Publications (66)146.91 Total impact
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Article: Vacuum-assisted closure for complicated wounds in head and neck region after reconstruction.
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ABSTRACT: OBJECTIVE: The aim of this study is to suggest that negative pressure wound therapy (NPWT) is an excellent alternative for managing complicated wounds after head and neck reconstruction. SUMMARY BACKGROUND DATA: Management of complicated wounds such as wound infection or persistent saliva leakage from poor wound healing with dead space is challenging in head and neck reconstruction. The NPWT is a useful device widely used in treating many complicated wounds. In this study, we applied this device on complicated wounds after head and neck reconstruction and share our experience and modifications. METHODS: From January 2004 to December 2009, 13 male patients (mean age: 50.0 years) were included. Eleven patients were reconstructed with free flap transfer and the other two patients received a local flap for repair immediately after tumour ablation. Among them, 12 patients (92%) had complicated wounds with infection and one patient (8%) with partial loss of the free flap. Eight of these 13 patients (62%) had saliva leakage and fistula formation. For those who had a free flap transfer, the vacuum-assisted closure (VAC) system was applied with modifications to the complicated wound 2 weeks later, after better neo-vascularisation around the free flap. Watertight suturing on the mucosal side is needed to ensure air sealing and enhance wound healing acquired by the VAC system. RESULTS: All wounds demonstrated adequate control of wound infection, quick obliteration of dead space and rapid growth of granulation tissue under the NPWT. Eleven patients (85%) had wound healing with secondary intention; one (8%) needed a further skin grafting; and one patient (8%) needed a free flap transfer due to partial flap loss in a severe wound infection even after the NPWT application. The average duration of the NPWT usage was 10.8 days (4-24 days); most of the wounds healed within 1 week after the NPWT application. CONCLUSION: The NPWT is an excellent alternative for managing complicated wounds after head and neck reconstruction. It is safe and comfortable for the patient and provides good results in infection control, dead space obliteration and improvement of wound healing.Journal of Plastic Reconstructive & Aesthetic Surgery 04/2013; · 1.49 Impact Factor -
Article: Clinical application of the internal mammary artery perforator flap in head and neck reconstruction.
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ABSTRACT: : The skin texture of the internal mammary artery perforator flap closely resembles that in the face and neck, making it the perfect source of tissue for head and neck reconstruction. In this article, the authors describe their experience in recent application of this flap in head and neck reconstruction and evaluate its pros and cons. : A total of 15 patients (three women and 12 men) with a mean age of 58.6 years received an internal mammary artery perforator flap for head and neck defect repair from April of 2007 to August of 2011. There were 11 internal mammary artery perforator pedicle flaps and four internal mammary artery perforator free flaps. : Flap size ranged from 5 × 3 cm to 15 × 8 cm, pedicle length ranged from 3 to 6 cm, and 14 of 15 flaps (93.3 percent) had a sizable perforator identified during dissection. In the female patient who had no sizable perforator, the originally intended free flap was transformed to a platysma myocutaneous flap, which served as a backup procedure, extending from the same surgical incision. All of the transfers were successful. The donor sites were closed primarily in all patients except one, who received a split-thickness skin graft for a 15 × 8-cm donor defect. : With excellent skin color and tissue texture matching and minimal donor-site morbidity, the internal mammary artery perforator flap is emerging as a potential alternative reconstructive tool for the head and neck region. : Therapeutic, IV.Plastic and reconstructive surgery 04/2013; 131(4):520e-6e. · 2.74 Impact Factor -
Article: Free-style puzzle flap: the concept of recycling a perforator flap.
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ABSTRACT: Theoretically, a flap can be supplied by any perforator based on the angiosome theory. In this study, the technique of free-style perforator flap dissection was used to harvest a pedicled or free skin flap from a previous free flap for a second difficult reconstruction. The authors call this a free-style puzzle flap. For the past 3 years, the authors treated 13 patients in whom 12 pedicled free-style puzzle flaps were harvested from previous redundant free flaps and recycled to reconstruct soft-tissue defects at various anatomical locations. One free-style free puzzle flap was harvested from a previous anterolateral thigh flap for buccal cancer to reconstruct a foot defect. Total flap survival was attained in 12 of 13 flaps. One transferred flap failed completely. This patient had received postoperative radiotherapy after the initial cancer ablation and free anterolateral thigh flap reconstruction. Another free flap was used to close and reconstruct the wound. All the donor sites could be closed primarily. The free-style puzzle flap, harvested from a previous redundant free flap and used as a perforator flap to reconstruct a new defect, has proven to be versatile and reliable. When indicated, it is an alternative donor site for further reconstruction of soft-tissue defects.Plastic and reconstructive surgery 02/2013; 131(2):258-63. · 2.74 Impact Factor -
Article: Circulating microRNA signatures in mice exposed to lipoteichoic acid.
