Instillation Of Solution Research Articles

Adoptive transfer of dendritic cells expressing CD11c reduces the immunological response associated with experimental colitis in BALB/c mice.

IntroductionIn addition to conventional therapies, several new strategies have been proposed for modulating autoimmune diseases, including the adoptive transfer of immunological cells. In this context, dendritic cells (DCs) appear to be one of the most promising treatments for autoimmune disorders. The present study aimed to evaluate the effects of adoptive transfer of DCs obtained from both naïve and ovalbumin (OVA)-tolerant mice on the severity of TNBS induced colitis and analyze the eventual protective mechanisms.Methods and resultsTo induce oral tolerance, BALB/c mice were fed 4mg/mL OVA solution for seven consecutive days. Spleen DCs were isolated from tolerant (tDC) and naïve (nDC) mice, and then adoptively transferred to syngeneic mice. Three days later, colitis was induced in DC treated mice by intrarectal instillation of 100μg2,4,6-trinitrobenzenesulfonic acid (TNBS) dissolved in 50% ethanol. Control subjects received only intrarectal instillation of either TNBS solution or a vehicle. Five days later, mice from all groups were euthanized and examined for physiological and immunological parameters. Regarding the phenotype, we observed that the frequencies of CD11+ MHC II+ and CD11+ MHCII+ CD86+ cells were significantly lower in DCs isolated from tolerant mice than in those from naive mice. However, pretreatment with both types of DCs was able to significantly reduce clinical signs of colitis such as diarrhea, rectal prolapse, bleeding, and cachexia, although only treatment with tDCs was able to prevent weight loss from instillation of TNBS. In vitro proliferation of spleen cells from mice treated with either type of DCs was significantly lower than that observed in splenic cell cultures of naïve mice. Although no significant difference was observed in the frequencies of Treg cells in the experimental groups, the frequency of Th17+CD4+cellsand the secretion of IL-17 were more reduced in the cultures of spleen cells from mice treated with either type of DCs. The levels of IL-9 and IFN-γ were lower in supernatants of cells from mice treated with nDCs.ConclusionThe results allow us to conclude that the adoptive transfer of cells expressing CD11c is able to reduce the clinical and immunological signs of drug-induced colitis. Adoptive transfer of CD11c+DC isolated from both naive and tolerant mice altered the proliferative and T cell responses. To the best of our knowledge, there is no previously published data showing the protective effects of DCs from naïve or tolerant mice in the treatment of colitis.

MODERN VIEW ON TRACHEOSTOMY

Aim - optimization of postoperative period in tracheostomy patients. Materials. Since 2016 we have followed up 48 patients with stenosis of the larynx and trachea of various etiologies, all the patients underwent urgent tracheostomy. Methods. It is necessary to adhere to the following principles: to carry out correction of psychoemotional status; to educate the patients how to take care and change the trachea cannula themselves; to use antitussive drugs in the absence of severe concomitant pathology of the lower respiratory tract; to perform moistening of the mucous membrane by instilling physiological solution into the trachea or using moistened gauze aprons; to use a humidifier in the room; in case of erosive tracheitis - to apply instillation of antiseptic solutions and hormonal preparations. Results. In patients who regularly follow these recommendations, the risk of postoperative complications (erosive tracheitis, cicatricial tracheal stenosis and respiratory failure) is much lower.

Nebulization of Cyclic Arginine-Glycine-(D)-Aspartic Acid-Peptide Grafted and Drug Encapsulated Liposomes for Inhibition of Acute Lung Injury.

