A new schematic for poly(3-alkylthiophene) in an amorphous film studied using a novel structural index in infrared spectroscopy

The molecular structure of poly(3-alkylthiophene-2,5-diyl) in an amorphous film reveals that the short axis of the thiophene ring is parallel to the substrate, whereas the long axis along the polymer chain is largely disordered. This is unveiled by infrared p-polarized multiple-angle incidence resolution spectroscopy.

Characterization of new monoclonal antibodies against porcine lymphocytes: molecular characterization of clone 7G3, an antibody reactive with the constant region of the T-cell receptor δ-chains

A battery of mouse monoclonal antibodies (mAbs) reactive with porcine peripheral blood (PB) leukocytes was generated. Among the mAbs, 6F10 was found to react probably with cluster of differentiation (CD)8 alpha-chain, while 7G3 and 3E12 were found to recognize gammadelta T-cells, as revealed by two-color flow cytometric and immunoprecipitation studies. 7G3 was shown to react with the constant (C) region of the T-cell receptor (TCR) delta-chain by the following facts: (1) 7G3 immunoprecipitated full-length TCR delta-chain protein fused with glutathione S-transferase (GST) produced by Esherichia coli and (2) 7G3 reacted with TCR delta-chain expressing Cos-7 cells transfected with either full-length or N-terminal deleted mutant cDNA, but did not react with Cos-7 cells transfected with C-terminal deleted mutant TCR delta-chain cDNA. All three mAbs produced high-quality immunostaining results on frozen sections, revealing a distinct distribution of gammadelta T-cells and CD8(+) cells. This report precisely characterizes mAbs against porcine TCR for the first time, facilitating molecular biological investigations of the porcine immune system.

Influence of castration on development of the thymus in neonatal male rats

The influence of castration on the development of the thymus in neonatal rats was studied to elucidate when after birth the thymus comes under inhibitory regulation by the testis in rats. The relative and absolute weights of the thymus were measured five days after castration these cases. No excessive changes in the weights of the thymus with castration were observed by 31 days after birth. Significant changes in the thymus appeared in the relative weight at 36-day-castration. The absolute weight of the thymus was also significantly increased after 41-day-castration. These findings suggest that in rats the inhibitory regulation of the thymus by testis development does not appear before at least 31 days of age.

Pretreatment of human keratinocyte sheets with laminin 5 improves their grafting efficiency

Laminin 5 is essential in epithelial attachment to stromal tissues, suggesting that it might improve keratinocyte attachment in a variety of clinical situations. In this study, we examined the effect of exogenous laminin 5 upon the efficiency of transplantation of keratinocyte sheets in animal models. Keratinocyte sheets were prepared according to the method of Rheinwald & Green (1975). Purified laminin 5 was added to the sheets of group 1 (1.0 microg per cm2), Dulbecco's modified Eagle's medium alone was added to group 2. The sheets were grafted to the panniculus carnosus of nude mice (BALB/C nu/nu) (n = 12) and nude rats (Fisher 344) (n = 15). The take rate was assessed by measurement of the area of surviving epithelium at 7 d postgrafting. Laminin 5 bound the keratinocyte sheets of group 1. At 7 d postgrafting, the area of epithelialization of group 1 was significantly larger than that of group 2. Immunohistochemistry staining showed that collagen IV, laminin 5, and collagen VII stained more strongly at the dermal-epidermal junction in group 1 than in group 2. Integrin chains alpha6 and beta4 were similar in both groups. Electron microscopy at day 3 after grafting, showed the lamina densa of group 1 to be more continuous than in group 2. Pretreatment of cultured human keratinocyte sheets with laminin 5 improved the extent of epithelial coverage and increased the rate of neobasement membrane formation. The results suggest that laminin 5 promotes epithelial attachment by increasing the rate of basement membrane assembly.

