[Clinical characteristics of patients with rheumatic diseases and abnormal liver function].

Objective: To investigate the clinical characteristics of patients with rheumatic diseases and abnormal liver function, as well as determine the proportion and severity of liver function abnormalities. Methods: Cross-sectional study. Data were collected from patients registered in the Chinese Rheumatism Date Center from 2011 to 2021. The rheumatic diseases analyzed in this study were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren syndrome (SS), ankylosing spondylitis (AS), and gout. Patient data, including demographic characteristics [ such as age, sex, body mass index,(BMI), and smoking history], liver function test results [including alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase(ALP), and total bilirubin], and use of anti-rheumatic immune drugs and liver-protective drugs, were collected and compared between groups with normal and abnormal liver functions. In addition, the proportions of abnormal liver function were compared between sex and age groups. Results: A total of 116 308 patients were included in this study, including 49 659 with RA, 17 597 with SLE, 9 039 with SS, 11 321 with AS, and 28 692 with gout. The lowest proportion of liver function abnormalities was observed in patients with RA[11.02% (5 470/49 659)], followed by those with SS[17.97% (1 624/9 039)] and AS [18.22% (2 063/11 321) ], whereas patients with SLE [21.14% (3 720/17 597) ] and gout [28.73% (8 242/28 692)] exhibited the highest proportion of these abnormalities. Elevated ALT, mostly classified as grade 1, was the most commonly noted liver function abnormality, whereas elevated ALP was the least common. Some patients who took liver-protective drugs had normal liver function, with the lowest percentage observed in patients with gout [7.45% (36/483) ] and ranging from 21.7% to 30.34% in patients with RA, SLE, SS, and AS. The proportion of liver function abnormalities was higher in males than in females for all disease types [RA: 13.8%(1 368/9 906) vs. 10.3%(4 102/39 753); SLE: 33.6% (479/1 424) vs. 20.0% (3 241/16 173); SS: 25.4%(111/437) vs. 17.6%(1 513/8 602); AS: 20.1%(1 629/8 119) vs. 13.6% (434/3 202); and gout: 29.3% (8 033/27 394) vs. 16.1% (209/1 298)]. In RA, SLE, and AS, the proportions of liver function abnormalities were similar across all age groups. In SS, the proportion of liver function abnormalities increased with age [<40 years: 14.9%(294/1 979); 40-59 years: 18.1%(858/4 741); ≥60 years: 20.4%(472/2 319)], whereas a reversal of this trend was observed in gout [<40 years: 34.9%(4 294/12 320); 40-59 years: 25.5%(2 905/11 398);≥60 years: 21.0%(1 042/4 971)]. Conclusions: The proportions of combined liver function abnormalities in patients with rheumatologic diseases were high, and the utilization rates of liver-protective drugs were low. It is necessary to pay more attention to monitoring patients' liver function, timely administer liver-protective drugs, and optimize liver-protective regimens during the treatment of rheumatic diseases.

[Recommendations on the diagnosis and treatment of osteoarthritis in China].

Osteoarthritis (OA) is the most common form of arthritis and the leading cause of old age disability, affecting an estimated 302 million people worldwide. OA is seriously overlooked in the world. The awareness of OA and the popularization of standardized diagnosis and treatment are all lacking. Knees, hips, and hands are the most commonly affected joints in OA. Based on the experience of diagnosis and treatment, consensus and guidelines, we formulated this diagnosis and treatment standard in order to standardize the diagnosis and treatment of OA. We hope that our standard can reduce misdiagnosis and mistreatment and improve the prognosis of OA.

Regulation of epithelial mesenchymal transition by the renin-angiotensin system: a role for klotho in renal tubular epithelial cells.

