension of the knee joint was obtained in all patients in the early postoperative period. No bleeding, neurological or vascular complications were encountered. The mean amount of recurrence in knee flexion contracture was 10 degrees (range, 0-15 degrees). The amount of the correction was significant (P = 0.0012) and the mean arc of motion was 51.6 degrees (range, 25-90 degrees) that show a decrease of 6.7 degrees (P = 0.04) at the end of follow-up. The circular external fixator is an important, safe and less invasive alternative surgical treatment modality with low recurrence rate. Using the external hinges and distraction during the correction has a protective effect on the joint. It requires a team-work consisting of a haematologist, an orthopaedic surgeon and a physical therapist. PMID:25143070

Balci, H I; Kocaoglu, M; Eralp, L; Bilen, F E

2014-11-01

142

Case of extreme growth deceleration after burns.  

PubMed

Studies have demonstrated deceleration in both weight and height following burns in children. It is expected patients will display catch up growth and return to normal weight within three years but continued height deficiency may remain in cases of severe burns. We describe a case of severe growth retardation of 8 years old orphan child from Ukraine who suffered of burn less than 40% of total body surface area when he was a 3 years of life. His case was complicated by domestic abuse, neglect and limited medical care. He initially presented to the United States for surgical care of his contractures but his treatment quickly focused on his profound growth retardation. Despite aggressive nutritional supplementation and evaluation he did not demonstrate any weight gain. PMID:24268621

Bline, Cheryl; Dylewski, Maggie L; Driscoll, Daniel N; Fuzaylov, Gennadiy

2014-05-01

143

Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery  

Microsoft Academic Search

Adequate acute treatment of the deeply burned hand and any subsequent reconstructive procedures may be hampered by the lack of sufficient suitable graft material and the risks of donor site morbidity and scarring. This investigation was designed to determine the feasibility of treating deep hand burns using a dermal regeneration template. Patients with deep hand burns underwent either acute treatment

E Dantzer; P Queruel; L Salinier; B Palmier; J. F Quinot

2003-01-01

144

Decorative tattooing for scar camouflage: patient innovation.  

PubMed

Dermatography has been used in medicine both for aesthetic purposes as permanent make-up or for coverage of scars, defects and skin colour abnormalities. These procedures demand skill and usually more than one session to achieve the desired result. We present an innovative idea from some of our plastic surgery patients to camouflage their scars using decorative tattooing done by non-medical professional tattooists. Long abdominal scars were covered with symmetrical tattoo designs rendering the scars inconspicuous even on close inspection. As tattooing is less of a social taboo nowadays and, indeed, quite acceptable among many of the younger generations, this method could be presented as an option to camouflage scars of the trunk and the limbs that are unacceptable or undesirable, especially in patients who already have tattoos on other parts of their bodies. PMID:18640088

Spyropoulou, G A; Fatah, F

2009-10-01

145

American Journal of Medical Genetics 130A:272276 (2004) Homozygosity Mapping of Lethal Congenital Contractural  

E-print Network

a novel autosomal recessive disorder, lethal congenital contractural syndrome type 2 (LCCS2) (OMIM 607598) is an autosomal recessive syndrome prevalent Fig. 1. Pedigrees of Israeli-Bedouin kindreds affected with LCCS2

Friedman, Nir

146

Burns (image)  

MedlinePLUS

... skin (epidermis) and cause pain, redness and swelling (erythema). Second degree burns damage the epidermis and the inner layer, the dermis, causing erythema and blistering. Damage from third degree burns extend ...

147

Monolateral external fixation for the progressive correction of neurological spastic knee flexion contracture in children  

Microsoft Academic Search

The purpose of this study was to report the results of the surgical treatment of spastic knee flexion contracture using tenotomy\\u000a and progressive correction by external fixator–distractor devices. The study design involved a prospective observational study\\u000a of 16 knees in nine patients with spastic flexion contracture greater than 30°. Treatment was indicated for both ambulatory\\u000a and nonambulatory patients; and, in

Pedro Gutiérrez Carbonell; Jose Valiente Valero; Pedro Doménech Fernández; Javier Roca Vicente-Franqueira

2007-01-01

148

Sonographic analyses of pulley and flexor tendon in idiopathic trigger finger with interphalangeal joint contracture.  

PubMed

This study investigated the sonographic appearance of the pulley and flexor tendon in idiopathic trigger finger in correlation with the contracture of the interphalangeal (IP) joint in the thumb or proximal IP (PIP) joint in the other digits. Sonographic measurements using axial images were performed in 177 affected digits including 17 thumbs and 34 other digits judged to have IP or PIP joint contracture and 77 contralateral control digits. The A1 pulley of the contracture group was significantly thicker than that of the non-contracture group in all digits, whereas the flexor tendon was thicker only in digits other than the thumb. In the analysis using calculated cut-off values, A1 pulley thickening in the thumb and A1 pulley and flexor tendon thickening in the other digits showed statistically significant correlations with IP or PIP joint contracture. This study sonographically confirmed previous reports showing that enlargement of the flexor tendons contribute to the pathogenesis of PIP joint contracture. PMID:24613641

Sato, Junko; Ishii, Yoshinori; Noguchi, Hideo; Takeda, Mitsuhiro

2014-06-01

149

Dupuytren’s Contracture in Alabama HFE Hemochromatosis Probands  

PubMed Central

Background Dupuytren’s contracture (DC) and HFE hemochromatosis occur in some of the same at-risk populations and present with similar comorbid conditions. Methods We estimated DC prevalence in two cohorts of white Alabama hemochromatosis probands (294 C282Y homozygotes, 67 C282Y/H63D compound heterozygotes) in a retrospective study. We performed logistic regressions on DC using the following independent variables: age, body mass index, heavy ethanol consumption, serum ferritin, elevated serum AST/ALT, non-alcoholic fatty liver disease, viral hepatitis, cirrhosis, and diabetes. Results One man and two women with C282Y homozygosity had DC (prevalence 1.02%; 95% CI 0.35%–2.96%). A man with C282Y/H63D had DC (prevalence 1.49%; 95% CI 0.26%–7.98%). DC occurred as an autosomal dominant trait in his kinship. In regression analyses, no single variable predicted DC. We observed no new DC cases after the diagnosis of hemochromatosis (mean follow-up 12.9 ± 7.5 years (1 SD), and 9.0 ± 5.1 years, respectively). Conclusions Our prevalence estimates of DC in white Alabama hemochromatosis probands are similar to those found in the white US population cohorts. DC risk was unrelated to the variables we studied. PMID:22952417

Barton, James C.; Barton, J. Clayborn

2012-01-01

150

Intelligent stretching of ankle joints with contracture/spasticity.  

PubMed

An intelligent stretching device was developed to treat the spastic/contractured ankle of neurologically impaired patients. The device stretched the ankle safely throughout the range of motion (ROM) to extreme dorsiflexion and plantarflexion until a specified peak resistance torque was reached with the stretching velocity controlled based on the resistance torque. The ankle was held at the extreme position for a period of time to let stress relaxation occur before it was rotated back to the other extreme position. Stretching was slow at the joint extreme positions, making it possible to reach a larger ROM safely and it was fast in the middle ROM so the majority of the treatment was spent in stretching the problematic extreme ROM. Furthermore, the device evaluated treatment outcome quantitatively in multiple aspects, including active and passive ROM, joint stiffness and viscous damping and reflex excitability. The stretching resulted in considerable changes in joint passive ROM, stiffness, viscous damping and reflex gain. The intelligent control and yet simple design of the device suggest that with appropriate simplification, the device can be made portable and low cost, making it available to patients and therapists for frequent use in clinics/home and allowing more effective treatment and long-term improvement. PMID:12503779

Zhang, Li-Qun; Chung, Sun G; Bai, Zhiqiang; Xu, Dali; van Rey, Elton M T; Rogers, Mark W; Johnson, Marjorie E; Roth, Elliot J

2002-09-01

151

Fibroblasts from phenotypically normal palmar fascia exhibit molecular profiles highly similar to fibroblasts from active disease in Dupuytren's Contracture  

PubMed Central

Background Dupuytren's contracture (DC) is a fibroproliferative disorder characterized by the progressive development of a scar-like collagen-rich cord that affects the palmar fascia of the hand and leads to digital flexion contractures. DC is most commonly treated by surgical resection of the diseased tissue, but has a high reported recurrence rate ranging from 27% to 80%. We sought to determine if the transcriptomic profiles of fibroblasts derived from DC-affected palmar fascia, adjacent phenotypically normal palmar fascia, and non-DC palmar fascial tissues might provide mechanistic clues to understanding the puzzle of disease predisposition and recurrence in DC. Methods To achieve this, total RNA was obtained from fibroblasts derived from primary DC-affected palmar fascia, patient-matched unaffected palmar fascia, and palmar fascia from non-DC patients undergoing carpal tunnel release (6 patients in each group). These cells were grown on a type-1 collagen substrate (to better mimic their in vivo environments). Microarray analyses were subsequently performed using Illumina BeadChip arrays to compare the transcriptomic profiles of these three cell populations. Data were analyzed using Significance Analysis of Microarrays (SAM v3.02), hierarchical clustering, concordance mapping and Venn diagram. Results We found that the transcriptomic profiles of DC-disease fibroblasts and fibroblasts from unaffected fascia of DC patients exhibited a much greater overlap than fibroblasts derived from the palmar fascia of patients undergoing carpal tunnel release. Quantitative real time RT-PCR confirmed the differential expression of select genes validating the microarray data analyses. These data are consistent with the hypothesis that predisposition and recurrence in DC may stem, at least in part, from intrinsic similarities in the basal gene expression of diseased and phenotypically unaffected palmar fascia fibroblasts. These data also demonstrate that a collagen-rich environment differentially alters gene expression in these cells. In addition, Ingenuity pathway analysis of the specific biological pathways that differentiate DC-derived cells from carpal tunnel-derived cells has identified the potential involvement of microRNAs in this fibroproliferative disorder. Conclusions These data show that the transcriptomic profiles of DC-disease fibroblasts and fibroblasts from unaffected palmar fascia in DC patients are highly similar, and differ significantly from the transcriptomic profiles of fibroblasts from the palmar fascia of patients undergoing carpal tunnel release. PMID:22559715

2012-01-01

152

Global Burned Area and Biomass Burning Emissions from Small Fires  

NASA Technical Reports Server (NTRS)

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.

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

2012-01-01

153

Global burned area and biomass burning emissions from small fires  

NASA Astrophysics Data System (ADS)

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.

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

2012-12-01

154

A retrospective review of burn dressings on a porcine burn model.  

PubMed

This is a study to compare wound healing among three types of dressings on a porcine model with deep-dermal-partial-thickness burns. The burns in this study were from eight animal trials conducted in the past for other purposes and only burns with a uniform pale appearance that had served as controls in original experiments were selected. In total, there were 57 burns in 33 pigs, using one of following three dressings: Acticoat (Silver) (3 trials), Jelonet (Gauze) (3 trials), and Solosite Gel/Jelonet (Gel/Gauze) (2 trials). The wound healing assessments included wound re-epithelialisation during a 6-week period, clinical and histological scar assessments at week 6 after burn. Of all wound healing/scar assessments, only re-epithelialisation showed statistical difference between dressings. Earlier re-epithelialisation was observed in Gel/Gauze dressings compared to Silver and/or Gauze dressings. However, this study revealed huge variation in wound healing outcome between 3 trials within both Silver and/or Gauze dressings, supported by significant differences on re-epithelialisation, clinical and histological scar measurements. In addition, it was found that larger animals healed better than smaller ones, based on weights from 21 pigs. Of all dressings, Silver delivers the best protection for wound colonization/infection. Wound colonization/infection was found to confine wound healing and lead to thinner RND in scars. From this study, we cannot find enough evidence to suggest the beneficial effect of one dressing(s) over others on burn wound healing outcome on a porcine model with small deep-dermal-partial-thickness burns with a relative small sample size. PMID:19864074

Wang, Xue-Qing; Kravchuk, Olena; Kimble, Roy M

2010-08-01

155

Synthetic TGF-b antagonist accelerates wound healing and reduces scarring  

Microsoft Academic Search

Wound healing consists of re-epithelialization, contraction and formation of granulation and scar tissue. TGF-? is involved in these events, but its exact roles are not well understood. Here we demonstrate that topical application of a synthetic TGF-? antagonist accelerates re-epithelialization in pig burn wounds (100% re-epithelialization in antagonist-treated wounds vs. ~ 70% re- epithelialization in control wounds on postburn day

Jung San Huang; Yao-Horng Wang; Thai-Yen Ling; Shiow-Shuh Chuang; Frank E. Johnson; Shuan Shian Huang

2002-01-01

156

9 CFR 11.3 - Scar rule.  

Code of Federal Regulations, 2013 CFR

... Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS...prohibitions of section 5 of the Act. The scar rule criteria...

2013-01-01

157

9 CFR 11.3 - Scar rule.  

Code of Federal Regulations, 2012 CFR

... Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS...prohibitions of section 5 of the Act. The scar rule criteria...

2012-01-01

158

9 CFR 11.3 - Scar rule.  

Code of Federal Regulations, 2011 CFR

... Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS...prohibitions of section 5 of the Act. The scar rule criteria...

2011-01-01

159

9 CFR 11.3 - Scar rule.  

... Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS...prohibitions of section 5 of the Act. The scar rule criteria...

2014-01-01

160

9 CFR 11.3 - Scar rule.  

Code of Federal Regulations, 2010 CFR

... Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE HORSE PROTECTION REGULATIONS...prohibitions of section 5 of the Act. The scar rule criteria...

2010-01-01

161

Current Concepts in Scar Evolution and Control  

Microsoft Academic Search

The basic principles influencing scar expression and outcome have long been defined. Although these were relatively clear\\u000a at the time, the exact events at a molecular level were poorly defined. The past decade has delineated the myriad of events\\u000a that occur in the run-up to scar evolution far more clearly, although the intricate details have yet to be elucidated. What

Alan D. Widgerow

162

[International clinical recommendations on scar management].  

PubMed

Many techniques for management of hypertrophic scars and keloids have been proven through extensive use, but few have been supported by prospective studies with adequate control groups. Several new therapies showed good results in small-scale trials, but these have not been repeated in larger trials with long-term follow-up. This article reports a qualitative overview of the available clinical literature by an international panel of experts using standard methods of appraisal. The article provides evidence- based recommendations on prevention and treatment of abnormal scarring and, where studies are insufficient, consensus on best practice. The recommendations focus on the management of hypertrophic scars and keloids, and are internationally applicable in a range of clinical situations. These recommendations support a move to a more evidence-based approach in scar management. This approach highlights a primary role for silicon gel sheeting and intralesional corticosteroids in the management of a wide variety of abnormal scars. The authors concluded that these are the only treatments for which sufficient evidence exists to make evidence-based recommendations. A number of other therapies that are in common use have achieved acceptance by the authors as standard practice. However, it is highly desirable that many standard practice and new emerging therapies undergo large-scale studies with long-term follow-up before being recommended conclusively as alternative therapies for scar management. PMID:15354252

Ziegler, U E

2004-08-01

163

Benefits and pitfalls of vertical scar breast reduction  

Microsoft Academic Search

A quality assurance study was undertaken three years after beginning the vertical scar breast reduction technique. We examined the rate of early and late complications (major and minor) and compared these to the formerly used inverted-T scar and L scar breast reduction techniques. Inverted-T scar breast reductions have an early complication rate of up to 20% and a late complication

G. M Beer; I Spicher; K. A Cierpka; V. E Meyer

2004-01-01

164

Characterization of hyaluronan and TSG-6 in skin scarring: differential distribution in keloid scars, normal scars and unscarred skin  

PubMed Central

Background Hyaluronan (HA) is a major component of the extracellular matrix (ECM) with increased synthesis during tissue repair. Tumour necrosis factor-stimulated gene-6 (TSG-6) is known to catalyze the covalent transfer of heavy chains (HC1 and HC2) from inter-?-inhibitor (I?I) onto HA, and resultant HC•HA complexes have been implicated in physiological and pathological processes related to remodelling and inflammation. Objective The aims of this study were to determine the expression of HA, TSG-6 and the I?I polypeptides in unscarred skin, normal scars and keloid scars. Methods Formalin-fixed paraffin-embedded sections of unscarred skin, normal scars and keloid scars were prepared from patient samples collected during scar revision surgery. Haematoxylin and eosin, as well as immunofluorescent staining for HA, TSG-6 and the three polypeptide chains of I?I (i.e. HC1, HC2 and bikunin) were performed. Results All skin types stained positive for TSG-6, HC1, HC2 and bikunin, associated with keratinocytes, fibroblasts and skin appendages all in close proximity to HA. Keloid lesions showed altered HA organization patterns compared with unscarred skin and normal scars. TSG-6 staining was significantly more intense in the epidermis compared with the dermis of all sample types. There was a significant reduction in TSG-6 levels within keloid lesions compared with the dermis of unscarred skin (P = 0.017). Conclusion TSG-6 is expressed in unscarred skin, where its close association with HA and I?I could give rise to TSG-6-mediated HC•HA formation within this tissue. A reduction in the beneficial effects of TSG-6, caused by diminished protein levels in keloid lesions, could contribute to this abnormal scarring process. PMID:20642475

Tan, KT; McGrouther, DA; Day, AJ; Milner, CM; Bayat, A

2011-01-01

165

Burns Encyclopedia  

NSDL National Science Digital Library

Provide by Burns Country, this full-text, online version of "the definitive Robert Burns reference volume" serves as a useful handbook to Scotland's most famous poet and the intellectual circles in which he turned. The encyclopedia, which is in HTML format, is organized alphabetically. Burns Country offers a number of other related resources, chief among them a songs and poems archive containing 100 of the poet's works. Other features at the site include a discussion area, Burns and Scottish association links, and some commercial content.

Lindsay, Maurice.

166

Understanding burn severity sensing in Arctic tundra: exploring vegetation indices, suboptimal assessment timing and the impact of increasing pixel size  

Microsoft Academic Search

Little is known about how satellite imagery can be used to describe burn severity in tundra landscapes. The Anaktuvuk River Fire (ARF) in 2007 burned over 1000 km of tundra on the North Slope of Alaska, creating a mosaic of small (1 m) to large (>100 m) patches that differed in burn severity. The ARF scar provided us with an

Natalie T. Boelman; Adrian V. Rocha; Gaius R. Shaver

2011-01-01

167

Outcomes of outpatient management of pediatric burns.  

PubMed

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

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

2014-01-01

168

Inhibition of procollagen C-proteinase reduces scar hypertrophy in a rabbit model of cutaneous scarring.  

PubMed

Hypertrophic scarring, which results from excessive collagen deposition at sites of dermal wound repair, can be functionally and cosmetically debilitating to the surgical patient. Pharmacological regulation of collagen synthesis and deposition is a direct approach to the control of scar tissue formation. One of the key steps in collagen stabilization is the cleavage of the C-terminal propeptide from the precursor molecule to form collagen fibrils, a reaction catalyzed by procollagen C-proteinase (PCP). We tested the ability of a PCP inhibitor to reduce hypertrophic scar formation in a rabbit ear model. After the placement of four, 7-mm dermal wounds on each ear, New Zealand white rabbits received PCP inhibitor subcutaneously in the left ear at four time points postwounding: days 7, 9, 11, 13 (early treatment; n=20 wounds) or days 11, 13, 15, 17 (late treatment; n=20 wounds). The right ear of each animal served as a control (vehicle alone). Wounds were harvested on postoperative day 28 and scar hypertrophy quantified by measurement of the scar elevation index. Early treatment of wounds with PCP inhibitor did not reduce scar formation compared with controls (p>0.05). However, late treatment resulted in a statistically significant reduction in the scar elevation index (p<0.01). Our results point not only to the potential use of PCP inhibitors to mitigate hypertrophic scarring but also to the temporal importance of drug delivery for antiscarring therapy. PMID:16630102

Reid, Russell R; Mogford, Jon E; Butt, Richard; deGiorgio-Miller, Alex; Mustoe, Thomas A

2006-01-01

169

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

PubMed

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

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

2013-07-01

170

Evaluating evidence for atrophic scarring treatment modalities  

PubMed Central

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.

McGrouther, Duncan; Chakrabarty, Kaushik

2014-01-01

171

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

PubMed

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

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

2014-09-01

172

The Incidence of Burns Among Sex-Trafficking Victims in India  

PubMed Central

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

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

2014-01-01

173

Early second trimester uterine scar rupture.  

PubMed

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

Bharatnur, Sunanda; Hebbar, Shripad; Shyamala, G

2013-01-01

174

Modifications in vertical scar breast reduction.  

PubMed

The use of vertical-scar breast reduction techniques is only slowly increasing, even though they have been advocated by Lassus and Lejour and are requested by patients. Possible reasons why surgeons are reluctant to use these techniques are that they are said to be more difficult to learn, they require considerable experience and intuition, and their applicability is confined to small breasts. Several surgeons have developed modifications, combining vertical-scar breast reduction techniques with details of the familiar inverted-T-scar technique. We present a procedure involving two further modifications of the vertical-scar breast reduction technique: first, a standardised, geometrical preoperative drawing from our superior-pedicle T technique, with the aim of establishing a reproducible method of reduction requiring no particular intuitive touch, and, second, the addition of a periareolar skin resection, to give the breast the desired round shape. Between September 1998 and December 1999 we used this technique in a prospective series of 52 patients. The median resection weight was 450 g. The maximal postoperative follow-up was 15 months. There were no acute postoperative complications necessitating reoperation. The late complication rate was within the expected range for such procedures (seven patients, 13.5%) and included vertical-scar widening, areolar distortion, residual wrinkles due to incomplete shrinkage of the undermined skin in the inferior pole and asymmetry of the breast. This procedure enables us to offer patients with moderate to marked hypertrophy a reproducible versatile vertical breast reduction technique. The technique is easy to teach and easy to learn, especially for those who are familiar with the superior pedicle inverted-T-scar technique. PMID:11355991

Beer, G M; Morgenthaler, W; Spicher, I; Meyer, V E

2001-06-01

175

In Vivo Confocal Microscopy in Scarring Trachoma  

PubMed Central

Objective To characterize the tissue and cellular changes found in trachomatous scarring (TS) and inflammation using in vivo confocal microscopy (IVCM). Design Two complimentary case-control studies. Participants The first study included 363 cases with TS (without trichiasis), of whom 328 had IVCM assessment, and 363 control subjects, of whom 319 had IVCM assessment. The second study included 34 cases with trachomatous trichiasis (TT), of whom 28 had IVCM assessment, and 33 control subjects, of whom 26 had IVCM assessment. Methods All participants were examined with ×2.5 loupes. The IVCM examination of the upper tarsal conjunctiva was carried out with a Heidelberg Retina Tomograph 3 with the Rostock Cornea Module (Heidelberg Engineering GmbH, Dossenheim, Germany). Main Outcome Measures The IVCM images were graded in a masked manner using a previously published grading system evaluating the inflammatory infiltrate density; the presence or absence of dendritiform cells (DCs), tissue edema, and papillae; and the level of subepithelial connective tissue organization. Results Subjects with clinical scarring had a characteristic appearance on IVCM of well-defined bands and sheets of scar tissue visible. Similar changes were also seen in some clinically normal subjects consistent with subclinical scarring. Scarred subjects had more DCs and an elevated inflammatory infiltrate, even after adjusting for other factors, including the level of clinical inflammation. Cellular activity was usually seen only in or just below the epithelium, rarely being seen deeper than 30 ?m from the surface. The presence of tissue edema was strongly associated with the level of clinical inflammation. Conclusions In vivo confocal microscopy can be quantitatively used to study inflammatory and scarring changes in the conjunctiva. Dendritic cells seem to be closely associated with the scarring process in trachoma and are likely to be an important target in antifibrotic therapies or the development of a chlamydial vaccine. The increased number of inflammatory cells seen in scarred subjects is consistent with the immunopathologic nature of the disease. The localization of cellular activity close to the conjunctival surface supports the view that the epithelium plays a central role in the pathogenesis of trachoma. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. PMID:21920608

Hu, Victor H.; Weiss, Helen A.; Massae, Patrick; Courtright, Paul; Makupa, William; Mabey, David C.W.; Bailey, Robin L.; Burton, Matthew J.

2011-01-01

176

Structural Characteristics of the Subscapularis Muscle in Children With Medial Rotation Contracture of the Shoulder After Obstetric Brachial Plexus Injury  

Microsoft Academic Search

The aim of this study was to obtain a better understanding of the cause of the medial rotation contracture of the shoulder after obstetric brachial plexus lesions by studying the morphology of the shortened subscapularis muscle. Muscle biopsy specimens were harvested from 13 children with obstetric brachial plexus palsy who underwent corrective surgery for the rotation contracture. The majority of

T. Hultgren; F. Einarsson; E. Runesson; C. Hemlin; J. Fridén; B.-O. Ljung

2010-01-01

177

The role of free flap reconstruction in paediatric caustic burns.  

PubMed

Ingestion of caustic soda can cause severe scarring of the oral cavity and the surrounding soft tissues. Free flap reconstruction for burns in the oral cavity has been described as a viable option in adults, but to the best of our knowledge has not been reported in children. We describe cases of successful microvascular reconstruction for burns caused by caustic soda in the oral cavity in children. PMID:23369780

Sadiq, Zaid; Farook, Shahme A; Ayliffe, Peter

2013-09-01

178

Long-term survival in a child with severe congenital contractural arachnodactyly, autism and severe intellectual disability.  

PubMed

The severe form of congenital contractural arachnodactyly is usually associated with early mortality due to multisystem complications. Here, we report a 9-year-old male child with severe skeletal manifestations of congenital contractural arachnodactyly. He had none of the cardiovascular or gastrointestinal features that have been described in severe congenital contractural arachnodactyly. He had profound intellectual disability with autism. All exons of FBN2, the gene associated with congenital contractural arachnodactyly, were sequenced and no disease-causing mutation was found. When severe congenital contractural arachnodactyly is diagnosed in the newborn period, parents need to be aware that long-term survival is possible, particularly if no significant extraskeletal complications are present, and that significant neurodevelopmental delay may occur. PMID:16531736

Snape, Katie M G; Fahey, Michael C; McGillivray, George; Gupta, Prateek; Milewicz, Dianna M; Delatycki, Martin B

2006-04-01

179

Biomass Burning  

NASA Technical Reports Server (NTRS)

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.

