A preliminary report on transplantation of microskin autografts overlaid with sheet allograft in the treatment of large burns

The technique of transplantation of autologous microskin grafts (MG) with overlays of split-thickness skin allografts was used in the treatment of nine extensively burned patients. Preparation of MG includes: 1) mincing small pieces of split-thickness skin autografts into skin particles (SPs); 2) dispersing the SPs evenly on a piece of silk cloth; 3) transferring SPs to the dermal surface of an allograft sheet (20/1000 in.); 4) transplanting the allograft with SPs to the excised wound. The mean burn area (total/3 degrees, mean +/- SEM) of this group was 74.9 +/- 16.6/62.1 +/- 18.1% TBSA (range 40 to 94/28 to 90%). The mean age was 27 years (range 19 to 38). Early staged excisions followed immediately by MG applications were performed on 35 large body sites, including extremities, chests plus abdomens and backs. The mean area excised and grafted with MG was 41.7 +/- 11.0% TBSA (range 26 to 62%). The average time for complete healing was about six to seven weeks postgrafting. Eight patients survived; one died of overwhelming pulmonary infection 22 days postburn. Advantages of this technique are: 1) the great potential of MG to provide a large expansion ratio of 8:1 to 15:1, average greater than 10:1 in this series; 2) good maintenance of the healed graft to withstand trauma except in areas of repeated flexion; 3) ease of preparation and application with less cost compared to cultured epidermal sheet grafts; 4) prevention of infection in extremely large burns by providing continuous epidermal coverage following sheet allograft application.

Titin: quantitative mass measurements by scanning transmission electron microscopy and structural implications for the sarcomere matrix of skeletal muscle

Scanning transmission electron microscopy has been used to investigate mass and linear mass density of native titin-2, a large soluble fragment of intact titin, from rabbit skeletal muscle. Dark field images of unstained, freeze-dried titin-2 appeared as either compact globules or looser and larger balls of string. Direct mass measurements indicated that the compact forms have an average mass of 2.40 +/- 0.50 x 10(6) Da. The mass to length ratio, determined from well-spread portions of titin strands (3-5 nm wide) from the ball of string forms, averaged 2.7 +/- 0.9 kDa/nm. Thus a single native intact titin molecule has a calculated contour length of well above approximately 1 micron, sufficient to span unidirectionally between the Z line and M line region in a resting-length sarcomere.

Sarcomere matrix of striated muscle: in vivo phosphorylation of titin and nebulin in mouse diaphragm muscle

Titin and nebulin are two major protein components of a cytoskeletal matrix that coexists with thick and thin filaments within the sarcomere of a wide range of striated muscles. Purified titin and nebulin from mouse diaphragm muscle are similar in size, in relative abundance, and in amino acid composition to analogous proteins from other mammals or avians. Phosphate analysis of these nucleic-acid-free proteins indicated that both proteins contain substantial amounts of protein-bound phosphate: about 12 mol of phosphate per mole of titin subunit and 11 mol of phosphate per mole of nebulin subunit. Incubation of intact, excised mouse diaphragm with radioactive inorganic phosphate resulted in significant incorporation of radiophosphate into titin and nebulin. The identification of titin and nebulin phosphorylation was facilitated by a simple salt fractionation and nuclease digestion procedure that effectively separated titin and nebulin from radiolabeled nucleic acids. Such in vivo phosphorylation studies indicated that approximately 2 mol of phosphate per titin subunit and 5 to 7 mol of phosphate per nebulin subunit were incorporated within 5 h of incubation. The incorporation nearly doubled when the beta-adrenergic agonist, isoproterenol, or a phosphodiesterase inhibitor, theophylline, was present in the medium. For both proteins, phosphorylation occurred mainly on serine residues. Nebulin also appears to possess a smaller number of threonine sites. Taken together, our data indicate that a small proportion (20 to 40%) of the steady-state titin phosphates are rapidly turning over. In contrast, most of the nebulin phosphates (50 to 100%) are readily exchanged. The modulation of turnover by external stimuli that increase cytosolic cAMP raises the possibility that at least a portion of the multiple phosphorylation sites of titin and nebulin may be involved in the functional regulation of the sarcomere matrix.

Giant polypeptides of skeletal muscle titin: sedimentation equilibrium in guanidine hydrochloride

Titin has been purified from rabbit skeletal myofibrils in guanidine hydrochloride by gel filtration on Sephacryl S-1000. The sedimentation coefficients of denatured titin in 6 M guanidine hydrochloride are highly concentration dependent and follow the equation: 1/S = 0.241 + 0.302 A280. Equilibrium sedimentation studies indicate that the average molecular weight of titin polypeptides is 2.4 to 2.6 X 10(6).

