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Mechanisms of burn shock protection after severe scald injury by cold-water treatment.

Following a 3-second subxiphoid immersion of shaved, unresuscitated guinea pigs in 100 degrees C water, cardiac output (CO), mean systemic blood pressure (BP), total peripheral resistance (TPR), hematocrit (HCT), serum histamine (SH), and serum lactate (SL) were measured in untreated and cold-water treated animals up to 24 hours after injury. Animals receiving cold-water treatment (CWT) were immersed in 15 degrees C water for 15 minutes immediately after scald injury. CWT significantly (p less than 0.05) reduced SH and SL for up to 8 and 24 hours, respectively, after injury compared to untreated injured animals. HCT of CWT animals remained significantly lower than that of untreated animals for the first 8 hours after injury. However, CWT-animal HCT was not significantly different from control-animal HCT for this same period. CWT-animal BP was significantly greater than untreated-animal BP for the first 8 hours after injury. CWT- and untreated-animal TPR progressively rose after injury; however, at 24 hours after injury CWT-animal TPR was significantly reduced to 87% +/- 18.0 of preinjury values while untreated-animal TPR was maximally elevated to 170% +/- 10.0 of preinjury values. At 4 hours after injury CO of both untreated and SWT animals was significantly depressed at 56% +/- 3.0 and 50% +/- 10.0 of preinjury values, respectively. However, by 24 hours after injury untreated-animal CO remained depressed at 52% +/- 3.0 while CWT-animal CO was significantly improved at 92% +/- 19.0 of preinjury values. These studies document a beneficial hemodynamic response of severely burned animals after CWT and further verify the phenomenon of cold inhibition of burn wound tissue histamine release after severe scald injury. A correlation between decreased serum histamine and lactate levels and improved cardiovascular function following severe scald injury and CWT is also suggested.

Animals↗

Multiple graft harvestings from deep partial-thickness scald wounds healed under the influence of weak direct current.

The time required for wound healing, contraction, and hypertrophic scarring often limit the use of deep partial-thickness burn wounds as donor sites for split-thickness grafts. We have examined the effects of weak direct current and silver nylon dressings on the healing of partial-thickness scald burns, split-thickness grafts taken from these wounds when healed, and the resulting donor sites in a guinea pig model. Dorsal scald wounds treated with weak direct current reepithealized by 12 days postinjury. Split-thickness grafts taken from healed scald wounds showed more rapid revascularization with direct current treatment than did control grafts. Grafts and donor sites treated with direct current showed more rapid reepithelialization, decreased contraction, improved hair survival, and decreased dermal fibrosis when compared to controls not treated with direct current. Only donor wounds treated with weak direct current were reusable as donor sites.

Animals↗

Adapting adult scald safety standards to children.

Scald burns by domestic tap water constitute a painful, potentially debilitating, and sometimes-fatal form of thermal injury. In this setting, the very young and older members of the population are particularly susceptible, owing in part to having thinner skin, which renders them more susceptible to thermal insult. Various codes have set forth a safety standard for maximum delivery temperature of domestic tap water at 120 degrees F (48.9 degrees C), based on adult susceptibility to burns. This work addresses the issue of how the current safety standard for tap water temperature could be adjusted to provide a level of protection to children equivalent to that for an adult at 120 degrees F. A well-accepted mathematical model for predicting burn injury as a function of applied surface temperature and time is used to identify these equivalent conditions. Data from the literature of sonographic measurements indicate a representative ratio of child to adult skin thickness of 0.72. The mathematical model shows that the equivalent surface temperature for a threshold scald injury in children is dependent on the depth into the skin at which the injury is identified. For example, the injury produced by a 120 degrees F, 10-second exposure at a depth of 600 microm in an adult is matched in a child at 72% of the depth (432 microm) by an insult of 115.9 degrees F for the same duration. The recommendation is that existing hot water standards be reduced by 3 to 4 degrees F to provide an equivalent level of scald protection to children.