Klotho is a putative aging suppressor gene that is primarily expressed in renal tubular epithelial cells. Its expression has been reported to protect against fibrosis in human chronic kidney disease. However, the roles of klotho in epithelial-mesenchymal transition (EMT) and renal fibrosis are yet to be elucidated. The present study aimed to investigate the putative roles of klotho in angiotensin (Ang) II-induced damage of renal tubular epithelial cells. NRK-52E rat cells were treated with various combinations of Ang II, the Ang-converting enzyme inhibitor fosinopril (Fos) and the Ang II receptor antagonist valsartan (Val). The levels of transforming growth factor (TGF)-ß1, soluble klotho, α-smooth muscle actin (α-SMA) and E-cadherin in NRK-52E culture supernatants were measured using enzyme-linked immunosorbent assays. Furthermore, the mRNA and protein expression of TGF-ß1, klotho, α-SMA and E-cadherin was detected using semiquantitative reverse transcription-polymerase chain reaction, immunocytochemistry and Western blot analysis. The results demonstrated that Ang II inhibited the expression of klotho and E-cadherin, while it upregulated the expression of TGF-ß1 and α-SMA, in NRK52E cells. Fos and/or Val were revealed to enhance klotho and E-cadherin expression, and suppress the expression of TGF-ß1 and α-SMA, compared with the Ang II-only group. Furthermore, a positive linear correlation was detected between the expression of klotho and E-cadherin, while negative linear correlations with klotho expression were detected for TGF-ß1 and α-SMA expression. In conclusion, the expression of klotho was demonstrated to be enhanced following treatment with Fos and Val in Ang II-treated NRK-52E cells. The present results indicate that klotho may be involved in the inhibition of Ang II-induced EMT in renal tubular epithelial cells. Therefore, klotho may serve as a protective factor in renal tubulointerstitial fibrosis and aid the treatment of chronic kidney disease (CKD) patients using precision therapy.

Expression of miR-217 and HIF-1α/VEGF pathway in patients with diabetic foot ulcer and its effect on angiogenesis of diabetic foot ulcer rats.

OBJECTIVE: To investigate the expression of miR-217 and HIF-1α/VEGF pathway in patients with diabetic foot ulcer (DFU) and its effect on angiogenesis in DFU rats. METHODS: The serum levels of miR-217, HIF-1α and VEGF were detected in DFU and simple diabetes mellitus (DM) patients, and healthy controls. DFU rat models were established and treated with miR-217 inhibitors and/or HIF-1α siRNA. The ulcer healing of DFU rats was observed. Besides, ELISA method was performed to detect the serum level of HIF-1α, VEGF and inflammatory factors, immunohistochemical (IHC) method to test the micro-vessel density (MVD), as well as qRT-PCR and Western blot to determine expressions of miR-217, HIF-1α, VEGF, VEGFR2, eNOS, MMP-2, and MMP-9 in tissues. RESULTS: The serum levels of miR-217 were up-regulated while HIF-1α and VEGF were down-regulated in DFU patients and rats when compared with DM and healthy controls (all P < 0.05). Dual-luciferase reporter gene assay confirmed that HIF-1α was the direct target gene of miR-217. DFU rats treated with miR-217 inhibitors had decreased foot ulcer area and accelerated ulcer healing, with significantly reduced inflammatory factors (IL-1ß, TNF-α and IL-6), as well as elevated HIF-1α and VEGF (all P < 0.05); meanwhile, they remarkably increased the MVD in foot dorsum wound tissues and the protein expressions of HIF-1α, VEGF, VEGFR2, eNOS, MMP-2, and MMP-9 (all P < 0.05). CONCLUSION: Inhibiting miR-217 could up-regulate HIF-1α/VEGF pathway to promote angiogenesis and ameliorate inflammation of DFU rats, thereby effectively advancing the healing of ulcerated area.

Single-photon avalanche diodes in 0.18-µm high-voltage CMOS technology.

We have designed and fabricated high-performance single-photon avalanche diodes (SPADs) by using 0.18-µm high-voltage CMOS technology. Without any technology customization, the SPADs have low dark-count rate, high photon-detection probability, low afterpulsing probability, and acceptable timing jitter and breakdown voltage. Our design provides a low-cost and high-performance SPAD for various applications.

Micro-autologous Fat Transplantation (MAFT) for Forehead Volumizing and Contouring.

