ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical application of flow-through deep inferior epigastric perforator flaps for reconstruction of large defects at the extremities.</p><p><b>METHODS</b>The deep inferior and superior epigastric arteries were designed as the axial vessel and the arterial supply to the flap was the paraumbilical perforator artery. Free deep inferior epigastric perforator flaps were harvested in flow- through manners to reconstruct associated arterial defect in the wound. The sensation assessment,Enneking score,and questionnaire of the flap aesthetic were all performed during follow-up period.</p><p><b>RESULTS</b>From December 2011 to September 2012, 5 patients with large defects at extremities were treated. The deep inferior and superior epigastric arteries were designed as the axial vessel and the arterial supply to the flap was the paraumbilical perforator artery. The wound defects ranged form 11 cm x 5 cm to 30 cm x 11 cm. And the flap size ranged from 13 cm x7 cm to 33 cm x 13 cm. All flaps survived completely. The recipient arteries were all bypassed well documented by color Doppler examinations. All cases had 12-24 months' follow-up period. The flaps had good appearance and high aesthetic satisfactory(100%). 12 months after operations, sensation assessment were all S3+, and the Enneking score ratios were 82%-95% ,with 87.2% in average.</p><p><b>CONCLUSIONS</b>Flow-through deep inferior epigastric perforator flaps are reliable and effective for reconstruction of large defects at the extremities with maintenance of the vascular status of the extremities. The flaps can also be designed in transverse or oblique mode for clinical application.</p>
Subject(s)
Aged , Humans , Arteries , Epigastric Arteries , Esthetics , Extremities , General Surgery , Leg Injuries , General Surgery , Perforator Flap , Plastic Surgery ProceduresABSTRACT
This study investigated the protective effect of EGB761 on blood vessels of denervated gastrocnemius of rat and its possible mechanism.Fifteen male adult SD rats were randomly divided into three groups:normal control group (n=3),control group (n=6) and EGB761-treated group (n=6).The rats in the control and EGB761-treated group underwent a neurotomy to bilateral sciatic nerves.Then,they were administered EGB761 [100 mg/(kg·d)] and isovolumic normal saline,respectively by gavage everyday.No treatment was given to the rats in the normal control group.Gastrocnemius was harvested at 1 and 3 week(s) postoperatively in each group.Immunohistochemical method was used to detect the ratio of capillary/fiber (CFR) of denervated gastrocnemius and the expression of VEGF,fetal liver kinase -l(Flk-1) receptor and HSP70 in the vascular wall.The results showed that in the normal control group,VEGF,Flk-1 and HSP70 were expressed in the vessel wall of gastrocnemius,with Flk-1 expressed only in the endothelial cell of vessels.CFR in the EGB761-treated group was significantly higher than that in the control group at 1 week and 3 week(s) after neurotomy.The expression of VEGF and Flk-1 in the vessel wall of both control and EGB761-treated group was much lower than that in the normal control group,and the expression of these proteins in the EGB761-treated group was decreased as compared with that in the control group.The expression of HSP70 in the vessel wall of both control and EGB761-treated groups was enhanced when compared with that in the normal control group,and it was substantially augmented in the EGB761-treated group in comparison to the control group.It was concluded that EGB761 has a protective effect on blood vessels of denervated gastrocnemius,which is related to the increased HSP70 expression but not the expression of VEGF and its receptor Flk-1.
ABSTRACT
Adult stem cells from skeletal muscle cells were induced to differentiate into cardiocytes to see if stem cells from another different but histologically-comparable tissues can differentiate to the target cells. Skeletal muscles-derived stem cells (MDSCs) were isolated from adult skeleton muscle tissues by differential adhesion,and immunocytochemically identified by using Sca-1. In order to induce the proliferation but not differentiation of MDSCs,the cells were cultured in Dulbecco's modified Eagle's medium/F12 (DMEM/F12) supplemented with 1:50 B27,20 ng/mL basic fibroblast growth factor (bFGF),20 ng/mL epidermal growth factor (EGF) in a suspension for 6 days. Then these stem cells were treated with 5 μmol/L 5-azacytidine for 24 h in an adherence culture. The characteristics of induced cells were examined by immunocytochemistry,quantitative real time RT-PCR and morphological observation of cell phenotype. Our results showed that the appearance of some cells gradually changed from spindle-shape into polygonal or short-column-shape. Some of these post-treated cells could contract spontaneously and rhythmically. The expression of GATA-4 and cTnT was increased 1 and 2 week(s) after the treatment. And about 16.6% of post-treated cells were cTnT-positive. Therefore,we are led to conclude that skeletal muscle-derived stem cells could differentiate into cardiocyte-like cells,which exhibited some characteristics of cardiocytes.