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Serial casting as a technique to correct burn scar contractures. A case report.  


Serial casting is a fast, relatively simple, and inexpensive way to effectively correct burn scar contractures. Plaster casts provide circumferential pressure and a prolonged stretch to contracted tissue and cannot be removed by the patient. When casts are applied well and padded appropriately, there is little risk of pressure areas, since the casts are conforming and do not slip distally. Serial casting may be a successful alternative when low-force dynamic splinting cannot be sized small enough for a child, or when patient compliance is unreliable. A case study of a 2-year-old male patient with severe plantar-flexion contractures of the ankles is presented. PMID:2022686

Ridgway, C L; Daugherty, M B; Warden, G D



An implant-supported removable partial denture for a patient with post-inflammatory scar contracture caused by burn complications: a clinical report  

PubMed Central

The scars and contracture around the oral-facial region may cause difficulty in prosthodontic treatment to restore esthetics and function for the patients, who suffered severe burns. This article presents a technique that uses a fixed partial denture prepared with a conventional milling technique and an attachment to support anterior cantilever removable partial denture, thereby providing a more esthetically acceptable and functional result. PMID:22439102

Kim, Jee-Hwan



California Burn Scars  

Atmospheric Science Data Center

article title:  Burn Scars Across Southern California     View Larger ... across Southern California between October 21 and November 18, 2003. Burn scars and vegetation changes wrought by the fires are illustrated ...



Ablative fractional laser resurfacing helps treat restrictive pediatric scar contractures.  


Conventional management of debilitating pediatric scar contractures, including hand therapy and surgery, may often be beset by delayed treatment, suboptimal results, and additional surgical morbidity. Ablative fractional laser resurfacing is an emerging adjunctive procedural option for scar contractures because of its promising efficacy and safety profile. However, its use to improve function has not been studied in the pediatric population. Herein we report 2 pediatric patients with recalcitrant scar contractures, causing persistent functional deficits, treated with an ablative fractional laser protocol. Both patients experienced rapid and cumulative subjective and objective improvements in range of motion and function as measured by an independent occupational therapist without reported complications. We highlight ablative fractional laser resurfacing as a novel and promising tool in the management of function-limiting scar contractures in children and propose that the technique be incorporated into existing scar treatment paradigms, guided by future research. PMID:25367535

Krakowski, Andrew C; Goldenberg, Alina; Eichenfield, Lawrence F; Murray, Jill-Peck; Shumaker, Peter R



Implementation of a Burn Scar Assessment System by Ultrasound Techniques  

Microsoft Academic Search

Tissue injury and its ensuing healing process cause scar formation. In addition to physical disability, the subsequent disfigurements from burns often bring negative psychological impacts on the survivors. Scar hypertrophy and contracture limit the joint motion and body function of the patient. With fast development of the current available technologies regarding the scar therapies, not only the process of wound

Yi-Chun Du; Chih-Ming Lin; Yung-Fu Chen; Chung-Lin Chen; Tainsong Chen



Malignant degeneration in burn scars.  


The malignant potential of burn scars has been recognized since Marjolin's classical description of cancer arising in several types of post-traumatic scars. With improved burn therapy since the last war, there has been a higher survival rate of severe burns with proportionate increase in cancer associated with burn scars. This will create increasing problems of permanent disability and compensation. The younger the patient at the time of the burn, the longer the time required for the cancer to develop. Acute cancer development in burn scars has been reported after a four-week interval. Cancer may develop from six weeks to fifty years or more. The etiology of cancer in burn scars is not known. The most important clinical finding is the fact that most of the burn cancers occur in areas which were not grafted. The most common type of cancer encountered in burn scars is squamous cell carcinoma, which forms in Marjolin ulcers. Basal cell carcinoma may develop in the most superficial of burn scars.Treatment should be directed primarily to prompt and adequate skin grafting in all deep burns in order to prevent malignant degeneration of the burn scars. Once it has developed the treatment is the same as for other malignancies which are not associated with burns. Wide surgical excision with block dissection of the regional lymph nodes when they are involved is the treatment of choice. The prognosis of burn scar cancer is poor, once the process has extended because of early and distant metastasis. PMID:13691372




The effect of myofibroblast on contracture of hypertrophic scar.  


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



Post Burn Contracture Neck: Clinical Profile and Management  

PubMed Central

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

Bankar, Sanket S.; Patil, Avinash



Surgical management of burn flexion and extension contractures of the toes.  


Burn contracture of the toes is a devastating sequela of thermal injury to the foot. Without proper treatment of toe burn contractures, patients suffer from significant functional and social limitations, including difficulties with activities of daily living. The authors classify the severity of toe burn scar contractures (TBSCs) by considering important characteristics of the deformity and tailor definitive surgical treatment based on the individual needs of the patient's condition. A retrospective review was performed on 20 patients who underwent a total of 32 reconstructive operations involving 275 TBSC procedures from 2000 to 2010. Multiple clinical, functional, and anatomic criteria were used to describe each patient's contracture as mild, moderate, or severe. Mild TBSC involved scarring of the superficial tissues only with no functional impairment; these were treated with scar release or local tissue rearrangement. Moderate TBSC involved soft tissue shortages requiring skin grafts and occasional closed joint capsulotomy. Severe TBSC caused the greatest impairment in function and involved burn injury to deeper structures. For these difficult contractures, a patient-specific technique was paramount to optimal reconstruction. There were six, three, and 11 patients with mild, moderate, and severe TBSC, respectively. The mean number of primary procedures per toe increased with increasing burn complexity from 1.1 procedures for mild, 1.5 for moderate, and 1.8 for severe groups, with severe TBSC undergoing more primary procedures overall (13.7 in severe vs 2.8 in mild TBSC). Complication rates per toe were highest for severe TBSC (59.0%). Only severe TBSC received secondary operations, and overall contracture recurrence was 35%. An individualized surgical approach based on TBSC severity is recommended for addressing burn contracture of the toes. Careful analysis of the clinical, functional, and anatomic characteristics of the burned foot determines the severity of each toe contracture and dictates the interventions necessary for reconstruction. PMID:24390110

Chang, Jessica B; Kung, Theodore A; Levi, Benjamin; Irwin, Todd; Kadakia, Anish; Cederna, Paul S



Burn Scar Neoplasm  

PubMed Central

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

Kadir, A.R.




PubMed Central

The malignant potential of burn scars has been recognized since Marjolin's classical description of cancer arising in several types of post-traumatic scars. With improved burn therapy since the last war, there has been a higher survival rate of severe burns with proportionate increase in cancer associated with burn scars. This will create increasing problems of permanent disability and compensation. The younger the patient at the time of the burn, the longer the time required for the cancer to develop. Acute cancer development in burn scars has been reported after a four-week interval. Cancer may develop from six weeks to fifty years or more. The etiology of cancer in burn scars is not known. The most important clinical finding is the fact that most of the burn cancers occur in areas which were not grafted. The most common type of cancer encountered in burn scars is squamous cell carcinoma, which forms in Marjolin ulcers. Basal cell carcinoma may develop in the most superficial of burn scars. Treatment should be directed primarily to prompt and adequate skin grafting in all deep burns in order to prevent malignant degeneration of the burn scars. Once it has developed the treatment is the same as for other malignancies which are not associated with burns. Wide surgical excision with block dissection of the regional lymph nodes when they are involved is the treatment of choice. The prognosis of burn scar cancer is poor, once the process has extended because of early and distant metastasis. ImagesFigure 1.Figure 2.Figure 2.Figure 3.Figure 3.Figure 4. PMID:13691372

Castañares, Salvador



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



Marjolin ulcer of the scalp: intruder of a burn scar.  


Childhood burn accidents are still a problem all over the world. Besides the contractures and hypertrophic scar conditions, malignant transformation in the burn scar is one of the primary concerns later in adulthood. Marjolin ulcer, commonly seen after burn scar, is a neoplastic change in the scar tissue. The scalp region necessitates additional attention because of the inevitable structures it protects. The long-standing ulcers with malignant transformation may cause invasion of different layers of the scalp. As the cranium is invaded, reconstruction after wide excision of these tumors becomes more difficult to deal with. Scalp invasion of Marjolin ulcers with different levels is presented in the following study. Consistent with the literature, histopathology of the tumors was squamous cell carcinoma in most patients. Although rare, mesenchymal tumor is involved in 2 of 9 patients. The latent period of the tumor is inversely proportional to the age at the time of burn injury. As the patient is younger at the time of injury, the occurrence of the ulcer is longer than expected. Lag period as long as 81 years is detected in the study. The delayed diagnosis due to social considerations such as financial limitations increases the likelihood of cranial invasion. A single huge scalp flap is often sufficient for soft tissue defects, and cranioplasty with methyl methacrylate is an appropriate option for reconstruction. PMID:18650725

Calikapan, Gaye Taylan; Akan, Mithat; Karaca, Mustafa; Aköz, Tayfun



Reverse flow flap use in upper extremity burn contractures.  


Upper extremity contractures still happen and constitute one of the most trying challenges in burn patients. This series comprised of 4 radial forearm flaps, 14 dorsoulnar artery flaps, and 4 medial arm flaps, all of which were used in a reverse pattern for upper extremity postburn contractures. The reverse flow radial forearm flap (RRFF) was chosen for reconstruction of extensive palmar contractures after burn. The reverse flow dorsoulnar flap (RDUF) was used particularly for reconstruction of the hypothenar aspect of the hand which requires moderate size tissue transfer. The reverse medial arm flap (RMAF) was used for elbow contractures after burn. In the first RMAF, venous congestion occurred and was finaly resolved with minimal flap loss, which was managed with STSG later. In the following 3 cases the flap was supercharged with anastomosis of the brachial vein into the antebrachial vein. Both RRFF and RDUF may provide a smooth and efficient solution. However, RMAF has a significant venous problem, which may result in flap loss, therefore, this flap should not be considered as a first option in the elbow area. PMID:18804917

Uygur, Fatih; Sever, Celalettin; Evinç, Rahmi; Ulkür, Ersin; Duman, Haluk



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


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

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



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

PubMed Central

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

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



Prevention and surgical management of postburn contractures of the hand.  


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



Use of preputial skin for coverage of post-burn contractures of fingers in children  

PubMed Central

Objective: Hand burns are common injuries. Children frequently sustain burn injuries, especially to their hands. Contractures are a common sequel of severe burns around joints. The prepuce, or foreskin, has been used as a skin graft for a number of indications. We conducted this study to evaluate the feasibility of utilising the preputial skin for the management of post-burn contractures of fingers in uncircumcised male children. Materials and Methods: Preputial skin was used for the coverage of released contractures of fingers in 12 patients aged 2-6 years. The aetiology of burns was “Kangri” burn in eight patients and scalding in four patients. Six patients had contracture in two fingers, four patients in one finger, and two patients had contractures in three fingers. Results: None of the patients had graft loss, and all the wounds healed within 2 weeks. All patients had complete release of contractures without any recurrence. Hyperpigmentation of the grafts was observed over a period of time, which was well accepted by the parents. Conclusions: Preputial skin can be used successfully for male children with mild-to-moderate contractures of 2-3 fingers for restoration of the hand function, minimal donor site morbidity. PMID:21713163

Zaroo, Mohammed I.; Sheikh, Bashir A.; Wani, Adil H.; Darzi, Mohammad A.; Mir, Mohsin; Dar, Hameedullah; Baba Peerzada, U. F.; Zargar, Haroon R.



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



Epidermal participation in post-burn hypertrophic scar development.  


The reconstruction of epidermal architecture over time in normotrophic and hypertrophic scars in untransplanted, spontaneously healed partial-thickness burns has scarcely been studied, unlike the regeneration of epidermal grafts used to cover burn wounds and the regeneration of the dermis during hypertrophic scarring. The expression of markers of epidermal proliferation, differentiation and activation in normotrophic and hypertrophic scars in spontaneously healed partial-thickness burns was assessed and compared with the expression of these markers in normal control skin of healthy persons to determine whether hypertrophic scarring is associated with abnormalities in the phenotype of keratinocytes. Punch biopsies were taken both of partial-thickness burns after re-epithelialisation and of matched unburned skin. At 4 and 7 months post-burn, biopsies were taken of normotrophic and hypertrophic scars that had developed in these wounds. The biopsies were analysed using immunostaining for markers of keratinocyte proliferation, differentiation and activation (keratins 5, 10, 16 and 17, filaggrin, transglutaminase and CD36). We observed a higher expression of markers for proliferation, differentiation and activation in the epidermis of scars at 1 month post-burn than in normal control skin of healthy persons. There was a striking difference between normotrophic and hypertrophic scars at 4 months post-burn. Keratinocytes in hypertrophic scars displayed a higher level of proliferation, differentiation and activation than did normotrophic scars. At 7 months post-burn all keratinocyte proliferation and differentiation markers showed normal expression, but the activation marker CD36 remained upregulated in both normotrophic and hypertrophic scars. Surprisingly, in matched unburned skin of burn patients, a state of hyperactivation was observed at 1 month. Our results suggest that keratinocytes may be involved in the pathogenesis of hypertrophic scarring. PMID:10190301

Hakvoort, T E; Altun, V; Ramrattan, R S; van der Kwast, T H; Benner, R; van Zuijlen, P P; Vloemans, A F; Prens, E P



Quality of life after burn injury: the impact of joint contracture.  


We sought to investigate quality of life, and to specifically assess how joint contracture affects it, in patients with burn injuries. The study is involved 22 adults with burn injuries. Patients were divided into two groups according to the presence (n = 11) or absence (n = 11) of any joint contracture. Patient age, sex, date of burn injury, burn type, location, and extent of burn (TBSA) were recorded for each case. Each individual underwent a thorough musculoskeletal system examination, with special focus on range of motion of the joints. Quality of life was evaluated using the Short Form 36 (SF-36). Eight (36.4%) of the patients were women, and 14 (63.6%) were men, and their mean age (+/- SE) was 24.7 +/- 4.68 years. The mean interval from injury to the study assessment was 21.45 +/- 14.69 months. Eleven patients (50%) had at least one joint contracture. The patients with one or more contractures had significantly lower scores for the SF-36 subscales of physical functioning, physical role limitations, bodily pain, and vitality (P = .05, P = .01, P = .04, and P = .02, respectively). In the 22 patients overall, TBSA was negatively correlated with the scores for the SF-36 subscales vitality and emotional role limitations (r = -.586 and r = -.805, respectively). Joint contracture does impact burn patients' quality of life, especially with respect to physical functioning, physical role limitations, bodily pain, and vitality. In addition, the amount of BSA burned is correlated with psychosocial problems and poorer quality of life, regardless of whether joint contractures develop. PMID:17091084

Leblebici, Berrin; Adam, Mehmet; Ba?i?, Selda; Tarim, Akin M; Noyan, Turgut; Akman, Mahmut N; Haberal, Mehmet A



Extensive Burn Scars in Russia's Amur Region  

NASA Technical Reports Server (NTRS)

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



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



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

PubMed Central

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

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



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.



Chromatic analysis of burn scar based on ANN by using photoelectrical technology  

NASA Astrophysics Data System (ADS)

In this paper a novel method for the chromatic analysis of burn scar is proposed. The aim of the algorithm is to evaluate the curative effect and set up the treatment plan pertinently, because the scar color is an impersonal parameter reflects the degree of scar hypertrophy. The method is based on artificial neural network (ANN) by using photoelectrical technique, and composed of three main parts: firstly capture the digital color images of the burn scar using CCD camera, then change the RGB color data of the burn scar into that of HSB color space and emend it using ANN, lastly judge the degree of burn scar hypertrophy by chromatic analysis using ANN again. The experimental results were good conformed to the degrees of scar hypertrophy given by clinical evaluations. It suggests that the chromatic analysis technique of the burn scar is valuable for further study and apply to the clinical engineering.

Wan, Baikun; Qi, Hongzhi; Ming, Dong; Zhang, Mingjian; Wang, Qifang



[Advances in the research of scar stricture after esophageal burn].  


Caustic esophageal burn is a common ailment in clinical practice. In some patients, scar stricture was formed in the late stage of injury, and it seriously undermined quality of life of the patients. We adopted various clinical interventions at an early stage in order to relieve and alleviate the formation and development of corrosive esophageal stricture as a result of chemical injury as well as to avoid invasive operations to make it more acceptable for the patients. This article summarized the progress in etiology, pathological changes, identification, early prevention, and surgical management of corrosive esophageal stricture. PMID:24360005

Zhao, Shi-lei; Gu, Chun-dong



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


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

Domergue, Sophie; Jorgensen, Christian; Noël, Danièle



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


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

Liuzzi, Francesca; Chadwick, Sarah; Shah, Mamta



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

PubMed Central

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

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



[Marjolin's ulcer of the cheek developed on burn scar: a case report].  


Marjolin ulcers are scar carcinomas most often arising in old burn injuries. They arise mostly in the extremities. We report medical history of a 50-year-old female suffering from a scar carcinoma on her right cheek which was histopathologically identified as a mean differentiated squamous cell carcinoma. PMID:22425392

El Hani, I; Touil, H; Romdhane, E; Bouzaiene, M; Zinelabdine, M T



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.



Lower-extremity burn reconstruction in the child.  


Lower-extremity burns in a pediatric patient require special consideration. The management of burn reconstruction in pediatric patients is often complex, requiring multiple reconstructive operations, and the primary intention of the surgeon is to prevent burn scar deformities. Timely management of the burn wound and postburn scars has decreased the incidence of burn scar deformities and contractures of the lower extremity in recent years. We present an overview of the principles of reconstruction techniques using skin grafting and biologic skin substitutes to restore the important barrier lost secondary to burns. In addition, we address methods of repairing scar contracture, a common occurrence in burn patients, at specific locations on the lower extremity. Finally, special scenarios such as burns associated with fractures, burn injury in insensate children, and Marjolin ulcer are discussed. PMID:18650720

Barbour, John R; Schweppe, Mark; O, Seung-Jun



Computerised colour: a technique for the assessment of burn scar hypertrophy. A preliminary report.  


A technique for the objective measurement of one parameter of burn scar hypertrophy is described. The technique involves capturing a video camera image on a computer and subsequent quantitative analysis of the colour of the scar using a custom-written computer programme. By analysing multiple areas and comparing the identical areas over the course of treatment, it is theoretically possible to measure the progress and compare differing modes of therapy. PMID:10323604

Davey, R B; Sprod, R T; Neild, T O



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

NASA Technical Reports Server (NTRS)

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



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


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

Qi Qi, Choo; Ajit Singh, Vivek



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

PubMed Central

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

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



Application of acellular dermis and autograft on burns and scars.  


The cases of two patients with burns treated with dermis allograft and of one patient for lip reconstructive aesthetic filling treated with less than one mm3 of radiosterilised acellular dermis are presented. This paper emphasizes the treatment with radiosterilised dermal grafts with a permanent character so far. Hospitals, therefore, can satisfy the demand for this kind of tissue in the case of disaster and patients with serious injuries. In the cases cited, histocompatibility analysis was not required, thus having the advantage of long-time storage of the radiosterilised dermis used on these patients. Neither inflammatory reaction nor acute phase re-absorption were observed. Moreover, shrink (contract) healing was diminished. After two years, the results are still satisfactory. PMID:10853787

Ramos Duron, L E; Martínez Pardo, M E; Olivera Zavaleta, V; Silva Diaz, T; Reyes Frías, M L; Luna Zaragoza, D



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


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



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%. PMID:25325060

Saaiq, Muhammad; Ashraf, Bushra



Burn Scar Mapping in Attica, Greece using the dNBR (differenced Normalised Burn Ratio) Index on Landsat TM/ETM+ Satellite Imagery   

E-print Network

This paper presents an attempt to map burn scars from 1984 to present around the city of Athens, Greece from a remote sensing perspective. Fine spatial resolution Landsat TM/ETM+ imagery was used favoured by an extensive ...

Stratoulias, Dimitris



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.



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


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

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



[Rail plastic surgery technique in the treatment of popliteal contractures].  


The case is presented of a patient aged 45 years suffering from thermal burns due to flame following the deflagration of a gas cylinder. The initial lesions involved the four limbs, in particular the knee, and the trunk. The initial taking in charge consisted in an early excision-graft of the limbs. The evolution of the burn was marked by the development of hypertrophic scars at the level of the non-transplanted zones and at the edge of the graft as also by the onset of contractures. Because of the functional problem caused by the contracture as a result of the considerably reduced extension, the patient was admitted for surgical treatment. Thanks to the rail technique described, the patient recovered normal knee function. Post-surgical treatment was straightforward with a hospitalization period of one month. The aesthetic results were satisfactory. The rail technique is part of the therapeutic arsenal for treating knee contractures. Its simplicity, easy technique, and satisfactory results, plus its easy follow-up, make it a highly appreciated technique in the treatment of this type of contracture. PMID:21991240

Achbouk, A; Khales, A; Bourra, K; Tourabi, K; Ababou, K; Ihrai, H



Marjolin's ulcer. Report of two cases and evidence that Marjolin did not describe cancer arising in scars of burns.  


Two patients who developed malignant neoplasms in scars (Marjolin's ulcers) are described in this report. The first patient developed a squamous cell carcinoma in the site of a chronic, draining urinary fistula. The malignancy later metastasized. The second patient developed a squamous cell carcinoma and a basal cell carcinoma in a scar from a burn and a keratoacanthoma in a scar from a vaccination. The history of the eponym "Marjolin's ulcer" is traced and it is pointed out that Marjolin did not describe the condition he is eponymously credited with, but that the false ascription to him arose over time. PMID:6375422

Steffen, C



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

PubMed Central

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

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



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


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



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

E-print Network

on the ecosystem and the climatic system. We have developed an automatic burn scar mapping method using daily temperature and vegetation water content, respectively, and an automatic region growing method basedAn automatic method for burn scar mapping using support vector machines X. CAO{{, J. CHEN*{, B

Wang, Le


Revising large scars.  


Large scars in the head and neck are often the cause of significant emotional distress to patients, and often present unique challenges to the plastic and reconstructive surgeon undertaking their revision. The primary goal of scar revision is to eliminate compromise of function that may have resulted from scar contracture; a secondary goal is to improve the appearance of the scar. Special techniques for the revision of large scars include serial partial excision, rapid intraoperative or prolonged tissue expansion, split- and full-thickness skin grafting, regional flaps, and free microvascular tissue transfer. Recent research has investigated the use of artificial skin and autologous fat grafting for large scar revision. PMID:23027215

Liotta, Dara R; Costantino, Peter D; Hiltzik, David H



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.



Prepatterned, Sculpted Free Flaps for Facial Burns  

Microsoft Academic Search

\\u000a The demands of the twenty-first century dictate aesthetic excellence as well as functional correction in complex burn reconstructions.\\u000a The severely disfigured burned face is marred by corrugated external scarring, distortion of facial features, and restricted\\u000a facial movement. Z-plasties, local flaps, and full thickness skin grafts are useful in addressing more limited functional\\u000a needs of ectropion release, nasal stenosis, perioral contractures,

Elliott H. Rose


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

PubMed Central

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



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


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



A comparative analysis of a fixed thresholding vs. a classification tree approach for operational burn scar detection and mapping  

NASA Astrophysics Data System (ADS)

The scope of this paper is to demonstrate, evaluate and compare two burn scar mapping (BSM) approaches developed and applied operationally in the framework of the RISK-EOS service element project within the Global Monitoring for Environment and Security (GMES) program funded by ESA ( The first method is the BSM_NOA, a fixed thresholding method using a set of specifically designed and combined image enhancements, whilst the second one is the BSM_ITF, a decision tree classification approach based on a wide range of biophysical parameters. The two methods were deployed and compared in the framework of operational mapping conditions set by RISK-EOS standards, based either on sets of uni- or multi-temporal satellite images acquired by Landsat 5 TM and SPOT 4 HRV. The evaluation of the performance of the two methods showed that either in uni- or multi-temporal acquisition mode, the two methods reach high detection capability rates ranging from 80% to 91%. At the same time, the minimum burnt area detected was of 0.9-1.0 ha, despite the coarser spatial resolution of Landsat 5 TM sensor. Among the advantages of the satellite-based approaches compared to conventional burn scar mapping, are cost-efficiency, repeatability, flexibility, and high spatial and thematic accuracy from local to country level. Following the catastrophic fire season of 2007, burn scar maps were generated using BSM_NOA for the entirety of Greece and BSM_ITF for south France in the framework of the RISK-EOS/GMES Services Element project.

Kontoes, C. C.; Poilvé, H.; Florsch, G.; Keramitsoglou, I.; Paralikidis, S.



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


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



Physical rehabilitation of pediatric burns  

PubMed Central

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

Atiyeh, B.; Janom, H.H.



Reconstruction of severe hand contractures: An illustrative series  

PubMed Central

Aim: An overview of a series of severe burn contractures in 44 hands reconstructed over a 20 month period with an easy to follow algorithm. Settings and Design: The series was carried out by a single surgeon at Green Pastures Rehabilitation Centre in Pokhara, Nepal. All patients attending with severe burn contractures to the hand were included in the series. Materials and Methods: This is a retrospective review of burn contractures in a total of 44 hands. All the contractures involved limitation of movement by 60 degrees in two or more joints or by 80 degrees in one joint. The decision making process is presented as a flow chart indicating when and which flaps were used. Results: Illustrations demonstrate what was achieved, with all hands obtaining an improvement in function. Conclusions: Although many of these contractures can be dealt with by skin grafting the series clearly illustrates the indications for flap coverage. PMID:21713162

Tucker, S. C.



Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction  

Microsoft Academic Search

Background  Despite civilization and progress, burns occur frequently in the world. Remarkable discoveries of wound healing mechanisms\\u000a have been reported. On the other hand, long-term outcomes from burn injuries represent a barrier to improvement of patients’\\u000a social, functional, and psychological condition. Lipofilling, described since the 1980s, currently is used for several clinical\\u000a applications. This study aimed to verify whether lipofilling could

M. Klinger; M. Marazzi; D. Vigo; M. Torre



Rehabilitation of the burn patient  

PubMed Central

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

Procter, Fiona



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



Use of Integra in the treatment of third degree burns to the penile shaft: a case series with 6-month follow-up.  


Third-degree burns to the penile shaft are serious injuries sometimes accompanied by poor healing, hypertrophic scar formation, painful erections, and dyspareunia. At this burn center, three patients with penile shaft burns have been treated successfully with Integra followed by thin, split-thickness skin grafting. Allowing a scar-free foundation for skin grafting to the penile shaft, in combination with early excisions and split-thickness autografting, Integra application facilitated the early return of near-normal skin quality, no contractures, and pain-free erectile function. With innovative management techniques, functional outcomes were obvious throughout the 6-month follow-up period. PMID:19349885

Jaskille, Amin D; Shupp, Jeffrey W; Jeng, James C; Jordan, Marion H



Mechanobiology of scarring.  


The mechanophysiological conditions of injured skin greatly influence the degree of scar formation, scar contracture, and abnormal scar progression/generation (e.g., keloids and hypertrophic scars). It is important that scar mechanobiology be understood from the perspective of the extracellular matrix and extracellular fluid, in order to analyze mechanotransduction pathways and develop new strategies for scar prevention and treatment. Mechanical forces such as stretching tension, shear force, scratch, compression, hydrostatic pressure, and osmotic pressure can be perceived by two types of skin receptors. These include cellular mechanoreceptors/mechanosensors, such as cytoskeleton (e.g., actin filaments), cell adhesion molecules (e.g., integrin), and mechanosensitive (MS) ion channels (e.g., Ca(2+) channel), and sensory nerve fibers (e.g., MS nociceptors) that produce the somatic sensation of mechanical force. Mechanical stimuli are received by MS nociceptors and signals are transmitted to the dorsal root ganglia that contain neuronal cell bodies in the afferent spinal nerves. Neuropeptides are thereby released from the peripheral terminals of the primary afferent sensory neurons in the skin, modulating scarring via skin and immune cell functions (e.g., cell proliferation, cytokine production, antigen presentation, sensory neurotransmission, mast cell degradation, vasodilation, and increased vascular permeability under physiological or pathophysiological conditions). Mechanoreceptor or MS nociceptor inhibition and mechanical force reduction should propel the development of novel methods for scar prevention and treatment. PMID:21793962

Ogawa, Rei



IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. XX, NO. XX, JULY 2004 1 A Modeling Approach for Burn Scar Assessment  

E-print Network

need for a quantitative and objective scar rating method based on the biophysical properties of skin of scars using the finite element model and regularization method. A set of natural point features]. These rating methods suffer from their subjective nature and low consistency among rates. There is a strong

Goldgof, Dmitry


Avoiding unfavorable results in postburn contracture hand  

PubMed Central

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

Bhattacharya, Sameek



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.



Scar revision  

PubMed Central

Most surgical patients end up with a scar and most of these would want at least some improvement in the appearance of the scar. Using sound techniques for wound closure surgeons can, to a certain extent, prevent suboptimal scars. This article reviews the principles of prevention and treatment of suboptimal scars. Surgical techniques of scar revision, i.e., Z plasty, W plasty, and geometrical broken line closure are described. Post-operative care and other adjuvant therapies of scars are described. A short description of dermabrasion and lasers for management of scars is given. It is hoped that this review helps the surgeon to formulate a comprehensive plan for management of scars of these patients. PMID:24516292

Sharma, Mohit; Wakure, Abhijeet



Acne Scars  


... Questions patients ask What to tell your dermatologist Laser hair removal Is it right for you How ... acne scars (left) with acne scar surgery and laser therapy. At 3 months (right), she has noticeable ...




NIGMS Home > Science Education > Burns Fact Sheet Burns Fact Sheet Tagline (Optional) Middle/Main Content Area What is a burn? A burn is tissue damage caused by heat, chemicals, electricity, sunlight ...


Honey Dressing Versus Silver Sulfadiazene Dressing for Wound Healing in Burn Patients: A Retrospective Study  

PubMed Central

Objective: The aim was to evaluate the effect of honey dressing and silver sulfadiazene (SSD) dressing on wound healing in burn patients. Materials and Methods: We retrospectively reviewed the records of 108 patients (14–68 years of age), with first and second degree burns of less than 50% of the total body surface area admitted to our institution, over a period of 5 years (2004–2008). Fifty-one patients were treated with honey dressings and 57 with SSD. Time elapsed since burn, site, percentage, degree and depth of burns, results of culture sensitivity at various time intervals, duration of healing, formation of post-treatment hypertrophic scar, and/or contracture were recorded and analyzed. Results: The average duration of healing was 18.16 and 32.68 days for the honey and SSD group, respectively. Wounds of all patients reporting within 1 h of burns became sterile with the honey dressing in less than 7 days while there was none with SSD. All wounds treated with honey became sterile within 21 days while for SSD-treated wounds, this figure was 36.5%. A complete outcome was seen in 81% of all patients in the “honey group” while in only 37% patients in the “SSD group.” Conclusion: Honey dressings make the wounds sterile in less time, enhance healing, and have a better outcome in terms of hypertropic scars and postburn contractures, as compared to SSD dressings. PMID:22279383

Gupta, Shilpi Singh; Singh, Onkar; Bhagel, Praveen Singh; Moses, Sonia; Shukla, Sumit; Mathur, Raj Kumar



Outcome of Split Thickness Skin Grafting and Multiple Z-Plasties in Postburn Contractures of Groin and Perineum: A 15-Year Experience  

PubMed Central

Background. Groin and perineal burn contracture is a rare postburn sequel. Such postburn contractures causes distressing symptoms to the patients and in the management of these contractures, both functional and cosmetic appearance should be the primary concern. Aims. To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postburn contractures of groin and perineum. Material and Methods. We conducted a study of 49 patients, with postburn groin and perineal contractures. Release of contracture with split thickness skin grafting (STSG) was done in 44 (89.79%) patients and release of contracture and closure by multiple Z-plasties was done in 5 (10.21%) patients. Results. Satisfactory functional and cosmetic outcome was seen in 44 (89.79%) patients. Minor secondary contractures of the graft were seen in 3 (6.81%) patients who were managed by physiotherapy and partial recurrence of the contracture in 4 (8.16%) patients required secondary surgery. Conclusion. We conclude that postburn contractures of the groin and perineum can be successfully treated with release of contracture followed by STSG with satisfactory functional and cosmetic results. Long term measures like regular physiotherapy, use of pressure garments, and messaging with emollient creams should not be neglected and should be instituted postoperatively to prevent secondary contractures of the graft and recurrence of the contracture. PMID:24967100

Sajad, Wani; Hamid, Raashid



Changes in the expression of epidermal differentiation markers at sites where cultured epithelial autografts were transplanted onto wounds from burn scar excision.  


