Duchenne muscular dystrophy (DMD) is a fatal, genetic neuromuscular disorders that manifests as progressive muscle wasting. Although there has been enormous progress in the studies of the molecular mechanism of muscular dystrophy, there is still no cure. Cell-based therapy is a promiseful option. This review will focus on the present status of cell-based therapy. Myoblast transfer therapy is hindered by minimal distribution of cells after injection, immune rejection, and poor cell survival. The drawback of bone marrow-derived stem cell transplantation is the low efficiency of transdifferentiation. Compared with them, the injection of postnatal muscle-derived stem cells (MDSC) results in a superior regeneration of dystrophin-expressing myofibers.
Animals ; Bone Marrow Cells ; cytology ; Humans ; Muscle, Skeletal ; cytology ; Muscular Dystrophy, Duchenne ; therapy ; Myoblasts, Skeletal ; transplantation ; Stem Cell Transplantation ; methods

OBJECTIVETo design an animal model for the reconstruction of penile erectile function with segmental gracilis musculocutaneous flap.

METHODSThe rabbit gracilis muscle was split longitudinally into two approximately equal halves completely according to the principles of muscle compartmentalization. An animal model was designed for the reconstruction of erectile function with segmental musculocutaneous flap based on the anterior gracilis muscle bundle, with a silicone stick implanted as a supporter. A multi-channel physiological signal acquisition and processing system were used to stimulate the reconstructed penis and its CMAP was measured synchronously.

RESULTSWhen its nerve was electric stimulated, the muscle bundle contracted, which made the reconstructed penis moving accordingly. It satisfactorily simulated the way of a normal penis's erection.

CONCLUSIONSThe reconstructed penis with rabbit segmental gracilis musculocutaneous flap according to the principles of muscle compartmentalization has achieved the erectile function satisfactorily. It has met the requirements of both improving reconstructive penis's appearance and retaining muscle' s contractive function.

Animals ; Male ; Muscle, Skeletal ; transplantation ; Penile Erection ; Penis ; surgery ; Rabbits ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thigh

OBJECTIVEThe traditional gracilis musculocutaneous flap is supplied by a branch of deep femoral artery, which enters the muscle in between the upper and middle third of it. So the flap barely reaches the pelvis and perineum region for reconstruction. By exploring the blood supply pattern we tried to rotate the flap Upon at the higher point starting at the obturator foramen in order to let it cover a bigger area.

METHODSanatomical reviewing of the blood supply of the gracilis branches of obturator, medial femoral circumflex and deep femoral arteries. Based on this a new type of longitudinal gracilis musculocutaneous flap supported only by the obturator artery was designed to reach the pelvis, female genitalia, pubic symphysis, inguinal area easily.

RESULTSThe new kind of flap has been applied to 9 patients for deformity repairing and tissue replacement in the pelvic and perineal area. All the flaps survived and achieved satisfactory result with 3 months to 3 years' follow up.

CONCLUSIONSLongitudinal gracilis musculocutaneous flaps supplied by the obturator artery can be used as regular musculocutaneous flap clinically.

Female ; Femoral Artery ; surgery ; Humans ; Muscle, Skeletal ; blood supply ; transplantation ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the design, procedures and effect of latissimus dorsi-myocutaneous flap (LDMF) for breast reconstruction.

METHODSFrom May, 2005 to April, 2006, 18 consecutive patients underwent breast reconstruction with LDMF. Combined breast implants were also inserted in 8 of the 18 cases. The procedure duration, complication and aesthetic results were assessed.

RESULTSThe mean procedure duration was 147 minutes. There was no flap loss and no severe complications. The reconstructed breast was a little over high in one patient. All the other 17 patients (94.4%) were very satisfied with the aesthetic result.

CONCLUSIONSLDMF or a combination of LDMF with breast implants is a reliable method for breast reconstruction with low complication. The procedure is easily performed with good aesthetic result.

Adult ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Muscle, Skeletal ; transplantation ; Surgical Flaps

OBJECTIVETo reconstruct a simpler and reliable composite tissue transplantation model-the femur osteomyocutaneous flap for the replacement of hindlimb transplantation.

METHODSTen femur osteomyocutaneous flaps from 5 Lewis rats were transplanted into 10 syngeneic recipients' inguinal region. Their nutrient vessels were anastomosed with recipients vessels. The graft of this model was consisted of the groin flap and partial femur. To verify the feasibility of this model, gross and histological appearance were studied after transplantation to evaluate the viability of grafts.

