This CSPG was PLX4032 ic50 associated with the proximity to the PN graft. FGF-1 reduced CSPG deposition in grafted animals regardless of the proximity to

the graft. The CSPG reduction was accompanied by reduced GFAP expression and macrophage activation. The amount of CSPG with dissociated glycosaminoglycan did not differ between groups. FGF-1 in Schwann cell–astrocyte coculture did not reduce CSPG deposition. Furthermore, the PN graft increased the calcitonin gene-related peptide immunoreactivity and altered the distribution of synaptophysin-positive axons. Conclusion: Peripheral nerve graft supported sensory re-innervation and partial protection of the grey matter, but up-regulated CSPG in the graft–stump junction compared to non-grafted rats. The reduction of CSPG was caused Torin 1 by FGF-1–PN synergy, and did not involve dissociation of CSPG or the suppression of a general immune response. “
“U. Rüb, K. Bürk, D. Timmann, W. den Dunnen, K. Seidel, K. Farrag, E. Brunt, H. Heinsen, R. Egensperger, A. Bornemann, S. Schwarzacher, H.-W. Korf, L. Schöls, J. Bohl and T. Deller (2012) Neuropathology and Applied Neurobiology 38, 665–680 Spinocerebellar ataxia

type 1 (SCA1): new pathoanatomical and clinico-pathological insights Aims: Spinocerebellar ataxia type 1 (SCA1) represents the first molecular genetically characterized autosomal dominantly inherited cerebellar ataxia and is assigned to the CAG-repeat or polyglutamine diseases. Owing to limited knowledge about SCA1 neuropathology, appropriate pathoanatomical correlates of a large variety of SCA1 disease symptoms are missing and the neuropathological basis for further morphological

and experimental SCA1 studies Reverse transcriptase is still fragmentary. Methods: In the present study, we investigated for the first time serial tissue sections through the complete brains of clinically diagnosed and genetically confirmed SCA1 patients. Results: Brain damage in the three SCA1 patients studied went beyond the well-known brain predilection sites of the underlying pathological process. Along with neuronal loss in the primary motor cortex, it included widespread degeneration of gray components of the basal forebrain, thalamus, brainstem and cerebellum, as well as of white matter components in the cerebellum and brainstem. It involved the motor cerebellothalamocortical and basal ganglia-thalamocortical circuits, the visual, auditory, somatosensory, oculomotor, vestibular, ingestion-related, precerebellar, basal forebrain cholinergic and midbrain dopaminergic systems. Conclusions: These findings show for the first time that the extent and severity of brain damage in SCA1 is very similar to that of clinically closely related spinocerebellar ataxias (that is, SCA2, SCA3 and SCA7). They offer suitable explanations for poorly understood SCA1 disease symptoms and will facilitate the interpretation of further morphological and experimental SCA1 studies.

In order to understand more clearly the gene transcriptional profiles associated see more with CsA treatment in OS patients, 90 genes related to the immune system were examined by TLDA before and after successful treatment (patient

1). After treatment, 26·6% (24 of 90) of genes showed an expression level of more than twofold increase or decrease compared with the patient’s baseline gene expression (Fig. 4). Of these, the expression of 11 genes (12·2%) was down-regulated (by a factor of 2·3–5·2, values of 0·44–0·19, respectively, in Fig. 4, and 13 genes (14·4%) were up-regulated (by a factor of 2·04–19). The expression of several genes that are known to be down-regulated by CsA therapy such as IL-2 and Fas ligand find more (FasL) were found to be low (0·197- and 0·32-fold decrease). Interestingly, several genes that are known to be involved in immune regulation and autoimmunity were found to be markedly up-regulated

[e.g. IL-10, intercellular adhesion molecule (ICAM) 1 and transforming growth factor (TGF)-β] or down-regulated (e.g. CCR4 and CCR5). The immunological hallmark of OS is the expansion and activation of an oligoclonal population of autoreactive T cells. We have already shown that, in OS, similar T cell expansions are found in peripheral blood and in target organs (e.g. skin) [12]. These cells should be controlled rapidly by immunosuppressive agents to avoid tissue infiltration and to improve the general outcome of OS patients [14]. Here we describe a selective immune response to such treatments in patients with Omenn phenotype. Diverse topical and systemic immunosuppressive

