scholarly journals Peripheral Nerve Transplantation: The Effects of Predegenerated Grafts and Immunosuppression

1992 ◽  
Vol 3 (1) ◽  
pp. 39-49 ◽  
Author(s):  
Thomas E. Trumble
Keyword(s):  
Cyclosporin A ◽  
Donor Site ◽  
Flexion Contracture ◽  
Brown Norway ◽  
Control Group ◽  
Neurologic Recovery ◽  
Nerve Grafts ◽  
Nerve Transplantation ◽  
Joint Flexion ◽  
Tissue Rejection

Research involving nerve transplantation has shown that tissue rejection limits the neurologic recovery unless the host is immunosuppressed. This study investigates an alternative to permanent or temporary immunosuppression using a rat model with nerve transplants from Brown- Norway rat donors to bridge defects in the sciatic nerve of Lewis rat recipients as these two inbred strains differ at both major and minor histocompatibility loci.The specific aim of this study was to evaluate if predegenerated nerve grafts decreased the tissue rejection and improved the neurologic recovery of animals with allogenic nerve grafts to avoid the problems associated with either short- or long-term immunosuppression. The animals in the experimental groups received cyclosporin-A, predegencrated grafts, both, or neither. The predegenerated grafts were produced by division of the nerve three weeks prior to grafting to allow for Wallerian degeneration to occur. The outcome was assessed by measurements stressing functional recovery (sensory testing, gait analysis, joint flexion contracture), studies of muscle recovery (muscle weight and hydroxyproline concentration), and histologic studies (axonal counts and inflammatory reaction). The animals receiving the predegenerated grafts without cyclosporin did have an improved recovery (joint flexion contracture 35° ± 8 ° and hydroxyproline ratio 1.52 ± 0.16) as compared to the joint flexion contractures and hydroxyproline ratios of the allograft group of animals without either cyclosporin- A or pretreatment and the ungrafted control group (47° ± 18°, 1.68 ± 0.34, and 53° ±15° ,4.50 ± 0.27, respectively, p < 0.01). However, all the isograft groups and allograft groups with cyclosporin-A, regardless of whether the graft had been predegenerated or not, had greater neurologic recovery than the allograft group with predegenerated grafts but without cyclosporin-A by the same parameters (p < 0.01). Allograft groups with short-term immunosuppression with cyclosporin-A did as well as isograft groups, and isograft groups with predegenerated grafts did not do any better than isografts without pretreatment (p <0.01).Clinical Relevance:Predegenerated nerve allografts will allow for greater neurologic recovery than standard nerve allografts avoiding the complications of immunosuppression, but the level of recovery is less than that of recipients of nerve allografts with immunosuppression. Nerve transplants would avoid the problems of neurologic deficits at the donor site and allow multiple large deficits to be treated easily.

Prolonging Nerve Grafts Using Chemical Extracted Muscle-in-vein with Vein Window Method Chemical acellular nerve grafts

2018 ◽  
Vol 68 (12) ◽  
pp. 2936-2940
Author(s):  
Irina Mihaela Jemnoschi Hreniuc ◽  
Camelia Tamas ◽  
Sorin Aurelian Pasca ◽  
Bogdan Ciuntu ◽  
Roxana Ciuntu ◽  
...  
Keyword(s):  
Classical Group ◽  
Donor Site ◽  
Good Alternative ◽  
Nerve Graft ◽  
Male Rats ◽  
Chemical Extraction ◽  
Nerve Grafting ◽  
Nerve Grafts ◽  
Local Resources ◽  
Window Method

