Effect of sildenafil citrate in nicotine-induced ischemia: An experimental study using a rat model

Recent experimental and clinical studies have demonstrated the negative effects of nicotine on the viability of skin flaps. Necrotic damage to skin flaps can result in significant complications including delayed wound healing, dehiscence and wound contraction. Phosphodiesterase type 5 inhibitors, such as sildenafil citrate, have a protective effect in ischemic injuries of the brain, kidney, myocardium, spinal cord, ileum and testes. In the present study, the authors evaluated the effect of sildenafil citrate on the viability of skin exposed to nicotine-induced ischemia in Sprague Dawley rats. In the preoperative period, the rats were divided into three groups of 10 rats each. Group C was treated with subcutaneous saline and group S and group N were treated with 2 mg/kg nicotine, administered subcutaneously twice per day for 28 days. McFarlane flaps were created in all experimental animals using an incision measuring 7 cm x 3 cm. Postoperative treatment varied among the groups: group S was treated with 20 mg/kg/day sildenafil citrate, while group C and group N were treated with equivalent doses of saline for seven days. A laser Doppler flow meter was used to monitor the microvasculature. Preoperative measurements of the microvasculature revealed decreased blood flow in group N and group S, both of which were treated with subcutaneous nicotine. During the postoperative evaluation, a trend toward increased blood flow was observed in group S compared with the group with nicotine-induced ischemia treated with saline alone post-operatively (group N). A visual fluorescein dye test was used to predict skin viability and demonstrated diminished skin viability in group N and group S (P<0.05) during the preoperative period. Following treatment with sildenafil for seven days, a statically significant improvement in skin viability was observed in group S (P<0.05). Nicotine decreased blood flow within the skin and impaired skin viability, while postoperative application of sildenafil significantly ameliorated the ischemic effects of nicotine and improved skin viability. Future studies will be required to evaluate the clinical use of sildenafil for the improvement of blood flow in ischemic injury of the skin

Effect of sildenafil citrate in nicotine-induced ischemia: An experimental study using a rat model

Recent experimental and clinical studies have demonstrated the negative effects of nicotine on the viability of skin flaps. Necrotic damage to skin flaps can result in significant complications including delayed wound healing, dehiscence and wound contraction. Phosphodiesterase type 5 inhibitors, such as sildenafil citrate, have a protective effect in ischemic injuries of the brain, kidney, myocardium, spinal cord, ileum and testes. In the present study, the authors evaluated the effect of sildenafil citrate on the viability of skin exposed to nicotine-induced ischemia in Sprague Dawley rats. In the preoperative period, the rats were divided into three groups of 10 rats each. Group C was treated with subcutaneous saline and group S and group N were treated with 2 mg/kg nicotine, administered subcutaneously twice per day for 28 days. McFarlane flaps were created in all experimental animals using an incision measuring 7 cm x 3 cm. Postoperative treatment varied among the groups: group S was treated with 20 mg/kg/day sildenafil citrate, while group C and group N were treated with equivalent doses of saline for seven days. A laser Doppler flow meter was used to monitor the microvasculature. Preoperative measurements of the microvasculature revealed decreased blood flow in group N and group S, both of which were treated with subcutaneous nicotine. During the postoperative evaluation, a trend toward increased blood flow was observed in group S compared with the group with nicotine-induced ischemia treated with saline alone post-operatively (group N). A visual fluorescein dye test was used to predict skin viability and demonstrated diminished skin viability in group N and group S (P<0.05) during the preoperative period. Following treatment with sildenafil for seven days, a statically significant improvement in skin viability was observed in group S (P<0.05). Nicotine decreased blood flow within the skin and impaired skin viability, while postoperative application of sildenafil significantly ameliorated the ischemic effects of nicotine and improved skin viability. Future studies will be required to evaluate the clinical use of sildenafil for the improvement of blood flow in ischemic injury of the skin

A Rare Minor Trauma Causing Diabetic Hand Ulcer

A high prevalence of foot ulcers was confirmed among patients with diabetes, which are common indications for hospitalization, and usually associated with a long hospital stay with adverse outcomes including amputation and death. However, a diabetic hand is less recognized and is usually overlooked by clinicians. We see rare serials and case reports about a hand ulcer in diabetic patients. The aim of this case presentation is to explore clinical and treatment elements for a hand ulcer as well as a review of the literature. [Arch Clin Exp Surg 2013; 2(3.000): 207-209

Severe contact dermatitis induced by an unusual blend of pure henna

Henna is a natural dye extracted from Lawsonia inermis leaves and is commonly used all over the world to dye skin, hair and leather. Pure henna is rarely reported as a cause of contact dermatitis. However, in many reports, additives of henna, especially paraphenylenediamine, have been accused of irritant and allergic contact dermatitis. This report is not only exhibiting a rare form of contact dermatitis resembling a chemical burn, but is also providing an insight into henna, which is widely used and commonly seen as safe. [Arch Clin Exp Surg 2015; 4(1.000): 46-48

Treatment of Superficial Cutaneous Vascular Lesions: Experience with the Long-Pulsed 1064 nm Nd:YAG Laser

