Fate of the TRAM flap after abdominoplasty in a rat model

During a classical abdominoplasty, all musculocutaneous perforators from the deep inferior epigastric vessels are normally divided. Even if somehow neovascularization could relink the abdominal skin and rectus abdominis muscles, reestablishing these same discrete perforators would be unlikely because of the barrier effect of the abdominal wall fascia. Therefore, a lower transverse rectus abdominis musculocutaneous (TRAM) flap intuitively should not regain sufficient vascularity for viability after a prior abdominoplasty, and a history of the latter should be expected to be a major contraindication for this procedure. Nevertheless, anecdotal observations of successful lower TRAM flaps following abdominoplasty seem to contradict our basic principles, which may need better further elucidation. Consequently, this two-stage study in Sprague-Dawley rats was undertaken, initially performing an abdominoplasty in all rats. This was followed 1 or 10 months later by the creation of an unipedicled superiorly based TRAM flap that incorporated virtually all of the abdominal skin. From our identical historical TRAM flap control (n = 5) except without prior abdominoplasty, 72.8 +/- 12.83 percent of this area survived. TRAM flaps raised 1 month after the abdominoplasty (n = 6) had 2.2 +/- 3.4 percent or essentially no viability. Unexpectedly, the long-term group (n = 7) demonstrated 13.7 +/- 10.0 percent viability, ranging from 0 to 30 percent. Both groups of TRAM flaps after abdominoplasty had a flap survival area significantly less than that of the control by two-tailed group t test (p < 0.001), and that of the long-term group area was significantly greater than that of the short-term (p = 0.022). Lead oxide studies 10 months after abdominoplasty revealed no irrefutable evidence of the reestablishment of rectus abdominis perforators to the integument, although obviously some reconnections had formed at the microcirculatory level to partially revascularize some flaps. The range of viability of the long-term rat TRAM flaps documented that for the majority, surviving surface area was minuscule even following a delay equivalent to a human decade after abdominoplasty (1 rat month - 1.1 human years), yet rarely sufficient revascularization did indeed occur, which could explain the prior unusual clinical successes. However, the basic principle that a TRAM flap raised following a classical abdominoplasty at any time would be a risky maneuver seems to still be a valid concept.     

Liver changes in protein malnutrition. An experimental study in rats

Congenital rubella syndrome has a wide variety of severe ophthalmic and systemic complications. A worldwide rubella epidemic from 1963 to 1965 affected thousands of infants. This is a 20 year follow up study of patients with congenital rubella syndrome analysing the prevalence of ophthalmic disorders, associated systemic problems, and correlations among these defects. The authors statistically analysed 125 cases of congenital rubella seen in the Mayo clinic ophthalmology department over a 32 year interval. Most patients were young adults. Ocular disease was the most commonly noted disorder (78%), followed by sensorineural hearing deficits (66%), psychomotor retardation (62%), cardiac abnormalities (58%), and mental retardation (42%). Multiorgan disease was typical (88%). Ocular disease and hearing loss were frequently associated (53% had both) but not significantly correlated. A similar association existed between ocular and cardiac disease. Cataracts and microphthalmia were significantly correlated with poor visual acuity (each p < 0.0001). Glaucoma was significantly correlated with cataracts (p = 0.0002) and microphthalmia (p = 0.0024) but not poor visual acuity. Four patients with microphthalmia developed late onset glaucoma. No significant association was found between gestational age at time of maternal infection and the incidence of individual ocular conditions. However, several cardiac disorders were significantly associated with gestational age. Although new cases of congenital rubella are rare, surviving victims continue to challenge the ophthalmic and medical communities with a wide range of ocular and systemic disorders.     

Preferential use of the ipsilateral pedicle in TRAM flap breast reconstruction

While numerous animal models exist for studying neonatal brain injury after cerebral ischemia-hypoxia, an adequate model for assessing reversible focal ischemia in the neonatal rat has not been reported. This paper describes in detail a new surgical procedure for creating a non-hemorrhagic, reperfused focal ischemic lesion in the neonatal, 7-day-old rat pup.     

