OBJECTIVETo report the therapeutic effect of retrograde island neurocutaneous flap pedicled with lateral antebrachial cutaneous nerve for the treatment of soft tissue defect at the dorsum of hand.

METHODS11 cases with soft tissue defects at the dorsum of hands were treated. The size of soft tissue defects ranged from 3.0 cm x 2.5 cm to 6.5 cm x 4.0 cm. The size of the flaps ranged from 3.5 cm x 3. 0 cm to 7. 0 cm x 4. 0 cm.

RESULTSAll the 11 flaps survived. The follow-up period was 2 months to 2 years. The texture and elasticity of the flaps were good. The appearance and function of the hands were satisfactory. The superficial sense was recovered. The wounds at the donor site of forearms were closed primarily in 7 cases, or covered by split-thickness skin grafts in other 4 cases. The appearance of the donor site was satisfactory too.

CONCLUSIONSThe retrograde island neurovascular flap pedicled with lateral antebrachial cutaneous nerve is an optimal method for soft tissue defects at the dorsum of hand.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Forearm ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Treatment Outcome ; Young Adult

OBJECTIVETo study the anatomy of angular nerve (AN), so as to provide safe approach for the denervation surgery of corrugator supercilii, depressor supercilii and procerus.

METHODS10 fresh cadaver (20 sides)were perfused and fixed with formalin. Dissection was performed in the 10 x operating microscope. The plexus of the zygomatic branch and the buccal branch were detected to confirm the AN. The relationship of AN with the surrounding blood vessels was observed. We tracked AN until it entered corrugator supercilii, depressor supercilii and procerus.

RESULTS(1) AN was classified into I, II, III type according to its formation pattern. Type I (20%, 4/20 sides) AN is single, which is mainly from the plexus of buccal branch plus the zygomatic branch from the orbicularis oculi muscle. In type II (20%, 4/20 sides), the single AN was formed by buccal branch plexus and zygomatic branch plexus in the "Four Muscle Gap". In type III (60%, 12/20 sides), the AN had two branches in the "Four Muscle Gap". (2) The three types AN passed inferior to the support ligament at the suborbital part, and then transversed medial to the support ligament at the medial canthus, along the vessels of medial canthus. (3) The branch of AN enters the depressor supercilii or procerus 2.19 to 4.28 mm above the medial canthus ligament. The backward branch enters the levator labii superioris alaeque nasi 6.89 to 9.38 mm below the medial canthus ligament.

CONCLUSIONSThe approach of denervation surgery for AN should be performed medial to the support ligation, between 2.19 mm above the medial canthus and 6.89 mm below the medial canthus.

Adult ; Cadaver ; Denervation ; Facial Muscles ; innervation ; Facial Nerve ; anatomy & histology ; surgery ; Female ; Humans ; Male

OBJECTIVETo study the role of the soluble factors secreted by tissue engineered cartilage in promoting bone marrow stromal cells (BMSCs) chondrogenesis as an important aspect.

METHODSPorcine BMSCs, chondrocytes and dermal fibroblasts were respectively in vitro expanded and then seeded onto the polyglycolic acid/polylactic acid (PGA/PLA) scaffold. After 3 days, they were indirectly co-cultured by transwell. BMSCs-scaffold constructs were co-cultured with chondrocytes-scaffold constructs as experiment group (Exp), while co-cultured with fibroblasts-scaffold constructs as control group. BMSCs with the same cell number were seeded onto the scaffolds as another control group. There were 3 specimens in each group. All specimens were harvested after in vitro indirect co-culture for 8 weeks. Gross observation, histology, immunohistochemistry and RT-PCR were used to evaluate the results.

RESULTSThe BMSCs-scaffold constructs co-cultured with chondrocytes-scaffold shrunk gradually during in vitro culture, but formed the mature lacuna structures and metachromatic matrices, collagen II expression could be observed by immunohistochemistry and RT-PCR examination. In the control group, the constructs shrunk greatly during in vitro culture and showed mainly fibrous tissue.

CONCLUSIONSThe soluble factors secreted by chondrocytes can solely induce chondrogenic differentiation of BMSCs and thus promote the in vitro chondrogenesis of BMSCs.

Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cells, Cultured ; Chondrocytes ; cytology ; secretion ; Chondrogenesis ; Coculture Techniques ; Female ; Male ; Stromal Cells ; cytology ; Swine ; Tissue Engineering ; Tissue Scaffolds

OBJECTIVETo investigate the effect of HMME-PDT on the proliferation and cell distribution of hypertrophic scar fibroblast (HSF).

METHODSHSF were cultured and only 4-6th passages were used in this study. Argyrophilic protein in nucleolar organizer regions(AgNORs) were calculated by I. S% after argyrophilic staining. Flow cytometry was applied to analyze the cell cycle and proliferation index (PI).

RESULTS1) I. S% of HSF after HMME-PDT was reduced markedly. 2) HMME-PDT inhibited HSF entering S stage from G, stage, cell percentage in S stage was decreased to (11.2 +/- 2.3)%. 3) PI in HMME-PDT group was less than that in control group [(35.0 +/- 3.4)% vs (27.2 +/- 3.1)%, P < 0.05].

CONCLUSIONSHMME-PDT can inhibit proliferation of HSF, and chang cell distribution.

Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix ; drug therapy ; pathology ; Fibroblasts ; drug effects ; metabolism ; pathology ; Humans ; Photochemotherapy

OBJECTIVETo explore the effect of electroporation mediated gene therapy on bone mineral density and strength of new-formed bone in mandibular distraction gap, so as to enhance the osteogenesis and shorten the distraction term.

METHODSNew-Zealand rabbits were employed. The distraction began after 3 days of latency period at the rate of 0. 8 mm per day for 7 days. After distraction, the rabbits were randomly divided into 5 groups to receive injection in the distraction gap with recombinant plasmid 2 microg (0.1 microg/microl) pIRES-hVEGF165-hBMP2 in group A, with recombinant plasmid pIRES-hBMP2 in group B, with recombinant plasmid pIRES-hVEGF165 in group C, with pIRES in group D, and with normal saline (NS) in group E. After injection, electroporation was performed in all the groups. After 1 week, 2 weeks, 4 weeks and 8 weeks of consolidation, all the animals underwent X-ray and quantitative computed tomography (QCT). The new-formed bone in distraction gap was selected as regions of interest (ROI) to measure the bone mineral density(BMD). Then the rabbits were sacrificed and the new-formed bone samples were harvested to detect 3-point crushing strength.

RESULTSBMD of newly formed bone in group A, B and C was markedly higher than that in group D and E (P < 0.01). After 2 weeks of consolidation, BMD in group A was much higher than that in the other groups, but there was no difference between group B and C. After 4 weeks of consolidation, BMD in group A and B was markedly higher than that in group C, D and E (P < 0.01). After 8 weeks of consolidation, BMD in group A was markedly higher than that in the other groups. While the BMD was not significantly different between group B and C, but the BMD in group B and C was higher than that in group D and E (P < 0.01). After 4 weeks of consolidation, the 3-point crushing strength of newly formed bone in group A was markedly higher than that in group B,C, D and E (P < 0.01), which was still the same after 8 weeks of consolidation. And the crushing strength in group B was higher than that in group C, D and E (P < 0. 05).

CONCLUSIONSElectroporation-mediated transfection of recombinant plasmid pIRES-hVEGF165-hBMP2 could greatly enhance osteogenesis and calcification. A combination of VEGF and BMP may promote osteogenesis and angiogenesis simultaneously, so as to magnify the effect of each growth factor, resulting a synergetic effect.

Animals ; Bone Density ; Bone Regeneration ; Electroporation ; Genetic Therapy ; Mandible ; physiology ; surgery ; Osteogenesis, Distraction ; Rabbits

OBJECTIVETo investigate the expression and its significance of melatonin receptor in human hypertrophic scarring.

METHODSThe expression of melatonin receptor GPR50 was detected with immunohistochemistry and the melatonin receptors (MT1, MT2) mRNA were assessed with RT-PCR method in 10 cases of human hypertrophic scar and normal skin. The positive production was sequenced with auto sequencing instrument.

