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61.
Vranckx JJ Slama J Preuss S Perez N Svensjö T Visovatti S Breuing K Bartlett R Pribaz J Weiss D Eriksson E 《Plastic and reconstructive surgery》2002,110(7):1680-1687
Wound treatment in a flexible transparent chamber attached to the perimeter of the wound and containing a liquid has been extensively tested in preclinical experiments in pigs and found to offer several advantages. It protects the wound; the liquid medium or saline in the chamber provides in vivo tissue culture-like conditions; and antibiotics, analgesics, and various molecules can be delivered to the wound through the chamber. The wound chamber causes no injury to the wound itself or to the surrounding intact skin. Topical delivery of, for instance, antibiotics can provide very high concentrations at the wound site and with a favorable direction of the concentration gradient. A series of 28 wounds in 20 patients were treated with a wound chamber containing saline and antibiotics. Most patients had significant comorbidity and had not responded to conservative or surgical management with débridement and delayed primary closure or skin grafts. Six wounds had foreign bodies present; four of these were joint prostheses. Seven patients were on corticosteroids for rheumatoid arthritis, lupus, or chronic obstructive pulmonary disease, and four patients had diabetes. Most patients were treated with the wound chamber in preparation for a delayed skin graft or flap procedure, but one was treated with a wound chamber until the wound healed. Twenty-five of the wounds (89 percent) healed, and five wounds (18 percent) required additional conservative management after the initial chamber treatment and grafting procedure. Of the three wounds that did not heal, one healed after additional chamber treatment, one had a skin graft that did not take, and one required reamputation at a higher level. Antibiotic delivery was less than one intravenous dose daily, which avoided the potential for systemic absorption to toxic levels. Antibiotics such as vancomycin and gentamicin could be used in concentrations of up to 10,000 times the minimal inhibitory concentration. Forty-eight hours after application, 20 percent or more of the original antibiotic concentration was present in the wound chamber fluid. In conclusion, the wound chamber provides a safe, powerful tool in the treatment of difficult infected wounds. 相似文献
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Folded free vascularized fibula transfer 总被引:3,自引:0,他引:3
A technique of improved free vascularized fibula grafting for bone defects up to 15 cm in length is presented with three illustrative cases. By dividing a harvested free fibula graft at its midpoint without dividing its vascular pedicle, two vascularized bone lengths are produced that require only one set of anastomoses. This folded fibula provides twice the cross-sectional area of a single fibula transfer and allows biomechanically improved graft placement. This technique has been successfully used in long bone defects of the upper and lower limbs. 相似文献
67.
Glycosylation sites and site-specific glycosylation in human Tamm- Horsfall glycoprotein 总被引:4,自引:1,他引:3
The N-glycosylation sites of human Tamm-Horsfall glycoprotein from one
healthy male donor have been characterized, based on an approach using
endoproteinase Glu-C (V-8 protease, Staphylococcus aureus ) digestion and a
combination of chromatographic techniques, automated Edman sequencing, and
fast atom bombardment mass spectrometry. Seven out of the eight potential
N-glycosylation sites, namely, Asn52, Asn56, Asn208, Asn251, Asn298,
Asn372, and Asn489, turned out to be glycosylated, and the potential
glycosylation site at Asn14, being close to the N-terminus, is not used.
The carbohydrate microheterogeneity on three of the glycosylation sites was
studied in more detail by high-pH anion-exchange chromatographic profiling
and 500 MHz1H-NMR spectroscopy. Glycosylation site Asn489 contains mainly
di- and tri-charged oligosaccharides which comprise, among others, the
GalNAc4 S (beta1-4)GlcNAc terminal sequence. Only glycosylation site Asn251
bears oligomannose-type carbohydrate chains ranging from Man5GlcNAc2to
Man8GlcNAc2, in addition to a small amount of complex- type structures.
Profiling of the carbohydrate moieties of Asn208 indicates a large
heterogeneity, similar to that established for native human Tamm-Horsfall
glycoprotein, namely, multiply charged complex-type carbohydrate
structures, terminated by sulfate groups, sialic acid residues, and/or the
Sda-determinant.
相似文献
68.
Leo AB Joosten Erik Lubberts Monique MA Helsen Tore Saxne Christina JJ Coenen-de Roo Dick Heinegård Wim B van den Berg 《Arthritis research & therapy》1999,1(1):81-11
Destruction of cartilage and bone are hallmarks of human rheumatoid arthritis (RA), and controlling these erosive processes
is the most challenging objective in the treatment of RA. Systemic interleukin-4 treatment of established murine collagen-induced
arthritis suppressed disease activity and protected against cartilage and bone destruction. Reduced cartilage pathology was
confirmed by both decreased serum cartilage oligomeric matrix protein (COMP) and histological examination. In addition, radiological
analysis revealed that bone destruction was also partially prevented. Improved suppression of joint swelling was achieved
when interleukin-4 treatment was combined with low-dose prednisolone treatment. Interestingly, synergistic reduction of both
serum COMP and inflammatory parameters was noted when low-dose interleukin-4 was combined with prednisolone. Systemic treatment
with interleukin-4 appeared to be a protective therapy for cartilage and bone in arthritis, and in combination with prednisolone
at low dosages may offer an alternative therapy in RA. 相似文献
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