Superficial nasal mucosal blood flow and nasal patency following topical oxymetazoline hydrochloride

The objective of this study was to evaluate the effect of 60 micrograms oxymetazoline on nasal mucosal blood flow (NMBF) measured by laser Doppler velocimetry. Nasal airflow (measured by anterior rhinomanometry) and subjectively perceived airflow (measured by visual analog scales) were also evaluated. A reduction of NMBF (mL/100 g tissue/min) was observed following local application of 60 micrograms oxymetazoline that was not observed after the vehicle was applied. For example, NMBF at baseline was measured at 78.8 +/- 10.3 mL/100 g tissue/min (mean +/- SEM). During the five minutes following vehicle application, mean values remained at 81.8 +/- 8.8 mL/100 g tissue/min. Five minutes after topical oxymetazoline treatment, NMBF was reduced 49% to 38.3 +/- 10.2 mL/100 g tissue/min. Nasal airflow (mL/sec), which was measured before and after LDV probe placement, was not significantly increased in either the ipsilateral (281.4 +/- 33.1 to 314.3 +/- 31.6) or contralateral nostril (335.7 +/- 26.9 to 262.1 +/- 36.4), probably due to the limited surface application of drug. Subjective assessments of congestion by both the investigator and the subject showed significant improvements in the ipsilateral nostril. We conclude that, under the conditions of our study, localized application of 60 micrograms oxymetazoline significantly reduces superficial nasal blood flow and provides subjectively perceived improvements in nasal stuffiness.

An alternate apoprotein conformation in high density apolipoprotein discoidal complexes. A Fourier transform infra-red study

Discoidal complexes have been prepared from 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and the apoproteins of HDL3 (apo HDL3) or purified apo A-I. Gel electrophoresis established that apo HDL3 contained 74% apo A-I. Deconvolution and curve-fitting of the infra-red amide I band of the apoprotein in the lipid-protein complex revealed a secondary structure containing approximately 40% alpha-helix and 50% beta-structure. This contrasted with the results from circular dichroism studies (Surewicz et al. (1986) J. Biol. Chem., 261, 16191) of apo A-I/DMPC complexes which predicted 68% alpha-helix and 7% beta-structure. The discrepancy between the two methods and limitations of the two techniques for lipoproteins is discussed.

Analysis of lines of mice selected on fat content. 4. Correlated responses in growth and reproduction

Lines of mice have been selected for 32 generations for either high or low fat content, resulting in a threefold divergence in the selection criterion (estimated fat content of males at 14 weeks of age). Male mice from both lines were dissected at a series of ages between 4 and 26 weeks and the following traits measured or estimated: body weight, fat content, lean weight, and the weights of several fatpads and internal organs. The lines appeared to have a similar underlying lean weight upon which the Fat line accumulated fat at a faster rate. This accumulation continued unabated in the Fat lines for at least 26 weeks but had effectively ceased by 8 weeks of age in the Lean. The liver and kidneys were slightly larger in the Fat line but there were no differences in the weights of heart, lung or spleen. This detailed phenotypic description of the lines complemented previous reports describing correlated changes in their physiology. The threefold divergence in estimated fat content was less than that in one of its component traits, growth of gonadal fatpad, but was greater than the divergence in other physiological indicators, i.e. the activity of lipogenic enzymes in vitro and direct measurement of lipogenic flux. Testis size in the Fat line was consistently lower than in the Lean although the Fat line was slightly more fecund, apparently due to a higher prenatal survival rate.

The first dorsal metacarpal flap in first web space and thumb reconstruction

Small local flaps for reconstruction of contractures or defects on the hand are useful. The first dorsal metacarpal flap from the dorsal surface of the proximal index is a convenient local flap in hand surgery. The flap may include the dorsal vein and, most importantly, the cutaneous branch of radial nerve. Although there may be some variations of the vascular pedicle, the flap is reliable using careful dissection. In a series of 15 patients, reconstruction with this flap was successful except for 1 patient with marginal necrosis. The first dorsal metacarpal flap is a reliable and convenient local flap in reconstruction of defects or contracture on the thumb and first web space.

