ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

This study evaluated B-lymphocyte function in 30 patients following major trauma with frequent screening over a period of 21 days post-trauma. Peripheral blood mononuclear cells (PBMC) were phenotyped with monoclonal antibodies and in vitro B-cell function was tested both for unstimulated cells (spontaneous) and following stimulation with pokeweed mitogen (PWM). The capacity for terminal B-cell maturation into plasma cells was assessed by the number of cells bearing cytoplasmic immunoglobulin (CIg+). Although the number of circulating B cells in the trauma patients was not decreased following injury (12 ± 2%), the number of CIg+ cells was significantly decreased (0.2 ± 0.1 to 3.0 ± 1.5) compared to controls (5 ± 1) up to 21 days post-trauma (p ≤ 0.01).Spontaneous B-cell synthesis of IgA, IgM, and IgG was significantly depressed on day 1, but IgA was within normal range (159 ± 30 ng/ml) by day 3, and IgA levels were supranormal (118 to 300% of control) on days 5–10 before returning to normal on days 14 to 21. Synthesis of IgG was 100 ± 20 ng/ml on day 3 (control, 165 ± 31 ng/ml), and IgG levels were supranormal (+45 to +139%) thereafter. On the other hand, IgM synthesis was decreased on all days studied (120 ± 35 to 220 ± 70 ng/ml) compared to controls (366 ± 105 ng/ml). Synthesis of all Ig subclasses in PWM cultures followed a similar pattern. There was a marked monocytosis (30 ± 2% LeuM3+ PBMC's) compared to control values (13 ± 2% LeuM3± PBMC's). In patients with an increase of monocytes (Mø) of > 30%, PWM-induced IgM synthesis was depressed to 35% of normal values, while IgG was normal and IgA was increased. These data suggest that altered B-cell function following trauma may be due largely to alterations in Mø/T-cell interaction.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A high-energy missile impact in an extremity of an animal creates a shock wave which is rapidly dispersed as a burst of oscillating pressure waves that traverses the entire body causing local, regional, and distant injuries. The present study was performed on dorsal root ganglion (DRG) cells, cultured for 3 weeks, to elucidate the cellular mechanism for damage of nerve cells, using a simplified test system.A model system was developed allowing exposure of DRG cultures to a burst of high-frequency oscillating pressure waves, comparable to those recorded in animals after high-energy missile extremity impact. The pressure waves were induced by impact of a high-energy missile in a rubber tube filled with water, in which nerve cell cultures were kept in a closed rubber glove filled with tissue culture medium.The pressure waves had a duration of 0.5–1.5 ms and a frequency spectrum ranging from 0–250 kHz. Within minutes the neurites showed changes in their microtubules. In addition, varicosities, enriched with tubulin immunoreactive material, became irregularly studded along the nerve cell processes. Scattered DRG cells were initially permeable to the marker complex Evans-blue albumin (EBA), used as an indicator of the ability of the plasma membranes to exclude proteins. After 6 hr, however, almost every DRG neuron was intensely stained by EBA. Concomitantly, there was swelling of the nerve cell cytoplasm and organelles, and, to a variable extent, neurofilament tangles were observed.It is concluded that the high-frequency pressure waves exert multiple damaging effects on the DRG nerve cells, including cytoskeletal disturbances and plasma membrane dysfunction, seemingly less obvious initially but affecting every DRG neuron with few exceptions by 6 hr.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A 10-year series of 75 acetabular fractures has been reviewed. Traffic accidents (61%) and falls from heights (20%) were the most common etiologic factors. In 80% of the patients multiple injuries were recorded. Seventeen patients were treated operatively. Forty-three patients were examined clinically and radiologically at an average of 7 years after the accident. The outcome of posterior wall fractures was usually good. Most of the fair and poor results occurred in the group of transverse fractures, in which conservative treatment did not accurately align the fracture dislocation. Operative treatment is suggested in both-column fractures and severely dislocated transverse fractures.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Riding accidents can be of a serious nature. Knowledge of risk factors is of essential value in the prevention of injuries. From the years 1969 through 1982 a series of 53 lethal riding injuries is analysed with reference to the rider, the horse, and the environment. Craniocerebral injuries dominate in this series, indicating the importance of adequately protecting helmets. Among the victims the female sex is dominating before the age of 25 and the males above this age. Older horses are less frequently involved in these accidents than younger ones. A long training period for riders under surveillance of a teacher is of outmost importance. Outdoor riding should be recommended only to experienced riders.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Injuries resulting from trauma are over-represented in Bahrain's intensive care unit beds. Using data from 1984 and 1985, this study examines the most severe etiologic agents and high-risk population groups among ICU trauma patients. Road traffic accidents were the principal cause of admission, accounting for 57% of all injury admissions. Most occurred in pedestrians suffering from severe head injury. Poisonings were the second largest category, followed by falls. In comparison with medical cases admitted to the ICU during the same 2-year period, the trauma cases included a disproportionate number of children and males in their most productive years of life, further adding to the economic burden which injuries have inflicted on this small country. The authors call for a new approach, namely passive prevention such as environmental modifications and legislation and tertiary prevention such as improvement of the country's underutilized ambulance service.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