A silver-sulfadiazine-impregnated synthetic wound dressing composed of poly-L-leucine spongy matrix: an evaluation of clinical cases

The management of severe burns requires the suppression of bacterial growth, particularly when eschar and damaged tissue are present. For such cases, silver sulfadiazine (AgSD) cream has been traditionally applied. This antibacterial cream, however, cannot be used in conjunction with a temporary wound dressing that is needed to promote healing. The authors developed a synthetic wound dressing with drug delivery capability for clinical use by impregnating a poly-L-leucine spongy matrix with AgSD, which is released in a controlled, sustained fashion. In general, the dressing adhered firmly to the wound in the case of superficial second-degree burns, and during the healing process it separated spontaneously from the re-epithelialized surface. In the management of deep second-degree burns where eschar and damaged tissue were present, the dressing had to be changed at intervals of 3 to 5 days until it adhered firmly to the wound. Once the dressing had firmly attached to the wound, it was left in place until it separated spontaneously from the re-epithelialized surface. Dressing changes were fewer than with other treatments and the pain was effectively reduced. Cleansed wounds were effectively protected from bacterial contamination. Of 52 cases treated with this wound dressing, 93% (14/15) of superficial second-degree burns, 75% (3/4) of deep second-degree burns, 85% (6/7) of superficial and deep second-degree burns, and 75% (12/16) of split-thickness skin donor sites were evaluated as achieving good or excellent results.

Histodifferentiation of hair follicles in grafting of cell aggregates obtained by rotation culture of embryonic rat skin

We have previously reported reconstruction of hair follicles from a single cell suspension of rat fetal upper lip by a two-step culture method consisting of rotation and flotation cultures. Rotation sorted out the cells and flotation facilitated histodifferentiation. In the present study, we added grafting procedures to the previous method to see whether cell aggregates obtained this way were graftable, and whether the grafting promoted histodifferentiation. The aggregates before and after flotation were grafted, and differentiation of hair follicles comparable to those in vivo was confirmed 10 days after grafting. There was no difference in the degree of differentiation between the two kinds of grafts. The grafting procedure therefore resulted in an appreciable increase in histodifferentiation even when aggregates obtained after flotation were grafted.

In vivo bioactivities and kinetic parameters of rat luteinizing hormone components: discrepancy between in vitro and in vivo assays

Rat pituitary LH shows an electrical charge heterogeneity owing to their carbohydrate moiety. The biological potencies of these isoelectric components increase with increasing pI when examined by in vitro testosterone production in isolated rat Leydig cells. The present study was carried out to clarify if this tendency was also true with of in vivo action and to estimate their kinetic parameters. Seven isoelectric components of LH, i.e. X (pI 7.9), A (8.4), B (8.8), C (9.1), D (9.3), E (9.6) and F (9.8), were administered to cannulated adult male rats. Blood samples were serially collected over a 5 h period from the conscious animal, and rat LH and testosterone were assayed by RIA. The doses of a single component showed a linear relationship with the areas under the curve (AUC) of the blood LH. The testosterone AUC also correlated well with LH AUC. It was found that the components with lower pIs had longer half-lives and larger LH AUC, and smaller total body clearance rates with highly significant correlation coefficients. The in vivo bioactivities of the components expressed as testosterone AUC increased with decreasing pIs, indicating that the in vivo bioactivity was much influenced by the total body clearance rate. The intrinsic activities of the components were calculated as ratios of testosterone AUC to LH AUC where the effect of the clearance rate (or biological half-life) was eliminated. The intrinsic activities of components were not significantly different among the components except component X which showed a smaller activity. These data indicated that, with the exception of component X, an LH component with a lower pI has a longer biological half-life, resulting in a higher in vivo potency, quite contrary to the tendency of in vitro potency.

Effect of a collagen matrix containing epidermal growth factor on wound contraction

Excessive wound contraction is known to lead to pathological wound contracture. Using a rabbit model, we applied a bovine type I collagen matrix sponge as a dermal substitute and human epidermal growth factor to full-thickness excisional wounds. Wound contraction was assessed 14 and 28 days after wounding. It was found that both collagen matrix and epidermal growth factor significantly inhibited wound contraction (p < 0.001) in all wounds treated with collagen matrix alone or treated with 0.1 and 1 microg of epidermal growth factor 28 days after wounding. Interestingly, the combination of collagen matrix with epidermal growth factor strongly inhibited wound contraction over matrix alone (p < 0.01 on day 28). Histological analyses showed a regular horizontal arrangement of collagen fibers in the dermis under wounds treated with these substances but not under untreated wounds. Furthermore, using a fibroblast-populated collagen gel, the direct inhibitory effect of epidermal growth factor on gel contraction by fibroblasts was also observed. Collagen gels without stimulation contracted to 29.5 +/- 0. 6% of their original size, as determined 6 days after culturing. At 3 days or more, epidermal growth factor inhibited collagen gel contraction by fibroblasts (after 6 days: 34.2 +/- 1.8%, p > 0.05; 36.5 +/- 2.8%, p < 0.05; and 39.8 +/- 2.1%, p < 0.001 at 1, 10, and 100 ng/ml of epidermal growth factor, respectively). In conclusion, collagen matrix and epidermal growth factor, particularly in combination, may be useful in the prevention of wound contracture.

