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Sample records for adductor muscle scar

  1. Extraction and Identification of the Pigment in the Adductor Muscle Scar of Pacific Oyster Crassostrea gigas.

    PubMed

    Hao, Shixin; Hou, Xin; Wei, Lei; Li, Jian; Li, Zhonghu; Wang, Xiaotong

    2015-01-01

    In this study, UV (ultraviolet) and IR (infrared radiation) spectral analysis were integrated to identify the pigment in the adductor muscle scar of the Pacific oyster Crassostrea gigas. The pigment was extracted from the adductor muscle scars of cleaned oyster shells that were pulverized, hydrolyzed in hot hydrochloric acid, purified with diethyl ether, and dissolved in 0.01 mL/L NaOH. The maximum absorption of the pigment in the UV absorption spectrum within the range of 190-500 nm was observed between 210-220 nm. The UV absorbance decreased with increasing wavelength which was consistent with the UV spectral absorption characteristics of melanin. In addition, Fourier transform infrared spectroscopy scanning revealed characteristic absorption peaks that emerged near 3440 cm-1 and 1630 cm-1, which was consistent with infrared scanning features of eumelanin (a type of melanin). This study has demonstrated for the first time that the pigment in the adductor muscle scar of the Pacific oyster is melanin, hinting that the adductor muscle could be another organ pigmenting the mollusc shell with melanin other than mantle.

  2. Jaw adductor muscles across lepidosaurs: a reappraisal.

    PubMed

    Daza, Juan Diego; Diogo, Rui; Johnston, Peter; Abdala, Virginia

    2011-10-01

    The exact homologies of tetrapod jaw muscles remain unresolved, and this provides a barrier for phylogenetic analysis and tracing character evolution. Here, lepidosaur jaw muscles are surveyed using direct examination of species from 23 families and published descriptions of species from 10 families. A revised nomenclature is applied according to proposed homologies with Latimeria. Among lepidosaurs, variation was found in many aspects of jaw muscle anatomy. The superficial layers mm. levator and retractor anguli oris (LAO and RAO) are present in Sphenodon but not all squamates. The external jaw adductor muscles universally present in lepidosaurs are homologous with the main adductor muscle, A2, of Latimeria and include four layers: superficialis (A2-SUP), medialis (A2-M), profundus (A2-PRO), and posterior (A2-PVM). The A2-SUP appears divided in Agamidae, Gekkota, Xantusiidae, and Varanidae. The A2-M is layered lateromedial in lizards but anteroposterior in snakes. The names pseudotemporalis (PS) and pterygomandibularis (PTM) are recommended for subdivisions of the internal adductors of reptiles and amphibians, because the homology of this muscle with the A3' and A3 ″ of Latimeria remains inconclusive. The intramandibularis of lepidosaurs and Latimeria (A-ω) are homologous. The distribution of six jaw muscle characters was found to plot more parsimoniously on phylogenies based on morphological rather than and molecular data. Character mapping indicates that Squamata presents reduction in the divisions of the A2-M, Scincoidea presents reduction or loss of LAO, and two apomorphic features are found for the Gekkota.

  3. Isokinetic imbalance of adductor-abductor hip muscles in professional soccer players with chronic adductor-related groin pain.

    PubMed

    Belhaj, K; Meftah, S; Mahir, L; Lmidmani, F; Elfatimi, A

    2016-11-01

    This study aims to compare the isokinetic profile of hip abductor and adductor muscle groups between soccer players suffering from chronic adductor-related groin pain (ARGP), soccer players without ARGP and healthy volunteers from general population. Study included 36 male professional soccer players, who were randomly selected and followed-up over two years. Of the 21 soccer players eligible to participate in the study, 9 players went on to develop chronic ARGP and 12 players did not. Ten healthy male volunteers were randomly selected from the general population as a control group. Comparison between the abductor and adductor muscle peak torques for players with and without chronic ARGP found a statistically significant difference on the dominant and non-dominant sides (p < .005), with the abductor muscle significantly stronger than the adductor muscle. In the group of healthy volunteers, the adductor muscle groups were significantly stronger than the abductor muscle groups on both dominant and non-dominant sides (p < .05). For the group of players who had developed chronic ARGP, abductor-adductor torque ratios were significantly higher on the affected side (p = .008). The adductor muscle strength was also significantly decreased on the affected side. This imbalance appears to be a risk factor for adductor-related groin injury. Therefore, restoring the correct relationship between these two agonist and antagonist hip muscles may be an important preventative measure that should be a primary concern of training and rehabilitation programmes.

  4. Scaling and Accommodation of Jaw Adductor Muscles in Canidae

    PubMed Central

    Kemp, Graham J.; Jeffery, Nathan

    2016-01-01

    ABSTRACT The masticatory apparatus amongst closely related carnivoran species raises intriguing questions about the interplay between allometry, function, and phylogeny in defining interspecific variations of cranial morphology. Here we describe the gross structure of the jaw adductor muscles of several species of canid, and then examine how the muscles are scaled across the range of body sizes, phylogenies, and trophic groups. We also consider how the muscles are accommodated on the skull, and how this is influenced by differences of endocranial size. Data were collected for a suite of morphological metrics, including body mass, endocranial volume, and muscle masses and we used geometric morphometric shape analysis to reveal associated form changes. We find that all jaw adductor muscles scale isometrically against body mass, regardless of phylogeny or trophic group, but that endocranial volume scales with negative allometry against body mass. These findings suggest that head shape is partly influenced by the need to house isometrically scaling muscles on a neurocranium scaling with negative allometry. Principal component analysis suggests that skull shape changes, such as the relatively wide zygomatic arches and large sagittal crests seen in species with higher body masses, allow the skull to accommodate a relative enlargement of the jaw adductors compared with the endocranium. Anat Rec, 299:951–966, 2016. © 2016 The Authors The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology Published by Wiley Periodicals, Inc. PMID:27103346

  5. Why adductor magnus muscle is large: the function based on muscle morphology in cadavers.

    PubMed

    Takizawa, M; Suzuki, D; Ito, H; Fujimiya, M; Uchiyama, E

    2014-02-01

    The aim of this study was to examine anatomical properties of the adductor magnus through a detailed classification, and to hypothesize its function and size to gather enough information about morphology. Ten cadaveric specimens of the adductor magnus were used. The muscle was separated into four portios (AM1-AM4) based on the courses of the corresponding perforating arteries, and its volume, muscle length, muscle fiber length and physiological cross-sectional area were assessed. The architectural characteristics of these four portions of the adductor magnus were then classified with the aid of principal component analysis. The results led us into demarcating the most proximal part of the adductor magnus (AM1) from the remaining parts (AM2, AM3, and AM4). Classification of the adductor magnus in terms of architectural characteristics differed from the more traditional anatomical distinction. The AM2, AM3, and AM4, having longer muscle fiber lengths than the AM1, appear to be designed as displacers for moving the thigh through a large range of motion. The AM1 appears instead to be oriented principally toward stabilizing the hip joint. The large mass of the adductor magnus should thus be regarded as a complex of functionally differentiable muscle portions.

  6. Influence of electrical stimulation on hip joint adductor muscle activity during maximum effort.

    PubMed

    Nakano, Sota; Wada, Chikamune

    2016-05-01

    [Purpose] This study investigated whether hip adductor activity was influenced by electrical stimulation of the tensor fascia lata muscle. [Subjects and Methods] The subjects were 16 nondisabled males. Each subject was asked to adduct the hip joint with maximum effort. The electromyogram of the adductor longus was recorded under two experimental conditions, with and without electrical stimulation of the tensor fascia lata. [Results] In the presence of electrical stimulation, muscle activity decreased to 72.9% (57.8-89.3%) of that without stimulation. [Conclusion] These results suggested that inactivation of the adductor group was promoted by electrical stimulation of the tensor fascia lata.

  7. Influence of electrical stimulation on hip joint adductor muscle activity during maximum effort

    PubMed Central

    Nakano, Sota; Wada, Chikamune

    2016-01-01

    [Purpose] This study investigated whether hip adductor activity was influenced by electrical stimulation of the tensor fascia lata muscle. [Subjects and Methods] The subjects were 16 nondisabled males. Each subject was asked to adduct the hip joint with maximum effort. The electromyogram of the adductor longus was recorded under two experimental conditions, with and without electrical stimulation of the tensor fascia lata. [Results] In the presence of electrical stimulation, muscle activity decreased to 72.9% (57.8–89.3%) of that without stimulation. [Conclusion] These results suggested that inactivation of the adductor group was promoted by electrical stimulation of the tensor fascia lata. PMID:27313387

  8. The hip adductor muscle group in caviomorph rodents: anatomy and homology.

    PubMed

    García-Esponda, César M; Candela, Adriana M

    2015-06-01

    Anatomical comparative studies including myological data of caviomorph rodents are relatively scarce, leading to a lack of use of muscular features in cladistic and morphofunctional analyses. In rodents, the hip adductor muscles constitute an important group of the hindlimb musculature, having an important function during the beginning of the stance phase. These muscles are subdivided in several distinct ways in the different clades of rodents, making the identification of their homologies hard to establish. In this contribution we provide a detailed description of the anatomical variation of the hip adductor muscle group of different genera of caviomorph rodents and identify the homologies of these muscles in the context of Rodentia. On this basis, we identify the characteristic pattern of the hip adductor muscles in Caviomorpha. Our results indicate that caviomorphs present a singular pattern of the hip adductor musculature that distinguishes them from other groups of rodents. They are characterized by having a single m. adductor brevis that includes solely its genicular part. This muscle, together with the m. gracilis, composes a muscular sheet that is medial to all other muscles of the hip adductor group. Both muscles probably have a synergistic action during locomotion, where the m. adductor brevis reinforces the multiple functions of the m. gracilis in caviomorphs. Mapping of analyzed myological characters in the context of Rodentia indicates that several features are recovered as potential synapomorphies of caviomorphs. Thus, analysis of the myological data described here adds to the current knowledge of caviomorph rodents from anatomical and functional points of view, indicating that this group has features that clearly differentiate them from other rodents.

  9. Thickness of the adductor pollicis muscle in nutritional assessment of surgical patients

    PubMed Central

    Valente, Katarina Papera; Silva, Naira Marceli Fraga; Faioli, Amanda Barcelos; Barreto, Marina Abelha; de Moraes, Rafael Araújo Guedes; Guandalini, Valdete Regina

    2016-01-01

    ABSTRACT Objective To evaluate the correlation between thickness of the muscle adductor pollicis and anthropometric measurements, body mass index and Subjective Global Assessment in the nutritional assessment of surgical patients. Methods The study population comprised patients admitted to the general and reconstructive surgery unit of a university hospital in the city of Vitória (ES), Brazil. The inclusion criteria were patients evaluated in the first 48 hours of admission, aged ≥20 years, hemodynamically stable, with no edema or ascites. Data analysis was performed using the software Statistical Package for Social Science 21.0, significance level of 5%. Results The sample consisted of 150 patients that were candidates to surgery, mean age of 42.7±12.0 years. The most common reasons for hospitalization were surgical procedures, gastrintestinal diseases and neoplasm. Significant association was observed between thickness of adductor pollicis muscle and Subjective Global Assessment (p=0.021) and body mass index (p=0.008) for nutritional risk. Significant correlation was found between thickness of adductor pollicis muscle and arm muscle circumference, corrected arm muscle area, calf circumference and body mass index. There were no significant correlations between thickness of adductor pollicis muscle and triceps skinfold and age. Conclusion The use of thickness of adductor pollicis muscle proved to be an efficient method to detect malnutrition in surgical patients and it should be added to the screening process of hospitalized patients, since it is easy to perform, inexpensive and noninvasive. PMID:27074229

  10. The Jaw Adductor Muscle Complex in Teleostean Fishes: Evolution, Homologies and Revised Nomenclature (Osteichthyes: Actinopterygii)

    PubMed Central

    Datovo, Aléssio; Vari, Richard P.

    2013-01-01

    The infraclass Teleostei is a highly diversified group of bony fishes that encompasses 96% of all species of living fishes and almost half of extant vertebrates. Evolution of various morphological complexes in teleosts, particularly those involving soft anatomy, remains poorly understood. Notable among these problematic complexes is the adductor mandibulae, the muscle that provides the primary force for jaw adduction and mouth closure and whose architecture varies from a simple arrangement of two segments to an intricate complex of up to ten discrete subdivisions. The present study analyzed multiple morphological attributes of the adductor mandibulae in representatives of 53 of the 55 extant teleostean orders, as well as significant information from the literature in order to elucidate the homologies of the main subdivisions of this muscle. The traditional alphanumeric terminology applied to the four main divisions of the adductor mandibulae – A1, A2, A3, and Aω – patently fails to reflect homologous components of that muscle across the expanse of the Teleostei. Some features traditionally used as landmarks for identification of some divisions of the adductor mandibulae proved highly variable across the Teleostei; notably the insertion on the maxilla and the position of muscle components relative to the path of the ramus mandibularis trigeminus nerve. The evolutionary model of gain and loss of sections of the adductor mandibulae most commonly adopted under the alphanumeric system additionally proved ontogenetically incongruent and less parsimonious than a model of subdivision and coalescence of facial muscle sections. Results of the analysis demonstrate the impossibility of adapting the alphanumeric terminology so as to reflect homologous entities across the spectrum of teleosts. A new nomenclatural scheme is proposed in order to achieve congruence between homology and nomenclature of the adductor mandibulae components across the entire Teleostei. PMID

  11. Relationship between adductor pollicis muscle thickness and subjective global assessment in a cardiac intensive care unit

    PubMed Central

    Karst, Fernanda Pickrodt; Vieira, Renata Monteiro; Barbiero, Sandra

    2015-01-01

    Objective To verify the relationship between the adductor pollicis muscle thickness test and the subjective global assessment and to correlate it with other anthropometric methods. Methods This observational cross-sectional study was conducted in the intensive care unit of a cardiology hospital in the state of Rio Grande do Sul, Brazil. The hospitalized patients underwent subjective global assessment and adductor pollicis muscle thickness tests on both hands, along with measurement of the right calf circumference. Laboratory parameters, length of stay, vital signs and electronic medical record data and tests were all collected. Results The study population included 83 patients, of whom 62% were men. The average age was 68.6 ± 12.5 years. The most common reason for hospitalization was acute myocardial infarction (34.9%), and the most common pathology was systolic blood pressure (63.9%), followed by diabetes mellitus (28.9%). According to subjective global assessment classifications, 62.7% of patients presented no nutritional risk, 20.5% were moderately malnourished and 16.9% were severely malnourished. Women had a higher nutritional risk, according to both the subjective global assessment and the adductor pollicis muscle thickness test, the cutoff for which was < 6.5mm (54.8%; p = 0.001). The pathology presenting the greatest nutritional risk was congestive heart failure (p = 0.001). Evaluation of the receiver operating characteristic (ROC) curve between adductor pollicis muscle thickness and subjective global assessment showed the accuracy of the former, with an area of 0.822. Conclusion Adductor pollicis muscle thickness proved to be a good method for evaluating nutritional risk. PMID:26761475

  12. Acute iliopsoas and adductor brevis abscesses presenting with proximal leg muscle weakness.

    PubMed

    Devetag Chalaupka, F

    2006-06-01

    Pyomyositis is a bacterial infection of skeletal muscle. We describe the clinical case of a 77-year-old woman affected by gait disturbance, repetitive falls, low back pain and left thigh and groin pain, but without symptoms of systemic infection. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed abscesses in the left psoas and adductor brevis muscles. Investigations of urogenital tract and gastrointestinal system were normal. Systemic antibiotic treatment alone was not efficient, while surgical drainage improved the clinical picture. The aetiological organism, isolated from the abscess, was Staphylococcus aureus. We suggest that this patient had a primary pyomyositis rather than a secondary form. This is the first report of concomitant abscesses of psoas and adductor brevis muscles with early neurological involvement.

  13. Cortical silent period reveals differences between adductor spasmodic dysphonia and muscle tension dysphonia

    PubMed Central

    Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

    2015-01-01

    Background The pathophysiology of adductor spasmodic dysphonia (AdSD), like other focal dystonias, is largely unknown. Objective The purposes of this study were to determine 1) cortical excitability differences between AdSD, muscle tension dysphonia (MTD) and healthy controls 2) distribution of potential differences in cranial or skeletal muscle, and 3) if cortical excitability measures assist in the differential diagnosis of AdSD and MTD. Methods 10 participants with adductor spasmodic dysphonia, 8 with muscle tension dysphonia and 10 healthy controls received single and paired pulse transcranial magnetic stimulation (TMS) to the primary motor cortex contralateral to tested muscles, first dorsal interosseus (FDI) and masseter. We tested the hypothesis that cortical excitability measures in AdSD would be significantly different than in MTD and healthy. In addition, we hypothesized there would be a correlation between cortical excitability measures and clinical voice severity in AdSD. Results Cortical silent period (CSP) duration in masseter and FDI was significantly shorter in AdSD than MTD and healthy controls. Other measures failed to demonstrate differences. Conclusion There are differences in cortical excitability between AdSD, MTD and healthy controls. These differences in the cortical measure of both the FDI and masseter muscles in AdSD suggest widespread dysfunction of the GABAB mechanism may be a pathophysiologic feature of AdSD, similar to other forms of focal dystonia. Further exploration of the use of TMS to assist in the differential diagnosis of AdSD and MTD is warranted. PMID:26089309

  14. Temporal changes in sarcomere lesions of rat adductor longus muscles during hindlimb reloading

    NASA Technical Reports Server (NTRS)

    Krippendorf, B. B.; Riley, D. A.

    1994-01-01

    Focal sarcomere disruptions were previously observed in adductor longus muscles of rats flown approximately two weeks aboard the Cosmos 1887 and 2044 biosatellite flights. These lesions, characterized by breakage and loss of myofilaments and Z-line streaming, resembled damage induced by unaccustomed exercise that includes eccentric contractions in which muscles lengthen as they develop tension. We hypothesized that sarcomere lesions in atrophied muscles of space flow rats were not produced in microgravity by muscle unloading but resulted from muscle reloading upon re-exposure to terrestrial gravity. To test this hypothesis, we examined temporal changes in sarcomere integrity of adductor longus muscles from rats subjected to 12.5 days of hindlimb suspension unloading and subsequent reloading by return to vivarium cages for 0, 6, 12, or 48 hours of normal weightbearing. Our ultrastructural observations suggested that muscle unloading (0 h reloading) induced myofibril misalignment associated with myofiber atrophy. Muscle reloading for 6 hours induced focal sarcomere lesions in which cross striations were abnormally widened. Such lesions were electron lucent due to extensive myofilament loss. Lesions in reloaded muscles showed rapid restructuring. By 12 hours of reloading, lesions were moderately stained foci and by 48 hours darkly stained foci in which the pattern of cross striations was indistinct at the light and electron microscopic levels. These lesions were spanned by Z-line-like electron dense filamentous material. Our findings suggest a new role for Z-line streaming in lesion restructuring: rather than an antecedent to damage, this type of Z-line streaming may be indicative of rapid, early sarcomere repair.

  15. Force depression following muscle shortening in sub-maximal voluntary contractions of human adductor pollicis.

    PubMed

    Rousanoglou, Elissavet N; Oskouei, Ali E; Herzog, Walter

    2007-01-01

    Mechanical properties of skeletal muscles are often studied for controlled, electrically induced, maximal, or supra-maximal contractions. However, many mechanical properties, such as the force-length relationship and force enhancement following active muscle stretching, are quite different for maximal and sub-maximal, or electrically induced and voluntary contractions. Force depression, the loss of force observed following active muscle shortening, has been observed and is well documented for electrically induced and maximal voluntary contractions. Since sub-maximal voluntary contractions are arguably the most important for everyday movement analysis and for biomechanical models of skeletal muscle function, it is important to study force depression properties under these conditions. Therefore, the purpose of this study was to examine force depression following sub-maximal, voluntary contractions. Sets of isometric reference and isometric-shortening-isometric test contractions at 30% of maximal voluntary effort were performed with the adductor pollicis muscle. All reference and test contractions were executed by controlling force or activation using a feedback system. Test contractions included adductor pollicis shortening over 10 degrees, 20 degrees, and 30 degrees of thumb adduction. Force depression was assessed by comparing the steady-state isometric forces (activation control) or average electromyograms (EMGs) (force control) following active muscle shortening with those obtained in the corresponding isometric reference contractions. Force was decreased by 20% and average EMG was increased by 18% in the shortening test contractions compared to the isometric reference contractions. Furthermore, force depression was increased with increasing shortening amplitudes, and the relative magnitudes of force depression were similar to those found in electrically stimulated and maximal contractions. We conclude from these results that force depression occurs in sub

  16. Absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer.

    PubMed

    Hirano, Masahiro; Katoh, Munenori

    2015-07-01

    [Purpose] The aim of this study was to verify the absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD). [Subjects and Methods] The subjects were 33 healthy college students. The measurements were made three times with the HHD fixed using a belt (BFHHD) or with the examiner's hand (conventional method; HFHHD). The absolute reliability of measurements was verified using Bland-Altman analysis, both in the all subjects group and a group of subjects showing measurements less than a fixed limit of 30 kgf. [Results] In the <30 kgf group, a systematic bias was not observed, and BFHHD values were greater than HFHHD values. BFHHD values in the all subjects group showed a systematic bias; the 3rd measurement value was less than the maximum value obtained during the 1st and 2nd measurements. [Conclusion] For obtaining an acceptable value during clinical measurements of horizontal adductor muscle strength, single measurements obtained using an HFHHD in the case of a <30 kgf group and the maximum value of two measurements obtained using a BFHHD are reliable.

  17. Detection of localized methylmercury contamination by use of the mussel adductor muscle in Minamata Bay and Kagoshima Bay, Japan.

    PubMed

    Haraguchi, K; Ando, T; Sato, M; Kawaguchi, C; Tomiyasu, T; Horvat, M; Akagi, H

    2000-10-16

    Based on our previous finding that the concentrations of total mercury in mussel adductor muscle approximated those of methylmercury, we compared concentrations of total mercury in the adductor muscle of the mussel Mytilus galloprovincialis, collected from four sites around Minamata City from 1993 to 1995 and four sites in Kagoshima Bay from 1997 to 1998, to assess the level of localized methylmercury contamination. Though the input of mercury from the chemical plant had stopped by around 1970, concentrations of total mercury in the mussel adductor muscle were higher at two sites (26-121 ng/g, n = 135) near the main fallout of wastewater from the chemical plant in Minamata Bay than at the other sites, i.e. two sites 1-5 km from the former sites in Minamata City (6-28 ng/g, n = 52), and all sites in Kagoshima Bay (2-30 ng/g, n = 287). The localized methylmercury contamination around the chemical plant in Minamata Bay was documented also by our sensitive analysis of mercury concentrations in seawater and sediment samples. The survey of concentrations of total mercury in the mussel adductor muscle seems to be useful for monitoring the methylmercury contamination in coastal areas.

  18. Contractile properties of the striated adductor muscle in the bay scallop Argopecten irradians at several temperatures.

    PubMed

    Olson, J M; Marsh, R L

    1993-03-01

    The isometric and isotonic contractile properties of the cross-striated adductor muscle of the bay scallop (Argopecten irradians) were measured in vitro at 10, 15 and 20 degrees C. The length at which twitch force was maximal as a function of the closed length in situ (L0/Lcl) averaged 1.38 +/- 0.01 (mean +/- S.E.M.) at 10 degrees C. This length is very close to the typical length at maximum gape during natural swimming at this temperature. Passive force was very low over the range of lengths measured here; at L0, passive force averaged approximately 0.08 N cm-2, or only 0.5% of the corresponding peak twitch force. The mean peak isometric twitch force (Ptw,max) at 10 degrees C was 21.43 +/- 0.68 N cm-2 (S.E.M.), and the ratio of peak twitch force to tetanic force (Ptw,max/P0) averaged 0.89 +/- 0.01. Temperature did not affect either twitch force (Ptw), once fatigue was taken into account, or Ptw,max/P0. In contrast, the time-related properties of twitch contractions (latent period, tL; time to peak tension, tPtw; and time from peak tension to half-relaxation, t50%R) were positively modified by temperature at all temperatures measured (Q10 > 1.8). All three properties were more temperature-sensitive over the range 10-15 degrees C than over the range 15-20 degrees C. The force-velocity relationships of the striated adductor muscle were fitted to the hyperbolic-linear (HYP-LIN) equation. The force-velocity curves of the striated adductor muscle of the scallop were strongly influenced by temperature. Maximal velocity at zero force (Vmax), and therefore maximal power output, increased significantly with temperature. The Q10 over the temperature range 10-15 degrees C (1.42) was significantly lower than that over the range 15-20 degrees C (2.41). The shape of the force-velocity relationship, assessed through comparisons of the power ratio (Wmax/VmaxP0), was not influenced by temperature.

  19. Phonatory air flow characteristics of adductor spasmodic dysphonia and muscle tension dysphonia.

    PubMed

    Higgins, M B; Chait, D H; Schulte, L

    1999-02-01

    The purpose of this study was to determine if phonatory air flow characteristics differed among women with adductor spasmodic dysphonia (AdSD), muscle tension dysphonia (MTD), and normal phonation. Phonatory air flow signals were gathered during [pa] syllable repetitions. Mean phonatory air flow, coefficients of variation, and the presence of large air flow perturbations (75 ml/s or more) were examined for the three groups of speakers. There was no significant difference in mean phonatory air flow across groups, and very large intersubject variation in mean phonatory air flow occurred for both the AdSD and MTD groups. Coefficients of variation were similar for the groups of women with MTD and normal phonation but were significantly larger for the group with AdSD. Air flow perturbations were common with AdSD and rare with MTD. Relatively large coefficients of variation and air flow perturbations of at least 75 ml/s did occur for some women with normal voices who were 70 years of age or older. It appears that intrasubject variability in phonatory air flow may aid in the differentiation of AdSD and MTD when used in conjunction with other elements of a thorough voice evaluation. However, the potential contribution of aging to increased intrasubject variability in phonatory air flow must be considered when interpreting findings.

  20. Five myofibrillar lesion types in eccentrically challenged, unloaded rat adductor longus muscle--a test model

    NASA Technical Reports Server (NTRS)

    Thompson, J. L.; Balog, E. M.; Fitts, R. H.; Riley, D. A.

    1999-01-01

    Sarcomere disruptions are observed in the adductor longus (AL) muscles following voluntary reloading of spaceflown and hindlimb suspension unloaded (HSU) rat, which resemble lesions in eccentrically challenged muscle. We devised and tested an eccentric contraction (ECCON) test system for the 14-day HSU rat AL. Six to 7 hours following ECCON, ALs were fixed to allow immunostaining and electron microscopy (EM). Toluidine blue-stained histology semithin sections were screened for lesion density (#/mm2). Serial semithin sections from the ECCON group were characterized for myosin immunointensity of lesions. Five myofibrillar lesion types were identified in histological semithin sections: focal contractions; wide A-bands; opaque areas; missing A-bands; and hyperstretched sarcomeres. Lesion density by type was greater for ECCON than NonECCON ALs (P< or =0.05; focal contractions and opaque regions). Lesion density (#-of-all-five-types/mm2) was significantly different (ECCON: 23.91+/-10.58 vs. NonECCON: 5.48+/-1.28, P< or =0.05; ECCON vs. SHAM: 0.00+/-0.00; P< or = 0.025). PostECCON optimal tension decreased (Poi-drop, 17.84+/-4.22%) and was correlated to lesion density (R2=0.596), but prestretch tension demonstrated the highest correlation with lesion density (R2=0.994). In lesions, the darkly staining A-band lost the normally organized thick filament alignment to differing degrees across the different lesion types. Ranking the five lesion types by a measure of lesion length deformation (hypercontracted to hyperstretched) at the light microscopy level, related to the severity of thick filament registry loss across the lesion types at the electron microscopic level. This ranking suggested that the five lesion types seen in semithin sections at the light level represented a lesion progression sequence and paralleled myosin immunostaining loss as the distorted A-band filaments spread across the hyperlengthening lesion types. Lesion ultrastructure indicated damage involved

  1. Cranial muscles of the anurans Leiopelma hochstetteri and Ascaphus truei and the homologies of the mandibular adductors in Lissamphibia and other gnathostomes.

    PubMed

    Johnston, Peter

    2011-12-01

    The frogs Ascaphus truei and Leiopelma hochstetteri are members of the most basal lineages of extant anurans. Their cranial muscles have not been previously described in full and are investigated here by dissection. Comparison of these taxa is used to review a controversy regarding the homologies of the jaw adductor muscles in Lissamphibia, to place these homologies in a wider gnathostome context, and to define features that may be useful for cladistic analysis of Anura. A new muscle is defined in Ascaphus and is designated m. levator anguli oris. The differences noted between Ascaphus and Leiopelma are in the penetration of the jaw adductor muscles by the mandibular nerve (V3). In the traditional view of this anatomy, the paths of the trigeminal nerve branches define homologous muscles. This scheme results in major differences among frogs, salamanders, and caecilians. The alternative view is that the topology of origins, insertions, and fiber directions are defining features, and the nerves penetrate the muscle mass in a variable way. The results given here support the latter view. A new model is proposed for Lissamphibia, whereby the adductor posterior (levator articularis) is a separate entity, and the rest of the adductor mass is configured around it as a folded sheet. This hypothesis is examined in other gnathostomes, including coelacanth and lungfish, and a possible sequence for the evolution of the jaw muscles is demonstrated. In this system, the main jaw adductor in teleost fish is not considered homologous with that of tetrapods. This hypothesis is consistent with available data on the domain of expression of the homeobox gene engrailed 2, which has previously not been considered indicative of homology. Terminology is discussed, and "adductor mandibulae" is preferred to "levator mandibulae" to align with usage in other gnathostomes.

  2. Intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer for geriatric and stroke patients.

    PubMed

    Hirano, Masahiro; Katoh, Munenori; Kawaguchi, Saori; Uemura, Tomomi

    2016-01-01

    [Purpose] This study aimed to verify the appropriate number of measurements and the intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD) for geriatric and stroke patients. [Subjects and Methods] The subjects were 40 inpatients, who were divided into two groups: 20 stroke patients in the stroke group (SG), and 20 geriatric patients in the no-stroke group (N-SG). Measurements were performed three times using an HHD with a belt. The reliability was verified using Bland-Altman analysis and the intraclass correlation coefficient (ICC). [Results] ICC (1, 1) was >0.9. A systematic bias was not observed between the first and second measurement values except for the right side in N-SG. A systematic bias between the maximum value obtained during the first and second measurements and third measurement value was observed on the left side in N-SG, and on the non-paralyzed side in SG: the third measurement values were small in both cases. [Conclusion] Intrarater reliabilities were high for shoulder horizontal adductor strength measurements using an HHD with a belt for geriatric and stroke patients. Taking the systematic bias into consideration, these findings suggest that the required number of measurements is two.

  3. Potential use of fatty acid profiles of the adductor muscle of cockles (Cerastoderma edule) for traceability of collection site

    PubMed Central

    Ricardo, Fernando; Pimentel, Tânia; Moreira, Ana S. P.; Rey, Felisa; Coimbra, Manuel A.; Rosário Domingues, M.; Domingues, Pedro; Costa Leal, Miguel; Calado, Ricardo

    2015-01-01

    Geographic traceability of seafood is key for controlling its quality and safeguarding consumers’ interest. The present study assessed if the fatty acid (FA) profile of the adductor muscle (AM) of fresh cockles (Cerastoderma edule) can be used to discriminate the origin of specimens collected in different bivalve capture/production areas legally defined within a coastal lagoon. Results suggest that this biochemical approach holds the potential to trace sampling locations with a spatial resolution <10 Km, even for areas with identical classification for bivalve production. Cockles further away from the inlet, i.e. in areas exposed to a higher saline variation, exhibited lower levels of saturated fatty acids, which are key for stabilizing the bilayer structure of cell membranes, and a higher percentage of polyunsaturated fatty acids, which enhance bilayer fluidity. Results suggest that the structural nature of the lipids present in the AM provides a stable fatty acid signature and holds potential for tracing the origin of bivalves to their capture/production areas. PMID:26084395

  4. Potential use of fatty acid profiles of the adductor muscle of cockles (Cerastoderma edule) for traceability of collection site.

    PubMed

    Ricardo, Fernando; Pimentel, Tânia; Moreira, Ana S P; Rey, Felisa; Coimbra, Manuel A; Rosário Domingues, M; Domingues, Pedro; Costa Leal, Miguel; Calado, Ricardo

    2015-06-18

    Geographic traceability of seafood is key for controlling its quality and safeguarding consumers' interest. The present study assessed if the fatty acid (FA) profile of the adductor muscle (AM) of fresh cockles (Cerastoderma edule) can be used to discriminate the origin of specimens collected in different bivalve capture/production areas legally defined within a coastal lagoon. Results suggest that this biochemical approach holds the potential to trace sampling locations with a spatial resolution <10 Km, even for areas with identical classification for bivalve production. Cockles further away from the inlet, i.e. in areas exposed to a higher saline variation, exhibited lower levels of saturated fatty acids, which are key for stabilizing the bilayer structure of cell membranes, and a higher percentage of polyunsaturated fatty acids, which enhance bilayer fluidity. Results suggest that the structural nature of the lipids present in the AM provides a stable fatty acid signature and holds potential for tracing the origin of bivalves to their capture/production areas.

  5. Aggressive Lymphoma “Sarcoma Mimicker” Originating in the Gluteus and Adductor Muscles: A Case Report and Literature Review

    PubMed Central

    Elkourashy, Sarah A.; Nashwan, Abdulqadir J.; Alam, Syed I.; Ammar, Adham A.; El Sayed, Ahmed M.; Omri, Halima El; Yassin, Mohamed A.

    2016-01-01

    Extranodal lymphoma (ENL) occurs in approximately 30%–40% of all patients with non-Hodgkin lymphoma and has been described in almost all organs and tissues. However, diffuse large B-cell lymphoma is the most common histological subtype of non-Hodgkin lymphoma, primarily arising in the retroperitoneal region. In this article, we report a rare case of an adult male diagnosed with primary diffuse large B-cell lymphoma of the gluteal and adductor muscles with aggressive bone involvement. All appropriate radiological and histopathological studies were done for diagnosis and staging. After discussion with the lymphoma multidisciplinary team, it was agreed to start on R-CHOP protocol (rituximab, cyclophosphamide, doxorubicin (Adriamycin), vincristine (Oncovin®), and prednisone) as the standard of care, which was later changed to R-CODOX-M/R-IVAC protocol (rituximab, cyclophosphamide, vincristine (Oncovin®), doxorubicin, and high-dose methotrexate alternating with rituximab, ifosfamide, etoposide, and high-dose cytarabine) due to inadequate response. Due to the refractory aggressive nature of the disease, subsequent decision of the multidisciplinary team was salvage chemotherapy and autologous stem cell transplant. The aim of this case report was to describe and evaluate the clinical presentation and important radiological features of extranodal lymphoma affecting the musculoskeletal system. PMID:27398038

  6. What are the stimulation parameters that affect the extent of twitch force potentiation in the adductor pollicis muscle?

    PubMed

    Mettler, Joni A; Griffin, Lisa

    2010-12-01

    Muscle force potentiation affects force output during electrical stimulation. Few studies have examined stimulation train parameters that influence potentiation such as pulse number, stimulation frequency, train duration, and force-time integral and peak force produced during the train. Pulse-matched trains (100 pulses) at 7.5, 15, 25, 30, 50, and 100 Hz, and trains of varying pulse number (50, 100, and 200 pulses) at 30 and 50 Hz were delivered to the ulnar nerve of 10 (5 male, 5 female; 23.4 ± 0.9 years), healthy individuals in random order. Single twitches of the adductor pollicis muscle were elicited before and after each train with a rest interval of at least 5 min between each train. No differences in potentiation occurred across the pulse-matched trains at frequencies of 15-50 Hz (38.9 ± 5.4-44.6 ± 5.5%). Twitch force potentiation following the highest (100 Hz) and lowest (7.5 Hz) frequency trains were not significantly different and were lower than the other 100 pulse-matched trains. As pulse number increased, potentiation increased for both the 30 and 50-Hz trains. There was a significant positive correlation between force potentiation and force-time integral produced by the stimulation train, r = 0.70. The results indicate that potentiation magnitude is dependent on the force-time integral produced during the test train and the number of pulses delivered, independent of stimulation frequency.

  7. Effects of free oxygen radicals on Ca2+ release mechanisms in the sarcoplasmic reticulum of scallop (Pecten jacobaeus) adductor muscle.

    PubMed

    Burlando, B; Viarengo, A; Pertica, M; Ponzano, E; Orunesu, M

    1997-08-01

    In vitro oxyradical effects on SR Ca2+ regulation were studied by using a SR-containing cell-free preparation from scallop (Pecten jacobaeus) adductor muscle. Ca2+ variations were fluorimetrically detected after incubation with Fluo-3 in the presence of ATP. Exposure to Fe3+/ascorbate produced dose-dependent Ca2+ release from SR vesicles, eventually leading to massive Ca2+ loss. Exposure to hypoxanthine/xanthine oxidase also caused Ca2+ release but at a much slower rate. Pre-incubations with catalase or with the hydroxyl radical scavenger KMBA led to a significant decrease in the Fe3+/ascorbate-induced Ca2+ release rate and to a delay of massive Ca2+ loss. Pre-incubations with GSH or DTT strongly reduced the Ca2+ release caused by Fe3+/ascorbate and, moreover, they prevented massive Ca2+ loss from SR vesicles. Addition of GSH or DTT after Fe3+/ascorbate promptly reduced the Ca2+ release rate and delayed massive Ca2+ release. Pre-incubation with the SR Ca2+ channel blocker ruthenium red strongly reduced the Ca2+ release caused by Fe3+/ascorbate, and also prevented massive Ca2+ loss. In the presence of ruthenium red, Fe3+/ascorbate treatments followed by Ca2+ addition revealed that Ca2+ uptake inhibition was slower than Ca2+ release. Taken together, data showed that free radicals and, in particular, hydroxyl radicals, affected the scallop SR Ca2+ regulation. This mainly occurred through Ca2+ channel opening, most likely triggered by sulfhydryl oxidation, which eventually led to massive Ca2+ release from SR vesicles. The demonstration of a specific effect of oxyradicals on SR Ca2+ channels is in line with their possible involvement in cell signaling.

  8. NMR-based metabolomic investigations on the differential responses in adductor muscles from two pedigrees of Manila clam Ruditapes philippinarum to Cadmium and Zinc.

    PubMed

    Wu, Huifeng; Liu, Xiaoli; Zhao, Jianmin; Yu, Junbao

    2011-01-01

    Manila clam Ruditapes philippinarum is one of the most important economic species in shellfishery in China due to its wide geographic distribution and high tolerance to environmental changes (e.g., salinity, temperature). In addition, Manila clam is a good biomonitor/bioindicator in "Mussel Watch Programs" and marine environmental toxicology. However, there are several pedigrees of R. philippinarum distributed in the marine environment in China. No attention has been paid to the biological differences between various pedigrees of Manila clams, which may introduce undesirable biological variation in toxicology studies. In this study, we applied NMR-based metabolomics to detect the biological differences in two main pedigrees (White and Zebra) of R. philippinarum and their differential responses to heavy metal exposures (Cadmium and Zinc) using adductor muscle as a target tissue to define one sensitive pedigree of R. philippinarum as biomonitor for heavy metals. Our results indicated that there were significant metabolic differences in adductor muscle tissues between White and Zebra clams, including higher levels of alanine, glutamine, hypotaurine, phosphocholine and homarine in White clam muscles and higher levels of branched chain amino acids (valine, leucine and isoleucine), succinate and 4-aminobutyrate in Zebra clam muscles, respectively. Differential metabolic responses to heavy metals between White and Zebra clams were also found. Overall, we concluded that White pedigree of clam could be a preferable bioindicator/biomonitor in marine toxicology studies and for marine heavy metals based on the relatively high sensitivity to heavy metals.

  9. [Spasm of the adductor muscles, pre-dislocation and dislocations of the hip joints in children and adolescents with cerebral palsy. Clinical observations on aetiology, pathogenesis, therapy and rehabilitation. Part I: The effect of open myotenotomy of the gracilis muscle and of the long and short adductor muscles in connection with total extrapelvine resection of the obturator nerve, on the hip joints and static function (author's transl)].

    PubMed

    Fettweis, E

    1979-02-01

    Spasm and contraction of the adductor muscles involve, on the one hand, danger in respect of the development of a dislocation of the hip, and are a serious impediment to a walking ability on the other. Hence, surgery is often necessary. The article reports on the results of consequent weakening of the adductor muscles as a result of open myotenotomy in association with complete extrapelvine resection of the obturator nerve. 27 patients were subjected to surgery--in most cases bilaterally--at an age between 2 years and 5 months and 18 years, with a follow-up period of up to 15 years. The study does not include patients with spastic dislocation of the hip in whom this method was applied on the non-dislocated side and on the dislocated side in combination with iliopsoas tenotomy. This method makes it possible to achieve regression of existing defective positions of the hip joints. In a few cases, the valgus position of the neck of the femur was corrected to some extent. In two patients it was not possible to prevent the progress of a developing dislocation of the hip. These results show that, whereas the adductor muscles represent an essential factor for the occurrence of a spastic dislocation of the hip, other forces are most probably also involved. In the majority of cases, results were favourable in respect of the static function, although in some cases the success became evident after several years only, especially in mentally retarded patients and in apathetic individuals. Important for therapeutic success is the follow-up. The principles of its therapy are thoroughly discussed. Surgery is indicated only in special cases. Indications must be observed very strictly, since the risk of excessive weakening of the adductor muscles should not be underestimated.

  10. Defining the Location of the Adductor Canal Using Ultrasound

    PubMed Central

    Wong, Wan Yi; Bjørn, Siska; Strid, Jennie Maria Christin; Børglum, Jens; Bendtsen, Thomas Fichtner

    2017-01-01

    Background and Objectives The precise location of the adductor canal remains controversial among anesthesiologists. In numerous studies of the analgesic effect of the so-called adductor canal block for total knee arthroplasty, the needle insertion point has been the midpoint of the thigh, determined as the midpoint between the anterior superior iliac spine and base of patella. “Adductor canal block” may be a misnomer for an approach that is actually an injection into the femoral triangle, a “femoral triangle block.” This block probably has a different analgesic effect compared with an injection into the adductor canal. We sought to determine the exact location of the adductor canal using ultrasound and relate it to the midpoint of the thigh. Methods Twenty-two volunteers were examined using ultrasound. The proximal end of the adductor canal was identified where the medial border of the sartorius muscle intersects the medial border of the adductor longus muscle. The distal end of the adductor canal is the adductor hiatus, which was also visualized ultrasonographically. Results The mean distance from the anterior superior iliac spine to the midpoint of the thigh was 22.9 cm (range, 20.3–24.9 cm). The mean distance from the anterior superior iliac spine to the proximal end of the adductor canal was 27.4 cm (range, 24.0–31.4 cm). Consequently, the mean distance from the midpoint of the thigh to the proximal end of the adductor canal was 4.6 cm (range, 2.3–7.0 cm). Conclusions In all volunteers, the midpoint of the thigh was proximal to the beginning of the adductor canal, suggesting that an injection performed at this level is in fact a femoral triangle block. PMID:28002228

  11. PET/CT imaging in polymyalgia rheumatica: praepubic 18F-FDG uptake correlates with pectineus and adductor longus muscles enthesitis and with tenosynovitis

    PubMed Central

    Sprlakova-Pukova, Andrea; Bortlicek, Zbynek; Fojtik, Zdenek; Kazda, Tomas; Joukal, Marek; Koukalova, Renata; Vasina, Jiri; Eremiasova, Jana; Nemec, Petr

    2017-01-01

    diminished in all patients (15/15, 100%) after treatment with steroids. Conclusions Increased praepubic 18F-FDG uptake in patients with PMR is relatively common and this region should be systematically evaluated during differential diagnosis of rheumatic and malignant disease. Praepubic inflammation is probably related to enthesitis and tenosynovitis at the origin of pectineus and adductor longus muscles ventrally from the pubis. PMID:28265227

  12. Scar revision

    MedlinePlus

    ... an entire, full thickness of skin, fat, nerves, blood vessels, and muscle from a healthy part of the body to the injured site. These techniques are used when a large amount of skin has been lost in the original injury, when a thin scar ...

  13. Effects of spaceflight in the adductor longus muscle of rats flown in the Soviet Biosatellite COSMOS 2044. A study employing neural cell adhesion molecule (N-CAM) immunocytochemistry and conventional morphological techniques (light and electron microscopy)

    NASA Technical Reports Server (NTRS)

    D'Amelio, F.; Daunton, N. G.

    1992-01-01

    The effects of spaceflight upon the "slow" muscle adductor longus were examined in rats flown in the Soviet Biosatellite COSMOS 2044. The techniques employed included standard methods for light microscopy, neural cell adhesion molecule (N-CAM) immunocytochemistry and electron microscopy. Light microscopic observations revealed myofiber atrophy and segmental necrosis accompanied by cellular infiltrates composed of macrophages, leukocytes and mononuclear cells. Neural cell adhesion molecule immunoreactivity (N-CAM-IR) was seen on the myofiber surface and in regenerating myofibers. Ultrastructural alterations included Z band streaming, disorganization of myofibrillar architecture, sarcoplasmic degradation, extensive segmental necrosis with apparent preservation of the basement membrane, degenerative phenomena of the capillary endothelium and cellular invasion of necrotic areas. Regenerating myofibers were identified by the presence of increased amounts of ribosomal aggregates and chains of polyribosomes associated with myofilaments. The principal electron microscopic changes of the neuromuscular junctions showed axon terminals with a decrease or absence of synaptic vesicles replaced by microtubules and neurofilaments, degeneration of axon terminals, vacant axonal spaces and changes suggestive of axonal sprouting. The present observations suggest that alterations such as myofibrillar disruption and necrosis, muscle regeneration and denervation and synaptic remodeling at the level of the neuromuscular junction may take place during spaceflight.

  14. Imaging of adductor-related groin pain.

    PubMed

    Pesquer, L; Reboul, G; Silvestre, A; Poussange, N; Meyer, P; Dallaudière, B

    2015-09-01

    Groin pain is a common condition in athletes and results from various causes. Osteitis pubis, adductor dysfunction, inguinal hernia, or a combination of all three entities, generally explains the onset of symptoms. Adductor longus tendinopathy is the main cause of adductor-related groin pain. It leads to a significant reduction of sports participation and can require surgical management. Diagnosis is based on ultrasonography and magnetic resonance imaging. Asymptomatic findings (tendinosis, calcifications, cortical erosions) are common in athletes and care should be taken when assessing groin pain. The most specific sign of tendinopathy is an intratendinous tear of the adductor longus.

  15. Same but different: ontogeny and evolution of the Musculus adductor mandibulae in the Tetraodontiformes.

    PubMed

    Konstantinidis, P; Harris, M P

    2011-01-15

    The morphological diversity of fishes provides a rich source to address questions regarding the evolution of complex and novel forms. The Tetraodontiformes represent an order of highly derived teleosts including fishes, such as the pelagic ocean sunfishes, triggerfishes, and pufferfishes. This makes the order attractive for comparative analyses to understand the role of development in generating new forms during evolution. The adductor mandibulae complex, the main muscle associated with jaw closure, represents an ideal model system within the Tetraodontiformes. The adductor mandibulae differs in terms of partitions and their attachment sites between members of the different tetraodontiform families. In order to understand the evolution of the jaws among the Tetraodontiformes, we investigate the development of the adductor mandibulae in pufferfishes and triggerfishes as representatives of two different suborders (Balistoidei and Tetraodontoidei) that follows two different adaptations to a durophagous feeding mode. We show that the varied patterns of the adductor mandibulae derive from similar developmental sequence of subdivision of the partitions. We propose a conserved developmental program for partitioning of the adductor mandibulae as a foundation for the evolution of different patterns of subdivisions in Tetraodontiformes. Furthermore, we argue that derived conditions in the higher taxa are realized by supplementary subdivisions and altered attachment sites. These findings support a reinterpretation of homology of different muscle partitions among the Tetraodontiformes, as muscle partitions previously thought to be disparate, are now clearly related.

  16. Adductor tenotomy as a treatment for groin pain in professional soccer players.

    PubMed

    Mei-Dan, Omer; Lopez, Vicente; Carmont, Michael R; McConkey, Mark O; Steinbacher, Gilbert; Alvarez, Pedro D; Cugat, Ramon B

    2013-09-01

    Chronic, exercise-related groin pain is a debilitating condition. Nonoperative treatment has limited efficacy, but surgical intervention on the adductor-abdomino complex may be used to alleviate symptoms and allow return to play (RTP). The purpose of this study was to report the outcome of adductor tenotomy and hernioplasty for professional soccer players with groin pain. Between 2000 and 2006, a total of 155 professional and recreational soccer players with recalcitrant groin pain (with or without lower abdominal pain) and resistance to conservative treatment were included in this retrospective analysis. Ninety-six patients were treated with adductor tenotomy and 59 patients were treated with combined adductor tenotomy and hernioplasty. No difference in pre- or postoperative parameters was detected between groups, apart from abdominal wall muscle defects revealed during ultrasound for patients in the combined group. The RTP time and subjective and objective outcome measures were compared. A combined score was developed to evaluate outcomes that consisted of overall satisfaction (50%), RTP time (15%), and Tegner scores (35%). Mean RTP was 11 weeks (range, 4-36 weeks). Postoperative Tegner score remained 8.2 (same as the preinjury Tegner score). Subjective outcome was rated 4.3 of 5. The combined score indicated 80% of good or excellent results for both groups. Surgical intervention allows RTP at the same level in professional soccer players following failure of nonoperative treatments. Athletes with adductor syndrome and accompanying sportsman's hernia may benefit from adductor tenotomy alone.

  17. Scar revision

    PubMed Central

    Sharma, Mohit; Wakure, Abhijeet

    2013-01-01

    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

  18. Acne Scars

    MedlinePlus

    ... How to Choose the Best Skin Care Products Acne Scars Treatment Options Learn more about treatment options ... and flawless as the original skin. Why treat acne scarring Physical, emotional and social reasons for treating ...

  19. Evolutionary Trends in the Jaw Adductor Mechanics of Ornithischian Dinosaurs.

    PubMed

    Nabavizadeh, Ali

    2016-03-01

    Jaw mechanics in ornithischian dinosaurs have been widely studied for well over a century. Most of these studies, however, use only one or few taxa within a given ornithischian clade as a model for feeding mechanics across the entire clade. In this study, mandibular mechanical advantages among 52 ornithischian genera spanning all subclades are calculated using 2D lever arm methods. These lever arm calculations estimate the effect of jaw shape and difference in adductor muscle line of action on relative bite forces along the jaw. Results show major instances of overlap between taxa in tooth positions at which there was highest mechanical advantage. A relatively low bite force is seen across the tooth row among thyreophorans (e.g., stegosaurs and ankylosaurs), with variation among taxa. A convergent transition occurs from a more evenly distributed bite force along the jaw in basal ornithopods and basal marginocephalians to a strong distal bite force in hadrosaurids and ceratopsids, respectively. Accordingly, adductor muscle vector angles show repeated trends from a mid-range caudodorsal orientation in basal ornithischians to a decrease in vector angles indicating more caudally oriented jaw movements in derived taxa (e.g., derived thyreophorans, basal ornithopods, lambeosaurines, pachycephalosaurs, and derived ceratopsids). Analyses of hypothetical jaw morphologies were also performed, indicating that both the coronoid process and lowered jaw joint increase moment arm length therefore increasing mechanical advantage of the jaw apparatus. Adaptive trends in craniomandibular anatomy show that ornithischians evolved more complex feeding apparatuses within different clades as well as morphological convergences between clades.

  20. Hip adductor activations during run-to-cut manoeuvres in compression shorts: implications for return to sport after groin injury.

    PubMed

    Chaudhari, Ajit M W; Jamison, Steven T; McNally, Michael P; Pan, Xueliang; Schmitt, Laura C

    2014-01-01

    Athletes at high risk of groin strains in sports such as hockey and soccer often choose to wear shorts with directional compression to aid in prevention of or recovery from hip adductor strains. Large, eccentric contractions are known to result in or exacerbate strain injuries, but it is unknown if these shorts have a beneficial effect on hip adductor muscle activity. In this study, surface electromyography (EMG) of the adductor longus and ground reaction force (GRF) data were obtained simultaneously on 29 healthy individuals without previous history of serious injury while performing unanticipated 45° run-to-cut manoeuvres in a laboratory setting wearing shorts with non-directional compression (control, HeatGear, Under Armour, USA) or shorts with directional compression (directional, CoreShort PRO, Under Armour, USA), in random order. Average adductor activity in the stance leg was significantly lower in the directional condition than in the control condition during all parts of stance phase (all P < 0.042). From this preliminary analysis, wearing directional compression shorts appears to be associated with reduced stance limb hip adductor activity. Athletes seeking to reduce demand on the hip adductors as they approach full return to activities may benefit from the use of directional compression shorts.

  1. Hip adductor activations during run-to-cut maneuvers in compression shorts: Implications for return to sport after groin injury

    PubMed Central

    CHAUDHARI, AJIT M. W.; JAMISON, STEVEN T.; MCNALLY, MICHAEL P.; PAN, XUELIANG; SCHMITT, LAURA C.

    2014-01-01

    Athletes at high risk of groin strains in sports such as hockey and soccer often choose to wear shorts with directional compression to aid in prevention or recovery from hip adductor strains. Large eccentric contractions are known to result in or exacerbate strain injuries, but it is unknown if these shorts have a beneficial effect on hip adductor muscle activity. In this study, surface electromyography of the adductor longus and ground reaction force (GRF) data were obtained simultaneously on 29 healthy individuals without previous history of serious injury while performing unanticipated 45° run-to-cut maneuvers in a laboratory setting wearing shorts with non-directional compression (control, HeatGear, Under Armour, USA) or shorts with directional compression (directional, CoreShort PRO, Under Armour, USA), in random order. Average adductor activity in the stance leg was significantly lower in the directional condition than in the control condition during all parts of stance phase (all p<0.042). From this preliminary analysis, wearing directional compression shorts appears to be associated with reduced stance limb hip adductor activity. Athletes seeking to reduce demand on the hip adductors as they approach full return to activities may benefit from the use of directional compression shorts. PMID:24669858

  2. Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

    ERIC Educational Resources Information Center

    Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

    2004-01-01

    This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

  3. Experiment K-7-18: Effects of Spaceflight in the Muscle Adductor Longus of Rats Flown in the Soviet Biosatellite Cosmos 2044. Part 1; A Study Employing Neural Cell Adhesion Molecules (N-CAM) Immunocytochemistry and Conventional Morphological Techniques (Light and Electron Microscopy)

    NASA Technical Reports Server (NTRS)

    Daunton, N. G.; DAmelio, F.; Wu, L.; Ilyina-Kakueva, E. I.; Krasnov, I. B.; Hyde, T. M.; Sigworth, S. K.

    1994-01-01

    The effects of spaceflight upon the 'slow' muscle adductor longus was examined in rats flown in the Soviet Biosatellite COSMOS 2044. Three groups - synchronous, vivarium and basal served as controls. The techniques employed included standard methods for light microscopy, N-CAM immunocytochemistry and electron microscopy. Light microscopic observations revealed myofiber atrophy, contraction bands and segmental necrosis accompanied by cellular infiltrates composed of macrophages, leucocytes and mononuclear cells. N-CAM immunoreactivity was seen (N-CAM-IR) on the myofiber surface, satellite cells and in regenerating myofibers reminiscent of myotubes. Ultrastructural alterations included Z band streaming, disorganization of myofibrillar architecture, sarcoplasmic degradation, extensive segmental necrosis with preservation of the basement membrane, degenerative phenomena of the capillary endothelium and cellular invasion of necrotic areas. Regenerating myofibers were identified by the presence of increased amounts of ribosomal aggregates and chains of polyribosomes associated with myofilaments that displayed varied distributive patterns. The principal electron microscopic changes of the neuromuscular junctions consisted of a decrease or absence of synaptic vesicles, degeneration of axon terminals, increased number of microtubules, vacant axonal spaces and axonal sprouting. The present observations indicate that major alterations such as myofibrillar disruption and necrosis, muscle regeneration and denervation and synaptic remodeling at the level of the neuromuscular junction may take place during spaceflight.

  4. Three dimensional digital reconstruction of the jaw adductor musculature of the extinct marsupial giant Diprotodon optatum

    PubMed Central

    2014-01-01

    The morphology and arrangement of the jaw adductor muscles in vertebrates reflects masticatory style and feeding processes, diet and ecology. However, gross muscle anatomy is rarely preserved in fossils and is, therefore, heavily dependent on reconstructions. An undeformed skull of the extinct marsupial, Diprotodon optatum, recovered from Pleistocene sediments at Bacchus Marsh in Victoria, represents the most complete and best preserved specimen of the species offering a unique opportunity to investigate functional anatomy. Computed tomography (CT) scans and digital reconstructions make it possible to visualise internal cranial anatomy and predict location and morphology of soft tissues, including muscles. This study resulted in a 3D digital reconstruction of the jaw adductor musculature of Diprotodon, revealing that the arrangement of muscles is similar to that of kangaroos and that the muscle actions were predominantly vertical. 3D digital muscle reconstructions provide considerable advantages over 2D reconstructions for the visualisation of the spatial arrangement of the individual muscles and the measurement of muscle properties (length, force vectors and volume). Such digital models can further be used to estimate muscle loads and attachment sites for biomechanical analyses. PMID:25165628

  5. The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves.

    PubMed

    Takizawa, Megumi; Suzuki, Daisuke; Ito, Hajime; Fujimiya, Mineko; Uchiyama, Eiichi

    2014-07-01

    The hip adductor group, innervated predominantly by the obturator nerve, occupies a large volume of the lower limb. However, case reports of patients with obturator nerve palsy or denervation have described no more than minimal gait disturbance. Those facts are surprising, given the architectural characteristics of the hip adductors. Our aim was to investigate which regions of the adductor magnus are innervated by the obturator nerve and by which sciatic nerve and to consider the clinical implications. Twenty-one lower limbs were examined from 21 formalin-fixed cadavers, 18 males and 3 females. The adductor magnus was dissected and was divided into four parts (AM1-AM4) based on the locations of the perforating arteries and the adductor hiatus. AM1 was supplied solely by the obturator nerve. AM2, AM3, and AM4 received innervation from both the posterior branch of the obturator nerve and the tibial nerve portion of the sciatic nerve in 2 (9.5%), 20 (95.2%), and 6 (28.6%) of the cadavers, respectively. The double innervation in more than 90% of the AM3s is especially noteworthy. Generally, AM1-AM3 corresponds to the adductor part, traditionally characterized as innervated by the obturator nerve, and AM4 corresponds to the hamstrings part, innervated by the sciatic nerve. Here, we showed that the sciatic nerve supplies not only the hamstrings part but also the adductor part. These two nerves spread more widely than has generally been believed, which could have practical implications for the assessment and treatment of motor disability.