This study investigated the recovery process during which grafted cultured epithelium formed normal epidermis. The subjects were 18 patients whose burn scars were excised at a depth not exposing the fat layer and who subsequently received cultured epithelial autografts. A total of 24 samples were obtained from the grafted sites: 6 samples within 6?weeks (stage 1), 5 samples after 6?weeks and within 6?months (stage 2), 6 samples after 6?months and within 18?months (stage 3) and 7 samples beyond 18?months (stage 4) after transplantation. These samples were stained for monoclonal antibodies against filaggrin, transglutaminase (TG), cytokeratin 6 and involucrin. Their expressions were examined in the epidermis. The expression patterns were classified using a six-grade scale. The grades of filaggrin and TG were significantly higher at stage 3 and 4 compared with stage 1. There was a marginally significant increase in the grade of cytokeratin 6 at stage 3 and it was significantly higher at stage 4 compared with stage 1. These results showed that wound healing continued at a molecular level until the end of stage 3. The recovery of involucrin was delayed compared with that of other markers. TG and involucrin are thought to be regulated independently at the grafted sites. PMID:25040836

Kadoya, Kuniko; Amano, Satoshi; Nishiyama, Toshio; Inomata, Shinji; Tsunenaga, Makoto; Kumagai, Norio; Matsuzaki, Kyoichi



An insight into Dupuytren's contracture.  

PubMed Central

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.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 2 Figure 6 PMID:1616255

Murrell, G. A.



Slow potassium contractures in mouse limb muscles.  

PubMed Central

1. Mouse extensor digitorum longus and soleus muscles respond to a sudden maintained increase in external K ion concentration with a fast contracture which inactivates and is followed by a slow contracture. 2. The slow contracture could not be selectively eliminated by altering the tonicity, ionic strength, anionic composition or buffer system of the external solution and depended only on the increase on external potassium concentration. The slow contracture differed from the fast K contracture in its time course, temperature sensitivity, fibre type dependence, and inactivation kinetics. The fast and slow contractures were similarly altered by changes in external anion species, by changes in external divalent cations, and by the presence of 20 mM-caffeine. 3. The mechanism and functional significance of the slow contracture are obscure. The results suggest that its generation is not identical to that of the fast contracture, but may depend, in part, upon the normal activation processes. PMID:7310704

Dulhunty, A F



Dupuytren's contracture in manual workers.  

PubMed Central

The incidence of Dupuytren's contracture in a polyvinyl chloride (PVC) manufacturing plant, where a great deal of bagging and packing took place by hand, was higher than in another plant in which there was no bagging or packing. The incidence in the packing plant was double that found in an earlier survey by Early at Crewe Locomotive Works of 4801 individuals, most of whom were manual workers. The implication is that the nature of the work of bagging and packing in our PVC compounding plant may have triggered Dupuytren's contracture. PMID:7066227

Bennett, B



Breast burns are not benign: long-term outcomes of burns to the breast in pre-pubertal girls.  


Chest burns in pre-pubescent girl are commonly seen in paediatric burn units. These patients are at risk of significant long-term problems with scarring and breast development requiring reconstructive surgery many years after the initial burn. Admissions to our unit over a 20-year period were reviewed to determine the frequency of these burns. Patients whose burns required surgical debridement and split skin grafting, and who would now be post-pubertal were included in the study. We attempted to trace and contact these patients and were able to find 13 out of 22 patients, of whom 11 agreed to participate. The mechanism of injury in six was scalds and the other five had flame burns. Mean age of patients with scald was 18 months and for flame burns 4 years 8 months. These women required a variety of reconstructive procedures to improve breast appearance including contracture releases, dermabrasion, breast augmentation and contralateral breast reduction. Girls burned as young children require follow-up and appropriate referral long after the burn to ensure good cosmetic results are achieved during and after puberty. PMID:17870241

Foley, P; Jeeves, A; Davey, R B; Sparnon, A L





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




... clean dressing. Protect the burn from pressure and friction. Over-the-counter ibuprofen or acetaminophen can help ... heart. Protect the burn area from pressure and friction. You will also need to prevent shock . If ...


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


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

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



Topical application of honey in treatment of burns.  


A total of 104 cases of superficial burn injury were studied to assess the efficiency of honey as a dressing in comparison with silver sulfadiazine gauze dressing. In the 52 patients treated with honey, 91 per cent of wounds were rendered sterile within 7 days. In the 52 patients treated with silver sulfadiazine, 7 per cent showed control of infection within 7 days. Healthy granulation tissue was observed earlier in patients treated with honey (mean 7.4 versus 13.4 days). Of the wounds treated with honey 87 per cent healed within 15 days as against 10 per cent in the control group. Relief of pain, a lower incidence of hypertrophic scar and postburn contracture, low cost and easy availability make honey an ideal dressing in the treatment of burns. PMID:2032114

Subrahmanyam, M



Molecular mechanisms underlying skeletal growth arrest by cutaneous scarring.  


In pediatric surgeries, cutaneous scarring is frequently accompanied by an arrest in skeletal growth. The molecular mechanisms responsible for this effect are not understood. Here, we investigated the relationship between scar contracture and osteogenesis. An excisional cutaneous wound was made on the tail of neonatal mice. Finite element (FE) modeling of the wound site was used to predict the distribution and magnitude of contractile forces within soft and hard tissues. Morphogenesis of the bony vertebrae was monitored by micro-CT analyses, and vertebral growth plates were interrogated throughout the healing period using assays for cell proliferation, death, differentiation, as well as matrix deposition and remodeling. Wound contracture was grossly evident on post-injury day 7 and accompanying it was a significant shortening in the tail. FE modeling indicated high compressive strains localized to the dorsal portions of the vertebral growth plates and intervertebral disks. These predicted strain distributions corresponded to sites of increased cell death, a cessation in cell proliferation, and a loss in mineralization within the growth plates and IVD. Although cutaneous contracture resolved and skeletal growth rates returned to normal, vertebrae under the cutaneous wound remained significantly shorter than controls. Thus, localized contractile forces generated by scarring led to spatial alterations in cell proliferation, death, and differentiation that inhibited bone growth in a location-dependent manner. Resolution of cutaneous scarring was not accompanied by compensatory bone growth, which left the bony elements permanently truncated. Therefore, targeting early scar reduction is critical to preserving pediatric bone growth after surgery. PMID:24933346

Li, Jingtao; Johnson, Chelsey A; Smith, Andrew A; Shi, Bing; Brunski, John B; Helms, Jill A



Prevention and therapy of postburn scars.  


The cosmetic and functional result in postburn scar deformities is influenced by following factors: 1. The type of patient's central nervous system and his response to burn injury. 2. Depth and site of burn areas. 3. Early excision and grafting. 4. Infection complications, their severity and location. 5. Fixation of dressings should be done using elastic materials and applied for so long until stabilisation of scars is completed. Elastic materials should be combined with rigid pressure and pressure massage. 6. Congenital predisposition of the patient to hypertrophic scarring. PMID:9212487

Bláha, J; Pond?licek, I



Severe burn injuries and the role of elastin in the design of dermal substitutes.  


Severe burn injuries are a major health problem as they can compromise whole body function and result in extensive emotional trauma exacerbated by prolonged hospital stay. Burn injury treatment has improved dramatically to increase the probability of survival, but burn survivors still suffer from excessive scarring and skin contractures, which substantially compromise their health and quality of life. Elastin is historically underrepresented in commercial dermal substitutes, yet deserves consideration because of its fundamental role in skin structure and function. Dermal elastic network is a strong determinant of skin resilience, texture, and quality but is not sufficiently regenerated following burn injury. In addition to its structural and mechanical roles, elastin has inherent cell signaling properties that promote a diverse range of cellular responses including chemotaxis, cell attachment, proliferation, and differentiation. Scaffold elasticity and regeneration of the elastic fiber system is now recognized as integral to the development of functional dermal substitutes. Dermal substitutes are intended to replace damaged dermal tissue in severe burn injuries. Elastin-based dermal substitutes have the potential to decrease wound contraction, improve scar appearance and functionality, and contribute to wound healing outcomes through a combination of elastin's mechanical and cell signaling properties. PMID:21091393

Rnjak, Jelena; Wise, Steven G; Mithieux, Suzanne M; Weiss, Anthony S



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.



Facial Scar Revision: Understanding Facial Scar Treatment  


... Contact Us Trust your face to a facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment ... face like the eyes or lips. A facial plastic surgeon has many options for treating and improving ...


Genetics Home Reference: Congenital contractural arachnodactyly  


... valves that control blood flow through the heart (mitral valve prolapse). The life expectancy of individuals with congenital contractural ... gene ; growth factor ; inherited ; kyphoscoliosis ; microfibrils ; mitral valve ; mitral valve prolapse ; mutation ; prevalence ; protein ; syndrome ; tissue You may find ...


Therapeutic improvement of scarring: mechanisms of scarless and scar-forming healing and approaches to the discovery of new treatments.  


Scarring in the skin after trauma, surgery, burn or sports injury is a major medical problem, often resulting in loss of function, restriction of tissue movement and adverse psychological effects. Whilst various studies have utilised a range of model systems that have increased our understanding of the pathways and processes underlying scar formation, they have typically not translated to the development of effective therapeutic approaches for scar management. Existing treatments are unreliable and unpredictable and there are no prescription drugs for the prevention or treatment of dermal scarring. As a consequence, scar improvement still remains an area of clear medical need. Here we describe the basic science of scar-free and scar-forming healing, the utility of pre-clinical model systems, their translation to humans, and our pioneering approach to the discovery and development of therapeutic approaches for the prophylactic improvement of scarring in man. PMID:20811598

Occleston, Nick L; Metcalfe, Anthony D; Boanas, Adam; Burgoyne, Nicholas J; Nield, Kerry; O'Kane, Sharon; Ferguson, Mark W J



Contractures in a superfused frog's ventricle  

PubMed Central

1. A new perfused preparation of frog's ventricle is described, whose main advantage is that there are short diffusion distances between the cells and the washing fluid. 2. This preparation responds within a few seconds to alterations in sodium, potassium or calcium concentration, or alteration in the osmotic pressure of the bathing fluid. The speed of these alterations is consistent with the diffusional distances involved measured histologically. 3. On depolarizing the preparation with Ringer + excess potassium, tension development starts at about -25 mV and is still increasing at -8 mV (the lowest voltage studied). As in earlier experimetns in frog ventricle (Niedergerke, 1956b) and in skeletal muscle (Hodgkin & Horowicz, 1960) the relation between potential and tension is very steep. 4. Sodium free contractures (Lüttgau & Niedergerke, 1958) are very rapid in onset with this preparation. To maintain the tension developed, a rapid rate of washing is necessary for 1-2 min. After this, slow washing is sufficient. It is proposed that this is due to the leaching out of cellular sodium. 5. In fresh preparations the twitch and maximum K contracture are of similar size when stimulated at 30/min in 1-2 mM-Ca. With the onset of hypodynamia the twitch tension falls, but the K contracture remains unaltered. In hypodynamic ventricles the sensitivity of the twitch to the ratio [Ca]/[Na]2 declines, whereas that of the K contractures remains unaltered. Hypodynamia therefore does not affect the contractile elements themselves. 6. During the staircase phenomenon the K contracture and twitch size alter in a similar manner, as previously described by Niedergerke. The sodium free contracture, however, remains unaltered. This tends to favour the hypothesis that the staircase phenomenon is due to effects at the cell membrane rather than in the cell interior. 7. Maximum K contractures occur at a [Ca]/[Na]2 ratio of about 0·7 × 10-4 mM-1, a figure similar to that obtained in earlier experiments (Lüttgau & Niedergerke, 1958). 8. The length—tension curves of K contractures are similar to those previously described for heart muscle, using single twitches to generate tension. 9. Application of K free solutions produced no rapid contractures in this preparation. PMID:16992235

Lamb, J. F.; McGuigan, J. A. S.



Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies  

PubMed Central

Excessive scars form as a result of aberrations of physiologic wound healing and may arise following any insult to the deep dermis. By causing pain, pruritus and contractures, excessive scarring significantly affects the patient’s quality of life, both physically and psychologically. Multiple studies on hypertrophic scar and keloid formation have been conducted for decades and have led to a plethora of therapeutic strategies to prevent or attenuate excessive scar formation. However, most therapeutic approaches remain clinically unsatisfactory, most likely owing to poor understanding of the complex mechanisms underlying the processes of scarring and wound contraction. In this review we summarize the current understanding of the pathophysiology underlying keloid and hypertrophic scar formation and discuss established treatments and novel therapeutic strategies. PMID:20927486

Gauglitz, Gerd G; Korting, Hans C; Pavicic, Tatiana; Ruzicka, Thomas; Jeschke, Marc G



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

PubMed Central

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

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



Dendrochronology of a Fire-Scarred Ponderosa Pine  

Microsoft Academic Search

Historical fire frequency in a stand of southwestern ponderosa pine has been doc- umented in a master fire chronology developed for a prescribed burning study area in Arizona. One of the 12 specimens used to assemble this chronology was a small, suppressed tree that contained 42 fire scars. Standard crossdating techniques were used to date the fire scars accurately, locate

John H. Dieterich; Thomas W. Swetnam



Potassium contractures in mouse limb muscles.  

PubMed Central

The force of contractures produced by 14-400 mM-K+ (as methanesulphonate) was measured in whole mouse soleus (sol.), extensor digitorum longus (e.d.l.), and in bundles from these muscles. Frog semitendinosus muscles were used for comparison. Whole mouse muscles displayed biphasic contracture responses lasting more than 5 min when provoked by 150m M-K+. Contractures of bundles dissected from these muscles were monophasic and had a short duration. The time required for the muscle bundles to contract and relax to 1/2 maximum force (T) was an inverse function of [K+]. T was increased by lowering [K+] from 400 to 50 mM by a factor of 8.3 and 7.0 in proximal and distal portions of sol. and by a factor of 4.2 and 2.8 in proximal and distal portions of e.d.l., respectively. The force-[K+] relation was steeper for sol. than for e.d.l., and the proximal portions were more sensitive to K+ than the distal portions, particularly in e.d.l. The capability of the muscles to produce force in response to 400 mM-K+ after a 10 min exposure to 30 or 50 mM-K+ was high in sol., somewhat lower in proximal parts of e.d.l. and in frog semitendinosus, and lowest in distal parts of e.d.l. It was concluded that K contractures of mouse muscles are basically monophasic, and that biphasic contractures of whole muscles arise because of K+-diffusion delays, slow responses to intermediate [K+], and differences in responsiveness of the fibres contained in a particular muscle. PMID:6606035

Lorkovi?, H



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




PubMed Central

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

Skalsky, Andrew J.; McDonald, Craig M.



Genetic influences on joint contractures secondary to immobilization.  


The primary research question of this study queries whether, beyond environmental conditions, genetic factors affect the development of joint contractures. We hypothesized that intrinsic genetic factors influence the severity of joint contractures developing secondary to joint immobilization. Forty rats from four inbred rat strains had one leg immobilized in knee flexion for 4 weeks. The contracture was measured mechanically as the lack of range of motion to a standardized torque. Using the contralateral leg as a control, the average severity of the contracture could be calculated and compared between strains. All immobilized legs presented knee contractures after 4 weeks of immobilization. Two strains (Dark Agouti and Fisher 344) showed a larger mean knee contracture than those of the two other rat strains (Augustus Copenhagen Irish and Brown Norway). Environmental factors, such as immobility, are usually identified as a cause of a joint contracture. These results demonstrate that, in addition to mechanical factors in the environment of a joint, intrinsic genetic factors participate in the process leading to joint contracture. This demonstration has important consequences for directing future research and may lead to interventions to help patients at risk of developing joint contractures. PMID:17195817

Laneuville, Odette; Zhou, Jian; Uhthoff, Hans K; Trudel, Guy



Atrophic Acne Scarring  

PubMed Central

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

Graber, Emmy M.



Management of scars: updated practical guidelines and use of silicones.  


Hypertrophic scars and keloids resulting from surgery, burns, trauma and infection can be associated with substantial physical and psychological distress. Various non-invasive and invasive options are currently available for the prevention and treatment of these scars. Recently, an international multidisciplinary group of 24 experts on scar management (dermatologists; plastic and reconstructive surgeons; general surgeons; physical medicine, rehabilitation and burns specialists; psychosocial and behavioural researchers; epidemiologists; beauticians) convened to update a set of practical guidelines for the prevention and treatment of hypertrophic and keloid scars on the basis of the latest published clinical evidence on existing scar management options. Silicone-based products such as sheets and gels are recommended as the gold standard, first-line, non-invasive option for both the prevention and treatment of scars. Other general scar preventative measures include avoiding sun exposure, compression therapy, taping and the use of moisturisers. Invasive treatment options include intralesional injections of corticosteroids and/or 5-fluorouracil, cryotherapy, radiotherapy, laser therapy and surgical excision. All of these options may be used alone or as part of combination therapy. Of utmost importance is the regular re-evaluation of patients every four to eight weeks to evaluate whether additional treatment is warranted. The amount of scar management measures that are applied to each wound depends on the patient's risk of developing a scar and their level of concern about the scar's appearance. The practical advice presented in the current guidelines should be combined with clinical judgement when deciding on the most appropriate scar management measures for an individual patient. PMID:25141160

Meaume, Sylvie; Le Pillouer-Prost, Anne; Richert, Bertrand; Roseeuw, Diane; Vadoud, Javid



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.



Activated keratinocytes in the epidermis of hypertrophic scars.  


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. PMID:9588880

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



Human hypertrophic and keloid scar models: principles, limitations and future challenges from a tissue engineering perspective  

PubMed Central

Most cutaneous wounds heal with scar formation. Ideally, an inconspicuous normotrophic scar is formed, but an abnormal scar (hypertrophic scar or keloid) can also develop. A major challenge to scientists and physicians is to prevent adverse scar formation after severe trauma (e.g. burn injury) and understand why some individuals will form adverse scars even after relatively minor injury. Currently, many different models exist to study scar formation, ranging from simple monolayer cell culture to 3D tissue-engineered models even to humanized mouse models. Currently, these high-/medium-throughput test models avoid the main questions referring to why an adverse scar forms instead of a normotrophic scar and what causes a hypertrophic scar to form rather than a keloid scar and also, how is the genetic predisposition of the individual and the immune system involved. This information is essential if we are to identify new drug targets and develop optimal strategies in the future to prevent adverse scar formation. This viewpoint review summarizes the progress on in vitro and animal scar models, stresses the limitations in the current models and identifies the future challenges if scar-free healing is to be achieved in the future. PMID:24750541

van den Broek, Lenie J; Limandjaja, Grace C; Niessen, Frank B; Gibbs, Susan



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

Microsoft Academic Search

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.

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



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.



[Razemon's lateral digital rotation flap in severe Dupuytren contracture of the fifth finger].  


In Dupuytren's disease, correction of severe contracture deformities and excision of dermal lesions are often responsible for palmar skin defects. This study aimed to assess the results of the lateral digital flap described by Razemon. Thirty-seven patients were analysed retrospectively for functional and trophic results. Twelve months of follow-up were at least required. The lack of extension was appreciated through Thomine's coefficient. Subjective patient's opinion was noted about function of fifth finger and hand. The flap trophicity was evaluated through softness, coverage quality and esthetic aspect. In the preoperative period, the average lack of extension was 105°; 89% of the patients were ranked as stages 3 or 4 of Tubiana's classification. At the 12th month, the average Thomine's coefficient was 0.74; 70% of the patients were very satisfied. Two patients exhibited some lack of suppleness and seven a dyschromic scars. The lateral digital rotation flap is a quite simple surgical procedure. It allows satisfactory results corresponding to functional and trophic coverage in severe Dupuytren's contracture involving the fifth finger. PMID:24094664

Ould-Slimane, M; Guinet, V; Foulongne, E; Melconian, A; Beccari, R; Milliez, P-Y; Auquit-Auckbur, I



[A long way to go in scar research-further enhancement of basic and clinical research of the scar].  


Scar, either hypertrophic scar or keloid, is one of the most common complications due to proliferative disorder of fibrosis in the process of wound healing after burn injuries, trauma, and surgical operations. To repair the cosmetic and functional impairments caused by scars poses a great challenge to all the burn surgery workers. With the advances in both basic research and clinical treatment, the understanding of scar formation and the therapeutic strategies of scar have been improved significantly. However, the remaining problems are still outstanding. In this discussion, the advances and problems in the scientific research in this field, including genetic predisposition, candidate gene, dysfunction of fibroblasts, interaction between fibroblasts and keratinocytes, as well as animal models for hypertrophic scar and keloid were summarized. In addition, the progresses in the clinical therapies are also discussed, including pressure treatment, silicone gel sheeting, corticosteroids, laser, and other emerging treatment strategies. The understanding and treatment of scar will improve in the future with further deepening basic research and clinical trials with stricter standard of assessment. PMID:22340784

Hu, Da-hai; Liu, Jia-qi



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


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

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



Malignancy in scars, chronic ulcers, and sinuses  

PubMed Central

A collection of 44 cases of malignancy in scars, chronic ulcers, and sinuses, included the following predisposing lesions: a 20-year-old sinus from ischial bursitis, a 23-year-old bed sore, a congenital gumma about 50 years old, three burn scars (average age of scar 56 years), 11 sinuses from chronic osteomyelitis, and 27 chronic ulcers of the leg. The osteomyelitis cases included two rapidly fatal sarcomas, one in a sinus present for 16 years, the other in a 20-year-old sinus. The remaining tumours in this group were squamous carcinomas that developed in sinuses with an average duration of 37 years. In the cases of varicose ulcer, the ulcer had been present on the average for 21 years before the onset of malignancy. One patient in this group, with an ulcer not known to be more than five years old, developed a sarcoma that was fatal in six months. The biopsy diagnosis was difficult in 17 cases, including one of the cases of sarcoma. The difficulty was greatest in cases of osteomyelitis. The conditions discussed are now known as `Marjolin's ulcer'. In the present series, the degree of malignancy in tumours arising in scars may be low but the malignancy of tumours arising in chronic ulcers and sinuses may be high. Images PMID:14076377

Cruickshank, A. H.; McConnell, E. Mavis; Miller, D. G.



Surgical Scar Revision: An Overview  

PubMed Central

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

Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh



Engagement, Adolescents, and Scar Stories  

NSDL National Science Digital Library

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

Jennifer Nichols


Establishing a Reproducible Hypertrophic Scar following Thermal Injury: A Porcine Model  

PubMed Central

Background: Our complete understanding of hypertrophic scarring is still deficient, as portrayed by the poor clinical outcomes when treating them. To address the need for alternative treatment strategies, we assess the swine animal burn model as an initial approach for immature scar evaluation and therapeutic application. Methods: Thermal contact burns were created on the dorsum of 3 domestic swine with the use of a branding iron at 170°F for 20 seconds. Deep partial-thickness burns were cared for with absorptive dressings over 10 weeks and wounds evaluated with laser and negative pressure transduction, histology, photographic analysis, and RNA isolation. Results: Overall average stiffness (mm Hg/mm) increased and elasticity (mm) decreased in the scars from the initial burn injury to 8 weeks when compared with normal skin (P < 0.01). Scars were thicker, more erythematous, and uniform in the caudal dorsum. The percent change of erythema in wounds increased from weeks 6 to 10. Histology demonstrated loss of dermal papillae, increased myofibroblast presence, vertically oriented vessels, epidermal and dermal hypercellularity, and parallel-layered collagen deposition. Immature scars remained elevated at 10 weeks, and minimal RNA was able to be isolated from the tissue. Conclusions: Deep partial-thickness thermal injury to the back of domestic swine produces an immature hypertrophic scar by 10 weeks following burn with thickness appearing to coincide with the location along the dorsal axis. With minimal pig to pig variation, we describe our technique to provide a testable immature scar model.

Rapp, Scott J.; Rumberg, Aaron; Visscher, Marty; Billmire, David A.; Schwentker, Ann S.



Pediatric cutaneous bleach burns.  


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



Pseudoabusive burns in Asian refugees.  


Six Southeast Asian refugee children had cigarettelike burn scars on the lower trunk and abdomen. Questioning of the families disclosed that the burns had been the result of therapeutic burning by folk medical healers for prior illnesses. Pediatric practitioners should recognize the therapeutic intent of these injuries to avoid inappropriate accusations of child abuse. They can likewise encourage families to seek less harmful alternative treatments. PMID:6741894

Feldman, K W



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; Júnior, Jayme Adriano Farina



Update on hypertrophic scar treatment.  


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



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.



Transmural "Scar-to-Scar" Reentrant Ventricular Tachycardia  

PubMed Central

We describe a scar-related reentrant ventricular tachycardia circuit with a proximal segment in an endocardial basal septal scar and an exit in a region of slow conduction in a non-overlapping region of epicardial basal lateral scar. The 12-lead EKG demonstrates criteria for a basal lateral epicardial VT, however the same morphology could be produced with a longer stim-latency with pace mapping or VT induction from the endocardial septal region of scar. A significant segment of myocardium demonstrated no endocardial or epicardial scar on electroanatomic mapping, suggesting the presence of a mid-myocardial isthmus. Further evidence was provided by assessment of unipolar settings. The epicardial VT that initially appeared to originate from the basal lateral epicardial region, was successfully treated with radiofrequency ablation of the lateral aspect of the endocardial septal scar. PMID:24482562

Bradfield, Jason S; Tung, Roderick; Shivkumar, Kalyanam



The successful treatment of pain associated with scar tissue using acupuncture.  


In this case report, a 48-year-old female who had suffered severe scar pain for 3 months was treated with acupuncture using the Wei Ci technique (surrounding the dragon). Scar tissue usually forms after deep trauma, such as piercings, burns, and surgery, to the dermis. In Chinese Medicine, scar tissue causes local Qi and blood stagnation which lead to pain. The Wei Ci technique (surrounding the dragon) and distal points Hegu-LI-4, Taichong-LIV-3, Zusanli-ST-36 were used. The patient received a total of eight treatments in 5 weeks. The scar pain decreased from 7 to 1 or 2 on a Likert scale of 0-10, with 0 being no pain and 10 being the worst pain. Acupuncture may have a good short-term pain-relieving effect on scar pain but its long-term scar-pain-relieving effects are still unclear. PMID:25441952

Fang, Sheng



A New Distal Arthrogryposis Syndrome Characterized by Plantar Flexion Contractures  

PubMed Central

The distal arthrogryposis (DA) syndromes are a distinct group of disorders characterized by contractures of two or more different body areas. More than a decade ago, we revised the classification of DAs and distinguished several new syndromes. This revision has facilitated the identification of five genes (i.e., TNNI2, TNNT3, MYH3, MYH8, and TPM2) that encode components of the contractile apparatus of fast-twitch myofibers and cause DA syndromes. We now report the phenotypic features of a novel DA disorder characterized primarily by plantar flexion contractures in a large five-generation Utah family. Contractures of hips, elbows, wrists, and fingers were much milder though they varied in severity among affected individuals. All affected individuals had normal neurological examinations; electromyography and creatinine kinase levels were normal on selected individuals. We have tentatively labeled this condition distal arthrogryposis type 10 (DA10). PMID:17103435

Stevenson, D.A.; Swoboda, K.J.; Sanders, R.K.; Bamshad, M.



Prenatal ultrasound findings in a fetus with congenital contractural arachnodactyly.  


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



Future management of scarring.  


Future growth and development of plastic and reconstructive surgery will push forward on all fronts, from the prevention of injury to improvements in primary and secondary wound closure, healing, surgical planning, instrumentation, and techniques. Current technology is on the brink of promoting rapid healing and preventing scar formation at the cellular level by affecting the healing process. Tissue engineering has the potential of creating new tissue with the potential to closely approximate missing or damaged tissue from a biopsy of the original. The next generation of reconstructive surgeons may approach traumatic wounds in a completely different fashion, with computers, growth factors, and cell cultures as opposed to a scalpel and suture. PMID:11735061

Schweinfurth, J M



Dune Avalanche Scars  

NASA Technical Reports Server (NTRS)

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



Dupuytren's contracture and gouty tophi in a black patient.  

PubMed Central

Dupuytren's disease is a relatively rare occurrence in a patient of the black race. The coexistence of a Dupuytren's contracture in a black patient who also presents with severe gouty tophi is described. This is the first reported case in the English literature. PMID:1994071

LeFlore, I.; Antoine, G. A.



Arthroscopic Gluteal Muscle Contracture Release With Radiofrequency Energy  

PubMed Central

Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior portals. With the patient lying laterally, we developed and enlarged a potential space between the gluteal muscle group and the subcutaneous fat using blunt dissection. Under arthroscopic guidance through the inferior portal, we débrided and removed fatty tissue overlying the contractile band of the gluteal muscle group using a motorized shaver introduced through the superior portal. Radiofrequency then was introduced through the superior portal to gradually excise the contracted bands from superior to inferior. Finally, hemostasis was ensured using radiofrequency. Patients were followed a minimum of 7 months (mean, 17.4 months; range, 7–42 months). At last followup, the adduction and flexion ranges of the hip were 45.3° ± 8.7° and 110.2° ± 11.9°, compared with 10.4° ± 7.2° and 44.8° ± 14.1° before surgery. No hip abductor contracture recurred and no patient had residual hip pain or gluteal muscle wasting. We found gluteal muscle contracture could be released effectively with radiofrequency energy. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. Electronic supplementary material The online version of this article (doi:10.1007/s11999-008-0595-7) contains supplementary material, which is available to authorized users. PMID:18975040

Liu, Yu-Jie; Wang, Yan; Xue, Jing; Lui, Pauline Po-Yee



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


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

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



Comparison and Evaluation of Current Animal Models for Perineural Scar Formation in Rat  

PubMed Central

Objective (s): Scar formation in injured peripheral nerve bed causes several consequences which impede the process of nerve regeneration. Several animal models are used for scar induction in preclinical studies which target prevention and/or suppression of perineural scar. This study evaluates the translational capacity of four of physical injury models to induce scar formation around the sciatic nerve of rat: laceration, crush, mince and burn. Materials and Methods: Functional (Toe out angle), macroscopic, and microscopic evaluations were performed weekly for four weeks and correlation of findings were analyzed. Result: While macroscopic and microscopic findings suggested a well-developed and adhesive fibrosis surrounding the sciatic nerve, functional assessment did not reveal any significant difference between control and experimental groups (P>0.05). Conclusion: Our study suggests that none of the applied animal models reproduce all essential features of clinical perineural scar formation. Therefore, more studies are needed to develop optimal animal models for translating preclinical investigations. PMID:23997921

O Zanjani, Leila; Firouzi, Masoumeh; Nabian, Mohammad-Hossein; Nategh, Mohsen; Rahimi-Movaghar, Vafa; S Kamrani, Reza



Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: A pilot study.  


A scar is a mark that remains after the healing of a wound or other morbid processes. In the past, treatment was mainly focused on severe scarring, such as the hypertrophic and burn scars. However, scars from relatively minor wounds can also be stressful. The site of an open thyroidectomy is the anterior neck, a prominently exposed part of the body, where postoperative scarring can cause patients distress. The cosmetic outcome of the scar after thyroidectomy is of particular importance to women, who constitute the majority of patients with thyroid disease. Active prevention is more likely to yield better cosmetic results and would require fewer treatment sessions and less expense than scar revision procedures. Many interventions have been proposed, but there is yet no universal consensus on optimal treatment. Recently, focus has been made on 'laser scar prevention', where various types of lasers have been used to improve the appearance of scars. The purpose of this study was to improve the appearance of scars, by laser intervention of the wound healing process. In this pilot study, we comparatively examined the effect of non-ablative 1550-nm fractional Er: glass laser and ablative 2940-nm fractional Er: YAG laser on fresh surgical scars of patients with Fitzpatrick skin type III-IV. PMID:22409153

Kim, Hei Sung; Lee, Ji Hae; Park, Young Min; Lee, Jun Young



Student Attitudes toward Children and Adolescents with Severe Burns.  

ERIC Educational Resources Information Center

Color photographs of burned and nonburned children were used to study the attitudes of 218 practice teachers, nursing students, and counselors-in-training. Findings revealed that children with severe burns and facial scarring were regarded less favorably. Stresses that professionals should be well-trained and empathic in order to assist burned

Holaday, Margot; McPhearson, Ruth



Secret scar free gracilis flap.  


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



Posttraumatic contracture of the elbow: current management issues.  


Posttraumatic elbow stiffness can impose severe functional limitations on the performance of activities of daily living. Prevention is key to avoiding a motion-limiting condition. Fractures should be anatomically reduced and stabilized with active and active-assisted range of motion exercises instituted as early as possible to minimize the development of stiffness. Established contractures should be treated initially with physical therapy and static-progressive splinting. Patients who have failed a minimum of six months of nonsurgical management and who are motivated to comply with postoperative rehabilitation are candidates for surgical release. There are several effective surgical approaches and techniques available. The choice of surgical approach and technique is dictated by the location of the pathology, condition of the skin, and degree of arthritic changes. A major challenge to care is the management of the young patient with posttraumatic elbow contracture and advanced degenerative changes for which there is currently no reliable long-term surgical treatment. PMID:16878834

Issack, Paul S; Egol, Kenneth A



Gold ion inhibits silver ion induced contracture and activates ryanodine receptors in skeletal muscle.  


