Efficacy of radiation treatment for recurrent keloids Essay Example for Free

Efficacy of radiation treatment for recurrent keloids Essay Keloid is a condition in which an overgrowth of scar tissue (basically fibrous tissue) occurs at the spot of damage to the skin. Besides skin injuries, keloids can also occur at the site of surgical incisions, traumatic lesions, burns, acne scars, scratches, insect bites, etc. The condition more frequently occurs in African-Americans, and is more common in younger individuals. The lesion usually crosses the site of normal skin injury. It appears flesh-colored, pink or red in color and may be nodular or ridged. They may be shiny and are slightly elevated above the skin. With time, the lesions become more and more flat and lighter in color. Keloids most often occur in the upper portion of the body including the chest and back. Areas that are frequently rubbed or experience great amounts of friction are at the high risk of developing keloids. Keloids that are exposed to sunlight are at the risk of become darker in color. The diagnosis of the keloids is made based on the basis of the history, physical examination and biopsy (Merck, 2005, Mayo, 2007 Lehrer, 2006). Usually, treatment is not required for keloids, as with time, the lesions become flatter and lighter in color. Several treatment modalities such as surgery, cryotherapy, pressure therapy, local injections of corticosteroid, laser therapy and radiation, have been employed and may seem to be beneficial in the treatment of the keloids. However, frequently, following removal of the keloids, a new lesion appearing larger than the previous one may develop. However, radiation therapy following surgery is known to be effective in preventing keloids from recurring (Merck, 2005, Mayo, 2007 Lehrer, 2006). Klumpar et al (1994) has reported that such a combination of treatment would help to control recurrence by about 72 to 92 %. Radiation is utilized to treat recurrence of keloids. About 126 cases were treated in the study by surgical removing the lesion, and then applying radiation, in the form of Electron beam or ortho-voltage. The rates of recurrences were found to be low. The study demonstrated that the recurrences were higher in those lesions that were infected and in patients who had tendencies for keloids in their families. The study also demonstrated that keloids that hampered cosmetic appearance could be effectively treated with surgery followed by radiation therapy (Klumpar, 1994). Narwong et al (2006) reported a recurrence rate of about 50 to 80 % in the earlobe keloids after removing them surgically. They performed a study on about simple exercise in about 15 patients and then treated them with iridium radiation therapy. The cases were followed up for about 6 months, and it was observed that only 12. 5 % of the cases developed recurrences (Narwong, 2006). De Lorenzi et al (2006) conducted more precise studies on the recurrence of keloids following radiation therapy. They treated about 24 patients with 30 keloids with high dose iridium therapy. The scar thickness reduced significantly following radiation therapy. Several symptoms such as pain, irritation, etc, also reduced significantly. A majority of the patients were satisfied with the treatment provided (De Lorenzi, 2006). Van de kar al (2007) reported that currently the data available is not sufficient to suggest the benefits of performing radiation therapy after surgical removal. Previous studies have demonstrated that surgery in association with radiation therapy seemed to be the most effective treatment for preventing keloids recurrences. However, Van der reported a recurrence rate of about 71. %, much higher than was anticipated. The cases were followed up for about 19 months (van de kar, 2007). Thus it felt that although, radiation therapy seems to be effective in reducing recurrences of keloids following surgery, several long-term studies and assessment of the factors which would increase the chances of developing keloids. These factors have to be identified following consistent results obtained through studies. From the paper observed, it is felt that radiation therapy following surgery, is the most efficient modality of reducing recurrences.

Controlling Automobile Traffic Essay -- Exploratory Research Papers

Controlling Automobile Traffic A safe community is comprised of many things. The most important thing to have in a community is correct traffic flow. The flow of traffic can determine how congested the community can be, and even how safe it can be. Parents would not want their children playing near a busy road, nor would they want to live in a community where traffic is constantly a problem. The most effective way to control these problems is through a system of â€Å"Signal Control Timings.† The new AUSCI (Adaptive Urban Street Control and Integration) technology automatically adjusts traffic signal timing based on actual traffic flow conditions. The conditions are monitored by video sensor, Auto scope Solo cameras: located before the actual signalized intersections. â€Å"Because the traffic signal timing is constantly adjusted, based on existing conditions, the community will experience a smoother flow, through few reduced delays. This feature is particularly helpful during special events or when traffic is disrupted,† said Roger Plum, traffic signal engineer, city of Minne...

