bluuebunny/crossref_metadata_2025_split huggingface dataset:
Free vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia
Authors: Minami Akio , Ogino Toshihiko , Sakuma Takashi , Usui Masamichi 
Published: March 2007

AbstractFive patients with congential pseudarthorsis of the tibia treated by a free vascularized fibular graft are described. Follow‐up evaluation ranged from 15 to 81 months, with a mean of 40 months. Bony union was attained in three of five cases as determined roentgenographically. The remaining two cases failed to attain bony union. All cases except one, who was treated with a below‐knee amputation, subsequently attained bony union. However, four cases had five fractures after bony union. We discussed unsolved problems regarding the free vascularized fibular graft and fracture after bony union.
Sterilization reversals performed by fellows in training: What success rates can we reasonably expect?
Authors: Sauer Mark V. , Zeffer Kirsten B. , Bustillo Maria C. , Buster John E. 
Published: March 2007

AbstractTo assess outcomes of sterilization reversal procedures performed by fellows in training, we retrospectively analyzed 44 women who had undergone this procedure at a large teaching institution. All women studied had been followed postoperatively for a minimum of 12 months. Sixty‐five percent of patients became pregnant. Fifty‐four percent of patients successfully delivered a term infant. Compared to results tallied by experienced microsurgeons, no significant differences in outcomes were noted. We conclude that clinically inexperienced microsurgeons can obtain reasonable success rates for sterilization reversal procedures by carefully following established microsurgical principles.
Dual innervated index to thumb cross finger or island flap reconstruction
Authors: Hastings Hill 
Published: March 2007

AbstractPartial volar amputations of the entire thumb pulp require soft tissue coverage that provides not only padding and protection for exposed bone and tendons, but also restoration of discriminative sensation. A modification of the radial sensory innervated cross finger flap from index to thumb is described, which includes separate reinnervation of the flap by repair of the dorsal sensory branch of the index radial digital nerve to the ulnar digital nerve of thumb. The anatomical basis for this flap is discussed and two example cases presented. Sensory reinnervation is rapid and does not require cortical reorientation.
Progression of the zone of injury in experimental nerve in juries
Authors: Zachary Lawrence S. , Dellon A. Lee 
Published: March 2007

AbstractThe extent of injury a nerve sustains after different mechanisms of injury is often difficult to determine at the time of injury. This study was designed to define the zone of injury for avulsed and transected nerves in an experimental animal model. We were able to demonstrate a progressive zone of injury in the avulsed nerves which would preclude primary neurorrhaphy while the zone of injury in a transected nerve tended to decrease during the three week period of observation.
Laser doppler bone probe in vascularized fibula transfers: A preliminary report
Authors: Schuurman Arnold H. , Bos Kurt E. , van Nus Yvonne H. 
Published: March 2007

AbstractContinuous monitoring of circulation in bone transfers without a skin element may be possible with a laser doppler bone probe consistent with any free tissue transfer. Immediate reintervention is necessary when vascular insufficiency is suspected. In two clinical cases of vascularized fibula transfer, we were able to compare skin probe recordings with intraosseous probe recordings. There was no apparent difference in the recordings, suggesting that the bone probe alone may be useful for monitoring bone transfers and that it warrants further study.
Microvascular anastomosis in spontaneously hypertensive and stroke‐prone rats
Authors: Klara Peter M. 
Published: March 2007

AbstractCarotid end‐to‐end microvascular anastomoses (MVA) were performed in 100 rats [50 spontaneously hypertensive (SHR); 30 spontaneously hypertensive stroke‐prone (SHR‐SP); and 20 normotensive controls (WKY)]. Animals were sacrificed at various intervals from immediately after anastomosis to 60 days after surgery, and vascular healing was studied with the sacnning electron microscope. In this manner vascular healing in normotensive rats (WKY) could be compared with that in hypertensive rats (SHR and SHR‐SP) with vascular disease. Results of this study suggest that vascular healing in hypertensive rats is delayed when compared with normotensive controls. Furthermore, suture material was occasionally incompletely endothelialized in hypertensive animals as long as 60 days after surgery and served as a potential source of emboli. Additionally, an increased susceptibility of hypertensive endothelium (SHR and SHR‐SP) to clamp and needle injury was apparent. In spite of this, there was a 100% patency rate of all anastomoses performed, indicating that patency, per se, is unaffected by hypertensive vasculopathy.
Experimental vascularized bone allografting
Authors: Randolph Mark A. , Yaremchuk Michael J. , Moore J. Russell , Robinson Robert A. , Weiland Andrew J. 
Published: March 2007

