Interferon-alpha (IF alpha) is used for the treatment of myeloproliferative diseases and chronic viral illnesses. Because the agent has antiproliferative activity, its effects on a fetus are a concern. We encountered a 40-year-old Japanese woman who inadvertently received IF alpha during pregnancy for the treatment of HCV hepatitis. The patient received 5 million units of IF alpha 2 to 4 times per week (total dose of 315 million units) between 13 and 33 weeks gestation. The patient delivered a normally formed healthy male infant, weighing 2,252 g at 37 weeks of gestation. The infant at 20-month-old exhibited normal growth and neurological development when last examined. Literatures were reviewed to determine the effects of IF alpha on the fetus. There have been 27 infants born to 26 mothers, including the present case, who were exposed to IF alpha in utero. Six women (23%) were administered IF alpha inadvertently during pregnancy. Four women (15%) gave birth prematurely. Although 6 infants (22%) were affected by intrauterine growth retardation (IUGR), there were no IF alpha-related malformed infants. These results suggested that an inadvertent administration of IF alpha during pregnancy may occur, but in that case IF alpha may not induce congenital malformations. These findings may encourage such women to continue pregnancy.

The effects of recombinant insulin-like growth factor I (rIGF-I) on wound healing were tested using senescent and young BDF-1 mice, aged 108 weeks and 10 weeks, respectively. After inflicting a full thickness dermal burn encompassing 15% of the body surface, a skin incision, 2 cm in length, was made in the back. A silicone tube containing a piece of polyvinyl sponge was then implanted into a subcutaneous pocket in the flank to collect body fluid. An osmotic pump was buried in the abdominal subcutaneous tissue for the continuous infusion of rIGF-I, the control being treated with the solvent of IGF-I, physiological saline, only. The administration of IGF-I produced favorable effects on wound healing in the senescent mice, shown by enhanced tensile strength and an elevated concentration in the hydroxyproline of the polyvinyl sponge content. The IGF-I-treated severely wounded senescent mice healed better than their counterparts and their skeletal muscles contained more glutamine. Furthermore, they showed more enhanced cutaneous hypersensitivity towards dinitrofluorobenzene than the controls, suggesting an enhanced grade of cellular immunity. There were no conspicuous differences between the two groups of young mice. These data may suggest the beneficial effects of rIGF-I on wound healing, especially in geriatric surgery.

Percutaneous transhepatic biliary drainage (PTBD) guided by color Doppler echography was performed on nine patients. By color Doppler echography, the segmental and subsegmental branches of both the portal vein and the hepatic artery could be identified and discriminated from the bile ducts because of their color flow mapping. We could select the safe pathway of needle advance, which did not injure the vessels. Thus, complication of bleeding did not occur in any of the patients. Color Doppler echography seems a very useful and safe method for the guidance of PTBD.

The role of some intestinal bacteria species on wound-healing in mice was studied by comparing male germ-free (GF) mice with their conventionalized (Cvz) and monoassociated counterparts harboring Lactobacillus reuteri (L), Bifidobacterium longum (BB), Escherichia coli (E), Bacteroides vulgatus (B) and Clostridium perfingens (C) species. An incision was made on the dorsal skin of each mouse. A tube containing a piece of sponge was then implanted subcutaneously to measure the hydroxyproline concentration in wound tissue fluid. Mice were killed on the 7th postoperative day. Mice in the Cvz, L and BB groups showed stronger break-strengths and higher concentrations of hydroxyproline than mice in the GF group. The lactic acid concentration in Cvz, L, and BB groups was much higher than that in GF, B and C groups. The amounts of SCFAs in the Cvz group was higher than those in the GF group. Concentrations of SCFAs in the L and BB groups were not significantly higher than the values in the GF group. These results showed that the wound-healing process could be enhanced by some intestinal bacteria, and that lactobacilli and bifidobacteria may play an important role in this enhancement. The data suggest that such enhanced wound-healing in mice carrying special types of bacteria was partly due to the improvement in the nutritional status of mice caused by extra lactic acid produced by bacteria.