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PubMed2006

An internally covered (lined) self-expanding metal esophageal stent: tissue response in a porcine model.

BACKGROUND: Self-expandable metal stents (SEMS) palliate malignant dysphagia but may embed in tissue, produce granulation tissue, and prevent removal. OBJECTIVE: Our purpose was to evaluate in a porcine model the tissue response induced by a new esophageal SEMS completely coated internally rather than externally. DESIGN: Eight Yucatan pigs were studied. Each animal underwent placement of 2 stents: 1 study stent and 1 control stent. SEMS were placed proximally or distally by random assignment. Follow-up endoscopy was performed 1, 2, 3, and 4 weeks after implantation. Ease of stent removal was assessed at 2 weeks and 4 weeks after placement. SETTING: Animal laboratory. INTERVENTIONS: Endoscopic placement of study stents (Alveolus ES-STS, Alveolus, Inc, Charlotte, NC; 18 mm diameter, fully covered internally) and control stents (Ultraflex stent, Boston Scientific, Natick, Mass; microvasive, 18 mm midbody, subtotally covered externally). MAIN OUTCOME MEASUREMENTS: Extent of granulation tissue and stent-induced esophageal injury. RESULTS: The tissue hyperplasia response of the study stents was endoscopically graded as mild to moderate. All study stents were endoscopically removed easily and atraumatically. Control stents produced severe granulation tissue formation with complete embedding of the uncovered stent ends; endoscopic removal was possible but resulted in trauma and endoscopically visible bleeding. Histopathologic findings revealed minimal tissue response at the ends of the study stents and severe pseudopolyps in the embedded portion of the control stent. Stent migration occurred in 7 of 8 study stents and 4 of 8 control stents. LIMITATIONS: Animal model lacks stricture. CONCLUSIONS: Fully internally lined SEMS may resist tissue embedding and hyperplasia and may be removable. Human studies are needed to assess applicability to treatment of benign and malignant esophageal disease.

Animals↗
PubMedDate not supplied

Wound healing activity of Ocimum sanctum Linn with supportive role of antioxidant enzymes.

The present study was performed to evaluate the wound healing and antioxidant effect of aqueous extract of Ocimum sanctum Linn. (O. sanctum) in rats. Albino rats of either sex were divided into 2 groups. Group I: Wounded control rats; Group II: Wounded rats administered O. sanctum aqueous extract. Wound breaking strength in incision wound model, epithelization period and percent wound contraction in excision wound model were studied. Using dead space wound model, granulation tissue breaking strength, granulation tissue dry weight, hydoxyproline level in dry granulation tissue, superoxide dismutase (SOD) and catalase levels in wet granulation tissue were estimated in both the groups. Increased wound breaking strength, decreased epithelization period, increased percent wound contraction, increased granulation tissue weight and hydroxyproline concentrations were observed. The increased activity of antioxidant enzymes such as SOD, catalase level in extract treated group compared to controls. Granulation tissue was subjected to histopathological examination to determine the pattern of lay-down for collagen using Haematoxylin and Eosin stains which confirm the results. Owing to wound healing and antioxidant activities, O. sanctum may be useful in the management of abnormal healing such as keloids and hypertrophic scars.

Animals↗
PubMed2004

The in vivo expression of membrane-bound CD14 in periodontal health and disease.

BACKGROUND: Membrane-bound CD14 (mCD14) is a myeloid differentiation antigen expressed on monocytes/macrophages and neutrophils. It is a key molecule responsible for the innate recognition of bacteria by host cells and functions as an important receptor for bacterial lipopolysaccharide. This study investigated the in vivo expression profile and levels of mCD14 in healthy and diseased gingival tissues. METHODS: Gingival biopsies were obtained from 24 patients with chronic periodontitis, including 22 periodontal pocket tissues, 13 clinically healthy tissues, and 18 inflamed connective tissues (i.e., granulation tissues). Gingival biopsies from seven periodontally healthy subjects were used as controls. mCD14 was detected by immunohistochemistry. RESULTS: mCD14 was detected in 21 of 22 periodontal pocket tissues and all other categories of tissues. The mCD14-positive cells were mainly confined to the gingival epithelium-connective tissue interface. The expression levels in periodontally healthy subjects were significantly higher than in the patients. Within the patients, clinically healthy tissues showed greater levels of mCD14 than periodontal pocket tissues and granulation tissues. CONCLUSIONS: mCD14 was commonly expressed in both healthy and diseased gingival tissues and was predominantly confined to the epithelium-connective tissue interface. The positive relationship observed between mCD14 expression levels and periodontal health may imply that mCD14 is associated with favorable host responses to bacterial challenge and contributes to maintaining periodontal homeostasis.

