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At least 19 recordsLinked to original sources
PubMed1984

[Experimental study on free muscle transplantation--histological changes and functional recovery of transplanted muscles in relation to the duration of ischemia and denervation].

UNLABELLED: The purpose of this study was to clarify the influence of temporary ischemia and denervation on the characteristics of transplanted muscles. MATERIALS AND METHODS: The rectus femoris brevis muscle of white rabbit was used. Under an operating microscope, this muscle was mobilized preserving its feeding vessels, and the innervating nerve was severed at 1 cm proximal to the entrance of the muscle. Six groups were made as follows. Group D: The severed nerve was left as it was. Group S: The nerve was sutured immediately after severance. No treatment was made on the feeding vessels. Group SI: The artery and vein were clamped for 1, 2, 3 and 4 hours (group SI-1, 2, 3 and 4) after nerve repair. The proximal and distal tendon were reattached to their original place in every group. Examination I: Transplanted muscles were examined histologically and histochemically from 48 hours to 6 months. Motor end-plate was one of the targets of observation. RESULTS: Main patho-histological changes observed on the muscle and motor end-plates at one week were thought due to denervation, and the longer ischemic time caused more severe change in the group SI-3 and 4. Phagocytosis, destruction of muscle fibers and edema in the interstitial tissue were seen in these long ischemic time groups. A few motor end-plates in the group SI-3 and many of them in the group SI-4 were atrophic and their acetylcholinesterase (AChE) activity was low. Reduced nicotinamide-adenine dinucleotide-tetrazolium reductase (NADH-TR) and phosphorylase activity were reduced in all groups at one week. At 3 weeks, muscle atrophy was pronounced and was found earlier in type II fibers than in type I as a result of denervation. Pathological changes such as elongation, atrophy or segmentation and low AChE activity were observed in the motor end-plates of all groups at 3 and 6 weeks. These findings were more pronounced in the group SI-3 and 4. In all groups at 6 weeks, phosphorylase activity was found to be generally low but NADH-TR reaction stained a few regenerated muscle fibers. Although muscle atrophy was still observed at 9 weeks, recovery in size and shape and histochemical reaction was seen in all groups at this stage. These findings became more manifest at 15 weeks and almost normal appearance of muscle fibers was observed at 6 months. Interstitial connective tissue, however, increased, and necrotized muscle fibers were seen extensively in the group SI-3 and 4.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholinesterase↗
PubMed1980

A possible mechanism of phenotypic expression of normal and dystrophic genomes on succinic dehydrogenase activity and fiber size within a single myofiber of muscle transplants.

Muscle transplantation was used to evaluate the ability of normal and dystrophic chickens to support regeneration of both normal and dystrophic muscle fragments. Pectoralis muscles were grafted into the site of the biceps muscle of host chickens. Identification of dystrophic characteristics of intact and regenerating muscle fibers was made by cytochemical analysis of mitochondrial succinic dehydrogenase (SDH) and by fiber size. In the biceps muscle of dystrophic chicks at 40 days ex ovo, the mean size of muscle fibers with low activity of SDH and fibers with high SDH activity was 29.0 +/- 5.9 micrometers and 42.0 +/- 10.4 micrometers, respectively. The mean size of normal muscle fibers was notably smaller than in dystrophic muscle and was 17.8 + 3.1 micrometers. The hypertrophy of fibers coupled with elevation of SDH activity tended to increase with age. Transplants were examined at 56 days postoperatively. The results of cross-transplantation between normal and dystrophic genotypes were similar to unoperated muscles in the correlation between SDH activity and fiber size. Donor muscles determined the type of myofibers regenerated in transplants regardless of whether the host was normal or dystrophic. In addition, combined transplantation was attempted to produce a single hybrid myofiber in which normal and dystrophic pectoralis muscle were mixed in equal volume. The mixtures were then allowed to regenerate in host chicks. A number of mosaic myofibers appeared in transplants and had regional differences in SDH activity along their length. It was concluded that: (1) The characteristics of high SDH activity and fiber hypertrophy are an expression of dystrophic nuclei, (2) combined transplantation of both normal and dystrophic muscle fragments can produce mosaic myofibers in SDH reaction; and (3) the local control of SDH activity and fiber size within nuclear territories in mosaic myofibers seems likely to be due to phenotypic expression of either normal or dystrophic genomes.

Age Factors↗
PubMed1997

Comparison of muscle mass preservation in denervated muscle and transplanted muscle flaps after motor and sensory reinnervation and neurotization.

