bluuebunny/crossref_metadata_2025 huggingface dataset:
Bystander effect caused by suicide gene expression indicates the feasibility of gene therapy for hepatocellular carcinoma
Authors: Kuriyama Shigeki , Nakatani Toshiya , Masui Kazuhiro , Sakamoto Takemi , Tominaga Kentarou , Yoshikawa Masahide , Fukui Hiroshi , Ikenaka Kazuhiro , Tsujii Tadasu
Published: March 2007

In the field of gene therapy using retroviral vectors, it appears impossible to introduce a foreign gene into all target cells. Therefore adjacent cell killing, the socalled bystander effect, caused by genetically modified cells provides therapeutic advantages for gene therapy against cancers. We retrovirally transduced the herpes simplex virus thymidine kinase (HSV-tk) gene into murine and rat hepatocellular carcinoma (HCC) cells. These HSV-tk gene-transduced HCC cells were cocultured with the corresponding parental cells in the presence of ganciclovir, at a concentration not at all cytotoxic to the parental cells. When parental HCC cells were cocultured with their HSV-tk gene-transduced counterparts at a high density at which most cells were in contact with one another, they were markedly eliminated. Conversely, when cocultured at a low density at which none of the cells were in contact, a weak but statistically significant bystander effect was observed. Addition of lysates of HSV-tk gene-transduced cells in the presence of ganciclovir did not cause any killing of parental cells. Furthermore, media conditioned by transduced cells with ganciclovir exhibited weak cytotoxic effects on parental cells. These results indicate that cell-cell contact plays a major causative role in the bystander effect and that minor contributors to this phenomenon are some cytotoxic substance released from transduced cells. Importantly, the bystander effect was induced in vivo as well as in vitro. When mixtures of transduced and untransduced HCC cells were implanted into the flank region of mice, intraperitoneal ganciclovir administration considerably inhibited tumor development, indicating the feasibility of gene therapy with HSV-tk gene and ganciclovir against HCC. (Hepatology 1995; 22:1838-1846).
Gene expression of N -acetylglucosaminyltransferases III and V: A possible implication for liver regeneration
Authors: Miyoshi Elji , Ihara Yoshito , Nishikawa Atsushi , Saito Hiroyuki , Uozumi Naofumi , Hayashi Norio , Fusamoto Hideyuki , Kamada Takenobu , Taniguchi Naoyuki
Published: March 2007

N-acetylglucosaminyltransferases III and V (GnT-III and -V) are key enzymes in the synthesis of the branches of asparagine-linked oligosaccharides. Although their messenger RNAs (mRNAs) are expressed in various rat tissues, they are not detected in normal rat liver. Expression of the GnT-III and -V mRNAs, however, increased in regenerating liver after two-thirds partial hepatectomy compared with sham-operated rats. The enzymatic activities of GnT-III and -V increased in proportion to mRNA expression. To determine which type of cells in the liver have high activities of these glycosyltransfersses, hepatocytes and nonparenchymal cells were separated by means of a two-step collagenase perfusion technique. GnT-III activity was only detected in nonparenchymal cells of normal rat liver. However, during liver regeneration, GnT-III activity increased and thus was also detectable in hepatocytes. GnT-V activity was detected in both types of cells. These data were supported by reverse transcription-polymerase chain reaction results. Although the mechanism underlying the induction of these glycosyltransferases is unknown, lectin blot analysis showed that oligosaccharides in many glycoproteins, including hepatocyte growth factor, a major growth factor associated with liver regeneration, were newly synthesized during liver regeneration. This is the first report on the expression of glycosyltransferases during liver regeneration and suggests that there are different mechanisms involved in regulation of the genes of GnT-III and-V during liver regeneration. (Hepatology 1995; 22:1847-1855).
Endothelium-dependent vascular hyporesponsiveness without detection of nitric oxide synthase induction in aortas of cirrhotic rats
Authors: Weigert Andre L. , Martin Pierre-Yves , Niederberger Michel , Higa Elisa M. S. , McMurtry Ivan F. , Gines Pere , Schrier Robert W.
Published: March 2007

The present experiments were designed to test if induction of nitric oxide synthase (NOS) plays a role in the systemic vasodilation observed in hepatic cirrhosis. Because endotoxin levels are elevated in cirrhosis, and endotoxin stimulates inducible nitric oxide synthase (iNOS) expression in several cell lines, aortas of carbon tetrachloride-induced cirrhotic rats with ascites were evaluated for iNOS expression. Endotoxin-treated rats were studied as positive controls. Phenylephrine contraction was decreased in aortic rings with endothelium from both endotoxin-treated and cirrhotic rats as compared with controls. However, after endothelium denudation, the reduced contractility persisted in endotoxin-treated rats but disappeared in cirrhotic rats. l-Nitro-arginine-meth-ylester (l-NAME), a nonselective inhibitor of NOS, potentiated the phenylephrine contraction of aortic rings with and without endothelium from endotoxin-treated rats but only rings with endothelium from cirrhotic rats. Moreover, aminoguanidine (AG), a preferential inhibitor of iNOS, did not affect phenylephrine contraction of rings with or without endothelium from cirrhotic rats but reversed the blunted response in endotoxin-treated rats. Northern analysis detected iNOS RNA (mRNA) expression in aortas of endotoxin-treated rats but did not detect it from cirrhotic rats. In summary, although several previous studies provide evidence for in vivo overproduction of nitric oxide in cirrhosis, the present results do not support iNOS induction as the source of nitric oxide in aortas of cirrhotic rats. Rather, because the aortic vascular hyporesponsiveness in cirrhosis is endothelium-dependent, overexpression or overstimulation of the endothelial constitutive isoform of NOS appears to be involved. (Hepatology 1995; 22:1856-1862).
Treatment of chronic type B and C hepatitis with interferon alfa: An economic appraisal
Authors: Dusheiko Geoffrey M. , Roberts Jennifer A.
Published: March 2007

