elastin and Bacterial-Infections

Implantable long-term central venous port systems (CVPS) are widely used as a permanent means of accessing the vascular system for intravenous delivery of drugs, parenteral nutrition, blood transfusion, and blood sampling. These systems allow easy and repetitive puncture without causing much damage to the vessels. However, the body foreign surface of CVPS induces an inflammatory response with varying intensity (depending on the implant materials) that leads to formation of a fibrous tissue capsule around the implant. This study was designed to investigate the influence of bacterial infection on the tissue reaction induced by implanted CVPS in adult patients. 20 patients (9 women, 11 men, 58 ± 14 yrs of age) were included in this study. These patients received explantation of a polysulfone based CVPS (ChemoSite™, Covidien, Mansfield, USA) due to port related infections (patients with bacterial infections at the implantation site: group A, 5 men, 1 women) or to other reasons such as termination of treatment, thrombosis, or CVPS dysfunction (patients without bacterial infections, group B, 6 men, 8 women) 299.9 ± 261.2 days after CVPS implantation. A sample of the encapsulating tissue covering the CVPS together with surrounding tissue (at least 1 × 1 cm2) was placed in a small container with fixing agent, a buffered neutral 4% formalin solution (pH 7). Histological sections of the samples were prepared for light microscopic analysis after paraffin embedding. Sections of 3 μm were cut and stained with haematoxylin and eosin, Weigert's elastic stain, and Heidenhain's azan stain. There was no difference in thickness, collagen and elastin content, or cell and capillary density of the fibrous capsule between both groups. Due to the wound healing reaction involving angiogenesis and fibroblast activation cell density and number of capillaries in the capsule tissue of all patients showed a positive correlation (r = 0.45, p < 0.05). However, the study demonstrated that at the end of the foreign body reaction the artificial tissue layer which covers the CVPS after implantation due to foreign body reaction shows only low reactivity towards infections.

Topics: Adult; Aged; Bacterial Infections; Biocompatible Materials; Blood Pressure; Capillaries; Catheterization, Central Venous; Central Venous Catheters; Collagen; Elasticity; Elastin; Female; Fibroblasts; Foreign-Body Reaction; Humans; Infusions, Intravenous; Male; Middle Aged; Neovascularization, Pathologic; Postoperative Complications; Surgical Wound Infection; Wound Healing

The aim of our case report was to analyse the results obtained with the Matriderm system and autologous skin grafting for the surgical treatment of diabetic ulcers. We recruited one patient with diabetic ulcers admitted at the Department of Plastic and Reconstructive Surgery, University of Rome 'Tor Vergata'. The patient underwent Matriderm system and autologous skin grafting for diabetic ulcer treatment. After just a single treatment, we obtained reduction in ulcer after 15 days from the surgical treatment. We achieved a reduction in pain and exudate secretion of the ulcer. We noticed an almost complete restoration of the missing volume and good quality of skin. Matriderm system and autologous skin grafting is a simple, safe and feasible technique. This method, when compared with other methods of treatment, is simple, cheap, less time consuming and does not require sophisticated laboratory facilities.

Topics: Aged; Anti-Bacterial Agents; Bacterial Infections; Collagen; Combined Modality Therapy; Diabetic Foot; Elastin; Exudates and Transudates; Humans; Male; Pain; Skin Care; Skin Transplantation; Transplantation, Autologous; Treatment Outcome; Wound Healing; Wound Infection

Rapid intraoperative examination of tissues for fungi is important for the surgical control of infection. Staining of frozen or paraffin-embedded tissues with calcofluor white (CFW) is a rapid nonspecific method for the identification of fungal infection. When viewed with a fluorescence microscope, fungal elements stained with CFW are sharply delineated from surrounding tissue and easily identified. Calcofluor white also stains tissue elements such as keratin, collagen, and elastin, which provide useful landmarks for the examination. To a much lesser degree, bacteria are also stained with CFW.

Topics: Animals; Bacterial Infections; Benzenesulfonates; Candidiasis; Collagen; Elastin; Humans; Keratins; Mice; Microscopy, Fluorescence; Mycoses; Staining and Labeling

This study examines the bronchial alveolar lavage (BAL) samples from a group of patients with acute bacterial pneumonia (n = 13) and makes a comparison with a control group (n = 5). The proteinase inhibitory capacity was examined and found to be composed primarily of alpha 1-proteinase inhibitor (PI, alpha 1-antitrypsin) and, to a lesser extent, bronchial mucosal inhibitor. Although the average PI concentration was elevated approximately 5-fold in the pneumonia group, its inhibitory function against elastase was decreased 15-fold when compared with that in the control group. The pneumonia group showed an increased concentration of immunologically identified elastin-derived peptides. Some of the BAL fluid from patients with pneumonia showed elastolytic activity against amorphous insoluble lung elastin. The majority of the elastase appears to be of neutrophil origin. Bronchial mucosal inhibitor is shown to be a component of both normal and pneumonia BAL fluids by both immunologic quantitation and by its resistance to perchloric acid inactivation. Compared with those from control subjects, BAL samples from patients with acute bacterial pneumonia showed a decreased proteinase inhibitor function and both increased elastolytic activity and elastin-derived peptide concentration.

Topics: Acute Disease; Adult; Aged; alpha 1-Antitrypsin; Bacterial Infections; Bronchoscopy; Cell Count; Elastin; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Pancreatic Elastase; Pneumonia; Protease Inhibitors; Pulmonary Alveoli; Therapeutic Irrigation