[The lateral crural flap nourished by cutaneous branches of peroneal artery: an anatomic and clinical study].

OBJECTIVE: To study the anatomy of lateral crural skin flap nourished by cutaneous branches of peroneal artery and its clinical application as vascularized skin flap transfer. METHODS: In 20 cadavers specimen with 40 lower limbs, the cutaneous branches of the peroneal artery were dissected and their measurements were recorded. In the other 30 adult legs, their perforating points of the cutaneous arteries of peroneal artery were detected with supersonic Doppler flow meter. With the aid of anatomic and supersonic Doppler flow meter study, vascularized transfer of lateral crural skin flap pedicled by cutaneous branches of peroneal artery were successfully performed in 21 clinical cases. RESULTS: In altogether 40 legs studied, 140 cutaneous branches were found. One to seven branches were found on one specimen, the average was 3.5 branches, in one leg was a high perforating skin branch. The perforating points of the cutaneous branches were mostly (76% cases) appeared within 7 - 21 cm length below the protruding point of head of fibula. The external diameter of the thickest cutaneous branch of each leg was (1 .4 - 2.9) mm, (1.8 +/- 0.4) mm, while the external diameters of two vena concomitants were (3.0 +/- 0.5) mm and (2.4 +/- 0.4) mm. 145 artery perforating points in 30 legs were detected by Doppler, with an average points of 4.8. The skin flaps taken in the 21 clinical cases were 5.0 cm x 3.5 cm - 28 cm x 11 cm in size. All the transferred free flaps survived uneventfully. CONCLUSIONS: The lateral crural skin flap is nourished by a variable number of cutaneous branches of peroneal artery. The main branch can meet the demand of microvascular anastomosis. The free transfer of lateral crural flap by anastomosis of cutaneous branch of peroneal artery is superior to lateral skin flap transfer by anastomosis of main trunk of peroneal artery with the merit of simple procedure, minimal trauma and more physiological circulation established.

Influence of IFN- alpha and IFN- gamma on lymphangiogenesis.

Malignant cancers commonly spread by local invasion followed by metastasis through venous or lymphatic passages or both to distant sites. Angiogenesis and its relation to tumor growth and metastasis have been extensively researched. To date, however, the role played by lymphangiogenesis and metastasis of cancer has been overlooked. Inhibition of lymphangiogenesis, compared with inhibition of angiogenesis, may provide new insight to the mechanisms of metastasis of cancers. The current study was designed to examine the effect of two commonly used inhibitors of angiogenesis, interferon-alpha (IFN-alpha ) and IFN-gamma, on the growth and proliferation of lymphatic endothelial (LE) cells isolated from pig thoracic duct under in vitro condition. The LE cells were isolated and marked using specific markers, such as VEGFR-3 and LYVE-1, before experimental studies. The results showed that treatment of LE cells derived from the thoracic duct with these two inhibitors caused a decrease in the rate of cell proliferation in a dose-dependent manner, as assessed by MTT assays (tetrazolium salt colorimetric assay). Cell migration rate was assessed by the speed at which the cell migrated out from the scrape-wound margin; the speed of migration of LE cells was significantly inhibited in a dose-dependent fashion compared with controls. Treatment with both IFN-alpha and IFN-gamma caused an increase in apoptosis of LE cells, as assessed by Hoechst staining and caspase-3 staining. Our results showed that both IFN-alpha and IFN-gamma were able to inhibit LE cell growth in a dose-dependent manner and that the inhibition may be through induction of apoptosis of endothelial cells.