Postsurgical wound progression monitored by temporal changes in the expression of matrix metalloproteinase-9

It is important to monitor the early stages of postoperative wound repair in order to identify those problems associated with impaired healing. Many of the crucial cellular responses of early wound healing, such as inflammatory infiltration, angiogenesis and re-epithelialization, are made possible through the action of matrix metalloproteinases (MMPs). Expression of MMP-2 and MMP-9 is elevated in acute wounds, and still greater levels are found in chronic wounds, indicating that uncontrolled proteolysis is a characteristic of retarded healing. Therefore, comparative measurements of MMPs may be used to monitor the progression of early wound healing. To investigate this, wound fluids and sera were collected from mastectomy and colectomy patients throughout early stages of repair, and the temporal expression profile established. Wounds which were healing were expressed maximal levels of MMP-9 at 24 h, followed by a significant decline by 48 h. Persistent elevation of MMP-9 expression was associated with infected and chronic wounds, and was identified in postoperative wounds by the absence of the significant decline between 24 and 48 h. Measurement of MMP-9 in postoperative wound fluids, therefore, provides an early indicator of impaired healing, which may be evaluated non-invasively within 48 h of closure.     

Low-dimensional modelling of dynamics via computer algebra

I describe a method, particularly suitable to implementation by computer algebra, for the derivation of low-dimensional models of dynamical systems. The method is systematic and is based upon centre manifold theory. Computer code for the algorithm is relatively simple, robust and flexible. The method is applied to two examples: one a straightforward pitchwork bifurcation, and one being the dynamics of thin fluid films.     

National and regional corporate spatial structure

Much is known about the macro-impacts of business activities on national and regional economies; however, comparatively little is known at the micro level about the impact spatial agglomeration of corporate wealth and performance has on urban systems. This paper reports on a collaborative research project between the Australian Housing and Urban Research Institute and Dun and Bradstreet, an international financial credit agency, to analyse the spatial implications of corporate structure in metropolitan regions. This paper analyses spatial patterns of medium to large businesses in three Australian State capital cities at the postcode level in order to assess the agglomeration of corporate capital, sales, and performance. The research indicates that ratio analysis can provide a useful insight into the competitiveness of metropolitan regions and the control corporate headquarters have over decision making and investment processes. The findings of this research are of special interest to capital markets, business and urban researchers in the Asia Pacific Region. Received: September 1997/Accepted: September 2001     

What influences patients' reports of three aspects of hospital services?

OBJECTIVES: Market forces make it essential to know what policies and actions influence patients' reports of hospital services. No studies have examined the role of patient characteristics, labor quality and staff characteristics, nonlabor resources, managerial practices, and employee attitudes within a single investigation. METHODS: The authors collected, simultaneously, data about labor, management and service processes, nonlabor resources, and employee attitudes on 117 nonintensive medical-surgical inpatient units in 17 hospitals selected from a pool of 69 institutions within a metropolitan area by a stratified random sample. Of the 2,595 patients who agreed to participate, 2,051 (79%) completed telephone interviews regarding their experiences with physical care, education, and pain management services within 26 days of hospital discharge. RESULTS: A significant amount of variation in patients' service reports was explained (adjusted R2 = 0.41 physical care, 0.35 pain management, 0.44 education). Although the predictors varied for each service report, patient characteristics, especially those related to personal resources, had a large explanatory role. A labor assignment pattern that could explain why earlier studies found labor quality and staff characteristics to have only a weak role in the prediction of patients' service reports was noted. CONCLUSIONS: The results related to patient characteristics may indicate opportunities to improve care by confronting service design strategies that erroneously rely on a homogeneous patient population. Measurement challenges identified by this study must be addressed to determine the role of labor quantity and staff characteristics.     

Cardiovascular abnormalities associated with human and rodent obesity

Obesity is a major risk factor for cardiovascular disease. However, a direct link between these two states is difficult to establish, since obesity frequently occurs with other disease states such as diabetes, hypertension and atherosclerosis. Clinical studies have clearly shown that uncorrected obesity is associated with cardiac hypertrophy and compromised ventricular function. A number of rodent models of obesity have been studied in terms of cardiovascular adaptations. Cardiac function of the obese Zucker rat appears to be normal at a younger age. Only after several months is depression in cardiac function discernable. These animals are mildly hypertensive, but do not exhibit the characteristic increase in cardiac output associated with human obesity. A unique characteristic of JCR:LA-cp rat is that they develop atherosclerotic and myocardial lesions. Hearts from these animals will maintain normal function when perfused with physiological levels of calcium. At higher calcium concentrations, however, mechanical function becomes impaired. Dietary-induced obese rats exhibit many of the hemodynamic alterations associated with human obesity, but there is no evidence to-date that these animals will develop severe cardiac depression. Short-term weight reduction apparently has beneficial cardiovascular effects, but weight cycling may be harmful. Given the widespread occurrence of obesity, further studies are warranted to characterize the cardiac manifestations of this condition.     

Stereological estimation of the total volume of MR visible brain lesions in patients with multiple sclerosis

Point counting represents a convenient and efficient technique for estimating the area of transects through multiple sclerosis (MS) lesions on magnetic resonance (MR) images obtained for sections through the brain. When sectioning has been performed according to the Cavalieri method, unbiased estimates of the total volume of MR-visible MS plaques can be obtained with a precision of 3–5% in 5–10 min.