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Background: In a survey of 2004 conducted by World Health Organization, chronic obstructive pulmonary disease (COPD) is proved third leading cause of death worldwide and develops frailty. However, the differences between pre-frailty and non-frailty or frailty are not well studied. Objective: To examine the working hypothesis that there is differences in phenotypes between pre-frailty and non-frailty or frailty in patients with COPD. Design and setting: This study is a cross-sectional study. Participants: Patients with consecutive COPD male patients, whose age is 50 year-old or older, visited COPD outpatient clinic at single institute, between 2011, March and August, were eligible. Measurements: The data categorized into seven domains according to Fried’s phenotypic criteria were collected in all subjects divided into three groups: non-, pre-, and frailty. All data was compared between two of three groups. Results: Pre-frail COPD patients showed declines in upper extremities’ muscle volume and functions assessed by arm muscle area and hand-grip strength (P

A method of introducing pinning sites in TbFeCo film by the using of focused ion beam was presented. The formed bulges in the film surface by discontinuous scan of light-dose focused ion beam have been proved to enhance the film's coercivity effectively. Coercivity increases almost linearly with the bulge density, giving the evidence of pinning effect contributed from those bulges predicted by domain wall pinning mechanism. Compared with the traditional way of etching the film for adjusting the coercivity, the method presented here shows superiority on reducing magnetic damage to film caused by the focused ion beam irradiation.

This study was aimed at finding microorganisms capable of biodegrading dioxins efficiently to develop a biotechnological treatment for decomposition of dioxins. Dibenzofuran (DBF) was used as a test substance to cultivate and to screen microbes active in degrading dioxins. Two microbial species (Pseudomonas aeruginosa and Xanthomonas maltophilia) which could degrade DBF were isolated from the sludge of a Kraft pulp mill wastewater treatment plant. The optimal conditions for biodegrading DBF were 30 and pH 7. Ps. aeruginosa, which had a high growth rate with DBF as carbon source showed high growth rates in the presence of such dioxins as dibenzo-p-dioxin, medium growth with 1-chlorodibenzo-p-dioxin, 2-chlorodibenzo-p-dioxin and 2,8-dichlorodibenzofuran, low growth with 2,6-dichlorodibenzo-p-dioxin and 1,2,3,4-tetrachlorodibenzo-p-dioxin and no growth with octachlorodibenzofuran. These results suggested that the growth rate of Ps. aeruginosa using dioxins as carbon source decreased with the increase in the ...

We have studied the DNA binding and DNA cleavage specificities of two novel classes of synthetic DNA breakage agents. One class comprises redox-activated metalloporphyrins, the other uses the photoactivable p-nitrobenzoyl group as the DNA breaking moiety linked covalently to a DNA recognizing entity such as an oligo N-methylpyrrolecarboxamide or oligothiazole group. Studies of DNA cleavage using end-labeled DNA restriction fragments and high resolution sequencing gel electrophoresis have allowed DNA break sites to be identified at the nucleotide level. This work in conjunction with induced CD spectroscopy has shown that these compounds, especially photoactive agents containing thiazole units, display high sequence specificity. The mechanism of sequence recognition appears to be quite different for the two series of compounds.

The rapid growth of the Internet impacts ATM networks to be furnished with IP handling capability. This paper discusses networking issues for IP and ATM integration. First, it considers function allocation at the boundary of an ATM backbone network and the Internet. As a result, the paper explains the necessity of built-in IP handling capability in an ATM switching system, and summarizes functional requirements for the system architecture. According to the discussion, the authors propose a system architecture for IP/ATM integration in the ATM switching system. The implementation of the proposed architecture is evaluated, and the wire-speed IP handling capability in the ATM switch is confirmed.

