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L S Levin - One of the best experts on this subject based on the ideXlab platform.
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the effect of muscle flap transposition to the Fracture Site on tnfalpha levels during Fracture healing
Plastic and Reconstructive Surgery, 2000Co-Authors: Spencer A Brown, A J Mayberry, J A Mathy, T M Phillips, Bruce Klitzman, L S LevinAbstract:The trauma and sepsis that follow open Fractures and wounds may lead to the production of various cytokines. Understanding wound healing requires a direct knowledge of the specific cytokines and the respective wound fluid levels that are present at the wound Site. An animal model was designed that mimics the open Fracture and the clinical repair of the human, high-energy open Fracture. Canine right tibiae were Fractured with a penetrating, captive-bolt device, then repaired in a standard clinical fashion using an interlocking intramedullary nail. Before primary wound closure, microdialysis probes were placed at the Fracture Site and in a muscle located at a contralateral Site. Canines received one of the following experimental protocols: (1) tibial Fracture (n = 5); (2) tibial Fracture plus Staphylococcus aureus inoculation at the Fracture Site (n = 5); and (3) tibial Fracture, S. aureus inoculation, and a rotational gastrocnemius muscle flap (n = 5). Microdialysis fluid samples were collected intermittently for 7 days. Tumor necrosis factor alpha (TNFalpha) levels at the Fracture Site were significantly elevated 3 to 34-fold (p<0.02), as compared with respective serum levels at all time points for all treatment groups. Fracture Site TNFalpha levels were elevated (p<0.02) in days 1 through 6, as compared with the baseline and contralateral in all treatment groups. At days 1 through 6, the TNFalpha levels of the muscle flap group Fracture Site were significantly decreased by approximately 50 percent (p<0.05), as compared with the Fractures without muscle flaps and regardless of additional S. aureus inoculation. On day 7, Fracture Site TNFalpha levels in all animal groups were similar, yet remained well above those of baseline TNFalpha. These results demonstrate that S. aureus does not further elevate TNFalpha levels in the presence of an open Fracture and that a muscle flap reduces pro-inflammatory TNFalpha levels during early wound healing. This experimental model allows for the characterization of specific biological signals and cellular pathways that are influenced by bacterial infection and surgical closure. These data provide a scientific framework on which to judge or validate therapeutic regimens for open-Fracture wound healing.
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The effect of muscle flap transposition to the Fracture Site on TNFalpha levels during Fracture healing.
Plastic and reconstructive surgery, 2000Co-Authors: Spencer A Brown, Bruce Klitzman, L S LevinAbstract:The trauma and sepsis that follow open Fractures and wounds may lead to the production of various cytokines. Understanding wound healing requires a direct knowledge of the specific cytokines and the respective wound fluid levels that are present at the wound Site. An animal model was designed that mimics the open Fracture and the clinical repair of the human, high-energy open Fracture. Canine right tibiae were Fractured with a penetrating, captive-bolt device, then repaired in a standard clinical fashion using an interlocking intramedullary nail. Before primary wound closure, microdialysis probes were placed at the Fracture Site and in a muscle located at a contralateral Site. Canines received one of the following experimental protocols: (1) tibial Fracture (n = 5); (2) tibial Fracture plus Staphylococcus aureus inoculation at the Fracture Site (n = 5); and (3) tibial Fracture, S. aureus inoculation, and a rotational gastrocnemius muscle flap (n = 5). Microdialysis fluid samples were collected intermittently for 7 days. Tumor necrosis factor alpha (TNFalpha) levels at the Fracture Site were significantly elevated 3 to 34-fold (p
Spencer A Brown - One of the best experts on this subject based on the ideXlab platform.
