Search

To validate the hypothesis that the reconstruction of the missing segment of the fibula using a redundant split fibular graft after a vascularized fibular flap transfer may have a better effect on ankle function. Of the 24 head and neck cancer patients who received a free fibula flap for mandible reconstruction, 14 patients underwent the conventional method of donor site closure, in which the redundant fibular bone was discarded (Group I). Ten patients underwent longitudinal osteotomy of the redundant non-vascularized fibular portion to bridge the donor site defect (Group II). Postoperative subjective satisfaction level was evaluated with a self-constructed questionnaire in 10 parameters (ambulation with assistance, ankle instability, ankle stiffness, muscle weakness, leg edema, foot numbness, ankle pain, other sites of pain besides the ankle, and restriction to run) and the 4 voluntary motions (dorsiflexion, plantar flexion, eversion, and inversion) of both ankles were measured using a CYBEX II dynamometer. The muscle peak torque of the donor leg was significantly lower at ankle plantar flexion ( P = 0.002), eversion ( P = 0.002), and inversion ( P = 0.0002) in Group I as well as at dorsiflexion ( P = 0.031), plantar flexion ( P = 0.016), and inversion ( P = 0.002) in Group II against the contralateral non-operated leg. The muscle power was significantly greater when performing ankle eversion ( P = 0.049) in those who underwent split fibular bone reconstruction. There was no difference in the subjective satisfaction score between these two groups. The reconstruction of the donor site with a split fibular bone graft led only a slight improvement in ankle eversion. [ABSTRACT FROM AUTHOR]

Background: This study investigates the effectiveness of extracorporeal shock wave (ECSW) in ameliorating inflammatory mediator expression and neointimal formation in a rat model of vascular injury. Methods and Results: Male Sprague-Dawley rats with left carotid artery (LCA) injury induced by balloon dilatation (BD; group 1) were compared with group 2 [LCA injury plus ECSW-181 (defined as 181 total shocks given in LCA at 0.011 mJ/mm2) on day 2 post-LCA injury], and group 3 (normal controls). The rats in each group were further divided into 3 subgroups (n = 6, each) that were sacrificed on postoperative day 3, 7 and 14, respectively. The results demonstrated that, compared to groups 2 and 3, group 1 had significantly increased cellular expression of CD40, interleukin-18, and connexin 43 at each analyzed time point (all p < 0.001). Additionally, LCCA macrophage (CD68) recruitment was substantially increased in group 1 compared to groups 2 and 3 (all p < 0.001). Furthermore, LCA neointimal proliferation and media thickness were markedly higher in group 1 than in groups 2 and 3 on days 7 and 14 post-BD (all p < 0.001). Conclusions: ECSW markedly attenuates inflammatory responses, proliferation of neointima and smooth muscle cells in a rat vascular injury model. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: The fact that prognoses remain poor in patients with advanced hepatocellular carcinoma highlights the demand for suitable animal models to facilitate the development of anti-cancer medications. This study employed a relatively non-invasive approach to establish an orthotopic hepatocellular carcinoma model in immune-competent rats. This was done by ultrasound-guided implantation of cancer cells and the model was used to evaluate the therapeutic efficacy of short-term and low-dose epirubicin chemotherapy. Methods: Rat Novikoff hepatoma cells were injected percutaneously into the liver lobes of Sprague-Dawley rats under the guidance of high resolution ultrasound. The implantation rate and the correlation between dissected and ultrasound-measured tumor sizes were evaluated. A similar induction procedure was performed by means of laparotomy in a different group of rats. Pairs of tumor measurement were compared by ultrasound and computerized tomography scan. Rats with a successful establishment of the tumor were divided into the treatment (7-day low-dose epirubicin) group and the control group. The tumor sizes were non-invasively monitored by the same ultrasound machine. Blood and tumor tissues from tumor-bearing rats were examined by biochemical and histological analysis respectively. Results: Ultrasound-guided implantation of Novikoff hepatoma cells led to the formation of orthotopic hepatocellular carcinoma in 60.4% (55/91) of the Sprague-Dawley rats. Moreover, tumor sizes measured by ultrasound significantly correlated with those measured by calipers after sacrificing the animals (P < 0.00001). The rate of tumor induction by ultrasound-guided implantation was comparable to that of laparotomy (55/91, 60.4% vs. 39/52, 75%) and no significant difference in sizes of tumor was noted between the two groups. There was a significant correlation in tumor size measurement by ultrasound and computerized tomography scan. In tumorbearing rats, short-term and low-dose epirubicin chemotherapy caused a significant reduction in tumor growth, and was found to be associated with enhanced apoptosis and attenuated proliferation as well as a decrease in the microvessel density in tumors. Conclusions: Ultrasound-guided implantation of Novikoff hepatoma cells is an effective means of establishing orthotopic hepatocellular carcinoma in Sprague-Dawley rats. Short-term and low-dose epirubicin chemotherapy had perturbed tumor progression by inducing apoptosis and neovascularization blockade. [ABSTRACT FROM AUTHOR]

