(2006) confirmed

similar findings By contrast, Lee et al

(2006) confirmed

similar findings. By contrast, Lee et al. (1999) found that IR strain RB51, with or without IL-12 as an adjuvant, did not protect against strain 2308 challenge. These conflicting results could possibly be explained based on the fact that other groups stimulated for 24 h while we stimulated for 4 h. Mechanistically, some of these differences between HK vs. IR vs. live strains in induced DC and T-cell function and protection could be due to the amount and nature of antigen being processed and presented as well as the extent to which DCs are stimulated. In a different model, the findings of Kalupahana et al. (2005) using HK and live Salmonella typhimurium supported the above premise by showing that prolonged contact with HK bacteria was necessary to obtain similar DC activation and function achieved by live strains in a shorter period. Additionally, in contrast to the 65 °C, 30 min of heat inactivation by Vemulapalli and colleagues (Sanakkayala et al., 2005), selleck we used a higher temperature of 80 °C for 1 h. Theoretically, although

not likely, additional heating may have disrupted the Brucella cell envelopes (Barquero-Calvo et al., 2007) and exposed large amounts of Brucella lipopolysaccharide, lipoproteins, peptidoglycan, DNA and other molecules recognized by innate immunity. Additional differences between IR and HK could be due to the fact that IR may stimulate a better DC-mediated CD8 response than HK (Datta et al., 2006). Besides differences in the ability of IR vs. HK to stimulate more CD8- vs. CD4-mediated learn more immune responses, and the role of IR vs. HK in protection, DC function is also regulated by TNF-α, IL-12 and IL-10. As stated previously,

TNF-α production is critical for maximal IL-12 production and CD4 Th1 response. If either is decreased, DC-mediated T-cell responses and potentially protection could be decreased. Another mechanism by which protection would be decreased would be through an IL-10-mediated T-regulatory response that would downregulate IL-12 production by DCs (Huang et al., 2001; McGuirk et al., 2002). Correspondingly, HK and/or IR strains may suboptimally stimulate BMDCs at a given dose, which might induce them to become tolerogenic DCs (semi-mature DCs) with the inability to produce proinflammatory cytokines (Lutz & Schuler, all 2002). As others have shown that both HK and IR strains of B. abortus induced similar levels of IL-10 (Sanakkayala et al., 2005), we did not determine the ability of HK or IR strains to induce IL-10 secretion from BMDCs. However, it is possible that live vs. HK or IR strains may induce different levels of IL-10 that could influence DC and T-cell function and protection. Thus, our findings, along with already published studies, suggest multiple mechanisms for differences between live vs. IR vs. HK strain-induced DC function, T-cell function and protection. Additional studies are warranted to further investigate these mechanisms as well as their impact on protection.

The role of infectious agents in triggering autoimmunity has been

The role of infectious agents in triggering autoimmunity has been highlighted, but a relatively unexplored area is the interaction between infectious agents and commensals in disease [49]. Technological advances in the molecular analysis of the microbiota will continue

apace, but one concern may be that the current enthusiasm for pyrosequencing everything will delay progress in developing selective culture media for biologically important organisms. Meanwhile, new technological approaches to the glycobiology of the gut microbiota are needed and may eclipse microbial proteomics. Due regard will also have to be given to the other microbiota, including the viriome [50,51]. Finally, in view of the hour-glass shape of the innate immune system, the question arises as to what degree are host–diet–microbe

interactions drugable. This is uncertain, but it is clear that the microbiota is manipulable, particularly in Ulixertinib ic50 early life, and is a rich opportunity for drug discovery. The author has been supported in part by grants from Science Adriamycin in vivo Foundation Ireland in the form of a research centre grant, the Higher Education Authority of Ireland and the European Union. The author is a stockholder in Alimentary Health Ltd, a recipient of research grants from GlaxoSmithKline Ltd, and a consultant to the Procter and Gamble Co. The content of this manuscript Inositol monophosphatase 1 was neither influenced nor constrained by these facts. “
“Acinetobacter baumannii has emerged as a bacterial pathogen of considerable healthcare concern. Yet, little is known about the organism’s basic biological processes and the regulatory networks that modulate expression of its virulence factors and antibiotic resistance. Using Affymetrix GeneChips®, we comprehensively defined and compared the transcriptomes of two A. baumannii strains, ATCC 17978 and 98-37-09, during exponential and stationary phase growth in Luria–Bertani (LB) medium. Results revealed that in addition to expected growth phase-associated metabolic