Eyelid reconstruction using a vascularized composite flap

For reconstruction of full-thickness eyelid defects, it is optimal to use the eyelid. As a new surgical technique, we reconstructed these defects using a composite flap with vascular pedicles. A composite flap was prepared using the inferior medial palpebral artery as a nutrient vessel for reconstruction in two cases. After surgery, partial necrosis of the skin in the composite flap occurred, and ciliary loss was observed; however, the tarsoconjunctival layer could be reconstructed, and good results were obtained in terms of function and morphology.

Extended lid-splitting surgery of marginal eyelid defects

The technique of extended lid-splitting surgery is described. This procedure was used to repair marginal defects of the lower and upper lid, and provided postoperative results that were excellent both functionally and cosmetically, principally because the technique allowed the anatomical structures to be maintained.

Unilateral multiple adenolymphomas originating in the parotid gland: a clinicopathological study

The validity of Seifert's hypothesis about growth pattern of adenolymphomas has been evaluated in three of five patients with adenolymphomas of the parotid gland, who at the time of a parotidectomy, were found to have multiple unilateral adenolymphomas in the intraglandular lymph nodes. This evaluation, which was based on assessing the epithelial: lymphoid tissue ratio in excised adenolymphomas and the growth in tumor size, showed that there was no association between the histological changes in the epithelial:lymphoid tissue and the tumor size. Adenolymphomas seem to have no consistent growth pattern and develop independently. However, as multiple tumors were detected histopathologically in lymph nodes as small as 5 mm in diameter the importance of a detailed examination of patients with adenolymphomas is stressed, so that other tumours are not overlooked.

Unusual palpebral foreign bodies

We encountered cases of palpebral foreign bodies, which were a bamboo chip that entered in a trauma, a gelatinoid material that formed an iatrogenic ulcer, and self-injected lipstick. Treatments and complications of these unusual palpebral foreign bodies are evaluated.

Evaluation of the median forehead flap and the nasolabial flap in nasal reconstruction

Basal cell carcinoma, which accounts for 70%-80% of all cutaneous malignancies in the United States, has increased recently in Japan. We compared methods for reconstruction after surgery for basal cell carcinoma, which is expected to increase further in the future. Thus patients who underwent reconstruction after surgery for basal cell carcinoma of the nose using medial forehead flaps and nasolabial flaps were selected, and the effectiveness of these flaps was compared by taking the size and location of the tissue defect into consideration. As a result, possibly because of anatomical and histological differences of the face between Caucasians and Asians, better results were obtained with nasolabial flaps than with median forehead flaps.

Development of new wound dressing composed of spongy collagen sheet containing dibutyryl cyclic AMP

Although cyclic AMP has been considered to regulate cell proliferation, the mechanism of this function is largely unknown. Recent studies suggest that cyclic AMP promotes the proliferation of skin cells in a dose-dependent manner. An ointment containing dibutyryl cyclic AMP has been used in the treatment of skin ulcers and found to be effective in promoting tissue repair. To search more efficacious wound management, the authors developed a new wound dressing composed of a spongy atelo-collagen sheet containing dibutyryl cyclic AMP. This wound dressing was evaluated in two types of animal tests. One is the application of the wound dressing to a full-thickness skin defect in order to evaluate the granulation tissue formation and the wound size reduction. The wound dressing was found to promote the granulation tissue formation and naturally reduce the wound size. The other test was the application of the wound dressing to the full-thickness skin defect, leaving behind a skin island in a central portion, in order to evaluate the epithelialization. This skin island left in a full-thickness skin defect was extremely enlarged. The enlargement of the skin island seems to be related to the epithelialization from the margin of the skin island as well as by the expansion of a skin island induced by contraction of the developed granulation tissue in the surrounding wound area. These results suggest that an atelo-collagen spongy sheet containing dibutyryl cyclic AMP is effective in promoting the granulation tissue formation and epithelialization.