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

1993-01-01

180

Textured Surface Breast Implants in the Prevention of Capsular Contracture among Breast Augmentation Patients: A Meta-Analysis of Randomized Controlled Trials  

Microsoft Academic Search

Background: Capsular contracture is a common complication associated with the use of breast implants. Numerous randomized controlled trials addressing the efficacy of textured surface breast implants in reducing capsular contracture have yielded nonuniform results. This meta-analysis addresses the use of tex- tured breast implants in the prevention of capsular contracture. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Con-

G. Philip Barnsley; Leif J. Sigurdson; Shannon E. Barnsley

2006-01-01

181

Laparoscopic cholecystectomy in the scarred abdomen  

Microsoft Academic Search

Summary  Laparoscopic cholecystectomy is rapidly becoming the definitive method for treating symptomatic gallbladder stones. Previous\\u000a upper abdominal surgery is a relative contraindication to this technique. We describe a method for safely placing the trocars\\u000a in a scarred abdomen, thus facilitating laparoscopic cholecystectomy in a wider group of patients.

P. A. Grace; A. Leahy; G. McEntee; D. Bouchier-Hayes

1991-01-01

182

Modifications in vertical scar breast reduction  

Microsoft Academic Search

The use of vertical-scar breast reduction techniques is only slowly increasing, even though they have been advocated by Lassus and Lejour and are requested by patients. Possible reasons why surgeons are reluctant to use these techniques are that they are said to be more difficult to learn, they require considerable experience and intuition, and their applicability is confined to small

G. M. Beer; W. Morgenthaler; I. Spicher; V. E. Meyer

2001-01-01

183

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

PubMed

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

Mita, Mariko; Kanamori, Tomomi; Tomita, Minoru

2013-11-01

184

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

PubMed Central

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

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

185

Irreversible muscle contracture after functioning free muscle transplantation using the ipsilateral facial nerve for reinnervation  

Microsoft Academic Search

Four patients who underwent functioning free muscle transplantation (FFMT) for facial reconstruction developed a progressive disfiguring muscle contracture. This complication has not been previously reported. Three of the patients had longstanding facial paralysis and were reanimated by FFMT. The fourth patient had left hemifacial atrophy but without facial paralysis. She also underwent FFMT for augmentation. All four FFMTs were innervated

Vikram S. Deveraj; F WEI

1995-01-01

186

Infrapatellar contracture syndromeAn unrecognized cause of knee stiffness with patella entrapment and patella infera  

Microsoft Academic Search

Infrapatellar Contracture Syndrome (IPCS) is an infre quently recognized cause of posttraumatic knee mor bidity. Unique to this group of patients is the combina tion of restricted knee extension and flexion associated with patella entrapment. IPCS can occur primarily as an exaggerated pathologic fibrous hyperplasia of the anterior soft tissues of the knee beyond that associated with normal healing. It

Lonnie E. Paulos; Thomas D. Rosenberg; John Drawbert; James Manning; Paul Abbott

1987-01-01

187

Biceps Brachii Long Head Overactivity Associated with Elbow Flexion Contracture in Brachial Plexus Birth Palsy  

PubMed Central

Background: The etiology of elbow flexion contracture in children with brachial plexus birth palsy remains unclear. We hypothesized that the long head of the biceps brachii muscle assists with shoulder stabilization in children with brachial plexus birth palsy and that overactivity of the long head during elbow and shoulder activity is associated with an elbow flexion contracture. Methods: Twenty-one patients with brachial plexus birth palsy-associated elbow flexion contracture underwent testing with surface electromyography. Twelve patients underwent repeat testing with fine-wire electromyography. Surface electrodes were placed on the muscle belly, and fine-wire electrodes were inserted bilaterally into the long and short heads of the biceps brachii. Patients were asked to perform four upper extremity tasks: elbow flexion-extension, hand to head, high reach, and overhead ball throw. The mean duration of muscle activity in the affected limb was compared with that in the contralateral, unaffected limb, which was used as a control. Three-dimensional motion analysis, surface dynamometry, and validated function measures were used to evaluate upper extremity kinematics, elbow flexor-extensor muscle imbalance, and function. Results: The mean activity duration of the long head of the biceps brachii muscle was significantly higher in the affected limb as compared with the contralateral, unaffected limb during hand-to-head tasks (p = 0.02) and high-reach tasks (p = 0.03). No significant differences in mean activity duration were observed for the short head of the biceps brachii muscle between the affected and unaffected limbs. Isometric strength of elbow flexion was not significantly higher than that of elbow extension in the affected limb (p = 0.11). Conclusions: Overactivity of the long head of the biceps brachii muscle is associated with and may contribute to the development of elbow flexion contracture in children with brachial plexus birth palsy. Elbow flexion contracture may not be associated with an elbow flexor-extensor muscle imbalance, as previously hypothesized. The negative impact of elbow flexion contracture on upper extremity function warrants future research in the development of preventive and therapeutic techniques to address elbow flexion contractures in children with brachial plexus birth palsy. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. PMID:22336968

Sheffler, Lindsey C.; Lattanza, Lisa; Sison-Williamson, Mitell; James, Michelle A.

2012-01-01

188

Combination Therapy in the Management of Atrophic Acne Scars  

PubMed Central

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

Garg, Shilpa; Baveja, Sukriti

2014-01-01

189

RoSCAR: Robot Stock Car Autonomous Racing , Corey Montella  

E-print Network

RoSCAR: Robot Stock Car Autonomous Racing Kyle Hart , Corey Montella , Georges Petitpas , DylanSCAR. The platform is based on a 1/10-scale short track race car, integrated with an on-board desktop-class computerSCAR to compete in a race around a 200 m indoor track. Students demonstrated reliable lane tracking and at- tained

Spletzer, John R.

190

A Rat Excised Larynx Model of Vocal Fold Scar  

ERIC Educational Resources Information Center

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…

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

2009-01-01

191

Treatment of localized post-traumatic neuropathic pain in scars with 5% lidocaine medicated plaster  

PubMed Central

Objective To evaluate the use of 5% lidocaine medicated plaster (LMP) for treating painful scars resulting from burns or skin degloving. Patients and methods This was a prospective, observational case series study in individuals with painful scars <70 cm2 in area, caused by burns or skin degloving. The study included a structured questionnaire incorporating demographic variables, pain evaluation using the numeric rating scale (NRS), the DN4 questionnaire, and measurement of the painful surface area. Patients with open wounds in the painful skin or with severe psychiatric disease were excluded. Results Twenty-one men and eight women were studied, aged (mean + standard deviation) 41.4 ± 11.0 years, with painful scars located in the upper extremity (n = 9), lower extremity (n = 19), or trunk (n = 1). Eleven patients (37.9%) had an associated peripheral nerve lesion. The scars were caused by burns (n = 13), degloving (n = 7), and/or orthopedic surgery (n = 9). The duration of pain before starting treatment with lidocaine plaster was 9.7 ± 10.0 (median 6) months. The initial NRS was 6.66 ± 1.84 points, average painful area 23.0 ± 18.6 (median 15) cm2, and DN4 score 4.7 ± 2.3 points. The duration of treatment with LMP was 13.9 ± 10.2 (median 11) weeks. After treatment, the NRS was reduced by 58.2% ± 27.8% to 2.72 ± 1.65. The average painful area was reduced by 72.4% ± 24.7% to 6.5 ± 8.6 (median 5) cm2. Nineteen patients (69%) showed functional improvement following treatment. Conclusion LMP was useful for treating painful scars with a neuropathic component, producing meaningful reductions in the intensity of pain and painful surface area. This is the first time that a decrease in the painful area has been demonstrated in neuropathic pain using topical therapy, and may reflect the disease-modifying potential of LMP. PMID:22915873

Correa-Illanes, Gerardo; Calderon, Wilfredo; Roa, Ricardo; Pineros, Jose Luis; Dote, Jacqueline; Medina, David

2010-01-01

192

Reclaiming body image: the hidden burn.  

PubMed

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

Willis-Helmich, J J

1992-01-01

193

Burning rubber  

SciTech Connect

Mario Andretti, look out You are about to be surpassed in the burning rubber category by a joint venture between Oxford Energy Company and General Electric. The two companies are building the first whole tire-to-energy facility in the US in Modesto, California. This $41 million facility does not require tires to be shredded prior to incineration; it has the capacity to burn 700 tires per minute. The electricity generated will be provided to a utility company. Oxford says there are two billion waste tires on the ground and this number is increasing by 220 million a year. Of that amount, only 18 million a year are recycled.

Not Available

1987-09-01

194

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

PubMed

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

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

195

The Spatial and Temporal Distribution of Lightning Strikes and Their Relationship with Vegetation Type, Elevation, and Fire Scars in the Northern Territory  

Microsoft Academic Search

In this paper the authors explore the spatial and temporal patterns of lightning strikes in northern Australia for the first time. In particular, the possible relationships between lightning strikes and elevation, vegetation type, and fire scars (burned areas) are examined. Lightning data provided by the Bureau of Meteorology were analyzed for a 6-yr period (1998-2003) over the northern, southern, and

Musa Kilinc; Jason Beringer

2007-01-01

196

Hand burn management: minimising pain and trauma at dressing change.  

PubMed

The aim of wound management in hand burn injuries is to restore function and prevent problem scars, so a key consideration in wound healing is the removal of dressings without causing pain and further trauma as well as preserving function. Conventionally, wound dressings such as paraffin gauze were used for burn injuries, but this led to pain and trauma on removal, as well as drying out. This study looks at the use of Mepitel® One on hand burns; this dressing incorporates all the benefits of Mepitel, however, it only has Safetac technology on the wound contact side, allowing easy handling and application. PMID:24225512

Edwards, Jacky; Mason, Sally

197

Partial excision of residual burn lesions.  

PubMed

Most burn victims have unattractive residual lesions, which may include hypertrophic donor sites, unsightly skin grafts, hypertrophic scars, and mature scars with altered pigmentation or texture. Some of these lesions can be treated by total excision in one or more stages or they can be reconstructed utilizing grafts, flaps, Z-plasties, or tissue expansion. But frequently these procedures are either not indicated or not elected by the patient. In such a situation, the only surgical option is partial excision, with the goal of making the lesion less conspicuous and more easily concealed by clothing. Whether or not such partial excisions are worthwhile is the obvious question. We could not find an answer in the literature and therefore decided to review our own experience. Between 6/30/81 and 3/12/86, 92 such procedures were performed and followed in 25 patients. Partial excision of hypertrophic donor sites, unsightly skin grafts, and hypertrophic scars did yield improved appearance in most patients. However, partial excision of mature scars, ie, areas of altered pigmentation or texture, did not have the same success. We continue to treat the first three types of lesions in this fashion but no longer include the latter. PMID:3312217

Engrav, L H; Gottlieb, J R; Millard, S P; Walkinshaw, M D; Heimbach, D M; Marvin, J A

1987-01-01

198

Tissue expansion for burn sequelae: Jeitawe Burn Center, Lebanon.  

PubMed

Burn sequelae used to be treated with skin grafts and local or distant flaps with a high morbidity on the donor site. The purpose of treatment today by skin expansion is to achieve aesthetic amelioration, as the advantage of this technique is that it becomes possible to obtain local flaps with the same characteristics of colour, texture, hair, and sensitivity as normal skin. This is a review of 14 cases of burn patients treated between 2006 and 2010 at our burn centre at Jeitawe Hospital, Lebanon. The patients' ages ranged from 6 to 50 yr. The regions expanded were the scalp, forehead, neck, trunk, and the upper and lower limbs. The implants were positioned on the fascial layer; antibiotics and drainage were routinely used. The inflation of the expander began two weeks after surgery and continued for an average time of three months. Complications were rare. Results were good with an improvement of scars and minimal morbidity. Fifty per cent of our patients underwent another expansion. PMID:22262964

Ghanime, G; Rizkallah, N; Said, J M

2011-06-30

199

[Burning mouth].  

PubMed

Various conditions of the oral mucosa can give rise to a burning sensation. Candidosis, geographic tongue (erythema migrans), mucocutaneous conditions and stomatitis can all cause mouth burns with visible changes to the oral mucosa. The so-called 'burning-mouth syndrome' (BMS) is a fairly rare but extremely unpleasant condition characterised by a bilateral burning sensation of the oral mucosa in the absence of clinically visible mucosal changes. Frequently-associated symptoms include dry mouth and loss or change of taste. The aetiology is unknown, even though most of the literature focuses on the role of a possible underlying psychogenic disorder. Several mucosal disorders can cause symptoms similar to BMS. Therefore, careful oral examination is required before establishing the diagnosis of BMS. Additional laboratory tests or a specialist examination rarely yield abnormal findings of relevance. Reassurance and understanding are important keywords in the management of patients suffering from BMS. Unless clearly indicated dental or medical treatment should be avoided, even if the patient insists on it, since such treatment is rarely effective. PMID:15932134

van der Waal, I

2005-05-14

200

Errors in visual estimation of flexion contractures during total knee arthroplasty  

PubMed Central

AIM: To quantify and reduce the errors in visual estimation of knee flexion contractures during total knee arthroplasty (TKA). METHODS: This study was divided into two parts: Quantification of error and reduction of error. To quantify error, 3 orthopedic surgeons visually estimated preoperative knee flexion contractures from lateral digital images of 23 patients prior to and after surgical draping. A repeated-measure analysis of variance was used to compare the estimated angles prior to and following the placement of the surgical drapes with the true knee angle measured with a long-arm goniometer. In an effort to reduce the error of visual estimation, a dual set of inclinometers was developed to improve intra-operative measurement of knee flexion contracture during TKA. A single surgeon performed 6 knee extension measurements with the device during 146 consecutive TKA cases. Three measurements were taken with the desired tibial liner trial thickness, and 3 were taken with a trial that was 2 mm thicker. An intraclass correlation coefficient (ICC) was calculated to assess the test-retest reliability for the 3 measurements taken with the desired liner thickness, and a paired t test was used to determine if the knee extension measurements differed when a thicker tibial trial liner was placed. RESULTS: The surgeons significantly overestimated flexion contractures in 23 TKAs prior to draping and significantly underestimated the contractures after draping (actual knee angle = 6.1° ± 6.4°, pre-drape estimate = 6.9° ± 6.8°, post-drape estimate = 4.3° ± 6.1°, P = 0.003). Following the development and application of the measurement devices, the measurements were highly reliable (ICC = 0.98), and the device indicated that 2.7° ± 2.2° of knee extension was lost with the insertion of a 2 mm thicker tibial liner. The device failed to detect a difference in knee extension angle with the insertion of the 2 mm thicker liner in 9/146 cases (6.2%). CONCLUSION: We determined the amount of error associated with visual estimation of knee flexion contractures, and developed a simple, reliable device and method to improve feedback related to sagittal alignment during TKA. PMID:23878779

Jacobs, Cale A; Christensen, Christian P; Hester, Peter W; Burandt, David M; Sciascia, Aaron D

2013-01-01

201

Translation into Brazilian Portuguese and validation of the "Quantitative Global Scarring Grading System for Post-acne Scarring" *  

PubMed Central

The "Quantitative Global Scarring Grading System for Postacne Scarring" was developed in English for acne scar grading, based on the number and severity of each type of scar. The aims of this study were to translate this scale into Brazilian Portuguese and verify its reliability and validity. The study followed five steps: Translation, Expert Panel, Back Translation, Approval of authors and Validation. The translated scale showed high internal consistency and high test-retest reliability, confirming its reproducibility. Therefore, it has been validated for our population and can be recommended as a reliable instrument to assess acne scarring. PMID:25184939

Cachafeiro, Thais Hofmann; Escobar, Gabriela Fortes; Maldonado, Gabriela; Cestari, Tania Ferreira

2014-01-01

202

Cheiloplasty in Post-burn Deformed Lips  

PubMed Central

Summary The lip is a part of the face that is frequently affected by burn injury. Post-burn scar sequelae in this area often result in cosmetic disfigurement and psychological upsets in patients, especially young adult females. A burn destroys the aesthetic features and lines of the lip. Plastic and reconstructive surgery of the face has a long history. Many local and regional flaps have been used for reconstruction of surgical or traumatic defects. Procedures to enhance the cosmetic features of the lips have been performed for centuries. Only within the past 25 years, however, has augmentation cheiloplasty become commonplace. Within that time, a number of different techniques have been developed. The goal of reconstruction is to achieve aesthetic results using plastic materials having the same properties as the affected area. This paper describes some clinical situations and possible reconstructive solutions. PMID:21991162

Saadeldeen, W.M.

2009-01-01

203

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

PubMed Central

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

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

2000-01-01

204

Validity of gait parameters for hip flexor contracture in patients with cerebral palsy  

Microsoft Academic Search

BACKGROUND: Psoas contracture is known to cause abnormal hip motion in patients with cerebral palsy. The authors investigated the clinical relevance of hip kinematic and kinetic parameters, and 3D modeled psoas length in terms of discriminant validty, convergent validity, and responsiveness. METHODS: Twenty-four patients with cerebral palsy (mean age 6.9 years) and 28 normal children (mean age 7.6 years) were

Sun Jong Choi; Chin Youb Chung; Kyoung Min Lee; Dae Gyu Kwon; Sang Hyeong Lee; Moon Soek Park

2011-01-01

205

The Relationship between Caffeine Contracture of Intact Muscle and the Effect of Caffeine on Reticulum  

Microsoft Academic Search

At concentrations between 1 to 10 raM, caffeine reduced the Ca-accumulating capacity of fragmented reticulum obtained from frog and rabbit muscle. With 8 mM caffeine enough Ca was released from frog reticulum to account for the force of the contracture. Caffeine did not affect all reticulum membranes equally. The fraction which was spun down at 2000 g was more sensitive

A. Weber; R. HERZ

1968-01-01

206

The eight-limb modified propeller flap—A safer new technique  

Microsoft Academic Search

IntroductionContracture deformities affecting the flexor aspect of the elbow joint and the 1st web space are not uncommon sequelae of burns. Surgical treatment is contemplated in those patients with established contractural deformities in whom non-surgical treatment is ineffective or functional integrity of the joint is at jeopardy. Surgical treatment consists of incising the scar tissue to release joint contracture and

Husam Hosny; Wael El-Shaer

2011-01-01

207

Chlorhexidine burns after shoulder arthroscopy.  

PubMed

Chlorhexidine is an antiseptic and disinfectant commonly used for surgical site preparation and cleansing. It is active against a broad spectrum of bacteria, viruses, mycobacteria, and fungi. We report 3 cases of patients with superficial partial thickness burns immediately following shoulder arthroscopic surgery with the use of a Chloraprep 26 mL applicator (2% chlorhexidine gluconate and 70% isopropyl alcohol; CareFusion, Leawood, Kansas). All 3 patients reported pain as the anesthetic waned at a localized area on the anterior arm near the axilla. Erythema and blistering were noticeable. These areas were immediately treated with irrigation and local application of ice, and subsequently with topical triple-antibiotic ointment. All 3 cases were resolved within 3 months of surgery, but noticeable scars remained. We believe a combination of chlorhexidine skin preparation, local swelling inherent to shoulder arthroscopy, and traction contributed to these postoperative complications. PMID:22530219

Sanders, Thomas H; Hawken, Samuel M

2012-04-01

208

Contractile elements in muscular fascial tissue - implications for in-vitro contracture testing for malignant hyperthermia.  

PubMed

Malignant hyperthermia is a dreaded complication of general anaesthesia. Predisposed individuals can be identified using the standardised caffeine/halothane in-vitro contracture test on a surgically dissected skeletal muscle specimen. Skeletal muscle is composed of muscle fibres and interwoven fascial components. Several malignant hyperthermia-associated neuromuscular diseases are associated with an altered connective tissue composition. We analysed adjacent fascial components of skeletal muscle histologically and physiologically. We investigated whether the fascial tissue is sensitive to electrical or pharmacological stimulation in a way similar to the in-vitro contracture test for diagnosing malignant hyperthermia. Using immunohistochemical staining, ?-smooth muscle actin-positive cells (myofibroblasts) were detected in the epi-, endo- and perimysium of human fascial tissue. Force measurements on isolated fascial strips after pharmacological challenge with mepyramin revealed that myofascial tissue is actively regulated by myofibroblasts, thereby influencing the biomechanical properties of skeletal muscle. Absence of electrical reactivity and insensitivity to caffeine and halothane suggests that, reassuringly, the malignant hyperthermia diagnostic in-vitro contracture test is not influenced by the muscular fascial tissue. PMID:24909539

Hoppe, K; Schleip, R; Lehmann-Horn, F; Jäger, H; Klingler, W

2014-09-01

209

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

NASA Astrophysics Data System (ADS)

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.

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

2005-07-01

210

Congenital contractures and distinctive phenotypic features consistent with Stuve-Wiedmann syndrome in a male infant  

PubMed Central

Introduction Expressionless face associated with multiple contractures has been encountered in an infant. There is a wide range of misconception regarding the categorization of children with multiple contractures among different pediatric disciplines. The fundamental element in categorizing children with multiple contractures is "the etiological understanding". In the absence of concomitant neuromuscular disease, however, the search for other reasons is mandatory. Our present paper signifies the necessity of proper interpretations of unusual clinical and radiographic features. Case presentation We describe a 3-months-old-infant presented with the phenotypic and the radiographic features consistent with the diagnosis of Stüve-Wiedemann syndrome. We report what might be the first clinical report of Stüve-Wiedemann syndrome from a consanguineous family in Austria. Conclusion Congenital limitations of the hips in a newborn infant raise the possibility of " Congenital Hip Dislocation". As congenital hip dislocation is a dysplastic process. Here further knowledge by the pediatrician and the orthopaedic surgeon is needed. Our present patient appears to constitute a distinct pathological entity consistent with Stüve-Wiedemann syndrome (SWS). Superti-Furga et al, and Cormier-Daire et al, also suggest that Stüve-Wiedemann syndrome and Schwartz-Jampel syndrome type 2 are allelic conditions. We wish to stress that, given the rarity of syndromic malformation complex, our impression is that it is more common than it is reported. PMID:18718019

Al Kaissi, Ali; Rumpler, Monika; Csepan, Robert; Grill, Franz; Klaushofer, Klaus

2008-01-01

211

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

PubMed

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

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

2014-09-01

212

Endoscopic-Assisted Total Thyroidectomy via Lateral Keloid Scar Incision  

PubMed Central

Thyroidectomy is traditionally performed by the transcervical approach. To avoid or reduce visible scarring, diverse innovative surgical trials have been reported. Here we report a patient who underwent endoscopic thyroidectomy via a lateral keloid scar due to a previous traffic accident. A 30-year-old woman presented with a papillary thyroid carcinoma. Total thyroidectomy was performed via a keloid scar incision. The keloid scar was then revised. The total thyroidectomy was successful, resulting in no acute complications, such as neural injury, hematoma, or seroma formation. The keloid scar healed with excellent cosmetic results and the patient remains free of disease 12 months after excision. Endoscopic total thyroidectomy via a lateral keloid scar incision healed not only the physical disease but also the mental disease.

2014-01-01

213

Breast cancer from the excisional scar of a benign mass.  

PubMed

Breast cancer developing from a surgical scar is rare; this type of malignancy has been reported in only 12 cases to date. Herein, we report on a 52-year-old female who developed infiltrating ductal carcinoma in a surgical scar following excision of a benign mass. Two years previously, the patient underwent surgery and radiotherapy for invasive ductal carcinoma of the contralateral breast. The initial appearance of the scar was similar to fat necrosis; it was observed to be progressively shrinking on follow-up sonography. On the two year follow-up ultrasound, the appearance changed, an angular margin and vascularity at the periphery of the scar were noted. A biopsy and subsequent excision of the scar were performed; the diagnosis of infiltrating ductal carcinoma of the scar was confirmed. PMID:17554196

Kim, Min Jung; Kim, Eun-Kyung; Lee, Ji Young; Youk, Ji Hyun; Park, Byeong-Woo; Kim, Haeryoung; Oh, Ki Keun

2007-01-01

214

Analysis of state of vehicular scars on Arctic Tundra, Alaska  

NASA Technical Reports Server (NTRS)

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.

Lathram, E. H.

1974-01-01

215

Therapy of keloid and hypertrophic scars: a review  

Microsoft Academic Search

Scar management for the prevention of excessive scar formation has always been important but never so important as it is today.\\u000a Optimal management continues to be an enigma for surgeons, and the best modality of treatment has been debated for many years.\\u000a However, most studies have unfortunately been either retrospective or case report descriptions. Advances in scar management\\u000a have been

Ahmed Samir Edriss; V. Smrcka

216

Post herpes-zoster scar sarcoidosis with pulmonary involvement  

PubMed Central

Cutaneous sarcoidosis presents with a wide range of clinical presentations. An uncommon cutaneous manifestation is infiltration of old cutaneous scars with non-caseating granulomas known as scar sarcoidosis. Most of the patients with this clinical entity have other systemic manifestations, particularly pulmonary changes. We report a case of a 50 years old man, presenting with cutaneous sarcoidosis overlying scars of healed herpes zoster. PMID:24616865

Singal, Archana; Vij, Amit; Pandhi, Deepika

2014-01-01

217

Uterine rupture following termination of pregnancy in a scarred uterus.  

PubMed

We present a series of two cases complicated by uterine rupture following termination of pregnancy (TOP) in the 1st and 2nd trimesters using misoprostol in women with caesarean section scar. Current literature and practise have also been reviewed on ruptured uterus in women with caesarean section scar undergoing TOP using misoprostol; the diagnosis of adherent placenta in the 1st and 2nd trimesters in women with previous caesarean uterine scar; and likely implications of a ruptured uterus. PMID:24456452

Bika, O; Huned, D; Jha, S; Selby, K

2014-02-01

218

Bioerosion by chemosynthetic biological communities on Holocene submarine slide scars  

Microsoft Academic Search

Geomorphic, stratigraphic, and faunal observations of submarine slide scars that occur along the flanks of Monterey Canyon in 2.0–2.5 km water depths were made to identify the processes that continue to alter the surface of a submarine landslide scar after the initial slope failure. Deep-sea chemosynthetic biological communities and small caves are common on the sediment-free surfaces of the slide scars,

C. K. Paull; W. Ussler; H. G. Greene; J. Barry; R. Keaten

2005-01-01

219

Midtrimester abortion in patients with a previous uterine scar  

Microsoft Academic Search

Objective: To investigate whether extraamniotic prostaglandin E2 (PGE2) for midtrimester pregnancy interruption in women with a scarred uterus has any adverse effects compared to those without an uterine scar. Study design: Two hundred and sixty-two women who underwent second trimester (16–27 gestational weeks) termination of pregnancy were enrolled in this study. Thirty-one women with a uterine scar were compared with

Abraham Debby; Abraham Golan; Ron Sagiv; Oscar Sadan; Marek Glezerman

2003-01-01

220

Skin Wound Healing and Scarring: Fetal Wounds and Regenerative Restitution  

PubMed Central

The adverse physiological and psychological effects of scars formation after healing of wounds are broad and a major medical problem for patients. In utero, fetal wounds heal in a regenerative manner, though the mechanisms are unknown. Differences in fetal scarless regeneration and adult repair can provide key insight into reduction of scarring therapy. Understanding the cellular and extracellular matrix alterations in excessive adult scarring in comparison to fetal scarless healing may have important implications. Herein, we propose that matrix can be controlled via cellular therapy to resemble a fetal-like matrix that will result in reduced scarring. PMID:24203921

Yates, Cecelia C.; Hebda, Patricia; Wells, Alan

2014-01-01

221

Where we stand with human hypertrophic and keloid scar models.  

