Free peroneal flap coverage of the great toe defect resulting from a wrap-around flap transfer

In thumb reconstruction, the wrap-around free flap from the great toe with distal terminal phalanx attached gives a better replica of a thumb esthetically and functionally and has many advantages. However, there are problems in the great toe, such as delayed wound healing, pain caused by long-time walking, ulceration, and skin erosion. We closed the skin defect of the great toe with a free peroneal flap in seven cases. In all cases of both the wrap-around flap and peroneal flap complete healing was obtained after the operation without trouble. The donor great toe causes no significant morbidity.     

Metabolism in vivo of 3,4,3',4'-tetrachlorobiphenyl and toxicological assessment of the metabolites in rats

1. Metabolism in vivo of 3,4,3',4'-tetrachlorobiphenyl (TCB) and toxicological assessment of the metabolites were investigated in the rat. 2. Four metabolites were isolated from faeces of rats dosed with 3,4,3',4'-TCB. Two were identified as 5-hydroxy-3,4,3',4'-TCB and a chlorine-shift metabolite, 4-hydroxy-3,5,3',4'-TCB, by comparison of melting points, chromatographic mobilities and spectral features with those of the synthetic samples. A dihydroxy-TCB and monohydroxy-trichlorobiphenyl were also indicated by mass spectrometry to be excreted in faeces as minor metabolites. 3. Faecal excretion of unchanged 3,4,3',4'-TCB, 5-hydroxy-3,4,3',4'-TCB and 4-hydroxy-3,5,3',4'-TCB was 0.8%, 19.6% and 11.6% of dose, respectively, in 5 days after i.p. injection of 3,4,3',4'-TCB at a dose of 50 mg/kg. 4. From the inability to cause the liver hypertrophy and thymus atrophy, both monohydroxy-metabolites of 3,4,3',4'-TCB are much less toxic than the parent 3,4,3',4'-TCB. In addition, these phenolic metabolites did not induce the activities of benzo[a]pyrene hydroxylase and DT-diaphorase, whereas 3,4,3',4'-TCB greatly induced these activities. These results indicated that unlike PCB congeners with phenobarbital-type inducing ability, 3,4,3',4'-TCB, a prototype of 3-methylcholanthrene-type inducers, is detoxified by metabolic hydroxylation.     

Retinal pigment epithelial cells produce fibronectin

Antichick fibronectin antiserum, noncross-reactive to bovine fibronectin, was prepared to determine the production of fibronectin by cultured chick retinal pigment epithelial cells which were grown in the presence of fetal bovine serum. The typical fibrillary net pattern of fibronectin was observed by an indirect immunofluorescent technique when this specific antiserum reacted with cultured chick retinal pigment epithelial cells. Cultured chick retinal pigment epithelial cells were shown to produce fibronectin.     

Relationship between cigarette smoking and oral health status]

The purpose of the study was to examine the relationship between the smoking habit and oral health status, while adjusting for age and some aspects of dental health behavior. The data used were based on a cross-sectional study on dental checkup in the worksite, which included a self-reported questionnaire and oral examination by a dentist. The oral health status variables were CPITN scores, missing teeth/filled teeth/decayed teeth, and self-reported gum bleeding. In addition, the subjects reported in a questionnaire concerning their smoking habit and dental health behavior. Of a total of 7,713 of workers, 5,232 (67.8%) participated in the dental checkup of the worksite. From the population, only the data for 3,303 men were analyzed. We used multiple logistic regression to calculate the odds ratio (OR) for each oral health status according to the smoking habit. Current smokers, compared to subjects who had never smoked, had a higher risk of periodontal disease (OR = 2.3; 95% CI: 1.9-2.7), missing teeth (OR = 1.6; 95% CI: 1.3-1.9) and decayed teeth (OR = 1.5; 95% CI: 1.3-1.8), but they had a reduced risk of gum bleeding (OR = 0.7; 95% CI: 0.6-0.8). Dose response relationships between smoking and these variables were also observed. The results indicated that cigarette smoking was associated with oral health status independent of some aspects of dental health behavior.     

Expression of Fas antigen on helper T lymphocytes in Vogt-Koyanagi-Harada disease

