PubMed Health⌕ Search

Biomedical subjects

M L Urken

Publications and source records attributed to M L Urken.

At least 19 recordsLinked to original sources
PubMed2000

Reconstruction of the pediatric maxilla and mandible.

BACKGROUND: The creation of osseous defects in the upper and lower jaws in children is an uncommon occurrence. It is therefore likely that a head and neck reconstructive surgeon will accumulate only limited experience in restoring such defects. We have reviewed 7 pediatric bone-containing microvascular free flap reconstructions in 6 patients for reconstruction of the upper or lower jaws. Three patients were available for long-term follow-up to evaluate the effect of osseous free flap reconstruction on function and growth and development of the donor site. DESIGN: Retrospective review. SETTING: Academic tertiary referral center for otolaryngology. PATIENTS AND METHODS: Six pediatric patients ranging in age from 8 to 16 years underwent 2 fibular, 4 scapular, and 1 iliac free flap procedure for restoration of 2 maxillary and 5 mandibular defects from 1992 to 1997. Three of the 6 patients were available for long-term follow-up to assess the postoperative donor site function in an effort to determine the effect of this surgery on long-term donor site morbidity and development. RESULTS: Two patients were lost to follow-up, and 1 died secondary to complications related to distant metastatic disease. Three of 6 patients were observed for 2 years 6 months, 4 years, and 4 years 2 months, respectively. Two of the 3 patients who were observed long term have undergone full dental rehabilitation and currently maintain a regular diet and deny pain with mastication or deglutition. One patient did not require dental rehabilitation. All 3 patients demonstrate gross facial symmetry and normal dental occlusion. Assessment of the fibular donor site demonstrated normal limb length and circumference. The patients denied pain or restriction to recreational activity. Scapular donor sites demonstrated normal range of motion, strength, and shoulder stability. CONCLUSIONS: Free flap reconstruction of the pediatric maxilla and mandible requires harvesting bone from actively growing donor sites. We have found no evidence of functional deficit after bone harvest from the fibular or scapular donor sites. Patients demonstrate normal growth at the donor sites, and symmetry of the mandible and maxilla is preserved.

Adolescent↗
PubMed2000

Posterior scalping flap revisited.

OBJECTIVE: To report our experience in a case series of 5 posterior scalping flaps. DESIGN: Retrospective review of a case series. SETTING: A tertiary academic care otolaryngology-head and neck surgery referral center. PATIENTS: Five patients having undergone posterior scalping flap reconstruction of cutaneous midface defects. METHODS: Reconstruction was performed for 4 cheek defects, 1 of which included the lateral third of the upper and lower lips, and 1 combined midfacial and lateral nasal wall defect. RESULTS: All 5 patients had excellent cosmetic and functional results. The only complication was a single case of partial-thickness distal flap necrosis. CONCLUSION: The posterior scalping flap offers a reliable source of skin with appropriate color and texture and minimal donor-site morbidity.

Adult↗
PubMed1999

Use of the peritracheal fold in the dog tracheal transplantation model.

OBJECTIVE: To investigate the technical aspects of the canine model of human tracheal transplantation for potential application to reconstruction of extremely long tracheal defects (> 10 cm). DESIGN: In phase 1, long tracheal segments were skeletonized and pedicled with the thyroid glands, cranial thyroid arteries and veins, and internal jugular vein branches. The segments were elevated completely, attached to the vascular pedicle only, and replaced with primary tracheal anastomoses. In phase 2, long segments were elevated along with a diffuse soft tissue "blanket" that envelops the trachea and thyroid glands. Because this study was designed to primarily address, in situ, tracheal perfusion territories of a cranially located vascular pedicle, microvascular anastomoses were not conducted. SUBJECTS: Two small-bodied beagles (10-15 kg) and 5 large-bodied mixed-breed dogs (20-30 kg) were humanely killed 2 to 41 days after surgery, and anatomic and histological analyses were conducted. RESULTS: Unlike that of humans, the thyroid gland complex of dogs is not intimately associated with the trachea but is conjoined with a peritracheal soft tissue "fold." Within this fold, blood is transmitted to the trachea via a diffuse, segmental vascular plexus. In phase 1, pronounced tracheal necrosis occurred within 2 to 5 days. In phase 2, extremely long tracheal segments (10-12 cm), based only on a cranially located pedicle, were still viable at 2 to 6 weeks. CONCLUSIONS: Preservation of the "peritracheal fold" in the dog model of tracheal transplantation is critical to the onset and maintenance of vascular perfusion in a long tracheal segment. Furthermore, the use of large-bodied dogs is necessary to provide for a usable venous efflux component.

