Abstract:
:The spinal cord cannot heal after severance because the central nervous system is "non-permissive" to the advancement of axons that regrow from presynaptic motoneurons. With the aim of overcoming paraplegia, the author has carried out extensive experimental research since 1980, first in rats and subsequently in monkeys, severing the cord and connecting its cephalad stump with the muscular nerve branches by means of peripheral-nerve grafts, and using various surgical protocols. Functional connections were established, ascertained by physical, electrophysiologic, and histologic examinations. In this reported study, it is demonstrated that presynaptic motoneurons are also able to reconstruct the cytoskeleton of peripheral neurons, as well as motor end-plates. The possibility of elongation of the axons of presynaptic motoneurons into the peripheral nerve up to the muscle had not previously even been hypotheized. This possibility, which has now been validated, can open the door to new surgical techniques for spinal-cord lesions. In addition, the author presents preliminary results from a single human case, utilizing the surgical procedures of the preceding animal experiments.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Brunelli GAdoi
10.1055/s-2001-18873subject
Has Abstractpub_date
2001-11-01 00:00:00pages
631-6issue
8eissn
0743-684Xissn
1098-8947journal_volume
17pub_type
杂志文章abstract::Background Topical vasodilators are frequently used during free tissue transfer to prevent and treat vasospasm and microvascular thrombosis. A variety of agents have been studied and are available, yet most microsurgeons select an agent based on anecdotal evidence or personal training. Our aim was to review the litera...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1592191
更新日期:2017-01-01 00:00:00
abstract::This is the first in a series of studies designed to investigate the simultaneous changes in blood flow and microcirculation in an island flap during ischemia, in an ischemia-reperfusion model in the rabbit. An island groin flap based on the inferior epigastric vessels was harvested in 17 rabbits. The flap was rendere...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006414
更新日期:1997-07-01 00:00:00
abstract::The authors present 20 microvascular flaps based on arteriovenous perfusion, harvested from the distal anterior forearm, and configured in three different designs. Indications were small palmar, dorsal, and commissural defects, when other conventional procedures were not available; problematic cases of open reduction ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000235
更新日期:1997-05-01 00:00:00
abstract::A case of degloving injury of the whole hand reconstructed by a combination of an anterolateral thigh (ALT) flap and a groin flap applied as a pedicled distant flap was reported. Despite complications of congestion of the ALT flap and superficial infection, both flaps were severed at 4 weeks after transplantation, and...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1278708
更新日期:2011-06-01 00:00:00
abstract::In microsurgical arterial anastomoses, there are some occasions in which the diameter of the distal artery is much larger than that of the proximal one. A fish-mouth incision technique is useful when there is considerable size discrepancy. However, this method cannot be used when the distal artery is much larger than ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006576
更新日期:1994-03-01 00:00:00
abstract::The ascending branch of the lateral circumflex artery may be of potential value as an alternative recipient vessel in the free-flap transfer to hip region. The anatomy of the ascending branch of the lateral circumflex femoral vessels has been reviewed with regards to size, location, and length and on the basis of prev...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1249321
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND: The distinction between supraclavicular and infraclavicular acute brachial plexus injuries (BPIs) could be challenging in cases of combined shoulder and elbow paresis. The reliability of several preoperative predictors was investigated to avoid unnecessary dissection, prolonged operation time, increased pos...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1702177
更新日期:2020-07-01 00:00:00
abstract::Four methods of nerve terminolateral neurorrhaphy (TLN) were studied in rat experimental model. In Group A, the distal end of a severed peroneal nerve was sutured end-to-side with an intact tibial nerve trunk, without removal of the tibial epineurium at the suture site. In Group B, the distal end of a severed peroneal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1063938
更新日期:1997-01-01 00:00:00
abstract::The time course of revascularization of grafted nerves, and the possible dependence of this revascularization on the length of the graft are two related questions that are addressed. Survival of Schwann cells in the nerve graft and a timely revascularization must be seen as a precondition for an optimal regeneration p...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006938
更新日期:1988-07-01 00:00:00
abstract::As reimbursement for free-tissue transfer decreases, the authors find an increase in the number of free flaps performed at their county facility. Over 60 percent of the free flaps performed during the past 10 years were completed within the last 4 years. This influx of patients prompted a review of their experience wi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-16357
更新日期:2001-08-01 00:00:00
abstract::An expanded latissimus dorsi flap (expanded LD flap) was transferred in two patients with severe post-burn neck contracture. Free flaps created using standard techniques are of limited size and sometimes cannot cover the defect after excision of scar tissue, particularly when a severe burn scar extends to the facial r...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-33018
更新日期:2002-07-01 00:00:00
abstract::The subject of ischemia-reperfusion has commonly been studied in rat hindlimb models. Unfortunately, in these experiments, the ischemia procedures lack standardization. For this reason, the authors evaluated the reliability of rat ischemia models described in the literature using scintigraphy. The study comprised six ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-830005
更新日期:2004-07-01 00:00:00
abstract::Experiments in rats, introducing the proximal and distal stumps of tibial and sural nerves into a vein graft, showed by acetylcholinesterase and toluidine blue staining that sensory and motor fibers mix inside the vein graft, but that nevertheless they are able to select their distal targets correctly. The authors' hy...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006969
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND: During reconstructive surgery, anterolateral thigh (ALT) flap harvest is challenging due to variation and uncertainty in perforator distribution. We performed a pilot study to identify the predictive value of catheter-based computed tomography angiography (C-CTA) and traditional CTA (T-CTA) in ALT perforato...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1672129
更新日期:2019-03-01 00:00:00
abstract::Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to ident...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1693142
更新日期:2019-11-01 00:00:00
abstract::Free flaps are usually needed for the reconstruction of extensive facial burns, but the final result is often a poor texture and color match. The authors report a burn case managed with a radial forearm free flap. The aesthetic result was improved by surgical tattooing of the flap, including the appearance of a beard....
