Scars Holistic Treatment
Tarnower Herman MD 191080 Developer of the Scarsdale Diet 1979 which stresses high protein and low calories
T arnower states that he developed the diet at the Scars-dale Medical Center in suburban, affluent New York when he urged his cardiac patients to take off that unhealthy flab (Tarnower and Baker 1980 2). His diet suggestions came out of his general and cardiac practice, but clearly followed the growing health and diet consciousness of the middle-class, suburban baby boomer generation, who by the i970s were entering into middle age. Successful diet books could sell millions of copies, and diet books that were labeled medical and linked with images of affluence (Scarsdale) were programmed for success. and the beautiful people of Scarsdale are now the skinny people of Scarsdale due to the work of the unknown Herman Tarnower (Alexander 1983 150). The publicity reached Oscar Dystel, the president of Bantam Books and a patient of Tarnower's Scarsdale medical group, who suggested to Samm Sinclair Baker that he contact Tar-nower. Baker was looking for another diet doc to follow up the...
After injury, self-healing proceeds in three stages inflammation, cellular regeneration and differentiation, and tissue replacement. During this process, primordial cells and fibroblast cells are produced. They secrete fibrogen for the construction of tissue fibers. Usually the formation of connective fibers predominates over formation of muscle, capillary, and capsule tissues. Some of this scar tissue will be absorbed and some will persist, which may cause permanent dysfunction of the organs and soft tissue.
An alternative to the chemical conjugate approach was developed by creating a single recombinant fusion molecule formed by the soluble extracellular form of CAR (sCAR) fused to epidermal growth factor (EGF) (53). Increased reporter gene expression was achieved in several EGFR-overex-pressing cancer cell lines compared with untargeted Ad or EGFR-negative cells in vitro. EGF-directed targeting to EGFR-positive cells was shown to be dependent on cell surface EGFR density. Initial proof-of-concept studies were followed up with construction of adenoviruses coding for the adapter and capable of achieving production and secretion of sCAR-EGF in human cells. Further, the effect of such retarget ing on the oncolytic potency of replication competent agents was tested in vitro and in vivo (54). To improve Ad-sCAR-li-gand complex stability, a trimeric sCAR-fibitin-anti-erbB2 single-chain antibody (sFv) adapter molecule was developed (55). The adapter displayed increased affinity to the Ad fiber...
Traditional Medicinal Uses The leaves are used as a tonic to treat bleeding resulting from coughs. 12 It is also used for cold and haemorrhage. Liquor brewed from fresh leaves is used as a tonic and to treat hemoptysis. Others include treatment for convulsions, excessive sweating and hepatitis. 3 Its roots are used on burns, scalds and to promote hair growth on scars. 3
Chronic soft tissue syndrome is not limited to mus-culoskeletal tissue. Compensatory dysfunctions such as contracture, adhesion, scarring, and blockage of circulation also develop after visceral injuries. Listed here are some examples, but underlying these different types of visceral pathology is the same chronic soft tissue syndrome caused by inflammation, contracture, adhesion, scarring, and blockage of local microcirculation. The following information was collected by the author from research performed in China Heart Many cardiovascular diseases involve contracture or hypertrophy of cardiac muscle fibers, adhesion of fibers, scar tissue, and blockage of circulation. Stomach Gastritis or gastric ulcer results in contracture and adhesion of muscle cells with the mucous membrane, accompanied by scars and blockage of circulation. Intestine Chronic inflammation produces contracture and adhesion of soft tissues with scar formation and blockage of circulation.
The lesion artificially created by needling mimics accidental injury but on a very small scale. When needling-induced lesions heal, no scarring is formed. Knowledge of the underlying mechanisms of these lesions enables clinicians to further understand the local axon reflex induced by needling.
The scarification of the skin during vaccination for smallpox results in viral replication in the dermis, pox formation over 5 to 7 days, and an aggressive immune response against the virus, which eliminates the virus and prevents systemic spread. A permanent scar in the skin results from the infection. It is not difficult to imagine that, if such an infection occurred in an organ such as the brain, this could result in a poor outcome. During vaccination for smallpox, some patients with T cell-deficient immune systems suffered progressive systemic infection and death from vaccinia (63). In vaccine trials for HIV patients, deaths have been attributed to systemic viremia in the setting of an immunocompromised host (91). Although intradermal delivery is quite safe for the vaccine strains, more virulent strains such as WR delivered systemically may be more pathogenic. These viruses need to be carefully examined in preclinical toxicology studies prior to human trials.
Going through cancer treatment often leads to musculoskeletal or other problems that can limit one's ability to exercise. Surgery can cause residual pain for weeks or even months. Scar tissue can reduce the range of motion of joints. Chemotherapy and radiation can also cause side effects that place limitations on exercise. For example, Carol is a 50-year-old woman who came to see me after she was diagnosed with breast cancer. Initially Carol underwent a right mastectomy combined with breast reconstruction. A few months later she had breast reduction surgery on her unaffected side to make her breasts the same size. Following this operation, the pathology reports revealed that Carol had cancer in her left breast as well, so she elected to have a left mastectomy with another reconstruction procedure, combined with chemotherapy and radiation. When I initially saw Carol in consultation more than a year later, she was complaining of tightness and pressure across her chest and she couldn't...
General Health Issues or But I Want to Hang Out in the Sun in a Tiny Bikini Smoking Cigarettes and Drinking with My
Exposure to sunlight (UVB radiation) should be avoided by adolescents with SLE. Some patients with SLE will develop scarring photosensitive rashes on UV exposure, and this exposure may also lead to an increase in SLE symptoms. Adolescents should be advised to use a sunscreen with SPF over 30 every day. Although particular care should be taken on sunny days, even a walk to school on an overcast day can be a problem. Use of a hat for facial protection is also advised. Certainly, suntanning is not recommended, and attending a tanning salon is definitely not advised.
In time, some of my adult friends allowed me to see their self-inflicted scars and shared their stories on past suicide attempts. In time I met some of their parents. The act of self-inflicting injuries caused pain to both parties. For many years these parents were unable to understand why their children behaved that way. Because their children spoke fluently (Asperger's Syndrome) the parents carers assumed that their children knew the implication of their actions (implied meaning again). Through our extended and repetitive dialogues I was able to find out the extent of their reasoning. Here are some reasons behind the actions of my friends and what the parents assumed had happened.
In the 1970s, the concept of coronary angioplasty went unnoticed as companies such as Bentley Laboratories (eventually bought by American Hospital Supply, which was then bought by Baxter and spun out as part of Edwards Lifesciences) and Cobe (bought by Sorin Biomedica) fought it out in the market for CABG. CABG is a highly invasive procedure that involves physical access into the thoracic cavity, and at the time, was the standard of care for treating occlusions in coronary vessels. A catheter-based percutaneous solution was first introduced in the 1960s and was conceived to reduce scarring, hospital stays, and, in turn, costs. In the decade to follow, smaller players such as Scimed, Schneider (now both part of Boston Scientific), and ACS (Guidant's vascular franchise) developed the technique and launched their first products in the United States in 1980. PTCA flew under the radar of the established players, as the technology needed to be refined for several years before penetration...
