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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 57(11): 1808-1812, 2023 Nov 06.
Article in Chinese | MEDLINE | ID: mdl-38008570

ABSTRACT

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, which poses a serious health risk to mothers and infants. In recent years, many studies have revealed the important role of exercise in preventing GDM, regulating blood glucose and ameliorating insulin resistance, as well as its potential value as an emerging therapeutic approach in improving maternal and infant outcomes and long-term health. This review discusses the latest research progress on the effect of exercise on the prevention and treatment of GDM, aims to deepen the knowledge of exercise therapy for GDM and provides guidance and assistance for the clinical treatment of GDM.


Subject(s)
Diabetes, Gestational , Insulin Resistance , Pregnancy , Infant , Female , Humans , Diabetes, Gestational/prevention & control , Exercise , Blood Glucose
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 57(5): 771-777, 2023 May 06.
Article in Chinese | MEDLINE | ID: mdl-37165826

ABSTRACT

Gestational diabetes mellitus (GDM) is associated with an increased risk of suffering diverse adverse pregnancy outcomes, threating maternal and child health seriously, with an increasing incidence rate year by year. However, the exact cause of GDM is still unknown. Prospective cohort studies obtain data through follow-up, which is helpful to clarify the causal relationship, so as to draw more accurate and reliable conclusions. In recent years, numerous prospective cohort studies on the GDM have emerged. This article elaborates along the occurrence and development process of GDM, in order to provide useful reference for the establishment of relevant high-quality prospective cohort studies in China.


Subject(s)
Diabetes, Gestational , Pregnancy , Child , Female , Humans , Diabetes, Gestational/epidemiology , Prospective Studies , Pregnancy Outcome , Incidence , China/epidemiology , Risk Factors
3.
Oncogenesis ; 4: e159, 2015 Jun 15.
Article in English | MEDLINE | ID: mdl-26075750

ABSTRACT

Human DCTPP1 (dCTP pyrophosphatase 1), also known as XTP3-transactivated protein A, belongs to MazG-like nucleoside triphosphate pyrophosphatase (NTP-PPase) superfamily. Being a newly identified pyrophosphatase, its relevance to tumorigenesis and the mechanisms are not well investigated. In the present study, we have confirmed our previous study that DCTPP1 was significantly hyperexpressed in breast cancer and further demonstrated its strong association with tumor progression and poor prognosis in breast cancer. Knockdown of DCTPP1 in breast cancer cell line MCF-7 cells remarkably retarded proliferation and colony formation in vitro. The capacity of mammosphere formation of MCF-7 was suppressed with the silence of DCTPP1, which was consistent with the enhanced mammosphere-forming ability in DCTPP1-overexpressed MDA-MB-231 cells. To further dissect the mechanisms of DCTPP1 in promoting tumor cell growth and stemness maintenance, its biochemical properties and biological functions were investigated. DCTPP1 displayed bioactive form with tetrameric structure similar to other MazG domain-containing pyrophosphatases based on structure simulation. A substrate preference for dCTP and its methylated or halogen-modified derivatives over the other canonical (deoxy-) NTPs was demonstrated from enzymatic assay. This substrate preference was also proved in breast cancer cells that the intracellular 5-methyl-dCTP level increased in DCTPP1-deficient MCF-7 cells but decreased in DCTPP1-overexpressed MDA-MB-231 cells. Moreover, global methylation level was elevated in DCTPP1-knockdown MCF-7 cells or mammosphere-forming MCF-7 cells but decreased significantly in DCTPP1-overexpressed MDA-MB-231 cells and its mammospheres. Our results thus indicated that human DCTPP1 was capable of modulating the concentration of intracellular 5-methyl-dCTP. This in turn affected global methylation, contributing to a known phenomenon of hypomethylation related to the cancer cell growth and stemness maintenance. Our current investigations point to the pathological functions of DCTPP1 overexpression in breast cancer cells with aberrant dCTP metabolism and epigenetic modification.

