Biomedical subjects

K Ash

Publications and source records attributed to K Ash.

At least 19 recordsLinked to original sources

PubMed2001

Nuclear factor-kappaB-mediated X-linked inhibitor of apoptosis protein expression prevents rat granulosa cells from tumor necrosis factor alpha-induced apoptosis.

Although X-linked inhibitor of apoptosis protein (Xiap) is an important intracellular suppressor of apoptosis in a variety of cell types and is present in ovary, its physiological role in follicular development remains unclear. The purpose of the present studies was to examine the modulatory role of Xiap in the proapoptotic action of tumor necrosis factor-alpha (TNFalpha) in rat granulosa cells. Granulosa cells from equine CG-primed immature rats were plated in RPMI 1640 medium containing 10% FCS and subsequently cultured in serum-free RPMI in the absence or presence of TNFalpha (20 ng/ml), the protein synthesis inhibitor cycloheximide (10 microM), and/or adenoviral Xiap sense or antisense complementary DNA. TNFalpha alone failed to induce granulosa cell death, but in the presence of cycloheximide, it markedly increased the number of apoptotic granulosa cells (as assessed by in situ terminal deoxynucleotidyl transferase-mediated deox-UTPbiotin end labeling and DNA fragmentation analysis). Western analysis indicated that TNFalpha alone increased the Xiap protein level, a response significantly reduced by adenoviral Xiap antisense expression. Down-regulation of Xiap expression by antisense complementary DNA induced granulosa cell apoptosis, which was potentiated by the cytokine. Inhibition of nuclear factor-kappaB activation by N-acetyl-cysteine and SN50 suppressed Xiap protein expression and enhanced apoptosis induced by TNFalpha. The latter phenomenon was readily attenuated by adenoviral Xiap sense expression. In conclusion, these findings suggest that Xiap is an important intracellular modulator of the TNFalpha death signaling pathway in granulosa cells. Its expression is regulated by the TNFalpha via a nuclear factor-kappaB-mediated mechanism.

Acetylcysteine↗

PubMed2000

Variable pulse erbium:YAG laser skin resurfacing of perioral rhytides and side-by-side comparison with carbon dioxide laser.

BACKGROUND AND OBJECTIVE: Laser resurfacing of facial rhytides has become a popular treatment option for many patients with wrinkles, photoaging, and acne scarring. Laser wavelength/pulse duration options and new techniques continue to shorten the healing phase associated with laser skin resurfacing while maintaining clinical efficacy. Variable pulse erbium:YAG (Er:YAG) laser systems are now available that offer the surgeon the ability to vary the Er:YAG pulse duration from a pulse that is primarily ablative to one that is more thermal. The objective of this study was to evaluate the histologic effects created with a variable pulse Er:YAG laser. To study prospectively the clinical effects on upper lip rhytides with a variable pulse Er:YAG laser when compared side by side with pulsed carbon dioxide (CO(2)) laser resurfacing. STUDY DESIGN/MATERIALS AND METHODS: Forty-two treatment sites on 21 patients were randomized and evaluated after treatment of the upper lip region with CO(2) laser resurfacing on one side and a variable pulse Er:YAG laser on the other. Patient diaries were maintained to assess erythema, crusting, pain, and pigmentary changes. Blinded objective grading of improvement was performed. Chromometer measurements were obtained to analyze erythema. RESULTS: The variable pulse Er:YAG laser treatment reduced the duration of crusting on average from 7.7 days with CO(2) to 3.4 days. Chromometer measurements noted decreased postoperative erythema. Grading by physicians in a blinded manner showed 63% improvement for the CO(2) treatment site and 48% improvement in the variable pulse Er:YAG site. No cases of permanent hyperpigmentation, hypopigmentation, or scarring occurred. CONCLUSION: The variable pulse Er:YAG laser resurfacing is a safe and effective resurfacing tool, which combines ablative and thermal modalities. The protocol used in this study approaches but does not equal the results we have traditionally seen with CO(2) laser resurfacing.

Carbon Dioxide↗

PubMed1999

Pericardio peritoneal window: laparoscopic approach.