At the cellular level, myocardial infarction results in the formation of a scar that is composed of cardiac fibroblasts. Given the terminal differentiation of cardiomyocytes, loss of cell mass due to infarction does not result in the regeneration of myocytes to repopulate the wound. Researchers have therefore pursued the possibility of genetically converting cardiac fibroblasts into functional cardiomyocytes. The feasibility of this notion gained support from the work of Tam et al. (95), who demonstrated the in vitro conversion of cardiac fibro-blasts into cells resembling skeletal myocytes via the forced expression of a skeletal muscle lineage-determining gene, MyoD, using retroviral-mediated gene transfer. Fibroblasts expressing the MyoD gene were observed to develop multinu-cleated myotubes similar to those seen in striated muscle, which expressed MHC and myocyte-specific enhancer factor-2. Additionally, Murry et al. (96) also showed expression of myogenin and embryonic skeletal...
Suspected recurrent loco-regional disease or distant metastases to the liver and lung may be imaged with chest X-ray, CT or MRI. Tumour spread into the inferior vena cava may also be accurately assessed by MRI, making caval venography obsolete. T2 weighted MRI images are useful in differentiating recurrent tumour from scar tissue in the operative field. USS or CT guided FNAC or needle biopsy provides histological confirmation of local recurrence, hepatic or other metastatic disease.
We have been blessed to learn from studying the remains of Egyptian mummies. They ate a diet much like we have been told to eat as of recent. Low fat, high carbohydrate, grains and corn residue have been discovered in their stomachs upon dissection. Their blood vessels had scarring similar to individuals today who have high blood pressure.
There are other reasons why early preemptive identification of patients with GBCA is technically favorable to a reoperative approach. After cholecystectomy, patients naturally form adhesions in the portal hepatis and gallbladder fossa, which can make it difficult to distinguish benign scar tissue and tumor.31 This in turn may lead to more extensive resections than would otherwise be necessary and could result in unnecessary biliary or liver resections.
Technique uses radiofrequency ablation that damages or cooks the LES, causing scarring and contraction of the area, which tightens it this procedure is called Stretta. Several techniques similar to a Nissen fundoplication wrap the stomach around the bottom of the esophagus and stitch it in place using the endoscope. These techniques are all different but have a similar result and are called the NDO Plicator, Bard EndoCinch, and the Wilson-Cook Endoscopic Suturing Device. All of these endoscopic therapies are FDA approved and are in use. They are discussed separately in the following questions.
I met the child who knew 1000 words but never put a sentence together. During his programme all he had learned was to feel afraid of people. I have also sheltered people who ran away from those techniques and rubbed cream on their self-inflicted scars. I received phone calls from autistic people after an article that described autistic behaviour as 'manic' made the headlines. They shared their desire to phone the writer but they were afraid of being labelled 'manic' for phoning in. What a vicious circle, don't you think There are children who continue to be tied to their beds, locked in solitary confinement or placed under heavy sedation - all that to teach them not to behave in an autistic way. It makes me wonder what happened to us, we the non-autistic people
SJS usually lasts four to six weeks and can be complicated by electrolyte imbalance, dehydration, secondary infections, and severe pneumonitis. Large areas of denudation can cause scarring leading to contractures. Ocular complications include corneal scarring, pseudomembrane formation leading to immobility of the eyelids, and lacrimal duct scarring. Lesions of the oral mucosa usually heal without complications. Esophageal or anal involvement can lead to strictures, and vaginal or urethral mucosal lesions can cause stenosis.
Plastic surgery techniques have been used to correct atrophy and scarring (100-103). For best results, surgery should be carried out when lesions are inactive, as otherwise, the imported tissue can become affected in the disease process. If it is imperative to do surgery while the lesion is active, for psychological reasons, surgery should be kept as simple as possible so that reconstructive surgery is possible at a later date. Surgical options include free fat grafting, autologous dermofat grafting, osteotomies, and bony augmentation with soft-tissue expansion and vascularized free-tissue transfer.
(8)(a) A scar extends from his ankle to his knee. (b) A scar extends from his knee to his ankle. (9) A scar extends to his knee from his ankle. step is not required. Nor in (8)(b), where we scan only once along the path but in the opposite direction. But in all cases the scar itself is static - the spatial path reflects our dynamic construal of the static situation.
On the auricle of healthy persons there are often different manifestations such as pigmentations, white nodules, small pustules and scars from chilblains, etc. Most of these are 'false appearances'. A method for distinguishing these is first inspect, secondly press. If pressure does not cause pain this indicates that the manifestation pertains to a 'false positive reaction'. our countries to find scars from chilblains. Tenderness at pressure of a skin alteration is, however, fundamental for diagnosis and may be used to treat symptoms. For example, acupuncture on a sensitive telangiectasia located within the representative area of a painful joint sometimes gives very quick and lasting relief. scar
Symptoms The first sign is excessive sensitivity in an area of skin, followed by pain after about five days the rash appears, turning into tense blisters that turn yellow within three more days. The blisters then dry out and crust over, gradually dropping off (leaving small pitted scars behind). Because the nerves have been damaged after the virus attack, after the blisters heal the nerves constantly produce strong pain impulses that may last for months or years. Examples of bacterial skin infections include impetigo, ecthyma, folliculitis, boils, carbuncles, erysipelas, scarlet fever, cellulitis, etc. Viral infections with skin symptoms include herpes simplex, chicken-pox, and shingles, warts, measles, german measles, fifth disease, aids, etc. smallpox A highly infectious serious viral disease (causing skin rash and flulike symptoms) that has been totally eradicated since 1980. A common scourge of the 19th century, smallpox was characterized by a rash that spread over the body,...
A century later auricular cauterization was brought back to light and ear acupuncture had a new lease of scientific life. The years 1950-51 were important ones for the French physician Paul Nogier of Lyons (1908-1996). Nogier was impressed by the scar on the anthelix borne by some patients who had been treated for sciatica by healers in south-eastern France. The unanimous tale of these patients was that of a rapid recovery from pain within hours, or even minutes, after treatment. An evident connection between cauterization and the alleviation of pain could not be denied and Dr Nogier, without preconception, started treating patients in the same way. At first he applied cauterizations and later a less harmful method such as pins or acupuncture
Burning off the wart with liquid nitrogen is often effective, nontoxic, and does not require anesthesia. If done properly, it does not scar. Cutting out the wart may also be successful. While alpha interferon is available for treatment of resistant cases, it is not recommended because of its high likelihood of toxicity, low effectiveness, and expense.
Before a muscle biopsy is done it is often useful to obtain an MRI of the thighs. Inflamed muscles are swollen and show up on the MRI because they have greater water content than uninvolved muscles. Once the MRI has demonstrated the presence of inflamed muscles in a weak child, a muscle biopsy may not need to be done unless another cause of muscle inflammation is suspected the diagnosis may be made on the basis of a characteristic history and examination findings with confirmatory laboratory tests. Children with dermatomyositis frequently have poor skin healing, and a biopsy may leave a significant scar.
Lumbar pedicle fixation has proven to be a safe, effective means of lumbar stabilization. Prospective, randomized trials and community clinical experience using lumbar instrumentation have demonstrated an increased fusion rate. Lumbar instrumentation has also improved the ability to mobilize patients after surgery and perhaps brace them for shorter periods of time or not at all. To date, techniques of lumbar pedicle screw placement have involved a single midline or bilateral paramedian incision. Some degree of muscular tendon detachment from the bone and muscle retraction has been necessary. Without question, this is a source of postoperative pain and subsequent muscle atrophy and scar formation.