Animals↗
PubMed1999

Human papillomavirus may be common within nasopharyngeal carcinoma of Caucasian Americans: investigation of Epstein-Barr virus and human papillomavirus in eastern and western nasopharyngeal carcinoma using ligation-dependent polymerase chain reaction.

BACKGROUND: Nasopharyngeal carcinoma (NPC), particularly those tumors endemic to the Far East, commonly harbor Epstein-Barr virus (EBV), thought to serve as an important oncogenic promoter. Human papillomavirus (HPV) is associated with a proportion of upper aerodigestive tract carcinomas. We hypothesized that HPV might also contribute to the pathogenesis of NPC, and we queried whether geographic and racial distinctions may be identified between NPC of the Far East versus those diagnosed in Caucasian American patients with regard to the interrelationship of histologic subtype and viral infection. MATERIALS AND METHODS: Formalin-fixed paraffin-embedded tissue (FFPET) from 30 patients (6 Caucasian Americans, 1 Chinese American, 14 and 9 patients from Korea and China, respectively) were studied using the ligation-dependent polymerase chain reaction (LD-PCR). These cases were histologically classified according to the World Health Organization (WHO) schema for NPC. Consensus target probes complementary to the L1 region of over 30 HPV types, as well as target probes complementary to EBER-1 (EBV-related nontranslated latency-associated RNA), were used to amplify target sequences. RESULTS: Seven of 30 NPC (23%) contained HPV sequences. There were 6 Caucasian American patients with NPC; 3 cases (50%) were HPV positive (HPV+). Two of these Caucasian Americans had WHO type I tumors: one was HPV+ and EBV negative (EBV-) and the other was HPV-/EBV+. The remaining Caucasian American NPCs were WHO-II/III tumors which tested as follows: two were coinfected with HPV and EBV, the other two contained EBER but not HPV sequences. The single Oriental American patient had a WHO-III NPC which was HPV-/EBV+. Of the Eastern NPC patients, 4 (1 WHO-I, 3 WHO-II/III) of 23 (17%) NPCs contained HPV sequences as well as EBV. Conclusion. Human papillomavirus appears to be uncommonly (17%) associated with NPC in patients from the Far East and was detected more often (50%) in NPC from American Caucasian patients. Some of these tumors conformed to our perceptions and expectations of NPC (eg, WHO-I tumors being EBV-/HPV+ and WHO-III tumors being EBV+/HPV-), but other tumors did not conform to these expectations (eg, WHO-III NPC occasionally harboring both HPV and EBV). There appears to be a broad profile in the relationship between HPV, EBV, and NPC histologic subtype. Unfortunately, the number of American Caucasian cases studied are too small to allow for strong conclusions.

Asian People↗
PubMed1999

Tracheal transplantation: defining the vascular territory of the canine cranial thyroid artery.

The management of long-segment tracheal stenosis remains an unsolved clinical problem that has significant implications for the survival of some patients and the quality of life of others. However, recent advances in microvascular tissue transfer may allow tracheal transplantation to be used as a treatment option. Studies in dogs have demonstrated that the reanastomosis of the cranial thyroid artery (CTA) after the transplantation of a short segment of trachea sustains cartilage viability. However, the distal perfusion zone of the CTA within the canine trachea has not been described. Hence it is unclear what length of trachea can be safely harvested, with use of the CTA as the donor artery, without risking ischemia of the distal trachea. This study determined the perfusion territory of the CTA by use of latex or dye infusion via the thyroid branches of the CTA. Findings in five perfusion-fixed cadaver mongrel dogs (8 to 12 kg) were studied. In each dog, both common carotid arteries were dissected and the CTAs identified. The right CTA was ligated and the left common carotid artery was ligated cranial to the CTA. The left common carotid artery was perfused for 10 minutes under 100 mm Hg pressure with black india ink/saline solution (20:1000 ml) or with blue latex solution. Perfusion territories were determined by grossly and microscopically measuring the region of stain in the endolaryngeal and endotracheal airways. The results demonstrated that up to 18 ipsilateral rings of the canine trachea are perfused after injection of dye under physiologic pressure into the CTA. Contralateral staining was also noted, but to a lesser degree. These results suggest that the canine CTA may perfuse, on average, a 16- to 17-ring tracheal segment.

Animals↗
PubMed1999

Upper aerodigestive tract liposarcoma: report on four cases and literature review.

