Acne Scars

Arch Dermatol Res. 2009 May 23; Zhang GY, Cheng T, Zheng MH, Yi CG, Pan H, Li ZJ, Chen XL, Yu Q, Jiang LF, Zhou FY, Li XY, Yang JQ, Chu TG, Gao WYPeroxisome proliferator-activated receptor-gamma (PPAR-gamma) ligands have been recently reported to have beneficial effects on organ fibrosis. However, their effects on extracellular matrix (ECM) turnover in hypertrophic scar fibroblasts (HSFs), and the related molecular mechanisms are unknown. HSFs were cultured and exposed to different concentration PPAR-gamma ligands in the presence of transforming growth factor-beta1 (TGF-beta1). In growth-arrested HSFs, a PPAR-gamma natural ligand (15-deoxy-D12,14-prostaglandin J2, 15d-PGJ2) and a synthetic ligand (GW7845) dose-dependently attenuated TGFbeta1-induced expression of Connective tissue growth factor (CTGF), collagens and fibronectin. Furthermore, the suppression of CTGF mRNA and protein expression are relieved by pretreatment with an antagonist of PPAR-gamma (GW9662). Moreover, GW7845 and 15d-PGJ2 partially inhibited the expression and phosphorylation of the TGF-beta1/Smad pathway. These results suggest that in TGFbeta1-stimulated HSFs, PPAR-gamma ligands caused an antiproliferative effect and reduced ECM production through mechanisms that included reducing CTGF expression, and a crosstalk between PPAR-gamma and Smad may be involved in the inhibitory effects of PPAR-gamma ligands.

Burns. 2009 May 26; Stiefel D, Schiestl C, Meuli MIntegra Artificial Skin((R)), a biosynthetic dermal template, is well established in acute burn surgery. The aim of the study was to determine the role of Integra in the surgical treatment of postburn scars in a younger population. Between March 1998 and November 2004, 17 patients (n=17; mean age=13.15 years) underwent complete excision of hypertrophic scars or keloids (1-4% TBSA; extremities=47%, head/neck=35%, trunk=18%) with subsequent implantation of Integra for defect closure. Split thickness skin grafting (STSG) of the Integra-derived neodermis was performed 3 weeks after the first operation. Scar excision and primary Integra implantation was successful in all but one patient (94%) who (6%) needed reimplantation once. Integra's mean take rate was 99.7% for all primarily successful patients. Complications occurred in three patients (18%), including minor problems without long-term consequences in 12% (seroma formation), and major problems in 6% (hematoma formation). Take rate of STSG ranged from 50% to 100% (mean 94%). Functional and cosmetic long-term outcome showed results scored "excellent" in 53%, "good" in 36%, and "fair" in 11%. Comparison of pre- and postoperative findings revealed a significant functional improvement in all and a considerable cosmetic improvement in all but two patients. These results suggest that Integra is a valid new treatment modality for extensive burn scar revision in younger patients.

Reprod Domest Anim. 2009 May 28; Kolkman I, Opsomer G, Lips D, Lindenbergh B, de Kruif A, De Vliegher SContents The aim of this study was to describe the difficulties encountered during caesarean section (CS) in practice on mainly Belgian Blue (BB) cows and to identify the associated risk factors. Data were collected using a questionnaire completed by veterinarians of the Ambulatory Clinic of the Faculty of Veterinary Medicine, Ghent University (Belgium), immediately after performing a CS. Results revealed that the BB breed had fewer severe pre-operative problems than animals of other breeds, most probably due to the fact that CSs in this breed are performed in a very early stage of parturition. Mild as well as severe difficulties were more likely to happen during surgery in cows that had undergone a CS before. Cows at their second or third surgery had a significantly higher proportion of larger calves and more skin scar tissue was present, both increasing the risk of abdominal wall muscular and uterine haemorrhage. These factors can all lead to problems with exteriorization and suturing of the uterus; hence special attention is needed when performing a CS on a cow which has experienced the procedure before. The more experienced veterinarians were less likely to report difficulties during the operation than less experienced surgeons.