Adult↗
PubMedDate not supplied

The validity of the clinical signs and symptoms used to identify localized chronic wound infection.

It is uncertain how accurately classic signs of acute infection identify infection in chronic wounds, or if the signs of infection specific to secondary wounds are better indicators of infection in these wounds. The purpose of this study was to examine the validity of the "classic" signs (i.e., pain, erythema, edema, heat, and purulence) and the signs specific to secondary wounds (i.e., serous exudate, delayed healing, discoloration of granulation tissue, friable granulation tissue, pocketing at the base of the wound, foul odor, and wound breakdown). Thirty-six chronic wounds were assessed for these signs and symptoms of infection with interobserver reliability ranging from 0.53 to 1.00. The wounds were then quantitatively cultured, and 11 (31%) were found to be infected. Increasing pain, friable granulation tissue, foul odor, and wound breakdown showed validity based on sensitivity, specificity, discriminatory power, and positive predictive values. The signs specific to secondary wounds were better indicators of chronic wound infection than the classic signs with a mean sensitivity of 0.62 and 0.38, respectively. None of the signs or symptoms was a necessary indicator of infection, but increasing pain and wound breakdown were both sufficient indicators with specificity of 100%.

Adult↗
PubMed2006

Effect of Ocimum sanctum Linn. on normal and dexamethasone suppressed wound healing.

Ethanolic extract of leaves of O. sanctum was investigated for normal wound healing and dexamethasone depressed healing using incision, excision and dead space wound models in albino rats. The extract of O. sanctum significantly increased the wound breaking strength in incision wound model. The extract treated wounds were found to epithelialize faster and the rate of wound contraction was significantly increased as compared to control wounds. Significant increase in wet and dry granulation tissue weight, granulation tissue breaking strength and hydroxyproline content in dead space wound model was observed. The extract significantly decreased the antihealing activities of dexamethasone in all the wound models. The results indicated that the leaf extract promotes wound healing significantly and able to overcome the wound healing suppressing action of dexamethasone. Histological examination of granulation tissue to determine the pattern of lay-down for collagen confirmed the results.

Animals↗
PubMed2006

Wound healing activities of Bark Extract of Jatropha curcas Linn in albino rats.

OBJECTIVE: To investigate the wound-healing properties of crude bark extract of Jatropha curcas Linn in Wistar albino rats. METHODS: This work was carried out in the Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India, in the year 2005. We divided the animals into 3 groups of 12 each. Group I was saline control without wound, group II was animals treated with JC extract in the dose of 2 ml/kg body weight with wound and group III was animals treated with 4 ml/kg body weight with wound. The wound healing parameters like wound breaking strength, epithelization period, percent wound contraction, granulation tissue breaking strength, granulation tissue dry weight, hydroxyproline level and histological features were assessed by using incision, excision and dead space wound models. RESULTS: The results obtained indicated that Jatropha curcas accelerates the healing process by increasing the skin breaking strength, granulation tissue breaking strength, wound contraction, dry granulation tissue weight and hydroxyproline levels. A significant decrease in epithelization period was also observed. The histopathological examination of granulation tissue showed much advanced phase of healing, with more collagen, which has organized to form bundles. CONCLUSION: The results of the study suggest that the crude bark extract of Jatropha curcas was very effective in accelerating wound healing process.

Animals↗
PubMed2001

Vanadate ingestion increases the gain in wound breaking strength and leads to better organized collagen fibers in rats during healing.

