https://www.jprasurg.com/article/0007-1226(87)90185-8/pdf

The vascular territories (angiosomes) of the body: experimental study and clinical applications

The origin and turnover of efferent populations of mouse mononuclear phagocytes has been described. Mononuclear phagocytes were defined as mononuclear cells which are able to adhere to glass and phagocytize.

In vitro labeling studies with thymidine-3H showed that monocytes in the peripheral blood and peritoneal macrophages do not multiply and can be considered end cells in a normal, steady state situation. However, the mononuclear phagocytes of the bone marrow appear to be rapidly dividing cells.

This conclusion was supported by in vivo labeling experiments. A peak of labeled mononuclear phagocytes of the bone marrow was found 24 hr after a pulse of thymidine-3H. This was followed, 24 hr later, by a peak of labeled monocytes in the peripheral blood. From these experiments it was concluded that the rapidly dividing mononuclear phagocytes of the bone marrow, called promonocytes, are the progenitor cells of the monocytes. Labeling studies after splenectomy and after X-irradiation excluded other organs as a major source of the monocytes.

Peak labeling of both the blood monocyte and peritoneal macrophages occurred at the same time. A rapid entry of monocytes from the blood into the peritoneal cavity was observed, after a sterile inflammation was evoked by an injection of newborn calf serum. These data have led to the conclusion that monocytes give rise to peritoneal macrophages.

No indications have been obtained that mononuclear phagocytes originate from lymphocytes.

In the normal steady state the monocytes leave the circulation by a random process, with a half-time of 22 hr. The average blood transit time of the monocytes has been calculated to be 32 hr. The turnover rate of peritoneal macrophages was low and estimated at about 0.1% per hour.

On the basis of these studies the life history of mouse mononuclear phagocytes was formulated to be: promonocytes in the bone marrow, → monocytes in the peripheral blood, → macrophages in the tissue.

/pdf/the-origin-and-kinetics-of-mononuclear-phagocytes-4teivtk94v.pdf

The origin and kinetics of mononuclear phagocytes

Transfer of allergic encephalomyelitis has been accomplished by injection of lymph node cells, obtained from donor rats sensitized to spinal cord, into recipient rats pretreated neonatally with normal rat spleen cells. Transfer of the disease may be achieved most frequently when the recipients are pretreated with spleen cells of the prospective lymph node cell donors. These transfers are attributed to the use of recipients which have acquired immunological tolerance to donor lymph node cells, as a result of the spleen cell pretreatment, and in which, therefore, the donor cells can survive and function longer after transfer.

https://rupress.org/jem/article-pdf/111/1/119/1391306/119.pdf

Transfer of allergic encephalomyelitis in rats by means of lymph node cells

Pathogenic Yersinia spp., including the etiological agent of plague, Y. pestis, all carry a common plasmid that encodes a number of essential virulence determinants, the Yop proteins. One of these, YopE, has been shown to be involved in the obstruction of the primary host defense by a molecular mechanism leading to inhibition of phagocytosis (R. Rosqvist, A. Forsberg, M. Rimpilainen, T. Bergman, and H. Wolf-Watz, Mol. Microbiol. 4:657-667, 1990). Although the Yop proteins are secreted into the culture supernatant in vast amounts, in vitro studies of the function of the Yop proteins have so far been unsuccessful. We show that isolated Yop proteins indeed can cause cytotoxic effects in vitro if the proteins are introduced intracellularly into the eukaryotic cell. Isolated Yop proteins of Yersinia pseudotuberculosis were found to disrupt the microfilament structure when microinjected intracellularly into the host cell. In particular, YopE was demonstrated to be directly involved in the cytotoxic action, whereas YopD seems to have a critical role in translocating the YopE protein through the host cell membrane. These results elucidate the requirement for at least some of the Yop proteins to leave the pathogen during infection.

Intracellular targeting of the Yersinia YopE cytotoxin in mammalian cells induces actin microfilament disruption.