Device that keeps a pierced ear hole intact while treating an infected earlobe

The authors describe a simple, inexpensive, Teflon shaft and silicone ring device that keeps a pierced hole in an infected earlobe intact while an infection is being treated.

Cytotoxicity tests for antimicrobial agents using cultured skin substitutes fixed at interface of air and culture medium

The present study is focused on a new cytotoxicity test using cultured dermal and epidermal sheets, which are fixed at the air and medium interface as a wound surface model. The cultured dermal sheet is composed of human fibroblasts and a collagen matrix, and the cultured epidermal sheet is composed of human keratinocytes and a collagen matrix. Each cultured sheet was fixed at the air and medium interface, over which a piece of test specimen was placed. The in vitro system created, provides a mimetic wound surface since during wound repair, fibroblasts are embedded in an extracellular matrix, while keratinocytes migrate and proliferate on provisional granulation tissue. The results thus obtained in this cytotoxicity test are useful for determining the efficacious amount of antimicrobial agent used in clinical cases.

Side-to-side earlobe variations with respect to surface area and shape: a quantitative study

Side-to-side earlobe variations, based on the size of the earlobe surface area and a classification into earlobe types, were quantitatively analyzed in 58 female students, ranging from 20 to 22 years old. Using a new earlobe measurement technique, a closed-circuit outline of each ear was directly traced onto a clear polyethylene sheet, after which the surface area of the earlobe portion of each ear was identified, measured by a digital planimeter, and analyzed. Results revealed that side-to-side differences in the size of the earlobe surface area existed in all subjects. In contrast, based on classifying the earlobe shape into three types (i.e., tapering, square, or pendulous), differences in the mean earlobe surface area value among the three types were not significant. However, when the classification of the earlobe shape was reduced to only two types (pendulous or nonpendulous), the mean earlobe surface area value between the two types was highly significant. These results thus suggest that for a quantitative analysis of earlobe variations, classification of the earlobe shape into two types rather than into three types is the better method. This method makes it easy to distinguish earlobe differences. Further, if the earlobe differences are noted before ear piercing, a balanced ear piercing effect can be achieved.

Evaluation of an allogeneic cultured dermal substitute composed of fibroblasts within a spongy collagen matrix as a wound dressing

The purpose of this study was to examine whether epithelialisation is promoted when an allogeneic cultured dermal substitute is used as a biological wound dressing. The dermal substitute was prepared by plating fibroblasts on to a spongy collagen matrix, and then culturing them for 7 to 10 days. A new animal wound model was designed to measure re-epithelialisation quantitatively. A full thickness skin defect was made on the dorsum of each of 33 rats; the skin was excised, leaving a layer of pannicular carnosus with an island of intact skin in the central portion of the skin defect. In the first group of rats (n = 13), a piece of cultured dermal substitute was applied to the wound, and a medicated covering material was placed over it. Re-epithelialisation from the island of intact skin was monitored over a period of 7 days. In the second group of rats (n = 10), the wound was covered with an acellular collagen matrix in conjunction with the medicated covering material, and in the third group of rats (n = 10), the wound was covered with the medicated covering material alone. Both the macroscopic and histological findings indicated that the epithelial migration of the first group of rats was far more rapid than that in the other two groups. It comes to the conclusion that the application of this new fibroblastic cultured dermal substitute provided a good environment for the promotion of wound healing.

Mixed cultures comprising syngeneic and allogeneic mouse keratinocytes as a graftable skin substitute

Using inbred mouse strains C3H/He and BALB/c and an anti-class I MHC monoclonal antibody, we examined the graftability of mixed cultures composed of syngeneic and allogeneic mouse keratinocytes. Keratinocytes from neonatal C3H/He (syngeneic donor) and BALB/c (allogeneic donor) mice were cultured for 7 days, both individually and at the inoculum ratio of 1:1, 1:3, or 1:15. The resulting sheets of keratinocytes were implanted subcutaneously into adult C3H/He mice and morphological evaluation was made on the 4th, 7th, and 14th days after grafting. The control cultures of 100% allogeneic keratinocytes were rejected, whereas epidermal reconstruction without typical signs of rejection took place in all grafts derived from the mixed cultures, including the 1:15 cultures. However, immunofluorescence staining showed that, within the grafts, the allogeneic keratinocytes were gradually replaced by syngeneic cells. Thus, these results suggested that graftable skin substitutes may be produced by co-culturing a small amount of autologous keratinocytes with allogeneic keratinocytes, which are readily available.