OBJECTIVE: To report on the clinical behavior, histopathology, treatment, and prognosis of laryngeal, hypopharyngeal, and cervical esophageal liposarcomas. STUDY DESIGN: Retrospective reviews of pathology files and hospital records at a tertiary care hospital and a retrospective search of the English-language literature. METHODS: Cases of upper aerodigestive tract (UADT) liposarcoma with adequate histopathologic documentation and clinical information were included for review. RESULTS: Four cases of UADT liposarcomas were identified. The literature review revealed 26 cases of laryngeal liposarcomas, 7 cases of hypopharyngeal liposarcomas, and 6 cases of esophageal liposarcomas: the mean age at presentation was 55.8 years, the male:female ratio was 5:1, and 60% of the patients presented with dysphagia. Eighty-six percent of tumors had low-grade histologic findings. The recurrence rate after primary resection was 50%. Recurrence correlated with surgical procedure rather than with histologic subtype; 94.7% of recurrences happened after simple excision. Distant metastases occurred in three patients; two of them died of the disease. CONCLUSIONS: The literature supports that UADT liposarcomas are rare and usually of low-grade histologic type. The rate of metastatic disease and tumor-related mortality is low. However, high recurrence rates have been noted, particularly when less radical surgery is employed.

Adult↗
PubMed1999

Videolaryngostroboscopy following vertical partial laryngectomy.

Phonation after partial laryngeal ablative surgery has not often been examined. Videolaryngostroboscopic recordings made after vertical partial laryngectomy (VPL) were retrospectively reviewed and correlated with patient historical and operative factors. Among VPL patients (n = 42), the most common site of vibration during phonation was the contralateral false vocal fold (17/42 patients or 40.5%), followed by the contralateral arytenoid mucosa (10/42 or 23.8%) and the contralateral true vocal fold (8/42 patients or 19.0%). There was no overall difference in vocal quality judgment with respect to site of vibration (ANOVA, p = .373). Vocal quality scores were similar with use of the pyriform mucosal flap versus other reconstructive methods (Student's t-test, p = .568). This study highlights the fact that reconstruction of a new vibratory source after VPL is important for voice production. Because VPL patients infrequently demonstrated true vocal fold vibration, alternative sites (ie, false vocal fold, arytenoid mucosa) must be considered as new phonatory sources after VPL.

Arytenoid Cartilage↗
PubMed1999

Surveillance CT and the prompt use of CT-guided fine-needle aspiration in patients with head and neck cancer who have undergone surgery.

OBJECTIVE: The purpose of this study was to assess the usefulness of prompt CT-guided fine-needle aspiration in the evaluation of suspected tumor recurrence seen on surveillance images of patients who had undergone surgery for head and neck cancer. SUBJECTS AND METHODS: We reviewed 32 patients who had undergone CT-guided fine-needle aspiration after surgery for head and neck cancer. CT-guided fine-needle aspiration was performed with a 22-gauge spinal needle and a cytopathologist was present to assess the adequacy of the biopsy sample. As many as five needle passes were made. RESULTS: Of the 32 cases, pathologic findings revealed squamous cell carcinoma (n = 27), mucoepidermoid carcinoma (n = 2), neuroendocrine carcinoma (n = 1), papillary thyroid carcinoma (n = 1), and adenocarcinoma (n = 1). In 20 cases (62.5%) the results of CT-guided fine-needle aspiration were positive for tumor recurrence, whereas in 11 cases (34.4%) the results were negative. In one case (3.1%) the results were nondiagnostic. Of the 11 patients with negative findings on CT-guided fine-needle aspiration, two patients had a subsequent recurrence that was not at the biopsy site. There were no complications from the procedure. CONCLUSION: When a radiologist who is trained in head and neck imaging identifies with CT a possible early recurrence of tumor, the prompt use of CT-guided fine-needle aspiration is an effective way to diagnose these tumors so that appropriate treatment can be initiated.

Adult↗
PubMed1999

Complications of head and neck surgery in the elderly.

Many recent studies have documented that complications of head and neck surgery are no more common in the elderly than in younger patients. But few studies have addressed complication rates in a population undergoing reconstruction with microvascular free tissue transfer (MFTT). We compared outcomes of patients older and younger than 70 who underwent MFTT and found no significant difference in the incidence of surgical complications. However, older patients did experience more medical morbidity and more surgical mortality. Nonetheless, we conclude that MFTT should not be withheld from patients 70 years and older solely on the basis of their advanced age.

Aged↗
PubMed1999

The back door: venous-mediated metastasis into cervical lymph nodes as an alternative metastatic pathway for oropharyngeal squamous cell carcinoma.