  6. Scar remodeling after strabismus surgery.

    PubMed Central

    Ludwig, I H

    1999-01-01

    PURPOSE: Patients with overcorrected strabismus (and several patients with undercorrection after extraocular muscle resection) underwent exploration of previously operated muscles, with the intention of advancing their tendons to prevent the need for surgery on additional muscles. Unexpectedly, it was found that, in many cases, an elongated scar segment of variable length was interposed between the muscle and its insertion site on the sclera. Laboratory investigations were carried out to elucidate the underlying mechanism(s) and to create an animal model of the disorder. METHODS: Lengthened scars were repaired on 198 muscles during 134 procedures performed on 123 patients. The scars consisted of amorphous connective tissue interposed between the globe and normal tendon. Repair was accomplished by excision of the scar and reattachment of the muscle to sclera, using absorbable sutures in 64 cases and nonabsorbable sutures in 70 cases. Histopathologic examination was performed on 82 clinical specimens, and tissue culture studies were performed on 7 specimens. To develop an animal model, 10 New Zealand white rabbits underwent bilateral superior rectus resection. Half of the eyes received sub-Tenon's injections of collagenase over the operative site during weeks 2, 3, 5, and 6 postoperatively; the other half received saline solution injections on the same schedule. At 10 weeks, half the sites were studied histologically, and the other half underwent collagen creep analysis. In a second study, the use of absorbable versus nonabsorbable sutures was compared in the rabbit model. RESULTS: In the clinical cases, the mean length of the elongated scar segments was 4.2 mm. A total of 105 of the 134 repair procedures were judged successful. Thirty-one procedures resulted in recurrence of the original overcorrection; 7 of these had documented restretches. Factors that distinguished patients with stretched scars from patients with classic slipped muscles included minimal or no

  7. Saphenous and Infrapatellar Nerves at the Adductor Canal: Anatomy and Implications in Regional Anesthesia.

    PubMed

    Anagnostopoulou, Sofia; Anagnostis, George; Saranteas, Theodosios; Mavrogenis, Andreas F; Paraskeuopoulos, Tilemachos

    2016-01-01

    Conflicting data exist regarding the anatomical relationship of the saphenous and infrapatellar nerves at the adductor canal and the location of the superior foramen of the canal. Therefore, the authors performed a cadaveric study to detail the relationship and course of the saphenous and infrapatellar nerves and the level of the superior foramen of the canal. The adductor canal and subsartorial compartment were dissected in 17 human cadavers. The distance between the superior foramen of the canal and the mid-distance (MD) between the base of the patella and the anterior superior iliac crest were measured; the course of the saphenous and infrapatellar nerves and the level of origin of the infrapatellar branch were detailed. In 13 of 17 specimens, the superior foramen of the adductor canal was distal to the MD (mean, 6.5 cm); in the remaining specimens, it was proximal to the MD. In 12 of 17 specimens, the infrapatellar branch exited the canal separately from the saphenous nerve; in the remaining specimens, it originated caudally to the canal. In all dissections, the infrapatellar branch had a constant course in close proximity to the saphenous nerve within the canal and between the sartorious muscle and femoral artery caudally to the canal. Most commonly, the superior foramen of the adductor canal is located caudally to the MD; the infrapatellar branch originates from the saphenous nerve within the canal and has a constant course in close proximity to the saphenous nerve. These observations should be considered for regional anesthesia techniques at the adductor canal.

  8. Radiological findings in symphyseal and adductor-related groin pain in athletes: a critical review of the literature.

    PubMed

    Branci, Sonia; Thorborg, Kristian; Nielsen, Michael Bachmann; Hölmich, Per

    2013-07-01

    Long-standing symphyseal and adductor-related groin pain is a common problem for many athletes, and requires a multidisciplinary approach. Radiological evaluation of symptomatic individuals is a cornerstone in the diagnostic workup, and should be based on precise and reliable diagnostic terms and imaging techniques. The authors performed a review of the existing original evidence-based radiological literature involving radiography, ultrasonography and MRI in athletes with long-standing symphyseal and adductor-related groin pain. Our search yielded 17 original articles, of which 12 were dedicated to MRI, four to radiography and one to ultrasonography. Four main radiological findings seem to consistently appear: degenerative changes at the pubic symphyseal joint, pathology at the adductor muscle insertions, pubic bone marrow oedema and the secondary cleft sign. However, the existing diagnostic terminology is confusing, and the interpretation of radiological findings would benefit from imaging studies using a more systematic approach.

  9. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review

    PubMed Central

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-01-01

    Summary Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289

  10. CLINICAL APPLICATION OF THE RIGHT SIDELYING RESPIRATORY LEFT ADDUCTOR PULL BACK EXERCISE

    PubMed Central

    2013-01-01

    Problem: Lumbopelvic‐femoral conditions are common and may be associated with asymmetrical musculoskeletal and respiratory impairments and postural mal‐alignment called a Left Anterior Interior Chain (AIC) pattern. An inherent pattern of asymmetry involves the trunk/ribs/spine/pelvis/hip joints and includes the tendency to stand on the right leg and shift the center of gravity to the right which may result for example, in a tight left posterior hip capsule, poorly approximated left hip, long/weak left adductors, internal obliques (IO) and transverse abdominus (TA), short/strong/over active paraspinals and muscles on the right anterior outlet (adductors, levator ani and obturator internus), a left rib flare and a decreased respiratory diaphragm zone of apposition (ZOA). The Solution: A therapeutic exercise technique that can address impairments associated with postural asymmetry may be beneficial in improving function, reducing and/or eliminating pain causation, and improving breathing. The Right Sidelying Left Respiratory Adductor Pull Back is an exercise designed to affect alignment of the lumbopelvic‐femoral region by influencing the left posterior ischiofemoral ligament, ZOA and right anterior outlet and left anterior inlet (rectus femoris, sartorius), activating/shortening the left adductors, left IO/TA's and inhibiting/lengthening the paraspinals, bilaterally. Discussion: The exercise technique is often used by Physical Therapists, Physical Therapist assistants and Athletic Trainers as an initial exercise to positively affect position/alignment of the lumbopelvic‐femoral region, referred to as “repositioning,” by clinicians who use it. Four published case studies have used similar exercises to address the above impairments associated with a Left AIC pattern and in each 100% improvement in function and pain intensity was described. This particular exercise technique is relatively new and warrants future research. PMID:23772350

  11. Facial Scar Revision: Understanding Facial Scar Treatment

    MedlinePlus

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

  12. Facial Scar Revision: Understanding Facial Scar Treatment

    MedlinePlus

    ... 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 ...

  13. Adductor T reflex abnormalities in patients with decreased patellar reflexes.

    PubMed

    Tataroglu, Cengiz; Deneri, Ersin; Ozkul, Ayca; Sair, Ahmet; Yaycioglu, Soner

    2009-08-01

    The adductor reflex (AR) is a tendon reflex that has various features that differ from other tendon reflexes. This reflex was tested in different disorders presenting with diminished patellar reflexes such as diabetic lumbosacral radiculoplexus neuropathy (DLRPN), L2-L4 radiculopathy, and distal symmetric diabetic neuropathy (diabetic PNP). The AR and crossed-AR (elicited by tapping the contralateral patellar tendon) were recorded using concentric needle electrodes. Additionally, the patellar T reflex (vm-TR) and vastus medialis H reflex (vm-HR) were recorded using surface electrodes. AR was recorded in only one out of eight patients with DLRPN, but it was recorded in 21 out of 22 patients with L2-L4 radiculopathy (95.5%). Of these reflexes, only AR showed prolonged latency in the L2-L4 radiculopathy group. The latencies of AR, vm-TR, and vm-HR were prolonged in patients with diabetic PNP. We conclude that AR can be useful in the differential diagnosis of some lower motor neuron disorders that present with patellar reflex disturbance. Muscle Nerve 40: 264-270, 2009.

  14. Periostin induces fibroblast proliferation and myofibroblast persistence in hypertrophic scarring.

    PubMed

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

    2015-02-01

    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, α 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 α 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.

  15. Acne scar subcision.

    PubMed

    Chandrashekar, Bs; Nandini, As

    2010-05-01

    Subcision is a simple and safe office surgery procedure for treatment of depressed acne scars. It can easily be combined with other treatments such as laser, dermaroller and scar revisions for maximum efficacy.

  16. Acne Scar Subcision

    PubMed Central

    Chandrashekar, BS; Nandini, AS

    2010-01-01

    Subcision is a simple and safe office surgery procedure for treatment of depressed acne scars. It can easily be combined with other treatments such as laser, dermaroller and scar revisions for maximum efficacy. PMID:21031076

  17. Scar contractures, hypertrophic scars, and keloids.

    PubMed

    Brissett, A E; Sherris, D A

    2001-11-01

    A scar contracture is the result of a contractile wound-healing process occurring in a scar that has already been reepithelialized and adequately healed. Keloids and hypertrophic scars (HTSs) are fibrous tissue outgrowths that result from a derailment in the normal wound-healing process. The exact incidence of keloids and HTSs remains unknown. Beyond the common belief that trauma is the initiating event of keloid and hypertrophic scar formation, the remainder of the process remains uncertain. A combination of biochemical factors, skin tension, endocrinologic factors, and genetic factors are the likely culprits. Treatment begins by educating the patient about the etiology of the scarring process. All treatment protocols are individualized, but the standard approach to keloids and HTSs begins with corticosteroid injection followed by surgical excision, pressure dressings, and long-term follow-up.

  18. Adductor Pollicis Longus Strain in a Professional Baseball Player

    PubMed Central

    Pinkowsky, Gregory J.; Roberts, John; Allred, Jeff; Pujalte, George G.; Gallo, Robert A.

    2013-01-01

    Thenar pain can represent a significant morbidity for a baseball player who relies on manual dexterity for gripping a bat and precise and accurate throws. While osseous, ligamentous, and neurovascular pathologies are commonly considered, musculotendinous injuries are often neglected in the differential diagnosis of thenar pain. We present a case of adductor pollicis longus strain as a cause of acute thenar pain in a baseball player. Adductor pollicis longus strains should be considered in any baseball player sustaining a hyperabduction force to the thumb. PMID:24459545

  19. The results of adductor magnus tenodesis in adolescents with recurrent patellar dislocation.

    PubMed

    Malecki, Krzysztof; Fabis, Jaroslaw; Flont, Pawel; Niedzielski, Kryspin Ryszard

    2015-01-01

    Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL) becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of our study is to assess the effectiveness of this surgical procedure. The outcomes were evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton index, sulcus angle, congruence angle, and patellofemoral angle). Four patients demonstrated redislocation with MPFL graft failure, despite the fact that patellar tracking was found to be normal before the injury, and the patients had not reported any symptoms. Statistically significant improvements in Lysholm and Kujala scales, in patellofemoral and congruence angle, were seen (P < 0.001). A statistically significant improvement in the peak torque of the quadriceps muscle and flexor was observed for 60°/sec and 180°/sec angular velocities (P = 0.01). Our results confirm the efficacy of MPFL reconstruction using the adductor magnus tendon in children and adolescents with recurrent patellar dislocation.

  20. The growth patterns of three hindlimb muscles in the chicken.

    PubMed Central

    Helmi, C; Cracraft, J

    1977-01-01

    This study was designed to investigate the growth patterns of three hindlimb muscles of the chicken relative to the functional-biomechanical demands of increasing body size. The biceps femoris, a bipennate non-postural muscle, grew relatively faster in terms of wet and dry weight than did the parallel-fibred adductor superficialis or the unipennate adductor profundus, both postural muscles. All three muscles exhibited positive allometry (relative to body weight) in muscle length but only biceps femoris and adductor profundus showed positive allometry in cross sectional area adductor superficialis having isometric growth in this parameter. In biceps femoris and adductor superficialis the lengths of the longest and shortest fasciculi grew at equal rates, whereas in adductor profundus the shortest fasciculi grew faster than the longest. We conclude that muscle weight alone is an insufficient indicator of changing function in growing muscle. Hence, growth studies should include other functionally relevant parameters such as cross sectional area, which is proportional to the force-producing capabilities of the muscle, or fibre (fasciculus) length, which is indicative of the absolute amount of stretching or shortening that is possible and of the contraction velocity. PMID:885779

  1. Botulinum toxin to minimize facial scarring.

    PubMed

    Jablonka, Eric M; Sherris, David A; Gassner, Holger G

    2012-10-01

    Chemoimmobilization with botulinum toxin A is an ideal biochemical agent that allows near-total elimination of muscle pull on the healing facial wound. The goal of chemoimmobilization of facial cutaneous wounds is to eliminate dynamic tension on the healing tissues to improve wound healing and minimize scarring for optimal aesthetic results.

  2. [Mastopexy with minimal scar].

    PubMed

    Tepavicharova-Romanska, P; Romanski, R K

    2004-01-01

    The image of the breast as a symbol of femininity plays an essential role in the way a woman looks at herself and contributes to her personal and social development. Fashion nowadays uncovers rather than covers a woman's body, and long scars resulting from mammaplasty are less accepted now than they were in the past, more so because the scar quality is unforeseeable. The main concern of mastopexy is to limit the scars, creating a nice breast shape. Ideally scarring is confined to the periareolar circle.

  3. Mechanobiology of scarring.

    PubMed

    Ogawa, Rei

    2011-09-01

    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.

  4. Laser scar revision.

    PubMed

    Lupton, Jason R; Alster, Tina S

    2002-01-01

    A variety of lasers can be used to treat scars and striae effectively. It is of paramount importance that the type of scar be properly classified on initial examination so that the most appropriate method of treatment can be chosen. Classification also allows the laser surgeon to discuss with the patient the anticipated response to treatment. The 585-nm pulsed dye laser (PDL) is the most appropriate system for treating hypertrophic scars, keloids, erythematous scars, and striae. The PDL carries a low risk of side effects and complications when operated at appropriate treatment parameters and time intervals. Atrophic scars are best treated with ablative CO2 and Er:YAG lasers; however, proliferative keloids and hypertrophic scars should not be vaporized because of the high risk of scar recurrence or progression. The appropriate choice and use of lasers can significantly improve most scars. As research in laser-skin interaction continues, further refinements in laser technology coupled with the addition of alternate treatment procedures will allow improved clinical efficacy and predictability.

  5. Psoas and adductor release in children with cerebral palsy.

    PubMed

    Spruit, M; Fabry, G

    1997-06-01

    In a retrospective study of 12 cerebral palsy patients with 17 hips treated for subluxation, clinical and radiographic results of psoas and adductor releases were reviewed. With an average follow-up of 4.05 years, the functional ability was improved in 3 spastic quadriplegics and 3 diplegics and maintained in 6 other patients. The CE-angle and femoral head coverage did not change significantly. The AC-index improved significantly (p = 0.01).

  6. Parrotfish grazing ability: interspecific differences in relation to jaw-lever mechanics and relative weight of adductor mandibulae on an Okinawan coral reef.

    PubMed

    Nanami, Atsushi

    2016-01-01

    Parrotfishes (family Labridae: Scarini) are regarded to have important roles for maintaining the ecosystem balance in coral reefs due to their removal of organic matter and calcic substrates by grazing. The purpose of the present study was to clarify the interspecific differences in grazing ability of five parrotfish species (Chlorurus sordidus, C. bowersi, Scarus rivulatus, S. niger and S. forsteni) in relation to interspecific differences in jaw-lever mechanics and the relative weight of the adductor mandibulae (muscles operating jaw closing). The grazing ability was calculated by using stomach contents (CaCO3 weight/organic matter weight) defined as the grazing ability index (GAI). There were significant interspecific differences in GAI (C. sordidus = C. bowersi > S. rivulatus > S. niger = S. forsteni). Teeth of C. sordidus and C. bowersi were protrusive-shape whereas teeth of S. rivulatus, S. niger and S. forsteni were flat-shape. C. sordidus and C. bowersihave jaw-lever mechanics producing a greater biting force and have a larger weight of adductor mandibulae. S. rivulatus has jaw-lever mechanics producing a greater biting force but a smaller weight of adductor mandibulae that produce an intermediate biting force. In contrast, S. niger and S. forsteni have jaw-lever mechanics producing a lesser biting force and have a smaller weight of adductor mandibulae. Feeding rates and foray size of S. rivulatus, S. niger and S. forsteni were greater than C. sordidus and C. bowersi. The degree in bioerosion (GAI × feeding rate) was the largest for S. rivulatusand the smallest for S. forsteni. The degree in bioerosion for C. sordidus was larger than S. niger whereas relatively equal between C. bowersi and S. niger. These results suggest that interspecific difference in GAI was explained by interspecific differences in teeth shape, jaw-lever mechanics and relative weight of adductor mandibulae. The interspecific difference in the degree of bioerosion suggests the

  7. Scars and Wounds

    MedlinePlus

    ... Skin Problems Dry Skin Itching Skin Color Changes Pressure Sores Scars and Wounds Treatments and Side Effects Managing ... purple bruising of skin Scaly, broken skin (see Pressure Sores ) Crusts, scabs, or cuts in the skin Bleeding ...

  8. [Unusual breast scars].

    PubMed

    Petit, F; Divaris, M; Guilbert, F

    1999-12-01

    The authors report the case of an unusual form of skin tattoo, discovered on the breasts of a young woman, corresponding to several scars forming a symbolic image, performed deliberately with a burning object. This form of mutilation is called "branding". Imported from England, it is developing in France as a result of fashion, but its followers could one day regret the permanent scars left by this deep burn.

  9. Botulinum toxin to minimize facial scarring.

    PubMed

    Sherris, David A; Gassner, Holger G

    2002-02-01

    Botulinum toxin injection has been used for a variety of indications in humans, including blepharospasm and hyperfunctional facial lines. This article describes a novel formulation of botulinum toxin, which supplies immediate feedback to the injecting physician. Additionally, recent findings are described that indicate the immediate injection of botulinum toxin into the muscles underlying a wound can improve the cosmetic outcome of the facial cutaneous scar. Future applications of these findings are discussed.

  10. Surgical Scar Revision: An Overview

    PubMed Central

    Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

    2014-01-01

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

  11. Can Acne Scars Be Removed?

    MedlinePlus

    ... Surgery? A Week of Healthy Breakfasts Shyness Can Acne Scars Be Removed? KidsHealth > For Teens > Can Acne ... eliminar las cicatrices del acné? Different Types of Acne Scars from acne can seem like double punishment — ...

  12. Scar revision - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100098.htm Scar revision - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  13. Changes in Adductor Strength After Competition in Academy Rugby Union Players.

    PubMed

    Roe, Gregory A B; Phibbs, Padraic J; Till, Kevin; Jones, Ben L; Read, Dale B; Weakley, Jonathon J; Darrall-Jones, Joshua D

    2016-02-01

    This study determined the magnitude of change in adductor strength after a competitive match in academy rugby union players and examined the relationship between locomotive demands of match-play and changes in postmatch adductor strength. A within-subject repeated measures design was used. Fourteen academy rugby union players (age, 17.4 ± 0.8 years; height, 182.7 ± 7.6 cm; body mass, 86.2 ± 11.6 kg) participated in the study. Each player performed 3 maximal adductor squeezes at 45° of hip flexion before and immediately, 24, 48, and 72 hours postmatch. Global positioning system was used to assess locomotive demands of match-play. Trivial decreases in adductor squeeze scores occurred immediately (-1.3 ± 2.5%; effect size [ES] = -0.11 ± 0.21; likely, 74%) and 24 hours after match (-0.7 ± 3%; ES = -0.06 ± 0.25; likely, 78%), whereas a small but substantial increase occurred at 48 hours (3.8 ± 1.9%; ES = 0.32 ± 0.16; likely, 89%) before reducing to trivial at 72 hours after match (3.1 ± 2.2%; ES = 0.26 ± 0.18; possibly, 72%). Large individual variation in adductor strength was observed at all time points. The relationship between changes in adductor strength and distance covered at sprinting speed (VO2max ≥ 81%) was large immediately postmatch (p = 0.056, r = -0.521), moderate at 24 hours (p = 0.094, r = -0.465), and very large at 48 hours postmatch (p = 0.005, r = -0.707). Players who cover greater distances sprinting may suffer greater adductor fatigue in the first 48 hours after competition. The assessment of adductor strength using the adductor squeeze test should be considered postmatch to identify players who may require additional rest before returning to field-based training.

  14. Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability.

    PubMed

    Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

    2014-02-07

    The purpose of this study was to compare cortical inhibition in the hand region of the primary motor cortex between subjects with focal hand dystonia (FHD), adductor spasmodic dysphonia (AdSD), and healthy controls. Data from 28 subjects were analyzed (FHD n=11, 53.25 ± 8.74 y; AdSD: n=8, 56.38 ± 7.5 y; and healthy controls: n=941.67 ± 10.85 y). All subjects received single pulse TMS to the left motor cortex to measure cortical silent period (CSP) in the right first dorsal interosseus (FDI) muscle. Duration of the CSP was measured and compared across groups. A one-way ANCOVA with age as a covariate revealed a significant group effect (p<0.001). Post hoc analysis revealed significantly longer CSP duration in the healthy group vs. AdSD group (p<0.001) and FHD group (p<0.001). These results suggest impaired intracortical inhibition is a neurophysiologic characteristic of FHD and AdSD. In addition, the shortened CSP in AdSD provides evidence to support a widespread decrease in cortical inhibition in areas of the motor cortex that represent an asymptomatic region of the body. These findings may inform future investigations of differential diagnosis as well as alternative treatments for focal dystonias.

  15. Modeling fibrosis using fibroblasts isolated from scarred rat vocal folds

    PubMed Central

    Kishimoto, Yo; Kishimoto, Ayami Ohno; Ye, Shuyun; Kendziorski, Christina; Welham, Nathan V.

    2016-01-01

    Following injury, pathologically activated vocal fold fibroblasts (VFFs) can engage in disordered extracellular matrix (ECM) remodeling, leading to VF fibrosis and impaired voice function. Given the importance of scar VFFs to phenotypically appropriate in vitro modeling of VF fibrosis, we pursued detailed characterization of scar VFFs obtained from surgically injured rat VF mucosae, compared to those obtained from experimentally naïve, age-matched tissue. Scar VFFs initially exhibited a myofibroblast phenotype characterized by increased proliferation, increased Col1a1 transcription and collagen, type I synthesis, increased Acta2 transcription and α-smooth muscle actin synthesis, and enhanced contractile function. These features were most distinct at passage 1 (P1); we observed a coalescence of the scar and naïve VFF phenotypes at later passages. An empirical Bayes statistical analysis of the P1 cell transcriptome identified 421 genes that were differentially expressed by scar, compared to naïve, VFFs. These genes were primarily associated with the wound response, ECM regulation, and cell proliferation. Follow-up comparison of P1 scar VFFs and their in vivo tissue source showed substantial transcriptomic differences. Finally, P1 scar VFFs responded to treatment with hepatocyte growth factor and transforming growth factor-β3, two biologics with reported therapeutic value. Despite the practical limitations inherent to working with early passage cells, this experimental model is easily implemented in any suitably equipped laboratory and has the potential to improve the applicability of preclinical VF fibrosis research. PMID:27111284

  16. Emerging Therapies for Scar Prevention

    PubMed Central

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

    2015-01-01

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

  17. Update on hypertrophic scar treatment

    PubMed Central

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

    2014-01-01

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

  18. Management of scar contractures, hypertrophic scars, and keloids.

    PubMed

    Sherris, D A; Larrabee, W F; Murakami, C S

    1995-10-01

    Aberrant fibrous tissue formation after surgery or trauma still presents a challenge to surgeons. Current research hopes to identify the characteristics of the population of fibroblasts that lead to hypertrophic or keloid scar formation. Surgical procedures and laser therapy followed by intralesional steroid treatments still are the foundation of treatment; but new modalities are being applied. The pathogenesis and management of hypertrophic scars, keloids, and scar contractures are discussed in this article.

  19. An anatomic and clinical study of the adductor magnus tendon-descending genicular artery bone flap.

    PubMed

    Huang, Dong; Wang, Hai-Wen; Xu, Da-Chuan; Wang, Hong-Gang; Wu, Wei-Zhi; Zhang, Hui-Ru

    2011-01-01

    The composite tissue flap of the descending genicular vessels with the adductor magnus tendon is a newly developed, reliable method to repair the Achilles tendon and relevant skin defects. The aim of this study was to evaluate the anatomy of the adductor magnus tendon-descending genicular artery bone flap, and the feasibility and value for the repair of the Achilles tendon and relevant skin defects. There were 34 adult specimens used for the anatomy of this flap. The descending genicular artery originates 10.5 ± 1.6 cm above the adductor tubercle, with a diameter of 1.8 ± 0.6 mm and a length of 1.2 ± 0.5 cm. Its articular branch is distributed in the adductor magnus tendon and the medial condyle of the femur. The saphenous branch has a diameter of 1.1 ± 0.3 mm and is distributed in the skin of the upper medial calf. A total of 16 cases of trauma-induced Achilles tendon damage and calcaneus and skin defects were repaired with the vascularized adductor magnus tendon bone flap, including the reconstruction of Achilles tendon insertion and repair of relevant skin defects. All of the composite tissue flaps were viable, the skin sensation of the flaps was recovered, and all patients walked with a normal gait. Our results suggested that the adductor magnus tendon-descending genicular artery bone flap is an alternative method to repair composite tissue defects of the Achilles tendon.

  20. Parrotfish grazing ability: interspecific differences in relation to jaw-lever mechanics and relative weight of adductor mandibulae on an Okinawan coral reef

    PubMed Central

    2016-01-01

    Parrotfishes (family Labridae: Scarini) are regarded to have important roles for maintaining the ecosystem balance in coral reefs due to their removal of organic matter and calcic substrates by grazing. The purpose of the present study was to clarify the interspecific differences in grazing ability of five parrotfish species (Chlorurus sordidus, C. bowersi, Scarus rivulatus, S. niger and S. forsteni) in relation to interspecific differences in jaw-lever mechanics and the relative weight of the adductor mandibulae (muscles operating jaw closing). The grazing ability was calculated by using stomach contents (CaCO3 weight/organic matter weight) defined as the grazing ability index (GAI). There were significant interspecific differences in GAI (C. sordidus = C. bowersi > S. rivulatus > S. niger = S. forsteni). Teeth of C. sordidus and C. bowersi were protrusive-shape whereas teeth of S. rivulatus, S. niger and S. forsteni were flat-shape. C. sordidus and C. bowersihave jaw-lever mechanics producing a greater biting force and have a larger weight of adductor mandibulae. S. rivulatus has jaw-lever mechanics producing a greater biting force but a smaller weight of adductor mandibulae that produce an intermediate biting force. In contrast, S. niger and S. forsteni have jaw-lever mechanics producing a lesser biting force and have a smaller weight of adductor mandibulae. Feeding rates and foray size of S. rivulatus, S. niger and S. forsteni were greater than C. sordidus and C. bowersi. The degree in bioerosion (GAI × feeding rate) was the largest for S. rivulatusand the smallest for S. forsteni. The degree in bioerosion for C. sordidus was larger than S. niger whereas relatively equal between C. bowersi and S. niger. These results suggest that interspecific difference in GAI was explained by interspecific differences in teeth shape, jaw-lever mechanics and relative weight of adductor mandibulae. The interspecific difference in the degree of bioerosion suggests the

  1. Dune Avalanche Scars

    NASA Technical Reports Server (NTRS)

    2004-01-01

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

  2. Longitudinal burn scar quantification.

    PubMed

    Nedelec, Bernadette; Correa, José A; de Oliveira, Ana; LaSalle, Leo; Perrault, Isabelle

    2014-12-01

    Quantitative studies of the clinical recovery of burn scars are currently lacking. Previous reports validate the objective, precise, diagnostic capabilities of high-frequency ultrasound to measure thickness, the Cutometer(®) to measure pliability and the Mexameter(®) to measure erythema and pigmentation of scars. Thus, we prospectively quantified clinical characteristics of patient-matched, after burn hypertrophic scar (HSc), donor site scar (D) and normal skin (N) using these instruments. One investigator measured 3 sites (HSc, D, N) in 46 burn survivors at 3, 6, and 12 months after-burn. A mixed model regression analysis, adjusting p-values for multiplicity of testing, was used to compare means among sites and time points. Participants were 41.2±13.5 years old, 87% males, predominantly Caucasian, with an average of 19.5% body surface area burned. HSc thickness decreased significantly between 3 and 6, 6 and 12, and 3 and 12 months (all p<0.0001), but remained thicker than D and N skin (all p<0.0001). Pliability differed significantly between HSc, D and N sites at all time points (all p<0.0001), with HSc and D increasing between 3 and 12 months (p<0.05) but not reaching normal. HSc and D sites were significantly more erythematous than normal skin (p<0.05) at 3 and 6 months but D sites approached normal by 12 months. The only time points at which pigmentation significantly differed were the HSc and D sites at 6 months. Thickness, pliability, erythema and pigmentation of N skin remained similar over the 12 months. We found that post-burn HSc thickness, pliability and erythema differed significantly from D and N skin at 3, 6, and 12 months and does not return to normal by 12 months after-injury; however, significant improvements towards normal can be expected. Donor sites are redder than normal skin at 3 and 6 months but can be expected to return to normal by 12 months. Although the color of HSc and D sites change markedly with time these color changes are

  3. Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.

    PubMed

    Hopp, Sascha; Tumin, Masjudin; Wilhelm, Peter; Pohlemann, Tim; Kelm, Jens

    2014-11-01

    We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting.

  4. Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia.

    PubMed

    Suppa, A; Marsili, L; Giovannelli, F; Di Stasio, F; Rocchi, L; Upadhyay, N; Ruoppolo, G; Cincotta, M; Berardelli, A

    2015-08-01

    In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during 'linguistic' tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated 'linguistic' task-related cortical excitability modulation in patients with adductor-type spasmodic dysphonia (ASD), a speech-related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non-dominant M1 excitability at baseline, during 'linguistic' (reading aloud/silent reading/producing simple phonation) and 'non-linguistic' tasks (looking at non-letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the 'linguistic' tasks with different voice intensities. We also examined MEPs in HS and ASD during hand-related 'action-verb' observation. Patients were studied under and not-under botulinum neurotoxin-type A (BoNT-A). In HS, TMS over the dominant M1 elicited larger MEPs during 'reading aloud' than during the other 'linguistic'/'non-linguistic' tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased-amplitude MEPs during 'reading aloud' and 'syllabic phonation' tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing 'linguistic'/'non-linguistic' tasks. In HS and ASD, 'linguistic' task-related excitability changes were present regardless of the different voice intensities. During hand-related 'action-verb' observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT-A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to 'linguistic' tasks; BoNT-A returns these excitability changes to normal.

  5. New innovations in scar management.

    PubMed

    Widgerow, A D; Chait, L A; Stals, R; Stals, P J

    2000-01-01

    As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. With this in mind, a scar management program has been adopted based on the modalities of wound support, hydration, and hastened maturity, all factors gleaned from scientific evidence published over the past 25 years. Tension on a scar in one axis will result in a stretched scar, probably initiated by neutrophils and their neutral proteases [18,26]. Tension on a scar from many directions or intermittently will result in a hypertrophic scar, possibly initiated by lymphocytes but definitely related to a prolongation of the inflammatory process, with increased fibroblast activity and overabundant extracellular matrix secretion [24,26]. The common initiating factor is the tension on the scar, and the critical element needed to counteract this tension is scar support. Clinical experience has shown us that the most reliable way to support a scar is by using microporous tape. Hydration is a second beneficial influence on scar control and is the basis of the use of silicone sheeting and gel [7,29,36]. Alpha Centella cream has two main components. The first is an extract from the plant Bulbine frutescens. This increases hydration under the tape by leaving a layer of fatty vesicles of glycoprotein on the skin surface. This also has antibacterial properties. The second component is the principal terpenoids extracted from the Centella asiatica plant. These include asiatic acid, madecassic acid, and asiaticoside. Centella asiatica has been documented to aid wound healing in a large number of scientific reports [5,12,21,22,33,34,40]. The most beneficial effect appears to be the stimulation of maturation of the scar by the production of type I collagen [4,19] and the resulting decrease in the inflammatory reaction and myofibroblast production. Thus these components have been incorporated into

  6. The connective tissue of the adductor canal--a morphological study in fetal and adult specimens.

    PubMed

    de Oliveira, Flavia; de Vasconcellos Fontes, Ricardo Bragança; da Silva Baptista, Josemberg; Mayer, William Paganini; de Campos Boldrini, Silvia; Liberti, Edson Aparecido

    2009-03-01

    The adductor canal is a conical or pyramid-shaped pathway that contains the femoral vessels, saphenous nerve and a varying amount of fibrous tissue. It is involved in adductor canal syndrome, a claudication syndrome involving young individuals. Our objective was to study modifications induced by aging on the connective tissue and to correlate them to the proposed pathophysiological mechanism. The bilateral adductor canals and femoral vessels of four adult and five fetal specimens were removed en bloc and analyzed. Sections 12 microm thick were obtained and the connective tissue studied with Sirius Red, Verhoeff, Weigert and Azo stains. Scanning electron microscopy (SEM) photomicrographs of the surfaces of each adductor canal were also analyzed. Findings were homogeneous inside each group. The connective tissue of the canal was continuous with the outer layer of the vessels in both groups. The pattern of concentric, thick collagen type I bundles in fetal specimens was replaced by a diffuse network of compact collagen bundles with several transversal fibers and an impressive content of collagen III fibers. Elastic fibers in adults were not concentrated in the thick bundles but dispersed in line with the transversal fiber system. A dynamic compression mechanism with or without an evident constricting fibrous band has been proposed previously for adductor canal syndrome, possibly involving the connective tissue inside the canal. The vessels may not slide freely during movement. These age-related modifications in normal individuals may represent necessary conditions for this syndrome to develop.

  7. The connective tissue of the adductor canal – a morphological study in fetal and adult specimens

    PubMed Central

    de Oliveira, Flavia; de Vasconcellos Fontes, Ricardo Bragança; da Silva Baptista, Josemberg; Mayer, William Paganini; de Campos Boldrini, Silvia; Liberti, Edson Aparecido

    2009-01-01

    The adductor canal is a conical or pyramid-shaped pathway that contains the femoral vessels, saphenous nerve and a varying amount of fibrous tissue. It is involved in adductor canal syndrome, a claudication syndrome involving young individuals. Our objective was to study modifications induced by aging on the connective tissue and to correlate them to the proposed pathophysiological mechanism. The bilateral adductor canals and femoral vessels of four adult and five fetal specimens were removed en bloc and analyzed. Sections 12 µm thick were obtained and the connective tissue studied with Sirius Red, Verhoeff, Weigert and Azo stains. Scanning electron microscopy (SEM) photomicrographs of the surfaces of each adductor canal were also analyzed. Findings were homogeneous inside each group. The connective tissue of the canal was continuous with the outer layer of the vessels in both groups. The pattern of concentric, thick collagen type I bundles in fetal specimens was replaced by a diffuse network of compact collagen bundles with several transversal fibers and an impressive content of collagen III fibers. Elastic fibers in adults were not concentrated in the thick bundles but dispersed in line with the transversal fiber system. A dynamic compression mechanism with or without an evident constricting fibrous band has been proposed previously for adductor canal syndrome, possibly involving the connective tissue inside the canal. The vessels may not slide freely during movement. These age-related modifications in normal individuals may represent necessary conditions for this syndrome to develop. PMID:19245505

  8. Homology of the jaw muscles in lizards and snakes-a solution from a comparative gnathostome approach.

    PubMed

    Johnston, Peter

    2014-03-01

    Homology or shared evolutionary origin of jaw adductor muscles in lizards and snakes has been difficult to establish, although snakes clearly arose within the lizard radiation. Lizards typically have temporal adductors layered lateral to medial, and in snakes the muscles are arranged in a rostral to caudal pattern. Recent work has suggested that the jaw adductor group in gnathostomes is arranged as a folded sheet; when this theory is applied to snakes, homology with lizard morphology can be seen. This conclusion revisits the work of S.B. McDowell, J Herpetol 1986; 20:353-407, who proposed that homology involves identity of m. levator anguli oris and the loss of m. adductor mandibulae externus profundus, at least in "advanced" (colubroid) snakes. Here I advance the folded sheet hypothesis across the whole snake tree using new and literature data, and provide a solution to this homology problem.

  9. Anatomy and adaptations of the chewing muscles in Daubentonia (Lemuriformes).

    PubMed

    Perry, Jonathan M G; Macneill, Kristen E; Heckler, Amanda L; Rakotoarisoa, Gilbert; Hartstone-Rose, Adam

    2014-02-01

    The extractive foraging behavior in aye-ayes (Daubentonia madagascariensis) is unique among primates and likely has led to selection for a specialized jaw adductor musculature. Although this musculature has previously been examined in a subadult, until now, no one has reported the fascicle length, weight, and physiological cross-sectional area (PCSA) for these muscles in an adult aye-aye specimen. For the present study, we dissected an adult wild-born aye-aye from the Tsimbazaza Botanical and Zoological Park, Antananarivo, Madagascar. The aye-aye follows the general strepsirrhine pattern in its overall jaw adductor muscle anatomy, but has very large muscles and PCSA relative to body size. Fascicle length is also relatively great, but not nearly as much as in the juvenile aye-aye previously dissected. Perhaps chewing muscle fascicles begin relatively long, but shorten through use and growth as connective tissue sheets expand and allow for pinnation and increased PCSA. Alternately, it may be that aye-ayes develop fascicular adaptation to wide gapes early in ontogeny, only to increase PCSA through later development into adulthood. The functional demands related to their distinctive manner of extractive foraging are likely responsible for the great PCSA in the jaw adductor muscles of the adult aye-aye. It may be that great jaw adductor PCSA in the adult, as compared to the juvenile, is a means of increasing foraging efficiency in the absence of parental assistance. Anat Rec, 297:308-316, 2014. © 2013 Wiley Periodicals, Inc.

  10. The impact of Pfannenstiel scars on TRAM flap complications.

    PubMed

    Dayhim, Fariba; Wilkins, Edwin G

    2004-11-01

    For the past two decades, the transverse rectus abdominis musculocutaneous (TRAM) flap has been a mainstay of postmastectomy breast reconstruction. Because the flap depends on musculocutaneous perforating vessels from the rectus muscle for survival, some authors have raised concerns about increased risks of TRAM flap loss in patients with scars from previous abdominal surgeries, particularly those with Pfannenstiel scars. To assess the effects of Pfannenstiel scars on complication rates, we retrospectively evaluated the inpatient and outpatient records of 241 patients undergoing TRAM reconstruction in a single institution over an 11-year period. Of these patients, 51 had previous Pfannenstiel scars. while 190 did not. Controlling for potential confounding variables (body mass index and timing of reconstruction), logistic regressions found no significant differences between the Pfannenstiel and nonPfannenstiel cohorts in the rate of flap loss (15.7% and 20%, respectively; P = 0.376) or in the incidence of postoperative abdominal donor site laxity (17.6% and 12.1%, respectively; P= 0.361). Within the Pfannenstiel group, the type of TRAM reconstruction (ie, pedicle versus free flaps) did not have a significant effect on complication rates. We conclude that previous concerns over the impact of preexisting Pfannenstiel scars on TRAM flap complications are unfounded.

  11. New insights into dinosaur jaw muscle anatomy.

    PubMed

    Holliday, Casey M

    2009-09-01

    Jaw muscles are key components of the head and critical to testing hypotheses of soft-tissue homology, skull function, and evolution. Dinosaurs evolved an extraordinary diversity of cranial forms adapted to a variety of feeding behaviors. However, disparate evolutionary transformations in head shape and function among dinosaurs and their living relatives, birds and crocodylians, impair straightforward reconstructions of muscles, and other important cephalic soft tissues. This study presents the osteological correlates and inferred soft tissue anatomy of the jaw muscles and relevant neurovasculature in the temporal region of the dinosaur head. Hypotheses of jaw muscle homology were tested across a broad range archosaur and sauropsid taxa to more accurately infer muscle attachments in the adductor chambers of non-avian dinosaurs. Many dinosaurs likely possessed m. levator pterygoideus, a trait shared with lepidosaurs but not extant archosaurs. Several major clades of dinosaurs (e.g., Ornithopoda, Ceratopsidae, Sauropoda) eliminated the epipterygoid, thus impacting interpretations of m. pseudotemporalis profundus. M. pseudotemporalis superficialis most likely attached to the caudoventral surface of the laterosphenoid, a trait shared with extant archosaurs. Although mm. adductor mandibulae externus profundus and medialis likely attached to the caudal half of the dorsotemporal fossa and coronoid process, clear osteological correlates separating the individual bellies are rare. Most dinosaur clades possess osteological correlates indicative of a pterygoideus ventralis muscle that attaches to the lateral surface of the mandible, although the muscle may have extended as far as the jugal in some taxa (e.g., hadrosaurs, tyrannosaurs). The cranial and mandibular attachments of mm adductor mandibulae externus superficialis and adductor mandibulae posterior were consistent across all taxa studied. These new data greatly increase the interpretive resolution of head anatomy in

  12. [The scars of Andy Warhol].

    PubMed

    Scholz, A

    1996-02-01

    The biographical and artistic documents describing to the attempted assassination of the artist Andy Warhol are reviewed. The visible scars are interpreted as symbols of the damaged integrity of the skin.

  13. Description and scaling of pectoral muscles in ictalurid catfishes.

    PubMed

    Miano, Joseph Paul; Loesser-Casey, Kathryn E; Fine, Michael L

    2013-04-01

    The pectoral spine of catfishes is an antipredator adaptation that can be bound, locked, and rubbed against the cleithrum to produce stridulation sounds. We describe muscle morphology of the pectoral spines and rays in six species in four genera of North American ictalurid catfishes. Since homologies of catfish pectoral muscles have not been universally accepted, we designate them functionally as the spine abductor and adductor and the arrector dorsalis and ventralis. The four muscles of the remaining pectoral rays are the superficial and deep (profundal) abductors and adductors. The large spine abductor and spine adductor are responsible for large amplitude movements, and the smaller arrector dorsalis and arrector ventralis have more specialized functions, that is, spine elevation and depression, respectively, although they also contribute to spine abduction. Three of the four spine muscles were pennate (the abductor and two arrectors), the spine adductor can be pennate or parallel, and ray muscles have parallel fibers. Insertions of pectoral muscles are similar across species, but there is a shift of origins in some muscles, particularly of the superficial abductor of the pectoral rays, which assumes a midline position in Ictalurus and increasingly more lateral placement in Ameiurus (one quarter way out from the midline), and Pylodictis and Noturus (half way out). Coincident with this lateral shift, the attachments of the hypaxial muscle to the ventral girdle become more robust. Comparison with its sister group supports the midline position as basal and lateral migration as derived. The muscles of the pectoral spine are heavier than muscles of the remaining rays in all species but the flathead, supporting the importance of specialized spine functions above typical movement. Further, spine muscles were larger than ray muscles in all species but the flathead catfish, which lives in water with the fastest currents.

  14. A pilot study to assess adductor canal catheter tip migration in a cadaver model.

    PubMed

    Leng, Jody C; Harrison, T Kyle; Miller, Brett; Howard, Steven K; Conroy, Myles; Udani, Ankeet; Shum, Cynthia; Mariano, Edward R

    2015-04-01

    An adductor canal catheter may facilitate early ambulation after total knee arthroplasty, but there is concern over preoperative placement since intraoperative migration of catheters may occur from surgical manipulation and result in ineffective analgesia. We hypothesized that catheter type and subcutaneous tunneling may influence tip migration for preoperatively inserted adductor canal catheters. In a male unembalmed human cadaver, 20 catheter insertion trials were divided randomly into one of four groups: flexible epidural catheter either tunneled or not tunneled; or rigid stimulating catheter either tunneled or not tunneled. Intraoperative patient manipulation was simulated by five range-of-motion exercises of the knee. Distance and length measurements were performed by a blinded regional anesthesiologist. Changes in catheter tip to nerve distance (p = 0.225) and length of catheter within the adductor canal (p = 0.467) were not different between the four groups. Two of five non-tunneled stimulating catheters (40 %) were dislodged compared to 0/5 in all other groups (p = 0.187). A cadaver model may be useful for assessing migration of regional anesthesia catheters; catheter type and subcutaneous tunneling may not affect migration of adductor canal catheters based on this preliminary study. However, future studies involving a larger sample size, actual patients, and other catheter types are warranted.

  15. Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task.

    ERIC Educational Resources Information Center

    Sapienza, Christine M.; Walton, Suzanne; Murry, Thomas

    1999-01-01

    Acoustic phonatory events were identified in 14 women diagnosed with adductor spasmodic dysphonia (ADSD), a focal laryngeal dystonia that disturbs phonatory function, and compared with those of 14 age-matched women with no vocal dysfunction. Findings indicated ADSD subjects produced more aberrant acoustic events than controls during tasks of…

  16. Motor innervation of respiratory muscles and an opercular display muscle in Siamese fighting fish Betta splendens.

    PubMed

    Gorlick, D L

    1989-12-15

    Horseradish peroxidase was used to identify motor neurons projecting to the adductor mandibulae, levator hyomandibulae, levator operculi, adductor operculi, and dilator operculi muscles in Siamese fighting fish, Betta splendens. These muscles participate in the production of respiratory and feeding movements in teleost fishes. The dilator operculi is also the effector muscle for gill-cover erection behavior that is part of Betta's aggressive display. The motor innervation of these muscles in Betta was compared to that previously described for carp. Motor neurons of the adductor mandibulae, levator hyomandibulae, and dilator operculi are located in the trigeminal motor nucleus, and motor neurons of the adductor operculi and levator operculi are located in the facial motor nucleus in Betta and in carp. The trigeminal motor nucleus in both species is divided into rostral and caudal subnuclei. However, there are substantial differences in the organization of the subnuclei, and in the distribution of motor neurons within them. In Betta, the rostral trigeminal subnucleus consists of a single part but the caudal subnucleus is divided into two parts. Motor neurons for the dilator operculi and levator hyomandibulae muscles are located in the lateral part of the caudal subnucleus; the medial part of the caudal subnucleus contains only dilator operculi motor neurons. The single caudal subnucleus in carp is located laterally, and contains motor neurons of both the dilator operculi and levator hyomandibulae muscles. Differences in the organization of the trigeminal motor nucleus may relate to the use of the dilator operculi muscle for aggressive display behavior by perciform fishes such as Betta but not by cypriniform fishes such as carp. Five species of perciform fishes that perform gill-cover erection behavior had a Betta-like pattern of organization of the caudal trigeminal nucleus and a similar distribution of dilator operculi motor neurons. Goldfish, which like carp are

  17. Adductor canal block versus femoral nerve block for total knee arthroplasty: a meta-analysis of randomized controlled trials

    PubMed Central

    Wang, Duan; Yang, Yang; Li, Qi; Tang, Shen-Li; Zeng, Wei-Nan; Xu, Jin; Xie, Tian-Hang; Pei, Fu-Xing; Yang, Liu; Li, Ling-Li; Zhou, Zong-Ke

    2017-01-01

    Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs. Of 309 citations identified by our search strategy, 12 RCTs met the inclusion criteria. Compared to FNB, quadriceps maximum voluntary isometric contraction (MVIC) was significantly higher for ACB, which was consistent with the results regarding quadriceps strength assessed with manual muscle strength scale. Moreover, ACB had significantly higher risk of falling versus FNB. At any follow-up time, ACB was not inferior to FNB regarding pain control or opioid consumption, and showed better range of motion in comparison with FNB. ACB is superior to the FNB regarding sparing of quadriceps strength and faster knee function recovery. It provides pain relief and opioid consumption comparable to FNB and is associated with decreased risk of falls. PMID:28079176

  18. Soft tissue trauma and scar revision.

    PubMed

    Mobley, Steven R; Sjogren, Phayvanh P

    2014-11-01

    Numerous techniques and treatments have been described for scar revision, with most studies focusing on the adult population. A comprehensive review of the literature reveals a paucity of references related specifically to scar revision in children. This review describes the available modalities in pediatric facial scar revision. The authors have integrated current practices in soft tissue trauma and scar revision, including closure techniques and materials, topical therapy, steroid injection, cutaneous laser therapy, and tissue expanders.

  19. Intrauterine endometriotic cyst at the site of previous cesarean scar; scar endometriosis.

    PubMed

    Isci, H; Gonenc, G; Yigiter, A B; Guducu, N; Dünder, I

    2015-01-01

    Uterine scar endometriosis is an extremely rare entitiy. As the surgical procedures of the uterus increases through time, scar endometriosis may be diagnosed more often in the future. A case of uterine scar endometriosis is presented with complaints of menstruation lasting one day with associated pelvic pain. When a cystic mass in the site of previous surgery is diagnosed, scar endometriosis must be considered.

  20. Stimulated infrared thermography applied to differentiate scar tissue from peri-scar tissue: a preliminary study.

    PubMed

    Riquet, Damien; Houel, Nicolas; Bodnar, Jean-Luc

    2016-08-01

    Every human injury leads to a scar formation. The healing process leads to the formation of new tissue: the scar, which is different from the original tissue. This process is influenced by mechanical strength and the local vasculature is modified. The purpose of this study is to show that there are various temperatures between the scar and the peri-scar area associated with the healing process that can be estimated using the thermal infrared camera. In the study, 12 scars were stimulated by cold. Several changes of temperature were observed between scar and peri-scar area for 10 min. Scars appeared significantly colder with a Wilcoxon test (p = 0.01). Results showed that stimulated infrared thermography can be used to monitor the temperature difference between the scar and peri-scar tissue.

  1. Muscle strain injuries.

    PubMed

    Garrett, W E

    1996-01-01

    One of the most common injuries seen in the office of the practicing physician is the muscle strain. Until recently, little data were available on the basic science and clinical application of this basic science for the treatment and prevention of muscle strains. Studies in the last 10 years represent action taken on the direction of investigation into muscle strain injuries from the laboratory and clinical fronts. Findings from the laboratory indicate that certain muscles are susceptible to strain injury (muscles that cross multiple joints or have complex architecture). These muscles have a strain threshold for both passive and active injury. Strain injury is not the result of muscle contraction alone, rather, strains are the result of excessive stretch or stretch while the muscle is being activated. When the muscle tears, the damage is localized very near the muscle-tendon junction. After injury, the muscle is weaker and at risk for further injury. The force output of the muscle returns over the following days as the muscle undertakes a predictable progression toward tissue healing. Current imaging studies have been used clinically to document the site of injury to the muscle-tendon junction. The commonly injured muscles have been described and include the hamstring, the rectus femoris, gastrocnemius, and adductor longus muscles. Injuries inconsistent with involvement of a single muscle-tendon junction proved to be at tendinous origins rather than within the muscle belly. Important information has also been provided regarding injuries with poor prognosis, which are potentially repairable surgically, including injuries to the rectus femoris muscle, the hamstring origin, and the abdominal wall. Data important to the management of common muscle injuries have been published. The risks of reinjury have been documented. The early efficacy and potential for long-term risks of nonsteroidal antiinflammatory agents have been shown. New data can also be applied to the field

  2. Physiological Implications of Myocardial Scar Structure.

    PubMed

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

    2015-09-20

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

  3. Physiological Implications of Myocardial Scar Structure

    PubMed Central

    Richardson, WJ; Clarke, SA; Quinn, TA; Holmes, JW

    2016-01-01

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

  4. Outcomes of ablative fractional laser scar treatment.

    PubMed

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

    2015-04-01

    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.

  5. Scar formation and ligament healing.

    PubMed

    Hildebrand, K A; Frank, C B

    1998-12-01

    Ligaments are highly organized, dense, fibrous connective-tissue structures that provide stability to joints and participate in joint proprioception. Injuries to ligaments induce a healing response that is characterized by the formation of a scar. The scar tissue is weaker, larger and creeps more than normal ligament and is associated with an increased amount of minor collagens (types III, V and VI), decreased collagen cross-links and an increased amount of glycosaminoglycans. Studies have shown that certain surgical variables alter the healing of ligaments. Such factors include the size of gap between the healing ligament, ends, the use of motion in a stable joint and the presence of multiple ligamentous injuries. Research on ligament healing includes studies on low-load and failure-load properties, alterations in the expression of matrix molecules, cytokine modulation of healing and gene therapy as a method to alter matrix protein and cytokine production.

  6. Two dimensional unstable scar statistics.

    SciTech Connect

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

    2006-12-01

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

  7. Quantification of scar margin in keloid different from atrophic scar by multiphoton microscopic imaging.

    PubMed

    Zhu, Xiaoqin; Zhuo, Shuangmu; Zheng, Liqin; Jiang, Xingshan; Chen, Jianxin; Lin, Bifang

    2011-01-01

    Multiphoton microscopy (MPM) was applied to examine the marginal region at dermis of keloid compared with atrophic scar. High-resolution large-area image showed an obvious boundary at the scar margin and different morphological patterns of elastin and collagen on the two sides, further visualized by the focused three-dimensional images. Content alteration of elastin or collagen between the two sides of boundary was quantified to show significant difference between keloid and atrophic scar. Owing to the raised property of keloid with overproduced collagen on the scar side, the content alteration was positive for elastin and negative for collagen. On the contrary, the content alteration was negative for elastin and positive for collagen in the atrophic scar case due to the atrophic collagen on the scar side. It indicated that examination of the scar margin by MPM may lead a new way to discriminate different types of scars and better understand the scarring mechanisms.

  8. Myofiber turnover is used to retrofit frog jaw muscles during metamorphosis.

    PubMed

    Alley, K E

    1989-01-01

    Metamorphic reorganization of the head in anuran amphibians entails abrupt restructuring of the jaw complex as larval feeding structures are transformed into their adult configurations. In this morphometric study, light microscopy wa used to analyze the larval maturation and metamorphic transfiguration of the adductor jaw muscles in the leopard frog (Rana pipiens). Larval jaw muscles, first established during embryogenesis, continue to grow by fiber addition until prometamorphosis, stage XII. Thereafter, fiber number remains stable but additional muscle growth continues by hypertrophy of the individual fibers until metamorphic climax. During metamorphic stages XIX-XXIII, a complete involution of all larval myofibers occurs. Simultaneously, within the same muscle beds, a second wave of myogenesis produces myoblasts which are the precursors of adult jaw myofibers. New muscle fibers continue to be added to these muscles well after the completion of metamorphosis; however, the total duration of the postmetamorphic myogenic period has not been defined. These observations provide clear evidence that the entir population of primary myofibers used in larval oral activity disappears from the adductor muscle beds and is replaced by a second wave of myogenesis commencing during climax. These findings indicate that the adductor jaw muscles are prepared for adult feeding by a complicated cellular process that retrofits existing muscle beds with a completely new complement of myofibers.

  9. Acne Scars: Pathogenesis, Classification and Treatment

    PubMed Central

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

    2010-01-01

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

  10. Effect of hindlimb suspension and clenbuterol treatment on polyamine levels in skeletal muscle

    NASA Technical Reports Server (NTRS)

    Abukhalaf, Imad K.; von Deutsch, Daniel A.; Wineski, Lawrence E.; Silvestrov, Natalia A.; Abera, Saare A.; Sahlu, Sinafikish W.; Potter, David E.; Thierry-Palmer, M. (Principal Investigator)

    2002-01-01

    Polyamines are unbiquitous, naturally occurring small aliphatic, polycationic, endogenous compounds. They are involved in many cellular processes and may serve as secondary or tertiary messengers to hormonal regulation. The relationship of polyamines and skeletal muscle mass of adductor longus, extensor digitorum longus, and gastrocnemius under unloading (hindlimb suspension) conditions was investigated. Unloading significantly affected skeletal muscle polyamine levels in a fiber-type-specific fashion. Under loading conditions, clenbuterol treatment increased all polyamine levels, whereas under unloading conditions, only the spermidine levels were consistently increased. Unloading attenuated the anabolic effects of clenbuterol in predominately slow-twitch muscles (adductor longus), but had little impact on clenbuterol's action as a countermeasure in fast- twitch muscles such as the extensor digitorum longus. Spermidine appeared to be the primary polyamine involved in skeletal muscle atrophy/hypertrophy. Copyright 2002 S. Karger AG, Basel.

  11. Effective Treatments of Atrophic Acne Scars

    PubMed Central

    Zhou, Bingrong

    2015-01-01

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

  12. Scars

    MedlinePlus

    ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ...

  13. [Molecular mechanisms of wound scarring].

    PubMed

    Borel, J P; Maquart, F X

    1998-01-01

    A few years ago, the discovery of growth factors, their pharmaceutical obtention at a purified grade, their powerful effects on cells in vitro, resulted in demeasured hopes that they could be applied easily and successfully to the treatment of wounds. Now, the process of healing is still uncompletely understood. The interplay of epithelial and matrix cells, the multiplicity of cell types involved, the huge number of growth factors implicated and the difficulties in describing the specific timing of their action on the cells present in wounds, explain why therapy of wound has not yet been revolutioned. An important distinction must be made between normal healing, which leads to a solid functional, reparation tissue, and scarring which opposes any functional healing by making extensive granulation tissue or even keloids. Recent studies pointed out the necessity of a convenient balance between the concentrations of growth factors present in the wound during the different stages of healing. Excess connective tissue production (scarring) would be more particularly due to an excess of TGF beta 1, whereas predominance of TGF beta 3 conducts to harmonious healing.

  14. The cost of post-burn scarring.

    PubMed

    Mirastschijski, U; Sander, J T; Zier, U; Rennekampff, H O; Weyand, B; Vogt, P M

    2015-09-30

    Deep burns lead to scarring and contractures for which there is little or no published data on treatment costs. The purpose of this study was to fill this gap by analysing treatment costs for burn sequelae. To do this, German-DRG for in-patient treatment was collected from the Burn Centre Lower Saxony. DRG-related T95.-coding served as a tool for burn-associated sequelae. Data on scar occurrence, plastic-reconstructive surgery and sick leave were collected by a questionnaire. The findings showed that 44.6% patients reported post-burn scarring and 31% needed surgical intervention. The expected risk for readmission was significantly higher (p=0.0002) with scars compared to without. Significantly higher costs for pressure garments were noted for scarred patients (p=0.04). No differences were found for ointments, silicone dressings or pain medication. Treatment costs for patients with scars were 5.6 times higher compared with no scar assessed by G-DRG. No differences were stated subsuming multiple readmissions for post-burn treatment per individual. Significantly higher costs (p=0.03) were noted for patients with burn sequelae other than scars with regard to individual readmissions. It has been revealed that treatment of scars causes higher costs than for other burn sequelae because of multiple surgical interventions. To reduce post-burn scarring and costs, specialized burn centres provide optimal and state-of-the-art treatment. As well as this, more emphasis should be laid on promoting research for the development of novel anti-scarring therapies.

  15. Prevention and treatment of excessive dermal scarring.

    PubMed Central

    Roseborough, Ingrid E.; Grevious, Mark A.; Lee, Raphael C.

    2004-01-01

    Today, wound management to avoid excessive scar formation is increasingly important, especially in populations with Fitzpatrick 3 or higher skin pigmentation. Medical science and industrial development are devoting more effort toward understanding and offering better therapy to control scars. However, advances in scar management have been hampered by the confusing or ambiguous terminology. There is no consensus on what amount of post-traumatic skin scar formation is "normal" and what should be considered "hypertrophic". In the World Health Organization's ICD-9, there is no diagnostic code for hypertrophic scar--only keloid is listed. Yet, the medical and scientific literature distinguishes them as different conditions. Our experience suggests that the diagnosis of keloid disease is greatly over-rendered. For black patients, an elevated scar seems, by default, diagnosed as keloid by most. This confusion results in inappropriate management of scar formation, and occasionally contributes to decision making related to elective or cosmetic surgery. Given that patients are expecting better outcomes from wound care today than in the past, this review article attempts to capture the essential biological factors related to wound scar production and discusses treatment options and indications used by the authors. Images Figure 1 Figure 2 Figure 3 PMID:14746360

  16. Endometriosis of episiotomy scar: a case report.

    PubMed

    Mihmanli, V; Ózkan, T; Genc, S; Cetinkaya, N; Uctas, H

    2015-01-01

    Endometriosis is characterized by the presence of histologically normal endometrial glands and stroma outside the uterine cavity. Endometriosis predominantly locates on peritoneal surfaces, but it also affects the vagina, vulva, and perineum, usually secondary to surgical or obstetric trauma. Endometriosis in an episiotomy scar is a fairly rare phenomenon. The authors present a case of endometriosis in an episiotomy scar.

