WorldWideScience

Sample records for accessory nerve results

  1. Spinal accessory nerve neurilemmoma

    A neurilemmoma of the spinal accessory nerve extending from the lower brain stem to the high cervical region, without typical jugular foramen syndome is presented. Preoperative diagnosis is difficult but should be considered in the differential diagnosis of a high cervical intradural extramedullary lesion in patients with lower cranial nerve(s) dysfunction. The value of intrathecal and intravenous contrast enhancement computed tomography (CT) myelogram is emphasized. 13 refs.; 3 figs

  2. Results of spinal accessory to suprascapular nerve transfer in 110 patients with complete palsy of the brachial plexus.

    Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

    2016-06-01

    OBJECTIVE Transfer of the spinal accessory nerve to the suprascapular nerve is a common procedure, performed to reestablish shoulder motion in patients with total brachial plexus palsy. However, the results of this procedure remain largely unknown. METHODS Over an 11-year period (2002-2012), 257 patients with total brachial plexus palsy were operated upon in the authors' department by a single surgeon and had the spinal accessory nerve transferred to the suprascapular nerve. Among these, 110 had adequate follow-up and were included in this study. Their average age was 26 years (SD 8.4 years), and the mean interval between their injury and surgery was 5.2 months (SD 2.4 months). Prior to 2005, the suprascapular and spinal accessory nerves were dissected through a classic supraclavicular L-shape incision (n = 29). Afterward (n = 81), the spinal accessory and suprascapular nerves were dissected via an oblique incision, extending from the point at which the plexus crossed the clavicle to the anterior border of the trapezius muscle. In 17 of these patients, because of clavicle fractures or dislocation, scapular fractures or retroclavicular scarring, the incision was extended by detaching the trapezius from the clavicle to expose the suprascapular nerve at the suprascapular fossa. In all patients, the brachial plexus was explored and elbow flexion reconstructed by root grafting (n = 95), root grafting and phrenic nerve transfer (n = 6), phrenic nerve transfer (n = 1), or third, fourth, and fifth intercostal nerve transfer. Postoperatively, patients were followed for an average of 40 months (SD 13.7 months). RESULTS Failed recovery, meaning less than 30° abduction, was observed in 10 (9%) of the 110 patients. The failure rate was 25% between 2002 and 2004, but dropped to 5% after the staged/extended approach was introduced. The mean overall range of abduction recovery was 58.5° (SD 26°). Comparing before and after distal suprascapular nerve exploration (2005-2012), the

  3. Biting palsy of the accessory nerve.

    Paljärvi, L; Partanen, J

    1980-01-01

    A young man was bitten by his girl friend at the anterior border of the left trapezius muscle. Weakness of the trapezius resulted and a longstanding ache in the shoulder developed. Clinically and neurophysiologically, an axonotmesis type crush injury of the accessory nerve was verified.

  4. The glossopharyngeal, vagus and spinal accessory nerves

    The glossopharyngeal, vagus and spinal accessory nerves are closely related anatomically, and to a certain extent, functionally. We present an overview of their anatomy, highlighting the important clinical and imaging implications. The main pathologic lesions arising from these nerves are also discussed and the imaging features reviewed.

  5. The glossopharyngeal, vagus and spinal accessory nerves

    Ong, Cheng Kang [Department of Diagnostic Imaging, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore (Singapore)], E-mail: ongck22@hotmail.com; Chong, Vincent Fook Hin [Department of Diagnostic Imaging, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore (Singapore)

    2010-05-15

    The glossopharyngeal, vagus and spinal accessory nerves are closely related anatomically, and to a certain extent, functionally. We present an overview of their anatomy, highlighting the important clinical and imaging implications. The main pathologic lesions arising from these nerves are also discussed and the imaging features reviewed.

  6. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    Shyam Sundar Krishnan; Sivaram Bojja; Madabhushi Chakravarthy Vasudevan

    2015-01-01

    Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8 th cranial nerve (the vestibulo-cochlear nerve) followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferior...

  7. The posterior triangle and the painful shoulder: spinal accessory nerve injury.

    Williams, W W; Twyman, R. S.; Donell, S. T.; Birch, R

    1996-01-01

    Forty-three cases of accessory nerve injury referred to the Peripheral Nerve Injury Unit have been reviewed. Accessory nerve injury results in a characteristic group of symptoms and signs. Referral for treatment is usually delayed, the average time being 11.3 months. Surgical treatment resulted in improvement of symptoms in almost all cases.

  8. Anatomical study of spinal accessory nerve using ultrasonography

    Canella, Clarissa [Service de Radiologie et d’Imagerie Musculosquelettique, Centre de Consultations et d’Imagerie de l’Appareil Locomoteur, CHRU, 59037, Lille (France); Serviço de Radiologia e Diagnostico por Imagem, Universitadade Federal do Rio de Janeiro, Rio de janeiro (Brazil); Demondion, Xavier [Service de Radiologie et d’Imagerie Musculosquelettique, Centre de Consultations et d’Imagerie de l’Appareil Locomoteur, CHRU, 59037, Lille (France); Laboratoire d’Anatomie, Faculté de Médecine de Lille, 59037, Lille (France); Abreu, Evandro [Service de Radiologie et d’Imagerie Musculosquelettique, Centre de Consultations et d’Imagerie de l’Appareil Locomoteur, CHRU, 59037, Lille (France); Marchiori, Edson [Serviço de Radiologia e Diagnostico por Imagem, Universitadade Federal do Rio de Janeiro, Rio de janeiro (Brazil); Cotten, Hervé [Anatomie et cytologie pathologiques, Bd de la Liberté, 59000, Lille (France); Cotten, Anne, E-mail: anne.cotten@chru-lille.fr [Service de Radiologie et d’Imagerie Musculosquelettique, Centre de Consultations et d’Imagerie de l’Appareil Locomoteur, CHRU, 59037, Lille (France)

    2013-01-15

    Objective: The purpose of our study was to demonstrate that ultrasonography may allow a precise assessment of the course and relationships of the spinal accessory nerve (SAN). Material and methods: This study, initially undertaken in 7 cadavers, was followed by high-resolution ultrasonographic study in 15 volunteers (30 nerves) by two radiologists in consensus. The location, course and relations to the adjacent anatomic structures of the SAN were analyzed. Results: The precise course of the SAN between the lateroposterior border of the sternocleidomastoid muscle and the anterior border of the trapezius muscle could be identified by high-resolution ultrasonography. In contrast, clinical bone landmarks were not found helpful for the identification of the nerve. Conclusion: The SAN can be clearly depicted by means of ultrasonography. Knowledge of the nerve's precise location, which may evidence individual variations, may have useful clinical applications.

  9. Anatomical study of spinal accessory nerve using ultrasonography

    Objective: The purpose of our study was to demonstrate that ultrasonography may allow a precise assessment of the course and relationships of the spinal accessory nerve (SAN). Material and methods: This study, initially undertaken in 7 cadavers, was followed by high-resolution ultrasonographic study in 15 volunteers (30 nerves) by two radiologists in consensus. The location, course and relations to the adjacent anatomic structures of the SAN were analyzed. Results: The precise course of the SAN between the lateroposterior border of the sternocleidomastoid muscle and the anterior border of the trapezius muscle could be identified by high-resolution ultrasonography. In contrast, clinical bone landmarks were not found helpful for the identification of the nerve. Conclusion: The SAN can be clearly depicted by means of ultrasonography. Knowledge of the nerve's precise location, which may evidence individual variations, may have useful clinical applications

  10. Accessory Nerve Schwannoma Containing Multiple Calcifed Foci: Unusual Presentation

    Leila Aghaghazvini; Habib Mazaher; Hashem Sharifian; Shirin Aghaghazvini

    2009-01-01

    "nIntroduction: Schwannomas are benign neural tumors which arise from the nerve sheath. Schwannomas of the accessory nerve are rare lesions. The clinical presentation of cranial nerve XI schwannomas relates to their location and extent: intracranial, jugular foramen, upper neck, or cervical spine. The extra cranial form is the least common reported. Calcified accessory schwannoma is rare. These lesions most often occur in the third to sixth decades of life. These tumors are slightly more...

  11. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    Shyam Sundar Krishnan

    2015-01-01

    Full Text Available Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8 th cranial nerve (the vestibulo-cochlear nerve followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed.

  12. Restoration of shoulder abduction by transfer of the spinal accessory nerve to suprascapular nerve through dorsal approach: a clinical study

    GUAN Shi-bing; HOU Chun-lin; CHEN De-song; GU Yu-dong

    2006-01-01

    Background In recent years, transfer of the spinal accessory nerve to suprascapular nerve has become a routine procedure for restoration of shoulder abduction. However, the operation via the traditional supraclavicular anterior approach often leads to partial denervation of the trapezius muscle. The purpose of the study was to introduce transfer of the spinal accessory nerve through dorsal approach, using distal branch of the spinal accessory nerve, to repair the suprascapular nerve for restoration of shoulder abduction, and to observe its therapeutic effect.Methods From January to October 2003, a total of 11 patients with a brachial plexus injury and an intact or nearly intact spinal accessory nerve were treated by transferring the spinal accessory nerve to the suprascapular nerve through dorsal approach. The patients were followed up for 18 to 26 months [mean (23.5 ±5.2) months] to evaluate their shoulder abduction and function of the trapezius muscle. The outcomes were compared with those of 26 patients treated with traditional anterior approach. And the data were analyzed by Student's t test using SPSS 10.5.Results In the 11 patients, the spinal accessory nerves were transferred to the suprascapular nerve through the dorsal approach successfully. Intact function of the upper trapezius was achieved in all of them. In the patients,the location of the two nerves was relatively stable at the level of superior margin of the scapula, the mean distance between them was (4.2±1.4) cm, both the nerves could be easily dissected and end-to-end anastomosed without any tension. During the follow-up, the first electrophysiological sign of recovery of the infraspinatus appeared at (6.8±2.7) months and the first sign of restoration of the shoulder abduction at (7.6±2.9) months after the operation, which were earlier than that after the traditional operation [(8.7±2.4) months and (9.9±2.8)months, respectively; P<0.05]. The postoperative shoulder abduction was 62.8°± 12

  13. Accessory Nerve Schwannoma Containing Multiple Calcifed Foci: Unusual Presentation

    Leila Aghaghazvini

    2009-01-01

    Full Text Available "nIntroduction: Schwannomas are benign neural tumors which arise from the nerve sheath. Schwannomas of the accessory nerve are rare lesions. The clinical presentation of cranial nerve XI schwannomas relates to their location and extent: intracranial, jugular foramen, upper neck, or cervical spine. The extra cranial form is the least common reported. Calcified accessory schwannoma is rare. These lesions most often occur in the third to sixth decades of life. These tumors are slightly more common in women. "nCase presentation: We present a 37-year-old woman with a painless right posterior neck space mass which gradually appeared during one year. Except for mild numbness of the overlying skin of the mentioned mass, there were no other associated symptoms. Examination confirmed a 25 × 18mm, firm, mobile, non tender lump in the right posterior neck. Ultrasonography revealed a 30×20 mm hypo-echoic mass with multiple calcified foci and in color Doppler mild vascularity was detected. On contrast-enhanced CT scan of the neck a 30×18mm heterogeneous enhancing mass with multiple calcified foci (on non contrast cuts was found posterior to the neck vessels and had displaced them anteriorly. No surrounding fat stranding or any other gross pathology was evident in the other neck spaces. "nAccording to the above findings, lymphadenopathy due to TB or less possibly, fungal infection, hemangioma, lymphangiomam, schwannoma were our differential diagnosis. Mass resection and histopathology revealed schwannoma of the accessory nerve with an unusual calcification presentation. No evidence of recurrence was detected after one year. "nDiscussion: The clinical presentation of cranial nerve XI Schwannomas relates to their location and extent. The interesting point of this case was the unusual manifestation of accessory nerve schwannoma, not only because of its rarity but also because of its unusual calcification presentation and symptom-free appearance.  

  14. Isolated spinal accessory neuropathy and intracisternal schwannomas of the spinal accessory nerve

    Abdullah M. Al-Ajmi

    2015-03-01

    Full Text Available We report a 40-year-old female patient presenting with isolated left spinal accessory neuropathy that developed insidiously over 6 years. She complained of ill-defined deep neck and shoulder pain. On examination, prominent sternocleidomastoid and trapezoid muscle weakness and atrophy, shoulder instability, and lateral scapular winging were observed. MRI identified a small mass of the cisternal portion of the spinal accessory nerve. Its appearance was typical of schwannoma. Surgical treatment was not offered because of the small tumor size, lack of mass effect and the questionable functional recovery in the presence of muscular atrophy.

  15. Anatomic landmarks for localization of the spinal accessory nerve.

    Durazzo, Marcelo D; Furlan, Julio C; Teixeira, Gilberto V; Friguglietti, Celso U M; Kulcsar, Marco A V; Magalhães, Roberto P; Ferraz, Alberto R; Brandão, Lenine G

    2009-05-01

    This anatomical study examines the anatomic topography and landmarks for localization of the spinal accessory nerve (SAN) during surgical dissections in 40 fresh human cadavers (2 females and 38 males; ages from 22 to 89 years with a mean of 60 years). In the submandibular region, the SAN was found anteriorly to the transverse process of the atlas in 77.5% of the dissections. When the SAN crossed the posterior belly of the digastric muscle, the mean distance from the point of crossing to the tendon of the muscle was 1.75 +/- 0.54 cm. Distally, the SAN crossed between the two heads of the SCM muscle in 45% of the dissections and deep to the muscle in 55%. The SAN exited the posterior border of the sternocleidomastoid muscle in a point superior to the nerve point with a mean distance between these two anatomic parameters of 0.97 +/- 0.46 cm. The mean overall extracranial length of the SAN was 12.02 +/- 2.32 cm, whereas the mean length of the SAN in the posterior triangle was 5.27 +/- 1.52 cm. There were 2-10 lymph nodes in the SAN chain. In conclusion, the nerve point is one of the most reliable anatomic landmarks for localization of the SAN in surgical neck dissections. Although other anatomic parameters including the transverse process of the atlas and the digastric muscle can also be used to localize the SAN, the surgeon should be aware of the possibility of anatomic variations of those parameters. Similar to previous investigations, our results suggest that the number of lymph nodes of the SAN chain greatly varies. PMID:19373901

  16. An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury

    N. Omar; Alvi, F.; M. S. Srinivasan

    2007-01-01

    Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Alt...

  17. Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome

    Freeman Michael

    2010-04-01

    Full Text Available Abstract Background Chronic problems from whiplash trauma generally include headache, pain and neck stiffness that may prove refractory to conservative treatment modalities. As has previously been reported, such afflicted patients may experience significant temporary relief with injections of local anesthetic to painful trigger points in muscles of the shoulder and neck, or lasting symptomatic improvement through surgical excision of myofascial trigger points. In a subset of patients who present with chronic whiplash syndrome, the clinical findings suggest an affliction of the spinal accessory nerve (CN XI, SAN by entrapment under the fascia of the trapezius muscle. The present study was undertaken to assess the effectiveness of SAN neurolysis in chronic whiplash syndrome. Methods A standardized questionnaire and a linear visual-analogue scale graded 0-10 was used to assess disability related to five symptoms (pain, headache, insomnia, weakness, and stiffness before, and one year after surgery in a series of thirty consecutive patients. Results The preoperative duration of symptoms ranged from seven months to 13 years. The following changes in disability scores were documented one year after surgery: Overall pain decreased from 9.5 +/- 0.9 to 3.2 +/- 2.6 (p Conclusions Entrapment of the spinal accessory nerve and/or chronic compartment syndrome of the trapezius muscle may cause chronic debilitating pain after whiplash trauma, without radiological or electrodiagnostic evidence of injury. In such cases, surgical treatment may provide lasting relief.

  18. The unique axon trajectory of the accessory nerve is determined by intrinsic properties of the neural tube in the avian embryo.

    Bai, Zhongtian; Pu, Qin; Haque, Ziaul; Wang, Jianlin; Huang, Ruijin

    2016-05-01

    The accessory nerve is a cranial nerve, composed of only motor axons, which control neck muscles. Its axons ascend many segments along the lateral surface of the cervical spinal cord and hindbrain. At the level of the first somite, they pass ventrally through the somitic mesoderm into the periphery. The factors governing the unique root trajectory are unknown. Ablation experiments at the accessory nerve outlet points have shown that somites do not regulate the trajectory of the accessory nerve fibres. Factors from the neural tube that may control the longitudinal pathfinding of the accessory nerve fibres were tested by heterotopic transplantations of an occipital neural tube to the cervical and thoracic level. These transplantations resulted in a typical accessory nerve trajectory in the cervical and thoracic spinal cord. In contrast, cervical neural tube grafts were unable to give rise to the typical accessory nerve root pattern when transplanted to occipital level. Our results show that the formation of the unique axon root pattern of the accessory nerve is an intrinsic property of the neural tube. PMID:26955910

  19. Prevalence of accessory deep peroneal nerve in referred patients to an electrodiagnostic medicine clinic

    Raeissadat Seyed

    2011-07-01

    Full Text Available Abstract Background Accessory Deep Peroneal Nerve (ADPN is an anatomic variation that can potentially cause disturbance in electrodiagnostic studies. This anomaly could be detected by nerve conduction studies. There are no recent updates about prevalence of this anatomic variation. Electrodiagnostic medicine clinic is the best environment for detecting presence and prevalence of this nerve, so present study enrolled. Materials & Methods In this cross sectional descriptive study that take place from March 2009 to July 2010, 230 cases comprising 460 legs referred for electrodiagnostic studies of upper limbs problems participated in the study. Compound muscle action potential (CMAP and Nerve conduction Velocity (NCV of Deep Peroneal Nerve (DPN were measured by using EMG machine by stimulating DPN at knee, ankle and lateral malleolous areas accordingly, with recording from extensor digitorum brevis muscle. Results were analyzed and conclusion made. Results The study population included 120 females (52% and 110 (47% males with mean age of 42.1 ± 13.5 years. ADPN was detected in 28 patients (12%. Among them,10(17.9% had bilateral ADPN and in remained 18 cases (82.1% APN was unilateral. In 8 patients there was no recorded CMAP from EDB by proximal and distal stimulation implying EDB agenesis. Gender distribution was similar which means half of the cases (14 patients belonged to each gender. Conclusion The prevalence of ADPN in this study was 12.2%, (17.9% bilateral and 82.1% unilateral.

