Acne Scars

Breast Cancer. 2009 Aug 4; Tanaka F, Mimori K, Tahara K, Inoue H, Mori MBACKGROUND: Here we report a study on the use of saline replacement after local resection of the breast. Local resection of breast tissue is widely used in the treatment of breast cancer due to the development of imaging analysis technology such as mammography, ultrasound sonography, computed tomography, and magnetic resonance. Preserving the size and shape of the breast after treatment is beneficial for the patient, and deformity of the residual breast can be a serious problem. METHODS: Following resection, the subcutaneous tissue was sutured with 4-0 polydioaxanone, and a 20-G syringe was inserted through the skin into the hole. After suturing the skin with 4-0 nylon, an adequate volume of saline was injected. A conservative treatment group did not receive saline injections and was used as controls. We sent self-administered questionnaires to 60 patients who had undergone local resection of the breast and received 55 responses (92%). RESULTS: Saline replacement was performed in 28 of the 55 patients, and conservative treatment (no saline replacement) was performed in 27 patients. The average volume of injected saline was 46 ml (range, 5-150 ml). There were no statistically significant differences in skin irritation, pain, fatigue, or daily activity between the two groups, but the saline replacement group was more satisfied with the surgical scar (p < 0.05) and shape of the breast (p = 0.05) after surgery. CONCLUSIONS: Saline replacement after local resection of the breast is a simple technique that provides benefits for patients undergoing conservative surgery of the breast.

Cell Mol Neurobiol. 2009 Aug 4; Komuta Y, Teng X, Yanagisawa H, Sango K, Kawamura K, Kawano HThe fibrotic scar which is formed after traumatic damage of the central nervous system (CNS) is considered as a major impediment for axonal regeneration. In the process of the fibrotic scar formation, meningeal fibroblasts invade and proliferate in the lesion site to secrete extracellular matrix proteins, such as collagen and laminin. Thereafter, end feet of reactive astrocytes elaborate a glia limitans surrounding the fibrotic scar. Transforming growth factor-beta1 (TGF-beta1), a potent scar-inducing factor, which is upregulated after CNS injury, has been implicated in the formation of the fibrotic scar and glia limitans. In the present study, expression of receptors to TGF-beta1 was examined by in situ hybridization histochemistry in transcortical knife lesions of the striatum in the mouse brain in combination with immunofluorescent staining for fibroblasts and astrocytes. Type I and type II TGF-beta receptor mRNAs were barely detected in the intact brain and first found in meningeal cells near the lesion 1 day postinjury. Many cells expressing TGF-beta receptors were found around the lesion site 3 days postinjury, and some of them were immunoreactive for fibronectin. After 5 days postinjury, many fibroblasts migrated from the meninges to the lesion site formed the fibrotic scar, and most of them expressed TGF-beta receptors. In contrast, few of reactive astrocytes expressed the receptors throughout the postinjury period examined. These results indicate that meningeal fibroblasts not reactive astrocytes are a major target of TGF-beta1 that is upregulated after CNS injury.

Cell Transplant. 2009 Aug 5; Ghanem A, Ziomka A, Krausgrill B, Schenk K, Troatz C, Michalszki-Jamka T, Nickenig G, Tiemann K, Müller-Ehmsen JIntramyocardial transplantation of bone marrow derived stem cells is a potential therapeutic option after myocardial infarction (MI). Intramyocardial administration is invasive but allows efficient and targeted stem cell delivery. Aims of this study were validation of minimal-invasive, echo-guided closed-chest cell transplantation (CTx) of mononuclear (MNC) or mesenchymal stem cells (MSC) and quantification of systolic left-ventricular function and assessment of contractile reserve with high-resolution reconstructive 3D-echocardiography (r3D-echo) three weeks after CTx.Female Fischer344 rats received syngeneic male MNC, MSC or medium after myocardial ischemia and reperfusion via echo-guided percutaneous injection (open-chest for control). Left-ventricular systolic function was measured and dysfunctional myocardium was quantified with r3D-echo. For investigation of contractile reserve and myocardial viability r3D-echo was additionally conducted during low-dose dobutamine three weeks after CTx. Cell persistence after echo-guided CTx was quantified via real-time PCR, scar size was measured histologically.Echo-guided percutaneous CTx was feasible in all animals (n=30) without periprocedural complications. 1.4+/-1.1% of transplanted MNC and 1.9+/-1.2% of MSC were detected after three weeks. These numbers were comparable to those after open-chest intramyocardial injection of MNC (0.8+/-1.1%; n=8, p=0.3). In r3D-echo no functional benefit was associated with CTx after MI and reperfusion. All groups (MNC, MSC and controls) revealed a significant decrease of dysfunctional myocardium and similar contractile reserve during inotropic stimulation.In conclusion, percutaneous echo-guided closed-chest CTx promises to be an effective and safe approach for CTx in small animal research. However, intramyocardial CTx of MNC or MSC had no influence on systolic function and contractile reserve after reperfused MI.