The Hunters: Phantom Chapter 4

It was the little changes that surprised Elena the most. She had expected the Guardians to bring Fel ‘s Church back. And they had. The last time she'd seen the town, probably a quarter of the houses had been rubble. They'd been burned or bombed, some ful y destroyed, some only half-gone, with police tape dangling dismal y across what was left of their entrances. Around and above the ruined houses, trees and bushes had grown and stretched strangely, vines draping over the debris, giving the streets of the smal town the look of an ancient jungle. Now Fel ‘s Church was – mostly – the way Elena remembered it. A picture postcard – perfect smal Southern town of deep-porched houses surrounded by careful y tended flower gardens and big old trees. The sun was shining and the air was warm with the promise of a hot and humid Virginia summer day. From a few blocks away came the muted roar of a lawn mower, and the smel of cut grass fil ed the air. The Kinkade kids in the house on the corner had dragged out their badminton set and were batting the birdie back and forth; the youngest girl waved to Elena and Stefan as they passed. Everything took Elena back to the long July days she'd known al the previous summers of her life. Elena hadn't asked for her old life back, though. Her exact words had been: I want a new life, with my real old life behind me. She'd wanted Fel ‘s Church to be the way it would have been now, months later, if evil had never come to town back at the beginning of her senior year. But she hadn't realized how jarring al the little changes would be. The smal colonial-style house in the middle of the next block had been painted a surprising shade of pink, and the old oak tree in its front lawn had been cut down and replaced with a flowering shrub. â€Å"Huh.† Elena turned to Stefan as they passed the house. â€Å"Mrs. McCloskey must have died, or moved to a nursing home.† Stefan looked at her blankly. â€Å"She never would have let them paint her house that color. There must be new people living there,† she explained, shivering slightly. â€Å"What is it?† Stefan asked instantly, as attuned to her moods as ever. â€Å"Nothing, it's just†¦Ã¢â‚¬  Elena tried to smile as she tucked a silky lock of hair behind her ear. â€Å"She used to feed me cookies when I was a kid. It's strange to realize she might have died of natural causes while we've been gone.† Stefan nodded, and the two walked silently to Fel ‘s Church's smal downtown. Elena was about to point out that her favorite coffee shop had been replaced by a drugstore, when she grabbed Stefan's arm. â€Å"Stefan. Look.† Coming toward them were Isobel Saitou and Jim Bryce. â€Å"Isobel! Jim!† Elena shouted joyful y, and ran toward them. But Isobel was stiff in her arms, and Jim was looking at her curiously. â€Å"Uh, hi?† Isobel said hesitantly. Elena instantly stepped back. Oops. In this life, did she even know Isobel? They'd been in school together, of course. Jim had gone out with Meredith a couple of times before he and Isobel started dating, although Elena hadn't known him wel . But it was possible she had never even spoken to quiet, studious Isobel Saitou before the kitsune came to town. Elena's mind worked busily, trying to figure out how to get out of this without seeming crazy. But a warm buzz of happiness kept rising up in her chest, keeping her from taking the problem too seriously. Isobel was okay. She'd suffered so much at the hands of the kitsune: She'd pierced herself in horrible ways and slit her own tongue so severely that even after she'd recovered from the kitsune's thral , she'd spoken in a soft slur. Worse, the kitsune goddess had been in Isobel's house the whole time, pretending to be Isobel's grandmother. And poor Jim†¦ Infected through Isobel, Jim had torn himself apart, eating at his own flesh. Yet here he was, as handsome and carefree – albeit mildly confused – as ever. Stefan smiled broadly, and Elena couldn't stop giggling. â€Å"Sorry, guys, I'm just†¦ so happy to see familiar faces from school. I must miss good old Robert E. Lee High School, you know? Who would have thought?† It was a pretty weak excuse, but Isobel and Jim smiled and nodded. Jim cleared his throat awkwardly and said, â€Å"Yeah, it was a good year, wasn't it?† Elena laughed again. She couldn't help herself. A good year. They chatted for a few minutes before Elena casual y asked, â€Å"How's your grandmother, Isobel?† Isobel looked at her blankly. â€Å"My grandmother?† she said. â€Å"You must be confusing me with someone else. Both my grandmothers have been dead for years.† â€Å"Oh, my mistake.† Elena said good-bye and managed to contain herself until Isobel and Jim were out of earshot. Then she took Stefan by the arms, pul ed him toward her, and gave him a resounding kiss, feeling delight and triumph passing back and forth between them. â€Å"We did it,† she said when the kiss had ended. â€Å"They're fine! And not just them.† More solemn now, she gazed up into his green eyes, so serious and kind. â€Å"We did something real y important and wonderful, didn't we?† â€Å"We did,† Stefan agreed, but she couldn't help but notice something hard in his voice as he said it. They walked hand in hand, and without discussing it, they headed for the edge of town, crossing Wickery Bridge and climbing the hil . They turned into the cemetery, past the ruined church where Katherine had hidden, and down into the little val ey below that held the newer part of the graveyard. Elena and Stefan sat down on the neatly trimmed grass by the big marble headstone with â€Å"Gilbert† carved into the front. â€Å"Hi, Mom. Hi, Dad,† Elena whispered. â€Å"I'm sorry it's been so long.