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Biomedical subjects

S Torii

Publications and source records attributed to S Torii.

At least 91 records · Page 5Linked to original sources

The potential of oral mucosal cells for cultured epithelium: a preliminary report.

We have developed a method to fabricate cultured epithelium for skin repair using mucosal cells. We grafted this epithelium in six cases. The site where the mucosal epithelium was transplanted keratinized normally within 4 weeks and formed normal skin. Mucosal epithelial cells have many advantages over skin epidermal keratinocytes: (1) Mucosal epithelial cells grow faster than skin keratinocytes. (2) Cultured epithelial sheets formed using mucosal cells remain viable for at least 14 days in vitro. (3) The oral cavity is a suitable location to take a tissue segment because scar due to biopsy is inconspicuous. Therefore, mucosal epithelial cells are a potential new source of cells for cultured epithelial graft.

Adult↗

Contraction potency of hypertrophic scar-derived fibroblasts in a connective tissue model: in vitro analysis of wound contraction.

Many investigators have reported that collagen gel contraction reflects the mechanism of wound contraction. By using a connective tissue model (CTM) of collagen gel lattice, we analyzed the contraction potency of fibroblasts that had been obtained from hypertrophic scar, normal skin, and normal oral mucosa. We then tried to analyze the mechanism of CTM contraction by immunofluorescent microscopic and transmission electron microscopic examinations. Hypertrophic scar-derived fibroblasts in CTM possessed the greatest contraction potency and the shortest lag time when compared with those of normal skin and normal oral mucosa-derived CTMs. It became clear that the initial contractive degree of CTM was closely related to morphological changes of fibroblast cells into bipolar and elongated shapes. Hypertrophic scar-derived fibroblasts elongated their processes faster, and their intracellular actin filaments were more numerous than those of normal fibroblasts. We believe that the hypertrophic scar-derived CTM is a useful pathological model for the research of wound contraction and hypertrophic scar formation.

Adolescent↗

Functional reconstruction of a bilateral maxillectomy defect using a fibula osteocutaneous flap with osseointegrated implants.

We have achieved functional reconstruction for a bilateral upper alveolar bone, gingival, and palatal defect that has various problems originating from instability of the prosthesis using the fibula osteocutaneous flap with osseointegrated implants. The flap had three bone segments and two skin paddles. The combined bone segments created the upper alveolar arch, and the skin paddles closed the palatal defect. Nine months later, prosthodontic treatment was performed successfully. Our procedure restored the patient to masticatory function of the upper jaw, intelligible speech, and natural facial appearance. As a result, quality of life of the patient was extremely improved.

Dental Implantation, Endosseous↗

Detection of IgE antibody against Candida albicans enolase and its crossreactivity to Saccharomyces cerevisiae enolase.

Candida albicans 46 kDa protein, a glycolytic enolase enzyme, is an important allergen of the yeast. The purpose of the study was to detect circulating IgE and IgG antibodies against C. albicans enolase (CAE). We isolated CAE using sequential DEAE Sephacel and P11 column chromatography from spheroplasts of C. albicans, and detected IgE and IgG antibody against CAE by immunoblotting. Crossreactivity of enolase of C. albicans and Saccharomyces cerevisiae was also examined by immunoblotting and immunoblot inhibition test. Among 54 sera with positive IgE RAST to C. albicans, IgE antibody against CAE was detected in 20 sera (37%) and IgG antibody in 27 sera (50%). The allergenic potency of CAE was confirmed using a skin-prick test in three patients. Simultaneous IgE binding to S. cerevisiae enolase was only observed in four out of 20 sera reacting to CAE. Pre-treatment of sera with CAE completely inhibited IgE binding to S. cerevisiae enolase. Whereas the latter only partially inhibited IgE binding to CAE. These results suggest that CAE shares some crossreacting epitopes with S. cerevisiae enolase, representing minor components of CAE but dominant segments of S. cerevisiae enolase.

Antibodies, Fungal↗

Characterization of IgE-binding epitopes on Candida albicans enolase.

Candida albicans enolase is one of the important allergens in Candida allergy. We isolated and purified 46kDa C. albicans enolase (CAE) from C. albicans and characterized epitopes for IgE antibody by lectin-blotting and enzymatic digestion followed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. Lectin blotting and deglycozilation indicated that this protein did not contain polysaccharide side chains. The purified CAE and recombinant fusion protein produced from CAE gene possessed common epitopes for IgE antibody. We estimated IgE binding epitopes on the basis of reported amino acid sequences from the analysis of cDNA encoding CAE. V8 protease digestion of CAE gave six polypeptide fragments (A-F). The N-termini of each fragment were confirmed by amino acid sequence and the C-termini were estimated by molecular weights of each fragment and the specific cutting site of V8 protease. Fragment C (25.0 kDa; F-171-I-399) reacted to 90% IgE antibodies examined, whereas fragments D (21.0 kDa; F-171-I-360), E (16.2 kDa; F-171-D-317) and F (13.0 kDa; A-47-E-170) showed no IgE binding. Our results suggest that epitopes for IgE antibodies exist near the C-terminal of the protein.