Accidents, Home↗

The influence of scald water pH on the death rates of Salmonella typhimurium and other bacteria attached to chicken skin.

Factory trials where scald tank water was maintained at pH 9.0 +/- 0.2 showed that compared with the usual system of scalding when the water is at pH 6.0 for much of the working day the bacterial counts on carcases post scalding and plucking were significantly lower. In laboratory experiments, attached Salmonella typhimurium and the naturally occurring skin flora were found to be killed significantly more quickly in water at pH 9.0 +/- 0.2.

Animals↗

Histamine-mediated delayed permeability response after scald burn inhibited by cimetidine or cold-water treatment.

Scald injury to one ear of the hairless mouse induced significant (P < .05) delayed edema formation in remote, uninjured skin. This remote edema formation was completely inhibited by immediate cold-water treatment of the scalded ear. Cold-water treatment significantly reduced histamine loss from the scalded ear, and the edema-inhibiting effect of the treatment could be mimicked by treating the animal prior to injury with the H2-histamine receptor antagonist cimetidine or a drug that causes histamine depletion. These observations suggest (i) that a histamine-mediated, delayed permeability response occurs after thermal injury that causes remote edema formation and (ii) that one mechanism of remote edema inhibition by cold-water treatment is the prevention of histamine release from thermally injured tissues.

Animals↗

Factors affecting the survival of Campylobacter jejuni in relation to immersion scalding of poultry.

Potential measures for reducing the survival of campylobacters during commercial scalding of poultry have been evaluated in a series of laboratory trials. At 50 degrees C, the lower temperature limit of commercial scalding, raising the pH of a buffered heating medium from 6.0 to 9.0 markedly increased the heat sensitivity of Campylobacter jejuni but the effect was largely nullified in the presence of 1 per cent 'organic material' (50:50 horse blood and milk). Either in the presence or absence of organic material a more rapid rate of kill was observed at 60 degrees C and it was again enhanced by raising the pH to 9.0. Use of a mild detergent at a concentration of 1000 ppm had little effect on the survival of C jejuni at 50 degrees C, but the addition of a cationic quaternary ammonium product at 50 to 100 ppm was highly effective in enhancing the rate of kill, even in the presence of organic material. It is suggested that such products should be evaluated in commercial scalding systems as a possible means of preventing the spread of campylobacters and other organisms of significance to public health.

Animals↗

Clinicopathological and ultrastructural study of multiple lobular capillary hemangioma after scalding.

We herein report 2 cases of multiple lobular capillary hemangiomas after scalding. The patients exhibited papules and nodules on the scalded areas after healing. Histopathological examination of the lesions showed capillary proliferation in the upper dermis with edematous stroma containing inflammatory infiltrates predominantly composed of neutrophils. Biopsy tissue and secretion specimens from lesions of case 1 were cultured for bacteria, and both grew Enterobacter cloacae. Ultrastructural examination revealed features typical of a lobular capillary hemangioma and viral inclusion bodies in the epidermis of case 1. Multiple lobular capillary hemangiomas after scalding are rarely reported. Trauma may play an important role in the development of this rare condition. Accumulation of similar cases and its precise observation is needed to confirm the associations and to establish an etiological link between the disease and the pathogens.

Adult↗

Histologic evaluation of preventive measures for scald injury on the peritoneo-serosal surface due to intraoperative hyperthermic chemoperfusion for patients with gastric cancer and peritoneal metastasis.

To histologically assess the preventive efficacy of cimetidine against scald injury on the peritoneo-serosal surface during intraperitoneal hyperthermic chemoperfusion (IHCP) for advanced gastric cancer, a randomized histologic study using cimetidine, a histamine H2-receptor antagonist, was performed for 20 patients with advanced or recurrent gastric cancer and peritoneal metastasis. Cimetidine 50 mg/kg was administered intravenously to 10 patients just prior to the IHCP (cimetidine group), and the remaining 10 patients underwent the IHCP without cimetidine (control group). The background factors and IHCP treatments of these two groups were nearly the same. Although the antitumour efficacy of the IHCP was not histologically different between the two groups, the histological analysis revealed that the peritoneo-serosal surface in the cimetidine group was protected against scald injury, compared with the control group. This finding suggests that pre-IHCP cimetidine is of great benefit for protecting the peritoneo-serosal surface from scald injury due to IHCP.