Circulating lymphocytes may home to lymph nodes (LNs) via paracortical postcapillary venules, high-endothelial venules (HEVs) that recognize circulating lymphocytes, enabling them to migrate into nodal cortical/paracortical regions. Our goal was to find any histologic, immunohistochemical, or in vitro evidence to support the hypothesis that squamous cell carcinoma (SCC) may gain access to LNs via an alternative venolymphatic pathway. Slides from 67 neck dissections with SCC were studied. Standard criteria for lymphatic-mediated metastasis were used; criteria for evidence ofvenolymphatic metastasis were tumor nests localized to the paracortical regions, directly contiguous to HEVs but not marginal sinuses. Cases in which LN architecture was obliterated by metastases were excluded. A modified Stamper-Woodruff assay, which assesses HEV binding, incubated cell lines from oral carcinomas and lung adenocarcinomas with fresh frozen LN sections. Double-blinded cell counts were performed by two observers and analyzed by Student's t test. Immunohistochemical examination was undertaken on 19 paraffin-embedded cases with the monoclonal antibody, MoAb CD44v6, to discover whether expression of this adhesion molecule correlated with metastatic pattern. Twenty-nine cases (66%) revealed evidence only for the LN route of metastasis; 4 cases (9%) were classified as venolymphatic metastasis; 11 cases (25%) showed evidence for both pathways. The Stamper-Woodruff assay confirmed that SCC cells preferentially bound to HEV within cervical LN sections more than did adenocarcinoma cells (P = .02). Strong staining to MoAb CD44v6 was seen in 18 (95%) of 19 SCCs with a membranous pattern. Occasionally, CD44v6 highlighted tumor emboli adjacent to HEVs, but no overall correlation could be made between CD44v6 expression and pattern of spread. Tumor metastasis via lymphatic channels is the predominant mode of metastatic spread, but the venolymphatic route is a plausible alternative pathway. The preferential attachment of SCC cells to HEVs supports this theory.

Cell Adhesion↗
PubMed1998

Oromandibular reconstruction using microvascular composite flaps: report of 210 cases.

OBJECTIVE: To review the experience of 1 microvascular surgeon during an 11-year period in performing 210 vascularized bone-containing free flaps for oromandibular reconstruction. DESIGN: Retrospective medical records review of patients who underwent primary and secondary oromandibular reconstruction with the use of vascularized bone free flaps. SETTING: Academic medical center. PATIENTS: A total of 201 patients underwent 210 composite free-flap reconstructions of the mandible for various disorders and with a range of bony and soft tissue defects. INTERVENTION: All patients underwent the microvascular transfer of vascularized bone flaps from the ilium, fibula, or scapula. In selected cases, 2 simultaneous free flaps were transferred to achieve an optimal bone and soft tissue reconstruction. Endosteal dental implants were used in 81 patients, with a total of 360 fixtures placed during these 11 years. MAIN OUTCOME MEASURES: The success of microvascular free tissue transfer, dental implant extrusion, and short- and long-term complications at the recipient and donor sites. RESULTS: Of the 210 mandibular reconstructions that were performed, 202 were successful in reestablishing mandibular continuity. Reexploration for vascular-related complications was done in 16 patients, 8 of whom were successfully treated, yielding an overall success rate of 96%. The overall success rate for endosteal dental implants was 92%. The implant success rate was 86% when the bone in which the fixtures were placed was irradiated postoperatively. The success rate was 64% in the 14 fixtures that were placed into previously irradiated bone. CONCLUSIONS: The success of the use of vascularized bone free flaps in restoring continuity to the mandible is clearly demonstrated in this series. There was an acceptable incidence of donor- and recipient-site complications that resulted in minimal long-term morbidity. The careful selection of a donor site(s) for oromandibular reconstruction allows for an optimal restoration of bony and soft tissue defects. Dental implants can be safely used in oromandibular reconstruction with a high level of success. Placing these implants during the initial surgery shortens the duration for achieving dental rehabilitation and enhances the success of the implants when postoperative radiotherapy is administered.

Adolescent↗
PubMed1998

Complications of microvascular head and neck surgery in the elderly.

OBJECTIVES: To evaluate the complications of head and neck reconstruction using microvascular free tissue transfers (MFTTs) performed in an elderly population and to determine whether these complications are more common than in a younger population. SETTING: Tertiary referral center. PATIENTS AND DESIGN: Retrospective, consecutive chart review of patients older than 70 years who underwent MFTT in the past 5 years (group 1). The complications in this population were compared with those in a second group (group 2) of consecutive patients younger than 70 years who were matched according to the site of the primary tumor. MAIN OUTCOME MEASURES: Surgical and medical complications. RESULTS: The median age for group 1 was 74 years and for group 2, 55 years. The overall complication rate for group 1 was 48%, compared with 57% for group 2. In group 1, surgical morbidity was less common and medical morbidity was more common than in group 2. Mortality rate was 6% for group 1 and 0% for group 2. The types of complications were similar for both groups. There was no difference in complication rates when complications were classified by site of the defect, patient status determined by American Society of Anesthesiologists classification, or use of preoperative radiation. The overall success rate of MFTT was 100% for group 1 and 94% for group 2. CONCLUSIONS: Microvascular free tissue transfers for head and neck reconstruction can be safely performed in the elderly. An age older than 70 years does not increase the rate of surgical complications following head and neck reconstruction with MFTT. Medical complications, however, are more common and are equally divided between bronchopulmonary and cardiovascular effects.

