bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitric oxide synthase inhibitor, nitro‐iminoethyl‐L‐ornithine, reduces ischemia‐reperfusion injury in rabbit skeletal muscle
Authors: Phan Long H. , Hickey Michael J. , Niazi Zahid B. M. , Stewart Alastair G. 
Published: March 2007

AbstractNitric oxide (NO), originally identified as the mediator of endothelial‐dependent relaxation of vascular smooth muscle, is now known to also have cytotoxic effects under certain conditions. Thus, we have investigated the effects of inhibition of NO synthesis on ischemia/reperfusion injury in the rabbit rectus femoris muscle. Three and a half hours of ischemia and 24 hours of reperfusion resulted in a 56% loss of viability. In muscles receiving an infusion of the nitric oxide synthase inhibitor, L‐NIO (30 μM), the loss of viability was reduced to 15%. Post‐ischemic blood flow was increased in muscles receiving a saline infusion, whereas there was a marked decrease in blood flow for at least the first 60 minutes of reperfusion in muscles treated with L‐NIO (30 μM). The increase in myeloperoxidase levels (indicative of neutrophil accumulation) following 24 hours of reperfusion was attenuated with L‐NIO infusion by approximately 50% and the reperfusion‐induced edema was also attenuated in L‐NIO treated muscle. These findings suggest that endogenous NO production during ischemia/reperfusion injury may be deleterious to muscle survival. © 1994 Wiley‐Liss, Inc.
Cold stored femoral vessels as microvascular allografts: A preliminary study
Authors: Crowe Daniel M. , Mitchell Geraldine M. , Hurley John V. , Olivier Thomas V. , O'Loughlin Kevin , Morrison Wayne A. 
Published: March 2007

AbstractCold stored femoral arteries or veins have been reinserted successfully as autografts into rabbits. The present study examines whether grafting with cold stored vascular allografts is equally successful. Rabbit femoral arteries and veins were stored at 4°C for 4 weeks before insertion as allografts into unrelated animals. Three weeks after insertion into the femoral artery all venous allografts and 80% of arterial allografts were patent, but patency of both graft types declined over the next few weeks. A small number of cold stored venous allografts when inserted into the femoral vein occluded within 3 weeks.No histological evidence of rejection was apparent. The findings suggest that cold stored vascular allografts could be used successfully as an arterial “prosthesis” to support free flaps where relatively short term patency is required until the flap can establish sufficient peripheral inset to survive in its own right. This technique could be applied when autologous veins are not available or not justified. © 1994 Wiley‐Liss, Inc.
Use of free interpositional vein grafts as pedicles for prefabrication of skin flaps
Authors: Wilson Yvonne T. , Kumta Samir , Hickey Michael J. , Hurley John V. , Morrison Wayne A. 
Published: March 2007

AbstractPedicles created from a long vein graft increase the scope and applications of prefabricated skin flaps. This study reports the survival and pattern of neovascularization of lower abdominal skin flaps in rabbits based on a pedicle formed by interposition of a long vein graft between the divided ipsilateral femoral artery and vein. Flaps were elevated 2–5 weeks after pedicle implantation and the surviving area quantitated and vascular patterns examined 1 week later. Only 8 out of 35 flaps were greater than 50% alive, the most frequent cause of flap failure being pedicle non‐patency. If the pedicle remained patent, complete flap survival was possible as early as 2 weeks after implantation. In non‐patent pedicles, recanalization or formation of a new vascular network may, given at least 4 weeks, be sufficient to ensure partial flap survival. The findings indicate that implantation of a long, skeletonized vein graft is an unreliable method of prefabrication of abdominal skin flaps in this model. © 1994 Wiley‐Liss, Inc.
Immediate and short‐term effect on arterial flow of clamping or stripping one vessel of a two vessel limb in a dog model
Authors: Olazabal A. E. , Morrison Wayne A. , O'Brien Bernard McC. 
Published: March 2007

