Extended latissimus dorsi musculocutaneous flap for closure of a meningomyelocele in a 5-hour-old neonate.
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Humans↗
Biomedical subjects
M Iwasawa
Publications and source records attributed to M Iwasawa.
Functional lip reconstruction with a radial forearm free flap combined with a masseter muscle transfer after wide total excision of the chin.
Total lower lip reconstruction was accomplished by combining a radial forearm free flap with a masseter muscle transfer. The patient, who had T4 carcinoma, had the entire lower lip resected including the depressor anguli oris muscle. A radial forearm flap was used to reconstruct the lower lip lining and the floor of the oral cavity. The right and left masseter musculofascial flaps were elevated and transferred in the medial-superior direction, and the peripheral margins of the flaps were sutured together. The lateral margins of the flaps were then sutured to the orbicularis oris muscle of the upper lip. Good sphincter function was obtained more than 1 year after the operation, electromyography revealed almost normal mobility of the transferred masseter muscles, and no sagging of the masseter muscle sling was observed. This procedure appears to be effective for the reconstruction of sphincter function of the lower lip after wide excision of the entire chin.
Aged↗
Genomic analysis of Blastocystis hominis strains isolated from two long-term health care facilities.
The genotype Blastocystis hominis is highly polymorphic. Therefore, a genetic marker would be a powerful tool for the identification or classification of B. hominis subtypes and could be used as a means to resolve the transmission route or origin of the parasite. To this end, 32 B. hominis isolates were collected from patients and/or staff members of two long-term health care facilities (facilities A and B), and these organisms were subjected to genotype analysis based on diagnostic PCR primers and restriction fragment length polymorphism (RFLP) of small subunit rRNA gene (rDNA). Based on PCR amplification using diagnostic primers which were developed from randomly amplified polymorphic DNA analysis of known strains of B. hominis, the 32 isolates of B. hominis were classified into three different subtypes. Thirty isolates, including twenty-four that were isolated from patients and a staff member, from facility A and all isolates isolated from six patients from facility B showed the same genotype. Two of six patients of facility B had been transferred from facility A, and these two patients also had the same-genotype B. hominis that corresponded to 24 isolates from facility A. This genotype strain may have been transmitted by these two patients from facility A to facility B, suggesting human-to-human transmission. In contrast, 2 of 26 isolates from facility A showed distinct genotypes, suggesting that the colonization by these two isolates is attributable to another infectious route. These different subtypes were subjected to RFLP analysis, and the RFLP profiles were correlated with the results obtained by diagnostic PCR primers. This study presents the first molecular evidence of possible human-to-human B. hominis infection between and/or among two small communities.
Animals↗
[Toward an integration of various models of marriage formation and fertility].
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Demography↗
Functional reconstruction of total lower lip defects with a radial forearm free flap combined with a depressor anguli oris muscle transfer.
Two total lower lip reconstructions were accomplished by combining a radial forearm free flap and a depressor anguli oris muscle transfer. The radial forearm flap was used to reconstruct the inner surface of the lower lip. The bipedicled musculofascial flap, which includes both depressor anguli oris muscles, the depressor labii inferioris muscles, and the mentalis muscles, was elevated onto the chin and sutured superiorly to the modioli to obtain innervated sphincter function. Good results were obtained both aesthetically and functionally. Electromyography revealed almost normal mobility of the depressor anguli oris muscles 6 months after the operation. No drooling was seen during mastication, and no air leakage was observed during puffing of the cheeks. This is an effective procedure for the reconstruction of the sphincter function of the lower lip.
Aged↗
Arterialized venous flaps from the thenar and hypothenar regions for repairing finger pulp tissue losses.
Pulp tissue loss of the fingers was repaired with arterialized venous flaps from the thenar or hypothenar regions in 13 patients. Thirteen of the 15 flaps transferred survived completely. The thenar and hypothenar skin is durable and of appropriate texture for replacement of finger pulp defects. An average flap size of 2 x 3 cm was adequate for repairing the tissue loss of the fingers. These are not sensory flaps. However, they exhibited useful sensory recovery within 6 months of the operation. This method is simple and results in minimal donor-site morbidity. The arterialized venous flap is thus a useful alternative for the repair of finger pulp tissue losses.
Adult↗
In vitro and in vivo anti-tumour effects of a humanised monoclonal antibody against c-erbB-2 product.
