"Minimally Invasive" Skin Grafting With Enzymatic Debridement and Autologous Skin Cell Spray: A Retrospective Case Series.

Minimally invasive surgery is becoming the standard of care across surgical subspecialties. Several new "minimally invasive" options for burn debridement and autografting exist. Enzymatic bromelain-based debridement (BBD) and autologous skin cell spray (ASCS) have independently proven to reduce the rate of split-thickness skin grafting (STSG) and decrease donor site size when grafting is performed. There is a paucity in the literature regarding the combination of these two therapies. The purpose of this study is to characterize a cohort of patients treated with both BBD and ASCS and qualitatively compare data to expected outcomes without these therapies. This retrospective study of a single academic burn center's experience using BBD and ASCS together included 13 patients with a total burn surface area (TBSA) from 1-30% and all had >50% deep partial thickness. All patients received BBD and ASCS. Deeper burns additionally received STSG with ASCS overspray. Median burn size was 14% TBSA (IQR:5.45,20), donor site size was 225 sq cm (IQR:28.5,556.5), and ratio of donor site area to total treatment area of 0.082 (IQR: 0.039, 0.241) was observed. Median observed length of stay (LOS) was 19 days (IQR:10,27), expected LOS was 15.4 days, and O/E ratio 1.06. Donor sites in both groups of patients were much smaller than expected versus treatment with conventional meshed STSG alone and length of stay is lower than expected based on burn size. An emphasis on expenses and scar development will guide future studies into the patient subset and wound features that are best for this combination treatment.

La chirurgie mini-invasive devient le standard de traitement dans de nombreuses spécialités. Il y a de telles possibilités en brûlologie comme de débridement enzymatique à la bromélaïne (DEB) et la pulvérisation de cellules cutanées autologues (PCCA) qui ont chacun permis de diminuer le recours aux autogreffes et de réduire la surface de la zone donneuse. La littérature est pauvre en ce qui concerne la combinaison des 2. Cette étude rétrospective rapporte une cohorte de 13 patients traités dans notre centre par combinaison de DEB et PCCA, et compare le résultat avec celui attendu avec un traitement conventionnel. Les patients étaient brûlés sur 1 à 30% de SCT (médiane 14, IQR 5,45-20) dont au moins la moitié de 2ème profond, ayant tous reçu une combinaison de DEB et PCCA. Les atteintes plus profondes étaient greffées, avec une PCCA par dessus. Le site donneur avait une surface médiane de 225 cm2 (IQR 28,5-556,5) avec un rapport surface donneuse/surface traitée de 0,082 (IQR 0,039-0,241). La durée médiane de séjour est de 19 jours (IQR 10-27) quand elle était supposée être de 15,4 jours (rapport 1,06). Les sites donneurs étaient plus exigus que sous traitement conventionnel et la durée de séjour plus courte que supposée. Une étude plus précise sur les séquelles et les coûts permettrait de cibler plus précisément les patients susceptibles de bénéficier de ce protocole.

Demonstration of the safety and effectiveness of the RECELL® System combined with split-thickness meshed autografts for the reduction of donor skin to treat mixed-depth burn injuries.

INTRODUCTION: Split-thickness skin grafts (STSG) are the standard of care (SOC) for burns undergoing autografting but are associated with donor skin site morbidity and limited by the availability of uninjured skin. The RECELL® Autologous Cell Harvesting Device (RECELL® System, or RECELL) was developed for point-of-care preparation and application of a suspension of non-cultured, disaggregated, autologous skin cells, using 1cm2 of the patient's skin to treat up to 80cm2 of excised burn. METHODS: A multi-center, prospective, within-subject controlled, randomized, clinical trial was conducted with 30 subjects to evaluate RECELL in combination with a more widely meshed STSG than a pre-defined SOC meshed STSG (RECELL treatment) for the treatment of mixed-depth burns, including full-thickness. Treatment areas were randomized to receive standard meshed STSG (Control treatment) or RECELL treatment, such that each subject had 1 Control and 1 RECELL treatment area. Effectiveness measures were assessed and included complete wound closure, donor skin use, subject satisfaction, and scarring outcomes out to one year following treatment. RESULTS: At 8 weeks, 85% of the Control-treated wounds were healed compared with 92% of the RECELL-treated wounds, establishing the non-inferiority of RECELL treatment for wound healing. Control-treated and RECELL-treated wounds were similar in mean size; however, mean donor skin use was significantly reduced by 32% with the use of RECELL (p<0.001), establishing the superiority of RECELL treatment for reducing donor skin requirements. Secondary effectiveness and safety outcomes were similar between the treatments. CONCLUSIONS: In combination with widely meshed STSG, RECELL is a safe and effective point-of-care treatment for mixed-depth burns without confluent dermis, achieving short- and long-term healing comparable to standard STSG, while significantly decreasing donor skin use.

