ISSN:0738-1085    

DOI:10.1002/micr.1920151202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractAdvances in the field of microsurgery over the past two decades, together with the discovery of a powerful immunosuppressive, cyclosporin A, have brought vascularized osteochondral allografts closer to reality. In this review, the authors describe the history of laboratory research on vascularized osteochondral allografts using immunosuppression, as well as their experimental and preliminary clinical experiences.

ISSN:0738-1085    

DOI:10.1002/micr.1920151203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractWe conducted a survey among 94 members of the Japanese Society of Reconstructive Microsurgery on the present status of replantation in Japan. The results indicate that 9,664 extremities were replanted (157 upper arms, 415 forearms, 471 hands, 8,320 digits, 33 thighs, 103 calves, 37 feet, and 128 toes); 8,227 replants survived, for a success rate of 85%. The survival rate was over 90% in 23 hospitals, and 7 of these hospitals replanted more than 100 limbs. Postoperative treatment consisted of continuous intravenous infusion of urokinase (120,000‐240,000 U/day), heparin (10,000‐20,000 U/day), and prostaglandin E1(80–120 μg/day) for 3–10 days. Fifty‐six surgeons attempted replantation whenever the patient requested it. At Nara Medical University, continuous local intra‐arterial infusion of anticoagulants and fibrinolytic agents has increased the survival rate of the replantation to 97%, compared with 88% when using intravenous infusion. © 1994 Wi

ISSN:0738-1085    

DOI:10.1002/micr.1920151204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractA series of 82 consecutive cases were studied concentrating on the influence of joint injury on the final motor and functional recovery of the successfully replanted or revascularized finger. In this series a 32.0% (41/128) incidence of joint injury was found. When the proximal interphalangeal (PIP) joint was injured and preservation was not possible, arthrodesis was done. This would cause a significantly lower Tamai's score (70.9), total active range of motion (TAM; 99.4°) and TAM‐minus the metacarpophalangeal joint TAM‐MP; (15.6°). The influence of arthrodesis on the distal interphalangeal (DIP) joint was relatively minor. When preservation of the joint was possible, the PIP arthroplasty group had a significantly higher Tamai's score (83.7,P<0.01), TAM (157.9°,P<0.05), and TAM‐MP (70.0°, P<0.001). Preservation of the DIP joint also significantly increased the TAM and TAM‐MP degrees, yet with no significant improvement in Tamai's score. Our study proves what most hand surgeons would expect, in that sacrifices of the PIP and MP joint would cause a significantly detrimental effect on the functional recovery of a finger. We also recommend joint preservation during replantation surgery whenever possible, especially for the PIP and MP joints, in order to achieve better functional recovery of

ISSN:0738-1085    

DOI:10.1002/micr.1920151205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe rat pectoralis muscle can serve as a vascularized, innervated muscle flap model. The muscle, consisting of superficialis and profundus portions, is supplied by separate neurovascular systems. The vessels to pectoralis profundus (averaging 0.3 mm in diameter) can be taken in continuity with the axillary vessels (averaging 11 mm in diameter), which are used for transplantation. The profundus portion of muscle weighed an average of 1.8 g, and the average pedicle length was 0.9 cm. Nine of 11 transplanted muscles were viable, with intact circulation at 72 hours. An example of muscle transplantation for tissue defect coverage was attempted. The pectoralis profundus transplant was technically reliable, and the muscle bulk and contour could allow biochemical and functional studies. © 1994 Wiley‐Liss, I

ISSN:0738-1085    

DOI:10.1002/micr.1920151206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractIn a rat model, we attempted to describe the natural healing course of the common bile duct (CBD) after primary microsurgical repair. Fifty‐three rats were divided into experimental groups with CBD microsurgical anastomoses and control groups with CBD mobilization and ligation. Examination of three experimental groups at 1 week, 1 month, and 3 months showed evolving inflammation and stricture changes with eventual patent, healed ducts in 92% of animals at the end of 3 months following transection and repair. There were no histologic abnormalities in the livers. There were fibrotic ducts and hepatic stasis and cirrhosis changes in the control group with CBD ligation. This study demonstrates that microsurgical techniques can achieve successful primary biliary repair in the rat. © 1994 Wiley‐Liss,

