Effect of 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) and dichloromethylidene-bisphosphonate (Cl2MBP) on the structure of the organic matrix of heterotopically induced bone tissue

Summary The effect of 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) and dichloromethylidene-bisphosphonate (Cl₂MBP) on the structure of the organic matrix of heterotopically induced bone in guinea pig was studied. Heterotopic bone formation was induced by transplantation of allogenic urinary bladder epithelium. Starting from the day of transplantation the animals were treated subcutaneously with HEBP and Cl₂MBP with a dose of 12.5 mg P/kg/day during 35 days. The control group was injected with 0.9% NaCl solution. The advantage of heterotopic bone induction as an experimental model is the fact that the applied drugs act on de novo bone formation. Collagen fibers were treated as markers of bone because their size and spatial arrangement reflect the structure and maturity of organic matrix of this tissue. Decalcified histological sections of induced bone, taken 35 days after implantation of inductor, were stained by the picrosirius method. This staining enhances the natural birefringency of collagen fibers and allows for better and specific visualization of collagen fibers bundles under polarizing microscope. In this way the amount of information in the analysed image is increased. Thirty five microphotographs were analysed from each of the investigated groups with the use of optical diffractometry. The radial distribution of light intensity in diffraction patterns was analysed what allowed to evaluate spatial frequencies connected with the width of collagen bundles in induced bone tissue. Since the spatial arrangement of collagen fibers in newly formed bone is random, analysis of angular distribution of light intensity in diffractograms was not performed.Using discriminant analysis the significant differences between all three studied groups of animals were found. The widest differences were found between the Cl₂MBP and HEBP treated animals. They were larger than those between each of these two groups and the control one. In control as well as in HEBP treated animals thicker bundles of collagen fibers were more frequently observed than in the Cl₂MBP treated group, while in the latter thin bundles, nondetected in the former two groups were found. Generally, the radial distribution of light intensity in diffraction patterns of the HEBP treated animals resembles more that in the control group than in the Cl₂MBP treated one. The different effects of the two analysed bisphosphonates (BPs) on the organic bone matrix of heterotopically induced bone is interpreted as differences in their influence on osteogenic cells and/or as differences in their direct influence on extracellular collagen fiber bundles formation.Dedicated to Professor Dr. T.H. Schiebler on the occasion of his 65th birthday     

Fluorescence microscopic distinction between elastin and collagen

Summary Distinction between elastin and collagen in arteriosclerotic lesions is difficult because immature and incompletely cross-linked collagen bind so-called elastica stains; furthermore, abnormal collagen can lack cross-striation and thus resemble elastin in electron microscopy. However, collagen and elastin differ significantly in their content of basic amino acids and hence in their affinity for heteropolyacids. This chemical difference was utilized for the development of a fluorescence microscopic method for distinction between collagen and elastin.Paraffin sections of human autopsy material were treated with a 1% aqueous solution of phosphomolybdic acid (PMA) for five minutes, rinsed in distilled water, dehydrated and mounted. Other series were treated with the PMA-molybdenum blue reaction and with various special stains.Only elastic membranes of aorta, the elastica interna and externa of sizable arteries, and true elastic fibers remained strongly fluorescent; the autofluorescence of collagen, reticulum fibers, basement membranes, pseudo-elastic fibers, and elastic membranes in small arteries was quenched. In other series PMA abolished the fluorescence of basic fluorochromes.Correlation of fluorescence and direct light microscopic observations with chemical and electron microscopic data showed that the PMA-fluorescence method permits distinction between elastin and various types of collagen.     

Aminoglutethimide-stimulated corticotrophs

Thirty-six rats of both sexes in two groups were treated with aminoglutethimide (AG), a steroid synthesis inhibitor, for 1 and 8 weeks respectively. The anterior pituitaries were investigated by light and electron microscopy, the techniques used including immunocytochemical and morphometric methods. Corticotrophs were identified by the avidinbiotin-peroxidase complex technique at the light and electron microscopic levels. AG administration resulted in hyperplasia of ACTH-containing cells. The increase in the volume density of corticotrophs was prevented by simultaneous medication with 3 mg corticosterone in male rats, whereas in female rats a larger dose of corticosterone was required to suppress pituitary corticotroph hyperplasia. Electron microscopy revealed that in AG-treated rats, corticotrophs were larger and contained more secretory granules than those in controls, the mean secretory granule diameter increasing from 100 nm to 165 nm. Under AG stimulation, corticotrophs showed considerable variations in structural features probably reflecting differences in their functional state. It was apparent that only one ACTH-producing cell type existed in the pars distalis of the rat adenohypophysis, although this cell type may undergo substantial morphologic alterations due to changes in endocrine activity. Gonadotrophs and thyrotrophs showed morphologic signs of stimulation and exhibited hyperplasia following AG treatment indicating that the effect of the drug was not restricted to corticotrophs.     

