Heat, Fire, Electricity, Lightning, Radiation, and Gases

A chi-square analysis of 66 cases, including the author's eight cases and 58 from the literature, was undertaken to determine prognostic signs for death in patients seriously injured by lightning. A review of the injuries and of the physics and pathophysiology of lightning is presented. Prognosis was poor for those victims suffering leg burns (mortality 30%), cranial burns (37%), or cardiopulmonary arrest (76%). Death occurred in 30% of the cases studied. Permanent sequelae were found in 74% of the survivors. Nonsignificant factors were age, sex, and trunk and arm burns. Resuscitation of victims exhibiting loss of consciousness should begin immediately, as these are the most likely to die.

Intracellular heat shock proteins (HSP) function as molecular chaperones, they support folding and transport mechanisms of other proteins under physiological conditions and following physical or chemical stress. More recently, extracellular localized HSP have been found to play key roles in the induction of a cellular immune response. Either they act as carrier molecules for immunogenic peptides that are presented on Antigen Presenting Cells (APC) to cytotoxic T-cells or they themselves act as activatory molecules for the innate immune system. Binding of uncomplexed HSP to HSP-receptors on APC has been found to induce the secretion of inflammatory cytokines. Furthermore, an unusual tumor-selective membrane-localization of non-conserved regions of the 72 000 Da HSP (Hsp70) has been found to act as a recognition structure for natural killer (NK) cells. In this review the interaction of NK cells with Hsp70 or peptides derived thereof will be eluciated in more detail.