therapies have been shown to be useful in OS patients. Many use CsA as the gold standard treatment for these patients. Alternatively, tacrolimus (FK506) is used. Despite similarity in their accepted mode of action, they alter T cell receptor expression differentially in vivo, therefore can have different effects on OS patients [15]. Failure of treatment Thiamine-diphosphate kinase sometimes requires alternative or a combination of therapies [16]. Herein, we report on two patients; the first patient responded to CsA treatment while the second patient did not. Surprisingly, the initial expanded oligoclonal autoreactive clone (TCR-Vβ 17) in the latter patient responded well to CsA treatment, but other TCR-Vβs had started to expand, probably causing the patient’s unremitting autoimmune symptoms. Many unknown environmental and/or host factors can produce expanded lymphocytes in OS. In some cases the trigger (e.g. infection) that exacerbates the autoreactive process is found [17]. Patient 2 underwent a thorough infectious work-up, which was found to be negative, and no other obvious factor to trigger his symptoms could be detected to explain the presence of new TCR clones. However, expansion of certain new TCR-Vβ clones may also represent not only pathogen exposure, but also skewing towards self-antigens and autoimmunity [9].

4 and 18.5 ± 1 days in the local two-stage group and 6 ± 0.2 and 14.3 ± 5.7 (P > 0.05). All allografts in the treatment groups did not develop Enzalutamide price rejection during the 42 days follow-up period. Conclusions: It is feasible, reliable, reproducible,

and safe to perform a two-stage face transplantation in rats. This novel approach has the potential to be applied in research and eventually in selected clinical cases of facial allotransplantation. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. “
“Lymphatico-venous anastomosis (LVA) is used to resolve lymph retention in lymphedema. However, the postoperative outcome of lower limb lymphedema is poorer than that for upper limb lymphedema, because of the location lower than the heart level. Improvement of the therapeutic outcome requires application of as many anastomoses as possible in a limited operation time, particularly since there is a positive

correlation between the number of anastomoses and the therapeutic effect of LVA. In this case, we described a method to increase the efficiency of lymphatico-venous anastomosis for bilateral severe lower limb lymphedema through efficient identification of lymph vessels and veins suitable for anastomosis using indocyanine green (ICG) contrast imaging and AccuVein, a noncontact vein visualization system, respectively. Ten LVAs were succeeded at seven incisions, and the operation time was 3 hours and 5 minutes. Accuvein can be used for identification LY294002 mw of subcutaneous venules

with a diameter of about 0.5–1.0 mm. We used this approach in surgery for a case of bilateral lower limb lymphedema, with a resultant improvement in the surgical outcome. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012. “
“The proximal lateral lower leg flap is a flap suited for the reconstruction of small and thin defects. The purpose of this study was to map the position and consistency of the perforator vessels and to review its reliability and technical considerations clinically. The location, number, and size of perforator vessels in the proximal third of the lateral lower leg were investigated in 20 fresh frozen cadaveric lower limbs. Tolmetin This was analyzed together with 22 clinical cases. Cadaveric dissection showed that there were 1–2 perforators in the proximal third of the lateral lower leg and these perforator vessels were found to be 63% septocutaneous and 37% musculocutaneous. The source vessel of the perforators was variable. Clinically the recipient site consisted of the head and neck in 8 cases, the foot and ankle region in 13 cases, and 1 case in the hand. The mean thickness of this flap was 5.8 ± 0.8 mm. Vascular pedicle length ranged from 5 to 8.5 cm. The mean diameter of flap artery was 1.3 ± 0.3 mm. One flap failure was seen due to arterial thrombosis. The overall flap survival rate was 95%. The proximal lateral lower leg flap has the advantages of being thin and pliable, quick to harvest with no major arteries sacrificed.

Although there is clear evidence that the activation mechanism of each inflammasome is different [9-11], a recent study reported that PKR is required for the activation of NLRP3, NLRC4 and AIM2 [8]. The latter study suggested that PKR is a common regulator of the inflammasomes. To further understand the role of PKR in caspase-1

activation, we studied the activation of the NLRP3, NLRC4 and AIM2 in macrophages from mice deficient in PKR. In RG7420 cost contrast to published results [8], we found that PKR is dispensable for inflammasome activation. PKR is phosphorylated in macrophages after LPS stimulation [6, 12]. To determine the potential role of PKR in the TLR4 signaling pathway, we treated BM-derived selleck chemicals macrophages (BMDMs) from Pkr+/− and Pkr−/− mice with LPS for different times, and analysed the phosphorylation status of IκBα, ERK and p38 (Fig. 1A). The phosphorylation levels of these proteins was indistinguishable in LPS-stimulated Pkr+/− and Pkr−/− macrophages, suggesting that PKR protein is not required for NF-κB, ERK and p38 activation in response to LPS. Notably, the production of iNOS, an enzyme catalysing NO which is involved in host defense against microbes [13], was markedly reduced in Pkr−/− macrophages when compared with that of Pkr+/− macrophages (Fig. 1B). Several transcription factors, including