Clinical safety of percutaneous ultrasound-guided fine-needle aspiration of adrenal gland lesions in 19 dogs.

OBJECTIVE: To evaluate the safety of fine-needle aspiration of adrenal gland lesions in dogs and to characterise the risks in a subset of patients with cytologically or histopathologically diagnosed phaeochromocytoma. MATERIALS AND METHODS: Retrospective review of medical records of dogs that underwent percutaneous ultrasound-guided fine-needle aspiration of adrenal gland lesions between August 2014 and December 2016. Nineteen dogs were identified, with three undergoing bilateral adrenal gland aspiration and one dog undergoing aspiration twice, yielding 23 cytology samples in total. Data collected included signalment, concurrent medical conditions, current medications, blood pressure and heart rate before adrenal fine-needle aspiration, imaging characteristics of the adrenal gland lesions and any clinically apparent procedure-related complications. RESULTS: Phaeochromocytoma was diagnosed in nine of 19 dogs, including one dog with bilateral phaeochromocytoma. One dog developed ventricular tachycardia following aspiration of an adrenal gland lesion cytologically consistent with a phaeochromocytoma. CLINICAL SIGNIFICANCE: Percutaneous ultrasound-guided fine-needle aspiration of adrenal gland lesions appears to be relatively safe, even in phaeochromocytoma, but further data are required to lend more weight to this finding. Minimally invasive aspirates could be considered as part of the diagnostic algorithm in the investigation of an incidentally detected adrenal gland lesion of uncertain clinical significance.

Young-onset dementia and the need for specialist care: a national and international perspective.

OBJECTIVES: Receiving a timely and accurate diagnosis and gaining access to age-appropriate support for younger people living with dementia (YPD) remains a challenge both in the UK and internationally because the focus of most dementia services is primarily upon the needs of older people. The political case to improve services for YPD depends upon the establishment of an understanding of the clinical symptoms, an unequivocal evidence base about need and an accurate evaluation of the size of the population affected. This short report assesses the evidence base from international studies regarding service design and delivery. The goal is to raise awareness, advance best practice and galvanise the international community to address the serious underfunding and underprovision of care for this marginalised group. CONCLUSION: The current evidence suggests that there are universal problems, regardless of continent, with delays to diagnosis and poor understanding of optimum models for service provision and long-term care.

Interleukin-8 is a key mediator of FKBP51-induced melanoma growth, angiogenesis and metastasis.

BACKGROUND: FKBP51 is overexpressed in melanoma and impacts tumour cell properties. However, its comprehensive role in melanoma pathogenesis and underlying mechanism(s) remain elusive. METHODS: FKBP51 was stably silenced in aggressive melanoma cell lines and its effect examined in vitro and in mouse model. Histological/immunohistochemical analyses were performed to confirm metastasis, angiogenesis and neutrophil infiltration. Gene expression was analyzed by qRT-PCR, immunoblot and/or ELISA. NF-κB transcriptional activity and promoter binding were monitored by luciferase-based promoter-reporter and ChIP assays, respectively. Interleukin (IL)-8 inhibition was achieved by gene silencing or neutralising-antibody treatment. RESULTS: FKBP51 silencing reduced melanoma growth, metastasis, angiogenesis and neutrophil infiltration and led to IL-8 downregulation through NF-κB suppression in cell lines and tumour xenografts. IL-8 inhibition drastically decreased growth, migration and invasiveness of FKPB51-overexpressing cells; whereas its treatment partially restored the suppressed phenotypes of FKBP51-silenced melanoma cells. Interleukin-8 depletion in conditioned medium (CM) of FKBP51-overexpressing melanoma cells inhibited endothelial cell proliferation and capillary-like structure formation, whereas its treatment promoted these effects in endothelial cells cultured in CM of FKBP51-silenced melanoma cells. CONCLUSIONS: FKBP51 promotes melanoma growth, metastasis and angiogenesis, and IL-8 plays a key role in these processes. Thus, targeting of FKBP51 or its upstream or downstream regulatory pathways could lead to effective therapeutic strategies against melanoma.