The aim of this study is to assess the long-term economic impact of treatment of chronic hepatitis B and C with interferon alfa. Estimates were made of the progression of the disease over a 30-year period using a transitional probability model. Cohorts of 1,000 hypothetical patients with either chronic hepatitis B or C treated with interferon alfa were compared with an untreated cohort. The costs were estimated for therapy, monitoring, and treatment of the disease, including transplantation. The cost-effectiveness of therapy was expressed in terms of cost per life saved, cost per year of life saved, and cost per quality-adjusted year of life saved. The analysis was extended to include the indirect costs to patients. The analysis included two rates of progression, two mortality rates, and discounted and undiscounted costs. Mortality in the treated group was lower, saving 18 to 31 lives in the hepatitis B virus (HBV) cohort and 13 to 22 lives in the hepatitis C virus (HCV) cohort. Fewer patients progressed to cirrhosis or decompensated cirrhosis. Discounted costs per year of life saved ranged from £2,142 to £17,128. A cost-benefit analysis indicated excess benefits over costs when values for life were included in the analysis. The potential usefulness of interferon alfa on the clinical and economic outcome of treatment is indicated from the model. These findings together with the benefits that are likely to accrue from the reduction in infectious individuals suggest that this therapy has a role to play in public health policy to contain the impact of hepatitis. (Hepatology 1995; 22:1863-1873).
Keratinocyte growth factor-just another mitogen or the “holy grail” that regulates liver regeneration?
Authors: Guha Chandan , Chowdhury Jayanta Roy
Published: March 2007

Keratinocyte growth factor (KGF), a member of the fibroblast growth factor (FGF) family, was identified as a specific keratinocyte mitogen after isolation from a lung fibroblast line. Recently, recombinant (r)KGF was found to influence proliferation and differentiation patterns of multiple epithelial cell lineages within skin, lung, and the reproductive tract. In the present study, we designed experiments to identify additional target tissues, and focused on the rat gastrointestinal (GI) system, since a putative receptor, K-sam, was originally identified in a gastric carcinoma. Expression of KGF receptor and KGF mRNA was detected within the entire GI tract, suggesting the gut both synthesized and responded to KGF. Therefore, rKGF was administered to adult rats and was found to induce markedly increased proliferation of epithelial cells from the foregut to the colon, and of hepatocytes, one day after systemic treatment. Daily treatment resulted in the marked selective induction of mucin-producing cell lineages throughout the GI tract in a dose-dependent fashion. Other cell lineages were either unaffected (e.g., Paneth cells), or relatively decreased (e.g., parietal cells, enterocytes) in rKGF-treated rats. The direct effect of rKGF was confirmed by demonstrating markedly increased carcinoembryonic antigen production in a human colon carcinoma cell line, LIM1899. Serum levels of albumin were specifically and significantly elevated after daily treatment. These results demonstrate rKGF can induce epithelial cell activation throughout the GI tract and liver. Further, endogenous KGF may be a normal paracrine mediator of growth within the gut. (J. Clin. Invest. 1994. 94:1764-1777.) Key words: fibroblast growth factors carcinoembryonic antigen colon carcinoma gastric small intestine. (Reproduced from The Journal of Clinical Investigation, 1994, vol. 94, pp. 1764-1777 by copyright permission of The Society for Clinical Investigation).
Can a guest liver bring the gift of a gene to disarm a hostile host?
Authors: Guha Chandan , Chowdhury Jayanta Roy
Published: March 2007

We have established a system of efficient gene transfer to liver grafts using adenovirus vectors. The purpose of this study was to examine variables affecting gene transfer to rat liver grafts during cold preservation. Our results demonstrate that gene transfer efficiency was directly correlated with the ratio of vector to hepatic cells (multiplicity of infection [MOI]) and the length of exposure to the vector. At MOls of 101 and 501, the hepatic cell transduction rate was 25-30% and 10%, respectively. However, higher MOI was associated with significant mortality. Prolonging the cold preservation/exposure time resulted in an increased transduction rate (50% at MOI of 10:1). Similar gene transfer efficiencies were observed when the vector was diluted in lactated Ringer’s or University of Wisconsin solution. Recombinant protein production was evident within 12 hr after reperfusion, and increased to a peak level within 48 hr. These results suggest a predictable pattern of gene transfer and expression after ex vivo transduction of liver grafts with adenovirus vectors. These data are es sential in directing desirable levels of recombinant protein within the transplanted organ.
Nuclear magnetic relaxation of water in ionic‐liquid solutions: determining the kosmotropicity of ionic liquids and its relationship with the enzyme enantioselectivity
Authors: Zhao Hua , Song Zhiyan
Published: March 2007

