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Tsuji H, Nakatsuka T, Yamazaki K, Takagi K. Summer relative humidity in northern Japan inferred fromδ18O values of the tree ring in (1776–2002 A.D.): Influence of the paleoclimate indices of atmospheric circulation. ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2007jd009080] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Saitoh H, Nakatsuka T. Hydrogen-bonded network structures of cocrystals of some naphthalenediol with pyrazine. Acta Crystallogr A 2008. [DOI: 10.1107/s010876730808728x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Goto M, Miyahara I, Hirotsu K, Kobayashi Y, Nakatsuka T, Toyama H, Adachi O, Matsushita K. Structure of membrane-bound quiohemoprotein alcohol dehydrogenase. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308092222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Huang YS, Nakatsuka T, Hamaguchi HO. Behaviors of the "raman spectroscopic signature of life" in single living fission yeast cells under different nutrient, stress, and atmospheric conditions. APPLIED SPECTROSCOPY 2007; 61:1290-1294. [PMID: 18198019 DOI: 10.1366/000370207783292082] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Time- and space-resolved Raman spectra of mitochondria in single living fission yeast cells have been measured under various nutrient, stress, and atmospheric conditions. A focus is placed on the behavior of the Raman band located at 1602 cm(-1), which sensitively reflects the metabolic activity in mitochondria and which has been called by us the "Raman spectroscopic signature of life". Addition of nutrients increases the intensity of this band by approximately 1.5 times, confirming its correlation with the metabolic activity in mitochondria. The spectra of cells cultured under 100% N(2), 100% O(2), and N(2)/O(2) (V(N2):V(O2) congruent with approximately = 4:1) atmospheres have been measured for both (16)O(2) and (18)O(2). Yeast cells have been found to lose their metabolic activity after the culture under 100% N(2) and 100% O(2) atmospheres. Cells cultured under a N(2)/(16)O(2) ((16)O(2) = 20%) atmosphere show strong "Raman spectroscopic signature of life". No (18)O isotopic shift has been found for the wavenumber 1602 cm(-1), indicating that the origin of this signature is neither O(2) nor an O-containing small molecule. Addition of H(2)O(2) causes a quick decrease of the "Raman spectroscopic signature of life", followed by the cis-trans isomerization in the unsaturated phospholipid chain. The "Raman spectroscopic signature of life" has thus been proved to be a reliable real-time and in vivo indicator for monitoring the metabolic activity in living cells.
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Nishioka J, Ono T, Saito H, Nakatsuka T, Takeda S, Yoshimura T, Suzuki K, Kuma K, Nakabayashi S, Tsumune D, Mitsudera H, Johnson WK, Tsuda A. Iron supply to the western subarctic Pacific: Importance of iron export from the Sea of Okhotsk. ACTA ACUST UNITED AC 2007. [DOI: 10.1029/2006jc004055] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tanaka R, Ichioka S, Sekiya N, Ohura N, Uchino S, Ojima A, Itoh Y, Ishihara O, Nakatsuka T, Ikebuchi K. Elastic plasma protein film blended with platelet releasate accelerates healing of diabetic mouse skin wounds. Vox Sang 2007; 93:49-56. [PMID: 17547565 DOI: 10.1111/j.1423-0410.2007.00913.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The growth factors derived from platelets and plasma proteins mediate the wound-healing process that is characterized by the sequential migration and differentiation of several cell populations that give rise to angiogenesis, collagen synthesis, wound contraction, and re-epithelialization. To evaluate the efficacy of the blood-derived factors in wound healing, we examined a novel wound dressing consisting of concentrated human plasma proteins and platelet releasate (CPPP). MATERIALS AND METHODS To generate CPPP, plasma proteins and platelets in the peripheral blood (n = 5) were concentrated with the cold ethanol precipitation method. The thrombin obtained from the same blood unit and calcium chloride (CaCl(2)) were mixed to a concentrate. The CPPP has enough strength to dress cutaneous wounds and contains large amounts of cytokines and fibronectin. We applied the CPPP to excisional skin wounds in genetically healing-impaired model mice (n= 5) and the wounds were evaluated 10 days after the operation. RESULTS The area of CPPP-treated wounds decreased significantly compared with that of the control wounds (65% vs. 94% of the original size, respectively, P= 0.032). The immunostained section revealed a striking effect of CPPP on vascularization compared with the control wounds (13.2 vs. 2.7 vessels per mm(2) as mean vascular density observed in the sections, respectively, P= 0.013). CONCLUSIONS Our results suggest that CPPP is a promising biologically active dressing for full-thickness skin wounds. CPPP can be an entirely autologous biological dressing, suggesting that it is free from the risk of transmission of pathogens through blood products.