  17. The Northwestern Abdominoplasty Scar Model: A Novel Human Model for Scar Research and Therapeutics.

    PubMed

    Lanier, Steven T; Liu, Jing; Chavez-Munoz, Claudia; Mustoe, Thomas A; Galiano, Robert D

    2016-09-01

    There is a growing interest in the development and evaluation of therapeutic agents that improve the cosmetic appearance of scars. Existing nonhuman animal models to study scarring, while valuable, have well-acknowledged limitations, as it is accepted that the biology of human scarring differs significantly from scarring in other species. Moreover, human clinical trials of scarring require large numbers of subjects to achieve statistical power and are plagued by inherent intersubject variability because of the complex nature of wound healing in human beings. As a better alternative, we have developed the Northwestern Abdominoplasty Scar Model-a novel human clinical model that permits analysis of up to 20 cutaneous scars in a single subject and allows for not only visual scar comparison, but also histologic and molecular analyses of factors involved in scarring and wound healing. We have utilized this model in 5 early phase clinical trials designed to test the safety and efficacy of a variety of scar therapeutics without any complications to date. The model not only is applicable to scar therapeutics, but also can be utilized for other applications, such as the testing of implantable biomaterials, injectable products, therapies such as lasers, or even for in vivo study of wound healing processes in humans.

  18. Development of mandibular, hyoid and hypobranchial muscles in the zebrafish: homologies and evolution of these muscles within bony fishes and tetrapods

    PubMed Central

    Diogo, Rui; Hinits, Yaniv; Hughes, Simon M

    2008-01-01

    Background During vertebrate head evolution, muscle changes accompanied radical modification of the skeleton. Recent studies have suggested that muscles and their innervation evolve less rapidly than cartilage. The freshwater teleostean zebrafish (Danio rerio) is the most studied actinopterygian model organism, and is sometimes taken to represent osteichthyans as a whole, which include bony fishes and tetrapods. Most work concerning zebrafish cranial muscles has focused on larval stages. We set out to describe the later development of zebrafish head muscles and compare muscle homologies across the Osteichthyes. Results We describe one new muscle and show that the number of mandibular, hyoid and hypobranchial muscles found in four day-old zebrafish larvae is similar to that found in the adult. However, the overall configuration and/or the number of divisions of these muscles change during development. For example, the undivided adductor mandibulae of early larvae gives rise to the adductor mandibulae sections A0, A1-OST, A2 and Aω, and the protractor hyoideus becomes divided into dorsal and ventral portions in adults. There is not always a correspondence between the ontogeny of these muscles in the zebrafish and their evolution within the Osteichthyes. All of the 13 mandibular, hyoid and hypobranchial muscles present in the adult zebrafish are found in at least some other living teleosts, and all except the protractor hyoideus are found in at least some extant non-teleost actinopterygians. Of these muscles, about a quarter (intermandibularis anterior, adductor mandibulae, sternohyoideus) are found in at least some living tetrapods, and a further quarter (levator arcus palatini, adductor arcus palatini, adductor operculi) in at least some extant sarcopterygian fish. Conclusion Although the zebrafish occupies a rather derived phylogenetic position within actinopterygians and even within teleosts, with respect to the mandibular, hyoid and hypobranchial muscles it

  19. Strong quantum scarring by local impurities

    NASA Astrophysics Data System (ADS)

    Luukko, Perttu J. J.; Drury, Byron; Klales, Anna; Kaplan, Lev; Heller, Eric J.; Räsänen, Esa

    2016-11-01

    We discover and characterise strong quantum scars, or quantum eigenstates resembling classical periodic orbits, in two-dimensional quantum wells perturbed by local impurities. These scars are not explained by ordinary scar theory, which would require the existence of short, moderately unstable periodic orbits in the perturbed system. Instead, they are supported by classical resonances in the unperturbed system and the resulting quantum near-degeneracy. Even in the case of a large number of randomly scattered impurities, the scars prefer distinct orientations that extremise the overlap with the impurities. We demonstrate that these preferred orientations can be used for highly efficient transport of quantum wave packets across the perturbed potential landscape. Assisted by the scars, wave-packet recurrences are significantly stronger than in the unperturbed system. Together with the controllability of the preferred orientations, this property may be very useful for quantum transport applications.

  20. Solanidine and tomatidine trigger scar pruritus.

    PubMed

    Alonso, Pedro E; Rioja, Luis F

    2016-05-01

    Scar pruritus is frequently encountered in clinical practice (particularly in burn patients) owing to its poorly known pathogenesis and difficult treatment. In previous work, we demonstrated the usefulness of a diet excluding edible solanaceae (viz., potatoes, tomatoes, peppers and aubergines) in patients with antihistamine-resistant scar pruritus. We hypothesized that alkaloids in solanaceae (particularly their secondary metabolites or aglycones) might be the actual pruritogens. In order to test this hypothesis, we conducted a single-blind prospective study on patients responding favourably to a solanaceae-free diet whose scar pruritus could be ascribed to one of the four foods. The study involved applying the aglycones solanidine and tomatidine to each scar and checking whether, and which, had a pruritogenic effect. A total of 18 patients (90%) responded by developing pruritus; also, the triggering aglycone coincided with that prevailing in the pruritogenic food. We concluded that solanaceae aglycones are directly involved in the pathogenesis of scar pruritus.

  1. Strong quantum scarring by local impurities

    PubMed Central

    Luukko, Perttu J. J.; Drury, Byron; Klales, Anna; Kaplan, Lev; Heller, Eric J.; Räsänen, Esa

    2016-01-01

    We discover and characterise strong quantum scars, or quantum eigenstates resembling classical periodic orbits, in two-dimensional quantum wells perturbed by local impurities. These scars are not explained by ordinary scar theory, which would require the existence of short, moderately unstable periodic orbits in the perturbed system. Instead, they are supported by classical resonances in the unperturbed system and the resulting quantum near-degeneracy. Even in the case of a large number of randomly scattered impurities, the scars prefer distinct orientations that extremise the overlap with the impurities. We demonstrate that these preferred orientations can be used for highly efficient transport of quantum wave packets across the perturbed potential landscape. Assisted by the scars, wave-packet recurrences are significantly stronger than in the unperturbed system. Together with the controllability of the preferred orientations, this property may be very useful for quantum transport applications. PMID:27892510

  2. DERMABRASIVE ABLATION OF ACNE SCARS

    PubMed Central

    Brown, Adolph M.

    1958-01-01

    Dermabrasion offers cosmetic improvement of acne pits and scars, but only well-adjusted patients should be selected for this esthetic improvement. In the dermabrasion operation the deep cup-shaped pits are made shallow by saucerization, for the deep sharp shadows are eliminated as the pits are shallowed. It is the elimination of the shadow effect which is so gratifying to the patient. Although dermabrasion is a superficial skin operation, it involves dangerous instruments and thousands of minute incisions. The procedure is a surgical operation, whether done in an office or in a hospital. The author performs the operation entirely as a hospital procedure, using pentothal anesthesia with meperidine added in small increments during the operation. Thus the operation may be unhurriedly and meticulously performed. ImagesFigure 1.Figure 2. PMID:13561125

  3. Analysis of frequency of use of different scar assessment scales based on the scar condition and treatment method.

    PubMed

    Bae, Seong Hwan; Bae, Yong Chan

    2014-03-01

    Analysis of scars in various conditions is essential, but no consensus had been reached on the scar assessment scale to select for a given condition. We reviewed papers to determine the scar assessment scale selected depending on the scar condition and treatment method. We searched PubMed for articles published since 2000 with the contents of the scar evaluation using a scar assessment scale with a Journal Citation Report impact factor >0.5. Among them, 96 articles that conducted a scar evaluation using a scar assessment scale were reviewed and analyzed. The scar assessment scales were identified and organized by various criteria. Among the types of scar assessment scales, the Patient and Observer Scar Assessment Scale (POSAS) was found to be the most frequently used scale. As for the assessment of newly developed operative scars, the POSAS was most used. Meanwhile, for categories depending on the treatment methods for preexisting scars, the Vancouver Scar Scale (VSS) was used in 6 studies following a laser treatment, the POSAS was used in 7 studies following surgical treatment, and the POSAS was used in 7 studies following a conservative treatment. Within the 12 categories of scar status, the VSS showed the highest frequency in 6 categories and the POSAS showed the highest frequency in the other 6 categories. According to our reviews, the POSAS and VSS are the most frequently used scar assessment scales. In the future, an optimal, universal scar scoring system is needed in order to better evaluate and treat pathologic scarring.

  4. Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar

    PubMed Central

    Chae, Jin Kyung; Kim, Eun Jung; Park, Kun

    2016-01-01

    Background The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. Objective To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Methods Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Results Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. Conclusion In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion. PMID:27746642

  5. Phase and Texture Characterizations of Scar Collagen Second-Harmonic Generation Images Varied with Scar Duration.

    PubMed

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

    2015-08-01

    This work developed a phase congruency algorithm combined with texture analysis to quantitatively characterize collagen morphology in second-harmonic generation (SHG) images from human scars. The extracted phase and texture parameters of the SHG images quantified collagen directionality, homogeneity, and coarseness in scars and varied with scar duration. Phase parameters showed an increasing tendency of the mean of phase congruency with scar duration, indicating that collagen fibers are better oriented over time. Texture parameters calculated from local difference local binary pattern (LD-LBP) and Haar wavelet transform, demonstrated that the LD-LBP variance decreased and the energy of all subimages increased with scar duration. It implied that collagen has a more regular pattern and becomes coarser with scar duration. In addition, the random forest regression was used to predict scar duration, demonstrating reliable performance of the extracted phase and texture parameters in characterizing collagen morphology in scar SHG images. Results indicate that the extracted parameters using the proposed method can be used as quantitative indicators to monitor scar progression with time and can help understand the mechanism of scar progression.

  6. Microneedling Therapy for Atrophic Acne Scars

    PubMed Central

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

    2015-01-01

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

  7. Astrocyte scar formation aids CNS axon regeneration

    PubMed Central

    Anderson, Mark A.; Burda, Joshua E.; Ren, Yilong; Ao, Yan; O’Shea, Timothy M.; Kawaguchi, Riki; Coppola, Giovanni; Khakh, Baljit S.; Deming, Timothy J.; Sofroniew, Michael V.

    2017-01-01

    Summary Transected axons fail to regrow in the mature central nervous system (CNS). Astrocyte scars are widely regarded as causal in this failure. Here, using three genetically targeted loss-of-function manipulations in adult mice, we show that preventing astrocyte scar formation, attenuating scar-forming astrocytes, or deleting chronic astrocyte scars all failed to result in spontaneous regrowth of transected corticospinal, sensory or serotonergic axons through severe spinal cord injury (SCI) lesions. In striking contrast, sustained local delivery via hydrogel depots of required axon-specific growth factors not present in SCI lesions, plus growth-activating priming injuries, stimulated robust, laminin-dependent sensory axon regrowth past scar-forming astrocytes and inhibitory molecules in SCI lesions. Preventing astrocyte scar formation significantly reduced this stimulated axon regrowth. RNA sequencing revealed that astrocytes and non-astrocyte cells in SCI lesions express multiple axon-growth supporting molecules. Our findings show that contrary to prevailing dogma, astrocyte scar formation aids rather than prevents CNS axon regeneration. PMID:27027288

  8. A quantitative approach to scar analysis.

    PubMed

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

    2011-02-01

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

  9. Stepping before standing: hip muscle function in stepping and standing balance after stroke

    PubMed Central

    Kirker, S; Simpson, D; Jenner, J; Wing, A

    2000-01-01

    OBJECTIVE—To compare the pattern of pelvic girdle muscle activation in normal subjects and hemiparetic patients while stepping and maintaining standing balance.
DESIGN—Group comparison.
METHOD—Seventeen patients who had regained the ability to walk after a single hemiparetic stroke were studied together with 16 normal controls. Median interval between stroke and testing was 17 months. Amplitude and onset latency of surface EMG activity in hip abductors and adductors were recorded in response to sideways pushes in either direction while standing. Similar recordings were made in the same subjects during gait initiation and a single stride.
RESULTS—In the standing balance task, normal subjects resisted a sideways push to the left with the left gluteus medius (74 ms) and with the right adductor (111 ms), and vice versa. In hemiparetic patients, the amplitude of activity was reduced in the hemiparetic muscles, the onset latencies of which were delayed (gluteus medius 96 ms, adductor 144 ms). Contralateral, non-paretic, adductor activity was increased after a push towards the hemiparetic side of patients with stroke and the latency was normal (110 ms). During self initiated sideways weight shifts at gait initiation, hemiplegic muscle activation was impaired. By contrast, the pattern and peak amplitude of hip muscle activation in stepping was normal in both hemiparetic and non-hemiparetic muscles of the subjects with stroke.
CONCLUSIONS—In ambulant patients with stroke, a normal pattern of activation of hemiparetic muscles is seen in stepping whereas the response of these muscles to a perturbation while standing remains grossly impaired and is compensated by increased activity of the contralateral muscles. This suggests that hemiparetic patients should be able to step before regaining standing balance.

 PMID:10727481

  10. The giant fiber and pectoral fin adductor motoneuron system in the hatchetfish.

    PubMed

    Gilat, E; Hall, D H; Bennett, M V

    1986-02-12

    In the medulla of the hatchetfish each Mauthner fiber forms chemical synapses on a number of large myelinated axons termed giant fibers. The giant fibers form rectifying electrotonic synapses on pectoral fin adductor motoneurons, and in this fish bilateral pectoral fin adduction is an important component of the Mauthner fiber-mediated escape reflex. The branching patterns of giant fibers were determined by intracellular injection of Lucifer yellow. Dye coupling to the motoneuron somata was not observed, although a low level of transfer might have been obscured by autofluorescence. Individual giant fibers terminate primarily on pectoral fin motoneurons contralateral to their cell bodies, but may also send a branch back across the midline to ipsilateral motoneurons. The rostral process of each giant fiber ends on neurons presumably associated with cranial musculature. The number and geometry of the pectoral fin motoneurons were determined using Golgi and Nissl staining and serial reconstruction methods.

  11. The evidence for natural therapeutics as potential anti-scarring agents in burn-related scarring.

    PubMed

    Mehta, M; Branford, O A; Rolfe, K J

    2016-01-01

    Though survival rate following severe thermal injuries has improved, the incidence and treatment of scarring have not improved at the same speed. This review discusses the formation of scars and in particular the formation of hypertrophic scars. Further, though there is as yet no gold standard treatment for the prevention or treatment of scarring, a brief overview is included. A number of natural therapeutics have shown beneficial effects both in vivo and in vitro with the potential of becoming clinical therapeutics in the future. These natural therapeutics include both plant-based products such as resveratrol, quercetin and epigallocatechin gallate as examples and includes the non-plant-based therapeutic honey. The review also includes potential mechanism of action for the therapeutics, any recorded adverse events and current administration of the therapeutics used. This review discusses a number of potential 'treatments' that may reduce or even prevent scarring particularly hypertrophic scarring, which is associated with thermal injuries without compromising wound repair.

  12. Medical makeup for concealing facial scars.

    PubMed

    Mee, Donna; Wong, Brian J F

    2012-10-01

    Surgical, laser, and pharmacological therapies are all used to correct scars and surgical incisions, though have limits with respect to how well facial skin can be restored or enhanced. The use of cosmetics has long been a relevant adjunct to all scar treatment modalities. In recent years, technical advancements in the chemistry and composition of cosmetic products have provided the patient with a broader range of products to employ for concealing scars. This review will provide an overview of contemporary methods for concealing facial scars, birthmarks, and pigmentary changes without the use of traditional/dated, heavy appearing camouflage products. Additionally, general guidelines and information will be provided with respect to identifying competent makeup artists for care of the medical patient. The article by no means is meant to be a tutorial, but rather serves as a starting point in this allied field of medicine.

  13. Proceedings of the SCAR Conference, Part 1

    NASA Technical Reports Server (NTRS)

    1976-01-01

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

  14. Answers to Common Questions about Scars

    MedlinePlus

    ... off the skin and fairly stiff to the touch. Reaching a peak after several months, the scar ... have received your message and will be in touch as soon as possible. Cleft Connection An Interview ...

  15. The "Sea" should not be operated on in scar revision for "Island-Like" scars.

    PubMed

    Nagasao, Tomohisa; Hamamoto, Yusuke; Tamai, Motoki; Kudo, Hiroo; Ensako, Toshiya; Kogure, Tetsukuni; Takano, Naoki; Tanaka, Yoshio

    2015-08-01

    Scars developing on body surfaces not only restrict body movement, but are also problematic from a cosmetic standpoint. Hence, revision is conducted by removing the scar and re-suturing the resultant defects. In performing scar revision, care should be taken to prevent the re-sutured wounds from developing hypertrophy again. Scars often present a pattern where hard, red parts are separated by soft parts in between. As the hard and soft parts may be analogized as islands and seas respectively, we call this the "Island-Like" scar. Two strategies can be taken to treat scars of this type. The first is to remove the entire scar-including both hard and soft parts; the second is to remove only the hard parts and leave the soft parts untouched. The authors conducted a biomechanical study using finite element analyses and found that as a body moves, greater stresses occur in the peri-wound regions with the first strategy than with the second strategy. A wound's likelihood to develop hypertrophy increases as the stresses working on it increase. Hence, it is hypothesized that the second strategy carries less risk of the operated wounds developing re-hypertrophy than the first strategy. Based on this logic, in performing scar revision for scars consisting of hard and soft parts, it is recommended only to remove only hard parts and not to operate on soft parts in between.

  16. Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

    PubMed

    van der Wal, Martijn B A; Vloemans, Jos F P M; Tuinebreijer, Wim E; van de Ven, Peter; van Unen, Ella; van Zuijlen, Paul P M; Middelkoop, Esther

    2012-01-01

    Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p < 0.001) improvement in scar quality at 12 months compared with the 3- and 6-month data. Predictors for severe scarring are depth of the wound (p < 0.001) and total body surface area burned (p < 0.001). Etiology (p = 0.753) and age (p > 0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively.

  17. Successful human scar regeneration by topical iodine: a case report: an interim (3.5 year) summary.

    PubMed

    Derry, David M

    2009-05-01

    Control of regeneration and wound healing are scientific and clinical objectives. In 1997, topical Lugol's iodine solution applied daily for 3 days to a 50 year old facial scar lead to hyperemic scar tissue. As a working hypothesis, the author proposed topical iodine could initiate, control and complete human scar regeneration. In 2005, after collecting three more surgical scars, topical iodine applications began. Within 3 days all four scars started regenerating. Stopping topical iodine halted the process. Within a week an appropriate adult scar formed. Digital cameras recorded events. Regeneration is complex and slow. Its appearance depends on whether scar is covered with plastic or open. Iodine's chemical properties are discussed along with their reaction with epithelial cells. As there are no visible signs detectable changes from oral iodine on regeneration, details of iodine staining are more thoroughly described. Not all, but most important results are presented. Topical iodine induces hair growth in and around scars. Hair is regeneration's workhorse, moving purposefully in all directions under arrector pili muscle power delivering regenate material accurately to scar tissues and coordinating centers. In addition, hair repeatedly self amputates possibly strengthening regenerating tissues. Two types of regenate material show under plastic wrap: white and globular. The white regenate appears and behaves somewhat like snow, but can be yellow, green or brown depending iodine content. The globular form of regenate material maybe derived from white regenate material with hair's help. Globular regenate material is larger, nondescript, variable in size and color (depends on iodine content) and seemed usually associated with hair. There are two centrally placed coordinating centers 5 mm apart on major scars. Wrist centers have a palpable, but not visible ridge, between them whereas abdominal centers do not. Wrist centers lasted through all regeneration of the wrist

  18. Overview of surgical scar prevention and management.

    PubMed

    Son, Daegu; Harijan, Aram

    2014-06-01

    Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.

  19. Isokinetic imbalance of hip muscles in soccer players with osteitis pubis.

    PubMed

    Mohammad, Walaa Sayed; Abdelraouf, Osama Ragaa; Elhafez, Salam Mohamed; Abdel-Aziem, Amr Almaz; Nassif, Nagui Sobhi

    2014-01-01

    In this study, we compared the isokinetic torques of hip flexors/extensors and abductors/adductors in soccer players suffering from osteitis pubis (OP), with normal soccer players. Twenty soccer male athletes with OP and 20 normal soccer athletes were included in this study. Peak torque/body weight (PT/BW) was recorded from hip flexor/extensor and abductor/adductor muscles during isokinetic concentric contraction modes at angular velocity of 2.1 rad · s(-1), for both groups. The results showed a significant difference between the normal and OP groups for hip flexors (P < 0.05). The normal group had significant, lower PT/BW value than the OP group for their hip flexors (P < 0.05). The hip flexor/extensor PT ratio of OP affected and non-affected limbs was significantly different from that of normal dominant and non-dominant limbs. There were no significant differences between the normal and OP groups for hip extensor, adductor and abductor muscles (P > 0.05). Regarding the hip adductor/abductor PT ratio, there was no significant difference between the normal and OP groups of athletes (P > 0.05). The OP group displayed increase in hip flexor strength that disturbed the hip flexor/extensor torque ratio of OP. Therefore, increasing the hip extensor strength should be part of rehabilitation programmes of patients with OP.

  20. Effectiveness of Onion Extract Gel on Surgical Scars in Asians

    PubMed Central

    Chanprapaph, Kumutnart; Tanrattanakorn, Somsak; Wattanakrai, Penpun; Wongkitisophon, Pranee; Vachiramon, Vasanop

    2012-01-01

    Background. Onion extracts have been shown in vitro to accelerate wound healing. Results from clinical studies on surgical scars in Caucasians were disappointing. The aim of this study is to evaluate the effectiveness of onion extract gel in improving the cosmetic and symptoms of surgical scars in Asians. Patients/Methods. Twenty Asians who had new Pfannenstiel's cesarean section scars were recruited in this prospective double-blinded, split-scar study. Each side was randomly assigned treatment with onion extract gel or placebo at 7 days after surgery. The product was applied three times daily for 12 weeks. Subjects were evaluated at baseline and 4th and 12th weeks. Scar redness was assessed by calorimeter, scar height and pliability were assessed by blinded investigators, and scar symptoms and overall cosmetic improvement were assessed by subjects. Results. Sixteen subjects completed the study. A statistically significant difference between two sides of scar in terms of scar height and scar symptoms was found. There was no statistically significant difference in scar redness, scar pliability, and overall cosmetic appearance between two sides. Conclusions. The early use of topical 12% onion extract gel on Pfannenstiel's cesarean section scar in Asians resulted in the improvement of scar height and scar symptoms. PMID:22924037

  1. Comparative jaw muscle anatomy in kangaroos, wallabies, and rat-kangaroos (marsupialia: macropodoidea).

    PubMed

    Warburton, Natalie Marina

    2009-06-01

    The jaw muscles were studied in seven genera of macropodoid marsupials with diets ranging from mainly fungi in Potorous to grass in Macropus. Relative size, attachments, and lamination within the jaw adductor muscles varied between macropodoid species. Among macropodine species, the jaw adductor muscle proportions vary with feeding type. The relative mass of the masseter is roughly consistent, but grazers and mixed-feeders (Macropus and Lagostrophus) had relatively larger medial pterygoids and smaller temporalis muscles than the browsers (Dendrolagus, Dorcopsulus, and Setonix). Grazing macropods show similar jaw muscle proportions to "ungulate-grinding" type placental mammals. The internal architecture of the jaw muscles also varies between grazing and browsing macropods, most significantly, the anatomy of the medial pterygoid muscle. Potoroines have distinctly different jaw muscle proportions to macropodines. The masseter muscle group, in particular, the superficial masseter is enlarged, while the temporalis group is relatively reduced. Lagostrophus fasciatus is anatomically distinct from other macropods with respect to its masticatory muscle anatomy, including enlarged superficial medial pterygoid and deep temporalis muscles, an anteriorly inflected masseteric process, and the shape of the mandibular condyle. The enlarged triangular pterygoid process of the sphenoid bone, in particular, is distinctive of Lagsotrophus.

  2. Thyroarytenoid muscle activity during hypocapnic central apneas in awake nonsedated lambs.

    PubMed

    Kianicka, I; Leroux, J F; Praud, J P

    1994-03-01

    In this study, we examined whether the glottis is open or closed during central apnea and the effect of arterial PO2 (PaO2) on this control. We hyperventilated nine 11- to 30-day-old awake nonsedated lambs via a tracheostomy for 1 min to induce central apnea. Four gas mixtures (8, 15, 21, and 30% O2) were used. At the end of the hyperventilation period, the lambs were allowed to breathe spontaneously through intact upper airways. Using a pneumotachograph attached to a face mask, we measured airflow, and we continuously recorded electromyographic (EMG) activity of the thyroarytenoid (TA), the main glottic adductor muscle. We also studied the lateral cricoarytenoid muscle (LCA, laryngeal adductor), the posterior cricoarytenoid muscle (PCA, laryngeal abductor), the cricothyroid muscle (CT), and the diaphragm. We found that hyperventilation consistently induced hypocapnic central apnea in all nine lambs in hyperoxic conditions [30% inspiratory fraction of O2 (FIO2)], in eight of nine lambs in normoxia or mild hypoxia (15 and 21% FIO2), and in four of seven lambs in hypoxia (8% FIO2). During baseline room air breathing, there was no glottic adductor muscle expiratory EMG activity or expiratory airflow braking. Continuous TA EMG activity began early during hyperventilation and continued throughout the central apnea, regardless of PaO2. The first subsequent breathing efforts were marked by expiratory flow braking and expiratory activity of the TA. The LCA and the TA demonstrated the same EMG activity pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Papular Acne Scars of the Nose and Chin: An Under-recognised Variant of Acne Scarring

    PubMed Central

    Ali, Faisal R; Kirk, Michael; Madan, Vishal

    2016-01-01

    Background: Scarring following acne vulgaris is common and can be of profound psychosocial consequence. Aims and Objectives: We have clinically noted a variant of acne scarring, overlooked by previous categorisation schemes, which we have denominated as papular acne scars of the nose and chin. We sought to characterise these novel entities further. Materials and Methods: Initially, we identified 14 patients with papular acne scars of the nose and chin in a cosmetic dermatology clinic, of whom two were female and rest were male. We then prospectively evaluated 100 consecutive patients attending our tertiary referral acne isotretinoin clinic and 49 patients attending a general dermatology clinic. Results: Amongst 149 patients, from a general dermatology and tertiary acne clinic, soft papular scars were noted in four patients, distributed on the nose and chin. Three of the four patients were male, three patients had additional acne scars and the median age was 23.5. Conclusions: We have identified 18 patients with papular acne scars of the nose and chin and propose that this new category should be added to acne scarring classification schemes. Future work should be directed at corroborating the epidemiology of such lesions and describing effective treatment modalities. PMID:28163455

  4. Coupled agent-based and finite-element models for predicting scar structure following myocardial infarction.

    PubMed

    Rouillard, Andrew D; Holmes, Jeffrey W

    2014-08-01

    Following myocardial infarction, damaged muscle is gradually replaced by collagenous scar tissue. The structural and mechanical properties of the scar are critical determinants of heart function, as well as the risk of serious post-infarction complications such as infarct rupture, infarct expansion, and progression to dilated heart failure. A number of therapeutic approaches currently under development aim to alter infarct mechanics in order to reduce complications, such as implantation of mechanical restraint devices, polymer injection, and peri-infarct pacing. Because mechanical stimuli regulate scar remodeling, the long-term consequences of therapies that alter infarct mechanics must be carefully considered. Computational models have the potential to greatly improve our ability to understand and predict how such therapies alter heart structure, mechanics, and function over time. Toward this end, we developed a straightforward method for coupling an agent-based model of scar formation to a finite-element model of tissue mechanics, creating a multi-scale model that captures the dynamic interplay between mechanical loading, scar deformation, and scar material properties. The agent-based component of the coupled model predicts how fibroblasts integrate local chemical, structural, and mechanical cues as they deposit and remodel collagen, while the finite-element component predicts local mechanics at any time point given the current collagen fiber structure and applied loads. We used the coupled model to explore the balance between increasing stiffness due to collagen deposition and increasing wall stress due to infarct thinning and left ventricular dilation during the normal time course of healing in myocardial infarcts, as well as the negative feedback between strain anisotropy and the structural anisotropy it promotes in healing scar. The coupled model reproduced the observed evolution of both collagen fiber structure and regional deformation following coronary

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

    PubMed

    Rochet, Jean-Michel; Zaoui, Affif

    2002-12-15

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

  6. A mini-invasive adductor magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note.

    PubMed

    Sillanpää, Petri J; Mäenpää, Heikki M; Mattila, Ville M; Visuri, Tuomo; Pihlajamäki, Harri

    2009-05-01

    Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed, safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3-4 cm is located at the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor magnus tendon is cut at 12-14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is tightened at 30 degrees knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion.

  7. Inflammation and cutaneous nervous system involvement in hypertrophic scarring

    PubMed Central

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

    2015-01-01

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

  8. Fraxelated radiofrequency device for acne scars

    NASA Astrophysics Data System (ADS)

    Rao, Babar K.; Khokher, Sairah

    2012-09-01

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

  9. Muscle silent period in Parkinson's disease.

    PubMed

    Higgins, D C; Haidri, N H; Wilbourn, A J

    1971-10-01

    The muscle silent period was measured in 11 patients with moderate to severe rigidity associated with Parkinson's disease. The determinations were made under conditions of maximum disability for each patient, since all medications had been withdrawn before testing. The duration of the EMG silence, produced by small and large electrical twitch contractions of the adductor pollicis muscle, fell within a range of values previously determined for normal individuals. Major alleviation of the rigidity and bradykinesia with chronic oral l-dopa therapy was not accompanied by any change in the silent period. It was concluded that in untreated Parkinsonism, and also after its treatment with l-dopa, the functioning of the muscle spindles and local inhibitory reflexes remains normal.

  10. Muscle injuries: optimising recovery.

    PubMed

    Järvinen, Tero A H; Järvinen, Teppo L N; Kääriäinen, Minna; Aärimaa, Ville; Vaittinen, Samuli; Kalimo, Hannu; Järvinen, Markku

    2007-04-01

    Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, there are only a few clinical studies on the treatment of muscle injuries. Lack of clinical studies is most probably attributable to the fact that there is not only a high heterogeneity in the severity of injuries, but also the injuries take place in different muscles, making it very demanding to carry out clinical trials. Accordingly, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested empirically only. Clinically, first aid for muscle injuries follows the RICE (Rest, Ice, Compression and Elevation) principle. The objective of RICE is to stop the injury-induced bleeding into the muscle tissue and thereby minimise the extent of the injury. Clinical examination should be carried out immediately after the injury and 5-7 days after the initial trauma, at which point the severity of the injury can be assessed more reliably. At that time, a more detailed characterisation of the injury can be made using imaging diagnostic modalities (ultrasound or MRI) if desired. The treatment of injured skeletal muscle should be carried out by immediate immobilisation of the injured muscle (clinically, relative immobility/avoidance of muscle contractions). However, the duration of immobilisation should be limited to a period sufficient to produce a scar of sufficient strength to bear the forces induced by remobilisation without re-rupture and the return to activity (mobilisation) should then be started gradually within the limits of pain. Early return to activity is needed to optimise the regeneration of healing muscle and recovery of the flexibility and strength of the injured skeletal muscle to pre-injury levels. The rehabilitation programme should be built around progressive agility and trunk stabilisation exercises, as these exercises seem to yield better outcome for injured skeletal muscle than programmes based

  11. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin.

    PubMed

    Dejonckere, P H; Neumann, K J; Moerman, M B J; Martens, J P; Giordano, A; Manfredi, C

    2012-04-01

    Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were performed on voices of 19 patients diagnosed with adductor spasmodic dysphonia (SD), before and after treatment with Botulinum toxin. The speech material consisted of 40 short sentences phonetically selected for constant voicing. Seven perceptual parameters (traditional and dedicated) were blindly rated by a panel of experienced clinicians. Nine acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals and validated with synthesized deviant voices. Patients also filled in a VHI-questionnaire. Significant improvement is shown by all three approaches. The traditional GRB perceptual parameters appear to be adequate for these patients. Conversely, the special acoustic analysis program is successful in objectivating the improved regularity of vocal fold vibration: the basic jitter remains the most valuable parameter, when reliably quantified. The VHI is well suited for the voice-related quality of life. Nevertheless, when considering pre-therapy and post-therapy changes, the current study illustrates a complete lack of correlation between the perceptual, acoustic, and self-assessment dimensions. Assessment of SD-voices needs to be tridimensional.

  12. Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

    PubMed

    Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

    2015-01-01

    Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD.

  13. Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia.

    PubMed

    Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Yanagida, Saori; Nishizawa, Noriko; Oridate, Nobuhiko; Fukuda, Satoshi; Homma, Akihiro

    2017-02-22

    Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

  14. Medullary mediation of the laryngeal adductor reflex: A possible role in sudden infant death syndrome.

    PubMed

    Wang, Xiaolu; Guo, Ruichen; Zhao, Wenjing; Pilowsky, Paul M

    2016-06-01

    The laryngeal adductor reflex (LAR) is a laryngeal protective reflex. Vagal afferent polymodal sensory fibres that have cell bodies in the nodose ganglion, originate in the sub-glottal area of the larynx and upper trachea. These polymodal sensory fibres respond to mechanical or chemical stimuli. The central axons of these sensory vagal neurons terminate in the dorsolateral subnuclei of the tractus solitarius in the medulla oblongata. The LAR is a critical, reflex in the pathways that play a protective role in the process of ventilation, and the sychronisation of ventilation with other activities that are undertaken by the oropharyngeal systems including: eating, speaking and singing. Failure of the LAR to operate properly at any time after birth can lead to SIDS, pneumonia or death. Despite the critical nature of this reflex, very little is known about the central pathways and neurotransmitters involved in the management of the LAR and any disorders associated with its failure to act properly. Here, we review current knowledge concerning the medullary nuclei and neurochemicals involved in the LAR and propose a potential neural pathway that may facilitate future SIDS research.

  15. Evaluation of voice quality in adductor spasmodic dysphonia before and after botulinum toxin treatment.

    PubMed

    Langeveld, T P; van Rossum, M; Houtman, E H; Zwinderman, A H; Briaire, J J; Baatenburg de Jong, R J

    2001-07-01

    In this prospective study, the efficacy of botulinum toxin (Botox) injections in patients with adductor spasmodic dysphonia (AdSD) was assessed by 3 different modalities: perceptual and acoustic analyses and subjective self-assessment. This was done by comparing AdSD patients' pretreatment and posttreatment values and comparing these values with those of normal control speakers. In contrast to most other studies, the posttreatment status was defined as the optimal voice quality as judged by the patient. The aim of the study was to assess to what extent Botox injections actually improve voice quality and function. The AdSD subjects rated a significantly improved voice quality and function after Botox treatment. However, the results were never within normal limits. Perceptually, the characteristic and severely impaired AdSD voice improved, but another "type" of pathological voice was detected after Botox treatment. Acoustic analyses demonstrated a significant improvement, as well. Nevertheless, the "optimally" treated AdSD voice still remained significantly deviant as compared to normal voice production. Currently, Botox injection is the therapy of first choice for AdSD. Although significant improvement could be measured in our study perceptually, acoustically, and subjectively, the optimal voice that was achieved never fully matched normal voice quality or function.

  16. [Surgical therapy of wounds and scars].

    PubMed

    Koller, J

    2013-08-01

    Surgery can be very useful in all phases of wound healing and in treating scars. It can be employed along with conservative therapy, either simultaneously or in a sequential manner. The spectrum of surgical measures includes debridement with excision of wound edges or necrotic areas, skin transplantation to cover granulating wounds, and simple excision or complex reconstructive approaches to scars. The advantages of surgical treatment are seen in all phases of wound healing and include rapid onset of action, avoidance of secondary infection and improved function. The shortened healing time helps save personal and material costs.

  17. Scar treatment variations by skin type.

    PubMed

    Visscher, Marty O; Bailey, J Kevin; Hom, David B

    2014-08-01

    Patients and clinicians use skin color attributes such as color uniformity, color distribution, and texture to infer physiologic health status. Normalization of skin color, surface texture, and height are important treatment goals in the treatment of scars. Skin color, structure, and response to trauma, vary with ethnicity. The incidence of hypertrophic and keloid scar formation is influenced by these inherent skin attributes. Skin type influences the response to various modalities including laser therapy and surgical intervention, and skin differences must be considered in treatment planning to achieve optimal results.

  18. Differences in collagen architecture between keloid, hypertrophic scar, normotrophic scar, and normal skin: An objective histopathological analysis.

    PubMed

    Verhaegen, Pauline D H M; van Zuijlen, Paul P M; Pennings, Noor M; van Marle, Jan; Niessen, Frank B; van der Horst, Chantal M A M; Middelkoop, Esther

    2009-01-01

    Normotrophic, hypertrophic, and keloidal scars are different types of scar formation, which all need a different approach in treatment. Therefore, it is important to differentiate between these types of scar, not only clinically but also histopathologically. Differences were explored for collagen orientation and bundle thickness in 25 normal skin, 57 normotrophic scar, 56 hypertrophic scar, and 56 keloid biopsies, which were selected on clinical diagnosis. Image analysis was performed by fast fourier transformation. The calculated collagen orientation index ranged from 0 (random orientation) to 1 (parallel orientation). The bundle distance was calculated by the average distance between the centers of the collagen bundles. The results showed that compared with all three types of scars, the collagen orientation index was significantly lower in normal skin, which indicates that scars are organized in a more parallel manner. No differences were found between the different scars. Secondly, compared with normal skin, normotrophic scar, and hypertrophic scar, the bundle distance was significantly larger in keloidal scar, which suggests that thicker collagen bundles are present in keloidal scar. This first extensive histological study showed objective differences between normal skin, normotrophic, hypertrophic, and keloidal scar.

  19. Muscle sarcomere lesions and thrombosis after spaceflight and suspension unloading

    SciTech Connect

    Riley, D.A.; Ellis, S.; Giometti, C.S.; Hoh, J.F.Y.; Ilyina-Kakueva, E.I.; Oganov, V.S.; Slocum, G.R.; Bain, J.L.W.; Sedlak, F.R. )

    1992-08-01

    Extended exposure of humans to spaceflight produces a progressive loss of skeletal muscle strength. This process must be understood to design effective countermeasures. The present investigation examined hindlimb muscles from flight rats killed as close to landing as possible. Spaceflight and tail suspension-hindlimb unloading (unloaded) produced significant decreases in fiber cross-sectional areas of the adductor longus (AL), a slow-twitch antigravity muscle. However, the mean wet weight of the flight AL muscles was near normal, whereas that of the suspension unloaded AL muscles was significantly reduced. Interstitial edema within the flight AL, but not in the unloaded AL, appeared to account for this apparent disagreement.In both conditions, the slow-twitch oxidative fibers atrophied more than the fast-twitch oxidative-glycolytic fibers. Microcirculation was also compromised by spaceflight, such that there was increased formation of thrombi in the postcapillary venules and capillaries.

  20. Laparoscopic Treatment of Cesarean Scar Ectopic Pregnancy

    PubMed Central

    Felsingerová, Zuzana; Felsinger, Michal; Jandakova, Eva

    2014-01-01

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

  1. Microtopography of the skin and scar formation.

    PubMed

    Tring, F C

    1976-11-01

    The surface microtopography of normal human skin varies from one anatomical region to another. The patterns at different sites are considered to reflect different orientations of dermal fibers. A simple technique is described that enables such orientations to be accurately delineated. Various scars resulting from lacerations, surgical incisions, and steroid-induced striae were examined in the manner described.

  2. Necrobiotic xanthogranuloma occurring in an eyelid scar.

    PubMed

    Rayner, S A; Duncombe, A S; Keefe, M; Theaker, J; Manners, R M

    2008-01-01

    We present a case report of necrobiotic xanthogranuloma (NXG) in a 76-year-old Caucasian lady occurring as a nodule in a blepharoplasty scar. NXG is a rare histiocytic disease with progressive orbital and systemic features. Management options of excision biopsy or chemotherapy are discussed.

  3. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited...

  4. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited...

  5. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited...

  6. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited...

  7. 9 CFR 11.3 - Scar rule.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited...

  8. A Rat Excised Larynx Model of Vocal Fold Scar

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  9. Combination Therapy in the Management of Atrophic Acne Scars

    PubMed Central

    Garg, Shilpa; Baveja, Sukriti

    2014-01-01

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

  10. Myocardial Scar Detection by Standard CT Coronary Angiography

    PubMed Central

    Jeevarethinam, Anand; Venuraju, Shreenidhi; Mehta, Vishal Shahil; Atwal, Satvir; Raval, Usha; Rakhit, Roby; Davar, Joseph; Lahiri, Avijit

    2014-01-01

    We have described a myocardial infarct scar identified by a standard dual source CT coronary angiography (CTCA). We were able to detect the scar during the routine coronary assessment without contrast late enhancement and without additional radiation exposure. It is therefore feasible to assess chronic scar using a standard CTCA technique.

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

    PubMed Central

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

    2015-01-01

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

  12. The Use of Silicone Adhesives for Scar Reduction

    PubMed Central

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

    2015-01-01

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

  13. Vertical scar versus the inverted-T scar reduction mammaplasty: a 10-year follow-up.

    PubMed

    Bouwer, Lesley R; van der Biezen, Jan Jaap; Spronk, Cees A; van der Lei, Berend

    2012-10-01

    A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction surgery in the period 1997-2000 at the Department of Reconstructive Plastic Surgery at the Medical Center of Leeuwarden were willing and able to participate in this study. A structured questionnaire was used to assess the degree of patient satisfaction. For subjective evaluation, the Strasser Grading System on photographs at the 3 months after surgery and after long-term follow-up (10 years) was used. The median general appreciation mark for the entire surgical procedure given by patients was 8 (1-10) on a scale from 1 to 10. Forty-six of the 69 patients could be scored according to Strasser: at 3 months in 17 patients (37%) the result was 'good', in 21 patients (46%) 'mediocre' and in eight patients (17%) 'poor'. After 10 years, in 37 of the patients (80%) the result was 'good', in six patients (13%) 'mediocre' and in three patients (7%) 'poor'. At 3 months, there was a higher incidence of bottoming out in the vertical scar group (one on two patients) as compared to the inverted-T scar group (one on 10 patients); however, at the 10-years follow-up bottoming out was 50% in the inverted-T scar group and 20% in the vertical scar group. Despite bottoming out, in both the vertical scar reduction mammaplasty technique and the inverted-T scar reduction mammaplasty technique, high patient satisfaction rates are achieved that remains for years.

  14. The effects of horseback riding simulator exercises on the muscle activity of the lower extremities according to changes in arm posture

    PubMed Central

    Park, Jungseo; Lee, Sangyong; Lee, Daehee

    2015-01-01

    [Purpose] This study aimed to determine the effects of horseback riding simulator exercise on the muscle activities of the lower extremities according to changes in arm posture. [Subjects] The subjects of this study were 30 normal adult males and females. [Methods] The horseback riding simulator exercise used a horseback riding simulator device; two arm postures were used, posture 1 (holding the handle of the device) and posture 2 (crossing both arms, with both hands on the shoulders). Electromyography was used to compare the muscle activities of the rectus femoris, biceps femoris, and hip adductors in the lower extremities. [Results] Posture 2 had significantly higher muscle activity than posture 1. [Conclusion] Posture 2, which entailed crossing both arms with both hands on the shoulders, was an effective intervention for improved muscle activity in the hip adductors. PMID:26504280

  15. Combined adductor canal block with periarticular infiltration versus periarticular infiltration for analgesia after total knee arthroplasty

    PubMed Central

    Ma, Jinhui; Gao, Fuqiang; Sun, Wei; Guo, Wanshou; Li, Zirong; Wang, Weiguo

    2016-01-01

    Abstract Background: Both adductor canal block (ACB) and periarticular infiltration (PI) have been shown to reduce pain after total knee arthroplasty (TKA) without the motor blockade. However, the efficacy and safety of combined ACB with PI (ACB + PI) as compared to PI alone for analgesia after TKA remains controversial. We therefore performed a meta-analysis to compare the effects of ACB + PI with PI alone on pain controll after TKA. Methods: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify studies comparing ACB + PI with PI alone for TKA patients. The primary outcomes included pain score with rest or activity and morphine consumption. Secondary outcomes were distance walked, length of hospital stay, and postoperative complications. Relevant data were analyzed using RevMan v5.3. Results: Three studies involving 337 patients were included. Combined ACB with PI was associated with longer distances walked than PI alone (MD = 7.27, 95% CI: 0.43–14.12, P = 0.04) on postoperative day 1. The outcomes of pain, morphine consumption, length of hospital stay, and postoperative complications were not statistically different between the 2 groups (P > 0.05). Conclusion: Our meta-analysis suggests that combined ACB with PI may achieve earlier ambulation for patients after TKA without a reduction in analgesia when compared to PI alone in the early postoperative period. There were no significant differences in morphine consumption, length of hospital stay, and postoperative complications between the 2 groups. However, owing to the variation of included studies, no firm conclusions can be drawn. PMID:28033266

  16. Effect of adductor canal block on medial compartment knee pain in patients with knee osteoarthritis

    PubMed Central

    Lee, Doo-Hyung; Lee, Michael Y.; Kwack, Kyu-Sung; Yoon, Seung-Hyun

    2017-01-01

    Abstract Knee osteoarthritis (KOA) is a common disease in middle-aged and elderly people. Pain is the chief complaint of symptomatic KOA and a leading cause of chronic disability, which is most often found in medial knees. The aim of this study is to evaluate the efficacy of pain relief and functional improvement in KOA patients treated with ultrasound-guided adductor canal block (ACB). This is a 3-month retrospective case-controlled comparative study. Two hundred patients with anteromedial knee pain owing to KOA that was unresponsive to 3-month long conservative treatments. Ninety-two patients received ACB with 9 mL of 1% of lidocaine and 1 mL of 10 mg triamcinolone acetonide (ACB group), and 108 continued conservative treatments (control group). The main outcome measure was visual analog scale (VAS) of the average knee pain level for the past one week. Secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the timed up and go test, numbers of analgesic ingestion per day, and opioid consumption per day. During the 3-month follow-up, 86 patients in ACB group and 92 in control group were analyzed. There was no significant difference, with the exception of the duration of symptoms, between the 2 groups in age, sex, body mass index, and Kellgren-Lawrence grade. Repeated-measures analysis of variance and post hoc tests showed improvement of VAS (at month 1), WOMAC (at month 1), and opioid consumption per day (at month 1 and 2) in ACB group. No adverse events were reported. To our knowledge, this is the first study to assess the efficacy of ACB for patients with KOA. ACB is an effective and safe treatment and can be an option for patients who are either unresponsive or unable to take analgesics. PMID:28328826

  17. Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia.

    PubMed

    Gandhi, Sachin; Remacle, Marc; Mishra, Prasun; Desai, Vrushali

    2014-12-01

    Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

  18. A muscle spindle abnormity in one laryngeal muscle would be sufficient to cause stuttering.

    PubMed

    Schuster, Steffen H; Schuster, Frank M

    2012-07-01

    Muscle spindles are increasingly recognized as playing a pivotal role in the cause of dystonia. This development and own laryngeal observations that support the idea of causally "well-intentioned" stuttering motivated us to present the following hypothesis: stuttering events compensate for a sensory problem that arises when the abductor/adductor ratio of afferent impulse rates from the posterior cricoarytenoid and lateral cricoarytenoid muscle spindles is abnormally reduced and processed for the occasional determination of the vocal fold position. This hypothesis implies that functional and structural brain abnormalities might be interpreted as secondary compensatory reactions. Verification of this hypothesis (using technologies such as microneurography, dissection and muscle afferent block) is important because its confirmation could relink dystonia and stuttering research, change the direction of stuttering therapy and destigmatize stuttering radically.

  19. Assessment of Anti-Scarring Therapies in Ex Vivo Organ Cultured Rabbit Corneas

    PubMed Central

    Sriram, Sriniwas; Gibson, Daniel; Robinson, Paulette; Pi, Liya; Tuli, Sonal; Lewin, Alfred S.; Schultz, Gregory

    2014-01-01

    The effects of a triple combination of siRNAs targeting key scarring genes was assessed using an ex vivo organ culture model of excimer ablated rabbit corneas. The central 6 mm diameter region of fresh rabbit globes was ablated to a depth of 155 microns with an excimer laser. Corneas were excised, cultured at the air-liquid interface in defined culture medium supplemented with transforming growth factor beta 1 (TGFB1), and treated with either 1% prednisolone acetate or with 22.5 μM cationic nanoparticles complexed with a triple combination of siRNAs (NP-siRNA) targeting TGFB1, TGFB Receptor (TGFBR2) and connective tissue growth factor (CTGF). Scar formation was measured using image analysis of digital images and levels of smooth muscle actin (SMA) were assessed in ablated region of corneas using qRT-PCR and immunostaining. Ex vivo cultured corneas developed intense haze-like scar in the wounded areas and levels of mRNAs for pro-fibrotic genes were significantly elevated 3 to 8 fold in wounded tissue compared to unablated corneas. Treatment with NP-siRNA or steroid significantly reduced quantitative haze levels by 55% and 68%, respectively, and reduced SMA mRNA and immunohistostaining. This ex vivo corneal culture system reproduced key molecular patterns of corneal scarring and haze formation generated in rabbits. Treatment with NP-siRNAs targeting key scarring genes or an anti-inflammatory steroid reduced corneal haze and SMA mRNA and protein. PMID:24971495

  20. Structural Composition of Myocardial Infarction Scar in Middle-aged Male and Female Rats

    PubMed Central

    Bogatyryov, Yevgen; Tomanek, Robert J.

    2013-01-01

    The present study was designed to determine whether the structural composition of the scar in middle-aged post–myocardial infraction (MI) rats is affected by the biological sex of the animals. A large MI was induced in 12-month-old male (M-MI) and female (F-MI) Sprague-Dawley rats by ligation of the left coronary artery. Four weeks after the MI, rats with transmural infarctions, greater than 50% of the left ventricular (LV) free wall, were evaluated. The extent of LV remodeling and fractional volumes of fibrillar collagen (FC), myofibroblasts, vascular smooth muscle (SM) cells, and surviving cardiac myocytes (CM) in the scars were compared between the two sexes. The left ventricle of post-MI male and female rats underwent a similar degree of remodeling as evidenced by the analogous scar thinning ratio (0.46 ± 0.02 vs. 0.42 ± 0.05) and infarct expansion index (1.06 ± 0.07 vs. 1.12 ± 0.08), respectively. Most important, the contents of major structural components of the scar revealed no evident difference between M-MI and F-MI rats (interstitial FC, 80.74 ± 2.08 vs. 82.57 ± 4.53; myofibroblasts, 9.59 ± 1.68 vs.9.56 ± 1.15; vascular SM cells, 2.27 ± 0.51 vs. 3.38 ± 0.47; and surviving CM, 3.26 ± 0.39 vs. 3.05 ± 0.38, respectively). Our data are the first to demonstrate that biological sex does not influence the structural composition of a mature scar in middle-aged post-MI rats. PMID:23867842

  1. Repigmentation of cutaneous scars depends on original wound type

    PubMed Central

    Chadwick, Sarah L; Yip, Christina; Ferguson, Mark W J; Shah, Mamta

    2013-01-01

    Cutaneous scarring is currently an inevitable outcome following skin injury. Abnormal pigmentation within scars makes them more noticeable, causing distress for patients, particularly as there is no reliable and effective treatment available to date. The Duroc pig, known to scar badly, was used to investigate repigmentation of scars resulting from three different wound types: incisional, partial thickness excisional and full thickness excisional. Wounds were created on the backs of Duroc pigs and the resulting scars harvested at days 35, 56, 70 and 90 days post-injury. Scars were processed for histology and immunohistochemistry, quantitatively analysed using image analysis software and subjected to statistical analysis. Photographs of the macroscopic appearance of scars were scored for pigmentation using a visual analogue scale. Results demonstrated temporal and spatial differences in melanocyte repopulation and function within scars from different wound types. The microscopic pigment deposition did not correlate with macroscopic appearances in mature scars. Pigmentation of scars is dependent on the width and depth of wounds. This study has provided important information on which we can base future studies to investigate factors controlling the repigmentation of scars. PMID:23668313

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

    PubMed

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

    2015-08-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic scar (NTscar) tissue. Another drawback is that often only one time period after wounding is studied, while scar formation is a dynamic process over a period of several months. In this study, we compared the expression of genes involved in inflammation, angiogenesis and extracellular matrix (ECM) formation and also macrophage infiltration in biopsies obtained before and up to 52 weeks after standard surgery in five patients who developed HTscar and six patients who developed NTscar. It was found that HTscar formation coincided with a prolonged decreased expression of inflammatory genes (TNFα, IL-1α, IL-1RN, CCL2, CCL3, CXCL2, CXCR2, C3 and IL-10) and an extended increased expression of ECM-related genes (PLAU, Col3A1, TGFβ3). This coincided with a delayed but prolonged infiltration of macrophages (type 2) in HTscar tissue compared to NTscar tissue. These findings were supported by immunohistochemical localization of proteins coding for select genes named above. Our study emphasizes that human cutaneous wound healing is a dynamic process that is needed to be studied over a period of time rather than a single point of time. Taken together, our results suggest innate immune stimulatory therapies may be a better option for improving scar quality than the currently used anti-inflammatory scar therapies.

  3. Your Muscles

    MedlinePlus

    ... Room? What Happens in the Operating Room? Your Muscles KidsHealth > For Kids > Your Muscles A A A ... and skeletal (say: SKEL-uh-tul) muscle. Smooth Muscles Smooth muscles — sometimes also called involuntary muscles — are ...

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

    PubMed Central

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

    2014-01-01

    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

  5. Umbilical scarring in hatchling American alligators

    USGS Publications Warehouse

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

    2004-01-01

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

  6. Digital imaging analysis to assess scar phenotype.

    PubMed

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

    2014-01-01

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

  7. Digital imaging analysis to assess scar phenotype

    PubMed Central

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

    2015-01-01

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

  8. Progression and variation of fatty infiltration of the thigh muscles in Duchenne muscular dystrophy, a muscle magnetic resonance imaging study.

    PubMed

    Li, Wenzhu; Zheng, Yiming; Zhang, Wei; Wang, Zhaoxia; Xiao, Jiangxi; Yuan, Yun

    2015-05-01

    The purpose of this study was to assess the progression and variation of fatty infiltration of the thigh muscles of Duchenne muscular dystrophy patients. Muscle magnetic resonance imaging was used to measure the degree of fatty infiltration of the thigh muscles of 171 boys with Duchenne muscular dystrophy (mean age, 6.09 ± 2.30 years). Fatty infiltration was assigned using a modified Mercuri's scale 0-5 (normal-severe). The gluteus maximus and adductor magnus were affected in patients less than two years old, followed by the biceps femoris. Quadriceps and semimembranosus were first affected at the age of five to six years; the sartorius, gracilis and adductor longus remained apparently unaffected until seven years of age. Fatty infiltration of all the thigh muscles developed rapidly after seven years of age. The standard deviation of the fatty infiltration scores ranged from 2.41 to 4.87 before five years old, and from 6.84 to 11.66 between six and ten years old. This study provides evidence of highly variable degrees of fatty infiltration in children of different ages with Duchenne muscular dystrophy, and indicates that fatty infiltration progresses more quickly after seven years of age. These findings may be beneficial for the selection of therapeutic regimens and the analysis of future clinical trials.

  9. Immediate effect of static and proprioceptive neuromuscular facilitation stretching on hip adductor flexibility in female ballet dancers.

    PubMed

    Rubini, Ercole C; Souza, Andréa C; Mello, Mônica L; Bacurau, Reury F P; Cabral, Leonardo F; Farinatti, Paulo T V

    2011-01-01

    The aim of the present study was to investigate the immediate effects of static and proprioceptive neuromuscular facilitation (PNF) stretching on the flexibility of hip adductors in female ballet dancers. Forty-five subjects (age: 28.5 ± 8.0 years; minimum two years of ballet training) were randomly assigned to three groups: PNF (contract-release technique), Static, and Control. Subjects in the PNF and Static groups performed four sets of 30 second stretching with an interval of 30 seconds between sets. The control group stayed at rest for the same time spent by the PNF and Static groups during the stretching sessions. Maximal range of motion was measured before and immediately after the experimental and control protocols in all groups. The results indicated significant differences between pre- and post-stretching flexibility in both PNF and Static groups (p < 0.0001; effect size = 0.24 and 0.39, respectively), whereas no change was identified in the Control group (p = 0.265). However, no differences in post-exercise flexibility were found between PNF and Static groups (p = 0.235). It is concluded that static and PNF stretching methods provoked similar post-exercise acute effects on the maximal range of motion of hip adductors in highly flexible female ballet dancers.

  10. Cellular events during scar-free skin regeneration in the spiny mouse, Acomys.

    PubMed

    Brant, Jason O; Yoon, Jung H; Polvadore, Trey; Barbazuk, William Brad; Maden, Malcolm

    2016-01-01

    In contrast to the lab mouse, Mus musculus, several species of spiny mouse, Acomys, can regenerate epidermis, dermis, hairs, sebaceous glands with smooth muscle erector pili muscles and skeletal muscle of the panniculus carnonsus after full thickness skin wounding. Here, we have compared the responses of these scarring and nonscarring organisms concentrating on the immune cells and wound cytokines, cell proliferation, and the collagenous components of the wound bed and scar. The blood of Acomys is very neutropenic but there are greater numbers of mast cells in the Acomys wound than the Mus wound. Most importantly there are no F4/80 macrophages in the Acomys wound and many proinflammatory cytokines are either absent or in very low levels which we suggest may be primarily responsible for the excellent regenerative properties of the skin of this species. There is little difference in cell proliferation in the two species either in the epidermis or mesenchymal tissues but the cell density and matrix composition of the wound is very different. In Mus there are 8 collagens which are up-regulated at least 5-fold in the wound creating a strongly trichrome-positive matrix whereas in Acomys there are very few collagens present and the matrix shows only light trichrome staining. The major component of the Mus matrix is collagen XII which is up-regulated between 10 and 30-fold after wounding. These results suggest that in the Acomys wound the absence of many cytokines resulting in the lack of macrophages is responsible for the failure to up-regulate fibrotic collagens, a situation which permits a regenerative response within the skin rather than the generation of a scar.

