[Severe burn injury caused by self-treatment of vitiligo].
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Adult↗
Biomedical subjects
T Waris
Publications and source records attributed to T Waris.
Free tissue coverage of wound complications following Achilles tendon rupture surgery.
The purpose of this study was to examine the long term functional results following free tissue coverage in 4 patients who developed wound complications after surgical treatment of partial or total Achilles tendon rupture. Between 1987 and 1993, 3 radial forearm flaps and 1 lateral arm flap were used. Two Achilles tendons were reinforced, 1 with palmaris longus tendon, and 1 with extensor carpi radialis and palmaris longus tendons. The patients were seen during followup an average of 3.1 years after the reconstruction. All patients were able to return to their preoperative level of activity within a year, and the aesthetic outcome was good in all cases. Isometric and isokinetic calf muscle performance was evaluated with a Lido Multi Joint II dynamometer, which showed the mean of isometric test values in 3 patients to be greater than 90% of that of the normal unaffected side, and probably abnormal (80%) in 1 patient. The mean isometric values obtained in 3 ankle positions, 20 degrees plantar flexion, neutral, and 10 degrees dorsiflexion, were 114%, 104%, and 94%, respectively. Isokinetic peak torque values were normal in 3 patients at a velocity of 30 degrees per second, and in 2 at 90 degrees per second. The mean peak torque value was 90% of normal at both angle velocities. The cross sectional area of the calf muscle was greater than 90% of the normal unaffected side. Ultrasonography indicated that the diameters of 2 reinforced tendons were larger than those on the control sides. Posterior peritendinous fibrosis was found in the upper corner of the scar in 2 patients.
Achilles Tendon↗
Development of the neurocranium after transsutural fixing by new, resorbable poly-L-lactide miniplates. A comparison to fixing with the common titanium miniplates.
The right coronal sutures of twelve (12) newborn rabbits were fixed with commercially available, self-reinforced poly-L-lactide miniplates, with eight (8) rabbits sham treated with titanium miniplate fixation as reference experiments, in order to demonstrate the possible effects on skull growth. After six (6) months follow-up, both types of plate were detected to have caused a similar asymmetry in the neurocranium. Therefore, in our opinion, fixing across growing sutures, even with the new biodegradable devices, should be avoided.
Animals↗
Polyglycolic acid membrane interpositioning for the prevention of skull deformity following experimental craniosynostosis.
The interpositioning of various materials to complete suturectomy for the treatment of craniosynostosis has been used by many surgeons to prevent early postoperative reunion. Clear scientific proof for this procedure has not yet been obtained with any material, however. A previously described model of experimental craniosynostosis was employed to examine the effects of an interpositioned biodegradable polyglycolic acid (PGA) membrane on the growing skull of 14 newborn rabbits. Additional 11 newborn rabbits served as controls, as on their skulls only unilateral resection of the coronal suture was performed (experimental craniosynostosis). The skulls were examined for shape and histology up to 6 months of age. The 11 rabbits in the control group developed a unilateral deformity on their calvaria as demonstrated by dry-skull osteometry. The 14 rabbit skulls having the interpositioning of a PGA membrane done into the resection site at the time of unilateral suturectomy were found to have grown in a remarkably symmetrical fashion. The interpositioning of a PGA membrane therefore seems to prevent the formation of a skull deformity during growth as compared with early suturectomy alone.
Animals↗
Generation of cartilage from auricular and rib free perichondrial grafts around a self-reinforced polyglycolic acid mould in rabbits.
The generative potential of free perichondrial grafts from rabbit auricular and rib cartilage around a self-reinforced polyglycolic acid (SR-PGA) rod was examined in eight growing rabbits. A 15 x 15 mm perichondrial graft was dissected away from the posterior side of each auricular cartilage. One graft was wrapped around a 1.1 x 10 mm SR-PGA rod and the other served as a control and was shaped into a tube without an implant. Fifth rib cartilages were then resected subperichondrially on both sides. The remaining perichondrium on the other side was wrapped around a 1.1 x 10 mm SR-PGA rod, while the other served as a control and was shaped into a tube without an implant. All the grafts were placed inside pectoralis major muscles. Grafts were biopsied six weeks postoperatively. Neocartilage formation was seen in all grafts with one exception on both the implant and control sides. It formed a tube-like structure around the implant in four cases after grafting of auricular perichondrium and in three cases after grafting of rib perichondrium. New bone formation was also observed. SR-PGA implants did not seem to disturb the generative potential of perichondrium.
