Photodynamic therapy for Staphylococcus aureus infected burn wounds in mice.

The rise of multiply antibiotic resistant bacteria has led to searches for novel antimicrobial therapies to treat infections. Photodynamic therapy (PDT) is a potential candidate; it uses the combination of a photosensitizer with visible light to produce reactive oxygen species that lead to cell death. We used PDT mediated by meso-mono-phenyl-tri(N-methyl-4-pyridyl)-porphyrin (PTMPP) to treat burn wounds in mice with established Staphylococcus aureus infections The third degree burn wounds were infected with bioluminescent S. aureus. PDT was applied after one day of bacterial growth by adding a 25% DMSO/500 microM PTMPP solution to the wound followed by illumination with red light and periodic imaging of the mice using a sensitive camera to detect the bioluminescence. More than 98% of the bacteria were eradicated after a light dose of 210 J cm(-2) in the presence of PTMPP. However, bacterial re-growth was observed. Light alone or PDT both delayed the wound healing. These data suggest that PDT has the potential to rapidly reduce the bacterial load in infected burns. The treatment needs to be optimized to reduce wound damage and prevent recurrence.     

Habenula--a new target for treatment of intractable depression

Despite substantial advancement in psychopharmacological and electro-magnetic treatments over the last decades on the depression patients, there are non-responders remain with a chronic disease and high suicidal risk yet. Deep brain stimulation (DBS) is now being experimentally to treat the intractable depression and yielded an impressive therapeutic benefit, and especially few adverse effect occurred. The beneficial action of DBS is closely related to the stimulation sit. And the efficacy of high frequency stimulation of lateral habenula is one of the best choice. In depression, the concentration of 5-HT released by the raphe nuclei is decreased. It's due to mainly the overactivation of the lateral habenula. High frequency stimulation of lateral habenula impairs the activation of lateral habenula, and the inhibitory effect of lateral habenula on raphe nuclei is decreased. Then, the 5-HT concentration released by the raphe nuclei is increased, the pathological changes of depression is eliminated. The lateral habenula could be a promising novel target for BDS in the cases of intractable depression.     

Development of new reconstructive techniques: use of Integra in combination with fibrin glue and negative-pressure therapy for reconstruction of acute and chronic wounds

Large wounds resulting from severe injuries are generally treated with extended reconstructive operations (e.g., free flaps), which are accompanied by long hospitalizations and risks of infection, thrombosis, and flap loss. Integra is a collagen template that can be used for reconstruction of defects. The take rate and the rate of infection are essential for the successful use of Integra (Johnson and Johnson, Hamburg, Germany). Whether the take rate and integration of Integra could be improved with the use of fibrin glue and negative-pressure therapy was assessed. Between January of 2002 and December of 2002, patients with large defects who underwent Integra grafting for reconstruction were randomly divided into groups receiving either a new treatment with fibrin glue-anchored Integra and postoperative negative-pressure therapy or conventional treatment. Demographic features, cause of the wound, location of the wound, take rate, complications of Integra coverage, time from Integra coverage to skin transplantation, and functional and aesthetic results were assessed. Twelve patients (with similar group distributions with respect to sex, age, and location and cause of the injury) were included in the study. The take rate was 78 +/- 8 percent in the conventional treatment group and 98 +/- 2 percent in the fibrin/negative-pressure therapy group (p < 0.003). The mean period from Integra coverage to skin transplantation was 24 +/- 3 days in the conventional treatment group but only 10 +/- 1 days in the fibrin/negative-pressure therapy group (p < 0.002). The decrease in the interval between coverage with Integra and skin transplantation resulted in shorter hospital stays. The use of fibrin glue and negative-pressure therapy in combination with Integra could shorten the period from coverage to integration, which would be beneficial in terms of decreased risks of infection, thrombosis, and catabolism. Therefore, it is suggested that Integra be used in combination with fibrin glue and negative-pressure therapy to improve clinical outcomes and shorten hospital stays, with decreased risks of accompanying complications.     