Raphael Nogier49 reported a specific set of points aimed at diagnosing particular co-factors to be checked in every patient with migraine, such as the oculomotor point pertaining to movements of the eye the interference of active scars and dental foci according to the principles of neuralther-apy the irritation due to the so-called 'first rib syndrome' and possible allergy and intolerance to food negatively influencing frequency and intensity of migraine attacks (Fig. 5.26).
Symptoms Slow eruption of teeth, wisdom teeth problems, and defects in skin, hair, and nails, due to poor absorption of minerals in the diet. Brittle, distorted, infected nails and ingrown toenails are also common symptoms. Wounds, even scratches, suppurate and heal slowly abscesses may form anywhere, including in the roots of teeth. There may be itchy scars or keloids after larger wounds,
Vomiting is a very common occurrence. Vomiting can occur early on as a result of swelling (due to the surgery) of the tissue surrounding the opening (stoma) between your new stomach pouch and the intestines. This typically resolves as the swelling due to surgery subsides. But sometimes scar tissue can develop at the same site. If or when the scar tissue creates a physical barrier that food cannot bypass, vomiting occurs. In this situation your surgeon may have to pass an endoscope (a tube with a light on the end that allows your doctor to see into your new pouch and even operate) into your stomach pouch and enlarge the opening a little. Sometimes once solid food is allowed, a person swallows a large piece of meat or other food. The food may have difficulty passing through the stoma. In general, over time the food will pass, but there have been cases where a big piece of meat has had to be removed using an endoscope. Vitamin deficiencies can develop following any gastric bypass...
Figure 1.11 The middle-inner part of the disc wall acts like a capsule to bear load whereas the outer part holds the segments together and is more like a tensile skin. Like any ligament, this 'ligamentous' part of the disc can scar and adaptively shorten, which makes that segment become a stiff link in the spine. Figure 1.11 The middle-inner part of the disc wall acts like a capsule to bear load whereas the outer part holds the segments together and is more like a tensile skin. Like any ligament, this 'ligamentous' part of the disc can scar and adaptively shorten, which makes that segment become a stiff link in the spine.
An esophageal stricture is a different kind of esophageal narrowing (see color plate 2). Strictures generally do get worse with minor difficulty swallowing solids that may progress to extreme difficulty with solids or, rarely, solids and liquids. Strictures are usually benign and result from chronic acid damage to the esophagus that causes the formation of scarring and contraction of the esophagus. Rarely, a stricture can be caused by cancer (discussed later). Barium studies can diagnose a stricture but may not be able to tell whether it is benign or malignant, and frequently an endoscopy is needed to make the ultimate diagnosis. Because strictures are caused by inflammation and chronic acid damage, they are longer and involve more of the esophagus than rings do. Strictures are scarring of not only the lining but also the wall of the esophagus. To allow healing they require more potent medication such as a PPI, which takes away the underlying cause of the stricture and allows the...
Focal nodular hyperplasia is defined as a nodule that consists of benign-appearing hepatocytes which are accompanied by fibrous stroma and which may contain ductules that form a characteristic central stellate scar. It usually occurs in an otherwise histologically normal or nearly normal liver. Macroscopically, FNH shows septations and, in classical cases, a central scar. However, in up to 30 of all cases a central scar is not present. In contrast to fibrolamellar carcinoma (126.96.36.199), the scar is not a true one, but rather congeries of blood vessels and bile ducts and sometimes a focal area of cirrhosis.An elevated fat- and glycogen-content can often be demonstrated. FNH is thought to derive from an initial regional vascular arteriovenous (AV) malformation which undergoes consecutive localized overgrowth of all liver constituents. Thus, histologically, FNH consists of abnormally arranged normal liver cells (Fig. 5). In contrast to adenoma, small bile ductules that do not communicate...
The presence of nodular enhancement which is isodense with the aorta has been found to be about 70 sensitive and 100 specific in differentiating hemangioma from hepatic metastases 59 .Although small lesions often fill-in rapidly and completely (Fig. 5), large tumors may show central non-enhanced areas corresponding to scar tissue, myxoid changes or cystic cavities (Fig. 4) 118 .
The majority of individuals ultimately diagnosed with SS initially present with dry eyes and or dry mouth. A few will present with the result of a secretory deficiency such as increased dental decay at incisal edges or exposed root surfaces of the teeth, oral mucosal burning secondary to a fungal infection, and corneal ulceration or corneal scarring. Dryness complaints may be accompanied by involvement of a diverse array of other organ systems Hashimoto's thyroiditis Graves' disease, severe fatigue, increased sedimentation rate, fever of unknown origin, myositis, peripheral neuropathy, leukocytoclastic vasculitis-purpura, renal tubular acidosis, atrophic gastritis, arthritis, and positive test for antinuclear antibodies or RF in asymptomatic patients (2,5,6).
But not all Yanomamo men are the same. There are at least two discernible groups that dif fer profoundly in personality . The lowland Yanomamo men are highly aggressive. They do not hesitate to hit their wives with sticks for infractions as minor as serving tea too slowly . They often challenge other men to club fights or ax fights And they sometimes declare war on neighboring villages, attempting to kill the enemy men and capture their wives. These Yanomamo men shave the tops of their heads to reveal proudly the scars from club fights sometimes painting the scars red to display them as symbols of courage and endurance. Indeed, one is not regarded as a true man until one has killed another man acquiring the honor of being called an unokai. The men who are unokai have the most wives (Chagnon, 1988).
When tissue is damaged, it scars and shortens or contracts and becomes stiffer. When the body repairs a wound, it uses a material it produces called collagen. Collagen in your body provides strength and elasticity to tissues. As you age, for example, collagen breaks down and leads to wrinkles also, plastic surgeons use collagen injections to treat wrinkles. A Stretta procedure uses this concept of scarring and collagen production to reinforce the lower esophageal sphincter (see Figure 15). First, the patient is heavily sedated or given general anesthesia and undergoes a regular endoscopy test. Then, the endoscope is removed and a probe is placed in the esophagus at the level of the LES. This tool has several needles sticking out to pierce the wall of the esophagus. When in place, radiofrequency energy (like that used in a microwave oven) is passed down the probe and out the needles into the esophageal wall. This causes the local temperature of the tissues to increase, virtually to the...
Cutting a circumcision scar In some communities, circumcision of girls (also called female genital cutting) is common . Female genital cutting (FGC) causes scars that may not stretch enough to let the baby out If the mother has been circumcised, you may need to cut open the scar of the circumcision before the baby's head starts to crown . Page 367 explains more about female genital cutting, and how to cut a circumcision scar .
Pantothenic acid has been both used as an oral supplement and applied topically in a cream base to enhance wound healing and it has been shown to accelerate closure of wounds and increase strength of scar tissue in experimental animals (Plesofsky 2002, Vaxman et al 1990). Although these results are encouraging, there has been little investigation in humans. One double-blind study testing the effects of vitamin C (1000 mg) and pantothenic acid (200 mg) supplements over a 21 -day period showed no significant alteration to wound healing with this treatment regimen (Vaxman et al 1995).
