Burns often cause the damaged tissue to produce a large amount of exudate and the formation of blisters on the wound. The burn blister fluid contains a large number of molecules related to wound healing, which can reflect the state of local tissue microenvironment of the burn wound. Analyzing relevant information such as cellular components, signal mediators, and protein molecules in burn blister fluid is helpful to understand the local reaction and tissue microenvironment of burn wounds, and then help clinical burn treatment. In this article, by understanding the production mechanism of burn blister fluid, discussing its role in wound evaluation, and integrating the research progress of burn blister fluid in proteomics, metabolomics, cellular components, and pharmacokinetics, we propose our thoughts and prospects on the research of burn blister fluid, in order to provide assistance for clinical evaluation and treatment of burn wounds, and also provide idea for the follow-up study of burn blister fluid.
Humans ; Blister/metabolism* ; Follow-Up Studies ; Burns/metabolism* ; Exudates and Transudates/metabolism* ; Wound Healing

OBJECTIVETo investigate the changes in pharmacokinetic parameters of vancomycin in the subeschar tissue fluid (STF) at early post-burn stage in patients with severe burns.

METHODSTen patients with severe burns were enrolled in the study and received intravenous injection of 500 mg vancomycin at an even rate within 60 mins 1 to 2 hours after admission. A total of 0.5 ml STF was collected each time and the concentration of vancomycin in the STF was determined by fluorescence polarization immunoassay (FPIA) method at 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 post-burn hours (PBH). Pharmacokinetic parameters of vancomycin were produced by program 3P97 and statistically analyzed by program package SPSS10. 0.

RESULTSThe STF concentration-time curves of vancomycin were best fit in two compartment model. Pharmacokinetic parameters of vancomycin in the STF were: t1/2alpha = (3.7 +/- 2.6) h, t1/2beta = (92 +/- 12)h, Vc = (26 +/- 6)L, AUC = (1279 +/- 256) microg x h x ml(-1), CLs = (0.40 +/- 0.08) L/h.

CONCLUSIONWhen vancomycin is used early after severe burns, the drug can be retained in the third space, and the concentration of the drug can be maintained for over 24hrs, and it is beneficial to form an antibiotic barrier around the wound to prevent an invasive bacterial infection to the burn wound.

Adult ; Burns ; drug therapy ; metabolism ; Exudates and Transudates ; chemistry ; metabolism ; Female ; Humans ; Male ; Vancomycin ; pharmacokinetics ; therapeutic use

OBJECTIVETo investigate the different velocity of polymorphonuclear neutrophil (PMN) infiltration, erythrocyte diapedesis and plasma exudation into the pulmonary tissue of the rats inflicted with smoke inhalation injury, so as to explore the different mechanisms of their existence in rat pulmonary tissue after inhalation injury.

METHODSThe rat smoke inhalation injury model was employed in the study. Wistar rats were inflicted with smoke inhalation injury, and then sacrificed at 1, 3, 6, 12 and 24 post injury hours (PIH). 131I-BSA, 99mTc-PMN or 99mTc-erythrocytes (RBC) were injected into rat pulmonary tissue 1 hour before sacrifice. Isotonic saline was infused into blood vessel to wash out circulation blood. Then the pulmonary tissue samples were harvested for gamma-value counting and then weighed. The infiltration of 131I-BSA, 99mTc-PMN or 99mTc-RBC in pulmonary tissue per gram and per minute was calculated, and MPO content was measured by phosphate T-tolidine method.

RESULTSThe amount of RBC diapedesis in rat lung tissue peaked at 1 PIH, decreased thereafter and approached to normal level at 24 PIH. The amount of PMN infiltration increased at 3 PIH, slightly decreased at 6 PIH but still higher than that in normal tissue, and increased again at 24 PIH. The pulmonary tissue content of MPO gradually increased from 1 PIH to 24 PIH. The pulmonary tissue content of 131I-BSA began to increase at 1 PIH and peaked at 6 PIH, and remained higher than that in normal tissue till 24 PIH.

CONCLUSIONEven though there was remarkable postburn increase in the erythrocyte diapedesis, neutrophil infiltration and albumin exudation with different peak time points (1, 3 and 6 PIH, respectively), Inflammation seemed not to be the premise of erythrocyte diapedesis, while the secondary inflammatory reaction might be the main cause of pulmonary edema.

Animals ; Capillary Permeability ; Exudates and Transudates ; metabolism ; Hemorrhage ; etiology ; Neutrophil Infiltration ; Rats ; Rats, Wistar ; Serum Albumin, Bovine ; metabolism ; Smoke Inhalation Injury ; complications ; metabolism

To report the surgical outcome of full-thickness sclerotomy in five cases of uveal effusion syndrome (UES). Full-thickness sclerotomy without sclerectomy was performed on five eyes of four patients with UES with or without nanophthalmos. In four of the eyes, exudative retinal detachment associated with UES resolved after the sclerotomy. The subretinal fluid in one eye, which had a normal axial length, was relieved after undergoing three sclerotomy procedures. Full-thickness sclerotomy without vortex vein decompression or sclerectomy is an effective surgical option for the management of significant UES.
Adult ; Aged ; Drainage/methods ; Exudates and Transudates/*metabolism ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures/*methods ; Retinal Detachment/metabolism/surgery ; Sclera/*surgery ; Uveal Diseases/*metabolism/*surgery

OBJECTIVETo investigate the changes of pharmacokinetic parameters of amikacin in the subeschar tissue fluid (STF) in the early stage of severe burns.

