Thesis (Ph.D.)--Virginia Commonwealth University, 2010. / Prepared for: Dept. of Biochemistry. Title from title-page of electronic thesis. Bibliography: leaves 137-141.

Thesis (M.T.S.)--Catholic Theological Union, 1987. / Vita. Bibliography: leaves 98-102.

The skin acts as a protective barrier, is crucial for thermoregulation and also forms part of the sensory, immunological and endocrine system. Therefore skin preservation is paramount to preserving life. The loss of skin homeostasis, through injury, initiates the wound healing process where the final outcome is the formation of a scar. Scar treatment remains a challenge, despite a plethora of treatments, resulting in a poor outcome and sub-optimal response to existing therapies. Photodynamic therapy (PDT) has been used to treat oncologic conditions affecting the skin. Its action depends on a photosensitiser and a specific light source. Aminolevolinic acid (5ALA) and its methyl ester (MALA) are commonly used pro-drugs of the photosensitiser protoporphyrin IX (PpIX), which in combination with red light produces reactive oxygen species (ROS). ROS will cause different responses such as cell death and tissue destruction. There is limited clinical evidence emerging for the use of PDT in treating wound healing and pathological skin scarring. For this reason, further investigations are required to better understand the role of PDT in adult human skin wound healing and skin scarring. The aim of this investigation was to evaluate the accumulation of PpIX after exposure to 5ALA or MALA, phototoxicity of red light arrengment, citotoxicity, cell death inducction, ROS generation and a gene related analysis post-PDT in keloid fibroblasts compared to normal skin fibroblasts. Optimization of a wound healing organ culture (WHOC) model and evaluation of re-epithelialization, cell death, proliferation, extracellular matrix arreangment (ECM) and a related gene analysis after 5ALA-PDT ex vivo. General histology, cell death, proliferation, ECM rearrengment and a gene related analysis after PDT in skin scarring ex vivo. This investigation found PpIX accumulation higher with MALA compared to 5ALA. Phototoxicity and cytotoxicity was site specific within the lesion and increased proportionately to fluence rates. ROS generation leads to the decrease of cytoproliferation and increased apoptosis and necrotic cell death, COLI, COLIII an HSP70 were found down-regualted. Ex vivo wound geometry, system of support and growth media were optimized in a human wound healing organ culture (WHOC). WHOCs treated with 5ALA-PDT (20 J/cm2), showed an advancing re-epithelialization tongue 3.5 folds longer, which were highly proliferative, showing increased CK14 and p16 levels. The neo-epidermis was fully differentiated and neo-collagen was present. PCNA, p16, COLI, COLIII, MMP3, MMP19 and alpha-SMA were significantly more expressed in the dermis. MALA/5ALA-PDT (40 J/cm2) applied to striae alba, fine line, hypertrophic and keloid scars ex vivo coused an increased of apoptosis while proliferation decreased, matrix components were found to be re-organised, both according to the severity of the scar. COLI and COLIII genetic expression decreased while MMP3 and tropoelastin increased significantly. However, no statistically significant difference was observed between 5ALA and MALA-PDT treatments. In conclusion, this thesis shows that cytotoxicity post-PDT in KD fibroblasts is dependent on the lesional site within the scar, a precursor of intracellular photosensitiser and fluence. PDT in wound healing ex vivo shows increased re-epithelialization and ECM reconstruction and remodelling. Finally, in dermal fibrosis morphological and cellular effects of the application of PDT correlate with the degree and severity of dermal fibrosis. In view of this, PDT may be ideal for treating abnormal skin scarring and improving human cutaneous wound healing.

No description available.

