DISSOCIATIVE TRANCE AND POSSESSION DISORDER IN A MULTIPAROUS FEMALE WITH BAD OBSTETRIC HISTORY – A CASE REPORT

Dissociative trance and possession disorder is common in clinical settings and is dif?cult to differentiate from psychotic disorder by clinicians. It has also been associated with non-suicidal self-injurious behaviours. A case of 24-year-old married female who is 4 months ANC was diagnosed with a case of trance and possession disorder with a bad obstetric history. She received treatment on OPD basis.

A six-herb Chinese medicine composition ointment as a promising candidate for treatment of hypertrophic scars / 中草药·英文版

Objective: To study the anti-hypertrophic scar effect of the six-herb Chinese medicine composition (SCMC) ointment on the rabbit ear hypertrophic scar models. Methods: The optimal formulation of SCMC ointment matrix was screened by the orthogonal designs and a series of evaluation tests. The SCMC ointment was prepared through emulsifying method. The rabbit ear hypertrophic scar models were established and used to investigate the anti-hypertrophic scar effect of SCMC ointment. Results: Our results demonstrated that all the quality control indications of the SCMC ointment met the requirements. Anti-hypertrophic scar activity results showed that all the rabbit ear scar tissues appeared different degrees of shrink and fading, and took an unobvious but palpable shift from hard to soft texture with the low, middle and high concentration SCMC ointments treatments in vivo. Additionally, on 21st day the scar area and thickness in different concentrations of SCMC ointment groups were significantly reduced than control group, in a concentration-dependent manner. The immunohistochemical results also indicated that the SCMC ointment had good anti-hypertrophic scar properties and could inhibit hypertrophic scar formation. Conclusion: The SCMC ointment could improve the blood circulation condition of hypertrophic scar tissues. Our research has demonstrated the Chinese medicine composition ointment with good anti-hypertrophic scar properties that could be used to treat hypertrophic scars. Meanwhile, it provides a theoretical basis for further clinical application.

Preparation of cell penetrating peptide TAT-modified liposomes loaded with salvianolic acid B and its effect on proliferation and migration of human skin fibroblasts / 中草药

Objective To prepare the liposomes of salvianolic acid B modified with cell penetrating peptide TAT (SAB-TAT-LIP), of which has effects on preventing and treating hypertrophic scars (HS), and establish the method of quality evaluation, as well as preliminarily investigate the effect on the proliferation and migration of human skin fibroblasts (HSF). Methods Liposomes were prepared by pH gradient reverse-phase evaporation method, and the entrapment efficiency was measured by ultrafiltration. Box-Behnken design was performed to optimize the formulation of liposomes by using encapsulation rate as evaluating index. The physicochemical properties of liposomes including morphology, entrapment efficiency, particle size, zeta potential, in vitro release and transdermal absorption, and stability were studied. In addition, the effect of liposomes on proliferation of HSF was examined by MTT assay, and the effect of liposomes on migration of HSF was investigated by scratching method and Transwell assay. Results Based on the optimal formulation of SAB-TAT-LIP, the entrapment efficiency of salvianolic acid B was (86.70 ± 0.85)%, the average particle size was (219.90 ± 5.09) nm, and the zeta potential was (-9.25 ± 0.92). The in vitro 24 h cumulative release was 62.49% of the total drug with no burst effect. The in vitro 32 h cumulated skin penetration rate was 17.21%, the permeance rate was (28.33 ± 4.9) μg/(cm2∙h), and the retention volume of dermis was (44.39 ± 6.87) μg/cm2. The stability was good when placed at 4 ℃ for 10 d. The in vitro cell studies showed that SAB-TAT-LIP can significantly inhibit the proliferation, migration and invasion of human skin fibroblasts, compared with the control group (P < 0.01). Conclusion The optimized SAB-TAT-LIP have higher encapsulation efficiency, smaller particle size, good sustained release effect, and good dermal retention effect which all satisfy the in vitro release and transdermal regulation of local transdermal preparation, and it can significantly inhibit the proliferation, migration and invasion of human skin fibroblasts in vitro.

