Pluronic F-127 gel preparation as an artificial skin in the treatment of third-degree burns in pigs.

A blinded study was designed to provide qualitative and quantitative evaluation on the possible therapeutic benefits of the use of Pluronic Polyol F-127 as a substitute skin in standardized third-degree thermal burns. Three separate burns, approximately 1600 mm2, were induced on the shaved backs of young, anesthetized pigs. Each animal served as its own control. One burn site was left untreated while the other two sites were covered with coded preparations of the Pluronic F-127 gel with additives. Polaroid photographs with a fixed focal-length camera were taken of all burn sites for planimetry analysis. Biopsies taken confirmed that third-degree burns were achieved. The pigs were followed for 30 days. The rate of healing of third-degree thermal burns was significantly accelerated over control sites when treated with Pluronic Polyol F-127 plus propylene glycol. When the bacteriostatic agent Garamycin was also added, the rate of healing remained significantly better than untreated controls. With the addition of Piracetam, burn wound healing was actually retarded within 30 days, when applied topically. Thus, wound healing was both accelerated and retarded as a function of the particular Pluronic preparation used to treat specific burn sites. This experimental modulation of wound healing suggests that the non-ionic poloxamer, Pluronic F-127, can significantly enhance the rate of wound healing by some unknown mechanism, possibly by stimulation of epithelial growth factor (EGF).

A simplified plan for follow-up of patients with colon and rectal cancer supported by prospective studies of laboratory and radiologic test results.

Reports of prolonged survival in patients with recurrent colon or rectal cancer following a reoperative surgery suggest that early diagnosis of locally persistent or limited metastatic disease may save some patients. To determine which laboratory and radiologic tests were useful, a prospective comparison of all currently available modalities was begun in 1978. Sixty-six patients at high risk for recurrent large-bowel cancer were studied. At present, mean follow-up is at 4 1/2 years. Protocol studies included monthly carcinoembryonic antigen (CEA) assays for 3 years and then at 3-month intervals for 2 more years. A review of symptoms and a physical examination were performed every 4 months for 3 years and then every 6 months for 2 more years. Computerized tomograms of the abdomen, full lung tomograms, and liver/spleen scintigrams were obtained every 4 months for 3 years and then annually for 2 more years. Intravenous pyelography, barium enema, and bone scintigraphy were performed yearly for 5 years. Thirty-three recurrences were observed in 31 patients. A progressive rise in serial CEA values was the first indication of recurrence in 22 of 33 patients (67%), review of symptoms and physical examination in seven of 33 (21%), CT scan in two of 33, and bone scintigraphy and full lung tomography each in one of 33 patients. Serial CEA assays and routine visits to a physician's office were the most useful tests in this study population. Use of a simplified follow-up plan will result in the earliest detection of recurrent colon cancer.