Faculty Bibliography

PURPOSE: To acquaint wound care practitioners with new information related to debridement of chronic wounds. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in wound care. OBJECTIVES: After reading this article and taking this test, the reader should be able to: 1. Explain the role of keratinocytes in wound healing. 2. Discuss new research findings on the physiological differences between healing and nonhealing wounds.3. Identify implications of the new research for debridement of chronic wounds

BACKGROUND: Surface modifications to dental implants have been used in an attempt to accelerate the osseointegration process. The objective of this study was to biomechanically/histomorphometrically evaluate a bioceramic grit-blasted and acid-etched surface (BGB/AA; test) versus a dual acid-etched implant surface (control) in a beagle dog model. METHODS: Control and BGB/AA implants were subjected to a series of physicochemical characterization tools, including scanning electron microscopy (SEM), atomic force microscopy (AFM), and auger photoelectron spectroscopy (APS). The animal model included the placement of 72 implants along the proximal tibiae of six beagle dogs, which remained in place for 2 or 4 weeks. After euthanization, half of the specimens were biomechanically tested (removal torque), and the other half was non-decalcified processed to slides of approximately 30 microm thickness for histomorphologic and histomorphometric (percentage of bone-to-implant contact [%BIC]) evaluation. Analysis of variance at the 95% confidence level and the Tukey post hoc test were used for multiple comparisons. RESULTS: SEM and AFM showed that surface microtextures were qualitatively and quantitatively different and that the BGB/AA surface presented higher submicrometer average roughness values (R(a)) and root mean square (RMS) values compared to control surfaces. Ca and P were detected at the BGB/AA surface by APS. Higher degrees of bone organization were observed along the perimeter of the BGB/AA surface compared to control, despite the non-significant differences in %BIC between the surfaces (P >0.25). Significantly higher removal torque was observed for the BGB/AA implants at both time periods (P <0.0001). CONCLUSION: According to the biomechanical and histomorphologic results, early biomechanical fixation was positively affected by the BGB/AA surface compared to the dual-acid etched surface.

Hypomorphic RAG mutants with severely reduced V(D)J recombination activity cause Omenn Syndrome (OS), an immunodeficiency with features of immune dysregulation and a restricted TCR repertoire. Precisely how RAG mutants produce autoimmune and allergic symptoms has been unclear. Current models posit that the severe recombination defect restricts the number of lymphocyte clones, a few of which are selected upon Ag exposure. We show that murine RAG1 R972Q, corresponding to an OS mutation, renders the recombinase hypersensitive to selected coding sequences at the hairpin formation step. Other RAG1 OS mutants tested do not manifest this sequence sensitivity. These new data support a novel mechanism for OS: by selectively impairing recombination at certain coding flanks, a RAG mutant can cause primary repertoire restriction, as opposed to a more random, limited repertoire that develops secondary to severely diminished recombination activity

The bony biochemical environment is an active and dynamic system that permits and promotes cellular functions that lead to matrix production and ossification. Each component is capable of conveying important regulatory cues to nearby cells, thus effecting gene expression and changes at the cytostructural level. Here, we review the various signaling molecules that contribute to the active and dynamic nature of the biochemical system. These components include hormones, cytokines, and growth factors. We describe their role in regulating bone metabolism. Certain growth factors (i.e., TGF-beta, IGF-1, and VEGF) are described in greater detail because of their potential importance in developing successful tissue-engineering strategies

OBJECTIVES: Profound and growing disparities exist in oral health among certain US populations. We sought here to determine the prevalence of oral health complaints among Harlem adults by measures of social class, as well as their access to oral health care. METHODS: A population-based survey of adults in Central Harlem was conducted from 1992 to 1994. Two questions on oral health were included: whether participants had experienced problems with their teeth or gums during the past 12 months and, if so, whether they had seen a dentist. RESULTS: Of 50 health conditions queried about, problems with teeth or gums were the chief complaint among participants (30%). Those more likely to report oral health problems than other participants had annual household incomes of less than $9000 (36%), were unemployed (34%), and lacked health insurance (34%). The privately insured were almost twice as likely to have seen a dentist for oral health problems (87%) than were the uninsured (48%). CONCLUSIONS: There is an urgent need to provide oral health services for adults in Harlem. Integrating oral health into comprehensive primary care is one promising mechanism