MMP is a chronic autoimmune mucocutaneous disease in which autoantibodies directed at structural proteins of the hemidesmosome destroy the epithelial-connective tissue attachment at the level of the basement membrane, producing a subepithelial separation (24,25). The protein targets of the autoantibodies include BP-1, BP-2, and laminin-5 (epiligrin), all components of the epithelial anchoring apparatus. MMP is a generalized term for a group of closely related disease processes (26). The term oral mucous membrane pemphigoid is used if the lesions are confined to the oral mucosa (Fig. 31). The term cicatricial pemphigoid is applied to patients with involvement of the ocular mucosa, which produces scarring and may result in blindness. The term bullous pemphigoid is the untoward effects of treatment. Involvement of the ocular mucosa in cicatricial pemphigoid produces scarring and may result in blindness. The lesions may remain localized to the gingiva for a period but generally progress...
The cellular structure of FNH is similar to that of the normal hepatic parenchyma apart from the presence of an abnormal biliary system. Since FNH contains the same elements as normal liver but with a disordered architecture, it mimics the appearance of normal liver and may be difficult to detect using any of the imaging modalities without exogenous contrast agents. On unenhanced MR imaging, the lesion is iso- to hypointense compared to normal liver on T1-weighted images, frequently with a hypointense central fibrous scar. On T2-weighted images it is isointense to mildly hyperin-tense compared to normal liver, with a hyperin-tense central scar. On dynamic Gd-enhanced T1-weighted images, the lesions show intense enhancement in the arterial phase that washes out rapidly on portal-venous and subsequent equilibrium phase images. A key characteristic of this enhancement is a homogeneous appearance (other than the central scar) which aids in differentiating these lesions from fibrolamellar...
Mann-burchard reaction for cholesterol. scifers Cornish name for Welsh onion (see onion, welsh). scintillation counter Instrument for measurement of radioactivity by emission of light from a solid or liquid scintillator that emits a photon after absorbing a P-particle or y-ray. sclerosis Hardening of tissue due to scarring, inflammation or ageing.
Fig. 9.4 Tender points of the ear lobe of a 52-year-old female patient with current vertigo attack. One tender point coincides with the scar of piercing. Fig. 9.4 Tender points of the ear lobe of a 52-year-old female patient with current vertigo attack. One tender point coincides with the scar of piercing.
Cicatricial pemphigoid (CP), Stevens-Johnson syndrome (SJS), and epidermolysis bullosa (EB) are rare causes of pharyngitis that deserve mentioning. CP is a rare, chronic blistering disease that involves the oral mucosa in nearly all patients lesions may extend to the oropharynx in a significant number of persons. Blisters, ulcers, erosions, and scarring are demonstrated clinically. Diagnosis is made by tissue biopsy and immunostaining microscopy. Steroids and other immunosup-pressants are used for supportive treatment. EB is a rare disorder characterized by skin and mucosal blister formation in response to mechanical trauma. The majority of cases are genetically inherited, although spontaneous cases are possible. Several forms of EB have been described, including EB simplex, EB junctional, and EB dystrophic, in order of decreasing incidence. The pathophysiology of this disease results from IgG autoantibodies targeting anchoring fibrils of collagen in the...
If scar tissue from adhesion has already developed, more tissue stretching is needed to reduce it. The rhythmic contraction and vibration created by the electrical current facilitates the separation of tissue that is in the process of becoming adhered or has already adhered. This rhythmic contraction may also have the effect of loosening and breaking up scar tissue. In summary, the clinical value of electrical acupuncture stimulation is that it can reduce adhesion and prevent the formation of scar tissue, as well as improve blood and lymphatic circulation by subjecting the muscles to passive movement.
The correct and appropriated mobilization of the scars to avoid adherence and important alterations in the posture of the patient is also highly relevant. This procedure contributes to the improvement of the quality of life of the patient immediatly and in the future 5 .
Partial restoration of gene expression can be achieved through direct injection of naked DNA into the human skin diseased area, but underscore the need for new advances to achieve efficient and sustained plasmid-based gene delivery to the skin. b. Junctional EB. There are 2 major forms of junctional EB, the Herlitz variant or EB letalis, and generalized atrophic benign EB (GABEB). In addition, there are several other variants (120). Both forms are transmitted in an autosomal recessive manner, and both have onset at birth and are associated with marked skin fragility and generalized blister formation. Although scarring and milia formation are usually absent in both forms of junctional EB, skin atrophy is a characteristic finding in GABEB patients who also tend to have marked dystrophic or absent nails, palmoplantar hyperkeratosis, and significant scarring alopecia of the scalp (120). A characteristic feature of Herlitz disease is the development of large, non-healing areas of...
Frozen shoulder is caused by scar tissue formed inside the space of the glenohumeral joint with reduced synovial fluid. This condition usually occurs after repeated tearing of soft tissue surrounding the joint, or it may be caused by scar tissue formed after shoulder injury or by adhesion after surgery. The joint capsule appears to be a major source of limitation of movement in this condition. A dull, aching pain is felt in the shoulder when the arm is lifted, and it often gets worse at night.
It is also important to talk with your partner about how your diagnosis will affect your sex life. Cervical cancer itself may make sex difficult, since vaginal intercourse can cause bleeding or pain. After surgery you should not have sex for at least 4-6 weeks (until the doctor examines you and says you are healed). Surgery may shorten the length of your vagina. Radiation can cause scarring and thinning of the vaginal walls, making intercourse more difficult. Using dilators and vaginal creams can help keep the vagina open after radiation. Exploring different positions may help, given the changes in your anatomy. It is also important to remember that there are many other ways to express love and experience sexual pleasure such as dancing, cuddling, petting, and oral stimulation. While it may be difficult to talk about these issues with your partner, it is better to have a frank discussion rather than remain silent.
In a survey of 57 lung cancer survivors, 56 had frequent pain, 46 had chronic pain from scars and surgery 25 had pain not controlled by medication.124 7.3.2.a. Post thoracotomy pain syndrome. In this syndrome, pain recurs or persists along a throracotomy scar at least 2 months following the surgical procedure.125 The prevalence varies. It has been estimated that 50 of patients who undergo thoracotomy will have mild to moderate pain and 5 of patients will have severe post thoracotomy pain.126 Pain at postoperative day 1 is predictive of pain 1 month and 1 year after thoracotomy.127 Physical exam usually shows sensory abnormalities such as absence of sensation or allodynia. Tumor recurrence should be excluded if the character of the pain changes, or becomes increasingly severe. Earlier reviews found little evidence for effective interventions.128 Capsaicin was effective in a trial for surgical neuropathic pain (see above),36 and topiramate was active in a small series of patients.129...
Focal nodular hyperplasia. A 13 year old boy presented with an unclear liver lesion on US, and had a medical history of chemotherapy and surgery for neuroblastoma. On the T2-weighted HASTE image (a), an isointense lesion (arrow) surrounded by a hypointense rim is visible in segment VII of the right liver lobe. The lesion is slightly hypointense on the corresponding T1-weighted in-phase image (b), and hyperintense on the T1-weighted fat-suppressed (c) and T1-weighted out-of-phase (d) images. Note the diffuse steatosis of the liver indicated by the reduced liver SI on the out-of-phase image due to preceding chemotherapy. On the arterial phase image (e) after administration of Gd-BOPTA (0.05 mmol kg), the lesion shows intense hypervascularisation with depiction of a central scar. On the portal venous phase image (f), the central scar shows uptake of contrast agent this is characteristic for FNH. This diagnosis is confirmed by the behavior of the lesion on the T1-weighted...
