Delayed primary versus late secondary wound closure in the treatment of postsurgical sternum osteomyelitis.

Sternal osteomyelitis and poststernotomy mediastinitis is a severe and life-threatening complication after the cardiac surgery. The incidence ranges up to 3% with a mortality rate up to 29%. In addition, postoperative infections after sternotomy are associated with prolonged hospital stay, increased healthcare costs and impaired quality of patient life, representing an economic and social burden. The emergence of increasing antimicrobial resistant bacteria augments the importance of postsurgical infections since the antimicrobial choices are becoming limited. Furthermore, the incidence of infection is an indicator for the quality of patient care in the international benchmark studies. Although several therapy strategies are nowadays present in clinical practice, there is a lack of evidence-based surgical consensus for treatment of this surgical complication. In most cases the poststernotomy mediastinitis involves surgical revision with debridement, open dressing and/or vacuum-assisted therapy. After the granulation tissue on open chest wound is achieved, secondary closure and/or reconstruction with vascularized soft tissue flaps, such as omentum or pectoral muscle is performed. It seems there is a need for more effective surgical treatment of poststernotomy wound infections, which may address the prolonged hospitalization and reduce the number of surgical interventions and with this also the perioperative morbidity. In light of this we propose a randomized study comparing new delayed primary closure of the sternum to the secondary vacuum-assisted closure.

Buccal mucosa graft for laryngotracheal reconstruction in severe laryngeal stenosis.

OBJECTIVE: An operative technique is described as a salvage treatment for severe subglottic and supraglottic laryngeal stenosis. In addition to expansion of the laryngeal framework with an anterior cartilage graft, as used in a classical laryngotracheal reconstruction, the scar tissue obliterating the airway lumen is excised and a mucosal graft is placed to reconstruct the inner lining of the airway. The graft is harvested from buccal mucosa. METHODS: The operative technique is outlined. Three cases, 2 paediatric and one adult, with complete or near complete laryngeal stenosis are presented where this operative technique was employed. In all patients several surgeries had been performed previously which were unsuccessful. RESULTS: In all 3 patients a patent airway was achieved with decannulation of the tracheostomy in the 2 paediatric patients. CONCLUSIONS: In patients with severe subglottic or supraglottic airway stenosis where other surgeries have failed, excision of endoluminal scar tissue and placement of a buccal mucosal graft, in addition to conventional laryngotracheal reconstruction, is a promising technique. In revision cases of subglottic stenosis cricotracheal resection might not be an option because of scarring from previous surgeries. This operation is an alternative, which allows an increase in the airway lumen by excising the scar tissue then re-lining the exposed internal lumen. The buccal mucosa reduces granulation formation and re-stenosis.

Vacuum-assisted closure device for the management of infected postpneumonectomy chest cavities.

BACKGROUND: Infected postpneumonectomy chest cavities may be related to chronic postpneumonectomy empyema or arise in rare situations of necrotizing pneumonia with complete lung destruction where pneumonectomy and pleural debridement are required. We evaluated the safety and efficacy of an intrathoracic vacuum-assisted closure device (VAC) for the treatment of infected postpneumonectomy chest cavities. METHOD: A retrospective single institution review of all patients with infected postpneumonectomy chest cavities treated by VAC between 2005 and 2013. Patients underwent surgical debridement of the thoracic cavity, muscle flap closure of the bronchial stump when a fistula was present, and repeated intrathoracic VAC dressings until granulation tissue covered the entire chest cavity. After this, the cavity was obliterated by a Clagett procedure and closed. RESULTS: Twenty-one patients (14 men and 7 women) underwent VAC treatment of their infected postpneumonectomy chest cavity. Twelve patients presented with a chronic postpneumonectomy empyema (10 of them with a bronchopleural fistula) and 9 patients with an empyema occurring in the context of necrotizing pneumonia treated by pneumonectomy. In-hospital mortality was 23%. The median duration of VAC therapy was 23 days (range, 4-61 days) and the median number of VAC changes per patient was 6 (range, 2-14 days). Infection control and successful chest cavity closure was achieved in all surviving patients. One adverse VAC treatment-related event was identified (5%). CONCLUSIONS: The intrathoracic VAC application is a safe and efficient treatment of infected postpneumonectomy chest cavities and allows the preservation of chest wall integrity.