Bioavailability of iodine in the UK-Peak District environment and its human bioaccessibility: an assessment of the causes of historical goitre in this area.

Iodine is an essential micronutrient for human health. Its deficiency causes a number of functional and developmental abnormalities such as goitre. The limestone region of Derbyshire, UK was goitre-endemic until it declined from the 1930s and the reason for this has escaped a conclusive explanation. The present study investigates the cause(s) of goitre in the UK-Peak District area through an assessment of iodine in terms of its environmental mobility, bioavailability, uptake into the food chain and human bioaccessibility. The goitre-endemic limestone area is compared with the background millstone grit area of the UK-Peak District. The findings of this study show that 'total' environmental iodine is not linked to goitre in the limestone area, but the governing factors include iodine mobility, bioavailability and bioaccessibility. Compared with the millstone grit area, higher soil pH and calcium content of the limestone area restrict iodine mobility in this area, also soil organic carbon in the limestone area is influential in binding the iodine to the soil. Higher calcium content in the limestone area is an important factor in terms of strongly fixing the iodine to the soil. Higher iodine bioaccessibility in the millstone grit than the limestone area suggests that its oral bioaccessibility is restricted in the limestone area. Iodine taken up by plant roots is transported freely into the aerial plant parts in the millstone grit area unlike the limestone area, thus providing higher iodine into the human food chain in the millstone grit area through grazing animals unlike the goitre-prevalent limestone area.

Coronal plane ankle alignment, gait, and end-stage ankle osteoarthritis.

OBJECTIVE: Unilateral ankle osteoarthritis (OA) is a debilitating condition which may lead to limb deformity, severe pain, and functional disability due to tibiotalar malalignment and gait dysfunction. The purpose of this study was to determine if coronal plane alignment (varus, valgus, or neutral) of the ankle resulted in different spatial-temporal gait mechanics, clinically-assessed function, and self-reported function in patients with end-stage ankle OA. METHODS: Following informed consent, 96 patients with end-stage unilateral ankle OA were radiographically categorized as having varus, valgus, or neutral tibiotalar alignment. Each subject completed the foot and ankle disability index (FADI) questionnaire to assess self-reported function. The spatial-temporal parameters of interest (stance time, step length, stride length, stride width, single-support time, double support time, and walking speed) were assessed while the subject walked at a self-selected speed. RESULTS: The varus group performed the timed up and go test significantly faster than the other groups (P=0.05). All other variables were similar between the three alignment groups. CONCLUSION: There was little difference in gait mechanics and function between patients with end-stage OA based on coronal plane ankle alignment suggesting that factors other than coronal plane alignment contribute to diminished function.

Amyloid beta-derived neuroplasticity in bone marrow-derived mesenchymal stem cells is mediated by NPY and 5-HT2B receptors via ERK1/2 signalling pathways.

OBJECTIVE: In Alzheimer's disease, toxic soluble and insoluble forms of amyloid beta (Abeta) cause synaptic dysfunction and neuronal loss. Given its potential role in producing a toxic host microenvironment for transplanted donor stem cells, we investigated the interaction between Abeta and proliferation, survival, and differentiation of bone marrow-derived mesenchymal stem cells (BM-MSC) in culture. MATERIALS AND METHODS: We used BM-MSC that had been isolated from mouse bone marrow and cultured, and we also assessed relevant reaction mechanisms using gene microarray, immunocytochemistry, and inhibitors of potential signalling molecules, such as mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK)1/2 and tyrosine protein kinase. RESULTS AND CONCLUSIONS: Interestingly, we found that treatment with aggregated (1-40 or 1-42) and oligomeric (1-42) Abeta promoted neuronal-like differentiation of BM-MSC without toxic effects. This was not dependent on soluble factors released from BM-MSC progeny nor solely on formation of Abeta fibrils. The effect of Abeta is mediated by G-protein coupled receptors, neuropeptide Y1 (NPY1R) and serotonin (5-hydroxytryptamine) receptor 2B, via phosphatidylinositol-3-OH kinase-dependent activation of the MAPK/ERK1/2. Our results lend support to the idea that reciprocal donor stem cell-host interactions may promote a regenerative response that can be exploited by epigenetic modulation of NPY/serotonergic gene expression, for stem cell therapy, in Alzheimer's disease.

