Surgical treatment of gynaecomastia. Five years' experience with liposuction.

Since liposuction became part of our surgical regimen in 1988, we have operated on 67 patients for gynaecomastia during the five year period 1988-1992. Sixty two of the patients were seen at an extra follow up 4-59 months (means 29 months) postoperatively. Compared to studies that did not include liposuction as part of the operation, we found a lower incidence of postoperative complications and a higher degree of patient satisfaction. Preoperative distinction between adipose and glandular tissue is difficult, and we therefore consider that liposuction should be used during the first part of the operation in nearly all cases of gynaecomastia. Regardless the amount of fat, tunnelling and suction are beneficial, because they help to refine the peripheral contour and define the glandular tissue. Liposuction seems to help the skin to contract, and skin resections are rarely indicated.

Benign symmetric lipomatosis of the neck treated by liposuction. Case report.

A patient with benign symmetrical lipomatosis of the neck (Madelung's disease) was successfully treated with liposuction rather than classic surgical lipectomy. To our knowledge this is only the second such patient treated in this way.

Monoclonal antibodies reacting with the exopolysaccharide xanthan from Xanthomonas campestris.

We have prepared murine hybridomas secreting monoclonal antibodies against the exopopolysaccharide xanthan from Xanthomonas campestris pv. campestris 646 after fusing NSO myeloma cells and spleen cells from BALB/c mice immunized with xanthan. Four hybridomas, secreting antibodies designated A6 (IgM kappa), B3 (IgM kappa), D1 (IgM kappa), and D3 (IgG2A kappa), were selected for further studies. All antibodies reacted with a range of different xanthans. Competition studies using variants of the exopopolysaccharide as competitors suggested that specificity was mainly against the side-chain. One of the antibodies (B3) appeared to require the fully acylated side-chain with the pyruvylated terminal mannose as the immunodominant part. The three others were assumed to be directed against the nonsubstituted trisaccharide with the inner mannose-glucuronic acid being immunodominant. None of the antibodies reacted with cellulose (the xanthan backbone). Using immunoblotting techniques on nitrocellulose paper both a mixture of monoclonal antibodies, and also polyclonal ascitic fluid, could detect xanthan quantities of approximately 0.1 microgram.

Blue-green algae (Microcystis aeruginosa) hepatotoxicosis in dairy cows.

Twenty cows from a dairy herd consisting of 60 healthy, lactating Holsteins developed clinical signs of anorexia, mental derangement, dehydration, recumbency, and ruminal atony after ingesting water containing blue-green algae. Of the 20 cows, 9 died. The algal bloom, which developed in a stagnant pond during hot, dry weather, was identified as the cyanobacterium Microcystis aeruginosa, a potentially hepatotoxic algae. One week after the onset of toxicosis, affected cows seemed healthy, although liver-associated enzyme activities (alkaline phosphatase, gamma-glutamyl transferase, aspartate transaminase, and lactate dehydrogenase) were increased. Intraruminal administration of the intact wet bloom to a healthy 125-kg Angus heifer was followed by hepatic necrosis and death. The liver was large, friable, and gun-metal blue, with microscopically evident hepatocyte dissociation, degeneration, and necrosis. The ingesta of the heifer contained typical clumps of cells that were identified as M aeruginosa. The intraperitoneal administration of lyophilized cell material from that bloom to 18 mice caused marked hepatic enlargement. The intraperitoneal median lethal dose of the dried bloom was estimated to be 10 mg/kg of body weight. A cyclic peptide toxin purified from the algae seems to be similar structurally to toxins from other characterized hepatotoxic blooms of M aeruginosa.

Penicillin-binding proteins in Bacillus subtilis mutants.

The penicillin-binding proteins (PBPs) from mutants of Bacillus subtilis were studied and related to morphology. In a previously described cloxacillin-resistant mutant of B. subtilis strain Porton, PBP 2a had an altered mobility by sodium dodecyl sulfate gel electrophoresis and was present in increased amounts. In addition, PBPs 1a and 1b were missing in this mutant. The only morphological change seen was a decrease in size of about 15%. Studies of two Triton-resistant morphological mutants of B. subtilis 168, Tr49 (small diameter) and Tr61 (helical form), revealed no change in the number of PBPs compared with that of the parent strain. However, PBPs 1a and 1b had an altered mobility in the mutant Tr49.

The specificity requirements of bacteriophage T4 lysozyme. Involvement of N-acetamido groups.

Bacillus cereus peptidoglycan with N-unsubstituted glucosamine residues was insensitive to treatment with bacteriophage T4 lysozyme. After N-acetylation with acetic anhydride, T4 lysozyme cleared solutions of the peptidoglycan and reducing sugars were liberated. The digestion products were mainly of high molecular weight, since the peptidoglycan is peptide cross-linked to a great extent. N-Propylation did not convert the partially N-unsubstituted peptidoglycan to a sensitive form. It is concluded that the acetamido groups are required for binding and/or catalysis by T4 lysozyme.