Animals↗
Assessment of tissue viability by thermography after experimentally produced frostbite of the rabbit ear.
Since it is difficult and time-consuming to monitor the formation of a demarcation line in frostbite by visual inspection only, thermography was used to study experimental freezing injuries of the rabbit ear. In 8 rabbits, anesthetized with ketamine hydrochloride and xylazine hydrochloride, frostbite was induced by pressing the bottom of a glass bottle 2 cm in diameter, filled with liquid nitrogen against the shaved ear skin. Thermography was performed on both ears after 2, 24, and 48 hours, and one and 3 weeks. At 2 to 48 hours the frost-bitten area was clearly warmer than the surroundings, after one week there were ill-defined diffuse cold spots in the injured area, and after 3 weeks a cold area had become clearly demarcated with a warm zone between the cold area and the surroundings. Thermography is an easy, noninvasive method for monitoring thermal changes after experimental frostbite, but its clinical value is as yet unresolved.
Animals↗
Molecular cloning of the mouse S-adenosylmethionine decarboxylase cDNA: specific protein binding to the conserved region of the mRNA 5'-untranslated region.
The nucleotide sequence of a cDNA encoding the proenzyme of mouse S-adenosylmethionine decarboxylase (AdoMetDC) including 257 nucleotides of the 5' untranslated region has been determined. Comparison of the nucleotide sequence of the mouse 5' untranslated region with those of other mammals shows it to be highly conserved. The 52 nucleotides upstream from the translation initiation codon are identical in human, rat, bovine and mouse. The polyamines, spermidine and spermine, have been shown to inhibit AdoMetDC mRNA translation. An RNA gel retardation assay demonstrated that a cytoplasmic extract from mouse brain forms an RNA-protein complex with the completely conserved 5' untranslated sequence and that the complex formation is highly dependent on the presence of spermine. Crosslinking by UV irradiation shows that the complex contains a 39-kDa protein interacting with the 5' untranslated sequence. These data demonstrate spermine-dependent specific protein binding to a highly conserved 5' untranslated region of an mRNA translationally regulated by polyamines.
Adenosylmethionine Decarboxylase↗
A new method for the creation and measurement of experimental craniosynostosis.
Craniosynostosis is described as a condition in which the premature closure of one or more cranial sutures is exposed as a skull deformity alone or accompanied by neurological disturbances. According to previous research it seemed possible to create an experimental model for investigating the disease by simply resecting a suture in a newborn rabbit. We resected 16 coronal sutures in 16 newborn rabbits and had the skulls investigated for shape and histology up to 6 months of age. A clear deformity at the cranial vault could be detected. The fused site of the suturectomy later on presented a suture-like structure which was macroscopically distinct from a normal skull suture. The procedure is thus established, first, for investigating procedures for treating craniosynostosis in the growing skull, and, secondly, for studying the pathophysiology of craniosynostosis.
Animals↗
Effect of acute distension on cholinergic innervation of the rat urinary bladder.
The effect of short-term urinary bladder distension on its cholinergic innervation was studied in Sprague-Dawley rats. Distension was induced for 3 h by forced diuresis and balloon outlet obstruction, and whole thick biopsy specimens were taken from the dome and lateral side of the anterior body 2, 7 and 21 days afterwards. The acetylcholinesterase (AChE) method was used to demonstrate the cholinergic nerves in the distended bladder wall. Cholinergic hypoinnervation was observed 7 days after the distension, persisting up to 21 days, although AChE-reactive nerves were then observed to be more numerous. The distribution of hypoinnervation was uneven, being more marked in the lateral side of the anterior body than in the dome. The distribution of AChE-reactive nerves varied even in the same biopsies, with areas of total hypoinnervation occurring next to areas of slightly diminished innervation. This was especially true 21 days after distension. The findings indicate transient damage to the cholinergic innervation, which may in turn explain the prolonged voiding difficulties often seen after catheterization of an overdistended bladder in a patient with urinary retention. The short-lasting effect of bladder dilatation therapy used to treat detrusor instability or interstitial cystitis may be due to the fairly rapid regeneration of cholinergic innervation.
Acetylcholinesterase↗
The effect of acute distension on vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY) and substance P (SP) immunoreactive nerves in the female rat urinary bladder.
