Comparison of kidney, composite tissue, and skin allograft survival in rats prolonged by donor blood and concomitant limited cyclosporine.
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Animals↗
Biomedical subjects
B M Achauer
Publications and source records attributed to B M Achauer.
Treatment of extensive adenoma sebaceum with a carbon dioxide laser.
This case report documents the successful removal of a sizable and symptomatic adenoma sebaceum from the face, nose, and palate with the carbon dioxide laser.
Adenoma↗
Argon laser treatment of telangiectasia of the face and neck: 5 years' experience.
This study documents the treatment and long-term follow-up of telangiectasias of the face and neck with the argon laser. This study concurs with other examiners that treatment is effective with minimal complications and satisfactory long-term results.
Face↗
Decreased reactivity of allosera against target lymphocytes obtained following thermal injury or long-term cyclosporine treatment.
We speculated that two diverse causes of potent cell-mediated immune suppression, cyclosporine (CsA) and thermal trauma, may demonstrate some similar actions, and thus tested whether either could alter antisera reactivity against allogeneic target lymphocytes. Target splenocytes from 40% body surface area full-thickness burned Brown-Norway (BN) rats demonstrated significant (P = 0.004) decreased reactivity (agglutination) with antisera produced across a full allogeneic barrier (RT1 major histocompatibility complex (MHC) and non-MHC) compared to control splenocytes. Depression of allogeneic splenic target cell reactivity against Lewis (LEW)-anti-BN allosera was similarly observed using lymphocytes from long-term CsA-treated rats (P = 0.004). The decreased reactivity induced by burn trauma was transferable to pooled normal splenocytes or blood lymphocytes by preincubation with burn plasma (P less than 0.001), and was confirmed by a cellular enzyme-linked immunosorbent assay (CELISA) (P = 0.003). In summary, a similarity consisting of decreased antibody reactivity against lymphocytes from either burned or long-term CsA-treated animals was demonstrated. These results suggested that lymphocyte cell surface allogeneic determinants and their expression and/or availability were altered by either regimen.
Animals↗
Prior administration of donor-strain epidermal cells or macrophages to enhance survival of rat hind-limb allografts.
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Animals↗
Two new composite tissue allograft models in rats to study neuromuscular functional return.
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Animals↗
Long-term residual cyclosporine levels following short-term administration in various allograft models demonstrating extensive survival prolongation.
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Animals↗
Long-term skin allograft survival after short-term cyclosporin treatment in a patient with massive burns.
In a child with extensive burns, cyclosporin was given to extend the survival of cadaveric skin allografts obtained from numerous unmatched donors. No evidence of graft rejection was seen, either during treatment or in the 2 years after cyclosporin was withdrawn.
Burns↗
An unusually aggressive Mycobacterium marinum hand infection.
An unusually aggressive Mycobacterium marinum infection of the hand that progressed despite surgical and medical treatment is presented. The infection progressed over a 3-week period after the patient had surgical treatment and received isoniazid (INH), rifampin, and ethambutol hydrochloride. The patient had a collar-button abscess, destruction of the metacarpophalangeal (MCP) joint capsule, flexor and extensor tenosynovitis, and metacarpal and proximal phalanx bone destruction at the MCP joint and metacarpal shaft. Although atypical mycobacterial infections of the hand are usually indolent but persistent, this Mycobacterium marinum hand infection progressed rapidly, even with surgical and medical treatment. A judgment was made to perform an index ray amputation. With a more complete excision of the infected tissue, there was a higher probability of controlling this severe infection. The patient was treated with antituberculosis medications for 6 months and is doing well 1 year after the operation.
Amputation, Surgical↗
Composite tissue (limb) allografts in rats. III. Development of donor-host lymphoid chimeras in long-term survivors.
Eight LEW rat recipients possessing long-term-surviving (206-701 days) LBN vascularized hind limb allografts (CTAs) were tested for donor-host lymphoid chimerism. The recipients received various cyclosporine (CsA) treatment protocols in order to induce indefinite CTA acceptance. Histological examination of long-term-surviving CTAs demonstrated normal-appearing bone marrow in the donor limb. Lymphocytes isolated from host hemopoietic tissues (peripheral blood and/or spleen) by ficoll-hypaque density gradient centrifugation were tested against LEW-anti-BN antisera. Comparisons were made to standard curves employing various known concentrations of LBN and LEW cell combinations. The level of lymphocyte agglutination (dependent variable) showed a significant (P less than 0.025-0.005) linear relationship to the concentration of LBN donor cells (independent variable) present. Lymphocyte suspensions isolated from long-term CTA host peripheral blood and/or spleen showed a mean of 19.7% (+/- 9.7-95% confidence interval) donor LBN mononuclear cells present. Thus, it appeared that lymphoid cells originated from, and/or were released from LBN donor bone marrow into the circulation, resulting in chimeric repopulation of hemopoietic tissues. The presence of donor immunocytes in these limb allograft recipients may have been beneficial, and thus could have helped contribute to the long-term CTA survival observed.