  20. Partial restoration of blink reflex function after spinal accessory-facial nerve anastomosis.

    Danziger, N; Chassande, B; Lamas, G.; Fligny, I; Soudant, J; Willer, J C

    1995-01-01

    Functional motor control requires perfect matching of the central connections of motoneurons with their peripheral inputs. It is not known, however, to what extent these central circuits are influenced by target muscles, either during development or after a lesion. Surgical interventions aimed at restoring function after peripheral nerve lesions provide an opportunity for studying this interaction in the mature human nervous system. A patient was studied in whom the spinal accessory nerve was...

  1. Treatment results of neck dissection with the preservation of cervical nerves for hypopharyngeal cancer

    Treatment results of neck dissection with the preservation of cervical nerves for hypopharyngeal cancer were analyzed retrospectively by comparing neck dissection with the preservation of cervical nerves and that with the resection of cervical nerves. Pharyngolaryngectomy or pharyngolaryngoesophagectomy with bilateral neck dissection was performed in 76 hypopharyngeal cancer cases between January 1992 and November 2001. Neck dissection with the resection of cervical nerves was performed on 42 sides of the neck in 21 cases (the cervical nerve-resected group). In 55 cases we attempted to employ neck dissection with the preservation of cervical nerves, but in 9 cases the cervical nerves were resected because of their nodal adhesion or involvement Neck dissection with the preservation of cervical nerves was performed on 92 sides of the neck in 46 cases (the cervical nerve-preserved group). There were significant differences between background factors of two groups about age, sex, induction chemotherapy, preservation of accessory nerve, and pN classification. The 5-year cumulative control rates of cervical lymph nodes were 81.3% for the cervical nerve-resected group and 79.7% for the cervical nerve-preserved group. There was no significant difference between the two groups. It was suggested that neck dissection with the preservation of cervical nerves for cases whose cervical nerves were able to be preserved from metastatic lymph nodes under induction chemotherapy and post-operative irradiation was as effective to control cervical lymph nodes as neck dissection with the resection of cervical nerves. (author)

  2. Tractography of lumbar nerve roots: initial results

    Balbi, Vincent; Budzik, Jean-Francois; Thuc, Vianney le; Cotten, Anne [Hopital Roger Salengro, Service de Radiologie et d' Imagerie musculo-squelettique, Lille Cedex (France); Duhamel, Alain [Universite de Lille 2, UDSL, Lille (France); Bera-Louville, Anne [Service de Rhumatologie, Hopital Roger Salengro, Lille (France)

    2011-06-15

    The aims of this preliminary study were to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and fibre tracking (FT) of the lumbar nerve roots, and to assess potential differences in the DTI parameters of the lumbar nerves between healthy volunteers and patients suffering from disc herniation. Nineteen patients with unilateral sciatica related to posterolateral or foraminal disc herniation and 19 healthy volunteers were enrolled in this study. DTI with tractography of the L5 or S1 nerves was performed. Mean fractional anisotropy (FA) and mean diffusivity (MD) values were calculated from tractography images. FA and MD values could be obtained from DTI-FT images in all controls and patients. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (p=0.0001) and of the nerve roots of volunteers (p=0.0001). MD was significantly higher in compressed nerve roots than in the contralateral nerve root (p=0.0002) and in the nerve roots of volunteers (p=0.04). DTI with tractography of the lumbar nerves is possible. Significant changes in diffusion parameters were found in the compressed lumbar nerves. (orig.)

  3. Spinal accessory nerve neuropathy following neck dissection Neuropatia do nervo acessório espinhal secundária à cirurgia de esvaziamento cervical

    Luciana Pereira de Lima

    2011-04-01

    Full Text Available Tthe most common complication of neck dissection is shoulder dysfunction due to manipulation of spinal accessory nerve, resulting in trapezius muscle atrophy mainly in procedures involving the posterior neck triangle. AIM: This study used electromyography to evaluate the injury to the spinal accessory nerve following neck dissection. MATERIALS AND METHODS: Prospective case series of 51 patients submitted to 60 neck dissections followed by physical therapy evaluation of shoulder dysfunction. Nerve integrity was evaluated before and after the surgery by means of surface EMG registering the electric activity of the trapezius muscle during voluntary contraction. The patients were grouped according to the type of neck dissection, presence of shoulder pain, impairment during abduction movement and hypotrophy/atrophy of the trapezius muscle. RESULTS: Action potential had median values of 54.3 microV before surgery and 11.6 microV after it (pUma das complicações mais comuns do esvaziamento cervical é a disfunção do ombro devido à manipulação do nervo acessório, que resulta na atrofia do músculo trapézio. OBJETIVO: Avaliar com eletromiografia de superfície (EMGs a lesão do XI par decorrente do esvaziamento cervical. MATERIAL E MÉTODO: Estudo prospectivo com 51 pacientes (60 esvaziamentos cervicais tratados de câncer de cabeça e pescoço. A função do nervo acessório foi avaliada no período pré e pós-operatório com registro da atividade elétrica das fibras descendentes do músculo trapézio em contração isométrica voluntária máxima. Os pacientes foram agrupados pelo tipo de esvaziamento e movimento de abdução do braço. RESULTADOS: O potencial de ação apresentou mediana de 54,3 microV no pré-operatório e 11,6 microV no pós-operatório (p<0,001. Os valores registrados no pós-operatório apresentaram decréscimo médio de 70% (20% a 94% em relação aos valores pré-operatórios. Com relação à extensão do EC, foram

  4. Causes of Secondary Radial Nerve Palsy and Results of Treatment.

    Reichert, Pawel; Wnukiewicz, Witold; Witkowski, Jarosław; Bocheńska, Aneta; Mizia, Sylwia; Gosk, Jerzy; Zimmer, Krzysztof

    2016-01-01

    BACKGROUND The aim of this study was to analyze the causes that lead to secondary damage of the radial nerve and to discuss the results of reconstructive treatment. MATERIAL AND METHODS The study group consisted of 33 patients treated for radial nerve palsy after humeral fractures. Patients were diagnosed based on clinical examinations, ultrasonography, electromyography, or nerve conduction velocity. During each operation, the location and type of nerve damage were analyzed. During the reconstructive treatment, neurolysis, direct neurorrhaphy, or reconstruction with a sural nerve graft was used. The outcomes were evaluated using the Medical Research Council (MRC) scales and the quick DASH score. RESULTS Secondary radial nerve palsy occurs after open reduction and internal fixation (ORIF) by plate, as well as by closed reduction and internal fixation (CRIF) by nail. In the case of ORIF, it most often occurs when the lateral approach is used, as in the case of CRIF with an insertion interlocking screws. The results of the surgical treatment were statistically significant and depended on the time between nerve injury and revision (reconstruction) surgery, type of damage to the radial nerve, surgery treatment, and type of fixation. Treatment results were not statistically significant, depending on the type of fracture or location of the nerve injury. CONCLUSIONS The potential risk of radial nerve neurotmesis justifies an operative intervention to treat neurological complications after a humeral fracture. Adequate surgical treatment in many of these cases allows for functional recovery of the radial nerve. PMID:26895570

  5. Delayed Sciatic Nerve Injury Resulting From Myositis Ossificans Traumatica.

    Guan, Zhe; Wilson, Thomas J; Jacobson, Jon A; Hollon, Todd C; Yang, Lynda J-S

    2016-05-01

    A motorcyclist sustained multiple-system trauma, including a left buttock hematoma requiring decompression and evacuation. Presentation for severe hip pain and lower extremity weakness was delayed. Imaging revealed myositis ossificans traumatica compressing the sciatic nerve in the buttock. The patient underwent sciatic nerve decompression with resection of heterotopic calcification, resulting in improvement in pain and left lower extremity function. This case illustrates the contrast in differential diagnosis of peripheral nerve injury immediately posttrauma and that occurring in a slow, delayed fashion posttrauma. Myositis ossificans may be an underrecognized complication of trauma but should be considered in cases of delayed peripheral nerve injury after trauma. PMID:26548968

  6. Common peroneal nerve injuries in knee dislocations: results with one-stage nerve repair and tibialis posterior tendon transfer

    Garozzo, D.; Ferraresi, S.; Buffatti, P.

    2002-01-01

    We report our experience in the treatment of common peroneal nerve (CPN) palsy following knee dislocations: a twelve-year surgical series of 26 patients presenting with a traumatic injury of the lateral sciatic nerve and no spontaneous recovery is reviewed. From 1988 to 1991, we performed nerve surgery alone on 3 patients. Their results were highly disappointing and in none did we observe muscle recovery. Since 1991 nerve surgery was associated with a palliative procedure for 23 patients. Alt...

  7. Unmasking of the trigemino-accessory reflex in accessory facial anastomosis

    Esteban, A.; Prieto, J.

    1999-01-01

    OBJECTIVE—To evaluate the possible blink reflex responses in facial muscles reinnervated by the accessory nerve.
METHOD—Eleven patients with a complete facial palsy were submitted to a surgical repair by an accessory facial nerve anastomosis (AFA). In this pathological group, blink reflex was studied by means of percutaneous electrical stimulation of the supraorbital nerve and recording from the orbicularis oculi muscle. A control group comprised seven normal people an...

  8. Bony exostosis of the atlas with resultant cranial nerve palsy

    A case of tenth and twelfth nerve compression secondary to a bony exostosis of the first cervical vertebra is described. This uncommon phenomenon serves to outline the importance of imaging the course of a cranial nerve when no intracranial abnormality is demonstrable on CT or MRI. The radiologic features of spinal osteochondromas are reviewed. (orig.)

  9. Hibernating myocardium results in partial sympathetic denervation and nerve sprouting

    Stanley F. Fernandez; Ovchinnikov, Vladislav; Canty, John M.; Fallavollita, James A.

    2012-01-01

    Hibernating myocardium due to chronic repetitive ischemia is associated with regional sympathetic nerve dysfunction and spontaneous arrhythmic death in the absence of infarction. Although inhomogeneity in regional sympathetic innervation is an acknowledged substrate for sudden death, the mechanism(s) responsible for these abnormalities in viable, dysfunctional myocardium (i.e., neural stunning vs. sympathetic denervation) and their association with nerve sprouting are unknown. Accordingly, ma...

  10. Painful accessory navicular

    Lawson, J.P.; Ogden, J.A.; Sella, E.; Barwick, K.W.

    1984-11-01

    The accessory navicular is usually considered a normal anatomic and roentgenographic variant. The term may refer to two distinct patterns. First, a sesamoid bone may be present within the posterior tibial tendon (Type 1); this is anatomically separate from the navicular. Second, an accessory ossification center may be medial to the navicular (Type 2). During postnatal development this is within a cartilaginous mass that is continuous with the cartilage of the navicular. At skeletal maturity the accessory center usually fuses with the navicular to form a curvilinear bone. The Type 2 pattern may be associated with a painful foot, particularly in the athletic adolescent, and should not be arbitrarily dismissed as a roentgenologic variant in the symptomatic patient. The clinical, radiologic, pathologic, and surgical findings in ten cases are reviewed. Roentgenographically the ossicle is triangular or heartshaped. sup(99m)Tc MDP imaging may be of value when the significance of the ossicle is uncertain. Even when the roentgenographic variant is bilateral, increased radionuclide activity occurs only on the symptomatic side. Histologic examination of surgically excised specimens reveals inflammatory chondro-osseous changes in the navicular-accessory navicular synchondrosis compatible with chronic trauma and stress fracture. Nonsurgical treatment with orthotics or cast immobilization produces variable results and resection of the accessory navicular may be the treatment of choice.

  11. The painful accessory navicular

    The accessory navicular is usually considered a normal anatomic and roentgenographic variant. The term may refer to two distinct patterns. First, a sesamoid bone may be present within the posterior tibial tendon (Type 1); this is anatomically separate from the navicular. Second, an accessory ossification center may be medial to the navicular (Type 2). During postnatal development this is within a cartilaginous mass that is continuous with the cartilage of the navicular. At skeletal maturity the accessory center usually fuses with the navicular to form a curvilinear bone. The Type 2 pattern may be associated with a painful foot, particularly in the athletic adolescent, and should not be arbitrarily dismissed as a roentgenologic variant in the symptomatic patient. The clinical, radiologic, pathologic, and surgical findings in ten cases are reviewed. Roentgenographically the ossicle is triangular or heartshaped. sup(99m)Tc MDP imaging may be of value when the significance of the ossicle is uncertain. Even when the roentgenographic variant is bilateral, increased radionuclide activity occurs only on the symptomatic side. Histologic examination of surgically excised specimens reveals inflammatory chondro-osseous changes in the navicular-accessory navicular synchondrosis compatible with chronic trauma and stress fracture. Nonsurgical treatment with orthotics or cast immobilization produces variable results and resection of the accessory navicular may be the treatment of choice. (orig.)

  12. Accessory scrotum in the perineum

    Pananghat A Kumar

    2011-01-01

    Full Text Available A case of accessory scrotum in a 2-day-old male infant is reported because of its rarity. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypotheses regarding etiology of accessory scrotum.

  13. Accessory scrotum in the perineum

    Pananghat A Kumar; Pavai Arunachalam; Kumar, Prasanna N.

    2011-01-01

    A case of accessory scrotum in a 2-day-old male infant is reported because of its rarity. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypotheses regarding etiology of accessory scrotum.

  14. A case of an intraneural ganglion cyst in the peroneal nerve resulting in drop foot

    Ozturk, Kahraman; Akman, Senol; Erturer, Erden; Ayanoglu, Semih; Aksoy, Bulent

    2004-01-01

    Intraneural ganglion cysts are rarely observed. Involvement of the peroneal nerve may cause neurological deficits, resulting in foot drop. Magnetic resonance imaging and electromyography are quite valuable in the diagnosis. A fourteen-year-old male patient presented with a painful swelling in the lateral part of his right knee, causing drop foot. An intraneural ganglion cyst was detected, affecting the peroneal nerve. Surgical removal of the lesion was performed. Nerve functions improved in t...

  15. How many mechanosensory organs in the bushcricket leg? Neuroanatomy of the scolopidial accessory organ in Tettigoniidae (Insecta: Orthoptera).

    Strauß, Johannes; Riesterer, Anja S; Lakes-Harlan, Reinhard

    2016-01-01

    The subgenual organ and associated scolopidial organs are well studied in Orthoptera and related taxa. In some insects, a small accessory organ or Nebenorgan is described posterior to the subgenual organ. In Tettigoniidae (Ensifera), the accessory organ has only been noted in one species though tibial sensory organs are well studied for neuroanatomy and physiology. Here, we use axonal tracing to analyse the posterior subgenual organ innervated by the main motor nerve. Investigating seven species from different groups of Tettigoniidae, we describe a small group of scolopidial sensilla (5-9 sensory neurons) which has features characteristic of the accessory organ: posterior tibial position, innervation by the main leg nerve rather than by the tympanal nerve, orientation of dendrites in proximal or ventro-proximal direction in the leg, and commonly association with a single campaniform sensillum. The neuroanatomy is highly similar between leg pairs. We show differences in the innervation in two species of the genus Poecilimon as compared to the other species. In Poecilimon, the sensilla of the accessory organ are innervated by one nerve branch together with the subgenual organ. The results suggest that the accessory organ is part of the sensory bauplan in the leg of Tettigoniidae and probably Ensifera. PMID:26627978

  16. Iatrogenic ulnar nerve injury resulting from a venous cut down procedure

    Gupta, Ravi Kumar; Kansay, Rajiv; Aggarwal, Varun; Gupta, Parmanand

    2008-01-01

    We present a case of an iatrogenic left ulnar nerve injury caused during the basilic vein cut down in a 25-year-old woman presenting with a ruptured ectopic pregnancy and requiring an emergency laparotomy. Two months after her discharge from the hospital, the patient presented to the hand surgery clinic with a weak grip strength and paraesthesias in the left hand, diagnosed to be resulting from a deficient ulnar nerve function. Surgical exploration of the nerve showed a complete section of th...