Nerve injuries are a common pathology in hand trauma. The consequences are drastic both for patients and doctors/medical system. In many cases direct coaptation is impossible. A nerve graft should be used in the case of a neuroma, trauma or tumor, for restoration of nervous influx. The aim of this study is demonstrate that by grafting restant nerve stumps with muscle-in-vein nerve grafts we obtain good result in terms of functional and sensibility recovery and also our method �window-vein� is a good way of prolonging nerve grafts. The method of study is experimental. We worked in the laboratory in optimal conditions for carrying out of muscles-in-vein nerve grafts (nerve grafts size 1.5 cm-3 cm). We used acellular muscle grafts with the chemical extraction method.The study was conducted on experimental animals (Wistar male rats).We used 30 experience animals in 3 equal groups (classical group and muscle-in-vein nerve grafts-2 nerve grafts of 1,5 cm central sutured and the third group with muscle-in-vein nerve grafts, window-vein method, 3 cm). At 4 and respectively 6 weeks postoperative at the quality tests we observed the progress with the footprint test. The operated hind in comparison with the healthy hind was 86% recovered and similar with classic nerve grafts. Quantitatively the number of regenerated axons in the group with muscle-in-vein nerve grafts was significant bigger in comparison with the classical group (15%).The method using muscle-in-vein nerve graft with windows-vein it�s a good alternative for nerve grafting in comparison with classical nerve grafting. When the local possibilities are limited, this method is good for prolonging the grafts. The relationship between cost and benefit in this case it�s an advantage because we use the local resources of the affected area. The motor results of nerve grafting ingroup 2 in comparison with group 3 were similar and in some cases better in group 1. Grafting with MVNG offers a better alternative for donor site regeneration in comparison with classical nerve grafts. This method is useful to prolong nerve grafts without adding morbidity.

Segmental Defects in Peripheral Nerves Xenotransplantation

2018 ◽  
Vol 2 (5) ◽  
pp. 01-02
Author(s):  
Ryan William
Keyword(s):  
Graft Rejection ◽  
Peripheral Nerves ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Clinical Use ◽  
Nerve Grafts ◽  
Surgery Research ◽  
The Ideal

Segmental defects in peripheral nerves that cannot be sutured directly require the use of nerve grafts. The ideal option for repair is nerve auto grafting, but there are some obvious disadvantages related to its use, such as lack of availability and donor site morbidity. The next step to consider for reconstruction is the use of nerve allografts, but they are also limited for clinical use, and they present with the added problem of graft rejection. Considering these limitations to the use of nerve autografts and allografts, clinical surgery research has turned to nerve xenotransplantation, which offers a potentially unlimited source of donor nerves.

Effects of erdosteine on cyclosporin-A-induced nephrotoxicity

2011 ◽  
Vol 31 (6) ◽  
pp. 565-573 ◽  
Author(s):  
M Tutanc ◽  
V Arica ◽  
N Yılmaz ◽  
A Nacar ◽  
I Zararsiz ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cyclosporin A ◽  
Protective Role ◽  
Control Group ◽  
Albino Rats ◽  
Protective Mechanism ◽  
Antioxidant Parameters ◽  
Group 2 ◽  
Wistar Albino Rats

Aim: In cyclosporin-A (CsA)-induced toxicity, oxidative stress has been implicated as a potential responsible mechanism. Therefore, we aimed to investigate the protective role of erdosteine against CsA-induced nephrotoxicity in terms of tissue oxidant/antioxidant parameters and light microscopy in rats. Materials and methods: Wistar albino rats were randomly separated into four groups. Group 1 rats treated with sodium chloride served as the control, group 2 rats were treated with CsA, group 3 with CsA plus erdosteine, and group 4 with erdosteine alone. Animals were killed and blood samples were analyzed for blood urea nitrogen (BUN), serum creatinine (Cr), uric acid (UA), total protein (TP), and albumin (ALB) levels. Kidney sections were analyzed for malondialdehyde (MDA) and nitric oxide (NO) levels and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities, as well as for histopathological changes. Results: In the CsA group, MDA, GSH-Px, BUN, and Cr levels were increased. The TP and ALB levels were decreased. These changes had been improved by erdosteine administration. Other biochemical parameters did not show any significant change. Conclusion: These results indicate that erdosteine produces a protective mechanism against CsA-induced nephrotoxicity and suggest a role of oxidative stress in pathogenesis.