The effect of acute distension on vasoactive polypeptide (VIP)-, neuropeptide Y (NPY)- and substance P (SP)-immunoreactive nerves in the wall of the urinary bladder was investigated. At the age of 3 months, 25 female albino rats underwent forced diuresis combined with balloon obstruction to achieve maximal distension for 3 h. A modified, indirect immunofluorescence detection method was applied 2 days, 7 days and 21 days after distension. A marked, extensive depletion of VIP, NPY- and SP-immunoreactive nerves was observed after distension. This disturbance was reversible, and increased fluorescence of VIP-, NPY- and SP-immunoreactive nerve fibres compared with control specimens was seen in bladder specimens taken even as soon as 21 days after distension. This transient depletion of peptidergic innervation may partly explain the prolonged voiding problems that often occur after acute urinary retention. The depletion of sensory nerves containing SP shortly after distension may explain the transient benefit obtained from distension therapy in patients with painful bladder disease. It is suggested that the increased SP activity during the recovery phase may be related to neurogenic inflammation.
Animals↗
Polylactide and polyglycolic acid-reinforced coralline hydroxy-apatite for the reconstruction of cranial bone defects in the rabbit.
The possibility of using coralline hydroxy-apatite in combination with polylactide and polyglcycolic acid instead of a bone graft in the skull region is examinated. Coralline hydroxy-apatite blocks strengthened with a membrane made of a combination of polylactide and polyglycolic acid were inserted into bony defects created in 12 rabbit skulls. The blocks were observed during a follow-up of 12 months. They became fixed to the surrounding bone and no adverse effects or harmful reactions in the nearby tissues could be detected.
Animals↗
Noradrenaline content of the tissue and nerve in the rabbit ear after freezing injury.
The aim of this study was to investigate the development of the demarcation line in the rabbit ear upon injury by experimental freezing and thawing. For this purpose the sequential changes in noradrenaline (NA) content in the tissue and nerve of the ear were determined by liquid chromatography. Frostbite was inflicted with a glass bottle filled with liquid nitrogen and specimens were taken from the injured area, the probable demarcation line area and the healthy area 1, 3, and 7 days after frostbite. Control samples were taken from the normal contralateral ear. Tissue NA levels in the injured area and the probable demarcation line area were significantly lower than those in corresponding areas of the control ear after 1 day. Day 3 NA levels in the demarcation line area were 90% higher than those on Day 1 in this area and were not significantly different from Day 3 levels in the control ear. By Day 7, NA levels in the demarcation line area were down to 70% of the Day 3 levels. NA levels in the central nerve at the probable demarcation line were much higher than those in the control ear nerve and also showed a peak on Day 3. In conclusion, the results suggest that NA is released from the adrenergic nerves and the reaction at the probable demarcation line is strongest on the third day.
Adrenergic Fibers↗
Assessment of tissue viability in frostbite by 99Tcm-HDP scintigraphy: an experimental study in New Zealand white rabbits.
Since the appearance of superficial tissue is often an unreliable indicator of deep tissue viability in cases of frostbite, radionuclide scintigraphy with 99Tcm-disodium oxidronate (HDP) was used to assess changes in tissue viability after experimental freezing and thawing of the rabbit ear. One shaved ear, left or right, of each of eight New Zealand white rabbits was frozen with a glass bottle (diameter of bottom 2 cm) filled with liquid nitrogen (-180 degrees C) for 5 min under Ketalar-Rompun anesthesia, the other ear serving as a control. Radionuclide scintigraphy was performed by giving a bolus intravenous injection of 130-170 MBq (3.5-4.5 mCi) 99Tcm-HDP. Radionuclide imaging was used to follow the development of the demarcation line. Scintigraphy was performed 2 h after frostbite and then after 24 h, 48 h, 1 week and 3 weeks. The frostbitten area seemed macroscopically to be warm and swollen immediately after the induction of frostbite. Scintigraphy showed the frostbitten area to be much warmer than the surrounding tissue for the first week and it was not until after that the first cold spots appeared in the middle of the frostbitten area. The necrotic and vital tissue could easily be distinguished after 3 weeks.
Animals↗
Changes in the noradrenaline content of the female rat urinary bladder after transient acute overdistension.