Background: We investigated whether early combined autologous adipose-derived mesenchymal stem cell (ADMSC) and sildenafil therapy offers an additive benefit in preserving heart function in rat dilated cardiomyopathy (DCM). Methods: Adult Lewis rats (n = 8 per group) were divided into group 1 (normal control), group 2 (saline-treated DCM rats), group 3 [2.0 x 106 ADMSC implanted into left ventricular (LV) myocardium of DCM rats], group 4 (DCM rats with sildenafil 30 mg/kg/day, orally), and group 5 (DCM rats with combined ADMSC-sildenafil). Treatment was started 1 week after DCM induction and the rats were sacrificed on day 90. Results: The results showed that mitochondrial protein expressions of connexin43 and cytochrome-C were lowest in group 2, and lower in groups 3 and 4 than in group 5 (p < 0.002). Conversely, oxidative index was highest in group 2, and also higher in groups 3 and 4 than in group 5 (p < 0.0003). The mRNA expressions of interleukin (IL)- 10, Gro/IL-8, endothelial nitric oxide synthase, and Bcl-2 were lowest in group 2, and lower in groups 3 and 4 compared with group 5 (p < 0.0001). The mRNA expressions of matrix metalloproteinase-9, Bax, caspase 3, and stromal-cell derived factor-1α were highest in group 2, and higher in groups 3 and 4 than in group 5 (p < 0.0004). Apoptosis and fibrosis in LV myocardium were most prominent in group 2 and higher in groups 3 and 4 than in group 5, whereas angiogenesis and LV ejection fraction were lowest in group 2 and lower in groups 3 and 4 than in group 5 (p < 0.003). Conclusion: Early combined ADMSC/sildenafil is superior to either treatment alone in preserving LV function. [ABSTRACT FROM AUTHOR]

Background: The therapeutic effect of adipose-derived mesenchymal stem cells (ADMSCs) on brain infarction area (BIA) and neurological status in a rat model of acute ischemic stroke (IS) was investigated. Methods: Adult male Sprague-Dawley (SD) rats (n = 30) were divided into IS plus intra-venous 1 mL saline (at 0, 12 and 24 h after IS induction) (control group) and IS plus intra-venous ADMSCs (2.0 x 106) (treated interval as controls) (treatment group) after occlusion of distal left internal carotid artery. The rats were sacrificed and brain tissues were harvested on day 21 after the procedure. Results: The results showed that BIA was larger in control group than in treatment group (p < 0.001). The sensorimotor functional test (Corner test) identified a higher frequency of turning movement to left in control group than in treatment group (p < 0.05). mRNA expressions of Bax, caspase 3, interleukin (IL)-18, toll-like receptor-4 and plasminogen activator inhibitor-1 were higher, whereas Bcl-2 and IL-8/Gro were lower in control group than in treatment group (all p < 0.05). Western blot demonstrated a lower CXCR4 and stromal-cell derived factor-1 (SDF-1) in control group than in treatment group (all p < 0.01). Immunohistofluorescent staining showed lower expressions of CXCR4, SDF-1, von Willebran factor and doublecortin, whereas the number of apoptotic nuclei on TUNEL assay was higher in control group than in treatment group (all p < 0.001). Immunohistochemical staining showed that cellular proliferation and number of small vessels were lower but glial fibrillary acid protein was higher in control group than in treatment group (all p < 0.01). Conclusions: ADMSC therapy significantly limited BIA and improved sensorimotor dysfunction after acute IS. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the hypothesis that acute myocardial infarction (AMI) induces cellular apoptosis and serial changes of protein kinase C epsilon and p38 mitogen-activated protein kinase. A total of 72 adult make Sprague-Dawley rats were used in the study. Results showed that three AMI with losartan-treated rats died during the study period. In addition, there was no significant differences for initial left ventricular end-diastolic dimension and initial left ventricular end-systolic dimension.