BACKGROUND: Frontal fullness in Asians is often considered to indicate one's public popularity and leadership skills. Numerous materials and techniques have been applied clinically to recontour or volumize the frontal area, with variable results. The micro-autologous fat transplantation (MAFT) technique proposed by Lin et al. (2nd academic congress of Taiwan Cosmetic Association Taipei, Taiwan) in 2007 has demonstrated its feasibility in facial rejuvenation. In the present study, we used an innovative instrument to apply the MAFT technique to frontal augmentation with fat grafting and reported the results. METHODS: MAFT was performed on 178 patients (167 female, 11 male) during a 5-year period starting in January 2010. Fat was harvested by liposuction, processed and refined by centrifugation at 1200×g for 3 min. The purified fat was micro-transplanted for frontal contouring with the assistance of an instrument, the MAFT-GUN. The patients were followed up regularly, and photographs were taken for comparison. RESULTS: On average, the MAFT procedure took 52 min to complete. The average amount of delivered fat was 10.2 mL. The follow-up period was 34 months on average. No complications, including neurovascular injury, skin necrosis, abscess, nodulation, calcification or irregularity, were noted. A patient-rated satisfaction 5-point Likert scale demonstrated that 83.1% of all patients had favorable results (48.3% were satisfied, and 34.8% were very satisfied). CONCLUSION: The concept and technique of MAFT has changed fat grafting from an operation with unpredictable clinical results to an easy, reliable and consistent procedure. Furthermore, the use of a precisely controlled instrument enabled surgeons to perform highly accurate micro-fat grafting. In comparison with other strategies for volume restoration, the MAFT procedure demonstrated high patient satisfaction with the long-term results. Therefore, the use of MAFT as an alternative approach to forehead contouring and volumizing was addressed. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Radiometric temperature measurement with Si and InGaAs single-photon avalanche photodiode.

We experimentally demonstrate the use of single-photon avalanche photodiode (SPAD) for radiometric temperature measurement. The low dark count rate CMOS SPAD and a commercial InGaAs/InP SPAD can detect the thermal radiation from a blackbody down to the temperatures of 510 and 405 K, respectively. Our work shows that current SPADs are cost-effective thermal sensors for various applications.

Contribution of postprandial glucose to excess hyperglycaemia in Asian type 2 diabetic patients using continuous glucose monitoring.

BACKGROUND: previous studies examining the contributions of fasting glucose (FG) and postprandial glucose (PPG) to glycated haemoglobin (HbA(1c)) have yielded conflicting results. We aimed to clarify the contributions of PPG to hyperglycaemia in Asian type 2 diabetic patients using continuous glucose monitoring. METHODS: continuous glucose monitoring was conducted in 121 non-insulin-using type 2 diabetic outpatients, who were divided into five groups according to quintiles of HbA(1c) (ranging from 5.7 to 12.7%). Glucose area under the curve (AUC) above a glucose value of 5.5 mmol/L 24 or 4 h after meals was defined as AUC(total). Glucose AUC above FG or preprandial glucose levels was defined as AUC(PPG). The contribution of PPG to hyperglycaemia was calculated as (AUC(PPG)/AUC(total) × 100%. The contribution of FG or preprandial glucose was calculated as [(AUC(total) - AUC(PPG))/AUC(total)] × 100%. RESULTS: the contribution of PPG to either 24-h hyperglycaemia or 4-h hyperglycaemia after meals was significantly higher than FG and preprandial glucose in the lowest quintile of HbA(1c) (both p < 0.001). However, no difference was observed in the other four quintiles. Peak PPG and glucose excursions were higher after breakfast than those after lunch and dinner (p < 0.01 for all comparisons). CONCLUSIONS: in Asian patients with type 2 diabetes, PPG 24 and 4 h after meals was a predominant contributor to excess hyperglycaemia in well-controlled patients and was equally important as FG or preprandial glucose in moderately to poorly controlled patients with mean HbA(1c) up to 10%.

Wide spectral range confocal microscope based on endlessly single-mode fiber.

We report an endlessly single mode, fiber-optic confocal microscope, based on a large mode area photonic crystal fiber. The microscope confines a very broad spectral range of excitation and emission wavelengths to a single spatial mode in the fiber. Single-mode operation over an optical octave is feasible. At a magnification of 10 and λ = 900 nm, its resolution was measured to be 1.0 µm (lateral) and 2.5 µm (axial). The microscope's use is demonstrated by imaging single photons emitted by individual InAs quantum dots in a pillar microcavity.

Using continuous glucose monitoring to assess contributions of premeal and postmeal glucose levels in diabetic patients treated with metformin alone.