Scarring of tissue Soft tissue pain, especially chronic pain, always involves all these dysfunctions and clinicians should treat all of them to achieve the optimum level of pain relief and recovery of tissue function. For example, when a joint is out of alignment, it causes both the attached and opposing muscle groups to be shortened or lengthened, which compromises the surrounding neuromuscular structures and connective tissues. Muscle spasm, muscle tension, and increased sympathetic output ensue, resulting in soft tissue pain, and the development of trigger points, edema, ischemia, and tissue degeneration. If the condition continues to the point of becoming chronic, tissue adhesion and the formation of scar tissue will occur and central sensitization will follow.
Skin disease occurs in 20 to 25 of patients with sarcoidosis, including lesions on the head and neck. Sarcoid skin lesions may appear as a maculopapular eruption of the alae nares, lips, eyelids, forehead, posterior neck, and at sites of trauma pink nodular facial lesions and plaque-like lesions, such as lupus pernio, a violaceous discoloration of the nose, cheeks, chin, and ears (30,33). Other cutaneous manifestations outside the head and neck region include erythema nodosum changes in old scars alopecia subcutaneous nodules and psoriaform, hypopigmented, morpheaform, and rosacea-like lesions (30,33). The simultaneous development of erythema nodosum, hilar adenopathy, migratory polyarthralgias, and fever is referred to as Lofgren's syndrome and occurs primarily in women.
Abnormal bone growth is often related to soft tissue dysfunction. Contracture, or shortened tissue, usually applies increased physical force to the bone. This results in an abnormal growth of bone material to adjust to the increased pulling force on the bone surface. In addition, shortening of the soft tissues, adhesions, scars, and blockage cause changes
Further developed by dentists, ophthalmologists and podiatrists. Acupuncturists too play a role in the investigation of postural disorders in patients with recurrent back problems for example they can individuate and test any scars for a negative influence on the patient's harmonious postural balance.
A chronic inflammatory disorder of the sebaceous glands which leads to the over-production of sebum. It involves the face, back and chest and is characterised by the presence of greasy, oily skin with enlarged pores, inflammation in and around the sebaceous glands, papules, pustules and, in more severe cases, cysts and scars. The damage to collagen and elastin in the dermis can lead to depressed and raised scars (the scars resulting from cysts are called ice-pick scars)
Treatment The condition is treated with prompt administration of antistaphylococcal antibiotics. Patients often appear very ill with dehydration they are at risk of secondary infection. The skin should be covered with wet dressings and antibiotic ointments such as bacitracin. Patients usually heal without scarring within a week. It is important to maintain correct body temperature infants must be kept warm, but any sudden rise in body temperature could indicate blood infection and the immediate need for more aggressive treatment. The skin should be loosely clothed and covered so as to reduce friction. Cotton should be inserted between affected fingers and toes to prevent scarring. Warm baths and soaks help healing and gentle removal of peeling skin will help. Scars from this condition rarely occur.
Damaged, but they are relatively preserved as compared with myelin. After the initial insult by these cells, scarring begins. This process varies greatly from one individual to another. Curiously, the macrophages contain hormones like brain-derived nerve growth factor that should stimulate repair. The macrophage also secretes another hormone that stimulates scarring (T-cell growth factor beta-1). The invading cells seeking to remove some unknown enemy virus or protein seem prepared to help in rebuilding the damaged tissue. Later in the development of the plaque, scarring occurs. It is this scarring that makes the plaque hard (sclerotic). In summary, the plaque is an area of intense inflammation with myelin damage where the nerve fibers are relatively preserved and show variable amounts of scarring.
CLD is characterized by decreased or absent hepatic secretion of bile into the intestine. The most common cause of CLD in children requiring liver transplantation is biliary atresia. Biliary atresia is a progressive disorder characterized by an inflammatory reaction towards the extrahepatic and intra-hepatic bile ducts, leading to their destruction and subsequent replacement by fibrotic scar tissue. The etiology of biliary atresia remains unknown, although an inflammatory reaction to a detrimental stimulus seems to play an initiating role. Suggested initiating stimuli include specific perinatal viral infections, genetic factors, defects in immune response, as well as defects in morphogenesis. Another disease that can lead to end-stage liver disease in infancy is Alagille's syndrome, an autosomal dominantly inherited syndrome including bile duct hypoplasia, and congenital anatomical defects in other organs. Progressive familial intrahepatic cholestasis (PFIC) is also a genetically...
A child with Class IV kidney involvement is at serious risk of kidney damage and even failure and must be treated appropriately. If you are told that your child has a class IV biopsy, you need to know the activity score, which measures inflammation in the kidney, and the chronicity score, which estimates the amount of scarring in the kidney. If the chronicity index is very high, it does not make sense to treat the child aggressively, as badly scarred kidneys are not going to recover. The key to a successful outcome is to catch the involvement early and prevent the chronicity index from going up over time. Class V biopsies indicate the serious kidney damage called membranous nephritis, which causes a whole host of problems. When enough of the kidneys' filtering system has failed, the kidneys are no longer effective and the child is in renal failure, which must be treated with dialysis and transplantation.
Many cutaneous disorders have associated esophageal involvement. The more common of these disorders include epidermolysis bullosa, cicatricial pemphigoid (CP), lichen planus, and pemphigus vulgaris. Epidermolysis bullosa is a relatively rare cutaneous disease mediated by circulating IgG antibodies directed against type VII collagen. Clinically, patients develop intradermal blistering lesions with scarring at sites of trauma (hands and feet are most common). The proximal third of the esophagus, consisting of stratified squamous epithelium, is at risk. Strictures can occur due to concentric scarring from large blisters. Treatment is dilation. There is reported treatment of severe cases by colonic interposition free tissue grafting, to replace the stratified squamous epithelium of the proximal third of the esophagus (25). Bullous pemphigoid (BP) is another autoimmune blistering disease, which generally affects patients over the age of 60. It is the most common of the bullous cutaneous...
Actually, there are a few people I know who haven't been shocked or repulsed by my scars. That thought is overgeneralizing. My family seems to have gotten used to my scars. If they can, it's certainly possible that others could do the same especially if they cared about me. If someone really likes and cares about me, she ought to be able to look past my scars.
Complications related to cervical mycobacterial infections are few. Uncommonly, soft-tissue breakdown may occur to the extent that wide debridement is required, resulting in significant fibrosis and scarring. In the immuno-competent patient, response to therapy is generally favorable, with a low incidence of recrudescence. Immunocompromised patients may respond slowly or not at all to therapy and are at risk for recurrence. Mycobacterial infections are discussed in more detail in Chapter 12.
In alcoholic cirrhosis there is fibrocollagenous deposition, with scarring and disruption of surrounding hepatic architecture. There is ongoing necrosis with concurrent regeneration. Alcoholic cirrhosis is classically said to be micronodular, but often a mixed pattern is present. The underlying pathological mechanisms are complex and are the subject of debate. Induction of the MEOS and oxidation of ethanol by catalase result in free radical production. Glutathione (a free radical scavenger) is reduced in alcoholics, impairing the ability to dispose of free radicals. Mitochondrial damage occurs, limiting their capacity to oxidize fatty acids. Peroxisomal oxidation of fatty acids further increases free radical production. These changes eventually result in hepatocyte necrosis, and inflammation and fibrosis ensue. Acetaldehyde also contributes by promoting collagen synthesis and fibrosis.
