[In-vitro suspension model of haemangioma vascular endothelial cells (HVECs)]. / Hemangioma Vascular Endothelial Cells (HVECs) im In-vitro-Modell.

INTRODUCTION: Haemangioma is the most common tumour of infancy. Its biological behaviour is one of a benign nature and characterised by a typical biphasic growth pattern. After an initial proliferation during the child's first year of life an involution takes place and usually lasts until the first decade. The expression of cellular and extracellular markers as well as cytokines follows its biphasic growth. In-vitro models reported so far have provided new insights in the tumour's biology and have identified possible targets for pharmacological agents. PURPOSE: Our study should enhance the functionality of current in-vitro models in establishing a suspension model of isolated proliferating haemangioma vascular endothelial cells (HVECs). MATERIAL AND METHODS: Tissue samples isolated from four haemangiomas (H1-H4) during the proliferation phase were cultivated in four different ways: H1 was cultivated in an MCDB-131 medium whereas for the H2 samples EGM2-MV medium was used. In the H3 series dispase enabled an immediate isolation of pure HVECs from the tissue sample which were cultivated under EMG2-MV medium. In the similarly cultivated H4 series an isolation of cultivated HVECs was enabled by the use of magnetic bead separation which finally led to a suspension model of isolated HVECs. RESULTS: In all four series HVECs were cultivated successfully. Depending on the selected medium different growth rates were observed. The use of dispase and the magnetic bead separation technique resulted in an isolation of cultivated HVECs which was documented in haematoxylin/eosin staining as well as under CD-31 immunohistochemistry. CONCLUSIONS: Research on tumour-specific processes as well as possible pharmacological targets necessitates a stable in-vitro model of proliferating HVECs. For our purposes, the described suspension model of HVECs fulfills the requirements of further research on antiproliferation and anti-angiogenesis.

Isolated cytochrome c oxidase deficiency as a cause of MELAS.

BACKGROUND: MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes) is one of the more common mitochondrial encephalomyopathies. About 80% of MELAS cases are caused by transition 3243A-->G in the mitochondrial tRNA(Leu(UUR)) gene (MT-TL1). Other mutations in MT-TL1, other mitochondrial tRNA genes and mitochondrial-encoded subunits of respiratory complex I account for the remainder of cases. OBJECTIVE: To characterise the molecular basis of a MELAS case without a mutation in any recognised MELAS target gene. RESULTS AND METHODS: Deletion of a single nucleotide (7630delT) within MT-CO2, the gene of subunit II of cytochrome c oxidase (COX), was identified by mitochondrial DNA (mtDNA) sequencing. The deletion-induced frameshift results in a stop codon close to the 5' end of the reading frame. The lack of subunit II (COII) precludes the assembly of COX and leads to the degradation of unassembled subunits, even those not directly affected by the mutation. Despite mitochondrial proliferation and transcriptional upregulation of nuclear and mtDNA-encoded COX genes (including MT-CO2), a severe COX deficiency was found with all investigations of the muscle biopsy (histochemistry, biochemistry, immunoblotting). CONCLUSIONS: The 7630delT mutation in MT-CO2 leads to a lack of COII with subsequent misassembly and degradation of respiratory complex IV despite transcriptional upregulation of its subunits. The causal association of the resulting isolated COX deficiency with MELAS is at odds with current concepts of the biochemical deficits underlying this common mitochondrial disease, and indicates that the genetic and pathobiochemical heterogeneity of MELAS is greater than previously appreciated.

[Use of V.A.C. Therapy in the surgical treatment of severe burns: the Viennese concept]. / Einsatz der V.A.C.-Therapie in der Behandlung Schwerbrandverletzter: Das Wiener Konzept.

INTRODUCTION: General principle in the treatment of severe burns is early wound closure. A good take of split-thickness-skin-grafts is essential for fast wound healing and thereby for the outcome of the patient. The aim of the study was to evaluate the impact of V.A.C. therapy in the field of acute burn surgery. PATIENTS AND METHODS: All patients of the Vienna burn centre who were treated with V.A.C. between 2004 and 2006, were evaluated concerning burn surface area, burn degree and outcome. RESULTS: 28 out of 29 patients, suffering from deep dermal and full thickness burns, were discharged with complete wound closure, only one patient died. CONCLUSION: In our opinion, split-thickness skin-fixation by using V.A.C. therapy is suitable for moist and irregular wound surfaces, for areas exposed to movements and especially for the treatment of older patients with co-morbidities.

Base deficit and lactate: early predictors of morbidity and mortality in patients with burns.

Severe burn results in severe and unique physiological changes called burn shock. Historically, resuscitation has been guided by a combination of basic laboratory values, invasive monitoring and clinical findings, but the optimal guide to the endpoint of resuscitation still remains controversial. Two hundred and eighty patients, who were admitted to our Burn Unit, were enrolled in this prospective study. Resuscitation of these patients was undertaken according to the current standard of care. Parkland formula was used as a first approximation of acquired fluid administration rates; final fluid administration was adapted in order to meet clinical needs. The aim of this study was to evaluate if plasma lactate (PL) and base deficit (BD) are useful early parameters to estimate the severity of a burn. One of the main objectives was to evaluate if BD and its changes due to fluid resuscitation adds additional information in comparison to the evaluation of PL alone. The results of this study indicate that initial PL and BD level (Day 0) are useful parameters to separate survivors from non-survivors. Moreover, an outcome predictor of shock and effective resuscitation could be defined by evaluating the changes of BD on Day 1. Normalization of the BD within 24 h is associated with a better chance of survival. One explanation for this phenomenon might be the fact that many burn patients are still sub-optimally resuscitated; in summary, measuring PL and BD may help to identify critically injured patients either for enhancement of treatment, or selection of therapeutic options.