Acne Scars

Lasers Med Sci. 2009 Jul 15; Elsaie ML, Nouri K, Vejjabhinanta V, Patricia Rivas M, Magaly Villafradez-Diaz L, Martins A, Rosso RThe purpose of this study is to evaluate the efficacy of tattoo removal using topical imiquimod 5% cream in conjunction with the 1,064-nm Nd:YAG laser. This procedure for tattoo removal will be compared to laser treatment alone, which is the standard for cosmetic removal of tattoos. Previous studies have linked partial tattoo removal to imiquimod application in a guinea pig model. Methods: This was a small-sized, double-blinded, placebo-controlled trial with patients with Fitzpatrick skin types I-IV (light skin) who were 18-65 years of age. The patients were required to have had two tattoos of similar age and dark blue or black in color in areas that can be covered by clothing. There were four visits in total, with laser treatment and photography being performed on the first visit. Laser settings were with 1,064-nm Nd:YAG with a 10-ns pulse, 3-mm spot size, and 4 J of energy, a standard laser used for tattoo removal. During the second visit, tattoos were randomized and chosen to receive either the laser-imiquimod treatment course or laser-vehicle cream treatment. The patients returned 1 month after the completion of cream application (week #10) and 2 months after the completion of treatment with cream (week #14) for final evaluation and photographing. Results: Three patients were enrolled in this study. All of them are Fitzpatrick skin type IV. All of the patients were compliant with the drug application and have good tolerability with only mild pruritus without changing of vascularity or pigmentation. None of the patients had ulceration or scar development during the cream application. Conclusions: imiquimod plus laser therapy demonstrated a more favorable outcome when evaluated by the investigators or subjects. The mean scores for tattoo clearance from baseline to 2 months after completion of treatment with 5% imiquimod cream versus placebo cream were 4.3 versus 2.7 as rated by investigators and 4.7 versus 2.3 as rated by subjects. No textural changes were observed after therapy and were not shown to be different between the two groups. Further large-scale studies are important in developing a role for the use of imiqumod in laser-assisted tattoo removal.

Spinal Cord. 2009 Jul 14; Onose G, Anghelescu A, Muresanu DF, Padure L, Haras MA, Chendreanu CO, Onose LV, Mirea A, Ciurea AV, El Masri WS, von Wild KRStudy design:Literature review.Objectives:To review the main published current neuroprotection research trends and results in spinal cord injury (SCI).Setting:This paper is the result of a collaboration between a group of European scientists.Methods:Recent studies, especially in genetic, immune, histochemical and bio (nano)-technological fields, have provided new insight into the cellular and molecular mechanisms occurring within the central nervous system (NS), including SCIs. As a consequence, a new spectrum of therapies aiming to antagonize the 'secondary injury' pathways (that is, to provide neuroprotection) and also to repair such classically irreparable structures is emerging. We reviewed the most significant published works related to such novel, but not yet entirely validated, clinical practice therapies.Results:There have been identified many molecules, primarily expressed by heterogenous glial and neural subpopulations of cells, which are directly or indirectly critical for tissue damaging/sparing/re-growth inhibiting, angiogenesis and neural plasticity, and also various substances/energy vectors with regenerative properties, such as MAG (myelin-associated glycoprotein), Omgp (oligodendrocyte myelin glycoprotein), KDI (synthetic: Lysine-Asparagine-Isoleucine 'gamma-1 of Laminin Kainat Domain'), Nogo (Neurite outgrowth inhibitor), NgR (Nogo protein Receptor), the Rho signaling pathway (superfamily of 'Rho-dopsin gene-including neurotransmitter-receptors'), EphA4 (Ephrine), GFAP (Glial Fibrillary Acidic Protein), different subtypes of serotonergic and glutamatergic receptors, antigens, antibodies, immune modulators, adhesion molecules, scavengers, neurotrophic factors, enzymes, hormones, collagen scar inhibitors, remyelinating agents and neurogenetic/plasticity inducers, all aiming to preserve/re-establish the morphology and functional connections across the lesion site. Accordingly, modern research and experimental SCI therapies focus on several intricate, rather overlapping, therapeutic objectives and means, such as neuroprotective, neurotrophic, neurorestorative, neuroreparative, neuroregenerative, neuro(re)constructive and neurogenetic interventions.Conclusion:The first three of these therapeutical directions are generically assimilated as neuroprotective, and are synthetically presented and commented in this paper in an attempt to conceptually systematize them; thus, the aim of this article is, by emphasizing the state-of-the art in the domain, to optimize theoretical support in selecting the most effective pharmacological and physical interventions for preventing, as much as possible, paralysis, and for maximizing recovery chances after SCI.Spinal Cord advance online publication, 14 July 2009; doi:10.1038/sc.2009.52.