The most common skin damage from repeated injection is needle-track scars. These are usually caused by unsterile injection techniques or by the injection of fibrogenic particulate matter material often used by dealers to add bulk and weight to the drug or buffers in tablets that have been ground up and liquified for injection. Carbon deposited on needles by users who try to sterilize by heating the needle tip with a match may produce a ''tattoo'' discoloration, accompanied by a mild inflammatory reaction under the skin at the point of entry. Such scars are found mostly on the arms, but they can occur anywhere on the user's body that has been used as an injection site, including thighs, ankles, neck, and penile veins.
The location of your abdominal incision will depend on several factors, such as whether your Caesarean birth is an emergency and whether you have any previous abdominal scars. Your baby's size or the position of placenta also will be considered. The low transverse incision, made sideways across the lower portion of the uterus, is the most common, used in more than 90 percent of all Caesarean births. It provides greater ease of entry, bleeds less than incisions higher on the uterus and poses less risk of bladder injury. It also forms a strong scar, presenting little danger of rupture during future labors. This makes vaginal birth after Caesarean (VBAC) a real option for future pregnancies.
Consequently, patients frequently suffer from recurrent infections. Collapse of the nasal bridge ( saddle nose deformity) may occur due to nasal chondritis (Fig. 2). Nasal examination typically reveals crusting, discharge, friable erythematous mucosa, and granulation tissue. Nasal septum perforation may occur. The paranasal sinuses, most commonly the maxillary and ethmoid sinuses, are affected in at least two-thirds of patients. In time, many patients develop pansinusitis. Inflammation of sinus mucosa and epithelium may result in discharge, obstruction, increased pressure, facial pain, headache, and secondary infection. Chronic inflammation usually produces sinuses lined by scar tissue and airspace obliteration. Mastoiditis may result in severe pain. Regional extension of sinus disease may lead to intracranial complications such as meningitis, epidural and subdural empyema, or cerebral abscess. Orbital complications may arise de novo or be a complication of...
Eye involvement is the other significant complication of pauciarticular JA. Although we do not fully understand why the eye is affected, the presence of a positive ANA is strongly correlated with the risk of eye disease (see Chapter 6). The eye disease, called uveitis or iridocyclitis, takes the form of inflammation of cells in the anterior chamber of the eye. The inflammation can lead to damage to the iris with scarring and irregularity of the pupil. These scars are called syn-echiae (see Fig. 5-1). Because the eye disease is usually painless and may go unnoticed for a long period, it is recommended that an ophthalmologist screen ANA-positive children every three months. Although the risk of eye involvement is lower in ANA-negative children and in children with polyarticular-onset disease, it may still occur, and ANAnegative children should be screened every six months. Note that it is rare for children with pauciarticular arthritis to develop new eye disease after ten years of age.
The most obvious lesions of the head and neck that can be seen in SLE are those involving the skin. The most characteristic dermatologic feature of lupus is the malar rash (Fig. 1). Also known as the butterfly rash, because of its shape across the cheeks and bridge of the nose, the malar rash is an erythematous and edematous eruption that classically spares the nasolabial folds. A similar rash may be seen on the forehead and chin. It may or may not result from exposure to sunlight, but is often abrupt in onset and can last for days. Malar rashes occur in 30 to 60 of patients. Discoid lupus (Fig. 2) is less frequent, occurring in 15 to 30 of patients. It too may occur in a malar distribution however, discoid lesions can occur anywhere on the face or scalp, in the pinnae, behind the ears, or on the neck. Discoid lesions tend to be discrete plaques, often erythematous with an adherent scale that extends into hair follicles. They can progress to lesions with indurated margins of erythema...
Massage will break down or stretch inflexible scar tissue found in muscles, tendons or ligaments of the sportsperson. These may be the result of past injuries or over-use. Scar tissue is part of the healing process and is laid down between the torn parts. It forms a tight inflexible mass that interferes with the normal function of the muscles or ligaments. Deep, short stroking movements or frictions will break down, or improve the flexibility of, this tissue, thus restoring function.
Xerophthalmic corneal scar (XS) Deficient serum retinol Corneal xerophthalmia Corneal xerophthalmia is manifested in increasingly severe stages. The earliest corneal lesions appear as superficial punctate defects, evident with a slit lamp, that with advanced deficiency become more numerous and concentrated. The cornea is considered xerotic (X2) when punctate keratopathy covers large areas of the surface, rendering a hazy, nonwetable, lusterless, and irregular appearance on handlight examination. Stromal edema may be present. In more severe cases, thick, elevated xerotic plaques may form. Usually, both eyes are affected. Corneal ulcers (X3A) can be sharply demarcated, round or oval defects that are usually shallow but may also perforate the cornea. Healed ulcers form a leukoma (scar) or adherent leukoma if the iris has plugged the perforated ulcer. Most ulcers occur peripheral to the visual axis and thus may not threaten central vision if treated promptly. Keratoma-lacia (X3B) refers...
The second important type of complication that occurs more frequently in children with polycyclic disease is the development of subcutaneous or intramuscular calcifications. These calcifications, which are easily seen in X-rays, appear as the muscle inflammation is disappearing and may be thought of as a scarring response. Unfortunately, they may cause major problems. Infection often occurs when the calcifications have formed over the elbows or other points where they are constantly being irritated by pressure. They may spontaneously become swollen and tender, and then drain to the outside. The initial drainage most often is not infected, but once leakage to the outside occurs, there is a significant risk that the draining lesion will become infected. Large calcifications within the musculature may become infected as well. They may also be a source of ongoing muscular irritation. In some cases these calcifications may disappear over time, but there is little that can be done for...
Alcoholic liver disease is among the top ten causes of mortality in the US with somewhat higher mortality rates in western European countries where wine is considered a dietary staple, and is a leading cause of death in Russia. Among the three stages of alcoholic liver disease, fatty liver is related to the acute effects of alcohol on hepatic lipid metabolism and is completely reversible. By contrast, alcoholic hepatitis usually occurs after a decade or more of chronic drinking, is associated with inflammation of the liver and necrosis of liver cells, and carries about a 40 mortality risk for each hospitalization. Alcoholic cirrhosis represents irreversible scarring of the liver with loss of liver cells, and may be associated with alcoholic hepatitis. The scarring process greatly alters the circulation of blood through the liver and is associated with increased blood pressure in the portal (visceral) circulation and shunting of blood flow away from the liver and through other organs...
At first, it just looks like a number of tiny blisters. However, the blisters leave a small scar when they heal. With continued medication and continued sun exposure, there will be more and more blisters and scars. The medication should be stopped and the sun avoided until the medicine is cleared from the body. This reaction has been noticed most often with naproxen, but that may be because so much naproxen is used. It has been reported with other NSAIDs, and all children on NSAIDs should be monitored for it.
Recently, some studies of wound healing and fibroblast growth have indicated that both pantothe-nic acid and ascorbic acid are involved in trace element distribution in the skin and scars of experimental animals, and that pantothenic acid can improve skin and colon wound healing in rabbits. It is not yet known whether these observations are relevant to wound healing in humans.
