A prefabricated hair-bearing island flap for lip reconstruction

We report a case of reconstruction of the upper lip in the male using a prefabricated hair-bearing island flap. The flap was made by implantation of a superficial temporal vascular bundle with microvascular anastomoses to the facial vessels. We conclude that the technique is a useful alternative to other methods of reconstruction because of its reliable blood supply.

[Relationship between clinical efficiency of cefoperazone and the value of area under the time concentration curve in infectious diseases]

Clinical efficiency and side effects of cefoperazone (CPZ) against 40 infectious diseases in the field of internal medicine were studied. In addition, relationship between clinical efficiency and the value of area under the time concentration curve (AUC) was evaluated. It was possible to evaluate clinical responses in 36 cases of 40 infections; Responses were excellent in 15, good in 16, fair in 3 and poor in 2. An overall efficacy rate was 86.1%. A high dose of CPZ (2 g X 2/day) produced a higher efficacy rate than a low dose of the drug (1 g X 2/day) [95.8% (23/24 cases) vs. 66.7% (8/12 cases)] but the difference was not statistically significant. It was possible to evaluate bacteriological efficacy in 32 cases. Bacteria were eradicated in 29 (90.6%) and decreased in 3. The value of AUC in the high dose group was significantly higher than that in the low dose group. Values of AUC in cases of excellent or good clinical responses tended to be higher than values in cases of fair or poor responses. Side effects were noted in 4 cases, but they were not serious and improvements were observed without withdrawal of the drug except 1 case.

Use of scarred flaps and secondary flaps for reconstructive surgery of extensive burns

We report the usefulness of scar flaps and secondary flaps in the surgical repair of extensively burned patients. Burn scar contractures repaired with scarred axial pattern flaps, scarred musculocutaneous flaps and scarred fasciocutaneous flaps are described. However, it is our contention that their application should be strictly limited. An example of the use of scarred secondary axial pattern and musculocutaneous flaps for reconstruction of a burned ear is shown.

Relation of hydrolytic enzymes in spleen to immunological dysregulation in mice

In order to know the role of hydrolytic enzymes in various immunological disturbances, we compared the enzymatic changes in the spleens of nude mice and NZB/W mice relative to their respective controls. In spite of the different immunological features of these models, multivariate analysis demonstrated that there is some commonness in enzymatic changes between the two models. The enzymes related to such commonness included glycosidases, alkaline phosphatase, fMet-AP, and esterase. These enzymes may play some important roles in immunologic dysregulation , especially in relation to B-cell dominance in these disease models.

A low level of macrophages enhances anti-TNP plaque-forming cell generation by human lymphocytes against TNP-Brucella abortus, a T-independent antigen

Making use of trinitrophenyl-Brucella abortus (TNP-Ba), a T-independent antigen, the mechanism of antibody production in vitro by human lymphocytes was studied, focusing on the accessory role played by macrophages (m phi). Human tonsillar cells and peripheral blood lymphocytes (PBL), and their fractions which were depleted of T cells, M phi, or both by rosetting with sheep erythrocytes and glass adherence plus passage through a Sephadex G-10 column, were stimulated in vitro with TNP-Ba under optimal culture conditions. Substantial antibody response against the antigen was induced in the whole tonsillar cells, while no appreciable level of response was induced in the whole PBL. The level of response observed after T-cell depletion was not different from that of the whole cells. In contrast, the response was significantly enhanced both in tonsillar cells and in PBL by depleting M phi to a low level, such as 1-2% of the cultured cells. It was further shown that a small amount of M phi added back to the M phi-depleted fraction activity suppressed the response again to the level seen in the whole cells. If allogenic M phi were substituted for autologous ones, the same degree of suppressor function was observed irrespective of the difference seen in the HLA types.

