Successful replantation in ten-digit complete amputations

The authors report a case of successful replantation of all fingers in a ten-finger complete amputation. Among the factors responsible for the successful outcome were an adequate number of microsurgically-trained resident surgeons and staff, good organization and supervision by senior staff, emphasis on precision and perseverance in the operative procedures, and postoperative management. Follow-up is 15 months, and the patient now has a pair of functionally and cosmetically good hands.

Involvement of a nucleolar component, perichromonucleolin, in the condensation and decondensation of chromosomes

A component of the nucleolar material, perichromonucleolin (PCN), was identified by a specific antiserum against nucleoli obtained from a scleroderma patient. The distribution and changes of PCN during the mitotic cycle were followed using this antiserum and indirect immunofluorescence microscopy. Based upon the behavior of PCN during mitosis, it could be differentiated into chromosomal and nonchromosomal portions. During prophase the former gradually associates with the surface of the condensing chromosomes and forms the coat or pellicle around the metaphase and anaphase chromosomes. This pellicle PCN is carried by the anaphase chromosomes to the daughter nuclei. During the time from telophase to interphase, the pellicle PCN dissociates from the decondensing chromosomes and is incorporated into the new nucleoli. The nonchromosomal PCN, after the breakdown of the nuclear membrane, distributes in the cytoplasmic region around the condensed chromosomes and diffuses into the cytoplasm during anaphase. Preliminary biochemical analysis by immunoblotting showed that the PCN consists of two main proteins with molecular masses of 36 kDa and 30 kDa.

Anatomical analysis of the cause of skin necrosis of the great toe after transplantation of the great toe nail flap

Necrosis of skin on the medial side of the great toe has been a significant complication of the great toe nail flap. To investigate the reason for this, a study of the blood supply of the medial side of the great toe was carried out on 55 feet with the injection of red latex into the arteries and on 13 vascular cast specimens. It was found that, after the blood vessels from the plantar and dorsal sides of the great toe are severed during the operation, the skin of the medial side of the great toe is mainly supplied by the medial vascular network at the head of the first metatarsal bone. It is clear that the blood supply from this network may sometimes be insufficient to nourish the skin. It is suggested that the operative incision should be changed so as to increase the blood supply to the medial vascular network which may decrease the incidence of skin necrosis.

Nonoperative treatment of Hirschsprung's disease: a new approach

The approach of the combined traditional Chinese and modern medicinal treatment of Hirschsprung's disease has been applied in 90 cases. Long-term follow-up showed satisfactory results. Of these, 55 cases with a typical history, plus a positive ACHE and x-ray were selected for analysis and discussion, making an over all rate of 78.18%. This treatment is particularly useful for those babies under 1 year of age with a short narrow segment of the rectum. In addition, it would be a good trial procedure for those babies over 1 year old with mild symptoms and the narrow segment just beyond the sigmoidorectal junction.

Plasma levels of antiprogestin RU 486 following oral administration to non-pregnant and early pregnant women

RU 486 is a synthetic steroid which acts as an antiprogestin at the receptor level. The clinical usefulness of the compound for menstrual regulation and termination of early pregnancy is currently being evaluated. The aim of the present study was to determine the plasma levels of RU 486 following the oral administration of the compound to 42 pregnant and 10 non-pregnant women. The levels of RU 486 were measured by a radioimmunoassay method which uses chromatography on Sephadex LH 20 columns. The identity of the compound assayed as RU 486 was confirmed, but the presence of small amounts of two highly cross-reacting metabolites (monodemethyl and didemethyl RU 486) in the analyzed fractions could not be excluded. Following the ingestion of a single tablet containing 25 and 50 mg of the compound, a peak plasma value of approximately 3.5 to 4.0 mumol/l in both the pregnant and non-pregnant subjects was reached one to two hours later. The half-lives of elimination were about 20 hours in both the pregnant and the non-pregnant women. Following the repeated oral administration of 50, 100 or 200 mg of RU 486 daily for four days, maximum plasma levels of 2.9, 4.5 and 5.4 mumol/l, respectively, were found. Thus, the increase in plasma levels was not directly proportional to the increase in the dose. No accumulation of RU 486 in the plasma was found, even when the duration of treatment was prolonged to six days. The data partly explain the reported lack of relation between ingested dose and frequency of induced abortion and they may be useful for designing future studies on the use of compound to prevent implantation, induce menstruation or terminate an early pregnancy.

