[Mitochondrial DNA genetic polymorphism of Drosophila immigrans in China]

This article uses RFLP to analyze the mitochondrial DNA(mtDNA) variation in geographic populations of Drosophila immigrans from 6 regions of mainland of China. With the use of fourteen restriction endonucleases, we only discoveried a total of 11 mtDNA haplotypes among 46 isofemale lines. The mean value of I is 0.833, the mean value of J is 0.797, and the estimated Gst value is only 16.8%. We recognized that the genetic structures among the geographic populations of D. immigrans are highly uniform, and the genetic differentiation rate is low. The UPGMA analysis of nucleotide diversity of the 6 populations shows specific characteristics of mtDNA variation in population of Huayang, Qinling Mountains Regions. From the haplotypes special included in each population, the event that the population spread into the high altitute localities of Yunnan perhaps happened more recently. Referring other references, we inferred the population of D. immigrans distributed in mainland of China is more original than that in Chinese Taiwan and Japan.

[Integrated protection capability afforded by a new type capstan anti-G equipment and anti-G straining maneuver]

Objective. To investigate the integrated protection capability afforded by a new type capstan anti-G equipment and anti-G straining maneuver, as a result we discussed the feasibility of protection for 8 G 10 s (rapid onset runs at 2 G/s) acceleration using an associated precept with the above both anti-G measures. Method. This study was accomplished using the human centrifuge with rapid onset at 2 G/s. First, we determined the relaxed +Gz tolerance of nine male aviation students, and then determined theirs most + Gz tolerance while thereinto the five aviation students using a new type capstan anti-G suit (NKH) + a new type anti-G valve (NKT) + L-1 anti-G straining maneuver (L-1) and the other four aviation students using a new type capstan counterpressure suit (NDC) + the new type anti-G valve (NKT) + L-1. Result. The most +Gz tolerance of five students was 8.80 +/- 0.27 G while using NKH + NKT + L-1 and was higher than their relaxed +Gz tolerance at 4.60 +/- 0.42 G (P< 0.01) and that the most +Gz tolerance of four students was 8.75 +/- 0.50 G while using NDC + NKT + L-1 and was higher than their relaxed +Gz tolerance at 4.50 +/- 0.46 G (P< 0.01). Conclusion. Pilot will be capable against the 8 G 10 s (rapid onset runs at 2 G/s) effectively using the new type capstan anti +/- G equipment and anti +/- G straining maneuver, and the provided precept has availability.

[Technical consideration of setting up a specification for human centrifuge evaluation of anti-G equipment]

Anti-G equipment needs to be evaluated using human centrifuge before further developed. However, there isn't a general specification for human centrifuge evaluation of anti-G equipment. From related literature and from our over thirty years experience in this area, we sum up to five aspect technical consideration below: human centrifuge, medical specification for using human in +Gz stress experiment, anti-G equipment experimental assembly, principle should be abided by during human centrifuge evaluation of anti-G equipment. We hope that the technical considerations mentioned in the paper should be helpful to the work of setting up a specification for human centrifuge evaluation anti-G equipment. After we have a specification, the research will be conducted orderly and the anti-G [correction of an-G] equipment will be developed sequentially.

Use of an acellular dermal allograft for dural replacement: an experimental study

OBJECTIVE

In this study, a nonimmunogenic, acellular, dermal collagen matrix termed XenoDerm (LifeCell Corp., The Woodlands, TX) was examined for use as a dural replacement material in a porcine model. This model was used to investigate whether AlloDerm (LifeCell), an almost identical material made from human dermis, could be safely used in neurological surgery.

METHODS

Bilateral temporoparietal dural defects were surgically created in 12 Yucatan minipigs. One side was repaired with autologous pericranium, and the other was repaired with XenoDerm. The pigs were killed after 1, 3, or 6 months, and the areas of dural repair were collected and examined macroscopically and histologically. XenoDerm is derived from porcine skin collected in thin sheets. It is processed so that the epidermis and all dermal cells are removed without disruption of the collagen matrix, rendering the material immunogenically inert and resistant to calcification. It is packaged as a freeze-dried sheet and is easily rehydrated at the time of surgery.

RESULTS

There were no postoperative complications, and all pigs survived. Both grafts performed well as dural replacements in all cases. There was no macroscopic evidence of inflammation or cerebrospinal fluid leakage. The XenoDerm grafts were intact, retained their original dimensions, and resembled the surrounding dura. The autologous pericranial grafts, in contrast, were thicker than when implanted and had bony excrescences firmly adhering to their surfaces. Again, however, there was no evidence of cerebrospinal fluid fistulae. There was no gross adherence to the underlying meninges or brain tissue in any specimen. Repopulation by fibroblasts and neovascularization were evident in the XenoDerm grafts as early as 1 month after surgery; by 3 months, the XenoDerm had been remodeled to assume the connective tissue appearance of the surrounding dura.

CONCLUSION

In this porcine model, an allograft of acellular dermis is a nearly ideal dural replacement. AlloDerm, the human equivalent of XenoDerm, would be an allograft of acellular dermis after implantation in human subjects. On the basis of this study and previous work with AlloDerm in other reconstructive applications, it is proposed that this material could be similarly used for duraplasty in human subjects.