Extracellular Matrix of Porcine Pericardium: Biochemistry and Collagen Architecture

Pericardial tissue has been used to construct bioprostheses employed in the repair of different kinds of injuries, mostly cardiac. However, calcification and mechanical failure have been the main causes of the limited durability of cardiac bioprostheses constructed with bovine pericardium. In the course of this work, a study was conducted on porcine fibrous pericardium, its microscopic structure and biochemical nature. The general morphology and architecture of collagen were studied under conventional light and polarized light microscopy. The biochemical study of the pericardial matrix was conducted according to the following procedures: swelling test, hydroxyproline and collagen dosage, quantification of amino acids in soluble collagen, component extraction of the extracellular matrix of the right and left ventral regions of pericardium with different molarities of guanidine chloride, protein and glycosaminoglycan (GAG) dosage, sodium dodecyl sulfate-polyacrylamide gel electrophoresis and total GAG analysis. Microscopic analysis showed collagen fibers arranged in multidirectionally oriented layers forming a closely knit web, with a larger number of fibers obliquely oriented, initiating at the lower central region toward the upper left lateral relative to the heart. No qualitative differences were found between proteins extracted from the right and left regions. Likewise, no differences were found between fresh and frozen material. Protein dosages from left frontal and right frontal pericardium regions showed no significant differences. The quantities of extracted GAGs were too small for detection by the method used. Enzymatic digestion and electrophoretic analysis showed that the GAG found is possibly dermatan sulfate. The proteoglycan showed a running standard very similar to the small proteoglycan decorin.     

消炎痛对大鼠成熟滤泡破裂的影响——形态学观察

本工作的目的是,观察前列腺素合成的抑制物——消炎痛对大鼠排卵的抑制作用,并从形态学的角度对已排卵的以及排卵受阻的滤泡壁成份进行比较,藉此,探讨卵巢自身的前列腺素在滤泡破裂机制中的作用。25—27天龄Wistar大鼠用PMSG与HCG诱导成熟,其中部分动物作为对照,排卵率为100%;另一部分动物皮下注射消炎痛3.0mg/只,94%的动物被抑制排卵。处于动情前期的自然成熟鼠,注射消炎痛5mg/只或7.5 mg/只,排卵抑制率达100%,而对照鼠均排卵。从诱导成熟及自然成熟的大鼠卵巢组织切片所见,对照鼠已排卵滤泡的裂口处的白膜与膜层的结缔组织纤维断裂;被消炎痛抑制排卵的动物,卵母细胞因不能突破膜层或白膜而受阻。于电镜下见到,对照动物滤泡裂口附近泡壁的白膜细胞及外膜细胞出现退化、解体;与此同时,存在于这两种组织巾的胶元蛋白纤维也呈溶解现象。实验组排卵被阻的滤泡,白膜下与外膜细胞中间仍存在大量胶元蛋白纤维,因而使白膜与外膜层成为阻挡卵母细胞排出的屏障。另外,内膜与颗粒细胞的高尔基体发达,粗糙的内质网趋向光滑,说明这两类细胞分泌功能旺盛。关于前列腺素对胶元蛋白纤维降解的可能作用以及动物经消炎痛处理后仍产生类固醇激素的可能性均进行了讨论。     

Effect of indomethacin on ovarian follicle rupture--a morphological observation

The purpose of this investigation was to study the role played by indomethacin in blocking ovulation. Immature Wistar rats induced to maturation by PMSG and HCG and normal mature rats were used. Changes in follicle wall of preovulatory follicles occurred after indomethacin treatment were studied both by light and electron microscopy, and were compared with those in controls. 94% of PMSG and HCG stimulated rats, then followed indomethacin injection (3 mg/rat), were inhibited to ovulate; while rats only given hormonal stimulation ovulated in 100%. Adult females in proestrus were treated with indomethacin in doses either of 5 mg or 7.5 mg, none of them ovulated. Whereas, ova were found in the ampullae of normal controls. Ovarian histological examinations of indomethacin treated rats showed that ovum frequently went through the stratum granulosa, however, the theca or the albuginea failed to rupture. The electron microscopy examinations showed that a large amount of collagen fibers scattered under the albuginea layer and interwove with cells of albuginea and theca externa. These two layers, due to containing abundant collagen fibers, thus became barriers for an ovum escaping from a follicle. Follicle walls near the gap of ovulated follicles in controls only had a small quantity of collagen fibers which were more or less with obscure appearance. Cytolysis in albuginea and theca externa layers was also noted. Theca interna cells and granulosa cells, with well developed Golgi bodies and more smooth endoplasmic reticulum in experimental rats revealed that these two tissue components still had a normal endocrine function in spite of receiving indomethacin treatment. The possible effects of prostaglandins on degradation of collagen fibers and contraction of preovulatory follicles were also discussed.     