  11. Nondestructive measurements of the properties of healing burn scars.

    PubMed

    Chu, B M; Brody, G

    1975-01-01

    A testing protocol and the requisite instrumentation have been developed to nondestructively monitor the temporal and mechanical properties of maturing scar. The maturing scar can become progressively and unpredictably adherent or contractured, producing varying degrees of functional impairment. By plotting these mechanical changes as a temporal function of limb motion history, more accurate prediction and control of the ultimate scarring may result. These same techniques could also be used to study normal skin aging. Extrapolation could be made to connective tissue scars in tendons, ligaments, and other structural elements. Scar contractures may develop slowly along lines of tension or areas of maximum skin defect in large maturing scars once the patient has recovered sufficiently to exercise the underlying joints. Since the present endeavor to monitor potential contractures requires measurement of the "in-plane" stresses and strains, we have chosen to utilize an in situ strip biaxial test configuration.

  12. Novel Insights on Understanding of Keloid Scar: Article Review.

    PubMed

    Mari, Walid; Alsabri, Sami G; Tabal, Najib; Younes, Sara; Sherif, Abdulamagid; Simman, Richard

    2015-12-01

    Keloid scar, dermal benign fibro-proliferative growth that extends outside the original wound and invades adjacent dermal tissue due to extensive production of extracellular matrix, especially collagen, which caused by over expression of cytokines and growth factors. Although many attempts were made to understand the exact pathophysiology and the molecular abnormalities, the pathogenesis of keloid scar is yet to be determined. Even though there are several treatment options for keloid scars include combination of medical and surgical therapies like combination of surgical removal followed by cryotherapy or intralesional steroid therapy, the reoccurrence rate is still high despite the present treatment. In this review, PubMed, clinical key and Wright State Library web site have been used to investigate any update regarding Keloid disease. We used Keloid, scar formation, hypertrophic scar and collagen as key words. More than 40 articles have been reviewed. This paper reviews literature about keloid scar formation mechanism, the most recent therapeutic options including the ones under research.

  13. Expanded thoracoacromial artery perforator flap for reconstruction of full-perioral scar contracture.

    PubMed

    Wang, Qianwen; Wang, Jiaqi

    2015-03-01

    Various types of anterior chest flaps can be recruited in the reconstruction of faciocervical region. Most of them were created based on the internal mammary artery and the lateral thoracic artery, and the thoracoacromial artery (TAA) is usually used in pectoralis major musculocutaneous flap. An anterior chest flap with TAA perforator (TAAP) will have no sacrifice of the pectoralis major muscle, but less reports, especially expanded pedicled one, can be reviewed. Here, we reported a case using expanded pedicled TAAP flap to reconstruct the perioral scar contracture. In this technique, expanded TAAP flap could be easily harvested without the sophisticated microsurgical technology. Acceptable esthetic and functional results were achieved.

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

    NASA Technical Reports Server (NTRS)

    Lathram, E. H.

    1974-01-01

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

  15. Dermal tunneling: a proposed treatment for depressed scars.

    PubMed

    Lima, Emerson Vasconcelos de Andrade

    2016-01-01

    Depressed facial scars are still a challenge in medical literature, despite the wide range of proposed treatments. Subcision is a technique that is frequently performed to improve this type of lesions. This article proposes a new method to release depressed scars, reported and named by the author as dermal tunneling. This study presents a simple and didactic manner to perform this method. The results in 17 patients with facial scars were considered promising. Thus, the technique was deemed to be safe and reproducible.

  16. Latest Mississippian (Namurian A) nonmarine ostracodes from West Virginia and Virginia.

    USGS Publications Warehouse

    Sohn, I.G.

    1985-01-01

    Nonmarine ostracodes occur as partly exfoliated carapaces and internal molds at the base of the Bramwell Member of the Bluestone Formation, which represents the uppermost Mississippian (Namurian A), stratigraphic subdivision in West Virginia and Virginia. These specimens are important in that they permit the determination of a variety of adductor-muscle-attachment scars. The adductor-muscle-attachment scar patterns illustrated herein for the first time are the oldest recorded in North America for nonmarine ostracodes. The new family Carbonitidae and superfamily Carbonitacea are established on the basis of the pattern of adductor-muscle-attachment scars. The following nonmarine genera in this unit are illustrated in open nomenclature: Carbonita Strand, 1928; Whipplella? Holland, 1934; Gutschickia Scott, 1944; Pruvostina? Scott and Summerson, 1943; Darwinula Brady and Robertson, 1885; and two steinkerns of geisinid ostracodes, 'Pseudo-ornamentation' on molds is illustrated.-Author

  17. [Participation of the primary motor cortex in programming of muscle activity during catching of falling object].

    PubMed

    Kazennikov, O V; Lipshits, M I

    2011-01-01

    Object fell into the cup that sitting subject held between thumb and index fingers. Transcranial magnetic stimulation (TMS) of the primary motor cortex was performed early before and during anticipatory grip force increasing. Comparison of current EMG activity of adductor pollicis brevis and first dorsal interosseous muscles and responses of these muscles on TMS showed that responses were increased before the raising of muscle activity. From the other side only slight augmentation of responses was observed during subsequent strong muscle activation. It is assumed that the increasing of the TMS responses that occurred before the initiation of muscle activity reflects the enhancement ofthe motor cortex excitability associated to specific processes related to the motor cortex participation in programming of the muscles activities.

  18. Interactive visualization for scar transmurality in cardiac resynchronization therapy

    NASA Astrophysics Data System (ADS)

    Reiml, Sabrina; Toth, Daniel; Panayiotou, Maria; Fahn, Bernhard; Karim, Rashed; Behar, Jonathan M.; Rinaldi, Christopher A.; Razavi, Reza; Rhode, Kawal S.; Brost, Alexander; Mountney, Peter

    2016-03-01

    Heart failure is a serious disease affecting about 23 million people worldwide. Cardiac resynchronization therapy is used to treat patients suffering from symptomatic heart failure. However, 30% to 50% of patients have limited clinical benefit. One of the main causes is suboptimal placement of the left ventricular lead. Pacing in areas of myocardial scar correlates with poor clinical outcomes. Therefore precise knowledge of the individual patient's scar characteristics is critical for delivering tailored treatments capable of improving response rates. Current research methods for scar assessment either map information to an alternative non-anatomical coordinate system or they use the image coordinate system but lose critical information about scar extent and scar distribution. This paper proposes two interactive methods for visualizing relevant scar information. A 2-D slice based approach with a scar mask overlaid on a 16 segment heart model and a 3-D layered mesh visualization which allows physicians to scroll through layers of scar from endocardium to epicardium. These complementary methods enable physicians to evaluate scar location and transmurality during planning and guidance. Six physicians evaluated the proposed system by identifying target regions for lead placement. With the proposed method more target regions could be identified.

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

    PubMed Central

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

    2015-01-01

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

  20. The role of scar origin in shaping men's body image.

    PubMed

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

    2015-03-01

    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.

  1. NEW MOLECULAR MEDICINE-BASED SCAR MANAGEMENT STRATEGIES

    PubMed Central

    Arno, Anna I; Gauglitz, Gerd G; Barret, Juan P; Jeschke, Marc G

    2014-01-01

    Keloids and hypertrophic scars are prevalent disabling conditions with still suboptimal treatments. Basic science and molecular-based medicine research has contributed to unravel new bench-to-bedside scar therapies, and to dissect the complex signaling pathways involved. Peptides such as transforming growth factor beta (TGF-β) superfamily, with SMADs, Ski, SnoN, Fussels, endoglin, DS-Sily, Cav-1p, AZX100, thymosin-β4 and other related molecules may emerge as targets to prevent and treat keloids and hypertrophic scars. The aim of this review is to describe the basic complexity of these new molecular scar management strategies, and point out new fibrosis research lines. PMID:24438742

  2. Abnormal pigmentation within cutaneous scars: A complication of wound healing

    PubMed Central

    Chadwick, Sarah; Heath, Rebecca; Shah, Mamta

    2012-01-01

    Abnormally pigmented scars are an undesirable consequence of cutaneous wound healing and are a complication every single individual worldwide is at risk of. They present a challenge for clinicians, as there are currently no definitive treatment options available, and render scars much more noticeable making them highly distressing for patients. Despite extensive research into both wound healing and the pigment cell, there remains a scarcity of knowledge surrounding the repigmentation of cutaneous scars. Pigment production is complex and under the control of many extrinsic and intrinsic factors and patterns of scar repigmentation are unpredictable. This article gives an overview of human skin pigmentation, repigmentation following wounding and current treatment options. PMID:23162241

  3. New Insights into Muscle Function during Pivot Feeding in Seahorses

    PubMed Central

    Van Wassenbergh, Sam; Dries, Billy; Herrel, Anthony

    2014-01-01

    Seahorses, pipefish and their syngnathiform relatives are considered unique amongst fishes in using elastic recoil of post-cranial tendons to pivot the head extremely quickly towards small crustacean prey. It is known that pipefish activate the epaxial muscles for a considerable time before striking, at which rotations of the head and the hyoid are temporarily prevented to allow energy storage in the epaxial tendons. Here, we studied the motor control of this system in seahorses using electromyographic recordings of the epaxial muscles and the sternohyoideus-hypaxial muscles with simultaneous high-speed video recordings of prey capture. In addition we present the results from a stimulation experiment including the muscle hypothesised to be responsible for the locking and triggering of pivot feeding in seahorses (m. adductor arcus palatini). Our data confirmed that the epaxial pre-activation pattern observed previously for pipefish also occurs in seahorses. Similar to the epaxials, the sternohyoideus-hypaxial muscle complex shows prolonged anticipatory activity. Although a considerable variation in displacements of the mouth via head rotation could be observed, it could not be demonstrated that seahorses have control over strike distance. In addition, we could not identify the source of the kinematic variability in the activation patterns of the associated muscles. Finally, the stimulation experiment supported the previously hypothesized role of the m. adductor arcus palatini as the trigger in this elastic recoil system. Our results show that pre-stressing of both the head elevators and the hyoid retractors is taking place. As pre-activation of the main muscles involved in pivot feeding has now been demonstrated for both seahorses and pipefish, this is probably a generalized trait of Syngnathidae. PMID:25271759

  4. Efficacy and Safety of a Novel 100% Silicone Scar Gel Treatment for Early Intervention in Scar Management

    PubMed Central

    2016-01-01

    Objective: To evaluate the efficacy and safety of a new topical silicone gel for the early intervention in the management of scars. Design: In this 12-week, observational study, healthy subjects (n=15) with an accessible linear or hypertrophic scar were given the test product and instructed to apply twice daily. Subjects returned 14, 28, 56, and 84 days later for evaluation and recording of adverse events. Setting: Private practice of the author. Participants: Eligible subjects had a scar with a Vancouver Scar Scale total score ≥3 at baseline. Measurements: Improvement was evaluated by the Vancouver Scar Scale and Observer Scar Assessment Scale at baseline and at four follow-up visits. Results: The median total Vancouver Scar Scale score and median total Observer Scar Assessment Scale score decreased significantly from baseline at each visit, showing rapid and continuing improvement in the appearance of the scars. For Vancouver Scar Scale, significant differences of individual parameters from baseline began at 28 days for pliability and height, 56 days for vascularity, and 84 days for pigmentation. For Observer Scar Assessment Scale parameters, significant differences from baseline began at 14 days and continued until 84 days for vascularization, thickness, and pigmentation. Pain and pruritis scores were low at each visit. Overall, 84.6 percent of subjects rated the treatment as excellent, very good, or good after three months of treatment. No adverse events were reported. Conclusion: The test product improved the appearance of scars after three months of twice-daily treatment and without adverse events. PMID:28210394

  5. Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking.

    PubMed

    Attias, M; Bonnefoy-Mazure, A; De Coulon, G; Cheze, L; Armand, S

    2016-10-01

    Contracture is a permanent shortening of the muscle-tendon-ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking. An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability. The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics.

  6. Corneal stromal stem cells reduce corneal scarring by mediating neutrophil infiltration after wounding

    PubMed Central

    Funderburgh, Martha L.; Mann, Mary M.; Du, Yiqin

    2017-01-01

    Corneal scarring limits vision for millions of individuals worldwide. Corneal transplantation (keratoplasty) is the standard of care for corneal opacity; however, it bears the risk of graft rejection and infection and is not universally available. Stem cell therapy holds promise as an alternative to keratoplasty. Stem cells from human corneal stroma (CSSC) induce regeneration of transparent corneal tissue in a mouse wound-healing model. In this study we investigated the mechanism by which CSSC prevent deposition of fibrotic tissue. Infiltration by CD11b+/Ly6G+ neutrophils and myeloperoxidase expression were increased in corneas 24 hr after corneal wounding but were reduced in CSSC-treated wounds. Secretion of TSG-6, a protein known to regulate neutrophil migration, was up-regulated in CSSC in response to TNFα and as CSSC differentiate to keratocytes. In vivo, wounded mouse corneas treated with CSSC contained human TSG-6. Inhibition of neutrophil infiltration into cornea by CSSC was reversed when TSG-6 expression was knocked down using siRNA. Silencing of TSG-6 expression in CSSC reduced their ability to block scarring and the expression of mRNA for fibrosis-associated proteins collagen III, tenascin C, and smooth muscle actin in wounded corneas. Neutropenic mice exhibited a significant reduction in corneal scarring and fibrotic mRNA expression 2 weeks after wounding. These results support the conclusion that neutrophil infiltration is an essential event in the fibrotic response to corneal damage and that prevention of scarring by CSSC is mediated by secretion of TSG-6 by these cells. PMID:28257425

  7. Macrophages are essential for the early wound healing response and the formation of a fibrovascular scar.

    PubMed

    He, Lizhi; Marneros, Alexander G

    2013-06-01

    After wounding, multiple cell types interact to form a fibrovascular scar; the formation and cellular origins of these scars are incompletely understood. We used a laser-injury wound model of choroidal neovascularization in the eye to determine the spatiotemporal cellular events that lead to formation of a fibrovascular scar. After laser injury, F4/80(+) myeloid cells infiltrate the wound site and induce smooth muscle actin (SMA) expression in adjacent retinal pigment epithelial cells, with subsequent formation of a SMA(+)NG2(+) myofibroblastic scaffold, into which endothelial cells then infiltrate to form a fibrovascular lesion. Cells of the fibrovascular scaffold express the proangiogenic factor IL-1β strongly, whereas retinal pigment epithelial cells are the main source of VEGF-A. Subsequent choroidal neovascularization is limited to the area demarcated by this myofibroblastic scaffold and occurs independently of epithelial- or myeloid-derived VEGF-A. The SMA(+)NG2(+) myofibroblastic cells, F4/80(+) macrophages, and adjacent epithelial cells actively proliferate in the early phase of the wound healing response. Cell-lineage tracing experiments suggest that the SMA(+)NG2(+) myofibroblastic scaffold originates from choroidal pericyte-like cells. Targeted ablation of macrophages inhibits the formation of this fibrovascular scaffold, and expression analysis reveals that these macrophages are Arg1(+)YM1(+)F4/80(+) alternatively activated M2-like macrophages, which do not require IL-4/STAT6 or IL-10 signaling for their activation. Thus, macrophages are essential for the early wound healing response and the formation of a fibrovascular scar.

  8. Corneal stromal stem cells reduce corneal scarring by mediating neutrophil infiltration after wounding.

    PubMed

    Hertsenberg, Andrew J; Shojaati, Golnar; Funderburgh, Martha L; Mann, Mary M; Du, Yiqin; Funderburgh, James L

    2017-01-01

    Corneal scarring limits vision for millions of individuals worldwide. Corneal transplantation (keratoplasty) is the standard of care for corneal opacity; however, it bears the risk of graft rejection and infection and is not universally available. Stem cell therapy holds promise as an alternative to keratoplasty. Stem cells from human corneal stroma (CSSC) induce regeneration of transparent corneal tissue in a mouse wound-healing model. In this study we investigated the mechanism by which CSSC prevent deposition of fibrotic tissue. Infiltration by CD11b+/Ly6G+ neutrophils and myeloperoxidase expression were increased in corneas 24 hr after corneal wounding but were reduced in CSSC-treated wounds. Secretion of TSG-6, a protein known to regulate neutrophil migration, was up-regulated in CSSC in response to TNFα and as CSSC differentiate to keratocytes. In vivo, wounded mouse corneas treated with CSSC contained human TSG-6. Inhibition of neutrophil infiltration into cornea by CSSC was reversed when TSG-6 expression was knocked down using siRNA. Silencing of TSG-6 expression in CSSC reduced their ability to block scarring and the expression of mRNA for fibrosis-associated proteins collagen III, tenascin C, and smooth muscle actin in wounded corneas. Neutropenic mice exhibited a significant reduction in corneal scarring and fibrotic mRNA expression 2 weeks after wounding. These results support the conclusion that neutrophil infiltration is an essential event in the fibrotic response to corneal damage and that prevention of scarring by CSSC is mediated by secretion of TSG-6 by these cells.

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

    PubMed

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

    2014-01-01

    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.

  10. Adductor canal block versus femoral nerve block combined with sciatic nerve block as an anesthetic technique for hindfoot and ankle surgery

    PubMed Central

    Joe, Han Bum; Choo, Ho Sik; Yoon, Ji Sang; Oh, Sang Eon; Cho, Jae Ho; Park, Young Uk

    2016-01-01

    Abstract Background: A femoral nerve block (FNB) in combination with a sciatic nerve block (SNB) is commonly used for anesthesia and analgesia in patients undergoing hindfoot and ankle surgery. The effects of FNB on motor function, related fall risk, and rehabilitation are controversial. An adductor canal block (ACB) potentially spares motor fibers in the femoral nerve, but the comparative effect on hindfoot and ankle surgeries between the 2 approaches is not yet well defined. We hypothesized that compared to FNB, ACB would cause less weakness in the quadriceps and produce similar pain scores during and after the operation. Methods: Sixty patients scheduled for hindfoot and ankle surgeries (arthroscopy, Achilles tendon surgery, or medial ankle surgery) were stratified randomized for each surgery to receive an FNB (FNB group) or an ACB (ACB group) combined with an SNB. The primary outcome was the visual analog scale (VAS) pain score at each stage. Secondary outcomes included quadriceps strength, time profiles (duration of the block procedure, time to full anesthesia and time to full recovery), patients’ analgesic requirements, satisfaction, and complications related to peripheral nerve blocks such as falls, neurologic symptoms, and local anesthetic systemic toxicity were evaluated. The primary outcome was tested for the noninferiority of ACB to FNB, and the other outcomes were tested for the superiority of each variable between the groups. Results: A total of 31 patients received an ACB and 29 received an FNB. The VAS pain scores of the ACB group were not inferior during and after the operation compared to those of the FNB group. At 30 minutes and 2 hours after anesthesia, patients who received an ACB had significantly higher average dynamometer readings than those who received a FNB (34.2 ± 20.4 and 30.4 ± 23.7 vs 1.7 ± 3.7 and 2.3 ± 7.4, respectively), and the results were similar at 24 and 48 hours after anesthesia. There were no differences

  11. Multiple muscular variations including tenuissimus and tensor fasciae suralis muscles in the posterior thigh of a human case.

    PubMed

    Arakawa, Takamitsu; Kondo, Takahiro; Tsutsumi, Masahiro; Watanabe, Yuko; Terashima, Toshio; Miki, Akinori

    2017-03-07

    The posterior thigh muscles on the right side of an 81-year-old male cadaver had multiple variations, denoted muscles I-IV. Muscle I originated from the posteromedial surface of the greater trochanter and divided into two muscle bellies. These muscle bellies fused with the long head of the biceps femoris and were innervated by two branches from muscular branches of the semitendinosus and the long head of the biceps. Muscle II separated from the medial surface of the long head of the biceps in the proximal third and fused with the semitendinosus in the distal fourth. Muscle III was a biventer muscle. Its superior belly separated from the medial surface of the long head of the biceps in the distal third. The inferior belly of this muscle fused with the posterior surface of the crural fascia and was innervated by the tibial nerve. Muscle IV separated from the adductor magnus muscle, passed between the long and short heads of the biceps, fused with the inferior belly of muscle III, and was innervated by the muscular branch of the common fibular nerve to the short head of the biceps. Peeling off the epineurium of the muscular branches to the inferior belly of muscle III showed that this nerve fascicle divided from the common trunk with branches to the gastrocnemius and soleus muscles. The inferior bellies of muscle III and muscle IV were thought to be equivalent to the tensor fasciae suralis and tenuissimus muscles, respectively.

  12. Cosmetic evaluation of surgical scars after external dacryocystorhinostomy

    PubMed Central

    Rizvi, Syed Ali Raza; Saquib, Mohammad; Maheshwari, Rakesh; Gupta, Yogesh; Iqbal, Zafar; Maheshwari, Puneet

    2016-01-01

    AIM To evaluate the surgical scars of external dacryocystorhinostomy (DCR) cosmetically. METHODS Totally 50 consecutive cases of primary acquired nasolacrimal duct obstruction (PANDO) were included in the study. Surgical scars were assessed by the patients and two independent observers at 2, 6 and 12wk postoperatively on the basis of visibility of the scars and still photographs respectively and were graded from 0-3. Kappa test was utilised to check the agreement of scar grading between the two observers. Wilcoxan signed ranks test was used to analyse the improvement of scar grading. RESULTS Thirty-four (68%) patients graded their incision site as very visible (grade 3) at 2wk. At 6 and 12wk, incision site was observed as grade 3 by 7 (14%) and 1 (2%) patients respectively. Photographic evaluation of patients by 2 observers showed an average score of 2.75, 1.94 and 0.94 at 2, 6 and 12wk respectively. Change in scar grading from grade 3 to grade 0 in consecutive follow-up (2, 6 and 12wk) was found to be highly significant both for the patient as well for the observers (P<0.0001). CONCLUSION The external DCR is a highly effective and safe procedure and in view of low percentage of cases who complained of marked scarring in the present study, thus scarring should not be the main ground for deciding the approach to DCR surgery, even in young cosmetically conscious patients. PMID:28003973

  13. Fractional Carbon Dioxide Laser in Treatment of Acne Scars

    PubMed Central

    Petrov, Andrej; Pljakovska, Vesna

    2016-01-01

    BACKGROUND: Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids. AIM: The aim of the study was to determine efficiency and safety of fractional carbon dioxide laser in the treatment of acne scars. MATERIAL AND METHODS: The study was carried out in Acibadem Sistina Clinical Hospital, Skopje at the Department of Dermatovenerology, with a total of 40 patients treated with fractional carbon dioxide laser (Lutronic eCO2). The study included patients with residual acne scars of a different type. RESULTS: Comedogenic and papular acne in our material were proportionately presented in 50% of cases, while the other half were the more severe clinical forms of acne - pustular inflammatory acne and nodulocystic acne that leave residual lesions in the form of second, third and fourth grade of scars. CONCLUSION: The experiences of our work confirm the world experiences that the best result with this method is achieved in dotted ice pick or V-shaped acne scars. PMID:27275326

  14. Scar-modulating treatments for central nervous system injury.

    PubMed

    Shen, Dingding; Wang, Xiaodong; Gu, Xiaosong

    2014-12-01

    Traumatic injury to the adult mammalian central nervous system (CNS) leads to complex cellular responses. Among them, the scar tissue formed is generally recognized as a major obstacle to CNS repair, both by the production of inhibitory molecules and by the physical impedance of axon regrowth. Therefore, scar-modulating treatments have become a leading therapeutic intervention for CNS injury. To date, a variety of biological and pharmaceutical treatments, targeting scar modulation, have been tested in animal models of CNS injury, and a few are likely to enter clinical trials. In this review, we summarize current knowledge of the scar-modulating treatments according to their specific aims: (1) inhibition of glial and fibrotic scar formation, and (2) blockade of the production of scar-associated inhibitory molecules. The removal of existing scar tissue is also discussed as a treatment of choice. It is believed that only a combinatorial strategy is likely to help eliminate the detrimental effects of scar tissue on CNS repair.

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

    Aktimur, Recep; Aktimur, Sude Hatun; Çolak, Elif; Alıcı, Ömer; Demirağ, Mehmet Derya

    2015-01-01

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

  17. Causes of shell scarring in dog cockles Glycymeris glycymeris L.

    NASA Astrophysics Data System (ADS)

    Ramsay, K.; Richardson, C. A.; Kaiser, M. J.

    2001-05-01

    Experimental studies were conducted to investigate the possible causes of shell scars in the bivalve mollusc Glycymeris glycymeris, including fishing disturbance, predator attacks and burrowing activity. Individuals collected from an area of sea bed experimentally fished once by a scallop dredge 12 months previously did not display significantly more shell scars than those collected before fishing or from a control area. In the laboratory, Glycymeris offered to the predatory crab Cancer pagurus had a significantly higher incidence of scars seen in acetate peels of shell cross-sections than control shells. However, scarring on Glycymeris excavated from the sediment and left to reburrow was not significantly different from those in an undisturbed control group. Currently, it is not possible in G. glycymeris to differentiate between scars caused by fishing disturbance or natural disturbances, either on the grounds of visual appearance or position of damage.

  18. Ablative fractional laser resurfacing helps treat restrictive pediatric scar contractures.

    PubMed

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

    2014-12-01

    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.

  19. Endometrial cancer implanted within a cesarean section scar.

    PubMed

    Baba, Tsukasa; Mandai, Masaki; Yamanishi, Yukio; Suzuki, Ayako; Kang, Hyun Sook; Konishi, Ikuo

    2011-03-01

    Several reports have documented adenocarcinoma arising from endometriotic implants within cesarean section (C-S) scars on the serosal surface of the uterus; however, endometrial cancer invading the C-S scar from the uterine cavity has not been described. We report a case of a grade 1 endometrioid adenocarcinoma 'drop' lesion invading a previous C-S scar with resultant cervical stromal invasion. Using both MR images and a thorough review of the pathology, the tumor at the C-S scar was determined to be an implant derived from a primary lesion at the uterine fundus. With increases in the incidence of both endometrial cancer and births by C-S, it is likely we will encounter more cases of iatrogenic implants of endometrial cancers in C-S scars.

  20. Drosophila Kette coordinates myoblast junction dissolution and the ratio of Scar-to-WASp during myoblast fusion

    PubMed Central

    Hamp, Julia; Löwer, Andreas; Dottermusch-Heidel, Christine; Beck, Lothar; Moussian, Bernard; Flötenmeyer, Matthias

    2016-01-01

    ABSTRACT The fusion of founder cells and fusion-competent myoblasts (FCMs) is crucial for muscle formation in Drosophila. Characteristic events of myoblast fusion include the recognition and adhesion of myoblasts, and the formation of branched F-actin by the Arp2/3 complex at the site of cell–cell contact. At the ultrastructural level, these events are reflected by the appearance of finger-like protrusions and electron-dense plaques that appear prior to fusion. Severe defects in myoblast fusion are caused by the loss of Kette (a homolog of Nap1 and Hem-2, also known as NCKAP1 and NCKAP1L, respectively), a member of the regulatory complex formed by Scar or WAVE proteins (represented by the single protein, Scar, in flies). kette mutants form finger-like protrusions, but the electron-dense plaques are extended. Here, we show that the electron-dense plaques in wild-type and kette mutant myoblasts resemble other electron-dense structures that are known to function as cellular junctions. Furthermore, analysis of double mutants and attempts to rescue the kette mutant phenotype with N-cadherin, wasp and genes of members of the regulatory Scar complex revealed that Kette has two functions during myoblast fusion. First, Kette controls the dissolution of electron-dense plaques. Second, Kette controls the ratio of the Arp2/3 activators Scar and WASp in FCMs. PMID:27521427

  1. Finite-element modelling reveals force modulation of jaw adductors in stag beetles.

    PubMed

    Goyens, J; Soons, J; Aerts, P; Dirckx, J

    2014-12-06

    Male stag beetles carry large and heavy mandibles that arose through sexual selection over mating rights. Although the mandibles of Cyclommatus metallifer males are used in pugnacious fights, they are surprisingly slender. Our bite force measurements show a muscle force reduction of 18% for tip biting when compared with bites with the teeth located halfway along the mandibles. This suggests a behavioural adaptation to prevent failure. We confirmed this by constructing finite-element (FE) models that mimic both natural bite situations as well as the hypothetical situation of tip biting without muscle force modulation. These models, based on micro-CT images, investigate the material stresses in the mandibles for different combinations of bite location and muscle force. Young's modulus of the cuticle was experimentally determined to be 5.1 GPa with the double indentation method, and the model was validated by digital image correlation on living beetles. FE analysis proves to be a valuable tool in the investigation of the trade-offs of (animal) weapon morphology and usage. Furthermore, the demonstrated bite force modulation in male stag beetles suggests the presence of mechanosensors inside the armature.

  2. Finite-element modelling reveals force modulation of jaw adductors in stag beetles

    PubMed Central

    Goyens, J.; Soons, J.; Aerts, P.; Dirckx, J.

    2014-01-01

    Male stag beetles carry large and heavy mandibles that arose through sexual selection over mating rights. Although the mandibles of Cyclommatus metallifer males are used in pugnacious fights, they are surprisingly slender. Our bite force measurements show a muscle force reduction of 18% for tip biting when compared with bites with the teeth located halfway along the mandibles. This suggests a behavioural adaptation to prevent failure. We confirmed this by constructing finite-element (FE) models that mimic both natural bite situations as well as the hypothetical situation of tip biting without muscle force modulation. These models, based on micro-CT images, investigate the material stresses in the mandibles for different combinations of bite location and muscle force. Young's modulus of the cuticle was experimentally determined to be 5.1 GPa with the double indentation method, and the model was validated by digital image correlation on living beetles. FE analysis proves to be a valuable tool in the investigation of the trade-offs of (animal) weapon morphology and usage. Furthermore, the demonstrated bite force modulation in male stag beetles suggests the presence of mechanosensors inside the armature. PMID:25297317

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

    PubMed Central

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

    1973-01-01

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

  4. Subcutaneous sarcoidosis in a rhinoplasty scar

    PubMed Central

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

    2015-01-01

    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

  5. Muscle Cramps

    MedlinePlus

    Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They often occur after exercise or at night, ... to several minutes. It is a very common muscle problem. Muscle cramps can be caused by nerves ...

  6. Muscle Disorders

    MedlinePlus

    Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even ...

  7. Your Muscles

    MedlinePlus

    ... of the heart because it controls the heartbeat. Skeletal Muscle Now, let's talk about the kind of muscle ... soccer ball into the goal. These are your skeletal muscles — sometimes called striated (say: STRY-ay-tud) muscle ...

  8. Individual muscle contributions to circular turning mechanics.

    PubMed

    Ventura, Jessica D; Klute, Glenn K; Neptune, Richard R

    2015-04-13

    Turning is an activity of daily living that involves both the acceleration of the body center-of-mass (COM) towards the center of curvature and rotation of the pelvis towards the new heading. The purpose of this study was to understand which muscles contribute to turning using experimentation, musculoskeletal modeling and simulation. Ten healthy adults consented to walk around a 1-m radius circular path at their self-selected walking speed and then along a straight line at the same speed. Forward dynamics simulations of the individual subjects during the turning and straight-line walking tasks were generated to identify the contributions of individual muscle groups to the body mediolateral and anterior-posterior COM acceleration impulse and to the pelvis angular acceleration impulse. The stance leg gluteus medius and ankle plantarflexor muscles and the swing leg adductor muscles were the primary contributors to redirect the body's COM relative to straight-line walking. In some cases, contributions to mediolateral COM acceleration were modulated through changes in leg orientation rather than through changes in muscle force. While modulation of the muscle contributions generally occurred in both the inner and outer legs, greater changes were observed during inner single-leg support than during outer single-leg support. Total pelvis angular acceleration was minimal during the single-support phase, but the swing leg muscles contributed significantly to balancing the internal and external rotation of the pelvis. The understanding of which muscles contribute to turning the body during walking may help guide the development of more effective locomotor therapies for those with movement impairments.

  9. Acute Marjolin's Ulcer in a Postauricular Scar after Mastoidectomy

    PubMed Central

    Bukhari, Sumaiyah M.; Hajjaj, Mutawakel F.

    2016-01-01

    Background. Marjolin's ulcer is a rare, aggressive cutaneous malignancy that arises primarily in burn scars but can occur in other types of scars. Squamous cell carcinoma is the most common variant, and while malignant degeneration usually takes a long time, it can develop acutely. Case Report. a 30-year-old man who developed Marjolin's ulcer acutely in a right postauricular scar after mastoidectomy and the incision and drainage of a mastoid abscess. To the best of our knowledge, this report is the first to describe a Marjolin's ulcer in a postauricular surgical scar. However, it has been reported in others areas in the head and neck. Conclusion. Marjolin's ulcer is most commonly observed after postburn scars, but it may be observed after any type of scars, as our patient developed an SCC with a postsurgical scar. Early diagnosis is essential, and a biopsy should be performed on any nonhealing wound or chronic wound that undergoes a sudden change. Tissue samples should be taken from both the centre and the margins of the wound. PMID:28050297

  10. Preventing Scars after Injury with Partial Irreversible Electroporation.

    PubMed

    Golberg, Alexander; Villiger, Martin; Khan, Saiqa; Quinn, Kyle P; Lo, William C Y; Bouma, Brett E; Mihm, Martin C; Austen, William G; Yarmush, Martin L

    2016-11-01

    Preventing the formation of hypertrophic scars, especially those that are a result of major trauma or burns, would have enormous impact in the fields of regenerative and trauma medicine. In this report, we introduce a noninvasive method to prevent scarring based on nonthermal partial irreversible electroporation. Contact burn injuries in rats were treated with varying treatment parameters to optimize the treatment protocol. Scar surface area and structural properties of the scar were assessed with histology and non-invasive, longitudinal imaging with polarization-sensitive optical coherence tomography. We found that partial irreversible electroporation using 200 pulses of 250 V and 70 μs duration, delivered at 3 Hz every 20 days during a total of five therapy sessions after the initial burn injury, resulted in a 57.9% reduction of the scar area compared with untreated scars and structural features approaching those of normal skin. Unlike humans, rats do not develop hypertrophic scars. Therefore, the use of a rat animal model is the limiting factor of this work.

  11. Medicinal Plants for the Treatment of Hypertrophic Scars

    PubMed Central

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

    2015-01-01

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

  12. Microneedling Therapy in Atrophic Facial Scars: An Objective Assessment

    PubMed Central

    Majid, Imran

    2009-01-01

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

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

    PubMed

    Foda, Hossam M T

    2004-01-01

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

  14. Defect Scars on Flexible Surfaces with Crystalline Order

    NASA Astrophysics Data System (ADS)

    Kohyama, Tamotsu; Gompper, Gerhard

    2007-05-01

    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 γ. 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 γ due to the presence of scars.

  15. Dermal tunneling: a proposed treatment for depressed scars*

    PubMed Central

    Lima, Emerson Vasconcelos de Andrade

    2016-01-01

    Depressed facial scars are still a challenge in medical literature, despite the wide range of proposed treatments. Subcision is a technique that is frequently performed to improve this type of lesions. This article proposes a new method to release depressed scars, reported and named by the author as dermal tunneling. This study presents a simple and didactic manner to perform this method. The results in 17 patients with facial scars were considered promising. Thus, the technique was deemed to be safe and reproducible. PMID:27828658

  16. Corneal tattooing: an alternative treatment for disfiguring corneal scars

    PubMed Central

    Pitz, S; Jahn, R; Frisch, L; Duis, A; Pfeiffer, N

    2002-01-01

    Background: The performance and results of corneal tattooing are described in a case series of 11 patients suffering from a disfiguring corneal scar using a technique similar to conventional dermatography. Methods: Drawing ink in different shades was applied into the anterior corneal stroma by punctures performed with a conventional spatula needle. Results: Up to 4 years after surgery all patients still had satisfactory staining of the formerly cosmetically disfiguring corneal scar. Conclusion: Tattooing of unsightly corneal scars proved to be an efficient and easy to perform technique, yielding acceptable results during follow up. PMID:11914207

  17. Reduced scar maturation and contractility lead to exaggerated left ventricular dilation after myocardial infarction in mice lacking AMPKα1.

    PubMed

    Noppe, Gauthier; Dufeys, Cécile; Buchlin, Patricia; Marquet, Nicolas; Castanares-Zapatero, Diego; Balteau, Magali; Hermida, Nerea; Bouzin, Caroline; Esfahani, Hrag; Viollet, Benoit; Bertrand, Luc; Balligand, Jean-Luc; Vanoverschelde, Jean-Louis; Beauloye, Christophe; Horman, Sandrine

    2014-09-01

    Cardiac fibroblasts (CF) are crucial in left ventricular (LV) healing and remodeling after myocardial infarction (MI). They are typically activated into myofibroblasts that express alpha-smooth muscle actin (α-SMA) microfilaments and contribute to the formation of contractile and mature collagen scars that minimize the adverse dilatation of infarcted areas. CF predominantly express the α1 catalytic subunit of AMP-activated protein kinase (AMPKα1), while AMPKα2 is the major catalytic isoform in cardiomyocytes. AMPKα2 is known to protect the heart by preserving the energy charge of cardiac myocytes during injury, but whether AMPKα1 interferes with maladaptative heart responses remains unexplored. In this study, we investigated the role of AMPKα1 in modulating LV dilatation and CF fibrosis during post-MI remodeling. AMPKα1 knockout (KO) and wild type (WT) mice were subjected to permanent ligation of the left anterior descending coronary artery. The absence of AMPKα1 was associated with increased CF proliferation in infarcted areas, while expression of the myodifferentiation marker α-SMA was decreased. Faulty maturation of myofibroblasts might derive from severe down-regulation of the non-canonical transforming growth factor-beta1/p38 mitogen-activated protein kinase (TGF-β1/p38 MAPK) pathway in KO infarcts. In addition, lysyl oxidase (LOX) protein expression was dramatically reduced in the scar of KO hearts. Although infarct size was similar in AMPK-KO and WT hearts subjected to MI, these changes resulted in compromised scar contractility, defective scar collagen maturation, and exacerbated adverse remodeling, as indicated by increased LV diastolic dimension 30days after MI. Our data genetically demonstrate the centrality of AMPKα1 in post-MI scar formation and highlight the specificity of this catalytic isoform in cardiac fibroblast/myofibroblast biology.

  18. Loureirin B inhibits fibroblast proliferation and extracellular matrix deposition in hypertrophic scar via TGF-β/Smad pathway.

    PubMed

    Bai, Xiaozhi; He, Ting; Liu, Jiaqi; Wang, Yunchuan; Fan, Lei; Tao, Ke; Shi, Jihong; Tang, Chaowu; Su, Linlin; Hu, Dahai

    2015-05-01

    The ethanolic extract of Resina Draconis (RDEE) has been reported beneficial to normal wound healing yielding more regularly arranged collagen fibres. Loureirin B, a major component in RDEE, has been supposed to be effective on the prevention and treatment of pathological scars. To investigate the therapeutic effects of loureirin B on hypertrophic scar (HS), fibroblasts from human HS and normal skin (NS) were isolated. Results showed that loureirin B dose-dependently downregulated both mRNA and protein levels of type I collagen (ColI), type III collagen (ColIII) and α-smooth muscle actin (α-SMA) in HS fibroblasts. Loureirin B also suppressed fibroblast proliferative activity and redistributed cell cycle, but did not affect cell apoptosis. In vivo rabbit ear scar model, loureirin B significantly improved the arrangement and deposition of collagen fibres, decreased protein levels of ColI, ColIII and α-SMA and suppressed myofibroblast differentiation and scar proliferative activity. In NS fibroblasts, loureirin B effectively inhibited TGF-β1-induced upregulation of ColI, ColIII and α-SMA levels, myofibroblast differentiation and the activation of Smad2 and Smad3. Loureirin B also affected mRNA levels of major MMPs and TIMPs in TGF-β1-stimulated fibroblasts. Taken together, this study demonstrates that loureirin B could downregulate the expression of fibrosis-related molecules by regulating MMPs and TIMPs levels, inhibit scar fibroblast proliferation and suppress TGF-β1-induced fibrosis, during which TGF-β1/Smad2/3 pathway is likely involved. These findings suggest that loureirin B is a potential therapeutic compound for HS treatment.

  19. Measurement of lower-limb muscle spasticity: intrarater reliability of Modified Modified Ashworth Scale.

    PubMed

    Ghotbi, Nastaran; Nakhostin Ansari, Noureddin; Naghdi, Soofia; Hasson, Scott

    2011-01-01

    The Modified Modified Ashworth Scale (MMAS) is a clinical instrument for measuring spasticity. Few studies have been performed on the reliability of the MMAS. The aim of the present study was to investigate the intrarater reliability of the MMAS for the assessment of spasticity in the lower limb. We conducted a test-retest study on spasticity in the hip adductors, knee extensors, and ankle plantar flexors. Each patient was measured by a hospital-based clinical physiotherapist. Twenty-three patients with stroke or multiple sclerosis (fourteen women, nine men) and a mean +/- standard deviation age of 37.3 +/- 14.1 years participated. The weighted kappa was moderate for the hip adductors (weighted kappa = 0.45, standard error [SE] = 0.16, p = 0.007), good for the knee extensors (weighted kappa = 0.62, SE = 0.12, p < 0.001), and very good for the ankle plantar flexors (weighted kappa = 0.85, SE = 0.05, p < 0.001). The kappa value for overall agreement was very good (weighted kappa = 0.87, SE = 0.03, p < 0.001). The reliability for the ankle plantar flexors was significantly higher than that for the hip adductors. The intrarater reliability of the MMAS in patients with lower-limb muscle spasticity was very good, and it can be used as a measure of spasticity over time.

  20. Experiment K-6-09. Morphological and biochemical investigation of microgravity-induced nerve and muscle breakdown. Part 1: Investigation of nerve and muscle breakdown during spaceflight; Part 2: Biochemical analysis of EDL and PLT muscles

    NASA Technical Reports Server (NTRS)

    Riley, D. A.; Ellis, S.; Bain, J.; Sedlak, F.; Slocum, G.; Oganov, V.

    1990-01-01

    The present findings on rat hindlimb muscles suggest that skeletal muscle weakness induced by prolonged spaceflight can result from a combination of muscle fiber atrophy, muscle fiber segmental necrosis, degeneration of motor nerve terminals and destruction of microcirculatory vessels. Damage was confined to the red adductor longus (AL) and soleus muscles. The midbelly region of the AL muscle had more segmental necrosis and edema than the ends. Macrophages and neutrophils were the major mononucleated cells infiltrating and phagocytosing the cellular debris. Toluidine blue-positive mast cells were significantly decreased in Flight AL muscles compared to controls; this indicated that degranulation of mast cells contributed to tissue edema. Increased ubiquitination of disrupted myofibrils may have promoted myofilament degradation. Overall, mitochondria content and SDH activity were normal, except for a decrease in the subsarcolemmal region. The myofibrillar ATPase activity shifted toward the fast type in the Flight AL muscles. Some of the pathological changes may have occurred or been exacerbated during the 2 day postflight period of readaptation to terrestrial gravity. While simple atrophy should be reversible by exercise, restoration of pathological changes depends upon complex processes of regeneration by stem cells. Initial signs of muscle and nerve fiber regeneration were detected. Even though regeneration proceeds on Earth, the space environment may inhibit repair and cause progressive irreversible deterioration during long term missions. Muscles obtained from Flight rats sacrificed immediately (within a few hours) after landing are needed to distinguish inflight changes from postflight readaptation.

  1. Elastic Stiffness of Grain Boundary Scars and Dislocation Dynamics

    NASA Astrophysics Data System (ADS)

    Shin, Homin; Bowick, Mark

    2006-03-01

    We analytically calculate the stiffness of finite-length grain boundaries (scars) on a spherical crystal within the continuum elasticity theory. The scar is composed of an isolated disclination with +1 topological charge together with a finite number of dislocations. We determine the elastic free energy of a single finite-grain boundary scar by considering interacting defects, such as Disclination-Disclination (D-D), Disclination-dislocation (D-d), and dislocation-dislocation (d-d). The harmonic potential binding dislocations to the scar is obtained by determining the free energy of a single dislocation perturbed away from its equilibrium position. The elastic spring constants so obtained are compared to experimental data on dislocation dynamics [1]. We conclude with some comments on interstitial dynamics. [1] Lipowsky, P., Bowick, M. J., Meinke, J. H., Nelson, D. R. and Bausch, A. R. Nature Mater. 4, 407-411 (2005).

  2. Innovative Therapies in the Treatment of Keloids and Hypertrophic Scars

    PubMed Central

    Viera, Martha H.; Amini, Sadegh; Valins, Whitney

    2010-01-01

    Keloids and hypertrophic scars are benign fibrous overgrowths of scar tissue, which results from an abnormal response to trauma. Several therapeutic modalities have been described for the treatment and prevention of these conditions, but the optimal management approach has not yet been defined. This article reviews the most recent, innovative, therapeutic strategies for the management of hypertrophic scars and keloids, including mitomycin-C, tamoxifen citrate, methotrexate, imidazolaquinolines, retinoids, calcineurin inhibitors, phenylakylamine calcium channel blockers, botulinum toxin, vascular endothelial growth factor inhibitors, hepatocyte growth factor, basic fibroblast growth factor, interleukin-10, manosa-6-phosphate, transforming growth factor beta, antihistamines, and prostaglandin E2. No consensus in treatment regimens has been reached due to the limited evidence-based information found in the literature. Most therapeutic options have potential effectiveness as both monotherapy and as combination therapy. However, recent reports offer novel modalities that may approach scarring from different angles. PMID:20725565

  3. Extensive Burn Scars in Russia's Amur Region

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

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

    PubMed

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

    2015-06-01

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

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

    NASA Astrophysics Data System (ADS)

    FitzGerald, James J.

    2016-04-01

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

  6. Quantitative measurement of hypertrophic scar: interrater reliability and concurrent validity.

    PubMed

    Nedelec, Bernadette; Correa, José A; Rachelska, Grazyna; Armour, Alexis; LaSalle, Léo

    2008-01-01

    Research into the pathophysiology and treatment of hypertrophic scar (HSc) remains limited by the heterogeneity of scar and the imprecision with which its severity is measured. The objective of this study was to test the interrater reliability and concurrent validity of the Cutometer measurement of elasticity, the Mexameter measurement of erythema and pigmentation, and total thickness measure of the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar, and HSc. Three independent investigators evaluated 128 sites (severe HSc, moderate or mild HSc, donor site, and normal skin) on 32 burn survivors using all of the above measurement tools. The intraclass correlation coefficient, which was used to measure interrater reliability, reflects the inherent amount of error in the measure and is considered acceptable when it is >0.75. Interrater reliability of the totals of the height, pliability, and vascularity subscales of the mVSS fell below the acceptable limit ( congruent with0.50). The individual subscales of the mVSS fell well below the acceptable level (< or =0.3). The Cutometer reading of elasticity provided acceptable reliability (>0.89) for each study site with the exception of severe scar. Mexameter and DermaScan C reliability measurements were acceptable for all sites (>0.82). Concurrent validity correlations with the mVSS were significant except for the comparison of the mVSS pliability subscale and the Cutometer maximum deformation measure comparison in severe scar. In conclusion, the Mexameter and DermaScan C measurements of scar color and thickness of all sites, as well as the Cutometer measurement of elasticity in all but the most severe scars shows high interrater reliability. Their significant concurrent validity with the mVSS confirms that these tools are measuring the same traits as the mVSS, and in a more objective way.

  7. Scar tissue and microvolt T-wave alternans.

    PubMed

    Kraaier, Karin; Olimulder, Marlon A G M; Galjee, Michel A; van Dessel, Pascal F H M; van der Palen, Job; Wilde, Arthur A M; Scholten, Marcoen F

    2014-04-01

    Microvolt T-wave alternans (MTWA) is an electrocardiographic marker for predicting sudden cardiac death. In this study, we aimed to study the relation between MTWA and scar assessed with cardiac magnetic resonance imaging (CMR) in patients with ischemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM). Sixty-eight patients with positive or negative MTWA and analysable CMR examination were included. Using CMR and the delayed enhancement technique, left ventricular ejection fraction (LVEF), volumes, wall motion and scar characteristics were assessed. Overall, positive MTWA (n = 40) was related to male gender (p = 0.04), lower LVEF (p = 0.04) and increased left ventricular end-diastolic volume (LVEDV) (p < 0.01). After multivariate analysis, male gender (p = 0.01) and lower LVEF remained significant (p = 0.02). Scar characteristics (presence, transmurality, and scar score) were not related to MTWA (all p > 0.5). In the patients with ICM (n = 40) scar was detected in 38. Positive MTWA (n = 18) was related to higher LVEDV (p = 0.05). In patients with DCM (n = 28), scar was detected in 11. Trends were found between positive MTWA (n = 15) and male gender (p = 0.10), lower LVEF (p = 0.10), and higher LVEDV (p = 0.09). In both subgroups, the presence, transmurality or extent of scar was not related to MTWA (all p > 0.45). In this small study, neither in patients with ICM or DCM a relation was found between the occurrence of MTWA and the presence, transmurality or extent of myocardial scar. Overall there was a significant relation between heart failure remodeling parameters and positive MTWA.

  8. Perennial plate tectonics with lasting mantle lithosphere scars

    NASA Astrophysics Data System (ADS)

    Heron, P.; Pysklywec, R. N.; Stephenson, R.

    2015-12-01

    Although the conventional theory of plate tectonics can explain non-rigid behaviour at plate boundaries, it cannot adequately explain the processes involved in deformation and seismicity within plate interiors. Here, we consider that the pre-existing deformation or "scarring" within the mantle lithosphere may have a very long lived presence that could incorporate deformation of the plate interior and plate boundary. Mantle lithosphere scars from continent-continent collisions could generate virtual plate boundaries that remain over long timescales, producing "perennial" plate tectonics. Local geophysical studies can map the crustal environment well, and global whole mantle tomography models are rapidly improving, yet high-resolution images of the mantle lithosphere are often not available in regions where scarring may be present. Where mantle lithosphere heterogeneities have been observed (usually interpreted simply as subduction scars), the same attention has not been afforded to them as, for example, re-activation of faults within the Earth's crust. In idealized numerical simulations, we compare how relic scarring at varying depths in the lithosphere affects patterns of deformation. High-resolution thermal-mechanical numerical experiments explore continental lithospheric deformation featuring a weakened crust and mantle lithosphere scars. Our models show that deep lithospheric scars can control the tectonic evolution of a region over shallow geological features, indicating the importance of mantle lithosphere heterogeneities. The Altyn Tagh Fault (ATF) in central China is an example of an ancient continental collision zone that undergoes periodic deformation during times of regional compression. We suggest that the ATF may be a locale where a long-lasting mantle lithosphere scar can control the subsequent crustal evolution and deformation, with ancient plate boundaries having a "perennial" plate tectonic presence.

  9. Scar Functions, Barriers for Chemical Reactivity, and Vibrational Basis Sets.

    PubMed

    Revuelta, F; Vergini, E; Benito, R M; Borondo, F

    2016-07-14

    The performance of a recently proposed method to efficiently calculate scar functions is analyzed in problems of chemical interest. An application to the computation of wave functions associated with barriers relevant for the LiNC ⇄ LiCN isomerization reaction is presented as an illustration. These scar functions also constitute excellent elements for basis sets suitable for quantum calculation of vibrational energy levels. To illustrate their efficiency, a calculation of the LiNC/LiCN eigenfunctions is also presented.

  10. Muscle Fatigue Affects the Interpolated Twitch Technique When Assessed Using Electrically-Induced Contractions in Human and Rat Muscles

    PubMed Central

    Neyroud, Daria; Cheng, Arthur J.; Bourdillon, Nicolas; Kayser, Bengt; Place, Nicolas; Westerblad, Håkan

    2016-01-01

    The interpolated twitch technique (ITT) is the gold standard to assess voluntary activation and central fatigue. Yet, its validity has been questioned. Here we studied how peripheral fatigue can affect the ITT. Repeated contractions at submaximal frequencies were produced by supramaximal electrical stimulations of the human adductor pollicis muscle in vivo and of isolated rat soleus fiber bundles; an extra stimulation pulse was given during contractions to induce a superimposed twitch. Human muscles fatigued by repeated 30-Hz stimulation trains (3 s on–1 s off) showed an ~80% reduction in the superimposed twitch force accompanied by a severely reduced EMG response (M-wave amplitude), which implies action potential failure. Subsequent experiments combined a less intense stimulation protocol (1.5 s on–3 s off) with ischemia to cause muscle fatigue, but which preserved M-wave amplitude. However, the superimposed twitch force still decreased markedly more than the potentiated twitch force; with ITT this would reflect increased “voluntary activation.” In contrast, the superimposed twitch force was relatively spared when a similar protocol was performed in rat soleus bundles. Force relaxation was slowed by >150% in fatigued human muscles, whereas it was unchanged in rat soleus bundles. Accordingly, results similar to those in the human muscle were obtained when relaxation was slowed by cooling the rat soleus muscles. In conclusion, our data demonstrate that muscle fatigue can confound the quantification of central fatigue using the ITT. PMID:27445844

  11. Muscle Fatigue Affects the Interpolated Twitch Technique When Assessed Using Electrically-Induced Contractions in Human and Rat Muscles.

    PubMed

    Neyroud, Daria; Cheng, Arthur J; Bourdillon, Nicolas; Kayser, Bengt; Place, Nicolas; Westerblad, Håkan

    2016-01-01

    The interpolated twitch technique (ITT) is the gold standard to assess voluntary activation and central fatigue. Yet, its validity has been questioned. Here we studied how peripheral fatigue can affect the ITT. Repeated contractions at submaximal frequencies were produced by supramaximal electrical stimulations of the human adductor pollicis muscle in vivo and of isolated rat soleus fiber bundles; an extra stimulation pulse was given during contractions to induce a superimposed twitch. Human muscles fatigued by repeated 30-Hz stimulation trains (3 s on-1 s off) showed an ~80% reduction in the superimposed twitch force accompanied by a severely reduced EMG response (M-wave amplitude), which implies action potential failure. Subsequent experiments combined a less intense stimulation protocol (1.5 s on-3 s off) with ischemia to cause muscle fatigue, but which preserved M-wave amplitude. However, the superimposed twitch force still decreased markedly more than the potentiated twitch force; with ITT this would reflect increased "voluntary activation." In contrast, the superimposed twitch force was relatively spared when a similar protocol was performed in rat soleus bundles. Force relaxation was slowed by >150% in fatigued human muscles, whereas it was unchanged in rat soleus bundles. Accordingly, results similar to those in the human muscle were obtained when relaxation was slowed by cooling the rat soleus muscles. In conclusion, our data demonstrate that muscle fatigue can confound the quantification of central fatigue using the ITT.

  12. Skeletal muscle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There are approximately 650-850 muscles in the human body these include skeletal (striated), smooth and cardiac muscle. The approximation is based on what some anatomists consider separate muscle or muscle systems. Muscles are classified based on their anatomy (striated vs. smooth) and if they are v...

  13. Coupled obturator neurotomies and lidocaine intrathecal infusion to treat bilateral adductor spasticity and drug-refractory pain.

    PubMed

    Carrillo-Ruiz, José D; Andrade, Pablo; Godínez-Cubillos, Nora; Montes-Castillo, María L; Jiménez, Fiacro; Velasco, Ana L; Castro, Guillermo; Velasco, Francisco

    2010-09-01

    Spastic diplegia is present in three-fourths of children with cerebral palsy, interfering with gait and frequently accompanied by severe pain. The authors report the case of a 28-year-old woman with history of perinatal hypoxia, who presented with cerebral palsy and severe spastic diplegia (Ashworth Scale Score 4, Tardieu Scale Score 5) and was confined to a wheelchair. She complained of pain in the left hip and knee with mixed neuropathic and somatic components. She consistently rated pain intensity as 10 of 10 on a visual analog scale, and her symptoms were resistant to multiple treatments. The patient underwent selective bilateral adductor myotomies and the implantation of an infusion pump for intrathecal lidocaine application. Postoperative control of pain and spasticity was dramatic (scores of 0 on the Ashworth, Tardieu, and visual analog scales) and persisted throughout a follow-up period of 36 months. This is the first report in the literature of combined selective neurotomies for the treatment of spasticity and chronic lidocaine subarachnoid infusion to treat associated pain. This therapy could represent an alternative to treat spasticity associated with neuropathic and somatic pain.

  14. Comparison of scar thickness measurements using trans-vaginal sonography and MRI in cases of pregnancy with previous caesarean section. Do they correlate with actual scar thickness?

    PubMed

    Singh, N; Tripathi, R; Mala, Y M; Dixit, R; Tyagi, S; Batra, A

    2013-11-01

    The aim of this study was to evaluate scar thickness in cases of pregnancy with previous caesarean section, by trans-vaginal sonography (TVS) and magnetic resonance imaging (MRI), and to correlate precision of radiologically-measured scar thickness with actual measurement of scar thickness. A total of 35 pregnant patients with previous caesarean section planned for elective caesarean section, were evaluated prospectively. Their scar thickness was measured by TVS and MRI on the day of elective repeat caesarean section. These measurements were correlated with each other and with scar thickness measured during elective repeat caesarean section by using a caliper. The correlation coefficients between scar thickness measured by TVS and MRI with peroperative evaluation with a caliper, were +0.72 and +0.59, respectively. The study concluded that as MRI is a costlier modality and TVS has better correlation coefficient with actual scar thickness, TVS can be considered to be the better modality for antenatal scar thickness measurement.

  15. Muscle Deoxygenation Causes Muscle Fatigue

    NASA Technical Reports Server (NTRS)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  16. Scar prevention and remodeling: a review of the medical, surgical, topical and light treatment approaches.

    PubMed

    Kerwin, Leonard Y; El Tal, Abdel Kader; Stiff, Mark A; Fakhouri, Tarek M

    2014-08-01

    Cosmetic, functional, and structural sequelae of scarring are innumerable, and measures exist to optimize and ultimately minimize these sequelae. To evaluate the innumerable methods available to decrease the cosmetic, functional, and structural repercussions of scarring, pubMed search of the English literature with key words scar, scar revision, scar prevention, scar treatment, scar remodeling, cicatrix, cicatrix treatment, and cicatrix remodeling was done. Original articles and reviews were examined and included. Seventy-nine manuscripts were reviewed. Techniques, comparisons, and results were reviewed and tabulated. Overall, though topical modalities are easier to use and are usually more attractive to the patient, the surgical approaches still prove to be superior and more reliable. However, advances in topical medications for scar modification are on the rise and a change towards medical treatment of scars may emerge as the next best approach. Comparison studies of the innumerable specific modalities for scar revision and prevention are impossible. Standardization of techniques is lacking. Scarring, the body's natural response to a wound, can create many adverse effects. At this point, the practice of sound, surgical fundamentals still trump the most advanced preventative methods and revision techniques. Advances in medical approaches are available, however, to assist the scarring process, which even the most advanced surgical fundamentals will ultimately lead to. Whether through newer topical therapies, light treatment, or classical surgical intervention, our treatment armamentarium of scars has expanded and will allow us to maximize scar prevention and to minimize scar morbidity.

  17. Muscle disorder

    MedlinePlus

    Myopathic changes; Myopathy; Muscle problem ... Blood tests sometimes show abnormally high muscle enzymes. If a muscle disorder might also affect other family members, genetic testing may be done. When someone has symptoms and signs ...

  18. Muscle aches

    MedlinePlus

    ... common cause of muscle aches and pain is fibromyalgia , a condition that causes tenderness in your muscles ... imbalance, such as too little potassium or calcium Fibromyalgia Infections, including the flu, Lyme disease , malaria , muscle ...