AbstractThe effect on distal blood flow in a 2 vessel limb of clamping one of the vessels or resecting it over a length is not known. Commonly this situation occurs clinically, for example, following lacerations to the radial or ulnar artery or as a result of removing a radial or ulnar artery flap. In a dog model established to mimic these clinical circumstances, a 2 vessel limb was created in which one vessel carried two‐thirds of the total flow and the other one‐third. Electromagnetic flow recordings were taken to measure the changes in flow in one vessel when the other was clamped or resected. Contrary to expectation, when one vessel was occluded the flow in the opposite vessel both immediately and for the following 30 minutes increased but remained well below the combined flow of 2 unclamped vessels. No increased flow was recorded in the dominant vessel when the smaller vessel was clamped, while an approximately 25% increase in flow was recorded in the smaller vessel when the larger one was clamped. This represents a reduction in total distal blood flow of one‐half of the preclamping levels. Clamping of the vessel or its resection over a length resulted in the same degree of alteration in flow in the opposite vessel. The sacrifice of a dominant vessel in a 2 vessel limb whether by simple ligation or by radical stripping as for free tissue transfer significantly decreases distal flow in that limb at least in the immediate and short term. End‐to‐side anastomosis or reconstitution of the vessel would be recommended. On the other hand, use of the non‐dominant vessel would appear to be safe. © 1994 Wiley‐Liss, Inc.
Experimental study and clinical observations on hypertrophy of vascularized bone grafts
Authors: Fujimaki Arihisa , Suda Hitoshi 
Published: March 2007

AbstractIn order to understand the mechanisms involved in the hypertrophy of vascularized bone grafts, a series of animal experiments were carried out and 32 clinical cases were studied. A defect in the tibial shaft was created in puppies and the ipsilateral fibula was transferred into the medullary cavity of the tibia with the anterior tibial artery and vein. The same procedure was performed on a control group but without vessel supply. Radiologically, in the vascularized group mild hypertrophy in the fibula was seen at 2 weeks, became marked by 4 weeks, but in no case did the thickening (hypertrophy) of the graft ever exceed the diameter of the recipient tibia. The control group did not show hypertrophy but fracture callus formed in the recipient tibia at both ends of the graft. On histological evaluation no reactive bone formation was evident in the control group but some reactive bone formation was seen in the vascularized group just beneath the periosteum. There was no change in the periosteum itself. In the clinical cases 47% of patients showed hypertrophy. Hypertrophy was noted mainly in the fibulae but rarely in other bones such as ilium or rib. The important factors were age and good vascularity of the grafted bone. During the period of study, weight‐bearing was eliminated, so that the effects of mechanical force did not explain hypertrophy. We conclude from these studies that true hypertrophy is an essentially different process from reactive callus which forms normally in response to fracture healing. Vascularized bone grafts show remarkable hypertrophy of the grafted bone, but the exact mechanism is ill defined. In order to investigate the mechanisms, a series of animal experiments were carried out and clinical cases were studied. © 1994 Wiley‐Liss, Inc.
Bernard O'Brien: The microsurgical transfer of immature bone
Authors: Bowen C. Vaughan A. , Singer Steven 
Published: March 2007

AbstractBernard O'Brien was one of the pioneers of vascularized epiphyseal plate transfer. His clear understanding of the wide array of potential applications for reconstructive microsurgery stimulated his interest in the transfer of growing long bones. Investigations have been carried out in his laboratory since the earliest days of skeletal free tissue transfers. This paper describes the work done with epiphyseal plate transfers in O'Brien's laboratory. Research from other centers is then reviewed. Finally, the experience with clinical application is described. © 1994 Wiley‐Liss, Inc.
Transsphenoidal microsurgical management of pituitary adenomas
Authors: Yang Shu‐Yuan , Zhu Tao , Zhang Jian‐Ning , Sun Yin‐Shui 
Published: March 2007

AbstractThe transsphenoidal microsurgical operation is the best choice for most pituitary adenomas, whether or not there is an extension into the sphenoid or a supra‐sellar extension without lateral spread. The advantage of this approach is that it allows selective removal of the adenoma and therefore can preserve normal pituitary function. In our series of 249 cases 79% had achieved a remission at follow‐up one year or more after surgery. The surgical failure rate was 21%, and the mortality rate 0.8%. Complications occurred in 5.6%; most were temporary and minimal. The recurrence rate after transsphenoidal microsurgery was lower than that quoted in the literature after craniotomy. The smaller the size of the adenomas and the less the hormone abnormality preoperatively, the better the outcome. © 1994 Wiley‐Liss, Inc.
Brachial plexus surgery: Our concept of the last twelve years
Authors: Berger Alfred , Becker Michael H.‐J. 
Published: March 2007