† Back in her old life, she had visited her parents' graves often, just to talk to them. She'd felt like they were able to hear her somehow, that they were wishing her wel from whatever higher plane they'd ended up on. It had always made her feel better to tel them her troubles, and before her life had gotten so complicated, she had told them everything. She put out one hand and gently touched the names and dates carved on the tombstone. Elena bent her head. â€Å"It's my fault they're dead,† she said. Stefan made a soft noise of disagreement, and she turned to look at him. â€Å"It is,† she said, her eyes burning. â€Å"The Guardians told me so.† Stefan sighed and kissed her forehead. â€Å"The Guardians wanted to kil you,† he said. â€Å"To make you one of them. And they accidental y kil ed your parents instead. It's no more your fault than if they had shot at you and missed.† â€Å"But I distracted my father at the critical moment and made him crash,† Elena said, hunching her shoulders. â€Å"So the Guardians say,† Stefan replied. â€Å"But they wouldn't want it to sound like their fault. They don't like to admit they make mistakes. The fact remains that the accident that kil ed your parents wouldn't have happened if the Guardians hadn't been there.† Elena lowered her eyes to hide the tears swimming in them. What Stefan said was true, she thought, but she couldn't stop the chorus of myfaultmyfaultmyfault in her head. A few wild violets were growing on her left, and she picked them, along with a patch of buttercups. Stefan joined her, handing her a sprig of columbine with yel ow bel -shaped blossoms to add to her tiny wildflower bouquet. â€Å"Damon never trusted the Guardians,† he said quietly. â€Å"Wel , he wouldn't – they don't think much of vampires. But beyond that†¦Ã¢â‚¬  He reached for a tal stalk of Queen Anne's lace growing beside a nearby headstone. â€Å"Damon had a pretty finely tuned sense for detecting lies – the lies people told themselves and the ones they told other people. When we were young we had a tutor – a priest, no less – who I liked and my father trusted, and Damon despised. When the man ran off with my father's gold and a young lady from the neighborhood, Damon was the only one who wasn't surprised.† Stefan smiled at Elena. â€Å"He said that the priest's eyes were wrong. And that he spoke too smoothly.† Stefan shrugged. â€Å"My father and I never noticed. But Damon did.† Elena smiled tremulously. â€Å"He always knew when I wasn't being total y honest with him.† She had a sudden flash of memory: of Damon's deep black eyes holding hers, his pupils dilated like a cat's, his head tilting as their lips met. She looked away from Stefan's warm green eyes, so different from Damon's dark ones, and twisted the thick stalk of the Queen Anne's lace around the other flowers. When the bouquet was tied together, she placed it on her parents' grave. â€Å"I miss him,† Stefan said softly. â€Å"There was a time when I would have thought†¦ when his death might have been a relief. But I'm so glad we came together – that we were brothers again – before he died.† He put a gentle hand beneath Elena's chin and tilted her head up so that her eyes met his again. â€Å"I know you loved him, Elena. It's okay. You don't have to pretend.† Elena gave a little gasp of pain. It was like there was a dark hole inside her. She could laugh and smile and marvel at the restored town; she could love her family; but al the time there was this dul ache, this terrible sense of loss. Letting her tears loose at last, Elena fel into Stefan's arms. â€Å"Oh, my love,† he said, his voice catching, and they wept together, taking comfort in each other's warmth. Fine ash had fal en for a long time. Now it settled at last and the smal moon of the Nether World was covered with thick, sticky piles of dust. Here and there, opalescent fluid pooled against the charred blackness, coloring it with the rainbow of an oil slick. Nothing moved. Now that the Great Tree had disintegrated, nothing lived in this place. Deep below the surface of the ruined moon was a body. His poisoned blood had stopped flowing and he lay unmoving, unfeeling, unseeing. But the drops of fluid saturating his skin nourished him, and a slow thrum of magical life beat steadily on. Every now and then a flicker of consciousness rose within him. He had forgotten who he was and how he had died. But there was a voice somewhere deep inside him, a light, sweet voice he knew wel , that told him, Close your eyes now. Let go. Let go. Go. It was comforting, and his last spark of consciousness was holding on for a moment longer, just to hear it. He couldn't remember whose voice it was, although something in it reminded him of sunlight, of gold and lapis lazuli. Let go. He was slipping away, the last spark dimming, but it was al right. It was warm and comfortable, and he was ready to let go now. The voice would take him al the way to†¦ to wherever it was he would go. As the flicker of consciousness was about to go out for the last time, another voice – a sharper, more commanding voice, the voice of someone used to having his orders obeyed – spoke within him. She needs you. She's in danger. He couldn't let go. Not yet. That voice pul ed painful y at him, holding him to life. With a sharp shock, everything shifted. As if he'd been ripped out of that gentle, cozy place, he was suddenly freezing cold. Everything hurt. Deep within the ash, his fingers twitched.