The nuclear magnetic relaxations of water in ionic‐liquid (IL) solutions were examined at various IL concentrations in order to better understand their hydration behaviors (in terms of nuclear magnetic resonance (NMR) B′‐coefficients). From these B′‐values of ILs, the individual ion's B′‐coefficients were further calculated based on the additivity. These coefficients represent the hydration behavior (‘kosmotropicity’) of ILs in aqueous solutions. Using these data, a linear correlation was found between enzyme enantioselectivity in aqueous solution and the δ′ parameter (difference in NMR B′‐coefficients of anion and cation). In general, high enzyme enantiomeric ratios (E) could be achieved in solutions of ILs with high δ′ values. Copyright © 2007 Society of Chemical Industry
Differentiation of fibroblastic meningiomas from other benign subtypes using diffusion tensor imaging
Authors: Tropine Andrei , Dellani Paulo D. , Glaser Martin , Bohl Juergen , Plöner Till , Vucurevic Goran , Perneczky Axel , Stoeter Peter
Published: March 2007

Purpose

To differentiate fibroblastic meningiomas, usually considered to be of a hard consistency, from other benign subtypes using diffusion tensor imaging (DTI).

Materials and Methods

From DTI data sets of 30 patients with benign meningiomas, we calculated diffusion tensors and mean diffusivity (MD) and fractional anisotropy (FA) maps as well as barycentric maps representing the geometrical shape of the tensors. The findings were compared to postoperative histology. The study was approved by the local ethics committee, and informed consent was given by the patients.

Results

According to one‐way analysis of variance (ANOVA), FA was the best parameter to differentiate between the subtypes (F = 32.2; p < 0.0001). Regarding tensor shape, endothelial meningiomas were represented by spherical tensors (80%) corresponding to isotropic diffusion, whereas the fibroblastic meningiomas showed a high percentage (43%) of nonspherical tensors, indicating planar or longitudinal diffusion. The difference was highly significant (F = 28.4; p < 0.0001) and may be due to the fascicular arrangement of long spindle‐shaped tumor cells and the high content of intra‐ and interfascicular fibers as shown in the histology. In addition, a capsule‐like rim of the in‐plane diffusion surrounded most meningiomas irrespective of their histological type.

Conclusion

If these results correlate to the intraoperative findings of meningioma consistency, DTI‐based measurement of FA and analysis of the shape of the diffusion tensor is a promising method to differentiate between fibroblastic and other subtypes of benign meningiomas in order to get information about their “hard” or “soft” consistency prior to removal. J. Magn. Reson. Imaging 2007. © 2007 Wiley‐Liss, Inc.
Effect of dermatan sulfate glycosaminoglycans on the quasi‐static material properties of the human medial collateral ligament
Authors: Lujan Trevor J. , Underwood Clayton J. , Henninger Heath B. , Thompson Brent M. , Weiss Jeffrey A.
Published: March 2007

The glycosaminoglycan of decorin, dermatan sulfate (DS), has been suggested to contribute to the mechanical properties of soft connective tissues such as ligaments and tendons. This study investigated the mechanical function of DS in human medial collateral ligaments (MCL) using nondestructive shear and tensile material tests performed before and after targeted removal of DS with chondroitinase B (ChB). The quasi‐static elastic material properties of human MCL were unchanged after DS removal. At peak deformation, tensile and shear stresses in ChB treated tissue were within 0.5% (p > 0.70) and 2.0% (p > 0.30) of pre‐treatment values, respectively. From pre‐ to post‐ChB treatment under tensile loading, the tensile tangent modulus went from 242 ± 64 to 233 ± 57 MPa (p = 0.44), and tissue strain at peak deformation went from 4.3 ± 0.3% to 4.4 ± 0.3% (p = 0.54). Tissue hysteresis was unaffected by DS removal for both tensile and shear loading. Biochemical analysis confirmed that 90% of DS was removed by ChB treatment when compared to control samples, and transmission electron microscopy (TEM) imaging further verified the degradation of DS by showing an 88% reduction (p < .001) of sulfated glycosaminoglycans in ChB treated tissue. These results demonstrate that DS in mature knee MCL tissue does not resist tensile or shear deformation under quasi‐static loading conditions, challenging the theory that decorin proteoglycans contribute to the elastic material behavior of ligament. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:894–903, 2007
Incidence and prognostic values of lymph node metastasis in operable hepatocellular carcinoma and evaluation of routine complete lymphadenectomy
Authors: Sun Hui‐Chuan , Zhuang Peng‐Yuan , Qin Lun‐Xiu , Ye Qing‐Hai , Wang Lu , Ren Ning , Zhang Ju‐Bo , Qian Yong‐Bing , Lu Lu , Fan Jia , Tang Zhao‐You
Published: March 2007

Background

To study lymph node metastasis (LNM) and prognosis in patients with operable hepatocellular carcinoma (HCC) as well as the value of routine complete lymphadenectomy. Few studies have been reported on LNM in patients with operable HCC.

Methods

Lymph node enlargement of 968 patients with operable HCC was carefully explored and LNM was diagnosed by typical intraoperative findings or pathology.

Results

Forty‐nine (5.1%) patients had LNM, which was associated with advanced tumor properties. The 1‐, 3‐, and 5‐year overall survival in patients with LNM was poorer than those without LNM (62.0%, 31.0%, and 26.0% vs. 81.0%, 62.0%, and 47.0%, P = 0.000). The 1‐, 3‐, and 5‐year overall survival in patients who received complete lymphadenectomy (n = 26) was poorer than those without LNM (68.0%, 31.0%, and 31.0% vs. 81.0%, 62.0%, and 47.0%, P = 0.017), and was not better than patients who received chemotherapy or radiotherapy (P = 0.944).

