Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. 

Dispatches from Second Base is the host for this week’s issue of Grand Rounds! You can read this week’s edition here.

Welcome to Grand Rounds! First, a quick shout-out to Nick Genes, an emergency medicine physician who blogs at blogborygmi (possibly the best blog name ever) and is one of the founders of Grand Rounds. I had no plans to host GR a second time until I saw Nick’s APB for April hosts. I had forgotten how much fun this was until the posts started coming in. So thanks, Nick.

The theme this time is what gives your life or work meaning. One of the loveliest, most contemplative posts I’ve seen on this topic is Nourishing Healthy Seeds from Deb Thomas, who blogs at Debbie’s Cancer Blog. ………..

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Last night a tornado all but wiped out the small town of Vilonia, AR.  I went to school there from the 4th through 12th grades.  I played basketball.  The town and school are much larger than when I went to school there (didn’t live in the town limits or postal zip code).  I have learned of at least one friend who lost her home in the storm, but all the family members are okay.

I know this is nothing compared to Japan’s disaster, but it is my hometown.  KATV has made it easy to donate to the Arkansas Red Cross (as well as the Japan Tsunami relief) here.

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NPR reminds us the Sitting All Day: Worse For You Than You Might Think  (photo credit), so get up and move. 

Yes, exercise is good for you. This we know. Heaps of evidence point to the countless benefits of regular physical activity. Federal health officials recommend at least 30 minutes of moderate exercise, like brisk walking, every day. ….

But now, researchers are beginning to suspect that even if you engage in regular exercise daily, it may not be enough to counteract the effects of too much sitting during the rest of the day.  ……

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Another great interview by NPR.  This one by Terry Gross (Fresh Air) of Dr. Emery Brown on 'What Happens In Your Brain During Anesthesia' :

If you've gone in for surgery, it's likely that your anesthesiologist has told you to count backwards from 100 — and that you'll wake up after a nice deep sleep.

But that's not exactly true.

"Sleep is not the state you're going in, nor would it be the state in which someone could perform an operation on you," explains Emery Brown. "What we need to do in order to be able to operate on you — to perform a procedure which, is indeed, very invasive — is to put you in a state which is effectively a coma which we can readily reverse."  ……..

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NPR had a very interesting segment yesterday on interviewing Amy Stewart, the author of the book Wicked Bugs:  Where To Find The World's Most 'Wicked Bugs' (photo credit)

Japan is home to the world's largest — and most painful — hornet. With a wingspan of up to three inches, the Asian giant hornet can look more like a tiny flying bird.

And if you're a bird — or a bee — watch out.

The Asian giant hornet can inject "a deadly neurotoxin, [which] actually can be fatal," says science writer Amy Stewart. "In Asia, they call it a yak-killer because it has such a potent neurotoxin."  …..

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NPR’s Science Friday is a wonderful site. This past Friday they highlighted three space science videos. One uses candy corn to demonstrate how soap works and the last shows what happens to water balloons in space when you pop them (or how large would rain drops be with no gravity).  Here’s the one that answers the question of how a yo-yo works in space.

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New Research in Prevention of Keloid Scars

Updated 3/2017-- photos and all links removed as many are no longer active and it was easier than checking each one.

A keloid scar is the result of an abnormal proliferation of scar tissue that forms at the site of an injury to the skin (eg, on the site of a surgical incision or trauma).  Keloid scars do not regress.  They grow beyond the original margins of the scar which differs from hypertrophic scars which while raised do not grow beyond the boundaries of the original wound.  Hypertrophic scars may reduce over time. 

Keloid scars tend to recur after excision so anything that can help me prevent their formation is welcome.

I stumbled across this press release a few weeks ago.  It explains the findings published in the article (first reference below) published online January 21, 2011in the British Journal of Dermatology which notes a possible molecular target in the prevention of keloid scarring.

Collagen triple helix repeat containing-1 protein (CTHRC1) inhibits the transforming growth factor (TGF)-β1-stimulated collagen production that occurs in keloid scar formation, report researchers.

"Keloids are manifestations of an abnormal process of tissue repair after trauma to the skin. Options for treatment are limited because of lack of understanding of the molecular and cellular mechanisms governing the formation," explain Hongxiang Chen (Huazhong University of Science and Technology, Wuhan, China) and colleagues.

"Increased understanding of the role of TGF-β signaling in keloids makes manipulation of TGF-β an attractive therapeutic strategy," they say.

CTHRC1 is expressed in the adventitia and neointima on arterial injury. Chen and team assessed regulation of the CTHRC1 gene, its interaction with TGF-β1, and its possible role in keloid scar formation in fibroblast cells from keloid tissue and normal skin.

TGF-β1 and CTHRC1 were localized to the dermis in both normal and keloid skin fibroblasts. Expression of both factors were increased in keloid compared with normal skin and CTHRC1 appeared to increase in a TGF-β1 concentration-dependent manner.

