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    Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?
    (BIOMED CENTRAL LTD, 2012) Ozden, Burcu Celet; Guven, Erdem; Aslay, Isik; Kemikler, Gonul; Olgac, Vakur; Tekkesin, Merva Soluk; Serarslan, Bengul; Ulug, Burcak Tumerdem; Karabulut, Aylin Bilgin; Arinci, Atilla; Emekli, Ufuk
    Background: The optimum protocol for expander volume adjustment with respect to the timing and application of radiotherapy remains controversial. Methods: Eighteen New Zealand rabbits were divided into three groups. Metallic port integrated anatomic breast expanders of 250 cc were implanted on the back of each animal and controlled expansion was performed. Group I underwent radiotherapy with full expanders while in Group II, expanders were partially deflated immediately prior to radiotherapy. Control group did not receive radiotherapy. The changes in blood flow at different volume adjustments were investigated in Group II by laser Doppler flowmetry. Variations in the histopathologic properties of the irradiated tissues including the skin, capsule and the pocket floor, were compared in the biopsy specimens taken from different locations in each group. Results: A significant increase in skin blood flow was detected in Group II with partial expander deflation. Overall, histopathologic exam revealed aggravated findings of chronic radiodermatitis (epidermal atrophy, dermal inflammation and fibrosis, neovascularisation and vascular changes as well as increased capsule thickness) especially around the lower expander pole, in Group II. Conclusions: Expander deflation immediately prior to radiotherapy, may augment the adverse effects, especially in the lower expander pole, possibly via enhanced radiosensitization due to a relative increase in the blood flow and tissue oxygenation.
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    The Effect of Vitamin C on Ischemia Reperfusion Injury Because of Prolonged Tourniquet Application With Reperfusion Intervals
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Ulug, Burcak Tumerdem; Aksungar, Fehime Benli; Mete, Ozgur; Tekeli, Fatma; Mutlu, Nilgun; Calik, Burcu
    We examined the effect of vitamin Con muscle injury distal to the tourniquet which was applied for 4 hours with 10- and 20-minute reperfusion intervals after 2 hours of tourniquet. Sixty-four Sprague-Dawley rats were allocated to 4 randomized groups. After 2 hours tourniquet, 10- and 20-minutes of reperfusion were allowed to half of each group respectively. Afterward an additional 2 hours compression was applied. Except the control group the animals received vitamin C intravenously, before the first tourniquet in Group 1, at the reperfusion interval in Group 11, and at both times in Group III. Malondialdehyde levels were measured in blood and the tibialis anterior muscle. The muscle was histopathologically examined. The data was evaluated statistically. The effects of timing and the dose of vitamin C on ischemia reperfusion injury remain controversial and there was no statistical difference between 10- and 20-minute reperfusion intervals. But the blood malondialdehyde levels showed that vitamin C has a positive effect on the muscle injury caused by ischemia-reperfusion.