Biomedical subjects

D L Feldman

Publications and source records attributed to D L Feldman.

7 recordsLinked to original sources

PubMed1991

Which dressing for split-thickness skin graft donor sites?

There is currently little agreement among surgeons regarding the dressing of choice for split-thickness skin graft donor sites, though many are available. In this article, I review the five major groups of dressings, open, semiopen, occlusive, semiocclusive, and biological. The different dressings in each group are described in terms of physiological basis for use, advantages, disadvantages, and practical application. Conclusions are reached regarding which donor site dressings might come closest to optimal for common clinical situations.

Bandages↗

PubMed1991

A prospective trial comparing Biobrane, Duoderm and xeroform for skin graft donor sites.

Many new dressings have been introduced for use on split-thickness skin graft donor sites in an effort to reduce pain at the donor site and decrease healing time, while maintaining a low infection rate and cost. To assess these factors in two such dressings, Biobrane (temporary wound dressing) (Winthrop) and Duoderm (hydrocolloid dressing) (Convatec), we compared them with a conventional fine mesh gauze dressing, xeroform, in a prospective, randomized study of 30 donor sites in the same number of patients. Wounds were considered healed when they were 100 per cent re-epithelialized and required no further dressings. Patient self-assessment of pain was quantified on a scale of zero to ten, with ten being the most severe pain. Donor sites dressed with xeroform had a healing time of 10.5 days, which was significantly better (p less than 0.05) than Duoderm (15.3 days) or Biobrane (19.0 days), although the protocol for Duoderm use (wound visualization at seven day intervals) extended the apparent healing times in this group. Duoderm was the most comfortable dressing (0.53 grade) when compared with Biobrane (1.44) and xeroform (2.41, p less than 0.05). No infections occurred in donor sites dressed with xeroform, but two developed in patients using Biobrane. One patient with a Duoderm dressing had a donor site infection during a drug-related neutropenic reaction. Xeroform was the least expensive dressing to use ($1.16 per patient), followed by Duoderm ($54.88 per patient) and Biobrane ($102.57 per patient). The results of our study confirm the usefulness of xeroform as a donor site dressing as it promotes relatively rapid healing, is easy to use and is inexpensive. We found Duoderm to be ideal for smaller donor sites when pain could be significantly reduced with minimal increase in cost. Biobrane is too costly and the infection rate too high for it to be used routinely as a skin graft donor site dressing.

Bandages↗

PubMed1987

Use of Histopaque for isolating mononuclear cells from rabbit blood.

This paper describes the use of Histopaque (Hp) density gradient medium and its advantage for separating mononuclear cells (mnc) from rabbit blood. Hp solutions of density (d) = 1.083 g/ml, 1.119 g/ml and 1:1 mixture of these solutions (final d = 1.103 g/ml) were compared to Ficoll-Paque (Fp, d = 1.077 g/ml) and Lymphopaque (d = 1.086 g/ml). The average leukocyte recovery was: Fp = 26% and Lp = 17%, while that with Hp was: Hp d = 1.083: 41%; Hp d = 1.119: 43%; Hp d = 1.103: 57%. Optimum mnc recovery (76%) was obtained with Hp d = 1.103. Average mnc purity for the various media was: Fp = 88% mnc; Lp = 91%mnc; Hp d = 1.083: 94% mnc; Hp d = 1.119: 93%; Hp d = 1.103: 94% mnc. Contamination was mainly from basophils. Viability was greater than 95% in all cases. Thus, Hp density gradient media provide increased recoveries of mnc from rabbit blood compared to Fp and Lp, while purity is not affected. Rabbit mnc appear to be denser than human mnc, which are recovered in greater numbers using Fp.

Animals↗

PubMed1983

An ACTH-induced renal glomerular lesion in the mouse: immunofluorescence microscopy.

Mice were injected with adrenocorticotropic hormone (ACTH) and the glomerular lesion that was induced was studied by light and immunofluorescence microscopy. By light microscopy, kidneys from ACTH-treated mice showed typical ACTH-induced glomerular lesions. Immunofluorescence of kidneys from ACTH-treated mice revealed intense staining for IgG and IgM in the extraglomerular mesangium (EGM), in Bowman's space, and in the ascending thick limb of Henle near the macula densa. Staining for immunoglobulins was unchanged after treatment with acid buffer. Immunoreactivity for complement (C3) was confined largely to the EGM and Bowman's space. Staining for albumin was almost exclusively in Bowman's space or the peripheral glomerular tuft in discrete aggregates. The above patterns of IgG, IgM, C3 and albumin were seen in control mice, although much less frequently. The results show that in mice, treatment with ACTH results in the increased accumulation of plasma proteins in the juxtaglomerular apparatus (JGA). This effect may reflect a role for the JGA in the normal clearing of plasma proteins from the glomerulus and/or directly from the blood.

