Inhibitory effect of statins on inflammatory cytokine production from human bronchial epithelial cells.

Statins are 3-hydroxy-3-methylglutaryl-co-enzyme A reductase inhibitors of cholesterol biosynthesis, and have been reported to exert pleiotropic effects on cellular signalling and cellular functions involved in inflammation. Recent reports have demonstrated that previous statin therapy reduced the risk of pneumonia or increased survival in patients with community-acquired pneumonia. However, the precise mechanisms responsible for these effects are unclear. In the present study, we examined the effects of statins on cytokine production from lipopolysaccharide (LPS)-stimulated human bronchial epithelial cells (BEAS-2B). Interleukin (IL)-6 and IL-8 mRNA expression and protein secretion in LPS-stimulated cells were inhibited significantly by the lipophilic statin pitavastatin and the hydrophilic statin pravastatin. As these inhibitory effects of statin were negated by adding mevalonate, the anti-inflammatory effects of statins appear to be exerted via the mevalonic cascade. In addition, the activation levels of Ras homologue gene family A (RhoA) in BEAS-2B cells cultured with pitavastatin were significantly lower than those without the statin. These results suggest that statins have anti-inflammatory effects by reducing cytokine production through inhibition of the mevalonic cascade followed by RhoA activation in the lung.

Studies of gastric mucosa regeneration and safety promoted by Mouriri pusa treatment in acetic acid ulcer model.

ETHNOPHARMACOLOGICAL RELEVANCE: Mouriri pusa Gardn. (Melastomataceae) is a medicinal plant commonly used by people living in the Cerrado to treat gastrointestinal disturbances. This medicinal plant has shown intense gastroprotective action in rodent gastric lesion, but still there are no data about its healing effect on gastric mucosa. AIM OF THE STUDY: To evaluate the methanolic extract (MeOH) obtained from Mouriri pusa leaves for its effect on the cicatrisation process of gastric ulcer. MATERIALS AND METHODS: The healing effects on gastric ulcers inducted by subserosal injection of acetic acid were evaluated by macroscopic and microscopic measures, immunohistochemistry and cell counting in rats treated with MeOH extract of Mouriri pusa (250 mg/kg, p.o./daily) for 14 or 30 days. The toxicity of Mouriri pusa was also evaluated by body and organ weight measure and clinical biochemical parameters. RESULTS: Mouriri pusa treatments lasting 14 and 30 days showed elevated mucus secretion (PAS) and thicker regenerative gastric mucosa, denoting increased cell proliferation, which was confirmed by PCNA immunohistochemical analysis. Moreover, there was important cell recruitment (neutrophils and mast cells) to the site of the ulcer, which is an important factor in ulcer healing. No toxic effect was observed in all parameters evaluated. Phenolic compounds present in the MeOH extract like tannins, flavonoids and epicatechin are the probable agents involved in the healing effects of this medicinal plant. CONCLUSIONS: These findings showed a potential effect of Mouriri pusa in increasing regeneration of damaged gastric mucosa with safety for human use.

Qualea grandiflora, a Brazilian "Cerrado" medicinal plant presents an important antiulcer activity.

Qualea grandiflora is one of the species widely used in folk medicine to treat gastric ulcers in Cerrado of the central region of Brazil. The hydroalcoholic extract of bark (HE) of Qualea grandiflora was investigated for their ability to prevent and heal lesions in the gastric mucosa. The oral administration of HE exhibited antiulcer activity decreasing the ulcerative index induced by HCl/ethanol solution, indomethacin/bethanechol and stress. In the Shay model, results showed that HE (p.o.) only reduced the severity of gastric lesions without effects on pH, gastric acidity or volume. When given by intraduodenal route, HE changed the pH, but did not modify the other parameters of the gastric juice. These data were in accordance with those obtained when HE was administered orally for 14 days after gastric ulcers were induced by acetic acid in rats. HE presented healing process in subacute gastric ulcer induced by acetic acid in rats. Moreover, histological examinations showed the simple columnar epithelium, lamina propria with simple branched tubular glandules with dilated lumen and large amounts of mucus secretion. Phytochemical investigation of HE led to the detection of terpenes, steroids, saponins, phenolic compounds and tannins in this extract, which may be involved in the observed activity.

Clonal structure and flowering traits of a bamboo [Phyllostachys pubescens (Mazel) Ohwi] stand grown from a simultaneous flowering as revealed by AFLP analysis.

Abstract Although many bamboo species are characterized by simultaneous flowering at long intervals of up to 120 years, few studies have revealed the length of the flowering interval for very-long-lived bamboo species by observing the whole life cycle of a single clone. The flowering interval of Phyllostachys pubescens had been determined to be 67 years by means of observation through the entire life cycle from 1912 to 1979. We observed and analysed the clonal structure and flowering traits of a P. pubescens community which had regenerated from seed in 1930 and began to flower in 1997. Although this interval was again 67 years, flowering and nonflowering culms were mixed, and the flowering event lasted three years in the community. AFLP analysis of DNA samples showed distinct genets that originated from the previous flowering event and that each genet had its own flowering time. This is the first report to show that (i) different genets are mixed in a community of a large bamboo species with a leptomorphic rhizome system, and (ii) a community that originated from a single flowering event can have a range of flowering years.