The c-erbB-2 product is thought to be a unique and useful target for antibody therapy of cancers overexpressing the c-erbB-2 gene. In vitro and in vivo anti-tumour effects of a humanised antibody against the extracellular domain of the c-erbB-2 gene product, rhu4D5, were examined. Rhu4D5 was less effective than its murine counterpart, mu4D5, for the direct antiproliferative activity against the c-erbB-2-overexpressing SK-BR-3 cell line. In vivo treatment of severe combined immunodeficient (SCID) mice carrying the c-erbB-2-overexpressing 4-1ST human gastric carcinoma xenograft with 4hu4D5 revealed that the recombinant protein had potent anti-tumour activity. Furthermore, cytotoxicity of human peripheral blood mononuclear cells against 4-1ST was significantly augmented with rhu4D5, but not with mu4D5. These results indicate that rhu4D5 might perform better in patients than predicted from preclinical studies.
Animals↗
Use of a monitor muscle flap in buried free forearm flap transfer.
The free forearm flap is a reliable and versatile tool in head and neck reconstruction. However, the patency of the microvascular anastomosis is difficult to monitor when the flap is buried in the reconstruction of the esophagus or orbital floor. We used a portion of forearm muscle on a branch of the radial artery and vein as a monitor flap. After the free forearm flap transfer, the monitor muscle flap was placed externally through a small skin incision. Flap viability was assessed by observing the color of the bleeding elicited from the muscle flap. Monitor muscle flaps are raised easily during elevation of the forearm flap. This technique was used successfully in 5 patients. This monitoring method provides a simple and reliable assessment of viability when direct monitoring of the forearm flap is not possible.
Aged↗
A four-pulp flap technique for creating nail folds in the separation of a mid-digital mass in a patient with Apert's disease.
Apert's disease is distinguished from other acrocephalosyndactylys by bilateral and symmetrical deformities, including symphalangism of the hands, which is commonly present in the index, long, and ring fingers. In the correction of the Apert hand, simple separation and skin grafting may be used to create a five-digit hand. However, this technique may result in narrow, atrophic fingertips, and pulp pads. In this paper, a simple technique to create nail folds and pulps for each finger with four transposition flaps from the common pulp is described. During the past 3 years, four Apert hand deformities in 2 patients were treated with this procedure. At a mean follow-up of 32 months, good results were obtained.
Acrocephalosyndactylia↗
Free temporal fascial flap for coverage and extensor tendon reconstruction.
An improved method for reconstructing injured tendons of the dorsum of the hand is presented. We transferred a two-layered temporal fascial flap to the hand and inserted the rolled, deep temporal fascia between the stump of the extensor tendons. This procedure can improve extensor tendon function with minimal scarring in spite of the limitation of available tissue.
Adult↗
Prolonged survival of mice with human gastric cancer treated with an anti-c-ErbB-2 monoclonal antibody.
A monoclonal antibody (MAb), 4D5, specifically recognising an extracellular epitope of the c-ErbB-2 protein, inhibited the growth of human gastric cancer overexpressing c-ErbB-2 severe combined immunodeficient (SCID) mice. This antibody also reduced the mass of established tumours xenografted into SCID mice, whereas gastric cancer not expressing c-ErbB-2 exhibited no regression in response to 4D5 treatment. In addition, administration of 4D5 prevented colonisation of cancer cells and prolonged the survival of host SCID mice inoculated i.v. with c-ErbB-2-overexpressing tumour cells. This is the first reported study to show that treatment with a single antibody specific to c-ErbB-2 prolongs the survival of host SCID mice bearing xenotransplanted tumours.
Animals↗
Reconstruction of the lips, oral commissure, and full-thickness cheek with a composite radial forearm palmaris longus free flap.
Reconstruction of the lower and upper lips, commissure, and full-thickness cheek defects using a composite radial forearm palmaris longus free flap with secondary commissuroplasty is described. This flap is useful for reconstruction of the total lower lip as well as larger defects that include full-thickness cheek and the commissure.
Aged↗
Nail plasty in the treatment of duplicated thumb.
We present refinements in the treatment of duplicated thumb. When applying the modified Bilhauts procedure including the nail, this design based on a lunula is useful to construct a natural looking nail in Wassel types 2 to 4. No bone fixation of each segment is also effective to produce an even transverse curvature of the reconstructed nail.
Female↗
Accelerated maturation in prefabricated flaps by transforming growth factor-beta: an experimental study in the rabbit.
We evaluated whether application of transforming growth factor-beta (TGF-beta) during the first operation could shorten the interval required before creating a neo-vascularized flap in rabbits. Central ear vessels were transferred under the skin. After different time intervals, the flaps were raised as an island flap. In the group receiving TGF-beta, flap survival was 94% of initial length, whereas the control group reached 49% of initial length 3 days later. Five days later, flap survival was 98% in the TGF-beta group and the control group reached 78%. Histological examination revealed prominent angio-neogenesis surrounding implanted vessels in the rabbits receiving TGF-beta. This suggests that TGF-beta may accelerate flap maturation.
