bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic techniques in neurosurgery
Authors: Harris Lewis W. 
Published: March 2007

AbstractEndoscopic techniques have been utilized in neurosurgery for nearly a century. The history of application of these techniques is reviewed. Because of recent improvements in optics, microinstrumentation, and other associated technologies endoscopy has begun to have an impact on neurosurgery. Documented uses of these techniques are reviewed. Greater experience with the techniques, along with continued improvements in the technology, has the potential to result in broadened applications. These procedures can be performed quickly, safely, and effectively, and in selected applications may reduce tissue trauma, risks associated with surgery, hospital stays, and costs. Neuroendoscopy presents exciting possibilities for the future. © 1994 Wiley‐Liss, Inc.
Short‐term response of epiphyseal plate cell populations following selective devascularization and microsurgical revascularization
Authors: Bowen C. Vaughan A. , Bray Peter W. , Boyer Martin I. , Fowler J. David , Nolan Liana 
Published: March 2007

AbstractThe distal femoral epiphyseal plates of 21 8‐week‐old New Zealand white rabbits were totally or partially (nutrient artery only) devascularized, or devascularized and then microsurgically revascularized. Sacrifice was at 24, 48 or 72 hours postoperatively. The heights of the proliferative and hypertrophic zones of the epiphyseal plates operated upon were compared with the contralateral control epiphyseal plates for both the central and the peripheral regions of the epiphyseal plate. Neither extent of devascularization nor revascularization had a significant effect on the height of the proliferative zone of chondrocytes at any of the follow‐up intervals. Selective devascularization of the nutrient artery led to a significant increase in height of the central region of the hypertrophic zone of chondrocytes at 48 and 72 hours. Microsurgical revascularization did not lead to a significant change in the height of either the central or the peripheral regions of the hypertrophic zone of chondrocytes at any of the follow‐up intervals. This study is another ‘building block’ experiment toward vascularized epiphyseal plate transplantation in humans. © 1994 Wiley‐Liss, Inc.
Venous flap—its classification and clinical applications
Authors: Fukui Akihiro , Inada Yuji , Maeda Masami , Mizumoto Shigeru , Yajima Hiroshi , Tamai Susumu 
Published: March 2007

AbstractWe previously reported pedicled venous flap survival using the rat model, as well as venovenous, arteriovenous, and arterialized flow‐through venous flap survival using the rabbit ear model. For this study, we utilized these flaps clinically. Five of seven pedicled venous flaps survived, displaying superficial necrosis. The others became partially necrotic; they were transferred after dissection of a long pedicle vein. Eight of nine venovenous flow‐through venous flaps survived; six displayed superficial necrosis. The nonsurviving flap became completely necrotic, possibly because only one donor vein and one recipient vein were used. Six of 10 arteriovenous flow‐through venous flaps survived. The remaining four became partially necrotic, possibly because only one vein was anastomosed for outflow. The arterialized flow‐through venous flap survived. The pedicled venous and venovenous groups studied seem likely to survive despite superficial necrosis. However, the draining vein should not be dissected more than 5 cm, and many draining veins should be anastomosed with recipient vessels. © 1994 Wiley‐Liss, Inc.
Experimental evaluation of small intestinal submucosa as a microvascular graft material
Authors: Prevel Christopher D. , Eppley Barry L. , McCarty Michael , Jackson J. Ryan , Voytik Sherry L. , Hiles Michael C. , Badylak Steven F. 
Published: March 2007

AbstractThe evaluation of porcine small intestine submucosa (SIS) in a microsurgical model was conducted using an interpositional graft in the rat femoral artery. The SIS grafts were fabricated from processed porcine material that was wrapped around a glass tube and oversewn longitudinally to produce a tubular structure. Of the 42 animals studied, 7 received grafts of untreated SIS (group I), 7 of the grafts were presoaked (PSH) in heparin (Group II), 7 animals were treated with systemic heparin prior to implantation of PSH‐SIS (group III), 7 animals received SIS grafts crosslinked to heparin (group IV), 7 animals received SIS grafts crosslinked to urokinase (group V), and 7 animals received untreated autologous epigastric vein grafts (group VI). Patency was assessed postoperatively and selected grafts were evaluated by histology.All SIS grafts failed to maintain patency beyond the first postoperative hour. Histologic examination of the thrombosed graft surfaces revealed a smooth luminal surface with a thick layer of attached fibrin and platelets with a central occluding thrombus. The thickness of the induced fibrin layer appears to narrow intraluminal space significantly at the microvascular level.While having excellent success at vessel diameters greater than 3 mm, and in a variety of nonporcine animal models without xenographic rejection, SIS in this model was thrombogenic despite a favorable surface morphology as demonstrated by SEM. Even with use of heparin and urokinase SIS graft thrombosis occurred. © 1994 Wiley‐Liss, Inc.
Bipolar coagulation at different energy levels: Effect on patency
Authors: Hood John M. , Lubahn John D. 
Published: March 2007