Transdiaphragmatic approach to the pericarium through the use of the laparoscope is a safe and rapid way to obtain biopsy of the pericardium and create a window. No drainage tubes are needed: pericardial fluid is absorbed by the peritoneum; there is no need for double lumen tubes for one lung ventilation; and the laparoscopy incisions are small and almost painless.

Adenocarcinoma↗

PubMed1999

Hair removal using a long-pulsed alexandrite laser.

The use of lasers for hair depilation has become a common modality for physicians in the recent past. As new lasers are developed, the complex mechanisms affecting this form of treatment are now under close investigation. The long-pulsed alexandrite laser functioning at a wavelength of 755 nm has recently been added to the armamentarium of health care providers to assist patients with unwanted body hair. A review of the embryology and anatomy of the hair follicle are discussed, as well as the findings of recent studies using this form of laser therapy. Using the suggested treatment protocols offered laser assisted depilation may be effectively achieved. The degree and duration of reduction vary with anatomic site and improve with multiple treatments.

Face↗

PubMed1999

Polymethoxylated flavones derived from citrus suppress tumor necrosis factor-alpha expression by human monocytes.

Flavonoids isolated from citrus were evaluated for their ability to affect the inflammation response through suppression of cytokine expression by human monocytes. Several polymethoxylated flavones inhibited lipopolysaccharide-induced monocyte expression of tumor necrosis factor (TNFalpha). Subsequent studies centered on the compound 3,5,6,7,8,3',4'-heptamethoxyflavone (HMF) which produced the highest inhibition (IC50 = 5 microM). HMF was also a potent inhibitor of macrophage inflammatory protein-1alpha (MIP-1alpha) and interleukin-10 (IL-10) production, but not of IL-1beta, IL-6, or IL-8 production. Suppression of TNFalpha production was at the level of mRNA induction as determined by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). HMF was also a potent inhibitor of human phosphodiesterase activity and was shown to induce a substantial elevation of cAMP levels in monocytes. The similarity of these results to the inhibition profile of the known phosphodiesterase inhibitor, 3-isobutyl-1-methylxanthine, suggests that the polymethoxylated flavones inhibit cytokine production in part by suppression of phosphodiesterase activity. The ability of HMF to also inhibit IL-10 production suggests the additional existence of a phosphodiesterase-independent mechanism for this compound.

Citrus↗

PubMed1999

Laser therapy of spider leg veins: clinical evaluation of a new long pulsed alexandrite laser.

BACKGROUND: The response of spider leg veins to laser or intense pulsed light therapy has generally been characterized by varying degrees of success and frequently inconsistent clinical response rates. OBJECTIVE: The purpose of this study was to examine the effectiveness of the 755 nm long pulsed infrared alexandrite (LPA) laser for the treatment of leg telangiectasias. METHODS: This study was constructed in four phases. Phase I examined 28 patients with variable sized telangiectasias using 5 treatment parameters (15 J/cm2 x 1 pulse, 20 J/cm2 x 1 pulse, 20 J/cm2 x 2 pulses, 20 J/cm2 x 3 pulses, or 30 J/cm2 x 1 pulse). Each patient received 3 treatments at 4 week intervals with the LPA. Patient diaries were obtained to examine the effects of the treatments. Subjective grading was performed at each follow-up visit by the investigators. Blinded objective grading was performed at the conclusion of the study by trained observers. Phase II examined the effects of these treatment parameters on varying vessel diameters. Vessels were grouped into small (<0.4 mm), intermediate (0.4-1.0 mm), and large (1.0-3.0 mm) subsets. Phase III examined the effects of a combination of LPA treatment followed by 23.4% hypertonic saline sclerotherapy. Subjective and blinded objective grading was used to determine improvement after a single treatment with the LPA at 20 J/cm2, single pulsed with a pulse duration of 5 or 10 msec followed by treatment with 23.4% hypertonic saline injected 3, 7, 14, or 28 days after laser therapy. Phase IV involved biopsies after LPA treatment alone at time intervals of immediately posttreatment and 5 and 21 days posttreatment. RESULTS: These evaluations revealed that the optimal treatment parameters for LPA therapy alone appeared to be 20 J/cm2, double pulsed at a repetition rate of one Hz. After 3 treatments at 4 week intervals, subjective grading indicated a 63% reduction in leg telangiectasias. Medium diameter vessels responded best with small vessel diameters responding poorly, if at all. The addition of 23.4% hypertonic saline sclerotherapy performed 3 to 7 days after laser therapy (LPA at 20 J/cm2, single pulsed with a pulse duration of 5 msec) produced 87% reduction in leg telangiectasias. Biopsies after LPA treatment revealed vessel wall endothelial cell necrosis at 5 days with fibrosis occurring at 3 weeks. The optimal clinical "window" for sclerotherapy seems to coincide with the period of endothelial cell necrosis. CONCLUSION: LPA therapy is most effective for leg telangiectasias 0.4-3.0 mm in diameter. This LPA technique is significantly improved with the addition of sclerotherapy.