Disinsertion of the levator aponeurosis from the tarsus in growing children.

To confirm when the levator aponeurosis is disinserted and how the disinsertion is compensated for in growing children, the earliest and latest photographs of the same children were the subjects of a retrospective comparative study regarding upward displacement of the superior palpebral crease and the eyeball in the palpebral fissure. Ninety-four children (48 boys and 46 girls) were selected from 615 patients with cleft lip and palate who were followed for more than several years at our outpatient clinic and whose 58,000 photographs were digitized. The earliest and latest photographs of the patients were taken in primary gaze position; the former, taken at less than 3 years of age, and the latter, taken at more than 6 years of age, were selected for this study. The intervals between the two photographs ranged from 3 to 14 years (mean, 9.61 years; SD, 3.11). The superior palpebral crease moved upward parallel with the growth of the children (p < 0.0001) as well as with the length of the growth period (p = 0.0141). The lower eyelid did not move downward (p < 0.0001). The eyeball also displaced upward parallel with growth (p < 0.0001) and with the length of the growth period (p = 0.0302). The more the superior palpebral crease was displaced upward, the more the eyeball was displaced upward (p = 0.0005). The levator aponeurosis may be likely to disinsert from the tarsus in growing children, thus requiring compensatory, excessive contraction of the levator muscle, which may cause upward displacement of the superior palpebral crease. Subsequently, excessive contraction of the superior rectus muscle in conjunction of the levator muscle may rotate the eyeball upward, which may incline the head. When the head is not inclined in the primary gaze position, compensatory contraction of the inferior rectus muscle to maintain the horizontal visual axis may displace the eyeball upward in the orbit by means of the inferior suspensory ligament of Lockwood.

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.

An anatomical structure which results in puffiness of the upper eyelid and a narrow palpebral fissure in the Mongoloid eye.

The typical Mongoloid eye differs from the Occidental one in puffiness of the upper eyelid and narrowness of the palpebral fissure. We surmised that an anatomical structure might exist in the preaponeurotic fat space, which determines the features of the Mongoloid eye. The upper eyelids of 720 Japanese patients and eight Japanese cadavers were macroscopically investigated, and sagittal slices of the central upper eyelid of one patient and nine cadavers were microscopically analysed. Another, lower-positioned transverse ligament different from the higher-positioned Whitnall's one was identified just above the fusional line between the orbital septum and the levator aponeurosis in almost every upper eyelid. A robust ligamentous structure was observed in 331 patients (46%) with puffier eyelids and a narrower palpebral fissure, a diaphanous retinaculum in 381 patients (53%) and no transverse ligamentous tissue in eight patients (1%). Histological evaluation demonstrated that this ligament was composed of tight bundles of collagen fibres containing few elastic fibres. Examination of the preaponeurotic fat space indicated that the superficial expansion of the levator aponeurosis turned up around this transverse ligament to become the orbital septum. When the levator muscle contracts, the deep expansion of the levator aponeurosis retracts the tarsus, the middle expansion retracts the pretarsal orbicularis oculi muscle and skin, and the superficial expansion retracts the preaponeurotic fat against this ligament. This structure thus determines the low position of the preaponeurotic fat and restricts the vertical width of the palpebral fissure, causing the features of the Mongoloid eye.

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.

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.

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.

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.

A bolster suture technique for ear reconstruction for microtia without skin necrosis.

A new bolster suture technique to prevent skin necrosis in microtia ear reconstruction is presented. An outer series of bolsters is placed distant from the ear framework in a zigzag fashion, the temporal skin being gathered on the framework. In this way, the skin flap overlying the framework is relaxed and has sufficient blood flow. Therefore the skin flap can be thinned with little risk of necrosis. Furthermore, the contour of the reconstructed auricle is accentuated because of the thin relaxed overlying skin. Seven ears with microtia were reconstructed using this method. The results were satisfactory, except for one auricle which became slightly congested at the conchal portion due to excessive thinning. There were no haematomas or skin necrosis.

Continuous intraarterial infusion of prostaglandin E1 and heparin to extend and improve the survival of pedicled musculocutaneous flaps through unusual routes: a clinical preliminary report.

Sixteen pedicled musculocutaneous flaps (pectoralis major, 3; latissimus dorsi, 4; and transverse rectus abdominis musculocutaneous [TRAM], 9) received continuous intraarterial infusion of prostaglandin E1 (5 micrograms/k of flap per day) and heparin (100 to 200 U/cannula per day) for 14 days postoperatively to extend the flap or improve survival in a high-risk patient. Therapy was successful in 15 patients. To preserve the main arterial inflow to the flap, the infusion was administered via the lateral thoracic artery in the pectoralis major and a branch to the serratus anterior muscle in latissimus dorsi flaps in retrograde fashion, respectively, and was via both the ipsilateral deep epigastric artery and the contralateral superficial epigastric artery in TRAM flaps. This technique permits the use of a pedicled flap in some patients who would otherwise require a free flap.