changes, several putative virulence factors were dramatically regulated in a growth phase-dependent manner. Because a common feature between the two most severe types of A. baumannii infection, pneumonia and septicemia, includes the organism’s dissemination to visceral organs via the circulatory system, microarray studies were expanded to define the expression properties of A. baumannii during growth in human serum. Growth in serum significantly upregulated iron acquisition systems, genes associated with epithelial cell adherence and DNA uptake, as well as numerous putative drug efflux pumps. Antibiotic susceptibility testing verified that the organism exhibits increased antibiotic tolerance when cultured in human serum, as compared to LB medium. Collectively, these studies provide researchers with a comprehensive database of A.

These findings suggest that the activation of TLRs in pregnancy c

These findings suggest that the activation of TLRs in pregnancy causes not only preterm labor and pregnancy loss, but also pre-eclampsia. The fetus is not indifferent to a viral or bacterial infection, and the immunological responses by the selleck products maternal immune system or the placenta or fetal immune system may have important consequences on the normal development and survival of the fetus. In the following section, we will discuss some studies

related to the long-term effects of TLR ligation in the offspring. Administration of LPS to pregnant mice was shown to cause acute fetal cardiovascular depression,54 and inhibit structural development of the distal fetal mouse lung in a TLR4-dependent manner.66 Similarly, cerebral white matter damage, which is one of the biggest problems seen in preterm neonates because of its strong association with their lifetime adverse outcome, is also believed to be caused by TLR4 activation in the fetus.67 It is worthy to mention that low-dose LPS, which has no adverse effects on pregnancy outcome, dramatically increases brain injury to subsequent hypoxic–ischemic challenge in a newborn rat animal model.67 These findings XAV-939 price are compatible with clinical findings showing that maternal exposure to bacteria not only causes preterm labor, but also

contributes to long-term adverse outcome in the offspring such as cerebral white matter damage. Adverse effects of maternal TLR3 activations were also found in fetuses in various animal models. Maternal poly(I:C) or virus exposure cause marked behavioral changes in the offspring mouse,68 which is relevant to many epidemiological studies showing that maternal exposure to virus causes not only abortion or preterm selleck compound birth but also fetal schizophrenia and autism.69,70 Offspring of poly(I:C)-treated pregnant mice were shown to have less expression of brain-derived neurotrophic factor (BDNF), nerve

growth factor (NGF) and TNF-α in their placenta, liver/spleen and brain, which may represent a potential mechanism through which maternal viral infection increases a risk of such neurodevelopmental disorders.71 In contrast to the ‘adverse’ effects of maternal infection on fetus, there is a notion called ‘hygiene hypothesis’, that is, ‘adequate’ maternal microbial exposure has protective effects on neonatal allergic disease. Very recently, it was demonstrated that TLR system is also involved in this effect. Conrad et al.72 showed that an administration of non-pathogenic microbe Acinetobacter Iwoffii F78 to pregnant mice has a protective effect on postnatal asthma, and the effect was completely abolished in TLR2/3/4/7/9/null mice.

[9] The genus Lichtheimia contains four species, of which L cory

[9] The genus Lichtheimia contains four species, of which L. corymbifera and L. ramosa have been reported from human infections.[10] Reviews describing the less common members of Mucorales causing the remaining 20–30% of mucormycosis cases mostly include Actinomucor, Apophysomyces, Cokeromyces, Cunninghamella, Rhizomucor, Saksenaea and Syncephalastrum.[3, 11] The prognosis of invasive mucormycosis remains poor, with recently reported mortality Bortezomib cell line rates varying between 45% and 64%, and in some report 85%,[12] depending on the underlying disease.[13, 14] Early recognition of the source of infection is among the key elements in successful management of infection.[15] Conventional

diagnosis is difficult because symptoms, signs, radiographic manifestations and histopathology of mucormycosis are non-specific,[6] and culture of sputum, paranasal sinus secretions or bronchoalveolar lavage fluid is frequently unsuccessful. In general conventional diagnostics are slow, unsuited for screening purposes and may have limited specificity. selleck chemicals Mucoralean fungi are particularly suitable for molecular techniques because interspecific distances tend to be large and intraspecific variability is relatively low.[11] The most common molecular method in clinics so far is sequencing of the ITS and D1/D2 ribosomal