Conclusion

The incidence of LNM in operable HCC patients was low, and patients with LNM had a poorer prognosis. LNM status determined the disease‐free survival but not the overall survival of HCC. The complete lymphadenectomy did not improve overall survival, as compared with chemotherapy or radiotherapy. J. Surg. Oncol. 2007;96:37–45. © 2007 Wiley‐Liss, Inc.
Assessment of interrater and intrarater reliability of the Fahn–Tolosa–Marin Tremor Rating Scale in essential tremor
Authors: Stacy Mark A. , Elble Rodger J. , Ondo William G. , Wu Shu‐Chen , Hulihan Joseph ,   TRS Study Group
Published: March 2007

The purpose of this study was to evaluate interrater and intrarater reliability of the Fahn–Tolosa–Marin Tremor Rating Scale (TRS) in essential tremor (ET). Proper treatment of ET is contingent upon correct assessment of the severity, loss of function, and disability related to tremor. Videotape recordings of 17 subjects with ET evaluated with the TRS were produced and sent to 59 raters. Once the raters returned the videotape and completed the score sheet, they were mailed a second tape with the same recordings presented in a different order. In the interrater reliability evaluation, modified Kappa statistics for seven tremor type composites ranged from 0.10 to 0.65 in the first videotape and 0.17 to 0.62 in the second videotape. Interrater reliabilities were greater for Part A items (magnitude of tremor in different body parts) than for Part B items (tremor in writing and drawings) of the TRS. The average Spearman correlation was 0.87, indicating very good consistency between the two videotapes, but correlations for Part A were somewhat better than for Part B. It is best when the same rater performs repeated measures of tremor on a patient, particularly when judging tremor in handwriting and drawings. Training of raters on use of the TRS would help standardize judgement. © 2007 Movement Disorder Society
Normal blood supply to the uncus
Authors: Waddington Margaret M.
Published: March 2007

One hundred human brains, obtained from the routine autopsy service of the Dartmouth Medical School (Hanover, NH) and Rutland Hospital (Rutland, VT), were studied to establish a better understanding of the anatomy of the arterial supply to the uncus. Drawings of each dissection were made and the findings summarized. The variability in the number and size of the vessels to this region may be striking.
The effects of artificial postoperative hematoma on patency of microvascular anastomoses in rat femoral blood vessels
Authors: Sadove Richard , Cline Carolyn , Buncke Harry J.
Published: March 2007

The effect of hematoma formation on thrombus formation at microvascular anastomotic sites in the femoral arteries and veins of rats was investigated. No difference in anastomotic patency or thrombus formation was observed in the presence of perivascular hematoma, although compression secondary to hematoma formation was not an experimental variable. This study suggests the possibility that the velocity of blood flow (which increases with vasoconstriction) counteracts the thrombogenicity of changes in the flow volume (which decreases with vasoconstriction) by preventing the accumulation of thrombogenic materials. The authors suggest that the role of vasoconstriction in relation to thrombus formation and anastomotic patency should be explored further using topical vasoconstrictors and appropriate platelet fractions.
Use of fresh human placenta for microsurgical training
Authors: Goldstein Marc
Published: March 2007

Microsurgery requires considerable practice before any attempt is made at clinical application. Live animals represent the ideal training medium; however, unlimited access to the animal laboratory is not always possible. In such situations, segments of fresh human placenta provide ideal specimens for microsurgical practice. They are readily available and abundant in a variety of vessels, and require a minimum of dissection.
Extracorporeal microvascular arterial reconstruction in donor kidneys prior to transplantation
Authors: Novick Andrew C. , Straffon Ralph A.
Published: March 2007

Revascularization of all renal arteries is important to the prevention of ischemic allograft complications. Extracorporeal arterial repair prior to transplantation was performed on 41 donor kidneys. Three extracorporeal reconstructive techniques are described that are applicable to most of the anatomic variants presented by multiple renal arteries and those that are damaged or diseased. These are simple and effective methods that avoid subjecting the kidney to prolonged ischemia.
Heterotopic and orthotopic liver transplants in inbred rat strains
Authors: Lee Sun , Edgington T. S. , Orloff M. J.
Published: March 2007

The functioning and survival of orthotopic liver allotransplants in toto were compared with heterotopic partial and whole allotransplants in inbred rats. In contrast to the rapid and aggressive rejection of the heterotopic allografts, the orthotopic whole‐liver allografts survived for prolonged periods. These latter grafts were subjected to mild cellular attack 11 to 12 days following transplantation, but they survived without the massive cellular infiltration and hepatocytolysis seen in the heterotopic partial grafts. Biliary secretion by the orthotopic whole‐liver allografts was functional throughout the survival period and was markedly increased during the final stages of survival, whereas the heterotopic liver grafts ceased to excrete normal bile by day 9, after which they were completely depigmented.
Laser photocoagulation for treatment of experimental aneurysms
Authors: Maira Giulio , Mohr Géarard , Panisset Alain , Hardy Jules
Published: March 2007