In Finland during the period 1972–1985, there occurred 3,468 severe traffic accidents in which one or more of the drivers or passengers sustained an injury leading to a fatal outcome within 30 days. Of the victims who had been wearing seatbelts, 207 had fatal and 73 had severe chest injuries. The four leading causes of fatalities resulting from chest injuries were ruptures of the aorta (37%), ruptures of the heart (28.4%), and bilateral lung contusions (31.1%) or lacerations (15.5%). Seatbelt wearers with heart ruptures more often had concomitant rib fractures, lung injuries, and sternum fractures than those who had sustained ruptures of the aorta. The side of rib fractures was associated with the victim's location in the car, drivers seated on the left having more right-sided and right front passengers more left-sided rib fractures. In addition to chest injuries, 87% of the victims had other concomitant injuries, the most common abdominal injuries being liver injuries (40.2%) and spleen ruptures (26.5%). In seatbelt wearers chest injuries with a fatal outcome appear to be caused by impacts of exceptional severity, since in more moderate accidents seatbelt wearing has proved to save lives.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A retrospective review of 160 cases of penetrating spinal injury (PSI) was undertaken to assess the benefits and risks of operative treatment. Criteria for operation included incomplete deficits, worsening neurological status, and associated visceral perforation. Of the 160 cases, 142 had gunshot wounds (GSW) and 18 had stab wounds (SW). Laminectomy, with or without intradural exploration, was undertaken in 23% of cases. No significant differences in outcome were found between the surgical and nonsurgical groups. Meningitis, CSF leakage, and wound infections were complications that occurred more often in the surgically treated group (22%) than the conservatively managed group (7%). It has not been possible to demonstrate a benefit of surgery in PSI in this retrospective study. A prospective study is proposed that would allow better control of the variables affecting outcome.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

In order to determine if omental tissue accelerates the healing of liver lacerations, simulated bile leakage and collagen biosynthesis were studied in 53 rabbits. After creating a standardized complex liver laceration, hemostasis was obtained by vessel ligation and electrocoagulation. The wound was either left open (OP) or viable omentum sutured to its base (OM). Simulated bile leakage was noted in all of eight animals (four OM, four OP) studied on day of injury. None of 18 OM and two of 17 OP animals demonstrated extravasation of dye from the wound on the second and third postinjury day (N.S.). The ratio of mRNA for a 1(1) procollagen/actin, used as an indicator of wound healing, was 56.3 ± 7.8 for OM and 50.6 ± 12.1 for OP at the wound edge, and 63.5 ± 18.6 and 69.2 ± 7.5, respectively, for RNA isolated from the scar (N.S.). For al(III) procollagen mRNA, the ratio was 23.9 ± 3.5 for OM and 22.4 ± 8.3 for OP at the wound edge, and 32.4 ± 6.5 and 31.8 ± 7.9, respectively, for RNA isolated from the scar (N.S.). There was no difference in the scar hydroxyproline content between the two repair methods. In this model of hepatic injury and repair, bile leakage was minimal by the second postinjury day with both repair methods. Placing the omentum in liver lacerations did not contribute to accelerated wound healing as measured by simulated bile leakage and collagen biosynthesis.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Allograft skin lyophilised in 98% glycerol is an effective overlay for widely expanded autografts. The technique was evaluated clinically on a total of 58 sandwich grafting procedures in a group of 39 patients with extensive third-degree burns. Forty-five grafting operations performed within 10 days postburn all resulted in an epithelialisation rate of at least 75% within 5 weeks. Thirty-three of these procedures achieved complete (more than 95%) wound closure. Of 13 operations performed after the 14th postburn day, ten resulted in a wound epithelialisation of at least 75%. Epithelial quality and cosmetic results were good. The mean length of hospitalisation was 56 days. One patient died from unassociated respiratory failure. The absence of allograft viability did not impair its function as an autograft overlay. The apparent attenuation of allograft antigenicity conferred by the action of 98% glycerol may have contributed to the results achieved. The process of cadaver skin preservation in 98% glycerol is simple and inexpensive.

ISSN:0022-5282    

出版商:OVID    

年代:1989

数据来源: OVID