Adrenocorticotropic Hormone↗

PubMed1981

The development of an acth-induced renal glomerular lesion in Mus musculus. An ultrastructural study.

Male house mice (Mus musculus) were injected with 4 international units of ACTH daily for 1, 2, 3 and 4 weeks and with four units daily for four weeks followed by 8 units for 8 days. Light microscopy of kidneys showed a glomerular lesion characterised by the expansion of the mesangium, deposition of PAS positive material in the glomerular mesangium and extraglomerular mesangium hypertrophy of juxtaglomerular cells and a successive increase in oil red-O staining material in the glomerulus. Electron microscopy revealed the progressive accumulation in the mesangial matrix of three morphologically distinct forms of deposits: amorphous, globular and particulate. The accumulation of amorphous deposit apparently is partially responsible for the increased PAS positive staining of the mesangium. Globular (and possibly particulate) deposit probably corresponds to the oil red-O positive material. The evidence suggests that the deposits are extraglomerular in origin, but their chemical nature is unknown.

Adrenocorticotropic Hormone↗

PubMed1969

Hyperthyroidism with periodic paralysis.

Hyperthyroidism may be associated with hypokalemic periodic paralysis. Two cases are presented demonstrating intermittent attacks of flaccid paralysis associated with clinical symptoms, signs and laboratory findings of hyperthyroidism. During an attack, one patient had a serum potassium of 2.1 mEq. per litre.Various factors such as trauma, exposure to cold, excessive carbohydrate ingestion and certain medications have been stated to precipitate an episode of paralysis. Attacks may range from mild weakness to generalized flaccid paralysis with loss of deep tendon reflexes. Several reported patients have died owing to cardiac arrest or respiratory paralysis.During attacks, the serum potassium is usually in the range of 2.2 to 3.2 mEq. per litre. It is postulated that a metabolic abnormality affecting the muscle-cell membrane can occur in the hyperthyroid state resulting in a shift of potassium to the intracellular position, thus producing a situation of hyperpolarization of the muscle-cell membrane which in turn alters the muscle contractibility.The importance of recognizing the unusual association of hypokalemic periodic paralysis with hyperthyroidism is stressed because, with successful treatment of the hyperthyroidism, the episodes of paralysis disappear.

Adult↗

PubMedDate not supplied

Leukocytosis in rabbits with diet-induced atherosclerosis.

In cholesterol-fed rabbits the extent of monocyte involvement in atherogenesis may be influenced by the level of circulating leukocytes during hypercholesterolemia. We characterized the leukocytosis in rabbits fed either a 0.25% or a 0.1% cholesterol-enriched diet (0.25% or 0.1% rabbits, respectively). Circulating leukocytes were elevated by 1 week of feeding, and the elevation was sustained for at least 30 weeks. Differential counts were unchanged. Immature leukocytes were not seen, indicating that the leukocytosis was not due to premature release of bone marrow cells. Animals were free of bacterial or parasitic disease; selected rabbits with leukocytosis had normal body temperatures. Spleen weights averaged at least 100% higher in 0.25% rabbits but did not show histological evidence for hematopoiesis that could account for the leukocytosis. At approximately 22 weeks there was a second rise in leukocytosis in bilirubinemic 0.25% rabbits, suggesting that in the late stages of hypercholesterolemia, leukocytosis is related to liver failure. Cholesterol-fed rabbits also showed thrombocytosis. Existing leukocytosis and hypercholesterolemia were reversed to pretreatment levels by switching the rabbits to chow diets. In bone marrow from 0.25% rabbits, the mean number of cells per gram was greater (p less than 0.05) than that from normocholesterolemic rabbits. In 0.25% rabbits, the fraction of blood mononuclear cells showing phagocytosis of immunoglobulin G-coated red blood cells did not differ from that of controls, suggesting an unchanged population of these cells with regard to Fc and phagocytic function during hypercholesterolemia. These data suggest an effect (direct or indirect) of hypercholesterolemia on the production of leukocytes in the bone marrow and/or on the circulation kinetics of leukocytes in the blood.

Animals↗