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Ninomiya K, Sugiura H, Nakatsuka T, Kasamatsu Y, Kikunaga H, Sato W, Yoshimura T, Matsumura H, Takamiya K, Kubo MK, Sueki K, Yokoyama A, Hamajima Y, Miura T, Nishiyama K, Shinohara A. Study of electronic X-rays emitted from pionic and muonic atoms. J Radioanal Nucl Chem 2007. [DOI: 10.1007/s10967-007-0642-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yoshimura M, Nakatsuka T, Furue H. 110 ANALOGY OF A-BETA AFFERENTS TERMINATION IN PATHOLOGICAL CONDITIONS WITH IMMATURE STATE. Eur J Pain 2007. [DOI: 10.1016/j.ejpain.2007.03.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Katsuki R, Fujita T, Koga A, Liu T, Nakatsuka T, Nakashima M, Kumamoto E. Tramadol, but not its major metabolite (mono-O-demethyl tramadol) depresses compound action potentials in frog sciatic nerves. Br J Pharmacol 2006; 149:319-27. [PMID: 16921387 PMCID: PMC2014268 DOI: 10.1038/sj.bjp.0706868] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Although tramadol is known to exhibit a local anaesthetic effect, how tramadol exerts this effect is not understood fully. EXPERIMENTAL APPROACH The effects of tramadol and its metabolite mono-O-demethyl-tramadol (M1) on compound action potentials (CAPs) were examined by applying the air-gap method to frog sciatic nerves, and the results were compared with those of other local anaesthetics, lidocaine and ropivacaine. KEY RESULTS Tramadol reduced the peak amplitude of the CAP in a dose-dependent manner (IC50=2.3 mM). On the other hand, M1 (1-2 mM), which exhibits a higher affinity for mu-opioid receptors than tramadol, did not affect CAPs. These effects of tramadol were resistant to the non-selective opioid receptor antagonist naloxone and the mu-opioid receptor agonist, DAMGO, did not affect CAPs. This tramadol action was not affected by a combination of the noradrenaline uptake inhibitor, desipramine, and the 5-hydroxytryptamine uptake inhibitor, fluoxetine. Lidocaine and ropivacaine also concentration-dependently reduced CAP peak amplitudes with IC50 values of 0.74 and 0.34 mM, respectively. CONCLUSIONS AND IMPLICATIONS These results indicate that tramadol reduces the peak amplitude of CAP in peripheral nerve fibres with a potency which is less than those of lidocaine and ropivacaine, whereas M1 has much less effect on CAPs. This action of tramadol was not produced by activation of mu-opioid receptors nor by inhibition of noradrenaline and 5-hydroxytryptamine uptake. It is suggested that the methyl group present in tramadol but not in M1 may play an important role in producing nerve conduction block.