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ABSTRACT: BACKGROUND: Previously, we had identified a specific whole blood--derived microRNAs (miRNAs) signature in mice following in vivo injection of lipopolysaccharide (LPS) originated from Gram-negative bacteria. This study was designed to profile the circulating miRNAs expression in mice exposed to lipoteichoic acid (LTA) which is a major component of the wall of Gram-positive bacteria. RESULTS: C57BL/6 mice received intraperitoneal injections of 100 mug of LTA originated from Bacillus subtilis, Streptococcus faecalis, and Staphylococcus aureus were killed 6 h and the whole blood samples were obtained for miRNA expression analysis using a miRNA array (Phalanx miRNA OneArray(R) 1.0). Up-regulated expression of miRNA targets in the whole blood, serum and white blood cells (WBCs) of C57BL/6 and Tlr2-/- mice upon LTA treatment in 10, 100, or 1000 ug concentrations was quantified at indicated time (2, 6, 24, and 72 h) using real-time RT-PCR and compared with that in the serum of C57BL/6 mice injected with 100 ug of LPS. A significant increase of 4 miRNAs (miR-451, miR-668, miR-1902, and miR-1904) was observed in the whole blood and the serum in a dose- and time-dependent fashion following LTA injection. Induction of miRNA occurred in the serum after 2 h and persisted for at least 6 h. No increased expression of these 4 miRNAs was found in the WBCs. Higher but not significant expression level of these 4 miRNAs were observed following LTA treatment in the serum of Tlr2-/-against that of C57BL6 mice. In contrast, LPS exposure induced moderate expression of miR-451 but not of the other 3 miRNA targets. CONCLUSIONS: We identified a specific circulating miRNA signature in mice exposed to LTA. That expression profile is different from those of mice exposed to LPS. Those circulating miRNAs induced by LTA or LPS treatment may serve as promising biomarkers for the differentiation between exposures to Gram-positive or Gram-negative bacteria.Journal of Biomedical Science 01/2013; 20(1):2. · 2.01 Impact Factor -
Article: The nasolabial flap as a one-stage procedure for reconstruction of intermediate-to-large lip defects with functional and aesthetic assessments.
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ABSTRACT: OBJECTIVES: The primary function of the lip is oral competence. The lips are also fundamental in facial aesthetics. Thus in lip reconstruction, it is paramount to achieve both good functional and aesthetic outcomes. Local flaps are able to provide the best tissue match in intermediate and large lip defects. Nevertheless, there has been limited literature on using the musculocutaneous nasolabial flap as a one-stage procedure for lip reconstruction. METHODS: The authors recruited 21 patients who underwent a one-stage nasolabial musculocutaneous flap reconstruction for lip defects for the study. The modiolus at the mouth angle was preserved and the nasolabial flap was de-epithelised and tunnelled subcutaneously in all patients for reconstructing the lips. Electromyography was performed for 14 flaps to detect muscle activity. Oral competency was assessed using the Drooling Rating Scale and aesthetic outcomes were also analysed postoperatively with the Patient and Observer Scar Assessment Scale. RESULTS: All patients successfully underwent lip reconstruction with the musculocutaneous nasolabial flap. There were no flap failures. Electromyographic activity was detected in 10 out of the 14 flaps tested. Oral competencies were well preserved and there were no cases of microstomia. Aesthetic results were also good. CONCLUSION: The nasolabial flap for one-stage reconstruction of lip defects following lip resection is feasible. Good functional and aesthetic outcome can be achieved.Journal of Plastic Reconstructive & Aesthetic Surgery 11/2012; · 1.49 Impact Factor -
Article: Use of Anteromedial Thigh Flaps as an Alternative to Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects in Cancer Patients.
