Hyperbaric Oxygen Therapy for Soft Tissue Injury in Open Musculoskeletal Trauma: A Prospective Study.

Background Non-union, chronic pain, functional disability, and infection are all things that have been associated with open fractures with severe soft tissue damage leading to the need for additional hospitalization, and sometimes even subsequent surgeries and weeks or months of rehabilitation. Open fractures and severe musculoskeletal injuries are occasionally treated with hyperbaric oxygen therapy (HBOT) in an effort to reduce the risk of complications and increase the likelihood of a successful recovery. Methods A prospective randomized controlled study was done between January 2019 and August 2022 at a tertiary health care center including 60 patients with a severe soft tissue injury (Grade II and III) divided into two groups - group-CT (30 patients who received conventional treatment) and group HT (30 patients, who received HBOT in addition to conventional treatment). The outcome was measured according to the Bates-Jensen Wound Assessment Tool. Results The wound size, depth, and granulation were significantly reduced in group-HT patients. In the final session, the patient's severity of the wound in group-HT was significantly reduced (P = 0.0001) compared to group-CT. Conclusions Patients who received HBOT reported a significant improvement in their wounds.

Evaluation of Vacuum Assisted Closure Therapy for Soft Tissue Injury in Open Musculoskeletal Trauma.

INTRODUCTION: The application of controlled levels of negative or sub atmospheric pressure for a prolonged period of time on a wound had shown to accelerate removal of excess fluid and promote hyperaemia, which eventually promote wound healing. AIM: The study was conducted with the aim to evaluate the effectiveness of Vacuum Assisted Closure (VAC) therapy for soft tissue injury in open musculoskeletal trauma. MATERIALS AND METHODS: Twenty cases of complex musculoskeletal wound involving different parts of body were included in this progressive randomized study. In patients, aggressive debridement was done before the application of VAC therapy. Controlled negative pressure was uniformly applied to the wound. Dressings were changed after every 4 to 5 days. The evaluation of results included healing rate of the wound, eradication of infection, complication rate, and number of secondary procedures. RESULTS: VAC therapy over the wound was administered for an average of 20.4 days ±6.72 days (range 14 to 42 days). There was decrease in wound size attained by VAC therapy ranged from 2.6 to 24.4cm(2), with an average reduction of 10.55 cm(2). Three wounds were infected at the start of VAC therapy. However, all patients were cleared of bacterial infection by the end of VAC therapy. CONCLUSION: VAC therapy using negative pressure promote Wound healing by increasing local capillary perfusion and increased rate of granulation tissue formation, decreases the duration of wound healing and requires fewer painful dressing change.

Gallium citrate Ga 67 scanning: clinical usefulness in lymphoma patients.

Gallium citrate Ga 67 (67Ga) scans were performed in 50 consecutive lymphoma patients who underwent routine staging. The overall accuracy of 67Ga scans was greater than 80% for all nodal sites except the spleen (68%). Sensitivity was greater than 88% in the neck and mediastinum, 67% in the abdomen-pelvis, and 33% for the spleen. Specificity was greater than 85% for all nodal sites except for the mediastinum (67%). The accuracy of pedal lymphangiograms was 75%, sensitivity 87%, and specificity 68%. Gallium 67 scans complemented the lymphogram in the abdomen-pelvis but, due to limited sensitivity and high number of equivocal studies (16%), did not replace it. Infraclavicular, pectoral, and mediastinal lesions were detected by 67Ga scans when missed by other means. In 20% to 25% of patients, 67Ga scans provided information not afforded by other diagnostic studies and are therefore considered an important staging procedure for lymphoma patients.

Subsequent fertility and birth histories of children and adolescents treated with 131I for thyroid cancer.

Forty patients aged 20 years or less who had been treated with 131I after surgery for papillary-follicular thyroid carcinoma were contacted for followup study. Five had died and two were unmarried; the remaining 33 were studied with respect to their subsequent reproductive histories and the health of the offspring. The mean age at the time of the first 131I therapeutic dose was 14.6 years (range 6-20), and the average followup interval, from that first dose until followup, was 18.7 years (range 14-25). The mean total dose of 131I was 196 mCi (range 80-691). The incidences of infertility (12%), miscarriage (1.4%), prematurity (8%), and major congenital anomaly (1.4%) found in this series are not significantly different from those in the general population. Thus, our study offers no overt evidence of genetic damage in children and adolescents treated with high doses of 131I for thyroid carcinoma.

Localization of radiolabeled enzyme inhibitors in the adrenal gland.