Repair of incision wounds closed by suturing is evaluated by the progressive gain in wound breaking strength. Previously the closure of open wounds in rats ingesting vanadate, an inhibitor of tyrosine phosphate phosphatases, was shown to occur with deposition of more uniformly organized collagen fiber bundles. The hypothesis of this study was that deposition of more uniformly organized collagen fibers would enhance the gain in wound breaking strength of incisional wounds. Six adult rats received vanadate-supplemented saline drinking water for 1 week before placement of two 6-cm, parallel, suture-closed wounds on their backs. Six control rats received identical wounds and were given saline drinking water. The drinking water regimen was continued for 1 week after wounding, and then wound strength was tested with a tensiometer and tissue samples were obtained for histologic evaluation. Wound breaking strength doubled in vanadate-treated rats compared with controls. Bright-field and polarized light microscopy showed that the connective tissue matrix of granulation tissue from control rats was oriented perpendicular to the surface of the skin. In contrast, the connective tissue matrix of granulation tissue from vanadate-treated rats was oriented parallel to the skin surface. The gap in granulation tissue between the edges of the wounds in the vanadate-treated rats was greater than that in controls. Electron microscopy showed that wounds in the vanadate-treated contained uniform collagen fibers that were 20 percent greater in diameter and more evenly spaced than they were in controls. It is proposed that these changes in the organization of collagen fibers within incisional wounds were responsible for the increased wound breaking strength observed in rats ingesting vanadate.

Animals↗
PubMed1986

Histological observations of amniotic fluid cellular content in the ear of neonates and infants.

Amniotic fluid cellular content (AFCC), especially keratinized, non-nucleated squamous epithelial cells and lanugo hair, have been detected in the fetal and neonatal ear. We wished to evaluate the incidence, amount and histological findings of AFCC in the neonatal and early infant period. Temporal bones (n = 63) from children aged 10 min to 70 days were examined. AFCC was discovered in 39 of 43 bones in neonates. In children of 31-70 days of age, AFCC was present in 11 of 20 bones. A measurement of the amount of AFCC was performed; the maximum was 11.47 mm3 with a mean of 2.40 mm3. Histological findings varied from the mere presence of AFCC to the formation of epithelialized granulation tissue. This granulation tissue was found in 19 of the bones. Theoretical clinical implications are considered for middle ear adhesions, otitis media and cholesteatoma.

Amniotic Fluid↗
PubMed2003

Vertical alveolar distraction osteogenesis with complications in a reconstructed mandible.

We report here a case of vertical alveolar distraction osteogenesis with many complications that required further surgical interventions. A 54-year-old man underwent mandibular resection followed by iliac bone grafting as the result of large mandibular odontogenic keratocyst. Eleven months later, alveolar vertical distraction osteogenesis was applied to the patient for prosthetic rehabilitation. Fracture of the basal bone occurred in the consolidation period, and the fracture was fixed by the titanium miniplate system. Radiographic examination after completion of distraction osteogenesis confirmed a radiolucent area in half of the distracted area between the basal bone and the transport segment, and when the distractor was removed the radiolucent area was filled with fibrous granulation tissue. The granulation tissue was removed and endosteal implants were inserted together with a bone graft. Ultimately, all implants were osseointegrated, and adequate esthetics and function of the implant-supported prosthesis were achieved.

Alveolar Bone Loss↗
PubMedDate not supplied

Effect of subatmospheric pressure on the acute healing wound.

PURPOSE: Vacuum-assisted closure (VAC), originally developed as an adjunct to wound care, has gained popularity in managing complex, chronic wounds. This study was designed to compare VAC with traditional saline-wet-to-dry (WD) dressings on acute wound healing in a pig model. METHODS: Nine animals were divided into groups of 3. Three rows of 2, 4-cm diameter circular defects were excised on each animal. Vacuum-assisted closure therapy was applied to 2 adjacent wound beds, WD dressings were applied to 2 adjacent wound beds, and ventilated transparent dressing covered the 2 remaining wounds as controls. Random members from each group had their wounds harvested on postoperative days (POD) number 4, 7, and 9, respectively. The specimens were histopathologically evaluated and graded with regard to immature granulation tissue, mature granulation tissue, necropurulent surface crust, proliferating cell nuclear antigen (PCNA), and collagen deposition. RESULTS: The WD-treated wounds had less necropurulent material on the surface compared with the VAC and control groups (p < 0.05). Day 9 specimens demonstrated increased immature collagen in the VAC and WD groups compared with control. No other statistically significant variations existed between the treatment groups. CONCLUSIONS: Under the conditions of this study, the histopathologic observations do not support more rapid wound healing for the acutely injured VAC-treated wound compared with the WD-treated wound in young healthy pigs.

Acute Disease↗
PubMed1982

Insertion tendopathy in athletes. A light microscopic, histochemical and electron microscopic examination.