AbstractIn patients with brachial plexus injuries restoration of complete function is seldom seen. The diagnosis is a clinical one; investigations such as MRI or myelography are not sufficiently reliable to base surgical indications on them. Surgery has to be performed within the first six months after the trauma. The surgical procedure firstly includes an exact intraoperative definition of the extent of the lesion. Depending on the type of the lesion, microsurgical neurolysis, nerve grafting, or reneurotization is performed. When regeneration is complete, secondary operations may follow if necessary as part of our integrated concept. The spectrum of secondary operations in our patients includes arthrodesis, tenodesis, tendon transfers, muscle transfers, and free neurovascular tissue transfer. In selected cases with extensive lesions a bifunctional latissimus dorsi transfer allows restoration of minimal grip with simultaneous elbow flexion. Our concept includes a series of hierarchical steps:

Diagnosis and indication
Nerve repair
Intensive physiotherapy, control in intervals
Secondary operations—if necessary
Intensive physiotherapy
Ergotherapy, orthosis

In the last 12 years 362 patients with brachial plexus lesions have been operated on in our clinic. In these patients we performed 104 neurolyses, 126 nerve grafting procedures, 87 reneurotizations, and 191 secondary operations in 96 patients. Only the combination of nerve repair with both conventional and newer methods of tendon and muscle transfers can restore the maximum function for the individual situation. © 1994 Wiley‐Liss, Inc.
Techniques of postoperative blood flow monitoring after free tissue transfer: An overview
Authors: Machens Hans‐Guenther , Mailaender Peter , Rieck Bernd , Berger Alfred 
Published: March 2007

AbstractEver since free tissue transfer has been established in microsurgery, success rates have greatly improved over the years, partly due to improved technical performance of microvascular anastomoses with better optical and instrumental aids. However, flap failure still occurs in 5–10%, mainly due to blood vessel thrombosis within the first 24 postoperative hours. Salvation rates of failing free tissue transfers can be optimized by in‐time diagnosis of irreversibly compromised tissue blood flow and immediate operative reexploration. Therefore, there is a special demand for adequate and reliable postoperative monitoring techniques. This article gives an overview of all monitoring techniques, which have been performed both in the experimental and clinical setting thus far. © 1994 Wiley‐Liss, Inc.
Closure of the second toe transfer donor site without disruption of the deep transverse metatarsal ligament
Authors: Webster Howard R. , Inglefield Christopher J. 
Published: March 2007

AbstractThe second metatarsal is routinely excised to facilitate closure of the defect created by the harvest of a second toe transfer. However, if the deep transverse metatarsal ligament is not disrupted by the harvest, it seems unnecessarily destructive to remove the metatarsal. A small arterialized venous flap provides a logical solution to the problem of wound closure in this circumstance. This paper describes such a reconstruction, discusses the reasons for its selection and the long term outcome, which has been very satisfactory. © 1994 Wiley‐Liss, Inc.
Flushing the vessel ends: The effect on ischemic free flap survival
Authors: Giele Henk P. , Ritz Morris , Morrison Wayne A. , O'Brien Bernard Mcc. 
Published: March 2007

AbstractDuring vascular anastomosis of experimental ischemic free flaps it is common to observe that stagnant blood in the vessel ends has clotted. A study was performed to investigate if flushing away the stagnant blood on division of the vessels would increase flap survival. Flushing did not influence flap survival. Clinically, clot is rarely seen, except in conditions of prolonged ischemia or damaged vessels. Current surgical practice does not involve flushing the vessel ends upon division of the vessels and this approach is affirmed by our results. © 1994 Wiley‐Liss, Inc.
Afferent arteriovenous anastomosis for thumb replantation: A case report
Authors: Theile David R. , Berger Anthony C. , Wilson Yvonne T. , Tham Stephen K. 
Published: March 2007

