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Biomedical subjects

M M Mani

Publications and source records attributed to M M Mani.

At least 19 recordsLinked to original sources
PubMed1994

Effects of argon beam coagulation on split thickness skin graft survival in the swine model.

Argon beam coagulation (ABC) uses argon gas to evacuate blood in an operative field and simultaneously to transport a coagulating electric current to bleeding sites. This allows a 'no touch' method of coagulation which is faster, more precise, and less destructive than conventional electrocautery. The technique has been used to reduce blood loss in liver surgery, trauma surgery and neck dissections. In this study, the effect of ABC treatment of the recipient graft beds on the survival of split thickness skin grafts was assessed in pigs, testing the hypothesis that ABC treatment of the recipient bed would have no adverse effect on skin graft survival. Nine 20 kg mixed breed pigs had split thickness skin grafts raised on each side of the paraspinous area. The graft beds on one side were prepared using ABC and the contralateral side served as controls. The percentage of graft survival on the ABC treated sides was compared to control graft survival on the other side at 12 days postsurgery. Our results confirm the hypothesis that treatment of the recipient bed with ABC does not adversely affect the survival of split thickness skin grafts.

Animals↗
PubMed1992

Reconstruction of the burned lower extremity.

Many of the long-term sequelae and deformities are preventable by early wound closure and aggressive physical managements. Concurrent and associated injuries and medical problems may place a patient with lower extremity burn injury into different clinical subsets. The standard care may have to be modified to accommodate these differences. The scars, the deformities, and the morbidity have decreased dramatically with early aggressive care and physical management. When contractures and deformities are recognized early in the rehabilitation phase, many of these can be satisfactorily corrected by physical means. If the contractures cause functional limitations, surgical release is indicated. The donor defects of free grafts or flaps should not be more deforming than the original injury. The goal is to return the patient to society as normal in function and appearance as possible.

Acute Disease↗
PubMed1989

Postburn heterotopic ossification: insights for management decision making.

An analysis of 1,478 consecutive admissions to the University of Kansas Burnett Burn Center revealed 18 patients who developed heterotopic ossification (1.2% incidence). Seventeen patients developed this disease in the elbows; one patient had shoulder involvement. Two patients eventually developed bilateral elbow disease. All patients initially presented with pain and limitation of joint motion. The diagnosis was then confirmed radiographically. All patients suspected of heterotopic ossification received physical therapy consisting of active range of motion only. Ten patients responded to conservative treatment and regained functional range of motion, and eight patients developed refractory ankylosis requiring surgical management. All surgically managed patients achieved a functional range of motion with an average followup of 35.0 months.

Adult↗
PubMed1986

Spinal cord injuries following electrical accidents.

Injuries from high tension electrical current result in approximately 1000 deaths per year and account for 3% of all major thermal injuries in the United States. Even though the complications from electrical injury can affect almost every organ system in the body, a neurological complication is perhaps the most common non-lethal one. 116 cases of electrical accidents among 1206 burn patients admitted to Kansas University Medical Center were reviewed. There were 5 cases of spinal cord injury which were detected from a few days up to four weeks from the injury. All had incomplete lesions. Two of them had quadriparesis, and 3 paraparesis. Clinical manifestations included motor and sensory involvement, predominantly motor. Possible mechanisms for the spinal cord damage include heating effect, electrogenic changes and vascular damage. Spinal cord injury following an electrical accident is more frequently encountered than is generally recognized.

Accidents↗
PubMed1986

Fluid resuscitation of the thermally injured patient. Current concepts with definition of clinical subsets and their specialized treatment.

The key to successful fluid resuscitation of the thermally injured patient is close monitoring of the clinical response. Individualized resuscitation based on the parameters described allows for approximation of this goal. An eclectic approach used by the authors has been described with reference to clinical subsets that may require specialized resuscitative methods. Efforts should be made to use the smallest volume of fluid needed to optimize end organ perfusion. The goals of fluid resuscitation have been summarized and a variety of formulas have been described. We anticipate that our understanding of patient subsets outlined in this paper will undergo further evolution.

Adult↗
PubMed1985

Ambulatory management of thermal injuries.

The majority of thermal injuries that occur in this country can be adequately treated on an ambulatory-care basis. The determination regarding ambulatory care can be arrived at using the simple algorithm. The primary concern in outpatient burn care is the management of the burn wound. Aggressive wound cleansing, frequent dressing changes, and appropriate antimicrobials should permit rapid re-epithelialization and prevention of bacterial infection. A nonhealing burn wound should be grafted if it takes more than two to three weeks to heal. Aftercare with splints and elastic compression may be required to obtain maximal functional and cosmetic results.

Age Factors↗
PubMed1984

The effect of informational feedback on food intake of adult burn patients.

The effect of informational feedback on the protein and caloric consumption of burn patients was investigated using a multiple-baseline across subjects. The patients were four severely burned adult males who failed to consume sufficient foods to achieve prescribed levels of protein or kilocalories via standard burn unit procedures during recovery. Feedback consisted of informing patients of (a) their prescribed levels of protein and kilocalories, (b) the protein and kilocalorie content of hospital foods and beverages, and (c) their actual intake of protein and kilocalories. Following the provision of feedback, there was an increase in protein and kilocalorie intakes and in the number of days during which prescribed levels for protein and kilocalories were achieved. These results suggest that the informational feedback was effective for improving the oral caloric intake of burn patients.

