Treatment of large distal extremity skin wounds with autogenous full-thickness mesh skin grafts in 5 cats

Five cats with large, distal extremity abrasion wounds were treated with an autogenous, full-thickness, mesh skin graft. Survival of the mesh grafts in all five cats was considered between 90 and 100%. Successful grafting requires asepsis, an adequately prepared recipient bed consisting of healthy granulation tissue, proper harvesting and preparation of the graft, meticulous surgical technique and strict postoperative care. Factors that are essential for the survival of skin grafts include good contact between the graft and the recipient bed, normal tension on the sutured graft, strict immobilization after grafting and prevention of accumulation of blood or serum under the graft. Meshing the graft provides more graft flexibility over uneven surfaces and allows adequate drainage. In contrast to previous proposals, the authors recommend no bandage change before the fourth day after grafting. Full-thickness mesh skin grafting can be used to successfully treat large distal skin wounds in cats.

Soft tissue wound healing around teeth and dental implants.

AIM To provide an overview on the biology and soft tissue wound healing around teeth and dental implants. MATERIAL AND METHODS This narrative review focuses on cell biology and histology of soft tissue wounds around natural teeth and dental implants. RESULTS AND CONCLUSIONS The available data indicate that: (a) Oral wounds follow a similar pattern. (b) The tissue specificities of the gingival, alveolar and palatal mucosa appear to be innately and not necessarily functionally determined. (c) The granulation tissue originating from the periodontal ligament or from connective tissue originally covered by keratinized epithelium has the potential to induce keratinization. However, it also appears that deep palatal connective tissue may not have the same potential to induce keratinization as the palatal connective tissue originating from an immediately subepithelial area. (d) Epithelial healing following non-surgical and surgical periodontal therapy appears to be completed after a period of 7–14 days. Structural integrity of a maturing wound between a denuded root surface and a soft tissue flap is achieved at approximately 14-days post-surgery. (e) The formation of the biological width and maturation of the barrier function around transmucosal implants requires 6–8 weeks of healing. (f) The established peri-implant soft connective tissue resembles a scar tissue in composition, fibre orientation, and vasculature. (g) The peri-implant junctional epithelium may reach a greater final length under certain conditions such as implants placed into fresh extraction sockets versus conventional implant procedures in healed sites.

[Therapy-resistant pneumonia]

We report the case of a 72 year old patient with B-symptoms and a persistent pulmonary infiltrate despite an antibiotic therapy. Buds of granulation tissue were found by transbronchial biopsy proving an organizing pneumonia. B-Symptoms and pulmonary infiltrate were improved immediately by a therapy with steroids. Even though there were reasons for a secondary organizing pneumonia due to a known chronic lymphocytic leukemia and a pneumonia treated four months before, we consider a cryptogenic organizing pneumonia as most probable.

Delayed Thrombus Resolution and Fibroproliferative Vascular Wound Healing From Deficiency of Type III Collagen: a Paradoxical Mechanism for Tissue Fragility

