bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mural repair following obliteration of aneurysms. Part III: Pathomorphological effects of Nd: YAG laser on aneurysm obliteration
Authors: Guity Afrassiab , Young Paul H. , Fischer Vernon W. , Albanna Faisal J. , Kennedy David G. 
Published: March 2007

AbstractTwenty‐four experimental aneurysms were created in rat carotid arteries using the venous pouch technique. Four to twelve weeks later, these aneurysms were totally obliterated by the external application of Nd:YAG laser. The aneurysmal dome and neck were both exposed to the laser using low amplitude (1–2 W) at continuous or repeat intervals (0.3 sec on/0.1 sec off). Small aneurysms were easily obliterated without external signs of necrosis, whereas aneurysms larger than 2 mm required complete coagulation resulting in a charcoal‐like appearance. At varying intervals (30 min, 7 days, 3 weeks, 6 weeks), the obliterated aneurysms were harvested and evaluated using the scanning electron microscope and standard histological techniques. The results indicate that the effects of the laser on the aneurysm and parent vessel are similar to those encountered following the application of bipolar coagulation with massive coagulation necrosis of the aneurysmal neck and dome. Notably, however, the extension of this process onto the parent vessel involving especially the endothelium surrounding the aneurysm orifice (commonly seen with bipolar coagulation) is minimal following laser coagulation. There appears to be a protective effect on the parent vessel endothelium by blood flow through the vessel. On this basis, it appears that the laser may be an alternative method of aneurysmal coagulation; the use of laser entails less manipulation of the aneurysm. The Nd:YAG laser may be a useful adjunct in the surgical obliteration of clinical cerebral artery aneurysms, especially small ones.
Simultaneous comparison of pre‐ and post‐microanastomotic hemodynamic profiles using a Tandem Doppler Probe
Authors: Tuchler Robert E. , Zhang Ling , Siebert John W. , Shaw William W. 
Published: March 2007

AbstractThe use of High‐Frequency Pulsed Doppler Ultrasound (HFPDU) for evaluation of microvascular hemodynamics is well established. Due to technical limitations of existing probes, quantitation of anastomotic stenoses and detailed waveform analyses are difficult to perform and impractical for clinical use. We present a new Tandem Doppler Probe (TDP) for simple and accurate study of blood flow in vessels smaller than 1 mm in diameter. Its unique ability to compare the pre‐ and post‐anastomotic waveforms simultaneously allows for quantitative detection of anastomotic narrowing of as little as 5%, as well as identification of subtle pathologic anastomotic waveform changes not seen with single probes. Such early and precise delineation of anastomotic problems in the operating room can provide an invaluable, objective assessment of the technical adequacy of the anastomoses as well as an important baseline for later post‐operative monitoring of free‐tissue transfers with implantable Doppler devices.
Rat femoral vein‐to‐vein grafts as a microvascular practice model: Factors that influence patency
Authors: Cooley Brian C. , Lan Ma , Gould John S. 
Published: March 2007

AbstractThe rat femoral vein has become a standard model for microvascular anastomosis practice as well as for research investigations into various manipulative influences upon venous patency. Although vein grafts to the rat artery are the focus of many experimental studies, few reports have investigated vein‐to‐vein grafts. This study examines the short‐term patency (1–3 days) of vein grafts interpositioned to the rat femoral vein. Several factors are studied for their ability to alter the patency rate. The results indicate that patency is difficult to achieve following the creation of a second serial anastomosis (construction of a vein‐to‐vein graft). Systemic heparin consistently improves patency rates, and trends toward increased patency are seen for reduction in longitudinal tension of the repaired vessel. It is also implied that a deeper understanding of venous hemodynamics and thrombotic events may lead to improved methodologies in the clinical applications of microvenous repairs. These results indicate that rat vein‐to‐vein grafts may provide a challenging microvascular training model, while introducing the novice microsurgeon to some of the complicating factors encountered with microvascular grafting.
Inhibition of epinephrine‐induced vasospasm with adrenoreceptor blockade in the rat cremaster muscle
Authors: Hartsock Langdon A. , Seaber Anthony V. , Urbaniak James R. 
Published: March 2007