DNA (rDNA) regions and Blast comparison in available databases. Rolling circle amplification (RCA) is an isothermal amplification method which has been proved to be rapid, cost-effective and specific for molecular identification of pathogenic fungi.[16-18] In this paper, we propose seven padlock probes on the basis of the rDNA ITS region to identify the most clinical relevant taxa of Mucorales, viz. R. microsporus, R. arrhizus var. arrhizus, R. arrhizus var. delemar, M. irregularis (formerly Rhizomucor variabilis), M. circinelloides, L. ramosa and L. corymbifera. In total 42 strains from reference

collection of the Centraalbureau voor Schimmelcultures (CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands), were used in this study and are listed in Table 1. Dichloromethane dehalogenase The set included six strains each of R. microsporus, R. arrhizus var. arrhizus, R. arrhizus var. delemar, M. irregularis, M. circinelloides, L. ramosa and L. corymbifera, including strains tested as negative controls. Isolates were identified with different genetic markers prior this study and there is no conflict about their taxonomic identification.[8, 11, 19] Lyophilised strains were grown on 5% Malt Extract Agar (MEA; Oxoid, Basingstoke, UK) in 8 cm culture plates incubated at 30 °C for 3 days. DNA was extracted using a CTAB method as described previously.[19] ITS amplicons were generated with primers V9G and LS266. The ITS amplicons were used as targets for RCA reactions. ITS sequences of all strains were aligned and adjusted manually using BioNumerics v. 4.

The co-incubated THP-1 cells and bacteria were resuspended in str

The co-incubated THP-1 cells and bacteria were resuspended in streptavidin–allophycocyanin (Pierce) diluted 1 : 25 in 1% BSA (Sigma). Following streptavidin staining, cells were resuspended in PBS for flow cytometry analysis. Samples were run on a BD FACScalibur™ flow cytometer

and data were analysed using CellQuest Pro software. The co-incubated THP-1 cells and bacteria were washed twice in PBS, resuspended in 300 μl PBS and added to a Polysine slide (Thermo Scientific, Waltham, ABT-888 MA). The unbound cells were then aspirated after 30 min and the bound cells were fixed with 10% neutral buffered formalin. The cells were stained with streptavidin–allophycocyanin diluted 1 : 25 in 1% BSA for 30 min at 4°. Cells were permeabilized with 0·2% Triton X-100 (Sigma). Selleckchem ZIETDFMK Filamentous (F)-actin was stained with 0·165 μm rhodamine phalloidin (Molecular Probes) for 15 min. Cells were mounted with ProLong® Gold antifade reagent (Molecular Probes) using No. 1·5 coverslips

(Marienfeld, Lauda-Königshofen, Germany). Slides were viewed with an Olympus FV1000 confocal laser scanning microscope (Olympus) consisting of an Olympus IX81 inverted microscope equipped with an oil-immersion Plan-Apo 60 ×/1·1 objective lens and a three-channel photomultiplier transmission detector using 1·5 × digital magnification. Five fields of view were collected from each slide to give a total of at least 100 cells per sample. Statistical analysis was carried out using GraphPad Prism (version 4.03; GraphPad Software, San Diego, CA). Means with standard error (SEM) are presented in each graph. Differences between two groups were calculated using Student’s

t-test. Differences between three or more groups were calculated by analysis of variance with Tukey’s post-hoc test. Differences were considered significant at P < 0·05. Microarray data were analysed using GeneSpring 7.3.1 software (Silicon Genetics) to determine significant changes with P < 0·05, and > 1·5-fold difference. Tenoxicam To increase stringency, the cut-off was increased to twofold for some analyses where indicated. Cluster analysis and visualization were performed using Genesis14 and VENNY was used for visualization of differentially expressed data sets.16 To investigate possible responsiveness of M cells to commensal bacteria we used a well described in vitro model of M-cell function.10 Transepithelial electrical resistance was used to confirm the integrity of the C2BBe1 (C2) monolayer. The transepithelial electrical resistance values for the C2BBe1 (C2) control wells and co-cultured C2 plus Raji cells (C2-M) M cells were 475·2 ± 88·7 Ω·cm2 and 457·2 2 ± 71·4 Ω·cm2, respectively (data not shown). TNF receptor superfamily, member 9 (TNFRSF9) is induced by lymphocyte activation and is up-regulated in M cells17 and matrix metallopeptidase 15 (MMP15) has also been found to be up-regulated in M cells in vitro.