NF-κB, AP-1 and STAT1, have been shown to regulate iNOS expression [13]. LPS-induced phosphorylation of STAT1 at Tyr 701, Resveratrol a site essential for its activation, was not altered by PKR deficiency, indicating that it is unlikely that PKR is involved in the upstream signaling

pathway of STAT1 activation (Fig. 1C). Consistent with the reduction of iNOS expression, the bacteria-killing capacity after exposure to Escherichia coli was reduced in Pkr−/− macrophages (Fig. 1D). Our results confirm and extend previous findings that PKR plays a role in LPS-induced iNOS production and bacteria-killing function of macrophages. Next, we investigated the involvement of PKR in inflammasome activation. LPS-primed Pkr+/− and Pkr−/− macrophages were treated with known activators of NLRP3, NLRC4 and AIM2. In contrast to a recent report [8], the amounts of processed caspase-1 (p20 and p10), and IL-1β/IL-18 maturation in the cell supernatant in response to activators of NLRP3 including ATP, nigerin and silica particles were comparable in Pkr+/− and Pkr−/− macrophages (Fig. 2A). No role for PKR was also found in the activation of caspase-1 and pro-IL-1β/IL-18 processing after infection of macrophages with Salmonella thyphimurium that activates the NLRC4 inflammasome (Fig. 2B). Furthermore, caspase-1 activation and IL-1β processing induced by poly (dA:dT) that triggers AIM2 activation [14-16], was comparable in Pkr+/− and Pkr+/− macrophages (Fig. 2C).

Contrastingly, there appeared to be a significant association of eNOS 894G>T and PARP-1 Val762Ala polymorphisms GDC-0068 cell line with DN wherein, the presence of 894T allele was associated with an enhanced risk for DN [P = 0.005; OR = 1.78 (1.17–2.7)], while the 762Ala allele seemed to confer significant protection against DN [P = 0.02; OR = 0.59 (0.37–0.92)]. Multiple logistic regression analysis revealed a significant and independent association of eNOS 894G>T, PARP-1 Val762Ala polymorphisms

and hypertension with DN in T2DM individuals. eNOS 894G>T and PARP-1 Val762Ala polymorphisms appeared to associate significantly with DN, with the former contributing to an enhanced risk and the latter to a reduced susceptibility to DN in South Indian T2DM individuals. “
“Aim:  Uric acid (UA) is strongly associated with the confirmed chronic kidney disease (CKD) risk factors, such as hypertension, diabetes and metabolic syndrome (MS); however, whether higher UA is independently associated with CKD is still debatable. Other studies found that low UA level may reflect inadequate protection against oxidant-mediated stress; it is also unknown whether hypouricemia may have a harmful effect on the kidney. No studies have examined whether

there is a J-shaped relationship between UA and incident CKD. Methods:  The association between UA and incident kidney disease (Glomerular filtration rate <60 mL/min per 1.73 m2) was examined among 94 422 Taiwanese participants, aged ≥20 years with a mean 3.5 years follow-up Olaparib chemical structure in a retrospective cohort. The association between UA and CKD was evaluated using Cox models with adjustment for confounders. Results:  The adjusted hazard ratio (HR) for incident CKD was 1.03 (95% confidence interval (CI), 1.01 to 1.06) for baseline UA level (increase by 1 mg/dL). Compared with MRIP serum UA in the first quintile (2.0 to 4.5 mg/dL), the multivariate-adjusted HR for CKD of

the fifth (≥7.3 mg/dL), fourth (6.3 to 7.2 mg/dL), third (5.5 to 6.2 mg/dL), second (4.6 to 5.4 mg/dL) and hyopuricemia (<2.0 mg/dL) were 1.15 (95%CI, 1.01–1.30), 0.98 (95%CI, 0.87–1.10), 1.06 (95%CI, 0.94–1.19), 1.02 (95%CI, 0.91–1.14) and 1.65(95%CI, 0.53–5.15), respectively. The tests for the non-linear association were all not significant for both male and female. Gender-specific model revealed only the UA above 7.3 mg/dL with the increased risk of new-onset CKD in males. Conclusion:  Hyperuricemia is a risk factor for CKD in Taiwan, future studies are still necessary to determine whether hypouricemia increases the risk of CKD. "
“The association of STAT4 gene polymorphism with systemic lupus erythematosus (SLE) / lupus nephritis (LN) results from the published studies is still conflicting.