Morphological aspects of LFA-1/ICAM-1 and VLA4/VCAM-1 adhesion pathways in human lymph nodes

Monoclonal antibodies specific for the adhesion molecules participating in lymphocyte homing, lymphocyte function associated antigen-1 (LFA-1) and very late antigen 4 (VLA4), and their respective ligands, intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), were used to characterize their expression pattern in human lymph nodes by immunohistochemical and immunoelectron microscopic techniques. The location of LFA-1-positive lymphocytes and selective expression of ICAM-1 on the luminal plasma membrane of high endothelial venule endothelium suggested that the LFA-1/ICAM-1 adhesion pathway participates only in the initial step of the lymphocyte migration process. Lymphocytes passing through endothelium appear not to be influenced by this pathway. VCAM-1 was detected occasionally on the endothelium of high endothelial venules in the hyperplastic lymph nodes in the mesentery, but not in peripheral lymph nodes. VLA4-positive lymphocytes tended to be more frequently observed within high endothelial venules in mesenteric lymph nodes than in peripheral ones. Strong expression of both ligands, ICAM-1 and VCAM-1, was noted on the plasma membrane of follicular dendritic cells, and was especially prominent on their labyrinthine folding, and on the interdigitating cells in the paracortex. Furthermore, both LFA-1- and VLA4-positive lymphocytes localized around these cells. This suggests that LFA-1/ICAM-1 and VLA4/VCAM-1 adhesion pathways play an important role in the lymphocyte recognition of antigen-presenting cells.

Development of a new wound dressing with antimicrobial delivery capability

A bilaminar wound dressing composed of an outer membrane and an inner three-dimensional matrix of a fabric or a sponge may be considered to constitute an ideal structure that promotes wound healing: the outer membrane prevents body fluid loss, controls water evaporation, and protects the wound surface from bacterial invasion, and the inner matrix encourages adherence by tissue growth into the matrix. Using this concept, we developed a biosynthetic wound dressing with a drug delivery capability. This medicated wound dressing is composed of a spongy sheet of a chitosane derivative and collagen mixture that is laminated to an antimicrobial-impregnated polyurethane membrane. In this study, a gentamycin sulfate-impregnated wound dressing was prepared and evaluated. The antimicrobial efficacy of this wound dressing was examined on an agar plate seeded with Pseudomonas aeruginosa. Also, the cytotoxicity of an antimicrobial released from this wound dressing was examined in an in vitro system with cultured skin substitutes. Both in vitro tests have shown that this wound dressing is capable of suppressing bacterial growth and minimizing cellular damage. In addition, in the treatment of wounds inflicted on rats and rabbits, this wound dressing was shown to be efficacious in covering full-thickness and split-thickness skin defects. Finally, the efficacy of this wound dressing was evaluated in a nonrandomized open-label study of 31 clinical cases. In 31 cases treated with this wound dressing, good or excellent wound healing was achieved.

A cultured skin substitute composed of fibroblasts and keratinocytes with a collagen matrix: preliminary results of clinical trials

The cultured skin substitute was created through successive cultivation of fibroblasts and keratinocytes that were combined within a collagen matrix. This collagen matrix was composed of a collagen spongy sheet and a collagen gel. The collagen spongy sheet was designed to produce a honeycomb structure having many holes in which all holes through the sheet were filled with collagen gel. This specific structure thereby allows for the nourishment of the cultured keratinocytes on the surface of the matrix when placed on the graft bed. In this study, autologous cultured skin substitute was applied to a 51-year-old man who had sustained a burn injury. Three sheets of the cultured skin substitute (6 x 9.5 cm) were grafted onto the full-thickness excised wound in the right anterior chest wall. One week after grafting most of the matrix disappeared and stratified keratinocytes were seen to have firmly attached to the underlying tissue. Five weeks after grafting a cornified epidermal layer was seen. Ten months after grafting a mature epidermis and a well-differentiated papillary and reticular dermis replacement were observed. The physical properties and color of this grafted area resemble those of normal skin. In the second test case, autologous cultured skin substitute was applied to a 30-year-old man with a scar remaining after tattoo removal. Eight sheets of the cultured skin substitute (10 x 18 cm) were applied on an excised wound (thickness, 0.02-0.025 in.) of both the fore- and upper arms. The histological appearance of a biopsied skin specimen from the grafted area at 3 months after grafting showed a mature epidermis and a well-differentiated reticular dermis replacement. The regenerated skin at 14 months after grafting showed an excellent result.