The gracilis muscle model was used either as a denervated muscle in situ or as a transplanted flap in 273 rats to compare the trophic effects of muscle reinnervation and neurotization using sensory and motor nerves. The average gracilis muscle flap weighed 626 +/- 94 mg at the time of the initial procedure. Experimental muscles were examined 6 months following the procedure. In denervated, nontransplanted muscles, both motor nerve reinnervation and neurotization resulted in significantly preserved muscle mass, averaging 570 +/- 69 and 521 +/- 116 mg, respectively, compared with the denervated control average of 178 +/- 22 mg (p < 0.05). Sensory nerve reinnervation and neurotization produced much smaller trophic effects (p > 0.05). In transplanted gracilis free flaps, however, only direct reinnervation with motor or sensory nerves resulted in improved bulk preservation, with average weights of 313 +/- 83 and 327 +/- 91 mg compared with the control average of 201 +/- 76 mg (p < 0.05). Neither sensory nor motor neurotization was significantly effective in the free-flap model (p > 0.05). These data suggest that transplantation may alter the response of muscle to reinnervation.

Animals↗
PubMed1984

Size and location of the motoneuron pool supplying normal and orthotopically transplanted muscles.

Following intramuscular placement of horseradish peroxidase (HRP) into the 129ReJ mouse extensor digitorum longus muscle, 15 +/- 1 (S.E.M.) labeled motoneurons were found in the antero-lateral motor column, between the exits of spinal roots L3 and L4. When HRP was placed in 100-day orthotopic whole muscle transplants of the extensor digitorum longus muscle, the location of the motoneurons supplying the graft was similar to that of control muscle; however, the number of motoneurons innervating the grafts was variable and usually reduced (7 +/- 1 S.E.M.).

Animals↗
PubMed1994

Coexistence of fast-muscle-type and slow-muscle-type troponin T isoforms in single chimeric muscle fibers induced by muscle transplantation.

Regenerated muscle fibers which appeared after transplantation of chicken slow muscle (anterior latissimus dorsi) into breast fast muscle (pectoralis major) of the same animal were studied by two-dimensional SDS-polyacrylamide gel electrophoresis, immunoblotting, and immunostaining with antisera against fast-muscle-type troponin T and slow-muscle-type troponin T. In the transplanted muscle, degeneration of muscle fibers was followed by regeneration of slow muscle, which was revealed by detecting slow-muscle-type troponin T with the antiserum. Furthermore, coexistence of fast-muscle-type and slow-muscle-type troponin T isoforms in single chimeric muscle fibers composed of partly fast and partly slow fibers was observed in the regenerated muscle. We suggested that the chimeric fibers were originated from the fusion of fast and slow myoblasts during regeneration after muscle transplantation and that two nuclei differently determined in troponin T expression were working independently in a single cell.

Animals↗
PubMed1984

Functioning free muscle transplantation.

Functioning free muscle transplantation to the extremity is technically feasible based on microvascular anastomosis and fascicular nerve repair. Success depends on precise operative technique and a vigorous program of postoperative therapy. The most important operative details are the nerve repair and placement of the muscle at optimum tension. The forearm should be considered for muscle transplantation if there is a lack of finger flexion as a result of the loss of flexor musculature and if simpler techniques of tendon transfer are unavailable. The long-term results of 12 muscle transplantations to the forearm are presented. Eleven muscles survived completely and provided useful function, Nine provided a full range of finger motion. The maximum grip strength obtained with this procedure was 50% of normal grip strength.

Adolescent↗
PubMed1997

Analysis of 100 cases of free-muscle transplantation for facial paralysis.

Free-muscle transplantation is the treatment of choice for long-standing facial paralysis. It enables the reconstructive surgeon to restore facial movement and some emotional animation. Despite all technical innovations and 20 years of experience with free-muscle transplantation, the aesthetic and functional outcomes of the surgery are still unpredictable. The present report reviews 100 free-muscle transplantations to the face by a single surgeon and analyzes various preoperative, intraoperative, and postoperative factors in relation to the functional recovery of the muscle transplants. These factors were demographic variables such as age, gender, and etiology as well as intraoperative variables such as choice of muscles, number of nerve coaptations, and ischemia time of the muscle. Additionally, four independent raters not involved in the care of these patients rated standardized preoperative and postoperative videos and judged the functional and aesthetic outcomes. From 1981 to 1993, 93 patients with facial paralysis underwent free-muscle transplantation. A total of 100 muscles were transplanted, since 7 patients received two muscle transplants. There were 33 male and 60 female patients ranging in age from 3 to 57 years, with an average of 22.2 +/- 14.9 years. The gracilis muscle was used in 63 cases of free-muscle transplantation, while the pectoralis minor was used in 34 cases. In 2 patients a segment of the rectus abdominis was transferred, and in 1 patient a small segment of the latissimus dorsi was transferred. In 89 patients the onset of muscle function was reported. The range was from 6 to 48 weeks postoperatively. The average was 21.6 +/- 9.14 weeks after muscle transplantation. The correlations showed a trend to earlier onset of function and higher aesthetic rating in young female patients. The intraoperative ischemia of the free muscle did not correlate with the onset of muscle function. Using a five-step scale of judgments, a higher postoperative rating was seen in 94 percent of the patients, and 80 percent of all patients achieved a moderate or better result.

