Activin is a dimeric protein of inhibin beta subunit, which is abundantly stored in normal bone matrix, presumably produced by osteoblasts in the process of normal bone formation. The expression of activins was examined in the wound healing of diabetic rats. In this study,insulin-dependent diabetes mellitus was induced in a group of mature Sprague-Dawley rats by injecting streptozotocin. Control animals were injected with citrate buffer only. After 3 weeks,all of rats underwent extraction of the right maxillary molars teeth after anesthesia. Rats were killed at varying intervals and the maxilla and calvaria were recovered in continuity. Tissue sections were stained with hematoxylin-eosin as well as immunohistochemical gent. Hematoxylin-eosin analyses showed that at 7 days after tooth extraction in the control and insulin-streptozotocin-treated rats there were, thick collagen fibers which formed a pretrabecular the scaffold dictated the direction of the forming trabeculae. However,the collagen fibers in the diabetic socket were thin and scanty, and only formed a narrow layer in the apical part of the socket. These histologic observations suggest that in uncontrolled, insulin-dependent diabetes, the formation of the collagenous framework in the tooth extraction socket is inhibited, resulting in delayed healing.The immunohistochemical analyses showed that at 7 days after tooth extraction in both control and insulin-streptozotocin-treated rats, osteoblasts were increased in extra-alveolar bone formation.Our findings also suggested that activin was actively involve in bone modeling during osteogenesis. These findings suggest that activin may play important role in the regulation of bone formation and it may be useful in the future for the wound healing in diabetic patients.

Thesis (M.S.), Biology--University of Central Oklahoma, 2009. / Includes bibliographical references (leaves 53-57).

Thesis (M. Phil.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 105-136).

Thesis (M.S.)--University of North Carolina at Wilmington, 2003. / Includes bibliographical references (leaves : [22]-26).

published_or_final_version / Nursing Studies / Master / Master of Nursing

Aims: To evaluate and compare the wound healing process following osteotomies performed with either conventional rotary burs or piezoelectric surgery in a rabbit model mimicking access to the maxillary sinus cavity for sinus floor augmentation. Materials and methods: On the nasal bone of 16 adult New Zealand white rabbits, two types of osteotomy window defects of nasal cavities were marked to critical size with a Trephine drill (ø 5 mm) and then prepared with either a conventional rotary bur or piezo-surgery (PIEZOSURGERY® Insert OT5 of PIEZOSURGERY® 3 unit, Mectron s.p.a., Genova, Italy). The defects were covered with a resorbable membrane (Bio-Gide®, Geistlich Pharma AG, Wohusen LU, Switzerland). Four animals were sacrificed at one, two, three and five weeks after surgical procedure, respectively. Histological and morphometric evaluations were performed to assess the volumetric density of various tissue components: the blood clot (BC), vascularized structures (VS), provisional matrix (PM), osteoid, mineralized bone (MB), bone debris (BD), residual tissue, old bone (OB). Results: at the 1 week, more BC detected after piezo- surgical preparation. However, the difference did not reach statistical significance. A tendency of higher proportions of osteoid in the conventional bur defects was noted, but not statistically significant. Significantly more BD was found in the conventionally compared to the piezo-surgically prepared defects. At two weeks, new bone formation was noted, and the process of modeling of the newly formed bone had started. More MB was detected in the defect prepared by piezo-surgery than by conventional bur, but without any statistically significant difference. In the marginal areas of defect, slightly more osteoblasts (Obl) were present in piezo-surgically prepared defect than in conventional prepared defect, although there is no significant difference. At 3 week, a newly formed hard tissue bridge mainly composed of woven bone was seen. A high volumetric density of mineralized bone (MB) presented in all the specimens, At the 5 week, the defects were completely filled with newly formed bone. Conclusion: the defect prepared by piezo-surgery showed a significantly decreased proportion of bone debris at one week compared to conventional rotary bur defect. Increased volumetric densities of mineralized bone were observed in the piezo-surgical compared to the conventional bur defect after two weeks, although not statistically significant. Irrespective of the preparation modality of the defect performed, the defect was almost filled with newly formed bone at three weeks. At five weeks, complete regeneration of the calvaria defects was achieved. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