Vascular Ehlers-Danlos syndrome is a heritable disease of connective tissue caused by mutations in COL3A1, conferring a tissue deficiency of type III collagen. Cutaneous wounds heal poorly in these patients, and they are susceptible to spontaneous and catastrophic rupture of expansible hollow organs like the gut, uterus, and medium-sized to large arteries, which leads to premature death. Although the predisposition for organ rupture is often attributed to inherent tissue fragility, investigation of arteries from a haploinsufficient Col3a1 mouse model (Col3a1+/-) demonstrates that mutant arteries withstand even supraphysiologic pressures comparably to wild-type vessels. We hypothesize that injury that elicits occlusive thrombi instead unmasks defective thrombus resolution resulting from impaired production of type III collagen, which causes deranged remodeling of matrix, persistent inflammation, and dysregulated behavior by resident myofibroblasts, culminating in the development of penetrating neovascular channels that disrupt the mechanical integrity of the arterial wall. Vascular injury and thrombus formation following ligation of the carotid artery reveals an abnormal persistence and elevated burden of occlusive thrombi at 21 post-operative days in vessels from Col3a1+/- mice, as opposed to near complete resolution and formation of a patent and mature neointima in wild-type mice. At only 14 days, both groups harbor comparable burdens of resolving thrombi, but wild-type mice increase production of type III collagen in actively resolving tissues, while mutant mice do not. Rather, thrombi in mutant mice contain higher burdens of macrophages and proliferative myofibroblasts, which persist through 21 days while wild-type thrombi, inflammatory cells, and proliferation all regress. At the same time that increased macrophage burdens were observed at 14 and 21 days post ligation, the medial layer of mutant arterial walls concurrently harbored a significantly higher incidence of penetrating neovessels compared with those in wild-type mice. To assess whether limited type III collagen production alters myofibroblast behavior, fibroblasts from vEDS patients with COL3A1 missense mutations were seeded into three-dimensional fibrin gel constructs and stimulated with transforming growth factor-β1 to initiate myofibroblast differentiation. Although early signaling events occur similarly in all cell lines, late extracellular matrix- and mechanically-regulated events like transcriptional upregulation of type I and type III collagen secretion are delayed in mutant cultures, while transcription of genes encoding intracellular contractile machinery is increased. Sophisticated imaging of collagen synthesized de novo by resident myofibroblasts visualizes complex matrix reorganization by control cells but only meager remodeling by COL3A1 mutant cells, concordant with their compensatory contraction to maintain tension in the matrix. Finally, administration of immunosuppressive rapamycin to mice following carotid ligation sufficiently halts the initial inflammatory phase of thrombus resolution and fully prevents both myofibroblast migration into the thrombus and the differential development of neovessels between mutant and wild-type mice, suggesting that pathological defects in mutant arteries develop secondarily to myofibroblast dysfunction and chronic inflammatory stimulation, rather than as a manifestation of tissue fragility. Together these data establish evidence that pathological defects in the vessel wall architecture develop in mutant arteries as sequelae to abnormal healing and remodeling responses activated by arterial injury. Thus, these data support the hypothesis that events threatening the integrity of type III collagen-deficient vessels develop not as a result of inherent tissue weakness and fragility at baseline but instead as an episodic byproduct of abnormally persistent granulation tissue and fibroproliferative intravascular remodeling.

Geochemistry of Pliocene-Pleistocene volcanic sands of ODP Site 136-842

Several distinct, thin (2-7 cm), volcanic sand layers ("ashes") were recovered in the upper portions of Holes 842A and 842B. These holes were drilled 320 km west of the island of Hawaii on the outer side of the arch that surrounds the southern end of the Hawaiian chain. These layers are Pliocene to Pleistocene in age, graded, and contain fresh glass and mineral fragments (mainly olivine, plagioclase, and clinopyroxene) and tests of Pleistocene to Eocene radiolarians. The glass fragments are weakly vesicular and blocky to platy in shape. The glass and olivine fragments from individual layers have large ranges in composition (i.e, larger than expected for a single eruption). These features are inconsistent with an explosive eruption origin for the sands. The only other viable mechanism for transporting these sands hundreds of kilometers from their probable source, the Hawaiian Islands, is turbidity currents. These currents were probably related to several of the giant debris slides that were identified from Gloria sidescan images around the islands. These currents would have run over the ~500-m-high Hawaiian Arch on their way to Site 842. This indicates that the turbidity currents were at least 325 m thick. Paleomagnetic and biostratigraphic data allow the ages of the sands to be constrained and, thus, related to particular Hawaiian debris flows. These correlations were checked by comparing the compositions of the glasses from the sands with those of glasses and rocks from islands with debris flows directed toward Site 842. Good correlations were found for the 110-ka slide from Mauna Loa and the ~1.4-Ma slide from Lanai. The correlation with Kauai is poor, probably because the data base for that volcano is small. The low to moderate sulfur content of the sand glasses indicates that they were derived from moderately to strongly degassed lavas (shallow marine or subaerially erupted), which correlates well with the location of the landslide scars on the flanks of the Hawaiian volcanoes. The glass sands may have been formed by brecciation during the landslide events or spallation and granulation as lava erupted into shallow water.