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Ohura N, Ichioka S, Nakatsuka T, Shibata M. Evaluating dressing materials for the prevention of shear force in the treatment of pressure ulcers. J Wound Care 2005; 14:401-4. [PMID: 16240617 DOI: 10.12968/jowc.2005.14.9.26831] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Shear force is believed to affect pressure ulceration. Therefore, dressing materials that reduce shear force may prevent ulceration and facilitate healing. METHOD We measured the following three properties: the coefficient of friction between the outer layer of the dressings and the patient's clothes; the degree of adhesiveness between the inner layer of the dressing and the patient's skin; the transmissibility of shear force of the dressing. RESULTS The coefficients of static friction were 1.01 for hydropolymer, 0.72 for hydrofoam and 0.48 for hydrocolloid. Adhesiveness was tested by rolling different sized ball bearings down a slope and over the adhesive lining under both wet and dry conditions. Under dry conditions, the heaviest ball bearing that stopped rolling for five seconds was 111.9g for both hydrofoam and hydrocolloid. Under wet condition, it was 11.9g for hydrofoam and under 1g for hydrocolloid. Tests showed the very low transmissibility (I N buffer) of shear force for hydrofoam, with significant differences between the dressings. Clinical observation has identified good results for hydrofoam when used under highly exuding conditions and for hydrocolloid when used with relatively slight or decreased exudate. CONCLUSION Existing dressing materials are being developed and evaluated for wound healing. However, if innovations in the raw materials from which dressings are manufactured could lead to a reduction in shear force and the prevention of pressure ulcers, then dressing materials could be discussed from a viewpoint that is quite different from wound healing.
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Asano Y, Ichioka S, Shibata M, Ando J, Nakatsuka T. Sprouting from arteriovenous shunt vessels with increased blood flow. Med Biol Eng Comput 2005; 43:126-30. [PMID: 15742730 DOI: 10.1007/bf02345133] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to evaluate the effect of increased blood flow on angiogenesis at the large vessels. The arteriovenous (AV) shunt was made on the thigh of male Wistar rats (n = 27) to increase blood flow, wrapped with artificial skin dermis, which consisted of a silicon outer layer, and isolated from surrounding tissues. Blood flow increased from 2.40 +/- 0.77 to 35.8 +/- 8.7 ml min(-1) (14.9 times), and the shear stress index (relative value of shear stress) increased from 10.7 +/- 3.6 to 73.4 +/- 18.1 (6.85 times) 60 min after the shunt formation. Newly formed vessels were observed around the AV shunt loop. Scanning electron micrographs at the AV shunt vessel lumen showed modified endothelial cells at day 7 and a remarkable number of pores at day 14. The volume of newly formed vessels was increased 12 times from day 5 to day 14. The mechanical factor of shear stress was considered the major stimulator of angiogenesis. This is the first report of electron-microscopic observation of sprouts from a large vessel lumen. The new AV shunt model is useful for basic research on angiogenesis at the large vessels in vivo and, furthermore, could generate vascularised tissues with various cultured cells.
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Ichioka S, Ohura N, Nakatsuka T. Benefits of surgical reconstruction in pressure ulcers with a non-advancing edge and scar formation. J Wound Care 2005; 14:301-5. [PMID: 16048214 DOI: 10.12968/jowc.2005.14.7.26807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To highlight the difficulty in treating pressure ulcers associated with scar formation and the benefits of surgical treatment in these cases by presenting a series of clinical cases. METHOD Nine sacral ulcers surrounded by significant scar formation and 14 sacral ulcers without significant scars were treated using the same conservative management protocol. Healing status was quantitatively estimated using an assessment tool called DESIGN, which classifies pressure ulcer severity and allows healing to be monitored; a decreasing score indicates progressive improvement. RESULTS Ulcers with scar formation showed little response to the treatment, while those without remarkable scars exhibited a significant decrease of the DESIGN scores. Surgical reconstruction was conducted in five ulcers surrounded by scar formation, and all showed complete healing within extremely short periods. CONCLUSION Conservative treatment of pressure ulcers with a non-advancing edge surrounded by scar formation presents considerable difficulties. Surgical reconstruction offers many benefits for non-healing ulcers.
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Ichioka S, Ohura N, Nakatsuka T. The positive experience of using a growth-factor product on deep wounds with exposed bone. J Wound Care 2005; 14:105-9. [PMID: 15779638 DOI: 10.12968/jowc.2005.14.3.26753] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Trafermin, a form of basic fibroblast growth factor, has been used in Japan since 2001. This study investigates whether it can facilitate closure in wounds with deep soft-tissue defects and exposed bone, where surgical closure is not possible.
