Allogenic vascularized transplantation of a human femoral diaphysis under cyclosporin A immunosuppression.
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Biomedical subjects
Publications and source records attributed to M H Kirschner.
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Allogeneic transplantation of human cancellous and cortical bone is a controversially discussed concept in trauma and orthopaedic surgery. Biological and immunological arguments support transplantation of autologous material whenever this is technically possible. On the other hand, synthetic alloplastic materials for bone substitution are available free of immunological and hygienic hazards. In this context the value of allogeneic bone grafts is discussed, especially considering the problem of AIDS. If autologous corticospongious bone is to be used its supply is limited. On the other hand, alloplastic synthetic artificial bone does not meet all the requirements demanded for substitution of large osseous defects up to now. The problems of geometric and mechanical stability of these alloplastic materials still remain. Therefore, no alternative to allografting of large, stable, corticospongious fragments exists in some cases. Bone transplantation is performed without vital indication in nearly every case. Thus an optimum of hygienic security has to be claimed for recipients of allogeneic bone. The "Munich model" for bone transplantation is presented and discussed.
Based on clinical observations in one female patient who suffered from Gardner-Diamond syndrome, we noticed that surgery can be performed without any bleeding complications, although operations normally are contraindicated in persons with this condition. Additionally, a correlation seems to exist between ASS and sexual and hormonal maturity.
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Based on selective dye injection studies, the regions of supply of the 3 rectal arteries have been defined. The cranial portion of the rectum receives its blood supply from the superior rectal artery, the inferior rectal artery supplies the entire rectal wall in a fan-shaped configuration up to the dentate line. A wedge-shaped portion of the muscularis in the proximal distribution of the inferior rectal artery receives a relatively reduced supply. The middle rectal artery can supply a variable portion of the muscularis which is usually supplied by the distal superior rectal artery. Intramural anastomoses between these regions exist only between the superior and inferior rectal arteries at the level of the dentate line in the submucosa.
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