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Burns and somatomedin activity
221
Abstracts frltrates of plasma and whole blood. All factors are retained by filters with a pore size of 25 000 daltons and can be precipitated by phosphotungstic acid, suggesting that they may be proteins. The 3551420 factor increases with oxidation, whereas both the 2801340 substance and the 398 nm material decrease. Powanda M. C., Dubois J., Villarreal Y. et al. (1981) Detection of potential biochemical indicators of infection in the burned rat. J. Lab. C/in. Med. 97,672.
3 : I expanded mesh allografi. Fourteen patients with a wide range of burned areas were treated with these two layers of expanded skin. Initially there was an average of 99 per cent autograR take and 95 per cent allograft take. Subsequently the allografi was rejected (half time of survival = I4 days) without any acute inflammation or loss of autograft. The ultimate cosmetic appearance and function was acceptable in all patients. Alexander J. W., MacMillan B. G., Law E. et al. (198I ) Treatment of severe bums with widely meshed skin autograft and meshed skin allograft overlay. J.
Permeability of heated skin The permeability of burned skin to water and various organic solvents (methanol, ethanol, butanol, hexanol and octanol) was studied in vifro following dry heat and wet heat bums at 60 ‘C for periods varying between I5 and 960 seconds. Dry heat burns produced similar effects as scalding for equivalent durations, i.e. I.5 to 2-fold increases for water, methanol and ethanol and 3- to 4-fold increases for the higher alkanols. The rate of increase in permeability was directly related to the duration of burning or scalding. At 60 ‘C the method of burning did not induce differences in the nature or degree ofthe altered permeability. Behl C. R., Flynn G. L., Barrett M. et al. (198 I) Permeability of thermally damaged skin II: immediate influences of branding at 60 ‘C on hairless mouse skin permeability. Burns 7,389.
Trauma 21,433.
CLINICAL
STUDIES
Elastin metabolism Desmosine, a breakdown product from elastin is excreted in significantly increased amounts by all patients with bums covering more than I9 oer cent of ihe body surface. The urine from these burned patients contained between 250 and I41 I nmoles compared with a normal excretion of between 82 and 142 nmoles per day. These quantities are equivalent to I4 to 78 mg of elastin degraded by burned patients and 5 to 8 mg for normal individuals. The urinary excretion of both desmosine and total hydroxyproline per g creatinine were also supranormal in the burned patients with peak concentrations during the first and second weeks after burning. The metabolism of elastin and collagen in the skin of burned patients was above normal for at least the first 2 months after injury. Yu S. Y., Janoff A., Hare1 S. et al. (1981) Urinary excretion of desmosine in patients with severe burns. Metabolism 30,497.
Combined meshed autograft and allograft skins The maximum use of limited sites of autograft skin in the very extensively burned patient can be made by protecting a 6 : I expanded mesh of autograR with a
Burns and somatomedin activity The mediators of growth hormone activity, the somatomedins, are found in greatly reduced concentrations or are absent in plasma taken from patients with bums during the first few days after injury. Subsequently the somatomedin activity slowly increased in the patients who survived and remained low or undetectable in the fatal injuries. The duration of depression of somatomedin activity was signiflcantly correlated with the extent of the bum and the volume of early fluid therapy and was inversely related to the plasma cortisol concentrations. The low somatomedin activity was considered to be due to degradation or binding of somatomedins to damaged tissue or to the lack of an agent which permitted or stimulated their action on cartilage. No evidence of an inhibitor of somatomedin activity was found. Coates C. L., Burwell R. G., Carlin S. A. et al. (198 I) Somatomedin activity in plasma from burned patients with observations on plasma cortisol. Burns 7,425.
Topical cerium nitrate plus silver sulphadiazine A mixture of cerium nitrate plus silver sulphadiazine was compared with silver sulphadiazine alone as topical antibacterial agents in children with bums covering more than 30 per cent of the body surface. Quantitative surface cultures were used to monitor bum wound flora during the first IO weeks in hospital. No superiority for the silver sulphadiazine cerium nitrate mixture could be found, since the wounds treated with the mixture showed a greater incidence of Gram-negative pathogens than when only the silver sulphadiazine was used. It is suggested that cerium nitrate should be reserved for the treatment of organisms that are resistant to silver sulphadiazine therapy. Bowser B. H., Caldwell F. T., Cone J. B. et al. (198 I ) A prospective analysis of silver sulfadiazine with and without cerium nitrate as a topical agent in the treatment ofseverely burned children. J. Trauma 21,558.
