ABSTRACT
Endothelial cells are most sensitively affected by ischemic-reperfusion injury, and also the endothelial cells have very important role in immune reaction of organ transplantation and preservation of the organ. To improve the survival rate of a flap, and also to reduce the possibility of flap necrosis, the protection and preservation of the endothelial cells are very important. Because reactive oxygen species(ROS) are thought to be an important cause of ischemic reperfusion injury, we studied the cytotoxicity of ROS on endothelial cells. We performed an in vitro study to document whether green-tea polyphenol pretreatment play an important role in preventing cytotoxic damage from ROS. Neonatal Dermal Microvascular Endothelial Cells were cultured in EGM-2 MV BulletKit. Endothelial cell suspension in concentration of 4x104, was distributed into the wells of 24-well plate, cultured for 1, 3, 5, 7 days and the growth rates of the cells were measured with ELISA reader. Green-tea polyphenolic compounds(GtPP) were administered on L929 mouse fibroblasts and the possible cytotoxicity was measured with ELISA reader. Cultured endothelial cells in the concentration of 2x105 cells were treated with 0.1mM, 1mM, 10mM H2O2 and also with 0.25mM xanthine and 0.1U/L, 1U/L, 10U/L xanthine oxidase to induce oxidative stresses. Then the morphological findings of the endothelial cells were observed under the light microscope and the growth rate was analyzed with flow cytometry. To evaluate its protective effect, 0.25, 1, 10, 100microgram/ml of GtPP were administered to endothelial cells in the concentration of 2x105cells, one hour before administration of the oxidative agents, and then the cells were cultured for 24 hours. Afterwards, the morphology of endothelial cells were observed under the light microscope and the growth rate was analyzed with flow cytometry. The results are as follows: The growth of human endothelial cells were normal, and polyphenol of each concentration administered in this study did not show cytotoxicity. As a result of oxidative stress induced by H2O2 or xanthine oxidase(+0.25mM xanthine), the endothelial cell viability decreased by more than 25%, thus confirming the effects of ROS to endothelial cells. The GtPP pretreatment before H2O2 or xanthine oxidase(+0.25mM xanthine) administration, resulted significant protective effects for endothelial cells in morphology and growth rate study. Through these studies, the authors confirmed the protective effects of polyphenol against ROS. We also conceived that the polyphenol can possibly be implemented as an agent for organ or tissue preservation.
Subject(s)
Animals , Humans , Mice , Endothelial Cells , Enzyme-Linked Immunosorbent Assay , Fibroblasts , Flow Cytometry , Necrosis , Organ Transplantation , Oxidative Stress , Oxygen , Reactive Oxygen Species , Reperfusion Injury , Survival Rate , Tissue Preservation , Transplants , Xanthine , Xanthine OxidaseABSTRACT
The orbital wall resection with removal of tumor in patient who has malignant tumor in paranasal sinuses or nasal cavity causes enophthalmos, dystopia, or severe facial deformities. The methods of reconstruction of orbital wall have been used skin graft, muscular sling, parietotemporal fascial calvarial bone flap, and free flaps. The parietotemporal fascial calvarial bone flap has been used as a pedicle flap, but it can not be used in reconstruction of medial wall of the orbit because it has a short vascular pedicle. Therefore we designed the galeal-frontalis- pericranial-calvarial bone flap which is a new pedicled bone flap for reconstruction of orbital wall. We used this flap in 2 patients who have orbital wall defect following resection of malignant tumor arising from the nasal cavity or maxilla. The outcome was gratifying in all two patients. We think that this flap is a new useful method in reconstruction of the orbit.
Subject(s)
Humans , Congenital Abnormalities , Enophthalmos , Free Tissue Flaps , Maxilla , Nasal Cavity , Orbit , Paranasal Sinuses , Skin , TransplantsABSTRACT
Congenital constriction band of the trunk is a rare congenital malformation. A 14-year-old girl with a congenital circumferential constriction band around the waist is described. Seven other cases of congenital constriction band on the trunk are reviewed in the literature. This malformation is probably related to the amniotic band syndrome such as constriction band on the limbs. The surgical treatment of this constriction band was W-plasty and produced good cosmetic results.
Subject(s)
Adolescent , Female , Humans , Infant, Newborn , Amniotic Band Syndrome , Constriction , ExtremitiesABSTRACT
Fibrous dysplasia in the orbit and cranial base may involve the optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve which can then induce visual disturbance as well as contour deformities of the skull and facial bone. The treatment of fibrous dysplasia in the orbit and cranial base is to resect the lesion as much as possible and then reconstruct immediately. As well, if there is any evidence of optic canal involvement and disease progression, the treatment of fibrous dysplasia may include optic nerve decompression. It is generally understood that some patients experience improvement of visual function after optic nerve decompression. We performed radical excision and reconstruction by means of autogenous calvarial bone graft and methylmethacrylate in 7 cases. The autogenous calvarial bone was used to reconstruct the orbit. The methylmethacrylate was used to reconstruct bony defect in the temporal area. The orbit was reconstruced into one block which was made of autogenous calvarial bone with a microplate and screw. This method is superior compared to the previous multifragment wiring method with regard to stability, operation time, and appearance. The patients in our series showed satisfactory appearance. In 6 cases, we performed optic nerve decompression. Therapeutic optic nerve decompression was done in 3 cases and prophylatic optic nerve decompression was done in the others. Following therapeutic optic nerve decompression, visual acuity was improved in 2 cases while the others showed a decrease in visual acuity. There was no change of visual acuity and visual field in 1 case after prophylactic optic nerve decompression. However, the others showed decrements in visual acuity or visual field. Therefore, we believe that more attention should be paid during optic nerve decompression procedure and strict indications to that procedure should be applied.
Subject(s)
Humans , Congenital Abnormalities , Decompression , Disease Progression , Facial Bones , Methylmethacrylate , Optic Nerve , Orbit , Skull , Skull Base , Transplants , Visual Acuity , Visual FieldsABSTRACT
Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30-75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.