Nebulin cDNAs detect a 25-kilobase transcript in skeletal muscle and localize to human chromosome 2

By virtue of the protein's size, myofibrillar localization, and proposed functional role, the gene encoding the giant sarcomere matrix protein nebulin represents a possible site for myopathic mutations. Using polyclonal anti-nebulin antisera to screen a cDNA expression library, we have isolated and characterized two separate human fetal muscle cDNA clones. By recovering fusion polypeptide-bound portions of our polyclonal antiserum and reutilizing them to probe Western blots, we further demonstrate that the expressed cDNAs encode polypeptide epitopes unique to the protein nebulin. Both cDNAs detect a 25-kb skeletal muscle RNA transcript and localize to human chromosome 2. The identification of nebulin cDNA clones enables the complete analysis of this enormous mRNA by transcript walking through muscle cDNA libraries. Here we report a restriction map of the 3' end of the human nebulin transcript, with reference to the genomic fragments identified by the cDNA.

In vivo phosphorylation of titin and nebulin in frog skeletal muscle

Titin and nebulin are two major protein components of the sarcomere matrix in striated muscles. Purified titin and nebulin from frog (Xenopus laevis) skeletal muscle are similar in size and in amino acid composition to their mammalian or avian counterparts. Both proteins contain substantial amounts of protein-bound phosphate: about 5 to 6 per titin subunit and 8 to 9 per nebulin subunit. Injection of radioactive inorganic phosphate into the dorsal lymph sacs of Xenopus laevis resulted in the significant incorporation of radioactivity into titin and nebulin within three days of incubation. Purified titin from in vivo labeled frog gastrocnemius muscle contains one mole of radioactive phosphoserine per mole of titin subunit. These data indicate that phosphorylation of frog titin and nebulin occurs in vivo.

[Hemihepatectomy under hepato-portal interruption at normal temperature for liver malignancies--a report of 20 patients]

From July 1984 to December 1985, hemihepatectomy was done in 20 liver cancer patients under normothermic interruption of porta hepatis. There were 19 primary and 1 secondary liver carcinomas. Of the former, 17 (89%) were associated with mild or moderate cirrhosis. The peak age ranged 36-60 years. Right hemihepatectomy was performed in 18 and left hemihepatectomy in 2 with an operative mortality of 0%. Hepatic failure or secondary bleeding was not found. In the specimens resected, the largest weight was 2,500 gm. The normothermic interruption of porta hepatis usually lasted 15-25 minutes, a time long enough for hemihepatectomy. This procedure, being simple in manipulation and less detrimental to physiologic and biochemical balance in the human body, is relatively practical and beneficial to hepatectomy.

Adenovirus sequences required for replication in vivo

We have studied the in vivo replication properties of plasmids carrying deletion mutations within cloned adenovirus terminal sequences. Deletion mapping located the adenovirus DNA replication origin entirely within the first 67 bp of the adenovirus inverted terminal repeat. This region could be further subdivided into two functional domains: a minimal replication origin and an adjacent auxillary region which boosted the efficiency of replication by more than 100-fold. The minimal origin occupies the first 18 to 21 bp and includes sequences conserved between all adenovirus serotypes. The adjacent auxillary region extends past nucleotide 36 but not past nucleotide 67 and contains the binding site for nuclear factor I.

Retinal detachment associated with coloboma of the choroid

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Effect of human tumor antigens on the active E-rosette-forming test (ARFT): a new diagnostic method for cancer

The "active" T-cell test was adapted into an in vitro assay for response to human tumor antigens, especially gastric, lung, liver, esophageal, and colonic tumors. Peripheral blood lymphocytes were isolated from 229 cancer patients, 60 non-cancer patients, and 70 normal adults. Tumor antigen, incubated with lymphocytes from patients with the corresponding cancer, produced a significant increase in the ability of the lymphocytes to function as active rosette-forming cells (ARFC) when compared with lymphocytes cultured without antigen (P less than 0.001). This potentiating effect on ARFC remained unimpaired even after tumor antigen refrigeration. Tumor antigen incubated with lymphocytes from normal donors produced no increase in ARFC ability. This assay appears to be specific for the antigen corresponding to the cancer of the given patient; for example, gastric tumor antigen increased the ARFC of gastric cancer patients, but produced no increase in ARFC of breast cancer patients. No interference by the HLA complex was found in this assay. This technique provides a novel in vitro method for investigating cell-mediated immunity and also a new, specific method for cancer diagnosis.