AbstractThis study demonstrates that intravenous epinephrine causes arterial vasospasm, but not venous constriction, in the microcirculation of the rat cremaster muscle. This effect can be blocked by a smooth muscle relaxant such as papaverine or an alpha receptor antagonist such as phentolamine. Circulating vasospastic agents such as epinephrine are important determinants of microcirculatory blood flow, and inhibition by pharmacologic means may enhance blood flow and survival in microvascular surgery.
Coupled suturing: A new technique for microvascular anastomosis
Authors: Cheng‐Da Huang , Sharkey Neil A. , Szabo Robert M. 
Published: March 2007

AbstractThe left carotid artery of 12 Sprague‐Dawley rats was sectioned and anastomoses immediately performed utilizing a new technique termed coupled suturing. Patency and constriction were assessed immediately postoperatively and at 1, 2, and 3 weeks. Specimens were also evaluated by light microscopy and scanning electron microscopy. Vessels healed well with excellent patency and edge eversion. With the development of a specialized needle, coupled suture could prove to be a reasonable alternative to current methods of anastomosis. Its main advantage is better intimal eversion, which decreases the risk of thrombosis.
Comparison of nerve regeneration through different types of neural prostheses
Authors: Gibson Karen L. , Remson Laura , Smith Andrea , Satterlee Nancy , Strain George M. , Daniloff Joanne K. 
Published: March 2007

AbstractRat sciatic nerve regeneration through three synthetic neural prostheses was compared with regeneration through nerve allografts. The synthetic prostheses were either nonpermeable nonabsorbable (Silastic), permeable absorbable (polyglactin mesh), or permeable nonabsorbable (polypropylene mesh). Animals were evaluated at 10, 24, and 90 days. Functional analysis of nerve regeneration was performed by noninvasive methods: electromyography and walking tracks. Nerve tissue was examined with routine histologic and immunofluorescent techniques. A compressive neuropathy developed with the use of the Silastic implant. A neutrophilic inflammatory infiltrate was consistently associated with implantation of the polyglactin mesh. A strong connective tissue response was noted around the polypropylene mesh. Early recovery of nerve function was seen with the Silastic implants, however, overall nerve function was best in the nerve allograft and polypropylene mesh groups. Polyglactin implantation increases the local inflammatory response and should not be used for nerve anastomoses. If Silastic entubulation is used, it should be removed between 24 and 90 days.
Experimental study of the influence of arterial trauma on dependent distal tissue survival
Authors: Cooley Brian C. , Lan Ma , Groner Jeffrey P. , Hoer Steven R. , Dollinger Beth M. , Hanel Douglas P. 
Published: March 2007

AbstractAn experimental model was developed combining arterial trauma with island flap creation using the rat groin flap system. Flap arteries were subjected to crush/avulsion injuries with subsequent microvascular repair. A second series involved resection 4 hr after thrombosis of injured flap arteries and interpositional vein grafting to reestablish circulation. A single bolus of systemic heparin was administered to half of the animals from each series on a blinded, randomized basis. Arterial patency at 7 days correlated with flap survival. There was no case of partial flap loss. Patencies improved in the first series from 31% to 71% with heparin administration (P < 0.05) and from 58% to 90% in the second (not significantly different). A third series involving immediate resection of traumatized vessel and vein graft replacement achieved a patency of 92% (without heparinization). These results support the value of replacement of all traumatized arterial tissue with vein grafts and indicate the efficacy of systemic heparin (in single bolus) for enhancing the likelihood of maintaining patency. Furthermore, it is suggested that the occurrence of a thrombogenic site in the arterial inflow to a region of dependent tissue does not lead to partial tissue loss, and thus thromboembolic events may not be responsible for this clinical phenomenon.
Nervous influence on traumatic vasospasm in the rabbit ear artery
Authors: Wadström Jonas , Gerdin Bengt 
Published: March 2007