AbstractDetermining the extent of damage caused by bipolar coagulation at different levels is critical in microsurgery. If no significant damage occurs at known levels, this technique can be used instead of ligation, saving considerable time. One hundred eighty Sprague‐Dawley rats were divided into six groups of 30 each. The effects of bipolar coagulation were assessed at either 2 or 10.4 watts at the junction between the common femoral artery and a branch vessel. Three common clinical settings were used: branch coagulation without interruption of blood flow in the common femoral artery; branch coagulation with interruption of blood flow for 30 minutes; and branch coagulation with arterial anastomosis 3–5 mm distal to the branch. Control procedures without coagulation were performed on the contralateral vessels. The animals were re‐explored at 5–7 days. No differences occurred in patency of the coagulated vessels at 2 or 10.4 watts of delivered energy as compared with controls. Recanalization of the side branch occurred in approximately 80% (144/180) of specimens. Extensive damage to endothelium, tunica intima, and tunica media occurred for 1–2 mm around the site of the coagulated branch. The forceps pick‐up test demonstrated little difference in flow of the cauterized vessel compared with controls. However, the cauterized vessel had a clinically weaker pulse stream of the transected common femoral artery. Recanalization of the coagulated side branch commonly occurred with a fibrin cap at the end of the vessel. Manipulation of the branch vessel frequently caused rebleeding. Our study shows that bipolar coagulation can be used effectively if coagulation is located at least 2 mm from the main vessel. © 1994 Wiley‐Liss, Inc.
Prelamination: Defining the prefabricated flap—a case report and review
Authors: Pribaz Julian J. , Fine Neil A. 
Published: March 2007

AbstractModification of flaps prior to local or distant transfer has gained wide acceptance. The term prefabricated has been used to describe all possible modifications. In this article we introduce the term prelamination to refer to the implantation of tissue or other devices into a flap prior to transfer and suggest that prefabrication be restricted to the implantation of vascular pedicles. A case is presented illustrating these concepts. © 1994 Wiley‐Liss, Inc.
Review of postoperative pharmacological infusions in ischemic skin flaps
Authors: Knight Kenneth R. 
Published: March 2007

AbstractNo single drug has yet been found which can overcome the inflammatory and microvascular changes which occur in a skin flap after ischemia‐reperfusion. Nevertheless, the continued failure of approximately 7% of all free flap transfers clinically suggests that there may be a place for pharmacological intervention at the time of threatened flap failure. To date, plastic and reconstructive microsurgeons have been reluctant to use drugs because of the mass of conflicting evidence emanating from the plastic surgery literature. However, scientists and surgeons now have a clearer understanding of the problems arising in ischemia‐reperfusion. Multi‐acting drugs which can inhibit most of the important inflammatory changes would be the ideal. This review considers some of the historical developments in the pharmacological treatment of ischemic flaps in the past decade and looks to the future when pharmacological infusions may be part of the routine for salvaging failing skin flaps. © 1994 Wiley‐Liss, Inc.
Nitric oxide synthase inhibitors improve skin flap survival in the rat
Authors: Knox Laura K. , Stewart Alastair G. , Hayward Peter G. , Morrison Wayne A. 
Published: March 2007

AbstractThe ability of nitric oxide (NO) synthase inhibitors to reduce ischemia‐induced skin flap necrosis was assessed using a modified McFarlane flap in the rat. Flap survival was significantly improved in L‐NIO treated (86 ± 2%), L‐NAME‐treated (84 ± 2%), and aminoguanidine‐treated (76 ± 2%) animals compared to the saline‐treated group (54 ± 2%), P < 0.005. Inhibition of NO synthase significantly decreased the hyperemia and edema within the flaps at 24 hours post‐elevation. These findings suggest that endogenous NO production contributes to ischemic necrosis and that inhibition of NO synthase may prove useful in extending survival of tissues subjected to ischemia. © 1994 Wiley‐Liss, Inc.
Heterotopic vascularized growth plate transfer in juvenile dogs
Authors: Shigetomi Mitsunori , Morrison Wayne A. , O'Loughlin Kevin C. , Sakai Kazuhiro , Kuwata Noriyuki , Ohta Ichiro , Hayward Peter G. , Hurley John V. , O'Brien Bernard McC. 
Published: March 2007