Suppressive effect of mizoribine on humoral antibody production in DBA/2 mice

The mode of action of mizoribine (MZR) as a B cell inhibitor was studied using DBA/2 mice. Its in vitro administration significantly delayed the primary response in hemagglutinin production against sheep erythrocytes by suppressing the IgM antibody formation. In vitro plaque-forming cell (PFC) response against both T-dependent and T-independent antigens, such as TNP-SRBC and TNP-Brucella abortus, was dose-dependently suppressed by MZR. Since PFC formation by the T-depleted fraction of splenocytes was likewise suppressed, MZR may inhibit humoral antibody response by directly affecting the B cells (and/or macrophages) as well as by modulating the regulatory T cells. MZR may only act on a certain stage of the cell cycle of B lymphocytes following antigenic stimulation. It may not interfere with the initial antigen recognition or with mature B cells.

Deranged concentrations of water-soluble vitamins in the blood of undialyzed and dialyzed patients with chronic renal failure

Blood concentration of water-soluble vitamins were measured in patients with mild chronic renal insufficiency, uremic undialyzed and dialyzed patients and control subjects. The whole blood concentration of B1 was significantly lower in dialyzed patients. Plasma levels of B2 were elevated in uremic and dialyzed patients and plasma B6 was significantly increased in dialyzed patients. Serum levels of B12 and folic acid were elevated in uremic and dialyzed patients. The results of this study differ from those reported from Europe and the U.S.A. These geographical differences may arise primarily from differences in staple food, vegetable intake, and traditional methods of food preparation.

Abnormality of the post-proline-cleaving enzyme activity in mice with systemic lupus erythematosus-like syndrome

Previous studies indicated the importance of hydrolytic enzymes in the pathogenesis of autoimmune diseases. In the present study, we examined the activities of such enzymes in various organs of the hybrids of the New Zealand Black and New Zealand White mouse (NZB/W mouse) as a laboratory model of human systemic lupus erythematosus. Of the 18 enzymatic activities tested, the activities of the post-proline-cleaving enzyme showed a particular behavior in the spleen of NZB/W mouse. The enzymatic activity progressively increased with age in contrast to the reverse tendency in the control. This phenomenon was not found in any organs other than the spleen. The activity of this enzyme showed a high level of correlation to that of proline-iminopeptidase in most organs tested from control animals. However, these correlations were almost completely absent in the spleen of NZB/W mice. This may suggest an important pathogenetic role for the post-proline-cleaving enzyme in immunological disturbances in this model animal.

Effects of bombesin and gastrin releasing peptide on catecholamine secretion from rat adrenal gland, in vitro

The effects of bombesin and gastrin releasing peptide (GRP) on the release of catecholamine were investigated by using isolated rat adrenal gland. Bombesin and GRP stimulated an epinephrine (E) release with dose-dependency. A half maximal effect of bombesin was observed at 1.2 X 10(-9) M, and a maximal release of E occurred at 1 X 10(-6) M of bombesin. The stimulatory effect of GRP on the E release was very similar to that of bombesin. Although both these peptides also stimulated a norepinephrine (NE) release, a significant effect was detected at concentrations of bombesin and GRP above 1 X 10(-7) M. Nicotine and pilocarpine stimulated both E and NE releases dose dependently, but the effect of pilocarpine on E and NE release was 1/100 or less potent than that of nicotine. Bombesin-induced catecholamine releases were not inhibited by hexamethonium or atropine that fully impeded the stimulatory effects of nicotine or pilocarpine. In addition, bombesin had additive effects on the nicotine- or pilocarpine-induced E and NE releases. These data strongly suggest that bombesin or GRP plays a physiological role as one of the important regulators in catecholamine secretion in the adrenal gland.

