ABSTRACT
BACKGROUND: The present study was undertaken to investigate the effect of denervation on leukocyte function in soft-tissue infection in an isolated in vivo ovine flap model. METHODS: Fifteen adult ewes were divided into three groups. An island pedicle flap was raised on the right buttock. In group I (no denervation), the cutaneous nerve remained intact, whereas in group II (acute denervation) the nerve was divided acutely. In group III (prolonged denervation) the nerve was divided 7 days before flap elevation. All flaps received intradermal inoculation of 10(7) Staphylococcus aureus, and the animals were observed for 96 hours. RESULTS: In both groups II and III, the leukocyte chemiluminescence and chemotaxis were significantly decreased when compared with group I. Furthermore, there was profound impairment of leukocyte functions in group III compared with group II. Group III also had significantly higher bacterial counts, larger septic foci, lower viable leukocyte ratios, and decreased bacterial killing compared with group I. CONCLUSIONS: Denervation, particularly over a period of time, results in increased bacterial growth of soft-tissue septic foci. This appears to be due to decreased leukocyte function resulting in diminished bacterial killing.
Subject(s)
Buttocks/innervation , Buttocks/physiopathology , Leukocytes/physiology , Staphylococcal Infections/physiopathology , Animals , Buttocks/microbiology , Buttocks/pathology , Chemotaxis, Leukocyte , Colony Count, Microbial , Denervation , Female , Leukocyte Count , Leukocytes/pathology , Luminescent Measurements , Nervous System/physiopathology , Neutrophils/physiology , Sheep , Staphylococcal Infections/microbiology , Staphylococcal Infections/pathologyABSTRACT
The effect of topical recombinant murine and human GM-CSF, 1 or 10 micrograms/cm2 for one to ten days, on the contraction and healing of acute and chronic granulating wounds infected with Escherichia coli was studied in Sprague-Dawley rats. Bacterial contamination of wounds produced significant inhibition of wound contraction. Application of GM-CSF at either dose level to infected wounds markedly increased the rate of wound closure compared to the rate in infected untreated controls. Ten days treatment was found to be more effective than a single application. An advanced stage of wound healing was observed at ten days in the GM-CSF-treated rats compared with controls. Bacterial counts decreased in the GM-CSF-treated wounds which may suggest bactericidal activity. Topical treatment with GM-CSF was shown to effectively inhibit the retardation of wound closure produced by bacterial contamination and may therefore be useful in the management of patients with infected wounds.
Subject(s)
Escherichia coli Infections/drug therapy , Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology , Wound Healing/drug effects , Wound Infection/drug therapy , Administration, Topical , Analysis of Variance , Animals , Disease Models, Animal , Granulocyte-Macrophage Colony-Stimulating Factor/administration & dosage , Rats , Rats, Sprague-Dawley , Recombinant Proteins/pharmacologyABSTRACT
The success of a centralized decedent affairs office depends on support by clinicians, the department chairman, and hospital administration. The benefits to the institution include improved public relations with a decedent's family, compliance with state and federal laws, increased organ donations, and better risk management programs. The only drawback of establishing such an office is the additional personnel necessary for 24-hour coverage. However, modifications in the functions and staffing levels of a decedent affairs office may be made, depending on the needs of individual institutions. We hypothesized that consent for autopsy would be easier to obtain and cause less emotional upheaval for family members if procedures were well established and specially trained individuals were involved in the process. With these ideas in mind, we established a decedent affairs office at The University of Texas Medical Branch in 1984.
Subject(s)
Autopsy , Pathology Department, Hospital , Professional-Family Relations , Tissue and Organ Procurement , HumansABSTRACT
The vitreous humor from 11 patients with acquired immunodeficiency syndrome was obtained at postmortem examination and tested for human immunodeficiency virus antigen and antibody by using the Abbott enzyme-linked immunosorbent assay procedures. Five patients had detectable antigen, supporting the recent observation that the virus may directly infect the retina.
Subject(s)
Acquired Immunodeficiency Syndrome/immunology , HIV Antigens/analysis , Vitreous Body/microbiology , HIV Antibodies/analysis , HumansSubject(s)
Autopsy , Hospital Departments , Pathology Department, Hospital , Humans , Medical Records , Quality Assurance, Health Care , TexasABSTRACT
Mucormycosis is a mycotic disease caused by certain genera of the class Zygomycetes (order Mucorales). It is usually a rapidly progressive opportunistic infection characterized by vascular invasion, neutrophilic response, and intravascular thromboses. Entomophthoromycosis describes another disease caused by Zycomycetes, but of the order Entophthorales. In contrast to mucormycosis, entomophthoromycosis is not associated with underlying disease. Vascular invasion by the hyphae does not occur, and the hyphae are surrounded by eosinophilic sheathes. These sheathes are regarded as one form of the Splendore-Hoeppli phenomenon. The authors report an unusual case of mucormycosis in a severely pancytopenic patient dying of acute myelogenous leukemia. At autopsy, eosinophilic sheathes with radiating fibrils were seen about intravascular hyphae, simulating entomophthoromycosis. This pseudo-Splendore-Hoeppli phenomenon appears to be caused by adsorption of plasma and fibrin to the hyphal walls in the absence of both neutrophilic response and extensive fibrin clotting.