A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries.

PubMed

Sood, Rajiv; Roggy, David Edward; Zieger, Madeline Jane; Nazim, Muhammad; Hartman, Brett Colby; Gibbs, Jeff Thomas

2015-02-01

ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin split-thickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface. In this Institutional Review Board-approved US Food and Drug Administration phase 2 study, the authors prospectively evaluated the treatment of partial-thickness burns in patients with two 320 cm2 areas, 1 area treated with the ACH device and the other with a meshed split-thickness skin graft (MSTSG) as a control. The authors compared the treatment areas for graft take, pigmentation, and color match to surrounding healthy tissue, scarring, and pain. In this preliminary study, 10 patients were treated with this protocol. Eight patients had 100% take to both treatment areas and 2 patients had significant non-take and graft loss attributable to underexcised wound beds and difficulty with the spray applicator. Pigmentation and color match ratings were identical at week 52 and the Modified Vancouver Scar Scale scores were comparable. One subject rated the autologous cell harvesting site as having a better appearance, while the remaining subjects rated their ACH and MSTSG sites' appearances as being comparable. In early follow-up visits, pain ratings were slightly elevated in the ACH group due to graft healing; however, in visits following week 2, pain ratings at the ACH and MSTSG sites were rated similarly by all patients. This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.

Wound Healing from Dermal Grafts Containing CD34+ Cells Is Comparable to Wound Healing with Split-Thickness Skin Micrografts.

PubMed

Nuutila, Kristo; Singh, Mansher; Kruse, Carla; Eriksson, Elof

2017-08-01

Epidermal stem cells present in the skin appendages of the dermis might be crucial in wound healing. In this study, the authors located these cells in the dermis and evaluated their contribution to full-thickness wound healing in a porcine model. Four sequentially deeper 0.35-mm-thick skin grafts were harvested from the same donor site going down to 1.4 mm in depth (layers 1 through 4). The layers were minced to 0.8 × 0.8 × 0.35-mm micrografts and transplanted (1:2) onto full-thickness porcine wounds. Healing was monitored up to 28 days and biopsy specimens were collected on days 6 and 10. Multiple wound healing parameters were used to assess the quality of healing. The authors' results showed that wounds transplanted with layer 2 (0.35 to 0.7 mm) and layer 3 (0.7 to 1.05 mm) micrografts demonstrated reepithelialization rates comparable to that of split-thickness skin graft (layer 1, 0.00 to 0.35 mm; split-thickness skin graft) at day 10. At day 28, dermal micrografts (layers 2 and 3) showed quality of healing comparable to that of split-thickness skin grafts (layer 1) in terms of wound contraction and scar elevation index. The amounts of epidermal stem cells [cluster of differentiation (CD) 34] and basal keratinocytes (KRT14) at each layer were quantified by immunohistochemistry. The analysis showed that layers 2 and 3 contained the most CD34 cells and layer 1 was the richest in KRT14 cells. The immunohistochemistry also indicated that, by day 6, CD34 cells had differentiated into KRT14 cells, which migrated from the grafts and contributed to the reepithelialization of the wound.

Split thickness skin graft for cervicovaginal reconstruction in congenital atresia of cervix.

PubMed

Zhang, Xuyin; Han, Tiantian; Ding, Jingxin; Hua, Keqin

2015-10-01

To introduce a new technique that combines laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of the cervix. Video article introducing a new surgical technique. University hospital. A 16-year-old patient with congenital cervical atresia, vaginal dysgenesis, and ovarian endometrial cyst. An original technique of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft for cervicovaginal reconstruction. A midline incision at the vaginal introitus was made, and a 9-cm canal was made between the bladder and the rectum using sharp and blunt dissection along the anatomic vaginal route, with the aid of laparoscopy to ensure correct orientation. A 14 × 12 cm split thickness skin graft was harvested from the right lateral thigh. By laparoscopy, the level of the lowest pole of the uterine cavity was exposed and the cervix was incised by shape dissection. The proximal segment of the harvested skin to the lower uterine segment was secured, and the distal segment was sutured with the upper margin of vulva vaginally. Surgical technique reports in anonymous patients are exempted from ethical approval by the Institutional Review Board. The patient gave consent to use the video in the article. The procedure was successfully completed. Since February 2013, our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in 10 patients with congenital atresia of cervix were positive, with successful results and without complications or cervical, or vaginal stenosis. Our technique is feasible and safe for congenital atresia of cervix, with successful results and without complications or cervical or vaginal stenosis. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Use of split-thickness plantar skin grafts in the management of leg and foot skin defects.

PubMed

Liu, Hung-Hui; Chang, Chun-Kai; Huang, Chih-Han; Wu, Jen-Ru; Chen, Chun-Yu; Huang, Dun-Wei; Chu, Tzi-Shiang; Hsu, Kuo-Feng; Wang, Chi-Yu; Chiang, I-Han; Ou, Kuang-Ling; Wang, Chih-Hsin; Dai, Niann-Tzyy; Chen, Shyi-Gen; Tzeng, Yuan-Sheng

2018-05-24

The basic principle of donor site selection is to take skin from areas that will heal with minimal scarring while balancing the needs of the recipient site. For skin loss from the lower legs and feet, the most common harvest site for split-thickness skin grafts is the anterior or posterior thigh; grafts from the plantar areas have been mostly used to cover the volar aspect of digits and palms. Between September 2015 and September 2017, 42 patients with areas of skin loss on the legs or feet were treated with plantar skin grafts because of their cosmetic benefits and the convenience of the surgical procedure and postoperative wound care. Our technique of harvesting a single layer of split-thickness skin graft (0.014 in. thick) from a non-weight-bearing area of the foot of the injured leg is simple and provided good functional and cosmetic outcomes at both the donor and recipient sites. All patients were very satisfied with the recovery progress and final results. Therefore, in the management of skin defects in the lower legs or feet that comprise less than 1.5% of the total body surface area, our surgical method is a reliable alternative to anterior or posterior thigh skin grafting. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Low-cost ultra-thin broadband terahertz beam-splitter.

PubMed

Ung, Benjamin S-Y; Fumeaux, Christophe; Lin, Hungyen; Fischer, Bernd M; Ng, Brian W-H; Abbott, Derek

2012-02-27

A low-cost terahertz beam-splitter is fabricated using ultra-thin LDPE plastic sheeting coated with a conducting silver layer. The beam splitting ratio is determined as a function of the thickness of the silver layer--thus any required splitting ratio can be printed on demand with a suitable rapid prototyping technology. The low-cost aspect is a consequence of the fact that ultra-thin LDPE sheeting is readily obtainable, known more commonly as domestic plastic wrap or cling wrap. The proposed beam-splitter has numerous advantages over float zone silicon wafers commonly used within the terahertz frequency range. These advantages include low-cost, ease of handling, ultra-thin thickness, and any required beam splitting ratio can be readily fabricated. Furthermore, as the beam-splitter is ultra-thin, it presents low loss and does not suffer from Fabry-Pérot effects. Measurements performed on manufactured prototypes with different splitting ratios demonstrate a good agreement with our theoretical model in both P and S polarizations, exhibiting nearly frequency-independent splitting ratios in the terahertz frequency range.

An easy, rapid, and reproducible way to create a split-thickness wound for experimental purposes.

PubMed

Gümüş, Nazim; Özkaya, Neşe Kurt; Bulut, Hüseyin Eray; Yilmaz, Sarper

2014-09-01

Partial-thickness wound models of rat skin have some difficulties in creating the wounds in equal size and depth. Moreover, making a split-thickness wound on the rat skin seems not to be simple and rapid. A new alternative method was presented here to overcome these obstacles, by using a waterjet device to create a split-thickness wound on rat skin. Twenty-four male Wistar rats were randomly divided into 3 groups. An area of 4 × 4 cm in diameter was marked on the center of the dorsal skin. Waterjet hydrosurgery system was used to create a wound on the dorsal rat skin, by removing the outer layers of the skin. In group 1, rat skin was wounded with setting 1 to create a superficial skin wound. In group 2, it was injured with setting 5 to make a deeper wound, and in group 3, skin wound was performed with setting 10 making the deepest wound in the experiment. After the wounds were created on the rat skin, a full-thickness skin biopsy was taken from the middle of the cranial margin of the wound, including both the wound surface and the healthy skin in a specimen. Healing time of the wounds of animals was recorded in the experiment groups. Then, the results were compared statistically between the groups. In the histologic assessment, both the thickness of the remnant of the epidermis in the wound surface and the thickness of the healthy epidermis were measured under light microscope. Thickness of the epidermis remaining after wounding was statistically compared among the groups and with the healthy epidermis. The mean thickness of the remaining epidermis was determined for each group. It was higher in the superficial wounds than in the deep wounds, because of the removal of the skin from its outer surface through the deep layers of the skin with waterjet device. The most superficial wound in the experiment was observed in group 1, which was statistically different from the wounds of group 3, whereas there was no difference between the wounds of groups 1 and 2. Compared with the wounds of groups 1 and 2, the wounds in group 3 were significantly deeper than the wounds of other groups, which was statistically significant. In all groups, mean thickness of epidermis in the wound surface showed statistically significant difference from that in the healthy skin. When compared with the healing times of the wounds in the groups, a statistically significant difference was found between them. Creation of a split-skin wound, by using the waterjet system, provides a wound in reproducible size and depth, also in a standardized and rapid manner. Moreover, it makes precise and controlled wound creation in the rat skin.

Use of Negative-Pressure Wound Therapy in Orthopaedic Trauma

DTIC Science & Technology

2012-09-01

sponge, and continuous suction is applied at −50 mm Hg. NPWT is discontinued after 2 to 5 days. Split-thickness Skin Graft When placing a NPWT dressing...over a split-thickness skin graft (STSG), we apply a single sheet of nonadher- ent dressing to the wound to provide a barrier between the STSG and the...trauma, including surgical incisions at increased risk of breakdown or in- fection, skin grafts , and infected wounds.21,22 Wounds With Associated Soft

Quality of life and female sexual function after skinning vulvectomy with split-thickness skin graft in women with vulvar intraepithelial neoplasia or vulvar Paget disease.

PubMed

Lavoué, V; Lemarrec, A; Bertheuil, N; Henno, S; Mesbah, H; Watier, E; Levêque, J; Morcel, K

2013-12-01

Vulvar intraepithelial neoplasia (VIN) and vulvar Paget disease are managed with either vulvectomy, destructive treatments (laser, antimitotic drugs) or immunostimulants. All these options are associated with functional complications. The purpose of this study was to evaluate the surgical technique consisting of skinning vulvectomy with split-thickness skin graft, and its effect on overall quality of life and sexual function. A retrospective study was conducted on thirteen patients who underwent skinning vulvectomy with split-thickness skin graft between 1999 and 2009. Overall quality of life and sexual function were assessed with the Medical Outcome Study Short Form 36 (MOS SF-36) and Female Sexual Function Index (FSFI), respectively. The median age of patients was 54 (range: 33-77) years. Three patients had Paget disease and 10 patients had VIN lesions. The excision margins were clear in 46% of cases. The incidence of occult cancer was 31%. The mean follow-up period was 77 (±35) months. Four patients experienced a relapse of their intraepithelial disease. The mean disease-free survival was 58 (±44) months. There was no significant difference in MOS SF-36 scores between the study population and the general population. The patients assessed with the FSFI regained normal sexual function after the surgical procedure. Skinning vulvectomy with split-thickness skin graft is a feasible technique yielding good results in terms of quality of life and sexual function. It enables occult cancer to be diagnosed in patients with VIN or Paget disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Experimental study on porcine acellular dermal matrix and split-thickness skin grafts to repair full-thickness skin defects].

PubMed

Ma, Shaoying; Li, Baoming; Wang, Xusheng; Li, Youchen; Kang, Yue; Dong, Li; Chen, Xueying; Zhao, Yaping; Li, Baoxing

2010-02-01

To compare the effect of the composite skin graft consisting of split-thickness skin grafts (STSGs) and porcine acellular dermal matrix (PADM) with STSGs only, and to histologically observe the turnover of the PADM in rats. Twenty female Sprague-Dawley rats, weighing 200-225 g, were included. The size of 4.0 cm x 2.5 cm PADM was implanted into hypoderm of the left side of Sprague-Dawley rats' back. After 10-14 days, the size of 4.0 cm x 2.5 cm full-thickness skin defects were made on the left to expose the PADM under the skin and the same size of full-thickness skin defects were made on the right of the rats' back. The excised full-thickness skin was made to STSGs about 0.2 mm by drum dermatome. The defects were grafted with composite skin (STSGs on the PADM, experimental group) and STSGs only (control group). The survival rate, the construction degree of grafts, and the histological change in grafts area were observed at 2, 4, 8, and 20 weeks after operation. At 2 weeks after STSGs (0.2 mm) placed on vascularized PADM, STSGs and PADM adhered together and the composite skin had a good survival. The control group also had a good survival. Histological observations showed that STSGs and PADM grew together, neutrophilic granulocytes and lymphocytes infiltrated in the PADM and some macrophages around the PADM. Fibrous connective tissues were filled under the STSGs in control group. At 4-8 weeks after transplantation, the composite skin had a good survival and the composite skin was thick, soft, and elastic. STSGs survived almost totally in control group, but the grafts were thin. Histological observations showed that inflammatory reactions of PADM faded gradually in experimental group; scar tissues formed under the STSGs in control group. At 20 weeks after transplantation, composite skin was flat, thick, and elastic in experimental group, but the STSGs were thinner and less elastic in control group. Histological observations showed that histological structures of the PADM were similar to the dermal matrix of rats, and the results showed that the collagen matrix of PADM was gradually replaced by the rats' collagen matrix. Scar tissues were filled under the STSGs in control group. Wound healing rates of experimental group were lower than those of control group at 4 and 8 weeks (P < 0.05); wound contraction rates of experimental group had lower tendency than those of control group, but showing no significant differences (P > 0.05). Coverage wound with composite skin which composed of STSGs and PADM could improve wound healing quality; the composite skin is thicker and better elastic than STSGs only. The collagen matrix of PADM is gradually replaced by rats' collagen matrix.

[Late results following surgical correction of syndactyly and symbrachydactyly].

PubMed

Deutinger, M; Mandl, H; Frey, M; Holle, J; Freilinger, G

1989-02-01

Growth and the type of surgical treatment of the hand play an important role in the results of surgery in children. 29 patients have been operated on because of syndactyly and symbrachydactyly and were controlled. The following parameters were assessed: kind of incision and skin graft, functional results, x-ray to examine the skeleton and the depth of the commissure, colour of the skin graft and use of the hand. After operation of syndactyly all patients were able to use their hands normally, although full extend of flexion and extension was achieved only in 20 of 22 hands. In 5 divided pairs of fingers there was recurrence of syndactyly. In all cases except one, a split thickness skin graft has been used. After operative treatment of symbrachydactyly and complex syndactyly, full extent of flexion was achieved in 13 of 19 hands, in 6 hands the range of flexion was incomplete because of skeleton abnormalities. Recurrence occurred in 9 divided pairs of fingers; in 7 cases, a split thickness skin graft had been used. Despite this, all patients were able to use their hands normally. The use of split thickness skin grafts resulted in a 60% recurrence rate, whereas the use of full thickness skin graft led merely to 7.5% recurrence rate. Our results show the advantage of the full thickness skin graft. As a consequence, full thickness skin graft should be used in all cases. Furthermore, the operation should be performed at an early age, if fingers of unequal length have to be separated. Zig-zag incision should be used in all cases.

Nanofat grafting under a split-thickness skin graft for problematic wound management.

PubMed

Kemaloğlu, Cemal Alper

2016-01-01

Obesity and certain medical disorders make the reconstruction of skin defects challenging. Different kind of procedure can be used for these defect, besides, skin grafting is one of the most common and simplest procedure. Fat grafting and stem cells which are located in the adipose tissue have been commonly used in plastic surgery for regeneration and rejuvenation purposes. To decrease graft failure rate we performed nanofat grafting under an autologous split-thickness skin graft in our patient who had a problematic wound. The case of a 35-year-old female patient with a traumatic skin defect on her left anterior crural region is described herein. After subsequent flap reconstruction, the result was disappointing and the defect size was widened. The defect was treated with combined grafting (nanofat grafting under an autologous split-thickness skin graft). At the 6 months follow-up assessment after combined grafting, the integrity of the skin graft was good with excellent pliability. Combined grafting for problematic wounds seems to be a useful technique for cases requiring reconstruction. The potential existence of stem cells may be responsible for the successful result in our patient.

[Split-thickness skin graft donor site: which dressing use?].

PubMed

Caliot, J; Bodin, F; Chiriac, S; Correia, N; Poli-Mérol, M-L; François-Fiquet, C

2015-04-01

The management of split-thickness skin graft donor sites is targeted towards promoting the healing process, reducing pain. This has been an inconclusive topic. The aim of this study was to list and to discuss the French practices in term of split-thickness skin graft (STSG) donor site dressing. Multicentric national study by questionnaire (Google Drive(®)) for the attention of the plastic and/or pediatric surgeons. The type of dressing used on skin and sclap and the rhythm of dressing changes were analyzed. The study included 26 surgical centers on 40 contacted. The alginate is mainly used (Algostéril(®)) (17/26). It is left in position until healing (13/17). Five other types of dressings have been reported: paraffin gauze (3/26), lipidocolloides (1/26), Mepitel(®) (1/26), Mepilex(®) (1/26), indifferent use of gauze or alginate dressings (4/26). Twenty-two out of 26 centers make no difference in dressing choice between skin and scalp. Medical practices did not differ between adult or pediatric departments. Cost-effectiveness has become an important issue in wound management, requiring judicious use. The lack of consensus regarding split-thickness skin graft donor site dressing and our clinical practices force us to reconsider the best therapeutic option. This study coupled with the analysis of the literature highlights the difficulties of the practitioner in choosing the best dressing. The alginate seems to get the preference of our practices by its ease of use, its absence of change (reduces pain by limiting manipulations) and its moderate cost. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Factors that Affected Functional Outcome After a Delayed Excision and Split-Thickness Skin Graft on the Dorsal Side of Burned Hands.

PubMed

Shichinohe, Ryuji; Yamamoto, Yuhei; Kawashima, Kunihiro; Kimura, Chu; Ono, Kentaro; Horiuchi, Katsumi; Yoshida, Tetsunori; Murao, Naoki; Hayashi, Toshihiko; Funayama, Emi; Oyama, Akihiko; Furukawa, Hiroshi

Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury. The hands were divided into two functional categories: Functional category A, normal or nearly normal joint movements, and functional category B, abnormal joint movements. Demographic data were assessed statistically by a univariate analysis following a multiple regression analysis by a stepwise selection. A significant difference was observed between the groups in the number of days from grafting to complete wound healing of the graft site and with or without an escharotomy in the analysis. These parameters were statistically significant predictors of functional category B. The functional outcome of a burned hand after a delayed excision and split-thickness skin graft on the dorsal side became degraded depending on the number of days from grafting to complete wound healing. Cases that underwent an escharotomy also showed deterioration in function.

Randomized, Paired-site Comparison of Autologous Engineered Skin Substitutes and Split-thickness Skin Graft for Closure of Extensive, Full-thickness Burns

PubMed Central

Boyce, Steven T.; Simpson, Peggy S.; Rieman, Mary T.; Warner, Petra M.; Yakuboff, Kevin P.; Bailey, J. Kevin; Nelson, Judith K.; Fowler, Laura A.; Kagan, Richard J.

2016-01-01

Objectives Stable closure of full-thickness burn wounds remains a limitation to recovery from burns of greater than 50% of the total body surface area (TBSA). Hypothetically, engineered skin substitutes (ESS) consisting of autologous keratinocytes and fibroblasts attached to collagen-based scaffolds may reduce requirements for donor skin, and decrease mortality. Methods ESS were prepared from split-thickness skin biopsies collected after enrollment of 16 pediatric burn patients into an approved study protocol. ESS and split-thickness autograft (AG) were applied to 15 subjects with full-thickness burns involving a mean of 76.9% TBSA. Data consisted of photographs, tracings of donor skin and healed wounds, comparison of mortality with the National Burn Repository (NBR), correlation of TBSA closed wounds with TBSA full-thickness burn, frequencies of regrafting, and immunoreactivity to the biopolymer scaffold. Results One subject expired before ESS application, and 15 subjects received 2056 ESS grafts. The ratio of closed wound to donor areas was 108.7±9.7 for ESS compared with a maximum of 4.0±0.0 for AG. Mortality for enrolled subjects was 6.25%, and 30.3% for a comparable population from the NBR (p<0.05). Engraftment was 83.5±2.0% for ESS and 96.5±0.9 for AG. Percentage TBSA closed was 29.9±3.3% for ESS, and 47.0±2.0 for AG. These values were significantly different between the graft types. Correlation of % TBSA closed with ESS with % TBSA full-thickness burn generated an R2 value of 0.65 (p<0.001). Conclusions These results indicate that autologous ESS reduce mortality and requirements for donor skin harvesting, for grafting of full-thickness burns of greater than 50% TBSA. PMID:27404165

Randomized, Paired-Site Comparison of Autologous Engineered Skin Substitutes and Split-Thickness Skin Graft for Closure of Extensive, Full-Thickness Burns.

PubMed

Boyce, Steven T; Simpson, Peggy S; Rieman, Mary T; Warner, Petra M; Yakuboff, Kevin P; Bailey, J Kevin; Nelson, Judith K; Fowler, Laura A; Kagan, Richard J

Stable closure of full-thickness burn wounds remains a limitation to recovery from burns of greater than 50% of the total body surface area (TBSA). Hypothetically, engineered skin substitutes (ESS) consisting of autologous keratinocytes and fibroblasts attached to collagen-based scaffolds may reduce requirements for donor skin, and decrease mortality. ESS were prepared from split-thickness skin biopsies collected after enrollment of 16 pediatric burn patients into an approved study protocol. ESS and split-thickness autograft (AG) were applied to 15 subjects with full-thickness burns involving a mean of 76.9% TBSA. Data consisted of photographs, tracings of donor skin and healed wounds, comparison of mortality with the National Burn Repository, correlation of TBSA closed wounds with TBSA full-thickness burn, frequencies of regrafting, and immunoreactivity to the biopolymer scaffold. One subject expired before ESS application, and 15 subjects received 2056 ESS grafts. The ratio of closed wound to donor areas was 108.7 ± 9.7 for ESS compared with a maximum of 4.0 ± 0.0 for AG. Mortality for enrolled subjects was 6.25%, and 30.3% for a comparable population from the National Burn Repository (P < .05). Engraftment was 83.5 ± 2.0% for ESS and 96.5 ± 0.9% for AG. Percentage TBSA closed was 29.9 ± 3.3% for ESS, and 47.0 ± 2.0% for AG. These values were significantly different between the graft types. Correlation of % TBSA closed with ESS with % TBSA full-thickness burn generated an R value of 0.65 (P < .001). These results indicate that autologous ESS reduce mortality and requirements for donor skin harvesting, for grafting of full-thickness burns of greater than 50% TBSA.

500-Gray γ-Irradiation May Increase Adhesion Strength of Lyophilized Cadaveric Split-Thickness Skin Graft to Wound Bed.

PubMed

Wei, Lin-Gwei; Chen, Chieh-Feng; Wang, Chi-Hsien; Cheng, Ya-Chen; Li, Chun-Chang; Chiu, Wen-Kuan; Wang, Hsian-Jenn

2017-03-01

Human cadaveric skin grafts are considered as the "gold standard" for temporary wound coverage because they provide a more conductive environment for natural wound healing. Lyophilization, packing, and terminal sterilization with gamma-ray can facilitate the application of cadaveric split-thickness skin grafts, but may alter the adhesion properties of the grafts. In a pilot study, we found that 500 Gy γ-irradiation seemed not to reduce the adherence between the grafts and wound beds. We conducted this experiment to compare the adherences of lyophilized, 500-Gy γ-irradiated skin grafts to that of lyophilized, nonirradiated grafts. Pairs of wounds were created over the backs of Sprague- Dawley rats. Pairs of "lyophilized, 500-Gy γ-irradiated" and "lyophilized, nonirradiated" cadaveric split-thickness skin grafts were fixed to the wound beds. Adhesion strength between the grafts and the wound beds was measured and compared. On post-skin-graft day 7 and day 10, the adhesion strength of γ-irradiated grafts was greater than that of the nonirradiated grafts. Because lyophilized cadaveric skin grafts can be vascularized and the collagen of its dermal component can be remodeled after grafting, the superior adhesion strength of 500-Gy γ-irradiated grafts can be explained by the collagen changes from irradiation.

STUDIES ON THE CONSERVATION OF EPIDERMAL SPECIFICITIES OF SKIN AND CERTAIN MUCOSAS IN ADULT MAMMALS

PubMed Central

Billingham, R. E.; Silvers, Willys K.

1967-01-01

To determine whether the factor(s) responsible for the conservation of epidermal specificities in adult guinea pigs and hamsters resides in the germinal layer of the epidermis or in the dermis, thin grafts of skin, possessing qualitatively distinct regional characteristics, were separated into their superficial epidermal and dermal components with the aid of trypsin. Dermis of one type was combined with epidermis of another to produce "recombinant" grafts which were then transplanted to small, full thickness cutaneous sites on the thorax of geneticaily compatible hosts. A variant of this procedure involved transplanting sheets of superficial epidermis of various types to shallow split thickness recipient areas in the skin of the thorax. All grafts were maintained for 100 days before they were excised and examined histologically. The results indicate that, whereas the dermis determines the kind of epidermis produced in recombinant grafts involving the ear, the sole of the foot, and the trunk, this is not the case in recombinants which include tongue, esophageal, or cheek pouch epithelia. The one exception to this occurred when tongue or esophagus epithelia were transplanted to split thickness beds in trunk skin. Here they appeared to produce an epidermis characteristic of their new location. It is believed that this exception is probably due to the fact that the native follicular epidermis present in trunk dermis made such a substantial contribution to the new superficial epidermis that it behaved overtly as body skin epidermis. Taken together, these results suggest that basal layer cells of the superficial epidermis of sole of foot skin, ear skin, and the hair-bearing skin of the general integument behave as if they are equipotential, and that in adult life maintenance of these particular epidermal specificities is the outcome of persistent specific inductive stimuli from the underlying dermis. The results of subsidiary experiments are reported which indicate that the epithelial component of mammary gland tissue is also pluripotential, being capable of producing, under appropriate conditions, a normal-looking, fully stratified superficial epidermis. PMID:5334545

Antimicrobial-impregnated dressing combined with negative-pressure wound therapy increases split-thickness skin graft engraftment: a simple effective technique.

PubMed

Wu, Cheng-Chun; Chew, Khong-Yik; Chen, Chien-Chang; Kuo, Yur-Ren

2015-01-01

Immobilization and adequate surface contact to wounds are critical for skin graft take. Techniques such as the tie-over dressing, cotton bolster, and vacuum-assisted closure are used to address this, but each has its limitations. This study is designed to assess the effect of antimicrobial-impregnated dressing (AMD) combined with negative-pressure wound therapy (NPWT) on skin graft survival. Retrospective case-control study : Patients with chronic or contaminated wounds treated with split-thickness skin graft. A broad spectrum of wounds was included, from causes such as trauma, burns, chronic diabetic ulcers, and infection. Antimicrobial-impregnated dressing, which contains 0.2% polyhexamethylene biguanide, with NPWT MAIN OUTCOME MEASURE:: Success of skin graft : In the AMD group, all skin grafts achieved 100% take without secondary intervention. No infection or graft failure was observed in any patients, and no complications, such as hematoma or seroma formation, were noted, although in the control group partial loss of skin grafts was noted in 3 patients. Infection and inadequate immobilization were thought to be the main reasons. There were no hematoma or seroma formations in the control group. Use of an AMD dressing with NPWT after split-thickness skin grafting can be an effective method to ensure good graft to wound contact and enhances skin graft take in chronic and contaminated wounds.

Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft.

PubMed

Sonker, Atul; Dubey, Anju; Bhatnagar, Ankur; Chaudhary, Rajendra

2015-01-01

Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at -80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality.

Clinical potential of a silk sericin-releasing bioactive wound dressing for the treatment of split-thickness skin graft donor sites.

PubMed

Siritientong, Tippawan; Angspatt, Apichai; Ratanavaraporn, Juthamas; Aramwit, Pornanong

2014-01-01

An ethyl alcohol-precipitated silk sericin/PVA scaffold that controlled the release of silk sericin was previously developed and applied for the treatment of full-thickness wounds in rats and demonstrated efficient healing. In this study, we aimed to further evaluate the clinical potential of this scaffold, hereafter called "silk sericin-releasing wound dressing", for the treatment of split-thickness skin graft donor sites by comparison with the clinically available wound dressing known as "Bactigras®". In vitro characterization and in vivo evaluation for safety of the wound dressings were performed. A clinical trial of the wound dressings was conducted according to standard protocols. The sericin released from the wound dressing was not toxic to HaCat human keratinocytes. A peel test indicated that the silk sericin-releasing wound dressing was less adhesive than Bactigras®, potentially reducing trauma and the risk of repeated injury upon removal. There was no evidence of skin irritation upon treatment with either wound dressing. When tested in patients with split-thickness skin graft donor sites, the wounds treated with the silk sericin-releasing wound dressing exhibited complete healing at 12 ± 5.0 days, whereas those treated with Bactigras® were completely healed at 14 ± 5.2 days (p = 1.99 × 10(-4)). In addition, treatment with the silk sericin-releasing wound dressing significantly reduced pain compared with Bactigras® particularly during the first 4 postoperative days (p = 2.70 × 10(-5) on day 1). We introduce this novel silk sericin-releasing wound dressing as an alternative treatment for split-thickness skin graft donor sites.

Reconstruction of full-thickness defects with bovine-derived collagen/elastin matrix: a series of challenging cases and the first reported post-burn facial reconstruction.

PubMed

Haik, Josef; Weissman, Oren; Hundeshagen, Gabriel; Farber, Nimrod; Harats, Moti; Rozenblatt, Shira M; Kamolz, Lars Peter; Winkler, Eyal; Zilinsky, Isaac

2012-07-01

Reconstruction of full-thickness defects may benefit from integration of dermal substitutes, which serve as a foundation for split-thickness skin grafts, thus enhancing short and long-term results. We present a series of 7 patients who were treated between 2010 and 2012 for complicated full-thickness defects by the second-generation collagen/elastin matrix Matriderm® covered by a split-thickness skin graft. The defects resulted from malignancy resection, trauma, and post-burn scar reconstruction. Overall graft take was excellent and no complications were noted regarding the dermal substitute. Graft quality was close to normal skin in terms of elasticity, pliability, texture, and color. Good contour and cushioning of defects in weight bearing areas was also achieved. Matriderm was found to be a useful adjunct to full-thickness defect reconstruction, especially in difficult areas where the desired result is a scar of the highest quality possible.

Effects of ultrasound and sodium lauryl sulfate on the transdermal delivery of hydrophilic permeants: Comparative in vitro studies with full-thickness and split-thickness pig and human skin

PubMed Central

Seto, Jennifer E.; Polat, Baris E.; Lopez, Renata F.V.; Blankschtein, Daniel; Langer, Robert

2010-01-01

The simultaneous application of ultrasound and the surfactant sodium lauryl sulfate (referred to as US/SLS) to skin enhances transdermal drug delivery (TDD) in a synergistic mechanical and chemical manner. Since full-thickness skin (FTS) and split-thickness skin (STS) differ in mechanical strength, US/SLS treatment may have different effects on their transdermal transport pathways. Therefore, we evaluated STS as an alternative to the well-established US/SLS-treated FTS model for TDD studies of hydrophilic permeants. We utilized the aqueous porous pathway model to compare the effects of US/SLS treatment on the skin permeability and the pore radius of pig and human FTS and STS over a range of skin electrical resistivity values. Our findings indicate that the US/SLS-treated pig skin models exhibit similar permeabilities and pore radii, but the human skin models do not. Furthermore, the US/SLS-enhanced delivery of gold nanoparticles and quantum dots (two model hydrophilic macromolecules) is greater through pig STS than through pig FTS, due to the presence of less dermis that acts as an artificial barrier to macromolecules. In spite of greater variability in correlations between STS permeability and resistivity, our findings strongly suggest the use of 700-μm-thick pig STS to investigate the in vitro US/SLS-enhanced delivery of hydrophilic macromolecules. PMID:20346994

Integra as a Dermal Replacement in a Meshed Composite Skin Graft in a Rat Model: A One-Step Operative Procedure

DTIC Science & Technology

2002-01-01

skin graft (MCSG) using Integra as a dermal template for a meshed split thickness autograft was developed in rats. The silicon layer of Integra was removed, the resulting dermal analogue was meshed (1:1.5), expanded, and placed on excised full thickness wound and covered with a meshed (1:1.5 or 1:6) split thickness autograft. Grafted wounds were dressed with BioBrane, Vaseline gauze, silver-impregnated nylon, or silver-nylon and direct current (SNDC). At scheduled intervals up to 3 months postgrafting, wounds were examined for epithelialization, collagen deposition and

Thick- and thin-skinned organisations and enactment in borderline and narcissistic disorders.

PubMed

Bateman, A W

1998-02-01

In this paper the author argues that enactment is any mutual action within the patient/analyst relationship that arises in the context of difficulties in countertransference work. Such enactment is common during the treatment of borderline and narcissistic disorders. In order to delineate different forms of enactment, which in his view may be either to the detriment or to the benefit of the analytic process, the author describes a patient who was identified primarily with a sadistic mother and who threatened the analyst with a knife during treatment. Three levels of enactment involving countertransference responses are described of which two, namely a collusive countertransference and a defensive countertransference, were detrimental to the analytic process. The third level of enactment was beneficial but only because the intervention by the analyst was independent of the analytic process and yet in response to it. The author uses Rosenfeld's distinction between thin-skinned and thick-skinned narcissists to illustrate how enactment is most likely when a patient moves between thick-skinned and thin-skinned narcissistic positions. Nevertheless the move between thin and thick-skinned positions presents an opportunity for effective interpretation, allowing progress in treatment.

A Novel Technique for Split-Thickness Skin Donor Site Pain Control: Subcutaneous Catheters for Continuous Local Anesthetic Infusion

DTIC Science & Technology

2012-01-01

the new: a novel approach to treating pain associated with rib fractures . World J Surg 2010;34:2359–62. 3. Wheatley GH III, Rosenbaum DH, Paul MC, et...has been described after laparotomy, tho- racotomy, inguinal hernia repair, and rib fractures .2–4 We describe our experience at the U.S. Army Insti...JAN 2012 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE A novel technique for split-thickness skin donor site pain control

Multiple Graft Harvestings from Deep Partial-Thickness Scald Wounds Healed under the Influence of Weak Direct Current

DTIC Science & Technology

1990-01-01

acanthosis (H&E, 10X). FIG. 8. Scald wound of a treated animal 16 days after the second split-thickness skin graft harvesting. A) Gross appearance...that is, simply cutting the skin graft at a prede- Doctor Monafo’s questions about another model: yes, in fact, termined thickness and then

Negative pressure wound therapy, staged excision and definitive closure with split-thickness skin graft for axillary hidradenitis suppurativa: a retrospective study.

PubMed

Pearce, F B; Richardson, K A

2017-01-02

Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol. Using ICD-9 codes (705.83) and CPT codes (11041, 11042, 11451, 11600, 11601, 11602, 11603, 11604) we reviewed cases performed at our institution from 1 January 2008 to 24 Febuary 2014 and we selected patients based on bilateral axillary involvement (alone) and >1 year history of active disease. Patients were excluded if resection of tissue encompassed regions outside of the immediately adjacent axillary. A total of seven patients matching criteria for bilateral axillary hidradenitis were selected for analysis. Clinical course, cost and surgical techniques were assessed. Of the seven patients, six required admission throughout their treatment due to lack of funding making use of negative pressure wound therapy at home not possible. These patients stayed an average of 10 days with a mean hospital charge of $35,178 and a mean hospital provider charge of $10,019. No recurrence was demonstrated. All patients attained full range of motion, post grafting. No patient required a further operation due to graft failure. Split-thickness skin grafting without use of bilayer dermal regenerative templates yielded definitive results with acceptable cosmesis and functionality, without the added cost of treatments such as a bilayer dermal regenerative template.

Penile Reconstruction with Skin Grafts and Dermal Matrices: Indications and Management

PubMed Central

Triana Junco, Paloma; Dore, Mariela; Nuñez Cerezo, Vanesa; Jimenez Gomez, Javier; Miguel Ferrero, Miriam; Díaz González, Mercedes; Lopez-Pereira, Pedro; Lopez-Gutierrez, Juan Carlos

2017-01-01

Introduction  The penis eventually needs specific cutaneous coverage in the context of reconstructive procedures following trauma or congenital anomalies. Local flaps are the first choice but are not always available after multiple previous procedures. In these cases, skin graft and dermal matrices should be considered. Materials and Methods  This study was a retrospective review of the past 4 years of four patients with severe loss of penile shaft skin who underwent skin reconstruction. Dermal matrices and skin grafts were utilized. Dermal matrices were placed for a median of 4.5 weeks (3.0–6.0 weeks). The skin graft was harvested from the inner thigh region for split-thickness skin graft (STSG) and the inguinal region for full-thickness skin graft (FTSG). Results  The four patients presented with complete loss of skin in the penile shaft. One patient had a vesical exstrophy, one had a buried penis with only one corpus cavernosum, one had a wide congenital lymphedema of the genitalia, and one had a lack of skin following circumcision at home. They underwent reconstruction with three patients undergoing split-thickness skin graft; two dermal matrices; and one full-thickness graft, respectively, thereby achieving a good cosmetic and functional result. There were no complications, and all the patients successfully accepted the graft. Conclusion  Dermal matrices and skin grafts may serve as effective tools in the management of severe penile skin defects unable to be covered with local flaps. PMID:28868232

Platelet-rich plasma-containing fragmin-protamine micro-nanoparticles promote epithelialization and angiogenesis in split-thickness skin graft donor sites.

PubMed

Takabayashi, Yuki; Ishihara, Masayuki; Sumi, Yuki; Takikawa, Makoto; Nakamura, Shingo; Kiyosawa, Tomoharu

2015-01-01

Platelet-rich plasma (PRP) contains multiple growth factors, and fragmin-protamine micro-nanoparticles (F-P M-NPs) significantly enhance and stabilize growth factors. The purpose of this study was to evaluate the effects of PRP-containing F-P M-NPs (PRP&F-P M-NPs) on wound repair in split-thickness skin graft (STSG-) donor sites (DS). A total of 56 inbred male rats were anesthetized and split-thickness skin graft donor site (STSG-DS) were created with a Padgett dermatome. PRP&F-P M-NPs, F-P M-NPs, PRP, and saline (control) were then intradermally injected evenly into the STSG-DSs. On 3, 4, 5, 7, and 10 d after creation of STSG-DS, skin sample sections were stained with hematoxylin and eosin to evaluate reepithelialization and angiogenesis. Treatment of STSG-DS with PRP&F-P M-NPs effectively promoted epithelialization and new vessel formation compared with those treated with PRP, F-P M-NPs, and control (saline). The intradermal injection of PRP&F-P M-NPs promotes epithelialization and angiogenesis in STSG-DS wounds. Copyright © 2015 Elsevier Inc. All rights reserved.

Reconstructive Surgery in the Thermally Injured Patient

DTIC Science & Technology

2012-01-01

Pedicle flaps • Reconstructive Surgery • Thermal injury • Z-plasties • Skin grafting AN INCREASED NEED FOR RECONSTRUCTIVE SURGERY Reconstruction is a...dermal structure and include the tendency for recurrent contractures. full-thickness skin graft s are usually reserved for reconstructions with...dermatologic surgery: review and update on full- and split thickness skin grafts , free cartilage grafts, and composite grafts. Dermatol Surg 2005;31

Continuous Aspirin Use Does Not Increase Bleeding Risk of Split-Thickness Skin Transplantation Repair to Chronic Wounds.

PubMed

Sun, Yanwei; Wang, Yibing; Li, Liang; Zhang, Zheng; Wang, Ning; Wu, Dan

Discontinuation of aspirin therapy before cutaneous surgery may cause serious complications. The aim of this prospective study was to evaluate the bleeding risk of split-thickness skin transplantation repair to chronic wounds in patients on aspirin therapy. A total of 97 patients who underwent split-thickness skin transplantation surgery of chronic wounds during a 2-year period were enrolled. They were categorized on the basis of aspirin therapies. The primary outcome was postoperative bleeding and bleeding complications. Univariate analysis was performed to examine the association between aspirin and bleeding complications. Among the 26 patients taking aspirin continuously in group A, there were 5 bleeding complications (19.23%). Among the 55 nonusers in group B, there were 10 bleeding complications (18.18%). Among the 16 discontinuous patients in group C, there were 3 bleeding complications (18.75%). No statistical differences were found among the groups ( P = .956). Univariate analysis showed that continuous aspirin use was not significantly associated with bleeding complications (odds ratio, 0.933; 95% confidence interval, 0.283-3.074; P = .910 in the aspirin and control groups) and that discontinuous aspirin use was not significantly associated with bleeding complications (odds ratio, 0.963; 95% confidence interval, 0.230-4.025; P = .959 in the aspirin and control groups; odds ratio, 0.969; 95% confidence interval, 0.198-4.752; P = .969 in the aspirin and discontinuous groups). Continuous aspirin use does not produce an additional bleeding risk in patients who undergo split-thickness skin transplantation repair of chronic wounds.

Effects of ultrasound and sodium lauryl sulfate on the transdermal delivery of hydrophilic permeants: Comparative in vitro studies with full-thickness and split-thickness pig and human skin.

PubMed

Seto, Jennifer E; Polat, Baris E; Lopez, Renata F V; Blankschtein, Daniel; Langer, Robert

2010-07-01

The simultaneous application of ultrasound and the surfactant sodium lauryl sulfate (referred to as US/SLS) to skin enhances transdermal drug delivery (TDD) in a synergistic mechanical and chemical manner. Since full-thickness skin (FTS) and split-thickness skin (STS) differ in mechanical strength, US/SLS treatment may have different effects on their transdermal transport pathways. Therefore, we evaluated STS as an alternative to the well-established US/SLS-treated FTS model for TDD studies of hydrophilic permeants. We utilized the aqueous porous pathway model to compare the effects of US/SLS treatment on the skin permeability and the pore radius of pig and human FTS and STS over a range of skin electrical resistivity values. Our findings indicate that the US/SLS-treated pig skin models exhibit similar permeabilities and pore radii, but the human skin models do not. Furthermore, the US/SLS-enhanced delivery of gold nanoparticles and quantum dots (two model hydrophilic macromolecules) is greater through pig STS than through pig FTS, due to the presence of less dermis that acts as an artificial barrier to macromolecules. In spite of greater variability in correlations between STS permeability and resistivity, our findings strongly suggest the use of 700microm-thick pig STS to investigate the in vitro US/SLS-enhanced delivery of hydrophilic macromolecules. 2010 Elsevier B.V. All rights reserved.

Vacuum-assisted closure device as a split-thickness skin graft bolster in the burn population.

PubMed

Waltzman, Joshua T; Bell, Derek E

2014-01-01

The vacuum-assisted closure device (VAC) is associated with improved wound healing outcomes. Its use as a bolster device to secure a split-thickness skin graft has been previously demonstrated; however, there is little published evidence demonstrating its benefits specifically in the burn population. With use of the VAC becoming more commonplace, its effect on skin graft take and overall time to healing in burn patients deserves further investigation. Retrospective review of burn registry database at a high-volume level I trauma center and regional burn center during a 16-month period was performed. Patients who had a third-degree burn injury requiring a split-thickness skin graft and who received a VAC bolster were included. Data points included age, sex, burn mechanism, burn location, grafted area in square centimeters, need for repeat grafting, percent graft take, and time to complete reepithelialization. Sixty-seven patients were included in the study with a total of 88 skin graft sites secured with a VAC. Age ranged from <1 year to 84 years (average 41 years). The average grafted area was 367 ± 545 cm. The three most common were the leg, thigh, and arm (28, 15, and 12%, respectively). Average percent graft take was 99.5 ± 1.5%. Notably, no patients returned to the operating room for repeat grafting. The average time to complete reepithelialization was 16 ± 7 days. The VAC is a highly reliable and reproducible method to bolster a split-thickness skin graft in the burn population. The observed rate of zero returns to the operating room for repeat grafting was especially encouraging. Its ability to conform to contours of the body and cover large surface areas makes it especially useful in securing a graft. This method of bolstering results in decreased repeat grafting and minimal graft loss, thus decreasing morbidity compared with conventional bolster dressings.

Testing thin-skinned inversion of a prerift salt-bearing passive margin (Eastern Prebetic Zone, SE Iberia)

NASA Astrophysics Data System (ADS)

Escosa, Frederic O.; Roca, Eduard; Ferrer, Oriol

2018-04-01

Detailed geologic mapping combined with well and seismic data from the Eastern Prebetic Zone (SE Iberia) reveal extensional and contractional structures that permit characterization of passive margin development and its incorporation into a thin-skinned fold-and-thrust belt. The study area is represented by NW-directed, ENE-trending folds and thrusts faults locally disrupted by the NW-trending Matamoros Basin and the active Jumilla and La Rosa diapirs. These structures resulted from the thin-skinned inversion of the proximal part of the Eastern South Iberian passive margin containing prerift salt. Here, Upper Jurassic to Santonian thick-skinned extension controlled the accumulation of sediment over mobile prerift salt. This in turn defined the style of salt tectonics characterized by monoclinal drape folds, suprasalt extensional faults and diapirs. The structural and sedimentological analysis suggests that during extension, salt localizes strain thus decoupling sub- and suprasalt deformation. Thick-skinned extension controls suprasalt deformation as well as its location and distribution which changes over time. Salt also localizes strain during inversion. The preexisting salt structures, weaker than adjacent areas, preferentially absorb the contractional deformation. In addition, the stepped subsalt geometry that results from thick-skinned extension also controls the shortening propagation. Therefore, the degree of strain localization depends on the thickness of the suprasalt cover and on the dip of subsalt faults relative to the thin-skinned transport direction.

Resurfacing the Penis of Complex Hypospadias Repair ("Hypospadias Cripples").

PubMed

Fam, Mina M; Hanna, Moneer K

2017-03-01

After the creation of a neourethra in a "hypospadias cripple," resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred and unusable. We reviewed our experience with various strategies to resurface the penis of hypospadias cripples. We retrospectively reviewed the records of 215 patients referred after multiple unsuccessful hypospadias repairs from 1981 to 2014. In 130 of 215 patients we performed resurfacing using local penile flaps using various techniques, including Byars flaps, Z-plasty or double Z-plasty, or a dorsal relaxing incision. Of the 215 patients 85 did not have adequate healthy local penile skin to resurface the penis after urethroplasty. Scrotal skin was used to resurface the penis in 54 patients, 6 underwent tissue expansion of the dorsal penile skin during a 12 to 16-week period prior to penile resurfacing, 23 underwent full-thickness skin grafting and another 4 received a split-thickness skin graft. Of the 56 patients who underwent fasciomyocutaneous rotational flaps, tissue expansion or a combination of both approaches 54 (96.4%) finally had a successful outcome. All 6 patients who underwent tissue expansion had a successful outcome without complications and were reported on previously. All 23 full-thickness skin grafts took with excellent results. All 4 patients who underwent fenestrated split-thickness skin grafting had 100% graft take but secondary contraction and ulceration were associated with sexual activity. In our experience scrotal skin flaps, tissue expansion of the dorsal penile skin and full-thickness skin grafts serve as reliable approaches in resurfacing the penis in almost any hypospadias cripple lacking healthy local skin. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Study on preparation of laser micropore porcine acellular dermal matrix combined with split-thickness autograft and its application in wound transplantation].

PubMed

Liang, Li-Ming; Chai, Ji-Ke; Yang, Hong-Ming; Feng, Rui; Yin, Hui-Nan; Li, Feng-Yu; Sun, Qiang

2007-04-01

To prepare a porcine acellular dermal matrix (PADM), and to optimize the interpore distance between PADM and co-grafted split-thickness autologous skin. Porcine skin was treated with trypsin/Triton X-100 to prepare an acellular dermal matrix. Micropores were produced on the PADM with a laser punch. The distance between micropores varied as 0.8 mm, 1.0 mm, 1.2 mm and 1.5 mm. Full-thickness defect wounds were created on the back of 144 SD rats. The rats were randomly divided into 6 groups as follows, with 24 rats in each group. Micropore groups I -IV: the wounds were grafted with PADM with micropores in four different intervals respectively, and covered with split-thickness autologous skin graft. Mesh group: the wounds were grafted with meshed PADM and split-thickness autograft. with simple split-thickness autografting. The gross observation of wound healing and histological observation were performed at 2, 4, 6 weeks after surgery. The wound healing rate and contraction rate were calculated. Two and four weeks after surgery, the wound healing rate in micropore groups I and II was lower than that in control group (P < 0.05), but no obvious difference was between micropore groups I , II and mesh group (P > 0.05) until 6 weeks after grafting( P <0.05). The wound contraction rate in micropore groups I and II ([(16.0 +/- 2.6)%, (15.1 +/- 2.4)%] was remarkably lower than that in control group 4 and 6 weeks after grafting (P < 0.05), and it was significantly lower than that in mesh group [(19.3 +/- 2.4)%] 6 weeks after surgery (P <0.05). Histological examination showed good epithelization, regularly arranged collagenous fibers, and integral structure of basement membrane. Laser micropore PADM (0.8 mm or 1.0 mm in distance) grafting in combination with split-thickness autografting can improve the quality of wound healing. PADM with laser micropores in 1.0 mm distance is the best choice among them.

Delayed grafting for banked skin graft in lymph node flap transfer.

PubMed

Ciudad, Pedro; Date, Shivprasad; Orfaniotis, Georgios; Dower, Rory; Nicoli, Fabio; Maruccia, Michele; Lin, Shu-Ping; Chuang, Chu-Yi; Chuang, Tsan-Yu; Wang, Gou-Jen; Chen, Hung-Chi

2017-02-01

Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us explore the possibility of attempting delayed skin grafting. We have herein reported our experience with delayed grafting with autologous banked split skin grafts in cases of LNF transfer for lymphoedema of the extremities. Ten patients with International Society of Lymphology stage II-III lymphoedema of upper or lower extremity were included in this study over an 8-month period. All patients were thoroughly evaluated and subjected to lymph node flap transfer. The split skin graft was harvested and banked at the donor site, avoiding immediate resurfacing over the flap. The same was carried out in an aseptic manner as a bedside procedure after confirming flap viability and allowing flap swelling to subside. Patients were followed up to evaluate long-term outcomes. Flap survival was 100%. Successful delayed skin grafting was done between the 4th and 6th post-operative day as a bedside procedure under local anaesthesia. The split thickness skin grafts (STSG) takes more than 97%. One patient needed additional medications during the bedside procedure. All patients had minimal post-operative pain and skin graft requirement. The patients were also reported to be satisfied with the final aesthetic results. There were no complications related to either the skin grafts or donor sites during the entire period of follow-up. Delayed split skin grafting is a reliable method of resurfacing lymph node flaps and has been shown to reduce the possibility of flap complications as well as the operative time and costs. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix.

PubMed

Zhang, Xuyin; Han, Tiantian; Ding, Jingxin; Hua, Keqin

2015-01-01

The aim of this study was to introduce a new technique which is combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix and to evaluate the feasibility and the safety of it. This is a prospective observational study of 10 patients with congenital atresia of cervix who underwent combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft for cervicovaginal reconstruction from February 2013 to August 2014 in our hospital. All of the surgical procedures were carried out by the same operation team. Patient data were collected including operating time, estimated blood loss, hospital stay post-surgery, complications, total cost, and median vaginal length at 3 month, resumption of menstruation, vaginal stenosis and stricture of the cervix postoperatively. The operative procedure lasted 237±46 (175-380) min. The estimated blood loss was 160±76 (50-300) ml. The hospital stay post-surgery was 12±2 (9-18) days. None of the patients had complications or required a blood transfusion. The mean total cost was $3352±1025. The average vaginal length at 3 month was 8.3±1.1 (8-10) cm. All patients had resumption of menstruation. The patients were followed for a mean of 5±2 (1-10) months. Cervical or vaginal stenosis did not occur in any of the patients. Our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in10 patients with congenital atresia of cervix were positive, with successful results and without complications, and cervical or vaginal stenosis.

Combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix

PubMed Central

Zhang, Xuyin; Han, Tiantian; Ding, Jingxin; Hua, Keqin

2015-01-01

Objective: The aim of this study was to introduce a new technique which is combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix and to evaluate the feasibility and the safety of it. Methods: This is a prospective observational study of 10 patients with congenital atresia of cervix who underwent combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft for cervicovaginal reconstruction from February 2013 to August 2014 in our hospital. All of the surgical procedures were carried out by the same operation team. Patient data were collected including operating time, estimated blood loss, hospital stay post-surgery, complications, total cost, and median vaginal length at 3 month, resumption of menstruation, vaginal stenosis and stricture of the cervix postoperatively. Results: The operative procedure lasted 237±46 (175-380) min. The estimated blood loss was 160±76 (50-300) ml. The hospital stay post-surgery was 12±2 (9-18) days. None of the patients had complications or required a blood transfusion. The mean total cost was $3352±1025. The average vaginal length at 3 month was 8.3±1.1 (8-10) cm. All patients had resumption of menstruation. The patients were followed for a mean of 5±2 (1-10) months. Cervical or vaginal stenosis did not occur in any of the patients. Conclusions: Our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in10 patients with congenital atresia of cervix were positive, with successful results and without complications, and cervical or vaginal stenosis. PMID:26309703

[Necrotizing fasciitis of the hand and forearm : Acute surgical treatment and defect reconstruction with MatriDerm® and split-thickness skin graft].

PubMed

Niedermueller, B; Singer, G; Pickl, P; Jesacher, M

2018-03-01

This case report describes a 55-year-old male patient with type II necrotizing fasciitis (NF) of the hand and forearm. The rapid progression of the tissue infection could be successfully stopped with radical surgical débridement and antibiotic therapy. For the reconstruction of the extensive loss of soft tissue a combination of split-thickness skin graft (STSG) and the synthetic dermal substitute MatriDerm® was used. In cases of NF, MatriDerm® and STSG provide a rapidly available and simple alternative to other reconstruction techniques.

Histological Stratification of Thick and Thin Plaque Psoriasis Explores Molecular Phenotypes with Clinical Implications

PubMed Central

Kim, Dong Joo; Brodmerkel, Carrie; Correa da Rosa, Joel; Krueger, James G.; Suárez-Fariñas, Mayte

2015-01-01

Psoriasis, which presents as red, scaly patches on the body, is a common, autoimmune skin disease that affects 2 to 3 percent of the world population. To leverage recent molecular findings into the personalized treatment of psoriasis, we need a strategy that integrates clinical stratification with molecular phenotyping. In this study, we sought to stratify psoriasis patients by histological measurements of epidermal thickness, and to compare their molecular characterizations by gene expression, serum cytokines, and response to biologics. We obtained histological measures of epidermal thickness in a cohort of 609 psoriasis patients, and identified a mixture of two subpopulations—thick and thin plaque psoriasis—from which they were derived. This stratification was verified in a subcohort of 65 patients from a previously published study with significant differences in inflammatory cell infiltrates in the psoriatic skin. Thick and thin plaque psoriasis shared 84.8% of the meta-analysis-derived psoriasis transcriptome, but a stronger dysregulation of the meta-analysis-derived psoriasis transcriptome was seen in thick plaque psoriasis on microarray. RT-PCR revealed that gene expression in thick and thin plaque psoriasis was different not only within psoriatic lesional skin but also in peripheral non-lesional skin. Additionally, differences in circulating cytokines and their changes in response to biologic treatments were found between the two subgroups. All together, we were able to integrate histological stratification with molecular phenotyping as a way of exploring clinical phenotypes with different expression levels of the psoriasis transcriptome and circulating cytokines. PMID:26176783

Auricular Split-Thickness Skin Graft for Ear Canal Coverage.

PubMed

Haidar, Yarah M; Walia, Sartaaj; Sahyouni, Ronald; Ghavami, Yaser; Lin, Harrison W; Djalilian, Hamid R

2016-12-01

Split-thickness skin graft (STSG) continues to be the preferred means of external auditory canal (EAC) reconstruction. We thus sought to describe our experience using skin from the posterior aspect of the auricle (SPAA) as a donor site in EAC reconstruction. Grafts were, on average, 5 × 10 mm in size and obtained with a No. 10 blade after tumescence injection. The cases of 39 patients who underwent 41 procedures were retrospectively reviewed. Of the 38 patients with both 3- and 6-month follow-ups, no postoperative stenosis or bony exposure occurred. STSG from the SPAA can be a good option in EAC reconstruction. Total EAC/tympanic membrane coverage can be obtained with STSG from the SPAA. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Elbow reconstruction with a pedicled thoracodorsal artery perforator flap after excision of an upper-extremity giant hairy nevus.

PubMed

Oksüz, Sinan; Ulkür, Ersin; Tuncer, Serhan; Sever, Celalettin; Karagöz, Hüseyin

2013-04-01

The complexity of managing large soft-tissue defects at the elbow region by conventional techniques arises from the difficulty of providing sufficient tissue with adequate elasticity and durability. Reconstruction options that allow early mobilisation and avoid the risk of functional loss should be considered to achieve defect closure at the elbow region. A 21-year-old man presented with a congenital giant hairy nevus on his left upper extremity. The nevus was excised and the resulting raw surface after the excision was covered with a split-thickness skin graft except for the elbow region. The elbow was covered in one stage with an ipsilateral 24 cm long pedicled thoracodorsal artery perforator (TDAP) flap. The follow-up examination 3 years after total reconstruction demonstrated durable elbow support provided by the TDAP flap. The patient revealed no complaint considering pain or sensitivity even when exposed to mechanical stress. Split-thickness skin grafting of the large superficial defects is almost always possible; however, impairment of the function on joint areas due to gradual contraction and skin graft propensity to ulcers under mechanical stresses can be devastating. The elbow is a weight-bearing area of the body. Elbow defects require durable and thin soft-tissue coverage and the tissue cover must possess excellent elastic properties to re-establish elbow mobility. The TDAP flap is an ideal choice for elbow soft-tissue defects. The longest pedicle length reported for the TDAP flap is 23 cm. In our case, the pedicle length was 24 cm and it was possible to transfer this flap to the elbow on its pedicle. A pedicled TDAP skin flap so as to provide elbow coverage in one stage is a useful choice to retain in one's armamentarium. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Avoiding secondary skin graft donor site morbidity in the fibula free flap harvest.

PubMed

Kim, Paul D; Fleck, Terry; Heffelfinger, Ryan; Blackwell, Keith E

2008-12-01

To compare donor site morbidity in patients who have undergone fibula free flap reconstruction in which the skin graft was taken from the expected cutaneous paddle of the fibula with the known complications of the popular technique of obtaining a split-thickness skin graft (STSG) from a secondary donor site. Cohort study. The tertiary care centers at Loma Linda University Medical Center and University of California, Los Angeles, Medical Center. From September 1, 2006, to March 30, 2007, 30 patients underwent fibula free flap harvest by 2 surgeons at separate tertiary care centers. Twenty-one of those procedures took place at the University of California, Los Angeles, and 9 at Loma Linda University. Patients included 15 men (50%) and 15 women (50%), with a mean age of 58 (range, 19-88) years. All 30 patients underwent fibula free flap harvest with a split-thickness skin graft (graft thickness, 0.04 cm), obtained from osteocutaneous paddle using a 5.1-cm-wide dermatome, as well as oral cavity and oropharyngeal reconstruction with the de-epithelialized skin paddle. Measures of donor site morbidity, including graft failure and wound breakdown, and measures of recipient site morbidity, including flap failure, hardware complications, intraoral complications, and the need for additional surgery. Of the 30 patients who underwent this procedure, 4 had partial skin graft failures, for a complete skin graft survival of 87%. There were no complete skin graft losses. Regarding the fibula osteocutaneous free flap, there were no complete flap losses, 1 skin paddle necrosis that required debridement, 2 postoperative orocutaneous fistulas, 1 case of infected/extruded hardware, and 1 adhesion formation that required additional surgery for lysis of adhesion and placement of the split-thickness skin graft. The outlined novel technique has similar rates of free flap survival and skin graft take compared with previously described methods. Harvesting the skin graft over the expected osteocutaneous paddle results in decreased lower extremity morbidity by providing equivalent graft tissue for donor site closure and eliminating the morbidity of a secondary donor site. As long as there will not be 2 large opposing grafted surfaces, this technique should be considered when harvesting fibula free flaps for reconstruction of oromandibular resection defects, especially in cancers of the alveolar ridge and floor of the mouth.

An evaluation of fibrin tissue adhesive concentration and application thickness on skin graft survival.

PubMed

O'Grady, K M; Agrawal, A; Bhattacharyya, T K; Shah, A; Toriumi, D M

2000-11-01

To examine the effects of fibrinogen concentration and application thickness of fibrin tissue adhesive on skin graft survival. Prospective controlled study. Ten domestic pigs were included in the study. A 20 x 5-cm area of skin was harvested bilaterally along the flanks of the animals using a Padgett dermatome. The harvested grafts were trimmed into four 4 x 4-cm squares. Donor sites were treated according to group assignment and the non-meshed grafts were placed on the side opposite their initial orientation and secured with staples. Both single- and multiple-donor human fibrin tissue adhesive preparations, with low and high average fibrinogen concentrations of 30 mg/mL and 60 mg/ mL, were used. Adhesive preparations were applied in either a thin layer (0.015 mL/cm2) or a thick layer (0.06 mL/cm2) using a spray applicator. A constant thrombin concentration of 10 U/mL was used in the study. No adhesive was used in the control group and grafts were stabilized with staples. No topical dressings were applied to any of the treatment sites. Animals were sacrificed 4 weeks after graft application. Based on statistical analysis, thickness of adhesive application had a significant effect on skin graft survival. Percent mean graft survival in the control and thin application groups was found to be 92% and 97.8% respectively; the mean survival rate in the thick application group was 63.1%. Fibrinogen concentration, when evaluated independently within the thin and thick application groups, was found to have no significant effect on graft survival. Independent of fibrinogen concentration, a thin layer of fibrin tissue adhesive, when applied between two opposing surfaces, does not interfere with and may support the healing process, whereas a thick layer of adhesive inhibits skin graft healing.

Transparent thin shield for radio frequency transmit coils.

PubMed

Rivera, Debra S; Schulz, Jessica; Siegert, Thomas; Zuber, Verena; Turner, Robert

2015-02-01

To identify a shielding material compatible with optical head-motion tracking for prospective motion correction and which minimizes radio frequency (RF) radiation losses at 7 T without sacrificing line-of-sight to an imaging target. We evaluated a polyamide mesh coated with silver. The thickness of the coating was approximated from the composition ratio provided by the material vendor and validated by an estimate derived from electrical conductivity and light transmission measurements. The performance of the shield is compared to a split-copper shield in the context of a four-channel transmit-only loop array. The mesh contains less than a skin-depth of silver coating (300 MHz) and attenuates light by 15 %. Elements of the array vary less in the presence of the mesh shield as compared to the split-copper shield indicating that the array behaves more symmetrically with the mesh shield. No degradation of transmit efficiency was observed for the mesh as compared to the split-copper shield. We present a shield compatible with future integration of camera-based motion-tracking systems. Based on transmit performance and eddy-current evaluations the mesh shield is appropriate for use at 7 T.

Allogeneic cultured keratinocytes vs. cadaveric skin to cover wide-mesh autogenous split-thickness skin grafts.

PubMed

Monstrey, S; Beele, H; Kettler, M; Van Landuyt, K; Blondeel, P; Matton, G; Naeyaert, J M

1999-09-01

Improved shock therapy has extended the limits of survival in patients with massive burns, and nowadays skin coverage has become the major problem in burn management. The use of mesh skin grafts is still the simplest technique to expand the amount of available donor skin. However, very wide-mesh skin grafts take a very long time to heal, often resulting in unaesthetic scar formation. On the other hand, allogeneic cultured keratinocytes have been reported as a natural source of growth factors and thus could be useful to improve wound healing of these wide-mesh grafts. A clinical study was performed to compare the use of cryopreserved allogeneic cultured keratinocytes vs. the traditional cadaveric skin as a double layer over widely expanded autogenous skin grafts. This procedure was performed in 18 pairs of full-thickness burn wounds (with similar depth and location) in 11 severely burned patients. Early clinical evaluation was made at 2, 3, and 4 to 5 weeks. Parameters such as epithelialization, granulation tissue formation, infection, and scar formation were evaluated. Biopsies were taken to compare the histological characteristics of the epidermis, the epidermal-dermal junction, and the dermis. Late evaluations were performed at 6 and 12 months regarding color, softness, thickness, and subjective feeling of the scar tissue. Aside from a faster (p < 0.05) epithelialization in the keratinocyte group at 2 weeks, there were no statistically different results in any of the early evaluated parameters, neither clinically nor histologically. At long-term follow-up, clinical results and scar characteristics were not significantly different in the two compared groups. It is concluded from the results of this study that, during the early phase, epithelialization was faster with allogeneic cultured keratinocytes compared with cadaveric skin. However, taking into account the substantial difference in costs, the described use of cryopreserved allogeneic cultured keratinocytes as a double layer on meshed autogenous split-thickness skin grafts can hardly be advocated.

Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model

PubMed Central

Masella, Pamela C.; Balent, Eric M.; Carlson, Terri L.; Lee, Karen W.

2013-01-01

Background: Numerous dressings for split-thickness skin graft donor sites are commercially available with no conclusive evidence-based consensus regarding the optimal dressing choice. This study was conducted to identify which of 5 commonly used materials promotes wound healing most effectively for use on split-thickness donor sites in comparison with our standard dressing, Xeroform (petrolatum gauze). Methods: Twenty-four partial-thickness wounds were created on the backs of 4 pigs using a dermatome. Wounds (n = 4 per dressing type per pig) were treated with Xeroform, Opsite (polyurethane film), Kaltostat ( calcium sodium alginate), DuoDERM (hydrocolloid), Aquacel (hydrofiber), and Mepilex (silicone foam). Full-thickness skin samples were excised at 3 or 5 days and evaluated histologically for reepithelialization and inflammation. Comparisons also included incidence of infection, ease of use, and cost analyses. Results: DuoDERM elicited the greatest percent reepithelialization (81%) and Mepilex the lowest (33%) after 3 days (P = 0.004). All dressings demonstrated complete reepithelialization except Mepilex (85%) at 5 days. There were no infections and inflammation was mild among all treatments. Mepilex was easiest to use, whereas Aquacel, Kaltostat, and Opsite were most difficult (P = 0.03). Xeroform was most cost-effective and Aquacel most expensive. Combined scoring revealed DuoDERM = Xeroform > Opsite = Mepilex > Kaltostat > Aquacel. Conclusions: DuoDERM and Xeroform were most effective overall. DuoDERM tended to outperform all dressings in reepithelialization at 3 days, while Xeroform was least expensive, easy to use, and demonstrated rapid reepithelialization. These findings suggest that Xeroform may be preferred for use on large donor-site areas. DuoDERM may be more appropriate for small donor sites when healing time is a priority. PMID:25289278

Variscan deformation along the Teisseyre-Tornquist Zone in SE Poland: Thick-skinned structural inheritance or thin-skinned thrusting?

NASA Astrophysics Data System (ADS)

Krzywiec, P.; Gągała, Ł.; Mazur, S.; Słonka, Ł.; Kufrasa, M.; Malinowski, M.; Pietsch, K.; Golonka, J.

2017-10-01

Recently acquired seismic reflection data provide better insight in the structural style of extensive sedimentary series overlying the SW slope of the East European Craton (EEC) in Poland. The two main seismic datasets - the POLCRUST-01 profile and PolandSPAN survey - yielded contrasting thick - and thin-skinned structural models for the same structural units in SE Poland. We reattempt an interpretation of the POLCRUST-01 profile using techniques of cross-section balancing and restoration aided by 2D forward seismic modelling. An outcome is the thin-skinned structural model is. This solution relies on a continuous top of the EEC crystalline basement well represented in the seismic data as well as on fragmentary, yet conclusive seismic geometries in shallow depth intervals proving the Ediacaran-Palaeozoic series to be thrust and folded. A Variscan (late Carboniferous) compressional regime is consequently invoked to explain thin-skinned structuring of the pre-Permian sedimentary pile and > 20 km of calculated shortening. We demonstrate an ambiguous nature of the top-basement irregularities previously used as indicators of basement-rooted vertical faulting. The tilt and abrupt increase of the top-basement taper under the thin-skinned belt are attributed to pre-Ordovician tectonic processes operating along the SW margin of the EEC. Post-rift subsidence and/or flexural loading giving rise to a broken foreland plate are invoked.

Change in reimbursement and costs in German oncological head and neck surgery over the last decade: ablative tongue cancer surgery and reconstruction with split-thickness skin graft vs. microvascular radial forearm flap.

PubMed

Hoefert, Sebastian; Lotter, Oliver

2018-05-01

Defects after ablative tongue cancer surgery can be reconstructed by split-thickness skin grafts or free microvascular flaps. The different surgical options may influence costs, reimbursement, and therefore possible profits. Our goal was to analyze the development of these parameters for different procedures in head and neck reconstruction in Germany over the last decade. After tumor resection and neck dissection of tongue cancer, three different scenarios were chosen to calculate costs, reimbursement, length of stay (LoS), and profits. Two options considered were reconstruction by split-thickness skin graft with (option Ia) and without (option Ib) tracheotomy. In addition, we analyzed microvascular reconstruction with radial forearm flap (option II). Furthermore, unsatisfactory results after options Ia and Ib may make secondary tongue plastic with split-thickness skin grafting necessary (option I+). The calculations were performed considering the German Diagnosis Related Group (DRG) system and compared to the specific DRG cost data of 250 German reference hospitals. The overall average length of stay (aLoS) declined from 16.7 to 12.8 days with a reduction in every option. Until 2011, all options showed similar accumulated DRG reimbursement. From 2012 onwards, earnings almost doubled for option II due to changes in the DRG allocation. As was expected, the highest costs were observed in option II. Profits (reimbursement minus costs) were also highest for option II (mean 2052 €, maximum 3630 Euros in 2015) followed by options Ia (765 €) and Ib/I+ (681 €). Average profits over time would be 17 to 19% higher if adjusted for inflation. We showed the development of the DRG allocation of two commonly used methods of reconstruction after ablative tongue cancer surgery and the associated LoS, reimbursement, costs, and profits. As expected, the highest values were found for microvascular reconstruction. Microvascular reconstruction may also be the primary choice of treatment from a medical point of view. However, prolonged operation times, intensive care, and hospital stay in connection with complex microvascular operations can easily turn profits into losses as opposed to the results of simple, reliable, and fast split-thickness skin grafting. The inflation rate influences profits in reimbursement systems where costs are based on a previous period of time. Surgeons find themselves daily in an area of conflict between economic interests and medical decision-making. Due to its multidimensional aspects, the choice of the reconstructive technique should be primarily based on the best medical care for the patient. But there should also be awareness of the economic risk of all three surgical procedures.

Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand.

PubMed

Weeks, Dexter; Kasdan, Morton L; Wilhelmi, Bradon J

2016-01-01

The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand. We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting. Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation. There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury.

Fixation of split-thickness skin graft using fast-clotting fibrin glue containing undiluted high-concentration thrombin or sutures: a comparison study.

PubMed

Han, Hyun Ho; Jun, Daiwon; Moon, Suk-Ho; Kang, In Sook; Kim, Min Cheol

2016-01-01

For skin defects caused by full-thickness burns, trauma, or tumor tissue excision, skin grafting is one of the most convenient and useful treatment methods. In this situation, graft fixation is important in skin grafting. This study was performed to compare the effectiveness of skin graft fixation between high-concentration fibrin sealant and sutures. There have been numerous studies using fibrin sealant for graft fixation, but they utilized slow-clotting fibrin sealant containing less than 10 IU/mL thrombin. Twenty-five patients underwent split-thickness skin grafting using fast-clotting fibrin sealant containing 400 IU/mL thrombin, while 30 patients underwent grafting using sutures. Rates of hematoma/seroma formation, graft dislocation, graft necrosis, and graft take were investigated postoperatively. The graft surface area was calculated using Image J software (National Institutes of Health, Bethesda, MD, USA). After 5 days, rates of hematoma/seroma formation and graft dislocation were 7.84 and 1.29% in group I, and 9.55 and 1.45% in group II, respectively. After 30 days, rates of graft necrosis and graft take were 1.86 and 98.14% in group I, and 4.65 and 95.35% in group II. Undiluted fibrin sealant showed significantly superior results for all rates ( p  < 0.05) except graft dislocation. When high-concentration fast-clotting fibrin sealant was applied to skin grafts without dilution, no difficulty was experienced during surgery. Sealant showed superior results compared with sutures and had an excellent graft take rate. II.

Sequential therapy with "vacuum sealing drainage-artificial dermis implantation-thin partial thickness skin grafting" for deep and infected wound surfaces in children.

PubMed

Yuan, X-G; Zhang, X; Fu, Y-X; Tian, X-F; Liu, Y; Xiao, J; Li, T-W; Qiu, L

2016-05-01

To evaluate the efficacy of a "vacuum sealing drainage (VSD) - artificial dermis implantation (ADI) - thin partial thickness skin grafting (TSG)" sequential therapy for deep and infected wounds in children. Fifty-three pediatric patients with deep and infected wounds were treated with sequential VSD-ADI-TSG therapy. The efficacy of this treatment was compared with that of the surgical debridement-change dressings-thin partial thickness skin grafting previously performed on 20 patients. Survival of tissue grafts, color and flexibility, subcutaneous fullness and scar formation of the graft site were examined and compared. The sequential therapy combined the advantages of the VSD treatment, in reducing tissue necrosis and infection on the wound surfaces and promoting the growth of granulation tissue, with the enhancement of grafting by artificial dermis. Compared with the 20 controls, skin grafted on the artificial dermis was more smooth and glossy, while the textures of the region were more elastic, and the scars were significantly lighter in Vancouver scale. The sequential VSD-ADI-TSG therapy is a simple and effective treatment for children with deep and infected wounds. IV. Copyright © 2016. Published by Elsevier Masson SAS.

Curative effects of microneedle fractional radiofrequency system on skin laxity in Asian patients: A prospective, double-blind, randomized, controlled face-split study.

PubMed

Lu, Wenli; Wu, Pinru; Zhang, Zhen; Chen, Jinan; Chen, Xiangdong; Ewelina, Biskup

2017-04-01

To date, no studies compared curative effects of thermal lesions in deep and superficial dermal layers in the same patient (face-split study). To evaluate skin laxity effects of microneedle fractional radiofrequency induced thermal lesions in different dermal layers. 13 patients underwent three sessions of a randomized face-split microneedle fractional radiofrequency system (MFRS) treatment of deep dermal and superficial dermal layer. Skin laxity changes were evaluated objectively (digital images, 2 independent experts) and subjectively (patients' satisfaction numerical rating). 12 of 13 subjects completed a course of 3 treatments and a 1-year follow-up. Improvement of nasolabial folds in deep dermal approach was significantly better than that in superficial approach at three months (P=.0002) and 12 months (P=.0057) follow-up. Effects on infraorbital rhytides were only slightly better (P=.3531). MFRS is an effective method to improve skin laxity. Thermal lesion approach seems to provide better outcomes when applied to deep dermal layers. It is necessary to consider the skin thickness of different facial regions when choosing the treatment depth.

K-wire assisted split-thickness skin graft harvesting from the anterior trunk.

PubMed

Yontar, Yalcin; Coruh, Atilla; Severcan, Mehmet

2016-02-01

Split thickness skin graft (STSG) harvesting from the anterior chest and abdominal wall skin is quite a difficult process. The main reason for the difficulty to perform this process is the unsuitable anatomic characteristics of the anterior trunk, such as irregular wavy-like surface over the ribs and lax abdominal wall skin resulting in collapse due to lack of adequate underneath supporting structures when a downward force is applied by the skin graft dermatome. Lower extremity and especially the thigh are generally chosen as the donor site where the STSGs are easily harvested from. However, extensive lower extremity burns, with or without other region burns, preclude harvesting auto STSGs from this invaluable anatomic site. We harvested K-wire assisted STSGs from the anterior chest and abdominal wall skin of 7 patients with lower extremity burns and also a patient that sustained motor vehicle collision. We encountered no problems in any of our patients both intra and postoperatively by using K-wire assisted STSG harvesting. All of the STSGs donor sites healed uneventfully without complications. In our opinion, K-wire assisted STSG harvesting must always be in the tool-box of any surgeon who deals with extensive burns with or without lower extremity burns and extensive traumas of lower extremities. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Rice cooker steam hand burn in the pediatric patient.

PubMed

Roh, T S; Kim, Y S; Burm, J S; Chung, C H; Kim, J B; Oh, S J

2000-07-01

Burn injuries often lead to significant cosmetic and functional deformity. In the Orient, household electric rice cookers have caused a significant number of steam burns to infant hands. The clinical course and treatment outcome of these burns have been studied retrospectively in a review of the medical records of 79 pediatric patients treated for acute hand steam burns and of 38 other patients who underwent correction for postburn contracture. Electric rice cookers caused all of the acute pediatric steam burns treated at our institute. Of the 81 hands treated between 1995 and 1998, 38.3 percent healed with conservative treatment and 61.7 percent required skin grafting. The volar aspects of the index and middle fingers were those most frequently involved. Eighteen of 36 hands (50 percent) grafted with split-thickness skin developed late contractures requiring additional procedures. Among the 38 patients who underwent correction for postburn deformity, initial treatment was split-thickness grafting for 60.5 percent, full-thickness skin grafting for 7.9 percent, and spontaneous healing for 31.6 percent. Awareness among medical personnel and continued public education should be promoted to help prevent this unique type of pediatric steam burn from occurring.

Origin and tectonic significance of a Mesozoic multi-layer over-thrust system within the Yangtze Block (South China)

NASA Astrophysics Data System (ADS)

Yan, Dan-Ping; Zhou, Mei-Fu; Song, Hong-Lin; Wang, Xin-Wen; Malpas, John

2003-01-01

In the Yangtze Block (South China), a well-developed Mesozoic thrust system extends through the Xuefeng and Wuling mountains in the southeast to the Sichuan basin in the northwest. The system comprises both thin- and thick-skinned thrust units separated by a boundary detachment fault, the Dayin fault. To the northwest, the thin-skinned belt is characterized by either chevron anticlines and box synclines to the northwest or chevron synclines to the southeast. The former structural style displays narrow exposures for the cores of anticlines and wider exposures for the cores of synclines. Thrust detachments occur along Silurian (Fs) and Lower Cambrian (Fc) strata and are dominantly associated with the anticlines. To the southeast, this style of deformation passes gradually into one characterized by chevron synclines with associated principal detachment faults along Silurian (Fs), Cambrian (Fc) and Lower Sinian (Fz) strata. There are, however, numerous secondary back thrusts. Therefore, the thin-skinned belt is like the Valley and Ridge Province of the North American Applachian Mountains. The thick-skinned belt structurally overlies the thin-skinned belt and is characterized by a number of klippen including the Xuefeng and Wuling nappes. It is thus comparable to the Blue Ridge Province of Appalachia. The structural pattern of this thrust system in South China can be explained by a model involving detachment faulting along various stratigraphic layers at different stages of its evolution. The system was developed through a northwest stepwise progression of deformation with the earliest delamination along Lower Sinian strata (Fz). Analyses of balanced geological cross-sections yield about 18.1-21% (total 88 km) shortening for the thin-skinned unit and at least this amount of shortening for the thick-skinned unit. The compressional deformation from southeast to northwest during Late Jurassic to Cretaceous time occurred after the westward progressive collision of the Yangtze Block with the North China Block and suggests that the orogenic event was intracontinental in nature.