In the ex vivo approach, the skin cells from the host are isolated and harvested after removal by biopsy. The cells are then grown in vitro where therapeutic gene transfer is performed. Finally, the altered cells are grafted back into the host (Fig. 2). This method offers some advantages because primary kera-tinocytes, including human, are receptive to gene modification, readily expanded in tissue culture under selective conditions, and easily grafted back into host (19-22, Buitrago and Roop, unpublished data). However, the ex vivo approach is disadvantageous because of its labor intensity and potential scarring.
If you have difficulty swallowing and experience the sensation of food getting stuck in your chest, you should see your doctor. Acid damage to the esophagus can cause scarring or narrowing of the esophagus called strictures or rings. Generally, symptoms may be caused by food, particularly solid food when it becomes stuck. These symptoms may be present for years and might occur infrequently. Occasionally, solids and liquids both may be difficult to swallow. Food can also get stuck and sometimes you may not be able to get the material all the way down to the stomach. You may need to vomit or regurgitate the retained material. Sometimes food can become completely stuck and a doctor may need to remove it in the emergency room or hospital.
Heartburn occurs when the stomach contents pass back up into the esophagus. This regurgitation can occur when the person vomits, the stomach is overfull, or the person is obese, pregnant, or running. The cardiac sphincter and the diaphragm do not entirely close off the connection to the stomach. It is fairly easy to overcome these barriers and bring stomach contents back up into the tube. Because the pH of the stomach fluids is usually below 4, or about the strength of a car's battery acid, the acid burns the epithelial layers of the esophagus and may cause scarring of the tissue. If this occurs, the esophagus does not fold when empty or propel food properly through peristaltic contractions. The scarring also leaves the tissue susceptible to further damage due to the loss of the stratified epithelial layers that protect the underlying tissue.
Contusions, muscle strain, ligament sprain, swelling, inflammation, and deficient microcirculation. During recovery and rehabilitation, adhesion and the formation of scar tissue are major concerns. ISDN is an effective modality for managing most of these soft tissue dysfunctions. It has been shown to provide faster and more specific recovery than any other known method.
Typically there is a red scaly rash on the face, affecting the nose and cheeks, arthritis, and progressive kidney damage the heart, lungs, and brain may also be affected by progressive attacks of inflammation followed by the formation of scar tissue. In the milder form (DLE) only the skin is affected. Patients with lupus often have fever, weakness, fatigue, or weight loss. They may experience muscle aches, loss of appetite, swollen glands, hair loss, or abdominal pain, which can be accompanied by nausea, diarrhea, and vomiting. Sometimes the person's fingers, toes, nose, or ears will be particularly sensitive to cold and will turn white in cold temperatures, a condition known as Raynaud's phenomenon.
The diagnosis of PSS is based on the characteristic findings on examination of the skin. In some cases, it is necessary to biopsy the skin for confirmation, but because the skin of children with scleroderma often heals poorly and the biopsy may produce a scar, it may be best to avoid this where possible. Eventually, the gastroesophageal reflux may cause scarring of the esophagus, making it more difficult for food to pass through. Often the pain and discomfort caused by this combination of problems make the child not want to eat, and he or she will begin to lose weight.
The integumentary tissues (skin, hair, nails) cover and protect the body. Two of the more classical and reproducible manifestations of aging can be seen in this system. The depigmentation of hair to gray or white is an almost universal aging effect given sufficient survival. Wrinkling of the skin, due to alteration in connective tissue composition, is another consequence of aging it should be assessed by the changes in skin texture only in the non-sun-exposed regions of the body. Beyond the cosmetic consequences of the aging integumentary tissues, wound healing is a health-relevant consideration. Healing of wounds is slower with increasing age, but the resulting scars have the same tensile strength. Reduced recruitment of vessels of the microvascular is a function of aging.
The classical presentation of Ehlers-Danlos syndrome is in a child who is tall (usually thin) with long arms, long legs, and long thin fingers (children with Marfan's syndrome may also have some of these characteristics). These children have a severe defect in their collagen and are easily recognized because it is easy to stretch their skin. If these children have a cut, it will heal poorly and the scars often become unusually large and thin. By the time they are ten or eleven years old, these children have often had multiple orthopedic problems because of the loose ligaments.
Patellar tendonitis (PT) or jumper's knee is a tendonitis (acute inflammation) or a tendonosis (chronic scarring and changes of the tendon) of the patellar tendon. It is a common overuse injury in sports that require jumping such as basketball. Pain occurs along the patellar tendon with knee flexion extension, running and jumping. There is no knee effusion or instability. Athletes typically have very tight hamstrings and a weak core body. Treatment consists of daily rehabilitation focusing on core body strengthening and flexibility of the hamstrings and quadriceps. Iontophoresis (electrical delivery of a steroid) can be helpful in decreasing pain. Icing after activity for 15 to 20 minutes along with use of a patellar tendon strap as coutertraction can help decrease pain. Athletes may participate as long as they are not limping or having a significant increase in pain.
The above radiological modalities can be used to locate metastatic disease. Ultrasound or CT guided FNAC or needle biopsy allow cytological confirmation of non-palpable recurrent, cervical or hepatic metastatic disease. MRI is potentially helpful in delineating scar tissue from recurrent disease in the neck and mediastinum. Medullary thyroid cancer does not concentrate and attempts at treatment with radioiodine have failed to demonstrate significant response (73). Radiotherapy treatment results in significant fibrosis and scarring, rendering further surgical resection difficult and hazardous. Studies on the effect of radiotherapy in medullary thyroid cancer
Of acid contents can inflame the lining of the esophagus and cause ulcers or other irritation. Swallowed food passes through irritated areas and can cause pain. When the irritated areas heal, these damaged cells are replaced but scarring may result in narrowing of the esophagus, a condition called a stricture or lower esophageal ring. This narrowing of the esophagus can cause difficulty swallowing, and you might experience it as the sensation of food becoming stuck in your throat or chest.
In general, physiotherapy management in the area of oncology have relevant contributions to patient care, including (i) Decreasing length of stay in acute facilities (early discharge planning, outpatient follow up and education, involvement in palliative care facilities and physiotherapy services in home care) (ii) Improving functional capacity (early mobilization, management of complications of surgery, convenient manipulations of the areas submitted to RT and other treatments, as treating lymphoedema and scars) (iii) Improving lymphoe-dema management that has lead to decreased hospital admissions for cellulitis (a feature of
Ron Langacker in his chapter shows how simple perceptual processes such as visual scanning are essential to the meaning of sentences such as A scar extends from his ankle to his knee, or A scar extends from his knee to his ankle, and also underlie the meaning of more abstract sentences such as The rainy season starts in December and runs through March.
Sparks people's emotions and a desire to take action against the offending adult. In reality there are many faces of child abuse and many more acts that leave scars ''invisible'' to the naked eye. There is a tendency to ignore children who display no physical or outward signs of abuse. A large number of these children go unrecognized, living in environments that hinder their potential and their development as secure, healthy individuals.
