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Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation method has become a widely practiced and established transplantation option for adult patients suffering with end-stage liver disease, and it has successfully helped address the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplantation Anesthesiologists jointly reviewed published studies on the perioperative management of adult live liver donors undergoing donor hemi-hepatectomy. The goal of the review is to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live donors. We featured the current status, donor selection process, outcomes and complications, surgical procedure, anesthetic management, Enhanced Recovery After Surgery protocols, avoidance of blood transfusion, and considerations for emergency donation. Recent surgical advances, including laparoscopic donor hemi-hepatectomy and robotic laparoscopic donor surgery, are also addressed.

With more than 14,000 patients awaiting liver transplantation in the USA and a mortality rate of 20–25% on the wait list, a diligent pre-operative evaluation is crucial to ensure optimal risk assessment. Cardiac disease remains the leading cause of early mortality after liver transplantation. In this review, we discuss common cardiac comorbidities, frequently used testing modalities, and updated literature on cardiac evaluation in liver transplant candidates. Optimal cardiac evaluation, especially in the asymptomatic patient, remains controversial as shown by conflicting results in the literature. Non-invasive testing is associated with low sensitivity in this patient population; therefore, coronary angiography remains the standard for detecting CAD. There is general agreement that all liver transplant candidates have to undergo cardiac evaluation; however, universally accepted guidelines are currently not available. Often the choice of the cardiac evaluation modality has to be made on a case-by-case basis by a multidisciplinary transplant team based on the perceived risk of invasive studies when compared to perioperative cardiac events.

BACKGROUND Wound infection can impair postoperative healing. Topical antibiotics have potential to treat wound infection and inflammation and minimize the adverse effects associated with systemic antibiotics. METHODS Full-thickness porcine wounds were infected with Staphylococcus aureus. Using polyurethane wound enclosure devices, wounds were treated with topical 100 μg/ml minocycline, topical 1000 μg/ml minocycline, topical saline control, or 4 mg/kg intravenous minocycline. Bacteria were quantified in wound tissue and fluid obtained over 9 hours. Immunosorbent assays were used to analyze inflammatory marker concentrations. Minocycline's effect on in vitro migration and proliferation of human keratinocytes and fibroblasts was tested using scratch assays and metabolic assays, respectively. RESULTS After 6 hours, 100 and 1000 μg/ml topical minocycline decreased bacteria in wound tissue to 3.5 ± 0.87 and 2.9 ± 2.3 log colony-forming units/g respectively, compared to 8.3 ± 0.9 log colony-forming units/g in control wounds (p < 0.001) and 6.9 ± 0.2 log colony-forming units/g in wounds treated with 4 mg/kg intravenous minocycline (p < 0.01). After 2 hours, topical minocycline reduced concentrations of the inflammatory cytokines interleukin-1β, interleukin-6, and tumor necrosis factor-α (p < 0.01), and inflammatory cell counts in wound tissue (p < 0.05). In noninfected wounds, topical minocycline significantly reduced interleukin-1β, interleukin-6, and inflammatory cell counts after 4 hours (p < 0.01). Matrix metalloproteinase-9 concentrations decreased after 1-hour treatment (p < 0.05). Keratinocyte and fibroblast in vitro functions were not adversely affected by 10 μg/ml minocycline or less. CONCLUSIONS Topical minocycline significantly reduces bacterial burden and inflammation in infected wounds compared with wounds treated with intravenous minocycline or control wounds. Minocycline also decreases local inflammation independently of its antimicrobial effect.

Burn and blast injuries are frequently complicated by invasive infections, which lead to poor wound healing, delay in treatment, disability, or death. Traditional approach centers on early debridement, fluid resuscitation, and adjunct intravenous antibiotics. These modalities often prove inadequate in burns, where compromised local vasculature limits the tissue penetration of systemic antibiotics. Here, we demonstrate the treatment of infected burns with topical delivery of ultrahigh concentrations of antibiotics. Standardized burns were inoculated with Staphylococcus aureus or Pseudomonas aeruginosa. After debridement, burns were treated with either gentamicin (2 mg/mL) or minocycline (1 mg/mL) at concentrations greater than 1,000 times the minimum inhibitory concentration. Amount of bacteria was quantified in tissue biopsies and wound fluid following treatment. After six days of gentamicin or minocycline treatment, S. aureus counts decreased from 4.2 to 0.31 and 0.72 log CFU/g in tissue, respectively. Similarly, P. aeruginosa counts decreased from 2.5 to 0.0 and 1.5 log CFU/g in tissue, respectively. Counts of both S. aureus and P. aeruginosa remained at a baseline of 0.0 log CFU/mL in wound fluid for both treatment groups. The findings here demonstrate that super-therapeutic concentrations of antibiotics delivered topically can rapidly reduce bacterial counts in infected full-thickness porcine burns. This treatment approach may aid wound bed preparation and accelerate time to grafting.