A novel protein kinase target for the lipid second messenger phosphatidic acid

Activation of phospholipase D occurs in response to a wide variety of hormones, growth factors, and other extracellular signals. The initial product of phospholipase D, phosphatidic acid (PA), is thought to serve a signaling function, but the intracellular targets for this lipid second messenger are not clearly identified. The production of PA in human neutrophils is closely correlated with the activation of NADPH oxidase, the enzyme responsible for the respiratory burst. We have developed a cell-free system, in which the activation of NADPH oxidase is induced by the addition of PA. Characterization of this system revealed that a multi-functional cytosolic protein kinase was a target for PA, and that two NADPH oxidase components were substrates for the enzyme. Partial purification of the PA-activated protein kinase separated the enzyme from known protein kinase targets of PA. The partially purified enzyme was selectively activated by PA, compared to other phospholipids, and phosphorylated the oxidase component p47-phox on both serine and tyrosine residues. PA-activated protein kinase activity was present in a variety of hematopoietic cells and cell lines and in rat brain, suggesting it has widespread distribution. We conclude that this protein kinase may be a novel target for the second messenger function of PA.

Staging arteriovenous fistula loops for lengthening of free-flap pedicles

The authors investigated the optimal period of maturation following the creation of arteriovenous (AV) loops using polyterafluoroethylene (PTFE) in a white rat model, which were subsequently used to support free-tissue transfer The AV loops in Group 1 (n = 17) were allowed to mature for 3 days prior to creation of the flap, while those from Group 2 (n = 14) were allowed to mature for 5 days. Results were compared to those from a previous study in which the authors reported an 80 percent initial patency rate (n = 30) and a 67 percent viability rate, based on 12 patent loops after 7 days. In the present study, patency rates were 59 percent for the 3-day group and 79 percent for the 5-day group; viability rates were 50 and 64 percent, respectively. Considering both patent and nonpatent loops, the overall viability rates were 29 and 50 percent respectively. Maturation periods longer than 3 days for AV loops constructed from PTFE micrografts were determined to be preferable for subsequent free-tissue transfer.

Locally administered vascular endothelial growth factor cDNA increases survival of ischemic experimental skin flaps

Microvascular surgery has emerged as an attractive area for recent advances in the field of gene therapy. The present study investigated the survival of ischemic, experimental skin flaps after treatment with the gene encoding vascular endothelial growth factor (VEGF). In 30 Sprague-Dawley rats, anterior abdominal skin flaps supplied by the epigastric artery and vein were created. Ten animals were treated with a mixture of liposomes and the cDNA encoding the 121-amino acid isoform of VEGF. Another 10 animals were treated with control plasmid DNA and liposome transfection medium; a third group of 10 animals was given physiologic saline. Each solution was injected directly into the femoral artery distal to the origin of the epigastric pedicle supplying the flap. Four days after injection, the pedicle was ligated and blood flow in the flap was approximated using dye fluorescence. Seven days later, the amount of viable tissue within the flap was measured by planimetry. After the animals were killed, specimens from both the operated and nonoperated sides of the abdomen were harvested for immunohistologic evidence of VEGF protein expression. Average dye fluorescence indices of the three groups (VEGF cDNA, control plasmid, and saline) 2 hours after pedicle ligation were 35.9, 23.9, and 53.9 percent, respectively (p < 0.05). Compared with the two control groups, flaps receiving VEGF cDNA had significantly greater tissue viability at the end of 7 days: 93.9 versus 28.1 percent for the control plasmid DNA group and 31.9 percent for the saline group (p < 0.05). Immunohistochemical staining documented increased deposition of VEGF protein in flaps that were infused with the VEGF cDNA versus saline alone (p < 0.05). The results indicated that the survival of ischemic tissues can be enhanced by administration of a cDNA encoding VEGF, a protein known to be important in the process of angiogenesis and wound healing.

Effect of time on the viability of ischemic skin flaps treated with vascular endothelial growth factor (VEGF) cDNA

This study examined the efficacy of gene therapy on wound healing. The authors investigated whether delivery of the gene encoding a particular cytokine, known to be important in angiogenesis, could affect ischemic skin flaps. Anterior abdominal skin flaps, based solely on the epigastric artery and vein, were created in the Sprague-Dawley rat model. At the time of elevation, the arterial pedicle supplying each flap was infused either with the gene for vascular endothelial growth factor (VEGF) or physiologic saline alone. The flaps were resutured into place and observed for a period of either 4 or 3 days, at which time the pedicle was ligated. Twenty minutes following ligation, blood flow in the flaps was measured by dye fluorescence. Tissue viability of the flaps was subsequently measured by planimetry after a period of 7 days. Flaps that received the VEGF gene and were ligated at 4 days had an average dye fluorescence index (DFI) of 31.1 following ligation, and 93.9 percent viable tissue after 7 days. Flaps that received saline alone, and were ligated following a similar interval, had an average DFI of 14.0 and 31.9 percent viable tissue. Among the subjects that were ligated at 3 days, only a single, gene-infused flap had any noticeable viable tissue after 7 days. The DFI of these groups was 11.0 for the gene-infused group and 22.1 for the saline-infused group. The results suggest that delivery of the gene for VEGF can improve the survival of ischemic skin flaps, but that the effect of gene therapy is not limitless.