Improved in vitro angiogenesis model by collagen density reduction and the use of type III collagen

Angiogenesis was examined by a three-dimensional model in vitro, using human umbilical vein endothelial cells (HUVECs) cultured in a collagen gel. An abundant capillary-like network with a lumen structure was identified histologically and shown to have formed at a collagen density of 0.05% or 0.10% instead of 0.15%, for either type I or type III collagen. At the same density, type III collagen induced a capillary-like network with HUVECs at an earlier stage of culture than type I collagen. In a two-dimensional culture, HUVECs were viable and proliferated to a great extent on the culture dish coated with collagen. This was particularly so in the case of type III collagen at lower density (5 ng/cm2). Type III collagen at a sufficiently low density is thus shown useful for studying angiogenesis in vitro. The capillary-like network that formed in the three-dimensional culture appeared somewhat labile, but became stable with the continuous addition of endothelial cell growth supplement and increase in the plating number of HUVECs.

[Analysis of transmission of continuous adventitious lung sounds in asthmatic patients--a comparison with continuous sounds due to bronchial stenosis]

We studied the acoustic features of continuous adventitious lung sounds in asthmatic patients, and analyzed the characteristics of transmission by comparing the continuous sounds in asthmatic patients with those due to bronchial stenosis. The results were as follows. 1) Continuous adventitious lung sounds in patients with bronchial stenosis confirmed by bronchoscopy were well transmitted to the neck over the trachea. Therefore, it was demonstrated that continuous adventitious lung sounds generated in the lung are able to be transmitted to the tracheal region. 2) Continuous adventitious lung sounds in asthmatic patients were divided into monophonic tones and polyphonic tones, according to sound spectrographic findings. From the results of the coherence analysis, the monophonic tones were considered to be generated in the right or left lung, and were well transmitted to the neck over the trachea. The origin of the polyphonic tones was unknown, but they were also relatively well transmitted to the neck over the trachea. It was confirmed that the tracheal region is a very important location for auscultating and monitoring asthmatic patients.

Formation of hair follicles from a single-cell suspension of embryonic rat skin by a two-step procedure in vitro

A technique for culturing skin was devised whereby hair follicles in a normal state were generated from a single-cell suspension of embryonic rat skin. Dissociated cells obtained by trypsinization of the day-15 embryonic lip were cultured by a two-step procedure in vitro. Reorganization of hair-follicle rudiments was accompanied by reaggregation of the cells during a 24-hour initial culture with rotation, and the rudiments differentiated into hair follicles within a week during subsequent subculture of the cell aggregates by floatation. The light-microscopic features and the size of the follicles were similar to those of day-18 vibrissa follicles during normal development in vivo. Furthermore, the stratification of cells, including subcellular differentiation, and the ultrastructure of the hair follicles generated in vitro were similar to those of normal hair follicles with well-keratinized hair shafts. The present system appears to be a useful model for analytical studies in vitro on the formation of hair follicles and for studies designed to facilitate the transplantation of human hair.

Evaluation of a synthetic wound dressing capable of releasing silver sulfadiazine

A silver sulfadiazine-impregnated poly-L-leucine wound dressing, AgSD-medicated wound dressing, was evaluated for antibacterial capacity against Pseudomonas aeruginosa and cytotoxicity to human fibroblasts and human epidermal keratinocytes. This wound dressing contained 0.4 mg AgSD/cm2. Antibacterial capacity was examined on experimentally infected wound surfaces (3.4 x 10(4) P. aeruginosa organisms/gm) on the dorsum of mice. The AgSD-medicated wound dressing showed effective bacterial control. Cytotoxicity was examined on a monolayer of cells formed in culture dishes. Cellular damage was reduced by the controlled release of AgSD from the hydrophobic poly-L-leucine sponge matrix of the AgSD-medicated wound dressing. Cytotoxicity of the AgSD-medicated wound dressing was much lower than that of 1% AgSD cream.