RESULTSPositive signals of melatonin receptor could be found in the cell membrane and cytoplasm. The melatonin receptor GPR50 was located in the epithelial basal cells,sweat gland cells and hair follicle in both hypertrophic scar and normal skin. The melatonin receptor GPR50 was extensively expressed in fibroblasts of hypertrophic scar, but not in fibroblasts in normal skin. RT-PCR showed that the expression of melatonin receptor (MT1, MT2) mRNA in hypertrophic scar was significantly higher than that in normal skin (P < 0.05). In normal skin and hypertrophic scar group, the expression of MT1 mRNA was higher than MT2 mRNA (P < 0.05). In normal skin and hypertrophic scar group, the expression of MT1 mRNA was 0.99081 +/- 0.26485 and 1.16584 +/- 0.21829 copy number/microl cDNA, respectively; the expression of MT2 mRNA was 0.77083 +/- 0.15927 and 0.99550 +/- 0.14624 copy number/ microl cDNA, respectively. Sequencing results indicated that the positive product coincided with cDNA of human melatonin receptor in GeneBank.

CONCLUSIONSPositive expression of melatonin receptor can be found in human hypertrophic scar and normal skin, but it is higher in scar. The over expression of melatonin receptor in hypertrophic scar may be related to the development of hypertrophic scar.

Adult ; Cicatrix, Hypertrophic ; metabolism ; Female ; Humans ; Male ; Nerve Tissue Proteins ; genetics ; metabolism ; RNA, Messenger ; genetics ; Receptors, G-Protein-Coupled ; genetics ; metabolism

OBJECTIVETo investigate the influence on costal cartilage reparative regeneration by replanting the small blocks of autogeneic cartilage into the perichondrial pocket at the donor-site.

METHODS16 rabbits (8-10 weeks old, 1.8-2.2 kg) were randomly divided into four groups as three experimental groups and one control group. The 1.5 cm in length of costal cartilage defect was made in experimental groups with the perichondrium and costochondral junction left completely intact. The cartilage defect was closed by 3 methods as saturation directly, or replanting the small blocks of autogeneic cartilage, or plugging bio-protein jelly after cartilage replanting. Each experimental group was handled with two methods in two sides of costal cartilage. No operation was performed in control group. All the rabbits were sacrificed 16 weeks after operation. The appearance of thoracic cage and new-formed tissue at the defect site were examined grossly. Haematoxylin-eosin staining was performed to evaluate the characteristics of new-formed tissues and biomechanical detection was used to measure intension of new-formed tissues.

RESULTSThe appearance of thoracic cage was normal in every experimental group. Histological study showed that the defect was filled with abundant fibrous tissue in each group. The chipping of cartilage survived effectively with little proliferation. Biomechanical detection showed that the intension of new-formed tissue in the non-replanted group [(193.92 +/- 41.41) N] was obviously less than that in the replanted group [(318.88 +/- 28.28) N], or bio-protein jelly group [(301.00 +/- 39.52) N], or control group [(300.54 +/- 38.35) N] (P < 0.01). Furthermore, there was no statistical difference between the latter three groups (P > 0.05).

CONCLUSIONSAlthough replanting the chipping of cartilage can't promote reparative regeneration of hyaline cartilage, it can definitively strengthen the intensity of new-formed tissue, reinforce thoracic stability. It may also indirectly decrease the incidence rate of postoperative chest wall deformity.

Animals ; Cartilage ; transplantation ; Male ; Rabbits ; Regeneration ; Ribs ; physiology ; surgery ; Transplantation, Autologous

OBJECTIVETo examine the expression of CEACAM-land CXCL-14 in the different stages of infantile hemangioma and to explore the role of CEACAM-1 and CXCL-14 in the occurrence and development of infantile hemangioma.

METHODSThe expression of CEACAM-1 and CXCL-14 was detected by immunohistochemical technique and Western Blot in cases of proliferating hemangiomas, involuting hemangiomas, involuted hemangiomas. The mean optical density was measured by image analysis system.

RESULTSThe expression of CEACAM-1 in early stage of proliferating hemangiomas was weak or negative, while it was strong in involuting hemangiomas and positive in the involuted stage. The differences between different stages had a statistically significance (P < 0.05). The expression of CXCL-14 was weak or negative in stage of proliferating hemangiomas, positive in involuting hemangiomas and strong in the involuted stage. The differences between different stages had a statistically significance (P < 0.05).