Aesthetic Plast Surg. 2009 Jul 14; Pereira LH, Sterodimas ABACKGROUND: During the last decades transaxillary breast augmentation (TBA) has gained worldwide acceptance. Breast augmentation via transaxillary access endoscopically assisted in the subglandular, subfascial, and submuscular planes has been previously described. Although TBA is a well-studied procedure, few reports exist concerning the subfascial plane of implant insertion and none exist comparing the three different planes of insertion by TBA. METHODS: A perspective study to evaluate the outcomes, complications, and patient satisfaction of TBA using the three different planes of implant insertion was performed during 2004-2005. Fifty-three patients fulfilled the inclusion criteria. They were randomly divided into three groups corresponding to the three planes of silicone insertion. All patients had a silicone texturized implant that ranged from 190 to 300 cc. Overall satisfaction with the breast appearance after TBA was rated on a scale of 1-5, where 1 is poor, 2 is fair, 3 is good, 4 is very good, and 5 is excellent. The evaluation was made at the follow-up times of 6 months and 3 years. RESULTS: There were 18 patients enrolled for the subcutaneous TBA (Group A), 18 for the subfascial TBA (Group B), and 17 for the submuscular TBA (Group C). Axillary incision-related complications occurred in 9% of the patients and included formation of a hypertrophic scar and small-wound dehiscence. There was no hematoma formation and no case of infection. There was one patient from Group A who developed seroma and was treated conservatively. Twenty-seven months postoperatively the same patient developed Baker III capsule contracture, which required silicone implant replacement in the subfascial plane. One case of stretch marks in a young nulliparous woman from Group B did not need treatment. One patient from Group A underwent implant exchange because of implant size dissatisfaction. Three patients in Group C had mild distortion of the implant during pectoral contracture. A meta-analysis of patient satisfaction 6 months and 3 years after TBA is presented. CONCLUSION: Transaxillary breast augmentation provides consistent, satisfactory results with ease of dissection, when properly indicated. Although the subfascial augmentation mammaplasty has all the advantages of the subpectoral and subglandular augmentation mammaplasties and eliminates the disadvantages of increased postoperative discomfort, implant visibility, and distortion, patients of all three groups had similar rates of satisfaction. Further follow-up is needed in order to compare the long-term effects of the three different planes of insertion.

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Jun; 23(6): 713-7Yuan J, Li T, Qi SOBJECTIVE: To investigate the inhibitory effect of Col I A1 antisense oligodeoxyneucleotide (ASODN) transfection mediated by cationic liposome on Col I A1 expression in human hypertrophic scar fibroblasts. METHODS: Scar tissue was obtained from volunteer donor. Human hypertrophic scar fibroblasts were cultured by tissue block method. The cells at passage 4 were seeded in a 6 well cell culture plate at 32.25 x 10(4) cells/well, and then divided into 4 groups: group A, liposome and Col I A1 ASODN; group B, Col I A1 ASODN; group C, liposome; group D, blank control. At 8 hours, 1, 2, 3 and 4 days after transfection, total RNA of the cells were extracted, the expression level of Col I A1 mRNA was detected by RT-PCR, the Col I A1 protein in ECM was extracted by pepsin-digestion method, its concentration was detected by ELISA method. RESULTS: Agarose gel electrophoresis detection of amplified products showed clear bands without occurrence of indistinct band, obvious primer dimmer and tailing phenomenon. Relative expression level of Col I A1 mRNA: at 8 hours after transfection, group A was less than groups B, C and D (P < 0.05), and groups B and C were less than group D (P < 0.05), and no significant difference was evident between group B and group C (P > 0.05); at 1 day after transfection, groups A and B were less than groups C and D (P < 0.05), and there was no significant difference between group A and group B, and between group C and group D (P > 0.05 ); at 2 days after transfection, there were significant differences among four groups (P < 0.05); at 3 and 4 days after transfection, group A was less than groups B, C and D (P < 0.05), group B was less than groups C and D (P < 0.05), and no significant difference was evident between group C and group D (P > 0.05). Concentration of Col I protein: at 8 hours after transfection, group A was less than groups B, C and D (P < 0.05), groups B and C were less than group D (P < 0.05), and no significant difference was evident between group B and group C (P > 0.05); at 1 day after transfection, significant differences were evident among four groups (P < 0.05); at 2, 3 and 4 days after tranfection, groups A and B were less than groups C and D (P < 0.05), and no significant difference was evident between group A and group B (P > 0.05). CONCLUSION: Col I A1 ASODN can inhibit mRNA and protein expression level of Col I A1. Cationic liposome, as the carrier, can enhance the inhibition by facilitating the entry of ASODN into cells and introducing ASODN into cell nucleus.

Nanomed. 2009 Jul; 4(5): 531-540Bellucci S, Chiaretti M, Cucina A, Carru G, Chiaretti AAim: We evaluated the effect of buckypaper (BP) on cancer and primary cell lines in vitro and in vivo in laboratory rats. BP is an innovative material with interesting physical/chemical properties that has possible pharmacological and prosthetic employment. Given that precautions need to be taken where carbon nanotubes are injected into human body for drug delivery, as contrast agent-carrying entities for MRI or as the material of a new prosthesis generation, we assessed the toxicity of BP carbon nanotubes. BP has structural resemblance to asbestos, whose toxicity has been linked to cancer. Results: BP decreased proliferation of human colorectal, breast and leukemic cancer cell lines in vitro. However, BP had no effect on the proliferation and viability of normal human arterial smooth muscle cells and human dermal fibroblasts in vitro. in vivo, BP induced a moderate inflammatory reaction but had no mutagenic effects. After BP implantation the animals showed an inflammatory reaction followed 2 weeks later by a cicatrization reaction with the organization and fibrosis of the scar. Conclusion: These results show a low toxicity of BP both in vitro and in vivo.