We investigate the evolution of the cross-plane thermal conductivity κ of a SiGe superlattice (SL) as it is gradually converted into an alloy via post-growth thermal treatment at temperatures varying from 650 to 1000 °C. X-ray diffraction (XRD), transmission electron microscopy (TEM), secondary-ion-mass-spectroscopy (SIMS), and photoluminescence (PL) spectroscopy measurements are used as complementary tools to gain insight into the structural properties of our SL and their evolution upon annealing. While the SL structure is preserved up to temperatures of ∼850 °C, full alloying is observed for higher temperatures. The thermal conductivity data, collected with differential 3ω method, show a monotonic increase of κ from ∼4.5 W/m K up to the values expected for a thin-film alloy. To understand the results, we compute the phonon mean-free-path (MFP) spectra using the experimentally determined composition profiles as input. The calculated thermal conductivity values are in good agreement with the experimental data and show that the increase of thermal conductivity is due to a gradual increase of MFP of low-to-mid-frequency phonons, i.e., to a weakening of interface scattering for alloyed SLs. The calculations also allow us to address finite-thickness effects on the measured thermal conductivity data. Although the used SL had a total thickness of only ∼250 nm, its thermal conductivity can be assumed to coincide with that of a “bulk” (infinitely thick) SL prior to annealing. As interdiffusion increases, boundary scattering at the film/substrate interface becomes relevant and leads to a slow increase of κ. Besides its fundamental relevance, this work shows that the thermal stability of superlattices is limited, and that sizeable structural changes (including defect formation) occur already at operation temperatures of ∼650 °C.

This chapter summarizes the current state of the literature regarding gender-specific differences in outcome for patients with burn injuries. The main focus of this chapter will be a consideration of the reasons for the sexual dimorphism in survival from burns. Despite increasing research directed at women’s health, the literature is limited and quite inconsistent. The lack of gender-specific research in burn patients becomes even more obvious when seeking explanations for the underlying mechanisms that cause the vulnerability of women to burn injury. Ultimately, if female gender influenced burn mortality it would be imperative to consider gender-related differences in the development of novel therapeutic interventions in burn patients.

Cell migration requires spatiotemporal integration of signals that regulate cytoskeletal dynamics. In response to a migration-promoting agent, cells begin to polarise and extend protrusions in the direction of migration. These cytoskeletal rearrangements are orchestrated by a variety of proteins, including focal adhesion kinase (FAK) and the Rho family of GTPases. CCN2, also known as connective tissue growth factor, has emerged as a regulator of cell migration but the mechanism by which CCN2 regulates keratinocyte function is not well understood. In this article, we sought to elucidate the basic mechanism of CCN2-induced cell migration in human keratinocytes. Immunohistochemical staining was used to demonstrate that treatment with CCN2 induces a migratory phenotype through actin disassembly, spreading of lamellipodia and re-orientation of the Golgi. In vitro assays were used to show that CCN2-induced cell migration is dependent on FAK, RhoA and Cdc42, but independent of Rac1. CCN2-treated keratinocytes displayed increased Cdc42 activity and decreased RhoA activity up to 12 hours post-treatment, with upregulation of p190RhoGAP. An improved understanding of how CCN2 regulates cell migration may establish the foundation for future therapeutics in fibrotic and neoplastic diseases.

The process of wound healing is dynamic and takes place over months to years, during which there is a resolution of angiogenesis, continued wound contraction, and connective tissue remodeling. The outcome of this process is most commonly the formation of a scar, defined as a fibrous tissue replacing normal tissues destroyed by injury or disease. Scars often have a lowered or total loss of vital skin functions and imbue a large burden on both the patient and the health care system as a whole. Scar treatments are plentiful but are often unsatisfactory or inconsistent. No single treatment method has been universally adopted. To evaluate the clinical treatment as well as research focused on developing novel methods for scar management, objective studies of the progression of scar formation and the properties of mature scars are needed. Several parameters, including barrier function as well as mechanical and physiological properties, need to be taken into account when both categorizing and treating healing wounds and scars. To date, there is no available methodology that provides a comprehensive evaluation of a scar's properties. This review aims at presenting an overview of available scar assessment methods and devices, ranging from analysis of collagen properties in tissue biopsies to noninvasive methods for studies of mechanical parameters such as breaking strength and skin elasticity. In the cases where conclusive studies have been performed, the differences between normal skin and scar with respect to the above parameters are presented. Furthermore, this review highlights areas where the development of additional modalities are needed.