AbstractPrior animal studies of vascularized epiphyseal transfers placed growth plates in 2 bone systems where the independent growth of epiphyses and their response to altered stresses has been difficult to assess. This study assessed growth of vascularized ulnar epiphyses transferred to the ipsilateral humerus of 12‐week‐old puppies. Growth was permitted by a specially designed extensible plate. Control groups showed that humeral dissection, osteotomy and ostectomy alone do not stimulate growth. In 4 puppies initial growth of the transferred epiphysis was seen but late collapse and formation of bridging callus occurred so that overall humeral length at maturity was not significantly different from control humeri. Physical forces inherent in heterotopic transfer may preclude long term growth of transferred epiphyses particularly in sites of higher relative load. The extensible plate used here may be a useful device in the fixation of transferred epiphyses with growth potential. © 1994 Wiley‐Liss, Inc.
Microvascular reconstruction of the upper extremity with the rectus abdominis muscle
Authors: Rao Venkat K. , Baertsch Andrew 
Published: March 2007

AbstractLarge soft‐tissue defects of the upper extremity are difficult to reconstruct. Defects in 21 patients (15–75 years old) were treated by free tissue transfer of the rectus abdominis muscle. The defects were the result of trauma or resection of tumor and measured more than 15 × 15 cm. The muscle was transferred on the inferior epigastric pedicle and covered with a skin graft within 48 hours. All transfers were successful, and early soft‐tissue healing occurred. This procedure offers the advantages of easy positioning, large donor vessels, and a highly vascular soft tissue reconstruction. The long‐term functional and cosmetic results have been excellent. © 1994 Wiley‐Liss, Inc.
Accessory nerve neurotization in infants with brachial plexus birth palsy
Authors: Kawabata Hidehiko , Kawai Hideo , Masatomi Takashi , Yasui Natsuo 
Published: March 2007

AbstractWe report the surgical results of 13 accessory nerve neurotizations in brachial plexus birth palsy. The mean age at operation was 5.9 months. The accessory nerve was transferred to three C5 roots, to three C6 roots, to four posterior division of the middle trunks, to one musculocutaneous nerve, and to two suprascapular nerves. Sixty‐seven percent of the cases acquired M4 or more in the deltoid muscle, 88% in the infraspinatus muscle, and 100% in the biceps brachii muscle. Twenty‐five percent of the cases acquired M4 or more in the triceps brachii muscle and the wrist extensor muscles. These results were much better than formerly reported for adult cases by other authors. No functional compromise of the trapezius muscle was noted. The accessory nerve neurotization can be used safely and effectively in neurosurgical reconstruction of the brachial plexus palsy in infants. © 1994 Wiley‐Liss, Inc.
Peripheral nerve allografts: Survey of present state in an experimental model of the rat
Authors: Berger Alfred , Lassner Franz 
Published: March 2007

AbstractRejection and regeneration processes in peripheral nerve allografts are analyzed in this review of a series of experiments with special reference to the possible clinical application of peripheral nerve allografting in clinical reconstructive surgery. A long segment of the sciatic nerve (2.5 cm) was grafted between congenic rat strains across a maximal genetic barrier; immunohistologically, donor‐ and recipient‐derived structures can be differentiated. If allografting was performed without immunosuppression, a rejection response with consecutive regeneration of minor quality was observed. Under immunosuppression with cyclosporin A no rejection response was observed and regeneration quality was comparable to control autografts. The persistence of donorderived Schwann cells in the immunosuppressed allografts can be demonstrated immunohistologically. After discontinuation of immunosuppression a rejection response is exerted. We conclude that Schwann cells are eliminated from peripheral nerves during rejection. Consecutive regeneration of minor quality is possible, which implies the ingrowth of recipient‐derived Schwann cells into the rejected allograft. Under immunosuppression, allogenic Schwann cells survive and actively promote regeneration. They are still immunologically competent and can exert rejection when immunosuppression is discontinued. A certain degree of replacement of donorderived Schwann cells seems possible. © 1994 Wiley‐Liss, Inc.
Endothelialization of anastomoses in the aorta and inferior vena cava of the rat
Authors: Sigurbjörnsson Björn Th. , Hallberg Eric , Andrén‐Sandberg Åke , Ribbe Else 
Published: March 2007

