Bleomycin Tattooing as a Promising Therapeutic Modality in Large Keloids and Hypertrophic Scars

BACKGROUND: Cryotherapy combined with intralesional triamcinolon injection is the most common traditional therapy for hypertrophic scars and keloids. The literature contains few articles on the use of bleomycin tattoo for treatment of these conditions. OBJECTIVE: This study compares the efficacy of bleomycin tattoo with that of cryotherapy combined with intralesional triamcinolon injection for the treatment of keloids and hypertrophic scars. MATERIALS AND METHODS: Forty-five patients with hypertrophic scars or keloids were randomly divided into two groups. Group A was treated with bleomycin tattoo, and group B, with cryotherapy combined with intralesional triamcinolon injection. There were four therapeutic sessions at 1-month intervals. All patients were followed for 3 months after the end of treatment. RESULTS: Therapeutic response in lesions less than 100 mm2 was higher than 88% in both groups, but in larger lesions, the therapeutic response to bleomycin was significantly better than cryotherapy combined with intralesional triamcinolon injection (p = .03). In group A, no relationship was observed between therapeutic response and lesion size (p = .58); however, in group B smaller lesions (< 100 mm2) displayed better therapeutic response (p = .007). CONCLUSIONS: Bleomycin tattoo may be more effective than cryotherapy combined with intralesional triamcinolon injection in treatment of larger keloids and hypertrophic scars (size > 100 mm2).     

Thoracoscopic Epicardial Radiofrequency Ablation for Vagal Atrial Fibrillation in Dogs

Epicardial radiofrequency catheter ablation of the atria in the open-chest dog has been shown to reduce inducibility of atrial fibrillation. Video-assisted endoscopic techniques decrease the operative trauma in adult thoracic surgery. We report our results of video-assisted thoracoscopic radiofrequency catheter ablation of the atria for the prevention of atrial fibrillation induction in canines. In 12 consecutive anesthetized dogs, induction of sustained atrial fibrillation was reproducibly obtained by burst pacing and cervical vagal stimulation. In six dogs, biatrial ablation was performed through right and left minithoracotomies and guided by video-assisted endoscopic techniques. The remaining six dogs underwent a video-guided left atrial procedure. Long continuous and transmural lesions were produced using epicardial temperature controlled radiofrequency energy delivered according to a simplified maze approach. Transmural lesions were demonstrated at the end of the study by examination of the heart. Sustained atrial fibrillation was still inducible after the right atrial ablation but sustained atrial fibrillation could not be induced following left atrial ablation. In acute canine studies: (1) epicardial radiofrequency catheter ablation of the atria is feasible using video-assisted endoscopic techniques; (2) ablation extended or confined to the left atrium appears to be effective in preventing the inducibility of sustained vagal atrial fibrillation; and (3) ablation of the right atrium alone had no antiarrhythmic effect .     

Incidence rate of mycosis fungoides in Isfahan (Iran)

Mycosis fungoides (MF) is an extranodal non‐Hodgkin’s lymphoma with primary involvement of the skin. The aim of the present study was to determine the incidence rate of MF in Isfahan (Iran) and to compare the results with other reports. We collected our data from the MF clinic of Alzahra Hospital which is the main center for treatment of MF patients in Isfahan (2007–2008). Eleven cases were reported to the MF clinic of Alzahra during the study, seven of which were diagnosed as MF. The incidence rate of MF in Isfahan in 2007–2008 was 3.91/1 million persons. The age spectrum was 28–80 years and the mean 43.14 years. The male : female ratio was 3:4. In conclusion, the incidence rate of MF in Isfahan (Iran) is similar to other areas. However, the male : female ratio is opposite to that of other studies