Adipofascial (anterior rectus sheath) flaps for breast reconstruction

A flat breast after a subcutaneous mastectomy for removal of a foreign body tumor or a benign tumor is not acceptable for many patients. If patients do not wish to use a silicone bag implant for reconstruction, it is necessary to use autologous tissue for the reconstruction of the breast mound. The use of a latissimus dorsi myocutaneous flap or a rectus abdominis myocutaneous flap for breast reconstruction in most patients who underwent subcutaneous mastectomy is too aggressive. Free fat grafts are also generally not effective for such patients because of the absorption of the grafted fat. We developed a procedure involving a cranial-based adipofascial (anterior rectus sheath) flap from immediately below the inframammary area for breast reconstruction. The skin incision is made at the inframammary line. After extirpation of the foreign body, the inframammary skin area is undermined. A tongue-shaped flap of the fat and the anterior sheath of the rectus abdominis muscle, approximately 7 cm in length, is pulled up, gathered, and inserted to reconstruct the breast mound. We used this technique in 7 patients, and the results were satisfactory.

Odontoclastic resorption at the pulpal surface of coronal dentin prior to the shedding of human deciduous teeth

Histological and histochemical observations of more than 150 extracted human deciduous teeth revealed that, prior to shedding, odontoclastic resorption as a rule takes place at the pulpal surface of coronal dentin. We also found that this phenomenon occurs in all kinds of deciduous teeth. The process of this internal resorption of coronal dentin of deciduous teeth clearly showed time-related histological changes. During the time the roots were actively being resorbed, the pulpal tissue retained its normal structure. However, when root resorption neared completion, inflammatory cells started to gradually infiltrate into the pulp, and odontoblasts began to degenerate. After that, multinucleate odontoclasts appeared, and resorption proceeded from the predentin to the dentin. The odontoclastic activity was initially detected only on the pulpal surface at the bottom areas of the crown. It gradually spread towards the pulpal horn regions along the wall of the pulp chamber. However, this internal resorption of coronal dentin did not continue until the teeth were finally shed. After the elimination of resorption, the resorbed dentin surface was repaired by a cementum-like deposition or covered with fibrous connective tissue.

Enhancement of murine alveolar macrophage functions by orally administered beta-glucan

The effect of orally administered SSG, a beta-1,3-glucan obtained from the culture filtrate of the fungus Sclerotinia sclerotiorum IFO 9395, on alveolar macrophage (AM) functions of CDF1 mice was examined. SSG administered orally (20, 40, 80 or 160 mg/kg) for 10 consecutive days enhanced the lysosomal enzyme activity of AM. The greatest enhancing effect was observed at 80 mg/kg of SSG. Multiple oral administrations of SSG (10 consecutive days) were needed to induce significant enhancing effects. Phagocytic activity and interleukin-1 (IL-1) production of AM were also augmented by oral administration of SSG, and the kinetics of the activated state differed depending on the kind of activity. However, H2O2 production of AM was not affected by SSG. Orally administered SSG also (40 or 80 mg/kg, 10 consecutive days) increased the number of AM and the greatest increment was observed 14 days after the first administration. On the other hand, the supernatant of Peyer's patch (PP) cells from mice administered SSG (80 mg/kg) orally stimulated the lysosomal enzyme activity of AM in vitro, and enhanced colony stimulating activity (CSA) was detected from this supernatant. These results demonstrate that SSG given by the oral route can activate murine AM both qualitatively and quantitatively, and it would mediated, at least in part, by the activation of PP cells in the intestine.

[A case of transfusion-associated GVHD after total laryngectomy]

We report a case of fatal transfusion-associated graft versus host disease (GVHD) that developed in a patient with laryngeal cancer. After a 39.6Gy irradiation dose, total laryngectomy with right radical neck dissection was performed. The postoperative course was uneventful. However, seven days after blood transfusion, high fever (38.5 degrees C) suddenly appeared. On the ninth day, watery diarrhea and facial erythema were observed. On the 12th day, liver disturbance and pancytopenia developed. The patient died on the 16th day because of overwhelming sepsis. Transfusion-associated GVHD has a mortality rate of more than 90%. Therefore, the most important procedure for preventing GVHD is the use of irradiated blood products. Furthermore unnecessary blood transfusion should be avoided.