4.
Genet Mol Res ; 14(2): 3234-43, 2015 Apr 13.
Article in English | MEDLINE | ID: mdl-25966089

ABSTRACT

In the present study, the complete mitochondrial (mt) genome of Cyclemys dentata was determined using PCR reactions. The structural organization and gene order of C. dentata were equivalent to those of most other vertebrates. The mt genome was 16,489 bp in length, has rich A+T content, consisting of 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes, and a control region (D-loop). All protein-coding genes started with ATG, many genes have complete stop codons, except ND2, COX3, ND3, and cyt-b genes had incomplete stop codons of T. The light-strand replication origin (OL) of C. dentata might fold into a stable stem-loop secondary structure, and its loop had 2 nt less than that of the Cyclemys atripons OL sequence. The D-Loop of C. dentata contained a central domain (CD), 2 extended termination associated sequences (ETAS1, ETAS2) and 3 conserved sequence blocks (CSB1, CSB2, CSB3). The average length of 20 turtles' mt genomes was 16,692.5 bp, including 34.1% A, 27.0% T, 26.0% C and 12.9% G. The C. dentata mitochondrial genome could provide useful data for further studies on phylogenetics and conservation genetics of this species. The phylogenetic relationships of the family Geoemydidae were analyzed by maximum-likelihood (ML) and neighbor-joining (NJ) based on concatenated sequences of 13 protein-coding genes from 20 turtle species. The ML and NJ trees had homologous topologies. The results support the existing classification of the genera of Geoemydidae, that C. dentata was a sister species of C. atripons, Pyxidea nested in Cuora, and Chinemys was synonymous with Mauremys.


Subject(s)
DNA, Mitochondrial/genetics , Genome, Mitochondrial/genetics , Phylogeny , Turtles/genetics , Animals , Base Sequence , DNA, Circular/chemistry , DNA, Circular/genetics , DNA, Mitochondrial/chemistry , DNA, Mitochondrial/classification , Gene Order , Genes, Mitochondrial/genetics , Mitochondrial Proteins/genetics , Molecular Sequence Data , Sequence Analysis, DNA , Turtles/classification
5.
Pharmacol Res ; 68(1): 16-23, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23142559

ABSTRACT

It was recently suggested that the non-neuronal cholinergic system has a regulatory role in pulmonary inflammation. We investigated this system's involvement in the control of cytokine production by the A549 human alveolar epithelial cell line. CXCL8 and acetylcholine (ACh) concentrations were measured using ELISA and LC-MS/MS, respectively. The mRNA expression of muscarinic receptor (MR) subtypes was determined using RT-PCR. In A549 cells, TNF-α increased the release of CXCL8 and ACh and the expression of the subtype 3 MR (M3R). Furthermore, TNF-α-induced CXCL8 secretion was (i) inhibited by the MR antagonist tiotropium and the M3R antagonist 4-DAMP and (ii) enhanced by the M1/M3R agonist pilocarpine and the cholinesterase inhibitor physostigmine. Taken as a whole, these results suggest that ACh release by A549 cells enhances TNF-α-induced CXCL8 secretion through activation of the M3R. Western blot analysis revealed that pilocarpine and physostigmine enhanced the TNF-α-induced phosphorylation of ERK1/2 and p38 MAPK and the degradation of IκBα. Inhibition of these pathways with specific inhibitors abrogated the pilocarpine-induced CXCL8 release. Our results suggest that the TNF-α-induced secretion of CXCL8 in A549 cells is regulated by the release of ACh, the latter's binding to the M3R and the downstream activation of NF-κB and the ERK1/2 and p38 MAPK signaling pathways. Our findings suggest that MR antagonists may have anti-inflammatory effects by preventing pro-inflammatory events driven by endogenous, non-neuronal ACh.


Subject(s)
Acetylcholine/metabolism , Interleukin-8/metabolism , Receptors, Muscarinic/genetics , Tumor Necrosis Factor-alpha/pharmacology , Cell Line, Tumor , Cholinesterase Inhibitors/pharmacology , Humans , Mitogen-Activated Protein Kinases/metabolism , NF-kappa B/metabolism , Physostigmine/pharmacology , RNA, Messenger/metabolism
6.
J Nanosci Nanotechnol ; 12(3): 2353-9, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22755058

ABSTRACT

Single-crystalline undoped and phosphrous-doped (P-doped) p-type ZnTe nanowires (NWs) were synthesized via a simple vapor transport and deposition method. Both undoped and P-doped ZnTe nanowires have zinc blende structure and uniform geometry. X-ray diffraction peaks of the P-doped ZnTe nanowires show an obvious shift toward higher diffraction angle as compared with the undoped ZnTe nanowires. X-ray photoelectron spectroscopy confirms the existence of P-dopant in the ZnTe nanowires. Field-effect transistors based on both undoped and P-doped ZnTe nanowires were fabricated and characterized. Electrical measurements demonstrated that P-doping led to an enhancement in ptype conductivity of ZnTe nanowires. A defect reaction mechanism was proposed to explain the p-type behaviors of both undoped and P-doped ZnTe nanowires.

7.
Opt Express ; 19(7): 6100-8, 2011 Mar 28.
Article in English | MEDLINE | ID: mdl-21451633

ABSTRACT

Single-crystalline ZnTe nanowires were prepared by a simple vapor transport and deposition method. Photodetectors of individual ZnTe nanowires were fabricated to study photoconductivity of the nanowires. It was observed the nanowire photodetectors show the highest visible-light photoconductive gains among all reported photodetectors based on 1D nanostructure semiconductors, including CdS, CdSe, ZnSe, etc. The high photosensitivity and relatively fast response speed are attributable to the high crystal quality of the ZnTe nanowires. These results reveal that such single-crystalline ZnTe nanowires are excellent candidates for optoelectronic applications.


Subject(s)
Colorimetry/instrumentation , Nanotubes/chemistry , Photometry/instrumentation , Tellurium/chemistry , Zinc/chemistry , Crystallization , Equipment Design , Equipment Failure Analysis , Light , Materials Testing , Nanotubes/ultrastructure
8.
ACS Nano ; 4(6): 3045-52, 2010 Jun 22.
Article in English | MEDLINE | ID: mdl-20565140

ABSTRACT

p-Type surface conductivity is a uniquely important property of hydrogen-terminated diamond surfaces. In this work, we report similar surface-dominated electrical properties in silicon nanowires (SiNWs). Significantly, we demonstrate tunable and reversible transition of p(+)-p-i-n-n(+) conductance in nominally intrinsic SiNWs via changing surface conditions, in sharp contrast to the only p-type conduction observed on diamond surfaces. On the basis of Si band energies and the electrochemical potentials of the ambient (pH value)-determined adsorbed aqueous layer, we propose an electron-transfer-dominated surface doping model, which can satisfactorily explain both diamond and silicon surface conductivity. The totality of our observations suggests that nanomaterials can be described as a core-shell structure due to their large surface-to-volume ratio. Consequently, controlling the surface or shell in the core-shell model represents a universal way to tune the properties of nanostructures, such as via surface-transfer doping, and is crucial for the development of nanostructure-based devices.


Subject(s)
Crystallization/methods , Models, Chemical , Nanostructures/chemistry , Nanostructures/ultrastructure , Nanotechnology/methods , Nanotubes/chemistry , Nanotubes/ultrastructure , Silicon/chemistry , Computer Simulation , Electric Conductivity , Macromolecular Substances/chemistry , Materials Testing , Molecular Conformation , Particle Size , Surface Properties
9.
J Nanosci Nanotechnol ; 10(4): 2360-5, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20355434

ABSTRACT

A facile hydrothermal method was adopted to in situ grow ZnO nanowire pyramidal bundle arrays on zinc substrates at low growth temperature without the assistance of catalysts and templates. The bundle arrays were shown to form by sticking of nanowires at their tips. Field electron emission characterization of nanowires bundle arrays revealed a very low turn-on electric field of about 2.3 V/microm and a threshold electric field (corresponding to the field electron emission current density of 10 mA/cm2) of 6.8 V/microm, which are comparable to those observed in carbon nanotube arrays. The bundle arrays also show pronounced long-term field electron emission stability at a high current density. In addition, the formation mechanism of the pyramidal bundled arrays and the origin of the peculiar field electron emission properties were discussed.

10.
Nanotechnology ; 20(45): 455702, 2009 Nov 11.
Article in English | MEDLINE | ID: mdl-19834241

ABSTRACT

Coaxial nanocables with a single-crystalline zinc telluride (ZnTe) nanowire core and an amorphous silicon oxide (SiO(x)) shell have been synthesized via a simple one-step chemical vapor deposition (CVD) method on gold-decorated silicon substrates. The single-crystal ZnTe nanowire core is in zinc-blende structure along the [111] direction, while the uniform SiO(x) shell fully covers the core with no observable pin-hole or crack. Formation mechanisms of the ZnTe-SiO(x) nanocables are discussed. The ZnTe nanowire core shows p-type electrical properties while the SiO(x) shell acts as an effective insulating layer. The ZnTe-SiO(x) nanocables may have potential applications in nanoscale devices, such as p-type FETs and nanosensors.

11.
Nano Lett ; 9(4): 1374-7, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19301858

ABSTRACT

Single- and few-layer graphene sheets with sizes up to 0.1 mm were fabricated by simply quenching hot graphite in an ammonium hydrogen carbonate aqueous solution. The identity and thickness of graphene sheets were characterized with transmission electron microscopy, atomic force microscopy, and Raman spectroscopy. In addition to its simplicity and scalability, the present synthesis can produce graphene sheets with excellent qualities in terms of sizes, purity, and crystal quality. The as-produced graphene sheets can be easily transferred to solid substrates for further processing. Field-effect transistors based on individual graphenes were fabricated and shown to have high ambipolar carrier mobilities.

12.
Cell Prolif ; 41(5): 775-85, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18823498

ABSTRACT

OBJECTIVES: Previously, we have found that the ClC-3 chloride channel is involved in endothelin-1 (ET-1)-induced rat aortic smooth muscle cell proliferation. The present study was to investigate the role of ClC-3 in cell cycle progression/distribution and the underlying mechanisms of proliferation. MATERIALS AND METHODS: Small interference RNA (siRNA) is used to silence ClC-3 expression. Cell proliferation, cell cycle distribution and protein expression were measured or detected with cell counting, bromodeoxyuridine (BrdU) incorporation, Western blot and flow cytometric assays respectively. RESULTS: ET-1-induced rat basilar vascular smooth muscle cell (BASMC) proliferation was parallel to a significant increase in endogenous expression of ClC-3 protein. Silence of ClC-3 by siRNA inhibited expression of ClC-3 protein, prevented an increase in BrdU incorporation and cell number induced by ET-1. Silence of ClC-3 also caused cell cycle arrest in G(0)/G(1) phase and prevented the cells' progression from G(1) to S phase. Knockdown of ClC-3 potently inhibited cyclin D1 and cyclin E expression and increased cyclin-dependent kinase inhibitors (CDKIs) p27(KIP) and p21(CIP) expression. Furthermore, ClC-3 knockdown significantly attenuated phosphorylation of Akt and glycogen synthase kinase-3beta (GSK-3beta) induced by ET-1. CONCLUSION: Silence of ClC-3 protein effectively suppressed phosphorylation of the Akt/GSK-3beta signal pathway, resulting in down-regulation of cyclin D1 and cyclin E, and up-regulation of p27(KIP) and p21(CIP). In these BASMCs, integrated effects lead to cell cycle G(1)/S arrest and inhibition of cell proliferation.


