ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

High-speed cineradiography and flash radiography were used to determine cardiac distortion and the motion of the heart within the thorax following nonpenetrating chest impact. Maximum ventricular distortion occurred approximately 3 ms after impact which was also the time of maximum chest wall displacement. Between +3 ms and +10 ms the heart moved posteriorly and regained much of its initial shape. Maximal posterior displacement of the body of the heart occurred at approximately +10 ms. Three-dimensional reconstruction showed that the heart moved caudally and to the right, with little rotation. The aortic arch moved cranially with consequent stretching of the thoracic aorta.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The participation of prostaglandin E in the regulation of the immune response via suppressor cell activation, and the release of large quantities of these prostaglandins as a result of thermal injuries, are both (separately) well documented. In this report, we present evidence that prostaglandin E plays an important immunologic role following thermal injuries. The concentration of PGE in sera from patients with major burn injuries is generally high (1,000–3,000 pg/ml), and these same sera are often significantly suppressive to in vitro lymphocyte responsiveness. We have documented the ability of PGE (both that which is commercially synthesized, and that isolated in fractions obtained from burned patient sera by column chromatography) to suppress mixed lymphocyte cultures, and show that such suppression can be blocked by either delipidation of serum fractions, or by the addition of monospecific anti-PGE to the cultures. We also report evidence suggesting the existence of a serum protein with a molecular weight of approximately 5,000 daltons which appears to be necessary for the expression of the immunosuppressive properties of PGE contained in patient sera.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The possible role of plasma fibronectin as a nonantibody, noncomplement opsonin forS. aureuswas studied using peripheral blood leukocytes from healthy rabbits. Fibronectin depletion of normal rabbit serum by affinity absorption chromatography reduced the opsonic ability of that serum (p< 0.05) and resulted in impaired bacterial killing ofS. aureusin vitro. The addition of purified fibronectin to fibronectin-depleted serum significantly reversed the opsonic defect (p< 0.01). The combination of complement inactivation, plus fibronectin depletion, resulted in a severe opsonic deficiency that was much worse than either deficiency alone (p< 0.05). However, fibronectin alone in the absence of other serum factors was a poor opsonin forS. aureus, suggesting that its major role as an opsonin might be to augment or amplify other serum factors.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Plasma fibronectin time course was studied in 30 patients versus clinical criteria: body surface area burn (BSA), unit burn standard (UBS), and infection state. The mean value for all the population was lowest within days 1–3. No correlation was observed between fibronectin concentration and clinical criteria, either at admission or subsequently. Fibronectin levels of nonseptic patients (Group 1) did not differ significantly during the first days from those of patients who, at any time of their hospitalization, would become moderately infected (Group 2) or septic (Group 3). Afterwards, protein concentration of Group 1 increased regularly and hyperopsonization was observed from day 17 until the end of the study, day 35. In contrast, protein levels of Groups 2 and 3 remained low with a further improvement for moderately infected patients. A marked and significant difference was observed between nonseptic patients and septic patients, from the 6th postburn day. Variation of Groups 2 and 3 may be related to the infectious period, whatever the BSA or UBS index evolution.Since infection was related to low fibronectin level in the three deaths observed, it appears that opsonic protein cryoprecipitate would be of value in the treatment of burn victims.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Cell-mediated immunity (CMI) was assessed in 58 patients with burns involving 10% to 40% of the total body surface area (TBSA), and in 16 normal healthy individuals, by using two parameters, the total T-cell counts in peripheral circulation and T-cell function as indicated by the leukocyte migration inhibition (LMI) test. Three recall antigens fromCandida albicans, S. typhi, andE. histolyticawere used to elicit the LMI. T-cell function was found to be significantly depressed in burns involving more than 25% TBSA. Depression of T-cell function started after the seventh postburn (PB) day and continued until the sixtieth PB day.