Proliferation hemangiomas formation through dual mechanism of vascular endothelial growth factor mediated endothelial progenitor cells proliferation and mobilization through matrix metalloproteinases 9.

Infantile hemangioma is the most common tumor of infancy and the mechanism leading to proliferation hemangiomas formation is poorly understood and currently no successful treatment modality exists. We hypothesize that EPCs formed during proliferation hemangiomas, as the result of vascular endothelial growth factor (VEGF) stimulation through MMP9, play the major role in the control of cell proliferation and capillary-like vessels production. Accepting the hypothesis to be correct, a therapy that inhibits EPC mobilization and proliferation can be used to prevent the proliferation hemangiomas formation. Current therapies are only partially effective and safe because they could not eliminate all the relative factors of proliferation hemangiomas formation at all, such as: EPCs in the peripheral blood, and at the same time inducing death (apoptosis and necrosis) of other normal cells. A more efficient prevention of proliferation hemangiomas could be achieved using specific drugs or biologic methods that inhibit EPC mobilization and proliferation. Therapy based on gene therapy, capable to specifically inhibit VEGF and MMP9 expression in gene level, can be possibly effective.

[Design of myocutaneous flap with color Doppler flow imaging technique for breast reconstruction in breast cancer after operation and radiotherapy].

OBJECTIVE: To investigate the method and effect of axial pattern myocutaneous flap in reconstructing breast by using color doppler flow imaging (CDFI) technique. METHODS: Suitable axial myocutaneous flaps were selected according to the character of the focus in 26 cases of breast cancer after operation and radiotherapy. All the axial pattern myocutaneous flaps were designed on the basis of traditional design method before operation; then, CDFI with high resolution was used to examine the starting spot, exterior diameter, trail and length of the myocutaneous flaps' major artery. The myocutaneous flaps were redesigned according to the results of CDFI and transferred to reconstruct the breasts. The results of operation and examination were investigated. RESULTS: According to the CDFI, only one thoracodorsal artery's blood current was slow, its wall was rough and presented with arteriosclerosis. The blood flow was fluent and the vessel wall was smooth with other supplying arteries in the flaps. And no embolism, sclerosis or absence of blood vessel was found. The starting spots, exterior diameters, trails and anatomic layers of the major supplying arteries of the flaps were displayed clearly with CDFI, in accordance with the results of operation. Twenty-one cases of latissimus dorsi myocutaneous flap, 4 cases of the contralateral transverse abdominis myocutaneous flap and 1 cases of the bilateral transverse abdominis myocutaneous flap were used in this group. The flaps survived and healed well, the breasts were reconstructed well with perfect appearance, shape and sensation. CONCLUSIONS: CDFI is a simple, visualized and noninvasive method for designing the axial pattern myocutaneous flap in breast reconstruction, it can provide more scientific and accurate evidence for preoperative determination of myocutaneous flap transplantation.