Effect of mizoribine on lupus nephropathy of New Zealand black/white F1 hybrid mice

Therapeutic trials with mizoribine (MZR), an imidazole nucleoside immunosuppressant, on experimental lupus nephropathy of NZB/W F1 mice resulted in the following. The MZR treatment, 20 mg per kilogram of body weight every other day, starting at 14 weeks of age, caused a significantly prolonged survival time of mice with a mean life span of 54.3 +/- 4.2 weeks, compared with the untreated controls, who had a mean survival time of 38.1 +/- 2.9 weeks (P less than 0.01). In addition, MZR suppressed the elevation of serum anti-DNA antibody titers, the spontaneous development of splenomegaly, and the histological development and progression of glomerulonephritis observed in untreated animals. Although no definite explanation is available at present to explain how MZR caused decreased anti-DNA antibody production and delay in the development of glomerulonephritis in these animals, it is suggested that it acts by directly suppressing the hyperfunctioning B cells of lupus mice. MZR may prove to be a promising immunosuppressant for the treatment of human lupus, in view of its lesser side effects such as bone marrow suppression or hepatotoxicity.

Derangement of humoral immune system in nondialyzed uremic patients

To evaluate the humoral immune system in patients with chronic renal failure, a cytological approach was taken. The uremic lymphocytes and their subsets in the peripheral blood were quantitated and their functions studied. In order to exclude the possible effects of extra-uremic factors, the lymphocytes were obtained from the uremic patients with serum creatinine levels of 8 mg/dl or more, and who had been submitted neither to blood transfusions nor dialysis therapy. Absolute numbers of PBL, T cells, B cells, null cells and double marker cells were decreased in uremic patients compared to healthy controls (p less than 0.001), although the percentages of each cell subset of the patients were the same as with the healthy controls. In vitro plaque forming cell responses and DNA synthesis by uremic lymphocytes, stimulated with pokeweed mitogen, were significantly lower than those of the healthy controls. These data point to B lymphocyte as well as T lymphocyte dysfunction in uremia, which may be causally related to the uremic state itself.

Immunosuppressive factors in uraemic sera are composed of both dialysable and non-dialysable components

The immunosuppressive factors in uraemic sera were studied. Sera were obtained from 46 uraemic patients with a mean serum creatinine of 1.24 mM/1 +/- 0.36 (s.d.) prior to being introduced to dialysis therapy. Normal peripheral blood mononuclear cells, which were incubated in vitro with pokeweed mitogen (PWM) in the presence of 10% uraemic sera plus 10% pooled normal human serum sustaining the culture, showed decreased 3H-thymidine uptake compared to the control culture with normal sera. The immunosuppressive activity of uraemic sera was partially lost by in vitro dialysis, although a moderate degree of suppressive potency to the normal cells cultured with PWM remained in the dialysed uraemic sera. The remaining inhibitory activity in the dialysed sera was found to be unrelated to anti-lymphocyte antibodies.

Effect of dialysis on lipid metabolism in chronic renal failure - acetate versus bicarbonate

The effect of two dialysate buffer bases--acetate and bicarbonate - on lipid profile in chronic renal failure was studied in nine patients on maintenance hemodialysis, employing a double crossover method. The total cholesterol level and LCAT crossover method. The total cholesterol level and LCAT activity significantly decreased during acetate dialysis compared to bicarbonate dialysis (p less than 0.05), although the HDL-cholesterol level remained low during both modalities of dialysis. Other serum lipids or lipoproteins, such as triglycerides, free fatty acids, phospholipids, VLDL and LDL, showed no manifest variations relevant to the change of the dialysate buffer base. Likewise, the levels of apoproteins A and C were not significantly affected by the difference of dialysate. No evidence was obtained for a more beneficial effect of the bicarbonate dialysis compared to the acetate bath on lipid metabolism of the dialyzed patients.

Immunosuppressive effect of bredinin on cell-mediated and humoral immune reactions in experimental animals

Bredinin (BR), an imidazole nucleoside isolated from Eupenicillium brefeldianum was previously reported to prolong kidney allograft survival in dogs. The immunosuppressive effect of BR was studied in experimental animals. In beagles, in vitro responses of lymphocytes stimulated by mitogens or allogeneic cells were suppressed by in vitro BR treatment. BR, given in vivo, also showed an inhibitory action against development of delayed hypersensitivity reaction to tubercle bacilli in guinea pigs or against hemagglutinin production following booster SRBC injection in rabbits. Of note may be the fact that BR was found to have an immunosuppressive potency comparable to that of azathioprine and, in addition, to show a decreased hepatotoxicity compared with the latter.