Amino Acid Sequence↗

Reconstruction of the anterior cranial base with the galeal frontalis myofascial flap and the vascularized outer table calvarial bone graft.

Reconstruction of the anterior cranial base after tumor extirpation must seal off the cranial cavity from the upper respiratory tract. The key to success is to use vascularized materials for the structural support of the brain. From October 1989 to July 1992, 10 patients underwent anterior cranial base reconstruction after basicranial tumor resection; the lesions were four meningiomas and six malignant tumors of the ethmoid, maxilla, and orbit. The malignant tumors included four recurrent tumors that had been previously treated by a transfacial approach. After tumor extirpation, the resultant bony defects in the anterior cranial base, involving the orbital roof as well as the cribriform plate, ranged from 4 x 3 to 6 x 7 cm in size. The materials used in reconstruction were the galeal frontalis myofascial flap and the outer table calvarial bone flap, which is based on the temporoparietal galeal flap. Both materials are known to have rich blood supplies. These flaps make a reliable separation between the cranial cavity and the respiratory tract in three layers: the galeal frontalis myofascial flap, the vascularized calvarial bone, and the temporoparietal galea. Postoperative complications included one subcutaneous hematoma and one temporary cerebrospinal fluid rhinorrhea. We think this reconstructive technique will be useful in selected circumstances, especially after resection of a recurrent malignant tumor.

Adult↗

[Coronary artery bypass grafting without cardiopulmonary bypass in patients with LV dysfunction (EF < or = 30%)--a report of 3 cases].

The purpose of this article is to describe our technique for performing coronary artery bypass grafting without cardiopulmonary bypass and to demonstrate that this operation is safe and useful to the case of LV dysfunction. Between April 1988 and March 1994, 2 men and 1 woman aged 61 to 69 years (mean 65 years) with LV dysfunction (EF < or = 30%) underwent coronary artery bypass grafting without cardiopulmonary bypass. Saphenous vein grafts were placed to the right coronary artery (n = 2), left anterior descending artery (n = 2), and internal thoracic artery grafts were placed to the right coronary artery (n = 1), left anterior descending artery (n = 1). The post operative course were uneventful in all patients and discharged with no complications. All patients underwent coronary angiography, and 5 of 6 (83.3%) grafts placed without cardiopulmonary bypass were patent. In selected patients, coronary artery bypass grafting to the case of LV dysfunction without cardiopulmonary bypass can be performed safe and satisfactory graft patency rates.

Aged↗

[Detection of IgE antibody to Pityrosporum orbiculare in patients with atopic dermatitis].

A lipophilic yeast, Pityrosporum orbiculare, found in normal microflora of the human skin, is considered to be a pathogenic allergen of atopic dermatitis (AD). We measured IgE antibody to P. orbiculare using a CAP RAST FEIA kit in 44 patients with AD (AD alone 17, AD+bronchial asthma (BA) 27). The incidence of positive RAST was 88.2% in the patients with AD alone and 74.1% in the patients with AD+BA. The IgE RAST index was 2.77 +/- 1.34 (mean +/- SD) in severe AD patients (n = 23), which was significantly higher than that in mild AD patients (1.88 +/- 1.41, n = 21). The patients with eczematous skin on the face, neck and scalp (n = 27) showed higher IgE titers (2.79 +/- 1.26) than those without skin lesions (1.64 +/- 1.44, n = 17). These results suggest that P. orbiculare is a pathogenic allergen of severe AD. IgE levels for P. orbiculare showed a statistically significant relation to those for Candida albicans (r = 0.62, p < 0.01). In RAST inhibition tests on five patients' sera, C. albicans extract significantly inhibited IgE RAST to P. orbiculare in only one serum, indicating that P. orbiculare shares some IgE binding epitopes with C. albicans, but that P. orbiculare-specific epitopes also exist.

Adolescent↗

Immediate hypersensitive reactions to buckwheat ingestion and cross allergenicity between buckwheat and rice antigens in subjects with high levels of IgE antibodies to buckwheat.

