Birth trauma causing nasal vestibular stenosis.

Nasal vestibular stenosis is caused by a disruption of the nasal vestibular lining with secondary proliferation of granulation and fibrous tissue. It is most commonly the result of significant nasal trauma of foreign body reaction. In the pediatric population, it is exceedingly rare, with only a few cases reported in the literature. We report the first case, to our knowledge, of complete stenosis caused by traumatic vaginal delivery. This case demonstrates the profound effect nasal vestibular stenosis can have on the developing nose. Correction can be difficult because of the tendency of wound contracture and recurrence. A new approach is presented, using a hard palate mucosal graft. This graft is tough, resilient, and easily harvested. Its ability to resist contracture obviates the need for postoperative stenting, which is especially useful in the pediatric population.

Rapid oscillations of actin polymerization/depolymerization in polymorphonuclear leukocytes stimulated by leukotriene B4 and platelet-activating factor.

We previously showed that activation of polymorphonuclear leukocytes by leukotriene B4 (LTB4) and platelet-activating factor produces a rapidly oscillating actin polymerization/depolymerization response. In this study, we show that 1) oscillations are not due to the stimulated cyclic release of autocoids that could bind to cell surface receptors and activate subsequent cycles; 2) oscillations are not related to oscillations of ligand binding; and 3) the particular kinetic pattern is a property of the receptor, not of the binding constants of the ligand. The major conclusion of these studies is that the oscillations are a property of the intrinsic signaling pathways triggered by these chemoattractants. We also questioned whether increased actin nucleation activity was induced by LTB4 and found that, although LTB4 induced a transient actin nucleation response, there was not a direct correlation between oscillations of the actin polymerization/depolymerization and the actin nucleation activity. This suggests that processes other than actin nucleation, such as release of monomeric actin from monomer sequestering proteins and regulation of depolymerization, are likely to be involved.

Comparative aspects of Na+/K+ pump-mediated uncoupled Na+ efflux in red blood cells and kidney proteoliposomes.

Ouabain-sensitive uncoupled Na+ efflux has been studied in human, pig, and rat red cells and in vesicles containing reconstituted kidney Na+/K+ pumps obtained from these same species. The red cells from the different species gave qualitatively similar results; the uncoupled Na+ efflux was 15-30% of the Na+/K+ exchange rate, and this flux was inhibited at 5 mM extracellular Na+ (Na+o). At higher levels of Na+o there was a monotonic increase in the Na+ efflux. As has previously been observed in human red cells, the uncoupled efflux from pig red cells consists of Na+ and anion cotransport, suggesting that anion cotransport may be a general characteristic of uncoupled Na+ efflux in red cells. The uncoupled Na+ efflux carried out by pig and rat kidney Na+/K+ pumps differs from the red cell activity in that it represents no more than 2-4% of the Na+/K+ exchange rate and that 5 mM Na+o does not inhibit this efflux. Furthermore, the efflux does not appear to be dependent on anion cotransport. Vesicles containing human kidney Na+/K+ pumps differ from vesicles derived from pig or rat kidneys in that the Na+ efflux is not inhibited or stimulated by Na+ present on the opposite side; it thus appears that the Na+,K(+)-ATPase in these vesicles may be incapable of Na+/Na+ exchange. These results indicate that the ligand and kinetic properties of the uncoupled Na+ efflux mode of red cells are markedly different from kidney-derived Na+/K+ pumps reconstituted into proteoliposomes. The basis for these differences may be inherent in the Na+/K+ pumps themselves or represent differences between the two types of preparations studied.