Pulsed and scanned carbon dioxide laser resurfacing 2 years after treatment: comparison by means of scanning electron microscopy

Studies have reported short-term and long-term (1-year) findings for laser skin resurfacing. Two of the most popular systems used for this procedure, the continuous-wave Sharplan 40C SilkTouch system and the pulsed Coherent 5000C UltraPulse system with a computer pattern generator, were previously compared for a range of follow-up times up to 1 year, using light microscopy and transmission electron microscopy. This study analyzed the 2-year morphological differences using scanning electron microscopy. Tissue samples were obtained from 10 patients (age range, 50 to 72 years; skin types II and III) who had undergone laser resurfacing 2 years previously. One half of the face of each patient had been treated with the continuous-wave system and the other half with the pulsed system. The samples were subjected to scanning electron microscopy. On the continuous-wave-treated side, significantly better dermal collagen organization was observed at 2 years, with plump-appearing fibers that were closely knit to form a compact structure. On the side treated with the pulsed system, the collagen fibers in the papillary dermis were more loosely arranged and appeared drier. In both the continuous-wave-treated and pulsed-treated areas, the epidermis appeared healthy and exhibited some signs of age-related deterioration, with slightly flatter plaques and somewhat more flaking keratin on the pulsed-treated side. Probably because of the greater degree of residual thermal damage associated with the continuous-wave system, at 2 years after treatment there was more prolific synthesis and better orientation of collagen fibers, which were maintained for longer times, compared with the pulsed-treated specimens.     

The formation of histotypic fibrous collagen in matrix tissue culture by 3T6 mouse fibroblasts: A response to ascorbic acid

Summary Dense cultures of mouse fibroblast cell line 3T6 were prepared for light microscopic study using either one of two physical substrates, glass slides or a matrix of collagencoated cellulose sponge. Whether propagated on glass or in matrix, cultures receiving a supplement of 250 μg per ml of ascorbic acid formed reticular fibers in less than 10 days. Reticular fibers were more abundant in the matrix cultures than on glass. Fibrous collagen was not found with light or electron microscopy in cultures fed on the control medium, i.e. without the ascorbic acid supplement. Supported by Research Grant P-442 from the American Cancer Society. Presented at the 19th annual meeting of the Tissue Culture Association in June 1968 at San Juan, Puerto Rico. During this investigation Dr. Coldblatt was a Faculty Research Associate of the American Cancer Society, Inc. (Grant PRA-60)     

A quantitative evaluation of Fourier components in transparent and opaque calf cornea

Fourier transform methods were applied to STEM (scanning transmission electron microscopy) images to detect and quantify the subtle differences between the structure of normal transparent calf cornea and opaque calf cornea. In order for a tissue to be transparent, it can scatter or absorb only a small amount of light. Light scattering is minimized when the principal Fourier components of the spatial fluctuations in the index of refraction have wavelengths which are small relative to the wavelength of light (Benedek, 1971). Corneal opacity was produced as a result of high intraocular pressure (100-150 mmHg) when liquid was injected into calf eyes (0-2 weeks old). Pressurization created large structural defects and slight disruptions in the organization of the collagen fibers. Although the fiber organization appeared similar in the micrographs of both opaque and transparent corneas, Fourier analysis of STEM images collected at 50K magnification identified statistically significant differences. Far fewer Fourier components with wavelengths in the light scattering range (200-1100 nm) were observed in the transparent corneas than in the pressurized corneas as predicted by Benedek's theory. It was of interest that corneas treated with 100% glycerol prior to pressurization remained transparent at high intraocular pressures, possibly because glycerol stabilized the structure of the corneas and maintained a uniform index of refraction across the corneal stroma. The results demonstrate the effectiveness of Fourier analysis in detection and quantification of slight changes in structure at the electron microscopic level.     

