RESUMEN
Adequate circulation is indispensable for flap survival. Ischemia-reperfusion injury is one of the causes of flap necrosis. Current evidence suggests that tissue damage associated with ischemia-reperfusion injury and inflammatory responses may be mediated by oxygen free radicals and neutrophils. Oxygen free radicals can directly alter structural component of tissue, attack membrane phospholipids and produce the chemotactic factor for neutrophil which is main cell in inflammatory reactions and an important source of oxygen free radicals. Deferoxamine is well known as a powerful chelator of iron and free radical scavenger. It is also known to decrease the skin flap necrosis. The purpose of this study is to evaluate the effects of deferoxamine on the oxygen free radicals and neutrophils after ischemia-reperfusion injury of skin flaps. A 6 x 3 cm sized island skin flap was made on the left abdomen of rat and the epigastric pedicle was occluded for 6 hours. Thirty minutes before reperfusion, the flaps were perfused with normal saline or deferoxamine. The flap survival rates were assessed by computerized planimetry on the fifth day after reperfusion. Tissues for assay of MDA and MPO were obtained at 6, 12, 24, 48 hours after reperfusion. The results were as follows: 1. Deferoxamine administration groups improved flap survival rates significantly compared to control groups (78.3+/-13.2%, 54.6+/-6.35%) (p = 0.0011). 2. The level of MDA was significantly lowered in deferoxamine administration groups compared to control groups(p<0.05). The levels of MDA were increased over time in each group but, the ircrement was steeper in control groups than that in deferoxamine administration groups. In control groups, the increment between 6 and 12 hours was argest. 3. MPO content was increased over time in each group but significantly low in deferoxamine administration groups compared to control groups(p<0.05). The increment of control groups was steeper than that of deferoxamine administration groups. We conclude that deferoxamine improve the flap survival rates after reperfusion injury by inhibition of production of oxygen free radicals and neutrophil influx via a free radical scavenger 8 anti-inflammatory action.
Asunto(s)
Animales , Ratas , Abdomen , Deferoxamina , Radicales Libres , Hierro , Membranas , Necrosis , Neutrófilos , Oxígeno , Fosfolípidos , Reperfusión , Daño por Reperfusión , Piel , Tasa de SupervivenciaRESUMEN
Basal cell carcinoma is the most common skin cancer, especially on the eyelid and nose. As it rarely invades to a underlying bone or metastasizes an distant site, and is usually found at an early stage, it is regarded as a curative disease. However, basal cell carcinoma on the eyelid and nose may be resected incompletely due to efforts to preserve important structures or as a result of esthetic considerations. We experienced two cases of basal cell carcinoma with local invasion to underlying bone. One was a recurred case on the nasal area extending to the nasal bone arts medial wall of the ethmoid sinus. The lesion was widely resected and covered with a radial forearm free flap. The other was on the eyelid extending to the orbit. It was treated with orbital exenteration and resection of the involved eyelid. The defect was reconstructed with the temporalis muscle flap with split-thickness skin graft. These patients were followed up for 7 months with no evidence of recurrence. Since basal cell carcinoma can invade to the bone and metastasize to a distance site, it should be resected radically in the regions of the eyelid and nose.
Asunto(s)
Humanos , Carcinoma Basocelular , Senos Etmoidales , Párpados , Antebrazo , Colgajos Tisulares Libres , Hueso Nasal , Nariz , Órbita , Recurrencia , Piel , Neoplasias Cutáneas , TrasplantesRESUMEN
We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans.
