A Prospective, Multicenter, Pilot Trial Of A Novel Homologous Skin Construct On Deep Partial-Thickness And Full-Thickness Burns.

Split-thickness skin grafting (STSG) is the standard of care for treating deep burns. They often contract, have unpredictable cosmetic outcomes, lack dermal appendages, and result in painful, conspicuous donor sites. An autologous homologous skin construct (AHSC) has been shown to produce full-thickness skin architecture. This study examined the safety profile, engraftment, and quality of healing of a pilot group of AHSC-treated burn wounds. Following IRB approval and informed consent, patients with deep-partial/full-thickness burns requiring grafting underwent side-by-side treatment with AHSC and STSG. A 2 cm2 fullthickness harvest was processed into AHSC at an FDA-registered facility, returned within 48 hours, and applied to a 4 cm2 area alongside a STSG. AHSC donor site was closed primarily. Wounds were evaluated for healing with digital photography and investigator assessments for 90 days. All adverse events (AEs) were recorded. Eight patients with average 13.3% TBSA [range 2-58%] burn wounds were treated: 5 Caucasian and 3 African American with an average body mass index (BMI) of 26.8. Injury was due to predominantly flame burn, with additional injury from grease, scald, contact, friction and flash. Mean time between injury and AHSC treatment was 11 days [range 5-35 days]. All patients had adequate engraftment and complete epithelialization by the end of the study. Patients required one application of AHSC and no other additional surgical procedures at the application sites. The most common AEs for STSG-treated wounds included hypertrophic scarring and pruritus. One non-infected AHSC harvest site experienced a dehiscence. There were no other AEs related to AHSC treatment. AHSC treatment is feasible in deep partial and fullthickness burn wounds warranting additional investigation.

La greffe dermo- épidermique (GDE) est le traitement de référence des brûlures profondes. La zone traitée est sujette aux brides, n'a pas d'appendices dermiques, a un aspect esthétique aléatoire et le site donneur est indéniablement douloureux. Un hybride cutané autologue- homologue (HCAH) a montré être architecturalement proche de la peau. Cette étude a pour but d'évaluer l'innocuité, la qualité de prise et la qualité cicatricielle obtenues sur un groupe pilote de brûlés profonds. Après autorisation des tutelles et consentement éclairé, les patients, nécessitant une greffe ont reçu, côte à côte, une GDE et un HCAH. Ce dernier est préparé à partir d'un prélèvement de 2 cm² de peau totale (auto- fermant), en 48 h, dans une structure approuvée par la FDA. On obtient une structure de 4 cm², installée à côté d'une GDE. Les brûlures ont été évaluées cliniquement et photographiées pendant 90 j. Tous les événements indésirables (EI) ont été répertoriés. Huit patients brûlés sur 13,3 % (2-58) de SCT ont été inclus. Il s'agissait de 5 blancs et 3 noirs (je dois traduire même ceci, qui me semble foncièrement non éthique- NDRLF) ayant un IMC de 26,8. Les brûlures étaient liées à un flamme mais aussi à de la graisse, par ébouillantement, contact, flash ou dermabrasion. Le délai moyen de mise en place de l'HCAH était de 11 jours (5-53). L'intégration de la greffe a été bonne et tous les patients étaient cicatrisés à la fin de l'étude, sans nécessité de nouvelle greffe. Les EI les plus fréquents observés sur les zones GDE étaient des cicatrices hypertrophiques et un prurit. Une zone HCAH s'est désunie (hors infection), seul EI observé dans ce groupe. L'HCAH semble utilisables sur les brûlures profondes et doit être étudié plus avant.

Heterogeneous nuclear ribonucleoprotein complexes from Xenopus laevis oocytes and somatic cells.

HnRNP proteins have been implicated in most stages of cellular mRNA metabolism, including processing, nucleocytoplasmic transport, stability, and localization. Several hnRNP proteins are also known to participate in key early developmental decisions. In order to facilitate functional studies of these pre-mRNA- and mRNA-binding proteins in a vertebrate organism amenable to developmental studies and experimental manipulation, we identified and purified the major hnRNP proteins and isolated the hnRNP complex from Xenopus laevis oocytes and somatic cells. Using affinity chromatography and immunological methods, we isolated a family of >15 abundant single-stranded nucleic acid-binding proteins, which range in apparent molecular weight from approximately 20 kDa to >150 kDa, and with isoelectric points from <5 to >8. Monoclonal antibodies revealed that a subset of these proteins are major hnRNP proteins in both oocytes and somatic cells in culture, and include proteins related to human hnRNP A2/B1/B2 and hnRNP K. UV crosslinking in living cells demonstrated that these proteins bind poly(A)+ RNA in vivo. Immunopurification using a monoclonal antibodyto X. aevishnRNPA2 resulted in the isolation of RNP complexes that contain a specific subset of single-stranded nucleic acid-binding proteins. The protein composition of complexes isolated from somatic cells and from oocyte germinal vesicles was similar, suggesting that the overall properties and functions of hnRNP proteins in these two cell types are comparable. These findings, together with the novel probes generated here, will also facilitate studies of the function of vertebrate RNA-binding proteins using the well characterized X. laevis oocyte and early embryo as experimental systems.

Reduced passage of alpha 2-macroglobulin into malignant serous effusions and diminished antifibrinolytic potential of the fluid.

The ratio of the relative concentrations of large and small proteins between effusions and serum was measured in patients with benign and malignant effusions. The ratio of values for a large protein, alpha 2 macroglobulin (alpha 2 M) was significantly (p less than 0.0005) lower in the 22 patients with tumoral effusion (0.436 +/- 0.016) and in the 16 patients with transudates (0.388 +/- 0.017) than in the 21 cases with inflammatory exudates (0.838 +/- 0.036) while the ratios between relative concentrations of the lower molecular weight alpha 1 antitrypsin (alpha 1AT) in serous fluids and sera were similar (close to 1.0) in all the above mentioned conditions. Most inflammatory exudates inhibited fibrinolysis in a urokinase activated system, while the activity of the inhibitors of fibrinolysis was very weak in tumoral effusions and in transudates. These findings suggest a rather selective passage of plasma proteins into a tumoral effusion, a fact that might be relevant for a pathogenic diagnosis.

[Dynamics of the composition of lipids in human milk during lactation]. / La dynamique de la composition des lipides du lait humain au cours de la lactation.

The authors have studied the total lipids, triglycerides and cholesterol in the milk of 30 mothers over a lactation period of 4 days to 10 months. The total lipids showed diurnal oscillations with a minimal level in the morning and maximal level (P less than 0.001) at 1 p.m. and a slight decrease in the evening, without reaching the levels found in the morning. The lipid concentration in the milk decreases after 4 months of lactation. The oscillations of the lipids take place on the expense of the triglyceride content (r = 0.99). Cholesterol represented on the average 1.54% of the lipid content, showed a maximum level at a month and decreased after 6 months of lactation. The dynamics of lipid composition of the human milk suggests a physiologic significance in the development of the infant.