Faculty Bibliography

Antibodies to the clonally unique variable-region determinants (idiotype) of the antigen-specific alpha beta heterodimeric receptor of a clone of cytotoxic T cells (CTLs) were shown previously to render diverse cells, regardless of their own surface antigens, susceptible to lysis by that clone of CTLs. To extend these findings, we have sought to develop a general means for targeting cells for destruction by any CTL, without regard to its alpha beta idiotype and specificity for antigen. We explored the use of heteroantibody duplexes formed by joining covalently an antibody to the T3 complex (anti-T3), which is associated with the alpha beta receptors on all human mature T cells, and a second antibody, specific for an antigen on the intended target cell. The second antibody selected in this study was specific for the idiotype (Id) of the surface immunoglobulin of a human B-lymphoma (anti-Ig Id). In the presence of the anti-T3/anti-Ig Id heteroantibody duplex the B-lymphoma cells were lysed by a clone of human T8+ CTLs (of unrelated specificity) but not by a noncytotoxic clone of human T4+ helper T cells, and lysis by the CTLs was specifically blocked by the uncoupled anti-T3 or the uncoupled anti-Ig Id antibodies. The extent of the heteroantibody-dependent cytolysis depended both on the heteroantibody concentration and on whether the intended target cells or the CTL effectors were initially preincubated with the heteroantibody. Under optimal conditions, heteroantibody-dependent lysis of the surrogate target (B-lymphoma) cells by the CTLs compared favorably with lysis of their natural target cells by the same CTLs. Overall, our findings suggest that heteroantibody duplexes containing anti-T3 antibody may be capable of targeting selected cells, such as tumor cells, for destruction in vivo by the body's CTLs.

Intraoral flaps are an excellent source of tissue for reconstruction after resection of small malignant tumors of the oral cavity, pharynx, and hypopharynx. The principal donor sites used are the tongue, buccal mucosa, and palate. Intraoral flaps enable rapid rehabilitation of deglutition and speech with minimal morbidity. They provide easily transferred, well-vascularized tissue from sites adjacent to the operative defects. These flaps permit closure without tension and obviate the need for more distant tissue transfers. Their use does not compromise the oncologic resection

Principles of osteosynthesis utilizing dynamic compression plating have been used in immediate and delayed mandibular reconstruction in five patients. Intermaxillary fixation was not used. Follow-up ranged from eight to 14 months. Four of five patients have viable bone grafts at the present time. One bone graft has been lost due to infection. We feel mandibular reconstruction based on principles of osteosynthesis helps to rapidly restore cosmesis and function with minimal morbidity

Cricopharyngeal myotomy is an effective procedure for the treatment of swallowing disorders due to dysfunction of the upper esophageal sphincter and pharyngeal musculature. Eight patients with documented pharyngeal and sphincteric dysfunction have undergone myotomies with significant improvement in swallowing associated with restoration of oral feeding without aspiration in 5, while 3 patients have not improved. The preoperative work-up and evaluation is discussed as well as criteria that may identify those patients most likely to benefit from this treatment

A rare case of mixed ependymoma and astrocytoma of the cerebellopontine angle is reported. Its clinical presentation, characteristics on evaluation, and prognosis are compared with those of the acoustic neuroma and glioma. The central form of von Recklinghausen's disease and familial multiple lipomatosis as it applies to the patient is also discussed

The longitudinal stability of personality was investigated in a group of several hundred adults who were rated by themselves, their marriage partners, and their acquaintances in 1935-1938 and by themselves and their marriage partners in 1954-1955. For both men and women, there were very similar factorial structures in all five sources of ratings. Individual differences in neuroticism, social extraversion, and impulse control had reasonably high levels of longitudinal stability over a 19-year period. Both the synchronic and diachronic correlations converged across methods and discriminated among traits. Self-report personality inventory data available in 1935-1938 and 1954-1955 provided corroborating evidence of the longitudinal and methodological robustness of personality traits. In data gathered on the same panel in 1980-1981, the questionnaire and the life history correlates of neuroticism and social extraversion displayed patterns indicative of temporal stability, methodological convergence, and discrimination among constructs. The data of this longitudinal study carried out over five decades strongly indicate that there is a set of personality traits that are generalizable across methods of assessment and are stable throughout adulthood.

Surface paper strips containing hemin (X factor) were tested on Middlebrook 7H10 agar and Lowenstein-Jensen medium to determine if the growth requirement of Mycobacterium haemophilum for iron-containing complexes could be met by this simplified method. One reference strain and seven strains of this species isolated from patients showed good growth around the strips on 7H10 within 2 weeks but failed to grow on Lowenstein-Jensen medium with X-factor strips. Middlebrook 7H10 medium with X-factor strips may be a useful alternative to the preparation of specialized media for the recovery of M. haemophilum from clinical specimens.

Facial hemihypertrophy, first described by Beck in 1836, aroused some interest in the early part of this century among European and American clinicians. However, a search of the otolaryngologic literature failed to reveal hemihypertrophy of the head and neck area as a well-recognized entity. We recently encountered a case of hemifacial hypertrophy in a 2-year-old. The child presented with airway compromise and swallowing difficulty. The treatment of this child and a review of associated head and neck findings are discussed

The decrement of evoked response amplitudes during the presentation of repetitive clicks was examined quantitatively at the level of the eighth nerve and inferior colliculus in mice aged 13-60 days postnatal. The amplitudes of both these potentials were found to decline during the course of stimulation, this being much more severe at the onset of hearing than in adults. Furthermore the following response at the level of the cochlear nerve was adult-like by day 18, while the response at the level of the inferior colliculus continued to improve through day 24. Recordings in the inferior colliculus were consistently obtained in two different regions along the frequency axis. The regions that responded best to a lower range of frequencies (e.g. 3-9 kHz) showed a more rapid and severe decrement in the evoked response to repetitive stimulation than those regions responding best to a higher range of frequencies (e.g. 8-17 kHz). This was found to be the case for repetitive click stimuli and repetitive tone bursts. Single unit responses in the inferior colliculus were consistent with this differential decline as a function of stimulus rate seen along the frequency axis