The effect of transient acute overdistension produced by forced diuresis and outflow occlusion was examined in female Sprague-Dawley rats. Their bladders were distented for three hours and studied at selected intervals during the postoperative period using high performance liquid chromatography (HPLC) for the exact measurement of tissue noradrenaline. Biopsies were taken from the bladder dome and anterior body 10 hours, 2 days, 7 days and 21 days after overdistension. A reduction in NA concentration was found in both the dome and anterior body at 2 to 21 days after distension. The results demonstrated at least partial transient damage to the adrenergic nerves containing NA. The primary success of the distension therapy used to treat bladder instability may be due to this injury.
Adrenergic Fibers↗
Pharyngo-oesophageal reconstruction with free jejunal transplants. New design of the upper anastomosis to improve monitoring of viability of transfer.
Since 1987, 13 free microsurgical jejunal transplants for large pharyngo-oesophageal tumors have been done in 12 patients at Tampere University Hospital. The conventional technique was used for the end to end upper anastomosis in seven patients, and our new end to side anastomotic technique in six. Five patients were alive at the time of writing, the mean survival being 22 months (range 1-48). Five patients developed orocutaneous fistulas, three of which healed spontaneously. In the remaining two the fistulas were caused by rapid recurrence of the tumour. There was no significant difference in ability to feed orally or swallow among the patients operated upon by the end to end or the end to side anastomotic technique. Our results show that the free microvascular jejunal transfer is a safe procedure for repair of the hypopharynx. Our new end to side hypopharyngojejunal anastomosis makes it possible to monitor the transplanted bowel reliably by direct vision.
Aged↗
Enzyme histochemical reactions at the demarcation line in frostbite: an experimental study on rabbits.
Eleven frostbites were induced on the ears of seven New Zealand White rabbits and specimens were taken from the lesion after 1, 4 and 8 hours, and from ten further frostbites on the ears of six rabbits for examination 1, 3 and 7 days later. The specimens were taken at the border between the frozen and non-frozen skin. NADH-diaphorase, alkaline phosphatase and esterase were demonstrated histochemically in the sample, which was also studied by haematoxylin and eosin staining. Five ears served as controls. Some granulocytes could be seen accumulating in the vessels and in the dermis at the border of the frostbite area after only 1 hour, and other enzyme rich cells (macrophages) also began to appear. After 4 hours the inflammation was quite obvious with the enzyme reactions clearly observable in the sections. After 8 hours there was no marked difference compared with the 4-hour picture. It was only after 3 days that the line of demarcation between the normal and frostbite tissue could be seen clearly. This was oblique in some specimens and vertical in others. The degeneration in the lesion could best be demonstrated by the NADH-diaphorase and esterase reactions and the early inflammation by the alkaline phosphatase reaction.
Alkaline Phosphatase↗
Rectus abdominis muscle flap with microvascular anastomoses for repair of recurrent sarcoma.
After radical resection of a recurrent leiomyosarcoma, the thoracic wall was stabilized with a Gore-Tex graft. The skin and soft tissue defect was repaired with a large rectus abdominis flap in which the circulation was secured by end-to-end microvascular anastomosis of the inferior epigastric artery to the internal mammary artery, which had to be cut during tumor removal.
Anastomosis, Surgical↗
Perivascular sympathectomy does not remove adrenergic nerves from distal vessels. The effect of various denervations on the rat saphenous bundle: a histochemical study.
It has been claimed earlier that perivascular sympathectomy removes distal adrenergic innervation of the vessels. Based on preliminary results suggesting the contrary, the purpose of this work was to reconsider the denervation effect of perivascular sympathectomy. We operated on 40 rats using different denervation methods mainly to test the effects of perivascular sympathectomy on the distal saphenous vessels of the leg. The operations were performed on the right leg, while the left leg was used as a control. Samples were taken 2 days after the operations for glyoxylic acid-induced fluorescence examination for the histochemical demonstration of adrenergic nerves. Perivascular sympathectomy seemed to remove the adrenergic innervation only from the operated segment of the vessel. There was a short segment of diminished innervation a few millimeters in length just distal to the perivascular sympathectomy while the more distal adrenergic nerves around the vessels appeared to be normal. When the saphenous nerve was cut the adrenergic innervation seemed to disappear for 1 cm and to continue to be diminished at the medial malleolus site. Lumbar sympathectomy did not seem to remove the distal adrenergic nerves around the vessels, but caused only a slight decrease in innervation. It can be concluded that the peripheral adrenergic innervation is apparently normal after perivascular sympathectomy and that the operation does not have the previously assumed denervation effects.
Adrenergic Fibers↗