PubMed HealthSearch

Biomedical subjects

H Gunji

Publications and source records attributed to H Gunji.

At least 19 recordsLinked to original sources

Effects of prostaglandin E1 on cultured dermal fibroblasts from normal and hypertrophic scarred skin.

To investigate the role of prostaglandin (PG) E1 in preventing scar formation as well as that of the related cytokines, we culture fibroblasts from hypertrophic scar tissue (SDF) and normal dermis (NDF) collected from patients with scar contracture. We have compared the type I collagen synthesis, type I collagenase activity, and the production of interleukin (IL)-6, IL-8 and transforming growth factor (TGF)-beta(1) in two types of cultured fibroblasts before and after addition of PGE1. Our results demonstrated that levels of type I collagen and TGF-beta(1) production were higher and that type I collagenase activity and IL-8 production were significantly lower in the culture supernatants of SDF. There was no significance difference in IL-6 production between SDF and NDF culture supernatants. On the other hand, PGE1 significantly increased type I collagenase activity and IL-8 production in the SDF culture supernatants and it increased IL-6 and TGF-beta(1) production in both types of fibroblasts. However, there was no effect on synthesis of type I collagen in either group. To further investigate the role of TGF-beta(1) in NDF and SDF, exogenous recombinant human (rh) TGF-beta(1) was added. In NDF group, rhTGF-beta(1) induced a decrease in the type I collagenase/type I collagen ratio, while rhTGF-beta(1) had no effect on the same ratio in the SDF group. These results suggest that PGE1 may have a role in the prevention of hypertrophic scar by increasing the activity of type I collagenase.

Adolescent

Reconstruction of defects of the entire vermilion with a buccal musculomucosal flap following resection of malignant tumors of the lower lip.

We reconstructed a defect of nearly the entire lower vermilion using a buccal musculomucosal flap following resection of a malignant tumor of the lower lip and obtained satisfactory results. The buccal musculomucosal flap was semi-spindle shaped and pedicled at the angle of the mouth. A flap measuring as much as 1.5 cm in width and 5 cm in length could be raised while ensuring that fibers of the buccinator muscle extended over its entire length. Using this technique, it was possible to reconstruct a wide defect following tumor resection and removal of almost the entire lower vermilion by means of only a transposition of a unilateral buccal musculomucosal flap after about one-quarter of the lower lip had been excised and sutured primarily. Reconstruction with this technique is a two-stage operation, and a secondary minor touch-up operation is performed on the angle of the mouth at the same time as repair of the dog-ear of the pedicle. Advantages of this technique are that food can be taken orally soon after the operation, hemodynamics in the flap are maintained stably because the flap contains fibers of the buccinator muscle, and the vermilion is given a natural eminence. In addition, postoperative drooling is minimized, and sensation returns to the vermilion within the early postoperative period. Based on these advantages, we think our technique should be the first choice for carrying out reconstruction of defects that are located mainly in the lower lip vermilion because this is a safe and reliable method with which we performed 12 cases of vermilion reconstruction without flap necrosis and with satisfactory aesthetic and functional results.

Aged

Clinical effectiveness of an ointment containing prostaglandin E1 for the treatment of burn wounds.

This report discusses the effectiveness of conservative treatment of burns using applications of prostaglandin E1 (PGE1) containing ointment (PGE1 ointment) to the wound site. Fourteen patients with superficial dermal burns (SDB), deep dermal burns (DDB) and full-thickness dermal burns (DB), who were treated with repeated applications of this ointment, showed rapid epithelialization of the affected tissue. Hypertrophic scarring after epithelialization was less than that expected after other therapies. The degree of scarring was graded as 'none', 'mild', 'moderate' or 'severe'. The results of this therapy revealed no scarring in two sites (8.7 per cent), mild scarring in 16 sites (69.6 per cent), moderate scarring in one site (4.3 per cent) and severe scarring in four sites (17.4 per cent) out of 23 sites distributed among the patients. The application of PGE1 ointment in combination with skin grafting surgery was found to improve functional and aesthetic results in the patients with DDB and DB, by minimizing the area of the donor site; it was especially useful for children with extensive burns because of the shortage of available tissue as donor site material for skin grafting.

Administration, Topical

An operation for Stahl's ear.

We devised an operation to correct Stahl's ear, a rare but difficult to treat auricular malformation. First, a wedge excision is made of the anterior skin and cartilage of the abnormal, third crus prominence. The abnormal, flat part of the helix is excised. A conchal cartilage graft is used to support the area after closure of the defect, including advancement of the helical edges. The procedure has been used in five cases with satisfactory results.

Child, Preschool

A sandwich enzyme-linked immunosorbent assay for human seminal gamma-glutamyl transpeptidase.