Effects of Au3+ on Ag(+)-induced contractures and Ca2+ release channel activity in the sarcoplasmic reticulum were studied in frog skeletal muscles. Single fibres spontaneously produced phasic and tonic contractures upon addition of 5-20 microM Ag+ or more than 50 microM Au3+. Simultaneous application of 5 microM Ag+ and 20 microM Au3+ inhibited contractures induced by Ag+. Au3+ applied immediately after development of Ag(+)-induced contractures shortened the duration of the phasic contracture and markedly decreased the subsequent tonic contracture. Pretreatment of fibres with Au3+ inhibited the Ag(+)-induced phasic contracture. Ca2+ release channels incorporated into planar lipid bilayers were activated in response to Au3+ at 20 to 200 microM. A close relationship was observed between Ca2+ release channel open probability and amplitude of the Au(3+)-induced tonic contracture. Channel activity was inhibited by 5 microM ruthenium red. We conclude that extracellular Au3+ at low concentrations modifies the interaction of Ag+ with voltage sensors in the transverse tubules to inhibit the Ag(+)-induced contracture and, if it enters the cell, Au3+ may directly activate the sarcoplasmic reticulum Ca2+ release channel to partially contribute to the tonic contracture. PMID:8891609

Nihonyanagi, K; Oba, T




Microsoft Academic Search

ABSTRACT SCAR - SCATTER, CONCEAL AND RECOVER Bryan Mills, M.S. University of Pittsburgh, 2007 This thesis describes a secure and reliable method,for stori ng data in a distributed hash table (DHT) that leverages the inherent properties of the DHT to provide a secure storage substrate. The framework,presented is referred to as “Scatter, Conceal, and Recover” (SCAR). The standard method of

Bryan Mills



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.



Ultrastructure and contractures of the pigeon iris striated muscle  

PubMed Central

1. The ultrastructure of adult pigeon iris muscle fibres has been described with emphasis on the distribution of the sarcoplasmic reticulum (SR). Contractures due to superfusion with solutions of different [K+] (3-150 mM) and acetylcholine (ACh) and their modification by alteration of external [Ca2+] and [Mg2+] were studied in isolated pigeon iris. 2. The arrangement of the contractile myofilaments was like that of vertebrate skeletal fibres. The SR is well developed in the I-band and sparse at the A-band level. Tubular elements (T-system) which form triads with the SR were seen at all levels of the sarcomere though usually adjacent to the A—I junction. 3. K+ contractures developed monotonically to a steady level which was maintained for the duration of the high [K+] superfusion. The response to a standard [K+] stepwise change was not altered by conditioning the preparation with various [K+]. 4. Decreasing external [Ca2+] from 20 mM to Ca2+-free (i.e. no Ca2+ added), enhanced iris contractures at all [K+] and in ACh enriched solutions. The K+ response was abolished when the iris was superfused with Ca2+ free solution plus EDTA (2 mM) for 45 min. Increasing [Mg2+] had little or no effect on iris contracture. 5. Reducing external [Ca2+] from 3 to 0·3 mM caused a reduction of 3-7 mV in resting membrane potential and an increase from 3 to 10 mM-Ca2+ caused 3 to 7 mV membrane hyperpolarization. Muscle fibre input resistance was not affected. 6. It is concluded that in the pigeon iris, Ca2+ required for contractile activation is obtained from internal stores, that membrane potential determines the degree of contractile activation and that the maintenance of the contracture is dependent on the failure of the Ca2+ releasing mechanism to inactive. In addition, it is speculated that because the iris muscle has only sparse SR at the A-band level of the sarcomere, there may be slow Ca2+ reaccumulation. ImagesABABCDE PMID:5003460

Pilar, G.; Vaughan, P. C.



Life Satisfaction Over the First Five Years Following Burn Injury  

E-print Network

of recovery. Van Loey and Van Son (2003) postulate that “it is strongly suggested that social difficulties do occur in burn populations” but offer support for this statement largely in terms of the relationship between scars, disfigurement, and social...

Hoskins, Jessica Lynne



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



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.



Biologicals and fetal cell therapy for wound and scar management.  


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



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



Classical Resonances and Quantum Scarring  

E-print Network

We study the correspondence between phase-space localization of quantum (quasi-)energy eigenstates and classical correlation decay, given by Ruelle-Pollicott resonances of the Frobenius-Perron operator. It will be shown that scarred (quasi-)energy eigenstates are correlated: Pairs of eigenstates strongly overlap in phase space (scar in same phase-space regions) if the difference of their eigenenergies is close to the phase of a leading classical resonance. Phase-space localization of quantum states will be measured by $L^2$ norms of their Husimi functions.

Christopher Manderfeld




Atmospheric Science Data Center

SCAR-B UWC131A Smoke/Sulfates, Clouds and Radiation - Brazil (SCAR-B) data include physical and chemical ... C2H4 Chemiluminescence Chemiluminescence Cloud Chamber FSSP Gerber Probe Int. Nephelometer IR Correlation ...



[Arthroscopy techniques in the treatment of extension contractures of the knee joint after total knee arthroplasty].  


Results are analyzed of treatment of four patients presenting with extension contractures of the knee joint after total knee replacement with the aid of the arthroscopic arthrolysis technique. All patients demonstrated increase in the joint movement size. The conclusion reached was that in the incipient manifestations of the knee joint extension contractures, the arthroscopic arthrolysis technique is superior to the conventional one. PMID:11560043

Ternovy?, M K; Zazirny?, I M



Orbital socket contracture: a complication of inflammatory orbital disease in patients with Wegener’s granulomatosis  

Microsoft Academic Search

Aim: To describe the clinical characteristics of orbital socket contracture in patients with Wegener’s granulomatosis (WG).Methods: A retrospective cohort study The medical records of 256 patients with WG examined at the National Institutes of Health from 1967 to 2004 were reviewed to identify patients with orbital socket contracture. Details of the orbital disease including Hertel exophthalmometry readings, radiological findings, and

C Talar-Williams; M C Sneller; C A Langford; J A Smith; T A Cox; M R Robinson



Studies on the contracture inducing action of triphenyltin in the mouse diaphragm.  


Triphenyltin induces a contracture of the mouse phrenic nerve-diaphragm preparation. This contracture was not inhibited by (+)-tubocurarine, high magnesium or the absence of electrical stimulation. Triphenyltin (0.1 mM) reduced the muscle membrane potential, the amplitude of the muscle action potential and the muscle membrane input resistance. Pretreatment with high K+ (25 mM) or veratridine (1.5 microM; a Na+ channel activator) briefly shortened the onset of the contracture and increased the peak tension of the contracture. Pretreatment with tetrodotoxin (0.3 microM; a Na+ channel blocker) or glycerol (a T tubule uncoupler) however, significantly reduced the triphenyltin-induced contracture. Removing Ca2+ from external solution and prolonged treatment with either caffeine (20 mM) or ryanodine (2 microM) inhibited the triphenyltin-induced contracture. However, a brief treatment with a lower concentration of caffeine (10 mM) potentiated the contracture. 45Ca2+ uptake studies showed that triphenyltin caused the muscle to accumulate Ca2+ which entered from external solution. Pretreatment with trypsin and dithiothreitol (a sulfhydryl-containing reducing agent) blocked the contracture induced by triphenyltin. These results suggest that triphenyltin initially interacts with the sulfhydryl groups of membrane bound proteins (possibly the Na+ channel) to cause depolarization of the muscle fibres. This depolarization triggers the release of Ca2+ from sarcoplasmic reticulum through the mechanism of Ca2+ inducing Ca2+ release, activates the contractile filaments and causes the muscle to contract. PMID:7867695

Liu, S H; Shiau, S Y



Congenital heart disease in adolescents with gluteal muscle contracture.  


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

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



Effects of a skin rehabilitation nursing program on skin status, depression, and burn-specific health in burn survivors.  


The objective of this study was to identify the effects of a skin rehabilitation nursing program (SRNP) on skin status, depression, and burn-specific health in Korean burn survivors. A pretest-posttest design with a nonequivalent control group was used to examine the effects of SRNP for 3 months in a group of 26 burn survivors. The SRNP group of 13 burn survivors received massage therapy 30 minutes three times a week for 3 months compared to a control group of 13 burn survivors receiving typical care. The SRNP group showed no significant changes in the burn scar, subjective skin status, depression, or burn-specific health. Burn survivors receiving SRNP had reduced burn scar depth after the intervention compared to the control group. The findings of this study demonstrate that SRNP for burn survivors may improve burn scars, and findings suggest that future studies with a larger sample should be conducted using SRNP as an intervention for burn survivors. PMID:20306614

Roh, Young Sook; Seo, Cheong Hoon; Jang, Ki Un



Forest fire scar detection in the boreal forest with multitemporal SPOT-VEGETATION data  

Microsoft Academic Search

Disturbance events, such as fire, have a major impact on boreal forest dynamics, succession, and the global carbon cycle. Methods using satellite imagery are well established for detecting forest fires in real time and mapping the burned area (fire scars) within one year of the fire. This paper focuses on the detection of older fire disturbance-regeneration patterns in the boreal

France Gerard; Stephen Plummer; Richard Wadsworth; Andrea Ferreruela Sanfeliu; Luke Iliffe; Heiko Balzter; Barry Wyatt



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

PubMed Central

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

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



Systolic pressure in wound scarring  

PubMed Central

The recommended goal of a systolic pressure under 13 mmHg in hypertensive diabetic patients results in a significant drop in blood pressure that often has caused conflicts in respect to maintaining a minimum systolic pressure for wound scaring in patients with peripheral artery disease. This, as long as the patient remains asymptomatic, is no problem, however if the patient has a peripheral wound, the low systolic pressures may affect scarring. PMID:25644733




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)



Outcomes of ablative fractional laser scar treatment.  


Ablative fractional laser (AFL) systems are commonly used to treat various scars, and recent reports have indicated that early scar treatment with fractional lasers has good aesthetic results. Some scars respond dramatically to AFL treatment, incurring high levels of patient satisfaction; however, other scars respond poorly or became worse after treatment. This study was designed to clarify prognostic factors that predict AFL scar treatment outcomes. A total of 108 patients were included in this study. The fractional laser treatments were repeated every 4 weeks until the scar site was acceptable and no additional improvement was expected or the patient discontinued the treatment. The scar improvements were defined as changes in the Manchester scar scale (MSS) from before to after laser treatment. A digital camera was used to acquire digital photographs of the scars under the same light source, the same background, exposure, and white balance. This study developed a modification of the MSS for image analysis in which colour assessment was based on L*a*b* colour co-ordinates of the digital images. The mean MSS values prior to and after laser treatments were 11.6 ± 3.6 and 9.5 ± 2.9, respectively (p < 0.01). AFL treatment improved the qualities of each scar, and the improvements were evident in colour and contour. Scar elevation, pigmentation, high vascularity, early onset of treatment, and the number of treatment sessions were directly related to scar improvement after AFL therapy (p < 0.05). AFL treatments were effective methods for scar treatment. Clinicians can use these prognostic factors to determine treatment plans and to estimate scar improvement after AFL treatment. PMID:24845386

Kim, Deok-Woo; Hwang, Na-Hyun; Yoon, Eul-Sik; Dhong, Eun-Sang; Park, Seung-Ha



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


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

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



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



Cost Comparison of Open Fasciectomy Versus Percutaneous Needle Aponeurotomy for Treatment of Dupuytren Contracture.  


BACKGROUND: Many surgical options exist for the treatment of Dupuytren contracture. Little has been written regarding their financial implications. The purpose of this study was to compare the immediate direct costs of open fasciectomy to percutaneous needle aponeurotomy (NA) for the surgical treatment of Dupuytren contracture. MATERIALS AND METHODS: A retrospective review was performed comparing patients treated with open fasciectomy (group 1) to patients treated with percutaneous NA (group 2) for the treatment of Dupuytren disease from 2008 to 2010. Financial and medical records were reviewed. Direct cost of treatment was calculated from hospital billing records, including surgical, anesthesia, and facility fees. Statistical analysis was performed using unpaired t test. RESULTS: Twenty-four patients received open segmental palmar and/or digital fasciectomy (group 1). Average preoperative metacarpophalangeal joint flexion contracture was 30 degrees, and proximal interphalangeal joint flexion contracture was 42 degrees. Group 2 consisted of 24 patients. Average preoperative metacarpophalangeal flexion contracture was 31 degrees, and proximal interphalangeal flexion contracture was 27 degrees. Mean cost for group 1 was $11,240 and mean cost for group 2 was $4657 (P < 0.0001). Immediate postoperative contracture correction was similar between both. Two complications occurred in group 1 (wound dehiscence and nerve injury); no complications in group 2. CONCLUSIONS: Percutaneous NA is associated with decreased direct costs in the short-term compared to traditional open fasciectomy with comparable deformity correction. PMID:23486126

Herrera, Fernando Antonio; Benhaim, Prosper; Suliman, Ahmed; Roostaeian, Jason; Azari, Kodi; Mitchell, Scott



Leg contracture in mice after single and multifractionated 137Cs exposure  

SciTech Connect

This is a report of studies of time-dose relationships for post-irradiation leg contractures in mice. The isoeffect doses for various degrees of contracture, measured 250 days after irradiation, increased with the number of fractions, but not with the overall treatment times, throughout 30 days. The isoeffect curves relating the total doses for given levels of responses to the doses per fraction were steeper for leg contractures than for acute skin reactions. The alpha/beta ratios ranged from 1.4 to 5.0 Gy, depending on the degrees of contracture. They were less than the 7.5 to 50 Gy for acute skin reactions as determined in previous experiments using the same animals and irradiation systems. Thus, the data resembled those from other slowly-responding normal tissues such as the spinal cord, kidney and lung. The leg contracture consisted of dermatogenic, myogenic, and arthrogenic components; after the mice were sacrificed there was residual contracture following removal of the skin and muscle. Inhibition of bone growth accounted for only a small proportion of the contracture. The overall response reflected responses of several tissue types.

Masuda, K.; Hunter, N.; Stone, H.B.; Withers, H.R.



A method to evaluate contractures effects during the gait of children with Duchenne dystrophy.  


Joint contractures are the second major impairment affecting the locomotor system of children with Duchenne muscular dystrophy (DMD). While the negative influence of joint contractures has been documented, the passive moments produced by joint contractures could benefit the gait of patients with muscle weakness. We describe a biomechanical model that quantifies the mechanical contribution of ankle and hip flexion contractures to the gait of DMD children. Kinematic and kinetic parameters were measured under the same experimental conditions during the gait and passive resistance assessment of two subjects: one healthy child as a control, and one child with DMD. The child with DMD had a plantar flexion contracture and a greater ankle stiffness coefficient than the control child. During gait, the contribution of the ankle passive moment to the net moment was more important for the child with DMD than for the control child. At the hip, passive joint moments and passive moment contribution were more important for the control child but this was not related to the presence of hip flexion contracture. These preliminary results suggest the model might be used to evaluate contractures effect on a larger cohort of subjects. PMID:17195816

Gaudreault, Nathaly; Gravel, Denis; Nadeau, Sylvie; Desjardins, Pierre; Brière, Anabèle



Burns and Their Psychological Effects on Children.  

ERIC Educational Resources Information Center

The psychological aspects of a child's reaction to major burn injuries include acute emotional reactions resulting from upsetting reactions of family members and unfamiliar hospital surroundings. Emotional and social adjustment problems of severely scarred children are viewed, and suggestions are made as to what health professionals might do to…

Luther, Stephen L.; Price, James H.



Marjolin’s ulcer: a preventable malignancy arising from scars  

PubMed Central

Background Marjolin’s ulcer (MU) is a rare malignancy arising from various forms of scars. This potentially fatal complication typically occurs after a certain latency period. This article attempts to reveal the importance of the latency period in the prevention and early treatment of the malignancy. Methods A retrospective review of 17 MU patients who underwent surgical procedures between June of 2005 and December 2011 was conducted. Etiology of injuries, latency period, repeated ulceration, and outcomes were recorded. This observational report reveals characteristics of patients who develop MU. Results An incidence of 0.7% of MU was found amongst patients complaining of existing scars in our study; burns and trauma were the most common etiology of MU. The mean latency period was 29 years (SD?=?19) and the mean post-ulceration period was 7 years (SD?=?9). Statistical analysis revealed a negative correlation between the age of patients at injury and the length of latency period (r?=??0.8, P <0.01), as well as the lengths of pre-ulceration and post-ulceration periods (r?=??0.7, P <0.01). Conclusions Patients experience different lengths of pre- and post-ulceration periods during the latency period. Younger patients tend to have a longer latency period. Skin breakdown on chronic scars and chronic unhealed ulcers are two main sources of MU. MU may be preventable with a close surveillance of the ulcer during the latency period. PMID:24341890



Influence of some operative and postoperative factors on capsular contracture around breast prostheses.  


In a follow-up of 490 patients with breast implants, neither the size of the prosthesis nor the nature of the surgical procedure (simple augmentation mammaplasty or after subcutaneous mastectomy) increased the incidence of capsular contracture. Hematoma or infection were followed by a higher incidence of capsular contracture. Drainage with suction and the instillation of steroid around the prostheses seemed to be effective in reducing the incidence of capsular contracture. In the steroid-treated group, the need for open surgical treatment was reduced. The recurrence rate after closed capsulotomy, or open capsulotomy, was not significantly different from that following the more extensive procedure of capsulectomy. PMID:343127

Hipps, C J; Raju, R; Straith, R E



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.



Pediatric Hand Friction Burns from Treadmill Contact  

PubMed Central

Background Treadmills have become relatively common in American homes. This machine can be dangerous for children because they can sustain friction burns to the hands when the moving treadmill is touched. With aggressive wound care and physical therapy, most of these burns will heal without surgery. However, some patients will require reconstructive surgery to release contractures. We report our experience with a series of patients who suffered friction burns to the hand from contact with a moving treadmill. The purpose of this study is to further understand the incidence and outcomes of this type of injury. Methods A retrospective chart review of all patients referred between September 2002 and June 2005 to our hand surgery clinic for treadmill friction burns on the hand(s) was conducted. Pertinent data collected included sex, age, injury distribution, and surgeries performed. An analysis of data maintained by the Consumer Product Safety Commission was used to understand the incidence of exercise equipment-induced injuries. Results Thirteen pediatric patients were evaluated for friction burns on the hand. Their total injuries included 24 fingers, 1 hand, and 1 forearm. Three patients (23%) required surgery for release of flexion contractures. All wounds of the remaining 10 patients healed, and with the implementation of hand therapy programs did not require subsequent surgery. Conclusions Treadmill friction burns to the hands of children can lead to limitations of the motion of the hand. Because this problem is completely preventable, parents and treadmill manufacturers are encouraged to be proactive in preventing these injuries. In addition, prompt initiation of wound care and hand therapy is integral to a favorable outcome. PMID:18780051

Muzaffar, Arshad R.; Hanel, Douglas P.



Effects of prostaglandin E1 on cultured dermal fibroblasts from normal and hypertrophic scarred skin.  


To investigate the role of prostaglandin (PG) E1 in preventing scar formation as well as that of the related cytokines, we culture fibroblasts from hypertrophic scar tissue (SDF) and normal dermis (NDF) collected from patients with scar contracture. We have compared the type I collagen synthesis, type I collagenase activity, and the production of interleukin (IL)-6, IL-8 and transforming growth factor (TGF)-beta(1) in two types of cultured fibroblasts before and after addition of PGE1. Our results demonstrated that levels of type I collagen and TGF-beta(1) production were higher and that type I collagenase activity and IL-8 production were significantly lower in the culture supernatants of SDF. There was no significance difference in IL-6 production between SDF and NDF culture supernatants. On the other hand, PGE1 significantly increased type I collagenase activity and IL-8 production in the SDF culture supernatants and it increased IL-6 and TGF-beta(1) production in both types of fibroblasts. However, there was no effect on synthesis of type I collagen in either group. To further investigate the role of TGF-beta(1) in NDF and SDF, exogenous recombinant human (rh) TGF-beta(1) was added. In NDF group, rhTGF-beta(1) induced a decrease in the type I collagenase/type I collagen ratio, while rhTGF-beta(1) had no effect on the same ratio in the SDF group. These results suggest that PGE1 may have a role in the prevention of hypertrophic scar by increasing the activity of type I collagenase. PMID:9138479

Zhou, L J; Inoue, M; Gunji, H; Ono, I; Kaneko, F



Chiral scars in chaotic Dirac fermion systems.  


Do relativistic quantum scars in classically chaotic systems possess unique features that are not shared by nonrelativistic quantum scars? We report a class of relativistic quantum scars in massless Dirac fermion systems whose phases return to the original values or acquire a 2? change only after circulating twice about some classical unstable periodic orbits. We name such scars chiral scars, the successful identification of which has been facilitated tremendously by our development of an analytic, conformal-mapping-based method to calculate an unprecedentedly large number of eigenstates with high accuracy. Our semiclassical theory indicates that the physical origin of chiral scars can be attributed to a combined effect of chirality intrinsic to massless Dirac fermions and the geometry of the underlying classical orbit. PMID:23432246

Xu, Hongya; Huang, Liang; Lai, Ying-Cheng; Grebogi, Celso





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A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients  

PubMed Central

To compare the effect of honey dressing and silver-sulfadiazene (SSD) dressing on wound healing in burn patients. Patients (n=78) of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area) were included in the study, over a period of 2 years (2006-08). After stabilization, patients were randomly attributed into two groups: ‘honey group’ and ‘SSD group’. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37) and SSD cream over the wounds of patients in SSD group (n=41), everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group) and control (SSD group) was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100%) who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound healing, makes the wound sterile in lesser time, has a better outcome in terms of prevention of hypertrophic scarring and post-burn contractures, and decreases the need of debridement irrespective of time of admission, when compared to SSD dressing. PMID:20368852

Baghel, P. S.; Shukla, S.; Mathur, R. K.; Randa, R.



A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients.  


To compare the effect of honey dressing and silver-sulfadiazene (SSD) dressing on wound healing in burn patients. Patients (n=78) of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area) were included in the study, over a period of 2 years (2006-08). After stabilization, patients were randomly attributed into two groups: 'honey group' and 'SSD group'. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37) and SSD cream over the wounds of patients in SSD group (n=41), everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group) and control (SSD group) was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100%) who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound healing, makes the wound sterile in lesser time, has a better outcome in terms of prevention of hypertrophic scarring and post-burn contractures, and decreases the need of debridement irrespective of time of admission, when compared to SSD dressing. PMID:20368852

Baghel, P S; Shukla, S; Mathur, R K; Randa, R



Effects of ginsenoside Rb1 on hypertrophic scar remodeling in rabbit model.  


Ginsenoside, one of the active compounds in Panax ginseng, inhibits tumor growth factor-beta 1 (TGF-?1) and reduces the level of collagen type 1. Ginsenoside Rb1 promotes burn wound healing. Our study evaluated the effects of ginsenoside Rb1 on hypertrophic scar remodeling. A total of 72 hypertrophic scars were generated on the ears of six New Zealand white rabbits. Treatment groups were administered with intradermal injections of ginsenoside Rb1 at various amounts (0.07mg, 0.28mg and 0.56mg), and evaluated on postoperative Day 35. Scar elevation index was used as a quantitative measure, and picrosirius staining of histological sections was used to assess collagen arrangement. We determined relative mRNA expression of collagen type 1 as well as scar related factors; matrix metalloproteinase 2 (MMP2), tissue-inhibitor of metalloproteinase 1 (TIMP1), alpha-smooth muscle actin (?-SMA), and TGF-?1. Immunohistochemistry assays were performed additionally. Application of 0.56mg of ginsenoside Rb1 resulted in significant decrement of scar elevation index, in comparison with control and lower dosage groups, furthermore achieved broader and randomly arranged collagen fibers resembling findings in normal dermis. Ginsenoside Rb1 concentration inversely correlated with the mRNA expression and immunohistochemical reactivity of scar related factors; MMP2, TIMP1, ?-SMA, and TGF-?1. In addition, ginsenoside Rb1 suppressed collagen type 1 expression. Ginsenoside Rb1 is therapeutic in hypertrophic scar remodeling with the highest efficacy at 0.56mg of dosage. Ginsenoside Rb1 demonstrated inhibitory effects on hypertrophic scar in quantitative and histologic analysis. Further research is needed to determine optimal ginsenoside Rb1 application and exposure conditions. PMID:25620132

Tark, Kwan Chul; Lee, Dong Won; Lew, Dae Hyun; Kang, Eun Hye; Roh, Hyun; Lee, Myung Chul



Treatment of upper motoneuron plantarflexion contractures by using an adjustable ankle-foot orthosis  

Microsoft Academic Search

Grissom SP, Blanton S. Treatment of upper motoneuron plantarflexion contractures by using an adjustable ankle-foot orthosis. Arch Phys Med Rehabil 2001;82:270-3. Objective: To assess the effectiveness of an adjustable ankle-foot orthosis in the treatment of plantarflexion contractures after central nervous system injury or disease. Design: Prospective, nonrandomized, interventional trial. Setting: University medical center's acute inpatient rehabilitation hospital. Participants: Nine ankles

Samuel P. Grissom; Sarah Blanton



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

E-print Network

Contractural Syndrome Type 2 (LCCS2) to a 6 cM Interval on Chromosome 12q13 Ginat Narkis,1,2 Daniella Landau,2 a novel autosomal recessive disorder, lethal congenital contractural syndrome type 2 (LCCS2) (OMIM 607598M (corresponding to $7.2 Mb) homozygosity region on chromosome 12q13 between markers D12S1604 and D12S83. Based

Friedman, Nir


High Rate of Joint Capsule Matrix Turnover in Chronic Human Elbow Contractures  

PubMed Central

The joint capsule is a key component in posttraumatic joint contractures. The capsule is described as thickened, but little data exist supporting the observation. Our hypotheses were that mRNA levels of (1) collagen; (2) decorin and biglycan; (3) matrix metalloproteinases; and (4) tissue inhibitors of matrix metalloproteinases were significantly elevated in anterior joint capsules obtained from 11 patients having surgery for posttraumatic contractures when compared with nine elbows, from organ donors, that were free of contractures. Reverse transcription-polymerase chain reaction was used to evaluate mRNA expression normalized to a housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase. In the joint capsules of the patients with elbow contractures, relative mRNA levels were increased for: collagen Types I, III, and V (1.5–2.5 times); biglycan (1.5 times); and matrix metalloproteinases-1, -2, -9, -13, and -15 (1.6–3.9 times). In contrast, expression of tissue inhibitors of matrix metalloproteinases-1, -2, and -4 were decreased (?–¾times) in the capsules of patients with contractures. There was no difference between the groups in relative mRNA expression for decorin, matrix metalloproteinases-8, -14 and -16, and tissue inhibitor of matrix metalloproteinase-3. The results indicate that joint capsule matrix molecule mRNA levels are altered in the chronic stages of posttraumatic elbow contractures in humans, potentially creating an environment with high matrix turnover rates. PMID:16205164

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



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


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

Ji, Xianglu; Tian, Feng; Tian, Lijie



Operative Treatment of the Knee Contractures in Cerebral Palsy Patients  

PubMed Central

Introduction: Knee flexion is one of the main problems of the lower extremities in cerebral palsy patients. Many operative procedures are recommended for contractures of the knee in cerebral palsy patients. We performed simple operation and analyzed the results after operative treatment with nine years follow up. Method: 85 patients with spastic cerebral palsy were treated in period 2001 – 2010. 40 were ambulatory and 45 non ambulatory with ability to stand with support. All of them underwent same surgical procedure with distal hamstrings lengthening. Tenotomies were performed on m. semitendinosus, m. semimembranosus, m. gracillis and biceps femoris. Only m. semitendinosus was tenotomized completely, other muscles were tenotomized only on tendinous part. The patients had a plaster immobilization for five days after the surgery with the knee extended. Results: All 85 patients had improvement of the popliteal angle pre and post operative respectively. Improvement in the crouch gait was noticed in the period of rehabilitation. We had no complication with the wound. Three of the patients had overcorrection and achieved recurvatum of the knees. Conclusion: We consider this procedure very simple with satisfying improvement of standing, walking and sitting abilities in children with spastic cerebral palsy. PMID:25568529

Bozinovski, Zoran; Popovski, Neron



Smoking and its effect on scar healing.  


Scar formation is influenced by several factors such as wound infection, tension, wound depth and anatomical localization. Hypertrophic scarring is often the result of an imbalance in the wound and scar healing process. The exact underlying pathophysiological mechanism remains unclear. Smoking has a higher risk of postoperative complications probably due to a diminished macrophage induction. Following our clinical impression that smokers without postoperative wound infections show esthetically better scars, we evaluated the scars after a reduction mammaplasty in smoking and nonsmoking patients in a prospective clinical trial. Between July 2006 and September 2007, 13 smokers and 30 non smokers with a reduction mammaplasty were included. They were recruited from Viecuri Medical Centre and Atrium Medical Centre in the Netherlands after written consent. Surgical data and data of the patients' condition were collected. Follow-up for erythema values of the scars was done with a colorimeter (The Minolta CR-300, Minolta Camera Co., Ltd., Osaka Japan) at 1, 3, 6 and 9 months postoperatively on four standardized postsurgical sites. ANOVA and Chi-square test were used for statistical analysis. In the smoking group, the scars were significantly less red compared to the nonsmoking group. No significant differences were found in BMI, resection weight and drain production between both groups. Although smoking is certainly not recommended as a preventive therapy to influence scar healing, this study confirms our assumption that smokers tend to have faster and less erythemateous scar healing to nonsmokers. Further research is needed to understand the mechanism of the effect of smoking on scars. PMID:22661831

Deliaert, A E K; Van den Kerckhove, E; Tuinder, S; Noordzij, S M J S; Dormaar, T S; van der Hulst, R R W J



Controlled Burn  

USGS Multimedia Gallery

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


Scald Burns  


... visit: Safety tipS & info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...


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.



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

PubMed Central

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

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



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

PubMed Central

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

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



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

E-print Network

of prescribed burning regimes and the reconstruction of fire history is enhanced by knowledge of the biological tree-ring data from many trees from the same site can increase the length of the fire history recordPost-oak fire scars as a function of diameter, growth, and tree age Richard P. Guyette* , Michael C

Stambaugh, Michael C


Coenzyme dependent suppression of 2,2-PDS induced contractures in Spirostomum.  


Spirostomum ambiguum was stimulated to contract by addition of the thiol inhibitor, 2,2-dithiobispyridine (PDS), which depletes intracellular reducing equivalents which are generated by coenzyme dependents reactions. PDS induced contractures were not suppressed after 2--4 h of pre-incubation in a medium enriched with ascorbic acid, thiamine, or riboflavin, singly. Two h of incubation with nicotinamide did not suppress contractures; however, 50% suppression occurred after 3 h incubation. Incubation of the cells in a medium enriched with all four coenzymes for up to 4 h, resulted in the suppression of PDS induced contractures to a level as low as 30% of control values. Suppression of contractures by the mixed coenzymes was concentration dependent. Cells that were stimulated with PDS and contracting, exhibited a 50% suppression of contractures within 3 min after transfer to a complementary medium enriched with mixed coenzymes. These results suggest that coenzymes interact synergistically with cellular metabolic processes to inhibit pharmacodynamic responses to PDS. PMID:153442

Levine, M A; Ettienne, E M



Excessive scarring as a consequence of healing.  


Synthesis and degradation of collagen is an essential component of wound healing. In most persons, this deposition of collagen results in the formation of a fine line scar which restores much of the tensile strength to the injured tissue and is cosmetically acceptable. However, in certain individuals, the result of wound healing is the excessive accumulation of collagen, resulting in a hypertrophic scar or keloid. The precise origin of this abnormal collagen deposition is unknown, but recent studies have begun to identify potential mechanisms for these disfiguring and painful lesions. This article will review the clinical and laboratory findings pertinent to understanding the origin and treatment of excessive scarring. PMID:17168858

Ladin, D A; Garner, W L; Smith, D J



Chemical burns  

PubMed Central

Objectives To report a burn unit’s experience with chemical burns and to discuss the fundamental principles in managing chemical burns. Design A chart review. Setting A burn centre at a major university-affiliated hospital. Patients Twenty-four patients with chemical burns, representing 2.6% of all burn admissions over an 8-year period at the Ross Tilley Regional Adult Burn Centre. Seventy-five percent of the burn injuries were work-related accidents. Chemicals involved included hydrofluoric acid, sulfuric acid, black liquor, various lyes, potassium permanganate and phenol. Results Fourteen patients required excision and skin grafting. Complications were frequent and included ocular chemical contacts, wound infections, tendon exposures, toe amputation and systemic reactions from absorption of chemical. One patient died from a chemical scald burn to 98% of the body surface area. Conclusions The key principles in the management of chemical burns include removal of the chemical, copious irrigation, limited use of antidotes, correct estimation of the extent of injury, identification of systemic toxicity, treatment of ocular contacts and management of chemical inhalation injury. Individualized treatment is emphasized. PMID:8640619

Cartotto, Robert C.; Peters, Walter J.; Neligan, Peter C.; Douglas, Leith G.; Beeston, Jeff



Proceedings of the SCAR Conference, Part 1  

NASA Technical Reports Server (NTRS)

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



SCAR-A Data and Information  

Atmospheric Science Data Center

... (SCAR-A) data include physical and chemical components of the Earth's surface, the atmosphere and the radiation field collected in the eastern part of the United States with an emphasis in air pollution. Discipline:  ...