Tendon tissue of eleven athletes suffering from insertion tendopathy and of two controls was examined. Part of the tissue was prepared for routine light microscopy, a part for enzyme histochemical staining of Nicotinamide-adenine-dinudeotide-diaphorase (NADP-diaphorase), lactate dehydrogenase (LDH), beta-glucuronidase and alkaline phosphatase. Small pieces of tissue were also prepared for electron microscopic examination. The removed tissue was edematous and mushy. The normally densely packed parallel or interwoven collagen bundles were loosened by edema, focal necrosis or hemorrhage. Infiltration of fatty tissue and granulation tissue was also present. The amount of acid mucopolysaccharides was markedly increased. The histochemical studies showed strong enzyme activity of NADP-diaphorase and LDH in normal tendon tissue as well as around areas of degeneration and in granulation tissue. beta-Glucuronidase and alkaline phosphatase was present, but in general with lesser activity than the above enzymes. The electron microscopic examination revealed marked degeneration of the fiber systems, focal necrosis, deposit of amorphous masses and mucopolysaccharides and focal mineralisation. The reparative zones showed proliferating capillaries, often with a collapsed lumen and prominent endothelial cells and basement membranes.

Adult↗
PubMed1995

Hypophysitis in surgical and autoptical specimens.

We present the clinical and histological findings of 11 cases of inflammatory anterior pituitary lesions, 8 of which were obtained during surgery and 3 of which were obtained from autopsies. Additionally, we extended the conventional classification of pituitary inflammatory disease by the new entity " secondary hypophysitis". Of the surgically obtained specimens 5 consisted of inflammatory extension into the pituitary gland out of the surrounding tissue. In all of these patients the inflammation originated from an additional tumor in the sellar region (4 craniopharyngiomas, 1 prolactinoma). These will be referred to as "secondary hypophysitis", an entity which has not yet been mentioned in the literature. Of the remaining 6 cases, 2 were granulomatous hypophysitis, 2 pituitary abscesses, 1 lymphocytic hypophysitis, and 1 showed extensive scarring of the anterior pituitary lobe due to preceeding lymphocytic hypophysitis. At histological examination the basic structure of the anterior pituitary was maintained in all cases. Relative counts of hormone-producing cells were normal. In secondary hypophysitis, the affected area was composed of fibrous tissue and granulation tissue. B and T lymphocytes were present in equal amounts. Granulomas were not found. Inflammatory infiltrates, granulation tissue and fibroses were seen in different proportions. Based on our results and three other cases reported in the literature so far, we think that the presently used classification of pituitary inflammatory diseases lacks an entity which describes a non-abscess-forming inflammation of the pituitary gland originating from an associated pathological process. Therefore, we introduced the term secondary hypophysitis to describe this fourth entity of pituitary inflammatory disease.

Adult↗
PubMed1992

Inactivation of substance P by granulation tissue-derived gelatinase.

An active gelatinase has been purified from the conditioned medium of granulation tissue culture formed by carrageenin injection in rats. The purified gelatinase gave a single band corresponding to a M(r) of 57 kDa on both sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and SDS-gelatin PAGE. The granulation tissue-derived gelatinase selectively cleaved the Gln6-Phe7 bond of substance P (SP) with a Km of 0.17 mM and a Vmax of 0.027 nmol SP7-11/min/micrograms protein, resulting in the generation of biologically inactive fragments, SP1-6 and SP7-11. Our data suggest that the gelatinase produced by granulation tissue participates in the inactivation of SP in the inflammatory site.

Animals↗
PubMed2006

Effect of Centella asiatica L (Umbelliferae) on normal and dexamethasone-suppressed wound healing in Wistar Albino rats.

Centella asiatica is a reputed medicinal plant used in the treatment of various skin diseases in the Indian system of medicine. The objective of the study presented in this article was to evaluate the wound-healing potential of the ethanolic extract of the plant in both normal and dexamethasone-suppressed wound healing. The study was done on Wistar albino rats using incision, excision, and dead space wounds models. The extract of C asiatica significantly increased the wound breaking strength in incision wound model compared to controls (P < .001). The extract-treated wounds were found to epithelize faster, and the rate of wound contraction was significantly increased as compared to control wounds (P < .001). Wet and dry granulation tissue weights, granulation tissue breaking strength, and hydroxyproline content in a dead space wound model also increased at statistically significant levels as shown. The extract of the leaves had the effect of attenuating the known effects of dexamethasone healing in all wound models (P < .001, P < .05). The results indicated that the leaf extract promotes wound healing significantly and is able to overcome the wound-healing suppressing action of dexamethasone in a rat model. These observations were supported by histology findings.