  19. Combination Therapy for Acne Scarring: Personal Experience and Clinical Suggestions.

    PubMed

    Kroepfl, Lucija; Emer, Jason J

    2016-11-01

    Acne is one of the most prevalent skin conditions seen by dermatologists. The cosmetic sequelae of severe acne, including scarring and pigmentation, have a profound psychological impact on those in icted. Topical (eg, retinoids, antibiotics, dapsone, hydroxyacids) and oral treatments (eg, antibiotics and/or spironolactone) are often bene cial to control acne or in the instance of oral isotretinoin use, rid the acne permanently; however, these treatments have very little affect on the ultimate cosmetic outcome of the acne scarring and skin texture that results. Given the variety of scar types that can form and the variability of responses seen in various skin types and textures, treatment options are vast without appropriate guidelines for pathways that dictate best timing, combinations, and options in given clinical scenarios. Current treatment options include solo or combina- tions of energy-based (eg, laser, radiofrequency), chemical-based (eg, peels, TCA cross), surgical-based options (eg, subcision, punch excision), microneedling, and llers and/or fat injections. Most recently, fractional radiofrequency-based treatments have been used to improve acne scarring with less reported downtime as compared to lasers or chemical peels and the ability to treat darker or sensitive skin types with less risk of scarring or hyperpigmentation. In severe cystic ares, scarring treatments are often postposed till the acne is under control and in many instances this can limit the dermatologists ability to affect future cosmetic treatments. Based on personal experience of various clinical scenarios in a busy laser practice that treats a signi cant number of patients with acne scarring, fractional radiofrequency is an excellent choice for treating all forms of acne scars with minimal risk to patients, even those on concurrent treatments such as isotretinoin. Additionally, fractional radiofrequency can be used in combination with all other treatment options to speed the time to

  20. Quantitative measurement of hypertrophic scar: intrarater reliability, sensitivity, and specificity.

    PubMed

    Nedelec, Bernadette; Correa, José A; Rachelska, Grazyna; Armour, Alexis; LaSalle, Léo

    2008-01-01

    The comparison of scar evaluation over time requires measurement tools with acceptable intrarater reliability and the ability to discriminate skin characteristics of interest. The objective of this study was to evaluate the intrarater reliability and sensitivity and specificity of the Cutometer, the Mexameter, and the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar (donor sites), and hypertrophic scar (HSc). A single investigator evaluated four tissue types (severe HSc, less severe HSc, donor site, and normal skin) in 30 burn survivors with all four measurement tools. The intraclass correlation coefficient (ICC) for the Cutometer was acceptable (> or =0.75) for the maximum deformation measure for the donor site and normal skin (>0.78) but was below the acceptable range for the HSc sites and all other parameters. The ICC for the Mexameter erythema (>0.75) and melanin index (>0.89) and the DermaScan C total thickness measurement (>0.82) were acceptable for all sites. The ICC for the total of the height, pliability, and vascularity subscales of the mVSS was acceptable (0.81) for normal scar but below the acceptable range for the scar sites. The DermaScan C was clearly able to discriminate HSc from normal scar and normal skin based on the total thickness measure. The Cutometer was less discriminating but was still able to discriminate HSc from normal scar and normal skin. The Mexameter erythema index was not a good discriminator of HSc and normal scar. Receiver operating characteristic curves were generated to establish the best cutoff point for the DermaScan C total thickness and the Cutometer maximum deformation, which were 2.034 and 0.387 mm, respectively. This study showed that although the Cutometer, the DermaScan C, and the Mexameter have measurement properties that make them attractive substitutes for the mVSS, caution must be used when interpreting results since the Cutometer has a ceiling effect when

  1. Blood-derived small Dot cells reduce scar in wound healing

    SciTech Connect

    Kong, Wuyi Li Shaowei; Longaker, Michael T.; Lorenz, H. Peter

    2008-04-15

    Wounds in fetal skin heal without scar, however the mechanism is unknown. We identified a novel group of E-cadherin positive cells in the blood of fetal and adult mice and named them 'Dot cells'. The percentage of Dot cells in E16.5 fetal mice blood is more than twenty times higher compared to adult blood. Dot cells also express integrin {beta}1, CD184, CD34, CD13{sup low} and Sca1{sup low}, but not CD45, CD44, and CD117. Dot cells have a tiny dot shape between 1 and 7 {mu}m diameters with fast proliferation in vitro. Most of the Dot cells remain positive for E-cadherin and integrin {beta}1 after one month in culture. Transplantation of Dot cells to adult mice heals skin wounds with less scar due to reduced smooth muscle actin and collagen expression in the repair tissue. Tracking GFP-positive Dot cells demonstrates that Dot cells migrate to wounds and differentiate into dermal cells, which also express strongly to FGF-2, and later lose their GFP expression. Our results indicate that Dot cells are a group of previously unidentified cells that have strong wound healing effect. The mechanism of scarless wound healing in fetal skin is due to the presence of a large number of Dot cells.

  2. Topical application of mitomycin C prevents epineural scar formation in rats.

    PubMed

    Ilbay, Konuralp; Etus, Volkan; Yildiz, Kursat; Ilbay, Gul; Ceylan, Savas

    2005-04-01

    The role of topically applied mitomycin C in preventing postoperative perineural fibrosis was examined by gross anatomical dissection and histological analysis in rats. The sciatic nerve was exposed bilaterally in 24 Wistar adult male rats, and an abrasion injury was produced on the exposed surface of the biceps femoris muscle in all animals. In the experimental group, cotton pads soaked with mitomycin C (0.5 mg/ml) were placed around the nerves for 5 min, whereas cotton pads soaked with saline were applied to the control group. Four weeks after surgery, the neurolysis sites were evaluated by blinded surgical dissection. Perineural adhesions were graded using a numerical grading scheme. The scar tissue formation index was also calculated, and a grading was made according to the number of fibroblasts/fibrocytes counted around the epineurium in histological evaluation. Mitomycin C-treated nerves showed significantly less perineural adhesions than controls. Quantification of the dense connective tissue surrounding the nerves revealed a statistically significant reduction around nerves treated with mitomycin C, and the number of fibroblast/fibrocytes was also significantly reduced. Application of topical mitomycin C might be effective in preventing epineural scar formation after neurolysis of peripheral nerves.

  3. Jaw myogenesis in the monk parakeet: evidence of developmental reprogramming in the emergence of novel muscles in Psittaciformes (Aves).

    PubMed

    Carril, Julieta; Ronderos, Jorge R; Tambussi, Claudia P; Chiale, María C

    2016-12-01

    Psittaciformes have apomorphies in the muscles of the jaw that include both the adductors m. ethmomandibularis (EM) and m. pseudomasseter (PM), which are responsible for the generation of strong bite forces. While the EM is present in all Psittaciformes, the PM can be absent or present, and even underdeveloped or well-developed. The aim of this study is to identify developmental reprogramming processes by comparing the myogenesis of the jaw of the monk parakeet Myiopsitta monachus with the information available about other species of Psittaciformes. Seventeen specimens including embryos at different developmental stages, and nestlings of different ages were studied through the analysis of serial histological sections. At embryonic stage 24 (S24) the muscle precursor was observed in the first pharyngeal arch. At S27 the muscle precursor was found to be divided into lateral, intermediate and medial portions. At S31 the independent development of the EM as a rostro-dorsal projection of the mm. pterygoidei could be observed. At S36 the individualization of all muscles was complete. Finally, the PM was detected two days after hatching as an aponeurotic dorsal projection of the m. adductor mandibulae externus superficialis, located lateral to the arcus jugalis. Our results suggest that in M. monachus the muscles EM and PM emerge as a result of a process of heterotipy, and variations in the degree of development of the PM are associated to a heterochronic process of post-displacement, with M. monachus having an underdeveloped PM with respect to basal Psittaciformes.

  4. Jaw muscles of Old World squirrels.

    PubMed

    Thorington, R W; Darrow, K

    1996-11-01

    The jaw, suprahyoid, and extrinsic tongue muscles were studied in 11 genera, belonging to five tribes, of Old World squirrels. Significant variation in most of the adductor muscles is evident. The most primitive state of sciuromorphy is seen in the African tree squirrels Paraxerus and Funisciurus, especially as reflected in the anterior deep masseter. A derived state of sciuromorphy is found in five genera of Old World squirrels and perhaps evolved independently in each. Reduction of the temporalis muscle was observed in three genera, distantly related to one another. A unique arrangement of the superficial masseter is reported in the Asian giant tree squirrels, Ratufa. The arrangement of the masseter in the African pygmy squirrel, Myosciurus, is very similar to that of the South American pygmy squirrel, Sciurillus. We present hypotheses about the functional significance of these differences. In the derived state of sciuromorphy, which is found in three cases in squirrels that feed extensively on hard fruits, the anterior deep masseter is well positioned to increase the strength of the power stroke of the incisor bite. Among the pygmy squirrels, the position of the anterior deep masseter suggests that it plays a more significant role in molar chewing.

  5. Postmastectomy radiotherapy with integrated scar boost using helical tomotherapy

    SciTech Connect

    Rong Yi; Yadav, Poonam; Welsh, James S.; Fahner, Tasha; Paliwal, Bhudatt

    2012-10-01

    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.

  6. Muscle contributions to frontal plane angular momentum during walking.

    PubMed

    Neptune, Richard R; McGowan, Craig P

    2016-09-06

    The regulation of whole-body angular momentum is important for maintaining dynamic balance during human walking, which is particularly challenging in the frontal plane. Whole-body angular momentum is actively regulated by individual muscle forces. Thus, understanding which muscles contribute to frontal plane angular momentum will further our understanding of mediolateral balance control and has the potential to help diagnose and treat balance disorders. The purpose of this study was to identify how individual muscles and gravity contribute to whole-body angular momentum in the frontal plane using a muscle-actuated forward dynamics simulation analysis. A three-dimensional simulation was developed that emulated the average walking mechanics of a group of young healthy adults (n=10). The results showed that a finite set of muscles are the primary contributors to frontal plane balance and that these contributions vary throughout the gait cycle. In early stance, the vasti, adductor magnus and gravity acted to rotate the body towards the contralateral leg while the gluteus medius acted to rotate the body towards the ipsilateral leg. In late stance, the gluteus medius continued to rotate the body towards the ipsilateral leg while the soleus and gastrocnemius acted to rotate the body towards the contralateral leg. These results highlight those muscles that are critical to maintaining dynamic balance in the frontal plane during walking and may provide targets for locomotor therapies aimed at treating balance disorders.

  7. Skeletal muscle fiber, nerve, and blood vessel breakdown in space-flown rats

    NASA Technical Reports Server (NTRS)

    Riley, D. A.; Ilyina-Kakueva, E. I.; Ellis, S.; Bain, J. L.; Slocum, G. R.; Sedlak, F. R.

    1990-01-01

    Histochemical and ultrastructural analyses were performed postflight on hind limb skeletal muscles of rats orbited for 12.5 days aboard the unmanned Cosmos 1887 biosatellite and returned to Earth 2 days before sacrifice. The antigravity adductor longus (AL), soleus, and plantaris muscles atrophied more than the non-weight-bearing extensor digitorum longus, and slow muscle fibers were more atrophic than fast fibers. Muscle fiber segmental necrosis occurred selectively in the AL and soleus muscles; primarily, macrophages and neutrophils infiltrated and phagocytosed cellular debris. Granule-rich mast cells were diminished in flight AL muscles compared with controls, indicating the mast cell secretion contributed to interstitial tissue edema. Increased ubiquitination of disrupted myofibrils implicated ubiquitin in myofilament degradation. Mitochondrial content and succinic dehydrogenase activity were normal, except for subsarcolemmal decreases. Myofibrillar ATPase activity of flight AL muscle fibers shifted toward the fast type. Absence of capillaries and extravasation of red blood cells indicated failed microcirculation. Muscle fiber regeneration from activated satellite cells was detected. About 17% of the flight AL end plates exhibited total or partial denervation. Thus, skeletal muscle weakness associated with spaceflight can result from muscle fiber atrophy and segmental necrosis, partial motor denervation, and disruption of the microcirculation.

  8. Contraction increases the T(2) of muscle in fresh water but not in marine invertebrates.

    PubMed

    Meyer, R A; Prior, B M; Siles, R I; Wiseman, R W

    2001-05-01

    Previous studies suggest that the activity-induced increase in (1)H-NMR transverse relaxation time (T(2)) observed in mammalian skeletal muscles is related to an osmotic effect of intracellular metabolite accumulation. This hypothesis was tested by comparing T(2) (measured by (1)H-NMR imaging at 4.7 T) and metabolite changes (measured by (31)P-NMR spectroscopy) after stimulation in the muscles of a freshwater (crayfish, Orconectes virilis) vs two osmoconforming marine invertebrates (lobster, Homarus americanus; scallop, Argopecten concentricus). Intracellular pH significantly decreased after stimulation in the lobster tail muscle, but not in the crayfish tail or scallop phasic adductor muscles. The decrease in phosphoarginine-to-ATP ratio after stimulation was similar in the three muscles. Muscle T(2) increased from 37 to 43 ms (p < 0.02, n = 7) after stimulation in crayfish, but was unchanged in lobster muscle (32 ms, n = 7), and significantly decreased (from 40 to 36 ms, p < 0.02, n = 11) in scallop muscle. The observation that T(2) does not increase after stimulation in muscles of marine invertebrates with high natural osmolarity is consistent with the hypothesis that the T(2) increase in mammalian muscle is related to osmotically driven shifts of fluid between subcellular compartments.

  9. Pseudopod growth and evolution during cell movement is controlled through SCAR/WAVE dephosphorylation

    PubMed Central

    Ura, Seiji; Pollitt, Alice Y.; Veltman, Douwe M.; Morrice, Nicholas A.; Machesky, Laura M.; Insall, Robert H.

    2016-01-01

    Background SCAR/WAVE is a principal regulator of pseudopod growth in crawling cells. It exists in a stable pentameric complex, which is regulated at multiple levels that are only beginning to be understood. SCAR/WAVE is phosphorylated at multiple sites, but how this affects its biological activity is unclear. Here we show that dephosphorylation of Dictyostelium SCAR controls normal pseudopod dynamics. Results We demonstrate that the C-terminal acidic domain of most Dictyostelium SCAR is basally phosphorylated at four serine residues. A small amount of singly phosphorylated SCAR is also found. SCAR phosphorylation site mutants cannot replace SCAR’s role in the pseudopod cycle, though they rescue cell size and growth. Unphosphorylatable SCAR is hyperactive – excessive recruitment to the front gives large pseudopods that fail to bifurcate because they continually grow forwards. Conversely, phosphomimetic SCAR is weakly active, causing frequent small, disorganised pseudopods. Even in its regulatory complex, SCAR is normally held inactive by an interaction between the phosphorylated acidic and basic domains. Loss of basic residues complementary to the acidic phosphosites yields a hyperactive protein similar to unphosphorylatable SCAR. Conclusions Regulated dephosphorylation of a fraction of the cellular SCAR pool is a key step in SCAR activation during pseudopod growth. Phosphorylation increases autoinhibition of the intact complex. Dephosphorylation weakens this interaction and facilitates SCAR activation, but also destabilizes the protein. We show that SCAR is specifically dephosphorylated in pseudopods, increasing activation by Rac and lipids and supporting positive feedback of pseudopod growth. PMID:22386315

  10. Noninvasive electrocardiographic imaging of chronic myocardial infarct scar§

    PubMed Central

    Horáček, B. Milan; Wang, Linwei; Dawoud, Fady; Xu, Jingjia; Sapp, John L.

    2015-01-01

    Background Myocardial infarction (MI) scar constitutes a substrate for ventricular tachycardia (VT), and an accurate delineation of infarct scar may help to identify reentrant circuits and thus facilitate catheter ablation. One of the recent advancements in characterization of a VT substrate is its volumetric delineation within the ventricular wall by noninvasive electrocardiographic imaging. This paper compares, in four specific cases, epicardial and volumetric inverse solutions, using magnetic resonance imaging (MRI) with late gadolinium enhancement as a gold standard. Methods For patients with chronic MI, who presented at Glasgow Western Infirmary, delayed-enhancement MRI and 120-lead body surface potential mapping (BSPM) data were acquired and 4 selected cases were later made available to a wider community as part of the 2007 PhysioNet/Computers in Cardiology Challenge. These data were used to perform patient-specific inverse solutions for epicardial electrograms and morphology-based criteria were applied to delineate infarct scar on the epicardial surface. Later, the Rochester group analyzed the same data by means of a novel inverse solution for reconstructing intramural transmembrane potentials, to delineate infarct scar in three dimensions. Comparison of the performance of three specific inverse-solution algorithms is presented here, using scores based on the 17-segment ventricular division scheme recommended by the American Heart Association. Results The noninvasive methods delineating infarct scar as three-dimensional (3D) intramural distribution of transmembrane action potentials outperform estimates providing scar delineation on the epicardial surface in all scores used for comparison. In particular, the extent of infarct scar (its percentage mass relative to the total ventricular mass) is rendered more accurately by the 3D estimate. Moreover, the volumetric rendition of scar border provides better clues to potential targets for catheter ablation

  11. Drought and Burn Scars in Southeastern Australia

    NASA Technical Reports Server (NTRS)

    2003-01-01

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

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

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

  12. The Living Scar – Cardiac Fibroblasts and the Injured Heart

    PubMed Central

    Rog-Zielinska, Eva A; Norris, Russell A; Kohl, Peter; Markwald, Roger

    2015-01-01

    Cardiac scars, often perceived as “dead” tissue, are very much alive, with heterocellular activity ensuring the maintenance of structural and mechanical integrity following heart injury. To form a scar, non-myocytes such as fibroblasts, proliferate and are recruited from intra- and extra-cardiac sources. Fibroblasts perform important autocrine and paracrine signalling functions. They also establish mechanical and, as is increasingly evident, electrical junctions with other cells. While fibroblasts were previously thought to act simply as electrical insulators, they may be electrically connected among themselves and, under certain circumstances, to other cells, including cardiomyocytes. A better understanding of these interactions will help target scar structure and function and facilitate the development of novel therapies aimed at modifying scar properties for patient benefit. This review explores available insight and recent concepts on fibroblast integration in the heart, and highlights potential avenues for harnessing their roles to optimise scar function following heart injury such as infarction, and therapeutic interventions such as ablation. PMID:26776094

  13. Closure of supporting cell scar formations requires dynamic actin mechanisms

    PubMed Central

    Hordichok, Andrew J.; Steyger, Peter S.

    2007-01-01

    In many vertebrate inner ear sensory epithelia, dying sensory hair cells are extruded, and the apices of surrounding supporting cells converge to re-seal the epithelial barrier between the electrochemically-distinct endolymph and perilymph. These cellular mechanisms remain poorly understood. Dynamic microtubular mechanisms have been proposed for hair cell extrusion; while contractile actomyosin-based mechanisms are required for cellular extrusion and closure in epithelial monolayers. The hypothesis that cytoskeletal mechanisms are required for hair cell extrusion and supporting cell scar formation was tested using bullfrog saccules incubated with gentamicin (6 hours), and allowed to recover (18 hours). Explants were then fixed, labeled for actin and cytokeratins, and viewed with confocal microscopy. To block dynamic cytoskeletal processes, disruption agents for microtubules (colchicine, paclitaxel) myosin (Y-27632, ML-9) or actin (cytochalasin D, latrunculin A) were added during treatment and recovery. Microtubule disruption agents had no effect on hair cell extrusion or supporting cell scar formation. Myosin disruption agents appeared to slow down scar formation but not hair cell extrusion. Actin disruption agents blocked scar formation, and largely prevented hair cell extrusion. These data suggest that actin-based cytoskeletal processes are required for hair cell extrusion and supporting cell scar formation in bullfrog saccules. PMID:17716843

  14. Computational Representations of Myocardial Infarct Scars and Implications for Arrhythmogenesis

    PubMed Central

    Connolly, Adam J.; Bishop, Martin J.

    2016-01-01

    Image-based computational modeling is becoming an increasingly used clinical tool to provide insight into the mechanisms of reentrant arrhythmias. In the context of ischemic heart disease, faithful representation of the electrophysiological properties of the infarct region within models is essential, due to the scars known for arrhythmic properties. Here, we review the different computational representations of the infarcted region, summarizing the experimental measurements upon which they are based. We then focus on the two most common representations of the scar core (complete insulator or electrically passive tissue) and perform simulations of electrical propagation around idealized infarct geometries. Our simulations highlight significant differences in action potential duration and focal effective refractory period (ERP) around the scar, driven by differences in electrotonic loading, depending on the choice of scar representation. Finally, a novel mechanism for arrhythmia induction, following a focal ectopic beat, is demonstrated, which relies on localized gradients in ERP directly caused by the electrotonic sink effects of the neighboring passive scar. PMID:27486348

  15. Understanding the NG2 Glial Scar after Spinal Cord Injury

    PubMed Central

    Hackett, Amber R.; Lee, Jae K.

    2016-01-01

    NG2 cells, also known as oligodendrocyte progenitor cells, are located throughout the central nervous system and serve as a pool of progenitors to differentiate into oligodendrocytes. In response to spinal cord injury (SCI), NG2 cells increase their proliferation and differentiation into remyelinating oligodendrocytes. While astrocytes are typically associated with being the major cell type in the glial scar, many NG2 cells also accumulate within the glial scar but their function remains poorly understood. Similar to astrocytes, these cells hypertrophy, upregulate expression of chondroitin sulfate proteoglycans, inhibit axon regeneration, contribute to the glial-fibrotic scar border, and some even differentiate into astrocytes. Whether NG2 cells also have a role in other astrocyte functions, such as preventing the spread of infiltrating leukocytes and expression of inflammatory cytokines, is not yet known. Thus, NG2 cells are not only important for remyelination after SCI but are also a major component of the glial scar with functions that overlap with astrocytes in this region. In this review, we describe the signaling pathways important for the proliferation and differentiation of NG2 cells, as well as the role of NG2 cells in scar formation and tissue repair. PMID:27895617

  16. Closed reduction with or without adductor tenotomy for developmental dysplasia of the hip presenting at walking age

    PubMed Central

    Zein, Abou Bakr; Arafa, Amr Said; Azab, Mostafa Abdelmaboud; Reda, Walid; Hegazy, Mohamed Mahmoud; Al Barbary, Hassan Magdy; Kaddah, Mohamed Abdelhalim

    2017-01-01

    Background: Many children with developmental dislocation of the hip especially in underdeveloped countries reach walking age and still remain undiagnosed, which can be detrimental to their growth and development. Because of the lack medical services often encountered in these regions, it would be attractive to find a cheap and effective treatment. Our work evaluated the results of treatment of these children by closed reduction with or without adductor tenotomy in a prospective study. Methods: We included 20 patients in this study with 29 affected hips (15 right and 14 left). Nine patients (45%) had bilateral DDH and 11 (55%) had unilateral DDH. There were 18 girls (90%) and two boys (10%) who were followed up for a mean of 21 mo (18-24 mo). Ages ranged from 9 to 36 mo (mean age 18.3 mo). Patients were divided according to age into two groups: between 9-18 mo and from 19-36 mo. The first group included nine patients (14 hips) while the second had 11 patients (15 hips). Results: In the first group, closed reduction failed in two patients (two hips) during the follow-up period (14.3%) and this necessitated shift to open reduction, while in the second group only one patient (bilateral DDH) had a similar failure (13.3%). We identified four hips with avascular necrosis. Three of them required no further treatment, the remaining hip was openly reduced. Conclusions: Closed reduction in older children offers a valid and reproducible treatment modality in the hands of an experienced pediatric orthopaedic surgeon as long as there is close follow-up and thorough knowledge of possible complications and their management including the ability to shift timely to open reduction. PMID:28286603

  17. Cranial myology and bite force performance of Erlikosaurus andrewsi: a novel approach for digital muscle reconstructions

    PubMed Central

    Lautenschlager, Stephan

    2013-01-01

    The estimation of bite force and bite performance in fossil and extinct animals is a challenging subject in palaeontology and is highly dependent on the reconstruction of the cranial myology. Furthermore, the morphology and arrangement of the adductor muscles considerably affect feeding processes and mastication and thus also have important dietary and ecological ramifications. However, in the past, the reconstruction of the (cranial) muscles was restricted to the identification of muscle attachment sites or simplified computer models. This study presents a detailed reconstruction of the adductor musculature of the Cretaceous therizinosaur Erlikosaurus andrewsi based on a stepwise and iterative approach. The detailed, three-dimensional models of the individual muscles allow for more accurate measurements of the muscle properties (length, cross-section, attachment angle and volume), from which muscle and bite force estimates are calculated. Bite force estimations are found to be the lowest at the tip of the snout (43–65 N) and respectively higher at the first (59–88 N) and last tooth (90–134 N) position. Nevertheless, bite forces are comparatively low for E. andrewsi, both in actual numbers as well as in comparison with other theropod dinosaurs. The results further indicate that the low bite performance was mainly used for leaf-stripping and plant cropping, rather than active mastication or chewing processes. Muscle and thus bite force in E. andrewsi (and most likely all therizinosaurs) is considerably constrained by the cranial anatomy and declines in derived taxa of this clade. This trend is reflected in the changes of dietary preferences from carnivory to herbivory in therizinosaurs. PMID:23061752

  18. Preclinical Study of Novel Gene Silencer Pyrrole-Imidazole Polyamide Targeting Human TGF-β1 Promoter for Hypertrophic Scars in a Common Marmoset Primate Model.

    PubMed

    Igarashi, Jun; Fukuda, Noboru; Inoue, Takashi; Nakai, Shigeki; Saito, Kosuke; Fujiwara, Kyoko; Matsuda, Hiroyuki; Ueno, Takahiro; Matsumoto, Yoshiaki; Watanabe, Takayoshi; Nagase, Hiroki; Bando, Toshikazu; Sugiyama, Hiroshi; Itoh, Toshio; Soma, Masayoshi

    2015-01-01

    We report a preclinical study of a pyrrole-imidazole (PI) polyamide that targets the human transforming growth factor (hTGF)-β1 gene as a novel transcriptional gene silencer in a common marmoset primate model. We designed and then synthesized PI polyamides to target the hTGF-β1 promoter. We examined effects of seven PI polyamides (GB1101-1107) on the expression of hTGF-β1 mRNA stimulated with phorbol 12-myristate 13-acetate (PMA) in human vascular smooth muscle cells. GB1101, GB1105 and GB1106 significantly inhibited hTGF-β1 mRNA expression. We examined GB1101 as a PI polyamide to hTGF-β1 for hypertrophic scars in marmosets in vivo. Injection of GB1101 completely inhibited hypertrophic scar formation at 35 days post-incision and inhibited cellular infiltration, TGF-β1 and vimentin staining, and epidermal thickness. Mismatch polyamide did not affect hypertrophic scarring or histological changes. Epidermis was significantly thinner with GB1101 than with water and mismatch PI polyamides. We developed the PI polyamides for practical ointment medicines for the treatment of hypertrophic scars. FITC-labeled GB1101 with solbase most efficiently distributed in the nuclei of epidermal keratinocytes, completely suppressed hypertropic scarring at 42 days after incision, and considerably inhibited epidermal thickness and vimentin-positive fibroblasts. PI polyamides targeting hTGF-β1 promoter with solbase ointment will be practical medicines for treating hypertrophic scars after surgical operations and skin burns.

  19. Preclinical Study of Novel Gene Silencer Pyrrole-Imidazole Polyamide Targeting Human TGF-β1 Promoter for Hypertrophic Scars in a Common Marmoset Primate Model

    PubMed Central

    Igarashi, Jun; Fukuda, Noboru; Inoue, Takashi; Nakai, Shigeki; Saito, Kosuke; Fujiwara, Kyoko; Matsuda, Hiroyuki; Ueno, Takahiro; Matsumoto, Yoshiaki; Watanabe, Takayoshi; Nagase, Hiroki; Bando, Toshikazu; Sugiyama, Hiroshi; Itoh, Toshio; Soma, Masayoshi

    2015-01-01

    We report a preclinical study of a pyrrole-imidazole (PI) polyamide that targets the human transforming growth factor (hTGF)-β1 gene as a novel transcriptional gene silencer in a common marmoset primate model. We designed and then synthesized PI polyamides to target the hTGF-β1 promoter. We examined effects of seven PI polyamides (GB1101-1107) on the expression of hTGF-β1 mRNA stimulated with phorbol 12-myristate 13-acetate (PMA) in human vascular smooth muscle cells. GB1101, GB1105 and GB1106 significantly inhibited hTGF-β1 mRNA expression. We examined GB1101 as a PI polyamide to hTGF-β1 for hypertrophic scars in marmosets in vivo. Injection of GB1101 completely inhibited hypertrophic scar formation at 35 days post-incision and inhibited cellular infiltration, TGF-β1 and vimentin staining, and epidermal thickness. Mismatch polyamide did not affect hypertrophic scarring or histological changes. Epidermis was significantly thinner with GB1101 than with water and mismatch PI polyamides. We developed the PI polyamides for practical ointment medicines for the treatment of hypertrophic scars. FITC-labeled GB1101 with solbase most efficiently distributed in the nuclei of epidermal keratinocytes, completely suppressed hypertropic scarring at 42 days after incision, and considerably inhibited epidermal thickness and vimentin-positive fibroblasts. PI polyamides targeting hTGF-β1 promoter with solbase ointment will be practical medicines for treating hypertrophic scars after surgical operations and skin burns. PMID:25938472

  20. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy.

    PubMed

    Bar-On, Lynn; Aertbeliën, Erwin; Molenaers, Guy; Desloovere, Kaat

    2014-01-01

    The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP) these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n = 35/19; 10.8 ± 3.8 yrs; bilateral/unilateral involvement n =  32/22; Gross Motor Functional Classification Score I-IV) of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG) from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG) compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01). The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between incremental position

  1. Use of a non-contact 3D digitiser to measure the volume of keloid scars: a useful tool for scar assessment.

    PubMed

    Taylor, Ben; McGrouther, D Angus; Bayat, Ardeshir

    2007-01-01

    Keloid scars often fail to respond to treatment, so research into new therapeutic regimes is important. However, research is limited by a scarcity of reliable, objective scar assessment tools. The volume of a keloid scar should decrease with successful treatment. This study demonstrates the use of a non-contact 3D digitiser to measure digitally the volume of a keloid scar. The scanner was used to scan 62 keloid scars and one fine-line normal scar. The scan took approximately 9s to complete. The volume was measured using 3D reverse modelling software. A previously validated scar assessment scale was used to score the scars according to their physical parameters. A significant correlation was found between volume and the scar score (Pearson's r=0.627, p<0.001). Linear regression was also statistically significant (p<0.001, R(2)=0.44). Therefore it was possible to predict the scar score from the measured volume. This technique could allow monitoring of a patient on treatment, or comparison of treatments in a research setting. It overcomes previous problems with the measurement of scar volume as it is quantitatively objective and well-tolerated.

  2. Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

    PubMed Central

    Man, W; Hopkinson, N; Harraf, F; Nikoletou, D; Polkey, M; Moxham, J

    2005-01-01

    Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and fibre type distribution to the quadriceps, although they remain active in COPD. Cough gastric pressure is a recently described technique that assesses abdominal muscle (and hence expiratory muscle) strength more accurately than traditional techniques. A study was undertaken to test the hypothesis that more severe weakness exists in the quadriceps than in the abdominal muscles of patients with COPD compared with healthy elderly controls. Methods: Maximum cough gastric pressure and quadriceps isometric strength were measured in 43 patients with stable COPD and 25 healthy elderly volunteers matched for anthropometric variables. Results: Despite a significant reduction in mean quadriceps strength (29.9 kg v 41.2 kg; 95% CI –17.9 to –4.6; p = 0.001), cough gastric pressure was preserved in patients with COPD (227.3 cm H2O v 204.8 cm H2O; 95% CI –5.4 to 50.6; p = 0.11). Conclusions: Abdominal muscle strength is preserved in stable COPD outpatients in the presence of quadriceps weakness. This suggests that anatomical location and fibre type cannot explain quadriceps weakness in COPD. By inference, we conclude that disuse and consequent deconditioning are important factors in the development of quadriceps muscle weakness in COPD patients, or that activity protects the abdominal muscles from possible systemic myopathic processes. PMID:15923239

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

    PubMed Central

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

    2010-01-01

    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

  4. Biologic-free mechanically induced muscle regeneration

    PubMed Central

    Cezar, Christine A.; Roche, Ellen T.; Vandenburgh, Herman H.; Duda, Georg N.; Walsh, Conor J.; Mooney, David J.

    2016-01-01

    Severe skeletal muscle injuries are common and can lead to extensive fibrosis, scarring, and loss of function. Clinically, no therapeutic intervention exists that allows for a full functional restoration. As a result, both drug and cellular therapies are being widely investigated for treatment of muscle injury. Because muscle is known to respond to mechanical loading, we investigated instead whether a material system capable of massage-like compressions could promote regeneration. Magnetic actuation of biphasic ferrogel scaffolds implanted at the site of muscle injury resulted in uniform cyclic compressions that led to reduced fibrous capsule formation around the implant, as well as reduced fibrosis and inflammation in the injured muscle. In contrast, no significant effect of ferrogel actuation on muscle vascularization or perfusion was found. Strikingly, ferrogel-driven mechanical compressions led to enhanced muscle regeneration and a ∼threefold increase in maximum contractile force of the treated muscle at 2 wk compared with no-treatment controls. Although this study focuses on the repair of severely injured skeletal muscle, magnetically stimulated bioagent-free ferrogels may find broad utility in the field of regenerative medicine. PMID:26811474

  5. Chemical peels in active acne and acne scars.

    PubMed

    Kontochristopoulos, Georgios; Platsidaki, Eftychia

    Chemical peeling is a widely used procedure in the management of acne and acne scars. It causes controlled destruction of a part of or the entire epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. The most frequently used peeling agents are salicylic acid, glycolic acid, pyruvic acid, lactic acid, mandelic acid, Jessner solution, trichloroacetic acid, and phenol. The appropriate peel is chosen based on the patient's skin type, acne activity, and type of acne scars. Combination peels minimize side effects. In acne scars, chemical peels may be combined with other procedures to achieve better clinical results. A series of chemical peels can lead to significant improvement over a short period, leading to patient satisfaction and maintenance of clinical results. © 2016 Elsevier Inc. All rights reserved.

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

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  7. A multidisciplinary approach to scars: a narrative review

    PubMed Central

    Zanier, Emiliano; Bordoni, Bruno

    2015-01-01

    The purpose of this article is to carry out a narrative review regarding the approach to scars through complementary and alternative medicine focusing on osteopathy, naturopathy, and other minor methods and traditional rehabilitative medicines, such as physiotherapy and manual therapies. We analyzed the existing literature regarding the possible influences of techniques relaxing the diaphragm – both manual and psychophysical relaxing techniques – and the consequent local response to events leading to scar tissue healing. The objective of the study is to become a useful instrument of knowledge for those manual therapists and professionals who deal with patients affected by discontinuity of the skin surface due to trauma or surgery. This article also intends to stimulate research in order to find and propose new methods of scar treatment, taking into consideration the information gained so far from other complementary and alternative disciplines. PMID:26316774

  8. The SCAR Astronomy & Astrophysics from Antarctica Scientific Research Programme

    NASA Astrophysics Data System (ADS)

    Storey, John W. V.; Abe, Lyu; Andersen, Michael; Anderson, Philip; Burton, Michael; Cui, Xiangqun; Ichikawa, Takashi; Karle, Albrecht; Lloyd, James; Masi, Silvia; Steinbring, Eric; Travouillon, Tony; Tuthill, Peter; Zhou, HongYang

    2013-01-01

    SCAR, the Scientific Committee on Antarctic Research, is, like the IAU, a committee of ICSU, the International Council for Science. For over 30 years, SCAR has provided scientific advice to the Antarctic Treaty System and made numerous recommendations on a variety of matters. In 2010, Astronomy and Astrophysics from Antarctica was recognized as one of SCAR's five Scientific Research Programs. Broadly stated, the objectives of Astronomy & Astrophysics from Antarctica are to coordinate astronomical activities in Antarctica in a way that ensures the best possible outcomes from international investment in Antarctic astronomy, and maximizes the opportunities for productive interaction with other disciplines. There are four Working Groups, dealing with site testing, Arctic astronomy, science goals, and major new facilities. Membership of the Working Groups is open to any professional working in astronomy or a related field.

  9. Real-time ultrasound-guided comparison of adductor canal block and psoas compartment block combined with sciatic nerve block in laparoscopic knee surgeries

    PubMed Central

    Messeha, Medhat M.

    2016-01-01

    Background: Lumbar plexus block, combined with a sciatic nerve block, is an effective locoregional anesthetic technique for analgesia and anesthesia of the lower extremity. The aim of this study was to compare the clinical results outcome of the adductor canal block versus the psoas compartment block combined with sciatic nerve block using real time ultrasound guidance in patients undergoing elective laparoscopic knee surgeries. Patients and Methods: Ninety patients who were undergoing elective laparoscopic knee surgeries were randomly allocated to receive a sciatic nerve block in addition to lumbar plexus block using either an adductor canal block (ACB) or a posterior psoas compartment approach (PCB) using 25 ml of bupivacine 0.5% with adrenaline 1:400,000 injection over 2-3 minutes while observing the distribution of the local anesthetic in real time. Successful nerve block was defined as a complete loss of pinprick sensation in the region that is supplied by the three nerves along with adequate motor block, 30 minutes after injection. The degree of motor block was evaluated 30 minutes after the block procedure. The results of the present study showed that the real time ultrasound guidance of PCB is more effective than ACB approach. Although the sensory blockade of the femoral nerve achieved equally by both techniques, the LFC and OBT nerves were faster and more effectively blocked with PCB technique. Also PCB group showed significant complete sensory block without need for general anesthesia, significant decrease in the post-operative VAS and significant increase time of first analgesic requirement as compared to the ACB group. Result and Conclusion: The present study demonstrates that blockade of lumber plexus by psoas compartment block is more effective in complete sensory block without general anesthesia supplementation in addition to decrease post-operative analgesic requirement than adductor canal block. PMID:27212766

  10. The contribution of Islet1-expressing splanchnic mesoderm cells to distinct branchiomeric muscles reveals significant heterogeneity in head muscle development.

    PubMed

    Nathan, Elisha; Monovich, Amir; Tirosh-Finkel, Libbat; Harrelson, Zachary; Rousso, Tal; Rinon, Ariel; Harel, Itamar; Evans, Sylvia M; Tzahor, Eldad

    2008-02-01

    During embryogenesis, paraxial mesoderm cells contribute skeletal muscle progenitors, whereas cardiac progenitors originate in the lateral splanchnic mesoderm (SpM). Here we focus on a subset of the SpM that contributes to the anterior or secondary heart field (AHF/SHF), and lies adjacent to the cranial paraxial mesoderm (CPM), the precursors for the head musculature. Molecular analyses in chick embryos delineated the boundaries between the CPM, undifferentiated SpM progenitors of the AHF/SHF, and differentiating cardiac cells. We then revealed the regionalization of branchial arch mesoderm: CPM cells contribute to the proximal region of the myogenic core, which gives rise to the mandibular adductor muscle. SpM cells contribute to the myogenic cells in the distal region of the branchial arch that later form the intermandibular muscle. Gene expression analyses of these branchiomeric muscles in chick uncovered a distinct molecular signature for both CPM- and SpM-derived muscles. Islet1 (Isl1) is expressed in the SpM/AHF and branchial arch in both chick and mouse embryos. Lineage studies using Isl1-Cre mice revealed the significant contribution of Isl1(+) cells to ventral/distal branchiomeric (stylohyoid, mylohyoid and digastric) and laryngeal muscles. By contrast, the Isl1 lineage contributes to mastication muscles (masseter, pterygoid and temporalis) to a lesser extent, with virtually no contribution to intrinsic and extrinsic tongue muscles or extraocular muscles. In addition, in vivo activation of the Wnt/beta-catenin pathway in chick embryos resulted in marked inhibition of Isl1, whereas inhibition of this pathway increased Isl1 expression. Our findings demonstrate, for the first time, the contribution of Isl1(+) SpM cells to a subset of branchiomeric skeletal muscles.

  11. Fatigue-related firing of distal muscle nociceptors reduces voluntary activation of proximal muscles of the same limb.

    PubMed

    Kennedy, David S; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

    2014-02-15

    With fatiguing exercise, firing of group III/IV muscle afferents reduces voluntary activation and force of the exercised muscles. These afferents can also act across agonist/antagonist pairs, reducing voluntary activation and force in nonfatigued muscles. We hypothesized that maintained firing of group III/IV muscle afferents after a fatiguing adductor pollicis (AP) contraction would decrease voluntary activation and force of AP and ipsilateral elbow flexors. In two experiments (n = 10) we examined voluntary activation of AP and elbow flexors by measuring changes in superimposed twitches evoked by ulnar nerve stimulation and transcranial magnetic stimulation of the motor cortex, respectively. Inflation of a sphygmomanometer cuff after a 2-min AP maximal voluntary contraction (MVC) blocked circulation of the hand for 2 min and maintained firing of group III/IV muscle afferents. After a 2-min AP MVC, maximal AP voluntary activation was lower with than without ischemia (56.2 ± 17.7% vs. 76.3 ± 14.6%; mean ± SD; P < 0.05) as was force (40.3 ± 12.8% vs. 57.1 ± 13.8% peak MVC; P < 0.05). Likewise, after a 2-min AP MVC, elbow flexion voluntary activation was lower with than without ischemia (88.3 ± 7.5% vs. 93.6 ± 3.9%; P < 0.05) as was torque (80.2 ± 4.6% vs. 86.6 ± 1.0% peak MVC; P < 0.05). Pain during ischemia was reported as Moderate to Very Strong. Postfatigue firing of group III/IV muscle afferents from the hand decreased voluntary drive and force of AP. Moreover, this effect decreased voluntary drive and torque of proximal unfatigued muscles, the elbow flexors. Fatigue-sensitive group III/IV muscle nociceptors act to limit voluntary drive not only to fatigued muscles but also to unfatigued muscles within the same limb.

  12. Recontouring, resurfacing, and scar revision in skin cancer reconstruction.

    PubMed

    Brenner, Michael J; Perro, Christopher A

    2009-08-01

    Residual disfigurement is a common problem for patients who have undergone skin cancer reconstruction. Restoring form and function in these patients is an artistic and technical endeavor. The efficacy of surgical scar revision, dermabrasion, chemical peels, and laser resurfacing is predicated upon the skin's innate ability to regenerate over time in response to mechanical, chemical, and thermal or ablative stresses. The patient and surgeon should be accepting of a process that is often gradual and may proceed in stages. Achieving proficiency with the secondary procedures for improving scars and local flaps may allow the motivated surgeon to mold an initially passable surgical result into an excellent one.

  13. Standardized approach for imaging and measuring Cesarean section scars using ultrasonography.

    PubMed

    Naji, O; Abdallah, Y; Bij De Vaate, A J; Smith, A; Pexsters, A; Stalder, C; McIndoe, A; Ghaem-Maghami, S; Lees, C; Brölmann, H A M; Huirne, J A F; Timmerman, D; Bourne, T

    2012-03-01

    Incomplete healing of the scar is a recognized sequel of Cesarean section (CS) and may be associated with complications in later pregnancies. These complications can include scar pregnancy, a morbidly adherent placenta, scar dehiscence or rupture. To date there is uncertainty relating to the factors that lead to poor scar healing and how to recognize it. In recent years, there has been an increase in studies using ultrasound that describe scars as deficient, or poorly, incompletely or inadequately healed with few data to associate the morphology of the scar with the functional integrity of the lower segment of the uterus. There have been multiple attempts to describe CS scars using ultrasonography. Different terminology, methods and results have been reported, yet there is still no consensus regarding the prevalence, clinical significance or most appropriate method to describe the appearances of these scars. Developing a test that can predict the likelihood of women having problems associated with a CS scar is becoming increasingly important. On the other hand, understanding whether the ultrasound appearances of the scar can tell us anything about its integrity is not well supported by the research evidence. In this article we present an overview of ultrasound-based definitions and methods used to describe CS scars. We also present information relating to the performance of alternative techniques used to evaluate CS scars. Having examined the current evidence we suggest a standardized approach to describe CS scars using ultrasound so that future studies can be meaningfully compared.

  14. Outcome of Dermal Grafting in the Management of Atrophic Facial Scars

    PubMed Central

    Shilpa, Kanathur; Sacchidanand, S; Leelavathy, Budamakuntla; Shilpashree, Padmanabha; Divya, Gorur; Ranjitha, Rammurthy; Lakshmi, DV

    2016-01-01

    Background: Scars over the face are cosmetically and psychologically disturbing. Various techniques have been described and are being practiced in the management of these scars. Aims and Objectives: This study was undertaken to study the safety, effectiveness of using dermal grafts as fillers in the management of facial scars due to acne, chickenpox, trauma or any others. Materials and Methods: Fifteen patients with atrophic facial scars of varied aetiology and willing for surgery were considered for dermal graft technique. After pre-operative workup, subcision was done 2 weeks before planned surgery. Depending on the type of scar, grafts were inserted using pocket or road railing techniques. Scar improvement was assessed based on patient satisfaction. Results: Linear scars showed excellent improvement. Acne, varicella and traumatic scars also showed good improvement. However, two patients did not appreciate improvement due to marked surface irregularities as the scars were elevated. They were further subjected to LASER and chemical peel resurfacing. Conclusion: Dermal grafting can be used in the management of any round to oval facial scar which is soft, prominent and at least 4–5 mm across; linear scars at least 2–3 mm across and 3–4 cm in length. However, scars with prominent surface irregularities need further resurfacing techniques along with dermal grafting. Limitations: Limitations of the study include small sample size, and only subjective assessment of the scar has been taken into consideration to assess the outcome. PMID:28163456

  15. Scar-free cutaneous wound healing in the leopard gecko, Eublepharis macularius.

    PubMed

    Peacock, Hanna M; Gilbert, Emily A B; Vickaryous, Matthew K

    2015-11-01

    Cutaneous wounds heal with two possible outcomes: scarification or near-perfect integumentary restoration. Whereas scar formation has been intensively investigated, less is known about the tissue-level events characterising wounds that spontaneously heal scar-free, particularly in non-foetal amniotes. Here, a spatiotemporal investigation of scar-free cutaneous wound healing following full-thickness excisional biopsies to the tail and body of leopard geckos (Eublepharis macularius) is provided. All injuries healed without scarring. Cutaneous repair involves the development of a cell-rich aggregate within the wound bed, similar to scarring wounds. Unlike scar formation, scar-free healing involves a more rapid closure of the wound epithelium, and a delay in blood vessel development and collagen deposition within the wound bed. It was found that, while granulation tissue of scarring wounds is hypervascular, scar-free wound healing conspicuously does not involve a period of exuberant blood vessel formation. In addition, during scar-free wound healing the newly formed blood vessels are typically perivascular cell-supported. Immunohistochemistry revealed widespread expression of both the pro-angiogenic factor vascular endothelial growth factor A and the anti-angiogenic factor thrombospondin-1 within the healing wound. It was found that scar-free wound healing is an intrinsic property of leopard gecko integument, and involves a modulation of the cutaneous scar repair program. This proportional revascularisation is an important factor in scar-free wound healing.

  16. Changes in motor cortical excitability during human muscle fatigue.

    PubMed Central

    Taylor, J L; Butler, J E; Allen, G M; Gandevia, S C

    1996-01-01

    1. The excitability of the motor cortex was investigated during fatiguing con of the elbow flexors in human subjects. During sustained contractions at 30 and 1 voluntary force (MVC), the short-latency electromyographic responses (EMG) evoke brachii and brachioradialis by transcranial magnetic stimulation increased in si EMG in the elbow flexors following the evoked muscle potential (silent period), duration during a sustained MVC but not during 30% MVCs nor during a sustained M muscle (adductor pollicis). 2. When the blood supply to brachioradialis was blocked with sphygmomanometer cuff sustained MVC, the changes in EMG responses to transcranial stimulation rapidly control values, This suggests that changes in these responses during fatigue wer small-diameter muscle afferents. 3. Tendon vibration during sustained MVCs indicated that the changes in the resp cortial stimulation were not mediated by reduced muscle spindle inputs. 4. Muscle action potentials evoked in brachioradialis by electrical stimulation cervicomedullary junction did not increase in size during sustained MVCs. Thus, cortically evoked responses during sustained MVCs reflects a change in cortical Although the silent period following cervicomedullary stimulation lengthened, it substantially shorter than the cortically evoked silent period. 5. The altered EMG responses to transcranial stimulation during fatigue suggest exitation and increased inhibition in the motor cortex. As these changes were un manipulation of afferent input they presumably result from intrinsic cortical pr altered voluntary drive to the motor cortex. Images Figure 1 PMID:8821148

  17. Centronuclear myopathy related to dynamin 2 mutations: Clinical, morphological, muscle imaging and genetic features of an Italian cohort

    PubMed Central

    Catteruccia, Michela; Fattori, Fabiana; Codemo, Valentina; Ruggiero, Lucia; Maggi, Lorenzo; Tasca, Giorgio; Fiorillo, Chiara; Pane, Marika; Berardinelli, Angela; Verardo, Margherita; Bragato, Cinzia; Mora, Marina; Morandi, Lucia; Bruno, Claudio; Santoro, Lucio; Pegoraro, Elena; Mercuri, Eugenio; Bertini, Enrico; D’Amico, Adele

    2013-01-01

    Mutations in dynamin 2 (DNM2) gene cause autosomal dominant centronuclear myopathy and occur in around 50% of patients with centronuclear myopathy. We report clinical, morphological, muscle imaging and genetic data of 10 unrelated Italian patients with centronuclear myopathy related to DNM2 mutations. Our results confirm the clinical heterogeneity of this disease, underlining some peculiar clinical features, such as severe pulmonary impairment and jaw contracture that should be considered in the clinical follow-up of these patients. Muscle MRI showed a distinct pattern of involvement, with predominant involvement of soleus and tibialis anterior in the lower leg muscles, followed by hamstring muscles and adductor magnus at thigh level and gluteus maximus. The detection of three novel DNM2 mutations and the first case of somatic mosaicism further expand the genetic spectrum of the disease. PMID:23394783

  18. Sequential treatment with intradermal incision (intracision) and 2,940-nm Er:YAG laser for chicken pox scars.

    PubMed

    Lee, Sang Ju; Kim, Young Koo; Choi, Sun Young; Park, Kui Young; Seo, Seong Jun

    2014-01-01

    Boxcar scars, such as chicken pox scars, are round to oval depressions with sharply defined vertical edges. Subcision is a simple and safe procedure for treatment of atrophic and depressed scars, but boxcar scars are generally not eliminated by subcision. Intradermal incision technique (intracision) can treat chicken pox scars by untethering fibrotic strands, raising collagen synthesis, and having additional intradermal blood pocket formation. We have found that chicken pox scars further improve when intracision is followed by laser skin resurfacing.

  19. In vivo assessment of human burn scars through automated quantification of vascularity using optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Liew, Yih Miin; McLaughlin, Robert A.; Gong, Peijun; Wood, Fiona M.; Sampson, David D.

    2013-06-01

    In scars arising from burns, objective assessment of vascularity is important in the early identification of pathological scarring, and in the assessment of progression and treatment response. We demonstrate the first clinical assessment and automated quantification of vascularity in cutaneous burn scars of human patients in vivo that uses optical coherence tomography (OCT). Scar microvasculature was delineated in three-dimensional OCT images using speckle decorrelation. The diameter and area density of blood vessels were automatically quantified. A substantial increase was observed in the measured density of vasculature in hypertrophic scar tissues (38%) when compared against normal, unscarred skin (22%). A proliferation of larger vessels (diameter≥100 μm) was revealed in hypertrophic scarring, which was absent from normal scars and normal skin over the investigated physical depth range of 600 μm. This study establishes the feasibility of this methodology as a means of clinical monitoring of scar progression.

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

    NASA Astrophysics Data System (ADS)

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

    2005-01-01

    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.

  1. Expression profile of proteins involved in scar formation in the healing process of full-thickness excisional wounds in the porcine model.

    PubMed

    Ulrich, Magda M W; Verkerk, Michelle; Reijnen, Linda; Vlig, Marcel; van den Bogaerdt, Antoon J; Middelkoop, Esther

    2007-01-01

    Scar formation in deep dermal wounds is associated with excessive collagen deposition and contraction. Increased collagen synthesis and decreased collagen degradation are the mechanisms through which this form of fibrosis can occur. Another factor might be a different kind of collagen cross-linking seen in fibrotic skin diseases. This type of cross-linking is dependent on the enzyme lysyl hydroxylase-2b. In this study, we examined the expression profile of the potential key players in scar formation in time in healing of acute wounds. Collagen types I and III, lysyl hydroxylase-2b, alpha-smooth muscle actin, transforming growth factor betas, and the matrix metalloproteinases and their inhibitor mRNA levels were determined. All genes examined show distinct expression patterns over time. The expression of lysyl hydroxylase-2b peaks at day 7, and precedes collagen types I and III expression. Eight weeks after wounding, the scars showed an increased level of lysyl hydroxylase-2b-mediated collagen cross-linking. This study shows that the fibrosis-specific type of cross-linking of collagen seen in human hypertrophic scarring also plays a role in this animal model of wound healing. Moreover, the expression of the putative gene responsible for this type of cross-linking, the lysyl hydroxylase-2b, is elevated during wound healing.

  2. The evolution of laser surgery for acne and other scarring processes.

    PubMed

    Morton, Laurel M

    2014-12-01

    The treatment of acne scars is an important part of a laser specialist's practice. For the last 20 years, the technology available for this application has progressed from nonablative to ablative and eventually to fractional lasers that are effective for a range of scar types. Although patients with mild to severe acne scarring have long been good laser candidates, we are beginning to understand the use of lasers for severe traumatic scars which can be disfiguring and functionally limiting in nature.

  3. 8. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH ...

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

    8. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH MOVING TO CONSTRUCT DAM, LOOKING NORTH - High Mountain Dams in Upalco Unit, East Timothy Lake Dam, Ashley National Forest, 8.4 miles North of Swift Creek Campground, Mountain Home, Duchesne County, UT

  4. 4. VIEW OF DOWNSTREAM FACE OF DAM, WITH SCARS FROM ...

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

    4. VIEW OF DOWNSTREAM FACE OF DAM, WITH SCARS FROM EARTH MOVING TO CONSTRUCT DAM IN FOREGROUND, LOOKING NORTHWEST - High Mountain Dams in Upalco Unit, Five Point Lake Dam, Ashley National Forest, 12 miles Northwest of Swift Creek Campground, Mountain Home, Duchesne County, UT

  5. 9. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH ...

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

    9. VIEW OF BASIN BEHIND DAM, SHOWING SCARS FROM EARTH MOVING TO CONSTRUCT DAM, LOOKING EAST - High Mountain Dams in Upalco Unit, East Timothy Lake Dam, Ashley National Forest, 8.4 miles North of Swift Creek Campground, Mountain Home, Duchesne County, UT

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

    PubMed Central

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

    2011-01-01

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

  7. Prediction of scar integrity and vaginal birth after caesarean delivery.

    PubMed

    Valentin, Lil

    2013-04-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has been published. A thin lower uterine segment at 35-40 weeks, as measured by ultrasound in women with a caesarean hysterotomy scar, increases the risk of uterine rupture or dehiscence. No cut-off for lower uterine segment thickness, however, can be suggested because of study heterogeneity, and because prospective validation is lacking. Large caesarean hysterotomy scar defects in non-pregnant women seen at ultrasound examination increase the risk of uterine rupture or dehiscence in subsequent pregnancy, but the strength of the association is unknown. To sum up, we currently lack a method that can provide a reliable estimate of the risk of uterine rupture or dehiscence during a trial of labour in women with caesarean hysterotomy scar(s).

  8. Histologic features of alopecias: part II: scarring alopecias.

    PubMed

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-05-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder.

  9. Basal Cell Carcinoma Arising in a Breast Augmentation Scar.

    PubMed

    Edwards, Lisa R; Cresce, Nicole D; Russell, Mark A

    2017-04-01

    We report a case of a 46-year-old female who presented with a persistent lesion on the inferior right breast. The lesion was located within the scar from a breast augmentation procedure 12 years ago. The lesion had been treated as several conditions with no improvement. Biopsy revealed a superficial and nodular basal cell carcinoma, and the lesion was successfully removed with Mohs micrographic surgery. Basal cell carcinoma arising in a surgical scar is exceedingly rare with only 13 reported cases to date. This is the first reported case of basal cell carcinoma arising in a breast augmentation scar. We emphasize the importance of biopsy for suspicious lesions or those refractory to treatment, particularly those lesions that form within a scar. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  10. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    PubMed

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  11. Malignant Melanoma on a Thermal Burn Scar with an Interval of More Than 70 Years

    PubMed Central

    Uchida, Shusuke; Oiso, Naoki; Shiga, Kuriko; Narita, Tomohiko; Kawada, Akira

    2016-01-01

    Cases of malignant melanoma on thermal burn scars have occasionally been reported. We report a 78-year-old Japanese female with malignant melanoma on a thermal burn scar with an interval of more than 70 years. Our case reemphasizes the importance of regular examinations in persons with thermal burn scars. PMID:27721752

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

    PubMed

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

    2014-08-01

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

  13. 77 FR 2909 - Schedule for Rating Disabilities; Evaluation of Scars; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... AFFAIRS 38 CFR Part 4 RIN 2900-AM55 Schedule for Rating Disabilities; Evaluation of Scars; Correction... clearly reflected VA's policies concerning the evaluation of scars. In the preamble of that document, VA... criteria for the evaluation of scars. In the DATES section of the rule document, we incorrectly stated...

  14. 77 FR 2910 - Schedule for Rating Disabilities; Evaluation of Scars; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... AFFAIRS 38 CFR Part 4 RIN 2900-AM55 Schedule for Rating Disabilities; Evaluation of Scars; Correction... it more clearly reflected VA's policies concerning the evaluation of scars. In the preamble of that... addresses the Skin, 38 CFR 4.118, by revising the criteria for the evaluation of scars. In the dates...

  15. Muscle biopsy

    MedlinePlus

    ... Inflammatory diseases of muscle (such as polymyositis or dermatomyositis ) Diseases of the connective tissue and blood vessels ( ... disease that involves inflammation and a skin rash ( dermatomyositis ) Inherited muscle disorder ( Duchenne muscular dystrophy ) Inflammation of ...

  16. Muscle fiber type specific induction of slow myosin heavy chain 2 gene expression by electrical stimulation

    SciTech Connect

    Crew, Jennifer R.; Falzari, Kanakeshwari; DiMario, Joseph X.

    2010-04-01

    Vertebrate skeletal muscle fiber types are defined by a broad array of differentially expressed contractile and metabolic protein genes. The mechanisms that establish and maintain these different fiber types vary throughout development and with changing functional demand. Chicken skeletal muscle fibers can be generally categorized as fast and fast/slow based on expression of the slow myosin heavy chain 2 (MyHC2) gene in fast/slow muscle fibers. To investigate the cellular and molecular mechanisms that control fiber type formation in secondary or fetal muscle fibers, myoblasts from the fast pectoralis major (PM) and fast/slow medial adductor (MA) muscles were isolated, allowed to differentiate in vitro, and electrically stimulated. MA muscle fibers were induced to express the slow MyHC2 gene by electrical stimulation, whereas PM muscle fibers did not express the slow MyHC2 gene under identical stimulation conditions. However, PM muscle fibers did express the slow MyHC2 gene when electrical stimulation was combined with inhibition of inositol triphosphate receptor (IP3R) activity. Electrical stimulation was sufficient to increase nuclear localization of expressed nuclear-factor-of-activated-T-cells (NFAT), NFAT-mediated transcription, and slow MyHC2 promoter activity in MA muscle fibers. In contrast, both electrical stimulation and inhibitors of IP3R activity were required for these effects in PM muscle fibers. Electrical stimulation also increased levels of peroxisome-proliferator-activated receptor-{gamma} co-activator-1 (PGC-1{alpha}) protein in PM and MA muscle fibers. These results indicate that MA muscle fibers can be induced by electrical stimulation to express the slow MyHC2 gene and that fast PM muscle fibers are refractory to stimulation-induced slow MyHC2 gene expression due to fast PM muscle fiber specific cellular mechanisms involving IP3R activity.