Molecular cloning of chick liver HMG 2a cDNA and developmental expression of HMG 2a mRNA

The cDNA clone encoding HMG 2a of chick liver was isolated from a lambda gt11 expression library using polyclonal antibodies. DNA sequence analysis revealed an open reading frame of 201 amino acids. Comparison of the nucleotide sequences of cDNA coding for chick liver HMG 2a with pig thymus HMG 2 and human monocytic leukemia cell HMG 2 showed 70% homology. 2.0 kb and 1.2 kb mRNAs were found in newly hatched chick liver and decreased during postnatal development of chicks.

Oral administration of a streptococcal agent OK-432 activates alveolar macrophages in mice

The effect of orally administered OK-432, a streptococcal preparation, on the functions of alveolar macrophages in mice was examined. The oral administration of OK-432 (1, 2 or 4 KE, four times every 3 days) augmented phagocytic activity, lysosomal enzyme activity and interleukin 1 (IL-1) production of murine alveolar macrophages recovered 5 days after the final administration while it did not augment H2O2 production. The number of alveolar macrophages was not affected by the same treatment. These results suggested that oral administration of OK-432 activates alveolar macrophages qualitatively to protect the lung from the metastasis of cancer cells and infectious diseases by pathogenic micro-organisms.

Interaction of doxapram and pentobarbital in mice

We found a statistically significant increase in duration of pentobarbital-induced narcosis in doxapram-treated mice. The influence of doxapram (a respiratory stimulant) pretreatment on pentobarbital metabolism in mice was assessed by measurements of sleeping times, hypothermia, LD50 values, hepatic microsomal metabolism and relative plasma and brain levels of pentobarbital. When doxapram was given intraperitoneally 60 min. prior to administration of pentobarbital, doxapram potentiated pentobarbital-induced narcosis in a dose- and time-dependent manner, but had no effect on onset time. Doxapram potentiated hypothermia, increased acute toxicity, and prolonged the pentobarbital half-life in brain and plasma, but measurement of the concentration of pentobarbital in the brain and plasma immediately upon recovery from narcosis showed that there were no differences in any of the groups examined. Also, brain-to-plasma ratios of pentobarbital did not differ between the control and doxapram-treated groups. Doxapram competitively inhibited the hepatic metabolism of pentobarbital in 9000 x g supernatant incubation mixtures. The results obtained from these experiments indicate that inhibition of drug-metabolizing enzymes by doxapram may account for its enhancement of the duration of pentobarbital-induced narcosis.

[A case report of atypical coarctation of the aorta with coarctation and left subclavian arterial aplasia]

A 18 year-old female was admitted to our hospital with hypertension of 190/100 mmHg in her right arm and 140/110 mmHg in the left arm. Femoral arterial pulsation was not palpable. Her physical status and growth of the lower limbs were normal. Aortography demonstrated slight coarctation with a pressure gradient of 10 mmHg and descending aortic stenosis with a pressure gradient of 80 mmHg. Main three branches from aortic arch were anatomically normal. However, the left subclavian artery distal to the origin of the left vertebral artery was not visualized and the axillary artery was perfused by collaterals. Atypical coarctation was replaced using a woven Dacron graft of 14 x 40 mm. Postoperatively proximal pressure decreased from 180/113 to 156/98 mmHg and there was no pressure gradient between proximal and distal of the graft. After six months blood pressure in the right arm gradually decreased to 120/78 mmHg.

Multiple subpial transection (MST) for the control of seizures that originated in unresectable cortical foci

Multiple subpial transection (MST) was applied to 12 cases with intractable epilepsy, the foci of which were located in unresectable essential areas. The result proved that MST is effective in controlling seizures, and no explicit neurological deficits have incurred postoperatively.

Inhibition of experimental pulmonary metastasis of Lewis lung carcinoma by orally administered beta-glucan in mice

The inhibitory effect on experimental pulmonary metastasis of Lewis lung carcinoma (3LL) of SSG, a (1----3)-beta-D-glucan obtained from the fungus Sclerotinia sclerotiorum IFO 9395, administered orally was examined in mice. Oral administration of SSG for 10 consecutive days just after the intravenous implantation of tumor cells significantly inhibited the experimental pulmonary metastasis of 3LL at a dose of 2000 micrograms. However, SSG administered orally involving other timings was less effective. In comparison with oral administration, SSG was effective when administered intraperitoneally for 10 consecutive days at a dose of 200 micrograms. These results suggest that SSG given by both parenteral and nonparenteral routes is effective in the inhibition of experimental pulmonary metastasis of tumors.