The role of bone scans in electric burns

From June 1986 to May 1989, 17 patients who sustained high tension electric burns received preoperative 99mTc-MDP bone scan examinations. They were done to detect soft tissue and bone injury and also as a guide for debridement and amputation. From our experience, the correlation between the results of scanning and clinical findings is 88.9 per cent. They are very sensitive and reliable for decision making regarding debridement and limb amputation level when there is coagulation necrosis.

[Changes in T-lymphocyte subsets in patients with orthopedic trauma and effects of yipanzhu decoction on the impaired immune function]

The effects of yipanzhu decoction (YD) on immune function in 40 patients [2 groups, YD and normal saline (NS) group] with orthopedic trauma by taking T lymphocyte subsets as indexes were observed. The peripheral venous blood samples randomly taken from 30 healthy subjects served as control. The blood were collected within 24 hours after trauma. Then the YD and NS were respectively given to the patients in the 2 groups for 3 days, and the blood were taken 4th, 7th, 14th day after trauma for the observation of T subsets. The results revealed that before administration of YD the percentage of pan-T cells was reduced with an increased percentage of Ts cells and a decreased ratio between Th and Ts cells; 3 days after giving the drugs in YD group the percentage of pan-T cells was slightly increased, and the changed percentage of Ts cells and the ratio of Th/Ts cells mentioned above was recovered to normal, while in NS group all these indexes remained at abnormal range during the period we observed. The results suggested that YD could promote the recovery of abnormal T lymphocyte subsets in traumatized patients, and it possessed to some extent the function of immune regulation that was helpful to reduce the ratio of infection after trauma.

Altered HIV expression and EBV-induced transformation in coinfected PBLs and PBL subpopulations

Human immunodeficiency virus (HIV) IIIB expression and Epstein-Barr virus (EBV) B95.8-induced transformation were studied during coinfection. Coinfection of peripheral blood lymphocyte (PBL) cultures with HIV and EBV resulted in down-regulation of HIV expression. EBV-induced and spontaneous transformation were markedly reduced in PBL cultures exposed to HIV before EBV. On the other hand, transformation was enhanced when PBL cultures were infected with HIV either simultaneous to or after EBV. Reconstitution of EBV-infected B cell cultures with autochthonous T cells demonstrated that HIV-infected T cells had a reduced ability to inhibit EBV-induced transformation. PHA stimulation of HIV-infected T cells eliminated their ability to inhibit EBV-induced transformation. Lymphoblastoid cell lines (LCLs) established from coinfected PBLs expressed B cell markers and were EBV positive, while a large proportion of the LCLs expressed HIV antigens, released reverse transcriptase activity into the supernatant, and produced syncytia when cocultivated with indicator cell line SupT1. HIV provirus could be detected in LCLs established from coinfected cultures by PCR amplification using specific sets of amplimers for gag and env genes of HIV. To more closely examine the role of various cell types in lymphocyte transformation and HIV replication during coinfection, experiments were carried out using subpopulations enriched for either B or T cells. Simultaneous coinfection of purified B cells with EBV and HIV resulted in a marked reduction of HIV expression, whereas EBV-induced transformation was enhanced. In contrast, spontaneous B cell transformation was inhibited by HIV. A proportion of LCLs established from purified B cells coinfected with EBV and HIV expressed HIV antigens, released reverse transcriptase activity, and produced syncytia on SupT1 cells. These results demonstrate that the IIIB strain of HIV and B95.8 strain of EBV can interact during coinfection of B cells to alter the course of virus expression.

Free flap transfer in burn reconstruction

Wound healing in burn patients with exposure of vital tissues has been greatly facilitated by the use of free flap transfers for reconstruction with good functional as well as aesthetic results. Preoperative angiography is not an indispensable way to localize recipient vessels. Knowledge of the changes that occur in vessels at the zone of injury is crucial in the selection and preparation for microsurgical anastomosis. One team approach is advocated because the plan for the procedure may be changed when no appropriate recipient vessel is located during the dissection. We present our study of ten cases followed up in the last six years. Nine cases were successful, and severe wound infection resulted in one flap failure. Proper recipient vessel selection and adequate wound debridement are important factors for successful free flap transfer in burn reconstruction.