The use of immunoblotting and immunoprecipitation of (U) small nuclear ribonucleoproteins in the analysis of sera of patients with mixed connective tissue disease and systemic lupus erythematosus. A cross-sectional, longitudinal study

Antibodies to ribonucleoproteins (RNP) and to the Sm antigen in sera from patients with mixed connective tissue disease (MCTD) and systemic lupus erythematosus were studied using the techniques of immunoblotting and immunoprecipitation of U small nuclear RNPs. A cross-sectional study indicated that antibodies reacting with a 68K protein were associated with anti-RNP specificity in MCTD, but rarely occurred in systemic lupus erythematosus patients' sera. A longitudinal study demonstrated the persistence of MCTD blotting patterns over many years, and the subsequent disappearance of those specificities in sera from patients who were in prolonged remission.

Pharmacokinetics of the progesterone antagonist 17 beta-hydroxy-11 beta-(4-dimethylaminophenyl)-17 alpha-(1-propynyl) estra-4,9-dien-3-one in the rabbit

Pharmacokinetic characteristics of compound RU 486 (17 beta-hydroxy-11 beta-(4-dimethylaminophenyl)-17 alpha-(1-propynyl)estra-4,9-dien-3-one) were investigated in 6 immature estrogenized female rabbits. A dose of 3.4 mg/kg was administered either intravenously or orally, in both cases together with 3H-RU 486 (13.4 muCi/kg). The concentration of RU 486 was measured in blood plasma following isolation by thin-layer chromatography. The concentration of ether-extractable metabolites was obtained from the difference between the total ether-extractable radioactivity and the radioactivity of the isolated RU 486. Following the i.v. administration it was found that the disposition of RU 486 could be described by a biexponential curve. The half-life of the slow disposition phase of RU 486 was significantly lower (t1/2 = 52 min: P greater than 0.05) than those of RU 486 metabolites (t1/2 = 99 min). High apparent volumes of distribution of RU 486 and RU 486 metabolites (5.8 and 6.0 l/kg, respectively) indicated a high extravascular binding. Following the oral administration in oil solution, RU 486 could not be found in plasma in reliably detectable amounts due to a poor absorption and a probable first-pass effect. In the measurements of the "total RU 486" (sum of RU 486 and ether-extractable metabolites), a similar rate of terminal disposition was found for both routes of administration.

Stage-specific expression of a homeo box-containing gene in the non-segmented sea urchin embryo

Hybridization of Drosophila homeo box DNA probes to Southern transfers of genomic DNA from the Hawaiian sea urchin Tripneustes gratilla has revealed that the sea urchin genome contains at least five homeo boxes. Examination of the DNA from several individuals shows that the sequences flanking these homeo boxes exhibit little restriction fragment length polymorphism, indicating they are more highly conserved than the majority of sea urchin DNA. Several clones in a T. gratilla genomic DNA library which hybridized with Drosophila homeo box probes were identified, and one found to be transcribed during embryogenesis was selected for further study. Southern transfer hybridizations showed the cloned gene to be single-copy. DNA sequencing of the sea urchin gene defined a homeo box 70-73% homologous to the Drosophila homeo box probes and an encoded homeo domain 78-88% homologous to those encoded by the probes. Hybridization of DNA probes from the sea urchin homeo box-containing gene to Northern transfers of embryonic RNA demonstrated that the gene produces two transcripts of 6.9 kb and 7.7 kb. Transcripts first accumulate at blastula stage and increase to a maximum level at gastrula stage before decreasing considerably in abundance by pluteus stage.

Mössbauer and electron nuclear double resonance study of oxidized bidirectional hydrogenase from Clostridium pasteurianum W5

The bidirectional hydrogenase from Clostridium pasteurianum W5 is an iron-sulfur protein containing approximately 12 Fe atoms and 12 labile sulfides. We have studied oxidized samples of the enzyme with Mössbauer and electron nuclear double resonance (ENDOR) spectroscopy to elucidate the nature of the center that gives rise to the EPR signal with principal g-values at 2.10, 2.04, and 2.01. The g = 2.10 center exhibits two well-resolved 57Fe ENDOR resonances. One is isotropic with A1 = 9.5 MHz; the other is nearly isotropic with A2 = 17 MHz. These magnetic hyperfine coupling constants are substantially (approximately 50%) smaller than those observed for [2Fe-2S], [3Fe-4S], and [4Fe-4S] clusters. The Mössbauer and ENDOR data, taken together, suggest that the g = 2.10 center contains at least two but not more than four iron atoms. Comparison of our data with recent results reported for Escherichia coli sulfite reductase and the ferricyanide-treated [4Fe-4S] cluster from Azotobacter vinelandii ferredoxin I suggests that the g = 2.10 center may possibly be formed, by oxidation, from a structure with a [4Fe-4S] core. The Mössbauer spectra give evidence that at least 8 of the 12 Fe atoms of oxidized hydrogenase are organized in two ferredoxin-type [4Fe-4S] clusters, supporting conclusions derived previously from EPR studies of the reduced enzyme.