AbstractThe effects of partial denervation, partial denervation with additional nervous blockade with bupivacaine, and total denervation achieved by amputation and replantation of the ear on traumatic vasospasm were studied in the rabbit. The central ear artery was exposed and compressed in a standardized fashion. The inner diameter was determined by in vivo microscopy using transillumination with cold light. The resulting spasm was assessed in terms of its duration, intensity (reduction of initial diameter), and severity (integrated change in diameter over time). None of the types of denervation had any influence on the vasospasm. The results suggest that the vasospasm is a local phenomenon of the vascular smooth muscle and is not modified by the nervous system.
The observation of endothelial cells in vein grafts by the en face silver staining method
Authors: Isogai Noritaka , Hashizume Keito , Uegaito Kaoru , Kamiishi Hiroshi 
Published: March 2007

AbstractThe introduction of en face silver staining to microsurgery has provided useful, detailed information about endothelial cells with regard to their size, shape, and number. With this staining method, endothelial cells of rat vein grafts have been morphologically investigated following division of the site of observation into three areas: the recipient artery, the proximal part of the vein graft, and the midportion of the vein graft. The results show that the arterial endothelial cells are small and spindle‐shaped, whereas the cells in the proximal vein graft location are larger. Finally, large, rounded endothelial cells are seen in the midportion of the graft. These results are quantitated through a computerized graphic analysis system, which provides estimations of the cell size, Feret's diameters, and irregularities in the cell borders. The combination of en face silver staining and computerized graphic analysis has been especially useful for comparing minute changes that occur in recovering/regenerating endothelial cells.
Anatomy and circulation of the canine skin
Authors: Pavletic Michael M. 
Published: March 2007

AbstractThe skin of the dog has several anatomic differences from human skin. Skin thickness, hair growth, and circulation vary regionally in the dog and between breeds to some degree. Direct cutaneous arteries supply the canine skin. The deep or subdermal layer is closely associated with the panniculus muscle (where present) and should be elevated with the overlying skin during routine flap elevation or undermining procedures. Flaps in the dog elevated without inclusion of a direct cutaneous artery and vein have been termed subdermal plexus flaps to avoid confusing them with random flaps in the human based on musculocutaneous vessels. Axial pattern flaps developed for veterinary clinical use are discussed, several of which have potential for free flap transfer in cutaneous reconstructive surgery.
Free tissue transfer of digital foot pads for reconstruction of the distal limb in the dog
Authors: Basher Anthony W. P. , Fowler J. David , Bowen C. Vaughan A. 
Published: March 2007

AbstractReconstructive procedures used in salvaging distal limb injuries in the dog are reviewed. Techniques employed to resurface the distal weight‐bearing surface include local reconstruction using pedicle flap transposition of foot pads. The development of a previously described free microneurovascular digital foot pad flap is reviewed; the experimental results and potential for clinical use of the free flap are discussed.
Microsurgical free bone transfer in the dog
Authors: Fowler J. David , Levitt Lyndell , Bowen C. Vaughan A. 
Published: March 2007

AbstractBone grafts have been used extensively for the reconstruction of skeletal injury in dogs. Cancellous and corticocancellous chip autografts are used for their osteoinductive and osteoconductive properties. Fresh, fresh‐frozen, freeze‐dried, and ethylene oxide‐sterilized cortical allografts have been recommended for the reconstruction of segmental cortical defects. Donor sites for microsurgical bone transfer have been identified experimentally in the dog, but these remain to be used clinically. This paper reviews the anatomy and structural characteristics of donor sites for microsurgical bone transfer. Potential clinical indications for microsurgical bone transfer in the dog are described.
Pedicled radial forearm flaps for recalcitrant defects about the elbow
Authors: Meland N. Bradly , Clinkscales Carlton M. , Wood Michael B. 
Published: March 2007

AbstractChronic, open wounds about the elbow frequently require flap coverage. Skin grafts, local transposition flaps, muscle transposition flaps, and two‐staged pedicled flaps from the chest and abdomen as well as free tissue transfers have all been reported. Recalcitrant elbow defects in patients in whom these previous flaps have failed are especially challenging to the upper extremity reconstructive surgeon. We have successfully employed pedicled radial forearm flaps in three patients in whom one or more previous flaps have failed.
Experience with calcium antagonists nitrendipine, diltiazem, and verapamil and β2‐agonist salbutamol in salvaging ischemic skin flaps in rabbits
Authors: Kawabata Hidehiko , Knight Kenneth R. , Coe Serena A. , Angus James A. , McC.o'brien Bernard 
Published: March 2007