Animals↗
Salvage of seeing eyes after avulsion of upper and lower lids.
It is often stated that any injury severe enough to avulse both lids will inevitably destroy the globe. Two cases are presented in which the globe was uninjured but exposed, requiring immediate coverage. Local skin flaps placed over mobilized conjunctiva were used for emergency cover. One was eventually made into functioning eyelids; the other remains dormant. First-line options for local flaps may not be available because of regional trauma. The reconstructive surgeon caring for acute trauma patients should be familiar with all available options, including recently described island and myocutaneous flaps.
Adolescent↗
Composite tissue (limb) allografts in rats. I. Dose-dependent increase in survival with cyclosporine.
The dose-response effect of cyclosporine on rat limb transplant prolongation was investigated across the LBN-to-LEW histocompatibility barrier. This composite tissue allograft model has been shown to represent a strong transplantation barrier. Median limb allograft survival times increased in a dose-dependent manner with low cyclosporine doses, and then reached a plateau at higher levels. The cyclosporine dose that produced half-maximal survival based on a 20-day treatment was only 3.7 mg/kg/day. Histopathology revealed that the rejection process was distinctly different in limb allografts treated with cyclosporine compared with non-cyclosporine-treated controls. Rejection appeared to be delayed or partly arrested in certain areas of cyclosporine-treated limb allografts. These studies represent an initial step in laying the experimental foundation for clinical transplantation of composite tissue allografts using cyclosporine-induced immune suppression.
Animals↗
Composite tissue (limb) allografts in rats. II. Indefinite survival using low-dose cyclosporine.
Cyclosporine has reawakened interest in transplantation of peripheral composite tissue allografts (CTA) of skin, muscle, bone, vessel, and nerves. The purpose of this study was to examine whether cyclosporine could produce indefinite survival of CTA. Two groups of LEW recipients of LBN limb transplants were given different long-term treatments of cyclosporine. Tolerance was achieved in many of the animals. Several possibilities for the mechanism of this tolerance are discussed.
Animals↗
Burn wound pathophysiology and care.
The pathophysiology of the burn injury and treatment factors that influence burn depth are explained. Details of burn wound care, including indications for early excision, topical antimicrobials, and the most recent advances in skin substitutes, are described. Burn wound sepsis, the most common and serious complication, is discussed in regard to diagnosis and treatment.
Anti-Bacterial Agents↗
Immunosurgery.
After being leaders in the field of transplantation, plastic surgeons became inactive in this field. Interest is reviving with the advent of the new immunosuppressant drug cyclosporine, as well as new knowledge of the immune mechanism. New generations of immunosuppressive drugs may allow allografting in patients with massive burns, limb transplants, and possibly even allografts of facial structures.
Antibodies↗
Burn care and the plastic surgeon.
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Burn Units↗
Argon laser treatment of strawberry hemangioma in infancy.
Argon laser therapy is effective for removing port-wine stains and for reducing cutaneous vascular and pigmented lesions. Strawberry hemangiomas, being much thicker lesions than port-wine stains, were considered not appropriate for argon laser treatment. Using argon laser therapy in 13 cases of strawberry hemangioma, we achieved poor to dramatic results.
Child, Preschool↗
A pair of five-day flaps: early division of distant pedicles after serial cross-clamping and observation with oximetry and fluorometry.
In each of 2 recent patients with distant pedicles (one a groin flap and the other a cross-leg flap), we were able to perform the final division and detachment of the flap on the fifth postoperative day. Cross-clamping was used to create intermittent periods of ischemia. The periods of ischemia were progressively increased until the time of division. Fluorometry with intravenous fluorescein played a role in deciding when to divide the flap. The patients were discharged from the hospital on the sixth and seventh days, respectively. Trimming was done on an outpatient basis.
Adult↗