PubMed

We have yet to create a human scar model that demonstrates the complex nature of hypertrophic scar and keloid formation as well as ways to prevent them despite emerging advances in our understanding of the immune system, the inflammatory response, and proteomic and genomic changes after injury. Despite more complex in vitro models, we fail to explain the fundamental principles to scar formation, and the timeline of their development. The solution to developing the ideal in vitro scar model is one that mimics the heterogeneous cellular and molecular interactions, as well as the evolving structure and function of human skin. PMID:25039250

Williams, Felicia N; Herndon, David N; Branski, Ludwik K

2014-11-01

222

?Cat FACE? SCAR ON LONGLEAF PINE TREE, OVERHILLS HISTORIC ENTRANCE ...  

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

?Cat FACE? SCAR ON LONGLEAF PINE TREE, OVERHILLS HISTORIC ENTRANCE ROAD, FACING NORTHEAST - Overhills, Fort Bragg Military Reservation, Approximately 15 miles NW of Fayetteville, Overhills, Harnett County, NC

223

Proximally based sural adipose-cutaneous/scar flap in elimination of ulcerous scar soft-tissue defect over the achilles tendon and posterior heel region: a new approach.  

PubMed

Scar ulcers that spread over the Achilles tendon and posterior heel disturb patients by causing pain, impeding hygiene, and creating difficulty in finding appropriate shoe wear. As this region undergoes pressure, effective reconstruction is based on the flap use. The most popular flaps currently used are distally based sural fasciocutaneous flap, calcaneal artery skin flap, and free flaps. These flaps, however, are insensate, can create soft-tissue excess, and cause donor site morbidity. Ulcerous soft-tissue defects over Achilles tendon and posterior heel after burns, frost, and trauma were studied and reconstructed in 16 patients, using proximally based sural adipose-cutaneous flap, the anatomy of which was studied on lower extremities of 27 cadavers. Ulcerous soft-tissue defect consists of two parts: ulcer and surrounding pathologic scars that should be excised in one block. Resulting soft-tissue defects with exposed tendon and calcaneal bone varied from 6 to 20 cm in length and 6 cm in width. For such wound resurfacing a flap was developed that was sensate, thin, large, and having steady blood circulation. The flap was harvested from the lower third of the leg and lateral foot, consisting of skin and subcutaneous fat layer (without fascia), including the sural nerve and lesser vein. The blood supply was ensured through peroneal and anterior tibial artery perforators, which formed a vascular net in the flap. In 14 of 16 cases excellent and stable functional and good cosmetic results with acceptable donor site morbidity were achieved. In two patients the distal flap loss took place because of arteriitis obliterans (one case) and because of the cross-cutting of the sural nerve and vessels during previous surgeries (another case). Proximally based sural adipose-cutaneous/scar flap is the only flap that satisfies all requirements for Achilles tendon and posterior heel region resurfacing. The author believes that this technique, based on this flap use, is anatomically justified, clinically profitable, and should be considered as the first choice operation. PMID:24043244

Grishkevich, Viktor M

2014-01-01

224

Burning system and method  

SciTech Connect

A substantially smokeless burning system is discussed for burning waste material fuels. An elongated hollow burning chamber is supported in a generally horizontal orientation. An elongated fuel accumulation chamber and a hydraulic hoist driven ram in the chamber are adapted to push elongated volumes of new fuel into the lower front end of the burning chamber such that already burning fuel is pushed to the rear of the chamber. This establishes a charcoal burning zone which at least partially overlies a volatile burning zone such that incomplete combustion products from the volatile burning zone pass over and through the charcoal burning zone to be substantially burned before exiting at the rear of the burning chamber. Integral preheat and air delivery channels are formed in the walls of the burning chamber. A pipe section is mounted within the burning chamber for incinerating liquid waste materials.

Burton, E.B.

1984-02-07

225

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

NASA Technical Reports Server (NTRS)

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.

Christopher, Sundar A.

1997-01-01

226

[Management options of caesarean scar pregnancy].  

PubMed

Cesarean scar pregnancy is an uncommon ectopic gestation. Without timely and proper management,it may cause major bleeding,uterine rupture,and other life-threatening complications. The causes of this condition remain unclear,and no standardized management has been available,although some medical and surgical treatment modalities have been suggested. The main treatment objectives include preventing massive blood loss,preserving the uterus function,and maintain the women's health and quality of life. Current data do not support expectant management. After early diagnosis,single or combined medical and surgical treatment options should be provided to avoid uterine rupture and haemorrhage,so as to preserve the uterus and thus the fertility. PMID:24791804

Li, Jin-jin; Liu, Xin-yan

2014-04-01

227

Preliminary study of the scars borne by Gammaridae (Amphipoda, Crustacea)  

Microsoft Academic Search

Many gammarid shrimps from the rivers Meuse and Viroin bear scars. A recent invader in the Meuse, Dikerogammarus villosus, is claimed to exhibit a strong predatory behaviour against other Gammaridae. Therefore we tested the hypothesis that scarred Gammaridae should be more numerous in the Meuse where D. villosus is dom- inant than in a tributary, the Viroin, where it is

Olivier Schmit; Guy Josens

2004-01-01

228

Effect of a Selective Cyclooxygenase2 Inhibitor on Renal Scarring  

Microsoft Academic Search

Background: Scarring is one of the steps of excessive wound healing, causing dysfunction of the involved tissues and clinically poor cosmetics. The aim of this study was to examine the effect of a highly selective cyclooxygenase-2 (COX-2) inhibitor on renal scar formation in experimental pyelonephritis. Materials and Methods: Four groups of 10 Balb\\/C mice were formed. In groups I and

Hasan Fehmi Kucuk; Necmi Kurt; Levent Kaptanoglu; Huseyin Akyol; Oguzhan Aziz Torlak; Elif Colak

2006-01-01

229

Original article Development of SCARs useful for species  

E-print Network

. multiflorum Lam. / Lolium perenne L. / RAPD marker / SCAR Résumé - Développement de SCAR pour l hasard) sur deux variétés de Lolium multiflorum Lam. et quatre de Lolium perenne L., dans le but de of agronomical- ly important temperate forage grass species. Lolium perenne L. and L. multiflorum Lam. are two

Paris-Sud XI, Université de

230

A case of spontaneous tubal pregnancy with caesarean scar pregnancy  

PubMed Central

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

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

2014-01-01

231

Clinical and Immune Impact of Mycobacterium bovis BCG Vaccination Scarring  

Microsoft Academic Search

The World Health Organization recommends Mycobacterium bovis BCG vaccination in areas of high tuber- culosis prevalence. BCG's clinical and immune effects, not necessarily Mycobacterium tuberculosis specific, are unclear. BCG vaccine scarring often is used as a surrogate marker of vaccination or of effective vaccination. We evaluated BCG scarring status in relation to clinical findings and outcome in 700 hospitalized Malawians,

Janine Jason; Lennox K. Archibald; Okey C. Nwanyanwu; Peter N. Kazembe; Julie A. Chatt; Elizabeth Norton; Hamish Dobbie; William R. Jarvis

2002-01-01

232

Quality of life of patients with keloid and hypertrophic scarring  

Microsoft Academic Search

Keloid and hypertrophic scarring represent chronic disfiguring dermatoses with a high resistance to therapy. The aim of our study was to assess for the first time the quality of life of patients with hypertrophic scars and keloids, because they suffer from quality of life impairment as much as patients with other chronic skin diseases. An item-pool was created modifying and

Oliver Bock; Gerhard Schmid-Ott; Peter Malewski; Ulrich Mrowietz

2006-01-01

233

Matrix adhesion characteristics of fibroblasts in keloid and hypertrophic scar  

Microsoft Academic Search

Background: Keloid and hypertrophic scar (HS) are abnormal scars and their fibroblasts are more sensitive to TGF-? stimulation with overproduction of extracelluar matrix (ECM), especially fibronectin and type I collagen. Binding of integrin ?1?1 to collagen may result in negative feedback of collagen synthesis. Binding of ?5?1 to fibronectin leads to promotion of cellular survival and growth via activation focal

Julia Yu-Yun Lee; Sheau-Chiou Chao; Tak-Wah Wong

2005-01-01

234

Assessment of vaccination coverage, vaccination scar rates, and smallpox scarring in five areas of West Africa*  

PubMed Central

In 1966, nineteen countries of West and Central Africa began a regional smallpox eradication and measles control programme in cooperation with the World Health Organization. This paper summarizes sample survey data collected to assess the results of the programme in Northern Nigeria (Sokoto and Katsina Provinces), Western Nigeria, Niger, Dahomey, and Togo. These data indicate that the programme, which used mass vaccination campaigns based on a collecting-point strategy, was generally successful in reaching a high proportion of the population. Analysis of vaccination coverage and vaccination scar rates by age underlined the importance to the programme of newborn children who accumulate rapidly following the mass campaign. Of all persons without vaccination scars at the time of the surveys, 34.4% were under 5 years of age; in the absence of a maintenance programme, this figure would rise to 40% after 1 year. PMID:4541684

Henderson, Ralph H.; Davis, Hillard; Eddins, Donald L.; Foege, William H.

1973-01-01

235

Effects of Cannabinoids on Caffeine Contractures in Slow and Fast Skeletal Muscle Fibers of the Frog  

Microsoft Academic Search

The effect of cannabinoids on caffeine contractures was investigated in slow and fast skeletal muscle fibers using isometric\\u000a tension recording. In slow muscle fibers, WIN 55,212-2 (10 and 5 ?M) caused a decrease in tension. These doses reduced maximum\\u000a tension to 67.43 ± 8.07% (P = 0.02, n = 5) and 79.4 ± 14.11% (P = 0.007, n = 5) compared to control, respectively. Tension-time integral was reduced to 58.37 ± 7.17% and 75.10 ± 3.60% (P = 0.002,

Miguel Huerta; Mónica Ortiz-Mesina; Xóchitl Trujillo; Enrique Sánchez-Pastor; Clemente Vásquez; Elena Castro; Raymundo Velasco; Rocío Montoya-Pérez; Carlos Onetti

2009-01-01

236

ULTRASOUND EVALUATION OF UTERINE SCAR AFTER CESAREAN SECTION  

PubMed Central

Introduction: The rate of attempted vaginal birth after previous cesarean delivery has decreased, while the success rate of such births increased. Advances in surgical techniques, the development of anesthesiology services, particularly endotracheal anesthesia, very quality postoperative care with cardiovascular, respiratory and biochemical resuscitation, significantly reduce maternal mortality and morbidity after cesarean section. Progress and development of neonatal services, and intensive care of newborns is enabled and a high survival of newborn infants. Complications after cesarean section were reduced, and the introduction of prophylaxis and therapy of powerful antibiotics, as well as materials for sewing drastically reduce all forms of puerperal infection. Goal: Goal was to establish a measurement value of the parameters that are evaluated by ultrasound. Material and methods: Each of the measured parameters was scored. The sum of points is shown in tables. Based on the sum of points was done an estimate of the scar on the uterus after previous caesarian section and make the decision whether to complete delivery naturally or repeat cesarean section. We conducted a prospective study of 108 pregnant women. Analyzed were: shape scar thickness (thickening), continuity, border scar out, echoing the structure of the lower uterine segment and scar volume Results: The study showed that scar thickness of 3.5 mm or more, the homogeneity of the scar, scar triangular shape, qualitatively richer perfusion, and scar volume verified by 3D technique up to10 cm are attributes of the quality of the scar. Conclusion: Based on the obtained results we conclude that ultrasound evaluation of the quality of the scar has practical application in the decision on the mode of delivery in women who had previously given birth by Caesarean section. PMID:23322970

Basic, Ejub; Basic-Cetkovic, Vesna; Kozaric, Hadzo; Rama, Admir

2012-01-01

237

Ram Burn Observations (RAMBO)  

NASA Technical Reports Server (NTRS)

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.

2002-01-01

238

Planning a Prescribed Burn  

E-print Network

This leaflet explains how to plan for adequate fuel for a prescribed burn, control the fire, notify the proper authority, manage the burn itself, and conduct follow-up management. A ranch checklist for prescribed burning is included....

Hanselka, C. Wayne

2009-04-01

239

Lentivirus-Mediated ERK2 siRNA Reduces Joint Capsule Fibrosis in a Rat Model of Post-Traumatic Joint Contracture  

PubMed Central

Extracellular signal-regulated kinase (ERK)-2 is presumed to play an important role in the development of post-traumatic joint contractures. Using a rat injury model, we investigated whether treatment with ERK2 small interfering RNA (siRNA) could reduce the extent of joint capsule fibrosis after an induced injury. Rats were separated into three groups (n = 32 each): non-operated control group, operated contracture group and contracture-treatment group. Stable post-traumatic joint contracture was created through surgical intra-articular joint injury followed by eight weeks of immobilization. In the contracture-treatment group, the rats were treated with lentivirus (LV)-mediated ERK2 siRNA at days 3 and 7 post-surgery. The posterior joint capsule was assessed by western blotting, immunohistochemistry and biochemical analysis for changes in ERK2, phosphorylated (p)-ERK2, myofibroblast, total collagen and relative collagen Type III expression level. Biomechanical testing was used to assess the development of flexion contractures. Statistical analysis was performed using an analysis of variance. In the operated contracture group, rats that developed flexion contractures also showed elevated phosphorylated p-ERK2 expression. In the contracture-treatment group, ERK2 siRNA significantly reduced p-ERK2 expression levels, as well as the severity of flexion contracture development (p < 0.01). Myofibroblast numbers and measurements of total collagen content were also significantly reduced following ERK2 siRNA (p < 0.01). Relative collagen type III expression as a proportion of total of Types I and III collagen, however, was significantly increased in response to ERK2 siRNA (p < 0.01). Our findings demonstrate a role for ERK2 in the induction of joint capsule fibrosis after injury. Furthermore, we show that development of flexion contractures and the resultant increase of joint capsule fibrosis can be reduced by LV-mediated ERK2 siRNA treatment. PMID:24141184

Li, Fengfeng; Liu, Shen; Fan, Cunyi

2013-01-01

240

Development of an in vitro burn wound model.  

PubMed

Healing of a deeper burn wound is a complex process that often leads to scar formation. Skin wound model systems are important for the development of treatments preventing scarring. The aim of this study is to develop a standardized in vitro burn wound model that resembles the in vivo situation. A burn wound (10 x 2 mm) was made in ex vivo skin and the skin samples were cultured at the air-liquid interface for 7, 14, and 21 days. Cells in the skin biopsies maintained their viability during the 21-day culture period. During culture, reepithelialization of the wound took place from the surrounding tissue and fibroblasts migrated into the wound area. Cells of the epithelial tongue and fibroblasts near the wound margin were proliferating. During culture, skin-derived antileukoproteinase and keratin 17 were expressed only in the epithelial tongue. Both collagen type IV and laminin were present underneath the newly formed epidermis, indicating that the basement membrane was restored. These results show that the burn wound model has many similarities to in vivo wound healing. This burn wound model may be useful to study different aspects of wound healing and testing pharmaceuticals and cosmetics on, e.g., migration and reepithelialization. PMID:18638275

Coolen, Neeltje A; Vlig, Marcel; van den Bogaerdt, Antoon J; Middelkoop, Esther; Ulrich, Magda M W

2008-01-01

241

Dupuytrens contracture  

MedlinePLUS

... than women. Risk factors are alcoholism, diabetes, and smoking. ... RN, Pederson WC, Kozin SH, eds. Green’s Operative Hand Surgery . ... . 2nd ed. Philadelphia, Pa.: Elsevier Saunders; 2008:chap 25.

242

BPrevention of Cutaneous Tissue Contracture During Removal of Craniofacial Implant Superstructures for CT and MRI Studies  

PubMed Central

ABSTRACT Objectives Head and neck cancer patients who have lost facial parts following surgical intervention frequently require craniofacial implant retained facial prostheses for restoration. Many craniofacial implant patients require computed tomography and magnetic resonance imaging scans as part of their long-term follow-up care. Consequently removal of implant superstructures and peri-abutment tissue management is required for those studies. The purpose of the present paper was to describe a method for eliminating cranial imaging artifacts in patients with craniofacial implants. Material and Methods Three patients wearing extraoral implant retained facial prostheses needing either computed tomography or magnetic resonance imaging studies were discussed. Peri-implant soft tissues contracture after removal of percutaneous craniofacial implant abutments during computed tomography and magnetic resonance imaging studies was prevented using a method proposed by authors. The procedure involves temporary removal of the supra-implant components prior to imaging and filling of the tissue openings with polyvinyl siloxane dental impression material. Results Immediately after filling of the tissue openings with polyvinyl siloxane dental impression material patients were sent for the imaging studies, and were asked to return for removal of the silicone plugs and reconnection of all superstructure hardware after imaging procedures were complete. The silicone plugs were easily removed with a dental explorer. The percutaneous abutments were immediately replaced and screwed into the implants which were at the bone level. Conclusions Presented herein method eliminates the source of artifacts and prevents contracture of percutaneous tissues upon removal of the implant abutments during imaging. PMID:24421969

Sullivan, Maureen; Rossitto, Rachael

2010-01-01

243

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

PubMed Central

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

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

2010-01-01

244

Antineutrophil cytoplasmic autoantibody-negative antiproteinase 3 syndrome presenting as vasculitis, endocarditis, polyneuropathy and Dupuytren's contracture.  

PubMed

Antiproteinase 3 antibodies (antiPR3) are assumed to be subtypes of antineutrophil cytoplasmic autoantibodies (ANCA), with a high specificity for active Wegener's granulomatosis and microscopic polyangiitis. Thus, antiPR3 positivity in ELISA, together with negativity in indirect immunofluorescence (IIF) is a rare finding. A 56-year-old man with Dupuytren's contracture and polyneuropathy was admitted for leukocytoclastic vasculitis. Echocardiography, performed because of fever and dyspnea, detected aortic valve endocarditis. Because of severe aortic insufficiency the valve was replaced. Blood cultures and bacteriologic investigations of the explanted valve were negative. AntiPR3 were elevated (123-163 U/ml; normal <6 U/ml), together with negativity in IIF. This case shows that antiPR3 elevation with negative ANCA may be associated with vasculitis, endocarditis, polyneuropathy and Dupuytren's contracture. A causal relationship between the clinical presentation and antiPR3 elevation is likely. In order not to miss such cases of vasculitis, combined screening by IIF and ELISA is recommended in selected cases. PMID:12918859

Stöllberger, Claudia; Finsterer, Josef; Zlabinger, Gerhard J; Weihsengruber, Felix; Redtenbacher, Susanne; Bonner, Gerhard; Herkner, Kurt; Deutsch, Manfred

2003-07-01

245

Fibrillin-2 (FBN2) mutations result in the Marfan-like disorder, congenital contractural arachnodactyly.  

PubMed

Congenital contractural arachnodactyly (CCA) is an autosomal dominant disorder that is phenotypically similar to Marfan syndrome (MFS) and characterized by arachnodactyly, dolichostenomelia, scoliosis, multiple congenital contractures and abnormalities of the external ears. In contrast to MFS, CCA does not affect the aorta or the eyes. Two closely related genes, FBN1 located on chromosome 15q15-21.3 and FBN2 located at 5q23-31, encode large fibrillin proteins found in extracellular matrix structures called microfibrils. The MFS is caused by mutations in FBN1, while CCA has been genetically linked to FBN2 (refs 2, 5, 6). We now describe a pair of FBN2 missense mutations in two CCA patients that cause substitution of distinct cysteine residues in separate epidermal growth-factor-like (EGF) repeats. Our study provides final proof of the association between FBN2 mutations and CCA pathology, thus establishing the role of the fibrillin-2 in extracellular matrix physiology and pathology. PMID:7493032

Putnam, E A; Zhang, H; Ramirez, F; Milewicz, D M

1995-12-01

246

Comprehensive clinical and molecular assessment of 32 probands with congenital contractural arachnodactyly: report of 14 novel mutations and review of the literature  

Microsoft Academic Search

Beals-Hecht syndrome or congenital contractural arachnodactyly (CCA) is a rare, autosomal dominant connective tissue disorder characterized by crumpled ears, arachnodactyly, contractures, and scoliosis. Recent reports also mention aortic root dilatation, a finding previously thought to differentiate the condition from Marfan syndrome (MFS). In many cases, the condition is caused by mutations in the fibrillin 2 gene (FBN2) with 26 mutations

Bert L. Callewaert; Bart L. Loeys; Anna Ficcadenti; Sascha Vermeer; Magnus Landgren; Hester Y. Kroes; Yuval Yaron; Michael Pope; Nicola Foulds; Odile Boute; F. Galan; Helen Kingston; Nathalie Van der Aa; Iratxe Salcedo; Marielle E. Swinkels; Carina Wallgren-Pettersson; Orazio Gabrielli; Julie De Backer; Paul J. Coucke; Anne M. De Paepe

2009-01-01

247

Microneedling Therapy in Atrophic Facial Scars: An Objective Assessment  

PubMed Central

Background: Atrophic facial scars are always a challenge to treat, especially the ones that are deep-seated and/or involve much of the face. Microneedling or dermaroller therapy is a new addition to the treatment armamentarium for such scars that offers a simple and reportedly effective management of these scars. Aims: The aim of the present study was to perform an objective evaluation of the efficacy of dermaroller treatment in atrophic facial scars of varying etiology. Materials and Methods: Thirty-seven patients of atrophic facial scarring were offered multiple sittings of microneedling (dermaroller) treatment and their scars were evaluated and graded clinically and by serial photography at the start as well as at two months after the conclusion of the treatment protocol. Any change in the grading of scars after the end of treatment and follow-up period was noted down. The patients were also asked to evaluate the effectiveness of the treatment received on a 1-10 point scale. The efficacy of dermaroller treatment was thus assessed both subjectively by the patients as well as objectively by a single observer. Results: Overall 36 out of the total of 37 patients completed the treatment schedule and were evaluated for its efficacy. Out of these 36 patients, 34 achieved a reduction in the severity of their scarring by one or two grades. More than 80% of patients assessed their treatment as ‘excellent’ on a 10-point scale. No significant adverse effects were noted in any patient. Conclusions: Microneedling therapy seems to be a simple and effective treatment option for the management of atrophic facial scars. PMID:20300368

Majid, Imran

2009-01-01

248

Soil respiration in a fire scar chronosequence of Canadian boreal jack pine forest  

NASA Astrophysics Data System (ADS)

To fully understand the carbon (C) cycle impacts of forest fires, both C emissions during the fire and post-disturbance fluxes need to be considered. The latter are dominated by soil respiration (Rs), which is still subject to large uncertainties. This research investigates Rs in a boreal jack pine fire scar chronosequence at Sharpsand Creek, Ontario, Canada. During two field campaigns in 2006 and 2007, Rs was measured in a chronosequence of fire scars aged between 0 and 59 years since the last fire. Mean Rs per fire scar was adjusted for soil temperature (Ts) and soil moisture (Ms) (denoted RST,M). RST,M ranged from 0.56 ?mol CO2/m2/s (32 years post fire) to 8.18 ?mol CO2/m2/s (58 years post fire). The coefficient of variation (CV) of RST,M ranged from 20% (16 years post fire) to 56% (58 years post fire). Across the field site, there was a statistically highly significant exponential relationship between Rs adjusted for soil organic carbon (Cs) and Ts (P<0.00001; Q10=2.21) but no effect of Ms on Rs adjusted for Cs and Ts for the range 0.21 to 0.77 volumetric Ms (P=0.702). RST,M decreased significantly (P=0.030) after fire (4 to 8 days post fire) in mature forest, though no significant (P>0.1) difference could be detected between recently burned (4 to 8 days post fire) and unburned young forest. There were significant differences in RST,M between recently burned (4 to 8 days post fire) scar age categories that differed in their burn history, with between-fire intervals of 32 vs. 16 years (P<0.001) and 32 vs 59 years (P=0.044). There was a highly significant exponential increase in RST,M with time since fire (r2=0.999; P=0.006) for the chronosequence 0, 16 and 59 years post fire, and for all these age categories, RST,M was significantly different from one another (P<0.05). The results of this study contribute to a better quantitative understanding of Rs in boreal jack pine fire scars and will facilitate improvements in C cycle modelling. Further work is needed in quantifying autotrophic and heterotrophic contributions to Rs in jack pine systems; in monitoring Rs for extended time periods after fire; and in measuring different fire-prone forest types.

Smith, D. R.; Kaduk, J. D.; Balzter, H.; Wooster, M. J.; Mottram, G. N.; Lynham, T. J.; Studens, J.; Curry, J.; Hartley, G.; Stocks, B. J.

2009-09-01

249

Burning Mouth Syndrome  

Microsoft Academic Search

Burning mouth syndrome is characterized by a painful burning or stinging sensation affecting the tongue or other areas of the mouth without obvious signs of an organic cause on physical examination. A burning mouth sensation can occur in several cutaneous or systemic diseases that must be ruled out prior to making a diagnosis of burning mouth syndrome, since this term

C. Brufau-Redondo; R. Martín-Brufau; R. Corbalán-Velez; A. de Concepción-Salesa

2008-01-01

250

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

251

Scar Endometriosis-A Sequel of Caesarean Section  

PubMed Central

Endometriosis is presence of functioning endometrial tissue outside the uterine cavity, usually in the pelvis. However, its occurrence is very rare (0.03%-0.4%) in the scars which follow obstetrical and gynaecological surgeries. We are reporting two cases of scar endometriosis which occurred after caesarean sections. Both cases presented with abdominal pain at caesarean scar sites, one of which gave a cyclical history. Clinical examination revealed painful swellings in both cases, which were misdiagnosed as stitch granulomas. Wide surgical excisions were done and histopathology examination revealed a diagnosis of scar endometriosis. We are presenting these cases because of their rarity, their uncommon sites and difficulty in diagnosing the conditions clinically. PMID:24959457

Patil, Nanda J; Kumar, Vijay

2014-01-01

252

A second case of contractures, webbed neck, micrognathia, hypoplastic nipples, and distinctive facial features: confirmation of the Dinno syndrome.  