Adult↗

PubMed1999

Laser hair removal: a review and report on the use of the long-pulsed alexandrite laser for hair reduction of the upper lip, leg, back, and bikini region.

BACKGROUND: The mechanism and permanence of laser-assisted hair removal remains a formidable task in the medical community. OBJECTIVE: The purpose of this study was to determine the safety and long-term efficacy of the long-pulsed or normal mode alexandrite infrared laser for hair depilation. METHODS: Beginning in October 1996, a total of 31 anatomic sites on 22 patients ranging in age from 25 to 59 years (mean 42 years) were evaluated to assess hair removal. Treatment sites included 17 upper lips, 9 legs, 2 backs, and 3 bikini regions. Eligible patients were of Fitzpatrick skin types I-III. Patients were treated using the long-pulsed alexandrite infrared laser at 755 nm, single-pulse technique, 10 mm spot size, 10% overlap, pulse durations of 5, 10, and 20 msec, and a fluence of 20 J/cm2. Subjective patient improvement and objective, blinded graded improvement was assessed at 1, 2, 3, and 6 months. RESULTS: Objective blinded grading at 6 months revealed that hair reduction varied both with the pulse duration and anatomic location. Maximum reductions observed were 40%, 56%, 50%, and 15% for the lip, leg, back, and bikini areas, respectively. Upper lip hair reduction increased from 40% to 54% at 6 months when a second treatment was performed 8 weeks after the initial treatment. CONCLUSION: The long-pulsed alexandrite laser is safe and effective in reducing hair growth. Treatment efficacy varies with the anatomic location, pulse duration, and number of treatments. A single-pulse technique utilizing a 10 msec pulse duration at 20 J/cm2 produced the greatest hair reduction. No permanent adverse effects occurred on skin types I-III at the parameters tested.

Adult↗

PubMed1999

Combined CO2/erbium:YAG laser resurfacing of peri-oral rhytides and side-by-side comparison with carbon dioxide laser alone.

BACKGROUND: Laser resurfacing of facial rhytids has become a popular treatment option for many patients with wrinkles, photoaging, and acne scarring. Laser wavelength options and optimization of techniques continue to evolve in an attempt to shorten the healing phase associated with laser skin resurfacing. OBJECTIVE: To prospectively study the clinical effects of pulsed carbon dioxide (CO2) laser resurfacing of facial rhytids used alone, compared with a combination of CO2 and the pulsed Erbium:YAG (Er:YAG) laser. METHODS: Forty treatment sites on 20 patients were randomized and evaluated following treatment of the upper lip region with a combination of CO2 laser resurfacing alone or with the same CO2 laser treatment followed by 3 passes with the Er:YAG laser. Patient diaries were maintained to assess erythema, crusting, pain, itching, swelling, pigmentary changes, and the day of first make-up application. Blinded objective grading of improvement was independently assessed by 4 blinded observers at time intervals 3, 6, and 10 days, and 1, 2, and 4 months. Chromometer measurements of erythema were also analyzed and percentage moisture recorded. RESULTS: Subjectively, all patients reported, on average, 10 days of redness and 2.4 days of pain, with no significant difference noted between the two procedures. On average, patients were able to apply make-up 5.5 days postoperatively, regardless of which procedure used. However, the combined CO2/Er:YAG laser treatment patients experienced reduced duration of crusting, compared to the patients treated with CO2 alone. The duration of crusting was reduced on average from 7.4 to 6.5 days, and also the duration of itching was reduced in patients receiving combined treatment from 5.5 to 4.8 days. Chromometer measurements noted no significant difference between techniques in the rate of resolution of erythema. Blinded objective grading revealed that crusting was reduced on average from 7.2 to 6.0 days, and swelling was reduced from 6.3 to 6.0 days in patients receiving the combined procedure. No cases of permanent hyperpigmentation, hypopigmentation, or scarring occurred in any patients. CONCLUSION: The addition of the Er:YAG laser following CO2 laser resurfacing reduces the duration of crusting, swelling, and itching postoperatively. Medium to deep (Grade III) facial rhytids were improved by 70% with both procedures with no significant difference noted between techniques.