Adolescent↗
PubMed1993

Reinnervated free muscle transplantation for extremity reconstruction.

Reinnervated free muscle transplantation was used to rehabilitate severely impaired extremities in patients with brachial plexus palsy and for functional limb salvage in cases of traumatic muscle loss or radical excision of a malignant soft-tissue tumor. Fifty-eight reinnervated free muscle transplantations were implanted in 46 patients. Twenty-four patients had simultaneous reconstruction of two functions, such as finger and elbow flexion lost to brachial plexus palsy; 12 patients underwent double muscle transplantation; 15 patients received free muscle transplants for limb salvage after tumor excision in an extremity; 6 transplants replaced traumatic muscle loss; and 1 was used for reconstruction of finger flexion after poliomyelitis. Twenty-six latissimus dorsi, 25 gracilis, and 7 rectus femoris muscles were used as donors. All muscles survived. The postoperative follow-up ranged from 18 months to 4 years. The speed and extent of reinnervation of the transplanted muscle depended on the choice of recipient nerve, the patient's age, and the occurrence of postoperative vascular complications. Neurotization by the spinal accessory nerve or the posterior interosseous nerve resulted in the most rapid recovery. The administration of postoperative chemotherapy did not delay recovery of function. Free muscle transplantation is consistently successful and provides a functional extremity in severely handicapped patients.

Adolescent↗
PubMed1996

Regenerated rat fast muscle transplanted to the slow muscle bed and innervated by the slow nerve, exhibits an identical myosin heavy chain repertoire to that of the slow muscle.

The hypothesis that the limited adaptive range observed in fast rat muscles in regard to expression of the slow myosin is due to intrinsic properties of their myogenic stem cells was tested by examining myosin heavy chain (MHC) expression in regenerated rat extensor digitorum longus (EDL) and soleus (SOL) muscles. The muscles were injured by bupivacaine, transplanted to the SOL muscle bed and innervated by the SOL nerve. Three months later, muscle fibre types were determined. MHC expression in muscle fibres was demonstrated immunohistochemically and analysed by SDS-glycerol gel electrophoresis. Regenerated EDL transplants became very similar to the control SOL muscles and indistinguishable from the SOL transplants. Slow type 1 fibres predominated and the slow MHC-1 isoform was present in more than 90% of all muscle fibres. It contributed more than 80% of total MHC content in the EDL transplants. About 7% of fibres exhibited MHC-2a and about 7% of fibres coexpressed MHC-1 and MHC-2a. MHC-2x/d contributed about 5-10% of the whole MHCs in regenerated EDL and SOL transplants. The restricted adaptive range of adult rat EDL muscle in regard to the synthesis of MHC-1 is not rooted in muscle progenitor cells; it is probably due to an irreversible maturation-related change switching off the gene for the slow MHC isoform.

Adenosine Triphosphatases↗
PubMed1988

Treatment of infected non-unions and segmental defects of the tibia with staged microvascular muscle transplantation and bone-grafting.

Fourteen patients who had an infected non-union or segmental defect of the tibia were treated with débridement and microvascular transplantation of muscle. Successful free muscle transplantation and control of the infection were achieved in all patients. The prognosis was, in general, related to the severity of the underlying osseous problems, which were categorized into types A (a tibial defect and non-union without significant segmental loss), B (a tibial defect that is more than three centimeters long and an intact fibula), and C (a tibial defect that is more than three centimeters long, involving both the tibia and the fibula). All of the six type-A patients healed without needing bone-grafting. Of the four type-B patients, all of whom had subsequent bone-grafting, reactivation of the infection occurred in two, and both ultimately had a below-the-knee amputation; the third patient had a non-union between the fibular graft and the tibia; and the fourth patient was fully weight-bearing. All of the four type-C patients also required subsequent bone-grafting; all finally healed and were able to walk with a brace. The results in the present series indicate that, in patients who have an infected tibial defect or non-union, including those that are so severe that an amputation might be considered, this method of treatment is a valid option for salvage of the limb.

Adolescent↗
PubMed1985

Selective reinnervation of intercostal muscles transplanted from different segmental levels to a common site.