Abstract  A 41-year-old female suffered from epigastralgia and intermittent constipation for 10 months, and abdominal fullness and intermittent pain for 6 months, before seeking help. Double contrast barium study of the colon showed multiple indentations on the sigmoid, ascending, and proximal transverse portions with tethered adjacent mucosal outline as well as the presence of ascites compatible with peritoneal carcinomatosis. Mediolateral oblique mammogram showed a speculated mass with some intratumoral microcalcifications in the upper retroareolar portion of the right breast. Due to the persistent abdominal complaints, laparotomy was done. Breast lump biopsy was done simultaneously. On opening abdominal cavity, massive yellowish ascites was noted. Diffuse small nodules over omentum and mesentery retraction were found. Bilateral ovarian masses were also noted. Right oophorectomy and omentectomy were performed. Histologic findings and results of immunohistochemical stains were consistent with diagnosis of primary breast cancer with metastasis to ovary and omentum. [ABSTRACT FROM AUTHOR]

Abstract  A 68-year-old women was admitted with the chief complaints of epigastralgia with radiation to the back and jaundice. Fever and chills were also noted. The laboratory data showed alkaline phosphatase, 245 U/L (normal range: 28–94); Direct Bilirubin, 5.29 mg% (0–0.4); Total Bilirubin, 8.4 mg% (0.2–1.4). Surprisingly, the serum CA19-9 was 5673.8 U/ml (normal value: [ABSTRACT FROM AUTHOR]

A continuing education unit multiple-choice test for laboratory studies is presented on the subject of accuracy in optical platelet counts and microcytic anemia.

Background We hypothesized that combined therapy with shock wave (SW) and autologous bone marrow-derived mesenchymal stem cells (BMDMSCs) is superior to either therapy alone for alleviating left ventricular (LV) dysfunction. Methods and results Male mini-pigs (n = 30) equally divided into group 1 (sham control), group 2 [acute myocardial infarction (AMI) by left coronary artery ligation], group 3 (AMI-SW), group 4 (AMI-BMDMSC), and group 5 (AMI-SW-BMDMSC) were sacrificed by day 60 and the hearts were collected for studies. Baseline LV injection fraction [LVEF (%)] and LV chamber size did not differ among the five groups (p > 0.5). By day 60, LVEF was highest in group 1 and lowest in group 2, significantly higher in group 5 than that in groups 3 and 4, and significantly higher in group 4 than that in group 3 (p < 0.001). Cellular and protein levels of VEGF, CXCR4, and SDF-1a were significantly increased progressively from groups 1 to 5 (all p < 0.05). Small vessel number and protein expressions of CD31 and eNOS were highest in groups 1 and 5, lowest in group 2, and significantly higher in group 4 than those in group 3 (p < 0.001). Protein (MMP-9, TNF-1a and NF-?B) and cellular (CD14 +, CD40 +) levels of inflammatory biomarkers, protein expressions of oxidative stress (oxidized protein, NOX-1, NOX-2), apoptosis (Bax, caspase-3, PARP), infarct size, and LV dimensions showed a pattern opposite to that of LVEF among all groups (all p < 0.001). Conclusions Combined SW-BMDMSC therapy is superior to either therapy alone for improving LVEF, reducing infarct size, and inhibiting LV remodeling. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the correlation between carotenoid content variation and vascular health after providing young adults with compound nutritional supplements. The young adults were divided into two groups: Group 1 comprised participants whose body mass index (BMI) ≦ 25 (n = 10), and Group 2 comprised participants whose BMI > 25 (n = 8). A non-invasive Biophotonic Scanner was used to measure the participants' skin carotenoid count (SCC) values, and other instruments were used to measure their pulse wave velocity (PWVfoot) and dilatation index (DI) as indicators of vascular health. Part A study required the participants to maintain their original eating habits for 3 months. The resulting SCC, PWVfoot, and DI values of the two groups exhibited no significant statistical differences. In Part B study, the participants consumed a fixed amount of compound nutritional supplements daily to increase carotenoids. After 1 month, the SCC and DI values of Group 1 showed a significant increase, and the PWVfoot values exhibited statistical differences. In conclusion, when young adults follow their original eating habits and lifestyle, their SCC counts do not vary significantly and vascular health does not improve. Moreover, the SCC count in young adults with a BMI < 25 can be increased through compound nutritional supplement intake, thus improving vascular health. [ABSTRACT FROM AUTHOR]