Adult↗

PubMed1998

Precautions in warming light therapy as an adjuvant to postoperative flap care.

Warming lights, circulating-water blankets, space heaters, and the Bair Hugger are used by surgeons in the perioperative period to maintain a patients core body temperature. Warming lights in particular are often used by plastic surgeons to augment the postoperative vasodilatation of reconstructive flaps by increasing the ambient temperature of the area around the flap. A review of the literature fails to elucidate even anecdotal experience regarding the actual intensity of thermal energy directly imparted to tissues from these modalities with respect to distance. The purpose of our study was to quantify actual tissue temperatures generated, as a function of distance, with the Emerson warming light. Our interest in this is a result of a full-thickness burn which occurred to a portion of a pedicled TRAM flap used for breast reconstruction when a warming light was inadvertently positioned, during the course of the first postoperative night, at a distance less than that recommended by the manufacturer. A biological model was created simulating a sympathectomized flap and the temperature curves generated by Emerson warming lights were recorded by calibrated glass bulb thermometers at 15 min intervals for distances of 32 and 71 cm using both focused and defocused light beams. The distance of 32 cm was used as a parameter as it was the distance noted between the patient and the warming light when the TRAM flap burn occurred. Temperatures obtained at a distance of 32 cm rose to 120 degrees F (48.8 degrees C) within 30 min for the focused beam and 118 degrees F (48 degrees C) after 1 h for the defocused beam. This exceeds the temperature at which tissue necrosis is known to occur (111.2 degrees F/44 degrees C). However, temperatures obtained at 71 cm for the focused and defocused beams plateaued at 93.2 and 96.8 degrees F (34 and 36 degrees C) respectively, which is well within physiologic limits and below the temperature resulting in tissue necrosis. Our conclusion is that warming lights can be successfully used as a safe adjuvant in order to optimize flap vasodilatation without compromising the thermal threshold of tissue damage if maintained at the manufacturer's minimum recommended distance of 71 cm. If this source of thermal energy is used, however, strict precautions and nursing guidelines must be instituted to maintain this minimum distance parameter and prevent patient morbidity.

Animals↗

PubMed1998

The gracilis free flap revisited: a review of 25 cases of transfer to traumatic extremity wounds.

Trauma to the extremities often results in a complex bony and soft-tissue injury requiring free flap reconstruction. Muscles from various body sites have been used in extremity reconstruction since the early 1970s. The gracilis muscle is usually not considered the first choice for free flap reconstruction of these defects. It is usually relegated to small defects or used to reanimate the face. Our purpose is to present our experience with the gracilis muscle as a first-choice flap in reconstruction of traumatic extremity defects. A retrospective review of all gracilis muscle free flap transfers for traumatic extremity wounds between 1988 and 1995 at the Naval Medical Center Portsmouth was performed. Twenty-five patients age 20 to 71 years (mean, 29.7 years) underwent 26 free flaps to the lower leg, ankle, foot, or forearm to cover traumatic wounds. Defects ranged in size from 3 x 3 cm (9 cm2) to 13 x 18 cm (234 cm2), with a mean of 75.5 cm2. There were no flap losses and all wounds healed. Nine patients experienced 11 complications, which consisted of minor wound separation (16%), wound infection (12%), partial or complete loss of split-thickness skin graft (8%), thrombosis of graft with successful revascularization (4%), and nonunion of an underlying fracture (4%). Our overall success rate for gracilis free flap reconstruction of traumatic wounds is 100%. The gracilis free muscle flap has become our first option for tissue coverage in traumatized extremities. It leaves minimal functional defect limited to the side of the primary injury and provides a good cosmetic result. It can cover large defects when the epimysium is cut, and allows an epidural block to be performed for sympathectomy effect and pain control in the affected extremity during the immediate postoperative period.