Interactions of skin thickness and physicochemical properties of test compounds in percutaneous penetration studies.

PubMed

Wilkinson, Simon C; Maas, Wilfred J M; Nielsen, Jesper Bo; Greaves, Laura C; van de Sandt, Johannes J M; Williams, Faith M

2006-05-01

To determine the effect of skin thickness on the percutaneous penetration and distribution of test compounds with varying physicochemical properties using in vitro systems. Studies were carried out in accordance with OECD guidelines on skin absorption tests. Percutaneous penetration of caffeine (log P -0.01), testosterone (log P 3.32), propoxur (log P 1.52) (finite dose in ethanol to water vehicle ratio) and butoxyethanol (log P 0.83) (undiluted finite dose or as an infinite dose 50% [v/v] aqueous solution) through skin of varying thicknesses under occluded conditions was measured using flow through cells for 8-24 h. Saline (adjusted to pH 7.4) was used as receptor fluid, with BSA added for studies with testosterone and propoxur. Following exposure, the remaining surface dose was removed by swabbing and the skin digested prior to scintillation counting. The maximum flux of caffeine was increased with decreasing skin thickness, although these differences were found to be non-significant. The presence of caffeine in the skin membrane was not altered by skin thickness. Maximum flux and cumulative dose absorbed of testosterone and butoxyethanol (in both finite and infinite doses) were markedly reduced with full thickness (about 1 mm thick) skin compared with split thickness skin (about 0.5 mm). Maximum flux of propoxur (dissolved in 60% ethanol) was clearly higher through skin of 0.71 mm than through skin of 1.36 mm, but no difference was found between 0.56 and 0.71 mm. The proportion of propoxur present in the membrane after 24 h increased significantly over the complete range of thicknesses tested (0.56-1.36 mm). A complex relationship exists between skin thickness, lipophilicity and percutaneous penetration and distribution. This has implications for risk assessment studies and for the validation of models with data from different sources.

Use of negative-pressure dressings and split-thickness skin grafts following penile shaft reduction and reduction scrotoplasty in the management of penoscrotal elephantiasis.

PubMed

Stokes, Tracey H; Follmar, Keith E; Silverstein, Ari D; Weizer, Alon Z; Donatucci, Craig F; Anderson, Everett E; Erdmann, Detlev

2006-06-01

From 1988 to 2005, 8 men who presented with penoscrotal elephantiasis underwent penile shaft degloving and reduction scrotoplasty, followed by transplantation of a split-thickness skin graft (STSG) to the penile shaft. The etiology of elephantiasis in these patients included self-injection of viscous fluid and postsurgical obstructive lymphedema. In the 6 most recent cases, negative-pressure dressings were applied over the STSG to promote graft take, and STSG take rate was 100%. The results of our series corroborate those of a previous report, which showed circumferential negative-pressure dressings to be safe and efficacious in bolstering STSGs to the penile shaft. Furthermore, these results suggest that the use of negative-pressure dressings may improve graft take in this patient population.

Effectiveness of Acellular Dermal Matrix on Autologous Split-Thickness Skin Graft in Treatment of Deep Tissue Defect: Esthetic Subjective and Objective Evaluation.

PubMed

Lee, Yoo Jung; Park, Myong Chul; Park, Dong Ha; Hahn, Hyung Min; Kim, Sue Min; Lee, Il Jae

2017-10-01

A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled. In all cases, autologous STSG was performed with 1:1.5 meshed 0.008-0.010-inch-thick skin. In the skin graft with ADM group, 0.008-0.013-inch-thick meshed ADM (CGderm ® ; CGBio, Inc., Seungnam, Korea) was co-grafted. Negative-pressure wound therapy (CuraVAC ® ; CGBio, Inc., Seungnam, Korea) was applied to both groups in continuous mode at -120 mmHg. We investigate early outcomes (skin loss rate, duration of negative-pressure wound therapy, days to removal of stitches, days to achieve complete healing, and complications) and late outcomes in terms of scar quality (vascularity, pigmentation, pliability and height) and graft-related symptoms (itching sensation and pain). Assessments used the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale. Skin fold was measured to evaluate the elasticity of scar tissue. In the Vancouver Scar Scale, vascularity subscore (p = 0.003) and total score (p = 0.016) were significantly lower in the skin graft with ADM group. In Patient and Observer Scar Assessment Scale, the pain (p = 0.037) and stiffness subscores (p = 0.002), and total score (p = 0.017) were significantly lower in the skin graft with ADM group. Skin graft with ADM results in better scar quality in objective and subjective aspects. 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 .

Glansectomy and Split-thickness Skin Graft for Penile Cancer.

PubMed

Parnham, Arie S; Albersen, Maarten; Sahdev, Varun; Christodoulidou, Michelle; Nigam, Raj; Malone, Peter; Freeman, Alex; Muneer, Asif

2018-02-01

Penile cancer is a rare malignancy that is confined to the glans in up to four out of five cases. Although descriptions of glansectomy exist, there are no contemporary video explanations or large published single centre series. To show the efficacy and safety of glansectomy and split-thickness skin graft (STSG) reconstruction. Data were collected retrospectively for patients identified from surgical theatre diaries between February 2005 and January 2016. 177 patients with histologically proven squamous-cell carcinoma on the glans underwent glansectomy and STSG at a tertiary referral centre in the UK. The median follow-up was 41.4 mo. The skin is incised at the subcoronal level and deepened onto Buck's fascia. Dissection is performed over or under Buck's fascia, depending on suspicion of invasion or risk of disease. The glans is excised and a neoglans is created using a STSG. Local recurrence, cancer-specific survival, overall survival, and complications. Sixteen out of 172 patients (9.3%) experienced local recurrence during the follow-up period. Eighteen out of 174 (10.7%) patients died of penile cancer, while 29 patients in total died during the follow-up period. Of 145 patients, 9% required operative intervention for complications, including graft loss and meatal stenosis. Limitations include the retrospective data collection and the lack of functional and sexual outcomes. Glansectomy and STSG comprise a safe procedure in terms of oncologic control and complications for patients with penile cancer confined to the glans penis. Further studies are required to assess functional and sexual outcomes in these patients. We report on the management of penile cancers confined to the head of the penis using glansectomy and a split-thickness skin graft to recreate the appearance of a glans. This technique is safe and effective, with limited complications. Copyright © 2016. Published by Elsevier B.V.

Prolonged survival of reconstituted skin grafts without immunosuppression.

PubMed

Sasamoto, Y; Alexander, J W; Babcock, G F

1990-01-01

Reconstituted skin composed of a cultured allogeneic epithelial sheet (CAES) and a cultured allogeneic dermis (CAD) was evaluated in a rat model to determine whether it could survive for a prolonged period without immunosuppression. Additionally, free CAD grafts were evaluated for their suitability as dermal substitutes. Male Buffalo rats were used as donors and male Lewis rats as recipients. Split-thickness skin obtained from Buffalo rats was separated into epidermis and dermis by means of Dispase II enzyme. The epidermal layers were minced and trypsinized. Then dispersed single keratinocytes were inoculated onto a irradiated 3T3 cell feeder layer. After a suitable period, a confluent cultured keratinocyte layer was detached and provided CAES grafts. Cultured allogeneic dermis grafts were prepared from cultures of the dermal component. Cultured allogeneic dermis grafts, covered by split thickness isografts (STIG) or local skin flaps, became revascularized at a rate of 94.6% and 90.9%, respectively, 7 days after grafting. However, only 25% of CAD grafts covered by synthetic materials became vascularized. Four types of wound coverage were compared including: (1) CAES grafts, (2) CAES over CAD grafts, (3) split-thickness isografts, and (4) STIG over CAD grafts. In groups 2 and 4, CAD grafts were applied 7 days before CAES grafts or STIG. Grafts of groups 1 and 2 were successful in only 36.7% and 31.1% of the animals and resulted in a high rate of wound contracture--72.4%, 66.7%, respectively. On the other hand, in groups 3 and 4, higher average rates of revascularization (92.0% and 88.3%) and lower rates of wound contracture (25.4% and 24.2%) were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Fractional Skin Harvesting: Autologous Skin Grafting without Donor-site Morbidity

PubMed Central

Wang, Ying; Farinelli, William A.; Jiménez-Lozano, Joel; Franco, Walfre; Sakamoto, Fernanda H.; Cheung, Evelyn J.; Purschke, Martin; Doukas, Apostolos G.; Anderson, R. Rox

2013-01-01

Background: Conventional autologous skin grafts are associated with significant donor-site morbidity. This study was conducted to determine feasibility, safety, and efficacy of a new strategy for skin grafting based on harvesting small columns of full-thickness skin with minimal donor-site morbidity. Methods: The swine model was used for this study. Hundreds of full-thickness columns of skin tissue (~700 µm diameter) were harvested using a custom-made harvesting device, and then applied directly to excisional skin wounds. Healing in donor and graft sites was evaluated over 3 months by digital photographic measurement of wound size and blinded, computer-aided evaluation of histological features and compared with control wounds that healed by secondary intention or with conventional split-thickness skin grafts (STSG). Results: After harvesting hundreds of skin columns, the donor sites healed rapidly without scarring. These sites reepithelialized within days and were grossly and histologically indistinguishable from normal skin within 7 weeks. By contrast, STSG donor sites required 2 weeks for reepithelialization and retained scar-like characteristics in epidermal and dermal architecture throughout the experiment. Wounds grafted with skin columns resulted in accelerated reepithelialization compared with ungrafted wounds while avoiding the “fish-net” patterning caused by STSG. Conclusion: Full-thickness columns of skin can be harvested in large quantities with negligible long-term donor-site morbidity, and these columns can be applied directly to skin wounds to enhance wound healing. PMID:25289241

Paracrine Factors from Irradiated Peripheral Blood Mononuclear Cells Improve Skin Regeneration and Angiogenesis in a Porcine Burn Model

PubMed Central

Hacker, Stefan; Mittermayr, Rainer; Nickl, Stefanie; Haider, Thomas; Lebherz-Eichinger, Diana; Beer, Lucian; Mitterbauer, Andreas; Leiss, Harald; Zimmermann, Matthias; Schweiger, Thomas; Keibl, Claudia; Hofbauer, Helmut; Gabriel, Christian; Pavone-Gyöngyösi, Mariann; Redl, Heinz; Tschachler, Erwin; Mildner, Michael; Ankersmit, Hendrik Jan

2016-01-01

Burn wounds pose a serious threat to patients and often require surgical treatment. Skin grafting aims to achieve wound closure but requires a well-vascularized wound bed. The secretome of peripheral blood mononuclear cells (PBMCs) has been shown to improve wound healing and angiogenesis. We hypothesized that topical application of the PBMC secretome would improve the quality of regenerating skin, increase angiogenesis, and reduce scar formation after burn injury and skin grafting in a porcine model. Full-thickness burn injuries were created on the back of female pigs. Necrotic areas were excised and the wounds were covered with split-thickness mesh skin grafts. Wounds were treated repeatedly with either the secretome of cultured PBMCs (SecPBMC), apoptotic PBMCs (Apo-SecPBMC), or controls. The wounds treated with Apo-SecPBMC had an increased epidermal thickness, higher number of rete ridges, and more advanced epidermal differentiation than controls. The samples treated with Apo-SecPBMC had a two-fold increase in CD31+ cells, indicating more angiogenesis. These data suggest that the repeated application of Apo-SecPBMC significantly improves epidermal thickness, angiogenesis, and skin quality in a porcine model of burn injury and skin grafting. PMID:27125302

First-order control of syntectonic sedimentation on crustal-scale structure of mountain belts

NASA Astrophysics Data System (ADS)

Erdős, Zoltán.; Huismans, Ritske S.; van der Beek, Peter

2015-07-01

The first-order characteristics of collisional mountain belts and the potential feedback with surface processes are predicted by critical taper theory. While the feedback between erosion and mountain belt structure has been fairly extensively studied, less attention has been given to the potential role of synorogenic deposition. For thin-skinned fold-and-thrust belts, recent studies indicate a strong control of syntectonic deposition on structure, as sedimentation tends to stabilize the thin-skinned wedge. However, the factors controlling basement deformation below fold-and-thrust belts, as evident, for example, in the Zagros Mountains or in the Swiss Alps, remain largely unknown. Previous work has suggested that such variations in orogenic structure may be explained by the thermotectonic "age" of the deforming lithosphere and hence its rheology. Here we demonstrate that sediment loading of the foreland basin area provides an additional control and may explain the variable basement involvement in orogenic belts. When examining the role of sedimentation, we identify two end-members: (1) sediment-starved orogenic systems with thick-skinned basement deformation in an axial orogenic core and thin-skinned deformation in the bordering forelands and (2) sediment-loaded orogens with thick packages of synorogenic deposits, derived from the axial basement zone, deposited on the surrounding foreland fold-and-thrust belts, and characterized by basement deformation below the foreland. Using high-resolution thermomechanical models, we demonstrate a strong feedback between deposition and crustal-scale thick-skinned deformation. Our results show that the loading effects of syntectonic sediments lead to long crustal-scale thrust sheets beneath the orogenic foreland and explain the contrasting characteristics of sediment-starved and sediment-loaded orogens, showing for the first time how both thin- and thick-skinned crustal deformations are linked to sediment deposition in these orogenic systems. We show that the observed model behavior is consistent with observations from a number of natural orogenic systems.

Method for preparing dosimeter for measuring skin dose

DOEpatents

Jones, Donald E.; Parker, DeRay; Boren, Paul R.

1982-01-01

A personnel dosimeter includes a plurality of compartments containing thermoluminescent dosimeter phosphors for registering radiation dose absorbed in the wearer's sensitive skin layer and for registering more deeply penetrating radiation. Two of the phosphor compartments communicate with thin windows of different thicknesses to obtain a ratio of shallowly penetrating radiation, e.g. beta. A third phosphor is disposed within a compartment communicating with a window of substantially greater thickness than the windows of the first two compartments for estimating the more deeply penetrating radiation dose. By selecting certain phosphors that are insensitive to neutrons and by loading the holder material with neutron-absorbing elements, energetic neutron dose can be estimated separately from other radiation dose. This invention also involves a method of injection molding of dosimeter holders with thin windows of consistent thickness at the corresponding compartments of different holders. This is achieved through use of a die insert having the thin window of precision thickness in place prior to the injection molding step.

Dosimeter for measuring skin dose and more deeply penetrating radiation

DOEpatents

Jones, Donald E.; Parker, DeRay; Boren, Paul R.

1981-01-01

A personnel dosimeter includes a plurality of compartments containing thermoluminescent dosimeter phosphors for registering radiation dose absorbed in the wearer's sensitive skin layer and for registering more deeply penetrating radiation. Two of the phosphor compartments communicate with thin windows of different thicknesses to obtain a ratio of shallowly penetrating radiation, e.g. beta. A third phosphor is disposed within a compartment communicating with a window of substantially greater thickness than the windows of the first two compartments for estimating the more deeply penetrating radiation dose. By selecting certain phosphors that are insensitive to neutrons and by loading the holder material with netruon-absorbing elements, energetic neutron dose can be estimated separately from other radiation dose. This invention also involves a method of injection molding of dosimeter holders with thin windows of consistent thickness at the corresponding compartments of different holders. This is achieved through use of a die insert having the thin window of precision thickness in place prior to the injection molding step.

Feasibility of Human Skin Grafts on an Isolated But Accessible Vascular Supply on Athymic Rats as a System to Study Percutaneous Penetration and Cutaneous Injury.

DTIC Science & Technology

1986-04-01

Ai87 466 FEASIBILITY OF HUMAN SKIN GRAFTS ON AN ISOLATED BUT / ACCESSIBLE VASCULAR 5 (U) UTAH UNIV SALT LAKE CITY SCHOOL OF MEDICINE 6 G KRUEGER APR...GOVT ACCESSION NO . RrCIPIcNTrS CATALOG NUMIER Feasibility of Human Skin Grafts on an Isolated 9 but Accessible Vascular Supply on Athymic Rats as...of the Skin Sandwich Flap....... . . . . . . . 35 Figure 15. Photograph of Hair Growth in a Human Split-Thickness Skin Graft on a Nude Rat

Using Amniotic Membrane as a Novel Method to Reduce Post-burn Hypertrophic Scar Formation: A Prospective Follow-up Study

PubMed Central

Mohammadi, Ali Akbar; Eskandari, Shima; Johari, Hamed Ghoddusi; Rajabnejad, Ata'ollah

2017-01-01

Background: Several studies have shown that the application of amniotic membrane as a biological dressing in the management of burns is accompanied by rapid re-epithelialisation. In this follow-up study, we aimed to evaluate the possible role of amniotic membrane as an adjunct to split thickness skin grafting on reducing itching and severity of hypertrophic scar formation. Materials and Methods: From October 2013 to January 2015, in a prospective follow-up study, 54 patients (108 limbs) with second and third degree burns, covering 4%–15% of total body surface area (TBSA), were included in the study. All patients needed split-thickness skin grafts for burn-wound coverage. Selected patients had symmetric burns on two (upper or lower) extremities. Then, in every patient, the extremities were randomly divided into two groups: In one limb, the skin graft was traditionally fixed with skin staples (control group) and in the other limb, the skin graft was covered with an amniotic membrane (amnion group). Therefore, in every patient, the graft was covered with an amniotic membrane in one extremity and fixed with skin staples in the other extremity. Finally, after 6 months, the degree of itching and hypertrophic scar formation was compared between the two groups. Results: The study group was composed of 108 limbs in 54 patients (27 males and 27 females) with a mean age of 23.54 ± 4.9 years and burn 9.03 ± 2.69% TBSA. The patients were divided into two groups: 54 limbs in amnion group and 54 limbs in control group. In 59.25% of the cases, patient had less itching in the extremity covered with amniotic membrane. Furthermore, in 64.81% of the cases, patients had less hypertrophic scar formation in the extremity covered with amniotic membrane. These differences were statistically significant (P < 0.001). Conclusions: Amniotic membrane used as an adjunct in split thickness skin grafting is a novel modality which significantly reduces scar formation and itching that can be greatly distressing to burn patients. However, still more prospective well designed studies are needed to prove it. PMID:28529415

[The use of negative pressure wound therapy in the fixation of split-thickness skin grafts].

PubMed

Ulianko, J; Janek, J; Laca, Ľ

2017-01-01

Negative pressure wound therapy is one of the latest methods of dealing with complicated healing wounds. It promotes granulation, mechanically attracts the edges of the wound, removes secretions, reduces the number of bacteria in the wound and reduces swelling. In addition to its use to start and enhance the healing process, this method is also important in the fixation of split-thickness skin grafts in non-ideal conditions. The goal of this article is to establish basic indications for negative pressure fixation of meshed split-thickness skin grafts in non-ideal conditions in the wound and to assess the impact of contamination of wounds on engraftment using vacuum therapy. Additional goals are to verify the use of this method of fixation in defects of various etiologies (trauma, ischemia), to optimize and determine the advantages and disadvantages of fixation of grafts using this method in clinical practice, and to evaluate the effectiveness of fixation of meshed split-thickness skin grafts. Set of 89 operated patients of both sexes, various ages, etiologies of defects, in non-ideal conditions; statistical evaluation of the percentage of engraftment, depending on the etiology of the defect, microbial contamination and location of the defect. Measured in vivo using a centimeter measure at the point of maximum length and width. Our set of 100% engraftments of StSG included 68 persons, 65 males and 24 females, in the following age groups: up to 30 years 11 persons; 3050 years 19 persons; 5070 years 38 persons; and above 70 years 21 persons, with negative microbial contamination of the defect in 20 cases, contamination with one germ in 33 cases, contamination with two germs in 22 cases and contamination with three germs in 14 cases. We obtained 100% engraftment in 68 cases, 9099% engraftment in 7 cases, 8089% engraftment in 5 cases, 7079% engraftment in 7 cases, and the 6069% and 5059% sets of engraftment were combined because of the low number of patients in this set. 51 of the patients had a traumatic origin of their defect, 22 had an ischemic origin of their defect and 16 had a different origin of their defect. We found a significant relationship between contamination and the percentage of engraftment, as well as dependence between patient age and the percentage of engraftment. Negative pressure fixation of meshed split-thickness skin grafts seems to be a convenient method of fixation in patients with defects of various origins in non-ideal conditions; this method increases the percentage of engraftment and apparently reduces the time required for fixation of the graft and the length of hospitalisation. We obtained 100% engraftment of StSG using negative pressure fixation. We concluded that traumatic origin had no effect on the percentage of engraftment, while ischemic origin had a significant effect on engraftment. Also, negative contamination of the defect had a positive effect on StSG engraftment, and contamination wit three microbial germs had a significant negative effect on the percentage of StSG engraftment using negative pressure fixation.Key words: negative pressure therapy - NPWT plastic surgery skin grafts complicated wounds.

Parabolic polarization splitting of Tamm states in a metal-organic microcavity

NASA Astrophysics Data System (ADS)

Brückner, R.; Sudzius, M.; Hintschich, S. I.; Fröb, H.; Lyssenko, V. G.; Kaliteevski, M. A.; Iorsh, I.; Abram, R. A.; Kavokin, A. V.; Leo, K.

2012-02-01

We observe hybrid states of cavity photons and Tamm plasmons in an organic microcavity with an incorporated thin silver layer of increasing thickness up to 40 nm. Via μ-photoluminescence spectroscopy, we investigate their angular dependence. At oblique angles, we observe a TE-TM polarization splitting of more than 40 meV for each mode. An analytical model is developed to describe the coupling of Tamm plasmons and cavity photons and to account for the splitting of the orthogonally polarized resonances.

Reconstruction of Knee Defects Using Pedicled Gastrocnemius Muscle Flap with Split-Thickness Skin Grafting: A Single Surgeon's Experience with 21 Patients.

PubMed

Kilic, Ali; Denney, Brad; de la Torre, Jorge

2018-05-31

Generally, reconstruction of knee defects with exposed bone, joint, tendon, and/or hardware requires a vascularized muscle flap for coverage. Although there are several surgical options for a knee defect reconstruction, the pedicled gastrocnemius muscle still remains the workhorse flap. Although this flap is commonly used for knee defect reconstruction and the technique is described very well, there is an absence of information in the literature detailing the technique of harvesting and insetting of the gastrocnemius flap step by step with illustrations. The purpose of this article is to describe in detail the technique to reconstruct defects of the knee with pedicled gastrocnemius muscle flap as well as to present demographics and surgical results of 21 patients who had knee reconstruction with a pedicled gastrocnemius muscle flap and split-thickness skin grafting. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Classification System for Individualized Treatment of Adult Buried Penis Syndrome.

PubMed

Tausch, Timothy J; Tachibana, Isamu; Siegel, Jordan A; Hoxworth, Ronald; Scott, Jeremy M; Morey, Allen F

2016-09-01

The authors present their experience with reconstructive strategies for men with various manifestations of adult buried penis syndrome, and propose a comprehensive anatomical classification system and treatment algorithm based on pathologic changes in the penile skin and involvement of neighboring abdominal and/or scrotal components. The authors reviewed all patients who underwent reconstruction of adult buried penis syndrome at their referral center between 2007 and 2015. Patients were stratified by location and severity of involved anatomical components. Procedures performed, demographics, comorbidities, and clinical outcomes were reviewed. Fifty-six patients underwent reconstruction of buried penis at the authors' center from 2007 to 2015. All procedures began with a ventral penile release. If the uncovered penile skin was determined to be viable, a phalloplasty was performed by anchoring penoscrotal skin to the proximal shaft, and the ventral shaft skin defect was closed with scrotal flaps. In more complex patients with circumferential nonviable penile skin, the penile skin was completely excised and replaced with a split-thickness skin graft. Complex patients with severe abdominal lipodystrophy required adjacent tissue transfer. For cases of genital lymphedema, the procedure involved complete excision of the lymphedematous tissue, and primary closure with or without a split-thickness skin graft, also often involving the scrotum. The authors' overall success rate was 88 percent (49 of 56), defined as resolution of symptoms without the need for additional procedures. Successful correction of adult buried penis often necessitates an interdisciplinary, multimodal approach. Therapeutic, IV.

Tactile Responses to Vibration

NASA Astrophysics Data System (ADS)

Verrillo, Ronald T.; Bolanowski, Stanley J.

The skin is by far the largest organ of the human body having an area of approximately 1.85 m2 in the adult male and 1.65 m2 in the adult female with an average weight of about 9 lb., comprising about 6% of the total body weight. In thickness it ranges from an average of 4.4 mm in non-hairy skin to 2.1 mm in hairy skin. It is thin over the eyelids and thick at the soles of the feet. The human body contains four types of skin.

The use of short spreader grafts in rhinoplasty for patients with thick nasal skin.

PubMed

Grigoryants, Vladimir; Baroni, Arpa

2013-06-01

Thick nasal skin presents a challenge in rhinoplasty. Conventional spreader grafts in patients with thick nasal skin may result in an undesirable widening of the lower half of the nose where the nasal skin is thick. The use of short spreader grafts was evaluated in patients with thick nasal skin. For this study, 32 patients underwent closed rhinoplasty in which short spreader grafts were used. The spreader graft was 1 to 2 cm long and extended only to the transition of thin and thick nasal skin. The patients were followed for more than 1 year postoperatively. Aesthetic improvement was observed in all the patients. Nasal airway patency was improved or maintained in 94 % of the patients. Short spreader grafts effectively restore or maintain the internal nasal valve area after dorsal hump reduction while allowing for more aggressive narrowing of the lower part of the nose where nasal skin is thick. 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 .

Malignant melanoma in Ferrara, Northern Italy: epidemiologic survey focusing on tumor thickness.

PubMed

Borghi, A; Corazza, M; Minghetti, S; Masarà, A; Virgili, A

2015-12-01

Estimates of malignant melanoma (MM) incidence and prognosis vary widely. The present study was performed to analyze epidemiologic and prognostic aspects of primary MM mainly in relation to tumor thickness. We conducted a retrospective study on a cohort of 435 patients with diagnosis of primary MM between 1997 and 2011. In the period 2009-2011, among the MM diagnosed 50.00% were thin, 32.43% in situ and 17.57% thicker while in 1997-1999 MM>1 mm accounted for 51.61% of diagnoses. Mean age of patients affected with thin MM was significantly lower than that of patients with MM>1 mm, and mean thickness resulted significantly lower in female patients than in males. Mean thickness of MM located on easily self-evaluable body areas was significantly lower than in those not accessible for skin self-examination. The commonest histogenetic type was superficially spreading melanoma. Mitotic rate, ulceration and vertical growth phase all resulted related to MM thickness. Out of 61 patients with thin MM who underwent SLNB, 3 resulted positive (4.92%): neither thickness >0.75 mm, nor ulceration, mitotic rate or Clark level were found to be associated with SLNB positivity. Five-year survival rate was 98.3% for thin MM patients and 76.4% for thick MM patients. Our trend analysis evidences a continuing increase of thinner primary MM throughout the study period, potentially enhancing patient prognosis. Regular skin self-examination could contribute to earlier recognition of MM. Identification of more powerful predictors of thin MM prognosis is necessary.

Experience With Wound VAC and Delayed Primary Closure of Contaminated Soft Tissue Injuries in Iraq

DTIC Science & Technology

2006-11-01

wound was definitively closed by delayed primary closure, flap mobilization, or split-thickness skin grafting . The VAC system was also used...postoperatively for 3 to 5 days over skin grafts , then removed at the bedside to assess graft take. Granulation tissue was not a prerequisite for wound closure...hospital until the closed wounds were clean and dry with good skin graft incorporation. All patients were scheduled for follow-up in our outpatient

A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft.

PubMed

Lim, Hyoseob; Han, Dae Hee; Lee, Il Jae; Park, Myong Chul

2014-03-01

Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

Treating pain on skin graft donor sites: Review and clinical recommendations.

PubMed

Sinha, Sarthak; Schreiner, Amanda J; Biernaskie, Jeff; Nickerson, Duncan; Gabriel, Vincent A

2017-11-01

Split-thickness skin grafting is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early postoperative period. Here, we (a) identify strategies for managing donor site pain, (b) assess the quality of individual studies, and (c) formulate evidence-based recommendations based on the amount and consistency of evidence. Our analysis revealed five distinct approaches to minimize donor site pain. These include: continuous subcutaneous local anesthetic infusion (three studies), subcutaneous anesthetic injection (five studies), topical agents (six studies), nonpharmacological interventions (three studies), and wound dressings (18 studies). Available randomized control trials typically evaluated pain on standardized scales (i.e. Visual Analog Scale, Numerical Rating Scale), and compared the experimental group with standard care. Recommended treatments include: (a) subcutaneous anesthetic injection of adrenaline-lidocaine; (b) ice application; (c) topical agents, such as lidocaine and bupivacaine; and (d) hydrocolloid- and polyurethane-based wound dressings accompanied with fibrin sealant. Methodologically sound randomized control trials examining the efficacy of modified tumescent solution, ropivacaine, plasma therapy, noncontact ultrasound, and morphine gels are lacking and should be a priority for future research.

Managing the Lower Eyelid Complex in the Thick-Skinned Patient.

PubMed

Floyd, Elizabeth Mia; Perkins, Stephen W

2018-02-01

Thick skin presents a unique set of challenges within the realm of facial plastic surgery, and addressing the lower lid complex is no exception. There are several procedures for addressing the lower lids, the first and foremost being lower lid blepharoplasty. However, the remaining procedures combined with surgical techniques have exclusive implications in thick skin. Understanding the anatomy and various techniques that can be applied to thick skin can help achieve aesthetically more pleasing results in comparison to those of thin skin. As will be discussed in this article, patients with skin color of Fitzpatrick's grade III or higher have several characteristics associated with their skin, including thicker dermis as well as different patterns of aging, which have implications for addressing the lower lid complex. The senior author has extensive experience performing lower lid procedures and seeks to impart how best to understand and adapt for these differences to allow for the best aesthetic result. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

7 CFR 51.772 - Fairly smooth texture.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Definitions § 51.772 Fairly smooth texture. Fairly smooth texture means that the skin is fairly thin and not coarse for the variety and size of the fruit. “Fairly thin” means that the skin thickness does not...

7 CFR 51.772 - Fairly smooth texture.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Definitions § 51.772 Fairly smooth texture. Fairly smooth texture means that the skin is fairly thin and not coarse for the variety and size of the fruit. “Fairly thin” means that the skin thickness does not...

Formation of fold-and-thrust belts on Venus by thick-skinned deformation

NASA Astrophysics Data System (ADS)

Zuber, M. T.; Parmentier, E. M.

1995-10-01

ON Venus, fold-and-thrust belts—which accommodate large-scale horizontal crustal convergence—are often located at the margins of kilometre-high plateaux1-5. Such mountain belts, typically hundreds of kilometres long and tens to hundreds of kilometres wide, surround the Lakshmi Planum plateau in the Ishtar Terra highland (Fig. 1). In explaining the origin of fold-and-thrust belts, it is important to understand the relative importance of thick-skinned deformation of the whole lithosphere and thin-skinned, large-scale overthrusting of near-surface layers. Previous quantitative analyses of mountain belts on Venus have been restricted to thin-skinned models6-8, but this style of deformation does not account for the pronounced topographic highs at the plateau edge. We propose that the long-wavelength topography of these venusian fold-and-thrust belts is more readily explained by horizontal shortening of a laterally heterogeneous lithosphere. In this thick-skinned model, deformation within the mechanically strong outer layer of Venus controls mountain building. Our results suggest that lateral variations in either the thermal or mechanical structure of the interior provide a mechanism for focusing deformation due to convergent, global-scale forces on Venus.

Facile fabrication of an efficient BiVO4 thin film electrode for water splitting under visible light irradiation.

PubMed

Jia, Qingxin; Iwashina, Katsuya; Kudo, Akihiko

2012-07-17

An efficient BiVO(4) thin film electrode for overall water splitting was prepared by dipping an F-doped SnO(2) (FTO) substrate electrode in an aqueous nitric acid solution of Bi(NO(3))(3) and NH(4)VO(3), and subsequently calcining it. X-ray diffraction of the BiVO(4) thin film revealed that a photocatalytically active phase of scheelite-monoclinic BiVO(4) was obtained. Scanning electron microscopy images showed that the surface of an FTO substrate was uniformly coated with the BiVO(4) film with 300-400 nm of the thickness. The BiVO(4) thin film electrode gave an excellent anodic photocurrent with 73% of an IPCE at 420 nm at 1.0 V vs. Ag/AgCl. Modification with CoO on the BiVO(4) electrode improved the photoelectrochemical property. A photoelectrochemical cell consisting of the BiVO(4) thin film electrode with and without CoO, and a Pt counter electrode was constructed for water splitting under visible light irradiation and simulated sunlight irradiation. Photocurrent due to water splitting to form H(2) and O(2) was confirmed with applying an external bias smaller than 1.23 V that is a theoretical voltage for electrolysis of water. Water splitting without applying external bias under visible light irradiation was demonstrated using a SrTiO(3)Rh photocathode and the BiVO(4) photoanode.

Pacifying the Open Abdomen with Concomitant Intestinal Fistula: A Novel Approach

DTIC Science & Technology

2009-05-08

have also effectively sed the same technique to aid in fistula control and bol- tering of our split-thickness skin graft during the process of nitial...graft in-growth. Once the skin graft has taken, more raditional stoma appliances or other methods can be used to igure 3 Appropriate positioning of... skin grafting at a lowerabor cost than traditional wet-to-dry dressing changes. The use f the wider aperture of the nipple also permits for the ade- uate

Heterotopic Ossification in Combat Amputees from Afghanistan and Iraq wars: Five Case Histories and Results from a Small Series of Patients

DTIC Science & Technology

2011-01-01

symptoms. This patient also had severe soft-tissue injuries to his nonamputated left arm that required a skin graft . Subse- quent to surgery, the...illustrates the use of preventive medi- cation and symptomatic HO following breakdown of a skin graft . This patient had bilateral transfemoral amputa...United States. He was fitted with prostheses and successfully learned to walk. This patient had a split-thickness skin graft on his right residual

7 CFR 51.768 - Smooth texture.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Smooth texture. Smooth texture means that the skin is thin and smooth for the variety and size of the fruit. “Thin” means that the skin thickness does not average more than 3/8 inch (9.5 mm), on a central...

7 CFR 51.768 - Smooth texture.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Smooth texture. Smooth texture means that the skin is thin and smooth for the variety and size of the fruit. “Thin” means that the skin thickness does not average more than 3/8 inch (9.5 mm), on a central...

7 CFR 51.772 - Fairly smooth texture.

Code of Federal Regulations, 2011 CFR

2011-01-01

... texture. Fairly smooth texture means that the skin is fairly thin and not coarse for the variety and size of the fruit. “Fairly thin” means that the skin thickness does not average more than 1/2 inch (12.7...

7 CFR 51.772 - Fairly smooth texture.

Code of Federal Regulations, 2012 CFR

2012-01-01

... texture. Fairly smooth texture means that the skin is fairly thin and not coarse for the variety and size of the fruit. “Fairly thin” means that the skin thickness does not average more than 1/2 inch (12.7...

7 CFR 51.772 - Fairly smooth texture.

Code of Federal Regulations, 2010 CFR

2010-01-01

... texture. Fairly smooth texture means that the skin is fairly thin and not coarse for the variety and size of the fruit. “Fairly thin” means that the skin thickness does not average more than 1/2 inch (12.7...

In Vitro Skin Penetration of Petrolatum and Soybean Oil and Effects of Glyceryl Monooleate.

PubMed

Intarakumhaeng, Rattikorn; Shi, Zhanquan; Wanasathop, Apipa; Stella, Q Ching; Wei, Karl S; Styczynski, P B; Li, Chuiying; Smith, Edward D; Li, S Kevin

2018-06-06

Petrolatum and soybean oil are common ingredients incorporated in topical skin formulations for skin protection and moisturization. However, the stratum corneum (SC) penetration kinetics of these two cosmetic ingredients has not been systematically studied. Glyceryl monooleate (GlyMOle) has been shown to enhance skin penetration of various compounds. It was hypothesized that GlyMOle could enhance skin penetration of petrolatum and soybean oil. The present study aimed to examine the in vitro skin penetration of petrolatum and soybean oil in the presence or absence of GlyMOle. Skin permeation experiments were conducted using the in vitro Franz diffusion cell model with split-thickness human skin and human epidermal membrane (HEM). The effect of permeant dose and the kinetics of permeant penetration were examined with and without GlyMOle in vitro. Petrolatum and soybean oil were found to permeate across HEM, and no effect of GlyMOle on skin permeation into the receptor chamber was observed. GlyMOle enhanced the penetration of petrolatum into the split-thickness skin at 50 μg dose (petrolatum:GlyMOle, 49:1, w/w). However, no effect of GlyMOle on petrolatum penetration was observed at 200 μg dose (petrolatum:GlyMOle, 49:1, w/w), indicating a dose-dependent effect. GlyMOle at the level used in the study did not enhance the penetration of soybean oil with 50 and 200 μg doses at any time points. GlyMOle was a skin penetration enhancer for petrolatum under the in vitro conditions identified in the present study. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Thick-skinned tectonics closing the Rifian Corridor

NASA Astrophysics Data System (ADS)

Capella, Walter; Matenco, Liviu; Dmitrieva, Evelina; Roest, Wilmer M. J.; Hessels, Suzanne; Hssain, Mohamed; Chakor-Alami, Abdelwahid; Sierro, Francisco J.; Krijgsman, Wout

2017-07-01

Tectonic processes in the Gibraltar region are associated with Africa-Iberia convergence and the formation of the Betic-Rif orogenic system. The Late Miocene shortening recorded in the Rif orogen resulted in gradual shallowing and eventual closure of the Rifian Corridor, a narrow marine gateway connecting the Atlantic Ocean with the Mediterranean Sea. This closure is associated with paleoenvironmental changes that ultimately led to the Mediterranean Messinian Salinity Crisis. Here we present a structural analysis based on a combination of field kinematic data and interpretation of reflection seismic lines acquired for petroleum exploration to understand the deformational phases associated with the closure of the Rifian Corridor. We show the succession of three Late Miocene to present day events, an initial thin-skinned nappe thrusting, followed by regional subsidence and continued by thick-skinned contraction. The transition from in sequence thin-skinned tectonics during subduction to thick-skinned contraction during continental collision resulted in significant acceleration of tectonic uplift and associated exhumation. This is related to a change in the regional deformation linked to plate convergence, but possibly also coupled with deep lithospheric or dynamic topography processes. Such a mechanism is also common for other Mediterranean orogens during late stages of slab retreat, where accelerated tectonics resulted in rapid sedimentation and associated basins evolution. We conclude that the thick-skinned contraction in the Rif orogeny initiated in the late Tortonian, has created a cumulative uplift in the order of 1 km, and provided high enough uplift rates to close the Rifian Corridor.

Pre-vascularization Enhances Therapeutic Effects of Human Mesenchymal Stem Cell Sheets in Full Thickness Skin Wound Repair.

PubMed

Chen, Lei; Xing, Qi; Zhai, Qiyi; Tahtinen, Mitchell; Zhou, Fei; Chen, Lili; Xu, Yingbin; Qi, Shaohai; Zhao, Feng

2017-01-01

Split thickness skin graft (STSG) implantation is one of the standard therapies for full thickness wound repair when full thickness autologous skin grafts (FTG) or skin flap transplants are inapplicable. Combined transplantation of STSG with dermal substitute could enhance its therapeutic effects but the results remain unsatisfactory due to insufficient blood supply at early stages, which causes graft necrosis and fibrosis. Human mesenchymal stem cell (hMSC) sheets are capable of accelerating the wound healing process. We hypothesized that pre-vascularized hMSC sheets would further improve regeneration by providing more versatile angiogenic factors and pre-formed microvessels. In this work, in vitro cultured hMSC cell sheets (HCS) and pre-vascularized hMSC cell sheets (PHCS) were implanted in a rat full thickness skin wound model covered with an autologous STSG. Results demonstrated that the HCS and the PHCS implantations significantly reduced skin contraction and improved cosmetic appearance relative to the STSG control group. The PHCS group experienced the least hemorrhage and necrosis, and lowest inflammatory cell infiltration. It also induced the highest neovascularization in early stages, which established a robust blood micro-circulation to support grafts survival and tissue regeneration. Moreover, the PHCS grafts preserved the largest amount of skin appendages, including hair follicles and sebaceous glands, and developed the smallest epidermal thickness. The superior therapeutic effects seen in PHCS groups were attributed to the elevated presence of growth factors and cytokines in the pre-vascularized cell sheet, which exerted a beneficial paracrine signaling during wound repair. Hence, the strategy of combining STSG with PHCS implantation appears to be a promising approach in regenerative treatment of full thickness skin wounds.

Clinical Experience and Best Practices Using Epidermal Skin Grafts on Wounds.

PubMed

Kirsner, Robert S; Bernstein, Brent; Bhatia, Animesh; Lantis, John; Le, Lam; Lincoln, Katherine; Liu, Paul; Rodgers, Lee; Shaw, Mark; Young, David

2015-11-01

Over the years, autologous skin grafting has been used extensively to achieve wound closure, optimize a functional scar, and improve aesthetic outcomes for the patient. Although a vast majority of the literature is on the use of full-thickness and split-thickness skin grafts, epidermal skin grafts (ESGs) have emerged as a viable option in the reconstructive ladder when only the epidermal layer is needed. These grafts are distinct from other types of autologous skin grafts in that they can be harvested without anesthesia and leave minimal or no scarring at the donor site. In order to explore the use of ESGs in the continuum of primary wound closure, a multidisciplinary expert panel convened in October 2014, in Las Vegas, NV, to review the scientific basis and clinical uses of epidermal grafting. This publication provides an overview of epidermal grafting, recommendations for graft application, and potential roles for its use in wound care and closure.

Investigation of porosity and heterojunction effects of a mesoporous hematite electrode on photoelectrochemical water splitting.

PubMed

Liu, Jingling; Shahid, Muhammad; Ko, Young-Seon; Kim, Eunchul; Ahn, Tae Kyu; Park, Jong Hyeok; Kwon, Young-Uk

2013-06-28

In this paper, we report the porosity and heterojunction effects of hematite (α-Fe2O3) on the photoelectrochemical (PEC) water splitting properties. The worm-like mesoporous hematite thin films (MHFs) with a pore size of ~9 nm and a wall thickness of ~5 nm were successfully obtained through the self-assembly process. MHFs formed on FTO showed much better PEC properties than those of nonporous hematite thin films (NP-HF) owing to the suppression of charge recombination. The PEC data of MHFs under front and back illumination conditions indicated that the porous structure allows the diffusion of electrolyte deep inside the MHF increasing the number of holes to be utilized in the water oxidation reaction. A heterojunction structure was formed by introducing a thin layer of SnO2 (~15 nm in thickness) between the MHF and FTO for a dramatically enhanced PEC response, which is attributed to the efficient electron transfer. Our spectroscopic and electrochemical data show that the SnO2 layer functions as an efficient electron transmitter, but does not affect the recombination kinetics of MHFs.

Reduction of pain via platelet-rich plasma in split-thickness skin graft donor sites: a series of matched pairs

PubMed Central

Miller, John D.; Rankin, Timothy M.; Hua, Natalie T.; Ontiveros, Tina; Giovinco, Nicholas A.; Mills, Joseph L.; Armstrong, David G.

2015-01-01

In the past decade, autologous platelet-rich plasma (PRP) therapy has seen increasingly widespread integration into medical specialties. PRP application is known to accelerate wound epithelialization rates, and may also reduce postoperative wound site pain. Recently, we observed an increase in patient satisfaction following PRP gel (Angel, Cytomedix, Rockville, MD) application to split-thickness skin graft (STSG) donor sites. We assessed all patients known to our university-based hospital service who underwent multiple STSGs up to the year 2014, with at least one treated with topical PRP. Based on these criteria, five patients aged 48.4±17.6 (80% male) were identified who could serve as their own control, with mean time of 4.4±5.1 years between operations. In both therapies, initial dressing changes occurred on postoperative day (POD) 7, with donor site pain measured by Likert visual pain scale. Paired t-tests compared the size and thickness of harvested skin graft and patient pain level, and STSG thickness and surface area were comparable between control and PRP interventions (p>0.05 for all). Donor site pain was reduced from an average of 7.2 (±2.6) to 3 (±3.7), an average reduction in pain of 4.2 (standard error 1.1, p=0.0098) following PRP use. Based on these results, the authors suggest PRP as a beneficial adjunct for reducing donor site pain following STSG harvest. PMID:25623477

Coeval gravity-driven and thick-skinned extensional tectonics in the mid-Cretaceous of the western Pyrenees

NASA Astrophysics Data System (ADS)

Bodego, Arantxa; Agirrezabala, Luis M.

2010-05-01

The Mesozoic Basque-Cantabrian Basin in the western Pyrenees constitutes a peri-cratonic basin originated by rifting related to the Cretaceous opening of the Bay of Biscay. During the mid-Cretaceous the basin experienced important extensional/transtensional tectonics, which controlled the deposition of thick sedimentary successions. Many extensional structures have been documented in the basin but their thin-skinned/thick-skinned character is an unresolved question. In this field-based study, we characterize contemporaneous thin-skinned and thick-skinned deformations that took place during the filling of the mid-Cretaceous Lasarte sub-basin, located in the northeastern margin of the Basque-Cantabrian Basin (western Pyrenees). Most of these extensional structures and associated growth strata are preserved and allow us to characterize and date different deformation phases. Moreover, verticalization and overturning of the successions during Tertiary compression allow mapping the geometry of the extensional structures at depth. The Lasarte sub-basin constitutes a triangular sag bordered by three major basement-involved faults, which trend N, E and NE, respectively. These trends, common in the Variscan fault pattern of Pyrenees, suggest that they are old faults reactivated during the mid-Cretaceous extension. Stratigraphy of the area shows very thin to absent Aptian-Albian (and older) deposits above the upward border blocks, whereas on the downward blocks (sub-basin interior) contemporaneous thick successions were deposited (up to 1500 m). The sub-basin fill is composed of different sedimentary systems (from alluvial to siliciclastic and carbonate platforms) affected by syndepositional extensional faults (and related folds). These faults die out in a southwestward dipping (~4°) detachment layer composed of Triassic evaporites and clays. A NE-SW cross-section of the sub-basin shows NW- to N-trending six planar and two listric extensional faults and associated folds, which define a horst and graben system. Rollovers (unfaulted and faulted), hangingwall synclines and central domes are present in the hangingwalls of both listric and planar faults. Also, a fault-propagation fold, a forced fold and a roller have been interpreted. Synkinematic depositional systems and sediment-filled fissures are parallel to the NW- to N-trending tectonic structures. Based on the trend of tectonic structures, the orientation of sediment-filled fissures and the paleocurrent pattern of growth strata, a thin-skinned NE-SW to E-W extension has been deduced for the interior of the Lasarte sub-basin. Both the coincidence between the directions of extension and dip of the detachment layer and the characteristics of the deformation suggest a thin-skinned gravity-driven extensional tectonics caused by the dip of the detachment layer. Recorded extensional deformation event in the Lasarte sub-basin is contemporaneous with and would have been triggered by the extreme crustal thinning and mantle exhumation processes documented recently in both the Basque-Cantabrian Basin and the Pyrenees.

Gas Permeation in Thin Glassy Polymer Films

NASA Astrophysics Data System (ADS)

Paul, Donald

2011-03-01

The development of asymmetric and composite membranes with very thin dense ``skins'' needed to achieve high gas fluxes enabled the commercial use of membranes for molecular level separations. It has been generally assumed that these thin skins, with thicknesses of the order of 100 nm, have the same permeation characteristics as films with thicknesses of 25 microns or more. Thick films are easily made in the laboratory and have been used extensively for measuring permeation characteristics to evaluate the potential of new polymers for membrane applications. There is now evidence that this assumption can be in very significant error, and use of thick film data to select membrane materials or predict performance should be done with caution. This presentation will summarize our work on preparing films of glassy polymers as thin as 20 nm and characterizing their behavior by gas permeation, ellipsometry and positron annihilation lifetime spectroscopy. Some of the most important polymers used commercially as gas separation membranes, i.e., Matrimid polyimide, polysulfone (PSF) and poly(2,6-dimethyl-1,4-phenylene oxide) (PPO), have been made into well-defined thin films in our laboratories by spin casting techniques and their properties studied using the techniques we have developed. These thin films densify (or physically age) much faster than thicker films, and, as result, the permeability decreases, sometimes by several-fold over weeks or months for thin films. This means that the properties of these thin films can be very different from bulk films. The techniques, interpretations and implications of these observations will be discussed. In a broader sense, gas permeation measurements can be a powerful way of developing a better understanding of the effects of polymer chain confinement and/or surface mobility on the behavior of thin films.

Full-Thickness Reconstruction with Pedicle Flap and Diced Homologous Cartilage Over the Pericardium Complicated. Cardiac Arrest

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rees, Thomas D.

1961-01-01

Successful repair by plastic surgery of nonhealing ulceration of the chest wall, induced by radiotherapy for breast cancer, is described. Reconstruction of the chest wali defect by pedicle flap coverage was carried out. Radiation injury extended through the entire thickness of the chest wall and osteoradionecrosis of the ribs was present. Reconstruction with thoracoabdominal tube was considered to be the best technique, so a 4- by 9-in. tube pedicle was constructed. The underlying donor wound of the pedicle was covered with a split- thickness skin graft. Healing was without incident, and approximates 3 weeks after formation, the inferior end ofmore » this tube pedicle was migrated to the left epigastrium as an intermediate step. Healing was uncomplicated, and the lateral attachment of the pedicle was partially severed. Three weeks later, resection of all avascular tissue along with portions of the fourth and fifth ribs was carried out. This created a full-thickness chest wall defect measuring 4 by 8 in., with the anterior surface of the pericardial sac exposed in the wound. The end of the abdominal tube pedicle was elevated from its bed, rotated into position, and sutured to the healthy margins of the chest wall defect. The exposed subcutaneous fat of the undersurface of the pedicle was placed in juxtaposition to the pericardium. A split-thickness skin graft was cut from the skin of the left thigh and draped over the pedicle flap donor wound. All sutured wounds healed per primum and the entire skin graft survived. The inferior inset of the tube pedicle was cut free and the pedicle flap was tailored into position 6 weeks later. The patient was discharged from the hospital in good condition and engaged in normal activities. An attempt was made to provide protection for the heart beneath the pedicle inset by introduction of diced homologous cartilage grafts, just beneath the skin of the pedicle flap. This healed with the formation of a thick fibrocartilaginous structure providing some protection for the pericardial contents beneath.« less

Suppression of α Smooth Muscle Actin Accumulation by Bovine Fetal Dermal Collagen Matrix in Full Thickness Skin Wounds

PubMed Central

Lineaweaver, William; Bush, Katie; James, Kenneth

2015-01-01

Abstract The suppression of elements associated with wound contracture and unfavorable scarring is a potentially important strategy in clinical wound management. In this study, the presence of α smooth muscle actin (αSMA), a protein involved in wound contraction, was analyzed in a series of wounds in which bovine fetal collagen (BFC) acellular dermal matrix (PriMatrix) was used in staged split thickness skin graft procedures. The results obtained through histological and quantitative image analyses of incidental biopsies from these wounds demonstrated a suppression of αSMA in the wound regions occupied by assimilated BFC relative to increased levels of αSMA found in other areas of the wound. The αSMA levels found in assimilated BFC were similar to αSMA levels in uninjured human dermis. These findings suggest a mechanism by which application of BFC could decrease contraction of full thickness skin wounds. PMID:25695450

Suppression of α Smooth Muscle Actin Accumulation by Bovine Fetal Dermal Collagen Matrix in Full Thickness Skin Wounds.

PubMed

Lineaweaver, William; Bush, Katie; James, Kenneth

2015-06-01

The suppression of elements associated with wound contracture and unfavorable scarring is a potentially important strategy in clinical wound management. In this study, the presence of α smooth muscle actin (αSMA), a protein involved in wound contraction, was analyzed in a series of wounds in which bovine fetal collagen (BFC) acellular dermal matrix (PriMatrix) was used in staged split thickness skin graft procedures. The results obtained through histological and quantitative image analyses of incidental biopsies from these wounds demonstrated a suppression of αSMA in the wound regions occupied by assimilated BFC relative to increased levels of αSMA found in other areas of the wound. The αSMA levels found in assimilated BFC were similar to αSMA levels in uninjured human dermis. These findings suggest a mechanism by which application of BFC could decrease contraction of full thickness skin wounds.

Optical coherence tomography demonstrates differential epidermal thinning of human forearm volar skin after 2 weeks application of a topical corticosteroid vs a non-steroidal anti-inflammatory alternative

NASA Astrophysics Data System (ADS)

Lu, Zenghai; Boadi, Joseph; Danby, Simon; Cork, Michael; Matcher, Stephen J.

2013-03-01

The effects on skin of two commercially available topical creams for the treatment of eczema are quantitatively studied using optical coherence tomography. An archetypal corticosteroid (Betamethasone valerate) is compared with a nonsteroidal anti-inflammatory drug (Tacrolimus monohydrate) via left/right comparisons of the epidermal thickness of volar forearm skin on selected volunteers, at baseline and after 14 days of treatment. In 3 of 4 subjects we confirmed previous observations that corticosteroids produce pronounced physical thinning of the epidermis over timescales of a few weeks. In 3 of 4 subjects we further found that Tacrolimus produced no change in epidermal thickness. In one of 4 subjects we found evidence that the epidermis was actually thickened following treatment using Tacrolimus.

Epidermal grafting versus split-thickness skin grafting for wound healing (EPIGRAAFT): study protocol for a randomised controlled trial.

PubMed

Kanapathy, Muholan; Hachach-Haram, Nadine; Bystrzonowski, Nicola; Harding, Keith; Mosahebi, Afshin; Richards, Toby

2016-05-17

Split-thickness skin grafting (SSG) is an important modality for wound closure. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Epidermal grafting (EG) is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying continuous negative pressure on the normal skin to raise blisters. This procedure has minimal donor site morbidity and is relatively pain-free, allowing autologous skin grafting in an outpatient setting. We plan to compare EG to SSG and to further investigate the cellular mechanism by which each technique achieves wound healing. EPIGRAAFT is a multicentre, randomised, controlled trial that compares the efficacy and wound-healing mechanism of EG with SSG for wound healing. The primary outcome measures are the proportion of wounds healed in 6 weeks and the donor site healing time. The secondary outcome measures include the mean time for complete wound healing, pain score, patient satisfaction, health care utilisation, cost analysis, and incidence of adverse events. This study is expected to define the efficacy of EG and promote further understanding of the mechanism of wound healing by EG compared to SSG. The results of this study can be used to inform the current best practise for wound care. Clinicaltrials.gov identifier, NCT02535481 . Registered on 11 August 2015.

Multilayer integral method for simulation of eddy currents in thin volumes of arbitrary geometry produced by MRI gradient coils.

PubMed

Sanchez Lopez, Hector; Freschi, Fabio; Trakic, Adnan; Smith, Elliot; Herbert, Jeremy; Fuentes, Miguel; Wilson, Stephen; Liu, Limei; Repetto, Maurizio; Crozier, Stuart

2014-05-01

This article aims to present a fast, efficient and accurate multi-layer integral method (MIM) for the evaluation of complex spatiotemporal eddy currents in nonmagnetic and thin volumes of irregular geometries induced by arbitrary arrangements of gradient coils. The volume of interest is divided into a number of layers, wherein the thickness of each layer is assumed to be smaller than the skin depth and where one of the linear dimensions is much smaller than the remaining two dimensions. The diffusion equation of the current density is solved both in time-harmonic and transient domain. The experimentally measured magnetic fields produced by the coil and the induced eddy currents as well as the corresponding time-decay constants were in close agreement with the results produced by the MIM. Relevant parameters such as power loss and force induced by the eddy currents in a split cryostat were simulated using the MIM. The proposed method is capable of accurately simulating the current diffusion process inside thin volumes, such as the magnet cryostat. The method permits the priori-calculation of optimal pre-emphasis parameters. The MIM enables unified designs of gradient coil-magnet structures for an optimal mitigation of deleterious eddy current effects. Copyright © 2013 Wiley Periodicals, Inc.

Full-thickness skin wound healing using autologous keratinocytes and dermal fibroblasts with fibrin: bilayered versus single-layered substitute.

PubMed

Idrus, Ruszymah Bt Hj; Rameli, Mohd Adha bin P; Low, Kiat Cheong; Law, Jia Xian; Chua, Kien Hui; Latiff, Mazlyzam Bin Abdul; Saim, Aminuddin Bin

2014-04-01

Split-skin grafting (SSG) is the gold standard treatment for full-thickness skin defects. For certain patients, however, an extensive skin lesion resulted in inadequacies of the donor site. Tissue engineering offers an alternative approach by using a very small portion of an individual's skin to harvest cells for propagation and biomaterials to support the cells for implantation. The objective of this study was to determine the effectiveness of autologous bilayered tissue-engineered skin (BTES) and single-layer tissue-engineered skin composed of only keratinocytes (SLTES-K) or fibroblasts (SLTES-F) as alternatives for full-thickness wound healing in a sheep model. Full-thickness skin biopsies were harvested from adult sheep. Isolated fibroblasts were cultured using medium Ham's F12: Dulbecco modified Eagle medium supplemented with 10% fetal bovine serum, whereas the keratinocytes were cultured using Define Keratinocytes Serum Free Medium. The BTES, SLTES-K, and SLTES-F were constructed using autologous fibrin as a biomaterial. Eight full-thickness wounds were created on the dorsum of the body of the sheep. On 4 wounds, polyvinyl chloride rings were used as chambers to prevent cell migration at the edge. The wounds were observed at days 7, 14, and 21. After 3 weeks of implantation, the sheep were euthanized and the skins were harvested. The excised tissues were fixed in formalin for histological examination via hematoxylin-eosin, Masson trichrome, and elastin van Gieson staining. The results showed that BTES, SLTES-K, and SLTES-F promote wound healing in nonchambered and chambered wounds, and BTES demonstrated the best healing potential. In conclusion, BTES proved to be an effective tissue-engineered construct that can promote the healing of full-thickness skin lesions. With the support of further clinical trials, this procedure could be an alternative to SSG for patients with partial- and full-thickness burns.

Total Facelift: Forehead Lift, Midface Lift, and Neck Lift

PubMed Central

2015-01-01

Patients with thick skin mainly exhibit the aging processes of sagging, whereas patients with thin skin develop wrinkles or volume loss. Asian skin is usually thicker than that of Westerners; and thus, the sagging of skin due to aging, rather than wrinkling, is the chief problem to be addressed in Asians. Asian skin is also relatively large in area and thick, implying that the weight of tissue to be lifted is considerably heavier. These factors account for the difficulties in performing a facelift in Asians. Facelifts can be divided into forehead lift, midface lift, and lower face lift. These can be performed individually or with 2-3 procedures combined. PMID:25798381

Split thickness skin graft meshing ratio indications and common practices.

PubMed

Pripotnev, Stahs; Papp, Anthony

2017-12-01

Split thickness skin grafting is a commonly used technique in burn surgery for resurfacing wounds that are unlikely to heal without scarring. Meshing and expanding skin grafts allow for reconstruction of larger wounds with smaller donor sites. A retrospective chart review was performed of 210 patients with burns equal to or greater than 20% total body surface area admitted to Vancouver General Hospital between 1998 and 2014. Charts were reviewed to collect data on patient and burn demographics. A survey was sent to Canadian plastic surgeons registered with the CSPS to collect data on common practices in burn surgery nationwide. The patients that received 3:1 or higher meshed grafts were all flame burns, had a significantly higher average TBSA (51.89%±14.87 vs 29.13%±9.48, p=0.001), and a significantly higher full thickness burn TBSA (25.76%±21.97 vs 6.20%±9.04, p=0.001). We found no significant differences in gender, age, or burn location between the less than 2:1 and 3:1 or greater meshing ratio groups. The survey of plastic surgeons performing burn surgery in Canada revealed that 60% of responders had experience with skin grafts using meshing ratios of 3:1 or higher. Of these surgeons, 100% felt that burn size and 36% felt that burn location would influence their decision to use a 3:1 or higher meshing ratio. A larger burn size is the major influencing factor for the use of higher skin graft meshing ratios by Canadian burn surgeons. Furthermore, burn location determines the choice of donor and recipient sites in these cases. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Fibrin gel as a scaffold for skin substitute – production and clinical experience.

PubMed

Kljenak, Antun; Tominac Trcin, Mirna; Bujić, Marina; Dolenec, Tamara; Jevak, Martina; Mršić, Gordan; Zmiš, Gordana; Barčot, Zoran; Muljačić, Ante; Popović, Maja

2016-06-01

The purpose of this study was to create a fibrin-based human skin substitute in vitro with epidermal and dermal component and to assess its healing potential in deep partial and full thickness burns. Fibrin scaffolds were prepared from commercial fibrin glue kits. Human fibroblasts were cultured in fibrin gel. Human keratinocytes were seeded on the top of the gel. Viability of cells was determined fluorimetrically. Scanning electron microscope and immunocytochemistry analysis of cultured cells were performed. After hydrosurgical preparation of deep burn necrotic tissue, wound bed was prepared for skin substitutes. Progress of healing was documented using visual estimation and photos. Scanning electron microscope images showed good cell attachment and colony spreading of keratinocytes and fibroblasts on fibrin scaff old. Immunofluorescent staining of cell cultures on fibrin scaffold showed expression of vimentin, a marker of fibroblast cells, cytokeratin 19, a marker of epithelial stem cells, as well as involucrin, a marker of differentiated keratinocytes. Clinical results clearly showed that appearance of the skin did not differ significantly from the areas of transplanted skin using split-thickness skin graft techniques. In conclusion, using these fibrin-cultured autografts on massive full-thickness burn resulted in good healing.

Treatment of the concrete scalp donor site.

PubMed

Engrav, L H; Grube, B J; Bubak, P J

1990-02-01

The scalp has become a popular donor site for split-thickness skin, and few complications have been reported. However, we have been troubled by 5 patients in whom the donor site did not epithelialize but rather turned into dried granulation tissue with embedded growing hairs, a situation rather like concrete with steel reinforcing rods. The pathophysiology is not clear but seems to be related to thick grafts from hair-bearing areas. We treated the lesions by removing the granulation tissue, shaving the hair, and treating the wound as a new donor site. Four lesions healed with total or near total regrowth of hair, and one required a small skin graft.

Honey Dressing Accelerates Split-Thickness Skin Graft Donor Site Healing.

PubMed

Subrahmanyam, M

2015-12-01

The management of the donor site after harvesting a skin graft is an important issue, as patients often report more discomfort at the donor site than at the recipient site. There is, however, a plethora of dressings available for the treatment and management of donor sites, yet, there is no widely accepted method established for these partial thickness wounds. Honey has been found to be useful in the treatment of burns and other wounds, split-thickness skin graft donor sites are like partial thickness burn wounds and honey's healing effect on burn wound can also be expected on these types of wounds. Therefore, this study was undertaken to evaluate the effect of honey on skin graft donor sites. From 2002 to 2004, 100 patients who have undergone skin grafting for various reasons formed the material of the randomized study divided into two groups of 50 each in honey-treated group and Vaseline gauze-treated group. Graft donor site area ranged from 30 to 48 cm(2), mean 32.6 cm(2). In the group treated with honey, 90 % of the patients had nil or only moderate pain, whereas in the group treated with Vaseline gauze,88 % had nil or mild pain (p > 0.001, not significant). There were no allergic reactions in any of the patients in either group. On opening of the dressing on the 7th day, epithelialization has occurred in 48 patients as compared to 39 in group 2, i.e., donor sites treated with Vaseline gauze (p < 0.05, statistically significant). By the 10th day, all the wounds healed in honey-treated group, whereas 76 % of wounds healed in Vaseline gauze-treated group (p < 0.05). At 1 month follow-up, the results were comparable in both groups, with regard to patient satisfaction. In conclusion, honey-impregnated gauze causes less pain and heals donor sites wounds faster with good cosmetic result.

Stretchable, adhesive and ultra-conformable elastomer thin films.

PubMed

Sato, Nobutaka; Murata, Atsushi; Fujie, Toshinori; Takeoka, Shinji

2016-11-16

Thermoplastic elastomers are attractive materials because of the drastic changes in their physical properties above and below the glass transition temperature (T g ). In this paper, we report that free-standing polystyrene (PS, T g : 100 °C) and polystyrene-polybutadiene-polystyrene triblock copolymer (SBS, T g : -70 °C) thin films with a thickness of hundreds of nanometers were prepared by a gravure coating method. Among the mechanical properties of these thin films determined by bulge testing and tensile testing, the SBS thin films exhibited a much lower elastic modulus (ca. 0.045 GPa, 212 nm thickness) in comparison with the PS thin films (ca. 1.19 GPa, 217 nm thickness). The lower elastic modulus and lower thickness of the SBS thin films resulted in higher conformability and thus higher strength of adhesion to an uneven surface such as an artificial skin model with roughness (R a = 10.6 μm), even though they both have similar surface energies. By analyzing the mechanical properties of the SBS thin films, the elastic modulus and thickness of the thin films were strongly correlated with their conformability to a rough surface, which thus led to a high adhesive strength. Therefore, the SBS thin films will be useful as coating layers for a variety of materials.

Automated Estimation of Melanocytic Skin Tumor Thickness by Ultrasonic Radiofrequency Data.

PubMed

Andrekute, Kristina; Valiukeviciene, Skaidra; Raisutis, Renaldas; Linkeviciute, Gintare; Makstiene, Jurgita; Kliunkiene, Renata

2016-05-01

High-frequency (>20-MHz) ultrasound (US) is a noninvasive preoperative tool for assessment of melanocytic skin tumor thickness. Ultrasonic melanocytic skin tumor thickness estimation is not always easy and is related to the experience of the clinician. In this article, we present an automated thickness measurement method based on time-frequency analysis of US radiofrequency signals. The study was performed on 52 thin (≤1-mm) melanocytic skin tumors (46 melanocytic nevi and 6 melanomas). Radiofrequency signals were obtained with a single-element focused transducer (fundamental frequency, 22 MHz; bandwidth, 12-28 MHz). The radiofrequency data were analyzed in the time-frequency domain to make the tumor boundaries more noticeable. The thicknesses of the tumors were evaluated by 3 different metrics: histologically measured Breslow thickness, manually measured US thickness, and automatically measured US thickness. The results showed a higher correlation coefficient between the automatically measured US thickness and Breslow thickness (r= 0.83; P< .0001) than the manually measured US thickness (r = 0.68; P < .0001). The sensitivity of the automated tumor thickness measurement algorithm was 96.55%, and the specificity was 78.26% compared with histologic measurement. The sensitivity of the manually measured US thickness was 75.86%, and the specificity was 73.91%. The efficient automated tumor thickness measurement method developed could be used as a tool for preoperative assessment of melanocytic skin tumor thickness. © 2016 by the American Institute of Ultrasound in Medicine.

[The advantages in using cyanoacrylate glue over skin staples as a method of skin graft fixation in the pediatric burns population].

PubMed

Curings, P; Vincent, P-L; Viard, R; Gir, P; Comparin, J-P; Voulliaume, D

2017-11-23

Local postoperative care and burn wound management can present with a certain degree of difficulty in the pediatric population. While the use of skin staples as a method of skin graft fixation is a well-known, rapid and simple method, their removal can be painful and may necessitate some sedation or even general anesthesia. We studied in this article the advantages and economic value of using the cyanoacrylate glue as a fixation method for skin grafts. A comparative study was carried out from 2012 to 2016. Hundred and eighteen infants with burns up to 5% of total body surface area were included in the study. Seventy-two infants had split thickness skin grafts fixed with skin staples. Forty-six infants had split thickness skin grafts fixed with cyanoacrylate glue. We compared the quality of graft, the sedation used during the first postoperative dressing, the length of hospital stay, the amount of glue used and the presence of complications. There is a difference between the two groups studied in terms of age and total burn surface area. The rate of graft take was 100% in both groups. The first postoperative dressing was carried out without the use of powerful analgesia in the cyanoacrylate group, while it was necessary to use general anesthesia in 64% of the skin staples group. The average length of stay in hospital after skin grafting was 4.9 days for the cyanoacrylate glue versus 6.5 days in the skin staples group. No complications were noted in the 2 groups. The use of cyanoacrylate glue allows rapid fixation of skin grafts and avoid general anesthesia for postoperative cares. Subsequently the length of hospital stay is reduced within 25%. The medico-economic value of glue protocol is highly significant compared to skin staples, while having similar good results and without significant problems. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Dillon cutoff-Basement-involved tectonic link between the disturbed belt of west-central Montana and the overthrust belt of extreme southwestern Montana

NASA Astrophysics Data System (ADS)

O'Neill, J. Michael; Schmidt, Christopher J.; Genovese, Paul W.

1990-11-01

The front of the Cordilleran fold and thrust belt in western Montana follows the disturbed belt in the north, merges with the southwest Montana transverse zone in the west-central part of the region, and in southwestern Montana is marked by a broad zone characterized by complex interaction between thrust belt structures and basement uplifts. The front margin of the thrust belt in Montana reflects mainly thin-skinned tectonic features in the north, an east-trending lateral ramp that curves southwest in the central part into the Dillon cutoff, an oblique-slip, thick-skinned displacement transfer zone that cuts through basement rocks of the Lima recess, and a zone of overlap between thin- and thick-skinned thrusts in extreme southwestern Montana. The transverse ramp and basement-involved thrust faults are controlled by Proterozoic structures.

Design and evaluation of thin metal surface insulation for hypersonic flight

NASA Technical Reports Server (NTRS)

Miller, R. C.; Petach, A. M.

1976-01-01

An all-metal insulation was studied as a thermal protection system for hypersonic vehicles. Key program goals included fabricating the insulation in thin packages which are optimized for high temperature insulation of an actively cooled aluminum structure, and the use of state-of-the-art alloys. The insulation was fabricated from 300 series stainless steel in thicknesses of 0.8 to 12 mm. The outer, 0.127 mm thick, skin was textured to accommodate thermal expansion and oxidized to increase emittance. The thin insulating package was achieved using an insulation concept consisting of foil radiation shields spaced within the package, and conical foil supports to carry loads from the skin and maintain package dimensions. Samples of the metal-insulation were tested to evaluate thermal insulation capability, rain and sand erosion resistance, high temperature oxidation resistance, applied load capability, and high temperature emittance.

The treatment of deep dermal hand burns: How do we achieve better results? Should we use allogeneic keratinocytes or skin grafts?

PubMed

Haslik, W; Kamolz, L-P; Lumenta, D B; Hladik, M; Beck, H; Frey, M

2010-05-01

The treatment of deep dermal burns has a broad spectrum and has been subject to discussion over the past years. The treatment of hand burns is challenging due to the high requirements to aesthetic and functional outcome. 27 patients, 7 women and 20 men with deep dermal hand burns with a mean age of 41.3+/-16.5 and a mean TBSA of 15%+/-19.6% were treated either with allogeneic cryopreserved keratinocytes or with split skin grafts. Long-term follow-up revealed no statistical significant differences between the two groups concerning Vancouver Scar Scale as well as hand function judged by the DASH score; however there was a tendency to higher VSS scores and impaired aesthetic results in the keratinocyte group. Allogeneic keratinocytes are a suitable armentarium for the treatment of deep dermal hand burns; and, if used correctly, they can produce a timely healing comparable to split-thickness skin grafts. Limited availability, high costs as well as the need for special skills are key factors, which render application of this technique outside specialist burn centres virtually impossible. In our opinion, the cultivation and use of keratinocytes should be reserved to these centres in order to facilitate a sensible application for a full range of indications. We recommend usage of allogeneic keratinocytes for deep dermal hand burns only in severely burned patients with a lack of donor sites. Patients with unrestricted availability of donor sites seem to profit from the application of split-thickness skin grafts according to our results. Copyright 2009 Elsevier Ltd and ISBI. All rights reserved.

Liquid Collagen (Type I) Wound Coverings

DTIC Science & Technology

1991-09-10

Medical School, has been recruited to the project for the coming year. He has continued to apply the Iodocol preparation to split " " thickness skin ... graft donor sites with very encouraging results. Again, study patients continue to report a decrease in pain on the donor site. = In June Dr. Waldorf

PRFM enhance wound healing process in skin graft.

PubMed

Reksodiputro, Mirta; Widodo, Dini; Bashiruddin, Jenny; Siregar, Nurjati; Malik, Safarina

2014-12-01

Facial plastic and reconstructive surgery often used skin graft on defects that cannot be covered primarily by a local flap. However, wound healing using skin graft is slow, most of the time the graft is contractured and the take of graft is not optimal. Platelet rich fibrin matrix (PRFM) is a new generation of concentrated platelets that produce natural fibrin and reported to speed up the healing process. Application of PRFM in the skin graft implants is expected to increase the survival of the graft. We used porcine as animal models to elucidate the effect of autologous PRFM on wound healing in full-thickness (FTSG) and split-thickness (STSG) skin grafts. Survival level of the skin graft was determined by using ImageJ software based on the formation of collagen type 1 and graft take. We observed that the use of PRFM in FTSG and STSG increased type 1 collagen formation. We also found that PRFM addition in STSG gave the best skin graft take. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Mechanics Model for Sensors Imperfectly Bonded to the Skin for Determination of the Young's Moduli of Epidermis and Dermis.

PubMed

Yuan, J H; Shi, Y; Pharr, M; Feng, X; Rogers, John A; Huang, Yonggang

2016-08-01

A mechanics model is developed for the encapsulated piezoelectric thin-film actuators/sensors system imperfectly bonded to the human skin to simultaneously determine the Young's moduli of the epidermis and dermis as well as the thickness of epidermis.

Survival of Burns Involving 90% of the Total Body Surface Area After Treatment With Autologous Engineered Skin Substitutes

DTIC Science & Technology

2008-12-01

during acute hospitalization, and can result in long-term morbidity from scars . In this study, autologous ESS were compared with split-thickness...meshed skin autograft treatment of two pediatric patients with burns of 90% TBSA or greater, and evaluated qualitatively for formation of scar , and...populations ( Armour et al. 2007). Availability of ESS for treatment of extensive, deep burns may reduce time to wound closure, morbidity and

Initial experience with a composite autologous skin substitute.

PubMed

Sheridan, R L; Morgan, J R; Cusick, J L; Petras, L M; Lydon, M M; Tompkins, R G

2001-08-01

Patients with large burns are surviving in increasing numbers, but there remains no durable and reliable permanent skin replacement. After initial favorable small animal experiments, a pilot trial of a composite skin replacement was performed in patients with massive burns. A composite skin replacement (CSR) was developed by culturing autologous keratinocytes on acellular allogenic dermis. This material was engrafted in patients with massive burns and compared to a matched wound covered with split thickness autograft. With human studies committee approval, 12 wounds in 7 patients were grafted with CSR while a matched control wound was covered with split thickness autograft. These 7 children had an average age of 6.4+/-1.4 yr and burn size of 75.9+/-5.0% of the body surface. Nine wounds were acute burns and three were reconstructive releases. Successful vascularization at 14 days averaged 45.7+/-14.2% (range 0-100%) in the study wounds and 98+/-1% (range 90-100%) in the control sites (P<0.05). Reduced CSR take seemed to correlate with wound colonization. All children survived. While CSR did not engraft with the reliability of standard autograft, this pilot experience is encouraging in that successful wound closure with this material is possible, if not yet dependable. It is hoped that a more mature epidermal layer may facilitate engraftment, and trials to explore this possibility are in progress.

Comparison between recreational male Ironman triathletes and marathon runners.

PubMed

Gianoli, Daniele; Knechtle, Beat; Knechtle, Patrizia; Barandun, Ursula; Rüst, Christoph Alexander; Rosemann, Thomas

2012-08-01

Recent investigations described a personal best marathon time as a predictor variable for an Ironman race time in recreational male Ironman triathletes. Similarities and differences in anthropometry and training were investigated between 83 recreational male Ironman triathletes and 81 recreational male marathoners. Ironman triathletes were significantly taller and had a higher body mass and a higher skin-fold thickness of the calf compared to the marathoners. Weekly training volume in hours was higher in Ironman triathletes. In the Ironman triathletes, percent body fat was related to overall race time and both the split time in cycling and running. The weekly swim kilometres were related to the split time in swimming, and the speed in cycling was related to the bike split time. For the marathoners, the calf skin-fold thickness and running speed during training were related to marathon race time. Although personal best marathon time was a predictor of Ironman race time in male triathletes, anthropometric and training characteristics of male marathoners were different from those of male Ironman triathletes, probably due to training of different muscle groups and metabolic endurance beyond marathon running, as the triathletes are also training for high-level performance in swimming and cycling. Future studies should compare Olympic distance triathletes and road cyclists with Ironman triathletes.

Reepithelialization from stem cells of hair follicles of dermal graft of the scalp in acute treatment of third-degree burns: first clinical and histologic study.

PubMed

Zakine, Gilbert; Mimoun, Maurice; Pham, Julien; Chaouat, Marc

2012-07-01

The scalp, an excellent donor site for thin skin grafts, presents a limited surface but is rich in keratinocyte stem cells. The purpose of this study was to double scalp harvesting in one procedure and to evaluate the capacity of the dermal layer to spontaneously reepithelialize from hair follicle stem cells. Two layers of 0.2-mm split-thickness skin graft, a dermoepidermal graft and a dermal graft, were harvested from scalp during the same procedure. Fifteen burn patients were included in this study. Healing of the scalp donor site and percentage of graft taken were evaluated. The Vancouver Scar Scale was used at 3 months and 1 year. Histologic studies were performed at day 0 and 3 months on grafts, and on the scalp at day 28. Nine patients were treated on the limbs with meshed dermal graft. Six were treated on the hands with unmeshed dermal graft. Graft take was good for both types of grafts. The mean time for scalp healing was 9.3 days. Histologic study confirmed that the second layer was a dermal graft with numerous annexes and that, at 3 months, the dermis had normal thickness but with rarer and smaller epidermal crests than dermal graft. The difference between the mean Vancouver Scar Scale score of dermal graft and dermoepidermal graft was not significant. The authors' study shows the efficacy of dermal graft from the scalp and good scalp healing. Therapeutic, II.

Skin graft fixation in severe burns: use of topical negative pressure.

PubMed

Kamolz, L P; Lumenta, D B; Parvizi, D; Wiedner, M; Justich, I; Keck, M; Pfurtscheller, K; Schintler, M

2014-09-30

Over the last 50 years, the evolution of burn care has led to a significant decrease in mortality. The biggest impact on survival has been the change in the approach to burn surgery. Early excision and grafting has become a standard of care for the majority of patients with deep burns; the survival of a given patient suffering from major burns is invariably linked to the take rate and survival of skin grafts. The application of topical negative pressure (TNP) therapy devices has demonstrated improved graft take in comparison to conventional dressing methods alone. The aim of this study was to analyze the impact of TNP therapy on skin graft fixation in large burns. In all patients, we applied TNP dressings covering a %TBSA of >25. The following parameters were recorded and documented using BurnCase 3D: age, gender, %TBSA, burn depth, hospital length-of-stay, Baux score, survival, as well as duration and incidence of TNP dressings. After a burn depth adapted wound debridement, coverage was simultaneously performed using split-thickness skin grafts, which were fixed with staples and covered with fatty gauzes and TNP foam. The TNP foam was again fixed with staples to prevent displacement and finally covered with the supplied transparent adhesive film. A continuous subatmospheric pressure between 75-120 mm Hg was applied (VAC®, KCI, Vienna, Austria). The first dressing change was performed on day 4. Thirty-six out of 37 patients, suffering from full thickness burns, were discharged with complete wound closure; only one patient succumbed to their injuries. The overall skin graft take rate was over 95%. In conclusion, we consider that split thickness skin graft fixation by TNP is an efficient method in major burns, notably in areas with irregular wound surfaces or subject to movement (e.g. joint proximity), and is worth considering for the treatment of aged patients.

