Type I and II collagen regulation of chondrogenic differentiation by mesenchymal progenitor cells.

Chondrogenic differentiation by mesenchymal progenitor cells (MPCs) is associated with cytokines such as transforming growth factor-beta 1 (TGF-beta1) and dexamethasone. Extracellular matrix (ECM) also regulates the differentiation by MPCs. To define whether ECM plays a functional role in regulation of the chondrogenic differentiation by MPCs, an in vitro model was used. That model exposed to dexamethasone, recombinant human TGF-beta1(rhTGF-beta1) and collagens. The results showed that MPCs incorporated with dexamethasone and rhTGF-beta1 increased proliferation and expression of glycosaminoglycan (GAG) after 14 days. Type II collagen enhanced the GAG synthesis, but did not increase alkaline phosphatase (ALP) activity. When adding dexamethasone and rhTGF-beta1 MPCs increased mRNA expression of Sox9. Incorporation with type II collagen, dexamethasone and rhTGF-beta1, MPCs induced mRNA expression of aggrecan and enhanced levels of type II collagen, and Sox9 mRNA. In contrast, incorporation with type I collagen, dexamethasone and rhTGF-beta1 MPCs reduced levels of aggrecan, and Sox9 mRNA, and showed no type II collagen mRNA. Altogether, these results indicate that type I and II collagen, in addition to the cytokine effect, may play a functional role in regulating of chondrogenic differentiation by MPCs.

The forgotten faces: the lonely journey of powerlessness experienced by elderly single Chinese men with heart disease in Taiwan.

The purpose of this study is to explore the content and background context of powerlessness experienced by elderly single Chinese men with heart disease and their coping behaviors during their hospitalization stage. Data were gathered by semi-structured interviews at a leading veterans' hospital in northern Taiwan and analyzed using a qualitative content analysis mode. Twenty-six men who were 65 or older, diagnosed with heart disease, and who lived alone during the preadmission stage were recruited. Eighty-one percent (N = 21) reported that their perceptions of powerlessness occurred either in the preadmission or hospitalization stage or were expected to occur after discharge. Other complaints of powerlessness were attributed to having no choices in appropriate living places during the preadmission stage, having no control over discomfort, being unable to obtain care and companionship from families and friends, failing to get medical information about their disease and options of treatment during hospitalization, or expecting deteriorating health and receiving no assistance during emergencies or in the dying stage after discharge from the hospital.

Health needs of lone elderly Chinese men with heart disease during their hospitalization.

Hospitalization is a unique health-illness transition for most elderly people. Whether the patient's health-related needs are met or not often influence his or her appraisal of quality of life during hospitalization. This qualitative study explored the health needs of elderly Chinese male cardiac patients during their hospitalization. Eighteen subjects were recruited from a veterans' hospital in northern Taiwan. These men all lived alone before their hospital admission. Data were gathered using semistructured interviews and then analysed by content analysis. Ninety-four per cent of the subjects described up to three categories of needs: met needs (72%), unmet needs (78%), and expected needs (50%). Needs that participants believed were met were those for psychological support, spiritual support, tangible support and information. Unmet needs were those for participation in decision making, maintaining daily activities and resuming a preadmission lifestyle. The expected needs included those for learning self-care strategies to maintain their daily activities after discharge from the hospital. The factors that framed the participants' perceptions of different health needs were identified to be lack of family support and locus of control. Finally, a discussion of the context background of this phenomenon, as well as some suggestions for its implications, are provided from a culturally sensitive ethical aspect.