An accumulation of proteoglycans in scarred fascia.  


A little is known about proteoglycan (PG) changes, occuring in the course of scarring of tissues another than skin. The aim of present study was biochemical characterization of glycosaminoglycans (GAGs) and proteoglycans (PGs) of normal and scarred fascia. Samples of normal fascia lata were taken at autopsy from 23 individuals and samples of scarred fascia lata were removed from 23 patients at reoperations for femoral fracture. The obtained tissues were divided into two samples: first of them was submitted to GAG isolation and the second one to PG isolation. GAGs were extracted by extensive papain digestion followed by the fractionation using cetylpyridinium chloride. In order to qualitative and quantitative characterization GAGs were submitted to electrophoresis on cellulose acetate before and after treatment with enzymes, specifically depolymerizing some kinds of GAGs. PGs were extracted using 4 M guanidine HCl followed by purification by forming complexes with Alcian blue. PGs were submitted to gel permeation chromatography on Sepharose 4B. In order to obtain core proteins PGs were depolymerized with chondroitinase ABC. The purified PGs and their core proteins were separated with sodium dodecyl sulphate/polyacrylamide gel electrophoresis (SDS/PAGE). It was found that total GAGs content was significantly elevated in scarred fascia. Both types of fascia contained chondroitin-, dermatan- and heparan sulphates and hyaluronic acid. Dermatan sulphates (DS) were the predominant GAGs of normal and scarred fascia. The contents of all GAG types were increased in scarred fascia. Both types of fascia contained two kinds of dermatan sulphate proteoglycans (DSPGs); first being similar to biglycan and the second one similar to decorin, as it was judged by molecular weight of their native molecules and core proteins as well as type of GAG components. Densitometric analysis showed that decorin is a predominant DSPG in both fascia types, but in scarred tissue the ratio of biglycan to decorin is considerably higher. Moreover, in scarred fascia a large chondroitin sulphate proteoglycan (CSPG) was also observed. The obtained results have shown that the scar formation is accompanied by quantitative and qualitative alterations in GAGs/PGs resembling those observed in hypertrophic skin scars. The biochemical modification of the scarred fascia lata may partly explain the clinically manifested damage to biomechanical properties of this tissue. PMID:10724338

Ko?ma, E M; Olczyk, K; G?owacki, A; Bobi?ski, R



"Scars" in parametrically excited surface waves  

E-print Network

We consider the Faraday surface waves of a fluid in a container with a non-integrable boundary shape. We show that, at sufficiently low frequencies, the wave patterns are ``scars'' selected by the instability of the corresponding periodic orbits, the dissipation at the container side walls, and interaction effects which reflect the nonlinear nature of the Faraday waves. The results explain the observation of a limited number of scars with anomalous strengths in recent experiments by Kudrolli, Abraham and Gollub.

Oded Agam; Boris L. Altshuler



Imaging scarred states in quantum dots.  


We have used the scanning gate microscopy technique to image scar structures in an open quantum dot, fabricated in an InAs quantum well and defined by electron beam lithography. These are shown to have a periodicity in magnetic field that correlates with that found in the conductance fluctuations. Simulations have shown that these magnetic transform images bear a strong resemblance to actual scars found in the dots. PMID:21825542

Burke, A M; Akis, R; Day, T; Speyer, G; Ferry, D K; Bennett, B R



Optical Scar in a chaotic fibre  

E-print Network

We propose to use a multimode optical fiber with a D-shaped cross section as a privileged system to image wavefunctions of a chaotic system. Scar modes are in particular the sub ject of our investigations. We study their imprints on the statistics of intensity and we show how the introduction of a localized gain region in the fiber is used to perform a selective excitation of scar modes.

Valérie Doya; Olivier Legrand; Claire Michel; Fabrice Mortessagne



Sense and nonsense of scar creams and gels  

Microsoft Academic Search

The wish to prevent or improve scars, whether they are of surgical or traumatic origin, has led to the development of scar creams and gels that are said to influence the aesthetic appearance of a scar. In this article the literature on results of the topical application of various scar creams and gels is reviewed. It is concluded that no

Cees J. M. van den Helder; J. Joris Hage



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



Congenital gluteus maximus contracture syndrome - a case report with review of imaging findings  

PubMed Central

Although the clinical features of gluteus maximus contracture syndrome have been frequently described, imaging features have been seldom described. Most commonly reported cases are those following intramuscular injection in the gluteal region although congenital contracture is an uncommon but important occurrence. This condition has most often been reported in children of school going age. These patients often present with difficulty in squatting, limitation of hip motion or specific deformities and often require surgical correction. We describe the plain radiography, ultrasonography (USG) and magnetic resonance imaging (MRI) features of this condition in a patient with no previous known history of intramuscular injections. PMID:24967033

Kotha, Vamshi Krishna; Reddy, Rajasekhar; Reddy, M. Venkateshwar; Moorthy, Rangubatla Sathyanrayana; Kishan, Tatikonda Venkat



Management of acid burns: Experience from Bangladesh.  


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

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



The Prevalence, Rate of Progression, and Treatment of Elbow Flexion Contracture in Children with Brachial Plexus Birth Palsy  

PubMed Central

Background: Elbow flexion contracture is a well-known complication of brachial plexus birth palsy that adversely affects upper-extremity function. The prevalence, risk factors, and rate of progression of elbow flexion contracture associated with brachial plexus birth palsy have not been established, and the effectiveness of nonoperative treatment involving nighttime splinting or serial casting has not been well studied. Methods: The medical records of 319 patients with brachial plexus birth palsy who had been seen at our institution between 1992 and 2009 were retrospectively reviewed to identify patients with an elbow flexion contracture (?10°). The chi-square test for trend and the Kaplan-Meier estimator were used to evaluate risk factors for contracture, including age, sex, and the extent of brachial plexus involvement. Longitudinal models were used to estimate the rate of contracture progression and the effectiveness of nonoperative treatment. Results: An elbow flexion contracture was present in 48% (152) of the patients with brachial plexus birth palsy. The median age of onset was 5.1 years (range, 0.25 to 14.8 years). The contracture was ?30° in 36% (fifty-four) of these 152 patients and was accompanied by a documented radial head dislocation in 6% (nine). The prevalence of contracture increased with increasing age (p < 0.001) but was not significantly associated with sex or with the extent of brachial plexus involvement. The magnitude of the contracture increased by 4.4% per year before treatment (p < 0.01). The magnitude of the contracture decreased by 31% when casting was performed (p < 0.01) but thereafter increased again at the same rate of 4.4% per year. The magnitude of the contracture did not improve when splinting was performed but the rate of increase thereafter decreased to <0.1% per year (p = 0.04). Conclusions: The prevalence of elbow flexion contracture in children with brachial plexus birth palsy may be greater than clinicians perceive. The prevalence increased with patient age but was not significantly affected by sex or by the extent of brachial plexus involvement. Serial casting may initially improve severe contractures, whereas nighttime splinting may prevent further progression of milder contractures. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:22398733

Sheffler, Lindsey C.; Lattanza, Lisa; Hagar, Yolanda; Bagley, Anita; James, Michelle A.



Lightning burns.  


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

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



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

PubMed Central

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

Kumar U., Mahesh; Yelikar, Balasaheb Ramling



The role of free flap reconstruction in paediatric caustic burns.  


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



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



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.



Lethal congenital contracture syndrome (LCCS) and other lethal arthrogryposes in Finland--an epidemiological study.  


Arthrogryposis multiplex congenita is a heterogeneous group of disorders characterized by multiple contractures with an estimated frequency of 1 in 3,000 births. With improving diagnostic methods, increasing numbers of fetuses with arthrogryposis are found. The pathogenetic mechanisms are relatively well known but the epidemiology and genetics of the prenatally lethal forms of arthrogryposis are less well known. In this study we collected all cases of a multiple contractures diagnosed in Finland during 1987-2002 including live born infants, stillbirths, and terminated pregnancies. Ninety-two cases of 214 suffered intrauterine demise (68 selective pregnancy terminations and 24 stillbirths) and 58 died in infancy. In 141 out of these cases the diagnosis could be included within lethal arthrogryposes, with a prevalence of 1 in 6,985 (1.43/10,000) births. Of these, 59 had spinal cord pathology at autopsy and thus were of neurogenic origin. Thirty-nine cases had lethal congenital contracture syndrome (LCCS) clinically characterized by total immobility of the fetus at all ultrasound examinations (12 weeks or later), multiple joint contractures in both upper and lower limbs, hydrops, and fetal death before the 32nd week of pregnancy. LCCS is noted as a unique Finnish disorder with a prevalence of 1 in 25,250 (0.40/10,000) births and is a major cause of lethal arthrogryposis in Finland. PMID:16892327

Pakkasjärvi, Niklas; Ritvanen, Annukka; Herva, Riitta; Peltonen, Leena; Kestilä, Marjo; Ignatius, Jaakko



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



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.



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. PMID:25352991

McGrouther, Duncan; Chakrabarty, Kaushik



Mitigation of hypertrophic scar contraction via an elastomeric biodegradable scaffold.  


Hypertrophic scar (HSc) occurs in 40-70% of patients treated for third degree burn injuries. Current burn therapies rely upon the use of bioengineered skin equivalents (BSEs), which assist in wound healing but do not prevent HSc contraction. HSc contraction leads to formation of a fixed, inelastic skin deformity. We propose that BSEs should maintain their architecture in the wound bed throughout the remodeling phase of repair to prevent HSc contraction. In this work we study a degradable, elastomeric, randomly oriented, electrospun micro-fibrous scaffold fabricated from the copolymer poly(l-lactide-co-?-caprolactone) (PLCL). PLCL scaffolds displayed appropriate elastomeric and tensile characteristics for implantation beneath a human skin graft. In vitro analysis using human dermal fibroblasts demonstrated that PLCL scaffolds decreased myofibroblast formation as compared to an in vitro HSc contraction model. Using a validated immune-competent murine HSc contraction model, we found that HSc contraction was significantly greater in animals treated with standard of care, Integra, as compared to those treated with collagen coated-PLCL (ccPLCL) scaffolds. Finally, wounds treated with ccPLCL were significantly less stiff than control wounds at d30 in vivo. Together, these data suggest that scaffolds which persist throughout the remodeling phase of repair may represent a clinically translatable method to prevent HSc contraction. PMID:25591962

Lorden, Elizabeth R; Miller, Kyle J; Bashirov, Latif; Ibrahim, Mohamed M; Hammett, Ellen; Jung, Youngmee; Medina, Manuel A; Rastegarpour, Ali; Selim, Maria A; Leong, Kam W; Levinson, Howard



Treatment of severe burn with DermACELL(®), an acellular dermal matrix.  


For treatment of skin burn injuries, there exist several methods of treatment related to tissue regeneration, including the use of autograft skin and cryopreserved skin. However, each method has drawbacks. An alternative method for tissue regeneration is allograft acellular dermal matrix, with potential as a biocompatible scaffold for new tissue growth. One recently produced material of this type is DermACELL(®), which was used in this case presentation for treating a scar resulting from second- and third-degree burns in a 33-year-old female patient. The patient presented with significant hypertrophic scarring from the elbow to the hand and with limited wrist and elbow motion. The scarring was removed, and the patient was treated with a 1:3 mesh of DermACELL. The wound was resurfaced with a split thickness skin graft, and postoperative care included application of pressure garment and silicone sheet, as well as range of motion exercise and massage. At 30 days after DermACELL application, the wound appeared well-healed with little scar formation. At 180 days post-application, the wound continued to appear healed well without significant scar formation. Additionally, the wound was supple, and the patient experienced significant improvement in range of motion. In the case presented, DermACELL appears to have been a successful method of treatment for scarring due to severe burns by preventing further scar formation and improving range of motion. PMID:23071908

Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Wang, Chih-Hsin



Contrast-enhanced ultrasonography evaluation after autologous fat grafting in scar revision  

PubMed Central

Aim Fat transfer is commonly used to fill loss of volume in depressed scars caused by trauma, deep burns or surgery. The aim of the study is to investigate the degree of fat graft take through evaluation of the microcirculation of grafted autologous adipose tissue using contrast-enhanced ultrasonography. Patients and method From 2010 to 2012 at the Department of Plastic and Reconstructive Surgery of the Traumatological Center in Turin, a study population was selected from patients with surgical indications for autologous fat transfer for scar correction. For each surgical procedure patients underwent a clinical and sonographic evaluation before and after intervention (at 1 month and 3 months). Results Out of a total of 28 interventions, 24 showed a good result; defined as improvement of the scar, and confirmed by the presence of vascularization in the transplanted tissue. In 4 cases, there was a lack of blood supply at the first evaluation but an initial good clinical scar correction. The absence of blood vessels was confirmed at 3 months accompanied by complete resorption of the transferred fat with a failure of good clinical outcome. Conclusion Contrast-enhanced ultrasonography was able to evaluate the microvasculature of adipose tissue after fat transfer. Due to this characteristic, it allows to monitor and predict the take of adipose tissue and provide realistic and early information on the clinical outcome of fat transfer. PMID:25644727




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.



Burns (For Parents)  


... outlets, etc.) overexposure to the sun Types of Burns Burns are often categorized as first-, second-, or ... if the burn is severe). Continue First-Degree Burns First-degree burns, the mildest of the three, ...


Burn and Scald Prevention  


Burn and Scald Prevention Approximately 450,000 burn injuries require medical treatment each year. American Burn Association National Burn Repository (2011 report) Prevent burns and scalds in the kitchen: • Place objects so ...


Ablative fractional laser resurfacing for the treatment of a third-degree burn.  


Burn scars are the result of wound healing following a partial-thickness or full-thickness thermal injury. Thermal injury can frequently result in extensive scarring, which may have profound psychologic impact on the victim, serving as a visible and palpable reminder of a traumatic event. Standard treatments for scars include the use of skin grafts, intralesional steroid injections, and pulsed-dye laser treatments. The authors have previously described successful treatment of a burn scar with nonablative fractional resurfacing. Ablative fractional lasers may offer burn patients advantages over nonablative techniques, including improved function and cosmetic outcomes. In addition, ablative fractional laser may require fewer treatments, and therefore, be a more cost-effective treatment option for patients. The authors report the use of fractional ablative laser for the treatment of a disfiguring scar that was more than 50-years-old. To our knowledge, this is the first report of this technology for the treatment of a scar resulting from a third-degree burn in the literature. The demonstrated successful outcome in this case patient may indicate a progessive treatment option for many patients who have been disfigured by these types of thermal injuries. PMID:19271380

Waibel, Jill; Beer, Kenneth



Detection of seagrass scars using sparse coding and morphological filter  

NASA Astrophysics Data System (ADS)

We present a two-step algorithm for the detection of seafloor propeller seagrass scars in shallow water using panchromatic images. The first step is to classify image pixels into scar and non-scar categories based on a sparse coding algorithm. The first step produces an initial scar map in which false positive scar pixels may be present. In the second step, local orientation of each detected scar pixel is computed using the morphological directional profile, which is defined as outputs of a directional filter with a varying orientation parameter. The profile is then utilized to eliminate false positives and generate the final scar detection map. We applied the algorithm to a panchromatic image captured at the Deckle Beach, Florida using the WorldView2 orbiting satellite. Our results show that the proposed method can achieve <90% accuracy on the detection of seagrass scars.

Oguslu, Ender; Erkanli, Sertan; Hill, Victoria J.; Bissett, W. Paul; Zimmerman, Richard C.; Li, Jiang



[The prevention of the development of myocardial contracture in the "calcium paradox" by action on Na-Ca metabolism].  


The effect of artificial high sodium gradient on the rate of the myocardium contracture development during "calcium paradox" was studied in the experiments on the isolated heart of Langendorf-perfused rats. It is stated that artificial creation of a high sodium gradient decreases the rate of the myocardium contracture development. Exogenous nucleotides, activators of Na, K-ATPase, and their precursors intensified the protective action of the hypersodium medium. Phosphocreatine (100 mmol/l) had no protective effect during the "calcium paradox". However, under conditions of the high sodium gradient phosphocreatine efficiently prevented development of the contracture during the "calcium paradox". It is important to note that under analogous conditions creation of high osmosity of the solution adding 12 mmol/l of saccharose does not protect the heart from development of the myocardium contracture. PMID:1286697

Alabovski?, V V; Vinokurov, A A



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.



Selective amplification of scars in a chaotic optical fiber  

E-print Network

In this letter we propose an original mechanism to select scar modes through coherent gain amplification in a multimode D-shaped fiber. More precisely, we numerically demonstrate how scar modes can be amplified by positioning a gain region in the vicinity of specific points of a short periodic orbit known to give rise to scar modes.

Claire Michel; Valérie Doya; Olivier Legrand; Fabrice Mortessagne



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



An unusual case of rapidly progressive contractures: Case report and brief review  

PubMed Central

An 8-year-old boy, diagnosed as cervical dystonia, was referred to our tertiary center. After a trivial trauma he had developed painful lumps in the axial region, which was followed by restricted movements of neck, shoulder, and abdominal muscles over 4 months. He had kyphoscoliosis, torticollis, rigid abdomen, and multiple muscle contractures. He also had short great toes. A detailed skeletal survey showed calcification in the soft tissues surrounding the shoulder anterior chest wall, thorax, and paraspinal muscles; there was also beaking of vertebrae, which was confirmed by CT thorax. This report showcases the diagnostic challenge posed by myositis ossificans progressiva, which can rarely cause rapidly progressing muscle contractures. A brief review of literature is also presented. PMID:19893652

Subasree, R.; Panda, Samhita; Pal, Pramod Kumar; Ravishankar, S.



Bethlem myopathy: An autosomal dominant myopathy with flexion contractures, keloids, and follicular hyperkeratosis  

PubMed Central

Bethlem myopathy and Ullrich congenital muscular dystrophy form a spectrum of collagenopathies caused by genetic mutations encoding for any of the three subunits of collagen VI. Bethlem phenotype is relatively benign and is characterized by proximal dominant myopathy, keloids, contractures, distal hyperextensibility, and follicular hyperkeratosis. Three patients from a single family were diagnosed to have Bethlem myopathy based on European Neuromuscular Centre Bethlem Consortium criteria. Affected father and his both sons had slowly progressive proximal dominant weakness and recurrent falls from the first decade. Both children aged 18 and 20 years were ambulant at presentation. All had flexion contractures, keloids, and follicular hyperkeratosis without muscle hypertrophy. Creatinine kinase was mildly elevated and electromyography revealed myopathic features. Muscle imaging revealed severe involvement of glutei and vasti with “central shadow” in rectus femoris. Muscle biopsy in the father showed dystrophic changes with normal immmunostaining for collagen VI, sarcoglycans, and dysferlin. PMID:24339618

Saroja, Aralikatte Onkarappa; Naik, Karkal Ravishankar; Nalini, Atcharayam; Gayathri, Narayanappa



A novel FBN2 mutation in a Chinese family with congenital contractural arachnodactyly  

PubMed Central

Congenital contractural arachnodactyly (CCA, OMIM: 121050) is an autosomal dominant condition that shares skeletal features with Marfan syndrome (MFS, OMIM: 154700), including contractures, arachnodactyly, dolichostenomelia, scoliosis, crumpled ears and pectus deformities but excluding the ocular and cardiovascular complications that characterize MFS. These two similar syndromes result from mutations in two genes belonging to the fibrillin family, FBN1 and FBN2, respectively. We successfully identified a novel FBN2 mutation (C1406R) in a Chinese family with CCA for over five generations. This mutation was detected in the patients of this family but not in the seven unaffected family members or 100 normal individuals. SIFT and PolyPhen analyses suggested that the mutation was pathogenic. We identified a missense mutation in the calcium binding-epidermal growth factor (cbEGF)-like domain. Our study extends the mutation spectrum of CCA and confirms a relationship between mutations in the FBN2 gene and the clinical findings of CCA.

Liu, Wei; Zhao, Ning; Li, Xue-fu; Wang, Hong; Sui, Yu; Lu, Yong-ping; Feng, Wen-hua; Ma, Chao; Han, Wei-tian; Jiang, Miao



Patch structure, fire-scar formation, and tree regeneration in a large mixed-severity fire in the South Dakota Black Hills, USA  

Microsoft Academic Search

We compared patch structure, fire-scar formation, and seedling regeneration in patches of low, moderate, and high burn severity following the large (~34 000 ha) Jasper fire of 2000 that occurred in ponderosa pine (Pinus ponder- osa Dougl. ex P. & C. Laws.) forests of the Black Hills of South Dakota, USA. This fire created a patchy mosaic of effects, where

Leigh B. Lentile; Frederick W. Smith; Wayne D. Shepperd



R E S E A R C H A R T I C L E Vegetation Recovery in Slash-Pile Scars Following  

E-print Network

R E S E A R C H A R T I C L E Vegetation Recovery in Slash-Pile Scars Following Conifer Removal piles to reduce woody residues from forest restoration practices generates intense, prolonged heating, with adverse effects on soils and vegetation. In this study, we examined veg- etation responses to pile burning

Halpern, Charles B.


Cheiloplasty in Post-burn Deformed Lips.  


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



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

PubMed Central

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

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



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



Evaluation of plantar flexion contracture contribution during the gait of children with Duchenne muscular dystrophy.  


Because of extensor weakness, children with Duchenne muscular dystrophy (DMD) maintain internal flexion moments at the joints of the lower extremities when they walk. We believe that at the ankle, the plantar flexion moments caused by contractures may contribute significantly to the production of the net ankle flexion moment during the gait in these children. The goal of the present study is to quantify ankle plantar flexion passive moments that may be associated with the presence of flexion contractures and to estimate their contribution to the net moment during the gait of children with DMD. Kinematic and kinetic parameters were collected during gait of eleven subjects with DMD. Ankle plantar flexion passive moments were also measured experimentally during the same session. Fourteen control children participated in the study in order to have normal reference values. The presence of ankle plantar flexion contractures in children with DMD was reflected by a rigidity coefficient obtained at a common moment of -7 Nm that was higher for these children (0.75 Nm/degrees vs. 0.48 Nm/degrees; p<0.05). The relative passive moment contribution to the net plantar flexion moments was higher for the children with DMD at the end of the lengthening phase of the plantar flexors (25% vs. 18%; p<0.05). We believe that the passive moments can compensate for the presence of progressive muscle weakness in the children with DMD and help these children with gait. PMID:17977021

Gaudreault, Nathaly; Gravel, Denis; Nadeau, Sylvie



Treatment of knee contracture in cerebral palsy by hamstring lengthening, posterior capsulotomy, and quadriceps mechanism shortening.  


Results of surgery to correct fixed flexion contracture of the knee and improve voluntary knee extension in 39 knees in 20 children (11 females, 9 males; mean age 12 years 8 months, age range 5 to 20 years) with cerebral palsy were analyzed. All patients had neuromotor disease and 18 children had spastic diplegia or quadriplegia. All patients could initiate voluntary knee extension but lacked full passive extension. Five patients (10 knees) were free walkers with a mean motor severity index of 19 and mean fixed knee contracture of 20 degrees. Fifteen patients (29 knees) were not free walkers and 13 were wheelchair ambulators. They had a mean motor severity index of 8 and mean fixed knee contractures of 30 degrees. Surgical procedures included various combinations of hamstring lengthening and/or posterior capsulotomy to allow free passive knee extension, with or without quadriceps mechanism shortening, to enhance voluntary extension. The best results were in patients who had hamstring lengthening, posterior capsulotomy, and quadriceps mechanism shortening. PMID:11769265

Beals, R K



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


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

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



Transverse musculocutaneous gracilis flap for treatment of capsular contracture in tertiary breast reconstruction.  


Capsular contracture is a common complication associated with implant-based breast reconstruction and augmentation leading to pain, displacement, and rupture. After capsulectomy and implant exchange, the problem often reappears. We performed 52 deepithelialized free transverse musculocutaneous gracilis (TMG) flaps in 33 patients for tertiary breast reconstruction or augmentation of small- and medium-sized breasts. The indications for implant removal were unnatural feel and emotion of their breasts with foreign body feel, asymmetry, pain, and sensation of cold. Anyway, most of the patients did not have a severe capsular contracture deformity. The TMG flap is formed into a cone shape by bringing the tips of the ellipse together. Depending on the contralateral breast, the muscle can also be shaped in an S-form to get more projection if needed. The operating time for unilateral TMG flap breast reconstruction or augmentation was on average 3 hours and for bilateral procedure 5 hours. One patient had a secondary revision of the donor site due to disruption of the normal gluteal fold. Eighty percent of the unilateral TMG flap reconstructions had a lipofilling procedure afterward to correct small irregularities or asymmetry. The advantages of the TMG flap such as short harvesting time, inconspicuous donor site, and the possibility of having a natural breast shape make it our first choice to treat capsular contracture after breast reconstruction and augmentation. PMID:23788151

Pülzl, Petra; Huemer, Georg M; Schoeller, Thomas



Umbilical scarring in hatchling American alligators  

USGS Publications Warehouse

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

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



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


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



Scarring of Dirac fermions in chaotic billiards.  


Scarring in quantum systems with classical chaotic dynamics is one of the most remarkable phenomena in modern physics. Previous works were concerned mostly with nonrelativistic quantum systems described by the Schrödinger equation. The question remains outstanding of whether truly relativistic quantum particles that obey the Dirac equation can scar. A significant challenge is the lack of a general method for solving the Dirac equation in closed domains of arbitrary shape. In this paper, we develop a numerical framework for obtaining complete eigensolutions of massless fermions in general two-dimensional confining geometries. The key ingredients of our method are the proper handling of the boundary conditions and an efficient discretization scheme that casts the original equation in a matrix representation. The method is validated by (1) comparing the numerical solutions to analytic results for a geometrically simple confinement and (2) verifying that the calculated energy level-spacing statistics of integrable and chaotic geometries agree with the known results. Solutions of the Dirac equation in a number of representative chaotic geometries establish firmly the existence of scarring of Dirac fermions. PMID:23005558

Ni, Xuan; Huang, Liang; Lai, Ying-Cheng; Grebogi, Celso



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

NASA Astrophysics Data System (ADS)

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

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



Burn resuscitation.  


Fluid resuscitation following burn injury must support organ perfusion with the least amount of fluid necessary and the least physiological cost. Under resuscitation may lead to organ failure and death. With adoption of weight and injury size-based formulas for resuscitation, multiple organ dysfunction and inadequate resuscitation have become uncommon. Instead, administration of fluid volumes well in excess of historic guidelines has been reported. A number of strategies including greater use of colloids and vasoactive drugs are now under investigation to optimize preservation of end organ function while avoiding complications which can include respiratory failure and compartment syndromes. Adjuncts to resuscitation, such as antioxidants, are also being investigated along with parameters beyond urine output and vital signs to identify endpoints of therapy. Here we briefly review the state-of-the-art and provide a sample of protocols now under investigation in North American burn centers. PMID:22078326

Endorf, Frederick W; Dries, David J



Periostin induces fibroblast proliferation and myofibroblast persistence in hypertrophic scarring.  


Hypertrophic scarring is characterized by the excessive development and persistence of myofibroblasts. These cells contract the surrounding extracellular matrix resulting in the increased tissue density characteristic of scar tissue. Periostin is a matricellular protein that is abnormally abundant in fibrotic dermis, however, its roles in hypertrophic scarring are largely unknown. In this report, we assessed the ability of matrix-associated periostin to promote the proliferation and myofibroblast differentiation of dermal fibroblasts isolated from the dermis of hypertrophic scars or healthy skin. Supplementation of a thin type-I collagen cell culture substrate with recombinant periostin induced a significant increase in the proliferation of hypertrophic scar fibroblasts but not normal dermal fibroblasts. Periostin induced significant increases in supermature focal adhesion formation, ? smooth muscle actin levels and collagen contraction in fibroblasts cultured from hypertrophic scars under conditions of increased matrix tension in three-dimensional type-I collagen lattices. Inhibition of Rho-associated protein kinase activity significantly attenuated the effects of matrix-associated periostin on hypertrophic scar fibroblasts and myofibroblasts. Depletion of endogenous periostin expression in hypertrophic scar myofibroblasts resulted in a sustained decrease in ? smooth muscle actin levels under conditions of reducing matrix tension, while matrix-associated periostin levels caused the cells to retain high levels of a smooth muscle actin under these conditions. These findings indicate that periostin promotes Rho-associated protein kinase-dependent proliferation and myofibroblast persistence of hypertrophic scar fibroblasts and implicate periostin as a potential therapeutic target to enhance the resolution of scars. PMID:25421393

Crawford, Justin; Nygard, Karen; Gan, Bing Siang; O'Gorman, David Brian



Iontophoretic drug delivery for the treatment of scars.  


Topical treatment of hypertrophic scars is challenging because of poor penetrability of drugs into the scar tissue. The objective of the study was to investigate the effectiveness of iontophoresis to deliver medicaments across the scar epidermis. Initially, biophysical studies were performed to investigate the differences between scar and normal skin epidermis obtained from cadaver. In case of scar skin epidermis, the transepidermal water loss was not significantly different from the normal skin epidermis, whereas the electrical resistivity was significantly higher. The passive permeation flux of sodium fluorescein was approximately one-third of that across the normal skin epidermis. Scanning electron microscopy studies revealed that the two membranes were alike except that the scar skin epidermis lacked follicles. Cathodal iontophoresis enhanced the delivery of sodium fluorescein across the scar skin epidermis by approximately 46 folds [51.90 ± 8.82 ng/(cm(2) h)]. However, the transport of sodium fluorescein across the scar skin epidermis was about an order of magnitude less than the normal skin epidermis. Overall, the studies suggest that iontophoresis could be utilized to overcome the barrier resistance of scar skin epidermis and treat the scar regionally. PMID:24648369

Manda, Prashanth; Angamuthu, Muralikrishnan; Hiremath, Shobharani R; Raman, Vijayasankar; Murthy, S Narasimha



Ken Burns  

NSDL National Science Digital Library

Ken Burns is a popular documentarian and, as it turns out, he is now a popular app, in a manner of speaking. This particular app gives interested parties the ability to view scenes from his documentaries (such as "Baseball" and "Jazz") in a variety of settings. The latest version allows visitors to access the Innovation playlist absolutely free while other playlists containing clips from his other programs are available for a small fee. This version is compatible with iPads running iOS 7.0 and newer.



Breast conservation therapy without capsular contracture in young augmented women using interstitial brachytherapy  

PubMed Central

Purpose To describe a breast-conserving technique using interstitial brachytherapy after lumpectomy and axillary nodal sampling in selected women who are diagnosed with breast cancer in the presence of augmentation mammoplasty. Material and methods Over the past 20 years, we have developed and improved a technique of “pinch view” image-guided catheter insertion that avoids implant puncture. Selection criteria include: 1) women of any age with either subpectoral or retroglandular, augmentation implants (silicone or saline) who were diagnosed with stages Tis, T1, T2, N0, or N1 breast cancer; 2) any pathologic subtype of malignant breast cancer was accepted; 3) microscopic tumor extent ? 3 cm; 4) axillary node negative or metastasis to 1 to 3 nodes without extracapsular extension; and 5) surgical margins clear by the NSABP “no ink on tumor” definition. More than 250 women have been successfully treated. Patients were treated with high dose rate Iridium-192 brachytherapy to 34 Gy in 10 or 32 Gy in 8 twice daily fractions. The target volume was the surgical cavity edge with 1.5 to 2 cm margin using 3-D treatment planning systems. Results The implant technique as currently employed is described. There have been no implant ruptures, and the Planning Treatment Volume (PTV-eval) exhibited at least 90% coverage by the 90% isodose line in the vast majority of cases. Dose Homogeneity Index exceeded 70% in most cases. The maximum skin dose was below the prescription dose in every case. Other than some patients with pre-existing capsular contracture, less than 5% experience new capsular contracture after interstitial brachytherapy. Conclusions A technique of reliable and reproducible accelerated partial breast irradiation is described that minimizes the risk of capsular contracture by avoiding circumferential dose to the foreign body in the breast. PMID:25097566



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.



Expanding the phenotypic spectrum of ECEL1-related congenital contracture syndromes.  