Administration, Topical↗
PubMed2001

A tool to assess clinical signs and symptoms of localized infection in chronic wounds: development and reliability.

This paper reports on the development and testing of a tool designed to assess chronic wounds for the clinical signs and symptoms of localized infection. Thirty-one wounds were assessed by two independent nurse observers for the signs and symptoms of infection using the Clinical Signs and Symptoms Checklist. The Clinical Signs and Symptoms Checklist delineates 12 signs and symptoms of infection (i.e., pain, erythema, edema, heat, purulent exudate, serous exudate with concurrent inflammation, delayed healing, discoloration of granulation tissue, friable granulation tissue, pocketing at the base of the wound, foul odor, and wound breakdown) and their definitions. The reliability of each sign or symptom on the checklist was calculated using percent agreement and the Kappa statistic. Percent agreement ranged from 65% to 100%, and Kappa statistics ranged from 0.53 to 1.00, excluding pocketing of the wound base. The reliability estimates obtained for signs and symptoms on the Clinical Signs and Symptoms Checklist compare favorably with other data regarding interclinician agreement on wound assessment. Incorporating a structured approach to assess and monitor for wound infection, such as the Clinical Signs and Symptoms Checklist, may improve clinician skill and accuracy in identifying this condition.

Aged↗
PubMedDate not supplied

[Tooth extraction wound healing after administration of vitamin B6 (pyridoxine). Histological study in rats].

Male rats with 250 grs of weight were injected daily with 0.1 ml of B6 vitamin by peritoneal (way paths). The animal were sacrificed at three, seven, 10, 15 and 21 day after the upper incisor extraction. Its hemimaxila were retired and fixed in 10% formalin and after had been embedded in paraffin sections were cut with 6 micrometers pick. The analysis of the sections stained by hematoxylin and eosin when compared with the controls showed that: 1) the blood clot and fibrin net are substituted more rapidly by the granulation tissue; 2) granulation tissue is more plentiful, early and mature; 3) the bone tissue is more plentiful and mature.

Animals↗
PubMed1997

Apoptosis during wound healing, fibrocontractive diseases and vascular wall injury.

Following injury, tissue repair involves inflammation, granulation tissue formation and scar constitution. Granulation tissue develops from the connective tissue surrounding the damaged or missing area and contains mainly small vessels, inflammatory cells, fibroblasts and myofibroblasts. As the wound closes and evolves into a scar, there is a striking decrease in cellularity, including disappearance of typical myofibroblasts. The question arises as to what process is responsible for granulation tissue cell disappearance. Our results (in cutaneous wounds) and results of other laboratories (particularly in lungs and kidney) suggest that apoptosis is the mechanism responsible for the evolution of granulation tissue into a scar. During excessive scarring (hypertrophic scar or fibrosis), it is conceivable that the process of apoptosis cannot take place. After experimental endothelial injury in an artery, accumulation of smooth muscle cells participates in the formation of intimal thickening. Apoptotic features have been observed in cells of intimal thickening and also within human atherosclerotic plaques. In the case of atherosclerosis, apoptosis could be detrimental: since smooth muscle cells participate in plaque stability, apoptosis could lead to weakening and rupture of the plaque. These results underline the fact that both increased cell survival or excessive cell death can be associated with pathological disorders. Specific therapies devised to enhance or decrease the susceptibility of individual cell types to apoptosis development could modify the evolution of a variety of human diseases.

Animals↗
PubMed1989

Effect of decidua angiogenic factors on experimental dermis allografts.

Meshed human dermis allografts containing human uterine angiogenic factor were implanted over full thickness surgical skin wounds in rats. Enhanced angiogenesis of the wound bed, three times more than that observed in control grafts, was found in experimental grafts at 3 days postimplantation. This was accompanied by a greater amount of granulation tissue formation, enhanced granulation tissue penetration into the dermal grafts and accelerated incorporation of the grafts. Angiogenesis of the wound bed regressed to control levels at 7 days postimplantation. The growth and penetration of the granulation tissue and the accelerated incorporation of the dermis grafts, however, continued ahead in the experimental grafts while necrosis appeared in the control grafts. The relevance of these results for acceleration of wound healing and improvement of the wound bed for subsequent application of cultured epidermal grafts is discussed. This method may be extended to the treatment of ulcers and burns.

Angiogenesis Inducing Agents↗