Background & aims: Infants with congenital heart disease (CHD) have elevated energy expenditure; however, they also have poor sucking and fluid restriction, which act as barriers to the delivery of adequate nutrition. The objective of this study was to investigate the effects of a high density formula (HDF) on safety, weight gain, and nutrient intake in CHD infants. Methods: We conducted a retrospective analysis of 21 CHD infants, comparing between two 4-week periods in which the children were given a standard density formula (SDF; 0.67 kcal/ml) and then a high density formula (HDF; 0.77e1.03 kcal/ml), respectively. In these children, we analyzed both safety parameters (serum creatinine, BUN, AST, ALT, and the frequencies of vomiting and diarrhea) and effective parameters (energy and protein intake, fluid volume, weight gain, and serum albumin). Results: The mean concentration of formula in the HDF period was 1.21 times greater than that in the SDF period. Energy and protein intake per body weight, weight gain, and serum albumin in the HDF period were significantly higher than in the SDF period. There was no clinical evidence of any adverse effects related to the HDF. Conclusion: Use of an HDF formulation is able to safely increase nutrient intake and promote weight gain in CHD infants. This nutritional formulation could potentially prevent malnutrition and failure to thrive in CHD infants. 2010 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Recently antigenic heterogeneity in human Pneumocystis carinii (Pc) isolates was observed in several laboratories. Monoclonal antibodies (MAb) were produced to human Pc (PcH) from a lung autopsy sample from a non-AIDS patient (MAb Group I, n = 10), or from bronchoalveolar lavage (BAL) fluid from AIDS patients (MAb Group II, n = 8). To detect Pc antigen from specimens, indirect immunofluorescence and immunoblotting techniques were used. The reactivity was evaluated by using one autopsy sample from the non-AIDS patient and 14 BAL samples from AIDS patients. The MAb in group I (C5-9, E9) stained a part of PcH from all isolates. On the other hand, several MAb in group II (L20-5, M34-2, M78-3, M79-5, N23-4) stained all PcH from all isolates. Some MAb (C5-9, E9, M34-2, M78-3) stained cysts as well as trophozoites. Immunoblot studies detected a 92 kDa molecule as a common antigen by all of these MAb. Therefore, we have found a common antigenic epitope on PcH and MAb that recognize this epitope may become useful for diagnosis of infection and for biological characterization studies on the organism.

Pneumocystis pneumonia is the most serious opportunistic infection in immunocompromised patients, particularly those with AIDS. Approved therapy is limited to pentamidine and inhibitors of folic acid synthesis, but these drugs show a high rate of adverse reactions in AIDS patients emphasizing the urgent need for additional effective therapies. Progress has, however, been hindered by lack of knowledge about this parasite's cellular characteristics. Previously we reported that beta (1,3)glucan is a major component of the Pneumocystis carinii cyst wall. This study shows that administration of aculeacin A, an inhibitor of beta (1,3)glucan biosynthesis, affects cyst wall formation, inhibits cyst maturation, and prevents severe pneumonia in steroid-treated rats. Thus this study not only demonstrates that beta (1,3)glucan is indispensable for growth of the parasite in rats, but suggests a new therapeutic strategy for human pneumocystosis.

SUMMARYWe examined the effects of cyclosporin A (CsA) administered in vivo on the capacity of peripheral blood mononuclear cells (PBMC) from kidney transplant recipients to express IL-2 receptor (IL-2R) gene at the level of mRNA after milogen stimulation in vitro. There were no differences in the percentage of IL-2R+ cells among the groups of normal individuals, azathioprine-prednisolone treated, and CsA-prednisolone-treated recipients, using FITC-labelled monoclonal anti-IL-2R antibody (anti-α chain): 40±3±10±1% and 62±8±11±1% of normal PBMC (n= 18), 37±0±9±3% and 61±7±5±8% of PBMC from azathioprine-prednisolone-treated recipients (n = 20), and 37±7±9±6% and 60±7±12±7% of PBMC from CsA-prednisolone-treated recipients (n = 20) expressed IL-2R after 24 h and 48 h of phytohaemagglutinin stimulation, respectively. However, in a study of Northern blotting using cDNA for 1L-2R (anti-a chain specific), both the 3500 and 1400 bp families of IL-2R mRNA were remarkably decreased in PBMC from CsA-prednisolone-treated recipients compared with azathioprine-prcdnisolone-trealed recipients and normal individuals. These studies demonstrated that CsA could inhibit IL-2R gene expression ai the level of mRNA at physiological concentration.