Antineoplastic Agents↗

Acute effect of scalding injury on blood flow in muscle and subcutaneous tissue in the paw of the anaesthetized dog.

Blood flow in muscle and subcutaneous tissue was studied before and after a scalding injury of the dog paw. The hydrogen clearance technique was used in anaesthetized dogs. As scalding of the paw resulted in an increased blood pressure and muscular movements, animals were given a muscle relaxant and ventilated artificially. Before scalding injury the blood flow was 29.8 and 19.7 ml per min per 100 g in muscular and subcutaneous tissue, respectively. After immersion of the paw for 10 sec in water of 100 degrees C the blood flow transiently increased and later decreased. No major changes were found in the contralateral paw. The decrease was most pronounced (50%) in subcutaneous tissue. In the acute situation the impeded circulation in the burn oedema may protect the organism from potentially harmful substances formed in the injured tissue.

Animals↗

Effects of cooling after scald injury to a dorsal skin fold of mouse.

Shaved trunk skin folds of hairy mice were scalded for 20 s by water immersion. In one set of experiments the effect of increasing burn temperature (51 degrees C-60 degrees C) was studied, in another the folds were first scalded at 51 degrees C-54 degrees C and then immediately cooled for 30 min in 8 degrees C water. Animals were killed 2 h and 4 days postburn. Before sacrifice, Evans blue was injected i.v. to some animals to visualize preserved vascular perfusion and areas of increased permeability. Macroscopic observations (and photographic documentation) were made of the outside and inside of the injured skin and biopsies for light microscopy were obtained centrally in the burns. The injured area was measured by planimetry on photographs and expressed in percent of the whole burned area. At 4 days, brownish, oval areas appeared on the skin being progressively larger with increasing burn temperature. The 51 degrees C burn only resulted in a very small, spotlike, tissue injury, while the greater than or equal to 52 degrees C produced a macroscopic necrosis amounting to 40%-94% of the burned area. Postburn cooling did not reduce the damaged area as recorded 4 days postburn. Histologically, the tissues seemed well preserved at 2 h after 51 degrees C scalds, whereas cell damage was obvious and increasingly pronounced after greater than or equal to 53 degrees C burns. After 52 degrees C burns a mixed picture emerged. A similar microscopic pattern was seen at 4 days; 51 degrees C specimens were undamaged, some 52 degrees C and all greater than or equal to 53 degrees C were necrotic.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Effects of endogenous beta-adrenoceptor agonist on lung edema in scalded rats].

The effect of endogenous beta-adrenoceptor agonist on lung edema in scalded rats were investigated. The results showed that lung water content, wet/dry lung weight ration, bronchoalveolar lavage (BAL) protein concentration, malondialdehyde (MDA) content and leukocyte count in scalded and PPN treated rats were obviously higher than hose in control rats. The above parameters in scalded rats pretreated with PPN were even much higher than those of control and tended to be higher than burn group. It is suggested that endogenous beta-agonist is effective in the prevention of lung edema and lipid peroxidation, and it acts as an important anti-inflammatory factor in vivo.

Adrenergic beta-Agonists↗

[Effect of scald processing on the content of recibufogenin in Pellis sicci Bufonis].

OBJECTIVE: To investigate the effect of scald processing on the content of recibufogenin in Pellis Sicci Bufonis. METHOD: Samples were analyzed by high performance liquid chromatography. RESULT: The content of recibufogenin in the scald processed product was 25.7% higher than that in the unprocessed one. The average recovery was 98.34% and RSD 1.28%. CONCLUSION: The results indicate that the content of recibufogenin in scald processed Pellis Sicci Bufonis is higher than that in the unprocessed drug.

