BACKGROUND
Ablative fractional laser-assisted therapy is increasingly used to facilitate drug delivery and intensify clinical efficacy of topically applied drugs.
OBJECTIVE
To evaluate the effectiveness of combined ablative fractional CO2 laser and topically applied 5-fluorouracil (5-FU) or verapamil hydrochloride in the treatment of hypertrophic scars (HTSs) and keloids and to examine their possible effects on TGF-β1 expression.
PATIENTS AND METHODS
Thirty patients with HTSs and keloids were randomly treated with combined CO2 laser followed by topical verapamil or 5-FU application or CO2 laser monotherapy. All patients received 4 treatments at 1-month intervals. Subjective and objective assessment was obtained using the Vancouver Scar Scale (VSS). Histological changes and immunohistochemical staining for TGF-β1 were performed.
RESULTS
Compared with baseline, there was a significant reduction in the VSS 1 month after the last treatment session in all groups (p < .05). Laser-assisted 5-FU delivery tended to show a higher extent of improvement in scar characteristics than laser-assisted verapamil hydrochloride delivery, without significance. No significant side effects were reported in all patient groups. TGF-β1 expression was significantly decreased after laser sessions.
CONCLUSION
Combined fractional CO2 laser and topical 5-FU or verapamil hydrochloride offer a safe therapy for HTSs and keloids.
Varicocele, a dilation of pampiniform plexus, has a common association in male factor infertility (Alsaikhan, Alrabeeah, Delouya, & Zini, 2016). Several studies showed that varicocele harms spermatogenesis, testicular volume, semen parameters, sperm functions, fertilisation, implantation and the embryo outcome (Kimura & Nagao, 2014; Çayan, Orhan, Akbay, & Kadıoğlu, 2019). In infertile men with varicocele, impairment of the venous drainage is accompanied by stasis, bilateral testicular ischemia, tissue hypoxia and oxidative stress that impairs testicular functions (Rao et al., 2015). It was shown also that varicocele compromises the countercurrent system of scrotal thermal regulation which hampers the cooling system of the arterial blood leading to apoptosis during specific stages of spermatogenesis (El-Kamshoushi, Zohdy, Abou Khedr,
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