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PubMed2003

Two examples of reimplantation from Croatian sacral patrimony.

In the current article, two paintings related to the topic of reimplantation from Croatian sacral patrimony are presented. The first one is "The Kiss of Judas," the fresco by Vincent of Kastav (1474) in Beram in Istria--a Gospel scene with Jesus performing reimplantation of the ear to Malchus after it was cut off by Apostle Peter. The second one is an old oil on canvas from the island of Rab, presenting St. Anthony of Padua performing reimplantation of a boy's amputated foot. Although in both cases the primary function of the painting is to convey a moral message, they are interesting from the medical-historical point of view for their view of universal popular imagination and the conception of healing severe wounds during the absence of modern medical knowledge.

Christianity↗
PubMed1982

Reflux--a retrospective study of 100 ureteric reimplantations by the Politano-Leadbetter method and 100 by the Cohen technique.

The results of 100 consecutive ureteric reimplantations using the Politano-Leadbetter technique were compared with those of 100 cases operated on by the Cohen technique. This retrospective study was concerned only with the effect of the operation on the ureterovesical junction. Cure of reflux was achieved in 88 Politano-Leadbetter reimplantations and in 97 Cohen reimplantations. Both groups and the results are analysed.

Adolescent↗
PubMed1993

Reimplantation of the ureter in a transtrigonal mucosal groove.

Reimplantation of the ureter into a groove of the bladder mucosa has been used to simplify the procedure of reimplantation and overcome problems in trabeculated bladders by obviating the creation of a submucosal tunnel. Further experience is presented regarding this procedure on 40 ureters of patients with unilateral or bilateral vesicoureteric reflux, ureteric orifice(s) stenosis, bladder diverticula and posterior urethral valves submitted to simultaneous resection. Intra-operative observations, post-operative cystography and long-term results led to the conclusion that the procedure is technically easy, facilitates reimplantation in trabeculated bladders, safeguards the valve mechanism by preventing vesicoureteric reflux and shortens hospitalisation time.

Adolescent↗
PubMed1990

Pulp revascularization in reimplanted immature monkey incisors--predictability and the effect of antibiotic systemic prophylaxis.

In 32 monkeys 105 immature maxillary incisors were extracted and reimplanted either immediately or after 30 or 60 min wet or dry storage. Of the monkeys, 17 (group I) did not receive and 15 (group II) received prophylactic treatment with 4 mg/kg doxycycline before extraction and 2 mg/kg for 5 d after reimplantation. The observation time varied from 6 to 8 weeks. After being histologically processed, the material was evaluated with respect to the amount of vital tissue and presence of micro-organisms in the pulpal lumen. A comparison revealed no difference in the results between the groups. The results were therefore pooled and statistically analysed with respect to the significance of apical foramen width, extra-alveolar time, wet or dry storage and presence of micro-organisms in the pulpal lumen for the occurrence of complete pulp revascularization (CPR). The overall frequency of CPR was 18%. Log-linear analyses (SAS, 1985) of the material as a whole or of separate parameters consistently revealed a relationship between presence of micro-organisms and absence of CPR (P = 0.0001). A higher frequency of CPR and a lower frequency of micro-organisms (P = 0.05) was found only for the group of immediately reimplanted teeth. The presence of micro-organisms could be explained for 61 teeth. In 27 of these, blood clots containing bacteria in the apical portion of pulpal lumen indicated contamination during the extra-alveolar time, while in 34, the micro-organisms originated from plaque covered mechanical damage in the cervical part of the root surface.

Animals↗
PubMed1999

Inflammatory and replacement resorption in reimplanted permanent incisor teeth: a study of the characteristics of 84 teeth.

Avulsion is a serious injury which can cause damage to some or all of the dental and surrounding tissues. This study examined the profiles of teeth showing inflammatory resorption, in terms of time prior to reimplantation, contamination, pulp extirpation time and period of splinting and compared them to teeth without resorption. There were a total of 71 children in the present study (mean age 9.8 years, range 6-16 years) with a total of 84 reimplanted teeth. Inflammatory resorption was present in 22 teeth. There was a significant relationship between the presence of inflammatory resorption and the time the teeth were dry prior to reimplantation, with a lesser effect for total delay time. There were slightly later pulp extirpation times for teeth with inflammatory resorption, with median delays of 16 and 11 days respectively and increased inflammatory resorption in teeth extirpated at 20 days or later. Replacement resorption was present in 40 teeth. There was a significantly longer splinting time in teeth with replacement resorption and more resorption in teeth splinted for longer than 10 days. It was concluded that pulp extirpation time was not critical unless the delay exceeded 20 days and that splinting time should not exceed 10 days.