The development of cytotoxic T cells and helper T cells in an intact or irradiated thymus was investigated. C57BL/6 (H-2b, Thy-1.2) mice were whole body-irradiated, or were irradiated with shielding over either the thymus or right leg and tail, and were transferred with 1.5 X 10(7) bone marrow cells from B10.Thy-1.1 mice (H-2b, Thy-1.1). At various days after reconstitution, thymus cells from the recipient mice were harvested and a peanut agglutinin low-binding population was isolated. This population was further treated with anti-Thy-1.2 plus complement to remove host-derived cells and was assayed for the frequency of cytotoxic T cell precursors (CTLp) and for the activity of helper T cells (Th). In the thymus of thymus-shielded and irradiated mice, Th activity reached normal control level by day 25, whereas CTLp frequency remained at a very low level during these days. In the thymus of whole body-irradiated mice, generation of CTLp was highly accelerated while that of Th was retarded, the period required for reconstitution being 25 days and more than 42 days for CTLp and Th, respectively. Preferential development of CTLp was also seen in right leg- and tail-shielded (L-T-shielded) and irradiated recipients. Histological observation indicated that Ia+ nonlymphoid cells were well preserved in the thymus of thymus-shielded and irradiated recipients, whereas in L-T-shielded and irradiated recipients, such cells in the medulla were markedly reduced in number. These results suggest strongly that the generation of Th but not CTLp is dependent on radiosensitive thymic component(s), and that such components may represent Ia+ cells themselves in the medulla or some microenvironment related to Ia+ cells.

An assay system for the stem cell that colonizes the thymus and differentiates into T cells was developed, and by using this assay system the existence of two subpopulations of stem cells for T cell lineage was clarified. Part-body-shielded and 900-R-irradiated C57BL/6 (H-2b, Thy-1.2) recipient mice, which do not require the transfer of pluripotent stem cells for their survival, were transferred with cells from B10 X Thy-1.1 (H-2b, Thy-1.1) donor mice. The reconstitution of the recipient's thymus lymphocytes was accomplished by stem cells in the donor cells and those spared in the shielded portion of the recipient that competitively colonize the thymus. Thus, the stem cell activity of donor cells can be evaluated by determining the proportion of donor-type (Thy-1.1+) cells in the recipient's thymus. Bone marrow cells were the most potent source of stem cells, the generation of donor-derived T cells being observed in two out of 14 recipients transferred with as few as 1.5 X 10(4) cells. The stem cell activity of spleen cells was estimated to be about 1% of that of bone marrow cells, and no activity was found in thymus cells. By contrast, when the stem cell activity was compared between spleen and bone marrow cells of whole-body-irradiated (800 R) C57BL/6 mice reconstituted with B10 X Thy-1.1 bone marrow cells by assaying in part-body-shielded and irradiated C57BL/6 mice, the activity of these two organs showed quite a different time course of development. Spleen cells showed a markedly high level of activity 7 days after the reconstitution, followed by a decline, whereas the activity of bone marrow cells was very low on day 7 and increased crosswise. The results strongly suggest that the stem cells for T cell lineage in the bone marrow comprise at least two subpopulations, spleen-seeking and bone marrow-seeking cells. Such patterns of compartmentalization of stem cells in the spleen and bone marrow of irradiated recipients completely conform to the general scheme of the relationship between restricted stem cells and less mature stem cells, including pluripotent stem cells, which became evident in other systems such as in the differentiation of spleen colony-forming cells or of stem cells for B cell lineage.

Dopamine-beta-hydroxylase (DBH) immunohistochemistry was used to demonstrate the noradrenergic fibers and terminals in the anterior column of the rat lumbosacral spinal segments. PAP-positive varicose fibers were widely distributed in the gray matter with preferential accumulation in the nuclear regions containing motoneurons involved in the contraction of perineal striated muscles. Unmyelinated DBH fibers were composed of nodular enlargements (varicosities, 0.4-3.0 microns in diameter) and very fine, short intervals (intervaricose segments, 0.1-0.2 micron in diameter and 1.0-4.0 microns in length). DBH-positive dense products were electron microscopically often confined within small granular particles and less frequently within large granules. Additionally, in order to characterize the innervation pattern of noradrenergic fibers on dendritic bundles organized in the motoneuronal pools innervating the pelvic small muscles, semi-quantitative analysis was done in the area of the dorsolateral nucleus endowed with especially well-developed dendritic bundles. DBH terminals contacting with unreactive dendrites were more common (67.9%) than those with neuronal somata (15.1%), and the remainder (17%) had no contacts with surrounding neuronal elements. Furthermore, specialized synaptic formations were observed in only 20.1% of these nodules. The results suggest that bulbospinal descending noradrenergic neuron systems influence the functioning of pelvic muscles principally via the neuronal contacts with dendritic bundles in the spinal cord.

Age-dependent resistance against tolerance induction is manifested in SJL mice whether they are immunized with antigen alone or with antigen and lipopolysaccharide. Age-dependent changes in the tolerizability of T cells have been documented in the past; in this paper corresponding changes in B cells have been deduced from the results of reconstitution experiments.