Twenty‐five autologous, artificially implanted venous and arterial aneurysms were treated by argon laser photocoagulation. Sequential angiographic follow‐up studies and final histologic studies demonstrated complete secondary occlusion in 11 cases, significant reduction of the aneurysm lumen in 10 cases, and no change in 4 cases. Delayed secondary occlusion appears to involve an active biologic process with progressive fibroblastic proliferation in the aneurysm wall.
High‐frequency pulsed doppler ultrasound: A new tool for microvascular surgery
Authors: Freed Debow , Hartley Craig J. , Christman Kenneth D. , Lyman Robert C. , Agris Joseph , Walker William F.
Published: March 2007

A wide variety of surgical procedures now depend on the suture repair of vessels smaller than 1.5 mm. The need persists, however, for a rapid and objective test of patency that is atraumatic. Small‐vessel studies indicate that the high‐frequency (20 MHz) pulsed Doppler velocimeter is particulary well suited for this task. We have evaluated the ability of such a system to quantitate stenosis produced by partial ligation in a rat model, and report its initial successful use as an intraoperative tool to determine the quality of microvascular anastomoses.
Prolactin‐producing pituitary adenomas
Authors: Page Larry K. , LeMaire William J.
Published: March 2007

Eight patients with amenorrhea, galactorrhea, and hyperprolactinemia underwent excision of pituitary adenomas by means of a microsurgical pro cedure that used a transsphenoidal approach. Prolactin values returned to normal in five of the patients and were significantly lower in three. Five patients resumed their menses. Two became pregnant. All eight patients had used oral contraceptives. The association of oral contraceptives and prolactin‐ producing pituitary adenomas is discussed.
An extracranial microsurgical approach to the optic nerve
Authors: Sofferman Robert A.
Published: March 2007

Lesions affecting the canalicular portion of the optic nerve have classically been addressed with intracranial surgical techniques. This article introduces a microsurgical extracranial approach to the optic canal that can be readily adapted by the neurosurgical‐rhinologic team familiar with transsphenoidal hypophysectomy. The approach became clinically feasible with the advent of coaxial illumination, magnification, and special microinstrumentation. The technique is described in detail, potential and actual clinical applications are further outlined, and the advantages and disadvantages of the approach are discussed. Future adaptability of this technique to unusual clinical situations such as ophthalmic artery aneurysms and carotid‐cavernous sinus fistulas may be possible but will first require careful laboratory study.
Osteogenesis from periosteal autografts in ulnar defects in dogs
Authors: Finley John M. , Wood Michael B. , Acland Robert D.
Published: March 2007

The quantity of new bone formed by revascularized periosteal grafts was compared with that formed by nonvascularized periosteal grafts in ulnar diaphyseal defects in dogs. Although in general the revascularized periosteal grafts produced a greater quantity of bone than their nonvascularized counterparts, this osteogenic behavior was not consistent. The results, however, are sufficiently encouraging to merit further investigation into the free transfer of revascularized periosteal autografts.
Experimental nonsuture microvascular anastomosis using a soluble pva tube and plastic adhesive
Authors: Yamagata Sen , Handa Hajime , Taki Waro , Yonekawa Yasuhiro , Ikada Yoshito , Iwata Hiroo
Published: March 2007

This article describes a new nonsuture method for microvascular anastomoses that uses plastic adhesives and soluble tube stents made of polyvinyl alcohol (PVA). Three soluble tubes were studied: one tube with a monolayered wall and two bilayered tubes of different thicknesses. The layers of the bilayered tubes consisted of PVA of different degrees of solubility. As plastic adhesives, ethyl 2‐cyanoacrylate, isopropyl 2‐cyanoacrylate, isobutyl 2‐cyanoacrylate, and methyl 2‐cyanoacrylate were employed; methyl 2‐cyanoacrylate was by far the least effective. Anastomoses were performed on the common carotid artery of rats, and macroscopic, angiographic, and histologic investigations were carried out at intervals ranging from seven days to six months. The patency rates were 81% for the monolayered tube, and 92% and 98% for the bilayered tubes. The principal advantage of this method is that blood flow can be reestablished through the anastomosed site immediately after release of the hemostatic clamps.
Absorbable and nonabsorbable sutures in microsurgery: Standardized comparable studies in rats
Authors: Thiede A. , Lütjohann K. , Beck C. , Blunck F.
Published: March 2007

In order to study the applicability and value of synthetic absorbable suture materials in microvascular surgery, 8–0 monofilament nonabsorbable polyamide sutures and 8–0 absorbable polyglycolic acid and polyglactin 910 sutures were used in end‐to‐end anastomoses of the aorta in rats, employing the same microsurgical model for all procedures. Comparable investigations of the anastomotic sites were carried out macroscopically and histologically at various intervals postoperatively. It was found that when placed under unphysiologic strain, microvascular anastomoses sutured with absorbable materials had less mechanical endurance than anastomoses stitched with nonabsorbable suture materials. It was also found, however, that this had no significance in vivo, inasmuch as no vascular ruptures or aneurysms appeared with either the absorbable or nonabsorbable sutures even after long‐term observation. The nonabsorbable sutures were fully recognizable up to 150 days, microscopically showing clear evidence of granuloma formation. The absorbable sutures, on the other hand, could hardly be discerned after 50 days, and after 150 days the foreign body and scar reactions had almost completely disappeared. Absorbable suture materials lead to more rapid restitution of the vascular wall than nonabsorbable sutures and consequently appear to be superior.
Some adjuncts for the microvascular laboratory
Authors: Kinnebrew MD Michael C. DDS, , Kaufman Howard H. , Huchton John D.
Published: March 2007