Continuous tissue oxygen tension measurement as a monitor of free-flap viability

Early recognition of vascular compromise within microvascular free-tissue transfers is essential if reexploration is to prove successful. Tissue oxygen tension is increasingly recognized to be a sensitive and reliable index of tissue perfusion, and preliminary studies suggest that it may be of value in the assessment of free-flap viability. We describe our investigation into the application of an implantable microcatheter oxygen sensor in the monitoring of free flaps used in head and neck and extremity reconstruction. In a preliminary study using the rabbit model, we sought to evaluate the response of oxygen tension as an index of tissue perfusion in myocutaneous (n = 20) and osteomyocutaneous flaps (n = 5) under conditions of arterial and venous occlusion. A clinical study was then undertaken to evaluate the role of this method in the monitoring of surface and buried free flaps. In 30 heterogeneous free-tissue transfers, sensors placed intraoperatively were used to provide continuous information about flap oxygen tension (mean monitoring period 3.2 +/- 0.8 days). The data generated were correlated with changes in clinical parameters and routine flap observations. Results for experimental and clinical data have confirmed the efficacy of continuous tissue oxygen measurements using this device as a method that provides an objective, recordable index of free-tissue transfer viability in a variety of circumstances and vascular events. Tissue oxygen tension is a suitable index by which to evaluate flap viability with the probe placed in muscle or bone but is unreliable when used for the monitoring of revascularized cutaneous flaps.

Reappraisal of the inferior epigastric flap: a new neurovascular flap model in the rat

An anatomic, histologic, and electrophysiologic study was carried out in order to determine the distribution and cutaneous sensory territory of the epigastric nerve in the rat. Results for nerve staining (Sihler's method) and electrophysiologic nerve mapping indicate that the neurosome of the epigastric nerve has a different autonomy than the vascular territory of the inferior epigastric artery. Based on these findings, an experimental model for neurovascular free-tissue transfer is proposed.

Periadventitial delivery of heparin in the prevention of microvenous thrombosis

PURPOSE

In spite of advances in technique and instrumentation, microvascular free tissue transfer remains associated with a persistent risk of flap failure. The use of systemic anticoagulants to overcome the formation of vasoocclusive thrombi at reactive anastomotic sites is associated with a high rate of flap hematoma and is ill advised in the operative setting. The purpose of this study was to investigate the use of a biodegradable, nontoxic polymer gel (polyvinyl alcohol, PVA) to effect a sustained localized release of perivascular heparin around thrombogenic venous anastomoses.

MATERIALS AND METHODS

A modified adventitial inclusion model was created in the femoral vein of 64 adult female Sprague-Dawley rats. Animals were divided into four experimental groups: 1) no treatment (controls), 2) periadventitial PVA gel contained in a vicryl chamber, 3) periadventitial PVA gel mixed with heparin, and 4) systemic heparin (intravenous pump). Patency rates in the femoral vein were checked at 10 minutes, 1 hour, 1 day, and 4 days after surgery. Systemic coagulation parameters and histology (scanning electron microscopy, SEM) were assessed in representative animals from all groups.

RESULTS

Patency rates for experimental groups showed a significant improvement in animals treated with PVA/heparin and systemic heparin over controls. Wound hematomas occurred in 7 of 16 animals in group 3, and in 4 of 16 animals in group 4. Activated partial thromboplastin times were elevated in group 4 only (> 150 seconds).

CONCLUSIONS

Continuous release of periadventitial heparin using a polymeric delivery system may represent an efficient means of attenuating the reactivity of microvenous anastomoses without affecting systemic coagulation parameters. In this model, however, its use was associated with a high rate of local wound hematoma.

Combination therapy for salvaging a failing, experimental skin flap

The failing free flap remains a major problem for the reconstructive surgeon. Many and varied pharmacologic agents have been utilized to reverse the effects of ischemia in these flaps. Treatments have been aimed at inhibiting presumed causative factors in the no-reflow phenomenon. Therapy has generally been single in nature and designed to affect only one of these presumed factors. In this study, several pharmacologic agents were utilized individually or in combination therapy as postischemic washouts, in an effort to attack the multiple causative factors in the no-reflow phenomenon and to improve flap survival in a rat abdominal skin flap model. The treatment agents included lactated Ringer's, superoxide dismutase, and urokinase, with each used independently as a postischemic perfusion washout. Combination therapy utilized an initial postischemic perfusion with urokinase, followed by a second perfusion washout with superoxide dismutase. After 18 hr of primary ischemia, there was increased flap survival in the animals undergoing perfusion washout with either superoxide dismutase alone or with combined urokinase and superoxide dismutase washouts, compared to all other treatments (p < 0.001). It was found that flaps undergoing combined urokinase and superoxide dismutase postischemic perfusion washouts demonstrated significantly improved survival after 20 hr of primary ischemia, compared to all other therapies (p < 0.05). By demonstrating improved survival when a thrombolytic agent is used in conjunction with an oxygen free radical scavenger, these findings may have implications in the treatment of clinically failing free flaps.

Increased patency of artificial microvascular grafts using arteriovenous fistula loops: a two-stage procedure for lengthening the pedicle of free-tissue transfer

The effect of a high-flow system on the patency of artificial microvascular grafts (AMG) was investigated using arteriovenous (A-V) fistula loops made of polytetrafluoroethylene (PTFE) in a clinically useful longer length. At a second stage, the A-V loops, matured for 7 days, were used as recipient conduits for free-tissue transfer. The patency rates of 5-cm long PTFE A-V fistula loops were compared with 5-cm and 1-cm long interpositional micrografts in a rat model. The patency rate of the loops at 7 days was 80 percent, compared to 0 percent for both the 5-cm and 1-cm interpositional grafts. A-V fistula loops matured for 7 days in vivo were divided in their midsections and used as arterial and venous conduits (each 2.5 cm long) for free epigastric flaps (3 x 6 cm) raised from the contralateral groin. Sixty-seven percent (8/12) of the free flaps were viable at 7 days. The A-V fistula loop in a high-flow system has a beneficial effect in maintaining patency of AMGs. PTFE fistula loops matured for 7 days can be used as arterial and venous conduits for microsurgical tissue transfer in rats.