The regulation and function of collagenase-3 (MMP-13) in cutaneous wound healing and squamous cell carcinoma

Matrix metalloproteinase-13 (MMP-13) is a potent proteolytic enzyme, whose expression has been previously associated with fetal bone development and postnatal bone remodeling and with adult gingival wound healing. MMP-13 is also known to be involved in the growth and invasion of various cancers including squamous cell carcinoma (SCC) of the skin. The aim of this study was to further elucidate the function and regulation of MMP-13 in wound repair and cancer. In this study, it was shown that fetal skin fibroblasts express MMP-13 in response to transforming growth factor-β in a p38 MAP kinase dependent manner. In addition, MMP-13 was found to be expressed in vivo by wound fibroblasts in human fetal skin grafted on SCID mice. Adenovirally delivered expression of MMP-13 enhanced collagen matrix contraction by fibroblasts in vitro in association with altered cytoskeletal structure, enhanced proliferation and survival. These results indicate that MMP-13 is involved in cell-mediated collagen matrix remodeling and suggest a role for MMP-13 in superior matrix remodeling and scarless healing of fetal skin wounds. Using an MMP-13 deficient mouse strain, it was shown that MMP-13 is essential for the normal development of experimental granulation tissue in mice. MMP-13 was implicated in the regulation of myofibroblast function and angiogenesis and the expression of genes involved in cellular proliferation and movement, immune response, angiogenesis and proteolysis. Finally, epidermal mitogen, keratinocyte growth factor (KGF) was shown to suppress the malignant properties of skin SCC cells by downregulating the expression of several target genes with potential cancer promoting properties, including MMP-13, and by reducing SCC cell invasion. These results provide evidence that MMP-13 potently regulates cell viability, myofibroblast function and angiogenesis associated with wound healing and cancer. In addition, fibroblasts expressing MMP-13 show high collagen reorganization capacity. Moreover, the results suggest that KGF mediates the anti-cancer effects on skin SCC

Puun ja turpeen seospolton vaikutus tuhkan hyötykäyttökohteisiin

Työn tavoitteena oli selvittää puun ja turpeen seospolton vaikutukset tuhkien hyötykäyttökohteiden valintaan laitoksella tehtävien koeajojen ja kustannus- sekä SWOT-analyysien avulla. Lisäksi tavoitteena oli selvittää lainsäädännön vaikutukset tuhkien hyötykäyttöön. Kustannusanalyysissä tarkasteltiin tuhkien hyödyntämisen nykytilan lisäksi rakeistuslaitosinvestointia ja selvitettiin eri hyötykäyttövaihtoehtojen etuja ja haittoja. Lainsäädäntö vaikuttaa oleellisesti tuhkien hyötykäyttöön. Hyötykäyttöä säädellään sekä kansallisella että EU-tasolta tulevalla lainsäädännöllä. Ympäristölainsäädännön ja etenkin jätelainsäädännön kokonaisuudistuksen myötä myös hyötykäyttöä koskevat lainsäädäntö uudistui. Energiantuotannon tuhkat tulivat jäteverolain piiriin ja lannoiteasetuksenuudistuksella pyrittiin helpottamaan tuhkien lannoitekäyttöä. Myös jäteluokittelu ja sen päättyminen tuhkien osalta vaikuttaa olennaisesti tuhkien käsittelymenetelmien ja hyödyntämisen kannattavuuteen. Jäteluokituksen päättyminen voi viedä tuhkat kemikaalilainsäädännön piiriin. Kustannus- ja SWOT-analyysissä selvitettiin tuhkien hyödyntämisen kannalta keskeiset kustannustekijät. Rakeistuslaitosinvestoinnissa huomioitiin erilaiset tuhkien käsittelymäärät ja niiden vaikutukset kustannuksiin ja investoinnin kannattavuuteen. SWOT-analyysin avulla selvitettiin hyödyntämisen vahvuudet, heikkoudet, mahdollisuudet ja uhkatekijät. Polttoainesuhteella ei ollut poissulkevaa vaikutusta tuhkien hyötykäyttövalintaan. Lentotuhkat soveltuivat parhaiten lannoitehyötykäyttöön ja pohjatuhkat maarakennushyötykäyttöön. Rakeistuslaitosinvestointi olisi kannattava etenkin suuremmilla tuhkamäärillä.