Because of its ideal color and texture, forehead skin is acknowledged as the best donor site with which to resurface the nose However, all forehead flaps, regardless of their vascular pedicles, are thicker than normal nasal skin Stiff and flat, they do not easily mold from a two-dimensional to a three-dimensional shape Traditionally, the forehead is transferred in two stages At the first stage, frontalis muscle and subcutaneous tissue are excised distally and the partially thinned flap is inset into the recipient site At a second stage, 3 weeks later, the pedicle is divided However, such soft-tissue "thinning" is limited, incomplete, and piecemeal Flap necrosis and contour irregularities are especially common in smokers and in major nasal reconstructions To overcome these problems, the technique of forehead flap transfer was modified An extra operation was added between transfer and divisionAt the first stage, a full-thickness forehead flap is elevated with all its layers and is transposed without thinning except for the columellar inset Primary cartilage grafts are placed if vascularized intranasal lining is present or restored Importantly, at the first stage, skin grafts or a folded forehead flap can be used effectively for lining A full-thickness skin graft will reliably survive when placed on a highly vascular bed A full-thickness forehead flap can be folded to replace missing cover skin, with a distal extension, in continuity, to supply lining At the second stage, 3 weeks later during an intermediate operation, the full-thickness forehead flap, now healed to its recipient bed, is physiologically delayed Forehead skin with 3 to 4 mm of subcutaneous fat (nasal skin thickness) is elevated in the unscarred subcutaneous plane over the entire nasal inset, except for the columella Skin grafts or folded flaps integrate into adjacent normal lining and can be completely separated from the overlying cover from which they were initially vascularized If used, a folded forehead flap is incised free along the rim, completely separating the proximal cover flap from the distal lining extension The underlying subcutaneous tissue, frontalis muscle, and any previously positioned cartilage grafts are now widely exposed, and excess soft tissue can be excised to carve an ideal subunit, rigid subsurface architecture Previous primary cartilage grafts can be repositioned, sculpted, or augmented, if required Delayed primary cartilage grafts can be placed to support lining created from a skin graft or a folded flap The forehead cover skin (thin, supple, and conforming) is then replaced on the underlying rigid, recontoured, three-dimensional recipient bed The pedicle is not transected At a third stage, 3 weeks later (6 weeks after the initial transfer), the pedicle is divided Over 10 years in 90 nasal reconstructions for partial and full-thickness defects, the three-stage forehead flap technique with an intermediate operation was used with primary and delayed primary grafts, and with intranasal lining flaps (n = 15), skin grafts (n = 11), folded forehead flaps (n = 3), turnover flaps (n = 5), prefabricated flaps (n = 4), and free flaps for lining (n = 2) Necrosis of the forehead flap did not occur Late revisions were not required or were minor in partial defects In full-thickness defects, a major revision and more than two minor revisions were performed in less than 5 percent of patients Overall, the aesthetic results approached normal The planned three-stage forehead flap technique of nasal repair with an intermediate operation (1) transfers subtle, conforming forehead skin of ideal thinness for cover, with little risk of necrosis; (2) uses primary and delayed primary grafts and permits modification of initial cartilage grafts to correct failures of design, malposition, or scar contraction before flap division; (3) creates an ideal, rigid subsurface framework of hard and soft tissue that is reflected through overlying skin and blends well into adjacent recipient tissues; (4) expands the application of lining techniques to include the use of skin grafts for lining at the first stage, or as a "salvage procedure" during the second stage, and also permits the aesthetic use of folded forehead flaps for lining; (5) ensures maximal blood supply and vascular safety to all nasal layers; (6) provides the surgeon with options to salvage reconstructive catastrophes; (7) improves the aesthetic result while decreasing the number and difficulty of revision operations and overall time for repair; and (8) emphasizes the interdependence of anatomy (cover, lining, and support) and provides insight into the nature of wound injury and repair in nasal reconstruction

Arthur L. Bloomfield

Papers

The principles and art of plastic surgery

Bacterial and mycotic infections of man

Leprosy in theory and practice

J. m. charcot—1825-1893—his life—his work

CLINICOPATHOLOGICAL CONFERENCES OF THE MASSACHUSETTS GENERAL HOSPITAL: Selected Medical Cases