Transduction of rabbit saphenous artery: a comparison of naked DNA, liposome complexes, and adenovirus vectors.

The methods and efficiency of gene transfer into rabbit saphenous artery were examined in this study. The purpose was to develop an animal model capable of evaluating the use of angiogenic gene therapy to revascularize necrotic bone more rapidly and completely than by surgical implantation of blood vessels alone. The success of transduction using adenovirus vectors, liposome/DNA complexes, and naked DNA was evaluated with delivery to both intra-luminal and adventitial sites. Intra-luminal and adventitial (extra-luminal) application was used for the viral and liposome methods. Naked DNA was evaluated only in the intra-luminal site, based upon previous reports. Relative transduction success was expressed as the percentage of total cells with beta-galactosidase activity. A 20-mm length of saphenous artery exposed surgically was targeted for lacZ gene transfer. Two days after transduction, the arteries were harvested and stained with X-gal for beta-galactosidase activity. The percentage of endothelial, media and adventitial cells with beta-galactosidase activity was determined. Intra-arterial injection of adenovirus vector transduced the largest amount of cells in all three areas of the vessel (endothelium, media and adventitia). The adenovirus vectors when applied to the adventitia only transduced adventitial cells. Following intra-arterial injection of liposome/DNA complexes transduction was detected only in endothelium. Extra-luminal liposome and intra-arterial naked DNA delivery resulted in no detectable gene transfer. Intra-arterial delivery of an adenovirus vector would likely provide optimal gene transfer for possible angiogenic gene therapy.

Extensor pollicis longus tenosynovitis mimicking de Quervain's disease because of its course through the first extensor compartment: a report of 2 cases.

We present 2 cases of extensor pollicis longus tenosynovitis caused by the unusual course of the extensor pollicis longus tendon. The extensor pollicis longus tendon passed through the first extensor compartment and was constricted severely. The symptoms were similar to those of de Quervain's disease. The clinical presentation, diagnosis, and surgical technique of this very rare anatomic condition are discussed.

Pedicle or free musculocutaneous flaps for shoulder defects after oncological resection.

Management of soft-tissue defects of the shoulder is described. Extensive defects of soft tissues with or without overlying skin were created after resection of sarcomas in five patients. Reconstruction was performed using musculocutaneous flaps, which included three pedicle latissimus dorsi and two free tensor fascia lata flaps. Simultaneous functioning replacement of the defects of the trapezius and deltoid muscles were each achieved in two patients. Primary wound healing was achieved, and each patient recovered good contour of the shoulder. Functional results were satisfactory in all patients with an average score of 93.4% (range, 83%-100%) using the system of the Musculoskeletal Tumor Society. The four functioning muscles recovered active contraction in the transferred position. The shoulder elevation was normal in three patients, and was 90 degrees and 30 degrees in one patient each. All patients remained disease-free at the time of latest follow-up. Thus, shoulder defects of the soft tissues can be managed appropriately with the two representative musculocutaneous flaps.