Clinical application of collagen sheet, YCWM, as a burn wound dressing

In the Linkou Burn Unit, a recently developed new wound dressing derived from porcine skin was evaluated. This newly designed porcine dressing, called young collagenous wettable membrane (YCWM), was developed by the staff of the Department of Cellular and Molecular Biology of Chang Gung Memorial Hospital. Many specific characteristics, such as negligible antigenicity, semitransparency, sterilizability, good pain relief and low costs, have been associated with it. The results of a clinical trial on 59 wounds on 50 burn patients proved encouraging. Some disadvantages such as maceration and delayed eschar separation were noted. We conclude that YCWM is suitable for the treatment of the clean, dry donor sites and superficial partial skin loss burn wounds of non-infected, non-immunocompromised patients.

Cloning and sequence analysis of the cDNA for human placental NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase

NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase catalyzes the oxidation of many prostaglandins at C-15, resulting in a subsequent reduction in their biological activity. We report the isolation of the cDNA for this enzyme. A human placental lambda gt11 cDNA library was screened using polyclonal antibodies prepared against the human placental enzyme. A 2.5-kilobase cDNA containing the entire coding region for the enzyme was isolated. The cDNA encodes for a protein of 266 amino acids with a calculated Mr of 28,975. Identification of the cDNA as that coding for 15-hydroxyprostaglandin dehydrogenase was based on the comparison of the deduced amino acid sequence with the amino acid sequence of two peptides, one from the rabbit lung enzyme and the other from the human placental enzyme. This cDNA hybridizes with two species of poly(A+) RNA isolated from human placenta: one of 3.4 kilobases and the other of 2.0 kilobases. Isolation of the cDNA for 15-hydroxyprostaglandin dehydrogenase should facilitate studies on the structure, function, and regulation of this enzyme.

Lyme disease presenting as urinary retention

We report a case of Lyme disease that presented with urinary retention. The individual then experienced lower extremity paralysis. Paralysis and urinary retention resolved with intravenous ceftriaxone antibiotic. To our knowledge this is the first report of a urological manifestation as the initial clinical presentation of Lyme disease. Recognition of clinical symptoms and urological complications of Lyme disease also are discussed.

Effect of wet decomposition methods on the determination of cobalt, copper, selenium, and zinc in biological samples using electrophoresis

A method combining radiotracer techniques with paper electrophoresis to investigate the optimal decomposition conditions for cobalt, copper, selenium, and zinc in rat liver samples is described. After oral and intraperitoneal administration of the respective nuclides of 60Co, 64Cu, 75Se, and 65Zn solutions, the livers of the tested rats are removed and decomposed with a nitric and sulfuric acid mixture. The completeness of decomposition is investigated by measuring the respective radionuclide-containing species in the decomposed samples by electrophoretic analysis. The results indicate that the Co- and Se-containing liver samples are more easily decomposed than those containing Cu and Zn under the specific conditions. The same decomposition effects are observed for ingested radioisotopes as for intraperitoneally injected ones. The possible connection of decomposition with the analytical error is discussed.

Experience of reverse medial arm flaps in the reconstruction of burned elbow scar contractures

There are many methods to correct scar contractures in the elbow region after burn injury, including Z-plasty, Y-V or rectangular flaps, local or distant fasciocutaneous flaps, muscle or myocutaneous flaps, free flaps, tissue expanders and non-surgical orthotics. Among these, the reverse medial arm island flap, based on the recurrent ulnar artery, has proved to be a convenient local fasciocutaneous flap for elbow scar reconstruction. In the past 2 years, 12 reverse medial arm flaps were used in 11 patients. The results are satisfactory. Two complications, one partial flap necrosis, another ulnar nerve compression, were noted. Our clinical experience with this flap encourages us to use it for burn elbow reconstruction in the future. The advantages and disadvantages are discussed.