Long-term follow-up is necessary for these asymptomatic

IWR-1 order children. “
“Background:  Studies of dietary sodium on vascular function and blood pressure in normotensive volunteers have shown conflicting results. There are very limited data available on the effect of chronic sodium loading from a low-sodium diet to a high-sodium diet on vascular function and blood pressure in normotensive volunteers. Objective:  To assess the effect of modifying dietary sodium intake on arterial function and surrogate markers of arterial remodelling in normal healthy volunteers. Design:  Twenty-three normotensive volunteers met the inclusion criteria. After a 2 week run-in with a low-sodium diet (60 mmol/day), the participants maintained their low-sodium

diets and were randomly assigned to receive sequentially one of three interventions for Hydroxychloroquine clinical trial 4 weeks, with a 2 week washout between interventions: sodium-free tomato juice (A), tomato juice containing 90 mmol Na (B) and tomato juice containing 140 mmol Na (C). The outcomes measured were changes in pulse wave velocity (PWV), systolic blood pressure and diastolic blood pressure. Results:  There was no difference in PWV between interventions (B–A 0.00 m/s, 95% CI: −0.30, 0.31 m/s; C–A 0.01 m/s, 95% CI: −0.38, 0.40 m/s). There was also no change in pulse wave analysis, systolic or diastolic blood pressure between interventions. There was an appropriate increase in urinary sodium excretion in the added sodium interventions. Conclusion:  Dietary salt loading did not produce significant increases in PWV and blood pressure in normotensive subjects with systolic blood pressure <130 mmHg. The lack of an observed effect supports Guyton's pressure–natriuresis hypothesis with appropriate renal excretion of the excess sodium load. "
“Background: 

The proportion of older people receiving Histamine H2 receptor dialysis is rapidly increasing. The typical choice for older patients is between home-based peritoneal dialysis (PD) and clinic-based haemodialysis (HD). Some centres have been successful in encouraging all patients – including older patients – to have home-based self-administered PD or HD. Aim:  To (i) describe the overall satisfaction with renal services among older patients dialysing, or in training, with HD or PD at home; and (ii) examine the relationship between residential distance from the nephrology unit and satisfaction with home-based dialysis. Methods:  Participants were aged 60 years or more; and were either dialysing at home or training for dialysis at home. Two methods of cross-sectional data collection were used: (i) structured quantitative interviews with all participants; and (ii) qualitative interviews with a selected subgroup. Results:  Participants comprised 45 patients on dialysis (94% of 48 eligible). Their average age was 68 years. Duration of dialysis averaged 28 months (range 3–150 months). Ratings of ‘very good or excellent’ were reported for dialysis treatment by 40 (89%) patients.

This enzyme is encoded by the thiopurine S-methyltransferase coding gene (TPMT gene). The TPMT locus is subjected to several polymorphisms,

with heterozygous individuals (6%–11% of Caucasian individuals) having intermediate TPMT activity and homozygous mutant individuals (0·2%–0·6% check details of Caucasian individuals) having very low TPMT activity. To date, 20 variant alleles (TPMT*2-*18) have been identified, which are associated with decreased activity compared with the TPMT*1 wild-type allele [28]. More than 95% of defective TPMT activity can be explained by the most frequent mutant alleles TPMT*2 and TPMT*3. The impaired or absent ability to metabolize AZA leads to high blood levels and an increased risk of developing severe and potentially life-threatening myelotoxicity when no dose reductions are performed [29,30].

