Free Radial Research Articles

Functional rehabilitation in advanced intraoral cancer.

Introduction:Modern treatment of advanced intraoral cancer involves multidisciplinary teams with use of complicated reconstructive techniques to provide improved survival with optimal rehabilitation. Mastication is an important part of this process, and it can be severely impaired by tumor ablation. Whether flap reconstruction is a determinant factor in dental rehabilitation is still in debate.Patients and methods:Thirty-five patients with advanced intraoral cancer were reviewed to determine dental rehabilitation of different reconstructive techniques. The patients were treated with a multidisciplinary team approach. The patients’ demographics, primary treatment, reconstructive surgery, dental rehabilitation, and functional outcome were recorded and analyzed.Results:Nine patients had Stadium III disease, and 26 patients had stadium IV. Thirty-two patients (91.42%) received postoperative radiotherapy. Masticatory and dental functional rehabilitation of patients was very poor. Only 15 patients (42.86%) could eat a normal diet, whereas 18 patients (51.42%) could manage only soft diets, and 2 patients (5.72%) could only be fed with a liquid diet. Denture rehabilitation was even more frustrating and had a direct impact on masticatory rehabilitation. Only 10 patients (28.57%) could use dentures postoperatively and 40% of patients (14 patients) could not use any denture at all. Above all reconstructive techniques, the free radial forearm flap provides the best functional outcome.Conclusions:Reconstruction of advanced intraoral cancer results in poor denture rehabilitation, especially when bulky flaps are used. If massive resections are necessary, the free radial forearm flap reconstruction provides the best functional outcome.

Le lambeau libre perforant antérolatéral de cuisse fin dans les reconstructions oropharyngées robot-assistées

Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb. The aim of our work was to prove the feasibility and the benefits in terms of reducing sequelae when using a thin anterolateral perforator flap harvested above the plane of the superficial fascia. We present this new original method in detail and the advantages it offers to patients after surgery.

Salvage of free radial artery forearm flap following reconstruction of lower lateral lip: A case report

The increasing success rate of free flaps along with their reconstructive advantages have got them into regular practice options in Maxillofacial reconstruction. Although associated complications are inevitable in a percentage of patients, it is good postoperative care and monitoring that determines the success or failure of the reconstruction. With early recognition and prompt intervention salvage of compromised flap is possible. The purpose of this article is to emphasise the importance of keeping low threshold for re- exploration in situation of any suspected failing free flap. Keywords: Free Radial Artery Forearm Flap (FRAFF), Squamous cell carcinoma (SCC), Supra Omohyoid Neck Dissection (SOND), Lymph Nodes (LN), Internal Jugular Vein (IJV)

Analysis of the hyoid motion of tongue cancer patients

ObjectiveWe aimed to analyze movement of the hyoid bone in patients with tongue cancer following radical surgery without pre- or postoperative chemotherapy or radiotherapy. MethodsTen patients (five males, five females; average age, 56.9 years) with histologically confirmed tongue squamous cell carcinoma underwent pre- and postoperative videofluoroscopic examination of swallowing and radical surgery at the Department of Oral and Maxillofacial Surgery of Kobe University Hospital, Japan. All patients underwent modified radical neck dissection and hemiglossectomy of the mobile tongue with reconstruction using a free radial forearm flap. Hyoid motion was analyzed using the DIPP-Motion PRO2D cineradiography system. According to previous reports, hyoid motion during swallowing is divided into three elements: rearward and upward, forward and upward, and rearward and downward movements. These movements were compared pre- and postoperatively. The endpoints were movement speed, distance, and time. ResultsPostoperatively, radical surgery resulted in motor impairment of the hyoid, with decreased movement capacity, including decreased movement distance, time required, speed, and range of motion during swallowing. ConclusionsHyoid motion analysis could be useful to maintain the quality of life of patients with oral cancer in the future as it could also be used to assess patients after bilateral neck dissection, mandibular resection, and radiotherapy.