  17. Surgical outcomes following nerve transfers in upper brachial plexus injuries

    Bhandari P

    2009-01-01

    Full Text Available Background: Brachial plexus injuries represent devastating injuries with a poor prognosis. Neurolysis, nerve repair, nerve grafts, nerve transfer, functioning free-muscle transfer and pedicle muscle transfer are the main surgical procedures for treating these injuries. Among these, nerve transfer or neurotization is mainly indicated in root avulsion injury. Materials and Methods: We analysed the results of various neurotization techniques in 20 patients (age group 20-41 years, mean 25.7 years in terms of denervation time, recovery time and functional results. The inclusion criteria for the study included irreparable injuries to the upper roots of brachial plexus (C5, C6 and C7 roots in various combinations, surgery within 10 months of injury and a minimum follow-up period of 18 months. The average denervation period was 4.2 months. Shoulder functions were restored by transfer of spinal accessory nerve to suprascapular nerve (19 patients, and phrenic nerve to suprascapular nerve (1 patient. In 11 patients, axillary nerve was also neurotized using different donors - radial nerve branch to the long head triceps (7 patients, intercostal nerves (2 patients, and phrenic nerve with nerve graft (2 patients. Elbow flexion was restored by transfer of ulnar nerve motor fascicle to the motor branch of biceps (4 patients, both ulnar and median nerve motor fascicles to the biceps and brachialis motor nerves (10 patients, spinal accessory nerve to musculocutaneous nerve with an intervening sural nerve graft (1 patient, intercostal nerves (3rd, 4th and 5th to musculocutaneous nerve (4 patients and phrenic nerve to musculocutaneous nerve with an intervening graft (1 patient. Results: Motor and sensory recovery was assessed according to Medical Research Council (MRC Scoring system. In shoulder abduction, five patients scored M4 and three patients M3+. Fair results were obtained in remaining 12 patients. The achieved abduction averaged 95 degrees (range, 50 - 170

  18. Long-term result of guided nerve regeneration with an inert microporous polytetrafluoroethylene conduit

    2003-01-01

    Objective: To evaluate the long-term outcome of Polytetrafluoroethylene (PTFE) conduit in nerve repair and to provide more evidence in view of its potential application to achieve a satisfactory functional recovery in clinical settings. Methods: Thirty-six Wistar rats had their right sciatic nerve transected and were repaired with either conventional microsuture technique (Control group, n=18) or a PTFE conduit with a gap of 5 mm left between the nerve stumps (PTFE group, n=18). At 6 and 9 months after the operation, electrophysiological assessment and measurement of gastrocnemius muscle weight were conducted and morphology of the regenerated nerves were studied with image analysis. Results: At 6 months postoperatively, the nerve conduction velocity recovered to 60.86% and 54.36% (P>0.05), and the gastrocnemius muscle weight recovered to 50.89% and 46.11% (P>0.05) in the Control group and the PTFE group respectively. At 9 months postoperatively, the recovery rate was 65.99% and 58.79% for NCV (P>0.05), and 52.56% and 47.89% for gastrocnemius muscle weight (P>0.05) in the Control group and the PTFE group respectively. Regenerated nerve fibers in the PTFE group had a regular round shape with no fragmentation, wrinkling or splitting of the myelin sheath. Image analysis revealed that the ratio of the myelin area to the total fiber area was larger at 9 months than at 6 months in both groups (P<0.01). Conclusions: Microporous PTFE conduit may be an alternative for nerve repair allowing of guided nerve regeneration and functional recovery with no obvious adverse effect at long-term.

  19. Delayed results of combined treatment of malignant neoplasms of nasal cavity and accessory basal sinuses with the use of remote neutron therapy

    Analysis of results of combined treatment of 24 patients with locally spread forms of malignant neoplasms in nasal cavity and accessory nasal sinuses, subjected to preoperational remote neutron therapy, was carried out. Mean neutron energy was 6.5 MeV, total focus dose - 38-40 Gy. It is shown that combined method of treatment features high efficiency, ensuring 5-year survival rate of 67.8% of the patients. However, the treatment is accompanied by grave complications, formation of face tissue-defects and radiation-induced cataract. The necessity of improving the methods of eye protection in the course of radiotherapy is emphasized. 1 ref

  20. Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury.

    Chu, Bin; Wang, Huan; Chen, Liang; Gu, Yudong; Hu, Shaonan

    2016-06-01

    The purpose of this study was to investigate the effectiveness of shoulder function restoration by dual nerve transfers, spinal accessory nerve to the suprascapular nerve and 2 intercostal nerves to the anterior branch of the axillary nerve, in patients with shoulder paralysis that resulted from brachial plexus avulsion injury. It was a retrospective analysis to assess the impact of a variety of factors on reanimation of shoulder functions with dual nerve transfers. A total of 19 patients were included in this study. Most of these patients sustained avulsions of C5, C6, and C7 nerve roots (16 patients). Three of them had avulsions of C5 and C6 roots only. Through a posterior approach, direct coaptation of the intercostal nerves and the anterior branch of the axillary nerve was performed, along with accessory nerve transfer to the suprascapular nerve. Satisfactory shoulder function recovery (93.83° of shoulder abduction and 54.00° of external rotation on average) was achieved after a 62-month follow-up. This dual nerve transfer procedure provided us with a reliable and effective method for shoulder function reconstruction after brachial plexus root avulsion, especially C5/C6/C7 avulsion. The level of evidence is therapeutic IV. PMID:26835823

  1. Morphogenesis and morphology of the brain stem nuclei of Cetacea. II. The nuclei of the accessory, vagal and glossopharyngeal nerves in baleen whales.

    Jansen, J; Osen, K K

    1984-01-01

    The development and final structure of the IXth, Xth and XIth cranial nerve nuclei are studied in ironhematoxylin -, thionin - and protargol -stained serial sections of about 50 baleen whale fetuses (blue whale, Balaenoptera musculus, and fin whale, Balaenoptera physalus ) and one adult fin whale. The nucleus ambiguus is composed of three subdivisions, oral, intermediate and caudal, the last mentioned being contiguous caudally with the dorsal motor Xth nucleus. The oral division develops as three parallel cell columns which merge into a well circumscribed solitary structure with a rostrally expanded "head". It is composed of medium-sized multipolar neurons in a myelin-poor neuropil. In the fin whale a minor group of larger cells is found medial to the "head". In both species a peculiar small-celled nucleus rich in capillaries is found ventral to the "head". The intermediate division initially contains a lateral cell column and a medial region of scattered cells. The lateral column persists throughout life, while the medial field develops into three columns only one of which remains distinct in mature individuals. The cells are larger than in the oral division with the largest cells in the medial column. The two columns are surrounded by a field of scattered neurons which continues without a sharp border into the caudal division which is composed of scattered cells throughout. In its rostral half the cells are of the same multipolar type as in the intermediate division while caudally they appear flattened in the horizontal plane. The dorsal motor Xth nucleus develops as three longitudinal columns. In the fetal brain these are cytologically distinct due to different proportions of small, medium-sized and larger multipolar neurons. The spindle-shaped ventromedial column extends the entire length of the nucleus. It is composed mostly of small to medium-sized cells which caudal to the obex are elongated parallel with the neuroaxis . The dorsolateral and ventrolateral

  2. Co-presentation of unilateral femoral and bilateral sciatic nerve variants in one cadaver: A case report with clinical implications

    Battaglia Patrick J

    2012-10-01

    Full Text Available Abstract Objective To present a group of anatomical findings that may have clinical significance. Design This study is an anatomical case report of combined lumbo-pelvic peripheral nerve and muscular variants. Setting University anatomy laboratory. Participants One cadaveric specimen. Methods During routine cadaveric dissection for a graduate teaching program, unilateral femoral and bilateral sciatic nerve variants were observed in relation to the iliacus and piriformis muscle, respectively. Further dissection of both the femoral nerve and accessory slip of iliacus muscle was performed to fully expose their anatomy. Results Piercing of the femoral nerve by an accessory iliacus muscle combined with wide variations in sciatic nerve and piriformis muscle presentations may have clinical significance. Conclusions Combined femoral and sciatic nerve variants should be considered when treatment for a lumbar disc herniation is refractory to care despite positive orthopedic testing.

  3. Femoral nerve palsy secondary to iliopsoas haemorrhage in patients with haemophilia: results from biceps femoral transfer

    Marcela Piña-Quintero

    2009-12-01

    Full Text Available Hemophilia causes injuries of peripheral nerves secondary to compressions by hematoma. In general, these injuries recover spontaneously after the cause of the compression is solved. A case of a 16-year-old adolescent with injury of the left femoral nerve, causing loss of the extension of the knee is described herein. During the evolution there was no recovery. For this reason a tendinous transfer of the femoral biceps was practiced. This technique was described formerly for the correction of poliomyelitis. Excellent results were obtained with complete recovery of the extension and force 4+/5.

  4. Small Engine & Accessory Test Area

    Federal Laboratory Consortium — The Small Engine and Accessories Test Area (SEATA) facilitates testaircraft starting and auxiliary power systems, small engines and accessories. The SEATA consists...

  5. Palsy of the rear limbs in Mycobacterium lepraemurium-infected mice results from bone damage and not from nerve involvement.

    Rojas-Espinosa, O; Becerril-Villanueva, E; Wek-Rodríguez, K; Arce-Paredes, P; Reyes-Maldonado, E

    2005-06-01

    A small but relatively constant proportion (3-5%) of mice chronically infected with Mycobacterium lepraemurium (MLM) develops bilateral paralysis of the rear limbs. The aim of the study was to investigate whether or not the bilateral leg palsy results from nerve involvement. Direct bacterial nerve infection or acute/delayed inflammation might possibly affect the nerves. Therefore, palsied animals were investigated for the presence of: (a) histopathological changes in the leg tissues including nerves, bones and annexes, and (b) serum antibodies to M. lepraemurium and M. leprae lipids, including phenolic glycolipid I from M. leprae. Histopathological study of the palsied legs revealed that the paralysis was not the result of direct involvement of the limb nerves, as neither bacilli nor inflammatory cells were observed in the nerve branches studied. Antibodies to brain lipids and cardiolipin were not detected in the serum of the palsied animals, thus ruling out an immune response to self-lipids as the basis for the paralysis. Although high levels of antibodies to MLM lipids were detected in the serum of palsied animals they were not related to limb paralysis, as the nerves of the palsied legs showed no evidence of inflammatory damage. In fact, nerves showed no evidence of damage. Paralysis resulted from severe damage of the leg bones. Within the bones the bone marrow became replaced by extended bacilli-laden granulomas that frequently eroded the bone wall, altering the normal architecture of the bone and its annexes, namely muscle, tendons and connective tissue. Although this study rules out definitively the infectious or inflammatory damage of nerves in murine leprosy, it opens a new avenue of research into the factors that participate in the involvement or the sparing of nerves in human and murine leprosy, respectively. PMID:15932504

  6. Latent x-ray damage in the rat sciatic nerve results in delay in functional recovery after a heat treatment

    The influence of X-irradiation on the sensitivity of the rat sciatic nerve to local hyperthermia was investigated. Irradiation (35 Gy) of a nerve segment, which included the heated part, resulted in a delayed recovery from heat treatment compared to controls (heat only). The time interval and sequence between irradiation and hyperthermia hardly influenced recovery delay. The size of the irradiated nerve segment did influence recovery delay. Irradiation of a 20 mm nerve segment led to longer recovery delays then irradiation of a 10 mm segment (5-10 days and 1-5 days respectively). A dose-response relation for irradiation-induced delay in recovery was observed when a large segment (20mm) of nerve was irradiated immediately after heat with a dose ranging from 5 to 40 Gy. The delay in heat recovery was dose-dependent below 20 Gy, but after radiation doses above 20 Gy recovery delay remained almost constant. (author)

  7. Histological and lectin histochemical studies on the main and accessory olfactory bulbs in the Japanese striped snake, Elaphe quadrivirgata.

    Kondoh, Daisuke; Wada, Akimi; Endo, Daisuke; Nakamuta, Nobuaki; Taniguchi, Kazuyuki

    2013-01-01

    The main and accessory olfactory bulbs were examined by histological methods and lectin histochemistry in the Japanese striped snake. As the results, the histological properties are similar between the main olfactory bulb and the accessory olfactory bulb. In lectin histochemistry, 21 lectins used in this study showed similar binding patterns in the main olfactory bulb and the accessory olfactory bulb. In detail, 15 lectins stained these olfactory bulbs with similar manner, and 6 lectins did not stain them at all. Two lectins, Lycopersicon esculentum lectin (LEL) and Solanum tuberosum lectin (STL), stained the nerve and glomerular layers and did not stain any other layers in both olfactory bulbs. Four lectins, Soybean agglutinin (SBA), Vicia villosa agglutinin (VVA), Peanut agglutinin (PNA) and Phaseolus vulgaris agglutinin-L (PHA-L) stained the nerve and glomerular layers more intensely than other layers in both olfactory bulbs. In addition, VVA showed the dot-like stainings in the glomeruli of both olfactory bulbs. These findings suggest that the degree of development and the properties of glycoconjugates are similar between the main olfactory bulb and the accessory olfactory bulb in the Japanese striped snake. PMID:23257605

  8. Diffuse reflectance spectroscopy for optical nerve identification. Preliminary ex vivo results for feedback controlled oral and maxillofacial laser surgery

    Stelzle, Florian; Zam, Azhar; Adler, Werner; Douplik, Alexandre; Tangermann-Gerk, Katja; Nkenke, Emeka; Neukam, Friedrich Wilhelm; Schmidt, Michael

    Objective: Laser surgery has many advantages. However, due to a lack of haptic feedback it is accompanied by the risk of iatrogenic nerve damage. The aim of this study was to evaluate the possibilities of optical nerve identification by diffuse reflectance spectroscopy to set the base for a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Materials and Methods: Diffuse reflectance spectra of nerve tissue, skin, mucosa, fat tissue, muscle, cartilage and bone (15120 spectra) of ex vivo pig heads were acquired in the wavelength range of 350-650 nm. Tissue differentiation was performed by principal components analysis (PCA) followed by linear discriminant analysis (LDA). Specificity and sensitivity were calculated by receiver operating characteristic (ROC) analysis and the area under curve (AUC). Results: Nerve tissue could correctly be identified and differed from skin, mucosa, fat tissue, muscle, cartilage and bone in more than 90% of the cases (AUC results) with a specificity of over 78% and a sensitivity of more than 86%. Conclusion: Nerve tissue can be identified by diffuse reflectance spectroscopy with high precision and reliability. The results may set the base for a feedback system to prevent iatrogenic nerve damage performing oral and maxillofacial laser surgery.

  9. Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen.

    Stulz, P; Pfeiffer, K M

    1982-03-01

    Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar. PMID:7065874

  10. [Clinical features of accessory parotid gland tumors].

    Iguchi, Hiroyoshi; Wada, Tadashi; Yamamoto, Hidefumi; Yamada, Kei; Matsushita, Naoki; Okamoto, Sachimi; Teranishi, Yuichi; Koda, Yuki; Kosugi, Yuki; Yamane, Hideo

    2013-12-01

    Accessory parotid gland tumors are relatively rare; hence, adequately detailed clinical analyses of these tumors are difficult to perform at a single institution. In this report, we describe the findings for 65 patients [29 men, 36 women; median age, 51 (9-81) years] with accessory parotid gland tumors, consisting of 4 cases documented by us and 61 cases previously reported by other Japanese authors. Approximately 50% of the patients were treated in an otolaryngology department, while the remaining patients were treated in plastic surgery, oral surgery, or dermatology departments. In 4 patients, the results of preoperative fine-needle aspiration cytology indicated that the tumor was benign; however, the postoperative histopathology results revealed malignant tumors. The frequencies of malignant and benign tumors were 44.6% (n = 29) and 55.4% (n = 36), respectively. Mucoepidermoid carcinoma and pleomorphic adenoma were the most frequent types of malignant and benign accessory parotid gland tumors, respectively. Among the various surgical methods that were used, such as direct cheek and intraoral incisions, a standard parotidectomy incision was the most preferred treatment approach for these tumors. Recently, an endoscopic approach has also been found to yield satisfactory results. An optimal approach should be selected after evaluating the advantages and disadvantages of these methods. No definite guidelines are available regarding the choice of elective neck dissection and postoperative radiation therapy for malignant accessory parotid gland tumors. Although tumor resection (plus elective neck dissection) and postoperative radiation therapy have been frequently performed for various kinds of malignant accessory parotid gland tumors to date, additional studies are needed regarding the criteria for selecting elective neck dissection and postoperative radiation therapy. Since the malignancy rate for accessory parotid gland tumors is higher than that for parotid gland

  11. TRPA1 activation by lidocaine in nerve terminals results in glutamate release increase

    We examined the effects of local anesthetics lidocaine and procaine on glutamatergic spontaneous excitatory transmission in substantia gelatinosa (SG) neurons in adult rat spinal cord slices with whole-cell patch-clamp techniques. Bath-applied lidocaine (1-5 mM) dose-dependently and reversibly increased the frequency but not the amplitude of spontaneous excitatory postsynaptic current (sEPSC) in SG neurons. Lidocaine activity was unaffected by the Na+-channel blocker, tetrodotoxin, and the TRPV1 antagonist, capsazepine, but was inhibited by the TRP antagonist, ruthenium red. In the same neuron, the TRPA1 agonist, allyl isothiocyanate, and lidocaine both increased sEPSC frequency. In contrast, procaine did not produce presynaptic enhancement. These results indicate that lidocaine activates TRPA1 in nerve terminals presynaptic to SG neurons to increase the spontaneous release of L-glutamate.

  12. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results

    Khalil, C.; Hancart, C.; Thuc, V.Le; Cotten, A. [Service de Radiologie Osteoarticulaire, Hopital Roger Salengro, CHRU de Lille (France); Chantelot, C. [Clinique d' Orthopedie, Hopital Roger Salengro, CHRU de Lille (France); Chechin, D. [Philips Medical Systems, Suresnes (France)

    2008-10-15

    The purpose was to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and tractography of the human median nerve with a 1.5-T MR scanner and to assess potential differences in diffusion between healthy volunteers and patients suffering from carpal tunnel syndrome. The median nerve was examined in 13 patients and 13 healthy volunteers with MR DTI and tractography using a 1.5-T MRI scanner with a dedicated wrist coil. T1-weighted images were performed for anatomical correlation. Mean fractional anisotropy (FA) and mean apparent diffusion coefficient (ADC) values were quantified in the median nerve on tractography images. In all subjects, the nerve orientation and course could be detected with tractography. Mean FA values were significantly lower in patients (p=0.03). However, no statistically significant differences were found for mean ADC values. In vivo assessment of the median nerve in the carpal tunnel using DTI with tractography on a 1.5-T MRI scanner is possible. Microstructural parameters can be easily obtained from tractography images. A significant decrease of mean FA values was found in patients suffering from chronic compression of the median nerve. Further investigations are necessary to determine if mean FA values may be correlated with the severity of nerve entrapment. (orig.)