Mädätysjäännöksen rakeistus, terminen kuivaus ja energiahyötykäyttö

Tutkimuksen tavoitteena oli kartoittaa alueellisen jäteyhtiön Kymenlaakson Jäte Oy:n mahdollisuuksia rakeistaa ja termisesti kuivata mekaanisesti kuivattua mädätysjäännöstä sekä mahdollisuuksia toimittaa termisesti kuivattua materiaalia energiahyötykäyttöön. Tutkimuksessa selvitettiin myös kokemuksia lattialämmityksen käyttämisestä mädätysjäännöksen kuivaukseen. Tutkimuksessa perehdyttiin erilaisiin rakeistus- ja kuivausmenetelmiin sekä termisen kuivurin valintaan vaikuttaviin asioihin. Kuvaukset perustuvat kirjallisuudesta ja internetistä saatuihin tietoihin. Tekniikkakuvausten pohjalta lähdettiin kyselemään tarjouksia termisiä kuivauslaitteistoja myyviltä yrityksiltä. Tarjoukset pyydettiin kuiva-ainepitoisuuden muutokselle 30 %:sta 90 %:iin ja oletettiin, että kuivaukseen on käytettävissä lämpöä viideltä kaatopaikkakaasua käyttävältä mikroturbiinilta. Tutkimuksen aikana saatiin tarjous kuudelta yritykseltä. Saadut tarjoukset esiteltiin tiivistetysti raportissa ja kokonaisuudessaan ne sisällytettiin Kymenlaakson Jäte Oy:n laajempaan raporttiin, joka ei ole julkinen. Yritykset antoivat hyvin erilaisia tietoja siitä, mitä tarjoukseen sisältyy, joten tarjoukset eivät olleet suoraan vertailukelpoisia. Tarjouksista myös havaittiin, että jos Mäkikylän biokaasulaitokselta vastaanotettaisiin enimmäismäärä (19 500 t/a) mädätysjäännöstä, mikroturbiineilta saatava lämpömäärä ei riittäisi kuivaamaan kaikkea mädätysjäännöstä 90 % kuiva-ainepitoisuuteen. Tutkimuksen aikana huomattiin myös, että sitovan tarjouksen saamiseksi mädätysjäännös tulee toimittaa testattavaksi, jolloin saadaan vahvistus kuivausmenetelmän soveltuvuudesta kyseiselle materiaalille. Tutkimuksessa selvitettiin myös, minkälaisia kokemuksia löytyy lattialämmityksen käyttämisestä kuivaukseen niin Suomesta kuin maailmalta ja voiko menetelmää käyttää mädätysjäännöksen kuivaukseen. Kyseistä menetelmää on käytetty tehostamaan aurinkokuivausta, joten tutkimuksen aikana perehdyttiin erityisesti aurinkokuivaukseen liittyviin tieteellisiin artikkeleihin. Lattialämmityksen käytöstä löytyi niin heikkouksia kuin vahvuuksia. Suomessa aurinkokuivauksen ja lattialämmityksen yhdistelmä ei ole kuitenkaan päätynyt laajaan käyttöön ja syynä voidaan nähdä muun muassa kylmät ja pimeät vuodenajat sekä suuri pinta-alan tarve. Tutkimusraportissa selvitettiin lisäksi polttolaitosten edustajien kiinnostusta ja rajoituksia ottaa vastaan termisesti kuivattua mädätysjäännöstä. Tutkimuksen aikana otettiin yhteyttä alle 100 km etäisyydellä Kymenlaakson Jäte Oy:stä sijaitsevien jätteenpolttoluvan omaavien yritysten edustajiin. Saatuja vastauksia käsiteltiin tiivistetysti raportissa ja vastaukset sisällytettiin kokonaisuudessaan Kymenlaakson Jäte Oy:n laajempaan raporttiin, joka ei ole julkinen. Puhelinhaastattelujen pohjalta nähtiin, että yrityksillä on kiinnostusta materiaalia kohtaan, mutta samalla vastauksiin vaikuttavat mädätysjäännöksen analyysitulokset. Poltto-ominaisuuksiin liittyvät analyysit tullaan toteuttamaan vuoden 2012 aikana. Laitoksilla oli myös vaihtelevia rajoituksia materiaalia kohtaan, mutta analyysituloksista riippuen materiaalia voidaan hyödyntää energiana tuhansia tai jopa kymmeniä tuhansia tonneja vuodessa alle 100 km etäisyydellä Kymenlaakson Jäte Oy:stä.

