Yano T.,5 45 Yushima |
Okazaki M.,5 45 Yushima |
Tanaka K.,5 45 Yushima |
Tsunoda A.,Tokyo Medical and Dental University |
Kishimoto S.,Kameda Medical Center
Annals of Plastic Surgery | Year: 2016
Background Pericranial flaps (PCFs) have been widely used for skull base reconstruction. The key to successful skull base reconstruction using PCF depends on flap vascularity, but there have been no reports describing the real-time vascularity of PCF. In this study, we performed intraoperative fluorescent indocyanine green angiography to evaluate the real-time vascularity and viability of PCF and to estimate the reliability of this flap. Methods Eleven anteriorly based PCF (with a bilateral pedicle, ipsilateral pedicle, and random-pattern flap) and 11 laterally based PCF (with and without temporal muscle) were included in this study. The flap vascularity of each flap type considering the patients' background was evaluated using indocyanine green angiography intraoperatively. Results Anteriorly based PCF had significantly better vascularity compared to laterally based PCF. In anteriorly based PCF, there was no significant difference in vascularity between PCF with bilateral pedicles and an ipsilateral pedicle. In laterally based PCF, PCF without temporal muscle showed a wider vascular area compared to PCF with temporal muscle. As for the patient background, those older than 45 years, body mass index more than 25, and who were smokers tended to have lower vascularity. Preoperative radiation therapy did not show any significant differences in terms of flap vascularity. Conclusions Anteriorly based PCF had significantly better vascularity compared to laterally based PCF and seemed safer to harvest regardless of flap pedicle type. Also, the feasibility of harvesting muscle sparing laterally based PCF was indicated. Finally, being older than 45 years, a body mass index more than 25, or being a smoker might increase the risk of reducing flap vascularity. © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Yamashiro K.,Jikei University School of Medicine |
Sasano T.,Medical Top Track Program |
Tojo K.,Jikei University School of Medicine |
Namekata I.,Toho University |
And 10 more authors.
Biochemical and Biophysical Research Communications | Year: 2010
There is considerable evidence indicating that intracellular Ca2+ participates as a second messenger in TLR4-dependent signaling. However, how intracellular free Ca2+ concentrations ([Ca2+]i) is increased in response to LPS and how they affect cytokine production are poorly understood. Here we examined the role of transient receptor potential (TRP), a major Ca2+ permeation pathway in non-excitable cells, in the LPS-induced cytokine production in macrophages. Pharmacologic experiments suggested that TRPV family members, but neither TRPC nor TRPM family members, are involved in the LPS-induced TNFα and IL-6 production in RAW264 macrophages. RT-PCR and immunoblot analyses showed that TRPV2 is the sole member of TRPV family expressed in macrophages. ShRNA against TRPV2 inhibited the LPS-induced TNFα and IL-6 production as well as IκBα degradation. Experiments using BAPTA/AM and EGTA, and Ca2+ imaging suggested that the LPS-induced increase in [Ca2+]i involves both the TRPV2-mediated intracellular and extracellular Ca2+ mobilizations. BAPTA/AM abolished LPS-induced TNFα and IL-6 production, while EGTA only partially suppressed LPS-induced IL-6 production, but not TNFα production. These data indicate that TRPV2 is involved in the LPS-induced Ca2+ mobilization from intracellular Ca2+ store and extracellular Ca2+. In addition to Ca2+ mobilization through the IP3-receptor, TRPV2-mediated intracellular Ca2+ mobilization is involved in NFκB-dependent TNFα and IL-6 expression, while extracellular Ca2+ entry is involved in NFκB-independent IL-6 production. © 2010 Elsevier Inc.