AIM: This study aimed to determine the contributions of basal excess glycaemia (BEG) and prandial excess glycaemia (PEG) to overall excess glycaemia in type 2 diabetes (T2D) patients treated with metformin alone. METHODS: Outpatients with T2D treated with metformin alone (n=46) who underwent continuous glucose monitoring (CGM) were divided into tertiles according to glycated haemoglobin (HbA1c) levels. For each CGM trace, the glucose area under the curve (AUC)>5.5mmol/L was expressed as the AUCoverall, representing overall excess glycaemia. The sum of glucose AUCs above the premeal glucose level at 4h after breakfast, lunch and dinner was expressed as the AUCpeg, representing PEG. The contribution of PEG to overall excess glycaemia was calculated as (AUCpeg/AUCoverall)×100%. The contribution of BEG was calculated as [(AUCoverall-AUCpeg)/AUCoverall]×100%. Factors related to PEG contribution were also analysed. RESULTS: BEG constituted more than half the overall excess glycaemia in all HbA1c tertiles. The contribution of PEG was negatively correlated with HbA1c and mean glucose values before each meal. Prebreakfast and predinner glucose values were the dominant factors affecting PEG contribution and was independent of HbA1c. CONCLUSION: In patients treated with metformin alone, BEG was the major contributor to excess glycaemia at HbA1c levels ≥7.7%, while PEG and BEG contributions were similar and stable below this level. For HbA1c levels ≥7.7%, add-on therapy to metformin should preferentially target control of BEG, whereas targeting both BEG and PEG could be of equivalent importance with lower HbA1c levels.

Effect of growth factors on dermal fibroblast contraction in normal skin and hypertrophic scar.

We have examined the effects of four 'exogenous' growth factors, i.e. PDGF-BB (5 ng/ml), TGF-beta1 (5 ng/ml), bFGF (10 ng/ml) and EGF (10 ng/ml) on the contraction of floating collagen type I lattices populated by human normal skin (NS) and hypertrophic scar (HS) fibroblasts (FPCL). Only TGF-beta1 enhanced the contractility of both NS and HS fibroblasts in the collagen lattice (P < 0.01). Other growth factors (PDGF-BB, bFGF and EGF) did not affect FPCLs contraction at 72 h (P > 0.05). The onset effect of TGF-beta1 on NS-FPCL contraction was relative early at 24 h after FPCL casting as compared to a 72 h delay on HS-FPCL contraction. Besides, PDGF-BB was found to be able to enhance HS-FPCL contraction (P < 0.05) but not on NS-FPCL contraction on day 4. On the other hand, three enzyme-linked immunosorbent assays (ELISA) were performed to demonstrate quantitatively the 'endogenous' growth factors that fibroblasts secreted into the culture medium 48 h after FPCL casting. No appreciable difference was found between 10 NS and 11 HS samples tested for PDGF-AB immunoassay (11.48 +/- 5.5 pg/ml versus 12.20 +/- 5.34 pg/ml). The same result existed in 7 NS and 13 HS samples for TGF-beta2 immunoassay (15.15 +/- 6.2 pg/ml versus 11.84 +/- 7.46 pg/ml). In bFGF immunoassay study, relative variable data was noted in both 7 NS (18.18 +/- 13.18 pg/ml) and 12 HS samples (20.41 +/- 22.36 pg/ml). In conclusion, we suppose that TGF-beta role in wound healing may be due to the secondary exogenous influences. The endogenous ability of TGF-beta2 secretion (quantity) in HS fibroblasts are the same as NS fibroblasts but with delayed timing responses (quality) to exogenous TGF-beta1 effect in the collagen lattice. Further studies with timing-regulated selective specific monoclonal antibodies against the growth factor receptors may provide the therapeutic applications on HS during wound healing.

Correlation of intellectual impairment in Parkinson's disease with FDG PET scan.

This study investigated the relationship between regional glucose metabolism with intellectual impairment in patients with Parkinson's disease using statistical parametric mapping. Regional cerebral glucose metabolism using [18F]deoxyglucose (FDG) PET scans were performed on 10 patients with Parkinson's disease. We used the intellectual impairment score from the UPDRS. PET scans were analyzed with SPM96. Patients showed significant positive correlations with left limbic structures such as the cingulate gyrus, parahippocampal gyrus, and medial frontal gyrus. Patients showed significant negative correlations with associative neocortical posterior structures such as bilateral parietal and occipital gyrus. There were significant relationships between regional glucose metabolism and intellectual impairment.

Fiber-optic bronchoscopic classification of inhalation injury: prediction of acute lung injury.

