A historical review of the use of silver in the treatment of burns. II. Renewed interest for silver

In 1965, Moyer revived interest in silver nitrate solution. He concluded on the basis on in vitro and in vivo studies that a 0.5% solution represented the lowest concentration at which antibacterial action (against Staphylococcus aureus, haemolytic streptococci and generally against Pseudomonas aeruginosa and E. coli) was obtained. Mafenide acetate was introduced a short time after the reintroduction of silver nitrate, followed a few years later by silver sulphadiazine. Thus, in a short period of time three medicaments appeared on the market which represented a radical change in the topical treatment of burns. The action of silver sulphadiazine has been intensively studied. Since silver sulphadiazine does not offer sufficient protection to prevent or retard the growth of gram-negative bacteria in patients with burns covering more than 50% of body surface, Monafo introduced the combined preparation silver sulphadiazine and cerium nitrate. Although various attempts have been made to develop more effective silver compounds, so far silver sulphadiazine still remains the most widely used substance of this type.     

A review on the nonoperative removal of necrotic tissue from burn wounds

The study of nonoperative debridement of burns got underway during the Second World War. A large number of substances such as enzymes of plant origin, acids and proteolytic enzymes of bacterial origin were examined since. The proteolytic enzymes derived from filtrates of C. histolyticum and B. subtilis have attracted the greatest interest. Although enzymatic debridement would seem at first sight to be an attractive form of treatment, unfortunately the results are highly variable.     

Cu(II) complexation of sulfanilamide derivatives

Cu(II) salts produce coloured compounds with sulfanilamides. InPh. Ned. VIII (derived fromPh. Eur. 1) two modifications of this reaction are applied for identification purposes of sulfanilamides, namely:

1. the reaction of copper sulphate in alkaline medium and
2. the reaction of copper acetate in methanolic solution.

Based on the results of a study of the isolation and structure determination of Cu(II) sulfanilamide complexes a variant of reaction (1) is formulated and compared with reaction (1) and (2). The variant is more useful as a general identification test on sulfanilamides, without loss of selectivity. The selectivity of the reaction is based on a relationship between the observed colour and the nature of the sulfanilamide (especially theN- 1 substituent). The colour formation of reaction (2) mostly differs from reaction (1) and the variant. Acetate acts as a deprotonating agent for the sulfanilamide. Solubility problems of the sulfanilamides prohibit the general application of reaction (2) as an identification test.     

Joint inflammation induced by a mature macrophage cell line and cloned MT4+, Lyt-2− T cells in allogeneic mice

Recently we reported the isolation of the mature macrophage cell line AP284. This line can efficiently present antigen to cloned helper T cellsin vitro andin vivo. In this paper we show that AP284 can also present antigen to cloned helper T cells in anin vivo model system in which joint inflammation is induced. It appeared that injection of cloned helper T cells specific for methylated bovine serum albumin (mBSA) together with mBSA and AP284 into the joints of allogeneic mice induced a substantial joint inflammation. This system offers great prospects for studying the involvement of soluble mediators in the induction of joint inflammation as well as regulatory aspects of this inflammation.     

The use of a tracheostomy tube for enteral stomal control

We found that the use of a zero-pressure tracheal foam cuff was the ideal way to drain the intestines through a colostomy, reducing skin irritations and mucosal damage.     

Infusion of plasma expanders may lead to unexpected results in urinary protein assays.

Overt proteinuria was detected in the urine of a potential kidney donor, ultimately leading to the refusal of the kidneys for transplantation purposes. Histological examination of the kidneys did not reveal any abnormalities. Searching for substances that could have interfered with the urinary total protein assay, the role of infused, modified gelatin plasma expanders was investigated. We therefore measured the concentration of protein before and after the addition of various artificial plasma expanders to urine. Only when Biuret reagent or Pyrogallol Red dye were used did we find elevated concentrations of protein. Other methods, including the turbidimetric assays, did not detect additional amounts of protein in the spiked urine. We conclude that the infusion of modified gelatin solutions may cause apparent proteinuria. This effect is not observed with starch-based plasma expanders. Clinical chemists and clinicians should be aware of this phenomenon and possibly repeat the analysis with a different technique.     

Real‐time noise cancellation for speech acquired in interactive functional magnetic resonance imaging studies

Purpose:

To present online scanner noise cancellation for speech acquired in functional magnetic resonance imaging (fMRI) studies.

Materials and Methods:

An online active noise cancellation method for speech acquired in fMRI studies was developed. The approach consists of two automated steps: 1) creation of an MR noise template in a short “test” fMRI scan; 2) application of the template for automatic recognition and subtraction of the MR noise from the acquired microphone signal during an fMRI study. The method was applied in an experimental paradigm where a subject and an investigator communicated in an interactive verbal generation task during fMRI.

Results:

By applying online active noise cancellation, the quality of the subject's speech was substantially improved. The present approach was found to be flexible, reliable, and easy to implement, providing a method for fMRI studies that investigate the neural correlates of interactive speech communication.

Conclusion:

Using online noise cancellation it is possible to improve the quality of acquired speech in fMRI. This approach may be recommended for interactive fMRI studies. J. Magn. Reson. Imaging 2010;32:705–713. © 2010 Wiley‐Liss, Inc.     

Anästhesie und Schlaf-Apnoe-Syndrom

The perioperative risk for patients with obstructive sleep apnea syndrome and the optimal anaesthesiological management of these patients have not been well elucidated. The prevalence of obstructive sleep apnea with significant symptoms is estimated to be 4% in men and 2% in women. However, in 80-95% of patients this syndrome is not sufficiently diagnosed. Thus identification of patients at risk and a thorough multidisciplinary diagnostic approach are essential for optimal perioperative management. The risk of perioperative complications, like cardiopulmonary compromise, and difficulties in airway management is elevated. The most important aspects of perioperative management include evaluation of intubating conditions, careful search for cardiopulmonary morbidity, permanent control of patient airways, sensible use of anaesthetics, sedatives, and narcotics, and strict monitoring of vital signs. If ambulatory nasal continuous positive airway pressure (CPAP) therapy has been established preoperatively, this should be continued in the perioperative period. Postoperative monitoring should be performed in an intensive care or intermediate care unit. Controlled clinical studies on the best perioperative management of patients with obstructive sleep apnea are urgently required.