ABSTRACT
The purpose of this study was to devise an expanded ischemic flap model and to investigate the role of AMD-3100 (Plerixafor, chemokine receptor 4 inhibitor) in this model by confirming its effect on mobilization of stem cells from the bone marrow. Male Sprague-Dawley rats were used as an animal research model. The mobilization of stem cells from the bone marrow was confirmed in the AMD-3100-treated group. The fractions of endothelial progenitor cells (EPC) and the vascular endothelial growth factor receptor (VEGFR) 2+ cells in the peripheral blood were increased in groups treated with AMD-3100. The expression of vascular endothelial growth factor (VEGF) was increased in response to expansion or AMD injection. The expression of stromal cell derived factor (SDF)-1 and VEGFR2 were increased only in unexpanded flap treated with AMD-3100. Treatment with AMD-3100 increased both the number and area of blood vessels. However, there were no statistically significant differences in the survival area or physiologic microcirculation in rats from the other groups. This endogenous neovascularization induced by AMD-3100 may be a result of the increase in both the area and number of vessels, as well as paracrine augmentation of the expression of VEGF and EPCs. However, the presence of a tissue expander under the flap could block the neovascularization between the flap and the recipient regardless of AMD-3100 treatment and expansion.
Subject(s)
Animals , Male , Rats , Anti-HIV Agents/pharmacology , Bone Marrow Cells/cytology , Chemokine CXCL12/biosynthesis , Endothelial Progenitor Cells/cytology , Hematopoietic Stem Cells/cytology , Heterocyclic Compounds/pharmacology , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Neovascularization, Physiologic , Nitric Oxide Synthase Type III/metabolism , Rats, Sprague-Dawley , Receptors, CXCR4/antagonists & inhibitors , Surgical Flaps/blood supply , Tissue Expansion/methods , Vascular Endothelial Growth Factor A/biosynthesis , Vascular Endothelial Growth Factor Receptor-2/biosynthesisABSTRACT
Eighteen cases of double outlet right ventricle were observed during past six years at the department of pediatrics, Seoul National University Hospital. 1. Therw were 13males and 5 females. Sex ratio showed male predominance with the ratio of 2, 6:1. 2. According to the Sondheimer's classification, 6 cases were in group l, none in group ll, 10cases in group lll and 2 cases in group lV. 3. Presenting symtoms and signs were cyanosis(18/18), dyspnea(17/18), growth retardtion(10/18), and cyanotic spell(6/18). 4. The range of hemoglonin concentration was 14 to 21 gm%(mean 18.2gm%). Simple chest X-ray showed cardiomegaly in 10 patients. On routine ECG examination, RVH were noted in all 18 cases. 5. In group l patients, mean oxygen saturation of the aorta was 74.5%, mean oxygen saturation of the pulmonary artery was 86.7%. But on group lll, the results were variable. And in guoup lV, oxygen saturation difference were negligible in both great arteries. 6. Pulmonic outflow obstruction were noted in 12 cases in which 8 cases were combined type. 7. Operation was done in 8 cases. Out of the 6 cases who were receive corrective surgery, 3 cases died of the right heart failure. 8. Associated anomalies were as follows : bilateral SVC in 6 cases, PDA in 5 cases, ASD in 4 cases and dextrocardia in 4 cases.