Aplicación de un tratamiento biológico a las aguas residuales provenientes de una destilería de alcohol de caña, utilizando un reactor UASB

En este trabajo se llevó a cabo el tratamiento de vinazas mediante dos tecnologías anaerobias. Se dividió en cuatro estudios técnicos. El primero fue el arranque y estabilización del reactor UASB (Upflow Anaerobic Sludge Blanket), en dónde se evaluó la estabilización mediante la eficiencia de remoción de DQO y la granulación del lodo. El segundo estudio evaluó el rendimiento del reactor UASB frente a diferentes Cva. El tercer estudio evaluó el efecto del TRH sobre la eficiencia del reactor UASB, y el cuarto de ellos fue evaluar el rendimiento del RABF (Reactor Anaerobio de Biomasa Fija). El reactor UASB de 2,6 L de capacidad, fue arrancado por lotes, con seis ensayos utilizando vinaza como sustrato. Se obtuvieron eficiencias de remoción en DQO en un rango de 79-91%, en los seis lotes. Se obtuvo formación de gránulos con diámetro (Ø) de 0,85-1,15 mm y un coeficiente de esfericidad (Є) de 0,7-0,77. Se logró la granulación de lodos tras 2 meses de operación. Alcanzada la estabilización del reactor UASB, se siguió una operación en flujo continuo. Las Cva probadas de 1, 2, 4 y 6 gDQO/L.d para el reactor UASB dan una respuesta bastante favorable con respecto al rendimiento del reactor, ya que presento eficiencias de remoción de DQOs del 51 hasta el 76%, eficiencias similares a los reportados por la literatura. En el estudio de TRH se operó con Cva de 6 gDQO/L.d y los TRH fueron de 24, 12 ,5 ,3 y 1 día. El % de eliminación de DQO fue de 51, 60, 57, 60 y 63 % remoción en DQOsoluble, respectivamente. Se alcanzó una producción de biogás máximo de 5.283 ml/d, pero al reducir el TRH se observó una reducción proporcional del volumen total de biogás. El %CH4 contenido en el biogás aumento al disminuir el TRH, reflejando valores de 80 al 92 % de CH4. El RABF con un volumen de 8,2 L, utilizo tubos de plástico corrugado como medio de soporte para las bacterias. Se aplicaron las siguientes Cva; 0,5, 1, 3 y 6 gDQO/L.d. El reactor RABF presento una excelente remoción de la materia orgánica (80% DQOs), una producción de biogás estable, y un contenido en CH4 del biogás muy interesante. Sin embargo, para una Cva superior a 3 gDQO/L.d empezó un comportamiento inesperado de reducción de capacidad. Las condiciones hidrodinámicas del reactor UASB son decisivas para la formación de los gránulos, condición previa para iniciar el flujo continuo. Al operar el reactor UASB en modo continuo, se pudo evaluar las mejores condiciones de operación para este tipo de residuo (vinaza). La Cva de 6 gDQO/L.d para el reactor UASB alimentado con vinaza bruta representa el límite de su capacidad. Sin embargo, al aumentar la Cva se genera una mayor producción de biogás y metano. La eficiencia de remoción de la DQO soluble es independiente del TRH, para una Cva de 6 g DQO/L•d y las condiciones de TRH probadas (24, 12, 5, 3 y 1 días). Los valores de remoción de DQO alcanzados son un poco superior a los valores de biodegradabilidad anaerobia de la vinaza observados de 50 %. De manera general, la reducción del TRH o bien la dilución de la vinaza no presenta un efecto significativo sobre la remoción de la materia orgánica soluble, pero si lo presenta en la remoción de sulfatos reduciendo indirectamente su toxicidad. El soporte termoplástico inoculado en el RABF y alimentado