Tissue distribution studies were performed in rats and dogs at five time intervals between 10 min and 24 hr after the intravenous injection of one of the following radiolabeled adrenocortical enzyme inhibitors: 3H-amino-glutethimide, 125I-3-iodoaminoglutethimide, 3H-SKF-12185, 125I-3-SKF-12185, 3H-metyrapone. 3H-metyrapol. 3H-amphenone B, and 3H-SU-10603. In rats, 3H-SKF-12185 showed the highest uptake in the whole adrenal (3.5% kg dose/gm at 1 hr). In dogs, 3H-metyrapol showed the highest uptake in the adrenal cortex (9% kg dose/gm at 1 hr), and the peak cortex-to-liver concentration ratio was 57 at 2 hr. These peaks uptakes were comparable to those obtained with the conventional iodocholesterols, but they were reached much earlier, with elimination of most of the adrenal radioactivity by 24 hr. These properties would permit the use of 123I as the label and a higher tracer dose, resulting in a higher photon flux. Thus, the radiolabeled enzyme inhibitors show promise as adrenal-scanning agents, with a markedly shortened scanning procedure, a lower absorbed radiation dose, and better resolution.

Selenium-75-19-selenocholesterol-a new adrenal scanning agent with high concentration in the adrenal medulla.

A tissue distribution study with 75Se-19-selenocholesterol in rats, rabbits, and dogs showed high adrenal concentrations and good adrenal images. In the dog, higher concentrations were obtained in the adrenal medulla than in the cortex at Days 1 and 7 after dosing. Extraction and thin-layer chromatography of the adrenal lipid in dogs given this compound showed that 75Se in the adrenal is still attached to the steroid moiety. A reduction in production costs is expected from its longer shelf life. Selenium-75-19-selenocholesterol is being evaluated in humans not only for routine use as a adrenal cortex scanning agent, but also for the detection of pheochromocytomas and other sympathetic tissue tumors, especially neuroblastomas.

Cloning, characterization, and genomic structure of the mouse Ikbkap gene.

Our laboratory recently reported that mutations in the human I-kappaB kinase-associated protein (IKBKAP) gene are responsible for familial dysautonomia (FD). Interestingly, amino acid substitutions in the IKAP correlate with increased risk for childhood bronchial asthma. Here, we report the cloning and genomic characterization of the mouse Ikbkap gene, the homolog of human IKBKAP. Like its human counterpart, Ikbkap encodes a protein of 1332 amino acids with a molecular weight of approximately 150 kDa. The Ikbkap gene product, Ikap, contains 37 exons that span approximately 51 kb. The protein shows 80% amino acid identity with human IKAP. It shows very high conservation across species and is homologous to the yeast Elp1/Iki3p protein, which is a member of the Elongator complex. The Ikbkap gene maps to chromosome 4 in a region that is syntenic to human chromosome 9q31.3. Because no animal model of FD currently exists, cloning of the mouse Ikbkap gene is an important first step toward creating a mouse model for FD. In addition, cloning of Ikbkap is crucial to the characterization of the putative mammalian Elongator complex.

Cryopreservation of rooster semen in thirteen and sixteen percent glycerol.

Semen from Barred Plymouth Rock roosters was cryopreserved with glycerol concentrations of 13 and 16% in a microprocessor-controlled freezer. Thawing and deglycerolation were facilitated by the use of an improved microprocessor-controlled thawing device and high speed dialyzer. Deglycerolated semen (100 mu L; 192 and 154 million sperm, respectively, for the 13 and 16% glycerol concentration) was inseminated into Single Comb white Leghorn hens. Three inseminations were done at 4-d intervals. Eggs were collected for 10 d starting 1 d after the first insemination, and incubated for 4th d. Fertility was determined by candling after the 4th d. Fertility measurements of 62.4 and 65% were obtained from the sperm frozen in 13 and 16% glycerol concentrations, respectively, for the 10-d period.

Exposure of turkey sperm to a synthetic peptide before insemination increases fertility.

Effects on fertility and hatch of eggs laid by hens inseminated with sperm exposed to a synthetic peptide were studied. Pooled semen from 40 randomly selected toms was split and held in vitro for 0 or 24 h before use. Just before insemination, sperm (at 8.33x10(9) sperm/mL) were exposed for 5 min to 0.0, 0.05, 0.25, or 0.50 microM peptide. Hens (28 per group) were inseminated within less than 30 min with 250x10(6) in 30 microL. Two inseminations 24 h before onset of lay were followed by weekly inseminations through 22 or 20 wk. For sperm that was fresh or held 24 h, peptide treatment (P<0.02 or 0.01) and week of lay (P<0.01) affected fertility and hatch of total eggs set. There was no effect of peptide treatment on hatchability of fertile eggs. For fresh sperm, use of 0.25 microM peptide, but not 0.05 or 5.0 microM peptide, increased (P<0.05) fertility and hatch of total eggs set compared with the control (0 microM). Values for fertility were 94 vs. 90% and for hatch were 84 vs. 80%. Increases in hatch were especially evident for fresh sperm after approximately 13 wk of lay.

Identifying potentially subfertile toms via a sperm-binding assay.