Using a combination of homozygosity mapping and whole-exome sequencing (WES), we identified a novel missense c.1819G>A mutation (G607S) in the endothelin-converting enzyme-like 1 (ECEL1) gene in a consanguineous pedigree of Turkish origin presenting with a syndrome of camptodactyly, scoliosis, limited knee flexion, significant refractive errors and ophthalmoplegia. ECEL1 mutations were recently reported to cause recessive forms of distal arthrogryposis. This report expands on the molecular basis and the phenotypic spectrum of ECEL1-associated congenital contracture syndromes. PMID:23808592

Shaaban, S; Duzcan, F; Yildirim, C; Chan, W-M; Andrews, C; Akarsu, N A; Engle, E C



Advanced proliferative diabetic retinopathy in four young patients with flexion contractures (Rosenbloom syndrome).  


In this report, we present four patients with type 1 diabetes of long duration (more than 20 years) who had multiple joint contractures (Rosenbloom syndrome) and who presented with reduced vision and advanced proliferative diabetic retinopathy. All of the cases had short stature which was non-familial and all had other microvascular complications (nephropathy and neuropathy). It seems that limited joint mobility (LJM) is a risk factor not only for microvascular complications, but also for more severe and advanced proliferative retinopathy. PMID:18398578

Riazi-Esfahani, M; Asghari, H; Piri, N



Adduction contracture of the shoulder due to fibrous long head of the triceps in children  

Microsoft Academic Search

Objective  To evaluate the clinical and functional results of surgical treatment for fibrous long head of the triceps in children.\\u000a \\u000a \\u000a \\u000a Materials and methods  Data were analyzed from 32 patients (38 shoulders) aged over 5 years of age from August 1995 to December 2004. The adduction\\u000a contracture, elbow flexed angles when the scapula was held in the chest wall, and scapulo-humeral angles in radiographs

Nguyen Ngoc Hung



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.



Scar Intensity Statistics in the Position Representation  

E-print Network

We obtain general predictions for the distribution of wave function intensities in position space on the periodic orbits of chaotic ballistic systems. The expressions depend on effective system size N, instability exponent lambda of the periodic orbit, and proximity to a focal point of the orbit. Limiting expressions are obtained that include the asymptotic probability distribution of rare high-intensity events and a perturbative formula valid in the limit of weak scarring. For finite system sizes, a single scaling variable lambda N describes deviations from the semiclassical N -> infinity limit.

K. Damborsky; L. Kaplan



Burning plasmas  

SciTech Connect

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

Furth, H.P.; Goldston, R.J.; Zweben, S.J. (Princeton Univ., NJ (USA). Plasma Physics Lab.); Sigmar, D.J. (Massachusetts Inst. of Tech., Cambridge, MA (USA))



The Role of Scar Origin in Shaping Men's Body Image.  


Men generally have a more positive body image than women. However, the extent to which scars negatively influence men's body image is uncertain. The aim of the current study was to assess body image in men with and without scars while taking scar origin into account (nonsuicidal self-harming injuries [NSSI] vs. accidents or surgery). One hundred and nine men (n = 19 with NSSI) and 185 women (n = 96 with NSSI) filled in multidimensional body image questionnaires. Results indicate that on most clinical subscales women had a significantly more negative body image compared with men. However, within a subsample whose scars resulted from NSSI, gender differences vanished. Among men, scar origin was significantly associated with negative body image after partialling out scar characteristics, age, and borderline symptomatology. The visibility of scars was not associated with more severe body image disturbances. The results of our study indicate that self-inflicted scars adversely affect body image. Although women generally reported having a more negative body image, disturbances in body image should not be neglected among men, especially in those who have self-inflicted scars. PMID:24785425

Dyer, Anne; Mayer-Eckhard, Lennart; White, Andrew J; Alpers, Georg W



A Mechanomodulatory Device to Minimize Incisional Scar Formation  

PubMed Central

Objective To mechanically control the wound environment and prevent cutaneous scar formation. Approach We subjected various material substrates to biomechanical testing to investigate their ability to modulate skin behavior. Combinations of elastomeric materials, adhesives, and strain applicators were evaluated to develop topical stress-shielding devices. Noninvasive imaging modalities were utilized to characterize anatomic site-specific differences in skin biomechanical properties in humans. The devices were tested in a validated large animal model of hypertrophic scarring. Phase I within-patient controlled clinical trials were conducted to confirm their safety and efficacy in scar reduction in patients undergoing abdominoplasty surgery. Results Among the tested materials and device applicators, a polymer device was developed that effectively off-loaded high tension wounds and blocked pro-fibrotic pathways and excess scar formation in red Duroc swine. In humans, different anatomic sites exhibit unique biomechanical properties that may correlate with the propensity to form scars. In the clinical trial, utilization of this device significantly reduced incisional scar formation and improved scar appearance for up to 12 months compared with control incisions that underwent routine postoperative care. Innovation This is the first device that is able to precisely control the mechanical environment of incisional wounds and has been demonstrated in multiple clinical trials to significantly reduce scar formation after surgery. Conclusion Mechanomodulatory strategies to control the incisional wound environment can significantly reduce pathologic scarring and fibrosis after surgery. PMID:24527342

Wong, Victor W.; Beasley, Bill; Zepeda, John; Dauskardt, Reinhold H.; Yock, Paul G.; Longaker, Michael T.; Gurtner, Geoffrey C.




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


Vicious cycle of multiple invasive treatments in a hemophilic inhibitor positive child with resistant knee flexion contracture, a case report.  


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

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



Safety and tolerability of collagenase Clostridium histolyticum and fasciectomy for Dupuytren’s contracture  

PubMed Central

Safety was evaluated for collagenase Clostridium histolyticum (CCH) based on 11 clinical trials (N = 1082) and compared with fasciectomy data in a structured literature review of 48 European studies (N = 7727) for treatment of Dupuytren’s contracture. Incidence of adverse events was numerically lower with CCH vs. equivalent complications from fasciectomy (median [range] incidence), including nerve injury (0% vs. 3.8% [0%?50+%]), neurapraxia (4.4% vs. 9.4% [0%?51.3%]), complex regional pain syndrome (0.1% vs. 4.5% [1.3%?18.5%]) and arterial injury (0% vs. 5.5% [0.8%?16.5%]). Tendon injury (0.3% vs. 0.1% [0%?0.2%]), skin injury (16.2% vs. 2.8% [0%?25.9%]) and haematoma (77.7% vs. 2.0% [0%?25%]) occurred at a numerically higher incidence with CCH than surgery. Adverse events in CCH trials not reported after fasciectomy included peripheral oedema; extremity pain; injection site pain, haemorrhage and swelling; tenderness; pruritus and lymphadenopathy. CCH-related adverse events were reported as predominantly injection-related and transient. These results may support clinical decision-making for treatment of Dupuytren’s contracture. PMID:24698851

Wilbrand, S.; Gerber, R. A.; Chapman, D.; Szczypa, P. P.



Nd:YAG Laser Treatment of Keloids and Hypertrophic Scars  

PubMed Central

Pathological cutaneous scars such as keloids and hypertrophic scars (HSs) are characterized by a diffuse redness that is caused by the overgrowth of capillary vessels due to chronic inflammation. Our group has been using long-pulsed, 1064-nm Nd:YAG laser in noncontact mode with low fluence and a submillisecond pulse duration to treat keloids and hypertrophic scars since 2006 with satisfactory results. The present study examined the efficacy of this approach in 22 Japanese patients with keloids (n = 16) or hypertrophic scars (n = 6) who were treated every 3 to 4 weeks. Treatment settings were as follows: 5 mm spot size diameter; 14 J/cm2 energy density; 300 ?s exposure time per pulse; and 10 Hz repetition rate. The responses of the pathological scars to the treatment were assessed by measuring their erythema, hypertrophy, hardness, itching, and pain or tenderness. Moreover, skin samples from 3 volunteer patients were subjected to histological evaluation and 5 patients underwent thermography during therapy. The average total scar assessment score dropped from 9.86 to 6.34. Hematoxylin and eosin staining and Elastica Masson-Goldner staining showed that laser treatment structurally changed the tissue collagen. This influence reached a depth of 0.5 to 1 mm. Electron microscopy revealed plasma protein leakage, proteoglycan particles, and a change in the collagen fiber fascicles. Further analyses revealed that noncontact mode Nd:YAG laser treatment is highly effective for keloids and hypertrophic scars regardless of patient age, the origin and multiplicity of scarring, the location of the scar(s), or the tension on the scar. PMID:22259645

Akaishi, Satoshi; Koike, Sachiko; Dohi, Teruyuki; Kobe, Kyoko; Hyakusoku, Hiko; Ogawa, Rei



American Burn Association  


... burn center and disaster related information View the ABA U.S. Regional Map Click above to access the ... Member Website Fire & Burn Prevention Newsletter - Winter 2014 ABA Membership Newsletter | Spring 2014 National Burn Repository ABA ...


Avoiding Household Burns  


... Vehicle Safety En Español Injury Prevention Avoiding Household Burns On average, in the U.S., someone dies in ... minutes. There were 40,000 hospitalizations related to burn injury, including 30,000 at hospital burn centers. " ...


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.



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



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


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

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



Endostatin inhibits hypertrophic scarring in a rabbit ear model*  

PubMed Central

Objective: The present study was designed to use an in vivo rabbit ear scar model to investigate the efficacy of systemic administration of endostatin in inhibiting scar formation. Methods: Eight male New Zealand white rabbits were randomly assigned to two groups. Scar model was established by making six full skin defect wounds in each ear. For the intervention group, intraperitoneal injection of endostatin was performed each day after the wound healed (about 15 d post wounding). For the control group, equal volume of saline was injected. Thickness of scars in each group was measured by sliding caliper and the scar microcirculatory perfusion was assessed by laser Doppler flowmetry on Days 15, 21, 28, and 35 post wounding. Rabbits were euthanatized and their scars were harvested for histological and proteomic analyses on Day 35 post wounding. Results: Macroscopically, scars of the control group were thicker than those of the intervention group. Significant differences between the two groups were observed on Days 21 and 35 (p<0.05). Scar thickness, measured by scar elevation index (SEI) at Day 35 post wounding, was significantly reduced in the intervention group (1.09±0.19) compared with the controls (1.36±0.28). Microvessel density (MVD) observed in the intervention group (1.73±0.94) was significantly lower than that of the control group (5.63±1.78) on Day 35. The distribution of collagen fibers in scars treated with endostatin was relatively regular, while collagen fibers in untreated controls were thicker and showed disordered alignment. Western blot analysis showed that the expressions of type I collagen and Bcl-2 were depressed by injection of endostatin. Conclusions: Our results from the rabbit ear hypertrophic scar model indicate that systemic application of endostatin could inhibit local hypertrophic scar formation, possibly through reducing scar vascularization and angiogenesis. Our results indicated that endostatin may promote the apoptosis of endothelial cells and block their release of platelet-derived growth factor (PDGF) and fibroblast growth factor (FGF), thereby controlling collagen production by fibroblasts. Blood vessel-targeted treatment may be a promising strategy for scar therapy. PMID:23463765

Ren, Hai-tao; Hu, Hang; Li, Yuan; Jiang, Hong-fei; Hu, Xin-lei; Han, Chun-mao



Intralesional 5-fluorouracil in the treatment of keloid scars.  


Two patients with keloid scars are described. The first patient presented with extensive keloid scarring on both cheeks secondary to acne. The second patient developed a keloid scar on her chest following excision of a mole. Both patients' scars were diagnosed clinically and treated with fortnightly injections of a mixture of 5-fluorouracil and betamethasone acetate and betamethasone sodium phosphate. At each injection session up to 1.6 mL of 5-fluorouracil at a concentration of 500 mg/10 mL and 0.4 mL of betamethasone acetate and betamethasone sodium phosphate (as betamethasone acetate 3 mg in suspension and betamethasone sodium phosphate 3.9 mg in solution) were used. Multiple treatments were required to obtain resolution of the keloid scars. Improvement was maintained in both patients at 1 year post treatment. PMID:15068466

Apikian, Martine; Goodman, Greg



Subcutaneous sarcoidosis in a rhinoplasty scar.  


The presence of a subcutaneous hard bony-like lump at the lateral nasal wall after a septorhinoplasty procedure is an unfavourable result. The reported patient developed this complication 2?years after a revision surgery, in which percutaneous osteotomies were performed. An excision biopsy of the lump took place and the histopathological analysis revealed a granulomatous gigantocellular inflammation with absence of birefringent particles on polarised lamp and negative mycobacteria culture. After additional investigations, the final diagnosis was consistent with grade 2 pulmonary sarcoidosis associated with subcutaneous sarcoidosis. No treatment was initiated. The facial symptoms resolved without any additional treatment and the pulmonary function tests have not deteriorated after 1?year of follow-up. The polymorphism of cutaneous lesions in sarcoidosis, the absence of systemic symptoms and the unrecognised entity of subcutaneous sarcoidosis in a scar illustrate the diagnostic challenge with this patient. PMID:25819832

Dulguerov, Nicolas; Vankatova, Lenka; Landis, Basile Nicolas



Collagen nerve wrap for median nerve scarring.  


Nerve wrapping materials have been manufactured to inhibit nerve tissue adhesions and diminish inflammatory and immunologic reactions in nerve surgery. Collagen nerve wrap is a biodegradable type I collagen material that acts as an interface between the nerve and the surrounding tissues. Its main advantage is that it stays in place during the period of tissue healing and is then gradually absorbed once tissue healing is completed. This article presents a surgical technique that used a collagen nerve wrap for the management of median nerve tissue adhesions in 2 patients with advanced carpal tunnel syndrome due to median nerve scarring and adhesions. At last follow-up, both patients had complete resolution with no recurrence of their symptoms. Complications related to the biodegradable material were not observed. PMID:25665110

Kokkalis, Zinon T; Mavrogenis, Andreas F; Ballas, Efstathios G; Papagelopoulos, Panayiotis J; Soucacos, Panayotis N




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



BKL maps, Poincaré sections, and quantum scars  

NASA Astrophysics Data System (ADS)

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

Lecian, Orchidea Maria



Hypertrophic scar model in the rabbit ear: a reproducible model for studying scar tissue behavior with new observations on silicone gel sheeting for scar reduction.  


Hypertrophic scarring poses a clinically relevant problem as it can be cosmetically disfiguring and functionally debilitating. A lack of animal models has hindered an understanding of the pathogenesis and development of new treatment strategies therefore has largely been empiric. Our group has developed a unique hypertrophic scar (HS) model in the rabbit ear. The model has been reproducible, quantifiable, and measurable over a time period of 1 month. We describe the development as well as the reliability and responsiveness of this model to different therapeutic agents, such as TGF-beta blockade, silicone occlusion, and application of collagen-synthesis inhibitors. Moreover, it has given insights into the mechanism of action of silicone sheeting occlusive treatment and ultimately suggests that the epidermis plays a critical role in the development of HS. Additionally, we will present new data supporting the importance of the epidermis and further clarify the mechanism of action of silicone sheeting. When a semi-occlusive polyurethane film was left in place for an additional time period, scar formation was reduced. HSs of this model covered with silicone sheets and five layers of Tegaderm showed a significant scar reduction by 80% compared with wounds with only one layer of Tegaderm. The HS model in the rabbit ear is a highly reliable, responsive, and practical model for studying scar tissue behavior. Furthermore, our data suggest that the degree and the duration of occlusion are most important for reducing scar tissue formation. PMID:17727466

Kloeters, Oliver; Tandara, Andrea; Mustoe, Thomas A



A New Method to Measure Post-Traumatic Joint Contractures in the Rabbit Knee  

PubMed Central

A new device and method to measure rabbit knee joint angles are described. The method was used to measure rabbit knee joint angles in normal specimens and in knee joints with obvious contractures. The custom-designed and manufactured gripping device has two clamps. The femoral clamp sits on a pinion gear that is driven by a rack attached to a materials testing system. A 100 N load cell in series with the rack gives force feedback. The tibial clamp is attached to a rotatory potentiometer. The system allows the knee joint multiple degrees-of-freedom (DOF). There are two independent DOF (compression-distraction and internal-external rotation) and two coupled motions (medial-lateral translation coupled with varus-valgus rotation; anterior-posterior translation coupled with flexion-extension rotation). Knee joint extension-flexion motion is measured, which is a combination of the materials testing system displacement (converted to degrees of motion) and the potentiometer values (calibrated to degrees). Internal frictional forces were determined to be at maximum 2% of measured loading. Two separate experiments were performed to evaluate rabbit knees. First, normal right and left pairs of knees from four New Zealand White (NZW) rabbits were subjected to cyclic loading. An extension torque of 0.2 Nm was applied to each knee. The average change in knee joint extension from the first to the fifth cycle was 1.9 deg ± 1.5 deg (mean ± sd) with a total of 49 tests of these eight knees. The maximum extension of the four left knees (tested 23 times) was 14.6 deg ± 7.1 deg, and of the four right knees (tested 26 times) was 12.0 deg ± 10.9 deg. There was no significant difference in the maximum extension between normal left and right knees. In the second experiment, nine skeletally mature NZW rabbits had stable fractures of the femoral condyles of the right knee that were immobilized for five, six or 10 weeks. The left knee served as an unoperated control. Loss of knee joint extension (flexion contracture) was demonstrated for the experimental knees using the new methodology where the maximum extension was 35 deg ± 9 deg, compared to the unoperated knee maximum extension of 11 deg ± 7 deg, 10 or 12 weeks after the immobilization was discontinued. The custom gripping device coupled to a materials testing machine will serve as a measurement test for future studies characterizing a rabbit knee model of post-traumatic joint contractures. PMID:14986415

Hildebrand, Kevin A.; Holmberg, Michael; Shrive, Nigel



Analysis of efficacy and safety of treatment with collagenase Clostridium histolyticum among subgroups of patients with Dupuytren contracture.  


Collagenase Clostridium histolyticum (CCH) injection is a nonoperative treatment of hand contractures from Dupuytren disease. This study assessed the efficacy and safety of CCH in several subgroups of patients with increased surgical risk.Data were pooled from 3 randomized, placebo-controlled, double-blind trials. This analysis included 271 patients with metacarpophalangeal (n = 167) or proximal interphalangeal (n = 104) joint contractures greater than or equal to 20 degrees treated with CCH (0.58 mg collagenase per injection). Subgroups included age, sex, and diabetes status. End points included rate of clinical success (reduction in contracture to 0-5 degrees of normal) and percentage of adverse events.There was no significant difference in clinical success by age, diabetes status, or sex with 63% reaching the end point. There was no difference in adverse events among the subgroups, with peripheral edema, contusion, and injection-site hemorrhage being most common.High-risk subgroups do not demonstrate differences in efficacy or safety with CCH treatment of Dupuytren-related contractures. PMID:23511746

Raven, Raymond B; Kushner, Harvey; Nguyen, Dat; Naam, Nash; Curtin, Catherine



The effect of knee flexion contracture following total knee arthroplasty on the energy cost of walking.  


This study evaluated the energy cost of walking (Cw) with knee flexion contractures (FC) simulated with a knee brace, in total knee arthroplasty (TKA) recipients (n=16) and normal controls (n=15), and compared it to baseline (no brace). There was no significant difference in Cw between the groups at baseline but TKA recipients walked slower (P=0.048) and with greater knee flexion in this condition (P=0.003). Simulated FC significantly increased Cw in both groups (TKA P=0.020, control P=0.002) and this occurred when FC exceeded 20° in the TKA group and 15° in the controls. Reported perceived exertion was only significantly increased by FC in the control group (control P<0.001, TKA P=0.058). Simulated knee FCs less than 20° do not increase Cw or perceived exertion in TKA recipients. PMID:23725927

Murphy, Michael T; Skinner, Tina L; Cresswell, Andrew G; Crawford, Ross W; Journeaux, Simon F; Russell, Trevor G



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


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. PMID:24585410

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



Arthrogryposis (multiple congenital contractures): diagnostic approach to etiology, classification, genetics, and general principles.  


Arthrogryposis has been the term used to describe multiple congenital contractures for over a century. It is a descriptive term and present in over 400 specific conditions. Responsible gene abnormalities have been found for more than 150 specific types of arthrogryposis. Decreased fetal movement is present in all affected individuals which leads to a variety of secondary deformations. Decreased fetal movement (fetal akinesia) is associated with increased connective tissue around the immobilized joint, skin dimpling overlying the immobilized joint, disuse atrophy of the muscles that mobilize the joint and abnormal surface of the joint depending on the immobilized position. Other frequently observed features include: micrognathia, mildly shortened limbs, intrauterine growth restriction, pulmonary hypoplasia and short and/or immature gut. Primary etiologies include neuropathic processes; myopathic processes; end-plate abnormalities; maternal illness, trauma and drugs; limitation of fetal space; vascular compromise; and metabolic disorders to the developing embryo/fetus. PMID:24704792

Hall, Judith G



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


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



Transcriptional Abnormalities of Hamstring Muscle Contractures in Children with Cerebral Palsy  

PubMed Central

Cerebral palsy (CP) is an upper motor neuron disease that results in a spectrum of movement disorders. Secondary to the neurological lesion, muscles from patients with CP are often spastic and form debilitating contractures that limit range of motion and joint function. With no genetic component, the pathology of skeletal muscle in CP is a response to aberrant complex neurological input in ways that are not fully understood. This study was designed to gain further understanding of the skeletal muscle response in CP using transcriptional profiling correlated with functional measures to broadly investigate muscle adaptations leading to mechanical deficits. Biospsies were obtained from both the gracilis and semitendinosus muscles from a cohort of patients with CP (n?=?10) and typically developing patients (n?=?10) undergoing surgery. Biopsies were obtained to define the unique expression profile of the contractures and passive mechanical testing was conducted to determine stiffness values in previously published work. Affymetrix HG-U133A 2.0 chips (n?=?40) generated expression data, which was validated for selected transcripts using quantitative real-time PCR. Chips were clustered based on their expression and those from patients with CP clustered separately. Significant genes were determined conservatively based on the overlap of three summarization algorithms (n?=?1,398). Significantly altered genes were analyzed for over-representation among gene ontologies and muscle specific networks. The majority of altered transcripts were related to increased extracellular matrix expression in CP and a decrease in metabolism and ubiquitin ligase activity. The increase in extracellular matrix products was correlated with mechanical measures demonstrating the importance in disability. These data lay a framework for further studies and development of novel therapies. PMID:22956992

Smith, Lucas R.; Chambers, Henry G.; Subramaniam, Shankar; Lieber, Richard L.



Medicinal Plants for the Treatment of Hypertrophic Scars  

PubMed Central

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

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



MRI evaluation of RF ablation scarring for atrial fibrillation treatment  

NASA Astrophysics Data System (ADS)

This study presents a multi-modality image registration method that evaluates left atrial scarring after radiofrequency (RF) ablation for pulmonary vein (PV) isolation. Our group has recently developed a delayed enhancement magnetic resonance imaging (DE-MRI) method with the potential to visualize and monitor non-invasively post-ablation scarring in the left atrium and the PV ostia. We wished to compare the 3D configuration of scarring in the DE-MRI image and the ablation points recorded by electroanatomical mapping (EAM) system, hypothesizing that scarring detected by DE-MRI overlaps with ablation points recorded by the EAM system used in the procedure. Methods and Results: Three data sets, DE-MRI images and pulmonary vein MR angiography (PV-MRA) images, and EAM data (CARTO-XP, Biosense-Webster, Inc., Diamond Bar, CA) from a patient who underwent PV ablation, were used for the multi-modal image registration. Contrast-enhanced MR imaging was performed 38 days after the ablation procedure. PV-MRA and DE-MRI were fused by intensity-based rigid registration. Scar tissue was extracted from the DE-MRI images using multiple threshold values. EAM data was further fused with segmented PV-MRA by the iterative closest point algorithm (ICP). After registration, the distance from PV-MRA to the scar was 2.6 +/- 2.1 mm, and from ablation points to the surface of the scar was 2.5 +/- 2.3 mm. The fused image demonstrates the 3D relationship between the PV ostia, the scar and the EAM recording of ablation points. Conclusion: Multimodal data fusion indicated that the scar tissue lesion after PV isolation showed good overlap with the ablation points.

Ishihara, Yuri; Nazafat, Reza; Wylie, John V.; Linguraru, Marius G.; Josephson, Mark E.; Howe, Robert D.; Manning, Warren J.; Peters, Dana C.



Burns and Ulcerative Colitis  

PubMed Central

Summary The co-existence of an extensive burn with a systemic disease negatively affects the outcome of the burn as well as the progress of the disease. A case report is presented regarding a 70-yr-old female patient with 45% total body surface area burns and ulcerative colitis under treatment. The outcome of the burns is described and it is pointed out that the healing process of the burns and the remission of the ulcerative colitis were related. PMID:21991043

Castana, O.; Makrodimou, M.; Mantzaris, G.; Tsandoulas, Z.; Prigouris, S.; Alexakis, D.



Burns and ulcerative colitis.  


The co-existence of an extensive burn with a systemic disease negatively affects the outcome of the burn as well as the progress of the disease. A case report is presented regarding a 70-yr-old female patient with 45% total body surface area burns and ulcerative colitis under treatment. The outcome of the burns is described and it is pointed out that the healing process of the burns and the remission of the ulcerative colitis were related. PMID:21991043

Castana, O; Makrodimou, M; Mantzaris, G; Tsandoulas, Z; Prigouris, S; Alexakis, D



Abdominal scar endometriosis after caesarean section: report of five cases.  


Scar endometriosis is an under-appreciated or misdiagnosed phenomenon in general surgery and may eventually be more common than reflected in the literature. We herein report five cases of scar endometriosis that were treated in our surgical department one to five years after Caesarean section. Scar endometriosis should be considered when the symptoms are present in a cyclic manner mostly after gynaecological operations and worsening during menstruation. Diagnosis is mainly based upon a high index ofsuspicion. The treatment of choice is surgical resection. PMID:22224353

Pikoulis, E; Karavokiros, J; Veltsista, K; Diamantis, T; Griniatsos, J; Basios, N; Avgerinos, E; Marinos, G; Kaliakmanis, V



Defect Scars on Flexible Surfaces with Crystalline Order  

NASA Astrophysics Data System (ADS)

The crystallography of two-dimensional particle packings on flexible surfaces of spherical topology is investigated. Examples are viral capsids and crystalline vesicles. Computer simulations of dynamically triangulated surfaces are employed to study the shape and structure of lattice defects as a function of the Föppl von Kármán number ?. We find that grain-boundary scars become much more fuzzy with increasing temperature, that the size of grain-boundary scars saturates with increasing vesicle radius, and that the buckling transition shifts to higher values of ? due to the presence of scars.

Kohyama, Tamotsu; Gompper, Gerhard



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


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



Effects of scars on crystalline shell stability under external pressure  

E-print Network

We study how the stability of spherical crystalline shells under external pressure is influenced by the defect structure. In particular, we compare stability for shells with a minimal set of topologically-required defects to shells with extended defect arrays (grain boundary "scars" with non-vanishing net disclination charge). We perform Monte Carlo simulations to compare how shells with and without scars deform quasi-statically under external hydrostatic pressure. We find that the critical pressure at which shells collapse is lowered for scarred configurations that break icosahedral symmetry and raised for scars that preserve icosahedral symmetry. The particular shapes which arise from breaking of an initial icosahedrally-symmetric shell depend on the F\\"oppl-von K\\'arm\\'an number.

Duanduan Wan; Mark J. Bowick; Rastko Sknepnek



Impact of Postthyroidectomy Scar on the Quality of Life of Thyroid Cancer Patients  

PubMed Central

Background Surgical scars are crucial cosmetic problem, especially when in exposed areas such as the anterior neck following thyroidectomy. Objective To evaluate the impact of post-thyroidectomy scars on quality of life (QoL) of thyroid cancer patients and identify the relationship between scar characteristics and QoL. Methods Patients with post-thyroidectomy scars on the neck were recruited. QoL was measured using the Dermatology Life Quality Index (DLQI). Scar characteristics were graded according to Vancouver scar scale (VSS) score. Results Ninety-seven patients completed a battery of questions at the time of enrollment. Post-thyroidectomy scars were classified according to morphology as linear flat scars, linear bulging scars, hypertrophic scars or adhesive scars. There were 32 patients (33.0%), 9 patients (9.3%), 41 patients (42.3%) and 15 patients (15.5%), respectively, in each group. The mean total DLQI score was 9.02. Domain 2 (daily activities, 2.87 points), which includes questions about clothing, was the most greatly impacted among patients. The total DLQI scores of patients who have experienced scar-related symptoms were significantly higher than those of patients without symptoms (p<0.05). The VSS scores were 3.09 for linear flat scars, 6.89 for linear bulging scars, 6.29 for hypertrophic scars and 5.60 for adhesive scars. However, the DLQI scores did not significantly differ among scar types or VSS scores. Conclusion Post-thyroidectomy scars on the neck affect the QoL of thyroid cancer patients regardless of scar type. Therefore, clinicians should pay attention to the psychological effects of scars on patients and take care to minimize post-thyroidectomy scar. PMID:25473220

Choi, Yuri; Lee, Ji Hye; Kim, Yeon Hee; Lee, Yong Sang; Chang, Hang-Seok; Park, Cheong Soo



Growth and Development of Scar Tissue in Lavigeria Gastropod Shells of Lake Tanganyika, East Africa  

Microsoft Academic Search

The shells of Lake Tanganyika gastropods exhibit high levels of scarring from failed predation attempts by various crab species (Phifer 2000, Socci 2001). Many individuals exhibit multiple scars. This project aims to look at the rate of gastropod self-healing\\/ re-growth and the nature of the shell scar tissue. In many other organisms, vertebrates for example, scars are formed rapidly, exhibiting

Ellinor Michel


Scar asymmetry after abdominoplasty: the unexpected role of seroma.  


Achievement of symmetry remains one of the goals of cosmetic procedures. Interestingly, scar asymmetry after abdominoplasty has been rarely considered a complication. However, this can have a significant impact on patient and surgeon satisfaction. This study identifies silent seromas as a potential cause of scar asymmetry.Among abdominoplasty procedures in a university hospital institution over a 30 months' period (October 1, 2007 to April 1, 2010), we retrospectively identified 6 patients who developed abdominal scar asymmetry only 3 months postoperatively and without any early warning complications (hematoma, seroma, or infection). Clinical examination was completed by abdominal diagnostic ultrasonography. Seroma capsulectomy under local anesthesia was performed in all cases.In all patients clinically presenting late abdominal scar asymmetry, ultrasonography confirmed the presence of an encapsulated chronic seroma. Surgical capsulectomy under local anesthesia resulted in reestablishment of former symmetry and high patient satisfaction. No complications such as wound infection, dehiscence, hematoma, or recurrence of seroma were detected after revision surgery.In our experience, fibrous capsule due to chronic seromas resulted in abdominal scar deviation and asymmetry. Surgical capsulectomy followed by wearing of compressive garments resulted to be an effective treatment with pleasant aesthetic outcome and no seroma recurrence. Silent seromas should be considered as a possible etiologic factor of scar asymmetries appearing during late follow-up after abdominoplasty. PMID:23143814

di Summa, Pietro Giovanni; Wettstein, Reto; Erba, Paolo; Raffoul, Wassim; Kalbermatten, Daniel Felix



The effects of topically applied silicone gel and its silver derivative on the prevention of hypertrophic scarring in two rabbit ear-scarring models.  


Topically applied silicone gel is an effective treatment in the management of hypertrophic scars. This early study of silicone gel predates other well-controlled scientific studies that demonstrate these findings. Our well-established rabbit ear scarring model creates 7 mm punch wounds down to the bare cartilage, including the removal of the perichondrium. In this study, we employ a new model that creates 10 mm punch wounds that leaves the perichondrium intact. Both the 7 mm and new 10 mm scar models were used to study the effectiveness of silicone gel and silicone gel silver respectively on hypertrophy and the inhibition of scar formation. All samples were harvested at post-wounding day 35 for histological analysis. Silicone gel significantly reduced scar area (p=0.005), scar elevation index (p=0.03), and epidermal area (p=0.016). Silicone gel silver significantly reduced scar elevation index (p=0.004). The new 10 mm scar model resulted in more hypertrophic scarring than the typical, 7 mm wound scar model (p=0.0001). In conclusion, silicone gel and its silver derivative are effective in preventing hypertrophic scarring and scar models that leave the perichondrium intact causes scars with more hypertrophy. PMID:21665562

Jia, Shengxian; Zhao, Yanan; Mustoe, Thomas A



A case of 47,XY,+der(15),t(3;15) (p25;qll)pat presenting as partial 3p trisomy syndrome with multiple joint contractures  

Microsoft Academic Search

Partial 3p trisomy is a rare chromosomal syndrome which results in a characteristic phenotype. We present a case of partial 3;15 trisomy with clinical features of partial 3p trisomy syndrome and multiple joint contractures.

Joseph H Hersh; Robert M Greenstein; Janice C Perkins; Patricia C Reardon



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


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



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



First Aid: Burns  


... KidsHealth in the Classroom What Other Parents Are Reading Measles: What to Know Vaccines: FAQs NBA Exercise ... socket, or chemicals. The burn is on the face, hands, feet, joints, or genitals. The burn looks ...


