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[Urinary bladder plastic enlargement with the use of autologous, homologous and heterologous skin transplants].

1. Expanded urinary bladder resection and the following replacement of the defect with various skin grafts were well tolerated by 161 cats. 2. Grafts of various species were shown to be of significantly different biomechanical properties. This depended on basic substance, compound and texture of collagenous and elastic fibres and the methods of conservation. Preoperatively the transplants were sufficiently resistent against urine and bladder pressure. 3. Within of few weeks postoperatively there was an increase in bladder capacity. This was more evident and arose in an earlier period than in cases without bladder wall replacement (x-ray-control). 4. Autologous grafts were infiltrated by young new tissue. Homologous and heterologous patches served as "guide" of regeneration. Complete transitional cell epithelium was proven to be present after four weeks in the predominantly connective tissue regenerates. The development of smooth muscle fibres in the regenerates is discussed. 5. The microcytotoxicity test showed a host response, but without clinically manifest rejection of the foreign transplants. 6. Apart from clinical urological application the results of this experimental investigation could be useful in general plastic surgery.

Animals

[The importance of heterologous implants in cardiovascular surgery (author's transl)].

The importance of heterologous transplants in the substitution of heart valves in cardiac surgery and the substitution or bypassing of displaced arteries of the thigh in vascular surgery is discussed with reference to some results and developmental considerations. In addition to the alloplastic valve material, heterologous bioprosthesis from glutaraldehyde-fixed pig's valves has proved useful to an increasing extent for the substitution of diseased and functionally impaired heart valves. The results of followup examinations show equally favorable results in comparison with the alloplastic prosthesis. In vascular surgery, the calf collagen prosthesis has proved a real alternative to the alloplastic Dacron prosthesis at the level of the thigh.

Animals

Transplantation of cultured bovine corneal endothelial cells to species with nonregenerative endothelium. The cat as an experimental model.

The in vivo transplantation of cultured bovine corneal endothelial cells has been attempted in the cat. Cat corneas denuded of their endothelium were coated with bovine corneal endothelial cells previously maintained in tissue culture. When grafted back into cat recipients, the corneal buttons remained clear with no edema. Alizarin red staining of the endothelial side of the corneal transplant demonstrated that the coated bovine corneal endothelial cells reorganized themselves into a highly organized cell monolayer within eight days in vivo. In contrast, corneas denuded of their endothelium became opaque and edematous within seven days and remained so thereafter. These results demonstrate that cultured corneal endothelial cells remain functional in vitro and can replace a damaged or nonfunctional endothelium i

Animals

Growth of human tumors in lethally irradiated mice reconstituted with syngeneic fetal liver cells.

Transplantation into lethally irradiated mice of hematopoietic and lymphoid cells from immature donors which hypothetically will not mount a cell mediated attack against simultaneously inoculated human tumor cells has resulted in tumor engraftment and growth in long-term surviving radiation chimeras. Twenty-four hours after lethal irradiation, A or CBA mice were given iv injections of 2 X 10(7) fetal liver cells from syngeneic donors of 14, 16, or 18 days of embryonation and sc injections of 1, 3, or 6 X 10(6) human choriocarcinoma (C-1, C-2, and C-3) cells or human breast carcinoma (B-1) cells that had been maintained in culture. Palpable tumors greater than or equal to 5 mm were noted in 18/22 mice injected with C-1, 9/16 with C-2, 10/10 with C-3, and 18/30 with B-1. Tumors of 17 (31%) of mice remained palpable until death of the animal or until termination of the experiment 100 days post inoculation. Histologic study of autopsy specimens revealed malignant tumors with occasional pulmonary metastases. Human chorionic gonadotropin was found in the serum of mice that received choriocarcinoma cells.

Animals

Can a small blood vessel prosthesis be derived from heterologous foreign body reactive tissue?

This study investigated as a small diameter vascular replacement the tissue formed adjacent to an implanted cylindrical foreign body, heterologously transplanted. Grafts of 4 mm i.d. were grown in rabbits and transplanted to dogs as segmental carotid and femoral artery replacements. These maintained 50% patency after 3 weeks. Variables in the further development of this concept are discussed.