Dervieux et al.[31], measuring the TPMT activity in red blood cells of paediatric patients after renal transplantation, demonstrated that elevated TPMT activity was associated with an increased risk of acute rejection. Genotyping for TPMT polymorphisms, before initiation of AZA therapy, may be a useful future tool to reduce clinical complications in patients undergoing this treatment. For cyclosporine (CsA) and tacrolimus (TAC), potent agents used widely to treat a variety of autoimmune renal disorders and to prevent acute rejection after renal transplantation, the impact of genetic variability has not yet been defined completely. KPT330 As shown in Table 1,

for phase I metabolism it has already been demonstrated that expression of the multi-drug resistance 1 (MDR-1) gene that encodes for an efflux pomp which removes lipophilic drugs may influence significantly the pharmacokinetics and pharmacodynamics of both CsA and TAC. Regarding phase II metabolism, the relationship between polymorphisms in the P450 cytochrome system, an intracellular transporter system that is capable of carrying a variety of endogenous and exogenous compounds out of the cell, and pharmacological and clinical DNA ligase outcomes associated with CNI administration has been evaluated in several reports (Table 1). In particular, it has been reported that patients carrying CYP3A5*3, an allelic variant of the CYP3A5 gene that results in lack of enzyme expression, reaching high dose-adjusted levels, need lower dosages of CNIs compared to those with the wild-type genotype (CYP3A5*1/*1) [32,35,37,41–43,46,47,49,54,55]. However, the contribution of additional polymorphisms needs to be evaluated more clearly and addressed in future pharmacogenetic studies. The metabolism of MPA, a selective inhibitor of the de novo purine synthesis via inosine monophosphate deydrogenase (IMPDH) enzyme inhibition, is also influenced largely by several genetic polymorphisms (Table 1).

First efforts representing an initial, yet comprehensive, molecular, mathematical

dynamic model of trypanosome physiology have also emerged as the Silicon trypanosome (86,93). The refinement of the Silicon trypanosome model in the long term, and the identification and validation of multiple chokepoints in many metabolic pathways, will likely help with the identification of potential drug targets. Trypanosomatids and other pathogens have developed diverse strategies to infect their hosts and survive within them, and their hosts have evolved complex immune defences in response. Direct protein–protein interactions (PPI) are at the core of the interspecies interface when pathogen-encoded proteins modulate host cellular processes by binding and modifying the function and activity of host protein complexes (94,95). selleck chemical Our current understanding of these interactions, however, is limited, and much remains to be investigated about the network of interactions between host and pathogen proteins. To date, high-throughput screens have been primarily used to detect see more intra-species PPIs. Intra-species PPI networks offer a valuable framework

for a better understanding of the functional layout of the proteome. They allow ‘guilt-by-association’ annotation of uncharacterized proteins and can reveal novel pathways of functional complexes (96,97). Protein–protein interaction data have been collected using Pregnenolone two complementary approaches, mass spectroscopy and yeast two-hybrid (Y2H) screens, although the Y2H system has proven to be a powerful tool for the detection of PPIs in high-throughput, and the tools are increasingly robust. Large-scale interaction mapping screens have been carried out successfully to detect PPIs in viruses (98–100) and across the proteomes of several organisms including Saccharomyces cerevisiae (101–103), Caenorhabditis elegans (104,105), Drosophila melanogaster (106,107), Helicobacter pylori (108), human (109,110), Escherichia coli (111), Campylobacter

jejuni (112) and Plasmodium falciparum (113). The resulting interactome maps, even though representing work in progress, are currently used to formulate hypotheses and jump-start experimentation. In trypanosomatids, protein–protein interaction studies have focused on a sub-compartment such as paraflagellar rod using yeast two-hybrid along with RNAi to interrogate the molecular structure and function (114). More recent work tackles one of the unique and interesting features in trypanosomes, mitochondrial mRNA editing and produces a protein–protein map of editosomes using yeast two-hybrid methodology as well as co-expression profiles (115). In addition to experimental methods, computational algorithms to predict interactions based on the protein structural information have been developed (116).

Among the dermatophytes, the most common pathogen isolated was Trichophyton rubrum (59.4%), followed in descending order by: Trichophyton mentagrophytes var. interdigitale (16.6%), Trichophyton mentagrophytes

var. mentagrophytes (9.0%), Trichophyton tonsurans (6.8%), Microsporum canis (5.1%) and Epidermophyton floccosum (2.7%). Among the yeast-like fungi, a marked predominance Cytoskeletal Signaling inhibitor of Candida species was observed (86.3%). Scopulariopsis brevicaulis was the most commonly isolated mould (25.2%). The most frequently affected body sites were the toenails (53.9%), followed by the fingernails (19.0%). In children under 15 years of age, glabrous skin was the most commonly affected body site with M. canis as the most frequent causative agent. “
“The aim of this study was to examine the antifungal activity of amphotericin B, caspofungin and posaconazole on Candida albicans biofilms in the intermediate https://www.selleckchem.com/products/midostaurin-pkc412.html and mature development phases. Candida albicans biofilms, previously grown for either 24, 48 or

72 h in 96-well microtitre plates, were treated for 48 h with amphotericin B, caspofungin or posaconazole in increasing concentrations according to the respective minimal inhibitory concentration (MIC) determined for planktonic cells (1–128 × MIC). The biofilms were quantified using the mean optical density (OD) determined by XTT assay. Antifungal activities were expressed as percentage of reduction in OD of drug-treated many biofilms compared to untreated biofilms.