A sandwich enzyme-linked immunosorbent assay (ELISA) was developed for detecting human seminal gamma-glutamyl transpeptidase (gamma-GTP) using a combination of anti-seminal gamma-GTP monoclonal antibodies. These monoclonal antibodies did not react with human ovary or uterus in immunohistochemical study. Optimal assay condition, resulting in a sensitive assay with a low background, is presented. The detection limit of this assay was estimated to be 1 ng/ml of seminal gamma-GTP corresponding to about 100,000 times dilution of seminal sample. This ELISA was specific for seminal gamma-GTP, without cross-reactivity to renal or hepatic gamma-GTP, normal blood serum, non-coital vaginal fluid or saliva. The recovery of seminal gamma-GTP added to various biological fluids were also examined.

Antibodies, Monoclonal

A study of cytokines in burn blister fluid related to wound healing.

This report indicates that retention fluid from blisters of partial skin thickness burns, which contains relatively large amounts of cytokines and growth factors, stimulates the wound healing process. Although epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) levels were low, relatively large amounts of cytokines including platelet derived growth factor (PDGF), interleukin (IL-6) and transforming growth factor (TGF) alpha were present and these exercised stimulatory effects on wound healing. TGF beta, which plays an important role in collagen metabolism and in scar formation, was also detected. Contrary to our expectations, IL-1 alpha and beta, both of which initiate inflammation, were detected at relatively low levels whereas IL-8 levels were rather high. Various cytokines were shown to coexist in a balanced state in the retention fluids, suggesting that epithelialization might be regulated via a cytokine network operating on the wound surface. The growth of keratinocytes in culture significantly increased with the addition of 1 per cent or more of blister fluid to the medium.

Blister

Studies on cytokines related to wound healing in donor site wound fluid.

This study was performed to evaluate cytokines in donor-site wound fluids and to determine their effect on wound healing. A film dressing was applied to the donor-site wound of 24 patients immediately after a split-thickness skin graft was taken. On the 5th day after treatment, 2-3 ml of the fluid retained under the film dressing was collected by means of puncture with a syringe. Growth factors and cytokines considered to accelerate wound healing were present in relatively large amounts in the exudate. Very low concentrations of epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) were detected by a commercially-available enzyme-linked immunosorbant assay (ELISA) kit. However, the presence of both growth factors in wound fluid could not be confirmed because of the possible cross-reactivity of the antibodies to other EGF and FGF family growth factors. In contrast, platelet derived growth factor (PDGF), interleukin-6 (IL-6), transforming growth factor-alpha (TGF-alpha) and TGF-beta were present in relatively large amounts. The finding that certain cytokines coexist in a balanced state under the film dressing suggests that epithelization can proceed, since an adequate balance would insure proper regulation by the cytokine network. Our present study increases the likelihood that film or hydrocolloid dressings will be used more frequently in the future for treatment of burn wounds, ulcers or donor-site wounds since these dressings were shown to be more capable than ointments of retaining cytokines, particularly intrinsic growth factors secreted at the wound site.

Adult

Efficacy of hydroxyapatite ceramic as a carrier for recombinant human bone morphogenetic protein.

In this study, we investigated the efficacy of hydroxyapatite ceramic (HAP) as a carrier of bone morphogenetic protein (BMP) using porous HAP pellets artificially fabricated from limestone. After treatment with recombinant human BMP-2, the pellets were inserted beneath the cranial periosteum of rabbits, and the degree of osteogenesis was examined histologically. The degree of osteogenesis was also evaluated using image-analyzing procedures. Results showed that extensive bone formation had occurred around the pellets 3 weeks after insertion in the group that received pellets treated with recombinant human BMP alone as well as in the group that received recombinant human BMP in addition to type I collagen-treated HAP pellets. Subsequently, osteogenesis within the pellets slowly progressed over time, and by 9 weeks after insertion most of the pellet pores in both groups were filled with newly generated bone. The recombinant human BMP-collagen group, however, exhibited a significantly greater bone induction. These results indicated that if recombinant human BMP is used clinically in the future, artificially fabricated HAP would be a suitable carrier.

Analysis of Variance

Pneumocephalus caused by fistulas of the mastoid air cells treated with a temporoparietal fascial flap.

Using a temporoparietal fascial flap and hydroxyapatite ceramics, we treated a patient for complications after a neurosurgical operation for glossopharyngeal neuralgia. These consisted of pneumocephalus and cerebrospinal fluid rhinorrhea resulting from fistulas of mastoid air cells associated with a subcutaneous dead space. By means of the temporoparietal fascial flap, we were able to fill the dead space and reinforce the repaired dural and mastoid lesion as well. Hydroxyapatite ceramics were also useful for closing the mastoid air cell fistulas.

Bone Diseases

Bone induction of hydroxyapatite combined with bone morphogenetic protein and covered with periosteum.