AbstractDenuding endothelial damage at anastomoses may lead to thrombotic complications and failure of microvascular reconstructions. Confluent endothelial healing at anastomoses may reduce thrombotic and other complications. The progress of endothelial coverage of anastomotic structures in the aorta and inferior vena cava (IVC) of the rat was evaluated at 3,5,8,11, and 14 days after completion of the anastomoses, by means of scanning electron microscopy. Arterial anastomotic patency was 100%; venous patency was 84%. It was found that endothelial healing progressed towards thin confluent coverage first, thereafter thickening. Coverage was first achieved at the needle defect, then the anastomotic junction, and lastly the suture. The same stage of endothelial coverage of anastomotic structures was reached 5 to 8 days sooner at the IVC anastomosis than in the aorta. © 1994 Wiley‐Liss, Inc.
Early development of suture holding capacity in vascular anastomoses in the rat
Authors: Sigurbjörnsson Björn Th. , Löwenhielm Peter , Agnarsson Bjarni A. , Stenram Unne , Ribbe Else 
Published: March 2007

AbstractEarly development of suture holding capacity (SHC) of end‐to‐end anastomoses in the infrarenal aorta and inferior vena cava (IVC) of the rat was studied by measuring the resistance to tensile forces at 0, 3, 5, 8, 11, or 14 days postoper‐atively. Comparable anastomoses were histologically evaluated. The SHC of the aortic wall decreased following anastomoses and did not regain the strength of nonanastomosed vessels during the first two weeks. The SHC of the IVC also decreased following anastomoses, but regained the strength of nonanastomosed vessels by the 5th day. The relative ultimate strain of the arterial and venous perianastomotic walls decreased slightly, while the relative compliance increased in the aorta and decreased in the IVC. Perianastomotic media necrosis was found exclusively in the arteries. The reduced perianastomotic SHC in the aorta indicates impaired healing, compared to the IVC. Changes in biomechanical properties of the aortic wall following anastomosis may increase its susceptibility to anastomotic complications such as pseudoaneurysms. © 1994 Wiley‐Liss, Inc.
Vascularized bone allografts: Review of current concepts
Authors: Doi Kazuteru , Akino Tatsuhiko , Shigetomi Mitsunori , Muramatsu Keiichi , Kawai Shinya 
Published: March 2007

AbstractAdvances in the field of microsurgery over the past two decades, together with the discovery of a powerful immunosuppressive, cyclosporin A, have brought vascularized osteochondral allografts closer to reality. In this review, the authors describe the history of laboratory research on vascularized osteochondral allografts using immunosuppression, as well as their experimental and preliminary clinical experiences.
Pectoralis major muscle free flap in rat model
Authors: Zhang Feng , Kao Samuel D. , Walker Richard , Lineaweaver William C. 
Published: March 2007

AbstractThe rat pectoralis muscle can serve as a vascularized, innervated muscle flap model. The muscle, consisting of superficialis and profundus portions, is supplied by separate neurovascular systems. The vessels to pectoralis profundus (averaging 0.3 mm in diameter) can be taken in continuity with the axillary vessels (averaging 11 mm in diameter), which are used for transplantation. The profundus portion of muscle weighed an average of 1.8 g, and the average pedicle length was 0.9 cm. Nine of 11 transplanted muscles were viable, with intact circulation at 72 hours. An example of muscle transplantation for tissue defect coverage was attempted. The pectoralis profundus transplant was technically reliable, and the muscle bulk and contour could allow biochemical and functional studies. © 1994 Wiley‐Liss, Inc.
Preservation of the vasodilative effect of endothelium‐derived relaxing factor in the hind limb of the rat
Authors: Ono Hiroshi , Nakagawa Yoji , Tamai Susumu , Mizumoto Shigeru 
Published: March 2007