Adolescent↗
PubMed2005

Four gland parathyroidectomy without reimplantation in patients with chronic renal failure.

BACKGROUND: The optimal surgical management of patients in end stage chronic renal failure with secondary hyperparathyroidism is controversial. One approach advocated is four gland parathyroidectomy without reimplantation. The aim of this study was to review the medium term results of this procedure. METHODS: Fifty four consecutive patients with end stage chronic renal failure and secondary hyperparathyroidism who had a four gland parathyroidectomy without reimplantation were studied. The procedure was performed by a single surgeon with a median (range) follow up of 29 (0-70) months. RESULTS: Most patients (76%) developed postoperative hypocalcaemia but this was easily treated and doses of long term drugs necessary to prevent this were low. Pre-operative bone symptoms, hypercalcaemia, hyperphosphataemia, and an increased alkaline phosphatase were improved or resolved in most patients. Thirteen (24%) patients had an undetectable postoperative parathyroid hormone (PTH), (6 of 12 (50%) with a functioning renal transplant and 7 of 42 (17%) who required dialysis, p = 0.02). Median (range) postoperative PTH values in these groups were 0.1 (0.1-31) compared with 1.0 (0.1-24) pmol/l (p = 0.085) respectively. The remaining 41 of 54 (76%) patients had residual PTH secretion and postoperative hyperparathyroidism was identified in eight (15%) patients with only two requiring neck re-exploration. CONCLUSION: Four gland parathyroidectomy without reimplantation produced good medium term biochemical and clinical results. Most patients had minor residual PTH secretion that may contribute to this and mitigate concerns regarding adynamic bone disease. Endogenous PTH secretion is only completely lost in a few patients but occurs more often in those with a functioning renal transplant. Bone densitometry is required to investigate the long term impact of this procedure.

Administration, Oral↗
PubMed1976

Changes in the fluid compartments and dry weights of reimplanted dog lungs.

We studied changes in fluid compartments and dry weights of reimplanted lungs of dogs during the first 6 wk after operation. Excision and reimplantation caused a large increase in lung weight. The increase in weight was maximal 3 days after operation, was proportionately greater in the upper middle lobe than in the lower lobe, and was principally due to increased extravascular water. Dry weight and noncirculating red cells (measured by subtracting 51Cr-labeled red cell mass from total red cell mass as measured by hemoglobin extraction) also increased within 3 days after operation. Lung weight and extravascular water decreased progressively after 3 days and were normal in 6 wk. Chromated blood mass remaining within excised, passively drained lobes did not change at any stage postoperatively. Three days after operation, frozen lung sections showed minimal alveolar fluid but large amounts of peribronchial and perivascular edema which was occasionally blood tinged; submucosal edema was present in a few bronchi. Using intraalveolar Evans blue dye, we confirmed that several bronchial lymphatics close within 6 h and refenerate during the first postoperative week. Many of observed functional changes in freshly reimplanted lungs are temporally related to changes in extravascular water.

Animals↗
PubMed1998

Functional evaluation of different ileal neobladders and ureteral reimplantation techniques.

OBJECTIVES: To compare and assess the function of ileal neobladders with different reconfiguration and with several types of ureteral reimplantation. METHODS: Forty-five male patients underwent radical cystectomy and detubularized ileal neobladder. In 20 patients an ileal neobladder was carried out according to Studer's technique, in 12 a 'W'- and in 13 a 'U'-shaped neobladder. In the Studer's patients 60 cm of ileum was used, in the 'W' 40 and in the 'U' 30 cm. For the uretero-ileal anastomosis Nesbit's technique was utilized in the Studer's, in the 'W' and 'U' neobladders Camey Le Duc's technique was performed instead. Four patients underwent a serous-lined extramural tunnel reimplantation. Follow-up included a functional and morphological study of the urinary system and a urodynamic study. RESULTS: All Nesbit's uretero-ileum anastomoses resulted refluent when the reservoir was filled up, 15 of 50 ureteral reimplantations according to the Camey Le Duc technique showed reflux at full filling. At 3, 6 and 12 months follow-up, the double reconfiguration reservoirs (Studer's and 'W') showed a larger capacity and a lower maximum pressure than neobladders with a single bending. At 12 months, continence and the voiding interval time was significantly higher in the double reconfiguration than in the 'U' neobladders. CONCLUSION: The double reconfiguration of the reservoir ('W') might be preferable to that with a single one. As for the type of ureteral anastomosis to select, the problem is still debatable even if in our case-control study we have had better results in terms of reflux and stenosis with the uretero-enteric anastomosis with Nesbit's and associated afferent long tubular ileal limb than with Studer's technique.

