Stratum corneum lipid profile and maturation pattern of corneocytes in the outermost layer of fresh scars: the presence of immature corneocytes plays a much more important role in the barrier dysfunction than do changes in intercellular lipids.

BACKGROUND: The functional characteristics of the stratum corneum (SC) of fresh scars as well as keloids and hypertrophic scars are characterized by elevated transepidermal water loss (TEWL) and increased SC hydration. OBJECTIVES: To study the composition of the intercellular lipids and maturation properties of the cornified envelope (CE) of the SC, as these are the most important components for the SC barrier function in fresh scars. METHODS: SC lipids were extracted from the donor site for split-thickness skin grafting soon after re-epithelialization using a cup method, and were analysed with high-performance thin-layer chromatography. CEs, which were prepared from superficial layers of the SC, were double stained with Nile red and anti-involucrin. RESULTS: We found a significant decrease in the proportion of ceramide (CER) in the SC lipids of fresh scars. We also observed changes in the SC CER profile that consisted of an increase in CER 4 and CER 7 and a decrease in CER 3, without any significant change in the proportion of CER 1. These changes were insufficient to explain the remarkably high TEWL recorded in the early stage of fresh scars. In contrast, with double staining of CE with Nile red and anti-involucrin, we detected the presence of numerous immature and less hydrophobic corneocytes in the outermost layer of the SC of fresh scars. Scanning electron microscopy of such corneocytes revealed numerous fine wrinkles on their enlarged surface area. Most of all, we found a closely similar, time-dependent, exponential decrease in the ratio of immature corneocytes with a poorly hydrophobic CE and in the recorded TEWL values in fresh scars. There was a highly significant positive correlation between the proportion of immature corneocytes in the outermost layer of the SC and TEWL values. CONCLUSIONS: These results suggest that the SC barrier dysfunction of the fresh scars is attributable to the presence of immature corneocytes with a less hydrophobic CE, rather than to the changes in SC lipid composition.

Serum levels of free and total prostate-specific antigen in males with liver cirrhosis.

OBJECTIVES: We examined the serum concentrations of total and free prostate-specific antigen (PSA) from patients with liver cirrhosis to clarify the influence of liver function on serum PSA levels. METHODS: Serum concentrations of total and free PSA, as well as the free/total PSA ratio were measured in 75 male patients with histologically confirmed liver cirrhosis. As a control group, 75 age-matched healthy blood donors were studied. RESULTS: The serum levels of total PSA in liver cirrhosis patients were significantly lower than those in controls (p = 0.0004). However, the serum free/total PSA ratios in liver cirrhosis patients were significantly higher than those of controls (p < 0.0001). CONCLUSIONS: Our results suggest the absence of an obvious clearance disturbance of serum PSA as a result of severe hepatic dysfunction and offer caution against the utility of standard cutoff values of serum PSA or free/total PSA ratios in the detection and staging of prostate cancer in men with severe liver dysfunction.

[Treatment of postoperative nausea and vomiting with ondansetron in patients administered anti-neoplastic agents].

The antiemetic effect of ondansetron (a 5-HT3 antagonist) was evaluated in patients treated with intraperitoneally administered anti-neoplastic agents (cisplatin and mitomycin-C) during surgery for ovarian cancer. Anesthesia was induced with intravenous thiopental 5 mg x kg-1 and maintained with nitrous oxide 66% in oxygen and isoflurane. After surgery, 6 patients received a single intravenous dose of ondansetron 4 mg (group O), 6 others did not receive ondansetron (group C). Both groups received an intravenous dose of methyl-prednisolone 500 mg. An intravenous dose of metoclopramide 10 mg was provided in case of continued vomiting or at the patient's request as a rescue antiemetic. The incidence of vomiting was 13% in group O and 87% in group C (P < 0.05). Nausea scores (range 1-4) were significantly lower in group O as compared with group C at 4 h and 8 h after surgery. Total dose of metoclopramide was 20 +/- 13 mg (mean +/- SD) in group C and 2 +/- 4 mg in group O. Administration of anti-neoplastic agents during surgery caused severe nausea and vomiting after surgery and ondansetron prevented the occurrence of nausea and vomiting almost completely. We conclude that ondansetron is an effective antiemetic for preventing postoperative nausea and vomiting in patients administered anti-neoplastic agents.

A virtual reality interface to an intelligent dental care system.

The design and fabrication of teeth restorations in dentistry rely increasingly on CAD/CAM techniques. We present an approach for interactive design of the occlusal surface of teeth based on simulation of jaw articulation and computer-aided diagnosis of occlusal disorders. To bridge the cognitive gap between the dentist and the computer system, we propose a virtual reality user interface, which applies the metaphors of tools and techniques known in dentistry. This makes the restoration design more intuitive for dentists. The system uses Virtual Reality Modeling Language (VRML) and HTML standards to generate a treatment report and exchange data in an electronic form. The simulation of jaw articulation requires fast calculation of multi-point contacts and detection of collisions between surfaces of teeth and restorations. We have developed a distance maps technique which exhibits realtime performance for objects with complex geometry and is suitable for other virtual reality systems dealing with complex contacts. The characteristics of contacts between teeth acquired during lower jaw motion are compactly represented as accumulated distance maps. These maps are then used for automatic removal of interferences between the restorations and the opponent teeth, and provide the dentist with information for further manual adjustments of the occlusal surfaces.

