Current concepts in pediatric burn care: the biology of cultured epithelial autografts: an eight-year study in pediatric burn patients.

An 8-year histopathological study of skin regeneration and wound healing in 22 pediatric patients treated with cultured epithelial autografts (CEA) grafted to full-thickness burn wounds excised to muscle fascia is reported. Biopsies of CEA have been analyzed by light microscopic, immunohistochemical, morphometric, electron microscopic and ultrastructural immunolabelling techniques and compared to controls of meshed split-thickness autograft (MSTA) interstices at comparable times postgrafting. At transplantation, CEA are undifferentiated and lack both granular and cornified cell layers. By 6 days postgrafting, CEA differentiate all normal epidermal strata but lack rete ridges. De novo formation of a confluent basal lamina and mature hemidesmosomes is complete by about 3 weeks. Anchoring fibrils appear sparse and immature (as in MSTA controls) compared to normal skin until about 6-12 months. CEA develop rete ridges and a neodermis with normal stromal and vascular organization at about 6-12 months, whereas MSTA interstice controls do not. At 4-5 years, elastin expression is also observed in the CEA neodermis, completing the dermal regeneration process. Normal epidermal differentiation is maintained long-term. These long-term results indicate that CEA regenerate a stable normal epidermis and are capable of inducing dermal regeneration from wound bed connective tissue.     

Rates of admission to six Northern Ireland psychiatric hospitals of patients with primary alcohol-related diagnoses

The rate of admissions to psychiatric hospitals of patients with primary alcohol-related diagnoses (PARD) has increased from 1971 to 1983 and they now account for 19.7% of all admissions. There is a wide variation in admission rates between hospitals, and the use of the Mental Health (NI) Act 1961 to admit these patients formally varies up to twelvefold.     

A phase II trial of amonafide, caracemide, and homoharringtonine in the treatment of patients with advanced renal cell cancer

Summary Forty-eight previously untreated, ambulatory patients with advanced or unresectable renal carcinoma were treated with either amonafide (17 patients), caracemide (17 patients), or homoharringtonine (14 patients). No objective responses were observed in any of the treatment cohorts. Amonafide and caracemide were well tolerated with no unexpected toxicities. One patient each died of pulmonary thromboembolism and sepsis with severe metabolic acidosis on the homoharringtonine arm. An additional 4 patients experienced grade 4 complications including myelosuppression, neurologic dysfunction, and respiratory failure. These severe and unexpected complications caused early termination of accrual to the homoharringtonine arm of the study. These agents have no activity in the treatment of advanced renal cell carcinoma.     

Evaluation of Flatbed Reciprocal Motion Agitators for Resuspension of Stored Platelet Concentrates

We studied the storage characteristics of platelet concentrates prepared in polyolefin (PL-732) and thin-film polyvinyl chloride (CLX) plastic bags and stored on a newly designed flatbed reciprocal motion agitator with a 1.5 inch (3.8 cm) lateral movement and an oscillation frequency of 70 cycles/min. We also studied the ability of this device to resuspend the platelet button formed after preparative centrifugation. Results showed that platelet concentrates stored on the 1.5-inch shaker had storage characteristics equivalent to those reported for the conventional 70 cycles/min, 1-inch (2.5-cm) lateral movement flatbed shaker. Due to a more rapid acceleration and deceleration rate, however, the 1.5-inch shaker resuspended the platelet button formed after preparative centrifugation much more efficiently than did the less dynamic 1-inch shaker. Furthermore, with either agitator, platelet aggregates in the CLX bag were more readily resuspended than were aggregates in the PL-732 bag due in part to differences in plastic bag wall elasticity.     

Renal vasodilatation after central administration of galanin

Galanin, a recently described brain-gut neuropeptide, exists in central nervous pathways subserving cardiovascular regulation in the rat. To investigate the possibility that this peptide is involved in the central control of cardiovascular function we administered galanin (1 or 5 nmol) into a lateral cerebral ventricle in conscious, Long-Evans and Brattleboro rats, chronically instrumented with pulsed Doppler probes for monitoring regional haemodynamics. In both strains galanin caused renal vasodilatation at a dose that had no significant effects on blood pressure or heart rate. These results highlight the need to monitor regional haemodynamics when assessing putative physiological roles of peptides in central cardiovascular regulation.     

Supported education for persons with psychiatric disabilities: Implementation in an urban setting

The onset of mental illness may drastically interrupt individual lives, often occurring during young adulthood when people are pursuing academic or vocational goals. Many individuals with psychiatric disabilities would like to resume these pursuits but need support to be successful. Responding to this need, the Michigan Supported Education Research Project (MSERP) was developed as a three-year federally funded collaborative effort providing support, assistance, and information to individuals with serious mental illness who wish to pursue college or vocational education. This article describes implementation of the project in metropolitan Detroit, the issues encountered, and solutions developed along the way. Significant factors in implementation include an urban-based location on a college campus, the collaboration between the public mental health system and academic institutions, and the many challenges presented by the students and the educational and mental health systems in place to serve them.