Introduktion: Sjuksköterskor idag står inför en växande patientgrupp med diabetes, som har svårläkta fotsår. Patienterna finns i alla vårdformer som primärvård, specialistvård och kommunal hälso- och sjukvård. För att patienten ska kunna upprätthålla en god livskvalitet och ett bra socialt liv krävs det en säker och snabb sårläkning. Syfte: Arbetets syfte var att beskriva vad som påverkar sårläkning hos patienter med diabetes och svårläkt fotsår, vid undertrycksbehandling. Metod: Denna litteraturstudie har utgått ifrån Polit och Becks (2012) niostegsmodell. Sökningarna har gjorts i CINAHL och PubMed. Kvalitetsgranskning gjordes som resulterade i tio kvantitativa vetenskapliga artiklar. Artiklarnas resultatdel analyserades och grupperades utifrån syftet och efter gemensamma områden.  Resultat: Resultatet i litteraturstudien delades in i två kategorier: sårstatus och behandlingstid. I resultatet framkom att undertrycksbehandling sågs som mer effektiv behandlingsmetod än konventionell fuktighetsbevarande sårbehandling. Volym och sårdjup minskade mer effektivt vid undertrycksbehandling än med konventionell fuktig sårbehandling. Slutsats: Litteraturstudien visar att undertrycksbehandling kan bidra till snabbare sårläkning hos diabetiker med svårläkt fotsår. Alla studier valde mätvärden som storlek, djup och typ av vävnad för att beskriva sårstatus. Behandlingstiden varierade i studierna. Det visade sig även att det vetenskapliga underlaget var begränsat.

No description available.

Many researchers have failed to find a relationship between experience and judgment accuracy. In this study the purpose was to understand the relationship between experience and expertise in clinical judgment. Common sense suggests that experienced subjects make better quality judgments, compared to novices. Clinical judgments, however, are ill-structured and characterized by uncertainty; they take place in a dynamic context, with delayed or nonexistent feedback and are difficult to learn. Cognitive operations that translate "cues" (such as risk factors, signs, and symptoms) into judgments are not fully understood. Cognitive constructs (conceptual structure, sensitivity to patterns in data, and judgment process) and individual differences in age, education, and experience were explored to identify their relationship to judgment expertise. Indicators of judgment quality were: accuracy, consistency, latency, confidence, calibration, and knowledge accessibility. In phase 1 of this study, cues were identified that best predicted healing time for 258 surgical patients with abdominal incisions. In Phase 2, the subjects were 36 nurses with a range of experience caring for surgical patients. Generating both quantitative and qualitative data, subjects made judgments about incisional healing on the basis of information from actual patients. Multidimensional scaling was used to reveal conceptual structure, and lens modeling was applied to assess sensitivity to broad patterns. An information board task with think-aloud protocols demonstrated judgment process. The selection of tasks was based on their analysis- or intuition-inducing features, using K. R. Hammond's (1990) cognitive continuum theory. Experience accounted for a only a small proportion of variance in performance, whereas confidence in judgment was more strongly related to experience. Taken together, these findings replicated previous research. Protocol data showed that metacognition, knowledge accessibility, and reflectivity increased with experience. Conceptual structure predicted judgment accuracy under intuitive conditions. Support was found for Dreyfus and Dreyfus' (1986) hypothesized transition in cognition, from deliberate processing of discrete cues, to intuitive processing of patterns of cues encoded in memories for specific cases. This study has theoretical significance by adding to knowledge about clinical judgment, and by increasing understanding of cognitive changes associated with expertise. This study has practical significance in providing direction for the development of teaching methods aimed to increase learning from experience in probabilistic contexts.

Poly(methacrylic acid -co- methyl methacrylate) beads were previously shown to have a therapeutic effect on wound closure through the promotion of angiogenesis. However, it was unclear how this polymer elicited its beneficial properties. The goal of this thesis was to characterize the host response to MAA beads by identifying molecules of interest involved in MAA-mediated angiogenesis (in comparison to poly(methyl methacrylate) beads, PMMA). Using a model of diabetic wound healing and a macrophage-like cell line (dTHP-1), eight molecules of interest were identified in the host response to MAA beads. Gene and/or protein expression analysis showed that MAA beads increased the expression of Shh, IL-1β, IL-6, TNF-α and Spry2, but decreased the expression of CXCL10 and CXCL12, compared to PMMA and no beads. MAA beads also appeared to modulate the expression of OPN. In vivo, the global gene expression of OPN was increased in wounds treated with MAA beads, compared to PMMA and no beads. In contrast, dTHP-1 decreased OPN gene expression compared to PMMA and no beads, but expressed the same amount of secreted OPN, suggesting that the cells decreased the expression of the intracellular isoform of OPN. Interestingly, MAA beads had no effect on the expression of pro-angiogenic growth factors VEGF, bFGF and PDGF-B in vivo or in vitro, suggesting that MAA beads do not induce angiogenesis by simply increasing the expression of pro-angiogenic factors, but use more subtle mechanisms. It was hypothesized that these mechanisms may involve modulation of toll-like receptor signaling in macrophages interacting with the protein layer adsorbed on to MAA beads, in a manner distinct from PMMA beads and no beads. Taken together, the results suggest that MAA beads promote angiogenesis through increased expression of Shh, decreased expression of CXCL10 and modulation of the expression of OPN, but not through increased expression of typical pro-angiogenic growth factors. The resulting vessel-rich “alternative foreign body reaction” has exciting clinical implications as the polymer itself was found to exert a therapeutic effect in the absence of bioactive components or transplanted cells. Understanding the mechanism could lead to new applications for this material and others designed on similar principles.