De novo development of hypercholesterolemia and elevated high-density lipoprotein cholesterol: apoprotein A-I ratio in patients with chronic renal failure following kidney transplantation

Serum lipids, apoprotein and lecithin-cholesterol acyltransferase activities were studied in 27 renal transplant recipients with stable and normal renal function (serum creatinine 0.16 mM/l or less) sustained for more than 1 year following grafting. Hypertriglyceridemia, which was characteristic of hyperlipidemia in 18 hemodialyzed patients with chronic renal failure, was no longer manifest in transplant recipients. On the other hand, de novo hypercholesterolemia was observed posttransplant with mean serum levels of 5.82 +/- 1.34 versus 5.01 +/- 0.88 mM/l in 575 normal controls. As to the high-density lipoprotein metabolism, the cholesterol content (1.72 +/- 0.56 mM/l) was significantly higher in transplant patients than in hemodialyzed patients (0.82 +/- 0.31 mM/l). In contrast, no variation in apoprotein A-I levels was found between both groups of patients, which produced an elevated high-density lipoprotein cholesterol:apoprotein A-I ratio. Thus, derangement in the serum lipid profile, although qualitatively different, continued to be present following transplantation, and its relevance to the cardiovascular morbidity in these patients remains to be evaluated.

Chromosomal investigations of the Usubuchi sarcoma. II. Chromosomal alteration of the stem line cells revealed by differential staining techniques

Stem line cells of the Usubuchi sarcoma (US) were karyologically investigated by means of G-, C-, and N-banding methods in ten samples from the 1,923rd to 2,081st transfer generations, with special attention to the structural alteration of marker-1 chromosome. The US cells showed wide variations in chromosome constitution and number, while the modal number of chromosomes was consistently 64 in all the generations examined. The chromosome constitutions varied widely even in cells with the modal number. In the early stage (1,923rd to 1,936th generations) the US contained two major stem lines characterized by marker combinations such as 1-2-3-4(1)-4(3)-8 and 2-3-4(1)-4(2)-4(3)-8, occurring with nearly similar frequency. From the middle to later transfer stages (from the 2,004th to the 2,081st generations), the 1-2-3-4(1)-4(3)-8 stem line rapidly declined and finally disappeared. In contrast, the 2-3-4(1)-4(2)-4(3)-8 line became a predominant part of the stem line. The G- and C-banding and population analyses of the stem line cells strongly suggested that marker 4(2) might have been derived from marker 1 by a deletion of the distal half of its long arm. The US studied contained a few stem lines and various types of sublines, each karyologically characteristic. G-Banding analysis revealed various types of intra- and interchromosomal rearrangements probably due to occasional chromosomal mutations either in markers or in nonmarkers in both stem lines and sublines. It seems likely that the stem line cells of the US are not always stable, but rather variable, in their chromosome makeup during the course of multiplication and successive transfers.

Pseudoplaque formation by cytophilic immunoglobulins in the sera of lupus patients as measured using reverse haemolytic plaque assay

Normal human peripheral blood lymphocytes cultured in vitro with lupus sera (LS) were studied for their possible immunoglobulin (Ig) secretion using reverse haemolytic plaque assay (RHPA). Plaque forming cells (PFC) produced in cultures with LS (2,323 +/- 858 PFC/10(6) cultured cells) significantly increased in number compared to the control cultures with normal human serum (206 +/- 43, P less than 0.05). However, the artifactual nature of the PFC formation due to cytophilic Ig in LS subsequently became evident from the kinetic curves, trypsinization or medium change at the end of the culture period, radiation of cells on the first day of culture, or by depletion of nylon wool column-adherent cells from the culture system. These cytophilic Ig were observed in 56% of the sera obtained from untreated lupus patients. Thus, their possible interference with the resultant spurious plaque formation might be difficult to eliminate when performing RHPA in lupus patients.