  13. ACCESSORY SPLEEN: A CLINICALLY RELEVANT ANATOMIC ANOMALY

    Prachi Saffar

    2016-02-01

    Full Text Available The purpose of our study is to emphasize on the clinical relevance of the presence of accessory spleen. It is not only a well-documented anatomic anomaly, it holds special significance in the differential diagnosis of intra-abdominal tumours and lymphadenopathy. MATERIALS AND METHODS Thirty male cadavers from North Indian population above the age of 60 yrs. were dissected in the Anatomy Department of FMHS, SGT University, Gurgaon, over a period of 5 yrs. (Sep 2010-Aug 2015 and presence of accessory spleen recorded. Tissue from the accessory spleen was also subjected to routine histological processing and slide prepared by haematoxylin and eosin staining. RESULTS Accessory spleen was present in two cadavers near the splenic hilum. One was 3.9 cm in the long axis and weighed about 48.4 grams, while the other was 1.2 cm in long axis and weighed about 12.5 grams. One had a separate arterial branch from the main splenic artery; that it was splenic tissue was confirmed histologically. DISCUSSION The presence of accessory spleen is considered to be due to embryonic non-fusion of the splenic aggregate with the main mass. CONCLUSION Though accessory spleen in itself pose no clinical problems, its significance cannot be undermined. Surgeons and radiologists are advised to look for and rule out the presence of accessory spleen, especially while evaluating a case of abdominal and perineal pathology, else it may be wrongly diagnosed as malignant tumour or enlarged lymph node leading to grave consequences.

  14. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks.

    Haninec, Pavel; Mencl, Libor; Bačinský, Peter; Kaiser, Radek

    2013-12-01

    A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months. PMID:23696291

  15. Motoneuron organisation of the muscles of the spinal accessory complex of the sheep investigated with the fluorescent retrograde tracer technique.

    P. Clavenzani; Scapolo, P A; Callegari, E; Barazzoni, A M; Petrosino, G.; Lucchi, M L; Bortolami, R

    1994-01-01

    Retrograde transport of the fluorescent tracers Diamidino Yellow dihydrochloride and Fast Blue was used to determine the location of the spinal nucleus of the accessory nerve in the sheep. We also considered whether in this species the sternocephalic, brachiocephalic, omotransversarius and trapezius muscles, i.e. the muscles of the spinal accessory complex, are supplied by more than one population of motoneurons. The spinal accessory nucleus extends as a single column of neurons from C1 to C7...

  16. Tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture: a case report

    Lee Kyung-Jae

    2009-11-01

    Full Text Available Abstract Introduction We report an extremely rare case of tardy posterior interosseous nerve palsy that developed 40 years after unreduced anterior dislocation of the radial head in a Monteggia fracture. Case presentation A 46-year-old Asian woman was diagnosed with tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture. The patient remembered that she had sustained a fracture to the right elbow when she was 6 years old but could not remember the details of either the injury or its treatment. Intra-operatively, the posterior interosseous nerve was compressed at the radial head, wrapped around the medial side of the radial neck, and ran into the distorted supinator muscle, and was stretched. We therefore excised the radial head and performed neurolysis. The function of the right hand was normal at a follow-up examination 8 months after surgery. Conclusion We theorize that excessive repeated motion with loss of elasticity of surrounding tissues because of long-term dislocation of the radial head may cause delayed posterior interosseous nerve palsy. It is necessary to make an accurate diagnosis and render proper treatment when a Monteggia fracture occurs, making sure that the radial head does not remain dislocated, to avoid possible posterior interosseous nerve palsy due to excessive pronation and supination even several decades later.

  17. Visualization of the lower cranial nerves by 3D-FIESTA

    MR cisternography has been introduced for use in neuroradiology. This method is capable of visualizing tiny structures such as blood vessels and cranial nerves in the cerebrospinal fluid (CSF) space because of its superior contrast resolution. The cranial nerves and small vessels are shown as structures of low intensity surrounded by marked hyperintensity of the CSF. In the present study, we evaluated visualization of the lower cranial nerves (glossopharyngeal, vagus, and accessory) by the three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) sequence and multiplanar reformation (MPR) technique. The subjects were 8 men and 3 women, ranging in age from 21 to 76 years (average, 54 yeas). We examined the visualization of a total of 66 nerves in 11 subjects by 3D-FIESTA. The results were classified into four categories ranging from good visualization to non-visualization. In all cases, all glossopharyngeal and vagus nerves were identified to some extent, while accessory nerves were visualized either partially or entirely in only 16 cases. The total visualization rate was about 91%. In conclusion, 3D-FIESTA may be a useful method for visualization of the lower cranial nerves. (author)

  18. Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report

    Kawamura Kenji

    2006-09-01

    Full Text Available Abstract An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery. Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve. This case demonstrates an excellent result of an Oberlin's nerve transfer for restoration of flexion of the elbow joint in Erb's birth palsy. However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

  19. Neuronal changes resulting in up-regulation of alpha-1 adrenoceptors after peripheral nerve injury

    Peter D.Drummond

    2014-01-01

    Under normal conditions, the sympathetic neurotransmitter noradrenaline inhibits the pro-duction and release of pro-inlfammatory cytokines. However, after peripheral nerve and tissue injury, pro-inflammatory cytokines appear to induce the expression of the alpha1A-adreno-ceptor subtype on immune cells and perhaps also on other cells in the injured tissue. In turn, noradrenaline may act on up-regulated alpha1-adrenoceptors to increase the production of the pro-inflammatory cytokine interleukin-6. In addition, the release of inflammatory mediators and nerve growth factor from keratinocytes and other cells may augment the expression of al-pha1-adrenoceptors on peripheral nerve ifbers. Consequently, nociceptive afferents acquire an abnormal excitability to adrenergic agents, and inlfammatory processes build. These mechanisms could contribute to the development of sympathetically maintained pain in conditions such as post-herpetic neuralgia, cutaneous neuromas, amputation stump pain and complex regional pain syndrome.

  20. Overview of the Cranial Nerves

    ... speech Because both the 9th and 10th cranial nerves control swallowing and the gag reflex, they are tested together. The person is asked ... of palate movement). 10th Vagus Swallowing, the gag reflex, and speech ... 11th Accessory Neck turning and shoulder shrugging ...

  1. Cranial nerve palsies in metastatic prostate cancer--results of base of skull radiotherapy

    We studied the rate of response to palliative external beam radiation therapy (20 Gy/5 or 30 Gy/10 fractions) to the base of skull in 32 prostate cancer patients with cranial nerve dysfunction. Sixteen patients (50%; 95% CI, 34-66%) had a useful response to therapy. The median survival post-therapy was 3 months

  2. Treatment of Idiopathic Chronic Orchialgia with Transcutaneous Electrical Nerve Stimulation (TENS:A Preliminary Result

    Ekrem Akdeniz

    2016-01-01

    Full Text Available Purpose: Unilateral or bilateral testicular pain lasting more than 3 months is called as chronic orchialgia. Aproximately 25-50% of chronic orchialgia is idiopatic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS therapy due to Idiopathic Chronic Orchialgia (ICO. Methods: Five patients were included into this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal doppler ultrasound. Medical history revealed that multiple conservative therapy attempts failed to alleviate the pain. Two of the patients had right sided ICO. Traditional TENS device is placed to the most painful points. TENS applied 3 times in a week with duration 30 minutes for 4 weeks. Before and after TENS application, patients were evaluated by using Visual Analog Scale (VAS at first and third months. Results: Median age of patients was 26.20±2.38 (22-30. Mean VAS value was 6.52 ± 0.89 before the procedure. After 1 month VAS value was 3.82 ± 0.83 (p0.05. None of the patients needed any analgesics after during the one month. No complications, hyperemia or hypoesthesia of the scrotal or penile skin, occurred after the procedure. Conclusion: TENS reduces pain by increasing endorphin release in the spinal cord dorsal horn. TENS is very effective method for first 1 month in patients with ICO but its effect reduces by the time. There is no standard therapeutic protocol for idiopathic chronic orchialgia. Therefore TENS may be an alternative for patients who do not benefit from medical therapy and do not want invasive procedures. Short-term use of TENS and low number of the patients are the limitations of this study. Randomized, placebo-controlled, and longer follow-up period studies are needed to better assess the efficacy of TENS for ICO.

  3. Assessment of nerve morphology in nerve activation during electrical stimulation

    Gomez-Tames, Jose; Yu, Wenwei

    2013-10-01

    The distance between nerve and stimulation electrode is fundamental for nerve activation in Transcutaneous Electrical Stimulation (TES). However, it is not clear the need to have an approximate representation of the morphology of peripheral nerves in simulation models and its influence in the nerve activation. In this work, depth and curvature of a nerve are investigated around the middle thigh. As preliminary result, the curvature of the nerve helps to reduce the simulation amplitude necessary for nerve activation from far field stimulation.

  4. Lost in Translation: Ambiguity in Nerve Sheath Tumor Nomenclature and Its Resultant Treatment Effect

    There is much ambiguity surrounding the diagnosis of nerve sheath tumors, including atypical neurofibroma and low-grade MPNST, and yet, the distinction between these entities designates either benign or malignant behavior and thus carries presumed profound prognostic importance that often guides treatment. This study reviews the diagnostic criteria used to designate atypical neurofibroma from low-grade MPNSTs and reviews existing literature the natural history of each of these tumors to see if the distinction is, in fact, of importance

  5. Accessory Proteins at ERES

    Klinkenberg, Rafael David

    proteins. Together these components co‐operate in cargo‐selection as well as forming, loading and releasing budding vesicles from specific regions on the membrane surface of the ER. Coat components furthermore convey vesicle targeting towards the Golgi. However, not much is known about the mechanisms that...... regulate the COPII assembly at the vesicle bud site. This thesis provides the first regulatory mechanism of COPII assembly in relation to ER‐membrane lipid‐signal recognition by the accessory protein p125A (Sec23IP). The aim of the project was to characterize p125A function by dissecting two main domains...... in the protein; a putative lipid‐associating domain termed the DDHD domain that is defined by the four amino acid motif that gives the domain its name; and a ubiquitously found domain termed Sterile α‐motif (SAM), which is mostly associated with oligomerization and polymerization. We first show, that...

  6. 药物中毒性周围神经病变肌电图分析%EMG analysis of peripheral nerve lesion resulting from drug toxicity

    张昆林; 马莎; 毛小川

    2003-01-01

    @@ INTRODUCTION Peripheral nerve lesion resulting from drug toxicity is caused by drugs which interrupt some enzymes in process of nervous metabolism and lead to loss of myelin sheath or axis- cylinder degeneration. Some drugs used in clinic can lead to peripheral nerve lesion. Patients showed symptoms such as numbness, asthenia.

  7. Aberrant Innervation of the Sternocleidomastoid Muscle By the Transverse Cervical Nerve: A Case Report

    Paraskevas, George; Lazaridis, Nikolaos; Spyridakis, Ioannis; Koutsouflianiotis, Konstantinos; Kitsoulis, Panagiotis

    2015-01-01

    Two aberrant rami originating from the right transverse cervical nerve and innervated the midportion of the sternocleidomastoid muscle (SM) were detected during routine cadaver dissection. Although SM is commonly innervated by the accessory nerve, as well as by cervical nerves, it is likely to be innervated additionally by other nerves such as hypoglossal nerve, ansa cervicalis, facial or external laryngeal nerve. Some considerations as regards the possible composition of the aberrant rami of...

  8. Lost in Translation: Ambiguity in Nerve Sheath Tumor Nomenclature and Its Resultant Treatment Effect

    R. Lor Randall

    2013-05-01

    Full Text Available There is much ambiguity surrounding the diagnosis of nerve sheath tumors, including atypical neurofibroma and low-grade MPNST, and yet, the distinction between these entities designates either benign or malignant behavior and thus carries presumed profound prognostic importance that often guides treatment. This study reviews the diagnostic criteria used to designate atypical neurofibroma from low-grade MPNSTs and reviews existing literature the natural history of each of these tumors to see if the distinction is, in fact, of importance.

  9. Ultrasonographic findings of accessory breast

    Accessory breast is an ectopic breast tissue from developmental remnants. It sometimes begins to make symptom, pain and swelling, during premenstrual period or pregnancy. For it has been known as a rear condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenitis or hidradentis. We have analyzed 52 accessory breast tissues prospectively, to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts, presence of nipple and/or areola, the obliteration of inner wall of dermis, the obliteration of subcutaneous fat layer, and the downward displacement of axillary fascia or underlying fascia if not in axilla without interruption

  10. Ultrasonographic findings of accessory breast

    Oh, Ki Keun; Cho, Jae Hyun; Yoon, Choon Sik; Kim, Mi Hye [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1993-07-15

    Accessory breast is an ectopic breast tissue from developmental remnants. It sometimes begins to make symptom, pain and swelling, during premenstrual period or pregnancy. For it has been known as a rear condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenitis or hidradentis. We have analyzed 52 accessory breast tissues prospectively, to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts, presence of nipple and/or areola, the obliteration of inner wall of dermis, the obliteration of subcutaneous fat layer, and the downward displacement of axillary fascia or underlying fascia if not in axilla without interruption.

  11. Perineal Accessory Scrotum with Congenital Lipoma: A Rare Case Report

    Souvik Chatterjee

    2012-01-01

    Full Text Available A case of accessory scrotum in a 1-year-old boy is reported because of its rarity. A boy presented with a tumor mass attached with scrotum-like skin on its tip in the right side of perineum between the scrotum and anus. Both testes had descended into the scrotum. There was no other urological anomaly. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion accessory scrotum. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypothesis regarding etiology of accessory scrotum.

  12. Symptomatic and asymptomatic accessory navicular bones: Findings of Tc-99m MDP bone scintigraphy

    Chiu, N.-T.; Jou, I.-M.; Lee, B.-F.; Yao, W.-J.; Tu, D.-G.; Wu, P.-S

    2000-05-01

    AIM: The accuracy of bone scintigraphy in diagnosing symptomatic accessory navicular bones has not been well studied. We conducted a retrospective study to explore the results and use of scintigraphy in symptomatic and asymptomatic accessory navicular bones. MATERIALS AND METHODS: Thirteen patients with a total of 13 symptomatic and 10 asymptomatic accessory navicular bones were included in the study. We used a scoring system to grade the scintigraphic abnormalities. The patients' symptoms and scintigraphic findings were recorded. RESULTS: Though focally increased radiopharmaceutical uptake was observed in all symptomatic accessory naviculars, half of the asymptomatic accessory navicular bones had the same manifestations. The scoring system was of no value in differentiating symptomatic from asymptomatic accessory navicular bones. CONCLUSION: Bone scintigraphy is a sensitive but not a specific tool for diagnosing a symptomatic accessory navicular. Chiu, N.-T. (2000)

  13. Symptomatic and asymptomatic accessory navicular bones: Findings of Tc-99m MDP bone scintigraphy

    AIM: The accuracy of bone scintigraphy in diagnosing symptomatic accessory navicular bones has not been well studied. We conducted a retrospective study to explore the results and use of scintigraphy in symptomatic and asymptomatic accessory navicular bones. MATERIALS AND METHODS: Thirteen patients with a total of 13 symptomatic and 10 asymptomatic accessory navicular bones were included in the study. We used a scoring system to grade the scintigraphic abnormalities. The patients' symptoms and scintigraphic findings were recorded. RESULTS: Though focally increased radiopharmaceutical uptake was observed in all symptomatic accessory naviculars, half of the asymptomatic accessory navicular bones had the same manifestations. The scoring system was of no value in differentiating symptomatic from asymptomatic accessory navicular bones. CONCLUSION: Bone scintigraphy is a sensitive but not a specific tool for diagnosing a symptomatic accessory navicular. Chiu, N.-T. (2000)

  14. Functioning transferred free muscle innervated by part of the vascularized ulnar nerve connecting the contralateral cervical seventh root to themedian nerve: Case report

    Nakayama Ken; Ikeguchi Ryosuke; Kakinoki Ryosuke; Nakamura Takashi

    2007-01-01

    Abstract Background The limited nerve sources available for the reconstruction and restoration of upper extremity function is the biggest obstacle in the treatment of brachial plexus injury (BPI). We used part of a transplanted vascularized ulnar nerve as a motor source of a free muscle graft. Case presentation A 21-year-old man with a left total brachial plexus injury had received surgical intercostal nerve transfer to the musculocutaneous nerve and a spinal accessory nerve transfer to the s...

  15. Accessory soleus muscle: a case report and clinical applicability

    William Paganini Mayer

    2013-10-01

    Full Text Available Variations in leg muscle are uncommon. Literature on this subject is scarce, but when those variations are reported they may cause alterations in joint mechanics or cause some discomfort in the leg and foot. The accessory soleus muscle (ASM is considered an unusual anatomical variation, with an  incidence of 0.5-6.0% in the population through studies in cadavers. During routine preparation of study material in the dissection room of the anatomy laboratory of the Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória/ES – Brazil, an ASM was found in the right inferior limb of a male cadaver fixed in 10% formalin. This supernumerary muscle was 3 cm wide, 9 cm long and 1 cm thick in its most voluminous part, in typical penniform fibers arrangement. It was located in the posteromedial region of the ankle, anterior to the Achilles tendon and posterior to the deep muscles of the leg compartment. Its anterior face covered the tibial nerve and the posterior tibial vessels, while its lower half was covered by the flexor retinaculum into the tarsal tunnel. Reports in the literature show possible compression of a neurovascular bundle because of its intimal position within the tarsal tunnel, which could result in ischemic compartment syndrome.

  16. Automobile accessories: Assessment and improvement

    Jackson, M. [Univ. of Nevada, Las Vegas, NV (United States)

    1995-11-01

    With mandates and regulatory policies to meet both the California Air Resources Board (CARB) and the Partnership for a New Generation of Vehicles (PNGV), designing vehicles of the future will become a difficult task. As we look into the use of electric and hybrid vehicles, reduction of the required power demand by influential automobile components is necessary in order to obtain performance and range goals. Among those automobile components are accessories. Accessories have a profound impact on the range and mileage of future vehicles with limited amounts of energy or without power generating capabilities such as conventional vehicles. Careful assessment of major power consuming accessories helps us focus on those that need improvement and contributes to attainment of mileage and range goals for electric and hybrid vehicles.

