Revisiting the vascularity of the keratinized gingiva in the maxillary esthetic zone

Background The active arterial-to-arterial collaterals are a significant factor in the prevention of ischemia and extensive tissue necrosis in the case of arterial blockage of various tissues. The present study investigates the mucogingival vasculature in the maxillary esthetic zone mucosa in human cadavers and functionally evaluates the area, which is supplied by the terminal arterioles, on the individual level. Methods In the human cadaver study, macroscopic arterial analyses of the anterior maxillary vestibule in 7 specimens were scrutinized by latex milk injection. The tracks of the mucosal branches in relation to the mucogingival junction were investigated. In the functional study, individual gingival blood flow (GBF) changes were measured by laser speckle contrast imaging (LSCI) in 31 young subjects with healthy gingiva before and during 30-s compressions. This was conducted with a ball-shaped condenser. The data was analyzed by the linear mixed model. Results The vertically aligned branches of the superior labial artery (SLA) divided into small, slightly deviating sub-branches near the mucogingival junction. These arteries created collateral plexuses and supplied the attached gingiva. The compression of these branches resulted in ischemia coronally with significant individual variation. The ischemia was either apico-mesial, apico-distal, or straight apical to the compression. A significant correlation was found between the ischemic area and the magnitude of the decrease in GBF (r = 0.81, p < 0.001). In males, 77% of the subjects, and 50% of the female subjects had an ischemic response in either region. The horizontal extension of the ischemic area ranged between 0.26 mm and 8.76 mm. Males had significantly higher baseline GBF and larger ischemia than females. At the base of the papilla, significant restoration of GBF was observed during compression in males, but not in females. Conclusion The arcade anastomoses formed by the small arteries in the keratinized gingiva of the upper esthetic zone explain the consequences of vertical incisions. The considerable individual variations in ischemic responses might be the reason for unexpected surgical outcomes in some cases. Furthermore, there is increasing evidence that men have different vascular reactivity and/or regulation of collateral circulation than women, which may affect wound healing.

Roux-En-Y By-Pass Ressection Due to Intestinal Ischemia

Obesity surgery is one of the most commonly performed surgical procedures today and laparoscopy has become the preferred technique for Roux-en-Y gastric bypass. A patient transferred to the surgery service for an abdominal pain had an abdominal tomography performed which demonstrated an aspect suggestive of internal hernia. Underwent emergency laparotomy. Resection of the ischemic area was performed. Reconstruct intestinal transit was madded 4 days after primary surgery. In this case, the complete ischemia of the Bypass segment has become a challenge to reconstruct the transit.

Application of Gastroscopy Based on Nano Carbon in the Remedy of Chronic Pulmonary Heart Disease Caused by Helicobacter Pylori

Chronic pulmonary heart disease is a common respiratory disease. Helicobacter pylori infection can lead to the occurrence of chronic pulmonary heart disease. However, most drugs for chronic pulmonary heart disease caused by helicobacter pylori are lack of tissue specificity. At the same time, due to the blocked blood circulation in the ischemic area, the distribution of drugs in the ischemic area is often not ideal. The gastroscope technology of nano carbon can make the drug release in the focus as much as possible, and can achieve the goal of targeted treatment. This paper mainly studies the application of the gastroscope technology based on nano carbon in the remedy of chronic pulmonary heart disease caused by helicobacter pylori. After 8 weeks of treatment, the indexes of right heart function in the two groups: TAPSE and RVMPI were better than before treatment, and the improvement degree in the remedy group was more obvious than that in the control group (P < 0.05). The improvement degree of E/A and PASP was not statistically significant, the difference between the two groups was not significant (P > 0.05). In addition, the gastroscope of nano carbon can also reduce UA and TG in blood. The overall response rate was 93.75% in the remedy group, which was higher than that in the control group (P < 0.05).

Coronary Collateral Microcirculation Reserve Becomes Vestigial with Aging

<b><i>Introduction:</i></b> Our previous study indicated that coronary collateral microcirculation reserve (CCMR), native collaterals, transports blood flow to an ischemic area to reduce ischemic tissue injury. This study aimed to observe the changes of CCMR in the hearts of different month-old rats. <b><i>Methods:</i></b> We selected 2-, 8-, 16-, and 24-month-old rats as the research objects to monitor the changes of CCMR in rats with aging. After acute myocardial infarction, lectin-FITC was injected into the femoral vein vessels of rats to mark CCMR vessels in the ischemic area. <b><i>Results:</i></b> Results of the lectin-FITC perfusion experiment indicated that the number and collagen IV coverage of CCMR vessels declined with aging. Moreover, data suggested a correlation between endothelial nitric oxide synthase and a decline in the number of CCMR vessels. <b><i>Conclusion:</i></b> Aging causes CCMR decline in rats.

STIMULATION OF RAT SKELETAL MUSCLE ANGIOGENESIS BY DIRECT AND CELL-MEDIATED ADMINISTRATION OF RECOMBINANT ANGIOGENIN GENE

