Inhibition of enteral enzymes by enteroclysis with nafamostat mesilate reduces neutrophil activation and transfusion requirements after hemorrhagic shock.

Background: The gut origin of the inflammatory response in trauma patients has been difficult to define. "In vivo" generation of neutrophil-activating factors by gut proteases may be a cause of multiorgan failure after hemorrhagic shock, and can be prevented with the serine protease inhibitor nafamostat mesilate (Futhan). The objective of this study was to determine the effect of nafamostat mesilate given by enteroclysis on enteric serine protease activity, neutrophil activation, and transfusion requirements during hemorrhagic shock.

Phase I trial of a human-mouse chimeric anti-disialoganglioside monoclonal antibody ch14.18 in patients with refractory neuroblastoma and osteosarcoma.

Purpose: To evaluate the toxicity, immunogenicity, and pharmacokinetics of a human-mouse chimeric monoclonal antibody (mAb) ch 14.18 directed against disialoganglioside (GD2) and to obtain preliminary information on its clinical efficacy, we conducted a phase I trial in 10 patients with refractory neuroblastoma and one patient with osteosarcoma.

Patients And Methods: Eleven patients were entered onto this phase I trial.

Use of a four-layer bandage system in the treatment of an i.v. drug abuser with chronic upper extremity ulcerations: a case study.

A patient with a ten-year history of heroin abuse presented to a wound healing clinic for treatment of multiple ulcerations to his upper arm. The largest measured 3.5 cm x 1.

Hypertonic saline resuscitation: a tool to modulate immune function in trauma patients?

Hypertonic saline (HS) resuscitation has recently gained attention from trauma physicians because it may benefit the immune system of trauma patients. We have found that HS augments in vitro and in vivo immune function of healthy T-cells. In addition, HS restored the function of suppressed T-cells in vitro and in vivo and reduced immunosuppression after hemorrhage, protecting mice from subsequent sepsis.

Parametric imaging of the chick embryonic cardiovascular system: a novel functional measure.

Morphogenesis of the cardiovascular system is likely linked to its functional development. This report presents an approach to functional assessment of early cardiovascular development using parametric imaging based on videodensitometry. Trypan blue was injected into the sinus venosus of chick embryos at stage 20 (3.

A comparison of thoracoscopic talc insufflation, slurry, and mechanical abrasion pleurodesis.

The purpose of this study was to compare the anatomic and histopathologic results of four different methods of pleurodesis in 10 dogs. Each animal was randomly assigned to receive two of the following methods of pleurodesis: thoracoscopic talc insufflation (poudrage), talc slurry administration, focal gauze abrasion by limited thoracotomy, and mechanical abrasion by thoracoscopy using a commercially available pleural abrader. Animals were killed 30 days after pleurodesis.

The ongoing challenge of retroperitoneal vascular injuries.

Background: Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed.

Methods: Eighty-nine patients sustaining abdominal aortic or inferior vena cava injury were concurrently evaluated for a 10-year period and retrospectively reviewed.

Cervical flexion: its contribution to normal and abnormal cardiac morphogenesis.

Although His in 1881 and Patten in 1922 suggested that cervical flexion could play an important role in normal cardiac morphogenesis, until recently this hypothesis has been largely neglected. The purpose of this report is to present data indicating that prevention of cervical flexion leads to double outlet right ventricle (DORV), which is unrelated to any affect on neural crest cell migration. At stage 11-12, suture material was inserted into the neural tube to prevent cervical flexion.

Clinical efficacy of the amplified Mycobacterium tuberculosis direct test for the diagnosis of pulmonary tuberculosis.

The amplified Mycobacterium tuberculosis direct test (MTD) is a rapid diagnostic test based on a nucleic acid amplification technique, which can be used directly on processed clinical specimens. We evaluated the clinical utility of the MTD for diagnosing pulmonary tuberculosis by comparing the sensitivity and specificity of the test with acid-fast smear, mycobacterial culture, and clinical evaluation. The study included 844 respiratory tract specimens from 421 patients, which were submitted to the microbiology laboratory of our urban teaching hospital over a 6-mo period.

Bladder injury model induced in rats by exposure to protamine sulfate followed by bacterial endotoxin.

Purpose: A bladder injury model was developed using protamine sulfate (PS) and endotoxin lipopolysaccharide (LPS) administered intravesically to female Sprague-Dawley rats.

Materials And Methods: Experimental and control animals were catheterized and intravesically exposed to PS-LPS, PS, LPS, or phosphate buffered saline. After 4, 24 or 72 hours, rats were sacrificed.

Cervical and lumbar MRI in asymptomatic older male lifelong athletes: frequency of degenerative findings.

Objective: The athletic activity of the adult U.S. population has increased markedly in the last 20 years.

