Two groups of patients in whom endotoxemia was suspected were studied with respect to the laboratory data, clinical picture and autopsy findings. The first group showed the signs of gram-negative septicemia (age range 3 to 54 years with burns of 25 to 80% TBSA) and the second group (age range 20 to 76 years with burns not greater than 20% TBSA) showed an unexpected deterioration of the patient's condition. In 15 patients we established the diagnosis of endotoxemia on positive Limulus test as well as on other laboratory examinations and on the clinical signs. Five different forms of endotoxemia were distinguished varying in the evoking circumstance, clinical manifestation and pathological findings at autopsy: (1) the so called laboratory form--all survived; (2) the pulmonary form displaying the most brief and fulminant course--all died; (3) the form of disseminated intravascular coagulopathy; (4) the form of endotoxic shock due to administration of antibiotics; (5) the form of endotoxic shock as terminal stage of protracted gram-negative septicemia--the fatal outcome was inevitable in all cases. The authors stress the importance of minding and preventing all circumstances that might provoke the endotoxic (septic) shock.

Adolescent↗

PubMed1979

Humoral antibodies against skin allografts.

Using the collodion agglutination method the authors studied antibody formation against skin allografts in severely burned patients. They succeeded in detecting antibodies which start appearing on the third day following transplantation at the earliest. Later their titers increase reaching the maximum a few days before first signs of graft rejection. High titers persist for relatively long periods after graft rejection. Antibodies were not detected if the grafts were taken from an identical twin. In this case the grafts were not rejected. These results could be used for the determination of the optimal time for debridement of adhering allografts before the onset of rejection.

Antibody Formation↗

PubMed1979

Endotoxemia and endotoxemia diagnostics.

After the study of a group of severely burned patients with septicemia the authors reached the conclusion that the diagnosis of endotoxemia should be based on the following criteria: clinical condition, laboratory results and autopsy findings. Clinical findings can be subdivided into anamnestic data (such as age, liver function etc.) and direct clinical observation (taking into account states of stress and some specific surgical procedures). The most significant laboratory findings in the investigated group of patients were hypoxy, metabolic acidosis, lowered platelet count and positive Limulus test. Autopsy findings corresponded to findings in septicemia and shock. The authors also discuss the significance of activated lymphocyte accumulation in the liver following endotoxin administration in animals.

Acidosis↗

PubMed1979

The effect of azathioprine, hydrocortisone and trimethazone on the occurrence of active lymphocytes in liver of endotoxin treated rabbits.

After the administration of azathioprine, hydrocortisone and trimethazone to endotoxin-treated rabbits, the percentage of active lymphocytes (determined by means of the nucleolar test) decreased in the liver, while the lymphocytes in the peripheral blood were not affected. The assumption that in endotoxemia the liver may be a target organ for active lymphocytes and that autoimmune processes may participate in liver damage is discussed.

Administration, Oral↗

PubMed1979