bluuebunny/crossref_metadata_2025_split huggingface dataset:
127 The Importance of Arm Dominance in Acute Wound Healing
Authors: Serena T. 
Published: March 2007

Background: Physiological differences between dominant and non‐dominant arms may play an important role in wound healing of the upper extremities. The Wound Healing Cooperative Group (WHCG) studied this phenomenon in a human forearm model of acute wound healing. Methods: With informed consent, sixteen normal healthy volunteers underwent four 6 mm biopsies on the flexor surface of both forearms: 2 biopsies on the dominant arm, and 2 on the non‐dominant arm. The acute wound sites were then treated with i) rhPDGF‐BB 0.01% gel topically at various dosing intervals (Q.D. versus Q.O.D.), ii) rhPDGF‐BB alone Q.D. × 7 days followed by bacitracin alone, or iii) bacitracin alone. Time‐to‐complete healing was measured as the primary endpoint. Results: The average time‐to‐complete healing for the dominant arm was shorter than the time required to heal the biopsies on the non‐dominant arm, irregardless of the treatment applied. Conclusion: In the forearm biopsy model of acute wound healing, arm dominance is an independent variable and must considered in study designs. We postulate that this effect may be due to variation in microvascular perfusion. These results provoke further investigation into the physiological mechanisms underlying increased rate of healing in the dominant extremity. Acknowledgements: Funding from The Angiogenesis Foundation.
131 Lateral Wicking, Good or Bad
Authors: Baldursson Baldur 
Published: March 2007

The ability of polyurethane sponge dressings to absorb and contain wound fluid is often insufficient, resulting in maceration and eczema.The term lateral wicking has been used to describe the fluid film between the peri‐ulcer skin and the dressing surface, responsible for the maceration. A “within dressing” lateral wicking is where the wound fluid is absorbed above the ulcer and transported laterally within the dressing without affecting the peri‐ulcer skin.We wanted to test this phenomenon in a new type of dressing with a silicon surface towards the wound, a polyurethane sponge layer with enclosed absorbent particles and a vapour permeable outer layer.A pump delivered 10 ml per hr of equine serum to a 1 sq cm surface at the centre of the dressings. The experiment went on for 2.5 hours. Seven dressings of each type were used in the experiment. The top and bottom aspects of the dressings were photographed at 30 min interval.In the new ulcer dressing the serum was absorbed and distributed in a “within dressing” lateral wicking. In the established dressing an “under dressing” lateral wicking took place leading to erratic distribution of absorption often at the margin of the dressing instead of over the centre.ConclusionEnhancing lateral wicking within a chronic ulcer dressing is a realistic way of optimising its fluid handling characteristics. In this experimental set‐up the new ulcer dressing performed as intended while the conventional dressing did not.Improved fluid handling characteristics are needed in today’s advanced dressings however, the importance of this phenomenon in the clinical situation must be tested in clinical trials.
133 Granulation Tissue Induction by Lassar Ointment vs. Collagen‐Polyvynilpyrrolidone in Venous Ulcers
Authors: Krötzsch Edgar , Suárez‐Colín Arturo , Salgado Rosa M. , Apis Ana M.Z. 
Published: March 2007

Venous leg ulcers derived from tissue destruction is the consequence of a chronic inflammatory process that produces pain and physical disability, diminishing quality of life in patients. In this work, Lassar ointment and lyophilized collagen‐polyvinylpyrrolidone were administered separated each on one half in the same ulcer to 9 patients at the beginning and every 4 days. On day 16, all patients were auto‐grafted with partial thickness skin. Granulation tissue and graft integration were assessed clinically during 3 months. Inflammatory infiltrate, type I and III collagens, elastic fibers, alkaline phosphatase as well as blood vessels were evaluated histologically or histochemically in biopsies taken at the beginning and 16 days after the local treatment.Clinically and morphologically, both treatments demonstrated appropriate granulation tissue promotion and optimal graft integration since the beginning. Nevertheless, in Lassar ointment treated group regionalization of alkaline phosphatase activity was observed, as well as the presence of granuloma in 2 of the 9 patients. In conclusion, Lassar ointment or lyophilized collagen‐polyvinylpyrrolidone are two different promoters of granulation tissue in venous leg ulcers, however Lassar ointment has the capability to produce granuloma and an exacerbated immune response; in consequence, ulcer recidivism could be present, may be due to mineral deposits in the wound.
139 Gene Array Profiling of Keloid Fibroblasts to Identify the Target Genes for Therapeutic Evaluations
Authors: Satish Latha , Luo Jian‐Hua , Priya Kulasekaran S , Wells Alan 
Published: March 2007