METHODSAmikacin concentration in the STF of 10 severely burned patients were determined by fluorescence polarization immunoassay (FPIA) at different time points after intravenous amikacin infusion of the initial dose of 400 mg given within 60 min. The pharmacokinetic parameters of amikacin were measured using 3P97 program and statistically analyzed with SPSS10.0 software.

RESULTS AND CONCLUSIONAfter the initial dose of 400 mg of amikacin, the STF concentration-time curves of amikacin were fitted in two compartment model. The pharmacokinetic parameters of amikacin in the STF were: t(1/2alpha)=(4.35-/+1.66) h, t(1/2beta)= (80.04-/+9.52) h, Vc= (13.17-/+1.32) L, AUC= (1802.49-/+285.68) microg. h.ml(-1), and CLs= (0.2272-/+0.0383) L. h(-1), demonstrating significantly lower clearance and longer elimination half life of amikacin in the STF following amikacin administration in early stage of severe burns. Elimination half-life of amikacin in the STF in severely burned patients was 28.20-44.78 times longer than that in the serum of normal volunteers, and the effective inhibitory concentration of amikacin could maintain for at least 24 h, suggesting antibiotic retention in the third space after early and short-term use of potent antibiotics and formation of antibiotic barrier in the STF, which may help prevent bacterial infection of the wound.

Adult ; Amikacin ; administration & dosage ; pharmacokinetics ; therapeutic use ; Anti-Bacterial Agents ; administration & dosage ; pharmacokinetics ; therapeutic use ; Burns ; drug therapy ; metabolism ; Extracellular Space ; metabolism ; Exudates and Transudates ; metabolism ; Female ; Humans ; Infusions, Intravenous ; Male ; Skin ; drug effects ; metabolism ; pathology

The authors experienced two cases of hydrochlorothiazide (HCTZ)-induced acute-onset bilateral myopia and shallowing of the anterior chambers. Two middle-aged women taking HCTZ, a sulfa derivative, visited our clinic complaining of acute bilateral visual deterioration. Both had good visual acuity without corrective lenses before taking HCTZ. A complete ophthalmologic examination revealed bilateral myopic shift, intraocular pressure elevation, shallowing of the anterior chambers, choroidal effusions, radiating retinal folds, and conjunctival chemosis. Approximately one week after HCTZ discontinuance, all ocular changes disappeared completely. Physicians should be aware of the adverse ocular effects of HCTZ and should manage patients accordingly.
Acute Disease ; Adult ; Anterior Chamber/drug effects ; Choroid/drug effects/*metabolism ; Cilia/drug effects/*metabolism ; Diuretics/*adverse effects ; Exudates and Transudates/*metabolism ; Female ; Humans ; Hydrochlorothiazide/*adverse effects ; Intraocular Pressure/drug effects ; Middle Aged ; Myopia/*chemically induced

We report a rare case of multicentric Castleman's disease that presented with ophthalmic involvement, along with a review of the literature. A 63-year-old male presented with decreased visual acuity in both eyes. Both eyes had serous elevations of the retinas with shifting subretinal fluid and annular choroidal detachment. No retinal breaks were found. Laboratory tests revealed pancytopenia, hypergammaglobulinemia, and an increased erythrocyte sedimentation rate. Chest and abdominal computed tomographies showed multiple lymphadenopathies in the mediastinum, abdomen, and in both inguinal areas. Histological examination of the inguinal lymph node biopsy was consistent with Castleman's disease. After combination chemotherapy, the serous elevations of both retinas and the annular choroidal detachments of both eyes disappeared. Ophthalmic involvement in Castleman's disease is very rare, and to the authors' knowledge, this is the first report of ophthalmic involvement of Castlemans's disease in Korea.
Aged ; Choroid Diseases/etiology ; Drug Therapy, Combination ; Exudates and Transudates/*metabolism ; Fluorescein Angiography ; Fundus Oculi ; Giant Lymph Node Hyperplasia/*complications/drug therapy ; Humans ; Hypergammaglobulinemia/complications ; Magnetic Resonance Imaging ; Male ; Syndrome ; Tomography, Optical Coherence ; Treatment Outcome ; Uveal Diseases/diagnosis/*etiology/*metabolism

OBJECTIVETo explore the half life and retention of Imipenem in the third space.

METHODSEight severely burned patients and eight healthy volunteers were enrolled as the burn group (B) and normal control group (C), respectively. HPLC (high performance liquid chromatography) was employed to determine the contents of Imipenem in the plasma, subeschar tissue fluid (STF) and the changes in its pharmacokinetics. Furthermore, the Imipenem content in the third space was calculated according to the systemic edema degree.