A new mouthprop for airway maintenance in the anesthetized rat, a vessel stabilizer and dilator, and a modification of the technique for end‐to‐end anastomosis in deep wounds are described.
Vascularized transplantation of skeletal muscle: A case report
Authors: Serafin Donald , Smith Paul J.
Published: March 2007

Reconstruction of a severely injured forearm, which lacked flexor muscle function and which had a complete absence of volar sensation, was undertaken. A gracilis musculocutaneous flap was used as a free muscle transfer to replace the flexor muscle function successfully.
Microsurgery of eye vessels
Authors: Gundorova Rosa A. , Galchin Alex S.
Published: March 2007

The results of 20 experiments performed on aortas and femoral arteries of rats and 150 experimental procedures performed on isolated posterior long ciliary arteries of cadaver eyes are presented. The authors draw the conclusion that it is possible in principle to perform surgical intervention on the eye vessels. The selection of microsurgical instruments, needles, and suture materials is discussed, and the ophthalmologic applications of this type of vascular surgery are contemplated.
Experiences with different techniques of microvascular anastomosis
Authors: Eisenhardt H. J. , Hennecken H. , Klein P. J. , Pichlmaier H.
Published: March 2007

In order to compare the effects of transverse and oblique anastomosis techniques with and without adventitial stripping in microvascular anastomoses, the aortas of 40 rats and the femoral arteries of another 40 rats were subjected to transverse end‐to‐end anastomosis, transverse anastomosis with adventitial stripping. oblique anastomosis, and oblique anastomosis with adventitial stripping. The rats were sacrificed at 5 hours or 3 weeks. The macroscopic and histologic findings showed that oblique anastomosis did not improve the patency rate and that adventitial stripping resulted in a high rate of false aneurysms.
Lumbar microdiscectomy in rats
Authors: Capanna Albert Howard
Published: March 2007

An operative method for lumbar microdiscectomy in rats is described in general terms so that it may be adapted to any microsurgical laboratory. The operation may be used as an advanced exercise in microsurgery, or to prepare surgeons for clinical lumbar microdiscectomy surgery.
Heart and spleen twin grafts in rats
Authors: Blanchard Jacqueline M. , Tauber Jurg W.
Published: March 2007

The technical details of a new procedure for the simultaneous transplantation of the spleen and the heart in rats are described. One hundred sixtyfour such twin grafts from LEW to ACI rats and vice versa were performed. Seventeen animals were followed postoperatively without additional immunologic manipulations. There is a definite change in rejection pattern in terms of timing as well as intensity when heart and spleen twin grafts are compared with single cardiac grafts. A delay and mild form of rejection of twin grafts were observed especially in the strain combination of LEW to ACI. No graft‐versus‐host reaction occurred. There was no perfect correlation of the cardiac and splenic allografts in regard to their survival time. When the cardiac allograft arrested, however, the spleen was found to be rejected as well in all cases. In three cases a selective survival of the heart over the spleen was observed. Thus, the cardiac allograft can be used as a simple but not completely reliable indicator of the functional state of both grafts.
The versatility of the basic microscope system in otolaryngology
Authors: Edwards Frcs William G. Ma,
Published: March 2007

The operating icroscope is now an essential tool for a large number of surgical procedures in a wide range of disciplines. At many medical centers, the optical equipment is often shared by surgeons from several disciplines. Theexpansion of microsurgical interest will continue to be interdisciplinary in the future, and this will call for microscope systems that are sufficiently versatile, both optically and mechanically, to meet the needs of surgery on a wide variety of anatomic structures. The development of the current range of microsurgical procedures in otolaryngology is presented to illustrate the concept of versatility by demonstrating the expansion of microsurgical technique to many regions of the head and neck. The key to this versatility has been the interchangeable objective lens system (200–400 mm), wich allows a working distance appropriate to the depth of the various surgical approaches and which also allows the free transfer of microsurgical skills and instrumentation to new procedures.
The hazard of cigarette smoking following digital replantation
Authors: Harris Gerald D. , Finseth Frederick , Buncke Harry J.
Published: March 2007

Two case histories are presented in which cigarette smoking in the early postoperative period following digital replantation led to vasospasm and thus compromise of the microvascular anastomoses.
The operating microscope. II. Individual parts, handling, assembling, focusing, and balancing
Authors: Hoerenz Peter
Published: March 2007

The major components of the Zeiss OPMI 1, OPMI 6‐S, and OPMI 7 P/H are discussed along with details on handling and assembling the components, changing couplings, focusing, and balancing the microscope system prior to use.
Sutureless microvascular anastomosis using a neodymium‐yag laser
Authors: Jain Kewal K.
Published: March 2007