Aged↗
PubMed1984

[Ureteral reimplantation using the psoas bladder-hitch. Experience based on 111 operations in 100 patients].

In a 12-year period we performed 111 ureteral reimplantations with vesico-psoas hitch in 100 patients. The indication was a stricture of the lower third of the ureter in 51 ureters, vesicoureteral reflux in 31 ureters, and intraoperative laceration of the ureter in 25 patients. A congenital megaureter was the indication for ureteral reimplantation with psoas hitch in 4 cases. The operative result was classified excellent or good in 72% of the cases, and only 16% had to be regarded as operative failures. Ureteral reimplantation with vesico-psoas hitch is a versatile procedure that suits a number of indications, it is invaluable for the replacement of the lower third of the ureter in difficult cases, and it leads to a good long-term result in a high percentage of patients.

Adolescent↗
PubMed1992

There is no activation of O2- production by alveolar macrophages and neutrophil polymorphonuclear leukocytes in rat lung transplants during the reimplantation response and acute rejection.

Activation of phagocytes (alveolar macrophages [AM] and neutrophil polymorphonuclear leukocytes [PMN]) can cause tissue damage in inflammatory lung diseases. In this study we investigated whether phagocytes contribute to the development of tissue damage in lung grafts histologically observed during two different processes: the reimplantation response and the acute rejection. Therefore, the number and profile of bronchoalveolar lavage (BAL) and blood phagocytes and their in vitro spontaneous and serum-treated-zymosan (STZ)-stimulated O2- production were assessed after allogeneic (BN to LEW) and syngeneic (LEW to LEW) transplantation of the left lung in rats. BAL PMN numbers increased during the reimplantation response, whereas during the late phase of the rejection process BAL AM and PMN numbers were increased. The O2- production by the BAL phagocytes and blood PMN were not increased at any stage. Strikingly, the STZ-stimulated O2- production by the BAL phagocytes was significantly impaired during acute rejection. Our data suggest that activation of the O2- production by bronchoalveolar phagocytes does not play an important role in the development of tissue damage in lung transplants during the reimplantation response and acute rejection. The impaired O2- production by alveolar phagocytes during acute lung rejection may contribute to the increased susceptibility for pulmonary infections after lung transplantation.

Animals↗
PubMed1989

Cochlear implant revision: effects of reimplantation on the cochlea.

The removal of an indwelling cochlear implant electrode followed by reinsertion of a new device has been a maneuver of uncertain consequences to the cochlea and its surviving neural population. The present study was conducted in an attempt to elucidate the factors that determine whether a reimplantation procedure will be successful. Cochlear implantation followed by explantation and subsequent reimplantation was performed in eight adult cats. Evaluation of cochlear histopathology suggested a significant increase in electrode insertion trauma when there was proliferation of granulation tissue in the round window area and scala tympani. In other cases, atraumatic reinsertion was achieved without apparent injury to the cochlea. The results of a survey of cochlear implant manufacturers and surgeons indicate that electrode replacement can usually be accomplished without adverse effects. Difficulties have been encountered, however, in removing implants with protuberant electrodes and when reimplantation was attempted on a delayed basis following explantation.

Acute Disease↗
PubMed1999

Use of a platysma myocutaneous flap for the reimplantation of a severed ear: experience with five cases.

CONTEXT: The traumatic loss of an ear greatly affects the patient because of the severe aesthetic deformity it entails. The characteristic format of the ear, with a fine skin covering a thin and elastic cartilage, is not found anywhere else in the human body. Thus, to reconstruct an ear, the surgeon may try to imitate it by sculpting cartilage and covering it with skin. OBJECTIVE: To use a platysma myocutaneous flap for the reimplantation of a severed ear in humans. DESIGN: Case report. SETTING: Emergency unit of the university hospital, Faculty of Medicine, Ribeirão Preto - USP. CASE REPORT: Five cases are reported, with whole ear reimplantation in 3 of them and only segments in 2 cases. The surgical technique used was original and was based on the principle of auricular cartilage revascularization using the platysma muscle. We implanted traumatically severed auricular cartilage into the platysma muscle. The prefabricated ear was later transferred to its original site in the form of a myocutaneous-cartilaginous flap. Of the 5 cases treated using this technique, 4 were successful. In these 4 cases the reimplanted ears showed no short- or long-term problems, with an aesthetic result quite close to natural appearance. In one case there was necrosis of the entire flap, with total loss of the ear. The surgical technique described is simple and utilizes the severed ear of the patient. Its application is excellent for skin losses in the auricular region or for the ear itself, thus obviating the need for microsurgery or the use of protheses or grafts.

Adolescent↗
PubMed1995

Survival and development of reimplanted fetal epiphyses. An experimental study.