What Is Child Slavery - 907 Words

What is child slavery? This is the slavery of children right from a very young age, in which this young kids are forced into labor or all other conditions that are not suitable for a little child. The rights of this children are taken away while they are young and are forced to do different things against their will for which they are often not rewarded or underpaid. In their book Modern-Day Slavery 2008, Van de Glind and Kooijmans defined child slavery based on the two different strategies used in sourcing for this children. The first he defined as the kind of slave trade involving all acts of capture , acquisition or disposal of a child with intent to having ownership right of this person and denying him his right to freedom . The second he defined in terms of the sale or exchange of a child under the age of 18 by any of his parents, guardians or any family member to another person, whether for reward or not with the plan for exploitation of this child of his labor. Both definitions help to explain the source of this child slaves. Child slavery would be further expatiated under the manner in which they are being trafficked and exploited. * Child Labor The children at a very young age would be coerced into traveling for labor by an employer or family member. They may deceive them by offering them legal and well-paid jobs. Others are forced by their family members on other to reduce the financial burden. After they have been trafficked or deceived thisShow MoreRelatedWhat Does Voluntary Child Labor Constitute Slavery? Essay2278 Words   |  10 PagesDespite slavery being deemed illegal across the majority of the world, millions of people are subjected to slave-like conditions on a daily basis, many of whom are children with little options for change. 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