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Current Concepts in Limb Regeneration: A Hand Surgeon's Perspective

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Cognitive-behavioral practices such as meditation and yoga have long been viewed as methods of reaching states of peace and relaxation, but recent research has focused on the role of these practices in reducing endogenous mediators of stress and inflammation that would otherwise be harmful to our bodies. Further, these stress-related factors play major roles in inflammation, acting as barriers to wound healing and tissue regeneration. Fractures, denervation, tendon and ligament rupture, and cartilage degradation are morbidities associated with injury and often act as an impediment for healing. Studies of human fingertip regeneration exist; however, the underlying molecular and environmental changes have yet to be completely elucidated. Studying the regenerative capabilities of lower organisms and fetal wound healing has allowed scientists to understand the mechanisms behind regeneration, coming closer to a human application. Much research relies on the idea that the developing embryo shares a great deal in common with regenerating appendages of organisms such as the salamander. This review will cover historical perspectives of regeneration biology and current topics in limb regeneration, with particular interest given to the upper extremity, including the commonalities between human embryological development and amphibian regeneration, growth factors and pathways that show correlation with development and regeneration, recently discovered differences in fetal and adult wound healing, and current research and knowledge regarding human extremity tissue regeneration. With a greater understanding of the mechanisms and mediators involved in regeneration, the application of cognitive-behavioral practices may assist in seeing the future goals of regeneration come to fruition.
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Keywords: Msx; apical ectodermal ridge; blastema; cognitive-behavioral; dedifferentiation; extracellular matrix; fetal wound healing; regeneration

Document Type: Research Article

Affiliations: 1: New York Medical College, Valhalla, New York, USA 2: North Shore-LIJHS, New Hyde Park, New York, USA

Publication date: August 1, 2009

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