con vinaza bruta, actuó como un filtro, además de obtener buenos resultados en eliminación de DQO, pero dada las dimensiones y la altura del relleno se frena la evacuación del metano. This work was carried out by treatment vinasses with two anaerobic technologies. It was divided into four technical studies. The first was the start up and stabilization Upflow Anaerobic Sludge Blanket (UASB) reactor, where the stability was evaluated by the removal efficiency of COD and sludge granulation. The second study evaluated the performance of the UASB reactor against different OLR. The third study evaluated the effect of HRT on the efficiency of the UASB reactor, and the fourth of which was evaluate the performance Fixed Biomass Anaerobic (FBA) reactor. The UASB reactor of 2,6 L capacity, was started in batch, with six assays using vinasse as substrate. Were obtained removal efficiencies of COD in the range of 79- 91% in the six batches. Forming granules were obtained with a diameter (Ø) of 0,85- 1,15 mm and sphericity coefficient (Є) of 0,7 to 0,77. Sludge granulation was achieved after 2 months of operation. Once stabilization is achieved of the UASB reactor, it was followed by a continuous flow operation. The OLR tested 1, 2, 4 and 6 gCOD/L.d for UASB reactor gives a very favorable response regarding the performance of the reactor, as presented COD5 removal efficiencies of 51 to 76%, similar efficiencies those reported in the literature The HRT study was operated with an OLR of 6 gCOD/L.d and HRT were 24, 12, 5, 3 and 1 day. The removal efficiency was 51, 60, 57, 60 and 63% in soluble COD, respectively. It reached a maximum biogas production of 5.283 ml / d, but by reducing the HRT showed a proportional reduction in the total volume of biogas. The %CH4 content in the biogas increased with decreasing TRH, reflecting values of 80 to 92% of CH4. The FBA reactor with a volume of 8,2 L, used corrugated plastic tubes as carrier for bacteria transportation. The following OLR was applied, 0,5, 1, 3 and 6 gCOD/L.d. The FBA reactor showed an excellent removal of organic matter (80% CODS), a stable biogas production, and CH4 content very interesting. However, for more than 3 gCOD/L.d OLR began with unexpected behavior of capacity reduction. The UASB reactor hydrodynamic conditions are decisive for the formation of the granules, precondition to start the continuous flow. By operating the UASB reactor in continuous mode, it was possible to evaluate the best operating conditions for this type of waste (vinasse). The OLR of 6 gCOD/L.d for the UASB reactor fed with raw vinasse represents the limit of its capacity. However, with increasing OLR creates increased biogas production and methane. The removal efficiency of soluble COD is independent of HRT for OLR of 6 gCOD/L.d and HRT conditions tested (24, 12, 5, 3 and 1 day). COD Removal values achieved are slightly higher than the values of the vinasse anaerobic biodegradability of observed at 50%. Generally, reduction of HRT or vinasse dilution does not present a significant effect on the removal of the soluble organic matter; however if it occurs in the removal of sulfate reducing indirectly its toxicity. The thermoplastic support inoculated in FBA reactor and fed with raw vinasse, acted as a filter, in addition to obtaining good results in COD removal, but given the size and height of the filling slows evacuation of methane.