Right 25 bp terminus sequence of the nopaline T-DNA is essential for and determines direction of DNA transfer from agrobacterium to the plant genome

We have determined which sequences at the right border of the T-DNA region of the nopaline C58 Ti plasmid are required for transfer and/or integration of the T-DNA into the plant cell genome. The results indicate that the 25 bp T-DNA terminus repeat sequence, TGACAGGATATATTGGCGGGTAAAC, is directly responsible for T-DNA transfer; furthermore, this sequence is directional in its mode of action. A transfer-negative nononcogenic Ti plasmid derivative, pGV3852, was constructed, in which 3 kb covering the right T-DNA border region was substituted for by pBR322 sequences. The pBR322 sequences in pGV3852 provide a site for homologous recombination with pBR-derived plasmids containing sequences to assay for transfer activity. First, a 3.3 kb restriction fragment overlapping the deleted region in pGV3852 was shown to restore transfer activity. Second, a sequence of only 25 bp, the T-DNA terminus sequence, was shown to be sufficient to restore normal transfer activity. The transfer-promoting sequences are most active when reinserted in one orientation, that normally found in the Ti plasmid.

Titin is an extraordinarily long, flexible, and slender myofibrillar protein

" Titin " is a term used to describe a pair of closely related megadalton polypeptides that together are the third most abundant myofibrillar protein in a wide range of striated muscles. It has been proposed that titin and another giant protein, nebulin , are the major components of an elastic cytoskeletal lattice within the sarcomere. We have now purified the leading band, titin -2 (T2), of the titin doublet in native forms by extraction with Guba -Straub solution followed by chromatography. Electron microscopy of low-angle-shadowed and negatively stained specimens revealed that T2 chains self-assembled into extremely long (from 0.1 micron to over 1.0 micron), flexible, and extensible slender strands (4-5 nm in diameter) with axial periodicity. Furthermore, these strands tended to associate to form filamentous bundles and meshworks. Thus, titin appears to be ideally suited as a component of an elastic lattice that serves as an organizing scaffold or template for thick and thin filaments.

Cytoskeletal Matrix in Striated Muscle: The Role of Titin, Nebulin and Intermediate Filaments

In this chapter, first I will briefly describe the molecular properties of titin and nebulin --two extremely large, myofibrillar proteins--and discuss their distribution and organization in the sarcomere. Although these novel proteins are major myofibrillar components of a wide range of striated muscles, they have escaped the attention of muscle biochemists until very recently. As I shall point out below, biochemical studies of these proteins have been unexpectedly challenging; many standard techniques had to be modified before they became capable of handling such giant proteins. In addition, our structural studies of these proteins have encountered a challange of a different nature: how to explain their distribution in the sarcomere according to the currently accepted two filament sarcomere model, because these proteins do not appear to be thick or thin filament-associated regulatory or anchoring proteins. These studies have led us to reexamine the question of whether continuous, longitudinal filaments exist within the sarcomere of striated muscle. I will attempt to integrate our results, as well as available literature data, within the framework of a hypothetical sarcomere model which incorporates an elastic filamentous matrix consisting of titin and nebulin as additional sarcomere constituents. Finally, I will very briefly mention our recent findings that an extensive three dimensional network of intermediate (10 nm) filaments, distinct from titin and nebulin , is intimately associated with the sarcomere of adult striated muscle. I believe that the recognition of the existence of two sets of sarcomere-associated cytoskeletal filaments within adult striated muscle fibers may be a significant step toward resolving some of the unsettled questions in muscle mechanics such as those that have been discussed in this meeting.

A network of transverse and longitudinal intermediate filaments is associated with sarcomeres of adult vertebrate skeletal muscle

An extensive network of transverse and longitudinal filamentous bridges was revealed when small myofibril bundles, prepared from Triton-EGTA-treated rabbit skeletal muscles, were extracted with Kl to remove the majority of thin and thick filaments. Transmission and scanning electron microscopic studies of these salt-resistant cytoskeletal residues indicated (a) small bundles of short transverse filaments connect adjacent myofibrils by forming Z to Z and M to M bridges; (b) parallel, continuous longitudinal filaments connect the peripheries of successive Z-disks and ensheath the sarcomere. These transverse and longitudinal filaments have the characteristic morphology of intermediate filaments; (c) two rings of tightly interwoven and tangled filaments, connected laterally by short filaments, encircle each Z disk. This double-ring also encircles a weblike meshwork which penetrates the sarcomeric space. From the peripheries of these rings, transverse and longitudinal intermediate filaments emerge; and (d) a massive amount of material translocated and accumulated near Z disks during Kl extraction. The residues were fairly resistant to solubilization by urea and SDS, and complete dissolution was achieved only with guanidinium chloride. SDS PAGE indicated that the residues consisted mainly of titin, nebulin, and variable amounts of residual myosin and actin. Desmin represented only a few percent of total residual proteins; however, it may be a major component of the intermediate filament network. We suggest that the intermediate filament should be considered an integral sarcomeric component that may play important cytoskeletal roles in muscle structure and mechanics.