Adult↗

PubMed1998

Endoscopic intracorporal abdominoplasty: a review of 85 cases.

The specialty of plastic surgery has witnessed an explosion of novel procedures with the advent of endoscopy. Surgeons are making more aggressive attempts to reduce the length of scars and subsequent morbidity associated with traditional "open" procedures. Our purpose is to present a new technique of endoscopic abdominoplasty that has largely replaced traditional "full open" techniques at our institution. Since 1985, 85 patients have undergone a procedure that we call the endoscopic intracorporal abdominoplasty. This technique combines traditional abdominal wall liposuction with endoscopic intracorporal plication of the rectus fascia by using a series of horizontal mattress sutures. The procedure is performed using three 1-cm incisions and a series of midline and lateral skin nicks. These 85 patients were compared with 25 patients who underwent traditional open abdominoplasty with anterior plication of the rectus fascia. Average length of surgery was 127 minutes compared to 149 minutes with the open techniques. Length of hospitalization at our institution was 1 postoperative day compared to an average of 3 days with open techniques. No drains were used with the endoscopic techniques, and all of the open procedures had two drains placed. The perioperative rate of morbidity for the intracorporal abdominoplasty was 15 percent (13 of 85 patients) and with the open abdominoplasty cases it was 24 percent (6 of 25 patients). Our conclusion is that the endoscopic intracorporal abdominoplasty reduces operative scars and effectively plicates the rectus fascia, thereby reducing abdominal wall laxity. It has a rate of morbidity in a skilled laparoscopist's hands no greater than with traditional open abdominoplasty.

Abdominal Muscles↗

PubMed1998

Accelerated laser resurfacing wound healing using a triad of topical antioxidants.

BACKGROUND: The speed of wound healing and the duration of erythema are the primary complaints after laser skin resurfacing. Antioxidants have been shown to enhance the healing of wounds by reducing free radical damage. Reepithelialization is also enhanced by the moist environment produced by occlusive dressings. OBJECTIVE: This study was conducted to compare two occlusive agents: white petrolatum and "melting" petrolatum. Another arm of the study evaluated the use of melting petrolatum with and without a triad of topical antioxidants (TTA). RESULTS: Plain white petrolatum proved superior to melting petrolatum in time required for reepithelialization as well as in discomfort. Crusting and pain were decreased with white petrolatum but duration of erythema was equivalent. Wound healing was enhanced when TTA was added. Time for reepithelialization, duration of crusting and scabbing, pain, redness, and swelling were decreased when TTA was added to topical therapy. CONCLUSION: TTA compound enhances and hastens wound healing. White petrolatum as a base occlusive vehicle shortens reepithelialization compared with "melting" petrolatum.

Administration, Cutaneous↗

PubMed1998

Comparison of topical therapy for striae alba (20% glycolic acid/0.05% tretinoin versus 20% glycolic acid/10% L-ascorbic acid).

BACKGROUND: Topical treatment of striae rubra with 0.1% tretinoin and laser treatment of striae rubra and alba with the 585-nm pulsed dye laser are proven therapeutic options. However, little efficacy has been shown for treatment of striae alba topically, and the laser is currently not a suitable treatment option for darker ethnic skin types. OBJECTIVE: The purpose of this study was to demonstrate that selected commercial topical agents can improve the appearance of striae alba. METHODS: Ten patients of varying skin types (I-V) having straie distensae alba on the abdomen or thighs were selected to evaluate the effectiveness of two topical treatment regimens. Patients were placed on daily topical application of 20% glycolic acid (MD Forte) to the entire treatment area. In addition, the patients applied 10% L-ascorbic acid, 2% zinc sulfate, and 0.5% tyrosine to half to the treatment area and 0.05% tretinoin emollient cream (Renova) to the other half of the treatment area. The creams were applied on a daily basis for 12 weeks. Improvement was evaluated at 4 and 12 weeks in an objective unblinded fashion at the follow-up visits, a objective blinded fashion by visual grading at the conclusion of the study, and in an objective blinded fashion with profilometry. Additionally, histopathologic analysis was performed. RESULTS: Analysis of these data reveals: 1) both regimens can improve the appearance of stretch marks; 2) these topical therapy regimens are safe and effective in study patients with minimal irritation; 3) elastin content within the reticular and papillary dermis can increase with topical 20% glycolic acid combined with 0.05% tretinoin emollient cream therapy; 4) both regimens increased epidermal thickness and decreased papillary dermal thickness in treated stretch marks when compared with untreated stretch marks; 5) combined epidermal and papillary dermal thickness in stretch marks treated with either topical regimen approaches that of normal skin; and 6) profilometry can objectively measure differences in skin texture associated with striae treatments when compared to controls, however, it is not sensitive enough to justify comparison or quantitative improvements between similarly effective treatments.