PubMed

We report on a child with micrognathia, a short, webbed neck, joint contractures, hypoplastic nipples, and a number of other anomalies. There are striking similarities to a patient reported by [Dinno and Weisskopf (1976); Synd Ident, 4:10-12], and we postulate that this child represents the second patient with this condition. PMID:22383252

Wall, Nerilee; McGaughran, Julie

2012-04-01

253

Scar prevention by laser-assisted scar healing (LASH) using thermal post-conditioning  

NASA Astrophysics Data System (ADS)

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).

Gossé, Alban; Iarmarcovai, Gwen; Capon, Alexandre; Cornil, Alain; Mordon, Serge

2009-02-01

254

Management of keloids and hypertrophic scars: current and emerging options  

PubMed Central

In the context of growing aesthetic awareness, a rising number of patients feel disappointed with their scars and are frequently seeking help for functional and aesthetic improvement. However, excessive scarring following surgery or trauma remains difficult to improve despite a plethora of advocated treatment strategies as frequently observed in daily clinical routine. It is thus still preferable to prevent scarring by minimizing risk factors as much as possible. Hence, it remains crucial for the physician to be aware of basic knowledge of healing mechanisms and skin anatomy, as well as an appreciation of suture material and wound closure techniques to minimize the risk of postoperative scarring. Next to existing, well known prophylactic and therapeutic strategies for the improvement of excessive scarring, this article discusses emerging techniques such as intralesional cryotherapy, intralesional 5-fluorouracil, interferon, and bleomycin. Some of them have been successfully tested in well-designed trials and already have extended or may extend the current spectrum of excessive scar treatment in the near future. Innovative options such as imiquimod 5% cream, photodynamic therapy, or botulinum toxin A may also be of certain importance; however, the data currently available is too contradictory for definite recommendations. PMID:23637546

Gauglitz, Gerd G

2013-01-01

255

Keloids and Hypertrophic Scars: Update and Future Directions  

PubMed Central

Summary: The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions.

Huang, Chenyu; Murphy, George F.; Akaishi, Satoshi

2013-01-01

256

Burn epidemiology: a basis for burn prevention.  

PubMed

An appreciation of the causes of burn injury is essential in order to direct burn prevention programs. Toward this goal, 1,564 patients treated at the UCI Burn Center were studied. There were 699 patients admitted acutely and 865 outpatients. The most common cause of thermal injury in both adults and children was scalding. In children scald burns accounted for 42% of the total number of children treated. In children under 4 years old scalds caused 75% of all burn injuries, most in the kitchen. Flammable liquids were responsible for the majority of the severe burns in the adult group (19% of acute admissions). Housefires, while accounting for only 5% of the adults treated, were responsible for 44% of the adult deaths. Continued public education in safety practices at home especially in the kitchen and bath, and with automobiles and outdoor stoves and fires is recommended, as well as planned escapes from homes and use of smoke detectors. PMID:592443

Jay, K M; Bartlett, R H; Danet, R; Allyn, P A

1977-12-01

257

Effect of Ebselen on Renal Scarring in Rats following Renal Infection  

Microsoft Academic Search

Renal scarring, which occurs following refluxing pyelonephritis, is considered to be involved in the development of reflux nephropathy. Prevention of renal scar formation requires immediate initiation of antimicrobial treatment; treatment delay results in renal scarring. We demonstrate that Ebselen, an antioxidant agent, given at a dose of 15 mg\\/kg twice a day prevents renal scarring in rats following direct renal

Masashi Haraoka; Tetsuro Matsumoto; Yoshimitsu Mizunoe; Koichi Takahashi; Shuta Kubo; Yasuhiro Koikawa; Masatoshi Tanaka; Yasuki Sakamoto; Misao Sakumoto; Tatsuo Nagafuji; Joichi Kumazawa

1995-01-01

258

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

PubMed

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

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

2009-10-15

259

A newborn with complex skeletal abnormalities, joint contractures, and bilateral corneal clouding with sclerocornea.  

PubMed

A newborn presented to genetics with complex skeletal abnormalities, joint contractures, and bilateral corneal clouding with sclerocornea. The patient survived for 8 months before succumbing to respiratory failure. Exome sequencing revealed a compound heterozygous mutation in theB3GALT6gene. Mutations in this gene have been associated with both Ehlers- Danlos syndrome, progeroid type 2 and spondyloepimetaphyseal dysplasia with joint laxity type 1. These diagnoses encompass the skeletal and joint findings. Our patient expands the phenotype of these diagnoses, as anterior segment eye anomalies have not been described with either syndrome, and he is much more profoundly affected. Interestingly, our patient fits the description of a rare genetic disease referred to as Al-Gazali syndrome, for which the genetic cause is unknown. PMID:25149931

Sellars, Elizabeth A; Bosanko, Katherine A; Lepard, Tiffany; Garnica, Adolfo; Schaefer, Gerald Bradley

2014-06-01

260

Beals syndrome (congenital contractural arachnodactyly): prenatal ultrasound findings and molecular analysis.  

PubMed

We report the prenatal findings in two cases of Beals syndrome. Both pregnancies presented with clinical features of arthrogryposis multiplex congenita/fetal akinesia syndrome (AMC/FAS), including clenched fists and multiple joint contractures on repeat prenatal ultrasound examinations. The first case was diagnosed as having Beals syndrome on physical examination shortly after birth and the diagnosis was confirmed by DNA analysis, shown as a point mutation in the fibrillin 2 (FBN2) gene. The second case was diagnosed with Beals syndrome following microarray analysis on amniocytes, which showed a deletion of the FBN2 gene. Although most cases with AMC/FAS carry a poor prognosis, Beals syndrome is consistent with normal cognitive development and a better prognosis. Thus, making the correct diagnosis is crucial, both pre- and postnatally, for accurate counseling and management. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. PMID:24585410

Inbar-Feigenberg, M; Meirowitz, N; Nanda, D; Toi, A; Okun, N; Chitayat, D

2014-10-01

261

FBN2, FBN1, TGFBR1, and TGFBR2 analyses in congenital contractural arachnodactyly.  

PubMed

FBN2, FBN1, TGFBR1, and TGFBR2 were analyzed by direct sequencing in 15 probands with suspected congenital contractural arachnodactyly (CCA). A total of four novel FBN2 mutations were found in four probands (27%, 4/15), but remaining the 11 did not show any abnormality in either of the genes. This study indicated that FBN2 mutations were major abnormality in CCA, and TGFBR and FBN1 defects may not be responsible for the disorder. FBN2 mutations were only found at introns 30, 31, and 35 in this study. Thus analysis of a mutational hotspot from exons 22 to 36 (a middle part) of FBN2 should be prioritized in CCA as previously suggested. PMID:17345643

Nishimura, Akira; Sakai, Haruya; Ikegawa, Shiro; Kitoh, Hiroshi; Haga, Nobuyuki; Ishikiriyama, Satoshi; Nagai, Toshiro; Takada, Fumio; Ohata, Takako; Tanaka, Fumihiko; Kamasaki, Hotaka; Saitsu, Hirotomo; Mizuguchi, Takeshi; Matsumoto, Naomichi

2007-04-01

262

Nasal reconstruction in panfacial burns: useful techniques in challenging cases.  

PubMed

Nasal reconstruction after severe panfacial burns can be challenging to correct because of scarring, loss of suitable donor sites, and variably limited blood supply of local flaps. We describe 2 cases of subtotal nasal reconstruction in which we overcame these difficulties. Both cases had alar subunit loss, which had left significant functional and esthetic deformities. However, both cases were managed very differently because of availability of donor sites.The first patient had 70% total body surface area burns with bilateral alar subunit loss: nasal reconstruction required a meticulous multistaged forehead flap. The second patient required nasal reconstruction using a turn-down flap to maximize take of a composite graft from previously burned ear donor sites.A number of surgical techniques have been described to manage subtotal burns nasal reconstruction, foremost of which are the nasolabial and paramedian forehead flaps. Cartilage grafts from the septum and the conchal bowl can be integrated into these flaps. Composite grafts can be unpredictable and are often used with caution.Such cases demonstrate that large composite grafts can be an extremely robust method of reconstruction even in a subset of patients with extensively scarred recipient and donor sites. In our second case, composite grafting avoided multistaged procedures such as the forehead flap and can be considered as a first-line procedure in large alar subunit loss. PMID:25397694

King, Ian C C; Nikkhah, Dariush; Martin, Niall A J; Gilbert, Philip M; Dheansa, Baljit S

2014-12-01

263

Propolis and amnion reepithelialise second-degree burns in rats.  

PubMed

Burns are serious consequences of trauma in terms of both imminent mortality and prolonged periods of morbidity. They are often accompanied by unsatisfactory cosmetic as well as functional and psychological outcomes. These complications emphasise the need for stronger efforts in achieving greater diversity and effectiveness in the treatment of skin burns. This study aimed to verify the effectiveness of gross and microscopic epidermal and dermal responses in the process of regenerative repair or healing of burns in rats that were treated either daily with 5% propolis ointment or by autologous amnion graft. Second-degree burns were inflicted in the neck region of female rats by contact with a hot metal (at 130 °C) for 5 s. Propolis treatment accelerated the process of tissue repair and led to decreased local inflammation, which indicates that treatment with propolis was successful in the initial period (7 days) and stimulated the production of collagen fibre (assessed by morphometry) in all the periods evaluated (14 and 21 days). Amnion treatment inhibited local inflammation (assessed macroscopically), stimulated local epithelial regeneration (assessed microscopically) and stimulated the production of collagen fibre (assessed by morphometry) in the days following burn. These treatments offer new therapeutic strategies for treating severe skin burns; these strategies may allow the minimisation of scar formation, a more rapid return of function and, ultimately, a better quality of life for burn patients. PMID:21741176

Pessolato, Alicia Greyce Turatti; Martins, Daniele dos Santos; Ambrósio, Carlos Eduardo; Mançanares, Celina Almeida Furlanetto; de Carvalho, Ana Flávia

2011-11-01

264

Effects of Noscarna™ on hypertrophic scarring in the rabbit ear model: histopathological aspects.  

PubMed

In this study, we evaluated the effects of silicone-based gel on the healing of hypertrophic scars in the rabbit ear model. After 4-week application of silicone-based gel containing allantoin, dexpanthenol and heparin (Noscarna™) to scars in a rabbit ear model of hypertrophic scarring, significant improvements in hypertrophic scar healing and a great loss of skin pigment were observed compared to the non-treated control, base or silicone control-treated scars. Furthermore, histological analysis of Noscarna™-treated scars revealed a significant reduction in scar elevation index (SEI), anterior skin and epithelial thicknesses, inflammatory cells, vessels, collagen disorganization and fibroblasts compared to all control hypertrophic scars. Furthermore, Noscarna™ showed more favorable effects on hypertrophic scars than a commercial product, Contractubex®. Therefore, these results clearly demonstrated that the newly developed silicone-based gel, Noscarna™, could be a promising formulation as an effective therapeutic agent for hypertrophic scars. PMID:23212642

Lee, Dong Won; Ku, Sae Kwang; Cho, Hyuk Jun; Kim, Jeong Hwan; Hiep, Tran Tuan; Han, Sang Duk; Kim, Bo Gyun; Kang, Min Kyung; Do, Eui Seon; Jun, Joon Ho; Jang, Sun Woo; Son, Mi-Won; Sohn, Young Taek; Choi, Han-Gon; Yong, Chul Soon; Kim, Jong Oh

2012-11-01

265

siRNA-targeting transforming growth factor-? type I receptor reduces wound scarring and extracellular matrix deposition of scar tissue.  

PubMed

Hypertrophic scarring is related to persistent activation of transforming growth factor-? (TGF-?)/Smad signaling. In the TGF-?/Smad signaling cascade, the TGF-? type I receptor (TGFBRI) phosphorylates Smad proteins to induce fibroblast proliferation and extracellular matrix deposition. In this study, we inhibited TGFBRI gene expression via TGFBRI small interfering RNA (siRNA) to reduce fibroblast proliferation and extracellular matrix deposition. Our results demonstrate that downregulating TGFBRI expression in cultured human hypertrophic scar fibroblasts significantly suppressed cell proliferation and reduced type I collagen, type III collagen, fibronectin, and connective tissue growth factor (CTGF) mRNA, and type I collagen and fibronectin protein expression. In addition, we applied TGFBRI siRNA to wound granulation tissue in a rabbit model of hypertrophic scarring. Downregulating TGFBRI expression reduced wound scarring, the extracellular matrix deposition of scar tissue, and decreased CTGF and ?-smooth muscle actin mRNA expression in vivo. These results suggest that TGFBRI siRNA could be applied clinically to prevent hypertrophic scarring. PMID:24670383

Wang, Yi-Wen; Liou, Nien-Hsien; Cherng, Juin-Hong; Chang, Shu-Jen; Ma, Kuo-Hsing; Fu, Earl; Liu, Jiang-Chuan; Dai, Niann-Tzyy

2014-07-01

266

Fire history in western Patagonia from paired tree-ring fire-scar and charcoal records  

NASA Astrophysics Data System (ADS)

Fire history reconstructions are typically based on tree ages and tree-ring fire scars or on charcoal in sedimentary records from lakes or bogs, but rarely on both. In this study of fire history in western Patagonia (47-48° S) in southern South America (SSA) we compared three sedimentary charcoal records collected in bogs with tree-ring fire-scar data collected at 13 nearby sample sites. We examined the temporal and spatial correspondence between the two fire proxies and also compared them to published charcoal records from distant sites in SSA, and with published proxy reconstructions of regional climate variability and large-scale climate modes. Two of our three charcoal records record fire activity for the last 4 ka yr and one for the last 11 ka yr. For the last ca. 400 yr, charcoal accumulation peaks tend to coincide with high fire activity in the tree-ring fire scar records, but the charcoal records failed to detect some of the fire activity recorded by tree rings. Potentially, this discrepancy reflects low-severity fires that burn in herbaceous and other fine fuels without depositing charcoal in the sedimentary record. Periods of high fire activity tended to be synchronous across sample areas, across proxy types, and with proxy records of regional climatic variability as well as major climate drivers. Fire activity throughout the Holocene in western Patagonia has responded to regional climate variation affecting a broad region of southern South America that is teleconnected to both tropical- and high-latitude climate drivers-El Niño-Southern Oscillation and the Southern Annular Mode. An early Holocene peak in fire activity pre-dates any known human presence in our study area, and consequently implicates lightning as the ignition source. In contrast, the increased fire activity during the 20th century, which was concomitantly recorded by charcoal from all the sampled bogs and at all fire-scar sample sites, is attributed to human-set fires and is outside the range of variability characteristic of these ecosystems over many centuries and probably millennia.

Holz, A.; Haberle, S.; Veblen, T. T.; de Pol-Holz, R.; Southon, J.

2012-03-01

267

Fire history in western Patagonia from paired tree-ring fire-scar and charcoal records  

NASA Astrophysics Data System (ADS)

Fire history reconstructions are typically based on tree ages and tree-ring fire scars or on charcoal in sedimentary records from lakes or bogs, but rarely on both. In this study of fire history in western Patagonia (47-48° S) in southern South America (SSA) we compared three sedimentary charcoal records collected in bogs with tree-ring fire-scar data collected at 13 nearby sample sites. We examined the temporal and spatial correspondence between the two fire proxies and also compared them to published charcoal records from distant sites in SSA, and with published proxy reconstructions of regional climate variability and large-scale climate modes. Two of our three charcoal records show fire activity for the last 4ka yrs and one for the last 11 ka yr. For the last ca. 400 yr, charcoal accumulation peaks tend to coincide with high fire activity in the tree-ring fire scar records, but the charcoal records failed to detect some of the fire activity recorded by tree rings. Potentially, this discrepancy reflects low-severity fires that burn in herbaceous and other fine fuels without depositing charcoal in the sedimentary record. Periods of high fire activity tended to be synchronous across sample areas, across proxy types, and with proxy records of regional climatic variability as well as major climate drivers. Fire activity throughout the Holocene in western Patagonia has responded to regional climate variation affecting a broad region of southern South America that is teleconnected to both tropical- and high-latitude climate drivers - El Nino-Southern Oscillation and the Southern Annular Mode. An early Holocene peak in fire activity pre-dates any known human presence in our study area, and consequently implicates lightning as the ignition source. In contrast, the increased fire activity during the 20th century, which was concomitantly recorded by charcoal from all the sampled bogs and at all fire-scar sample sites, is attributed to human-set fires and is outside the range of variability characteristic of these ecosystems over many centuries and probably millennia.

Holz, A.; Haberle, S.; Veblen, T. T.; de Pol-Holz, R.; Southon, J.

2011-10-01

268

Dermal preservation using the Versajet hydrosurgery system for debridement of paediatric burns.  

PubMed

Loss of dermis is one of the principal factors that contributes to poor scar outcome after severe burn. Dermal loss may be due to the primary injury, surgical management or as a result of infection. Strategies for dermal preservation are therefore important to improve scar quality. We report our early experience using the Versajet hydrosurgery system, to preserve dermal tissues, both directly during surgical debridement and indirectly by reducing infection and optimising the use of biological dressings. In deep partial thickness burns softer necrotic dermis can be removed with the Versajet sparing the underlying tougher viable dermis. In superficial burns the Versajet cleans and removes loose epidermal elements providing an optimal wound surface for the application of biological dressings, even a number of days after injury. Versajet is most useful when the tissue to be removed is softer than that to be left behind. PMID:16849034

Cubison, Tania C S; Pape, Sarah A; Jeffery, Steven L A

2006-09-01

269

Postmastectomy radiotherapy with integrated scar boost using helical tomotherapy  

SciTech Connect

The purpose of this study was to evaluate helical tomotherapy dosimetry in postmastectomy patients undergoing treatment for chest wall and positive nodal regions with simultaneous integrated boost (SIB) in the scar region using strip bolus. Six postmastectomy patients were scanned with a 5-mm-thick strip bolus covering the scar planning target volume (PTV) plus 2-cm margin. For all 6 cases, the chest wall received a total cumulative dose of 49.3-50.4 Gy with daily fraction size of 1.7-2.0 Gy. Total dose to the scar PTV was prescribed to 58.0-60.2 Gy at 2.0-2.5 Gy per fraction. The supraclavicular PTV and mammary nodal PTV received 1.7-1.9 dose per fraction. Two plans (with and without bolus) were generated for all 6 cases. To generate no-bolus plans, strip bolus was contoured and overrode to air density before planning. The setup reproducibility and delivered dose accuracy were evaluated for all 6 cases. Dose-volume histograms were used to evaluate dose-volume coverage of targets and critical structures. We observed reduced air cavities with the strip bolus setup compared with what we normally see with the full bolus. The thermoluminescence dosimeters (TLD) in vivo dosimetry confirmed accurate dose delivery beneath the bolus. The verification plans performed on the first day megavoltage computed tomography (MVCT) image verified that the daily setup and overall dose delivery was within 2% accuracy compared with the planned dose. The hotspot of the scar PTV in no-bolus plans was 111.4% of the prescribed dose averaged over 6 cases compared with 106.6% with strip bolus. With a strip bolus only covering the postmastectomy scar region, we observed increased dose uniformity to the scar PTV, higher setup reproducibility, and accurate dose delivered beneath the bolus. This study demonstrates the feasibility of using a strip bolus over the scar using tomotherapy for SIB dosimetry in postmastectomy treatments.

Rong Yi, E-mail: rong@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); University of Wisconsin Riverview Cancer Center, Wisconsin Rapids, WI (United States); Yadav, Poonam [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); Vellore Institute of Technology University, Vellore, Tamil Nadu (India); Welsh, James S. [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); University of Wisconsin Riverview Cancer Center, Wisconsin Rapids, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); Fahner, Tasha [University of Wisconsin Riverview Cancer Center, Wisconsin Rapids, WI (United States); Paliwal, Bhudatt [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States)

2012-10-01

270

Burning system and method  

SciTech Connect

A substantially smokeless burning system for burning waste material fuels. An elongated hollow burning chamber is supported in a generally horizontal orientation with a slight degree of upward tilt from front to rear. An elongated fuel accumulation chamber and a hydraulic hoist driven ram in the chamber are adapted to push elongated volumes of new fuel into the lower front end of the burning chamber such that already burning fuel is pushed to the rear of the chamber. This establishes a charcoal burning zone which at least partially overlies a volatile burning zone such that incomplete combustion products from the volatile burning zone pass over and through the charcoal burning zone to be substantially burned before exiting at the rear of the burning chamber. The burning chamber is formed of a plurality of pipe sections which are molded of refractory material in a concrete pipe making machine. Integral preheat and air delivery channels are formed in the walls of the burning chamber during the molding process.

Burton, R.E.

1982-05-18

271

Wound Coverage Technologies in Burn Care: Novel Techniques  

PubMed Central

Improvements in burn wound care have vastly decreased morbidity and mortality in severely burned patients. Development of new therapeutic approaches to increase wound repair has the potential to reduce infection, graft rejection, and hypertrophic scarring. The incorporation of tissue engineering techniques, along with the use of exogenous proteins, genes, or stem cells to enhance wound healing, heralds new treatment regimens based on the modification of already existing biological activity. Refinements to surgical techniques have enabled the creation of protocols for full facial transplantation. With new technologies and advances such as these, care of the severely burned will undergo massive changes over the next decade. This review centers on new developments that have recently shown great promise in the investigational arena. PMID:23877140

Jeschke, Marc G.; Finnerty, Celeste C.; Shahrokhi, Shahriar; Branski, Ludwik K.; Dibildox, Manuel

2013-01-01

272

Burning Rate Emulator  

NASA Video Gallery

The Burning Rate Emulator is a gas fuel investigation attempting to emulate the burning of solids to improve our understanding of materials''flammability over a wide range of conditions. The approa...

273

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2011 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.10411...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2011-07-01

274

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2010 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.11021...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2010-07-01

275

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2011 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.11021...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2011-07-01

276

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2010 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.10411...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2010-07-01

277

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2013 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.11021...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2013-07-01

278

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2013 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.10411...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2013-07-01

279

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2012 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.10411...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2012-07-01

280

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.  

Code of Federal Regulations, 2012 CFR

...open burning, agricultural burning, and forestry and silvicultural burning. 49.11021...open burning, agricultural burning, and forestry and silvicultural burning. (a...of a permit under § 49.134 Rule for forestry and silvicultural burning...

2012-07-01

281

Caesarean scar pregnancy: hysterotomy is rapid and safe management option.  

PubMed

Caesarean scar pregnancy (CSP) is implantation of the gestational sac within the hysterotomy scar. Ultrasound is the main diagnostic tool. Early diagnosis and termination of pregnancy is crucial to avoid the risk of uterine rupture. The termination modalities available are dilatation and curettage, methotrexate therapy, hysteroscopy, uterine artery embolization and laparotomy. We present a case of undisturbed CSP which presented at 6 weeks + 6 days gestation. Our management was termination of pregnancy by exploratory laparotomy and hysterotomy for excision of the mass. The postoperative period was uneventful and there was rapid decline of beta human chorionic gonadotrophin to the normal level. PMID:24643804

Abdelkader, Mohamed Ali; Fouad, Reham; Gebril, Amr Hosny; El Far, Mohamed Ahmed; Elyassergi, Dina Fauzi

2014-08-01

282

Conjunctival Hypertrophic Scar Following Cryotherapy for Retinopathy of Prematurity  

PubMed Central

A 6-year-old boy was referred to our hospital with symblepharon and lateral canthal deformity in both eyes, which developed 6 years ago. The patient was born at 27 weeks gestation. He had received cryotherapy for retinopathy of prematurity. One month after cryotherapy, he developed a conjunctival scar with symblepharon in both eyes and underwent symblepharon lysis at another hospital 5 years prior. Ocular examination revealed an extensive conjunctival hypertrophic scar with symblepharon and limitation of extraocular movements. An excisional biopsy, lateral canthoplasty, and symblepharon lysis with conjunctival autograft from the contralateral eye were performed in the left eye. Histopathologic examination revealed diffuse proliferation and infiltration of collagenous tissue. PMID:23372382

Lyu, In Jeong; Sa, Ho-Seok; Woo, Kyung In

2013-01-01

283

Facial Burns - Our Experience  

PubMed Central

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

Zatriqi, Violeta; Arifi, Hysni; Zatriqi, Skender; Duci, Shkelzen; Rrecaj, Sh.; Martinaj, M.

2013-01-01

284

Pediatric burn injuries  

PubMed Central

Pediatric burns comprise a major mechanism of injury, affecting millions of children worldwide, with causes including scald injury, fire injury, and child abuse. Burn injuries tend to be classified based on the total body surface area involved and the depth of injury. Large burn injuries have multisystemic manifestations, including injuries to all major organ systems, requiring close supportive and therapeutic measures. Management of burn injuries requires intensive medical therapy for multi-organ dysfunction/failure, and aggressive surgical therapy to prevent sepsis and secondary complications. In addition, pain management throughout this period is vital. Specialized burn centers, which care for these patients with multidisciplinary teams, may be the best places to treat children with major thermal injuries. This review highlights the major components of burn care, stressing the pathophysiologic consequences of burn injury, circulatory and respiratory care, surgical management, and pain management of these often critically ill patients. PMID:23181206

Krishnamoorthy, Vijay; Ramaiah, Ramesh; Bhananker, Sanjay M

2012-01-01

285

Unroofed Midline Prostate Cyst Misled Into a Stricture With Obliterative Bladder Neck Contracture Following a Laser Prostatectomy  

PubMed Central

We report on a case of a 67-year-old man who presented with persistent lower urinary tract symptoms following a potassium titanyl phosphate laser photoselective vaporization of prostate. Upon further diagnostic examinations were performed, he was noted to have an obliterative bladder neck contracture with an incidental, misleading, and rare presence of an unroofed midline anterior prostatic cyst presenting as a stricture. As we were presented with this case, it was imperative to address these complications of bladder neck contracture and incompletely ablated prostatic cyst. This report brings to light underestimated complicating factors in the urinary tract, and the diagnostic and therapeutic interventions we had undertaken to rectify the identified complications and improve patien's quality of life. The patient underwent internal urethrotomy, resection of prostatic cyst wall and transurethral resection of the prostate directed to improve his quality of life and prevent urinary retention. PMID:23610710

Diaz, Richilda Red; Lee, Joo Yong; Choi, Young Deuk

2013-01-01

286

Familial occurrence of typical and severe lethal congenital contractural arachnodactyly caused by missplicing of exon 34 of fibrillin-2.  