Recent published studies evaluating the long-pulsed 1064 nm Nd:YAG laser for superficial cutaneous vascular lesions have limited subjects and optimal treatment parameters have not been established. To determine the efficacy and safety of the long-pulsed 1064 nm Nd:YAG laser on superficial cutaneus vascular lesions and analyse retrospectively our experience of a 3-year period are the aims of this study. Over the 3-year period, 255 patients were treated [189 female and 66 male; median age 35 (range 7–65) years; Fitzpatrick skin types II-V]. Twenty-six patients with spider angioma, 130 with facial telangiectasia, and 99 with leg telangiectasia were treated. A long-pulsed 1064 nm Nd:YAG laser was used. A test dose was performed at the initial consultation and thereafter patients were reviewed and treated at 4-week intervals for 5 months. Of those patients who completed treatment and followup, 26/26 (100%) of spider angiomas, 125/130 (97%) of facial telangiectasia, and 80/99 (80,8%) of leg telangiectasia markedly improved or cleared. We suggest that the long pulsed Nd:YAG laser is a safe and effective treatment for common superficial cutaneous vascular lesions. However, it is not the first choise to use to treat superficial vessels on the face where depth is not the concern

A Fractional Modeling of Tumor-Immune System Interaction Related to Lung Cancer with Real Data

In this study, we investigate a new fractional-order mathematical model which considers population dynamics among tumor cells-macrophage cells-active macrophage cells, and host cells involving the Caputo fractional derivative. Firstly, the stability of the positive steady state of the model is studied. Subsequently, the conditions for existence and uniqueness of the solutions are examined. Then, the least squares curve fitting method (LSCFM) which is one of the prominent methods for parameter estimation is used to fit the parameters of the model. It is aimed to fit the relevant parameters with the help of the tumor tissue samples which were collected from the patient with non-small cell lung cancer who had chemotherapy-naive hospitalized at Kayseri Erciyes University hospital in Turkey. A total of 12 parameters in the model are estimated using the data of lung tumor cells of this patient for 14 days. Moreover, the numerical simulations are given by considering the different fractional orders and different parameters for the model. So, it is achieved how the change in a affects the dynamic behavior of the system. In the sequel, to point out the advantages of the fractional-order modeling, the memory trace and hereditary traits are taken into consideration. Finally, the interpretations in terms of biological science are provided in conclusion. We believe that this interdisciplinary study will open new doors for other similar studies and will shed light on the studies to be developed on the use of real data in the mathematical modeling of cancer

The synthesis of peptide-conjugated poly(2-ethyl-2-oxazoline)-b-poly(L-lactide) (PEtOx-b-PLA) polymeric systems through the combination of controlled polymerization techniques and click reactions

To optimize the therapeutic effect of pharmaceutical agents, drug delivery systems tailored from FDA-approved polymers like poly(L-lactide) (PLA) is an effective strategy. Because of their hydrophobic character, these systems greatly suffer from reduced circulation time thus, amphiphilic block copolymers became favorable to overcome this limitation. Of them, poly(oxazoline)-b-poly(L-lactide) are of choice as poly(oxazoline) (PEtOx) is compatible, biodegradable, while exhibiting minimum cytotoxicity. To tailor selective drug targeting drug delivery systems, whereby their selectivity for tumor tissues is maximized, these polymers should be decorated with so-called tumor-homing agents, such as antibodies, peptides and so forth. To this respect, we designed a new block copolymer, allyl-poly(2-ethyl-2-oxazoline)-b-poly(L-lactide) allyl-(PEtOx-b-PLA) and its subsequent conjugation to tumor-homing peptides, peptide-18, and peptide-563 at the terminal position. In this manuscript, we report our synthetic route to obtain this building block and its conjugation to tumor-homing agents

The Synthesis of Peptide-Conjugated Poly(2-Ethyl-2-Oxazoline)-bpoly(L-Lactide) (PEtOx-B-PLA) Polymeric Systems Through the Combination of Controlled Polymerization Techniques and Click Reactions

To optimize the therapeutic effect of pharmaceutical agents, drug delivery systems tailored from FDA-approved polymers like poly(L-lactide) (PLA) is an effective strategy. Because of their hydrophobic character, these systems greatly suffer from reduced circulation time thus, amphiphilic block copolymers became favourable to overcome this limitation. Of them, poly(oxazoline)-b-poly(L-lactide) are of choice as poly(oxazoline) (PEtOx) is compatibile, biodegradable, while exhibiting minimum cytotoxicity. To tailor selective drug targeting drug delivery systems, whereby their selectivity for tumour tissues is maximised, these polymers should be decorated with so-called tumour-homing agents, such as antibodies, peptides and so forth. To this respect, we designed a new block copolymer, allyl-poly(2-ethyl-2-oxazoline)-b-poly(L-lactide) allyl-(PEtOx-b-PLA) and its subsequent conjugation to tumour-homing peptides, peptide-18 and peptide-563 at the terminal position. In this manuscript, we report our synthetic route to obtain this building block and its conjugation to tumour-homing agents