  17. Modeling Muscles

    ERIC Educational Resources Information Center

    Goodwyn, Lauren; Salm, Sarah

    2007-01-01

    Teaching the anatomy of the muscle system to high school students can be challenging. Students often learn about muscle anatomy by memorizing information from textbooks or by observing plastic, inflexible models. Although these mediums help students learn about muscle placement, the mediums do not facilitate understanding regarding integration of…

  18. Save the skin and improve the scar: a simple technique to minimize the scar from a temporary stoma.

    PubMed

    Keating, John; Kelly, Erica Whineray; Hunt, Ian

    2003-10-01

    Reversal of a loop ileostomy is not infrequently associated with wound infection and delayed wound healing. This in turn may lead to a disappointing scar. A simple modification to the technique of stoma construction simplifies wound closure, reduces the rate of wound morbidity, and improves the cosmetic result.

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

    PubMed

    Simons, Megan; Tyack, Zephanie

    2011-01-01

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

  20. The influence of He-Ne laser on scar formation after trabeculectomy in rabbits

    PubMed Central

    Hu, Jun; Li, Gui-Gang; Zhang, Hong; Xiang, Nan; Chen, Zhi-Qi; Wang, Rui-Lin; Xiang, Yan; Li, Bin; Li, Zheng-Jia; He, Yan-Yan; Wang, Li-Fang

    2010-01-01

    AIM To investigate the influence of He-Ne lasers on scar formation in the filtration canal after trabeculectomy in a rabbit model, as well as to explore the mechanisms for preventing scar formation when using He-Ne lasers in vivo. METHODS Experiment 1: Four groups were established (four eyes in each group). In 12 eyes, the upper nasal limbus area next to the upper rectus muscle received 10 minutes of He-Ne laser irradiation (100, 150, 200mW/cm2; 60, 90, 120J/cm2) every day for three days. Four eyes served as controls. Twenty-four hours after the final irradiation, the rabbits were sacrificed and the irradiated tissue was excised, fixed with paraformaldehyde and tested for proliferating cell nuclear antigen (PCNA), connective tissue growth factor (CTGF) and apoptosis (TUNEL). Experiment 2: Forty-two rabbits were randomly divided into two groups and standard trabeculectomy was performed in the right eyes either after 200mW/cm2 He-Ne laser irradiation or not in the filtration area. The expression of PCNA and CTGF, apoptosis and collagen density in the filtration area were tested on the 7th, 14th and 28th day after surgery. RESULTS Experiment 1: There were no more PCNA and CTGF positive cells in the He-Ne irradiation group than in the control group. No apoptotic cells were found in either group. Experiment 2: The expression of PCNA and CTGF was lower in the He-Ne irradiation group than in the control group on the 7th and 14th day after trabeculectomy surgery (P<0.05); no apoptotic cells were detected in either group. Collagen density was significantly lower in the He-Ne irradiation group than in the control group on the 14th and 28th day after surgery (P<0.05). CONCLUSION Pretreating the filtration area with 200mW/cm2 (120J/cm2) of He-Ne laser irradiation may be helpful in preventing scar formation after trabeculectomy, possibly due to the downregulation of the expression of PCNA, CTGF and collagen synthesis in fibroblasts. PMID:22553536

  1. Use of makeup, hairstyles, glasses, and prosthetics as adjuncts to scar camouflage.

    PubMed

    Sidle, Douglas M; Decker, Jennifer R

    2011-08-01

    Scars after facial trauma or surgery can be a source of distress for patients, and facial plastic surgeons are frequently called upon to help manage them. Although no technique can remove a scar, numerous treatment modalities have been developed to improve facial scar appearance with varying levels of invasiveness. This article reviews techniques that camouflage scars without surgical intervention. Topical scar treatments, camouflage cosmetics, use of hairstyling and glasses, and facial prosthetics are discussed. In addition, professional counseling is provided on selection and application of topical cosmetics for use as part of an office practice.

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

    PubMed

    Stozkowska, Wiesława

    2002-01-01

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

  3. Interactive effects of growth hormone and exercise on muscle mass in suspended rats

    NASA Technical Reports Server (NTRS)

    Grindeland, Richard E.; Roy, Roland R.; Edgerton, V. Reggie; Grossman, Elena J.; Mukku, Venkat R.; Jiang, Bian; Pierotti, David J.; Rudolph, Ingrid

    1994-01-01

    Measures to attenuate muscle atrophy in rats in response to simulated microgravity (hindlimb suspension (HS)) have been only partially successful. In the present study, hypophysectomized rats were in HS for 7 days, and the effects of recombinant human growth hormone (GH), exercise (Ex), or GH+Ex on the weights, protein concentrations, and fiber cross-sectional areas (CSAs) of hindlimb muscles were determined. The weights of four extensor muscles, i.e., the soleus (Sol), medial (MG) and lateral (LG) gastrocnemius, and plantaris (Plt), and one adductor, i.e., the adductor longus (AL), were decreased by 10-22% after HS. Fiber CSAs were decreased by 34% in the Sol and by 1 17% in the MG after HS. In contrast, two flexors, i.e., the tibialis anterior (TA) and extensor digitorum longus (EDL), did not atrophy. In HS rats, GH treatment alone maintained the weights of the fast extensors (MG, LG, Plt) and flexors (TA, EDL) at or above those of control rats. This effect was not observed in the slow extensor (Sol) or AL. Exercise had no significant effect on the weight of any muscle in HS rats. A combination of GH and Ex treatments yielded a significant increase in the weights of the fast extensors and in the CSA of both fast and slow fibers of the MG and significantly increased Sol weight and CSA of the slow fibers of the Sol. The AL was not responsive to either GH or Ex treatments. Protein concentrations of the Sol and MG were higher only in the Sol of Ex and GH+Ex rats. These results suggest that while GH treatment or intermittent high intensity exercise alone have a minimal effect in maintaining the mass of unloaded muscle, there is a strong interactive effect of these two treatments.

  4. The efficacy of a novel collagen-gelatin scaffold with basic fibroblast growth factor for the treatment of vocal fold scar.

    PubMed

    Hiwatashi, Nao; Hirano, Shigeru; Mizuta, Masanobu; Kobayashi, Toshiki; Kawai, Yoshitaka; Kanemaru, Shin-Ichi; Nakamura, Tatsuo; Ito, Juichi; Kawai, Katsuya; Suzuki, Shigehiko

    2015-06-29

    Vocal fold scar remains a therapeutic challenge. Basic fibroblast growth factor (bFGF) was reported to have regenerative effects for vocal fold scar, although it has the disadvantage of rapid absorption in vivo. A collagen-gelatin sponge (CGS) can compensate for the disadvantage by providing a sustained release system. The current study evaluated the efficacy of CGS combined with bFGF on vocal fold scar, using rat fibroblasts for an in vitro model and a canine in vivo model. We prepared fibroblasts from scarred vocal folds (sVFs) in rats and showed that bFGF accelerated cell proliferation and suppressed expression levels of cleaved caspase 3 and α-smooth muscle actin. Has 1, Has 3, Fgf2, Hgf and Vegfa mRNA levels were significantly upregulated, while Col1a1 and Col3a1 were dose-dependently downregulated, with a maximum effect at 100 ng/ml bFGF. In an in vivo assay, 6 weeks after lamina propria stripping, beagles were divided into three groups: CGS alone (CGS group); CGS with bFGF (7 µg/cm(2) ; CGS + bFGF group); or a sham-treated group. Vibratory examination revealed that the glottal gap was significantly reduced in the bFGF group and the two implanted groups, whereas the CGS + bFGF group showed higher mucosal wave amplitude. Histological examination revealed significantly restored hyaluronic acid and elastin redistribution in the CGS + bFGF group and reductions in dense collagen deposition. These results provide evidence that CGS and bFGF combination therapy may have therapeutic potential and could be a promising tool for treating vocal fold scar. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Predictors of renal scar in children with urinary infection and vesicoureteral reflux.

    PubMed

    Soylu, Alper; Demir, Belde Kasap; Türkmen, Mehmet; Bekem, Ozlem; Saygi, Murat; Cakmakçi, Handan; Kavukçu, Salih

    2008-12-01

    We evaluated the predictors of renal scar in children with urinary tract infections (UTIs) having primary vesicoureteral reflux (VUR). Data of patients who were examined by dimercaptosuccinic acid (DMSA) scintigraphy between 1995 and 2005 were evaluated retrospectively. Gender, age, reflux grade, presence/development of scarring, breakthrough UTIs, and resolution of reflux, were recorded. The relation of gender, age and VUR grade to preformed scarring and the relation of gender, age, VUR grade, presence of preformed scarring, number of breakthrough UTIs and reflux resolution to new scarring were assessed. There were 138 patients [male/female (M/F) 53/85]. Multivariate analysis showed that male gender [odds ratio (OR) 2.5], age > or = 27 months in girls (OR 4.2) and grades IV-V reflux (OR 12.4) were independent indicators of renal scarring. On the other hand, only the presence of previous renal scarring was found to be an independent indicator for the development of new renal scar (OR 13.4). In conclusion, while the most predictive variables for the presence of renal scarring among children presenting with a UTI were male gender, age > or = 27 months in girls, and grades IV-V reflux, the best predictor of new scar formation was presence of previous renal scarring.

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

    PubMed Central

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

    2015-01-01

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

  7. Clinimetric properties and clinical utility in rehabilitation of postsurgical scar rating scales: a systematic review.

    PubMed

    Vercelli, Stefano; Ferriero, Giorgio; Sartorio, Francesco; Cisari, Carlo; Bravini, Elisabetta

    2015-12-01

    The aim of this study was to review and critically assess the most used and clinimetrically sound outcome measures currently available for postsurgical scar assessment in rehabilitation. We performed a systematic review of the Medline and Embase databases to June 2015. All published peer-reviewed studies referring to the development, validation, or clinical use of scales or questionnaires in patients with linear scars were screened. Of 922 articles initially identified in the literature search, 48 full-text articles were retrieved for assessment. Of these, 16 fulfilled the inclusion criteria for data collection. Data were collected pertaining to instrument item domains, validity, reliability, and Rasch analysis. The eight outcome measures identified were as follows: Vancouver Scar Scale, Dermatology Life Quality Index, Manchester Scar Scale, Patient and Observer Scar Assessment Scale, Bock Quality of Life (Bock QoL) questionnaire, Stony Brook Scar Evaluation Scale, Patient-Reported Impact of Scars Measure, and Patient Scar Assessment Questionnaire. Scales were examined for their clinimetric properties, and recommendations for their clinical or research use and selection were made. There is currently no absolute gold standard to be used in rehabilitation for the assessment of postsurgical scars, although the Patient and Observer Scar Assessment Scale and the Patient-Reported Impact of Scars Measure emerged as the most robust scales.

  8. Muscle MRI in Duchenne muscular dystrophy: Evidence of a distinctive pattern.

    PubMed

    Polavarapu, Kiran; Manjunath, Mahadevappa; Preethish-Kumar, Veeramani; Sekar, Deepha; Vengalil, Seena; Thomas, PriyaTreesa; Sathyaprabha, Talakad N; Bharath, Rose Dawn; Nalini, Atchayaram

    2016-11-01

    The purpose of this study was to describe the pattern of muscle involvement using MRI findings and correlate with functional as well as muscle strength measurements. Fifty genetically confirmed DMD children with a mean age of 7.6 ± 2.8 (4-15 years) underwent muscle MRI and qualitative assessment was done for muscle changes using Mercuri staging for fibro-fatty replacement on T1 sequence and Borsato score for myoedema on STIR sequence. Detailed phenotypic characterisation was done with Manual muscle testing (modified MRC grading) and Muscular Dystrophy Functional Rating Scale (MDFRS). Mercuri scoring showed severe fibro-fatty changes in Gluteus medius, minimus and Adductor magnus followed by moderate to severe changes in Gluteus maximus and Quadriceps muscles. Total sparing of Gracilis, Sartorius and Semimembranosus muscles was observed. Superficial posterior and lateral leg muscles were preferentially involved with sparing of deep posterior and anterior leg muscles. Myoedema showed significant inverse correlation with fatty infiltration in thigh muscles. Similarly, significant inverse correlation was observed between Mercuri scores and MRC grading as well as MDFRS scores. A direct linear correlation was observed between duration of illness and fibro-fatty changes in piriformis, quadriceps and superficial posterior leg muscles. There was no correlation between MRI findings and genotypic characteristics. However, this specific pattern of muscle involvement in MRI could aid in proceeding for genetic testing when clinical suspicion is high, thus reducing the need for muscle biopsy. Fibro fatty infiltration as measured by Mercuri scoring can be a useful marker for assessing the disease severity and progression.

  9. Resistance exercise-induced fluid shifts: change in active muscle size and plasma volume

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, L. L.; Convertino, V. A.; Dudley, G. A.

    1995-01-01

    The purpose of this study was to test the hypothesis that the reduction in plasma volume (PV) induced by resistance exercise reflects fluid loss to the extravascular space and subsequently selective increase in cross-sectional area (CSA) of active but not inactive skeletal muscle. We compared changes in active and inactive muscle CSA and PV after barbell squat exercise. Magnetic resonance imaging (MRI) was used to quantify muscle involvement in exercise and to determine CSA of muscle groups or individual muscles [vasti (VS), adductor (Add), hamstring (Ham), and rectus femoris (RF)]. Muscle involvement in exercise was determined using exercise-induced contrast shift in spin-spin relaxation time (T2)-weighted MR images immediately postexercise. Alterations in muscle size were based on the mean CSA of individual slices. Hematocrit, hemoglobin, and Evans blue dye were used to estimate changes in PV. Muscle CSA and PV data were obtained preexercise and immediately postexercise and 15 and 45 min thereafter. A hierarchy of muscle involvement in exercise was found such that VS > Add > Ham > RF, with the Ham and RF showing essentially no involvement. CSA of the VS and Add muscle groups were increased 10 and 5%, respectively, immediately after exercise in each thigh with no changes in Ham and RF CSA. PV was decreased 22% immediately following exercise. The absolute loss of PV was correlated (r2 = 0.75) with absolute increase in muscle CSA immediately postexercise, supporting the notion that increased muscle size after resistance exercise reflects primarily fluid movement from the vascular space into active but not inactive muscle.

  10. Comparison of different laser systems in the treatment of hypertrophic and atrophic scars and keloids

    NASA Astrophysics Data System (ADS)

    Scharschmidt, D.; Algermissen, Bernd; Willms-Jones, J.-C.; Philipp, Carsten M.; Berlien, Hans-Peter

    1997-12-01

    Different laser systems and techniques are used for the treatment of hypertrophic scars, keloids and acne scars. Significant criteria in selecting a suitable laser system are the scar's vascularization, age and diameter. Flashlamp- pumped dye-lasers, CO2-lasers with scanner, Argon and Nd:YAG-lasers are used. Telangiectatic scars respond well to argon lasers, erythematous scars and keloids to dye-laser treatment. Using interstitial Nd:YAG-laser vaporization, scars with a cross-section over 1 cm can generally be reduced. For the treatment of atrophic and acne scars good cosmetic results are achieved with a CO2-laser/scanner system, which allows a precise ablation of the upper dermis with low risk of side-effects.

  11. Transforming medical imaging: the first SCAR TRIP conference a position paper from the SCAR TRIP subcommittee of the SCAR research and development committee.

    PubMed

    Andriole, Katherine P; Morin, Richard L

    2006-03-01

    The First Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Conference and Workshop, "Transforming Medical Imaging" was held on January 31-February 1, 2005 in Bethesda, MD. Representatives from all areas of medical and scientific imaging-academia, research, industry, and government agencies-joined together to discuss the future of medical imaging and potential new ways to manage the explosion in numbers, size, and complexity of images generated by today's continually advancing imaging technologies. The two-day conference included plenary, scientific poster, and breakout sessions covering six major research areas related to TRIP. These topic areas included human perception, image processing and computer-aided detection, data visualization, image set navigation and usability, databases and systems integration, and methodology evaluation and performance validation. The plenary presentations provided a general status review of each broad research field to use as a starting point for discussion in the breakout sessions, with emphasis on specific topics requiring further study. The goals for the breakout sessions were to define specific research questions in each topic area, to list the impediments to carrying out research in these fields, to suggest possible solutions and near- and distant-future directions for each general topic, and to report back to the general session. The scientific poster session provided another mechanism for presenting and discussing TRIP-related research. This report summarizes each plenary and breakout session, and describes the group recommendations as to the issues facing the field, major impediments to progress, and the outlook for radiology in the short and long term. The conference helped refine the definition of the SCAR TRIP Initiative and the problems facing radiology with respect to the dramatic growth in medical imaging data, and it underscored a present and future need

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

    PubMed

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

    2015-03-31

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

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

    PubMed Central

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

    2015-01-01

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

  14. Evaluating lubricant performance by 3D profilometry of wear scars

    NASA Astrophysics Data System (ADS)

    Georgescu, C.; Deleanu, L.; Pirvu, C.

    2016-08-01

    Due to improvement in analysing surface texture and optical instruments for investigating the texture surface, the authors propose to evaluate the lubricant performance by analysing the change in several 3D parameters in comparison to an analysis on 2D profile. All the surface of the wear scar generated on the four ball machine is investigated and the conclusion is that from the tribological point of view, the 3D parameters reflect better the surface quality evolution after testing. Investigation was done on the wear scars generated on the three fixed balls, for five lubricants: a non-additivated transmission mineral oil (T90), two grades of rapeseed oil (coarse degummed and refined) and two grades of soybean oil (coarse and degummed).

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

    PubMed Central

    Bordoni, Bruno; Zanier, Emiliano

    2014-01-01

    Every element or cell in the human body produces substances that communicate and respond in an autocrine or paracrine mode, consequently affecting organs and structures that are seemingly far from each other. The same also applies to the skin. In fact, when the integrity of the skin has been altered, or when its healing process is disturbed, it becomes a source of symptoms that are not merely cutaneous. The skin is an organ, and similar to any other structure, it has different functions in addition to connections with the central and peripheral nervous system. This article examines pathological responses produced by scars, analyzing definitions and differences. At the same time, it considers the subcutaneous fascias, as this connective structure is altered when there is a discontinuous cutaneous surface. The consequence is an ample symptomatology, which is not limited to the body area where the scar is located, such as a postural or trigeminal disorder. PMID:24403836

  16. Overcoming the Low-Learning Scar Effect: Narratives of Learning and Resilience of Italian Low-Skilled

    ERIC Educational Resources Information Center

    Tomassini, Massimo

    2016-01-01

    The idea of the "low-learning scar" is borrowed from recent labour economics literature in which concepts such as "unemployment scarring", "wage scarring" and "scarred generation" are increasingly used for the interpretation of problems (the NEETs problem, for instance) which presently plague all Western…

  17. Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring

    PubMed Central

    Shaikh, Nader; Pohl, Hans; Gravens-Mueller, Lisa; Ivanova, Anastasia; Zaoutis, Lisa; Patel, Melissa; deBerardinis, Rachel; Parker, Allison; Bhatnagar, Sonika; Haralam, Mary Ann; Pope, Marcia; Kearney, Diana; Sprague, Bruce; Barrera, Raquel; Viteri, Bernarda; Egigueron, Martina; Shah, Neha; Hoberman, Alejandro

    2015-01-01

    OBJECTIVES: To identify risk factors for recurrent urinary tract infection (UTI) and renal scarring in children who have had 1 or 2 febrile or symptomatic UTIs and received no antimicrobial prophylaxis. METHODS: This 2-year, multisite prospective cohort study included 305 children aged 2 to 71 months with vesicoureteral reflux (VUR) receiving placebo in the RIVUR (Randomized Intervention for Vesicoureteral Reflux) study and 195 children with no VUR observed in the CUTIE (Careful Urinary Tract Infection Evaluation) study. Primary exposure was presence of VUR; secondary exposures included bladder and bowel dysfunction (BBD), age, and race. Outcomes were recurrent febrile or symptomatic urinary tract infection (F/SUTI) and renal scarring. RESULTS: Children with VUR had higher 2-year rates of recurrent F/SUTI (Kaplan-Meier estimate 25.4% compared with 17.3% for VUR and no VUR, respectively). Other factors associated with recurrent F/SUTI included presence of BBD at baseline (adjusted hazard ratio: 2.07 [95% confidence interval (CI): 1.09–3.93]) and presence of renal scarring on the baseline 99mTc-labeled dimercaptosuccinic acid scan (adjusted hazard ratio: 2.88 [95% CI: 1.22–6.80]). Children with BBD and any degree of VUR had the highest risk of recurrent F/SUTI (56%). At the end of the 2-year follow-up period, 8 (5.6%) children in the no VUR group and 24 (10.2%) in the VUR group had renal scars, but the difference was not statistically significant (adjusted odds ratio: 2.05 [95% CI: 0.86–4.87]). CONCLUSIONS: VUR and BBD are risk factors for recurrent UTI, especially when they appear in combination. Strategies for preventing recurrent UTI include antimicrobial prophylaxis and treatment of BBD. PMID:26055855

  18. Utilizing topical therapies and mitomycin to reduce scars.

    PubMed

    Cupp, Craig; Gaball, Curtis Wesley

    2012-10-01

    Minimizing scar size, width, and contour of elevation is a common goal for the facial plastic surgeon. Various standard techniques are employed to reduce tension and enhance the rapid and uneventful healing of incisions. In some cases, these routine measures are not judged to be adequate, and additional intraoperative and postsurgical measures are employed to control the body's innate healing processes. Mitomycin C and self-drying silicone gel have been particularity useful in our practice.

  19. The Use of Chemotherapeutics for the Treatment of Keloid Scars

    PubMed Central

    Jones, Christopher David; Guiot, Luke; Samy, Mike; Gorman, Mark; Tehrani, Hamid

    2015-01-01

    Keloid scars are pathological scars, which develop as a result of exaggerated dermal tissue proliferation following cutaneous injury and often cause physical, psychological and cosmetic problems. Various theories regarding keloidogenesis exist, however the precise pathophysiological events remain unclear. Many different treatment modalities have been implicated in their management, but currently there is no entirely satisfactory method for treating all keloid lesions. We review a number of different chemotherapeutic agents which have been proposed for the treatment of keloid and hypertrophic scars while giving insight into some of the novel chemotherapeutic drugs which are currently being investigated. Non-randomized trials evaluating the influence of different chemotherapeutic agents, such as 5-fluorouracil (5-FU); mitomycin C; bleomycin and steroid injection, either alone or in combination with other chemotherapeutic agents or alternative treatment modalities, for the treatment of keloids were identified using a predefined PubMed search strategy. Twenty seven papers were identified. Scar improvement ≥50% was found in the majority of cases treated with 5-FU, with similar results found for mitomycin C, bleomycin and steroid injection. Combined intralesional 5-FU and steroid injection produced statistically significant improvements when compared to monotherapy. Monotherapy recurrence rates ranged from 0-47% for 5-FU, 0-15% for bleomycin and 0-50% for steroid injection. However, combined therapy in the form of surgical excision and adjuvant 5-FU or steroid injections demonstrated lower recurrence rates; 19% and 6% respectively. Currently, most of the literature supports the use of combination therapy (usually surgery and adjuvant chemotherapy) as the mainstay treatment of keloids, however further investigation is necessary to determine success rates over longer time frames. Furthermore, there is the potential for novel therapies, but further investigation is

  20. Pressure effects on the growth of human scar fibroblasts.

    PubMed

    Chang, Liang-Wey; Deng, Win-Ping; Yeong, Eng-Kean; Wu, Ching-Yuan; Yeh, Shih-Wei

    2008-01-01

    Although pressure therapy is the mainstay of treatment for hypertrophic scars, its actual mechanism remains unknown. An in vitro study was designed to investigate the effects of positive pressure on the growth of human scar-derived fibroblasts through its transforming growth factor beta1 (TGF-beta1) secretion. A pneumatic pressure system connecting to a cell culture chamber was designed. Six-well cultured plates with fibroblasts implanted were treated with different pressure settings. Cells were treated with constant pressure 20 mm Hg above atmosphere pressure (group A n = 18) or with 40 mm Hg above atmosphere pressure (group B n = 18) daily for nine successive days. Cells without pressure were treated as the control study (group C n = 6). Each experimental group was divided into daily pressure applied at 24 hours (n = 6), 18 hours (n = 6), and 12 hours (n = 6). Cell counting was performed on the 2nd, 4th, 7th, 9th, 11th, and 14th day after implantation. On day 4, the concentration of transforming growth factor beta1 was measured, and cell doubling time was calculated. Compared with the control group, there was a significant decrease in cell count and the concentration in the 18-hour and 24-hour 20 mm Hg or 40 mm Hg pressure treated group. The cell doubling time was significantly increased in the 24-hour 20 mm Hg or 40 mm Hg pressure treated groups, and the 18-hour 40 mm Hg pressure treated group. (P < .05) Pressure inhibits the growth and activity of human scar fibroblasts, and a higher pressure application can shorten the daily application period. There should be an optimal pressure level corresponding to a daily application period to achieve the most effective results on pressure therapy for scars.

  1. Slippery Scar: A New Mushroom Disease in Auricularia polytricha

    PubMed Central

    Sun, Jie

    2012-01-01

    A new disease, the slippery scar, was investigated in cultivated bags of Auricularia polytricha. This fungus was isolated from the infected mycelia of cultivated bags. Based on morphological observation, rDNA-internal transcribed spacer and 18S sequence analysis, this pathogen was identified as the Ascomycete Scytalidium lignicola. According to Koch's Postulation, the pathogenicity of S. lignicola to the mycelia of A. polytricha was confirmed. The parasitism of this fungus on mushroom mycelia in China has not been reported before. PMID:22870056

  2. Three-Dimensional Electromagnetic High Frequency Axisymmetric Cavity Scars.

    SciTech Connect

    Warne, Larry Kevin; Jorgenson, Roy Eberhardt

    2014-10-01

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

  3. Fire scars and ancient sand dunes in southern Australia

    NASA Technical Reports Server (NTRS)

    1994-01-01

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

  4. Cranial muscle development in frogs with different developmental modes: direct development versus biphasic development.

    PubMed

    Ziermann, Janine M; Diogo, Rui

    2014-04-01

    Normal development in anurans includes a free swimming larva that goes through metamorphosis to develop into the adult frog. We have investigated cranial muscle development and adult cranial muscle morphology in three different anuran species. Xenopus laevis is obligate aquatic throughout lifetime, Rana(Lithobates) pipiens has an aquatic larvae and a terrestrial adult form, and Eleutherodactylus coqui has direct developing juveniles that hatch from eggs deposited on leaves (terrestrial). The adult morphology shows hardly any differences between the investigated species. Cranial muscle development of E. coqui shows many similarities and only few differences to the development of Rana (Lithobates) and Xenopus. The differences are missing muscles of the branchial arches (which disappear during metamorphosis of biphasic anurans) and a few heterochronic changes. The development of the mandibular arch (adductor mandibulae) and hyoid arch (depressor mandibulae) muscles is similar to that observed in Xenopus and Rana (Lithobates), although the first appearance of these muscles displays a midmetamorphic pattern in E. coqui. We show that the mix of characters observed in E. coqui indicates that the larval stage is not completely lost even without a free swimming larval stage. Cryptic metamorphosis is the process in which morphological changes in the larva/embryo take place that are not as obvious as in normal metamorphosing anurans with a clear biphasic lifestyle. During cryptic metamorphosis, a normal adult frog develops, indicating that the majority of developmental mechanisms towards the functional adult cranial muscles are preserved.

  5. Comparative functional anatomy of hindlimb muscles and bones with reference to aquatic adaptation of the sea otter.

    PubMed

    Mori, Kent; Suzuki, Satoshi; Koyabu, Daisuke; Kimura, Junpei; Han, Sung-Yong; Endo, Hideki

    2015-05-01

    Although the sea otter (Enhydra lutris) is a complete aquatic species, spending its entire life in the ocean, it has been considered morphologically to be a semi-aquatic animal. This study aimed to clarify the unique hindlimb morphology and functional adaptations of E. lutris in comparison to other Mustelidae species. We compared muscle mass and bone measurements of five Mustelidae species: the sea otter, Eurasian river otter (Lutra lutra), American mink (Neovison vison), Japanese weasel (Mustela itatsi) and Siberian weasel (M. sibirica). In comparison with the other 4 species, E. lutris possessed significantly larger gluteus, popliteus and peroneus muscles, but smaller adductor and ischiopubic muscles. The popliteus muscle may act as a medial rotator of the crus, and the peroneus muscle may act as an abductor of the fifth toe and/or the pronator of the foot. The bundles of the gluteus superficialis muscle of E. lutris were fused with those of the tensor fasciae latae muscle and gluteofemoralis muscles, and they may play a role in femur abduction. These results suggest that E. lutris uses the abducted femur, medially rotated crus, eversion of the ankle and abducted fifth digit or extended interdigital web as a powerful propulsion generator. Therefore, we conclude that E. lutris is a complete aquatic animal, possessing differences in the proportions of the hindlimb muscles compared with those in other semi-aquatic and terrestrial mustelids.

  6. Thigh muscle function in stroke patients revealed by velocity-encoded cine phase-contrast magnetic resonance imaging.

    PubMed

    Wen, Hongmei; Dou, Zulin; Finni, Taija; Havu, Marko; Kang, Zhuang; Cheng, Shumei; Sipilä, Sarianna; Sinha, Shantanu; Usenius, Jussi-Pekka; Cheng, Sulin

    2008-06-01

    Current methods of clinical assessment of muscle coordination and function after stroke do not provide information on deep muscles. The objective of this study was to examine how stroke affects both superficial and deep muscles' coordination and whether muscle function improves after rehabilitation. Muscle function, coordination, and activity of quadriceps femoris (QF) and hamstrings were evaluated in 10 stroke patients with mild hemiparesis and in 6 controls using velocity-encoded cine phase-contrast magnetic resonance imaging (VE-PC MRI), surface electromyography (sEMG), and maximal voluntary isometric contraction torque (MVC). At baseline, the peak muscle velocity of the rectus femoris (RF) and the ratio between the peak velocities of the RF and vasti were lower in the affected limb (AL) of stroke patients than in controls. Co-contraction of agonists and antagonists was higher in the AL than in controls. Muscle activity measured by sEMG showed similar behavior. After rehabilitation, the activity ratio of hamstrings and adductors to QF decreased slightly toward normal so there were no significant differences between the AL and controls. Impaired biarticular RF muscle function in stroke patients is the limiting factor during knee extension-flexion movements. After rehabilitation, improved functional performance was partly explained by the fact that the activities of the RF and vasti became more synchronized. VE-PC MRI can provide quantitative in vivo measurements of both superficial and deep muscles, and the information acquired after stroke can be utilized to render therapy more efficient and individually tailored.

  7. [Phantom studies using echo contrast media to improve the Doppler color sonographic imaging of the superficial femoral artery in the adductor canal].

    PubMed

    Hendrickx, P; Brassel, F; Roth, U; Froehlich, H; Wagner, H H

    1991-01-01

    The adductor canal was simulated using 2.6 cm muscular tissue and 2 fasciae to analyse the limits of colour-coded Doppler sonography (angiodynography) in this region. Defects in the spectral signal cause a significant underestimation of mean, peak systolic and peak diastolic (backflow) velocities and of calculated blood flow. Furthermore the pulsatility index is overestimated and the colour-coded visualisation of the arteries is almost lost. For the most part, these changes can be compensated by administration of a sonographic contrast agent (SH U 454). A minimum of 9 mg microbubbles/ml blood is required. Nevertheless, the adjustment of system controls (e.g. transducer power) becomes more difficult and an ideal setting impossible.

  8. Morphology of the jaw, suspensorial, and opercle musculature of Beloniformes and related species (Teleostei: Acanthopterygii), with a special reference to the m. adductor mandibulae complex.

    PubMed

    Werneburg, Ingmar

    2015-01-01

    The taxon Beloniformes represents a heterogeneous group of teleost fishes that show an extraordinary diversity of jaw morphology. I present new anatomical descriptions of the jaw musculature in six selected beloniforms and four closely related species. A reduction of the external jaw adductor (A1) and a changed morphology of the intramandibular musculature were found in many Beloniformes. This might be correlated with the progressively reduced mobility of the upper and lower jaw bones. The needlefishes and sauries, which are characterised by extremely elongated and stiffened jaws, show several derived characters, which in combination enable the capture of fish at high velocity. The ricefishes are characterised by several derived and many plesiomorphic characters that make broad scale comparisons difficult. Soft tissue characters are highly diverse among hemiramphids and flying fishes reflecting the uncertainty about their phylogenetic position and interrelationship. The morphological findings presented herein may help to interpret future phylogenetic analyses using cranial musculature in Beloniformes.

  9. Morphology of the jaw, suspensorial, and opercle musculature of Beloniformes and related species (Teleostei: Acanthopterygii), with a special reference to the m. adductor mandibulae complex

    PubMed Central

    2015-01-01

    The taxon Beloniformes represents a heterogeneous group of teleost fishes that show an extraordinary diversity of jaw morphology. I present new anatomical descriptions of the jaw musculature in six selected beloniforms and four closely related species. A reduction of the external jaw adductor (A1) and a changed morphology of the intramandibular musculature were found in many Beloniformes. This might be correlated with the progressively reduced mobility of the upper and lower jaw bones. The needlefishes and sauries, which are characterised by extremely elongated and stiffened jaws, show several derived characters, which in combination enable the capture of fish at high velocity. The ricefishes are characterised by several derived and many plesiomorphic characters that make broad scale comparisons difficult. Soft tissue characters are highly diverse among hemiramphids and flying fishes reflecting the uncertainty about their phylogenetic position and interrelationship. The morphological findings presented herein may help to interpret future phylogenetic analyses using cranial musculature in Beloniformes. PMID:25755920

  10. Histological evidence for muscle insertion in extant amniote femora: implications for muscle reconstruction in fossils.

    PubMed

    Petermann, Holger; Sander, Martin

    2013-04-01

    Since the 19th century, identification of muscle attachment sites on bones has been important for muscle reconstructions, especially in fossil tetrapods, and therefore has been the subject of numerous biological and paleontological studies. At the microscopic level, in histological thin sections, the only features that can be used reliably for identifying tendon-bone or muscle-tendon-bone interactions are Sharpey's fibers. Muscles, however, do not only attach to the bone indirectly with tendons, but also directly. Previous studies failed to provide new indicators for muscle attachment, or to address the question of whether muscles with direct attachment can be identified histologically. However, histological identification of direct muscle attachments is important because these attachments do not leave visible marks (e.g. scars and rugosities) on the bone surface. We dissected the right hind limb and mapped the muscle attachment sites on the femur of one rabbit (Oryctolagus cuniculus), one Alligator mississippiensis, and one turkey (Meleagris cuniculus). We then extracted the femur and prepared four histological thin sections for the rabbit and the turkey and five histological thin sections for the alligator. Sharpey's fibers, vascular canal orientation, and a frayed periosteal margin can be indicators for indirect but also direct muscle attachment. Sharpey's fibers can be oriented to the cutting plane of the thin section at high angles, and two Sharpey's fibers orientations can occur in one area, possibly indicating a secondary force axis. However, only about 60% of mapped muscle attachment sites could be detected in thin sections, and frequently histological features suggestive of muscle attachment occurred outside mapped sites. While these insights should improve our ability to successfully identify and reconstruct muscles in extinct species, they also show the limitations of this approach.

  11. 3-D analysis of breast morphology changes after inverted T-scar and vertical-scar reduction mammaplasty over 12 months.

    PubMed

    Eder, Maximilian; Klöppel, Markus; Müller, Daniel; Papadopulos, Nikolaos A; Machens, Hans-Günther; Kovacs, Laszlo

    2013-06-01

    One major objective of all types of breast reduction procedures is to achieve a long-lasting, stable and aesthetically pleasing three-dimensional (3-D) breast shape, but current surgical outcome evaluation is limited. This study compares the extent of soft-tissue oedema and breast tissue migration related to 3-D breast morphology changes after inverted T-scar and vertical-scar breast reduction over 12 months. 3-D breast surface scans of patients undergoing inverted T-scar (n=52 breasts) and vertical-scar (n=44 breasts) reduction mammaplasty were obtained preoperatively and 2-3 days, 1 week, 1 month, 3 months, 6 months, 9 months and 12 months postoperatively. 3-D images were analysed at each time point comparing distances, 3-D breast contour deviations (%), breast surface (cm2) and volume (cc) measurements including volumetric distribution between the upper portion (UP) and the lower portion (LP) of the breast (%). Total postoperative breast volume decreased by 11.7% (T-scar) and by 7.8% (vertical-scar) during the first 3 months (both p<0.001) without relevant changes in the following months, indicating that soft-tissue oedema is resolved after 3 months. The T-scar (vertical-scar) group showed a preoperative UP to LP volumetric distribution of 43:57% (45:55%) versus 86:14% (91:9%) immediately after surgery. Breast tissue significantly redistributes (both p=0.001) from the UP to the LP during the first postoperative year by 16.5% (T-scar) and 21% (vertical-scar), resulting in a final UP to LP ratio of 70:30% for both techniques, without further breast contour deviations (both p>0.05) after 6 months (T-scar) and 9 months (vertical-scar). Breast morphological changes after reduction mammaplasty are completed after a period of 3-6 months in the T-scar group and 6-9 months in the vertical-scar group.

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

    NASA Technical Reports Server (NTRS)

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

    1998-01-01

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

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

    PubMed

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

    2015-02-01

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

  14. Thermal Injury Model in the Rabbit Ear with Quantifiable Burn Progression and Hypertrophic Scar.

    PubMed

    Friedrich, Emily E; Niknam-Bienia, Solmaz; Xie, Ping; Jia, Sheng-Xian; Hong, Seok Jong; Mustoe, Thomas A; Galiano, Robert D

    2017-04-01

    Hypertrophic scar is a major clinical outcome of deep-partial thickness to full thickness thermal burn injury. Appropriate animal models are a limitation to burn research due to the lack of, or access to, animal models which address the endpoint of hypertrophic scar. Lower species, such as rodents, heal mainly by contracture, which limits the duration of study. Higher species, such as pigs, heal more similarly to humans, but are associated with high cost, long duration for scar development, challenges in quantifying scar hypertrophy, and poor manageability. Here we present a quantifiable deep-partial thickness burn model in the rabbit ear. Burns were created using a dry-heated brass rod for 10 s and 20 s at 90°C. At the time of eschar excision on day 3, excisional wounds were made on the contralateral ear for comparison. Burn wound progression, in which the wound size expands over time is a major distinction between excisional and thermal injuries, was quantified at 1 h and 3 d after the injuries using calibrated photographs and histology and the size of the wounds was found to be unchanged from the initial wound size at 1 h, but 10% in the 20 s burn wounds at 3 d. A quantifiable hypertrophic scar, measured by histology as the scar elevation index, was present in both 20 s burn wounds and excisional wounds at day 35. ImageJ measurements revealed that the 20 s burn wound scars were 22% larger than the excisional wound scars and the 20 s burn scar area measurements from histology were 26% greater than in the excisional wound scar. The ability to measure both burn progression and scar hypertrophy over a 35-day time frame suits this model to screening early intervention burn wound therapeutics or scar treatments in a burn-specific scar model. This article is protected by copyright. All rights reserved.

  15. Temporalis Muscle Tendon Unit Transfer for Smile Restoration After Facial Paralysis.

    PubMed

    Owusu Boahene, Kofi D

    2016-02-01

    Temporalis muscle tendon unit (MTU) transfer may be used as a single-stage procedure for dynamic reanimation of the paralyzed face. Principles and biomechanics of muscle function and tendon transposition are essential in optimizing outcome. Critical steps and pearls for success include minimizing scarring, maintaining glide plains, mobilizing adequate tendon length, insertion of MTU at ideal tension based on intraoperative dynamic tension-excursion relationship, and insertion of tendon as close to the lip margin as possible. Because muscles adapt to tension, load, and task changes by altering their sarcomere arrangement and muscle fiber composition, physiotherapy should be initiated to use the repurposed temporalis MTU for smile restoration.

  16. Cranial muscle development in the model organism ambystoma mexicanum: implications for tetrapod and vertebrate comparative and evolutionary morphology and notes on ontogeny and phylogeny.

    PubMed

    Ziermann, Janine M; Diogo, Rui

    2013-07-01

    There is still confusion about the homology of several cranial muscles in salamanders with those of other vertebrates. This is true, in part, because of the fact that many muscles present in early ontogeny of amphibians disappear during development and specifically during metamorphosis. Resolving this confusion is important for the understanding of the comparative and evolutionary morphology of vertebrates and tetrapods because amphibians are the phylogenetically most plesiomorphic tetrapods, concerning for example their myology, and include two often used model organisms, Xenopus laevis (anuran) and Ambystoma mexicanum (urodele). Here we provide the first detailed report of the cranial muscle development in axolotl from early ontogenetic stages to the adult stage. We describe different and complementary types of general muscle morphogenetic gradients in the head: from anterior to posterior, from lateral to medial, and from origin to insertion. Furthermore, even during the development of neotenic salamanders such as axolotls, various larval muscles become indistinct, contradicting the commonly accepted view that during ontogeny the tendency is mostly toward the differentiation of muscles. We provide an updated comparison between these muscles and the muscles of other vertebrates, a discussion of the homologies and evolution, and show that the order in which the muscles appear during axolotl ontogeny is in general similar to their appearance in phylogeny (e.g. differentiation of adductor mandibulae muscles from one anlage to four muscles), with only a few remarkable exceptions, as for example the dilatator laryngis that appears evolutionary later but in the development before the intermandibularis.

  17. Immunolocalization of 5BrdU long retaining labeled cells and macrophage infiltration in the scarring limb of lizard after limb amputation.

    PubMed

    Alibardi, L

    2016-06-01

    After limb amputation in lizards no regeneration occurs following massive inflammatory reaction. Light immunocytochemistry for CD68 and ultrastructural observations show that numerous macrophages persist for over 18days post-amputation in the limb and fibroblasts producing high levels of collagen are present underneath a differentiating wound epidermis. Injections of 5BrdU for 1 week in normal lizards followed by a 4 weeks chase period indicate that most Long Retention Cells are present in the dense connectives of the dermis and inter-muscle septa, sparse cells in bone marrow and epidermis and scattered cells in muscle satellite cells. Most of the fibrocytes forming the scarring outgrowth of the amputated limb likely derive from the proliferation of dermal and inter-muscle fibrocytes after amputation. Differently from the tail where autotomous planes limit the extension of the damage, in the limb the injury produces massive tissue damage that favors intense and lasting inflammation. Numerous CD68 labeled macrophages likely stimulate fibroblast activation and rapid production of collagen fibrils underneath the wound epidermis. The latter does not form a growing apical region but rapidly differentiates into a mature epidermis so that no distal elongation of the limb occurs and a scar is instead formed.

  18. Histological evidence for muscle insertion in extant amniote femora: implications for muscle reconstruction in fossils

    PubMed Central

    Petermann, Holger; Sander, Martin

    2013-01-01

    Since the 19th century, identification of muscle attachment sites on bones has been important for muscle reconstructions, especially in fossil tetrapods, and therefore has been the subject of numerous biological and paleontological studies. At the microscopic level, in histological thin sections, the only features that can be used reliably for identifying tendon–bone or muscle–tendon-bone interactions are Sharpey's fibers. Muscles, however, do not only attach to the bone indirectly with tendons, but also directly. Previous studies failed to provide new indicators for muscle attachment, or to address the question of whether muscles with direct attachment can be identified histologically. However, histological identification of direct muscle attachments is important because these attachments do not leave visible marks (e.g. scars and rugosities) on the bone surface. We dissected the right hind limb and mapped the muscle attachment sites on the femur of one rabbit (Oryctolagus cuniculus), one Alligator mississippiensis, and one turkey (Meleagris cuniculus). We then extracted the femur and prepared four histological thin sections for the rabbit and the turkey and five histological thin sections for the alligator. Sharpey's fibers, vascular canal orientation, and a frayed periosteal margin can be indicators for indirect but also direct muscle attachment. Sharpey's fibers can be oriented to the cutting plane of the thin section at high angles, and two Sharpey's fibers orientations can occur in one area, possibly indicating a secondary force axis. However, only about 60% of mapped muscle attachment sites could be detected in thin sections, and frequently histological features suggestive of muscle attachment occurred outside mapped sites. While these insights should improve our ability to successfully identify and reconstruct muscles in extinct species, they also show the limitations of this approach. PMID:23439026

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

    PubMed

    Fang, Sheng

    2014-10-01

    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.

  20. The Immunomodulatory Effects of Mesenchymal Stem Cells in Prevention or Treatment of Excessive Scars

    PubMed Central

    Jung, Sung-No

    2016-01-01

    Excessive scars, including keloids and hypertrophic scars, result from aberrations in the process of physiologic wound healing. An exaggerated inflammatory process is one of the main pathophysiological contributors. Scars may cause pain, and pruritis, limit joint mobility, and cause a range of cosmetic deformities that affect the patient's quality of life. Extensive research has been done on hypertrophic scar and keloid formation that has resulted in the plethora of treatment and prevention methods practiced today. Mesenchymal stem cells, among their multifunctional roles, are known regulators of inflammation and have been receiving attention as a major candidate for cell therapy to treat or prevent excessive scars. This paper extensively reviews the body of research examining the mechanism and potential of stem cell therapy in the treatment of excessive scars. PMID:26839566

  1. Severe hypoxia and malnutrition collectively contribute to scar fibroblast inhibition and cell apoptosis.

    PubMed

    Lynam, Emily C; Xie, Yan; Dawson, Rebecca; Mcgovern, Jacqui; Upton, Zee; Wang, XiQiao

    2015-09-01

    This study aims to investigate whether severe hypoxia and malnutrition in scar tissue play key roles to induce hypertrophic scar regression. And scar-derived fibroblasts were treated with moderate/severe hypoxia and malnutrition to model condition of proliferative and regressive scar (5%O2 +5%FCS and 0.5%O2  + 0.5%FCS), and normoxia with well nutrition as control (10%O2  + 10%FCS). Our results demonstrated that severe hypoxia and malnutrition resulted in significantly reduced cell viability and collagen production, as well as HIF-1, VEGF, TGF-β1, and Bcl-2 protein expression when compared with control, and cell apoptosis occurred. Therefore, the severe hypoxia and malnutrition in scar tissue contribute to fibroblast inhibition and cell apoptosis, which is correlated with scar regression.

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

    PubMed Central

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

    2011-01-01

    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

  3. A Modeling Approach for Burn Scar Assessment Using Natural Features and Elastic Property

    SciTech Connect

    Tsap, L V; Zhang, Y; Goldgof, D B; Sarkar, S

    2004-04-02

    A modeling approach is presented for quantitative burn scar assessment. Emphases are given to: (1) constructing a finite element model from natural image features with an adaptive mesh, and (2) quantifying the Young's modulus of scars using the finite element model and the regularization method. A set of natural point features is extracted from the images of burn patients. A Delaunay triangle mesh is then generated that adapts to the point features. A 3D finite element model is built on top of the mesh with the aid of range images providing the depth information. The Young's modulus of scars is quantified with a simplified regularization functional, assuming that the knowledge of scar's geometry is available. The consistency between the Relative Elasticity Index and the physician's rating based on the Vancouver Scale (a relative scale used to rate burn scars) indicates that the proposed modeling approach has high potentials for image-based quantitative burn scar assessment.

  4. Cesarean scar pregnancy: uterine artery embolization combined with a hysterectomy at 13 weeks' gestation--a case report and review of the literature.

    PubMed

    Kwaśniewska, Anna; Stupak, Aleksandra; Krzyzanowski, Arkadiusz; Pietura, Radoslaw; Kotarski, Jan

    2014-12-01

    A cesarean scar pregnancy is a pregnancy located within the uterine muscle after previous cesarean sections. Recent years have shown a significant increase in the rate of CS and an improvement in the ultrasound diagnosis, and therefore a trend towards an increase in the rate of CSP cases has been reported in many countries. We report on a case of CSP diagnosed using ultrasound at 5/6 weeks'gestation and confirmedbymagnetic resonance imaging. The patient underwent surgical management at 13 weeks, combined with the chemioembolization of the uterine arteries. The current review aims to update the knowledge of the available treatment modalities.

  5. Fibrosis, adipogenesis, and muscle atrophy in congenital muscular torticollis.

    PubMed

    Chen, Huan-Xiong; Tang, Sheng-Ping; Gao, Fu-Tang; Xu, Jiang-Long; Jiang, Xian-Ping; Cao, Juan; Fu, Gui-Bing; Sun, Ke; Liu, Shi-Zhe; Shi, Wei

    2014-11-01

    In the traditional view, muscle atrophy and interstitial fibrosis were regarded as the basic pathological features of congenital muscular torticollis (CMT). But in the ultrastructure study, the mesenchyme-like cells, myoblasts, myofibroblasts, and fibroblasts were found in the proliferation of interstitium of CMT. To investigate the characteristics of pathological features and the mechanisms of muscle atrophy in CMT, we retrospectively reviewed the medical records of 185 CMT patients from July 2009 to July 2011 in Shenzhen Children's Hospital in China and performed pathological studies. According to age, the 185 CMT patients were divided into 4 groups. All resected surgical specimens were processed for hematoxylin and eosin staining and Masson trichromic staining. Sudan III staining was used for frozen sections, whereas immunohistochemical staining for S-100, calpain-1, ubiquitin, and 20S proteasome was carried out on 40 CMT specimens. Eight adductor muscle specimens from 8 patients with development dysplasia of the hip were taken as control group in the immunohistochemical staining. By Masson trichromic staining, the differences in the percent area of fibrous tissue in each CMT groups were significant. In Sudan III staining and immunostaining for S-100, adipocyte hyperplasia was the pathological feature of CMT. Moreover, compared with controls, most atrophic muscle fibers in CMT specimens were found to show strong immunoreactivity for calpain-1, ubiquitin, and 20S proteasome. With increasing age, fibrosis peaked at both sides and it was low in middle age group. Adipocytes increased with age. The characteristics of pathological features in CMT are changeable with age. The calpain and the ubiquitin-proteasome system may play a role in muscle atrophy of CMT. In the CMT, adipogenesis, fibrogenesis, and myogenesis may be the results of mesenchyme-like cells in SCM (sternocleidomastoid muscle). In conclusion, the present study furthermore supports maldevelopment of the

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

    PubMed

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

    2005-05-01

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

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

    PubMed

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

    2015-01-22

    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.

  8. Ablative fractional resurfacing for the treatment of traumatic scars and contractures.

    PubMed

    Uebelhoer, Nathan S; Ross, E Victor; Shumaker, Peter R

    2012-06-01

    After a decade of military conflict, thousands of wounded warriors have suffered debilitating and cosmetically disfiguring scars and scar contractures. Clearly, there is a need for effective scar treatment regimens to assist in the functional and cosmetic rehabilitation of these patients. Traditional treatments, including aggressive physical and occupational therapy and dedicated wound care, are essential. Adjunctive treatments with established laser technologies, such as vascular lasers and full-field ablative lasers, have had a somewhat limited role in scar contractures due to modest efficacy and/or an unacceptable side effect profile in compromised skin. Refractory scar contractures often require surgical revision, which can be effective, but is associated with additional surgical morbidity and a significant risk of recurrence. Furthermore, current scar treatment paradigms often dictate scar maturation for approximately a year to allow for spontaneous improvement before surgical intervention. Since 2009, the Dermatology Clinic at the Naval Medical Center San Diego has been treating scars and scar contractures in wounded warriors and others using ablative fractionated laser technology. Although traditionally associated with the rejuvenation of aged and photo-damaged skin, our clinical experience and a handful of early reports indicate that laser ablative fractional resurfacing demonstrates promising efficacy and an excellent side effect profile when applied to the functional and cosmetic enhancement of traumatic scars and contractures. This article discusses our clinical experience with ablative fractional resurfacing and its potential prominent role in rehabilitation from traumatic injuries, including a possible shift in scar treatment paradigms toward earlier procedural intervention. Potential benefits include the optimization of scar trajectory and higher levels of full or adapted function in a more favorable time course.

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

    PubMed

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

    2014-01-01

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

  10. Contributions of muscles to mediolateral ground reaction force over a range of walking speeds.

    PubMed

    John, Chand T; Seth, Ajay; Schwartz, Michael H; Delp, Scott L

    2012-09-21

    Impaired control of mediolateral body motion during walking is an important health concern. Developing treatments to improve mediolateral control is challenging, partly because the mechanisms by which muscles modulate mediolateral ground reaction force (and thereby modulate mediolateral acceleration of the body mass center) during unimpaired walking are poorly understood. To investigate this, we examined mediolateral ground reaction forces in eight unimpaired subjects walking at four speeds and determined the contributions of muscles, gravity, and velocity-related forces to the mediolateral ground reaction force by analyzing muscle-driven simulations of these subjects. During early stance (0-6% gait cycle), peak ground reaction force on the leading foot was directed laterally and increased significantly (p<0.05) with walking speed. During early single support (14-30% gait cycle), peak ground reaction force on the stance foot was directed medially and increased significantly (p<0.01) with speed. Muscles accounted for more than 92% of the mediolateral ground reaction force over all walking speeds, whereas gravity and velocity-related forces made relatively small contributions. Muscles coordinate mediolateral acceleration via an interplay between the medial ground reaction force contributed by the abductors and the lateral ground reaction forces contributed by the knee extensors, plantarflexors, and adductors. Our findings show how muscles that contribute to forward progression and body-weight support also modulate mediolateral acceleration of the body mass center while weight is transferred from one leg to another during double support.

  11. Anti-scarring properties of different tryptophan derivatives.

    PubMed

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

    2014-01-01

    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.

  12. Anti-Scarring Properties of Different Tryptophan Derivatives

    PubMed Central

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

    2014-01-01

    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

  13. Relationship Between Scarring and Dog Aggression in Pit Bull-Type Dogs Involved in Organized Dogfighting.

    PubMed

    Miller, Katherine A; Touroo, Rachel; Spain, C Victor; Jones, Kelly; Reid, Pamela; Lockwood, Randall

    2016-11-15

    When pit bull-type dogs are seized in an investigation of organized dogfighting, heavily scarred dogs are often assumed to be highly dog aggressive due to a history of fighting. These dogs may be deemed dangerous and euthanized based on scarring alone. We analyzed our existing data on dogs seized from four dogfighting investigations, examining the relationship between the dogs' scars with aggression towards other dogs. Scar and wound data were tallied in three body zones where dogfighting injuries tend to be concentrated. Dog aggression was assessed using a model dog and a friendly stimulus dog in a standardized behavior evaluation. Scarring and dog aggression were significantly related, more strongly among male (Fisher's Exact p < 0.001) than female dogs (Fisher's Exact p = 0.05). Ten or more scars in the three body zones was a reasonable threshold with which to classify a dog as high risk for dog aggression: 82% of males and 60% of females with such scarring displayed dog aggression. However, because many unscarred dogs were dog aggressive while some highly scarred dogs were not, we recommend collecting behavioral information to supplement scar counts when making disposition decisions about dogs seized in dogfighting investigations.

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

    PubMed

    Ahuja, Rajeev B; Chatterjee, Pallab

    2014-06-01

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

  15. Comparison of the histological morphology between normal skin and scar tissue.

    PubMed

    Yang, Shao-wei; Geng, Zhi-jun; Ma, Kui; Sun, Xiao-yan; Fu, Xiao-bing

    2016-04-01

    Skin wound healing is a complex event, and interrupted wound healing process could lead to scar formation. The aim of this study was to examine the morphological changes of scar tissue. Pathological staining (HE staining, Masson's trichrome staining, methenamine silver staining) was used to evaluate the morphological changes of regenerating epidermis in normal skin and scar tissue, and immunofluorescence staining to detect the expression of collagen IV, a component of basement membrane (BM), and the expression of integrinβ4, a receptor for BM laminins. Additionally, the expression of CK14, CK5, and CK10 was measured to evaluate the proliferation and differentiation of keratinocytes in normal skin and scar tissue. The results showed that the structure of the skin was histologically changed in scar tissue. Collagen IV, expressed under the epidermis of normal skin, was reduced distinctly in scar tissue. Integrinβ4, expressed in the basal layer of normal skin, was found absent in the basal layer of scar tissue. Additionally, it was found that keratinocytes in scarring epidermis were more proliferative than in normal skin. These results indicate that during the skin wound healing, altered formation of BM may affect the proliferation of keratinocytes, reepithelial and tissue remodeling, and then result in scar formation. Thus, remodeling BM structure during wound repair may be beneficial for improving healing in cutaneous wounds during clinical practice.

  16. Autologous Smashed Dermal Graft with Epidermal Re-closure: Modified Technique for Acne Scars

    PubMed Central

    Nagaraju, Umashankar; Chikkaiah, Mahesh K; Raju, Belliappa P; Agarwal, Priyanka

    2016-01-01

    Conventional technique of dermal grafting for acne scars where the source of filler material used is the patient's own dermis requires longer surgical time, recovery period and can result in unsightly scars at the donor area. Hence, it is not suitable for treating a larger number of scars. Furthermore, these dermal grafts are firm and cannot be contoured to fit all types of acne scars. Occurrence of epidermal cyst and secondary infection is another complication if epidermis is not completely removed. Enzymatic techniques need trypsinisation which is expensive and requires laboratory facilities. PMID:28163459

  17. Analysis of scar formation after lower limb lengthening: influence on cosmesis and patient satisfaction.

    PubMed

    Karlen, Law Ka Pui; Yinusa, Wahab; Yan, Lam Shuk; Wang, Kwan Wing; Hoi, Li Yun; John, Leong Chi Yan

    2004-01-01

    Limb lengthening aims to reduce limb length discrepancy, improve cosmesis, and permit more functional mobility. Scarring, however, is a major concern of patients. In this study 25 patients (27 lengthening sites) were assessed; 6 sites were lengthened with Orthofix and 21 sites with Ilizarov. Altogether, 452 pin tract scars were assessed. The mean scar length was 11.5 mm in the Ilizarov group (n=415) and 54.1 mm in the Orthofix group (n=37). The mean scar width was 5.6 mm in the Ilizarov group and 11.5 mm in the Orthofix group. The mean patient satisfaction was 7.3 in the Orthofix group and 5.5 in the Ilizarov group. The mean Vancouver score was 0.66 in the Ilizarov group and 3.1 in the Orthofix group. The scars were shorter and cosmetically better in the Ilizarov group, but patients were more satisfied in the Orthofix group because there were fewer scars. Patients were also more satisfied with the thigh scars than with the leg scars because clothing can easily cover the thigh scars.