Abstracts frltrates of plasma and whole blood. All factors are retained by filters with a pore size of 25 000 daltons and can be precipitated by phosphotungstic acid, suggesting that they may be proteins. The 3551420 factor increases with oxidation, whereas both the 2801340 substance and the 398 nm material decrease. Powanda M. C., Dubois J., Villarreal Y. et al. (1981) Detection of potential biochemical indicators of infection in the burned rat. J. Lab. C/in. Med. 97,672.
3 : I expanded mesh allografi. Fourteen patients with a wide range of burned areas were treated with these two layers of expanded skin. Initially there was an average of 99 per cent autograR take and 95 per cent allograft take. Subsequently the allografi was rejected (half time of survival = I4 days) without any acute inflammation or loss of autograft. The ultimate cosmetic appearance and function was acceptable in all patients. Alexander J. W., MacMillan B. G., Law E. et al. (198I ) Treatment of severe bums with widely meshed skin autograft and meshed skin allograft overlay. J.
Permeability of heated skin The permeability of burned skin to water and various organic solvents (methanol, ethanol, butanol, hexanol and octanol) was studied in vifro following dry heat and wet heat bums at 60 ‘C for periods varying between I5 and 960 seconds. Dry heat burns produced similar effects as scalding for equivalent durations, i.e. I.5 to 2-fold increases for water, methanol and ethanol and 3- to 4-fold increases for the higher alkanols. The rate of increase in permeability was directly related to the duration of burning or scalding. At 60 ‘C the method of burning did not induce differences in the nature or degree ofthe altered permeability. Behl C. R., Flynn G. L., Barrett M. et al. (198 I) Permeability of thermally damaged skin II: immediate influences of branding at 60 ‘C on hairless mouse skin permeability. Burns 7,389.
Trauma 21,433.
CLINICAL
STUDIES
Elastin metabolism Desmosine, a breakdown product from elastin is excreted in significantly increased amounts by all patients with bums covering more than I9 oer cent of ihe body surface. The urine from these burned patients contained between 250 and I41 I nmoles compared with a normal excretion of between 82 and 142 nmoles per day. These quantities are equivalent to I4 to 78 mg of elastin degraded by burned patients and 5 to 8 mg for normal individuals. The urinary excretion of both desmosine and total hydroxyproline per g creatinine were also supranormal in the burned patients with peak concentrations during the first and second weeks after burning. The metabolism of elastin and collagen in the skin of burned patients was above normal for at least the first 2 months after injury. Yu S. Y., Janoff A., Hare1 S. et al. (1981) Urinary excretion of desmosine in patients with severe burns. Metabolism 30,497.
Combined meshed autograft and allograft skins The maximum use of limited sites of autograft skin in the very extensively burned patient can be made by protecting a 6 : I expanded mesh of autograR with a
Burns and somatomedin activity The mediators of growth hormone activity, the somatomedins, are found in greatly reduced concentrations or are absent in plasma taken from patients with bums during the first few days after injury. Subsequently the somatomedin activity slowly increased in the patients who survived and remained low or undetectable in the fatal injuries. The duration of depression of somatomedin activity was signiflcantly correlated with the extent of the bum and the volume of early fluid therapy and was inversely related to the plasma cortisol concentrations. The low somatomedin activity was considered to be due to degradation or binding of somatomedins to damaged tissue or to the lack of an agent which permitted or stimulated their action on cartilage. No evidence of an inhibitor of somatomedin activity was found. Coates C. L., Burwell R. G., Carlin S. A. et al. (198 I) Somatomedin activity in plasma from burned patients with observations on plasma cortisol. Burns 7,425.
Topical cerium nitrate plus silver sulphadiazine A mixture of cerium nitrate plus silver sulphadiazine was compared with silver sulphadiazine alone as topical antibacterial agents in children with bums covering more than 30 per cent of the body surface. Quantitative surface cultures were used to monitor bum wound flora during the first IO weeks in hospital. No superiority for the silver sulphadiazine cerium nitrate mixture could be found, since the wounds treated with the mixture showed a greater incidence of Gram-negative pathogens than when only the silver sulphadiazine was used. It is suggested that cerium nitrate should be reserved for the treatment of organisms that are resistant to silver sulphadiazine therapy. Bowser B. H., Caldwell F. T., Cone J. B. et al. (198 I ) A prospective analysis of silver sulfadiazine with and without cerium nitrate as a topical agent in the treatment ofseverely burned children. J. Trauma 21,558.