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Since 1-stage phallic reconstruction using the radial forearm free flap was reported in 1984 by Chang and Hwang 1 Chang T.S. Hwang W.Y. Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg. 1984; 74: 251-258 Crossref PubMed Scopus (323) Google Scholar and Kao et al, 2 Kao X.S. Kao J.H. Ho C.L. Yang Z.N. Shi H.R. One-stage reconstruction of the penis with free skin flap: report of three cases. J Reconstr Microsurg. 1984; 1: 149 Crossref PubMed Scopus (30) Google Scholar the radial forearm free flap has become the most frequently used flap in penile reconstruction. Massanyi et al reported positive results using this technique in patients with exstrophy. 3 Massanyi E.Z. Gupta A. Goel S. et al. Radial forearm free flap phalloplasty for penile inadequacy in patients with exstrophy. J Urol. 2013; 190: 1577-1582 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar The technique of phallic reconstruction using radial forearm free flap is universally considered the standard technique for penile reconstruction. 4 Hage J.J. Bout C.A. Bloem J.J. Megens J.A. Phalloplasty in female-to-male transsexuals: what do our patients ask for?. Ann Plast Surg. 1993; 30: 323-326 Crossref PubMed Scopus (85) Google Scholar , 5 Fang R.H. Kao Y.S. Ma S. Lin J.T. Phalloplasty in female-to-male transsexuals using free radial osteocutaneous flap: a series of 22 cases. Br J Plast Surg. 1999; 52: 217-222 Abstract Full Text PDF PubMed Scopus (100) Google Scholar , 6 Monstrey S. Hoebeke P. Dhont M. et al. Radial forearm phalloplasty: a review of 81 cases. Eur J Plast Surg. 2005; 28: 206-212 Crossref Scopus (59) Google Scholar , 7 Monstrey S. Hoebeke P. Selvaggi G. et al. Penile reconstruction: is the radial forearm really the standard technique?. Plast Reconstr Surg. 2009; 124: 510-518 Crossref PubMed Scopus (191) Google Scholar

RECONSTRUCTIVE MICROSURGERY IN THE TREATMENT OF SURFACE FORMS OF CALCANEal OSTEOMYELITIS

One of the most common complications associated with the treatment of calcaneus fracturesis, a necrosis of the edges of the surgical wound and as a result – chronic nonhealing ulcers of the heel region and osteomyelitis of the calcaneus. In the structure of skeletal lesions osteomyelitic chronic osteomyelitis of the calcaneus occurs in 3.1–14.8% of cases, and in relation to the bones of the foot – up to 51%. At the same time after open fractures of the total incidence of deep infection from soft tissue even higher than that for the surface (12.2% vs. 9.6%). The traditional approach to the treatment of osteomyelitis of the calcaneus is often accompanied by poor performance with recurrent osteomyelitis process and highsubsequent disability of working age.Objective: to identify opportunities and assess the effectiveness of the use of reconstructive microsurgery techniques in the treatment of patients with superficial forms of osteomyelitis of the calcaneus, accompanied by the presence of soft tissue defect.Materials and мethods.The results of treatment of 28 patients with superficial forms of osteomyelitis of the calcaneus, which in the period from 2006 to 2013 in RNIITO them. R.R.Vredena were performed reconstructive plastic surgery using microsurgical techniques. Defects covering tissues were located on the sole (20) and back-side surfaces (8) of the calcaneus. Scope of interventions included the radical surgical treatment of osteomyelitis focus, marginal resection of the affected heel bone and tissue replacement of defect cover flap with axial blood supply.Results. With the localization of the defect cover tissues to non-reference surface of the heel region was carried out free plastic ray skin-fascial flap (9 cases). When the location of the defect on the plantar surface of the heel region favored medial plantar flap (10 cases). However, the presence of scarring and damage to the medial plantar artery was performed two-step replacement of defect prefabrikovannym flap medial arch of the foot (9 cases). Complications were observed in 7% of cases (2 patients) in 1 patient who had undergone plastic free radial flap in 1 case – after replacing a defect medial plantar flap. In both cases they were associated with impaired blood supply to the flap and ended necrosis of transplanted grafts. In the remaining cases (93%) failed to achieve full engraftment. Long-term results were followed up in 78,5% (n = 22) of patients in the period from 1 to 8 years after the end of treatment. In four cases, the plantar surface of the calcaneus formed edge wound defects, require additional surgical treatment. on the AOFAS scale results averaged 85 points, that, given the severity of the disease, regarded as a good result.Conclusions. The use of microsurgical techniques for the treatment of patients with superficial forms of osteomyelitis of the calcaneus, including the presence of soft tissue defect, achieves sustained remission osteomyelitic process and restore support ability of the injured limb. Thus the support surface for the replacement of the heel region is expedient to use grafts comprising the plantar surface of the foot skin.