Acute lung injury (ALI) is a fatal syndrome in critically ill patients. It is characterized by lung edema and inflammation. Numerous pro-inflammatory mediators are released into alveoli. Among them, interleukin-1beta (IL-1β) causes an increase in solute permeability across the alveolar-capillary barrier leading to edema. It activates key effector cells (alveolar epithelial and endothelial cells) releasing inflammatory chemokines and cytokines. The purpose of the study was to demonstrate that nebulized liposomes inhibit ALI in vivo. In vivo ALI model was simulated through intra-tracheal instillation of IL-1β solution (100μg/mL in PBS, pH7.2, 200μL) in male Sprague-Dawley rats. Various formulations were tested in ALI induced rats. These formulations include plain liposomes (PL), methylprednisolone sodium succinate solution (MPS solution), cRGD-peptide grafted liposomes (LcRGD) and methylprednisolone sodium succinate encapsulated and cRGD-peptide grafted liposomes (MPS-LcRGD). Formulations were nebulized in vivo in rats using micro-pump nebulizer. Liposome formulations exhibited higher levels of drug concentration in lungs. The physicochemical parameters demonstrated that the liposome formulations were stable. On the basis of aerodynamic droplet-size, nebulized formulations were estimated to deposit in different regions of respiratory tract, especially alveolar region, Among the formulations, MPS-LcRGD caused significant reduction of edema, neutrophil infiltration and inflammation biochemical marker levels. From the results, it can be inferred that nebulization of targeted liposomes had facilitated spatial and temporal modulation of drug delivery resulting in alleviation of ALI.

Traction-assisted Internal Negative Pressure Wound Therapy With Bridging Retention Sutures to Facilitate Staged Closure of High-risk Wounds Under Tension.

Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures. Instillation of antimicrobial solution was reserved for wounds containing infected/exposed hardware or prosthetic devices. Demographic data, wound characteristics, reconstructive outcomes, and complications were reviewed retrospectively. Eighteen wounds were treated with traction-assisted internal NPWT using the conventional (n = 11) or modified instillation (n = 7) technique. Defects involved the lower extremity (n = 14), trunk (n = 3), and proximal upper extremity (n = 1), with positive cultures identified in 12 wounds (67%). Therapy continued for 3 to 8 days (mean, 4.3 days), resulting in an average wound surface area reduction of 78% (149 cm² vs. 33 cm²) at definitive closure. Seventeen wounds (94%) were closed directly, whereas the remaining defect required coverage with a local muscle flap and skin graft. At final follow-up (mean, 12 months), 89% of wounds remained closed. In 2 patients with delayed, recurrent periprosthetic infection (mean, 7.5 weeks), serial debridement/hardware removal mandated free tissue transfer for composite defect reconstruction. Traction-assisted internal NPWT provides a safe and effective alternative to reduce wound burden and facilitate definitive closure in cases where delayed reconstruction of high-tension wounds is planned.

Abstract: Use of Negative Pressure Wound Therapy with Instillation in Acute Post-Surgical Breast Reconstruction Infections—Retrospective Review

INTRODUCTION: In recent years, combining instillation of a topical wound solution with negative pressure wound therapy (NPWT) has facilitated wound cleansing. Furthermore, published studies have positively reported on the use of a NPWT system with automated instillation and a dwell time (NPWTi-d) that provides a method of cyclically instilling and dwelling topical solutions to help improve healing outcomes of acute and chronic wounds. Our purpose was to analyze our outcomes of patients who received adjunctive NPWTi-d with a polyhexanide solution to address surgical site occurrences (SSO) following first stage expander-implant breast reconstruction. METHODS: A retrospective record review was conducted. Patient data were extracted from the electronic medical record by means of manual review and stored in a database. Adult patient records were included for analysis if the patient underwent a mastectomy followed by immediate or delayed expander reconstruction, had infection of at least one pocket confirmed via culture, had received oral and systemic antibiotics for at least one week, and subsequently received NPWTi-d. All procedures were completed between January 1, 2016 and February 1, 2017. Demographics, surgical approach, comorbidities and expander salvage rate were recorded and analyzed. Six female patients with a median age of 50.8 were included in the analysis. Five of 6 patients had undergone sub-pectoral expander reconstruction and one patient received pre-pectoral expander reconstruction. Antibiotics were also continued based on specific cultures. All surgical site infections were thoroughly debrided and irrigated. Adjunctive NPWTi-d was initiated: instillation of a polyhexanide solution with a 20-minute dwell time, followed by 3.5 hours of -125 mmHg negative pressure. Duration of therapy ranged from 1–3 days. RESULTS: Salvage of the expander was achieved in all 6 patients. None of the pockets showed signs of infection after application of NPWTi-d. Healthy granulation tissue was present in all NPWTi-d treated pockets. All breast incisions were successfully closed with good cosmetic results and without further sequelae. CONCLUSION: Tissue expanders could be salvaged in all 6 patients with SSOs in this series who received NPWTi-d. This small sample size does not allow for a reliable extrapolation to the general population. Although further studies are needed, the results from these 6 patients suggest that NPWTi-d may represent an important new adjunctive therapy option in device salvage for breast reconstruction patients.