The original Ilizarov frame is a form of circular external fixation in which bone fragments are supported by tensioned fine wires; the wires give the frame a nonlinear axial stiffness which is one of its key qualities. However, as the wires deform plastically in response to loads imposed by functional weight bearing, the stiffness of frame gradually decreases with time. To circumvent this problem the modified Ilizarov frame was conceived in which half pins rather than wires are used for bone support. As fractures managed with Ilizarov fixation tend to unite with little radiographic evidence, monitoring the progression of fracture healing is difficult. The study described in this dissertation had three primary objectives. The first was to investigate the significance of the plastic deformation which occurs in the tensioned fine wires to the long term performance of the original frame. The second was to investigate the biomechanics of the modified frame. The third objective was to conduct a in-vivo feasibility study on the use of fracture axial stiffness measurements as method of monitoring the progression of fracture healing. Plastic deformation of the wires in the original frame readily occurs at moderate load levels because stress concentrations arise at the wire-clamp and wire-bone interfaces. The reduction in frame stiffness is typically 20-30%; re-tensioning only temporarily restores the original frame stiffness. In contrast to the original frame, the modified frame displays a linear stiffness and, as the half pins act as cantilevers, shearing of the bone ends can occur under axial loading. The in-vivo study showed that the technique of relative stiffness measurement, which has been successfully applied to uniaxial fixators, is not directly applicable to Ilizarov fixation. However, it was noted that the standardd eviation of repeatm easurementsd ecreasedw ith the progressiono f healing. It is suggestedt hat this may arise as a result of decreasedm icromovement at the fracture site and might provide a means of monitoring fracture healing itself

A terapia a laser de baixa potência vem sendo utilizada para minimizar os efeitos maléficos da inflamação, bem como para acelerar a cicatrização dos tecidos lesados. Este estudo, visa observar as alterações causadas pela irradiação do laser diodo arsenieto de gálio (904nm), no tendão calcâneo em ratos. Foram utilizados 30 ratos da linhagem Wistar, com peso médio de 235g, divididos em dois grupos, um com 20 e outro com 10 animais. Todos os animais foram submetidos a tenotomia do tendão calcâneo direito. O tratamento com laser foi iniciado após 24 horas em um dos grupos, com a dose de 4 J/cm 2 ; e o outro grupo foi usado como controle. Utilizamos o método pontual, com a caneta do aparelho em contato direto com a pele do animal. Os dois grupos foram divididos em subgrupos, e os animais destes, sacrificados em períodos distintos, sendo no 8º e 15º pós-operatório. O tendão foi excisado e submetido a análise histológica pela microscopia de luz, onde foi observado a presença de células inflamatórias, fibroblastos, vascularização e deposição de colágeno. Houve diferença estatisticamente significante (p<0.05), entre controle e tratamento na deposição de colágeno e presença de células inflamatórias. Este estudo, sugestiona que a terapia a laser, proporciona a aceleração da cicatrização na tenotomia calcâneana em ratos, pelo aumento da deposição de colágeno, tanto na fase inicial como na tardia do tratamento. / Low-potency laser therapy has been used as a means of minimizing the hazardous effects of inflammation and accelerating healing in damaged tissues. This paper aims at observeving the alterations caused by diode AsGa (904nm), laser in the calcaneal tendon of rats. Thirty 235g (average weight) Wistar rats were divided into 2 groups – one with 20 and other with 10 animals, all of which underwent right calcaneal tendon tenotomy. One group started laser treatment at a dosege of 4 J/cm 2 24hours after surgery, the other being used as control. The punctual method was employed and the appliance pen kept in direct contact with animal's skin. Both groups were divided into subgroups, the animals of which were sacrificed in different times – on the 8 th and 15 th postoperative day, respectively. The tendon was excised and submitted to histology analysis using light microscopy, which revealed the presence of inflammatory cells, fibroblasts, vascularization and collagen deposition. There was a statistically significant difference (p <0.05) between the control and the treatment as far as collagen deposition at the presence of inflammatory cells are concerned. This study suggests that laser therapy accelerates healing in calcanean tenotomy in rats by increase collagen deposition both in the early and late parts of the treatment.