Atypical multiple benign osteoblastomas accompanied by simple bone cysts. A case report

A case of atypical benign osteoblastomas occurring at multiple sites in the maxilla and mandible of a 38-year-old woman, in association with simple bone cysts, is described. The tumors produced hazy or ground-glass-like semiradiolucent lesions with well-defined or poorly-defined margins on conventional radiographs. Histologically, the lesions were characterized by a proliferation of plump osteoblast-like cells forming trabeculae of osteoid and immature bone in a well-vascularized stroma. In addition, simple bone cysts associated with a radiolucent-radiopaque lesion consisting of lamellar bone and loose connective tissue were found next to one of the tumours. Possible pathogenesis of the tumours and cysts is discussed.

Sequence-specific interactions of a maize factor with a GC-rich repeat in the phosphoenolpyruvate carboxylase gene

A plant nuclear protein PEP-I, which binds specifically to the promoter region of the phosphoenolpyruvate carboxylase (PEPC) gene, was identified. Methylation interference analysis and DNA binding assays using synthetic oligonucleotides revealed that PEP-I binds to GC-rich elements. These elements are directly repeated sequences in the promoter region of the PEPC gene and we have suggested that they may be cis-regulatory elements of this gene. The consensus sequence of the element is CCCTCTCCACATCC and the CTCC is essential for binding of PEP-I. PEP-I is present in the nuclear extracts of green leaves, where the PEPC gene is expressed. However, no binding was detected in tissues where the PEPC gene is not expressed in vivo, such as roots or etiolated leaves. Thus, PEP-I is the first factor identified in plants which has different binding activity in light-grown compared with dark-grown tissue. PEP-I binding is also tissue-specific, suggesting that PEP-I may function to coordinate PEPC gene expression with respect to light and tissue specificity. This report describes the identification and characterization of the sequences required for PEP-I binding.

Oral administration of SSG, a beta-glucan obtained from Sclerotinia sclerotiorum, affects the function of Peyer's patch cells

The effect of orally administered SSG, a beta-1,3-glucan obtained from the culture filtrate of a fungus, Sclerotinia sclerotiorum IFO 9395, on the function of Peyer's patch (PP) cells was investigated in comparison with that on spleen cells in mice. Oral administration of SSG enhanced the proliferative response of PP cells to a T-cell mitogen, concanavalin A (Con A), and a B-cell mitogen, lipopolysaccharide (LPS), although the response of spleen cells was not affected. Peyer's patch cells taken from mice which had received oral administration of SSG two days before, showed enhanced plaque-forming cell (PFC) response to sheep red blood cells (SRBC) after antigen (SRBC) stimulation for 5 days in vitro. These results suggest that oral administration of SSG can modulate the mucosal immune response.

Effect of intraperitoneally administered beta-1,3-glucan, SSG, obtained from Sclerotinia sclerotiorum IFO 9395 on the functions of murine alveolar macrophages

The effect of intraperitoneally (i.p.) administered SSG, a beta-1,3-glucan obtained from the culture filtrate of the fungus Sclerotinia sclerotiorum IFO 9395, on the functions of alveolar macrophages (AM) in CDF1 mice was examined. SSG administered i.p. increased the number of AM and enhanced several functions of murine AM (lysosomal enzyme activity, phagocytic activity, candidacidal activity, H2O2 production and interleukin 1 (IL-1) production) at a dose of 250 micrograms/mouse on days 1 and 8, especially on day 8. Furthermore, SSG (250 micrograms/mouse) administered i.p. for 10 consecutive days significantly inhibited the experimental pulmonary metastasis of Lewis Lung Carcinoma (3LL) on BDF1 mice.

Oral administration of a streptococcal agent OK-432 activates peritoneal macrophages in mice

The effect of orally administered OK-432, a streptococcal preparation, on the function of peritoneal macrophages in mice was examined. The administration of OK-432 orally (1 KE or 2 KE, four times every three days) did not affect the numbers of both total peritoneal cells and macrophages recovered five days after the final administration. However, the macrophages exhibited an increase in their spreading ability. Other functions of the peritoneal macrophages including lysosomal enzyme activity, phagocytic activity and interleukin 1 (IL-1) production were also enhanced significantly by the oral administration of OK-432 (1 KE or 2 KE). The production of H2O2, however, was not affected by the same treatment with OK-432. The activation of peritoneal macrophages by orally administered OK-432 reported here may contribute to expansion of the clinical application of this drug.