To identify gene targets induced by non-limiting

IL-7 sig

To identify gene targets induced by non-limiting

IL-7 signalling, we also examined gene expression by control F5 T cells stimulated overnight with IL-7 at a concentration sufficient to induce Bcl2 upregulation similar to that observed in F5 T cells transferred to lymphopenic Rag1−/− hosts (Fig. 3) 2. Figure 5A shows the Principle Components Analysis (PCA) of the array data. Biological replicates of IL-7-stimulated, Z-VAD-FMK in vitro control ex vivo F5 T cells and cells from F5 TetIL-7R mice all clustered in a distinct manner to one another. Our previous studies have suggested that the very low levels of IL-7Rα expression on peripheral T cells in dox-fed F5 TetIL-7R mice are not functionally significant in vivo 24, and consistent with this, the PCA analysis of F5 TetIL-7R array data all clustered together, regardless of dox feeding of donors. Comparison of gene expression between samples from dox-fed and dox-free mice revealed no statistically significant differences between these two data sets, supporting the view that the

low levels of IL-7Rα expression by peripheral F5 T cells in dox-fed F5 TetIL-7R mice were not functionally significant. We therefore pooled the six replicate arrays from both dox-fed and dox-free F5 TetIL-7R donors to compare gene expression with control ex vivo samples. We specifically analysed expression of genes involved in regulating the mitochondrial pathways of apoptosis. Figure 5B summarizes changes induced by IL-7 stimulation of control GSK-3 beta pathway GNAT2 F5 T cells compared with ex vivo F5 T cells, whereas Fig. 5C compares gene expression between IL-7R– F5 T cells with control IL-7R+ F5 T cells. IL-7 stimulation resulted in statistically significant induction in expression of anti-apoptotic factors Bcl2, Bcl-xL and Mcl1 expression (Fig.

5B and S3A) and reduced expression of the pro-apoptotic BH3-only family member Bid. However, other BH3-only family members like Bim (Fig. 5B and S3B) were slightly elevated or not affected. Similarly, expression of the BH3-multidomain proteins Bax, Bak and Bok, was not affected by IL-7 stimulation (Supporting Information Fig. 3B and C). Thus, non-limiting IL-7 stimulation specifically upregulated expression of anti-apoptotic molecules Bcl2, Bcl-xL and Mcl1 and this is likely to be the primary mechanism of anti-apoptotic activity by such IL-7 stimulation, consistent with previous reports. In contrast, comparison of gene expression between IL-7R– F5 and control F5 T cells revealed surprisingly few differences in key molecules regulating apoptosis (Fig. 5C). In addition to Bcl2, levels of expression of other anti-apoptotic factors Bcl-xL and Mcl1, BH3 only molecules Bad, Bik, Bim, Noxa, Puma and multi-domain BH3 molecules Bax, Bak and Bok were all unaffected by the absence of IL-7 signalling (Supporting Information Fig. 3).

Analogously, Irf8 mutation only affects CD8α+ DCs in spleen, alth

Analogously, Irf8 mutation only affects CD8α+ DCs in spleen, although it is now widely agreed upon that both CD8α+ DCs and CD8α− DCs are mostly derived from the same set of canonical DC precursors 1, 4. The hypothesis put forward by Luche et al. that CD8α+ tDCs develop via a canonical DC developmental pathway is consistent with a recent Maraviroc price fate mapping study of T-cell progenitors assessing the history of Il7r expression 13. In this study, Schlenner et al. showed that the vast majority of

ETPs (∼85%) has a history of Il7r expression, suggesting lymphoid commitment prior to thymus seeding. In contrast, thymic myeloid cells and DCs (except pDCs) were mostly of non-lymphoid origin. In addition, Schlenner et al. demonstrated that even ETPs lacking a history of Il7r expression were unable to generate myeloid cells upon intrathymic transfer. Thus, together with the present study of Luche et al. two independent lines of evidence now indicate that T cells and CD8α+ tDCs are of separate origins. How can these recent data be reconciled selleck screening library with earlier findings suggesting that ETPs (or earlier T-cell precursors) are the primary source of CD8α+ tDCs? Elucidation of lineage potential has been shown to be massively dependent on assay conditions.