BACKGROUND: Fiber-optic bronchoscopy is widely used for the early diagnosis of inhalation injury. However, there is no current bronchoscopic classification of inhalation injury for the prediction of acute lung injury (ALI). Our goal was to devise such a classification. METHODS: Between February 1993 and January 2002, 167 patients with highly suspicious inhalation injuries were collected. All patients received fiber-optic bronchoscopy within 24 h after their accident. In total, 108 patients were diagnosed as positive under direct inspection. The patients were divided into three groups (G(1), G(2), and G(3)) according to the depth of mucosal damage. Six patients were found to be positive by biopsy and were assigned to group Gb. Of these 114 positive cases, 27 developed ALI. Meanwhile, 53 patients were diagnosed as negative; these patients were assigned to group G(0). RESULTS: After analysis, the following results were noted: G(0) (n = 53), two ALI (3.8%); G(1) (n = 49), two ALI (4%); G(2) (n = 46), 15 ALI (33%); G(3)(n = 13),10 ALI (77%); Gb (n = 6), no ALI. We discovered that the deeper the mucosal injuries, the higher the rate of ALI. There were no deaths related to the procedure. CONCLUSIONS: Fiber-optic bronchoscopy is a safe and effective method for the early diagnosis of inhalation injuries. Also, it is a good predictor of ALL. We hope that in the near future, this classification will serve as a treatment guideline for the early prevention of ALI. The more severe the damage, the more alert clinicians need to be to improve the patient's chances for survival.

Continuous intra-arterial infusion therapy in hydrofluoric acid burns.

To determine the effect of continuous intra-arterial calcium gluconate infusion therapy on patients suffering from hydrofluoric acid dermal burns of the digits, clinical treatment was performed prospectively on 10 patients from January 1997 to December 1998 at the burn care unit of Kaohsiung Medical University Hospital. An arterial catheter was inserted transcutaneously through the radial artery of the involved hand. After confirmation of the proper position of the catheter, calcium gluconate was infused continuously with an ambulatory infusion pump. Rapid pain relief was achieved immediately after infusion. The rate of infusion was then tapered down gradually, and treatment was completed with no major therapeutic complication. All injured digits of these 10 patients were successfully salvaged with good cosmetic appearance and complete functional preservation. Compared with other conventional therapies, continuous intra-arterial calcium gluconate infusion therapy proved to be a safe, rapid, simple, portable, and effective method for treating hydrofluoric acid dermal burns.

Augmentation of tendon-bone healing by the use of calcium-phosphate cement.

The healing of a hamstring graft to bone is the weak link in the reconstruction of a cruciate ligament using this donor material. We therefore investigated the augmentation of healing at the tendon-bone interface using calcium-phosphate cement (CPC). We performed semitendinosus autograft reconstructions of the anterior cruciate ligament on both knees of 22 New Zealand white rabbits. The interface between the grafted tendon and the bone tunnel for one knee was filled with CPC. Six rabbits were killed at the end of the first and second post-operative weeks in order to evaluate the biomechanical changes. Two rabbits were then killed sequentially at the end of weeks 1, 3, 6, 12 and 24 after operation and tissue removed for serial histological observation. Histological examination showed that the use of CPC produced early, diffuse and massive bone ingrowth. By contrast, in the non-CPC group of rabbits only a thin layer of new bone was seen. Mechanical pull-out testing at one week showed that the mean maximal tensile strength was 6.505 +/- 1.333 N for the CPC group and 2.048 +/- 0.950 N for the non-CPC group. At two weeks the values were 11.491 +/- 2.865 N and 5.452 +/- 3.955 N, respectively. Our findings indicate that CPC is a potentially promising material in clinical practice as regards its ability to reinforce the fixation of the tendon attachment to bone and to augment the overall effectiveness of tendon healing to bone.

An easy method for preparation of postage stamp autografts.

A modified technique of postage stamp autografting is studied. By using quick cutting plates, chessboard tray, skiing technique and petrolatum gauze, skin islands can be uniformly located and correctly oriented on the gauze. Moving the skin squares on the stainless steel tray is relatively easy, and the expansion ratio can be predicted by means of the chessboard diagram. The skin island grafts adhere to the petrolatum gauze when the gauze is applied to the tray. Then, as in the modified Meek technique, the "autografting carrier" can be used to cover the burn wound. In comparison with the modified Meek technique, this method does not require expensive equipment. The quick cutting plates can take over the function of the modified Meek-Wall dermatome. The stainless steel trays and the petrolatum gauze are easily available. The advantages of this method include: (1) the expansion ratio can reach up to 1:9, (2) the preparation procedures are not time consuming, (3) regular distribution of these skin islands shortens the healing time, and (4) the cost of this method is relative low. The results of this technique are comparable to that of the modified Meek technique. This preliminary study reveals that this technique is an easy and economic alternative for the treatment of extensive burn patients.