Thrombolysis at a controlled pressure prolongs the survival of skin flaps treated with superoxide dismutase

The role of thrombolysis in reestablishing patency in the microcirculation following ischemia, and thereby improving the efficacy of agents attenuating reperfusion injury, such as the oxygen free radical scavenger, superoxide dismutase (SOD), was investigated in a rat model. Abdominal skin flaps were subjected to normothermic ischemia induced by complete occlusion of the pedicle for periods of 12, 13, 14, 16, 18, 20, 22, and 24 hr. In Group 1 (n = 64), all animals received flap washout using 100,000U urokinase (manual injection) followed by 7,500 IU SOD given intra-arterially immediately prior to reperfusion. Animals in Group 2 received flap washout consisting of 100,000U urokinase given via a pressurized delivery system, followed by 7,500 IU SOD. Results demonstrated a statistically significant improvement in flap survival in Group 2. The authors concluded that thrombolytic therapy may be useful in improving the delivery of agents, such as SOD, which attenuate reperfusion injury in skin flaps.

A standardized model of microvenous thrombosis

A standardized model of venous thrombosis is necessary when evaluating potential antithrombotic or thrombolytic agents in microsurgery. Previous studies have shown the adventitial "tuck" model to be advantageous in terms of the vascular reactivity achieved and the relative ease of performance. However, variability exists in the current design, due to the lack of standardized dimensions of the adventitial flap. Two variations of this model are presented which attempt to overcome this problem, and their reproducibility is compared to the inversion graft model of venous thrombosis in the rat femoral vein. The "femoral vein flap" is suggested as a suitable model to simulate anastomotic thrombosis during microvenorrhaphy.

Evaluation of a continuous systemic infusion of iloprost, a stable PGI-2 analog, on the survival of experimental skin flaps

Numerous investigators have attempted to enhance the survival of ischemic experimental skin flaps using various pharmacologic manipulations. Recently, the authors' laboratory demonstrated the beneficial effect of iloprost, a stable PGI2 analogue, as a post-ischemic perfusion washout, in improving the survival of ischemic skin flaps. The rat unilateral abdominal skin flap, based on the superficial epigastric vessels, was utilized in this study involving 30 animals. The animals were divided into three different treatment groups, with ischemic periods of 16 and 18 hr. Perfusion washouts were performed at the completion of the various ischemic periods. Alzet osmotic pumps were used to deliver a continuous systemic infusion of iloprost for 7 days postoperatively. The groups consisted of the following: Group 1 (single ILO)--perfusion washout with iloprost only; Group 2 (continuous LD ILO)--low-dose systemic iloprost infusion (0.066 mcg/kg/min) and perfusion washout with iloprost; and Group 3 (continuous HD ILO)--high-dose systemic iloprost infusion (0.1 mcg/kg/min) and perfusion washout with iloprost. The percentage of flap survival was assessed on postoperative day 7. Skin flaps of the animals receiving the continuous systemic infusion of iloprost were noted to have varying percentages of survival, while skin flaps undergoing perfusion washout only were found to have either complete survival using a continuous systemic infusion of iloprost, compared to iloprost perfusion washout alone. In addition, the hypotensive side effects of systemic iloprost infusion limit its use in the rat skin-flap model.

Use of the guinea pig flank flap in skin flap research

A variety of flaps in laboratory animals have been designed that propose to parallel the behavior of human skin under different experimental conditions. In the search for a readily available and affordable island skin flap model that combines reliable anatomy with a pedicle of substantial size, we have designed in the guinea pig a cutaneous flap based on the superficial circumflex iliac artery and vein. In 22 adult female Hartley guinea pigs, an 8 x 4 cm flank flap based on the superficial circumflex iliac pedicle was raised, and its characteristics were evaluated for applications to skin flap research. Dermofluorometric studies were performed that confirm the vascularity of this flap, and 100% survival of the flap was seen 5 days after surgery in all animals. Of particular benefit was the demonstration that both afferent and efferent blood samples can be taken from the pedicle directly, which allows for the direct quantification of plasma markers after physiologic insults to the skin flap, such as burn or ischemia. This anatomically reliable and easily dissected flap lends itself well to preliminary skin flap research and may contribute to standardization of a model for further studies examining the behavior of skin microcirculation under adverse physiologic conditions.

Use of the Guinea Pig Flank Flap in Skin Flap Research

A variety of flaps in laboratory animals have been designed that propose to parallel the behavior of human skin under different experimental conditions. In the search for a readily available and affordable island skin flap model that combines reliable anatomy with a pedicle of substantial size, we have designed in the guinea pig a cutaneous flap based on the superficial circumflex iliac artery and vein. In 22 adult female Hartley guinea pigs, an 8 × 4 cm flank flap based on the superficial circumflex iliac pedicle was raised, and its characteristics were evaluated for applications to skin flap research. Dermofluorometric studies were performed that confirm the vascularity of this flap, and 100% survival of the flap was seen 5 days after surgery in all animals. Of particular benefit was the demonstration that both afferent and efferent blood samples can be taken from the pedicle directly, which allows for the direct quantification of plasma markers after physiologic insults to the skin flap, such as burn or ischemia. This anatomically reliable and easily dissected flap lends itself well to preliminary skin flap research and may contribute to standardization of a model for further studies examining the behavior of skin microcirculation under adverse physiologic conditions.

