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Biomedical subjects

G D Lister

Publications and source records attributed to G D Lister.

At least 19 recordsLinked to original sources
PubMed1997

Anti-ICAM-1 antibodies protect allografts against microvascular and parenchymal cell damage.

Anti-ICAM-1 (anti-intercellular adhesion molecule-1) monoclonal antibodies (CD54) were tested for treating composite tissue allografts in the rat hindlimb-cremaster transplantation model for intravital microcirculatory studies. Twenty-four transplantations were carried out across major histocompatibility barriers between Lewis-Brown Norway and Lewis rats. Isograft control transplants were compared to nontreated allograft control transplants and to allografts treated with 1 mg/kg of anti-ICAM-1 monoclonal antibodies. At 24 and 72 hours, microcirculatory vessel diameters, red blood cell velocities, functional capillary perfusion, endothelial edema index, and leukocyte-endothelial interactions were measured. At 24 and 72 hours, the number of sticking leukocytes, sticking lymphocytes, transmigrating leukocytes, and the endothelial edema index in the treated allografts were significantly decreased more than in the other 2 groups (p < .05 for all variables). Anti-ICAM monoclonal antibodies significantly reduced leukocyte-endothelial interactions, protecting the allografts from acute microvascular and parenchymal injury.

Animals↗
PubMed1995

Ergonomic disorders.

Explore the source record for details and available documents.

Cumulative Trauma Disorders↗
PubMed1995

Acute adverse effects of blunt adventitial stripping.

The adventitia is routinely removed from small arteries before the anastomosis, but the microcirculatory response to this maneuver has not been documented. We have used a rat cremaster muscle flap model for intravital microscopy to compare at the microcirculatory level the effect of blunt (n = 18) and sharp (n = 18) adventitial removal with unmanipulated control arteries (n = 18). Blunt stripping resulted in transient but significant reductions in the red cell velocity (50%, p < 0.05) and capillary perfusion (91%, p < 0.05). Sharp dissection did not affect red cell velocity; however, capillary perfusion was transiently reduced by 25% (p < 0.05). In this study, sharp adventitial dissection was found to be a less harmful method of small arteries preparation for microvascular anastomosis.

Anastomosis, Surgical↗
PubMed1994

The effect of combined immunosuppression with systemic low-dose cyclosporin and topical fluocinolone acetonide on the survival of rat hind-limb allografts.

Sixty rat hind-limb allotransplantations across strong histocompatibility barriers were performed. Group I (isograft controls), (Lewis-Brown-Norway [LBN] to LBN) limb transplantations were performed; Group II (rejection controls), LBN limbs transplanted to Lewis rat LEW recipients with no immunosuppressive treatment; Group III (steroid group), fluocinolone acetonide (50 micrograms/ml) was applied topically; Group IV (cyclosporine group), 4 mg/kg of cyclosporine was administered subcutaneously daily; Group V (combination group), combined systemic cyclosporine with topical fluocinolone acetonide was administered daily. Group II: Limb rejection was present on the fourth day. Group III: Limb survival was extended for 3 weeks with no signs of skin rejection in 75% of animals. Group IV: Rejection was complete at 3 weeks. Group V: Limbs survived to 6 weeks. Topical steroid prevented skin rejection and delayed rejection of other components of the composite allograft. Combined treatment of topical steroid and low cyclosporine doses significantly extended survival rate of limb allografts.

Administration, Topical↗
PubMed1994

The posterior interosseous arterial graft.

The posterior interosseous artery is a suitable donor vessel for harvesting autogenous arterial grafts which are often necessary for thumb or finger revascularization or replantation. Grafts 8 to 10 cm long can be taken from the dorsal ulnar aspect of the forearm ranging in caliber from 1 to 1.5 mm. The arterial graft can be harvested together with the lateral branch of the posterior interosseous nerve, offering the possibility of vascularized nerve transfer. Removal of the posterior interosseous artery does not influence peripheral perfusion or leave functional deficits. During dissection, care must be taken not to harm motor branches of the posterior interosseous nerve. We report a patient in whom this technique was used successfully.

Adult↗
PubMed1993

Soft tissue reconstruction. Coverage of hand injuries.

The complexity of the hand necessitates careful assessment of an injury. Wound coverage requires careful appraisal of the tissue available for coverage and consideration of its functional and cosmetic aspects. The simplest yet most appropriate flap should be chosen. Local flaps can cover many wounds. Larger wounds may require significant debridement, which should be performed early using the pseudotumor technique. Free flap coverage is then indicated and should be completed within 3 days of injury if no extenuating circumstances exist.