Erythrophagocytic low-grade extranodal T-cell lymphoma in a cat.

A 13-year-old male castrated domestic shorthair cat was presented to the referring veterinarian with a 2-month history of weight loss and lethargy. Splenomegaly, hepatomegaly, nonregenerative anemia, neutropenia, and hyperbilirubinemia were noted. Results of testing for feline immunodeficiency virus, feline leukemia virus, Toxoplasma gondii, and Mycoplasma sp. were negative. On cytologic examination of aspirates from the enlarged spleen and liver, a population of erythrophagocytic round cells was observed. Splenectomy and a liver biopsy were done which revealed a population of CD3+/CD79a- erythrophagocytic mononuclear round cells localized in the hepatic and splenic sinusoids. T-cell PARR (PCR for antigen receptor gene rearrangements) analysis of bone marrow and spleen demonstrated a single band indicative of a clonal proliferation of T cells. Based on the marked splenomegaly, sinusoidal infiltration, lack of lymphadenopathy, and results of cytology, PARR, and immunophenotyping, a diagnosis of low-grade extranodal T-cell lymphoma was made. The cat was treated with chlorambucil and prednisolone; clinical and laboratory abnormalities resolved and the cat has remained clinically normal for 2.5 years. To our knowledge, this report documents the first case of an erythrophagocytic T-cell lymphoma in a cat. The clinicopathologic findings were suggestive of hepatosplenic T-cell lymphoma, a neoplasm described previously only in humans and dogs.

Somatotype and size of elite female basketball players.

The aim of this study was to compare the somatotype and size of elite female basketball players in terms of playing position and team performance. Anthropometry and somatotype data were collected on 168 players from 14 countries before the Women's World Basketball Championship, Australia, 1994. There were 64 guards (mean +/- s: age 25.4 +/- 3.3 years, height 1.72 +/- 0.06 m, mass 66.1 +/- 6.2 kg, somatotype = 2.9-3.9-2.6), 57 forwards (age 25.2 +/- 3.8 years, height 1.81 +/- 0.06 m, mass 73.3 +/- 5.9 kg, somatotype = 2.8-3.5-3.2) and 47 centres (age 24.1 +/- 3.1 years, height 1.90 +/- 0.06 m, mass 82.6 +/- 8.2 kg, somatotype = 3.2-3.1-3.4). Mean somatotypes by position were significantly different (F = 7.73, P < 0.01). Guards had greater mesomorphy than centres and less ectomorphy than forwards and centres. When discriminant function analysis was applied to endomorphy, mesomorphy, ectomorphy, age, height and mass, only height, mass and ectomorphy entered (Wilks' lambda = 0.351, F = 31.40, P < 0.000), 70% of the variance was accounted for, and 72% of players were correctly classified. In the four top versus four bottom teams, guards were taller and more ectomorphic, forwards were taller, with lower mesomorphy and higher ectomorphy, and centres did not differ. Thus there are some differences in somatotypes by position and team placing, but the combination of height, mass and ectomorphy provide the best differentiation by position.

Clinical validation for oxacillin susceptibility testing of coagulase negative staphylococci.

Oxacillin susceptibility of coagulase negative staphylococci as assessed by conventional methods was confirmed by a modified Etest method, extended to detect heteroresistance. Verification of susceptibility was followed by successful treatment for six consecutive children with deep seated infections. Physicians' trust in such a validated method will contribute to the appropriate use of antibiotics.

Changes in the leachability of metals from dredged canal sediments during drying and oxidation.

The behaviour of metals in canal sediments after their disposal to land has important implications for the environmental management of canal dredgings. The leaching behaviour of trace metals was investigated in a laboratory-based experiment using sediment from a canal in the UK (139 mg Zn kg-1dry sediment, 1.1 mg Cd, kg-1dry sediment 31.5 mg Cr kg-1dry sediment, 20.6 mg Cu kg-1dry sediment 48.4 mg Ni kg-1dry sediment, 43.4 mg Pb kg-1dry sediment and 7.6 mg As kg-1dry sediment). The sediment was allowed to dry. Cores (10 cm long) of the drying canal sediment were taken over a period of 12 weeks. A simple water extraction procedure was used to investigate changes in metal leachability at varying depths through the cores. Metal leachability increased over the first five weeks of drying and then subsequently decreased between weeks five and twelve, (e.g. Cd increased from approximately 0.006 to 0.018 mg/kgsediment then decreased to approximately 0.006 mg/kgsediment, Zn increased from approximately 1.5 to 3 mg/kgsediment and then decreased to approximately 1.5 mg/kgsediment). These results were combined with sulphide/sulphate ratios, which showed a decrease as the sediment dried (e.g. at 2-4 cm depth from approximately 1 to 0.49), and BCR sequential extraction data. Most metals (except Cd and As) showed a redistribution from the residual phase into more mobile phases as the sediment dried and oxidised. Metal leachability was strongly correlated with the sulphide/sulphate ratio with leachability normally increasing with decreasing sulphide/sulphate ratio. The combined results were used to infer the likely behaviour of dredged material upon disposal to land.