Graphene Electronic Tattoo Sensors.

PubMed

Kabiri Ameri, Shideh; Ho, Rebecca; Jang, Hongwoo; Tao, Li; Wang, Youhua; Wang, Liu; Schnyer, David M; Akinwande, Deji; Lu, Nanshu

2017-08-22

Tattoo-like epidermal sensors are an emerging class of truly wearable electronics, owing to their thinness and softness. While most of them are based on thin metal films, a silicon membrane, or nanoparticle-based printable inks, we report sub-micrometer thick, multimodal electronic tattoo sensors that are made of graphene. The graphene electronic tattoo (GET) is designed as filamentary serpentines and fabricated by a cost- and time-effective "wet transfer, dry patterning" method. It has a total thickness of 463 ± 30 nm, an optical transparency of ∼85%, and a stretchability of more than 40%. The GET can be directly laminated on human skin just like a temporary tattoo and can fully conform to the microscopic morphology of the surface of skin via just van der Waals forces. The open-mesh structure of the GET makes it breathable and its stiffness negligible. A bare GET is able to stay attached to skin for several hours without fracture or delamination. With liquid bandage coverage, a GET may stay functional on the skin for up to several days. As a dry electrode, GET-skin interface impedance is on par with medically used silver/silver-chloride (Ag/AgCl) gel electrodes, while offering superior comfort, mobility, and reliability. GET has been successfully applied to measure electrocardiogram (ECG), electromyogram (EMG), electroencephalogram (EEG), skin temperature, and skin hydration.

Age and evolution of thin-skinned deformation in Zacatecas, Mexico: Sevier orogeny evidence in the Mexican Fold-Thrust Belt

NASA Astrophysics Data System (ADS)

Ramírez-Peña, César Francisco; Chávez-Cabello, Gabriel

2017-07-01

Integrating U-Pb ages from zircons of syn- and postectonic intrusives emplaced in folded pre- and synorogenic marine sedimentary rocks, it is proposed that thin-skinned deformation in the Concepción del Oro salient of the Mexican Fold Thrust Belt in northern Zacatecas, Mexico, was active between 92 and 71.6 Ma. The intrusives Pico de Teyra and El Peñuelo (U-Pb zircon ages: 76.9 and 72.5 Ma) show internal tectonic foliations and horizontal shear zones that cut off aplitic veins, which apparently developed syntectonically to thin-skinned deformation. Other intrusives like Saltillito (71.6 Ma) and Concepción del Oro are clearly postectonic because they are undeformed internally, cut regional structures and are younger than syntectonic plutons. Biostratigraphic ages reported for synorogenic sediments (Concepción del Oro and Parras formations) indicate that regional thin-skinned deformation was active between Early Turonian and Late Campanian, which is in agreement with syn and postectonic intrusive emplacement ages in the area. Nevertheless, the thin-skinned structures are disrupted by a younger NNW-SSE high angle reverse and normal faults that uplifts the San Julián Block in the west and truncate the Concepción del Oro salient, suggesting a post-Paleocene thick-skinned stage of deformation. In this work, we propose that style and age of thin-skinned deformation is similar to the Sevier orogeny in the Rocky Mountains.

An analytical theory for a three-dimensional thick-disc thin-plate vibratory gyroscope

NASA Astrophysics Data System (ADS)

Sedebo, G. T.; Joubert, S. V.; Shatalov, M. Y.

2018-04-01

We consider a cylindrical vibratory gyroscope comprising a not necessarliy thin-shelled annular disc with small-plate thickness, vibrating in the m -th vibration mode in-plane and in the (m + 1)st vibration mode out-of-plane. We derive the equations of motion for this contrivance in the “force-to-rebalance regime” and show how a slow (three-dimensional) inertial rotation rate of the gyroscope can be calculated in terms of amplitudes of vibration and other constants, all of which can be measured experimentally or calculated when the eigenfunctions and eigenvalues of the system are known. By means of a concrete example, a numerical experiment demonstrates how varying the inner radius of the annulus as well as the thickness of the plate allows us to “tune” the vibration frequencies of the in-plane and out-of-plane vibrations so that they coincide (for all practical purposes), eliminating any frequency split. Conventionally, an array of at least three thin-shelled hemispherical (or thin-ring) vibratory (resonator) gyroscopes is used to measure any three-dimensional rotation of the craft to which the gyroscopes are fixed. With the design proposed here, the array can be reduced to a solitary, tuned, annular thick-disc thin-plate vibratory gyroscope, reducing both size and cost.

Feasibility and Advantages of Full Thickness Skin Graft from the Anterolateral Thigh.

PubMed

Shin, Seung-Han; Kim, Chulkyu; Lee, Yong-Suk; Kang, Jin-Woo; Chung, Yang-Guk

2017-12-01

Full thickness skin graft (FTSG) gives better outcomes than split thickness skin graft (STSG), but it has the drawback of limited donor sites. Anterolateral thigh (ALT), a popular donor site of STSG, is also a popular donor site of perforator flaps. This area has the advantage of large flap size available with primary closure. Based on this we harvested FTSG instead of STSG from the ALT. We retrospectively reviewed 10 cases of FTSG from the ALT, with the recipient site of foot in 3, ankle in 2, lower leg in 2, forearm in 2, and wrist in 1 patient. In all cases elliptical full thickness skin was harvested from the ALT, and the donor site was closed primarily. The skin was defatted and placed onto the defect with vacuum-assisted closure (VAC). The skin size ranged 7-30 cm in length and 3-12 cm in width. Mean follow up period was 7 months (range, 3-13). FTSG from the ALT provided durable wound coverage, with excellent color and texture matching. Partial (< 20%) graft failure was observed in 1 case, but no additional surgery was necessary. No patient reported donor site pain at postoperative 2 weeks. No donor site complications were encountered. No patient complained a feeling of tension in the thigh at final follow-up. FTSG from the ALT is feasible with the aid of VAC. Considering the skin quality, large skin size available, early pain relief, and little donor site morbidity, the ALT should be revisited as a donor site of FTSG.

Implant-supported fixed restoration of post-traumatic mandibular defect accompanied with skin grafting: A clinical report

PubMed Central

Noh, Kwantae; Choi, Woo-Jin

2013-01-01

Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology. PMID:23508120

Pedal macrodactyly: coverage of a large defect with a rectus abdominus free flap.

PubMed

Hendrix, C L; Thomson, J G; Blume, P A

2000-01-01

The authors report a case of a unique reconstructive approach for an isolated macrodactyly of the lower extremity in an otherwise healthy African male. Surgical treatment included excision and local resection of the affected hypertrophied skin, soft tissue, and bone. A rectus abdominis free-tissue transfer and split-thickness skin graft were used for coverage of the defect. The foot healed without complication, and at 2-year follow-up, the patient had an aesthetically pleasing and fully functional result.

Advances in Measurement of Skin Friction in Airflow

NASA Technical Reports Server (NTRS)

Brown, James L.; Naughton, Jonathan W.

2006-01-01

The surface interferometric skin-friction (SISF) measurement system is an instrument for determining the distribution of surface shear stress (skin friction) on a wind-tunnel model. The SISF system utilizes the established oil-film interference method, along with advanced image-data-processing techniques and mathematical models that express the relationship between interferograms and skin friction, to determine the distribution of skin friction over an observed region of the surface of a model during a single wind-tunnel test. In the oil-film interference method, a wind-tunnel model is coated with a thin film of oil of known viscosity and is illuminated with quasi-monochromatic, collimated light, typically from a mercury lamp. The light reflected from the outer surface of the oil film interferes with the light reflected from the oil-covered surface of the model. In the present version of the oil-film interference method, a camera captures an image of the illuminated model and the image in the camera is modulated by the interference pattern. The interference pattern depends on the oil-thickness distribution on the observed surface, and this distribution can be extracted through analysis of the image acquired by the camera. The oil-film technique is augmented by a tracer technique for observing the streamline pattern. To make the streamlines visible, small dots of fluorescentchalk/oil mixture are placed on the model just before a test. During the test, the chalk particles are embedded in the oil flow and produce chalk streaks that mark the streamlines. The instantaneous rate of thinning of the oil film at a given position on the surface of the model can be expressed as a function of the instantaneous thickness, the skin-friction distribution on the surface, and the streamline pattern on the surface; the functional relationship is expressed by a mathematical model that is nonlinear in the oil-film thickness and is known simply as the thin-oil-film equation. From the image data acquired as described, the time-dependent oil-thickness distribution and streamline pattern are extracted and by inversion of the thin-oil-film equation it is then possible to determine the skin-friction distribution. In addition to a quasi-monochromatic light source, the SISF system includes a beam splitter and two video cameras equipped with filters for observing the same area on a model in different wavelength ranges, plus a frame grabber and a computer for digitizing the video images and processing the image data. One video camera acquires the interference pattern in a narrow wavelength range of the quasi-monochromatic source. The other video camera acquires the streamline image of fluorescence from the chalk in a nearby but wider wavelength range. The interference- pattern and fluorescence images are digitized, and the resulting data are processed by an algorithm that inverts the thin-oil-film equation to find the skin-friction distribution.

A Mechanics Model for Sensors Imperfectly Bonded to the Skin for Determination of the Young's Moduli of Epidermis and Dermis

PubMed Central

Yuan, J. H.; Shi, Y.; Pharr, M.; Feng, X.; Rogers, John A.; Huang, Yonggang

2016-01-01

A mechanics model is developed for the encapsulated piezoelectric thin-film actuators/sensors system imperfectly bonded to the human skin to simultaneously determine the Young's moduli of the epidermis and dermis as well as the thickness of epidermis. PMID:27330219

Thin and thick primary cutaneous melanomas reveal distinct patterns of somatic copy number alterations

PubMed Central

Apollo, Alessandro; Pescucci, Chiara; Licastro, Danilo; Urso, Carmelo; Gerlini, Gianni; Borgognoni, Lorenzo; Luzzatto, Lucio; Stecca, Barbara

2016-01-01

Cutaneous melanoma is one of the most aggressive type of skin tumor. Early stage melanoma can be often cured by surgery; therefore current management guidelines dictate a different approach for thin (<1mm) versus thick (>4mm) melanomas. We have carried out whole-exome sequencing in 5 thin and 5 thick fresh-frozen primary cutaneous melanomas. Unsupervised hierarchical clustering analysis of somatic copy number alterations (SCNAs) identified two groups corresponding to thin and thick melanomas. The most striking difference between them was the much greater abundance of SCNAs in thick melanomas, whereas mutation frequency did not significantly change between the two groups. We found novel mutations and focal SCNAs in genes that are embryonic regulators of axon guidance, predominantly in thick melanomas. Analysis of publicly available microarray datasets provided further support for a potential role of Ephrin receptors in melanoma progression. In addition, we have identified a set of SCNAs, including amplification of BRAF and ofthe epigenetic modifier EZH2, that are specific for the group of thick melanomas that developed metastasis during the follow-up. Our data suggest that mutations occur early during melanoma development, whereas SCNAs might be involved in melanoma progression. PMID:27095580

Thin and thick primary cutaneous melanomas reveal distinct patterns of somatic copy number alterations.

PubMed

Montagnani, Valentina; Benelli, Matteo; Apollo, Alessandro; Pescucci, Chiara; Licastro, Danilo; Urso, Carmelo; Gerlini, Gianni; Borgognoni, Lorenzo; Luzzatto, Lucio; Stecca, Barbara

2016-05-24

Cutaneous melanoma is one of the most aggressive type of skin tumor. Early stage melanoma can be often cured by surgery; therefore current management guidelines dictate a different approach for thin (<1mm) versus thick (>4mm) melanomas. We have carried out whole-exome sequencing in 5 thin and 5 thick fresh-frozen primary cutaneous melanomas. Unsupervised hierarchical clustering analysis of somatic copy number alterations (SCNAs) identified two groups corresponding to thin and thick melanomas. The most striking difference between them was the much greater abundance of SCNAs in thick melanomas, whereas mutation frequency did not significantly change between the two groups. We found novel mutations and focal SCNAs in genes that are embryonic regulators of axon guidance, predominantly in thick melanomas. Analysis of publicly available microarray datasets provided further support for a potential role of Ephrin receptors in melanoma progression. In addition, we have identified a set of SCNAs, including amplification of BRAF and ofthe epigenetic modifier EZH2, that are specific for the group of thick melanomas that developed metastasis during the follow-up. Our data suggest that mutations occur early during melanoma development, whereas SCNAs might be involved in melanoma progression.

Bioengineering methods employed in the study of wound healing of sulphur mustard burns.

PubMed

Graham, John S; Schomacker, Kevin T; Glatter, Robert D; Briscoe, Crystal M; Braue, Ernest H; Squibb, Katherine S

2002-02-01

Sulphur mustard (SM) is a potent incapacitating chemical warfare agent that remains a threat to war fighters and civilians worldwide. SM lesions may require weeks or months to heal, depending upon their severity. This study was undertaken to find a treatment regimen that promotes speedier healing of deep cutaneous SM burns in a weanling pig model. The principal objective of the study was to compare four treatment regimens and establish which achieved the shortest healing time. Twelve Yorkshire Cross weanling pigs were exposed to SM liquid for 2h, generating six large deep dermal/full thickness burns on the ventrum of each animal. Three additional animals served as sham-exposed controls. Surgical intervention occurred at 48 h postexposure. Treatments included: (i) full-thickness debridement of the burns with a computer controlled, raster scanned continuous wave CO2 laser followed by autologous split-thickness skin grafting; (ii) full-thickness sharp surgical tangential excision followed by skin grafting, the 'Gold Standard' used in human deep dermal/full-thickness thermal burns management; (iii) partial-thickness laser ablation with no grafting; and (iv) partial-thickness sharp surgical excision with no grafting. Several non-invasive bioengineering methods were used to monitor the progress of wound healing throughout a 36-day healing period: reflectance colourimetry, evaporimetry, laser Doppler perfusion imaging and ballistometry. Bioengineering methods indicated that laser debridement followed by autologous split-thickness skin grafting was as efficacious in improving the wound healing of deep SM burns in weanling swine as the 'Gold Standard.' Regardless of the method of debridement, barrier function, skin colour and mechanical properties returned to near-normal levels within 15 days of treatment in the grafted sites. Regardless of surgical approach, blood flux levels remained approximately 50-60% of normal tissue throughout the 36-day postsurgical observation period. Mid-dermal debridement by sharp surgical tangential excision or laser ablation without the use of skin grafts did not produce as good a result as those attained through the use of grafts, but was better than no surgical treatment of the wounds. Bioengineering methods were useful in evaluating multiple characteristics during wound healing: (i) reflectance colourimetry for skin colour, (ii) evaporimetry to measure transepidermal water loss as an indicator of barrier function, (iii) laser Doppler perfusion imaging to assess cutaneous blood flow, and (iv) ballistometry to measure the mechanical properties of skin hardness and elasticity. Perhaps the most useful method was evaporimetry, as a restored barrier function was the best indicator of healed wounds. The use of reflectance colourimetry and ballistometry will continue in future wound healing studies for their contributions in judging cosmetic and functional outcomes. While useful, laser Doppler perfusion imaging was found to be rather time consuming. This methodology will be limited in the future to burn depth estimation prior to treatment, and for evaluation of pharmaceuticals specifically designed to improve or sustain blood flow into damaged areas.

Accelerated re-epithelialization of partial-thickness skin wounds by a topical betulin gel: Results of a randomized phase III clinical trials program.

PubMed

Barret, Juan P; Podmelle, Fred; Lipový, Břetislav; Rennekampff, Hans-Oliver; Schumann, Hauke; Schwieger-Briel, Agnes; Zahn, Tobias R; Metelmann, Hans-Robert

2017-09-01

The clinical significance of timely re-epithelialization is obvious in burn care, since delayed wound closure is enhancing the risk of wound site infection and extensive scarring. Topical treatments that accelerate wound healing are urgently needed to reduce these sequelae. Evidence from preliminary studies suggests that betulin can accelerate the healing of different types of wounds, including second degree burns and split-thickness skin graft wounds. The goal of this combined study program consisting of two randomized phase III clinical trials in parallel is to evaluate whether a topical betulin gel (TBG) is accelerating re-epithelialization of split-thickness skin graft (STSG) donor site wounds compared to standard of care. Two parallel blindly evaluated, randomised, controlled, multicentre phase III clinical trials were performed in adults undergoing STSG surgery (EudraCT nos. 2012-003390-26 and 2012-000777-23). Donor site wounds were split into two equal halves and randomized 1:1 to standard of care (a non-adhesive moist wound dressing) or standard of care plus TBG consisting of 10% birch bark extract and 90% sunflower oil (Episalvan, Birken AG, Niefern-Oeschelbronn, Germany). The primary efficacy assessment was the intra-individual difference in time to wound closure assessed from digital photographs by three blinded experts. A total of 219 patients were included and treated in the two trials. Wounds closed faster with TBG than without it (15.3 vs. 16.5 days; mean intra-individual difference=-1.1 days [95% CI, -1.5 to -0.7]; p<0.0001). This agreed with unblinded direct clinical assessment (difference=-2.1 days [95% CI, -2.7 to -1.5]; p<0.0001). Adverse events possibly related to treatment were mild or moderate and mostly at the application site. TBG accelerates re-epithelialization of partial thickness wounds compared to the current standard of care, providing a well-tolerated contribution to burn care in practice. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving the colour match of free tissue transfers to the face with non-cultured autologous cellular spray--a case report on a chin reconstruction.

PubMed

Hivelin, M; MacIver, Colin; Heusse, J L; Atlan, M; Lantieri, L

2012-08-01

Animal bites can result in extensive avulsion injuries of the face justifying microsurgical replantation attempts. Reconstruction using local tissue harvesting increases the local morbidity while distant tissues can result in colour and skin texture mismatching. Skin grafting of the skin paddle by a split-thickness skin graft is a conventional approach to help overcome this problem. An 18-year-old patient was treated for a chin avulsion after a dog bite injury. The avulsed segment included the whole chin aesthetic unit and one-fifth of the lower lip. The segment was replanted on the inferior labial artery. The replantation failed and a reconstruction with a parascapular free flap was performed. Despite a debulking at 1 month, the aesthetic result had a poor colour match. The technique used to improve this was to de-epithelialise the skin and apply non-cultured autologous epidermal cells (NCAECs) 100 days after the reconstruction. The reconstruction was uneventful. At 3 months follow-up, the patient was able to purse her lips and had regained sensation. After 5 months, the free flap paddle was consistent in colour, pigmentation and texture with the surrounding skin. At 10 months, the patient's only complaint was residual firmness in her scar and flap. The long-term follow-up, over 23 months, confirmed the stability of the results. The use of an NCAEC spray to treat the dyschromia on a parascapular flap used for facial reconstruction is less invasive than split-thickness overgrafting and could extend the use of distant flaps that have been avoided due to poor colour match. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Influence of human fibroblasts on development and quality of multilayered composite grafts in athymic nude mice.

PubMed

Cedidi, C Can; Wilkens, L; Berger, A; Ingianni, G

2007-11-05

In patients after extensive burn injury the lack of split thickness skin graft donor sites, and consecutive delay in wound closure are critical factors of morbidity and mortality. In addition limited functional and aesthetic results after transplantation of split thickness skin grafts present a socioeconomic problem. For improved wound closure the aim of this study was the development of a one stage technique for the establishment of a multi layer composite graft, existing of a collagen-GAG-matrix with silicon layer of a two layer synthetic dermal equivalent (DE) with integrated fibroblasts, and ceratinocytes. - In 64 athymic nude mice the evaluation of the multi layer skin grafts potential to re-establish a human epidermis, and high quality dermal structure was performed. In addition to clinical investigations we measured wound contraction, and analyzed histomorphologic, immunohistologic, "in situ hybridisation", and electro microscopic data. - Our results show, that the seeding of DE with human fibroblasts and ceratinocytes as a composite skin graft reproducible enabled a wound healing with an organised human dermis and epidermis within 10 - 15 days. The histological studies of the grafted composite skin grafts in this model showed morphologically a characteristic dermal-epidermal skin structure with a cornifying epithelium, being of human origin ("in situ hybridisation"). Through the co-cultivation of fibroblasts and ceratinocytes in the DE the generation and structural morphology of collagen fibres, and inflammatory reaction in the neodermis is positively influenced, and as a consequence wound contraction significantly reduced. In regard to the early preparation of composite grafts, and the minimal requirements for donor sites - with dependable stable reconstruction of the integument - this technique may present a step forward in the treatment of patients with extensive burns.

Application of the Aqueous Porous Pathway Model to Quantify the Effect of Sodium Lauryl Sulfate on Ultrasound-Induced Skin Structural Perturbation

PubMed Central

Polat, Baris E.; Seto, Jennifer E.; Blankschtein, Daniel; Langer, Robert

2011-01-01

This study investigated the effect of sodium lauryl sulfate (SLS) on skin structural perturbation when utilized simultaneously with low-frequency sonophoresis (LFS). Pig full-thickness skin (FTS) and pig split-thickness skin (STS) treated with LFS/SLS and LFS were analyzed in the context of the aqueous porous pathway model to quantify skin perturbation through changes in skin pore radius and porosity-to-tortuosity ratio (ε/τ). In addition, skin treatment times required to attain specific levels of skin electrical resistivity were analyzed to draw conclusions about the effect of SLS on reproducibility and predictability of skin perturbation. We found that LFS/SLS-treated FTS, LFS/SLS-treated STS, and LFS-treated FTS exhibited similar skin perturbation. However, LFS-treated STS exhibited significantly higher skin perturbation, suggesting greater structural changes to the less robust STS induced by the purely physical enhancement mechanism of LFS. Evaluation of ε/τ values revealed that LFS/SLS-treated FTS and STS have similar transport pathways, while LFS-treated FTS and STS have lower ε/τ values. In addition, LFS/SLS treatment times were much shorter than LFS treatment times for both FTS and STS. Moreover, the simultaneous use of SLS and LFS not only results in synergistic enhancement, as reflected in the shorter skin treatment times, but also in more predictable and reproducible skin perturbation. PMID:20963845

Sol-gel deposited Cu2O and CuO thin films for photocatalytic water splitting.

PubMed

Lim, Yee-Fun; Chua, Chin Sheng; Lee, Coryl Jing Jun; Chi, Dongzhi

2014-12-21

Cu2O and CuO are attractive photocatalytic materials for water splitting due to their earth abundance and low cost. In this paper, we report the deposition of Cu2O and CuO thin films by a sol-gel spin-coating process. Sol-gel deposition has distinctive advantages such as low-cost solution processing and uniform film formation over large areas with a precise stoichiometry and thickness control. Pure-phase Cu2O and CuO films were obtained by thermal annealing at 500 °C in nitrogen and ambient air, respectively. The films were successfully incorporated as photocathodes in a photoelectrochemical (PEC) cell, achieving photocurrents of -0.28 mA cm(-2) and -0.35 mA cm(-2) (for Cu2O and CuO, respectively) at 0.05 V vs. a reversible hydrogen electrode (RHE). The Cu2O photocurrent was enhanced to -0.47 mA cm(-2) upon incorporation of a thin layer of a NiOx co-catalyst. Preliminary stability studies indicate that CuO may be more stable than Cu2O as a photocathode for PEC water-splitting.

Numerical modeling of fold-and-thrust belts: Applications to Kuqa foreland fold belt, China

NASA Astrophysics Data System (ADS)

Yin, H.; Morgan, J. K.; Zhang, J.; Wang, Z.

2009-12-01

We constructed discrete element models to simulate the evolution of fold-and-thrust belts. The impact of rock competence and decollement strength on the geometric pattern and deformation mechanics of fold-and-thrust belts has been investigated. The models reproduced some characteristic features of fold-and-thrust belts, such as faulted detachment folds, pop-ups, far-traveled thrust sheets, passive-roof duplexes, and back thrusts. In general, deformation propagates farther above a weak decollement than above a strong decollement. Our model results confirm that fold-and-thrust belts with strong frictional decollements develop relatively steep and narrow wedges formed by closely spaced imbricate thrust slices, whereas fold belts with weak decollements form wide low-taper wedges composed of faulted detachment folds, pop-ups, and back thrusts. Far-traveled thrust sheets and passive-roof duplexes are observed in the model with a strong lower decollement and a weak upper detachment. Model results also indicate that the thickness of the weak layer is critical. If it is thick enough, it acts as a ductile layer that is able to flow under differential stress, which helps to partition deformation above and below it. The discrete element modeling results were used to interpret the evolution of Kuqa Cenozoic fold-and-thrust belt along northern Tarim basin, China. Seismic and well data show that the widely distributed Paleogene rock salt has a significant impact on the deformation in this area. Structures beneath salt are closely spaced imbricate thrust and passive-roof duplex systems. Deformation above salt propagates much farther than below the salt. Faults above salt are relatively wide spaced. A huge controversy over the Kuqa fold-and-thrust belt is whether it is thin-skinned or thick-skinned. With the insights from DEM results, we suggest that Kuqa structures are mostly thin-skinned with Paleogene salt as decollement, except for the rear part near the backstop, where the faults below the salt are thick-skinned and involve the Paleozoic basement. We think that most basement-involved sub-salt faults, if not all, formed later than the above salt-detached thin-skinned structures.

Cultured Skin Substitutes Reduce Donor Skin Harvesting for Closure of Excised, Full-Thickness Burns

PubMed Central

Boyce, Steven T.; Kagan, Richard J.; Yakuboff, Kevin P.; Meyer, Nicholas A.; Rieman, Mary T.; Greenhalgh, David G.; Warden, Glenn D.

2002-01-01

Objective Comparison of cultured skin substitutes (CSS) and split-thickness skin autograft (AG) was performed to assess whether donor-site harvesting can be reduced quantitatively and whether functional and cosmetic outcome is similar qualitatively in the treatment of patients with massive cutaneous burns. Summary Background Data Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates populated with autologous fibroblasts and keratinocytes have been shown to close full-thickness skin wounds in preclinical and clinical studies with acceptable functional and cosmetic results. Methods Qualitative outcome was compared between CSS and AG in 45 patients on an ordinal scale (0, worst; 10, best) with primary analyses at postoperative day 28 and after about 1 year for erythema, pigmentation, pliability, raised scar, epithelial blistering, and surface texture. In the latest 12 of the 45 patients, tracings were performed of donor skin biopsies and wounds treated with CSS at postoperative days 14 and 28 to calculate percentage engraftment, the ratio of closed wound:donor skin areas, and the percentage of total body surface area closed with CSS. Results Measures of qualitative outcome of CSS or AG were not different statistically at 1 year after grafting. Engraftment at postoperative day 14 exceeded 75% in the 12 patients evaluated. The ratio of closed wound:donor skin areas for CSS at postoperative day 28 was significantly greater than for conventional 4:1 meshed autografts. The percentage of total body surface area closed with CSS at postoperative day 28 was significantly less than with AG. Conclusions The requirement for harvesting of donor skin for CSS was less than for conventional skin autografts. These results suggest that acute-phase recovery of patients with extensive burns is facilitated and that complications are reduced by the use of CSS together with conventional skin grafting. PMID:11807368

Cultured skin substitutes reduce donor skin harvesting for closure of excised, full-thickness burns.

PubMed

Boyce, Steven T; Kagan, Richard J; Yakuboff, Kevin P; Meyer, Nicholas A; Rieman, Mary T; Greenhalgh, David G; Warden, Glenn D

2002-02-01

Comparison of cultured skin substitutes (CSS) and split-thickness skin autograft (AG) was performed to assess whether donor-site harvesting can be reduced quantitatively and whether functional and cosmetic outcome is similar qualitatively in the treatment of patients with massive cutaneous burns. Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates populated with autologous fibroblasts and keratinocytes have been shown to close full-thickness skin wounds in preclinical and clinical studies with acceptable functional and cosmetic results. Qualitative outcome was compared between CSS and AG in 45 patients on an ordinal scale (0, worst; 10, best) with primary analyses at postoperative day 28 and after about 1 year for erythema, pigmentation, pliability, raised scar, epithelial blistering, and surface texture. In the latest 12 of the 45 patients, tracings were performed of donor skin biopsies and wounds treated with CSS at postoperative days 14 and 28 to calculate percentage engraftment, the ratio of closed wound:donor skin areas, and the percentage of total body surface area closed with CSS. Measures of qualitative outcome of CSS or AG were not different statistically at 1 year after grafting. Engraftment at postoperative day 14 exceeded 75% in the 12 patients evaluated. The ratio of closed wound:donor skin areas for CSS at postoperative day 28 was significantly greater than for conventional 4:1 meshed autografts. The percentage of total body surface area closed with CSS at postoperative day 28 was significantly less than with AG. The requirement for harvesting of donor skin for CSS was less than for conventional skin autografts. These results suggest that acute-phase recovery of patients with extensive burns is facilitated and that complications are reduced by the use of CSS together with conventional skin grafting.

Structural properties and UV to NIR absorption spectra of metal-free phthalocyanine (H2Pc) thin films P. B. Thakor, P. N. Gajjar and A. R. Jani: Different reference systems in the study of structural properties of some simple liquid metals Shazia Bashir, M. S. Rafique, M. Khaleeq-ur-Rahman, Faizan-ul-Haq and B. R. Alvina: CO2 and Nd:YAG laser radiation induced damage in aluminium Smail Bougouffa: The study of atomic transitions by use of Numerov technique in schematic model

NASA Astrophysics Data System (ADS)

El-Nahass, M. M.; Farid, A. M.; Attia, A. A.; Ali, H. A. M.

The structural properties and absorption spectra of H2Pc thin films have been studied. The films used in these studies were thermally evaporated on glass/quartz substrates with thickness ranging from 60 to 460 nm. The XRD studies of H2Pc thin films showed that the as-deposited films have a-form with monoclinic system. The mean crystallite size (L), the dislocation density (d) and the strain (x) were evaluated. The molecular structure of H2Pc thin films is confirmed by analysis of (FTIR) spectra. The surface morphology of H2Pc thin films was examined by scanning electron microscope. The absorption spectra of H2Pc recorded in the UV - VIS - IR region for the as-deposited and the annealed thin films of different thickness have been analyzed. The spectra showed two absorption bands namely the Q-band and the Soret (B)-band. The Q-band shows its characteristic splitting (Davydove splitting) with DQ = 0.21 eV. Values of some important optical parameters, namely optical absorption coefficient (a¢), molar extinction coefficient (emolar), half-band-width (Dl), electronic dipole strength (q2) and oscillator strength (f) were calculated. The fundamental and the onset of the indirect energy gaps were also determined as 2.47 and 1.4 eV, respectively.

Effect of wellbore storage and finite thickness skin on flow to a partially penetrating well in a phreatic aquifer

NASA Astrophysics Data System (ADS)

Pasandi, M.; Samani, N.; Barry, D. A.

2008-02-01

An analytical model is presented for the analysis of constant flux tests conducted in a phreatic aquifer having a partially penetrating well with a finite thickness skin. The solution is derived in the Laplace transform domain for the drawdown in the pumping well, skin and formation regions. The time-domain solution in terms of the aquifer drawdown is then obtained from the numerical inversion of the Laplace transform and presented as dimensionless drawdown-time curves. The derived solution is used to investigate the effects of the hydraulic conductivity contrast between the skin and formation, in addition to wellbore storage, skin thickness, delayed yield, partial penetration and distance to the observation well. The results of the developed solution were compared with those from an existing solution for the case of an infinitesimally thin skin. The latter solution can never approximate that for the developed finite skin. Dimensionless drawdown-time curves were compared with the other published results for a confined aquifer. Positive skin effects are reflected in the early time and disappear in the intermediate and late time aquifer responses. But in the case of negative skin this is reversed and the negative skin also tends to disguise the wellbore storage effect. A thick negative skin lowers the overall drawdown in the aquifer and leads to more persistent delayed drainage. Partial penetration increases the drawdown in the case of a positive skin; however its effect is masked by the negative skin. The influence of a negative skin is pronounced over a broad range of radial distances. At distant observation points the influence of a positive skin is too small to be reflected in early and intermediate time pumping test data and consequently the type curve takes its asymptotic form.

Did the Eruption of the Mt. Pinatubo Volcano Affect Cirrus Properties?

NASA Technical Reports Server (NTRS)

Luo, Zhengzhao; Rossow, William B.; Inoue, Toshiro; Stubenrauch, Claudia J.; Hansen, James E. (Technical Monitor)

2001-01-01

Some observations suggest that the volcanic aerosols produced by the Mt. Pinatubo eruption may have altered cirrus properties. We look for evidence that such modification of cirrus is extensive enough to be climatically significant by comparing three satellite-based cirrus datasets produced by the ISCCP (International Satellite Cloud Climatology Project) analysis, the 'split-window' analysis, and 3I analysis. Since the former two have not been compared in detail before, we conduct such a comparison here. When applied to AVHRR (Advanced Very High Resolution Radiometer) data, both the ISCCP and split-window analyses identify about 0.2 - 0.3 cirrus cloud amount in tropical latitudes; however, there are detailed differences of classification for about half of these clouds. The discrepancies are attributed to the simplified assumptions made by both methods. The latter two datasets are derived from infrared radiances, so they are much less sensitive to volcanic aerosols than the ISCCP analysis. After the Mt. Pinatubo eruption, the ISCCP results indicate a dramatic decrease of thin cirrus (cloud top pressure less than 440 mb and visible optical thickness less than 1.3) over ocean, accompanied by a comparable increase of altocumulus and cumulus clouds; over land, there are no significant changes. In contrast, results from the split-window and 3I analyses show little change in thin cirrus amount over either ocean or land that is associated with the volcanic eruption. The ISCCP results can, therefore, be understood as a misclassification of thin cirrus because the additional reflected sunlight by the volcanic aerosol makes the cirrus clouds appear to be optically thicker. Examination of the split-window signature and the infrared emissivities from 3I show no significant change in infrared emissivity (or optical thickness). These results indicate that the Mt. Pinatubo volcanic aerosol did not have a significant systematic effect on tropical cirrus properties, but rather produced only temporary, local effects. Hence, these results indicate that there was no significant climate feedback produced by aerosol-cirrus-radiative interactions.

Skin graft take and healing following 193-nm excimer, continuous-wave carbon dioxide (CO2), pulsed CO2, or pulsed holmium: YAG laser ablation of the graft bed.

PubMed

Green, H A; Burd, E E; Nishioka, N S; Compton, C C

1993-08-01

Ablative lasers have been used for cutaneous surgery for greater than two decades since they can remove skin and skin lesions bloodlessly and efficiently. Because full-thickness skin wounds created after thermal laser ablation may require skin grafting in order to heal, we have examined the effect of the residual laser-induced thermal damage in the wound bed on subsequent skin graft take and healing. In a pig model, four different pulsed and continuous-wave lasers with varying wavelengths and radiant energy exposures were used to create uniform fascial graft bed thermal damage of approximately 25, 160, 470, and 1100 microns. Meshed split-thickness skin graft take and healing on the thermally damaged fascial graft beds were examined on a gross and microscopic level on days 3 and 7, and then weekly up to 42 days. Laser-induced thermal damage on the graft bed measuring greater than 160 +/- 60 microns in depth significantly decreased skin graft take. Other deleterious effects included delayed graft revascularization, increased inflammatory cell infiltrate at the graft-wound bed interface, and accelerated formation of hypertrophied fibrous tissue within the graft bed and underlying muscle. Ablative lasers developed for cutaneous surgery should create less than 160 +/- 60 microns of residual thermal damage to permit optimal skin graft take and healing. Pulsed carbon dioxide and 193-nm excimer lasers may be valuable instruments for the removal of full-thickness skin, skin lesions, and necrotic tissue, since they create wound beds with minimal thermal damage permitting graft take comparable to that achieved with standard surgical techniques.

Laser-induced thermal coagulation enhances skin uptake of topically applied compounds.

PubMed

Haak, C S; Hannibal, J; Paasch, U; Anderson, R R; Haedersdal, M

2017-08-01

Ablative fractional laser (AFL) generates microchannels in skin surrounded by a zone of thermally altered tissue, termed the coagulation zone (CZ). The thickness of CZ varies according to applied wavelength and laser settings. It is well-known that AFL channels facilitate uptake of topically applied compounds, but the importance of CZ is unknown. Franz Cells were used to investigate skin uptake and permeation of fluorescent labeled polyethylene glycols (PEGs) with mean molecular weights (MW) of 350, 1,000, and 5,000 Da. Microchannels with CZ thicknesses ranging from 0 to 80 μm were generated from micro-needles (0 μm, CZ-0), and AFL (10,600 nm) applied to -80°C deep frozen skin (20 μm, CZ-20) and skin equilibrated to room temperature (80 μm, CZ-80). Channels penetrated into similar mid-dermal skin depths of 600-700 μm, and number of channels per skin area was similar. At 4 hours incubation, skin uptake of PEGs into CZ and dermis was evaluated by fluorescence microscopy at specific skin depths of 150, 400, and 1,000 μm and the transcutaneous permeation was quantified by fluorescence of receptor fluids. Overall, the highest uptake of PEGs was reached through microchannels surrounded by CZ compared to channels with no CZ (CZ-20 and CZ-80>CZ-0).The thickness of CZ affected PEG distribution in skin. A thin CZ-20 favored significantly higher mean fluorescence intensities inside CZ areas compared to CZ-80 (PEG 350, 1,000, and 5,000; P < 0.001). In dermis, the uptake through CZ-20 channels was significantly higher than through CZ-80 and CZ-0 at all skin depths (PEG 350, 1,000 and 5,000, 150-1,000 μm; P < 0.001). Correspondingly, transcutaneous permeation of PEG 350 was highest in CZ-20 compared to CZ-80 and CZ-0 samples (P < 0.001). Permeation of larger molecules (PEG 1,000 and PEG 5,000) was generally low. Uptake of topical compounds is higher through microchannels surrounded by a CZ than without a CZ. Moreover, CZ thickness influences PEG distribution, with highest PEG uptake achieved from microchannels surrounded by a thin CZ. Lasers Surg. Med. 49:582-591, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

A comparative analysis of advanced techniques for skin reconstruction with autologous keratinocyte culture in severely burned children: own experience

PubMed Central

Nessler, Michał B.; Drukala, Justyna; Bartoszewicz, Marzenna; Mądry, Ryszard

2014-01-01

Introduction The local treatment in burns larger than 50% of total body surface area is still the great challenge for surgeons. Aim This paper presents a review of different solutions for deep burn wound healing in children and the early outcomes of treatment with combined autologous cell culture technique. Material and methods For this study, 20 children aged between 4 and 12 years with 55–65% of TBSA III grade burn injury were analyzed. A skin sample, 1 cm × 1 cm in size, for keratinocyte cultivation, was taken on the day of the burn. After necrotic tissue excision, the covering of the burned area with an isolated meshed skin graft was carried out between day 4 and 7. After 7 days of keratinocyte cultivation, the mentioned areas were covered with cells from the culture. We divided the burned regions, according to the way of wound closure, into 3 groups each consisting of 15 treated regions of the body. We used meshed split thickness skin grafts (SSG group), cultured autologous keratinocytes (CAC group), and both techniques applied in one stage (SSG + CAC group). Results In the SSG group, the mean time for complete closure of wounds was 12.7 days. Wounds treated with CAC only needed a non-significantly longer time to heal – 14.2 days (p = 0.056) when compared to SSG. The shortest time to heal was observed in the group treated with SSG + CAC – 8.5 days, and it was significantly shorter when compared to the SSG and CAC groups (p < 0.001). Conclusions This study suggests that cultured keratinocytes obtained after short-time multiplication, combined with meshed autologous split thickness skin grafts, constitute the optimal wound closure in burned children. PMID:25097488

Scrotal reconstruction and testicular prosthetics

PubMed Central

Lucas, Jacob W.; Lester, Kyle M.; Chen, Andrew

2017-01-01

Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques, and pit-falls for various reconstructive scrotal surgeries as-well-as surgical tips for placement of testicular prostheses. Penoscrotal webbing (PSW) is an abnormal, often-problematic distal insertion of scrotal skin onto the ventral penile shaft. There are several effective and straightforward techniques used to revise this condition, which include simple scrotoplasty, single- or double-Z-plasty, or the VY-flap scrotoplasty. Reconstruction is also commonly indicated following scrotal skin loss caused by infection, trauma, lymphedema, hidradenitis, and cancer. Although initial management of these conditions often involves scrotal skin removal, repair of expansive scrotal skin loss can be technically difficult and can be accomplished by using one of several skin flaps or skin grafting. Split-thickness skin grafting of scrotal defects can be accomplished easily, and provides durable results. PMID:28904904

Marjolin's ulcer in a 20 years old split thickness skin graft on the knee-A case report.

PubMed

Saltvig, Iselin; Matzen, Steen H

2018-01-01

Marjolin's Ulcer (MU) is a rare cutaneous neoplasm arising in cikatrical tissue. Due to its typical clinical presentation as a non-healing lesion in scar tissue, the diagnosis can be delayed and even overlooked. We present the case of an elderly woman who developed an ulcerated, exophytic lesion in a split thickness skin graft (STSG) on the lateral aspect of the left knee. Histology showed a radically excised highly differentiated squamous cell carcinoma (SCC) with keratine pearls and a component of basocellular carcinoma (BCC). The histological picture combined with the location and long time interval since the primary surgery made the diagnosis of MU highly likely. Considering the risk of metastasis and mortality it is important to recognize the diagnosis and initiate adequate treatment. The diagnosis of MU is clinical and confirmed by pathology. The typical long delay from the primary lesion to the malignant transformation might occlude the diagnosis. As such, a thorough anamnesis is essential in a non- healing ulcerated lesion in a cikatrical area to adequately diagnose and treat the condition. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Surface Plasmon Waves on Thin Metal Films.

NASA Astrophysics Data System (ADS)

Craig, Alan Ellsworth

Surface-plasmon polaritons propagating on thin metal films bounded by dielectrics of nearly equal refractive indexes comprise two bound modes. Calculations indicate that, while the modes are degenerate on thick films, both the real and the imaginary components of the propagation constants for the modes split into two branches on successively thinner films. Considering these non-degenerate modes, the mode exhibiting a symmetric (antisymmetric) transverse profile of the longitudinally polarized electric field component, has propagation constant components both of which increase (decrease) with decreasing film thickness. Theoretical propagation constant eigenvalue (PCE) curves have been plotted which delineate this dependence of both propagation constant components on film thickness. By means of a retroreflecting, hemispherical glass coupler in an attenuated total reflection (ATR) configuration, light of wavelength 632.8 nm coupled to the modes of thin silver films deposited on polished glass substrates. Lorentzian lineshape dips in the plots of reflectance vs. angle of incidence indicate the presence of the plasmon modes. The real and imaginary components of the propagation constraints (i.e., the propagation constant and loss coefficient) were calculated from the angular positions and widths of the ATR resonances recorded. Films of several thicknesses were probed. Results which support the theoretically predicted curves were reported.

MINIVER: Miniature version of real/ideal gas aero-heating and ablation computer program

NASA Technical Reports Server (NTRS)

Hendler, D. R.

1976-01-01

Computer code is used to determine heat transfer multiplication factors, special flow field simulation techniques, different heat transfer methods, different transition criteria, crossflow simulation, and more efficient thin skin thickness optimization procedure.

Immediate Regrafting of the Split Thickness Skin Graft Donor Site Assists Healing.

PubMed

Bradow, Brian P; Hallock, Geoffrey G; Wilcock, Samuel P

2017-05-01

Delayed or even lack of healing of a split-thickness skin graft (STSG) donor site is a potential problem with elderly patients or those with poor wound healing capabilities. A proactive solution that may minimize this risk is to regraft that donor site using otherwise discarded skin graft remnants. A prospective, nonrandomized, consecutive study was designed to compare the time to healing of the commonly used anterior thigh STSG donor site in patients who had routine dressings (n = 113) versus those with comorbidities known to adversely affect wound healing and had planned regrafting (n = 204). Those comorbidities included age (≥65 years), diabetes mellitus, peripheral vascular disease, chronic renal disease, and chronic steroid use. The average number of comorbidities in the regrafted subgroup versus those not regrafted was 1.41 and 0.31, respectively. This was considered to be a significant difference ( P < 0.0001) confirming the validity in predicting patients at risk for adverse donor-site healing that would benefit by regrafting. The mean time required for donor-site reepithelialization of those regrafted was 17.2 days compared with 17.8 days for those not regrafted ( P = 0.2395), which was not significantly different. Regrafting the STSG donor site of patients with known comorbidities, that is, those expected to have delayed healing in general, had a mean time to reepithelialization comparable with conventionally treated individuals. This was considered a direct consequence of recycling rather than discarding any excess skin graft materials when so indicated and can be a proactive solution to a potentially cumbersome dilemma.

Treatment of Diabetic Foot Ulcer Using Matriderm In Comparison with a Skin Graft

PubMed Central

Jeon, Hyojin; Yeo, Hyeonjung; Jeong, Hoijoon; Son, Daegu; Han, Kihwan

2013-01-01

Background For patients with neuropathy, vasculopathy, and impairment of wound healing, treatment of a diabetic foot ulcer poses many challenges. A large number of dermal analogues have been invented in an effort to overcome these challenges. Matriderm, a dermal analogue, is made from bovine collagen and elastin. This study was conducted in order to evaluate the effectiveness of Matriderm for treatment of diabetic foot ulcers, in comparison with skin grafting. Methods Sixty patients with diabetic foot ulcer were included in this prospective study. The average age of the patients, who had type II diabetes mellitus, was 58 years old. The patients were allocated to an experimental or control group with their consents. The patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Results A shorter hospitalization period (7.52 weeks) was observed in the experimental group than in the control group (9.22 weeks), and a shorter period of time (8.61 weeks) was required for complete healing, compared with the control group (12.94 weeks), with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.01). Conclusions Matriderm enables effective healing and improves elasticity in treatment of patients with diabetic foot ulcer. PMID:23898439

Application of the aqueous porous pathway model to quantify the effect of sodium lauryl sulfate on ultrasound-induced skin structural perturbation.

PubMed

Polat, Baris E; Seto, Jennifer E; Blankschtein, Daniel; Langer, Robert

2011-04-01

This study investigated the effect of sodium lauryl sulfate (SLS) on skin structural perturbation when utilized simultaneously with low-frequency sonophoresis (LFS). Pig full-thickness skin (FTS) and pig split-thickness skin (STS) treated with LFS/SLS and LFS were analyzed in the context of the aqueous porous pathway model to quantify skin perturbation through changes in skin pore radius and porosity-to-tortuosity ratio (ε/τ). In addition, skin treatment times required to attain specific levels of skin electrical resistivity were analyzed to draw conclusions about the effect of SLS on reproducibility and predictability of skin perturbation. We found that LFS/SLS-treated FTS, LFS/SLS-treated STS, and LFS-treated FTS exhibited similar skin perturbation. However, LFS-treated STS exhibited significantly higher skin perturbation, suggesting greater structural changes to the less robust STS induced by the purely physical enhancement mechanism of LFS. Evaluation of ε/τ values revealed that LFS/SLS-treated FTS and STS have similar transport pathways, whereas LFS-treated FTS and STS have lower ε/τ values. In addition, LFS/SLS treatment times were much shorter than LFS treatment times for both FTS and STS. Moreover, the simultaneous use of SLS and LFS not only results in synergistic enhancement, as reflected in the shorter skin treatment times, but also in more predictable and reproducible skin perturbation. Copyright © 2010 Wiley-Liss, Inc.

Metal-insulator transition in CaVO3 thin films: Interplay between epitaxial strain, dimensional confinement, and surface effects

NASA Astrophysics Data System (ADS)

Beck, Sophie; Sclauzero, Gabriele; Chopra, Uday; Ederer, Claude

2018-02-01

We use density functional theory plus dynamical mean-field theory (DFT+DMFT) to study multiple control parameters for tuning the metal-insulator transition (MIT) in CaVO3 thin films. We focus on separating the effects resulting from substrate-induced epitaxial strain from those related to the reduced thickness of the film. We show that tensile epitaxial strain of around 3%-4% is sufficient to induce a transition to a paramagnetic Mott-insulating phase. This corresponds to the level of strain that could be achieved on a SrTiO3 substrate. Using free-standing slab models, we then demonstrate that reduced film thickness can also cause a MIT in CaVO3, however, only for thicknesses of less than 4 perovskite units. Our calculations indicate that the MIT in such ultrathin films results mainly from a surface-induced crystal-field splitting between the t2 g orbitals, favoring the formation of an orbitally polarized Mott insulator. This surface-induced crystal-field splitting is of the same type as the one resulting from tensile epitaxial strain, and thus the two effects can also cooperate. Furthermore, our calculations confirm an enhancement of correlation effects at the film surface, resulting in a reduced quasiparticle spectral weight in the outermost layer, whereas bulklike properties are recovered within only a few layers away from the surface.

Fetal Bovine Collagen Matrix in the Treatment of a Full Thickness Burn Wound: A Case Report With Long-Term Follow-Up.

PubMed

Strong, Amy L; Bennett, Danielle K; Spreen, Elizabeth B; Adhvaryu, Dhaval V; Littleton, Jeffrey C; Mencer, Ernest J

2016-01-01

The treatment of full thickness skin wounds commonly associated with large burns continues to represent a challenging clinical entity. The current treatment for large TBSA burns is split thickness autologous skin grafting; however, this treatment often results in poor textural durability, hypertrophic scarring, and fibrotic contractures. In this case report, we describe our experience and long-term follow-up results after the application of fetal bovine collagen (FBC) matrix (PriMatrix, TEI Biosciences, Boston, MA) to burn wounds clinically assessed as full thickness that healed without the need for subsequent skin grafting. The patient presented with 25% TBSA burns and was debrided and covered with FBC on postburn day 7. By postoperative day 12, the patient had large areas of reepithelialization distributed throughout the wound bed. By postoperative day 26, the patient had significantly more areas of wound closure and was discharged. Reepithelialization and repigmentation continued, and long-term follow-up after 26 months demonstrated complete reepithelialization and nearly complete repigmentation, without the appearance of contractures or hypertrophic scarring. This case report highlights the use of FBC as a scaffold capable of dermal regeneration and spontaneous reepithelialization with an excellent long-term functional and cosmetic outcome.

Fetal Bovine Collagen Matrix in the Treatment of a Full Thickness Burn Wound: A Case Report With Long-Term Follow-Up

PubMed Central

Strong, Amy L.; Bennett, Danielle K.; Spreen, Elizabeth B.; Adhvaryu, Dhaval V.; Littleton, Jeffrey C.

2016-01-01

The treatment of full thickness skin wounds commonly associated with large burns continues to represent a challenging clinical entity. The current treatment for large TBSA burns is split thickness autologous skin grafting; however, this treatment often results in poor textural durability, hypertrophic scarring, and fibrotic contractures. In this case report, we describe our experience and long-term follow-up results after the application of fetal bovine collagen (FBC) matrix (PriMatrix, TEI Biosciences, Boston, MA) to burn wounds clinically assessed as full thickness that healed without the need for subsequent skin grafting. The patient presented with 25% TBSA burns and was debrided and covered with FBC on postburn day 7. By postoperative day 12, the patient had large areas of reepithelialization distributed throughout the wound bed. By postoperative day 26, the patient had significantly more areas of wound closure and was discharged. Reepithelialization and repigmentation continued, and long-term follow-up after 26 months demonstrated complete reepithelialization and nearly complete repigmentation, without the appearance of contractures or hypertrophic scarring. This case report highlights the use of FBC as a scaffold capable of dermal regeneration and spontaneous reepithelialization with an excellent long-term functional and cosmetic outcome. PMID:25494213

Topical Delivery of Immunosuppression to Prolong Xenogeneic and Allogeneic Split-Thickness Skin Graft Survival.

PubMed

Mastroianni, Melissa; Ng, Zhi Yang; Goyal, Ritu; Mallard, Christopher; Farkash, Evan A; Leonard, David A; Albritton, Alexander; Shanmugarajah, Kumaran; Kurtz, Josef M; Sachs, David H; Macri, Lauren K; Kohn, Joachim; Cetrulo, Curtis L

2017-06-07

Cadaveric skin allograft is the current standard of treatment for temporary coverage of large burn wounds. Porcine xenografts are viable alternatives but undergo α-1,3-galactose (Gal)-mediated hyperacute rejection and are lost by POD 3 because of naturally occurring antibodies to Gal in primate recipients. Using baboons, we previously demonstrated that xenografts from GalT-KO swine (lacking Gal) provided wound coverage comparable with allografts with systemic immunosuppression. In this study, we investigate topical immunosuppression as an alternative to prolong xenograft survival. Full-thickness wounds in baboons were created and covered with xenogeneic and allogeneic split-thickness skin grafts (STSGs). Animals were treated with slow-release (TyroSphere-encapsulated) topical formulations (cyclosporine-A [CSA] or Tacrolimus) applied 1) directly to the STSGs only, or 2) additionally to the wound bed before STSG and 1). Topical CSA did not improve either xenograft or allograft survival (median: treated grafts = 12.5 days, control = 14 days; P = 0.27) with similar results when topical Tacrolimus was used. Pretreatment of wound beds resulted in a significant reduction of xenograft survival compared with controls (10 vs 14 days; P = 0.0002), with comparable results observed in allografts. This observation was associated with marked reduction of inflammation on histology with Tacrolimus and not CSA. Prolongation of allograft and xenograft survival after application to full-thickness wound beds was not achieved with the current formulation of topical immunosuppressants. Modulation of inflammation within the wound bed was effective with Tacrolimus pretreatment before STSG application and may serve as a treatment strategy in related fields.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Transplanting Human Skin Grafts onto Nude Mice to Model Skin Scars.

PubMed

Ding, Jie; Tredget, Edward E

2017-01-01

Hypertrophic scar (HTS) is a common outcome of deep dermal wound healing mainly followed mechanical, chemical, and thermal injuries in the skin. Because of the lack of the most effective prevention and treatment, it is particularly important to establish an ideal dermal animal model for improving the understanding of the pathogenesis and exploring therapeutic approaches of HTS. Compared to other dermal fibrotic animal models in rabbits, red Duroc pigs, guinea pigs, rats, and mice, the approach that uses normal human split-thickness skin grafted onto nude or other immunodeficient mice which develop scars that resemble human HTS offers the advantages of lower cost, easier manipulation, and shorter research period. In this chapter, we will introduce the detailed procedures to create the ideal dermal fibrotic mouse model.

An External Wire Frame Fixation Method of Skin Grafting for Burn Reconstruction.

PubMed

Yoshino, Yukiko; Ueda, Hyakuzoh; Ono, Simpei; Ogawa, Rei

2017-06-28

The skin graft is a prevalent reconstructive method for burn injuries. We have been applying external wire frame fixation methods in combination with skin grafts since 1986 and have experienced better outcomes in percentage of successful graft take. The overall purpose of this method was to further secure skin graft adherence to wound beds in hard to stabilize areas. There are also location-specific benefits to this technique such as eliminating the need of tarsorrhaphy in periorbital area, allowing immediate food intake after surgery in perioral area, and performing less invasive fixing methods in digits, and so on. The purpose of this study was to clarify its benefits and applicable locations. We reviewed 22 postburn patients with skin graft reconstructions using the external wire frame method at our institution from December 2012 through September 2016. Details of the surgical technique and individual reports are also discussed. Of the 22 cases, 15 (68%) were split-thickness skin grafts and 7 (32%) were full-thickness skin grafts. Five cases (23%) involved periorbital reconstruction, 5 (23%) involved perioral reconstruction, 2 (9%) involved lower limb reconstruction, and 10 (45%) involved digital reconstruction. Complete (100%) survival of the skin graft was attained in all cases. No signs of complication were observed. With 30 years of experiences all combined, we have summarized fail-proof recommendations to a successful graft survival with an emphasis on the locations of its application.

Grafting of burns with widely meshed autograft split skin and Langerhans cell-depressed allograft split skin overlay

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alsbjoern, B.F.S.; Sorensen, B.

1986-12-01

Extensively burned patients suffer from lack of sufficient autologous donor skin. Meshing and wide expansion of the obtained split skin has met the requirement to a large degree. However, the wider the expansion, the less chance of a proper take. By covering widely expanded autografts with viable cadaver split skin, the take has been improved. If the epidermal Langerhans cells in the cadaver split skin are depressed by ultraviolet B light and glucocorticosteroids before grafting, a prolonged allograft take can be achieved and the healing of the underlying autografts is ensured for an extended period. Grafting results in 6 patientsmore » with extensive burns are reported.« less

Incidence of the concrete scalp deformity associated with deep scalp donor sites and management with the Unna cap.

PubMed

Carter, Y M; Summer, G J; Engrav, L H; Hansen, F L; Costa, B A; Matsumura, H

1999-01-01

The scalp has become a popular donor site for split-thickness skin grafts. This donor site does, however, have complications, including the concrete scalp deformity, which consists of hairs embedded in a thick, desiccated, exudative crust. This article presents our burn unit's experience with this complication. Fifty-six patients underwent scalp skin graft harvesting between 1984 and 1996. All grafts were quite thick and were used for resurfacing facial burns. Thirty-eight donor sites were treated with medicated gauze, and 18 were treated with the Unna cap, which is an Unna dressing applied over Aquaphor gauze (Beiersdorf, Norwalk, Conn). Eighteen of the 38 patients (32%) treated with medicated gauze developed the concrete scalp deformity. None of the patients treated with the Unna cap developed the deformity. Although useful, the deep scalp donor site has complications, including the concrete scalp deformity. However, with use of the Unna cap dressing, we have had no occurrences of this problem.

Cellulose Dressing Versus Rayon Dressing in Skin Graft Donor Sites: Aspects of Patients' Health-related Quality of Life and Self-esteem .

PubMed

Ferreira, Lydia M; Blanes, Leila; Gragnani, Alfredo; Veiga, Daniela F; Veiga, Frederico; Nery, Gilka B; Rocha, Gustavo H; Gomes, Heitor C; Rocha, Mario G; Okamoto, Regina

2009-06-01

 Objective. The aim of this study was to compare the health-related quality of life (HRQoL) and self-esteem of patients who underwent split-thickness skin grafting, when either cellulose dressings or rayon dressings were applied to the donor sites. A total of 25 patients, who were enrolled at five participant hospitals and required split-thickness skin grafting for various clinical reasons, were randomized into two treatment groups, the rayon dressing group (n = 13), or the cellulose dressing group (n = 12). All patients were assessed preoperatively and 60 days postoperatively. The HRQoL was assessed with the Short Form-36 (SF-36) health survey questionnaire, and self-esteem was evaluated using the Rosenberg Self-Esteem Scale (RSE)/UNIFESP-EPM (Brazilian versions). There were no surgery-related complications during the study period. In both treatment groups, SF-36 scores for emotional role, mental health, vitality, and general health decreased from baseline. RSE scores increased from baseline in both treatment groups, showing a reduction in self-esteem after treatment. There was a statistical difference (P = 0.024) in the SF-36 bodily pain domain for the rayon group. There were no significant differences in HRQoL and self-esteem between treatment groups. In the rayon-dressing group, there was a significant decrease in bodily pain from baseline .

Animal Identification

PubMed Central

Macpherson, J. W.; Penner, P.

1967-01-01

A number of branding tools of various metals and various sizes in combination with several wetting agents were cooled with liquid nitrogen and applied for different lengths of time to calves and mature cattle. White hair appeared in the shape of the brand on the animals in place of dark hair when the application was properly carried out. Best results can be obtained by using metal irons at least 25 millimeters thick and 14 millimeters wide with xylol as a wetting agent for ten seconds in young or thin skinned animals and up to twenty seconds in mature or thick skinned animals. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 5. PMID:4229181

Development of Millimeter Wave Fabry-Pérot Resonator for Simultaneous Electron-Spin and Nuclear Magnetic Resonance Measurement

NASA Astrophysics Data System (ADS)

Ishikawa, Yuya; Ohya, Kenta; Fujii, Yutaka; Fukuda, Akira; Miura, Shunsuke; Mitsudo, Seitaro; Yamamori, Hidetomo; Kikuchi, Hikomitsu

2018-04-01

We report a Fabry-Pérot resonator with spherical and flat mirrors to allow simultaneous electron-spin resonance (ESR) and nuclear magnetic resonance (NMR) measurements that could be used for double magnetic resonance (DoMR). In order to perform simultaneous ESR and NMR measurements, the flat mirror must reflect millimeter wavelength electromagnetic waves and the resonator must have a high Q value ( Q > 3000) for ESR frequencies, while the mirror must simultaneously let NMR frequencies pass through. This requirement can be achieved by exploiting the difference of skin depth for the two frequencies, since skin depth is inversely proportional to the square root of the frequency. In consideration of the skin depth, the optimum conditions for conducting ESR and NMR using a gold thin film are explored by examining the relation between the Q value and the film thickness. A flat mirror with a gold thin film was fabricated by sputtering gold on an epoxy plate. We also installed a Helmholtz radio frequency coil for NMR and tested the system both at room and low temperatures with an optimally thick gold film. As a result, signals were obtained at 0.18 K for ESR and at 1.3 K for NMR. A flat-mirrored resonator with a thin gold film surface is an effective way to locate NMR coils closer to the sample being examined with DoMR.

Global-Local Analysis and Optimization of a Composite Civil Tilt-Rotor Wing

NASA Technical Reports Server (NTRS)

Rais-Rohani, Masound

1999-01-01

This report gives highlights of an investigation on the design and optimization of a thin composite wing box structure for a civil tilt-rotor aircraft. Two different concepts are considered for the cantilever wing: (a) a thin monolithic skin design, and (b) a thick sandwich skin design. Each concept is examined with three different skin ply patterns based on various combinations of 0, +/-45, and 90 degree plies. The global-local technique is used in the analysis and optimization of the six design models. The global analysis is based on a finite element model of the wing-pylon configuration while the local analysis uses a uniformly supported plate representing a wing panel. Design allowables include those on vibration frequencies, panel buckling, and material strength. The design optimization problem is formulated as one of minimizing the structural weight subject to strength, stiffness, and d,vnamic constraints. Six different loading conditions based on three different flight modes are considered in the design optimization. The results of this investigation reveal that of all the loading conditions the one corresponding to the rolling pull-out in the airplane mode is the most stringent. Also the frequency constraints are found to drive the skin thickness limits, rendering the buckling constraints inactive. The optimum skin ply pattern for the monolithic skin concept is found to be (((0/+/-45/90/(0/90)(sub 2))(sub s))(sub s), while for the sandwich skin concept the optimal ply pattern is found to be ((0/+/-45/90)(sub 2s))(sub s).

Unravelling Photocarrier Dynamics beyond the Space Charge Region for Photoelectrochemical Water Splitting

DOE PAGES

Zhang, Wenrui; Yan, Danhua; Appavoo, Kannatassen; ...

2017-04-18

Semiconductor photoelectrodes for photoelectrochemical (PEC) water splitting require efficient carrier generation, separation, and transport at and beyond the space charge region (SCR) formed at the aqueous interface. The trade-off between photon collection and minority carrier delivery governs the photoelectrode design and implies maximum water splitting efficiency at an electrode thickness equivalent to the light absorption depth. Here, using planar ZnO thin films as a model system, we identify the photocarriers beyond the SCR as another significant source to substantially enhance the PEC performance. The high-quality ZnO films synthesized by pulsed laser deposition feature very few deep trap states and supportmore » a long photocarrier lifetime. Combined with photoelectrochemical characterization, ultrafast spectroscopy, and numerical calculations, it is revealed that engineering the exciton concentration gradient by film thickness facilitates the inward diffusion of photocarriers from the neighboring illuminated region to the SCR and, therefore, achieves a record high quantum efficiency over 80% at a thickness far beyond its light absorption depth and the SCR width. Furthermore, these results elucidate the important role of the photocarriers beyond SCR for the PEC process and provide new insight into exploring the full potential for efficient photoelectrode materials with large exciton diffusivity.« less

Dynamics of laser ablation at the early stage during and after ultrashort pulse

NASA Astrophysics Data System (ADS)

Ilnitsky, D. K.; Khokhlov, V. A.; Zhakhovsky, V. V.; Petrov, Yu V.; Migdal, K. P.; Inogamov, N. A.

2016-11-01

Study of material flow in two-temperature states is needed for a fundamental understanding the physics of femtosecond laser ablation. To explore phenomena at a very early stage of laser action on a metallic target our in-house two-temperature hydrodynamics code is used here. The early stage covers duration of laser pulse with next first few picoseconds. We draw attention to the difference in behavior at this stage between the cases: (i) of an ultrathin film (thickness of order of skin depth d skin or less), (ii) thin films (thickness of a film is 4-7 of d skin for gold), and (iii) bulk targets (more than 10d skin for gold). We demonstrate that these differences follow from a competition among conductive cooling of laser excited electrons in a skin layer, electron-ion coupling, and hydrodynamics of unloading caused by excess of pressure of excited free electrons. Conductive cooling of the skin needs a heat sink, which is performed by the cold material outside the skin. Such sink is unavailable in the ultrathin films.

Healing efficacy of sea buckthorn (Hippophae rhamnoides L.) seed oil in an ovine burn wound model.

PubMed

Ito, Hiroshi; Asmussen, Sven; Traber, Daniel L; Cox, Robert A; Hawkins, Hal K; Connelly, Rhykka; Traber, Lillian D; Walker, Timothy W; Malgerud, Erik; Sakurai, Hiroyuki; Enkhbaatar, Perenlei

2014-05-01

To investigate the efficacy of sea buckthorn (SBT) seed oil - a rich source of substances known to have anti-atherogenic and cardioprotective activity, and to promote skin and mucosa epithelization - on burn wound healing, five adult sheep were subjected to 3rd degree flame burns. Two burn sites were made on the dorsum of the sheep and the eschar was excised down to the fascia. Split-thickness skin grafts were harvested, meshed, and fitted to the wounds. The autograft was placed on the fascia and SBT seed oil was topically applied to one recipient and one donor site, respectively, with the remaining sites treated with vehicle. The wound blood flow (LASER Doppler), and epithelization (ultrasound) were determined at 6, 14, and 21 days after injury. 14 days after grafting, the percentage of epithelization in the treated sites was greater (95 ± 2.2% vs. 83 ± 2.9%, p<0.05) than in the untreated sites. Complete epithelization time was shorter in both treated recipient and donor sites (14.20 ± 0.48 vs. 19.60 ± 0.40 days, p<0.05 and 13.40 ± 1.02 vs. 19.60 ± 0.50 days, p<0.05, respectively) than in the untreated sites, confirmed by ultrasound. In conclusion, SBT seed oil has significant wound healing activity in full-thickness burns and split-thickness harvested wounds. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

An objective long-term evaluation of Integra (a dermal skin substitute) and split thickness skin grafts, in acute burns and reconstructive surgery.

PubMed

Nguyen, Dai Q A; Potokar, Tom S; Price, Patricia

2010-02-01

The field of wound healing and tissue repair has advanced rapidly in the last decade, with this there is an increasing emphasis on the importance of the functional and cosmetic outcomes following injury. Integra artificial skin is the most widely used synthetic skin substitute and is reported to have better outcomes in relation to the appearance and elasticity when compared to split thickness skin grafting (SSG). A review of the literature reveals very few trials that are based on an objective evaluation of Integra treated scars as compared to SSGs. This research aimed to provide objective data on the long-term outcome of Integra. All adult patients from the Welsh Burns Centre who had been successfully treated with Integra+/-SSG were invited to attend a clinic for a follow up provided they had been healed for greater than one year. The hypothesis that Integra scars are more pliable than skin grafts was tested objectively using the Cutometer, a suction device which measures skin elasticity. Of the 13 patients eligible, six were available for assessment. The results of this study suggest that Integra treated sites correlate well with normal skin as measured by the Cutometer. This was statistically significant for the parameters Ur/Ue (elastic function) and Ur/Uf (gross elasticity). On the other hand there was no correlation seen between the patients SSG sites and the patient's normal skin. With advances in medicine we are increasingly able to modulate wound healing and the resultant scars. In order to assess new and often costly treatments the need for objective scar measurement tools have become apparent. Integra has been advocated to improve scarring from injury. However, there have been few studies to evaluate the long-term outcome of Integra as compared to traditional methods such as SSG. In the past scar evaluation has been based on subjective scores by patients and clinicians. Now the mechanical properties of the skin can be evaluated using simple bioengineering methods such as the Cutometer Suction Device. Using this device our study has objectively demonstrated that the elastic properties of areas treated with Integra is comparable to normal skin. Copyright (c) 2009 Elsevier Ltd and ISBI. All rights reserved.

Real-time three-dimensional imaging of epidermal splitting and removal by high-definition optical coherence tomography.

PubMed

Boone, Marc; Draye, Jean Pierre; Verween, Gunther; Pirnay, Jean-Paul; Verbeken, Gilbert; De Vos, Daniel; Rose, Thomas; Jennes, Serge; Jemec, Gregor B E; Del Marmol, Véronique

2014-10-01

While real-time 3-D evaluation of human skin constructs is needed, only 2-D non-invasive imaging techniques are available. The aim of this paper is to evaluate the potential of high-definition optical coherence tomography (HD-OCT) for real-time 3-D assessment of the epidermal splitting and decellularization. Human skin samples were incubated with four different agents: Dispase II, NaCl 1 M, sodium dodecyl sulphate (SDS) and Triton X-100. Epidermal splitting, dermo-epidermal junction, acellularity and 3-D architecture of dermal matrices were evaluated by High-definition optical coherence tomography before and after incubation. Real-time 3-D HD-OCT assessment was compared with 2-D en face assessment by reflectance confocal microscopy (RCM). (Immuno) histopathology was used as control. HD-OCT imaging allowed real-time 3-D visualization of the impact of selected agents on epidermal splitting, dermo-epidermal junction, dermal architecture, vascular spaces and cellularity. RCM has a better resolution (1 μm) than HD-OCT (3 μm), permitting differentiation of different collagen fibres, but HD-OCT imaging has deeper penetration (570 μm) than RCM imaging (200 μm). Dispase II and NaCl treatments were found to be equally efficient in the removal of the epidermis from human split-thickness skin allografts. However, a different epidermal splitting level at the dermo-epidermal junction could be observed and confirmed by immunolabelling of collagen type IV and type VII. Epidermal splitting occurred at the level of the lamina densa with dispase II and above the lamina densa (in the lamina lucida) with NaCl. The 3-D architecture of dermal papillae and dermis was more affected by Dispase II on HD-OCT which corresponded with histopathologic (orcein staining) fragmentation of elastic fibres. With SDS treatment, the epidermal removal was incomplete as remnants of the epidermal basal cell layer remained attached to the basement membrane on the dermis. With Triton X-100 treatment, the epidermis was not removed. In conclusion, HD-OCT imaging permits real-time 3-D visualization of the impact of selected agents on human skin allografts. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Thick melanoma in Tuscany.

PubMed

Chiarugi, Alessandra; Nardini, Paolo; Borgognoni, Lorenzo; Brandani, Paola; Gerlini, Gianni; Rubegni, Pietro; Lamberti, Arianna; Salvini, Camilla; Lo Scocco, Giovanni; Cecchi, Roberto; Sirna, Riccardo; Lorenzi, Stefano; Gattai, Riccardo; Battistini, Silvio; Crocetti, Emanuele

2017-03-14

The epidemiologic trends of cutaneous melanoma are similar in several countries with a Western-type life style, where there is a progressive increasing incidence and a low but not decreasing mor- tality, or somewhere an increase too, especially in the older age groups. Also in Tuscany there is a steady rise in incidence with prevalence of in situ and invasive thin melanomas, with also an increase of thick melanomas. It is necessary to reduce the frequency of thick melanomas to reduce specific mortality. The objective of the current survey has been to compare, in the Tuscany population, by a case- case study, thin and thick melanoma cases, trying to find out those personal and tumour characteristics which may help to customize preventive interventions. RESULTS The results confirmed the age and the lower edu- cation level are associated with a later detection. The habit to perform skin self-examination is resulted protec- tive forward thick melanoma and also the diagnosis by a doctor. The elements emerging from the survey allow to hypothesize a group of subjects resulting at higher risk for a late diagnosis, aged over 50 and carrier of a fewer constitutional and environmental risk factors: few total and few atypical nevi, and lower sun exposure and burning. It is assumable that a part of people did not be reached from messages of prevention because does not recognize oneself in the categories of people at risk for skin cancers described in educational cam- paigns. If we want to obtain better results on diagnosis of skin melanoma we have to think a new strategy. At least to think over the educational messages discriminating people more at risk of incidence of melanoma from people more at risk to die from melanoma, and to renewed active involvement of the Gen- eral Practitioners .

Evaluation of human amniotic membrane as a wound dressing for split-thickness skin-graft donor sites.

PubMed

Loeffelbein, Denys J; Rohleder, Nils H; Eddicks, Matthias; Baumann, Claudia M; Stoeckelhuber, Mechthild; Wolff, Klaus-D; Drecoll, Enken; Steinstraesser, Lars; Hennerbichler, Simone; Kesting, Marco R

2014-01-01

Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.

Numerical solution of periodic vortical flows about a thin airfoil

NASA Technical Reports Server (NTRS)

Scott, James R.; Atassi, Hafiz M.

1989-01-01

A numerical method is developed for computing periodic, three-dimensional, vortical flows around isolated airfoils. The unsteady velocity is split into a vortical component which is a known function of the upstream flow conditions and the Lagrangian coordinates of the mean flow, and an irrotational field whose potential satisfies a nonconstant-coefficient, inhomogeneous, convective wave equation. Solutions for thin airfoils at zero degrees incidence to the mean flow are presented in this paper. Using an elliptic coordinate transformation, the computational domain is transformed into a rectangle. The Sommerfeld radiation condition is applied to the unsteady pressure on the grid line corresponding to the far field boundary. The results are compared with a Possio solver, and it is shown that for maximum accuracy the grid should depend on both the Mach number and reduced frequency. Finally, in order to assess the range of validity of the classical thin airfoil approximation, results for airfoils with zero thickness are compared with results for airfoils with small thickness.

Three Skin Zones in the Asian Upper Eyelid Pertaining to the Asian Blepharoplasty.

PubMed

Choi, Yeop; Kang, Hyun Gu; Nam, Yong Seok

2017-06-01

Natural looking double fold is an essential and aesthetically pleasing masterpiece in Asian blepharoplasty. This study aims to emphasize the 3 skin zone concept in the Asian upper blepharoplasty. The authors examined the anterior lamella of each skin zone microscopically by performing 31 double-eyelid surgeries and 11 infrabrow lifts. Characteristics of dermal components, subcutaneous tissue, and outer fascia of OOM (OFOOM) at each skin zone were documented. The authors evaluated the vertical scales of each skin zone in young and aged Asian patients who visited the first author's clinic for the primary or secondary upper blepharoplasty with ×3.5 magnifying surgical loupe. The thickness of OOM had no difference among zones 1, 2, and 3. The skin and subdermal tissue had varying characteristics according to its skin zone. At zone 1, it seemed that only thin skin was on the OOM. The anterior lamella of zone 2 seemed to consist of skin, white fascia (OFOOM) including a venous network, and OOM in a gross field. At zone 3, thick skin, thick subcutaneous fatty layer, and OOM were magnified. The OFOOM of zone 3 was not significantly identified due to a sticky adherence with OOM. At the point of vertical scales of skin zone, good eyelids have lower zone 3 ratio and higher zones 1 and 2 ratio with qualified topographic condition. The authors classified the Asian upper eyelid as with 3 skin zones. Based on its anatomical investigation, the authors can afford anthropometric data and supplemental theory for the creation of aesthetic folds.

[Function of the acetabulum of digenetic trematodes, as exemplified by Dicrocoelium dendriticum].

PubMed

Neuhaus, W

1985-01-01

The suckers of animals adhere to the substratum either in air or in aqueous fluids. The varying compressibility of these media causes differences in function, the principles of which are described. The ventral arch of the acetabulum of Dicrocoelium dendriticum, like the remaining body, is limited by the integument, basal lamina and skin muscles. The dorsal arch covers a basal lamina, which is close to a plexus of diagonal, longitudinal and circular muscles. The radical muscles, attached at the ventral basal lamina by thin connective tissue, continue in relatively thick contractile fibers, which split up into several fibrils, which also attached by thin connective tissue at the dorsal basal lamina. In this way the tension of the muscles is likewise distributed over the dorsal and ventral arches of the acetabulum. After contact with the substratum the sucker creates a partial vacuum and attachment by means of the pressure of the radial muscles against the wall of the hole. Because of the fluid content of the hole, the volume does not change much. The dorsal arch of the sucker withstands the pressure of the radical muscles, because its surface area is six times greater than that of the ventral arch and consequently the load is six times less. The sucker, covered with basal lamina, has a constant volume; its layer of muscles resists deformation and supports the stability of the arch.

Morphogenesis and Biomechanics of Engineered Skin Cultured Under Uniaxial Strain.

PubMed

Blackstone, Britani N; Powell, Heather M

2012-04-01

Split-thickness autograft is the standard wound treatment for full-thickness burns. In large burns, sparse availability of uninjured skin prevents rapid closure of the wound, resulting in increased scar tissue formation or mortality. Tissue-engineered skin (ES) offers promise when autografts are not available. ES, constructed from a polymeric scaffold and skin cells, has been shown to reduce donor site area required to permanently close wounds, mortality, and morbidity from scarring but cannot restore all skin functions. Current generations of ES are orders of magnitude weaker than normal human skin, leading to difficulty in surgical application, greater susceptibility to mechanical damage during fabrication and application, and less elasticity and strength once engrafted. Previous studies to improve ES biomechanics focus on altering the scaffolding material, which resulted in modest improvements but often inhibited proper skin development. As the skin is naturally under static strain, adding these mechanical cues to the culture environment is hypothesized to improve ES biomechanics. ES was cultured under applied static strains ranging from 0% to 40% strain for a total of 10 days. Strain magnitudes of 10% and 20% strain resulted in significantly stronger ES than unstrained controls, showed upregulation of many genes encoding structural extracellular matrix proteins, and exhibited increased epidermal cell proliferation and differentiation. Enhanced biomechanical properties of ES can allow for facile surgical application and less damage during dressing changes. These findings suggest that mechanical cues play a significant role in skin development and should be further explored.

Evaluation of cultured human dermal- and dermo-epidermal substitutes focusing on extracellular matrix components: Comparison of protein and RNA analysis.

PubMed

Oostendorp, Corien; Meyer, Sarah; Sobrio, Monia; van Arendonk, Joyce; Reichmann, Ernst; Daamen, Willeke F; van Kuppevelt, Toin H

2017-05-01

Treatment of full-thickness skin defects with split-thickness skin grafts is generally associated with contraction and scar formation and cellular skin substitutes have been developed to improve skin regeneration. The evaluation of cultured skin substitutes is generally based on qualitative parameters focusing on histology. In this study we focused on quantitative evaluation to provide a template for comparison of human bio-engineered skin substitutes between clinical and/or research centers, and to supplement histological data. We focused on extracellular matrix proteins since these components play an important role in skin regeneration. As a model we analyzed the human dermal substitute denovoDerm and the dermo-epidermal skin substitute denovoSkin. The quantification of the extracellular matrix proteins type III collagen and laminin 5 in tissue homogenates using western blotting analysis and ELISA was not successful. The same was true for assaying lysyl oxidase, an enzyme involved in crosslinking of matrix molecules. As an alternative, gene expression levels were measured using qPCR. Various RNA isolation procedures were probed. The gene expression profile for specific dermal and epidermal genes could be measured reliably and reproducibly. Differences caused by changes in the cell culture conditions could easily be detected. The number of cells in the skin substitutes was measured using the PicoGreen dsDNA assay, which was found highly quantitative and reproducible. The (dis) advantages of assays used for quantitative evaluation of skin substitutes are discussed. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Nanofibrillar cellulose wound dressing in skin graft donor site treatment.

