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Biomedical subjects

R A Winchurch

Publications and source records attributed to R A Winchurch.

51 records · Page 3Linked to original sources
PubMed1980

Immunomodulation in major burns: an in vitro system for assaying the effect of modulators.

The restoration of normal immune responses is a clinical goal in the severely immunosuppressed burn-trauma patient. The recently documented emergence of the suppressor system following major burns, however, dictates caution in the use of agents which stimulate immunologically competent cells. We describe an in vitro system, utilizing human peripheral lymphocytes, which accurately reflects the degree of immunosuppression of burned patients, and which can be used to predict the effect of immunologically active agents. Of a group of synthetic polyribonucleotides tested in this system, Poly I:C produced a significant favorable modulation in doses of 3.7 micrograms/ml. The most marked effect was noted in the subgroup of patients who eventually succumbed and in whom clinical modulation would be most advantageous.

Adjuvants, Immunologic↗
PubMed1979

Ribonuclease activity of preparations of human lymphoblastoid interferon.

Crude human lymphoblastoid interferon has less ribonuclease activity than equivalent primary leukocyte interferon and ribonuclease was eliminated when it was purified. The methods used differed from those that had failed to eliminate similar activity from leukocyte interferon. This result makes it unlikely that exogenous ribonuclease plays a major role in the antiviral action of interferon preparations.

Burkitt Lymphoma↗
PubMed1977

RNase activity in human interferon preparations.

The level of RNase activity in human interferon preparations was examined. Although sequential purification of interferon resulted in nearly a 300-fold increase in specific activity, RNase-specific activity remained more or less constant. The implications of this finding for the analyses of the mode of action of interferon are discussed.

Humans↗
PubMed1977

The effects of adrenergic agonists and blockers on antigen-induced DNA synthesis in vitro.

The effects of both alpha and beta adrenergic agonists and blockers on antigen-stimulated DNA synthesis in human lymphocyte cultures were studied. Results show that antigen-induced responses were enhanced by the presence of the beta blockers, propranolol and dichloroisoproterenol, and that this effect appeared to be specific blocking of the lymphocyte beta receptor since D (+) propranolol, a compound devoid of such acitvity, has no effect. Similarly, and alpha adrenergic agonist such as norepinephrine enhanced lymphocyte responsiveness.

Adrenergic Agonists↗
PubMedDate not supplied

Prophylactic intravenous immunoglobulin replacement in high-risk burn patients.

Twenty patients with extensive thermal injury were entered into a prospective randomized double-blind trial of prophylactic intravenous immunoglobulin administration. Ten patients received intravenous immunoglobulin and ten, albumin controls. No statistically significant difference was found between mortality rates, mortality rates from sepsis, the incidence of positive blood cultures, the positive quantitative wound biopsies, urine cultures, or positive intravenous line cultures. No significant improvement was noted in assays of neutrophil chemotactic index or intracellular kill, assays of lymphocyte function, or helper/suppressor ratio. We did, however, note significant improvement in the incidence of polymicrobial blood cultures, cytomegalovirus titers, and blood endotoxin concentration in treated patients. While the high incidence of inhalation injury (16 out of 20 patients) and, therefore, the disproportionately high mortality rate (40% overall) in the study group do not permit extension of these observations to the burn patient population at large, certain cautious recommendations may be made with regard to the use of intravenous immunoglobulin G in the management of burn patients.

Adolescent↗
PubMedDate not supplied

Control of endotoxemia in burn patients by use of polymyxin B.

A group of patients with severe burns were entered into two sequential prospective randomized trials for reduction of endotoxemia by the use of intravenous polymyxin B. The first group underwent polymyxin administration during the first week after burn injury in a bell-shaped dosage form constructed to resemble the level of endotoxemia as previously documented. This group showed a statistically highly significant reduction in endotoxin levels and a suggestive, but not statistically significant, reduction in wound infection and mortality in the treated group compared with controls. The second group of patients underwent treatment with perioperative polymyxin B given in conjunction with an excisional procedure of the burn wound. In this group, polymyxin B also accomplished a reduction in endotoxemia from preoperative to postoperative cases, but there was no significant reduction in clinical complication rate or mortality. In the dosages used, polymyxin B is nontoxic and promises to be a useful part of the surgeon's armamentarium in dealing with severe complications of gram-negative sepsis.

Adult↗
PubMedDate not supplied

The Baltimore Sepsis Scale: measurement of sepsis in patients with burns using a new scoring system.

A new sepsis scale has been developed, and it consists of 13 parameters, each of which is measured daily on a variable point scale. In 41 patients with major burns the Baltimore Sepsis scale correlated well with death or survival, with occurrence of septicemia, and with the level of serum interleukin-6. It did not correlate well with the level of plasma endotoxin or with the type of organism that was grown in blood cultures (gram-positive or gram-negative). We propose that the Baltimore Sepsis Scale would be an accurate and easy scale to use for the measurement of interventions that are aimed at improving the septic state.

Burns↗