In particular, in vitro approaches or transplantation into irradiated hosts do not necessarily reflect developmental processes occurring in the steady state 16, although such analyses are clearly of merit when assessing lineage relationships.

Furthermore, progressive subfractionation of precursor populations has revealed a striking heterogeneity of apparently homogeneous populations 11. Thymic DCs have been proposed to develop in a coordinated fashion with thymocytes, displaying similar kinetics of expansion and contraction 8, 9. Although this may be considered indirect evidence for a common origin, it is also possible that environmental cues, such as periodic opening of progenitor niches, might equally apply to independent precursor populations. In contrast tuclazepam to CD8α+ DCs from spleen, CD8α+ tDCs carry DHJH rearrangements, indicating a lymphoid history for these cells 5. However, DHJH rearrangements in CD8α+ tDCs remain to be analysed on the single-cell level and it may well be possible that only a minor fraction of CD8α+ tDCs display these rearrangements. In this context, one might speculate that DCs with a history of Il7r expression correspond to this fraction. Is a model of CD8α+ tDC generation via two pathways, a major pathway following canonical DC differentiation and a minor pathway originating from T-cell precursors (Fig. 1), compatible with the complete lack of DC potential of ETPs upon intrathymic transfer? On the one hand, developing DCs might branch off from a T-cell precursor that is more immature than ETPs, such as a yet elusive thymus seeding progenitor.

Hypertrophy of tubules (predominantly the proximal tubule) and gl

Hypertrophy of tubules (predominantly the proximal tubule) and glomeruli is accompanied by increased single nephron glomerular filtration rate and tubular reabsorption of sodium. We propose that the very factors, which contribute to the increase in growth R788 mouse and function of the renal tubular system, are, in the long term, the precursors to the development of hypertension in those with a nephron deficit. The increase in single nephron glomerular filtration rate is dependent on multiple factors, including reduced renal vascular resistance

associated with an increased influence of nitric oxide, and a rightward shift in the tubuloglomerular feedback curve, both of which contribute to the normal maturation of renal function. The increased influence of nitric oxide appears to contribute to the reduction in tubuloglomerular feedback sensitivity and facilitate the initial increase in glomerular filtration rate. The increased single-nephron filtered load associated with nephron deficiency www.selleckchem.com/products/Temsirolimus.html may promote hypertrophy of the proximal tubule and so increased reabsorption of sodium, and thus a rightward

shift in the pressure natriuresis relationship. Normalization of sodium balance can then only occur at the expense of chronically increased arterial pressure. Therefore, alterations/adaptations in tubules and glomeruli in response to nephron deficiency may increase the risk of hypertension and renal disease in the long-term. At birth, as the fetus transitions into a PIK3C2G terrestrial environment and placental support is lost, the kidneys have to profoundly adapt to regulate their own function. These adaptations include both structural and functional development of the nephron; the glomeruli and associated tubules.

The human kidney exhibits a 10-fold range in nephron number (200 000–2 000 000 nephrons per kidney).[1] Those at the lower end of the range may be at a higher risk of developing hypertension in adulthood. The association between low nephron number and development of hypertension was proposed by Brenner and colleagues.[2] On the basis of observations in the rat model of 5/6th renal ablation, they suggested that glomerular hyperfiltration is a maladaptive response to nephron loss as it leads to sclerosis of the remaining glomeruli and further nephron loss. This increase in single nephron glomerular filtration rate (SNGFR) results partly from increased glomerular capillary surface area, capillary plasma flow and capillary hydraulic pressure, secondary to a large reduction in pre-glomerular vascular resistance and a lesser reduction in post-glomerular vascular resistance.[3] Brenner and colleagues’ postulate was initially based on observations in models of hypertension. Observations in the diabetic rat led them to conclude that systemic hypertension is not a requirement for either glomerular hyperfiltration or glomerular hypertension.

Current dosing of IVIg for neurological disorders has been extrap

Current dosing of IVIg for neurological disorders has been extrapolated from earlier studies with small numbers of patients. A study of immunomodulation with IVIg described seven paediatric patients with idiopathic thrombocytopenic purpura [2]. The patients received an initial dose of 0·4 g/kg for 5 consecutive days, followed by maintenance therapy of 0·4 g/kg every 1–6 weeks. Two small-scale trials published in 1984 demonstrated that IVIg treatment was effective in myasthenia gravis (MG) patients at

doses of six infusions of 20 g for 2 weeks [3] or 1–2 g/kg for 5 days [4]. In nine CIDP patients initial treatment was with 0·4 g/kg/day for 5 consecutive days [5]. Thereafter, the patients were treated with the lowest effective dose at the longest Alvelestat possible intervals.