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006739
更新日期:1993-09-01 00:00:00
abstract::From August 1996 to June 2000, 33 free thoracoumbilical flaps were transferred to reconstruct a variety of soft-tissue defects. The size of the flaps ranged from 10 to 40 cm in length and 8 to 25 cm in width. The blood supply to the skin island came from the largest periumbilical perforator of the deep inferior epigas...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-820768
更新日期:2004-02-01 00:00:00
abstract::Vascularized bone allografts (VBAs) could be useful adjuncts to the clinical reconstructive surgeon's arsenal. These grafts are known experimentally to be subject to host rejection. One way to control the rejection problem would be to develop specific immune unresponsiveness via host conditioning. Using a proven relia...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006992
更新日期:1987-04-01 00:00:00
abstract::An "off the shelf" vascular conduit for free flap surgery that remained patent until the flap is vascularized from the recipient bed would be useful to avoid autograft donor-site morbidity and reduce operation time. To date, no successful studies of microvascular prostheses in low-flow states exist. This study investi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-985210
更新日期:2007-08-01 00:00:00
abstract::The authors' experiences with 34 free lower TRAM flap transfers, in which 19 primary reconstructions and 15 secondary reconstructions were successfully achieved, are reviewed. The free TRAM flap yielded better results than the pedicled TRAM flap in cases where reconstruction of the infraclavicular and anterior axillar...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006676
更新日期:1992-01-01 00:00:00
abstract::The ideal monitoring tool to evaluate free flap success should be noninvasive, continuous, and reliable. A new device, the ViOptix Tissue Oximeter (ODISsey) based on near-infrared spectroscopy was evaluated in 30 patients undergoing autologous tissue perforator free flap breast reconstruction with continuous monitorin...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-974655
更新日期:2007-05-01 00:00:00
abstract::Sixteen rats underwent two procedures to test the efficacy of oblique vs. transverse nerve repair. On the left, the peroneal nerve was transected at an oblique angle (30-degree) with subsequent oblique end-to-end repair performed. On the right, the peroneal nerve was transected at a transverse angle (90-degree) with s...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-36503
更新日期:2002-11-01 00:00:00
abstract::Achilles-tendon repair wounds are prone to breakdowns and secondary infections, compromising the integrity of the repair and the ultimate function of the repaired tendon. Unlike defects resulting from tumor excision, burns, or trauma, Achilles-tendon repair wounds have their own special considerations. The dissection ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-8389
更新日期:2000-10-01 00:00:00
abstract::In both vascular and microvascular surgery, there is a need for a non-thrombogenic, small-caliber, arterial substitute. Clinically, most vessel substitutes with diameters under 4 mm have low patency rates. An arterial conduit made from a biocompatible human acellular dermis may be useful as a small vessel conduit. The...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006491
更新日期:1996-07-01 00:00:00
abstract::Among arterial anatomic conditions which will adversely affect the harvest of the fibula are 1) significant arteriosclerotic disease within the tibial-peroneal vessels; 2) peroneal arteria magna (PAM), a condition in which only the peroneal artery supplies the foot; and 3) absence of the peroneal artery, either congen...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006596
更新日期:1994-09-01 00:00:00
abstract::Severe contracture of the palm causes great difficulty in the performance of the tasks required in daily life. Resurfacing with skin grafts may be sufficient for treating mild and small contractures; but severe and extensive contractures involving the joints, tendons, and neurovascular bundles should be covered with t...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-836124
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The anterolateral thigh (ALT) flap has been widely used in reconstruction of soft tissue defects. The anatomic variations of perforators increase the difficulties of flap elevation. The ABC system has been described for locating the most common three perforators in Western populations. Less evidence has been...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1343496
更新日期:2013-06-01 00:00:00
abstract::Two patients with scleroderma, ischemic pain, non-healing digital ulceration, and digital arterial obstruction were successfully treated with peripheral sympathectomy and digital arterial reconstruction using a reversed small-caliber vein graft. Postoperatively, digital blood flow increased and ulceration healed in bo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-30181
更新日期:2002-05-01 00:00:00
abstract::Composite tissue allograft (CTA) transplantation, such as the clinical face and hand transplants, has now been performed in multiple centers across the world. The transplants have successfully treated complex injuries that have either failed conventional approaches or where autologous reconstruction could not restore ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1285988
更新日期:2012-01-01 00:00:00
abstract::Periosteum's role in fracture healing is widely recognized, and its function in bone tissue engineering shows great potential. Here we introduce a novel periosteal free flap to be used as an abundant source of periosteum in the engineering and repair of bone. The descending branch of the lateral femoral circumflex ves...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1249317
更新日期:2010-07-01 00:00:00