PubMed

Hakkarainen, T; Koivuniemi, R; Kosonen, M; Escobedo-Lucea, C; Sanz-Garcia, A; Vuola, J; Valtonen, J; Tammela, P; Mäkitie, A; Luukko, K; Yliperttula, M; Kavola, H

2016-12-28

Although new therapeutic approaches for burn treatment have made progress, there is still need for better methods to enhance wound healing and recovery especially in severely burned patients. Nanofibrillar cellulose (NFC) has gained attention due to its renewable nature, good biocompatibility and excellent physical properties that are of importance for a range of applications in pharmaceutical and biomedical fields. In the present study, we investigated the potential of a wood based NFC wound dressing in a clinical trial on burn patients. Previously, we have investigated NFC as a topical functionalized wound dressing that contributes to improve wound healing in mice. Wood based NFC wound dressing was tested in split-thickness skin graft donor site treatment for nine burn patients in clinical trials at Helsinki Burn Centre. NFC dressing was applied to split thickness skin graft donor sites. The dressing gradually dehydrated and attached to donor site during the first days. During the clinical trials, physical and mechanical properties of NFC wound dressing were optimized by changing its composition. From patient 5 forward, NFC dressing was compared to commercial lactocapromer dressing, Suprathel® (PMI Polymedics, Germany). Epithelialization of the NFC dressing-covered donor site was faster in comparison to Suprathel®. Healthy epithelialized skin was revealed under the detached NFC dressing. NFC dressing self-detached after 11-21days for patients 1-9, while Suprathel® self-detached after 16-28days for patients 5-9. In comparison studies with patients 5-9, NFC dressing self-detached on average 4days earlier compared with Suprathel®. Lower NFC content in the material was evaluated to influence the enhanced pliability of the dressing and attachment to the wound bed. No allergic reaction or inflammatory response to NFC was observed. NFC dressing did not cause more pain for patients than the traditional methods to treat the skin graft donor sites. Based on the preliminary clinical data, NFC dressing seems to be promising for skin graft donor site treatment since it is biocompatible, attaches easily to wound bed, and remains in place until donor site has renewed. It also detaches from the epithelialized skin by itself. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

The Influence of Skin Redness on Blinding in Transcranial Direct Current Stimulation Studies: A Crossover Trial.

PubMed

Ezquerro, Fernando; Moffa, Adriano H; Bikson, Marom; Khadka, Niranjan; Aparicio, Luana V M; de Sampaio-Junior, Bernardo; Fregni, Felipe; Bensenor, Isabela M; Lotufo, Paulo A; Pereira, Alexandre Costa; Brunoni, Andre R

2017-04-01

To evaluate whether and to which extent skin redness (erythema) affects investigator blinding in transcranial direct current stimulation (tDCS) trials. Twenty-six volunteers received sham and active tDCS, which was applied with saline-soaked sponges of different thicknesses. High-resolution skin images, taken before and 5, 15, and 30 min after stimulation, were randomized and presented to experienced raters who evaluated erythema intensity and judged on the likelihood of stimulation condition (sham vs. active). In addition, semi-automated image processing generated probability heatmaps and surface area coverage of erythema. Adverse events were also collected. Erythema was present, but less intense in sham compared to active groups. Erythema intensity was inversely and directly associated to correct sham and active stimulation group allocation, respectively. Our image analyses found that erythema also occurs after sham and its distribution is homogenous below electrodes. Tingling frequency was higher using thin compared to thick sponges, whereas erythema was more intense under thick sponges. Optimal investigator blinding is achieved when erythema after tDCS is mild. Erythema distribution under the electrode is patchy, occurs after sham tDCS and varies according to sponge thickness. We discuss methods to address skin erythema-related tDCS unblinding. © 2016 International Neuromodulation Society.

Quantum resonances of Landau damping in the electromagnetic response of metallic nanoslabs.

PubMed

Castillo-López, S G; Makarov, N M; Pérez-Rodríguez, F

2018-05-15

The resonant quantization of Landau damping in far-infrared absorption spectra of metal nano-thin films is predicted within the Kubo formalism. Specifically, it is found that the discretization of the electromagnetic and electron wave numbers inside a metal nanoslab produces quantum nonlocal resonances well-resolved at slab thicknesses smaller than the electromagnetic skin depth. Landau damping manifests itself precisely as such resonances, tracing the spectral curve obtained within the semiclassical Boltzmann approach. For slab thicknesses much greater than the skin depth, the classical regime emerges. Here the results of the quantum model and the Boltzmann approach coincide. Our analytical study is in perfect agreement with corresponding numerical simulations.

Modeling slug tests in unconfined aquifers with both oscillatory and overdamped responses, and with low-K and high-K skin effects

NASA Astrophysics Data System (ADS)

Thoma, M. J.; Malama, B.; Barrash, W.; Bohling, G.; Butler, J. J.

2009-12-01

We extend the models for slug tests developed by Hyder et al. (1994) and Butler and Zhan (2004) to obtain a single general model for slug tests in unconfined aquifers in partially penetrating wells with a near-well disturbed zone (skin). The full range of responses, oscillatory to overdamped, is considered since both types of responses are common in wells in unconsolidated coarse fluvial aquifers, and others. The general semi-analytical solution allows for skin and formation storage as well as anisotropy in skin and formation hydraulic conductivity (K). The water table is treated as a fixed head boundary so the solution is applicable for wells screened below the water table. The model is validated by comparison with other models and by matching field data from unconfined fluvial aquifers at sites in Nebraska (MSEA) and Idaho (BHRS). We examine the effects of varying skin K and skin thickness to simulate the impact of a near-well disturbed zone that is lower (damage) or higher (filter pack) K than the formation. Results indicate that, for a given set of measured behavior at an example test zone, minor progressive decreases in estimated formation K occur with increases in assumed skin K, and moderate increases in estimated formation K occur with decreases in assumed skin K. Major increases (orders of magnitude) in estimated formation K occur with increased thickness of low-K skin. The importance of incorporating a finite-thickness representation of the skin, rather than the conventional infinitely thin representation, is also addressed.

Nanostructured tungsten trioxide thin films synthesized for photoelectrocatalytic water oxidation: a review.

PubMed

Zhu, Tao; Chong, Meng Nan; Chan, Eng Seng

2014-11-01

The recent developments of nanostructured WO3 thin films synthesized through the electrochemical route of electrochemical anodization and cathodic electrodeposition for the application in photoelectrochemical (PEC) water splitting are reviewed. The key fundamental reaction mechanisms of electrochemical anodization and cathodic electrodeposition methods for synthesizing nanostructured WO3 thin films are explained. In addition, the effects of metal oxide precursors, electrode substrates, applied potentials and current densities, and annealing temperatures on size, composition, and thickness of the electrochemically synthesized nanostructured WO3 thin films are elucidated in detail. Finally, a summary is given for the general evaluation practices used to calculate the energy conversion efficiency of nanostructured WO3 thin films and a recommendation is provided to standardize the presentation of research results in the field to allow for easy comparison of reported PEC efficiencies in the near future. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

PubMed

Saraiya, Hemant

2003-01-01

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

Analyzing contraction of full thickness skin grafts in time: Choosing the donor site does matter.

PubMed

Stekelenburg, Carlijn M; Simons, Janine M; Tuinebreijer, Wim E; van Zuijlen, Paul P M

2016-11-01

In reconstructive burn surgery full thickness skin grafts (FTSGs) are frequently preferred over split thickness skin grafts because they are known to provide superior esthetic results and less contraction. However, the contraction rate of FTSGs on the long term has never been studied. The surface area of FTSGs of consecutive patients was measured during surgery and at their regular follow up (at approximately 1, 6,13 and 52 weeks postoperatively) by means of 3D-stereophotogrammetry. Linear regression analysis was conducted to assess the influence of age, recipient- and donor site and operation indication. 38 FTSGs in 26 patients, with a mean age of 37.4 (SD 21.9) were evaluated. A significant reduction in remaining surface area to 79.1% was observed after approximately 6 weeks (p=0.002), to 85.9% after approximately 13 weeks (p=0.040) and to 91.5% after approximately 52 weeks (p=0.033). Grafts excised from the trunk showed significantly less contraction than grafts excised from the extremities (94.0% vs. 75.7% p=0.036). FTSGs showed a significant reduction in surface area, followed by a relaxation phase, but remained significantly smaller. Furthermore, the trunk should be preferred as donor site location over the extremities. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

A nonintrusive laser interferometer method for measurement of skin friction

NASA Technical Reports Server (NTRS)

Monson, D. J.

1982-01-01

A method is described for monitoring the changing thickness of a thin oil film subject to an aerodynamic shear stress using two focused laser beams. The measurement is then simply analyzed in terms of the surface skin friction of the flow. The analysis includes the effects of arbitrarily large pressure and skin friction gradients, gravity, and time varying oil temperature. It may also be applied to three dimensional flows with unknown direction. Applications are presented for a variety of flows including two dimensional flows, three dimensional swirling flows, separated flow, supersonic high Reynolds number flows, and delta wing vortical flows.

Preservation of anal function after total excision of the anal mucosa for Bowen's disease.

PubMed

Reynolds, V H; Madden, J J; Franklin, J D; Burnett, L S; Jones, H W; Lynch, J B

1984-05-01

Six women with Bowen's disease of the anogenital area were treated by total excision of the anal mucosa, perianal skin and, in some cases, partial vulvectomy. Two patients had foci of microinvasive squamous carcinoma. Adequate tumor margins were determined by frozen sections. The resulting mucosal and cutaneous defects were grafted with medium split-thickness skin grafts applied to the anal canal and sutured circumferentially to the rectal mucosa. Grafts were held in place by a finger cot inserted in the anal canal and stuffed with cotton balls. Patients were constipated five or six days with codeine. The skin grafts healed per primam. One additional patient was similarly treated for a chronic herpetic ulceration of the anus and healed. Contrary to dire predictions, all patients were able to distinguish between gaseous and solid rectal contents and sphincter function was preserved. In one patient, Bowen's disease has recurred in the grafted perianal skin.

Efficient Skin Temperature Sensor and Stable Gel-Less Sticky ECG Sensor for a Wearable Flexible Healthcare Patch.

PubMed

Yamamoto, Yuki; Yamamoto, Daisuke; Takada, Makoto; Naito, Hiroyoshi; Arie, Takayuki; Akita, Seiji; Takei, Kuniharu

2017-09-01

Wearable, flexible healthcare devices, which can monitor health data to predict and diagnose disease in advance, benefit society. Toward this future, various flexible and stretchable sensors as well as other components are demonstrated by arranging materials, structures, and processes. Although there are many sensor demonstrations, the fundamental characteristics such as the dependence of a temperature sensor on film thickness and the impact of adhesive for an electrocardiogram (ECG) sensor are yet to be explored in detail. In this study, the effect of film thickness for skin temperature measurements, adhesive force, and reliability of gel-less ECG sensors as well as an integrated real-time demonstration is reported. Depending on the ambient conditions, film thickness strongly affects the precision of skin temperature measurements, resulting in a thin flexible film suitable for a temperature sensor in wearable device applications. Furthermore, by arranging the material composition, stable gel-less sticky ECG electrodes are realized. Finally, real-time simultaneous skin temperature and ECG signal recordings are demonstrated by attaching an optimized device onto a volunteer's chest. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Photocatalytic generation of hydrogen by core-shell WO3/BiVO4 nanorods with ultimate water splitting efficiency

PubMed Central

Pihosh, Yuriy; Turkevych, Ivan; Mawatari, Kazuma; Uemura, Jin; Kazoe, Yutaka; Kosar, Sonya; Makita, Kikuo; Sugaya, Takeyoshi; Matsui, Takuya; Fujita, Daisuke; Tosa, Masahiro; Kondo, Michio; Kitamori, Takehiko

2015-01-01

Efficient photocatalytic water splitting requires effective generation, separation and transfer of photo-induced charge carriers that can hardly be achieved simultaneously in a single material. Here we show that the effectiveness of each process can be separately maximized in a nanostructured heterojunction with extremely thin absorber layer. We demonstrate this concept on WO3/BiVO4+CoPi core-shell nanostructured photoanode that achieves near theoretical water splitting efficiency. BiVO4 is characterized by a high recombination rate of photogenerated carriers that have much shorter diffusion length than the thickness required for sufficient light absorption. This issue can be resolved by the combination of BiVO4 with more conductive WO3 nanorods in a form of core-shell heterojunction, where the BiVO4 absorber layer is thinner than the carrier diffusion length while it’s optical thickness is reestablished by light trapping in high aspect ratio nanostructures. Our photoanode demonstrates ultimate water splitting photocurrent of 6.72 mA cm−2 under 1 sun illumination at 1.23 VRHE that corresponds to ~90% of the theoretically possible value for BiVO4. We also demonstrate a self-biased operation of the photoanode in tandem with a double-junction GaAs/InGaAsP photovoltaic cell with stable water splitting photocurrent of 6.56 mA cm−2 that corresponds to the solar to hydrogen generation efficiency of 8.1%. PMID:26053164

Photocatalytic generation of hydrogen by core-shell WO3/BiVO4 nanorods with ultimate water splitting efficiency

NASA Astrophysics Data System (ADS)

Pihosh, Yuriy; Turkevych, Ivan; Mawatari, Kazuma; Uemura, Jin; Kazoe, Yutaka; Kosar, Sonya; Makita, Kikuo; Sugaya, Takeyoshi; Matsui, Takuya; Fujita, Daisuke; Tosa, Masahiro; Kondo, Michio; Kitamori, Takehiko

2015-06-01

Efficient photocatalytic water splitting requires effective generation, separation and transfer of photo-induced charge carriers that can hardly be achieved simultaneously in a single material. Here we show that the effectiveness of each process can be separately maximized in a nanostructured heterojunction with extremely thin absorber layer. We demonstrate this concept on WO3/BiVO4+CoPi core-shell nanostructured photoanode that achieves near theoretical water splitting efficiency. BiVO4 is characterized by a high recombination rate of photogenerated carriers that have much shorter diffusion length than the thickness required for sufficient light absorption. This issue can be resolved by the combination of BiVO4 with more conductive WO3 nanorods in a form of core-shell heterojunction, where the BiVO4 absorber layer is thinner than the carrier diffusion length while it’s optical thickness is reestablished by light trapping in high aspect ratio nanostructures. Our photoanode demonstrates ultimate water splitting photocurrent of 6.72 mA cm-2 under 1 sun illumination at 1.23 VRHE that corresponds to ~90% of the theoretically possible value for BiVO4. We also demonstrate a self-biased operation of the photoanode in tandem with a double-junction GaAs/InGaAsP photovoltaic cell with stable water splitting photocurrent of 6.56 mA cm-2 that corresponds to the solar to hydrogen generation efficiency of 8.1%.

Lack of Effect of 94 GHz Radio Frequency Radiation Exposure in an Animal Model of Skin Carcinogenesis

DTIC Science & Technology

2001-10-01

villous or arborescent outgrowths of fibrovascular stroma covered by neoplastic cells; although benign, papillomas are premalignant lesions that will...thin stratum corneum; 1, minimal hyperplasia , epithelium ~4–6 cell layers thick; 2, minimal to mild hyperplasia , variable amounts of hyperplasia ...across the specimen, areas fitting each description present; 3, mild hyperplasia , epithelium ~7–9 cell layers thick or epithelial layer composed of ~4–6

Species-specific differences in adaptive phenotypic plasticity in an ecologically relevant trophic trait: hypertrophic lips in Midas cichlid fishes.

PubMed

Machado-Schiaffino, Gonzalo; Henning, Frederico; Meyer, Axel

2014-07-01

The spectacular species richness of cichlids and their diversity in morphology, coloration, and behavior have made them an ideal model for the study of speciation and adaptive evolution. Hypertrophic lips evolved repeatedly and independently in African and Neotropical cichlid radiations. Cichlids with hypertrophic lips forage predominantly in rocky crevices and it has been hypothesized that mechanical stress caused by friction could result in larger lips through phenotypic plasticity. To test the influence of the environment on the size and development of lips, we conducted a series of breeding and feeding experiments on Midas cichlids. Full-sibs of Amphilophus labiatus (thick-lipped) and Amphilophus citrinellus (thin-lipped) each were split into a control group which was fed food from the water column and a treatment group whose food was fixed to substrates. We found strong evidence for phenotypic plasticity on lip area in the thick-lipped species, but not in the thin-lipped species. Intermediate phenotypic values were observed in hybrids from thick- and thin-lipped species reared under "control" conditions. Thus, both a genetic, but also a phenotypic plastic component is involved in the development of hypertrophic lips in Neotropical cichlids. Moreover, species-specific adaptive phenotypic plasticity was found, suggesting that plasticity is selected for in recent thick-lipped species. © 2014 The Author(s). Evolution © 2014 The Society for the Study of Evolution.

Morphogenesis and Biomechanics of Engineered Skin Cultured Under Uniaxial Strain

PubMed Central

Blackstone, Britani N.; Powell, Heather M.

2012-01-01

Background Split-thickness autograft is the standard wound treatment for full-thickness burns. In large burns, sparse availability of uninjured skin prevents rapid closure of the wound, resulting in increased scar tissue formation or mortality. Tissue-engineered skin (ES) offers promise when autografts are not available. The Problem ES, constructed from a polymeric scaffold and skin cells, has been shown to reduce donor site area required to permanently close wounds, mortality, and morbidity from scarring but cannot restore all skin functions. Current generations of ES are orders of magnitude weaker than normal human skin, leading to difficulty in surgical application, greater susceptibility to mechanical damage during fabrication and application, and less elasticity and strength once engrafted. Basic/Clinical Science Advances Previous studies to improve ES biomechanics focus on altering the scaffolding material, which resulted in modest improvements but often inhibited proper skin development. As the skin is naturally under static strain, adding these mechanical cues to the culture environment is hypothesized to improve ES biomechanics. ES was cultured under applied static strains ranging from 0% to 40% strain for a total of 10 days. Strain magnitudes of 10% and 20% strain resulted in significantly stronger ES than unstrained controls, showed upregulation of many genes encoding structural extracellular matrix proteins, and exhibited increased epidermal cell proliferation and differentiation. Clinical Care Relevance Enhanced biomechanical properties of ES can allow for facile surgical application and less damage during dressing changes. Conclusion These findings suggest that mechanical cues play a significant role in skin development and should be further explored. PMID:24527283

Detection of Electrocardiogram by Electrodes with Fabrics Using Capacitive Coupling

NASA Astrophysics Data System (ADS)

Ueno, Akinori; Furusawa, Yoichi; Hoshino, Hiroshi; Ishiyama, Yoji

This article reports on a novel technique for detecting electrocardiogram (ECG) at a condition where thin cloth is interpolated between sensing electrodes and the skin to which the electrodes are attached. The technique is based upon capacitive coupling composed of the electrode, the cloth and the skin, so that the electrode can lead alternating electrocardiographic current through capacitance of the coupling. The technique is also founded on impedance transforming circuit that has extremely high input impedance around 1000GΩ and low output impedance, so as to match high output impedance of the electrode to low input impedance required by subsequent circuitry. A pilot ECG measuring device was manufactured using the technique and experiments showed (1) ECG recordings using the device with silk of 240μm thickness or with cotton of 564μm thickness were quite similar to ECGs recorded from the skin using conventional system, (2) stable ECGs were observed with the silk below 600μm thickness or with the cotton below 1128μm thickness, (3) effects of long-term measurement and perspiration on ECG waveform were negligible. These results prove feasibility of the proposed technique for detecting ECG by electrodes with fabrics.

Spectroscopic in situ Measurements of the Relative Pt Skin Thicknesses and Porosities of Dealloyed PtMn (Ni, Co) Electrocatalysts

PubMed Central

Caldwell, Keegan M.; Ramaker, David E.; Jia, Qingying; Mukerjee, Sanjeev; Ziegelbauer, Joseph M.; Kukreja, Ratandeep S.; Kongkanand, Anusorn

2015-01-01

X-ray adsorption near edge structure (XANES) data at the Co or Ni K-edge, analyzed using the Δμ difference procedure, are reported for dealloyed PtCox and PtNix catalysts (six different catalysts at different stages of life). All catalysts meet the 2017 DOE beginning of life target Pt mass activity target (>0.44 A mgPt−1), but exhibit varying activities and durabilities. The variance factors include different initial precursors, dealloying in HNO3 vs H2SO4, if a postdealloying thermal annealing step was performed, and different morphologies (some with a multi PtMx core and porous Pt skin, some single core with nonporous skin). Data are obtained at the initial beginning of life (BOL, ~200 voltage cycles) and after 10k and 30k (end of life, EOL) voltage cycles following DOE protocol (0.6–1.0 V vs reversible hydrogen electrode). The Δμ data are used to determine at what potential (Vpen) the Pt skin is penetrated by O. The durability, related to a drop in the electrochemical surface areas (ECSAs) after extensive voltage cycling, directly correlates with the Vpen at BOL. The data indicate that cycling produces a “characteristic” Pt skin robustness (porosity or thickness). When the Pt skin at BOL is “thin” (Vpen < 0.9 V) it grows to a “characteristic” thickness consistent with a Vpen of ≈1.1 V, and if it begins very thick, it thins to the same “characteristic” thickness. Particles dealloyed in H2SO4 appear to have a thicker Pt skin at BOL than those dealloyed in HNO3, and a postdealloying annealing procedure appears to produce a particularly nonporous skin with high Vpen, but not necessarily thicker. Furthermore, the PtM3 catalysts exhibited a fast skin “healing” process whereby the initial porous skin appears to become more nonporous after holding the potential at 0.9 V. This work is believed to be the first in situ XAS study to shed light on the nature of the Pt skin, its thickness, and/or porosity, and how it changes with respect to operating electrochemical conditions. PMID:26191117

Echo's Legacy

NASA Technical Reports Server (NTRS)

1980-01-01

The Echo 1 Satellite is simply a very large balloon, the diameter of a 10 story building. Metallized Products, Inc. developed a special material for NASA used for the balloons's skin. For "bouncing signals," material had to be reflective, lightweight, and thin enough to be folded into a beach ball size canister for delivery into orbit, where it would automatically inflate. Material selected was mylar polyester, with a reflective layer of tiny aluminum particles so fine that Echo's skin had a thickness half that of cellophane on a cigarette package.

The Use of Bovine Collagen-glycosaminoglycan Matrix for Atypical Lower Extremity Ulcers.

PubMed

Garwood, Caitlin S; Kim, Paul J; Matai, Vinay; Steinberg, John S; Evans, Karen K; Mitnick, Carol Deane B; Attinger, Christopher E

2016-09-01

The primary purpose of this study was to evaluate the use of bovine collagen-glycosaminoglycan matrix on atypical lower extremity ulcers. A retrospective chart review was performed on patients who underwent application of bovine collagen matrix to a lower extremity ulcer with an atypical etiology including autoimmune disease, sickle cell anemia, radiation therapy, connective tissue disease, vasculitis, or coagulopathy from January 2009 to October 2014. The following outcomes were evaluated: rate of ulcer healing and closure, number of ulcers that received a split-thickness skin graft, improvement in pain, and complications related to the ulcer. Thirty-eight patients with 71 lower extremity ulcers were analyzed. The most common ulcer etiolo- gies included rheumatoid arthritis, sickle cell anemia, and coagulopa- thy. After application of the bovine collagen matrix, 30 (42.3%) ulcers healed at a mean of 220.9 days. Of the 71 ulcers, 26 (36.6%) re- ceived a split-thickness skin graft after application of the matrix and 17 (65.4%) of those went on to complete healing. Ten patients had a local infection noted during follow-up, and 5 patients had dehiscence or dissociation of the matrix. Atypical lower extremity ulcers, such as those caused by autoimmune diseases and sickle cell anemia, proved difficult to heal. This case series shows that bovine collagen matrix can be a successful adjunctive therapy for the treatment of these challenging ulcers.

Matriderm for Management of Scalp Necrosis Following Surgical Treatment of Giant Parietal Encephalocele.

PubMed

Vilela, Marcelo D; Pedrosa, Hugo A S; Sampaio, Felipe D; Carneiro, Junia L

2018-02-01

Management of encephaloceles is challenging when massive brain herniation is present. In such instances, an expansile cranioplasty may be attempted so as to preserve some herniated brain tissue. Complications such as wound dehiscence, cerebrospinal fluid leak, and scalp necrosis are postoperative concerns. The treatment of scalp necrosis with dural and brain exposure is certainly a challenge due to the complexity of flap techniques in such a young age. Herein we describe the use of a novel technique for the management of a scalp necrosis and dehiscence in an infant. A patient with a giant parietal encephalocele and massive brain herniation underwent an expansile cranioplasty. A large scalp necrosis ensued as a complication and later progressed to a suture dehiscence despite a new surgical intervention, with resultant brain exposure. A scalp reconstruction was subsequently performed using an artificial dermal substitute, laid directly onto the brain, followed by a split-thickness skin graft. We observed a rapid engraftment, without any further complications, with an acceptable cosmetic result in the long-term follow-up. A simple technique, such as the use of an artificial dermal matrix with simultaneous split-thickness skin graft, may be an effective treatment for the repair of scalp defects, even when coverage of exposed brain tissue is necessary, when no other techniques are found to be suitable. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed Central

Sajad, Wani; Hamid, Raashid

2014-01-01

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

Outcome of split thickness skin grafting and multiple z-plasties in postburn contractures of groin and perineum: a 15-year experience.

PubMed

Sajad, Wani; Hamid, Raashid

2014-01-01

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

Integra®-Dermal Regeneration Template and Split-Thickness Skin Grafting: A Therapy Approach to Correct Aplasia Cutis Congenita and Epidermolysis Bullosa in Carmi Syndrome.

PubMed

Trah, Julian; Has, Christina; Hausser, Ingrid; Kutzner, Heinz; Reinshagen, Konrad; Königs, Ingo

2018-05-18

The association of junctional epidermolysis bullosa with pyloric atresia (JEB-PA) and aplasia cutis congenita (ACC) was described by El Shafie et al. (J Pediatr Surg 14(4):446-449, 1979) and Carmi et al. (Am J Med Genet 11:319-328, 1982). Most patients die in the first weeks of life, and no curative treatment options are available so far. We describe a patient with JEB-PA and ACC (OMIM # 226730) who was treated for extensive areas of ACC by Integra ® -Dermal Regeneration Template and split-thickness skin grafting (STSG). Clinically, the dermal template changed into well-vascularized neodermis, and after STSG, full take of the transplants was detected. No infections of the huge ACC areas were seen. Further studies must validate this treatment option in severe and acute cases of JEB-PA with ACC. Based on clinical findings, we postulate that placement of Integra ® -Dermal Regeneration Template with STSG could be a new treatment option for patients having JEB-PA with ACC to prevent severe infection, compartment-syndrome-like conditions, and deformities. Based on literature findings, we assume that Integra ® -Dermal Regeneration Template with STSG could even be able to prevent new blistering and thereby be a treatment option in cases of ACC and JEB.

Clinical evaluation of coverage of open wounds: Polyglycolic acid sheet with fibrin glue spray vs split thickness skin

PubMed Central

Mochizuki, Yumi; Tomioka, Hirofumi; Tushima, Fumihiko; Shimamoto, Hiroaki; Hirai, Hideaki; Oikawa, Yuu; Harada, Hiroyuki

2016-01-01

Purpose: This study aimed to evaluate the coverage of oral wounds using either a polyglycolic acid (PGA) sheet or split-thickness skin grafting (STSG). Materials and Methods: A total of 119 cases of wound coverage using a PGA sheet and fibrin glue spray as well as 132 cases of wound coverage cases using STSG were reviewed retrospectively. The site of the excision area, perioperative conditions, and postoperative functional problems were evaluated. Results: The PGA group had significantly shorter operation time, earlier start of oral intake, and shorter hospitalization than the STSG group. If the PGA sheet over the wound with exposed bone could be protected by a surgical sprint, oral food intake could be started on the day after surgery at the earliest. When the size of the wound in the buccal excisional area was classified into two groups (<6 or ≥6 cm2), mouth opening in the STSG group was significantly larger at 3 months postoperatively. When the size of the wound in the tongue and floor of mouth was classified into two groups (<12 or ≥12 cm2), the STSG group had a significantly higher score in postoperative speech intelligibility. Conclusion: Selection of a PGA sheet or STSG based on the consideration of defect size, tumor location, patients’ local and general condition and tolerance for surgery could reduce the patients’ postsurgical dysfunctional problems. PMID:28299263

Cost analysis of negative-pressure wound therapy with instillation for wound bed preparation preceding split-thickness skin grafts for massive (>100 cm(2)) chronic venous leg ulcers.

PubMed

Yang, C Kevin; Alcantara, Sean; Goss, Selena; Lantis, John C

2015-04-01

Massive (≥100 cm(2)) venous leg ulcers (VLUs) demonstrate very low closure rates with standard compression therapy and are costly to manage. Negative-pressure wound therapy (NPWT), followed by a split-thickness skin graft (STSG), can be a cost-effective alternative to this standard care. We performed a cost analysis of these two treatments. A retrospective review was performed of 10 ulcers treated with surgical debridement, 7 days of inpatient NPWT with topical antiseptic instillation (NPWTi), and STSG, with 4 additional days of inpatient NPWT bolster over the graft. Independent medical cost estimators were used to compare the cost of this treatment protocol with standard outpatient compression therapy. The average length of time ulcers were present before patients entered the study was 38 months (range, 3-120 months). Eight of 10 patients had complete VLU closure by 6 months after NPWTi with STSG. The 6-month costs of the proposed treatment protocol and standard twice-weekly compression therapy were estimated to be $27,000 and $28,000, respectively. NPWTi with STSG treatment is more effective for closure of massive VLUs at 6 months than that reported for standard compression therapy. Further, the cost of the proposed treatment protocol is comparable with standard compression therapy. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Successful management of angiolymphoid hyperplasia with eosinophilia in a split-face trial of topical tacrolimus and timolol solution.

PubMed

Chacon, Anna; Mercer, Jessica

2016-08-01

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon, benign condition characterized by multiple benign angiomatous nodules or plaques. Cutaneous lesions can be painful, pruritic, pulsatile, or potentially disfiguring resulting in significant morbidity. ALHE is a pathologic diagnosis featuring proliferations of capillary-sized vessels with epithelioid endothelial cells surrounded by larger, thick-walled vessels and accompanying eosinophils and lymphocytes. Surgery is generally required, however the skin lesions often recur after excision. ALHE is notoriously difficult to treat and many physicians would prefer a non-invasive treatment of choice. We report a case of ALHE that was successfully treated with the novel use of topical tacrolimus in a split-face trial with topical timolol solution.

[Surgical treatment of penile lymphedema associated with hidradenitis suppurativa].

PubMed

García-Tutor, E; Botellé del Hierro, J; San Martín Maya, A; Castro García, J; España, A; Fernández Montero, J; Robles García, J E

2005-05-01

Penoscrotal lymphedema is a rare disease in the developed countries, although it is relatively frequent in tropical countries. The most common cause is filariasis, although in our practice usually is associate to neoplasic and inflammatory processes, surgery, radiotherapy, hidroelectrolitic disbalances and idiopathic. We present a 22 years old patient with penoscrotal lymphedema due to hidradenitis suppurativa. After unsuccessful medical treatment, was performed a total excision of the penile skin and subcutaneous tissue to Buck's fascia. Split thickness skin grafts were used to cover the defect. Even medical management of penoscrotal lymphedema is not effective for most patients, surgery is a safe and effective procedure that gives excellent functional and cosmetic results.

Cutaneous anthrax in an unusual location: case report.

PubMed

Sari, Tugba; Koruk, Suda Tekin

2015-12-01

Cutaneous anthrax is well known, unlike anthrax of the lumbar region, which is not reported elsewhere. We present a case of anthrax of the lumbar region in a 50-year-old man. The infection was characterised by a wide, black eschar and oedema on an erythematous ground. After isolation of the Gram-positive bacilli from the skin lesions, prompt antibiotic treatment (intravenous sulbactam-ampicillin 1.5 g every six hours) was initiated. Following eradication of the bacilli after 14 days of antibiotic treatment, a split-thickness skin graft was applied. A diagnosis of anthrax depends on clinical suspicion. Early diagnosis, antibiotic and surgical treatment can facilitate the treatment and prevent development of complications.

A soft X-ray beam-splitting multilayer optic for the NASA GEMS Bragg Reflection Polarimeter

DOE PAGES

Allured, Ryan; Kaaret, Philip; Fernandez-Perea, Monica; ...

2013-04-12

A soft X-ray, beam-splitting, multilayer optic has been developed for the Bragg Reflection Polarimeter (BRP) on the NASA Gravity and Extreme Magnetism Small Explorer Mission (GEMS). The optic is designed to reflect 0.5 keV X-rays through a 90° angle to the BRP detector, and transmit 2–10 keV X-rays to the primary polarimeter. The transmission requirement prevents the use of a thick substrate, so a 2 μm thick polyimide membrane was used. Atomic force microscopy has shown the membrane to possess high spatial frequency roughness less than 0.2 nm rms, permitting adequate X-ray reflectance. A multilayer thin film was especially developedmore » and deposited via magnetron sputtering with reflectance and transmission properties that satisfy the BRP requirements and with near-zero stress. Furthermore, reflectance and transmission measurements of BRP prototype elements closely match theoretical predictions, both before and after rigorous environmental testing.« less

A soft X-ray beam-splitting multilayer optic for the NASA GEMS Bragg Reflection Polarimeter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allured, Ryan; Kaaret, Philip; Fernandez-Perea, Monica

A soft X-ray, beam-splitting, multilayer optic has been developed for the Bragg Reflection Polarimeter (BRP) on the NASA Gravity and Extreme Magnetism Small Explorer Mission (GEMS). The optic is designed to reflect 0.5 keV X-rays through a 90° angle to the BRP detector, and transmit 2–10 keV X-rays to the primary polarimeter. The transmission requirement prevents the use of a thick substrate, so a 2 μm thick polyimide membrane was used. Atomic force microscopy has shown the membrane to possess high spatial frequency roughness less than 0.2 nm rms, permitting adequate X-ray reflectance. A multilayer thin film was especially developedmore » and deposited via magnetron sputtering with reflectance and transmission properties that satisfy the BRP requirements and with near-zero stress. Furthermore, reflectance and transmission measurements of BRP prototype elements closely match theoretical predictions, both before and after rigorous environmental testing.« less

Overheating instability of a thin conductor with respect to stratification

NASA Astrophysics Data System (ADS)

Garanin, S. F.; Kuznetsov, S. D.

2018-04-01

We consider an overheating instability of a thin (compared to the skin depth) conductor with respect to stratification at the stage when its resistivity rises up to an electrical explosion. Temperature perturbations under such conditions are shown to grow in proportion to resistivity. In the model, when resistivity is proportional to temperature, perturbations grow in proportion to temperature and hence exhibit no relative growth. For a conductor with initial thickness perturbations, temperature perturbations grow in proportion to resistivity and current action integral, i.e., somewhat faster than perturbations in the problem of constant thickness conductors. Comparison of our results with simulations of the growth of stratification during electrical heating of foils in warm dense matter generation systems demonstrates their close agreement.

A nonintrusive laser interferometer method for measurement of skin friction

NASA Technical Reports Server (NTRS)

Monson, D. J.

1983-01-01

A method is described for monitoring the changing thickness of a thin oil film subject to an aerodynamic shear stress using two focused laser beams. The measurement is then simply analyzed in terms of the surface skin friction of the flow. The analysis includes the effects of arbitrarily large pressure and skin friction gradients, gravity, and time varying oil temperature. It may also be applied to three dimensional flows with unknown direction. Applications are presented for a variety of flows, including two dimensional flows, three dimensional swirling flows, separated flow, supersonic high Reynolds number flows, and delta wing vortical flows. Previously announced in STAR as N83-12393

Genetically modified porcine split-thickness skin grafts as an alternative to allograft for provision of temporary wound coverage: preliminary characterization.

PubMed

Leto Barone, Angelo A; Mastroianni, Melissa; Farkash, Evan A; Mallard, Christopher; Albritton, Alexander; Torabi, Radbeh; Leonard, David A; Kurtz, Josef M; Sachs, David H; Cetrulo, Curtis L

2015-05-01

Temporary coverage of severely burned patients with cadaver allograft skin represents an important component of burn care, but is limited by availability and cost. Porcine skin shares many physical properties with human skin, but is susceptible to hyperacute rejection due to preformed antibodies to α-1,3-galactose (Gal), a carbohydrate on all porcine cells. Our preliminary studies have suggested that skin grafts from α-1,3-galactosyltransferase knock out (GalT-KO) miniature swine might provide temporary wound coverage comparable to allografts, since GalT-KO swine lack this carbohydrate. To further evaluate this possibility, eight non-human primates received primary autologous, allogeneic, GalT-KO, and GalT+xenogeneic skin grafts. Additionally, secondary grafts were placed to assess whether sensitization would affect the rejection time course of identical-type grafts. We demonstrate that both GalT-KO xenografts and allografts provide temporary coverage of partial- and full-thickness wounds for up to 11 days. In contrast, GalT+xenografts displayed hyperacute rejection, with no signs of vascularization and rapid avulsion from wounds. Furthermore, secondary GalT-KO transplants failed to vascularize, demonstrating that primary graft rejection sensitizes the recipient. We conclude that GalT-KO xenografts may provide temporary coverage of wounds for a duration equivalent to allografts, and thus, could serve as a readily available alternative treatment of severe burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Multilayer Ni/Fe thin films as oxygen evolution catalysts for solar fuel production

NASA Astrophysics Data System (ADS)

Biset-Peiró, M.; Murcia-López, S.; Fàbrega, C.; Morante, J. R.; Andreu, T.

2017-03-01

The slow kinetics and high overpotential of the oxygen evolution reaction is one of the main limiting factors to achieve the minimum required performances of the so-called photoelectrochemical water splitting systems. An oxygen evolution catalyst (OEC) becomes essential in order to perform this process with higher efficiency. Herein, we report the physical, optical and electrochemical characterization of multilayer Ni/Fe thin films as earth-abundant OEC, to avoid the use of platinum group metals (PGM). Uniform films of thicknesses ranging from 1 to 10 nm were fabricated by sequential and alternate thermal evaporation of Ni and Fe. It was found that the successive deposition allows the fabrication of a Ni terminated surface that does not need activation due to the Fe underlayer. The lowest overpotential achieved for NiFe was 370 mV at 10 mA cm-2 and a Tafel slope of 37 mV dec-1 with 1 nm thickness and 95% transmittance. Finally, NiFe OEC was implemented on top of Mo:BiVO4 photoanodes which resulted in a reduction of the open circuit potential of 0.2 V and up to five fold increase of the oxidation efficiency at 0.7 VRHE. The results presented facilitate the practical implementation of BiVO4 photoanodes in tandem configuration for bias free photoassisted water splitting.

External tissue expansion for difficult wounds using a simple cost effective technique.

PubMed

Nandhagopal, Vijayaraghavan; Chittoria, Ravi Kumar; Mohapatra, Devi Prasad; Thiruvoth, Friji Meethale; Sivakumar, Dinesh Kumar; Ashokan, Arjun

2015-01-01

To study and discuss role of external tissue expansion and wound closure (ETEWC) technique using hooks and rubber bands. The present study is a retrospective analysis of nine cases of wounds of different aetiology where ETEWC technique was applied using hooks and rubber bands. All the wounds in the study healed completely without split thickness skin graft (SSG) or flap. ETEWC technique using hooks and rubber bands is a cost-effective technique which can be used for wound closure without SSG or flap.

Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients.

PubMed

Salehi, Seyed Hamid; As'adi, Kamran; Mousavi, Seyed Jaber; Shoar, Saeed

2015-12-01

Although the recipient site in burn wounds is dressed with universally accepted materials, the ideal management of split-thickness skin donor sites remains controversial. The aim of our study is to compare two methods of wound dressing in donor sites of split-thickness skin graft in patients undergoing burn wound reconstructive surgery. Forty-two consecutive patients with second- and third-degree burns with a total body surface area between 20 and 40 % were enrolled in this randomized clinical trial conducted in Motahari Burn Hospital in Tehran, Iran. In each patient, two anatomic areas with similar features were randomly selected as intervention and control donor sites. The intervention site was dressed with amniotic membrane, whereas the control site was treated with Vaseline-impregnated gauze. Wounds were examined daily by expert surgeons to measure the clinical outcomes including duration of healing, severity of pain, and infection rate. The mean ± SD age of patients was 31.17 ± 13.72 years; furthermore, burn percentage had a mean ± SD of 31.19 ± 10.56. The mean ± SD of patients' cooperation score was 1.6 ± 0.79 in the intervention group compared with 2.93 ± 0.71 in the control group, revealing a statistically significant difference (P < 0.05). Duration of wound healing was significantly shorter (P < 0.05) in the intervention group (17.61 ± 2.56 days) compared with the control group (21.16 ± 3.45 days). However, there was no significant difference in terms of wound infection rate between donor sites in the control and intervention groups (P > 0.05). Amniotic membrane as an alternative for dressing of skin graft donor sites provides significant benefits by increasing patients' comfort via diminishing the number of dressing changes and facilitating the process of wound healing.

The origin and distribution of subbottom sediments in southern Lake Champlain.

USGS Publications Warehouse

Freeman-Lynde, R. P.; Hutchinson, D.R.; Folger, D.W.; Wiley, B.H.; Hewett, M.J.

1980-01-01

3 units, correlatable with recent Lake Champlain, late-glacial marine Champlain Sea, and proglacial Lake Vermont sediments, have been identified from seismic reflection profiles and 8 piston cores. Lake Vermont deposits are nonfossiliferous and range from thin to absent nearshore and on bedrock highs to more than 126 m thick near Split Rock Point. Champlain Sea sediments contain marine foraminifers and ostracodes and are fairly uniform in thickness (20-30 m). Recent Lake Champlain sediments range in thickness from 0 to 25 m. Average sedimentation rates for Lake Vermont are considerably higher (4-8 cm/yr) than those for the Champlain Sea (0.8-1.2 cm/yr) and Lake Champlain (0.14-0.15 cm/yr). Bedrock, till, and deltaic and alluvial deposits were also identified.- from Authors

Investigating backward scattered second harmonic generation from various mouse collagen tissues

NASA Astrophysics Data System (ADS)

Shen, Mengzhe; Tian, Yunxian; Chong, Shau Poh; Zhao, Jianhua; Zeng, Haishan; Tang, Shuo

2014-02-01

A confocal multiphoton microscopy system with various detection pinholes was used to differentiate backward scattered second harmonic generation (BS-SHG) from backward generated SHG (BG-SHG) based on the fact that BS-SHG is more scattered and therefore has a much bigger spot size than BG-SHG. BS-SHG is quantified from two types of mouse tissues, such as Achilles tendon, and skin, and at various focal depths. It is found that the BS-SHG contributes less to the total backward SHG for the skin than Achilles tendon with thicknesses of around three hundred micrometers. For tissue with larger F/B intensity ratio such as Achilles tendon, increasing the tissue thickness reduces it tremendously. However, for tissue with smaller F/B intensity ratio, tissue thickness increment does not alter it significantly. In addition, larger F/B intensity ratio might be related with a greater scattering coefficient from our Achilles tendon and skin comparison. When the focal point is moved deeper into tissue, the contribution of BS-SHG is found to decrease due to a reduced pass length of the forward propagated photons. On the contrary, when the tissue thickness increases, the contribution of the BS-SHG is increased. These observations for thicker skin tissues are related with our F/B intensity ratio measurement for thin mouse skin sample in terms of that the magnitude of backward generated SHG are dominant among the total backward SHG in mouse skin tissue. Considering the phase mismatching condition in the forward and backward directions, these results may indicate that quasi-phase matching originating from the regular structure of collagen could help with reducing the phase mismatch especially in the backward direction.

Thick-to-Thin Filament Surface Distance Modulates Cross-Bridge Kinetics in Drosophila Flight Muscle

PubMed Central

Tanner, Bertrand C.W.; Farman, Gerrie P.; Irving, Thomas C.; Maughan, David W.; Palmer, Bradley M.; Miller, Mark S.

2012-01-01

The demembranated (skinned) muscle fiber preparation is widely used to investigate muscle contraction because the intracellular ionic conditions can be precisely controlled. However, plasma membrane removal results in a loss of osmotic regulation, causing abnormal hydration of the myofilament lattice and its proteins. We investigated the structural and functional consequences of varied myofilament lattice spacing and protein hydration on cross-bridge rates of force development and detachment in Drosophila melanogaster indirect flight muscle, using x-ray diffraction to compare the lattice spacing of dissected, osmotically compressed skinned fibers to native muscle fibers in living flies. Osmolytes of different sizes and exclusion properties (Dextran T-500 and T-10) were used to differentially alter lattice spacing and protein hydration. At in vivo lattice spacing, cross-bridge attachment time (ton) increased with higher osmotic pressures, consistent with a reduced cross-bridge detachment rate as myofilament protein hydration decreased. In contrast, in the swollen lattice, ton decreased with higher osmotic pressures. These divergent responses were reconciled using a structural model that predicts ton varies inversely with thick-to-thin filament surface distance, suggesting that cross-bridge rates of force development and detachment are modulated more by myofilament lattice geometry than protein hydration. Generalizing these findings, our results suggest that cross-bridge cycling rates slow as thick-to-thin filament surface distance decreases with sarcomere lengthening, and likewise, cross-bridge cycling rates increase during sarcomere shortening. Together, these structural changes may provide a mechanism for altering cross-bridge performance throughout a contraction-relaxation cycle. PMID:22995500

Thick-to-Thin Filament Surface Distance Modulates Cross-Bridge Kinetics in Drosophila Flight Muscle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanner, Bertrand C.W.; Farman, Gerrie P.; Irving, Thomas C.

2012-09-19

The demembranated (skinned) muscle fiber preparation is widely used to investigate muscle contraction because the intracellular ionic conditions can be precisely controlled. However, plasma membrane removal results in a loss of osmotic regulation, causing abnormal hydration of the myofilament lattice and its proteins. We investigated the structural and functional consequences of varied myofilament lattice spacing and protein hydration on cross-bridge rates of force development and detachment in Drosophila melanogaster indirect flight muscle, using x-ray diffraction to compare the lattice spacing of dissected, osmotically compressed skinned fibers to native muscle fibers in living flies. Osmolytes of different sizes and exclusion propertiesmore » (Dextran T-500 and T-10) were used to differentially alter lattice spacing and protein hydration. At in vivo lattice spacing, cross-bridge attachment time (t{sub on}) increased with higher osmotic pressures, consistent with a reduced cross-bridge detachment rate as myofilament protein hydration decreased. In contrast, in the swollen lattice, t{sub on} decreased with higher osmotic pressures. These divergent responses were reconciled using a structural model that predicts t{sub on} varies inversely with thick-to-thin filament surface distance, suggesting that cross-bridge rates of force development and detachment are modulated more by myofilament lattice geometry than protein hydration. Generalizing these findings, our results suggest that cross-bridge cycling rates slow as thick-to-thin filament surface distance decreases with sarcomere lengthening, and likewise, cross-bridge cycling rates increase during sarcomere shortening. Together, these structural changes may provide a mechanism for altering cross-bridge performance throughout a contraction-relaxation cycle.« less

Skin dose measurement by using ultra-thin TLDs.

PubMed

Lin, J P; Chu, T C; Lin, S Y; Liu, M T

2001-09-01

The treatment schedule for radiation therapy is often interrupted because of complicated skin reactions. Quantitative information relating beam parameters and skin reactions will be helpful. Measurements were performed for 6-15 MV photons and 6-21 MeV electrons with ultra thin TLD films (GR-200F, surface area 0.5 x 0.5cm2, nominal thickness 5 mg cm(-2)). The skin doses for various field sizes, ranging from 10 x 10 to 40 x 40 cm2, and various incident angles of beam from 0 degrees to 80 degrees were measured. The ratios of skin dose to maximum dose in phantom for 10 x 10 cm2 are 16.10+/-0.68%, 14.03+/-1.04% and 10.59+/-0.64% for 6, 10 and 15 MV, respectively. Such ratios increase with a larger field size. For electrons the ratios are 72.59+/-1.72%, 78.52+/-2.99%, 78.89+/-2.86%, 86.08+/-2.62%. 87.75+/-1.94% and 86.33+/-3.09% for 6, 9, 12, 15, 18 and 21 MeV, respectively. They also increase with a larger size. The oblique factors also increase with larger incident angle.

Electronic and magnetic structure of ultra-thin Ni films grown on W(110)

NASA Astrophysics Data System (ADS)

Calloni, A.; Bussetti, G.; Berti, G.; Yivlialin, R.; Camera, A.; Finazzi, M.; Duò, L.; Ciccacci, F.

2016-12-01

We studied the electronic structure of thin Ni films grown on a W(110) single crystal, as a function of the Ni thickness, by means of angle-resolved photoemission and inverse photoemission spectroscopy, also with spin resolution. The results are discussed in the light of the different stages characterizing the transition from the pseudomorphic bcc to the fully relaxed fcc phase. A clear spin polarization is detected as soon as a bulk-like electronic structure is observed. In these conditions, we characterized the exchange splitting of the occupied bands at the Γbar and Mbar points of the surface Brillouin zone, providing further experimental support to previous interpretations of photoemission spectra from bulk Ni.

The AMBRE project: The thick thin disk and thin thick disk of the Milky Way

NASA Astrophysics Data System (ADS)

Hayden, M. R.; Recio-Blanco, A.; de Laverny, P.; Mikolaitis, S.; Worley, C. C.

2017-11-01

We analyze 494 main sequence turnoff and subgiant stars from the AMBRE:HARPS survey. These stars have accurate astrometric information from Gaia DR1, providing reliable age estimates with relative uncertainties of ±1 or 2 Gyr and allowing precise orbital determinations. The sample is split based on chemistry into a low-[Mg/Fe] sequence, which are often identified as thin disk stellar populations, and high-[Mg/Fe] sequence, which are often associated with thick disk stellar populations. We find that the high-[Mg/Fe] chemical sequence has extended star formation for several Gyr and is coeval with the oldest stars of the low-[Mg/Fe] chemical sequence: both the low- and high-[Mg/Fe] sequences were forming stars at the same time. We find that the high-[Mg/Fe] stellar populations are only vertically extended for the oldest, most-metal poor and highest [Mg/Fe] stars. When comparing vertical velocity dispersion for the low- and high-[Mg/Fe] sequences, the high-[Mg/Fe] sequence has lower vertical velocity dispersion than the low-[Mg/Fe] sequence for stars of similar age. This means that identifying either group as thin or thick disk based on chemistry is misleading. The stars belonging to the high-[Mg/Fe] sequence have perigalacticons that originate in the inner disk, while the perigalacticons of stars on the low-[Mg/Fe] sequence are generally around the solar neighborhood. From the orbital properties of the stars, the high-[Mg/Fe] and low-[Mg/Fe] sequences are most likely a reflection of the chemical enrichment history of the inner and outer disk populations, respectively; radial mixing causes both populations to be observed in situ at the solar position. Based on these results, we emphasize that it is important to be clear in defining what populations are being referenced when using the terms thin and thick disk, and that ideally the term thick disk should be reserved for purely geometric definitions to avoid confusion and be consistent with definitions in external galaxies.

Epidermal culture and grafting. A brief review.

PubMed

Muehleman, C; Wise, R D

1993-08-01

In summary, technological advances in culturing epidermis for the purpose of grafting allow this approach in the treatment of cutaneous wounds. Certainly, full- and split-thickness autografts offer immediate availability and permanent wound coverage, but they also involve a large, painful donor site. Cultured epidermal autografts can provide permanent wound coverage, but the delay required for cultivation of confluent sheets of keratinocytes makes them somewhat less desirable. Both allografts and cultured allografts, on the other hand, are available for immediate use, but the possibility of infectious disease transmission may be a concern. In any case, all types of skin grafts function as biological dressings that promote the proliferation of the host's epidermis and, thus, facilitate the ability of the patient's skin to repair itself.

Thin film surface modifications of thin/tunable liquid/gas diffusion layers for high-efficiency proton exchange membrane electrolyzer cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Zhenye; Mo, Jingke; Yang, Gaoqiang

We present that a proton exchange membrane electrolyzer cell (PEMEC) is one of the most promising devices for high-efficiency and low-cost energy storage and ultrahigh purity hydrogen production. As one of the critical components in PEMECs, the titanium thin/tunable LGDL (TT-LGDL) with its advantages of small thickness, planar surface, straight-through pores, and well-controlled pore morphologies, achieved superior multifunctional performance for hydrogen and oxygen production from water splitting even at low temperature. Different thin film surface treatments on the novel TT-LGDLs for enhancing the interfacial contacts and PEMEC performance were investigated both in-situ and ex-situ for the first time. Surface modifiedmore » TT-LGDLs with about 180 nm thick Au thin film yielded performance improvement (voltage reduction), from 1.6849 V with untreated TT-LGDLs to only 1.6328 V with treated TT-LGDLs at 2.0 A/cm 2 and 80°C. Furthermore, the hydrogen/oxygen production rate was increased by about 28.2% at 1.60 V and 80°C. The durability test demonstrated that the surface treated TT-LGDL has good stability as well. Finally, the gold electroplating surface treatment is a promising method for the PEMEC performance enhancement and titanium material protection even in harsh environment.« less

Thin film surface modifications of thin/tunable liquid/gas diffusion layers for high-efficiency proton exchange membrane electrolyzer cells

DOE PAGES

Kang, Zhenye; Mo, Jingke; Yang, Gaoqiang; ...

2017-09-14

We present that a proton exchange membrane electrolyzer cell (PEMEC) is one of the most promising devices for high-efficiency and low-cost energy storage and ultrahigh purity hydrogen production. As one of the critical components in PEMECs, the titanium thin/tunable LGDL (TT-LGDL) with its advantages of small thickness, planar surface, straight-through pores, and well-controlled pore morphologies, achieved superior multifunctional performance for hydrogen and oxygen production from water splitting even at low temperature. Different thin film surface treatments on the novel TT-LGDLs for enhancing the interfacial contacts and PEMEC performance were investigated both in-situ and ex-situ for the first time. Surface modifiedmore » TT-LGDLs with about 180 nm thick Au thin film yielded performance improvement (voltage reduction), from 1.6849 V with untreated TT-LGDLs to only 1.6328 V with treated TT-LGDLs at 2.0 A/cm 2 and 80°C. Furthermore, the hydrogen/oxygen production rate was increased by about 28.2% at 1.60 V and 80°C. The durability test demonstrated that the surface treated TT-LGDL has good stability as well. Finally, the gold electroplating surface treatment is a promising method for the PEMEC performance enhancement and titanium material protection even in harsh environment.« less

Preliminary results in single-step wound closure procedure of full-thickness facial burns in children by using the collagen-elastin matrix and review of pediatric facial burns.

PubMed

Demircan, Mehmet; Cicek, Tugrul; Yetis, Muhammed Ikbal

2015-09-01

Management of full-thickness facial burns remains one of the greatest challenges. Controversy exists among surgeons regarding the use of early excision for facial burns. Unfortunately, delayed excision of deeper burns often results in more scarring and subsequent reconstruction becomes more difficult. A collagen-elastin matrix is used to improve the quality of the reconstructed skin, to reduce scarring and to prevent wound contraction. It serves as a foundation for split thickness skin graft and enhances short and long-term results. We report the usage of a collagen-elastin matrix during single-step wound closure technique of severe full-thickness facial burns in 15 children with large burned body surface area, and also we review the literature about pediatric facial burns. There were 15 pediatric patients with severe facial burns, 8 girls and 7 boys ranging in age from 10 months to 12 years, mean age 7 years and 6 months old. The facial burn surface area (FBSA) among the patients includes seven patients with 100%, five with 75%, and three with 50%. The average total body surface area (TBSA) for the patients was 72%, ranging between 50 and 90%. 5 of the patients' admissions were late, more than four days after burns while the rest of the patients were admitted within the first four days (acute admission time). The burns were caused by flame in eight of the patients, bomb blast in four, and scalding in three. All patients were treated by the simultaneous application of the collagen-elastin matrix and an unmeshed split thickness skin graft at Turgut Özal Medical Center, Pediatric Burn Center, Malatya, Turkey. After the treatment only two patients needed a second operation for revision of the grafts. All grafts transplanted to the face survived. The average Vancouver scar scales (VSS) were 2.55±1.42, ranging between one and six, in the first 10 of 15 patients at the end of 6 months postoperatively. VSS measurements of the last 5 patients were not taken since the 6 months postoperative period was not over. In regard to early results, graft quality was close to normal skin in terms of vascularity, elasticity, pliability, texture and color. Esthetic and functional results have been encouraging. This study shows us that the collagen-elastin matrix as a dermal substitute is a useful adjunct, which may result in quick healing with satisfying esthetic and functional results. It also may enhance short and long-term results in after burn facial wound closure in children. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Mechanisms of crustal shortening in the foreland of the central Andes, Argentina: insights from data-driven three-dimensional gravity, thermal and rheological modelling

NASA Astrophysics Data System (ADS)

Meeßen, Christian; Scheck-Wenderoth, Magdalena; Sippel, Judith; Strecker, Manfred

2017-04-01

Thin- and thick-skinned deformation styles in the foreland of the central Andes are the result of ongoing crustal shortening since the early Neogene. The mechanisms proposed for these different styles range from variations in subduction angle of the Nazca plate, lithospheric thickening to variations in temperature and strength of the crystalline crust. The latter hypothesis states a cold and strong lithosphere in the foreland of the Altiplano Plateau, facilitating thin-skinned shortening. In contrast, the foreland of the Puna plateau is proposed to be characterized by a warm lithosphere and strong upper crust, resulting in thick-skinned deformation. Whilst this hypothesis has been confirmed in numerical thermomechanical experiments, there is no evidence for this mechanism from data integrative modelling. We test this hypothesis by means of three-dimensional data integrative gravity, thermal and rheological modelling. Therefore, we constructed a lithospheric-scale density model of the foreland of northern Argentina and southern Bolivia using gravity forward modelling and inversion techniques. Into this density model we implemented sediment isopachs, data from receiver functions and densities from shear-wave velocities of the upper mantle. The model was verified using the observed Bouguer gravity anomaly. By assigning thermal and rheological properties to the modelled units we are able to quantify the strength of the lithosphere and test the predictions by the thermomechanical models.

Preservation of anal function after total excision of the anal mucosa for Bowen's disease.

PubMed Central

Reynolds, V H; Madden, J J; Franklin, J D; Burnett, L S; Jones, H W; Lynch, J B

1984-01-01

Six women with Bowen's disease of the anogenital area were treated by total excision of the anal mucosa, perianal skin and, in some cases, partial vulvectomy. Two patients had foci of microinvasive squamous carcinoma. Adequate tumor margins were determined by frozen sections. The resulting mucosal and cutaneous defects were grafted with medium split-thickness skin grafts applied to the anal canal and sutured circumferentially to the rectal mucosa. Grafts were held in place by a finger cot inserted in the anal canal and stuffed with cotton balls. Patients were constipated five or six days with codeine. The skin grafts healed per primam. One additional patient was similarly treated for a chronic herpetic ulceration of the anus and healed. Contrary to dire predictions, all patients were able to distinguish between gaseous and solid rectal contents and sphincter function was preserved. In one patient, Bowen's disease has recurred in the grafted perianal skin. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:6372711

Coal deposits of the Hedstrom Lake area, McCone, Garfield, Prairie, Custer, and Rosebud counties, Montana

USGS Publications Warehouse

Wincentsen, Herbert

1979-01-01

The Hedstrom Lake area is located on the southwestern flank of the Williston basin, which is a major structural feature in eastern Montana and western North Dakota. Locally, the rocks have a structural high in T. 12 N., R. 47 E., a structural low in T. 18 N., R. 46 E., and a maximum structural relief of more than 700 ft. The exposed rocks in most of the area are part of the Tongue River Member of the Paleocene Fort Union Formation. The Tongue River Member consists of interbedded siltstone, sandstone, shale, and coal. In ascending order, the five main or principal coal beds are the S, Haughins, R, Q, and Rogers. The S bed ranges in thickness from 0 to 11 ft. The Haughins bed is usually a single bed 2-10 ft thick; in the southern part of the area, it splits into two benches which have a total thickness of 12 ft. The R bed is thin in most of the area, but in the northern part it attains a thickness of 9 ft.. The Q bed occurs at about the same horizon as the Rogers bed, but the drilling control and surface mapping are insufficient for correlation. The Rogers bed has a maximum thickness of 17.1 ft in sec. 15, T. 13N., R. 47 E., but thins rapidly to the northwest.

Structure of the Lithosphere and Upper Mantle Across the Arabian Peninsula

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Amri, A; Rodgers, A

2007-01-05

Analysis of modern broadband (BB) waveform data allows for the inference of seismic velocity structure of the crust and upper mantle using a variety of techniques. This presentation will report inferences of seismic structure of the Arabian Plate using BB data from various networks. Most data were recorded by the Saudi Arabian National Digital Seismic Network (SANDSN) which consists of 38 (26 BB, 11 SP) stations, mostly located on the Arabian Shield. Additional data were taken from the 1995-7 Saudi Arabian IRIS-PASSCAL Deployment (9 BB stations) and other stations across the Peninsula. Crustal structure, inferred from teleseismic P-wave receiver functions,more » reveals thicker crust in the Arabian Platform (40-45 km) and the interior of the Arabian Shield (35-40 km) and thinner crust along the Red Sea coast. Lithospheric thickness inferred from teleseismic S-wave receiver functions reveals very thin lithosphere (40-80 km) along the Red Sea coast which thickens rapidly toward the interior of the Arabian Shield (100-120 km). We also observe a step of 20-40 km in lithospheric thickness across the Shield-Platform boundary. Seismic velocity structure of the upper mantle inferred from teleseismic P- and S-wave travel time tomography reveals large differences between the Shield and Platform, with the Shield being underlain by slower velocities, {+-}3% for P-waves and {+-}6% for S-waves. Seismic anisotropy was inferred from shear-wave splitting, using teleseismic SKS waveforms. Results reveal a splitting time of approximately 1.4 seconds, with the fast axis slightly east of north. The shear-wave splitting results are consistent across the Peninsula, with a slight clockwise rotation parallel for stations near the Gulf of Aqaba. In summary, these results allow us to make several conclusions about the tectonic evolution and current state of the Arabian Plate. Lithospheric thickness implies that thinning near the Red Sea has accompanied the rupturing of the Arabian-Nubian continental lithosphere. The step in the lithospheric thickness across the Shield-Platform boundary likely reveals a pre-existing difference in the lithospheric structure prior to accretion of the terranes composing the eastern Arabian Shield. Tomographic imaging of upper mantle velocities implies a single large-scale thermal anomaly underlies the Arabian Shield and is associated with Cenozoic uplift and volcanism.« less

Skin Friction Measurements Using Luminescent Oil Films

NASA Astrophysics Data System (ADS)

Husen, Nicholas M.

As aircraft are designed to a greater extent on computers, the need for accurate and fast CFD algorithms has never been greater. The development of CFD algorithms requires experimental data against which CFD output can be validated and from which insight about flow physics can be acquired. Skin friction, in particular, is an important quantity to predict with CFD, and experimental skin friction data sets aid not only with the validation of the CFD predictions, but also in tuning the CFD models to predict specific flow fields. However, a practical experimental technique for collecting spatially and temporally resolved skin friction data on complex models does not yet exist. This dissertation develops and demonstrates a new luminescent oil film skin friction meter which can produce spatially-resolved quantitative steady and unsteady skin friction data on models with complex curvature. The skin friction acting on the surface of a thin film of oil can be approximated by the expression tauw =mu ouh/h, where mu o is the dynamic viscosity of the oil, uh is the velocity of the surface of the oil film, and h is the thickness of the oil film. The new skin friction meter determines skin friction by measuring h and uh. The oil film thickness h is determined by ratioing the intensity of the fluorescent emissions from the oil film with the intensity of the incident light which is scattered from the surface of the model. When properly calibrated, that ratio provides an absolute oil film thickness value. This oil film thickness meter is therefore referred as the Ratioed-Image Film-Thickness (RIFT) Meter. The oil film velocity uh is determined by monitoring the evolution of tagged molecules within the oil film: Photochromic molecules are dissolved into the fluorescent oil and a pattern is written into the oil film using an ultraviolet laser. The evolution of the pattern is recorded, and standard cross-correlation techniques are applied to the resulting sequence of images. This newly developed skin friction meter is therefore called the Luminescent Oil Film Flow-Tagging skin friction meter, or the LOFFT skin friction meter. The LOFFT skin friction meter is demonstrated by collecting time-averaged skin friction measurements on NASA's FAITH model and by collecting unsteady skin friction measurements with a frequency response of 600Hz. Higher frequency response is possible and is dependent on the experimental setup. This dissertation also contributes to the work done on the Global Luminescent Oil Film Skin Friction Meter (GLOFSFM) by noting that the technique could be influenced by ripples at the oil-air interface. An experiment studying the evolution of ripples at the oil-air interface was conducted to determine under what oil film conditions the GLOFSFM can be appropriately applied. The RIFT meter was crucial for this experiment, as it facilitated quantitative distributed oil film thickness measurements during the wind-tunnel run. The resulting data set is rich in content, permitting the computation of mean wavelengths, peak-to-trough ripple heights, wave speeds, and mean thicknesses. In addition to determining under what oil film conditions the GLOFSFM may be applied, this experiment directly determined the oil film conditions under which the velocity of the ripples may be used to proxy the velocity of the oil film surface. The RIFT meter and the ability to determine oil film surface velocity by monitoring ripple velocities admit yet another time-averaged skin friction meter, the Fluorescent-Oil Ripple-Velocity (FORV) skin friction meter. The FORV skin friction meter recovers skin friction as tau w = muovrip/H, where vrip is the velocity of the ripples, and H is the oil film thickness averaged over the thickness fluctuations due to the ripples. The FORV skin friction meter is demonstrated on NASA's FAITH model.

Complete horizontal skin cell resurfacing and delayed vertical cell infiltration into porcine reconstructive tissue matrix compared to bovine collagen matrix and human dermis.

PubMed

Mirastschijski, Ursula; Kerzel, Corinna; Schnabel, Reinhild; Strauss, Sarah; Breuing, Karl-Heinz

2013-10-01

Xenogenous dermal matrices are used for hernia repair and breast reconstruction. Full-thickness skin replacement is needed after burn or degloving injuries with exposure of tendons or bones. The authors used a human skin organ culture model to study whether porcine reconstructive tissue matrix (Strattice) is effective as a dermal tissue replacement. Skin cells or split-thickness skin grafts were seeded onto human deepidermized dermis, Strattice, and Matriderm. Cellular resurfacing and matrix infiltration were monitored by live fluorescence imaging, histology, and electron microscopy. Proliferation, apoptosis, cell differentiation, and adhesion were analyzed by immunohistochemistry. Epithelial resurfacing and vertical proliferation were reduced and delayed with both bioartificial matrices compared with deepidermized dermis; however, no differences in apoptosis, cell differentiation, or basement membrane formation were found. Vertical penetration was greatest on Matriderm, whereas no matrix infiltration was found on Strattice in the first 12 days. Uncompromised horizontal resurfacing was greatest with Strattice but was absent with Matriderm. Strattice showed no stimulatory effect on cellular inflammation. Matrix texture and surface properties governed cellular performance on tissues. Although dense dermal compaction delayed vertical cellular ingrowth for Strattice, it allowed uncompromised horizontal resurfacing. Dense dermal compaction may slow matrix decomposition and result in prolonged biomechanical stability of the graft. Reconstructive surgeons should choose the adequate matrix substitute depending on biomechanical requirements at the recipient site. Strattice may be suitable as a dermal replacement at recipient sites with high mechanical load requirements.

Surface-supported metal-organic framework thin films: fabrication methods, applications, and challenges.

PubMed

Liu, Jinxuan; Wöll, Christof

2017-10-02

Surface-supported metal-organic framework thin films are receiving increasing attention as a novel form of nanotechnology. New deposition techniques that enable the control of the film thickness, homogeneity, morphology, and dimensions with a huge number of metal-organic framework compounds offer tremendous opportunities in a number of different application fields. In response to increasing demands for environmental sustainability and cleaner energy, much effort in recent years has been devoted to the development of MOF thin films for applications in photovoltaics, CO 2 reduction, energy storage, water splitting, and electronic devices, as well as for the fabrication of membranes. Although existing applications are promising and encouraging, MOF thin films still face numerous challenges, including the need for a more thorough understanding of the thin-film growth mechanism, stability of the internal and external interfaces, strategies for doping and models for charge carrier transport. In this paper, we review the recent advances in MOF thin films, including fabrication and patterning strategies and existing nanotechnology applications. We conclude by listing the most attractive future opportunities as well as the most urgent challenges.

Mössbauer Magnetic Scan experiments

NASA Astrophysics Data System (ADS)

Pasquevich, G. A.; Mendoza Zélis, P.; Lencina, A.; Veiga, A.; Fernández van Raap, M. B.; Sánchez, F. H.

2014-06-01

We report an application of the Mössbauer Effect designed to retrieve specific information on the magnetic response of iron-containing materials. It consists in the measurement of the nuclear absorption of gamma-rays as a function of an external magnetic field for a specific nuclear transition between magnetically-split nuclear levels. The experiments, here termed Mössbauer Magnetic Scan experiments, were carried out recording the absorption of 57Fe 14.4 keV gamma-ray in α-Fe at constant Doppler energies coincident with some of the spectral lines of the magnetically split Mössbauer spectrum. Due to the dependence of the transition probabilities on the relative orientation between the nuclear magnetic moment and the gamma-ray direction, the present application results in a useful method to study the magnetic-field evolution of the distribution of atomic-magnetic-moment orientations. The proposed technique inherit from the Mössbauer Spectroscopy the chemical-element selectiveness as well as the ability to differentiate responses from iron atoms located at inequivalent site or at different phases. In this work, we show that the data analysis for these experiments depends on the sample thickness that the gamma-ray has to cross. For thin samples (i.e.samples with Mössbauer effective thicknesses lower than one) the magnetic-field dependence of the second-order-moment of the orientation distribution in the direction of the gamma ray is obtained. On the other hand, for thicker samples, although the data analysis is more complex, the dependences of the three second-order-moments of the orientation distribution are obtained. The experiments were performed on two α-Fe foils of different Mössbauer effective thicknesses. They were chosen to represent the cases of thin and thick Mössbauer absorbers. The magnetic evolution of the orientations distribution is compared with results obtained from magnetometric measurements showing a good agreement as well indicating the complementarity of both techniques. A complete description of the experimental set up and the formalism for Mössbauer Magnetic Scan data analysis are presented.

Systematic approach to study of thinly and thickly sectioned melanoma tissues with scanning acoustic microscopy

NASA Astrophysics Data System (ADS)

Miyasaka, C.; Tittmann, B. R.; Tutwiler, R.; Tian, Y.; Maeva, E.; Shum, D.

2010-03-01

The present study is to investigate the feasibility of applying in-vivo acoustic microscopy to the analysis of cancerous tissue. The study was implemented with mechanical scanning reflection acoustic microscope (SAM) by the following procedures. First, we ultrasonically visualized thick sections of normal and tumor tissues to determine the lowest transducer frequency required for cellular imaging. We used skin for normal tissue and the tumor was a malignant melanoma. Thin sections of the tissue were also studied with the optical and high-frequency-ultrasonic imaging for pathological evaluation. Secondly, we ultrasonically visualized subsurface cellular details of thin tissue specimens with different modes (i.e., pulse and tone-burst wave modes) to obtain the highest quality ultrasonic images. The objective is to select the best mode for the future design of a future SAM for in-vivo examination. Thirdly, we developed a mathematical modeling technique based on an angular spectrum approach for improving image processing and comparing numerical to experimental results.

Functional respiratory morphology in the newborn quokka wallaby (Setonix brachyurus)

PubMed Central

Makanya, A N; Tschanz, S A; Haenni, B; Burri, P H

2007-01-01

A morphological and morphometric study of the lung of the newborn quokka wallaby (Setonix brachyurus) was undertaken to assess its morphofunctional status at birth. Additionally, skin structure and morphometry were investigated to assess the possibility of cutaneous gas exchange. The lung was at canalicular stage and comprised a few conducting airways and a parenchyma of thick-walled tubules lined by stretches of cuboidal pneumocytes alternating with squamous epithelium, with occasional portions of thin blood–gas barrier. The tubules were separated by abundant intertubular mesenchyme, aggregations of developing capillaries and mesenchymal cells. Conversion of the cuboidal pneumocytes to type I cells occurred through cell broadening and lamellar body extrusion. Superfluous cuboidal cells were lost through apoptosis and subsequent clearance by alveolar macrophages. The establishment of the thin blood–gas barrier was established through apposition of the incipient capillaries to the formative thin squamous epithelium. The absolute volume of the lung was 0.02 ± 0.001 cm3 with an air space surface area of 4.85 ± 0.43 cm2. Differentiated type I pneumocytes covered 78% of the tubular surface, the rest 22% going to long stretches of type II cells, their precursors or low cuboidal transitory cells with sparse lamellar bodies. The body weight-related diffusion capacity was 2.52 ± 0.56 mL O2 min−1 kg−1. The epidermis was poorly developed, and measured 29.97 ± 4.88 µm in thickness, 13% of which was taken by a thin layer of stratum corneum, measuring 4.87 ± 0.98 µm thick. Superficial capillaries were closely associated with the epidermis, showing the possibility that the skin also participated in some gaseous exchange. Qualitatively, the neonate quokka lung had the basic constituents for gas exchange but was quantitatively inadequate, implying the significance of percutaneous gas exchange. PMID:17553103

Efficacy and Safety of the Collagenase of the Bacterium Clostridium Histolyticum for the Treatment of Capsular Contracture after Silicone Implants: Ex-Vivo Study on Human Tissue.

PubMed

Fischer, Sebastian; Hirche, Christoph; Diehm, Yannick; Nuutila, Kristo; Kiefer, Jurij; Gazyakan, Emre; Bueno, Ericka M; Kremer, Thomas; Kneser, Ulrich; Pomahac, Bohdan

2016-01-01

The fibrotic capsule that surrounds silicone implants consists mainly of collagen. The FDA-approved collagenase of the bacterium clostridium histolyticum provides a reasonable treatment option. Safety and efficacy at the female breast site must be evaluated before clinical utilization. We incubated 20 samples of fibrotic capsule as well as 12 full thickness skin grafts harvested from the female breast site for 24 hours with different doses of collagenase. Outcome measures involved histological assessment of thickness and density of the capsule tissue as well as the skin grafts. Furthermore, we performed a collagen assay and immunohistochemistry staining for collagen subtypes. Collagenase treatment was able to degrade human capsule contracture tissue ex-vivo. The remaining collagen subtype after degradation was type 4 only. 0.3 mg/ml of collagenase was most effective in reducing capsule thickness when compared with higher concentrations. Of note, effectiveness was inversely related to capsule density, such that there was less reduction in thickness with higher capsule densities and vice versa. Furthermore, the application of 0.3mg/ml collagenase did not lead to thinning or perforation of full thickness skin grafts. Adjustment of collagenase dose will depend on thickness and density of the contracted capsule. A concentration of 0.3mg/ml seems to be safe and effective in an ex-vivo setting. The remaining collagen subtype 4 is suitable to serve as a neo-capsule/acellular tissue matrix. Collagenase treatment for capsular contracture may soon become a clinical reality.

Honey: A Skin Graft Fixator Convenient for Both Patient and Surgeon.

PubMed

Maghsoudi, Hemmat; Moradi, Sohrab

2015-12-01

Skin grafts can be used effectively to cover burn injuries. A critical element of this treatment is the adherence of the graft to the wound bed. Honey has been shown to increase the adherence of skin grafts to wound beds and have antibacterial and anti-inflammatory effects and increase healing rate of wounds. We therefore devised a clinical trial to determine the effect of honey on skin graft fixation in burn injuries. Sixty patients were included in this study (in 30 patients, graft was fixed with medical honey, and in 30 patients, it was fixed with dressing or suturing). All patients in two groups were evaluated for infection, graft loss, graft contraction, severity of pain, and need for re-operation. The most common cause of burn was kerosene. Honey significantly decreased infection rate on fifth day and reduced the patient pain. The mean hospital stay was shorter in honey group. Contraction of graft was significantly less in honey group. Honey has strong adhesive properties for skin graft fixation. Medical honey is a natural material, not synthetic. For this reason, we can advise the application of medical honey for the fixation of split thickness skin graft.

Electrical burns of the abdomen.

PubMed

Srivastava, Rakesh Kumar; Kumar, Ritesh

2013-09-01

A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

Enhancing the transdermal delivery of rigid nanoparticles using the simultaneous application of ultrasound and sodium lauryl sulfate

PubMed Central

Lopez, Renata F.V.; Seto, Jennifer E.; Blankschtein, Daniel; Langer, Robert

2010-01-01

The potential of rigid nanoparticles to serve as transdermal drug carriers can be greatly enhanced by improving their skin penetration. Therefore, the simultaneous application of ultrasound and sodium lauryl sulfate (referred to as US/SLS) was evaluated as a skin pre-treatment method for enhancing the passive transdermal delivery of nanoparticles. We utilized inductively-coupled plasma mass spectrometry and an improved application of confocal microscopy to compare the delivery of 10- and 20-nm cationic, neutral, and anionic quantum dots (QDs) into US/SLS-treated and untreated pig split-thickness skin. Our findings include: (a) ~0.01% of the QDs penetrate the dermis of untreated skin (which we quantify for the first time), (b) the QDs fully permeate US/SLS-treated skin, (c) the two cationic QDs studied exhibit different extents of skin penetration and dermal clearance, and (d) the QD skin penetration is heterogeneous. We discuss routes of nanoparticle skin penetration and the application of the methods described herein to address conflicting literature reports on nanoparticle skin penetration. We conclude that US/SLS treatment significantly enhances QD transdermal penetration by 500–1300%. Our findings suggest that an optimum surface charge exists for nanoparticle skin penetration, and motivate the application of nanoparticle carriers to US/SLS-treated skin for enhanced transdermal drug delivery. PMID:20971504

Enhancing the transdermal delivery of rigid nanoparticles using the simultaneous application of ultrasound and sodium lauryl sulfate.

PubMed

Lopez, Renata F V; Seto, Jennifer E; Blankschtein, Daniel; Langer, Robert

2011-01-01

The potential of rigid nanoparticles to serve as transdermal drug carriers can be greatly enhanced by improving their skin penetration. Therefore, the simultaneous application of ultrasound and sodium lauryl sulfate (referred to as US/SLS) was evaluated as a skin pre-treatment method for enhancing the passive transdermal delivery of nanoparticles. We utilized inductively coupled plasma mass spectrometry and an improved application of confocal microscopy to compare the delivery of 10- and 20-nm cationic, neutral, and anionic quantum dots (QDs) into US/SLS-treated and untreated pig split-thickness skin. Our findings include: (a) ∼0.01% of the QDs penetrate the dermis of untreated skin (which we quantify for the first time), (b) the QDs fully permeate US/SLS-treated skin, (c) the two cationic QDs studied exhibit different extents of skin penetration and dermal clearance, and (d) the QD skin penetration is heterogeneous. We discuss routes of nanoparticle skin penetration and the application of the methods described herein to address conflicting literature reports on nanoparticle skin penetration. We conclude that US/SLS treatment significantly enhances QD transdermal penetration by 500-1300%. Our findings suggest that an optimum surface charge exists for nanoparticle skin penetration, and motivate the application of nanoparticle carriers to US/SLS-treated skin for enhanced transdermal drug delivery. Copyright © 2010 Elsevier Ltd. All rights reserved.

Thick Smear is a Good Substitute for the Thin Smear in Parasitological Confirmation of Canine Visceral Leishmaniasis.