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the effect of muscle flap transposition to the Fracture Site on tnfalpha levels during Fracture healing
Plastic and Reconstructive Surgery, 2000Co-Authors: Spencer A Brown, A J Mayberry, J A Mathy, T M Phillips, Bruce Klitzman, L S LevinAbstract:The trauma and sepsis that follow open Fractures and wounds may lead to the production of various cytokines. Understanding wound healing requires a direct knowledge of the specific cytokines and the respective wound fluid levels that are present at the wound Site. An animal model was designed that mimics the open Fracture and the clinical repair of the human, high-energy open Fracture. Canine right tibiae were Fractured with a penetrating, captive-bolt device, then repaired in a standard clinical fashion using an interlocking intramedullary nail. Before primary wound closure, microdialysis probes were placed at the Fracture Site and in a muscle located at a contralateral Site. Canines received one of the following experimental protocols: (1) tibial Fracture (n = 5); (2) tibial Fracture plus Staphylococcus aureus inoculation at the Fracture Site (n = 5); and (3) tibial Fracture, S. aureus inoculation, and a rotational gastrocnemius muscle flap (n = 5). Microdialysis fluid samples were collected intermittently for 7 days. Tumor necrosis factor alpha (TNFalpha) levels at the Fracture Site were significantly elevated 3 to 34-fold (p<0.02), as compared with respective serum levels at all time points for all treatment groups. Fracture Site TNFalpha levels were elevated (p<0.02) in days 1 through 6, as compared with the baseline and contralateral in all treatment groups. At days 1 through 6, the TNFalpha levels of the muscle flap group Fracture Site were significantly decreased by approximately 50 percent (p<0.05), as compared with the Fractures without muscle flaps and regardless of additional S. aureus inoculation. On day 7, Fracture Site TNFalpha levels in all animal groups were similar, yet remained well above those of baseline TNFalpha. These results demonstrate that S. aureus does not further elevate TNFalpha levels in the presence of an open Fracture and that a muscle flap reduces pro-inflammatory TNFalpha levels during early wound healing. This experimental model allows for the characterization of specific biological signals and cellular pathways that are influenced by bacterial infection and surgical closure. These data provide a scientific framework on which to judge or validate therapeutic regimens for open-Fracture wound healing.
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The effect of muscle flap transposition to the Fracture Site on TNFalpha levels during Fracture healing.
Plastic and reconstructive surgery, 2000Co-Authors: Spencer A Brown, Bruce Klitzman, L S LevinAbstract:The trauma and sepsis that follow open Fractures and wounds may lead to the production of various cytokines. Understanding wound healing requires a direct knowledge of the specific cytokines and the respective wound fluid levels that are present at the wound Site. An animal model was designed that mimics the open Fracture and the clinical repair of the human, high-energy open Fracture. Canine right tibiae were Fractured with a penetrating, captive-bolt device, then repaired in a standard clinical fashion using an interlocking intramedullary nail. Before primary wound closure, microdialysis probes were placed at the Fracture Site and in a muscle located at a contralateral Site. Canines received one of the following experimental protocols: (1) tibial Fracture (n = 5); (2) tibial Fracture plus Staphylococcus aureus inoculation at the Fracture Site (n = 5); and (3) tibial Fracture, S. aureus inoculation, and a rotational gastrocnemius muscle flap (n = 5). Microdialysis fluid samples were collected intermittently for 7 days. Tumor necrosis factor alpha (TNFalpha) levels at the Fracture Site were significantly elevated 3 to 34-fold (p
Bruce Klitzman - One of the best experts on this subject based on the ideXlab platform.