Subject(s)
Basilar Artery/cytology , Chloride Channels/metabolism , Gene Silencing , Myocytes, Smooth Muscle/cytology , Myocytes, Smooth Muscle/metabolism , S Phase , Animals , Basilar Artery/enzymology , Cell Proliferation/drug effects , Cells, Cultured , Cyclin-Dependent Kinase Inhibitor Proteins/metabolism , Cyclins/metabolism , Endothelin-1/pharmacology , Flow Cytometry , G1 Phase/drug effects , Gene Silencing/drug effects , Glycogen Synthase Kinase 3/metabolism , Glycogen Synthase Kinase 3 beta , Male , Myocytes, Smooth Muscle/drug effects , Myocytes, Smooth Muscle/enzymology , Phosphorylation/drug effects , Proto-Oncogene Proteins c-akt/metabolism , RNA, Small Interfering/metabolism , Rats , Rats, Sprague-Dawley , S Phase/drug effects , Signal Transduction/drug effects
13.
Transplant Proc ; 40(2): 570-3, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18374131

ABSTRACT

In allotransplantation, donor-recipient human leukocyte antigen (HLA) matches improve graft survival. For studies of the role of donor-recipient HLA II matching on xenotransplantation, we successfully generated HLA-DR15+ transgenic pigs the the skins of which were transplanted to SCID mice, which were thereafter reconstituted with HLA-DR15+ or -DR15(-) hPBMC. Cyclosporine was given intraperitoneally to SCID mice for 12 days. Human T cells were observed in SCID mice after reconstitution. Mixed lymphocytes responses showed greater responses by HLA-DR15(-) human peripheral blood mononuclear cells (hPBMC) against HLA-DR15+ porcine PBMC. HLA-DR15+ porcine skins survived more than 100 days in all SCID mice. HLA-DR15+ porcine skins were rejected in all non-SCID (Balb/c) mice. The histologic pictures of transplanted HLA-DR15+ porcine skins showed surviving porcine epithelium in remodeling murine dermis and little lymphocyte infiltration into the murine dermis. The long-term survival of HLA-DR15+ pig skin in all hPBMC-SCID mice might be due to poor engraftment or function of reconstituted T cells. Further studies are needed to clarify the role of donor-recipient matching of HLA-DR15.


Subject(s)
Graft Survival/immunology , HLA-DR Antigens/immunology , Leukocytes, Mononuclear/immunology , Skin Transplantation/immunology , Skin/immunology , Animals , HLA-DR Serological Subtypes , Humans , Immunosuppression Therapy , Mice , Mice, SCID , Swine
14.
Nano Lett ; 8(12): 4191-5, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19367961

ABSTRACT

Vertically aligned Mg-doped GaN nanorods have been epitaxially grown on n-type Si substrate to form a heterostructure for fabricating p-n heterojunction photovoltaic cells. The p-type GaN nanorod/n-Si heterojunction cell shows a well-defined rectifying behavior with a rectification ratio larger than 10(4) in dark. The cell has a high short-circuit photocurrent density of 7.6 mAlcm2 and energy conversion efficiency of 2.73% under AM 1.5G illumination at 100 mW/cm2. Moreover, the nanorod array may be used as an antireflection coating for solar cell applications to effectively reduce light loss due to reflection. This study provides an experimental demonstration for integrating one-dimensional nanostructure arrays with the substrate to directly fabricate heterojunction photovoltaic cells.

15.
J Plast Reconstr Aesthet Surg ; 59(4): 343-6, 2006.
Article in English | MEDLINE | ID: mdl-16756247

ABSTRACT

This paper investigates the effectiveness of the breast dissector to create a substernal space for oesophageal reconstruction. The surgeon must be extremely careful while dissecting the tissue below the sternum in order to avoid pneumothorax. The endoscopically assisted preparation of the substernal route is safe but it requires appropriate training. A retrospective study on 68 patients who underwent oesophageal reconstruction was done analysing the patients' records. In 39 cases, the breast dissector was used. In 29 cases, the substernal tunnel was created with hand dissection only. All 68 colon segments were successfully transferred in the two groups of patients. In all 39 the cases where the breast dissector was used no pneumothorax followed. In 10 (34%) patients of the control group pneumothorax occurred. Concluding, no more pneumothorax has occurred during the substernal oesophageal reconstruction since we started using the breast dissector.