Radial forearm and forehead flap reconstruction following resection of a nasal arteriovenous malformation: A case report.

Arteriovenous malformation (AVM) is a structural vascular abnormality in which the arterial vasculature connects with the venous vasculature without capillary connections. AVM confined to the nasal cavity is considerably rare. Blurred vision can be one of the associated symptoms. A combined approach of complete surgical resection with prior superselective embolization is the treatment of choice. Following resection, the reconstruction of facial defects, particularly in the nasal area, is challenging. The present study reports the rare case of a patient with an AVM in the nasal cavity, in which embolization, resection and flap reconstruction were performed. Embolization and complete surgical resection were used to avoid recurrence. Subsequently, a combination of free radial forearm and forehead flaps was used for the reconstruction of the nasal defect, without prosthesis. To the best of our knowledge, this is the first report of AVM confined to the nasal cavity, managed by a combination of free radial forearm and forehead flap reconstruction following complete resection. The cosmetic results of the procedure were acceptable.

A New Surgical Procedure for Penile Reconstruction by Combined Free Radial Forearm Flap and Dorsalis Pedis Flap

To introduce a new surgical procedure for penile reconstruction, emphasizing both the aesthetic appearance and the function by combined free radial forearm flap and dorsalis pedis flap. In this procedure, the penis was subdivided into 2 anatomic subunits: the penile shaft and the glans penis. A sequential innervated radial forearm free flap was combined with a dorsalis pedis free flap to reconstruct the penile shaft and the glans, separately. Cartilage prosthesis was implanted at the same time. Since May 2011, 14 biologically male patients with total penile losses by various reasons were treated with this procedure. Patient satisfaction was evaluated by questionnaire, and sensory testing was performed. The ages of the patients ranged between 21 and 53 years (mean, 35.2 years). The average follow-up period was 38.1 months (range, 25.5-56 months). Twenty-five flaps in 11 patients were 100% viable. One dorsalis pedis flap in a patient underwent partial necrosis. There were no cases of urethral fistula or urethral stenosis, but 1 case of prosthesis infection and 1 case of abdominal hernia were recorded. The sensation of the neophallus recovered 3-6 months after surgery, and the patient satisfaction rate was quite high. The new surgical procedure of combined free radial forearm flap and dorsalis pedis flap for penile reconstruction achieves both satisfactory aesthetic and functional results. We recommend this procedure as an alternative ideal method for total penile reconstruction.

Vibration of a prestressed tube in the presence of plastic zone

The paper is devoted to a problem of radial steady state vibrations for a tube taking into account the inhomogeneous residual stress (RS) field. According to the theory of ideal plasticity the RS field is caused by elastoplastic deformation due to the internal pressure and the further unloading process. Various RS distributions inside both elastic and plastic zones are described. A finding of displacement function is reduced to the numerical solving of the first-order differential equations. Within the framework of the acoustical method, the inverse problem for RS field identification is stated. On the basis of the free radial vibration problem for tube, we derived the formula for a dependency of eigenfrequency on RS distribution by using the linearization method. By using this formula for two different values of eigenfrequencies, we state the system of two equations to identify the plasticity zone radius and RS level. Examples of numerical solution of this system for different values of parameters (RS level and tube thickness) are demonstrated. The estimation accuracy of eigenfrequencies measurement for successful implementation of the proposed approach is given.