AbstractPresented here is a compendium of studies investigating the fate of vascularized bone allografts. The first set of experiments employ the posterior rib graft in two canine models. The rib‐to‐mandible model was used to evaluate the rejection phenomena of vascularized bone allografts in an outbred dog model. This ascertained the time course of rejection and histological characteristics of the grafts. Immunosuppression of the graft recipients was attempted with azathioprine and cyclosporine. The results demonstrated that azathioprine was not an effective immunosuppressant, whereas cyclosporine resulted in survival of cortical osteons. The use of the vascularized rib allograft, with and without azathioprine, to bridge the defect in the dog femur was met with failure. Further studies employed a genetically defined rat model to determine the effect of different histocompatibilities on the survival of vascularized knee allografts. Grafts were transplanted from Lewis rats to syngeneic Lewis rats as isografts and to Fischer‐344 rats (F‐344) and Brown‐Norway rats (BN) as allografts. Grafts across a major histocompatibility barrier to BN were rejected by 7 days, whereas grafts across a weak histocompatibility barrier to F‐344 were rejected more slowly. The use of cyclosporine in this model abrogated the rejection response when administered to both groups continuously. However, a short course of cyclosporine was effective in preventing rejection in the F‐344 animals. Efforts to induce tolerance by blood transfusions, from the donor strain or from a third‐party donor, were not effective in preventing rejection.
Customized prefabricated neovascularized free flaps
Authors: Hirase Yuichi , Valauri Fredrick A. , Buncke Harry J. , Newlin Leonard Y. 
Published: March 2007

AbstractNeovascularization of tissues into which a vascular pedicle has been implanted can result in the creation of a flap, or free flap, which is supported by those vessels as a neopedicle. This phenomenon allows the construction of customized prefabricated free flaps from tissue without restriction to naturally occurring vascular territories.
Parameters altering the success of the one‐anastomosis rat heart‐lung transplant
Authors: Scott Michael H. , D'Silva Milbhor , Gaarde William A. , Leisten James C. , Sadoff Joel A. , Axtelle Timothy S. , Hahn Gary S. , Plummer James M. , Chang Eil Sung , Lee Sun 
Published: March 2007

AbstractThe single‐anastomosis heart‐lung transplantation method in the rat developed by Lee and associates has been examined and has proven to be simple and reproducible. Technical procedures are discussed emphasizing those procedures that require special caution to ensure successful graft function. The donor and recipient rat strain combination has been found to influence the success of the transplantation procedure. Rat strain combinations used in our laboratories resulted in different percentages of donor heart survival. Using Lewis rat (RT11/1) recipients, 68% of Brown Norway rat (RT1 n/n) donor hearts and 97% of NBR rat (RT1 1/1) donor hearts survived. However, only 29% of Fischer rat (RT 1/1) donor hearts survived longer than 2 days when transplanted into Lewis rat recipients. In our laboratories, the Lee method of single‐anastomosis heart‐lung transplantation has been used successfully to evaluate whether immunoregulatory compounds alter heart allograft rejection.
Review of tissue welding applications in neurosurgery
Authors: Bailes Julian E. , Quigley Matthew R. , Cerullo Leonard J. , Kwaan Hau C. 
Published: March 2007

AbstractNew technical advances have made feasible the utilization of low‐powered laser energy for constructive applications. Experience with laser bonding of blood vessels, peripheral nerves, and dura has been obtained. These studies are summarized, and the future potential of laser bonding of tissues of the central nervous system is discussed.
The effects of intravenous prostacyclin in a model of microsurgical thrombosis
Authors: Bailes Julian E. , Quigley Matthew R. , Kwaan Hau C. , Nishiura Bing R. , Cerullo Leonard J. , Lastre Clara 
Published: March 2007