Hypertonic/hyperoncotic fluids reverse prostaglandin E2 (PGE2)-induced T-cell suppression.

In recent years, hypertonic, and hyperoncotic fluids have been examined for their potential to replace conventional isotonic fluids. This study describes the effects of commonly used intravenous fluids on immune function. The action of increased concentrations of hypertonic saline (HTS), hypertonic saline-dextran (HSD), dextran (Dx), albumin (ALB), and hydroxyethylstarch (HET) on in vitro proliferation of phytohemagglutinin-stimulated normal and prostaglandin E2-suppressed human peripheral blood mononuclear cells was tested.

Immunopharmacologic profile of nedocromil sodium.

Nedocromil sodium, a pyranoquinolone, was specifically designed as an agent to suppress allergic inflammation. Nedocromil sodium significantly affects not only the early-phase of allergen-induced responses, but also expression of late-phase inflammation, even when administered after the onset of early-phase responses. Nedocromil sodium also limits bronchoconstriction induced by nonallergic factors, including cold air and sulfur dioxide at dosages lower than required with cromolyn sodium.

Tumor necrosis factor antibody treatment of septic baboons reduces the production of sustained T-cell suppressive factors.

Post-traumatic septic complications result from impaired cell-mediated immune function, which is caused in part by circulating T-cell suppressive factors (TSFs). We examined whether tumor necrosis factor alpha (TNF-alpha) antibody treatment in a baboon sepsis model influences the production of TSFs, including interleukin-10 (IL-10) and transforming growth factor-beta (TGF-beta). Sepsis was induced in anesthetized baboons by Escherichia coli infusion, and caused an increase in plasma levels of TNF, TSF activity, IL-10, and active TGF-beta, as well as a decrease in latent TGF-beta.

1,25-Dihydroxyvitamin D3 increases collagen production in dermal fibroblasts.

The effect of 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) on proliferation and collagen type I and type III production in cultured human fibroblasts was examined. Previous studies have identified receptors for the vitamin in human dermal fibroblasts, and have suggested the skin to be a target tissue. While many studies examining keratinocyte modulation by 1,25-(OH)2D3 have been undertaken, very few have been performed on dermal fibroblasts.

Effects of trauma on immune cell function: impairment of intracellular calcium signaling.

Immunosuppression following injury influences infectious morbidity and mortality. Impaired T-cell activation conceding to inadequate antigen recognition contributes to this immunosuppression. Successful activation and proliferation of T-cells requires precisely specified levels of intracellular calcium thresholds and peak signals.

Pediatric leptomeningeal metastasis: 111In-DTPA cerebrospinal fluid flow studies.

Nine children (five girls and four boys) ranging in age from 1 to 18 years (median age, 12 years) with leptomeningeal metastasis were evaluated for cerebrospinal fluid compartmentalization with cerebrospinal fluid flow studies using ventricular diethylenetriaminepentaacetic acid labeled with indium 111 (111In-DTPA). Histologic diagnosis included medulloblastoma (two), primitive neuroectodermal tumor (two), acute lymphoblastic leukemia (two), pineoblastoma (one), ependymoma (one), and anaplastic astrocytoma (one). Sixteen 111In-DTPA cerebrospinal fluid flow studies were performed, of which nine demonstrated normal anterograde cerebrospinal fluid flow of radionuclide, with the following cerebrospinal fluid compartment median times to appearance, with ranges in parentheses: ventricles, 1 minute (0 to 3 minutes); cisterna magna/basal cisterns, 5 minutes (3 to 5 minutes); cervical subarachnoid space, 8 minutes (5 to 10 minutes); thoracic subarachnoid space, 15 minutes (10 to 30 minutes); lumbar subarachnoid space, 35 minutes (20 to 45 minutes); and sylvian cistern, 80 minutes (60 to 90 minutes).

Fibroblast behavior in vitro is unaltered by products of staphylococci cultured from silicone implants.

Our previous clinical study supported the concept that capsular contracture is associated with subclinical infection of silicone implants. If bacterial presence, indeed, contributes to capsular contracture, then fibroblast behavior might be expected to change in the presence of bacteria by-products. Therefore, study of possible alteration of fibroblast behavior by bacteria products was undertaken using an in vitro model with cultured dermal fibroblasts.

Enhanced activity of lysosomal beta-galactosidase after silicone implantation: an experimental study in rats.

Biologic consequences of silicone implantation may include changes in host connective tissue metabolism. Lysosomal beta-galactosidase (beta-GAL) activity, which is a sensitive marker of fibrotic diseases and may be a useful marker of collagen turnover, was examined in the serum of rats with implanted silicones. No significant difference in spectrofluorometrically determined enzyme activity was demonstrated in rats subjected to dorsal submuscular pocket dissection without implantation and corresponding nonoperative controls.