Statistical modeling of ultrastructural features of murine dermal collagen under chronic low-dose whole body X-irradiation

The present study investigated the changes in ultrastructural features of dermal collagen fibrils of mice following exposure to different cumulative chronic low-dose X-irradiation through digital image analysis-based statistical modeling. Pubertal mice were X-irradiated and dorsal skin biopsies were collected and processed for transmission electron microscopic (TEM) analysis. TEM features of collagen fibrils showed alteration in the cross-sectional area, population density and in the axial periodic pattern of light and dark bands. The mathematical analysis of histogram data from TEM images revealed some adaptive behavior in collagen structures of the X-irradiated group. This finding indicated that exposure to chronic low-dose X-radiation induced an altered steady state with adaptive variation in dermal collagen fibrils in irradiated mice.     

Immunoelectron microscopic localization of laminin, type IV collagen, and type III pN-collagen in reticular fibers of human lymph nodes

We studied the ultrastructural distribution of laminin, type IV collagen, and the amino terminal pro-peptide of type III collagen (type III pN-collagen) in normal human lymph nodes. After fixation with freshly prepared 4% paraformaldehyde mixed with 0.1% glutaraldehyde, cryoultramicrotomy proved to preserve the antigenicity of these proteins better than embedding in Lowicryl K4M. Sections were treated with rabbit antibodies against the 7S domain of human type IV collagen, the fragment P1 of human laminin, and the amino terminal pro-peptide of human type III pro-collagen, followed by anti-rabbit IgG conjugated to 10-nm colloidal gold. Laminin and type IV collagen were seen in the basement membrane structures of the blood vessels and in the walls of sinuses. The amorphous material between the collagenous fibers in locations corresponding to reticular fibers also contained laminin and type IV collagen. The amino terminal pro-peptide of type III pro-collagen was present in the collagenous fibers in reticular fibers and in the walls of blood vessels and sinuses. Therefore, a significant number of the type III collagen molecules in these fibers must have retained their amino terminal pro-peptide. These results indicate that the basement membrane proteins laminin and type IV collagen are genuine components of reticular fibers, as suggested earlier by immunohistochemical studies at the light microscopic level.     

Effect of Mederma on hypertrophic scarring in the rabbit ear model

Currently accepted conservative treatments of hypertrophic scars are limited to steroid injections, radiation therapy, and silicone occlusive therapy. However, the use of Mederma for these problematic lesions has become quite prevalent in the clinical setting. Little scientific evidence exists to support the efficacy of this product in reducing hypertrophic scars. The aim of this study was to study the effects of Mederma on hypertrophic scars in the rabbit hypertrophic scar model, allowing the histologic quantification of scar elevation, dermal collagen organization, vascularity, and inflammation and the gross examination of scar erythema. Full-thickness wounds down to cartilage, four per ear, were created in four New Zealand White rabbits, for a total of 32 scars. Twenty-eight days after the initial wounding, the hypertrophic scars were photographed, and treatment of half of the scars on each ear was begun with Mederma three times per day for a total of 4 weeks. The untreated scars served as control scars and were left exposed to air. After 4 weeks of treatment, the scars were once again photographed. The rabbits were then killed, and the scars were analyzed histologically. The pretreatment and posttreatment photographs were compared by using computer quantification of magenta, yellow, and cyan expression within the scars.Histologic analysis demonstrated no significant reduction in scar hypertrophy or scar elevation index. However, a significant improvement in dermal collagen organization was noted on comparing Mederma-treated scars with untreated control scars (p < 0.05). No significant difference in dermal vascularity or inflammation was noted. Computer analysis of the scar photographs demonstrated no significant reduction in scar erythema with Mederma treatment. The active product in Mederma, allium cepa, has as its derivative quercetin, a bioflavonoid noted for its antiproliferative effects on both normal and malignant cells, and its antihistamine release effects. These properties could theoretically prove beneficial in reversing the inflammatory and proliferative responses noted in hypertrophic scars. Despite the authors' inability to demonstrate a reduction in scar hypertrophy, the improvement in collagen organization noted in the Mederma-treated scars suggests it may have an effect on the pathophysiology of hypertrophic scar formation.     