AbstractNumerous agents have been administered in an attempt to achieve specific biochemical antiplatelet activity. A model of microsurgical trauma was utilized to create a nonocclusive thrombus, similar to what occurs in the postoperative period. Prostacyclin (PGI2) was given in a high intravenous dose which caused in vitro inhibition of platelet aggregation in rats and rabbits. Although hematological and cardiovascular side effects of PGI2 were tolerated, in vivo platelet thrombus formation persisted and constituted 25–75% of the postoperative thrombus. Even though platelets were inhibited by PGI2, other significant stimuli remained at the site of injury for activation and participation of platelets in the formation of a thrombus.
Effect of blood bonding on bursting strength of laser‐assisted microvascular anastomoses
Authors: Wang Su , Grubbs Philip E. , Basu Samir , Robertazzi Robert R. , Thomsen Sharon , Rose Daniel M. , Jacobowitz Israel J. , Cunningham Joseph N. 
Published: March 2007

AbstractThis experiment evaluated the influence of blood on the weld strength of laser‐assisted microvascular anastomoses (LAMA). Rat femoral arteries were anastomosed end‐to‐end by either direct laser welding (group I) or by a bloodbonded technique (group II) whereby fresh blood was applied to the vessel edges before laser exposure. Bursting strength was measured at 0, 1, and 24 hours and at 3 and 7 days by infusing methylene blue into the vessel while pressure was monitored. The results showed significantly increased bursting strength in group II compared with group I at 0 hour and 7 days (P < 0.05). There was a significant increase in bursting strength in group I from 0 hour to 1 hour (P < 0.05). It is concluded that blood‐bonding enhances the early bursting strength of LAMAs and may facilitate arterial wall healing.
An interposed superficial temporal artery graft bypass for anterior cerebral artery ischemia
Authors: Iwata Yoshikazu , Mizuta Tadahisa , Takemoto Osamu , Shimizu Keiji , Nakatani Susumu 
Published: March 2007

AbstractA new microsurgical revascularization technique for anterior cerebral artery ischemia is reported. An arterial graft bypass interposed between the superficial temporal artery and the distal anterior cerebral artery was successfully completed in a 43‐year‐old male with transient ischemic attacks in the anterior cerebral artery territory. The contralateral superficial temporal artery was harvested and used as an arterial graft. Both procedures were carried out with one single transcoronal scalp incision. The patient's postoperative cerebral angiogram revealed good filling of the area distal to the stenotic lesion of the anterior cerebral artery through the bypass graft. The patient was discharged with no neurological deficit and has been free of ischemic events for more than 2 years since the surgery. If the bilateral superficial temporal arteries are fairly well developed, the ipsilateral superficial temporal artery can be used as an arterial graft for revascularization of the anterior cerebral artery territory.
Rat surgery board
Authors: Boydell Cheryl L. , Rank William R. , Swartz William M. 
Published: March 2007

AbstractOur microsurgery laboratory needed a number of surgical rat boards, and considering the expense of the ones already on the market, we decided to make our own. A 14 in × 10 in board was cut from a large Plexiglas® sheet. Suction cups with metal hooks were used to hold the rat in place. We found this board to be less expensive and also very versatile.
Recent microsurgical advances in China
Authors: Pan Yu‐Chuan , Lee W. P. Andrew 
Published: March 2007

AbstractFor more than two decades, microsurgery has been developed, practiced, and refined in China. For the most part, this has taken place independent of a parallel process in the Western World. Only until recent years has there been some communication from China regarding this microsurgical experience. The authors believe that there is much yet to be learned from the wealth of Chinese experience in microsurgery, just as Chinese surgeons have gained valuable information from the West. The authors reviewed the microsurgical literature in China from 1983 to 1986, and present here what we regard to be of particular interest to American microsurgeons, including the areas of digital reconstruction, replantation, flap transfer and transposition, and microsurgical techniques and patient management. Some historical background in the development of Chinese microsurgery is also provided.
Experimental microvascular autogenous vein grafts for arterial defects: II. A histopathologic study of the grafts
Authors: Fletcher Christopher D. M. , Kruavit Arthi , Mayou Brian , McKee Philip H. 
Published: March 2007