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the effect of muscle flap transposition to the Fracture Site on tnfalpha levels during Fracture healing
Plastic and Reconstructive Surgery, 2000Co-Authors: Spencer A Brown, A J Mayberry, J A Mathy, T M Phillips, Bruce Klitzman, L S LevinAbstract:The trauma and sepsis that follow open Fractures and wounds may lead to the production of various cytokines. Understanding wound healing requires a direct knowledge of the specific cytokines and the respective wound fluid levels that are present at the wound Site. An animal model was designed that mimics the open Fracture and the clinical repair of the human, high-energy open Fracture. Canine right tibiae were Fractured with a penetrating, captive-bolt device, then repaired in a standard clinical fashion using an interlocking intramedullary nail. Before primary wound closure, microdialysis probes were placed at the Fracture Site and in a muscle located at a contralateral Site. Canines received one of the following experimental protocols: (1) tibial Fracture (n = 5); (2) tibial Fracture plus Staphylococcus aureus inoculation at the Fracture Site (n = 5); and (3) tibial Fracture, S. aureus inoculation, and a rotational gastrocnemius muscle flap (n = 5). Microdialysis fluid samples were collected intermittently for 7 days. Tumor necrosis factor alpha (TNFalpha) levels at the Fracture Site were significantly elevated 3 to 34-fold (p<0.02), as compared with respective serum levels at all time points for all treatment groups. Fracture Site TNFalpha levels were elevated (p<0.02) in days 1 through 6, as compared with the baseline and contralateral in all treatment groups. At days 1 through 6, the TNFalpha levels of the muscle flap group Fracture Site were significantly decreased by approximately 50 percent (p<0.05), as compared with the Fractures without muscle flaps and regardless of additional S. aureus inoculation. On day 7, Fracture Site TNFalpha levels in all animal groups were similar, yet remained well above those of baseline TNFalpha. These results demonstrate that S. aureus does not further elevate TNFalpha levels in the presence of an open Fracture and that a muscle flap reduces pro-inflammatory TNFalpha levels during early wound healing. This experimental model allows for the characterization of specific biological signals and cellular pathways that are influenced by bacterial infection and surgical closure. These data provide a scientific framework on which to judge or validate therapeutic regimens for open-Fracture wound healing.
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The effect of muscle flap transposition to the Fracture Site on TNFalpha levels during Fracture healing.
Plastic and reconstructive surgery, 2000Co-Authors: Spencer A Brown, Bruce Klitzman, L S LevinAbstract:The trauma and sepsis that follow open Fractures and wounds may lead to the production of various cytokines. Understanding wound healing requires a direct knowledge of the specific cytokines and the respective wound fluid levels that are present at the wound Site. An animal model was designed that mimics the open Fracture and the clinical repair of the human, high-energy open Fracture. Canine right tibiae were Fractured with a penetrating, captive-bolt device, then repaired in a standard clinical fashion using an interlocking intramedullary nail. Before primary wound closure, microdialysis probes were placed at the Fracture Site and in a muscle located at a contralateral Site. Canines received one of the following experimental protocols: (1) tibial Fracture (n = 5); (2) tibial Fracture plus Staphylococcus aureus inoculation at the Fracture Site (n = 5); and (3) tibial Fracture, S. aureus inoculation, and a rotational gastrocnemius muscle flap (n = 5). Microdialysis fluid samples were collected intermittently for 7 days. Tumor necrosis factor alpha (TNFalpha) levels at the Fracture Site were significantly elevated 3 to 34-fold (p
Ahmad Nazrun Shuid - One of the best experts on this subject based on the ideXlab platform.
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Targeted Delivery of Lovastatin and Tocotrienol to Fracture Site Promotes Fracture Healing in Osteoporosis Model: Micro-Computed Tomography and Biomechanical Evaluation
PloS one, 2014Co-Authors: Nurul ‘izzah Ibrahim, Mohd Fadhli Khamis, Mohd Faridz Mod Yunoh, Shahrum Abdullah, Norazlina Mohamed, Ahmad Nazrun ShuidAbstract:Osteoporosis is becoming a major health problem that is associated with increased Fracture risk. Previous studies have shown that osteoporosis could delay Fracture healing. Although there are potential agents available to promote Fracture healing of osteoporotic bone such as statins and tocotrienol, studies on direct delivery of these agents to the Fracture Site are limited. This study was designed to investigate the effects of two potential agents, lovastatin and tocotrienol using targeted drug delivery system on Fracture healing of postmenopausal osteoporosis rats. The Fracture healing was evaluated using micro CT and biomechanical parameters. Forty-eight Sprague-Dawley female rats were divided into 6 groups. The first group was sham-operated (SO), while the others were ovariectomized (OVx). After two