Keloids are scars that overgrow the original boundaries of the injury, involving aberrant functioning of the fibroblasts. We have found that during normal wound healing the ELR‐negative CXC chemokines IP‐9 (CXCL11) and IP‐10 (CXCL10) act to limit fibroblast immigration. Our initial goal was to determine if keloid fibroblasts failed to respond to this ‘stop’ signal. Immunohistochemical and immunocytochemical studies on keloid fibroblasts show that these lesions express excessive amounts of IP‐9 and CXCR3 receptor. The protein levels of CXCR3 receptor was also not dissimilar between normal and keloid fibroblasts. Though, the expression of the protein and the receptor seems to be normal, the fibroblasts derived from these abnormal lesions did not respond to IP‐9 during EGF induced cell migration. We have extended these findings to determine whether other genes are differentially expressed by keloid fibroblasts. The immediate first gene that interest us was the mRNA levels of CXCR3 receptor (GPR9) wherein, we did not find any significant difference between normal and keloid fibroblasts. Further, we also found interestingly, that genes related to tumor progression are up regulated in keloid fibroblasts than the normal fibroblasts. The marker genes like calgranulin, BCL‐2 associated anthogen 4 (BAG4), and dual specificity phosphatase 1 (DUSP1). Certain transcription factors like GATA‐6 and SpiB are also increased. Apart, the classical growth factor and growth factor receptor related genes which includes, bone morphogenetic protein BMP‐1, heparin binding EGF like growth factor, EGF like repeats discoidin1, IGFBP‐5 and 3, EphB1&B2, tumor necrosis factor alpha induced protein, protein tyrosine phosphatase receptor, serine threonine kinase 6 along with chondroitin sulfate proteoglycan brevican and versican and vitronectin are also up regulated. The newl identified genes will open new avenues in targeting keloid lesions by understanding the basic signaling mechanism of these specific proteins.This work was supported by grants from NIH/NIGMS and PPRTP.
149 Angiogenesis Induced by Enriched Bone Marrow Cell Transplantation in Ischemic Hindlimb Canine Model
Authors: De La Garza Anabel S. , Padilla Luis , Krötzsch Edgar , Figueroa Siegfred A. , Avila Gerardo , Morales José A. , Glennie German , Di Silvio Mauricio 
Published: March 2007

Bone marrow is an important supply for many progenitor cells, among them endothelial precursor cells. They have been already considered as potential therapeutic angiogenesis for ischemic hindlimb. In this work we performed an unilateral chronic ischemic hindlimb model in 20 dogs, we were dissected and ligated the middle sacra artery and external right iliac artery preserving the internal iliac artery, after one week we removed de femoral artery performing a proximal and distal ligation and inserted into the gracilis muscle 3 Silastic tubes (0.8 mm diameter) in a middle circle form in order to created fibrocollagenous tunnels. Fifteen days later, we obtained bone marrow (30 mL) and mononuclear cells were separated; at the same time, all tubes were removed and bone marrow cells were transplanted into the fibrocollagenous tunnels, only in the third and fourth groups. During the 8 at 12 days we administered subcutaneously saline solution to the first and third groups and G‐CSF to the second and fourth groups. Finally, after 30 days we performed contrasted angiographies from both limbs and was calculated mean angiographic score (MAS) from the number of vascular intersections, also was taken a biopsy from the central portion of right gracilis muscle for vascular assessment, as well as for vascular proliferating cells by immunohistochemistry.Results demonstrated that white bone marrow cell transplantation enrichment by G‐CSF administration stimulates angiogenesis in ischemic hindlimb, twice than controls, and it is better than white bone marrow cell transplantation alone. White bone marrow cell is a potential therapy for ischemic hindlimb, because stem cells are growth factor provider, as well as an important source for endothelial precursors capable to form vessels de novo, mainly when this stem cells are deposited in an appropriate extracellular matrix, such as the fibrocollagenous tunnels in this model.
151 Engineering a Human ‘Skin” with Adult Primary Cells.
Authors: Martins‐Green M. , Li QiJing , Yao Min 
Published: March 2007