Animals

Possible role of fibronectin in malignancy.

Frozen sections of tumors induced by injecting virally transformed cells into animals were stained for fibronectin by immunofluorescence. Many tumor cell lines do not express fibronectin in tumors in situ even though some of them express fibronectin in culture. Cell shape and hormones appear to influence the expression of fibronectin in culture; however, it is unclear how fibronectin expression is regulated in vivo.

Animals

Effect of preimplantation treatment on the bone-forming potential of decalcified allogeneic and xenogeneic bone-matrix implants.

Bone-forming property of 0.6 M HCl decalcified (a) allogeneic bone matrix preserved in 70% alcohol, (b) allogeneic bone matrix preserved in anaesthetic ether, (c) allogeneic 'Ossein' provided by the Leather Research Institute, Madras, and (d) xenogeneic bone-matrix preserved in alcohol was studied by fitting the implants in surgically created complete circumferential osteo-periosteal gaps in the ulna of rabbits. Bone formation was assessed radiologically, macroscopically, histologically, and by tetracycline fluorescence up to 16 postimplantation weeks. Successful bridging of the gap by new bone formation was observed in 75% of (a) and 28.6% of (d) preserved up to 2 weeks. Ether-preserved implants did not induce bone formation. The 'Ossein' implants remained as inert material neither invaded by host cells nor inducing any bone formation. The xenogeneic implants exhibited local immune response which was probably responsible for poor osteogeneic response. Bone forming quality of bone-matrix implants appears to be influenced by the chemical treatment during preparation and preservation, host cellular response and immune reaction invoked by the implant.

Animals

Implantable artificial capillary unit for pancreatic islet allograft and xenograft.

Implantable artificial capillary units containing approximately 1,200 allogeneic rat islets, or approximately 3,000 xenogeneic rabbit or human islets as an implantable artificial endocrine pancreas (IAEP) were implanted in streptozotocin-induced (55 mg/kg) diabetic rats. A total of 26 rats received IAEP containing allogeneic islets. Twenty were short term experiments which lasted for 12-24 h. Four recipients survived between 1-3 days and the remaining two for 4 and 11 days respectively. Five diabetic rats received IAEP containing xenogeneic islets. The four recipients of IAEP containing rabbit islets survived up to 4 days while the recipient of IAEP containing human islets survived for 8 days. Following implantation, a decrease of plasma glucose from the initial value of 500 mg/dl to normoglycaemia and a corresponding increase in circulating levels of insulin up to 100 muU/ml were observed in the recipient animals. Furthermore the IAEPs were shown to produce a near normal plasma glucose and insulin response to an intravenous glucose tolerance test. These findings suggest the feasibility of achieving amelioration of diabetes with allogeneic or xenogeneic pancreatic islets implanted as an artificial endocrine pancreas unit in the experimental animals which has the potential of future clinical application in man.

Animals

Tissue valve replacement of prosthetic heart valves for thromboembolism.

Twenty-five patients who had repeated thromboemboli from a prosthetic mitral valve were treated with reoperation using a tissue valve prosthesis. Reoperation was performed an average of 4.0 years after the original valve replacement in 14 men and 11 women, with an average age of 50 (range 35 to 65) years. A stented allograft was used in the first 7 patients and a porcine xenograft in the last 18 patients. There were one hospital death and two late deaths. With the first prosthetic valve there were 66 documented embolic episodes in 101.5 patient years (0.65 embolus/year). Only four embolic episodes in 67.4 patient years (0.059 embolus/year) occurred after tissue valve replacement (P less than 0.001). These results indicate that in patients with recurrent or severe embolization after prosthetic heart valve replacement, rereplacement with a tissue prosthesis can be safely performed and significantly reduces the likelihood that additional embolic episodes will occur.

Adult

The amnion in surgery, past and present.

The clinical application of the fetal membarnes has been under study for many years. An attempt is made to bring the reader up to date in this fascinating subject and to indicate practical employment of the membrane in modern medicine. The amnion and chorion are detailed separately where possible, particularly in the field of surgery.

Amnion