A technique is described in which a Neodymium‐YAG laser is used to anastomose arteries 0.8 to 1.0 mm in diameter. Heat generated by the laser causes fusion of the collagen of the media, making direct handling of the vessel wall unnecessary. Four variations of the technique were performed in 120 rat carotid arteries. Angiographic and scanning electron microscopic studies were carried out immediately after surgery and at intervals of 1 day to 6 months after anastomosis. Patency rates as high as 92.5% were recorded. The technique that produced the most secure anastomosis was considered to be one in which a vascular strut was used as an aid in apposition, followed by the application of a piece of vein wall to the anastomosis with tissue adhesive. The main advantages of the laser technique are speed and consistency. Complications such as disruption and aneurysm formation are considered to be rare.
The effect of hepatic interposition on ovary‐pituitary interaction
Authors: Lee Sun , Chandler James G. , Broelsch Christoph E. , Ehara Yoichi , Condon James K. , Charters A. Crane , Yen Samuel S. C. , Orloff Marshall J.
Published: March 2007

When the livers of female rats were provided with exclusive first access to all ovarian venous effluents by simultaneous castration and implantation of a portion of one of the ovaries beneath the splenic capsule, systemic venous plasma concentrations of estrone and estradiol were reduced 40%. Paradoxically, progestins in the peripheral plasma increased threefold, most probably because of augmented adrenocortical progestin secretion. Nevertheless, the change in estrogen levels alone was sufficient to abolish trophic effects on the genital organs and to block normal inhibition of pituitary gonadotropin secretion. Plasma gonadotropin concentrations were markedly elevated to levels comparable to those of castrates, and, as a result, the intrasplenic ovarian implants grew excessively and became histologically disorganized. A patent portacaval shunt negated the entire process, providing proof that the measured hormonal alterations and the change in the implant itself were direct consequences of hepatic screening.
Expanded polytetrafluoroethylene as a microvascular graft: An experimental study
Authors: Lidman Disa H. , Faibisoff Burt , Daniel Rollin K.
Published: March 2007

The patency rates of expanded polytetrafluoroethylene (PTFE) vascular grafts with internal diameters of 1.0–3.0 mm were evaluated in three different species (dogs, rabbits, and rats). An overall 2‐week patency rate of 14 (23%) of 60 was obtained, with the exception of 10 (83%) of 12 grafts 1.8 mm in diameter inserted in the carotid arteries of rabbits. The presence of numerous variables in the structural properties of PTFE may explain the variable results reported in the literature and this study. Heparinization did not improve the results, nor did modification in suture technique. At the present time, PTFE cannot be considered an equivalent to or a substitute for autogenous vein grafts in microvascular surgery.
Intramuscular urography in rats
Authors: Lamesch Alfred J. , Schreiner Bernard
Published: March 2007

In addition to macroscopic studies, microscopic studies, and biologic tests, urography is a valuable method for investigating renal function in rats. Intravenous urography is complicated, however, by the difficulty of puncturing a tail vein or the femoral vein. Intramuscular urography, on the other hand, is a simple and reliable method for radiographic examination of the kidneys and ureters, and gives information on morphology as well as physiology. In this study in 40 rats, intramuscular urography was performed under general anesthesia, and the contrast medium was injected into the gluteal muscles. Dense nephrograms and optimum films of the calices and the ureters were obtained approximately 40 minutes after injection.
Use of a tilted double clamp in microvascular anastomosis
Authors: Hendel P. M. , Buncke Harry J.
Published: March 2007

A tilted or angulated double microvascular clamp is described that, when applied to the vessels to be anastomosed, presents the vessel ends angulated upward facing the surgeon, so that the initial suturing of the posterior wall can be completed without rotating the vessel. Such a clamp is valuable in clinical situations where space is limited and where conventional double clamps cannot be rotated in the usual fashion.
Bilateral digital artery thrombosis: A case report
Authors: Lucas George L.
Published: March 2007

Blunt arterial trauma can cause digital arterial occlusion, and vein grafts may be required to restore adequate digital blood flow, as in the case of this 55‐year‐old man who developed thrombosis of both the radial and ulnar digital arteries of his ring finger.
Microarterial prostheses of expanded polytetrafluoroethylene
Authors: Watanabe Katsueki
Published: March 2007

Forty grafts of expanded polytetrafluoroethylene (PTFE) with an inside diameter of 1.5 mm were placed in the femoral arteries of rabbits. The telescoped technique was used for the anastomoses. The animals were sacrificed at intervals beginning the day after implantation. Four of the grafts lost patency and one graft had a remarkable degree of intimal hypertrophy. The remaining grafts developed thin neointimal formations and remained patent up to 7 months after implantation. The overall patency rate was 90%. Neointimization was established 35 to 90 days following surgery. The formation of neointima began at the anastomotic sites and extended into the grafts. It is concluded that PTFE prostheses can be used for grafting arteries as small as 1.0–1.2 mm in diameter, which up to now had been considered impossible.
The operating microscope. III. Accessories
Authors: Hoerenz Peter
Published: March 2007

The beam splitter, observation tubes, and assistant's microscope, available as accessories for the OPMI series of operating microscopes, are discussed.
Platelets, prostaglandins, and pateny in microvascular surgery
Authors: Change Wallace H. J. , Petry Judith J.
Published: March 2007

In light of recent research dealing with the proaggregatory and antiaggregatory effects of prostaglandins on the primary hemostatic event of platelet aggregation, we suggest that patency in microvascular surgery be viewed from a new perspective. The sequence of events in platelet aggregation and the effects of the products of arachidonic acid metabolism on these events are reviewed. Drugs affecting platelet aggregation are classified according to their sites of action. In particular, heparin, dextran, and aspirin are discussed in relation to new information regarding their effects on arachidonic acid metabolism. Original early experimental work and clinical reports from the literature are discussed with a view toward future directions for research in improving patency in microvascular surgery.
Limb preservation for reimplantation. A review
Authors: Kaufman Howard H. , Huchton John D. , Patten Bernard M. , Vogel Robert G. , Adler Susan K.
Published: March 2007