Development of photochemical method for meniscal repair: a preliminary study

Visible light combined with naphthalimides has previously been shown to catalyze formation of physical bonds in avascular meniscal tissue. The first objective was to modify the existing in vitro testing method (i.e., adhesion testing using lap-jointed slices) to gain more sensitivity in detecting relative bonding strengths among candidate bonding agents. A repeated measures experimental design (RMED) was used to account for variability in properties among bovine menisci and was achieved by testing all treatments/controls on slices from each meniscus. Additionally, to make the method more clinically relevant in modeling a bucket-handle tear, the bovine meniscal slices were cut with collagen fibers parallel to the test slice's length. Peak stress was greater for the complete treatment group (light plus naphthalimide) than for the control or incomplete treatment groups (light only or napthalimide only). The second objective was to perform concentration and photoactivation time dose-response studies. In the concentration dose-response study, peak stress was greater for all treatments when compared with the control but not different among treatment groups; however, there was a trend of increased bonding strength with increased concentration. In the photoactivation time dose-response study, peak stress was greater for all treatments when compared with the control and greater for the 3-min treatment vs. the 6- and 9-min treatments. Peak stress was not different between the longer treatments. The RMED provided increased reproducibility and statistical sensitivity for detecting differences among treatments and will be used to test candidate bonding agents prior to in vivo testing.     

Effect of P144? (Anti-TGF-β) in an “In Vivo” Human Hypertrophic Scar Model in Nude Mice

Background

Hypertrophic scars are one of the most important complications in surgery due to their cosmetic and functional impairments. Previous studies in tissue fibrotic disorders have shown promising results by inhibiting the biological activity effect of Transforming Growth Factor-beta 1 (TGF-β1). The aim of the current study was to determine the clinical effect of the inhibition of TGF-β1 signaling in human hypertrophic scars implanted in nude mice by topical application of an inhibitor of TGF-β1 (P144®).

Material and Methods

A total of 30 human hypertrophic scars were implanted in 60 nude mice. The animals were divided in two groups, group A (placebo) and group B (treatment). Group C (basal) was considered as the preimplanted scar samples and they were not implanted in the nude mice. After the shedding period, topical application of a lipogel containing placebo (group A) or P144 (group B) was daily administered during two weeks. The animals were sacrificed upon completion of the study. Total area, thickness and collagen fibers area were measure and compared across all groups. Immunohistochemistry was also performed in order to quantify collagen type I and type III and elastic fiber expressions present in the dermis.

Results

Successful shedding was achieved in 83,3% of the xenografts. The mean time for shedding was 35±5.4 days. Statistically significant differences were found in the total area, collagen fibers area and thickness between the groups. Increased elastic fibers and decreased collagen I were found in the P144-treated group compared to the basal group.

Conclusion

Topical application of an inhibitor of TGF-β1 may promote scar maturation and clinical improvement of hypertrophic scar morphology features in an “in vivo” model in nude mice after two weeks of treatment.     

Light and electron microscopic studies on the localization of steroid-binding protein (SBP) in rabbit spermatozoa

Light (fluorescence) and electron microscopic studies were carried out to localize steroid-binding protein (SBP) in rabbit spermatozoa. Both nonpermeabilized and permeabilized (with Tween 20, saponin, or cold acetone) spermatozoa showed fluorescence following treatment with antirabbit SBP (anti-rSBP) and subsequently with rabbit antisheep immunoglobulin G-fluorescein isothiocyanate. While the ejaculated spermatozoa were positive, epididymal sperm were observed to be negative. Although the pattern of localization of rSBP was variable, the occurrence of a negative equatorial region as well as the presence of an intense positive spherical profile ("spot") at the junction of the head and midpiece were notably consistent. The intensity of labeling with the probe, both at light and electron microscopic level, was maximal following permeabilization with cold acetone. A possible role of SBP as a steroid carrier protein across the plasma membrane of the sperm has been suggested.     

Proteoglycans and collagenase in hypertrophic scar formation.

The collagen fibers of the nodules and whorl-like figures in hypertrophic scars are "coated" with proteoglycans, mainly chondroitin-4-sulfate. The latter was shown to prevent collagenase from breaking down collagen. This suggests that the presence of great amounts of chondroitin-4-sulfate in hypertrophic scars may contribute to the overabundance of collagen deposition which is characteristic of this abnormal healing process.     

