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B Gerdts AFPM Vloemans RW Kreis 《Journal of the European Academy of Dermatology and Venereology》2007,21(6):781-788
BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe and potentially fatal drug reaction characterized by an extensive skin rash with blisters and exfoliation, frequently accompanied by mucositis. The wounds caused by TEN are similar to second-degree burns and severe cases may involve large areas of skin loss. OBJECTIVES: Analysis of our results in patients with TEN and evaluation of the variety of therapeutic interventions that has been studied and suggested in TEN. PATIENTS/METHODS: Retrospective analysis of 19 consecutive patients with TEN treated in our burns centre between 1989 and 2004. RESULTS: Immediate withdrawal of any potentially fatal drug, maximum supportive care, and a restricted and tailored antibiotic, medical and surgical treatment regimen confined mortality to 21%, whereas prognosis scores like APACHE II and SCORTEN predicted mortality of 22 and 30%, respectively. A positive contribution of selective digestive decontamination is suggested but has yet to be established. CONCLUSIONS: Because of a potentially fatal outcome, fast referral of a patient suspected of TEN to a specialized centre (mostly a burns unit or specialized dermatology centre) for expert wound management and tailored comprehensive care is strongly advised and contributes to survival. 相似文献
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Immunologic Memory Induced by a Glycoconjugate Vaccine in a Murine Adoptive Lymphocyte Transfer Model 下载免费PDF全文
Hilde-Kari Guttormsen Lee M. Wetzler Robert W. Finberg Dennis L. Kasper 《Infection and immunity》1998,66(5):2026-2032
We have developed an adoptive cell transfer model in mice to study the ability of a glycoprotein conjugate vaccine to induce immunologic memory for the polysaccharide moiety. We used type III capsular polysaccharide from the clinically relevant pathogen group B streptococci conjugated to tetanus toxoid (GBSIII-TT) as our model vaccine. GBS are a major cause of neonatal infections in humans, and type-specific antibodies to the capsular polysaccharide protect against invasive disease. Adoptive transfer of splenocytes from mice immunized with the GBSIII-TT conjugate vaccine conferred anti-polysaccharide immunologic memory to naive recipient mice. The transfer of memory occurred in a dose-dependent manner. The observed anamnestic immune response was characterized by (i) more rapid kinetics, (ii) isotype switching from immunoglobulin M (IgM) to IgG, and (iii) 10-fold-higher levels of type III-specific IgG antibody than for the primary response in animals with cells transferred from placebo-immunized mice. The adoptive cell transfer model described in this paper can be used for at least two purposes: (i) to evaluate conjugate vaccines with different physicochemical properties for their ability to induce immunologic memory and (ii) to study the cellular interactions required for an immune response to these molecules. 相似文献
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Dou Q; Tarnuzzer RW; Williams RS; Schultz GS; Chegini N 《Molecular human reproduction》1997,3(11):1005-1014
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Fifty women with polycystic ovaries took part in a prospective randomized
study. All women required treatment by in-vitro fertilization (IVF) for
reasons other than anovulation. They had all previously undergone ovarian
stimulation with gonadotrophin therapy which had failed to result in
pregnancy or had been abandoned due to high risk of developing ovarian
hyperstimulation syndrome (OHSS). Twenty-five women were treated by
long-term pituitary desensitization followed by gonadotrophin therapy,
oocyte retrieval and embryo transfer (group 1). Twenty-five women underwent
laparoscopic ovarian electrocautery after pituitary desensitization
followed by gonadotrophin therapy, oocyte retrieval and embryo transfer
(group 2). A significantly higher number of women in group 1 had to have
the treatment cycle abandoned due to impending or actual OHSS, determined
by endocrine and clinical findings. In addition, the development of
moderate or severe OHSS in completed cycles was higher in group 1. The
pregnancy rate and miscarriage rates in the two treatment groups were
similar. The authors propose that laparoscopic ovarian electrocautery is a
potentially useful treatment for women who have previously had an IVF
treatment cycle cancelled due to risk of OHSS or who have suffered OHSS in
a previous treatment cycle.
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