Animals↗
Human c-erbB-2 proto-oncogene product as a target for bispecific-antibody-directed adoptive tumor immunotherapy.
To develop an efficient strategy for the targeting of anti-tumor effector cells, we prepared bispecific antibody (BsAb) containing anti-CD3 and an anti-c-erbB-2 proto-oncogene product. The prepared BsAb specifically reacts with both c-erbB-2-positive tumor cells and CD3+ CTL. Human CD4+ helper/killer T cells, induced from peripheral-blood mononuclear cells by activation with immobilized anti-CD3 monoclonal antibody (MAb) plus IL-2, showed no significant cytotoxicity against tumor cells. However, treatment of human CD4+ helper/killer cells with the BsAb caused the induction of specific cytotoxicity against c-erbB-2-positive tumor cells. CD4+ helper/killer cells also produced significant amounts of IL-2 during co-culture with c-erbB-2-positive tumor cells in the presence of the BsAb. Moreover, by combination with the BsAb, CD4+ helper/killer cells showed a strong in vivo anti-tumor effect against c-erbB-2 transfectant or human colon-cancer cells implanted in nude mice. Our results strongly suggest that the c-erbB-2 proto-oncogene product on human tumor cells may be a good target for BsAb-directed adoptive tumor immunotherapy.
Antibodies, Monoclonal↗
Generation propagation, and targeting of human CD4+ helper/killer T cells induced by anti-CD3 monoclonal antibody plus recombinant IL-2. An efficient strategy for adoptive tumor immunotherapy.
We developed a culture system for the rapid generation of CD4+ T cells that have both helper and killer functions. CD4+ T cells isolated from human PBL did not proliferate or develop significant cytotoxicity when treated with rIL-2 because of the lack of p75 IL-2R expression. However, culture of isolated CD4+ T cells with immobilized anti-CD3 mAb plus rIL-2 resulted in a marked proliferation (500-fold increase in 14 days) of CD4+ T cells. The proliferating CD4+ T cells produced IL-2 (92 U/ml) and showed strong cytotoxicity against OKT3 hybridoma cells and Daudi, K562, and U937 tumor cells in an anti-CD3 mAb-dependent manner. The CD4+ T cells contained significant amounts of cytolytic granule-related proteins such as serine esterase and perforin. Activated CD4+ helper/killer cells can be generated from both healthy donors and tumor patients and can be propagated in vitro for 14 to 35 days by biweekly restimulation with immobilized anti-CD3 mAb plus rIL-2. This culture yielded about 20,000-fold increase in cell number after a 21-day culture. Bispecific antibody containing anti-CD3 and anti-glioma Fab components enhanced the cytotoxicity of activated CD4+ helper/killer cells against IMR32 glioma cells. Moreover, the activated CD4+ helper/killer cells showed both helper and antitumor activity in vivo and prevented growth of anti-CD3 hybridoma cells in nude mice whether or not IL-2 was administered. These results indicate that anti-CD3 mAb plus IL-2-activated CD4+ helper/killer cells may provide an effective strategy for adoptive tumor immunotherapy of cancer.
Antibodies, Monoclonal↗
Large-scale culture system of human CD4+ helper/killer T cells for the application to adoptive tumour immunotherapy.
A simple method for the rapid expansion of human CD4+ T cells with both helper and killer functions was established. CD4+ T cells separated from peripheral blood mononuclear cells using immunomagnetic beads were stimulated with immobilised OKT-3 monoclonal antibody (mAb) plus recombinant interleukin 2 (rIL-2) in 96 well culture plates. After 6 day-culture, the CD4+ T cells were restimulated by immobilised OKT-3 mAb for an additional 24 h, then inoculated into concentrated rotary-tissue culture bag and cultured for further 9 days. This procedure yielded a 3000-fold increase in cell number (about 3-5 x 10(9) per bag). Most of the cells (over 96%) continued to express CD4+ antigen and retained their capacity to produce IL-2. The activated CD4+ T cells showed marked cytotoxicity against Fc receptor positive tumour cells in the presence of OKT-3 mAb. Moreover, we succeeded in a specific targeting of the expanded CD4+ helper/killer T cells to c-erb B-2 positive tumour cells by means of anti-CD3 x anti-c-erb B-2 bispecific antibody. These results suggested that our established simple system will be available for the expansion of large number of CD4+ helper/killer T cells which may provide an efficient strategy for adoptive tumour immunotherapy.
Antibodies, Monoclonal↗
Reconstruction of fingertip deformities of the thumb using a venous flap.
Reconstructions of fingertip deformities have been attempted recently. We report a patient in whom the missing tip of a thumb was reconstructed by a local hinge flap and vascularized venous nail flap. This technique is less invasive than other reported methods and, in this situation, achieves a good result with a minimal donor deformity.
Adult↗