Brachial plexus birth injuries: anaesthesia for surgical nerve reconstruction and preoperative myelography and computed tomographic myelography

Surgical nerve reconstruction for brachial plexus birth injuries and preoperative myelography and computed tomographic (CT) myelography require special anaesthetic considerations. Anaesthesia and medical records were retrospectively reviewed for the infants who underwent myelography, CT myelography (n=37) and microsurgical nerve reconstruction (n=34) at our institution from January 1993 to August 1996. Anaesthetic considerations include long duration of operation, perioperative respiratory complications and plaster application which makes reintubation difficult. Myelography for diagnosis requires a specific positioning of the patient with the head fixed in a midline and prone position.     

Intermittent administration of the combination chemotherapy with cis-platin, adriamycin and cyclophosphamide (cyclic-PAC chemotherapy) for the ovarian cancers

Despite cis-platin-based combination chemotherapy with initially high response rates in advanced ovarian cancer, the overall survival rate remains unsatisfactory. This prompted us to design a new systematic approach using a combination chemotherapy consisting of cis-platin, adriamycin and cyclophosphamide (PAC), namely cyclic-PAC chemotherapy: Three-step chemotherapies consisting of 3 courses of the PAC regimen in each step were administered for 18 months to patients with Stage Ic-IV, after cytoreductive surgery and chemotherapy. In the present study, the survival rate with the cyclic-PAC chemotherapy was compared to that with short course-PAC and FAM (5-Fu, Alkylating agent and Mitomycin C) chemotherapies. The cyclic-PAC, PAC and FAM groups included 24 cases, 31 cases and 30 cases, respectively. Treatment of Stage Ic-IV diseases by cyclic-PAC improved the outcome (66% 3-year survival rate) compared to PAC and FAM groups (PAC 35% and FAM 30% 3-year survival rates), while no difference was observed between PAC and FAM. The outcome for patients with Stage III. IV was also superior for the cyclic-PAC group compared to the PAC and FAM groups (cyclic-PAC 54%, PAC 18% and FAM 13% 3-year survival rates). Cyclic-PAC chemotherapy is capable of dramatically improving the long-term survival rate of ovarian cancer patients.     

Analysis of the molecular requirements for T cell recognition and activation by using Ia-containing lipid vesicles and stopped-flow fluorometry

Using Ia antigen-containing lipid vesicles, we investigated by stopped-flow fluorometry the requirements for helper T cell recognition and activation. When azobenzenearsonate-L-tyrosine (ABA-L-Tyr)-specific, I-Ak-restricted helper T cell hybridomas 2-45-12 were mixed with ABA-L-Tyr and purified I-Ak molecules on lipid vesicles, an increase of intercellular calcium ion concentration ([Ca2+]i) in the T cells were detected within 1-2s. The average increases of [Ca2+]i were not much different when the lipid vesicles were composed of dimyristoylphosphatidylcholine or of egg phosphatidylcholine, but they were dependent on the density of I-Ak molecules on the liposomes. The increase of [Ca2+]i was inhibited in the presence of anti-I-Ak monoclonal antibody 10.2.16, but not by the addition of anti-L3T4 monoclonal antibody GK1.5. However, the addition of anti-L3T4 antibody during the first 3 h of cultivation completely inhibited the T cell activation [interleukin (IL-2) production]. In our experimental system, IL-2 production was observed either when L3T4-positive T cell hybridomas 2-45-12 were stimulated with ABA-L-Tyr and Ia molecules on the vesicles in the presence of phorbol 12-myristate 13-acetate, or when L3T4-negative T cell hybridomas 3H60.12 were incubated with ABA-L-Tyr and Ia molecules on the planar membranes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Monoclonal Antibody OKB19, Reactive with a B-Lymphoid Differentiation Antigen (CD19), Binding to Basal Layer Keratinocytes of Normal Human Skin

Monoclonal antibody (moAB) OKB19 reacts with CD19 antigen, which is the broadest lineage-specific surface marker on B-lymphocytes. In frozen tissue sections, using an immunohistochemical technique, the OKB19-positive cells in the basal layer were sharply demarcated from the negative suprabasal layers. In normal hair follicles, the OKB19 reactivity was also confined to one layer of the dermal side of the outer root sheath. However, this reactivity gradually disappeared in the lower areas. The inner surface of the lumina in the eccrine duct was weakly stained with OKB19. The basal keratinocytes were also stained with OKB19 in the lesional epidermis of the various dermatoses examined in this study, when the basal keratinocytes remained unaffected. Even in the hyperproliferative state of psoriasis, the OKB19 reactivity was confined to the basal layer. Several kinds of tumor cells derived from the skin were not stained with OKB19. No labeling was seen even in the basaloid cells of basal cell carcinoma, which are morphologically similar to basal keratinocytes. B4 and Leu-12, other monoclonal antibodies reacting with CD19, did not recognize any keratinocytes in the normal human skin. MoAB OKB19, therefore, reacts with an antigen present on basal keratinocytes and provides a probe for the isolation of the basal keratinocyte subpopulation. Thus, this antibody should be useful in studies of not only B-lymphocyte differentiation, but also normal and aberrant differentiation of the epidermal keratinocytes.     

Synergistic inhibition of DNA synthesis in Ehrlich ascites tumour cells by a combination of unsaturated fatty acids and hyperthermia

Wide attention has been given to hyperthermia as a new measure for cancer treatment. Clinical trials of hyperthermia, as they possess antitumour activity on some occasions. When cells were incubated with oleic we examine if fatty acids exert a synergistic effect on Ehrlich ascites tumour cells when combined with hyperthermia, as they possess antitumour activity on some occasions. When cells were incubated with oleic acid and linoleic acid (unsaturated fatty acids) at 37 degrees C, the DNA synthesis of cells was significantly inhibited. Palmitic and stearic acids, which are saturated fatty acids, did not suppress DNA synthesis. Hyperthermic treatment without the presence of fatty acids at 42 degrees C for 1 h decreased DNA synthesis to 62% of the control level of 37 degrees C. The combination of an unsaturated fatty acid and hyperthermia synergistically suppressed DNA synthesis. When the cells were incubated in serum-free medium containing 0.1% albumin, unsaturated fatty acids were more effective in inhibiting DNA synthesis. However, saturated fatty acids had little or no effect on DNA synthesis in control or hyperthermia-treated cells. These results indicate that unsaturated fatty acids are useful for enhancing the inhibitory effect of hyperthermia on DNA synthesis, which may increase the in vitro antitumour effects of hyperthermia.