Optimizing Outcomes in the Reconstruction of Postburn Scar Hand Deformities

PURPOSE: Reconstruction of severe postburn hand deformities with flexion or extension contractures with finger webbing deformities, large hypertrophic scars of dorsal hand are frequently encountered problems in burn hand surgery. To obtain the good results after correction of various type of postburn scar hand deformities, we have used the sophisticated reconstructive procedures such as scar contracture release, skin graft, and use of acellular dermal matrix (ADM). We report reliability and usefulness of these novel updated procedures according the type of postburn hand deformities, and reviewed the literatures. METHODS: We had 82 postburn hand deformities. Among them we selected 7 patients of severe postburn hand deformities, which had different affected sites involving over 1/3 of hand. To reconstruct the finger flexion contractures, the scar contracture release and full thickness skin graft was most frequently performed. For correction of finger webbing deformities, the 5 flap Z-plasty for 1(st) web, dorsal and volar interposition flap for 2, 3 and 4 web, FTSG were used. The diffuse hypertrophic scar of dorsum of hand was reconstructed with total excision of scars, skin coverage with one piece of medium thickness STSG, and postoperative clenched hand position. The postburn palmar contractures was reconstructed with extensive contracture release followed by resurfacing with ADM (AlloDerm™) and thin STSG. The severe postburn abduction contractures of wrist was treated by total excision of scars, ADM (CGDerm™), and thin STSG. RESULTS: After 1 month to 1.6 years follow up, relatively satisfactory results were obtained in all patients. As complications, 1 case of recurrent palmar contractures, which was reconstructed with ADM (AlloDerm™) with thin STSG, were noticed. CONCLUSION: The postburn finger flexion contractures could be managed by the scar contractures release and FTSG. This method is very safe and reliable. For reconstruction of postburn finger webbing deformities, it is mandatory to use 5-flap Z-plasty for 1(st) webbing deformities, and dorsal and volar interposition flap for 2, 3 and 4(th) webbing deformities concomitantly with resurfacing with FTSG. The diffuse hypertrophic scars of dorsum of hand was managed by total excision of scars, resurfacing with one large piece of over medium thickness STSG, and postoperative clenched hand position. After release of scar contractures of hand, acellular dermal matrix (ADM) with thin STSG can be used in case of deficient FTSG donor site.

Steroid Injection on Facial Hypertrophic Scar: Report of 3 Cases

Estudo da eficácia percebida na melhora da textura, elasticidade e aparência geral de cicatrizes hipertróficas, através da aplicação do produto cosmético Renopel® / Perceived efficacy on the improvement of texture, elasticity, and general appearance of hypertrophic scars through the application of the cosmetic product Renopel®

Cicatrizes hipertróficas e queloides resultam de variações no processo de cicatrização normal de feridas no tecido cutâneo. Diferentemente dos queloides, as cicatrizes hipertróficas são passíveis de regressão gradativa e espontânea, podendo esse processo ser acelerado através de tratamentos específicos. Dentre os tratamentos para redução desse tipo de cicatriz, a utilização de cremes tópicos, com ativos hidratantes e queratolíticos, associados a massagens no local, são capazes de melhorar a textura e qualidade das cicatrizes hipertróficas. Essa resposta foi observada no presente estudo clínico de eficácia percebida, em que voluntários/julgadores, com presença de cicatrizes hipertróficas, avaliaram os parâmetros de textura, elasticidade e aparência geral das mesmas, antes e após aplicação do produto cosmético Renopel®, um novo produto cosmético a ser lançado no mercado. Os resultados obtidos foram promissores. Após 28 dias de aplicação do produto sobre as cicatrizes, os voluntários/julgadores referiram melhora de 87,0%, 82,6% e 95,7% da textura, elasticidade e aparência geral da cicatriz, respectivamente.

Standard guidelines of care: Keloids and hypertrophic scars.