Improved efficacy of urokinase further prolongs ischemic skin-flap survival

Salvage of a free-tissue transfer, when postoperative vascular compromise is detected, depends largely upon the restoration of a patent microcirculation. The therapeutic efficacy of thrombolytics infused directly into the failing flap has been clearly demonstrated. In this experiment, the authors investigated whether the method of selective administration of urokinase to failing skin flaps in 68 Sprague-Dawley rats had any effect on flap survival. In one group of animals, postischemic flaps were perfused with 100,000 IU of urokinase given by manual injection, and via a pressurized delivery system (150 mmHg) in the other group. Flap survival was assessed at 7 days. A significantly greater survival was seen in flaps treated with urokinase by controlled pressure infusion (p < 0.01). This simple method is suggested to increase the efficacy of urokinase used in the context of flap salvage.

[Studies of long-term cryopreservation of hepatocytes and their transplantation treating acute hepatic failure in Wistar rats]

The experiment aimed at studying long-term cryopreservation of hepatocytes and therapeutic effect of their transplantation for acute hepatic failure. Hepatocytes of wistar rats were cryopreserved in liquid nitrogen for 30, 60, 90, and 180 days. Their viabilities were respectively 71.2%, 75.7%, 69.7%, and 73.5% of fresh cells', however, there were no significant differences among all cryopreserved groups. Differences of viably intra-hepatocellular enzyme contents among all groups, such as glutamic oxaloacetic transaminase and so on, were not significant. Morphologically intact hepatocytes were observed under light microscopy and transmission electron microscopy. Survival rate of Sprague-Dawley rats with acute hepatic failure were increased from 1/8 to 5/7 because of the transplantation of syngeneic frozen hepatocytes (P = 0.035). The results showed that after 30 days of cryopreservation in liquid nitrogen, the viability of hepatocytes decreased significantly, but no longer decreased in subsequent freeze up to 180 days. The viable intact cells and their normal enzyme contents were kept. The acute hepatic failure could be treated by them.

Iloprost improves survival of ischemic experimental skin flaps

The ability of the prostacyclin analogue iloprost to improve survival of ischemic experimental skin flaps was investigated. Unilateral island skin flaps based on the superficial inferior epigastric vessels were raised in 70 rats and subjected to varying lengths of primary ischemia. The flaps were divided into the following four groups: group I, no perfusion washout; group II, postischemic washout with lactated Ringer's solution; group III, postischemic washout with urokinase; and group IV, postischemic washout with iloprost. Flap survival rates for group IV were significantly higher than all other groups (p < 0.05). The primary ischemia time at which 50% of the flaps failed was 8.9 hours for group I, 9.5 hours for group II, 13.3 hours for group III, and 15.3 hours for group IV. This is the first study to investigate the effect of iloprost on skin flap survival. Iloprost was found to be significantly more effective than urokinase in salvaging ischemic experimental skin flaps.

Use of urokinase during secondary ischemia in experimental skin flaps

The ability of urokinase to salvage experimental flaps after a secondary ischemic insult was investigated in a rat model. Unilateral abdominal island skin flaps based on the superficial inferior epigastric vessels were raised and subjected to either 4 or 6 hours of primary ischemia followed by 12 hours of reperfusion and varying lengths of secondary ischemia. At the conclusion of secondary ischemia, the flaps were perfused with either lactated Ringer's solution or urokinase. One group of flaps served as a control and received no postischemic perfusion washout. The secondary critical ischemia time at which 50% of the flaps failed clinically was greater for flaps perfused with urokinase. Furthermore, the survival rates for all flaps perfused with urokinase were significantly greater than either control flaps or flaps perfused with lactated Ringer's solution (p < 0.05). Flap survival decreased significantly in all groups with increasing primary and/or secondary ischemia time (p < 0.05).

Epidemiology of age-related dementia in China

The results of these epidemiological studies suggest that the morbidity of age related moderate and severe dementia among the population of 65+ was 1.82%, when adjusted by 1984 US population ratio, it became 3.2%, as reported by US and European authors. Yet MID appears more common than PDD, which was more close to the data from Japan. The average annual incidence of moderate and severe dementia for persons aged 60+ was 0.3% (95% CI: 0.08%-0.52%). The incidence for those aged 70-79 (0.41%) was similar to that reported by US authors (Sluss), 0.58% among 70-74 years old, but lower than that observed by European authors (Hagnell, Magnusso) varied from 1.2% to 5.2% in the same age group. These great differences are likely to be partly due to differences in the age structure of samples, instruments for testing dementia, and diagnostic criteria. The course and outcome of dementia after 3-year follow-up indicated that the average survival time was 8 years, and the risk for death of dementia was 3 times higher than that of the whole cohort; the results were similar to those reported by westerners. The major risk factors for AD as identified in this study showed that family history both in first degree relatives of AD and psychosis were significantly associated with AD. The finding was consistent with the genetic hypothesis in western countries. In 7 risk factors that have been studied in US and European countries, 6 showed that the family history of dementia was significantly associated with AD.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhancement of fluorescein perfusion in experimental skin flaps following postischemic washout with iloprost, urokinase, verapamil, and University of Wisconsin solution