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ABSTRACT: BACKGROUND: To determine whether anteromedial thigh (AMT) flaps are a good choice for reconstruction in cases in which no sizable skin perforator is found in anterolateral thigh (ALT) flap dissection or ALT flaps have been previously harvested. METHODS: From February 2006 to August 2008, 17 free AMT flaps were used to reconstruct soft tissue defects of the head and neck. We recorded the age and sex of the patients, sites of primary tumor, tumor stage, size of defect, previous operative conditions, results of flap transfer, and donor-site complications. RESULTS: Of the 17 AMT flaps, 1 flap failed and 1 showed partial necrosis. Venous insufficiency developed in 2 cases, and the flaps were successfully salvaged in both the cases. The success rate was 94.1%. The AMT flaps were 6 to 20 cm long and 4 to 9 cm wide. The mean length of the pedicle was 7.5 ± 1.0 cm (range, 5-12 cm). Of the 17 donor sites, 6 were closed directly, 9 were closed using split-thickness skin grafts, and 2 were closed using full-thickness skin grafts. Complications and morbidity of the donor site were minimal. CONCLUSIONS: Cases in which no sizable perforator is found or an ALT flap has been previously harvested pose an aesthetic challenge, and an AMT flap is a good alternative for performing successful reconstruction in such cases.Annals of plastic surgery 08/2012; · 1.29 Impact Factor -
Article: Whole blood-derived microRNA signatures in mice exposed to lipopolysaccharides.
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ABSTRACT: Lipopolysaccharide (LPS) is recognized as the most potent microbial mediator presaging the threat of invasion of Gram-negative bacteria that implicated in the pathogenesis of sepsis and septic shock. This study was designed to examine the microRNA (miRNA) expression in whole blood from mice injected with intraperitoneal LPS. C57BL/6 mice received intraperitoneal injections of varying concentrations (range, 10-1000 μg) of LPS from different bacteria, including Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Salmonella enterica, and Serratia marcescens and were killed 2, 6, 24, and 72 h after LPS injection. Whole blood samples were obtained and tissues, including lung, brain, liver, and spleen, were harvested for miRNA expression analysis using an miRNA array (Phalanx miRNA OneArray® 1.0). Upregulated expression of miRNA targets in the whole blood of C57BL/6 and Tlr4(-/-) mice injected with LPS was quantified using real-time RT-PCR and compared with that in the whole blood of C57BL/6 mice injected with lipoteichoic acid (LTA) from Staphylococcus aureus. Following LPS injection, a significant increase of 15 miRNAs was observed in the whole blood. Among them, only 3 miRNAs showed up-regulated expression in the lung, but no miRNAs showed a high expression level in the other examined tissues. Upregulated expression of the miRNA targets (let-7d, miR-15b, miR-16, miR-25, miR-92a, miR-103, miR-107 and miR-451) following LPS injection on real-time RT-PCR was dose- and time-dependent. miRNA induction occurred after 2 h and persisted for at least 6 h. Exposure to LPS from different bacteria did not induce significantly different expression of these miRNA targets. Additionally, significantly lower expression levels of let-7d, miR-25, miR-92a, miR-103, and miR-107 were observed in whole blood of Tlr4(-/-) mice. In contrast, LTA exposure induced moderate expression of miR-451 but not of the other 7 miRNA targets. We identified a specific whole blood-derived miRNA signature in mice exposed to LPS, but not to LTA, from different gram-negative bacteria. These whole blood-derived miRNAs are promising as biomarkers for LPS exposure.Journal of Biomedical Science 07/2012; 19:69. · 2.01 Impact Factor -
Article: Simvastatin reduces VCAM-1 expression in human umbilical vein endothelial cells exposed to lipopolysaccharide.