The inability to experiment in humans creates a great need to develop culture systems that mimic human tissues/organs. Skin is arguably the simplest human tissue and therefore provides an excellent prototype for tissue engineering. Moreover, skin is the body’s first line of defense.Currently available skin replacements have been classified into four categories: (i) those that are composed completely of epidermal cells; (ii) those consisting of dermal components derived from processing of cadaver skin or from collagen and other matrix molecules; (iii) those containing both dermal and epidermal components and (iv) those that contain dermal, epidermal and vascular components. All of these substitutes have drawbacks. Therefore, there is a need for skin replacements that: (a) are prepared with pertinent primary human cells but yet can be ready “off” the shelf; (b) can be prepared rapidly; (c) contain stable structures in particular microvessels that can rapidly connect with the patient’s vasculature in this manner establish circulation in the “graft” increasing the chances of survival; (d) can be tailored for specific wound impairments (e) are long lasting. We have developed a new generation human “skin” that can fulfil these requirements and can potentially be used as a “living bandage”. We start with three primary human cell types and a collagen matrix that self‐assemble into a connective tissue containing a network of mature microvessels, is covered with a stratified epidermis, expresses biochemical markers, matrix molecules, and cytokines characteristic of normal human skin and matures in 10–15 days. Moreover, two additional cell types, pericytes and monocytes, differentiate in situ adjacent to and within microvessels, respectively providing stability to the micriovessels and the epidermis expresses keratins that are typical of mature skin and not those characteristically produced in response to injury such as keratins 6, 16, 17. This tissue can potentially be developed into a skin replacement for patients with impaired healing. In addition, this tissue responds normally to bological stimuli, providing a powerful vehicle to investigate mechanisms of skin development and regeneration, understand pathological processes, and test drugs and treatments for skin diseases
152 Blocking IL‐6 Receptors Increases Matrix Metalloproteinase‐3 Production in Hypertrophic Scar Fibroblasts
Authors: Mohan R.K.Dasu , Barrow RE , Hawkins HK , McCauley RL , Herndon DN 
Published: March 2007

Introduction: We hypothesize that interleukin‐6 receptor (IL‐6r) blockade with IL‐6r antibody will increase matrix metalloproteinase‐3 (MMP‐3) production in hypertrophic scar fibroblasts.To test this hypothesis, MMP‐3 protein levels were measured in fibroblasts cultured from normal skin and hypertrophic scar with and without IL‐6 receptor blockade. Methods: Primary cell cultures of normal skin (NSF) and hypertrophic scar fibroblasts (HTS) were obtained from the same patient (n = 5) and seeded into 6 well plates (40,000 cells/cm2) in complete media. Cells were treated with and without IL‐6 receptor antibody and IgG (10 ng/ml) for 6 hours. Protein concentrations of MMP‐3 are determined in equal volume of supernatants by ELISA.Statistical analysis was by unpaired t‐test(*P < 0.05). Results: Blocking IL‐6 receptors with its antibody showed significant increase in MMP‐3 protein concentration in HTS compared to NSF.

MMP‐3(ng/ml)

MMP‐3(ng/ml)

NSF
1.6 ± 0.13
HTS
0.7 ± 0.37

NSF + IL‐6r
0.3 ± 0.15
HTS + IL‐6r
2.3 ± 0.5*

NSF + IgG
0.26 ± 0.16
HTS + IgG
0.75 ± 0.14

Conclusion: IL‐6 receptor mediated signaling is involved in the pathogenesis of hypertrophic scar formation and its blockade may reduce hypertrophic scar formation.
023 The Use of Cilostazol in the Treatment of Raynaulds Disease with Digital Ischemia and Tissue Loss
Authors: Serena T. , Probst J. 
Published: March 2007