Abdomen↗

PubMed1997

Abnormal fetal cardiac axis in the detection of intrathoracic anomalies and congenital heart disease.

In a 14-month period, 409 women with singleton gestations referred for perinatal ultrasound consultation underwent evaluation of the fetal cardiac axis. Cardiac and intrathoracic anomalies were confirmed either by neonatal echocardiography or autopsy. Overall, 32 fetuses had an abnormal axis (nine, smaller axis than normal; 23, larger axis than normal). Of the 29 found to have cardiac (n = 24) or intrathoracic (n = 5) anomalies, 23 had an abnormal axis. The median cardiac axis of the normal group (44.0 degrees) was significantly smaller than that of the cardiac/intrathoracic anomaly group(60.0 degrees) (p = 0.002). The cardiac axis was independent of gestational age. The mean interobserver variation was 1.3 +/- 1.8 degrees. The sensitivity of an abnormal axis (< 28 degrees or > 59 degrees) in detecting congenital heart disease or intrathoracic anomalies was 23/29 (79.3%), with specificity of 371/380 (97.5%), positive predictive value of 23/32 (71.9%), and negative predictive value of 371/377 (98.4%). Of those with a cardiac anomaly and an abnormal axis (n = 18), five were felt to have an initial normal four-chamber view. An abnormal fetal cardiac axis, either larger or smaller than normal, is suggestive of a cardiac or intrathoracic anomaly and requires further investigation, such as fetal echocardiography. The cardiac axis should be considered with the four-chamber view in fetal ultrasound evaluation.

Adult↗

PubMed1996

The sonographic finding of persistent umbilical cord cystic masses is associated with lethal aneuploidy and/or congenital anomalies.

Advancements in sonographic technology have led to improved prenatal detection of fetal anomalies. Umbilical cord cystic masses are being detected prenatally and several case reports have appeared in the literature. We report three new cases in which umbilical cord cystic masses were detected prenatally; two cases in the later half of pregnancy and one case in the first trimester. The literature was reviewed and summaries of the 23 reported cases of persistent second- and third-trimester umbilical cord cystic masses and their implications are discussed. There is a high association (18 of 23 cases) with lethal chromosomal anomalies and/or congenital malformations suggesting that the finding of an isolated umbilical cord cystic mass should lead to further detailed sonographic evaluation.

Adult↗

PubMed1996

Breast reduction under intravenous sedation: a review of 50 cases.

Breast reduction is a surgical procedure most commonly performed on an inpatient basis under general anesthesia. In the current climate of health care reform, we must evaluate such procedures to determine if there are alternate, less expensive, but equally safe means to perform them. Our purpose is to present our experience with 50 bilateral breast reductions performed under local anesthesia with intravenous sedation between October of 1991 and October of 1994. We have excluded bilateral reductions under 500 gm total, unilateral reductions, mastopexies, and gynecomastia procedures. Patients were sedated with intravenous Versed and fentanyl and a local solution consisting of marcaine, lidocaine, and 1:2000,000 epinephrine. Intercostal blocks were not used routinely. Monitoring and sedation were performed by nonanesthesia personnel in 49 patients. There were no complications relating to the sedation or to the local solution. All reductions were performed by the inferior pedicle technique. The average patient age was 28.0 years (20 to 67 years). The total breast tissue resected was 1372 gm (516 to 2948 gm), with 33 patients having resections greater than 1000 gm. Operative times averaged 3 hours (115 to 275 minutes). Forty-nine of the 50 patients tolerated the procedure with little or no recall. Twenty-eight patients were discharged on the same day as admission. One patient recalled some significant discomfort during parts of the procedure. All stated that they would again have the procedure performed under local anesthesia with intravenous sedation. Our conclusions are as follows: (1) Breast reduction can be performed safely and comfortably under local anesthesia with intravenous sedation. (2) Patients should be chosen on their acceptability as intravenous sedation candidates and not with regard to the amount of breast tissue removed. (3) There will be a subset of patients who can be discharged on the same day.

