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Biomedical subjects

H Slater

Publications and source records attributed to H Slater.

At least 19 recordsLinked to original sources

Absence of satellite III DNA in the centromere and the proximal long-arm region of human chromosome 14: analysis of a 14p- variant.

Cytogenetic methods and molecular probes derived from the centromere and short arm of chromosome 14 were used to investigate the structural properties of a chromosome 14 variant. Results of GTL, CBG, Ag-NOR, and non-banded Giemsa staining of the chromosomes suggested the complete absence of the short arm and possibly a large part of the centromere. Negative in situ hybridisation with an alpha satellite III probe confirmed the absence of the arm; the detection of normal amounts of alpha satellite DNA, however, indicated retention of the centromeric domain. The natural occurrence of a human acrocentric variant lacking a short arm was thus established. Within the detection limits of the methods used, the results demonstrate that satellite III DNA is not essential for normal centromeric activity and allow us to exclude the presence of this satellite DNA within the centromere and proximal long-arm region of human chromosome 14.

Centromere

Chondritis of the burned ear: a review.

Seventy-six patients with burns of the ears presented to the Western Pennsylvania Hospital Burn Trauma Center over a three year period. To prevent chondritis, all ears were treated prophylactically with periauricular hair shaving, daily cleaning, avoidance of pressure dressings and Sulfamylon Burn Cream. Chondritis developed in two patients. Aspects of auricular chondritis prevention and treatment are reviewed. Biology of the disease is discussed.

Burns

Influences of different resuscitation regimens on acute early weight gain in extensively burned patients.

Dissatisfaction with the massive weight gain that commonly followed crystalloid resuscitation of extensively burned patients dictated the need for a study to determine if acute weight gain could be minimized with an alternative form of resuscitation. Three groups of ten patients each with statistically similar age and burn size (mean BSA 46 per cent) were resuscitated with lactated Ringer's solution (LR), hypertonic saline solution (HPT), or fresh frozen plasma (FFP). The volume of infused fluid and the patient weight gain were measured over the first 48 h of treatment. The mean urine output of the three groups was comparable (P greater than 0.05). The volume of infused resuscitation fluid to maintain urine output was a mean of 4.8 ml/kg/per cent BSA in the LR group, 3.16 in the HPT group and 2.68 in the FFP group. The difference in infusion rate between the FFP group and the LR group was statistically significant (P less than 0.01). All patients gained weight with resuscitation. The median percentage weight gain at the end of the first day of treatment was 10.69 per cent in the LR group, 7.88 per cent in the HPT group and 2.38 per cent in the FFP group. Weight gain at the end of the second day of treatment was 13.9 per cent in the LR group, 11.99 per cent in the HPT group, and 4.37 per cent in the FFP group. The differences between FFP, HPT and LR groups were statistically significant (P less than 0.01). In our study the use of fresh frozen plasma for resuscitation of extensively burned patients has been associated with minimal weight gain and minimal oedema. We believe that fresh frozen plasma resuscitation is an attractive alternative to crystalloid infusion and that further comparative studies should be performed.

Acute Disease

Transparent polyurethane (Omiderm) dressing for free flaps.

A transparent polyurethane dressing (Omiderm) for free flaps is presented. Considering the importance of reliable flap monitoring postoperatively, this synthetic membrane allows for constant ability to observe the flap, assess the capillary filling, and detect the blood flow with an ultrasound Doppler device.

Bandages

Penetration of antibiotics through omiderm in vitro and on split-thickness skin grafts in burn patients.

Penetration of antibiotic preparations (gentamicin, neomycin, silver sulfadiazine, mupirocin) through Omiderm, a synthetic wound covering, was tested in vitro and in 5 patients with full-thickness burns who had undergone tangential excision and split-thickness skin grafting. All antibiotic preparations tested penetrated both meshed and unmeshed Omiderm. Omiderm did not affect the zones of inhibition of antimicrobial activity as compared with controls.

Absorption

From hopeful to hopeless ... when do we write "do not resuscitate"?

