Porous, block hydroxyapatite as an interpositional bone graft substitute in orthognathic surgery

Forty-six nonconsecutive patients undergoing orthognathic surgery in whom blocks of coralline, porous hydroxyapatite (Interpore-200) were used in lieu of interpositional bone grafts are the subjects of this report. Surgical procedures included inferior repositioning of the maxilla (7) and chin (12), maxillary advancements in cleft (4) and noncleft individuals (13), and transverse maxillary expansions (12). Patients included in this study were only those in whom bone grafts would have been harvested had hydroxyapatite not been available. A total of 93 anatomic sites were implanted. The complication rate attributable to the use of the implant was 4.3 percent. Follow-up period ranged from 6 to 20 months, with a mean of 9.3 months. At this time, osseous stability was confirmed cephalometrically in all but two patients undergoing maxillary expansions. The biologic behavior and mechanical properties of coralline-derived, porous, block hydroxyapatite are discussed. These implant characteristics make it a feasible bone graft substitute for interpositional use in orthognathic surgery. Proper indications for its use as well as technical details to minimize complications are stressed.     

Trade-off relationship between vein density and vein diameter of Achnatherum splendens in response to habitat changes in Zhangye wetland

Aims The coevolution between vein traits has influences on water use strategies of plant and the formation of leaf economic spectrum, and therefore is important for understanding the trade-off between carbon input in leaf vein construction and the functional feedback from leaf veins. Our aim is to study the allometric relationship between vein density and vein diameter of Achnatherum splendens populations at three natural microhabitats (subcanopy, transitional and open areas) in Zhangye wetland. Methods According to the shade condition of the arbor canopy and the distance to arbor, the A. splendens community were divided into three microenvironments: subcanopy, transitional and open areas. We sampled 10 (4 m × 4 m) A. splendens plots from each microenvironment and investigate the biological characteristics of the plots and leaf traits of the plants within the plots. Then the soil physical and chemical properties, and community photosynthetically active radiation (PAR) were investigated at three gradients. Six individual of A. splendens were selected in each plot and the leaf length, leaf width, vein density and vein diameter of two or three healthy and complete leaves from four directions of each individual were measured in laboratory. The SMA estimation method and correlation analysis were then used to examine the allometric relationship between vein density and vein diameter. Important findings Along the gradient from subcanopy, transitional zone to open areas, soil moisture displayed a pattern of initial decrease of plant community, and soil electric conductivity displayed increase changing trends. Photosynthetically active radiation (PAR), vapor pressure deficit (VPD), vein density (1.28-1.59 mm·mm^-2), leaf width and water use efficiency (WUE) increase gradually, while the leaf length, vein diameter (0.21-0.16 mm) of A. splendens decrease. The average value of plasticity indexes of leaf characteristics was 0.19. Leaf net photosynthetic rate (P_n), transpiration rate (T_r) and bundle density increase first and them decrease. The vein density and vein diameter of A. splendens were negatively correlated with each other in subcanopy environment (p < 0.01), transitional and open areas (p < 0.05). The SMA (0.54-1.50) slope of regression equation in the scaling relationships between vein density and vein diameter decrease gradually from subcanopy to open areas.     

Morphology of a neonatal umbilical vein graft under prolonged experimental conditions

The authors carried out a comparative histological and electron microscopic study of the bioprosthesis of the umbilical vein (Biograft manufactured by Meadox) and bioprosthesis obtained according to the method by M. I. Kuzin and coworkers. A far greater preservation of the new bioprosthesis was observed at long-term periods both at the histological and ultrastructural levels. Some morphological phenomena reflecting the time course of the vessel graft rearrangement were delineated 18 to 24 months after transplantation, particularly the development of "collateral" vessels in the perivenous space. The suggestion was made about an important role of Wharton's substance in the formation of the vessels.     

Prolonged systemic delivery of tirofiban in a thrombus-laden saphenous vein graft

Results from previous trials have shown conflicting results from local delivery of thrombolytic agents to diminish thrombus burden before intervention in native coronary arteries and saphenous vein grafts. We described a patient with an acute coronary syndrome who was treated for 24 hours with systemic tirofiban (Aggrastat), a glycoprotein IIb/IIIa inhibitor, for the treatment of a degenerated saphenous vein graft with a TIMI grade 4 thrombus (large-sized thrombus). Angiographic evaluation 48 hours later revealed complete resolution of the thrombus with normal coronary blood flow.     

Intraorganic blood vessels of the intestinal graft after its ortho- and heterotopic transplantation

In experiments, performed on 85 dogs of both sex ortho- and heterotopic total autotransplantation of the small intestine and extracorporal connection of the allogenic segments of the small intestine have been carried out. Certain dependency of morphological changes of the intraorganic blood bed on the operation model has been stated. Essential changes in the blood bed at the heterotopic autotransplantation depend on inadequate regional hemodynamics in the graft. Therefore, the heterotopic model should be considered less preferable than the orthotopic one. One of the peculiarities in reconstruction of the intraorganic vascular bed after ortho- and heterotropic transplantation of the small intestine is, evidently, opening of lympho-venular anastomoses.     

Postsurgical changes of the opening angle of canine autogenous vein graft.