Characterization of the h1 protein antigen from Staphylococcus aureus 17A.

The h1 protein antigen from Staphylococcus aureus 17 A was found to be present associated with the cell wall as well as freely in the growth medium. The two forms did not differ in size or immunological properties. Only lytic or proteolytic enzymes could release h1 from the isolated cell wall. The molecule was readily broken down by trypsin to discrete fragments which all had common antigenic determinants. The results suggest that the antigen is covalently linked in the cell wall and that its structure might be similar to that of protein A.

Isolation and characterization of Fc gamma receptors from human placenta.

Placental extract was prepared with Tris-HCl buffer pH 7.4 containing EDTA and 2-mercaptoethanol. It agglutinated erythrocytes (E) sensitized with subagglutinating amounts of IgG antibodies from rabbits, guinea pigs and mice, but not E sensitized with IgG from chickens. E or E sensitized with F(ab)2 or IgM antibodies were not agglutinated. The agglutination of EA by the extract was inhibited by human, rabbit and guinea pig IgG, but not by bovine and porcine IgG. Aggregated IgG was more inhibitory than monomeric IgG. IgG3 was the most effective subclass. The extract inhibited the formation of EA rosettes with human mononuclear cells, but did not influence the formation of E or EAC rosettes. The significance of the disulfide bonds and the C gamma 3 and C gamma 2 regions was implied by the finding that the extract neither agglutinated E sensitized with preparations of mildly reduced and alkylated IgG, nor with Facb fragments. These preparations did not inhibit the agglutination. The results strongly indicated that the active component was solubilized placental Fc receptor (FcR). Functionally active FcR was purified by affinity chromatography using aggregated human IgG coupled to Sepharose 4B. SDS-PAGE if the purified FcR under reducing conditions showed one distance band corresponding to approx. 47,000 daltons. The band neither consisted o Ig fragments nor Clq. A rabbit antiserum against the FcR inhibited the agglutination of EA by the extract and stained th FcR-positive areas in placenta.

Studies of the high molecular weight penicillin-binding proteins of Bacillus subtilis.

Seven or eight penicillin-binding proteins (PBPs) were detected in Bacillus subtilis membranes. By introducing covalent affinity chromatography employing cephalosporins as ligands, milligram amounts of three high molecular weight PBPs (PBP 1 ab, Mr = 120,000; PBP 2b, Mr = 94,000; and PBP 4, Mr = 78,000) were obtained without any contamination of the major PBP 5, the D-alanine carboxypeptidase. Small amounts of pure PBP 2b could be isolated by manipulation of the affinity chromatography conditions. Structural and physical properties of these proteins as well as the generation of one major penicilloyl peptide from each PBP by digestion with pepsin suggest that each PBP is the product of a separate gene. No enzymatic activity could be found in mixtures of these high molecular weight PBPs employing substrates used for the transpeptidase and D-alanine carboxypeptidase assays in particulate membrane fractions.

The specificity requirements of bacteriophage T4 lysozyme.

A series of bacterial cell wall glycopeptides of low molecular weight and cell wall nucleotide precursors have been tested for their inhibitory action on the digestion by T4 lysozyme of a radioactively labeled linear uncrosslinked peptidoglycan. The disaccharide-peptides GlcNAc-MurNAc-l-Ala-D-Glu(A2pm) (C5) and GlcNAc-MurNAc-L-Ala-D-Glu(A2pm-D-Ala) (C6) as well as the monosaccharide-peptide MurNAc-L-Ala-D-Glu(A2pm) were found to be good competitive inhibitors (with similar Ki values) whereas the disaccharide-pentapeptide GlcNAcMurNAc-L-Ala-DGlu-Gly-L-Lys-D-Ala was a poor inhibitor. T4 lysozyme did not catalyse transglycosylation reactions from Escherichia coli B peptidoglycan to the disaccharide-peptide C6. No changes were seen in the circular dichroism spectra (200-250 nm) or fluorescence emmission spectra upon binding of the good inhibitors. The results obtained indicate that T4 lysozyme has a small active site capable of recognizing a unit consisting of MurNAc-L-Ala-D-Glu(A2pm).

Studies on the specificity of action of bacteriophage T4 lysozyme.

Lysozyme from bacteriophage T4 was found to digest a soluble, uncrosslinked peptidoglycan which is secreted by cells of Micrococcus luteus when incubated in the presence of penicillin G. Analysis of the enzymatic degradation products shows that T4 acts as an endo-acetylmuramidase capable of cleaving glycosidic bonds only at muramic acid residues that are substituted with peptide side-chains. The results indicate that the secreted peptidoglycan may consist of a mixture of chains, approximately half of which are substituted by peptide side chains on most of their muramic acid residues, while the other half is made up of chains in which the muramic acid moieties are unsubstituted.