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PURPOSE: The present survey among the members of the DAM deals with the application of endoscopic methods in plastic and reconstructive procedures. Special interest is focussed upon endoscopically assisted microsurgery. METHODS: A questionnaire was sent to all members of the DAM. It contained questions about the application of endoscopic techniques, the types of operations performed with the endoscope, the advantages, disadvantages, and complications of endoscopic operations. RESULTS: In 26 of 40 cases the question about the application of endoscopic techniques was answered positively. The most frequent indications were carpal tunnel release, wrist arthroscopy, the harvesting of flaps, breast reconstruction, and implantation of expanders. Incomplete release of the flexor retinaculum and partial lesions of the median nerve in patients referred from other departments were listed as complications. CONCLUSION: Endoscopic techniques have found acceptance among the DAM-members, but are restricted to traditional indications such as arthroscopy, carpal tunnel release, and aesthetic procedures. Future attempts must attract the interest of industrial companies for the development of high-resolution endoscopes for microsurgery.
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The authors studied an enzymatic activity (BAME-esterase) from human plasma, intimately related with the bradykinin release mechanisms. The optimal conditions of evaluation of the different plasmas were determined. Lately, the authors showed the results obtained with plasma from maternal peripheral blood, umbilical vessels blood and human placental intervillous space blood. It was concluded: 1. The study of enzymatic kinetics allows to establish a reaction time of 30 minutes, and the enzymatic concentration contained within 0.5 ml. of plasma, as ideal parameters to determine the enzymatic activities into the different compartments. 2. In the cases studied, considered clinically normals, the enzymatic activity in plasma from the interveillous space, before and after the detachment of the placenta, was greater than in peripheral maternal and umbilical vessels bloods. The activity in umbilical artery plasma was greater than in umbilical vein and practically the same as in maternal plasma. 3. The esterase activity values into the compartments studied in pre-eclamptics, were similar to that found in the cases considered clinically normal.
The effects of cryogenic injury on femoral blood vessels and nerves were studied in 28 rats. The femoral neurovascular bundles were dissected out bilaterally and the vessels and nerves subjected to cryogenic injury. The rats were sacrificed at intervals of up to 2 weeks. Damage to the nerves and to a number of femoral vessels was severe and included necrosis and thrombus formation. The results indicate that significant vascular damage can occur during cryotherapy, and the possible complications of this should be considered.
This investigation was undertaken to examine trophic interrelationships between nerves and arteries in male Wistar rats. Two approaches were used. (1) Surgical denervation of two peripheral muscular arteries in the thigh (the superficial epigastric and saphenous) was carried out on young animals (5-20 days old). (2) Arteries from young adults, either with a high density of innervation in situ (the tail artery), or virtually uninnervated (the femoral artery), were transplanted into intact or sympathectomized anterior eye chambers of adult rat hosts. In the denervation experiments, the maximum length of time before reinnervation occurred was 15 days postoperatively. The only evidence of morphological change in the vessel wall was in the external elastic lamina that became irregular and laminated. Reinnervation followed the typical developmental sequence, and was accelerated in the younger animals and by a double lesion. Translocating the proximal part of the nerve carrying the vasomotor innervation indicated that sprouting was directional toward the muscular arteries, bypassing an artery with very sparse innervation. The transplant experiments into the anterior eye chamber showed that only an artery densely innervated in situ (the tail artery) could induce reinnervation by iridean nerve sprouting. The tail artery, in the chamber lacking adrenergic innervation of the iris, became reinnervated by terminals with small agranular vesicles. These vesicles were part of Schwann cell complexes, at a similar relative density, occupying the same position in the vessel wall, as the ingrowing nerves in the fully innervated iris. The latter also had a proportion of terminals with the small clear vesicles. A small population of large granular vesicles could also be found in both types of terminals. Therefore, tissue normally having only sympathetic innervation cannot be assumed to be completely noninnervated when transplanted into a sympathectomized anterior eye chamber. The denervation and transplant experiments described here demonstrated the presence of trophic interactions between nerves and arteries, but also revealed a heterogeneity of response between vessels with very high and extremely low levels of innervation in situ.
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This survey concerns the years 1989 and 1990. While the number of institutions performing replantations remained constant in Austria and Switzerland, there has been a noticeable trend in Germany from around-the-clock replantation centers to simple replantation services, offering emergency microsurgery by arrangement only. The total number of replantations performed decreased from 975 replanted parts (903 microreplantations and 72 macroreplantations) in 1989 to 875 in 1990, with a micro-/macroreplantation ratio of 12.8:1. Based on the results of questionaire received from 34 university and city hospitals in Austria, Switzerland and former West Germany, an analysis of clinical organization and management of replantation services is presented.
PURPOSE: Chondroadherin (Chad) is a unique member of the small leucine rich repeat proteoglycan gene family. It is expressed at high levels in certain zones of cartilage and also has been detected in bone, tendon, bone marrow, and chondrosarcoma cells. Recently, we demonstrated that Chad is expressed in human and mouse lens and that its expression is decreased in the absence of mimecan/osteoglycin. This finding prompted us to explore the expression of Chad in other ocular and non-ocular tissues. METHODS: Reverse transcription-polymerase chain reaction amplification (RT-PCR), in situ hybridization (ISH), and immunohistochemistry (IHC) were used to determine the expression of Chad in human and mouse tissues. RESULTS: RT-PCR analysis showed strong expression of Chad in mouse brain, heart, lung, and embryo. Moderate expression was detected in mouse thymus, spleen, testis, and ovary, and very low expression in kidney and liver. Chad was highly expressed in human cornea, brain, and skeletal muscle, and moderately in human retina and lens. By ISH, Chad mRNA was detected in cornea, lens, and retina of postnatal day 21 mouse eyes. By IHC, immunostaining for Chad was seen in epithelial and endothelial layers of the cornea, as well as in lens, ciliary body, and retina of the adult mouse eye. Strong immunostaining was noted in retinal rod, cone, and plexiform layers. IHC analysis of tissue microarray demonstrated presence of Chad in brain (cerebellum), skeletal and cardiac muscles, lung, gastrointestinal tract, ovary, and cartilage. In most tissues, Chad expression was associated with either peripheral nerves and/or blood vessels. In the stomach and intestines, positive immunostaining was observed in Meissner's plexus and enteroendocrine cells. Intriguingly, positive immunostaining also was observed in Purkinje cells of the cerebellum and pancreatic islets. CONCLUSIONS: The present work establishes the expression and localization of Chad in several new locations including cornea, lens, ciliary body, retina, cerebellum, pancreatic islet, blood vessels, and peripheral nerves. The surprisingly broad expression pattern of Chad suggests potential roles for this protein in cell specific and/or tissues specific function(s). The results reported here are an essential prerequisite for future studies aimed at understanding the biological roles of Chad in health and disease.
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