Background: More than three quarters of patients with a connective tissue disorder will develop secondary Raynauld’s disease. This more severe form of the Raynauld’s can lead to digital ischemia, tissue loss and may even result in the need for amputation of one or more digits. Cilostazol is a phosphodiesterase inhibitor currently approved for use in vascular disease of the lower extremities. Case History: In August of 2002 a 62 year old female pianist with scleroderma presented to the wound clinic with a two year history of intractable digital pain secondary to ischemic ulcerations of the index, long and ring fingers of the right hand. She suffered from secondary Raynauld’s disease. Prior unsuccessful treatments included warming the hands, calcium channel blockade, anticoagulation, topical xylocaine and narcotic analgesics. In August of 2002 cilostazol was started at 100mg BID. Wound care consisted of serial debridement, moist wound healing and topical rhPDGF. Results: Four weeks into treatment the patient’s narcotic requirement decreased substantially and the fingers had a pink appearance. The ring finger healed after eight weeks. At three months the patient discontinued narcotic pain medication. Nine months into treatment the index finger had healed and she resumed playing the piano. The long finger finally healed one year after she initially presented to the wound clinic. Conclusion: Cilostazol may be an important adjunct in the treatment of secondary Raynauld’s disease particularly when digital ischemia has developed. Acknowledgements: Funding from Otsuka Pharmaceuticals.
014 Macrophage Suspensions Treatment of Infected Sternal Wounds Following Cabg Surgery
Authors: Danon David , Zuloff‐Shani Adi , Kachel Erez , Mohr Raphael , Shinar Eilat , Orenstein Arie 
Published: March 2007

Macrophages serve as the coordinators of the wound healing process. Since 1998 following the Israeli Ministry of health authorization, macrophage suspensions have been used for the treatment of ulcers, in more than 800 elderly and paraplegic patients suffering from decubital chronic ulcers.As previously published, a significant number of genes showed increased levels of expression in hypo‐osmotic shock activated cells, using DNA microarrays technique. The majority of these genes are considered to be directly involved in the macrophage function and in the wound healing process.Macrophge suspensions are prepared from a whole blood unit of healthy, young volunteer blood donors in a closed, sterile system, as previously described. The activated cells are applied to the wounds either by local injection or by direct deposition to the wound.Between January 2000 and October 2003, 112 patients with postoperative sternal wound infection were treated with macrophage suspension. Full closure of the wounds was achieved in 104 (93%) of the patients.

Original wound surface area
8–175 cm2 (mean 93)

Days until treatment
6–180 (mean 47)

Days until 50% closure
6–60 (mean 21)

Days until full closure
10–138 (mean 49)

No side effects were noted.The use of macrophage suspension is a safe and effective therapeutic strategy that reduces risk of complications and morbidity and improves the quality of life for long ‐suffering patients. Length and cost of hospital stay may be reduced, as the treatment requires no hospitalization.
018 Healing Rate for Diabetic Neuropathic Foot Ulcer
Authors: Margolis DJ , Allen‐Taylor L , Hoffstad O , Berlin JA 
Published: March 2007

The goal of this study was to benchmark by year the likelihood that an individual with a diabetic neuropathic foot ulcer (DNFU) will heal. We observed these rates over a more than 10 year period (1988–2000). For this study, we designed a cohort study within the multi‐center Curative Health System wound care network of diabetics who have DNFU and whether they healed by the 20th week of care stratified by calendar year.In total, we evaluated 27, 193 individuals with a DNFU. For, example, between 1988 and 1990 approximately 66% of patients did not heal. By 1999 this percentage had decreased to 49%. Most of the change in improvement occurred before 1998. We noted that the change in the rate of failure to heal was very closely associated with an increase over time in the proportion of patients seen with wounds identified as prognostically favorable as determined by a previously published prognostic model (i.e., individuals with wounds ≤ 2 cm2, wound less ≤2 months old, and wound of grade less ≤ 2). Among those most likely to heal, the likelihood of failing to heal went from 62% in 1990 to 32% in 2000. Therefore, the overall decrease in likelihood that a patient with a DNFU would not heal is not just due to the enrollment of less severe cases. There was, however, no real improvement in the likelihood that those with wounds that were unlikely to heal over time and fewer patients with these wounds sought care over time.In conclusion, those with a DFFU seeking care are more likely to heal today than 10 years ago. This improvement is related to the fact that individuals are seeking care when their wounds are most easily treated and these wounds are now more likely to heal. Unfortunately, those with the most severe wounds are not anymore likely to heal today than they were 10 years ago.
The effect of maternal depression and marital adjustment on young children's internalizing and externalizing behaviour problems
Authors: Trapolini T. , McMahon C. A. , Ungerer J. A. 
Published: March 2007