BACKGROUND: Immediate hypersensitive reactions induced by buckwheat ingestion are considered to be IgE-mediated. Some subjects, however, develop no immediate adverse reactions after buckwheat ingestion despite high levels of buckwheat-specific antigens IgE. The mechanism is unknown. OBJECTIVE: To investigate the mechanisms. METHODS: RAST for buckwheat and rice and RAST inhibition between these antigens were performed using sera from 23 buckwheat-sensitive subjects and 30 buckwheat-tolerant subjects who had IgE antibodies for both buckwheat and rice. RESULTS: RAST values for buckwheat and rice were significantly correlated with each other (P < .01) in the buckwheat-tolerant group, but not in the buckwheat-sensitive group. This suggests the IgE antibodies from the subjects without any overt symptoms after buckwheat ingestion recognize the cross-reactive epitope between buckwheat and rice, whereas the IgE antibodies from those with immediate reactions to buckwheat ingestion do not. RAST inhibition assays were performed to evaluate this. RAST inhibition of heterogeneous combination of inhibitor and disc antigen such as rice and buckwheat was significantly smaller than that of homologous combination of rice and rice or buckwheat and buckwheat in the group with immediate symptoms after buckwheat ingestion. There was no significant difference in RAST inhibition between homologous and heterogeneous combinations in the group without the symptoms. CONCLUSIONS: There was cross-reactivity with IgE antibodies between buckwheat and rice and IgE antibodies from the buckwheat-tolerant subjects with high levels of IgE antibodies from the buckwheat might recognize the epitopes on buckwheat antigens which cross-react with rice antigens, whereas IgE antibodies from the buckwheat-sensitive subjects might bind to buckwheat-specific epitopes.

Adolescent↗

[A case of surgical repair for the aortic insufficiency due to the tears of the aortic cusps during PTCA].

We report a rare case of aortic insufficiency due to the tears of the aortic cusps during percutaneous transluminal coronary angioplasty (PTCA). A 62-year-old man successfully underwent simultaneous aortic valve replacement and coronary artery bypass grafting. The post operative course was uneventful, and the patient was discharged in a stable condition. This report emphasizes the need to consider the possibility of acquired aortic insufficiency due to the complication of PTCA.

Angioplasty, Balloon, Coronary↗

[A surgical case of descending aortic aneurysm combined with simultaneous aortocoronary bypass grafting through a left lateral thoracotomy].

A 71-year-old man with a descending aortic aneurysm was admitted to the hospital because of abnormal chest CT. Aortogram revealed an aneurysm of the descending aorta. His coronary angiogram showed 75% stenosis at LCX (Seg II). The graft replacement of descending aortic aneurysm and coronary artery bypass grafting (CABG) were performed through a left lateral thoracotomy. Postoperative course was good. Postoperative angiogram demonstrated successful reconstruction of the descending aorta and a patent bypass graft. The patient discharged healthy without any complications.

Aged↗

Evidence for defects in V(D)J rearrangements in patients with severe combined immunodeficiency.

We investigated the patterns of DNA rearrangements at loci for Ig JH genes in patients with severe combined immunodeficiency (SCID). Four SCID patients without B cells (B- SCID) and four SCID patients with B cells (B+ SCID) were examined. Bone marrow cells of these patients were transformed with EBV. The majority of the transformed cells from three B- SCID patients had the germline configuration at their JH gene loci. The rearranged fragments from one patient were analyzed extensively. The rearranged regions in all of the fragments had a common structure wherein two fragments derived from the JH-S mu region were connected inversely. The possible presence of rearranged forms of VHDJH and DHQ52JH sequences in bone marrow cells of two B- SCID patients were examined directly by the polymerase chain reaction (PCR) method. In one patient, we found neither a VHDJH sequence nor a DHQ52JH sequence within the range of sensitivity of the PCR method. In another patient, we found a VHDJH sequence at an extremely low level and DHQ52JH sequences at a relatively low level. Either RAG-1 or RAG-2 gene was not expressed in the B- SCID-derived cell lines. B+ SCID patients did not show any abnormalities in terms of VHDJH rearrangements. These results indicate that B- SCID may be caused by defects in factors involved in V(D)J rearrangements.

Base Sequence↗

A new method of anterior mediastinal tracheostomy following resection of cervical esophagus and the larynx: report of a case.

We report herein the case of a 52-year-old man for whom a split pectoralis major myocutaneous flap was applied at the time of extended radical surgery for esophageal carcinoma with tracheal involvement, to avoid the postoperative complications of anterior tracheostomy such as tracheal necrosis and rupture of the major vessels. Laryngopharyngectomy and extended resection of the proximal trachea was performed through a manubrectomy, leaving the tracheal remnant only 4 cm above the carina. A pectoralis major myocutaneous flap was split into two with one piece being wrapped around the trachea at the anterior mediastinal tracheostomy site, and the other being placed between the trachea and brachiocephalic artery. The postoperative course was uneventful and the patient was discharged from hospital on the 34th postoperative day. A split pectoralis major myocutaneous flap may be effective not only for filling the dead space between the trachea and brachiocephalic artery, but also for reducing tension at the tracheocutaneous anastomosis and protecting against circulatory damage at the mediastinal tracheostomy site to minimize stomal retraction.