Adult↗

PubMed1996

Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser.

BACKGROUND: Striae, or stretch marks, are very common skin disorders that do not impair bodily function, but are of considerable cosmetic concern to many patients. Traditionally, treatment options have been very limited. This study examines the results of treating striae using the 585-nm pulsed dye laser. Stimulation of a variety of wound healing processes has been attributed to low energy laser therapy. Clinically, improvement of hypertrophic and erythematous scars with the 585-nm pulsed dye laser at energy densities of 6-7 J/cm2 is well established. Since striae are dermal scars, evaluation of this same therapy to treat striae was undertaken. OBJECTIVE: To evaluate the effectiveness of the 585-nm flashlamp-pumped pulse dye laser in treating cutaneous striae. METHODS: Thirty-nine striae were treated with four treatment protocols. These treated striae were compared with untreated striae controls in the same patient. The patients ages ranged from 23 to 52 years, with an average age of 36 years. The average age of the treated striae prior to initial treatment was 14 years (range, 8 months to 32 years). Treatment parameters included spot sizes of 7 and 10 mm and fluences of 2.0, 2.5, 3.0, and 4.0 J/cm2. Response to therapy was evaluated through clinical grading, sequential photography, and optical profilometry at a blinded laboratory. Skin biopsies were also examined with light microscopy from two of the 39 striae that were treated. RESULTS: Subjectively, striae appeared to return toward the appearance of normal skin with all protocols. However, the protocol with 10-mm spot size using 3.0 J/cm2 fluence improved the appearance of striae better than the other treatment protocols. Objectively, shadow profilometry revealed that all treatment protocols reduced skin shadowing in striae. This result corresponds with surface patterns of striae returning to that closely resembling adjacent normal skin surface patterns. Histologically, using hematoxylin and eosin stains as well as elastin strains, striae treated with a low fluence pulsed dye laser treatment protocol regained normal appearing elastin content when compared with normal (non-striae) skin adjacent to the treated striae. CONCLUSION: Treatment with the 585-nm pulsed dye laser at low energy densities was shown to improve the appearance of striae. Apparent increased dermal elastin was also observed 8 weeks posttherapy and possibly contributed to the improvement seen in the study patients.

Adult↗

PubMed1995

Identification of porcine sperm plasma membrane proteins that may play a role in sperm-egg fusion.

Sperm plasma membrane (PM) proteins that demonstrate affinity for egg PM preparations have the potential to be biologically important during sperm-egg binding and/or fusion. In this study four such proteins have been identified. To provide quantitative evidence for possible biological function, the large natural variation among different porcine sperm populations with regard to their ability to interact with the egg was compared with the relative binding of egg PM material to individual proteins. An aliquot from each of 24 porcine ejaculates was evaluated by the zona-free hamster ova bioassay and the remainder processed to yield sperm PM vesicles. Aliquots of sperm PM were solubilised, separated by SDS-PAGE, western blotted and probed with partially purified, biotinylated egg PM protein. Bound egg PM proteins were visualised on western blots by an avidin/biotin/horseradish peroxidase system and analysed by scanning laser densitometry. Four sperm PM proteins (62, 39, 27 and 7 kDa estimated molecular mass) were the predominant binders of egg PM. The amount of egg PM bound to the 62 kDa protein was significantly correlated with the ability of sperm from the 24 ejaculates to penetrate zona-free hamster ova (percentage of ova penetrated, p = 0.01, R = 0.65; number of penetrated sperm per ovum, p = 0.02, R = 0.63).

Animals↗