PubMed

de Mello, Cintia Xavier; Figueiredo, Fabiano Borges; Mendes Júnior, Artur Augusto Velho; Miranda, Luciana de Freitas Campos; de Oliveira, Raquel de Vasconcellos Carvalhaes; Madeira, Maria de Fátima

2016-07-06

Although direct examination methods are important for diagnosing leishmaniasis, such methods are often neglected because of their low sensitivity relative to other techniques. Our study aimed to evaluate the performance of bone marrow (BM) thick smears and cytocentrifugation tests as alternatives to direct examination for diagnosing canine visceral leishmaniasis (CVL). Ninety-two dogs exhibiting leishmaniasis seroreactivity were evaluated. The animals were euthanized; and healthy skin, spleen, popliteal lymph node, and BM puncture samples were cultured. BM cultures were used as the reference standard. Of the 92 dogs studied, 85.9% exhibited positive cultures, and Leishmania infantum (synonym Leishmania chagasi) was confirmed in all positive culture cases. The sensitivity rates for cytocentrifugation as well as thin and thick smears were 47.1%, 52.8%, and 77%, respectively. However, no association between the dogs' clinical status and culture or direct examination results was found. To our knowledge, this was the first study to use thick smears and cytocentrifugation for diagnosing CVL. Our results indicate that BM thick smears have a good sensitivity and their use reduces the time required to read slides. Therefore, thick smears can provide a rapid and safe alternative to parasitological confirmation of seroreactive dogs. © The American Society of Tropical Medicine and Hygiene.

Intermediate surface structure between step bunching and step flow in SrRuO3 thin film growth

NASA Astrophysics Data System (ADS)

Bertino, Giulia; Gura, Anna; Dawber, Matthew

We performed a systematic study of SrRuO3 thin films grown on TiO2 terminated SrTiO3 substrates using off-axis magnetron sputtering. We investigated the step bunching formation and the evolution of the SRO film morphology by varying the step size of the substrate, the growth temperature and the film thickness. The thin films were characterized using Atomic Force Microscopy and X-Ray Diffraction. We identified single and multiple step bunching and step flow growth regimes as a function of the growth parameters. Also, we clearly observe a stronger influence of the step size of the substrate on the evolution of the SRO film surface with respect to the other growth parameters. Remarkably, we observe the formation of a smooth, regular and uniform ``fish skin'' structure at the transition between one regime and another. We believe that the fish skin structure results from the merging of 2D flat islands predicted by previous models. The direct observation of this transition structure allows us to better understand how and when step bunching develops in the growth of SrRuO3 thin films.

A Comparative Study of the ReCell® Device and Autologous Spit-thickness Meshed Skin Graft in the Treatment of Acute Burn Injuries.

PubMed

Holmes, J H; Molnar, J A; Carter, J E; Hwang, J; Cairns, B A; King, B T; Smith, D J; Cruse, C W; Foster, K N; Peck, M D; Sood, R; Feldman, M J; Jordan, M H; Mozingo, D W; Greenhalgh, D G; Palmieri, T L; Griswold, J A; Dissanaike, S; Hickerson, W L

2018-05-24

Early excision and autografting are standard care for deeper burns. However, donor sites are a source of significant morbidity. To address this, the ReCell® Autologous Cell Harvesting Device (ReCell) was designed for use at the point-of-care to prepare a non-cultured, autologous skin cell suspension (ASCS) capable of epidermal regeneration utilizing minimal donor skin. A prospective study was conducted to evaluate the clinical performance of ReCell versus meshed split-thickness skin grafts (STSG, Control) for the treatment of deep partial-thickness (DPT) burns. Effectiveness measures were assessed to 1 year for both ASCS and Control treatment sites and donor sites, including the incidence of healing, scarring, and pain. At 4 weeks, 98% of the ASCS-treated sites were healed compared to 100% of the Controls. Pain and assessments of scarring at the treatment sites were reported to be similar between groups. Significant differences were observed between ReCell and Control donor sites. The mean ReCell donor area was approximately 40 times smaller than that of the Control (194.1±158.5 cm2; p<0.0001), and after 1 week, significantly more ReCell donor sites were healed than Controls (p=0.04). Over the first 16 weeks, patients reported significantly less pain at the ReCell donor sites compared with Controls (p≤0.05 at each time point). Long-term, patients reported higher satisfaction with ReCell donor site outcomes compared with the Controls. This study provides evidence that the treatment of DPT burns with ASCS results in comparable healing, with significantly reduced donor site size and pain and improved appearance relative to STSG.

Low-level laser therapy (LLLT) does not reduce subcutaneous adipose tissue by local adipocyte injury but rather by modulation of systemic lipid metabolism.

PubMed

Jankowski, Marek; Gawrych, Mariusz; Adamska, Urszula; Ciescinski, Jakub; Serafin, Zbigniew; Czajkowski, Rafal

2017-02-01

Low-level laser (light) therapy (LLLT) has been applied recently to body contouring. However the mechanism of LLLT-induced reduction of subcutaneous adipose tissue thickness has not been elucidated and proposed hypotheses are highly controversial. Non-obese volunteers were subject to 650nm LLLT therapy. Each patient received 6 treatments 2-3 days apart to one side of the abdomen. The contralateral side was left untreated and served as control. Subjects' abdominal adipose tissue thickness was measured by ultrasound imaging at baseline and 2 weeks post-treatment. Our study is to the best of our knowledge, the largest split-abdomen study employing subcutaneous abdominal fat imaging. We could not show a statistically significant reduction of abdominal subcutaneous adipose tissue by LLLT therapy. Paradoxically when the measurements of the loss of fat thickness on treated side was corrected for change in thickness on non treated side, we have observed that in 8 out of 17 patients LLLT increased adipose tissue thickness. In two patients severe side effect occurred as a result of treatment: one patient developed ulceration within appendectomy scar, the other over the posterior superior iliac spine. The paradoxical net increase in subcutaneous fat thickness observed in some of our patients is a rationale against liquefactive and transitory pore models of LLLT-induced adipose tissue reduction. LLLT devices with laser diode panels applied directly on the skin are not as safe as devices with treatment panels separated from the patient's skin.

Elevated-Temperature Tests Under Static and Aerodynamic Conditions on Honeycomb-Core Sandwich Panels

NASA Technical Reports Server (NTRS)

Groen, Joseph M.; Johnson, Aldie E., Jr.

1959-01-01

Stainless-steel honeycomb-core sandwich panels which differed primarily in skin thicknesses were tested at elevated temperatures under static and aerodynamic conditions. The results of these tests were evaluated to determine the insulating effectiveness and structural integrity of the panels. The static radiant-heating tests were performed in front of a quartz-tube radiant heater at panel skin temperatures up to 1,5000 F. The aerodynamic tests were made in a Mach 1.4 heated blowdown wind tunnel. The tunnel temperature was augmented by additional heat supplied by a radiant heater which raised the panel surface temperature above 8000 F during air flow. Static radiant-heating tests of 2 minutes duration showed that all the panels protected the load-carrying structure about equally well. Thin-skin panels showed an advantage for this short-time test over thick-skin panels from a standpoint of weight against insulation. Permanent inelastic strains in the form of local buckles over each cell of the honeycomb core caused an increase in surface roughness. During the aero- dynamic tests all of the panels survived with little or no damage, and panel flutter did not occur.

Mechanics of fluid flow over compliant wrinkled polymeric surfaces

NASA Astrophysics Data System (ADS)

Raayai, Shabnam; McKinley, Gareth; Boyce, Mary

2014-03-01

Skin friction coefficients (based on frontal area) of sharks and dolphins are lower than birds, fish and swimming beetles. By either exploiting flow-induced changes in their flexible skin or microscale textures, dolphins and sharks can change the structure of the fluid flow around them and thus reduce viscous drag forces on their bodies. Inspired by this ability, investigators have tried using compliant walls and riblet-like textures as drag reduction methods in aircraft and marine industries and have been able to achieve reductions up to 19%. Here we investigate flow-structure interaction and wrinkling of soft polymer surfaces that can emulate shark riblets and dolphin's flexible skin. Wrinkling arises spontaneously as the result of mismatched deformation of a thin stiff coating bound to a thick soft elastic substrate. Wrinkles can be fabricated by controlling the ratio of the stiffness of the coating and substrate, the applied displacement and the thickness of the coating. In this work we will examine the evolution in the kinematic structures associated with steady viscous flow over the polymer wrinkled surfaces and in particular compare the skin friction with corresponding results for flow over non-textured and rigid surfaces.

Can increasing the viscosity of formulations be used to reduce the human skin penetration of the sunscreen oxybenzone?

PubMed

Cross, S E; Jiang, R; Benson, H A; Roberts, M S

2001-07-01

The effect of adding thickening agents on the penetration of a sunscreen benzophenone-3 through epidermal and a high-density polyethylene membrane was studied using both very thick (infinite dose) and thin (in use) applications. Contradictory results were obtained. Thickening agents retard skin penetration, in a manner consistent with a diffusional resistance in the formulation, when applied as an infinite dose. In contrast, when applied as in thin (in use) doses, thickening agents promote penetration, most likely through greater stratum corneum diffusivity arising from an enhanced hydration by the thicker formulations. The two key implications from this work are (i) a recognition of the danger in the potential extrapolation of infinite dosing to in use situations, and (ii) to recognize that thicker formulations may sometimes enhance the penetration of other topical agents when applied "in use".

How to Avoid Cast Saw Complications.

PubMed

Halanski, Matthew A

2016-06-01

As casts are routinely used in pediatric orthopaedics, casts saws are commonly used to remove such casts. Despite being a viewed as the "conservative" and therefore often assumed safest treatment modality, complications associated with the use of casts and cast saws occur. In this manuscript, we review the risk factors associated with cast saw injuries. Cast saw injuries are thermal or abrasive (or both) in nature. Thermal risk factors include: cast saw specifications (including a lack of attached vacuum), use of a dull blade, cutting in a concavity, too thin padding, and overly thick casting materials. Risk factors associated with abrasive injuries include: sharp blades, thin padding, and cutting over boney prominences. Because nearly all clinicians contact the skin with the blade during cast removal, appropriate "in-out technique" is critical. Such technique prevents a hot blade from remaining in contact with the skin for any significant time, diminishing the risk of burn. Similarly, using such technique prevents "dragging the blade" that may pull the skin taught, cutting it. It may be useful to teach proper technique as perforating a cast rather than cutting a cast.

Surgical and Functional Outcomes Following Buried Penis Repair With Limited Panniculectomy and Split-thickness Skin Graft.

PubMed

Hampson, Lindsay A; Muncey, Wade; Chung, Paul H; Ma, C C; Friedrich, Jeffrey; Wessells, Hunter; Voelzke, Bryan B

2017-12-01

To report surgical and functional outcomes of buried penis surgery. Outcomes following buried penis surgery at the University of Washington were assessed from June 1, 2005 to June 1, 2016. Patient demographic and surgical data were abstracted from a retrospective chart review. All patients were attempted to be contacted by phone for long-term follow-up. Uni- and multivariate analysis was performed to evaluate for association with any complication. A total of 42 men underwent buried penis repair surgery (mean short-term follow-up 8.1 months). There was an overall 33% 90-day complication rate (21 events). In univariate analysis, body mass index (BMI; P = .02) and no history of gastric bypass (P = .03) were significant predictors of any complication. In multivariate analysis, only BMI remained significant (odds ratio 1.1 for each increase in unit of BMI, 95% confidence interval 1.01-1.27). Twenty-seven patients were reached for long-term follow-up (mean 39 months). Patients reported improvements in every functional domain that was assessed. Of the patients, 85% reported they would undergo buried penis surgery again, 74% that surgery led to a positive change in their lives, and 85% that the surgery had remained a long-term success. Surgical correction of buried penis with penile split-thickness skin graft and limited panniculectomy is well tolerated and results in functional, long-term improvements. BMI is associated with an increased likelihood of a complication following surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgical treatment and management of the severely burn patient: Review and update.

PubMed

Gacto-Sanchez, P

Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult. Research into stem cells, grafting, biomarkers, inflammation control, and rehabilitation will continue to improve individualized care and create new treatment options for these patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Transition regime from step-flow to step-bunching in the growth of epitaxial SrRuO3 on (001) SrTiO3

NASA Astrophysics Data System (ADS)

Gura, Anna; Bertino, Giulia; Bein, Benjamin; Dawber, Matthew

2018-04-01

We present a study of the surface morphology of SrRuO3 thin films grown on TiO2 terminated (001) SrTiO3 substrates using an off-axis RF magnetron sputtering deposition technique. We investigated the step bunching formation and the evolution of the films by varying deposition parameters. The thin films were characterized using atomic force microscopy methods, allowing us to study the various growth regimes of SrRuO3 as a function of the growth parameters. We observe a strong influence of both the miscut angle and growth temperature on the evolution of the SrRuO3 surface morphology. In addition, a thickness dependence is present. Remarkably, the formation of a smooth, regular, and uniform "fish-skin" structure at the step-bunch transition is observed. The fish-skin morphology results from the merging of 2D flat islands predicted by previous models. The direct observation of surface evolution allows us to better understand the different growth regimes of SrRuO3 thin films.

Success Rate of Split-Thickness Skin Grafting of Chronic Venous Leg Ulcers Depends on the Presence of Pseudomonas aeruginosa: A Retrospective Study

PubMed Central

Høgsberg, Trine; Bjarnsholt, Thomas; Thomsen, Jens Schiersing; Kirketerp-Møller, Klaus

2011-01-01

The last years of research have proposed that bacteria might be involved in and contribute to the lack of healing of chronic wounds. Especially it seems that Pseudomonas aeruginosa play a crucial role in the healing. At Copenhagen Wound Healing Centre it was for many years clinical suspected that once chronic venous leg ulcers were colonized (weeks or months preoperatively) by P. aeruginosa, the success rate of skin grafting deteriorated despite aggressive treatment. To investigate this, a retrospective study was performed on the clinical outcome of 82 consecutive patients with chronic venous leg ulcers on 91 extremities, from the 1st of March 2005 until the 31st of August 2006. This was achieved by analysing the microbiology, demographic data, smoking and drinking habits, diabetes, renal impairment, co-morbidities, approximated size and age of the wounds, immunosuppressive treatment and complicating factors on the clinical outcome of each patient. The results were evaluated using a Student T-test for continuous parameters, chi-square test for categorical parameters and a logistic regression analysis to predict healing after 12 weeks. The analysis revealed that only 33,3% of ulcers with P. aeruginosa, isolated at least once from 12 weeks prior, to or during surgery, were healed (98% or more) by week 12 follow-up, while 73,1% of ulcers without P. aeruginosa were so by the same time (p = 0,001). Smoking also significantly suppressed the outcome at the 12-week follow-up. Subsequently, a logistic regression analysis was carried out leaving P. aeruginosa as the only predictor left in the model (p = 0,001). This study supports our hypothesis that P. aeruginosa in chronic venous leg ulcers, despite treatment, has considerable impact on partial take or rejection of split-thickness skin grafts. PMID:21655269

Success rate of split-thickness skin grafting of chronic venous leg ulcers depends on the presence of Pseudomonas aeruginosa: a retrospective study.

PubMed

Høgsberg, Trine; Bjarnsholt, Thomas; Thomsen, Jens Schiersing; Kirketerp-Møller, Klaus

2011-01-01

The last years of research have proposed that bacteria might be involved in and contribute to the lack of healing of chronic wounds. Especially it seems that Pseudomonas aeruginosa play a crucial role in the healing. At Copenhagen Wound Healing Centre it was for many years clinical suspected that once chronic venous leg ulcers were colonized (weeks or months preoperatively) by P. aeruginosa, the success rate of skin grafting deteriorated despite aggressive treatment. To investigate this, a retrospective study was performed on the clinical outcome of 82 consecutive patients with chronic venous leg ulcers on 91 extremities, from the 1(st) of March 2005 until the 31(st) of August 2006. This was achieved by analysing the microbiology, demographic data, smoking and drinking habits, diabetes, renal impairment, co-morbidities, approximated size and age of the wounds, immunosuppressive treatment and complicating factors on the clinical outcome of each patient. The results were evaluated using a Student T-test for continuous parameters, chi-square test for categorical parameters and a logistic regression analysis to predict healing after 12 weeks. The analysis revealed that only 33,3% of ulcers with P. aeruginosa, isolated at least once from 12 weeks prior, to or during surgery, were healed (98% or more) by week 12 follow-up, while 73,1% of ulcers without P. aeruginosa were so by the same time (p = 0.001). Smoking also significantly suppressed the outcome at the 12-week follow-up. Subsequently, a logistic regression analysis was carried out leaving P. aeruginosa as the only predictor left in the model (p = 0.001). This study supports our hypothesis that P. aeruginosa in chronic venous leg ulcers, despite treatment, has considerable impact on partial take or rejection of split-thickness skin grafts.

Proposal for an in vivo histopathologic scoring system for skin aging by means of confocal microscopy.

PubMed

Longo, Caterina; Casari, Alice; De Pace, Barbara; Simonazzi, Silvia; Mazzaglia, Giovanna; Pellacani, Giovanni

2013-02-01

Many instrumental devices have been testing in analysing and quantifying the skin aging signs. However, histopathology still remains the only methods that allow a microscopic assessment of the skin. However, a skin biopsy is not feasible in aesthetically critical areas such as the face. Recently, confocal microscopy has been discovered as a noninvasive tool with a nearly histologic resolution. Distinct morphologic confocal aspects on facial skin have been described and correlated with the histopathologic counterparts. In our study we aim to develop an easy to use confocal aging score to quantify the skin aging related signs. A sample of facial skin of fifty volunteers has been subjected to confocal imaging. Combining the previously identified confocal features, three different semi-quantitative scores were calculated: - epidermal disarray score (irregular honeycombed pattern + epidermal thickness + furrow pattern); - epidermal hyperplasia score (mottled pigmentation + extent of polycyclic papillary + epidermal thickness; - collagen score (curled fibers, 2 for huddles of collagen, 1 for coarse collagen structures, and 0 for thin reticulated collagen) The epidermal disarray score showed a stable trend up to 65 years and a dramatic increase in the elderly subjects epidermal. Hyperplasia score was characterized by an ascending trend from younger subjects to middle age. The total collagen score showed a progressive trend with age with a different proportion of distinct collagen type. RCM is a powerful, noninvasive technique that could permit to microscopically quantify the aging signs and to test cosmetic efficacy. © 2012 John Wiley & Sons A/S.

Damage in a Thin Metal Film by High-Power Terahertz Radiation.

PubMed

Agranat, M B; Chefonov, O V; Ovchinnikov, A V; Ashitkov, S I; Fortov, V E; Kondratenko, P S

2018-02-23

We report on the experimental observation of high-power terahertz-radiation-induced damage in a thin aluminum film with a thickness less than a terahertz skin depth. Damage in a thin metal film produced by a single terahertz pulse is observed for the first time. The damage mechanism induced by a single terahertz pulse could be attributed to thermal expansion of the film causing debonding of the film from the substrate, film cracking, and ablation. The damage pattern induced by multiple terahertz pulses at fluences below the damage threshold is quite different from that observed in single-pulse experiments. The observed damage pattern resembles an array of microcracks elongated perpendicular to the in-plane field direction. A mechanism related to microcracks' generation and based on a new phenomenon of electrostriction in thin metal films is proposed.

Damage in a Thin Metal Film by High-Power Terahertz Radiation

NASA Astrophysics Data System (ADS)

Agranat, M. B.; Chefonov, O. V.; Ovchinnikov, A. V.; Ashitkov, S. I.; Fortov, V. E.; Kondratenko, P. S.

2018-02-01

We report on the experimental observation of high-power terahertz-radiation-induced damage in a thin aluminum film with a thickness less than a terahertz skin depth. Damage in a thin metal film produced by a single terahertz pulse is observed for the first time. The damage mechanism induced by a single terahertz pulse could be attributed to thermal expansion of the film causing debonding of the film from the substrate, film cracking, and ablation. The damage pattern induced by multiple terahertz pulses at fluences below the damage threshold is quite different from that observed in single-pulse experiments. The observed damage pattern resembles an array of microcracks elongated perpendicular to the in-plane field direction. A mechanism related to microcracks' generation and based on a new phenomenon of electrostriction in thin metal films is proposed.

Highly Sensitive and Multifunctional Tactile Sensor Using Free-standing ZnO/PVDF Thin Film with Graphene Electrodes for Pressure and Temperature Monitoring

PubMed Central

Lee, James S.; Shin, Keun-Young; Cheong, Oug Jae; Kim, Jae Hyun; Jang, Jyongsik

2015-01-01

We demonstrate an 80-μm-thick film (which is around 15% of the thickness of the human epidermis), which is a highly sensitive hybrid functional gauge sensor, and was fabricated from poly(vinylidene fluoride) (PVDF) and ZnO nanostructures with graphene electrodes. Using this film, we were able to simultaneously measure pressure and temperature in real time. The pressure was monitored from the change in the electrical resistance via the piezoresistance of the material, and the temperature was inferred based on the recovery time of the signal. Our thin film system enabled us to detect changes in pressure as small as 10 Pa which is pressure detection limit was 103-fold lower than the minimum level required for artificial skin, and to detect temperatures in the range 20–120°C. PMID:25601479

Highly sensitive and multifunctional tactile sensor using free-standing ZnO/PVDF thin film with graphene electrodes for pressure and temperature monitoring.

PubMed

Lee, James S; Shin, Keun-Young; Cheong, Oug Jae; Kim, Jae Hyun; Jang, Jyongsik

2015-01-20

We demonstrate an 80-μm-thick film (which is around 15% of the thickness of the human epidermis), which is a highly sensitive hybrid functional gauge sensor, and was fabricated from poly(vinylidene fluoride) (PVDF) and ZnO nanostructures with graphene electrodes. Using this film, we were able to simultaneously measure pressure and temperature in real time. The pressure was monitored from the change in the electrical resistance via the piezoresistance of the material, and the temperature was inferred based on the recovery time of the signal. Our thin film system enabled us to detect changes in pressure as small as 10 Pa which is pressure detection limit was 10(3)-fold lower than the minimum level required for artificial skin, and to detect temperatures in the range 20-120 °C.

Human Hair as a Natural Sun Protection Agent: A Quantitative Study.

PubMed

de Gálvez, María Victoria; Aguilera, José; Bernabó, Jean-Luc; Sánchez-Roldán, Cristina; Herrera-Ceballos, Enrique

2015-01-01

The rising incidence of skin cancers attributable to excessive sun exposure has become a major health concern worldwide. While numerous studies have analyzed the sun protective effect of sunscreens, clothing and antioxidants, none to date have measured the photoprotective effect of hair, despite clinical evidence that individuals with balding or thinning hair are at greater risk of skin lesions that can progress to cancer, hence the recommendation to use hats or umbrellas. We analyzed the level of protection offered by hair according to hair density, thickness and color using the spectral transmittance and corrected for relative erythema effectiveness. Our results show that hair provides a barrier against both UVB and UVA radiation which is significantly increased with respect to the hair density, thickness and the presence of melanins. This is the first study to quantify sun protection factor offered by hair, namely hair ultraviolet protection factor (HUPF). We believe that hair should be recognized as an important natural sun barrier in the prevention of UV-induced skin cancers. © 2015 The American Society of Photobiology.

Recurrence case of rare scalp dermatofibrosarcoma protuberans: Two case reports of a wide radical excision, craniectomy bone involvement followed by cranioplasty and reconstruction

PubMed Central

Faried, Ahmad; Hadisaputra, Wargian; Arifin, Muhammad Z.

2017-01-01

Background: Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade sarcoma of the fibroblast originating from the dermal layer of the skin, characterized by a locally aggressive growth and high rate of local recurrence. Case Description: Two patients underwent a wide radical excision of recurrent scalp DFSP which was reconstructed with translational skin flap and split-thickness skin graft. We described above cases several years ago with a local excision of the tumor; recently, they developed local recurrence of DFSP with calvarial involvement. We then performed a wide radical excision, with craniectomy of the cranial defect followed by cranioplasty using titanium mesh, continuing with reconstruction. Conclusion: A successful treatment and management depends on achieving local control and preventing cosmetic and functional deficit; all efforts should be made for complete excision. Postoperative follow-up recommended for highly suspicious cases and annual checkups should be performed up to 5 years after definitive therapy. PMID:28607816

[Antegrade extended peroneal artery perforator flap for knee reconstruction].

PubMed

Ruan, Hongjiang; Cai, Peihua; Fan, Cunyi; Chai, Yimin; Liu, Shenghe

2009-03-01

To investigate the operative technique and clinical results of repairing the soft tissue defects of knee with antegrade extended peroneal artery perforator flap. From October 2007 to January 2008, 3 patients (2 men and 1 woman) with the soft tissue defects of knee were treated, with the ages of 18, 31 and 42 years, respectively. The first case sustained femur and pelvis fractures and soft tissue defect over his right popliteal fossa, which were treated with open reduction and internal fixation (ORIF) and debridement of knee joint 2 weeks ago. The second case was necrosis of skin 3 weeks after ORIF for fracture of tibial plateau. The third case suffered from open fracture of tibial plateau and soft tissue defect, which were treated with external fixation and debridement 3 weeks ago. The defect sizes were 16 cm x 9 cm, 11 cm x 6 cm and 14 cm x 7 cm. The flap was raised by dividing the peroneal artery and veins distally and elevating them proximally, which covered for the defects of knee. The flaps were designed with the size of 18 cm x 10 cm, 12 cm 7 cm and 15 cm x 8 cm. The pure vascular pedicle of the flap was 10 cm to 17 cm in length, including the peroneal vessels and one or two perforator branches. The donor site is covered by a split thickness skin graft. All flaps survived after surgery. The donor sites healed by first intention and the skin grafts survived. After following up for 6, 8 and 11 months, the appearance and function of the flaps were all satisfactory. Based on the modified HSS knee performance system, post-operative knee functional outcomes of three patients were excellent. The antegrade extended peroneal artery perforator flap supplied by a pure vascular pedicle can be a good alternative for reconstruction of knee. The flap, with a long and thin pure vascular pedicle, could provide good texture and contour matching the recipient area.

Eddy Current Testing and Sizing of Deep Cracks in a Thick Structure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, H.; Endo, H.; Uchimoto, T.

2004-02-26

Due to the skin effect of eddy current testing, target of ECT restricts to thin structure such as steam generator tubes with 1.27mm thickness. Detecting and sizing of a deep crack in a thick structure remains a problem. In this paper, an ECT probe is presented to solve this problem with the help of numerical analysis. The parameters such as frequency, coil size etc. are discussed. The inverse problem of crack sizing is solved by applying a fast simulator of ECT based on an edge based finite element method and steepest descent method, and reconstructed results of 5, 10 andmore » 15mm depth cracks from experimental signals are shown.« less

Parametric analysis: SOC meteoroid and debris protection

NASA Technical Reports Server (NTRS)

Kowalski, R.

1985-01-01

The meteoroid and man made space debris environments of an Earth orbital manned space operations center are discussed. Protective shielding thickness and design configurations for providing given levels of no penetration probability were also calculated. Meteoroid/debris protection consists of a radiator/shield thickness, which is actually an outer skin, separated from the pressure wall, thickness by a distance. An ideal shield thickness, will, upon impact with a particle, cause both the particle and shield to vaporize, allowing a minimum amount of debris to impact the pressure wall itself. A shield which is too thick will crater on the outside, and release small particles of shield from the inside causing damage to the pressure wall. Inversely, if the shield is too thin, it will afford no protection, and the backup must provide all necessary protection. It was concluded that a double wall concept is most effective.

An open, prospective, randomized pilot investigation evaluating pain with the use of a soft silicone wound contact layer vs bridal veil and staples on split thickness skin grafts as a primary dressing.

PubMed

Patton, Mary Lou; Mullins, Robert Fred; Smith, David; Korentager, Richard

2013-01-01

An open, prospective, randomized, pilot investigation was implemented to evaluate the pain, cost-effectiveness, ease of use, tolerance, efficacy, and safety of a soft silicone wound contact layer (Mepitel One) vs Bridal Veil and staples used on split thickness skin grafts in the treatment of deep partial or full-thickness thermal burns. Individuals aged between 18 and 70 years with deep partial or full-thickness thermal burns (1-25% TBSA) were randomized into two groups and treated for 14 days or until greater than 95% graft take was achieved, whichever occurred first. Data were obtained and analyzed on pain experienced before, during, and after dressing removal. Secondary considerations included the overall cost (direct), graft take and healing, the ease of product use, overall experience of the dressing, and adverse events. A total of 43 subjects were recruited. There were no significant differences in burn area profiles within the groups. The pain level during dressing removal was significant between the groups (P = .0118) with the removal of Mepitel One being less painful. The staff costs were lower in the group of patients treated with Mepitel One (P = .0064) as reflected in the shorter time required for dressing removal (P = .0005), with Mepitel One taking on average less than a quarter of the time to remove. There was no significant difference in healing between the two groups, with 99.0% of the Mepitel One group and 93.1% of the Bridal Veil and staples group showing greater than 95% graft take at post-op day 7 (+/-1) (P = .2373). Clinicians reported that the soft silicone dressing was easier to use, more conformable, and demonstrated better ability to stay in place, compared with the Bridal Veil and staples regime. Both treatments were well tolerated, with no serious adverse events in either treatment group. Mepitel One was at least as effective in the treatment of patients as the standard care (Bridal Veil and staples). In addition, the group of patients treated with the soft silicone dressing demonstrated decreased pain and lower costs associated with treatment.

Second-harmonic diffraction from holographic volume grating.

PubMed

Nee, Tsu-Wei

2006-10-01

The full polarization property of holographic volume-grating enhanced second-harmonic diffraction (SHD) is investigated theoretically. The nonlinear coefficient is derived from a simple atomic model of the material. By using a simple volume-grating model, the SHD fields and Mueller matrices are first derived. The SHD phase-mismatching effect for a thick sample is analytically investigated. This theory is justified by fitting with published experimental SHD data of thin-film samples. The SHD of an existing polymethyl methacrylate (PMMA) holographic 2-mm-thick volume-grating sample is investigated. This sample has two strong coupling linear diffraction peaks and five SHD peaks. The splitting of SHD peaks is due to the phase-mismatching effect. The detector sensitivity and laser power needed to measure these peak signals are quantitatively estimated.

Crustal and mantle structure and anisotropy beneath the incipient segments of the East African Rift System: Preliminary results from the ongoing SAFARI

NASA Astrophysics Data System (ADS)

Yu, Y.; Reed, C. A.; Gao, S. S.; Liu, K. H.; Massinque, B.; Mdala, H. S.; moidaki, M.; Mutamina, D. M.; Atekwana, E. A.; Ingate, S. F.; Reusch, A.; Barstow, N.

2013-12-01

Despite the vast wealth of research conducted toward understanding processes associated with continental rifting, the extent of our knowledge is derived primarily from studies focused on mature rift systems, such as the well-developed portions of the East African Rift System (EARS) north of Lake Malawi. To explore the dynamics of early rift evolution, the SAFARI (Seismic Arrays for African Rift Initiation) team deployed 50 PASSCAL broadband seismic stations across the Malawi, Luangwa, and Okavango rifts of the EARS during the summer of 2012. The cumulative length of the profiles is about 2500 km and the planned recording duration is 2 years. Here we present the preliminary results of systematic analyses of data obtained from the first year of acquisition for all 50 stations. A total of 446 high-quality shear-wave splitting measurements using PKS, SKKS, and SKS phases from 84 teleseismic events were used to constrain fast polarization directions and splitting times throughout the region. The Malawi and Okavango rifts are characterized by mostly NE trending fast directions with a mean splitting time of about 1 s. The fast directions on the west side of the Luangwa Rift Zone are parallel to the rift valley, and those on the east side are more N-S oriented. Stacking of approximately 1900 radial receiver functions reveals significant spatial variations of both crustal thickness and the ratio of crustal P and S wave velocities, as well as the thickness of the mantle transition zone. Stations situated within the Malawi rift demonstrate a southward increase in observed crustal thickness, which is consistent with the hypothesis that the Malawi rift originated at the northern end of the rift system and propagated southward. Both the Okavango and Luangwa rifts are associated with thinned crust and increased Vp/Vs, although additional data is required at some stations to enhance the reliability of the observations. Teleseismic P-wave travel-time residuals show a delay of about 1 s at stations in the Okavango rift relative to the Limpopo belt. The study region is characterized by a relatively average mantle transition zone thickness of 250 km except for stations located within and to the immediate NW of the Okavango rift, where it is probably abnormally thin. Additional seismological techniques will be applied to the data set, and the preliminary results from the above initial analyses will be confirmed or modified by data from the SAFARI stations in the second year.

Skin Graft Fixation Using Hydrofiber (Aquacel® Extra).

PubMed

Yen, Ya-Hui; Lin, Chih-Ming; Hsu, Honda; Chen, Ying-Chen; Chen, Yi-Wen; Li, Wan-Yu; Hsieh, Chia-Nan; Huang, Chieh-Chi

2018-06-01

The traditional method of skin graft fixation is with tie-over bollus dressing. The use of splints in the extremities for skin graft fixation is a common practice. However, these splints are heavy and uncomfortable and contribute considerably to our overall medical waste. Hydrofiber (Aquacel Extra) has a strong fluid absorption property and fixates well to the underlying wound once applied. In this study, we used hydrofiber for fixation, avoiding the use of splints after skin grafting. A total of 56 patients reconstructed with split-thickness skin graft that was fixated only with hydrofiber between March 2015 and March 2016 were included in this retrospective study. There were 44 men and 12 women with a mean age of 61 ± 18 years. The defect size ranged from 1 × 1 cm for fingertips to 30 × 12 cm for lower limb defects. The average defect size was 61 ± 78 cm. The mean skin graft take was 96% ± 6%. Because splints were not required, we saved around 48 kg of medical waste over the space of 1 year. The use of hydrofiber for skin graft fixation was effective and technically very simple. Splints were not required with this method, decreasing the medical waste created and increasing patient comfort. We suggest that this is an excellent alternative for skin graft fixation while at the same time decreasing our carbon footprint as surgeons.

Application of a Laser Interferometer Skin-Friction Meter in Complex Flows

NASA Technical Reports Server (NTRS)

Monson, D. J.; Driver, D. M.; Szodruch, J.

1981-01-01

A nonintrusive skin-friction meter has been found useful for a variety of complex wind-tunnel flows. This meter measures skin friction with a remotely located laser interferometer that monitors the thickness change of a thin oil film. Its accuracy has been proven in a low-speed flat-plate flow. The wind-tunnel flows described here include sub-sonic separated and reattached flow over a rearward-facing step, supersonic flow over a flat plate at high Reynolds numbers, and supersonic three - dimensional vortical flow over the lee of a delta wing at angle of attack. The data-reduction analysis was extended to apply to three-dimensional flows with unknown flow direction, large pressure and shear gradients, and large oil viscosity changes with time. The skin friction measurements were verified, where possible, with results from more conventional techniques and also from theoretical computations.

Linear least-squares method for global luminescent oil film skin friction field analysis

NASA Astrophysics Data System (ADS)

Lee, Taekjin; Nonomura, Taku; Asai, Keisuke; Liu, Tianshu

2018-06-01

A data analysis method based on the linear least-squares (LLS) method was developed for the extraction of high-resolution skin friction fields from global luminescent oil film (GLOF) visualization images of a surface in an aerodynamic flow. In this method, the oil film thickness distribution and its spatiotemporal development are measured by detecting the luminescence intensity of the thin oil film. From the resulting set of GLOF images, the thin oil film equation is solved to obtain an ensemble-averaged (steady) skin friction field as an inverse problem. In this paper, the formulation of a discrete linear system of equations for the LLS method is described, and an error analysis is given to identify the main error sources and the relevant parameters. Simulations were conducted to evaluate the accuracy of the LLS method and the effects of the image patterns, image noise, and sample numbers on the results in comparison with the previous snapshot-solution-averaging (SSA) method. An experimental case is shown to enable the comparison of the results obtained using conventional oil flow visualization and those obtained using both the LLS and SSA methods. The overall results show that the LLS method is more reliable than the SSA method and the LLS method can yield a more detailed skin friction topology in an objective way.

Repair of Craniomaxillofacial Traumatic Soft Tissue Defects With Tissue Expansion in the Early Stage.

PubMed

Han, Yan; Zhao, Jianhui; Tao, Ran; Guo, Lingli; Yang, Hongyan; Zeng, Wei; Song, Baoqiang; Xia, Wensen

2017-09-01

Craniomaxillofacial traumatic soft tissue defects severely affect the function and appearance of the patients. The traditional skin grafting or free flap transplantation can only close the defects in the early stage of operation but cannot ensure similar color, texture, and relative aesthetic contour. In the present study, the authors have explored a novel strategy to repair craniomaxillofacial traumatic soft tissue defects by tissue expansion in the early stage and have obtained satisfactory results. Eighteen patients suffering large craniomaxillofacial traumatic soft tissue defects were treated by thorough debridement leaving the wounds unclosed or simply closed with thin split-thickness scalp grafts, adjacent expander implantation in the first stage, and expanded flap transposition in the second stage. There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years (mean, 19.4 ± 12.2 years), with average 15 months follow-up (range, 3-67 months). The average expansion time was 74.3 days (range, 53-96 days). The 18 patients with a total of 22 expanders were treated with satisfactory results. All the flaps survived and the skin color, texture, and contour well matched those of the peripheral tissue. Only 1 complication of infection happened in the 18 cases (5.56%) and the 22 expanders (4.55%), which was similar to the rate reported in the literature. No other complications related to the expanders occurred. Debridement and tissue expansion in the early stage has been proved to be a more effective strategy to repair craniomaxillofacial traumatic soft tissue defects. This strategy can not only achieve satisfactory color, unbulky and well-matched texture similar to normal, but also avoid unnecessary donor site injuries.

Outdoor measurements of a photovoltaic system using diffractive spectrum-splitting and concentration

DOE PAGES

Mohammad, N.; Schulz, M.; Wang, P.; ...

2016-09-16

In a single-bandgap absorber, photons having energy less than the bandgap are not absorbed, while those having energy larger than the bandgap lose the excess energy via thermalization. We present outdoor measurements of a photovoltaic system that overcomes these losses via spectrum splitting and concentration using a planar diffractive optic. The system was comprised of the diffractive optic coupled with GaInP and CIGS solar cells. The optic provides a geometric concentration of 3X for each solar cell. It is easily fabricated by single-step grayscale lithography and it is ultra-thin with a maximum thickness of only 2.5μm. Electrical measurements under directmore » sunlight demonstrated an increase of ~25% in total output power compared to the reference case without spectrum splitting and concentration. Since different bandgaps are in the same plane, the proposed photovoltaic system successfully circumvents the lattice-matching and current-matching issues in conventional tandem multi-junction solar cells. As a result, this system is also tolerant to solar spectrum variation and fill-factor degradation of constitutive solar cells.« less

Outdoor measurements of a photovoltaic system using diffractive spectrum-splitting and concentration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mohammad, N.; Schulz, M.; Wang, P.

In a single-bandgap absorber, photons having energy less than the bandgap are not absorbed, while those having energy larger than the bandgap lose the excess energy via thermalization. We present outdoor measurements of a photovoltaic system that overcomes these losses via spectrum splitting and concentration using a planar diffractive optic. The system was comprised of the diffractive optic coupled with GaInP and CIGS solar cells. The optic provides a geometric concentration of 3X for each solar cell. It is easily fabricated by single-step grayscale lithography and it is ultra-thin with a maximum thickness of only 2.5μm. Electrical measurements under directmore » sunlight demonstrated an increase of ~25% in total output power compared to the reference case without spectrum splitting and concentration. Since different bandgaps are in the same plane, the proposed photovoltaic system successfully circumvents the lattice-matching and current-matching issues in conventional tandem multi-junction solar cells. As a result, this system is also tolerant to solar spectrum variation and fill-factor degradation of constitutive solar cells.« less

Human unrestricted somatic stem cells loaded in nanofibrous PCL scaffold and their healing effect on skin defects.

PubMed

Bahrami, Hoda; Keshel, Saeed Heidari; Chari, Aliakbar Jafari; Biazar, Esmaeil

2016-09-01

Unrestricted somatic stem cells (USSCs) loaded in nanofibrous polycaprolactone (PCL) scaffolds can be used for skin regeneration when grafted onto full-thickness skin defects of rats. Nanofibrous PCL scaffolds were designed by the electrospinning method and crosslinked with laminin protein. Afterwards, the scaffolds were evaluated by scanning electron microscopy, and physical and mechanical assays. In this study, nanofibrous PCL scaffolds loaded with USSCs were grafted onto the skin defects. The wounds were subsequently investigated 21 days after grafting. Results of mechanical and physical analyses showed good resilience and compliance to movement as a skin graft. In animal models; study samples exhibited the most pronounced effect on wound closure, with statistically significant improvement in wound healing being seen at 21 days post-operatively. Histological examinations of healed wounds from all samples showed a thin epidermis plus recovered skin appendages in the dermal layer for samples with cell. Thus, the graft of nanofibrous PCL scaffolds loaded with USSC showed better results during the healing process of skin defects in rat models.

Application of a laser interferometer skin-friction meter in complex flows

NASA Technical Reports Server (NTRS)

Monson, D. J.; Driver, D. M.; Szodruch, J.

1981-01-01

The application of a nonintrusive laser-interferometer skin-friction meter, which measures skin friction with a remotely located laser interferometer that monitors the thickness change of a thin oil film, is extended both experimentally and theoretically to several complex wind-tunnel flows. These include two-dimensional seperated and reattached subsonic flows with large pressure and shear gradients, and two and three-dimensional supersonic flows at high Reynolds number, which include variable wall temperatures and cross-flows. In addition, it is found that the instrument can provide an accurate location of the mean reattachment length for separated flows. Results show that levels up to 120 N/sq m, or 40 times higher than previous tests, can be obtained, despite encountering some limits to the method for very high skin-friction levels. It is concluded that these results establish the utility of this instrument for measuring skin friction in a wide variety of flows of interest in aerodynamic testing.

Deepening Fornix Technique Using Central Split-Medium Thickness Skin Graft to Treat Contracted Anophthalmic Sockets.

PubMed

AlHassan, Sultan; Galindo-Ferreiro, Alicia; Khandekar, Rajiv; AlShaikh, Osama; Schellini, Silvana Artioli

2018-05-08

The aim of thhis study was to present the outcomes of postauricular split-medium thickness skin graft (SMTSG) to treat anophthalmic sockets with contracted fornices. This case series enrolled patients with grade 2 or 3 anophthalmic sockets between 2015 and 2016. Data were collected on patient demographics, objective and subjective parameters preoperatively and 180 days postoperatively. Success of the surgery was graded on the height of the graft, the depth of the superior and inferior fornices, and presence/abscence of lagophthalmos, entropion, and ability to retain an external prosthesis. Eighteen patients were enrolled with a mean age of 35.9 ± 18 years. The median height of the graft was 22 mm (25% quartile = 18.75) when removed and 20 mm (25% quartile = 16) postoperatively. The median depth of the superior fornix was 6.5 mm (25% quartile = 4.5 mm) preoperatively and 10 mm (25% quartile = 8 mm) postoperatively (P = 0.5). The median inferior fornix depth was 7 mm (25% quartile = 3.5 mm) preoperatively and 8 mm (25% quartile = 5 mm) (P = 0.27) postoperatively. Preoperatively, there were 13 (72.2%) patients with lagophthalmos, 10 (44.4%) with entropion, 3 (37.5%) with poor prosthesis retention, and 5 (62.5%) who were unable to retain the prosthesis. Postoperatively, 7 (38.9%) patients had lagophthamos, 1 (5.6%) had entropion, and all the patients could retain the prosthesis. None of the sockets had a foul odor postoperatively. Postauricular SMTSG achieves successful outcomes for the treatment of contracted anophthalmic sockets, reshaping the anterior socket surface and deepening the fornices.

Topical Human Epidermal Growth Factor in the Treatment of Senile Purpura and the Prevention of Dermatoporosis.

PubMed

McKnight, Braden; Seidel, Rachel; Moy, Ron

2015-10-01

Senile purpura presents itself as a largely unexplored challenge as it has been long thought of as a benign condition without long-term health sequelae. It is becoming increasingly accepted that skin aging not only results in cosmetic disturbances, but as a functional ones. With modern increases in lifespan, skin atrophy associated with solar damage is presenting as a clinically significant inability to mechanically protect patients. This chronic cutaneous insufficiency/fragility syndrome was recently termed dermatoporosis and senile purpura appears to be a visible marker of early stage dysfunction. To examine the effects of topically human epidermal growth factor on the clinical presence of senile purpura and its effect on skin thickness as measured via cutaneous ultrasound. Six subjects applied human epidermal growth factor morning and night for six weeks. Clinical outcomes were evaluated by comparing initial clinical photos to 6-week photos and performing a blinded investigator's global assessment (IGA). Skin thickness was evaluated via cutaneous ultrasound measurement. Ultrasound measurements indicated a mean skin thickening of 195.2 ± 35.7 um (SEM) over 6 weeks. The average number of purpuric lesions decreased from 15 ± 4.6 (SEM) to 2.3 ± 0.7 (SEM) over that same period. Senile purpura presents itself as a cosmetic disturbance posing significant psychological distress and serves as a marker of the severity of skin thinning. In this study, we demonstrate that topical h-EGF diminishes the appearance of senile purpura by thickening skin and may help prevent the development of late stage dermatoporosis.

Spin-resolved photoemission study of epitaxially grown MoSe 2 and WSe 2 thin films

DOE PAGES

Mo, Sung-Kwan; Hwang, Choongyu; Zhang, Yi; ...

2016-09-12

Few-layer thick MoSe 2 and WSe 2 possess non-trivial spin textures with sizable spin splitting due to the inversion symmetry breaking embedded in the crystal structure and strong spin–orbit coupling. Here, we report a spin-resolved photoemission study of MoSe 2 and WSe 2 thin film samples epitaxially grown on a bilayer graphene substrate. Furthermore, we only found spin polarization in the single- and trilayer samples—not in the bilayer sample—mostly along the out-of-plane direction of the sample surface. The measured spin polarization is found to be strongly dependent on the light polarization as well as the measurement geometry, which reveals intricatemore » coupling between the spin and orbital degrees of freedom in this class of material.« less

Bilateral syndactyly. A unique case with surgical correction.

PubMed

Cisco, R W; Pitts, T E; Cicchinelli, L D; Caldarella, D J

1993-11-01

Cases must be treated on an individual basis, appreciating the complexity of the syndactyly, considering the patient compliance, and understanding the goals of the surgical correction. Extensive discussion with the patient and parents must occur to clarify the goals of the surgery, the expectations, and possible complications. Careful preoperative planning and incision design is paramount in obtaining satisfactory results. Skin grafting may be required, either full-thickness from a variety of donor sites or split-thickness grafting as in one case study reported. Adjunctively, manipulation and stretching of the web space for 2 to 3 months preoperatively may be helpful to achieve more laxity of the soft tissues. The choice of suture material is of particular concern when dealing with a small child. It is usually wise to use an absorbable suture material for skin closure in a small child to prevent undue emotional stress to the child or even further anesthesia upon suture removal. Vascular compromise caused by soft tissue tension in not an infrequent occurrence. As with any surgery that addresses largely cosmetic deformities, there is no substitute for exact prior planning, meticulous technique, and surgeon experience to optimize results.

Electrothermal ring burn from a car battery.

PubMed

Sibley, Paul A; Godwin, Kenneth A

2013-08-01

Despite prevention efforts, burn injuries among auto mechanics are described in the literature. Electrothermal ring burns from car batteries occur by short-circuiting through the ring when it touches the open terminal or metal housing. This article describes a 34-year-old male auto mechanic who was holding a wrench when his gold ring touched the positive terminal of a 12-volt car battery and the wrench touched both his ring and the negative terminal. He felt instant pain and had a deep partial-thickness circumferential burn at the base of his ring finger. No other soft tissues were injured. He was initially managed conservatively, but after minimal healing at 3 weeks, he underwent a full-thickness skin graft. The graft incorporated well and healed by 4 weeks postoperatively. He had full range of motion. The cause of ring burns has been controversial, but based on reports similar to the current patient's mechanism, they are most likely electrothermal burns. Gold, a metal with high thermal conductivity, can heat up to its melting point in a matter of seconds. Many treatments have been described, including local wound care to split- and full-thickness skin grafts. Because most burns are preventable, staff should be warned and trained about the potential risks of contact burns. All jewelry should be removed, and the live battery terminal should be covered while working in the vicinity of the battery. Copyright 2013, SLACK Incorporated.

The Effect of Particles on Electrolytically Polymerized Thin Natural MCF Rubber for Soft Sensors Installed in Artificial Skin.

PubMed

Shimada, Kunio; Mochizuki, Osamu; Kubota, Yoshihiro

2017-04-19

The aim of this study is to investigate the effect of particles as filler in soft rubber sensors installed in artificial skin. We examine sensors made of natural rubber (NR-latex) that include magnetic particles of Ni and Fe₃O₄ using magnetic compound fluid (MCF). The 1-mm thickness of the electrolytically polymerized MCF rubber makes production of comparatively thin rubber sensors feasible. We first investigate the effect of magnetic particles Ni and Fe₃O₄ on the curing of MCF rubber. Next, in order to adjust the electric properties of the MCF rubber, we adopt Al₂O₃ dielectric particles. We investigate the effect of Al₂O₃ particles on changes in electric current, voltage and temperature of electrolytically polymerized MCF rubber liquid, and on the electric properties under the application of normal and shear forces. By adjusting the ratio of Ni, Fe₃O₄, Al₂O₃ and water in MCF rubber with Al₂O₃, it is possible to change the electric properties.

Wafer-scale two-dimensional semiconductors from printed oxide skin of liquid metals

NASA Astrophysics Data System (ADS)

Carey, Benjamin J.; Ou, Jian Zhen; Clark, Rhiannon M.; Berean, Kyle J.; Zavabeti, Ali; Chesman, Anthony S. R.; Russo, Salvy P.; Lau, Desmond W. M.; Xu, Zai-Quan; Bao, Qiaoliang; Kevehei, Omid; Gibson, Brant C.; Dickey, Michael D.; Kaner, Richard B.; Daeneke, Torben; Kalantar-Zadeh, Kourosh

2017-02-01

A variety of deposition methods for two-dimensional crystals have been demonstrated; however, their wafer-scale deposition remains a challenge. Here we introduce a technique for depositing and patterning of wafer-scale two-dimensional metal chalcogenide compounds by transforming the native interfacial metal oxide layer of low melting point metal precursors (group III and IV) in liquid form. In an oxygen-containing atmosphere, these metals establish an atomically thin oxide layer in a self-limiting reaction. The layer increases the wettability of the liquid metal placed on oxygen-terminated substrates, leaving the thin oxide layer behind. In the case of liquid gallium, the oxide skin attaches exclusively to a substrate and is then sulfurized via a relatively low temperature process. By controlling the surface chemistry of the substrate, we produce large area two-dimensional semiconducting GaS of unit cell thickness (~1.5 nm). The presented deposition and patterning method offers great commercial potential for wafer-scale processes.

Wafer-scale two-dimensional semiconductors from printed oxide skin of liquid metals.

PubMed

Carey, Benjamin J; Ou, Jian Zhen; Clark, Rhiannon M; Berean, Kyle J; Zavabeti, Ali; Chesman, Anthony S R; Russo, Salvy P; Lau, Desmond W M; Xu, Zai-Quan; Bao, Qiaoliang; Kevehei, Omid; Gibson, Brant C; Dickey, Michael D; Kaner, Richard B; Daeneke, Torben; Kalantar-Zadeh, Kourosh

2017-02-17

A variety of deposition methods for two-dimensional crystals have been demonstrated; however, their wafer-scale deposition remains a challenge. Here we introduce a technique for depositing and patterning of wafer-scale two-dimensional metal chalcogenide compounds by transforming the native interfacial metal oxide layer of low melting point metal precursors (group III and IV) in liquid form. In an oxygen-containing atmosphere, these metals establish an atomically thin oxide layer in a self-limiting reaction. The layer increases the wettability of the liquid metal placed on oxygen-terminated substrates, leaving the thin oxide layer behind. In the case of liquid gallium, the oxide skin attaches exclusively to a substrate and is then sulfurized via a relatively low temperature process. By controlling the surface chemistry of the substrate, we produce large area two-dimensional semiconducting GaS of unit cell thickness (∼1.5 nm). The presented deposition and patterning method offers great commercial potential for wafer-scale processes.

Wafer-scale two-dimensional semiconductors from printed oxide skin of liquid metals

PubMed Central

Carey, Benjamin J.; Ou, Jian Zhen; Clark, Rhiannon M.; Berean, Kyle J.; Zavabeti, Ali; Chesman, Anthony S. R.; Russo, Salvy P.; Lau, Desmond W. M.; Xu, Zai-Quan; Bao, Qiaoliang; Kavehei, Omid; Gibson, Brant C.; Dickey, Michael D.; Kaner, Richard B.; Daeneke, Torben; Kalantar-Zadeh, Kourosh

2017-01-01

A variety of deposition methods for two-dimensional crystals have been demonstrated; however, their wafer-scale deposition remains a challenge. Here we introduce a technique for depositing and patterning of wafer-scale two-dimensional metal chalcogenide compounds by transforming the native interfacial metal oxide layer of low melting point metal precursors (group III and IV) in liquid form. In an oxygen-containing atmosphere, these metals establish an atomically thin oxide layer in a self-limiting reaction. The layer increases the wettability of the liquid metal placed on oxygen-terminated substrates, leaving the thin oxide layer behind. In the case of liquid gallium, the oxide skin attaches exclusively to a substrate and is then sulfurized via a relatively low temperature process. By controlling the surface chemistry of the substrate, we produce large area two-dimensional semiconducting GaS of unit cell thickness (∼1.5 nm). The presented deposition and patterning method offers great commercial potential for wafer-scale processes. PMID:28211538

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reifenrath, W.G.; Hawkins, G.S.; Kurtz, M.S.

Formulations of the mosquito repellent N,N-diethyl-3-methylbenzamide (deet) in combination with a variety of additives were developed to control repellent evaporation and percutaneous penetration. Deet was also formulated with the repellent dimethyl phthalate to study the interaction of the two compounds on the skin. The evaporation and penetration processes were evaluated on whole and split-thickness pig skin using radiolabeled repellents with an in vitro apparatus. Under essentially still air and air flow conditions, one of the deet formulations resulted in significantly reduced total evaporation and percutaneous penetration of deet as compared to unformulated repellent. When deet and dimethyl phthalate were combined,more » neither repellent affected the total amount of evaporation and penetration of the other compound. However, initial percutaneous penetration and evaporation rates were slightly less and decayed less rapidly than when both chemicals were tested separately at the same dose. These results indicated a degree of competition of the two compounds for the same avenues of loss.« less

[Hidradenitis Suppurativa: Combined Treatment with Dermal Template, Skin Graft and Negative Pressure Wound Therapy, a Case Study].

PubMed

Ribeiro, Luís Mata; Guerra, Ana Silva

2018-01-31

Hidrosadenitis supurativa is a chronic inflammatory disease with great physical and psychological impact. Although conservative treatments may be effective in mild forms of the disease, extensive surgical resection and reconstruction are necessary in more severe forms of the disease. The purpose of this paper is to describe our two-stage reconstructive procedure regarding this kind of disease. We present a clinical case of a patient with severe, bilateral axillary hidrosadenitis. In the first surgical step we excised the lesions and applied the artificial dermis secured with negative pressure wound therapy. In the second step we used a split thickness skin graft to close the wound and again applied negative pressure wound therapy. The graft take was very good, without complications. The cosmetic outcome is acceptable and shoulder mobility was not compromised. No recurrence was detected (nine months follow up).

Scrotal Reconstruction with Integra Following Necrotizing Fasciitis.

PubMed

Dent, Briar L; Dinesh, Anant; Khan, Khuram; Engdahl, Ryan

2018-01-01

Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. Integra TM bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. We report the successful use of Integra and a subsequent split-thickness skin graft for reconstruction of the anterior scrotum and coverage of the exposed testes in a 43-year-old man who developed Group A Streptococcus necrotizing fasciitis of his right lower extremity, groin, and scrotum requiring serial operative debridements. Stable testicular coverage was achieved with closely matched skin and minimal donor-site morbidity. Further study and a larger sample size will be necessary to better understand the advantages and disadvantages of scrotal reconstruction with Integra.

Human skin cell fractions fail to self-organize within a gellan gum/hyaluronic acid matrix but positively influence early wound healing.

PubMed

Cerqueira, Mariana T; da Silva, Lucília P; Santos, Tírcia C; Pirraco, Rogério P; Correlo, Vitor M; Marques, Alexandra P; Reis, Rui L

2014-05-01

Split-thickness autografts still are the current gold standard to treat skin, upon severe injuries. Nonetheless, autografts are dependent on donor site availability and often associated to poor quality neoskin. The generation of dermal-epidermal substitutes by tissue engineering is seen as a promising strategy to overcome this problematic. However, solutions that can be safely and conveniently transplanted in one single surgical intervention are still very challenging as their production normally requires long culture time, and graft survival is many times compromised by delayed vascularization upon transplantation. This work intended to propose a strategy that circumvents the prolonged and laborious preparation period of skin substitutes and allows skin cells self-organization toward improved healing. Human dermal/epidermal cell fractions were entrapped directly from isolation within a gellan gum/hyaluronic acid (GG-HA) spongy-like hydrogel formed from an off-the-shelf dried polymeric network. Upon transplantation into full-thickness mice wounds, the proposed constructs accelerated the wound closure rate and re-epithelialization, as well as tissue neovascularization. A synergistic effect of the GG-HA matrix and the transplanted cells over those processes was demonstrated at early time points. Despite the human-derived and chimeric blood vessels found, the proposed matrix did not succeed in prolonging cells residence time and in sustaining the self-organization of transplanted human cells possibly due to primitive degradation. Despite this, the herein proposed approach open the opportunity to tackle wound healing at early stages contributing to re-epithelialization and neovascularization.

Human Skin Cell Fractions Fail to Self-Organize Within a Gellan Gum/Hyaluronic Acid Matrix but Positively Influence Early Wound Healing

PubMed Central

Cerqueira, Mariana T.; da Silva, Lucília P.; Santos, Tírcia C.; Pirraco, Rogério P.; Correlo, Vitor M.; Reis, Rui L.

2014-01-01

Split-thickness autografts still are the current gold standard to treat skin, upon severe injuries. Nonetheless, autografts are dependent on donor site availability and often associated to poor quality neoskin. The generation of dermal–epidermal substitutes by tissue engineering is seen as a promising strategy to overcome this problematic. However, solutions that can be safely and conveniently transplanted in one single surgical intervention are still very challenging as their production normally requires long culture time, and graft survival is many times compromised by delayed vascularization upon transplantation. This work intended to propose a strategy that circumvents the prolonged and laborious preparation period of skin substitutes and allows skin cells self-organization toward improved healing. Human dermal/epidermal cell fractions were entrapped directly from isolation within a gellan gum/hyaluronic acid (GG-HA) spongy-like hydrogel formed from an off-the-shelf dried polymeric network. Upon transplantation into full-thickness mice wounds, the proposed constructs accelerated the wound closure rate and re-epithelialization, as well as tissue neovascularization. A synergistic effect of the GG-HA matrix and the transplanted cells over those processes was demonstrated at early time points. Despite the human-derived and chimeric blood vessels found, the proposed matrix did not succeed in prolonging cells residence time and in sustaining the self-organization of transplanted human cells possibly due to primitive degradation. Despite this, the herein proposed approach open the opportunity to tackle wound healing at early stages contributing to re-epithelialization and neovascularization. PMID:24299468

Psychic skin: psychotic defences, borderline process and delusions.

PubMed

Schmidt, Martin

2012-02-01

In this paper, I apply the concept of psychic skin to analytic work with people suffering from personality disorders and psychoses. When psychoses emerge, the defensive skin which protects the ego is breached and violent unconscious forces rip through the personality. Some of the patients diagnosed as schizophrenic with whom I work have identified with archetypal characters such as Christ, Satan, John Lennon and the Queen. I attempt to show how the adoption of these inflated personas can serve as secondary psychic skins. Such delusional identifications can provide a protective shield to hide the denuded self and prevent intrusion from the external world. Through clinical example, I try to demonstrate how these archetypal 'second skins' can preserve life until internal and external conditions make it possible for the self to emerge. I contrast such psychotic identifications with 'thin-skinned' and 'thick-skinned' narcissism as well as 'defences of the self' in borderline states where the psychic skin may be damaged but does not disintegrate. I also look at the ways in which Jung's own personal experience was different from this and how he managed to avert psychotic breakdown. © 2012, The Society of Analytical Psychology.

Management of complex pediatric laryngotracheal stenosis with skin graft reconstruction.

PubMed

Bowe, Sarah N; Wentland, Carissa J; Sandhu, G S; Hartnick, Christopher J

2018-05-01

For pediatric patients with laryngotracheal stenosis, the ultimate goal is creation of a safe, functional airway. Unfortunately, wound healing in a hollow structure can complicate repair attempts, leading to restenosis. Herein, we present our experience using skin-grafting techniques in two complex pediatric laryngotracheal stenosis cases, leading to successful decannulation or speech production. A chart review was performed examining the evaluation and management of two pediatric patients with laryngotracheal stenosis despite prior reconstructive attempts. Patient history, bronchoscopic evaluation, intra-operative technique, post-operative management, treatment outcomes, and complications were noted. Harvesting and preparation of the split-thickness skin grafts (STSG) proceeded in a similar manner for each case. Stenting material varied based on the clinical scenario. Using this technique, our patient with a Type 3 glottic web achieved substantial improvement in exercise tolerance, as well as vocal strength and quality. In addition, our aphonic patient could vocalize for the first time since her laryngotracheal injury. Temporary endoluminal stenting with skin graft lining can reproduce epithelial continuity and provide "biological inhibition" to enhance the wound healing process. When previous reconstructive efforts have failed, use of STSG can be considered in the management of complex pediatric laryngotracheal stenosis. Copyright © 2018. Published by Elsevier B.V.

Linear discriminant analysis of dermoscopic parameters for the differentiation of early melanomas from Clark naevi.

PubMed

Oka, Hiroshi; Tanaka, Masaru; Kobayashi, Seiichiro; Argenziano, Giuseppe; Soyer, H Peter; Nishikawa, Takeji

2004-04-01

As a first step to develop a screening system for pigmented skin lesions, we performed digital discriminant analyses between early melanomas and Clark naevi. A total of 59 cases of melanoma, including 23 melanoma in situ and 36 thin invasive melanomas (Breslow thickness < or =0.75 mm), and 188 clinically equivocal, histopathologically diagnosed Clark naevi were used in our study. After calculating 62 mathematical variables related to the colour, texture, asymmetry and circularity based on the dermoscopic findings of the pigmented skin lesions, we performed multivariate stepwise discriminant analysis using these variables to differentiate melanomas from naevi. The sensitivities and specificities of our model were 94.4 and 98.4%, respectively, for discriminating between melanomas (Breslow thickness < or =0.75 mm) and Clark naevi, and 73.9 and 85.6%, respectively, for discriminating between melanoma in situ and Clark naevi. Our algorithm accurately discriminated invasive melanomas from Clark naevi, but not melanomas in situ from Clark naevi.

Topical corticosteroids and topical calcineurin inhibitors in the treatment of atopic dermatitis: focus on percutaneous absorption.

PubMed

Pariser, David

2009-01-01

The 2 primary classes of drugs used to treat atopic dermatitis (AD) are topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs). For maximum efficacy, topical agents must efficiently penetrate the skin but, for optimal safety, should not be absorbed into the bloodstream. TCSs, a mainstay in AD treatment for more than 50 years, can potentially be absorbed into the systemic circulation, particularly when used on young children, for prolonged periods, or on areas of thin and sensitive skin, such as the eyelids, face, and flexures. There is a risk of cutaneous and systemic adverse events, including suppression of the hypothalamic-pituitary-adrenal axis and related sequelae, especially when potent or superpotent TCSs are used for extended periods. Ideally, TCSs should be used for short periods (2-4 weeks), but clinical reality often necessitates longer use. TCIs also effectively and safely treat AD, with the most commonly observed local adverse events being skin irritation and burning. These agents have demonstrated good penetration of the skin with minimal systemic absorption, as evidenced by low blood concentrations, and can be used safely on thin and sensitive skin. The use of mid-potency TCSs to treat acute flares involving skin of normal thickness, followed by the introduction of TCIs for maintenance therapy, constitutes an appropriate application of both drug classes. Pharmacists with a clear understanding of how both types of agents affect the systemic circulation have the opportunity to inform patients and caregivers about benefits and limitations of different therapeutic agents, address patient concerns about adverse events, and help patients understand how to use medical therapies appropriately.

Benefit of computer-aided detection analysis for the detection of subsolid and solid lung nodules on thin- and thick-section CT.

PubMed

Godoy, Myrna C B; Kim, Tae Jung; White, Charles S; Bogoni, Luca; de Groot, Patricia; Florin, Charles; Obuchowski, Nancy; Babb, James S; Salganicoff, Marcos; Naidich, David P; Anand, Vikram; Park, Sangmin; Vlahos, Ioannis; Ko, Jane P

2013-01-01

The objective of our study was to evaluate the impact of computer-aided detection (CAD) on the identification of subsolid and solid lung nodules on thin- and thick-section CT. For 46 chest CT examinations with ground-glass opacity (GGO) nodules, CAD marks computed using thin data were evaluated in two phases. First, four chest radiologists reviewed thin sections (reader(thin)) for nodules and subsequently CAD marks (reader(thin) + CAD(thin)). After 4 months, the same cases were reviewed on thick sections (reader(thick)) and subsequently with CAD marks (reader(thick) + CAD(thick)). Sensitivities were evaluated. Additionally, reader(thick) sensitivity with assessment of CAD marks on thin sections was estimated (reader(thick) + CAD(thin)). For 155 nodules (mean, 5.5 mm; range, 4.0-27.5 mm)-74 solid nodules, 22 part-solid (part-solid nodules), and 59 GGO nodules-CAD stand-alone sensitivity was 80%, 95%, and 71%, respectively, with three false-positives on average (0-12) per CT study. Reader(thin) + CAD(thin) sensitivities were higher than reader(thin) for solid nodules (82% vs 57%, p < 0.001), part-solid nodules (97% vs 81%, p = 0.0027), and GGO nodules (82% vs 69%, p < 0.001) for all readers (p < 0.001). Respective sensitivities for reader(thick), reader(thick) + CAD(thick), reader(thick) + CAD(thin) were 40%, 58% (p < 0.001), and 77% (p < 0.001) for solid nodules; 72%, 73% (p = 0.322), and 94% (p < 0.001) for part-solid nodules; and 53%, 58% (p = 0.008), and 79% (p < 0.001) for GGO nodules. For reader(thin), false-positives increased from 0.64 per case to 0.90 with CAD(thin) (p < 0.001) but not for reader(thick); false-positive rates were 1.17, 1.19, and 1.26 per case for reader(thick), reader(thick) + CAD(thick), and reader(thick) + CAD(thin), respectively. Detection of GGO nodules and solid nodules is significantly improved with CAD. When interpretation is performed on thick sections, the benefit is greater when CAD marks are reviewed on thin rather than thick sections.

An Andean-type retro-arc foreland system beneath northwest South China revealed by SINOPROBE profiling

NASA Astrophysics Data System (ADS)

Li, Jianhua; Dong, Shuwen; Cawood, Peter A.; Zhao, Guochun; Johnston, Stephen T.; Zhang, Yueqiao; Xin, Yujia

2018-05-01

In the Mesozoic, South China was situated along the convergent margin between the Asian and Pacific plates, providing an excellent laboratory to understand the interactions between deformation, sedimentation and magmatism in a retroarc environment. The crustal architecture of northwest South China is displayed along the ∼600-km-long SINOPROBE deep seismic reflection profiles and reveals from east to west: (1) highly folded and truncated reflectors in the upper crust of the Yangtze Fold Zone, which correspond to thin- and thick-skinned thrust systems, and document large-scale intraplate structural imbrication and shortening; (2) a crustal-scale flat-ramp-flat structure, termed the Main Yangtze decollement, which forms a weak, viscous layer to accommodate strain decoupling and material transport in the thin- and thick-skinned systems; and (3) nearly flat-lying reflectors in the Sichuan Basin, which support interpretation of the basin as a weakly deformed depocentre. The Yangtze Fold Zone and the Sichuan Basin represent a retro-arc foreland basin system that is >800 km away from the continental-margin magmatic arc. We suggest that tectonic processes across the arc and retro-arc systems, including arc magma flare-up, basin sedimentation, retroarc thrust propagation, lithosphere underthrusting, root foundering, and extension-related magmatism were interrelated and governed mass transfer. Age data and geological relations link the tectonic processes to evolving geodynamics of the subducting Paleo-Pacific plate.

Initiation of diapirism by regional extension

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jackson, M.P.A.; Vendeville, B.C.

Initiation of diapirism is one of the least understood aspects of salt tectonics. Sedimentary differential loading is a favorite explanation, but special conditions such as focused sedimentation are needed to trigger diapirism by differential loading. Compilation of published data from 18 of the world's salt-diapir provinces shows that salt upwelling is consistently linked in time with regional extension, whether thin-skinned or thick-skinned. Extended salt basins typically develop salt structures, whereas nonextended basins typically do not. In some basins containing thick salt (SW Iran), diapirism was delayed as long as 400 Ma until the basin was regionally extended. In other saltmore » provinces (Maritime Alps), episodic growth of salt diapirs correlates with episodic regional extension during opening of the Neo-Tethys and Atlantic Oceans. Once initiated, salt diapirism can continue after regional extension is succeeded by contraction or quiescence. Thus even in salt basins overprinted by inversion or orogenic contraction (Morocco, Lusitania, Basque-Cantabrian, North Sea), the diapirs were initiated during extension on divergent continental margins or in intracontinental rifts. This observed temporal link between extension and diapirism is consistent with physical and numerical modeling, which demonstrates that extensional faulting of the overburden directly causes diapirism whether the salt was deposited before, during, or after rifting. Where the overburden is thinned by extension, pressurized salt wells up in response to the shifting positions of fault blocks.« less

Advances in Surgical Reconstructive Techniques in the Management of Penile, Urethral, and Scrotal Cancer.

PubMed

Bickell, Michael; Beilan, Jonathan; Wallen, Jared; Wiegand, Lucas; Carrion, Rafael

2016-11-01

This article reviews the most up-to-date surgical treatment options for the reconstructive management of patients with penile, urethral, and scrotal cancer. Each organ system is examined individually. Techniques and discussion for penile cancer reconstruction include Mohs surgery, glans resurfacing, partial and total glansectomy, and phalloplasty. Included in the penile cancer reconstruction section is the use of penile prosthesis in phalloplasty patients after penectomy, tissue engineering in phallic regeneration, and penile transplantation. Reconstruction following treatment of primary urethral carcinoma and current techniques for scrotal cancer reconstruction using split-thickness skin grafts and flaps are described. Copyright © 2016 Elsevier Inc. All rights reserved.

Third-degree burns caused by ignition of chlorhexidine: A case report and systematic review of the literature

PubMed Central

Vo, Anthony; Bengezi, Omar

2014-01-01

Ignition of chlorhexidine by an electrocautery unit is rare but can have devastating consequences for the patient and the surgeon. A case involving a 77-year-old man who underwent removal of an indwelling artificial urethral sphincter is presented. The chlorhexidine was ignited when the urologist activated the electrocautery unit, causing third-degree burns to the patient. A plastic surgeon treated the burns with surgical debridement and split-thickness skin grafting. A systematic review of the literature was performed with best practice recommendations. To the authors’ knowledge, the present case is the ninth such case reported. PMID:25535466

A modified surgical technique in the management of eyelid burns: a case series

PubMed Central

2011-01-01

Introduction Contractures, ectropion and scarring, the most common sequelae of skin grafts after eyelid burn injuries, can result in corneal exposure, corneal ulceration and even blindness. Split-thickness or full-thickness skin grafts are commonly used for the treatment of acute eyelid burns. Plasma exudation and infection are common early complications of eyelid burns, which decrease the success rate of grafts. Case presentation We present the cases of eight patients, two Chinese women and six Chinese men. The first Chinese woman was 36 years old, with 70% body surface area second or third degree flame burn injuries involving her eyelids on both sides. The other Chinese woman was 28 years old, with sulfuric acid burns on her face and third degree burn on her eyelids. The six Chinese men were aged 21, 31, 38, 42, 44, and 55 years, respectively. The 38-year-old patient was transferred from the ER with 80% body surface area second or third degree flame burn injuries and third degree burn injuries to his eyelids. The other five men were all patients with flame burn injuries, with 7% to 10% body surface area third degree burns and eyelids involved. All patients were treated with a modified surgical procedure consisting of separation and loosening of the musculus orbicularis oculi between tarsal plate and septum orbital, followed by grafting a large full-thickness skin graft in three days after burn injury. The use of our modified surgical procedure resulted in 100% successful eyelid grafting on first attempt, and all our patients were in good condition at six-month follow-up. Conclusions This new surgical technique is highly successful in treating eyelid burn injuries, especially flame burn injuries of the eyelid. PMID:21843322

Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin?

PubMed

van Hoof, Marc; Wigren, Stina; Duimel, Hans; Savelkoul, Paul H M; Flynn, Mark; Stokroos, Robert Jan

2015-01-01

Percutaneous implants, such as bone conduction hearing implants, suffer from complications that include inflammation of the surrounding skin. A sealed skin-abutment interface can prevent the ingress of bacteria, which should reduce the occurrence of peri-abutment dermatitis. It was hypothesized that a hydroxyapatite (HA)-coated abutment in conjunction with soft tissue preservation surgery should enable integration with the adjacent skin. Previous research has confirmed that integration is never achieved with as-machined titanium abutments. Here, we investigate, in vivo, if skin integration is achievable in patients using a HA-coated abutment. One titanium abutment (control) and one HA-coated abutment (case) together with the surrounding skin were surgically retrieved from two patients who had a medical indication for this procedure. Histological sections of the skin were investigated using light microscopy. The abutment was qualitatively analyzed using scanning electron microscopy. The titanium abutment only had a partial and thin layer of attached amorphous biological material. The HA-coated abutment was almost fully covered by a pronounced thick layer of organized skin, composed of different interconnected structural layers. Proof-of-principle evidence that the HA-coated abutment can achieve integration with the surrounding skin was presented for the first time.

A flexible skin piloerection monitoring sensor

NASA Astrophysics Data System (ADS)

Kim, Jaemin; Seo, Dae Geon; Cho, Young-Ho

2014-06-01

We have designed, fabricated, and tested a capacitive-type flexible micro sensor for measurement of the human skin piloerection arisen from sudden emotional and environmental change. The present skin piloerection monitoring methods are limited in objective and quantitative measurement by physical disturbance stimulation to the skin due to bulky size and heavy weight of measuring devices. The proposed flexible skin piloerection monitoring sensor is composed of 3 × 3 spiral coplanar capacitor array using conductive polymer for having high capacitive density and thin enough thickness to be attached to human skin. The performance of the skin piloerection monitoring sensor is characterized using the artificial bump, representing human skin goosebump; thus, resulting in the sensitivity of -0.00252%/μm and the nonlinearity of 25.9% for the artificial goosebump deformation in the range of 0-326 μm. We also verified successive human skin piloerection having 3.5 s duration on the subject's dorsal forearms, thus resulting in the capacitance change of -6.2 fF and -9.2 fF for the piloerection intensity of 145 μm and 194 μm, respectively. It is demonstrated experimentally that the proposed sensor is capable to measure the human skin piloerection objectively and quantitatively, thereby suggesting the quantitative evaluation method of the qualitative human emotional status for cognitive human-machine interfaces applications.

Using an adhesive retention tape on split skin graft donor areas.

PubMed

McPhee, Helen

Donor split skin graft areas are often painful, a problem that can be exacerbated when dressings that have been applied slip, particularly when they are on the patient's thigh. Helen McPhee carried out a small trial to assess whether Mefix, an adhesive retention tape, could help to reduce these problems

Crustal and Mantle Structure beneath the Okavango and Malawi Rifts and Its Geodynamic Implications

NASA Astrophysics Data System (ADS)

Gao, S. S.; Liu, K. H.; Yu, Y.; Reed, C. A.; Mickus, K. L.; Moidaki, M.

2017-12-01

To investigate crustal and mantle structure beneath the young and incipient sections of the East African Rift System and provide constraints on rifting models, a total of 50 broadband seismic stations were placed along three profiles across the Okavango and Malawi rifts, with a total length of about 2500 km. Results to date suggest minor crustal thinning and nearly normal seismic velocities in the upper mantle beneath both rifts. The thickness of the mantle transition zone is comparable to the global average, suggesting the lack of thermal upwelling from the lower mantle beneath the rifts. In addition, shear-wave splitting analysis found no anomalies in either the fast polarization orientation or the splitting time associated with the rifts, and thus has ruled out the existence of small-scale mantle convection or plume-related mantle flow beneath the rifts. While the Okavango rift has long been recognized to be located in a Precambrian orogenic zone between the Kalahari and Congo cratons, our results suggest that the Malawi Rift is also developing along the western edge of a lithospheric block with relatively greater thickness relative to the surrounding area. Those seismological and gravity modeling results are consistent with a passive rifting model, in which rifts develop along pre-existing zones of lithospheric weakness, where rapid variations of lithospheric thickness is observed. Lateral variations of dragging stress applied to the bottom of the lithosphere are the most likely cause for the initiation and development of both rifts.

A Ga2O3 underlayer as an isomorphic template for ultrathin hematite films toward efficient photoelectrochemical water splitting.

PubMed

Hisatomi, Takashi; Brillet, Jérémie; Cornuz, Maurin; Le Formal, Florian; Tétreault, Nicolas; Sivula, Kevin; Grätzel, Michael

2012-01-01

Hematite photoanodes for photoelectrochemical (PEC) water splitting are often fabricated as extremely-thin films to minimize charge recombination because of the short diffusion lengths of photoexcited carriers. However, poor crystallinity caused by structural interaction with a substrate negates the potential of ultrathin hematite photoanodes. This study demonstrates that ultrathin Ga2O3 underlayers, which were deposited on conducting substrates prior to hematite layers by atomic layer deposition, served as an isomorphic (corundum-type) structural template for ultrathin hematite and improved the photocurrent onset of PEC water splitting by 0.2 V. The benefit from Ga2O3 underlayers was most pronounced when the thickness of the underlayer was approximately 2 nm. Thinner underlayers did not work effectively as a template presumably because of insufficient crystallinity of the underlayer, while thicker ones diminished the PEC performance of hematite because the underlayer prevented electron injection from hematite to a conductive substrate due to the large conduction band offset. The enhancement of PEC performance by a Ga2O3 underlayer was more significant for thinner hematite layers owing to greater margins for improving the crystallinity of ultrathin hematite. It was confirmed that a Ga2O3 underlayer was applicable to a rough conducting substrate loaded with Sb-doped SnO2 nanoparticles, improving the photocurrent by a factor of 1.4. Accordingly, a Ga2O3 underlayer could push forward the development of host-guest-type nanocomposites consisting of highly-rough substrates and extremely-thin hematite absorbers.

Altered (/sup 125/I)epidermal growth factor binding and receptor distribution in psoriasis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nanney, L.B.; Stoscheck, C.M.; Magid, M.