Effects of irradiation on the biomechanics of osseointegration. An experimental in vivo study in rats

The present study reports on the late effects of increasing doses of radiation on the biomechanics of commercially pure titanium implants (fixtures) installed in the proximal tibia in 26 rats. Twelve weeks after various doses (10, 20, 30, and 35 Gy) of irradiation, the fixtures were inserted into rat tibiae, and after another eight weeks these were tested mechanically in vivo. Acute dose dependent skin reactions developed after all doses except 10 Gy, but most subsided within two to three weeks. There was a statistically significant reduction in torsion but the pull-out load was not significantly reduced for single doses up to 30 Gy. Histological analysis showed that bone remodelling was impaired. Shear stresses and shear moduli were estimated for the bone-implant interface and in the surrounding bone tissue. These estimated stresses and moduli were not found to be correlated to the dose of radiation.     

Translocation of bacteria due to direct mucosal damage caused by Gastrografin. An experimental study in newborn rats

The aim of this study was to investigate the role of heat-shock proteins after heat-shock stress on the post-ischemic recovery of cardiac mechanical and endothelial function following a prolonged cardiac arrest. Isolated working rat hearts were subjected to a cardioplegic arrest for 4 hours at 4 degrees C. Three groups (n = 8 in each) were studied: (1) control, (2) sham-treated, and (3) heat-shocked rats. Postischemic recovery of cardiac output and endothelial function (as percent of preischemic control values) was 57.8% +/- 2.8% and 20.8% +/- 3.9% in group 1, 50.9% +/- 4.0% and 26.3% +/- 5.9% in group 2, and 74.0% +/- 2.4% and 51.2% +/- 8.0% in group 3, respectively. Both postischemic myocardial and endothelial function were improved by heat stress.     

Use of a buried nasolabial flap to fill a depression over the lower jaw. Case report

A viable local flap is not plagued by the problems of resorption and dissolution. If it is to be denuded and buried, however, great care must be taken to select a donor area that is as hairless as possible. Otherwise, there may be cyst formation, drainage, and infection.     

Revascularization of a necrotic bone by transfer of a arteriovenous pedicle flap. Experimental study in rats

An experiment in adult rats with histologic study of isolated bone segment revascularization is reported vascular bundle is inserted into the humeral head that has been transferred under abdominal skin. It induces an active proliferation of new blood vessels with formation of new bone/invading the necrotized bone.     

An experimental study of the effectiveness of brainstorming.

In the study of conditions favorable to creativity 2 different ways of conducting brainstorming groups were compared. 3 groups each composed of 7 university students were given instructions to uncritically invent names for 3 kinds of articles; 3 other groups of students each composed of 7 persons were given instructions to also invent names for the same articles only to do so critically. 150 different students rated the invented names of both groups for quality. "For each product, the noncritical condition produced a greater number or responses than the critical condition… . If it is the purpose of problem solving to produce a specific number of ideas of highest possible quality, these best ideas will tend to be of higher or equal quality when the noncritical method is used." From Psyc Abstracts 36:02:2HD45W. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tumor-related arthrodesis. Reconstruction of the shoulder contour using a free TRAM (Transverse Rectus Abdominis Musculocutaneous) flap]

We evaluated growth hormone binding protein (GHBP) activity in a group of obese children (12 boys and 12 girls, age 3.1-14.7 years, BMI 21.1-33.3, 11 prepubertal and 13 early pubertal) and in 26 age-matched normal weight children (14 boys and 12 girls, age 2.1-16.0 years, BMI 14.2-21.4, 18 prepubertal and 8 early pubertal). All children were of normal stature. GHBP activity was significantly higher in the obese (39.1 +/- 1.1%) than in the control children (28.3 +/- 1.0%, p < 0.0001). Mean serum GHBP was not different between boys and girls or between prepubertal and pubertal subjects. A positive correlation was found between BMI and GHBP levels only in the normal weight children (r = 0.425, p < 0.05). Baseline insulin concentrations in the obese children were 97.6 +/- 7.9 pmol/l (normal values, 45.0 +/- 18.6 pmol/l), and the mean insulin AUC following OGTT in the obese was 811.3 +/- 160.7 pmol/l (normal values, 373.1 +/- 150.1 pmol/l). Serum GHBP activity in the obese was not correlated with baseline serum insulin concentrations or with the insulin AUC following OGTT. In conclusion, we found that obese children have elevated GHBP activity, and speculate that this phenomenon may serve to compensate for their reduced GH secretion and accelerated GH clearance.     