We transplanted external intercostal muscles from one of several thoracic (T) levels to the neck of adult rats. The cervical sympathetic trunk, which innervates the superior cervical ganglion, was cut, and its proximal end was apposed to the muscle. Preganglionic axons in the trunk reinnervated muscle fibers in the transplants. We determined the segmental origin of synaptic inputs to transplanted muscles by recording intracellularly from muscle fibers while stimulating individual ventral roots which supply axons to the trunk. In one series of experiments, T2 or T8 muscles were transplanted from the thorax to the neck of the same rat. While T2 and T8 muscles were reinnervated to a similar extent, they differed in the segmental origin of the innervation they received: T2 muscles received more inputs from rostral segments (T1 and T2) than did T8 muscles, and T8 muscles received more inputs from caudal segments (T4 to T6) than did T2 muscles. This difference between reinnervation of T2 and T8 muscles was detected both 2 to 4 weeks and 10 to 14 weeks after surgery. In a separate series, using rats of an inbred strain, T3, T4, or T5 muscles were transplanted from one rat to a separate host. Again, the average segmental origin of inputs to transplants from different levels differed systematically: it was most rostral to T3 muscles, intermediate to T4 muscles, and most caudal to T5 muscles. Finally, T3 and T5 muscles were soaked in a myotoxin, Marcaine, before reimplantation. This treatment kills muscle fibers but not myoblastic satellite cells; therefore, muscle fibers were replaced by regeneration. Marcaine-treated T3 and T5 muscles were successfully reinnervated but did not differ significantly in the segmental origin of their inputs. Our results show that adult mammalian muscles can be selectively reinnervated, and they raise the possibility that the selectivity is based on some positional quality that matches axons and muscles from corresponding segments. However, while differences among muscles survive denervation and transplantation, their expression or accessibility may change during regeneration.

Animals↗
PubMed1984

Urinary incontinence in children: treatment with free autogenous muscle transplantation.

Free autogenous muscle transplantation has now been carried out in 13 patients with anal incontinence and 16 patients with urinary incontinence. In anal incontinence the results have been excellent; all patients were improved and 12 out of 13 reached an acceptable level of continence. In 10 patients with urinary incontinence the results were good, with increase of functional bladder capacity and abandonment of nappies during the day. Two patients were improved and 4 were failures. Cinematographic studies in both anal and urinary incontinence clearly demonstrated the muscular activity of the transplants and confirmed the existence of a reinnervation process. The longest postoperative observation time is now 7-years in the anal patients and 6 years in the urinary patients.

Adolescent↗
PubMed2002

Basic science behind functioning free muscle transplantation.

Free muscle transfer is now a feasible procedure in several fields of reconstructive surgery. In this article, basic science behind clinical free muscle transfer, including essential aspects like donor muscle selection (type of blood supply, architecture of fibers, fiber length, and muscle volume), donor nerve selection, placement and routing of muscle, tension of muscle at suturing, postoperative monitoring of muscle circulation, postoperative reinnervation, and rehabilitation are discussed in detail.

Facial Paralysis↗
PubMed1998

Immunohistochemical analysis of clinically transplanted muscles.

BACKGROUND: Although a number of studies have examined the morphology and function of experimentally transplanted muscles, immunohistochemical evaluation of clinically transplanted muscles has not been reported. The purpose of this study was to examine clinically transplanted muscles at long periods after transplantation with biochemical markers specific for satellite cell activation and muscle regeneration. MATERIALS AND METHODS: Nine biopsies of muscles transplanted to the paralyzed face were examined. In five cases, the gracilis muscles were transplanted about 1 year after cross face nerve grafting. The other four cases underwent one-stage latissimus dorsi (LD) muscle transplantation. Twelve to 162 months after transplantation, muscle biopsies were harvested in nine cases. In eight cases, secondary corrections of facial expression including debulking of the grafted muscle were required, while another muscle was transplanted in one case because of the failed first operation. As control, six specimens of normal LDs were examined as well. Monoclonal antibodies were employed to visualize myosin heavy chain (MHC) isoforms (slow, fast, and embryonic) and MyoD protein. RESULTS: Although one specimen exhibited only small, atrophic fibers indicating failed reinnervation, the remaining eight specimens showed regularly distributed fibers and type grouping indicating successful reinnervation. There was no statistically significant difference in fiber area and lesser diameter between normal LDs and transplanted LDs. However, even in these successfully reinnervated muscles, intermediate and small fibers expressing embryonic MHC and small cells expressing MyoD were observed, suggesting that satellite cells were activated for repair of the adjacent fibers. CONCLUSIONS: Muscle adaptation (presumably to denervation), which is a regenerative change accompanied by activation of satellite cells, was still seen even long periods after transplantation. It is concluded that, in microneurovascular human skeletal muscle transfers, there is a wide variation in the time required for reinnervation of individual muscle fibers, and it may be that human muscle fibers cannot be properly reinnervated after denervation has continued for a certain period such as 12 months.

Adult↗