To test the fungicidal activity of antifungal agents, the unfixed biofilms were scraped off and seeded to Sabouraud agar. Caspofungin and amphotericin B showed higher activity against C. albicans biofilm grown for 24 h and 72 h (≥50% reduction of OD) than biofilms grown for 48 h, whereas posaconazole showed similar, but reduced activity against all phases of C. albicans biofilm (≤50% reduction of OD). Caspofungin at 1–4 × MIC achieved the greatest decrease in the biofilm OD grown for 24, 48 and 72 h, whereas amphotericin B showed dose-dependent activity. However, all tested antifungals failed to reach fungicidal activity in all biofilm development phases. Invasive Candida infections are associated with high morbidity and mortality in immunocompromised and severely ill patients.1 Surgery, long-term admission at intensive care units, broad-spectrum antibiotics and percutaneous intravascular catheters are predisposing factors for the development of invasive Candida infections.2 Colonisation is common and considered a risk factor for invasive Candida infection.3 On the skin, mucosa and inert surfaces of intravascular catheters Candida cells attach, proliferate and may finally form a biofilm of hyphae and densely packed cells embedded within an inert matrix.4,5 Established biofilms are difficult to eliminate and are a source of persistent infections and recurrent fungaemia.

Initially, following two-stitch neurorrhaphy, 40 limbs (20 rats) underwent wrapping in 7- or 10-μm honeycomb film, cast film, no wrapping, or extra two-stitch neurorrhaphy CP-673451 solubility dmso (8 limbs each). Breaking strength was tested 2 days postoperatively. Another 30 limbs

(15 rats) then underwent wrapping in 7- or 10-μm honeycomb film, cast film, no wrapping, or sham operation (six limbs each). Histological and functional analyses were performed 6 weeks postoperatively. Breaking strength was significantly higher for the 10-μm honeycomb film than for no wrapping (P = 0.013), although no significant difference was observed between the 7-μm honeycomb and no wrapping (P = 0.085). Breaking strength for the cast film was almost equal to that for no wrapping (P = 0.994). Extra two-stitch (four-stitch) neurorrhaphy was significantly stronger than all groups, except the 10-μm honeycomb group. No significant difference was observed between the 10-μm honeycomb and the four-stitch (P = 0.497). No negative effects on functional recovery were identified. No adhesions or inflammation were observed between the film and surrounding tissues in the honeycomb groups. Honeycomb film may offer a suitable

reinforcing material for adhesion-free neurorrhaphy. © 2012 Wiley Periodicals, Inc. Microsurgery 2012. “
“The present selleck chemicals llc study was to compare the success rates of single venous anastomosis with dual venous anastomoses of the free fibula osteocutaneous flap in mandibular reconstruction. Retrospective review of all cases of mandibular reconstruction using free fibula osteocutaneous flaps performed by a single surgeon in our department during the period January 2005 to April 2012. All the flaps were harvested and transplanted by the standard protocols. Microvascular anastomosis Miconazole of either one or two veins was performed. In addition to routine clinical evaluation, the viability of the flap was evaluated by a portable Doppler at the tenth day after surgery. Two hundred and one free fibula osteocutaneous flaps

were performed during this time period. Single venous anastomosis was performed in 112 flaps and dual venous anastomoses were performed in 89 flaps. The overall incidence of vascular thrombosis was 3%, and the success rate of the transplantation was 98.5%. Six cases developed vascular thrombosis postoperatively. One was arterial thrombosis that occurred 12 hours after initial operation in the dual venous anastomoses group. Three venous thrombosis occurred 24 hr after the operation in the single venous anastomosis group. In dual venous anastomoses group, two venous thrombosis occurred 3–4 days after initial operation and attempt to salvage failed in both the cases. Fisher’s exact test showed that there was no significant difference of the success rate between single and dual anastomoses groups (P = 0.59).