  17. Mammographic appearance of accessory breast tissue in the axilla

    Objective: To observe the mammographic appearance of accessory breast tissue in the axilla. Methods: In the past 3 years, 7562 women were underwent bilateral screen-film mammography. All of the mediolateral oblique (MLO) films were reviewed retrospectively to look for whether there was accessory breast tissue and what the mammographic features were like. Radiographically the accessory tissue resembled the main normal breast glandular tissue but was separated from it. Results: Of the 7652 case, accessory breast tissue in the axilla was detected in 161 cases. The prevalence was 2%. The age ranged from 17 to 70 years (mean, 39 years). 38% of them were found in the bilateral axilla, 42% only in the right, and 20% only in the left. The dimensions on the right ranged from 0.7 to 8.0 cm (mean, 3.5 cm), and that on the left ranged from 1.0 to 7.0 cm (mean, 3.3 cm). There were four types among the accessory breast tissue: patchy type was the most (35%), then the branched type (26%), mixed type (20%), and mass-like type (19%). 3 cases were proved by pathology. Conclusion: It is important that the radiologist be familiar with the mammographic appearance of accessory breast tissue in the axilla in order that they could be distinguished from other pathological changes

  18. The etiology of altered sensation in the inferior alveolar, lingual, and mental nerves as a result of dental treatment.

    Pogrel, M A; Thamby, S

    1999-07-01

    In a review of 163 consecutive patients referred with trigeminal nerve (inferior alveolar or lingual nerve) involvement following dental treatment, the most common etiology was third-molar removal (87 patients). The second most common cause was an inferior alveolar nerve block injection (34 patients), with a smaller number of endodontic and periodontal complications. Female patients outnumbered male 3.3 to 1. Twenty-seven patients were offered surgical exploration and possible nerve repair surgery; of them, 14 underwent surgery. Forty percent of the patients admitted to being involved in litigation during the time they were undergoing treatment. PMID:10530111

  19. Pinched Nerve

    ... Enhancing Diversity Find People About NINDS NINDS Pinched Nerve Information Page Table of Contents (click to jump ... being done? Clinical Trials Organizations What is Pinched Nerve? The term "pinched nerve" is a colloquial term ...

  20. Nerve biopsy

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  1. Feasibility Study on MR-Guided High-Intensity Focused Ultrasound Ablation of Sciatic Nerve in a Swine Model: Preliminary Results

    IntroductionSpastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system.MethodsThe HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T MRI scanner. Acute lesions were confirmed using T1-weighted contrast-enhanced (CE) MRI and histopathology using hematoxylin and eosin staining. The animals were euthanized immediately following post-ablation imaging.ResultsReddening and mild thickening of the nerve and pallor of the adjacent muscle were seen in all animals. The HIFU-treated sections of the nerves displayed nuclear pyknosis of Schwann cells, vascular hyperemia, perineural edema, hyalinization of the collagenous stroma of the nerve, myelin sheet swelling, and loss of axons. Ablations were visible on CE MRI. Non-perfused volume of the lesions (5.8–64.6 cc) linearly correlated with estimated lethal thermal dose volume (4.7–34.2 cc). Skin burn adjacent to the largest ablated zone was observed in the first animal. Bilateral treatment time ranged from 55 to 138 min, and preparation time required 2 h on average.ConclusionThe acute pilot study in swine demonstrated the feasibility of a noninvasive neurolysis of the sciatic nerve using a clinical MRgHIFU system. Results revealed that acute HIFU nerve lesions were detectable on CE MRI, gross pathology, and histology

  2. Feasibility Study on MR-Guided High-Intensity Focused Ultrasound Ablation of Sciatic Nerve in a Swine Model: Preliminary Results

    Kaye, Elena A., E-mail: kayee@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Medical Physics (United States); Gutta, Narendra Babu, E-mail: gnbabu.aiims@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Monette, Sebastien, E-mail: monettes@mskcc.org [The Rockefeller University, Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (United States); Gulati, Amitabh, E-mail: gulatia@mskcc.org; Loh, Jeffrey, E-mail: jeffreyloh@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Anesthesiology-Critical Care (United States); Srimathveeravalli, Govindarajan, E-mail: srimaths@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Ezell, Paula C., E-mail: paula.ezell@intusurg.com [The Rockefeller University, Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (United States); Erinjeri, Joseph P., E-mail: erinjerj@mskcc.org; Solomon, Stephen B., E-mail: solomons@mskcc.org; Maybody, Majid, E-mail: maybodym@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States)

    2015-08-15

    IntroductionSpastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system.MethodsThe HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T MRI scanner. Acute lesions were confirmed using T1-weighted contrast-enhanced (CE) MRI and histopathology using hematoxylin and eosin staining. The animals were euthanized immediately following post-ablation imaging.ResultsReddening and mild thickening of the nerve and pallor of the adjacent muscle were seen in all animals. The HIFU-treated sections of the nerves displayed nuclear pyknosis of Schwann cells, vascular hyperemia, perineural edema, hyalinization of the collagenous stroma of the nerve, myelin sheet swelling, and loss of axons. Ablations were visible on CE MRI. Non-perfused volume of the lesions (5.8–64.6 cc) linearly correlated with estimated lethal thermal dose volume (4.7–34.2 cc). Skin burn adjacent to the largest ablated zone was observed in the first animal. Bilateral treatment time ranged from 55 to 138 min, and preparation time required 2 h on average.ConclusionThe acute pilot study in swine demonstrated the feasibility of a noninvasive neurolysis of the sciatic nerve using a clinical MRgHIFU system. Results revealed that acute HIFU nerve lesions were detectable on CE MRI, gross pathology, and histology.

  3. Remote therapeutic effect of early nerve transposition in treatment of obstetric al brachial plexus palsy

    2001-01-01

    Objective: To report a method and remote therape utic effect of early nerve transposition in treatment of obstetrical brachial pl exus palsy.   Methods: From May 1995 to August 1996, 12 patients who had no r ecovery of biceps 3 months after birth were treated with nerve transposition. Ei ght had neuroma at the upper trunk and 4 had rupture or avulsion of the upper tr unk. Mallet test was used to evaluate the results.   Results: The follow-up of 40-52 months showed that excellent and good recovery in functions was found in 75% of the patients and the excellen t rate of phrenic nerve and accessory nerve transposition was 83.3% and 6 6.7% respectively. A complete recovery in shoulder and elbow joint function wa s in 3 patients and Mallet Ⅳ was in 6 patients.   Conclusions: Satisfactory outcome can be obtained by using earl y nerve transposition in treating obstetrical brachial plexus.Paralysis, obstetric; Peripheral nerves; Nerve trans position

  4. Accessory belly of piriformis, as a cause of superior gluteal neurovascular entrapment

    Rimple Bansal

    2013-06-01

    Full Text Available During routine dissection on 50 years old male cadaver, an accessory belly of piriformis was observed. This accessory belly was superior and parallel to the main piriformis muscle. This was associated with emergence of superior gluteal nerve and superior gluteal artery between the two bellies. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. But interestingly in the present case, superior gluteal nerve was interposed between two bellies that may help the clinicians to establish a rare yet important cause of piriformis syndrome and a rare cause of undiagnosed chronic pain in gluteal region. As superior gluteal artery was also interposed, so this rare variation holds interest to surgeons especially in isolated buttock claudication despite otherwise normal vascular investigations. [Int J Res Med Sci 2013; 1(3.000: 296-298

  5. Building iPhone OS Accessories

    Maskrey, Ken

    2010-01-01

    This book provides a serious, in-depth look at Apple's External Accessory Framework and the iPhone Accessories API. You'll learn how to create new, integrated solutions that combine iPhone apps with dedicated hardware. The iPhone OS Accessories API expands the opportunities for innovative iPhone developers, allowing you to control and monitor external devices, whether you've built them yourself or obtained them from a third party. What you'll learn * Develop accessories and apps for the iPhone and iPod touch. * Use Apple's External Accessory Framework to create hardware/software interaction. *

  6. Identifying a Safe Range of Stimulation Current for Intraoperative Neuromonitoring of the Recurrent Laryngeal Nerve: Results from a Canine Model

    Li, Tao; Zhou, Gang; Yang, Yang; Gao, Zhi-Dong; Guo, Peng; Shen, Zhan-Long; Yang, Xiao-Dong; Xie, Qi-Wei; Ye, Ying-Jiang; Jiang, Ke-Wei; Wang, Shan

    2016-01-01

    Background: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been widely applied during thyroid surgery. However, the safe range of stimulation intensity for IONM remains undetermined. Methods: Total thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5–20 mA (step-wise in 5 mA increments) for 1 min. The evoked electromyography (EMG) of vocal muscles before and after supramaximal stimulation were recorded and compared. Acute microstructural morphological changes in the RLNs were observed immediately postoperatively under an electron microscope. Results: The average stimulating threshold for RLNs stimulated with 15 mA and 20 mA showed no significant changes compared to the unstimulated RLNs (15 mA group: 0.320 ± 0.123 mA vs. 0.315 ± 0.097 mA, P = 0.847; 20 mA group: 0.305 ± 0.101 mA vs. 0.300 ± 0.103 mA, P = 0.758). Similar outcomes were shown in average evoked EMG amplitude (15 mA group: 1,026 ± 268 μV vs. 1,021 ± 273 μV, P = 0.834; 20 mA group: 1,162 ± 275 μV vs. 1,200 ± 258 μV, P = 0.148). However, obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 mA. Conclusions: A stimulation intensity less than 15 mA might be safe for IONM of the RLN. PMID:27453233

  7. Deleting the accessory subunit KChIP2 results in loss of I(to,f) and increased I(K,slow) that maintains normal action potential configuration

    Thomsen, Morten B; Sosunov, Eugene A; Anyukhovsky, Evgeny P; Ozgen, Nazira; Boyden, Penelope A; Rosen, Michael R

    2008-01-01

    potential duration (APD) is maintained in KChIP2 knockout mice. OBJECTIVE: We tested the role of KChIP2 in regulating APD and studied the underlying ionic currents. METHODS: We used microelectrode techniques, whole-cell patch clamp studies, and real-time polymerase chain reaction amplification to...... characterize ventricular repolarization and its determinants in wild-type and KChIP2(-/-) mice. RESULTS: Despite comparable baseline action potentials, APD was more markedly prolonged by 4-aminopyridine (4-AP) in KChIP2(-/-) preparations. Peak K(+) current densities were similar in wild-type and KChIP2...

  8. The Impact of Motor and Sensory Nerve Architecture on Nerve Regeneration

    MORADZADEH, ARASH; Borschel, Gregory H.; Luciano, Janina P.; Whitlock, Elizabeth L.; Hayashi, Ayato; Hunter, Daniel A.; Mackinnon, Susan E.

    2008-01-01

    Sensory nerve autografting is the standard of care for injuries resulting in a nerve gap. Recent work demonstrates superior regeneration with motor nerve grafts. Improved regeneration with motor grafting may be a result of the nerve’s Schwann cell basal lamina tube size. Motor nerves have larger SC basal lamina tubes, which may allow more nerve fibers to cross a nerve graft repair. Architecture may partially explain the suboptimal clinical results seen with sensory nerve grafting techniques. ...

  9. Microneurolysis and decompression of long thoracic nerve injury are effective in reversing scapular winging: Long-term results in 50 cases

    Lyons Andrew B

    2007-03-01

    Full Text Available Abstract Background Long thoracic nerve injury leading to scapular winging is common, often caused by closed trauma through compression, stretching, traction, direct extrinsic force, penetrating injury, or neuritides such as Parsonage-Turner syndrome. We undertook the largest series of long thoracic nerve decompression and neurolysis yet reported to demonstrate the usefulness of long thoracic nerve decompression. Methods Winging was bilateral in 3 of the 47 patients (26 male, 21 female, yielding a total of 50 procedures. The mean age of the patients was 33.4 years, ranging from 24–57. Causation included heavy weight-lifting (31 patients, repetitive throwing (5 patients, deep massage (2 patients, repetitive overhead movement (1 patient, direct trauma (1 patient, motor bike accident (1 patient, and idiopathic causes (9 patients. Decompression and microneurolysis of the long thoracic nerve were performed in the supraclavicular space. Follow-up (average of 25.7 months consisted of physical examination and phone conversations. The degree of winging was measured by the operating surgeon (RKN. Patients also answered questions covering 11 quality-of-life facets spanning four domains of the World Health Organization Quality of Life questionnaire. Results Thoracic nerve decompression and neurolysis improved scapular winging in 49 (98% of the 50 cases, producing "good" or "excellent" results in 46 cases (92%. At least some improvement occurred in 98% of cases that were less than 10 years old. Pain reduction through surgery was good or excellent in 43 (86% cases. Shoulder instability affected 21 patients preoperatively and persisted in 5 of these patients after surgery, even in the 5 patients with persistent instability who experienced some relief from the winging itself. Conclusion Surgical decompression and neurolysis of the long thoracic nerve significantly improve scapular winging in appropriate patients, for whom these techniques should be considered

  10. Nerve conduction

    ... the central nervous system (CNS) and peripheral nervous system (PNS). The CNS contains the brain and the spinal cord and the PNS consists of thousands of nerves that connect the spinal cord to muscles and sensory receptors. A peripheral nerve is composed of nerve ...

  11. Mechanical accessories for mobile teleoperators

    The choice of optimum mechanical accessories for mobile teleoperators involves matching the criteria for emergency response with the available technology. This paper presents a general background to teleoperations, a potpourri of the manipulator systems available, and an argument for force reflecting manipulation. The theme presented is that the accomplishment of humanlike endeavors in hostile environments will be most successful when man model capabilities are utilized. The application of recent electronic technology to manipulator development has made new tools available to be applied to emergency response activities. The development activities described are products of the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory. 13 refs., 7 figs

  12. Mechanical accessories for mobile teleoperators

    Feldman, M.J.; Herndon, J.N.

    1985-01-01

    The choice of optimum mechanical accessories for mobile teleoperators involves matching the criteria for emergency response with the available technology. This paper presents a general background to teleoperations, a potpourri of the manipulator systems available, and an argument for force reflecting manipulation. The theme presented is that the accomplishment of humanlike endeavors in hostile environments will be most successful when man model capabilities are utilized. The application of recent electronic technology to manipulator development has made new tools available to be applied to emergency response activities. The development activities described are products of the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory. 13 refs., 7 figs.

  13. Accessory mental foramen: A rare anatomical variation detected by cone-beam computed tomography

    Torres, Marianna Guanaes Gomes; De Faro Valverde, Ludmila; Vidal, Manuela Torres Andion; Crusoe-Rebello, Ieda Margarida [Dept. of Oral Radiology, School of Dentistry, Federal University of Bahia, Salvador (Brazil)

    2015-03-15

    The mental foramen is a bilateral opening in the vestibular portion of the mandible through which nerve endings, such as the mental nerve, emerge. In general, the mental foramen is located between the lower premolars. This region is a common area for the placement of dental implants. It is very important to identify anatomical variations in presurgical imaging exams since damage to neurovascular bundles may have a direct influence on treatment success. In the hemimandible, the mental foramen normally appears as a single structure, but there are some rare reports on the presence and number of anatomical variations; these variations may include accessory foramina. The present report describes the presence of accessory mental foramina in the right mandible, as detected by cone-beam computed tomography before dental implant placement.

  14. Cytokine and protein markers of leprosy reactions in skin and nerves: baseline results for the North Indian INFIR cohort.

    Diana N J Lockwood

    2011-12-01

    Full Text Available BACKGROUND: Previous studies investigating the role of cytokines in the pathogenesis of leprosy have either been on only small numbers of patients or have not combined clinical and histological data. The INFIR Cohort study is a prospective study of 303 new multibacillary leprosy patients to identify risk factors for reaction and nerve damage. This study characterised the cellular infiltrate in skin and nerve biopsies using light microscopic and immunohistochemical techniques to identify any association of cytokine markers, nerve and cell markers with leprosy reactions. METHODOLOGY/PRINCIPAL FINDINGS: TNF-α, TGF-β and iNOS protein in skin and nerve biopsies were detected using monoclonal antibody detection immunohistochemistry techniques in 299 skin biopsies and 68 nerve biopsies taken from patients at recruitment. The tissues were stained with hematoxylin and eosin, modified Fite Faraco, CD68 macrophage cell marker and S100. CONCLUSIONS/SIGNIFICANCE: Histological analysis of the biopsies showed that 43% had borderline tuberculoid (BT leprosy, 27% borderline lepromatous leprosy, 9% lepromatous leprosy, 13% indeterminate leprosy types and 7% had no inflammation. Forty-six percent had histological evidence of a Type 1 Reaction (T1R and 10% of Erythema Nodosum Leprosum. TNF-α was detected in 78% of skin biopsies (181/232, iNOS in 78% and TGF-β in 94%. All three molecules were detected at higher levels in patients with BT leprosy. TNF-α was localised within macrophages and epithelioid cells in the granuloma, in the epidermis and in dermal nerves in a few cases. TNF-α, iNOS and TGF-β were all significantly associated with T1R (p<0.001. Sixty-eight nerve biopsies were analysed. CD68, TNF-α and iNOS staining were detectable in 88%, 38% and 28% of the biopsies respectively. The three cytokines TNF-α, iNOS and TGF-β detected by immunohistochemistry showed a significant association with the presence of skin reaction. This study is the first to

  15. Fast Image Retrieval of Textile Industrial Accessory Based on Multi-Feature Fusion

    沈文忠; 杨杰

    2004-01-01

    A hierarchical retrieval scheme of the accessory image database is proposed based on textile industrial accessory contour feature and region feature. At first smallest enclosed rectangle[1] feature (degree of accessory coordination) is used to filter the image database to decouple the image search scope. After the accessory contour information and region information are extracted, the fusion multi-feature of the centroid distance Fourier descriptor and distance distribution histogram is adopted to finish image retrieval accurately. All the features above are invariable under translation, scaling and rotation. Results from the test on the image database including 1,000 accessory images demonstrate that the method is effective and practical with high accuracy and fast speed.

  16. Autosomal Dominant Transmission of Accessory Navicular

    Dobbs, Matthew B.; Walton, Tim

    2004-01-01

    The accessory navicular bone is one of the most symptomatic bones of the foot. Although it has been reported to be present in various members of the same family, there is a lack of knowledge about its inheritance pattern. We report two large pedigrees in which accessory navicular is inherited in an autosomal dominant fashion with incomplete penetrance.