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ABSTRACT: Reducing the expression of endothelial cell adhesion molecules (ECAMs) is known to decrease inflammation-induced vascular complications. In this paper we looked at whether statins can reduce inflammation-induced ECAM expression after lipopolysaccharide (LPS) treatment in endothelial cells. Human umbilical vein endothelial cells (HUVECs) were pretreated with different concentrations of simvastatin, atorvastatin, and rosuvastatin and subsequently exposed to 5 μg/ml LPS. Semi-quantitative RT-PCR analysis was used to measure the mRNA expression of ECAMs, including VCAM-1, ICAM-1, and E-selectin. VCAM-1 mRNA appeared to be the only target that was affected by the statins, with its expression being partially and almost completely reduced by simvastatin at 50 and 125 μM concentrations, respectively, and only partially reduced by atorvastatin, but not reduced by rosuvastatin. VCAM-1 protein production was inhibited by simvastatin at concentrations from 5 to 125 μM. Leukocyte-endothelial cell adhesion assay revealed that simvastatin could inhibit the adhesion of labelled U937 cells to the HUVEC monolayer. This study showed that simvastatin reduces VCAM-1 expression in HUVECs exposed to LPS and decreases leukocyte-endothelial cell adhesion.Agents and Actions 01/2012; 61(5):485-91. · 1.59 Impact Factor -
Article: Risk factors of subsequent vertebral compression fractures after vertebroplasty.
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ABSTRACT: To elucidate the risk factors for a subsequent vertebral compression fracture following percutaneous vertebroplasty, we analyzed the potential predictors of vertebral compression fractures adjacent to or remote from fractures previously treated with percutaneous vertebroplasty. This is a retrospective cohort study. A major concern after percutaneous vertebroplasty in patients with osteoporosis is the occurrence of subsequent vertebral compression fractures in the untreated vertebral bodies. The risk factors for the development of subsequent vertebral compression fractures after percutaneous vertebroplasty are unclear. Two hundred four consecutive patients underwent percutaneous vertebroplasty for acute vertebral compression fractures between January 2007 and December 2008. Forty-nine patients were excluded. Subsequent vertebral compression fractures were diagnosed by bone edema changes on magnetic resonance imaging. Patient's demographic data were used for univariate and multivariable binary logistic regression analyses. Forty-three (27.7%) of the 155 patients had subsequent vertebral compression fractures within 2 years of percutaneous vertebroplasty, with 21 (48.8%) of these patients having fractures detected within 3 months. Adjacent vertebral compression fractures tended to occur sooner, although not significantly (log-rank test, P = 0.112). On multivariate analyses, only the T-score of bone mineral density was significantly associated with subsequent vertebral compression fractures (P < 0.0001; odds ratio = 0.27; 95% confidence interval, 0.15-0.49). The only risk factor significantly associated with subsequent vertebral compression fractures following percutaneous vertebroplasty was a low bone mineral density T-score. Patients with lower bone mineral density have a higher incidence of vertebral compression fractures and thus need more intensive clinical and radiological follow-up.Pain Medicine 01/2012; 13(3):376-82. · 2.35 Impact Factor -
Article: Effect of extracorporeal shockwave treatment on the melanogenic activity of cultured melanocytes.
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ABSTRACT: In addition to the traditional lithotripsy treatment, extracorporeal shockwaves (ESWs) have been shown to be effective in the treatment of certain musculoskeletal disorders and in enhancing skin flap neovascularization. However, relatively little is known about its effect on melanocytes. To investigate its effect on the melanogenic activity of cultured melanocytes, mouse B16F10 melanocytes were treated with defocused ESWs of different energies (15, 21, and 27 kV) and at different doses (300 and 600 impulses). Cell viability was measured 1 and 24 h after treatment. Melanin content was measured and compared against a standard curve generated with fungal melanin. Cellular tyrosinase activity was calculated with the 3,4-dihydroxyphenylalanine (DOPA) oxidase assay. The results demonstrated that ESW treatment reduced cell viability. Our results also indicated that the overall decrease in cell viability lasted for 6 days. After ESW treatment with 300 or 600 impulses at 21 kV, no significant change in melanin content or tyrosinase activity of the B16F10 melanocytes was noted as compared to those of the control. The present study suggests that ESW treatment does not alter the melanogenic activity of the cultured melanocytes.Applied biochemistry and biotechnology 11/2011; 166(3):632-9. · 1.94 Impact Factor -
Article: Qualitative and quantitative analyses of donor-site morbidity following suprafascial versus subfascial free fibula flap harvesting.