Animals↗

[Screening of aberrant genes of immunocytes in severely scalded rats by inhibition of subtractive hybridization].

OBJECTIVE: To explore the relationship between the postburn changes of gene expression of immunocytes and postburn immunological functional disturbance in severely scalded rats. METHODS: Immunocytes of female F344 rats with severe scalding were harvested and the mRNA was extracted for the inhibition of the expression of aberrant gene selected by subtractive hybridization in contrast to that before scalding. The aberrant genes were cloned and sequenced and compared to those in Genebank for homology. RESULTS: The harvested immunocytes were identified by LM to be monocytes and lymphocytes. Multiple strips located at 200 approximately 400 bp were obtained by inhibiting subtractive hybridization and were cloned into PGEM-T easy plasmid vector. Thus the genebank of aberrant expression was constructed. Twenty clones were sequenced randomly and partial obtained known genes were in accord with postburn systemic changes. Several novel genes were accepted and registered by Genebank. CONCLUSION: There exhibited change in the gene expression of peripheral immunocytes at early postburn stage in rats inflicted by severe burn.

Animals↗

[A study on the myocardial contractile function and intracellular free calcium in scalded rats].

OBJECTIVE: To explore the relationship between postburn myocardial function and intracellular free calcium concentration. METHODS: Sprague-Dawley (SD) rats were employed as the model in which 7 were inflicted with 43% TBSA degree scalding (S group) and 7 as sham scalding control group (C group). The hearts of the injured rats were isolated and perfused in vitro by Langendorff method after 24 postburn hours (PBHs). The hearts were connected to a cardiac function monitor, and the dynamic changes in left ventricular develop pressure (LVDP) were continuously monitored. The cardiac 19F and 31P NMR spectroscopy was determined before and after and TF-BAPTA was added to the perfusate. RESULTS: When compared with those in C group, the LVDP of scalded rat heart decreased by 40% (P < 0.01), and the myocardial cytoplasmic free calcium concentration was four times above that in C group (P < 0.01). After TF-BAPTA was taken by myocytes, cardiac LVDP only decreased by 15% to 20%, and the PCr/Pi ratio decreased, while there was no change in ATP. CONCLUSION: Myocardial contractile function could be inhibited after burn injury, which might be related to the increase of myocardial cytoplasmic free calcium concentration.

Animals↗

[Effects of cytokine gene therapy on prolonging survival time of allografted skin after scalding in a murine model].

OBJECTIVE: To explore the role of cytokine gene therapy on prolonging survival time of allografted skin after scalding in a murine model. METHODS: Interleukin 10 (IL-10) gene was employed as therapeutic objective gene and fibroblast was as a carrier cell. Gene transcription technique was adopted to establish an experimental murine model in which fibroblast-mediated gene therapy was used to prolong allografted skin survival time after scalding. IL-10 was transferred into fibroblastocyte (NIH3T3) by reverse transcriptive virus vector. The mice were grafted with alloskin after scalding. In addition, collagen capsulized NIH3T-3-IL-10 cells were implanted intraperitoneally in the mice so as to observe its influence on allografted skin survival time and on the changes of their main internal organs. RESULTS: Cytokine gene therapy could obviously prolong the survival time of allografted skin (P < 0.01) without any evident detrimental effect on the internal organs. CONCLUSION: These results demonstrated that skin allograft rejection could be inhibited and the survival time be prolonged with the implantation of the fibroblastocyte transferred IL-10 gene.

Animals↗

[The effects of zinc supplementation on postburn nutritional status of zinc-deficient scalded rats].