Intereses exógenos y resistencia ciudadana en la transformación físicosocial de un asentamiento auto-producido de Dakar (2005-2011)

La presión sobre el acceso a la tierra en la península de Dakar, Senegal, ha generado un proceso de transformación físico-social del mayor asentamiento auto-producido de la periferia urbana de Dakar (Pikine Irregular Sur) en el periodo 2005-2011. Esta investigación se propone analizar en qué medida las acciones llevadas a cabo: i) satisfacen o no el sistema integral de necesidades de los afectados (Demanda); ii) favorecen la implicación de los afectados o, por el contrario, fortalecen las estructuras de poder dominantes (Oferta), y iii) promueven o no la autonomía económica, la sostenibilidad ambiental, la equidad social y la legitimidad de los actores que participan (Entorno). La investigación se ha llevado a cabo por el método de estudio de casos, mediante un proceso de recogida de información participativo, articulado de abajo hacia arriba, en el que han participado 196 personas; la información recogida se ha procesado mediante la utilización de dos herramientas de análisis de realidades complejas: flujo de programa y sistema funcional. Los resultados del estudio de los casos 1 y 2 muestran que las acciones se han llevado a cabo en beneficio de los intereses de los mercados y de los actores que toman las decisiones y gestionan los recursos, incrementando la dependencia económica, empobreciendo a los directamente afectados y fragmentando su tejido social, promoviendo un desarrollo urbano desequilibrado, disperso y segregado, y deslegitimando a las instituciones involucradas. En el estudio del caso 3, en cambio, se verifica que la acción se ha llevado a cabo en beneficio de los intereses de los directamente afectados, utilizando recursos endógenos, fortaleciendo su tejido social, promoviendo un desarrollo urbano concentrado e inclusivo, e incrementando la legitimidad de las instituciones involucradas. El análisis cruzado de los resultados muestra que la pobreza, la exclusión social y la precariedad habitacional, en el contexto específico de la periferia de Dakar, no son un problema de falta de recursos, sino de falta de ética por parte de quienes gestionan y financian los procesos de transformación físico-social, y de falta de voluntad por parte de las autoridades de implicar a los ciudadanos, y en particular a los directamente afectados, en los procesos de toma de decisiones de las acciones y los programas que les afectan. Finalmente se concluye que no se trata de luchar contra la pobreza, sino de luchar contra los sistemas injustos que generan la pobreza y la exclusión. ABSTRACT The pressure on the access to land in the area of Dakar, Senegal, has generated a physical/social transformation process in the largest self-produced settlement in the urban periphery of Dakar (South Irregular Pikine), in the period 2005-2011. This research aims to analyze to what extent the actions carried out: i) satisfy the integral needs of the affected population (Demand), ii) encourage the involvement of those affected or otherwise strengthen dominant power structures (Supply), and iii) promote or inhibit economic autonomy, environmental sustainability, social equity and legitimacy of the actors involved (Environment). The research was conducted by the case study method. 196 people participated in a bottom-up participatory process of information gathering. The information collected was processed using two custom tools aimed to analyse complex systems: the program flow and the functional system. The results of case studies 1 and 2 show that the actions were carried out in the best interest of the markets and the actors who made decisions and managed resources, increasing economic dependence, impoverishing those directly affected and fragmenting their social network by promoting an unbalanced, dispersed and segregated urban development, and de-legitimizing the institutions involved in the process. On the contrary, in the case study 3 it is verified that the action has been carried out on behalf of the interests of those directly affected, using endogenous resources, strengthening the social network, promoting a focused and inclusive urban development, and increasing legitimacy of the institutions involved. The comparative analysis of the results shows that poverty, social exclusion and precarious housing in South Irregular Pikine are not a problem of lack of resources but of unethical behaviour of those who manage and finance physical and social transformation processes, as well as unwillingness on the part of the authorities to involve citizens in the decision making processes for the actions and programs that affect them. Finally we conclude that the enemy to fight against is not poverty but unfair systems that generate poverty and exclusion. RÉSUMÉ La pression sur le foncier dans la presqu'île de Dakar, au Sénégal, a généré un processus de transformation physico-sociale du plus grand établissement auto-produit de la périphérie urbaine de Dakar (Pikine Irrégulier Sud), durant la période 2005-2011. Cette recherche vise à analyser dans quelle mesure les actions menées: i) répondent ou non à l’ensemble des besoins intégrales des personnes concernés (Demande), ii) encouragent l'implication des concernées ou au contraire renforcent les structures de pouvoir dominant (Offre), et iii) favorisent ou non l'autonomie économique, la durabilité environnementale, l'équité sociale et la légitimité des acteurs concernés (Contexte). La recherche a été menée par la méthode des études de cas, par un processus de collecte d'information participative articulée du bas vers le haut dans lequel ont participé 196 personnes. Les informations recueillies ont été traitées à l'aide de deux outils d'analyse de réalités complexes: le système fonctionnel et le flux de programme. Les résultats de l'étude de cas 1 et 2 montrent que les actions ont été menées au profit des intérêts des marchés et des acteurs qui prennent les décisions et gèrent les ressources, augmentant la dépendance économique, appauvrissant ceux qui sont directement concernés et fragmentant leur tissu social, encourageant un développement urbain déséquilibré, dispersé et ségrégé, et délégitimant les institutions concernées. Dans l'étude de cas 3, cependant, il est vérifié que l'action a été menée au profit des intérêts de ceux qui sont directement concernés, en utilisant des ressources endogènes, en renforçant son tissu social, en encourageant un développement urbain concentré et inclusif, et en augmentant la légitimité des institutions concernées. L'analyse comparée des résultats montre que la pauvreté, l'exclusion sociale et le logement précaire, dans le contexte spécifique de la banlieue de Dakar, ne sont pas un problème de manque de ressources, mais de manque d'éthique de la part de ceux qui gèrent et financent les processus de transformation physico-sociale, et de manque de volonté de la part des autorités d'impliquer les citoyens, en particulier ceux qui sont directement concernés, dans le processus de prise de décision des actions et des programmes qui les impliquent. Finalement, on conclut qu'il ne s'agit pas de lutter contre la pauvreté, mais de lutter contre les systèmes injustes qui produisent la pauvreté et l'exclusion.