RESULTSThe operative time was (159.0 +/- 8.3) min with the harvesting time of (68.0 +/- 4.8) min and the ischemia time of (55. 8 +/- 6.8) min. The methylene blue injection showed rich blood supply of transplanted femur osteomyocutaneous flap. All the 10 flaps survived completely with pink skin color and hair regrowth. The histologic examination of the flaps also revealed the normal appearance of the viable skin and bone marrow.

CONCLUSIONSThe femur osteomyocutaneous flap is a simple and reliable model for composite tissue transplantation, and its establishment will provide a new tool for the study of composite tissue allografts.

Animals ; Bone Transplantation ; Femur ; transplantation ; Male ; Models, Animal ; Muscle, Skeletal ; transplantation ; Rats ; Rats, Inbred Lew ; Skin Transplantation ; Surgical Flaps ; Tissue Transplantation

OBJECTIVETo evaluate the effect of insular pectoralis major myocutaneous flap on repair of jaw and neck tissue defect as a result of high-voltage electric burn.

METHODSEighteen patients with large area tissue defect in jaw and neck caused by high-voltage electric burn hospitalized from August 2001 to December 2007 were repaired with insular pectoralis major myocutaneous flap. The flaps (from 12 cm x 10 cm to 16 cm x 13 cm) was transplanted in 8 patients after early wound debridement, and in 10 patients on infected wounds.

RESULTSAll flaps survived wells except in 4 patients necrotic area (length 2-5 cm, width 1-2 cm) appeared in the distal wound edge, localized dehiscence of wound edge in 2 cases, which were healed after dressing change or secondary suturing. Patients were followed up from 6 months to 3 years, and the appearance and function were satisfactory.

CONCLUSIONSPectoralis major muscle island myocutaneous flap has the advantage of large tissue mass, with thin and flat muscle belly, and rich blood supply, which is suitable for repair of large deep tissue defect in jaw and neck.

Adolescent ; Adult ; Burns, Electric ; surgery ; Female ; Humans ; Middle Aged ; Muscle, Skeletal ; transplantation ; Neck ; surgery ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

OBJECTIVETo study the effect of different access routes on autologous satellite cell implantation to stimulate myocardial regeneration.

METHODSSatellite cells were procured from skeletal muscle (gluteus max) of adult mongrel canine, cultured, proliferated and labeled with 4', 6-diamidino-2-phenylindone (DAPI) in vitro. The cells were autologously implanted into the site of acute myocardial infarction by local injection or perfusion through the ligated distal left anterior descending coronary artery. Specimens were harvested 2, 4 and 8 weeks later for histological study.

RESULTSThe labeling efficiency of satellite cells with DAPI was close to 100%. Fluorescent cells were found at the infarcted zone, papillary muscle and local injection site. Some of these cells had progressively differentiated into striated muscle fibers connected to intercalated discs. The infant cells appeared different from the mature myocardium under an electron microscope. Satellite cells implanted by perfusion through the coronary artery were arranged in order of consistency with host myocardial fibers. The satellite cells, implanted by local injection, were found growing in a disordered way.

CONCLUSIONSatellite cells, implanted by coronary artery perfusion, can progressively differentiate into striated muscle fibers, arranging in order and disseminating over the infarcted zone. This approach seems more favorable for the recovery of myocardial contractile function than that of local injection.

Animals ; Cell Differentiation ; physiology ; Dogs ; Myocardial Infarction ; pathology ; therapy ; Myocardium ; cytology ; Regeneration ; Satellite Cells, Skeletal Muscle ; cytology ; transplantation ; Transplantation, Autologous

OBJECTIVETo reconstruct tracheal defect after tumor excision, we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.

METHODSThe contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy. The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully.

RESULTSAll flaps survived with epithelization and osteogenesis. The endotracheal tubes were pulled out safely without trachea stenosis in all the patients.

CONCLUSIONSThe contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged. This method extends the application of the musculo-periosteum flap.

Adult ; Aged ; Clavicle ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Periosteum ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Trachea ; injuries ; surgery ; Young Adult

OBJECTIVETo investigate a method to reconstruct the breast and repair the chest wall defects at the same time.

METHODSThe operation procedure combined the transverse rectus abdominis myocutaneous (TRAM) flap with the latissimus dorsi muscle(LDM) flap for breast reconstruction and repair of chest wall defect. Two patients underwent delayed breast reconstruction using this technique.

RESULTS8 flaps in the four patients survived completely. The aesthetic results were very good.

CONCLUSIONThis method can be used to reconstruct breast and repair the defect of chest wall at the same time, avoiding the disadvantage in the flap transfer of TRAM or LDM.

Adult ; Breast Implantation ; methods ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Muscle, Skeletal ; transplantation ; Rectus Abdominis ; transplantation ; Surgical Flaps ; Transplantation, Autologous ; Treatment Outcome