NLRX1 attenuates damage following traumatic brain injury through negatively regulating NF-κB signaling

Abstract Mechanical trauma to the CNS results in the disruption of the cellular microenvironment leading to massive necrotic and apoptotic loss of neuronal and glia populations. The progressive cascade of secondary events, including ischemia, inflammation, excitotoxicity and free radial release contribute to neural tissue damage. Members of the NLR family of pattern recognition receptors are essential mediators of the host immune response. Recently, our lab and others identified a novel sub-group of NLRs that function as negative regulators of inflammation. One of the members of this sub-group, NLRX1, is a potent regulator of interferon, NF-κB, ROS production and autophagy. Thus, we hypothesized that NLRX1 attenuates Traumatic Brain Injury (TBI) through the negative regulation of overzealous innate immune system signaling. To evaluate this hypothesis, we utilized Nlrx1−/− mice in a controlled cortical impact (CCI) injury model. The Nlrx1−/− mice exhibited significantly larger brain lesions and increased motor deficits following CCI injury. We also observed significant proliferation of microglia within the Nlrx1−/− lesions compared to wild type animals. Mechanistically, our data indicates that NLRX1 attenuates TBI progression through the microglia compartment via negative regulation of NF-κB signaling and IL-6 production. Together, our data extends the function of NLRX1 beyond its currently characterized role in host-pathogen defense and identifies this highly novel NLR as a significant modulator of TBI progression.

Free radial artery as an alternate conduit in CABG

Objective: This study was under taken to explore the potential of the Free Radial Graft as a safe efficient and suitable alternative conduit in coronary artery bypass grafting incase of in availability of the more established conduits like the IMA and Great Saphenous Vein graft especially in redo surgery. Method: This prospective randomized single center trial was conducted on three groups of patients under going CABG. The study was conducted from 1st January 1999 to December 2002.The first group A (n=15 with mean age of 47.05±8.35years) Radial artery was used for grafting in Right and Left sided grafts except the LAD. In the second group B (n=15 with a mean age of 54.80±11.14 years) Great Saphenous Vein was used for grafting in Right and Left sided grafts except the LAD. In the third group C (n=20 with a mean age of 55.93± 11.14 years) IMA was only grafted to LAD. Proximal ends of both the GSV and the Radial Artery were anastomosed to the Aorta. All patients were male . Follow up was done in these patien ts both by non invasive and invasive methods such as ETT , Thallium scan , Angiography. Comparison was mainly done between the Radial artery and the Great Saphenous Vein taking as granted that the IMA g the best graft for the LAD in all cases. Results: IMA was always applied to LAD in all patients in the three groups. In group (A) Radial Artery was grafted to RCA in 5 (33.3%) pts. Diagonal in 4 (26.7%)pts. Obtuse Marginal 12(80%) pts. And PDA 3 (20%) pts. In group (B) Great Saphenous Vein was grafted to RCA in 6(40%)pts. Circumflex 1(6.7%)pts. Diagonals 2 (13.3%) pts. Obtuse marginals 6 (40%) pts. And on PDA 4(20%) pts. All patients were regularly followed up for 18 months to 24 months. Post operative angina was reported in 2 (13.3%)pts. in group A and 5(33.3%) pts. In group B (p=0549). ETT was done in all these pts. Was positive in 1(6.7%) in group A and 2 (13.3%) in group B (p=0.309). Thallium scan was done in all the study population and was found positive in 4 (26.7%) in group A and 5 (33.3%) in group B Patients(p=0.265). Coronary angiograms were done on 10 patients out of each group. In group A the grafts were patent in 9 patients (90%). In the group B the grafts were found patent in 8 (86%) patients.(p=0.543). Moderate Graft stenosis was found in 01 patient in group B and none in group A (p=0.35). Totally blocked grafts were found in 01 patients in each group (p=1.00).