Alcohol abuse affects all organs of the body (Lieber, 1992a). It atrophies many tissues, including the brain and the endocrine glands. Indeed, altered hepatic (liver) metabolism plays a key role in a variety of endocrinological imbalances (such as go-nadal dysfunctions and reproductive problems). Alcohol also exerts toxic effects on the bone marrow and alters hematological status (e.g., macrocytic anemias), and it scars the heart and other muscles. This article focuses mainly on the liver and gastrointestinal tract, since this is where alcohol penetrates into the body and has its most vicious effects this focus will also allow exemplification of the insights and possible benefits that can be derived from the application of newly acquired knowledge in biochemistry, pathology, and molecular biology.
Primary treatment of Wegener's granulomatosis is pharmacologic. Steroids are usually effective. Second-line therapy includes cytotoxic drugs. Medical therapy may keep the disease in check, but often the disease progresses. In systemic disease, death results from pulmonary and or renal failure. Laryngeal stenosis may require endoscopic excision to relieve airway obstruction but may be complicated by scarring, with further voice impairment and recurrent obstruction (Fig. 1). Tracheotomy is an alternate way of relieving obstruction. Surgical management of stenosis and scarring may be attempted when there is no active disease, but it may be complicated by reactivation (1).
Diagnosis is established by immunofluorescence to detect the antibodies causing the lesions. Biopsy is often negative because it shows nonspecific necrosis, particularly in the center of ulcerated lesions. Serology is sometimes helpful. Before the advent of drug treatment, pemphigus vulgaris was fatal in 99 of cases, but with treatment including dapsone, steroids, and azathioprine, mortality is 5 to 15 . The mucosal lesions of pemphigus and pemphigoid generally respond well to medical management, but untreated lesions may become infected and cause scarring sufficient to obstruct the airway.
Vitamin E is used both as an oral supplement and as a topical preparation in a variety of dermatological conditions. It is a popular ingredient in many moisturising preparations used to alleviate dry and cracked skin, assist in the repair of abrasions, burns, grazes and skin lesions, prevent stretch marks and diminish scar tissue. Vitamin E oil is used as a stand-alone preparation or incorporated into a cream or ointment base for these purposes. Scar tissue Although vitamin E is widely used to diminish the appearance of scars, a small double-blind study of 1 5 patients who had undergone skin cancer removal found that applying an emollient preparation known as Aquaphor with added vitamin E after surgery either had no effect or worsened the appearance of scars compared with Aquaphor alone (Baumann & Spencer 1999). A larger study of 80 people with hypertrophic scars and keloids found that treatment with vitamin E and silicone gel sheets was successful in scar treatment (Palmieri et al...
Pancreatitis occurs less frequently than liver disease in chronic alcoholics, and is characterized by severe attacks of abdominal pain due to pancreatic inflammation, while pancreatic insufficiency is due to the eventual destruction of pancreatic cells that secrete digestive enzymes and insulin. This destructive process is associated with progressive scarring of the pancreas together with distortion and partial blockage of the pancreatic ducts, which promote recurrent episodes of acute inflammatory pancreatitis. Since the pancreas is the site of production of proteases and lipases for protein and lipid digestion, destruction of more than 90 of the pancreas results in significant malabsorption of these major dietary constituents, as well as diabetes secondary to reduced insulin secretion. Consequently, patients with pancreatic insufficiency exhibit severe loss of body fat and muscle protein. Since the absorption of fat-soluble vitamins is dependent upon pancreatic lipase for...
Placing a small, metallic device within each fallopian tube. These devices cause scar tissue to form, effectively blocking the fallopian tube and preventing fertilization of the egg. Your doctor inserts a device into each of your fallopian tubes using a thin, flexible tube (catheter) that's threaded through the vagina into the uterus and on into the fallopian tube. For the following three months, you must use an alternate form of birth control. After this time, you undergo an X-ray to ensure that the scar tissue has grown into place. If the X-ray shows that your tubes are fully blocked, you can discontinue other forms of birth control.
Prompt administration of antibiotics is usually given in the hospital, since children often appear very ill with low fluid levels and risk of secondary infections. The skin is treated with wet dressings for crusted sites and antibiotic ointments. Patients usually heal without scarring within a week. Thousands of children are hospitalized each year for scald burns, which are among the most painful and disfiguring injuries. Severe scalds can require skin grafts and may leave severe scars.
Our memories of experiences vary greatly in strength. Some memories fade quickly and completely, whereas others last a lifetime. Generally, remembrance of experiences varies with their significance emotionally arousing events are better remembered (Christianson 1992). William james observed that, An experience may be so exciting emotionally as almost to leave a scar on the cerebral tissue (James 1890). Studies of retrograde amnesia and memory enhancement provide important clues to the physiological systems underlying variations in memory strength. In particular, the finding that drugs enhance memory consolidation suggests that hormonal systems activated by emotional arousal may influence consolidation (Cahill and McGaugh 1996).
Matthew was in sixth grade when he was diagnosed, and he was worried about the surgery for implanting the port. He didn't know what the scar would look like and he was concerned about AIDS, because it had been in the news a lot that year. The child life worker came in and really helped. She showed him what a port looked like then they explored the pre-op area, the actual surgery room, and postop. She showed him on a cloth doll exactly where the incision would be and how the scar would look. Then she introduced him to Fred, the IV pump. She said that Fred would be going places with him, and that Fred would keep him from getting so many pokes. She told Matthew that he could bring something from home to hang on Fred. Of course, he brought in a really ugly stuffed animal. Throughout treatment, she really helped his fears and my feelings about losing control over my child's daily life.
Although radiation therapy may sound more appealing than an operation, surgery is actually quicker and usually has fewer long-term side effects. Radiation therapy may contribute to urinary problems or difficulties with bowel movements and can sometimes make sex difficult or painful by causing scarring or shortening of the vagina. It may be hard for you to discuss these issues with your doctor, but be sure that you do. Many people make the mistake of assuming that sex is not important to older women.
Most apparent but not always sufficiently addressed are the cosmetic effects of surgery. Patients may be embarrassed by their own distress from a seemingly minor problem with an otherwise good outcome and consequently may not bring forth their concerns. Nonetheless, visible scars from cancer surgery can result in some cases in social isolation. Other patients find the sight and smell of an ostomy to be repugnant and greatly overestimate how much it is apparent to others around them. It is incumbent on providers caring for these patients to explore these issues with them to ensure that they are as satisfied as possible with long-term cosmesis. If distress is identified, they should look for ways to optimize the cosmetic result, and where this is not possible, try to help the patient best cope with their situation.
Transductional and transcriptional targeting can be combined to create double-targeted viruses. Conceivably, this approach could be synergistic with regard to safety and efficacy. Initial proof of concept was achieved by using a pulmonary vascula-ture specific promoter and a lung endothelium-targeted adaptor strategy (56). Impressively, the tumor-to-liver ratio of gene expression was increased 300,000-fold when both targeting modalities were used. Also, double targeting for ovarian cancer has been achieved in vitro and in vivo (89). Transductional targeting with a sCAR-fibritin-antiErbB2-sFv adapter was able to increase gene transfer to target cells while reducing transduction of nontarget cells. When combining transcriptional targeting with the SLPI promoter, an increase in selectivity was seen. Also, the transductional targeting increased the level of SLPI-mediated transgene expression in target cells, thereby compensating for the lower gene expression typically seen with TSPs.
How To Reduce Acne Scarring
Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.