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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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Summary The efficiency of three commercially available blood culture systems for isolatingCampylobacter sp. was investigated. Thirteen of 189,688 blood cultures from patients seen at the Mayo Clinic from 1984 through 1990 were positive forCampylobacter sp. Eleven out of 13 blood cultures positive forCampylobacter sp. were part of a complete three bottle set of cultures (Isolator from Du Pont, Roche Septi-Chek from Hoffman-La Roche, and non-vented Tryptic Soy Broth from Difco), none of them providing a specific microaerophilic mileu. The aerobic Roche Septi-Chek seems to be more efficient for the detection ofCampylobacter sp. in blood cultures than either the anaerobic Tryptic Soy Broth (Difco) or the Isolator (Du Pont) using the incubator condition of 5% CO2.
Campylobacter Bakteriämie: Erfahrungen mit drei verschiedenen Blutkultursystemen an der Mayo Clinic 1984–1990
Zusammenfassung Drei kommerzielle Blutkultursysteme wurden auf ihre Eignung für den Nachweis vonCampylobacter sp. untersucht. In den Jahren 1984 bis 1990 waren 13 von 189.688 Blutkulturen von Patienten der Mayo Clinic positiv fürCampylobacter sp. Elf dieser 13 Blutkulturen bestanden aus einem Set von drei gleichzeitig beimpften Systemen (Isolator von Du Pont, Roche Septi-Chek von Hoffman-La Roche und unbelüftete Tryptic Soy Broth von Difco); keines dieser Systeme bietet dezidiert ein mikroaerophiles Milieu. Das aerobe System von Hoffman-La Roche (Roche Septi-Chek) erwies sich im Hinblick auf den Nachweis vonCampylobacter-Bakteriämien sowohl der anaeroben Tryptic Soy Broth von Difco als auch dem Isolatorsystem von Du Pont mit Bebrütung der Platten in 5% CO2 als überlegen.相似文献
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We report the first documented case of Bartonella washoensis bacteremia in a dog with mitral valve endocarditis. B. washoensis was isolated in 1995 from a human patient with cardiac disease. The main reservoir species appears to be ground squirrels (Spermophilus beecheyi) in the western United States. Based on echocardiographic findings, a diagnosis of infective vegetative valvular mitral endocarditis was made in a spayed 12-year-old female Doberman pinscher. A year prior to presentation, the referring veterinarian had detected a heart murmur, which led to progressive dyspnea and a diagnosis of congestive heart failure the week before examination. One month after initial presentation, symptoms worsened. An emergency therapy for congestive heart failure was unsuccessfully implemented, and necropsy evaluation of the dog was not permitted. Indirect immunofluorescence tests showed that the dog was strongly seropositive (titer of 1:4,096) for several Bartonella antigens (B. vinsonii subsp. berkhoffii, B. clarridgeiae, and B. henselae), highly suggestive of Bartonella endocarditis. Standard aerobic and aerobic-anaerobic cultures were negative. However, a specific blood culture for Bartonella isolation grew a fastidious, gram-negative organism 7 days after being plated. Phenotypic and genotypic characterizations of the isolate, including partial sequencing of the citrate synthase (gltA), groEL, and 16S rRNA genes, indicated that this organism was identical to B. washoensis. The dog was seronegative for all tick-borne pathogens tested (Anaplasma phagocytophilum, Ehrlichia canis, and Rickettsia rickettsii), but the sample was highly positive for B. washoensis (titer of 1:8,192) and, according to indirect immunofluorescent-antibody assay, weakly positive for phase II Coxiella burnetii infection. 相似文献
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Ectopic bone formation associated with mesenchymal stem cells in a resorbable calcium deficient hydroxyapatite carrier 总被引:6,自引:0,他引:6
Kasten P Vogel J Luginbühl R Niemeyer P Tonak M Lorenz H Helbig L Weiss S Fellenberg J Leo A Simank HG Richter W 《Biomaterials》2005,26(29):5879-5889
Bone substitute materials can induce bone formation in combination with mesenchymal stem cells (MSC). The aim of the current study was to examine ectopic in vivo bone formation with and without MSC on a new resorbable ceramic, called calcium deficient hydroxyapatite (CDHA). Ceramic blocks characterized by a large surface (48 m2/g) were compared with beta-tricalcium phosphate (beta-TCP), hydroxyapatite (HA) ceramics (both ca. 0.5 m2/g surface) and demineralized bone matrix (DBM). Before implantation in the back of SCID mice carriers were freshly loaded with 2x10(5) expanded human MSC or loaded with cells and kept under osteogenic conditions for two weeks in vitro. Culture conditions were kept free of xenogenic supplements. Deposits of osteoid at the margins of ceramic pores occurred independent of osteogenic pre-induction, contained human cells, and appeared in 416 MSC/CDHA composites compared to 216 MSC/beta-TCP composites. ALP activity was significantly higher in samples with MSC versus empty controls (p<0.001). Furthermore, ALP was significantly (p<0.05) higher for all ceramics when compared to the DBM matrix. Compared to previous studies, overall bone formation appeared to be reduced possibly due to the strict human protocol. Ectopic bone formation in the novel biomaterial CDHA varied considerably with the cell pool and was at least equal to beta-TCP blocks. 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