This study may represent one of the first attempts at optimizing IVIg therapy. Current practice is to use a broad range of dosages for these chronic neurological conditions. PF-02341066 in vivo The same is true in primary immunodeficiencies in terms of the wide variations in dosage, treatment interval and target trough levels, as demonstrated in a 2012 survey of immunologists [6]. The selection of appropriate IVIg dose and dosing interval has far wider implications, including the impact on economic considerations (including the cost of IVIg), the limited supply of Ig, convenience to the patient, possible adverse effects and, of course, optimizing maintenance therapy in order to prevent long-term disability in these patients. Although most neurologists will treat with initiation therapy, typically

0·4 g/kg for 5 days, followed by maintenance therapy of 1–2 g/kg/month, other therapeutic regimens have been utilized in different neurological disorders. A study in 2005 compared selleck screening library 1 g/kg with 2 g/kg dosing in MG patients, and found no significant difference between the two doses for the primary and secondary end-points [7]. A similar study in Guillain-Barré syndrome (GBS) patients compared 0·4 g/kg/day for 3 days versus the same dose for 6 days, and found no significant difference between the two regimens on time to walking with assistance [8]; however, there was a significant difference between the two groups when studying the subset of patients on mechanical ventilation, indicating that variable dosing may be of benefit for patients with more severe disease. Guidelines have been published to review indications for neurological disorders [9], and in 2010 the European Federation of Neurological Societies published guidelines for the management of CIDP and multifocal motor neuropathy (MMN), respectively, which suggest individualized assessment and treatment with IVIg [10, 11]. When contemplating the appropriate use of a limited resource, a convenient solution is to consider reducing the IVIg dose or discontinuing treatment if the patient no longer requires it, or if treatment is ineffective.

© 2010 Wiley-Liss, Inc Microsurgery, 2011 “

© 2010 Wiley-Liss, Inc. Microsurgery, 2011. “
“Peripheral selleck products nerve surgery performed under unfavorable conditions results

in increased scar formation and suboptimal clinical outcomes. Providing the operated nerve with a protective barrier, reduces fibrosis and adhesion formation and may lead to improved outcomes. The ideal coverage material should prevent scar and adhesion formation, and maintain nerve gliding during motion. Nerve protection using autologous tissues has shown good results, but shortcomings include donor site morbidity and limited availability. Various types of methods and materials have been used to protect nerves. There are both advantages and disadvantages associated with the various materials and techniques. In this report we summarize currently used protective materials applied for nerve coverage under various surgical conditions. © 2013 Wiley Periodicals, Inc. Microsurgery, 2013. “
“Although success of digital replantations

in children has been reported by many authors, the very distal fingertip replantation remains technically demanding. The aim of this article PF-02341066 price is to review our experience with fingertip replantations at or distal to the nail base in pediatric patients and evaluate the clinical outcomes. From October 2000 to May 2007, 12 pediatric fingertips amputated at or distal to the nail base were replanted. Only one artery was anastomosed for revascularization with or without nerve Isoconazole repair; vein drainage was provided by the controlled bleeding technique. Eleven of the 12 replants (91%) survived; one replant of crushed digit failed. An average of 26 month (range, 6 to 36 months) follow-up revealed excellent restoration of finger motion and appearance. The regained static 2-point discrimination (S2PD) sensation was from 3.2 to 5.0 mm (mean, 4.2 mm). Both

the parents and the children were satisfied with the final results. In conclusion, fingertip replantation in children allows good functional and esthetical recovery and should be attempted if technically feasible. © 2010 Wiley-Liss, Inc. Microsurgery 30:380–385, 2010. “
“Severe auricular traumas with extensive involvement of the surrounding structures present with a serious defect necessitating free tissue transfers for reconstruction. In this case report, we present a case of whole left auricle reconstruction with a radial forearm flap prelaminated with porous polyethylene (Medpor®) implant in a 17-year-old female patient. First, a subdermal pouch was fashioned on the volar aspect of the left forearm along the projection of the radial artery and the Medpor implant was placed in this pouch. Four weeks later, the prelaminated radial forearm flap containing the Medpor implant was transferred to the recipient site.