scholarly journals Cografts of artificial dermis matrix and autogenetic split-thickness of repaired skin in severe hand wounds in patients with deep burns

2014 ◽  
Vol 66 (1) ◽  
pp. 173-178
Author(s):  
Hongqi Liu ◽  
Yan Li ◽  
Deqian Sha
Keyword(s):  
Wound Healing ◽  
Hand Function ◽  
Donor Site ◽  
Test Group ◽  
Healing Time ◽  
Whole Body ◽  
Control Group ◽  
Large Area ◽  
Artificial Dermis ◽  
Thickness Skin

The aim of this paper was to evaluate the effect of using artificial dermis matrix plus autologous split-thickness skin (ADM and ASTS) in the treatment of deep-burns in hands of severely burned patients?We recruited a total of 58 patients with large area burns greater than 80% that were eschar-excised. Twenty-eight of them were treated with ADM and ASTS (test group); 30 were treated with autologous medium-thickness skin (AMTS) (control group). The healing time of the hand wound was noted, clinical and photographic evaluations were performed, and a Jebsen-Taylor hand function test was compared and analyzed in the two groups. The wound healing time in the test group (24.22?3.34 days) were longer than that of the control group (13.42?3.36 days) and statistically significant. The healing time of skin graft donor sites was shorter than that of the control group (7.14?1.63 vs. 14.28?2.37 days) and statistically significant (P<0.05). The 3rd and 6th month follow-up with clinical and functional evaluations revealed no differences between the two groups. In addition, there was no obvious scar formation and less pigmentation in either group. The repair of deeply burned hands with artificial dermis matrix was beneficial to both wound healing and the donor site, and was beneficial to the whole body rehabilitation of severely burned patients.

scholarly journals THE EARLY CELLULAR REACTION OF EYE TISSUES TO THE IMPLANTATION OF BIORESORBABLE DRAINAGES SATURATED BY IMMUNOSUPPRESSANTS WITH A SELECTIVE MECHANISM OF ACTION

2020 ◽  
Vol 28 (3) ◽  
pp. 15-20
Author(s):  
Viktoria N. Germanova ◽  
Natal'ya N. Sarbaeva ◽  
Elena V. Karlova ◽  
Larisa T. Volova ◽  
Irina F. Nefyodova ◽  
...  
Keyword(s):  
Cyclosporin A ◽  
Mechanism Of Action ◽  
Cellular Response ◽  
Collagen Synthesis ◽  
Mononuclear Cells ◽  
Early Postoperative Period ◽  
Lower Amount ◽  
Control Group ◽  
Eye Tissues ◽  
Selective Mechanism

Prolonged use of immunosuppressants with a selective mechanism of action is a promising strategy in the prevention of postoperative scarring in glaucoma surgery. In order to assess the cellular response of eye tissues to the implantation of bioresorbable drains saturated with cyclosporin A or everolimus, a filter-type hypotensive operation with implantation of polylactide-based drains was simulated in 12 rabbits. Drainages implanted in rabbits of the two experimental groups under study were pre-saturated with either cyclosporin A or everolimus. The control group consisted of animals that were implanted with drains not saturated with any drugs. On the 7th day after the operation, the animals were taken out of the experiment, the eyeballs were enucleated, and histological preparations stained with hematoxylin and eosin, as well as hematoxylin and Picrosirius-red were prepared. Using a score on a scale from 0 to 5, the cellular composition within the drainage material, the intensity of collagen synthesis in the drainage, the thickness of the capsule around the drainage, and the number of blood vessels were analyzed. In comparison with the control group, the study groups showed a significantly lower amount of mononuclear cells, fibroblasts and giant cells of foreign bodies, as well as a lower thickness of the capsules surrounding the drainage, up to their complete absence. In addition, the intensity of collagen synthesis inside the drainage material of the studied groups was significantly lower. The drains of the everolimus group were characterized by an extremely low density of viable cellular elements inside the implanted material and a complete absence of collagen. At the same time, no toxic effect of the substance on the surrounding tissues was found. Thus, the saturation of bioresorbable drainages based on polylactide with cyclosporin A and everolimus contributed to a decrease in the intensity of the formation of connective tissue elements both inside and around the drainage in the early postoperative period.