Comparative Study of the Free Microvascular Groin Flap: Optimizing the Donor Site After Free Radial Forearm Flap Phalloplasty

To improve the donor-site morbidity of the radial forearm flap through coverage with a free vascularized groin flap and comparing this flap coverage to the current standard, a full-thickness skin graft (FTSG). A retrospective analysis of all free radial forearm flap phalloplasties for transgender surgery at our institution was performed. We examined patient characteristics, donor site defects, surgical procedure, and clinical courses. Between October 2013 and February 2016, 27 consecutive patients underwent phalloplasty for female-to-male reassignment surgery with free radial forearm flaps. A total of 7 free groin flaps (group A) and 20 full-thickness skin graft from the groin region (group B) for donor-site defect coverage of the forearm were performed. The mean age in group A was 28.4 years with a mean body mass index of 21.6 kg/m(2) and a mean follow-up time of 10.6 months. The mean surgery time was 724 minutes. The mean patients' functional rating was 3.6 accompanied by the mean patients' aesthetical rating of 3.7. The mean age in group B was 30.5 years with a mean body mass index of 23.7 kg/m(2) and a mean follow-up time of 13.4 months. The mean surgery time was 563 minutes. The mean patients' functional rating was 3.1 accompanied by the mean patients' aesthetical rating of 2.9. We suggest that the free microvascular groin flap should be considered for immediate defect closure after phalloplasty with a radial forearm flap due to its beneficial functional and aesthetic results and the low rate of complications.

An Alternative Method of the Direct Closure for the Radial Forearm Flap Donor-Site Defect: Lazy S Double-Opposing Rotation Flaps

The free radial forearm flap remains aworkhorseflap for head and neck reconstruction, although perforator flap or super microsurgery has become increasingly popular. Yet donorsite morbidities, including unsightly appearances that may occur when sites are closed via skin graft, cause reconstructive surgeons to be hesitant to use the forearm flap. Elliot et al (1988) reported the direct closure method for donor-site defects of the radial forearm flap using the V–Y flap, and several modifications have been reported based on their methods.1–8However, partial skin necrosis sometimes occurs along the lateral side of the flap even though the perforators from ulnar artery are preserved well, and this necrosis leaves ugly wide scarring on patients’ forearms (►Fig. 1). To minimize these drawbacks, simple lazy S double-opposing rotation flaps were designed for the donor site of the radial forearm flap, and the donor-site defect was closed directly. In this report, the details of the method and the outcomes are described. Materials and Methods

Facile synthesis of hierarchical Mo-doped S/BiOCl heterostructured spheres and its excellent photo/thermocatalytic activity under near room temperature

Hierarchical Mo-doped S/BiOCl (MSB) heterostructures were successfully prepared by a facile one-step reflux method. The resulting samples were evaluated by XRD, SEM, TEM, DRS and XPS. The results obtained showed that MSB possessed an outstanding photo and/or thermocatalytic performance under near room-temperature for removal of methylene blue (MB), reaching up to 99.9 and 96.5% for photo/thermocatalytic degradation (PTD) and thermocatalytic degradation (TD), respectively. The hole/radical scavenger tests indicated holes and free radial were both participated in PTD and TD reactions, but the holes formed from degradation reactions were strongly considered as the most influential impact on conducting PTD and TD patterns rather than free radicals. Furthermore, the kinetics regarding PTD and TD routes were also monitored, preferentially fitting to Langmuir–Hinshelwood behavior. Briefly, this study may provide new insights into fabricating hierarchical heterostructures by in-suit one-step approach for decontamination of organic pollutants separately using PTD or TD.