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ABSTRACT: The free fibular flap has become the workhorse flap for composite mandibular defect reconstruction. As advancements in microsurgery have improved flap survival, greater interest has shifted toward flap refinements to avert donor-site morbidities. A total of 27 free fibular flaps used for mandible reconstruction were studied prospectively. Of the 27 flaps, 18 suprafascial and nine subfascial dissections were performed. A questionnaire was developed and completed by all patients to assess qualitative aspects of donor-site morbidity and function. Quantitative studies focused on bilateral isokinetic testing of each patient's lower extremities by comparing and quantifying the ankle function. For the subfascial group, 42 percent of patients complained of pain and alteration in sensation. These donor-site morbidities within the suprafascial group were negligible. Using the Wilcoxon rank sum test, scores obtained from the questionnaires were analyzed, with significant differences seen in wound problems/cosmetic appearance between the two groups (p = 0.0114). For the subfascial group, the donor leg showed significantly less range of motion in plantar-flexion exercises (p = 0.03). Comparing the isokinetic examination results of the suprafascial and subfascial groups, a significant decrease in ankle dorsiflexion, plantar flexion, and foot eversion was evident in the subfascial group. The qualitative or subjective perception of donor-site morbidity, for the suprafascial method of fibular flap harvest, is relatively low. Quantitative analysis revealed that this method did not cause decreases in ankle function, and it had superior contour and aesthetic outcomes compared with the conventional, subfascial method. Therapeutic, II.(Figure is included in full-text article.).Plastic and reconstructive surgery 07/2011; 128(1):137-45. · 2.74 Impact Factor -
Article: Altered expression of the microRNAS and their potential target genes in the soleus muscle after peripheral denervation and reinnervation in rats.
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ABSTRACT: To profile the expression of microRNAs (miRNAs) and their potential target genes in the soleus muscles after denervation and reinnervation of the sciatic nerve in rats. The 4 months denervated and reinnervated soleus muscles were analyzed with Agilent Rat miRNA array to detect the expressed miRNAs against those from the sham control. These differentially expressed miRNAs were applied for hierarchical cluster analysis using average linkage and Pearson correlation as a measure of similarity. A combined approach using computational prediction by the miRanda algorithm and the Agilent Whole Rat Genome 4× 44K oligo microarray experiment was performed to identify the potential target genes of these up-regulated miRNAs. Gene ontology (GO) analysis of these potential target genes into one of the three ontologies, biological process, molecular function, or cellular component, was performed and compared between the denervated and reinnervated muscles. Thirty-six and 39 miRNAs of 350 rat miRNAs tested were significantly up-regulated in the denervated and reinnervated muscles, respectively. The expressed miRNAs in these two groups were similar but with different folds, and the unsupervised hierarchy clustering was able to separate the samples into denervation and reinnervation groupings. In the GO analysis, all three categories indicated a considerable reduced number of the potential target genes of the up-regulated miRNAs and less fraction of differentially expressed genes in most of the GO terms in the reinnervated muscle. This study demonstrated a different involvement of miRNAs and their potential target genes in the soleus muscle after denervation and after reinnervation of the sciatic nerve in a rat model.The Journal of trauma 02/2011; 70(2):472-80. · 2.48 Impact Factor -
Article: Comparing clinical outcomes following percutaneous vertebroplasty with conservative therapy for acute osteoporotic vertebral compression fractures.
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ABSTRACT: To compare the efficacy of percutaneous vertebroplasty (PV) with conservative therapy for patients with acute vertebral compression fractures. Prospective, nonrandomized, comparison study. The efficacy of PV has not been well established because there have been few comparative studies with conservatively treated control groups. Fifty-five consecutive patients (8 men and 47 women, age 47-94) with osteoporosis and symptomatic acute vertebral compression fractures were enrolled. thirty-two patients received pv, whereas 23 received conservative therapy. Changes in pain intensity, physical functioning, and pain medication requirement were evaluated. Both PV and conservative therapy provided pain reduction (P < 0.001), improvements in physical functioning (P < 0.001), and decreased medication (P < 0.001). Reductions in visual analogue pain scores were more significant in the vertebroplasty group at 1 (P < 0.001) and 4 weeks (P < 0.001) but not at 12 months. Improvements in physical functioning were significant at 1 (P < 0.001) and 4 weeks (P < 0.001). Medication requirements were lower in the vertebroplasty group at all three time points. Pain relief, physical functioning improvement, and medication requirement after vertebroplasty are immediately and significantly better when compared with conservative therapy.Pain Medicine 11/2010; 11(11):1659-65. · 2.35 Impact Factor -
Article: Far-infrared radiation promotes angiogenesis in human microvascular endothelial cells via extracellular signal-regulated kinase activation.