  17. The accessory fallopian tube: A rare anomaly

    Kusum R Gandhi

    2012-01-01

    Full Text Available This paper presents a rare anatomical variation in the form of accessory fallopian tube on right side. The duplication of fallopian tube was observed in a 34-year-old female during routine undergraduate dissection in our department. Fallopian tube is the part of uterus that carries the ovum from the ovary to the uterus. Accessory fallopian tube is the congenital anomaly attached to the ampullary part of main tube. This accessory tube is common site of pyosalpinx, hydrosalpinx, cystic swelling and torsion. The ovum released by the ovary may also be captured by the blind accessory tube leading to infertility or ectopic pregnancy. Hence, all patients of infertility or pelvic inflammatory disease should be screened to rule out the presence of accessory fallopian tube and if encountered should be removed.

  18. Terminal nerve: cranial nerve zero

    Jorge Eduardo Duque Parra

    2006-12-01

    Full Text Available It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH. In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a common nerve that integrates the terminal nerve with the olfactory nerves and the vomeronasals nerves which seem to carry out the odors detection function as well as in the food search, pheromone detection and nasal vascular regulation.

  19. Therapeutic cranial nerve irradiation: results from a multi-center dose response study of radiosurgery for trigeminal neuralgia

    Purpose/Objective: We performed a multi-institution study to evaluate the technique, dose-selection parameters, and results of gamma knife stereotactic radiosurgery in the management of trigeminal neuralgia. We hypothesized that MRI-stereotactic targeting of the trigeminal nerve and irradiation with a single 4 mm isocenter, 2-4 mm anterior to the brainstem, could be a safe and effective treatment for this disorder. Materials and Methods: Fifty patients at five centers had radiosurgery using a single 4 mm isocenter targeted at the root entry zone. All patients had typical trigeminal neuralgia. The mean patient age was 70 years, (range, 40-87). Thirty-two patients had undergone prior surgery, and the mean number of procedures performed was 2.8 (range, 1-7). Eighteen patients (36%) had not had prior surgery before radiosurgery. Maximum radiosurgery doses included 60 Gy (n=8), 65 Gy (n=3), 70 Gy (n=27), 75 Gy (n=2), 80 Gy (n=6) and 90 Gy (n=4). All patients were discharged within 24 hours and were studied in regard to the degree of pain relief, latency interval to pain relief, sensory loss, and the need for further therapy. Mean follow-up after radiosurgery was 9.2 months (range, 2-26 months). Results: At last follow-up, 25 patients (50%) had excellent control (pain-free), 17 (34%) had good control (50-90% relief), and 8 (16%) had failed (see Figure). The median time to pain relief was one month. We identified an actuarial response rate of 53% for complete pain relief at seven months, and 93% for pain reduction (50-100% relief). At 18 months, these results declined to 48% and 77% respectively. A significantly greater proportion of patients receiving a radiosurgery maximum dose of ≥ 70 Gy achieved complete pain relief (63% vs. 18%) and >50% pain reduction (96% vs. 80%) than those with doses <70 Gy. Patients without prior surgery had significantly better outcomes in univariate testing. Three patients (6%) developed increased facial paresthesiae after radiosurgery

  20. Intraoperative vagal nerve monitoring.

    Leonetti, J P; Jellish, W S; Warf, P; Hudson, E

    1996-08-01

    A variety of benign and malignant neoplasms occur in the superior cervical neck, parapharyngeal space or the infratemporal fossa. The surgical resection of these lesions may result in postoperative iatrogenic injury to the vagus nerve with associated dysfunctional swallowing and airway protection. Anatomic and functional preservation of this critical cranial nerve will contribute to a favorable surgical outcome. Fourteen patients with tumors of the cervical neck or adjacent skull base underwent intraoperative vagal nerve monitoring in an attempt to preserve neural integrity following tumor removal. Of the 11 patients with anatomically preserved vagal nerves in this group, seven patients had normal vocal cord mobility following surgery and all 11 patients demonstrated normal vocal cord movement by six months. In an earlier series of 23 patients with tumors in the same region who underwent tumor resection without vagal nerve monitoring, 18 patients had anatomically preserved vagal nerves. Within this group, five patients had normal vocal cord movement at one month and 13 patients demonstrated normal vocal cord movement at six months. This paper will outline a technique for intraoperative vagal nerve monitoring utilizing transcricothyroid membrane placement of bipolar hook-wire electrodes in the vocalis muscle. Our results with the surgical treatment of cervical neck and lateral skull base tumors for patients with unmonitored and monitored vagal nerves will be outlined. PMID:8828272

  1. Successful operative management of an upper lumbar spinal canal stenosis resulting in multilevel lower nerve root radiculopathy

    Shearwood McClelland; Stefan S Kim

    2015-01-01

    Lumbar stenosis is a common disorder, usually characterized clinically by neurogenic claudication with or without lumbar/sacral radiculopathy corresponding to the level of stenosis. We present a case of lumbar stenosis manifesting as a multilevel radiculopathy inferior to the nerve roots at the level of the stenosis. A 55-year-old gentleman presented with bilateral lower extremity pain with neurogenic claudication in an L5/S1 distribution (posterior thigh, calf, into the foot) concomitant wit...

  2. Carcinoma in accessory axillary breast.

    Khanna, Seema; Mishra, Shashi Prakash; Kumar, Satendra; Khanna, Ajay Kumar

    2015-01-01

    We present a rare case of carcinoma developing in an accessory breast. The patient presented with a progressive lump in her right axilla for 1 year. On examination, there was a well-developed nipple areola complex in the right axilla overlying a hard, fixed 5 × 3 cm lump. On investigation, core biopsy revealed poorly differentiated carcinoma of the breast. Mammography also revealed features of a malignant lesion with skin and muscle infiltration. Neoadjuvant chemotherapy was administered followed by modified radical mastectomy after three cycles. Immunohistochemistry study showed positive status of oestrogen and progesterone receptors, and negative HER-2 neu. Three more cycles of chemotherapy along with 50 Gy radiotherapy were given in an adjuvant setting followed by hormone therapy. PMID:26260957

  3. Neuromuscular Ultrasound of Cranial Nerves

    Tawfik, Eman A.; Walker, Francis O.; Cartwright, Michael S.

    2015-01-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few re...

  4. Terminal nerve: cranial nerve zero

    Jorge Eduardo Duque Parra; Carlos Alberto Duque Parra

    2006-01-01

    It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH). In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a co...

  5. Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report

    Kawamura Kenji; Kobata Yasunori; Yajima Hiroshi; Shigematsu Koji; Maegawa Naoki; Takakura Yoshinori

    2006-01-01

    Abstract An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery. Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve. This case dem...

  6. Melanocortin receptors and their accessory proteins

    Cooray, Sadani N.; Clark, Adrian J.L.

    2010-01-01

    Abstract The melanocortin receptor family consists of 5 members which belong to the GPCR superfamily. Their specific ligands, the melanocortins are peptide hormones which are formed by the proteolytic cleavage of the proopiomelanocortin (POMC) protein. It is now recognised that certain GPCRs require accessory proteins for their function. Like these GPCRs the melanocortin receptor family is also known to be associated with accessory proteins that regulate their function. ...

  7. Microvascular Cranial Nerve Palsy

    ... Español Eye Health / Eye Health A-Z Microvascular Cranial Nerve Palsy Sections What Is Microvascular Cranial Nerve Palsy? ... Microvascular Cranial Nerve Palsy Treatment What Is Microvascular Cranial Nerve Palsy? Aug. 02, 2012 Microvascular cranial nerve palsy ( ...

  8. Extra and Intramuscular Distribution of the Thoracodorsal Nerve with Regard to Nerve Reconstruction Surgeries.

    Malalasekera, Ajith; Beneragama, Thushan; Kanesu, Sivasuganthan; Sahathevan, Vithoosan; Jayasekara, Rohan

    2016-06-01

    Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate length and thickness for nerve coaptation. Aim Our objective was to evaluate the length of the LBTN that could be obtained as a donor nerve, externally and within the muscle. Method Eight (8) cadavers with intact upper limbs and thorax which could be positioned in the anatomical position were selected for the study. Cadavers with dissected axillae, brachial plexus or upper limbs were excluded. The thoracodorsal neurovascular bundle was dissected and the number of branches of the thoracodorsal nerve was identified along with its lateral branch. The lateral branch was dissected up to the latissimus dorsi muscle and further intramuscularly. All lengths were measured using a vernier caliper. Results The mean length of the LBTN, up to its first intramuscular branch, is 8.14 cm (range 5.99-12.29 cm). Beyond this, the intramuscular nerve branched further and was of very minute diameter. The mean unbranched intramuscular length of the nerve is 3.36 cm (range 1.3-7.71 cm) which is 41.28% of the total length of the LBTN. Conclusion A significant proportion of the LBTN is found within the latissimus dorsi muscle. This length could potentially be used for direct nerve coaptation by intrafascicular dissection. PMID:26890860

  9. Optic nerve oxygenation

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen...... through a mechanism of vasodilatation and lowering of the intraocular pressure. Carbonic anhydrase inhibition reduces the removal of CO2 from the tissue and the CO2 accumulation induces vasodilatation resulting in increased blood flow and improved oxygen supply. This effect is inhibited by the cyclo...

  10. Radial Nerve Tendon Transfers.

    Cheah, Andre Eu-Jin; Etcheson, Jennifer; Yao, Jeffrey

    2016-08-01

    Radial nerve palsy typically occurs as a result of trauma or iatrogenic injury and leads to the loss of wrist extension, finger extension, thumb extension, and a reduction in grip strength. In the absence of nerve recovery, reconstruction of motor function involves tendon transfer surgery. The most common donor tendons include the pronator teres, wrist flexors, and finger flexors. The type of tendon transfer is classified based on the donor for the extensor digitorum communis. Good outcomes have been reported for most methods of radial nerve tendon transfers as is typical for positional tendon transfers not requiring significant power. PMID:27387076

  11. Properties of Phase Transition of Traffic Flow on Urban Expressway Systems with Ramps and Accessory Roads

    梅超群; 刘业进

    2011-01-01

    In this paper, we develop a cellular automaton model to describe the phase transition of traffic flow on urban expressway systems with on-off-ramps and accessory roads. The lane changing rules are given in detailed, the numerical results show that the main road and the accessory road both produce phase transitions. These phase transitions will omen be influenced by the number of lanes, lane changing, the ramp flow, the input flow rate, and the geometry structure.

  12. Fascicular Involvement of the Posterior Tibial Nerve as a Result of Perineural Ganglion Cyst at the Posterior Tibial Nerve in the Calf: A Case Report and Review of Literature.

    Patel, Chilvana; Vishnubhakat, Surya Murthy; Narayan, Raj

    2015-12-01

    We report a 19-year-old woman with a 6-month history of nontraumatic left foot numbness associated with intermittent weakness. Nerve conduction studies and electromyography localized the lesion to the posterior tibial nerve, below the innervation to the soleus and medial gastrocnemius muscles. MRI of the left leg revealed a multiloculated cystic collection near the proximal tibiofibular joint. Surgical excision and pathology confirmed the diagnosis of a ganglion cyst, in an atypical location distal to the popliteal fossa. We believe this is the first reported case of fascicular posterior tibial nerve involvement by a ganglion cyst in the calf. PMID:26583496

  13. Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome

    Freeman Michael; Champagne Lloyd P; Nystrom N Ake; Blix Elisabet

    2010-01-01

    Abstract Background Chronic problems from whiplash trauma generally include headache, pain and neck stiffness that may prove refractory to conservative treatment modalities. As has previously been reported, such afflicted patients may experience significant temporary relief with injections of local anesthetic to painful trigger points in muscles of the shoulder and neck, or lasting symptomatic improvement through surgical excision of myofascial trigger points. In a subset of patients who pres...

  14. Successful operative management of an upper lumbar spinal canal stenosis resulting in multilevel lower nerve root radiculopathy

    Shearwood McClelland

    2015-01-01

    Full Text Available Lumbar stenosis is a common disorder, usually characterized clinically by neurogenic claudication with or without lumbar/sacral radiculopathy corresponding to the level of stenosis. We present a case of lumbar stenosis manifesting as a multilevel radiculopathy inferior to the nerve roots at the level of the stenosis. A 55-year-old gentleman presented with bilateral lower extremity pain with neurogenic claudication in an L5/S1 distribution (posterior thigh, calf, into the foot concomitant with dorsiflexion and plantarflexion weakness. Imaging revealed grade I spondylolisthesis of L3 on L4 with severe spinal canal stenosis at L3-L4, mild left L4-L5 disc herniation, no stenosis at L5-S1, and no instability. EMG revealed active and chronic L5 and S1 radiculopathy. The patient underwent bilateral L3-L4 hemilaminotomy with left L4-L5 microdiscectomy for treatment of his L3-L4 stenosis. Postoperatively, he exhibited significant improvement in dorsiflexion and plantarflexion. The L5-S1 level was not involved in the operative decompression. Patients with radiculopathy and normal imaging at the level corresponding to the radiculopathy should not be ruled out for operative intervention should they have imaging evidence of lumbar stenosis superior to the expected affected level.

  15. Accessory breast tissue mimicking pedunculated lipoma.

    Husain, Musharraf; Khan, Sabina; Bhat, Ashraf; Hajini, Firdoos

    2014-01-01

    Accessory breast tissue is an uncommon condition which occurs in 0.4-6% of women. It is mostly located in the axilla where it can cause diagnostic difficulty, especially if it is unilateral and large. Usually it is bilateral and presents as an asymptomatic mass during pregnancy or lactation. The diagnosis of ectopic breast tissue is important as it can undergo the same pathological changes that occur in a normal breast, such as mastitis, fibrocystic disease and carcinoma. We present a case of a large right-sided accessory breast in a 32-year-old woman that was clinically diagnosed as pedunculated lipoma. However, subsequent histopathological examination proved it to be an accessory breast tissue with lactational changes. PMID:25006058

  16. Repair of sciatic nerve defects using tissue engineered nerves

    Zhang, Caishun; Lv, Gang

    2013-01-01

    In this study, we constructed tissue-engineered nerves with acellular nerve allografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cells of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tissue-engine...

  17. Cast functional accessories for heat treatment furnaces

    A. Drotlew

    2010-10-01

    Full Text Available The study gives examples of the cast functional accessories operating in furnaces for the heat treatment of metals and alloys. The describeddesign solutions of castings and their respective assemblies are used for charge preparation and handling. They were put in systematicorder depending on furnace design and the technological purpose of heat treatment. Basic grades of austenitic cast steel, used for castings of this type, were enumerated, and examples of general guidelines formulated for their use were stated. The functional accessories described in this study were designed and made by the Foundry Research Laboratory of West Pomeranian University of Technology.

  18. Secondary digital nerve repair in the foot with resorbable p(DLLA-epsilon-CL) nerve conduits

    Meek, MF; Nicolai, JPA; Robinson, PH

    2006-01-01

    Nerve guides are increasingly being used in peripheral nerve repair. In the last decade, Much preclinical research has been undertaken into a resorbable nerve guide composed of p(DLLA-epsilon-CL). This report describes the results of secondary digital nerve reconstruction in the foot in a patient wi

  19. Typology of the arteries in the human scalenus region, with special reference to the accessory ascending cervical artery.

    Su WD

    2000-12-01

    Full Text Available The accessory ascending cervical artery (Murakami et al., 1996, which arises from the subclavian artery and ascends between the scalenus anterior and medius muscles, was studied in 87 Japanese adult cadavers (174 sides, with special attention being given to its origin, distribution, and relationship to other arteries at the cervical or scalenus region. In 154 sides (88.5%, the accessory ascending cervical artery was found to originate from the subclavian artery behind the scalenus anterior muscle, and to branch out to the scalenus anterior and medius muscles as well as those entering the 5th and 6th intervertebral foramens along the 6th and 7th cervical nerves. This artery arose independently in 105 sides. The accessory ascending cervical artery issued off or formed a common trunk with the transverse cervical artery and/or costocervical trunk in 49 sides. In cases lacking the accessory ascending cervical artery, it was usually compensated for by the costocervial trunk and/or transverse cervical artery (18 sides. Common trunk formation with the vertebral, internal thoracic, or suprascapular arteries was not observed. The authors suggest that the accessory ascending cervical artery, the transverse cervical artery, and the costocervical trunk should be grouped into one arterial system, a system that may be a remnant of the precostal longitudinal anastomoses of intersegmental arteries of the dorsal aorta behind the scalenus anterior muscle.

  20. Cutaneous nerve entrapment syndrome

    DongFuhui

    2004-01-01

    The cutaneous nerve entrapment syndrome is named that, the cutaneous nerve's functional disorder caused by some chronic entrapment, moreover appears a series of nerve's feeling obstacle,vegetative nerve function obstacle, nutrition obstacle, even motor function obstacle in various degree.

  1. Nerve biopsy (image)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  2. 21 CFR 890.3910 - Wheelchair accessory.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wheelchair accessory. 890.3910 Section 890.3910 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3910...

  3. Mrap2 Accessory Linked to Obesity

    Liu, Tiemin; Elmquist, Joel K.; Williams, Kevin W.

    2013-01-01

    Melanocortin receptors are critical modulators of energy balance and glucose homeostasis. Companion studies published in Science (Asai et al., 2013; Sebag et al., 2013) establish a role for melanocortin receptor accessory protein 2 (Mrap2) in regulating melanocortin receptor activity and in the development of obesity in zebrafish, rodents, and humans.

  4. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  5. 21 CFR 884.6120 - Assisted reproduction accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction accessories. 884.6120... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6120 Assisted reproduction accessories. (a) Identification. Assisted reproduction accessories are a group...

  6. 21 CFR 872.3980 - Endosseous dental implant accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endosseous dental implant accessories. 872.3980... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3980 Endosseous dental implant accessories. (a) Identification. Endosseous dental implant accessories are manually powered devices...