First Aid: Burns  


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


Burns and Fire Safety  


1 Burns and Fire Safety Fact Sheet (2014) Fatalities ? 325 children ages 19 and under died from fires or ... from 1999 to 2011. 1 1999?2011 Fire/Burn Fatalities and Death Rate Among Children Ages 19 ...


Erosive burning. Modeling problems  

Microsoft Academic Search

Existing models for the erosive burning of homogeneous energetic materials ignore the fact that the burning regime can be\\u000a changed radically by exposure to a hot gas blowing over the burning surface. In other words, transition can occur from the\\u000a gasification regime at very high blowing rates (where the burning rate is determined primarily by the heat transfer from the

L. K. Gusachenko; V. E. Zarko



The burning mouth.  


Burning in the mouth in and of itself is not all that uncommon. It may result from a variety of local or generalized oral mucosal disorders, or may be secondary to referred phenomena from other locations. Primary burning mouth syndrome, on the other hand, is relatively uncommon. Burning mouth syndrome is an idiopathic pain disorder, which appears to be neuropathic in origin. Thoughts on management of secondary and particularly primary burning mouth syndrome are discussed. PMID:17849966

McDonald, John S



[Ear prostheses in burns of the external ear. Technical notes].  


Ear reconstruction is best performed with autologous tissue. However, there are selected cases in which a prosthesis may be preferred. Some patients are unwilling to undertake multiple surgical procedures, others do not accept the chest wall scar. More importantly, in severe post burn cases, the scars in the periauricular region can truly compromise the outcome of an autologous reconstruction. In such cases, the authors perform a prosthetic reconstruction which is anchored to the cranial bone by means of osteointegrated titanium screws. The method described here has been modified compared to the original Bränemark system. A new microscrew design allows the implants to be inserted in a single surgical procedure. A magnetic anchoring system avoids cumbersome external rods, and the overall size of the masses emerging from the skin is significantly reduced. These improvements increase patient comfort and compliance. PMID:7574403

Signorini, M; Rafanelli, G; Pajardi, G; Stefani, A; Venini, G



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: [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)



To burn or not to burn  

SciTech Connect

While taking a match to an oil slick may sound like the making of a chaotic inferno, emergency response specialists say burning may be the most efficient way to remove large oil spills from the ocean's surface. But tests of this technique are being resisted by environmentalists as well as the Environmental Protection Agency (EPA), which has final authority over the matter. The debate over test burning arose most recently in Alaska when a proposal to spill and then ignite 1,000 barrels of crude on the Arctic Ocean this past summer was rejected by the EPA. The EPA didn't object to the technique or to the notion of burning spilled oil. However, it contends that it's not necessary to spill thousands of gallons of oil to conduct tests, and unnecessarily pollute the environment, when plenty of oil is already available from accidental spills. Researchers disagree, claiming they won't be able to use the burning technique on an actual spill until it has been tested in a controlled experiment. Despite such concerns, the Canadian government is going ahead with a test burn off the coast of Newfoundland next year. Faced with a choice of test burning or the kind of shoreline contamination left in the wake of the Exxon Valdez disaster, Environment Canada opts for testing. Learning valuable lessons about rapid oil-spill cleanup is worth the relatively minor risks to the environment that test burning would pose.

Busch, L.



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


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



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


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<0.0001). While Lf values were similar between children with CP and TD children, this was due to highly stretched sarcomeres within the soleus muscle. Surgical manipulation of muscle-tendon unit length will thus alter muscle sarcomere length and change force generating capacity of the muscle. PMID:25242618

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



Arthroscopic release of shoulder internal rotation contracture in children with brachial plexus birth palsy.  


In children with brachial plexus birth palsy, the unopposed contraction of the shoulder internal rotators and adductors, secondary to weakness of the external rotators and abductors, leads to internal rotation contracture of the shoulder joint. Latissimus dorsi and/or teres major tendon transfers combined with open musculotendinous lengthening can improve shoulder function. Arthroscopic release of the anterior glenohumeral ligaments, capsule and upper intra-articular subscapularis tendon, with or without tendon transfer(s), can also be performed in young children to restore external rotation and abduction of the shoulder. Joint alignment, thus obtained, may provide improvement of glenohumeral joint morphology in the long term, although the extent of glenoid remodeling has not been well defined. The authors review and discuss the recent literature on arthroscopic release, with or without tendon transfers, for reduction of the glenohumeral joint subluxation and for restoration of external rotation. Both pathologies respond well to these procedures. According to the literature, arthroscopic release "alone" may be sufficient in children up to 3 years. This minimally invasive procedure restores function successfully, and leads to a centered glenohumeral joint and to glenoid remodeling. A successful arthroscopic release of the shoulder in a 2.5-year-old child is described. PMID:24205762

Kokkalis, Zinon T; Ballas, Efstathios G; Mavrogenis, Andreas F



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



The reported effects of bullying on burn-surviving children.  


There is a trend of increasing childhood aggression in America, which has been tied to bullying. Although there is growing research concerning bullying in the general pediatric population, there are limited data on bullying and its effects on children with disfigurements and physical limitations. This study was conducted to assess burned children's experience with bullying. A pretest was administered regarding experience with bullying and teasing. A curriculum regarding bullying, which incorporated the Harry Potter and the Sorcerer's Stone movie, was presented. After reviewing bullying depicted in the film and participating in a class regarding bullying, children were invited to complete a survey regarding their experience with bullying. A total of 61% of these children reported being bullied at school; 25% reported experiencing headaches or stomachaches due to bullying, and 12% reported staying home from school. Nearly 25% reported bullying as a big problem. Of those with visible scars (55%), a full 68% reported bullying as a problem, versus 54% with hidden scars (P < .05). However, those with visible scars were no more likely to tell an adult (54%) than those without (56%). Children were much more willing to disclose personal bullying experiences after participating in the class (57%) than before (45%) (P < .01). This study revealed that bullying impacts many burn-injured children and has negative effects on their physical and mental well-being. Many children (with visible or hidden scars) did not seek adult intervention for the problem. Participation in a bullying course appears to give children a forum that increases their willingness to disclose personal bullying experiences and can provide them with prevention information and a safe place to seek help. PMID:17438488

Rimmer, Ruth B; Foster, Kevin N; Bay, Curtis R; Floros, Jim; Rutter, Cindy; Bosch, Jim; Wadsworth, Michelle M; Caruso, Daniel M



Burn therapist contributions to theAmerican Burn Association and the Journal ofBurn Care and Research: a 45th anniversary review.  


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



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.



Analysis of Brush Fire Scars in Semi-Arid Urban Environments: Implications for Future Fire and Flood Hazards Using Field and Satellite Data  

NASA Astrophysics Data System (ADS)

The number of forest fires has increased dramatically over the past five years in the western United States, due to both human and natural causes. These fires commonly expand rapidly as a function of vegetation, climate as well as past and present fire fighting practices. Many urban areas, such as Phoenix, AZ have experienced extreme population growth rates over the past 50 years. A majority of the development now occurring is in desert areas that have once burned, or are currently threatened by the potential of brush fires. These regions northeast of the city of Phoenix have experienced numerous fires over the past two decades that have been expensive to fight, and caused a considerable amount of property damage. This region is also currently targeted as one of the prime suburban growth corridors in a metropolitan area. As people expand into these environments there is an increased risk of fire, and the potential of subsequent flooding focused within the scars. Therefore, the ability to predict and control fires is increasingly important in these rapidly growing areas. Remote sensing together with detailed field data has been used to characterize areas scarred by past fires with the goal of assessing the risk for burning in the future. Space and airborne data from ASTER, Landsat ETM, SIR-C, TIMS and balloon-based cameras have been combined within a GIS model to characterize existing fire scars northeast of Phoenix, AZ. These data sets were used to quantify the relationship of fire scar age to vegetative recovery, and to determine the control of local topography on fire behavior. In addition, detailed field topographic surveys were combined with sediment trap data to contrast erosion rates in several burned and unburned catchments. Initial results imply a slightly higher erosion rate in the scars and therefore increased flooding risks. The combination of remote sensing data analyses with a GIS database, constrained by careful geomorphic and sedimentological investigations, may permit city officials and urban planners to better calculate potential risks for both future fire and flood hazards within the region. By examining the spatial variability of numerous scars in one location, and given the potential to evaluate their relative ages automatically, it should be possible to establish fire recurrence intervals around any urban area. This can be compared with lightning frequency, climate, vegetation, and terrain characteristics to vastly improve the characterization of hazards associated with semi-arid environment brush fires.

Misner, T.; Ramsey, M.; Arrowsmith, R.



Comparison of the Postoperative Incidence Rate of Capsular Contracture among Different Breast Implants: A Cumulative Meta-Analysis  

PubMed Central

Background A large number of clinical studies have reported that the different materials used in breast implants were a possible cause of the different incidence rates of capsular contracture observed in patients after implantation. However, this theory lacks comprehensive support from evidence-based medicine, and considerable controversy remains. Objectives In this study, a cumulative systematic review examined breast augmentation that used implants with textured or smooth surfaces to analyze the effects of these two types of implants on the occurrence of postoperative capsular contracture. Methods We conducted a comprehensive search of literature databases, including PubMed and EMBASE, for clinical reports on the incidence of capsular contracture after the implantation of breast prostheses. We performed a cumulative meta-analysis on the incidence of capsular contracture in order from small to large sample sizes and conducted subgroup analyses according to the prosthetic material used, the implant pocket placement, the incision type and the duration of follow-up. Relative risks (RR) and 95% confidence intervals (CI) were used as the final pooled statistics. Results This meta-analysis included 16 randomized controlled trials (RCTs) and two retrospective studies. The cumulative comparison of textured and smooth breast implants showed statistical significance at 2.13 (95% CI, 1.18-3.86) when the fourth study was entered into the analysis. With the inclusion of more reports, the final results indicated that smooth breast implants were more likely to be associated with capsular contracture, with statistical significance at 3.10 (95% CI, 2.23-4.33). In the subgroup analyses, the subgroups based on implant materials included the silicone implant group and the saline implant group, with significant pooled statistical levels of 4.05 (95% CI, 1.97-8.31) and 3.12 (95% CI, 2.19-4.42), respectively. According to implant pocket placement, a subglandular group and a submuscular group were included in the analyses, and only the subglandular group had a statistically significant pooled result of 3.59 (95% CI, 2.43-5.30). Four subgroups were included in the analyses according to incision type: the inframammary incision group, the periareolar incision group, the transaxillary incision group and the mastectomy incision group. Among these groups, only the pooled results of the inframammary and mastectomy incision groups were statistically significant, at 2.82 (95% CI, 1.30-6.11) and 2.30 (95% CI, 1.17-4.50), respectively. Three follow-up duration subgroups were included in the analyses: the one-year group, the two- to three-year group and the ?five-year group. These subgroups had statistically significant results of 4.67 (95% CI, 2.35-9.28), 3.42 (95% CI, 2.26-5.16) and 2.71 (95% CI, 1.64-4.49), respectively. Conclusion In mammaplasty, the use of textured implants reduces the incidence of postoperative capsular contracture. Differences in implant pocket placement and incision type are also likely to affect the incidence of capsular contracture; however, this conclusion awaits further study. PMID:25680100

Liu, Xing; Zhou, Liang; Pan, Fuqiang; Gao, Yang; Yuan, Xi; Fan, Dongli



Scarring Effects on Tunneling in Chaotic Double-Well Potentials  

E-print Network

The connection between scarring and tunneling in chaotic double-well potentials is studied in detail through the distribution of level splittings. The mean level splitting is found to have oscillations as a function of energy, as expected if scarring plays a role in determining the size of the splittings, and the spacing between peaks is observed to be periodic of period {$2\\pi\\hbar$} in action. Moreover, the size of the oscillations is directly correlated with the strength of scarring. These results are interpreted within the theoretical framework of Creagh and Whelan. The semiclassical limit and finite-{$\\hbar$} effects are discussed, and connections are made with reaction rates and resonance widths in metastable wells.

W. E. Bies; L. Kaplan; E. J. Heller



The Modified POSAS: A Novel Approach to Defining Pathologic and Non-Pathologic Scarring  

PubMed Central

Background Scarring is a highly prevalent and multifactorial process, yet no studies to date have attempted to distinguish pathologic from non-pathologic scarring. Methods This article defines and proposes methods of classifying pathologic scarring as it pertains to clinical presentation. Results We propose a new scar scale that incorporates pain and functional impairment. Conclusion The modified POSAS scar assessment scale is the first of its kind to factor in the functional deficits, pain and pruritus of scarring into measurements of associated morbidity. This has great potential in evaluating patient response to treatment and analyzing clinical outcomes. PMID:21200219

Fearmonti, Regina; Bond, Jennifer; Erdmann, Detlev; Levin, L. Scott; Pizzo, Salvatore V; Levinson, Howard



[Cesarean scar pregnancy: a case report of conservative management].  


A caesarean scar pregnancy is a rare type of ectopic pregnancy which engages the vital prognosis either by hemorrhage or by early uterine rupture. We report the case of a 38-years-old patient who presented an ectopic pregnancy developed inside a previous caesarean section scar. The diagnosis was made at eight weeks of gestation by ultra-sound and allowed a fast management. We chose a conservative medical treatment by methotrexate both systemic and in situ. A hemorrhagic complication occured in two months of the initial treatment, requiring an endovascular therapy as well. PMID:20227196

Maheut, L; Seconda, S; Bauville, E; Levêque, J



Indium-111 octreotide uptake in the surgical scar.  


Indium-111 octreotide uptake has been reported in various somatostatin receptor positive tumors, granulomas and autoimmune diseases in which activated leucocytes may play a role, subcutaneous cavernous hemangioma and angiofibroma. We present Indium-111 octreotide uptake in a surgical abdominal scar tissue 1.5 and 6 months after surgery in a patient who had been treated for recurrent carcinoid tumor in the rectosigmoid junction. Indium-111 octreotide uptake in a surgical scar may be related to the binding to somatostatin receptors in the activated lymphocytes and fibroblasts that is previously reported. PMID:10599072

Degirmenci, B; Bekis, R; Sen, M; Durak, H; Derebek, E



Marjolin's Ulcers on the Thigh two Years after Burn.  


An 18-yr-old female patient presented to our unit two years after she had sustained a flame burn, with a three-month history of a right thigh scar ulcer. The ulcer had rapidly progressed with involvement of the sciatic nerve and infiltration of the right femur. Biopsy of the ulcer revealed squamous cell carcinoma. The patient however died shortly after admission from an overwhelming sepsis. The rarity of early onset of Marjolin's ulcer and the rapidity of fatality in this case constitute the reasons for presenting this report. PMID:21991089

Olaitan, P B; Ogbonnaya, I S



Marjolin's Ulcers on the Thigh two Years after Burn  

PubMed Central

Summary An 18-yr-old female patient presented to our unit two years after she had sustained a flame burn, with a three-month history of a right thigh scar ulcer. The ulcer had rapidly progressed with involvement of the sciatic nerve and infiltration of the right femur. Biopsy of the ulcer revealed squamous cell carcinoma. The patient however died shortly after admission from an overwhelming sepsis. The rarity of early onset of Marjolin's ulcer and the rapidity of fatality in this case constitute the reasons for presenting this report. PMID:21991089

Olaitan, P.B.; Ogbonnaya, I.S.



Dupuytren contracture recurrence project: reaching consensus on a definition of recurrence.  


The aim of this study was to determine a definition of recurrence of Dupuytren disease that could be utilized for the comparison of the results independently from the treatment used. 24 hand surgeons from 17 countries met in an international consensus conference. The participants used the Delphi method to evaluate a series of statements: (1) the need for defining recurrence, (2) the concept of recurrence applied to the Tubiana staging system, (3) the concept of recurrence applied to each single treated joint, and (4) the concept of recurrence applied to the finger ray. For each item, the possible answer was given on a scale of 1-5: 1=maximum disagreement; 2=disagreement; 3=agreement; 4=strong agreement; 5=absolute agreement. There was consensus on disagreement if 1 and 2 comprised at least 66% of the recorded answers and consensus on agreement if 3, 4 and 5 comprised at least 66% of the recorded answers. If a threshold of 66% was not reached, the related statement was considered "not defined". A need for a definition of recurrence was established. The presence of nodules or cords without finger contracture was not considered an indication of recurrence. The Tubiana staging system was considered inappropriate for reporting recurrence. Recurrence was best determined by the measurement of a specific joint, rather than a total ray. Time 0 occurred between 6 weeks and 3 months. Recurrence was defined as a PED of more than 20° for at least one of treated joint, in the presence of a palpable cord, compared to the result obtained at time 0. This study determined the need for a standard definition of recurrence and reached consensus on that definition, which we should become the standard for the reporting of recurrence. If utilized in subsequent publications, this will allow surgeons to compare different techniques and make is easier to help patients make an informed choice. PMID:25412239

Felici, N; Marcoccio, I; Giunta, R; Haerle, M; Leclercq, C; Pajardi, G; Wilbrand, S; Georgescu, A V; Pess, G



Cost-effectiveness of laser Doppler imaging in burn care in the Netherlands  

PubMed Central

Background Early accurate assessment of burn depth is important to determine the optimal treatment of burns. The method most used to determine burn depth is clinical assessment, which is the least expensive, but not the most accurate. Laser Doppler imaging (LDI) is a technique with which a more accurate (>95%) estimate of burn depth can be made by measuring the dermal perfusion. The actual effect on therapeutic decisions, clinical outcomes and the costs of the introduction of this device, however, are unknown. Before we decide to implement LDI in Dutch burn care, a study on the effectiveness and cost-effectiveness of LDI is necessary. Methods/design A multicenter randomised controlled trial will be conducted in the Dutch burn centres: Beverwijk, Groningen and Rotterdam. All patients treated as outpatient or admitted to a burn centre within 5 days post burn, with burns of indeterminate depth (burns not obviously superficial or full thickness) and a total body surface area burned of ? 20% are eligible. A total of 200 patients will be included. Burn depth will be diagnosed by both clinical assessment and laser Doppler imaging between 2–5 days post burn in all patients. Subsequently, patients are randomly divided in two groups: ‘new diagnostic strategy’ versus ‘current diagnostic strategy’. The results of the LDI-scan will only be provided to the treating clinician in the ‘new diagnostic strategy’ group. The main endpoint is the effect of LDI on wound healing time. In addition we measure: a) the effect of LDI on other patient outcomes (quality of life, scar quality), b) the effect of LDI on diagnostic and therapeutic decisions, and c) the effect of LDI on total (medical and non-medical) costs and cost-effectiveness. Discussion This trial will contribute to our current knowledge on the use of LDI in burn care and will provide evidence on its cost-effectiveness. Trial registration NCT01489540 PMID:23369360



Carburetion type burning apparatus  

SciTech Connect

A carburetion type burning apparatus is described having a carburetion chamber for evaporating liquid fuel which comprises a timer for counting time from the initiation of burning operation. An ion current detecting device is positioned in the flames for measuring an ion current in the flames (if) at the time after a predetermined time counted by the timer in which the ion current in flames is stabilized, a judging device for judging existence or non-existence of an abnormal burning state by comparing the measured ion current (if) and a predetermined open threshold value of ion current which causes an abnormal burning condition. A burning quantity device controls the quantity of fuel to be burned in response to the output from the judging device and an alarming device for generating an alarm when the judging device provides judgment of abnormal condition.

Kasada, T.



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.



Early outcomes of a sequential series of 144 patients with Dupuytren's contracture treated by collagenase injection using an increased dose, multi-cord technique.  


Collagenase clostridium histolyticum is the first and only United States Food and Drug Association approved nonsurgical treatment for patients with a palpable Dupuytren's contracture cord. However, the Food and Drug Association has only approved injection of 0.58 mg of this enzyme into one palpable Dupuytren's contracture cord at a time. This review reports on the early outcome of 144 patients treated with the entire bottle of enzyme, approximately 0.78 mg, along with use of a novel slow intracord multi-cord technique. Use of 0.78 mg of enzyme, with the slow intracord multi-cord technique is safe and allows one to inject multiple Dupuytren's contracture cords at one setting. Correction at metacarpophalangeal and proximal interphalangeal joints, taken individually, are comparable with the Collagenase Option for the Reduction of Dupuytren's studies at 43° and 33°, respectively, however due to the multi-cord injection, we achieved 94° average immediate and 76° average final combined metacarpophalangeal and proximal interphalangeal contracture releases per bottle of enzyme. Implementation of the slow intracord multi-cord technique has the potential to improve current treatment for Dupuytren's contracture with resultant significant healthcare savings. PMID:24698852

Verheyden, J R



Electrospun poly(L-lactide) fiber with ginsenoside rg3 for inhibiting scar hyperplasia of skin.  


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

Cui, Wenguo; Cheng, Liying; Hu, Changmin; Li, Haiyan; Zhang, Yuguang; Chang, Jiang



Recovery From Major Depressive Disorder Among Female Adolescents: A Prospective Test of the Scar Hypothesis  

E-print Network

Recovery From Major Depressive Disorder Among Female Adolescents: A Prospective Test of the Scar these factors may help to reduce depression incidence and recurrence among female adolescents. Keywords: major depression, consequences, psychosocial scars, adolescence, longitudinal One of the strongest predictors

Beevers, Christopher



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



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



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


RoSCAR: Robot Stock Car Autonomous Racing , Corey Montella  

E-print Network

RoSCAR: Robot Stock Car Autonomous Racing Kyle Hart , Corey Montella , Georges Petitpas , Dylan Competition, which involves no perception and limited autonomous con- trol [2]. A majority of the competition, June 16, 2014, Bretton Woods, New Hampshire, USA. Copyright is held by the owner/author(s). Publication

Spletzer, John R.


Mathematical Modeling of Wound Healing and Subsequent Scarring Literature Report  

E-print Network

Mathematical Modeling of Wound Healing and Subsequent Scarring Literature Report W. M. Boon Nov 11th , 2013 #12;Chapter 1 Introduction Wound healing is a process orchestrated by many closely related mediators. Each of these mediators plays its own specific role as the wound heals in a series of different

Vuik, Kees


Occlusion regulates epidermal cytokine production and inhibits scar formation.  


Hypertrophic scars are a major clinical problem, yet there are few therapeutics available to prevent or treat scar formation. One of the oldest known and most effective treatments is occlusion with silicone gel. However, little is known about its mode of action. It is hypothesized that occlusion increases the hydration state of the epidermis, and that this affects the epidermal and dermal cell behavior. This study investigated this possibility. Using the rabbit hypertrophic scar model, we determined that occlusion increased the hydration state of the epidermis in a dose-dependent manner, and significantly reduced the scar hypertrophy. Quantitative reverse transcription-polymerase chain reaction and immunohistochemistry showed that occlusion altered keratinocyte behavior, including keratin expression. Furthermore, occlusion significantly decreased the epidermal expression of the profibrotic cytokine interleukin-1beta and increased the epidermal expression of the antifibrotic cytokine tumor necrosis factor alpha. These alterations in the epidermal gene expression resulted in concomitant changes in the expression of the transforming growth factor-beta family members by cells in the dermis, resulting in a decrease in profibrotic signaling within the dermis. In summary, the results of this study indicate that occlusive therapy was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and antifibrotic signals produced following injury. PMID:20419876

Gallant-Behm, Corrie L; Mustoe, Thomas A



Occlusion Regulates Epidermal Cytokine Production and Inhibits Scar Formation  

PubMed Central

Hypertrophic scars are a major clinical problem, yet there are few therapeutics available to prevent or treat scar formation. One of the oldest known and most effective treatments is occlusion with silicone gel. However, little is known about its mode of action. It is hypothesized that occlusion increases the hydration state of the epidermis, and that this affects the epidermal and dermal cell behavior. This study investigated that possibility. Using the rabbit hypertrophic scar model, we determined that occlusion was able to increase the hydration state of the epidermis in a dose dependent manner, and significantly reduced the scar hypertrophy. Quantitative RT-PCR and immunohistochemistry demonstrated that occlusion altered the keratinocyte behavior, including keratin expression. Furthermore, occlusion significantly decreased the epidermal expression of the pro-fibrotic cytokine IL-1? and increased the epidermal expression of the anti-fibrotic cytokine TNF-?. Those alterations in epidermal gene expression resulted in concomitant changes in the expression of TGF-? family members by cells in the dermis, resulting in a decrease in pro-fibrotic signaling within the dermis. In summary, the results of this study indicate that occlusive therapy was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and anti-fibrotic signals produced following injury. PMID:20419876

Gallant-Behm, Corrie L; Mustoe, Thomas A



Extensive hypertrophic scarring after toxic epidermal necrolysis in a child.  


Stevens-Johnson syndrome and toxic epidermal necrolysis are some of the most serious, usually drug-induced, skin reactions. We report a case of severe toxic epidermal necrolysis in a child, which in addition to ophthalmic sequelae, caused extensive hypertrophic scarring of the skin. Such a course is uncommon and has rarely been described in the literature. PMID:23025572

Kreft, Burkhard; Lieser, Ulla; Haase, Roland; Marsch, Wolfgang Christian; Wohlrab, Johannes



Burns and military clothing.  


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



Carburetion type burning apparatus  

Microsoft Academic Search

A carburetion type burning apparatus is described having a carburetion chamber for evaporating liquid fuel which comprises a timer for counting time from the initiation of burning operation. An ion current detecting device is positioned in the flames for measuring an ion current in the flames (if) at the time after a predetermined time counted by the timer in which




“Chemical Changes: Burning  

NSDL National Science Digital Library

This lesson demonstrates how students can apply the process of identifying main idea and supporting details to show the different ways burning can chemically change matter. The students can identify these changes and discuss the details that support these changes, which will help them further understand how burning matter is considered a chemical change.

Kris Ryan



Erosive burning of propellants  

Microsoft Academic Search

The movement of the gases in the duct of solid propellant motors has an effect on the burning rate of the propellant in two cases: when there is a high ratio of burning surface to the cross-sectional area of the duct (the Pobedonostsev number) and when gasdynamic vibrations occur in the duct and cause quite high acoustic velocities along the

A. M. Klimov



Unusual persistence of Tc99m MDP uptake in the incisional scar after thoracotomy  

Microsoft Academic Search

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




Fire scars reveal variability and dynamics oF eastern Fire regimes  

Microsoft Academic Search

Fire scar evidence in eastern North America is sparse and complex but shows promise in defining the dynamics of these fire regimes and their influence on ecosystems. We review fire scar data, methods, and limitations, and use this information to identify and examine the factors influencing fire regimes. Fire scar data from studies at more than 40 sites in Eastern

Richard P. Guyette; Daniel C. Dey; Michael C. Stambaugh; Rose-Marie Muzika


Changes of Achilles tendon properties via 12-week PNF based robotic rehabilitation of ankle joints with spasticity and/or contracture.  


Ankle joint with spasticity and/or contracture can severely affect mobility and independence of stroke survivors. Due to that, the Achilles tendon(AT) is affected. In this paper, we aim to study changes of AT properties via proprioceptive neuromuscular facilitation (PNF) treatment. A robotic ankle-foot rehabilitation system has been proposed, which consists of a robotic ankle-foot platform and a graphic user interface. In this pilot study, two post-stroke patients participated and carried out a 12-week PNF treatment with the robotic system. The treatment is evaluated quantitatively in AT properties. The evaluation shows that after the PNF treatment, the average decrease of AT length is 4.1 mm (6.5%) and the recovery ratio is 30.4%, while the thickness has no change. The results indicate that the PNF based robotic rehabilitation for ankle joints with spasticity and/or contracture is effective to improve the ankle spasticity/contracture. PMID:25570183

Zhihao Zhou; Yuan Zhou; Ninghua Wang; Fan Gao; Long Wang; Kunlin Wei; Qining Wang



Hand chemical burns.  


There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes. PMID:25653184

Robinson, Elliot P; Chhabra, A Bobby



Bladder neck contracture–incidence and management following contemporary robot assisted radical prostatectomy technique  

PubMed Central

Purpose: Bladder neck contracture (BNC) is a well-recognized complication following robot-assisted radical prostatectomy (RARP) for treatment of localized prostate cancer with a reported incidence of up to 1.4%. In this series, we report our institutional experience and management results. Methods: A prospectively collected database of patients who underwent RARP by a single surgeon from 2006 to 2012 was reviewed. Watertight bladder neck to urethral anastomosis was performed over 18-French foley catheter. BNC was diagnosed by flexible cystoscopy in patients who developed symptoms of bladder outlet obstruction. Subsequently, these patients underwent cold knife bladder neck incisions. Patients then followed a strict self regimen of clean intermittent catheterization (CIC). We identify the patient demographics, incidence of BNC, associated risk factors and success of subsequent management. Results: Total of 930 patients who underwent RARP for localized prostate cancer was identified. BNC was identified in 15 patients, 1.6% incidence. Mean patient age and preoperative prostate-specific antigen was 58.8 years old and 7.83 ng/mL (range, 2.5–14.55 ng/mL) respectively. Mean estimated blood loss was 361±193 mL (range, 50–650 mL). Follow-up was mean of 23.4 months. Average time to BNC diagnosis was 5.5 months. In three patients, a foreign body was identified at bladder neck. On multivariate analysis, estimated blood loss was significantly associated with development of BNC. All patients underwent cystoscopy and bladder neck incision with a 3-month CIC regimen. Out of 15 index patients, none had a BNC recurrence over the follow-up period. Conclusions: BNC was identified in 1.6% of patients in our series following RARP. Intraoperative blood loss was a significant risk factor for BNC. In 20% of BNC patients a migrated foreign body was noted at vesicourethral anastomosis. Primary management of patients with BNC following RARP should be bladder neck incision and self CIC regimen. PMID:24693529

Parihar, Jaspreet Singh; Ha, Yun-Sok; Kim, Isaac Yi



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


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



JAMA Patient Page: Burn Injuries  


... of the American Medical Association JAMA PATIENT PAGE Burn Injuries B urns, most commonly caused by fire, ... burn injuries in the United States. TYPES OF BURNS FOR MORE INFORMATION • World Health Organization www.who. ...


IL-6 Trans-signaling-STAT3 Pathway Mediates ECM and Cellular Proliferation in Fibroblasts from Hypertrophic Scar  

PubMed Central

The molecular mechanisms behind the pathogenesis of post-burn hypertrophic scar (HS) remain unclear. Here, we investigate the role of interleukin-6 (IL-6) trans-signaling-STAT3 pathway in HS fibroblasts (HSF) derived from burned-induced HS skin. HSF showed increased Tyr 705 STAT3 phosphorylation over normal fibroblast (NF) after IL-6•IL-6R? stimulation by immunoassays. The endogenous STAT3 target gene, SOCS3, was upregulated in HSF and showed increased STAT3 binding on its promoter relative to NF in Chromatin Immunoprecipitation assay. We observed that the cell surface signaling transducer glycoprotein 130 is upregulated in HSF using Q-RT-PCR and flow cytometry. The production of excessive extracellular matrix (ECM), including the expression of alpha2 (1) procollagen (Col1A2) and fibronectin 1 (FN) were seen in HSFs. A STAT3 peptide inhibitor abrogated FN and Col1A2 gene expression in HSF indicating involvement of STAT3 in ECM production. The cellular proliferation markers Cyclin D1, Bcl-Xl and c-Myc were also upregulated in HSF and knockdown of STAT3 by siRNA attenuated c-Myc expression indicating the essential role of STAT3 in fibroblast proliferation. Taken together, our results suggest that the IL-6-trans-signaling-STAT3 pathway may play an integral role in HS pathogenesis and disruption of this pathway could be a potential therapeutic strategy for the treatment of burn-induced HS. PMID:23303450

Ray, Sutapa; Ju, Xiaoxi; Sun, Hong; Finnerty, Celeste C; Herndon, David N; Brasier, Allan R



An alternative approach in the treatment of Dupuytren's contracture skin defects: first dorsal metacarpal artery island flap.  


