White blood cell consumption in the microcirculation after a major burn

The mesenteric microvasculature was observed before and after a distant full-thickness cutaneous burn in rats. Diameters, flow velocities, and white blood cell sticking and emigration were measured. Between 30 and 360 minutes postburn 13 to 16 WBC's were found to stick to the venular walls which had an area of 1.57 x 10(4) microns(2). Therefore, the number of WBC's emigrating from the vascular compartment during the 6-hour observation period could be as many as 0.51 X 10(9)/kg. Based on known values for total stores of WBC's, the data suggest that granulocyte sticking and emigration could account for a consumption of granulocytes that on an acute basis could deplete the body stores, which could explain the apparent decrease in total body granulocytes seen clinically following major thermal trauma.

Determination of prekallikrein in plasma by means of a chromogenic tripeptide substrate for plasma kallikrein

A method for plasma prekallikrein determination utilizing a chromogenic tripeptic substrate is presented. The method has a good reproducibility and can easily be automized. Several parameters have been optimized. By using mixtures of deficient plasmas and pooled normal plasma or purified factors it was proved that prekallikrein was the factor determined and that more than 10% (of normal plasma concentration) of FXII and HMW kininogen were essential for the activation of prekallikrein in our method. Further experiments showed that the method was fairly selective and was not influenced by inhibitors present in normal plasma. The later finding was attributed to the high dilution of plasma made possible by using a potent activator and a sensitive substrate.

Cylinder or mobile cast brace after knee ligament surgery. A clinical analysis and morphologic and enzymatic studies of changes in the quadriceps muscle

Sixteen patients participated in a prospective randomized trial in which a standard cylinder cast was compared with a mobile cast brace. Both were worn for 4 weeks, beginning at 1 week after reconstruction of the anterior cruciate ligament. The athletes that had used a cast brace could return to sports activities in about one-half the time it took for the athletes with a standard cast. The patients with a standard cast showed a significant atrophy of Type I (slow twitch) muscle fibers in the vastus lateralis. The cast brace patients did not show any significant changes in cross-sectional areas of Type I or Type II (fast twitch) muscle fibers. The standard cast patients had a significant reduction of succinate dehydrogenase (SDH) activity in the vastus lateralis whereas the patients with the cast brace did not show any significant changes. No difference in surgical end result was found. A cast brace with a limited range of motion between 20 and 60 degrees of flexion is recommended as the standard postoperative treatment after knee ligament surgery.

Experimental flap delay with formic acid

Using dorsal, cranially based 10 X 3 cm composite pedicle flaps in rats, the effects of an injection of 2 ml of formic acid in different concentrations was studied. Concentrations of 0.2 per cent gave a very significant increase in flap survival over controls. Preoperative penicillin did not influence the outcome.

Prevention of dermal ischemia after thermal injury

One percent methylprednisolone acetate was evaluated as a pharmacologic agent in the prevention of dermal ischemia following burning. Standardized partial thickness burns were inflicted on guinea pigs. Burned guinea pigs were separated into five groups; one was treated with topical steroid, one with systemic steroid, one with both, one with emollient base without steroid, and one served as an untreated control. Histology and depth of dermal ischemia were evaluated by india ink perfusion technique. Untreated controls showed progressive dermal ischemia with complete absence of india ink-filled vessels in the dermis by 24 hours. Topical steroid alone improved dermal perfusion as suggested by relative levels of india ink filling. Topical steroid in the dosage used does not potentiate infection in standard burn wound sepsis models. Preservation of dermal appendages was seen secondary to improved dermal microcirculation with a ninefold increase in hair follicles in treated guinea pigs compared with controls.

Methods for determination of prekallikrein in plasma, glandular kallikrein and urokinase

New chromogenic tripeptide substrates have been used for the determination of kallikreins and urokinase. The conditions have been optimized. It is possible to determine prekallikrein in plasma after activation with Cephotest. No significant loss in activity caused by plasma kallikrein inhibitors is observed at the dilutions used.

Hepatitis B immune globulin in prevention of hepatitis B among hospital staff members

In a double-blind trial of hospital staff members at risk of contracting hepatitis B, 110 subjects received hepatitis B immune globulin or immune serum globulin prophylactically. An additional 125 individuals working in the same locations were unwilling to participate in the trial and received no prophylaxis. During the study period of 28 months, 13 cases of clinical hepatitis B occurred in the untreated group, whereas only three cases occurred among the subjects who received prophylaxis.