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The effects of trauma (laparotomy) and trauma complicated by sepsis (laparotomy and ligation and puncture of the cecum) on protein metabolism in liver and skeletal muscle were studied in rats. Unoperated animals served as controls. Rate of amino acid incorporation into proteins was determined in incubated liver slices and bundles of muscle fibers. Proteolysis in skeletal muscle was measured as release of tyrosine from incubated muscle biopsies. Protein synthesis in liver tissue was increased by 42% following trauma and by 164% following trauma and sepsis. In skeletal muscle amino acid incorporation into proteins was reduced by 50% in both conditions while protein degradation was enhanced by about 70%. Thus when injury was complicated by sepsis the metabolic response was augmented in liver but not in skeletal muscle. One reason for this difference might be that changes of protein metabolism in trauma and sepsis are regulated by different mechanisms in liver and skeletal muscle. The results also indicate that increased amino acid supply from peripheral protein breakdown is not the only signal for enhanced hepatic protein synthesis in trauma and sepsis.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The endogenous catecholamine response to hemorrhagic hypotension is poorly defined since most data have been derived from experiments in lower animal species. To clarify this situation we studied the plasma norepinephrine (NE) and epinephrine (Epi) responses to hemorrhagic hypotension in ten healthy male baboons (Papio anubis). After an overnight fast, animals were tranquilized with 100 mg of ketamine hydrochloride after which femoral artery and vein catheters were inserted. The animals then underwent phlebotomy of 20 ml/kg over 60 minutes with retransfusion of the autologous blood over the next 30 minutes. Plasma specimens for catecholamines were collected at 5, 15, 30, and 60 minutes during phlebotomy and again at 15 and 30 minutes during retransfusion. Plasma NE and Epi concentrations were measured by a radioenzymatic technique. Mean arterial blood pressure (MAP) decreased (p< 0.01) and heart rate (HR) increased (p< 0.01) within 15 minutes of phlebotomy, and these variables returned to baseline with retransfusion. Plasma NE and Epi levels increased (p< 0.025) within 5 minutes of the onset of ‘hemorrhage’ and within 15 minutes plasma NE concentrations were 56% above baseline, whereas plasma Epi levels were six times greater than baseline. With retransfusion, plasma NE and Epi levels returned to baseline concentrations. We conclude: 1) in a primate species, the sympathetic nervous system responds rapidly to hemorrhage; 2) contrary to prior studies in rats, plasma NE increases as rapidly as Epi but not to the same degree; 3) plasma NE and Epi concentrations rapidly return to baseline levels with fluid resuscitation; and 4) there is little justification for the use of exogenous synthetic catecholamines in hemorrhagic hypotension where fluid resuscitation remains the treatment of choice.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Thirty-five states repealed or altered mandatory motorcycle helmet legislation since May 1976. In-depth evaluation of the impact of the change has been reported from four states. The results reveal significant decreases in helmet usage and significant increases in head injury and deaths. In one state (Kansas) there was also an increase in the accident rate. Evaluation of the financial impact reveals up to 200% increase in medical costs and a significant increase in days of disability. Repeal of mandatory helmet legislation is extremely costly in any parameter measured.

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The economic costs of trauma to the United States were analyzed by taking latest available data from United States Vital Statistics and using models to convert to dollar costs for trauma fatalities and nonfatalities. Trauma cost the nation approximately $61,025 billion dollars in fiscal 1982 (1977 figures indexed to 1982 dollars). This included $19,278 billion for direct costs (treatment related) and $41,746 billion in indirect costs (forgone earnings). The largest single category by group was indirect costs (forgone earnings) for male fatalities ($26,635 billion). The next largest was direct costs (treatment related) for male nonfatalities ($12,145 billion.) This disease is currently responsible in economic costs (1982 dollars) for 6.9% of health care expenditures and 2.3% of the United States gross national product (GNP).

ISSN:0022-5282    

出版商:OVID    

年代:1984

数据来源: OVID