Effects of inhalation of low-dose nitrite or carbon monoxide on post-reperfusion mitochondrial function and tissue injury in hemorrhagic shock swine.

IntroductionTissue reperfusion following hemorrhagic shock may paradoxically cause tissue injury and organ dysfunction by mitochondrial free radical expression. Both nitrite and carbon monoxide (CO) may protect from this reperfusion injury by limiting mitochondrial free radial production. We explored the effects of very small doses of inhaled nitrite and CO on tissue injury in a porcine model of hemorrhagic shock.MethodsTwenty pigs (mean wt. 30.6 kg, range 27.2 to 36.4 kg) had microdialysis catheters inserted in muscle, peritoneum, and liver to measure lactate, pyruvate, glucose, glycerol, and nitrite. Nineteen of the pigs were bled at a rate of 20 ml/min to a mean arterial pressure of 30 mmHg and kept between 30 and 40 mmHg for 90 minutes and then resuscitated. One pig was instrumented but not bled (sham). Hemorrhaged animals were randomized to inhale nothing (control, n = 7), 11 mg nitrite (nitrite, n = 7) or 250 ppm CO (CO, n = 5) over 30 minutes before fluid resuscitation. Mitochondrial respiratory control ratio was measured in muscle biopsies. Repeated measures from microdialysis catheters were analyzed in a random effects mixed model.ResultsNeither nitrite nor CO had any effects on the measured hemodynamic variables. Following inhalation of nitrite, plasma, but not tissue, nitrite increased. Following reperfusion, plasma nitrite only increased in the control and CO groups. Thereafter, nitrite decreased only in the nitrite group. Inhalation of nitrite was associated with decreases in blood lactate, whereas both nitrite and CO were associated with decreases in glycerol release into peritoneal fluid. Following resuscitation, the muscular mitochondrial respiratory control ratio was reduced in the control group but preserved in the nitrite and CO groups.ConclusionsWe conclude that small doses of nebulized sodium nitrite or inhaled CO may be associated with intestinal protection during resuscitation from severe hemorrhagic shock.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0903-z) contains supplementary material, which is available to authorized users.

The value of postoperative anticoagulants to improve flap survival in the free radial forearm flap: a systematic review and retrospective multicentre analysis.

Free radial forearm flap (FRFF) reconstruction is a valuable technique in head and neck surgery, which allows closure of large defects while striving to maintain functionality. Anticoagulative drugs are often administered to improve flap survival, although evidence regarding effectiveness is lacking. To investigate the effectiveness of postoperative anticoagulants to improve survival of the FRFF in head and neck reconstruction. Systematic review and multicentre, individual patient data meta-analysis. MEDLINE, EMBASE, Web of Science and CINAHL were searched for synonyms of 'anticoagulants' and 'free flap reconstruction'. Studies were critically appraised for directness of evidence and risk of bias. Authors of the highest quality publications were invited to submit their original data for meta-analysis. Five studies were of adequate quality, and data from four studies (80%) were available for meta-analysis, describing 759 FRFF procedures. Anticoagulants used were as follows: aspirin (12%), low molecular weight dextran (18.3%), unfractioned heparin (28.1%), low molecular weight heparin (49%) and prostaglandin-E1 (2.1%). Thirty-one per cent did not receive anticoagulants. Flap failure occurred in 40 of 759 patients (5.3%) On univariate analysis, use of unfractioned heparin was associated with a higher rate of flap failure. However, these regimens were often administered to patients who had revision surgery of the anastomosis. In multivariate logistic regression analysis, anticoagulant use was not associated with improved flap survival or flap-related complications. The studied anticoagulative drugs did not improve FRFF survival or lower the rate of flap-related complications. In addition, some anticoagulants may cause systemic complications.