Clinical comparison of commercially available Biobrane preparations

This prospective clinical comparison of the three commercially available Biobrane preparations indicated that: (1) All three products of Biobrane are excellent skin substitutes. (2) Regular Biobrane has satisfactory wound adherence, however, its non-porous structure allows limited wound drainage. Because of this, it has the highest incidence of haematoma and fluid accumulation (13.3 per cent) and delayed epithelialization (18.8 per cent) of the three products. (3) Thin Porous Biobrane has poor adherence which limits patient activity and provides poor pain relief. The infection rate of 10 per cent was the highest of the three products. (4) Regular Porous Biobrane demonstrated superiority to the other two Biobrane products in this study. It provided good wound adherence while maintaining wound drainage because of its porous structure. The incidence of blood or fluid accumulation (7.1 per cent) was the lowest in the three products. (5) Most of the complications such as infection, delayed epithelialization, pain and activity impairment were related to fluid or blood accumulation. Adherence was found to be more important and reliable than pore structure. Operative haemostasis thus should be emphasized when using porous Biobrane, as with all skin substitutes.

Pediatric burns--2 year survey of cases admitted to the Chang Gung Memorial Hospital

A total of 722 patients were admitted to the Burn Unit of Chang Gung Memorial Hospital over a 2-year period, of these 285 (39.5%) were under 15 years of age. The major cause of pediatric burns was scalding, 236 (82.8%). Most of the patients under age of 15 years had total burn surface under 20% (199 patients, 70%), and were discharged from the hospital within one month (263 patients, 91%). Treatments included debridement done in 98 patients (41.5%) and skin grafting in 81 patients (28%). Oxacillin-Resistant Staphylococcus Aureus infections were the most common complication (5.3%). The mortality rate was 5.3%.

Matching perspective views of a polyhedron using circuits

We present a novel approach for finding corresponding points between two line drawings extracted from perspective views of a moving object whose surface is composed of planar polygons. In our approach, each circuit of the drawings is encoded with a boundary shape code which we call the RLCC code (run length code of convex and concave strings), then a clustering technique is used to obtain the matching result recursively. A series of measures are taken to make the algorithm tolerate considerable dissimilarities which may exist between the two drawings, such as missing lines, scale differences, rotation, perspective shape distortions, etc. Experimental results are presented.

The application of turn-over flaps to burn wounds

Satisfactory coverage of some deep burn wounds is very difficult. During the past year, 20 de-epithelialized turn-over flaps have been used to cover deep burn wounds in 17 patients. Most of the wounds resulted from electrical injuries which caused exposure of tendons, nerves, bone or joint space. A turn-over flap is a convenient local flap for covering deep burn wounds and reducing morbidity. They adhere well, cause less contracture, and make a good bed for the overlying graft. One disadvantage is that healthy tissue around the wound is not always available; another is questionable tendon gliding. Complications consisted of partial flap necrosis, osteomyelitis and an epithelial cyst. Overall results for the reconstruction of difficult burn wounds were considered exceptionally good.

Electrical burn with visceral injury

A 37-year-old female patient suffered high voltage electrical injury with resultant exit wound on the left quadrant of the abdomen measuring 15 X 10 cm2 involving full thickness of the abdominal wall including the peritoneum. Early debridement and exploratory laparotomy was performed on the fifth post-burn day although the patient had no abdominal symptoms. All visceral organs were grossly normal. The peritoneum was closed and the wound covered with split thickness skin graft. On the twelfth post-burn day the anterior wall of the stomach sloughed and resulted in a 10 X 10 cm2 gastrocutaneous fistula. After 1 month of duodenostomy feeding via the fistula using a Foley catheter, the fistula was closed and was covered with greater omental flap and split thickness skin. Seventeen days later the patient was discharged following an uneventful recovery.

Interaction of -aryl di-N-acetylchitobiosides with lysozyme

Nonproductive and productive interactions of lysozyme with some β-aryl di-N-acetylchitobiosides were studied. Difference ultraviolet and proton magnetic resonance spectroscopic methods were used to examine the nature and extent of nonproductive interactions. In the nonproductive binding mode, two glycose residues interact with subsites B and C. Information concerning productive interactions was deduced indirectly from rates of phenol liberation and from product analyses. The productive binding modes which place two glycose residues either at subsites C and D, or at subsites D and E, are consistent with experimental results. The contribution of the aryl aglycone to nonproductive and productive interactions suggests that there is flexibility of substrate specificity in lysozyme catalysis.