AbstractThis study investigated the efficacy of selected agents in the salvage of experimental skin flaps in rabbits after 21 hours of 25°C ischemia. Calcium channel antagonists nitrendipine, diltiazem, and verapamil increased ischemic skin flap survival in rabbits from 33.3% for buffered saline infused controls to 71.4% (P < 0.05), 71.4% (P < 0.05), and 50.0% (not significant) respectively. The β2‐adrenoceptor agonist salbutamol produced an increase in survival to 64.3%, which narrowly missed statistical significance. All four test agents invoked a vasodilatory response (greatest for nitrendipine, diltiazem, and salbutamol), a slight fall in blood pressure, and a small increase in heart rate. It is concluded that the vasodilatory response in the microcirculation of the ischemic flap helped to minimize the risk of occlusion due to thrombosis or cell sludging during reperfusion, thus leading to improved flap survival.
Free vascularized whole joint transfer in children
Authors: Ishida Osamu , Tsai Tsu‐Min 
Published: March 2007

AbstractReconstruction of the traumatized finger joint with epiphyseal destruction has long been problematic. Since free vascularized whole joint transfer was introduced as a treatment for joint and epiphyseal destruction, this procedure has been selected as an alternative treatment because it may provide a growing epiphysis. We have reviewed our series of 19 joint transfers. Mean age at operation was 6.2 years (range 3 to 12). Average active range of motion was 31°/61° for the group with posttraumatic reconstruction (n = 12) and 21°/43° for the group with reconstruction of a congenital deformity (n = 7), with an overall average of 27°/54°. Average range of motion following transfer of an metatarsophalangeal (MTP) or metacarpophalangeal (MCP) joint to an MCP joint position was 39°/75° (n = 4); proximal interphalangeal (PIP) to PIP transfer was 22°/39° (n = 13); and PIP to MCP transfer was 38°/51° (n = 2). The proximal phalanges in MCP joints transferred to the MCP position grew an average of 7.0 mm, and the middle phalanges of joints transferred to the PIP position grew 4.3 mm. Almost normal growth was observed in all transferred joints except two that showed premature epiphyseal closure. Indications for this procedure and techniques to improve range of motion are described.
Major limb replantation in children
Authors: Daigle Jean Pierre , Kleinert James M. 
Published: March 2007

AbstractThis retrospective study evaluated patients under 18 years of age who underwent major limb replantation between 1976 and 1989 at Louisville Hand Surgery. The age of the 15 patients followed for between 1 and 8.5 years (mean 4.2 years) ranged from 2 to 17 years (mean 9.8). Of amputations, 40% were guillotine, 40% were limited crush‐avulsions, 7% were extended crushing, and eight were of an upper extremity and seven of a lower extremity. Average warm/total ischemia times were 4.8/14.8 hr in failures and 1.1/7.5 hours in successful replantation. Overall limb survival was 87%. Among the patients, 93% felt that their replanted limb functioned and looked better than a prosthesis; 87% of patients had a sensory recovery of more than S2 + in the lower extremity or S3 in the upper extremity; and 38% of upper extremity replantation patients had two‐point discrimination of less than 15 mm.
Root reconstruction for bladder reinnervation: An experimental study in rats
Authors: Chuang David Chwei‐Chin , Chang Phei‐Lang , Cheng Shaw‐Yi 
Published: March 2007

AbstractNerve transfer (or nerve crossover) is a well established technique for achieving reinnervation of a valuable sensory or motor territory by reconnection using a functional nerve of lesser value. Patients with lower spinal cord lesions causing neurogenic bladder dysfunction could theoretically benefit from such an approach for return of useful micturition. Based on the known anatomical details of the spinal nerve, a new reconstructive method was created to provide intradural ventral root transfer for pure motor‐to‐motor reinnervation and extradural postganglionic spinal nerve transfer for pure sensory‐to‐sensory reinnervation. Experimental studies in rats were performed, demonstrating the feasibility of this approach. A modified method is further suggested that would use nerve grafts for extradural approaches to pure motor and sensory transfers, without the need for extensive laminectomy and dura opening. This proposed approach is anticipated to minimize the associated morbidity and mortality with such spinal nerve reconstruction.
Refined technique for intestinal transplantation in the rat
Authors: Zhong Robert , Grant David , Sutherland Francis , Wang Pengzhi , Chen Huifang , Lo Steven , Stiller Calvin , Duff John 
Published: March 2007