Cleland’s ligaments and Dupuytren’s disease

2013 ◽  
Vol 39 (5) ◽  
pp. 477-481 ◽  
Author(s):  
D. J. Shewring ◽  
U. Rethnam
Keyword(s):  
Histological Analysis ◽  
Residual Disease ◽  
Flexion Contracture ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Histological Findings ◽  
Dupuytren's Disease ◽  
Pip Joint ◽  
Joint Flexion ◽  
Neurovascular Bundles

The aim of this study was to investigate whether Cleland’s ligaments are affected by Dupuytren’s disease and assess their contribution to the flexion contracture of the proximal interphalangeal (PIP) joint. Twenty patients with Dupuytren’s disease undergoing fasciectomy for a PIP joint contracture > 40° (mean 61°, range 45°–100°) were included. After excision of all other identifiable digital disease, Cleland’s ligaments were assessed. If they appeared to be macroscopically affected by Dupuytren’s disease they were excised, sent for histological analysis, and any further improvement of PIP joint contracture was recorded. There were 14 males and six females with a mean age of 62 (range 40–79) years. Excision of Cleland’s ligaments resulted in a mean further correction of 7° (range 0°–15°). Histological analysis indicated that Cleland’s ligament was clearly involved with Dupuytren’s disease in 12 patients, indicating that Cleland’s ligaments can be affected by Dupuytren’s disease. In the remaining specimens the histological findings were equivocal. As these structures are situated dorsal to the neurovascular bundles, a specific dissection has to be undertaken to identify them. Excision of Cleland’s ligaments at digital fasciectomy further avoids leaving residual disease and may yield a worthwhile further correction of PIP joint flexion contracture.

Free Flaps in the Reconstruction of Hand and Distal Forearm Injuries

1992 ◽  
Vol 17 (2) ◽  
pp. 185-188 ◽  
Author(s):  
A. REIGSTAD ◽  
K. R. HETLAND ◽  
K. BYE ◽  
M. RØKKUM
Keyword(s):  
Donor Site ◽  
Hand Surgery ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Medium Size ◽  
Nerve Grafts ◽  
Partial Necrosis ◽  
Tendon Grafts ◽  
Large Skin ◽  
Forearm Injuries

We report a series of 32 free flap reconstructions following acute hand and forearm trauma. The series consists of two dorsalis pedis flaps, four scapular flaps and 26 lateral arm flaps. One flap became infected and failed completely, and a partial necrosis occurred in another flap. The transfers covered large skin defects, exposed tendons, tendon grafts, bone, bone grafts, joints, nerves and nerve grafts. The donor site morbidity was negligible. Our study shows that free microvascular flaps are a safe and convenient alternative to conventional flaps in hand surgery. The lateral arm flap seems very suitable for small and medium size defects.

Failure of FK-506, a new immunosuppressant, to prevent cerebral vasospasm in a canine two-hemorrhage model

1993 ◽  
Vol 79 (5) ◽  
pp. 710-715 ◽  
Author(s):  
Kazuya Nagata ◽  
Tomio Sasaki ◽  
Junichi Iwama ◽  
Takashi Mori ◽  
Shoko Iwamoto ◽  
...  
Keyword(s):  
Cyclosporin A ◽  
Cerebral Vasospasm ◽  
Basilar Artery ◽  
Interleukin 1 ◽  
Interleukin 2 ◽  
Muscle Layer ◽  
Treated Group ◽  
Control Group ◽  
Fk 506 ◽  
Content Type