AbstractTwelve autogenous vein grafts, of average diameter 1.5 mm, which had been used to bridge defects in the contralateral femoral artery of adult rabbits by a minimally traumatic technique, were examined over a 12‐week postoperative period. Each graft remained widely patent but showed fibroelastic intimal thickening with time. Further evidence of arterialisation was the development of a prominent subintimal layer of smooth muscle. Also noted was the presence of medial fibrosis, with both calcification and ossification. This latter is suggestive of damage due to disruption of the vasa vasorum. It would appear that arterialisation of microvascular vein grafts occurs independently of surgical trauma and is therefore difficult to avoid. However, these pathologic changes were not as severe, nor was there as much luminal narrowing, as at the previously described anastomotic sites. The most important cause of these changes appears to be arterial pressure.
Re‐endothelialization stages at the microvascular anastomosis
Authors: Isogai Noritaka , Kamiishi Hiroshi , Chichibu Shiko 
Published: March 2007

AbstractAfter microsurgical suturing, the wound healing process at the rat femoral artery anastomosis was studied with scanning electron microscopy. The reendothelialization was divided into four successive stages, based on the development of a fibrin network and the rate of endothelial regrowth. Within 5 minutes of blood flow re‐establishment the fibrin network formation started to cover the wound surface; it was completed by the 3rd or 4th day. The endothelial recovery started on the 2nd day and continued to the base of the suture by the 6th day. Re‐endothelialization from the wound edge, which was formed between intact and injured endothelium toward the suture‐restrained site, was a two‐fold process: initially, a single endothelial film covered the anastomosis site, then, the singled endothelial sheet proliferated and thickened to complete the endothelialization. A better understanding of the stages involved in microvascular repair is beneficial in evaluating vascular recovery and its relationship to patency rates in microvascular surgery.
Wandering nerve graft technique for management of the recalcitrant painful neuroma in the hand: A case report
Authors: Mackinnon Susan E. 
Published: March 2007

AbstractA new technique for the management of the painful neuroma following ray amputation of the index finger is reported. The rationale behind this operative procedure, which is based on both clinical and experimental work, is outlined. The patients' follow‐up to 4 years postoperatively is presented.
Axonal regeneration through peripheral nerve grafts: The effect of proximo‐distal orientation
Authors: Ansselin Annick D. , Davey David F. 
Published: March 2007

AbstractPeripheral nerve transplants are used for the surgical repair of nerve loss. If normally orientated grafts contain branches, regenerating axons may be lost into them, limiting re‐innervation and restoration of function in the denervated area. Since axons entering a reversed graft may not be lost in this way, we have investigated whether reverse implantation could enhance the number of axons that reach the distal stump. In young adult rats, a section of sciatic nerve, including one major branch, was removed and reinserted with either the normal or reversed proximo‐distal orientation, using microsurgical techniques. After signs of recovery of function, the operated and contralateral unoperated nerves of each animal were fixed and processed for electron microscopy. Regenerated axons were seen to enter branches in normally orientated grafts, and there was substantial loss in the cross‐sectional area of the graft distal to the branch termination. Reverse grafts are as well reinnervated by regenerating axons as normally orientated grafts and show a smaller loss in the cross‐sectional area, even though the branches of these implants seemed to disappear.
Thin cutaneous flap for intra oral reconstruction: The dorsalis pedis free flap revisited
Authors: Banis Joseph C. 
Published: March 2007

