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Reimplantation of growth plate chondrocytes into growth plate defects in sheep.

Defects in growth plates due to trauma, infection, or genetic causes can result in bone formation across the defect, bridging the epiphysis and metaphysis, resulting in growth arrest and limb deformation. We have investigated the capacity of implanted chondrocyte cultures to prevent this process. Sheep growth plate chondrocytes were isolated, and after culture at high density produced easily manipulated cartilaginous discs. The tissue was implanted into growth plate defects produced in lambs and the response was assessed histologically. Following implantation, cultures continued to proliferate and maintain a cartilage-like matrix. After 8 to 12 weeks, hypertrophic maturation chondrocyte columnation, and associated endochondral calcification were observed. Culture implantation was always associated with local immune inflammatory reaction, which continued throughout the course of investigation. Cellular survival was variable and resulted in the presence of viable implants as well as residual cartilage matrix devoid of chondrocytes; however, implanted chondrocyte discs always prevented bone bridge formation. These findings encourage the expectation that cultured chondrocytes may provide a useful replacement for the inert interpositional materials currently used in the treatment of growth arrest. The potential of this technique for growth plate replacement, however, requires a more predictable rate of implant survival. The likely reasons for implant loss are discussed.

Animals↗

The ileopsoas tunnel, a new antireflux technique for ureteroileal reimplantation: an experimental study in dogs.

A new antirefluxing ureteroileal anastomosis is described in which the implanted ureter is placed between the ileal segment and psoas muscle. The procedure was studied in eight experimental dogs, which were observed for 20 weeks. Radiologic and bacteriologic examinations, necropsy assessment and histopathologic results provided evidence that this ileo-psoas tunnel technique allows a unidirectional, non-obstructed flow of urine. The technique could be applied when ileal replacement of the ureter is necessary or in association with continent bladder replacement.

Anastomosis, Surgical↗

Radical resection of superior sagittal sinus meningioma with venous interposition graft and reimplantation of the rolandic veins. Case report.

A case of a 48 year old women is reported in whom a haemangiopericytic meningioma involving the middle third of the superior sagittal sinus was radically excised. The sinus was replaced by a saphenous vein graft and the Rolandic veins were reinserted. During clamping of the sinus the patient was heparinized and hypothermia, hypotension and barbiturates were used to prevent swelling of the brain. The postoperative course was uncomplicated and patency of the graft was demonstrated 2 weeks after the operation by Doppler sonography performed through a midline burr hole. The technical details of the operation and the pertinent physiology of cerebral venous flow are discussed.

Cranial Sinuses↗

Further study on the vascular basis for the reimplantation of the hand amputated through the palm.

Based on the anatomic data obtained from earlier studies on the vascular anatomy of the hand, the vascular architecture in the palm of the hand was studied on 60 sides of unembalmed adult upper extremities. Each palm was divided into 64 squares by 8 sagittal and 8 transverse sections. The vascular architecture in these squares and the arterial relations between them were observed and measured by angiography, operative microscopic dissection and computerised three-dimensional reconstruction. According to the pattern of the blood-vessels, the amputated palms can be classified into 4 types. The anatomic basis for the vascular anastomosis in each type is defined. There are three key-areas for the blood-supply of the palm and their significance is discussed. Apart from the 4 types of transversely amputated palms, the repair program of the blood-vessels in 4 types of common obliquely amputated palms are also discussed.

Amputation, Traumatic↗

[Simultaneous reimplantation of both lower legs--5-year follow-up (case report)].

We are reporting the case of a 29 year old male in whom we performed successful reimplantaton of both lower legs following trauma inflicted by a railroad boxcar. Five years after this accident, the patient's walk is almost normal and both deep sensitivity and two point discrimination on the soles of his feet are sufficient. The patient can walk, run and stand very well on one leg, both on even and on uneven ground.He returned to his job with the railroad 8 months after his accident. Originally the patient was employed as a railroad workman, and is now an office employee. His private life is normal and he enjoys hiking and dancing. In our opinion, sufficient function of the tibial nerve in the reconstructed extremity is important for clinically satisfactory long-term results. Both the Mangled Extremity Severity Score (MESS) and the NISSSA are helpful in making the decision on whether to primarily amputate or reconstruct Gustillo IIIC cases. Good long-term results as well as general cost reduction are achievable following reconstruction of extremities. Amputation of an extremity can be predicted with 100% certainty when MESS is 9 or more. Primary shortening and secondary lengthening of an extremity is a good method of treating Gustillo III C fractures.

Accidents, Occupational↗