Single-center experience with mycophenolate mofetil in pediatric renal transplant recipients.

Mycophenolate mofetil (MMF), a potent and specific inhibitor of guanosine nucleotide synthesis, is a new immunosuppressive drug used to prevent rejection in transplant patients. Extensive data on its utility and efficacy exists in adult patients but there is limited experience in pediatrics. Twenty-four children (14 male, 10 female; 2-19 yr of age), eight of whom had received living-related donor (LRD) transplants and 16 of whom had received cadaveric donor (CD) transplants, have been treated with MMF in our institution since September 1996. MMF was administered for a duration ranging from 13 weeks to 38 months, at an average dose of 600 mg/m2 (range: 200-1,000 mg/dose) every 12 h, for a total experience of 304 patient months. MMF capsules were used in 16 patients and/or pediatric suspension in eight. Five patients were switched to MMF from azathioprine as a result of rejection episodes or inability to taper prednisone, between 5 weeks and 3.5 yr post-transplant. All patients received prednisone, cyclosporin A (CsA), and induction therapy with anti-lymphocyte globulin (19 patients), anti-thymocyte globulin (one patient) or daclizumab (four patients). In 12 patients started on MMF at the time of CD transplant, five (42%) had an acute rejection episode. In seven who received a LRD transplant, one (14%) had an acute rejection episode. No patients who were converted to MMF were treated for acute rejection following conversion to MMF. One LRD graft was lost at 19 days following injury to the donor artery at the time of retrieval. At the last follow-up, the average creatinine level was 93 micromol/L and average urea level was 8.6 mmol/L. One patient developed epigastric distress. Three patients developed diarrhea/abdominal pain requiring dose adjustment. Five episodes of leukopenia and one episode of thrombocytopenia required dose adjustment. Two patients developed symptomatic cytomegalovirus (CMV) infection, one while on acyclovir prophylaxis. No malignancy has been encountered to date. Hence, MMF can be administered safely to children with good effect and with an acceptable side-effect profile.

Towards the characterisation of heavy metals in dredged canal sediments and an appreciation of 'availability': two examples from the UK.

Canal sediments can act as sinks for a wide range of contaminants including heavy metals from various sources (e.g. industrial and waste water discharges). Dredging of canals is required to maintain navigational depth and prevent flooding. The sediments removed from canals are often disposed of to land, being deposited either straight on to the banks of the canal or, in recent years, in licensed disposal sites. The aim of this work was to investigate the nature of dredged sediment-derived soils and the heavy metals present in them. Two disposal sites in the United Kingdom (UK) were investigated and soil samples taken. A variety of analytical techniques were used, including Aqua regia digestion and sequential extraction, in order to assess the concentrations and associations of metals present. Diethylene triaminepenta-acetic acid extracts, performed to illustrate plant-available metal concentrations, reveal that up to 40% of the total extracted metals were in an 'available' form. Variations in metal concentrations with depth in the soil cores show a significant correlation with total organic carbon content.

Vaginal vault suspension and enterocele repair by Richardson-Saye laparoscopic technique: description of training technique and results.

OBJECTIVES: To describe the Richardson-Saye technique for laparoscopic vaginal vault suspension and enterocele repair (vaginal apex reconstruction) and the appropriate training needed for performance of this technique. METHODS: Before using this technique, Drs Carter, Winter, and Mendelsohn first received training by observation of skilled surgeons performing the procedure, attending courses, and finally being tutored and proctored by Dr Saye on the appropriate performance of the technique. They then used this technique to surgically treat eight patients, 42 to 85 years of age, mean age 62 years, between March and September of 1999. RESULTS: We included eight patients in this study who underwent the Saye-Richardson vaginal vault suspension and enterocele repair (apical vaginal vault reconstruction) by the suture technique. In all patients at six-month follow-up, the vaginal apex remains intact and well supported. We describe here the entire vaginal vault suspension and enterocele repair procedure with all its relevant details. CONCLUSION: Laparoscopic reconstruction of the disrupted vaginal apex followed by reattachment to the previously broken uterosacral ligament with the use of permanent suture provides a secure and anatomically correct vault suspension. Before performing this technique, physicians should undergo proper training, including observation, courses, tutoring, and proctorship by a surgeon experienced in performing this technique.