AbstractBackground  The present study aimed to clarify the circumstances under which maternal depression is associated with adverse outcomes in pre‐school‐aged children, and to explore the additional impact of the marital relationship in a socio‐economically low‐risk sample.Methods  Ninety‐two mothers recruited into a longitudinal study were assessed for symptoms of depression when their children were 4, 12 and 15 months, and later at 4 years of age. At 4 years of age, mothers were also asked to report on marital adjustment. Mothers, fathers and pre‐school teachers were asked to report on children's internalizing and externalizing behaviour problems.Results  Children exposed to chronic maternal depression were rated by their parents as significantly more problematic on internalizing and externalizing behaviours. This association was not mediated or moderated by low marital satisfaction. No parent‐reported effects were evident for children exposed to transient depression. Ten per cent of the children had internalizing scores in the clinical range, and 7% had externalizing scores in the clinical range. Almost all of the children with clinically elevated scores had been exposed to chronic maternal depression. Teacher reports of internalizing behaviours corroborated parent reports; however, teachers tended to report significantly lower levels of behaviour problems. Although there was a tendency for teachers to rate children exposed to any depression as more problematic on internalizing behaviours, the subgroup differences were not significant.Conclusions  Findings confirm that depression chronicity is important in determining child behavioural outcomes, and that depression effects cannot be accounted for by low marital adjustment. Results are discussed with reference to transmission of risk models, and treatment implications are considered.
The costs of key worker support for disabled children and their families
Authors: Beecham J. , Sloper P. , Greco V , Webb R. 
Published: March 2007

AbstractBackground  Key workers provide a single point of contact for disabled children and their families, supporting them and facilitating access to other services. Key worker services appear to generate good outcomes for families and provision is encouraged through central government policy. Recent increases in key worker provision have been accompanied by a proliferation of delivery models yet there is very little information on their costs.Methods  Within a study identifying which service characteristics generate good outcomes for families, unit costs for seven key worker services were estimated. Informed by economic theory, the estimates drew on data from managers, finance departments and other publicly available sources. Data on the frequency and duration of contact with key workers were obtained from families and combined with the service‐specific unit costs to arrive at the contact cost per family. The variations in the costs of supporting families were explored.Results  On average, key worker contact with disabled children and their families cost £151 over a 3‐month period. Contact costs were found to vary with the level of the child's disability and the number of role aspects that key workers performed. This latter variable was associated with improved outcomes.Conclusion  The low response rate to the questionnaire and absence of data on the costs of other elements of the families' support packages may limit generalization from this study. Even so, such findings can help inform managers and planners about allocation of their scarce resources. Good‐quality services appear to cost more but the relationship between cost, quality and outcomes is not a simple one.
The impact of percutaneous endoscopic gastrostomy feeding in children; the parental perspective
Authors: Brotherton A. M. , Abbott J. , Aggett P. J. 
Published: March 2007

AbstractBackground  The prevalence of percutaneous endoscopic gastrostomy (PEG) feeding of children in the UK has increased. This study explored how gastrostomy feeding affects the daily lives of children and their families, from the parents' perspectives and developed a conceptual framework for assessing the impact of feeding on family life.Methods  A semi‐structured interview approach was used to obtain the parents' views regarding the impact of feeding on daily lives; both of the children and their family. The study was a cross‐sectional qualitative design employing purposive sampling. Twenty‐four interviews were conducted and data were analysed descriptively and thematically.Results  Difficulties arising from PEG feeding included vomiting (71%), diarrhoea (33%), infection of the PEG site (46%) and leakage (54%). The key issues that emerged included delayed and disturbed sleep, restricted ability to go out, difficulties finding a place to feed, childcare problems, negative attitudes of others towards feeding and family divisions. Parents primarily raised key issues regarding the impact of PEG feeding on themselves or the family rather than on the child.Conclusions  An assessment framework has been developed, based on the parents perceptions, for use in assessing the impact of feeding upon family life and identifying the support required for parents of children receiving PEG feeding. Provision of adequate support is likely to require a network of healthcare professionals, social care and support groups, all working together to meet identified needs.