[Methods of burn treatment. Part II: Technical aspects]. / Behandlungskonzepte bei Verbrennungen. Teil II: Technische Aspekte.

The best treatment for burns and scalds depends on the depth of the skin necrosis. Epidermal and superficial dermal burn injuries (IIa) can heal spontaneously with conservative treatment without scar development, but deep dermal or full-thickness burns constitute an absolute indication for surgery. Full-thickness or split-thickness skin grafts are used for wound closure. In the case of extensive burn injuries allografts are used for temporary wound closure. In certain licensed laboratories autologous keratinocytes can be cultured for transplantation. In circumferential burn injuries affecting the extremities or the trunk the rigid eschar has to be incised to relieve the pressure behind it. Following a debridement conservative treatment of superficial dermal burns involving wound coverage with biosynthetic dressings or nanocristalline silver gauze dressings or use of special disinfecting ointments can be implemented.

[Methods of burn treatment. Part I: general aspects]. / Behandlungskonzepte bei Verbrennungen Teil I: Allgemeine Aspekte.

Burns and scalds are common injuries that present with a wide range of severity. Correct evaluation of a burn's depth and extent is essential for adequate treatment, not only initially but also for late results. The depth of a burn is classified as first-to-third degree, and its extent can be deducted from specific tables. As a generalised haemodynamic reaction, a capillary leak allows fluid and colloidal substances to leave the intravasal system. This can lead to hypovolemic shock. In the first 24 h, only cristalloid fluid according to Baxter's formula should be administered. Transfer to a burn centre is indicated in accordance with well-defined guidelines. Concomitant injuries, especially inhalation traumata, need to be diagnosed and treated early. By activation of the immune response, a sepsis-like immune response syndrome can occur,resulting in bacterial translocation and colonisation with high mortality rates.

[Aneurysm of the ductus arteriosus Botalli]. / Aneurysma des Ductus arteriosus Botalli.

A congenital aneurysm of the ductus arteriosus Botalli was detected by chest X-ray as an intrathoracic mass in a 7-day-old infant. Following confirmation of the diagnosis by echocardiography and MRI the aneurysm was successfully resected via left lateral thoracotomy without cardiopulmonary bypass. The postoperative course was uneventful. Six years after operation the patient is asymptomatic and growing normally. An intrathoracic mass may be considered in the differential diagnosis especially in infants and children. Aneurysms of ductus arteriosus potentially are associated with serious complications. Timely diagnosis and early surgical intervention are decisive for prevention of serious complication and death.

Pre-evaluation and system optimization of the Elecsys thyroid electrochemiluminescence immunoassays.

We present the results of a pre-evaluation of the thyroid function test free thyroxine, free triiodothyronine and third generation TSH using the Elecsys electrochemiluminescence immunoassay system. A collaborative field study between the development center of the manufacturer and a clinical chemistry laboratory addressed the reliability and comparability of the new Elecsys assays to established methods under clinical laboratory conditions using samples from routine in vitro thyroid testing. Preliminary (reference) formulations of the reagents and several electrochemiluminescent pilot models were used for assay measurements, either in the company's research center or in the clinical setting. The new thyroid assays were compared with the respective Enzymun-Test assays, performed on the ES300 automated immunoassay analyzer. A WHO standard was used for standardization of TSH, whereas an equilibrium dialysis method was applied for free triiodothyronine. The free thyroxine assay was standardized against the Enzymun-Test free thyroxine assay, which had previously been calibrated against equilibrium dialysis. The aim of this field study was to support the optimization of the technology used for Elecsys in an early stage of development and thereby prepare the ground for the adaptation of the immunoassays to the final Elecsys 2010 random access analyzer. A subsequent multicenter evaluation demonstrated that the requirements of routine thyroid testing in terms of reliability were fulfilled by the system.

Optimized conditions for determining activity concentration of alpha-amylase in serum, with 1,4-alpha-D-4-nitrophenylmaltoheptaoside as substrate.

We describe a method for measuring the catalytic activity of alpha-amylase (EC 3.2.1.1) in serum and urine, by use of a defined substrate: 1,4-alpha, D-4-nitrophenyl maltoheptaoside. We use a phosphate buffer of pH 7.10, containing chloride as activator and alpha-glucosidase (EC 3.2.1.20) as the auxiliary enzyme. After a lag phase of 4 min at 25 degrees C or 30 degrees C, or 3 min at 37 degrees C, the increase of absorption of 4-nitrophenol is measured at 410 nm or 405 nm. The pH value of the assay mixture is a compromise between optimum pH for the alpha-amylase reaction, shortest possible lag phase, and an acceptable absorptivity of 4-nitrophenol. Because the dissociation of 4-nitrophenol depends strongly on pH and temperature, we determined its absorptivity with various combinations of these variables in the assay. Heparin-treated plasma can be used, but not EDTA, fluoride, or citrate. Lipemia, hemoglobin less than or equal to mumol/L, bilirubin less than or equal to 170 mumol/L, glucose less than or equal to 100 mmol/L, and ascorbic acid less than or equal to 1 mmol/L of sample do not interfere in the assay.