months, the right tibiae of all rats were Fractured at metaphysis region using pulsed ultrasound and were fixed with plates and screws. The SO and OVxC groups were given two single injections of lovastatin and tocotrienol carriers. The estrogen group (OVx+EST) was given daily oral gavages of Premarin (64.5 µg/kg). The Lovastatin treatment group (OVx+Lov) was given a single injection of 750 µg/kg lovastatin particles. The tocotrienol group (OVx+TT) was given a single injection of 60 mg/kg tocotrienol particles. The combination treatment group (OVx+Lov+TT) was given two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks of treatment, the Fractured tibiae were dissected out for micro-CT and biomechanical assessments. The combined treatment group (OVx+Lov+TT) showed significantly higher callus volume and callus strength than the OVxC group (p
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targeted delivery of lovastatin and tocotrienol to Fracture Site promotes Fracture healing in osteoporosis model micro computed tomography and biomechanical evaluation
PLOS ONE, 2014Co-Authors: Nurul Izzah Ibrahim, Mohd Fadhli Khamis, Mohd Faridz Mod Yunoh, Shahrum Abdullah, Norazlina Mohamed, Ahmad Nazrun ShuidAbstract:Osteoporosis is becoming a major health problem that is associated with increased Fracture risk. Previous studies have shown that osteoporosis could delay Fracture healing. Although there are potential agents available to promote Fracture healing of osteoporotic bone such as statins and tocotrienol, studies on direct delivery of these agents to the Fracture Site are limited. This study was designed to investigate the effects of two potential agents, lovastatin and tocotrienol using targeted drug delivery system on Fracture healing of postmenopausal osteoporosis rats. The Fracture healing was evaluated using micro CT and biomechanical parameters. Forty-eight Sprague-Dawley female rats were divided into 6 groups. The first group was sham-operated (SO), while the others were ovariectomized (OVx). After two months, the right tibiae of all rats were Fractured at metaphysis region using pulsed ultrasound and were fixed with plates and screws. The SO and OVxC groups were given two single injections of lovastatin and tocotrienol carriers. The estrogen group (OVx+EST) was given daily oral gavages of Premarin (64.5 µg/kg). The Lovastatin treatment group (OVx+Lov) was given a single injection of 750 µg/kg lovastatin particles. The tocotrienol group (OVx+TT) was given a single injection of 60 mg/kg tocotrienol particles. The combination treatment group (OVx+Lov+TT) was given two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks of treatment, the Fractured tibiae were dissected out for micro-CT and biomechanical assessments. The combined treatment group (OVx+Lov+TT) showed significantly higher callus volume and callus strength than the OVxC group (p<0.05). Both the OVx+Lov and OVx+TT groups showed significantly higher callus strength than the OVxC group (p<0.05), but not for callus volume. In conclusion, combined lovastatin and tocotrienol may promote better Fracture healing of osteoporotic bone.
K M S Mohamed - One of the best experts on this subject based on the ideXlab platform.
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Open Access Superficial Peroneal Nerve Incarceration in the Fibular Fracture Site of a Pronation External Rotation Type Ankle Fracture
2016Co-Authors: P Ellanti, K M S MohamedAbstract:Abstract: Ankle Fractures are common representing up to 10 % of all Fractures with an incidence that is rising. Both conservative treatment and operative management of ankle Fractures can lead to excellent outcomes. Neurovascular injuries are uncommon but can be a source of significant morbidity and associated poor outcome. The superficial peroneal nerve (SPN) in the lateral approach and the sural nerve in the posterolateral approach are at risk of injury. We report an unexpected finding of a superficial peroneal nerve incarcerated in the fibular Fracture Site of pronation external rotation type / Weber-C ankle Fracture. To the best of our knowledge we believe this to be the first English language report of an incarcerated SPN at a fibular ankle Fracture Site
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superficial peroneal nerve incarceration in the fibular Fracture Site of a pronation external rotation type ankle Fracture
The Open Orthopaedics Journal, 2015Co-Authors: P Ellanti, K M S Mohamed, K OsheaAbstract:Ankle Fractures are common representing up to 10% of all Fractures with an incidence that is rising. Both conservative treatment and operative management of ankle Fractures can lead to excellent outcomes. Neurovascular injuries are uncommon but can be a source of significant morbidity and associated poor outcome. The superficial peroneal nerve (SPN) in the lateral approach and the sural nerve in the posterolateral approach are at risk of injury. We report an unexpected finding of a superficial peroneal nerve incarcerated in the fibular Fracture Site of pronation external rotation type/ Weber-C ankle Fracture. To the best of our knowledge we believe this to be the first English language report of an incarcerated SPN at a fibular ankle Fracture Site.