Active immunization against tetanus in man. II. Combined active and passive prophylaxis with human tetanus immune globulin

19 Persons were actively immunized with adsorbed tetanus toxoid and were simultaneously given tetanus immune globulin of human origin, TIG(H), in doses of 500-1500 IU. Their antitoxin titres were followed for 1 year. Seven persons were given only TIG(H), 500 IU and 1500 IU and their antitoxin titres were followed for 3 months to 1 year. For comparison, 30 military recruits were actively immunized with adsorbed tetanus toxiod according to common practice. Their antitoxin titres were followed for 1 year. The response to complete active immunization could not be demonstrated to be impaired by passive immunization, when 500 IU or 1500 IU OF TIG(H) were given simultaneously with toxoid. The titres were in accordance with those achieved by active immunization of the recruits.

Hydrophobic surface properties of erythrocytes studied by affinity partition in aqueous two-phase systems

Erythrocytes from various species have been partitioned in aqueous two-phase systems consisting of water, dextran, poly-(ethylene glycol), salt and buffer. The terminal hydroxyl groups of the latter polymer were esterified with palmitic, oleic, linoleic and linolenic acids, as well as with deoxycholic acid. In a two-phase system containing unesterified poly(ethylene glycol) the erythrocytes are exclusively in the dextran-rich lower phase. When the poly(ethylene glycol)-rich upper phase depending on the type and concentration of esterified acid. Palmitate ester is most effective in increasing the affinity of the cells for the upper phase, followed by oleate, linolate, linolenate, and deoxycholate esters. The partition behaviour of erythrocytes from various species differs considerably. Two groups can be distinguished: one consisting of erythrocytes from dog, guinea pig and rat, the other from human, sheep and rabbit. This division can be correlated to the content of sphingomyelin and phosphatidyl choline in the erythrocyte membranes.

Ski injuries in Sweden: a one year survey

In a study of ski injuries in Sweden in 1973-1974, information regarding 1199 ski injuries was obtained. Downhill skiing was responsible for 75 per cent of the injuries. Cross country skiing proved to be a safe sport. Poor adjustment of release bindings, skiing at too high a speed, and deficiencies in the slopes were the most common causes of injury. The investigation led to an information program that seems to have reduced the injury rate by 25 to 30 per cent.

Reconstruction of the anterior cruciate ligament

A report is given of a personal series of 72 cases of injury of the anterior cruciate ligament, reconstructed by use of modifications of the Jones procedure. After one year, stability of the knee without a drawer sign was obtained in 80 per cent of the cases.

Hepatitis B immune serum globulin and standard gamma globulin in prevention of hepatitis B infection among hospital staff: a preliminary report

In May 1973 a controlled double-blind clinical trail with prophylactic injects of hepatitis B immune serum globulin (antibody titer by passive hemagglutination 1:355,000) and standard gamma globulin (1:100) was started in Sahlgren's Hospital, Göteborg, Sweden. The annual attack rate of clinical hepatitis B in the three departments studied had been 5 to 8 per cent during recent years. A total of 118 members of the hospital staff were prophylactically treated while 125 staff members were unwilling to participate and received no prophylactic treatment. During the first 20 months of study nine cases of clinical hepatitis B with jaundice occurred within the untreated group (7.2 per cent) while three cases (2.5 per cent) were observed in prophylactically treated individuals. After decoding it was found that 60 individuals had received specific hepatitis B immune serum globulin while 58 had received standard gamma globulin. Two of the three clinical cases of hepatitis B occurred within the standard gamma globulin group. Both groups included two individuals with transient antigenemia only and the standard gamma globulin group also included four individuals with antibody seroconversion.

Varicose ulcers

The results of a combined dermatological and surgical treatment of varicose ulcers was studied in 100 patients. This chronic disease, often persisting for decades, was halted in 90 percent of leg operated upon. Even when the general outcome of the treatment was favourable, it was found that, for 5 out of the 12 ulcers which were the same or larger in size at follow-up than before operation, the patient assessed the result as good or even excellent. This finding deserves further study. It indicates that patients and physicians sometimes use different standards by which to measure therapeutic success.

Active immunization against tetanus in man. I. Duration of anamnestic reaction after one dose of vaccine

Fifteen men, 30-40 years old, who had received one dose of vaccine against tetanus, were given a booster dose 8-13 years later. Their serum content of tetanus antitoxin was determined (1) before the booster dose, (2) 3-4 days and (3) 8 days after the booster dose. A control group of ten men with 2-3 earlier vaccine injections was treated in the same way. All the men in the first group had an antitoxin content of 0.01 IU/ml or more, 8 days after the booster dose, while the comparative titres increased to more than 1 IU/ml in the control group. The advantage of a complete basic immunization is obvious, but the investigation shows that, even after one injection, the titre after a booster dose increased to a generally accepted protective level.