[Transplantation of fetal and xenogeneic tissue in Parkinson disease].
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Biomedical subjects
Publications and source records attributed to S V Voĭtyna.
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With the YPCK-7H unit, serving as a base, a cryo-ultrasonic instrument for a combined use of cryogenic and ultrasonic methods has been constructed. A pipe for the passage of liquid nitrogen is mounted on an ultrasonic waveguide, this securing the cooling of the soft tissue subjected to the operation down to--135--80degreesC and separation of the tissues with the frequency of ultrasonic oscillations within a range of 20 to 45 kHz. The surgical cryoultrasonic instrument is apt to significantly increase the efficacy of hemostasis and helps achieve a still better neatness of the cut, this obviously being due to the cryogenic factor which adds advantage to the ultrasonic operative intervention.
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To simplify the design of the cryo-instrument and to adapt it to the forms and dimensions of the organ undergoing surgery or of any other object a cryocatheter-tourniquet is proposed, where a thin-walled, flexible tube passed in a loop like-manner through the opening of another tube (after the type of a tourniquet), is used as a conduit of the cooling agent. The loop out on the object to be operated upon forms the working part of the cryosurgical appliance.
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A study of the action produced by local freezing on the esophageal and gastric mucosa under conditions of acute hyperemia, on the veins and arteries of various diameter - for preventive stasis of the blood flow along them and on the nerve: carrying sheaths of major arteries made it possible to construct a cryosurgical instrument of a simple design and easy to handle. The working end of this instrument that acts on the organ undergoing operation is cooled down to -185 degrees. The instrument ensures a sufficiently effective utilization of the coolant and its low consumption during surgery.
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Four patients with Stage III-IV Parkinson's disease were operated on. Stereotactic cryodestruction of the ventrolateral nucleus was made, followed 10 minutes later by implantation of mixed fetal and xenogenic nerve tissue cells. The nerve cells-the fetal part-are obtained from human fetuses in the age range of 14-18 weeks of development. Tissues from the ventral portion of the midbrain and basal ganglia of the forebrain were used. Neurogenic layings of Notch Drosophila melanogaster mutants serve as a xenograft. The mixture of nerve cells were prepared in ratios of 1000:20 and 1000:12. The follow-up of the patients lasted a year. Relapses were absent. The effect occurred on the operating table (in the combination of nuclear destruction and nerve cell transplantation) and only 6 months later only during transplantation of nerve cells (without destruction). An attempt of transplanting the above fetal xenogenic mixture of nerve cells to patients previously undergone 2 ineffective stereotactic operations provided no significant clinical effect. The concurrent destruction of ventrolateral nuclei in combination with fetal xenogenic tissue grafting is considered to be promising.
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