PubMed

Genetic linkage studies have linked congenital contractural arachnodactyly (CCA), a usually mild heritable connective-tissue disorder, to FBN2, the fibrillin gene on chromosome 5. Recently, FBN2 mutations in two patients with CCA have been described. Here we report an A-->T transversion at the -2 position of the consensus acceptor splice site, resulting in the missplicing of exon 34, a calcium-binding epidermal growth factor-like repeat in fibrillin-2 in a mother and daughter with CCA. Significantly, the mother exhibited a classic CCA phenotype with arachnodactyly, joint contractures, and abnormal pinnae, whereas her daughter exhibited a markedly more severe CCA phenotype, which included cardiovascular and gastrointestinal anomalies that led to death in infancy. Analysis of cloned fibroblasts showed that the mother is a somatic mosaic for the exon 34 missplicing mutation, whereas all the daughter's cells harbored the mutation. PMID:8900230

Wang, M; Clericuzio, C L; Godfrey, M

1996-11-01

287

A single mutation that results in an Asp to His substitution and partial exon skipping in a family with congenital contractural arachnodactyly  

Microsoft Academic Search

Congenital contractural arachnodactyly (CCA) is an autosomal dominant disorder of connective tissue and is characterized\\u000a by multiple congenital contractures, arachnodactyly, and external ear malformations. Recent investigations indicate that mutations\\u000a in the fibrillin-2 gene (FBN2) cause CCA. Here, we report a G?C transversion at nucleotide 3340 (G3340C) of FBN2 in a family\\u000a with phenotypic characteristics of CCA. The G3340C mutation predicts

Darcie Babcock; Cheryll Gasner; Uta Francke; Cheryl Maslen

1998-01-01

288

Treatment of sandal burns of the feet in children in a moist environment.  

PubMed

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

Shakirov, Babur M

2014-05-01

289

Burn therapist contributions to the american burn association and the journal of burn care and research: a 45th anniversary review.  

PubMed

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

Richard, Reginald

2014-01-01

290

Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.  

PubMed

In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing. PMID:23908426

Baltzer, H; Binhammer, P A

2013-08-01

291

A case of an electrical burn in the oral cavity of an adult.  

PubMed

Electrical burns in the oral cavity account for 2.2% of all electrical burns and only 0.12% of all burns; thus, the incidence of electrical burns in the oral cavity is relatively low. As this type of injury occurs in the oral cavity when an individual sucks or chews on a live electrical wire, extension cord, plug, or outlet, most cases occur in toddlers or preschool children, and adult cases are extremely rare. Here we describe a case of an electrical burn in a 56-year-old man who accidentally bit the electric wire of a cleaner while carrying out repairs. Conservative treatment, without surgery, was performed. Two years after the injury, a slight scar and a small tongue deformity remain, but no functional disturbance has been observed. PMID:10692838

Shimoyama, T; Kaneko, T; Nasu, D; Suzuki, T; Horie, N

1999-09-01

292

A novel mutation (C1425Y) in the FBN2 gene in a father and son with congenital contractural arachnodactyly.  

PubMed

Congenital contractural arachnodactyly (Beals syndrome) is a rare autosomal dominantly inherited connective tissue disorder characterized by flexion contractures, arachnodactyly, crumpled ears, and mild muscular hypoplasia. Here, a father and son with congenital contractural arachnodactyly features were identified. After sequencing 15 exons (22 to 36) of the FBN2 gene, a novel mutation (C1425Y) was found in exon 33. This de novo mutation presented first in the father and was transmitted to his son, but not in the other 14 unaffected family members and 365 normal people. The C1425Y mutation occurs at the 19th cbEGF domain. Cysteines in this cbEGF domain are rather conserved in species, from human down to ascidian. The cbEGF12-13 in human FBN1 was employed as the template to perform homology modeling of cbEGF18-19 of human FBN2 protein. The mutation has also been evaluated by further prediction tools, for example, SIFT, Blosum62, biochemical Yu's matrice, and UMD-Predictor tool. In all analysis, the mutation is predicted to be pathogenic. Thus, the structure destabilization by C1425Y might be the cause of the disorder. PMID:19473076

Chen, Ying; Lei, Yun-Ping; Zheng, Hong-Xiang; Wang, Wei; Cheng, Hong-Bo; Zhang, Jing; Wang, Hong-Yan; Jin, Li; Li, Hong

2009-06-01

293

Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies  

PubMed Central

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

Steiert, Andreas E; Boyce, Maria; Sorg, Heiko

2013-01-01

294

High resolution muscle measurements provide insights into equinus contractures in patients with cerebral palsy.  

PubMed

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 and formalin fixed, and Ls was 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?

Mathewson, Margie A; Ward, Samuel R; Chambers, Henry G; Lieber, Richard L

2015-01-01

295

ZBTB42 mutation defines a novel lethal congenital contracture syndrome (LCCS6).  

PubMed

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

Patel, Nisha; Smith, Laura L; Faqeih, Eissa; Mohamed, Jawahir; Gupta, Vandana A; Alkuraya, Fowzan S

2014-12-15

296

Mutations in FAM111B Cause Hereditary Fibrosing Poikiloderma with Tendon Contracture, Myopathy, and Pulmonary Fibrosis  

PubMed Central

Congenital poikiloderma is characterized by a combination of mottled pigmentation, telangiectasia, and epidermal atrophy in the first few months of life. We have previously described a South African European-descent family affected by a rare autosomal-dominant form of hereditary fibrosing poikiloderma accompanied by tendon contracture, myopathy, and pulmonary fibrosis. Here, we report the identification of causative mutations in FAM111B by whole-exome sequencing. In total, three FAM111B missense mutations were identified in five kindreds of different ethnic backgrounds. The mutation segregated with the disease in one large pedigree, and mutations were de novo in two other pedigrees. All three mutations were absent from public databases and were not observed on Sanger sequencing of 388 ethnically matched control subjects. The three single-nucleotide mutations code for amino acid changes that are clustered within a putative trypsin-like cysteine/serine peptidase domain of FAM111B. These findings provide evidence of the involvement of FAM111B in congenital poikiloderma and multisystem fibrosis. PMID:24268661

Mercier, Sandra; Kury, Sebastien; Shaboodien, Gasnat; Houniet, Darren T.; Khumalo, Nonhlanhla P.; Bou-Hanna, Chantal; Bodak, Nathalie; Cormier-Daire, Valerie; David, Albert; Faivre, Laurence; Figarella-Branger, Dominique; Gherardi, Romain K.; Glen, Elise; Hamel, Antoine; Laboisse, Christian; Le Caignec, Cedric; Lindenbaum, Pierre; Magot, Armelle; Munnich, Arnold; Mussini, Jean-Marie; Pillay, Komala; Rahman, Thahira; Redon, Richard; Salort-Campana, Emmanuelle; Santibanez-Koref, Mauro; Thauvin, Christel; Barbarot, Sebastien; Keavney, Bernard; Bezieau, Stephane; Mayosi, Bongani M.

2013-01-01

297

[The pain from burns].  

PubMed

The painful events associated with the treatment of a severe burn can, because of their long-lasting and repetitive characteristics, be one of the most excruciating experiences in clinical practice. Moreover, burn pain has been shown to be detrimental to burn patients. Although nociception and peripheral hyperalgesia are considered the major causes of burn pain, the study of more hypothetical mechanisms like central hyperalgesia and neuropathic pain may lead to a better understanding of burn pain symptoms and to new therapeutic approaches. Continuous pain and intermittent pain due to therapeutic procedures are two distinct components of burn pain. They have to be evaluated and managed separately. Although continuous pain is by far less severe than intermittent pain, the treatment is, in both cases, essentially pharmacological relying basically on opioids. Because of wide intra- and inter-individual variations, protocols will have to leave large possibilities of adaptation for each case, systematic pain evaluation being mandatory to achieve the best risk/benefit ratio. Surprisingly, the dose of medication decreases only slowly with time, a burn often remaining painful for long periods after healing. Non pharmacological treatments are often useful and sometimes indispensable adjuncts; but their rationale and their feasibility depends entirely on previous optimal pharmacological control of burn pain. Several recent studies show that burn pain management is inadequate in most burn centres. PMID:11933833

Latarjet, J

2002-03-01

298

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

299

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

300

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

301

Electrospun Poly(L-Lactide) Fiber with Ginsenoside Rg3 for Inhibiting Scar Hyperplasia of Skin  

PubMed Central

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

Hu, Changmin; Li, Haiyan; Zhang, Yuguang; Chang, Jiang

2013-01-01

302

Blockade of Mast Cell Activation Reduces Cutaneous Scar Formation  

PubMed Central

Damage to the skin initiates a cascade of well-orchestrated events that ultimately leads to repair of the wound. The inflammatory response is key to wound healing both through preventing infection and stimulating proliferation and remodeling of the skin. Mast cells within the tissue are one of the first immune cells to respond to trauma, and upon activation they release pro-inflammatory molecules to initiate recruitment of leukocytes and promote a vascular response in the tissue. Additionally, mast cells stimulate collagen synthesis by dermal fibroblasts, suggesting they may also influence scar formation. To examine the contribution of mast cells in tissue repair, we determined the effects the mast cell inhibitor, disodium cromoglycate (DSCG), on several parameters of dermal repair including, inflammation, re-epithelialization, collagen fiber organization, collagen ultrastructure, scar width and wound breaking strength. Mice treated with DSCG had significantly reduced levels of the inflammatory cytokines IL-1?, IL-1?, and CXCL1. Although DSCG treatment reduced the production of inflammatory mediators, the rate of re-epithelialization was not affected. Compared to control, inhibition of mast cell activity caused a significant decrease in scar width along with accelerated collagen re-organization. Despite the reduced scar width, DSCG treatment did not affect the breaking strength of the healed tissue. Tryptase ?1 exclusively produced by mast cells was found to increase significantly in the course of wound healing. However, DSCG treatment did not change its level in the wounds. These results indicate that blockade of mast cell activation reduces scar formation and inflammation without further weakening the healed wound. PMID:24465509

Ranzer, Matthew J.; Wilgus, Traci A.; DiPietro, Luisa A.

2014-01-01

303

Fire-scar formation and compartmentalization in Kevin T. Smith and Elaine Kennedy Sutherland  

E-print Network

Fire-scar formation and compartmentalization in oak Kevin T. Smith and Elaine Kennedy Sutherland in April 1995 and 1997 scarred Quercus prinus L. and Q. velutina Lam. Low-intensity fires scorched bark

304

Outpatient burn management.  

PubMed

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

Warner, Petra M; Coffee, Tammy L; Yowler, Charles J

2014-08-01

305

Histology of the thick scar on the female, red Duroc pig: Final similarities to human hypertrophic scar  

PubMed Central

The etiology and treatment of hypertrophic scar remain puzzles even after decades of research. A significant reason is the lack of an accepted animal model of the process. The female, red Duroc pig model was described long ago. Since the skin of the pig is similar to that of humans, we are attempting to validate this model and found it to be encouraging. In this project we quantified myofibroblasts, mast cells and collagen nodules in the thick scar of the Duroc pig and compared these to the values for human hypertrophic scar. We found the results to be quite similar and so further validated the model. In addition, we observed that soon after wounding an inflammatory cell layer forms. The thickness of the inflammatory layer approaches the thickness of the skin removed as if the remaining dermis “knows” how much dermis is gone. In deep wounds this inflammatory layer thickens and this thickness is predictive of the thickness of the ultimate scar. PMID:16905264

Harunari, Nobuyuki; Zhu, Kathy Q.; Armendariz, Rebecca T.; Deubner, Heike; Muangman, Pornprom; Carrougher, Gretchen J.; Isik, F. Frank; Gibran, Nicole S.; Engrav, Loren H.

2010-01-01

306

Burns and military clothing.  

PubMed

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

McLean, A D

2001-02-01

307

Comparison of the incisions for the open surgical treatment of gluteal muscle contracture.  

PubMed

Gluteal muscle contracture is not very common, but cases are still seen in China. Open surgical treatment is considered as an efficient method to treat this disease. However, the type of incision that can provide best results is yet to be determined. The authors therefore compared various incisions to determine the better one. In this retrospective study, patients who underwent surgery with a traverse straight incision, a curved incision, a longitudinal straight incision, or an 'S'-shaped incision above the greater trochanter were enrolled and divided into four groups: A, B, C, and D. In each group, the patients were divided into different levels according to a specific standard. The four groups were compared in terms of incision length, postoperative drainage amounts, wound healing rates, visual analog scale scores, and improvement in the degree of range of motion (ROM). During the follow-up period, the validity of the results, complications, and recurrent cases were evaluated. In our study, incision length and visual analog scale score of the four groups showed no significant differences (P>0.05). Wound healing rates, drainage amount, improvement in ROM, validity of the results, and recurrences in group D were significantly the best (P<0.05). No significant differences in wound healing rates, drainage amount, and improvement in ROM were found in groups A, B, and C. In terms of validity of the results and 1-year recurrence, no significant difference was observed between groups A and B; however, these factors were better than those in group C. We concluded that the 'S'-shaped incision above the greater trochanter is the most efficient among the incisions described in this study. This incision has the following advantages: clear exposure, less damage, high safety rate, excellent results, and low recurrence rate. PMID:24887050

Xu, Jian; Geng, Xiang; Muhammad, Hassan; Wang, Xu; Huang, Jia-Zhang; Zhang, Chao; Ma, Xin

2014-09-01

308

Hip flexion contracture caused by an intraspinal osteochondroma of the lumbar spine.  

PubMed

Osteochondroma (or osteocartilaginous exostosis) is the most common bone tumor of childhood, with an incidence ranging from 1 to 1.4 per 1,000,000. In the lumbar spine, osteochondromata usually arise from the posterior column at the secondary ossification center and grow away from the spinal canal without causing neurologic deficits. This article reports a rare intraspinal lumbar osteochondroma that compressed the thecal sac, resulting in a hip flexion contracture in an 11-year-old boy. This lumbar, intraspinal, extradural exostosis was confluent with the L3 inferior articular process and compressed the L3 nerve root and thecal sac severely. The patient underwent an en bloc resection of the tumor with a right-sided hemilaminectomy of L3 and L4, a right-sided partial facetectomy at L3 to L4, and an extended resection from the pars intra-articularis of the L2 to the L5 vertebrae. The tumor specimen measured 4.8×3.7×2.5 cm with clear margins. Instrumented posterolateral fusion was completed from L2 to L5 due to iatrogenic instability from the resection. The patient had an uneventful recovery and returned to his normal activities of daily living, including sports. He remains asymptomatic at 54-month follow-up. A solitary lumbar osteochondroma that compresses the spinal cord, resulting in a motor neurological deficit, has not been reported in a pediatric patient. Orthopedic surgeons should be aware of potential intraspinal presentation of osteochondromas. Magnetic resonance imaging is the modality of choice in diagnosing and screening for spinal osteochondromas. These cases can be treated with resection surgery. PMID:24762848

Pourtaheri, Sina; Emami, Arash; Stewart, Tyler; Hwang, Ki; Issa, Kimona; Harwin, Steven F; Mont, Michael A

2014-04-01

309

Burned children from the Bashkir train-gas pipeline disaster. II. Follow-up experience at Children's Hospital 9, Moscow.  

PubMed

A group of US surgeons and nurses was invited by the Soviet surgeons and nurses of the Burn Unit of Childrens Hospital 9 to return to Moscow to participate in the evaluation and treatment of a group of 25 children burned in the Bashkir train-gas pipeline accident of 4 June 1989. The US group had participated in the acute care of the children 7 months before. Major sequelae observed were hepatitis, cardiomyopathy and severe emotional disorders. Reconstructive surgery for burn scars was jointly planned and carried out during a 2-week period of mutually instructive cooperation. PMID:2275762

Remensnyder, J P; Ackroyd, F P; Astrozjnikova, S; Budkevitch, L G; Buletova, A A; Creedon, C M; Lankina, N; Lybarger, P M; Okatyev, V; Prodeus, P P

1990-10-01

310

Skin, fascias, and scars: symptoms and systemic connections.  

PubMed

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

Bordoni, Bruno; Zanier, Emiliano

2013-01-01

311

Skin, fascias, and scars: symptoms and systemic connections  

PubMed Central

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

Bordoni, Bruno; Zanier, Emiliano

2014-01-01

312

Decorin blocks scarring and cystic cavitation in acute and induces scar dissolution in chronic spinal cord wounds.  

PubMed

In the injured central nervous system (CNS), transforming growth factor (TGF)-?1/2-induced scarring and wound cavitation impede axon regeneration implying that a combination of both scar suppression and axogenic treatments is required to achieve functional recovery. After treating acute and chronic dorsal funicular spinal cord lesions (DFL) in adult rats with the pan-TGF-?1/2 antagonist Decorin, we report that in: (1), acute DFL, the development of all injury parameters was significantly retarded e.g., wound cavity area by 68%, encapsulation of the wound by a glia limitans accessoria (GLA) by 65%, GLA basal lamina thickness by 94%, fibronectin, NG2 and Sema-3A deposition by 87%, 48% and 48%, respectively, and both macrophage and reactive microglia accumulations by 60%; and (2), chronic DFL, all the above parameters were attenuated to a lesser extent e.g., wound cavity area by 11%, GLA encapsulation by 25%, GLA basal lamina thickness by 31%, extracellular fibronectin, NG2 and Sema-3A deposition by 58%, 22% and 29%, respectively, and macrophage and reactive microglia accumulations by 44%. Moreover, in acute and chronic DFL, levels of tissue plasminogen activator (tPA) were raised (by 236% and 482%, respectively), as were active-MMP-2 (by 64% and 91%, respectively) and active-MMP-9 (by 122% and 18%, respectively), while plasminogen activator inhibitor-1 (PAI-1) was suppressed (by 56% and 23%, respectively) and active-TIMP-1 and active TIMP-2 were both lower but only significantly suppressed in acute DFL (by 56 and 21%, respectively). These findings demonstrate that both scar tissue mass and cavitation are attenuated in acute and chronic spinal cord wounds by Decorin treatment and suggest that the dominant effect of Decorin during acute scarring is anti-fibrogenic through suppression of inflammatory fibrosis by neutralisation of TGF-?1/2 whereas, in chronic lesions, Decorin-induction of tPA and MMP (concomitant with reduced complimentary levels of TIMP and PAI-1) leads to dissolution of the mature established scar by fibrolysis. Decorin also promoted the regeneration of similar numbers of axons through acute and chronic wounds. Accordingly, intrathecal delivery of Decorin offers a potential translatable treatment for scar tissue attenuation in patients with spinal cord injury. PMID:24384090

Ahmed, Zubair; Bansal, Daljeet; Tizzard, Katie; Surey, Sarina; Esmaeili, Maryam; Gonzalez, Ana Maria; Berry, Martin; Logan, Ann

2014-04-01

313

An Intensive Programme of Passive Stretch and Motor Training to Manage Severe Knee Contractures after Traumatic Brain Injury: A Case Report  

PubMed Central

ABSTRACT Purpose: While contemporary management of contractures (a common secondary problem of acquired brain injury that can be difficult to treat) includes passive stretch, recent evidence indicates that this intervention may not be effective. This may be because clinical trials have not provided a sufficient dose or have not combined passive stretch with other treatments. The purpose of this case report is to describe a programme of intensive passive stretch combined with motor training administered over a 1.5-year period to treat severe knee contractures. Method: Five months after traumatic brain injury, an adolescent client with severe contractures in multiple joints underwent an intensive stretch programme for his knee contractures, including serial casting and splinting, which was administered for 10 months in conjunction with a motor training programme administered for 1.5 years. Results: The client regained full extension range in his knees and progressed from being totally dependent to walking short distances with assistance; these effects were maintained at follow-up 5.5 years after injury. Conclusion: The use of a high dose of passive stretch in conjunction with motor training may be an option to consider for correcting severe contractures following acquired brain injury. PMID:24403690

Harvey, Lisa A.; Moseley, Anne M.

2013-01-01

314

Heterotopic cesarean scar pregnancy: diagnosis, treatment, and prognosis.  

PubMed

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

OuYang, Zhenbo; Yin, Qian; Xu, Yujing; Ma, Yunyan; Zhang, Qiushi; Yu, Yanhong

2014-09-01

315

Scar wars: is TGF? the phantom menace in scleroderma?  

Microsoft Academic Search

The autoimmune disease scleroderma (systemic sclerosis (SSc)) is characterized by extensive tissue fibrosis, causing significant\\u000a morbidity. There is no therapy for the fibrosis observed in SSc; indeed, the underlying cause of the scarring observed in\\u000a this disease is unknown. Transforming growth factor-? (TGF?) has long been hypothesized to be a major contributor to pathological\\u000a fibrotic diseases, including SSc. Recently, the

Andrew Leask

2006-01-01

316

Slippery Scar: A New Mushroom Disease in Auricularia polytricha  

PubMed Central

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

Sun, Jie

2012-01-01

317

Silicone-Based Scar Therapy: A Review of the Literature  

Microsoft Academic Search

Hypertrophic and keloid scars still are among the banes of plastic surgery. In the treatment arsenal at the disposal of the\\u000a plastic surgeon, topical silicone therapy usually is considered the first line of treatment or as an adjuvant to other treatment\\u000a methods. Yet, knowledge concerning its mechanisms of action, clinical efficacy, and possible adverse effects is rather obscure\\u000a and sometimes

Demetris StavrouOren; Oren Weissman; Eyal Winkler; Lior Yankelson; Eran Millet; Oren Paul Mushin; Alon Liran; Joseph Haik

2010-01-01

318

Clinical and impression cytology findings of amniotic membrane and oral mucosal membrane transplantation for the management of socket contracture  

PubMed Central

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

Kurtul, Bengi Ece; Erdener, Ugur; Mocan, Mehmet Cem; Irkec, Murat; Orhan, Mehmet

2014-01-01

319

Tacrolimus reduces scar formation and promotes sciatic nerve regeneration?  

PubMed Central

A sciatic nerve transection and repair model was established in Sprague-Dawley rats by transecting the tendon of obturator internus muscle in the greater sciatic foramen and suturing with nylon sutures. The models were treated with tacrolimus gavage (4 mg/kg per day) for 0, 2, 4 and 6 weeks. Specimens were harvested at 6 weeks of intragastric administration. Masson staining revealed that the collagen fiber content and scar area in the nerve anastomosis of the sciatic nerve injury rats were significantly reduced after tacrolimus administration. Hematoxylin-eosin staining showed that tacrolimus significantly increased myelinated nerve fiber density, average axon diameter and myelin sheath thickness. Intragastric administration of tacrolimus also led to a significant increase in the recovery rate of gastrocnemius muscle wet weight and the sciatic functional index after sciatic nerve injury. The above indices were most significantly improved at 6 weeks after of tacrolimus gavage. The myelinated nerve fiber density in the nerve anastomosis and the sciatic nerve functions had a significant negative correlation with the scar area, as detected by Spearman’s rank correlation analysis. These findings indicate that tacrolimus can promote peripheral nerve regeneration and accelerate the recovery of neurological function through the reduction of scar formation. PMID:25337101

Que, Jun; Cao, Quan; Sui, Tao; Du, Shihao; Zhang, Ailiang; Kong, Dechao; Cao, Xiaojian

2012-01-01

320

An unusual amniotic rupture sequence with thoracoabdominal restricting band, low-set posterior hairline, and trapezius contracture.  

PubMed

Amniotic rupture sequence is associated with defects of variable severity and at different sites. Analysis of the literature reveals difficulties in the classification, which, in addition to uncertainties surrounding its causes, make diagnosis of unusual presentations rather difficult. We present an unusual case of a thoracoabdominal restrictive band from the umbilicus to a low-set posterior hairline with severe trapezius contracture, sternoclavicular dislocation, and no associated craniofacial or limb abnormalities. Amnion rupture sequence with adhesion band seems to be the most probable cause of this rare combination of anomalies. PMID:20818258

Atiyeh, Bishara S; Moucharafieh, Ramzi

2010-09-01

321

Estrogen treatment of acetic acid burns to the vagina, cervix, and perineum: a case report and review of the literature.  

PubMed

In colposcopic evaluation of the cervix, acetic acid of 3 to 5% is commonly used for identification of preneoplastic and neoplastic cells. Acetic acid is a known caustic substance and has the potential to cause irritation and chemical burns when there is sufficient concentration or duration of contact. The authors present a unique case of a woman who inadvertently received undiluted acetic acid during a routine colposcopy, resulting in significant chemical burns of the vagina, cervix, and perineum. Her burns were treated with topical estrogen cream of 1 g twice daily applied directly to the wounds. The burn wounds were fully healed within 8 weeks without complication or additional treatment. At 6 months after the injury, the patient was allowed to engage in sexual activity, and vaginal dilation and pelvic floor therapy were initiated. At 12 months postinjury, her only symptomatic scarring at the left vaginal wall continues to improve. Thus, topical estrogen treatment of 1 g applied twice daily should be continued until burn scar maturation is complete and treatment improvement plateaus in cases of burns to the vagina, cervix, and perineum. This case is further clinical evidence of estrogen's positive effect on wound healing and its potential role in burn treatment. PMID:25144814

Ching, Jessica A; Kuykendall, Lauren V; Troy, Jared S; Smith, David J

2014-01-01

322

A case report of a chemical burn due to the misuse of glacial acetic acid.  

PubMed

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

Yoo, Jun-Ho; Roh, Si-Gyun; Lee, Nae-Ho; Yang, Kyung-Moo; Moon, Ji-Hyun

2010-12-01

323

Rapid cooling contracture of the myocardium. The adverse effect of prearrest cardiac hypothermia.  