Iniciativas institucionales y asociativas destinadas a la integración sociocultural a través del deporte en París y Madrid

El deporte como fenómeno social y cultural ha sido ampliamente reivindicado por sus virtudes integradoras. A la actividad físico-deportiva, ya sea de competición o recreativa, se le han atribuido unos valores integradores que permitirían un ascenso de estatus social, argumento justificado en parte por los éxitos de jugadores de origen inmigrante en el deporte profesional. Por otro lado, el tejido asociativo, y especialmente el generado por la comunidad migrante, también utiliza la organización deportiva como forma de solidaridad y reivindicación identitaria. El objetivo de la tesis es analizar la formulación de los programas deportivos formulados a nivel político y asociativo en los barrios con mayor presencia de jóvenes inmigrantes y/o de segunda generación de París y Madrid destinadas a su integración sociocultural y analizar la implementación de dichas iniciativas. El método de recogida de datos consistió en la realización de 72 entrevistas en profundidad a varios niveles de responsabilidad política y de tipología de entidades sociales, así como el análisis documental de fuentes institucionales y asociativas. Los resultados muestran diferencias entre el planteamiento y la ejecución de las iniciativas condicionadas por el modelo de integración de cada contexto –oposición del modelo republicano en París al deporte comunitarista– y por la situación de crisis económica –fragilidad de los programas por el recorte presupuestario y subvenciones en el contexto madrileño–. Las conclusiones de esta tesis buscan profundizar en la verdadera contribución del deporte a la integración social y cultural de los jóvenes de origen inmigrante, y por extensión, a las sociedades culturalmente plurales. RÉSUMÉ Le sport en tant que phénomène social et culturel a été largement revendiqué pour ses vertus intégratrices. À l'activité physique et sportive, en forme de compétition où de loisirs, ont a attribué certaines valeurs intégratrices qui permettent une ascension de statut social, argument justifié en partie par le succès des joueurs d'origine immigrée dans le sport professionnel. Par ailleurs, le tissu associatif, et surtout celui engendré par la communauté migrante, a également utilisé l'organisation sportive comme une forme de solidarité et de revendication identitaire. L'objectif de la thèse est d'analyser la formulation des programmes sportifs à niveau politique et associatif dans les quartiers ayant une plus grande présence de jeunes immigrants et / ou deuxième génération de Paris et de Madrid, destinés à leur intégration socioculturelle et d'analyser la mise en oeuvre de ces initiatives. La méthode de collecte de données était de mener 72 entretiens semi-structurés à différents niveaux de responsabilité politique et de typologie des entités sociales, ainsi que l'analyse documentaire des sources officielles et associatives. Les résultats montrent des différences entre l'approche et la mise en oeuvre d'initiatives conditionnées par le modèle d'intégration de chaque contexte –l'opposition du modèle républicain à Paris envers le sport communautariste– et par la situation de crise économique –fragilité des programmes par les compressions budgétaires et les subventions dans le contexte madrilène–. Les conclusions de cette thèse visent à approfondir la véritable contribution du sport à l'intégration sociale et culturelle des jeunes immigrants, et, par extension, des sociétés culturellement plurielles. ABSTRACT Sport as a social and cultural phenomenon has been widely claimed by its integrative virtues. Whether competition or recreational, sport has been claimed for some integrative values that allow a rise in social status justified in part by the success of immigrant origin players in professional sports. On the other hand, associations, and especially those generated by the migrant community, also uses sports organization as a form of solidarity and identity recognition. The aim of the thesis is double: to understand the formulation of sports programs intended for sociocultural integration designed by political and and associative entities in neighborhoods with greater presence of young immigrants and/or second generation of Paris and Madrid and to analyze the implementation of such initiatives. The method of data collection was to conduct 72 in-depth interviews to various levels of political responsibility and typology of social entities and documentary analysis of institutional and associative sources. The results show differences between the approach and implementation of initiatives conditioned by the integration model of each context –an opposition of the republican model in Paris from ethnic sports– and the situation of economic crisis –programs weakness due to budget cuts and subsidies in the Madrid–. The conclusions of this thesis aim to deepen the true contribution of sport to social and cultural integration of young immigrants, and by extension, to culturally plural societies.