Aged↗
PubMed1998

Characterizing the antigenic profile of the human trachea: implications for tracheal transplantation.

BACKGROUND: Tracheal transplantation may be a viable alternative in select situations of long-segment tracheal stenosis. Issues concerning human tracheal antigenicity and the requirement for systemic immunosuppression need to be addressed. This study examined the distribution of the major transplantation antigens on fresh human trachea. METHODS: Frozen sections of 10 human tracheas were examined for class I (HLA [human leukocyte antigen]-A, -B, -C) and class II (HLA-DR) histocompatibility antigens using mouse monoclonal antibodies in an indirect immunoperoxidase assay. The tracheal mucosa, perichondrium, cartilage matrix, and chondrocytes were examined and assigned a semiquantitative score for HLA class I and class II expression. RESULTS: The tracheal mucosa was strongly antigenic for HLA class I and class II antigens, whereas the perichondrium contained only scattered fibroblasts that were positive for both classes. The polysaccharide matrix was consistently devoid of class I or class II expression. The chondrocytes of all 10 specimens expressed diffuse class I positivity; only two specimens contained chondrocytes that expressed class II positivity. CONCLUSIONS: The human trachea contains "compartments" of highly antigenic tissue that are morphologically distinct from regions of lesser antigenicity.

Biopsy↗
PubMed1998

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.

Analysis of Variance↗
PubMed1998

Tracheal transplantation: superior and inferior thyroid artery perfusion territory.

OBJECTIVE: To determine the perfusion territories of the superior and inferior thyroid arteries in humans. Tracheal transplantation is a potential option for management of long-segment tracheal stenosis. However, the maximum length of vascularized trachea that can be reliably transplanted has not been established. STUDY DESIGN: The tracheal vascular territory of individual superior and inferior thyroid arteries was determined separately in 10 humans postmortem. METHODS: India ink was infused unilaterally under controlled pressure into the superior (n = 5) and inferior (n = 5) thyroid arteries of cadaveric tracheas. Tracheas were sectioned longitudinally and the caudalmost extent of mucosal dye staining was determined via microscopic assessment. RESULTS: The tracheal perfusion territory of the superior thyroid artery was two to five rings (1.7 +/- 0.5 cm) and the inferior thyroid artery, nine to 13 rings (6.5 +/- 1.1 cm). In both cases, the tracheal mucosa on the contralateral side was stained to the same caudal level. CONCLUSIONS: The inferior thyroid artery was shown to perfuse the trachea maximally to the 13th ring (8.1 cm). As such, the unilateral inferior thyroid artery would serve as a suitable vascular component for long-segment tracheal transplantation in humans.

Adult↗
PubMed1998

Anatomy and vascular perfusion territories of the superior thyroid artery in Macaca mulatta.

OBJECTIVE: Currently, methods used to repair long segment tracheal stenosis are unreliable. Here, a new nonhuman primate model of tracheal transplantation is used based on its evolutionary proximity to humans. STUDY DESIGN: Prospective dye perfusion study in Macaca mulatta. METHODS: After anatomical characterization, Evan's blue solution was injected into the right superior thyroid artery unilaterally (n = 5). Staining of the tracheal vasculature was then examined. RESULTS: In M mulatta, the superior thyroid artery branched from the lingual-facial trunk and was 0.64 +/- 0.18 mm in diameter. Dye staining was bilateral, with the ipsilateral side extending to 2.98 +/- 0.58 cm and the contralateral to 2.88 +/- 0.88 cm, 12.9 +/- 3.45 rings (47% of trachea). CONCLUSIONS: The tracheal vasculature has extensive bilateral collateral vascular channels that may provide a graft survival advantage. Macaques may serve as a good model of tracheal transplantation because of the collateral vascularization of the trachea and the extensive tracheal segment supplied by the superior thyroid artery, and because the superior thyroid artery and vein are anastomosable.

Anastomosis, Surgical↗
PubMed1998

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.

Animals↗