Fibroblast subpopulations in intra-oral wound healing

The objective of this study was to characterize fibroblasts at sequential time points during intra-oral wound healing in the rat. Experimental wounds were made at several time points in the mucoperiosteum of the palate of 35-day-old Wistar rats. Fibroblasts were cultured from the biopsies under standard conditions for the same number of passages. The expression of the integrin subunits alpha 1, alpha 6, and beta 1; and the intermediate filaments alpha-smooth muscle actin and vimentin were analyzed by flow cytometry. Western blot analysis was performed at 0, 8, and 60 days postwounding to confirm the expression of both intermediate filaments. The phenotypic profiles of fibroblasts cultured from subsequent stages in the wound healing process differed considerably. We conclude that distinct fibroblast phenotypes can be isolated from different stages in wound healing. These phenotypes remained stable during in vitro culturing. In addition, cryosections of the wound areas were made at identical time points and were immunohistochemically stained for the same antigens. The immunohistochemical staining correlated well to the flow-cytometric data. These results suggest the occurrence of multiple subpopulations of fibroblasts with a specialized function during wound healing. We hypothesize that undesirable consequences of wound healing might be prevented through the modulation of specific fibroblast subpopulations.     

Temporomandibular joint: morphology and signal intensity characteristics of the disk at MR imaging

Magnetic resonance (MR) imaging has been used in the temporomandibular joint (TMJ) primarily to define the disk position. This report examines altered morphology and signal intensity characteristics of the TMJ disk as they relate to the severity of internal derangement. Two hundred sixteen joints in 133 patients with a history of such derangement. were imaged with MR. Disk position, signal intensity, morphology, and the presence of osteoarthritis were determined for each joint. The normal disk was not anteriorly displaced and had a normal "bow-tie" shape. A grade 1 disk was anteriorly displaced and had a normal shape; a grade 2 disk was anteriorly displaced and had an abnormal shape. Forty (19%) joints were considered normal; none of these exhibited osteoarthritis. One hundred thirty-nine (64%) joints were grade 1; osteoarthritis was found in 17%. Thirty-seven (17%) were grade 2; osteoarthritis was found in 95%. All forty normal joints had high or intermediate signal intensity in the disk. Osteoarthritic joints had a higher percentage of disks with diminished intensity (P less than .0001). Severe or untreated osteoarthritis is known to be a complication of TMJ internal derangements; hence this grading system seems to correlate with the severity of internal derangement.     

De visie van Europese farmaciestudenten op studie en beroep

In view of the mutual recognition of the pharmacy degree in the European Community, a survey was held in the spring of 1979 in Cardiff (United Kingdom), Frankfurt (Federal Republic of Germany) and Leiden (The Netherlands) among 70, 47 and 51 senior pharmacy students respectively. They were asked for their personal background and their opinions on the following subjects: the study of pharmacy, duties of the retail pharmacist, presentation of information to physicians and patients, the consumption of medicines, the working conditions for retail pharmacists and the mutual recognition of pharmacy qualifications within the EC. Questions on these subjects were presented in the form of a questionnaire. The responses were analysed by means of a number of computer programs, including that of Homals-1, a technique for the multidimensional analysis of categoric data. The results reflect the views in each separate city as well as the differences between the cities. For example, students in all three cities were unanimous in their views that providing information to patients and physicians should be one of the major activities of the pharmacist, which, according to the students, is not the case at the present time. With respect to mutual recognition, a number of objections were raised by students in Leiden, while Cardiff students had no objections and students from Frankfurt took an intermediate position.Samenvatting Met het oog op een wederzijdse erkenning van het apothekersdiploma in de Europese Gemeenschap, zijn in het voorjaar van 1979 in Cardiff (Verenigd Koninkrijk), Frankfurt (Bondsrepubliek Duitsland) en Leiden (Nederland) respectievelijk 70, 47 en 51 ouderejaars farmaciestudenten geënquÊteerd. Gevraagd is naar hun persoonlijke achtergrond en naar hun mening over de farmaciestudie, de taken van de officine apotheker, de voorlichting aan arts en patiënt, de geneesmiddelenconsumptie, de werkomstandigheden van de officine apotheker en de wederzijdse erkenning van het apothekersdiploma in de EG. Vragen over genoemde onderwerpen werden gesteld door middel van een vragenlijst. Voor de analyse van de antwoorden werd gebruik gemaakt van een aantal computerprogramma's waaronder Homals-1, een techniek voor de meer-dimensionale analyse van categorische gegevens. De resultaten geven de meningen in iedere stad afzonderlijk weer, alsmede de verschillen tussen de steden. Zo bestaat in alle steden de opvatting dat het voorlichten van patiënten en artsen tot de belangrijkste werkzaamheden van de apotheker zou moeten behoren, hetgeen volgens de Studenten nu nog niet het geval is. Ten aanzien van een wederzijdse erkenning hebben de Leidse Studenten veel bezwaar, Studenten uit Cardiff geen bezwaar en Studenten uit Frankfurt nemen een tussenpositie in.

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Naar het bijvakverslag Onderzoek Farmacie in de EG, Subfaculteit Farmacie, Rijksuniversiteit Leiden, Wassenaarseweg 76, 2300 RA Leiden.     

How has psycho-behavioural research advanced our understanding of hypoglycaemia in type 1 diabetes?

Almost 100 years since the discovery of insulin, hypoglycaemia remains a barrier for people with type 1 diabetes to achieve and maintain blood glucose at levels which prevent long-term diabetes-related complications. Although hypoglycaemia is primarily attributable to the limitations of current treatment and defective hormonal counter-regulation in type 1 diabetes, the central role of psycho-behavioural factors in preventing, recognizing and treating hypoglycaemia has been acknowledged since the early 1980s. Over the past 25 years, as documented in the present review, there has been a substantial increase in psycho-behavioural research focused on understanding the experience and impact of hypoglycaemia. The significant contributions have been in understanding the impact of hypoglycaemia on a person's emotional well-being and aspects of life (e.g. sleep, driving, work/social life), identifying modifiable psychological and behavioural risk factors, as well as in developing psycho-behavioural interventions to prevent and better manage (severe) hypoglycaemia. The impact of hypoglycaemia on family members has also been confirmed. Structured diabetes education programmes and psycho-behavioural interventions with a focus on hypoglycaemia have both been shown to be effective in addressing problematic hypoglycaemia. However, the findings have also revealed the complexity of the problem and the need for a personalized approach, taking into account the individual's knowledge of, and emotional/behavioural reactions to hypoglycaemia. Evidence is emerging that people with persistent and recurrent severe hypoglycaemia, characterized by deeply entrenched cognitions and lack of concern around hypoglycaemia, can benefit from tailored cognitive behavioural therapy.