Chitosan treatment for skin ulcers associated with diabetes

Infections, ulcerations, gangrene and, in severe cases, extremity amputation, are common complications among diabetic subjects. Various biomaterials have been utilized for the treatment of these lesions. Chitosan is an amino sugar with a low risk of toxicity and immune response. In this study, we evaluated chitosan topical gel and film treatments for subjects with diabetic ulcerations and wounds associated with diabetes mellitus. In a pre-experimental design, we described the result of chitosan gel and film treatment for wounds and skin ulcers among patients with long-standing diabetes mellitus. We studied 8 diabetic patients with wounds and skin ulcers (long duration and Wagner degree 1–2). Initially, most lesions had some degree of infection, tissue damage and ulceration. At the end of the treatment (topical chitosan) period, the infections were cured. All patients experienced a significant improvement in the initial injury and developed granulation tissue and a healthy skin cover. This report represents one of the few published clinical experience regarding the chitosan for the treatment of skin lesions among diabetic subjects. These results are relevant and promising for the treatment of this disease.     

Gel formulations for the treatment of pruning wounds.

Gels incorporating carbendazim and triadimefon were prepared from sodium alginate, a xanthan gum or an esterified alginic acid and evaluated as wound treatments on apple and plum trees. Fungicide movement and persistence were similar with sodium alginate and xanthan gels but movement was reduced and persistence increased with the esterified material. Callus tissue formation was not inhibited by any formulation. Adding acid to fungicides to form salts had little effect on fungicide movement or persistence and caused unacceptable phytotoxicity. Thiophanate-methyl or thiabendazole were not superior to carbendazim, nor imazalil to triadimefon, for protection against Nectria galligena and Chondroster-eum purpureum respectively. Sealants containing octhilinone, carbendazim plus captan, or mercuric oxide quickly established sufficient fungicide in the wood to eradicate N. galligena but possibly insufficient to protect adequately against C. purpureum. Gel formulations are valid alternatives to sealants as fresh wound pathogen treatments but fungicide persistence is insufficient for them to be recommended for treatment against mature wound pathogens.     

Topical pectins for the treatment of burn wounds]

The results of the burned wounds treatment with 1-2% solution of apple or beet pectins were analysed. The control results were examined at the same patients with symmetrical wounds treated by chlorhexidine, levomecol, furacillin liniment. Clinical evaluation demonstrated good tolerability of the treatment regime, absence of side effects and complications, inhibition of inflammation, acceleration of epithelisation of the burns II-IIIA class, allowed to diminish the preliminary period before autodermoplastic operation (burns of IIIB class), diminished microbial dissemination and dissemination with Pseudomonas aeruginosa. The best results were demonstrated when the pectins application was performed since the first day after the burned injury.     

Immunoreactive systems in the healing of aseptic and infected wounds in an experiment

Main parameters of systemic immune reactivity were studied in 240 mature Wistar male rats with simulated aseptic and infected surface wounds before surgical intervention, and 1-10, 12 and 15 days after it. It was stated that aseptic wounds were responsible for nonspecific systemic response to the stress, whereas the presence of bacterial flora in the wound inhibited the development of humoral immune response in the presence of T-cell activation thus causing the dysfunction of the immune system and therefore affecting the course of wound progress. The consideration of all factors mentioned permits averting wound purulent complications in postsurgical period.     

New beta-lactamase-resistant cephem treatment of guinea pigs infected with Legionella pneumophila

The in vivo antimicrobial effect of seven new beta-lactamase-resistant cephems (cefotaxime, latamoxef, ceftazidime, ceftriaxone, cefotiam, cefbuperazone, and MT-141) on Legionella pneumophila (strain 81-066, serogroup IV) in guinea pigs was compared with that of erythromycin. As the minimal LD100 within one week was about 4.0 X 10(9) CFU/ml by intraperitoneal injection of the strain, the animals were inoculated with 2.0 ml of twofold dilutions of a suspension of this bacterium. The animals developed purulent peritonitis and systemic involvement demonstrated by the development of periangitis, pneumonia and pleuritis in the lungs. Three different doses of antibiotics were administered intraperitoneally immediately after the rectal temperature reached more than 40 C. Erythromycin had a significant therapeutic effect but none of the new cephems tested death of the infected guinea pigs.