摘要:

T cells expressing CD4 can be farther subdivided by their expression of CD45R In humans, CD45RO+ cells function as memory T cells, and CD4+CD45RA+ function as naive T cells, i.e., cells that have never previously encountered antigen. In the rat, similar functional division of CD4 cells can be made with antibody OX-22 (anti-CD45RC) with CD4+CD45RC- and CD4+CD45RC+ identifying the memory and naive phenotypes respectively. With use of the rat model, we studied the effect of burn injury on CD4 cell subpopulations and memory and naive T cells in lymph nodes draining the burn wound (NDB) and spleen. In the NDB we found that numbers of memory and naive CD4 cells increased significantly as a function of time after burn injury, and that this increase was greater for naive cells (5.7-fold) than for memory cells (4.1-fold). However, in the spleen, we found memory T-cell numbers decreased significantly on postburn days 12 and 18, whereas naive CD4 cells in the spleen manifested no changes at any time after burn. These results may be explained by the different trafficking patterns of memory and naive cells. Based on the cell surface marker, L-selectin, naive cells preferentially migrate into the NDB where they undergo differentiation into memory cells. Memory cells selectively migrate into inflamed burned tissue, which may account for their lesser-fold increase in NDB when compared to naive cells, and their decreased numbers in the spleen after burn injury.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Autologous mesh grafting, widely used in the treatment of severe burns, remains the most conventional approach for permanent skin replacement. However, during the last decade several types of skin substitutes were reported as suitable alternatives for full-thickness burn wound coverage. The clinical use of such dressings requires new surgical skills to maintain the integrity of the grafts and favor their permanent implantation in vivo. This article reports observations made on nude mice grafted with cultured human skin equivalents. Some parameters such as the quality of adhesion between the implant and the graft bed, the size, the stability and the thickness of the graft, the humidity of the chamber, and the protocol of antibiotic administration were identified as crucial for the success of the surgery. The grafting procedures are described in this paper. These results should be taken into consideration in all transplantations of skin grafts m vivo.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Thermal injury is one trigger for pulmonary neutrophil recruitment. This article describes the time course of neutrophil recruitment after scald injury. Mice aged 8 to 10 weeks were anesthetized and subjected to 15% topical scald injury. Animals were put to death at 6 hours, 24 hours, 3 days, and 7 days after injury, and the pulmonary tissue harvested for staining with hematoxylin and cosin and neutrophil estcrase. Cell counts for neutrophil accumulation were obtained. Control animals were handled in a comparable manner apart from the scald injury. Animals killed at 6 hours demonstrated significant neutrophil recruitment relative to the control. This difference had resolved at 24 hours. Animals killed at 3 and 7 days again demonstrated neutrophil accumulation despite normal behavior and absence of weight change from the control. Quantitative cultures of burn wounds failed to disclose infection. Scald injury was associated with significant pulmonary neutrophil recruitment that resolved at 24 hours. The presence of an untreated wound was associated with neutrophil recruitment beyond 24 hours despite outward normal behavior.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study was undertaken to determine whether tangential excision and thick split-thickness skin grafting (STSG) of deep facial burns give a better cosmetic and functional result than conservative management. Forty patients (28 adults, 12 children) treated for facial burns between July 1989 and July 1991 were evaluated in follow-up (mean 18.3 ± 8.3 months). The patients were categorized into the following groups according to depth and management of their facial burns: (A) healed without surgery in less than 21 days (n=13), (B) healed without surgery in 21 days or more (n=11), (C) early debridement and thick STSG in 18 days or less after die burn (n=6), and (D) delayed debridement and thick STSG in more than 18 days after the burn (n=10). Facial esthetics were evaluated by use of a modified scar assessment scale [range 0 (normal) to 16 (multiple abnormalities)], and functional problems .of the face and neck were evaluated by use of physical examination. Group A patients had a significantly better overall rating on the scar assessment scale (2.1 + 2.9) than the patients in the other groups that required more than 21 days to heal, B (8.0 ± 2.7), C (7.3 ± 2.9), and D (5.7 ± 2.5) (P<0.01, analysis of variance). Also, skin-grafted areas in the surgically treated groups C and D had a significantly better scar rating than wounds that healed spontaneously in group B (5.7 ± 4.0 vs 8.0 ± 2.7,P<0.05; and 5.1 + 2.6 vs 8.0 ± 2.7,P<0.05). There was no significant difference among groups B, C, and D when the total number of persistent functional problems after treatment were compared. The most common functional problems for these patients were microstomia (17/27) and eyelid ectropion (17/27). Patients with superficial facial burns that heal in less than 21 days appear to heal with generally very acceptable cosmetic and functional results. However, in those patients with deep facial burns that require prolonged periods for spontaneous wound healing, tangential excision of die wound and resurfacing with thick STSG appear to give better cosmetic results than conservative management, with no greater incidence of functional complications.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This retrospective review of the 1990 ABA orally presented abstracts found an overall publication rate of slightly more than 26%. This included both same-content and related-content publications. When the abstracts were made a subset by theme, a major variance in the publication rates was found. Abstracts that had a psychologic content (72.73%), for example, fared much better than reports of in vitro research (6.9%). This overall rate when compared to publication studies in other clinical areas was found to be quite low. This study further found that there was a great deal of similarity between abstracts that were published and those that were not. The one meaningful predictor of ultimate journal publication was the clarity of the presentation of statistically related information.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Toxic epidermal necrolysis syndrome is one of several clinically similar, severe acute, exfoliative.skin disorders that have become of increasing interest to burn surgeons in recent years. Recognition of a clinical course similar to extensive second-degree burns has resulted in the development of treatment protocols that are best carried out in a burn unit by personnel experienced in critical care techniques, the management of extensive cutaneous injuries, fluid and electrolyte derangements, and intensive nutritional support of critically ill patients. Current evidence suggests that in most instances toxic epidermal necrolysis syndrome is a CD8 lymphocyte-mediated reaction triggered by exposure to certain drugs. The target organs of the immune reaction are skin and mucous membranes. Appropriate management of the extensive skin wounds and the nutritional and critical care support afforded by treatment in burn units appears to have contributed significantly to the increasing survival of patients with this devastating and potentially lethal illness.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Haloperidol has become the drug of choice for sedation of the acutely agitated, delirious adult patient in the critical care setting because of its well-documented efficacy and lack of major side effects. Its use in die critically ill pediatric patient with burns has not been described. To determine the safety and efficacy of haloperidol in this population, the medical records of 30 critically ill pediatric patients with burns treated with haloperidol during the1 period 1986 to 1992 were reviewed. Our findings support the safe and effective use of haloperidol to treat severe agitation and delirium in the critically ill pediatric patient. The intravenous route appears to be more effective than the enteral route and should be considered when rapid, acute control of agitation is required.

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Data were collected prospectively from 196 patients admitted to our regional burn center during a 10-month period. Fifteen patients died during hospitalization, for a mortality rate of 7.7%. The mean hospital stay of the 181 patients who survived was 13.9 days (+13.7 SD), ranging from 2 to 89 days. The mean burn size was 9.2% (±11% SD), ranging from 0.5% to 60% total body surface area. One hundred ten patients received at least 1 day of antibiotic treatment, and 22 patients required ventilatory support during hospitalization. Hospital stay was longer for those requiring antibiotics (18.6 days vs 7 days) or ventilatory support (34.4 days vs 11.2 days). When these and other variables were entered into a linear regression model, the most powerful predictors of hospital stay were burn size and duration of antibiotic use (P=0.0001), followed next by the presence of other traumatic injuries(P=0.047).

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1996

数据来源: OVID