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ABSTRACT: This study was designed to determine the in vitro angiogenic ability of far-infrared (FIR) radiation in the skin-derived cultured human microvascular endothelial cells and to elucidate the role of mitogen-activated protein kinases (MAPKs) in this process. The results revealed that FIR radiation from a WS(TM) TY301 FIR emitter activated p38 and extracellular signal-regulated kinase (ERK), but not Akt or c-Jun N-terminal protein kinases (JNK), and significantly promoted angiogenesis by increasing tube formation in Matrigel and the migration of cells across an eight micron polyester filter. The addition of 50 μM PD98059, a MEK inhibitor, significantly inhibited the activation of ERK and the enhanced angiogenesis; in contrast, the inhibition of p38 phosphorylation did not inhibit the enhanced angiogenesis. After FIR radiation, there was no increase in vascular endothelial growth factor (VEGF) isoforms (VEGF-A, -B, -C and -D) mRNA and VEGF protein, no increase phosphorylation of endothelial nitric oxide synthase (eNOS) detected using Western blotting, and no increase in NO production detected using flow cytometry in cells pre-incubated with the cell-permeable NO-binding dye diluted 4-amino-5-methylamino-2', 7'-difluorofluorescein diacetate (DAF-FM DA). This study revealed that FIR radiation possesses in vitro angiogenic activity via the activation of the MEK/ERK but not the VEGF/Akt/eNOS-dependent signaling pathways.Photochemistry and Photobiology 11/2010; 87(2):441-6. · 2.41 Impact Factor -
Article: A reliable parameter for primary closure of the free anterolateral thigh flap donor site.
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ABSTRACT: Primary closure of the donor site after flap harvest is key to achieving a satisfactory result. The authors investigated the width of the harvested anterolateral thigh flap allowing primary closure of the donor site. Sixty-five consecutive patients undergoing reconstructive procedures using anterolateral thigh flaps were divided into two groups: group A, primary closure of the donor site; and group B, donor site covered with split-thickness skin graft. Maximum flap width and thigh circumference were measured at the midpoint of the line connecting the lateral superior margin of the patella and the anterior superior iliac spine. The maximum flap width-to-thigh circumference ratio was calculated. Patients' body mass index and age were recorded. The outcome was evaluated by the surgeon. Primary closure of the donor site was possible in 56 patients (86 percent), and in nine patients (14 percent) a split-thickness skin graft was necessary. All of the donor sites were closed primarily when the flap width was less than 16 percent of the thigh circumference. There was a significant correlation between body mass index and the ratio (p<0.001, r=-0.573) and between patient age and the ratio (p=0.033, r=0.267). Muscle herniation was significantly higher in group B (p=0.029). The flap width-to-thigh circumference ratio is a reliable parameter for preoperative planning of primary closure of the anterolateral thigh flap donor site. Primary closure can be achieved if the flap width-to-thigh circumference ratio is less than 16 percent. The patient's body mass index and age have to be taken into consideration.Plastic and reconstructive surgery 11/2010; 126(5):1558-62. · 2.74 Impact Factor -
Article: Microsurgical replantation and salvage procedures in traumatic ear amputation.
