LIMB REPLANTATION AFTER AVULSION INJURIES: TECHNIQUES AND TACTICS FOR SUCCESS

Objectives: Retrospective evaluation of cases of limb replantation after avulsion injuries. Evaluation of the techniques and tactics used, that contributed to success and good functional results. Methods: Forty-three patients' records were assessed. All the cases had been submitted to limb replantation after avulsion injuries. Results: The majority of the cases were young men. The most common injury was to the thumbs. The surgical techniques and tactics used were: nerve grafting, vein grafting, transposition of the digital vessels, limb shortening, and heterotopic replantation. The most commonly used technique was vein graft. The limb survival rate was high (93%), as was patient satisfaction. Conclusion: Replantation after avulsion injury depends on the correct diagnosis of the limb viability and the use of appropriate surgical techniques and tactics for each case. The experience of the team of surgeons and a good hospital structure are essential for good results. There are few articles in medical literature about the indications, techniques and results of limb replantation after avulsion injuries. We believe that this retrospective evaluation can bring new information and contributions to the correct management of this highly complex situation. Level of evidence IV, Case Series.

Electric consumption in SHSs in rural communities of brazil and Peru and recommendations for sizing

The lack of data records of electric power consumption of smallphotovoltaic home systems, independently of the method used for sizing them, drives to consider the demand as a constant. However, the existing data reveal the variability of the consumption due to the influences of some social, cultural and psychosocial aspects of the human groups. This paper presents records of consumption data obtainedfrom several solar home systems (SHSs) in Brazil and Peru, and it discusses about the Gamma distribution function that can express to a great extent the behaviour of the demand. By this analysis it was verified that `a lot of people consume little and few people consume a lot`. In that sense, a few recommendations for sizing procedures that can be useful in the implantation of extensive programmes of rural electrification by SHSs are presented. Copyright (c) 2007 John Wiley & Sons, Ltd.

Human Adipose-Derived Mesenchymal Stromal Cells Injected Systemically Into GRMD Dogs Without Immunosuppression Are Able to Reach the Host Muscle and Express Human Dystrophin

Duchenne muscular dystrophy (DMD), a lethal X-linked disorder, is the most common and severe form of muscular dystrophies, affecting I in 3,500 male births. Mutations in the DMD gene lead to the absence of muscle dystrophin and a progressive degeneration of skeletal muscle. The possibility to treat DMD through cell therapy has been widely investigated. We have previously shown that human adipose-derived stromal cells (hASCs) injected systemically in SJL mice are able to reach and engraft in the host muscle, express human muscle proteins, and ameliorate the functional performance of injected animals without any immunosuppression. However, before starting clinical trials in humans many questions still need to be addressed in preclinical studies, in particular in larger animal models, when available. The best animal model to address these questions is the golden retriever muscular dystrophy (GRMD) dog that reproduces the full spectrum of human DMD. Affected animals carry a mutation that predicts a premature termination codon in exon 8 and a peptide that is 5% the size of normal dystrophin. These dogs present clinical signs within the first weeks and most of them do not survive beyond age two. Here we show the results of local and intravenous injections of hASCs into GRMD dogs, without immunosuppression. We observed that hASCs injected systemically into the dog cephalic vein are able to reach, engraft, and express human dystrophin in the host GRMD dystrophic muscle up to 6 months after transplantation. Most importantly, we demonstrated that injecting a huge quantity of human mesenchymal cells in a large-animal model, without immunosuppression, is a safe procedure, which may have important applications for future therapy in patients with different forms of muscular dystrophies.

The legs: a key to bird evolutionary success

Birds are the most diverse and largest group of extant tetrapods. They show marked variability, yet much of this variation is superficial and due to feather and bill color and shape. Under the feathers, the skeleto-muscular system is rather constant throughout the bird group. The adaptation to flight is the explanation for this uniformity. The more obvious morphological adaptations for flight are the wings, but the trunk is always rigid, the tail is short and the neck is flexible, since all these features are correlated with flying behaviour. Unrelated to the exigencies of flight, the legs always have three long bones, and all the birds walk on their toes. This leg structure is a striking plesiomorphic feature that was already present in related dinosaurs. The multi-purpose potential of the legs is the result of the skeletal architecture of a body with three segmented flexed legs. This configuration provides mechanical properties that allow the use of the legs as propulsive, paddling, foraging or grooming tools. It is the association of diverse modes of locomotion-walking, running, hopping, flying and swimming-that have enabled the birds to colonize almost all the environments on Earth.