Pharmacological approaches to induce neuroregeneration in spinal cord injury: an overview.

Curr Drug Discov Technol. 2009 Jun; 6(2): 82-90Ibarra A, Martiñón SSpinal cord (SC) injury causes serious neurological alterations that importantly disturb the physical, emotional and economical stability of affected individuals. Damage to the neural tissue is primarily caused by the lesion itself and secondarily by a multitude of destructive mechanisms that develop afterwards. Unfortunately, the restoring capacity of the central nervous system is very limited because of reduced intrinsic growth capacity and non-permissive environment for axonal elongation. The regenerative processes are blocked by diverse factors such as growth inhibitory proteins and the glial scar formed in the site of lesion. In spite of these problems, central neurons regenerate if a permissive environment is provided. In line with this thought, some pharmacological compounds have been tested to achieve neuroregeneration. The main objective of this manuscript is to provide the state-of-art of chemotherapeutic treatments for spinal cord regeneration after injury in the field. The efficacy and usefulness of different therapeutic strategies will be reviewed, including Rho-ROCK inhibitors, cyclic AMP-enhancers, glial scar inhibitors and immunophilin ligands. Aside from this, the use of hydrogels alone or in combination with drugs, growth factors or stem cells will also be revised.

Clinical presentation and outcome of chorioretinitis sclopetaria: A case series study.

Injury. 2009 Jun 12; Ahmadabadi MN, Karkhaneh R, Roohipoor R, Tabatabai A, Alimardani APURPOSE: To report the clinical presentation, treatment approach and natural course of a series of chorioretinitis sclopetaria patients. METHODS: Thirteen consecutive patients with clinical diagnosis of chorioretinitis sclopetaria were included in a case series study during 2000-2006. All patients underwent clinical examination, including the best-corrected Snellen visual acuity, slit-lamp examination, applanation tonometry, funduscopy and fundus photography. Three-port standard vitrectomy was performed in two patients due to dense vitreous haemorrhage and suspected retinal detachment in both cases. All patients were followed up at week 4, months 2 and 6 and then every 6 months. RESULTS: The mean age of the patients was 16+/-6 (range: 5-27) years and 11 patients (84.6%) were male. The mean follow-up period was 37+/-18 (range: 17-82) months. Baseline best-corrected visual acuity ranged from no light perception (NLP) to 20/1600, and final visual acuity range was from NLP to 20/1200. Only one patient developed acute retinal detachment, and the retina remained attached in others through follow-up. CONCLUSION: In spite of severe retinal and choroidal injuries in chorioretinitis sclopetaria, retinal detachment does not usually occur, probably due to spontaneous retinopexy and scar formation. Whilst dealing with chorioretinitis sclopetaria, it is important to make an accurate diagnosis to prevent unwarranted surgical intervention.

The biological effects of topical alginate treatment in an animal model of skin wound healing.

Wound Repair Regen. 2009 Jun 12; Lee WR, Park JH, Kim KH, Kim SJ, Park DH, Chae MH, Suh SH, Jeong SW, Park KKWound healing is a dynamic and complex process of tissue repair that involves a number of cellular and molecular events. It proceeds from inflammatory response to reepithelialization and finally to formation of a permanent scar. Alginate is a polymer of guluronic and mannuronic acid that is used as a scaffolding material in biomedical applications. For the purpose of studying wound healing, full-thickness skin defects were produced on the dorsal area in rats. We measured the relative sizes of the wounds on days 3, 5, 7, 14, and 28. The wound sizes were decreased in the alginate-treated group compared with the control group and the vaseline-treated group. The expressions of transforming growth factor-beta1, fibronectin, and vascular endothelial growth factor were significantly decreased in the alginate-treated group compared with the control group, while the expression of collagen-I was increased in the alginate-treated group, as indicated by Western blotting and immunohistochemical staining. These data suggest that alginate has significant wound healing promoting activity. The results from the present study indicate that the effect of alginate on wound healing may involve biological mechanisms associated with the expression of transforming growth factor-beta1, fibronectin, vascular endothelial growth factor, and collagen-I.

Does Surgical Closure Technique Affect Early Mammographic Detection of Tumor Recurrence After Breast-Conserving Therapy?

Am J Clin Oncol. 2009 Jun 12; Newlin HE, Indelicato DJ, Abbitt P, Marshall J, Wymer D, Grobmeyer S, Haigh L, Copeland E, Morris CG, Mendenhall NPPURPOSE:: Scarring in the tumor bed may mask or mimic local recurrence of tumor on surveillance mammography. Type of surgical closure technique used during lumpectomy may impact the pattern or density of scar tissue apparent in the tumor bed on mammography. This study sought to determine whether surgical closure type affects tumor-bed scar formation and impacts interpretation of surveillance mammography in women treated with breast-conserving therapy for early-stage breast cancer. MATERIALS AND METHODS:: One hundred women who received breast-conserving therapy were selected; 99 of them had 2-year post-treatment mammograms for the treated breast. Craniocaudal and mediolateral oblique views were reviewed by 3 subspecialty radiologists who routinely read mammograms. The mammograms were scored on 5-point scales for overall breast density and scarring within the tumor bed. RESULTS:: The analyses did not demonstrate greater scarring or density in breast status post superficial closure compared with breast status post full-thickness closure, or vice versa (P > 0.05 for scarring and density). There were no detectable differences between the 2 closure techniques either within the data from individual reviewers, within the composite data for the entire group of reviewers, or in instances where 2 of 3 reviewers agreed (P > 0.05). There was significant interobserver variability in scoring among the mammographers for both scarring (P = 0.001) and density (P < 0.0001). CONCLUSION:: Based on our study of the 2-year post-treatment mammograms, there was no evidence that closure technique impacts degree of scarring in the tumor bed. However, striking interobserver variability in scoring density and scarring was noted.

Do postsurgical interventions optimize ultimate scar cosmesis.

G Ital Dermatol Venereol. 2009 Jun; 144(3): 243-57Viera MH, Amini S, Konda S, Barman BKeloids and other scars are different manifestations of the normal wound healing process. If located in visible areas, scars may have a psychological impact that could affect the quality of life of the scar-bearing population. Good preoperatory planning including hiding incisions in natural anatomical landmarks or placing them parallel to relaxed skin tension lines are among the techniques used to improve the cosmesis of scars. Once a prominent or noticeable scar has developed, multiple therapeutic modalities can be applied including surgical excision, although high recurrence rates precludes its use as monotherapy. Several advanced surgical correction techniques including Z-plasty and W-plasty may be useful in repositioning scars. Other modalities that have been reported to improve scar cosmesis include cryosurgery, radiotherapy, lasers, and skin substitute grafts. Adjuvant postsurgical treatment modalities have reduced dramatically the recurrence rates associated with the removal of the scar. In this review of the literature the authors discuss evidence based data related to the abovementioned modalities and other topical and intralesional therapies including occlusion, compression, silicone, corticosteroids, interferons, imiquimod, resiquimod, tacrolimus, 5-fluorouracil, retinoids, as well as the role of several over-the-counter agents such as onion extract, vitamin E and the combination of hydrocortisone, vitamin E and silicone. Finally, they address newer modalities including vascular endothelial growth factor inhibitor, transforming growth factor-3, interleukin-10, mannose-6-phosphate, UVA-1, narrowband UVB, intense pulsed light and photodynamic therapy. Ultimately, the decision of choosing the most appropriate postexcisional management treatment should be taken by physicians on a case-by-case basis in order to obtain the best cosmetically acceptable results.