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Biomedical subjects

M A Randolph

Publications and source records attributed to M A Randolph.

65 records · Page 4Linked to original sources

Blood vessel implantation into ischemic bone.

Blood vessel implantation, core decompression, and core decompression plus cancellous bone grafting were compared in 36 adult mongrel dogs to evaluate their relative effectiveness in revascularizing an ischemic femoral head. Each of the methods resulted in a reversal of the ischemic changes to varying degrees. Blood vessel implantation resulted in increased new bone formation at the site of vessel implantation but no significant revascularization in the peripheral portion of the femoral head. The method of creating avascular necrosis of the femoral head of the canine, as described by Hori, was studied in a controlled fashion. Although ischemic changes were noted in our hands, the model failed to produced findings consistent with avascular necrosis.

Angiography↗

Vascularized bone allograft transplantation in a genetically defined rat model.

A heterotopic subcutaneous model for experimental vascularized bone allograft transplantation has been presented. This model uses genetically defined rats and allows serial assessment of graft viability. The reliability of this model has been proven by successful isograft transplantation. This model was used to study the effect of matching at the major histocompatibility complex on vascularized bone allograft survival. Whereas grafts transplanted across a minor histocompatibility barrier survived until sacrifice, grafts transplanted across a major histocompatibility barrier were victims of an acute rejection process. This study, therefore, showed genetic disparity to be a critical determinant of vascularized bone allograft survival. It indicates that primary vascularized bone allografts are as susceptible to rejection as heart and kidney allografts. For these reasons, it can be anticipated that genetic matching will be important in clinical vascularized bone allograft transplantation. The model used in this study should be useful for obtaining further fundamental immunologic information concerning vascularized bone allograft transplantation.

Animals↗

Molded vascularized osteoneogenesis: a preliminary study in rabbits.

The clinical application of free vascularized bone grafting techniques in reconstructive surgery has limitations with respect to available donor sites and configuration of the graft. In this study, we were able to produce a vascularized bone graft with a predetermined size and shape by the use of titanium chambers implanted into the groins of rabbits. Forty adult New Zealand white rabbits were included in this study. In all animals, bone fragments were harvested from the iliac crests and placed within a titanium chamber. The chamber was positioned in the groin with the saphenous vessels passing through the chamber longitudinally in contact with the bony fragments. In half the animals, a segment of periosteum was harvested from the tibia and sutured around the vessels with the cambium layer facing the bone fragments. Sacrifices were performed at 4, 8, 12, and 16 weeks to examine the chamber contents. At all time periods, the contents completely filled the chamber, and the saphenous vessels remained patent. Histologic evaluation showed remodeling of the bone fragments as early as 4 weeks concomitant with a sprouting vascular network demonstrable with microangiography. Fluorochrome bone labels documented new bone formation within the chamber. These changes were progressive to week 12, but the 16-week specimens appeared to be undergoing resorption.

Angiography↗

Allogenic transplants of bone revascularized by microvascular anastomoses: a preliminary study.

An area of experimental bone grafting that needs further study is the use of free vascularized allografts of bone. In 35 outbred mongrel dogs, the viability of vascularized bone allografts with and without azathioprine immunosuppression was compared to vascularized autogenous bone grafts. Viability was assessed by histologic techniques, fluorochrome bone labeling, and electron microscopy. Autogenous vascularized bone grafts remained viable, and it was concluded that microvascular technique was not the limiting factor in attaining survival of the grafts. The behavior of autogenous vascularized bone grafts with and without the influence of azathioprine was similar. Allogenic vascularized bone transplants uniformly failed at a period between 2 and 3 weeks. Immunosuppression with azathioprine did not appreciably affect survival of the osteocytes. However, the host response to the foreign tissue was slightly modified. The clinical ramifications of bone transplantations in humans are not analogous to the clinical situation of transplantation of other organs. If vascularized bone transplants are performed in humans, a relatively safe form of immunosuppression is necessary. This study suggests that azathioprine alone does not offer sufficient immunosuppression to insure viability of the vascularized transplant.

Animals↗

Physiologic isolation of the canine proximal fibular epiphysis on a vascular pedicle.

In order to create a model for epiphyseal growth plate transplantation by microvascular technique, a well-defined donor site was established. Dissection of latex-injected adult and juvenile dogs established the vascular supply to the proximal canine fibula. By isolating 7 cm of proximal fibula on the popliteal vessels, the nutrient supply to the epiphyses, metaphysis, and diaphysis is retained. This preserves the nutrient arterial supply to the fibula originating from the cranial tibial artery, the caudal tibial artery, and the small blood vessels from these to the epiphysis. Perfusion of the graft through the defined vascular pedicle was confirmed using 141Ce-labeled microspheres. These results showed a perfusion of the established graft that was as great as or greater than the control, unoperated side. It is concluded that the technique described for isolation can be used for developing a model for vascularized transplantation of epiphyseal growth cartilage in canines.

