Impact of Vascularization Type on Peripheral Nerve Microstructure

WOS: 000265871700005PubMed: 19085817Experimental and clinical studies have demonstrated that vascularized nerve grafts are superior to nonvascularized nerve grafts with respect to healing. By means of the inherent vascularity in vascularized nerve grafts, Schwann cells remain viable, and endoneurial necrosis and fibrosis are not seen. In this study the effects of three different vascularization patterns oil the vascular microstructure of a nerve segment in the rat based on the femoral artery and vein was investigated. Sixty adult male Wistar Albino rats were divided into five groups. In each group, a 1.5-cm segment of femoral nerve was transected at two sides, without disturbing the unity of the contents of the femoral sheath. The experimental design consisted of prefabricated venous nerve segment, venous nerve segment, arterial nerve segment, no blood flow, and controls groups. To assess the microstructure of the nerve segment, myelin and Schwann cell morphology and fibrosis were examined. There were many Schwann cells with near normal morphology in the venous nerve segment and arterial nerve segment groups. In conclusion, the venous nerve segment model in which Schwann cell viability was high due to the presence of sufficient and uninterrupted blood supply to the nerve graft, resulting in successful nerve healing, showed superior results over others

Reconstruction of mandibular defects using autografts combined with demineralized bone matrix and cancellous allograft

WOS: 000243853800018PubMed: 17251844Facial bone defects can be managed by a variety of means, such as inlay or onlay applied nonvascularized bone grafts, local pedicled/distal free osteocutaneous/osseous flaps or distraction osteogenesis. Although each method has its own advantages and drawbacks, the indications of using these methods may overlap in certain clinical situations. The use of nonvascularized bone grafts, conceptually and technically simple method, relies on creeping substitution of applied graft with regenerating new bone. However, using vascularized osteocutaneous free flaps provide not only plenty of bony tissue for reconstruction, but also soft tissue coverage over the reconstructed bony segment. Furthermore, bone healing in vascularized osteocutaneous free flaps resembles as the physiologic fracture healing. In selected cases with enough soft tissue coverage over the defective bony segment, on the other hand, using larger nonvascularized bone grafts with osteoinductive growth factors may decrease the risk of graft failure while avoiding the drawbacks of the free tissue transfer. Here we present our results of three cases with facial bone defects, to which nonvascularized iliac bone grafts and demineralized bone matrix with cancellous allograft (Orthoblast II (TM)) as a source of BMP were used together for mandibular reconstruction

Reconstruction of Coup de Sabre Deformity (Linear Localized Scleroderma) by Using Galeal Frontalis Muscle Flap and Demineralized Bone Matrix Combination

WOS: 000286195600060PubMed: 21233742In this clinical report, we are presenting the combination of demineralized bone matrix combined with bilateral galea frontalis flaps. Based on our 6-month results, this seems to be a reasonable combination to accomplish long-lasting restoration of forehead defects related to en coup de sabre linear localized scleroderma

Results of botilinum toxin: An application to blepharospasm in Schwartz-Jampel syndrome

WOS: 000239535700008PubMed: 16877909Schwartz-Jampel syndrome (SJS) is a rare congenital disorder of continuous myotonia, causing visual and eyelid problems such as blepharospasm, acquired ptosis, and blepharophimosis. We report the management of blepharospasm in two sisters with Schwartz-Jampel syndrome with application of botilinum toxin type A (BTX-A), as an alternative to the surgical treatments, such as orbicularis oculi myectomy, levator aponeurosis resection, and lateral canthopexy as described in the literature. Three consequent doses of commercially available BTX-A (Botox(R)-Allergan, Inc. 100 u/via) were injected to orbicularis oculi muscle in two sisters with Schwartz-Jampel syndrome. At the least, the authors waited for a six-month interval to prevent development of sensitivity to BTX-A in patients. No significant improvement was observed after the injection of first dose of BTX-A, with the total dose of 25 units of BTX-A to each orbicularis oculi muscle of the eyes. The muscle tone weakened after the second dose, which was the twice as such of the first applied total dose (50 units of BTX-A to each orbicularis oculi muscle of the eyes) and significant functional and cosmetic improvements were achieved after injection of the third dose, in which the total applied dose was the same as the one applied in second dose. The blepharospasm and eyelid alterations caused by Schwartz-Jampel syndrome should be treated to provide functional and cosmetic improvements. Application of BTX-A to orbicularis oculi muscle for the treatment of blepharospasm could be considered as an alternative to levator resection, and lateral canthopexy in Schwartz-Jampel syndrome

Repeated tissue expansions on solit-thickness skin graft in a patient with neurocutaneous syndrome

WOS: 000246986300040PubMed: 17538342Soft tissue expansion is a mechanical process that increases the surface area of local tissue available for reconstructive procedures. In most cases, adjacent tissue that matches the recipient site in color, texture, and hair-bearing quality is preferred for tissue expansion. In this particular case with neurocutaneous syndrome, the defects that resulted from removal of parts of a giant hairy nevus overlying the latissimus dorsi muscle bilaterally were grafted with a split-thickness skin graft. Two expanders were then placed under the latissimus dorsi muscles. After full expansion of the grafted area, some part of the remaining nevus surrounding the grafted area was removed and the defects were covered with the expanded skin graft obtained after deflation of the expanders. The expanders placed under the latissimus dorsi muscle in the first operation were reused in the second operation to obtain a second expansion of the skin graft. After the second expansion of the skin graft, the expanders were deflated and another portion of the remaining nevus surrounding the grafted area was removed. The resulting defects were again covered with the excess expanded skin graft. Although repeated expansion of the skin graft is a time-consuming and laborious process, it eliminates the need for taking repeated skin grafts; it decreases skin graft donor site morbidity; it decreases possible infectious complications of tissue expansion by decreasing the number of surgical interventions to the expander pocket; and it increases the aesthetic outcome by keeping all the surgical scars around the grafted Area without extending them into healthy surrounding skin