Allogeneic microskin grafting of rabbits' skin wounds.

Allogeneic microskin grafts (expansion ratio of 10:1), overlain with Biobrane, were applied to 30 rabbits. There were two groups. In group I, the allogeneic donor microskin grafts were transplanted without specific management. In group II, the donor skin was treated with ultraviolet (312 nm) irradiation to depress Langerhans cells immediately before the transplantation. Histological examination of these grafted wounds in the early stage showed that these micrografts proliferated actively with increased mitotic figures and became regularly stratified under the conditions provided by the Biobrane. By day 9, these wounds in group I were almost resurfaced with neoepithelium. In group II, the rate of regeneration of the neoepithelium was slower than those of group I. Subsequently there was rejection with moderate mononuclear infiltration, hydropic degeneration and satellite necrosis of basal and suprabasal keratinocytes, and local destruction of epithelium. Grossly these reactions caused 'melting' of the neoepithelium and resulted in raw areas. These rejections were more severe about 2 weeks after transplantation and then subsided gradually. Mild cellular infiltration continued to prevent the formation of rete ridges and the dermoepidermal junction was smooth at all times. Langerhans cells could not be found in these grafted wounds using OKT-6 and S100 stain. In spite of the destruction caused by these rejections in both groups, 25 wounds were completely resurfaced with well-differentiated neoepithelium by day 21. This study revealed that the transplanted allogeneic microskin grafts could proliferate to form neoepithelium and resurface the skin wounds of rabbits.

Microskin grafting of rabbits with pigskin xenograft overlay.

Pigskin xenografts were used to replace allografts in microskin grafting (10:1 expansion ratio) on 15 rabbits. Rabbits were selected randomly for the removal of the overlaid pigskin at days 7, 10 or 14 for the evaluation of the degree of epithelialization. Histological examination of the removed pigskin 7 days after application showed obvious eosinophilic changes in the epidermal cells and pyknotic changes of the nuclei, however in some areas newly formed epidermis could be found. The pigskin became an eschar or slough on day 14. The microskin autografts proliferated and expanded actively under the protection of this overlaid pigskin. The epidermis increased in thickness and with increasing differentiation. The dermal layer was well vascularized with a large number of capillaries and fibroblasts. The wound was covered by the neoepithelium with almost normal skin texture on day 14, by which time the overlaid pigskin became a dry eschar. In areas where the overlaid pigskin was sloughing, the epithelialization of the underlying microskin grafts was not complete at the same time. In these animal studies of microskin grafting, these overlaid pigskin xenografts showed the same effects as those of allografts.

Management of hypertrophic scars on the pubic area with an iliac flap.

Postburn hypertrophic scars on the pubic area are rare. A local iliac flap has been used in four female patients for covering the raw areas after total excision of these scars. The largest flap in this series was 7 x 13 cm. Although bilateral flaps could be used simultaneously, only a unilateral flap was used in each patient. All the donor sites were closed primarily. The postoperative course was uneventful in each patient. Itching subsided completely in all patients and distortions of the genitalia were corrected. There was no recurrence of the scar formation in the follow-up period from 2 to 7 years. The only drawback of this flap for coverage of the symphysis pubis is that it is hairless. The experience with the present patients proved that this is an easy, quick and reliable method for removing hypertrophic scars on the pubic area.

Microskin grafting of rabbit skin wounds with Biobrane overlay.

Biobrane was used to overlay micrografts and the wound using the microskin grafting technique with an expansion ratio of 10:1 in 16 rabbits. The rabbits were divided randomly into four groups, with four rabbits in each group, for evaluating the wound conditions on days 7, 10, 12 and 14. Histological examination of the removed Biobrane showed a variable degree of entrapment of inflammatory cells within the nylon fabric. Biobrane adhered well to the wounds although many wrinkles containing fluid accumulations were noted on day 7. By 10, 12 and 14 days all the wounds become dry and their Biobrane adhered completely. Histological examination of the grafted wound on day 7 showed active proliferation and spread of micrografts. In the later groups, the neoepidermis increased in thickness and differentiated into skin with a normal texture. On day 10, the wounds were almost completely resurfaced with neoepithelium. The growth of these grafts progressed smoothly as the adherent Biobrane was kept on the wound for 12 or 14 days. In these animal studies, the overlain Biobrane provided favourable conditions for the successful growth of micrografts.