Keloids and hypertrophic scars (HTS) are the result of overgrowth of fibrous tissue, following healing of a cutaneous injury, and cause morbidity. There are several treatment modalities which are useful for the management of keloids, though no single modality is completely effective. The most commonly used modalities are pressure, silicone gel sheet, intralesional steroids, 5-fluorouracil (5 FU), cryotherapy, surgical excision, and lasers. They may be used either singly or, as is done more commonly, in combinations. Any qualified dermatologist who has attained postgraduate qualification in dermatology can treat keloids and HTS. Some procedures, such as cryosurgery and surgical excision, may require additional training in dermatologic surgery. Most modalities for keloids, including intralesional injections and mechanical therapies such as pressure and silicone gel based products, can be given/prescribed on OPD basis. Surgical excision requires a minor operation theater with the facility to handle emergencies. It is important to counsel the patient about the nature of the problem. One should realize that keloid will only improve and not disappear completely. Patients should be informed about the high recurrence rates. Different modalities carry risk of adverse effects and complications and the treating physician needs to be aware of these and patients should be informed about them.

Prosthodontist contribution in treating post-burn hypertrophic facial scars.

The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.

Effects of carboxyl methyl chitosan on hypertrophic scars in rabbit ears / 中华医学美学美容杂志

Objective To investigate the effect of carboxyl methyl chitosan on hypertrophic scars by establishing a hypertrophic scar model on the ventral side of rabbit ears.Methods Full-thick-ness excisional wounds,1 cm in diameter,were made in the ears of 12 adult New Zealand white rabbits,and 123 hypertrophic sears were made in all.Then the rabbits were divided into 3 groups:group A was an experimental group (carboxyl methyl chitosan,500μg/ml),group B was a control group 1 (triamcinolone),and group C was control group 2 (physiological saline).All the scars were injected with drugs on the 30th and 40th days after operation,and then the samples were collected on the 35th and 45th day and analyzed.Results Compared with group C,group A appeared to be flatter,softer,and lighter in color;the area density of fibroblast decreased using HE stain and masson stain (P<0.05),and hydroxyproline content and hypertrophic index were also lower than group C (P<0.05).There were no significant differences of those criteria between group A and group B (P>0.05).Conclusion Injection of carboxyl methyl chitosan into Iocal hypertrophic scars On rabbit ears has similar effects to triamcinolone,and both of them can prevent and cure hypertrophic scars in proliferative stage.

The Changes of Main Oxidase and Antioxidase Activities in The Pathological Scars / 生物化学与生物物理进展

In order to study the changes of main oxidase and antioxidase in the pathological scars,the tissues of hypertrophic scar(10 cases),keloid(10 cases)and normal skin(8 cases)were obtained.The concentration of malonaldehyde(MDA)and the activities of xanthine oxidase(XO),copper,zinc-superoxide dismutase(CuZn-SOD),catalase(CAT)as well as glutathione peroxidase(GPX)were detected by spectrophotometric method.Compared with normal skin tissues,the concentration of malonaldehyde and xanthine oxidase activity were significantly higer in pathological scars(P

Effect of Small Needle-Knife on Collagens Ⅰ and Ⅲ in Transplanted Human Skin Hypertrophic Scar Tissues in Nude Mice / 中国微创外科杂志

Objective To discuss the effect of small needle knife therapy on collagensⅠ and Ⅲ in the hypertrophic scar tissues that was subcutaneously transplanted into nude mice. Methods Six samples of human hypertrophic scar tissues without cuticle were subcutaneously transplanted into the back of 24 nude mice to create the animal models of hypertrophic scar. Ten days after of the operation,the mice were divided into control,0.1 mg/ml triamcinolone,0.2 mg/ml triamcinolone,and small needle-knife groups with 6 mice in each. Specimens of the scar tissues were collected in 14 days for immunohistochemistry to detect the collagen Ⅰ and Ⅲ. Results In all the groups,collagens Ⅰand Ⅲ distributed extensively in the cytoplasm of fibroblast and tissues. Image analysis showed that the concentration of collagens Ⅰand Ⅲ in 0.1 mg/ml and 0.2 mg/ml triamcinolone groups were significantly lower than those in the control (0.09?0.03,0.11?0.05 and 0.12?0.02,0.11?0.01 vs. 0.17?0.04,0.19?0.03,P0.05). Conclusions Small needle-knife therapy can reduce the concentration of collagens Ⅰand Ⅲ in transplanted hypertrophic scar tissues in nude mice.