Silk Sericin and Potential Application Areas

İpek, fibroin (lifli protein) ve serisin (globüler, zamklama proteini) olarak isimlendirilen iki ana proteinden oluşmaktadır. Fibroin tekstil üretiminde ve çeşitli biyomalzeme uygulamalarında kullanılırken, serisin tekstil endüstrisinde bir atık malzeme olarak kabul edilmektedir. Serisin, belirsiz bir yapıya sahip çok bileşenli bir protein olması nedeniyle, fibroinden daha az dikkat çekmiştir, ancak bu proteinin de biyolojik aktiviteye sahip olduğu ve biyouyumlu olduğu yapılan çalışmalarla gösterilmiştir. Serisin değişken amino asit bileşimi ve çeşitli fonksiyonel grupları ile biyomedikal uygulamalar için ilgi çekici biyoaktif özelliklere sahiptir. Antioksidan karakteri, nemlendirme yeteneği ve memeli hücreleri üzerindeki mitojenik etkisi nedeniyle, serisinin hücre kültürü ve doku mühendisliğinde yararlı olduğu son yıllarda yapılan çalışmalarla gösterilmiştir. Ayrıca, keratinositler ve fibroblastlar üzerindeki olumlu etkileri, başta yara bakım malzemeleri olmak üzere deri dokusu onarımı için serisin bazlı biyomalzemelerin gelişmesine yol açmıştır. Ek olarak, serisin, kemik benzeri hidroksiapatit nükleasyonunu indükleme kabiliyeti nedeniyle kemik doku mühendisliği için kullanılma potansiyeline de sahip olduğu gösterilmiştir. Filmler, süngerler ve hidrojeller gibi kararlı ipek serisin biyomalzemeleri, çapraz bağlama veya diğer polimerler ile karıştırılarak hazırlanmaktadır. Serisin aynı zamanda ilaç salımı için de kullanılma potansiyeline sahiptir, çünkü kimyasal reaktivitesi ve pH yanıtı, serisin bazlı nano-mikropartiküllerin, hidrojellerin ve konjuge moleküllerin üretimini kolaylaştırmakta ve ilaçların biyoaktivitesini arttırmaktadır. Bu çalışmada, önemli bir protein olan ipek serisinin özellikleri ve kullanım alanları özetlenmiştir.Silk consists of two main proteins called fibroin (fibrous protein) and sericin (globular, glued protein). While fibroin is used in textile production and various biomaterial applications, sericin is considered as a waste material in the textile industry. Sericin is a multicomponent protein with an indefinite structure and has received less attention than fibroin, but it has been shown to be biocompatible and has biological activity. Sericin has interesting bioactive properties for biomedical applications with variable amino acid composition and various functional groups. Because of its antioxidant character, its moisturizing ability and its mitogenic effect on mammalian cells, in recent years, it has been shown that sericin is useful in cell culture and tissue engineering. In addition, the positive effects on keratinocytes and fibroblasts have led to the development of sericin-based biomaterials for the repair of skin tissue, especially for wound care materials. In addition, sericin has the potential to be used for bone tissue engineering because of its ability to induce bone-like hydroxyapatite nucleation. Stable silk sericin biomaterials such as films, sponges and hydrogels are prepared by cross-linking or mixing with other polymers. Sericin also has the potential to be used for drug release because its chemical reactivity and pH response facilitate the production of sericin-based nano-microparticles, hydrogels and conjugated molecules, and increase the bioactivity of drugs. In this study, the properties and usage areas of silk sericin, which is an important protein, are summarized

Surgical method for critical sized cranial defects in rat cranium

Cranial tissue models are a widely used model to show the bone repair and the regeneration ability of candidate biomaterials for tissue engineering purposes. Until now, efficacy studies of different biomaterials for calvarial defect bone regeneration have been reported, generally in small animal models. This paper offers a versatile, reliable, and reproducible surgical method for creating a critical-sized cranial defect in rats including critical steps and tried-and-tested tips. The method proposed here, • Shows a general procedure for in vivo cranial models. • Provide an insight to restore bone tissue repair that may be used in combination with several tissue engineering strategies • Is a crucial technique that may guide in vivo bone tissue engineering

Hypertrophic Frontal Sinus Reduction by Using Anterior Wall Internalization and Galeal Frontalis Flap Obliteration

WOS: 000278102200075PubMed: 20485090In this article, we are introducing the use of galeal-frontalis flap to reduce hypertrophic sinus based on 1 case: a 25-year-old amateur boxer who had prominent frontal area due to hypertrophic frontal sinus. Three-dimensional reformatted computed tomography scans were obtained for evaluation of the hypertrophy and the morphology of the frontal sinus. Reduction of the hypertrophic frontal sinus was performed by resection and shaping of the anterior wall and obliteration of the frontal sinus by right-side galeal-frontalis flap excision via bicoronal approach. The trimmed anterior wall was inserted into the frontal sinus and secured with three 3.0 PDS sutures to the bone edges, and the incision was closed. The outcome was satisfactory without any complications during 1-year follow-up, and sixth-month computed tomography scans revealed no bone resorption. Here we are introducing a novel technique to reduce hypertrophic sinus based on a clinical report

Second toe-to-thumb transfer with transposition of the thumb stump to second finger

WOS: 000318991000030PubMed: 22704466