A long-time presence of a foreign body in an episiotomy scar

OBJECTIVES: The object of our study was a long-time presence of a foreign body in an episiotomy scar. STUDY DESIGN: A case of 46-year old woman with a palpable tumour in a perineal region is described. RESULTS: This false tumour was caused by a surgical needle which was left in the body of the patient 19 years ago during the episiorrhaphy after the last labour. CONCLUSION: Because of a character and localisation of the change the method of choice was surgical treatment which completely eliminated all symptoms.     

An experimental study of the double bind hypothesis.

The primary aim of the study was to assess whether persons highly conversant with the double bind concept could reliably identify such communication in letters, and, if so, whether its presence or absence was related to the fact of the letter having been written by the parent of a schizophrenic or nonschizophrenic person. The interjudge correlations of the double bind judges were very low, indicating that their judgments regarding presence or absence of double bind communication were not reliable. Other judges achieved statistically significant interjudge reliability and were able to differentiate between letters written by parents of patients and a comparison group. It was concluded from these results that a more critical appraisal of the double bind concept is indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tooth mobility and resolution of experimental periodontitis. An experimental study in the dog

The aim of the present experiment was to study alterations in the mobility of teeth that occurred during resolution of experimentally induced periodontitis lesions in the dog. 5, 1-year-old, beagle dogs were used in the study. The left and right 4th, 3rd, and 2nd mandibular premolars (4P4, 3P3, 2P2) served as experimental teeth. Periodontal tissue breakdown was initiated by placing plaque-collecting cotton-floss ligatures around the neck of the experimental teeth. The ligatures were replaced to the level of the receding gingival margin 1 x every month. On Day 120, the ligatures were removed and debridement was performed. A groove, parallel to the long axis of the mesial root, was prepared in the mesio-buccal surface of the crowns of 2P and P2. Guided by the groove and with a probing force of 0.5 N, a probe was inserted into the buccal gingival pocket of the mesial root and was attached to the buccal surface. Biopsies including both the mesial and distal root of 2P and P2 and the surrounding hard and soft tissues were harvested. The biopsy procedure was repeated in a similar manner 15 days (i.e. Day 135) and 3 months (i.e. Day 225) after ligature removal in the 4th (4P4) and 3rd (3P3) premolar regions. After fixation, decalcification and sectioning, the biopsy material was exposed to histometric and morphometric measurements. Assessment of the mobility of the experimental teeth was performed on Days 120, 135 and 225 using the Periotest system.(ABSTRACT TRUNCATED AT 250 WORDS)     

Crossing the midline: a study of four-year-old children

Selenomethionine, an amino acid occurring in proteins in place of methionine, reacts efficiently with oxidants, e.g., peroxynitrite, a biological oxidant generated in inflammatory states, to produce the oxidation product, methionine selenoxide. The present work describes the rapid and efficient reduction of the selenoxide to selenomethionine by glutathione in a stoichiometric reaction utilizing two equivalents of thiol. This nonenzymatic reaction establishes a defense line against peroxynitrite or other oxidants by selenomethionine residues in proteins, maintained by the ubiquitous thiol, glutathione.     

Decadron in the treatment of cerebral abscess. An experimental study

Forty rabbits were inoculated with Streptococcus pyogenes or Staphylococcus aureus to produce cerebral abscesses. One-third of the rabbits received no treatment and served as controls. One-third received dexamethasone (Decadron) plus an appropriate antibiotic. One-third received only the appropriate antibiotic in the same dosage. The animals were sacrificed 10 days after inoculation and the brains examined. In the control group, an abscess at the stage of granulation tissue encapsulation containing the inoculated organisms was found. The surrounding brain showed a marked inflammatory response. In the Decadron plus antibiotic group, necrotic lesions were found containing the inoculated organisms and surrounded by relatively normal brain. In the group treated with antibiotic alone, healed glial scars were found in relatively normal brain. Our findings are discussed with reference to the medical literature regarding the influence of glucocorticoids on the inflammatory response and the efficacy of antibiotics when this response is suppressed.     