595nm Pulsed Dye Laser (Vbeam(R)) Treatment of Hypertrophic Scar

Hypertrophic scars are relatively common, but they remain very difficult to treat and induce functional and psychologic morbidity. Many treatment modalities have been advocated in the past. But none of these are satisfactory with unpredictable result, long treatment interval and sometimes unacceptable side effects. Recent use of the flashlamp-pumped pulsed-dye laser(585nm) has been shown to be effective in the treatment of various traumatic and surgical scars with improvement in scar texture, color and pliability with minimal side effects. 80 patients with 95 hypertrophic scars which had little response to usual conservative treatment and resulted from trauma, operation, skin graft donor sites, and burns were treated with Vbeam(R)(595nm) pulsed dye laser(Candela Laser Corporation, Wayland, Mass). The mean number of treatment was 2.2. Period of follow-up vary from 2 month to 16 months. The 595nm Pulsed Dye Laser can effectively improve scar pliability and texture and decrease erythema and associated symptoms yielding cosmetically and functionally acceptabel clinical results. Complications such as hypopigmentation, ulcer and infection were not seen.

A Case of Hypertrophic Scars After Therapy with CO2 Laser for Treatment of Multiple Cutaneous Neurofibromas / 대한피부과학회지

Multiple cutaneous neurofibromas are the most common skin manifestation of Von Recklinghausen neurofibromatosis(NF-1). CO2 laser surgery is a treatment modality for multiple cutaneous neurofibromas and a simple procedure that quickly removes the tumor with minimal postoperative discomfort and acceptable cosmetic results. But, hypertrophic and atrophic scars can result from treatment with CO2 laser surgery. We herein report a case of multiple cutaneous neurofibromas that developed hypertrophic scars postoperatively.

The treatment modality evolving of hypertrophic scars and keloids / 医学研究生学报

Because the exact pathological mechanism underlying hypertrophic scars and keloids is unknown,there are a great number of treatment modalities, but it is unsatisfactory for the effect of treatment for the pathological scar.The vast array of treatment modalities for hypertrophic scars and keloids described by literature,whose treatmetn effects are varied and none of them is universally accepted in permanent hypertrophic scars and keloids ablation,are reviewed in this article in order to afford a reference for clinic medico.

The 585 nm Flashlamp-Pulsed Dye Laser of Treating Keloids and Hypertrophic Scars

Hypertrophic scars and keloids are difficult to treat. Currently numerous treatment modalities are available, but results are often hard to predict. We used the 585 nm flashlamp-pumped dye laser based on the principle that selective thermolysis of the increased vasculature in a scar may prevent scar hypertrophy through decrease in cellular function/nutrition within the scar. We treated 41 patients with hypertrophic or keloidal scars of more than 6 months duration. The number of treatments per person ranged from 1 to 8 (mean 3.7) and patients were treated every four weeks. Duration of follow-up ranged from 6 to 24 months. There was a significant improvement in appearance, texture and symptoms such as pain and pruritis. No recurrence or worsening of the scar was reported.

Role of angiotensin Ⅱ receptors in collagen synthesis of fibroblast in human hypertrophic scars / 解放军医学杂志

Objective To observe the expression of both type 1 (AT1) and type 2 (AT2) receptors of angiotensin Ⅱ (AngⅡ) in human hypertrophic scars, and to explore theirs role in collagen synthesis of fibroblasts in human hypertrophic scars. Methods The expression of both AT1 and AT2 receptors in fibroblasts of hypertrophic scars was detected with immunohistochemical staining and radioligand receptor binding assay. Collagen synthesis was examined in cultured in vitro fibroblasts of hypertrophic scars by measuring [~3H]proline incorporation into collagenous proteins. Results Positive staining signals of both AT1 and AT2 receptors were found in fibroblasts of hypertrophic scars. Similar results were also got in cultured in vitro fibroblasts of hypertrophic scars, expression level of AT1 and AT2 receptors were 10.69?2.15fmol/10~6cells and 4.9?1.05fmol/10~6cells respectively. In cultured in vitro fibroblasts, AngⅡ may accelerate the collagen synthesis significantly (P