I. BIOLOGY OF BONE FRACTURE HEALING
Basic multicellular unit (BMU). Intercellular interactions in basic multicellular unit, activation of pathways. Bone fracture, periods of bone healing. Biology of bone fracture healing with relation to the patient’s age, bone fusion in adults and children Pseudoarthroses and delayed unions of long bones in upper and lower limbs, applications of orthopaedical surgical techniques and bone transplants
II. BONE AND CARTILAGE TRANSPLANTATION, APPLICATION OF MEMBRANES IN JOINT SURGERY
Application of exogenous growth factors in bone healing. Biostimulating aspects of bone transplantation. Banks of bone tissue: biological aspects, immunogenicity of transplants. Application of peripheral and bone marrow blood concentrates in orthopedics. Histological specification of cartilage tissue; degeneration and regeneration of cartilage. Cultures of autologous chondrocytes, contemporary practical applications. Biomaterials used for scaffoldings and membranes.
III. REGENERATION OF PERIPHERAL NERVES
1. Clinical forms of nerve damage – classification according to Seddon and Sunderland: neuropraxia, axonotmesis, neurotmesis. 2. Degenerative and regenerative processes occurring after nerve damage; steps of nerve regeneration – damage, nerve migration, neural tropism of axons, degeneration, creation of Schwann cells’ columns, growth of axon. 3. Classical ways of nerve repair – surgical stich “end to end”, reconstruction with nerve transplant, neurotubes. 4. Alternative ways of nerve repair – vascular transplants, allogeneic nerve transplants, pre-degenerated transplants, transplants from veins, nerve transfers. 5. Contemporary aspects of peripheral nerves healing. 6. Application of non-embryonic stem cells in treatment of nerve system diseases such as brain stroke, Parkinson’s disease, Huntington’s disease.
IV. NATURAL REGENERATION IN HUMAN BODY
1. Wound healing a) Inflammatory phase of wound healing – vascular response, cellular response, mediators of inflammation, factors modulating the inflammatory reaction (acetylsalicylic acid, steroids). b) Proliferation phase of wound healing – generation of epithelium, deposition of collagen, generation of scar tissue. c) Phase of maturation and remodelling–changes in the structure of connective tissue, collagen resorption, factors affecting the remodelling (age, wound localization, wound type, duration of the inflammatory phase). d) Factors affecting wound healing – systemic factors and local factors. 2. Liver regeneration a) Factors causing liver damage – physical and chemical factors, infectious agents b) Phases of liver regeneration: – Priming of hepatocytes – activation of genes associated with production of transcription factors, activation of proto-oncogenes (c-fos, c-jun, c-myc), anti-apoptotic genes (p53, p21, BCL-xl). – Cell division – effect of mitogens (TGF, EGF, HGF) and co-mitogens (insulin, glucagon, noradrenalin, Ang II). – Participation of non-parenchymal cells in liver regeneration 3. Regeneration of skeletal and cardiac muscles a) Factors damaging skeletal muscles – mechanical, thermal and chemical; diseases caused by inappropriate innervation of muscles or lack of important structural proteins. b) Participation of satellite cell in muscle regeneration. c) Miogenic potential of stem cells – hematopoietic stem cells, mesenchymal stem cells, stem cells derived from blood vessels, embryonic stem cells. d) Experimental therapies of dysfunctional muscles involving the application of stem cells.
V. REGENERATION OF SKIN AND EPIDERMIS – CLINICAL APPLICATIONS
Epidermal stem cells – localization of stem cells, epidermal stem cell markers, epidermal stem cells in vitro and in vivo, application of epidermal stem cells in medicine. In vitro cultures of isolated skin cells – 2D and 3D cultures. Biological substitutes of skin – autologous transplants, allografts, cultures of autologous and allogeneic keratinocytes, living substitues of skin, complex substitutes of skin. Regenration of the epidermis in plastic surgery.