Using a rabbit model, we evaluated the role of the periosteum in bone induction using hydroxyapatite ceramic pellets, some of which had been coated with bone morphogenetic protein. Eighteen rabbits were divided into two groups, a control group that received pellets soaked in phosphate-buffered saline alone and another group for which the pellets had been supplemented with bone morphogenetic protein. After making a skin incision on the head of each rabbit, two caudally pedicled periosteal flaps measuring 1 cm in width and 2.5 cm in length were elevated. These flaps were wrapped around hydroxyapatite pellets manufactured from limestone and fixed with sutures. After implantation, both groups of rabbits were returned to their cages, maintained for 3, 6, or 9 weeks [every group consisted of 3 rabbits (6 pellets)], and then sacrificed. In this study, the extent of bone induction, which was measured with a dual x-ray densitometer, that resulted from covering the hydroxyapatite pellet with periosteum alone (control group) was minimal. On the contrary, since osteogenesis from the periosteum toward the pores of the pellet was observed in the bone morphogenetic protein group much more than in the control group, the usefulness of our technique was confirmed. However, active osteogenesis was observed with subperiosteal implantation of the hydroxyapatite-bone morphogenetic protein complex in the bone morphogenetic protein group, but the osteogenesis observed was not distributed over the entire pellet.

Animals

A new operative method for treating severe cryptotia.

Results following surgical treatment for cryptotia are as yet far from fully satisfactory in cases in which deformity of the upper auricular portion is severe and particularly when there is contraction of the helical skin and auricular cartilage. Therefore, improvements in operative procedures have been considered necessary. We have developed a new method for treating cryptotia using a rhomboid flap in the superior and anterior auricular regions to correct the contraction of skin in the helix in cases in which the deformity of the upper auricular portion is large and shortening in the anterior and posterior directions is significant and in which severe contraction of the helix is observed. In this report, we describe the operative procedures used and present the relatively favorable results obtained in three patients. Using these techniques, we have been able to elongate the contracted helix frequently observed in cases of cryptotia by preparing a flap in the anterior auricular region. This approach appears to be a useful and safe means of treating cryptotia and so-called constricted ear as well.

Child, Preschool

Immunocytochemical study of seminal gamma-glutamyltransferase using monoclonal antibodies.

We produced three monoclonal antibodies, SG1, SG2 and SG3, specific for human seminal gamma-glutamyltransferase when characterized by enzyme-linked immunosorbent assay and immunoblotting. Seminal gamma-glutamyltransferase was localized, by immunostaining, to the epithelial cells of the ductus epididymidis, seminal vesicle and prostate gland with SG1, those of the prostate gland with SG2, and those of the seminal vesicle with SG3. Rabbit polyclonal anti-seminal gamma-glutamyltransferase serum reacted with the proximal convolution of the kidney and the bile capillaries of the liver, and with the epithelial cells of the reproductive organs. However, immunoreactivity was not observed in the kidney or liver with the monoclonal antibodies. Thus, these monoclonal antibodies are probably all specific to seminal gamma-glutamyltransferase but recognize different epitopes.

Animals

Effects of cilostazol lotion on blood flow in rabbit skin.

Cilostazol (Cls) is a inhibitor of phosphodiesterase and increases cyclic AMP (cAMP) in platelets and also raises the vascular smooth muscle cell cAMP level causing vasodilation. Therefore, it was expected to increase local blood flow in the skin. Topical application of Cls may improve local blood flow without systemic effects in clinical situations. In this paper the effect of Cls lotion on skin blood flow was assessed in animal experiments. Application of this lotion allowed skin blood flow to remain at increased levels for about 60-90 min. Tissue assay of the Cls content revealed that Cls is absorbed percutaneously and retained, even in the inner tissue layer, for at least 180 min.

Administration, Cutaneous

Method for preparing an exact-size model using helical volume scan computed tomography.

Helical volume scan computed tomography is a recently developed technology by means of which detailed data for most facial bone areas can be accumulated in a very short period, i.e., about 30 seconds, a much shorter time than required with conventional computed tomography. From a clinical standpoint, this is extremely important. In this report we discuss the principles of a method for preparing actual-size models by laser lithographic procedures based on data obtained by helical volume scan computed tomography. With these procedures, it is possible to obtain a good reproduction with high accuracy, on the order of 0.5 mm, not only of the outer morphologic structure of the cranial and maxillofacial bones but also of portions of the inner structure of cavities such as the cranium and paranasal sinuses. The difference between the original and model was under 3 percent, as confirmed by constructing a model of the dry skull with helical volume scan computed tomography. Therefore, production of exact-size models using helical volume scan computed tomography data represents an important technological development, breaking through previous limits imposed by conventional simulations prepared with three-dimensional images using CRT. With the combined use of laser lithographics and helical volume scan computed tomography, operative methods for craniomaxillofacial surgery should improve significantly in the near future.

Adult