Free radial forearm flap for reconstruction of head and neck soft tissue defects after tumor resection

To explore the clinical effect of the free radial forearm flap on repairing tissue defects and reconstructing functions after tumor resection. From January, 2003 to December, 2011, 70 patients, including 43 squamous cell carcinomas of tongue, 12 buccal cancers, 5 carcinomas of the soft palate, 4 basal cell carcinomas of external nose, 3 lower lip cancers, 2 upper lip cancers, and 1 posterior wall of hypopharynx carcinoma, with the soft tissue defects in the head and neck underwent reconstructive operations with the free radial forearm flap after the malignant tumor resection. The area of defects ranged from 5 cm × 4 cm to 14 cm × 8 cm with the process of diseases from 4 to 30 months. The technique for grafting the free radial forearm flap and the appearance at sites of the donor and recipient, and the influence on the anatomy and function in both local sites were analyzed. In the 70 patients, only 1 case of flap appeared necrosis due to venous reflux obstacle, and the remaining (98.4 ﹪) survived. During the follow-up for 12-36 months, one case of hypopharyngeal carcinoma died from distant metastasis a year later, 2 cases of tongue cancer died of cardiovascular accident. Morphology and function for the sites at donor and recipient were satisfactory. Free radical forearm flap is a good choice for the repair and functional reconstruction for tissue defects after tumor resection.

웅포지역 녹차와 홍차의 항산화 효과

Ungpo region in Iksan, Jeonbuk of South Korea is the uppermost limit of wether for cultivating tea. This study focuses on analyzing biologically active constituents and antioxidant effects of green and black tea from Ungpo to brighten hidden zone of related tea studies. Firstly, we starts from examining total polyphenol and flavonoid contents of Green Tea extracts(GTE) and Black tea extracts(BTE) from Ungpo and evaluating the possible antioxidant activities from its extracts. Therefore, we could measur the effects of GTE and BTE on vitalizing activities against DPPH radical and ABTS radical. These results indicate that GTE and BTE protects oxidative activities through activating free radials.

Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection

Introduction
 Primary closure following oncosurgical resection of carcinoma tongue has been found to compromise tongue function in regards to speech and swallowing very badly. In contrast, reconstruction of tongue with free radial forearm flap following oncosurgical resection has shown promising functional outcome.
 Materials and Methods
 Thirteen patients (ten male and three female) with squamous cell carcinoma involving anterior 2/3rd of tongue had undergone either hemiglossectomy or subtotal glossectomy. Reconstruction was done with free radial forearm flap following oncosurgical resection and neck dissection. All of them received postoperative radiotherapy. Follow-up ranged from 2 months to 2 years. The age of the patients ranged between 32 and 65 years. Flap dimension ranged from 7x6 cm to 10x8 cm. Vascular anastomosis performed in an end-to-end manner with 8-0 Ethilon® under loupe magnifiacation.
 Results
 Venous congestion occurred in one patient after 48 hours postoperatively and the flap underwent complete necrosis on postoperative day 5. Postoperative hematoma was found in one patient within first 24 hours of reconstruction. Re-exploration was done immediately, blood clots were removed. No fresh bleeding point was seen and the flap survived. In this series, 12 out of 13 flaps survived completely (92%).
 Conclusion
 The free radial forearm flap has become a workhorse flap in head and reconstruction due to its lack of extra bulk, relative ease of dissection, long vascular pedicle, good calibre vessels, malleability and minimal donor site morbidity. Furthermore its low flap loss and complication rate offer the best choice for tongue reconstruction.

El Amaranto como Fuente de Reforzamiento: Un Estudio con Roedores

This study evaluates amaranth as an alternative to reinforcers which are currently used in experimental laboratories with rodents. We compared some elements such as consumer preference, motivation and reinforcing value of three types of food (two types of pellets and amaranth) through four experiments with free radial maze and free consumption in 11 Wistar rats. The results show that amaranth has a high reinforcing value. Also, there was a preference for amaranth consumption compared with the other two reinforcers. Amaranth is proposed as a good alternative for use as a reinforcer with several advantages such as consumer preference, its reinforcing value, accessibility in the country and that it is cheaper than the usual pellets.