Investigation of anthropometric and work-rate profiles of elite South American international soccer players.

BACKGROUND: The aim of the current investigation was to determine the movement profiles of elite South American soccer players during international competition and examine the relationship between anthropometric profile and work-rate variables. METHODS: Seventeen full-time professional soccer players were filmed while competing for their countries. Anthropometric profiles were obtained for eleven of these players. Six full-time professional players from the English Premier League were also filmed for comparative purposes. RESULTS: The South American international players covered significantly less (p<0.05) total distance during match-play than English Premier League players (International, 8638+/-1158 m; English Premier League, 10104+/-703 m). The total distance covered during the second half of the game was significantly reduced (p<0.05) compared to the first half distance for both groups of players (mean+/-SD first half 4605+/-625 m; mean+/-SD second half 4415+/-634 m). The data for both groups of players were combined to evaluate positional differences in the workrate profile. Midfield players covered a significantly greater (p<0.05) distance than forward players (midfield, 9826+/-1031 m; forwards, 7736+/-929 m) and defenders covered a greater (p<0.05) distance jogging backwards than forward players (defenders, 276+/-155 m; forwards, 68+/-25 m). Forwards sprinted a greater distance (p<0.05) than defensive players (defenders, 231+/-142 m; forwards, 557+/-142 m). Mean somatotype was a balanced mesomorph (2-5 1/2-2). Body mass and muscle mass was related to the total distance covered (r=0.43, r=0.53, p<0.05). CONCLUSIONS: Based on these data, it seems that an individual's work-rate profile is dependent upon the type of competition and the playing position. Relationships between anthropometric profile and work-rate are complex due to the interaction between the variables that determine work-rate.

Enterocele repair and vaginal vault suspension.

A paradigm shift has occurred in the approach to enterocele repair and vaginal vault suspension. This change in our approach is based on anatomic dissections that demonstrate that the loss of the upper suspensory fibers of the paracolpium and parametrium lead to uterine prolapse and vaginal prolapse after hysterectomy. In addition, the separation of the pubocervical from the rectovaginal fascia results in apical enterocele where the peritoneum is in contact with the vaginal mucosa. These fascial defects are hernias, and appropriate herniorraphy techniques will correct these defects and result in successful reconstruction of the vaginal tube and its reattachment to the suspensory cardinal uterosacral complex.

The adapter protein LAT enhances fcgamma receptor-mediated signal transduction in myeloid cells.

FcgammaR clustering in monocytes initiates a cascade of signaling events that culminate in biological responses such as phagocytosis, production of inflammatory cytokines, and generation of reactive oxygen species. We have identified and determined the function of the adapter protein linker of activation of T cell (LAT) in FcgammaR-mediated signaling and function. Clustering of FcgammaRs on the human monocytic cell line, THP-1, induces phosphorylation of a major 36-kDa protein which immunoreacts with anti-LAT antisera. Our data indicate that although both the 36-kDa and 38-kDa isoforms of LAT are expressed in THP-1 and U937 human monocytic cells, FcgammaR clustering induces phosphorylation of the 36-kDa isoform only. Co-immunoprecipitation experiments revealed a constitutive association of p36 LAT with both FcgammaRI and FcgammaRIIa immunoprecipitates, and an activation-induced association of LAT with PLCgamma1, Grb2, and the p85 subunit of phosphatidylinositol 3-kinase. Transient transfection experiments in COS-7 cells indicated that overexpression of a wild type but not a dominant-negative LAT, that is incapable of binding to p85, enhances phagocytosis by FcgammaRI. Furthermore, bone marrow-derived macrophages from LAT-deficient mice displayed reduced phagocytic efficiency in comparison to the macrophages from wild-type mice. Thus, we conclude that p36 LAT serves to enhance FcgammaR-induced signal transduction in myeloid cells.