The enhancement of blood flow in experimental skin flaps following postischemic perfusion washout was investigated in rats. Unilateral island skin flaps based on the superficial epigastric vessels were raised and subjected to 6 hr of primary ischemia. Group 1 was designated as a control and did not undergo postischemic perfusion washout. In the remaining rats, postischemic washout was performed with one of five agents: Group 2--lactated Ringer's solution; Group 3--University of Wisconsin solution, an organ preservation medium; Group 4--verapamil, a calcium channel blocker; Group 5--urokinase, a thrombolytic agent; Group 6--iloprost, a stable prostacyclin analog. Two hours following perfusion washout, fluorometric analysis revealed a statistically significant enhancement of blood flow in Groups 4, 5, and 6, compared to Groups 2 and 3 (p < 0.05). Furthermore, a significant increase in skin surface fluorescence was demonstrated in all the flaps that underwent perfusion washout, compared to the control flaps (p < 0.05). By analyzing skin surface fluorescence, the enhancement of nutritive blood flow in flaps, following postischemic perfusion washout, was evaluated. This is the first study in which the above pharmacologic agents were compared in a quantitative manner.

Hemodynamics of the rodent abdominal skin flap following primary ischemia

The effect of varying periods of ischemia and reperfusion times on subsequent blood flow was studied in the rodent abdominal skin flap. Using perfusion fluorometry, measurements of blood flow were quantified in 60 Sprague-Dawley rats undergoing clamp-induced ischemic periods ranging from 0 to 6 hours and reperfusion times ranging from 2 to 8 hours. Flaps subjected to ischemia times of 0, 2, 4, or 6 hours require 8 hours of reperfusion time before reaching baseline levels of blood flow. Blood flow in flaps subjected to 6 hours of ischemia was statistically less than the flow in flaps ischemic for 0, 2, and 4 hours and was directly related to length of reperfusion. These results demonstrate that flap perfusion does not fully take place immediately after clamp release. The factors thought to be responsible for these findings and the implications for the design and interpretation of flap ischemia experiments are discussed.

The additive beneficial effect of UW solution and urokinase on experimental microvascular free-flap survival

Pharmacologic manipulation of free flaps to enhance tolerance to ischemia has become a subject of great interest in the research literature. In an effort to improve survival, perfusion washout of experimental free flaps was performed following an episode of primary ischemia. The perfusates utilized were lactated Ringer's solution (LR), University of Wisconsin solution (UW), a high-molecular-weight medium used in organ preservation, and urokinase, a thrombolytic agent. Seventy-five rats were used in this study and divided into groups of 5 each. A 3 x 6-cm abdominal free flap based on the superficial inferior epigastric vessels was raised in each rat. The free flaps were subjected to either 12 or 18 hr of primary ischemia. Following the period of ischemia, perfusion washout was performed with either LR, UW solution, or urokinase at increasing concentrations alone or in combination with UW solution. Urokinase was first evaluated as a perfusate alone at increasing concentrations. In the 12-hr ischemia group, free-flap survival was shown to increase from 0 percent in the LR-perfused flaps to 20 percent, 60 percent, and 80 percent in flaps perfused with 12,500, 25,000, and 100,000 U of urokinase, respectively (p < 0.05). A similar increase in survival was demonstrated in the 18-hr ischemia group, where 0 percent, 20 percent, and 40 percent of flaps survived following perfusion with 12,500, 25,000, and 100,000 U of urokinase, respectively (p < 0.05). Urokinase was then perfused along with UW solution to evaluate the combined effect on flap survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Prolongation of secondary critical ischemia time of experimental skin flaps using UW solution as a normothermic perfusate

A myriad of investigations have been published on the pharmacologic manipulation of flaps to enhance tolerance to ischemia. We recently reported a threefold increase in ischemic tolerance of the rat abdominal skin flap pedicle after 6 hours of primary ischemia and 12 hours of reperfusion. Flaps underwent normothermic perfusion washout with lactated Ringer's or U.W. solution, a newly developed organ preservation medium. Perfusion washouts were performed at one of three different points in the protocol: (1) onset of primary ischemia; (2) onset of secondary ischemia; or (3) 2 hours after onset of secondary ischemia. The last group was used to simulate the clinical situation in which flaps are discovered and salvage procedures instituted at a delayed time interval. This is the longest normothermic ischemic interval reported. We undertook the present study to determine the utility of the U.W solution in prolonging the tolerance of the flap to a second ischemic insult after a period of reperfusion. Seventy-five unilateral rat abdominal skin flaps were raised. Secondary ischemia was produced by placing a microvascular clamp across the inferior epigastric pedicle. Flap survival was assessed at 1 week postoperatively. While none of the nonperfused flaps survived 8 hours of secondary ischemia, at least 50% of the U.W. perfused flaps survived an average of 14 hours of secondary ischemia. Lactated Ringer's perfusion washout only modestly increased the ischemic tolerance. Perfusion washout in the secondary ischemic phase improved the ischemic tolerance to a significantly greater degree than in the primary ischemic interval.

UW solution as an experimental microvascular skin flap perfusate

UW solution has been found to be an effective organ perfusate for transplantation. Initial studies in experimental pedicle skin flaps have also demonstrated its unique effectiveness in prolonged ischemia. To understand better the limits of its preservation properties without the influence of endothelial clamp damage, we have undertaken to study the properties of UW solution in experimental microvascular free flaps. Control, lactated Ringer's, and UW solutions were utilized in pedicle and microvascular free flaps in Sprague-Dawley rats over varying periods of ischemia. UW solution demonstrated a clear superiority over all other solutions in both flap models. In addition there also was a significant prolongation of critical ischemia time in UW-treated free flaps compared to pedicle flaps.