  18. Actinic Granuloma Annulare With Scarring and Open Comedones.

    PubMed

    Gavioli, Cfb; Valente, Nys; Sangueza, M; Nico, M M

    2017-02-14

    Actinic granuloma and annular elastolytic giant cell granuloma are variants of granuloma annulare affecting, respectively, sun-exposed and sun-covered skin sites on where, besides classical findings, abundant elastophagocytosis is observed. Here, we report a case of exuberant actinic granuloma annulare that, in addition to extensive scarring, showed multiple overlying open comedones. Markedly dilated follicular infundibula filled with compact masses of laminated keratinous material were observed in proximity to dermal inflammation composed of many histiocytes and multinucleated giant cells in close association with degenerated elastic fibers and abundant elastophagocytosis.

  19. The pectoral fin muscles of the coelacanth Latimeria chalumnae: Functional and evolutionary implications for the fin-to-limb transition and subsequent evolution of tetrapods.

    PubMed

    Miyake, Tsutomu; Kumamoto, Minayori; Iwata, Masamitsu; Sato, Ryuichi; Okabe, Masataka; Koie, Hiroshi; Kumai, Nori; Fujii, Kenichi; Matsuzaki, Koji; Nakamura, Chiho; Yamauchi, Shinya; Yoshida, Kosuke; Yoshimura, Kohtaroh; Komoda, Akira; Uyeno, Teruya; Abe, Yoshitaka

    2016-09-01

    To investigate the morphology and evolutionary origin of muscles in vertebrate limbs, we conducted anatomical dissections, computed tomography and kinematic analyses on the pectoral fin of the African coelacanth, Latimeria chalumnae. We discovered nine antagonistic pairs of pronators and supinators that are anatomically and functionally distinct from the abductor and adductor superficiales and profundi. In particular, the first pronator and supinator pair represents mono- and biarticular muscles; a portion of the muscle fibers is attached to ridges on the humerus and is separated into two monoarticular muscles, whereas, as a biarticular muscle, the main body is inserted into the radius by crossing two joints from the shoulder girdle. This pair, consisting of a pronator and supinator, constitutes a muscle arrangement equivalent to two human antagonistic pairs of monoarticular muscles and one antagonistic pair of biarticular muscles in the stylopod between the shoulder and elbow joints. Our recent kinesiological and biomechanical engineering studies on human limbs have demonstrated that two antagonistic pairs of monoarticular muscles and one antagonistic pair of biarticular muscles in the stylopod (1) coordinately control output force and force direction at the wrist and ankle and (2) achieve a contact task to carry out weight-bearing motion and maintain stable posture. Therefore, along with dissections of the pectoral fins in two lungfish species, Neoceratodus forsteri and Protopterus aethiopicus, we discuss the functional and evolutionary implications for the fin-to-limb transition and subsequent evolution of tetrapods. Anat Rec, 299:1203-1223, 2016. © 2016 Wiley Periodicals, Inc.

  20. Warner-Bratzler shear evaluations of 40 bovine muscles.

    PubMed

    Belew, J B; Brooks, J C; McKenna, D R; Savell, J W

    2003-08-01

    Forty muscles from each of 20 beef carcass sides were used to perform Warner-Bratzler shear (WBS) force determinations for within and among muscle effects. The M. triceps brachii differed (P <0.05) in WBS values between the caput longum and caput laterale, and the M. gluteobiceps differed (P <0.05) in WBS values between the vertebral, cranial, and caudal portions. The M. trapezius did not differ between the pars cervicalis and pars thoracica. Larger muscles were evaluated for location effects within muscles. The M. pectoralis profundus, M. infraspinatus, M. triceps brachii (caput longum), psoas major, and M. semimembranosus all had significant location effects. Muscles were allocated into "very tender," "tender," "intermediate" or "tough" categories. Those muscles considered "very tender" (WBS <3.2 kg) were the diaphragm (outside skirt or wing of diaphragm), M. spinalis, M. infraspinatus, M. iliacus, M. psoas major, M. serratus ventralis, M. biceps brachii, M. obliquus internus abdominis, and M. vastus medius. Muscles considered "tender" (3.2 kg Muscles classified as "intermediate" (3.9 kg adductor, M. vastus lateralis, M. deltoideus, M. latissimus dorsi, M. transversus abdominis, and M. semimembranosus. Muscles classed as "tough" (WBS > 4.6 kg) were the M. extensor carpi radialis, M. trapezius, M. brachialis, M. pectoralis profundus, and M. flexor digitorum superficialis (hind limb). The diaphragm muscle was the most tender (WBS=2.03 kg), and the M. flexor digitorum superficialis was the toughest (WBS=7.74 kg

  1. Muscle atrophy

    MedlinePlus

    ... damage caused by injury, diabetes, toxins, or alcohol Polio ( poliomyelitis ) Spinal cord injury Although people can adapt to ... Guillain-Barré syndrome Hypotonia Muscle cramps Muscular dystrophy Polio Review Date 1/5/2016 Updated by: Joseph ...

  2. Getting Muscles

    MedlinePlus

    ... muscular as a superhero or your favorite professional athlete? Well, the big muscles you're thinking about ... Superheroes, of course, aren't real, and professional athletes are grownups, whose bodies are different from kids' ...

  3. Muscle twitching

    MedlinePlus

    ... patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ... Selcen D. Muscle diseases. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

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

    PubMed Central

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

    2015-01-01

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

  5. Lysyl oxidase activity in human normal skins and postburn scars.

    PubMed

    Hayakawa, T; Hino, N; Fuyamada, H; Nagatsu, T; Aoyama, H

    1976-09-06

    Lysyl oxidase activity of human normal skins derived from the frontal thighs of 33 subjects showed large variations and the mean value was 11 455 +/- 7 172 (S.D.) cpm/g of wet weight tissue. The age of lesion affected the lysyl oxidase activity in postburn scars. Granulation tissues showed a fairly low activity; however, the activity increased sharply within 2--3 months, and reached a significantly higher value than that of normal skin. The high level of activity continued for up to 2--3 years, then gradually decreased to normal range after 5 years or so. Lysyl oxidase activity was detected only after 4 M urea treatment of tissues. Benzylamine oxidase activity also showed large variations in both normal skins and postburn scars, with mean values of: 0.128 +/- 0.077 (S.D.) and 0.145 +/- 0.090 (S.D.) mmol/g of wet weight/h, respectively. No correlation was observed between lysyl oxidase and benzylamine oxidase activities. The granulation tissues showed significantly high values of benzylamine oxidase activity in contrast to the low values of lysyl oxidase activity.

  6. Anesthetic Practices for Laser Rehabilitation of Pediatric Hypertrophic Burn Scars.

    PubMed

    Wong, Brendan M; Keilman, Jeffrey; Zuccaro, Jennifer; Kelly, Charis; Maynes, Jason T; Fish, Joel S

    The use of ablative fractional carbon dioxide laser therapy and pulsed dye laser therapy has led to significant improvements in the rehabilitation of hypertrophic burn scars. However, laser procedures are associated with appreciable pain among pediatric patients. Clinical consensus suggests using general anesthesia for pediatric laser procedures; however, guidelines for perioperative care are lacking. The objective of this quality improvement study is to determine whether a difference exists in postoperative pain outcomes in pediatric patients who receive intraoperative opioid regimens compared with patients who receive opioid-sparing regimens for laser therapy of hypertrophic burn scars. A retrospective review of patients who received laser therapy at a pediatric burn center from April 2014 to May 2015 was performed. Overall, 88 of the 92 procedures reviewed were included. A statistically significant difference was not found between the likelihood of postoperative pain when intraoperative opioid regimens (n = 63) were given compared with opioid-sparing regimens (n = 25) X (1, n = 88) = 2.870, P = .0902. There was also no difference between short-acting (n = 48), long-acting (n = 9), or combination (n = 6) intraoperative opioids compared with opioid-sparing regimens (n = 25) in the likelihood of postoperative pain. Despite the small sample size, the low number of postoperative pain cases is encouraging. Ultimately, these data provide a foundation for developing anesthetic guidelines for pediatric laser procedures. Specifically, clinicians should consider the potential to deliver adequate perioperative care via an opioid-sparing regimen ± adjuvant.

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2015-03-15

    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-1β, IL-6 and TNF-α, 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-1β, IL-6, TNF-α 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.

  9. Biomaterial-based delivery for skeletal muscle repair

    PubMed Central

    Cezar, Christine A.; Mooney, David J.

    2015-01-01

    Skeletal muscle possesses a remarkable capacity for regeneration in response to minor damage, but severe injury resulting in a volumetric muscle loss can lead to extensive and irreversible fibrosis, scarring, and loss of muscle function. In early clinical trials, the intramuscular injection of cultured myoblasts was proven to be a safe but ineffective cell therapy, likely due to rapid death, poor migration, and immune rejection of the injected cells. In recent years, appropriate therapeutic cell types and culturing techniques have improved progenitor cell engraftment upon transplantation. Importantly, the identification of several key biophysical and biochemical cues that synergistically regulate satellite cell fate has paved the way for the development of cell-instructive biomaterials that serve as delivery vehicles for cells to promote in vivo regeneration. Material carriers designed to spatially and temporally mimic the satellite cell niche may be of particular importance for the complete regeneration of severely damaged skeletal muscle. PMID:25271446

  10. Characteristics of tetanic muscle contraction in Parkinson patients.

    PubMed

    Pedersen, S W; Bäckman, E; Oberg, B

    1991-09-01

    The aim of this study was to examine contraction characteristics in striated muscles from Parkinson patients and to measure any changes in characteristics based on changes in medication. Fifteen patients, 9 men and 6 women, mean age 61.6 (range 43-70) with mild to moderate parkinsonism, (Hoehn and Yahr I-III) were investigated, and the results were compared with a group of 8 normal controls (mean age 59.6, range 50-70). Twelve of the patients (7 men and 5 women) were also tested after a 24-h period without medication. Using supramaximal electrical stimulation of the ulnary nerve at the wrist contraction, characteristics in the m. adductor pollicis muscle can be recorded. Stimulation results were printed on a fast paper writer. The following characteristics were recorded: 1) electromechanical delay of contraction EMDc; 2) contraction time to half tetanus CTT1/2; 3) electromechanical delay of relaxation EMDr; 4) relaxation rate RR for 10 ms RR-10; 5) the force produced in the tetanic contraction at stimulus frequencies 5, 10, 20, 50 Hz. The results showed that the in initiation of contraction (EMDc) was normal compared with controls. CTT1/2 was shorter (p less than 0.001) in the group of Parkinson patients compared with normals. EMDr was not changed when compared with normals, but RR-10 was increased, p less than 0.05. Force levels at the different stimulation rates were not significantly changed. After withdrawal of medication all parameters were unchanged. Muscle contraction characteristics in tetanic contraction were found to be abnormal indicating either a possible preactivation in the muscle contraction or a secondary change in the muscles of patients with Parkinson's disease.

  11. Tissue tonometry is a simple, objective measure for pliability of burn scar: is it reliable?

    PubMed

    Lye, Ian; Edgar, Dale W; Wood, Fiona M; Carroll, Sara

    2006-01-01

    Objective measurement of burn scar response to treatment is important to facilitate individual patient care, research, and service development. This work examines the validity and reliability of the tonometer as a means of quantifying scar pliability. Ten burn survivors were recruited into the study. Triplicate measures were taken for each of four scar and one normal skin point. The pliability score from the Vancouver Scar Scale also was used as a comparison. The tonometer demonstrated a high degree of reliability (intraclass correlation coefficients 0.91-0.94). It also was shown to provide a valid measure of pliability by quantifying decreased tissue deformation for scar (2.04 +/- 0.45 mm) compared with normal tissue (3.02 +/- 0.92 mm; t = 4.28, P = .004) and a moderate correlation with Vancouver Scar Scale scores. The tissue tonometer provides a repeatable, objective index of burn scar pliability. Using the methods described, it is a simple, clinically useful technique for monitoring an individual's scar.

  12. Rupture of uterine scar 3 weeks after vaginal birth after cesarean section (VBAC).

    PubMed

    El-Kehdy, Georges I; Ghanem, Joseph K; El-Rahi, Chadi C; Nakad, Toufic I

    2006-06-01

    Uterine scar rupture in vaginal birth after cesarean section (VBAC) usually occurs during labor or after placental extraction. We report herein the case of a patient who had a cesarean section in her first pregnancy and a VBAC in her second. The present one also ended with a normal VBAC and a documented intact scar, which then ruptured three weeks later.

  13. Connexin43 contributes to electrotonic conduction across scar tissue in the intact heart

    NASA Astrophysics Data System (ADS)

    Mahoney, Vanessa M.; Mezzano, Valeria; Mirams, Gary R.; Maass, Karen; Li, Zhen; Cerrone, Marina; Vasquez, Carolina; Bapat, Aneesh; Delmar, Mario; Morley, Gregory E.

    2016-05-01

    Studies have demonstrated non-myocytes, including fibroblasts, can electrically couple to myocytes in culture. However, evidence demonstrating current can passively spread across scar tissue in the intact heart remains elusive. We hypothesize electrotonic conduction occurs across non-myocyte gaps in the heart and is partly mediated by Connexin43 (Cx43). We investigated whether non-myocytes in ventricular scar tissue are electrically connected to surrounding myocardial tissue in wild type and fibroblast-specific protein-1 driven conditional Cx43 knock-out mice (Cx43fsp1KO). Electrical coupling between the scar and uninjured myocardium was demonstrated by injecting current into the myocardium and recording depolarization in the scar through optical mapping. Coupling was significantly reduced in Cx43fsp1KO hearts. Voltage signals were recorded using microelectrodes from control scars but no signals were obtained from Cx43fsp1KO hearts. Recordings showed significantly decreased amplitude, depolarized resting membrane potential, increased duration and reduced upstroke velocity compared to surrounding myocytes, suggesting that the non-excitable cells in the scar closely follow myocyte action potentials. These results were further validated by mathematical simulations. Optical mapping demonstrated that current delivered within the scar could induce activation of the surrounding myocardium. These data demonstrate non-myocytes in the scar are electrically coupled to myocytes, and coupling depends on Cx43 expression.

  14. Burn Patient Acuity Demographics, Scar Contractures and Rehabilitation Treatment Time Related to Patient Outcomes (ACT)

    DTIC Science & Technology

    2011-10-01

    Patient Acuity Demographics, Scar Contractures and Rehabilitation Treatment Time Related to Patient Outcomes (ACT) Mr. Reginald Richard American Burn...and Rehabilitation Treatment Time Related to Patient Outcomes, conveniently referred to as the ACT representing Acuity, Contractures and Time, is...wound leading to scar contracture begins almost immediately after the burning process stops. Rehabilitation treatment delivered prior to beginning

  15. Lesion of a lower lip scar--an initial presentation of sarcoidosis.

    PubMed

    Ribeiro de Castro, Maria Cristina; Maya, Tullia Cuzzi; Pereira, Lea Freitas; Lugon, Nilza Viana; Ramos-e-Silva, Marcia

    2002-09-01

    The development of sarcoidosis at the site of previous scar is unusual and may be the first sign of systemic disease. Sarcoidosis on a lower lip scar persisting for 13 years, which pointed to examination for internal manifestations, is presented along with a review of the subject

  16. Keratosis follicularis spinulosa decalvans: a rare cause of scarring alopecia in two young Indian girls.

    PubMed

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

    2013-01-01

    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.

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

    PubMed Central

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

    2013-01-01

    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

  18. A Mathematical Model of Regenerative Axon Growing along Glial Scar after Spinal Cord Injury

    PubMed Central

    Chen, Xuning; Zhu, Weiping

    2016-01-01

    A major factor in the failure of central nervous system (CNS) axon regeneration is the formation of glial scar after the injury of CNS. Glial scar generates a dense barrier which the regenerative axons cannot easily pass through or by. In this paper, a mathematical model was established to explore how the regenerative axons grow along the surface of glial scar or bypass the glial scar. This mathematical model was constructed based on the spinal cord injury (SCI) repair experiments by transplanting Schwann cells as bridge over the glial scar. The Lattice Boltzmann Method (LBM) was used in this model for three-dimensional numerical simulation. The advantage of this model is that it provides a parallel and easily implemented algorithm and has the capability of handling complicated boundaries. Using the simulated data, two significant conclusions were made in this study: (1) the levels of inhibitory factors on the surface of the glial scar are the main factors affecting axon elongation and (2) when the inhibitory factor levels on the surface of the glial scar remain constant, the longitudinal size of the glial scar has greater influence on the average rate of axon growth than the transverse size. These results will provide theoretical guidance and reference for researchers to design efficient experiments. PMID:27274762

  19. 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...

  20. Inactivation of Salmonella on tomato stem scars by acidic sanitizing solutions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tomato stem scars are a likely contamination point for Salmonella, although they are recalcitrant to decontamination. Investigating stem scar sanitation may represent a worst-case-scenario model for inactivating Salmonella from externally-contaminated tomatoes. A composite of Salmonella Saintpau...

  1. Troponin-like regulation in muscle thin filaments of the mussel Crenomytilus grayanus (Bivalvia: Mytiloida).

    PubMed

    Vyatchin, Ilya G; Shevchenko, Ulyana V; Lazarev, Stanislav S; Matusovsky, Oleg S; Shelud'ko, Nikolay S

    2015-10-01

    Muscles of bivalve molluscs have double calcium regulation--myosin-linked and actin-linked. While the mechanism of myosin-linked regulation is sufficiently studied, there is still no consensus on the mechanism of actin-linked regulation. Earlier we showed a high degree of Ca2+-sensitivity of thin filaments from the adductor muscle of the mussel Crenomytilus grayanus (Mytiloida). In order to elucidate the nature of this regulation, we isolated the fraction of minor proteins from the mussel thin filaments, which confers Ca2+-sensitivity to reconstituted actomyosin-tropomyosin. Proteins of this fraction, ABP-19, ABP-20, and ABP-28, were chromatographically purified and identified. According to the results of mass spectrometry and Western blot analysis, as well as by their functional properties, these mussel actin-binding proteins appeared to correspond to the troponin components from the skeletal muscles of vertebrates (TnC, TnI and TnT). The reconstituted mussel troponin complex confers to actomyosin-tropomyosin more than 80% Ca2+-sensitivity. The in vivo molar ratio of actin/tropomyosin/troponin was calculated to be 7:1:0.5, i.e., the content of troponin in mussel thin filaments is two times lower than in thin filaments of skeletal muscles of vertebrates. These data demonstrate that troponin-like regulation found in the catch muscle of the mussel C. grayanus is present at least in two suborders of bivalves: Pectinoida and Mytiloida.

  2. A clinical case and anatomical study of the innervation supply of the vastus medialis muscle.

    PubMed

    Ozer, H; Tekdemir, I; Elhan, A; Turanli, S; Engebretsen, L

    2004-03-01

    The innervation supply to the vastus medialis (VM) muscle, a component of quadriceps femoris (QF), is provided by a branch of the femoral nerve (FN) running along the muscle. The course of the nerve from lumbar roots to the muscle has been described by many researchers. It is known to ride along the femoral vein, artery and saphenous nerve and enter the adductor canal (Hunter's canal), and then to divide into branches that supply vastus medialis and the knee joint. Femoral mononeuropathy is uncommon, and is usually due to compression in the spinal level. Hematoma in the psoas and iliacus muscles, drug abuse, lithotomy position and limb lengthening are the other associated reasons for a mononeuropathy of the femoral nerve. Isolated vastus lateralis (VL) atrophies have been reported by a few authors, suggesting that compression of the nerve and direct violation of the nerve with injections might be the reason for mononeuropathy. Isolated VM atrophy has not been previously reported. The purpose of the study was to identify the anatomical structures around the FN branch which innervates the VM muscle.

  3. Effective treatment of acne scars using pneumatic injection of hyaluronic acid.

    PubMed

    Patel, Tapan; Tevet, Oren

    2015-01-01

    Acne scars remain a challenging condition to treat despite multiple currently available technologies. This study evaluated the clinical efficacy and safety of pneumatic injections of Hyaluronic Acid in the treatment of acne scars. Two patients (Fitzpatrick skin type IV-V) with acne scars received two sessions of pneumatic, needleless injections of crosslinked hyaluronic acid (HA) at 4-week intervals. The treatment response was assessed by comparing pre- and 3-month posttreatment clinical photography. The patients' acne scar grade improved from 2 to 1 in the first case, and 3 to 2 in the second case, based on independent physician assessment. Patient degree of satisfaction was similar to the physicians' assessment. No significant adverse events were noted. We conclude that pneumatic injection technology to deliver HA to the tissue is an effective and safe method for improving acne scars, even in patients with dark complexion.

  4. Ineffectual Medical Treatment of Cesarean Scar Ectopic Pregnancy With Systemic Methotrexate: A Report of Two Cases.

    PubMed

    Kelekçi, Sefa; Aydoğmuş, Serpil; Aydoğmuş, Hüseyin; Eriş, Serenat; Demirel, Emine; Şen Selim, Halime

    2014-01-01

    The implantation of a pregnancy within the scar of a previous cesarean section is known as a "cesarean scar pregnancy." Its incidence was reported to be 6.1%. However, with the increasing rates of cesarean sections, the incidence is expected to rise. A variety of conservative and surgical treatment modalities have been proposed for the management of cesarean scar pregnancy; however, there are no optimal universal treatment guidelines because of its rarity. Treatment should be tailored to the individual patient. It is obvious that more scar pregnancies will be seen in the future and therefore a set of criteria for the choice of various modes of management should be developed. Here, we present 2 cases of cesarean scar pregnancies treated with a local injection of potassium chloride after the failure of methotrexate administration.

  5. Targeted killing of myofibroblasts by biosurfactant di-rhamnolipid suggests a therapy against scar formation

    PubMed Central

    Shen, Chong; Jiang, Lifang; Shao, Huawei; You, Chuangang; Zhang, Guoliang; Ding, Sitong; Bian, Tingwei; Han, Chunmao; Meng, Qin

    2016-01-01

    Pathological myofibroblasts are often involved in skin scarring via generating contractile force and over-expressing collagen fibers, but no compound has been found to inhibit the myofibroblasts without showing severe toxicity to surrounding physiological cells. Here we report that di-rhamnolipid, a biosurfactant secreted by Pseudomonas aeruginosa, showed potent effects on scar therapy via a unique mechanism of targeted killing the myofibroblasts. In cell culture, the fibroblasts-derived myofibroblasts were more sensitive to di-rhamnolipid toxicity than fibroblasts at a concentration-dependent manner, and could be completely inhibited of their specific functions including α-SMA expression and collagen secretion/contraction. The anti-fibrotic function of di-rhamnolipid was further verified in rabbit ear hypertrophic scar models by presenting the significant reduction of scar elevation index, type I collagen fibers and α-SMA expression. In this regard, di-rhamnolipid treatment could be suggested as a therapy against skin scarring. PMID:27901027

  6. Successful pregnancy after excision of cesarean scar endometriosis with uterovesicocutaneous fistula: A rare case report

    PubMed Central

    Juneja, Sunil Kumar; Tandon, Pooja; Chopra, Isha

    2016-01-01

    Scar endometriosis is an infrequent type of extrapelvic endometriosis. The most common extrapelvic form of endometriosis is cutaneous endometriosis, involving scar tissues occurring after obstetric or gynecologic procedures such as episiotomy, hysterotomy, cesarean section, and even laparoscopic surgery. The clinical presentation of scar endometriosis, i.e., tender swellings, mimics other dermatological and/or surgical conditions and delays the diagnosis. Scar endometriosis very rarely can get complicated with uterocutaneous fistula with a reported incidence of very few cases in world literature. We report a case of a 36-year-old woman presenting with scar endometriosis with complicated uterocutaneous fistula 11 years after her last lower segment cesarean section, managed successfully with laparotomy-fistulectomy and sleeve resection of the bladder with repair followed by successful subsequent spontaneous conception and pregnancy terminated by lower segment cesarean section. PMID:27857904

  7. Fractional CO2 lasers for the treatment of atrophic acne scars: a review of the literature.

    PubMed

    Magnani, Lauren Rose; Schweiger, Eric S

    2014-04-01

    This review examines the efficacy and safety of fractional CO2 lasers for the treatment of atrophic scarring secondary to acne vulgaris. We reviewed 20 papers published between 2008 and 2013 that conducted clinical studies using fractional CO2 lasers to treat atrophic scarring. We discuss the prevalence and pathogenesis of acne scarring, as well as the laser mechanism. The histologic findings are included to highlight the ability of these lasers to induce the collagen reorganization and formation that improves scar appearance. We considered the number of treatments and different laser settings to determine which methods achieve optimal outcomes. We noted unique treatment regimens that yielded superior results. An overview of adverse effects is included to identify the most common ones. We concluded that more studies need to be done using uniform treatment parameters and reporting in order to establish which fractional CO2 laser treatment approaches allow for the greatest scar improvement.

  8. Follicular density and ratios in scarring and nonscarring alopecia.

    PubMed

    Horenstein, Marcelo G; Bacheler, Christian J

    2013-12-01

    Follicular counts from transverse sectioning of scalp biopsies have not been statistically scrutinized across disease entities in a standardized fashion. We applied uniform histological criteria and strict statistical measures to compare nonscarring and scarring alopecia. We studied 700 consecutive cases including 355 nonscarring alopecia [136 telogen effluvium, 115 alopecia areata (AA), 95 androgenetic alopecia, and 9 trichotillosis] and 345 scarring alopecia [238 central centrifugal cicatricial alopecia, 29 traction alopecia, 26 lichen planopilaris, 21 end-stage alopecia, 20 lupus erythematosus, 11 folliculitis decalvans]. We counted follicular units, anagen, catagen/telogen, and vellus-like follicles at the central follicular unit level. We calculated follicular density per square centimeter, anagen percentage, telogen percentage, anagen to telogen ratio, and terminal to vellus ratio (TVR). The following achieved statistical significance (P < 0.05): follicular density was 249.4 ± 4.6 in nonscarring alopecia versus 120.1 ± 3.8 in scarring alopecia, follicular density of telogen effluvium was 273.5 ± 7.0 (36.5 ± 12.5 above nonscarring alopecia mean), TVR of androgenetic alopecia was 1.6 ± 0.1 (3.6 ± 0.5 below nonscarring alopecia mean), TVR of AA was 3.2 ± 0.4 (1.5 ± 0.6 below nonscarring alopecia mean), anagen percentage of AA was 26.8 ± 1.8 (26.3 ± 3.0 below nonscarring alopecia mean), anagen to telogen ratio of AA was 1.6 ± 0.4 (3.9 ± 0.7 below nonscarring alopecia mean), and telogen percentage of AA was 59.0 ± 2.3 (31.0 ± 3.5 above nonscarring alopecia mean). There exists a great overlap of densities and ratios across the various disorders due to the limited nature of the punch biopsy sample, variations in scalp anatomy, disease biology and duration, patient gender, and age, etc. Our data provide a bell curve distribution that helps analyze hair counts in the clinicopathologic context.

  9. A biomechanical model for analysis of muscle force, power output and lower jaw motion in fishes.

    PubMed

    Westneat, Mark W

    2003-08-07

    Fish skulls are complex kinetic systems with movable components that are powered by muscles. Cranial muscles for jaw closing pull the mandible around a point of rotation at the jaw joint using a third-order lever mechanism. The present study develops a lever model for the jaw of fishes that uses muscle design and the Hill equation for nonlinear length-tension properties of muscle to calculate dynamic power output. The model uses morphometric data on skeletal dimensions and muscle proportions in order to predict behavior and force transmission mediated by lever action. The computer model calculates a range of dynamic parameters of jaw function including muscle force, torque, effective mechanical advantage, jaw velocity, bite duration, bite force, work and power. A complete list of required morphometrics is presented and a software program (MandibLever 2.0) is available for implementing lever analysis. Results show that simulations yield kinematics and timing profiles similar to actual fish feeding events. Simulation of muscle properties shows that mandibles reach their peak velocity near the start of jaw closing, peak force at the end of jaw closing, and peak power output at about 25% of the closing cycle time. Adductor jaw muscles with different mechanical designs must have different contractile properties and/or different muscle activity patterns to coordinate jaw closing. The effective mechanical advantage calculated by the model is considerably lower than the mechanical advantage estimated from morphological lever ratios, suggesting that previous studies of morphological lever ratios have overestimated force and underestimated velocity transmission to the mandible. A biomechanical model of jaw closing can be used to interpret the mechanics of a wide range of jaw mechanisms and will enable studies of the functional results of developmental and evolutionary changes in skull morphology and physiology.

  10. Characterization and structure of the manganese-responsive transcriptional regulator ScaR.

    PubMed

    Stoll, Kate E; Draper, William E; Kliegman, Joseph I; Golynskiy, Misha V; Brew-Appiah, Rhoda A T; Phillips, Rebecca K; Brown, Hattie K; Breyer, Wendy A; Jakubovics, Nicholas S; Jenkinson, Howard F; Brennan, Richard G; Cohen, Seth M; Glasfeld, Arthur

    2009-11-03

    The streptococcal coaggregation regulator (ScaR) of Streptococcus gordonii is a manganese-dependent transcriptional regulator. When intracellular manganese concentrations become elevated, ScaR represses transcription of the scaCBA operon, which encodes a manganese uptake transporter. A member of the DtxR/MntR family of metalloregulators, ScaR shares sequence similarity with other family members, and many metal-binding residues are conserved. Here, we show that ScaR is an active dimer, with two dimers binding the 46 base pair scaC operator. Each ScaR subunit binds two manganese ions, and the protein is activated by a variety of other metal ions, including Cd(2+), Co(2+), and Ni(2+) but not Zn(2+). The crystal structure of apo-ScaR reveals a tertiary and quaternary structure similar to its homologue, the iron-responsive regulator DtxR. While each DtxR subunit binds a metal ion in two sites, labeled primary and ancillary, crystal structures of ScaR determined in the presence of Cd(2+) and Zn(2+) show only a single occupied metal-binding site that is novel to ScaR. The site analogous to the primary site in DtxR is unoccupied, and the ancillary site is absent from ScaR. Instead, metal ions bind to ScaR at a site labeled "secondary", which is composed of Glu80, Cys123, His125, and Asp160 and lies roughly 5 A away from where the ancillary site would be predicted to exist. This difference suggests that ScaR and its closely related homologues are activated by a mechanism distinct from that of either DtxR or MntR.

  11. Lasting mantle scars lead to perennial plate tectonics

    PubMed Central

    Heron, Philip J.; Pysklywec, Russell N.; Stephenson, Randell

    2016-01-01

    Mid-ocean ridges, transform faults, subduction and continental collisions form the conventional theory of plate tectonics to explain non-rigid behaviour at plate boundaries. However, the theory does not explain directly the processes involved in intraplate deformation and seismicity. Recently, damage structures in the lithosphere have been linked to the origin of plate tectonics. Despite seismological imaging suggesting that inherited mantle lithosphere heterogeneities are ubiquitous, their plate tectonic role is rarely considered. Here we show that deep lithospheric anomalies can dominate shallow geological features in activating tectonics in plate interiors. In numerical experiments, we found that structures frozen into the mantle lithosphere through plate tectonic processes can behave as quasi-plate boundaries reactivated under far-field compressional forcing. Intraplate locations where proto-lithospheric plates have been scarred by earlier suturing could be regions where latent plate boundaries remain, and where plate tectonics processes are expressed as a ‘perennial' phenomenon. PMID:27282541

  12. Lasting mantle scars lead to perennial plate tectonics.

    PubMed

    Heron, Philip J; Pysklywec, Russell N; Stephenson, Randell

    2016-06-10

    Mid-ocean ridges, transform faults, subduction and continental collisions form the conventional theory of plate tectonics to explain non-rigid behaviour at plate boundaries. However, the theory does not explain directly the processes involved in intraplate deformation and seismicity. Recently, damage structures in the lithosphere have been linked to the origin of plate tectonics. Despite seismological imaging suggesting that inherited mantle lithosphere heterogeneities are ubiquitous, their plate tectonic role is rarely considered. Here we show that deep lithospheric anomalies can dominate shallow geological features in activating tectonics in plate interiors. In numerical experiments, we found that structures frozen into the mantle lithosphere through plate tectonic processes can behave as quasi-plate boundaries reactivated under far-field compressional forcing. Intraplate locations where proto-lithospheric plates have been scarred by earlier suturing could be regions where latent plate boundaries remain, and where plate tectonics processes are expressed as a 'perennial' phenomenon.

  13. Lasting mantle scars lead to perennial plate tectonics

    NASA Astrophysics Data System (ADS)

    Heron, Philip J.; Pysklywec, Russell N.; Stephenson, Randell

    2016-06-01

    Mid-ocean ridges, transform faults, subduction and continental collisions form the conventional theory of plate tectonics to explain non-rigid behaviour at plate boundaries. However, the theory does not explain directly the processes involved in intraplate deformation and seismicity. Recently, damage structures in the lithosphere have been linked to the origin of plate tectonics. Despite seismological imaging suggesting that inherited mantle lithosphere heterogeneities are ubiquitous, their plate tectonic role is rarely considered. Here we show that deep lithospheric anomalies can dominate shallow geological features in activating tectonics in plate interiors. In numerical experiments, we found that structures frozen into the mantle lithosphere through plate tectonic processes can behave as quasi-plate boundaries reactivated under far-field compressional forcing. Intraplate locations where proto-lithospheric plates have been scarred by earlier suturing could be regions where latent plate boundaries remain, and where plate tectonics processes are expressed as a `perennial' phenomenon.

  14. [Cause and prevention of surgical site infection and hypertrophic scars].

    PubMed

    Ogawa, Rei

    2012-03-01

    Surgical site infection (SSI) occurs at the site of surgery within 1 month of an operation or within 1 year of an operation if a foreign body is implanted as part of the surgery. Most SSIs (about 70%) are superficial infections involving the skin and subcutaneous tissues only. The remaining infections are more serious and can involve tissues under the skin, organs, or implanted material. Hypertrophic scars( HSs) occur frequently on particular sites, including the anterior chest wall. The anterior chest wall is frequently subjected to skin stretching caused by the natural daily movements of the body. Most cases of SSIs and HSs can be prevented by (1) suture technique modification to prevent high stretching tension and ischemia, and (2) appropriate wound care after surgery. It would be useful to avoid subjecting wounded skin to sustained mechanical force, thereby permitting the wound to rest and heal normally.

  15. Mathematical modeling of chemotaxis and glial scarring around implanted electrodes

    NASA Astrophysics Data System (ADS)

    Silchenko, Alexander N.; Tass, Peter A.

    2015-02-01

    It is well known that the implantation of electrodes for deep brain stimulation or microelectrode probes for the recording of neuronal activity is always accompanied by the response of the brain’s immune system leading to the formation of a glial scar around the implantation sites. The implantation of electrodes causes massive release of adenosine-5‧-triphosphate (ATP) and different cytokines into the extracellular space and activates the microglia. The released ATP and the products of its hydrolysis, such as ADP and adenosine, become the main elements mediating chemotactic sensitivity and motility of microglial cells via subsequent activation of P2Y2,12 as well as A3A/A2A adenosine receptors. The size and density of an insulating sheath around the electrode, formed by microglial cells, are important criteria for the optimization of the signal-to-noise ratio during microelectrode recordings or parameters of electrical current delivered to the brain tissue. Here, we study a purinergic signaling pathway underlying the chemotactic motion of microglia towards implanted electrodes as well as the possible impact of an anti-inflammatory coating consisting of the interleukin-1 receptor antagonist. We present a model describing the formation of a stable aggregate around the electrode due to the joint chemo-attractive action of ATP and ADP and the mixed influence of extracellular adenosine. The bioactive coating is modeled as a source of chemo-repellent located near the electrode surface. The obtained analytical and numerical results allowed us to reveal the dependences of size and spatial location of the insulating sheath on the amount of released ATP and estimate the impact of immune suppressive coating on the scarring process.

  16. Fire Scars Area Estimation Using CHRIS PROBA Satellite Data

    NASA Astrophysics Data System (ADS)

    Filchev, Lachezar; Dimitrov, Petar

    2013-12-01

    The dawn of 21st century is marked by severe and unpredictable natural and man - made hazards and disasters linked as to climate change as to human impact on environment. To study their effects on natural landscapes and protected areas it is important to perform, in some restrict regime protected areas, a continuous monitoring. Earth observation by satellites is one of the most promising instruments for this as it has the necessary time, spatial, and spectral resolution for this as well as it provides for non-contact estimation of the overall condition of the environment. This study presents preliminary results of fire scars area estimation on the territory of Bistrishko Branishte UNESCO Man and Biosphere (MAB) reserve in Vitosha Mountain, Bulgaria using CHRIS/PROBA satellite data. During the summer and early autumn of 2012 CHRIS/PROBA instrument was tasked to perform a series of acquisitions with a view to study the vegetation structure. The study uses two CHRIS/PROBA scenes acquired subsequently on 22 June 2012 and on 28 September 2012. The wildfire, which effects are studied, took place during the first two weeks of July 2012. After it was settled the second acquisition of CHRIS/PROBA instrument made possible the analysis of the post fire situation. The methods used for the study are the standard methods for image change detection based on spectral data employed in ENVI software (Academic license). In order to perform the change detection, the CHRIS/PROBA source data was geometrically and atmospherically corrected as well as co-registered. The multi angle product of CHRIS/PROBA Mode 1, consisting of 5 images, was used to check to what extent the five viewing angles affect the area estimation of the fire scars in the mountainous area following same procedures. The results from the analysis shown that almost 60 hectares from the coniferous vegetation (dead and healthy tree stands) were devastated by the wildfire.

  17. Inhibitory effect of biopolymer materials on scar formation following trabeculectomy

    PubMed Central

    Sha, Qian; Jiao, Guang-Yu; Cui, Hai-Bin; Jie, Wang; Sun, Li-Bin; Chen, Ming; Fu, Song-Bin

    2011-01-01

    AIM To investigate the inhibitory effects of amniotic membrane, polylactic acid membrane and chitosan membrane on scar formation following trabeculectomy. METHODS A total of 24 New Zealand white rabbits (48 eyes) were randomly divided into 4 groups: amniotic membrane group, polylactic acid membrane group, chitosan membrane group, and control group, with 6 rabbits (12 eyes) in each group. The left eyes underwent routine trabeculectomy, and the right eyes were considered as controls. Amniotic membrane, polylactic acid membrane and chitosan membrane were respectively installed under sclera flap in three groups, but any treatment was not applied in control group. Intraocular pressure, conjunctival filtering bleb, and anterior chamber inflammation responses were monitored at day 1, 3, 7, 14, 28 and 56 post-operatively. Eyeball tissue underwent histopathological examination at day 56 post-operatively. RESULTS Fibrocytes and inflammatory cells were reduced in amniotic membrane, polylactic acid membrane and chitosan membrane groups compared to that in control group. At day 1 post-operatively, intraocular pressure was decreased in three membrane groups compared to that in control group. At day 14 post-operatively, the intraocular pressure was decreased significantly, while it of three membrane groups was significantly lower than that of preoperative (P<0.01). There were no significant differences among three membrane groups (P>0.05). Filtering bleb of four groups was clearly observed at day 7 post-operatively, but there was no significant difference in pair-wise comparison. At day 28 and 56 post-operatively, filtering bleb in control group was significantly narrowed compared to that in three membrane groups (P<0.05), but there was no significant difference in pair-wise comparison of three membrane groups. CONCLUSION All amniotic membrane, polylactic acid membrane and chitosan membrane can effectively inhibit scar formation following trabeculectomy, the effect of amniotic

  18. In vitro mechanical compression induces apoptosis and regulates cytokines release in hypertrophic scars.

    PubMed

    Renò, Filippo; Sabbatini, Maurizio; Lombardi, Francesca; Stella, Maurizio; Pezzuto, Carla; Magliacani, Gilberto; Cannas, Mario

    2003-01-01

    Hypertrophic scars resulting from severe burns are usually treated by continuous elastic compression. Although pressure therapy reaches success rates of 60-85% its mechanisms of action are still poorly understood. In this study, apoptosis induction and release of interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were evaluated in normal (n = 3) and hypertrophic (=7) scars from burns after in vitro mechanical compression. In the absence of compression (basal condition) apoptotic cells, scored using terminal deoxyribonucleotidyl transferase assay, were present after 24 hours in the derma of both normal scar (23 +/- 0.4% of total cell) and hypertrophic scar (11.3 +/- 1.4%). Mechanical compression (constant pressure of 35 mmHg for 24 hours) increased apoptotic cell percentage both in normal scar (29.5 +/- 0.4%) and hypertrophic scar (29 +/- 1.7%). IL-1beta released in the medium was undetectable in normal scar under basal conditions while in hypertrophic scar the IL-1beta concentration was 3.48 +/- 0.2 ng/g. Compression in hypertrophic scar-induced secretion of IL-1beta twofold higher compared to basal condition. (7.72 +/- 0.2 ng/g). TNF-alpha basal concentration measured in normal scar medium was 8.52 +/- 4.01 ng/g and compression did not altered TNF-alpha release (12.86 +/- 7.84 ng/g). TNF-alpha basal release was significantly higher in hypertrophic scar (14.74 +/- 1.42 ng/g) compared to normal scar samples and TNF-alpha secretion was diminished (3.52 +/- 0.97 ng/g) after compression. In conclusion, in our in vitro model, mechanical compression resembling the clinical use of elastocompression was able to strongly increase apoptosis in the hypertrophic scar derma as observed during granulation tissue regression in normal wound healing. Moreover, the observed modulation of IL-1beta and TNF-alpha release by mechanical loading could play a key role in hypertrophy regression induced by elastocompression.

  19. Mapping of intramuscular tenderness and muscle fiber orientation of muscles in the beef round.

    PubMed

    Senaratne, L S; Calkins, C R; de Mello, A S; Pokharel, S; Hinkle, J B

    2010-09-01

    Intramuscular tenderness variation and muscle fiber orientation of beef M. adductor femoris (AF), M. biceps femoris (BF), M. gracilis (GL), M. pectineus (PT), M. sartorius (SR), M. semimembranosus (SM), M. semitendinosus (SO), M. vastus intermedius (VI), M. vastus medialis (VM), and M. vastus lateralis (VL) were investigated. The USDA Choice boxed beef subprimals were purchased and aged for 14 d from boxed date. The AF, BF, GL, PT, SR, SM, SO, VI, VM, and VL (n = 10 each) were fabricated from subprimals. Crust-frozen AF, BF, SO, SM, and VL were cut into 2.54-cm steaks perpendicular to the long axis and grilled (71 degrees C). The PT, SR, VI, and VM were grilled (71 degrees C) as whole muscles, whereas the GL was grilled after cutting into anterior and posterior regions. Grilled muscles were cut into equal size sections perpendicular to long axis of muscles. Location-specific cores were prepared from each steak/section, and Warner-Bratzler shear force (WBSF) was measured. The muscle fiber orientations of BF, PT, and VI were bipennate, SR and SO were fusiform, and AD, SM, VL, GL, and VM were unipennate. The overall mean WBSF values for BF, SO, AF, SM, PT, SR, GL, VI, VM, and VL were 5.62, 4.86, 4.18, 4.90, 3.76, 4.44, 4.75, 4.78, 4.24, and 6.53 kg, respectively. Based on WBSF values, PT was tender, BF and VL were tough, and VM, VI, SM, GL SR, AF, and SO were intermediate. The first 2 proximal steaks of long head BF were more tender than the rest (P < 0.05). In the SO, the tenderness decreased from the middle of the muscle to both ends (P < 0.05). The anterior sides of the long head BF and SO were tougher than their posterior sides (P < 0.05).The first 4 steaks of the SM were more tender than the rest of the muscle (P < 0.05). There was a significant tenderness increment from the middle of the AF and SR to both ends of each muscle (P < 0.05). The medial side of the VI was more tender than its lateral side (P < 0.05). The VM had its smallest shear force value at the

  20. Muscle strain (image)

    MedlinePlus

    A muscle strain is the stretching or tearing of muscle fibers. A muscle strain can be caused by sports, exercise, a ... something that is too heavy. Symptoms of a muscle strain include pain, tightness, swelling, tenderness, and the ...

  1. Musculotopic organization of the motor neurons supplying the mouse hindlimb muscles: a quantitative study using Fluoro-Gold retrograde tracing.

    PubMed

    Bácskai, Tímea; Rusznák, Zoltán; Paxinos, George; Watson, Charles

    2014-01-01

    We have mapped the motor neurons (MNs) supplying the major hindlimb muscles of transgenic (C57/BL6J-ChAT-EGFP) and wild-type (C57/BL6J) mice. The fluorescent retrograde tracer Fluoro-Gold was injected into 19 hindlimb muscles. Consecutive transverse spinal cord sections were harvested, the MNs counted, and the MN columns reconstructed in 3D. Three longitudinal MN columns were identified. The dorsolateral column extends from L4 to L6 and consists of MNs innervating the crural muscles and the foot. The ventrolateral column extends from L1 to L6 and accommodates MNs supplying the iliopsoas, gluteal, and quadriceps femoris muscles. The middle part of the ventral horn hosts the central MN column, which extends between L2 and L6 and consists of MNs for the thigh adductor, hamstring, and quadratus femoris muscles. Within these longitudinal columns, the arrangement of the different MN groups reflects their somatotopic organization. MNs innervating muscles developing from the dorsal (e.g., quadriceps) and ventral muscle mass (e.g., hamstring) are situated in the lateral and medial part of the ventral gray, respectively. MN pools belonging to proximal muscles (e.g., quadratus femoris and iliopsoas) are situated ventral to those supplying more distal ones (e.g., plantar muscles). Finally, MNs innervating flexors (e.g., posterior crural muscles) are more medial than those belonging to extensors of the same joint (e.g., anterior crural muscles). These data extend and modify the MN maps in the recently published atlas of the mouse spinal cord and may help when assessing neuronal loss associated with MN diseases.

  2. The Role of Magnetic Resonance Imaging in Athletic Pubalgia and Core Muscle Injury.

    PubMed

    Coker, Dana J; Zoga, Adam C

    2015-08-01

    Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury. Beyond these established patterns of MRI findings, there are many confounders and contributing pathologies about the pelvis in patients with activity related groin pain, including internal and periarticular derangements of the hip. The MRI is ideally suited to delineate the extent of expected injury and to identify the unexpected visceral and musculoskeletal lesions.

  3. Should Cesarean Scar Defect Be Treated Laparoscopically? A Case Report and Review of the Literature.

    PubMed

    Api, Murat; Boza, Aysen; Gorgen, Husnu; Api, Olus

    2015-01-01

    Several obstetric complications due to inappropriately healed cesarean scar such as placenta accreta, scar dehiscence, and ectopic scar pregnancy are increasingly reported along with rising cesarean rates. Furthermore, many gynecologic conditions, including abnormal uterine bleeding, pelvic pain and infertility, are imputed to deficient cesarean scar healing. Hysteroscopy is the most commonly reported approach for the revision of cesarean scar defects (CSDs). Nevertheless, existing evidence is inadequate to conclude that either hysteroscopy or laparoscopy is effective or superior to each other. Although several management options have been suggested recently, the laparoscopic approach has not been thoroughly scrutinized. We present a case and reviewed the data related to the laparoscopic repair of CSDs and compared the hysteroscopic and laparoscopic management options based on the data from previously published articles. As a result of our analyses, the laparoscopic approach increases uterine wall thickness when compared with the hysteroscopic approach, and both surgical techniques seem to be effective for the resolution of gynecologic symptoms. Hysteroscopic treatment most likely corrects the scar defect but does not strengthen the uterine wall; thus, the potential risk of dehiscence or rupture in subsequent pregnancies does not seem to be improved. Because large uterine defects are known risk factors for scar dehiscence, the repair of the defect to reinforce the myometrial endurance seems to be an appropriate method of treatment.

  4. Use of radiofrequency in cosmetic dermatology: focus on nonablative treatment of acne scars

    PubMed Central

    Simmons, Brian J; Griffith, Robert D; Falto-Aizpurua, Leyre A; Nouri, Keyvan

    2014-01-01

    Acne is a common affliction among many teens and some adults that usually resolves over time. However, the severe sequela of acne scarring can lead to long-term psychological and psychiatric problems. There exists a multitude of modalities to treat acne scars such as more invasive surgical techniques, subcision, chemical peels, ablative lasers, fractional lasers, etc. A more recent technique for the treatment of acne scars is nonablative radiofrequency (RF) that works by passing a current through the dermis at a preset depth to produce small thermal wounds in the dermis which, in turn, stimulates dermal remodeling to produce new collagen and soften scar defects. This review article demonstrates that out of all RF modalities, microneedle bipolar RF and fractional bipolar RF treatments offers the best results for acne scarring. An improvement of 25%–75% can be expected after three to four treatment sessions using one to two passes per session. Treatment results are optimal approximately 3 months after final treatment. Common side effects can include transient pain, erythema, and scabbing. Further studies are needed to determine what RF treatment modalities work best for specific scar subtypes, so that further optimization of RF treatments for acne scars can be determined. PMID:25540589

  5. A SCAR-based method for rapid identification of four major lepidopterous stored-product pests.

    PubMed

    Yao, Me-Chi; Chang, Shu-Chen; Lee, Chi-Yang; Lu, Kuang-Hui

    2012-06-01

    Since Taiwan became a World Trade Organization member in 2002, large quantities of grain have been imported from different countries, and insect pests are frequently intercepted from these imported commodities in quarantine inspection. Because most insects are intercepted as immature forms, morphological identification is problematic; therefore, we developed a DNA identification method based on a sequence-characterized amplified region- polymerase chain reaction (SCAR-PCR). Three sets of multiplex SCAR-PCR mixtures, namely SCAR-I, -II, and -III, were developed with each set composed of four species-specific primer pairs derived from the genomic DNA of four major lepidopterous stored-product pests: Corcyra cephalonica (Stainton), Cadra cautella (Walker), Sitotroga cerealella Oliver, and Plodia interpunctella (Hübner). The SCAR-I amplicons of C. cephalonica, C. cautella, S. cerealella, and P. interpunctella were 205, 550, 324, 382 bp, respectively, while those of SCAR-II were 341, 565, 261, and 170 bp, and those of SCAR-III were 514, 555, 445, and 299 bp. These multiplex PCR mixtures could sensitively and unambiguously detect and identify in approximately 5 h individuals among the four lepidopterous pests intercepted in imported stored-products. In summary, the SCAR-PCR method we developed represents a rapid, sensitive and accurate technique for identifying insect species of stored products in plant quarantine operation.

  6. The persistence of epiphyseal scars in the distal radius in adult individuals.

    PubMed

    Davies, Catriona; Hackman, Lucina; Black, Sue

    2016-01-01

    The use of radiographic imaging in the estimation of chronological age facilitates the analysis of structures not visible on gross morphological inspection. Following the completion of epiphyseal fusion, a thin radio-opaque band, the epiphyseal scar, may be observed at the locus of the former growth plate. The obliteration of this feature has previously been interpreted as the final stage of skeletal maturation and consequently has been included as a criterion in several methods of age estimation, particularly from the distal radius. Due to the recommendations relating to age estimation in living individuals, accurate assessment of age from the distal radius is of great importance in human identification; however, the validity of the interpretation of the obliteration of the epiphyseal scar as an age-related process has not been tested. A study was undertaken to assess the persistence of epiphyseal scars in adults between 20 and 50 years of age through the assessment of 616 radiographs of left and right distal radii from a cross-sectional population. This study found that 86% of females and 78% of males retained some remnant of the epiphyseal scar in the distal radius. The relationships between chronological age, biological sex and the persistence of the epiphyseal scar were not statistically significant. The findings of this study indicate that the epiphyseal scars may persist in adult individuals until at least 50 years of age. No maximum age should therefore be applied to the persistence of an epiphyseal scar in the distal radius.

  7. Effect of intense pulsed light on immature burn scars: A clinical study

    PubMed Central

    Sarkar, Arindam; Dewangan, Yatindra Kumar; Bain, Jayanta; Rakshit, Pritha; Dhruw, Krishnanand; Basu, Sandip Kanti; Saha, Jayanta Kumar; Majumdar, Bijay Kumar

    2014-01-01

    Introduction: As intense pulsed light (IPL) is widely used to treat cutaneous vascular malformations and also used as non-ablative skin rejunuvation to remodel the skin collagen. A study has been undertaken to gauze the effect of IPL on immature burn scars with regard to vascularity, pliability and height. Materials and Methods: This study was conducted between June 2013 and May 2014, among patients with immature burn scars that healed conservatively within 2 months. Photographic evidence of appearance of scars and grading and rating was done with Vancouver Scar Scale parameters. Ratings were done for both case and control scar after the completion of four IPL treatment sessions and were compared. Results: Out of the 19 cases, vascularity, pliability and height improved significantly (P < 0.05) in 13, 14 and 11 scars respectively following IPL treatment. Conclusions: Intense pulsed light was well-tolerated by patients, caused good improvement in terms of vascularity, pliability, and height of immature burn scar. PMID:25593424

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

    PubMed Central

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

    2015-01-01

    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. PMID:25750848

  9. Echocardiography as a Screening Test for Myocardial Scarring in Children with Hypertrophic Cardiomyopathy

    PubMed Central

    Nield, Lynne; Dragulescu, Andreea; Benson, Lee

    2016-01-01

    Introduction. Hypertrophic cardiomyopathy (HCM) is burdened with morbidity and mortality including tachyarrhythmias and sudden cardiac death. These complications are attributed in part to the formation of proarrhythmic scars in the myocardium. The presence of extensive LGE is a risk factor for adverse outcomes in HCM. Late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (cMRI) is the standard for the noninvasive evaluation of myocardial scars. However, echocardiography represents an attractive screening tool for myocardial scarring. The aim of this study was to compare the suitability of echocardiography to detect myocardial scars to the standard of cMRI-LGE. Methods. The cMRI studies and echocardiograms from 56 consecutive children with HCM were independently evaluated for the presence of cMRI-LGE and echocardiographic evidence of scarring by expert readers. Results. Echocardiography had a high sensitivity (93%) and negative predictive value (94%) in comparison to LGE. The false positive rate was high, leading to a low specificity (37%) and a low positive predictive value (35%). Conclusions. Given the poor specificity and positive predictive value, echocardiography is not a suitable screening test for the presence of myocardial scarring in children with HCM. However, children without echocardiographic evidence of myocardial scarring may not need to undergo cardiac magnetic resonance imaging to “rule in” LGE. PMID:27974896

  10. The principal structure of male genital sclerites and muscles of bombycoid moths, with special reference to Anthelidae (Lepidoptera: Bombycoidea).

    PubMed

    Zwick, Andreas

    2009-03-01

    Male genital structures and muscles of bombycoid moths have repeatedly been misidentified in the literature. Furthermore, the genital structures of some bombycoid families, such as the poorly known Australo-New Guinean Anthelidae, have essentially remained unstudied. Based on comparative morphology, this study details the principal arrangements of male genital sclerites and muscles in all bombycoid families, with particular focus on basic structures and their modifications in Anthelidae. Emphasis is placed on the homology of and fusions between these structures and their function, providing a basis for the interpretation of modifications in future phylogenetic and taxonomic studies. This includes the unique fusion of gnathos and valvae in several bombycoid families, the arrangement and extent of the fused tegumen and vinculum, as well as the homology of the "transtilla". Further, a modification of the valve adductor muscle (the segment IX sternum to valva muscle, m4) widely regarded as a synapomorphy of Bombycoidea is demonstrated to be non-existent, as is the presumed presence of the valve abductor muscle (the segment IX tergum to valva muscle, m2) in Saturniidae.

  11. Evolution of a Novel Muscle Design in Sea Urchins (Echinodermata: Echinoidea)

    PubMed Central

    Ziegler, Alexander; Schröder, Leif; Ogurreck, Malte; Faber, Cornelius; Stach, Thomas

    2012-01-01

    The sea urchin (Echinodermata: Echinoidea) masticatory apparatus, or Aristotle's lantern, is a complex structure composed of numerous hard and soft components. The lantern is powered by various paired and unpaired muscle groups. We describe how one set of these muscles, the lantern protractor muscles, has evolved a specialized morphology. This morphology is characterized by the formation of adaxially-facing lobes perpendicular to the main orientation of the muscle, giving the protractor a frilled aspect in horizontal section. Histological and ultrastructural analyses show that the microstructure of frilled muscles is largely identical to that of conventional, flat muscles. Measurements of muscle dimensions in equally-sized specimens demonstrate that the frilled muscle design, in comparison to that of the flat muscle type, considerably increases muscle volume as well as the muscle's surface directed towards the interradial cavity, a compartment of the peripharyngeal coelom. Scanning electron microscopical observations reveal that the insertions of frilled and flat protractor muscles result in characteristic muscle scars on the stereom, reflecting the shapes of individual muscles. Our comparative study of 49 derived “regular” echinoid species using magnetic resonance imaging (MRI) shows that frilled protractor muscles are found only in taxa belonging to the families Toxopneustidae, Echinometridae, and Strongylocentrotidae. The onset of lobe formation during ontogenesis varies between species of these three families. Because frilled protractor muscles are best observed in situ, the application of a non-invasive imaging technique was crucial for the unequivocal identification of this morphological character on a large scale. Although it is currently possible only to speculate on the functional advantages which the frilled muscle morphology might confer, our study forms the anatomical and evolutionary framework for future analyses of this unusual muscle design among

  12. Evolution of a novel muscle design in sea urchins (Echinodermata: Echinoidea).

    PubMed

    Ziegler, Alexander; Schröder, Leif; Ogurreck, Malte; Faber, Cornelius; Stach, Thomas

    2012-01-01

    The sea urchin (Echinodermata: Echinoidea) masticatory apparatus, or Aristotle's lantern, is a complex structure composed of numerous hard and soft components. The lantern is powered by various paired and unpaired muscle groups. We describe how one set of these muscles, the lantern protractor muscles, has evolved a specialized morphology. This morphology is characterized by the formation of adaxially-facing lobes perpendicular to the main orientation of the muscle, giving the protractor a frilled aspect in horizontal section. Histological and ultrastructural analyses show that the microstructure of frilled muscles is largely identical to that of conventional, flat muscles. Measurements of muscle dimensions in equally-sized specimens demonstrate that the frilled muscle design, in comparison to that of the flat muscle type, considerably increases muscle volume as well as the muscle's surface directed towards the interradial cavity, a compartment of the peripharyngeal coelom. Scanning electron microscopical observations reveal that the insertions of frilled and flat protractor muscles result in characteristic muscle scars on the stereom, reflecting the shapes of individual muscles. Our comparative study of 49 derived "regular" echinoid species using magnetic resonance imaging (MRI) shows that frilled protractor muscles are found only in taxa belonging to the families Toxopneustidae, Echinometridae, and Strongylocentrotidae. The onset of lobe formation during ontogenesis varies between species of these three families. Because frilled protractor muscles are best observed in situ, the application of a non-invasive imaging technique was crucial for the unequivocal identification of this morphological character on a large scale. Although it is currently possible only to speculate on the functional advantages which the frilled muscle morphology might confer, our study forms the anatomical and evolutionary framework for future analyses of this unusual muscle design among sea

  13. Making better scar: Emerging approaches for modifying mechanical and electrical properties following infarction and ablation.

