New model for in vivo quantification of microvascular embolization, thrombus formation, and recanalization in composite flaps

BACKGROUND

Microthrombi are suggested to be involved in the pathogenesis of composite flap failure. Due to the lack of appropriate experimental models, however, the significance of microvascular thrombus formation and microthromboembolization in free flap failure remains poorly understood. The purpose of this study was therefore to develop a rat hindlimb model that allows tissue-confined in vivo analysis of thrombus formation, thromboembolization, and recanalization within the microcirculation of osteomyocutaneous flaps using intravital fluorescence microscopy.

MATERIALS AND METHODS

Thrombus formation was induced photochemically in individual arterioles and venules of muscle, subcutis, and periosteum. To study thromboembolization, autologous arterial thrombi (40 microm) were preformed in vitro and were injected into the femoral artery supplying the osteomyocutaneous flap.

RESULTS

First platelet deposition was found independent from microvascular red blood cell velocity, while the subsequent growth of thrombus correlated inversely with red blood cell flow measured in the respective microvessel. Time required for complete thrombotic arteriolar occlusion exceeded 700 s, whereas thrombus growth in venules was found to be significantly accelerated ( approximately 300 s) without differences between the individual tissues analyzed. The embolization resulted in a complete shutdown of capillary perfusion in muscle, subcutis, skin, and periosteum. During subsequent spontaneous recanalization, capillary perfusion increased in all tissues to approximately half of baseline, however, without further recovery during the 4-h postembolization period.

CONCLUSIONS

The model presented is suitable to quantitatively study the pathophysiology of microvascular thrombus formation, thromboembolization, and recanalization in composite flaps, and may thus be used to evaluate the effectiveness of novel therapeutic strategies to prevent flap failure.

Childhood leukemia and electromagnetic fields: results of a population-based case-control study in Germany

The investigation of an association between increased exposure to residential extremely-low frequency electromagnetic fields (ELF-EMF) and childhood leukemia was part of a population-based case-control study carried out between 1992 and 1995 in the northwestern part of Germany. A total of 129 children with leukemia and 328 controls participated in the EMF-study. Exposure assessment comprised measurements of the magnetic field over 24 hours in the child's bedroom at the residence where the child had been living for the longest period before the date of diagnosis, and spot measurements at all residences where the child had been living for more than one year. The median of the 24h-measurement in the child's bedroom was regarded as the most valid exposure variable. For children exposed to more than 0.2 microT, an elevated but not significant odds ratio (OR) was observed (OR = 3.2, 95 percent confidence interval = 0.7-14.9). These figures are based on only four leukemia cases and three controls since only 1.5 percent of the study population was classified as highly exposed. Exploratory analyses revealed ORs that were not statistically significantly increased for other characteristics of the magnetic field at varying cut-points. The results are comparable with those from other studies. Although not statistically significant, they may indicate a positive association between EMF and childhood leukemia.

In situ activation of mouse alveolar macrophages by aerosolized liposomal IFN-gamma and muramyl tripeptide

Interferon-gamma (IFN-gamma) was entrapped with an efficiency of 30-40% in muramyl tripeptide-containing liposomes by a freeze-thawing procedure. A microcytotoxicity assay was developed to measure the tumoricidal activity of mouse alveolar macrophages (AM) against tumoral target cells with a colorimetric viability test. Free IFN-gamma and liposomal muramyl tripeptide phosphatidylethanolamine (MTP-PE) were found to be only slightly effective to activate in vitro AM, whereas encapsulation of both INF-gamma and MTP-PE within the same liposomes produced higher activation of AM. Aerosolized IFN-gamma and liposomal immunomodulators enhanced antitumor properties of AM recovered in mice 24 h postinhalation. Whereas free IFN-gamma also induced a substantial activation of peritoneal macrophages, liposomal encapsulation significantly reduced the systemic activity of inhaled immunomodulators. This approach provides a useful model for the compartmentalized organ-specific activation of AM in mice.

Cytological effects of 50 Hz electromagnetic fields on human lymphocytes in vitro

Incubation of human peripheral blood cultures in the presence of an electromagnetic field (EMF) of 50 Hz and 5 mT leads to stimulation of the cell cycle of dividing lymphocytes but has no influence on the frequencies of sister-chromatid exchanges. Comparative studies with two different exposure systems and with different culture temperatures indicate that the effect on the cell cycle results from the EMF and is not a thermal effect. These data support the assumption that with respect to their suspected carcinogenic effects EMFs have no initiating but probably promoting effects.

Effects of weak alternating magnetic fields on nocturnal melatonin production and mammary carcinogenesis in rats

Since extremely low frequency (i.e., 50- or 60-Hz) magnetic fields (MFs) from overhead power lines and other electromagnetic sources are ubiquitous in modern societies, the possible carcinogenic effect of such fields recently suggested by epidemiological studies has engendered much concern. However, in view of various unknown and uncontrolled variables which may bias epidemiological studies on MF interactions, a causal relationship between MFs and tumorigenesis can only be determined precisely in animal experiments. The goal of the study reported here was to determine if low frequency MFs at the low flux densities which are relevant for human populations induce tumor-promoting or copromoting effects in a model of breast cancer. Furthermore, since reduction in pineal production of melatonin has been implicated as a cause of tumor promotion by electromagnetic fields, determinations of nocturnal melatonin peak levels in serum were performed during MF exposure. Mammary tumors were induced by intragastric administration of 20 mg (5 mg/week) 7,12-dimethylbenz(a)anthracene (DMBA) in female Sprague-Dawley rats. Groups of 36 rats were either sham-exposed or exposed for 91 days at a 50-Hz gradient MF of 0.3-1 microT, which is a relevant range for elevated domestic MF exposure as arising from neighboring power lines. Nocturnal melatonin levels were significantly reduced by exposure to this weak alternating MF. However, histopathological evaluation of mammary lesions did not disclose any significant difference between MF- and sham-exposed animals. Incidence of mammary tumors was 61% in controls versus 67% in MF-exposed rats. The predominant tumor type was the invasive adenocarcinoma, which was found in 21 rats of both groups. Examination of tumor size did not indicate significant differences in tumor burden between both groups. Furthermore, the incidence of preneoplastic lesions was not altered by MF exposure. Thus, the data of this study indicate that alternating MF do not exert significant tumor promoting or copromoting effects at environmentally relevant flux densities in the rat mammary cancer system.