Transplantation of skin micrografts in a 1:100 ratio regenerate the epidermis of full-thickness wounds in pigs within 14 days in a wet environment. The aim of the current study was to combine micrografts and commercially available moist dressings. We hypothesized that micrografts regenerate the epidermis when covered with a moist dressing. 5cm×5cm and 10cm×10cm full-thickness wounds were created on the backs of pigs. Wounds were transplanted with 0.8mm×0.8mm micrografts created from a split-thickness skin graft in a 1:100 ratio. 5cm×5cm wounds were treated with wound chambers, moist dressings or dry gauze (non-transplanted control group). 10cm×10cm wounds were compared to non-transplanted wounds, both covered with moist dressings. Reepithelialization was assessed in biopsies from day 10, 14 and 18 post-transplantation. 5cm×5cm transplanted wounds covered with moist dressings showed 69.5±20.6% reepithelialization by day 14 and 90.5±10.4% by day 18, similar to wounds covered with a wound chamber (63.9±16.7 and 86.2±11.9%, respectively). 18 days post-transplantation, 10cm×10cm transplanted wounds covered with moist dressings showed 66.1±10.3% reepithelialization, whereas nontransplanted wounds covered with moist dressings were 40.6±6.6% reepithelialized. We conclude that micrografts combined with clinically available moist dressings regenerate the epidermis of full-thickness wounds.

In this work, it is shown how different carrier recombination paths significantly broaden the photoluminescence (PL) emission bandwidth observed in type-II self-assembled SiGe/Si(001) quantum dots (QDs). QDs grown by molecular beam epitaxy with very homogeneous size distribution, onion-shaped composition profile, and Si capping layer thicknesses varying from 0 to 1100 nm are utilized to assess the optical carrier-recombination paths. By using high-energy photons for PL excitation, electron-hole pairs can be selectively generated either above or below the QD layer and, thus, clearly access two radiative carrier recombination channels. Fitting the charge carrier capture-, loss- and recombination-dynamics to PL time-decay curves measured for different experimental configurations allows to obtain quantitative information of carrier capture-, excitonic-emission-, and Auger-recombination rates in this type-II nano-system.

CCN2 (previously known as connective tissue growth factor) is a multifunctional matricellular protein that has numerous effects on cell life and cell interactions with the connective tissue. Although the importance of CCN2 for the fibrotic process in wound healing has been well studied, the involvement of CCN2 in keratinocyte function has not yet been explored. Therefore, the aim of the present study was to investigate the role of CCN2 in the epidermis during wound healing.Immunohistochemistry was done on sections from full-thickness porcine wounds. The effect of CCN2 on the migration of cultured human keratinocytes exposed to scratch wounds, the effect on phosphorylation of extracellular signal-related kinases (ERK), and the effect of adding inhibitors to the ERK/mitogen-activated protein kinase pathway to human keratinocytes were studied.The CCN2 protein was transiently expressed in vivo at the leading keratinocyte edge during re-epithelialization of full-thickness porcine wounds. In vitro, exogenous addition of CCN2 to human keratinocyte cultures regulated keratinocyte migration and resulted in phosphorylation of ERK. The addition of inhibitors of ERK/mitogen-activated protein kinase counteracted the effect of CCN2 on migration.CCN2 was transiently expressed at the leading keratinocyte edge in vivo. The biologic importance of this was supported in vitro, because CCN2 regulated human keratinocyte migration through activation of the Ras-mitogen-activated protein kinase kinase-ERK signal transduction pathway.

Recently, it was shown that lasing from epitaxial Ge quantum dots (QDs) on Si substrates can be obtained if they are partially amorphized by Ge ion bombardment (GIB). Here, we present a model for the microscopic origin of the radiative transitions leading to enhanced photoluminescence (PL) from such GIB-QDs. We provide an energy level scheme for GIB-QDs in a crystalline Si matrix that is based on atomistic modeling with Monte Carlo (MC) analysis and density functional theory (DFT). The level scheme is consistent with a broad variety of PL experiments performed on as-grown and annealed GIB-QDs. Our results show that an extended point defect consisting of a split-[110] self-interstitial surrounded by a distorted crystal lattice of about 45 atoms leads to electronic states at the Γ-point of the Brillouin zone well below the conduction band minimum of crystalline Ge. Such defects in Ge QDs allow direct transitions of electrons localized at the split-interstitial with holes confined in the Ge QD. We identify the relevant growth and annealing parameters that will let GIB-QDs be employed as an efficient laser active medium.

