epidermal-growth-factor and Rupture

This article is a comprehensive overview of tympanic membrane injury and its healing. Its wound healing process is unique from soft tissue because epithelialization occurs before fibrous tissue advancement. Contemporary and future modalities to improve tympanic membrane repair are also discussed in this article.

Topics: Animals; Chinchilla; Epidermal Growth Factor; Hearing Loss, Conductive; Humans; Myringoplasty; Otitis Media; Rupture; Tympanic Membrane; Wound Healing

Arthroscopic reconstruction is a standard surgical procedure in cases of symptomatic knee instability due to rupture of the anterior cruciate ligament. Bone-tendon-bone and hamstring tendon grafts are both in use for anterior cruciate ligament reconstruction. There are no significant differences between the two types of graft in relation to function scores, but there is a difference in anteroposterior stability when measured on the KT-2000 arthrometer: knee joints after reconstruction with bone-tendon-bone autografts are more stable than those reconstructed with hamstring tendon autografts.. To improve knee stability after anterior cruciate ligament reconstruction with a hamstring graft and use of platelet-derived growth factors.. Platelet-leukocyte gel was produced from platelet-leukocyte-rich plasma prepared from a unit of whole blood in an autologous platelet separator. The gel was applied locally, after hamstring graft placement. Fifty patients were included in the study: 25 in the platelet gel group, 25 in a control group. We evaluated anteroposterior knee stability with the KT-2000 arthrometer before surgery and at 3 and 6 months after surgery.. Patients treated with the gel demonstrated significantly better anteroposterior knee stability than patients in the control group. The calculated improvements in knee stability at 6 months were 1.3 +/- 1.8 mm in the control group and 3.1 +/- 2.5 mm in the platelet gel group (P = 0.011).. Platelet-leukocyte gel, applied locally, can improve knee stability in surgery for reconstruction of the anterior cruciate ligament.

Topics: Administration, Topical; Adult; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Arthrometry, Articular; Arthroscopy; Connective Tissue Growth Factor; Epidermal Growth Factor; Female; Fibroblast Growth Factor 2; Growth Substances; Humans; Joint Instability; Knee Injuries; Male; Middle Aged; Platelet-Derived Growth Factor; Plateletpheresis; Rupture; Tendon Transfer; Transforming Growth Factor beta; Vascular Endothelial Growth Factor A; Young Adult

Cleft of the secondary palate is one of the most common congenital birth defects in humans. The primary cause of cleft palate formation is a failure of fusion of bilateral palatal shelves, but rupture of the once fused palate has also been suggested to take place in utero. The possibility of post-fusion rupture of the palate in humans has hardly been accepted, mainly because in all the cleft palate cases, the cleft palatal edge is always covered with intact epithelium. To verify whether the intrauterine environment of the fetus plays roles in wound healing when the once fused palate is torn apart, we artificially tore apart fetal mouse palates after fusion and cultivated them in culture medium with or without mouse or human amniotic fluid. We thereby found that the wounded palatal edge became completely covered with flattened epithelium after 36 hours in culture with amniotic fluid, but not in culture without amniotic fluid. Using histological and scanning electron microscopic analyses of the healing process, it was revealed that the epithelium covering the wound was almost exclusively derived from the adjacent nasal epithelium, but not from the oral epithelium. Such actions of amniotic fluid on the fetal wound were never simulated by exogenous epidermal growth factor (EGF), albumin, or both. In addition, the rapid epithelialization induced by amniotic fluid was not prevented by either PD168393 (an inhibitor of the EGF receptor-specific tyrosine kinase) or SB431542 (a specific inhibitor of TGFbeta receptor type I/ALK5). The present study provides new insights into the unique biological actions of amniotic fluid in the repair of injured fetal palate.

Topics: Activin Receptors, Type I; Amniotic Fluid; Animals; Cleft Palate; Epidermal Growth Factor; Epithelium; ErbB Receptors; Female; Fetus; Humans; Male; Mice; Mice, Inbred ICR; Microscopy, Electron, Scanning; Nasal Mucosa; Organ Culture Techniques; Palate; Protein Serine-Threonine Kinases; Receptor, Transforming Growth Factor-beta Type I; Receptors, Transforming Growth Factor beta; Rupture; Wound Healing

Chronic tympanic membrane (TM) perforation is a common problem worldwide. Recent reports have shown epidermal growth factor (EGF) to stimulate healing in approximately 80% of chronic TM perforations in chinchillas when applied in three doses over 1 week. The objective of this controlled study is to evaluate the efficacy of long-term EGF in the closure of TM perforations. Chronic chinchilla TM perforations were treated with EGF for up to 6 weeks. One hundred percent (17 of 17) of treatment group perforations completely healed. However, two new findings with this long dosing scheme were reperforation on long-term follow-up and three TMs with cholesteatomas. It is likely that reperforation was due to a progressive thinning seen with prolonged EGF application. Long-term EGF use is not recommended for the treatment of TM perforations because of possible wound healing impairment and possible cholesteatoma induction.

Topics: Animals; Chinchilla; Cholesteatoma, Middle Ear; Chronic Disease; Drug Administration Schedule; Endoscopy; Epidermal Growth Factor; Follow-Up Studies; Gelatin Sponge, Absorbable; Longitudinal Studies; Placebos; Recurrence; Rupture; Sodium Chloride; Time Factors; Tympanic Membrane; Wound Healing