1986-03-01

Stimulation of growth and differentiation of human epidermis by epidermal growth factor (EGF) is mediated by its binding to specific receptors. Whether EGF receptors primarily mediate cell division or differentiation in hyperproliferative disease such as psoriasis vulgaris is unclear. To study the pathogenesis of psoriasis, 4-mm2 punch biopsy specimens of normal, uninvolved, and involved psoriatic skin were assayed for EGF receptors by autoradiographic, immunohistochemical, and biochemical methods. Using autoradiographic and immunohistochemical methods, basal keratinocytes were found to contain the greatest number of EGF binding sites and immunoreactive receptors as compared to the upper layers of the epidermis in both normalmore » epidermis and psoriatic skin. No EGF receptor differences between normal and psoriatic epidermis were observed in this layer. In the upper layers of the epidermis, a 2-fold increase in EGF binding capacity was observed in psoriatic skin as compared with normal thin or thick skin. Biochemical methods indicated that (/sup 125/I)EGF binding was increased in psoriatic epidermis as compared with similar thickness normal epidermis when measured on a protein basis. Epidermal growth factor was shown to increase phosphorylation of the EGF receptor in skin. EGF receptors retained in the nonmitotic stratum spinosum and parakeratotic stratum corneum may reflect the incomplete, abnormal differentiation that occurs in active psoriatic lesions. Alternatively, retained EGF receptors may play a direct role in inhibiting cellular differentiation in the suprabasal layers.« less

Compound surface-plasmon-polariton waves guided by a thin metal layer sandwiched between a homogeneous isotropic dielectric material and a structurally chiral material

NASA Astrophysics Data System (ADS)

Chiadini, Francesco; Fiumara, Vincenzo; Scaglione, Antonio; Lakhtakia, Akhlesh

2016-03-01

Multiple compound surface plasmon-polariton (SPP) waves can be guided by a structure consisting of a sufficiently thick layer of metal sandwiched between a homogeneous isotropic dielectric (HID) material and a dielectric structurally chiral material (SCM). The compound SPP waves are strongly bound to both metal/dielectric interfaces when the thickness of the metal layer is comparable to the skin depth but just to one of the two interfaces when the thickness is much larger. The compound SPP waves differ in phase speed, attenuation rate, and field profile, even though all are excitable at the same frequency. Some compound SPP waves are not greatly affected by the choice of the direction of propagation in the transverse plane but others are, depending on metal thickness. For fixed metal thickness, the number of compound SPP waves depends on the relative permittivity of the HID material, which can be useful for sensing applications.

Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible.

PubMed

Wang, Tongyue; Han, Jeong Joon; Oh, Hee-Kyun; Park, Hong-Ju; Jung, Seunggon; Park, Yeong-Joon; Kook, Min-Suk

2016-07-01

This study aimed to identify risk factors associated with bad splits during sagittal split ramus osteotomy by using three-dimensional computed tomography. This study included 8 bad splits and 47 normal patients without bad splits. Mandibular anatomic parameters related to osteotomy line were measured. These included anteroposterior width of the ramus at level of lingula, distance between external oblique ridge and lingula, distance between sigmoid notch and inferior border of mandible, mandibular angle, distance between inferior outer surface of mandibular canal and inferior border of mandible under distal root of second molar (MCEM), buccolingual thickness of the ramus at level of lingula, and buccolingual thickness of the area just distal to first molar (BTM1) and second molar (BTM2). The incidence of bad splits in 625 sagittal split osteotomies was 1.28%. Compared with normal group, bad split group exhibited significantly thinner BTM2 and shorter sigmoid notch and inferior border of mandible (P <0.05). However, for BTM1 and buccolingual thickness of the ramus at level of lingula, there was no statistical difference between the 2 groups. Mandibular angle, anteroposterior width of the ramus at level of lingula, external oblique ridge and lingula, and MCEM were not significantly different between the groups. This study suggests that patients with shorter ramus and low thickness of the buccolingual alveolar region distal to the second molar had a higher risk of bad splits. These anatomic data may help surgeons to choose the safest surgical techniques and best osteotomy sites.

High-energy roller injuries to the upper extremity.

PubMed

Askins, G; Finley, R; Parenti, J; Bush, D; Brotman, S

1986-12-01

Eleven cases of high-energy industrial roller injuries treated between 1980 and 1984 were retrospectively reviewed. The dominant extremity was affected in nine. Six patients sustained fractures and/or dislocations, and three of these patients required fasciotomies for clinical signs of impending compartment syndromes. All fracture/dislocations, with the exception of a scapula fracture, anterior dislocation of a thumb interphalangeal joint, and a fractured coronoid process of the ulna, required open reduction with internal fixation. Three patients required split-thickness skin grafting for extensive skin degloving. Two patients required immediate amputation. Late sequelae included prolonged edema, nutritional depletion, neuroma formation of the superficial branch of the radial nerve, late carpal tunnel syndrome, and partial brachial plexus palsy. Industrial roller injuries continue to be an occupational hazard associated with more severe crushing trauma than the low-energy wringer washer injuries first described by MacCollum (11). Attention must be paid to the treatment of crushed skin, muscle, and nerves, fracture stabilization, nutritional support, and occupational therapy. Concurrent monitoring for signs of a developing compartment syndrome and complications of rhabdomyolysis is essential.

Necrotizing fasciitis after scrotum skin injury in an infant: A case report.

PubMed

Ren, Z X; Liu, C L; Zhang, Q; Xu, F; Zheng, Y N; Li, X J; Yang, J

2018-03-01

Necrotizing fasciitis (NF) is a life-threatening situation that is rare in children, especially infants, and early diagnosis is challenging. Timely identification and broad-spectrum antibiotic and supportive treatment before surgical debridement are very important for survival and may reduce scar formation. A previously healthy 4-month-old infant was admitted to our pediatric intensive care unit (PICU) with a history of fever and cough for 5 days and extreme swelling of the scrotum for one day. Necrotic-like tissue without margins appeared on his scrotum and perineum in 24 hours. NF was suspected, and the patient soon developed shock. The patient underwent surgical debridement after his condition stabilized. Pathological analysis confirmed the diagnosis of NF. Broad-spectrum antibiotic, immediate fluid resuscitation, assistant ventilation, and vasoactive drugs were administered. Surgical debridement and autologous split-thickness skin grafting were performed. The wound recovered well after 2 months. Ultrasound revealed normal testicles, and no anorectal injury was found. Close clinical monitoring and timely treatment of skin injuries in sick children are very important. Sufficient antibiotic administration and supportive treatment before surgical debridement are crucial for survival from NF.

The Barrancas anticline in west-central Argentina: new geomorphic and geologic constraints on the geometry and activity of a fault-related fold

NASA Astrophysics Data System (ADS)

Rimando, J. M.; Schoenbohm, L. M.

2016-12-01

The Barrancas anticline in Mendoza Province, west-central Argentina is a N-NW-oriented, east-vergent fault-bend fold located in the transition from the mainly east-vergent, thin-skinned Argentine Precordillera to the mainly west-vergent, thick-skinned Sierras Pampeanas — one of the most active thrust zones on Earth. Previous studies of the Barrancas anticline interpreted its structure from 2-D and 3-D seismic data. The anticline is a fault-bend fold with multiple segments with different uplift histories and which linked only after 2.3Ma. This study aims to establish the temporal persistence of segmentation and to describe the role, extent and rates of deformation processes involved in the development of the Barrancas anticline from morphometric analyses, geologic and geomorphic mapping, and accurate dating of relevant geomorphic features. Longitudinal profile analysis of streams on the anticline reveals marked differences in normalized steepness index (ksn) between the western and eastern limbs as well as variation along strike. This distribution of ksn values reveals patterns consistent with asymmetry and segmentation of the Barrancas anticline. Swath profiles parallel to the fold axis resemble fault slip distribution profiles which was a basis for segmentation from previous studies. Drainage basin morphometric indices such as hypsometry, drainage density, and basin elongation were also measured. Hypsometric integral values were particularly higher on the west than on the east, possibly indicating younger folding on the western limb. This study will contribute to a better understanding of the nature, extent, timing, and rate of folding at the transition from thin- to thick-skinned thrust deformation in west-central Argentina. Additionally, this study will contribute to assessment of seismic hazards associated with fault-related folds in Argentina and in similar tectonic settings worldwide.

SU-E-I-53: Variation in Measurements of Breast Skin Thickness Obtained Using Different Imaging Modalities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, U; Kumaraswamy, N; Markey, M

Purpose: To investigate variation in measurements of breast skin thickness obtained using different imaging modalities, including mammography, computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI). Methods: Breast skin thicknesses as measured by mammography, CT, ultrasound, and MRI were compared. Mammographic measurements of skin thickness were obtained from published studies that utilized standard positioning (upright) and compression. CT measurements of skin thickness were obtained from a published study of a prototype breast CT scanner in which the women were in the prone position and the breast was uncompressed. Dermatological ultrasound exams of the breast skin were conducted at our institution,more » with the subjects in the upright position and the breast uncompressed. Breast skin thickness was calculated from breast MRI exams at our institution, with the patient in the prone position and the breast uncompressed. Results: T tests for independent samples demonstrated significant differences in the mean breast skin thickness as measured by different imaging modalities. Repeated measures ANOVA revealed significant differences in breast skin thickness across different quadrants of the breast for some modalities. Conclusion: The measurement of breast skin thickness is significantly different across different imaging modalities. Differences in the amount of compression and differences in patient positioning are possible reasons why measurements of breast skin thickness vary by modality.« less

The role of ultra-thin SiO2 layers in metal-insulator-semiconductor (MIS) photoelectrochemical devices (Presentation Recording)

NASA Astrophysics Data System (ADS)

Esposito, Daniel V.

2015-08-01

Solid-state junctions based on a metal-insulator-semiconductor (MIS) architecture are of great interest for a number of optoelectronic applications such as photovoltaics, photoelectrochemical cells, and photodetection. One major advantage of the MIS junction compared to the closely related metal-semiconductor junction, or Schottky junction, is that the thin insulating layer (1-3 nm thick) that separates the metal and semiconductor can significantly reduce the density of undesirable interfacial mid-gap states. The reduction in mid-gap states helps "un-pin" the junction, allowing for significantly higher built-in-voltages to be achieved. A second major advantage of the MIS junction is that the thin insulating layer can also protect the underlying semiconductor from corrosion in an electrochemical environment, making the MIS architecture well-suited for application in (photo)electrochemical applications. In this presentation, discontinuous Si-based MIS junctions immersed in electrolyte are explored for use as i.) photoelectrodes for solar-water splitting in photoelectrochemical cells (PECs) and ii.) position-sensitive photodetectors. The development and optimization of MIS photoelectrodes for both of these applications relies heavily on understanding how processing of the thin SiO2 layer impacts the properties of nano- and micro-scale MIS junctions, as well as the interactions of the insulating layer with the electrolyte. In this work, we systematically explore the effects of insulator thickness, synthesis method, and chemical treatment on the photoelectrochemical and electrochemical properties of these MIS devices. It is shown that electrolyte-induced inversion plays a critical role in determining the charge carrier dynamics within the MIS photoelectrodes for both applications.

Lithospheric deformation in the Canadian Appalachians: evidence from shear wave splitting

NASA Astrophysics Data System (ADS)

Bastow, I. D.; Gilligan, A.; Watson, E.; Darbyshire, F. A.; Levin, V. L.; Menke, W. H.; Lane, V.; Boyce, A.; Liddell, M. V.; Petrescu, L.; Hawthorn, D.

2016-12-01

Plate-scale deformation is expected to impart seismic anisotropic fabrics on the lithosphere. Determination of the fast shear wave orientation (φ ) and the delay time between the fast and slow split shear waves (δt ) via SKS splitting can help place spatial and temporal constraints on lithospheric deformation. The Canadian Appalachians experienced multiple episodes of deformation during the Phanerozoic: accretionary collisions during the Palaeozoic prior to the collision between Laurentia and Gondwana, and rifting related to the Mesozoic opening of the North Atlantic. However, the extent to which extensional events have overprinted older orogenic trends is uncertain. We address this issue through measurements of seismic anisotropy beneath the Canadian Appalachians, computing shear wave splitting parameters (φ , δt ) for new and existing seismic stations in Nova Scotia and New Brunswick. Average δt values of 1.2 s, relatively short length scale (≥ 100 km) splitting parameter variations, and a lack of correlation with absolute plate motion direction and mantle flow models, demonstrate that fossil lithospheric anisotropic fabrics dominate our results. Most fast directions parallel Appalachian orogenic trends observed at the surface, while δt values point towards coherent deformation of the crust and mantle lithosphere. Mesozoic rifting had minimal impact on our study area, except locally within the Bay of Fundy and in southern Nova Scotia, where fast directions are subparallel to the opening direction of Mesozoic rifting; associated δt values of > 1 s require an anisotropic layer that spans both the crust and mantle, meaning the formation of the Bay of Fundy was not merely a thin-skinned tectonic event.

Lithospheric deformation in the Canadian Appalachians: evidence from shear wave splitting

NASA Astrophysics Data System (ADS)

Gilligan, Amy; Bastow, Ian D.; Watson, Emma; Darbyshire, Fiona A.; Levin, Vadim; Menke, William; Lane, Victoria; Hawthorn, David; Boyce, Alistair; Liddell, Mitchell V.; Petrescu, Laura

2016-08-01

Plate-scale deformation is expected to impart seismic anisotropic fabrics on the lithosphere. Determination of the fast shear wave orientation (ϕ) and the delay time between the fast and slow split shear waves (δt) via SKS splitting can help place spatial and temporal constraints on lithospheric deformation. The Canadian Appalachians experienced multiple episodes of deformation during the Phanerozoic: accretionary collisions during the Palaeozoic prior to the collision between Laurentia and Gondwana, and rifting related to the Mesozoic opening of the North Atlantic. However, the extent to which extensional events have overprinted older orogenic trends is uncertain. We address this issue through measurements of seismic anisotropy beneath the Canadian Appalachians, computing shear wave splitting parameters (ϕ, δt) for new and existing seismic stations in Nova Scotia and New Brunswick. Average δt values of 1.2 s, relatively short length scale (≥100 km) splitting parameter variations, and a lack of correlation with absolute plate motion direction and mantle flow models, demonstrate that fossil lithospheric anisotropic fabrics dominate our results. Most fast directions parallel Appalachian orogenic trends observed at the surface, while δt values point towards coherent deformation of the crust and mantle lithosphere. Mesozoic rifting had minimal impact on our study area, except locally within the Bay of Fundy and in southern Nova Scotia, where fast directions are subparallel to the opening direction of Mesozoic rifting; associated δt values of >1 s require an anisotropic layer that spans both the crust and mantle, meaning the formation of the Bay of Fundy was not merely a thin-skinned tectonic event.

Preliminary Investigations on Therapy Thresholds for Laser Dosimetry, Cryogen Spray Cooling Duration, and Treatment Cycles for Laser Cartilage Reshaping in the New Zealand White Rabbit Auricle

PubMed Central

Chlebicki, Cara A.; Protsenko, Dmitry E.; Wong, Brian J.

2014-01-01

Previous studies have demonstrated the feasibility of laser irradiation (λ=1.45 μm) in tandem with cryogen spray cooling (CSC) to reshape rabbit auricular cartilage using total energy density of 14 J/cm2. The aim of this study was to further explore and identify the dosimetry parameter space for laser output energy, CSC duration, and treatment cycles required to achieve shape change while limiting skin and cartilage injury. Ten New Zealand white rabbits were treated with the 1.45 μm diode laser combined with cryogen spray cooling (Candela Smoothbeam™, Candela Co., Wayland, MA). The ear's central portion was bent around a cylindrical jig and irradiated in consecutive spots of 6 mm diameter (13 J/cm2 or 14 J/cm2 per spot) along 3 rows encompassing the bend. CSC was delivered during irradiation in cycles consisting of 25-35 ms. At thin and thick portions of the ear, 4-7 and 6-10 treatment cycles were delivered, respectively. After surgery, ears were examined and splinted for 6 weeks. Treatment parameters resulting in acceptable (Grades 1 & 2) and unacceptable (Grade 3) skin injuries for thick and thin regions were identified and shape change was observed. Confocal and histological analysis of cartilage tissue revealed several outcomes correlating to laser dosimetry, CSC duration, and treatment cycles. These outcomes included expansion of cartilage layers (thickening), partial cartilage injuries, and full thickness cartilage injuries. We determined therapy thresholds for laser output energy, cryogen spray cooling duration, and treatment cycles in the rabbit auricular model. These parameters are a starting point for future clinical procedures aimed at correcting external ear deformities. PMID:24202858

Preliminary investigations on therapy thresholds for laser dosimetry, cryogen spray cooling duration, and treatment cycles for laser cartilage reshaping in the New Zealand white rabbit auricle.

PubMed

Chlebicki, Cara A; Protsenko, Dmitry E; Wong, Brian J

2014-05-01

Previous studies have demonstrated the feasibility of laser irradiation (λ = 1.45 μm) in tandem with cryogen spray cooling (CSC) to reshape rabbit auricular cartilage using a total energy density of 14 J/cm(2). The aim of this study was to further explore and identify the dosimetry parameter space for laser output energy, CSC duration, and treatment cycles required to achieve shape change while limiting skin and cartilage injury. Ten New Zealand white rabbits were treated with the 1.45 μm diode laser combined with cryogen spray cooling (Candela Smoothbeam™, Candela Co., Wayland, MA, USA). The ear's central portion was bent around a cylindrical jig and irradiated in consecutive spots of 6 mm diameter (13 or 14 J/cm(2) per spot) along three rows encompassing the bend. CSC was delivered during irradiation in cycles consisting of 25-35 ms. At thin and thick portions of the ear, 4-7 and 6-10 treatment cycles were delivered, respectively. After surgery, ears were examined and splinted for 6 weeks. Treatment parameters resulting in acceptable (grades 1 and 2) and unacceptable (grade 3) skin injuries for thick and thin regions were identified, and shape change was observed. Confocal and histological analysis of cartilage tissue revealed several outcomes correlating to laser dosimetry, CSC duration, and treatment cycles. These outcomes included expansion of cartilage layers (thickening), partial cartilage injuries, and full-thickness cartilage injuries. We determined therapy thresholds for laser output energy, cryogen spray cooling duration, and treatment cycles in the rabbit auricular model. These parameters are a starting point for future clinical procedures aimed at correcting external ear deformities.

Efficacy of Epidermal Skin Grafts Over Complex, Chronic Wounds in Patients With Multiple Comorbidities.

PubMed

Fearmonti, Regina M

2016-07-01

Epidermal skin grafting presents an alternative to traditional autografts since only epidermal skin is harvested from the donor site. Split-thickness skin grafts are associated with difficulties at the donor site, including excessive pain, delayed healing, fluid loss, and unsatisfactory cosmetic results - all exacerbated in patients with comorbidities. A new automated epidermal harvesting tool (CelluTome Epidermal Harvesting System, KCI, an Acelity company, San Antonio, TX) involves concurrent application of heat and suction to normal skin to produce epidermal grafts. This article outlines the author's experience using this automated epidermal harvesting tool to harvest epidermal grafts and apply them on 23 chronic lower extremity wounds of patients with multiple comorbidities. Vacuum and heat were applied until epidermal microdomes were formed (30-45 minutes); an epidermal microdome array was collected onto a transfer dressing and applied over the wound. The automated harvesting tool yielded viable epithelium with every use. In addition to the epidermal skin graft, 16 of 23 wounds (70%) received adjunctive wound treatment, including negative pressure wound therapy, hyperbaric oxygen therapy, and/or regenerative tissue matrix. The average reepithelialization rate was 88.1% during a mean follow-up period of 76.4 days; no use of an anesthetic/operating room was required for the procedure. All donor sites were completely healed within 2 weeks without complications or scarring. Epidermal skin grafting provided a simplified, office-based grafting option with no donor site morbidity, and assisted in closure or size reduction of chronic wounds in this series.

Advanced film-forming gel formula vs spring thermal water and white petrolatum as primary dressings after full-face ablative fractional CO2 laser resurfacing: a comparative split-face pilot study.

PubMed

Marini, L

2018-01-01

Aesthetically pleasing results and fast, uneventful recovery are highly desirable after rejuvenating ablative laser procedures. Wound dressings following ablative laser procedures should ideally improve and optimize the wound healing environment. The purpose of this comparative split-face, single-blinded, prospective observational study was to assess the efficacy and acceptability of two primary wound dressings immediately after a full-face fractional CO 2 laser resurfacing procedure. The assessments of an innovative film-forming dressing called Stratacel (SC) vs spring thermal water + Vaseline (V+) were conducted after a standardized, single-pass, full-face ablative fractional CO 2 laser skin resurfacing procedure. Clinical parameters, such as haemoglobin - HB; surface temperature - ST; micro-textural modifications - MT; superficial melanin - M; intrafollicular porphyrins - P, were assessed at different phases of the healing process using standardized, non-invasive technologies. Five female volunteers were enrolled in this inpatient, controlled pilot study. Most of the clinical parameters considered, including 3D surface texture analysis, revealed a better performance of SC vs. V+ during the early, more delicate phases of the healing process. This preliminary study, even if performed on a small number of volunteers, confirmed a definite advantage of the tested semipermeable film-forming formula (SC) over a more conventional postoperative skin care regime (V+). Clinical results could be explained by a better uniformity of distribution of SC over the micro-irregularities induced by ablative fractional CO 2 laser resurfacing. Its thin, semipermeable film might, in fact, act as an efficient, perfectly biocompatible, full contact, temporary skin barrier, able to protect extremely delicate healing surfaces from potential environmental irritations. © 2017 European Academy of Dermatology and Venereology.

SU-F-T-379: Dosimetric Impacts of Topical Agents and Dressings On Skin in Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tse, K; Morley, L; Cashell, A

Purpose: This study investigated the superficial dose enhancement in the application of topical agents, clinical materials (thermal mask and bolus) and dressings in megavoltage photon beam radiotherapy. Different topical skin agents, clinical materials and dressings were evaluated and compared for their skin dosimetric impacts on the patients during radiation treatment. Methods: Superficial dose enhancements, or percentage doses with and without the studying materials, were measured using the 6 MV (Field size = 10×10 cm{sup 2}) photon beams produced by a Varian TrueBeam linear accelerator. Twelve topical agents, five dressings (dry and wet conditions) and three clinical materials were studied. Amore » solid water phantom was used with a MOSFET dose detector (TN-1002RD, Thomson and Nielsen Electronic, Ottawa, Ontario, Canada) located under a 1-mm PMMA slab to measure the skin dose. The distance between the radiation source and phantom surface was set to 100 cm in all measurements. The topical agents were distributed evenly with 1.5 mm thickness using our specific sample holder on the phantom surface. Extrapolations were made of 0.5 mm thickness for the agents to provide meaningful clinical value. Results: By comparing surface doses without studying materials, it is found that no topical agents had superficial dose enhancement higher than the clinical materials namely, thermoplastic mask (128%), 5-mm Superflab™ bolus (158%) and 10-mm Superflab™ bolus (171%) regarding the same thickness. Superficial dose enhancement of dry dressing did not exceed 110.5%, while wet dressings produced higher dose enhancements (133% for wet Mepilex lite and 141% for wet Mepilex Ag transfer). Conclusion: It is concluded that the evaluated topical agents and dry dressings did not increase the superficial dose to a concerning level, even using excessive thickness in every fraction of radiation treatment. Wet dressings were found producing the bolus effect, but was still substantially less than applying a thin 5-mm bolus.« less

Autologous transplantation of bone marrow-derived mesenchymal stem cells: a promising therapeutic strategy for prevention of skin-graft contraction.

PubMed

Xu, Y; Huang, S; Fu, X

2012-07-01

Hypertrophic scars result from abnormal healing of severe burns, and are characterized by loss of the original structure and function of the skin. Transplantation of autologous split skin is the preferred treatment after scar excision; however, there will be some unavoidable degree of contraction within the grafts. To our knowledge, it is very rare that bone marrow-derived mesenchymal stem cells (BM-MSCs) have been used for the treatment of skin-graft contraction. However, in our clinics, we found that during a 2-year follow-up analysis, areas treated with autologous BM-MSCs combined with transplantation of split skin were less likely to have contraction of the skin grafts than areas treated with skin grafts alone. This result indicates that BM-MSCs may be a potential and promising treatment to prevent contraction of skin grafts. © The Author(s). CED © 2012 British Association of Dermatologists.

Vapor-fed microfluidic hydrogen generator.

PubMed

Modestino, M A; Dumortier, M; Hosseini Hashemi, S M; Haussener, S; Moser, C; Psaltis, D

2015-05-21

Water-splitting devices that operate with humid air feeds are an attractive alternative for hydrogen production as the required water input can be obtained directly from ambient air. This article presents a novel proof-of-concept microfluidic platform that makes use of polymeric ion conductor (Nafion®) thin films to absorb water from air and performs the electrochemical water-splitting process. Modelling and experimental tools are used to demonstrate that these microstructured devices can achieve the delicate balance between water, gas, and ionic transport processes required for vapor-fed devices to operate continuously and at steady state, at current densities above 3 mA cm(-2). The results presented here show that factors such as the thickness of the Nafion films covering the electrodes, convection of air streams, and water content of the ionomer can significantly affect the device performance. The insights presented in this work provide important guidelines for the material requirements and device designs that can be used to create practical electrochemical hydrogen generators that work directly under ambient air.

Spin Lifetimes in III-V Semiconductor Heterostructures Originating from Zincblende Symmetry

NASA Astrophysics Data System (ADS)

Lau, Wayne; Olesberg, Jon; Flatté, Michael

2000-03-01

Electron spin relaxation in zincblende type semiconductors at room temperature is dominated by the D'yakonov-Perel' mechanism (DP), which is a direct result of the spin splitting of the conduction band due to the bulk inversion asymmetry (BIA) of zincblende materials. To accurately describe the DP spin relaxation mechanism in quantum wells we employ a heterostructure model based on a fourteen bulk band basis, which accounts for the zincblende symmetry of the heterostructure constituents. Electron spin lifetimes are calculated for 75Å n-doped GaAs/Al_0.4Ga_0.6As quantum wells at room temperature. Excellent agreement between theory and experiments is found. In contrast, the calculated spin lifetimes based on the D'yakonov-Kachorovskii theory are an order magnitude shorter than the experimental values. The spin splitting and spin lifetime in no common atom In_0.53Ga_0.47As/InP quantum wells are also investigated. The contribution to the conduction subband spin splitting is dominated by the native interface asymmetry (NIA) mechanism for thin quantum wells; while the spin splitting is governed by the BIA mechanism for thick quantum wells. We find that BIA provides a satisfactory explanation for the spin lifetime measured in an In_0.53Ga_0.47As/InP quantum well with a 97Å barrier and a 70Å well at room temperature.

Impact of skin cancer screening and secondary prevention campaigns on skin cancer incidence and mortality: A systematic review.

PubMed

Brunssen, Alicia; Waldmann, Annika; Eisemann, Nora; Katalinic, Alexander

2017-01-01

Benefits of skin cancer screening remain controversial. We sought to update evidence on the impact of skin cancer screening and secondary prevention campaigns on skin cancer incidence, mortality, stage-specific incidence, and interval cancers after negative screening. We searched MEDLINE and EMBASE for studies published in English or German between January 1, 2005, and February 4, 2015. Two reviewers independently performed study selection, data extraction, and critical appraisal. Results were described in a narrative synthesis. Of 2066 records identified in databases and 10 records found by manual search, we included 15 articles. Overall, evidence suggests that with implementation of skin cancer screening, incidence of in situ and invasive skin cancer increased; increasing rates of thin and decreasing rates of thick melanoma were observed. After cessation of screening, invasive melanoma incidence decreased. A significant melanoma mortality reduction was shown in a German study; 2 other studies observed fewer deaths than expected. No study on interval cancers was identified. Publication bias cannot be ruled out. Most studies are limited because of their ecological design. Large ecological studies, a cohort study, a case-control study, and a survey indicate benefits of skin cancer screening, but the evidence level is very low. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Selective Matrix (Hyaluronan) Interaction with CD44 and RhoGTPase Signaling Promotes Keratinocyte Functions and Overcomes Age-related Epidermal Dysfunction

PubMed Central

Bourguignon, Lilly Y.W.; Wong, Gabriel; Xia, Weiliang; Man, Mao-Qiang; Holleran, Walter M.; Elias, Peter M.

2013-01-01

Background Mouse epidermal chronologic aging is closely associated with aberrant matrix (hyaluronan, HA) -size distribution/production and impaired keratinocyte proliferation/differentiation, leading to a marked thinning of the epidermis with functional consequence that causes a slower recovery of permeability barrier function. Objective The goal of this study is to demonstrate mechanism-based, corrective therapeutic strategies using topical applications of small HA (HAS) and/or large HA (HAL) [or a sequential small HA (HAS) and large HA(HAL) (HAs-»HAL) treatment] as well as RhoGTPase signaling perturbation agents to regulate HA/CD44-mediated signaling, thereby restoring normal epidermal function, and permeability barrier homeostasis in aged mouse skin. Methods A number of biochemical, cell biological/molecular, pharmacological and physiological approaches were used to investigate matrix HA-CD44-mediated RhoGTPase signaling in regulating epidermal functions and skin aging. Results In this study we demonstrated that topical application of small HA (HAS) promotes keratinocyte proliferation and increases skin thickness, while it fails to upregulate keratinocyte differentiation or permeability barrier repair in aged mouse skin. In contrast, large HA (HAL) induces only minimal changes in keratinocyte proliferation and skin thickness, but restores keratinocyte differentiation and improves permeability barrier function in aged epidermis. Since neither HAS nor HAL corrects these epidermal defects in aged CD44 knock-out mice, CD44 likely mediates HA-associated epidermal functions in aged mouse skin. Finally, blockade of Rho-kinase activity with Y27632 or protein kinase-Nγ activity with Ro31-8220 significantly decreased the HA (HAS or HAL)-mediated changes in epidermal function in aged mouse skin. Conclusion The results of our study show first that HA application of different sizes regulates epidermal proliferation, differentiation and barrier function in aged mouse skin. Second, manipulation of matrix (HA) interaction with CD44 and RhoGTPase signaling could provide further novel therapeutic approaches that could be targeted for the treatment of various aging-related skin disorders. PMID:23790635

Some Physical and Computational Issues in Land Surface Data Assimilation of Satellite Skin Temperatures

NASA Astrophysics Data System (ADS)

Mackaro, Scott M.; McNider, Richard T.; Biazar, Arastoo Pour

2012-03-01

Skin temperatures that reflect the radiating temperature of a surface observed by infrared radiometers are one of the most widely available products from polar orbiting and geostationary satellites and the most commonly used satellite data in land surface assimilation. Past work has indicated that a simple land surface scheme with a few key parameters constrained by observations such as skin temperatures may be preferable to complex land use schemes with many unknown parameters. However, a true radiating skin temperature is sometimes not a prognostic variable in weather forecast models. Additionally, recent research has shown that skin temperatures cannot be directly used in surface similarity forms for inferring fluxes. This paper examines issues encountered in using satellite derived skin temperatures to improve surface flux specifications in weather forecast and air quality models. Attention is given to iterations necessary when attempting to nudge the surface energy budget equation to a desired state. Finally, the issue of mathematical operator splitting is examined in which the surface energy budget calculations are split with the atmospheric vertical diffusion calculations. However, the high level of connectivity between the surface and first atmospheric level means that the operator splitting leads to high frequency oscillations. These oscillations may hinder the assimilation of skin temperature derived moisture fluxes.

In vivo observation of age-related structural changes of dermal collagen in human facial skin using collagen-sensitive second harmonic generation microscope equipped with 1250-nm mode-locked Cr:Forsterite laser

NASA Astrophysics Data System (ADS)

Yasui, Takeshi; Yonetsu, Makoto; Tanaka, Ryosuke; Tanaka, Yuji; Fukushima, Shu-ichiro; Yamashita, Toyonobu; Ogura, Yuki; Hirao, Tetsuji; Murota, Hiroyuki; Araki, Tsutomu

2013-03-01

In vivo visualization of human skin aging is demonstrated using a Cr:Forsterite (Cr:F) laser-based, collagen-sensitive second harmonic generation (SHG) microscope. The deep penetration into human skin, as well as the specific sensitivity to collagen molecules, achieved by this microscope enables us to clearly visualize age-related structural changes of collagen fiber in the reticular dermis. Here we investigated intrinsic aging and/or photoaging in the male facial skin. Young subjects show dense distributions of thin collagen fibers, whereas elderly subjects show coarse distributions of thick collagen fibers. Furthermore, a comparison of SHG images between young and elderly subjects with and without a recent life history of excessive sun exposure show that a combination of photoaging with intrinsic aging significantly accelerates skin aging. We also perform image analysis based on two-dimensional Fourier transformation of the SHG images and extracted an aging parameter for human skin. The in vivo collagen-sensitive SHG microscope will be a powerful tool in fields such as cosmeceutical sciences and anti-aging dermatology.

The Effect of Particles on Electrolytically Polymerized Thin Natural MCF Rubber for Soft Sensors Installed in Artificial Skin

PubMed Central

Shimada, Kunio; Mochizuki, Osamu; Kubota, Yoshihiro

2017-01-01

The aim of this study is to investigate the effect of particles as filler in soft rubber sensors installed in artificial skin. We examine sensors made of natural rubber (NR-latex) that include magnetic particles of Ni and Fe3O4 using magnetic compound fluid (MCF). The 1-mm thickness of the electrolytically polymerized MCF rubber makes production of comparatively thin rubber sensors feasible. We first investigate the effect of magnetic particles Ni and Fe3O4 on the curing of MCF rubber. Next, in order to adjust the electric properties of the MCF rubber, we adopt Al2O3 dielectric particles. We investigate the effect of Al2O3 particles on changes in electric current, voltage and temperature of electrolytically polymerized MCF rubber liquid, and on the electric properties under the application of normal and shear forces. By adjusting the ratio of Ni, Fe3O4, Al2O3 and water in MCF rubber with Al2O3, it is possible to change the electric properties. PMID:28422061

[Skin graft combined with thorax wire fastening for repairing postoperative coloboma After resection of chest back giant nevus].

PubMed

Zhao, Weimin; Dai, Tao; Yuan, Depin; Zhang, Gongbao

2011-11-01

To observe the effectiveness of skin graft combined with thorax wire fastening for repairing postoperative coloboma after resection of chest back giant nevus. Between June 2007 and October 2010, 17 cases of chest back giant nevus were treated. There were 7 males and 10 females, aged from 3 years and 6 months to 15 years (mean, 8 years). The size of giant nevus was 20 cm x 12 cm to 60 cm x 50 cm. Two cases of them were ever treated by laser, while the others were never treated. The check before operation showed ulcer of the skin and effusion in 2 cases, hard skin in 3 cases, hair growth in 7 cases, and normal in 5 cases. Five cases had serious itch. After giant nevus was cut off, thorax wire was fastened to reduce the wound area, and then the intermediate split thickness skin graft of thigh was used to repair the wound. Comprehensive anti-scar treatment was given postoperatively. The wound size was (2 110.74 +/- 725.69) cm2 after resection of giant nevus, and was (1 624.94 +/- 560.57) cm2 after thorax wire fastening, showing significant difference (t = 9.006, P = 0.001). All the grafting skin survived; the incision and wound at donor site healed by first intention. The patients were followed up 6 months to 2 years (mean, 13 months). No scar proliferation or contracture occurred. The skin color and elasticity were similar to the normal skin; the nipple, navel, and other local apparatus were not shifted after operation. It can reduce donor site of skin and postoperative scar, and achieve satisfactory appearance to cover the wound by skin graft combined with thorax wire fastening after chest back giant nevus was cut off.

Comparison between Conventional Mechanical Fixation and Use of Autologous Platelet Rich Plasma (PRP) in Wound Beds Prior to Resurfacing with Split Thickness Skin Graft.

PubMed

P Waiker, Veena; Shivalingappa, Shanthakumar

2015-01-01

Platelet rich plasma is known for its hemostatic, adhesive and healing properties in view of the multiple growth factors released from the platelets to the site of wound. The primary objective of this study was to use autologous platelet rich plasma (PRP) in wound beds for anchorage of skin grafts instead of conventional methods like sutures, staplers or glue. In a single center based randomized controlled prospective study of nine months duration, 200 patients with wounds were divided into two equal groups. Autologous PRP was applied on wound beds in PRP group and conventional methods like staples/sutures used to anchor the skin grafts in a control group. Instant graft adherence to wound bed was statistically significant in the PRP group. Time of first post-graft inspection was delayed, and hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in plastic surgery unit were significantly less in the PRP group. Autologous PRP ensured instant skin graft adherence to wound bed in comparison to conventional methods of anchorage. Hence, we recommend the use of autologous PRP routinely on wounds prior to resurfacing to ensure the benefits of early healing.

Stability of finite difference numerical simulations of acoustic logging-while-drilling with different perfectly matched layer schemes

NASA Astrophysics Data System (ADS)

Wang, Hua; Tao, Guo; Shang, Xue-Feng; Fang, Xin-Ding; Burns, Daniel R.

2013-12-01

In acoustic logging-while-drilling (ALWD) finite difference in time domain (FDTD) simulations, large drill collar occupies, most of the fluid-filled borehole and divides the borehole fluid into two thin fluid columns (radius ˜27 mm). Fine grids and large computational models are required to model the thin fluid region between the tool and the formation. As a result, small time step and more iterations are needed, which increases the cumulative numerical error. Furthermore, due to high impedance contrast between the drill collar and fluid in the borehole (the difference is >30 times), the stability and efficiency of the perfectly matched layer (PML) scheme is critical to simulate complicated wave modes accurately. In this paper, we compared four different PML implementations in a staggered grid finite difference in time domain (FDTD) in the ALWD simulation, including field-splitting PML (SPML), multiaxial PML(MPML), non-splitting PML (NPML), and complex frequency-shifted PML (CFS-PML). The comparison indicated that NPML and CFS-PML can absorb the guided wave reflection from the computational boundaries more efficiently than SPML and M-PML. For large simulation time, SPML, M-PML, and NPML are numerically unstable. However, the stability of M-PML can be improved further to some extent. Based on the analysis, we proposed that the CFS-PML method is used in FDTD to eliminate the numerical instability and to improve the efficiency of absorption in the PML layers for LWD modeling. The optimal values of CFS-PML parameters in the LWD simulation were investigated based on thousands of 3D simulations. For typical LWD cases, the best maximum value of the quadratic damping profile was obtained using one d 0. The optimal parameter space for the maximum value of the linear frequency-shifted factor ( α 0) and the scaling factor ( β 0) depended on the thickness of the PML layer. For typical formations, if the PML thickness is 10 grid points, the global error can be reduced to <1% using the optimal PML parameters, and the error will decrease as the PML thickness increases.

CT analysis of fat distribution superficial and deep to the Scarpa's fascial layer in the mid and lower abdomen.

PubMed

Harley, O J H; Pickford, M A

2013-04-01

Mismatches in the thickness of subcutaneous fat at the level of the umbilicus and suprapubic region can result in an unsightly bulge and an unfavourable result following standard abdominoplasty. This problem can be avoided by thinning the abdominoplasty flap. This study was carried out to assess the thickness of the subcutaneous fat layer at the level of the umbilicus and the supra-pubic region. Measurements of full thickness fat and the depth of Scarpa's fascia separating superficial and sub-Scarpa fat layers were taken from the CT scans in 69 women; mean age 52 years (range 30-79). The thickness of the skin and abdominal wall fat was an average of 7 mm thicker (max 22 mm; p < 0.05). The thickness of the fat layer superficial to Scarpa's fascia was an average of 19 mm at mid abdomen and 22 mm in the lower abdomen (p < 0.05). The thickness of the fat layer deep to Scarpa's fascia was 14 mm in the mid abdomen and 5 mm in the lower abdomen (p < 0.05). In 55% of patients the difference in thickness of the mid abdominal and lower abdominal fat was greater than 5 mm, a difference that could lead to a noticeable mismatch and therefore an unfavourable outcome. Results of this study suggest that selectively thinning the fat layer deep to Scarpa's fascia would address potential mismatches and preserve the Scarpa's fascia layer in more than 50% of cases, therefore allowing wounds to be closed with an effective deep tension layer. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Supraclavicular Artery Flap for Head and Neck Oncologic Reconstruction: An Emerging Alternative

PubMed Central

Shenoy, Ashok; Patil, Vijayraj S.; Prithvi, B. S.; Chavan, P.; Halkud, Rajshekar

2013-01-01

Aim. Head and Neck oncologic resections often leave complex defects which are challenging to reconstruct. The need of the hour is a versatile flap which has the advantages of both a regional flap (viz. reliable and easy to harvest) and a free flap (thin, pliable with good colour match). In this a study we assessed the usefulness of the supraclavicular artery flap in head and neck oncologic defects. Materials and Method. The flap was used as a pedicled fasciocutanous and was based on the transverse supraclavicular artery. We assessed this reconstructive option for complications as well as its and functional out comes. Results. Eleven cases underwent supraclavicular artery flap between 20011-2012 of which 5 were males and 6 females. Mean defect size was 5 cm × 6 cm. Nine donor sites were closed primarily and 1 required split skin grafting. We encountered one complete flap loss which was attributed to a band of constricting skin bridge over the vascular pedicle in a defect involving lateral third of midface. Two patient developed pharyngeocutaneous fistula (without flap loss) out of 3 patients who underwent augmentation pharyngoplasty post Near total laryngectomy. Conclusion. Supra clavicular artery flap is a thin versatile, reliable, easy to harvest, with good cosmetic and functional outcome at both ends (recipient and donor) for reconstructing head and neck oncologic defects. PMID:24490064

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levy, Miguel; Chakravarty, A.; Huang, H.-C.

Significant departures from bulk-like magneto-optic behavior are found in ultra-thin bismuth-substituted iron-garnet films grown by liquid-phase-epitaxy. These changes are due, at least in part, to geometrical factors and not to departures from bulk-composition in the transient layer at the film-substrate interface. A monotonic increase in specific Faraday rotation with reduced thickness is the signature feature of the observed phenomena. These are traced to size-dependent modifications in the diamagnetic transition processes responsible for the Faraday rotation. These processes correspond to the electronic transitions from singlet {sup 6}S ground states to spin-orbit split excited states of the Fe{sup 3+} ions in themore » garnet. A measurable reduction in the corresponding ferrimagnetic resonance linewidths is found, thus pointing to an increase in electronic relaxation times and longer lived excitations at reduced thicknesses. These changes together with a shift in vibrational frequency of the Bi-O bonds in the garnet at reduced thicknesses result in greatly enhanced magneto-optical performance. These studies were conducted on epitaxial monocrystalline Bi{sub 0.8}Gd{sub 0.2}Lu{sub 2}Fe{sub 5}O{sub 12} films.« less

Highly efficient photocatalytic conversion of solar energy to hydrogen by WO3/BiVO4 core-shell heterojunction nanorods

NASA Astrophysics Data System (ADS)

Kosar, Sonya; Pihosh, Yuriy; Bekarevich, Raman; Mitsuishi, Kazutaka; Mawatari, Kazuma; Kazoe, Yutaka; Kitamori, Takehiko; Tosa, Masahiro; Tarasov, Alexey B.; Goodilin, Eugene A.; Struk, Yaroslav M.; Kondo, Michio; Turkevych, Ivan

2018-04-01

Photocatalytic splitting of water under solar light has proved itself to be a promising approach toward the utilization of solar energy and the generation of environmentally friendly fuel in a form of hydrogen. In this work, we demonstrate highly efficient solar-to-hydrogen conversion efficiency of 7.7% by photovoltaic-photoelectrochemical (PV-PEC) device based on hybrid MAPbI3 perovskite PV cell and WO3/BiVO4 core-shell nanorods PEC cell tandem that utilizes spectral splitting approach. Although BiVO4 is characterized by intrinsically high recombination rate of photogenerated carriers, this is not an issue for WO3/BiVO4 core-shell nanorods, where highly conductive WO3 cores are combined with extremely thin absorber BiVO4 shell layer. Since the BiVO4 layer is thinner than the characteristic carrier diffusion length, the photogenerated charge carriers are separated at the WO3/BiVO4 heterojunction before their recombination. Also, such architecture provides sufficient optical thickness even for extremely thin BiVO4 layer due to efficient light trapping in the core-shell WO3/BiVO4 nanorods with high aspect ratio. We also demonstrate that the concept of fill factor can be used to compare I-V characteristics of different photoanodes regarding their optimization for PV/PEC tandem devices.

Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain.

PubMed

Healy, Ciaran; Greig, Aina V H; Murphy, Adrian D; Powell, Christopher; Pinder, Richard J; Saour, Samer; Abela, Christopher; Knight, William; Geh, Jenny L C

2013-07-01

Pain at split skin graft donor sites is common. Fibrin sealant has been demonstrated to reduce time to hemostasis at wound sites, and patients receiving this treatment were incidentally noted to report less pain. This study aimed to evaluate pain and incapacity in split skin graft donor sites treated with and without fibrin sealant. Fifty patients requiring thigh donor-site split skin grafts were prospectively randomized to receive either a self-adhesive fabric dressing alone or fibrin sealant plus the self-adhesive fabric dressing as primary donor-site dressings. External secondary dressings were the same. Patients were blinded with regard to treatment group. Using visual analogue scales (scored 0 to 5), patients rated their donor-site pain and incapacity for 14 days postoperatively. Secondary endpoints were length of hospital stay and duration of requirement for dressings. Forty patients were included in the study analysis and completed self-reported pain and incapacity scores. Twenty received the fibrin sealant plus self-adhesive fabric dressing and 20 received the fabric dressing only (controls). Patients using the fibrin sealant plus the dressing reported significantly less pain (mean score, 0.42 versus 1.60, p < 0.001) and significantly less incapacity (mean score, 0.48 versus 1.71, p < 0.001). Patients allocated to the fibrin sealant group recorded shorter lengths of stay and faster time to discontinuation of dressing, though statistical significance was not achieved. Patients whose split skin graft donor sites were dressed with fibrin sealant plus self-adhesive fabric dressing experienced significantly less pain and incapacity than patients with self-adhesive fabric dressings alone, allowing a more rapid return to normal activity. Therapeutic, II.

Hair-follicle Transplant Into Chronic Ulcers: A New Graft Concept.

PubMed

Martínez Martínez, M L; Escario Travesedo, E; Jiménez Acosta, F

Chronic venous leg ulcers are a major therapeutic challenge in clinical practice, and the search for new approaches to improve wound healing is essential. Many ulcers do not heal with traditional treatment using compression, debridement, and dressings. Skin-grafts variants, such as pinch grafts, punch grafts, split- or full-thickness skin grafts, and grafts derived from cells cultured in the laboratory, are among the most widely used options in ulcers that do not heal. In recent years, numerous studies have brought to our attention the important role of the hair follicle in the healing process of cutaneous wounds. Putting knowledge into practice, hair follicles from the scalp have been used in punch-type grafts transplanted to the base of chronic ulcers to stimulate healing. Results appear to be better than those with traditional hairless punch grafts, opening new lines of treatment for recalcitrant chronic venous ulcers. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Awful face of the war-impacted smoke bomb capsule in the face and systemic toxicity: reports from the conflict in Syria.

PubMed

Yilmaz, Bahar; Yeşiloğlu, Nebil; Firincioğullari, Remzi; Gökkaya, Ali; Özbey, Rafet; Özgür, Mustafa

2015-01-01

In this study, a rare kind of injury due to smoke bomb capsule impaction to midface and under the cranial base is presented, and maneuvers to reduce mortality are discussed. Three male patients were presented with impacted smoke bomb capsules into the midface and under the cranial base structures. Midface structures, anterior cranial base, and, in 2 patients, unilateral eye were severely damaged. Two patients died after the initial emergency operations because their lung disease progressed to acute respiratory distress syndrome. One of the patients lived, and soft tissue reconstruction was achieved by using temporal transposition and cheek advancement skin flaps with split-thickness skin graft from donor site. However, craniofacial destruction is important in these patients; a multidisciplinary approach is needed for the treatment of direct smoke bomb injuries because the patients experienced chemical burn and acute trauma. The timing of maxillofacial reconstruction is also a question in these specific patients.

Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male.

PubMed

Heiner, Jason D; Eng, Katisha D; Bialowas, Todd A; Devita, Diane

2012-01-01

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.

Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male

PubMed Central

Heiner, Jason D.; Eng, Katisha D.; Bialowas, Todd A.; Devita, Diane

2012-01-01

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening. PMID:23326701

Interaction of preservation methods and radiation sterilization in human skin processing, with particular insight on the impact of the final water content and collagen disruption. Part I: process validation, water activity and collagen changes in tissues cryopreserved or processed using 50, 85 or 98% glycerol solutions.

PubMed

Herson, M R; Hamilton, K; White, J; Alexander, D; Poniatowski, S; O'Connor, A J; Werkmeister, J A

2018-04-25

Current regulatory requirements demand an in-depth understanding and validation of protocols used in tissue banking. The aim of this work was to characterize the quality of split thickness skin allografts cryopreserved or manufactured using highly concentrated solutions of glycerol (50, 85 or 98%), where tissue water activity (a w ), histology and birefringence changes were chosen as parameters. Consistent a w outcomes validated the proposed processing protocols. While no significant changes in tissue quality were observed under bright-field microscopy or in collagen birefringence, in-process findings can be harnessed to fine-tune and optimize manufacturing outcomes in particular when further radiation sterilization is considered. Furthermore, exposing the tissues to 85% glycerol seems to derive the most efficient outcomes as far as a w and control of microbiological growth.

Benefits of plasma rich in growth factors (PRGF) in skin photodamage: clinical response and histological assessment.

PubMed

Díaz-Ley, B; Cuevast, J; Alonso-Castro, L; Calvo, M I; Ríos-Buceta, L; Orive, G; Anitua, E; Jaén, P

2015-01-01

Skin ageing is characterized by small and fine wrinkles, roughness, laxity, and pigmentation as a result of epidermal thinning, collagen degradation, dermal atrophy, and fewer fibroblasts. Plasma rich in growth factors (PRGF) is an autologous plasma preparation enriched in proteins obtained from patient's own blood aimed at accelerating tissue repair and regeneration. To evaluate the benefits of PRGF in skin photodamage, 10 healthy volunteers were treated with three consecutive intradermal injections of PRGF in the facial area. Clinical outcomes and histological analysis were performed. A statistically significant increase in the epidermis and papillary dermis thickness was seen after PRGF treatment (p < 0.001). Skin thickening was observed in all patients studied, being more intense in the group of patients with photodamage (p < 0.001). After PRGF treatment, a reduction of the average area fraction of solar elastosis was observed in patients with clinical and histological signs of skin photodamage (p < 0.05).No changeswere observed in the number of CD31, XIIIa factor, cKit, CD10, nor p53-positive cells. The improvement score after PRGF use was 0.75 (9/12) for the group of patients with signs of skin photodamage. Intradermal PRGF infiltration appears to be an effective treatment for the photodamaged skin. © 2015 Wiley Periodicals, Inc.

3D printing-assisted fabrication of double-layered optical tissue phantoms for laser tattoo treatments.

PubMed

Kim, Hanna; Hau, Nguyen Trung; Chae, Yu-Gyeong; Lee, Byeong-Il; Kang, Hyun Wook

2016-04-01

Artificial skin phantoms have been developed as an alternative tissue for human skin experiments due to convenient use and easy storage. However, fabricating both thin (∼100 μm) epidermis and relatively thick dermis is often cumbersome, and most developed phantoms have hardly reflected specific human skin types. The objective of this study was to fabricate skin phantoms with 3D printing technique to emulate various human skin types (I-VI) along with the corresponding optical and mechanical properties for laser tattoo removal. Both gelatin and agar powders were mixed with coffee and TiO2 particles to fabricate skin phantoms with materials properties for various skin types (I-VI). A 3D printer was employed to precisely control the thickness of each phantom for epidermis and dermis layers. A number of concentrations of the coffee and TiO2 particles were used to determine the degree of absorption and scattering effects in various skin types. The optical properties between 500 and 1,000 nm for the fabricated phantoms were measured by double-integrating spheres with an inverse adding-doubling (IAD) algorithm. Optical coherence tomography (OCT) and rheometer were also utilized to evaluate optical (absorption and reduced scattering coefficients) and mechanical properties (compression modulus) of the fabricated phantoms, respectively. Visible color inspections presented that the skin phantoms for types I, III, and VI similarly emulated the color space of the human skin types. The optical property measurements demonstrated that the absorption (μa) and reduced scattering (μ(s')) coefficients decreased with wavelengths. Compared to the human skin type VI, a dermis phantom represented quite equivalent values of μa and μ(s') whereas an epidermis phantom showed up to 30% lower μa but almost identical μ(s') over the wavelengths. The OCT measurements confirmed that the thicknesses of the epidermis and the dermis phantoms were measured to be 138.50 ± 0.01 μm and 0.81 ± 0.04 mm, respectively. The mechanical properties of the phantoms mixed with the agar volume of 40% yielded a compression modulus of 83.7 ± 14.8 kPa, which well corresponded to that of human forearm skin (50-95 kPa). The 3D printing technique was able to reliably fabricate the double-layered phantoms emulating a variety of skin types (I-VI) along with the comparable optical and mechanical properties. Further investigations will incorporate artificial chromophores into the fabricated skin phantoms to reliably evaluate the new therapeutic wavelengths for laser tattoo removal. © 2016 Wiley Periodicals, Inc.

Scar due to skin incision for screw fixation through the transbuccal approach after sagittal split ramus osteotomy.

PubMed

Muto, Toshitaka

2012-05-01

Most rigid fixation techniques after sagittal split ramus osteotomies of the mandible involve the transbuccal approach. A skin incision in the cheek carries with it possible undesirable sequelae, such as noticeable scarring. The aim of this study was to investigate whether there is scarring in the face after this technique. For screw insertion, a 5-mm stab incision was performed on 40 Japanese patients (20 men and 20 women) with class III occlusion. After surgery, gross examination (via the naked eyes) of the skin incision was performed monthly for 1 year by the same oral surgeon. In all cases, the skin incision had disappeared by 1 year after the surgery.

Novel thin/tunable gas diffusion electrodes with ultra-low catalyst loading for hydrogen evolution reactions in proton exchange membrane electrolyzer cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Zhenye; Yang, Gaoqiang; Mo, Jingke

2018-05-01

Proton exchange membrane electrolyzer cells (PEMECs) have received great attention for hydrogen/oxygen production due to their high efficiencies even at low-temperature operation. Because of the high cost of noble platinum-group metal (PGM) catalysts (Ir, Ru, Pt, etc.) that are widely used in water splitting, a PEMEC with low catalyst loadings and high catalyst utilizations is strongly desired for its wide commercialization. In this study, the ultrafast and multiscale hydrogen evolution reaction (HER) phenomena in an operating PEMEC is in-situ observed for the first time. The visualization results reveal that the HER and hydrogen bubble nucleation mainly occur on catalyst layersmore » at the rim of the pores of the thin/tunable liquid/gas diffusion layers (TT-LGDLs). This indicates that the catalyst material of the conventional catalyst-coated membrane (CCM) that is located in the middle area of the LGDL pore is underutilized/inactive. Based on this discovery, a novel thin and tunable gas diffusion electrode (GDE) with a Pt catalyst thickness of 15 nm and a total thickness of about 25 um has been proposed and developed by taking advantage of advanced micro/nano manufacturing. The novel thin GDEs are comprehensively characterized both ex-situ and in-situ, and exhibit excellent PEMEC performance. More importantly, they achieve catalyst mass activity of up to 58 times higher than conventional CCM at 1.6 V under the operating conditions of 80 degrees C and 1 atm. This study demonstrates a promising concept for PEMEC electrode development, and provides a direction of future catalyst designs and fabrications for electrochemical devices.« less

The Work Softening by Deformation-Induced Disordering and Cold Rolling of 6.5 wt pct Si Steel Thin Sheets

NASA Astrophysics Data System (ADS)

Wang, Xianglong; Li, Haoze; Zhang, Weina; Liu, Zhenyu; Wang, Guodong; Luo, Zhonghan; Zhang, Fengquan

2016-09-01

As-cast strip of 6.5 wt pct Si steel was fabricated by twin-roll strip casting. After hot rolling at 1323 K (1050 °C), thin sheets with the thickness of 0.35 mm were produced by warm rolling at 373 K (100 °C) with rolling reductions of 15, 25, 35, 45, 55, and 65 pct. Influence of warm rolling reduction on ductility was investigated by room temperature bending test. The measurement of macro-hardness showed that "work softening" could begin when the warm rolling reduction exceeded 35 pct. The room temperature ductility of the thin sheets gradually increased with the increase of warm rolling reductions, and the plastic deformation during bending began to form when the warm rolling reduction was greater than 45 pct, the 65 pct rolled thin sheet exhibited the maximum plastic deformation of about 0.6 pct during bending at room temperature, with a few small dimples having been observed on the fracture surfaces. B2-ordered domains were formed in the 15, 25, 35, 45, and 55 pct rolled specimens, and their average size decreased with the increase of warm rolling reductions. By contrast, no B2-ordered domain could be found in the 65 pct rolled specimen. It had been observed that large-ordered domains could be split into several small parts by the slip of partial super-dislocations during warm rolling, which led to significant decrease of the order degree to cause the phenomenon of deformation-induced disordering. On the basis of these results, cold rolling schedule was developed to successfully fabricate 0.25-mm-thick sheets with good surface qualities and magnetic properties from warm rolled sheets.

Novel thin/tunable gas diffusion electrodes with ultra-low catalyst loading for hydrogen evolution reactions in proton exchange membrane electrolyzer cells

DOE PAGES

Kang, Zhenye; Yang, Gaoqiang; Mo, Jingke; ...

2018-03-09

Proton exchange membrane electrolyzer cells (PEMECs) have received great attention for hydrogen/oxygen production due to their high efficiencies even at low-temperature operation. Because of the high cost of noble platinum-group metal (PGM) catalysts (Ir, Ru, Pt, etc.) that are widely used in water splitting, a PEMEC with low catalyst loadings and high catalyst utilizations is strongly desired for its wide commercialization. In this study, the ultrafast and multiscale hydrogen evolution reaction (HER) phenomena in an operating PEMEC is in-situ observed for the first time. The visualization results reveal that the HER and hydrogen bubble nucleation mainly occur on catalyst layersmore » at the rim of the pores of the thin/tunable liquid/gas diffusion layers (TT-LGDLs). This indicates that the catalyst material of the conventional catalyst-coated membrane (CCM) that is located in the middle area of the LGDL pore is underutilized/inactive. Based on this discovery, a novel thin and tunable gas diffusion electrode (GDE) with a Pt catalyst thickness of 15 nm and a total thickness of about 25 um has been proposed and developed by taking advantage of advanced micro/nano manufacturing. The novel thin GDEs are comprehensively characterized both ex-situ and in-situ, and exhibit excellent PEMEC performance. More importantly, they achieve catalyst mass activity of up to 58 times higher than conventional CCM at 1.6 V under the operating conditions of 80 degrees C and 1 atm. This study demonstrates a promising concept for PEMEC electrode development, and provides a direction of future catalyst designs and fabrications for electrochemical devices.« less

Novel thin/tunable gas diffusion electrodes with ultra-low catalyst loading for hydrogen evolution reactions in proton exchange membrane electrolyzer cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Zhenye; Yang, Gaoqiang; Mo, Jingke

Proton exchange membrane electrolyzer cells (PEMECs) have received great attention for hydrogen/oxygen production due to their high efficiencies even at low-temperature operation. Because of the high cost of noble platinum-group metal (PGM) catalysts (Ir, Ru, Pt, etc.) that are widely used in water splitting, a PEMEC with low catalyst loadings and high catalyst utilizations is strongly desired for its wide commercialization. In this study, the ultrafast and multiscale hydrogen evolution reaction (HER) phenomena in an operating PEMEC is in-situ observed for the first time. The visualization results reveal that the HER and hydrogen bubble nucleation mainly occur on catalyst layersmore » at the rim of the pores of the thin/tunable liquid/gas diffusion layers (TT-LGDLs). This indicates that the catalyst material of the conventional catalyst-coated membrane (CCM) that is located in the middle area of the LGDL pore is underutilized/inactive. Based on this discovery, a novel thin and tunable gas diffusion electrode (GDE) with a Pt catalyst thickness of 15 nm and a total thickness of about 25 um has been proposed and developed by taking advantage of advanced micro/nano manufacturing. The novel thin GDEs are comprehensively characterized both ex-situ and in-situ, and exhibit excellent PEMEC performance. More importantly, they achieve catalyst mass activity of up to 58 times higher than conventional CCM at 1.6 V under the operating conditions of 80 degrees C and 1 atm. This study demonstrates a promising concept for PEMEC electrode development, and provides a direction of future catalyst designs and fabrications for electrochemical devices.« less

A stretchable and flexible system for skin-mounted measurement of motion tracking and physiological signals.

PubMed

Pinghung Wei; Raj, Milan; Yung-Yu Hsu; Morey, Briana; DePetrillo, Paolo; McGrane, Bryan; Xianyan Wang; Lin, Monica; Keen, Bryan; Papakyrikos, Cole; Lowe, Jared; Ghaffari, Roozbeh

2014-01-01

In this paper, we present a stretchable wearable system capable of i) measuring multiple physiological parameters and ii) transmitting data via radio frequency to a smart phone. The electrical architecture consists of ultra thin sensors (<; 20 μm thick) and a conformal network of associated active and passive electronics in a mesh-like geometry that can mechanically couple with the curvilinear surfaces of the human body. Spring-like metal interconnects between individual chips on board the device allow the system to accommodate strains approaching ~30% A representative example of a smart patch that measures movement and electromyography (EMG) signals highlights the utility of this new class of medical skin-mounted system in monitoring a broad range of neuromuscular and cardiovascular diseases.

Dynamics of glycerine and water transport across human skin from binary mixtures.

PubMed

Ventura, S A; Kasting, G B

2017-04-01

Skin transport properties of glycerine and water from binary mixtures contacting human skin were determined to better understand the mechanism of skin moisturization by aqueous glycerine formulations. Steady-state permeation for 3 H 2 O and 14 C-glycerine across split-thickness human skin in vitro and desorption dynamics of the same permeants in isolated human stratum corneum (HSC) were experimentally determined under near equilibrium conditions. These data were compared to a priori values developed in the context of a thermodynamic model for binary mixtures of glycerine and water and a previously determined water sorption isotherm for HSC. This allowed the estimation of diffusion and partition coefficients for each permeant in the HSC, as well as HSC thickness, as a function of composition of the contacting solution. These data may be used to estimate water retention and associated HSC swelling related to the absorption and slow release of glycerine from the skin. It took 6+ days for glycerine to completely desorb from HSC immersed in glycerine/water binary solutions. Desorption of both 3 H 2 O and 14 C-glycerine from HSC was slower in pure water than from binary mixtures, a result that is largely explained by the greater swelling of HSC in water. Parametric relationships were developed for water and glycerine intradiffusivities in HSC as functions of HSC water content, and a mutual diffusion coefficient was estimated by analogy with glycerine/water binary solutions. The intradiffusivity of 14 C-glycerine in HSC as inferred from sorption/desorption experiments was shown to be approximately 10-fold less than that inferred from permeation experiments, whereas the corresponding values for 3 H 2 O were comparable. These studies confirm that glycerine enters HSC in substantial quantities and has a long residence time therein. The coupling between bulk water and glycerine transport projected from binary solution data suggests the net effect of glycerine is to slow water loss from the skin. The data support the concept of glycerine as a humectant with an excellent balance of skin penetration and retention characteristics; however, they do not rule out the possibility of an additional biological effect on skin barrier homoeostasis. © 2016 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

The effects of chemical and physical penetration enhancers on the percutaneous permeation of lidocaine through equine skin

PubMed Central

2014-01-01

Background The effect of physical and chemical permeation enhancers on in vitro transdermal permeation of lidocaine was investigated in the horse. Therefore, the effect of six vehicles (phosphate-buffered saline (PBS), 50% ethanol, 50% propylene glycol, 50% isopropylalcohol, 50% isopropylalcohol/isopropylmyristate and 50% dimethylsulfoxide) was examined as well as the effect of microneedle pretreatment with different needle lengths on transdermal drug delivery of lidocaine. The skin was obtained from the thorax of six Warmblood horses and was stored up to two weeks at - 20°C. Franz-type diffusion cells were used to study the transdermal permeation through split skin (600 μm thickness). The amount of lidocaine in the receptor fluid was determined by UV–VIS high-performance liquid chromatography. Results All investigated vehicle supplementations diminished the transdermal flux of lidocaine through equine skin in comparison to pure PBS except dimethylsulfoxide, which resulted in comparable permeation rates to PBS. The maximum flux (Jmax) was 1.6-1.8 fold lower for lidocaine applied in 50% ethanol, propylene glycol, isopropylalcohol and isopropylalcohol/isopropylmyristate. A significant higher Jmax of lidocaine was observed when lidocaine was applied in PBS onto microneedle pretreated skin with similar permeation rates in both needle lengths. After 6 hours, 1.7 fold higher recovery rates were observed in the microneedle pretreated skin samples than in the untreated control samples. The lagtimes were reduced to 20–50% in the microneedle pretreated skin samples. Conclusion Microneedles represent a promising tool for transdermal lidocaine application in the horse with a rapid systemic bioavailability. PMID:24950611

Tandem Core–Shell Si–Ta 3N 5 Photoanodes for Photoelectrochemical Water Splitting

DOE PAGES

Narkeviciute, Ieva; Chakthranont, Pongkarn; Mackus, Adriaan J. M.; ...

2016-11-22

Here, nanostructured core–shell Si–Ta 3N 5 photoanodes were designed and synthesized to overcome charge transport limitations of Ta 3N 5 for photoelectrochemical water splitting. The core–shell devices were fabricated by atomic layer deposition of amorphous Ta 2O 5 onto nanostructured Si and subsequent nitridation to crystalline Ta 3N 5. Nanostructuring with a thin shell of Ta 3N 5 results in a 10-fold improvement in photocurrent compared to a planar device of the same thickness. In examining thickness dependence of the Ta 3N 5 shell from 10 to 70 nm, superior photocurrent and absorbed-photon-to-current efficiencies are obtained from the thinner Tamore » 3N 5 shells, indicating minority carrier diffusion lengths on the order of tens of nanometers. The fabrication of a heterostructure based on a semiconducting, n-type Si core produced a tandem photoanode with a photocurrent onset shifted to lower potentials by 200 mV. CoTiO x and NiO x water oxidation cocatalysts were deposited onto the Si–Ta 3N 5 to yield active photoanodes that with NiO x retained 50–60% of their maximum photocurrent after 24 h chronoamperometry experiments and are thus among the most stable Ta 3N 5 photoanodes reported to date.« less

Design and performance of a high-Tc superconductor coplanar waveguide filter

NASA Technical Reports Server (NTRS)

Chew, Wilbert; Riley, A. L.; Rascoe, Daniel L.; Hunt, Brian D.; Foote, Marc C.; Cooley, Thomas W.; Bajuk, Louis J.

1991-01-01

The design of a coplanar waveguide low-pass filter made of YBa2Cu3O(7-delta) (YBCO) on an LaAlO3 substrate is described. Measurements were incorporated into simple models for microwave CAD analysis to develop a final design. The patterned and packaged coplanar waveguide low-pass filter of YBCO, with dimensions suited for integrated circuits, exhibited measured insertion losses when cooled in liquid nitrogen superior to those of a similarly cooled thin-film copper filter throughout the 0 to 9.5 GHz passband. Coplanar waveguide models for use with thin-film normal metal (with thickness either greater or less than the skin depth) and YBCO are discussed and used to compare the losses of the measured YBCO and copper circuits.

The Lymphatic Response to Injury with Soft-Tissue Reconstruction in High-Energy Open Tibial Fractures of the Lower Extremity.

PubMed

van Zanten, Malou C; Mistry, Raakhi M; Suami, Hiroo; Campbell-Lloyd, Andrew; Finkemeyer, James P; Piller, Neil B; Caplash, Yugesh

2017-02-01

Severe compound tibial fractures are associated with extensive soft-tissue damage, resulting in disruption of lymphatic pathways that leave the patient at risk of developing chronic lymphedema. There are limited data on lymphatic response following lower limb trauma. Indocyanine green fluorescence lymphography is a novel, real-time imaging technique for superficial lymphatic mapping. The authors used this technique to image the superficial lymphatic vessels of the lower limbs in patients with severe compound tibial fracture. Baseline demographics and clinical and operative details were recorded in a prospective cohort of 17 patients who had undergone bone and soft-tissue reconstruction after severe compound tibial fracture between 2009 and 2014. Normal lymphatic images were obtained from the patients' noninjured limbs as a control. In this way, the authors investigated any changes to the normal anatomy of the lymphatic system in the affected limbs. Of the 17 patients, eight had free muscle flaps with split-thickness skin grafting, one had a free fasciocutaneous flap, one had a full-thickness skin graft, six had local fasciocutaneous flaps, and one had a pedicled gastrocnemius flap. None of the free flaps demonstrated any functional lymphatic vessels; the fasciocutaneous flaps and the skin graft demonstrated impaired lymphatic vessel function and dermal backflow pattern similar to that in lymphedema. Local flaps demonstrated lymphatic blockage at the scar edge. Severe compound fractures and the associated soft-tissue injury can result in significant lymphatic disruption and an increased risk for the development of chronic lymphedema.

Split-face histological and biochemical evaluation of tightening efficacy using temperature- and impedance-controlled continuous non-invasive radiofrequency energy.

PubMed

Boisnic, Sylvie; Divaris, Marc; Branchet, Marie-Christine; Nelson, Andrew A

2017-06-01

Bipolar radiofrequency (RF) is capable of heating dermal collagen fibers and inducing skin tightening by collagen remodeling. To substantiate safety and improvement of skin laxity following skin heating with a novel temperature- and impedance-controlled non-invasive radiofrequency (RF) device by histological and biochemical evaluations. A split-face study was performed on 4 subjects who underwent 8 weekly RF sessions on one side of their face, leaving the other side an untreated control and then underwent facelift procedure. Clinical evaluation by photographs was done prior to the surgical procedure. Ex vivo fragments were harvested from both sides and compared. Morphometric analysis of dermal collagen fibers, collagen synthesis, and elastin synthesis evaluations were compared in triplicates. Facial skin tightening was apparent in split-face photographs. A significant increase of 7.9% in dermal collagen content, and a significant increase of 34.7% in collagen synthesis were demonstrated in the treated samples. No statistically significant effect on elastin synthesis was detected. Skin tightening following treatment with non-invasive RF has proven histologically and biochemically to derive from increase in dermal collagen synthesis and content.

Advantages of using a bank of allogenic keratinocytes for the rapid coverage of extensive and deep second-degree burns.

PubMed

Braye, F; Pascal, P; Bertin-Maghit, M; Colpart, J J; Tissot, E; Damour, O

2000-03-01

In 1975, serial subculture of human keratinocytes was first described. Clinical application of this discovery was made possible after the preparation of these cells into epithelial sheets. In 1981, the earliest application of cultured autologous epithelia was made for the treatment of extensive third-degree burns. Although the most important advantage is the large surface area obtained from a relatively small biopsy of healthy skin from the patient, a disadvantage is the delay, which is too long, especially for the treatment of extensive deep burns. This delay leads to denutrition and infection of the burn wounds, which in turn risks the life of the patient and jeopardizes the engraftment of the cultures. More recently, allogenic cultured epidermis, obtained more quickly from donor skin, has been described in the treatment of leg ulcers, repair of skin donor site harvested for split thickness autograft, dermatological diseases and in second-degree burns, although limited to certain areas. In this last case, grafted cells act by stimulation of epithelialisation from the adnexal appendages. To be able rapidly to treat patients suffering extensive and deep second-degree burns, a bank of allogenic keratinocytes has been created, with due attention to safety and security. The paper demonstrates the advantages of using allogenic keratinocytes in the first phase of treatment of a 97% deep second-degree burn patient awaiting autologous cultured keratinocytes. The time required for complete healing achieved using such a strategy is compared with the results obtained after treatment using autologous sheets of two patients burnt on 80% and 82% of their total body area. The treatment of these two latter patients is relatively long and complicated by potentially lethal problems. In the 97% burnt patient, however, the clinical course is shorter and without complication. Moreover, autologous and allogenic cultured epithelia give good aesthetic results, without the mesh aspect obtained with a split-thickness autograft, and also without the discomfort for the patient of removing a sample of skin. Deep second-degree burns are an application of choice for the cultured epithelia, as the presence of the dermis avoids retractions responsible for functional complications usually observed in third-degree burns where dermis is absent. Because of the safety of the bank of allogenic keratinocytes, the treatment of extensive and deep second-degree burns has become safer and faster, with better functional and aesthetic results.

MALL liposuction: the natural evolution of subdermal superficial liposuction.

PubMed

Gasperoni, C; Salgarello, M

1994-01-01

Subdermal superficial liposuction, first presented by the authors at the ISAPS Congress at Zurich in 1989, is performed with thin three-hole Mercedes cannulas (diameter ranges from 1.8 to 2 mm) to treat small and secondary adiposities and to allow better skin retraction. Suction of the subdermal layer of fat reduces the thickness and consistency of the superficial fat and enhances the possibility of skin retraction. In cases where there is a large adiposity of the abdomen, arms, or inner thighs, there is a conspicuous volume of fat whose weight tends to overstretch and to carry the overlying skin downward. In these cases we need to reduce the large fat volume to permit effective skin retraction. Therefore, we apply the principles of traditional liposuction with those of subdermal superficial liposuction to aspirate large amounts of fat from all the adipose layers. We call this technique Massive All Layer Liposuction (MALL). The amount of skin shrinkage after this "defatting" procedure is remarkable and the clinical results are very good. The MALL technique can be applied to other areas as well. In our experience this new liposuction technique has dramatically reduced the indications of abdominoplasties and dermolipectomies of inner thighs and arms.

Clinical and histopathological results following TriPollar radiofrequency skin treatments.

PubMed

Kaplan, Haim; Gat, Andrea

2009-06-01

Skin laxity, wrinkles and cellulite are common aesthetic problems associated with the aging process. These symptoms are due to the weakening and thinning of dermal connective tissue and the enlargement of hypodermal fat cells. The aim of this study was to evaluate the safety and efficacy of the TriPollar RF technology in reducing fat and collagen regeneration. Twelve healthy patients underwent weekly treatments on different body sites using the TriPollar technology. Treatment areas were photographed and measured and patient satisfaction was monitored. One abdominal patient consented to a series of TriPollar treatments prior to her scheduled abdominoplasty. A controlled histopathology analysis was performed on skin samples taken during the abdominoplasty procedure. Histopathological examination revealed marked differences between treated and non-treated abdominal skin areas. An increase of 49% in dermal thickness, focal thickening of collagen fibers and focal shrinkage of fat cells was shown following TriPollar treatments. Average patient satisfaction indicated clear satisfaction with the clinical results achieved. The TriPollar is a safe and effective non-invasive technology leading to skin tightening and body shaping. Histology results indicate changes at the dermal and fat layers following TriPollar treatments resulting in increased collagen regeneration and stimulated fat metabolism.

Real-Time Demonstration of Split Skin Graft Inosculation and Integra Dermal Matrix Neovascularization Using Confocal Laser Scanning Microscopy

PubMed Central

Greenwood, John; Amjadi, Mahyar; Dearman, Bronwyn; Mackie, Ian

2009-01-01

Objectives: During the first 48 hours after placement, an autograft “drinks” nutrients and dissolved oxygen from fluid exuding from the underlying recipient bed (“plasmatic imbibition”). The theory of inosculation (that skin grafts subsequently obtain nourishment via blood vessel “anastomosis” between new vessels invading from the wound bed and existing graft vessels) was hotly debated from the late 19th to mid-20th century. This study aimed to noninvasively observe blood flow in split skin grafts and Integra™ dermal regeneration matrix to provide further proof of inosculation and to contrast the structure of vascularization in both materials, reflecting mechanism. Methods: Observations were made both clinically and using confocal microscopy on normal skin, split skin graft, and Integra™. The VivaScope™ allows noninvasive, real-time, in vivo images of tissue to be obtained. Results: Observations of blood flow and tissue architecture in autologous skin graft and Integra™ suggest that 2 very different processes are occurring in the establishment of circulation in each case. Inosculation provides rapid circulatory return to skin grafts whereas slower neovascularization creates an unusual initial Integra™ circulation. Conclusions: The advent of confocal laser microscopy like the VivaScope 1500™, together with “virtual” journals such as ePlasty, enables us to provide exciting images and distribute them widely to a “reading” audience. The development of the early Integra™ vasculature by neovascularization results in a large-vessel, high-volume, rapid flow circulation contrasting markedly from the inosculatory process in skin grafts and the capillary circulation in normal skin and merits further (planned) investigation. PMID:19787028

Correlation between skin, bone, and cerebrospinal fluid layer thickness and optical coefficients measured by multidistance frequency-domain near-infrared spectroscopy in term and preterm infants.

PubMed

Demel, Anja; Feilke, Katharina; Wolf, Martin; Poets, Christian F; Franz, Axel R

2014-01-01

Near-infrared spectroscopy (NIRS) is increasingly used in neonatal intensive care. We investigated the impact of skin, bone, and cerebrospinal fluid (CSF) layer thickness in term and preterm infants on absorption-(μa) and/or reduced scattering coefficients (μs') measured by multidistance frequency-domain (FD)-NIRS. Transcranial ultrasound was performed to measure the layer thicknesses. Correlations were only statistically significant for μa at 692 nm with bone thickness and μs' at 834 nm with skin thickness. There is no evidence that skin, bone, or CSF thickness have an important effect on μa and μs'. Layer thicknesses of skin, bone, and CSF in the range studied do not seem to affect cerebral oxygenation measurements by multidistance FD-NIRS significantly.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shi Linxi; Vedantham, Srinivasan; Karellas, Andrew

Purpose: To determine the mean and range of location-averaged breast skin thickness using high-resolution dedicated breast CT for use in Monte Carlo-based estimation of normalized glandular dose coefficients. Methods: This study retrospectively analyzed image data from a clinical study investigating dedicated breast CT. An algorithm similar to that described by Huang et al.['The effect of skin thickness determined using breast CT on mammographic dosimetry,' Med. Phys. 35(4), 1199-1206 (2008)] was used to determine the skin thickness in 137 dedicated breast CT volumes from 136 women. The location-averaged mean breast skin thickness for each breast was estimated and the study populationmore » mean and range were determined. Pathology results were available for 132 women, and were used to investigate if the distribution of location-averaged mean breast skin thickness varied with pathology. The effect of surface fitting to account for breast curvature was also studied. Results: The study mean ({+-} interbreast SD) for breast skin thickness was 1.44 {+-} 0.25 mm (range: 0.87-2.34 mm), which was in excellent agreement with Huang et al. Based on pathology, pair-wise statistical analysis (Mann-Whitney test) indicated that at the 0.05 significance level, there were no significant difference in the location-averaged mean breast skin thickness distributions between the groups: benign vs malignant (p= 0.223), benign vs hyperplasia (p= 0.651), hyperplasia vs malignant (p= 0.229), and malignant vs nonmalignant (p= 0.172). Conclusions: Considering this study used a different clinical prototype system, and the study participants were from a different geographical location, the observed agreement between the two studies suggests that the choice of 1.45 mm thick skin layer comprising the epidermis and the dermis for breast dosimetry is appropriate. While some benign and malignant conditions could cause skin thickening, in this study cohort the location-averaged mean breast skin thickness distributions did not differ significantly with pathology. The study also underscored the importance of considering breast curvature in estimating breast skin thickness.« less

Reconstruction of the anus, rectovaginal septum, and distal part of the vagina after postirradiation necrosis. Report of a unique case

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nowacki, M.P.; Towpik, E.

1988-08-01

Successful repair of postirradiation total loss of the anal sphincters, rectovaginal septum, and distal part of the vagina is reported. Gracilis muscle flap was used as a substitute sphincter. Part of the muscle was wrapped-up in a split skin graft. To the authors' knowledge, this is the first report on new application of gracilis muscle and split skin graft in perineal reconstruction.

Transdermal permeation of WIN 55,212-2 and CP 55,940 in human skin in vitro.