Stimulation of new bone formation by direct transfer of osteogenic plasmid genes.

Degradable matrices containing expression plasmid DNA [gene-activated matrices (GAMs)] were implanted into segmental gaps created in the adult rat femur. Implantation of GAMs containing beta-galactosidase or luciferase plasmids led to DNA uptake and functional enzyme expression by repair cells (granulation tissue) growing into the gap. Implantation of a GAM containing either a bone morphogenetic protein-4 plasmid or a plasmid coding for a fragment of parathyroid hormone (amino acids 1-34) resulted in a biological response of new bone filling the gap. Finally, implantation of a two-plasmid GAM encoding bone morphogenetic protein-4 and the parathyroid hormone fragment, which act synergistically in vitro, caused new bone to form faster than with either factor alone. These studies demonstrate for the first time that repair cells (fibroblasts) in bone can be genetically manipulated in vivo. While serving as a useful tool to study the biology of repair fibroblasts and the wound healing response, the GAM technology may also have wide therapeutic utility.

Identification of endothelin 1 and big endothelin 1 in secretory vesicles isolated from bovine aortic endothelial cells.

Vesicles containing endothelin 1 (ET-1) were isolated from bovine aortic endothelial cells (BAECs) by fractionation of homogenates on sucrose density gradients by ultracentrifugation. The vesicles were localized at the 1.0/1.2 M sucrose interface using a specific anti-ET-1-(16-21) RIA. Identification of ET-1 and big ET-1 in this fraction was confirmed by HPLC analysis combined with RIA. Morphological examination of the ET-1-enriched fraction by electron microscopy identified clusters of vesicles approximately 100 nm in diameter. Immunostaining of ultrathin cryosections prepared from the vesicle fraction for ET-1 or big ET-1 showed clusters of 15-nm gold particles attached to or within vesicles. Immunofluorescence staining of whole BAECs using a specific ET-1-(16-21) IgG purified by affinity chromatography revealed punctate granulation of the cell cytoplasm viewed under light microscopy. This distinct pattern of staining was shown by confocal light microscopy to be intracellular. Immunofluorescence staining of whole cells with a polyclonal antiserum for big ET-1-(22-39) showed a defined perinuclear localization of precursor molecule. Hence, several different approaches have demonstrated that ET-1 and big ET-1 are localized within intracellular vesicles in BAECs, suggesting that these subcellular compartments are an important site for processing of big ET-1 by endothelin-converting enzyme.

Platelet-derived growth factor BB induces functional vascular anastomoses in vivo.

Neovascularization that generates collateral blood flow can limit the extent of tissue damage after acute ischemia caused by occlusion of the primary blood supply. The neovascular response stimulated by the BB homodimeric form of recombinant platelet-derived growth factor (PDGF-BB) was evaluated for its capacity to protect tissue from necrosis in a rat skin flap model of acutely induced ischemia. Complete survival of the tissue ensued, when the original nutritive blood supply was occluded, as early as 5 days after local PDGF-BB application, and the presence of a patent vasculature was evident compared to control flaps. To further evaluate the vascular regenerative response, PDGF-BB was injected into the muscle/connective tissue bed between the separated ends of a divided femoral artery in rats. A patent new vessel that functionally reconnected the ends of the divided artery within the original 3- to 4-mm gap was regenerated 3 weeks later in all PDGF-BB-treated limbs. In contrast, none of the paired control limbs, which received vehicle with an inactive variant of PDGF-BB, had vessel regrowth (P < 0.001). The absence of a sustained inflammatory response and granulation tissue suggests locally delivered PDGF-BB may directly stimulate the angiogenic phenotype in endothelial cells. These findings indicate that PDGF-BB can generate functional new blood vessels and nonsurgically anastomose severed vessels in vivo. This study supports the possibility of a therapeutic modality for the salvage of ischemic tissue through exogenous cytokine-induced vascular reconnection.