M. Tech. / Phototobiomodulation (PBM), also known as low level laser therapy (LLLT) or photobiostimulation, is a non-invasive form of therapy that utilizes low intensity laser light or irradiation to provide healing. However, in order for healing to be successful certain laser parameters need to be taken into consideration i.e. fluence (dosage), wavelength and power density. Laser therapy has been used for various medical applications and fields. Multiple cytokines and growth factors are involved in wound healing including Interleukin (IL)-1, IL-6 and Tumour Necrosis Factor alpha (TNF- a). In diseased state(s) such as diabetes mellitus (DM) or psoriasis, these growth factors or cytokines are either found elevated or decreased depending on various factors and for abnormally prolonged periods. However, inflammatory cytokines are usually elevated. Phototherapy has been reported to accelerate wound healing, attenuate pain and cease inflammation. However, the effect of phototherapy on cytokine modulation has not been explored extensively, especially under various stress mechanisms. Furthermore, the pathway that laser irradiation induces on modulated pro-inflammatory cytokines has not been clearly elucidated as scientists typically report on the up- or down-regulated expression of cytokines. Numerous authors have reported on the efficacy of laser irradiation to enhance the rate of wound healing and proliferation in normal and diabetic cells or tissue; however, literature that has demonstrated the latter on hypoxic insulted cells is inadequate. In this study hypoxic insult was induced as it is one of the factors that usually prolong the healing process in diabetic wounds. Prior to commencing with the main study, a pilot study was done to exclude the effect of osmotic pressure on cells grown in media containing additional glucose, and thus simulating a diabetic model iv in vitro. Mannitol was used as a control since it is not absorbed by the cells. The study involved four groups namely: normal, normal wounded, mannitol wounded and diabetic wounded cells with each group having a non-irradiated control. Mannitol wounded and diabetic wounded cells had a final concentration of 30 mM mannitol and glucose respectively. A wavelength of 636 nm at a fluence of 5 J/cm2 was used on day 1; experiments were repeated four times and all tests were done in duplicate. Cellular responses (Trypan Blue, adenosine triphosphate (ATP) and lactate dehydrogenase (LDH)) and morphological changes were assessed after 1 h incubation post-irradiation in both irradiated and non-irradiated cultures.

Submitted in accordance with the requirements for the Degree of Masters in the subject of Psychology, Faculty of Arts at the University of Zululand, 2007. / This study identifies a new paradigm for working with body, mind and spirit that facilitates psychotherapeutic processes. It uses both the verbal and non¬verbal components of human experience. It transforms life's challenges into an empowering, transformational and healing process, allowing opportunities for unfolding our true potential. Philophonetics is a modality of counselling, psychotherapy and coaching. It is a phenomenological approach to human experiences that facilitate the client in a process of active exploration, self discovery and empowerment to become more conscious in their own knowing and way of being in the world. It accepts awareness through the living body as a way of knowing through sensation, movement and gesture, visualization of internal dynamics and the resonance of sound therapy. The skills learnt in the sessions can be practiced and integrated by the client and used for self-management and self-care between sessions and after therapy is completed. The present study has shown how effective philophonetics can be and it is evident that this modality cuts across cultures. The findings of the present study are in keeping with international literature which confirms that philophonetics unlike other therapeutic modalities, it does not rely heavily on the verbal mode but employs about 80% of the nonverbal phase.

Submitted in partial fulfilment of the requirements for the degree of Master of Arts in the Department of Psychology University of Zululand, 1984. / As indigenous healers are so important to the health of many not only in South Africa but also throughout the world, a closer, scientific look at their practices is needed. Again, there is a tendency of the majority of South Africans (especially the Blacks) to consult both western oriented mental health> services and indigenous healers. Various prominent mental health professionals in South Africa have appealed that greater recognition be given to and greater use made of the skills of indigenous healers in the treatment of persons who could benefit from the services- It is for these reasons that this research on indigenous healing was undertaken. The purpose of this research was to investigate diagnostic and treat¬ment methods used by a random sample of indigenous healers from the rural Mtunzini district in Kwa-Zulu, and to ascertain whether there is any consistency (inter-practitioner) in their diagnostic and treatment methods. Twelve practitioners were each invited by a researcher and a confederate with a problem requiring treatment. Diagnostic and treatment procedures were tape recorded. Standardized data regarding diagnosis, cause symptomatology, treatment and prognosis, including practitioners' biographical data was collected. In order to ascertain inter-practitioner consistency, practitioners were asked to rank order six diagnosis and six treatment procedures ascertained to be the most frequently occuring among all twelve practitioners. The results emphasized the three distinct basic categories of Zulu indigenous practitioners viz. doctors (izinyanga), diviners (jzangoma) and faith healers (abathantfazi). Of these categories, the diviner deserve special mention as the results consistently portrayed her as a superior specialist e.g. an elderly, educated, female preserver and provider of traditional Zulu culture. Diagnostic and treatment procedures used by the practitioners were found to be based on dualistic levels viz. natural and supernatural. As suggested by previous studies and also supported in this research, more integration of Western and African oriented mental health subsystems was recommended.

No description available.