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Ohura N, Ichioka S, Asano T, Nakatsuka T. Open Wound Integrated Regenerative Therapy with Topical bFGF Trafermin for Deep Soft Tissue Defects with Bone Exposure. Wound Repair Regen 2005. [DOI: 10.1111/j.1067-1927.2005.130116al.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ichioka S, Tsuji S, Sekiya N, Nakatsuka T. Analysis of Pathophysiology of Pressure Ulcer in a Microcirculatory Model. Wound Repair Regen 2005. [DOI: 10.1111/j.1067-1927.2005.130116as.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yoshimura M, Furue H, Nakatsuka T, Matayoshi T, Katafuchi T. Functional reorganization of the spinal pain pathways in developmental and pathological conditions. NOVARTIS FOUNDATION SYMPOSIUM 2004; 261:116-24; discussion 124-31, 149-54. [PMID: 15469047 DOI: 10.1002/0470869127.ch9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Following inflammation, a subpopulation of Abeta afferents that terminates preferentially in deeper laminae have been shown to extend their axons to the superficial dorsal horn, particularly substantia gelatinosa (SG). Similarly, SG neurons in immature spinal cord receive mainly Abeta afferent inputs. To clarify whether the reorganized sensory pathway in the inflamed rats has a functional similarity with that in the developmental state, we compared synaptic inputs from primary afferents using in vitro and in vivo patch-damp recordings from SG neurons. SG neurons in the mature state had monosynaptic inputs from Adelta and C afferents, while only a few neurons received inputs from Abeta afferents. Following inflammation, the Abeta afferents extended their axons to SG and established functional monosynaptic transmission. Meanwhile, SG neurons in the immature state received preferentially Abeta as well as Adelta afferent inputs, and the majority of Abeta afferent inputs were monosynaptic. These observations support the idea that the sprouting of the large afferent fibres observed in inflamed rats is, at least in part, a regeneration process. However, the process, maybe distinct at some point from the process during development, therefore, produces pathological pain. Though the idea that the regeneration mimics the developmental process has been widely accepted, other possibilities cannot be excluded.
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Ando J, Sekiya N, Nakatsuka T, Ichioka S, Kudo S, Tokioka K, Shibata M. A symmetrical dorsal island double flap in the mouse. EUROPEAN JOURNAL OF PLASTIC SURGERY 2004. [DOI: 10.1007/s00238-004-0600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yoshimura M, Furue H, Nakatsuka T, Katafuchi T. Analysis of receptive fields revealed by in vivo patch-clamp recordings from dorsal horn neurons and in situ intracellular recordings from dorsal root ganglion neurons. Life Sci 2004; 74:2611-8. [PMID: 15041443 DOI: 10.1016/j.lfs.2004.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It has been thought that spinal dorsal horn neurons receive convergent inputs from not only somatosensory but also visceral pathways. For instance, the referred pain is presumed to be due to the convergence of sensory inputs from cardiac and shoulder receptive fields. However, precise investigation has not been made from dorsal horn neurons yet, because of difficulty in studying the pathways from those regions by means of conventional electrophysiology. The purpose of this study is to clarify the convergent inputs to single dorsal horn neurons from wide receptive fields using an in vivo patch-clamp recording technique from the superficial spinal dorsal horn and an intracellular recording from dorsal root ganglion neurons that keep physiological connections with the peripheral sites. Identified dorsal root ganglion neurons received an input from a quite small area, about 1 x 1 mm in width of the skin. In contrast, substantia gelatinosa neurons in the spinal cord received inputs from an unexpectedly wide area of the skin. Previous extracellular recordings have, however, revealed that substantia gelatinosa neurons have small receptive field. This discrepancy is probably due mainly to an availability of the in vivo patch-clamp method to analyze sub-threshold synaptic responses. In contrast, the extracellular recording technique allows us to analyze predominantly the firing frequency of neurons. Thus, the in vivo patch-clamp recordings from dorsal horn neurons and the intracellular recordings from DRG neurons will be useful for well understanding the sensory processing in the spinal cord.
