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Lupus nephritis (LN) is a major cause of mortality and morbidity in both adult and pediatric patients. However, studies regarding pathogenesis and predictors of renal outcomes in childhood LN are limited. Transforming growth factor-β1 (TGF-β1) and Connective tissue growth factor (CTGF) have an important role in proliferative and fibrotic changes in many renal diseases. We aim to evaluate the role of such two profibrotic factors in the progression of childhood onset LN and to detect if their glomerular expression could represent an early predictor of future deterioration of renal function. METHODS: 34 children with new onset of LN were included. Glomerular expressions of TGF-β1 and CTGF were evaluated by immunohistochemical analysis in the renal tissue of such patients and in control tissue. GFR was estimated at time of renal biopsy at the onset of LN and after 2 years of follow-up. Rate of GFR change (ΔGFR) was calculated and used as indicative of degree of renal disease progression. RESULTS: Glomerular TGF-β1 and CTGF expressions in children with LN were significantly higher than in control tissue (LN 15.41±9.84 and 15.56±10.51 vs. 2.15±1.45 and 1.35±1.07 in control respectively, with p 0.001 in both). In addition, the glomerular expressions of TGF-β1 and CTGF were significantly higher in patients with further decline in GFR (20.68±7.73 and 21.05±8.75) versus (5.75±4.37 and 5.50±3.78) in those without change in GFR with (p= 0.000 for both of them). CONCLUSIONS: Patients with LN have increased glomerular expressions of TGF-β1 and CTGF, which

Lupus nephritis (LN) is a major cause of mortality and morbidity in both adult and pediatric patients. However, studies regarding pathogenesis and predictors of renal outcomes in childhood LN are limited. Transforming growth factor-β1 (TGF-β1) and Connective tissue growth factor (CTGF) have an important role in proliferative and fibrotic changes in many renal diseases. We aim to evaluate the role of such two profibrotic factors in the progression of childhood onset LN and to detect if their glomerular expression could represent an early predictor of future deterioration of renal function. METHODS: 34 children with new onset of LN were included. Glomerular expressions of TGF-β1 and CTGF were evaluated by immunohistochemical analysis in the renal tissue of such patients and in control tissue. GFR was estimated at time of renal biopsy at the onset of LN and after 2 years of follow-up. Rate of GFR change (ΔGFR) was calculated and used as indicative of degree of renal disease progression. RESULTS: Glomerular TGF-β1 and CTGF expressions in children with LN were significantly higher than in control tissue (LN 15.41±9.84 and 15.56±10.51 vs. 2.15±1.45 and 1.35±1.07 in control respectively, with p 0.001 in both). In addition, the glomerular expressions of TGF-β1 and CTGF were significantly higher in patients with further decline in GFR (20.68±7.73 and 21.05±8.75) versus (5.75±4.37 and 5.50±3.78) in those without change in GFR with (p= 0.000 for both of them). CONCLUSIONS: Patients with LN have increased glomerular expressions of TGF-β1 and CTGF, which

ABSTRACT Introduction: Atrophic scar is the result of decrease collagen production and matrix formation, that's why management of atrophic scar is challenging for plastic surgeons.PRP plays an important role in tissue regeneration during wound healing via release of growth factors that have an important role in the regulation and proliferation of mesenchymal and fibroblast cells, hence it increase collagen production and improve wound healing. The main goal of the article is to evaluate the efficacy and safety of autologous platelet-rich plasma (PRP) injections in improvement of atrophic scar. Patients and Methods: Twenty patients with atrophic scar were included in this study at plastic surgery department, Assiut university hospital, in duration from July 2016 to February 2017. Mean age was 22.68±6.75 years. Patients were randomly divided into 2 groups to allow equal distribution. Group 1 (control), underwent scar revision only. Group 2 (study), underwent scar revision, followed by immediately intradermal autologous Platelet rich plasma (PRP) injection at the edges of the wound. This was followed by PRP injection every month for the next five months. Patients with atrophic non pigmented scars at any region of the body were included. Any case with history of medical co-morbidities also was excluded. Scar width, Vancouver scar scale (VSS), surgeon assessment scar scale, patient assessment scar scale and complications, were the outcome measurements. Results: Surgeon assessment scar scale, VSS, and patient assessment scar scale showed no significant difference (pvalue 0.05) between the two groups preoperative, while there was significant clinical improvement of the resulting scar in group II compared to group I six months postoperatively, No complications were noticed in both groups. Conclusion: We conclude that intradermal injection of autologous PRP in an atrophic scar after its revision could be considered as a promising option for atrophic scar management as it improves wound healing process that appears in the improvement of clinical appearance of the scar.

