[The effect of adipose-derived stem cells on viability of random pattern skin flap in rabbits].

OBJECTIVE: To explore the effect of the adipose derived stem cells (ADSCs) on the survival of random pattern skin flap in rabbits. METHODS: ADSCs were isolated from fresh human fat and expanded in vitro for five passages. Then the characterization of ADSCs were determined by their CD marker profile and their ability to differentiate into osteogenic, adipogenic and chondrogenic lineages. On the back of the rabbits, two symmetric cephalic-based random pattern skin flaps were designed (6 cm x 2 cm). The right flaps were used as experimental groups with the contra-side flaps as control group. Human ADSCs were pre-labeled before seeding with fluorescent 3, 30-dioctadecyloxacarbocyanine perchlorate (DiO) dye. The experimental flaps evenly received 5-point injection of 2 x 10(6)Dio-labeled ADSCs resuspended in 0.5 ml of serum-free DMEM, while only 0.5 ml medium was injected into the control flaps. Seven days later, the survival rate of flaps was evaluated. The flaps underwent frozen section and were observed under the laser scanning confocal microscope to detect the fluorescence imaging. Flaps also underwent HE staining and were observed under light microscope to detect the vascular density. RESULTS: Compared with control group, there was a significant increase of flap survival rate in the experimental group (P < 0.01). Histological analysis also demonstrated a statistically significant increase in capillary density in the experimental group. CONCLUSIONS: It suggests that ADSCs have a better immune compatibility and potential for enhancing the blood supply of random pattern skin flaps.

[Evaluation of the role of serum vascular endothelial growth factor and urinary basic fibroblast growth factor in differential diagnosis of vascular anomalies].

OBJECTIVE: To evaluate the role of serum vascular endothelial growth factor (VEGF) and urine basic fibroblast growth factor (bFGF) in the differential diagnosis of vascular anomalies by receiver operating characteristic curve. METHODS: Using the method of enzyme linked immunosorbent assay (ELISA), 364 cases of various vascular anomalies (proliferating hemangiomas, n = 146; hemangiomas, n = 106; vascular malformations, n = 112) and 440 cases of various vascular anomalies (proliferating hemangiomas, n = 154; involuting hemangiomas, n = 148; vascular malformations, n = 138) subjects were examined for the serum levels of VEGF and the urine bFGF respectively. Nonparametric statistical tests were used for data analysis. The VEGF levels of proliferating hemangioma, involuting hemangioma, vascular malformation and control groups were analyzed by the Kruskal-Wallis test. When there was significance (P < 0.05), a subgroup analysis was performed by the Mann-Whitney U test. A receiver operator characteristic (ROC) curve was constructed for both the serum levels of VEGF and urine bFGF to determine the optimal diagnostic cut-off to differentiate proliferating hemangioma from involuting hemangioma, vascular malformation and controls. RESULTS: The serum level of VEGF and the urine bFGF in proliferating hemangiomas were significantly higher than those in involuting hemangiomas, vascular malformations and negative controls (P < 0.01). And the differences among the latter three groups were not statistically significant (P > 0.05). The optimal diagnostic cut-off point of serum VEGF and urine bFGF to differentiate proliferating hemangioma from involuting hemangioma, vascular malformation and controls was 99.6 pg/mg and 0.16 ng/mmol respectively. The area under ROC curve, the sensitivity and specificity were 99.7%, 99.3%, 99.7% and 91.9%, 98.7%, 71.1% respectively. The differences of the area under ROC curve of serum VEGF and urine bFGF showed no statistical significance (P > 0.05). CONCLUSION: Serum VEGF and urine bFGF are helpful for differentiating proliferating hemangioma from involuting hemangioma, vascular malformation and controls. Both parameters have higher values of clinical application.

[Experience of vaginal reconstruction by using a pudendal-thigh island flaps].

OBJECTIVE: To evaluate a pudendal-thigh island flap for vaginal reconstruction. METHODS: Forty-seven patients with congenital absence of vagina were undergoing the treatment. Based on the pedicle including the posterior labial neurovascular bundle, a pudendal-thigh island flap was designed and raised in the groin crease just lateral to the labia majora under the deep fascia. It was then transferred to the tunnel between the urethra and the anus for reconstruction of the vagina. RESULTS: From May of 1993 to July of 2001, 47 patients were successfully treated for the vaginal reconstruction with the flap. The results were satisfactory without complications. CONCLUSION: The above mentioned technique could be a safe and effect method for vaginal reconstruction with the advantages of reliable blood supply, good sensation and few complications. The areaes with the bilateral pudendal-thigh could be large enongh for the vaginal reconstruction without problem of the donor closure.