RESULTSThe half life of Imipenem in STF (2.53 h) was longer than that in plasma (1.73 h), P < 0.05). The Imipenem content in STF increased gradually along with the lapse of time after repeated intravenous infusion of Imipenem, and at the same the total content of imipenem was increased significantly in the third space.

CONCLUSIONThere was antibiotic retention in the third space after severe burn injury, and a prolonged action of the drug could be expected when the drug re-entered the blood stream.

Adolescent ; Adult ; Anti-Bacterial Agents ; pharmacokinetics ; therapeutic use ; Burns ; drug therapy ; metabolism ; Case-Control Studies ; Exudates and Transudates ; metabolism ; Female ; Half-Life ; Humans ; Imipenem ; pharmacokinetics ; therapeutic use ; Male ; Young Adult

BACKGROUND: A few reports of transudative malignant effusion on a small number of patients have suggested the need to perform routine cytologic examination in all cases of transudative pleural effusion, whether encountered for malignancy or not. The purpose of this study was to investigate whether cytologic examination should be performed in all cases of transudative pleural effusion for the diagnosis of malignancy. METHODS: We performed a retrospective study of 229 consecutive patients with malignant pleural effusion, proven either cytologically or with biopsy. In patients with transudative pleural effusion, we reviewed medical records, results of transthoracic echocardiography, fiberoptic bronchoscopy, chest X-ray, chest CT scan, and ultrasonogram of the abdomen. These data were examined with particular attention to identifying whether or not the malignancy was suggested on chest X-ray, examining the involvement of the superior vena cava, great vessels, and lymph nodes, determining the presence of pericardial effusion, and observing the endobronchial obstruction. RESULTS: Transudative malignant pleural effusion was observed in seven (3.1%) of the 229 patients, and was caused either by the malignancy itself (6 patients) or by coexisting cardiac diseases (1 patient). All the patients showed evidence suggesting the presence of malignancy at the time of initial thoracentesis, which facilitated the decision of most clinicians on whether to perform cytologic examination for the diagnosis of malignancy. CONCLUSION: Therefore, in all cases of transudative pleaural effusion, no clinical implications indicating malignancy were found on cytologic examination.
Biopsy ; Carcinoma/classification/*pathology/*secondary ; Exudates and Transudates ; Human ; Lung Neoplasms/*pathology ; Lymphatic Metastasis ; Neoplasm Staging ; Neoplasms, Unknown Primary/*pathology ; Pleural Effusion, Malignant/metabolism/*pathology ; Retrospective Studies ; Support, Non-U.S. Gov't

AIM: In the present study, the anti-inflammatory and antioxidant activities of the methanol extract of Ruta graveolens leaves (RG-M) were evaluated using various in vivo and in vitro models. METHOD: For anti-inflammatory activity, RG-M was administered by the oral route (p.o.) in a carrageenan-induced paw edema model, and by the intraperitoneal route (i.p.) in an exudative inflammation model. In vitro inhibition of cyclooxygenase and lipoxygenase enzymes was evaluated. In vitro antioxidant activity was also examined. Endogenous antioxidant status was further evaluated by ferric reducing ability of plasma model. RESULTS: RG-M showed maximum inhibition of carrageenan-induced edema (100 mg·kg⁻¹ - 33.36%; 200 mg·kg⁻¹ - 45.32% and 400 mg·kg⁻¹ - 56.28%). In the exudative inflammation model, a significant reduction in leukocyte migration (200 mg·kg⁻¹ - 54.75% and 400 mg·kg⁻¹ - 77.97%) and protein exudation (200 mg·kg⁻¹ - 31.14% and 400 mg·kg⁻¹ - 49.91%) were observed. RG-M also exhibited inhibition of COX-1 (IC50 182.27 μg·mL⁻¹) and COX-2 (IC50 190.16 μg·mL⁻¹) as well as 5-LOX (IC50 215.71 μg·mL⁻¹). Antioxidant activity was significant with improved endogenous antioxidant status. CONCLUSION The results demonstrated the anti-inflammatory and antioxidant activity of RG-M with potent inhibitory effects on the arachidonic acid pathways.
Animals ; Anti-Inflammatory Agents ; pharmacology ; therapeutic use ; Antioxidants ; pharmacology ; therapeutic use ; Arachidonic Acid ; metabolism ; Carrageenan ; Cyclooxygenase 1 ; metabolism ; Cyclooxygenase 2 ; metabolism ; Cyclooxygenase Inhibitors ; pharmacology ; therapeutic use ; Disease Models, Animal ; Edema ; drug therapy ; Exudates and Transudates ; Ferric Compounds ; metabolism ; Inflammation ; drug therapy ; metabolism ; Leukocytes ; metabolism ; Lipoxygenase Inhibitors ; pharmacology ; therapeutic use ; Lipoxygenases ; metabolism ; Male ; Phytotherapy ; Plant Extracts ; pharmacology ; therapeutic use ; Plant Leaves ; Rats, Wistar ; Ruta