Isotonic saline nasal irrigation in clinical practice: a literature review

Abstract Introduction: Nasal instillation of saline solution has been used as part of the treatment of patients with upper respiratory tract diseases. Despite its use for a number of years, factors such as the amount of saline solution to be used, degree of salinity, method and frequency of application have yet to be fully explained. Objective: Review the reported outcomes of saline nasal irrigation in adults with allergic rhinitis, acute or chronic sinusitis and after functional endoscopic sinus surgery (FESS), and provide evidence to assist physiotherapists in decision making in clinical practice. Methods: A search was conducted of the Pubmed and Cochrane Library databases between 2007 and 2014. A combination of the following descriptors was used as a search strategy: nasal irrigation, nasal lavage, rhinitis, sinusitis, saline, saline solution. Results: Eight clinical trials were included, analyzed according to participant diagnosis. Conclusion: The evidence found was heterogeneous, but contributed to elucidating uncertainties regarding the use of nasal lavage in the clinical practice of physical therapy, such as the protocols used.

Evaluating tear clearance rate with optical coherence tomography.

To assess the early-phase of tear clearance rate (TCR) with anterior segment optical coherence tomography (OCT) and to determine the association between TCR and other clinical measures of the tear film in a group of young subjects with different levels of tear film quality. TCR was classified as the percentage decrease of subject's inferior tear meniscus height 30s after instillation of 5μl 0.9% saline solution. Fifty subjects (32F and 18M) aged (mean±standard deviation) 25.5±4.3 years volunteered for the study. It consisted of a review of medical history, Ocular Surface Disease Index (OSDI) questionnaire, tear film osmolarity measurements, slit lamp examination and TCR estimation based on dynamic measurements of the lower tear meniscus with OCT. Estimates of TCR were contrasted against subject age and tear film measures commonly used for dry eye diagnosis, which includes OSDI score, fluorescein tear film break-up time (FBUT), tear meniscus height (TMH), blinking frequency, tear film osmolarity and corneal staining. The group mean TCR was 29±13% and 36±19% respectively after 30 and 60s margin after saline solution instillation. Statistically significant correlations were found between TCR and FBUT (r2=0.319, p<0.001), blinking frequency (r2=0.138, p<0.01), tear film osmolarity (r2=0.133, p<0.01) and subject's age (r2=0.095, p<0.05). Anterior segment optical coherence tomography allows following changes of tear meniscus morphology post saline solution instillation and evaluating the TCR. OCT based TCR might be used as additional measure of the lacrimal functional unit.

Antibiotic susceptibility profiles of ocular and nasal flora in patients undergoing cataract surgery in Taiwan: an observational and cross-sectional study

ObjectiveTo investigate the conjunctival and nasal flora and the antibiotic susceptibility profiles of isolates from patients undergoing cataract surgery.DesignObservational and cross-sectional study.SettingA single-centre study in Taiwan.Participants128 consecutive patients precataract surgery.Primary...