[Vestibular ataxia caused by meningeal carcinomatosis]

A 74-year-old man developed progressive deafness and unsteady gait two years after gastrectomy for a gastric cancer. Neurological examination revealed an alert and intelligent Japanese male in no acute distress. The optic fundi were normal. The pupils and the extraocular muscles were normal, however, horizontal nystagmus was noted in right and left gaze. He showed marked bilateral deafness, and loss of caloric response bilaterally. No muscle atrophy nor weakness was noted. His gait was wide-based and ataxic. Tandem gait was impossible. Romberg sign was present. No cerebellar ataxia was noted in the finger-to-nose or the heel-to-knee test. No adiadochokinesis was noted. Hyperextensibility was noted in the lower extremities. Deep reflexes were normal in the upper limbs, and diminished in the lower extremities. Sensation was intact. He showed the jumbling phenomenon, and the disturbance of the righting reflex in the tilt-table examination. Neuroradiological as well as laboratory studies were unremarkable except for the high titer of CEA in the CSF. Four months after his admission, malignant tumor cells were found in the CSF. It seemed likely that he had completely lost bilateral vestibular and auditory functions caused by meningeal carcinomatosis. His disturbance of gait and station was apparently similar to cerebellar ataxic gait, however, he did not have limb ataxia. The cranial CT scans failed to show cerebellar atrophy. It was our impression that his motor disturbance was in all likelihood caused by the bilateral loss of vestibular functions, i.e., vestibular ataxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Anterofrontal superficial temporal artery island flap for full-thickness eyelid reconstruction

The development of movable skin flaps appears to be a popular aspiration of contemporary plastic surgeons, although it seems to us that the classic skin flap, devised by pioneers a century ago, still remains worthy of application.

Correction of a chest wall deformity utilizing latissimus dorsi with a turnover procedure

Infraclavicular hollowing and the abnormal anterior axillary fold are often seen in patients with Poland's syndrome and related conditions. The operative procedure described in this article corrects these deformities. The procedure uses the latissimus dorsi island flap. The inserted muscle is moved anteriorly and sutured between the deltoid and the biceps. Then the muscle flap is twisted between its origin and where it is inserted. The muscle fibers act like a pivot and the thickness of the flap is increased, which enables us to achieve a round anterior axillary fold. The muscle flap fills the infraclavicular region and softens the deep hollow area.

Postoperative sequelae of augmentation mammaplasty by injection method in Japan

Postoperative sequelae of 696 cases following augmentation mammaplasty by the injection method have been studied. The most frequently used foreign material for injection was silicone. Paraffin had been previously used somewhat less frequently. Of the 696 cases studied, the most common complications were hardening, skin change, transformation, and pain. Of the total number of cases studied for removal of the foreign material, 244 were seen in university hospitals and 416 in private clinics. Reaugmentation was performed in many cases using both a flap technique and bag prostheses with no significant degree of incidence of complications following reaugmentation.

The role of psychiatry in aesthetic surgery

Twenty-five patients seeking aesthetic surgery were investigated and treated with the cooperation of the plastic surgeon and a psychiatrist. Three-fourths of the patients revealed psychiatric problems in their backgrounds. On the recommendation of the psychiatrist, eight cases underwent operations, in spite of psychiatric problems, and were satisfied with the treatment. Patients not operated on had been persuaded to abandon their operation after psychiatric therapy. In conclusion, the cooperation of the psychiatrist was found to be very effective in the treatment of those seeking aesthetic surgery.

A simple sternal turnover procedure using a vascular pedicle for a funnel chest

We have improved the sternal turnover surgical procedure by using a vascular pedicle for a funnel chest. Rather than performing a simple sternal turnover, we thought it better to use the sternum with the vascular pedicle attached, anticipating that this would lead to fewer postoperative complications and a more desirable result. The following method for performing the operation was devised: (1) cutting the deformed sternum at the second intercostal position; (2) cutting the second costal cartilages to allow a repositioning of the vascular pedicle onto the presternal surface; (3) turning the sternum over, placing one end on the other, and attaching one end to the other; and (4) making a groove in the turned-over sternum to prevent the decussated vascular pedicle from becoming constricted. By using this method, it is easily possible to keep the bilateral internal thoracic vessels intact. We used this surgical technique on a 17-year-old boy and obtained very favorable results.