Terahertz-rate optical pulse generation from a passively mode-locked semiconductor laser diode.

We report what is to our knowledge the first demonstration of terahertz-rate optical pulse generation by harmonic passive mode locking in a distributed-Bragg-reflector laser diode. Along with the fundamental repetition rate of 38.8 GHz, we observed 400-GHz, 800-GHz, and 1.54-THz harmonics, depending on the bias condition of gain section. The pulse envelope for 1.54-THz pulses was in good agreement with a calculation from the Fourier transformation of the optical spectrum, indicating that the output pulses are transform limited.

[Evaluation of pulmonary capillary wedge pressure tracing for the detection of intraoperative myocardial ischemia].

We studied the usefulness of the pulmonary capillary wedge pressure (PCWP) tracing for the detection of intraoperative myocardial ischemia. Both PCWP wave forms and 7-lead electrocardiogram were monitored in 109 patients undergoing coronary artery bypass graft surgery. Measurements were made six times in each patient. Myocardial ischemia was identified in 99 (27%) of the 366 measurements, and among them, 68 (69%) developed abnormal PCWP wave forms (AC wave greater than 15 mmHg, or V wave greater than 20 mmHg). Although these results were consistent with those of Kaplan et al (1981), we could not agree with their conclusion that PCWP tracing can be helpful in the early diagnosis of subendocardial ischemia. It was not possible to record PCWP continuously because of the risk of pulmonary infarction, and PCWP was influenced by noncardiac factors such as sympathetic reaction to surgical stimuli. We think that PCWP tracing would be of benefit in detecting intraoperative serious ischemia; serious myocardial ischemia was likely to have occurred when abnormalities in both PCWP tracing and ST segment changes were identified. The incidence of both PCWP changes and ECG ischemia was highest in the postbypass period, suggesting that the risk of serious myocardial ischemia is highest in the post-bypass period.

Walking through a human ear.

A computer animation system was developed to show the inside of a human ear as if the viewer were walking through it. A surface model of the human temporal bone was graphically reconstructed from serially sectioned celloidin specimens. In order to input the outline curves of ear structures, several reference marks were drilled into a celloidin block prior to sectioning. A sliding microtome was put on a worktable with a specially designed motor-driven drill. The machine made it possible to drill holes perpendicular to the plane to be used for serial sectioning. Superimposed outline curves and the reference marks were fed into a computer, and their shapes were altered by scaling, rotation, and translation before triangulation for surface coating. Parts of the structures of the ear were painted in different colours.

Quantitative distribution of cluster 1 small cell lung cancer antigen in cancerous and non-cancerous tissues, cultured cells and sera.

Three monoclonal antibodies (mAbs), NCC-LU-243, -244 and -246, detected three different epitopes on a 145-kDa cell membrane antigen, which had been designated as the cluster 1 antigen at the First International Workshop on Small Cell Lung Cancer (SCLC) Antigens. The distribution of the antigen in various tissues, cultured cells and sera was examined by immunohistochemistry and sandwich radioimmunoassay using these mAbs. The antigen is a normal differentiation antigen and is present in neuronal, neuroendocrine and cardiac muscle cells. The level of the antigen was highest in central nervous tissues, while it was undetectable in the liver, kidney and peripheral lung. Among tumor tissues, the antigen was detected only in SCLC, carcinoid tumor and neuroblastoma, indicating its usefulness as a marker for discriminating SCLC from non-SCLC. The level of the antigen varied among SCLC tissues and tended to be lower in variant-type cultured SCLC cells. Although an increase in the antigen level was observed in sera of some patients with advanced SCLC, the antigen did not possess any additional value over neuron-specific enolase as a serum tumor marker for monitoring SCLC patients.

Monoclonal antibody raised by sera of athymic mice bearing human lung cancer xenografts.

A monoclonal antibody, NCC-LU-165 (IgM, k), was obtained by somatic cell hybridization between mouse myeloma cells (P3-X63-Ag8-U1) and spleen cells of an immunocompetent mouse (BALB/c, nu/+) immunized with sera of immunodeficient athymic mice (BALB/c, nu/nu) bearing human giant cell lung cancer xenografts (Lu65). Immunohistochemically, the antibody was reactive with most nonsmall cell carcinoma of the lung. It also reacted with adenocarcinoma of the stomach, colon, pancreas and breast. Antigens were detected in sera of athymic mice bearing human lung cancer xenografts and in cell-free conditioned media of Lu65 cells by a sandwich enzyme immunoassay. This immunization method may be useful to raise monoclonal antibodies that detect circulating tumor-associated antigen.