Background Transplantation of skin micrografts (MGs), split-thickness skin grafts (STSGs), or cultured autologous keratinocytes (CKs) enhances the healing of large full-thickness wounds. This study compares these methods in a porcine wound model, investigating the utility of micrograft transplantation in skin restoration. Study Design Full-thickness wounds were created on Yorkshire pigs and assigned to one of the following treatment groups: MGs, STSGs, CKs, wet nontransplanted, or dry nontransplanted. Dry wounds were covered with gauze and the other groups' wounds were enclosed in a polyurethane chamber containing saline. Biopsies were collected 6, 12, and 18 days after wounding. Quantitative and qualitative wound healing parameters including macroscopic scar appearance, wound contraction, neoepidermal maturation, rete ridge formation, granulation tissue thickness and width, and scar tissue formation were studied. Results Transplanted wounds scored lower on the Vancouver Scar Scale compared with nontransplanted wounds, indicating a better healing outcome. All transplanted wounds exhibited significantly lower contraction compared with nontransplanted wounds. Wounds transplanted with either MGs, STSGs, or CKs showed a significant increase in re-epithelialization compared with nontransplanted wounds. Wounds transplanted with MGs or STSGs exhibited improved epidermal healing compared with nongrafted wounds. Furthermore, transplantation with STSGs or MGs led to less scar tissue formation compared with the nontransplanted wounds. No significant impact on scar formation was observed after transplantation of CKs. Conclusions Qualitative and quantitative measurements collected from full-thickness porcine wounds show that transplantation of MGs improve wound healing parameters and is comparable to treatment with STSGs.

Transplantation of genetically modified keratinocytes has been shown to accelerate wound healing. However, this method is labor-intensive and time-consuming. We have developed a new technique of intraoperative gene delivery to wounds that involves transplantation of transfected minced skin particles (MSPs) derived from harvested partial-thickness skin.MSPs measuring 0.8 × 0.8 × 0.35 mm were created from a split-thickness skin graft of a pig. In vitro transfection was carried out with adenoviral LacZ (Ad-LacZ) for qualitative and adenoviral vascular endothelial growth factor (Ad-VEGF) for quantitative analysis. Transfected MSPs were transplanted to each of 2.5 × 2.5 cm full-thickness wounds on the dorsum of the pig. Nontransfected MSPs served as controls. Wound chambers were applied and injected with saline to create a wet environment.LacZ expression was detected in migrating cells originating from MSPs both in vitro and in vivo. VEGF expression in the wound fluid of Ad-VEGF-MSP-transplanted wounds on each of days 2 to 4 (mean ± SEM 6.74 ± 1.89 ng/mL, day 2; 9.88 ± 2.27 ng/mL, day 3; 9.87 ± 1.28 ng/mL, day 4) was significantly higher (p0.0001) compared with wounds transplanted with either untransfected MSPs, Ad-LacZ-MSPs, or untransplanted controls. In vitro VEGF expression was significantly higher (p0.0001) in Ad-VEGF 1 × 10(10) transfected MSPs compared with either Ad-VEGF 1 × 10(9) transfected MSPs or untransfected MSPs. Wounds transplanted with Ad-VEGF-MSPs showed significantly higher (p0.0001) numbers of newly formed blood vessels (12.6 ± 0.9 vessels/high power field [HPF]) compared with wounds transplanted with either Ad-LacZ-MSPs (4.4 ± 0.5 vessels/HPF) or untransfected MSPs (5.2 ± 0.7 vessels/HPF). All MSP-transplanted wounds (Ad-VEGF-MSPs, untransfected MSPs, Ad-LacZ-MSPs) showed significantly higher re-epithelialization compared with untransplanted wounds on days 10 and 14 (p0.0001).We demonstrated successful transfection of MSPs that can be transplanted to wounds as a source of gene-expressing cells. This technique can be used to deliver growth-modulating genes in wound healing.

Semiconductor light-emitters compatible with standard Si integration technology (SIT) are of particular interest for overcoming limitations in the operating speed of microelectronic devices. Light sources based on group IV elements would be SIT-compatible, but suffer from the poor optoelectronic properties of bulk Si and Ge. Here we demonstrate that epitaxially grown Ge quantum dots (QDs) in a defect-free Si matrix show extraordinary optical properties if partially amorphized by Ge-ion bombardment (GIB). In contrast to conventional SiGe nanostructures, these QDs exhibit dramatically shortened carrier lifetimes and negligible thermal quenching of the photoluminescence (PL) up to room temperature. Microdisk resonators with embedded GIB-QDs exhibit threshold behavior as well as a superlinear increase of the integrated PL intensity with concomitant line width narrowing as the pump power increases. These findings demonstrate light amplification by stimulated emission in a fully SIT-compatible group IV nanosystem.

We fabricated photonic crystal nanocavities containing single SiGe QDs deterministically aligned to the antinodes of a cavity mode. Cavity coupling drastically enhances the vertical QD emission and allows, for the first time, the optical characterization of a single SiGe QD. For low excitation intensities, a single exponential PL decay with a time constant of 22ns at T=10K is observed for such a coupled QD-PhC-cavity system.

