Publications by authors named "McManus A"

Fifty randomly selected computed tomographic (CT) scans of the lumbosacral spine (25 males and 25 females) were studied to determine: 1) if the lateral sacral masses could safely accept a 7 mm diameter rod (i.e., intrasacral rod insertion) and 2) what percentage of patients, both males and females, demonstrated coverage of the posterolateral sacrum by the ilia (i.

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The ability of B-CLL lymphocyte populations to respond to cytokine stimulation of mononuclear cultures was examined using 3-colour immunofluorescence and multiparameter flow cytometry. The simultaneous detection of the membrane antigens CD5 and CD19, with the proliferation antigen Ki-67, allowed examination of the cell-cycle entry of the B-CLL lymphocyte population. Upon stimulation with IFN-gamma, IFN-gamma+IL-2, TPA+IL-4, between 10 and 44% of B-CLL lymphocytes from 10 patients were stimulated to enter into cell-cycle.

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Nitric oxide is biosynthesized from the amino acid L-arginine by the enzyme nitric oxide synthase. Nitric oxide is a vasodilator, a neurotransmitter, and may modulate immune function. The experiments presented here were performed to determine whether the synthesis of nitric oxide is increased following experimental burn injury in rats.

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Prophylactic administration of antibiotics can decrease postoperative morbidity, shorten hospitalization, and reduce the overall costs attributable to infections. Principles of prophylaxis include providing effective levels of antibiotics in the decisive interval, and, in most instances, limiting the course to intraoperative coverage only. Use in The National Research Council clean contaminated operations is appropriate and, in many instances, has been proven beneficial.

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Topical chemotherapy, prompt excision, and timely closure of the burn wound have significantly reduced the occurrence of invasive burn wound infection and its related mortality. Since wound protection is imperfect and invasive wound infection may still occur in patients with massive burns in whom wound closure is delayed, scheduled wound surveillance and biopsy monitoring are necessary to assess the microbial status of the burn wound and identify wound infections caused by resistant bacteria or non-bacterial opportunists at a stage when therapeutic intervention can control the process. As a reflection of the systemic immunosuppressive effects of burn injury, infection remains the most common cause of morbidity and mortality even though the occurrence of wound infections has been significantly decreased.

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We have examined the effects of direct current (DC) conducted through silver-nylon dressings on the healing time and morphologic maturation of split-thickness grafts placed on tangentially excised deep partial-thickness burn wounds. Male guinea pigs (n = 120) were used as the experimental hosts. The DC-treated animals required 2 days for complete revascularization of their grafts; control animals required 7 days (p less than 0.

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To evaluate our experience with fungal burn wound infection, we performed a 10-year review for comparison with our experience with bacterial burn wound infection. During the study period, a marked decline occurred in bacterial wound infection but not in fungal wound infection. Patients with either bacterial or fungal burn wound infection had massive injury, with burn size averaging greater than 50% of the total body surface area.

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The United States Army Institute of Surgical Research was asked to provide burn care assistance in June 1989 following the explosion of leaking methane/propane gas in the Central Soviet Union, which destroyed two passenger trains and injured 800 passengers. A 17-member burn team flew from San Antonio, Texas, to Ufa, USSR and assisted in the management of 150 burn patients in a general medical-surgical hospital. Early problems included heavily colonized burn wounds, with a microbial flora that demonstrated broad antibiotic resistance.

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The time required for wound healing, contraction, and hypertrophic scarring often limit the use of deep partial-thickness burn wounds as donor sites for split-thickness grafts. We have examined the effects of weak direct current and silver nylon dressings on the healing of partial-thickness scald burns, split-thickness grafts taken from these wounds when healed, and the resulting donor sites in a guinea pig model. Dorsal scald wounds treated with weak direct current reepithealized by 12 days postinjury.

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Using intact bacterial cells, it was found that Pseudomonas aeruginosa was more susceptible to mafenide than Escherichia coli, that p-aminobenzoic acid (pABA) did not reverse or prevent inhibition by mafenide and that pABA itself was inhibitory. Under the experimental conditions used in these studies, pABA was more inhibitory to E. coli than to P.

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Methicillin-resistant Staphylococcus aureus (MRSA) strains, principally resistant to penicillinase-resistant penicillins and aminoglycosides, are increasingly common hospital isolates. We have examined the significance of MRSA colonization and infection in 1100 consecutively admitted, seriously burned patients in whom vancomycin was used to treat all staphylococcal infections. Colonization with S aureus (SA) was identified in 658 patients, in 319 of whom MRSA colonization was identified.

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Intact cells of Pseudomonas aeruginosa were more susceptible to phosphanilic acid (PA) than cells of Escherichia coli. In cell extracts, the dihydropteroate synthases of P. aeruginosa and E.

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Burn injuries have been shown to impair immune function. One of the hypotheses for the etiology of the immunosuppression is that burn injuries result in an elevation of prostaglandin E (PGE) levels which then impair leukocyte function. We evaluated the effect of PGE levels on immune function in multiple animal models utilizing T cell subset levels for our immunologic measurements.

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The effects of prophylactic administration of intravenous IgG on immune-cell phenotype and function in burn patients were compared with those of patients receiving standard therapy. Intravenous IgG infusions were given twice weekly for three weeks postburn or until wound closure. Intravenous IgG had no effect on the proportion of total T-lymphocytes, T-helper lymphocytes, or T-suppressor lymphocytes, but the proportion of B-lymphocytes decreased 40% in treated patient samples.

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The therapeutic and prophylactic effects of nylon dressings coated with metallic silver in a direct current circuit have been examined in a rat model of fatal burn wound sepsis. Male Sprague-Dawley rats weighing 325 +/- 25 grams with 20% full-thickness scald injuries were used. Therapeutic effects were examined at 4 or 24 hours after surface inoculation with a lethal dose of Pseudomonas aeruginosa (Strain 59-1244).

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Meager quantitative anatomic information is available regarding the orientation of the left ventricular outflow tract (LVOT) relative to the ventricular septum (VS), or the relation of these variables to patient age, sex, or other cardiac features. We studied 57 formaldehyde-fixed adult human heart specimens at autopsy from 29 men and 28 women ranging in age from 20 to 91 years (mean age = 66 years). Blinded measurement of 10 morphologic parameters, repeated on 2 occasions, included anatomic indexes of VS sigmoidity (angle between the aortic and the mitral plane).

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Imipenem/cilastatin was examined for safety and efficacy in a population of 20 seriously burned patients with acute bacterial infections. The study was made up of 18 males and two females with an average age of 38 years and average burn size of 52 per cent of the total body surface area. Inhalation injury was present in 14 patients.

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We examined the association between quantitative microbiologic results and histopathologic findings in divided biopsy specimens from 200 burned patients. Microbiologic counts were determined as log10 colony-forming units per gram of disrupted tissue. Histopathologic results were scored on a scale of 1 to 6, values of 4 or greater indicating microbial invasion of viable tissue.

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