ABSTRACT Introduction: Atrophic scar is the result of decrease collagen production and matrix formation, that's why management of atrophic scar is challenging for plastic surgeons.PRP plays an important role in tissue regeneration during wound healing via release of growth factors that have an important role in the regulation and proliferation of mesenchymal and fibroblast cells, hence it increase collagen production and improve wound healing. The main goal of the article is to evaluate the efficacy and safety of autologous platelet-rich plasma (PRP) injections in improvement of atrophic scar. Patients and Methods: Twenty patients with atrophic scar were included in this study at plastic surgery department, Assiut university hospital, in duration from July 2016 to February 2017. Mean age was 22.68±6.75 years. Patients were randomly divided into 2 groups to allow equal distribution. Group 1 (control), underwent scar revision only. Group 2 (study), underwent scar revision, followed by immediately intradermal autologous Platelet rich plasma (PRP) injection at the edges of the wound. This was followed by PRP injection every month for the next five months. Patients with atrophic non pigmented scars at any region of the body were included. Any case with history of medical co-morbidities also was excluded. Scar width, Vancouver scar scale (VSS), surgeon assessment scar scale, patient assessment scar scale and complications, were the outcome measurements. Results: Surgeon assessment scar scale, VSS, and patient assessment scar scale showed no significant difference (pvalue 0.05) between the two groups preoperative, while there was significant clinical improvement of the resulting scar in group II compared to group I six months postoperatively, No complications were noticed in both groups. Conclusion: We conclude that intradermal injection of autologous PRP in an atrophic scar after its revision could be considered as a promising option for atrophic scar management as it improves wound healing process that appears in the improvement of clinical appearance of the scar.

ABSTRACT Introduction: Atrophic scar is the result of decrease collagen production and matrix formation, that's why management of atrophic scar is challenging for plastic surgeons.PRP plays an important role in tissue regeneration during wound healing via release of growth factors that have an important role in the regulation and proliferation of mesenchymal and fibroblast cells, hence it increase collagen production and improve wound healing. The main goal of the article is to evaluate the efficacy and safety of autologous platelet-rich plasma (PRP) injections in improvement of atrophic scar. Patients and Methods: Twenty patients with atrophic scar were included in this study at plastic surgery department, Assiut university hospital, in duration from July 2016 to February 2017. Mean age was 22.68±6.75 years. Patients were randomly divided into 2 groups to allow equal distribution. Group 1 (control), underwent scar revision only. Group 2 (study), underwent scar revision, followed by immediately intradermal autologous Platelet rich plasma (PRP) injection at the edges of the wound. This was followed by PRP injection every month for the next five months. Patients with atrophic non pigmented scars at any region of the body were included. Any case with history of medical co-morbidities also was excluded. Scar width, Vancouver scar scale (VSS), surgeon assessment scar scale, patient assessment scar scale and complications, were the outcome measurements. Results: Surgeon assessment scar scale, VSS, and patient assessment scar scale showed no significant difference (pvalue 0.05) between the two groups preoperative, while there was significant clinical improvement of the resulting scar in group II compared to group I six months postoperatively, No complications were noticed in both groups. Conclusion: We conclude that intradermal injection of autologous PRP in an atrophic scar after its revision could be considered as a promising option for atrophic scar management as it improves wound healing process that appears in the improvement of clinical appearance of the scar.

ABSTRACT Introduction: Atrophic scar is the result of decrease collagen production and matrix formation, that's why management of atrophic scar is challenging for plastic surgeons.PRP plays an important role in tissue regeneration during wound healing via release of growth factors that have an important role in the regulation and proliferation of mesenchymal and fibroblast cells, hence it increase collagen production and improve wound healing. The main goal of the article is to evaluate the efficacy and safety of autologous platelet-rich plasma (PRP) injections in improvement of atrophic scar. Patients and Methods: Twenty patients with atrophic scar were included in this study at plastic surgery department, Assiut university hospital, in duration from July 2016 to February 2017. Mean age was 22.68±6.75 years. Patients were randomly divided into 2 groups to allow equal distribution. Group 1 (control), underwent scar revision only. Group 2 (study), underwent scar revision, followed by immediately intradermal autologous Platelet rich plasma (PRP) injection at the edges of the wound. This was followed by PRP injection every month for the next five months. Patients with atrophic non pigmented scars at any region of the body were included. Any case with history of medical co-morbidities also was excluded. Scar width, Vancouver scar scale (VSS), surgeon assessment scar scale, patient assessment scar scale and complications, were the outcome measurements. Results: Surgeon assessment scar scale, VSS, and patient assessment scar scale showed no significant difference (pvalue 0.05) between the two groups preoperative, while there was significant clinical improvement of the resulting scar in group II compared to group I six months postoperatively, No complications were noticed in both groups. Conclusion: We conclude that intradermal injection of autologous PRP in an atrophic scar after its revision could be considered as a promising option for atrophic scar management as it improves wound healing process that appears in the improvement of clinical appearance of the scar.

Abstract Background: The functional, cosmetic and psychological effects of longstanding facial palsy are considerable. Temporalis muscle has proven to be a reliable and versatile flap for muscle transposition in treatment of long-standing facial paralysis However temporalis muscle is short and failed to reach sufficiently large areas. Our goal is to use temporalis galea and periosteal extension as part of a comprehensive approach to facial reanimation to achieve a dynamic rehabilitation of the eyelids and mouth, to allow closure of eyes and symmetry and satisfactory when smiling. Patients and methods: This study included 16 patients presented by facial palsy in a period from January 2015 to February 2018. Their age ranged from 12 years to 65 years. 15 facial palsy patients were unilateral, and one was bilateral. 6 (37.5%) patients were males and 10(62.5%) were female. Results: good result was achieved in all patients during follow-up. One of the patients required a revision of surgery for unacceptable asymmetry. Bulging of the temporal and malar regions on eye closure was found in three patients, and hollow deformity of the temporal region was obvious in one patient. No muscle atrophy since vascularity and innervation is maintained. The follow-up time of patients ranged from 6 to 24 months, Conclusion: This simple procedure has helped reconstruction of natural symmetrical smile and closure of the eye with highly successful results.