Burn and blast injuries are frequently complicated by invasive infections, which lead to poor wound healing, delay in treatment, disability, or death. Traditional approach centers on early debridement, fluid resuscitation, and adjunct intravenous antibiotics. These modalities often prove inadequate in burns, where compromised local vasculature limits the tissue penetration of systemic antibiotics. Here, we demonstrate the treatment of infected burns with topical delivery of ultrahigh concentrations of antibiotics. Standardized burns were inoculated with Staphylococcus aureus or Pseudomonas aeruginosa. After debridement, burns were treated with either gentamicin (2 mg/mL) or minocycline (1 mg/mL) at concentrations greater than 1,000 times the minimum inhibitory concentration. Amount of bacteria was quantified in tissue biopsies and wound fluid following treatment. After six days of gentamicin or minocycline treatment, S. aureus counts decreased from 4.2 to 0.31 and 0.72 log CFU/g in tissue, respectively. Similarly, P. aeruginosa counts decreased from 2.5 to 0.0 and 1.5 log CFU/g in tissue, respectively. Counts of both S. aureus and P. aeruginosa remained at a baseline of 0.0 log CFU/mL in wound fluid for both treatment groups. The findings here demonstrate that super-therapeutic concentrations of antibiotics delivered topically can rapidly reduce bacterial counts in infected full-thickness porcine burns. This treatment approach may aid wound bed preparation and accelerate time to grafting.

Injury to the skin can predispose individuals to invasive infection. The standard of care for infected wounds is treatment with intravenous antibiotics. However, antibiotics delivered intravenously may have poor tissue penetration and be dose limited by systemic side effects. Topical delivery of antibiotics reduces systemic complications and delivers increased drug concentrations directly to the wound.Porcine full-thickness wounds infected with Staphylococcus aureus were treated with ultrahigh concentrations (over 1000 times the minimum inhibitory concentration) of gentamicin using an incubator-like wound healing platform. The aim of the present study was to evaluate clearance of infection and reduction in inflammation following treatment. Gentamicin cytotoxicity was evaluated by in vitro assays.Application of 2000 μg/ml gentamicin decreased bacterial counts in wound tissue from 7.2 ± 0.3 log colony-forming units/g to 2.6 ± 0.6 log colony-forming units/g in 6 hours, with no reduction observed in saline controls (p0.005). Bacterial counts in wound fluid decreased from 5.7 ± 0.9 log colony-forming units/ml to 0.0 ± 0 log colony-forming units/ml in 1 hour, with no reduction observed in saline controls (p0.005). Levels of interleukin-1β were significantly reduced in gentamicin-treated wounds compared with saline controls (p0.005). In vitro, keratinocyte migration and proliferation were reduced at gentamicin concentrations between 100 and 1000 μg/ml.Topical delivery of ultrahigh concentrations of gentamicin rapidly decontaminates acutely infected wounds and maintains safe systemic levels. Treatment of infected wounds using the proposed methodology protects the wound and establishes a favorable baseline for subsequent treatment.

We previously demonstrated that intratracheally administered S-ketamine inhibits alveolar fluid clearance (AFC), whereas an intravenous (i.v.) bolus injection had no effect. The aim of the present study was to characterize whether continuous i.v. infusion of S-ketamine, yielding clinically relevant plasma concentrations, inhibits AFC and whether its effect is enhanced in acute lung injury (ALI) which might favor the appearance of i.v. S-ketamine at the alveolar surface. AFC was measured in fluid-instilled rat lungs. S-ketamine was administered i.v. over 6 h (loading dose: 20 mg/kg, followed by 20 mg/kg/h), or intratracheally by addition to the instillate (75 µg/ml). ALI was induced by i.v. lipopolysaccharide (LPS; 7 mg/kg). Interleukin (IL)-6 and cytokine-induced neutrophil chemoattractant (CINC)-3 were measured by ELISA in plasma and bronchoalveolar lavage fluid. Isolated rat alveolar type-II cells were exposed to S-ketamine (75 µg/ml) and/or LPS (1 mg/ml) for 6 h, and transepithelial ion transport was measured as short circuit current (ISC). AFC was 27±5% (mean±SD) over 60 min in control rats and was unaffected by i.v. S-ketamine. Tracheal S-ketamine reduced AFC to 18±9%. In LPS-treated rats, AFC decreased to 16±6%. This effect was not enhanced by i.v. S-ketamine. LPS increased IL-6 and CINC-3 in plasma and bronchoalveolar lavage fluid. In alveolar type-II cells, S-ketamine reduced ISC by 37% via a decrease in amiloride-inhibitable sodium transport. Continuous administration of i.v. S-ketamine does not affect rat AFC even in endotoxin-induced ALI. Tracheal application with direct exposure of alveolar epithelial cells to S-ketamine decreases AFC by inhibition of amiloride-inhibitable sodium transport.