PubMed

Hypothermic total circulatory arrest for repair of congenital heart lesions in neonates requires a period of rapid core cooling on cardiopulmonary bypass during which the myocardium is also exposed to hypothermic perfusion. Myocardial hypothermia in the nonarrested state results in an increase in contractility due to elevation of intracellular calcium levels. This study was designed to test the hypothesis that rapid myocardial cooling before cardioplegic ischemic arrest results in damage, with impaired recovery during reperfusion. Two groups of 10 rabbit hearts were perfused on an isolated Langendorff apparatus. Group N (normothermia) was perfused at 37 degrees C before 2 hours of cardioplegic ischemic arrest at 10 degrees C. Group C (cooling) was perfused at 15 degrees C in the unarrested state for 20 minutes before the same cardioplegic arrest conditions as group N. Left ventricular isovolumic pressure measurements, biochemical measurements from right ventricular biopsy specimens, and ventricular necrosis as defined by tetrazolium staining were used to compare the groups at 30 and 60 minutes of normothermic reperfusion. Developed pressure at a constant volume was preserved in group N at 90.7 +/- 4.5 mm Hg versus 76.9 +/- 6.3 in group C after reperfusion (p less than 0.05). Diastolic compliance showed significant deterioration in group C, with marked elevation of diastolic pressure during reperfusion (group N = 6.8 +/- 2.5 mm Hg versus group C = 38.9 +/- 6.1 after reperfusion; p less than 0.001). Adenosine triphosphate levels were significantly higher in group N both at end-ischemia and after reperfusion versus group C (group N = 17.0 +/- 1.1 nmol/mg protein versus group C = 7.7 +/- 1.0 after reperfusion; p less than 0.001). Group N had 0.4% +/- 0.4% necrosis of ventricular mass versus 19.3% +/- 2.2% with prearrest cooling in group C (p less than 0.0001). These results indicate that, when combined with cardioplegic ischemic arrest, rapid myocardial cooling in the unarrested state results in significant damage. The mechanism may be related to the cytosolic calcium loading effect of hypothermia that is not relieved during the subsequent period of cardioplegic arrest. Although hypothermia is an essential component to ischemic preservation, rapid cooling contracture can adversely influence cardioplegic myocardial protection. PMID:2385121

Rebeyka, I M; Hanan, S A; Borges, M R; Lee, K F; Yeh, T; Tuchy, G E; Abd-Elfattah, A S; Williams, W G; Wechsler, A S

1990-08-01

324

Psychosocial functioning differences in pediatric burn survivors compared with healthy norms.  

PubMed

Burn injury is one of the most traumatic injuries a child or adolescent can experience. When a burn injury occurs, the child can suffer pain, uncertainty, fear, and trauma from acute treatment to rehabilitation and reintegration. He or she can also experience long-term psychosocial and psychological difficulties. The objective of the study was to compare health-related quality of life (HRQoL), psychopathology, and self-concept of children who have suffered a burn injury with a matched sample of healthy controls. Sixty-six children and adolescents with a burn injury, who were aged between 8 to 17 years, and a caregiver were recruited from six burn centers in Australia and New Zealand. Participants completed the Paediatric Quality of Life Inventory, the Strengths and Difficulties Questionnaire, and the Piers-Harris Self-Concept Scale (P-H SCS). Scores were compared with published normative data. As scarring and appearance are a distinct issue, the Paediatric Quality of Life Inventory cancer module perceived physical appearance subscale was also included. Pediatric burn survivors and their caregivers reported significantly higher emotional and behavioral problems and lower HRQoL, but no significant differences in self-concept compared with healthy counterparts. Pediatric burn survivors also reported significantly poorer perceived physical appearance than the matched pediatric cancer sample. Burned children reported lowered quality of life, particularly related to scarring and appearance; however, they reported normative self-concept. This may be because of self-concept being a psychological trait, whereas HRQoL is influenced by societal norms and expectations. Psychosocial support is necessary to build positive coping strategies and manage the unpleasant social experiences that may reduce quality of life. PMID:23702857

Maskell, Jessica; Newcombe, Peter; Martin, Graham; Kimble, Roy

2013-01-01

325

Post-oak fire scars as a function of diameter, growth, and tree age Richard P. Guyette*  

E-print Network

measured, tree-ring dated, and characterized 126 fire scars on post-oaks (Quercus stellata) from fire; Oak; Fire scars; Probability; Tree-rings 1. Introduction 1.1. Fire scarring The implementation). Tree-ring dating of fire scars provides temporal infor- mation about the effect of an injury

Stambaugh, Michael C

326

Chemical burn or reaction  

MedlinePLUS

... the skin has come in contact with the toxic substance Rash , blisters , burns on the skin Unconsciousness ... locked cabinet. Avoid mixing different products that contain toxic chemicals such as ammonia and bleach. The mixture ...

327

Burns (For Parents)  

MedlinePLUS

... hot faucet to an accidental tipping of a coffee cup, burns are a potential hazard in every ... culprit (from steam, hot bath water, tipped-over coffee cups, hot foods, cooking fluids, etc.) contact with ...

328

Treating and Preventing Burns  

MedlinePLUS

... injury worse. For anything more serious than a superficial burn, or if redness and pain continue for ... or ignition sources. Lower the temperature of your water heater to below 120 degrees Fahrenheit (48.9 ...

329

Burned to the bone.  

PubMed

Heterotopic ossification-a complication of severe burns, head or blast injuries, and orthopaedic trauma-can result from altered adenosine metabolism in mesenchymal stem cells in response to elevated extracellular ATP (Peterson et al., this issue). PMID:25253672

Forsberg, Jonathan A; Davis, Thomas A; Elster, Eric A; Gimble, Jeffrey M

2014-09-24

330

American Burn Association  

MedlinePLUS

... center and disaster related information View the ABA U.S. Regional Map Click above to access the new ... and Exhibitor Prospectus Now Available! 2014 Western Region Burn Conference November 6-8, 2014 | Las ...

331

Lava Flow Burning Vegetation  

USGS Multimedia Gallery

Lava flow activity continues to burn vegetation in the kipuka adjacent to the trail, causing the viewing trail to be closed beyond the trailhead. The new viewing area is still very close to the active flows. ...

2010-06-18

332

Burning mouth syndrome  

Microsoft Academic Search

Burning mouth syndrome (BMS) is a chronic disease characterized by burning of the oral mucosa associated with a sensation\\u000a of dry mouth and\\/or taste alterations. BMS occurs more frequently among postmenopausal women. The pathophysiology of the disease\\u000a is still unknown, and evidence is conflicting; although some studies suggest a central origin, others point to a peripheral\\u000a neuropathic origin. The efficacy

José G. Speciali; Juliana Stuginski-Barbosa

2008-01-01

333

Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)  

PubMed Central

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

Ponticorvo, Adrien; Burmeister, David M.; Yang, Bruce; Choi, Bernard; Christy, Robert J.; Durkin, Anthony J.

2014-01-01

334

Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI).  

PubMed

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

Ponticorvo, Adrien; Burmeister, David M; Yang, Bruce; Choi, Bernard; Christy, Robert J; Durkin, Anthony J

2014-10-01

335

Multispectral Imaging Of Burn Wounds  

NASA Astrophysics Data System (ADS)

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.

Afromowitz, Martin A.; Callis, James B.; Heimbach, David M.; DeSoto, Larry A.; Norton, Mary K.

1988-06-01

336

Burns in Nigeria: a Review  

PubMed Central

Summary Burn injuries continue to be a major source of mortality and morbidity in low- and middle-income countries of the world, of which Nigeria is a part. Overview data on burn care in Nigeria are sparse but the available literature on burns and burn care in Nigeria was retrieved through Internet-based search engines, collated, and reviewed. Peculiarities of epidemiology, types of burn, pattern of injuries, complications, and outcome of burn care were reviewed. There were no broad-based overview statistical data on burns in Nigeria in all the articles reviewed. There was no documentation on the regionalization of care and there were no national databases. All reports on epidemiology were hospital-based. Flame is emerging as the predominant cause of burns, and burn injury is occurring increasingly away from the domestic setting. The severity of the injuries is also increasing. Deliberate burn injury remains a practice and a wide range of complications occur as burns sequelae in Nigeria. Several challenges militate against optimal care for burn victims. Burn injuries continue to contribute significantly to the burden of disease in Nigeria. There is a need for broad-based data collection systems. Avoidable complications are common and mortality remains high. Pooling of resources by regionalization of care could increase focus on burn prevention and improve the care of burn victims. Nongovernmental and governmental support to reduce the burden of burns is advocated. PMID:21991210

Oladele, A.O.; Olabanji, J.K.

2010-01-01

337

The media glorifying burns: a hindrance to burn prevention.  

PubMed

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

Greenhalgh, David G; Palmieri, Tina L

2003-01-01

338

Anti-Scarring Properties of Different Tryptophan Derivatives  

PubMed Central

Hypertrophic scars are associated with prolonged extracellular matrix (ECM) production, aberrant ECM degradation and high tissue cellularity. Routinely used antifibrotic strategies aim to reduce ECM deposition and enhance matrix remodeling. Our previous study investigating the antifibrotic effects of indoleamine2, 3 dioxygenase (IDO) led to the identification of kynurenine (Kyn) as an antiscarring agent. A topical antifibrogenic therapy using Kyn is very attractive; however, it is well established that Kyn passes the blood brain barrier (BBB) which causes complications including excitatory neuronal death. Here we investigated the antiscarring properties of kynurenic acid (KynA), a downstream end product of Kyn that is unlikely to pass the BBB, as an effective and safe replacement for Kyn. Our results indicated that while not having any adverse effect on dermal cell viability, KynA significantly increases the expression of matrix metalloproteinases (MMP1 and MMP3) and suppresses the production of type-I collagen and fibronectin by fibroblasts. Topical application of cream containing KynA in fibrotic rabbit ear significantly decreased scar elevation index (1.13±0.13 vs. 1.61±0.12) and tissue cellularity (221.38±21.7 vs. 314.56±8.66 cells/hpf) in KynA treated wounds compared to controls. KynA treated wounds exhibited lower levels of collagen deposition which is accompanied with a significant decrease in type-I collagen and fibronectin expression, as well as an increase in MMP1 expression compared to untreated wounds or wounds treated with cream only. The results of this study provided evidence for the first time that KynA is promising candidate antifibrogenic agent to improve healing outcome in patients at risk of hypertrophic scarring. PMID:24637853

Poormasjedi-Meibod, Malihe-Sadat; Hartwell, Ryan; Taghi Kilani, Ruhangiz; Ghahary, Aziz

2014-01-01

339

Sepsis in burned patients.  

PubMed

A prospective study was conducted from June 2001 to May 2002 at the Burns Unit of Hospital Regional da Asa Norte, Brasília, Brazil. During the period of the study, 252 patients were treated at the Burns Unit, 49 (19.4%) developed clinically and microbiologically proven sepsis. Twenty-six (53.1%) were males and 23 (46.9%) females with a mean age of 22 years (range one to 89 years) and mean burned body surface area of 37.7 +/- 18.4% (range 7 to 84%). Forty-three patients had flame burns, five a scald and one an electric burn. These 49 patients had a total of 62 septic episodes. Forty (81.6%) patients had only one and nine (18.4%) had up to three episodes of sepsis. Thirty (61.2%) patients had their first septicemic episode either earlier or by one week postburn. Out of 62 septic episodes, 58 were due to bacteria and four due to Candida sp. The most common bacteria isolated from blood culture were Staphylococccus aureus, coagulase-negative Staphylococcus, Acinetobacter baumannii, Enterobacter cloacae and Klebsiella pneumoniae. Eleven (18.9%) episodes were due to oxacillin resistant Staphylococcus aureus. Acinetobacter baumannii was sensitive to ampicillin/sulbactam in 71.4% and to imipenem in 85.7% of the cases. The primary foci of sepsis were the burn wound in 15 (24.2%) episodes. The most common clinical findings of sepsis in these patients were fever, dyspnea, hypotension and oliguria. The most common laboratory findings of these patients were anemia, leukocytosis, hypoalbuminemia and thrombocytopenia. Twelve (24.5%) patients died. The appropriate knowledge of clinical, epidemiological, laboratorial and microbiological aspects of sepsis in burned patients permits an adequate diagnosis and treatment of this complication. PMID:15049101

de Macedo, Jefferson Lessa; Rosa, Simone C; Castro, Cleudson

2003-01-01

340

A clinical report of the effect of mechanical stress on functional results after fasciectomy for Dupuytren's contracture  

Microsoft Academic Search

Early postoperative treatment after Dupuytren's fasciectomy traditionally has included the application of mechanical stress to digital extension with splints and exercise. This study examines the effect of mechanical stress, which may compromise nutrient delivery to the tissues, on inflammation, flare, hypertrophic scar, digital range of motion (ROM), and therapy visits. The authors compared functional outcomes in operated digits treated postoperatively

Paul Fiolkowski; Paul C. Dell

2002-01-01

341

Aesthetic restoration of the severely disfigured face in burn victims: a comprehensive strategy.  

PubMed

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

Rose, E H

1995-12-01

342

Carbon dioxide laser ablation with immediate autografting in a full-thickness porcine burn model.  

PubMed Central

OBJECTIVE: To compare the long-term clinical and histologic outcome of immediate autografting of full-thickness burn wounds ablated with a high-power continuous-wave CO2 laser to sharply débrided wounds in a porcine model. SUMMARY BACKGROUND DATA: Continuous-wave CO2 lasers have performed poorly as tools for burn excision because the large amount of thermal damage to viable subeschar tissues precluded successful autografting. However, a new technique, in which a high-power laser is rapidly scanned over the eschar, results in eschar vaporization without significant damage to underlying viable tissues, allowing successful immediate autografting. METHODS: Full-thickness paravertebral burn wounds measuring 36 cm2 were created on 11 farm swine. Wounds were ablated to adipose tissue 48 hours later using either a surgical blade or a 150-Watt continuous-wave CO2 laser deflected by an x-y galvanometric scanner that translated the beam over the tissue surface, removing 200 microm of tissue per scan. Both sites were immediately autografted and serially evaluated clinically and histologically for 180 days. RESULTS: The laser-treated sites were nearly bloodless. The mean residual thermal damage was 0.18+/-0.05 mm. The mean graft take was 96+/-11% in manual sites and 93+/-8% in laser sites. On postoperative day 7, the thickness of granulation tissue at the graft-wound bed interface was greater in laser-debrided sites. By postoperative day 180, the manual and laser sites were histologically identical. Vancouver scar assessment revealed no differences in scarring at postoperative day 180. CONCLUSIONS: Long-term scarring, based on Vancouver scar assessments and histologic evaluation, was equivalent at 6 months in laser-ablated and sharply excised sites. Should this technology become practical, the potential clinical implications include a reduction in surgical blood loss without sacrifice of immediate engraftment rates or long-term outcome. Images Figure 1. Figure 2. Figure 3. Figure 4. PMID:9712572

Glatter, R D; Goldberg, J S; Schomacker, K T; Compton, C C; Flotte, T J; Bua, D P; Greaves, K W; Nishioka, N S; Sheridan, R L

1998-01-01

343

Combat burn life support: a military burn-education program.  

PubMed

The Advanced Burn Life Support Course has been used to train military physicians and nurses for more than 16 years. Although it useful for teaching the fundamentals of burn care, the course is designed for a civilian audience, covers only the first 24 hours of burn care, and presumes the availability of a burn center for patient transfer. In preparation for hostilities in Iraq, we developed several add-on modules to the standard Advanced Burn Life Support course to meet specific needs of military audiences. These modules cover the treatment of white phosphorus burns; the treatment of mustard gas exposure; the long-range aeromedical transfer of burn patients; the management of burn patients beyond the first 24 hours; and the delivery of burn care in austere environments. These add-on modules are termed Combat Burn Life Support. Between January 22, 2003, and May 12, 2003, Advanced Burn Life Support and/or Combat Burn Life Support courses were provided to a total of 1035 military health care providers in the United States, Germany, and the Middle East. Student feedback was largely positive and is being used for further course refinement. The Combat Burn Life Support Course is designed to augment, rather than replace, the Advanced Burn Life Support Course. Although intended for a military audience, the course material is equally applicable to civilian terrorist or mass casualty situations. PMID:15756118

Barillo, David J; Cancio, Leopoldo C; Hutton, Brad G; Mittelsteadt, Paul J; Gueller, Glen E; Holcomb, John B

2005-01-01

344

Smad interacting protein 1 as a regulator of skin fibrosis in pathological scars  

Microsoft Academic Search

Keloids and hypertrophic scars are significant symptomatic clinical problems characterized by the excessive and abnormal deposition of collagen-based extracellular matrix (ECM) components. However, the molecular basis of keloid and hypertrophic scar formation has not been fully elucidated. Here, we demonstrated that down-regulation of the transcription factor Smad interacting protein 1 (SIP1) could be relevant to keloid and hypertrophic scar formation.

Zhan-feng Zhang; Yan-gang Zhang; Da-hai Hu; Ji-hong Shi; Jia-qi Liu; Zhou-ting Zhao; Hong-tao Wang; Xiao-zhi Bai; Wei-xia Cai; Hua-yu Zhu; Chao-wu Tang

2011-01-01

345

Cytokine Expression is Downregulated by Collagen-Polyvinylpyrrolidone in Hypertrophic Scars1  

Microsoft Academic Search

We evaluated the in situ expression of adhesion molecules (E-selectin and vascular cell-adhesion molecule) and pro-inflammatory\\/fibrogenic cytokines (IL-1?, TNF-?, TGF-?1, and PDGF) in sections of normal skin, hypertrophic scar, and hypertrophic scar previously treated with an irradiated mixture of collagen-polyvinylpyrrolidone and completely resolved. Expression of these proteins was detected by indirect immunoperoxidase staining. The hypertrophic scar group displayed an increased

Fernando E. Krotzsch-Gomez; Janette Furuzawa-Carballeda; Roberto Reyes-Márquez; Ernesto Quiróz-Hernández; Lino Díaz de León

1998-01-01

346

Combining scalp tissue expansion with porous polyethylene total ear reconstruction in burned patients.  

PubMed

Burned ear reconstruction remains one of the most difficult areas of plastic surgery. A superior result is needed to justify the donor site morbidity when reconstructing with a costochondral graft. Recently, more studies have evaluated porous polyethylene ear reconstruction in microtia and in burns. A total loss of the pinna from burns is rare and often associated with significant alopecia. Tissue expansion is an excellent means of reconstructing burned scalp alopecia. Deeply burned skin is often so densely scarred that a costochondral graft would produce a nondescript scarred mass with little resemblance to the native ear. This mini series overview describes 3 cases of porous polyethylene and total ear reconstructions done in conjunction with tissue expansion reconstruction for burn alopecia. This method can be used as a very efficient combination of procedures in a severely burned patient without the additional morbidity of costochondral grafting.This is the first description of this combination of procedures. At the initial procedure, a large tissue expander is placed beneath the hair-bearing scalp in a subgaleal plane. At the time of tissue expander removal and alopecia resection, a temporoparietal fascia flap is elevated. The incisions for alopecia resection allow easy dissection behind the external auditory meatus. The porous polyethylene construct is then placed posteriorly and wrapped with the temporoparietal fascial flap. The hairline is reconstructed simultaneously. The technique described makes full use of the temporoparietal fascial flap that may, otherwise, be resected or injured with the alopecia resection. It also allows alopecia reconstruction and accomplishes 2 reconstructive goals at once with little or no donor site morbidity. PMID:20098104

Driscoll, Daniel N; Lee, Jeffrey H

2010-02-01

347

Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids.  

PubMed

There is not much level 1 evidence based literature to guide management of hypertrophic scars and keloids despite an array of therapeutic modalities at disposal. Intralesional (i/l) triamcinolone injections have remained a gold standard in non surgical management. Sporadic reports on use of i/l verapamil suggest its efficacy. Since verapamil has not found sufficient mention as an effective alternative modality, it was decided to undertake a randomized study which could also address some additional clinical parameters. A randomized, parallel group and observer blinded comparison with 40 patients (48 scars) was carried out to compare the effects of i/l triamcinolone (T) (22 scars) and verapamil injections (V) (26 scars). 1.5 ml was the maximum indicative volume decided in the study protocol for both the drugs (triamcinolone @40 mg/ml and verapamil @ 2.5 mg/ml). Patients included were aged between 15-60 years with scars ranging between 0.5-5 cm (but total area roughly <6 cm(2)), and scars under 2 years duration. Patients with keloidal diathesis were excluded. Injections were scheduled every three weeks until complete flattening of the scar or eight sessions, which ever came earlier. No concomitant therapies like massage, silicone gel or pressure garments were used. Scar evaluation at each stage was done by serial photographic records as well as by Vancouver Scar Scale (VSS). Comparative survival analysis between the two drugs was done using Kaplan Meier curves, and VSS scores were analyzed using Wilcoxon test and log rank test. Mean zero VSS scores were achieved with treatments in respect of scar height (T-12 weeks, V-21 weeks), vascularity (T-15 weeks, V-18 weeks) and pliability (T-15 weeks, V-21 weeks). The improvement in scar vascularity and pliability kept pace with decrease in scar height, in both the groups. There was not much difference in the rate of change of scar pigmentation with either drug but almost 60% patients in both the groups regained normal pigmentation. Our study adds to evidence of verapamil's capability in flattening the raised scars. With an extremely low cost and fewer adverse effects it deserves better positioning in the wide armamentarium against hypertrophic scars. It also offers several therapeutic possibilities to alternate with triamcinolone or be used simultaneously in larger (or multiple) scars. PMID:24182692

Ahuja, Rajeev B; Chatterjee, Pallab

2014-06-01

348

Unusual persistence of Tc-99m MDP uptake in the incisional scar after thoracotomy  

SciTech Connect

Postoperative scar is one of the causes of extraosseous localization of Tc-99m phosphonate bone agents. Usually, an incisional scar will not be visualized in a Tc-99m phosphonate skeletal image two weeks after surgery. A case is reported with an unusually persistent localization of radiotracer in the scar of a thoracotomy seen in three consecutive bone images done beyond two weeks postoperatively. This patient suffered from ''pulmonary insufficiency'' before and after the thoracotomy. The abnormal radiotracer localization in the scar is presumably related to his pulmonary insufficiency, with resulting relatively delayed wound healing.

Shih, W.J.; DeLand, F.H.; Domstad, P.A.; Dillon, M.L.

1984-10-01

349

Smad interacting protein 1 as a regulator of skin fibrosis in pathological scars.  

PubMed

Keloids and hypertrophic scars are significant symptomatic clinical problems characterized by the excessive and abnormal deposition of collagen-based extracellular matrix (ECM) components. However, the molecular basis of keloid and hypertrophic scar formation has not been fully elucidated. Here, we demonstrated that down-regulation of the transcription factor Smad interacting protein 1 (SIP1) could be relevant to keloid and hypertrophic scar formation. The results of the present study show that the level of SIP1 mRNA is significantly decreased in pathological scar tissues and in normal skin and pathological scar fibroblasts treated with transforming growth factor ?1 (TGF-?1). In contrast, the expression of SIP1 mRNA is not decreased in normotrophic scar samples. The SIP1 mRNA level inversely correlates with the mRNA level of type I collagen (COL1A2) and directly correlates with the mRNA level of matrix metalloproteinase-1 (MMP1). Overexpression of SIP1 in keloid and hypertrophic scar fibroblasts represses TGF-?1-stimulated COL1A2 expression and induces MMP1 expression. Alternatively, knockdown of SIP1 in normal skin fibroblasts enhance TGF-?1-induced COL1A2 levels. These findings suggest that SIP1 could be a regulator of skin fibrosis, and depletion of SIP1 in pathological scar tissues could result in an up-regulation of collagen and down-regulation of matrix metalloproteinase, leading to an abnormal accumulation of ECM along with fibrosis and pathological scar formation. PMID:21236582

Zhang, Zhan-Feng; Zhang, Yan-Gang; Hu, Da-Hai; Shi, Ji-Hong; Liu, Jia-Qi; Zhao, Zhou-Ting; Wang, Hong-Tao; Bai, Xiao-Zhi; Cai, Wei-Xia; Zhu, Hua-Yu; Tang, Chao-Wu

2011-06-01

350

Cell-matrix interactions in dermal repair and scarring.  

PubMed

Regulation of cellular functions during dermal repair following injury is complex and critically dependent on the interaction of cells with the surrounding extracellular matrix (ECM). The ECM comprises various families of macromolecules that form the structural scaffold of the tissue, but also carry distinct biological activities. After injury to the skin, the defect is filled by a provisional matrix that is invaded by inflammatory cells, sprouting blood vessels and fibroblasts. In a later phase, the wound contracts, the tissue is replaced by mature connective tissue produced by activated fibroblasts, and a scar is formed. All cells involved communicate directly with the ECM by integrins and other matrix receptors. These transmit signals and induce adaptive responses to the environment by the embedded cells. The ECM or proteolytic fragments of individual ECM constituents exert defined biological activities influencing cell survival, differentiation of myofibroblasts, ECM synthesis and turnover, wound angiogenesis and scar remodeling. Extensive crosstalk exists between ECM and growth factors, and between growth factors and integrins. ECM-cell contact also enables direct transmission of mechanical tension, which then modulates many activities of all cellular players. Understanding this complex interplay is important to provide a basis for designing effective wound therapy and for strategic interference with mechanisms that have gone out of control in fibrotic conditions. PMID:20222960

Eckes, Beate; Nischt, Roswitha; Krieg, Thomas

2010-01-01

351

Low scar abdominoplasty with inferior positioning of the umbilicus.  

PubMed

Miniabdominoplasty with umbilical free float has received little attention in the literature in 15 years and has been criticized for an abnormally low umbilicus. We hypothesized the umbilicus in women presenting for abdominal contouring is positioned higher than ideal and thus may benefit from lowering. In addition, we felt modifications of the original umbilical float technique would improve aesthetic results. A retrospective review identified 60 patients aged 34 to 56 who had abdominoplasty with umbilical fascial transection and inferior positioning. Technical modifications included low placement of a full transverse abdominal scar, abdominal flap undermining to the rib cage, more inferior umbilical repositioning, flank liposuction, and plication of diastasis recti from xiphoid to pubis. Patients did not have enough excess skin to allow traditional abdominoplasty without a high-transverse or vertical midline scar. No umbilical or incisional skin necrosis occurred. To assess optimal umbilical position, plastic surgeons were asked to draw the ideal position on pre- and postoperative photographs from 5 patients. The mean ideal umbilical position was 2.2 cm lower than the actual position (P < 0.01) in preoperative photographs and was close to the true position in postoperative photographs. In conclusion, lower abdominoplasty with inferior umbilical positioning is an excellent choice for the middle age, postpartum woman with excess abdominal skin and full length diastasis recti but a normal body mass index. PMID:20395799

Colwell, Amy S; Kpodzo, Dzifa; Gallico, G Gregory

2010-05-01

352

Surgical correction of unsuccessful derotational humeral osteotomy in obstetric brachial plexus palsy: Evidence of the significance of scapular deformity in the pathophysiology of the medial rotation contracture  

Microsoft Academic Search

BACKGROUND: The current method of treatment for persistent internal rotation due to the medial rotation contracture in patients with obstetric brachial plexus injury is humeral derotational osteotomy. While this procedure places the arm in a more functional position, it does not attend to the abnormal glenohumeral joint. Poor positioning of the humeral head secondary to elevation and rotation of the

Rahul K Nath; Sonya E Melcher; Melia Paizi

2006-01-01

353

Burning trees and bridges  

NASA Technical Reports Server (NTRS)

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.