The issue of do not resuscitate (DNR) decisions has been the subject of much discussion in the medical literature. To try to understand the factors that may be determinants of the timing of DNR decisions, we reviewed the charts of 70 consecutive burned patients who died between 1986 and 1988. When a DNR decision was written, it was within 48 hours of the patient's death (74% of patients). No statistical difference was found in the sex distribution or in the percentage of body surface area burned in the DNR group and in the resuscitation group. Physicians, nurses, social workers, the hospital attorney, the district attorney, and the coroner of our county were interviewed. The uncertainty of legal guidelines and practical considerations of family expectations preclude a uniform approach to this problem.

Adult

Eidetic-like imagery in hypnosis: rare but there.

The production of eidetic-like imagery during hypnosis in subjects with high but not low hypnotizability was supported in three separate experiments using nonfakable stereograms (Julesz, 1971; Gummerman, Gray, & Wilson, 1972). In Experiment 1, 6 (25%) of 24 stringently chosen, high hypnotizables were able to perceive one of the superimposed stereograms (presented monocularly) during conditions of standard hypnosis or hypnotic age regression, or under both conditions, but not during waking. In Experiments 2 and 3, low and high hypnotizables were presented stereograms in an alternating, monocular fashion (one-half to each eye). In Experiment 2, 10% of the high hypnotizables perceived one or more stereograms in hypnosis or age regression, but not during waking. In Experiment 3, none of the 17 low hypnotizables reported correct stereograms, but 6 of the 23 high hypnotizables (26%) did. Relationships between imagery performance and visuo-spatial abilities were investigated. Results support the general hypothesis that hypnosis enhances imaginal processing of information to be remembered that is a literal or untransformed representation.

Eidetic Imagery

[Giant duodenal diverticula with heterotopic gastric mucosa. Its demonstration with technetium 99].

The duodenal diverticulum, except for occasional findings, are diagnosed by their complications, these are found in 10% of the cases and they are: 1) diverticulitis 2) haemorrhage 3) mechanic disturbances 4) perforation 5) obstruction 6) malabsorption syndrome. The case that motivated our communication appeared as a massive haemorrhage, that was medically treated considering the high mortality, rate of the surgical procedures. As the duodenal diverticuli can be cause of acute or chronic digestive haemorrhage, and this is frequently due to the erosion produced, by the heterotopic gastric mucosae, we consider that its demonstration with technetium 99 can be a valuable diagnostic method, as has already been demonstrated in other pathologies that present heterotopic mucosae, and as has been demonstrated in our case.

Diverticulitis

Direct inoculation procedure for the rapid classification of bacteria from blood culture.

A procedure was developed for 4-h identification of bacteria from blood culture. From a turbid blood culture bottle a 10- to 15-ml aliquot was drawn off and centrifuged. The pellet was utilized to inoculate a series of enzymatic and physiologic reactions. Three hundred eight positive blood cultures were tested including 222 strains of Enterobacteriaceae, 40 strains of facultative grampositive cocci, 26 strains of anaerobes, and 20 assorted strains. There was over 96.5% agreement between 4-h and conventional methods with the Enterobacteriaceae, 98% with facultative gram-positive cocci, 100% with anaerobes, and 99% with the assorted strains.

Bacteria

Inhalation injury with burns: a lethal combination.

Inhalation injury is known to add significant morbidity and mortality to patients with burns. Estimating the severity of inhalation injury is difficult, as signs of respiratory failure may occur hours or even days after the injury. We have reviewed 86 consecutive patients who were admitted to our Burn/Trauma Center with burns and evidence suggestive of smoke inhalation. Of these patients, 88% required endotracheal intubation. There was a 62% mortality. Admission chest x-rays studies, PAO2, and auscultation of the patient's lungs were normal in 90% of the study group. These factors could not be used to predict respiratory failure or death. Patients with as little as 15% total body surface burns with mild smoke inhalation are at significant risk of respiratory failure and the need for ventilatory support.

Adolescent