✓ In order to clarify the possible role of immunological reaction in the pathogenesis of cerebral vasospasm, the authors examined the prophylactic effect of the immunosuppressant agents FK-506 and cyclosporin A on chronic vasospasm in a canine two-hemorrhage model. While a mean constriction of the basilar artery to 81.0% ± 4.0% (± standard error of the mean) occurred on Day 2 and to 63.8% ± 3.5% on Day 7 in the untreated group, constriction to 77.9% ± 3.4% on Day 2 and 62.8% ± 3.0% on Day 7 was demonstrated in the FK-506-treated group (difference not significant). This tendency was also noted in the cyclosporin A-treated group, with basilar artery constriction to 81.8% ± 3.7% and 56.3% ± 2.7%, respectively (difference not significant). The histological changes of the basilar artery, including corrugation of the elastic lamina, detachment of endothelial cells, and vacuolar formation in the smooth-muscle layer were not different in the two treated groups and the one control group. Since these immunosuppressant agents are known to inhibit the release of interleukin-2 (IL-2), the level of IL-2 was examined in the cerebrospinal fluid of patients with cerebral vasospasm. While interleukin-1 gradually increased in level as time passed, the level of IL-2 was consistently low during the course of the study, indicating less participation of IL-2 in the pathogenesis of cerebral vasospasm. This clinical observation matched the experimental results. The authors conclude that cell-mediated immunoreaction, initiated mainly by IL-2, plays little role in the pathogenesis of cerebral vasospasm.

Increased apical targeting of renal ENaC subunits and decreased expression of 11βHSD2 in HgCl2-induced nephrotic syndrome in rats

2006 ◽  
Vol 290 (3) ◽  
pp. F674-F687 ◽  
Author(s):  
Soo Wan Kim ◽  
Sophie de Seigneux ◽  
Martin C. Sassen ◽  
JongUn Lee ◽  
Jin Kim ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Sodium Excretion ◽  
Collecting Duct ◽  
Urinary Sodium Excretion ◽  
Brown Norway ◽  
Apical Plasma Membrane ◽  
Control Group ◽  
Sodium Retention ◽  
Outer Medulla ◽  
Outer Stripe

Nephrotic syndrome is often accompanied by sodium retention and generalized edema. We hypothesize that dysregulation of the epithelial sodium channel (ENaC) and/or of sodium (co)transporters may be responsible for the increased sodium retention associated with HgCl2-induced nephropathy. In addition, we examined the hypothesis that the expression of type 2 11β-hydroxysteroid dehydrogenase (11βHSD2) is reduced, contributing to the enhanced mineralocorticoid activity. Membranous nephropathy was induced in Brown Norway rats by repeated injections of HgCl2 (1 mg/kg sc), whereas the control group received only vehicle. After 13 days of treatment, the abundance of ENaC subunits, sodium (co)transporters, and 11βHSD2 in the kidney was examined by immunoblotting and immunohistochemistry. HgCl2 treatment induced marked proteinuria, hypoalbuminemia, decreased urinary sodium excretion, and ascites. The protein abundance of α-ENaC was increased in the cortex/outer stripe of outer medulla (OSOM) and inner stripe of the outer medulla (ISOM). The protein abundances of β-ENaC and γ-ENaC were decreased in the cortex/OSOM while increased in the ISOM. Immunoperoxidase microscopy demonstrated increased targeting of ENaC subunits to the apical plasma membrane in the distal convoluted tubule, connecting tubule, and cortical and medullary collecting duct segments. Moreover, 11βHSD2 abundance was decreased in cortex/OSOM and ISOM. The protein abundances of type 3 Na/H exchanger (NHE3), Na-K-2Cl cotransporter (NKCC2), and thiazide-sensitive Na-Cl cotransporter (NCC) were decreased. Moreover, the abundance of the α-1 subunit of the Na-K-ATPase was decreased in the cortex/OSOM and ISOM but remained unchanged in the inner medulla. These results suggest that increased apical targeting of ENaC subunits combined with diminished abundance of 11βHSD2 may contribute to sodium retention associated with HgCl2-induced nephrotic syndrome. The decreased abundance of NHE3, NKCC2, NCC, and Na-K-ATPase may play a compensatory role in promoting sodium excretion.

Sign in / Sign up

Export Citation Format

Share Document