Abstract. The hepatoprotective effects of ACTIValoe ® N-931 complex, a mixture of Aloe vera and Silybum marianum, against acute and chronic carbon tetrachloride (CCl 4 )-induced liver injuries were investigated. Acute hepatotoxicity was induced by intraperitoneal injection of CCl 4 (50 μl / kg), and ACTIValoe ® N-931 complex at 85, 170, and 340 mg / kg was administered orally 48, 24, and 2 h before and 6 h after injection of CCl 4 . Hepatotoxicity was assessed 24 h after CCl 4 treatment. Liver fibrosis was induced by intraperitoneal injection of CCl 4 for 8 weeks (0.5 ml / kg, twice per week), and mice were treated with ACTIValoe ® N-931 complex at 85, 170, or 340 mg / kg once a day (p.o.). In both acute hepatotoxicity and liver fibrosis, serum aminotransferase levels and lipid peroxidation were increased and the hepatic glutathione content was decreased. These changes were prevented by ACTIValoe

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Purpose: This study evaluated the functional and aesthetic outcomes of a wide-second dorsal metacarpal artery perforator flap for reconstruction of the first web space of the hand. This flap sets the proximal edge of the extensor retinaculum as the distal limit.Methods: We measured the preoperative and postoperative angles of the first web space and assessed the quality of the donor site scar in eight patients.Results: The average flap size was 5.5 × 2.8 cm (range, 5.0 × 1.5 cm to 5.0 × 6.0 cm), and all flaps survived completely. The mean postoperative angle was 53°. The mean Vancouver Scar Scale score of the donor site was 4 points, and the patients had near-normal thickness and vascularity values. There was no distortion of the scar, and patients were satisfied with the scar appearance of the donor site.Conclusion: The wide-second dorsal metacarpal artery perforator flap is a useful technique to reconstruct large defects of the first web space. It is easy to raise, thin, and pliable, and has excellent color and tissue matching.

We report the fate of neglected vascular injury in cases of incomplete amputation of the digits and hand after delayed revascularization. Twelve patients underwent primary bone fixation, tendon or skin repair for hand injuries without vessel repair despite ischaemic findings. There was discoloration or necrosis of the fingertips during follow-up examination and the patients were referred to us for treatment. The mean warm ischaemic time was 53 hours (range 17–120). Delayed revascularization was performed with end-to-end anastomosis of the digital arteries in eight and vein graft in four cases. Digital nerves were repaired in four cases and flexor tendons in two cases. Of the 12 cases, eight cases showed complete survival. However, in four patients, complete necrosis of the fingers occurred, with one finger surviving partially. Revision amputation was performed in the four cases where necrosis occurred. We conclude that neglected vascular injury associated with incomplete amputation of digits and hands can be overcome in some patients by delayed revascularization even after prolonged warm ischaemic time. Level of evidence: IV