The opening angles of 30 canine autogenous vein grafts were measured to determine the postsurgical change of residual strain in the vein graft. Canine femoral veins were grafted to femoral arteries in the end-to-end anastomosis fashion. When harvested, the vein grafts were cut into short segments and the segments were cut open radially. The opened-up configurations were taken as the zero-stress states of the vessels. Opening angle, defined as the angle between the two lines from the middle point to the tips of the inner wall, was used to describe the zero-stress states. Results show that the opening angles (mean +/- SD) are 63.0 +/- 30.6 deg for normal femoral veins, and -0.4 +/- 4.6, 6.1 +/- 19.4, 25.4 +/- 20.1, and 47.8 +/- 11.4 deg for vein grafts at 1 day, 1 week, 4 and 12 weeks postsurgery, respectively. The postsurgical changes in opening angle reveal nonuniform transmural tissue remodeling in the vascular wall. The relations between the changes in opening angle and the changes in the morphology of the vein grafts are discussed. Intimal hyperplasia is correlated to the opening angle and is suggested to be the main factor for the postsurgical increase in opening angle. The longitudinal strain in the vein graft is found to decrease postsurgically.     

Method of inserting thin-walled polymeric cannulas and catheters into vessels of diameter up to 0.2 mm

To facilitate cannulation of thin blood vessels, a removable sharpened metal wire was inserted into a catheter. It made it possible to cannulate vessels under 0.2 mm in diameter with thin-walled soft flexible plastic tubes.     

Successful development of small diameter tissue-engineering vascular vessels by our novel integrally designed pulsatile perfusion-based bioreactor

Small-diameter (<4 mm) vascular constructs are urgently needed for patients requiring replacement of their peripheral vessels. However, successful development of constructs remains a significant challenge. In this study, we successfully developed small-diameter vascular constructs with high patency using our integrally designed computer-controlled bioreactor system. This computer-controlled bioreactor system can confer physiological mechanical stimuli and fluid flow similar to physiological stimuli to the cultured grafts. The medium circulating system optimizes the culture conditions by maintaining fixed concentration of O(2) and CO(2) in the medium flow and constant delivery of nutrients and waste metabolites, as well as eliminates the complicated replacement of culture medium in traditional vascular tissue engineering. Biochemical and mechanical assay of newly developed grafts confirm the feasibility of the bioreactor system for small-diameter vascular engineering. Furthermore, the computer-controlled bioreactor is superior for cultured cell proliferation compared with the traditional non-computer-controlled bioreactor. Specifically, our novel bioreactor system may be a potential alternative for tissue engineering of large-scale small-diameter vascular vessels for clinical use.     

Human saphenous vein and coronary bypass surgery: ultrastructural aspects of conventional and "no-touch" vein graft preparations

Coronary artery bypass graft surgery (CABG) is routinely used to restore blood flow to diseased cardiac muscle due to coronary artery disease. The patency of conventional grafts decreases with time, which is due to thrombosis and formation of neointima. A primary cause of graft failure is the mechanical damage inflicted to the graft during harvesting, including removal of surrounding tissue accompanied by high pressure saline distension to overcome vasospasm (both causing considerable mechanical trauma). The aim of this study was to compare the ultrastructural features of human saphenous vein (SV) grafts harvested conventionally and grafts prepared using an atraumatic 'no-touch' harvesting technique introduced by Souza (1996). The results of this study showed a better preservation of the lumenal endothelium and medial vascular smooth muscle (SM) in 'no-touch' versus conventional grafts. A 'fast' (within 30 min) response of SM cells to conventional harvesting was noted where features of both SM cell division and apoptosis were observed. It is concluded that the 'preserved' nature of the 'no-touch' aortocoronary SV grafts renders them less susceptible to thrombotic and atherosclerotic factors than grafts harvested conventionally. These features are suggested to contribute to the improved early patency rate described using the no-touch technique of SV harvesting.     

Construction of interleukin-1 alpha mutants using unequal contamination of synthetic oligonucleotides.

Proteins without readily available three-dimensional structural data present a difficult problem in the exploration of structure/function relationships. Saturation mutagenesis using contaminated oligonucleotides can identify potentially interesting regions of such a protein. This technique, in which synthesized oligonucleotides contain low-level base substitutions, allows random mutations to be placed throughout a gene sequence. Using double-stranded cassettes, a region of the human interleukin-1 alpha gene has been altered using such mutagenic oligonucleotides. However, instead of contaminating both strands of the gene sequence at the same level, each strand of the insert was contaminated at a different level. Several recombinants were sequenced and the effects of the mutations on the activity of the proteins were examined. Contaminating the two oligonucleotides at different levels produced a significantly different distribution of nucleotide changes from that seen if both strands were contaminated at the same level. The observed distribution followed the average of the distributions for each of the two contamination levels. This resulted in roughly equal frequencies of 1 to 5 nucleotide changes per clone with very few clones containing the wild-type nucleotide sequence. This helped overcome the redundancy in the genetic code, resulting in a high frequency of amino acid changes, and allowed changes at every amino acid to be sampled in a small number of mutants. This procedure can allow a gene sequence to be screened rapidly by removing most wild-type sequences from analysis while making sure that there are many amino acid changes in the resultant mutants.