Levine, Joel S.

1990-01-01

354

Fast burning propellants  

SciTech Connect

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/.

Colgate, S.A.; Roos, G.E.

1987-07-21

355

Burning Down the House  

NSDL National Science Digital Library

In this demonstration, the teacher will use a potato and hydrogen peroxide to generate oxygen in a closed environment. Students can then observe its effects on a burning wooden splint and on burning steel wool. They will understand that a large amount of energy can be released by the process of oxidation. As an extension, the teacher can discuss how the appearance of oxygen (produced by cyanobacteria) in Earth's early atmosphere initially resulted in the formation of large deposits of iron oxide (Banded Iron Formations) and then aided in the evolution of more complex life forms.

Dolphin, Glenn

356

Long QT, Syndactyly, Joint Contractures, Stroke and Novel CACNA1C Mutation: Expanding the Spectrum of Timothy Syndrome  

PubMed Central

Timothy syndrome (TS) is described as an autosomal dominant condition with the constellation of features including prolonged QT interval, hand and foot abnormalities and mental retardation or autism. Splawski et al. [2004] previously described two phenotypes associated with TS distinguished by two unique and different mutations within the CACNA1C gene. We report on a newborn who presented with prolonged QT interval and associated polymorphic ventricular tachycardia, dysmorphic facial features, syndactyly of the hands and feet and joint contractures, suggestive of TS. He developed a stroke, subsequent intractable seizures and was found to have cortical blindness and later profound developmental delay. Initial targeted mutation analysis did not identify either of the previously described TS associated mutations; however, full gene sequencing detected a novel CACNA1C gene mutation (p.Ala1473Gly). The clinical and genetic findings in our case expand both the clinical and molecular knowledge of TS. PMID:22106044

Gillis, Jane; Burashnikov, Elena; Antzelevitch, Charles; Blaser, Susan; Gross, Gil; Turner, Lesley; Babul-Hirji, Riyana; Chitayat, David

2011-01-01

357

Familial occurrence of typical and severe lethal congenital contractural arachnodactyly caused by missplicing of exon 34 of fibrillin-2  

SciTech Connect

Genetic linkage studies have linked congenital contractual arachnodactyly (CCA), a usually mild heritable connective-tissue disorder, to FBN2, the fibrillin gene on chromosome 5. Recently, FBN2 mutations in two patients with CCA have been described. Here we report an A{r_arrow}T transversion at the -2 position of the consensus acceptor splice site, resulting in the missplicing of exon 34, a calcium-binding epidermal growth factor-like repeat in fibrillin-2 in a mother and daughter with CCA. Significantly, the mother exhibited a classic CCA phenotype with arachnodactyly, joint contractures, and abnormal pinnae, whereas her daughter exhibited a markedly more severe CCA phenotype, which included cardiovascular and gastrointestinal anomalies that led to death in infancy. Analysis of cloned fibroblasts showed that the mother is a somatic mosaic for the exon 34 missplicing mutation, whereas all the daughter`s cells harbored the mutation. 48 refs., 6 figs., 2 tabs.

Wang, Mei; Godfrey, M. [Univ. of Nebraska Medical Center, Omaha, NE (United States); Clericuzio, C.L. [Univ. of New Mexico, Albuquerque, NM (United States)

1996-11-01

358

Evaluation of a highly skin permeable low-molecular-weight protamine conjugated epidermal growth factor for novel burn wound healing therapy.  

PubMed

We evaluated the laser induced burn wound healing efficacy of a recombinant low-molecular-weight protamine conjugated epidermal growth factor (rLMWP-EGF). rLMWP-EGF was prepared by genetically combining LMWP with the N-terminal sequence of EGF; we obtained a homogeneous modified EGF without reduced biological activity. Because of the protein transduction domain of LMWP, rLMWP-EGF showed enhanced drug penetration across artificial skin constructs and excised mouse skin layers versus EGF and showed significantly improved burn wound healing efficacy, with accelerated wound closure and minimized eschar and scar formation, compared with EGF or no treatment. Histological examination also revealed that rLMWP-EGF permeated through the intact skin around the wound and facilitated residual epithelial cell proliferation in an integrated manner to reform an intact epidermis. Radiofrequency microwound formation was effective for reducing large hypertrophic scars formed after severe laser burning by collagen remodeling but rLMWP-EGF did not show a meaningful synergistic effect in burn scar reduction. However, rLMWP-EGF was helpful for forming skin with a more normal appearance and texture. Thus, rLMWP-EGF demonstrated therapeutic potential as a novel topical burn wound healing drug with no obvious toxic effect. PMID:24018779

Lee, Ji Hae; Bae, Il-Hong; Choi, Jin Kyu; Park, Jin Woo

2013-11-01

359

Ocular surface reconstruction using amniotic membrane allograft for severe surface disorders in chemical burns: case report and review of the literature.  

PubMed

Ocular chemical burns are frustrating disorders. The conjunctival surface provides a defense mechanism protecting against infection, desiccation, and injury, being centered in the epithelial lining of the ocular surface. A monocular case of severe acid chemical burn is presented. Postinjury-stratified epithelium in the inferior cul-de-sac with eye movement and contact with the lower eyelid resulted in repeated corneal abrasions, vascularization, and scarring. This vexing problem was recalcitrant to medical and conservative treatment because of delayed and prevented healing from continuous conjunctival abrasive irritation inflicted on the corneal surface. Amniotic membrane allograft transplantation in destructive lesions of the conjunctiva acts as a reconstructive graft in nonhealing lesions of the ocular surface. Successful placement of an amniotic membrane allograft (AmbioDry) in conjunction with excision of an extensive amount of stratified epithelial scar tissue was accomplished. Marked improvement followed surgery, and a definitive solution resulted for the severely burned right eye. PMID:15912900

Fournier, John H; McLachlan, Daniel L

2005-01-01

360

Burning Your Own CDs.  

ERIC Educational Resources Information Center

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)

Ekhaml, Leticia

2001-01-01

361

Burns and Fire Safety  

MedlinePLUS

... Pressman M, Blank E, Mickalide A. Hot tap water legislation in the United States. J Burn Care Res . 2010; 31(6): 918?925. 13 Safe Kids Worldwide, Public Policy Department, 2005. 14 AntiScald, Inc. Available from: http:// ...

362

[Burns with lighter gas].  

PubMed

Attention is drawn to a particularly dangerous party activity. Balloons filled with lighter gas so as to float are used for party decorations. A case of hand burn caused by accidentally lighting such a balloon with a cigarette is reported. The method is strongly advised against, it is a much better idea to use helium for such purposes. PMID:7734004

Davidsen, M T

1993-06-28

363

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...

364

Bacteriology of burns  

Microsoft Academic Search

A retrospective study was undertaken at University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, to examine the bacterial isolates from the Burns unit and to determine the antibiograms of the isolates to commonly used antimicrobial agents. A total of 600 pus samples from as many patients received, over a period of 5 years (June 1993–June 1997) yielded

G. Revathi; J. Puri; B. K. Jain

1998-01-01

365

The Earth Could Burn.  

ERIC Educational Resources Information Center

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…

Yarrow, Ruth

1982-01-01

366

Discovery Performs Terminal Initiation Burn  

NASA Video Gallery

The terminal initiation burn, a left Orbital Maneuvering System engine firing that gave Discovery one last big push toward the space station, took place Feb. 26, 2011 at 10:33 a.m. The burn lasted ...

367

Improved Scar Quality Following Primary and Secondary Healing of Cutaneous Wounds  

Microsoft Academic Search

Poor wound healing remains a critical problem in our daily practice of surgery, exerting a heavy toll on our patients as well as on the health care system. In susceptible individuals, scars can become raised, reddish, and rigid, may cause itching and pain, and might even lead to serious cosmetic and functional problems. Hypertrophic scars do not occur spontaneously in

Bishara S. Atiyeh; Christian A. Amm; Kusai A. El Musa

2003-01-01

368

Evaluation of Microneedling Fractional Radiofrequency Device for Treatment of Acne Scars  

PubMed Central

Background: Various treatment modalities including non-invasive methods such as chemical peels, topical retinoids, microdermabrasion, minimally invasive techniques such as microneedling, fractional lasers, microneedling radiofrequency devices and invasive procedures such as acne scar surgeries and ablative lasers are used for acne scars, each with its own unique advantages and disadvantages. This study is a retrospective assessment of efficacy and safety of microneedling fractional radiofrequency in the treatment of acne scars. Methods: Thirty one patients of skin types III-V with moderate and severe facial acne scarring received four sequential fractional radiofrequency treatments over a period of 6 months with an interval of 6 weeks between each session. Goodman & Baron's acne scar grading system was used for assessment by a side by side comparison of preoperative and post- operative photographs taken at their first visit and at the end of 3 months after the last session. Results: Estimation of improvement with Goodman and Baron's Global Acne Scarring System showed that by qualitative assessment of 31 patients with grade 3 and grade 4 acne scars, 80.64% showed improvement by 2 grades and 19.35% showed improvement by 1 grade. Quantitative assessment showed that 58% of the patients had moderate, 29% had minimal, 9% had good and 3% showed very good improvement. Adverse effects were limited to transient pain, erythema, edema and hyperpigmentation. Conclusion: Microneedling fractional radiofrequency is efficacious for the treatment of moderate and severe acne scars. PMID:25136209

Chandrashekar, Byalekere Shivanna; Sriram, Rashmi; Mysore, Rajdeep; Bhaskar, Sapnashree; Shetty, Abhishek

2014-01-01

369

Enhancement and Segmentation of Scar Color Images after a Scoliosis Surgery  

E-print Network

different wound closing techniques, industrial tools, and wire involved in plastic surgery proce- dures. 2Enhancement and Segmentation of Scar Color Images after a Scoliosis Surgery Thomas Hurtut1 of a thousand adolescent diagnosed with scoliosis require surgery, which involves a long scar on the back

Paris-Sud XI, Université de

370

An investigation of fire scars in Pseudotsuga macrocarpa by Scanning X-Ray Fluorescence Microscopy  

Microsoft Academic Search

Fire scars in dated sequences of tree-rings are regularly used for the reconstruction of histories of forest fire frequency and investigations of various exogenous factors (climate in particular) which may control such events. The potential of the tree-ring archive in this regard is such that in circumstances where no scarring occurs following a particular fire, or where sampling is limited

Charlotte L. Pearson; Darren Dale; Keith Lombardo

2011-01-01

371

Breast reduction: Evolution of a technique—A single vertical scar  

Microsoft Academic Search

In the past 20 years, patients have become more critical about the result of a breast reduction operation. Natural lasting shape and minimal residual scarring are now expected by most of the candidates to that surgery. In 1969 the author described a vertical technique that achieved reduction and good shape but the end of the vertical scar could be seen

Claude Lassus

1987-01-01

372

A TGF-?1Dependent Autocrine Loop Regulates the Structure of Focal Adhesions in Hypertrophic Scar Fibroblasts  

Microsoft Academic Search

Following injury, fibroblasts migrate into wounds and differentiate into ? smooth muscle cell actin (SMCA)-positive cells, termed myofibroblasts, that assemble and remodel the scar. Cultured myofibroblasts assemble larger focal adhesions than do normal dermal fibroblasts and these focal adhesions attach to ? SMCA-rich stress fibers. Following severe traumatic or thermal injury to the dermis, hypertrophic scars (HTSs) often develop and

Ganary Dabiri; Anelisa Campaner; Jeffrey R Morgan; Livingston Van De Water

2006-01-01

373

Hydrofluoric acid burn: latent period was key factor  

SciTech Connect

To clean oxidation from silver soldering on a copper component, a technician used a commercial solution containing 15% hydrofluoric acid. At 9:30 a.m., the technician finished the job. The solution was used for approximately 1 hr. He removed his protective clothing and washed up, but not thoroughly (since there was no indication of anything out of the ordinary). It was not until 5:30 p.m. that he felt a burning sensation in one hand and his fingers started turning white (indicative of an acid burn). Because of the one day lapse of time since the exposure, specific hydrofluoric acid emergency treatment was not given. The next morning he saw the hand surgeon who injected calcium gluconate into the burned area. Later the wounds were debrided. Serious damage to the fingers could have resulted had the hydrofluoric acid reached the bone. Fortunately, the hydrofluoric acid had not penetrated as far as expected and, after debridement of the upper tissue, only a few minor scars remained. Three months after the accident, his hand was still swollen, and the use and dexterity of his fingers had not fully returned. After seven months, dexterity had returned although some swelling remained.

Stencel, J.R.; Tobin, J.S.

1987-07-01

374

Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids.  

PubMed

Although therapeutic management of hypertrophic scars and keloids using contact or spray cryosurgery has yielded significant improvement or complete regression of hypertrophic scars and keloids, it requires one to 20 treatment sessions. This study was designed to assess the clinical safety and efficacy of an intralesional needle cryoprobe method in the treatment of hypertrophic scars and keloids. Ten patients, ranging in age from 3 to 54 years, with a total of 12 hypertrophic scars and keloids of more than 6 months duration and of diverse causes, were included in this study. The 18-month trial evaluated volume reduction of the hypertrophic scars and keloids after a single session of intralesional cryotherapy. Objective (hardness and color) and subjective (pain/tenderness and itchiness/discomfort) parameters were examined on a scale of 0 to 3 (low score was better). Pretreatment and posttreatment histomorphometric studies of the collagen fibers included spectral picrosirius red polarization and fast Fourier transformation orientation index. A specially designed cryo-needle was inserted into the long axis of the hypertrophic scars and keloids so as to maximize the volume of the hypertrophic scars and keloids to be frozen. The cryo-needle was connected by an adaptor to a cryogun filled with liquid nitrogen, which was introduced into the cryoprobe, thereby freezing the hypertrophic scars and keloids. After the hypertrophic scars and keloids were completely frozen, the cryoprobe defrosted and was withdrawn. An average of 51.4 percent of scar volume reduction was achieved after one session of intralesional cryosurgery treatment (average preoperative hypertrophic scars and keloids volume, 1.82 +/- 0.33; average posttreatment volume, 0.95 +/- 0.21; p < 0.0022). Significant alleviation of objective and subjective clinical symptoms was documented. Mild pain or discomfort during and after the procedure was easily managed. Only mild local edema and epidermolysis, followed by a short reepithelialization period, were evident. During the 18-month follow-up period, there was no evidence of bleeding, infection, adverse effects, recurrence, or permanent depigmentation. The histomorphometric analysis demonstrated rejuvenation of the treated scars (i.e., parallelization) and a more organized architecture of the collagen fibers compared with the pretreated scars. This study demonstrated the increased efficacy of this method as a result of increased freezing area of deep scar material compared with that obtained with contact/spray probes. As a result, fewer treatment cycles are needed. Because the reepithelialization period is short, treatment intervals, if any, can be shortened to 2 to 3 weeks. This intralesional cryoneedle method is simple to operate and safe to use, it necessitates less postoperative care of the wound, and it can easily be added to any preexisting cryosurgical unit. PMID:12711943

Har-Shai, Yaron; Amar, Micha; Sabo, Edmond

2003-05-01

375

Harborview Burns – 1974 to 2009  

Microsoft Academic Search

BackgroundBurn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1) identify new and confirm previously described changes, 2) make comparisons to the American Burn Association National Burn Repository, 3) determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4) model mortality over time, during

Loren H. Engrav; David M. Heimbach; Frederick P. Rivara; Kathleen F. Kerr; Turner Osler; Tam N. Pham; Sam R. Sharar; Peter C. Esselman; Eileen M. Bulger; Gretchen J. Carrougher; Shari Honari; Nicole S. Gibran

2012-01-01

376

7, 1733917366, 2007 Biomass burning  

E-print Network

ACPD 7, 17339­17366, 2007 Biomass burning plumes during the AMMA wet season experiment C. H. Mari a Creative Commons License. Atmospheric Chemistry and Physics Discussions Tracing biomass burning plumes from. Mari (marc@aero.obs-mip.fr) 17339 #12;ACPD 7, 17339­17366, 2007 Biomass burning plumes during the AMMA

Paris-Sud XI, Université de

377

Biomass Burning Data and Information  

Biomass Burning Data and Information This data set represents ... geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ... models of the atmosphere. Project Title:  Biomass Burning Discipline:  Tropospheric Chemistry ...

2014-08-06

378

13, 3226932289, 2013 Biomass burning  

E-print Network

ACPD 13, 32269­32289, 2013 Biomass burning aerosol properties over the Northern Great Plains T (ACP). Please refer to the corresponding final paper in ACP if available. Biomass burning aerosol Geosciences Union. 32269 #12;ACPD 13, 32269­32289, 2013 Biomass burning aerosol properties over the Northern

Dong, Xiquan

379

Anatomy of a Prescribed Burn  

NSDL National Science Digital Library

This poster shows how prescribed burns operate, using careful planning and preparation to start a fire that will renew habitat without threatening ecosystems or homes. This image describes the steps required to prepare a prescribed burn, how fire crews set up for the burn, and how the wind is used to help control the fire.

Forestry, Florida D.; Smokeybear.com

380

Biaxial serial excision: A technique to deal with benign skin lesions and scars  

PubMed Central

Background: In the best of hands, the ultimate surgical scar of an otherwise well-performed surgery is unpredictable, and surgical techniques are constantly evolving to prevent or revise large scars. The present series uses the principles of serial excision to reduce the eventual scar length. Materials and Methods: Between January 1991 and December 2010, 30 patients were operated upon. In the first stage, a lesion was reduced in two dimensions with the intent to create a smaller lesion with the long axis favourably placed. The residual lesion was then excised after 4 weeks or more. Results: The resultant scars were smaller and better aligned, with an excellent skin match. Conclusion: A well-planned serial excision in a biaxial manner helps reduce the final scar. PMID:23450072

Gajiwala, Kalpesh J.

2012-01-01

381

Versajet hydrosurgery versus classic escharectomy for burn débridment: a prospective randomized trial.  

PubMed

Our purpose was to conduct a prospective randomized trial to compare the Versajet system (Smith & Nephew, London, UK) vs hand-held dermatome escharectomy for burn débridment. All patients admitted over the course of 1 year at our burn center were recruited and randomly assigned to Versajet or hand-held dermatome escharectomy. We evaluated the 1) time for complete débridment and 2) the efficacy of Versajet in reaching the correct dermal plane. Secondary end points were the assessment of postoperative pain (evaluated with the visual analog scale), adverse effects, complete healing times, and contractures rates (after 6 months). A total of 87 patients were analyzed in two homogeneous groups of 42 (Versajet) and 45 (escharectomy) patients. All of them received adequate débridment, but the Versajet procedure was faster (P < .05) and more precise in obtaining the correct plane. One Versajet patient required ligation of a large subcutaneous vessel, which inadvertently was cut during the procedure. Versajet is a feasible, simple, and safe technique that hastens surgical débridment of burns and adds more precision to the procedure. PMID:17667835

Gravante, Gianpiero; Delogu, Daniela; Esposito, Gaetano; Montone, Antonio

2007-01-01

382

Is proportion burned severely related to daily area burned?  

NASA Astrophysics Data System (ADS)

The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall ? = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day.

Birch, Donovan S.; Morgan, Penelope; Kolden, Crystal A.; Hudak, Andrew T.; Smith, Alistair M. S.

2014-05-01

383

Chemical Debridement of Burns  

PubMed Central

The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. The removal of the devitalized tissue, without damage to unburned skin or skin only partially injured by burning, and in ways which would permit immediate (or very prompt) skin grafting, would lessen substantially the problems of sepsis, speed convalescence and the return of these individuals to society as effective human beings, and would decrease deaths. The usefulness and limitations of surgical excision for patients with extensive third degree burns are discussed. Chemical debridement lends itself to complementary use with surgical excision and has the potential advantage over surgical excision in not requiring anesthesia or a formal surgical operation. The authors' work with the chemical debridement of burns, in particular the use of Bromelain, indicates that this approach will likely achieve clinical usefulness. The experimental studies indicate that rapid controlled debridement, with minimal local and systemic toxicity, is possible, and that effective chemotherapeutic agents may be combined with the Bromelain without either interfering with the actions of the other. The authors believe that rapid (hours) debridement accomplished by the combined use of chemical debriding and chemotherapeutic agents will obviate the possibility of any increase in infection, caused by the use of chemical agents for debridement, as reported for Paraenzyme21 and Travase.39,48 It is possible that the short term use of systemic antibiotics begun just before and continued during, and for a short time after, the rapid chemical debridement may prove useful for the prevention of infection, as appears to be the case for abdominal operations of the clean-contaminated and contaminated types. ImagesFigs. 1a-c.Fig. 1b.Fig. 1c.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6.Fig. 7.Fig. 8.Fig. 9a.Fig. 9B.Fig. 10.Fig. 11.Figs. 12a-c.Fig. 12b.Fig. 12c.Figs. 14a-c.Fig. 14b.Fig. 14c.Figs. 15a-c.Fig. 15b.Fig. 15c. PMID:4606330

Levenson, Stanley M.; Kan, Dorinne; Gruber, Charles; Crowley, Leo V.; Lent, Richard; Watford, Alvin; Seifter, Eli

1974-01-01

384

Air-Freshener Burns: A New Paradigm in Burns Etiology?  

PubMed Central

Objectives: We report a rare case of burns following the use of automated air-fresheners. Methods: We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described. Results: A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms resulting in a seven-day hospital admission. The burns were treated conservatively. Conclusions: To our knowledge this is one of the few documented cases of burns as a result of air-fresheners. As they become more ubiquitous, we anticipate the incidence of such cases to increase. As such, they pose a potential public health concern on a massive scale. PMID:22174972

Sarwar, Umran; Nicolaou, M.; Khan, M. S.; Tiernan, E.

2011-01-01

385

[Burning mouth syndrome (glossalgia)].  

PubMed

Burning mouth syndrome (glossalgia) is manifested by oral pin and tingling sensations, numbness and even burning and severe pains, more frequently in the tongue. Unpleasant sensations may involve the anterior two thirds of the tongue or be extended to the front part of the hard palate and the mucous membrane of the lower lip. This condition is characterized by "mirror" and "food dominant" symptoms, disordered salivation, dysgeusia, or psychological disorders. The disease shows a chronic course. Its etiology may be multifactorial. There are no universally accepted diagnostic criteria; the diagnosis of glossalgia is made to rule out all other causes. A thorough examination should be conducted to establish a differential diagnosis. Glossalgia occurs primarily in middle-aged and elderly people. Women get sick much more frequently than men of the same age. Glossalgia remains difficult to treat. Continuous symptomatic treatment and follow-up help relieve its symptoms. PMID:24757710

2014-01-01

386

Cultured epithelial autografts for coverage of large burn wounds in eighty-eight patients: the Indiana University experience.  

PubMed

Since 1990, the authors have used a new technique for coverage of large burns, which begins with early tangential excision and coverage with cadaver allograft (A), followed by placement of cultured epithelial autograft (CEA) onto an allodermis base (CEA/A). They present their 18-year experience (1990-present) using CEA in 88 patients (20 children and 68 adults) with age range of 6 months to 73 years. A review of prospectively collected data was conducted on adult and pediatric patients grafted with CEA at the Indiana University Medical Center for definitive wound coverage (TBSA 28-98%). These patients were followed up for 3 to 90 months. Complications, take rates, and outpatient follow-ups were noted. The mean final take rate of CEA/A was 72.7%, and the overall patient survival rate was 91% (80 of 88 patients). Complications were classified as early and late, they included: (early) blistering and shearing (31%), pruritus and itching (4.7%), (late) CEA loss (2 patients, 2.3%), and wound contractures (66%). Contracture releases were performed on 32 patients (36%); of which, 18 were children (56%). Cultured keratinocytes provide an excellent alternative or adjunct to conventional split-thickness skin grafting in treating large burn wounds. A dedicated team of physicians, nurses, and therapists well rehearsed in CEA care are vital for success in keratinocyte grafting. The final graft take of 72.7% with a 91% overall survival rate gives much optimism for continuing to use CEA in critically burned patients. PMID:20616650

Sood, Rajiv; Roggy, David; Zieger, Madeline; Balledux, Jerone; Chaudhari, Swetanshu; Koumanis, Dimitri J; Mir, Haaris S; Cohen, Adam; Knipe, Cynthia; Gabehart, Kari; Coleman, John J

2010-01-01

387

Acute Deep Hand Burns Covered by a Pocket Flap-Graft  

PubMed Central

Objective: We evaluated the long-term outcome of the “pocket flap-graft” technique, used to cover acute deep burns of the dorsum of the hand, and analyzed surgical alternatives. Methods: This was a 6-year, retrospective study of 8 patients with extensive burns and 1 patient with a single burn (11 hands in all) treated by defatted abdominal wall pockets. We studied the medical records of the patients, and conducted a follow-up examination. Results: All hands had fourth-degree thermal burns caused by flames, with exposure of tendons, bones, and joints, and poor functional prognosis. One third of patients had multiple injuries. Burns affected an average of 36% of the hand surface, and mean coverage was 92.8 cm2. One patient died. The 8 others were seen at 30-month follow-up: the skin quality of the flap was found to be good in 55% of the cases, the score on the Vancouver Scar Scale was 2.4, the Kapandji score was 4.5, and total active motion was 37% of that of a normal hand. Hand function was limited in only 2 cases, 8 patients were able to drive, and 3 patients had gone back to work. Conclusion: The pocket flap-graft allows preservation of hand function following severe burns, when local or free flaps are impossible to perform. Debulking of the flap at the time of elevation limits the need for secondary procedures. PMID:17268577

Pradier, Jean-Philippe; Oberlin, Christophe; Bey, Eric

2007-01-01

388

Five-year experience with burns from glass fireplace doors in the pediatric population.  

