Characteristics of sepsis in burn patients today

An analysis of lethal outcomes following thermal traumas during the recent 8 years has shown sepsis to occupy one of the leading places as a cause of death of burned people. During the recent years the incidence of early sepsis has been increased. This kind of sepsis develops in the period of shock and acute toxemia, is often of lightening character, possesses certain specific morphological features and is caused predominantly by gram-negative flora threatening to patients with critical burns of more than 40% of the body surface.     

Adenocarcinoma of the stomach: Areas of failure in a re-operation series (second or symptomatic look) clinicopathologic correlation and implications for adjuvant therapy

Following initial “curative” operative procedures for gastric carcinoma, 107 patients had planned single or multiple re-operations at the University of Minnesota. Later evidence of cancer was found in 86 patients at re-operation and/or other follow-up. Initial operative-pathologic extent of disease was correlated with incidence and patterns of failure. Distant metastasis (DM) alone was uncommon, but was found as a new component in 25.6 °k of the failure group. Nearly half of the peritoneal failures (PS) were localized, and when diffuse, were usually accompanied by a moderate sized local-regional failure. Local recurrence and/or regional lymph node metastasis (LF-RF) occurred as the only failure in 53.7% of the failure group if localized peritoneal failures were included, and as any component of failure in 87.8% (67.3% of the total 107 patients). Operation alone yields inadequate results for the majority of patients with gastric carcinoma. The rationale of adjuvant radiation and systemic therapy alone or in combination is discussed.     

An outbreak of furunculosis among high school athletes

Furuncles (boils) are common among teenagers; however, few outbreaks have been documented. We investigated an outbreak of furuncles that occurred among male athletes of a Kentucky high school during the 1986 to 1987 school year. The overall attack rate was 25% (31/124). The risk of developing a furuncle increased two to three times in those who had skin injury. Athletes who sustained abrasions more than twice per week (P less than 0.01), who had a cut that required bandaging (P = 0.01), or had an unspecified injury causing a missed practice or game (P = 0.04) were at increased risk. The risk of developing furunculosis did not appear to be related to contact with formites, but rather, to contact with furuncles. Although athletes shared common areas (showers, locker rooms, practice areas, the attack rates for varsity football (36%) and varsity basketball (33%) were four times greater than for nonvarsity teams (P less than 0.01). Players who had a friend with a furuncle were more than twice as likely to also have had a furuncle (P less than 0.01). Exposure to furuncles appeared to increase the risk of furunculosis independently of reported skin injury. Control and prevention should, therefore, focus on both reducing skin injury and reducing exposure to furuncles, rather than attempting to sterilize inanimate objects.     

Isolated Peritoneal Donor‐Related Plasmacytoma 3 Years After Liver Transplantation: A Case Report

Organ transplantation carries a risk of disease transmission from donor to recipient, primarily infection or malignancy. Although donors are thoroughly screened, donor‐related malignancies are reported to occur in 0.01% of solid organ transplants. Plasma cell neoplasm, to the best of our knowledge, has not been reported as a donor‐transmitted malignancy in liver transplantation. We describe a liver transplant from a donor with unrecognized plasmacytoma requiring retransplantation. Three years after the first transplant a single peritoneal mass was detected on surveillance imaging and radically excised; HLA phenotyping confirmed the mass to be an isolated extra‐medullary plasmacytoma of chimeric donor and recipient origin.     

Subvastus and medial parapatellar approaches in TKA: comparison of functional results

The purpose of this study was to compare the clinical results of total knee arthroplasty (TKA) in the early and late postoperative period using subvastus and medial parapatellar approach. A prospective randomized controlled study was conducted in a group of 169 patients (180 TKAs) with 2-year follow-up. Patients were divided into a study group (97 TKAs) with a subvastus approach and a control group (83 TKAs) with a parapatellar approach. Assessment of the results of both operating approaches was based on functional, clinical Knee Society Score, and pain (visual analog scale). Patients in the subvastus group achieved full active extension, better range of motion, and better Knee Society Score results at 12 days, 6 weeks, and 12 weeks earlier than patients in the medial parapatellar group. They also had less pain at 12 days. No statistically significant differences existed between assessed end points in both groups at 24- and 52-weeks, and 24-months postoperatively. The subvastus approach has given patients better early clinical results; however, at longer follow-up, both groups had similar outcomes. The potential benefits of the subvastus approach are: protection of the extensor mechanism from damage, less risk of damaging the blood supply to the patella, earlier clinical recovery, and less pain in the early postoperative period. The subvastus approach is an alternative to the standard medial parapatellar approach in TKA. It can be used with equally good results, especially taking into consideration positive clinical aspects in the early postoperative period.     

Manufacturing medical instruments by friction welding

Biomedical Engineering -     

Head injury-associated deaths in the United States from 1979 to 1986

Review of US mortality data from 1979 to 1986 identified 315,328 deaths associated with head injury, which represented 2% of all deaths, 26% of injury deaths, and an annualized head injury-associated death rate of 16.9 per 100,000 residents. Motor vehicles (57%), firearms (14%), and falls (12%) were the most frequent causes. Death rates peaked at 15 to 24 years of age and at 75 years or older, with the younger group most affected by motor vehicles (77%) and the older group by falls (43%). Although blacks and whites had similar death rates overall, age- and cause-specific rates varied considerably. The rate of head injury-associated death for males was three times that of females. Rates for head injury-associated death plateaued after declining in the early 1980s. Physicians can play an important role in primary prevention of head injury through careful prescribing of medications, patient counseling, and advocacy of proved interventions such as motor vehicle-occupant restraints. use, we observed 9827 children riding bicycles at sites in high-, middle-, and