RESUMO
Management of extensive bone and soft tissue defects, which occur after severe trauma of lower extremities and always lead to an unacceptable amputation in some cases, continues to challenge reconstructive surgeons. When performing lower extremity amputation, preservation of the knee joint has been put into a higher priority. The benefit of below-knee amputation over above-knee ones concentrates on a more normal gait with less energy expenditure during ambulation when a functioning knee joint is present.
Assuntos
Humanos , Lactente , Masculino , Acidentes de Trânsito , Cotos de Amputação , Amputação Traumática , Cirurgia Geral , Traumatismos do Pé , Cirurgia Geral , Traumatismos da Perna , Cirurgia Geral , Retalhos CirúrgicosRESUMO
<p><b>OBJECTIVE</b>To explore a new method to treat brachial plexus root avulsion experimentally by reimplantation combined with transplantation of neural stem cells (NSCs) modified by neurotrophin-3 gene (NT-3).</p><p><b>METHODS</b>The total RNA was extracted from neonatal rat striatum and the NT-3 cDNA was obtained by reverse transcription and amplified by polymerase chain reaction. The NT-3 gene was transferred into NSCs via the pLEGFP-C1, an expression plasmid vectors. The untransfected NSCs, the pLEGFP-C1 treated NSCs, and the pLEGFP-C1-NT-3 treated NSCs were transplanted into corresponding spinal cord segment with brachial plexus root avulsion. The survival, differentiation, and migration of the transplanted cells were determined under confocal laser scanning microscope or by immunohistochemistry method. The nerve regeneration was evaluated by gross observation, electrophysiological examination and reverse horseradish peroxidase tracing.</p><p><b>RESULTS</b>The NT-3 gene was successfully amplified and transferred into neural stem cells via the plasmid vectors. The transplanted cells survived, differentiated, and migrated and NT-3 was expressed within the spinal cord. The animals regained some muscle strength which was less than 3-degree muscular strength according to the British Medical Research Council (BMRC) evaluating system. The results of electrophysiological examination and reverse horseradish peroxidase tracing were superior in the pLEGFP-C1-NT-3 group to the NSCs untransfected group or the pLEGFP-C1 group.</p><p><b>CONCLUSION</b>Transplantation of NSCs modified by NT-3 gene combined with reimplantation is a relatively effective way to treat brachial plexus root avulsion experimentally. It still need further study to improve the results.</p>
Assuntos
Animais , Ratos , Plexo Braquial , Ferimentos e Lesões , Neurotrofina 3 , Genética , Radiculopatia , Cirurgia Geral , Reimplante , Transplante de Células-Tronco , TransfecçãoRESUMO
<p><b>OBJECTIVE</b>To evaluate the clinical application and discuss the operative indication of the reverse dorsal metacarpal flap and its compound flap on the skin defects of hand.</p><p><b>METHODS</b>From 1990 to 2003, we applied the reverse dorsal metacarpal flap and its compound flap to repair soft tissue defects of fingers in 122 cases, which included 90 cases of the reverse metacarpal flap and 32 cases of its compound flaps with tendon grafts, nerve grafts or bone grafts. Based on the follow-up observations, we analyzed the indications of the reverse metacarpal flap and its compound flaps, the postoperative contours, flap colors and textures in comparison to contralateral fingers retrospectively.</p><p><b>RESULTS</b>In the series of 122 cases, flaps survived and the donor site defects were closed directly. The follow-up period ranged from 1-12 years. The postoperative contours, colors and textures of the flaps and its compound flaps were similar to those of normal fingers, although linear scar remained. According to standards of sense recovery (British Medical Research Council, BMRC), the sense function of the flaps resumed S3 after operation for 1 year. In 10 cases with the tendon defects treated by the flap with tendon grafts, function of flexion-extension of fingers resumed 50%-75% in comparison to the contralateral fingers using the method of measurement of total active motion. In 7 cases with the phalangeal nonunion or bone defects treated by the flap with bone grafts, union occurred after operation for 3 months.</p><p><b>CONCLUSIONS</b>To soft tissue defects on fingers with bone or tendon exposure, the reverse metacarpal flap and its compound flap are a better choice for repairing. The range of repairing is up to the distal interphalangeal joint of fingers. The second dorsal metacarpal artery is more consistent and larger as the choice of vascular pedicle, in comparison with other dorsal metacarpal arteries. Postoperative flap color and texture are similar to normal fingers.</p>
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos dos Dedos , Cirurgia Geral , Sobrevivência de Enxerto , Metacarpo , Cirurgia Geral , Estudos Retrospectivos , Lesões dos Tecidos Moles , Cirurgia Geral , Retalhos Cirúrgicos , Resultado do TratamentoRESUMO
<p><b>BACKGROUND</b>Velvet antler polypeptides (VAPs), which are derived from the antler velvets, have been reported to maintain survival and promote growth and differentiation of neural cells and, especially the development of neural tissues. This study was designed to explore the influence of VAPs on neural stem cells in vitro derived from embryonic rat brain.</p><p><b>METHODS</b>Neural stem cells derived from E12-14 rat brain were isolated, cultured, and expanded for 7 days until neural stem cell aggregations and neurospheres were generated. The neurospheres were cultured under the condition of different concentration of VAPs followed by immunocytochemistry to detect the differentiation of neural stem cells.</p><p><b>RESULTS</b>VAPs could remarkably promote differentiation of neural stem cells and most neural stem cells were induced to differentiate towards the direction of neurons under certain concentration of VAPs.</p><p><b>CONCLUSION</b>Neural stem cells can be successfully induced into neurons by VAPs in vitro, which could provide a basis for regeneration of the nervous system.</p>
Assuntos
Animais , Ratos , Chifres de Veado , Química , Encéfalo , Embriologia , Diferenciação Celular , Células Cultivadas , Relação Dose-Resposta a Droga , Proteína Glial Fibrilar Ácida , Imuno-Histoquímica , Fatores de Crescimento Neural , Farmacologia , Neurônios , Biologia Celular , Peptídeos , Farmacologia , Ratos Wistar , Células-Tronco , Biologia CelularRESUMO
Objective To measure Ihe effect on rats spinal neuron flow according nerve roots repair time.Methods We adopted the experimental rats on the root avulsion and extravertebral foramen nerve root divison of C_(5~7).We divided them into four groupsin each which there were 16 ratsaccording the type of nerves root injury and repair timeGroup AC:the avulsed roots were reimplanted into the spinal cord and the transeeted roots were sutured to the proximal stump immediately.Group B,Dthe avulsed roots and the transected roots were reimplanted into the spinal cord or were sutured to the proximal stump in delayed 3 weeks each with 16 rats.At the different time point(3 weeks3 months6 months)through pathological examina- tion and immunohistological lechniques and nerve tracing techniqueswe examined the spinal cord and distal nerve trunk in order to observe the pathologic changes and axonal regeneration.Results Group A、C were much better than group B、D in the numberthe conformation and the degree of abatement of spinal motoneu- rons and nissl body.It is the same on the number and the development level of regenerating nerve fiber. Conclusion It had the advantage of neuronal protection and nerve regeneration that reparing the injured nerve roots earlv after nerve roots injury.