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REPAIR

REPAIR. Sally E. Self, M.D. Proliferative Potential of Cells . Continuously dividing (labile) cells Stratified epithelia of skin, oral cavity, vagina, cervix; cuboidal epithelia of exocrine ducts; columnar epithelium of GI tract, uterus; transitional epithelium of bladder; hematopoietic cells

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REPAIR

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  1. REPAIR Sally E. Self, M.D.

  2. Proliferative Potential of Cells • Continuously dividing (labile) cells • Stratified epithelia of skin, oral cavity, vagina, cervix; cuboidal epithelia of exocrine ducts; columnar epithelium of GI tract, uterus; transitional epithelium of bladder; hematopoietic cells • Quiescent (stable) cells • Parenchymal cells of liver, kidney, pancreas; endothelial cells, smooth muscle, fibroblasts • Nondividing (permanent) cells • Nerve cells, cardiac myocytes, skeletal muscle

  3. Growth Inhibition • Contact inhibition • Tumor suppressor genes • Transforming growth factor beta • Tumor necrosis factor

  4. Repair by Connective Tissue • Granulation tissue – fibroblasts and new capillaries in a loose extracellular matrix • Leads to scar formation

  5. Granulation Tissue

  6. Granulation Tissue

  7. Pathological Aspects of Repair • Inhibitors of good wound healing • Infection • Poor nutrition (low protein, scurvy) • Glucocorticoids • Mechanical factors • Poor perfusion • Foreign bodies • Complete repair can occur only in tissue composed of stable or labile cells

  8. Pathological Aspects of Repair • Location – inflammations in tissue spaces may undergo resolution or organization • Aberrations of cell growth and ECM production – keloids and proud flesh • Same mechanisms which occur in normal wound healing responsible for damage in chronic inflammatory diseases such as rheumatoid arthritis, pulmonary fibrosis, cirrhosis

  9. Poor wound healing in a patient being treated with corticosteroids.

  10. Keloid

  11. Keloid

  12. Hyalinized collagen in a keloid

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