Background aims. We tested the hypothesis that sitagliptin is capable of increasing blood flow in the rat critical limb ischemia (CU) model by enhancement of angiogenesis. Methods. Adipose tissue from adult-male Fischer 344 rats (n = 6) were cultured in endothelial progenitor cell culture medium for 14 d with (25 μmol/L) or without sitagliptin. CLI was induced by ligation of the left femoral artery. Rats (n = 32) were equally separated into four groups: untreated controls (group 1), sitagliptin (4 mg/kg per day; group 2), CLI (group 3) and CLI with sitagliptin (group 4). Results. In vitro, 7 and 14 d after cell culture, endothelial progenitor cell biomarkers assessed by flow cytometry (Sca-l/CD31+, CXCR4+, c-kit+ and CD34+ cells) and Western blot (vascular endothelial growth factor, CXCR4 and stromal-derived factor [SDF]-1α) were remarkably higher in group 4 than in the other groups (all P < 0.01). In vivo, 2 and 14 d after the CLI procedure, circulating angiogenic cell (Sca-1/CD31+, Sca-l+ and CD31+) numbers were significantly higher in group 4 than in the other groups (all P < 0.00 1). Additionally, the messenger RNA and protein expression of angiogenic biomarkers (CXCR4, SDF-1α and vascular endothelial growth factor), immunofluorescent staining of angiogenic cells (CXCR4+, SDF-1α+, CD3 1+, von Willebrand factor + cells) and immunohistochemical staining of small vessel numbers in the ischemic area were significantly higher in group 4 than in the other groups (all P < 0.01). Furthermore, laser Doppler showed that the ratio of ischemic/normal blood flow was remarkably higher group 4 than in group 3 by days 14 and 28 after the CLI procedure (all P < 0.01). Conclusions. Sitagliptin therapy enhances circulating angiogenic cell numbers, angiogenesis and blood flow in the CLI area. [ABSTRACT FROM AUTHOR]

This study aimed at observing the relationship between carotenoids status, parameters of metabolic syndrome, and vascular health prior to changing their dietary condition, i.e. eating out. This study consisted of two parts. In Part A study, the skin carotenoids counts (SCC) of three different groups, Group 1: young people (n=20), Group 2: upper mid-aged people (n=14), and Group 3: diabetics (n=17), were obtained and compared. Although Group 1 appeared to be the youngest, the SCC was much lower than that of Group 2 (19619±11147 vs. 32571± 4351) but close to that of Group 3 (18974±9089). As far as vascular health was concerned, it was not statistically different between Group 1 and Group 2. In Part B study, SCC, pulse wave velocity (PWVfoot), and dilatation index (DI) of healthy young subjects (Group 4, n=14) were measured for three consecutive months with their dietary condition remaining unchanged. Although there was no significant difference between the abovementioned values, the SCC were still significantly correlated with the parameters of metabolic syndrome factor and PWVfoot (r=-0.435, P=0.001). With their dietary condition remaining unchanged for three consecutive months, Group 4 exhibited no significant improvement in either the SCC or parameters of vascular health. [ABSTRACT FROM AUTHOR]

Background aims. We hypothesized that the long-term therapeutic effect of combined sildenafil and bone marrow-derived endothelial progenitor cells (BMDEPCs) on monocrotaline (MCT)-induced rat pulmonary arterial hypertension (PAH) is superior to either treatment alone. Methods. Male Sprague-Dawley rats (n = 40) were equally divided into normal controls, MCT (65 mg/kg, subcutaneously) only, MCT + sildenafil (25 mg/kg/day, orally), MCT + BMDEPCs (2.0 × 106 autologous cells, intravenously) and MCT + sildenafil+ BMDEPCs. BMDEPCs and sildenafil were given on day 21 after MCT administration. Animals were sacrificed by day 90 after MCT administration. Results. The apoptotic (caspase 3, Bax) and inflammatory (tumor necrosis factor-α, matrix metalloproteinase-9) biomarkers in right ventricle and lung and pulmonary expressions of fibrotic biomarkers (transforming growth factor-β, p-Smad3) and connexin 43 protein were lower in monotherapy groups (i.e., MCT + sildenafil and MCT + BMDEPCs) and further decreased in normal controls and combined treatment groups (i.e., MCT + sildenafil + BMDEPCs) compared with untreated animals (i.e., MCT only) (all P < 0.01). Expressions of anti-fibrotic biomarkers (bone morphogenetic protein-2, p-Smad l/5) and numbers of alveolar sacs and arterioles in lung were higher in monotherapy groups and further increased in normal controls and combined treatment groups compared with untreated animals (all P < 0.005). In right ventricle, connexin 43 and α-myosin heavy chain (MHC) expressions were higher in the monotherapy groups and further elevated in normal controls and combined treatment groups compared with untreated animals, whereas β-MHC exhibited the opposite pattern (all P < 0.01). Right ventricular systolic pressure and weight were lower in the monotherapy animals and further reduced in normal controls and combined treatment groups compared with untreated animals (all P < 0.0001). Conclusions. Combined therapy with BMDEPCs and sildenafil was superior to either treatment alone in attenuating rodent MCT-induced PAH. [ABSTRACT FROM AUTHOR]

The article describes the case of a 53-year-old man with a history of poorly controlled diabetes who sent to the emergency department due to syncope with 10-minute disturbance. Topics discussed include hypotheses on diabetic striatopathy (DS)-associated striatal abnormalities on neuroimaging, pathology reports revealing evidence of haemorrhage, and factors that made microhaemorrhage a probability.