· Background: Our purpose was to analyze the expression of Fas antigen on CD4⁺ lymphocytes in the aqueous humor (AH) and cerebrospinal fluid (CSF) of patients with Vogt-Koyanagi-Harada disease (VKH). · Methods: Using three-color flow cytometry, we assessed T-lymphocyte subsets stained with fluorescence-conjugated anti-CD3, CD4, CD8, CD29, CD45RA, CD45RO, HLA-DR, and Fas monoclonal antibodies in AH, CSF and peripheral blood (PB) from 8 patients with active VKH. · Results: CD3⁺ T cells constituted the majority of lymphocytes in AH and CSF, in contrast to with PB. The percentages of CD4⁺ lymphocytes in uveitic AH and CSF were significantly higher than that in PB (P < 0.01). Activated CD4⁺ and CD8⁺cells were significantly more frequent in AH than in CSF and PB (P < 0.01). Although the percentages of CD45RA⁺ cells within CD4⁺ cells in AH and CSF were extremely low compared with those in PB, the proportions of CD29⁺ and CD45RO⁺ (memory) cells within CD4⁺ were much higher than those in PB (P < 0.01). Fas antigen was also highly expressed on such CD4⁺ cells in AH, as in other uveitis patients and on such cells in CSF. Moreover, the percentages of Fas⁺ and memory cells in AH were significantly higher than those in CSF. · Conclusions: The majority of CD4⁺ lymphocytes in AH and CSF from patients with active VKH were activated memory cells, on which Fas antigen was also highly expressed. Although this Fas expression may not be an apoptosis-related phenomenon, accumulation of Fas⁺ memory T lymphocytes in AH and CSF probably reflects the immunopathologic mechanism of VKH. Received: 12 June 1997 Revised version received: 6 October 1997 Accepted: 7 October 1997     

Granulocyte-colony stimulating factor- and interleukin 6-producing diffuse deciduoid peritoneal mesothelioma.

An autopsy case of granulocyte colony-stimulating factor (G-CSF)- and interleukin-6 (IL-6)-producing diffuse deciduoid peritoneal mesothelioma is reported. The patient was a 70-year-old man with abdominal distension and weight loss in the year prior to his death. Laboratory data suggested severe inflammation with marked leukocytosis, thrombocytosis and elevated serum levels of C-reactive protein, G-CSF and IL-6. Imaging studies showed an expansive mass occupying the entire abdomen and pelvic cavity. Histological diagnosis of tissue taken by needle biopsy was difficult due to the unusual sarcomatoid-appearance of the tumor. In addition, there was severe infiltration of numerous neutrophilic leukocytes. An autopsy revealed that the diffuse peritoneal tumor had a fresh fishmeat-like appearance with focal mucinous degeneration and entirely encased the abdominal organs. Histological examination showed a sheet-like proliferation of tumor cells with large ovoid or polygonal cytoplasm, large atypical nuclei and obvious nucleoli. The tumor cells showed abundant glycogen and hyaluronic acid, and were immunoreactive to cytokeratin, calretinin, epithelial membrane antigen (EMA), CA-125, and focally to vimentin. The tumor cells were immunoreactive to G-CSF and IL-6. Electron microscopy revealed long, slender microvilli on the tumor cell surface. This tumor was diagnosed as a G-CSF- and IL-6-producing, diffuse deciduoid mesothelioma. We report this case with special reference to the differential diagnosis of deciduoid peritoneal mesothelioma with paraneoplastic syndrome.     

Possible fusimotor innervation to frog muscle spindles

In some muscle spindles located in or near the red area of semitendinosus muscle of the bull frog, a fine motor axon innervates the intracapsular compact zone, without any branches onto the extrafusal muscle fibers. The fine motor axon is 3.9 microns in mean diameter (measured in living axon) and 9.8 m X s-1 in mean conduction velocity at 20 degrees C. A ramp-and-hold stretch during 20 Hz repetitive stimulation of the fine motor axon markedly increased the rate of afferent discharges during static phase. Histochemical studies indicated depletion of glycogen in a compact zone along a small diameter intrafusal muscle fiber of the muscle spindles frozen immediately after tetanic stimulation of the fine motor axon. These results suggest that the fine motor axon is a fusimotor system in the frog muscle spindle.     

Serum soluble interleukin-2 receptor levels in patients with malignant lymphoma of bone

Background  The reliability of selected serum markers and radiological features for distinguishing malignant lymphoma of the bone from other osteolytic bone lesions was examined in an effort to improve the differential diagnosis. Methods  A total of 23 patients with histologically verified malignant lymphoma of the bone, 57 patients with other osteolytic malignancies (35 males, 22 females; mean age 62.8 years, range 13–89 years), and 13 patients with benign bone lesions that resemble malignant tumor radiographically (6 men, 7 women; mean age 48.1 years, range 20–73 years) were retrospectively reviewed. We evaluated the serum levels of soluble interleukin-2 receptor (sIL-2R), lactate dehydrogenase, and C-reactive protein in addition to radiographic examination and gallium-67 scanning. Results  Although every clinical feature examined was found to show significant differences between lymphoma and the other two groups, the feature most highly suggestive of malignant lymphoma is a high serum sIL-2R level (sensitivity 0.95, specificity 0.70, accuracy 0.81). Conclusions  The serum sIL-2R level can be a valuable marker for diagnosing malignant lymphoma of the bone.