Effects of adipose and bone marrow-derived mesenchymal stem cells on vaginal atrophy in a rat menopause model.

BACKGROUND & OBJECTIVES: Vaginal atrophy is characterized by thinning of vaginal epithelial layers and decreased local blood flow. We aimed to evaluate the regenerative effects of Adipose derived mesenchymal stem cells (ADMSC) and Bone marrow derived mesenchymal stem cells (BMDSC) on vaginal atrophy in rat menopause model. MATERIALS AND METHODS: Rats were randomly divided into 4 (four) groups: sham, control, ADMSC, BMDSC. Vaginal epithelial thickness, structure of the lamina propria, blood vessels in the lamina propria, collagen deposition, and muscle structure were evaluated. Anti ER α, VEGF, VEGFR 1, Bax and bcl-2 antibodies were analyzed. Beta actin gene was used as endogenous control. Genetical differences among the groups were compared by using Kruskal Wallis and Mann Whitney U test. p < 0.05 was regarded as statistically significant. RESULTS: Epithelial thickness of ADMSC group was higher than control group, but less than sham group Epithelial thickness of BMDSC group was less than sham group. Lamina propria and muscle tissue of ADMSC and BMDSC groups were found to be similar to sham group. VEGFR-1, VEGF, Bax and ER-α staining levels were higher in ADMSC and BMDSC groups than control group. ADMSC group stained stronger with VEGFR-1 and VEGF than BMDSC group. Bcl-2 staining level was increased in ADMSC applied group. No statistically significant difference was detected in Bax and Bcl-2 genes and Bax-/Bcl-2 ratio. CONCLUSIONS: Although genetic expression might have ended and could not be significantly demonstrated, histological and immunohistochemical results favor ADMSC application in vaginal atrophy rather than BMDSC.

A Wise Surgical Approach for Reconstruction of Postburn Axillary Contractures and Versatility of Perforator Flaps.

Postburn axillary adduction contractures should essentially be released for adequate shoulder function. Many methods have been described for this purpose. However, use of perforator flaps prevents harm to the underlying muscle and provides thin, pliable skin flaps. Despite the major advantages offered by perforator flaps, certain shortcomings of perforator flap surgery restrict their widespread use by inexperienced surgeons, including anatomic variations of perforator vessels. In order to rule out these shortcomings, we devised a new surgical approach with an initial incision that provides access to possible perforator systems on the dorsolateral thoracic area. The approach can easily be converted to a fasciocutaneous transposition flap when attempts for identification of a proper perforator fail. Nevertheless, a proper perforator can easily be reached through the exposure provided by this initial incision. With the intention of using perforator-based flap for reconstruction, we used this surgical approach for coverage in 14 cases of postburn axillary contractures. In 3 cases, conversions of the initial incision to local transposition flap (parascapular flap) were required. There was only 2 tip necrosis observed, which healed with secondary intention. Our current surgical approach may offer taking the advantages of using a true perforator flap for reconstruction while avoiding a second stress on the patient when an operative plan for perforator flap harvest fails.

Effects of Keratinocytes Differentiated from Embryonic and Adipogenic Stem Cells on Wound Healing in a Diabetic Mouse Model.

OBJECTIVE: The current study aims to assess the molecular effects of keratinocytes derived from embryonic and adipose-derived stem cells (ADSCs) on wound healing in mice with diabetes mellitus. MATERIALS AND METHODS: Sixty BALB/c mice were randomly allocated into 6 groups of 10. Following diabetes mellitus induction by intraperitoneal injection of streptozocin, wounds were created and covered with gauze dipped in various solutions: isotonic saline, carrier and transfer medium-engineered dermal template, keratinocytes derived from embryonic stem cells (ESCs), keratinocytes differentiated from ADSCs, or ADSC medium alone. Histopathological changes and immunohistochemical alterations in the activities of cytokeratin 8, cytokeratin 14, epidermal growth factor (EGF), interleukin 8 (IL-8), fibroblast growth factor 2 (FGF-2), monocyte chemoattractant protein 1 (MCP-1), and collagen I were compared among the 6 groups. RESULTS: Histopathological analysis revealed that wound healing was accelerated by application of keratinocytes derived from ESCs. Such cells increased the activities of cytokeratin 8 and cytokeratin 14. No significant among-group differences were noted in terms of IL-8, FGF-2, MCP-1, or collagen I production. CONCLUSIONS: Keratinocytes derived from ESCs accelerated wound healing in mice with diabetes mellitus. The beneficial effects were evident both histomorphologically and immunohistochemically. Although keratinocytes derived from ADSCs are readily available, such cells did not accelerate wound healing.

A Case Report of Prilocaine-Induced Methemoglobinemia after Liposuction Procedure.

Prilocaine-induced methemoglobinemia is a rarely seen condition. In this paper, a case is presented with methemoglobinemia developed secondary to prilocaine use in a liposuction procedure, and the importance of this rarely seen condition is emphasized. A 20-year-old female patient presented with complaints of prostration, lassitude, shivering, shortness of breath, and cyanosis. It was learned that the patient underwent nearly 1000 mg prilocaine infiltration 8 hours priorly during a liposuction procedure. At admission, her blood pressure (130/80 mmHg), pulse rate (140 bpm), body temperature (36°C), and respiratory rate (40/min) were recorded. The patient had marked acrocyanosis. The arterial blood gas methemoglobin level was measured as 40%. The patient received oxygen therapy with a mask and was administered vitamin C in normal saline (500 mg tid), N-acetylcysteine (300 mg tid), and 50 mg 10% methylene blue in the intensive care unit of the internal medicine department. Methemoglobin level dropped down to 2% after her treatment with methylene blue and she was clinically cured and discharged 2 days later. Emergency service physicians should remember to consider methemoglobinemia when making a differential diagnosis between dyspnea and cyanosis developing after prilocaine infiltration performed for liposuctions in the adult age group.