Skin defects are often present following surgery for Dupuytren's contracture. The first dorsal metacarpal artery island flap (FDMA) has been used by others for soft tissue reconstruction about the radial and dorsal aspect of the hand, thumb and fingers. We have used it successfully to fill the skin defects often seen following palmar fasciectomy for Dupuytren's contracture. The thin nature of the flap makes it suitable for this application. The FDMA arises from the radial artery just before the radial artery enters the first dorsal interosseous muscle and divides into three branches: 1 to the thumb, 1 to the index finger (radiodorsal branch) and a muscular branch. It is the radiodorsal branch that supplies the skin over the index finger. The island flap based on this artery includes the dorsal terminal branches of the radial nerve and venae comitantes. The flap is formed to include the fascia of the first dorsal interosseous muscle to avoid injury to a possible deep artery and to yield sufficient fat to promote venous drainage. The flap is passed subcutaneously through the first web space and sutured in place to cover the skin defect in the palm. A full thickness skin graft is used to cover the defect over the proximal phalanx of the index finger. PMID:16518236

Ozdemir, Oguz; Coskunol, E; Ozalp, T



Reliability of biomass burning estimates from savanna fires: Biomass burning in northern Australia during the 1999 Biomass Burning and Lightning Experiment B field campaign  

NASA Astrophysics Data System (ADS)

This paper estimates the two-daily extent of savanna burning and consumption of fine (grass and litter) fuels from an extensive 230,000 km2 region of northern Australia during August-September 1999 encompassing the Australian continental component of the Biomass Burning and Lightning Experiment B (BIBLE B) campaign [, 2002]. The extent of burning for the study region was derived from fire scar mapping of imagery from the advanced very high resolution radiometer (AVHRR) on board the National Oceanic and Atmospheric Administration (NOAA) satellite. The mapping was calibrated and verified with reference to one Landsat scene and associated aerial transect validation data. Fine fuel loads were estimated using published fuel accumulation relationships for major regional fuel types. It is estimated that more than 43,000 km2 was burnt during the 25 day study period, with about 19 Mt of fine (grass and litter) fuels. This paper examines assumptions and errors associated with these estimates. It is estimated from uncalibrated fire mapping derived from AVHRR imagery that 417,500 km2 of the northern Australian savanna was burnt in 1999, of which 136,405 km2, or 30%, occurred in the Northern Territory study region. Using generalized fuel accumulation equations, such biomass burning consumed an estimated 212.3 Mt of fine fuels, but no data are available for consumption of coarse fuels. This figure exceeds a recent estimate, based on fine fuels only, for the combined Australian savanna and temperate grassland biomass burning over the period 1990-1999 but is lower than past estimates derived from classification approaches. We conclude that (1) fire maps derived from coarse-resolution optical imagery can be applied relatively reliably to estimate the extent of savanna fires, generally with 70-80% confidence using the approach adopted here, over the major burning period in northern Australia and (2) substantial further field assessment and associated modeling of fuel accumulation, especially of coarse fuels, is required.

Russell-Smith, Jeremy; Edwards, Andrew C.; Cook, Garry D.



Burning mouth and saliva.  


Stomatodynia is the complaint of burning, tickling or itching of the oral cavity, and can be associated with other oral and non-oral signs and symptoms. However, the oral mucosa often appears normal, with no apparent underlying organic cause to account for the symptomatology. The etiology is unknown, though evidence points to the participation of numerous local, systemic and psychological factors. Among the local factors, saliva may play an important role in the symptoms of burning mouth. Saliva possesses specific rheological properties as a result of its chemical, physical and biological characteristics - these properties being essential for maintaining balanced conditions within the oral cavity. Patients with burning mouth present evidence of changes in salivary composition and flow, as well as a probable alteration in the oral mucosal sensory perception related particularly to dry mouth and taste alterations. On the other hand, alterations in salivary composition appear to reflect on its viscosity and symptomatology of burning mouth. Saliva is a field open to much research related to burning mouth, and knowledge of its properties (e.g., viscosity) merits special attention in view of its apparent relationship to the symptoms of burning mouth. The present study describes our clinical experience with burning mouth, and discusses some of the aspects pointing to salivary alterations as one of the most important factors underlying stomatodynia. PMID:12134125

Chimenos-Kustner, Eduardo; Marques-Soares, Maria Sueli



Obesity and burns.  


The population of overweight patients presenting to burn facilities is expected to increase significantly over the next decades due to the global epidemic of obesity. Excess adiposity mediates alterations to key physiological responses and poses challenges to the optimal management of burns. The purpose of this study is to document the general epidemiological aspects of thermal injuries in the obese population, outline relevant physiological aspects associated with obesity, and draw attention to topics relating to the management, rehabilitation, and prognosis of burns in this emerging subpopulation of patients. PMID:22274633

Goutos, Ioannis; Sadideen, Hazim; Pandya, Atisha A; Ghosh, Sudip J



Burn wound management.  


In this chapter the local therapy for burns is discussed. Between 400 and 500 children with burns are treated every year at the Red Cross War Memorial Children's Hospital in Cape Town, but in only 10% of them do the burns affect over 20% of the body surface. These latter patients are treated in special rooms equipped for intensive therapy. Open and closed methods of treatment for burns used in addition to early excision are compared. The first aim is early skin cover for areas with skin loss preserving as much function as possible and achieving the best possible cosmetic result. Local therapy must be atraumatic to prevent extension of the skin lesion. Bacterial contamination must be prevented as far as possible by keeping the wound clean. Emergency treatment and the course of wound healing up to the third week after the injury using the appropriate dressings are described. Early excision until the fifth day after the accident should be used mainly for burns of the hand, deep second degree burns of up to 10% of the body surface, deep second degree burns over the joints and deep second degree burns of the neck. It must be admitted that the depth of the burn can only be definitely estimated between the seventh and tenth day after the accident. If no autografts are available homografts or grafts from animals are used. The age of the patient, associated injuries, associated diseases and the extent of the burn all play a role in determining the prognosis. Furthermore endogenous bacterial infections, absorption of local therapeutic agents and the state of the surrounding skin do also influence the healing process. Finally the various local therapeutic agents like sulphamylon, silver sulphadiazine and betadine are discussed. A 0.05% solution of silver nitrate is also active against gram-negative infections. Skin transplants are disinfected with a solution containing one third 0.25% acetic acid, one third 3% cent hydrogen peroxide and one third saline. Hydrogen peroxide must not be applied to burns that are healing spontaneously. A classification of burns to help to choose the appropriate local therapy is proposed. PMID:7012931

Davies, M R; Rode, H; Cywes, S; van der Riet, R L



Recommendations on clinical proof of efficacy for potential scar prevention and reduction therapies.  


Cutaneous scarring is an enormous medical problem with approximately 100 million patients acquiring scars each year. Scar prevention/reduction represents a significant, and largely unmet, clinical need. Research into the prophylactic modulation of scar outcome differs from research into other disease processes as the scar is not present at the start of the study; measurements of changes from baseline are impossible. Final scar morphology is influenced by many variables. A fundamental principle that should be observed in the prospective evaluation of scar prevention/reduction therapies is that, if left untreated, wounds in treatment and control groups should have healed with identical scars. Observation of this principle will allow the detection of true treatment effects. The many variables that influence scar morphology mean that the evaluation of potential pharmaceutical products for this indication favors the use of self-controlled designs in clinical trials. In this article, we review variables that affect scar morphology and recommend the self-controlled design for clinical trials aiming to establish proof of efficacy of scar prevention and reduction pharmaceuticals. With no pharmaceutical products currently licensed for this indication, this represents a new therapeutic area. The principles discussed will also have direct relevance to the wider fields of wound healing and regenerative medicine. PMID:21793964

Bush, James A; McGrouther, D Angus; Young, V Leroy; Herndon, David N; Longaker, Michael T; Mustoe, Thomas A; Ferguson, Mark W J



Retinoic acid and glycolic acid combination in the treatment of acne scars  

PubMed Central

Introduction: Acne is a prevalent condition in society affecting nearly 80-90% of adolescents often resulting in secondary damage in the form of scarring. Retinoic acid (RA) is said to improve acne scars and reduce postinflammatory hyperpigmentation while glycolic acid (GA) is known for its keratolytic properties and its ability to reduce atrophic acne scars. There are studies exploring the combined effect of retinaldehyde and GA combination with positive results while the efficacy of retinoic acid and GA (RAGA) combination remains unexplored. Aim: The aim of this study remains to retrospectively assess the efficacy of RAGA combination on acne scars in patients previously treated for active acne. Materials and Methods: A retrospective assessment of 35 patients using topical RAGA combination on acne scars was done. The subjects were 17-34 years old and previously treated for active acne. Case records and photographs of each patient were assessed and the acne scars were graded as per Goodman and Baron's global scarring grading system (GSGS), before the start and after 12 weeks of RAGA treatment. The differences in the scar grades were noted to assess the improvement. Results: At the end of 12 weeks, significant improvement in acne scars was noticed in 91.4% of the patients. Conclusion: The RAGA combination shows efficacy in treating acne scars in the majority of patients, minimizing the need of procedural treatment for acne scars. PMID:25821727

Chandrashekar, BS; Ashwini, KR; Vasanth, Vani; Navale, Shreya



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.



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

Code of Federal Regulations, 2010 CFR

...2010-07-01 false Permits for general open burning, agricultural burning, and forestry...49.11021 Permits for general open burning, agricultural burning, and forestry...under § 49.132 Rule for general open burning permits. (b) Beginning...



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

Code of Federal Regulations, 2010 CFR

...2010-07-01 false Permits for general open burning, agricultural burning, and forestry...49.10411 Permits for general open burning, agricultural burning, and forestry...under § 49.132 Rule for general open burning permits. (b) Beginning...



Microstructural and mechanical characterization of scarred vocal folds.  


The goal of this study was to characterize the vocal folds microstructure and elasticity using nonlinear laser scanning microscopy and atomic force microscopy-based indentation, respectively. As a pilot study, the vocal folds of fourteen rats were unilaterally injured by full removal of lamina propria; the uninjured folds of the same animals served as controls. The area fraction of collagen fibrils was found to be greater in scarred tissues two months after injury than the uninjured controls. A novel mathematical model was also proposed to relate collagen concentration and tissue bulk modulus. This work presents a first step towards systematic investigation of microstructural and mechanical characteristics in scarred vocal fold tissue. PMID:25648495

Heris, Hossein K; Miri, Amir K; Ghattamaneni, Nageswara R; Li, Nicole Y K; Thibeault, Susan L; Wiseman, Paul W; Mongeau, Luc



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



[Indications for surgical treatment of hard scarring gastric ulcers].  


It was done the comparative analysis of the morphofunctional state of the upper gastrointestinal tract between 350 patients with effective conservative treatment and 104 patients with hard scarring gastric ulcers. The analysis identified the predictors of ineffective medical treatment and led to deliver the indications for timely surgical treatment. It was identified the next indications for planned organ-preserving surgical treatment of patients with hard scarring gastric ulcers: penetrating and non-healing ulcers with large or gigantic size in case of the adequate medical therapy, high-grade dysplasia and colonic metaplasia of the gastric epithelium in the borders or fundus of the ulcer,ulcers combination with fixed cardio-fundal or fundo-corporal hiatal hernias; hypotonic-hypokinetic type of the gastric and duodenal activity with the development of gastrostasis and pronounced duodenogastric reflux. PMID:24781063

Durleshter, V M; Korochanskaia, N V; Serikova, S N



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



ACE gene polymorphism and renal scarring in primary vesicoureteric reflux  

Microsoft Academic Search

The objective of this study was to investigate whether mutations of the renin-angiotensin system genes are involved in primary vesicoureteric reflux (VUR) and VUR-associated renal scarring. The M235T polymorphism of the angiotensinogen (ATG) gene, the I\\/D polymorphism of the angiotensin converting enzyme (ACE) gene, and the A1166C polymorphism of the angiotensin II type 1 receptor (AT1) gene were identified in

Ibolya Haszon; Aaron L. Friedman; Ferenc Papp; Csaba Bereczki; Sándor Baji; Tibor Bodrogi; Éva Károly; Emöke Endreffy; Sándor Túri



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



Acute and chronic animal models for excessive dermal scarring: quantitative studies.  


Excessive scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the cellular and molecular biology of these entities. Previous observations made by the authors that some surgical scars in the rabbit ear remain raised for months after wounding prompted us to investigate whether the rabbit ear might provide a model by which to study excessive dermal scarring. After establishing the model in preliminary study, 40 excisional wounds, 6 mm in diameter, were created over the ventral surface of rabbit ears. Elevated scars were treated with either intralesional triamcinolone acetonide or saline at day 16 postwounding. On day 22, 25 scar wounds were used for thorough histomorphometric analysis, 15 wounds were eliminated prior to analysis because of invagination of epithelial tissue, which made analysis difficult. Total area of scar and Hypertrophic Index, a ratio comparing scar prominence with the thickness of adjacent unwounded tissue, were measured for 25 (62 percent) of the resulting scars. Both total area of scar and Hypertrophic Index were found to be significantly decreased in the steroid-treated group (p < 0.02 and < 0.03, respectively). In a chronic form of this model, in which larger excisions were taken, an excessive accumulation of both new collagen and cartilage over 9 months was observed. An animal model for excessive dermal scarring that allows quantitation of scar formation and, at an early stage, can be modulated in a predictable way with intralesional corticosteroid treatment is presented. This model may parallel hypertrophic scarring in humans and thus might provide a tool by which to study its pathophysiology and objectively evaluate therapeutic modalities. PMID:9283567

Morris, D E; Wu, L; Zhao, L L; Bolton, L; Roth, S I; Ladin, D A; Mustoe, T A



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. ...


Three-Dimensional Electromagnetic High Frequency Axisymmetric Cavity Scars.  

SciTech Connect

This report examines the localization of high frequency electromagnetic fi elds in three-dimensional axisymmetric cavities along periodic paths between opposing sides of the cavity. The cases where these orbits lead to unstable localized modes are known as scars. This report treats both the case where the opposing sides, or mirrors, are convex, where there are no interior foci, and the case where they are concave, leading to interior foci. The scalar problem is treated fi rst but the approximations required to treat the vector fi eld components are also examined. Particular att ention is focused on the normalization through the electromagnetic energy theorem. Both projections of the fi eld along the scarred orbit as well as point statistics are examined. Statistical comparisons are m ade with a numerical calculation of the scars run with an axisymmetric simulation. This axisymmetric cas eformstheoppositeextreme(wherethetwomirror radii at each end of the ray orbit are equal) from the two -dimensional solution examined previously (where one mirror radius is vastly di ff erent from the other). The enhancement of the fi eldontheorbitaxiscanbe larger here than in the two-dimensional case. Intentionally Left Blank

Warne, Larry K.; Jorgenson, Roy E.



Tacrolimus reduces scar formation and promotes sciatic nerve regeneration.  


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



Lectin binding sites in normal, scarred, and lattice dystrophy corneas.  

PubMed Central

Normal, scarred, and dystrophic corneas were histochemically probed with a panel of 16 lectins by means of an avidin-biotin revealing system. Normal corneal epithelial cells, keratocytes, and endothelial cells expressed at least two distinct N-linked oligosaccharide subsets, of the non-bisected, biantennary and bisected, bi-/triantennary types. Corneal scars stained variably with the lectin subsets described above, and with Maclura pomifera agglutinin. Lattice dystrophy corneas showed a loss of the oligosaccharide expression observed on the plasma membranes of normal epithelial cells, and there was concurrent deposition of extracellular glycoprotein within the corneal stroma, which was of the same oligosaccharide subsets as were lost from the epithelial cell plasma membranes. This extracellular stromal glycoprotein was far more widely deposited than the amyloid and extended well beyond the stromal scarring. We propose that these observations are related and that in lattice corneal dystrophy a glycoprotein(s) is shed from the plasma membranes of epithelial cells and sequestrated within the corneal stroma, where it subsequently stimulates amyloid deposition. Images PMID:1703789

Bishop, P N; Bonshek, R E; Jones, C J; Ridgway, A E; Stoddart, R W



Burning Mouth Syndrome  

PubMed Central

Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is poorly understood with few evidence based remedies. More recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the “state of the art” today. PMID:20690412

Mock, David; Chugh, Deepika




NSDL National Science Digital Library

Developed by Professor Matthew Weinstein of Kent State University, Books2burn translates text files into a series of audio files, which may then subsequently be converted to mp3's or other formats. This program will be a great boon to scholars and the general public alike, as the application allows for the easy transfer and replication of potentially large and problematic files into a number of audio formats. Books2burn is compatible with all systems running Mac OS X.

Weinstein, Matthew


30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.  

Code of Federal Regulations, 2010 CFR

... false Coal mine waste: Burning and burned waste utilization. 816.87 Section...816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal...extinguishing operations. (b) No burning or burned coal mine waste shall be removed...



A subscapularis-preserving arthroscopic release of capsule in the treatment of internal rotation contracture of shoulder in Erb's palsy (SPARC procedure).  


The purpose of this study was to evaluate a minimally invasive subscapularis-preserving arthroscopic release of capsule in the treatment of internal rotation contracture of the shoulder due to Erb's palsy. We performed our procedure (subscapularis-preserving arthroscopic release of capsule) in 10 paediatric shoulders with an average age of 20.2 months and followed them for an average period of 41.5 months. All the patients were assessed clinically and radiologically preoperatively and postoperatively at regular intervals. The Mallet scoring system was used for analysing the results. The average gain in passive external rotation was 50°. The active internal rotation was preserved in all the cases. With the mid-term follow-up, there was no loss of the gained external rotation or the recurrence of internal rotation contracture of the shoulder. Our hypothesis has achieved its goal in preserving subscapularis, active internal rotation and treatment of internal rotation contracture of the shoulder. The success of this procedure lies in the early identification of starting of internal rotation contracture and early surgical intervention to prevent progressive permanent glenohumeral osseocartilaginous deformity. PMID:22588075

Kany, Jean; Kumar, Hemanth A; Amaravathi, Rajkumar S; Abid, Abdelaziz; Accabled, Franck; de Gauzy, Jérôme Sales; Cahuzac, Jean Philippe



Multiple congenital contractures (MCC) and cleft palate induced in goats by ingestion of piperidine alkaloid-containing plants: reduction in fetal movement as the probable cause.  


Fetal movement, observed by ultrasound imaging, was significantly reduced (P less than or equal to 0.001) in pregnant goats gavaged with Conium seed and Nicotiana glauca and temporarily reduced with fresh Conium plant. Conium seed and Nicotiana glauca induced cleft palate and multiple congenital contractures in 100% of the kids born to pregnant goats gavaged with these plants. Multiple congenital contractures included torticollis, scoliosis, lordosis, arthrogryposis, rib cage anomalies, over extension, and flexure and rigidity of the joints. However, in goats gavaged with fresh Conium plant, fetal movement was inhibited for only about 5 hours after each individual dosage and gradually returned to control levels 12 hours after dosing. Fetal malformations in this group were limited from modest to moderate contractures of the front limbs, which resolved by 8-10 weeks post partum. No cleft palates were induced. Fetal movement was not inhibited in goats fed Lupinus caudatus and no cleft palates or multiple congenital contractures were induced in their offspring. The duration of the reduction in fetal movement appears to be an important factor in the severity and permanence of the deformities, particularly with cleft palate, spinal column defects, and severe joint deviation and fixation. PMID:2381024

Panter, K E; Bunch, T D; Keeler, R F; Sisson, D V; Callan, R J



A myofibroblast-mast cell-neuropeptide axis of fibrosis in post-traumatic joint contractures: an in vitro analysis of mechanistic components.  


Previous studies have implicated a myofibroblast-mast cell-neuropeptide axis of fibrosis in pathologic joint capsules from post-traumatic contractures. The hypothesis to be tested is that joint capsule cells (JC) from human elbows with post-traumatic contractures and their interactions with mast cells (MC) and neuropeptides in the microenvironment underlie the pathogenesis of contractures. The hypothesis was tested using an in vitro collagen gel contraction model. The JC were isolated from human elbow capsules and mixed with neutralized PureCol collagen I. The gels were treated in various ways, including addition of MC (HMC-1), the neuropeptide substance P (SP), an NK1 receptor (SP receptor) antagonist RP67580 and the mast cell stabilizer ketotifen fumarate (KF). The collagen gels were released from the wells and gel size (contraction) was measured optically at multiple time points. The JC contracted collagen gels in a dose-dependent manner. This was enhanced in the presence of MC and increased further with SP. Increasing concentrations of the SP receptor antagonist, RP67580 or the mast cell stabilizer, KF decreased the magnitude of contraction. These observations identify putative mechanistic components of a myofibroblast-mast cell-neuropeptide axis of fibrosis in the joint capsules in post-traumatic contractures and potential prophylactic or therapeutic interventions. PMID:24985721

Hildebrand, Kevin A; Zhang, Mei; Befus, A Dean; Salo, Paul T; Hart, David A



Alleviation of neuropathic scar pain using autologous fat grafting.  


Traumatic wounds inflict small- and large-fiber sensory nerve damage, causing neuropathic pain in scar tissue, thus impairing patients' quality of life and leading to the development of psychological disorders. Autologous fat grafting has been clinically shown to improve scar quality, but few studies have explored the effects of this technique on pain. The purpose of this study was to assess the effect of fat grafting on treating neuropathic scar pain. From February 2008 to January 2013, 13 patients who were identified using the Douleur Neuropathique 4 Questions (scores >4/10) were enrolled in this study. The Visual Analog Scale (VAS) and Neuropathic Pain Symptom Inventory (NPSI) were used to evaluate pain preoperatively and 1 week, 4 weeks, and 24 weeks postoperatively. The mechanism of trauma, scar location and size, duration of allodynia, fat graft volume, pharmacologic therapy duration, and total follow-up time were recorded. Thirteen patients experiencing neuropathic pain were enrolled in this study. The mean ± SD age was 33.08 ± 16.35 years. The mean duration of pain was 4.29 ± 2.85 months. The mean VAS score before treatment was 7.54 ± 1.05. The mean VAS scores decreased by 4.38 ± 1.66 after 1 week of treatment (P = 0.009), 5.38 ± 2.06 after 4 weeks of treatment, and 5.62 ± 2.18 after 24 weeks of treatment. The mean NPSI scores were 49.38 ± 13.25 before treatment, 25 ± 14.4 after 1 week of treatment (P = 0.004), 21 ± 17.78 after 4 weeks of treatment, and 14.62 ± 16.88 after 24 weeks of treatment. The 13 patients followed a mean of 24 weeks; 10 (77%) of the patients had improvement of 5 or greater on the VAS score. The mean follow-up period was 19.3 ± 12.26 months (range, 6-38 months). No surgical complications were noted in this series. In our study, both VAS and NPSI scores decreased significantly, revealing that the autologous fat grafting can alleviate neuropathic scar pain 1 week after operation and in the long term. PMID:25695456

Huang, Shu-Hung; Wu, Sheng-Hua; Chang, Kao-Ping; Lin, Cen-Hung; Chang, Chih-Hau; Wu, Yi-Chia; Lee, Su-Shin; Lin, Sin-Daw; Lai, Chung-Sheng



Texture analysis of collagen second-harmonic generation images based on local difference local binary pattern and wavelets differentiates human skin abnormal scars from normal scars  

NASA Astrophysics Data System (ADS)

Quantitative methods for noninvasive diagnosis of scars are a challenging issue in medicine. This work aims to implement a texture analysis method for quantitatively discriminating abnormal scars from normal scars based on second-harmonic generation (SHG) images. A local difference local binary pattern (LD-LBP) operator combined with a wavelet transform was explored to extract diagnosis features from scar SHG images that were related to the alteration in collagen morphology. Based on the quantitative parameters including the homogeneity, directional and coarse features in SHG images, the scar collagen SHG images were classified into normal or abnormal scars by a support vector machine classifier in a leave-one-out cross-validation procedure. Our experiments and data analyses demonstrated apparent differences between normal and abnormal scars in terms of their morphological structure of collagen. By comparing with gray level co-occurrence matrix, wavelet transform, and combined basic local binary pattern and wavelet transform with respect to the accuracy and receiver operating characteristic analysis, the method proposed herein was demonstrated to achieve higher accuracy and more reliable classification of SHG images. This result indicated that the extracted texture features with the proposed method were effective in the classification of scars. It could provide assistance for physicians in the diagnostic process.

Liu, Yao; Zhu, Xiaoqin; Huang, Zufang; Cai, Jianyong; Chen, Rong; Xiong, Shuyuan; Chen, Guannan; Zeng, Haishan



Texture analysis of collagen second-harmonic generation images based on local difference local binary pattern and wavelets differentiates human skin abnormal scars from normal scars.  


Quantitative methods for noninvasive diagnosis of scars are a challenging issue in medicine. This work aims to implement a texture analysis method for quantitatively discriminating abnormal scars from normal scars based on second-harmonic generation (SHG) images. A local difference local binary pattern (LD-LBP) operator combined with a wavelet transform was explored to extract diagnosis features from scar SHG images that were related to the alteration in collagen morphology. Based on the quantitative parameters including the homogeneity, directional and coarse features in SHG images, the scar collagen SHG images were classified into normal or abnormal scars by a support vector machine classifier in a leave-one-out cross-validation procedure. Our experiments and data analyses demonstrated apparent differences between normal and abnormal scars in terms of their morphological structure of collagen. By comparing with gray level co-occurrence matrix, wavelet transform, and combined basic local binary pattern and wavelet transform with respect to the accuracy and receiver operating characteristic analysis, the method proposed herein was demonstrated to achieve higher accuracy and more reliable classification of SHG images. This result indicated that the extracted texture features with the proposed method were effective in the classification of scars. It could provide assistance for physicians in the diagnostic process. PMID:25611867

Liu, Yao; Zhu, Xiaoqin; Huang, Zufang; Cai, Jianyong; Chen, Rong; Xiong, Shuyuan; Chen, Guannan; Zeng, Haishan



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



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


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



Non-invasive evaluation of therapeutic response in keloid scar using diffuse reflectance spectroscopy.  


The pathogenesis and ideal treatment of keloid are still largely unknown, and it is essential to develop an objective assessment of keloid severity to evaluate the therapeutic response. We previously reported that our diffuse reflectance spectroscopy (DRS) system could assist clinicians in understanding the functional and structural condition of keloid scars. The purpose of this study was to understand clinical applicability of our DRS system on evaluating the scar severity and therapeutic response of keloid. We analyzed 228 spectral data from 71 subjects with keloid scars. The scars were classified into mild (0-3), moderate (4-7) and severe (8-11) according to the Vancouver scar scale. We found that as the severity of the scar increased, collagen concentration and water content increased, and the reduced scattering coefficient at 800 nm and oxygen saturation (SaO2) decreased. Using the DRS system, we found that collagen bundles aligned in a specific direction in keloid scars, but not in normal scars. Water content and SaO2 may be utilized as reliable parameters for evaluating the therapeutic response of keloid. In conclusion, the results obtained here suggest that the DRS has potential as an objective technique with which to evaluate keloid scar severity. In addition, it may be useful as a tool with which to track longitudinal response of scars in response to various therapeutic interventions. PMID:25780731

Hsu, Chao-Kai; Tzeng, Shih-Yu; Yang, Chao-Chun; Lee, Julia Yu-Yun; Huang, Lynn Ling-Huei; Chen, Wan-Rung; Hughes, Michael; Chen, Yu-Wen; Liao, Yu-Kai; Tseng, Sheng-Hao



?2-Adrenoceptor Activation Modulates Skin Wound Healing Processes to Reduce Scarring  

PubMed Central

During wound healing, excessive inflammation, angiogenesis, and differentiated human dermal fibroblast (HDF?) function contribute to scarring, whereas hyperpigmentation negatively affects scar quality. Over 100 million patients heal with a scar every year. To investigate the role of the beta 2 adrenergic receptor (?2AR) in wound scarring, the ability of beta 2 adrenergic receptor agonist (?2ARag) to alter HDF differentiation and function, wound inflammation, angiogenesis, and wound scarring was explored in HDFs, zebrafish, chick chorioallantoic membrane assay (CAM), and a porcine skin wound model, respectively. Here we identify a ?2AR-mediated mechanism for scar reduction. ?2ARag significantly reduced HDF differentiation, via multiple cAMP and/or fibroblast growth factor 2 or basic FGF (FGF2)-dependent mechanisms, in the presence of transforming growth factor beta?1, reduced contractile function, and inhibited mRNA expression of a number of profibrotic markers. ?2ARag also reduced inflammation and angiogenesis in zebrafish and CAMs in vivo, respectively. In Red Duroc pig full-thickness wounds, ?2ARag reduced both scar area and hyperpigmentation by almost 50% and significantly improved scar quality. Indeed, mechanisms delineated in vitro and in other in vivo models were evident in the ?2ARag-treated porcine scars in vivo. Both macrophage infiltration and angiogenesis were initially decreased, whereas DF function was impaired in the ?2ARag-treated porcine wound bed. These data collectively reveal the potential of ?2ARag to improve skin scarring. PMID:25050597

Le Provost, Gabrielle S; Pullar, Christine E



Non-invasive evaluation of therapeutic response in keloid scar using diffuse reflectance spectroscopy  

PubMed Central

The pathogenesis and ideal treatment of keloid are still largely unknown, and it is essential to develop an objective assessment of keloid severity to evaluate the therapeutic response. We previously reported that our diffuse reflectance spectroscopy (DRS) system could assist clinicians in understanding the functional and structural condition of keloid scars. The purpose of this study was to understand clinical applicability of our DRS system on evaluating the scar severity and therapeutic response of keloid. We analyzed 228 spectral data from 71 subjects with keloid scars. The scars were classified into mild (0-3), moderate (4-7) and severe (8-11) according to the Vancouver scar scale. We found that as the severity of the scar increased, collagen concentration and water content increased, and the reduced scattering coefficient at 800 nm and oxygen saturation (SaO2) decreased. Using the DRS system, we found that collagen bundles aligned in a specific direction in keloid scars, but not in normal scars. Water content and SaO2 may be utilized as reliable parameters for evaluating the therapeutic response of keloid. In conclusion, the results obtained here suggest that the DRS has potential as an objective technique with which to evaluate keloid scar severity. In addition, it may be useful as a tool with which to track longitudinal response of scars in response to various therapeutic interventions.

Hsu, Chao-Kai; Tzeng, Shih-Yu; Yang, Chao-Chun; Lee, Julia Yu-Yun; Huang, Lynn Ling-Huei; Chen, Wan-Rung; Hughes, Michael; Chen, Yu-Wen; Liao, Yu-Kai; Tseng, Sheng-Hao



Long QT, syndactyly, joint contractures, stroke and novel CACNA1C mutation: expanding the spectrum of Timothy syndrome.  


Timothy syndrome (TS) is 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



Intralesional Injection of Mitomycin C at Transurethral Incision of Bladder Neck Contracture May Offer Limited Benefit: TURNS Study Group  

PubMed Central

Purpose Injection of mitomycin C may increase the success of transurethral incision of the bladder neck for the treatment of bladder neck contracture. We evaluated the efficacy of mitomycin C injection across multiple institutions. Materials and Methods Data on all patients who underwent transurethral incision of the bladder neck with mitomycin C from 2009 to 2014 were retrospectively reviewed from 6 centers in the TURNS. Patients with at least 3 months of cystoscopic followup were included in the analysis. Results A total of 66 patients underwent transurethral incision of the bladder neck with mitomycin C and 55 meeting the study inclusion criteria were analyzed. Mean ± SD patient age was 64 ± 7.6 years. Dilation or prior transurethral incision of the bladder neck failed in 80% (44 of 55) of patients. Overall 58% (32 of 55) of patients achieved resolution of bladder neck contracture after 1 transurethral incision of the bladder neck with mitomycin C at a median followup of 9.2 months (IQR 11.7). There were 23 patients who had recurrence at a median of 3.7 months (IQR 4.2), 15 who underwent repeat transurethral incision of the bladder neck with mitomycin C and 9 of 15 (60%) who were free of another recurrence at a median of 8.6 months (IQR 8.8), for an overall success rate of 75% (41 of 55). Incision with electrocautery (Collins knife) was predictive of success compared with cold knife incision (63% vs 50%, p=0.03). Four patients experienced serious adverse events related to mitomycin C and 3 needed or are planning cystectomy. Conclusions The efficacy of intralesional injection of mitomycin C at transurethral incision of the bladder neck was lower than previously reported and was associated with a 7% rate of serious adverse events. PMID:25200807

Redshaw, Jeffrey D.; Broghammer, Joshua A.; Smith, Thomas G.; Voelzke, Bryan B.; Erickson, Bradley A.; McClung, Christopher D.; Elliott, Sean P.; Alsikafi, Nejd F.; Presson, Angela P.; Aberger, Michael E.; Craig, James R.; Brant, William O.; Myers, Jeremy B.



Using the pulsed dye laser to influence scar formation after breast reduction surgery: a preliminary report.  


Many patients undergoing bilateral breast reduction surgery develop problems. Foremost among these problems is scar hypertrophy and its attendant symptoms. Although there is as yet no firm prognostic indicator for hypertrophy, scars that become hypertrophic often have a particular blood vessel pattern, observable by transcutaneous microscopy, showing vessels that lay transversely across the incision line with minimal crosslinks between them. Hypertrophic scars that develop in incision lines become wide, with the final width of the scar dependent on the maximum thickness during the growth stages before maturation and resolution. Close monitoring of scars forming in the incision line using the transcutaneous microscope detected this aligned vessel pattern before overt hypertrophy was seen. Use of the Pulsed Dye Laser caused disruption in the vessel pattern, appeared to inhibit additional hypertrophic development, and promoted early maturation of scars. PMID:11037155

Shakespeare, P G; Tiernan, E; Dewar, A E; Hambleton, J



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.



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



Anti-scarring properties of different tryptophan derivatives.  