FLUORESCENCE DIAGNOSIS OF BLADDER CANCER WITH AGENT HEXASENS – THE RESULTS OF MULTICENTER TRIAL

The results of multicenter trial for efficacy of fluorescence diagnosis for bladder cancer with agent hexasens (SSC Scientific Research Institute Organic Intermediates and Dyes, Russia) based on hexyl ester of 5-aminolevulinic acid compared with routine cystoscopy are represented in the article. The study included 124 patients. All patients had intravesical instillation of 50 ml of 0,2% hexasens. The exposure time accounted for 1-2 h. After removal of the drug from bladder standard cystoscopy followed by fluorescence diagnosis was performed in every patient. During the local fluorescence spectroscopy the intravesical instillation of the agent hexasens was shown to induce selective accumulation of photoactive protoporphyrin IX in tumor cells comparing with intact bladder mucosa. During 1 h after intravesical instillation of hexasens solution the level of fluorescence of hexasens-induced protoporphyrin IX in the tumor was higher than that in surrounding intact mucosa at average in 5.8 fold. As compared with results of standard cystoscopy, fluorescence diagnosis improved the sensitivity of the method by 24.4% (from 75.6% to 100%), the accuracy – by 15.2% (from 83.3% to 98.5%) and negative predictive value – by 33.5% (from 66.5% to 100%). Fluorescence diagnosis gave an opportunity to detect additional tumor foci, which were invisible in white light, in 27.4% of patients. For fluorescence diagnosis in 4.0% of patients false-positive fluorescence of bladder mucosa was detected that was probably due to inflammation. None of patients received active dose of the drug hexasens had adverse reactions, changes in general well-being and blood and urine parameters. According to the results of the study fluorescence diagnosis with hexasens for bladder cancer is recommended for use in clinical practice.

Enzymotherapy of toxic anterior segment syndrome after phacoemulsification

Purpose. To investigate the efficacy of recombinant prourokinase (RPU) treatment in patients with toxic anterior segment syndrome after phacoemulsification.&#x0D; Material and methods. We observed 123 patients (123 eyes) with toxic anterior segment syndrome after phacoemulsification; patients of the group I (n = 30) received only antiinflammatory treatment; in treatment of patients of the group II (n = 31), instillations of the RPU solution were used, in the group III (n = 31), RPU solution was injected subconjunctivally, in the group IV (n = 31) RPU solution electrophoresis was used. Treatment result analysis was carried out within 30 days.&#x0D; Results. Initial mean visual acuity in groups was 0.09 0.04; 0.1 0.04; 0.09 0.04; 0.08 0.04, and was virtually the same (p 0.05). In 24 hours after treatment initiation, mean visual acuity in the group III was higher, than in the others. In three days and up to the end of observation period, the lowest mean visual acuity was noted in the group I (p 0.05). Anterior chamber assessment showed that beginning from the first 24 hours after treatment initiation, in groups III and IV, fibrin lysis in the anterior chamber was more pronounced, than in groups I and II (p 0.05); by the end of the observation period, worst indices of anterior chamber state were found in the group I (p 0.05), in other groups, they were almost identical (p 0.05). When using RPU, no allergic reaction was noted.&#x0D; Conclusions. RPU use in combined toxic anterior segment syndrome therapy after phacoemulsification allows increasing visual acuity, reducing convalescence time, and reducing the number of laser dissections. It was established that all methods of RPU administration are effective. RPU may be administered as eye drops on an outpatient basis, receiving efficacy similar to other administration methods.

Влияние инстилляций коллоидного раствора наночастиц серебра на ультраструктуру переднего эпителия и стромы роговицы

Влияние инстилляций коллоидного раствора наночастиц серебра на ультраструктуру переднего эпителия и стромы роговицы