AbstractThe dorsalis pedis flap provides thin, hairless tissue for a variety of intra oral defects. Due to concerns for the donor site, reconstructive surgeons have largely overlooked this flap, despite its numerous desirable qualities. The paper focuses on the anatomy of the first dorsal metatarsal artery and techniques which insure the preservation of adequate flap vascularity. The prevention of donor site complications centers around meticulous attention to the placement of skin grafts, with a secure tie‐over dressing and the use of a posterior splint. Patients are allowed to ambulate in the early postoperative period only when venous compression is provided with an ace bandage. Vigorous attention to detail on reconstructing the foot has minimized donor site complications. The dorsalis pedis flap continues to be an important method of reconstruction in our armamentarium of free tissue donor sites.
Mandibular reconstruction in the young adult using free vascularized iliac crest
Authors: Boyd J. Brian 
Published: March 2007

AbstractFive young adults between the ages of 16 and 27 years underwent mandibular reconstruction with free vascularized iliac crest bone grafts based on the deep circumflex iliac artery. These were the only patients under age 30 years in a series of over 60 patients undergoing this procedure.In all cases, the ipsilateral crest was employed, and special efforts were made to minimize bony bulk by removing the outer cortex and carefully shaping the graft. The bone graft underwent final trimming in situ, the exact dimensions being reproduced from measurements taken from the excised specimen.When bone alone requires replacement, as in the majority of young patients, an excellent functional result can be anticipated. Occlusion can be maintained or even restored, and the normal facial contour can be re‐established. Osteointegrated implants hold out the possibility of providing full dental rehabilitation in an age group in which anything less is considered failure. Furthermore, the donor site scar can be hidden by a bathing suit.It is concluded that this form of reconstruction is particularly suitable for the young adult, in whom cosmesis, function, donor site, and freedom from longterm complications are of supreme importance.
Postoperative monitoring of microsurgical free tissue transfers for head and neck reconstruction
Authors: Jones Neil Ford 
Published: March 2007

AbstractApproximately 10% of free tissue transfers fail because of thrombosis of the arterial or venous anastomoses. Postoperative monitoring to allow early detection of impaired flap perfusion is crucial, especially in head and neck reconstruction, in which failure of a free flap may be associated with significant morbidity. Furthermore, the increasing use of “buried” free tissue transfers in the head and neck precludes direct clinical observation. The various techniques that have been advocated for clinical monitoring of free tissue transfers are reviewed, and their potential applications in head and neck reconstruction are discussed with specific emphasis on the use of lowfrequency continuous‐wave Doppler surface monitoring and implantable highfrequency pulsed ultrasonic Doppler monitoring.
Neurolized nerve padding in actinic lesions: Omentum versus muscle use. An experimental study
Authors: Brunelli Giorgio A. , Brunelli Francesco , Di Rosa Fabio 
Published: March 2007

AbstractFree microvascular greater omentum flap to pad brachial plexus after neurolysis for actinic lesions is a major operation. Thus several authors have suggested a simple padding by means of traditional muscle flaps. As contouring the brachial plexus elements is difficult using muscle, we wished to evaluate the formation of perineural fibrosis with either omentum or muscle, following neurolysis. An experimental model in rats was set up, dividing the two femoral nerves and wrapping one of them with the greater omentum and the other with abdominal muscles. The degree of perineural fibrosis at light microscopy observation was fivefold greater when muscle, rather than omentum, was used.
Emergency intracranial thromboendarterectomy for acute middle cerebral artery embolus
Authors: Opalak Michael E. , Chehrazi Bahram B. , Boggan James E. 
Published: March 2007

AbstractClinical application of microvascular techniques in emergency intracranial thromboembolectomy of middle cerebral artery bifurcation subsequent to angiography is presented. Blood flow was re‐established with 5–7 hours of the onset of the focal cerebral ischemic symptoms. Review of the literature supports a role for acute intracranial embolectomy in a selected group of patients in the absence of more effective medical therapy.
The venous flow augmentation pump: A solution to venous congestion
Authors: Lendvay Paul G. , Teston Leana M. , Maver Eric , Lyons Geoffrey 
Published: March 2007

AbstractVenous congestion is a well‐recognized cause of failure of survival of replanted digits. When re‐exploration of a venous congested digit is not possible, an alternate solution is presented. A description of the venous flow augmentation pump is provided, along with a preliminary case report of its successful use.