During molecular beam epitaxial growth of Ge islands on Si(001) substrates containing pit-patterned areas, an efficient Ge surface diffusion from unpatterned to pit-patterned substrate regions results in position-dependent island growth rates. We exploit this effect to map out the evolution of strictly ordered Ge islands from prepyramids via pyramids and transition domes into domes by atomic force microscopy. A one-dimensional diffusion model is established which allows a quantitative determination of the Ge surface diffusion constant and the rates at which Ge atoms are incorporated into the growing islands. We find evidence that during the shape transitions from nonfaceted islands to ${105}$-faceted pyramids and from pyramids to domes, Ge is incorporated at higher rates than during the growth of pure pyramids or domes. From these data it follows that a Ge atom passes on average several thousand pits before it is incorporated into one. Within our model we show that secondary-island nucleation in the substrate regions between the pits is a consequence of a mismatch between Ge incorporation and deposition rates, which results in a growing wetting layer between the ordered island sites, the thickness of which eventually exceeds the critical one for spontaneous island nucleation. We experimentally demonstrate that by lowering the Ge deposition rate, perfectly ordered islands with large pit periods of around 1 $\ensuremath{\mu}$m can be grown, in agreement with the model predictions.

The process of wound healing is dynamic and takes place over months to years, during which there is a resolution of angiogenesis, continued wound contraction, and connective tissue remodeling. The outcome of this process is most commonly the formation of a scar, defined as a fibrous tissue replacing normal tissues destroyed by injury or disease. Scars often have a lowered or total loss of vital skin functions and imbue a large burden on both the patient and the health care system as a whole. Scar treatments are plentiful but are often unsatisfactory or inconsistent. No single treatment method has been universally adopted. To evaluate the clinical treatment as well as research focused on developing novel methods for scar management, objective studies of the progression of scar formation and the properties of mature scars are needed. Several parameters, including barrier function as well as mechanical and physiological properties, need to be taken into account when both categorizing and treating healing wounds and scars. To date, there is no available methodology that provides a comprehensive evaluation of a scar's properties. This review aims at presenting an overview of available scar assessment methods and devices, ranging from analysis of collagen properties in tissue biopsies to noninvasive methods for studies of mechanical parameters such as breaking strength and skin elasticity. In the cases where conclusive studies have been performed, the differences between normal skin and scar with respect to the above parameters are presented. Furthermore, this review highlights areas where the development of additional modalities are needed.

The pumping intensity (I) dependence of the photoluminescence (PL) spectra of perfectly laterally two-dimensionally ordered SiGe quantum dots on Si(001) substrates was studied. The PL results from recombinations of holes localized in the SiGe quantum dots and electrons localized due to the strain field in the surrounding Si matrix. The analysis of the spectra revealed several distinct bands, attributed to phonon-assisted recombination and no-phonon recombination of the excitonic ground state and of the excited excitonic states, which all exhibit a linear I dependence of the PL intensity. At approximately I larger than 3 W cm-2, additional bands with a nearly quadratic I dependence appear in the PL spectra, resulting from biexcitonic transitions. These emerging PL contributions shift the composite no-phonon PL band of the SiGe quantum dots to higher energies. The experimentally obtained energies of the no-phonon transitions are in good agreement with the exciton and biexciton energies calculated using the envelope function approximation and the configuration interaction method.

Background Major loss of skin following burns or trauma requires skin grafting for repair. In addition, chronic wounds frequently require skin grafts. Current treatments are either cumbersome, limited in possible expansion ratio, costly, or require extensive time for treatment. This study investigates a new way of regenerating skin after major burns and other trauma, providing 100-fold expansion of a split-thickness skin graft. Methods Submillimeter micrografts were created by controlled mincing of a split-thickness skin graft and transplanted to porcine full-thickness wounds. By creating an incubator-like microenvironment using wound chambers, the micrografts provide reepithelialization whether placed dermal side up or dermal side down. Results Transplantation of micrografts in a 1:100 expansion ratio results in complete epithelialization of both healthy and diabetic wounds within 14 days. In comparison, nontransplanted wounds showed 62 percent reepithelialization in healthy pigs and 49 percent in diabetic pigs at the corresponding time point. Conclusions Minced skin micrografts are very effective in wound repair and can provide 100-fold expansion of a skin graft. Early clinical results confirm the utility of this technique.

The basic concept of gene therapy is to introduce into a cell a therapeutic gene whose expression can offer a transient advantage for tissue growth and regeneration or lead to the cure of a disease. In this chapter, we look at current gene therapy for cutaneous wound healing, focusing on the most commonly used genes for wound healing enhancement. We have included a short account of the important ethical issues related to gene therapy and conclude with a discussion on future prospects of gene therapy.

Decreased inflammatory response seen in wet wound healing may be correlated with diminished scarring. This study seeks to test this hypothesis and to validate a model of scarring in the Yorkshire pig. Four Yorkshire pigs were used to create 36 dorsal wounds per pig (144 wounds total) in the following groups: full-thickness excisional, partial thickness, meshed split-thickness skin grafts, sheet split-thickness skin grafts, minced skin, and incisional wounds. Wounds were randomized into wet and dry groups. Wet wounds were enclosed in polyurethane chambers with 2 mL of normal saline. Dry wounds were covered with regular gauze. Terminal biopsies were performed at 72 hours and day 28. Histology demonstrated significantly less inflammatory infiltrate, thicker neoepidermis, more pronounced rete ridge formation, and decreased scar tissue thickness in wet wounds. The mean macroscopic scar surface area was significantly decreased in full-thickness excisional wet wounds compared with dry wounds (61.2 mm(2) vs. 150.8 mm(2), p

High yields of pure and viable porcine islet cells (PICs) to be used for microencapsulation are crucial for successful xenotransplantation. Mechanical disruption of the pancreas, enzymes used for digestion, digestion temperature and time are among the factors known to cause oxidative stress and to impact on the yield, purity and viability of PICs. The aim of our study was to optimize conventional procedures in order to minimize the oxidative stress that occurs during the isolation and purification of PICs. Porcine pancreatic tissue was harvested at a local slaughterhouse, and 15 consecutive isolations of PICs were performed with a modified automated Ricordi method (Graz method) using a shorter digestion time, a lower digestion temperature and minimal mechanical stress. PICs were purified with the Lymphoprep density gradient medium. Purity and viability were assessed immediately after the isolation process and after overnight culture. PIC function was tested in glucose stimulation experiments and insulin concentration was determined by ELISA. Oxidative stress was assessed by measuring isoprostanes (IP), malondialdehyde (MDA) and lipase levels using a HPLC-based, colorimetric liquid assay or ELISA, respectively. The mean yield of PICs was 3479 +/- 542 IEQs/g pancreas, with 96.4% viability and 97.7% purity. There was no significant loss in PIC viability after overnight culture. Insulin secretion in response to glucose was not impaired after isolation and purification. IP, MDA and lipase levels did not change significantly during the isolation procedure. With our new Graz method we seem to have succeeded in preventing oxidative stress and achieving high yields of pure and viable PICs.

The main drawback of the rapidly evolving field of silicon photonics lies in the absence of efficient monolithically integrated radiation sources as a consequence of the indirect bandgap of Si and Ge. Relevant alternatives based on the hybrid combination of Si with optically active materials have to be technologically simple, temporally stable, and provide efficient coupling to the Si waveguides. Lead-sulfide nanocrystals (NCs) were blended into a polymer resist suitable for deep-UV- and electron-beam lithography and integrated into Si-based vertically slotted waveguides and ring resonators. The polymer both stabilizes the NC’s photoluminescence emission against degradation under ambient conditions and allows lithographic patterning of this compound material. After integration into the optoelectronic structures and upon optical pumping, intense photoluminescence emission from ring resonators was recorded at the output of bus-waveguides. The resonator quality factors were investigated for polymer-NC compounds with NC concentrations in the range between 0.1 and 8 vol%. The spontaneous emission rate enhancement for vertically slotted resonators was estimated to be a factor of two higher as compared to unslotted ones. The stable integration of colloidal NCs as well as the improved light coupling to silicon circuits is an important step in the development of silicon-based hybrid photonics.

INTRODUCTION: This study presents the new finding that connective tissue growth factor (CTGF/CCN2) is expressed by hyperproliferating keratinocytes during reepithelialization. CTGF/CCN2 is a marker and mediator of fibrosis, regulating important cellular events during wound healing. There has been contradicting data regarding whether CTGF/CCN2 is expressed by epidermis or not. This study uses a well-established porcine wound model to investigare the expression of CTGF/CCN2 during epithelialization of full-thickness wounds.

INTRODUCTION: Transplantation of split-thickness skin grafts, culturedautologouskeratinocytesandskinmicrograftsresultinhealing of full-thickness wounds. This study compares these methods in a porcine wound model, investigating the utility of micrograft transplantation in skin restoration. METHODS: Full-thickness wounds were created on Yorkshire pigs and assigned to one of the following treatment groups: meshed splitthickness skin graft (STSG), cultured autologous keratinocytes (CK), skin micrografts (MG), wet environment (W) and dry environment (D). Dry wounds were covered with gauze and the other groups were enclosed in a polyurethane chamber containing 2 mL of saline. Samples were taken 6, 12 and 18 days post wounding. Macroscopic wound healing was quantified using the Vancouver Scar Scale (VSS). Wound healing parameters such as contraction, reepithelialization, epidermal characteristics and scar formation was determined by quantitative morphometric or morphologic analysis. RESULTS: Grafted wounds had a lower VSS score compared to non-grafted wounds (STSG:4, CK:6, MG:3, W:8.5, D:10, unwounded skin:0). Wounds grafted with STSG and MG showed significantly reduced contraction compared to non-grafted wounds (STSG:25%, CK:35%, MG:28%, W:43%, D:44%). All grafted wounds showed increased epidermal healing compared to nongrafted wounds. Furthermore, transplantation with STSG or MG led to less scar tissue formation compared to the non-grafted wounds andnosignificantimpactonscarformationwasobservedaftertransplantation of CK.