Protective effects of tranilast on experimental colitis in rats

The present study aimed to verify the efficacy of tranilast (TL) for treating inflammatory bowel disease (IBD) with the use of an experimental colitis model. The experimental colitis model was prepared by intrarectal instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS; 40mg/kg) dissolved in water containing 25% ethanol. The pharmacological effects of TL after repeated oral administration were evaluated by biomarker and histological analyses, and the pharmacokinetic behavior of TL was also examined after single oral administration. The intrarectal instillation of TNBS solution caused colitis, as evidenced by ca. 2.2-, 5-, and 3-fold increases in myeloperoxidase (MPO) activity, infiltrated cell numbers, and the thickness of the submucosa in the colon, respectively. However, orally-taken TL (10mg/kg, twice a day for 9days) led to a 92% reduction in the increase of the MPO level by TNBS enema, and cellular infiltration and thickened submucosa in the experimental colitis model tended to also be suppressed by repeated oral administration of TL. The oral bioavailability of TL in TNBS-treated rats was calculated to be as low as ca. 6.5%, and the poor oral absorption of TL may be a limitation of the treatment for IBD. TL could attenuate TNBS-induced colitis on the basis of the obtained results, and the anti-inflammatory effects would have clinical relevance to the therapeutic outcomes of TL in IBD patients. Although further improvement in the oral bioavailability of TL might be required for better pharmacological outcomes, TL would be an efficacious agent for treating IBD.

Does NPWT improve the outcome of osteomyelitis in HCV-HIV coinfected patient?

Osteomyelitis with severe skin and soft tissue damage in a critical patient cannot be treated by an orthopedic specialist. In such patients, a team appOsteomyelitis with severe skin and soft tissue damage in critically ill patients cannot be treated solely by an orthopedic specialist. In such patients, a team approach is required. We report the treatment of osteomyelitis in an HCV and HIV positive patient with several severe comorbidities (liver failure, peripheral vascular disease, and peripheral neuropathy). The patient underwent mechanical debridement, followed by three months of antibiotic therapy. Six months later the infection relapsed and a second debridement was performed. V.A.C.Ulta therapy with instillation of “Dermacyn” solution, a super-oxidized disinfectant, as an antiseptic solution was applied for 20 days and the wound healed. Three years follow-up with inflammatory laboratory tests, clinical and radiographic examinations showed healing of the wound without any relapse of the infection. In this paper, we suggest combining debridement and NPWT with installation for critical patients with severe soft tissue damage that poorly respond to other therapies. Keywords—antibiotic therapy, HCV, HIroach is required. We report the treatment of osteomyelitis in patient HCV/HIV coinfected with several severe comorbidities (liver failure, peripheral vascular disease and peripheral neuropathy). The patient was underwent debridement, followed by a long period of antibiotic therapy. Six months later the infection relapsed, the second debridement was performed, VAC-Ulta therapy with instillation of antiseptic solution was applied for 20 days and the wound healed. Three-years follow-up with inflammatory laboratory tests, clinical and radiographic examinations showed healing of wound without any relapse of infection. In this paper, we suggest different therapeutic strategies for critical patients with severe soft tissue damage that are not good responsive to other therapies, showing that the melding of different approaches can provide a picturesque legacy of outcomes for unusual procedures.

The expression levels of Notch-related signaling molecules in pulmonary microvascular endothelial cells in bleomycin-induced rat pulmonary fibrosis.

Previous studies have suggested that the Notch signaling pathway plays a very important role in the proliferation and differentiation of pulmonary microvascular endothelial cells (PMVECs). Therefore, we aimed to investigate the expression level of Notch-related signaling molecules in PMVECs in bleomycin (BLM)-induced rat pulmonary fibrosis. Immunohistochemistry, immunofluorescence, Western blotting, and real-time PCR were used to analyze the differences in protein and mRNA expression levels of Notch-related signaling molecules, i.e. Notch1, Jagged1, Delta-like ligand 4 (Dll4), and hairy and enhancer of split homolog 1 (Hes1), between a control group treated with intratracheal instillation of saline and a study group treated with intratracheal instillation of BLM solution. Expression levels of the receptor Notch1 and one of its ligands, Jagged1, were upregulated, while the expression levels of the ligand Dll4 and the target molecule of the Notch signaling pathway, Hes1, were downregulated. The differences in protein and mRNA expression levels between the control and study groups were significant (p<0.001). The Jagged1/Notch1 signaling pathway is activated in the pathogenesis of BLM-induced rat pulmonary fibrosis, while the Dll4/Notch1 signaling pathway is inhibited, which inhibits the suppressive effect of Dll4/Notch1 signaling on PMVEC overproliferation, further causing PMVEC dysfunction in cell sprouting and maturation as well as abnormal differentiation of the cell phenotype. Conversely, the down-expression of Hes1 indicates that the Jagged1/Notch1 signaling pathway could be a non-canonical Notch signaling pathway independent of Hes1 activation, which differs from the canonical Dll4/Notch1 signaling pathway.