Adolescent↗
PubMed1979

Burn wound biopsy bacterial quantitation: a statistical analysis.

Sequential paired punch biopsy samples were taken from three separate locations on each of four burn patients and were quantitated for the number of viable bacteria per gram of tissue. The range (log10 0.02 to log10 1.51) and the standard deviation (log10 0.67) were determined for each pair. The 95 per cent confidence interval based on any single observation, x, was determined to be x +/- 1.31. It is concluded that the burn wound biopsy is a reliable procedure for quantitating organisms in a burn wound and that changes in sequential samples give an indication of the dynamics of infection in the burn patients.

Bacteria↗
PubMed1979

Metabolic profiles of thermal trauma.

The study was designed to establish where significant correlations exist in a variety of metabolic substrates and hormone mediators in patients sustaining thermal injury. The factors studied were insulin, human growth hormone, cortisol, glucagon, free fatty acid, triglyceride and glucose. Incorporated into this design was an evaluation of the impact of quantitated severity of injury upon these correlations. In patients sustaining a low severity of injury (Probability of death (p = 2.2 to 33.9) there appeared a loss of glucose regulation in conjunction with insulin resistance without significant interplay of other factors studied. In contrast, patients sustaining high severity injury (p = 46.9 to 100) evidenced correlations between glucagon and glucose (negative), cortisol and free fatty acid indicating a significant role of hyperglucagonemia in these patients. A discriminant function analysis was employed to incorporate all significant variables into a probability model. Only insulin, glucose and glucagon appeared in the optimal classification equation.

Adolescent↗
PubMed1979

Mononuclear cell analysis of peripheral blood from burn patients.

Mononuclear and polymorphonuclear cells isolated by Ficoll-hypaque density-gradient sedimentation from peripheral blood of 25 burn patients at 3-to 4-day intervals during hospitalization were subjected to morphologic analysis. The aim was to identify all cells isolated and to examine the cell population characterized as B-lymphocytes. Patterns of response comprised of lymphocytes, monocytes, neutrophils, and precursor cells in varying stages of maturity were delineated. Shortly after thermal trauma, isolated cell pools from all patients contained high proportions of immature cells. In surviving patients during convalescence, the cell pools had increasing proportions of mature cells and corresponding declines in immature cell types. Patients who died did not produce large populations of mature cells at any time during their hospitalization. Cells identified morphologically as lymphocytes were accounted for by E-rosette assay (T-lymphocytes). Cells previously identified as B-lymphocytes appeared morphologically to be monocytes, were positive for Fc and complement receptor activity, and were phagocytically active.

B-Lymphocytes↗
PubMed1979

Quantification of serum IgE in patients with burns.

IgE levels in the serum of individuals with burns were sequentially measured and compared to IgE levels in normal control blood donors. Following a burn, the levels of IgE protein showed a significant, although modest, increase, usually evident of IgE protein showed a significant, although modest, increase, usually evident between days 14 and 22. In an occasional patient, the IgE levels rose by as much as five times in value during this period. Because of the complexity of the clinical situation associated with the burn patients, we cannot ascribe these elevations of IgE to the burn per se, but must consider the possibility of other factors, especially those involved in the treatment of the burn as well as the infection. The magnitude of the elevation of IgE in the burn patients (geometric mean=272 ng/ml) was considerably lower than the magnitude of the elevations seen in atopic dermatitis and generalized neurodermatitis (geometric means=2265 and 2071 ng/ml, respectively). Thus simple trauma to the skin is not a sufficient explanation for the elevated serum IgE levels in atopic dermatitis and generalized neurodermatitis.

Adult↗
PubMed1976

The immunosuppressive effect of concanavalin A in monkeys.

These studies were performed to evaluate the immunosuppressive effect of concanavalin A (ConA) in monkeys. Bonnet monkeys (Macaca radiata) weighing between 2.5-3.5 kg were used. Following the exchange of full thickness skin allografts in randomly selected animals, gross and histopathological studies of the rejection reaction were performed. Gross observations showed the allograft reaction in control animals to be a well defined phenomenon occurring at 9.0 +/- 0.7 days. In contrast the rejection process in animals that received i.v. ConA was a poorly defined prolonged process occurring at 14.8 +/- 3.9 days (single 75-mg dose of ConA), and 19.0 +/- 2.2 days (75 mg 1 day before and 25 mg 3 days after grafting). In monkeys that received the double dose schedule of ConA, histopathological studies showed distinct retardation of the rejection reaction with reduced lymphocytic infiltration of the graft-host junction. Control grafts showed almost complete rejection in 7-9 days while allografts on ConA-treated animals showed corresponding degrees of destruction only by the 15th day. These studies indicate that ConA does have an immunosuppressive effect in vivo in monkeys. The local and systemic toxic effects of ConA encountered in these animals have been reported and its haematological effects in vivo briefly described.

Animals↗