  7. Non‑Azygos Accessory Fissure in Right Upper Lobe Associated with Superior and Inferior Accessory Fissures in Right Lower Lobe

    Thomas Jose Eluvathingal Muttikkal; Chunli Deng

    2012-01-01

    Accessory fissures in the lungs are common congenital variations, usually detected as incidental findings in radiographs or CT scan. Accessory fissures can act as an anatomic barrier to the spread of inflammatory or neoplastic disease, as well as due to the variant anatomy, mimic lesions. It is important to recognize the presence of accessory fissures, as they affect surgical planning of pulmonary lobectomy and segmentectomy. Accessory fissure in the right upper lobe other than due to the ano...

  8. Concomitant calcaneo-cuboid-cuneiform osteotomies and the modified Kidner procedure for severe flatfoot associated with symptomatic accessory navicular in children and adolescents

    Kim, Jung Ryul; Park, Chan Il; Moon, Young Jae; Wang, Sung Il; Kwon, Keun Sang

    2014-01-01

    Background Accessory navicular can become symptomatic in childhood, and in some cases, the condition is associated with progressive flattening of the longitudinal arch. Moreover, some severe, rigid flatfoot deformities are associated with an accessory navicular. We investigated the results of concomitant calcaneo-cuboid-cuneiform osteotomies (triple C) and the modified Kidner procedure for severe flatfoot associated with a symptomatic accessory navicular in children and adolescents. Methods T...

  9. Prediabetes May Damage Nerves More Than Thought

    ... medlineplus/news/fullstory_158274.html Prediabetes May Damage Nerves More Than Thought Early pain and tingling in ... 12, 2016 (HealthDay News) -- Prediabetes may cause more nerve damage than previously believed, researchers say. "The results ...

  10. Regional tissue immune responses after sciatic nerve injury in rats

    Chen, Yu-ming; Shen, Ruo-Wu; Zhang, Bei; Zhang, Wei-Ning

    2015-01-01

    Inflammatory cells play a critical role during nerve regeneration following peripheral nerve injury. In this study, we investigated immune responses in rat sciatic nerve after injury. Wistar rats were randomly divided into the sciatic nerve injury (model) group and control group. The right sciatic nerve of rats in the model group was transected and sutured end-to-end. Our results showed that rats in the model group functionally recovered following sciatic nerve injury. We detected inflammator...

  11. Chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor promotes sciatic nerve repair.

    Zhang, Yanru; Zhang, Hui; Katiella, Kaka; Huang, Wenhua

    2014-07-15

    A chemically extracted acellular allogeneic nerve graft can reduce postoperative immune rejection, similar to an autologous nerve graft, and can guide neural regeneration. However, it remains poorly understood whether a chemically extracted acellular allogeneic nerve graft combined with neurotrophic factors provides a good local environment for neural regeneration. This study investigated the repair of injured rat sciatic nerve using a chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor. An autologous nerve anastomosis group and a chemical acellular allogeneic nerve bridging group were prepared as controls. At 8 weeks after repair, sciatic functional index, evoked potential amplitude of the soleus muscle, triceps wet weight recovery rate, total number of myelinated nerve fibers and myelin sheath thickness were measured. For these indices, values in the three groups showed the autologous nerve anastomosis group > chemically extracted acellular nerve graft + ciliary neurotrophic factor group > chemical acellular allogeneic nerve bridging group. These results suggest that chemically extracted acellular nerve grafts combined with ciliary neurotrophic factor can repair sciatic nerve defects, and that this repair is inferior to autologous nerve anastomosis, but superior to chemically extracted acellular allogeneic nerve bridging alone. PMID:25221592

  12. Chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor promotes sciatic nerve repair

    Yanru Zhang; Hui Zhang; Kaka Katiella; Wenhua Huang

    2014-01-01

    A chemically extracted acellular allogeneic nerve graft can reduce postoperative immune re-jection, similar to an autologous nerve graft, and can guide neural regeneration. However, it remains poorly understood whether a chemically extracted acellular allogeneic nerve graft combined with neurotrophic factors provides a good local environment for neural regenera-tion. This study investigated the repair of injured rat sciatic nerve using a chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor. An autologous nerve anastomosis group and a chemical acellular allogeneic nerve bridging group were prepared as controls. At 8 weeks after repair, sciatic functional index, evoked potential amplitude of the soleus muscle, triceps wet weight recovery rate, total number of myelinated nerve fibers and myelin sheath thickness were measured. For these indices, values in the three groups showed the autologous nerve anastomosis group > chemically extracted acellular nerve graft + ciliary neurotrophic factor group > chemical acellular allogeneic nerve bridging group. These results suggest that chemically extracted acellular nerve grafts combined with ciliary neurotrophic factor can repair sciatic nerve defects, and that this repair is inferior to autologous nerve anasto-mosis, but superior to chemically extracted acellular allogeneic nerve bridging alone.

  13. Efficacy and safety of methylcobalamin, alpha lipoic acid and pregabalin combination versus pregabalin monotherapy in improving pain and nerve conduction velocity in type 2 diabetes associated impaired peripheral neuropathic condition. [MAINTAIN]: Results of a pilot study

    D Vasudevan

    2014-01-01

    Full Text Available Background and Objective: To assess whether methylcobalamin and alpha lipoic acid (ALA added to pregabalin provide additional benefit compared to pregabalin alone in type 2 diabetes mellitus associated peripheral neuropathy. Setting and Design: An open label, randomized, controlled parallel-group pilot study. Materials and Methods: Thirty adult patients with type 2 diabetes mellitus with symptoms of peripheral neuropathy for ≥6 months were randomized to receive pregabalin 75 mg, methylcobalamin 750 μg, and ALA 100 mg (PMA, n = 15; or pregabalin 75 mg (PG, n = 15 for 12 weeks. Assessment variables were numeric rating scale (NRS, sleep interference scores (SIS, response rate to pain, and global assessment for the usefulness of therapy. The nerve conduction velocity was assessed for sensory and motor nerves. Safety assessment included adverse events reported by the patients, clinical laboratory, and general medical, neurological examinations. Statistical Analysis: Efficacy analyses were done on per-protocol (PP population, whereas safety analyses were done on intent-to-treat (ITT population. Results: Significant improvement was seen in pain and sleep interference in both groups. Mean nerve conduction velocity of left common peroneal nerve (CPN showed significant improvement in PMA group at week 12 compared to baseline (P = 0.018. For right CPN both groups showed significant improvement. (PMA, P = 0.002, PG, P = 0.007. For sensory testing, at week 12, right superficial peroneal nerve showed reduction in nerve conduction velocity in PG group compared to baseline (P = 0.043. Conclusion: Methylcobalamine, ALA and pregabalin combination provides pain relief and improves sleep interference. Addition of methylcobalamin and ALA to pregabalin improves the nerve function. Due to small sample size, most of the efficacy parameters could not reach significant difference between groups; hence benefit of the 3-drug-combimation should be interpreted with

  14. An experimental study of nerve bypass graft

    XU Jie; LI Xue-shi

    2008-01-01

    Objective: To study the use of a nerve "bypass" graft as a possible alternative to neurolysis or segmental resection with interposition grafting in the treatment of neuroma-in-continuity. Methods: A sciatic nerve crush injury model was established in the Sprague-Dawley rat by compression with a straight hemostatic forceps. Epineurial windows were created proximal and distal to the injury site. An 8-mm segment of radial nerve was harvested and coaptated to the sciatic nerve at the epineurial window sites proximal and distal to the compressed segment (bypass group). A sciatic nerve crush injury without bypass served as a control. Nerve conduction studies were performed over an 8-week period. Sciatic nerves were then harvested and studied under transmission electron microscopy. Myelinated axon counts were obtained. Results: Nerve conduction velocity was significantly faster in the bypass group than in the control group at 8 weeks (63.57 m/s±5.83 m/s vs. 54.88 m/s±4.79m/s, P<0.01). Myelinated axon counts in distal segments were found more in the experimental sciatic nerve than in the control sciatic nerve. Significant axonal growth was noted in the bypass nerve segment itself. Conclusion: Nerve bypass may serve to augment peripheral axonal growth while avoiding further loss of the native nerve.

  15. Frequency of Syncope in Patients with Accessory Atrioventricular Connection

    A Aslani

    2010-03-01

    Full Text Available Background: Syncope in patients with Wolff-Parkinson-White (WPW syndrome is related to rapid reciprocating tachycardia or rapid ventricular response over the accessory pathway during atrial fibrillation (AF. The aim of this retrospective study is to evaluate the frequency of syncope in patients with WPW syndrome. Methods: We reviewed the records of 150 consecutive patients with WPW syndrome.Results: There were 20 patients (13.3% who reported at least one episode of syncope and 130 patients (86.7% without such a history.Conclusion: Syncope is relatively frequent in patients with WPW. Patient with WPW syndrome who has experienced this symptom should be thoroughly evaluated.

  16. Investigating Consumer Insight by Using Completion Techniques: A Case Study of a Motorcycle Accessory Shop in Thailand

    2012-01-01

    Full Text Available With almost 10% of the world’s motorcycles in use in Thailand, this indicates that Thailand is a big market for motorcycle accessories in the world. This qualitative research aims to investigate consumer insight by using completion techniques (sentence completion and story completion. Three respondents were deployed by using accidental sampling. Respondents were recruited to complete questionnaires when they entered the motorcycle accessory shop and were reported as male, currently studying, and at least 12 years old. The research was conducted in a motorcycle accessory shop in Sakon Nakhon province, Thailand. From the results of the story completion tests, all participants agreed to take part in a promotion which gave a 10% discount for membership card holders. They came to the motorcycle accessory shop by the recommendation of friends (positive Word-Of-Mouth. Moreover, consumers are satisfied when a seller can give them information or suggestions on motorcycle accessories as well as providing good after-sales service. When motorcycle accessory shoppers are satisfied with a motorcycle accessory shop, they will return to the shop and hence demonstrate consumer loyalty.

  17. Posterior Interosseous Nerve Syndrome from Thermal Injury

    Singh, Vijay A.; Rami E. Michael; Duy-Bao P. Dinh; Scott Bloom; Michael Cooper

    2014-01-01

    Background. Due to anatomical proximity to bone, the radial nerve is the most frequently injured major nerve of the upper extremity, frequently secondary to fractures (Li et al. (2013)). We describe an incidence when a branch of the radial nerve is injured as a result of a thermal injury. Observation. Radial nerve injury can occur anywhere along the anatomical course with varied etiologies, but commonly related to trauma. The most frequent site is in the proximal forearm involving the posteri...

  18. Alternative delivery of male accessory gland products

    Zizzari, Z Valentina; Smolders, Irene; Koene, Joris M

    2014-01-01

    To increase fertilization success, males transfer accessory gland products (Acps). Several species have evolved unconventional Acps transfer modes, meaning that Acps are transferred separately from the sperm. By surveying the sperm-free Acps transfer cases, we show that these animals have evolved a common strategy to deliver Acps: they all inject Acps directly through the partner’s body wall into the hemolymph. Our review of this mode of Acps transfer reveals another striking similarity: they...

  19. Instruments and accessories for neutron scattering research

    This report describes neutron scattering instruments and accessories installed by four neutron scattering research groups at the ASRC (Advanced Science Research Center) of the JAERI and the recent topics of neutron scattering research using these instruments. The specifications of nine instruments (HRPD, BIX-I, TAS-1 and PNO in the reactor hall, RESA, BIX-II, TAS-2, LTAS and SANS-J in the guide hall of the JRR-3M) are summarized in this booklet. (author)

  20. ACCESSORY SPLEEN: A CLINICALLY RELEVANT ANATOMIC ANOMALY

    Prachi Saffar; Amit Kumar; Ankur

    2016-01-01

    The purpose of our study is to emphasize on the clinical relevance of the presence of accessory spleen. It is not only a well-documented anatomic anomaly, it holds special significance in the differential diagnosis of intra-abdominal tumours and lymphadenopathy. MATERIALS AND METHODS Thirty male cadavers from North Indian population above the age of 60 yrs. were dissected in the Anatomy Department of FMHS, SGT University, Gurgaon, over a period of 5 yrs. (Sep 2010-Aug 2015) and presence...

  1. Ephaptic coupling of myelinated nerve fibers

    Binczak, S.; Eilbeck, J. C.; Scott, Alwyn C.

    Numerical predictions of a simple myelinated nerve fiber model are compared with theoretical results in the continuum and discrete limits, clarifying the nature of the conduction process on an isolated nerve axon. Since myelinated nerve fibers are often arranged in bundles, this model is used to...

  2. Disorders of Cranial Nerves IX and X

    Erman, Audrey B.; Kejner, Alexandra E.; Hogikyan, Norman D.; Eva L Feldman

    2009-01-01

    The glossopharyngeal and vagus nerves mediate the complex interplay between the many functions of the upper aerodigestive tract. Defects may occur anywhere from the brainstem to the peripheral nerve and can result in significant impairment in speech, swallowing, and breathing. Multiple etiologies can produce symptoms. This review will broadly examine the normal functions, clinical examination, and various pathologies of cranial nerves IX and X.

  3. Effects on steroid hormones secretion resulting from the acute stimulation of sectioning the superior ovarian nerve to pre-pubertal rats

    Morales-Ledesma Leticia

    2012-10-01

    Full Text Available Abstract In the adult rat, neural signals arriving to the ovary via the superior ovarian nerve (SON modulate progesterone (P4, testosterone (T and estradiol (E2 secretion. The aims of the present study were to analyze if the SON in the pre-pubertal rat also modulates ovarian hormone secretion and the release of follicle stimulating hormone (FSH and luteinizing (LH hormone. P4, T, E2, FSH and LH serum levels were measured 30 or 60 minutes after sectioning the SON of pre-pubertal female rats. Our results indicate that the effects on hormone levels resulting from unilaterally or bilaterally sectioning the SON depends on the analyzed hormone, and the time lapse between surgery and autopsy, and that the treatment yielded asymmetric results. The results also suggest that in the pre-pubertal rat the neural signals arriving to the ovaries via the SON regulate the enzymes participating in P4, T and E2 synthesis in a non-parallel way, indicating that the mechanisms regulating the synthesis of each hormone are not regulated by the same signals. Also, that the changes in the steroids hormones are not explained exclusively by the modifications in gonadotropins secretion. The observed differences in hormone levels between rats sacrificed 30 and 60 min after surgery reflect the onset of the compensatory systems regulating hormones secretion.

  4. Combination of Acellular Nerve Graft and Schwann Cells-Like Cells for Rat Sciatic Nerve Regeneration

    Songtao Gao

    2014-01-01

    Full Text Available Objective. To investigate the effect of tissue engineering nerve on repair of rat sciatic nerve defect. Methods. Forty-five rats with defective sciatic nerve were randomly divided into three groups. Rats in group A were repaired by acellular nerve grafts only. Rats in group B were repaired by tissue engineering nerve. In group C, rats were repaired by autogenous nerve grafts. After six and twelve weeks, sciatic nerve functional index (SFI, neural electrophysiology (NEP, histological and transmission electron microscope observation, recovery ratio of wet weight of gastrocnemius muscle, regenerated myelinated nerve fibers number, nerve fiber diameter, and thickness of the myelin sheath were measured to assess the effect. Results. After six and twelve weeks, the recovery ratio of SFI and wet weight of gastrocnemius muscle, NEP, and the result of regenerated myelinated nerve fibers in groups B and C were superior to that of group A (P0.05. Conclusion. The tissue engineering nerve composed of acellular allogenic nerve scaffold and Schwann cells-like cells can effectively repair the nerve defect in rats and its effect was similar to that of the autogenous nerve grafts.

  5. The longitudinal epineural incision and complete nerve transection method for modeling sciatic nerve injury

    Xing-long Cheng

    2015-01-01

    Full Text Available Injury severity, operative technique and nerve regeneration are important factors to consider when constructing a model of peripheral nerve injury. Here, we present a novel peripheral nerve injury model and compare it with the complete sciatic nerve transection method. In the experimental group, under a microscope, a 3-mm longitudinal incision was made in the epineurium of the sciatic nerve to reveal the nerve fibers, which were then transected. The small, longitudinal incision in the epineurium was then sutured closed, requiring no stump anastomosis. In the control group, the sciatic nerve was completely transected, and the epineurium was repaired by anastomosis. At 2 and 4 weeks after surgery, Wallerian degeneration was observed in both groups. In the experimental group, at 8 and 12 weeks after surgery, distinct medullary nerve fibers and axons were observed in the injured sciatic nerve. Regular, dense myelin sheaths were visible, as well as some scarring. By 12 weeks, the myelin sheaths were normal and intact, and a tight lamellar structure was observed. Functionally, limb movement and nerve conduction recovered in the injured region between 4 and 12 weeks. The present results demonstrate that longitudinal epineural incision with nerve transection can stably replicate a model of Sunderland grade IV peripheral nerve injury. Compared with the complete sciatic nerve transection model, our method reduced the difficulties of micromanipulation and surgery time, and resulted in good stump restoration, nerve regeneration, and functional recovery.

