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PubMed · 14235808

[CICATRICES].

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W E SCHNEIDRZIK. 1964. [CICATRICES].. https://pubmed.ncbi.nlm.nih.gov/14235808/

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Running W incision in open rhinoplasty: better scar quality.

Since 1997, 129 patients have undergone the open approach rhinoplasty procedure. Scar quality with running W incision was compared to the scar with V type incision. According to clinical and statistical evaluations after 6 months, postoperatively the running W incision group showed better scar quality than the V type incision group. The advantages of a running W incision are camouflaging the depressed scar in the incision line and decreasing the angles of the corners of incision lines. Running W type incision is superior to V incision on the columella and may provide less scaring than a single Z, and reverse V incisions according to our long-term clinical results.

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Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses.

BACKGROUND: Abnormal collagen metabolism is suspected to play an important role in the pathogenesis of recurring inguinal and incisional hernias. Whereas alloplastic prostheses are nowadays routinely used, the quantity and quality of collagen formation after repair in humans has not been analysed in a large cohort. METHOD: Seventy-eight prostheses (Prolene, Atrium, Marlex, Vypro, Mersilene, Gore-Tex) implanted for inguinal and incisional hernia repair were explanted because of recurrence, chronic pain or infection. The mean implantation period was 17.9+/-11.2 (range 0.5-48) months. Collagen formation was investigated quantitatively (collagen-protein ratio) and qualitatively (collagen type I/III ratio). Results were related to clinical data that included gender, age, implantation period, indication for implantation/explantation, type and location of prosthesis. RESULTS: Mean collagen-protein ratio was 45.3+/-8.5 microg/mg, with significant differences between male (43.8+/-9.1 microg/mg) and female tissue samples (48.1+/-6.8 microg/mg, P=0.033). The mean collagen type I/III ratio of all samples investigated was 2.1+/-1.4. Samples explanted for recurring hernias exhibited a significantly decreased ratio (1.3+/-0.7, P<0.05) compared to samples explanted because of pain (3.4+/-1.2) or infection (2.9+/-1.6). Multivariate analysis excluded independent effects of age, gender, indication for implantation of prostheses, location and implantation period on collagen type I/III ratio. CONCLUSION: The present study confirms the importance of a biological approach, next to technical aspects, to the understanding of the pathogenesis of recurrent hernia formation and underscores the presence of a disturbed scarring process. The composition of scar tissue with a lowered collagen type I/III ratio and, therefore, reduced tensile strength may be a major contribution to hernia recurrence.

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[Gene expression in keratoconus. Initial results using DNA microarrays].

INTRODUCTION: Keratoconus is a non-inflammatory ocular disease characterised by conical deformation, progressive thinning and scarring of the central cornea. Despite intensive investigations, the exact cause of the disease still remains unclear. Clinical studies provide strong indications of a major genetic role in the aetiology. We set out to examine the involvement in the manifestation of keratoconus of any of the 5,600 gene specificities available on the Affymetrix GeneChip HuGeneFL. METHODS: After examination of two corneas they were stored in RNAlater, RNA was extracted and hybridised on the chips. Using a combination of dyes it was possible to read the chips with laser detection and to visualise the gene expression pattern. RESULTS: We found an upregulation of collagens, versican, metalloproteinases and cell adhesion proteins. A downregulation was observed for TIGR protein, cytokeratins, eyes absent homologue (Eab1) and the proteins for radical treatment selenoprotein P and monooxygenase. CONCLUSIONS: Our results indicate that keratoconus is a process in which repair and scar-formation mechanisms operate at the same time. As candidate genes for this mechanism, collagen IV and related proteoglycans were favoured.

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