Animals↗

Bone grafts: a radiologic, histologic, and biomechanical model comparing autografts, allografts, and free vascularized bone grafts.

We developed an experimental model to compare the efficacy of free vascularized bone grafts, conventional segmental autografts, matchstick autografts, and fresh segmental allografts in terms of their ability to reconstruct a 7-cm segmental diaphyseal defect created in the canine femur. Forty-five adult mongrel dogs were studied and followed for 6 to 12 months prior to sacrifice. Evaluation included radiologic assessment of graft incorporation and hypertrophy, histology, and biomechanical testing. These studies indicated that microsurgically revascularized autografts were superior to all other groups in terms of early incorporation, hypertrophy, and the highest mechanical strength to failure. Union of the bone graft to the recipient femur was achieved by 6 months in 25 of 26 autografts, and no difference in union rate was seen within the autograft group. However, only two of five allografts achieved bony union during this time interval. Arteriography, microangiography, fluorochrome, and histologic studies all supported the concept that microsurgically revascularized grafts, when successful, maintain their viability. However, the premise that all osteocytes survive in a successfully revascularized bone graft is open to question. While decalcified sections showed that all microsurgically revascularized grafts maintained normal viability in the central marrow and cancellous portions compared with the other three groups, the viability of cortical bone in the vascularized autografts was less clear. Undecalcified fluorochrome sections suggested that circulation was not preserved in all portions of the cortex. Revascularization of the nonvascularized autografts was complete at 3 months, while, in the avascular allografts, the process was not complete at 6 months.

Angiography↗

Free microvascular epiphyseal-plate transplantation. An experimental study in dogs.

To evaluate the feasibility of transplanting vascularized epiphyseal plates while maintaining normal growth in the recipient site, twenty-two puppies from known, large breeds were divided into one control and three experimental groups of four animals each and one long-term group of six animals. The control group underwent insertion of a radiopaque marker in the fibular metaphysis bilaterally, and, in addition, a fibular osteotomy was performed on one side. In the experimental groups, a fibular switch was carried out, selecting one fibula as a vascularized graft and the other as a non-vascularized graft. Both the controls and the experimental groups were evaluated using serial roentgenograms, histological examination, fluorescent bone-labeling, and microangiography. One week, six weeks, three months, and seven months postoperatively, animals from each group were killed. Continuous growth was observed in the vascularized epiphyseal transplants and in the controls, with no statistical difference noted, whereas the non-vascularized transplants exhibited considerably less or no growth. Vascularized transplants demonstrated an average 21.2-millimeter increase in length while non-vascularized transplants showed a 6.6-millimeter increase. Histological examination, fluorochrome bone-labeling, and microangiography confirmed the continued viability of the vascularized epiphyseal transplants in contrast to the non-vascularized transplants.

Angiography↗

Prolonged general anesthesia for experimental craniofacial surgery in fetal swine.

A protocol utilizing high preoperative doses of altrenogest (Regu-Mate) and a "balanced" general anesthesia regimen consisting of isoflurane at subanesthetic doses supplemented with intravenous doses of sodium thiopental was developed to prevent preterm labor, minimize intracranial fetal cerebral edema, and decrease postpartum mortality of fetal swine after undergoing complex in utero craniofacial procedures. A total of 20 fetal piglets at 75% gestation were exposed to prolonged (> 3 h) anesthesia conditions of which 7 piglets were randomly selected to undergo experimental craniofacial procedures consisting of periosteal stripping of frontal and parietal bone segments with/without extensive coronal suture fusion procedures. Neither sows nor piglets were lost to anesthetic complications during the initial laparotomy or subsequent cesarean delivery. None of the sows experienced uterine sepsis or underwent preterm labor. The overall survival rate for all piglets exposed to prolonged anesthesia conditions was 95% at 4 weeks and 45% at 11 weeks after surgery. The experimental group's survival was 85.7% at 4 weeks and 28.5% at 11 weeks after surgery.

Anesthesia, General↗

Prolonged survival in fetal rabbit surgery.

Timing and outcome of antenatal surgical intervention is being explored using fetal animal models. Models that are currently used range from larger animals with fewer offspring and higher cost to smaller animals with larger litters and lower cost. The rabbit is an ideal "small" animal model for experimentation in the third trimester, with a large litter, short gestation and a relatively large fetus. This paper reports methods by which prolonged survival (greater than 110 days) may be achieved in as many as 60% of operated fetuses following complex fetal surgery in the rabbit.

Animals↗