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Nakatsuka T. Biogenic and lithogenic particle fluxes in the western region of the Sea of Okhotsk: Implications for lateral material transport and biological productivity. ACTA ACUST UNITED AC 2004. [DOI: 10.1029/2003jc001908] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nakatsuka T. Dissolved and particulate organic carbon in the Sea of Okhotsk: Transport from continental shelf to ocean interior. ACTA ACUST UNITED AC 2004. [DOI: 10.1029/2003jc001909] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nakatsuka T, Sasaki T, Kaiser ET. Peptide segment synthesis catalyzed by the semisynthetic enzyme thiolsubtilisin. J Am Chem Soc 2002. [DOI: 10.1021/ja00246a064] [Citation(s) in RCA: 138] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nakatsuka T, Mena N, Ling J, Gu JG. Depletion of substance P from rat primary sensory neurons by ATP, an implication of P2X receptor-mediated release of substance P. Neuroscience 2002; 107:293-300. [PMID: 11731103 DOI: 10.1016/s0306-4522(01)00342-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Effects of ATP on substance P immunoreactivity were examined in cultured dorsal root ganglion neurons. We found that treatment of dorsal root ganglion neurons with ATP significantly depleted substance P immunoreactivity on the neurites and somata of the neurons. The effects of ATP were significantly inhibited by the purinergic P2 receptor antagonists suramin (30 microM) and pyridoxal-phosphate-6-azophenyl-2',4'-disulfonic acid (10 microM). We also showed that ATP-induced depletion of substance P immunoreactivity from dorsal root ganglion neurons depended on the entry of Ca(2+). In a spinal cord slice preparation, we also found the internalization of neurokinin-1/substance P receptors in many dorsal horn neurons following the application of ATP or alpha,beta-methylene-ATP. Together these results indicate that activation of P2X receptors may result in release of substance P from primary afferent neurons.
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Ichioka S, Nakatsuka T, Ohura N, Sato Y, Harii K. Clinical use of amrinone (a selective phosphodiesterase III inhibitor) in reconstructive surgery. Plast Reconstr Surg 2001; 108:1931-7. [PMID: 11743379 DOI: 10.1097/00006534-200112000-00013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Amrinone is a selective phosphodiesterase III inhibitor that increases cyclic adenosine monophosphate by preventing its breakdown. It is effective in the treatment of congestive heart failure because of its ability to increase myocardial contractility and vascular smooth muscle relaxation. This study was designed to clarify the potential efficacy of amrinone in plastic surgery by clinically assessing its ability to enhance flap blood flow after reconstructive surgery and relieve intraoperative vasospasm. Its effects were compared with those of prostaglandin E1 and lidocaine, which are widely approved agents for improving the hemodynamics of flaps. In the first clinical study, the effects on flap blood flow after flap transfers were investigated. Twenty-six patients underwent reconstructive surgery with vascularized free or pedicled flaps. Blood flow was measured before and 60 minutes after intravenous infusion of lactated Ringer solution (control), amrinone (10 microg/kg/min), or prostaglandin E1 (10 ng/kg/min) using a laser Doppler flowmeter. In the second study, the effects on relief of vasospasm during operation were evaluated. The blood flow of 28 island flaps was measured by laser Doppler flowmetry immediately after flap elevation and 10 minutes after topical application of saline (control), amrinone (5 mg/ml), or lidocaine (10%) to the pedicle in an attempt to resolve the vasospasm. In both clinical studies, the effects of amrinone were statistically no less than those of prostaglandin E1 and lidocaine. The results show that amrinone positively influences the microcirculatory blood flow of transferred flaps and relieves intraoperative vasospasm in clinical cases. The present study suggests that amrinone could be useful for postoperative and intraoperative care in reconstructive surgery.