Stem cell activities of bone marrow, spleen, thymus, and fetal liver cells for T cell lineage were studied comparatively by transferring the cells from these organs through i.v. or intrathymus (i.t.) route into right leg- and tail-shielded (L-T-shielded) and 900 R-irradiated recipient mice, which were able to survive without supplying hemopoietic stem cells. Cells from B10.Thy-1.1 (H-2b, Thy-1.1) mice were serially diluted and were transferred into L-T-shielded and irradiated C57BL/6 (H-2b, Thy-1.2) mice, and 21 days later the thymus cells of recipient mice were assayed for Thy-1.1+ cells by flow cytofluorometry. The percentage of recipient mice possessing donor-type T cells was plotted against the number of cells transferred, and the stem cell activity in each cell source was expressed as the 50% positive value, the number of donor cells required for generating donor-type T cells in the thymuses of 50% of recipient mice. In i.v. transfer experiments, the activity of bone marrow cells was similar to that of fetal liver cells, and about 100 times and nearly 1000 times higher than those of spleen cells and thymus cells, respectively. In i.t. transfer experiments, the number of cells required for generating donor-type T cells was much lower than that in i.v. transfer experiments, although the ratio in 50% positive values between i.v. and i.t. transfers differed among cell sources. In i.t. transfers, the 50% positive value of bone marrow cells was five times, 400 times, and 500 times higher than that of fetal liver cells, spleen cells, and thymus cells, respectively. Our previous finding that stem cells are enriched in the spleens of mice which were whole body-irradiated and marrow-reconstituted 7 days earlier was confirmed also by the present limiting dilution assay carried out in i.v. as well as i.t. transfers.

In the period of intestinal adaptation following massive resection of intestine, patients have several difficulties and problems. This study was done in 17 survivals of 31 infants and children received massive intestinal resection (residual intestine; less than 75 cm) between 1966-1987 to define these problems and difficulties. 1) Postoperative hepatic dysfunction occurred in 11 of the 17 survivals. The relationship between relapsing frequency of hepatic dysfunction and length of remaining ileal segment suggested that the reduced ileal length may be one of the etiologic factors of the hepatic dysfunction. 2) Evaluation of serum bile acid levels suggested that the disturbance of bile acid reabsorption and its rapid turn over might still remain even after catch-up growth of these patients. 3) Abnormal levels of serum minerals (Ca, InP, Mg, Zn and Cu) were observed in 4 cases during TPN, and these abnormalities disappeared by discontinuation of parenteral nutrition and beginning of oral feeding. 4) Serum vitamin levels (Vit.A, Vit.E, 25-OH-D3, and Vit.B12) still remained in abnormal even after the patients reached school age. These results suggested that very long-term nutritional cares, especially in lipid and vitamin nutrition, are necessary for the children with massive intestinal resection.

E-643, a newly developed alpha 1-adrenergic blocker with a postsynaptic action, was tried on 17 subjects, 10 patients with neurogenic bladder and 7 patients with lower urethral obstruction. The results of treatment were excellent in 5, good in 7, and poor in 5 of them, the rate of effectiveness therefore being 70.6%. The inhibitory effect of E-643 on the contractility of the detrusor was no stronger than that of other alpha-blockers. The rate of effectiveness for neurogenic bladders was as high as 80% whereas that for lower urethral obstruction was much lower: 57%. Concerning benign prostatic hyperplasia (B.P.H.) alone, this agent was markedly beneficial. In the case of B.P.H the urethra pressure in the prostatic urethra tends to drop and urination is facilitated even without a change in maximum urethral closure pressure, which reduces the amount of residual urine, this sequence of events taking place on condition that the contractility of the detrusor is adequate. According to urodynamic criteria, the underlying causes of the so-called bladder neck contracture can be classified into organic and functional obstruction, but it is mistaken to use this term for functional disturbance of the bladder neck. It seems worthwhile to determine the clinical effect of alpha-blockers on functional urethral obstruction. E-643 produced few if any appreciable signs or symptoms of side effects either subjectively or objectively.