Subject(s)
Colon/transplantation , Esophageal Diseases/surgery , Esophagus/surgery , Surgical Instruments , Adolescent , Adult , Aged , Child , Dissection/instrumentation , Equipment Design , Female , Humans , Male , Middle Aged , Retrospective Studies , Transplantation, Autologous
16.
Hand Clin ; 17(3): 433-45, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11599211

ABSTRACT

In replantation for avulsion amputation of the thumb, high survival rate of replanted digits depends on good debridement, good arterial repair with vein grafts or neurovascular bundles, and good coverage, with loose closure of the wound. The functional success depends on liberal use of nerve and tendon grafts or transfer; subsequent procedures, such as tenolysis and opponensplasty; and backup procedures for cases with severe soft tissue avulsion or long ischemic periods. All thumb amputations should be explored in the operating room for evaluation of replantability. If it is still questionable, an experienced microsurgeon should be consulted to choose between replantation and an alternative reconstructive procedure.


Subject(s)
Amputation, Traumatic/surgery , Replantation , Thumb/injuries , Thumb/surgery , Adolescent , Adult , Aged , Debridement , Female , Humans , Male , Middle Aged , Retrospective Studies , Surgical Flaps/blood supply
17.
Clin Plast Surg ; 28(2): 389-402, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11400832

ABSTRACT

Voice reconstruction and rehabilitation are important for quality of life for patients after surgical ablation of tumors in the larynx or pharynx. In addition to the esophageal voice, the artificial larynx, and external voice devices, the following procedures have been developed: (1) after laryngectomy with preservation of pharynx, neoglottis or TEP can be performed; (2) after laryngopharyngectomy a forearm flap with TEP, or a jejunal transfer with TEP or voice tube shunt can be selected; and (3) after laryngopharyngoesophagectomy, either pharyngogastrotomy with TEP, or colon segment interposition with TEP can be employed. The voice tube shunt is improving, and allograft transplantation is currently under investigation.


Subject(s)
Laryngectomy/rehabilitation , Larynx, Artificial , Speech, Alaryngeal , Esophagus/surgery , Humans , Jejunum/transplantation , Laryngeal Neoplasms/rehabilitation , Laryngeal Neoplasms/surgery , Pharyngeal Neoplasms/rehabilitation , Pharyngeal Neoplasms/surgery , Postoperative Complications , Surgical Flaps , Trachea/surgery
18.
Scand J Plast Reconstr Surg Hand Surg ; 34(3): 207-12, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11020916

ABSTRACT

In recent years, it has been found that maintenance of venous circulation alone may support a small flap with no direct arterial inflow. The clinical application of a venous flap has potential in the field of microsurgery. The purpose of this study was to evaluate the haemodynamics within a pedicled venous flap in rabbits, compared with those of a composite graft. Pedicled venous flaps and composite grafts were raised from the abdominal walls of 30 adult New Zealand rabbits. Flap survival was measured and recorded and blood flow studies with microspheres were done for seven days. The viability of the pedicled venous flaps was much better than that of the composite grafts. At two weeks 24 of the venous flaps (80%) showed more than 75% surviving, but 29 (97%) of the composite grafts had less than 25% surviving. The results suggest that the blood flow through a patent vein maintained in a venous skin flap can provide enough nutrients for the flap to survive during the initial three days until neovascularisation. The venous flap receives more blood flow than a composite graft. We conclude that a venous flap depends on blood supply from the axial vein in addition to neovascularisation to maintain its survival.