Asunto(s)
Animales , Humanos , Conejos , Callo Óseo , Fracturas Abiertas , Seno Maxilar , Modelos Animales , Membrana Mucosa , Nueva Zelanda , Órbita , Polietileno , Regeneración , Siliconas , Fijación del Tejido , Trasplantes , Cicatrización de HeridasRESUMEN
Breast cancer is one of the leading causes of death attributable to cancer in women. In view of the limitations of conventional predictable factors of the breast cancer, additional second-generation parameters would be valuable in selecting the patients who would be most likely to be beneficial from adjuvant therapy and breast reconstruction. The author investigated the HER2/neu gene amplification and the number of chromosome 17 in 39 cases of paraffin embedded breast cancer tissues, 20 cases without lymph node metastasis and 19 cases with lymph node metastasis, using fluorescent in situ hybridization(FISH) and compared the results with HER2/neu and p 53 protein expression detected by immunohistochemical method. Eleven cases fibroadenoma were used as benign tumor control. Numerical aberrations of chromosome 17 were found in 17 out 39 breast cancer cases (44%)(monosomy in 10 cases, 26%; trisomy in 3 cases, 8%; tetrasomy in 3 cases, 8%; polysomy in 1 case ,3%), and the frequency of each type aberration was not significantly different between the negative and positive groups in lymph node metastasis. Monosomy of chromosome 17 was found in 2 out of 11(12%) fibroadenoma cases. HER2/neu gene amplification was found in 8 out of 39 cases (19%) and other 2 cases revealed HER2/neu gene amplification in lymph node metastatic tumor only, not in original tumor. Fourteen out of 19 cases of breast cancer with lymph metastasis showed HER2/neu protein expression both in original and metastatic tumors. All of the six cases showing HER2/neu gene amplification in original and/or metastatic tumor revealed HER2/neu protein expression. The frequency of HER2/neu gene amplification in the 39 breast cancer cases was not different between metastatic and non-metastatic groups(p= 0.284). However, HER2/neu protein expression was increased significantly in the metastatic group(p=0.028). None of the 11 fibroadenoma cases revealed HER2/neu gene amplification or HER2/ neu protein expression. Nine out of 19 cases of breast cancer with lymph node metastasis showed p 53 protein accumulation in original tumor(47%), but 3 of them revealed p 53 protein accumulation only in original tumor. The frequency of p 53 protein accumulation was not significantly different between metastatic and non-metastatic groups. None of the 11 fibroadenoma cases revealed p 53 protein accumulation. In conclusion, there are no differences between the lymph node metastatic group and non-metastatic groups in numerical aberrations of the chromosome 17 , amplification of the HER2/neu gene expression and accumulation of the p 53 protein in breast cancer. However, the HER2/neu protein expression was increased significantly in lymph node metastatic group, so it could be one of the predictors of the metastasis in breast cancer.
Asunto(s)
Femenino , Humanos , Neoplasias de la Mama , Mama , Causas de Muerte , Cromosomas Humanos Par 17 , Fibroadenoma , Amplificación de Genes , Expresión Génica , Ganglios Linfáticos , Mamoplastia , Monosomía , Metástasis de la Neoplasia , Parafina , Tetrasomía , TrisomíaRESUMEN
Dermatofibrosarcoma protuberans (DFSP) is a rare, distinctive cutaneous tumor, which consists of spindle shaped ceils arranged in densely packed interlacing bundles with the storiform or cartwheel pattern. Histologically, it resembles deep growing dermatofibroma, nodular fasciitis, neurofibroma and neural sheath tumors. DFSP is one of t.he connective tissue tumors which is difficult. to diagnose histologically as well as clinically. Recently, the immunochemical staining with a monoclonal antibody to CD34 is reported to give assistance in the clear differential diagnosis of DFSP from other fibrous or neural tumors. Herein, three cases of DFSP were stained by immunohistochemical staining with S-100 protein, vimentin, factor VIII and anti-CD34 antibody in order to assess the use of anti-CD34 in the differential diagnosis of DFSP.
Asunto(s)
Tejido Conectivo , Dermatofibrosarcoma , Diagnóstico Diferencial , Factor VIII , Fascitis , Histiocitoma Fibroso Benigno , Neurofibroma , Proteínas S100 , VimentinaRESUMEN
No abstract available.