The characteristics of natural killer (NK) activity of human peripheral blood lymphocytes treated with human leukocyte interferon (HuIFN-alpha) were compared with those of the untreated original NK activity. HuIFN-alpha, at a concentration of 50 IU/ml or more, augmented the NK activity against BALL-1, Daudi, and Namalwa target cells. On the other hand, the augmentation was less evident for the activity against Raji and Molt-4 cells. Original NK activity was detected mainly in the fraction that passed through a nylon wool column. Nylon-retained cells, however, could be activated by the addition of HuIFN-alpha to express activity against BALL-1. The activity of the nylon-passed fraction was augmented by HuIFN-alpha as well as that of unfractionated cells. NK cells could be activated by HuIFN-alpha under calcium-free conditions that allow NK cells to bind but not to lyse the target cells; augmented cytotoxicity was observed when calcium was added 2 hr later. This suggests that the augmentation of NK activity by HuIFN-alpha may have resulted from an increase in the number of NK cells.

Neuroblastoma (NB) arises from primitive sympathetic neuroblasts in the adrenal gland or the sympathetic ganglion. NB in situ, sometimes observed in the adrenal glands of autopsied infants, is considered to be a premalignant lesion that may develop into NB. Little is understood about the morphological and biochemical changes that accompany this malignant progression. In this study, a unique monoclonal antibody, KP-NAC8, raised against a human NB cell line is described. This binds to NB cells but not to fetal neuroblasts. The antibody recognizes a Mr 200,000 surface protein on NB cells. KP-NAC8 binds to 15 of 17 human NB cell lines and all 26 fresh NB samples either from tumor tissues or from marrow aspirates involved with tumor. The antibody was found to cross-react with some other tumor cell lines, namely, Ewing's sarcoma (1 of 2), melanoma (1 of 4), lung cancer (3 of 3), and leukemia (2 of 14) cell lines. However, KP-NAC8 did not bind to any rhabdomyosarcoma (0 of 4), Wilms' tumor (0 of 4), retinoblastoma (0 of 2), glioma (0 of 4), and gastric cancer (0 of 2) cell lines examined. Among fetal tissues, KP-NAC8 did not react with normal neuroblasts in the adrenal glands of 5 fetuses. In a further study, the membrane phenotype of fetal adrenal neuroblasts was analyzed by a panel of 12 monoclonal antibodies including KP-NAC8. A comparison of the binding of the same panel of antibodies to fresh NB revealed that antibodies UJ13A, UJ127:11, PI153/3, anti-Thy-1, A2B5, BA-1, BA-2, HSAN1.2, and Leu-7 bound to both fetal adrenal neuroblasts and NB cells. Monoclonal antibodies OKIa-1 and J5 did not bind to either tissues. The only antibody that could distinguish fetal adrenal neuroblasts from NB cells was KP-NAC8. KP-NAC8 may, therefore, define a differentiation-related antigen that may prove helpful in understanding the biological nature of NB and NB in situ.

One hundred and eighteen patients with 169 bladder tumors were treated transurethrally by Nd:YAG laser surgery. In relation to the tumor staging, 79 of 103 patients of T1 (77%) underwent laser operation only, but most of the T2 cases (87%) required laser therapy with electroresection. With regard to the tumor size, 93 of the 97 small tumors (96%) were treated with laser irradiation alone, and 25 of 44 middle-sized tumors (57%) were eradicated by laser therapy, During and after the operation we never experience severe complications such as perforation of either the bladder or the intestine. Uncontrollable bleeding did appear in four cases. Tumor recurrence occurred in 25% for one year and 50% for three years. Therefore, laser surgery was limited to T1 tumor. But the indication of laser surgery would be magnified with the progress of the instrument and the technique.

Adult normal mice and those mice which had been thymectomized, X-irradiated, and reconstituted either with bone marrow cells and thymus cells (TxXBT) or with bone marrow cells along (TxXB), were given varying amounts (0.1-5 mg) of deaggregated soluble bovine serum albumin (sBSA). They were challenged 10 days later with an immunogenic form of BSA. TxXB mice were supplemented with normal thymus cells 3 days before the challenge. With any dose of sBSA, TxXBT and normal mice were made tolerant. Only 5 mg of sBSA, the highest dose in these experiments, was effective in inducing the tolerance in TxXB mice. The simultaneous administration of 5 mg of sBSA and 0.1 mg of alumprecipitated BSA plus 0.01 mg of endotoxin resulted in the priming in TxXBT mice but induced tolerance in TxXB mice. These results indicate that: (a) B-cell tolerance could be induced independently of the influence of T cells; (b) the tolerogen susceptibility of B cells may be lower than that of T cells; (c) such a weakly immunogenic agent as the mixture of tolerogen and immunogen could either activate the antibody response in the presence of T cells or induce B-cell tolerance in the absence of T cells.