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ABSTRACT: The purpose of this study is to present our experience with patients who underwent traumatic ear amputation. Between January 1988 and April 2002, 10 patients sustained ear amputations. Of these, six patients underwent microvascular replantation (arterial anastomosis only and arterial and venous anastomosis in three patients each), and replantation was attempted in one patient. However, no suitable vessel could be found for the anastomosis, and the amputated ear was treated as a composite graft and buried in a retroauricular pocket. Staged costal cartilage reconstruction was performed in three patients who lost the ear replant after trauma (two patients) or due to infection (one patient). The ear replant survived and showed good cosmetic results in the three patients who underwent arterial and venous anastomoses. The patients who had artery anastomosis only required intrareplant heparin injection (chemical leech) to resolve venous congestion and sustained partial loss of the replanted ear. Secondary procedures were necessary to repair the reconstructions, including an advancement, temporoparietal fascia, or retroauricular flap. Those who underwent staged ear reconstruction had late ear deformities. Microvascular replantation is the best method for reattaching an amputated ear, giving excellent esthetic results. If only arterial anastomosis is performed, a chemical leech is an option for decompressing the venous congestion. In those patients without a suitable vessel for microanastomosis, nonmicrosurgical methods are suggested, such as a temporoparietal fascia flap, retroauricular pocket procedure, or staged-costal cartilage reconstruction, depending on the ear defect.The Journal of trauma 10/2010; 69(4):E15-9. · 2.48 Impact Factor -
Article: Involvement of the p38 pathway in the differential induction of heme oxygenase-1 by statins in Neuro-2A cells exposed to lipopolysaccharide.
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ABSTRACT: Heme oxygenase-1 (HO-1) expression, in response to various stimuli, has been generally reported to protect against cellular stress. However, we previously demonstrated simvastatin-induced HO-1-exaggerated nuclear factor kappa beta (NF-κβ) activation and superoxide production on exposure to lipopolysaccharide (LPS). The addition of the iron chelator, desferrioxamine, to reduce the accumulation of ferric iron from heme by HO-1 resulted in a blockade of aggravated superoxide production. In this study, we demonstrated that, unlike simvastatin, neither atorvastatin- nor rosuvastatin-induced HO-1 upregulation resulted in increased NF-κβ activation and superoxide production of Neuro-2A cells against LPS. Moreover, increased superoxide formation by either atorvastatin or rosuvastatin, in the presence or absence of LPS, could not be reduced by the addition of desferrioxamine, unlike simvastatin. In contrast to our previous experiment, in which simvastatin activated ERK and p38, but not JNK or Akt, both atorvastatin and rosuvastatin phosphorylated ERK, but not p38. Inhibition of p38 activation by 5 μM of SB203580 effectively reduced exaggerated HO-1 upregulation in cells pretreated with simvastatin, but not atorvastatin or rosuvastatin, plus exposure to LPS. The addition of an ERK inhibitor (50 μM of PD98059) did not decrease HO-1 upregulation in cells following any statin pretreatment. Further, the effect of simvastatin on primary cultures of cortical neurons was also different from that on Neuro-2A cells, as HO-1 upregulation did not result in exaggerated NF-κβ activation and superoxide production. This study demonstrated the involvement of p38 in the differential induction of HO-1 by different statins and showed the different physiological relevance of experiments on different cell types.Drug and Chemical Toxicology 10/2010; 34(1):8-19. · 1.08 Impact Factor -
Article: Relationship between injury severity and serum tau protein levels in traumatic brain injured rats.
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ABSTRACT: Although serum tau protein levels increase following TBI, the time course is unknown. The aim of the present study was to determine whether serum tau protein levels increased in both a severity-dependent and time-dependent manner in an experimental model of rat traumatic brain injury (TBI). A total of 24 Sprague-Dawley rats were subjected to varying grades of TBI using a contusion injury model on the right parietal cortex. Enzyme-linked Immunoabsorbent Assay (ELISA) analysis for serum was performed at 15 min pre-injury, 1, 6, 24, 48, and 168 h post-injury. Immunoblotting for serum tau protein, neurological evaluation and histological observation were also performed. Tau protein levels rapidly increased after 1 h in both mild and severe TBI groups (p<0.001), and declined after 6 h. In the sham-operated group, tau protein levels did not change significantly after TBI. Tau protein levels were severity-dependent at 1 and 6 h after TBI. The levels were higher in the severe TBI group than in the mild TBI group at 1 h (p<0.001) and 6 h (p<0.001). Serum tau protein levels were severity-dependent and time-dependent at 1 and 6 h after TBI. However, the serum tau protein may not be a useful marker 24 h after TBI.Resuscitation 09/2010; 81(9):1205-8. · 3.60 Impact Factor -
Article: Evaluation of the ankle function following reconstruction of the donor defect with a split fibular bone after a vascularized fibular flap transfer.