Effects of Corynespora cassiicola on Lantana camara

The present study combines the examination of toxins produced by C. cassiicola and the effects of the fungus colonization on L. camara. C. cassiicola was cultivated on solid media and the crude extracts CAE and CE were produced. Both extracts were submitted to a seed germination and growth assay utilizing Physalis ixocarpa, Trifolium alexandrinum, Lolium multiflorum and Amaranthus hypochodriacus. The effect of the extracts on the ATP-synthesis in isolated spinach chloroplasts was also tested. Bioassay guided chromatographic fractionation identified the most active extract (CAE). From this extract ergosta-4,6,8(14),22-tetraen-3-one (C1) and fatty acids were isolated. The C1 compound reduce ATP synthesis in isolated spinach chloroplasts. The interference of fatty acids with ATP synthesis and also with weed growth provides one explanation of the phytogrowth-inhibitory properties of such fungal extracts. Histological observations involving fungus-plant interaction were made on L. camara plants inoculated with C. cassiicola conidia suspension. After inoculations, fragments of the leaf blades were prepared for observation by light and scanning electron microscopy. Fungal colonization of Lantana camara was typical of a necrotroph and penetration initiated a hypersensitive response. L. camara reacted to the pathogen penetration through thickening of the epidermis walls, cytoplasm granulation and a cicatrisation tissue.

Repair of the anophthalmic cavity of rats with synthetic hydroxyapatite

We placed spheres of synthetic hydroxyapatite (calcium chloride combined with sodium phosphate) in the eviscerated or enucleated orbital cavity of rats in order to evaluate the biocompatibility of this material with the orbital cavity. The study was conducted on 50 albino rats, 25 of which were submitted to enucleation and 25 to evisceration of one eye. The animals were sacrificed 7, 15, 21, 30 and 60 days after surgery and the orbital content was submitted to histopathological examination. A reaction of the young granulation tissue type was observed first. The hydroxyapatite was gradually surrounded by a granulomatous macrophage inflammatory response and covered with dense connective tissue that formed a sort of" mesh" septating and supporting progressively smaller blocks of the substance. The same type of reaction was observed in the enucleated and eviscerated cavities. We conclude that synthetic hydroxyapatite is an inert nonallergenic material which is appropriate for volume replacement in the anophthalmic cavity

Effect of sodium carboxymethylcellulose and methylprednisolone on the healing of jejunal anastomoses in rats

Sodium carboxymethylcellulose (SCMC) has been effective in reducing adhesion formation and corticosteroids reduce the inflammatory process. The objective of this study was to define the intraperitoneal (ip) effects of SCMC combined with intramuscular (im) methylprednisolone on peritoneal adhesion formation and on jejunal anastomosis healing in rats. Twenty Wistar rats (200-350 g) were divided into four groups (N = 5): groups I and III (controls) 5 and 21 days of treatment before sacrifice, respectively; groups II and IV (experimental groups) 5 and 21 days of treatment, respectively. SCMC (1%) was infused into the abdominal cavity and methylprednisolone (10 mg kg-1 day-1) was injected im daily from the day before surgery for animals of groups II and IV. All rats were submitted to a jejunal anastomosis. Sections of the anastomosis were prepared for routine histopathological analysis. The abdominal adhesion of group IV was less intense when compared with group III (P<0.0008). Anastomotic resistance was higher in groups II and IV when compared with groups I and III, respectively (P<0.05). There was no histological difference between groups I and II (exuberant granulation tissue on the serosal surface). Group III presented little peritoneal fibrinous tissue, with numerous thick collagen fibers. Group IV presented extensive although immature young fibrous tissue with rare thick collagen fibers. Sodium carboxymethylcellulose combined with corticosteroids seemed to diminish peritoneal adhesion but did not reduce anastomotic resistance.

