Improvement of a long random skin flap survival by application of vascular endothelial growth factor in various ways of local administration in a rat model

Background:

Vascular endothelial growth factor (VEGF) is a heparin-binding glycoprotein which plays a significant role in angiogenesis and vascular permeability. The effect of various ways of local administration of VEGF on random skin flap survival was studied, using flaps with a relatively high length (L) to width (W) ratio (5:1).

Materials and Methods:

An 1.5 × 7.5 cm dorsal skin flap with the pedicle orientated, centered, and remaining attached between the lower angles of the scapulae was elevated in 45 Wistar rats in different phases, depending on the group. Rats were divided in five groups of nine. In group A, injections of saline were administered, in equally divided spaces, into flap''s fascia and transposed to a created skin defect. In group B, injections of VEGF were applied subdermally, in equally divided spaces, within the limits of a predesigned flap, a week prior to flap dissection and transposition. In group C, injections of VEGF were applied into a recipient bed''s fascia just before flap raising and transposition. In group D, injections of VEGF were applied subdermally, only in the distal third of the flap and then the flap was transposed to a recipient area. Finally, in group E, injections of VEGF were applied in the flap intrafascially and in equally divided spaces and then again, the flap was transposed to a recipient area. A week after final flap raising and positioning, rats were euthanatised and flaps were excised. Specimens were photographed, measured, put in formalin 10% and were sent for histological and image analysis.

Results:

Mean flap survival percentage was 35.4% in group A, and 33.7% in group B. In groups C and D, the mean survival area was 56.3% and 80.4%, respectively. In group E, the mean flap survival percentage was 28.3%. Histological analysis demonstrated increased angiogenesis in groups C and D.

Conclusions:

VEGF application improved skin flap survival when injected subdermally in the distal third of a random skin flap or into the fascia of a recipient area even though the length-to-width ratio was high.KEY WORDS: Angiogenesis, flap survival, neovascularisation, skin necrosis, vascular endothelial growth factor     

Comparison of two diode lasers on bactericidity in root canals—an in vitro study

This in vitro study compares two 810-nm and 940-nm diode lasers on bacterial kill in root canals of extracted human teeth and shows the clinical relevance of different treatment modalities. Ninety root canals of single-rooted human teeth were prepared up to ISO 70, steam sterilized, and assigned to two test groups (810 nm, 940 nm) and one control group. Following an initiatory experiment in which access opening of root canals and surrounding cavity were excluded from irradiation in the main experiment, 60 teeth were inoculated with 2 μl of either Escherichia coli or Enterococcus faecalis suspension. Laser irradiation was performed, additionally including access opening of root canals and surrounding cavity in the laser treatment. Excluding access opening of root canals and surrounding cavity from the laser treatment, the diode laser achieved an average bacterial reduction of Escherichia coli of 76.06% (810 nm) and 68.15% (940 nm), while including access cavities showed an average bacterial reduction of Escherichia coli of 97.84% (810 nm) and 98.83% (940 nm) and an average bacterial reduction of Enterococcus faecalis of 98.8% (810 nm) and 98.66% (940 nm). Diode laser wavelengths are effective in endodontic therapy. It seems to be clinically relevant that additional irradiation of the access cavity produces significantly better bactericidal results.     

Association of TNFα, TNFR1, and TNFR2 polymorphisms with sperm concentration and motility

Tumor necrosis factor α (TNFα) is a multifunctional cytokine that regulates various cellular processes related to spermatogenesis. Two types of cell receptors, TNFR1 and TNFR2, mediate TNFα activity. In the present study, we sought to explore the association of TNFα -857C→T, TNFR1 36A→G, and TNFR2 676T→G polymorphisms with sperm concentration and motility. Two hundred ninety men were examined during infertility investigation; of those, 170 men were normozoospermic and 120 were oligospermic. Polymerase chain reaction analysis revealed significant differences in genotype distribution of the TNFR1 36A→G polymorphism between normozoospermic and oligospermic men. Men with oligozoospermia presented TNFR1 36A/A genotypes less frequently than normozoospermic men (P < .001). The presence of the TNFR1 36G allele was significantly increased in oligospermic men (P < .001). Furthermore, the presence of the TNFR1 36G allele was associated with lower sperm concentration in normozoospermic men (P < .03) and in the total study population (P < .001), and with lower sperm motility in normozoospermic men (P < .007) and in the total study population (P < .001). No significant associations were found between TNFα -857C→T and TNFR2 676T→G polymorphisms and semen quality. The TNFR1 36A allele is associated with increased sperm concentration and motility in our series, supporting the significance of TNFR1 gene in semen quality.