Impaired visual evoked potential and primary axonopathy of the optic nerve in the diabetic BB/W-rat

The spontaneously diabetic BB/W-rat has emerged as an important model system for somatic and autonomic diabetic polyneuropathy. In this study we examined visual evoked potentials and the presence of morphometric and structural changes in the optic nerve and the retinal ganglion cells and their afferent axons contained in the retinal nerve fibre layer. A six-month duration of diabetes mellitus was associated with significant increases in the latencies of the visual evoked potentials. The latency of the first positive potential showed a 44% increase, and that of the first negative potential was prolonged by 41%. No significant changes were demonstrated at any of the amplitudes. In the optic nerve mean myelinated fibre size was significantly reduced to 82% of control values, which was accounted for by a significant reduction in axonal size. Axo-glial dysjunction, a prominent structural defect of diabetic somato-sensory neuropathy in both man and diabetic rodents, was non-significantly increased in the optic nerve. In diabetic animals retinal ganglion cells displayed dystrophic changes. No such changes were observed in age- and sex-matched control animals. Proximal axons of the retinal nerve fibre layer showed an increase in dystrophic axons in diabetic BB/W-rats. Morphometric analysis of optic nerve capillaries revealed no abnormalities except for basement membrane thickening. The present data suggest that the diabetic BB/W-rat develops a central sensory neuropathy, characterized functionally by prolonged latencies of the visual evoked potentials and structurally by an axonopathy of optic nerve fibres.

Temporal factors affecting the secondary critical ischemia of normothermic experimental skin flaps

In free tissue transfer surgery all flaps are subjected to a primary ischemic episode prior to reperfusion. Some flaps may fail due to a second ischemic insult in the postoperative period. The maximum allowable time for salvage of such failing flaps is referred to as the secondary critical ischemia time. Unilateral abdominal island skin flaps based on the superficial inferior epigastric vessels were raised in 96 Sprague-Dawley rats. Animals were divided into 24 groups of four rats each. Normothermic ischemia was produced by applying microvascular clamps to the vascular pedicles. The flap groups were subjected to combinations of primary ischemia, reperfusion, and secondary ischemia. Flap survival was assessed on the seventh postoperative day. Flap survival decreases significantly with increased primary and/or secondary ischemia time and decreased reperfusion period. Moreover, a longer primary ischemia and/or shorter reperfusion decrease the tolerance of the flap to a second ischemic insult.

The use of a new perfusate in experimental microvascular flaps: a threefold increase in ischemic tolerance

The benefit of perfusion washout in both experimental and clinical skin flaps has long been debated. By perfusing ischemic rat pedicled flaps with UW solution, a recently developed, high-molecular-weight, organ-preservation medium, a 170 percent increase in the critical ischemia time of treated versus untreated control flaps was demonstrated. Sixty rats were used in this study. A 3- x 6-cm unilateral abdominal skin flap based on the superficial inferior epigastric artery and vein was raised. The flaps were divided into three groups: Group 1 (control--no perfusion washout (n = 15); Group 2 (LR)--perfusion washout with lactated Ringer's solution (n = 15); Group 3 (UW)--perfusion washout with UW solution (n = 30). Flaps were subjected to varying periods of ischemia, ranging between 8 and 30 hr. The primary ischemia time at which 50 percent of the flaps survived clinically was 10 hr for Group 1, 15 hr for Group 2, and 27 hr for Group 3. The differences between the survival rates for flaps in Groups 1, 2, and 3 were statistically significant (p less than .0005). By bathing the vascular and parenchymal cells in an impermeant preservation solution, it was hypothesized that cellular swelling would be inhibited, thereby significantly improving a skin flap's tolerance to warm ischemia. Furthermore, after reviewing the pertinent literature, it is evident that the primary critical ischemia time of 27 hr is the highest reported to date for the normothermic experimental rat pedicled flap. Clinical application of these findings, as well as the need for further studies, are discussed.

Diabetic autonomic neuropathy in BB rats and effect of ARI treatment on heart-rate variability and vagus nerve structure

The preventive effect of the aldose reductase inhibitor (ARI) ponalrestat on heart-rate variability and the development of autonomic neuropathy in the vagus nerve was investigated in the spontaneously diabetic BB rat. ARI treatment completely prevented the characteristic decrease in heart-rate variability and axonal atrophy of the vagus nerve for 4 mo in hyperglycemic BB rats. After 6 mo of treatment, the preventive effect on heart-rate variability was partial, and the vagus nerve demonstrated an increase in regenerating myelinated and unmyelinated fibers. These data suggest that autonomic neuropathy involving the vagus nerve is metabolically induced by demonstrating that inhibition of the polyol pathway significantly delays the occurrence of functional and structural autonomic neuropathy despite the presence of hyperglycemia.

Preventive effect of long-term aldose reductase inhibition (ponalrestat) on nerve conduction and sural nerve structure in the spontaneously diabetic Bio-Breeding rat

To test the hypothesis that aldose reductase inhibition may prevent or delay the development of functional and structural neuropathy in the insulin-deficient diabetic Bio-Breeding rat (BB-rat), hyperglycemic rats were begun on the aldose reductase inhibitor (ARI) ponalrestat 25 mg/kg body wt soon after the onset of diabetes and followed for 4 or 6 mo. Ponalrestat treatment completely prevented the characteristic nerve conduction slowing and structural abnormalities of the node of Ranvier for 4 mo despite only partial preservation of axonal integrity. Ponalrestat treatment for 6 mo achieved a partial but significant prevention of nerve conduction slowing, axoglial dysjunction, and axonal degenerative changes. This incomplete but significant prevention of neuropathy by ponalrestat suggests that additional mechanisms besides polyol-pathway activation may be of importance in the pathogenesis of diabetic neuropathy. Alternatively, the dosage used in the present study may not have been sufficient to achieve a complete prevention. Despite the only partial protective effect of ARI treatment on degenerative peripheral nerve changes in hyperglycemic BB-rats, 6 mo of treatment resulted in a more than threefold increase in regenerating nerve fibers. These data suggest that prophylactic ARI treatment may be efficacious in delaying the development of diabetic neuropathy.