Intensification of Operation of Inclined Plate Settler at Fertilizer Plant

Fertilizer plant’s process waters contain high concentrations of nitrogen compounds, such as ammonium and nitrate. Phosphorus and fluorine, which originate from phosphoric acid and rock phosphate (apatite) used in fertilizer production, are also present. Phosphorus and nitrogen are the primary nutrients causing eutrophication of surface waters. At fertilizer plant process waters are held in closed internal circulation. In a scrubber system process waters are used for washing exhaust gases from fertilizer reactors and dry gases from granulation drums as well as for cooling down the fertilizer slurry in neutralization reactor. Solids in process waters are separated in an inclined plate settler by gravitational sedimentation. However, the operation of inclined plate settler has been inadequate. The aim of this thesis was to intensify the operation of inclined plate settler and thus the solids separation e.g. through coagulation and/or flocculation process. Chemical precipitation was studied to reduce the amount of dissolved species in process waters. Specific interest was in precipitation of nitrogen, phosphorus, and fluorine containing specimens. Amounts of phosphorus and fluorine were reduced significantly by chemical precipitation. When compared to earlier studies, annual chemical costs were almost eight times lower. Instead, nitrogen compounds are readily dissolved in water, thus being difficult to remove by precipitation. Possible alternative techniques for nitrogen removal are adsorption, ion exchange, and reverse osmosis. Settling velocities of pH adjusted and flocculated process waters were sufficient for the operation of inclined plate settler. Design principles of inclined plate settler are also presented. In continuation studies, flow conditions in inclined plate settler should be modelled with computational fluid dynamics and suitability of adsorbents, ion exchange resins, and membranes should be studied in laboratory scale tests.

Moderate intensity physical training accelerates healing of full-thickness wounds in mice

Physical training influences the cells and mediators involved in skin wound healing. The objective of this study was to determine the changes induced by different intensities of physical training in mouse skin wound healing. Ninety male C57BL6 mice (8 weeks old, 20-25 g) were randomized into three physical training groups: moderate (70% VO2max), high (80% VO2max), and strenuous intensity (90% VO2max). Animals trained on a motorized treadmill for 8 weeks (Elesion: physical training until the day of excisional lesion, N = 10) or 10 weeks (Eeuthan: physical training for 2 additional weeks after excisional lesion until euthanasia, N = 10), five times/week, for 45 min. Control groups (CG) trained on the treadmill three times/week only for 5 min (N = 10). In the 8th week, mice were anesthetized, submitted to a dorsal full-thickness excisional wound of 1 cm², and sacrificed 14 days after wounding. Wound areas were measured 4, 7, and 14 days after wounding to evaluate contraction (d4, d7 and d14) and re-epithelialization (d14). Fragments of lesion and adjacent skin were processed and submitted to routine histological staining. Immunohistochemistry against alpha-smooth muscle actin (α-SMA) was performed. Moderate-intensity training (M) until lesion (M/Elesion) led to better wound closure 7 days after wounding compared to controls and M/Eeuthan (P < 0.05), and both moderate-intensity groups showed better re-epithelialization rates than controls (M/Elesion = 85.9%, M/Eeuthan = 96.4% and M/CG = 79.9%; P < 0.05). Sections of M/Elesion and M/Eeuthan groups stained with hematoxylin-eosin, Picrosirius red and α-SMA showed the most mature granulation tissues among all trained groups and controls. Thus, moderate-intensity physical training improves skin wound healing.

