Distinct patterns of microvascular endothelial cell morphology are determined by extracellular matrix composition.

Endothelial interactions with the extracellular matrix (ECM) play important roles in angiogenesis but whether specific ECM signals can determine specific cellular morphologies is unclear. The authors compared in vitro ECM-induced morphological responses of the phenotypically distinct human placental microvascular endothelial cells (HPMECs) with large vessel endothelial cells (HUVECs). HPMECs showed distinct patterns of reorganization in response to collagen-I or collagen-IV (monolayer disruption, sprouting, migration) and Matrigel or laminin-A (intussusception, cord formation, tubulogenesis), and an intermediate response to fibrin; whereas HUVECs responded similarly to collagen-1 and Matrigel (elongation, lattice formation, vacuolation) and showed little response to fibrin.

Practical stoma care.

Patricia Black looks at the reasons behind and management of different types of stoma as well as outlining some of the possible problems associated with stomas. She emphasises the importance of caring for a stoma patient's psychological as well as physical wellbeing.

Encouraging HIV testing in GUM clinics--can we dispense with the pre-test discussion? Genitourinary Medicine.

In a genitourinary medicine (GUM) clinic on the periphery of the London conurbation, HIV testing was promoted during a one-month period by offering testing without preliminary pre-test discussion to patients who assessed themselves to be low risk. The testing rate rose from 5.9% to 10.

Kerato-dermal grafts: the importance of dermis for the in vivo growth of cultured keratinocytes.

In a porcine model, we studied the benefit of dermis for the growth of cultured autologous keratinocytes (CAK) on full-thickness wounds isolated within skin graft chambers. Kerato-dermal grafts were prepared in a two stage process using autologous de-epidermalised dermis (DED) and CAK (Group 1). Control wounds were prepared by grafting either CAK only (Group 2) or DED only (Group 3).

A porcine model using skin graft chambers for studies on cultured keratinocytes.

In wound healing research, animal models permit an extensive tissue analysis which is not normally possible in clinical studies. A morphological comparison of human and porcine skin was made in order to identify those aspects of the wound healing process where a porcine model may help our understanding of clinical problems. We describe a porcine model for evaluating the growth of cultured keratinocytes on a variety of wound beds.

Restoration of basement membrane structure in pigs following keratinocyte autografting.

The attachment of grafts of keratinocyte sheets is mediated in part by the presence and organisation of basement membrane components. The reappearance of basement membrane following keratinocyte autografting was examined in pigs. These studies showed that there was rapid expression of anchoring fibrils and hemidesmosomes, which reached normal numbers at 10 days.

The Misti Gold bio-oncotic gel filled breast prosthesis: an acceptable alternative to silicone?

Concern about the use of silicone gel as a filler for breast prostheses has stimulated interest in other materials. We have evaluated the Misti Gold prosthesis which contains a "bio-oncotic" gel of low molecular weight Polyvinylpyrrolidone (PLASDONE 24AUK). Our experience of its use in breast augmentation is that the aesthetic results obtained with retromammary placement are inferior to those obtained from a silicone gel filled prosthesis.

The effect of backing materials on keratinocyte autograft take.

A porcine model has been established to study keratinocyte autografts as a model of human keratinocyte grafting. Keratinocyte autografts were placed on 104 full thickness wounds in 13 pigs and backed with 3 dressings which varied in their ability to maintain an occlusive environment. Sixteen control wounds were ungrafted.

Early diagnosis of staphylococcal toxaemia in burned children.

The features of toxic shock syndrome in burned children have been described in a review of seven patients (J. D. Frame et al.

Cavernous haemangioma of the nasal bones.

A case report of a cavernous haemangioma arising in the nasal bones is described, together with a discussion of the relevant literature. The condition, although rare, can be reliably diagnosed pre-operatively.

The exposed total knee replacement prosthesis: a new classification and treatment algorithm.

The increased frequency of total knee replacement arthroplasty (TKRA) has been reflected in the number of patients with exposed prostheses referred to this unit. An algorithm has been developed to assist in the preoperative assessment of the wound and this has been tested on 25 patients with wound breakdown following TKRA. The grade of exposure so derived predicts the most appropriate surgical management.