ISSN:0738-1085    

DOI:10.1002/micr.1920151207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractUsing an extracorporeal circulatory system of fresh blood, the vasodilative effect of endothelium‐derived relaxing factor (EDRF) secreted from vascular endothelium, stimulated by acetylcholine (ACh), was evaluated. The bioassay cascade technique was applied to elucidate the release of EDRF. Elevated blood pressure of freshly amputated rat hind limbs, created by injection of norepinephrine (NE), decreased by 56% with ACh infusion, suggesting the existence of EDRF in the peripheral vascular system of rat hind limbs. The vasodilative effect of EDRF could be preserved for at least 6 hours when stored at room temperature. The effect of EDRF decreased markedly following storage for more than 9 hours at room temperature and storage for more than 3 hours at 4°C. © 1994 Wiley‐Liss

ISSN:0738-1085    

DOI:10.1002/micr.1920151208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractFollowing free vascularized normal muscle graft in mice, a study was made to determine whether dystrophin expression is possible in dystrophin‐deficient muscles. In this study, dystrophic C57BL/10 ScSn‐mdx mice were used as recipients and normal C57BL/10 ScSn mice as donors. A free vascularized quadriceps muscle 8.0 × 6.0 × 6.0 mm in size was orthotopically transplanted into a muscle defect produced in the recipient mouse. The diameter of the sutured vessels was about 0.4 mm. Transplantation was successful in 7 of 20 mice. At 12 weeks after the transplantation, the grafted muscle was examined by immunocytochemical stain using antidystrophin antibody. This study showed that dystrophin was expressed in the transplanted muscle but not in the adjacent recipient quadriceps muscle, suggesting that grafted donor cells with dystrophin failed to migrate into dystrophic muscle cells and fuse together. However, since the grafted normal skeletal muscle successfully survived and normal dystrophin was expressed in almost all the grafted muscle fibers, the possibility was suggested that the function of muscular dystrophy muscle can be compensated by complete replacement with a larger muscle. © 1994 Wiley‐L

ISSN:0738-1085    

DOI:10.1002/micr.1920151209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractRegeneration through vascularized nerve grafts (VNG) seems to be better than nonvascularized nerve grafts (NVNG), especially in hostile beds. We report on an experimental technique of prefabrication of VNG by direct vessel implantation. An arteriovenous fistula was created in the groin region with autologous vein grafts in the Wistar rat model, and implanted into the sciatic nerve. Five weeks later the sciatic VNG was elevated on the prefabricated pedicle. The flap was free‐transferred orthotopically over a silicone sheet to impede plasmatic imbibition. Flap viability at 3 days was complete. India ink injection of the AV fistula resulted in capillary ink filling within the nerve and surrounding tissues. Histologic sections of the flap were examined, revealing its neovascularity. In an ongoing study, the regeneration through this prefabricated VNG is being compared to native VNG. © 1994 Wiley‐Liss,

ISSN:0738-1085    

DOI:10.1002/micr.1920151210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractTendocutaneous free flap transfer has been used to treat troublesome wounds involving skin and tendons, with the dorsum of the foot being the most frequent donor site. Free flaps consist of the dorsalis pedis artery, saphenous vein, branch of the superficial peroneal nerve, long extensor tendons, and overlying skin. We analyzed 13 cases of skin and tendon loss from the dorsum of the hand and wrist that were treated with tendocutaneous free flap from the dorsum of the foot. The size of the flap was from 6 × 5 cm to 11.5 × 7.1 cm (average, 9.2 × 5.9 cm), and the transferred tendons ranged from 1 to 5 in number (average, 2.9), and 5 to 17 cm in length (average, 9.2 cm). The transferred flaps survived in all cases, and the transferred tendons were functioning well except in two cases of electrical burn. The complications included two cases of tendon adhesion, one case of marginal necrosis of the flap, and three cases of donor‐site wound pro

ISSN:0738-1085    

DOI:10.1002/micr.1920151211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY