Plastic and Reconstructive Surgery Global Open, 2019
a three wavelength NIRS device designed to detect the oxidation state of cytochrome aa3, which is... more a three wavelength NIRS device designed to detect the oxidation state of cytochrome aa3, which is a direct measure of cellular ischemia. The device lessened StO2 variation using an established ischemia and reperfusion model, but did not adequately reflect cytochrome aa3 oxidation state. The objective of this study was to compare a broadband NIRS device using white light (> 1000 wavelengths) to the standard two wavelength NIRS device (ViOptix Inc, Freemont CA) commonly employed for flap monitoring by measuring StO2 variability during ischemia and reperfusion and corresponding cytochrome aa3 oxidation – a direct measure of cellular ischemia.
Plastic and Reconstructive Surgery Global Open, 2021
Purpose: Although advanced prosthetic devices have the potential to allow fine-motor movements an... more Purpose: Although advanced prosthetic devices have the potential to allow fine-motor movements and extract somatosensory signals via sensitive pressure sensors, an ideal interface to integrate the human nervous system with the prosthetic doesn’t exist. Furthermore, the requirement for the implantation of indwelling electrodes and prohibitive costs limits the application of current technologies. The Regenerative Peripheral Nerve Interface (RPNI) was developed as a stable biologic interface on the notion of providing physiologic end-organ targets for regenerating axons by implantation of a residual nerve into an autogenous free muscle graft. Despite providing intuitive motor control, RPNI sensory feedback is limited and also relies on implantable electrodes for myoelectric signal transmission. To address these challenges, we investigated the placement of RPNIs underneath the defatted skin in rats to capture myoelectric signals using surface electrodes. This strategy simultaneously pro...
Regenerative peripheral nerve interfaces (RPNIs) transduce neural signals to provide high‐fidelit... more Regenerative peripheral nerve interfaces (RPNIs) transduce neural signals to provide high‐fidelity control of neuroprosthetic devices. Traditionally, rat RPNIs are constructed with ~150 mg of free skeletal muscle grafts. It is unknown whether larger free muscle grafts allow RPNIs to transduce greater signal.
ABSTRACT Objectives To investigate the therapeutic effects of sumatriptan in a rat model of spina... more ABSTRACT Objectives To investigate the therapeutic effects of sumatriptan in a rat model of spinal cord injury (SCI) and possible anti-inflammatory and analgesic mechanisms underlying this effect. Methods Using an aneurysm mini-clip model of contusive SCI, T9-10 laminectomies were performed for 60 male rats. Animals were divided into six experimental groups (n = 10 per group) as follows: a minocycline administered positive control group, a saline-vehicle negative control group, a sham-operated group, and three experimental groups which received separate doses of sumatriptan (0.1, 0.3 and 1 mg/kg). Behavioural assessments were used to evaluate locomotor activity and neuropathic pain for 28 days. At the end of the study, spinal cord tissues were collected from sacrificed animals for histopathological analysis. Levels of calcitonin gene-related peptide (CGRP) and two pro-inflammatory cytokines (tumor necrosis factor [TNF]-α and interleukin [IL]-1β) were assessed by the enzyme-linked immunosorbent assay (ELISA). Results Sumatriptan significantly (P < 0.001) improved the locomotor activity in SCI group. Sumatriptan was also more effective than the positive control, i.e. minocycline (0.3 mg/kg). Additionally, sumatriptan and minocycline similarly attenuated the mechanical and thermal allodynia in SCI (P < 0.001). TNF-α, IL-1β and CGRP levels in sumatriptan- and minocycline-treated groups significantly (P < 0.001) decreased compared to controls. Histopathological analysis also revealed a markedly improvement in hemorrhage followed by inflammatory cell invasion, neuronal vacuolation, and cyst formation in both sumatriptan- and minocycline-treated groups compared to control animals. Conclusions Sumatriptan improves functional recovery from SCI through its anti-inflammatory effects and reducing pro-inflammatory and pain mediators.
Painful terminal neuromas resulting from nerve injury following amputation are common. However, t... more Painful terminal neuromas resulting from nerve injury following amputation are common. However, there is currently no universally accepted gold standard of treatment for this condition. A comprehensive literature review is presented on the treatment of terminal neuromas. Four categories of terminal neuroma surgical procedures are assessed: epineurial closure; nerve transposition with implantation; neurorrhaphy, and alternate target reinnervation. Significant patient and case studies are highlighted in each section, focusing on surgical technique and patient outcome metrics. Studies presented consisted of a PubMed search for "terminal neuromas," without year limitation. The current available research supports the use of implantation into muscle for the surgical treatment of terminal neuromas. However, this technique has several fundamental flaws that limit its utility, as it does not address the underlying physiology behind neuroma formation. Regenerative peripheral nerve i...
Regenerative peripheral nerve interfaces (RPNIs) are neurotized free autologous muscle grafts equ... more Regenerative peripheral nerve interfaces (RPNIs) are neurotized free autologous muscle grafts equipped with electrodes to record myoelectric signals for prosthesis control. Viability of rat RPNI constructs have been demonstrated using evoked responses. In vivo RPNI characterization is the next critical step for assessment as a control modality for prosthetic devices. Two RPNIs were created in each of two rats by grafting portions of free muscle to the ends of divided peripheral nerves (peroneal in the left and tibial in the right hind limb) and placing bipolar electrodes on the graft surface. After four months, we examined in vivo electromyographic signal activity and compared these signals to muscular electromyographic signals recorded from autologous muscles in two rats serving as controls. An additional group of two rats in which the autologous muscles were denervated served to quantify cross-talk in the electrode recordings. Recordings were made while rats walked on a treadmill ...
Introduction: Regenerative Peripheral Nerve Interfaces (RPNIs) are neurotized muscle grafts that ... more Introduction: Regenerative Peripheral Nerve Interfaces (RPNIs) are neurotized muscle grafts that control prostheses through electromyography (EMG). RPNI signals have not been quantified during phases of voluntary movements. This study: a) characterizes active RPNI signaling compared to background activity and b) defines the reliability and validity of RPNI function during gait phases of rat walking. Material and Methods: Rat groups were: Control (n=3), RPNI (n=3), Denervated (n=3). Bipolar electrodes were implanted onto the soleus muscles in each group. The Control group was left intact. The Denervated group had the tibial nerve transected. For RPNIs, the soleus muscle was freely grafted to the ipsilateral thigh and neurotized by the transected tibial nerve. While walking on a treadmill, rats were videographed and raw EMG signals were simultaneously recorded. Outcome measurements were integrated EMG (iEMG) and iEMG normalized (NiEMG) to stance, swing, or sit gait phase. Results: Majority of EMG activity was observed within the stance phase—70% for Control and 79% for RPNI—as expected for active soleus postural muscles. Stance NiEMG signals were greater than swing NiEMG averages for Control and RPNI groups (Fig 1). The Denervated group stance and swing NiEMG signals were not different without peripheral nerve control. Fidelity of RPNI stance activity (NiEMG signal to background signal) was 5.6 to 1, or double the Control signal fidelity. Correlations between iEMG and stance time for the Control (r=0.74) and RPNI (r=0.76) indicate strong signal reliability (Fig. 2). Conclusion: Measurements of fidelity, reliability, and validity for RPNI signal detection all exceeded normal probability (p<0.05) during voluntary movement.
Plastic and Reconstructive Surgery Global Open, 2019
a three wavelength NIRS device designed to detect the oxidation state of cytochrome aa3, which is... more a three wavelength NIRS device designed to detect the oxidation state of cytochrome aa3, which is a direct measure of cellular ischemia. The device lessened StO2 variation using an established ischemia and reperfusion model, but did not adequately reflect cytochrome aa3 oxidation state. The objective of this study was to compare a broadband NIRS device using white light (> 1000 wavelengths) to the standard two wavelength NIRS device (ViOptix Inc, Freemont CA) commonly employed for flap monitoring by measuring StO2 variability during ischemia and reperfusion and corresponding cytochrome aa3 oxidation – a direct measure of cellular ischemia.
Plastic and Reconstructive Surgery Global Open, 2021
Purpose: Although advanced prosthetic devices have the potential to allow fine-motor movements an... more Purpose: Although advanced prosthetic devices have the potential to allow fine-motor movements and extract somatosensory signals via sensitive pressure sensors, an ideal interface to integrate the human nervous system with the prosthetic doesn’t exist. Furthermore, the requirement for the implantation of indwelling electrodes and prohibitive costs limits the application of current technologies. The Regenerative Peripheral Nerve Interface (RPNI) was developed as a stable biologic interface on the notion of providing physiologic end-organ targets for regenerating axons by implantation of a residual nerve into an autogenous free muscle graft. Despite providing intuitive motor control, RPNI sensory feedback is limited and also relies on implantable electrodes for myoelectric signal transmission. To address these challenges, we investigated the placement of RPNIs underneath the defatted skin in rats to capture myoelectric signals using surface electrodes. This strategy simultaneously pro...
Regenerative peripheral nerve interfaces (RPNIs) transduce neural signals to provide high‐fidelit... more Regenerative peripheral nerve interfaces (RPNIs) transduce neural signals to provide high‐fidelity control of neuroprosthetic devices. Traditionally, rat RPNIs are constructed with ~150 mg of free skeletal muscle grafts. It is unknown whether larger free muscle grafts allow RPNIs to transduce greater signal.
ABSTRACT Objectives To investigate the therapeutic effects of sumatriptan in a rat model of spina... more ABSTRACT Objectives To investigate the therapeutic effects of sumatriptan in a rat model of spinal cord injury (SCI) and possible anti-inflammatory and analgesic mechanisms underlying this effect. Methods Using an aneurysm mini-clip model of contusive SCI, T9-10 laminectomies were performed for 60 male rats. Animals were divided into six experimental groups (n = 10 per group) as follows: a minocycline administered positive control group, a saline-vehicle negative control group, a sham-operated group, and three experimental groups which received separate doses of sumatriptan (0.1, 0.3 and 1 mg/kg). Behavioural assessments were used to evaluate locomotor activity and neuropathic pain for 28 days. At the end of the study, spinal cord tissues were collected from sacrificed animals for histopathological analysis. Levels of calcitonin gene-related peptide (CGRP) and two pro-inflammatory cytokines (tumor necrosis factor [TNF]-α and interleukin [IL]-1β) were assessed by the enzyme-linked immunosorbent assay (ELISA). Results Sumatriptan significantly (P < 0.001) improved the locomotor activity in SCI group. Sumatriptan was also more effective than the positive control, i.e. minocycline (0.3 mg/kg). Additionally, sumatriptan and minocycline similarly attenuated the mechanical and thermal allodynia in SCI (P < 0.001). TNF-α, IL-1β and CGRP levels in sumatriptan- and minocycline-treated groups significantly (P < 0.001) decreased compared to controls. Histopathological analysis also revealed a markedly improvement in hemorrhage followed by inflammatory cell invasion, neuronal vacuolation, and cyst formation in both sumatriptan- and minocycline-treated groups compared to control animals. Conclusions Sumatriptan improves functional recovery from SCI through its anti-inflammatory effects and reducing pro-inflammatory and pain mediators.
Painful terminal neuromas resulting from nerve injury following amputation are common. However, t... more Painful terminal neuromas resulting from nerve injury following amputation are common. However, there is currently no universally accepted gold standard of treatment for this condition. A comprehensive literature review is presented on the treatment of terminal neuromas. Four categories of terminal neuroma surgical procedures are assessed: epineurial closure; nerve transposition with implantation; neurorrhaphy, and alternate target reinnervation. Significant patient and case studies are highlighted in each section, focusing on surgical technique and patient outcome metrics. Studies presented consisted of a PubMed search for "terminal neuromas," without year limitation. The current available research supports the use of implantation into muscle for the surgical treatment of terminal neuromas. However, this technique has several fundamental flaws that limit its utility, as it does not address the underlying physiology behind neuroma formation. Regenerative peripheral nerve i...
Regenerative peripheral nerve interfaces (RPNIs) are neurotized free autologous muscle grafts equ... more Regenerative peripheral nerve interfaces (RPNIs) are neurotized free autologous muscle grafts equipped with electrodes to record myoelectric signals for prosthesis control. Viability of rat RPNI constructs have been demonstrated using evoked responses. In vivo RPNI characterization is the next critical step for assessment as a control modality for prosthetic devices. Two RPNIs were created in each of two rats by grafting portions of free muscle to the ends of divided peripheral nerves (peroneal in the left and tibial in the right hind limb) and placing bipolar electrodes on the graft surface. After four months, we examined in vivo electromyographic signal activity and compared these signals to muscular electromyographic signals recorded from autologous muscles in two rats serving as controls. An additional group of two rats in which the autologous muscles were denervated served to quantify cross-talk in the electrode recordings. Recordings were made while rats walked on a treadmill ...
Introduction: Regenerative Peripheral Nerve Interfaces (RPNIs) are neurotized muscle grafts that ... more Introduction: Regenerative Peripheral Nerve Interfaces (RPNIs) are neurotized muscle grafts that control prostheses through electromyography (EMG). RPNI signals have not been quantified during phases of voluntary movements. This study: a) characterizes active RPNI signaling compared to background activity and b) defines the reliability and validity of RPNI function during gait phases of rat walking. Material and Methods: Rat groups were: Control (n=3), RPNI (n=3), Denervated (n=3). Bipolar electrodes were implanted onto the soleus muscles in each group. The Control group was left intact. The Denervated group had the tibial nerve transected. For RPNIs, the soleus muscle was freely grafted to the ipsilateral thigh and neurotized by the transected tibial nerve. While walking on a treadmill, rats were videographed and raw EMG signals were simultaneously recorded. Outcome measurements were integrated EMG (iEMG) and iEMG normalized (NiEMG) to stance, swing, or sit gait phase. Results: Majority of EMG activity was observed within the stance phase—70% for Control and 79% for RPNI—as expected for active soleus postural muscles. Stance NiEMG signals were greater than swing NiEMG averages for Control and RPNI groups (Fig 1). The Denervated group stance and swing NiEMG signals were not different without peripheral nerve control. Fidelity of RPNI stance activity (NiEMG signal to background signal) was 5.6 to 1, or double the Control signal fidelity. Correlations between iEMG and stance time for the Control (r=0.74) and RPNI (r=0.76) indicate strong signal reliability (Fig. 2). Conclusion: Measurements of fidelity, reliability, and validity for RPNI signal detection all exceeded normal probability (p<0.05) during voluntary movement.
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