Finger Injuries↗
PubMed1992

Venous anatomy of the thumb and thenar area.

The venous anatomy of the thumb and the thenar area, including the first web space, was studied after injection of a polymerizing plastic resin into the vascular tree of six fresh human cadaveric specimens. As in the previously described parts of the hand and fingers, certain anatomical features were consistently present in all examined specimens. The topography of the vessels is different from that of veins in other parts of the hand, and we conclude that this reflects differences in mechanical demands upon the soft tissues in various parts of the hand and the digits.

Hand↗
PubMed1992

Treatment of skin and soft-tissue loss of the thumb.

Many options exist to provide soft-tissue cover of the thumb. The choice of cover should be dictated by the defect itself: the location, size, and requirements for sensibility and durability. Within these boundaries, the choice of cover should be in accordance with the goals of any extremity reconstruction, permitting primary wound healing and early active use.

Humans↗
PubMed1992

Early free-flap coverage of electrical and thermal burns.

Because of the clinical concept of progressive tissue necrosis, the concept of immediate excision and coverage of high-tension electrical burns and deep thermal burns has been a controversial subject. Recent clinical and laboratory research has cast doubt on this concept. We present a series of five patients who suffered severe extremity electrical and thermal injuries in whom early excisions were performed with immediate free-flap reconstruction. Special importance is given to radical debridement of all questionably nonviable tissues, excepting intact tendons, nerves, and bone. In these tissues, anatomic continuity is more important than apparent viability. No infections or wound-healing complications were seen as a result of this protocol. Of eight digital nerves that did not function at the initial examination, five subsequently recovered two-point discrimination of less than 10 mm.

Adult↗
PubMed1992

Radial nerve compression.

Symptomatic radial nerve compression is relatively uncommon. A relatively high incidence of compressive neuropathy involves other major nerves in the same extremity. Because sensory complaints are minor, radial nerve compression may successfully masquerade as tendonitis or tendon rupture. The most common site of radial nerve compression is in the forearm, at the arcade of Frohse. Spontaneous onset of dense paralysis is often due to space-occupying lesions in the forearm. Trauma-related compression in the forearm is most often due to radial head dislocation and either humeral fracture or local external pressure in the upper arm. Compression resulting in weakness that does not improve with several months of splinting, anti-inflammatory medication, and activity changes should be treated surgically to reduce the extent of permanent deficit. After decompression, early active motion is instituted to encourage nerve gliding. Results after decompression are not as favorable as those for carpal or cubital tunnel release. The worst results of decompression are seen in patients who have work-related injuries, chronic pain, and poor localization of symptoms on physical examination.

Diagnosis, Differential↗
PubMed1991

Toe transfer for congenital hand defects.

Toe-to-hand transfer is a well-established reconstructive option for certain congenital hand anomalies. It is the only technique which can add growth potential to the immature skeleton. Toe transfer is best suited for constriction ring amputations, which have relatively normal proximal anatomy. Transfers should be performed early in life to avoid lack of cortical integration of the new part. Anatomic variations of both hand and foot are often encountered, which influence both operative approach and functional prognosis. Indications, techniques, and complications are reviewed.

Fingers↗
PubMed1991

Preferential use of the posterior approach to blood vessels of the lower leg in microvascular surgery.

A posterior approach to the vessels of the lower leg, with particular emphasis on the posterior tibial artery, is presented as the method of choice for microvascular free-tissue transfer to the region. This approach offers wide exposure, better definition of the zone of injury, appropriate selection of the recipient vessel and of the site of anastomosis, and enough room for microsurgical work. Exposing the large posterior tibial artery down to the distal third of the lower leg facilitates the use of end-to-side anastomosis and makes the transfer of large muscle flaps to that region more predictable, in part by obviating the need for long vein grafts. This exposure leaves no functional and few aesthetic deficits.

Arteries↗
PubMed1991

Arterial T and Y grafts.

Presented is the use of an autogenous arterial T graft for the salvage of a thrombosed arterial end-to-side anastomosis. The T-graft concept also offers the possibility of replacing a segment of artery in patients with arterial vessel wall defects, stenosis, obliteration, or disease during free latissimus dorsi or scapular flap transfer. The arterial T graft is harvested from the axilla and consists of segments of the subscapular, circumflex scapular, and thoracodorsal arteries. The large diameter of these vessels offers a good match with the arteries of the lower leg and forearm. The arterial Y graft consists of the same arteries and is used as an interpositional graft to revascularize two distal vessels from one proximal vessel.

Anastomosis, Surgical↗