OBJECTIVE: To investigate the effects of zinc supplementation on postburn nutritional status of zinc-deficient scalded rats. METHODS: Weanling Wistar rats were fed with zinc-deficient diets for one week to induce zinc-deficient status. The rats were inflicted with 20% TBSA deep partial thickness burn and thereafter fed with diets of low, normal and high zinc contents. The scalded rats fed with normal zinc-containing diet before and after injury were taken as normal control group. The changes of body weight, cumulative nitrogen balance and the contents of DNA and protein in jejunum mucous, liver, kidneys, spleen and testis were employed to represent the nutritional status of the rats. RESULTS: The rats fed with diets with normal and high contents of zinc were superior to those with low content of zinc in terms of body weight, food conversion rate, cumulative nitrogen balance and organ protein contents. The serum zinc level, alkaline phosphatase (ALP) activity and the DNA contents in jejunum mucous, kidneys, spleen and testis increased significantly after zinc supplementation. CONCLUSION: Zinc supplementation was helpful to improve postburn nutritional status in scalded rats. And relative higher amount of zinc supplementation might be beneficial to raise the DNA content in testis and kidneys when compared to that with normal zinc supplement.

Animals↗

[The effects of the receptor antagonist of glutamic acid on the brain tissue of severely scalded rats].

OBJECTIVE: To explore the influence of glutamic acid on burned rat brain tissue and the effects of the receptor antagonist of glutamic acid. METHODS: Rats inflicted with 30% TBSA III degree scalding injury were taken as the model. The water content, K(+), Na(+), Ca(2+), Mg(2+), nitric oxide metabolites (NO(2)(-)/NO(3)(minus sign))concentrations of scalded rat brain were determined at 2, 6, 12 and 24 postburn hours (PBH). Morphological and histochemical studies of the brain tissue were carried out with LM and EM. RESULTS: The water content, Na(+), Ca(2+)and NO(2)(minus sign)/NO(3)(minus sign) concentrations of the brain tissue after scalding injury were higher than those in control group. But intracerebral ATP enzyme decreased postburn. It was found by EM examination that there existed swelling of capillary endothelium, nerve cells and some intracytoplasmic mitochondria. There appeared pinosome on capillary wall. After the administration of receptor antagonist of glutamic acid, D-2-amino-group-7-phosphoenanthate (D-AP7), the brain water content, Na(+), Ca(2+)and NO(2)(-)/NO(3)(-) concentrations in brain tissue, and the capillary wall pinosome decreased, and the swelling of nerve cells ameliorated. CONCLUSION: There might be postburn increased cerebral microvascular permeability, ischemic injury of cerebral tissue cells and the development of brain edema. The postburn alterations in the morphology and metabolism of brain tissue were correlated with the over secretion of glutamic acid. And the excitatory toxic effects of glutamic acid were mediated by its receptor. The receptor antagonist of glutamic acid D-AP7 might ameliorate postburn cerebral injury.

Adenosine Triphosphatases↗

[The protective effects of Zn-metallothionein on severely scalded rats inflicted by oxygen free radicals].

OBJECTIVE: To investigate the protective effects of metallothionein (MT) on severely scalded rats inflicted by oxygen free radicals after delayed resuscitation. METHODS: Wistar rats inflicted by 30% TBSA III degree scalding injury were taken as the model. Fifty-Six rats were randomly divided into four groups, i.e. normal control, delayed resuscitation, MT treated and VitC treated groups. The changes in superoxide dismutase (SOD) and malondialdehyde (MDA) contents in plasma and subeschar edematous fluid were determined at 24 and 48 postburn hours with traditional indirect detecting method and electron spin resonance (ESR). Pathomorphological examination was simultaneously carried out for cardiac, hepatic, renal and intestinal samples. Plasma biochemical indices were determined at the same time. RESULTS: In delayed resuscitation group, SOD content decreased and the MDA contents increased in plasma and subeschar fluid obviously, with remarkable changes in the pathomorphology of all the internal organs and the blood biochemical indices. But in MT treating group, SOD content increased (P < 0.05) with decreased content of MDA (P < 0.05) and the pathomorphology and blood biochemical indices improved significantly when compared with those in delayed resuscitation group and VitC treatment group. CONCLUSION: MT treatment might be beneficial in the management of severely scalding rats infliced by oxygen free radicals.

Alanine Transaminase↗