Although reimplantation of severed limbs and other parts of the body has become prevalent in recent years, the questions of how best to preserve limbs for reimplantation and how to determine if a transected part is viable have not been fully answered. The problem of preservation involves combating direct anoxic damage to tissue as well as combating the changes in the vascular system that lead to the “no reflow phenomenon.” Current information concerning kidney preservation as well as experimental and clinical reports on limb preservation are reviewed in this article, and suggestions are made for further investigations.
Successful replantation of four fingers by a single common digital artery anastomosis
Authors: Nakamura Junji , Kinoshita Yukihiro , Hama Hiroki , Ishimori Yoshiro , Kasai Shoji
Published: March 2007

The replantation of 4 digits of 1 hand was attempted in a patient who had completely amputated his fingers at the level of the metacarpophalangeal joints. Anastomosis of the severed ends of the third common volar digital artery proved to be successful not only in re‐establishing arterial circulation in the middle and ring fingers but also in the index and little fingers, as evidenced by survival of the digits and as evaluated by postoperative angiography. The reasons for this success are discussed in light of anatomic studies.
An international program for the assessment of tubal anastomosis by microsurgical technique: A preliminary report
Authors: Rock John A. , Burkman Ronald T. , Genadry René , King Theodore M.
Published: March 2007

This report outlines a microsurgical training program that has established 16 centers around the world for the reversal of sterilization by microsurgical technique and for the evaluation of such procedures. An obstetrician‐gynecologist was selected from each of several developing countries where an existing family planning program was responsible for a large number of sterilization procedures. Each course participant attended a 2‐week course in microsurgical techniques for tubal anastomosis and then returned to his or her home country to establish a microsurgical center for sterilization reversal. Each of these centers has since been evaluated by the program director and is fully operational.
Special eyeglasses for use in microsurgery
Authors: Lamesch Alfred J.
Published: March 2007

Special eyeglasses, designed to be used with the operating microscope, are described. These eyeglasses, which fit inside the eyecups of the oculars of the microscope, give the wearer a better view through the microscope than do conventional glasses and at the same time enable him to shift his vision to the surgical field or the instrument table without a sacrifice in clarity. Because they permit the wearer to maintain the eyecups of the oculars in the “up” position, the eyeglasses also prevent interference from outside illumination.
Microlumbar discectomy: Follow‐up of 477 patients
Authors: Goald Harold J.
Published: March 2007

A survey of the surgical experience with microlumbar discectomy in 477 patients over a 4.3‐year period is presented. A good result was obtained in more than 90% of the patients and morbidity was negligible. Photographs of the various phases of the microsurgical procedure are included. This conservative operation is a worthwhile alternative in the treatment of herniated lumbar discs because the postoperative pain is minimal and does not require treatment with narcotics, early ambulation is possible, there is no need for transfusion, the surgery is brief, and the postoperative stay is only about 3 days.
Microvascular free transfer of iliac bone based on the deep circumflex iliac vessels
Authors: Huang G. K. , Liu Z. Z. , Shen Y. L. , Hu R. Q. , Miao H. , Yin Z. Y.
Published: March 2007

The findings from dissections, injection studies, and angiograms of 180 specimens of the anterior portion of left and right iliac crests taken from 90 cadavers are reported. These findings suggested that the deep circumflex iliac vessels were suitable for use as a nutritive pedicle in microvascular free transfer of iliac bone. Therefore, the technique of microvascular free transfer of iliac bone based on these vessels was developed and applied clinically in 2 cases with good results. The advantages and disadvantages of using the superficial circumflex iliac vessels or the deep circumflex iliac vessels as the vascular pedicle for iliac bone grafts also are discussed.
A continuous suction device for maintaining a dry microsurgical field
Authors: Clifford John R. , Cort Judy Frederic
Published: March 2007

A device that permits low‐pressure, continuous suction in a microsurgical wound is described. The suction apparatus is easily constructed from supplies readily available in most operating rooms.
Handling properties and thrombogenicity of microsutures
Authors: Krag Christen , Larsen J⊘Rn , Reumert Torsten
Published: March 2007

The thrombogenicity and handling properties of 1 polypropylene and 2 polyamide 10‐0 microsuture materials were evaluated in a paired comparative study in rats. Using a sequential analysis method with significance limits corresponding to 2 α = 0.05 and β = 0.05, it was found that the handling properties of Supramide (polyamide) sutures were better than those of Prolene (polypropylene), and that the handling properties of Prolene did not differ from those of Nylon (polyamide). Also using a sequential analysis method with significance limits corresponding to 2 α = 0.05 and β = 0.02, it was found that the thrombogenicity of Prolene was significantly less than the thrombogenicity of Supramide and Nylon. It is concluded that Prolene is the microsuture of choice among the three materials tested.
Some contributions of microsurgery to clinical and experimental transplantation
Authors: Bartlett Scott P. , Russell Paul S.
Published: March 2007

The clinical applications of microsurgery in the transplantation of kidneys, lungs, reproductive organs, and endocrine organs and in pediatric transplantation are discussed, along with the role of microsurgery in transplantation research in laboratory animals.