We use UV nanoimprint lithography for the pit-patterning of silicon substrates. Ordered silicon-germanium islands are grown inside these pits by molecular-beam epitaxy on arrays of 3×3 mm2 and characterized by atomic force microscopy (AFM) and photoluminescence (PL) measurements. AFM-based statistics reveals an extremely uniform size distribution of the islands in the patterned areas. These results are confirmed by very narrow and uniform PL peaks recorded at various positions across the patterned arrays.

We show that both the morphology and the optoelectronic properties of SiGe islands growing in the pits of periodically pre-patterned Si(001) substrates are determined by the amount of Ge deposited per unit cell of the pattern. Pit-periods (p) ranging from 300 to 900 nm were investigated, and Ge growth was performed by molecular beam epitaxy (MBE) at temperatures of 690 and 760 °C. The ordered SiGe islands show photoluminescence (PL) emission, which becomes almost completely quenched, once a critical island volume is exceeded. By atomic force and transmission electron microscope images we identify the transition from pyramid-shaped to dome-shaped islands with increasing p. Eventually, the nucleation of dislocations in the islands leads to PL quenching. Below a critical Ge coverage a narrowing and a blue shift of the PL emission is observed, as compared to islands grown on a planar reference area of the same sample.

A detailed study of the so far unexplored Ge island nucleation on Si (001) substrates patterned with {111} faceted pyramidal pits is reported. The pits are defined by an anisotropic wet-chemical etch through a SiNx hard mask. Due to the self-limiting of the wet etch, an extremely uniform pit pattern is achieved. On these substrates, Ge layers were grown by solid source molecular beam epitaxy at various growth temperatures TGe. For TGe=550 °C, Ge fills the pits in the form of inverted {111} pyramids with a rounded apex and a (001)-oriented top surface. These islands have aspect ratios much larger than upright pyramids and domes that are usually obtained on substrates with cylindrical pits fabricated by lithographic techniques and reactive ion etching. Based on the experimentally determined shape, three-dimensional (3D) energy level calculations in an envelop function approach have been performed for the inverted pyramids. They show that, due to the orientation of the pyramid square base along 110 directions, the overlap between the hole ground states and electron states confined to the Si conduction band valleys perpendicular to the growth direction is much larger than for upright SiGe domes and {105} pyramids. For elevated growth temperatures around 700 °C, already a Ge coverage of five monolayers induces a strong Si transfer into the {111} pits, effectively converting them towards {1 1 10} faceted ones.

The Stranski–Krastanow growth of SiGe islands by deposition of SiGe alloys instead of pure Ge allows us to control both the Ge concentration and gradient in the islands. In contrast to the commonly found increasing Ge content with island height, growth conditions for islands with nearly constant and even decreasing Ge profile along the growth direction were found. Atomic force microscopy, transmission electron microscopy and high-resolution x-ray diffraction were employed to determine the islands' size, shape, lateral distance and Ge composition. Efficient photoluminescence is emitted from these islands. We show that for islands with higher Ge contents at the bottom than at the apex, transitions between heavy holes and electron $Δ_{xy}$ states in the compressive Si regions around the island's circumference dominate the photoluminescence spectra instead of the usually observed recombination between heavy holes and electrons in the $Δ_z$ valleys in the tensile Si above the island's apex. The relative importance of the $Δ_{xy}$ transitions is enhanced for lateral island distances less than 10 nm, where overlapping strain fields of neighbouring islands increase the compressive strain in the Si region between them. At intense photoexcitation, recombinations between electrons in the $Δ_z$ valleys and light holes within the islands appear in the photoluminescence spectra. These so far, for SiGe islands, unobserved transitions were identified by a quantitative modelling of the band structure within the islands and in the surrounding Si matrix based on full 3D simulations using the nextnano$^3$ package with the experimentally obtained island shape and composition as input parameters.

For randomly nucleated SiGe/Si(001) islands, a significantly stronger blue-shift of the PL spectra as a function of the excitation intensity is observed when compared to islands grown on patterned substrates side by side within the same run in a solid source molecular beam epitaxy chamber. We ascribe this different PL behavior to the much larger inhomogeneity of the Ge distribution in islands on planar substrates when compared to islands grown on pit-patterned ones, as observed previously. 3D band-structure calculations show that Ge-rich inclusions of approximately 5 nm diameter at the apex of the islands can account for the observed differences in the PL spectra. The existence of such inclusions can be regarded as a quantum dot in an island and is in agreement with recent nano-tomography experiments.