When keloid fibroblasts were treated with TGF-β1 (10 ng/ml), cell proliferation increased dramatically, specifically, collagen type I synthesis was preferentially stimulated.

However, when recombinant CTHRC1 was added to the TGF-β1-treated keloid cells, the proliferation effect was reversed and excess collagen synthesis was inhibited.

Notably, treatment with recombinant CTHRC1 appeared to have no adverse effects on cell viability.

"Our data indicated that TGF-β1 was overexpressed in keloid fibroblasts and recombinant CTHRC1 could reverse TGF-β1-induced collagen type I expression at least in part by decreasing collagen synthesis," conclude the authors.

"As a potent negative regulator of collagen matrix deposition, CTHRC1 may have therapeutic value in antifibrotic treatment strategies," they suggest.

It would be nice if someday this research lead to a “prevention” therapy.


Related posts:
Scars and Their Therapy – an Article Review  (January 21, 2009)
Fluorouracil Treatment of Problematic Scars – an Article Review  (April 1, 2009)
Scar Scales and Measuring Devices  (September 8, 2010)
 

REFERENCES

1.  Collagen triple helix repeat containing 1 inhibits TGF-β1-induced collagen type I expression in keloid; J. Li, J. Cao, M. Li, Y. Yu, Y. Yang, X. Xiao, Z. Wu, L. Wang, Y. Tu, H. Chen; British Journal of Dermatology, January 2011, DOI: 10.1111/j.1365-2133.2011.10215.x

2.  Treatment of a Postburn Keloid Scar with Topical Captopril: Report of the First Case; Ardekani, Gholamreza Safaee; Aghaie, Shahin; Nemati, Mohammad Hassan; Handjani, Farhad; Kasraee, Behrooz; Plastic & Reconstructive Surgery. 123(3):112e-113e, March 2009; doi: 10.1097/PRS.0b013e31819a34db

3.  Correction: Treatment of a Postburn Keloid Scar with Topical Captopril: Report of the First Case; Plastic & Reconstructive Surgery. 123(6):1898, June 2009; doi: 10.1097/PRS.0b013e3181abc4b4

4.  Keloid and Hypertrophic Scar; eMedicine article, May 2010; Brian Berman, MD, PhD, Whitney Valins, Sadegh Amini, MD, Martha H Viera, MD

5.  Wound Healing, Keloids; eMedicine article, June 26, 2009; R Edward Newsome, MD, Ravi Tandon, MD, Robert P Bolling, MD, MPH, Alun R Wang, MD, PhD, David A Jansen, MD

Shark Skin &

Updated 3/2017-- photos and all links removed as many are no longer active and it was easier than checking each one.

Did you happen to catch the CBS Sunday Morning piece by David Pogue  “How Shark Skin May Help Save Lives”? 

Turns out nothing grows on a shark’s skin.  Not barnacles.  Not bacteria.  This is why biomedical engineer Tony Brennan, University of Florida, is studying shark skin.

Initially, Brennan studied shark skin as a way to help the Navy solve the huge and expensive problem of barnacle buildup on their ships.

When he studied shark denticles under the electron microscope, he discovered why.

"I said, "Wow!, That shark pattern, I'd never seen it before,'" he said. And he believes that has something to do with no bacterial growth.

Brennan wondered if he could re-create the shark skin surface on plastic sheets.

"Sharks' denticles are set up like a diamond pattern," he said, showing Pogue a clear plastic sheet he called a Sharklet, which also had a diamond pattern. Its microscopic pattern of ridges mimics the denticles of shark skin.  (photo credit)

And when you stick it on ships, sure enough - NOTHING GROWS.

Dr. Shravanthi Reddy, director of research for Sharklet, is testing Sharklet to see if it can repel bacteria the way shark skin repels algae and barnacles.

Two pieces of plastic - one smooth, one patterned with Sharklet - are subjected to bacteria and incubated for 24 hours.

The electron microscope reveals the astounding results. The plain plastic is covered with a bacteria film - "Just these big clumps of bacteria all piled up on one another," Dr. Reddy said.

And on the Sharklet surface? "You might see one or two cells, but you don't see that big clumping the way you see it on the smooth surface," said Dr. Reddy. "What's really interesting is that there are no chemical differences between the surfaces. It's the same material. No differences, other than the physical shape."

If Sharklet really works, it could be used to cover many of the ordinary surfaces in a hospital and doctors office  -- bedside tables, door panels, stethoscopes, and as Dr. Reddy notes

"Those wristbands, have you ever seen anyone clean those wristbands?" said Dr. Reddy. "Never, right? And they're on the patient the whole time they're in the hospital."

As a way to fight community based MRSA and flu, it could be used to cover gym surfaces, desks in schools, play grounds.

The topic is to be explored further in tonight in the PBS "Nova" series, "Making Stuff."