An experiment was undertaken to study the survival and development of fetal epiphyses after excision and reimplantation in rats. The proximal part of fibula in the hindlimb was dissected free from surrounding tissues and then reimplanted again. Of 80 fetuses that were operated on, nine that had been operated on survived to birth. Histological examination on the hindlimbs of these rats at four and six weeks after birth showed that the reimplanted segments survived, and the bony nuclei of the epiphyses were present. Radiographically, at 6 weeks old, secondary centres of ossification at proximal ends of the fibulas could be seen in both operated and normal limbs. These results indicate the clinical possibility of correcting congenital musculoskeletal abnormalities in the future by in utero transplantation of epiphyses.

Animals↗
PubMed1987

Diaphyseal reconstruction by autoclaved bone. Reimplantation experiments in rabbits.

In 8 adult rabbits, reconstruction of large humeral defects by reimplantation of resected, autoclaved bone supplemented with allogeneic bone matrix was investigated with respect to incorporation (radiography, histology), bone metabolic activity (scintigraphy, autoradiography), and strength (torsional test). Radiography showed that seven out of eight implants were incorporated at 3 months. Scintigraphy and autoradiography disclosed bone metabolic activity in the reconstructions still 8 months postoperatively. Histological investigations evidenced abundant new viable bone that partially had replaced the implants at 8 months. The torsional test disclosed that the strength of the reconstructions was 84 per cent of normal 8 months after reimplantation. Our experiment supports the concept of reimplantation of autoclaved tumorous bone supplemented with allogeneic bone matrix in reconstruction after local resection.

Animals↗
PubMed1996

Treatment of aneurysms by excision or trapping with arterial reimplantation or interpositional grafting. Report of three cases.

The authors report three cases of ruptured, large or giant aneurysms that were treated by excision or trapping, followed by revascularization of distal vessels by means of arterial reimplantation or superficial temporal artery interpositional grafting. In the first case, a large serpentine aneurysm arising from the anterior temporal branch of the right middle cerebral artery (MCA) was excised and the distal segment of the anterior temporal artery was reimplanted into one of the branches of the MCA. In the second case, a giant aneurysm, fusiform in shape, arose from the rolandic branch of the MCA. This aneurysm was totally excised and the M3 branch in which it had been contained was reconstructed with an arterial interpositional graft. In the third case the patient, who presented with a subarachnoid hemorrhage, had a dissecting aneurysm that involved the distal portion of the left vertebral artery. In this case the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm and coursed onward to supply the brainstem. This aneurysm was managed by trapping and the PICA was reimplanted into the ipsilateral large anterior inferior cerebellar artery. None of the patients suffered a postoperative stroke and all recovered to a good or excellent postoperative condition. These techniques allowed complete isolation of the aneurysm from the normal blood circulation and preserved the blood flow through the distal vessel that came out of the aneurysm. These techniques should be considered as alternatives when traditional means of cerebral revascularization are not feasible.

Brain Tissue Transplantation↗
PubMed1988

Evaluation of reimplant total hip prostheses and resection arthroplasty.

Results of reimplanted total hip prostheses and resection arthroplasty were compared. Using the Iowa hip rating scale, the reimplanted prostheses population was rated higher for function, gait, and absence of deformity, however, the resection arthroplasty population rated better in freedom from pain. Radiographic findings in the reimplanted prostheses population included radiolucent lines around the cement, loosening, and cortex bone stock loss. These findings cause concern for the future of these implants. Repair and remodeling of the bone lesions were observed in resection arthroplasties. It was concluded that if healing of infection is achieved or if resection is performed for mechanical failure, the results may be considered permanent.

Adult↗
PubMed1976

[Reimplantation of severed fingers (author's transl)].

Finger reimplantation is actually feasible. Two cases of complete amputation and three of partial amputation are presented. There were four successes out of five. A partial reimplantation failed on the 12th postoperative day. The technique and the postoperative care are presented. Success does not depend solely on technique. Physiopathology of the microcirculation at the level of the anastomoses, not well known at present, conditions vascular patency and survival of the reimplanted finger.

Adult↗
PubMed1975

Reimplantation of freeze-treated mandibular bone.

Mandibular bone devitalized by freezing after removal from the body and subsequent reimplantation was observed for its potential to act as a framework of new bone formation. Clinical union and bony replacement occurred when the reimplanted bone was covered by healthy, well-vascularized soft tissue. New bone initially formed subperiosteally along the devitalized bone. Later specimens showed increased production of endosteal bone. The results suggest that a resected mandible subjected to freezing might be immediately reimplanted as a graft when the mandible is involved as part of a radical operative procedure. Further studies are indicated to evaluate this potential when the periosteal covering is removed.

Animals↗