Goal-directed and habitual control in the basal ganglia: implications for Parkinson's disease

Progressive loss of the ascending dopaminergic projection in the basal ganglia is a fundamental pathological feature of Parkinson's disease. Studies in animals and humans have identified spatially segregated functional territories in the basal ganglia for the control of goal-directed and habitual actions. In patients with Parkinson's disease the loss of dopamine is predominantly in the posterior putamen, a region of the basal ganglia associated with the control of habitual behaviour. These patients may therefore be forced into a progressive reliance on the goal-directed mode of action control that is mediated by comparatively preserved processing in the rostromedial striatum. Thus, many of their behavioural difficulties may reflect a loss of normal automatic control owing to distorting output signals from habitual control circuits, which impede the expression of goal-directed action. © 2010 Macmillan Publishers Limited. All rights reserved

Current concepts in the physiology of adult wound healing

Wound healing requires a complex interaction and coordination of different cells and molecules. Any alteration in these highly coordinated events can lead to either delayed or excessive healing. This review provides an overview of adult wound healing physiology. A review of the literature focused on wound healing physiology and current advances in wound healing was conducted using the online Medline/PubMed database. The aim of this review was to inspire further investigation into wound healing physiology that will ultimately translate into improved patient care

External tissue expansion for difficult wounds using a simple cost effective technique

Objective: To study and discuss role of external tissue expansion and wound closure (ETEWC) technique using hooks and rubber bands. Materials and Methods: The present study is a retrospective analysis of nine cases of wounds of different aetiology where ETEWC technique was applied using hooks and rubber bands. Results: All the wounds in the study healed completely without split thickness skin graft (SSG) or flap. Conclusion: ETEWC technique using hooks and rubber bands is a cost-effective technique which can be used for wound closure without SSG or flap

Diode and Nd:YAG laser in a case of refractory acne keloidalis nuchae

Acne keloidalis nuchae (AKN) is a disease of unclear etiology that mainly affects males. Medical treatment of AKN is difficult, with refractory cases often requiring ablation by laser or surgical resection. We report herein, a 23-year-old male with refractory AKN treated successfully with combined laser ablation, using an 810-nm diode laser and a 1064-nm Nd:YAG laser

Role of jet force technology in wound management

Aim: The aim was to study the role of Jet force technology (JFT) in wound management.Methods: This is a retrospective analysis of 18 cases of chronic nonhealing wounds in which JFT was used. Chronic wounds which had already undergone surgical debridement but which were not ready for reconstruction (skin graft/flap) secondary to a persistent bacterial load or infection (tissue culture positive) were included in the study. Patients were divided into two groups. Group 1 included those patients who were poor candidates for anesthesia or who refused for reconstruction and were managed with JFT only. Group 2 included those patients who were cleared for anesthesia and who were managed with JFT and skin graft or flap coverage. The time to negative wound cultures after JFT and the total duration of healing were noted.Results: In both the groups, all tissue culture positive chronic wounds became negative after 2 ± 1 weeks and were ready for reconstruction. In Group 1 (6 patients) the wounds completely healed in 5-6 weeks with JFT only. In Group 2 (12 patients), the wounds completely healed in 3-4 weeks with JFT and skin graft/flap.Conclusion: Hydrotherapy with JFT helps in the removal of contaminants, debris, and microbial colonization of the wound leading to spontaneous wound healing and facilitating wound bed preparation for wound coverage by a skin graft or flap