Scleroderma is a chronic connective tissue disease characterized by inflammation,vascular injury,and progressive skin fibrosis,resulting in significant aesthetic and functional impairments for patients.Current therapi...Scleroderma is a chronic connective tissue disease characterized by inflammation,vascular injury,and progressive skin fibrosis,resulting in significant aesthetic and functional impairments for patients.Current therapies are limited and insufficiently treat the cutaneous manifestations of scleroderma.Autologous fat transfer(AFT)is a surgical technique that has been utilized for many decades for facial rejuvenation.The adipose stem cells(ASCs)present in fat grafts have also shown significant promise for their anti-inflammatory and regenerative properties.Recently,AFT has been repurposed to treat the skin manifestations of systemic sclerosis and localized scleroderma.Studies suggest that AFT in scleroderma patients improves mouth and hand functions,Raynaud’s symptoms,and digital ulcerations.AFT is a safe procedure with rare postoperative complications,making it a promising intervention for the treatment of scleroderma.Further studies are required to better characterize the influence of fat grafts on the recipient site and to establish standards for fat transfer in fibrotic skin diseases.展开更多
Proximal nerve injury can lead to devastating functional impairment.Because axonal regeneration is slow,timely reinnervation of denervated muscle does not occur.These denervated muscles atrophy and lose function.Senso...Proximal nerve injury can lead to devastating functional impairment.Because axonal regeneration is slow,timely reinnervation of denervated muscle does not occur.These denervated muscles atrophy and lose function.Sensory protection is a surgical technique thought to prevent denervated muscle impairment using local sensory nerves to provide trophic support to the muscle until motor nerves can regenerate,and neuromuscular junctions are reestablished.We performed a comprehensive literature search using multiple databases to find primary articles reporting on the outcomes and treatment of sensory protection.This paper reviews the three main approaches to sensory protection:(1)end-to-end neurorrhaphy,(2)end-to-side neurorrhaphy,and(3)direct muscle neurotization.It discusses the evidence supporting each technique and outlines goals for future investigations.展开更多
Despite significant advancements in neuroprosthetic control strategies,current peripheral nerve interfacing techniques are limited in their ability to facilitate accurate and reliable long-term control.The regenerativ...Despite significant advancements in neuroprosthetic control strategies,current peripheral nerve interfacing techniques are limited in their ability to facilitate accurate and reliable long-term control.The regenerative peripheral nerve interface(RPNI)is a biologically stable bioamplifier of efferent motor action potentials with demonstrated long-term stability.This innovative,straightforward,and reproducible surgical technique has shown enormous potential in improving prosthetic control for individuals with upper limb amputations.The RPNI consists of an autologous free muscle graft secured around the end of a transected peripheral nerve or individual fascicles within a residual limb.This construct facilitates EMG signal transduction from the residual peripheral nerve to a neuroprosthetic device using indwelling bipolar electrodes on the muscle surface.This review article focuses on the development of the RPNI and its use for intuitive and enhanced prosthetic control and sensory feedback.In addition,this article also highlights the use of RPNIs for the prevention and treatment of postamputation pain.展开更多
文摘Scleroderma is a chronic connective tissue disease characterized by inflammation,vascular injury,and progressive skin fibrosis,resulting in significant aesthetic and functional impairments for patients.Current therapies are limited and insufficiently treat the cutaneous manifestations of scleroderma.Autologous fat transfer(AFT)is a surgical technique that has been utilized for many decades for facial rejuvenation.The adipose stem cells(ASCs)present in fat grafts have also shown significant promise for their anti-inflammatory and regenerative properties.Recently,AFT has been repurposed to treat the skin manifestations of systemic sclerosis and localized scleroderma.Studies suggest that AFT in scleroderma patients improves mouth and hand functions,Raynaud’s symptoms,and digital ulcerations.AFT is a safe procedure with rare postoperative complications,making it a promising intervention for the treatment of scleroderma.Further studies are required to better characterize the influence of fat grafts on the recipient site and to establish standards for fat transfer in fibrotic skin diseases.
文摘Proximal nerve injury can lead to devastating functional impairment.Because axonal regeneration is slow,timely reinnervation of denervated muscle does not occur.These denervated muscles atrophy and lose function.Sensory protection is a surgical technique thought to prevent denervated muscle impairment using local sensory nerves to provide trophic support to the muscle until motor nerves can regenerate,and neuromuscular junctions are reestablished.We performed a comprehensive literature search using multiple databases to find primary articles reporting on the outcomes and treatment of sensory protection.This paper reviews the three main approaches to sensory protection:(1)end-to-end neurorrhaphy,(2)end-to-side neurorrhaphy,and(3)direct muscle neurotization.It discusses the evidence supporting each technique and outlines goals for future investigations.
文摘Despite significant advancements in neuroprosthetic control strategies,current peripheral nerve interfacing techniques are limited in their ability to facilitate accurate and reliable long-term control.The regenerative peripheral nerve interface(RPNI)is a biologically stable bioamplifier of efferent motor action potentials with demonstrated long-term stability.This innovative,straightforward,and reproducible surgical technique has shown enormous potential in improving prosthetic control for individuals with upper limb amputations.The RPNI consists of an autologous free muscle graft secured around the end of a transected peripheral nerve or individual fascicles within a residual limb.This construct facilitates EMG signal transduction from the residual peripheral nerve to a neuroprosthetic device using indwelling bipolar electrodes on the muscle surface.This review article focuses on the development of the RPNI and its use for intuitive and enhanced prosthetic control and sensory feedback.In addition,this article also highlights the use of RPNIs for the prevention and treatment of postamputation pain.