Neuroaxonal dystrophy in distal symmetric sensory polyneuropathy of the diabetic BB-rat

We and others have previously described neuroaxonal dystrophic changes as one of the hallmarks of structural diabetic autonomic polyneuropathy involving sympathetic nerves. In the present study, a systemic search for similar changes was undertaken in the mainly sensory symmetric polyneuropathy of the spontaneously diabetic BB-rat. Changes identical to those described in sympathetic nerves in this model were found in sensory ganglion cells, in their proximal extramedullary axons, and in proximal and distal myelinated axons of the spinal dorsal columns. The dystrophic substructures consisted of tubulovesicles, tubular rings, layered membranes, electron-dense membranous bodies, and neurofilamentous changes. Neuroaxonal dystrophic abnormalities increased with increasing duration of diabetes, and exhibited a topographic distribution along the sensory neuroaxonal axis, suggesting metabolic abnormalities as well as abnormalities in the turn-around mechanism of fast axonal transport in the pathogenesis of dystrophic changes in diabetic nerves.

Autonomic neuropathy in BB rats and alterations in bladder function

In vivo urinary bladder function was examined in BB rats after 4 and 6 mo of diabetes, and the data were correlated with morphometric changes in the pelvic and hypogastric nerves, which constitute the micturition reflex arc. After controlled bladder distension, diabetic animals revealed irregular bladder contractions at frequencies that were reduced to 33% of normal values and with significantly increased amplitudes. The abnormal micturition in diabetic animals was elicited at moderately elevated threshold volumes. These functional abnormalities of the diabetic bladder were associated with a progressive axonopathy of afferent myelinated sensory fibers and later-occurring axonal atrophy of unmyelinated efferent preganglionic fibers. These data suggest that diabetic urinary bladder dysfunction is initiated by a visceral sensory neuropathy involving the afferent limb of the micturition reflex arc.

Diabetic and hypoglycemic neuropathy--a comparison in the BB rat

Functional and structural neuropathy was examined in hyperglycemic (diabetic) BB rats maintained on small maintenance doses of insulin, hyperglycemic BB rats receiving no insulin, and BB rats in whom hypoglycemia was induced by the administration of excessive insulin doses. The data were compared with those of non-diabetic age- and sex-matched BB rats. Functional deficits and structural abnormalities were comparable in diabetic rats with and without insulin supplementation, suggesting that the generally necessary insulin dosing in this model does not per se account for the neuropathy. Hypoglycemic neuropathy was characterized by slowing of nerve conduction velocity, marked loss of anterior horn motoneurons and Wallerian degeneration, as well as loss of large myelinated fibers, suggesting a neuropathy involving predominantly motoneurons. Diabetic neuropathy was not associated with nerve cell loss but showed marked axonal atrophy involving predominantly sensory fibers. Thus, diabetic and hypoglycemic neuropathies are two distinguishable entities under strict experimental conditions, but may overlap in human diabetic subjects in whom tight insulin control is desirable.

Diabetic neuropathy in STZ-induced diabetic rat and effect of allogeneic islet cell transplantation. Morphometric analysis

The effect of pancreatic islet cell allotransplantation on the development of diabetic neuropathy in streptozocin-induced diabetic ACI rats was examined morphometrically with light- and electron-microscopic procedures. Peripheral nerve function was evaluated by nerve conduction velocity and evoked muscle potential amplitude measurements. Diabetes was induced at 4 mo of age, and diabetic animals were transplanted by intracerebral and intraportal grafts 2 wk later. Diabetic animals with accepted grafts returned to euglycemia and showed a normal body-weight gain over the subsequent 14-mo observation period. Transplanted animals with accepted grafts and those in whom graft rejection was induced were compared with age-matched nontransplanted diabetic rats and nondiabetic control rats at 18 mo of age. Successful allotransplantation completely prevented axonal atrophy and the characteristic nodal and paranodal structural abnormalities in diabetic nerve, as well as the typical slowing of nerve conduction velocity. Our data suggest that islet cell allotransplantation is an effective therapeutic approach to the prevention of diabetic neuropathy.

Somatic embryogenesis and plant regeneration in callus from inflorescences of Hordeum vulgare X Triticum aestivum hybrids

Embryogenic callus cultures were obtained by culturing young inflorescence tissues of Hordeum vulgare cv. 'PF51811' (2x)XTriticum aestivum cv. 'Chinese Spring' (6x) hybrids on 2,4-D-containing N6 medium. After subculture for about 10 months the calli retained a high potentiality for somatic embryogenesis and plant regeneration. Of about 300 regenerated plants, approximately 100 were transplanted to potting soil. Eight embryoids and three regenerated plants examined had 28 chromosomes identical to the original hybrid plants, while one regenerated plant was found to be a mixploid composed of cells with 28 and 56 chromosomes. The possibility for obtaining amphiploid hybrids through tissue culture is discussed.