AbstractUnlike other solid organ transplants, intestinal transplantation (IT) remains a highly experimental procedure. Rejection, sepsis, and graft‐versus‐host disease have been the major barriers to successful IT in humans. These problems can be studied in the rat model, but this requires a reliable surgical technique that will produce high survival rates and excellent graft function. Herein, we review 400 consecutive IT in rats and describe important technical aspects of surgery. Technical modifications that have helped to reduce the morbidity after IT in rats include 1) minimizing mechanical and ischemic injuries to grafts during the donor procedure, 2) marking the portal vein and aortic conduit with sutures to ensure correct orientation of the graft, 3) using a macaroni noodle to stent the intestinal anastomosis, and 4) administering large volumes of crystalloid to maintain a normal blood pressure during the donor and recipient surgeries. The survival rate in 298 rats with accessory, heterotopic grafts was 90%. The survival rate in 102 rats with orthotopic (in continuity) graft (OIT) was 86%. Rats have survived more than 500 days after OIT, maintaining normal weights, intestinal function, and intestinal histology.
Use of anticoagulants in replantation and elective microsurgery
Authors: Siegel David B. 
Published: March 2007

AbstractClinical and experimental data support the adjunctive use of anticoagulant medication following microvascular anastomosis. Local irrigating solutions, oral and intravenous anticoagulants, thrombolytic agents, plasma expanders, vasodilators, and antiplatelet medications are currently used in patients undergoing microsurgery, but for some time there has been considerable controversy over the agent or combination of agents that should be used and the optimal time when administration should begin and end. Over the past 15 years, however, experience with microsurgery for replantation and elective reconstruction has increased dramatically. With this greater experience and refined operative technique, the indications for varying anticoagulant regimens have changed so that it is now possible to make specific recommendations for antithrombotic therapy in traumatic and elective situations.
Evaluation of the effect of pharmacologic agents on crush‐avulsion arterial injuries: A scanning electron microscopy study
Authors: Savoie F. H. , Cooley Brian C. , Gould John S. 
Published: March 2007

AbstractThis study was designed to investigate the short‐term formation and composition of thrombus occurring at sites of arterial intimal injury in rabbits. Anticoagulants, platelet anti‐aggregation agents, and fibrinolytic agents were evaluated for their influence upon the developing thrombus, utilizing scanning electron microscopy to determine thrombus surface composition. These agents included: heparin, aspirin, dextran 40, streptokinase, and prostacyclin. The results are consistent with the known nature of each of these agents. When two agents were given simultaneously, each acting on different aspects of thrombogenesis (platelets vs. fibrin), the outcome appeared synergistic, with substantial reduction in thrombus accumulation; clear inhibition of both platelet aggregation and fibrin polymerization was noted. These findings support the clinical use of two agents used simultaneously, one inhibiting fibrin strand formation and the other inhibiting platelet adherence/aggregation, for the prevention of micro‐arterial thrombosis.
Selective heparinization of venous anastomosis in latissimus dorsi free flaps to cover lower‐extremity soft‐tissue defects
Authors: Labosky David A. 
Published: March 2007

AbstractTwo groups of consecutive patients treated with latissimus dorsi free myocutaneous flaps to cover lower‐extremity soft‐tissue defects were compared for postoperative vascular occlusion. In the first group of 13 patients (group I), there were five (38%) venous occlusions and no arterial occlusions. The second group of 15 patients (group II) was treated with selective heparinization of each venous anastomosis via a 0.35′ catheter sutured into the serratus branch of the donor vein. In this group one patient suffered an arterial occlusion, but no patient suffered a venous occlusion. Statistical analysis using the Fisher exact probabilities test showed a significant decrease in vascular occlusion rate in group II, proving that selective heparinization had a beneficial effect on the venous patency rate.