In Vitro Orientation of Fibroblasts and Myoblasts on Aligned Collagen Film

A collagen film in which the collagen fibers were aligned was prepared and characterized by scanning electron microscopy. Cell orientation on this film was studied in vitro using human fibroblasts and chick embryo myoblasts. Ninety-four percent of innoculated fibroblasts were aligned along the direction of the collagen fiber. The cell orientation was disturbed when cytochalasin B or colchicine was added to the culture medium. The myoblasts showed a similar alignment along the direction of collagen fiber. The scanning electron microscopic observation revealed that none of the cytoplasmic extensions had consistent relationships to the direction of collagen fiber. Myoblast fusion was accelerated on the aligned membrane as compared to a randomly oriented film, suggesting some role of contact guidance in muscle cell differentiation.     

Study of tensiometric properties,microbiological and collagen content in nile tilapia skin submitted to different sterilization methods

Tissue bioengineering development is a global concern and different materials are studied and created to be safe, effective and with low cost. Nile Tilapia skin had shown its biological potential as covers for the burn wound. This study evaluates the tilapia skin histological, collagen properties and tensiometric resistance, after treatment by different sterilization methods. Tilapia skin samples were submitted to two sterilization processes: (1) chemical, which consisted in two 2% chlorhexidin baths, followed by sequential baths in increasing glycerol concentrations; and (2) radiation, when glycerolized skin samples were submitted to gamma radiation at 25, 30 and 50 kGy. Microscopic analyzes were performed through Haematoxylin–eosin and Picrosirius Red under polarized light. For tensiometric analysis, traction tests were performed. Glycerol treated skin presented a discrete collagen fibers disorganization within the deep dermis, while irradiated skin did not show any additional change. Throughout the steps of chemical sterilization, there was a higher proportion of collagen with red/yellow birefringence (type I) in the skin samples up to the first bath in chlorhexidin, when compared to samples after the first two glycerol baths (P < 0.005). However, there was no difference in relation to total collagen between groups. In irradiated skin, there was a larger total collagen preservation when using until 30 kGy (P < 0.005). Tensiometric evaluation did not show significant differences in relation to maximum load in the groups studied. We concluded that chemical and radiation (25 and 30 kGy) are efficient methods to sterilize Nile Tilapia skin without altering its microscopic or tensiometric characteristics.     

Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids

Although therapeutic management of hypertrophic scars and keloids using contact or spray cryosurgery has yielded significant improvement or complete regression of hypertrophic scars and keloids, it requires one to 20 treatment sessions. This study was designed to assess the clinical safety and efficacy of an intralesional needle cryoprobe method in the treatment of hypertrophic scars and keloids.Ten patients, ranging in age from 3 to 54 years, with a total of 12 hypertrophic scars and keloids of more than 6 months duration and of diverse causes, were included in this study. The 18-month trial evaluated volume reduction of the hypertrophic scars and keloids after a single session of intralesional cryotherapy. Objective (hardness and color) and subjective (pain/tenderness and itchiness/discomfort) parameters were examined on a scale of 0 to 3 (low score was better). Pretreatment and posttreatment histomorphometric studies of the collagen fibers included spectral picrosirius red polarization and fast Fourier transformation orientation index. A specially designed cryo-needle was inserted into the long axis of the hypertrophic scars and keloids so as to maximize the volume of the hypertrophic scars and keloids to be frozen. The cryo-needle was connected by an adaptor to a cryogun filled with liquid nitrogen, which was introduced into the cryoprobe, thereby freezing the hypertrophic scars and keloids. After the hypertrophic scars and keloids were completely frozen, the cryoprobe defrosted and was withdrawn.An average of 51.4 percent of scar volume reduction was achieved after one session of intralesional cryosurgery treatment (average preoperative hypertrophic scars and keloids volume, 1.82 +/- 0.33; average posttreatment volume, 0.95 +/- 0.21; p < 0.0022). Significant alleviation of objective and subjective clinical symptoms was documented. Mild pain or discomfort during and after the procedure was easily managed. Only mild local edema and epidermolysis, followed by a short reepithelialization period, were evident. During the 18-month follow-up period, there was no evidence of bleeding, infection, adverse effects, recurrence, or permanent depigmentation. The histomorphometric analysis demonstrated rejuvenation of the treated scars (i.e., parallelization) and a more organized architecture of the collagen fibers compared with the pretreated scars.This study demonstrated the increased efficacy of this method as a result of increased freezing area of deep scar material compared with that obtained with contact/spray probes. As a result, fewer treatment cycles are needed. Because the reepithelialization period is short, treatment intervals, if any, can be shortened to 2 to 3 weeks. This intralesional cryoneedle method is simple to operate and safe to use, it necessitates less postoperative care of the wound, and it can easily be added to any preexisting cryosurgical unit.