CONCLUSIONSCEACAM-1 and CXCL-14 are involved in the occurrence and development of infantile hemangioma.

Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Chemokines, CXC ; metabolism ; Child ; Child, Preschool ; Female ; Hemangioma ; metabolism ; pathology ; Humans ; Infant ; Male

OBJECTIVETo evaluate anatomical and functional images of contrast MR lymphangiography in the diagnosis of limb lymphatic circulation disorders.

METHODS30 patients with limb lymphedema were enrolled in the study. There were 27 patients of primary lymphedema and 3 of secondary lymphedema. Contrast enhanced lymphangiography was performed with 3.0 T MR Unit after intracutaneous injection of gadobenate dimeglumine into the interdigital webs of the dorsal foot and hand. The kinetics of enhanced lymph flow within the lymphatics were calculated using the formula: Speed (cm) = total length of visualized lymph vessel (cm)/ inspection time (minutes) and by comparing dynamic nodal enhancement and time-signal intensity curves between edematous and contralateral limbs. Morphological abnormalities of the lymphatic system were also evaluated.

RESULTSFollowing injection of the contrast agent enhanced lymphatic channels were consistently visualized in all clinical lymphedematous limbs and five contralateral limbs of unilateral lymphedema cases. The speed of enhanced flow within the lymphatics of lymphedematous limbs ranged from 0.30 to 1.48 cm/min. The contrast enhancement in inguinal nodes of edematous limbs was significantly lower than that of contralateral limbs (P < 0.01). Dynamic measurement of contrast enhancement showed a remarkable lowering of peak time (P < 0.01) and peak enhancement (P < 0.01) and a delay in outflow in inguinal nodes of affected limbs compared with that of control limbs. Post-contrast MR imaging also depicted varied distribution patterns of lymphatics and abnormal lymph flow pathways within lymph nodes in the limbs with lymphatic circulation disorders.

CONCLUSIONSContrast MR lymphangiography with gadobenate dimeglumine was able to visualize the precise anatomy of lymphatic vessels and lymph nodes in lymphedematous limbs. It also provided comprehensive information about the functional status of lymph flow transportation in lymphatics and lymph nodes.

Adolescent ; Adult ; Child ; Humans ; Lymph Nodes ; pathology ; Lymphatic Vessels ; pathology ; Lymphedema ; diagnostic imaging ; pathology ; Lymphography ; methods ; Middle Aged ; Young Adult

OBJECTIVETo study the biomechanical characteristic of maxillary Le fort- I osteotomy with rigid internal fixation (RIF) , so as to choose best fixation method.

METHODSThe 3-dimensional finite element models of maxillary Le Fort-I osteotomy with 9 kinds of RIF methods were established. Then the models were divided into three groups to calculate the stress distribution of the maxilla and the displacement of bone segment under 3 kinds of occlusion condition. The fixation stability of the different RIF methods was evaluated.

RESULTSUnder the incisor occlusion condition, the stress of the cranio maxillary complex transmits mainly along the nasal-maxillary buttress. Under the premolar and molar occlusion condition, the stress transmits along the alveolar process first, then turns to the nasal-maxillary and zygomatic-maxillary buttress. The focused stress position of the internal fixation system is at the connection between the screws and the plate and at the plate near the osteotomy line. Under the premolar occlusion condition, the displacement of bone segment with different RIF methods was (in a decreasing order) 0.396509 mm (with bio-absorbable plate), 0.148393 mm (with micro-plate ), 0.078436 mm (with mini-plate) in group 1; 0.188791 mm (fixing at the nasal-maxillary buttress), 0.121718 mm (fixing at the zygomatic-maxillary buttress), 0.078436 mm (fixing at the both buttress) in group 2; 0.091023 mm (with straight plate), 0.078436 mm (with L shape plate), 0.072450 mm (with Y shape plate), 0.065617 mm (with T shape plate) in group 3.

CONCLUSIONSThe fixation stability of using the bio-absorbable plate in Le Fort-I osteotomy is less stable than using the titanium plate. Fixing at the zygomatic-maxillary buttress is more stable than at the naso-maxillary buttress. The fixation stability is different by using different shapes of plates.

Bone Plates ; Finite Element Analysis ; Humans ; Maxilla ; surgery ; Osteotomy, Le Fort ; methods