Цель - оценить эффективность реваскуляризации икроножной мышцы крысы в условиях прямой и опосредованной мононуклеарными клетками крови пуповины человека (МККП) доставки в область ишемии рекомбинантного гена ангиогенина (Ang) человека при помощи аденовирусного вектора 5-го серотипа (Ad5). Материал и методы. Исследования проведены на 30 крысах линии Wistar. Через 14 сут после иссечения фрагмента бедренной артерии животным инъецировали в ишемизированную икроножную мышцу генетическую конструкцию (группа Ad5-Ang, n=15). Крысам другой группы (МККП+Ad5-Ang, n=15) в тот же срок трансген доставляли в мышцу при помощи МККП. В группе контроля животным (n=15) вводили в мышцу 0,9 % NaCl в тех же условиях. Через 14 и 28 сут в области ишемии оценивали отношение капилляры/мышечные волокна, количество мышечных волокон и количество мышечных волокон с центральным расположением ядер (МЦЯ). Капилляры идентифицировали по локализации эндотелиальных клеток, выявляемых при помощи иммуногистохимической реакции с антителами против CD31. Результаты. На 14-е сутки после введения МККП+Ad5-Ang показатель отношения количества капилляров к количеству мышечных волокон в области ишемии увеличивается на 57 % (p<0,05). На 28-е сутки в группе МККП+Ad5-Ang и в группе Ad5-Ang значимые различия по данному показателю при сравнении с контрольной группой не выявлены. Количество мышечных волокон на 14-е сутки в группе Ad5-Ang не изменяется, а в группе МККП+Ad5-Ang - уменьшается на 58,4 % (p<0,05). К 28-м суткам этот показатель в группе МККП+Ad5-Ang уменьшается на 95,9 % (p<0,05), а в группе Ad5-Ang - на 197,8 % (p<0,05). Количество МЦЯ существенно увеличивается в обеих экспериментальных группах с применением генетических конструкций на 14-е сутки. Выводы. Введение рекомбинантного гена Ang в область ишемии скелетной мышцы или его доставка в эту область при помощи мононуклеарных клеток крови пуповины стимулирует ангиогенез и постишемическую регенерацию мышечных волокон. Objective - to evaluate the effectiveness of revascularization of the rat gastrocnemius muscle following direct and human umbilical cord blood mononuclear cells (MNCs)-mediated delivery of human recombinant angiogenin (Ang) gene to the ischemic area using adenovirus serotype 5 vector (Ad5). Materials and methods. The study was carried out on 30 Wistar rats. Fourteen days after the excision of the femoral artery fragment, the genetic construct was injected into the animals’ ischemic gastrocnemius muscle (AD5-Ang group, n=15). In the other group (mccp+Ad5-Ang, n=15), the transgene was delivered to the muscle with the help of MNCs within the same time limit. In the control group (n=15) 0,9 % NaCl was injected into the muscle of animals under the same conditions. Fourteen and twenty-eight days after the injection, the ratio of capillaries/muscle fibers, the number of muscle fibers and the number of muscle fibers with a central location of nuclei (MCN) were evaluated in the ischemic area. Capillaries were identified by localization of endothelial cells detected by immunohistochemical reaction with antibodies against CD31. Results. On the 14th day after administration of MNCs+Ad5Ang, the ratio of capillaries to the number of muscle fibers in the ischemic area increased by 57 % (p<0,05). On the 28th day in the MNCs+Ad5-Ang group and in the Ad5-Ang group, no significant differences in this indicator were found compared with the control group. The number of muscle fibers on the 14 day in the Ad5-Ang group did not change, and in the MNCs+Ad5-Ang group, it decreased by 58,4 % (p<0,05). By the 28th day, this indicator in the MNCs+Ad5-Ang group decreased by 95,9 % (p<0,05), and in the Ad5-Ang group - by 197,8 % (p<0,05). The number of MCN on the 14 day significantly increased in both experimental groups, in which the genetic constructs were used. Conclusion. The introduction of recombinant ang gene into the area of skeletal muscle ischemia or its delivery to this area with the help of MCNs stimulates angiogenesis and post-ischemic regeneration of muscle fibers.

P4712Hyperbaric oxygen therapy enhanced circulating levels of endothelial progenitor cells and angiogenesis biomarkers, blood flow in ischemic area in patients with peripheral arterial occlusive disease

Background Arterial atherosclerotic occlusive syndrome remains the leading cause of mortality and morbidity worldwide. Peripheral arterial occlusive disease (PAOD) is a manifestation of atherosclerosis in the lower extremities. In our previous preclinical study, hyperbaric oxygen (HBO) therapy improved ischemic PAOD mainly through an increase of vascular wall permeability and recruiting endothelial progenitor cells (EPCs) to enhance the angiogenesis and blood flow in the ischemic area. Purpose This study tested the hypothesis that hyperbaric oxygen (HBO) therapy enhanced the circulating levels of endothelial progenitor cells (EPCs), soluble angiogenesis factors and blood flow in ischemic area in patients with peripheral arterial occlusive disease (PAOD). Methods 57 consecutive patients with PAOD undergoing the HBO therapy (3 atm for 2h/each time) were prospectively enrolled into the present study. The venous blood sampling was drawn for assessing the circulating levels of EPCs and soluble angiogenesis factors prior to and during five times of HBO therapy. Additionally, skin perfusion pressure (SPP), an indicator of blood flow at ischemic area, was measured by moorVMS-PRES. Results The results demonstrated that the circulating levels of EPCs (CD34+/CD133+/CD45dim, CD31+/CD133+/CD45dim, CD34+) and soluble angiogenesis factors (VEGF/SDF-1α/HGF/FGF) were significantly increased in post-HBO therapy than in pre-HBO therapy (all p<0.01). Additionally, Matrigel assay exhibited that the angiogenesis was significantly increased in post-HBO therapy than prior to the therapy (p<0.001). Furthermore, the SPP was significantly increased in ischemic area (i.e., plantar foot and mean SPP of the ischemic foot) in post-HBO therapy than in pre-HBO therapy (all p<0.01). Importantly, the HBO therapy did not show any complication and all the patients were uneventfully discharged without amputation. Conclusions HBO therapy augmented circulating levels of EPCs and angiogenesis factors as well as improved the blood flow in the ischemic area. Acknowledgement/Funding Kaohsiung Chang Gung Memorial Hospital, Taiwan Society of Stem Cell Research