El uso de apósitos hidrocelulares de la gama Allevyn® en heridas agudas: resultados a partir del estudio AURIGA-04 en Atención Primaria

Aunque los apósitos de cura en ambiente (CAH) húmedo se han utilizado predominantemente en heridas crónicas, ello no es óbice para que su uso en heridas agudas permita solucionar algunos problemas, como el conseguir un ambiente óptimo que facilite la migración epitelial, así como una adecuada protección de las heridas y una correcta gestión del exudado. Es por ello que, dentro del marco del estudio AURIGA-04, nos planteamos la realización de un estudio prospectivo observacional, abierto y multicéntrico, de medidas repetidas en una cohorte de pacientes que presentan heridas agudas de diversa etiología en el que se incluyeron pacientes con heridas traumáticas, quirúrgicas o quemaduras tratados por profesionales de Atención Primaria, con el objetivo de generar evidencias acerca de la utilización de apósitos de CAH, en concreto, de la gama de apósitos hidrocelulares Allevyn®, en el tratamiento de heridas agudas. Se consideraron como criterios de exclusión heridas con signos clínicos de infección. Solo se incluyó una lesión por paciente. En el caso de los pacientes con heridas agudas, la muestra a estudio quedó compuesta por 61 pacientes con una edad media de 71,1 años; 36 casos corresponden a mujeres (60%). El estado general de salud de la muestra era bueno en un 49,1% de los casos y prácticamente la totalidad de los pacientes presentaba pluripatología. Un 10% de los pacientes consumía fármacos que podían interferir en la cicatrización y un 6% presentaba malnutrición. El 67,2% de las lesiones eran heridas traumáticas, el 24,6% quirúrgicas y un 8,2% quemaduras. Un 37% de las lesiones fueron clasificadas como superficiales y el 63% restante como profundas. Presentaban 64 días de evolución previa a su inclusión en el estudio y una superficie media de 23,34 cm2. Los pacientes permanecieron en el estudio un promedio de 43,6 días, con una cadencia de cambios de apósito cada 2,7 días. Durante el estudio cicatrizaron el 63,9% de las heridas, en un promedio de 40,9 días. La superficie inicial de las lesiones mostró una reducción significativa a lo largo del seguimiento (inicial: 23,34 cm2, final: 4,27 cm2, p ≤ 0,001). En los modelos de regresión de Cox, sólo resultó estadísticamente significativa la edad del paciente, en el grupo de lesiones traumáticas (RR: –0,03, p= 0,039). Durante el período de seguimiento, un 80,3% de los pacientes fue tratado en combinación con Intrasite Conformable®, Iruxol Mono® o la combinación de ambos productos. Los profesionales que realizaron las curas con Allevyn® valoraron muy favorablemente su manejo durante todo el estudio; así, en más del 96% de los cambios se consideró fácil de colocar, en el 100% indoloro y también en el 100% de fácil retirada. A la vista de los resultados, los apósitos de CAH y, en concreto, la gama de apósitos Allevyn®, tienen una clara aplicación en el caso de las heridas agudas, permitiendo un óptimo abordaje local de las lesiones, proporcionando unos niveles óptimos de humedad, pH y temperatura para las células implicadas en el proceso de cicatrización. Así, se promueve la formación de tejido de granulación y facilita la epitelización, además de proteger la herida ante traumatismos y gérmenes.

Modélisation de l’activité électrique des oreillettes avant et après ablation par cathéter

- Réalisé au centre de recherche de l'hospital du Sacré-Coeur de Montréal. - Programme conjoint entre Université de Montréal et École Polytechnique de Montréal.

Roundel

D: 2 51/64 in.; gold, filigree and granulation