AbstractDescribed is a case where an afferent arteriovenous anastomosis was successfully employed in the replantation of a large piece of composite tissue amputated from a patient's thumb. The operative procedure is described and aspects of arterialized venous vascular networks are discussed. © 1994 Wiley‐Liss, Inc.
Inflammation and repair in the mammalian fetus: A Reappraisal
Authors: Hurley John V. 
Published: March 2007

AbstractReview of our recent experimental findings and published studies indicates that the mammalian fetus responds to injury in a similar way to adult animals. Persistent inflammatory stimuli evoke an extensive cellular response whose composition varies with the stage of gestation and which is succeeded by formation of typical scar tissue. In fetal sheep excisional skin wounds and wounds in bone, muscle, tendon, and nerve heal by scar. There is disagreement whether, early in gestation, sutured incised skin wounds heal without scar, but this cannot justify a claim of scarless fetal healing. In the immature fetuses of rats and rabbits sutured wounds heal rapidly but open wounds remain unhealed until birth. Injury to deeper tissues has not been examined. The little evidence available suggests that inflammation and repair in the human fetus is similar to that in fetal sheep. © 1994 Wiley‐Liss, Inc.
In vivo microscopy of a rat abdominal skin flap: A new model
Authors: Whan Elizabeth B. , Hurley John V. , Morrison Wayne A. 
Published: March 2007

AbstractThis study describes a rat abdominal skin flap model of in vivo microscopy which provides a reliable, easy to perform system in which to examine the microcirculation of flaps. The island flap, which is based on the superficial inferior epigastric vessels caudally, and drained proximally by the lateral thoracic vein, can be mounted directly on a Perspex microscope stage. In vivo microscopy of the subdermal plexus of the flap allows detailed study of blood flow pattern, capillary flow, microvessel diameter, and margination of leucocytes, in a skin flap with versatile blood supply and innervation. © 1994 Wiley‐Liss, Inc.
Training model for microvessel anastomosis
Authors: Kim David C. , Niazi Zahid B. M. , Hayward Peter G. , Morrison Wayne A. 
Published: March 2007

AbstractIn the early stages of microsurgical training a model is required which is accessible, inexpensive, and approximates human tissue. In this research centre initial training exercises utilize cold stored vessels harvested from sacrificed animals used in other experiments. This model serves as an initial training tool prior to the progression to live animal research which maximizes use of animal specimens and approximates the in vivo qualities of blood vessels. The costs involved are minimal and a large number of vessels can be efficiently harvested and stored using basic equipment. As a training model, cold stored vessels have balanced cost with practicality, given an excellent approximation to living tissue and have markedly reduced our usage of live animals for teaching. This latter effect is significant at a time of increased scrutiny of the ethical use of laboratory animals. © 1994 Wiley‐Liss, Inc.
Present status of replantation in Japan
Authors: Fukui Akihiro , Tamai Susumu 
Published: March 2007

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 Wiley‐Liss, Inc.
Influence of joint injury on motor and functional recovery of finger replantation
Authors: Chiu Haw‐Yen , Lee Jing‐Wei 
Published: March 2007

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 the finger.
Primary common bile duct anastomosis in the rat using microsurgical techniques
Authors: Chansmorn Chuphan , Lineaweaver William C. , Tonken Heidi , Zhang Feng , Campagna‐Pinto Dante , Newlin Leonard , Yim Kenneth , Buncke Harry J. 
Published: March 2007

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, Inc.
Experimental challenge for the treatment of duchenne muscular dystrophy using a vascularized free muscle graft
Authors: Dohi Daisuke , Ikuta Yoshikazu , Ishida Osamu , Kimori Kenji , Kuroki Hidenao 
Published: March 2007

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‐Liss, Inc.
Prefabrication of a vascularized nerve graft by vessel implantation: Preliminary report of an experimental model
Authors: Cavadas Pedro C. , Vera‐Sempere Francisco J. 
Published: March 2007

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, Inc.
Tendocutaneous free flap transfer from the dorsum of the foot
Authors: Lee Kwang Suk , Park Sang Won , Kim Hak Yoon 
Published: March 2007

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 problem.