Anatomy of the internal mammary veins and their use in free TRAM flap breast reconstruction

The anatomy of 61 internal mammary veins (IMV) in the 3rd, 4th and 5th intercostal spaces was studied in 34 fresh human cadavers by injection and corrosion methods and surgical dissection. The IMV was present in all 34 cadavers. Four different patterns of venous anatomy were identified: Types 1 (69%) and 2 (26%) were common, Types 3 (3%) and 4(2%) were rare. The most common arrangement (Type 1) consists of the internal mammary vein running medial and parallel to the artery to the 4th intercostal space where it divides into the medial and the lateral IMV, the lateral crossing the internal mammary artery (IMA) anterior to it in direction from medial to lateral. Both veins are connected by interconnecting branches. The mean diameter of internal mammary veins is 2.7 mm (range 1.1-4.8 mm) for the medial and 1.8 mm (range 0.5-3.5 mm) for the lateral one. The mean distance from the lateral bordoffof the sternum of the medial vein is 9 mm (range 2-18 mm) and 14 mm (range 9-24 mm) for the lateral vepfpff. We present a review of 7 patients in whom internal mammary vessels were used as recipient vessels for breast reconstruction with free TRAM flaps with no complications, as well as the advantages and disadvantages of such a procedure.     

Organisation of the reticular thalamic projection to the intralaminar and midline nuclei in rats

Risk detection and reduction methods for persons at high risk of ischemic stroke involve screening and identification of risk factors. Population-based health surveys affirm a persistent dilemma in the inability to reduce the frequency of ischemic stroke risk factors, such as hypertension, cigarette smoking, obesity, and physical inactivity levels. These alarming trends indicate that "mass approach" policies and programs need to be implemented or rethought to attain maximum levels of benefit in ischemic stroke risk reduction for the entire community.     

Percutaneous reinsertion of the nucleus pulposus. An experimental study

STUDY DESIGN: An analysis of the histologic changes in intervertebral discs after percutaneous reinsertion of the nucleus pulposus in rats. OBJECTIVE: To devise a way to delay further disc degeneration resulting from spinal deformity and the adverse effects of various treatments. SUMMARY OF BACKGROUND DATA: The role of the nucleus pulposus of the intervertebral disc described by many investigators has not been fully clarified. METHODS: Disc herniation was induced in the tails of 112 Wistar rats, using a fixation device between the 5th and 8th coccygeal vertebrae. After percutaneous nucleotomy at coccygeal vertebrae 5-6 and 6-7, fresh nucleus pulposus, cryopreserved nucleus pulposus, or an artificial substitute was inserted into the intervertebral disc at coccygeal vertebrae 5-6. Two, 4, or 8 weeks after reinsertion, disc sections from each coccygeal level were studied histopathologically. RESULTS: In the groups with reinsertion of fresh or cryopreserved nucleus pulposus, degenerative changes of the disc with the reinserted nucleus at coccygeal vertebrae 5-6 were milder than those of the disc without reinsertion at coccygeal vertebrae 6-7. However, no apparent benefit from reinsertion was observed in the group with artificial substitutes. CONCLUSIONS: Early reinsertion of the nucleus pulposus (fresh or cryopreserved) delays degeneration of such disc materials as the anulus fibrosus, endplate, and remaining nucleus pulposus.     

An experimental study of cross-cultural norm conflict.

"An experimental study was conducted in which normative conflict of foreign students was examined. From a treatment of norms as force-fields, predictions were made about the resolution of intergroup norm conflict under two conditions of situational potency of membership. It was hypothesized that the resolution of intergroup norm conflict favors the norm of the group whose situational potency is increased. The results obtained did not show the clarity necessary for a definitive validation of the hypotheses. The major analyses led to acceptable levels of significance in only half of the tests made; nevertheless, all the results presented a consistent pattern in harmony with the theoretical formulation." (PsycINFO Database Record (c) 2010 APA, all rights reserved)