Using wound bed preparation to heal a malignant fungating wound: a single case study.

Full healing was achieved within eight weeks in a malignant fungating wound using the principles of the TIME paradigm. This concept appears to provide a structured and systematic approach for managing such non-healing wounds.

Murine model of ferric chloride-induced vena cava thrombosis: evidence for effect of potato carboxypeptidase inhibitor.

BACKGROUND/OBJECTIVE: Thrombin-activatable fibrinolysis inhibitor (TAFI) is a plasma carboxypeptidase that renders a fibrin-containing thrombus less sensitive to lysis. In the present study, we describe the development of a murine model of vena cava thrombosis and its use to characterize the antithrombotic activity of potato carboxypeptidase inhibitor (PCI) of TAFIa (activated TAFI) in mice. METHODS/RESULTS: Vena cava thrombosis was induced by various concentrations of FeCl(3) in C57BL/6 mice. A relatively mild stimulus (3.5% FeCl(3)) induced thrombosis that was consistent and sensitive to reference antithrombotic agents such as clopidogrel and heparin. Dose-response studies identified a PCI dose (5 mg kg(-1) bolus plus 5 mg kg(-1) h(-1), i.v.) that produced a maximum 45% decrease in vena cava thrombus mass as assessed by protein content (n = 8, P < 0.01 compared to vehicle) in the 3.5% FeCl(3)-induced model without exogenous tissue plasminogen activator administration. In contrast, PCI had no effect on 3.5% FeCl(3)-induced carotid artery thrombosis in mice. In a tail transection bleeding model, the 5 mg kg(-1) bolus plus 5 mg kg(-1) h(-1) dose of PCI increased tail-bleeding time up to 3.5 times control (n = 8, P < 0.05). The ex vivo activity of antithrombotic doses of PCI was also demonstrated by the enhanced lysis of whole blood clots formed in a thrombelastograph with the addition of a sub-threshold concentration of tPA. CONCLUSION: These studies provide evidence for a role of TAFIa in venous thrombosis in mice, and describe an optimized vena cava injury model appropriate for the evaluation of antithrombotic drugs and the characterization of novel therapeutic targets.

[Clinical evaluation of aggressive nutritional care to head and neck cancer patients during radiation therapy].

Anorexia, dysphagia, and dysgeusia are the most prevalent symptoms in head and neck cancer patients during radiation therapy. The patients, who were in poor general condition, suffered marked loss of body weight and consequently were unable to tolerate further anti-cancer treatments. Aggressive nutritional support to the head and neck cancer patients was started in April, 1986 to improve the general condition of these patients in our hospital. The physiological condition of 152 patients who underwent nutritional support were evaluated as a study group (Group I) between August 1986 and May 1987. Group II, 165 patients without nutritional care were evaluated as a control group between August 1985 and May 1986. In Group I, oral supplementary diets or enteral feedings were provided as nutritional support to all of the anorectic patients. Anthropometric measurement and laboratory data were collected in both groups at the several time points. An average of 1.1 kilogram (Kg) and 3.5Kg body weight loss was observed in Group I and Group II, respectively (P less than 0.005). In patients diagnosed with nasopharyngeal carcinoma, the average duration of radiation treatment was 11 days shorter in Group I than that in Group II (42 vs 53 days). In conclusion, aggressive nutritional care performed by a group of clinical staff, which included doctors (radiation oncologist), dietitians and oncologic nurses, was sufficient to improve the general condition of the head and neck cancer patients during radiation therapy and to therefore increase the recovery rate of these patients after radiation treatments.(ABSTRACT TRUNCATED AT 250 WORDS)