Prerequisites for commercialization of tube granulator for fly ash

A large amount of fly ash is produced in power plants and a big fraction of it ends up as waste to landfills. Disposal of fly ash to landfills is expensive for power plants due to for example waste taxation. However fly ash can utilized in different applications. Possibility of utilizing fly ash can be increased by granulation which also removes the dustiness problems of ash. This Thesis deals with the prerequisites for commercialization of a new granulation technique, tube granulation. Tube granulation technique utilizes water, calcium oxide in fly ash plus carbon dioxide and heat from flue gas. This Thesis determines the necessary auxiliary equipment for tube granulation, approaches for process dimensioning and implementation of the granulation process into a continuous power plant process. In addition, the economic benefits of tube granulation are examined from the user’s perspective. A continuous tube granulation process requires the following auxiliary systems to function: ash system, water feed system and flue gas system. Implementation of tube granulation system into a power plant process depends on the specific power plant but a general principle is that fly ash should be obtained to the granulator as fresh as possible and flue gas should be taken from the pressure side of a flue gas fan. Dimensioning of the process can be examined for example in terms of degree of filling and residence time in the granulator or in terms of granule drying. Determining the optimal dimensioning parameters requires pilot tests with the granulator.

Contribution de l'hypoxie à la cicatrisation cutanée anormale chez le cheval : méthodes physiques d'évaluation

La guérison des plaies cutanées appendiculaires chez le cheval, à la différence de celle des plaies corporelles, se complique régulièrement. Un retard de cicatrisation s’y observe et un tissu de granulation exubérant tend à s’y développer, le tout menant à une cicatrice pathologique hypertrophiée. La pathogénie exacte du tissu de granulation exubérant chez le cheval demeure inconnue à ce jour. Une hypoxie tissulaire pourrait favoriser son développement tout comme elle semble contribuer au développement de cicatrices cutanées pathologiques similaires observées chez l’Homme. L’objectif de cette étude était d’évaluer la perfusion vasculaire et la disponibilité locale en oxygène de plaies cutanées appendiculaires et corporelles en cours de cicatrisation normale et pathologique chez le cheval, à l’aide de la thermographie infrarouge et de la spectroscopie par réflectance dans le proche infrarouge. Six juments âgées de 3 à 4 ans ont été utilisées. Trois plaies cutanées ont été créées à l’aspect dorso-latéral du canon des membres thoraciques (plaies appendiculaires), et sur la paroi costale de l’un des hémithorax (plaies corporelles). Chez chaque jument, un canon a été aléatoirement bandé dans le but d’induire la formation de tissu de granulation exubérant dans les plaies s’y trouvant, tel que rapporté. La perfusion vasculaire et la disponibilité locale en oxygène ont été évaluées séquentiellement par thermographie infrarouge et spectroscopie par réflectance dans le proche infrarouge pour chaque plaie de chaque site (thorax; membre bandé; membre non bandé) au cours du processus de cicatrisation cutanée. Un modèle linéaire à doubles mesures répétées associé à une correction séquentielle de Bonferroni a révélé des différences significatives de perfusion vasculaire et de disponibilité locale en oxygène entre les plaies appendiculaires et corporelles. Ainsi la perfusion vasculaire et la disponibilité locale en oxygène étaient significativement plus élevées dans les plaies corporelles (P<0.05) et la perfusion vasculaire était significativement plus élevée dans les plaies appendiculaires non bandées que dans celles bandées (P<0.05). Nous avons récemment rapporté une plus grande occlusion de la micro-vascularisation au niveau des plaies appendiculaires chez le cheval. Nous rapportons maintenant que la perfusion vasculaire et la disponibilité locale en oxygène sont significativement inférieures dans les plaies appendiculaires, en particulier lorsqu’un tissu de granulation exubérant s’y développe. Compilés, ces résultats sous-tendent l’hypothèse que les plaies appendiculaires souffrent d’une altération de la perfusion vasculaire à l’origine possible d’une hypoxie tissulaire qui pourrait favoriser une cicatrisation cutanée anormale, telle la formation d’un tissu de granulation exubérant.

