background. Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp‐pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars.
objective. To determine the efficacy of the 532 nm frequency‐doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL.
methods. Six patients with pigmented hypertrophic scars and skin phototypes II–IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 μsec, and a 10 mm spot size. A 532 nm Q‐switched frequency‐doubled Nd:YAG laser was set to an energy of 2.8 J, a 10‐nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10‐msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4–6 weeks and long‐term follow‐up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t‐test was used to determine the statistical significance of the values obtained.
results. Treatment of pigmented hypertrophic scars with the 532 nm Q‐switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P = .005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow‐up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q‐switched Nd:YAG laser as the best segment overall.
conclusion. The 532 nm Q‐switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q‐switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars.
Uteri taken from guinea pigs in different stages of pregnancy and during lactation, as well as animals that had been ovariectomized and treated with hormones, were examined for relaxin with the peroxidase-antiperoxidase (PAP) technique employing an antiserum produced against porcine relaxin. While relaxin was not detected in uteri of day 15 pregnant animals, small amounts were noted in a few endometrial glands in day 30 pregnant animals. Uteri from day 45, day 60, and late-pregnant animals exhibited heavy amounts of relaxin; however, endometrial gland cells from lactating animals contained very little or no relaxin. Injections of estrogen and progesterone that brought a relaxation of the pelvic ligaments in ovariectomized guinea pigs also induced an accumulation of relaxin in the endometrial glands. Relaxin was not detected in nonendometrial portions of the uterus, endometrial stromal components, luminal surface epithelium, or uterine cervical glands. Extracts prepared from uteri of day 45, day 60, and late-pregnant animals showed positive responses for relaxin in the mouse uterus bioassay.
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