We evaluated the utility of the commercial version of a new sperm-egg binding assay for detection of differences in sperm quality in samples of turkey semen from individual toms. Each sample had a swirl of 2 or more on a scale of 0 to 4. For assays conducted with fresh semen at 4 x 10(6) sperm per well, values ranged from 0.11 to 12% sperm bound to an extract of perivitelline membrane. Within-male variation averaged 0.17 percentage units, based on three ejaculates per male evaluated. Two experiments compared fertility and hatch for hens after weekly insemination with pooled semen from subpopulations of toms classified as having sperm with LOW or HIGH binding. Average fertility and hatch were lower (P < 0.05) for eggs laid by hens inseminated with semen from LOW toms in one experiment. In another experiment, hen fertility was not different between treatments after insemination during Weeks 32 to 39; however, a sharp decline in hatch was observed only for hens inseminated with semen from LOW toms after 40 wk of age. With semen from HIGH toms, hatch remained at > or = 80%. For these experiments, approximately 7% more poults were obtained from hens inseminated with semen from HIGH toms. We demonstrated that the sperm-egg binding assay detects differences in sperm quality between individuals, and these differences influence fertility.

Carbonic anhydrase and its isozymes in heat stressed white Leghorn hens.

Experiments were conducted to study the effect of heat stress on uterine tissue carbonic anhydrase levels and their isozyme patterns in relation to production of no- and thin-shelled eggs. Birds exposed to naturally occurring heat stress had lower enzyme levels in their uteri than birds kept in an air-conditioned pen. 4 isozyme bands of carbonic anhydrase were visible in uterine tissue homogenate from both groups of birds. Isozymes were suppressed in heat-stressed birds, as was evident from staining intensities of the bands. This provided evidence to the effect that heat stress not only decreased the total quantity of carbonic anhydrase in the uteri of the hens but also suppressed its isozyme fractions, leading to greater production of no-shell and thin-shelled eggs.

Value of sialography and scintigraphy in diagnosis of salivary gland disorders.

The purpose of this study was to examine the diagnostic value of sialographic and scintigraphic tests conducted to determine changes in salivary gland function and structure in patients with salivary gland disorders. A simple sialographic technique using a catheter fitted over a lacrimal probe was performed. For optimal pantomographic study of the salivary glands, a slightly oblique view with the head turned to the side was demonstrated to be of value. Examination of the salivary glands by sialography reveals the detailed morphology of the duct system. Sialograms were evaluated for filling and secretory phases and major ducts were also studied morphologically. Clearing radiographs indicated that glands with impaired function have prolonged clearing times. The contrast sialogram is most useful in evaluating recurrent inflammatory disorders, and the radiosialogram finds its greatest value in evaluating patients with suspected neoplasms. These examinations should not be used in lieu of a histologic diagnosis in tumor cases, except when a smooth margined radiopositive lesion corresponding with a clinically evident Warthin's tumor is noted. Perhaps the most important feature of salivary scintigraphy is its sensitivity in depicting changes in glandular dysfunction. In this study objective documentation provided by the scintigraphy closely parallels the results of sialography.

Effects of an antistress drug on the heat tolerance of broiler breeder hens.

12 broiler breeder hens aged 56 weeks were given 0.2 ml Geriforte/kg body weight via the drinking water. The experiment was carried out between May 25 and July 23. The plasma corticosteroid content of the treated animals was significantly reduced as compared with the 12 control hens (3.86 vs. 5.21 mg/dl during the dry season and 4.0 vs. 5.0 mg/dl during the rainy season). There was no significant influence on the number of eggs, feed consumption, respiration rate, body temperature, protein, glucose, sodium, and potassium content of the blood plasma.

Tissue-specific expression of a splicing mutation in the IKBKAP gene causes familial dysautonomia.

Familial dysautonomia (FD; also known as "Riley-Day syndrome"), an Ashkenazi Jewish disorder, is the best known and most frequent of a group of congenital sensory neuropathies and is characterized by widespread sensory and variable autonomic dysfunction. Previously, we had mapped the FD gene, DYS, to a 0.5-cM region on chromosome 9q31 and had shown that the ethnic bias is due to a founder effect, with >99.5% of disease alleles sharing a common ancestral haplotype. To investigate the molecular basis of FD, we sequenced the minimal candidate region and cloned and characterized its five genes. One of these, IKBKAP, harbors two mutations that can cause FD. The major haplotype mutation is located in the donor splice site of intron 20. This mutation can result in skipping of exon 20 in the mRNA of patients with FD, although they continue to express varying levels of wild-type message in a tissue-specific manner. RNA isolated from lymphoblasts of patients is primarily wild-type, whereas only the deleted message is seen in RNA isolated from brain. The mutation associated with the minor haplotype in four patients is a missense (R696P) mutation in exon 19, which is predicted to disrupt a potential phosphorylation site. Our findings indicate that almost all cases of FD are caused by an unusual splice defect that displays tissue-specific expression; and they also provide the basis for rapid carrier screening in the Ashkenazi Jewish population.