Contribution de l’hypoxie et du facteur hif1a à la guérison cutanée chez le cheval

Le cheval est souvent victime de plaies traumatiques, dont la guérison est fréquemment problématique, et ce, principalement quand la plaie survient sur le membre. Il est courant de voir chez le cheval le développement d’un tissu de granulation exubérant ou « bouton de chair », qui mène à une cicatrisation excessive due à la surproduction de tissu fibreux. Ce tissu cicatriciel, non épithélialisé, est caractérisé par une occlusion au niveau de la microcirculation due à l’hypertrophie des cellules endothéliales, qui laisse supposer la présence d’hypoxie tissulaire. Une hypoxie relative a effectivement été mesurée par spectroscopie dans le proche infrarouge au niveau des plaies appendiculaires prédisposées au développement de tissu de granulation exubérant, par rapport aux plaies corporelles. De plus, une étude thermographique a révélé un patron spatial similaire de la perfusion. Au niveau moléculaire, la littérature rapporte que le facteur de transcription «hypoxia inducible factor» (HIF) est à l’origine de plusieurs changements dans les niveaux d’expression de divers gènes régulés par l’hypoxie. L’objectif du présent projet de recherche était de définir la contribution de l’hypoxie à la guérison cutanée chez le cheval. Le premier volet (in vivo) du projet visait à mesurer l’expression protéique temporelle du HIF1A dans des échantillons tissulaires en provenance de plaies cutanées guérissant normalement et d’autres développant une cicatrisation excessive, selon divers sites anatomiques (tronc, membre). Les résultats obtenus suggèrent que la mesure de HIF1A, dans les échantillons pluricellulaires de cette étude, reflète l’épithélialisation de la plaie plutôt que les niveaux d’oxygène tissulaire. En effet, le HIF1A semble réguler l’homéostasie et la prolifération des kératinocytes. Le second volet (in vitro), consistait en la mise en culture de fibroblastes dermiques équins provenant du tronc ou du membre, en condition de normoxie ou d’hypoxie (à 1% d’O2 ou à l’aide d’un mimétique, le CoCl2) afin d’en étudier le comportement (capacités de prolifération et de synthèse protéique). Les résultats obtenus soutiennent une contribution de l’hypoxie à la cicatrisation extensive chez le cheval puisque l’hypoxie favorise la prolifération des fibroblastes en plus d’encourager la synthèse de collagène de type 1 et de diminuer la synthèse de la métalloprotéinase de type 2. Les changements observés semblent dépendre de facteurs extrinsèques (environnementaux) car les fibroblastes dermiques se comportent de façon similaire indépendamment de la provenance anatomique. En somme, les deux volets de l’étude ont permis d’élucider une part des mécanismes sous-jacents à la formation du tissu de granulation exubérant lors de guérison cutanée chez le cheval. La poursuite des recherches dans ce domaine mènera à une meilleure compréhension de la pathologie et ainsi, permettra de développer des méthodes de traitement spécifiques à la condition.

Approche systémique pour la composition d’œuvres acousmatiques, mixtes, vidéomusicales et pluridisciplinaires

Cette thèse est une exploration de mon processus compositionnel. En tentant de comprendre comment s’organise ma pensée créatrice, j’ai dégagé trois observations : l’organicisme du processus et des œuvres, la notion de mouvement et la relation récursive entre la matière et le compositeur. Ces thèmes m’ont amené à établir un lien épistémologique entre la composition musicale et l’étude des systèmes complexes. Dans ce cadre systémique, j’ai établi que les informations qui motivent mes prises de décision artistiques ont entre elles des ramifications opérationnelles et structurelles qui évoquent une arborescence rhizomatique plutôt qu’une hiérarchie linéaire. La transdisciplinarité propre à la systémique m’a également permis d’introduire des notions provenant d’autres champs de recherche. S’articulant d’emblée avec mon processus compositionnel, ces notions m’ont procuré une vision holistique de ma démarche artistique. Conséquemment, je considère l’acte de composer comme une interaction entre ma conscience et tout ce qui peut émaner de la matière sonore, les deux s’informant l’une et l’autre dans une boucle récursive que je nomme action⟳perception. L’œuvre ainsi produite n’est pas exclusivement tributaire de ma propre volition puisque, au fil du processus, mes décisions opératoires et artistiques sont en grande partie guidées par les propriétés invariantes et les propriétés morphogéniques inhérentes au matériau sonore. Cette approche dynamique n’est possible que si l’interaction avec le compositeur se fait en temps réel, ce que permet la lutherie numérique. Les résultats de mes recherches m’ont guidé dans la composition d’œuvres choisies, autant acousmatiques, mixtes, vidéomusicales que pluridisciplinaires.