AbstractUsing an extracorporeal circulatory system of fresh blood, the vasodilative effect of endothelium‐derived relaxing factor (EDRF) secreted from vascular endothelium, stimulated by acetylcholine (ACh), was evaluated. The bioassay cascade technique was applied to elucidate the release of EDRF. Elevated blood pressure of freshly amputated rat hind limbs, created by injection of norepinephrine (NE), decreased by 56% with ACh infusion, suggesting the existence of EDRF in the peripheral vascular system of rat hind limbs. The vasodilative effect of EDRF could be preserved for at least 6 hours when stored at room temperature. The effect of EDRF decreased markedly following storage for more than 9 hours at room temperature and storage for more than 3 hours at 4°C. © 1994 Wiley‐Liss, Inc.
Spinal nerve root injuries in brachial plexus lesions: Basic science and clinical application of new surgical strategies. A review
Authors: Carlstedt Thomas P. 
Published: March 2007

AbstractThis paper reviews studies aimed at developing novel surgical means to correct functional deficits after spinal nerve root injuries in brachial plexus lesions. In a long series of animal experiments it has been possible to demonstrate re‐established connectivity between severed roots and the damaged spinal cord segment. This encouraging functional recovery by a new surgical strategy of managing ventral root avulsion injuries prompted clinical application, with restoration of activity. © Wiley‐Liss, Inc. © 1995 Wiley‐Liss, Inc.
Brachial plexus injury in Thailand: A report of 520 cases
Authors: Songcharoen Panupan 
Published: March 2007

AbstractBetween October 1984 and October 1993, 520 patients with traumatic brachial plexus injuries were treated at the Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. There were 486 male and 34 female patients. Eighty‐two percent of the injuries were caused by motorcycle accidents, 9% by other traffic accidents, and 9% by gunshot, stabbing, and other means. The initial physical examination revealed 332 (63.8%) complete paralyses and 88 (36.2%) incomplete paralyses. One hundred twenty‐seven patients were treated conservatively, 43 patients were observed before definitive treatment was given, and 350 patients were treated by operative means. Four hundred and twenty‐one surgical procedures were performed, consisting of 314 neurotisations (250 spinal accessory, 14 plexo‐plexal, 21 intercostal, 21 phrenic, 4 cervical plexus, 1 long thoracic, and 3 neuromuscular), 38 neurolyses, 23 nerve grafting, 16 free muscle transfers combined with neurotisations, and 30 musculotendinous transfers. Motor functional recovery of patients followed up for more than 2 years was evaluated. Nerve grafting gave 82% good (more than MRC grade 3) and 18% fair and poor recovery. Neurolysis gave 69% good and 31% fair and poor recovery. In patients with neurotisation, the spinal accessory (to supra‐scapular, axillary, and musculocutaneous), intercostal (to musculocutaneous), phrenic (to suprascapular, axillary, and musculocutaneous), and plexo‐plexal methods gave a significant number of good results. © Wiley‐Liss, Inc. © 1995 Wiley‐Liss, Inc.
Value of a dynamic MR scan in predicting vascular ingrowth from free vascularized scapular transplant used for treatment of avascular femoral head necrosis
Authors: Fujisawa Kohzou , Hirata Hitoshi , Inada Hitoshi , Morita Akimasa , Takeda Kan , Hibasami Hiroshige 
Published: March 2007

AbstractWe have treated three patients with avascular osteonecrosis using vascularized scapular bone graft. To predict blood perfusion in both the diseased femoral head and the transferred bone, all the hips were followed up using dynamic magnetic resonance (MR) scans, performed 1 and 7 months after surgery. In the present cases, it was shown that conventional enhanced MR imaging sometimes depicts increased intensity in bone marrow without blood perfusion due to the leakage of gadolinium‐DTPA (Gd‐DTPA) from the capillaries surrounding the avascular tissue. It was found that Gd‐DTPA remaining in the dead bone marrow resulted in a false‐positive image. By contrast, the dynamic MR scan evaluated only those images taken before the leakage. This is one of the advantages of the dynamic study, which reflects actual blood flow in the bone. The fast rise in the time‐intensity curve following bolus injection of Gd‐DTPA indicates that there is fast blood perfusion in the bone. The dynamic MR scan has demonstrated that there is little blood perfusion in the diseased bone 1 month after the operation and that vascular ingrowth from the transferred bone flap proceeds gradually between 1 and 7 months after surgery. These findings indicate that the dynamic MR scan is very useful in demonstrating vascular ingrowth after surgery in avascular necrosis of the femoral head and can be a reliable monitoring technique for anastomotic patency of the vascularized bone flap. © 1995 Wiley‐Liss, Inc.