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概要: Recent advances in keratin biology were summarized and the usefulness of keratin staining and keratin electrophoresis in dermatology was introduced. Anti-hair keratin monoclonal antibodies were produced against human hair keratin filament … proteins by mouse hybridoma method. Some of the antibodies showed immunohistochemical reactivities limited within hair tissue and others cross-reacted with hair tissue and other epithelia. The innermost cell layer of the outer root sheath in anagen hair follicle was tmmunohistochemically and ultrastructurally found to be a unique layer showing own cell differentiation. When these monoclenal antibodies and anti-soft keratin monoclonal antibodies were applied on immunohistochemical surveys of various kinds of skin epithelial tumors, the tumors were classified into several types based on their keratin expression. The keratin staining was also useful to investigate the keratinization disorder in a congenital bullous disease. As well as keratins, keratin-related substances such as keratohyalin and trichohyalin may be important for further studies in keratin biology. 続きを見る

概要: Significant advances in the management for burned patients, such as fluid therapy, burn wound excision, and stress ulcer … prevention, have further accentuated infection as more frequent cause of morbidity and mortality. The present study was conducted to clarify the various microbiological aspects in 28 burn patients who were admitted to and survived early shock stage at the Emergency and Critical Care Unit at Niigata University Hospital from 1986 through 1996. Results：1) Cause of all the 3 died patients was the severe infection. 2) The systemic prophylactic antibiotics most commonly used in the early stage of management was cephazolin (CEZ), while povidone iodine and silver sulphadiazine were the most popular topical agents. 3) Burn wound infection (including colonization) was observed in 13 patients (46%). The main organisms from burn wound were MRSA, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans. These organisms remained at the wound during the long period of the clinical course. 4) Pneumonia, urinary tract infection, intravenous catheter tip infection, and sepsis (septic symptoms with bacteremia) were observed in 4, 7, 4 and 4 patients, respectively. In many cases, common organisms to those from the burn wound were isolated from their relevant specimens. 5) MRSAs were detected in 9 patients, although there were no succumbed patients, nor patients suffered from MRSA pneumonia or enteritis among them. 6) Culture results showed that all the isolated strains of MRSA and Enterococcus faecalis were vancomycin-sensitive. Comprehensive management including not only the use of adequate topical and systemic antibacterial agents, but debridement of the devitalized tissue, nutritional support which enhance the host defense mechanism, and etc. would be essential to prevent infection of burned patients. 続きを見る

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