The study findings demonstrated a statistically significant decrease in adipocyte diameters during both the early and late phases of the subjects injected with CO(2). With adipocyte volume defined as an achievement, CO(2) therapy was found to be more successful than air injection. Furthermore, compared with the control group, the decrease in adipocyte volume also was statistically significant in breathable air injected groups (groups 3 and 5). This result suggests that the mechanical effects of gas injection are more important than the metabolic effects.

Vaginal reconstruction in congenital vaginal agenesis with split LM flaps and full-thickness skin grafts is a simple and effective method, which shortens the standing period and decreases the contraction in neovagina. Total vaginal reconstruction with split LM flaps could also be possible; to achieve this goal, expansion of LM flaps could be a further alternative.

The development of microsurgical techniques and better understanding of nerve biology has resulted in significant improvement in the results of nerve repair. Some problems are still present. What would be the method of choice if 2 transected nerves were to be coapted and only one neighboring intact nerve was available? We performed neurotization of 2 different muscles by a single intact nerve, using only one nerve graft by reverse end-to-side coaptation that has already been introduced into the literature. We assessed the results histomorphologically and functionally. Twenty-four adult rats were used in the present study and equally divided into 4 groups. Group 1 (n = 6): Control group; Group 2 (n = 6): Unrepaired nerve damage group; Group 3 (n = 6): End-to-end repair group. The peroneal branch of the sciatic nerve was excised to obtain an approximate size of 2 cm-graft, which was subsequently divided into 2 equal pieces to obtain 2 pieces of grafts each 1 cm long. Then, the tibial branch of the sciatic nerve was also cut to produce a nerve defect. End-to-end coaptation was obtained. A “V” shape was obtained. Group 4 (n = 6): Reverse end-to-side repair group. The peroneal branch of the sciatic nerve was excised as a graft approximately 2-cm in length. Subsequently a defect was produced by cutting the tibial branch of the sciatic nerve. Coaptation was performed by suturing the dissected proximal end of the tibial nerve by reverse end-to-side coaptation. A “U” shape resembling a horse shoe was obtained. The success of Group 4 was demonstrated when both peek-to-peek and latency timing of extensor digitorum and gastrocnemius muscles, determined as the target organ, were evaluated. Besides, an equal distribution was observed in Group 4 when number of myelinated (P = 0.596) and unmyelinated (P = 0.936) axons in both legs of grafts were compared with each other. However, myelinated axons were not equally distributed between the legs of the nerve graft in Group 3 (P = 0.027). In conclusion, reverse end-to-side coaptation is a useful technique for 2 different muscle neurotization via a single nerve graft and a single nerve coaptation with a donor nerve.

No abstract

Most studies agree on the demonstration of the existence of nerve tissue specificity and that if a non-nervous target (e.g. a tendon) were sutured to one of the distal limbs of a Y-shaped nerve guide, independent of the type of guide, all nerve fibers would regenerate toward the nerve tissue. Recent studies suggest that optimum nerve regeneration may arise from the tissue environment in general. We developed an experimental model in order to eliminate all the microenvironment problems that we experienced in previous studies, and to be able to evaluate the neurotropic affinity of various tissues. Group 1 (n:8): The control group. The sciatic nerve was only explored, but certainly not touched. Group 2 (n:8): Both lower ends of the peroneal nerve graft, prepared by reverse end-to-side coaptation in the shape of a horseshoe, were coapted to tibial and peroneal nerves distally by end-to-end coaptation. Group 3 (n:8): As one end of the peroneal nerve graft, prepared by reverse end-to-side coaptation in the shape of a horseshoe, was coapted to the peroneal nerve distally, the other end was sutured directly by opening the fascia of the gastrocnemius muscle. Group 4 (n:8): As one end of the peroneal nerve graft, prepared by reverse end-to-side coaptation in the shape of a horseshoe, was coapted to peroneal nerve distally, the other end was ligated As seen in the histomorphometric analysis, axons were observed to sprout towards both ends of the horseshoe-shaped nerve graft in a free fashion without being affected by the negative influences of the microenvironment.