A randomised controlled trial of amniotic membrane in the treatment of a standardised burn injury in the merino lamb.
Burns. 2009 May 15; Fraser JF, Cuttle L, Kempf M, Phillips GE, Hayes MT, Kimble RMBurn injury is associated with disabling scar formation which impacts on many aspects of the patient's life. Previously we have shown that the fetus heals a deep dermal burn in a scarless fashion. Amniotic membrane (AM) is the outermost fetal tisue and has beeen used as a dressing in thermal injuries, though there is little data to support this use. To assess the efficacy of AM in scar minimisation after deep dermal burn wound, we conducted a randomised controlled study in the 1-month lamb. Lambs were delivered by caesarian section and the amniotic membranes stored after which lambs were returned to their mothers post-operatively. At 1 month, a standardised deep dermal burn was created under general anaesthesia on both flanks of the lamb. One flank was covered with unmatched AM, the other with paraffin gauze. Animals were sequentially euthanased from Day 3-60 after injury and tissue analysed for histopathology and immunohistochemically for alpha-smooth muscle actin (alphaSMA) content. AM resulted in reduced scar tissue as assessed histopathologically and reduced alphaSMA content. This study provides the first laboratory evidence that AM may reduce scar formation after burn injury.
CT and MR Imaging Findings in Patients with Acquired Heart Disease at Risk for Sudden Cardiac Death.
Radiographics. 2009 May-Jun; 29(3): 805-23Sparrow PJ, Merchant N, Provost YL, Doyle DJ, Nguyen ET, Paul NSNoninvasive imaging is an important screening and diagnostic tool in conditions associated with sudden cardiac death. The most common cause of sudden cardiac death is coronary artery disease, with myocarditis, cardiac sarcoidosis, and dilated and infiltrative cardiomyopathies being less common acquired causes. Common risk factors for sudden cardiac death, regardless of the disease process, include severe ventricular dysfunction and the presence of macroscopic scar seen at delayed contrast material-enhanced imaging. Recent advances in electrocardiographically (ECG) gated cardiac magnetic resonance (MR) imaging and multidetector computed tomography (CT) have led to increased referrals for cross-sectional imaging; thus, cardiac radiologists should be familiar with the disease entities associated with sudden cardiac death. Inflammatory processes and cardiomyopathies are best depicted with cardiac MR imaging. Steady-state free precession cine sequences coupled with inversion-recovery prepared gradient-echo T1-weighted sequences performed after the intravenous administration of gadolinium-based contrast material should form the basis of cardiac MR imaging protocols for cardiomyopathy. A clinical history that is suggestive of myocardial ischemia, specific requests to exclude coronary artery disease, or contraindications for MR imaging may imply that multidetector CT would be more appropriate. Nevertheless, both cardiac MR imaging and ECG-gated multidetector CT offer robust diagnosis and risk stratification for individual disease processes associated with sudden cardiac death. (c) RSNA, 2009.