    PubMed

    Holmes, Jeffrey W; Laksman, Zachary; Gepstein, Lior

    2016-01-01

    Following myocardial infarction (MI), damaged myocytes are replaced by collagenous scar tissue, which serves an important mechanical function - maintaining integrity of the heart wall against enormous mechanical forces - but also disrupts electrical function as structural and electrical remodeling in the infarct and borderzone predispose to re-entry and ventricular tachycardia. Novel emerging regenerative approaches aim to replace this scar tissue with viable myocytes. Yet an alternative strategy of therapeutically modifying selected scar properties may also prove important, and in some cases may offer similar benefits with lower risk or regulatory complexity. Here, we review potential goals for such modifications as well as recent proof-of-concept studies employing specific modifications, including gene therapy to locally increase conduction velocity or prolong the refractory period in and around the infarct scar, and modification of scar anisotropy to improve regional mechanics and pump function. Another advantage of scar modification techniques is that they have applications well beyond MI. In particular, ablation treats electrical abnormalities of the heart by intentionally generating scar to block aberrant conduction pathways. Yet in diseases such as atrial fibrillation (AF) where ablation can be extensive, treating the electrical disorder can significantly impair mechanical function. Creating smaller, denser scars that more effectively block conduction, and choosing the location of those lesions by balancing their electrical and mechanical impacts, could significantly improve outcomes for AF patients. We review some recent advances in this area, including the use of computational models to predict the mechanical effects of specific lesion sets and gene therapy for functional ablation. Overall, emerging techniques for modifying scar properties represents a potentially important set of tools for improving patient outcomes across a range of heart diseases

  14. Semi-automated scar detection in delayed enhanced cardiac magnetic resonance images

    NASA Astrophysics Data System (ADS)

    Morisi, Rita; Donini, Bruno; Lanconelli, Nico; Rosengarden, James; Morgan, John; Harden, Stephen; Curzen, Nick

    2015-06-01

    Late enhancement cardiac magnetic resonance images (MRI) has the ability to precisely delineate myocardial scars. We present a semi-automated method for detecting scars in cardiac MRI. This model has the potential to improve routine clinical practice since quantification is not currently offered due to time constraints. A first segmentation step was developed for extracting the target regions for potential scar and determining pre-candidate objects. Pattern recognition methods are then applied to the segmented images in order to detect the position of the myocardial scar. The database of late gadolinium enhancement (LE) cardiac MR images consists of 111 blocks of images acquired from 63 patients at the University Hospital Southampton NHS Foundation Trust (UK). At least one scar was present for each patient, and all the scars were manually annotated by an expert. A group of images (around one third of the entire set) was used for training the system which was subsequently tested on all the remaining images. Four different classifiers were trained (Support Vector Machine (SVM), k-nearest neighbor (KNN), Bayesian and feed-forward neural network) and their performance was evaluated by using Free response Receiver Operating Characteristic (FROC) analysis. Feature selection was implemented for analyzing the importance of the various features. The segmentation method proposed allowed the region affected by the scar to be extracted correctly in 96% of the blocks of images. The SVM was shown to be the best classifier for our task, and our system reached an overall sensitivity of 80% with less than 7 false positives per patient. The method we present provides an effective tool for detection of scars on cardiac MRI. This may be of value in clinical practice by permitting routine reporting of scar quantification.

  15. Sevoflurane enhances neuromuscular blockade by increasing the sensitivity of skeletal muscle to neuromuscular blockers

    PubMed Central

    Ye, Ling; Zuo, Yunxia; Zhang, Peng; Yang, Pingliang

    2015-01-01

    The aim of this study was to investigate the effects of sevoflurane on skeletal muscle contractility. In the first part, twenty-two American Society of Anesthesiology (ASA I-II) female adult patients undergoing elective hysterectomy surgery inhaled sevoflurane 1.0, 1.5 and 2.0 minimum alveolar concentrations (MAC) in succession. Neuromuscular function was assessed at each dose. In the second part, forty-four ASA I-II female adult patients were randomized into four groups: group 1 (propofol + atracurium, sevoflurane 0 MAC), and groups 2 to 4 (atracurium + sevoflurane 1.0, 1.5 and 2.0 MAC, respectively). In group 1, patients were anesthetized by propofol. Then 0.01 mg/kg atracurium was injected into the tested arm intravenously after the arterial blood flow was blocked using a tourniquet. For the other 3 groups, patients inhaled 1.0 MAC, 1.5 MAC, or 2.0 MAC of sevoflurane. Then 0.01 mg/kg atracurium was injected. Neuromuscular function was recorded for the 4 groups. Neuromuscular function was assessed by acceleromyography measurement of evoked responses to train-of four (TOF) stimuli (2 Hz for 2 s applied every 12 s) at the adductor pollicis using a TOF-GuardTM neuromuscular transmission monitor. Amplitudes of first response (T1) in each TOF sequence and the ratios of fourth TOF response (T4) to the first were similar at 1.0 MAC, 1.5 MAC, and 2.0 MAC sevoflurane. Compared to baseline, there was no significant change in the TOF value after inhaling 1.0 MAC, 1.5 MAC, or 2.0 MAC sevoflurane. Compared to group 1, there was no significant difference in atracurium onset time (time to reach TOF ratio = 0.25) in group 2 ( 5.6 ± 1.8 min vs. 6.5 ± 1.7 min, P>0.05), or degree of adductor pollicis block (subject number with TOF ratio = 0, 5 vs. 2 subjects, p = 0.3). However, inhaling 1.5 or 2.0 MAC sevoflurane decreased atracurium onset time (4.6 ± 1.5 min and 4.0 ± 1.3 min vs. 6.5 ± 1.7 min, P<0.01 and P<0.001, respectively), and enhanced the block degree (9 and 10 vs. 2

  16. [Study on the progress of the mechanism of TGF-beta in the scarring and the effect of TCM].

    PubMed

    Wang, Rong-Guo; Zhou, Wei; Zhang, Yong-Dong

    2008-02-01

    Transforming growth factor (TGF-beta) plays a central role in wound healing and scarring. TGF-beta is a member of cytokine family, involving cell proliferation, migration, differentiation and apoptosis, which subsequently trigger extracellular matrix (ECM) deposite and collagen overproduction. A number of regulators of TGF-beta expression bave been identified, including Decorin CTGF, etc. TCM can reduced later scarring, and it accelerates wound healing. TCM can reduce the expression of TGF-beta, resistance of fibrosis, so that lighten the development of scar. This article reviewed the mechanism of TGF-beta in the scarring and TCM can decrease the development of scar effected by TGF-beta.

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  18. Quantitative differentiation of normal and scarred tissues using second-harmonic generation microscopy.

    PubMed

    Yildirim, Murat; Quinn, Kyle P; Kobler, James B; Zeitels, Steven M; Georgakoudi, Irene; Ben-Yakar, Adela

    2016-11-01

    The aim of this study was to differentiate normal and scarred hamster cheek pouch samples by applying a quantitative image analysis technique for determining collagen fiber direction and density in second-harmonic generation microscopy images. This paper presents a collagen tissue analysis of scarred cheek pouches of four adult male Golden Syrian hamsters as an animal model for vocal fold scarring. One cheek pouch was scarred using an electrocautery unit and the other cheek was used as a control for each hamster. A home-built upright microscope and a compact ultrafast fiber laser were used to acquire depth resolved epi-collected second-harmonic generation images of collagen fibers. To quantify the average fiber direction and fiber density in each image, we applied two-dimensional Fourier analysis and intensity thresholding at five different locations for each control and scarred tissue sample, respectively. The resultant depth-resolved average fiber direction variance for scarred hamster cheek pouches (0.61 ± 0.03) was significantly lower (p < 0.05) than control tissue (0.73 ± 0.04), indicating increased fiber alignment within the scar. Depth-resolved average voxel density measurements indicated scarred tissues contained greater (p < 0.005) fiber density (0.72 ± 0.09) compared to controls (0.18 ± 0.03). In the present study, image analysis of both fiber alignment and density from depth-resolved second-harmonic generation images in epi-detection mode enabled the quantification of the increased collagen fiber deposition and alignment typically observed in fibrosis. The epi-detection geometry is the only viable method for in vivo imaging as well as imaging thick turbid tissues. These quantitative endpoints, clearly differentiating between control and scarred hamster cheek pouches, provide an objective means to characterize the extent of vocal fold scarring in vivo in preclinical and clinical research. In particular, this non-invasive method

  19. Depressed scar after filler injection successfully treated with pneumatic needleless injector and radiofrequency device.

    PubMed

    Seok, Joon; Choi, Sun Young; Park, Kui Young; Jang, Ji Hye; Bae, Joon Ho; Kim, Beom Joon; Kim, Myeung Nam; Hong, Chang Kwon

    2016-01-01

    Fillers are known to be associated with a number of side effects, one of the most severe being skin necrosis. The most vulnerable areas are those that are supplied by a single arterial branch; for example, the glabellar and nasolabial folds are susceptible. In this study, we report good cosmetic outcomes were produced by utilizing the pneumatic needleless injector and radiofrequency device to treat depressed scars that occurred after necrosis following filler injection. Initially, applying light-emitting diode treatment and following through with the two devices appears to have synergistic effects for scar remodeling when dealing with treatment of depressed scars with irregular borders.

  20. Relationship Between Scarring and Dog Aggression in Pit Bull-Type Dogs Involved in Organized Dogfighting

    PubMed Central

    Miller, Katherine A.; Touroo, Rachel; Spain, C. Victor; Jones, Kelly; Reid, Pamela; Lockwood, Randall

    2016-01-01

    Simple Summary Organizations responsible for placing dogs seized from dogfighting investigations often must determine if a particular dog should be euthanized because it is too dangerous or if it is safe to place the dog in an adoptive home. In this study, we examine whether the extent of scarring from dog fighting is a reliable predictor of aggression towards other dogs and therefore could be used to help make that decision. We found that dogs with 10 or more scars in the three body zones where dogfighting injuries tend to be concentrated were more likely, on average, to show aggression to other dogs. The relationship is imperfect, however. Many unscarred dogs were dog aggressive while some highly scarred dogs were not. Therefore, we recommend also assessing a dog’s behavior before making decisions about its disposition. Abstract When pit bull-type dogs are seized in an investigation of organized dogfighting, heavily scarred dogs are often assumed to be highly dog aggressive due to a history of fighting. These dogs may be deemed dangerous and euthanized based on scarring alone. We analyzed our existing data on dogs seized from four dogfighting investigations, examining the relationship between the dogs’ scars with aggression towards other dogs. Scar and wound data were tallied in three body zones where dogfighting injuries tend to be concentrated. Dog aggression was assessed using a model dog and a friendly stimulus dog in a standardized behavior evaluation. Scarring and dog aggression were significantly related, more strongly among male (Fisher’s Exact p < 0.001) than female dogs (Fisher’s Exact p = 0.05). Ten or more scars in the three body zones was a reasonable threshold with which to classify a dog as high risk for dog aggression: 82% of males and 60% of females with such scarring displayed dog aggression. However, because many unscarred dogs were dog aggressive while some highly scarred dogs were not, we recommend collecting behavioral information to

  1. High-frequency electromagnetic scarring in three-dimensional axisymmetric convex cavities

    SciTech Connect

    Warne, Larry K.; Jorgenson, Roy E.

    2016-04-13

    Here, this article examines the localization of high-frequency electromagnetic fields in three-dimensional axisymmetric cavities along periodic paths between opposing sides of the cavity. When these orbits lead to unstable localized modes, they are known as scars. This article treats the case where the opposing sides, or mirrors, are convex. Particular attention is focused on the normalization through the electromagnetic energy theorem. Both projections of the field along the scarred orbit as well as field point statistics are examined. Statistical comparisons are made with a numerical calculation of the scars run with an axisymmetric simulation.

  2. Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome.

    PubMed

    Tornero-Caballero, Maria C; Salom-Moreno, Jaime; Cigarán-Méndez, Margarita; Morales-Cabezas, Matilde; Madeleine, Pascal; Fernández-de-Las-Peñas, César

    2016-10-01

    OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored. Pressure pain thresholds (PPTs) were assessed in a blind manner over seven locations on each foot. Topographical pressure sensitivity maps of the plantar region were generated using the averaged PPT of each location. RESULTS : The prevalence rate of foot pain was 63% (n = 32). The number of active TrPs for each FMS woman with foot pain was 5 ± 1.5 without any latent TrPs. Women with FMS without foot pain and healthy controls had only latent TrPs (2.2 ± 0.8 and 1.5 ± 1.3, respectively). Active TrPs in the flexor hallucis brevis and adductor hallucis muscles were the most prevalent. Topographical pressure pain sensitivity maps revealed that FMS women with foot pain had lower PPT than FMS women without pain and healthy controls, and higher PPT on the calcaneus bone (P < 0.001). CONCLUSIONS : The presence of foot pain in women with FMS is high. The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in these patients. FMS women suffering foot pain showed higher pressure hypersensitivity in the plantar region than those FMS women without pain.

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

    PubMed

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

    2012-04-01

    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.

  4. Intravenous contrast-enhanced CT of the postoperative lumbar spine: improved identification of recurrent disk herniation, scar, arachnoiditis, and diskitis

    SciTech Connect

    Teplick, J.G.; Haskin, M.E.

    1984-10-01

    Unsuccessful relief of symptoms after back surgery is usually attributable to hypertrophic extradural scar or recurrent herniated disk. Their clinical and myelographic differentiation is difficult, yet important because reoperation is not always beneficial for scar removal. This article examines the usefulness of intravenous contrast-enhanced computed tomography for this problem. Forty-five postsurgical patients were studied; eight had subsequent surgery. In the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with recurrent disk herniation, nonenhancement of the extruded disk allowed its recognition in three. In the other 37 patients who were not reoperated, 33 were believed to have scar on the basis of contrast enhancement. The method seems promising for more accurate evaluation of failed back surgery, including the recognition of diskitis.

  5. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation.

    PubMed

    Balius, Ramon; Pedret, Carles; Pacheco, Laura; Gutierrez, Josep Antoni; Vives, Joan; Escoda, Jaume

    2011-01-01

    Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball.

  6. Relative Importance of Four Muscle Groups for Indoor Rock Climbing Performance.

    PubMed

    Deyhle, Michael R; Hsu, Hung-Sheng; Fairfield, Timothy J; Cadez-Schmidt, Taryn L; Gurney, Burke A; Mermier, Christine M

    2015-07-01

    Little research is available to guide training programs for rock climbers. To help meet this need, we sought to determine the relative importance of 4 muscle groups for rock climbing performance. Eleven male climbers were familiarized with an indoor climbing route before 5 separate days of testing. On testing days, subjects were randomly assigned to climb with no prefatiguing exercise (control climb) or after a prefatiguing exercise designed to specifically target the digit flexors (DF), shoulder adductors (SA), elbow flexors (EF), or lumbar flexors (LF). Immediately after the prefatiguing exercise, the subject climbed the route as far as possible without rest until failure. The number of climbing moves was recorded for each climb. Surface electromyography of the target muscles was recorded during the prefatigue. Fewer climbing moves were completed after prefatigue of the DF (50 ± 18%) and EF (78 ± 22%) (p ≤ 0.05) compared with the control climb. The number of moves completed after prefatigue of the LF and SA were not statistically significant compared with the control climb (p > 0.05). The short time lapse between the end of prefatiguing exercise and the start of climbing (transit time), which may have allowed for some recovery, was not different among trials (p > 0.05). Electromyography median frequency was reduced from beginning to end of each prefatiguing exercise. These results suggest that among the muscle groups studied in men, muscular endurance of DF and EF muscle groups is especially important for rock climbing on 40° overhanging terrain.

  7. Mandibular and hyoid muscles of Galeomorph sharks (Chondrichthyes: Elasmobranchii), with remarks on their phylogenetic intrarelationships.

    PubMed

    Soares, Mateus C; de Carvalho, Marcelo R

    2013-10-01

    The superorder Galeomorph comprises the orders Heterodontiformes, Orectolobiformes, Lamniformes, and Carcharhiniformes. Recent morphological and molecular support that it is a monophyletic taxon. The phyletic relationship within the Galeomorphi are also well resolved. However, only few morphological characters of the mandibular and hyoid muscles have been employed, and a detailed description of these muscles and their variations may contribute new interpretations of homology and to the discussion of different hypothesis of intrarelationships. This paper provides a detailed description of mandibular and hyoid arch muscles in galeomorph sharks, within a comparative elasmobranch framework, with the objective to discuss putative homologies that may elucidate our understanding of galeomorph evolution. Twenty-eight galeomorph species were dissected, described, illustrated and compared with other elasmobranchs and with data from the literature. The Galeomorphi are supported as monophyletic by presenting the m. levator labii superioris attached directly to the neurocranium, different from the attachment through a tendon in basal squalomorphs. Heterodontiformes and Orectolobiformes share particular variations in the position and insertion of the m. levator labii superioris and the presence of a well-defined m. levator hyomandibulae. Lamniformes and Carcharhiniformes show similar patterns in the position and attachment of the m. levator labii superioris, subdivision of the m. adductor mandibulae, and the presence of an almost indivisible m. levator hyomandibulae and m. constrictor hyoideus dorsalis, similar to the condition, albeit independently, in basal squalomorphs. No specific mandibular or hyoid arch muscle character was found to support the clade composed of Orectolobiformes, Lamniformes, and Carcharhiniformes, as advocated by recent phylogenetic analyses.

  8. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation

    PubMed Central

    Balius, Ramon; Pedret, Carles; Pacheco, Laura; Gutierrez, Josep Antoni; Vives, Joan; Escoda, Jaume

    2011-01-01

    Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball. PMID:24198573

  9. The stretch-shortening cycle (SSC) revisited: residual force enhancement contributes to increased performance during fast SSCs of human m. adductor pollicis

    PubMed Central

    Seiberl, Wolfgang; Power, Geoffrey A; Herzog, Walter; Hahn, Daniel

    2015-01-01

    The stretch-shortening cycle (SSC) occurs in most everyday movements, and is thought to provoke a performance enhancement of the musculoskeletal system. However, mechanisms of this performance enhancement remain a matter of debate. One proposed mechanism is associated with a stretch-induced increase in steady-state force, referred to as residual force enhancement (RFE). As yet, direct evidence relating RFE to increased force/work during SSCs is missing. Therefore, forces of electrically stimulated m. adductor pollicis (n = 14 subjects) were measured during and after pure stretch, pure shortening, and stretch-shortening contractions with varying shortening amplitudes. Active stretch (30°, ω = 161 ± 6°s−1) caused significant RFE (16%, P < 0.01), whereas active shortening (10°, 20°, and 30°; ω = 103 ± 3°s−1, 152 ± 5°s−1, and 170 ± 5°s−1) resulted in significant force depression (9–15%, P < 0.01). In contrast, after SSCs (that is when active stretch preceded active shortening) no force depression was found. Indeed for our specific case in which the shortening amplitude was only 1/3 of the lengthening amplitude, there was a remnant RFE (10%, P < 0.01) following the active shortening. This result indicates that the RFE generated during lengthening affected force depression when active lengthening was followed by active shortening. As conventional explanations, such as the storage and release of elastic energy, cannot explain the enhanced steady-state force after SSCs, it appears that the stretch-induced RFE is not immediately abolished during shortening and contributes to the increased force and work during SSCs. PMID:25975646

  10. Prospective study concerning 71 cases of caesarean scar endometriosis (CSE).

    PubMed

    Pas, Katarzyna; Joanna, Skręt-Magierło; Renata, Raś; Skręt, Andrzej; Barnaś, Edyta

    2017-04-11

    A prospective study was undertaken involving 71 patients with caesarean scar endometriosis (CSE) between the years 2007 and 2013. A prospective study enabled us to find out: mean age of patients with CSE; 34.0 years (range 22.0-48.0), time between CS and diagnosis of CSE; 12.0 months (range 19.0-39.0), duration between symptoms and surgery; 24.0 months (range 1.0-204.0), mean operation time; 40.0 min. (range 15.0-160.0), and mean lesion size; 54.4 ± 42.3 mm(3). In three patients (4.2%) a large deficit in the abdominal wall was closed by means of polypropylene mesh. One of them conceived a year later. Surgical excision is the only effective treatment in patients with CSE. Wide local excision with clear margins is the key to prevent recurrence. Repair of large post-excisional deficits with mesh may also be offered to woman planning their next pregnancy. Impact statement • What is already known on this subject? Endometriosis in the scar may occur after various abdominal surgeries, more frequently after caesarean sections. The excision of large nodules is connected with suboptimal cosmetic outcomes and the possibility of recurrence. • What the results of this study add? In this study including 71 patients with CSE, wide excision with electrocoagulatory was associated with a single recurrence in 12-month follow-up. In three patients (4.2%) large deficits in the abdominal wall were closed with the use of polypropylene mesh. One of them conceived a year later and had a successful pregnancy. • What the implications are of these findings for clinical practice and/or futher research? Surgical excision is the only effective treatment in patients with CSE. Wide local excision with clear margins is the key to preventing recurrence. Repair of large post excisional deficit with mesh may be offered also to woman planning pregnancy.

  11. The soft mechanical signature of glial scars in the central nervous system

    PubMed Central

    Moeendarbary, Emad; Weber, Isabell P.; Sheridan, Graham K.; Koser, David E.; Soleman, Sara; Haenzi, Barbara; Bradbury, Elizabeth J.; Fawcett, James; Franze, Kristian

    2017-01-01

    Injury to the central nervous system (CNS) alters the molecular and cellular composition of neural tissue and leads to glial scarring, which inhibits the regrowth of damaged axons. Mammalian glial scars supposedly form a chemical and mechanical barrier to neuronal regeneration. While tremendous effort has been devoted to identifying molecular characteristics of the scar, very little is known about its mechanical properties. Here we characterize spatiotemporal changes of the elastic stiffness of the injured rat neocortex and spinal cord at 1.5 and three weeks post-injury using atomic force microscopy. In contrast to scars in other mammalian tissues, CNS tissue significantly softens after injury. Expression levels of glial intermediate filaments (GFAP, vimentin) and extracellular matrix components (laminin, collagen IV) correlate with tissue softening. As tissue stiffness is a regulator of neuronal growth, our results may help to understand why mammalian neurons do not regenerate after injury. PMID:28317912

  12. An automated image processing method to quantify collagen fibre organization within cutaneous scar tissue.

    PubMed

    Quinn, Kyle P; Golberg, Alexander; Broelsch, G Felix; Khan, Saiqa; Villiger, Martin; Bouma, Brett; Austen, William G; Sheridan, Robert L; Mihm, Martin C; Yarmush, Martin L; Georgakoudi, Irene

    2015-01-01

    Standard approaches to evaluate scar formation within histological sections rely on qualitative evaluations and scoring, which limits our understanding of the remodelling process. We have recently developed an image analysis technique for the rapid quantification of fibre alignment at each pixel location. The goal of this study was to evaluate its application for quantitatively mapping scar formation in histological sections of cutaneous burns. To this end, we utilized directional statistics to define maps of fibre density and directional variance from Masson's trichrome-stained sections for quantifying changes in collagen organization during scar remodelling. Significant increases in collagen fibre density are detectable soon after burn injury in a rat model. Decreased fibre directional variance in the scar was also detectable between 3 weeks and 6 months after injury, indicating increasing fibre alignment. This automated analysis of fibre organization can provide objective surrogate endpoints for evaluating cutaneous wound repair and regeneration.

  13. The soft mechanical signature of glial scars in the central nervous system

    NASA Astrophysics Data System (ADS)

    Moeendarbary, Emad; Weber, Isabell P.; Sheridan, Graham K.; Koser, David E.; Soleman, Sara; Haenzi, Barbara; Bradbury, Elizabeth J.; Fawcett, James; Franze, Kristian

    2017-03-01

    Injury to the central nervous system (CNS) alters the molecular and cellular composition of neural tissue and leads to glial scarring, which inhibits the regrowth of damaged axons. Mammalian glial scars supposedly form a chemical and mechanical barrier to neuronal regeneration. While tremendous effort has been devoted to identifying molecular characteristics of the scar, very little is known about its mechanical properties. Here we characterize spatiotemporal changes of the elastic stiffness of the injured rat neocortex and spinal cord at 1.5 and three weeks post-injury using atomic force microscopy. In contrast to scars in other mammalian tissues, CNS tissue significantly softens after injury. Expression levels of glial intermediate filaments (GFAP, vimentin) and extracellular matrix components (laminin, collagen IV) correlate with tissue softening. As tissue stiffness is a regulator of neuronal growth, our results may help to understand why mammalian neurons do not regenerate after injury.

  14. An automated image processing method to quantify collagen fiber organization within cutaneous scar tissue

    PubMed Central

    Quinn, Kyle P.; Golberg, Alexander; Broelsch, G. Felix; Khan, Saiqa; Villiger, Martin; Bouma, Brett; Austen, William G.; Sheridan, Robert L.; Mihm, Martin C.; Yarmush, Martin L.; Georgakoudi, Irene

    2014-01-01

    Standard approaches to evaluate scar formation within histological sections rely on qualitative evaluations and scoring, which limits our understanding of the remodeling process. We have recently developed an image analysis technique for the rapid quantification of fiber alignment at each pixel location. The goal of this study was to evaluate its application for quantitatively mapping scar formation in histological sections of cutaneous burns. To this end, we utilized directional statistics to define maps of fiber density and directional variance from Masson’s Trichrome stained sections for quantifying changes in collagen organization during scar remodeling. Significant increases in collagen fiber density are detectable soon after burn injury in a rat model. Decreased fiber directional variance in the scar was also detectable between 3 weeks and 6 months after injury, indicating increasing fiber alignment. This automated analysis of fiber organization can provide objective surrogate endpoints for evaluating cutaneous wound repair and regeneration. PMID:25256009

  15. Crmp4 deletion promotes recovery from spinal cord injury by neuroprotection and limited scar formation

    PubMed Central

    Nagai, Jun; Kitamura, Yoshiteru; Owada, Kazuki; Yamashita, Naoya; Takei, Kohtaro; Goshima, Yoshio; Ohshima, Toshio

    2015-01-01

    Axonal outgrowth inhibitors and scar formation are two major obstacles to central nervous system (CNS) repair. No target molecule that regulates both axonal growth and scarring has been identified. Here we identified collapsin response mediator protein 4 (CRMP4), a common mediator of inhibitory signals after neural injury, as a crucial factor that contributes to both axonal growth inhibition and scarring after spinal cord injury (SCI). We found increases in the inhibitory and toxic forms of CRMP4 in injured spinal cord. Notably, CRMP4 expression was evident in inflammatory cells as well as in neurons after spinal cord transection. Crmp4−/− mice displayed neuroprotection against SCI and reductions in inflammatory response and scar formation. This permissive environment for axonal growth due to CRMP4 deletion restored locomotor activity at an unusually early phase of healing. These results suggest that deletion of CRMP4 is a unique therapeutic strategy that overcomes two obstacles to CNS repair after SCI. PMID:25652774

  16. A rare case of gallbladder fistulation with a 60-year-old appendicectomy scar.

    PubMed

    Thiruchandran, Gajendiran; Joyce, Megan; Baggott, Paul James

    2016-04-12

    We present an extremely unusual case of an external biliary fistula in an 87-year-old woman who presented with a 1-day history of spontaneous green discharge from a 60-year-old appendicectomy scar. Examination revealed a sinus in the right iliac fossa overlying her appendicectomy scar, with a raised white cell count and C reactive protein. A CT scan revealed a complex fistula connecting the gallbladder to the subcutaneous tissue in the right flank, which further connected inferiorly with a fistula to the previous appendicectomy scar and a small iliopsoas collection. Endoscopic retrograde cholangiopancreatography revealed several stones in the common bile duct, which were removed using a balloon catheter. The patient was further managed with a long course of antibiotics and discharged with a long-term drainage bag. A literature search revealed no previously reported cases of an external biliary fistula communicating with an appendicectomy scar.

  17. Scars in Dirac fermion systems: the influence of an Aharonov-Bohm flux

    NASA Astrophysics Data System (ADS)

    Wang, Cheng-Zhen; Huang, Liang; Chang, Kai

    2017-01-01

    Time-reversal ({ T }-) symmetry is fundamental to many physical processes. Typically, { T }-breaking for microscopic processes requires the presence of magnetic field. However, for 2D massless Dirac billiards, { T }-symmetry is broken automatically by the mass confinement, leading to chiral quantum scars. In this paper, we investigate the mechanism of { T }-breaking by analyzing the local current of the scarring eigenstates and their magnetic response to an Aharonov-Bohm flux. Our results unveil the complete understanding of the subtle { T }-breaking phenomena from both the semiclassical formula of chiral scars and the microscopic current and spin reflection at the boundaries, leading to a controlling scheme to change the chirality of the relativistic quantum scars. Our findings not only have significant implications on the transport behavior and spin textures of the relativistic pseudoparticles, but also add basic knowledge to relativistic quantum chaos.

  18. Screening of differentially expressed genes in pathological scar tissues using expression microarray.

    PubMed

    Huang, L P; Mao, Z; Zhang, L; Liu, X X; Huang, C; Jia, Z S

    2015-09-09

    Pathological scar tissues and normal skin tissues were differentiated by screening for differentially expressed genes in pathologic scar tissues via gene expression microarray. The differentially expressed gene data was analyzed by gene ontology and pathway analyses. There were 5001 up- or down-regulated genes in 2-fold differentially expressed genes, 956 up- or down-regulated genes in 5-fold differentially expressed genes, and 114 up- or down-regulated genes in 20-fold differentially expressed genes. Therefore, significant differences were observed in the gene expression in pathological scar tissues and normal foreskin tissues. The development of pathological scar tissues has been correlated to changes in multiple genes and pathways, which are believed to form a dynamic network connection.

  19. Extracellular matrix considerations for scar-free repair and regeneration: insights from regenerative diversity among vertebrates.

    PubMed

    Godwin, James; Kuraitis, Drew; Rosenthal, Nadia

    2014-11-01

    The extracellular matrix (ECM) is an essential feature of development, tissue homeostasis and recovery from injury. How the ECM responds dynamically to cellular and soluble components to support the faithful repair of damaged tissues in some animals but leads to the formation of acellular fibrotic scar tissue in others has important clinical implications. Studies in highly regenerative organisms such as the zebrafish and the salamander have revealed a specialist formulation of ECM components that support repair and regeneration, while avoiding scar tissue formation. By comparing a range of different contexts that feature scar-less healing and full regeneration vs. scarring through fibrotic repair, regenerative therapies that incorporate ECM components could be significantly enhanced to improve both regenerative potential and functional outcomes. This article is part of a directed issue entitled: Regenerative Medicine: the challenge of translation.

  20. Aldehyde dehydrogenase inhibition blocks mucosal fibrosis in human and mouse ocular scarring

    PubMed Central

    Ahadome, Sarah D.; Abraham, David J.; Rayapureddi, Suryanarayana; Saw, Valerie P.; Saban, Daniel R.; Calder, Virginia L.; Norman, Jill T.; Ponticos, Markella; Daniels, Julie T.; Dart, John K.

    2016-01-01

    Mucous membrane pemphigoid (MMP) is a systemic mucosal scarring disease, commonly causing blindness, for which there is no antifibrotic therapy. Aldehyde dehydrogenase family 1 (ALDH1) is upregulated in both ocular MMP (OMMP) conjunctiva and cultured fibroblasts. Application of the ALDH metabolite, retinoic acid (RA), to normal human conjunctival fibroblasts in vitro induced a diseased phenotype. Conversely, application of ALDH inhibitors, including disulfiram, to OMMP fibroblasts in vitro restored their functionality to that of normal controls. ALDH1 is also upregulated in the mucosa of the mouse model of scarring allergic eye disease (AED), used here as a surrogate for OMMP, in which topical application of disulfiram decreased fibrosis in vivo. These data suggest that progressive scarring in OMMP results from ALDH/RA fibroblast autoregulation, that the ALDH1 subfamily has a central role in immune-mediated ocular mucosal scarring, and that ALDH inhibition with disulfiram is a potential and readily translatable antifibrotic therapy. PMID:27699226

  1. “Cat FACE” SCAR ON LONGLEAF PINE TREE, OVERHILLS HISTORIC ENTRANCE ...

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

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

  2. Herpes zoster developing within recent subciliary incision scar.

    PubMed

    Choi, Hwan Jun; Kim, Jun Hyuk; Lee, Young Man

    2012-05-01

    Herpes zoster is a common dermatologic disease characterized by unilateral pain and vesicular lesions over the unilateral sensory dermatomes being caused by the reactivation of varicella zoster virus, and its incidence seems to be increasing recently. In case of involving the ganglion of the fifth cranial nerve (trigeminal nerve), it can descend down the affected nerve into the skin, then producing an eruption in the dermatome. Among the patients with this disease, about 40% to 50% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, or pharyngitis but rarely facial trauma. Generally, herpes zoster was commonly associated with systemic disorders, and the treatment duration was prolonged in associated diseases. However, herpes zoster occurring specifically at the site of previously traumatized facial bone has not yet been reported. Retrospective study of 1 case of herpes zoster with blow-out fracture, which had been treated with acyclovir and steroid, was done. Follow-up length was about 3 months. After treatment, the patient became stable, and there was no complication. We treated herpes zoster developing within a recent operative subciliary scar, and the case is presented with the review of literature. Finally, facial trauma or reconstruction of the orbital floor with alloplastic implant might be a risk factor for herpes zoster in traumatized patient.

  3. Transforming the radiological interpretation process: the SCAR TRIP initiative

    NASA Astrophysics Data System (ADS)

    Andriole, Katherine P.; Morin, Richard L.; Arenson, Ronald L.; Carrino, John A.; Erickson, Bradley J.; Horii, Steven C.; Piraino, David W.; Reiner, Bruce I.; Seibert, James A.; Siegel, Eliot L.

    2004-04-01

    The Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Initiative aims to spearhead research, education, and discovery of innovative solutions to address the problem of information and image data overload. The initiative will foster inter-disciplinary research on technological, environmental and human factors to better manage and exploit the massive amounts of data. TRIP will focus on the following basic objectives: improving the efficiency of interpretation of large data sets, improving the timeliness and effectiveness of communication, and decreasing medical errors. The ultimate goal of the initiative is to improve the quality and safety of patient care. Interdisciplinary research into several broad areas will be necessary to make progress in managing the ever-increasing volume of data. The six concepts involved include: human perception, image processing and computer-aided detection (CAD), visualization, navigation and usability, databases and integration, and evaluation and validation of methods and performance. The result of this transformation will affect several key processes in radiology, including image interpretation; communication of imaging results; workflow and efficiency within the health care enterprise; diagnostic accuracy and a reduction in medical errors; and, ultimately, the overall quality of care.

  4. Interplay between transglutaminases and heparan sulphate in progressive renal scarring

    PubMed Central

    Burhan, Izhar; Furini, Giulia; Lortat-Jacob, Hugues; Atobatele, Adeola G.; Scarpellini, Alessandra; Schroeder, Nina; Atkinson, John; Maamra, Mabrouka; Nutter, Faith H.; Watson, Philip; Vinciguerra, Manlio; Johnson, Timothy S.; Verderio, Elisabetta A. M.

    2016-01-01

    Transglutaminase-2 (TG2) is a new anti-fibrotic target for chronic kidney disease, for its role in altering the extracellular homeostatic balance leading to excessive build-up of matrix in kidney. However, there is no confirmation that TG2 is the only transglutaminase involved, neither there are strategies to control its action specifically over that of the conserved family-members. In this study, we have profiled transglutaminase isozymes in the rat subtotal nephrectomy (SNx) model of progressive renal scarring. All transglutaminases increased post-SNx peaking at loss of renal function but TG2 was the predominant enzyme. Upon SNx, extracellular TG2 deposited in the tubulointerstitium and peri-glomerulus via binding to heparan sulphate (HS) chains of proteoglycans and co-associated with syndecan-4. Extracellular TG2 was sufficient to activate transforming growth factor-β1 in tubular epithelial cells, and this process occurred in a HS-dependent way, in keeping with TG2-affinity for HS. Analysis of heparin binding of the main transglutaminases revealed that although the interaction between TG1 and HS is strong, the conformational heparin binding site of TG2 is not conserved, suggesting that TG2 has a unique interaction with HS within the family. Our data provides a rationale for a novel anti-fibrotic strategy specifically targeting the conformation-dependent TG2-epitope interacting with HS. PMID:27694984

  5. Successful Treatment of Caesarean Scar Pregnancies by Local Treatment Only

    PubMed Central

    Nagata, Chie; Ueno, Kazunori; Ozawa, Nobuaki; Nagaoka, Shinichi; Tanaka, Kei; Sago, Haruhiko; Iwashita, Mitsutoshi

    2017-01-01

    Background. Caesarean scar pregnancy (CSP) is a rare ectopic pregnancy associated with life-threatening complications. To date, no therapeutic protocols have been established. Sono-guided local methotrexate (MTX) injection is a relatively easy and low-invasive treatment. Additional systemic MTX is sometimes needed for CSP cases, especially when β-subunit human chorionic gonadotropin (β-hCG) levels are >20,000 mIU/ml at diagnosis. We report on six cases of CSP treated with local MTX injection, five of which received combined local treatment. Methods. Under intravenous anesthesia, six CSPs including a case with β-hCG levels >20,000 mIU/ml received MTX injection to the gestational sac. Five cases received gestational sac aspiration. Three cases had additional local potassium chloride injection and one case had a saline injection aiming at the fetal heart beat concurrent with MTX injection. MTX was administered weekly if β-hCG levels stayed beyond the expected values. Outcomes. All cases achieved β-hCG normalization without additional systemic MTX, with one case having a successful pregnancy after treatment. Conclusion. Sono-guided local MTX injection with concurrent local treatment might be a potentially effective approach for CSP cases. The accumulation of further cases is necessary to confirm this.

  6. A new CO2 laser technique for the treatment of pediatric hypertrophic burn scars

    PubMed Central

    Żądkowski, Tomasz; Nachulewicz, Paweł; Mazgaj, Maciej; Woźniak, Magdalena; Cielecki, Czesław; Wieczorek, Andrzej Paweł; Beń-Skowronek, Iwona

    2016-01-01

    Abstract Treatment of hypertrophic scars arising as a result of thermal burns in children is still a big problem. The results of the treatment are not satisfactory for patients and parents, and new methods of treatment are still investigated. We present the use of one of the most modern carbon dioxide (CO2) lasers (Lumenis Encore laser equipped with a Synergistic Coagulation and Ablation for Advanced Resurfacing module) in the treatment of hypertrophic scars in children after burns. From March to April of 2013, a group of 47 patients aged 6 to 16 years underwent 57 laser surgery treatments. The average time from accident was 7.5 years. The results of treatment were investigated in 114 areas. The assessed areas were divided into 2 groups: 9-cm2 area 1, where the thickness of the scar measured by physician was the lowest and 9-cm2 area 2, where the thickness of the scar was the biggest. The results were considered on the Vancouver Scar Scale (VSS) independently by the surgeon and by parents 1, 4, and 8 months after the procedure. In addition, ultrasound evaluation of the scar thickness before and after laser procedure was made. VSS total score improved in all areas assessed by both the physician and parents. The biggest change in total VSS score in area 1 in the evaluation of the investigator was obtained at follow-up after the 1st month of treatment (average 7.23 points before and 5.18 points after the 1st month after surgery—a difference of 2.05 points). Scar ratings by parents and the physician did not differ statistically (P < 0.05). In the ultrasound assessment, the improvement was statistically significant, more frequently for both minimum and maximum thickness of the scars (B-mode measures) (P < 0.05). The use of a CO2 laser in the treatment of hypertrophic scars in children is an effective and safe method. The use of a CO2 laser improves the appearance and morphology of scarring assessed using the VSS by both the parents and the physician. The

  7. A New Proprietary Onion Extract Gel Improves the Appearance of New Scars

    PubMed Central

    Draelos, Zoe D.; Baumann, Leslie; Fleischer, Alan B.; Plaum, Stefan; Hardas, Bhushan

    2012-01-01

    Objective: This randomized, controlled, single-blind study evaluated the appearance of new dermal scars after eight weeks of once-daily application of a nonprescription proprietary onion extract gel formulation compared to control (no application scars) in a dermatological surgical setting. Methods: At Visit 1, 44 healthy male and female subjects aged 18 to 70 years gave informed consent, were screened, and enrolled in the study. Two bilateral, 8mm seborrheic keratoses, one on the right and one on the left chest, were surgically removed from each subject. The wounds were photographed at all visits. Two weeks later (Visit 2), each subject was randomly assigned to apply onion extract gel to either the right or left side wound site once daily for eight weeks and no treatment on the opposite wound. The investigator was blinded to which wound was treated. At two, four, and eight weeks after gel application, right and left scars were graded by the investigator and subjects for improvement from baseline in overall appearance, texture, redness, and softness using 4-point ordinal scales (0=no improvement, 1=mild improvement; 2= moderate improvement; 3=significant improvement). Safety was evaluated by adverse events. Results: Six subjects (13.6%) experienced mild stinging that resolved spontaneously. At two weeks, the subjects rated gel-applied scars to be significantly softer than control scars (p=0.014). After four and eight weeks of application, the investigator and subjects rated all appearance variables of the gel-applied scars to be significantly more improved from baseline than control scars (p=0.017 to p<0.01). Conclusion: The new proprietary onion extract gel is safe and significantly improves scar appearance after four weeks of once-daily application. PMID:22768353

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

    NASA Technical Reports Server (NTRS)

    Hoffman, S.

    1977-01-01

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

  9. Is manual palpation of the uterine scar following vaginal birth after cesarean section (VBAC) helpful?

    PubMed

    Dinglas, C; Rafael, T J; Vintzileos, A

    2015-05-01

    Risk of uterine rupture with trial of labor after cesarean (TOLAC) is less than one percent. Discovery of uterine rupture often occurs during labor. In our case, the uterine scar is discovered to be ruptured during the postpartum period. The exact cause and time of uterine rupture is difficult to ascertain in this case, yet manual palpation of the uterine scar did not aid in the eventual diagnosis.

  10. Linear Non Scarring Alopecia of the Scalp: A Rare Manifestation of Lupus Panniculitis

    PubMed Central

    Kshetrimayum, Sandhyarani; Thokchom, Nandakishore; Hmar, Vanlalhriatpuii

    2016-01-01

    Alopecia in a linear pattern is very rare with only a few cases reported in the medical literature. We report a case of linear non scarring alopecia involving the scalp in a 17-year-old boy with a histological diagnosis of lupus panniculitis. We report this case because of its rarity and also the inclusion of this entity as one of the rare differential of non scarring alopecia. PMID:27688465

  11. Immunohistochemical evaluation of COX-1 and COX-2 expression in keloid and hypertrophic scar.

    PubMed

    Abdou, Asmaa G; Maraee, Alaa H; Saif, Hala F Abd-Elsattar

    2014-04-01

    Both keloids (KLs) and hypertrophic scars (HSs) are considered as dermal fibroproliferative diseases that differ clinically and histopathologically. Although several factors have been postulated in the etiopathogenesis of these conditions, there has been growing evidence to suggest the role of COXs in the pathogenesis of abnormal wound healing because of the reduction of formation of KL and HS in patients using nonsteroidal anti-inflammatory drugs and a COX-2 inhibitor. The aim of the present work is to evaluate the pattern and localization of COX-1 and COX-2 expression in KL and HS compared with surgical scars. COX-1 and COX-2 were analyzed on skin biopsies of 30 patients who presented with KL (15) and HS (15) and 10 normal surgical scars (controls). Both COX-1 and COX-2 were expressed not only in dermal components (fibroblasts, inflammatory cells, and endothelial cells) but also in keratinocytes of the overlying epidermis in the different studied scar lesions. The percentage of COX-1 expression increased progressively from surgical scar (40%) to HS (53.3%) to KL (100%) with a statistically significant difference (P = 0.002). COX-2 was expressed in 100% of surgical scars, 73.3% of HS and 86.7% of KL with the absence of significant differences (P > 0.05). The significant difference in COX-1 expression between HS and KL may refer to the presence of different pathways for the emergence of these diseases. The expression of COX-2 in all scars (normal or abnormal) indicates its active role as an inflammatory mediator. Keratinocytes play an active role in induction of scarring by up-regulation of inflammatory mediators, such as COX-1 and COX-2.

  12. The use of moxibustion scars in the identification of individuals in forensic medicine.

    PubMed

    Sakabe, Masaaki; Miyamori, Daisuke; Mclean, Stuart; Shinmen, Natsuko; Kato, Hideaki; Yoshimoto, Kanji; Ikegaya, Hiroshi

    2012-06-10

    The use of moxibustion today does not only take place in Eastern Asia, but recently also in Europe and the United States. Moxibustion scars are often seen in autopsy cases in Japan. However, no reports of the use of moxibustion in autopsy cases have been reported. This paper reports on an autopsy case in which moxibustion scars were used to extrapolate on the past symptoms of the deceased, date of therapy and the location of the moxibustion clinic which administered the moxibustion.

  13. Pressure therapy in treatment of hypertrophic scar, burn contracture and keloid: the Kenyan experience.

    PubMed

    Haq, M A; Haq, A

    1990-11-01

    A preliminary report of the results of pressure therapy for hypertrophic scar, burn contracture and keloid is presented. Thirty four patients over a four year period were treated with four types of pressure therapy. Results showed over 50% improvement in 21 (61.8%) cases. This method obviated the need for repetitive surgery and no recurrence was noted. Pressure therapy is advocated as an adjunct measure for all cases of hypertrophic scarring, burn contracture and keloid.

  14. Seepage of methane at Jaco Scar, a slide caused by seamount subduction offshore Costa Rica

    NASA Astrophysics Data System (ADS)

    Mau, Susan; Rehder, Gregor; Sahling, Heiko; Schleicher, Tina; Linke, Peter

    2014-10-01

    Methane (CH4) concentrations and CH4 stable carbon isotopic composition () were investigated in the water column within Jaco Scar. It is one of several scars formed by massive slides resulting from the subduction of seamounts offshore Costa Rica, a process that can open up structural and stratigraphical pathways for migrating CH4. The release of large amounts of CH4 into the adjacent water column was discovered at the outcropping lowermost sedimentary sequence of the hanging wall in the northwest corner of Jaco Scar, where concentrations reached up to 1,500 nmol L-1. There CH4-rich fluids seeping from the sedimentary sequence stimulate both growth and activity of a dense chemosynthetic community. Additional point sources supplying CH4 at lower concentrations were identified in density layers above and below the main plume from light carbon isotope ratios. The injected CH4 is most likely a mixture of microbial and thermogenic CH4 as suggested by values between -50 and -62 ‰ Vienna Pee Dee Belemnite. This CH4 spreads along isopycnal surfaces throughout the whole area of the scar, and the concentrations decrease due to mixing with ocean water and microbial oxidation. The supply of CH4 appears to be persistent as repeatedly high CH4 concentrations were found within the scar over 6 years. The maximum CH4 concentration and average excess CH4 concentration at Jaco Scar indicate that CH4 seepage from scars might be as significant as seepage from other tectonic structures in the marine realm. Hence, taking into account the global abundance of scars, such structures might constitute a substantial, hitherto unconsidered contribution to natural CH4 sources at the seafloor.

  15. Periodic scarred States in open quantum dots as evidence of quantum Darwinism.

    PubMed

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

    2010-04-30

    Scanning gate microscopy (SGM) is used to image scar structures in an open quantum dot, which is created in an InAs quantum well by electron-beam lithography and wet etching. The scanned images demonstrate periodicities in magnetic field that correlate to those found in the conductance fluctuations. Simulations have shown that these magnetic transform images bear a strong resemblance to actual scars found in the dot that replicate through the modes in direct agreement with quantum Darwinism.

  16. Periodic Scarred States in Open Quantum Dots as Evidence of Quantum Darwinism

    NASA Astrophysics Data System (ADS)

    Burke, A. M.; Akis, R.; Day, T. E.; Speyer, Gil; Ferry, D. K.; Bennett, B. R.

    2010-04-01

    Scanning gate microscopy (SGM) is used to image scar structures in an open quantum dot, which is created in an InAs quantum well by electron-beam lithography and wet etching. The scanned images demonstrate periodicities in magnetic field that correlate to those found in the conductance fluctuations. Simulations have shown that these magnetic transform images bear a strong resemblance to actual scars found in the dot that replicate through the modes in direct agreement with quantum Darwinism.

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

    USGS Publications Warehouse

    Garman, Steven L.; McBeth, Jamie L.

    2014-01-01

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

  18. Musculoskeletal Geometry, Muscle Architecture and Functional Specialisations of the Mouse Hindlimb

    PubMed Central

    Charles, James P.; Cappellari, Ornella; Spence, Andrew J.; Hutchinson, John R.; Wells, Dominic J.

    2016-01-01

    Mice are one of the most commonly used laboratory animals, with an extensive array of disease models in existence, including for many neuromuscular diseases. The hindlimb is of particular interest due to several close muscle analogues/homologues to humans and other species. A detailed anatomical study describing the adult morphology is lacking, however. This study describes in detail the musculoskeletal geometry and skeletal muscle architecture of the mouse hindlimb and pelvis, determining the extent to which the muscles are adapted for their function, as inferred from their architecture. Using I2KI enhanced microCT scanning and digital segmentation, it was possible to identify 39 distinct muscles of the hindlimb and pelvis belonging to nine functional groups. The architecture of each of these muscles was determined through microdissections, revealing strong architectural specialisations between the functional groups. The hip extensors and hip adductors showed significantly stronger adaptations towards high contraction velocities and joint control relative to the distal functional groups, which exhibited larger physiological cross sectional areas and longer tendons, adaptations for high force output and elastic energy savings. These results suggest that a proximo-distal gradient in muscle architecture exists in the mouse hindlimb. Such a gradient has been purported to function in aiding locomotor stability and efficiency. The data presented here will be especially valuable to any research with a focus on the architecture or gross anatomy of the mouse hindlimb and pelvis musculature, but also of use to anyone interested in the functional significance of muscle design in relation to quadrupedal locomotion. PMID:27115354

  19. Difference in the Recruitment of Hip and Knee Muscles between Back Squat and Plyometric Squat Jump

    PubMed Central

    Sugisaki, Norihide; Kurokawa, Sadao; Okada, Junichi; Kanehisa, Hiroaki

    2014-01-01

    Athletes who aim to improve both muscular endurance and power often perform exercises that involve similar joint actions under different lifting conditions, such as changes in the load or speed, which are implemented at different times during a periodized exercise program or simultaneously. The prescribed exercises are considered to recruit the same muscles even if the lifting conditions differ to each other. The present study aimed to clarify this by examining whether the recruitment of individual hip and knee muscles during the squat exercise differs between lifting conditions adopted for muscular endurance and power training regimens. Moderately trained men performed back squats (BS), with a load of approximately 60% of one repetition maximum, as a muscular endurance training exercise, and they performed plyometric squat jumping (PSJ) for power training. During each exercise, the lower limb joint torques and the recruitment of five hip and knee muscles were determined with inverse-dynamics and T2-weighted magnetic resonance imaging, respectively. While the maximal and mean knee joint torques were greater during PSJ than during BS (p<0.01), the T2 values for the quadriceps femoris muscle did not differ between the exercises. In contrast, the T2 values of the gluteus maximus and hip adductor muscles were higher during PSJ (p<0.05) than during BS, although there was no significant difference in the mean hip extension torque between the two exercises. The current results indicate that the individual use of the agonist muscles differs between BS and PSJ, and it does not always correspond with the joint kinetics during the exercises. Therefore, in addition to the exercise type, the lifting condition should also be taken into consideration as a determinant of the major muscles trained during a resistance exercise. PMID:24979707

  20. Differential contributions of vision, touch and muscle proprioception to the coding of hand movements.

    PubMed

    Blanchard, Caroline; Roll, Régine; Roll, Jean-Pierre; Kavounoudias, Anne

    2013-01-01

    To further elucidate the mechanisms underlying multisensory integration, this study examines the controversial issue of whether congruent inputs from three different sensory sources can enhance the perception of hand movement. Illusory sensations of clockwise rotations of the right hand were induced by either separately or simultaneously stimulating visual, tactile and muscle proprioceptive channels at various intensity levels. For this purpose, mechanical vibrations were applied to the pollicis longus muscle group in the subjects' wrists, and a textured disk was rotated under the palmar skin of the subjects' right hands while a background visual scene was projected onto the rotating disk. The elicited kinaesthetic illusions were copied by the subjects in real time and the EMG activity in the adductor and abductor wrist muscles was recorded. The results show that the velocity of the perceived movements and the amplitude of the corresponding motor responses were modulated by the nature and intensity of the stimulation. Combining two sensory modalities resulted in faster movement illusions, except for the case of visuo-tactile co-stimulation. When a third sensory input was added to the bimodal combinations, the perceptual responses increased only when a muscle proprioceptive stimulation was added to a visuo-tactile combination. Otherwise, trisensory stimulation did not override bimodal conditions that already included a muscle proprioceptive stimulation. We confirmed that vision or touch alone can encode the kinematic parameters of hand movement, as is known for muscle proprioception. When these three sensory modalities are available, they contribute unequally to kinaesthesia. In addition to muscle proprioception, the complementary kinaesthetic content of visual or tactile inputs may optimize the velocity estimation of an on-going movement, whereas the redundant kinaesthetic content of the visual and tactile inputs may rather enhance the latency of the perception.

  1. Difference in the recruitment of hip and knee muscles between back squat and plyometric squat jump.

    PubMed

    Sugisaki, Norihide; Kurokawa, Sadao; Okada, Junichi; Kanehisa, Hiroaki

    2014-01-01

    Athletes who aim to improve both muscular endurance and power often perform exercises that involve similar joint actions under different lifting conditions, such as changes in the load or speed, which are implemented at different times during a periodized exercise program or simultaneously. The prescribed exercises are considered to recruit the same muscles even if the lifting conditions differ to each other. The present study aimed to clarify this by examining whether the recruitment of individual hip and knee muscles during the squat exercise differs between lifting conditions adopted for muscular endurance and power training regimens. Moderately trained men performed back squats (BS), with a load of approximately 60% of one repetition maximum, as a muscular endurance training exercise, and they performed plyometric squat jumping (PSJ) for power training. During each exercise, the lower limb joint torques and the recruitment of five hip and knee muscles were determined with inverse-dynamics and T2-weighted magnetic resonance imaging, respectively. While the maximal and mean knee joint torques were greater during PSJ than during BS (p<0.01), the T2 values for the quadriceps femoris muscle did not differ between the exercises. In contrast, the T2 values of the gluteus maximus and hip adductor muscles were higher during PSJ (p<0.05) than during BS, although there was no significant difference in the mean hip extension torque between the two exercises. The current results indicate that the individual use of the agonist muscles differs between BS and PSJ, and it does not always correspond with the joint kinetics during the exercises. Therefore, in addition to the exercise type, the lifting condition should also be taken into consideration as a determinant of the major muscles trained during a resistance exercise.

  2. Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction.

    PubMed

    Leonardo, Cristiane R; Filgueiras, Maria Francisca T; Vasconcelos, Mônica M; Vasconcelos, Roberta; Marino, Viviane P; Pires, Cleidismar; Pereira, Ana Cristina; Reis, Fernanda; Oliveira, Eduardo A; Lima, Eleonora M

    2007-11-01

    Risk factors for renal scarring in children with lower urinary tract dysfunction (LUTD) were evaluated. The medical records of 120 patients were assessed concerning gender, presence of vesicoureteric reflux (VUR), bladder capacity, detrusor overactivity, residual urine, febrile urinary tract infection (UTI), bacteriuria, constipation, detrusor sphincter incoordination (DSI), high detrusor pressure at maximal cystometric capacity (PMCC), low compliance, and thickness and trabeculation of the bladder wall. Renal scarring was diagnosed by (99m)technetium-dimercaptosuccinic acid renal scan (DMSA). Renal scarring was detected in 38 patients (31%). VUR, UTI, decreased bladder capacity, urinary residue, and trabeculated and thick bladder wall were associated with scarring at univariate analysis. Multivariate analysis showed VUR (P < 0.0001) as the independent risk factor for renal scarring. Thickness of the bladder wall was a marginal risk factor (P = 0.07). Although UTI was not a risk factor, it was associated with VUR (P = 0.03). In our analysis, VUR was the main risk factor; however, renal scarring was probably due to multifactorial causes, as VUR was associated with UTI.

  3. Risk factors for renal scarring in children with primary vesicoureteral reflux disease.

    PubMed

    Mir, Sevgi; Ertan, Pelin; Ozkayin, Nese

    2013-01-01

    To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR) and the possible risk factor(s), we studied 90 children (60 girls and 30 boys) with VUR followed in the Pediatric Nephrology Unit at the Ege University Hospital from 1998 to 2003. All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m) technetium dimercapto-succinic acid scintigraphy. All infants with VUR were given low-dose prophylactic antibiotics and followed-up until resolution of the reflux. Grade of reflux and number of urinary tract infection (UTI) episodes (≥3) were found to be statistically significant risk factors for renal scarring (P <0.05). However, gender, familial history and laterality of the disease were not found to be statistically significant risk factors (P >0.05). Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05). We conclude that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

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

    PubMed

    Moorthy, Ima; Wheat, Deirdre; Gordon, Isky

    2004-02-01

    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 (UTI). Results were extracted from the radiology information system and recorded for analysis. All children with a UTI who had undergone DMSA and ultrasound examination on the same day between January 1995 and December 1999 were included; 930 kidneys were compared. DMSA scan was utilized as the reference method. When used to detect focal renal scarring, ultrasonography had a sensitivity of 5.2%, specificity of 98.3%, a positive predictive value (PPV) of 50% and a negative predictive value (NPV) of 75.8%. When used to detect diffuse renal scarring, ultrasonography had a sensitivity of 47.2%, specificity of 91.8%, PPV of 60.8% and NPV of 86.6%. Our results demonstrate that although ultrasonography has a good specificity for the detection of renal scarring compared with DMSA, it has low sensitivity, PPV and NPV. Ultrasonography cannot be substituted for DMSA scan in the evaluation of focal renal scarring.

  5. Scar sarcoidosis on a finger mimicking a rapidly growing soft tissue tumour: a case report

    PubMed Central

    2012-01-01

    Background Scar sarcoidosis is a rare and uncommon but specific cutaneous manifestation of sarcoidosis. In general it arises in pre-existing scars deriving from mechanical traumas. As most surgeons dealing with scars might not be aware of cutaneous sarcoidosis and its different types of appearance the appropriate staging and treatment might be missed or at least delayed. To our knowledge this is the first case in literature of scar sarcoidosis on a finger. Case presentation We present a case of a 33-year-old carpenter who developed scar sarcoidosis on his right index finger 4 years after the tendon of the long digital flexor got accidentally cut by an angle grinder. He was referred due to a swelling of the finger suspected to be a malignant soft tissue tumour. The circumference of the affected finger had almost doubled, adding up to 94 mm. Incision biopsy revealed typical noncaseating granulomas. Further investigation showed a systemic extent of the disease with involvement of the lung. A systemic treatment with oral steroids led to an almost full regression of the swelling with restoration of function and resolution of lung infiltrates. Conclusion In case of a suspicious and/or progressive swelling a definite diagnosis should be achieved by biopsy within a short time to enable a proper treatment. If scar sarcoidosis is proven further investigation is necessary to exclude a systemical involvement. A surgical treatment of the swelling is not indicated. PMID:23031186

  6. Opuntia Extract Reduces Scar Formation in Rabbit Ear Model: A Randomized Controlled Study.

    PubMed

    Fang, Quan; Huang, Chunlan; You, Chuangang; Ma, Shaolin

    2015-12-01

    The purpose of this article is to investigate the effect o