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ABSTRACT: To validate the hypothesis that the reconstruction of the missing segment of the fibula using a redundant split fibular graft after a vascularized fibular flap transfer may have a better effect on ankle function. Of the 24 head and neck cancer patients who received a free fibula flap for mandible reconstruction, 14 patients underwent the conventional method of donor site closure, in which the redundant fibular bone was discarded (Group I). Ten patients underwent longitudinal osteotomy of the redundant non-vascularized fibular portion to bridge the donor site defect (Group II). Postoperative subjective satisfaction level was evaluated with a self-constructed questionnaire in 10 parameters (ambulation with assistance, ankle instability, ankle stiffness, muscle weakness, leg edema, foot numbness, ankle pain, other sites of pain besides the ankle, and restriction to run) and the 4 voluntary motions (dorsiflexion, plantar flexion, eversion, and inversion) of both ankles were measured using a CYBEX II dynamometer. The muscle peak torque of the donor leg was significantly lower at ankle plantar flexion (P = 0.002), eversion (P = 0.002), and inversion (P = 0.0002) in Group I as well as at dorsiflexion (P = 0.031), plantar flexion (P = 0.016), and inversion (P = 0.002) in Group II against the contralateral non-operated leg. The muscle power was significantly greater when performing ankle eversion (P = 0.049) in those who underwent split fibular bone reconstruction. There was no difference in the subjective satisfaction score between these two groups. The reconstruction of the donor site with a split fibular bone graft led only a slight improvement in ankle eversion.Archives of Orthopaedic and Trauma Surgery 06/2010; 130(6):781-6. · 1.37 Impact Factor -
Article: MicroRNA profiling in ischemic injury of the gracilis muscle in rats
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ABSTRACT: Abstract Background To profile the expression of microRNAs (miRNAs) and their potential target genes in the gracilis muscles following ischemic injury in rats by monitoring miRNA and mRNA expression on a genome-wide basis. Methods Following 4 h of ischemia and subsequent reperfusion for 4 h of the gracilis muscles, the specimens were analyzed with an Agilent rat miRNA array to detect the expressed miRNAs in the experimental muscles compared to those from the sham-operated controls. Their expressions were subsequently quantified by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) to determine their expression pattern after different durations of ischemia and reperfusion. In addition, the expression of the mRNA in the muscle specimens after 4 h of ischemia and reperfusion for 1, 3, 7, and 14 d were detected with the Agilent Whole Rat Genome 4 × 44 k oligo microarray. A combined approach using a computational prediction algorithm that included miRanda, PicTar, TargetScanS, MirTarget2, RNAhybrid, and the whole genome microarray experiment was performed by monitoring the mRNA:miRNA association to identify potential target genes. Results Three miRNAs (miR-21, miR-200c, and miR-205) of 350 tested rat miRNAs were found to have an increased expression in the miRNA array. Real-time RT-PCR demonstrated that, with 2-fold increase after 4 h of ischemia, a maximum 24-fold increase at 7 d, and a 7.5-fold increase at 14 d after reperfusion, only the miR-21, but not the miR-200c or miR-205 was upregulated throughout the experimental time. In monitoring the target genes of miR-21 in the expression array at 1, 3, 7, 14 d after reperfusion, with persistent expression throughout the experiment, we detected the same 4 persistently downregulated target genes ( Nqo1 , Pdpn , CXCL3 , and Rad23b ) with the prediction algorithms miRanda and RNAhybrid, but no target gene was revealed with PicTar, TargetScanS, and MirTarget2. Conclusions This study revealed 3 upregulated miRNAs in the gracilis muscle following ischemic injury and identified 4 potential target genes of miR-21 by examining miRNAs and mRNAs expression patterns in a time-course fashion using a combined approach with prediction algorithms and a whole genome expression array experiment.BMC Musculoskeletal Disorders. 01/2010;
Top co-authors
Top Journals
Institutions
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2004–2013
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Chang Gung University
- College of Medicine
Taoyuan, Taiwan, Taiwan
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2007–2012
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I-Shou University
Kaohsiung, Kaohsiung, Taiwan
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2003–2012
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Chang Gung Memorial Hospital
- • Division of Plastic and Reconstructive Surgery
- • Department of Neurology
Taipei, Taipei, Taiwan
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