Immunocytochemical localization of laminin in the epithelial rests of Malassez of immature rat molars

Immediately after disruption of Hertwig's root sheath, epithelial cells were found near the root apex, singly or in groups of two or three cells. They were irregular in shape with only a partial lining of basal lamina. Immunoreactivity for laminin was intense in the basal lamina and weak between projections of the epithelial cells. In 5-week-old rats, the epithelial rests consisted of about five cells and still had an incomplete basal lamina with collagen fibrils in the intercellular spaces. Immunoreaction products were seen in the basal lamina and diffusely in the intercellular spaces. The epithelial rests of 9-week-old rats had more cells, an almost complete lining of basal lamina, and narrowed intercellular spaces. Immunoreaction products were seen in the basal lamina but not in the intercellular spaces. These findings indicate the basal lamina is involved in the formation of the epithelial rests.

Chai-ling-tang (Japanese name: sairei-to) as an oral adjuvant

Immunomodulating and anti-tumor activities of orally administered Chai-Ling-Tang (Japanese name: sairei-to, ST) were investigated. The oral administration of ST into mice augmented the antibody response to intraperitoneally administered 2, 4, 6-trinitrophenyl-haptenated sheep red blood cells (TNP-SRBC). Orally administered ST showed also an enhancing effect on the antibody response to TNP-SRBC administered by the oral route. In addition, orally administered ST markedly activated the peritoneal macrophages to enhanced phagocytic and lysosomal enzyme activities. A significant inhibition of tumor growth was observed in a syngeneic tumor-mouse system when ST was administered orally. These results suggest that ST has an efficiency as an oral adjuvant or an oral biological response modifier (BRM).

[The use of the bio-pump with an interposed soft reservoir in replacement of descending thoracic aortic aneurysms]

The centrifugal pump (bio-pump) as a temporary shunt during the operation of the descending thoracic aortic aneurysms was used as effective means of providing adequate circulation to the lower body. But in the acute excessive bleeding, estimates of the flow to the abdominal viscera as well as spinal cord are variable. We employed bio-pump with an interposed soft reservoir under low dose systemic heparinization in 2 cases of the descending thoracic aortic aneurysms. Both cases had been maintained adequate flow and perfusion pressure in the time of acute excessive hemorrhage, and there were no evidence of the organ failures due to microembolism. Furthermore, postoperative hemorrhage by using low dose heparin seemed to be unrisky. Compared with the previous method, bio-pump with an interposed soft reservoir provides adequate circulation to the lower body even if acute excessive bleeding occurred.

Modifications of temporal lobectomy according to the extent of epileptic foci and speech-related areas

The authors applied combined depth and subdural electrodes in patients with intractable complex partial seizures to detect the precise extent of epileptic foci and functionally map speech-related areas. The medial temporal structures were explored with depth electrodes and the lateral temporal cortex with subdural electrodes. On the speech-dominant side, electrical stimulation was given to demarcate the speech-related areas in the lateral temporal cortex. Based on these data, the extent of surgical resections was tailored to include as much of the epileptogenic areas as possible while preserving the functionally essential zones of the lateral cortex. According to the range of resection, three different approaches were employed for en bloc ablation of the lateral cortex and opening of the inferior ventricle. The results thus acquired have been satisfactory in terms of seizure control and the preservation of speech function.

Light Induction and the Effect of Nitrogen Status upon the Activity of Carbonic Anhydrase in Maize Leaves

The regulation of carbonic anhydrase (CA) activity in maize (Zea mays L.) leaves by light and nitrogen nutrition was determined. CA activity increased by more than 100-fold in illuminated leaves and decreased in leaves placed in the dark; low levels of CA activity were observed in leaves illuminated with low light intensities. CA activity was reduced in plants grown under nitrogen deficiency and recovered only slowly when supplemented with nitrate. Parallel studies were conducted to follow the levels of phosphoenolpyruvate carboxylase. Experiments indicate that the level of CA and phosphoenolpyruvate carboxylase present in leaves may be controlled by similar mechanisms.