Graft rejection is one of the major obstacles to successful bone marrow transplantation (BMT). If resistance to marrow grafting could be avoided, BMT could be used widely in treatment of hematological and immunological disorders. There has been evidence that natural killer (NK) cells play a major role in genetic resistance to BMT and that macrophages are also involved in genetic resistance. Agents toxic to macrophages such as silica and carrageenan have been found to have a suppressive effect on genetic resistance to BMT. Parenteral fat emulsions are known to accumulate in macrophages and to impair various functions of macrophages and those of the reticuloendothelial system. We show here that the administration of a fat emulsion, Intralipos 20%, to recipient mice can suppress genetic resistance to bone marrow grafts and NK cell activity probably through the impairment of the macrophage function. The administration of the fat emulsion might be a new tactic in conditioning protocols for human BMT in the future.

This study reports the establishment of cloned hybridomas between mouse myeloma cells (P3-X63-Ag8, 6.5.3) and spleen cells from BALB/c mice immunized with lung homogenates of nude mice (BALB/c nu/nu) heavily infected with Pneumocystis carinii. A hybridoma subclone, designated 1E12-8, produced antibodies of an IgG1 subclass. Using indirect immunofluorescent antibody techniques, the monoclonal antibody was found to be directed toward the pellicle antigen of air-dried P. carinii both in trophozoite and cyst forms, and to recognize the P. carinii antigen not only from nude mice but also from rats. The antibody did not cross-react with other components of the infected host lung tissue and showed little cross-reactivity with fungi examined. The monoclonal antibody should be useful in the isolation and identification of corresponding antigenic substances of P. carinii and may provide a useful tool in epidemiology, taxonomy, and diagnosis of this organism.

A concanavalin A (Con A)-mediated polyclonal helper assay system was established by using the thymus cells or splenic T cells as a source of helper T cells. When splenic B cells were cocultured with thymus cells or splenic Lyt-2- T cells in the presence of an optimal dose of Con A, B Cells were polyclonally activated and differentiated into immunoglobulin-secreting cells. This Con A-mediated helper activity was completely inhibited by the addition of alpha-methyl-D-mannoside and could not be substituted by culture supernatant of Con A-stimulated thymocytes or splenic T cells. Almost all the activity of the thymus cells was carried by peanut agglutinin low binding population. Genetic restriction between T and B cells was not observed in this helper function. In ontogeny, Con A-mediated helper activity in the thymus was first detected at a few days after birth and reached the adult level at about 1 week of age. The polyclonal helper assay system developed in the present study provides a sensitive system to analyse the helper function of thymus cells and also to delineate the early phase of the differentiation of helper T cell population.

We report the details of our treatment of 5 patients with recessive dystrophic epidermolysis bullosa (RDEB). Good results were obtained by esophageal dilatation using the balloon catheter method. Prior to the operation, we corrected the patients' nutritional status with oral supplementation of Hinex-R as well as intravenous drip infusion of Intra-lipid, based on the nutrition index obtained by body weight, serum albumin, rapid turnover proteins, and blood minimum essence. After sufficient anesthesia of the nasopharyngeal mucosa with xylocain spray, we inserted a Microvasive Rigiflex Balloon Dilator into the stenotic region while scanning the upper GI. Then we dilated gradually by barium injection. The patients' condition improved after this treatment and follow up X-ray examination revealed no recurrence of stenosis. There were several advantages to this method: 1) It was safer and could be done repeatedly. 2) It caused less stress for patients. 3) Its effectiveness appeared rapidly. We analyzed the frequency and severity of esophageal stenosis of 12 cases with EB in our department. Ten out of 12 cases complained of subjective esophageal symptoms. Esophageal stenosis was observed in all 8 cases examined by esophagogram. We concluded that this surgical procedure for esophageal stenosis was as important as digit reconstruction in the management of RDEB.

We investigated the effects of local administration of interferon (IFN) on 13 patients with recurrent brain tumors. Histologic diagnoses were glioblastoma (eight patients), medulloblastoma (one), ependymoma (one), ependymoblastoma (one), pontine glioma (one), and astrocytoma (one). When tumor recurrence was evident local administration of IFN was started through an Ommaya reservoir, which was placed during repeat craniotomy. No tumor regressions were seen in the patients given weekly injections of IFN; however, in two of six patients given daily injections, a decrease of tumor volume and augmentation of natural killer activity were seen.