Subject(s)
Surgical Flaps/blood supply , Animals , Blood Flow Velocity , Graft Survival , Microcirculation , Microspheres , Rabbits , Veins
19.
Semin Surg Oncol ; 19(3): 235-45, 2000.
Article in English | MEDLINE | ID: mdl-11135480

ABSTRACT

The loss or stricture of the esophagus has a tremendous impact on daily life. Before the era of microsurgery, many patients had to rely on tube feeding from jejunostomy following failure of esophageal reconstruction with conventional methods. Since the application of microsurgery, almost all kinds of esophageal defects can be reconstructed successfully with microvascular transfer of jejunum, colon, and skin flaps. Microsurgery is also used to augment the blood supply for the pedicled colon and jejunum flaps. In 97.6% of cases, successful reconstruction has been achieved. The leakage rate and functional results are evaluated for each group. For the pharynx and cervical esophagus, jejunum is the best choice. For replacement of the thoracic esophagus, a pedicled colon flap is the first choice, but it can be supercharged with microvascular anastomoses to the neck vessels if necessary. We conclude that the microsurgical transfer of jejunum, colon, and skin flaps is a useful approach for reconstruction of the esophagus. With proper selection of the organ substitute and correct inset of the flap, it not only provides anatomical replacement, but also a superior functional result. Free jejunum flap transfer requires attention to flap length and duration of ischemia. Free colon flap transfer requires attention to arteriosclerotic changes and the vascular pattern. Free skin flaps require attention to leakage prevention. Semin. Surg. Oncol. 19:235-245, 2000.


Subject(s)
Colon/transplantation , Esophagus/surgery , Jejunum/transplantation , Microsurgery/methods , Plastic Surgery Procedures/methods , Adolescent , Adult , Aged , Child , Child, Preschool , Deglutition , Esophageal Diseases/surgery , Esophagus/pathology , Female , Humans , Larynx/surgery , Male , Middle Aged , Pharynx/surgery , Postoperative Complications , Retrospective Studies , Surgical Flaps , Treatment Outcome
20.
Ann Thorac Surg ; 67(4): 911-6, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10320227

ABSTRACT

BACKGROUND: Reconstruction of the esophagus for complicated benign stricture or after resection of malignant lesion is still a challenge for surgeons. When abdominal viscera cannot be used, skin flaps are selected for esophageal reconstruction. However, skin flaps for esophageal reconstruction are notorious for leakage, and have not been widely accepted. Prefabrication before microvascular transfer to its final site can improve the result of esophageal reconstruction when skin flaps are used. METHODS: Eight patients with complicated corrosive esophagitis had been treated with prefabricated skin flaps for esophageal reconstruction. The procedures are described in detail. RESULTS: All patients healed well without leakage. The barium study showed smooth passage. There was no dysphasia or regurgitation after education. Pulmonary complication happened in only 1 patient. Revision for the distal anastomosis was required in 1 patient due to narrowing. When the skin tube is long, the patients need water (or soup) to facilitate swallowing and occasionally use their hand to help the food passage. This method has the following advantages: (1) healing of the long suture line before transfer to withstand the intestinal juice; (2) reliable viability in the distal part of the flap, especially when an extended length of the flap is required; (3) more length of stable tissue for two-layered, tension-free anastomosis at the junction of skin and gastrointestinal mucosa to prevent leakage; and (4) the flap can be placed in the substernal position to meet the aesthetic requirement of young patients. The disadvantage was the staged operations. However, after prefabrication the transfer becomes safe and free of leakage. The overall morbidity is minimal. CONCLUSIONS: In rare situations when skin flaps are used for esophageal reconstruction, prefabrication provides advantages over conventional one-stage methods, although it needs additional procedures. This method is a combination of conventional technique and microsurgery.


Subject(s)
Esophagoplasty/methods , Surgical Flaps , Adult , Esophagitis/surgery , Fascia Lata , Female , Forearm , Humans , Male , Microcirculation , Middle Aged , Postoperative Complications , Skin
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