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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Granulation tissue, consisting of an accumulation of fibroblasts and myofibroblasts, forms on the surfaces of a wound during the healing process. On a thermogram, granulation tissue appears mottled, with interspersed hot and cool areas due to uneven surface evaporation, avascular wound debris, and neovascularization (see Figure 10.4).
Global Medicinal Plants and Phyto-Derived Compounds in Wound Healing
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Samantha R. Loggenberg, Namrita Lall
The formation of granulation tissue is a vital step in wound healing, as it acts as an ECM in which cell proliferation and migration may occur. The granulation tissue is filled with collagen and actin filaments, which actively contract, along with the proliferation and migration of epithelial cells to facilitate wound closure (Lynch, Colvin, and Antoniades, 1989). Once the wound is completely closed, the newly formed tissues may undergo maturation and increase in tensile strength. This is known as the final stage of wound healing, the tissue remodeling phase, in which collagen and other connective tissues re-organize to form stronger associations between epithelial cells (Figure 7.1D). The maturation of other dermal structures such as hair follicles, transmembrane proteins and associated cytoplasmic proteins also occurs during the remodeling phase of wound healing. The remaining aggregated-extracellular tissue is degraded until only the matured epithelial tissue is left. The recovery process after a dermal injury occurs is highly complex, and the duration may vary based on the physiology and pre-existing health conditions of the individual (Singer and Clark, 1999).
Conditions of the External Ear
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Ayeshah Abdul-Hamid, Samuel MacKeith
Progression of disease can result in cranial neuropathies, including facial and bulbar nerves. Diagnosis is clinical combined with radiological assessment which may utilise CT (showing bone erosion) and contrast magnetic resonance imaging (MRI) and bone scans. Biopsy of granulation tissue should be considered to exclude malignancy. Treatment should be guided by microbial sampling. P. aeruginosa is the most common pathogen and therefore agents should target this. Anti-microbial treatment is usually prolonged, typically lasting 6–12 weeks, and may benefit from a multidisciplinary guidance by microbiology colleagues. Rarely NOE can be fungal. Treatment response is assessed clinically (most importantly resolution of pain), with inflammatory markers and in some units with imaging (nuclear medicine scans or MRI). The role of surgery is limited to obtaining microbiological samples, removing bony sequestra, and draining abscesses. There is evidence from cases series for the therapeutic benefit of hyperbaric oxygen in NOE.
Immunologic underpinnings and treatment of morphea
Published in Expert Review of Clinical Immunology, 2022
Avery H. LaChance, Nathaniel Goldman, Bina Kassamali, Ruth Ann Vleugels
Transforming growth factor-β (TGF-β) is a growth factor that controls the growth, differentiation, and function of a number of different cell types [70]. It is essential to granulation tissue formation in wound repair during physiologic conditions [34]. In particular, TGF-β promotes the development and expression of several different collagen subtypes as well as other extracellular matrix components [70]. In disease, TGF-β has been characterized as a key profibrotic cytokine given its role as a driver of cell proliferation and differentiation of fibroblasts [71]. Additionally, in the setting of tissue growth factors, TGF-β suppresses the expression of collagenase and simultaneously stimulates the expression of the tissue inhibitor of metalloproteinase, TIMP [72]. In doing so, TGF-β, in the presence of growth factors, creates an imbalance in the body’s collagen homeostatic mechanism, creating an environment that suppresses the ability to degrade collagen once laid down [72]. Within the skin, several studies have implicated TGF-β in the development of systemic sclerosis as well as in keloid formation [2–4]. While TGF-β has also been posited as a key player in the pathogenesis of morphea, the data to support this is not as robust.
Hunner lesion disease differs in diagnosis, treatment and outcome from bladder pain syndrome: an ESSIC working group report
Published in Scandinavian Journal of Urology, 2020
Magnus Fall, Jørgen Nordling, Mauro Cervigni, Paulo Dinis Oliveira, Jennifer Fariello, Philip Hanno, Christina Kåbjörn-Gustafsson, Yr Logadottir, Jane Meijlink, Nagendra Mishra, Robert Moldwin, Loredana Nasta, Jorgen Quaghebeur, Vicki Ratner, Jukka Sairanen, Rajesh Taneja, Hikaru Tomoe, Tomohiro Ueda, Gjertrud Wennevik, Kristene Whitmore, Jean Jacques Wyndaele, Andrew Zaitcev
Biopsy retrieval and histopathology evaluation are important in the diagnosis of BPS to exclude confusable diseases. In non-HLD phenotypes, the majority of histopathology features are slight and non-specific, while certain signs are characteristic for HLD. Deep biopsies including bladder muscle have been recommended, since the disease process involves superficial as well as deeper layers of the bladder wall. Specimens from patients with HLD display striking histologic alterations with prominent ulcerations that may be covered by fibrin mixed with inflammatory cells, in particular neutrophils. The lesions are often wedge-shaped and involve the superficial part of the lamina propria, often extending into the muscularis mucosae. Underlying granulation tissue is present in the vast majority of the subjects. There is often denudation of the urothelium, but if present reactive changes are common (Figure 2(A)).
Ciprofloxacin HCl and quercetin functionalized electrospun nanofiber membrane: fabrication and its evaluation in full thickness wound healing
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Gufran Ajmal, Gunjan Vasant Bonde, Sathish Thokala, Pooja Mittal, Gayasuddin Khan, Juhi Singh, Vivek Kumar Pandey, Brahmeshwar Mishra
Granulation tissue is mainly constituted of collagen fibre, fibroblast and newly developed blood vessel. Collagen fibre is composed of 13–14% hydroxyproline in addition to other amino acid. Hence, hydroxyproline level has been used as biochemical index for collagen content. The content of hydroxyproline or collagen fibre indicates activity of proliferating fibroblast and physical strength of regenerating tissue. On the 8th day, all groups demonstrated insignificant (p < .001) improvement in comparison with control, although PCL/CHL-nanofiber and PCL/CHL/Que-nanofiber treated groups displayed significant improvement (p < .001) in comparison to rest two groups (Figure 10(c)). This increment could be attributed to pro-wound healing environment provided by nanofiber. On the 16th day, only PCL/CHL/Que-nanofiber treated group showed significant increase in hydroxyproline level in respect to other groups. Although hydroxyproline level was higher in PCL/CHL-nanofiber treated group than in the gauze treated and PCL-nanofiber group, but no significant difference could be achieved between PCL/CHL-nanofiber treated group and control. On both time points, PCL/CHL/Que-nanofiber treated animals exhibited significant (p < .05) improvement in wound healing in respect of PCL/CHL-nanofiber treated group, which could be due to neutralization of reactive oxygen species and subsequently better collagenases.