Biological evaluation of burn blister fluid

Human dermal fibroblasts were cultured with blister fluid and 3 of their properties were investigated: cell shape, growth rate, and ability to contract collagen fibrils. In the medium containing the blister fluid, fibroblasts became attached to the tissue culture plastic and became well elongated to a spindle form. The blister fluid demonstrated a potent fibroblast growth-promoting activity comparable to that observed in the serum obtained from the same patient. This activity was independent of the patient's age and the time elapsed since the burn. The growth rate of cells increased as the concentration rose to 20% in the case of serum. Growth promotion by the blister fluid, however, was maximum at the concentration of 2.5%, leveling off thereafter, a fact which suggests the presence of some other factor possessing an inhibitory action on fibroblast growth. The growth-promoting activity of the blister fluid was not destroyed by tryptic digestion. The blister fluid promoted a fibroblast-mediated contraction of collagen fibrils to an extent comparable to that of the serum. The protein-banding pattern of the fluid, obtained by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, was similar to that of the serum. These results suggest that the fluid is an exudate mainly from the vascular system, that is provides a good environment for the fibroblasts in the damaged site, and that it facilitates the healing process.

Orbital lipoma

A patient who had a huge orbital lipoma with extension to the muscle cone is described. The lipoma was 42 x 34 x 32 mm in size, and there was no visual disturbance following removal of the tumor and iliac bone grafting. Diagnosis of orbital lipoma is difficult to make. This is particularly true of a lipoma with an obvious capsule, which cannot be easily differentiated from a dermoid cyst. However, computed tomography scanning is useful in ascertaining the location, size, and relationship with orbital contents. A review of the literature concerning orbital lipoma revealed only a few reports, and the features of the orbital lipoma are summarized. In addition, the possible mechanism of orbital enlargement and the approach to the muscle cone are described.

A case of Hodgkin's disease arising from an intraglandular lymph node in the parotid gland

Malignant lymphoma of the parotid gland region, especially Hodgkin's disease of the gland, is an extremely rare disorder. We have recently experienced a case initially suspected of being pleomorphic adenoma and later, on postoperative histopathological examination, diagnosed as Hodgkin's disease. The present report describes this case of Hodgkin's disease arising from an intraglandular lymph node in the parotid gland.

The fate of free omental transfers

The authors have carried out six free omental transfers for the treatment of two chronic ulcers, two progressive hemifacial atrophies, one precancerous disorder and one contused wound. The follow-up periods ranged from 3 years 9 months to 7 years 7 months. From our experience the transferred omentum maintained its volume and nature under normal circumstances. The decrease in volume or atrophy of the transferred omentum may be caused by panniculitis of the omental fatty tissue or narrowing of the anastomosed vessels.

Comparative studies on methods of isolating rat epidermal cells

Epidermal basal cells have been prepared using trypsin or dispase to remove the epidermal sheet from the skin. In addition, for trypsin, the "immersion method" and the "flotation method" have been described. However, there has been no study that quantitatively compares these methods using the same animal, making their usefulness difficult to evaluate. In this report, comparative studies on these methods were undertaken concurrently with newborn and adult rats. The flotation method using trypsin was found to be preferable to the immersion method, because separation of the epidermal sheet by the former method was easier than by the latter. Then, the flotation method using trypsin was compared with the isolation method using dispase, and quantitative estimation was made of the yield, viability, and the number of attached epidermal cells. The dispase method was found to be superior to the trypsin method, especially for cell yield, which was about four times as high as with the latter method. Furthermore, cells dissociated with dispase showed a higher rate of viability and attachment to culture dishes than those done with trypsin. These results clearly demonstrated that the dispase method is more useful for preparing epidermal basal cells than the trypsin method.

Collagen-dependent growth suppression and changes in the shape of human dermal fibroblasts

This study was designed to investigate the effects of collagen on the growth and cellular shape of cultured human fibroblasts. The fibroblasts grown in the presence of collagen assumed a slim, rod-like form with abundant cytoplasmic protrusions, while the cells on a plain dish showed flat forms with fewer cytoplasmic protrusions. Incorporation of [3H]thymidine was remarkably suppressed in the cells grown on collagen when compared with the fibroblasts on the plain dish. Specific cellular shape and suppressed DNA synthesis showed dependence on the steric conformation of native collagen, because collagen-specific effects on fibroblasts were completely abolished when 60% of the helix content was lost by heat denaturation. These collagen-dependent features of the cells disappeared when the collagen-containing medium was treated with bacterial collagenase. Growth of fibroblasts in contact with collagen was suppressed as compared to that on the plastic dish. These results indicate the importance of the native conformation of collagen in the interaction of collagen and fibroblasts.