Carcinoma, Squamous Cell↗

New reconstruction for total maxillectomy defect with a fibula osteocutaneous free flap.

The osteocutaneous fibula free transfer with three segments of bone and the peroneal flap was used to reconstruct a total unilateral maxillectomy defect. Satisfactory restoration of three-dimensional facial structure, orbital support, and prosthesis wearing was achieved. The fibula osteocutaneous free flap is a very useful alternative for reconstructing a maxillectomy defect.

Bone Transplantation↗

A new composite gastric seromuscular and omental pedicle flap.

OBJECTIVE: The authors performed a study to see if gastric seromuscular patch elevation is anatomically feasible and to estimate the maximum size of the patch relative to its blood supply. SUMMARY BACKGROUND DATA: A flap composed of greater omentum and a full-thickness segment of the greater curvature of the stomach, based on the right gastroepiploic artery, was first described in 1977. Elevation of the greater omentum along with a seromuscular patch of stomach has not been reported previously. METHODS: Angiography was performed via the right gastroepiploic artery in a stomach obtained from ten patients who underwent gastrectomy, then india ink was injected. The stomach was then fixed in 10% formalin, and histochemical examination was performed to determine if seromuscular patch elevation was possible. RESULT: Results of the angiography and injection experiment of india ink indicated that the territory of a single gastric ramus was approximately 5 cm x 5 cm in both anterior and posterior walls of the stomach. Histology revealed that the gastric rami lay between the muscular layer and the mucosa. CONCLUSION: The authors believed that a composite gastric seromuscular patch and omental pedicle flap would be clinically applicable. The authors also believed that the maximum size of the patch was 10 cm x 10 cm. They used this flap to successfully treat three patients with chronic soft-tissue defects--two bronchopleural fistulae and a radiation ulcer.

Aged↗

The distally based superficial sural artery flap.

The distally based superficial sural artery flap, first described as a distally based neuroskin flap by Masquelet et al., is a skin island flap supplied by the vascular axis of the sural nerve. The aim of this paper is to refine the surgical technique in order to establish the reliability of this flap. We treated 20 patients with 21 distally based superficial sural artery flaps, including 2 fascial flaps. All flaps survived. Most flaps showed slight venous congestion. In the largest flap (10 cm wide by 13 cm long), edema lasted 2 months. In the flap whose pedicle was raised without the deep fascia, there was necrosis at the distal tip of the flap. The advantages are the following: The blood supply is reliable, elevation is easy and quick, and major arteries are not sacrificed. This new flap may be useful in selected circumstances.

Accidents, Traffic↗

[Surgical treatment of a long-term decubitus ulcer].

A 64-year-old male presented with a large decubitus ulcer of the sacrum which had not healed for thirteen years in spite of various conservative treatments. His primary disease was paraplegia following spondylitis. Although he was not ambulatory, he was able to manage a wheelchair. The decubitus, which had a 8 x 13 cm dead space, was successfully closed with a single operation using two fasciocutaneous flaps. The patient was discharged two months postoperatively. The medical cost of his treatment before and after the surgery was investigated. The expense including the surgery and postoperative care until discharge was five times more than the monthly cost of the preoperative period. These findings suggest that a decubitus ulcer which does not respond to conservative treatments for more than several months should be considered for a surgical management, as long as the patient's general condition permits an operation.

Aged↗

[Immediate hypersensitive reactions to the ingestion of egg white and IgE binding to the egg white components].

IgE is considered to be involved in immediate hypersensitive reactions (IHR) following egg ingestion. IgE antibody levels to egg-white (EW) antigens in the IHR-positive group (n = 19, mean age +/- SD = 5.2 +/- 4.5 yr) were higher than those in the IHR-negative group (n = 13, mean of age +/- SD = 3.6 +/- 2.2 yr). However, even in the IHR-negative group, some patients showed high IgE to EW. RAST inhibition tests with heat-treated (100 degrees C, 5, 10, and 30 min) egg-white antigens were performed on 13 serum samples from subjects with IHR and 9 serum samples from subjects without IHR. Heat treatment decreased the IgE-binding activity of egg white and it was speculated that IgE from IHR-negative subjects bound to relatively heat-unstable sites of egg-white antigens. Furthermore, we selected IHR-negative subjects (n = 8, mean of age +/- SD = 3.0 +/- 1.7 yr) with higher IgE antibody levels than the lowest limit of IgE to EW of the IHR-positive group and compared IgE to ovomucoid (OM), ovalbumin (OA), conalbumin (CA), and lysozyme (Ly) between these IHR-negative and positive groups. IgE-binding activities to egg-white components, including OA, CA, and Ly but not OM, were significantly decreased with heat treatment. The IHR-negative group showed significantly lower IgE to OM (untreated, 5, 10, 30 min treatment) and 5 min treated OA alone than the IHR-positive group, while no difference was found in IgE to other components between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