PubMed

Burns from contact with glass doors of gas fireplaces have been previously reported. The purpose of this study is to examine the incidence and severity of this injury in our population. Patients were identified for inclusion in the retrospective chart review study using the National Trauma Registry of the American College of Surgeons (NTRACS) and our local outpatient database. Criteria for inclusion were burn injuries sustained from contact with fireplace glass doors treated at our pediatric burn center from 2007 through 2011. Fifty children met these criteria, including two children whose burns were caused by electric fireplace glass doors. BSA burned was 1.5 ± 1.5% (mean ± SD), range 0.5 to 10%. Age was 27.2 ± 27.3 months, range 8 months to 13 years. Forty-five children (90%) had hand burns; of these, 18 children had bilateral hand involvement. Facial burns were found in three children (6%), and eight children (16%) had other areas burned. One patient developed cellulitis. Two patients required surgery. Six children (12%) required hospitalization; mean length of stay was 5.8 ± 5 days, range 1 to 5 days. Although the number of inpatient admissions was relatively few, 329 outpatient visits and 309 rehabilitation visits were required for treatment of these children. Nineteen patients (38%) required splints and six patients (12%) required scar treatment with pressure garments. Burns from contact with fireplace glass doors are a recurring problem. Toddlers are most at risk. Directed preventive strategies including parent education, safety warnings, and design modifications such as temperature sensors and barrier screens could be potentially helpful in reducing the incidence of this injury. PMID:24043229

Baryza, Mary Jo; Hinson, Michelle; Conway, Jennifer; Ryan, Colleen M

2013-01-01

389

Fire-scar formation in Jeffrey pine mixed conifer forests in the Sierra San Pedro Martir, Mexico  

E-print Network

occurrence can be found in the ring structure of individual trees, such as fire scars and (or) patternsFire-scar formation in Jeffrey pine ­ mixed conifer forests in the Sierra San Pedro Ma´rtir, Mexico-Vizcai´no, and Travis J. Freed Abstract: Little is known about the probability of fire-scar formation. In this study, we

Stephens, Scott L.

390

Reconstruction of facial burn sequelae utilizing tissue expanders with embodiment injection site: case report.  

PubMed

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. Hypertrophic scars and tissue defects are the most common cause of functional and aesthetic problems in the head and neck region. Plastic surgeons use full-thickness or split-thickness skin grafts, pedicled flaps, free flaps, transplantation of bone or cartilage and tissue expansion. The authors present a case of a patient who suffered from third-degree flame burns to the face. Prior skin grafting procedures left him with severe scar deformity of the face. The patient was treated utilizing multiple tissue expansion. Facial animation has retained and facial integrity has been aesthetically restored and, with the use of make-up, it is near normal in social settings at conversational distances. The tissue expansion technique is advantageous in facial reconstruction because it makes it possible to resurface even wider defects with neighboring skin, similar in colour and texture, and superior to skin obtained elsewhere. PMID:17165599

Foustanos, A; Zavrides, H

2006-01-01

391

Sphericity and morphology of smoke particles from biomass burning in Brazil  

NASA Astrophysics Data System (ADS)

The degree of nonsphericity of smoke particles from biomass burning in Brazil was measured aboard the University of Washington C-131A aircraft during the Smoke, Clouds, and Radiation-Brazil (SCAR-B) project for several regions, types of fuel, and combustion. The nonsphericity (?o) of the particles was obtained from electrooptical light-scattering measurements, using an aerosol asymmetry analyzer, and from scanning electron microscopy (SEM) images of the particles. The electrooptical measurements provide a measure of the nonsphericity based on the difference between the light scattering coefficient for aligned and randomly oriented particles. The SEM photographs provide information on the geometric shapes of the particles. The maximum value of ?o obtained during the SCAR-B for biomass burning in Brazil was below 13%. The degree of nonsphericity of the particles is shown to be related to the combustion efficiency, the mass absorption efficiency, and the fraction of black carbon to total particle mass. It is concluded after smoke particles from biomass burning in Brazil have been in the atmosphere for more than about 1 hour that the spherical approximation (and therefore Mie theory) is reasonably valid for estimating the physical and optical properties of the particles.

Martins, J. Vanderlei; Hobbs, Peter V.; Weiss, Ray E.; Artaxo, Paulo

1998-12-01

392

Skin regeneration in adult axolotls: a blueprint for scar-free healing in vertebrates.  

PubMed

While considerable progress has been made towards understanding the complex processes and pathways that regulate human wound healing, regenerative medicine has been unable to develop therapies that coax the natural wound environment to heal scar-free. The inability to induce perfect skin regeneration stems partly from our limited understanding of how scar-free healing occurs in a natural setting. Here we have investigated the wound repair process in adult axolotls and demonstrate that they are capable of perfectly repairing full thickness excisional wounds made on the flank. In the context of mammalian wound repair, our findings reveal a substantial reduction in hemostasis, reduced neutrophil infiltration and a relatively long delay in production of new extracellular matrix (ECM) during scar-free healing. Additionally, we test the hypothesis that metamorphosis leads to scarring and instead show that terrestrial axolotls also heal scar-free, albeit at a slower rate. Analysis of newly forming dermal ECM suggests that low levels of fibronectin and high levels of tenascin-C promote regeneration in lieu of scarring. Lastly, a genetic analysis during wound healing comparing epidermis between aquatic and terrestrial axolotls suggests that matrix metalloproteinases may regulate the fibrotic response. Our findings outline a blueprint to understand the cellular and molecular mechanisms coordinating scar-free healing that will be useful towards elucidating new regenerative therapies targeting fibrosis and wound repair. PMID:22485136

Seifert, Ashley W; Monaghan, James R; Voss, S Randal; Maden, Malcolm

2012-01-01

393

Prevention of epidural scarring after microdiscectomy: a randomized clinical trial comparing gel and expanded polytetrafluoroethylene membrane  

PubMed Central

A randomized clinical trial compared two materials used to prevent epidural scarring after microdiscectomy. To determine whether ADCON®-L Gel (ALG) or Preclude Spinal Membrane® (PSM) was more effective in preventing scarring, reducing pain, and improving quality of life postoperatively. Postdiscectomy syndrome may result from epidural scarring. Various materials have been used in attempts to prevent this problem, but none have provided optimal results. Previous laboratory and clinical studies have found ALG and PSM to be effective, but none compared the two materials. Thirty-one patients undergoing primary microdiscectomy were randomly assigned to receive either ALG or PSM. Postoperatively, patients were evaluated by magnetic resonance imaging (MRI), with contrast, for volume and rostral–caudal extent of scar tissue and nerve root involvement. Back and leg pain and quality of life were assessed by neurologic examinations and standardized patient surveys. Findings at any reoperations were recorded. Results in the PSM (n = 18) and ALG (n = 13) groups were compared statistically. No operative or postoperative complications occurred. Two patients in each group required reoperation. MRI at 6 months showed no, mild or mild-moderate scarring in most patients, with no significant differences between the ALG and PSM groups in scar volume and extent or nerve root involvement. Neurologic examinations and patient surveys showed substantial reductions in pain over time in both groups but no significant differences between groups. PSM was easy to see and remove at reoperation. PSM and ALG are equally effective in preventing epidural scarring associated with postdiscectomy syndrome. PMID:16763848

Pink, Peter T.; Schneider, Frank; Stuecker, Markus; Homann, Nicolaus C.; Preidler, Klaus W.

2006-01-01

394

Keloids and Hypertrophic Scars: Characteristic Vascular Structures Visualized by Using Dermoscopy  

PubMed Central

Background Keloids and hypertrophic scars represent excessive scarring. They require different therapeutic approaches, which can be hampered because of an apparent lack of morphologic difference between the two diseases. Objective This study investigated the clinical and dermoscopic features of keloids and hypertrophic scars in order to help dermatologists distinguish these lesions better. Methods A total of 41 keloids and hypertrophic scars in 41 patients were examined clinically and by performing dermoscopy with a digital imaging system. Lesions were evaluated for vascular structures. Results Dermoscopy revealed vascular structures in most keloid lesions (90%) but in only 27% of hypertrophic scar lesions. The most common dermoscopic vascular structures in keloids were arborizing (52%), followed by linear irregular (33%) and commashaped (15%); these features were present but less evident in hypertrophic scars (9% for all types). The distribution frequency of the vascular structures differed significantly between diseases (p<0.001). Conclusion A strong association of vascular structures with keloids was observed on dermoscopic examination. The results suggest dermoscopic examination of vascular structures is a clinically useful diagnostic tool for differentiating between keloids and hypertrophic scars.

Yoo, Min Gun

2014-01-01

395

Dermatopathology: SY07-2 CAN YOU DIAGNOSE HAIR LOSS (NON-SCARRING ALOPECIA).  

PubMed

Alopecias are broadly divided into scarring and non-scarring forms. From a clinical perspective, follicular ostia are preserved in non-scarring alopecia, while histopathologically, there is preservation of follicular unit architecture, presence of intact sebaceous glands, and normal to near normal numbers of hair follicles. In chronic, long-standing non-scarring alopecias, follicular drop out may eventually ensue, resulting in absolute decrease in hair follicle numbers.Choice of biopsy site contributes significantly to accurate histopathological diagnosis. Areas of active hair loss are preferred. At the National Skin Centre, Singapore, it is routine practice to take two 4?mm punch biopsy specimens in suspected non-scarring alopecia; one specimen is sectioned vertically while the other is sectioned transversely. In non-scarring alopecias, transverse sections render very useful information. It allows for assessment of follicular unit integrity, hair counts, anagen:telogen and terminal:vellus hair ratios. It also allows for visualisation of all hair follicles within the biopsy specimen at a glance.In this talk, some common forms of non-scarring alopecias (e.g., androgenetic alopecia, alopecia areata, traction alopecia, trichotillomania, etc.) will be discussed, with emphasis on interpreting transverse sections. PMID:25188056

Lee, Joyce S S

2014-10-01

396

Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars  

PubMed Central

Background: While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between. Aim: The aim of the present study is to assess the efficacy and safety of fractional CO2 laser resurfacing in atrophic facial acne scars. Materials and Methods: Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ‘excellent’ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ‘good’ and ‘poor’ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted. Results: Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3%) while 15 (25%) and 19 patients (31.7%) demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks. Conclusions: Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar scars with minimal adverse effects. PMID:25136208

Majid, Imran; Imran, Saher

2014-01-01

397

A new in vitro model of the glial scar inhibits axon growth  

PubMed Central

Astrocytes respond to central nervous system (CNS) injury with reactive astrogliosis and participate in the formation of the glial scar, an inhibitory barrier for axonal regeneration. Little is known about the injury-induced mechanisms underlying astrocyte reactivity and subsequent development of an axon-inhibitory scar. We combined two key aspects of CNS injury, mechanical trauma and co-culture with meningeal cells, to produce an in vitro model of the scar from cultures of highly differentiated astrocytes. Our model displayed widespread morphological signs of astrocyte reactivity, increases in expression of glial fibrillary acidic protein (GFAP), and accumulation of GFAP in astrocytic processes. Expression levels of scar-associated markers phosphacan, neurocan and tenascins were also increased. Importantly, neurite growth from various CNS neuronal populations was significantly reduced when neurons were seeded on the scar-like cultures, compared to growth on cultures of mature astrocytes. Quantification of neurite growth parameters on the scar model demonstrated significant reductions in neuronal adhesion and neurite lengths. Interestingly, neurite outgrowth of postnatal neurons was reduced to a greater extent than that of embryonic neurons, and outgrowth inhibition varied among neuronal populations. Scar-like reactive sites and neurite-inhibitory patches were found throughout these cultures, creating a patchwork of growth-inhibitory areas mimicking a CNS injury site. Thus, our model showed relevant aspects of scar formation and produced widespread inhibition of axonal regeneration; it should be useful both for examining mechanisms underlying scar formation and to assess various treatments for their potential to improve regeneration after CNS injury. PMID:18618667

Wanner, Ina B.; Deik, Andres; Torres, Miguel; Rosendahl, Andrew; Neary, Joseph T.; Lemmon, Vance P.; Bixby, John L.

2011-01-01

398

Congenital contractures, short stature, abnormal face, microcephaly, scoliosis, hip dislocation, and severe psychomotor retardation in two unrelated girls. a new MCA/MR syndrome?  

PubMed

Severe mental retardation, congenital contractures, short stature, microcephaly, ptosis, myopia, beaked nose, abnormal teeth, hip dislocation, and severe scoliosis, are described in a 16-year-old and an unrelated 24-year-old females. Results of all laboratory investigations were normal. Review of the literature, of the London Dysmorphology Data Base and POSSUM did not yield to any diagnosis. Whether these patients present a new MCA/MR syndrome is discussed. PMID:12150211

Mégarbané, A; Ghanem, I; Romana, S; Gosset, P; Caillaud, C

2002-01-01

399

Cumulative and Bolus In Vitro Contracture Testing with 4-Chloro-3-Ethylphenol in Malignant Hyperthermia Positive and Negative Human Skeletal Muscles  

Microsoft Academic Search

In this study we evaluated the in vitro effects of 4-chloro-3-ethylphenol (CEP) using cumulative (12.5- 200 mol\\/L) or bolus (75 and 100 mol\\/L) administra- tions, on muscle specimens from malignant hyperther- mia(MH)susceptibleandMHnonsusceptiblepatients, respectively. In the cumulative CEPin vitrocontracture test, contractures were significantly greater in the MH susceptible compared with the MH nonsusceptible muscles in all concentrations between 25 and 100

Mark Ulrich Gerbershagen; Marko Fiege; Ralf Weisshorn; Kerstin Kolodzie; Jochen Schulte am Esch; Frank Wappler

2005-01-01

400

Scar sarcoidosis in childhood: case report and review of the literature.  

PubMed

Sarcoidosis is a rare disease among children, manifesting differently in children below and above 4-5 years of age. Although the exact incidence and prevalence of childhood sarcoidosis is not known, the cutaneous involvement is frequent in both children and adults. Infiltration of old cutaneous scars with sarcoid granuloma in the active phase of disease, known as scar sarcoidosis is one of the uncommon cutaneous manifestations of sarcoidosis. We report a case of scar sarcoidosis in an 11-year-old child along with a brief review of the literature. PMID:15807680

Singal, A; Thami, G P; Goraya, J S

2005-05-01

401

Acoustic emission strand burning technique for motor burning rate prediction  

NASA Technical Reports Server (NTRS)

An acoustic emission (AE) method is being used to measure the burning rate of solid propellant strands. This method has a precision of 0.5% and excellent burning rate correlation with both subscale and large rocket motors. The AE procedure burns the sample under water and measures the burning rate from the acoustic output. The acoustic signal provides a continuous readout during testing, which allows complete data analysis rather than the start-stop clockwires used by the conventional method. The AE method helps eliminate such problems as inhibiting the sample, pressure increase and temperature rise, during testing.

Christensen, W. N.

1978-01-01

402

[Treatment of surgical site infection and hypertrophic scars].  

PubMed

For the treatment of surgical site infection (SSI), removal of foreign body materials and débridement of infected/necrotized tissues should be performed after careful imaging diagnosis. Then, wound irrigation should be performed everyday. For critically colonized wounds, iodine preparations are useful. If healthy granulation tissues start to grow, wound dressing with the basic fibroblast growth factor (bFGF) spray and/or prostaglandin E? (PGE?) ointment should be recommended. Poor increase in granulation tissues, is a good indication for vacuum assisted closure (VAC) therapy. In Japan, the V.A.C. system is the only device for negative pressure wound therapy (NPWT) that is covered by the health insurance scheme. If entire wounds are covered by healthy granulation, chest wall reconstruction using skin graft or flap can be considered. For the treatment of hypertrophic scars (HSs), multimodal therapies should be performed. Tranilast and/or Saireito are widely used as internal agents in Japan. Corticosteroid ointments/creams/tapes/ injections are useful to decrease chronic inflammation in HSs. Moreover, wound stabilization, compression and keeping the affected area moist are effective to decrease subjective symptoms including itch and pain. Surgery, radiation therapy, pulsed dye laser, neodymium yttrium aluminum garnet(Nd:YAG) laser, make-up therapy such as rehabilitation make-up should be selected on a case-by-case basis. PMID:22569501

Ogawa, R

2012-05-01

403

Ten novel FBN2 mutations in congenital contractural arachnodactyly: delineation of the molecular pathogenesis and clinical phenotype.  

PubMed

Congenital contractural arachnodactyly (CCA) is an autosomal dominant condition that shares skeletal features with Marfan syndrome (MFS), but does not have the ocular and cardiovascular complications that characterize MFS. CCA and MFS result from mutations in highly similar genes, FBN2 and FBN1, respectively. All the identified CCA mutations in FBN2 cluster in a limited region similar to where severe MFS mutations cluster in FBN1, specifically between exons 23 and 34. We screened exons 22 through 36 of FBN2 for mutations in 13 patients with classic CCA by single stranded conformational polymorphism analysis (SSCP) and then by direct sequencing. We successfully identified 10 novel mutations in this critical region of FBN2 in these patients, indicating a mutation detection rate of 75% in this limited region. Interestingly, none of these identified FBN2 mutations alter amino acids in the calcium binding consensus sequence in the EGF-like domains, whereas many of the FBN1 mutations alter the consensus sequence. Furthermore, analysis of the clinical data of the CCA patients with characterized FBN2 mutation indicate that CCA patients have aortic root dilatation and the vast majority lack evidence of congenital heart disease. These studies have implications for our understanding of the molecular basis of CCA, along with the diagnosis and genetic counseling of CCA patients. PMID:11754102

Gupta, Prateek A; Putnam, Elizabeth A; Carmical, Sonya G; Kaitila, Ilkka; Steinmann, Beat; Child, Anne; Danesino, Cesare; Metcalfe, Kay; Berry, Susan A; Chen, Emily; Delorme, Catherine Vincent; Thong, Meow-Keong; Adès, Lesley C; Milewicz, Dianna M

2002-01-01

404

Clothing burns in Canadian children  

PubMed Central

A Canadian survey of 11 tertiary care pediatric centres with specialized burn facilities revealed that an estimated 37 children up to 9 years of age are admitted annually to such hospitals because of clothing burns. Sleepwear accounts for an estimated 21 such burns per year. Girls were found to suffer the most severe burns and represented eight of the nine children in the series who died. Loose and flowing garments dominated the girls' styles. The results of multiple-regression analysis confirmed that style of clothing (loose and flowing as opposed to snug) was the most significant predictor of burn severity, length of hospital stay, the need for skin grafting and survival. The ignition situation (avoidance of parental supervision at the time of injury) was the only other important predictor. The success of regulatory actions in other countries in reducing the incidence of severe clothing burns is reviewed, and preventive strategies for Canada are explored. ImagesFig. 2 PMID:3995433

Stanwick, Richard S.

1985-01-01

405

CAD tool for burn diagnosis.  

PubMed

In this paper a new system for burn diagnosis is proposed. The aim of the system is to separate burn wounds from healthy skin, and the different types of burns (burn depths) from each other, identifying each one. The system is based on the colour and texture information, as these are the characteristics observed by physicians in order to give a diagnosis. We use a perceptually uniform colour space (L*u*v*), since Euclidean distances calculated in this space correspond to perceptually colour differences. After the burn is segmented, some colour and texture descriptors are calculated and they are the inputs to a Fuzzy-ARTMAP neural network. The neural network classifies them into three types of bums: superficial dermal, deep dermal and full thickness. Clinical effectiveness of the method was demonstrated on 62 clinical burn wound images obtained from digital colour photographs, yielding an average classification success rate of 82% compared to expert classified images. PMID:15344466

Acha, Begoña; Serrano, Carmen; Acha, José I; Roa, Laura M

2003-07-01

406

Curbing Inflammation in Burn Patients  

PubMed Central

Patients who suffer from severe burns develop metabolic imbalances and systemic inflammatory response syndrome (SIRS) which can result in multiple organ failure and death. Research aimed at reducing the inflammatory process has yielded new insight into burn injury therapies. In this review, we discuss strategies used to curb inflammation in burn injuries and note that further studies with high quality evidence are necessary. PMID:23762773

Farina, Jayme A.; Rosique, Marina Junqueira; Rosique, Rodrigo G.

2013-01-01

407

Burning Fuel Droplet  

NASA Technical Reports Server (NTRS)

Fuel ignites and burns in the Droplet Combustion Experiment (DCE) on STS-94 on July 4 1997, MET:2/05:40 (approximate). The DCE was designed to investigate the fundamental combustion aspects of single, isolated droplets under different pressures and ambient oxygen concentrations for a range of droplet sizes varying between 2 and 5 mm. DCE used various fuels -- in drops ranging from 1 mm (0.04 inches) to 5 mm (0.2 inches) -- and mixtures of oxidizers and inert gases to learn more about the physics of combustion in the simplest burning configuration, a sphere. The experiment elapsed time is shown at the bottom of the composite image. The DCE principal investigator was Forman Williams, University of California, San Diego. The experiment was part of the space research investigations conducted during the Microgravity Science Laboratory-1R mission (STS-94, July 1-17 1997). Advanced combustion experiments will be a part of investigations plarned for the International Space Station. (121KB JPEG, 654 x 977 pixels; downlinked video, higher quality not available) The MPG from which this composite was made is available at http://mix.msfc.nasa.gov/ABSTRACTS/MSFC-0300169.html.

2003-01-01

408

Residual scarring from hidradenitis suppurativa: fractionated CO2 laser as a novel and noninvasive approach.  

PubMed

Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin condition that can have a significant psychosocial impact, both with the active disease and with residual scarring. Although a wide variety of treatment options exist for HS, to our knowledge there are no reported modalities aimed specifically at treating HS scarring. We describe the case of an adolescent female who received medical management of intramammary HS followed by successful treatment with fractionated 10,600-nm carbon dioxide laser for her residual cribriform scarring. We believe there is great potential for the use of fractionated carbon dioxide laser to improve short- and long-term psychosocial outcomes of HS, promote physical scar remodeling, and possibly alter the disease process itself. PMID:24323993

Krakowski, Andrew C; Admani, Shehla; Uebelhoer, Nathan S; Eichenfield, Lawrence F; Shumaker, Peter R

2014-01-01

409

Considerations on the use of platelet-rich plasma, specifically for burn treatment.  

PubMed

Platelet-rich plasma (PRP) is a fraction of blood plasma with a platelet concentration above baseline. After activation of the platelets, growth factors are released, which are involved in wound-healing processes. Application of a multitude of growth factors seems to boost the healing process. In this review the authors provide a comprehensive overview of the many different aspects of PRP; this is followed by a short outline of the evidence for a wide range of applications and finally narrowing down to a more in-depth analysis of the literature on the potential use of PRP in burn treatment. The authors performed an extensive search on PRP and the different biological, as well as practical aspects for the different applications. Furthermore, we performed a systematic search on PRP in the treatment of burn wounds. A high variety exists in PRP products, procedures, and content. This makes interpretation and comparison of the evidence difficult. PRP has been reported to have beneficial effects on wound healing in different fields of surgery and in the treatment of acute, chronic, and diabetic wounds. Literature on the use of PRP in burns is scarce. Separate growth factors have shown beneficial results in the treatment of burns. Furthermore, an animal study and several case reports showed improved burn wound-healing time after the application of PRP. A deep dermal burn could benefit from PRP through its hemostatic antimicrobial abilities and the positive effects seen in wound healing. However, burn patients have an altered physiological state and it is unknown how this may affect platelet function and quality. Furthermore, the effect of PRP on scarring has not been evaluated properly. Future research is needed to elucidate the role of PRP in the treatment of burns. PMID:24518678

Marck, Rose E; Middelkoop, Esther; Breederveld, Roelf S

2014-01-01

410

Scar Prevention Using Laser-Assisted Skin Healing (LASH) in Plastic Surgery  

Microsoft Academic Search

Background  The use of lasers has been proposed for scar revision. A recent pilot clinical study demonstrated that lasers could also be\\u000a used immediately after surgery to reduce the appearance of scars. The LASH (Laser-Assisted Skin Healing) technique induces\\u000a a temperature elevation in the skin which modifies the wound-healing process. We report a prospective comparative clinical\\u000a trial aimed at evaluating an

Alexandre Capon; Gwen Iarmarcovai; David Gonnelli; Nathalie Degardin; Guy Magalon; Serge Mordon

2010-01-01

411

Digital representation of oil and natural gas well pad scars in southwest Wyoming  

USGS Publications Warehouse

The recent proliferation of oil and natural gas energy development in southwest Wyoming has stimulated the need to understand wildlife responses to this development. Central to many wildlife assessments is the use of geospatial methods that rely on digital representation of energy infrastructure. Surface disturbance of the well pad scars associated with oil and natural gas extraction has been an important but unavailable infrastructure layer. To provide a digital baseline of this surface disturbance, we extracted visible oil and gas well pad scars from 1-meter National Agriculture Imagery Program imagery (NAIP) acquired in 2009 for a 7.7 million-hectare region of southwest Wyoming. Scars include the pad area where wellheads, pumps, and storage facilities reside, and the surrounding area that was scraped and denuded of vegetation during the establishment of the pad. Scars containing tanks, compressors, and the storage of oil and gas related equipment, and produced-water ponds were also collected on occasion. Our extraction method was a two-step process starting with automated extraction followed by manual inspection and clean up. We used available well-point information to guide manual clean up and to derive estimates of year of origin and duration of activity on a pad scar. We also derived estimates of the proportion of non-vegetated area on a scar using a Normalized Difference Vegetation Index derived using 1-meter NAIP imagery. We extracted 16,973 pad scars of which 15,318 were oil and gas well pads. Digital representation of pad scars along with time-stamps of activity and estimates of non-vegetated area provides important baseline (circa 2009) data for assessments of wildlife responses, land-use trends, and disturbance-mediated pattern assessments.

Garman, Steven L.; McBeth, Jamie L.

2014-01-01

412

Bibliography of Supersonic Cruise Aircraft Research (SCAR) Program from 1972 to Mid-1977  

NASA Technical Reports Server (NTRS)

This bibliography documents publications of the supersonic cruise aircraft research (SCAR) program that were generated during the first 5 years of effort. The reports are arranged according to systems studies and five SCAR disciplines: propulsion, stratospheric emissions impact, structures and materials, aerodynamic performance, and stability and control. The specific objectives of each discipline are summarized. Annotation is included for all NASA inhouse and low-number contractor reports. There are 444 papers and articles included.

Hoffman, S.

1977-01-01

413

A SCAR marker for detection of micropropagated banana dwarf off-types is chloroplast encoded  

Microsoft Academic Search

Dwarfs are the most common off-type regenerated from micropropagated bananas, particularly from the international banana of commerce, the Cavendish (AAA genome) types. A RAPD marker for dwarfism (Damasco et al. 1996, Plant Cell Reports 16:118) has been converted into a SCAR marker. This SCAR marker may be used as a robust means of identifying dwarf off-types both in vitro and

Ian D Godwin; Olivia P Damasco; Steve W Adkins; Robert J Henry; Mike K Smith