Prog Brain Res. 2009; 175: 173-86Tannemaat MR, Boer GJ, Eggers R, Malessy MJ, Verhaagen JReconstructive surgery of the peripheral nerve has undergone major technical improvements over the last decades, leading to a significant improvement in the clinical outcome of surgery. Nonetheless, functional recovery remains suboptimal in the majority of patients after nerve repair surgery. In this review, we first discuss the molecular mechanisms involved in peripheral nerve injury and regeneration, with a special emphasis on the role of neurotrophic factors. We then identify five major challenges that currently exist in the clinical practice of nerve repair and their molecular basis. The first challenge is the slow rate of axonal outgrowth after peripheral nerve repair. The second problem is that of scar formation at the site of nerve injury, which is detrimental to functional recovery. As a third issue, we discuss the difficulty in assessing the degree of injury in closed traction lesions without total loss of continuity of the involved nerve elements. The fourth challenge is the problem of misrouting of regenerating axons. As a fifth and final issue we discuss the potential drawbacks of using sensory nerve grafts to support the regeneration of motoneurons. For all these challenges, solutions are likely to emerge from (a) a better understanding of their molecular basis and (b) the ability to influence these processes at a molecular level, possibly with the aid of viral vectors. We discuss how lentiviral vectors have been applied in the peripheral nerve to express neurotrophic factors and summarize both the advantages and drawbacks of this approach. Finally, we discuss how lentiviral vectors can be used to provide new, molecular neurobiology-based, approaches to address the clinical challenges described above.

Lasers Med Sci. 2009 Aug 7; Nouri K, Elsaie ML, Vejjabhinanta V, Stevens M, Patel SS, Caperton C, Elgart GMore than 70 million surgical procedures are performed annually in the USA with the majority involving a skin lesion and almost all individuals in their lifetime will have one or more surgical procedures resulting in scars. Patients and physicians alike are thereby motivated to improve the cosmetic outcome of scars. Prior studies have shown that the pulsed dye laser (PDL) is effective in improving the quality and appearance of the scar when using the 585-nm PDL immediately after the removal of sutures. Most published studies used a pulse duration of 450 micros, which along with the other study parameters, has led to an overall improvement of the scars. However, a pulse duration of 1.5 ms is also available when using the pulsed dye laser and it should theoretically cause fewer side-effects. To our knowledge, there are no other studies comparing the effectiveness of different pulse durations in the treatment of surgical scars starting on the day of suture removal. The purpose of this study is to compare the effect of different pulse durations (450 micros vs. 1.5 ms) in the treatments of postsurgical linear scars immediately after suture removal when using the 585-nm pulsed dye laser (PDL). Twenty non-hospitalized male and female patients (older than 18 years of age) with skin types I-IV and with postoperative linear scars measuring at least 2.1 cm were enrolled in this prospective study. Scars were randomly divided into three equal sections. The different fields were randomly chosen to receive treatment (two out of three fields) or remain as control (one field). The two fields chosen to be treated received treatment with the 585-nm PDL using a 7-mm spot size at 4.0 J. One of the treated sections was randomly selected to receive a pulse duration of 450 micros, and the other section to receive a 1.5-ms pulse. The remaining scar section was designated as control (no treatment). The three sections were mapped and recorded. The patient received treatment immediately after the sutures were removed from the wound and then monthly for 3 months. Evaluations were performed before each treatment and 1 month after the last treatment. The short-pulse and long-pulse 585-nm PDL-treated sections demonstrated a statistically significant overall average improvement of the VSS of 92 and 89%, respectively, compared to 67% for the control site (Fig. 1). Further, for individual parameters of the Vancouver scar scale (VSS), there were significant (p < 0.05) differences between control and treatment groups for all parameters, but there were no differences between the short- and long-pulse treatment groups for any parameter. Both short-pulse and long-pulse PDL are safe and effective in improving the quality and cosmetic appearance of surgical scars in skin type's I-IV starting on the day of suture removal with no significant difference between the two pulse durations.