PubMed

Valiveti, Satyanarayana; Kiptoo, Paul K; Hammell, Dana C; Stinchcomb, Audra L

2004-06-18

Synthetic cannabinoids have a promising future as treatments for nausea, appetite modulation, pain, and many neurological disorders. Transdermal delivery is a convenient and desirable dosage form for these drugs and health conditions. The aim of the present study was to investigate the in vitro transdermal permeation of two synthetic cannabinoids, WIN 55,212-2 and CP 55,940. Transdermal flux, drug content in the skin, and lag times were measured in split-thickness human abdominal skin in flow-through diffusion cells with receiver solutions of 4% bovine serum albumin (BSA) or 0.5% Brij 98. Differential thermal analysis (DSC) was performed in order to determine heats of fusion, melting points, and relative thermodynamic activities. The in vitro diffusion studies in 0.5% Brij 98 indicated that WIN 55,212-2 diffuses across human skin faster than CP 55,940. The WIN 55,212-2 skin disposition concentration levels were also significantly higher than that of CP 55,940. Correspondingly, CP 55,940 was significantly metabolized in the skin. WIN 55,212-2 flux and skin disposition were significantly lower into 4% BSA than into 0.5% Brij 98 receiver solutions. There was no significant difference in the flux, lag time, and drug content in the skin of CP 55,940 in 4% BSA versus 0.5% Brij 98 receiver solutions. The DSC studies showed that CP 55,940 had a significantly lower melting point, smaller heat of fusion, and corresponding higher calculated thermodynamic activity than the more crystalline WIN 55,212-2 mesylate salt. The permeation results indicated that WIN 55,212-2 mesylate, CP 55,940, and other potent synthetic cannabinoids with these physicochemical properties could be ideal candidates for the development of a transdermal therapeutic system. Copyright 2004 Elsevier B.V.

Split face study on the cutaneous tensile effect of 2-dimethylaminoethanol (deanol) gel.

PubMed

Uhoda, Isabelle; Faska, Najat; Robert, Caroline; Cauwenbergh, Geert; Piérard, Gérald E

2002-08-01

Beyond subjective assessments, the effect of skin tensors is difficult to assess. The present 2-phase randomized double-blind split face study was designed to compare the effect of a gel containing 3% 2-dimethylaminoethanol (deanol, DMAE) with the same formulation without DMAE. In a first pilot study, sensorial assessments and measures of the skin distension under suction were performed in eight volunteers. In a second study conducted in 30 volunteers, shear wave propagation was measured. Large interindividual variations precluded any significant finding in the first study. The DMAE formulation showed, however, a significant effect characterized by increased shear wave velocity in the direction where the mechanical anisotropy of skin showed looseness. The DMAE formulation under investigation increased skin firmness.

Mineral Oil-induced Sclerosing Lipogranuloma of the Penis

PubMed Central

Bjurlin, Marc A.; Carlsen, Jens; Grevious, Mark; Jordan, Michael D.; Taylor, Aisha; Divakaruni, Naveen

2010-01-01

Sclerosing lipogranuloma of the penis results from injection of high viscosity fluid for the purpose of penile augmentation and may have devastating cosmetic and sexual function consequences. Although rare, sclerosing lipogranuloma should be considered in the differential diagnosis of subcutaneous induration or nodules of the male genitalia as it may mimic carcinoma and poses a diagnostic challenge in patients reluctant to admit to injection therapy. Surgical excision with penile reconstruction is the mainstay of treatment. The authors present a case of a 35-year-old Myanmarese man with a sclerosing lipogranuloma of the penis due to injection of mineral oil successfully managed with penile biopsy and excision with split-thickness skin graft phalloplasty and provide a review of the current literature. PMID:20877525

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

PubMed

Saraiya, H

2001-03-01

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

Barium and calcium analyses in sediment cores using µ-XRF core scanners

NASA Astrophysics Data System (ADS)

Acar, Dursun; Çaǧatay, Namık; Genç, S. Can; Eriş, K. Kadir; Sarı, Erol; Uçarkus, Gülsen

2017-04-01

Barium and Ca are used as proxies for organic productivity in paleooceanographic studies. With its heavy atomic weight (137.33 u), barium is easily detectable in small concentrations (several ppm levels) in marine sediments using XRF methods, including the analysis by µ-XRF core scanners. Calcium has an intermediate atomic weight (40.078 u) but is a major element in the earth's crust and in sediments and sedimentary rocks, and hence it is easily detectable by µ-XRF techniques. Normally, µ-XRF elemental analysis of cores are carried out using split half cores or 1-2 cm thich u-channels with an original moisture. Sediment cores show variation in different water content (and porosity) along their length. This in turn results in variation in the XRF counts of the elements and causes error in the elemental concentrations. We tried µ-XRF elemental analysis of split half cores, subsampled as 1 cm thick u-channels with original moisture and 0.3 mm-thin film slices of the core with original wet sample and after air drying with humidity protector mylar film. We found considerable increase in counts of most elements, and in particular for Ba and Ca, when we used 0.3 mm thin film, dried slice. In the case of Ba, the counts increased about three times that of the analysis made with wet and 1 cm thick u-channels. The higher Ba and Ca counts are mainly due to the possible precipitation of Ba as barite and Ca as gypsum from oxidation of Fe-sulphides and the evaporation of pore waters. The secondary barite and gypsum precipitation would be especially serious in unoxic sediment units, such as sapropels, with considerable Fe-sulphides and bio-barite.It is therefore suggested that reseachers should be cautious of such secondary precipitation on core surfaces when analyzing cores that have long been exposed to the atmospheric conditions.

Medical management of cutaneous sulfur mustard injuries.

PubMed

Graham, John S; Stevenson, Robert S; Mitcheltree, Larry W; Hamilton, Tracey A; Deckert, Robin R; Lee, Robyn B; Schiavetta, Ann M

2009-09-01

Sulfur mustard (2,2'-dichlorodiethyl sulfide; HD) is a potent vesicating chemical warfare agent that poses a continuing threat to both military and civilian populations. Significant cutaneous HD injuries can take several months to heal, necessitate lengthy hospitalizations, and result in long-term complications. There are currently no standardized or optimized methods of casualty management. New strategies are needed to provide for optimal and rapid wound healing. The primary aim of this research was to develop improved clinical strategies (treatment guidelines) for optimal treatment of superficial dermal (second degree) cutaneous HD injuries, with the goal of returning damaged skin to optimal appearance and normal function in the shortest period of time. Superficial dermal HD injuries were created on the ventral abdominal surface of weanling pigs. At 48h post-exposure, lesions were laser debrided and a treatment adjunct applied. Cultured epithelial allografts and 11 commercial off-the-shelf (COTS) products were examined for their efficacy in improving wound healing of these injuries. Clinical evaluations and a variety of non-invasive bioengineering methods were used at 7 and 14 days post-surgery to follow the progress of wound healing and evaluate various cosmetic and functional properties of the wounds. Measurements included reflectance colorimetry to measure erythema; evaporimetry to examine transepidermal water loss as a method of evaluating barrier function; torsional ballistometry to evaluate the mechanical properties of skin firmness and elasticity; and two-dimensional high frequency ultrasonography (HFU) to monitor skin thickness (e.g., edema, scar tissue). Histopathology and immunohistochemistry were performed 14 days following surgery to examine structural integrity and quality of healing. Logical Decisions((R)) for Windows was used to rank the 12 treatment adjuncts that were studied. The most efficacious treatment adjuncts included (1) Vacuum Assisted Closure, V.A.C., involving application of topical negative pressure, (2) Amino-Plex Spray (biO(2) Cosmeceuticals International, Inc., Beverly Hills, CA), a nutritive cosmeceutical product that is designed to increase oxygen in cells, stimulate ATP synthesis, improve glucose transportation, stimulate collagen formation, and promote angiogenesis, and (3) ReCell Autologous Cell Harvesting Device (Clinical Cell Culture Americas LLC, Coral Springs, Florida), an innovative medical device that was developed to allow rapid harvesting of autologous cells from a thin split-thickness biopsy followed by spray application of a population of skin cells onto wounds within 30 min of collecting the biopsy, without the need of culturing the keratinocytes in a clinical laboratory. Complete re-epithelialization of debrided HD injuries in 7 days is possible. In general, shallow laser debridement through the basement membrane zone (100 microm) appears to provide better results than deeper debridement (400 microm) with respect to early re-epithelialization, cosmetic appearance, functional restoration, and structural integrity. Of the 12 treatment adjuncts examined, the most promising included Vacuum Assisted Closure, Amino-Plex Spray, and ReCell Autologous Cell Harvesting Device.

In vitro 3D full thickness skin equivalent tissue model using silk and collagen biomaterials

PubMed Central

Bellas, Evangelia; Seiberg, Miri; Garlick, Jonathan; Kaplan, David L.

2013-01-01

Current approaches to develop skin equivalents often only include the epidermal and dermal components. Yet, full thickness skin includes the hypodermis, a layer below the dermis of adipose tissue containing vasculature, nerves and fibroblasts, necessary to support the epidermis and dermis. In the present study, we developed a full thickness skin equivalent including an epidermis, dermis and hypodermis that could serve as an in vitro model for studying skin development, disease or as a platform for consumer product testing as a means to avoid animal testing. The full thickness skin equivalent was easy to handle and was maintained in culture for greater than 14 days while expressing physiologically relevant morphologies of both the epidermis and dermis, as seen by keratin 10, collagen I and collagen IV expression. The skin equivalent produced glycerol and leptin, markers of adipose tissue metabolism. This work serves as a foundation for our understanding of some of the necessary factors needed to develop a stable, functional model of full-thickness skin. PMID:23161763

Intrinsic And Extrinsic Controls On Unsteady Deformation Rates, Northern Apennine Mountains, Italy

NASA Astrophysics Data System (ADS)

Anastasio, D. J.; Gunderson, K. L.; Pazzaglia, F. J.; Kodama, K. P.

2017-12-01

The slip rates of faults in the Northern Apennine Mountains were unsteady at 104-105 year timescales during the Neogene and Quaternary. Fault slip rates were recovered from growth strata and uplifted fluvial terraces associated with the Salsomaggiore, Quatto Castella, and Castevetro fault-related folds, sampled along the Stirone, Enza, and Panaro Rivers, respectively. The forelimb stratigraphy of each anticline was dated using rock magnetic-based cyclostratigraphy, which varies with Milankovitch periodicity, multispecies biostratigraphy, magnetostratigraphy, OSL luminescence dating, TCN burial dating, and radiocarbon dating of uplifted and folded fluvial terraces. Fault slip magnitudes were constrained with trishear forward models. We observed decoupled deformation and sediment accumulation rates at each structure. From 3.5Ma deformation of a thick and thin-skinned thrusts was temporally variable and controlled by intrinsic rock processes, whereas, the more regional Pede-Apenninic thrust fault, a thick-skinned thrust underlying the mountain front, was likely activated because of extrinsic forcing from foreland basin sedimentation rate accelerations since 1.4Ma. We found that reconstructed slip rate variability increased as the time resolution increased. The reconstructed slip history of the thin-skinned thrust faults was characterized relatively long, slow fold growth and associated fault slip, punctuated by shorter, more rapid periods limb rotation, and slip on the underlying thrust fault timed asynchronously. Thrust fault slip rates slip rates were ≤ 0.1 to 6 mm/yr at these intermediate timescales. The variability of slip rates on the thrusts is likely related to strain partitioning neighboring faults within the orogenic wedge. The studied structures slowed down at 1Ma when there was a switch to slower synchronous fault slip coincident with orogenic wedge thickening due to the emplacement of the out of sequence Pene-Apenninic thrust fault that was emplaced at 1.4±0.7 mm/yr. Both tectonic control and climate controlled variability on syntectonic sedimentation was observed in the growth sections.

Thin-skinned tectonics in the Central Basin of the Iranian Plateau in the Semnan area, Central Iran

NASA Astrophysics Data System (ADS)

Bouzari, Soheila; Konon, Andrzej; Koprianiuk, Marek; Julapour, Ali A.

2013-01-01

During continent-continent convergence of the Arabian and Eurasian plates, and after the late Eocene inversion of a back-arc rift, the Iranian Plateau underwent broad subsidence resulting in the formation of the Central Basin (Morley et al., 2009). New 2D seismic data acquired by National Iranian Oil Company (NIOC) in the NW-SW-trending arm of the Central Basin suggest that during the main stage of shortening (middle-late? Miocene to Pliocene), strain concentrations resulted in the development of the thin-skinned Kuh-e-Gachab, Kuh-e-Gugerd, Garmsar and Sorkh-e-Kuh structures. These structures are built of Oligocene-Miocene/Pliocene(?) rocks belonging to the Lower Red, Qom and Upper Red formations. Seismic data suggest that one of these structures comprises the south-verging Kuh-e-Gachab anticline, which is bounded by the N-dipping Kuh-e-Gachab thrust and cored by a complex array of thrust sheets forming a triangle zone. During the deformation process, two salt evaporate levels played a significant role as detachment horizons. The main detachment horizon was rooted within the Lower Red Formation, whereas the second detachment horizon was located along evaporites belonging to the Upper Red Formation. Variations in the thin-skinned style of deformation between the larger triangle zone in the western part of the Kuh-e-Gachab structure contrasts with less shortening in the smaller triangle zone to the east. This suggests that the change resulted from the increase of thickness of the mobile detachment horizon to the east. Contraction deformations are still active south of the Alborz Mountains, which is confirmed by GPS data and present-day seismicity.

Evidence for synchronous thin-skinned and basement deformation in the Cordilleran fold-thrust belt: the Tendoy Mountains, southwestern Montana

NASA Astrophysics Data System (ADS)

McDowell, Robin John

1997-01-01

The Tendoy Mountains contain the easternmost thin-skinned thrust sheets in the Cordilleran fold-thrust belt of southwestern Montana, and are in the zone of tectonic overlap between the Rocky Mountain foreland and the Cordilleran fold-thrust belt. The three frontal thrust sheets of the Tendoy Mountains are from north to south, the Armstead, McKenzie, and Tendoy sheets. Near the southeastern terminus of the Tendoy thrust sheet is a lateral ramp in which the Tendoy thrust climbs along strike from the Upper Mississippian Lombard Limestone to lower Cretaceous rocks. This ramp coincides with the southeastern side of the Paleozoic Snowcrest trough and projection of the range-flanking basement thrust of the Blacktail-Snowcrest uplift, suggesting either basement or stratigraphic control on location of the lateral ramp. Axes of major folds on the southern part of the Tendoy thrust sheet are parallel to the direction of thrust transport and to the trend of the Snowcrest Range. They are a result of: (1) Pre-thrust folding above basement faults; (2) Passive transportation of the folds from a down-plunge position; (3) Minor reactivation of basement faults; and (4) Emplacement of blind, sub-Tendoy, thin-skinned thrust faults. The Tendoy sheet also contains a major out-of-sequence thrust fault that formed in thick Upper Mississippian shales and created large, overturned, foreland-verging folds in Upper Mississippian to Triassic rocks. The out-of-sequence fault can be identified where stratigraphic section is omitted, and by a stratigraphic separation diagram that shows it cutting down section in the direction of transport. The prominent lateral ramp at the southern terminus of the Tendoy thrust sheet is a result of fault propagation through strata folded over the edge of the Blacktail-Snowcrest uplift.

Topical 11β-Hydroxysteroid Dehydrogenase Type 1 Inhibition Corrects Cutaneous Features of Systemic Glucocorticoid Excess in Female Mice.

PubMed

Tiganescu, Ana; Hupe, Melanie; Uchida, Yoshikazu; Mauro, Theadora; Elias, Peter M; Holleran, Walter M

2018-01-01

Glucocorticoid (GC) excess drives multiple cutaneous adverse effects, including skin thinning and poor wound healing. The ubiquitously expressed enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activates mouse corticosterone from 11-dehydrocorticosterone (and human cortisol from cortisone). We previously demonstrated elevated 11β-HSD1 activity during mouse wound healing, but the interplay between cutaneous 11β-HSD1 and systemic GC excess is unexplored. Here, we examined effects of 11β-HSD1 inhibition by carbenoxolone (CBX) in mice treated with corticosterone (CORT) or vehicle for 6 weeks. Mice were treated bidaily with topical CBX or vehicle (VEH) 7 days before wounding and during wound healing. CORT mice displayed skin thinning and impaired wound healing but also increased epidermal integrity. 11β-HSD1 activity was elevated in unwounded CORT skin and was inhibited by CBX. CORT mice treated with CBX displayed 51%, 59%, and 100% normalization of wound healing, epidermal thickness, and epidermal integrity, respectively. Gene expression studies revealed normalization of interleukin 6, keratinocyte growth factor, collagen 1, collagen 3, matrix metalloproteinase 9, and tissue inhibitor of matrix metalloproteinase 4 by CBX during wound healing. Importantly, proinflammatory cytokine expression and resolution of inflammation were unaffected by 11β-HSD1 inhibition. CBX did not regulate skin function or wound healing in the absence of CORT. Our findings demonstrate that 11β-HSD1 inhibition can limit the cutaneous effects of GC excess, which may improve the safety profile of systemic steroids and the prognosis of chronic wounds. Copyright © 2018 Endocrine Society.

Two-dimensional turning of thermal flux from normal to lateral propagation in thin metal film irradiated by femtosecond laser pulse

NASA Astrophysics Data System (ADS)

Shepelev, V. V.; Inogamov, N. A.

2018-01-01

There are various geometrical variants of laser illumination and target design. Important direction of investigations is connected with tightly focused action (spot size may be less than micron) onto a thin metal film: thickness of a film is just few skin-layer depths. Duration of a pulse is τ L ˜ 0.1 ps. In these conditions energy absorbed in a skin layer first propagates normally to a surface: gradient ∂Te /∂x dominates, here and below x and y are normal and lateral directions. This process in 1-2 ps homogenizes electron temperature T e along thickness of a film. We consider conditions when a film or is supported by weakly conducting substrate, or is free standing. Therefore all absorbed energy is confined inside the film. At the next stage the internal energy begin to flow along the lateral direction—thus direction of energy expansion is changed from x to y because of the heat non-penetrating boundary condition imposed on the rear-side of the film. At the short two-temperature stage of lateral expansion the thermal conductivity κ is high. After that electron and ion temperatures equilibrates and later on the heat propagates with usual value of κ. Lateral expansion cools down the hot spot on long time scales and finally the molten spot recrystallizes. Two-dimensional approach allows us to consider all these stages from propagation in x direction (normal to a film) to propagation in y direction (along a film).

Use of an autologous bioengineered composite skin in extensive burns: Clinical and functional outcomes. A multicentric study.

PubMed

Gómez, C; Galán, J M; Torrero, V; Ferreiro, I; Pérez, D; Palao, R; Martínez, E; Llames, S; Meana, A; Holguín, P

2011-06-01

We report clinical and functional outcomes obtained after application of an autologous bioengineered composite skin (ABCS) produced in a single Spanish tissue-engineering unit. Twenty-five burned patients treated with ABCS from 1999 to 2007 in five burn centres were included in the study. Mean age was 29 years (SD 11), with mean total body surface area (TBSA) burned being 74% (SD 17) and mean full-thickness injury of 61% (SD 19) of TBSA. The mean area initially engrafted with ABCS was 24% (SD 13) of TBSA, with a final take of 49% (SD 30, range 0-100%). ABCS achieved permanent coverage of a mean of 11% (SD 8) of TBSA. In subset analyses, lack of pre- and post-application wound bed infection and lack of serious acute systemic complications at the time of engraftment were significantly associated with better ABCS take. Final take obtained with ABCS could be improved with the use of non-cytotoxic topical antibiotics following engraftment. The use of plasma to prepare ABCS reduces production costs: cost-effectiveness ratio is not a limitation for its use. In terms of patient satisfaction, cosmetic/functional outcomes (general appearance, texture, flexibility, sensitivity and colour) of ABCS and split-thickness autografts are not different statistically. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

Skin grafting the contaminated wound bed: reassessing the role of the preoperative swab.

PubMed

Aerden, D; Bosmans, I; Vanmierlo, B; Spinnael, J; Keymeule, B; Van den Brande, P

2013-02-01

To investigate use of the preoperative wound swab to predict graft failure compared with establishing the indication for skin grafting on clinical grounds alone. Patients requiring meshed split-thickness skin grafting were prospectively included; the indication for grafting was established on clinical grounds exclusively. A preoperative swab of the wound bed was taken, but its result was concealed to prevent it influencing clinical decision-making. Negative pressure wound therapy (NPWT) was used for both wound bed preparation and graft fixation.After 2 months, graft area take percentage was measured using digital image processing software and the results validated against the result of the preoperative wound swab. Eighty-seven wounds were included in the study. Mean graft area take percentage was 88%,with five grafts considered complete failures(< 25% take).A posteriori analysis of the wound cultures showed that 53% had been contaminated on grafting, but these did not fare any worse than near-sterile wounds. Qualitative analysis of cultures showed that wounds containing either Pseudomonas aeruginosa or Staphylococcus aureus did have inferior outcome (mean take percentage 78.9% vs 91.3%; p=0.038).Diabetes was also a deteriorating factor (mean take percentage 83.0% vs 90.7%; p=0.004). Establishing the indication for skin grafting on clinical grounds exclusively does not yield grossly inferior results. In light of recent advances in skin grafting, including use of NPWT as adjuvant therapy, the requirement for routine preoperative wound swabs may be questioned.

Band-offsets at BaTiO3/Cu2O heterojunction and enhanced photoelectrochemical response: theory and experiment(Conference Presentation)

NASA Astrophysics Data System (ADS)

Sharma, Dipika; Satsangi, Vibha R.; Dass Kaura, Sahab; Shrivastav, Rohit; Waghmare, Umesh V.

2016-10-01

Band-offsets at BaTiO3/Cu2O heterojunction and enhanced photoelectrochemical response: theory and experiment Dipika Sharmaa, Vibha R. Satsangib, Rohit Shrivastava, Umesh V. Waghmarec, Sahab Dassa aDepartment of Chemistry, Dayalbagh Educational Institute, Agra-282 110 (India) bDepartment of Physics and Computer Sciences, Dayalbagh Educational Institute, Agra-282 110 (India) cTheoretical Sciences Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bangalore-560 064 (India) * Phone: +91-9219695960. Fax: +91-562-2801226. E-mail: drsahabdas@gmail.com. Study on photoelectrochemical activity of pristine BaTiO3, Cu2O and BaTiO3/Cu2O heterojunction has been carried out using DFT based band offsets and charge carriers effective mass calculations and their experimental verification. The results of DFT calculations show that BaTiO3 and Cu2O have staggered type band alignment after the heterojunction formation and high mobility of electrons in Cu2O as compared to the electrons in BaTiO3. Staggered type band edges alignment and high mobility of electrons and holes improved the separation of photo-generated charge carriers in BaTiO3/Cu2O heterojunction. To validate the theoretical results experiments were carried out on pristine BaTiO3, Cu2O and BaTiO3/Cu2O heterojunction with varying thickness of Cu2O. All samples were characterized by X- Ray Diffractometer, SEM and UV-Vis spectrometry. Nanostructured thin films of pristine BaTiO3, Cu2O and BaTiO3/Cu2O heterojunction were used as photoelectrode in the photoelectrochemical cell for water splitting reaction. Maximum photocurrent density of 1.44 mA/cm2 at 0.90 V/SCE was exhibited by 442 nm thick BaTiO3/Cu2O heterojunction photoelectrode Increased photocurrent density and enhanced photoconversion efficiency, exhibited by the heterojunction may be attributed to improved conductivity and enhanced separation of the photogenerated carriers at the BaTiO3/Cu2O interface. The experimental results and first-principles calculations compare well, thus suggesting that such calculations have the potential to be used in screening various metal oxide heterojunction before performing the experiments thereby saving precious chemicals, time and energy. Keywords: Photoelectrochemical, Water splitting, heterojunction, Cu2O, BaTiO3 References: [1] Surbhi Choudhary, et al. Nanostructured bilayered thin films in photoelectrochemical water splitting - A review: International Journal of Hydrogen Energy, (2012). [2] Dipika Sharma, Anuradha Verma, V.R. Satsangi, Rohit shrivastav, Sahab Dass Nanostructured SrTiO3 thin films sensitized by Cu2O for Photoelectrochemical Hydrogen Generation. International journal of Hydrogen Energy;42:,4230-4241, 2014.

Long-Term Isothermal Aging Effects on Carbon Fabric-Reinforced PMR-15 Composites: Compression Strength

NASA Technical Reports Server (NTRS)

Bowles, Kenneth J.; Roberts, Gary D.; Kamvouris, John E.

1996-01-01

A study was conducted to determine the effects of long-term isothermal thermo-oxidative aging on the compressive properties of T-650-35 fabric reinforced PMR-15 composites. The temperatures that were studied were 204, 260, 288, 316, and 343 C. Specimens of different geometries were evaluated. Cut edge-to-surface ratios of 0.03 to 0.89 were fabricated and aged. Aging times extended to a period in excess of 15,000 hours for the lower temperature runs. The unaged and aged specimens were tested in compression in accordance with ASTM D-695. Both thin and thick (plasma) specimens were tested. Three specimens were tested at each time/temperature/geometry condition. The failure modes appeared to be initiated by fiber kinking with longitudinal, interlaminar splitting. In general, it appears that the thermo-oxidative degradation of the compression strength of the composite material may occur by both thermal (time-dependent) and oxidative (weight-loss) mechanisms. Both mechanisms appear to be specimen-thickness dependent.

An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit.

PubMed

Isitt, Catherine E; McCloskey, Kayleigh A; Caballo, Alvaro; Sharma, Pranev; Williams, Andrew; Leon-Villapalos, Jorge; Vizcaychipi, Marcela P

2016-01-01

Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors contributing to graft failure. Inclusion criteria were admission to our Burns Intensive Care Unit (BICU) between January 2009 and October 2013 with a major burn. After exclusion for death before hospital discharge or prior skin graft at a different hospital, 35 patients remained and were divided into those with successful autografts (n=16) and those with a failed autograft (n=19). For the purposes of this study, we defined poor autograft viability as requiring at least one additional skin graft to the same site. Logistic regression of variables was performed using SPSS (Version 22.0 IBMTM). Age, Sex, %Total Burn Surface Area or Belgian Outcome Burns Injury score did not significantly differ between groups. No differences were found in any surgical factor at logistic regression (graft site, harvest site, infection etc.). When all operations were analysed, the use of colloids was found to be significantly associated with graft failure (p=0.035, CI 95%) and this remained significant when only split thickness skin grafts (STSGs) and debridement operations were included (p=0.034, CI 95%). No differences were found in crystalloid use, intraoperative temperature, pre-operative haemoglobin and blood products or vasopressor use. This analysis highlights an independent association between colloids and graft failure which has not been previously documented.

[Deep alkali burns: Evaluation of a two-step surgical strategy].

PubMed

Devinck, F; Deveaux, C; Bennis, Y; Deken-Delannoy, V; Jeanne, M; Martinot-Duquennoy, V; Guerreschi, P; Pasquesoone, L

2018-04-10

Chemical burns are rare but often lead to deep cutaneous lesions. Alkali agents have a deep and long lasting penetrating power, causing burns that evolve over several days. The local treatment for these patients is excision of the wound and split thickness skin graft. Early excision and immediate skin grafting of alkali burns are more likely to be complicated by graft failure and delayed wound healing. We propose a two-step method that delays skin grafting until two-three days after burn wound excision. Our population included 25 controls and 16 cases. Men were predominant with a mean age of 41.9 years. In 78% of cases, burns were located on the lower limbs. The mean delay between the burn and excision was 16.5 days. In cases, the skin graft was performed at a mean of 11.3 days after the initial excision. We did not unveil any significant difference between both groups for the total skin surface affected, topography of the burns and the causal agent. Wound healing was significantly shorter in cases vs controls (37.5 days vs 50.3 days; P<0.025). Furthermore, we observed a decreased number of graft failures in cases vs controls (13.3% vs 46.7%; P=0.059). Our study shows the relevance of a two-step surgical strategy in patients with alkali chemical burns. Early excision followed by interval skin grafting is associated with quicker wound healing and decreased rate of graft failure. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Case Report Reconstruction of Exposed Ilium With Reverse Turnover Latissimus Dorsi Muscle Flap

PubMed Central

Hayashida, Kenji; Endo, Yoshie; Kamebuchi, Katsuhiko

2011-01-01

Objective: It is difficult to cover a large skin and soft tissue defect with exposure of the ilium. We therefore performed a new reconstruction technique, using a reverse latissimus dorsi muscle flap fed by perforating branches of only the 10th intercostal artery. Methods: A 45-year-old man had a large traumatic defect located on the hip with exposure of the iliac crest. After confirming and preserving perforating branches of the 10th intercostal artery, the latissimus dorsi muscle flap was turned over just proximal to the perforating branch, and a split-thickness skin graft was performed over the flap. Results: The skin graft took place well and there were no circulation problems. Conclusions: This flap covered a larger area on the hip than the musculocutaneous flap. Furthermore, this is easier to perform and is less invasive than a vascularized free flap. Skin and soft tissue defects that expose bones of the lumbar or hip region can be reconstructed with a local flap; however, the deficit is small for this coverage and usually there is little skin and soft tissue to cover the wound defect in the surrounding area. Thus, it is often difficult to deal with large defects. We performed a reconstruction, using a reverse latissimus dorsi flap fed by perforating branches of the 10th intercostal artery for a large skin and soft tissue defect of the hip with exposure of the iliac crest, resulting in a good outcome. This technique is thought to be useful for reconstruction when the ilium is exposed, and we report the case and surgical procedure. PMID:21559059

Revision Vaginoplasty: A Comparison of Surgical Outcomes of Laparoscopic Intestinal versus Perineal Full-Thickness Skin Graft Vaginoplasty.

PubMed

Van der Sluis, Wouter B; Bouman, Mark-Bram; Buncamper, Marlon E; Mullender, Margriet G; Meijerink, Wilhelmus J

2016-10-01

Vaginal (re)construction can greatly improve the quality of life of indicated patients. If primary vaginoplasty fails, multiple surgical approaches exist for revision. The authors compared surgical results of laparoscopic intestinal versus full-thickness skin graft revision vaginoplasty. A retrospective chart review of patients who underwent revision vaginoplasty at the authors' institution was conducted. Patient demographics, surgical characteristics, complications, hospitalization, reoperations, and neovaginal depth for both surgical techniques were recorded and compared. The authors studied a consecutive series of 50 transgender and three biological women who underwent revision vaginoplasty, of which 21 were laparoscopic intestinal and 32 were perineal full-thickness skin graft vaginoplasties, with a median clinical follow-up of 3.2 years (range, 0.5 to 19.7 years). Patient demographics did not differ significantly. There was no mortality. Two intraoperative rectal perforations (10 percent) occurred in the intestinal group versus six (19 percent) in the full-thickness skin graft group. Operative time was shorter for the full-thickness skin graft vaginoplasty group (131 ± 35 minutes versus 191 ± 45 minutes; p < 0.01). Hospitalization length did not differ significantly. Successful vaginal (re)construction was achieved in 19 intestinal (91 percent) and 26 full-thickness skin graft (81 percent) vaginoplasty procedures. A deeper neovagina was achieved with intestinal vaginoplasty (15.9 ± 1.4 cm versus 12.5 ± 2.8 cm; p < 0.01). Both laparoscopic intestinal and full-thickness skin graft vaginoplasty can be used as secondary vaginal reconstruction. Intraoperative and postoperative complications do not differ significantly, but rectal perforation was more prevalent in the full-thickness skin graft vaginoplasty group. Although the operative time of laparoscopic intestinal vaginoplasty is longer, adequate neovaginal depth was more frequently achieved than in secondary perineal full-thickness skin graft vaginoplasty. Therapeutic, III.

Associated use of silicone-vitamin E gauzes and α-tocopherol acetate oil in healing of skin graft donor sites.

PubMed

Stanizzi, Antonio; Bottoni, Manuela; Tartaglione, Caterina; Bolletta, Elisa; Benedetto, Giovanni Di

2017-10-01

Split-thickness skin graft is one of the most used procedures in plastic surgery. This procedure involves numerous painful dressings at the donor site. α-Tocopherol acetate has anti-oxidative and anti-inflammatory properties and it can reduce the local bacterial growth, thereby promoting wound healing. We designed a prospective study to evaluate the effects of two different kinds of dressings at skin graft donor sites. A total of 30 patients were subjected to daily dressings with α-tocopherol acetate oil and traditional moist gauzes (group 1). Another 30 patients were subjected to dressings every 4 days with α-tocopherol acetate oil and silicone-vitamin E gauzes (group 2). Healing time, infection rate, patient's pain perception and costs were evaluated in both the groups. No statistically significant difference was found in terms of healing time. The infection rate was slightly different in the two groups. Significant reduction of pain perception was detected in group 2. In the same group, significant reduction in the total cost of the treatment was also observed. α-Tocopherol acetate oil and silicone-vitamin E gauzes may represent a safe, simple, painless and inexpensive method for improving skin graft donor site healing. © 2017 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

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

PubMed

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

2012-01-01

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

Management of Acquired Atresia of the External Auditory Canal.

PubMed

Bajin, Münir Demir; Yılmaz, Taner; Günaydın, Rıza Önder; Kuşçu, Oğuz; Sözen, Tevfik; Jafarov, Shamkal

2015-08-01

The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split- or full-thickness skin grafts, or pre- or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.

Skin grafting impairs postsynaptic cutaneous vasodilator and sweating responses.

PubMed

Davis, Scott L; Shibasaki, Manabu; Low, David A; Cui, Jian; Keller, David M; Purdue, Gary F; Hunt, John L; Arnoldo, Brett D; Kowalske, Karen J; Crandall, Craig G

2007-01-01

This study tested the hypothesis that postsynaptic cutaneous vascular responses to endothelial-dependent and -independent vasodilators, as well as sweat gland function, are impaired in split-thickness grafted skin 5 to 9 months after surgery. Intradermal microdialysis membranes were placed in grafted and adjacent control skin, thereby allowing local delivery of the endothelial-dependent vasodilator, acetylcholine (ACh; 1 x 10(-7) to 1 x 10(-1) M at 10-fold increments) and the endothelial-independent nitric oxide donor, sodium nitroprusside (SNP; 5 x 10(-8) to 5 x 10(-2) M at 10-fold increments). Skin blood flow and sweat rate were simultaneously assessed over the semipermeable portion of the membrane. Cutaneous vascular conductance (CVC) was calculated from the ratio of laser Doppler-derived skin blood flow to mean arterial blood pressure. deltaCVC responses from baseline to these drugs were modeled via nonlinear regression curve fitting to identify the dose of ACh and SNP causing 50% of the maximal vasodilator response (EC50). A rightward shift in the CVC dose response curve for ACh was observed in grafted (EC50 = -2.61 +/- 0.44 log M) compared to adjacent control skin (EC50 = -3.34 +/- 0.46 log M; P = .003), whereas the mean EC50 for SNP was similar between grafted (EC50 = -4.21 +/- 0.94 log M) and adjacent control skin (EC50 = -3.87 +/- 0.65 log M; P = 0.332). Only minimal sweating to exogenous ACh was observed in grafted skin whereas normal sweating was observed in control skin. Increased EC50 and decreased maximal CVC responses to the exogenous administration of ACh suggest impairment of endothelial-dependent cutaneous vasodilator responses in grafted skin 5 to 9 months after surgery. Greatly attenuated sweating responses to ACh suggests either abnormal or an absence of functional sweat glands in the grafted skin.

Joining strength performances of metal skin and CFRP core laminate structures realized by compression-curing process, with supporting experiments

NASA Astrophysics Data System (ADS)

Quagliato, Luca; Jang, Changsoon; Kim, Naksoo

2018-05-01

In the recent years, the trend of lightening vehicles and structures of every kind has become an ever-growing issue, both for university and industrial researchers. As demonstrated in previous authors' works, laminate structures made of metal skin (MS) and carbon fiber reinforced polymer (CFRP) core show high specific bending strength properties while granting considerable weight reduction but, so far, no investigations have been carried out on the hole sensitivity and joinability of these hybrid structures. In the present research work, the hole size sensitivity of MS-CFRP structure has been studied by means of uniaxial tensile test on 160mm (length), 25mm (width), 2.0mm (average thickness) specimens bored with Ø06mm, Ø9mm, and Ø12mm holes. The specimen thickness is composed of two metal skins of 0.4mm thickness each, 8×0.2mm CFRP stacked layers and two thin epoxy-based adhesive layers. The specimens have been manufactured by means of a compression-curing process in which the different materials are stacked and, thanks to die pressure and temperature, the curing process is completed in a relatively short time (15˜20 minutes). The specimens have been tested by means of simple tension test showing that, for the MS-CFRP material, the smaller the hole the smaller the maximum bearable load. Moreover, specimens with the same hole sizes have been bolted together with class 12 resistance bolts and tested by means of tensile test, allowing to determine the maximum transferable load between the two MS-CFRP plates. Aiming to prove the improvement in the specific transferable load, experiments on only-steel specimens with the same weight of the MS-CFRP ones and joined with the same method and bolts have been carried out, allowing to conclude that, for the 9mm hole bolted plates, the proposed material has a specific maximum transferable 27% higher than that of the steel composing their skins.

Surgical Management of the Thick-Skinned Nose.

PubMed

Davis, Richard E; Hrisomalos, Emily N

2018-02-01

When executed properly, open structure rhinoplasty can dramatically improve the consistency, durability, and quality of the cosmetic surgical outcome. Moreover, in expert hands, dramatic transformations in skeletal architecture can be accomplished with minimal risk and unparalleled control, all while preserving nasal airway function. While skeletal enhancements have become increasingly more controlled and precise, the outer skin-soft tissue envelope (SSTE) often presents a formidable obstacle to a satisfactory cosmetic result. In noses with unusually thick skin, excessive skin volume and characteristically hostile healing responses frequently combine to obscure or sometimes even negate cosmetic skeletal modifications and taint the surgical outcome. For this challenging patient subgroup, care must be taken to optimize the SSTE using a graduated treatment strategy directed at minimizing skin thickness and controlling unfavorable healing responses. When appropriate efforts are implemented to manage thick nasal skin, cosmetic outcomes are often substantially improved, sometimes even negating the ill-effects of thick skin altogether. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rapid onset of squamous cell carcinoma in a thin skin graft donor site.

PubMed

Herard, C; Arnaud, D; Goga, D; Rousseau, P; Potier, B

2016-01-01

Squamous cell carcinomas are malignant tumours of epithelial origin that can appear on sites subjected to chronic inflammation after a period of several years. The rapid development of squamous cell carcinoma at the donor site for a thin skin graft is a rare and poorly understood situation. We report the case of a patient undergoing thin skin grafting to cover the area of removal of a vertex squamous cell carcinoma and in whom squamous cell carcinoma appeared at the donor site within 9 weeks. In our case, we ruled out intraoperative contamination because two sets of surgical instruments were used. Given the number of cases reported in the literature, a chance event seems unlikely. The hypothesis of an acute inflammatory process caused by scarring of the thin skin graft site appears to us the most convincing. Development of cancer at the graft donor site may thus be added to the list of complications of thin skin grafting. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A prospective, randomised study of a novel transforming methacrylate dressing compared with a silver-containing sodium carboxymethylcellulose dressing on partial-thickness skin graft donor sites in burn patients.

PubMed

Assadian, Ojan; Arnoldo, Brett; Purdue, Gary; Burris, Agnes; Skrinjar, Edda; Duschek, Nikolaus; Leaper, David J

2015-06-01

This prospective, randomised study compares a new transforming methacrylate dressing (TMD) with a silver-containing carboxymethylcellulose dressing (CMC-Ag) after application to split-thickness skin graft (STSG) donor sites. This was an unblinded, non-inferiority, between-patient, comparison study that involved patients admitted to a single-centre burn unit who required two skin graft donor sites. Each patient's donor sites were covered immediately after surgery: one donor site with TMD and the other with CMC-Ag. The donor sites were evaluated until healing or until 24 days post-application, whichever came first. Study endpoints were time to healing, daily pain scores, number of dressing changes, patient comfort and physicians' and patients' willingness to use the dressings in the future. Nineteen patients had both the dressings applied. No statistically significant difference was noted in time to healing between the two dressings (14·2 days using TMD compared with 13·2 days using CMC-Ag). When pain scores were compared, TMD resulted in statistically significantly less pain at three different time periods (2-5 days, 6-10 days and 11-15 days; P < 0·001 at all time periods). Patients also reported greater comfort with TMD (P < 0·001). Users rated TMD as being less easy to use because of the time and technique required for application. Reductions in pain and increased patient comfort with the use of the TMD dressing, compared with CMC-Ag, were seen as clinical benefits as these are the major issues in donor site management. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Study on Surgical Management of Post Burn Hand Deformities

PubMed Central

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

2015-01-01

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

Outcome of Burns Treated With Autologous Cultured Proliferating Epidermal Cells: A Prospective Randomized Multicenter Intrapatient Comparative Trial.

PubMed

Gardien, Kim L M; Marck, Roos E; Bloemen, Monica C T; Waaijman, Taco; Gibbs, Sue; Ulrich, Magda M W; Middelkoop, Esther

2016-01-01

Standard treatment for large burns is transplantation with meshed split skin autografts (SSGs). A disadvantage of this treatment is that healing is accompanied by scar formation. Application of autologous epidermal cells (keratinocytes and melanocytes) may be a suitable therapeutic alternative, since this may enhance wound closure and improve scar quality. A prospective, multicenter randomized clinical trial was performed in 40 adult patients with acute full thickness burns. On two comparable wound areas, conventional treatment with SSGs was compared to an experimental treatment consisting of SSGs in combination with cultured autologous epidermal cells (ECs) seeded in a collagen carrier. The primary outcome measure was wound closure after 5-7 days. Secondary outcomes were safety aspects and scar quality measured by graft take, scar score (POSAS), skin colorimeter (DermaSpectrometer) and elasticity (Cutometer). Wound epithelialization after 5-7 days was significantly better for the experimental treatment (71%) compared to the standard treatment (67%) (p = 0.034, Wilcoxon), whereas the take rates of the grafts were similar. No related adverse events were recorded. Scar quality was evaluated at 3 (n = 33) and 12 (n = 28) months. The POSAS of the observer after 3 and 12 months and of the patient after 12 months were significantly better for the experimental area. Improvements between 12% and 23% (p ≤ 0.010, Wilcoxon) were detected for redness, pigmentation, thickness, relief, and pliability. Melanin index at 3 and 12 months and erythema index at 12 months were closer to normal skin for the experimental treatment than for conventional treatment (p ≤ 0.025 paired samples t-test). Skin elasticity showed significantly higher elasticity (p = 0.030) in the experimental area at 3 months follow-up. We showed a safe application and significant improvements of wound healing and scar quality in burn patients after treatment with ECs versus SSGs only. The relevance of cultured autologous cells in treatment of extensive burns is supported by our current findings.

Ellipsometric porosimetry on pore-controlled TiO2 layers

NASA Astrophysics Data System (ADS)

Rosu, Dana-Maria; Ortel, Erik; Hodoroaba, Vasile-Dan; Kraehnert, Ralph; Hertwig, Andreas

2017-11-01

The practical performance of surface coatings in applications like catalysis, water splitting or batteries depends critically on the coating materials' porosity. Determining the porosity in a fast and non-destructive way is still an unsolved problem for industrial thin-films technology. As a contribution to calibrated, non-destructive, optical layer characterisation, we present a multi-method comparison study on porous TiO2 films deposited by sol-gel synthesis on Si wafers. The ellipsometric data were collected on a range of samples with different TiO2 layer thickness and different porosity values. These samples were produced by templated sol-gel synthesis resulting in layers with a well-defined pore size and pore density. The ellipsometry measurement data were analysed by means of a Bruggeman effective medium approximation (BEMA), with the aim to determine the mixture ratio of void and matrix material by a multi-sample analysis strategy. This analysis yielded porosities and layer thicknesses for all samples as well as the dielectric function for the matrix material. Following the idea of multi-method techniques in metrology, the data was referenced to imaging by electron microscopy (SEM) and to a new EPMA (electron probe microanalysis) porosity approach for thin film analysis. This work might lead to a better metrological understanding of optical porosimetry and also to better-qualified characterisation methods for nano-porous layer systems.

An Effective Algorithm for Management of Noses with Thick Skin.

PubMed

Guyuron, Bahman; Lee, Michelle

2017-04-01

Thicker nasal skin blunts the definition of the underlying osseocartilaginous frame and the delicate topography of the nose posing additional challenges in producing desirable tip definition. Despite the recognized challenge in this patient population, there is a paucity of literature on how to overcome this problem. The goal of this article is to provide a systematic algorithm to manage patients with thick nasal skin. Approach to the thick nasal skin patient begins with an evaluation of the etiology of their skin thickness. Skin thickness secondary to sebaceous overactivity is diminished with the use of retinoic acid derivatives, lasers or isotretinoin (Accutane), commonly under the advice of the dermatologist. Rhinoplasty maneuvers include open technique, raising a healthy and reasonably thick skin flap overlying the tip, removing the remaining fat overlying and between the domes, creating a firm cartilaginous frame and eliminating dead space using the supratip suture reported by the senior author, and trimming redundant nasal skin envelope when indicated. This systematic approach has been greatly effective in achieving often predictable and aesthetically pleasing rhinoplasty results. 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 .

Penetration of gold nanoparticles across the stratum corneum layer of thick-Skin.

PubMed

Raju, Gayathri; Katiyar, Neeraj; Vadukumpully, Sajini; Shankarappa, Sahadev A

2018-02-01

Transdermal particulate penetration across thick-skin, such as that of palms and sole, is particularly important for drug delivery for disorders such as small fiber neuropathies. Nanoparticle-based drug delivery across skin is believed to have much translational applications, but their penetration especially through thick-skin, is not clear. This study specifically investigates the effectiveness of gold nanoparticles (AuNPs) for thick-skin penetration, especially across the stratum corneum (SC) as a function of particle size. The thick-skinned hind-paw of rat was used to characterize depth and distribution of AuNPs of varying sizes, namely, 22±3, 105±11, and 186±20nm. Epidermal penetration of AuNPs was characterized both, in harvested skin from the hind-paw using a diffusion chamber, as well as in vivo. Harvested skin segments exposed to 22nm AuNPs for only 3h demonstrated higher penetration (p<0.05) as compared to the 105 and 186nm particles. In animal studies, hind-paw skin of adult rats exposed to AuNPs solution for the same time, demonstrated nanoparticles in blood on the 4th day, and histological analysis revealed AuNPs in epidermal layers just below the SC, with no apparent tissue response. We conclude that the thick-skin allows nanoparticle penetration and acts as a depot for release of AuNPs into circulation long after the initial exposure has ceased. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

Adhesive retention dressings are more comfortable than alginate dressings on split-skin-graft donor sites.

PubMed

Hormbrey, E; Pandya, A; Giele, H

2003-07-01

Painful split-skin-graft donor sites remain a common problem for patients. We undertook a prospective randomised trial to examine the comparative comfort and ease of care of two different donor-site dressings. One dressing is the alginate Kaltostat, the standard plastic-surgical dressing in the UK and abroad, and the other is the adhesive retention tape Mefix, a novel use of a readily available dressing. We randomised 50 patients requiring split-skin grafts to receive either alginate (Kaltostat) or retention (Mefix) donor-site dressings. Dressings were assessed by interview and questionnaire at 24, 72 h and 2 weeks, and by wound review at 2 weeks. Retention dressings were found to be more comfortable, required less nursing intervention and allowed patients easier mobility with a greater range of daily activities, especially washing, without compromising wound healing. We recommend adhesive retention dressings as cost-effective comfortable dressings, which readily conform to any donor site.

First report of nonpsychotic self-cannibalism (autophagy), tongue splitting, and scar patterns (scarification) as an extreme form of cultural body modification in a western civilization.

PubMed

Benecke, M

1999-09-01

As part of her current lifestyle, a 28-year-old Caucasian woman routinely injures and allows subsequent healing of her skin and other tissues. Her body modifications include a "split tongue" (a tongue split to the base), which does not interfere with speaking and eating. Other modifications include large scarification patterns produced by branding and cutting. This woman has been known to eat parts of her skin that were previously cut out of her body. She also performs "needle play" by allowing medical syringe needles to be lodged temporarily under her skin. The patient had a normal childhood, is currently employed full-time as an office manager, and is psychologically stable. Although one other case of self-induced penoscrotal hypospadias is known, this is the only report of extensive, nonpsychotic, autodestructive behavior. However, this may not be the case in the future as an increasing number of young individuals have become interested in body modifications.

Improving scar quality: a prospective clinical study.

PubMed

Atiyeh, Bishara S; Ioannovich, John; Al-Amm, Christian A; El-Musa, Kusai A; Dham, Ruwayda

2002-01-01

Following traumatic or surgical injury to the skin, wounds do not heal by tissue regeneration but rather by scar formation. Though healing is definitely a welcomed event, the resultant scar, very often, is not aesthetically pleasing, and not infrequently, may be pathologic causing serious deformities and contractures. Management of problematic scars continues to be a frustrating endeavor with less than optimal results. Prophylactic methods of wound management to minimize serious scarring are being developed. In a previously published study, we have demonstrated improved healing of split thickness skin graft donor sites following treatment with Moist Exposed Burn Ointment (MEBO, Julphar Gulf Pharmaceutical Industries, Ras Al-Khaimah, UAE). At present, we are reporting the results of a comparative clinical prospective study evaluating scar quality following primary healing of elective surgical and traumatic facial wounds with prophylactic MEBO application, topical antibiotic ointment application, and no topical therapy at all. Scars were evaluated according to the Visual Analogue Scale for scar assessment. Statistical analysis of scar assessment scores demonstrated marked prevention of unfavorable scars with improved cosmetic results following MEBO prophylactic therapy.

A method to determine shear adhesive strength of fibrin sealants.

PubMed

Sierra, D H; Feldman, D S; Saltz, R; Huang, S

1992-01-01

The adhesive strength of fibrin sealants has not been rigorously evaluated to date. The adhesive strength of six different concentrations of cryoprecipitated fibrinogen as well as the commercially available fibrin tissue adhesive Tissucol was tested under controlled conditions utilizing split-thickness skin grafts as the test adherand. This test configuration permitted the modeling of bonding strength for attachment of skin grafts as well as incorporate established engineering test standards for adhesives. An increase in fibrin concentration corresponded with an increase in shear adhesive strength. No significant increases in adhesive strength were attained after 5 min of bonding for all tested concentrations, except for the commercial adhesive, which attained the adhesive strength of an equivalent concentration of cryoprecipitated adhesive after 90 min. The adhesive strength, however, was an order of magnitude less than reported values of the tensile strength of fibrin material for similar concentrations. Therefore, it is important that the surgeon use a sufficiently high fibrinogen concentration for the specific clinical indication. The method of fibrin sealant preparation and/or the compounding adjuncts appear to have an effect on the development of adhesive strength.

Pig but not Human Interferon-γ Initiates Human Cell-Mediated Rejection of Pig Tissue in vivo

NASA Astrophysics Data System (ADS)

Sultan, Parvez; Murray, Allan G.; McNiff, Jennifer M.; Lorber, Marc I.; Askenase, Philip W.; Bothwell, Alfred L. M.; Pober, Jordan S.

1997-08-01

Split-thickness pig skin was transplanted on severe combined immunodeficient mice so that pig dermal microvessels spontaneously inosculated with mouse microvessels and functioned to perfuse the grafts. Pig endothelial cells in the healed grafts constitutively expressed class I and class II major histocompatibility complex molecules. Major histocompatibility complex molecule expression could be further increased by intradermal injection of pig interferon-γ (IFN-γ ) but not human IFN-γ or tumor necrosis factor. Grafts injected with pig IFN-γ also developed a sparse infiltrate of mouse neutrophils and eosinophils without evidence of injury. Introduction of human peripheral blood mononuclear cells into the animals by intraperitoneal inoculation resulted in sparse perivascular mononuclear cell infiltrates in the grafts confined to the pig dermis. Injection of pig skin grafts on mice that received human peripheral blood mononuclear cells with pig IFN-γ (but not human IFN-γ or heat-inactivated pig IFN-γ ) induced human CD4+ and CD8+ T cells and macrophages to more extensively infiltrate the pig skin grafts and injure pig dermal microvessels. These findings suggest that human T cell-mediated rejection of xenotransplanted pig organs may be prevented if cellular sources of pig interferon (e.g., passenger lymphocytes) are eliminated from the graft.

An effective hair detection algorithm for dermoscopic melanoma images of skin lesions

NASA Astrophysics Data System (ADS)

Chakraborti, Damayanti; Kaur, Ravneet; Umbaugh, Scott; LeAnder, Robert

2016-09-01

Dermoscopic images are obtained using the method of skin surface microscopy. Pigmented skin lesions are evaluated in terms of texture features such as color and structure. Artifacts, such as hairs, bubbles, black frames, ruler-marks, etc., create obstacles that prevent accurate detection of skin lesions by both clinicians and computer-aided diagnosis. In this article, we propose a new algorithm for the automated detection of hairs, using an adaptive, Canny edge-detection method, followed by morphological filtering and an arithmetic addition operation. The algorithm was applied to 50 dermoscopic melanoma images. In order to ascertain this method's relative detection accuracy, it was compared to the Razmjooy hair-detection method [1], using segmentation error (SE), true detection rate (TDR) and false positioning rate (FPR). The new method produced 6.57% SE, 96.28% TDR and 3.47% FPR, compared to 15.751% SE, 86.29% TDR and 11.74% FPR produced by the Razmjooy method [1]. Because of the 7.27-9.99% improvement in those parameters, we conclude that the new algorithm produces much better results for detecting thick, thin, dark and light hairs. The new method proposed here, shows an appreciable difference in the rate of detecting bubbles, as well.

Smart skin spiral antenna with chiral absorber

NASA Astrophysics Data System (ADS)

Varadan, Vijay K.; Varadan, Vasundara V.

1995-05-01

Recently there has been considerable interest toward designing 'smart skins' for aircraft. The smart skin is a composite layer which may contain conformal radars, conformal microstrip antennas or spiral antennas for electromagnetic applications. These embedded antennas will give rise to very low radar cross section (RCS) or can be completely 'hidden' to tracking radar. In addition, they can be used to detect, monitor or even jam other unwanted electromagnetic field signatures. This paper is designed to address some technical advances made to reduce the size of spiral antennas using tunable dielectric materials and chiral absorbers. The purpose is to design, develop and fabricate a thin, wideband, conformal spiral antenna architecture that is structurally integrable and which uses advanced Penn State dielectric and absorber materials to achieve wideband ground planes, and together with low RCS. Traditional practice has been to design radome and antenna as separate entities and then resolve any interface problems during an integration phase. A structurally integrable conformal antenna, however, demands that the functional components be highly integrated both conceptually and in practice. Our concept is to use the lower skin of the radome as a substrate on which the radiator can be made using standard photolithography, thick film or LTCC techniques.

After a century-Revised Paleogene coal stratigraphy, correlation, and deposition, Powder River Basin, Wyoming and Montana

USGS Publications Warehouse

Flores, Romeo M.; Spear, Brianne D.; Kinney, Scott A.; Purchase, Peter A.; Gallagher, Craig M.

2010-01-01

The stratigraphy, correlation, mapping, and depositional history of coal-bearing strata in the Paleogene Fort Union and Wasatch Formations in the Powder River Basin were mainly based on measurement and description of outcrops during the early 20th century. Subsequently, the quality and quantity of data improved with (1) exploration and development of oil, gas, and coal during the middle 20th century and (2) the onset of coalbed methane (CBM) development during the late 20th and early 21st centuries that resulted in the drilling of more than 26,000 closely spaced wells with accompanying geophysical logs. The closeness of the data control points, which average 0.5 mi (805 m) apart, made for better accuracy in the subsurface delineation and correlation of coal beds that greatly facilitated the construction of regional stratigraphic cross sections and the assessment of resources. The drillhole data show that coal beds previously mapped as merged coal zones, such as the Wyodak coal zone in the Wyoming part of the Powder River Basin, gradually thinned into several discontinuous beds and sequentially split into as many as 7 hierarchical orders westward and northward. The thinning and splitting of coal beds in these directions were accompanied by as much as a ten-fold increase in the thicknesses of sandstone-dominated intervals within the Wyodak coal zone. This probably resulted from thrust loading by the eastern front of the Bighorn uplift accompanied by vertical displacement along lineaments that caused subsidence of the western axial part of the Powder River Basin during Laramide deformation in Late Cretaceous and early Tertiary time. Accommodation space was thereby created for synsedimentary alluvial infilling that controlled thickening, thinning, splitting, pinching out, and areal distribution of coal beds. Equally important was differential subsidence between this main accommodation space and adjoining areas, which influenced the overlapping, for example, of the Dietz coal zone in Montana, over the Wyodak coal zone in Wyoming. Correlation in a circular track of the Wyodak coal zone in the southern part of the basin also demonstrates overlapping with lower coal zones. Recognition of this stratigraphic relationship has led to revision of the correlations and nomenclature of coal beds because of inconsistency within these zones as well as those below and above them, which have long been subjects of controversy. Also, it significantly changes the traditional coal bed-to-bed correlations, and estimates of coal and coalbed methane resources of these coal zones due to thinning and pinching out of beds. More notably, thickness isopach, orientation, and distribution of the merged Wyodak coal bodies in the south-southeast part of the basin suggest that differential movement of lineament zones active during the Cretaceous was not a major influence on coal accumulation during the Paleocene. Improved knowledge of alluvial depositional environments as influenced by external and internal paleotectonic conditions within the Powder River Basin permits more accurate correlation, mapping, and resource estimation of the Fort Union and Wasatch coal beds. The result is a better understanding of the sedimentology of the basin infill deposits in relation to peat bog accumulation.

7 CFR 993.97 - Exhibit A; minimum standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... condition; (3) end cracks; (4) fermentation; (5) skin or flesh damage; (6) scab; (7) burned; (8) mold; (9... substantially affected. (3) End cracks means callous growth cracks, at the blossom end of prunes, aggregating... flavor is substantially affected. (5) Skin or flesh damage means growth cracks, splits, breaks in skin or...

Effects of channel thickness on oxide thin film transistor with double-stacked channel layer

NASA Astrophysics Data System (ADS)

Lee, Kimoon; Kim, Yong-Hoon; Yoon, Sung-Min; Kim, Jiwan; Oh, Min Suk

2017-11-01

To improve the field effect mobility and control the threshold voltage ( V th ) of oxide thin film transistors (TFTs), we fabricated the oxide TFTs with double-stacked channel layers which consist of thick Zn-Sn-O (ZTO) and very thin In-Zn-O (IZO) layers. We investigated the effects of the thickness of thin conductive layer and the conductivity of thick layer on oxide TFTs with doublestacked channel layer. When we changed the thickness of thin conductive IZO channel layer, the resistivity values were changed. This resistivity of thin channel layer affected on the saturation field effect mobility and the off current of TFTs. In case of the thick ZTO channel layer which was deposited by sputtering in Ar: O2 = 10: 1, the device showed better performances than that which was deposited in Ar: O2 = 1: 1. Our TFTs showed high mobility ( μ FE ) of 40.7 cm2/Vs and V th of 4.3 V. We assumed that high mobility and the controlled V th were caused by thin conductive IZO layer and thick stable ZTO layer. Therefore, this double-stacked channel structure can be very promising way to improve the electrical characteristics of various oxide thin film transistors.

An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy

PubMed Central

2011-01-01

Background To determine the usefulness of ultrasonography in the assessment of post radiotherapy skin changes in postmastectomy breast cancer patients. Methods Patients treated for postmastectomy radiotherapy in National University Hospital (NUH) and Tan Tock Seng Hospital (TTSH), Singapore between January 2004- December 2005 was recruited retrospectively. Ultrasound scan was performed on these Asian patients who had been treated to a total dose of 46-50 Gy with 1 cm bolus placed on the skin. The ultrasound scans were performed blinded to the RTOG scores, and the skin thickness of the individually marked points on the irradiated chest wall was compared to the corresponding points on the non-irradiated breast. Results The mean total skin thickness inclusive of the epidermis and the dermis of the right irradiated chest wall was 0.1712 mm (± 0.03392 mm) compared with the contra-lateral non-irradiated breast which was 0.1845 mm (± 0.04089 mm; p = 0.007). The left irradiated chest wall had a mean skin thickness of 0.1764 mm (± 0.03184 mm) compared with the right non-irradiated breast which was 0.1835 mm (± 0.02584 mm; p = 0.025). These independent t-tests produced a significant difference of reduced skin thickness on the right irradiated chest wall, p = 0.007 (p < 0.05) and left irradiated chest wall p = 0.025 (p < 0.025) in comparison to the non-irradiated skin thickness investigating chronic skin reactions. Patients with grade 2 acute skin toxicity presented with thinner skin as compared to patients with grade 1 (p = 0.006). Conclusions This study has shown that there is a statistically significant difference between the skin thicknesses of the irradiated chest wall and the contra-lateral non-irradiated breast and a predisposition to chronic reactions was found in patients with acute RTOG scoring of grade1 and grade 2. PMID:21261940

Probing Neutron-Skin Thickness of Unstable Nuclei with Total Reaction Cross Sections

NASA Astrophysics Data System (ADS)

Horiuchi, Wataru; Suzuki, Yasuyuki; Inakura, Tsunenori

We present our recent analysis of the total reaction cross sections, σR, of unstable nuclei and discuss their sensitivity to the neutron-skin thickness. The σR is calculated with the Glauber model using projectile densities obtained with the Skyrme-Hartree-Fock method on the three-dimensional coordinate space. We cover 91 nuclei of O, Ne, Mg, Si, S, Ca, and Ni isotopes. Defining a reaction radius, aR = √{σ R/π } , to characterize the nuclear size and target (proton or 12C) dependence, we see the 12C target probes the matter radius while the proton target is sensitive to the skin-thickness. We find an empirical formula for expressing aR with the point matter radius and the skin thickness, which can be used to determine the skin thickness.

Germanium Nanowires-in-Graphite Tubes via Self-Catalyzed Synergetic Confined Growth and Shell-Splitting Enhanced Li-Storage Performance.

PubMed

Sun, Yong; Jin, Shuaixing; Yang, Guowei; Wang, Jing; Wang, Chengxin

2015-04-28

Despite the high theoretical capacity, pure Ge has various difficulties such as significant volume expansion and electron and Li(+) transfer problems, when applied as anode materials in lithium ion battery (LIB), for which the solution would finally rely on rational design like advanced structures and available hybrid. Here in this work, we report a one-step synthesis of Ge nanowires-in-graphite tubes (GNIGTs) with the liquid Ge/C synergetic confined growth method. The structure exhibits impressing LIB behavior in terms of both cyclic stability and rate performance. We found the semiclosed graphite shell with thickness of ∼50 layers experience an interesting splitting process that was driven by electrolyte diffusion, which occurs before the Ge-Li alloying plateau begins. Two types of different splitting mechanism addressed as "inside-out"/zipper effect and "outside-in" dominate this process, which are resulted from the SEI layer growing longitudinally along the Ge-graphite interface and the lateral diffusion of Li(+) across the shell, respectively. The former mechanism is the predominant way driving the initial shell to split, which behaves like a zipper with SEI layer as invisible puller. After repeated Li(+) insertion/exaction, the GNIGTs configuration is finally reconstructed by forming Ge nanowires-thin graphite strip hybrid, both of which are in close contact, resulting in enormous enchantment to the electrons/Li(+) transport. These features make the structures perform well as anode material in LIB. We believe both the progress in 1D assembly and the structure evolution of this Ge-C composite would contribute to the design of advanced LIB anode materials.

Epidermal electronic systems for sensing and therapy

NASA Astrophysics Data System (ADS)

Lu, Nanshu; Ameri, Shideh K.; Ha, Taewoo; Nicolini, Luke; Stier, Andrew; Wang, Pulin

2017-04-01

Epidermal electronic system is a class of hair thin, skin soft, stretchable sensors and electronics capable of continuous and long-term physiological sensing and clinical therapy when applied on human skin. The high cost of manpower, materials, and photolithographic facilities associated with its manufacture limit the availability of disposable epidermal electronics. We have invented a cost and time effective, completely dry, benchtop "cut-and-paste" method for the green, freeform and portable manufacture of epidermal electronics within minutes. We have applied the "cut-and-paste" method to manufacture epidermal electrodes, hydration and temperature sensors, conformable power-efficient heaters, as well as cuffless continuous blood pressure monitors out of metal thin films, two-dimensional (2D) materials, and piezoelectric polymer sheets. For demonstration purpose, we will discuss three examples of "cut-and-pasted" epidermal electronic systems in this paper. The first will be submicron thick, transparent epidermal graphene electrodes that can be directly transferred to human skin like a temporary transfer tattoo and can measure electrocardiogram (ECG) with signal-to-noise ratio and motion artifacts on par with conventional gel electrodes. The second will be a chest patch which houses both electrodes and pressure sensors for the synchronous measurements of ECG and seismocardiogram (SCG) such that beat-to-beat blood pressure can be inferred from the time interval between the R peak of the ECG and the AC peak of the SCG. The last example will be a highly conformable, low power consumption epidermal heater for thermal therapy.

Phase-field simulations of thickness-dependent domain stability in PbTiO3 thin films

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheng, Guang; Hu, Jia-Mian; Zhang, Jinxian

Phase-field approach is used to predict the thickness effect on the domain stability in ferroelectric thin films. The strain relaxation mechanism and critical thickness for dislocation formation from both Matthews-Blakeslee (MB) and People-Bean (PB) models are employed. Thickness - strain domain stability diagrams are obtained for PbTiO3 thin films under different strain relaxation models. The relative domain fractions as a function of film thickness are also calculated and compared with experiment measurements in PbTiO3 thin films grown on SrTiO3 and KTaO3 substrates.

Behavior of composite sandwich panels with several core designs at different impact velocities

NASA Astrophysics Data System (ADS)

Jiga, Gabriel; Stamin, Ştefan; Dinu, Gabriela

2018-02-01

A sandwich composite represents a special class of composite materials that is manufactured by bonding two thin but stiff faces to a low density and low strength but thick core. The distance between the skins given by the core increases the flexural modulus of the panel with a low mass increase, producing an efficient structure able to resist at flexural and buckling loads. The strength of sandwich panels depends on the size of the panel, skins material and number or density of the cells within it. Sandwich composites are used widely in several industries, such as aerospace, automotive, medical and leisure industries. The behavior of composite sandwich panels with different core designs under different impact velocities are analyzed in this paper by numerical simulations performed on sandwich panels. The modeling was done in ANSYS and the analysis was performed through LS-DYNA.

Perioperative thermal insulation.

PubMed

Sessler, D I; McGuire, J; Sessler, A M

1991-05-01

To determine the efficacy of passive insulators advocated for prevention of cutaneous heat loss, we determined heat loss in unanesthetized volunteers covered by one of the following: a cloth "split sheet" surgical drape; a Convertors disposable-paper split sheet; a Thermadrape disposable laparotomy sheet; an unheated Bair Hugger patient-warming blanket; 1.5-mil-thick plastic hamper bags; and a prewarmed, cotton hospital blanket. Cutaneous heat loss was measured using 10 area-weighted thermal flux transducers while volunteers were exposed to a 20.6 degrees C environment for 1 h. Heat loss decreased significantly from 100 +/- 3 W during the control periods to 69 +/- 6 W (average of all covers) after 1 h of treatment. Heat losses from volunteers insulated by the Thermadrape (61 +/- 6 W) and Bair Hugger covers (64 +/- 5 W) were significantly less than losses from those insulated by plastic bags (77 +/- 11 W). The paper drape (67 +/- 7 W) provided slightly, but not significantly, better insulation than the cloth drape (70 +/- 4 W). Coverage by prewarmed cotton blankets initially resulted in the least heat loss (58 +/- 8 W), but after 40 min, resulted in heat loss significantly greater than that for the Thermadrape (71 +/- 7 W). Regional heat loss was roughly proportional to surface area, and the distribution of regional heat loss remained similar with all covers. These data suggest that cost and convenience should be major factors when choosing among passive perioperative insulating covers. It is likely that the amount of skin surface covered is more important than the choice of skin region covered or the choice of insulating material.

Neutron Zeeman beam-splitting for the investigation of magnetic nanostructures

NASA Astrophysics Data System (ADS)

Kozhevnikov, S. V.; Ott, F.; Semenova, E.

2017-03-01

Zeeman spatial splitting of a neutron beam takes place during a neutron spin-flip in magnetically non-collinear systems at grazing incidence geometry. We apply the neutron beam-splitting method for the investigation of magnetically non-collinear clusters of submicron size in a thin film. The experimental results are compared with ones obtained by other methods.

Early cessation of pressure garment therapy results in scar contraction and thickening

PubMed Central

DeBruler, Danielle M.; Zbinden, Jacob C.; Baumann, Molly E.; Blackstone, Britani N.; Malara, Megan M.; Bailey, J. Kevin

2018-01-01

Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1–2 years), though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure) or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released); scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements. PMID:29897933

Early cessation of pressure garment therapy results in scar contraction and thickening.

PubMed

DeBruler, Danielle M; Zbinden, Jacob C; Baumann, Molly E; Blackstone, Britani N; Malara, Megan M; Bailey, J Kevin; Supp, Dorothy M; Powell, Heather M

2018-01-01

Pressure garment therapy is often prescribed to improve scar properties following full-thickness burn injuries. Pressure garment therapy is generally recommended for long periods of time following injury (1-2 years), though it is plagued by extremely low patient compliance. The goal of this study was to examine the effects of early cessation of pressure garment therapy on scar properties. Full-thickness burn injuries were created along the dorsum of red Duroc pigs. The burn eschar was excised and wound sites autografted with split-thickness skin. Scars were treated with pressure garments within 1 week of injury and pressure was maintained for either 29 weeks (continuous pressure) or for 17 weeks followed by cessation of pressure for an additional 12 weeks (pressure released); scars receiving no treatment served as controls. Scars that underwent pressure garment therapy were significantly smoother and less contracted with decreased scar height compared to control scars at 17 weeks. These benefits were maintained in the continuous pressure group until week 29. In the pressure released group, grafts significantly contracted and became more raised, harder and rougher after the therapy was discontinued. Pressure cessation also resulted in large changes in collagen fiber orientation and increases in collagen fiber thickness. The results suggest that pressure garment therapy effectively improves scar properties following severe burn injury; however, early cessation of the therapy results in substantial loss of these improvements.

Estimating optically-thin cirrus cloud induced cold bias on infrared radiometric satellite sea surface temperature retrieval in the tropics

NASA Astrophysics Data System (ADS)

Marquis, Jared Wayne

Passive longwave infrared radiometric satellite-based retrievals of sea surface temperature (SST) at instrument nadir are investigated for cold bias caused by unscreened optically-thin cirrus (OTC) clouds (cloud optical depth ≤ 0.3; COD). Level 2 split-window SST retrievals over tropical oceans (30° S - 30° N) from Moderate Resolution Imaging Spectroradiometer (MODIS) radiances collected aboard the NASA Aqua satellite (Aqua-MODIS) are collocated with cloud profiles from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) instrument, mounted on the independent NASA CALIPSO satellite. OTC are present in approximately 25% of tropical quality-assured (QA) Aqua-MODIS Level-2 data, representing over 99% of all contaminating cirrus found. This results in cold-biased SST retrievals using either split- (MODIS, AVHRR and VIIRS) or triple-window (AVHRR and VIIRS only) retrieval methods. SST retrievals are modeled based on operational algorithms using radiative transfer model simulations conducted with a hypothetical 1.5 km thick OTC cloud placed incrementally from 10.0 - 18.0 km above mean sea level for cloud optical depths (COD) between 0.0 - 0.3. Corresponding cold bias estimates for each sensor are estimated using relative Aqua-MODIS cloud contamination frequencies as a function of cloud top height and COD (assuming them consistent across each platform) integrated within each corresponding modeled cold bias matrix. Split-window relative OTC cold biases, for any single observation, range from 0.40° - 0.49° C for the three sensors, with an absolute (bulk mean) bias between 0.10° - 0.13° C. Triple-window retrievals are more resilient, ranging from 0.03° - 0.04° C relative and 0.11° - 0.16° C absolute. Cold biases are constant across the Pacific and Indian Ocean domains. Absolute bias is smaller over the Atlantic, but relative bias is larger due to different cloud properties indicating that this issue persists globally.

Mutual Inductance Problem for a System Consisting of a Current Sheet and a Thin Metal Plate

NASA Technical Reports Server (NTRS)

Fulton, J. P.; Wincheski, B.; Nath, S.; Namkung, M.

1993-01-01

Rapid inspection of aircraft structures for flaws is of vital importance to the commercial and defense aircraft industry. In particular, inspecting thin aluminum structures for flaws is the focus of a large scale R&D effort in the nondestructive evaluation (NDE) community. Traditional eddy current methods used today are effective, but require long inspection times. New electromagnetic techniques which monitor the normal component of the magnetic field above a sample due to a sheet of current as the excitation, seem to be promising. This paper is an attempt to understand and analyze the magnetic field distribution due to a current sheet above an aluminum test sample. A simple theoretical model, coupled with a two dimensional finite element model (FEM) and experimental data will be presented in the next few sections. A current sheet above a conducting sample generates eddy currents in the material, while a sensor above the current sheet or in between the two plates monitors the normal component of the magnetic field. A rivet or a surface flaw near a rivet in an aircraft aluminum skin will disturb the magnetic field, which is imaged by the sensor. Initial results showed a strong dependence of the flaw induced normal magnetic field strength on the thickness and conductivity of the current-sheet that could not be accounted for by skin depth attenuation alone. It was believed that the eddy current imaging method explained the dependence of the thickness and conductivity of the flaw induced normal magnetic field. Further investigation, suggested the complexity associated with the mutual inductance of the system needed to be studied. The next section gives an analytical model to better understand the phenomenon.

Comparison of a new hydro-surgical technique to traditional methods for the preparation of full-thickness skin grafts from canine cadaveric skin and report of a single clinical case.

PubMed

Townsend, F I; Ralphs, S C; Coronado, G; Sweet, D C; Ward, J; Bloch, C P

2012-01-01

To compare the hydro-surgical technique to traditional techniques for removal of subcutaneous tissue in the preparation of full-thickness skin grafts. Ex vivo experimental study and a single clinical case report. Four canine cadavers and a single clinical case. Four sections of skin were harvested from the lateral flank of recently euthanatized dogs. Traditional preparation methods used included both a blade or scissors technique, each of which were compared to the hydro-surgical technique individually. Preparation methods were compared based on length of time for removal of the subcutaneous tissue from the graft, histologic grading, and measurable thickness as compared to an untreated sample. The hydro-surgical technique had the shortest skin graft preparation time as compared to traditional techniques (p = 0.002). There was no significant difference in the histological grading or measurable subcutaneous thickness between skin specimens. The hydro-surgical technique provides a rapid, effective debridement of subcutaneous tissue in the preparation of full-thickness skin grafts. There were not any significant changes in histological grade and subcutaneous tissue remaining among all treatment types. Additionally the hydro-surgical technique was successfully used to prepare a full-thickness meshed free skin graft in the reconstruction of a traumatic medial tarsal wound in a dog.

Controlling water evaporation through self-assembly

PubMed Central

Roger, Kevin; Liebi, Marianne; Heimdal, Jimmy; Pham, Quoc Dat; Sparr, Emma

2016-01-01

Water evaporation concerns all land-living organisms, as ambient air is dryer than their corresponding equilibrium humidity. Contrarily to plants, mammals are covered with a skin that not only hinders evaporation but also maintains its rate at a nearly constant value, independently of air humidity. Here, we show that simple amphiphiles/water systems reproduce this behavior, which suggests a common underlying mechanism originating from responding self-assembly structures. The composition and structure gradients arising from the evaporation process were characterized using optical microscopy, infrared microscopy, and small-angle X-ray scattering. We observed a thin and dry outer phase that responds to changes in air humidity by increasing its thickness as the air becomes dryer, which decreases its permeability to water, thus counterbalancing the increase in the evaporation driving force. This thin and dry outer phase therefore shields the systems from humidity variations. Such a feedback loop achieves a homeostatic regulation of water evaporation. PMID:27573848

Controlling water evaporation through self-assembly.

PubMed

Roger, Kevin; Liebi, Marianne; Heimdal, Jimmy; Pham, Quoc Dat; Sparr, Emma

2016-09-13

Water evaporation concerns all land-living organisms, as ambient air is dryer than their corresponding equilibrium humidity. Contrarily to plants, mammals are covered with a skin that not only hinders evaporation but also maintains its rate at a nearly constant value, independently of air humidity. Here, we show that simple amphiphiles/water systems reproduce this behavior, which suggests a common underlying mechanism originating from responding self-assembly structures. The composition and structure gradients arising from the evaporation process were characterized using optical microscopy, infrared microscopy, and small-angle X-ray scattering. We observed a thin and dry outer phase that responds to changes in air humidity by increasing its thickness as the air becomes dryer, which decreases its permeability to water, thus counterbalancing the increase in the evaporation driving force. This thin and dry outer phase therefore shields the systems from humidity variations. Such a feedback loop achieves a homeostatic regulation of water evaporation.

Determining the origin of cells in tissue engineered skin substitutes: a pilot study employing in situ hybridization.

PubMed

Weber, Andreas Daniel; Pontiggia, Luca; Biedermann, Thomas; Schiestl, Clemens; Meuli, Martin; Reichmann, Ernst

2011-03-01

Definitive and high-quality coverage of large and, in particular, massive skin defects remains a significant challenge in burn as well as plastic and reconstructive surgery because of donor site shortage. A novel and promising approach to overcome these problems is tissue engineering of skin. Clearly, before eventual clinical application, engineered skin substitutes of human origin must be grafted and then evaluated in animal models. For the various tests to be conducted it is indispensable to be able to identify human cells as such in culture and also to distinguish between graft and recipient tissue after transplantation. Here we describe a tool to identify human cells in vitro and in vivo. In situ hybridization allows for the detection and localization of specific DNA or RNA sequences in morphologically preserved cells in culture or tissue sections, respectively. We used digoxigenin-labeled DNA probes corresponding to human-specific Alu repeats in order to identify human keratinocytes grown in culture together with rat cells, and also to label split and full thickness skin grafts of human origin after transplantation on immuno-incompetent rats. Digoxigenin-labeled DNA probing resulted in an intensive nuclear staining of human cells, both in culture and after transplantation onto recipient animals, while recipient animal cells (rat cells) did not stain. In situ hybridization using primate-specific Alu probes reliably allows distinguishing between cells of human and non-human origin both in culture as well as in histological sections. This method is an essential tool for those preclinical experiments (performed on non-primate animals) that must be conducted before novel tissue engineered skin substitutes might be introduced into clinical practice.

A Novel Collagen-Gelatin Scaffold for the Treatment of Deep Dermal Wounds-An Evaluation in a Minipig Model.

PubMed

Held, Manuel; Rahmanian-Schwarz, Afshin; Schiefer, Jennifer; Rath, Rebekka; Werner, Jan-Ole; Rahmanian, Shahab; Schaller, Hans-Eberhard; Petersen, Wiebke

2016-06-01

Today, autologous skin transplantation is frequently used for full-thickness skin defects. There is still a high demand for new wound-healing products to replace autologous skin transplantation. In this context, the effect of a new collagen-gelatin scaffold on full-thickness skin defects was evaluated. Four full-thickness skin defects were created surgically on the dorsum of 6 Göttingen minipigs. Three wounds were randomly treated with a novel collagen-gelatin scaffold in different thicknesses, whereas the fourth wound was left untreated and served as a control wound. During the experimental period of 21 days, a close-up photographic documentation was performed. Afterwards, the areas of the initial wounds were excised and examined histologically. The systematic evaluation of 24 wounds showed that treatment with the new collagen-gelatin scaffold led to an accelerated wound repair of 1.1 days. Compared to control wounds, it also demonstrated improved skin quality in regard to epidermal thickness. The new collagen-gelatin scaffold supports and accelerates dermal wound repair compared to untreated control wounds. Nevertheless, wound treatment with the scaffold was only performed on the first day. In further studies, the impact of multiple scaffold applications on full-thickness skin defects should be investigated.