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Takushima A, Harii K, Asato H, Nakatsuka T, Kimata Y. Mandibular reconstruction using microvascular free flaps: a statistical analysis of 178 cases. Plast Reconstr Surg 2001; 108:1555-63. [PMID: 11711927 DOI: 10.1097/00006534-200111000-00018] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
For this article, 178 consecutive cases of mandibular reconstruction using microvascular free flaps and performed from 1979 to 1997 were studied. The purpose of this report is to compare flap success rates, complications, and aesthetic and functional results. The ages of the 131 men and 47 women ranged from 13 to 85 years, with an average of 55 years. Donor sites included the rib (11 cases), radius (one case), ilium (36 cases), scapula (51 cases), fibula (34 cases), and soft-tissue flaps with implant (45 cases). Complications included total flap necrosis, partial flap necrosis, major fistula formation, and minor fistula formation. The rate of total flap necrosis involving the ilium and fibula was significantly higher than that of all other materials combined (p < 0.05). The overall rate of implant plate removal, which resulted from the exposure or fracture of the plate, was 35.6 percent (16 of 45 cases). Each mandibular defect was classified by the extent of the bony defect and by the extent of the soft-tissue defect. The extent of the mandibular bony defect was classified according to the HCL method of Jewer et al. The extent of the soft-tissue defect was classified into four groups: none, skin, mucosal, and through-and-through. According to these classifications, functional and aesthetic assessments of deglutition and contour were performed on 115 subjects, and speech was evaluated in 110. To evaluate the postoperative results, points were assigned to each assessment of deglutition, speech, and mandibular contour. Statistical analysis between pairs of bone-defect groups revealed that there was no significant difference in each category. Regarding deglutition, statistical analysis between pairs of soft-tissue-defect groups revealed there were significant differences (p < 0.05) between the none and the mucosal groups and also between the none and the through-and-through groups. Regarding speech, there was a significant difference (p < 0.05) between the none and the through-and-through groups. Regarding contour, there were significant differences (p < 0.01) between the none and the through-and-through groups and between the mucosal and the through-and-through groups. The points given for each function, depending on the reconstruction material, revealed that there was no significant difference between pairs of material groups. From this prospective study, the authors have developed an algorithm for oromandibular reconstruction. When the bony defect is lateral, the ilium, fibula, or scapula should be chosen as the donor site, depending on the extent of the soft-tissue defect. When the bony defect is anterior, the fibula is always the best choice. When the soft-tissue defect is extensive or through-and-through with an anterior bony defect, the fibula should be used with other soft-tissue flaps.
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Nakatsuka T, Gu JG. ATP P2X receptor-mediated enhancement of glutamate release and evoked EPSCs in dorsal horn neurons of the rat spinal cord. J Neurosci 2001; 21:6522-31. [PMID: 11517241 PMCID: PMC6763085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Presynaptic ATP P2X receptors have been proposed to play a role in modulating glutamate release from the first sensory synapse in the spinal cord. Using spinal cord slice preparations and patch-clamp recordings from dorsal horn neurons in lamina V of the rat spinal cord, we showed that the activation of P2X receptors by alpha,beta-methylene-ATP (alphabetam-ATP) resulted in a large increase in the frequency of spontaneous EPSCs (sEPSCs) and miniature EPSCs (mEPSCs). The increases in mEPSC frequency by alphabetam-ATP were not blocked by the Ca(2+) channel blocker, 30 microm La(3+), but were abolished in a bath solution when Ca(2+) was omitted. The increases in mEPSC frequency by alphabetam-ATP were blocked completely by the P2 receptor antagonist pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid (PPADS) at 10 microm. Furthermore, the EPSCs evoked by dorsal root stimulation were potentiated by alphabetam-ATP as well as by the ecto-ATPase inhibitor ARL67156 and were depressed in the presence of P2 receptor antagonists PPADS (10 microm) and suramin (5 microm). The effects of these compounds on the evoked EPSCs were associated with the changes in glutamate release probability of primary afferent central terminals. Our results indicate that alphabetam-ATP-sensitive P2X receptors play a significant role in modulating excitatory sensory synaptic transmission in the spinal cord, and the potential role of endogenous ATP is suggested.
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