Intrauterine Extra-amniotic Misoprostol Solution is Effective for Termination of Second Trimester Missed Abortion: A clinical pilot descriptive study

Objectives: The purpose of this study was to determine the efficacy and safety of intrauterine extra-amniotic misoprostol solution for termination of the second trimester missed abortion. Methods: A clinical pilot descriptive study that was done in Women Health Hospital, Assiut University, Egypt between March 2015 and June 2015. Fifty patients having missed abortion of gestational age between 13 to 24 weeks were included in the study. Insertion of an intrauterine Foley’s catheter followed by infusion of sterile misoprostol solution through a sterile infusion set at a constant drip rate. The primary outcome was successful expulsion of the fetus in 12 hours after starting misoprostol infusion. Results: The mean age of the study group was 27.25±4.08, the mean BMI was 26.35±3.6, the mean gestational age was 22.85±3.4 and the mean parity was 2.5±1.5. The mean induction expulsion interval was 5.27±2.66 hours. Six cases (12%) needed analgesic. Surgical evacuation of retained contents was needed in 3 cases (6%). Side effects in the form of rigors, fever and diarrhea were recorded in 4 cases (8%). No serious maternal events were recorded. Conclusion: Our results showed that intrauterine extra-amniotic misoprostol solution instillation appear to be effective and safe for termination of a second trimester missed abortions.

Improving the Quality of Nasal Specimen Collection for Influenza A and B Screening

PROBLEM: Rapid diagnosis of seasonal influenza leads to optimized clinical care and reduces the spread of infection. The collection of adequate cellular material can be facilitated by the presence of moisture in the nares. The specific aim of this project was to determine if the installation of sterile saline into the nares prior to specimen collection would improve the quality of the specimen. This quasi-experimental single group design tested an initial "dry swab" specimen against a second swab after instillation of sterile saline solution using a nasal atomizer, a "wet swab." A total of 80 paired specimens were collected and analyzed between December 7, 2015, and April 21, 2016, with an 11.25% infection rate in those tested. Of 9 positive tests, 6 subjects tested positive for influenza A or B for both the dry swab and the wet swab. Three subjects tested positive for influenza A or B for only the wet swab, and these subjects had experienced their symptoms longer than did subjects who tested positive for both methods (mean symptom onset of 72 hours vs 66 hours). We found an important inconsistency between manufacturers' recommendations and typical hospital practice. The results appear somewhat equivocal. Because viral shedding declines after the first 48 to 72 hours in adults, the wet swab method may be clinically superior for detecting influenza in adults presenting later in the course of their illness. Hospital policy was revised for consistency in using the gel medium before sampling in accordance with manufacturer recommendations.

Effects of nasal instillation of a nitric oxide-releasing solution or parenteral administration of tilmicosin on the nasopharyngeal microbiota of beef feedlot cattle at high-risk of developing respiratory tract disease

Nitric oxide has bactericidal and virucidal properties. Nasal instillation of a nitric oxide releasing solution (NORS) on arrival at the feedlot was recently reported as inferior to a parenteral injection of tilmicosin (macrolide antibiotic) for control of bovine respiratory disease (BRD) in cattle at high-risk of developing BRD. We hypothesized that this inferiority was due to differences between treatments with regards to their effects on the nasopharyngeal microbiota. The objective was to compare nasal instillation of NORS versus parenteral administration of tilmicosin regarding their effects on the nasopharyngeal microbiota of feedlot cattle at high-risk of developing BRD. Culture-independent community profiling (16S rRNA sequencing) and culture-based methods were used to evaluate treatment effects. High-risk Angus-cross heifers (n=20) were randomly allocated to 2 treatment groups on arrival at a feedlot and received either NORS or tilmicosin for prevention of BRD. Heifers were sampled using guarded deep nasal swabs immediately prior to treatment (day 0) and on days 1, 5 and 10 after treatment. Based on culture-independent community profiling, there was a distinct shift in composition of the nasopharyngeal microbiota during the first 10 d after arrival, with 116 OTUs changing over time, but no difference between treatment groups. However, culture-based methods detected a difference between treatment groups, with more cattle culture-positive for Pasteurellaceae in the NORS group at day 5 post-treatment. This difference in ability to inhibit colonization of the nasopharynx by Pasteurellaceae may be the basis for NORS being inferior to tilmicosin for control of BRD in high-risk cattle.