Influence of proton-skin thickness on the {{\\alpha }} decays of heavy nuclei

NASA Astrophysics Data System (ADS)

Seif, W. M.; Abdurrahman, A.

2018-01-01

We investigate the effect of proton-skin thickness on the α decay process. We consider 188 neutron-deficient nuclei belonging to the isotopic chains from Te (Z = 52) to Pb (Z = 82). The calculations of the half-life are carried out in the framework of the preformed cluster model, with the Wentzel-Kramers-Brillouin penetration probability and assault frequency. It is shown that the proton-skin thickness ({\\varDelta }{{p}}) of the daughter nucleus gives rise to a total α- daughter nucleus interaction potential of relatively wide deep internal pocket and a thinner Coulomb barrier of less height. This increases the penetration probability but decreases the assault frequency. The overall impact of the proton-skin thickness appears as a decrease in the decay half-life. The proton-skin thickness decreases the stability of the nucleus. The half-lives of the proton-skinned isotopes along the isotopic chain decrease exponentially with increasing the proton-skin thickness, whereas the {Q}α -value increases with {\\varDelta }{{p}}. α-decay manifests itself as the second favorite decay mode of neutron-deficient nuclei, next to the {β }+-decay and before proton-decay. It is indicated as main, competing, and minor decay mode, at 21%, 7%, and 57%, respectively, of the investigated nuclei.

The evolution of acute burn care - retiring the split skin graft.

PubMed

Greenwood, J E

2017-07-01

The skin graft was born in 1869 and since then, surgeons have been using split skin grafts for wound repair. Nevertheless, this asset fails the big burn patient, who deserves an elastic, mobile and robust outcome but who receives the poorest possible outcome based on donor site paucity. Negating the need for the skin graft requires an autologous composite cultured skin and a material capable of temporising the burn wound for four weeks until the composite is produced. A novel, biodegradable polyurethane chemistry has been used to create two such products. This paper describes the design, production, optimisation and evaluation of several iterations of these products. The evaluation has occurred in a variety of models, both in vitro and in vivo, employing Hunterian scientific principles, and embracing Hunter's love and appreciation of comparative anatomy. The process has culminated in significant human experience in complex wounds and extensive burn injury. Used serially, the products offer robust and elastic healing in deep burns of any size within 6 weeks of injury.

Luminescence behaviour and deposition of Sc2O3 thin films from scandium(III) acetylacetonate at ambient pressure

NASA Astrophysics Data System (ADS)

Dixon, Sebastian C.; Jiamprasertboon, Arreerat; Carmalt, Claire J.; Parkin, Ivan P.

2018-05-01

Scandium(III) oxide thin film deposition has been historically difficult to achieve without the use of vacuum-based or wet chemical systems due to precursor limitations of low vapour pressure or ambient instability. In this letter, the adoption of aerosol-assisted delivery of scandium(III) acetylacetonate has enabled the chemical vapour deposition of polycrystalline and amorphous Sc2O3 thin films at ambient pressure with high growth rates (ca. 500 nm h-1). The scandia films were intrinsically highly photoluminescent, exhibiting broad emission bands centred at 3.6 and 3.0 eV, which increased significantly in intensity upon aerobic annealing, accompanying a transition from amorphous to crystalline, while bands appearing at 2.1 and 2.3 eV seemed to occur only in the crystalline films. In addition, both amorphous and crystalline scandia films exhibited blue-green vibronic fine structure between 2.3 and 3.2 eV attributed to the electronic transition B→κ Σ+ 2 Σ+ in surface ⋯ O - ⋯ O - S c = O groups and split by a vibrational mode observed at 920 ± 60 cm - 1 by infrared spectroscopy. Band gaps of amorphous and crystalline Sc2O3 were determined to be 5.3 and 5.7 eV, respectively via diffuse reflectance. All films had high refractive indices, varying between 1.8 and 2.0 at 400 nm depending on film thickness and carrier gas used in the deposition; film thicknesses less than ca. 300 nm were observed to have a strong influence on the refractive index measured, while there was little variation for films thicker than this. The synthesis process itself is exceedingly low-cost and facile thus promising streamlined industrial scalability.

Results of aerodynamic heat transfer tests of a 0.0175-scale model of the Rockwell International Space Shuttle Orbiter 139 (model number 22-0) in the NASA/Ames 3.5-foot hypersonic wind tunnel (test OH6)

NASA Technical Reports Server (NTRS)

Dye, W. H.; Lockman, W. K.

1975-01-01

The results of a hypersonic wind tunnel test program conducted using a 0.0175 scale thin-skin thermocouple model of the Space Shuttle Orbiter to obtain aerodynamic heat transfer data on the Orbiter under simulated reentry conditions were presented. The test program was conducted at a Mach number of 7.3 and a freestream Reynolds number ranging between 1.0 and 6.0 million/foot. The model was tested for angles of attack ranging between 10 deg and 30 deg and a sideslip angle of 0 deg. The model was constructed of 15-5 PH stainless steel with the instrumented areas machined to a nominal skin thickness of 0.030 in. The model instrumentation consisted of 288 iron-constantan thermocouples spot welded to the skin inner surface, but only 75 of these were used in this test program. A high-speed, analog-to-digital data acquisition system was used to record data on magnetic tape.

Experimental Evaluation of Hot Films on Ceramic Substrates for Skin-Friction Measurement

NASA Technical Reports Server (NTRS)

Noffz, Gregory K.; Lavine, Adrienne S.; Hamory, Philip J.

2003-01-01

An investigation has been performed on the use of low-thermal conductivity, ceramic substrates for hot films intended to measure skin friction. Hot films were deposited on two types of ceramic substrates. Four hot films used composite-ceramic substrates with subsurface thermocouples (TCs), and two hot films were deposited on thin Macor(R) substrates. All six sensors were tested side by side in the wall of the NASA Glenn Research Center 8-ft by 6-ft Supersonic Wind Tunnel (SWT). Data were obtained from zero flow to Mach 1.98 in air. Control measurements were made with three Preston tubes and two boundary-layer rakes. The tests were repeated at two different hot film power levels. All hot films and subsurface TCs functioned throughout the three days of testing. At zero flow, the films on the high-thermal conductivity Macor(R) substrates required approximately twice the power as those on the composite-ceramic substrates. Skin-friction results were consistent with the control measurements. Estimates of the conduction heat losses were made using the embedded TCs but were hampered by variability in coating thicknesses and TC locations.

Skin condition measurement by using multispectral imaging system (Conference Presentation)

NASA Astrophysics Data System (ADS)

Jung, Geunho; Kim, Sungchul; Kim, Jae Gwan

2017-02-01

There are a number of commercially available low level light therapy (LLLT) devices in a market, and face whitening or wrinkle reduction is one of targets in LLLT. The facial improvement could be known simply by visual observation of face, but it cannot provide either quantitative data or recognize a subtle change. Clinical diagnostic instruments such as mexameter can provide a quantitative data, but it costs too high for home users. Therefore, we designed a low cost multi-spectral imaging device by adding additional LEDs (470nm, 640nm, white LED, 905nm) to a commercial USB microscope which has two LEDs (395nm, 940nm) as light sources. Among various LLLT skin treatments, we focused on getting melanin and wrinkle information. For melanin index measurements, multi-spectral images of nevus were acquired and melanin index values from color image (conventional method) and from multi-spectral images were compared. The results showed that multi-spectral analysis of melanin index can visualize nevus with a different depth and concentration. A cross section of wrinkle on skin resembles a wedge which can be a source of high frequency components when the skin image is Fourier transformed into a spatial frequency domain map. In that case, the entropy value of the spatial frequency map can represent the frequency distribution which is related with the amount and thickness of wrinkle. Entropy values from multi-spectral images can potentially separate the percentage of thin and shallow wrinkle from thick and deep wrinkle. From the results, we found that this low cost multi-spectral imaging system could be beneficial for home users of LLLT by providing the treatment efficacy in a quantitative way.

Split-face vitamin C consumer preference study.

PubMed

Baumann, Leslie; Duque, Deysi K; Schirripa, Michael J

2014-10-01

Vitamin C is commonly used to treat aged skin. It has shown regenerative effects on skin wrinkles, texture, strength, and evenness of tone through its roles as an antioxidant, tyrosinase inhibitor, and inducer of collagen synthesis. Available vitamin C formulations on the anti-aging skin care market vary by their pH, packaging, and vehicle, which may decrease absorption, and therefore, the efficacy of the product. The purpose of this study was to assess the subjective efficacy, wearability, tolerance and overall preference of two professional vitamin C topical serums and sunscreens in Caucasian females using a split face method. A virtual split-face study of 39 Caucasian women compared two popular vitamin C and SPF product combinations - C-ESTA® Face Serum and Marini Physical Protectant SPF 45 (Jan Marini Skin, San Jose, CA; Products A) and CE Ferulic® and Physical Fusion UV Defense SPF 50 (Products B; SkinCeuticals Inc, Garland, TX). The products were assigned to each subject's left or right side of the face, and subjects rated and compared products through 5 online surveys at baseline, 24 hours, days 3, 7, and 14. Over 86% of the 35 subjects who completed the study preferred the smell and 83% preferred the feel and application of vitamin C Serum A over Serum B. Seventy-one percent of subjects preferred the feel and application of Sunscreen A over Sunscreen B. Results also showed a significant skin texture improvement and skin tone with Products A vs Product B. Products A trended higher for multiple additional categories. Products A exhibited superior anti-aging benefits than Products B. Subjects preferred the smell, feel, and application of Products A and experienced significantly less irritation than Products B. Overall, Products A were preferred over Products B with subjects willing to pay more for Products A over Products B.

7 CFR 51.776 - Slightly rough texture.

Code of Federal Regulations, 2011 CFR

2011-01-01

... texture. Slightly rough texture means that the skin may be slightly thick but not excessively thick, materially ridged or grooved. “Slightly thick” means that the skin thickness does not average more than 5/8...

7 CFR 51.776 - Slightly rough texture.

Code of Federal Regulations, 2012 CFR

2012-01-01

... texture. Slightly rough texture means that the skin may be slightly thick but not excessively thick, materially ridged or grooved. “Slightly thick” means that the skin thickness does not average more than 5/8...

7 CFR 51.776 - Slightly rough texture.

Code of Federal Regulations, 2010 CFR

2010-01-01

... texture. Slightly rough texture means that the skin may be slightly thick but not excessively thick, materially ridged or grooved. “Slightly thick” means that the skin thickness does not average more than 5/8...

Growth of the Zagros Fold-Thrust Belt and Foreland Basin, Northern Iraq, Kurdistan

NASA Astrophysics Data System (ADS)

Koshnaw, Renas; Horton, Brian; Stockli, Daniel; Barber, Douglas; Ghalib, Hafidh; Dara, Rebwar

2016-04-01

The Zagros orogenic belt in the Middle Eastern segment of the Alpine-Himalayan system is among the youngest seismically active continental collision zones on Earth. However, due to diachronous and incremental collision, the precise ages and kinematics of shortening and deposition remain poorly understood. The Kurdistan region of the Zagros fold-thrust belt and foreland basin contains well-preserved Neogene wedge-top and foredeep deposits that include clastic nonmarine fill of the Upper Fars, Lower Bakhtiari, and Upper Bakhtiari Formations. These deposits record significant information about orogenic growth, fold-thrust dynamics, and advance of the deformation front. Thermochronologic and geochronologic data from thrust sheets and stratigraphic archives combined with local earthquake data provide a unique opportunity to address the linkages between surface and subsurface geologic relationships. This research seeks to constrain the timing and geometry of exhumation and deformation by addressing two key questions: (1) Did the northwestern Zagros fold-thrust belt evolve from initial thin-skinned shortening to later thick-skinned deformation or vice-versa? (2) Did the fold-thrust belt advance steadily under critical/supercritical wedge conditions involving in-sequence thrusting or propagate intermittently under subcritical conditions with out-of-sequence deformation? From north to south, apatite (U-Th)/He ages from the Main Zagros Thrust, the Mountain Front Flexure (MFF), and additional frontal thrusts suggest rapid exhumation by ~10 Ma, ~5 Ma, and ~8 Ma respectively. Field observations and seismic sections indicate progressive tilting and development of growth strata within the Lower Bakhtiari Formation adjacent to the frontal thrusts and within the Upper Bakhtiari Formation near the MFF. In the Kurdistan region of Iraq, a regional balanced cross section constrained by new thermochronometric results, proprietary seismic reflection profiles, and earthquake hypocenters suggest prolonged thin-skinned shortening in sequence from north to south followed by a thick-skinned out-of-sequence MFF deformation and intermittent hinterland uplift postdating initial collision. Magnetostratigraphic analyses of Dinarta wedge-top deposits and Kifri foredeep deposits constrain accumulation of the Upper Fars-Lower Bakhtiari synorogenic succession to 12.5-5 Ma. These findings suggest that temporal and spatial shifts in upper-crustal modes of deformation in the Kurdistan segment of the Zagros orogenic belt strongly influenced patterns of topographic growth, landscape development, and resulting foreland basin stratigraphy.

Geology Field Camp at Southern Illinois University: Six weeks exploring four tectonic regimes

NASA Astrophysics Data System (ADS)

Friedman, S. A.; Conder, J. A.; Ferre, E. C.; Heij, G.

2013-12-01

Field Geology is typically the capstone course for an undergraduate Bachelor of Science degree in Geology. This type of course brings together the varied sub-disciplines and course topics students encounter in their undergraduate experience, and puts these in context of active Earth processes. At the same time, a significant fraction of Geology departments have dropped field geology from their offerings and students must choose from those programs still offering the course. Southern Illinois University has offered field geology for over 40 years, stationed in and around southwestern Montana. This field camp offers experiences with four distinct tectonic settings: thick-skin contractional, thin-skin contractional, extensional, and anorogenic. The most challenging projects of the course involve mapping and interpreting Laramide and Sevier compressionally deformed areas. The major difference between the two types of deformation is that Laramide ('thick-skinned') tectonics encompasses the mid-crust in deformation while Sevier ('thin-skinned') deformation is limited to the uppermost portion of the crust. This difference results in markedly different fold styles and other deformational structures encountered, requiring different approaches to understanding and constructing the deformational histories of the regions. Extensional tectonics are explored with a paleoseismology project at Hebgen Lake, in Grand Teton National Park where the students typically spend two days, and at the Bitterroot Shear Zone - the edge of a metamorphic core complex along the eastern boundary of the Idaho batholith. While recent work from EarthScope and elsewhere casts doubt on Yellowstone as a mantle plume, Yellowstone remains the classic example of a continental hotspot. During visits through the park, students distinguish between the recent volcanics and hydrothermal activity of Yellowstone and the nearby Eocene Absaroka volcanics. Expanding on the story of the Yellowstone hotspot, a visit is made to Craters of the Moon National Monument in the Snake River Plain to examine some of the youngest volcanics in North America. Not only does field camp give students an occasion to put their knowledge-base developed during their undergraduate years into action, but it is also an ideal opportunity to expose students to the varied approaches applicable to distinct tectonic problems and situations. At SIU, we are proud to offer a wide range of experiences drawing from several important tectonic provinces giving students a strong foundation for their future geological careers and continuing scientific development.

Rouleaux red blood cells splitting in microscopic thin blood smear images via local maxima, circles drawing, and mapping with original RBCs.

PubMed

Rehman, Amjad; Abbas, Naveed; Saba, Tanzila; Mahmood, Toqeer; Kolivand, Hoshang

2018-04-10

Splitting the rouleaux RBCs from single RBCs and its further subdivision is a challenging area in computer-assisted diagnosis of blood. This phenomenon is applied in complete blood count, anemia, leukemia, and malaria tests. Several automated techniques are reported in the state of art for this task but face either under or over splitting problems. The current research presents a novel approach to split Rouleaux red blood cells (chains of RBCs) precisely, which are frequently observed in the thin blood smear images. Accordingly, this research address the rouleaux splitting problem in a realistic, efficient and automated way by considering the distance transform and local maxima of the rouleaux RBCs. Rouleaux RBCs are splitted by taking their local maxima as the centres to draw circles by mid-point circle algorithm. The resulting circles are further mapped with single RBC in Rouleaux to preserve its original shape. The results of the proposed approach on standard data set are presented and analyzed statistically by achieving an average recall of 0.059, an average precision of 0.067 and F-measure 0.063 are achieved through ground truth with visual inspection. © 2018 Wiley Periodicals, Inc.

Dermofat graft in deep nasolabial fold and facial rhytidectomy.

PubMed

Hwang, Kun; Han, Jin Yi; Kim, Dae Joong

2003-01-01

Fat and dermis or the combined tissues are used commonly in augmentation of the nasolabial fold. Guyuron obtained the dermofat graft from either the suprapubic or the groin region. The thickness of the preauricular skin was measured in seven Korean cadavers, five male and two female. We used the dermofat graft out of the preauricular skin remnant after facial rhytidectomy to augment the deep nasolabial fold in a patient. The average thickness of the epidermis was 56 +/- 12 microm, the dermis was 1820 +/- 265 microm thick, and the subcutaneous tissue was 4783 +/- 137 microm. More dense connective tissues, such as SMAS, are seen in the preauricular skin. The dermofat graft was easily obtained and prepared from the leftover preauricular skin after dissection of the lax skin in face lifting. This technique could be employed effectively and successfully to alleviate a deep nasolabial fold and concomitant facial rhytidectomy in an Asian with a thick preauricular skin.

Evaluation of cytotoxicity and antimicrobial activity of Acticoat Burn Dressing for management of microbial contamination in cultured skin substitutes grafted to athymic mice.

PubMed

Supp, Andrew P; Neely, Alice N; Supp, Dorothy M; Warden, Glenn D; Boyce, Steven T

2005-01-01

Cultured skin substitutes (CSS) have become a useful adjunctive treatment for closure of burn wounds, but CSS are avascular and remain susceptible to microbial destruction longer than split-thickness skin grafts. Irrigation of CSS grafted to burn wounds with a topical antimicrobial solution (TAS) has been shown to promote engraftment of CSS, but TAS usage has potential limitations. Acticoat Burn Dressing (Acticoat; Westaim Biomedical, Exeter, NH) is a silver-coated barrier dressing reported to exhibit antimicrobial activity and to reduce infection in partial-thickness and full-thickness wounds. This study evaluated the cytotoxicity of Acticoat with CSS and the efficacy of Acticoat for the management of microbial contamination in CSS grafted to full-thickness wounds in athymic mice. The cytotoxicity of Acticoat was assessed in preliminary studies after 1 week of exposure to CSS during in vitro maturation or healing on wounds in athymic mice. Histologies were analyzed and cellular viability in the CSS was determined by MTT conversion on days 0, 1, and 7 of Acticoat exposure. At 1, 2, 3, and 4 weeks after grafting, wounds were traced, and areas of healing CSS were calculated by image analysis. At 4 weeks, wound biopsies were evaluated and scored for engraftment of human cells. In a subsequent study, wounds were inoculated with strain SBI-N of Pseudomonas aeruginosa at 1 x 10(5) cfu/wound before the application of CSS or inoculated onto the surface of Acticoat. At 4 weeks, swab cultures were collected from the surface of CSS and scored for the presence of SBI-N. Statistical significance was accepted at the 95% confidence level (P <.05). The data show that exposure in vitro of CSS to Acticoat was cytotoxic within 1 day, but 1 week of exposure in vivo did not injure CSS or inhibit wound healing. Contaminated wounds treated with Acticoat healed similarly to control treatments, with comparable rates of engraftment, and detection of SBI-N on the surface of only one graft. No SBI-N was detected on CSS after inoculation onto the surface of Acticoat. These results suggest that Acticoat may be suitable as a protective dressing to reduce environmental contamination of CSS, if used in conjunction with additional antimicrobials to control organisms present in the wound.

Balancing sub- and supra-salt strain in salt-influenced rifts: Implications for extension estimates

NASA Astrophysics Data System (ADS)

Coleman, Alexander J.; Jackson, Christopher A.-L.; Duffy, Oliver B.

2017-09-01

The structural style of salt-influenced rifts may differ from those formed in predominantly brittle crust. Salt can decouple sub- and supra-salt strain, causing sub-salt faults to be geometrically decoupled from, but kinematically coupled to and responsible for, supra-salt forced folding. Salt-influenced rifts thus contain more folds than their brittle counterparts, an observation often ignored in extension estimates. Fundamental to determining whether sub- and supra-salt structures are kinematically coherent, and the relative contributions of thin- (i.e. gravity-driven) and thick-skinned (i.e. whole-plate stretching) deformation to accommodating rift-related strain, is our ability to measure extension at both structural levels. We here use published physical models of salt-influenced extension to show that line-length estimates yield more accurate values of sub- and supra-salt extension compared to fault-heave, before applying these methods to seismic data from the Halten Terrace, offshore Norway. We show that, given the abundance of ductile deformation in salt-influenced rifts, significant amounts of extension may be ignored, leading to the erroneous interpretations of thin-skinned, gravity-gliding. If a system is kinematically coherent, supra-salt structures can help predict the occurrence and kinematics of sub-salt faults that may be poorly imaged and otherwise poorly constrained.

Evaluation of SRB phenolic TPS material made by an alternate vendor

NASA Technical Reports Server (NTRS)

Karu, Z. S.

1982-01-01

Tests conducted to evaluate the adequacy of solid rocket booster (SRB) phenolic thermal protection system (TPS) material supplied by an alternate vendor chosen by United Space Boosters, Inc. (USBI), to replace the current phenolic TPS sections used thus far on the first four Shuttle flights. The phenolic TPS is applied mainly to the attach and kick rings of the solid rocket booster (SRB). Full-scale sectional models of both the attach and kick ring structure were made up with 0.0265 in. thick stainless steel thin skin covers with thermocouples on them to determine the heating rates. Such models were made up for both the forward and rear faces of the kick ring which has a different configuration on each side. The thin skins were replaced with the alternate phenolic TPS sections cut from flight hardware configuration phenolic parts as supplied by the new vendor. Two tests were performed for each configuration of the attach and kick rings and the samples were exposed to the flow for a duration that gave a heat load equivalent to that obtained in the series of runs made for the current line of phenolic TPS. The samples performed very well with no loss of any phenolic layers. The post-test samples looked better than those used to verify the current phenolic TPS.

Flexible patch composed of PZT thin-film on stainless steel foil for energy harvesting from low-frequency human motions

NASA Astrophysics Data System (ADS)

Wang, Yin Jie; Chen, Chao Ting; Chen, Jiun Jung; Yeh, Sou Peng; Wu, Wen Jong

2015-03-01

To harvest energy from human motion and generate power for the emerging wearable devices, energy harvesters are required to work at very low frequency. There are several studies based on energy harvesting through human gait, which can generate significant power. However, when wearing these kind of devices, additional effort may be required and the user may feel uncomfortable when moving. The energy harvester developed here is composed of a 10 μm PZT thin-film deposited on 50 μm thick stainless steel foil by the aerosol deposition method. The PZT layer and the stainless steel foil are both very thin, thus the patch is highly flexible. The patch can be attached on the skin to harvester power through human motions such as the expansion of the chest region while breathing. The energy harvester will first be tested with a moving stage for power output measurements. The energy density can be determined for different deformation ranges and frequencies. The fabrication processes and testing results will all be detailed in this paper.

Spreading Resistance on Thin Film Contacts

NASA Astrophysics Data System (ADS)

Zhang, Peng; Lau, Y. Y.; Hung, D.; Gilgenbach, R. M.

2012-10-01

Electrical contact [1] is important to wire-array z-pinches, metal-insulator-vacuum junctions, and high power microwave sources, etc. Contact problems account for 40 percent of all electrical failures, from small scale consumer electronics to large scale defense and aerospace systems. The crowding of the current lines at contacts leads to enhanced localized heating, a measure of which is the spreading resistance (Rs). For a microscopic area of contact (the ``a-spot'' [1]) on a thin film, we calculate Rs in both Cartesian and cylindrical geometries [2]. In the limit of small film thickness, h, the normalized thin film spreading resistance converges to the finite values, 2.77 for the Cartesian case and 0.28 for the cylindrical case. These same finite limits are found to be applicable to the a-spot between bulk solids in the high frequency limit if the skin depth is identified with h. Extension to a general a-spot geometry is proposed [2]. [4pt] [1] R. Holm, Electric Contacts, 4th ed., Springer (1967). [0pt] [2] P. Zhang et al., IEEE Trans. Electron Devices 59, 1936 (2012).

Thickness-modulated anisotropic ferromagnetism in Fe-doped epitaxial HfO2 thin films

NASA Astrophysics Data System (ADS)

Liu, Wenlong; Liu, Ming; Zhang, Ruyi; Ma, Rong; Wang, Hong

2017-10-01

Epitaxial tetragonal Fe-doped Hf0.95Fe0.05O2 (FHO) thin films with various thicknesses were deposited on (001)-oriented NdCaAlO4 (NCAO) substrates by using a pulsed laser deposition (PLD) system. The crystal structure and epitaxial nature of the FHO thin films were confirmed by typical x-ray diffraction (XRD) θ-2θ scan and reciprocal space mapping (RSM). The results indicate that two sets of lattice sites exist with two different crystal orientations [(001) and (100)] in the thicker FHO thin films. Further, the intensity of the (100) direction increases with the increase in thicknesses, which should have a significant effect on the anisotropic magnetization of the FHO thin films. Meanwhile, all the FHO thin films possess a tetragonal phase structure. An anisotropy behavior in magnetization has been observed in the FHO thin films. The anisotropic magnetization of the FHO thin films is slowly weakened as the thickness increases. Meanwhile, the saturation magnetization (Ms) of both in-plane and out-of-plane decreases with the increase in the thickness. The change in the anisotropic magnetization and Ms is attributed to the crystal lattice and the variation in the valence of Fe ions. These results indicate that the thickness-modulated anisotropic ferromagnetism of the tetragonal FHO epitaxial thin films is of potential use for the integration of metal-oxide semiconductors with spintronics.

Use of high-frequency ultrasonography for evaluation of skin thickness in relation to hydration status and fluid distribution at various cutaneous sites in dogs.

PubMed

Diana, Alessia; Guglielmini, Carlo; Fracassi, Federico; Pietra, Marco; Balletti, Erika; Cipone, Mario

2008-09-01

To assess the usefulness of high-frequency diagnostic ultrasonography for evaluation of changes of skin thickness in relation to hydration status and fluid distribution at various cutaneous sites in dogs. 10 clinically normal adult dogs (6 males and 4 females) of various breeds. Ultrasonographic examination of the skin was performed before and after hydration via IV administration of an isotonic crystalloid solution (30 mL/kg/h for 30 minutes). A 13-MHz linear-array transducer was used to obtain series of ultrasonographic images at 4 different cutaneous sites (the frontal, sacral, flank, and metatarsal regions). Weight and various clinicopathologic variables (PCV; serum osmolality; and serum total protein, albumin, and sodium concentrations) were determined before and after the infusion. These variables and ultrasonographic measurements of skin thickness before and after hydration were compared. Among the 10 dogs, mean preinfusion skin thickness ranged from 2,211 microm (metatarsal region) to 3,249 microm (sacral region). Compared with preinfusion values, weight was significantly increased, whereas PCV; serum osmolality; and serum total protein, albumin, and sodium concentrations were significantly decreased after infusion. After infusion, dermal echogenicity decreased and skin thickness increased significantly by 21%, 14%, 15%, and 13% in the frontal, sacral, flank, and metatarsal regions, respectively. Cutaneous site and hydration were correlated with cutaneous characteristics and skin thickness determined by use of high-frequency ultrasonography in dogs. Thus, diagnostic ultrasonography may be a useful tool for the noninvasive evaluation of skin hydration in healthy dogs and in dogs with skin edema.

Morpho-functional assessment of interatrial septum: a transesophageal echocardiographic study.

PubMed

Galzerano, D; Tuccillo, B; Lama, D; Paolisso, G; Mirra, G; Giasi, M

1995-08-01

Despite the increasing number of reports on lipomatous hypertrophy of interatrial septum, a standardization of measurement of the dimensions of the interatrial septum (IAS) in the different phases of cardiac cycle has not been reported. Moreover, no data on modification of thickness with age and in specific cardiac diseases are available. Our purpose was to study whether the changes of thickness and thinning of IAS may be related to age, left atrial dimension, cardiac cycle and different cardiac diseases. 248 patients (mean age 52.7 +/- 19.9 years) underwent transthoracic (TTE) and transesophageal (TEE) echocardiography. IAS was measured at the constant regions anterior and posterior to the fossa ovalis. IAS thickness (tk), thinning (th) and % thinning (% th) were measured. IAS thickness ranged from 4 to 13 mm at the time of ventricular end-systolic phase (mean 6.7 +/- 1.9 mm) and from 6 to 16 mm at the time of atrial systole (mean 9.9 +/- 1.8 mm); significant statistical difference between these values was found (P < 0.01). IAS thinning ranged from 1 to 7 mm (mean 3.42 +/- 1.8) while % IAS thinning from 18 to 76% (mean 36.53 +/- 16.36%). Statistical analysis showed a significant positive correlation between age and ventricular end-systolic thickness and atrial systolic thickness and thinning. An insignificant correlation was found between age and % IAS thinning and between left atrial dimension and IAS tk and th. Our results demonstrate that IAS thickness increases by age; no correlation exists between IAS thinning and age. There is no difference between IAS thickness and thinning in patients with or without cardiac disease. We believe that the thickness of IAS can be considered hypertrophic only if it exceeds the value of 15 mm during both ventricular end-systolic and atrial systolic phases of the cardiac cycle. IAS thickness and thinning might be an additional parameter to evaluate systolic atrial function particularly with regard to maintenance of synus rhythm after conversion from atrial fibrillation as well as to better understand its role in determining the filling of ventricles in different clinical conditions.

Effects of high temperature and film thicknesses on the texture evolution in Ag thin films

NASA Astrophysics Data System (ADS)

Eshaghi, F.; Zolanvari, A.

2017-04-01

In situ high-temperature X-ray diffraction techniques were used to study the effect of high temperatures (up to 600°C) on the texture evolution in silver thin films. Ag thin films with different thicknesses of 40, 80, 120 and 160nm were sputtered on the Si(100) substrates at room temperature. Then, microstructure of thin films was determined using X-ray diffraction. To investigate the influence of temperature on the texture development in the Ag thin films with different thicknesses, (111), (200) and (220) pole figures were evaluated and orientation distribution functions were calculated. Minimizing the total energy of the system which is affected by competition between surface and elastic strain energy was a key factor in the as-deposited and post annealed thin films. Since sputtering depositions was performed at room temperature and at the same thermodynamic conditions, the competition growth caused the formation of the {122} < uvw \\rangle weak fiber texture in as-deposited Ag thin films. It was significantly observed that the post annealed Ag thin films showed {111} < uvw \\rangle orientations as their preferred orientations, but their preferred fiber texture varied with the thickness of thin films. Increasing thin film thickness from 40nm to 160nm led to decreasing the intensity of the {111} < uvw \\rangle fiber texture.

Relevance of sunscreen application method, visible light and sunlight intensity to free-radical protection: A study of ex vivo human skin.

PubMed

Haywood, Rachel

2006-01-01

With the continued rise in skin cancers worldwide there is a need for effective skin protection against sunlight damage. It was shown previously that sunscreens, which claimed UVA protection (SPF 20+), provided limited protection against UV-induced ascorbate radicals in human skin. Here the results of an electron spin resonance (ESR) investigation to irradiate ex vivo human skin with solar-simulated light are reported. The ascorbate radical signal in the majority of skin samples was directly proportional to the irradiance over relevant sunlight intensities (0.9-2.9 mW cm(-2)). Radical production (substratum-corneum) by UV (wavelengths < 400 nm) and visible components (> 400 nm) was approximately 67% and 33% respectively. Ascorbate radicals were in steady state concentration at low irradiance (approximately 1 mW cm(-2) equivalent to UK sunlight), but at higher irradiance (approximately 3 mW cm(-2)) decreased with time, suggesting ascorbate depletion. Radical protection by a four star-rated sunscreen (with UVA protection) was optimal when applied as a thin film (40-60% at 2 mg cm(-2)) but less so when rubbed into the skin (37% at 4 mg cm(-2) and no significant protection at 2 mg cm(-2)), possibly due to cream filling crevices, which reduced film thickness. This study validates ESR determinations of the ascorbate radical for quantitative protection measurements. Visible light contribution to radical production, and loss of protection when sunscreen is rubbed into skin, has implications for sunscreen design and use for the prevention of free-radical damage.

Al decorated ZnO thin-film photoanode for SPR-enhanced photoelectrochemical water splitting

NASA Astrophysics Data System (ADS)

Li, Hongxia; Li, Xin; Dong, Wei; Xi, Junhua; Wu, Xin

2018-06-01

Photoelectrochemical (PEC) water splitting has been considered to be a promising approach to ease the energy and environmental crisis. Herein, Al decorated ZnO thin films are successfully achieved through a facile dc magnetron-sputtering method followed with Al evaporation for further enhanced PEC performance. The Al/ZnO thin film with 60 s Al evaporating time exhibits the highest photocurrent density under AM1.5G and visible light irradiation, which are more than 5 and 3 times as the pure ZnO film, respectively. Such surface modification by Al not only enlarges the visible light absorption based on surface plasmonic resonance effect, but facilitates the charge separation and transportation at the electrode/electrolyte interface. Finally, a possible mechanism is proposed for the photocatalytic activity enhancement of Al/ZnO thin film photoanode.

Surface vibrational modes in disk-shaped resonators.

PubMed

Dmitriev, A V; Gritsenko, D S; Mitrofanov, V P

2014-03-01

The natural frequencies and distributions of displacement components for the surface vibrational modes in thin isotropic elastic disks are calculated. In particular, the research is focused on even solutions for low-lying resonant vibrations with large angular wave numbers. Several families of modes are found which are interpreted as modified surface modes of an infinitely long cylinder and Lamb modes of a plate. The results of calculation are compared with the results of the experimental measurements of vibrational modes generated by means of resonant excitation in duraluminum disk with radius of ≈90 mm and thickness of 16 mm in the frequency range of 130-200 kHz. An excellent agreement between the calculated and measured frequencies is found. Measurements of the structure of the resonant peaks show splitting of some modes. About a half of the measured modes has splitting Δfsplit/fmode at the level of the order of 10(-5). The Q-factors of all modes measured in vacuum lie in the interval (2…3)×10(5). This value is typical for duraluminum mechanical resonators in the ultrasonic frequency range. Copyright © 2013 Elsevier B.V. All rights reserved.

C@SiNW/TiO2 Core-Shell Nanoarrays with Sandwiched Carbon Passivation Layer as High Efficiency Photoelectrode for Water Splitting

PubMed Central

Devarapalli, Rami Reddy; Debgupta, Joyashish; Pillai, Vijayamohanan K.; Shelke, Manjusha V.

2014-01-01

One-dimensional heterostructure nanoarrays are efficiently promising as high performance electrodes for photo electrochemical (PEC) water splitting applications, wherein it is highly desirable for the electrode to have a broad light absorption, efficient charge separation and redox properties as well as defect free surface with high area suitable for fast interfacial charge transfer. We present highly active and unique photoelectrode for solar H2 production, consisting of silicon nanowires (SiNWs)/TiO2 core-shell structures. SiNWs are passivated to reduce defect sites and protected against oxidation in air or water by forming very thin carbon layer sandwiched between SiNW and TiO2 surfaces. This carbon layer decreases recombination rates and also enhances the interfacial charge transfer between the silicon and TiO2. A systematic investigation of the role of SiNW length and TiO2 thickness on photocurrent reveals enhanced photocurrent density up to 5.97 mA/cm2 at 1.0 V vs.NHE by using C@SiNW/TiO2 nanoarrays with photo electrochemical efficiency of 1.17%. PMID:24810865

BiVO{sub 4} photoanodes for water splitting with high injection efficiency, deposited by reactive magnetron co-sputtering

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gong, Haibo; Institute for Solar Fuels, Helmholtz-Zentrum Berlin für Materialien und Energie GmbH, Hahn-Meitner-Platz 1, 14109 Berlin; Freudenberg, Norman

2016-04-15

Photoactive bismuth vanadate (BiVO{sub 4}) thin films were deposited by reactive co-magnetron sputtering from metallic Bi and V targets. The effects of the V-to-Bi ratio, molybdenum doping and post-annealing on the crystallographic and photoelectrochemical (PEC) properties of the BiVO{sub 4} films were investigated. Phase-pure monoclinic BiVO{sub 4} films, which are more photoactive than the tetragonal BiVO{sub 4} phase, were obtained under slightly vanadium-rich conditions. After annealing of the Mo-doped BiVO{sub 4} films, the photocurrent increased 2.6 times compared to undoped films. After optimization of the BiVO{sub 4} film thickness, the photocurrent densities (without a catalyst or a blocking layer ormore » a hole scavenger) exceeded 1.2 mA/cm{sup 2} at a potential of 1.23 V{sub RHE} under solar AM1.5 irradiation. The surprisingly high injection efficiency of holes into the electrolyte is attributed to the highly porous film morphology. This co-magnetron sputtering preparation route for photoactive BiVO{sub 4} films opens new possibilities for the fabrication of large-scale devices for water splitting.« less

Study of low-defect and strain-relaxed GeSn growth via reduced pressure CVD in H2 and N2 carrier gas

NASA Astrophysics Data System (ADS)

Margetis, J.; Mosleh, A.; Al-Kabi, S.; Ghetmiri, S. A.; Du, W.; Dou, W.; Benamara, M.; Li, B.; Mortazavi, M.; Naseem, H. A.; Yu, S.-Q.; Tolle, J.

2017-04-01

High quality, thick (up to 1.1 μm), strain relaxed GeSn alloys were grown on Ge-buffered Si (1 0 0) in an ASM Epsilon® chemical vapor deposition system using SnCl4 and low-cost commercial GeH4 precursors. The significance of surface chemistry in regards to growth rate and Sn-incorporation is discussed by comparing growth kinetics data in H2 and N2 carrier gas. The role of carrier gas is also explored in the suppression of Sn surface segregation and evolution of layer composition and strain profiles via secondary ion mass spectrometry and X-ray diffraction. Transmission electron microscopy revealed the spontaneous compositional splitting and formation of a thin intermediate layer in which dislocations are pinned. This intermediate layer enables the growth of a thick, strain relaxed, and defect-free epitaxial layer on its top. Last, we present photoluminescence results which indicate that both N2 and H2 growth methods produce optoelectronic device quality material.

Design and stray light analysis of ultra-thin geometrical waveguide

NASA Astrophysics Data System (ADS)

Wang, Qiwei; Cheng, Dewen; Hou, Qichao; Hu, Yuan; Wang, Yongtian

2015-08-01

Nowadays, the waveguide has the advantages of small thickness and light weight so that it attracts more and more attention in the field of near-eye display. However, as a major problem, stray lights generated in the waveguide seriously degrade the display quality. In this paper, a geometrical waveguide with a beam-splitting mirror array (BSMA) is designed by using the non-sequential ray-tracing software LightTools, and great efforts are paid to study the causes and solutions of the stray light. With mass calculation and optimization based on the criterion of stray light/useful light ratio, an optimum design with the least amount of stray lights is found. To further eliminate the stray light, a novel structure that couples the rays into the waveguide is designed. The optimized waveguide has a FOV of 36° in the pupil-expanding direction of the waveguide, with stray light energy reduced to 1% over the useful light, the exit pupil diameter is 11.6mm at an eye relief of 20mm and the thickness is 2.4mm.

Comparison of thin-film resistance heat-transfer gages with thin-skin transient calorimeter gages in conventional hypersonic wind tunnels

NASA Technical Reports Server (NTRS)

Miller, C. G., III

1981-01-01

Thin film gages deposited at the stagnation region of small (8.1-mm-diameter) hemispheres and gages mounted flush with the surface of a sharp-leading-edge flat plate were tested in the Langley continuous-flow hypersonic tunnel and in the Langley hypersonic CF4 tunnel. Two substrate materials were tested, quartz and a machinable glass-ceramic. Small hemispheres were also tested utilizing the thin-skin transient calorimeter technique usually employed in conventional tunnels. One transient calorimeter model was a thin shell of stainless steel, and the other was a thin-skin insert of stainless steel mounted into a hemisphere fabricated from a machinable-glass-ceramic. Measured heat-transfer rates from the various hemispheres were compared with one another and with predicted rates. The results demonstrate the feasibility and advantages of using-film resistance heat-transfer gages in conventional hypersonic wind tunnels over a wide range of conditions.

Crustal and uppermost mantle structure and deformation in east-central China

NASA Astrophysics Data System (ADS)

Li, H.; Yang, X.; Ouyang, L.; Li, J.

2017-12-01

We conduct a non-linear joint inversion of receiver functions and Rayleigh wave dispersions to obtain the crustal and upper mantle velocity structure in east-central China. In the meanwhile, the lithosphere and upper mantle deformation beneath east-central China is also evaluated with teleseismic shear wave splitting measurements. The resulting velocity model reveals that to the east of the North-South Gravity Lineament, the crust and the lithosphere are significantly thinned. Furthermore, three extensive crustal/lithospheric thinning sub-regions are clearly identified within the study area. This indicates that the modification of the crust and lithosphere in central-eastern China is non-uniform due to the heterogeneity of the lithospheric strength. Extensive crustal and lithospheric thinning could occur in some weak zones such as the basin-range junction belts and large faults. The structure beneath the Dabie orogenic belt is complex due to the collision between the North and South China Blocks during the Late Paleozoic-Triassic. The Dabie orogenic belt is generally delineated by a thick crust with a mid-crust low-velocity zone and a two-directional convergence in the lithospheric scale. Obvious velocity contrast exhibits in the crust and upper mantle at both sides of the Tanlu fault, which suggests the deep penetration of this lithospheric-scale fault. Most of our splitting measurements show nearly E-W trending fast polarization direction which is slightly deviating from the direction of plate motion. The similar present-day lithosphere structure and upper mantle deformation may imply that the eastern NCC and the eastern SCB were dominated by a common dynamic process after late Mesozoic, i.e., the westward subduction of Pacific plate and the retreat of the subduction plate. The westward subduction of the Philippine plate and the long-range effects of the collision between the Indian plate and Eurasia plate during Cenozoic may have also contributed to the present velocity structure and stress environment of eastern China.

Skin color and tissue thickness effects on transmittance, reflectance, and skin temperature when using 635 and 808 nm lasers in low intensity therapeutics.

PubMed

Souza-Barros, Leanna; Dhaidan, Ghaith; Maunula, Mikko; Solomon, Vaeda; Gabison, Sharon; Lilge, Lothar; Nussbaum, Ethne L

2018-04-01

To examine the role of skin color and tissue thickness on transmittance, reflectance, and skin heating using red and infrared laser light. Forty volunteers were measured for skin color and skin-fold thickness at a standardized site near the elbow. Transmittance, reflectance and skin temperature were recorded for energy doses of 2, 6, 9, and 12 Joules using 635 nm (36 mW) and 808 nm (40 mW) wavelength laser diodes with irradiances within American National Standards Institute safety guidelines (4.88 mm diameter, 0.192 W/cm 2 and 4.88 mm diameter, 0.214 W/cm 2 , respectively). The key factors affecting reflectance to an important degree were skin color and wavelength. However, the skin color effects were different for the two wavelengths: reflectance decreased for darker skin with a greater decrease for red light than near infrared light. Transmittance was greater using 808 nm compared with 635 nm. However, the effect was partly lost when the skin was dark rather than light, and was increasingly lost as tissue thickness increased. Dose had an increasing effect on temperature (0.7-1.6°C across the 6, 9, and 12 J doses); any effects of wavelength, skin color, and tissue thickness were insignificant compared to dose effects. Subjects themselves were not aware of the increased skin temperature. Transmittance and reflectance changes as a function of energy were very small and likely of no clinical significance. Absorption did not change with higher energy doses and increasing temperature. Skin color and skin thickness affect transmittance and reflectance of laser light and must be accounted for when selecting energy dose to ensure therapeutic effectiveness at the target tissue. Skin heating appears not to be a concern when using 635 and 808 nm lasers at energy doses of up to 12 J and irradiance within American National Standards Institute standards. Photobiomodulation therapy should never exceed the American National Standards Institute recommendation for the maximum permissible exposure to the skin. Lasers Surg. Med. 50:291-301, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Improved Stability and Performance of Visible Photoelectrochemical Water Splitting on Solution-Processed Organic Semiconductor Thin Films by Ultrathin Metal Oxide Passivation

DOE PAGES

Wang, Lei; Yan, Danhua; Shaffer, David W.; ...

2017-12-27

Solution-processable organic semiconductors have potentials as visible photoelectrochemical (PEC) water splitting photoelectrodes due to their tunable small band gap and electronic energy levels, but they are typically limited by poor stability and photocatalytic activity. In this study, we demonstrate the direct visible PEC water oxidation on solution-processed organic semiconductor thin films with improved stability and performance by ultrathin metal oxide passivation layers. N-type fullerene-derivative thin films passivated by sub-2 nm ZnO via atomic layer deposition enabled the visible PEC water oxidation at wavelengths longer than 600 nm in harsh alkaline electrolyte environments with up to 30 μA/cm 2 photocurrents atmore » the thermodynamic water-oxidation equilibrium potential and the photoanode half-lifetime extended to ~1000 s. The systematic investigation reveals the enhanced water oxidation catalytic activity afforded by ZnO passivation and the charge tunneling governing the hole transfer through passivation layers. Further enhanced PEC performances were realized by improving the bottom ohmic contact to the organic semiconductor, achieving ~60 μA/cm 2 water oxidation photocurrent at the equilibrium potential, the highest values reported for organic semiconductor thin films to our knowledge. The improved stability and performance of passivated organic photoelectrodes and discovered design rationales provide useful guidelines for realizing the stable visible solar PEC water splitting based on organic semiconductor thin films.« less

Improved Stability and Performance of Visible Photoelectrochemical Water Splitting on Solution-Processed Organic Semiconductor Thin Films by Ultrathin Metal Oxide Passivation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Lei; Yan, Danhua; Shaffer, David W.

Solution-processable organic semiconductors have potentials as visible photoelectrochemical (PEC) water splitting photoelectrodes due to their tunable small band gap and electronic energy levels, but they are typically limited by poor stability and photocatalytic activity. In this study, we demonstrate the direct visible PEC water oxidation on solution-processed organic semiconductor thin films with improved stability and performance by ultrathin metal oxide passivation layers. N-type fullerene-derivative thin films passivated by sub-2 nm ZnO via atomic layer deposition enabled the visible PEC water oxidation at wavelengths longer than 600 nm in harsh alkaline electrolyte environments with up to 30 μA/cm 2 photocurrents atmore » the thermodynamic water-oxidation equilibrium potential and the photoanode half-lifetime extended to ~1000 s. The systematic investigation reveals the enhanced water oxidation catalytic activity afforded by ZnO passivation and the charge tunneling governing the hole transfer through passivation layers. Further enhanced PEC performances were realized by improving the bottom ohmic contact to the organic semiconductor, achieving ~60 μA/cm 2 water oxidation photocurrent at the equilibrium potential, the highest values reported for organic semiconductor thin films to our knowledge. The improved stability and performance of passivated organic photoelectrodes and discovered design rationales provide useful guidelines for realizing the stable visible solar PEC water splitting based on organic semiconductor thin films.« less

Ultra-thin, light-trapping silicon solar cells

NASA Technical Reports Server (NTRS)

Landis, Geoffrey A.

1989-01-01

Design concepts for ultra-thin (2 to 10 microns) high efficiency single-crystal silicon cells are discussed. Light trapping allows more light to be absorbed at a given thickness, or allows thinner cells of a given Jsc. Extremely thin cells require low surface recombination velocity at both surfaces, including the ohmic contacts. Reduction of surface recombination by growth of heterojunctions of ZnS and GaP on Si has been demonstrated. The effects of these improvements on AM0 efficiency is shown. The peak efficiency increases, and the optimum thickness decreases. Cells under 10 microns thickness can retain almost optimum power. The increase of absorptance due to light trapping is considered. This is not a problem if the light-trapping cells are sufficiently thin. Ultra-thin cells have high radiation tolerance. A 2 microns thick light-trapping cell remains over 18 percent efficient after the equivalent of 20 years in geosynchronous orbit. Including a 50 microns thick coverglass, the thin cells had specific power after irradiation over ten times higher than the baseline design.

Differential effects of Losartan and Atorvastatin in partial and full thickness burn wounds

PubMed Central

Akershoek, Johanneke J.; Brouwer, Katrien M.; Vlig, Marcel; Boekema, Bouke K. H. L.; Beelen, Rob H. J.; Middelkoop, Esther

2017-01-01

Healing of burn wounds is often associated with scar formation due to excessive inflammation and delayed wound closure. To date, no effective treatment is available to prevent the fibrotic process. The Renin Angiotensin System (RAS) was shown to be involved in fibrosis in various organs. Statins (e.g. Atorvastatin), Angiotensin receptor antagonists (e.g. Losartan) and the combination of these drugs are able to reduce the local RAS activation, and reduced fibrosis in other organs. We investigated whether inhibition of the RAS could improve healing of burn wounds by treatment with Atorvastatin, Losartan or the combination of both drugs. Therefore, full and partial thickness burn wounds were inflicted on both flanks of Yorkshire pigs. Oral administration of Atorvastatin, Losartan or the combination was started at post-burn day 1 and continued for 28 days. Full thickness wounds were excised and transplanted with an autologous meshed split-thickness skin graft at post-burn day 14. Partial thickness wounds received conservative treatment. Atorvastatin treatment resulted in enhanced graft take and wound closure of the full thickness wounds, faster resolution of neutrophils compared to all treatments and reduced alpha-smooth muscle actin positive cells compared to control treatment. Treatment with Losartan and to a lesser extent the combination therapy resulted in diminished graft take, increased wound contraction and poorer scar outcome. In contrast, Losartan treatment in partial thickness wounds decreased the alpha-smooth muscle actin+ fibroblasts and contraction. In conclusion, we showed differential effects of Losartan and Atorvastatin in full and partial thickness wounds. The extensive graft loss seen in Losartan treated wounds is most likely responsible for the poor clinical outcome of these full thickness burn wounds. Therefore, Losartan treatment should not be started before transplantation in order to prevent graft loss. Atorvastatin seems to accelerate the healing process in full thickness wounds possibly by dampening the pro-inflammatory response. PMID:28614412

Differential effects of Losartan and Atorvastatin in partial and full thickness burn wounds.

PubMed

Akershoek, Johanneke J; Brouwer, Katrien M; Vlig, Marcel; Boekema, Bouke K H L; Beelen, Rob H J; Middelkoop, Esther; Ulrich, Magda M W

2017-01-01

Healing of burn wounds is often associated with scar formation due to excessive inflammation and delayed wound closure. To date, no effective treatment is available to prevent the fibrotic process. The Renin Angiotensin System (RAS) was shown to be involved in fibrosis in various organs. Statins (e.g. Atorvastatin), Angiotensin receptor antagonists (e.g. Losartan) and the combination of these drugs are able to reduce the local RAS activation, and reduced fibrosis in other organs. We investigated whether inhibition of the RAS could improve healing of burn wounds by treatment with Atorvastatin, Losartan or the combination of both drugs. Therefore, full and partial thickness burn wounds were inflicted on both flanks of Yorkshire pigs. Oral administration of Atorvastatin, Losartan or the combination was started at post-burn day 1 and continued for 28 days. Full thickness wounds were excised and transplanted with an autologous meshed split-thickness skin graft at post-burn day 14. Partial thickness wounds received conservative treatment. Atorvastatin treatment resulted in enhanced graft take and wound closure of the full thickness wounds, faster resolution of neutrophils compared to all treatments and reduced alpha-smooth muscle actin positive cells compared to control treatment. Treatment with Losartan and to a lesser extent the combination therapy resulted in diminished graft take, increased wound contraction and poorer scar outcome. In contrast, Losartan treatment in partial thickness wounds decreased the alpha-smooth muscle actin+ fibroblasts and contraction. In conclusion, we showed differential effects of Losartan and Atorvastatin in full and partial thickness wounds. The extensive graft loss seen in Losartan treated wounds is most likely responsible for the poor clinical outcome of these full thickness burn wounds. Therefore, Losartan treatment should not be started before transplantation in order to prevent graft loss. Atorvastatin seems to accelerate the healing process in full thickness wounds possibly by dampening the pro-inflammatory response.

Are we seeing the effects of public awareness campaigns? A 10-year analysis of Breslow thickness at presentation of malignant melanoma in the South West of England.

PubMed

Armstrong, A; Powell, C; Powell, R; Hallam, N; Taylor, J; Bird, J; Sarran, C; Oliver, D

2014-03-01

The last 20 years has seen a marked improvement in skin cancer awareness campaigns. We sought to establish whether this has affected the presenting Breslow thickness of malignant melanoma in the South West. This is a retrospective study looking at the first presentation of melanomas from 2003 to 2011. Data was accessed using the local online melanoma database. A total of 2001 new melanomas presented from 2003 to 2012 (Male:Female = 1:1.062). The average yearly number of melanomas was 200.1 (range = 138-312). The mean age was 62.5 years (range 12-99). Data was analysed using a Chi² test. For 0-1 mm melanomas, there is a significant difference in the observed versus expected values over the 10 years (p = 0.0018). There is an increasing proportion of 0-1 mm (thin) melanomas presenting year on year, with a positive linear trend. This is very statistically significant (p < 0.0001). The 1-2 mm melanomas are decreasing in proportion with a negative linear trend (p = 0.0013). The 2-4 mm are also decreasing in proportion (p = 0.0253). There is no significant change in the thick >4 mm melanomas (p = 0.1456). The proportion of thin 0-1 mm melanomas presenting in South West England has significantly increased from 2003 to 2012. There is no significant change in the thick >4 mm melanomas. This may be a result of increased public awareness due to effective public health campaigns which has significant prognostic and financial implications. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Penile Inversion Vaginoplasty with or without Additional Full-Thickness Skin Graft: To Graft or Not to Graft?

PubMed

Buncamper, Marlon E; van der Sluis, Wouter B; de Vries, Max; Witte, Birgit I; Bouman, Mark-Bram; Mullender, Margriet G

2017-03-01

Penile inversion vaginoplasty is considered to be the gold standard for gender reassignment surgery in transgender women. The use of additional full-thickness skin graft as neovaginal lining is controversial. Some believe that having extra penile skin for the vulva gives better aesthetic results. Others believe that it gives inferior functional results because of insensitivity and skin graft contraction. Transgender women undergoing penile inversion vaginoplasty were studied prospectively. The option to add full-thickness skin graft is offered in patients where the penile skin length lies between 7 and 12 cm. Neovaginal depth was measured at surgery and during follow-up (3, 13, 26, and 52 weeks postoperatively). Satisfaction with the aesthetic result, neovaginal depth, and dilation regimen during follow-up were recorded. Satisfaction, sexual function, and genital self-image were assessed using questionnaires. A total of 100 patients were included (32 with and 68 without additional full-thickness skin graft). Patient-reported aesthetic outcome, overall satisfaction with the neovagina, sexual function, and genital self-image were not significantly associated with surgical technique. The mean intraoperative neovaginal depth was 13.8 ± 1.4 cm. After 1 year, this was 11.5 ± 2.5 cm. The largest decline (-15 percent) in depth is observed in the first 3 postoperative weeks (p < 0.01). The authors can confirm neither of the suggested arguments, for or against full-thickness skin graft use, in penile inversion vaginoplasty. The additional use of full-thickness skin graft does not influence neovaginal shrinkage, nor does it affect the patient- and physician-reported aesthetic or functional outcome. Therapeutic, IV.

Histologic change of arteriovenous malformations of the face and scalp after free flap transfer.

PubMed

Tark, K C; Chung, S

2000-07-01

In three patients with long-standing vascular malformations of the face and scalp, radial forearm free flaps were transferred after a near-total excision of the lesion. All patients had typical high-flow malformations with thrill and bruit. The onset and progression of the malformations were analyzed through clinical and histologic studies. After free flap transfer, the vascular malformations were followed up grossly and histologically for between 4 and 9 years. There was no recurrence of arteriovenous malformation after free flap transfer. The portion of the residual lesion adjacent to the transferred free flap disappeared, and the remaining discoloration also vanished grossly. Histologic comparison of immediate postoperative and 4-month postoperative specimens from the margin and residual lesion using Victoria blue staining showed that the typical preoperative findings for arteriovenous malformation-an intermingling of thick-walled vessels with abundant elastic fibers and thin-walled vessels without elastic fibers-had undergone change, resulting in the disappearance of the thick-walled vessels and leaving only homogeneous, thin-walled vasculature. The highly vascularized free flap, which does not contain abnormal fistulas, impacted the histologic change of the arteriovenous malformation by blocking the vicious cycle of ischemia and anatomic replacement of disfigured skin and subcutaneous tissues.

Excimer laser debridement of necrotic erosions of skin without collateral damage

NASA Astrophysics Data System (ADS)

Wynne, James J.; Felsenstein, Jerome M.; Trzcinski, Robert; Zupanski-Nielsen, Donna; Connors, Daniel P.

2011-07-01

Pulsed ArF excimer laser radiation at 6.4 eV, at fluence exceeding the ablation threshold, will debride burn eschar and other dry necrotic erosions of the skin. Debridement will cease when sufficiently moist viable tissue is exposed, due to absorption by aqueous chloride ions (Cl-) through the non-thermal process of electron photodetachment, thereby inhibiting collateral damage to the viable tissue. ArF excimer laser radiation debrides/ablates ~1 micron of tissue with each pulse. While this provides great precision in controlling the depth of debridement, the process is relatively time-consuming. In contrast, XeCl excimer laser radiation debrides ~8 microns of tissue with each pulse. However the 4.0 eV photon energy of the XeCl excimer laser is insufficient to photodetach an electron from a Cl- ion, so blood or saline will not inhibit debridement. Consequently, a practical laser debridement system should incorporate both lasers, used in sequence. First, the XeCl excimer laser would be used for accelerated debridement. When the necrotic tissue is thinned to a predetermined thickness, the ArF excimer laser would be used for very precise and well-controlled debridement, removing ultra-thin layers of material with each pulse. Clearly, the use of the ArF laser is very desirable when debriding very close to the interface between necrotic tissue and viable tissue, where the overall speed of debridement need not be so rapid and collateral damage to viable tissue is undesirable. Such tissue will be sterile and ready for further treatment, such as a wound dressing and/or a skin graft.

The influence of gender and age on the thickness and echo-density of skin.

PubMed

Firooz, A; Rajabi-Estarabadi, A; Zartab, H; Pazhohi, N; Fanian, F; Janani, L

2017-02-01

The more recent use of ultrasound scanning allows a direct measurement on unmodified skin, and is considered to be a reliable method for in vivo measurement of epidermal and dermal thickness. The objective of this study was to assess the influence of gender and age on the thickness and echo-density of skin measured by high frequency ultrasonography (HFUS). This study was carried out on 30 healthy volunteers (17 female, 13 male) with age range of 24-61 years old. The thickness and echo-density of dermis as well as epidermal entrance echo thickness in five anatomic sites (cheek, neck, palm, dorsal foot, and sole) were measured using two different types of B mode HFUS, 22 and 50 MHz frequencies. The epidermal entrance echo thickness and thickness of dermis in males were higher than females, which was statistically significant on neck and dorsum of foot. The echo-density of dermis was higher in females on all sites, but was only statistically significant on neck. The epidermal entrance echo thickness and thickness of dermis in young age group was statistically higher than old group on sole and dorsal of the foot respectively. Overall, the skin thickness decreased with age. High frequency ultrasonography method provides a simple non-invasive method for evaluating the skin thickness and echo-density. Gender and age have significant effect on these parameters. Differences in study method, population, and body site likely account for different results previously reported. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of inherited structures on the growth of basement-cored ranges, basin inversion and foreland basin development in the Central Andes, from apatite fission-track and apatite Helium thermochronology.

NASA Astrophysics Data System (ADS)

Zapata, S.; Sobel, E. R.; Del Papa, C.; Jelinek, A. R.; Muruaga, C.

2017-12-01

The Central Andes in NW of Argentina is part of a long-lived subduction zone, active since the Paleozoic. This region experienced several tectonic cycles; each of which created an unique set of structures and may have reactivated preexisting structures. These inherited structures may exert a first-order control over the different foreland deformational styles observed along the strike in the Central Andes. Our study area is located between 26°S and 28°S on the transition between the broken foreland (Santa Barbara system), which expresses a combination of thin-skin and thick-skin styles, and the Sierras Pampeanas, which is deform in a thick-skin style. The Cumbres Calchaquies range and the associated Choromoro Basin are located in the northern part of the study area, and are the southern expression of the Santa Barbara system. Published thermochronology data suggest that the rocks from the basement experienced Late Cretaceous and Late Miocene exhumation; the associated sedimentary rocks within the Choromoro basin experienced Paleogene and Late Miocene deformational phases. In contrast, the Sierra Aconquija range, located immediately south on the transition to the Sierras Pampeanas (thick skin) foreland basin, exhibit larger amounts of Miocene exhumation and lack of Cretaceous exhumation; the associated sedimentary rocks from the Tucuman basin have not been deformed since the Cretaceous. Our goal is to understand the evolution of the structural blocks and the structures responsible for the along strike changes in foreland basin deformational styles and their relation with inherited structures from previous tectonic cycles. We are obtaining new apatite U-Th/He and fission track data to reconstruct the thermal history of the basement, accompanied by U-Pb geochronology and stratigraphy to constrain the evolution of the associated sedimentary basins. Preliminary results combined with published data suggest that inherited structures within the study area have evolved through different tectonic cycles, controlling the thicknes and the geometry of the sediments within the Mesozoic rift basin, the Miocene amount of exhumation in the basement-cored ranges and the deformation style of the associated foreland basins.

Late Alpine to recent thick-skinned tectonics of the central Swiss Molasse Basin, Canton of Bern, Switzerland

NASA Astrophysics Data System (ADS)

Mock, Samuel; Allenbach, Robin; Wehrens, Philip; Reynolds, Lance; Kurmann-Matzenauer, Eva; Michael, Salomè; Herwegh, Marco

2017-04-01

The Swiss Molasse Basin (SMB) forms part of the North Alpine Foreland Basin. It is a typical peripheral foreland basin, which developed in Paleogene and Neogene times in response to flexural bending of the European lithosphere induced by the orogenic loading of the advancing Alpine thrust wedge. The tectonics of the SMB and the role of Paleozoic and Mesozoic structures are still poorly understood. It is widely accepted that during the main deformation phase of the Jura fold-and-thrust belt, the SMB was riding piggy-back above a major detachment horizon situated within Triassic evaporites. In recent years it has been observed that the Jura fold-and-thrust belt is today deforming in a thick-skinned tectonic style. As for the western and central SMB, most authors still argue in favor of a classical foreland type, thin-skinned style of deformation. Based on the geological 3D modeling of seismic interpretations, we present new insights into the structural configuration of the central SMB. Revised and new interpretations of 2D reflection seismic data from the 1960s to the 1980s reveal a major strike-slip fault zone affecting not only the Mesozoic and Cenozoic cover, but also the crystalline basement beneath. The fault zone reactivated late Paleozoic synsedimentary normal faults bounding a Permo-Carboniferous trough. Basement-involved thrusting observed in the southern part of the SMB seems to be controlled by the presence of slightly inverted Permo-Carboniferous troughs as well. These observations, combined with a compiled structural map and the distribution of recent earthquake hypocenters suggest a late stage, NNW-SSE directed, compressional thick-skinned and strike-slip dominated tectonic activity of the central SMB, post-dating the main deformation phase of the Jura fold-and-thrust belt. This still ongoing deformation might be related to the slab rollback of the European plate and the associated lower crustal delamination as recently suggested by Singer et al. (2014). References: Singer, J., Diehl, T., Husen, S., Kissling, E., Duretz, T., 2014. Alpine lithosphere slab rollback causing lower crustal seismicity in northern foreland. Earth Planet. Sci. Lett. 397, 42-56. doi:10.1016/j.epsl.2014.04.002

Estimating dose to implantable cardioverter-defibrillator outside the treatment fields using a skin QED diode, optically stimulated luminescent dosimeters, and LiF thermoluminescent dosimeters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chan, Maria F., E-mail: chanm@mskcc.org; Song, Yulin; Dauer, Lawrence T.

2012-10-01

The purpose of this work was to determine the relative sensitivity of skin QED diodes, optically stimulated luminescent dosimeters (OSLDs) (microStar Trade-Mark-Sign DOT, Landauer), and LiF thermoluminescent dosimeters (TLDs) as a function of distance from a photon beam field edge when applied to measure dose at out-of-field points. These detectors have been used to estimate radiation dose to patients' implantable cardioverter-defibrillators (ICDs) located outside the treatment field. The ICDs have a thin outer case made of 0.4- to 0.6-mm-thick titanium ({approx}2.4-mm tissue equivalent). A 5-mm bolus, being the equivalent depth of the devices under the patient's skin, was placed overmore » the ICDs. Response per unit absorbed dose-to-water was measured for each of the dosimeters with and without bolus on the beam central axis (CAX) and at a distance up to 20 cm from the CAX. Doses were measured with an ionization chamber at various depths for 6- and 15-MV x-rays on a Varian Clinac-iX linear accelerator. Relative sensitivity of the detectors was determined as the ratio of the sensitivity at each off-axis distance to that at the CAX. The detector sensitivity as a function of the distance from the field edge changed by {+-} 3% (1-11%) for LiF TLD-700, decreased by 10% (5-21%) for OSLD, and increased by 16% (11-19%) for the skin QED diode (Sun Nuclear Corp.) at the equivalent depth of 5 mm for 6- or 15-MV photon energies. Our results showed that the use of bolus with proper thickness (i.e., {approx}d{sub max} of the photon energy) on the top of the ICD would reduce the scattered dose to a lower level. Dosimeters should be calibrated out-of-field and preferably with bolus equal in thickness to the depth of interest. This can be readily performed in clinic.« less

Ultra thin metallic coatings to control near field radiative heat transfer

NASA Astrophysics Data System (ADS)

Esquivel-Sirvent, R.

2016-09-01

We present a theoretical calculation of the changes in the near field radiative heat transfer between two surfaces due to the presence of ultra thin metallic coatings on semiconductors. Depending on the substrates, the radiative heat transfer is modulated by the thickness of the ultra thin film. In particular we consider gold thin films with thicknesses varying from 4 to 20 nm. The ultra-thin film has an insulator-conductor transition close to a critical thickness of dc = 6.4 nm and there is an increase in the near field spectral heat transfer just before the percolation transition. Depending on the substrates (Si or SiC) and the thickness of the metallic coatings we show how the near field heat transfer can be increased or decreased as a function of the metallic coating thickness. The calculations are based on available experimental data for the optical properties of ultrathin coatings.

Evolution of structural distortion in BiFeO3 thin films probed by second-harmonic generation

NASA Astrophysics Data System (ADS)

Jin, Kuijuan; Wang, Jiesu; Gu, Junxing; L03 Group in Institute of Physics, Chinese Academy of Sciences Team

BiFeO3 thin films have drawn much attention due to its potential applications for novel magnetoelectric devices and fundamental physics in magnetoelectric coupling. However, the structural evolution of BiFeO3 films with thickness remains controversial. Here we use an optical second-harmonic generation technique to explore the phase-related symmetry evolution of BiFeO3 thin films with the variation of thickness. The crystalline structures for 60 and 180-nm-thick BiFeO3 thin films were characterized by high-resolution X-ray diffractometry reciprocal space mapping and the local piezoelectric response for 60-nm-thick BiFeO3 thin films was characterized by piezoresponse force microscopy. The present results show that the symmetry of BiFeO3 thin films with a thickness below 60 nm belongs to the point group 4mm. We conclude that the disappearance of fourfold rotational symmetry in SHG s-out pattern implies for the appearance of R-phase. The fact that the thinner the film is, the closer to 1 the tensor element ratio χ31/ χ15 tends, indicates an increase of symmetry with the decrease of thickness for BiFeO3 thin films. email: kjjin@iphy.ac.cn

Evolution of structural distortion in BiFeO3 thin films probed by second-harmonic generation.

PubMed

Wang, Jie-Su; Jin, Kui-Juan; Guo, Hai-Zhong; Gu, Jun-Xing; Wan, Qian; He, Xu; Li, Xiao-Long; Xu, Xiu-Lai; Yang, Guo-Zhen

2016-12-01

BiFeO 3 thin films have drawn much attention due to its potential applications for novel magnetoelectric devices and fundamental physics in magnetoelectric coupling. However, the structural evolution of BiFeO 3 films with thickness remains controversial. Here we use an optical second-harmonic generation technique to explore the phase-related symmetry evolution of BiFeO 3 thin films with the variation of thickness. The crystalline structures for 60 and 180-nm-thick BiFeO 3 thin films were characterized by high-resolution X-ray diffractometry reciprocal space mapping and the local piezoelectric response for 60-nm-thick BiFeO 3 thin films was characterized by piezoresponse force microscopy. The present results show that the symmetry of BiFeO 3 thin films with a thickness below 60 nm belongs to the point group 4 mm. We conclude that the disappearance of fourfold rotational symmetry in SHG s-out pattern implies for the appearance of R-phase. The fact that the thinner the film is, the closer to 1 the tensor element ratio χ 31 /χ 15 tends, indicates an increase of symmetry with the decrease of thickness for BiFeO 3 thin films.

Evolution of structural distortion in BiFeO3 thin films probed by second-harmonic generation

PubMed Central

Wang, Jie-su; Jin, Kui-juan; Guo, Hai-zhong; Gu, Jun-xing; Wan, Qian; He, Xu; Li, Xiao-long; Xu, Xiu-lai; Yang, Guo-zhen

2016-01-01

BiFeO3 thin films have drawn much attention due to its potential applications for novel magnetoelectric devices and fundamental physics in magnetoelectric coupling. However, the structural evolution of BiFeO3 films with thickness remains controversial. Here we use an optical second-harmonic generation technique to explore the phase-related symmetry evolution of BiFeO3 thin films with the variation of thickness. The crystalline structures for 60 and 180-nm-thick BiFeO3 thin films were characterized by high-resolution X-ray diffractometry reciprocal space mapping and the local piezoelectric response for 60-nm-thick BiFeO3 thin films was characterized by piezoresponse force microscopy. The present results show that the symmetry of BiFeO3 thin films with a thickness below 60 nm belongs to the point group 4 mm. We conclude that the disappearance of fourfold rotational symmetry in SHG s-out pattern implies for the appearance of R-phase. The fact that the thinner the film is, the closer to 1 the tensor element ratio χ31/χ15 tends, indicates an increase of symmetry with the decrease of thickness for BiFeO3 thin films. PMID:27905565

Rationale of subdermal superficial liposuction related to the anatomy of subcutaneous fat and the superficial fascial system.

PubMed

Gasperoni, C; Salgarello, M

1995-01-01

The liposuction technique has changed greatly over the years. In 1989, the authors presented subdermal superficial liposuction which treats the superficial fat layer and yields better skin retraction. With this technique the surgeon can treat thin adipose layers to obtain better results in more cases than the traditional liposuction technique. The technique can be used in cases with difficult skin adjustment and in secondary cases when "deep only" liposuction has been performed and there were residual adiposities. Subdermal superficial liposuction evolved so that one could obtain good skin retraction by performing massive liposuction of all the fat layers. The authors named this technique MALL (Massive All Layer Liposuction). The technique is applied in body areas where the fat layer is very thick and stretches the skin because of its volume and weight such as in the abdomen, posterior arms, and internal surface of the upper third of the thighs. MALL liposuction drastically reduces the indications for abdominoplasty and inner thigh and arm dermolipectomies. Knowledge of the anatomy of the subcutaneous fat and the superficial fascial system allows one to explain the subdermal superficial liposuction from an anatomical point of view, to perform a more rational and effective procedure, and to differentiate the technique depending on the area of the body.

Photosensitivity enhancement with TiO2 in semitransparent light-sensitive skins of nanocrystal monolayers.

PubMed

Akhavan, Shahab; Yeltik, Aydan; Demir, Hilmi Volkan

2014-06-25

We propose and demonstrate light-sensitive nanocrystal skins that exhibit broadband sensitivity enhancement based on electron transfer to a thin TiO2 film grown by atomic layer deposition. In these photosensors, which operate with no external bias, photogenerated electrons remain trapped inside the nanocrystals. These electrons generally recombine with the photogenerated holes that accumulate at the top interfacing contact, which leads to lower photovoltage buildup. Because favorable conduction band offset aids in transferring photoelectrons from CdTe nanocrystals to the TiO2 layer, which decreases the exciton recombination probability, TiO2 has been utilized as the electron-accepting material in these light-sensitive nanocrystal skins. A controlled interface thickness between the TiO2 layer and the monolayer of CdTe nanocrystals enables a photovoltage buildup enhancement in the proposed nanostructure platform. With TiO2 serving as the electron acceptor, we observed broadband sensitivity improvement across 350-475 nm, with an approximately 22% enhancement. Furthermore, time-resolved fluorescence measurements verified the electron transfer from the CdTe nanocrystals to the TiO2 layer in light-sensitive skins. These results could pave the way for engineering nanocrystal-based light-sensing platforms, such as smart transparent windows, light-sensitive walls, and large-area optical detection systems.

[Vacuum sealing drainage combined with free skin graft in repairing cutaneous deficiency of traumatic shank amputation stump].

PubMed

Zhao, Xiao-fei; Li, Chun-you; Jin, Guo-qiang; Ming, Xiao-feng; Wang, Guo-jie

2014-12-01

To observe clinical efficacy in treating cutaneous deficiency of traumatic shank amputation stump with full-thickness skin graft combined with vacuum sealing drainage. From September 2009 to December 2012, 15 patients with cutaneous deficiency of traumatic shank amputation stump were treated with full-thickness skin graft combined with vacuum sealing drainage. Among patients, there were 11 males and 4 females with an average age of 41.5 (ranged from 25 to 62) years old. Ten cases were caused by traffic accident and 5 cases were caused by heavy object, 9 cases on left and 6 cases on right. Six patients with smashed wound were treated with debridement and amputation, combined with vacuum aspiration in-emergency; 9 patients caused by infection and necrosis were treated with debridement and amputation, combined with vacuum aspiration, and full-thickness skin graft were performed at stage II. The skin defect area of residual limbs ranged from 40 cm x 20 cm to 25 cm x 15 cm. All patients were followed up from 3 months to 1 year. Full-thickness skin graft of residual limbs were survived,and obtained satisfactory walking function with prosthetic. Residual skin increased thicken, wearproof without rupture and pain. Full-thickness skin graft combined with vacuum sealing drainage in treating cutaneous deficiency of traumatic shank amputation stump could reserve the length of residual limbs, increase survival rate of skin graft with less scar of survival skin, get good wearability and it is conducive to prosthetic wear. It is a simple and easy treatment method.

BREAKS IN THIN AND THICK DISKS OF EDGE-ON GALAXIES IMAGED IN THE SPITZER SURVEY OF STELLAR STRUCTURE IN GALAXIES (S{sup 4}G)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Comeron, Sebastien; Salo, Heikki; Laurikainen, Eija

2012-11-10

Breaks in the radial luminosity profiles of galaxies have until now been mostly studied averaged over disks. Here, we study separately breaks in thin and thick disks in 70 edge-on galaxies using imaging from the Spitzer Survey of Stellar Structure in Galaxies. We built luminosity profiles of the thin and thick disks parallel to midplanes and we found that thin disks often truncate (77%). Thick disks truncate less often (31%), but when they do, their break radius is comparable with that in the thin disk. This suggests either two different truncation mechanisms-one of dynamical origin affecting both disks simultaneously andmore » another one only affecting the thin disk-or a single mechanism that creates a truncation in one disk or in both depending on some galaxy property. Thin disks apparently antitruncate in around 40% of galaxies. However, in many cases, these antitruncations are an artifact caused by the superposition of a thin disk and a thick disk, with the latter having a longer scale length. We estimate the real thin disk antitruncation fraction to be less than 15%. We found that the ratio of the thick and thin stellar disk mass is roughly constant (0.2 < M{sub T} /M{sub t} < 0.7) for circular velocities v{sub c} > 120 km s{sup -1}, but becomes much larger at smaller velocities. We hypothesize that this is due to a combination of a high efficiency of supernova feedback and a slower dynamical evolution in lower-mass galaxies causing stellar thin disks to be younger and less massive than in higher-mass galaxies.« less

Improved Coal-Thickness Measurement

NASA Technical Reports Server (NTRS)

Barr, T. A.

1984-01-01

Summed signals and dielectric-filled antenna improve measurement. Improved FM radar for measuring thickness of coal seam eliminates spectrum splitting and reduces magnitude of echo from front coal surface.

Hypertonic Glucose Combined with Negative Pressure Wound Therapy to Prepare Wounds with Pseudomonas aeruginosa Infection for Skin Grafting: A Report of 3 Cases.

PubMed

Zhao, Jing-Chun; Xian, Chun-Jing; Yu, Jia-Ao; Shi, Kai; Hong, Lei

2015-06-01

Soft tissue losses from acute or chronic trauma are a challenge for surgeons. To explore a method to expedite granulation tissue formation in preparation for a split-thickness skin graft (STSG), the medical records of 3 patients - 2 adult men with wounds related to trauma injury and 1 infant with necrotizing fasciitis, all infected with Pseudomonas aeruginosa - were reviewed. All wounds were surgically debrided and managed by applying gauze soaked in 50% glucose followed by continuous negative pressure wound therapy (NPWT) before definitive skin grafting. NPWT pressure was applied at -80 mm Hg for the 2 adult males (ages 39 and 25 years) and -50 mm Hg for the 7-month-old male infant. The dressings were changed every 2 to 3 days. No adverse events occurred, and wounds were successfully closed with a STSG after an average of 7 days. In 1 case, NPWT was able to help affix dressings in a difficult-to-dress area (genital region). The combination of hypertonic glucose and hand-made, gauze-based NPWT was found to be safe, well-tolerated, and effective in preparing the wound bed for grafting. Prospective, randomized, controlled clinical studies are needed to compare the safety, effectiveness, and efficacy of this method to other treatment approaches for P. aeruginosa-infected wounds.

Nasofacial defect following fibrosarcoma excision and radiotherapy.

PubMed

Burget, G L; Panje, W R; Krause, C J

1988-01-01

For initial reconstruction, Dr. Burget suggests that he would have advanced the cheek flap medially toward the nasal septum and, subsequently, reconstructed the missing right half of the nose with a forehead flap and cartilage grafts. Dr. Panje suggested early prosthetic rehabilitation, while Dr. Krause's concepts were similar to Dr. Burget's, with forehead flap nasal reconstruction, after cheek reconstruction to the nasofacial and nasolabial lines with a medially advanced cheek flap. Dr. Panje recommended an immediate maxillary denture prosthesis, as did Dr. Krause (who supplemented this with foam rubber). Dr. Burget placed the prosthesis 3 weeks after tumor ablation. For skin grafts, Drs. Panje and Burget suggested split thickness grafts to all new surfaces to decrease wound contracture, while Dr. Krause used dermis grafts for the same purpose. Other reconstructive methods mentioned were the (1) cervical tubed flap, (2) free scapular flap, (3) Washio flap, (4) tissue expansion, and (5) nasolabial flap. Suggestions for isolated defects included: Lower eyelid--increase internal support by building up the prosthesis; release lower lid from deltopectoral flap and V-Y advancement; support graft or irradiated cartilage (1-2 mm sheet) under orbicularis oculi. Nasal ala--bring present ala down and insert cartilage graft; turn internal skin down and fill the resulting defect with a composite graft. Upper lip--multiple Z-plasty. Retrodisplacement of cheek due to maxillectomy--release buccal scar; skin graft the raw internal surface and build up prosthesis.