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; Kilani, Ruhangiz Taghi; Ghahary, Aziz



shRNA targeting SFRP2 promotes the apoptosis of hypertrophic scar fibroblast  

Microsoft Academic Search

Hypertrophic scars result from a dysregulated process in wound healing. Although the basic mechanism is unclear, increased\\u000a proliferation and decreased cell apoptosis are noticed in the development of hypertrophic scar. In previous study, we found\\u000a that secreted frizzled-related protein 2 (SFRP2), which was associated with cell proliferation, apoptosis, and differentiation,\\u000a was dramatically upregulated in hypertrophic scar (HS) tissue. In this

Zhicheng SunShirong; Shirong Li; Chuan Cao; Jun Wu; Bing Ma; Vu Tran



Axonal regeneration through the fibrous scar in lesioned goldfish spinal cord.  


Spontaneous nerve regeneration beyond the scar frequently occurs in fish after spinal cord lesions, in contrast to mammals. Here we examined the spatiotemporal relationship between the fibrous scar and axonal regeneration in the goldfish. Within 1 week after hemisection of the spinal cord, the open wound was closed by a fibrous scar that was demarcated from the surrounding nervous tissue by the glia limitans, which was immunoreactive for laminin. Within 1 week after hemisection, regenerating axons entered the fibrous scar, and were surrounded by laminin-coated tubular structures continuous with the glia limitans. Regenerating axons that initially entered the fibrous scar were usually accompanied by glial processes. Within 2-3 weeks after hemisection, the tubular structures became enlarged, and the regenerating axons increased in number, fasciculating in the tubules. Glial processes immunoreactive for glial fibrillary acid protein and 5-hydroxytryptamine neurons then entered the tubular structures to associate with the regenerating axons. The tubular structures developed further, creating tunnels that penetrated the fibrous scar, through which the regenerating axons passed. At 6-12 weeks after hemisection, the fibrous scar was smaller and the enlarged tunnels contained many glial processes and several axons. The findings of present study demonstrated that, following spinal lesions in goldfish, regenerating axons enter and pass the scar tissue. The regenerating axons first enter the fibrous scar with glial elements and then grow through laminin-coated tubular structures within the fibrous scar. Invasion by glial processes and neuronal elements into the tubular structures reduces the fibrous scar area and allows for more regenerating axons to pass beyond the fibrous scar. PMID:25290012

Takeda, A; Atobe, Y; Kadota, T; Goris, R C; Funakoshi, K



Sensitivity and specificity of BCG scar reading among HIV-infected children  

Microsoft Academic Search

BCG scar has been used as an indicator of vaccination with BCG in the past, but the validity of scar among HIV-positive children is still unknown. The validity of BCG scar reading among such children was estimated, using three different gold standards. The sensitivity ranged from 81.3% (95%-CI: 78.0–84.2) to 91.6% (95%-CI: 88.4–94.0), when the gold standards were, respectively, information

Joaquim Carlos Vicente Dias Van-Dunem; Luiz Cláudio Arraes de Alencar; Laura Cunha Rodrigues; Maria de Fátima Pessoa Militão de Albuquerque; Maria Eugénia Ramos; Ricardo Arraes de Alencar Ximenes



Nd:YAG Laser Treatment for Keloids and Hypertrophic Scars: An Analysis of 102 Cases  

PubMed Central

Background: The present retrospective cohort study was performed to determine the efficacy of contact-mode 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser laser for keloids and hypertrophic scars. The indication and limitations of this modality are discussed. Methods: The cohort consisted of 102 consecutive Japanese patients (23 males and 79 females) with keloids and hypertrophic scars for more than 1 year. They were treated every 3–4 weeks for 1 year with a long-pulsed 1064 nm Nd:YAG laser (Cutera, Brisbane, Calif.) in contact mode. Thirty-eight patients had hypertrophic scars and 64 had keloids. The scars were evaluated before the treatment commenced and 1 month after the last session by using the Japan Scar Workshop Scar Scale 2011. Recurrence was assessed at 6 months after the termination of treatment. Results: The average total Japan Scar Workshop score of the keloid and hypertrophic scar region groups dropped significantly after 1 year of treatment compared with before treatment (all P < 0.05). None of the hypertrophic scars or keloids deteriorated. However, 3 of the 34 anterior chest keloids (8.8%) did not respond. The following recurrence rates were observed 6 months after stopping laser treatment: 1 of the abdomen hypertrophic scars (4%), 18 of the anterior chest keloids (52.9%), 5 of the upper arm keloids (35.7%), and 4 of the scapula keloids (25%). Conclusions: Hypertrophic scars responded significantly better to 1064 nm Nd:YAG laser treatment than keloids. However, keloid recurrence occurred when there was remaining redness and induration, even if only a small part of the scar was affected. PMID:25587506

Koike, Sachiko; Akaishi, Satoshi; Nagashima, Yuki; Dohi, Teruyuki; Hyakusoku, Hiko



An endoscopic study on relationship between Helicobacter pylori infection and endoscopic gastric ulcer scars  

Microsoft Academic Search

A two-year endoscopic follow-up study of 45 gastric ulcer patients was conducted in order to ascertain the relationship betweenHelicobacter pylori infection, the transformation of ulcer scar patterns, and ulcer relapse during maintenance therapy. Endoscopic findings of gastric ulcer scar patterns, which established the quality of ulcer scars, were classified as follows: Sa, with a central depression, Sb, with a coarse

Nobuhiro Sakaki; Kumiko Momma; Yoshiya Yamada; Naoto Egawa; Junichi Ishiwata



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.

Glenn Dolphin


Science at Burning Man  

NSDL National Science Digital Library

Recently, the Exploratorium Museum in San Francisco sent a dedicated crew to check out the activities at the Burning Man festival in Nevada. The results of their journey and explorations can be seen here, and interested parties can learn about pyrotechnics, flight, dust devils, and rainbows. The site contains several dozen short films that feature Exploratorium scientists like Paul Doherty investigating the properties of alkali and a rare double rainbow sighting. One of the most impressive videos is a bird's eye view from an 88-NV plane over the Burning Man site. Finally, visitors are also encouraged to share these resources with others via social media sites, including Twitter and Facebook.


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

PubMed Central

The autoimmune disease scleroderma (systemic sclerosis (SSc)) is characterized by extensive tissue fibrosis, causing significant morbidity. There is no therapy for the fibrosis observed in SSc; indeed, the underlying cause of the scarring observed in this disease is unknown. Transforming growth factor-? (TGF?) has long been hypothesized to be a major contributor to pathological fibrotic diseases, including SSc. Recently, the signaling pathways through which TGF? activates a fibrotic program have been elucidated and, as a consequence, several possible points for anti-fibrotic drug intervention in SSc have emerged. PMID:16774692

Leask, Andrew



Burn Safety Awareness on Playgrounds: Thermal Burns from Playground Equipment  


... Safety Awareness on Playgrounds Thermal Burns from Playground Equipment The U.S. Consumer Product Safety Commission CPSC wants ... of the risk of thermal burns from playground equipment. You may remember the metal slides of your ...


Homeostasis of the epidermal barrier layer: a theory of how occlusion reduces hypertrophic scarring.  


The mechanism of hypertrophic scar reduction using silicone gel sheeting remains elusive. We hypothesize that the decrease in scar formation is due to occlusion and homeostasis of the barrier layer. Using an established model of hypertrophic scarring, rabbits were divided into four groups and scars were tape-stripped or occluded with Kelocote, Cavilon, or Indermil, with each rabbit serving as its own internal control. All wounds were harvested on day 28 and examined histologically to measure the scar elevation index (SEI), epithelial thickness, and cellularity. Immunohistochemistry fluorescence was used to quantify inflammation in the dermis. Transepidermal water loss (TEWL) was measured for each occlusive agent and tape stripping. Ultrastructural analysis was performed by electron microscopy. Kelocote, Cavilon, and Indermil all significantly decreased SEI when compared with controls. Each of the occlusive treatments was shown to decrease TEWL while tape stripping increased TEWL. Tape stripping significantly increased the SEI, epithelial thickness, and cellularity. Immunostaining for macrophages showed increased density of inflammatory cells in the tape-stripped scars. Under electron microscopy, the tape-stripped wounds displayed extensive inflammation and keratinocyte damage. Both unwounded skin and occlusion-treated scars did not display these characteristics. In conclusion, hypertrophic scarring was reduced regardless of occlusive method used. Furthermore, repeated disruption of the permeability barrier by tape stripping led to an increase in scarring. Ultrastructural analysis suggests that occluded wounds may be in an advanced state of wound repair. Occlusion may mediate its effects through establishing homeostasis of the epidermal barrier layer. PMID:19769722

O'Shaughnessy, Kristina D; De La Garza, Mauricio; Roy, Nakshatra K; Mustoe, Thomas A



Is the persistence of an epiphyseal scar of the knee a reliable marker of biological age?  


Age estimation of living individuals is a regular activity in medico-legal practice. Among the available tools for determining skeletal age, some authors have stated that the disappearance of epiphyseal scars could be a useful marker. The aim of the present study was to assess whether the presence of an epiphyseal scar on the knee, as seen on a plain X-ray, was linked to biological age. A total of 988 frontal X-rays of individuals (509 females and 479 males) aged between 15 and 40 years were analyzed to see whether a scar was visible or not on each of the three epiphyses of the knee. A scar was visible for 96 % of the females and 98 % of the males. For each sex, scars were visible at each year of age, from 15 to 40 years. In younger females, there were 15 individuals with no scar visible on the fibula, 16 on the tibia, and 20 on the femur. For males, the ages were respectively 16, 17, and 18 years. On a frontal X-ray, the persistence of epiphyseal scars was not a marker of a recent fusion. All individuals with fully ossified knee that had no scar on the femur were older than 18 years. Further studies focusing on epiphyseal scars on MR and CT scans could be useful, as these techniques allow the more precise analysis of the epiphysis. PMID:25476542

Faisant, Maxime; Rerolle, Camille; Faber, Camille; Dedouit, Fabrice; Telmon, Norbert; Saint-Martin, Pauline




E-print Network

PRESCRIBED BURN CERTIFICATION AFFIDAVIT State of County I, (name) (title) Being an employee study of materials provided by mail prior to the program, followed by a two-day training session of study materials. How to Register: Online at or Mail your registration form

Scott, Robert A.


Gas Hydrates Burning  

USGS Multimedia Gallery

An image of gas hydrates burning. Gas hydrates are naturally-occurring “ice-like” combinations of natural gas and water that have the potential to provide an immense resource of natural gas from the world’s oceans and polar regions....


Carburetion type burning apparatus  

Microsoft Academic Search

A carburetion type burning apparatus is described which comprises a needle for opening and closing a nozzle orifice, a carburetion chamber, a fuel tank for receiving fuel, a pump for feeding the fuel to the carburetion chamber from the fuel tank, a heater element for vaporizing the fuel. The nozzle orifice receives the vaporized fuel from the carburetion chamber. The




Burn a Peanut  

NSDL National Science Digital Library

In this activity, learners burn a peanut, which produces a flame that can be used to boil away water and count the calories contained in the peanut. Learners use a formula to calculate the calories in a peanut and then differentiate between food calories and physicist calories as well as calories and joules.

Paul Doherty



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



Resilience and Severe Burns.  

ERIC Educational Resources Information Center

Incorporated findings of a general literature review with opinions offered by 39 burn survivors. Results indicate that care factors influencing resiliency include social support (cultural influences and community, school, personal, and familial support), cognitive skills (intelligence, coping style, personal control, and assignment of meaning),…

Holaday, Margot; McPhearson, Ruth W.




EPA Science Inventory

When conducting a trial burn, it is necessary to make a number of measurements in order to adequately define the performance of the incinerator. n addition to flue gas emissions for particulate matter, HCl, and selected organics, it is also necessary to measure selected organics ...


Fast burn booster technology  

NASA Astrophysics Data System (ADS)

Advances in solid rocket booster motors in the Solid Propellant Booster Development (SPBD) Program are addressed. The technologies discussed include cheaper nondetonable versatile burn rate propellant, advanced performance tapered composite case, lower-cost lighter-weight nozzles, laser ignition, and improved combustion modelling and performance. The demonstration of these technologies in a series of motor static tests is reviewed.

Burnett, Jimmy; McCain, J. W.




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...


Implantation of atelocollagen sheet for vocal fold scar  

PubMed Central

Purpose of review This article reviews recent advances in scaffold-based interventions for the treatment of vocal fold scarring, with a particular emphasis on atelocollagen sheet implantation in the vocal fold lamina propria. Recent findings Scaffold-based therapies have demonstrated therapeutic promise in both pre-clinical and early clinical studies. Recent research has begun to shed light on the interactions between scaffold material properties, encapsulated and infiltrating cells, stimulatory molecules such as growth factors, and external regulatory variables such as stress, strain and vibration. The atelocollagen sheet, a cross-linked collagen material with abundant micropores, has an established clinical track record as a scaffold for dermal and epidermal repair and exhibited potential therapeutic benefit in a recent study of patients with vocal fold scarring and sulcus vocalis. Summary Scaffolding is one of the useful tools in tissue engineering and atelocollagen sheet implantation has shown to be effective in vocal fold regeneration. However, many of the scaffold materials under investigation still await clinical translation, and those that have been investigated in human patients (such as the atelocollagen sheet) require additional research in appropriately powered placebo controlled studies. PMID:20856118

Kishimoto, Yo; Welham, Nathan V.; Hirano, Shigeru



Squamous cell carcinoma arising in previously burned or irradiated skin  

SciTech Connect

Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation.

Edwards, M.J.; Hirsch, R.M.; Broadwater, J.R.; Netscher, D.T.; Ames, F.C.



Anti-inflammatory cytokine TSG-6 inhibits hypertrophic scar formation in a rabbit ear model.  


Hypertrophic scars are characterized by excessive fibrosis and extracellular matrix (ECM) deposition and can be functionally and cosmetically problematic; however, there are few satisfactory treatments for controlling hypertrophic scars. The inflammatory cells and cytokines involved in excessive inflammation during wound healing facilitate fibroblast proliferation and collagen deposition, leading to pathologic scar formation. TSG-6 exhibits anti-inflammatory activity. This study examined the effect of recombinant TSG-6 on inflammation in hypertrophic scars using a rabbit ear model. Six 7-mm, full-thickness, circular wounds were made on the ears of 12 rabbits. TSG-6 and PBS were intradermally injected into the right and left ear wounds, respectively. The methods of TEM and TUNEL were used to detect fibroblast apoptosis. The expressions of inflammatory factors: IL-1?, IL-6 and TNF-?, were detected by immunohistochemistry and real time polymerase chain reaction. Collagen I and III expression detected by immunohistochemistry and Masson?s trichrome staining and SEI (scar elevation index) was used to evaluate the extent of scarring. TSG-6 injection mitigated the formation of a hypertrophic scar in the rabbit ear. TSG-6-treated wounds exhibited decreased inflammation compared with the control group, as evidenced by the lower levels of IL-1?, IL-6, TNF-? and MPO. The SEI and the synthesis of collagens I and III were significantly decreased in the TSG-6-treated scars compared with control scars. The apoptosis rate was higher in the TSG-6-treated scars. TSG-6 exhibited anti-inflammatory effects during the wound healing process and cicatrization and significantly diminished hypertrophic scar formation in a rabbit ear model. PMID:25661977

Wang, Hui; Chen, Zhao; Li, Xiao-Jing; Ma, Li; Tang, Yue-Ling



Objective color measurements: clinimetric performance of three devices on normal skin and scar tissue.  


Color measurements are an essential part of scar evaluation. Thus, vascularization (erythema) and pigmentation (melanin) are common outcome parameters in scar research. The aim of this study was to investigate the clinimetric properties and clinical feasibility of the Mexameter, Colorimeter, and the DSM II ColorMeter for objective measurements on skin and scars. Fifty scars with a mean age of 6 years (2 months to 53 years) were included. Reliability was tested using the single-measure interobserver intraclass correlation coefficient. Validity was determined by measuring the Pearson correlation with the Fitzpatrick skin type classification (for skin) and the Patient and Observer Scar Assessment Scale (for scar tissue). All three instruments provided reliable readings (intraclass correlation coefficient ? 0.83; confidence interval: 0.71-0.90) on normal skin and scar tissue. Parameters with the highest correlations with the Fitzpatrick classification were melanin (Mexameter), 0.72; ITA (Colorimeter), -0.74; and melanin (DSM II), 0.70. On scars, the highest correlations with the Patient and Observer Scar Assessment Scale vascularization scores were the following: erythema (Mexameter), 0.59; LAB2 (Colorimeter), 0.69; and erythema (DSM II), 0.66. For hyperpigmentation, the highest correlations were melanin (Mexameter), 0.75; ITA (Colorimeter), -0.80; and melanin (DSM II), 0.83. This study shows that all three instruments can provide reliable color data on skin and scars with a single measurement. The authors also demonstrated that they can assist in objective skin type classification. For scar assessment, the most valid parameters in each instrument were identified. PMID:23237819

van der Wal, Martijn; Bloemen, Monica; Verhaegen, Pauline; Tuinebreijer, Wim; de Vet, Henrica; van Zuijlen, Paul; Middelkoop, Esther



The overall patterns of burns  

PubMed Central

Summary Burn patterns differ across the whole world and not only in relation to lack of education, overcrowding, and poverty. Cultures, habits, traditions, psychiatric illness, and epilepsy are strongly correlated to burn patterns. However, burns may also occur because of specific religious beliefs and activities, social events and festivals, traditional medical practices, occupational activities, and war. PMID:22639565

Almoghrabi, A.; Abu Shaban, N.



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.

Florida Department of Forestry


PGN Prescribed Burn Research Summary  

Technology Transfer Automated Retrieval System (TEKTRAN)

Since 1997, we have been studying the effects of prescribed burns conducted during late winter on shortgrass steppe on the Pawnee National Grassland. During 1997 – 2002, we studied burns on the western (Crow Valley) portion of the Pawnee by comparing plant growth on burns conducted by the Forest Ser...



EPA Science Inventory

The Burn Data Coordinating Center (BDCC) began collecting data in 1994 and is currently the largest burn database in the country. Pediatric burn data was added in 1998. The BMS database contains over 2,800 cases supporting clinical research and research on outcomes including empl...


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.



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



Episodic nitrous oxide soil emissions in Brazilian savanna (cerrado) fire-scars  

NASA Technical Reports Server (NTRS)

The seasonally burned cerrados of Brazil are the largest savanna-type ecosystem of South America and their contribution to the global atmospheric nitrous oxide (N20) budget is unknown. Four types of fire-scarred cerrado along a vegetation gradient from grassland to forest were investigated during the wet season of 1992/93. The effect of fire and subsequent water additions on epiodic emissions of N2O and the associated profile dynamic of soil/gas phase N2O concentrations were studied for several months. Additionally, the effect on episodic emissions of N2O of nitrate and glucose additions to a cerrado soil after fire and the associated profile dynamic of soil/gas phase N2O mixing ratios were determined. Finally, N2O episodic emissions in cerrado converted to corn, soybean, and pasture fields were investigated during one growing/wet season. Results showed N2O consumption/emission for the four fire-scared savanna ecosystems, for nitrogen and carbon fertilization, and for agriculture/pasture ranging from -0.3 to +0.7, 1.8 to 9.1, and 0.5 to 3.7 g N2O-N ha(exp -1) d(exp -1), respectively. During the wet season the cerrado biome does not appear to be a major source of N2O to the troposphere, even following fire events. However, the results of this study suggest that conversion of the cerrado to high input agriculture, with liming and fertilization, can increase N2O emissions more than ten fold.

Nobre, A. D.; Crill, P. M.; Harriss, R. C.



Ultrasonography in the evaluation of renal scarring using DMSA scan as the gold standard  

Microsoft Academic Search

Dimercaptosuccinic acid (DMSA) renal scan is presently the technique of choice for assessing renal scars. Recent advances suggest that ultrasonography could replace DMSA scan for this purpose. This paper describes the experience of a tertiary pediatric referral hospital performing ultrasonography and DMSA scans in the assessment of renal scarring. Investigations were conducted 3–6 months after patients presented with urinary tract infection

Ima Moorthy; Deirdre Wheat; Isky Gordon



Quantified characterization of dermal collagen structure in human cutaneous scars from second harmonic generation imaging  

Microsoft Academic Search

In this paper, high resolution images of collagens based on second harmonic generation (SHG) were obtained in the dermis of different scar tissues and surrounding considered uninjured skins, demonstrating differences in their microstructures. In order to quantitatively analyze their structural features, Fourier analysis was applied for the SHG images to compare the alteration in collagen orientation of different scars. Moreover,

Xiaoqin Zhu; Youting Chen; Shuangmu Zhuo; Biying Yu; Liqin Zheng; Kecheng Lu; Jianxin Chen



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



Keratosis Follicularis Spinulosa Decalvans: A Rare Cause of Scarring Alopecia in Two Young Indian Girls  

PubMed Central

Keratosis follicularis spinulosa decalvans (KFSD) is an X-linked xenodermatosis characterized by scarring alopecia and follicular hyperkeratosis. This condition mainly affects males with females being carriers and will have milder symptoms. We present two sisters with severe form of KFSD, progressing to scarring alopecia. PMID:23960394

Maheswari, Uma G; Chaitra, V; Mohan, Subbiah S



Matrix metalloproteinase-2 and -9 activities in human keloids, hypertrophic and atrophic scars: a pilot study.  


Proteolytic degradation of extracellular matrix is one of the principal features of cutaneous wound healing but little is known about the activities of gelatinases; matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) on abnormal scar formation. The aim of this study is to determine collagen levels and the gelatinase activities in tissue from hypertrophic scars, atrophic scars, keloids and donor skin in 36 patients and 14 donors. Gelatinase levels (proenzyme + active enzyme) were determined by ELISA and their activities by gelatin zymography. MMP-9 activity was undetectable in gelatin zymography analysis. Pro-MMP-2 levels (median) were highest in normal skin group 53.58 (36.40-75.11) OD microg(-1) protein, while active MMP-2 levels were highest in keloid group 52.53 (42.47-61.51) OD microg(-1) protein. The active/pro ratio was the highest in keloid group 0.97 followed by hypertrophic scar, normal skin and atrophic scar groups 0.69 > 0.54 > 0.48, respectively. According to results of our study, the two-phase theory of the duration of hypertrophic scar and keloid formation can be supported by the data of tissue collagen and gelatinase analysis. This study is the first to relate scar formation relationship in regard to gelatinase activation ratio in a keloid, hypertrophic and atrophic scar patient group which is chosen appropriate in age and sex. PMID:19165813

Tanriverdi-Akhisaroglu, S; Menderes, A; Oktay, G



Longleaf pine (Pinus palustris Mill.) fire scars reveal new details of a frequent fire regime  

E-print Network

-century fire history records from longleaf pine ecosystems are difficult to obtain due to historic land for reconstructing detailed fire histories in this ecosystem. Fire scars quantitatively documented one of the mostLongleaf pine (Pinus palustris Mill.) fire scars reveal new details of a frequent fire regime

Stambaugh, Michael C


Ultrasonographic measurement of lower uterine segment to assess risk of defects of scarred uterus  

Microsoft Academic Search

SummaryBackground Ultrasonography has been used to examine the scarred uterus in women who have had previous caesarean sections in an attempt to assess the risk of rupture of the scar during subsequent labour. The predictive value of such measurements has not been adequately assessed, however. We aimed to evaluate the usefulness of sonographic measurement of the lower uterine segment before

P Rozenberg; F Goffinet; H. J Philippe; I Nisand



Primary and acquired renal scarring in boys and girls with urinary tract infection  

Microsoft Academic Search

Objectives: To determine when pyelonephritic renal scarring was detected in children with urinary tract infection (UTI) and characterize those with primary and acquired scarring, respectively.Study design: A population-based cohort of 1221 children (989 girls and 232 boys) with first recognized symptomatic UTI, aged 0 to 15 years, were diagnosed and followed up prospectively at a single children's hospital; 652 had

Martin Wennerström; Sverker Hansson; Ulf Jodal; Eira Stokland



The predatory mite Typhlodromus pyri (Acari: Phytoseiidae) causes feeding scars on leaves and fruits of apple.  


Typhlodromus pyri Scheuten (Acari: Phytoseiidae) is the most important predator of Panonychus ulmi (Koch) (Acari: Tetranychidae) in orchards and vineyards. It was recently found that adult T. pyri females cause microscopic scars on apple leaves. The present laboratory experiments were carried out to confirm the production of scars on apple leaves and to assess if females cause scars on fruits as well. Scar production on apple leaves and/or fruits was investigated under various nutritional conditions: no food, pollen of Scots pine (Pinus sylvsestris L.) only, nymphs of P. ulmi only, and pollen + prey. Both on leaves and fruits, either offered alone or in combination, feeding scars were produced under all nutritional conditions, but mostly in the 'no food' treatment. The predators consumed significantly more P. ulmi nymphs when offered alone than when offered in combination with pollen. T. pyri laid eggs under all nutritional conditions, but mostly in the 'pollen + prey' treatment and least when no food was offered. T. pyri females caused scars on both leaves and fruits when offered simultaneously, but more on leaves than on fruits. The scars were also bigger on leaves than on fruits in all experiments. T. pyri survived and reproduced on plant material in the absence of other food sources. Whether the scars produced on leaves and fruits harm the quality of fruits or the yield of apple cannot be concluded from the present experiments. PMID:15285137

Sengonca, C; Khan, I A; Blaeser, P



Extracting Scar and Ridge Features from 3D-scanned Lithic Artifacts Eitan Richardson1)  

E-print Network

a method for computer analysis of 3D-scanned lithic artifacts. It provides a detailed description1 Extracting Scar and Ridge Features from 3D-scanned Lithic Artifacts Eitan Richardson1) , Leore, together with a quantitative analysis of the scar and the ridge networks. The proposed algorithm detects

Werman, Michael


76 FR 6650 - Culturally Significant Objects Imported for Exhibition Determinations: “Splendors of Faith/Scars...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Scars of Conquest: The Arts of the Missions of Northern New Spain, 1600-1821'' SUMMARY: Notice is hereby given of the following...Scars of Conquest: The Arts of the Missions of Northern New Spain, 1600-1821,'' imported from abroad for temporary...



Long-term Observation of Soil Creep Activity around a Landslide Scar  

EPA Science Inventory

Rate of sediment infilling into landslide scars by soil creep is needed to estimate the timing of subsequent landslide activity at a particular site. However, knowledge about the spatial distribution of its activity around the landslide scar is scarce. Additionally, there are few...


Near-infrared hyperspectral imaging: the road traveled to a clinical burn application  

NASA Astrophysics Data System (ADS)

The process of taking a concept to a clinical device begins with the idea for a technological solution to an unmet clinical challenge. Burns are one of the most destructive insults to the skin causing damage, scarring, and in some cases death. The approach most commonly used to evaluate burns is based on the appearance of the wound. This technique is somewhat subjective and unreliable, relying on clinical experience to assess the burn. Instrument based diagnostic techniques as an adjunct to current practices has the potential to enhance the quality and timeliness of decisions concerning wound assessment and treatment. Near Infrared Spectroscopy is a promising technique that can track changes within the tissue, and can therefore provide insight as to how deep the burn actually penetrates before visual signs become apparent. Preliminary bench and animal studies were used to prove the concept of a near infrared based method of burn assessment. This study demonstrated the ability of near infrared imaging to detect and monitor the hemodynamics of burn injuries in the early post-burn period. Based on this study, a pre-prototype near infrared spectroscopic system was built with the goal of developing a reliable yet simple system that could be used in a clinical setting. A pilot clinical study was designed and implemented at the Ross Tilley Burn Center (Toronto, Canada) in order to assess the feasibility of our strategy in the clinical realm. The goal of this preliminary clinical study was to determine if the pre-prototype could be integrated into the strict regiment of an active burn centre. Both the instrument performance in a clinical setting and the injury assessment based on the analysis of near infrared reflectance measurements were a success.

Levasseur, Michelle; Leonardi, Lorenzo; Payette, Jeri; Kohlenberg, Elicia; Sowa, Michael; Fish, Joel S.; Cross, Karen; Gomez, Manuel



Burning Magnesium (GCMP)  

NSDL National Science Digital Library

Burning Magnesium: this is a resource in the collection "General Chemistry Multimedia Problems". In this problem we will look at the reactions of two elements with oxygen in air. We will begin by observing the reaction of magnesium metal with oxygen when the metal is heated in air. General Chemistry Multimedia Problems ask students questions about experiments they see presented using videos and images. The questions asked apply concepts from different parts of an introductory course, encouraging students to decompartmentalize the material.


Perivascular Fibroblasts Form the Fibrotic Scar after Contusive Spinal Cord Injury  

PubMed Central

Injury to the CNS leads to formation of scar tissue, which is important in sealing the lesion and inhibiting axon regeneration. The fibrotic scar that comprises a dense extracellular matrix is thought to originate from meningeal cells surrounding the CNS. However, using transgenic mice, we demonstrate that perivascular collagen1?1 cells are the main source of the cellular composition of the fibrotic scar after contusive spinal cord injury in which the dura remains intact. Using genetic lineage tracing, light sheet fluorescent microscopy, and antigenic profiling, we identify collagen1?1 cells as perivascular fibroblasts that are distinct from pericytes. Our results identify collagen1?1 cells as a novel source of the fibrotic scar after spinal cord injury and shift the focus from the meninges to the vasculature during scar formation. PMID:23966707

Soderblom, Cynthia; Luo, Xueting; Blumenthal, Ezra; Bray, Eric; Lyapichev, Kirill; Ramos, Jose; Krishnan, Vidhya; Lai-Hsu, Catherine; Park, Kevin K.; Tsoulfas, Pantelis



Evolution of silicone therapy and mechanism of action in scar management.  


Silicone-based products are widely used in the management of hypertrophic scarring and keloids. This review discusses the range of products available and the clinical evidence of their efficacy in preventing excessive scarring and improving established scars. Silicone gel sheeting has been used successfully for more than 20 years in scar management. A new formulation of silicone gel applied from a tube forms a thin flexible sheet over the newly epithelialized wound or more mature scar. Results from clinical trials and clinical experience suggest that silicone gel is equivalent in efficacy to traditional silicone gel sheeting but easier to use. The mechanism of action of silicone therapy has not been completely determined but is likely to involve occlusion and hydration of the stratum corneum with subsequent cytokine-mediated signaling from keratinocytes to dermal fibroblasts. PMID:17968615

Mustoe, Thomas A



The Role of the Epidermis and the Mechanism of Action of Occlusive Dressings in Scarring  

PubMed Central

The problem of cutaneous scarring has conventionally been approached as a pathology of the dermis. Multiple lines of evidence from the clinic, in vitro experiments, and in vivo animal and human studies, however, increasingly suggest that the epidermis plays a major role in the control of underlying dermal scar. Building on the demonstrated efficacy of silicone gel occlusion, in this paper we review the evidence for epidermal regulation of scar, and propose the novel hypothesis that dermal fibrosis is exquisitely linked to the inflammatory state of the epidermis, which in turn is linked to hydration state as a function of epidermal barrier function. In the spectrum of factors contributing to dermal scar, the epidermis and its downstream effectors offer promising new targets for the development of anti-scar therapies. PMID:21793961

Mustoe, Thomas A.; Gurjala, Anandev



A Novel Triple Medicine Combination Injection for the Resolution of Keloids and Hypertrophic Scars  

PubMed Central

Keloids and hypertrophic scars remain one of the more difficult treatment concerns for clinicians. A variety of therapies have been used in the past with moderate success. On occasion, combination therapy has been used to treat these lesion, in an attempt to lessen the symptoms of pain and pruritus that often accompanies keloids and hypertrophic scars, as well as treating the actual lesions themselves. A novel triple combination injection process is introduced here in an attempt to further reduce the signs and symptoms of these lesions. The combination includes 5-fluoruracil, triamcinolone acetonide, and hyaluronidase. All three work in concert to treat keloids and hypertrophic scars, and this is the first work at looking at these medicines given together, at the same time, in a series of recalcitrant keloids and hypertrophic scars. The positive results warrant further investigation and hope for those with keloids and hypertrophic scars. PMID:25489380

Gold, Michael H.



Outpatient burns: prevention and care.  


Most burn injuries can be managed on an outpatient basis by primary care physicians. Prevention efforts can significantly lower the incidence of burns, especially in children. Burns should be managed in the same manner as any other trauma, including a primary and secondary survey. Superficial burns can be treated with topical application of lotions, honey, aloe vera, or antibiotic ointment. Partial-thickness burns should be treated with a topical antimicrobial agent or an absorptive occlusive dressing to help reduce pain, promote healing, and prevent wound desiccation. Topical silver sulfadiazine is the standard treatment; however, newer occlusive dressings can provide faster healing and are often more cost-effective. Physicians must reevaluate patients frequently after a burn injury and be aware of the indications for referral to a burn specialist. PMID:22230304

Lloyd, Emillia C O; Rodgers, Blake C; Michener, Michael; Williams, Michael S