Negative pressure therapy for the treatment of complex wounds.

The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response. The main indications of NPT are complex wounds, such as pressure ulcers, traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, prevention of complications in closed incisions and in the association with instillation of solutions in infected wounds.

Effect of sodium hydrosulfide on mRNA expression of prostaglandin E2 receptors in response to mucosal acidification and distention-induced gastric acid secretion in rats.

Objective(s):Prostaglandins have been shown to mediate the gastro-protective effect of sodium hydrosulfide (NaHS) but effect of NaHS on mRNA expression of prostaglandin E2 receptors (EP1, 3-4; EPs) has not been investigated. Therefore, this study designed to evaluate the effect of NaHS on mRNA expression of EPs receptors in response to mucosal acidification and distention-induced gastric acid secretion in rats.Materials and Methods:Fasted rats were randomly assigned into 4 groups (n=6/group). They were control, and NaHS-treated groups. To evaluate the effect of NaHS on mucosal mRNA expression of EPs receptors, the gastric mucosa exposed to stimulated gastric acid output and mucosal acidification. The pylorus sphincter catheterized for instillation of isotonic neutral saline or acidic solution. Ninety min after beginning the experiments, animals sacrificed and the gastric mucosa collected to determine the pH, mucus secretion and to quantify the mRNA expression of EPs receptors by quantitative real-time PCR.Results:present results showed that a) NaHS increased the mucus secretion, mRNA expression of EP3 and EP4 receptors in response to distention-induced expression; b) The mRNA expression of EP1 receptors increased while EP4 mRNA receptors decreased in response to mucosal acidification in NaHS-pretreated rats; and c) NaHS increased pH of gastric contents both in response to distention-induced gastric acid secretion and mucosal acidification.Conclusion:NaHS behaves in a different manner. It effectively only increased the pH of gastric contents to reinforce the gastric mucosa against a highly acidic solution but modulated both acid and mucus secretion when the rate of acid increase in the stomach was slower.

Atopic keratoconjunctivitis complicated by Kocuria koreensis keratitis: the first case

BackgroundPatients with atopic dermatitis have a predisposition to Staphylococcus aureus and a Herpes simplex virus infection. The treatment of atopic diseases with steroid and immunosuppressive agents induces opportunistic infection. However, there is a concern regarding visual prognosis in patients with atopic keratoconjunctivitis (AKC) complicated with infectious keratitis. We report an unusual case of an atopic shield ulcer with Kocuria keratitis.Case presentationA 51-year-old Japanese man presented with a 14-day history of eye pain and visual loss in his left eye. At the initial examination, a shield ulcer was observed in the upper-central cornea of the left eye, and the conjunctiva in both eyes had a velvety appearance due to papillary formation, as well as hyperemia and swelling in the palpebral area. The shield ulcer showed white stromal opacification in the marginal zone with a coral-like appearance. Samples were obtained by corneal scraping, and Kocuria sp. was identified by microbiological examination including culture and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The 16S rRNA gene sequence analysis was performed using isolated Kocuria strain from the patient. The obtained DNA sequence showed 99% homology with Kocuria koreensis. The combination of corneal scraping and instillation of cefmenoxime antibiotic ophthalmic solution was considered useful for the treatment of Kocuria keratitis.ConclusionClinicians should be aware of Kocuria keratitis as a corneal complication of AKC, and that rapid diagnosis of Kocuria keratitis may improve visual prognosis.