  6. Localization of an accessory helicase at the replisome is critical in sustaining efficient genome duplication.

    Atkinson, John; Gupta, Milind K; Rudolph, Christian J; Bell, Hazel; Lloyd, Robert G; McGlynn, Peter

    2011-02-01

    Genome duplication requires accessory helicases to displace proteins ahead of advancing replication forks. Escherichia coli contains three helicases, Rep, UvrD and DinG, that might promote replication of protein-bound DNA. One of these helicases, Rep, also interacts with the replicative helicase DnaB. We demonstrate that Rep is the only putative accessory helicase whose absence results in an increased chromosome duplication time. We show also that the interaction between Rep and DnaB is required for Rep to maintain rapid genome duplication. Furthermore, this Rep-DnaB interaction is critical in minimizing the need for both recombinational processing of blocked replication forks and replisome reassembly, indicating that colocalization of Rep and DnaB minimizes stalling and subsequent inactivation of replication forks. These data indicate that E. coli contains only one helicase that acts as an accessory motor at the fork in wild-type cells, that such an activity is critical for the maintenance of rapid genome duplication and that colocalization with the replisome is crucial for this function. Given that the only other characterized accessory motor, Saccharomyces cerevisiae Rrm3p, associates physically with the replisome, our demonstration of the functional importance of such an association indicates that colocalization may be a conserved feature of accessory replicative motors. PMID:20923786

  7. Behaviour of bentonite accessory minerals during the thermal stage

    Arcos, David; Bruno, Jordi [Enviros-QuantiSci, Barcelona (Spain); Benbow, Steven; Takase, Hiro [Quintessa Limited, Henley-on-Thames (United Kingdom)

    2000-03-15

    This report discusses in a quantitative manner the evolution of the accessory minerals in the bentonite as a result of the thermal event exerted by the spent fuel in the near field. Three different modelling approaches have been used and the results compared between them. The three different approaches have been calculated using two Differential Algebraic Equation (DAE) solver: DYLAN (Model-1) and the Nag DAE solver, d02ngf (Model-2) and the third approach (Model-3) using the last version of PHREEQC. The results from these calculations indicate the feasibility of the modelling approach to model the migration of bentonite accessory minerals and relevant aqueous species throughout the thermal gradient. These calculations indicate that the migration of quartz and quartz polymorphs is a lesser problem. The aqueous speciation of Ca in the bentonite pore water is fundamental in order to define the potential migration of anhydrite during the thermal stage. If CaSO{sub 4}(aq) is the predominant aqueous species, then anhydrite dissolves at the initial groundwater migration times through bentonite. However, if Ca{sup 2+} is considered to be the dominant Ca species at the bentonite pore water, then anhydrite migrates towards the clay/granite interface. This is the main difference in the chemical systems considered in the three model approaches used in this work. The main process affecting the trace mineral behaviour in bentonite is cation exchange. This process controls the concentration of calcium, which results in a direct control of the calcite precipitation-dissolution.

  8. Distal anterior interosseous nerve transfer to the deep ulnar nerve and end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve for treatment of high ulnar nerve injuries: experience in five cases

    Leandro Pretto Flores

    2011-01-01

    OBJECTIVE: To demonstrate the results of a double nerve transfer at the level of the hand for recovery of the motor and sensory function of the hand in cases of high ulnar nerve injuries. METHOD: Five patients underwent a transfer of the distal branch of the anterior interosseous nerve to the deep ulnar nerve, and an end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve. RESULTS: Two patients recovered strength M3 and three cases were graded as M4; recover...

  9. Cervical Radiculopathy (Pinched Nerve)

    ... the seven small vertebrae that form the neck. Spinal nerve root. AAOS does not endorse any treatments, procedures, ... whether your symptoms are caused by pressure on spinal nerve roots and nerve damage or by another condition ...

  10. Nerve conduction velocity

    Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. ... surface electrodes are placed on the skin over nerves at different spots. Each patch gives off a ...

  11. Optic Nerve Imaging

    ... News About Us Donate In This Section Optic Nerve Imaging email Send this article to a friend ... measurements of nerve fiber damage (or loss). The Nerve Fiber Analyzer (GDx) uses laser light to measure ...

  12. Femoral nerve damage (image)

    The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

  13. Ulnar nerve damage (image)

    The ulnar nerve originates from the brachial plexus and travels down arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where ...

  14. Retinal nerve fiber layer and ganglion cell complex thickness assessment in patients with Alzheimer disease and mild cognitive impairment. Preliminary results

    A. S. Tiganov

    2014-07-01

    Full Text Available Purpose: to investigate the retinal nerve fiber layer (RNFL and the macular ganglion cell complex (GCC in patients with Alzheimer`s disease and mild cognitive impairment.Methods: this study included 10 patients (20 eyes with Alzheimer`s disease, 10 patients with mild cognitive impairment and 10 age- and sex-matched healthy controls that had no history of dementia. All the subjects underwent psychiatric examination, including the Mini-Mental State Examination (MMSE, and complete ophthalmological examination, comprising optical coherence tomography and scanning laser polarimetry.Results: there was a significant decrease in GCC thickness in patients with Alzheimer`s disease compared to the control group, global loss volume of ganglion cells was higher than in control group. there was no significant difference among the groups in terms of RNFL thickness. Weak positive correlation of GCC thickness and MMSE results was observed.Conclusion: Our data confirm the retinal involvement in Alzheimer`s disease, as reflected by loss of ganglion cells. Further studies will clear up the role and contribution of dementia in pathogenesis of optic neuropathy.

  15. Shoulder posture and median nerve sliding

    Dilley Andrew

    2004-07-01

    Full Text Available Abstract Background Patients with upper limb pain often have a slumped sitting position and poor shoulder posture. Pain could be due to poor posture causing mechanical changes (stretch; local pressure that in turn affect the function of major limb nerves (e.g. median nerve. This study examines (1 whether the individual components of slumped sitting (forward head position, trunk flexion and shoulder protraction cause median nerve stretch and (2 whether shoulder protraction restricts normal nerve movements. Methods Longitudinal nerve movement was measured using frame-by-frame cross-correlation analysis from high frequency ultrasound images during individual components of slumped sitting. The effects of protraction on nerve movement through the shoulder region were investigated by examining nerve movement in the arm in response to contralateral neck side flexion. Results Neither moving the head forward or trunk flexion caused significant movement of the median nerve. In contrast, 4.3 mm of movement, adding 0.7% strain, occurred in the forearm during shoulder protraction. A delay in movement at the start of protraction and straightening of the nerve trunk provided evidence of unloading with the shoulder flexed and elbow extended and the scapulothoracic joint in neutral. There was a 60% reduction in nerve movement in the arm during contralateral neck side flexion when the shoulder was protracted compared to scapulothoracic neutral. Conclusion Slumped sitting is unlikely to increase nerve strain sufficient to cause changes to nerve function. However, shoulder protraction may place the median nerve at risk of injury, since nerve movement is reduced through the shoulder region when the shoulder is protracted and other joints are moved. Both altered nerve dynamics in response to moving other joints and local changes to blood supply may adversely affect nerve function and increase the risk of developing upper quadrant pain.

  16. Imaging of the symptomatic type Il accessory navicular bone

    Accessory ossicles of the foot are commonly mistaken for fractures. The accessory navicular is one of the most common accessory ossicles of the foot. There is a higher incidence in women and the finding might be bilateral in 50-90%. This entity is usually asymptomatic, although populations with medial foot pain have a higher prevalence. Three types of accessory navicular bone have been described. The type Il accessory navicular is the most commonly symptomatic variant with localized chronic or acute on chronic medial foot pain and tenderness with associated inflammation of overlying soft tissues. Plain radiographic identification of the accessory navicular is insufficient to attribute symptomatology. Ultrasound allows for comparison with the asymptomatic side and localization of pain. Bone scintigraphy has a high sensitivity but positive findings lack specificity. Magnetic resonance imaging is of high diagnostic value for demonstrating both bone marrow and soft tissue oedema. Copyright (2004) Blackwell Science Pty Ltd

  17. Imaging of the symptomatic type II accessory navicular bone

    Accessory ossicles of the foot are commonly mistaken for fractures. The accessory navicular is one of the most common accessory ossicles of the foot. There is a higher incidence in women and the finding might be bilateral in 50-90%. This entity is usually asymptomatic, although populations with medial foot pain have a higher prevalence. Three types of accessory navicular bone have been described. The type II accessory navicular is the most commonly symptomatic variant with localized chronic or acute on chronic medial foot pain and tenderness with associated inflammation of overlying soft tissues. Plain radiographic identification of the accessory navicular is insufficient to attribute symptomatology. Ultrasound allows for comparison with the asymptomatic side and localization of pain. Bone scintigraphy has a high sensitivity but positive findings lack specificity. Magnetic resonance imaging is of high diagnostic value for demonstrating both bone marrow and soft tissue oedema Copyright (2004) Blackwell Publishing Asia Pty Ltd

  18. Bilateral high division of sciatic nerve

    K. Shwetha

    2014-08-01

    Full Text Available Sciatic nerve is the thickest nerve in the body formed by the sacral plexus from L4 to S3 in the lesser pelvis. It emerges through the greater sciatic foramen below the piriformis and enter the gluteal region. Then the nerve passes on the back of the thigh and at the level of superior angle of popliteal fossa it terminates by dividing into tibial and common peroneal nerve. The knowledge of anatomical variations in the division of nerve is important for various surgical and anaesthetic procedures. During routine dissection in the department of anatomy, Mysore Medical College and Research Institute, Mysore, a rare bilateral high division of sciatic nerve was observed in a female cadaver aged about 40 years. In the present case there was bilateral high division of sciatic nerve. The nerve was seen dividing into two branches before it emerges through the greater sciatic foramen. The tibial nerve was entering the gluteal region below the piriformis muscle and common peroneal nerve was entering by piercing the piriformis. The knowledge of this variation is important as the nerve may get compressed with surrounding anatomical structures resulting in non discogenic sciatica. The awareness of variations is important for surgeons during various procedures like fracture, posterior dislocation of hip joint and hip joint replacement. The anatomical variations are important during deep intramuscular injections in gluteal region and also for anaesthetists during sciatic nerve block. [Int J Res Med Sci 2014; 2(4.000: 1785-1787

  19. An exploration study to find important factors influencing on brand in car accessory market

    Naser Azad

    2013-08-01

    Full Text Available Supplying car accessory is one of the most important growing industries in the world. Every year, millions of cars are produced and people need to have the access to necessary car accessory. In this paper, we present an exploration study to detect important factors influencing car accessory market. The proposed study designs a questionnaire in Likert scale consists of 16 questions, distributes it among 200 experts and analyses it using factor analysis. Cronbach alpha and Kaiser-Meyer-Olkin Measure of Sampling Adequacy are calculated as 0.823 and 0.863, which validate the overall questionnaire. The results indicate that there are three influencing factors including brand capability, brand characteristics and consumers’ believe.

  20. Male breast cancer originating in an accessory mammary gland in the axilla: a case report.

    Yamamura, Jun; Masuda, Norikazu; Kodama, Yoshinori; Yasojima, Hiroyuki; Mizutani, Makiko; Kuriyama, Keiko; Mano, Masayuki; Nakamori, Shoji; Sekimoto, Mitsugu

    2012-01-01

    Carcinoma of an accessory mammary gland is an extremely rare tumor. A 61-year-old male patient presented with a hard mass measuring 85 mm × 51 mm in the left axilla. Incisional biopsy histopathologically showed an adenocarcinoma compatible with breast carcinoma originating in an accessory mammary gland. Systemic examinations revealed no evidence of malignant or occult primary lesion in the bilateral mammary glands or in other organs. Neoadjuvant chemotherapy was performed for the locally advanced axillary tumor and reduced the tumor to 55 mm in size, and, then, he could undergo complete resection with a negative surgical margin in combination with reconstructive surgery to fill the resulting skin defect with a local flap of the latissimus dorsi muscle. The patient has presented with no metastatic lesion in four years since the operation. This unusual case shows that neoadjuvant chemotherapy is an effective and tolerated therapy for advanced accessory breast cancer in the axilla. PMID:23251170

  1. Melanocortin receptor accessory proteins in adrenal disease and obesity

    Jackson, David S.; Ramachandrappa, Shwetha; Clark, Adrian J; Chan, Li F.

    2015-01-01

    Melanocortin receptor accessory proteins (MRAPs) are regulators of the melanocortin receptor family. MRAP is an essential accessory factor for the functional expression of the MC2R/ACTH receptor. The importance of MRAP in adrenal gland physiology is demonstrated by the clinical condition familial glucocorticoid deficiency type 2. The role of its paralog melanocortin-2-receptor accessory protein 2 (MRAP2), which is predominantly expressed in the hypothalamus including the paraventricular nucle...

  2. Accessory slips of the extensor digiti minimi.

    Li, Jing; Mao, Qing Hua

    2014-01-01

    During the educational dissection of a 69-year-old Chinese male cadaver, an extensor digiti minimi (EDM) with five slips on the right hand was discovered. Except for the two slips of the little finger, the two radial slips were inserted into the dorsal aponeurosis of the middle finger and the ring finger, respectively. The middle slip was connected to the junctura tendinum in the fourth intermetacarpal spaces. Variations in this region are of paramount importance for the reconstructive surgeons, who may utilize the accessory slips to restore functional capacity of the fingers. PMID:24970007

  3. Relative contribution of expectancy and immediate arousal to the facilitatory effect of an auditory accessory stimulus

    F. Del-Fava

    2004-08-01

    Full Text Available An auditory stimulus speeds up a digital response to a subsequent visual stimulus. This facilitatory effect has been related to the expectancy and the immediate arousal that would be caused by the accessory stimulus. The present study examined the relative contribution of these two influences. In a first and a third experiment a simple reaction time task was used. In a second and fourth experiment a go/no-go reaction time task was used. In each of these experiments, the accessory stimulus preceded the target stimulus by 200 ms for one group of male and female volunteers (G Fix. For another group of similar volunteers (G Var the accessory stimulus preceded the target stimulus by 200 ms in 25% of the trials, by 1000 ms in 25% of the trials and was not followed by the target stimulus in 50% of the trials (Experiments 1a and 1b or preceded the target stimulus by 200 ms in 6% of the trials and by 1000 ms in 94% of the trials (Experiments 2a and 2b. There was a facilitatory effect of the accessory stimulus for G Fix in the four experiments. There was also a facilitatory effect of the accessory stimulus at the 200-ms stimulus onset asynchrony for G Var in Experiments 1a and 1b but not in Experiments 2a and 2b. The facilitatory effects observed were larger in the go/no-go task than in the simple task. Taken together, these results suggest that expectancy is much more important than immediate arousal for the improvement of performance caused by an accessory stimulus.

  4. Sciatic nerve regeneration using a nerve growth factor-containing fibrin glue membrane

    Shengzhong Ma; Changliang Peng; Shiqing Wu; Dongjin Wu; Chunzheng Gao

    2013-01-01

    Our previous findings confirmed that the nerve growth factor-containing fibrin glue membrane pro-vides a good microenvironment for peripheral nerve regeneration;however, the precise mechanism remains unclear. p75 neurotrophin receptor (p75NTR) plays an important role in the regulation of pe-ripheral nerve regeneration. We hypothesized that a nerve growth factor-containing fibrin glue membrane can promote neural regeneration by up-regulating p75NTR expression. In this study, we used a silicon nerve conduit to bridge a 15 mm-long sciatic nerve defect and injected a mixture of nerve growth factor and fibrin glue at the anastomotic site of the nerve conduit and the sciatic nerve. Through RT-PCR and western blot analysis, nerve growth factor-containing fibrin glue membrane significantly increased p75NTR mRNA and protein expression in the Schwann cells at the anasto-motic site, in particular at 8 weeks after injection of the nerve growth factor/fibrin glue mixture. These results indicate that nerve growth factor-containing fibrin glue membrane can promote pe-ripheral nerve regeneration by up-regulating p75NTR expression in Schwann cells.

  5. Nerve Transfers for Treatment of Isolated Axillary Nerve Injuries

    Wheelock, Margie; Clark, Tod A; Giuffre, Jennifer L

    2015-01-01

    Almost one-half of all dislocations involve the shoulder and may also involve the axillary nerves, which may influence functional recovery and result in persistent shoulder neuropathy. Although individuals with intact rotator cuffs may be able to compensate for axillary nerve dysfunction, the injury may become problematic in later years, especially given the increasing incidence of rotator cuff tears in aging populations, thus placing increased importance on the immediate success of acute man...

  6. Infrahyoid and accessory motoneurons in the Japanese monkey (Macaca fuscata).

    Ueyama, T; Satoda, T; Tashiro, T; Sugimoto, T; Matsushima, R; Mizuno, N

    1990-01-15

    The segmental and topographical organization of motoneurons innervating the infrahyoid (IH) and the spinal accessory (AC) muscles was studied in the Japanese monkey (Macaca fuscata) with the retrograde horseradish peroxidase (HRP) method after application of HRP to the peripheral nerve branches supplying the IH and AC muscles. IH motoneurons constitute two distinct slender cell columns, a longer medial and a shorter lateral one. The medial cell column extends from the most caudal level of the hypoglossal nucleus to the lower levels of the second cervical (C2) cord segment. In the medial column, motoneurons supplying the sternohyoid and sternothyroid muscles are distributed at the medullary and C1 levels, while those innervating the omohyoid muscle are primarily distributed at the C2 level. The lateral cell column consists of motoneurons supplying the thyrohyoid muscle and extends from the most caudal level of the hypoglossal nucleus to the middle levels of the C1 cord segment. Axons of thyrohyoid motoneurons follow a dorsomedially directed bent emergent course, making a hairpin turn. AC motoneurons supplying the sternocleidomastoid (SC) and trapezius (TZ) muscles form a single slender cell column extending from the most rostral level of the pyramidal decussation to the middle levels of the C6 cord segment. SC motoneurons are distributed from the most rostral level of the pyramidal decussation to the middle levels of the C3 cord segment, while TZ motoneurons are distributed from the upper levels of the C2 cord segment to the lower levels of the C6 cord segment. At the levels of the C2 and C3 cord segments, both SC and TZ motoneurons are distributed in the AC cell column; the cluster of SC motoneurons is located dorsomedial to that of TZ motoneurons. PMID:2152765

  7. A randomized prospective comparative study of nerve stimulator and ultrasonogram in popliteal sciatic nerve block for ankle and foot surgeries

    2015-01-01

    Background: Regional blocks in the field of anaesthesia were done traditionally with paraesthesia technique. To overcome the demerits with paraesthesia technique, nerve locator was applied for nerve blocks. Later, the application of ultrasonogram for regional blocks got the real time imaging of the nerves and drug administration. This resulted in publications of numerous studies with variable results. Therefore we planned to compare ultrasonogram and nerve locator in popliteal sciatic nerve b...

  8. FY 1998 report on the results of the technology development on the integration of nerve information; 1998 nendo shinkei joho togo ni kansuru gijutsu kaihatsu

    NONE

    2000-03-01

    This R and D aims at developing the interface system including 2D multipoint high density electrode elements which measure and analyze the information processing process of cranial nerves at high speed and in minute detail. The R and D were carried out on the following 4 subjects: 1) development of 2D high density multipoint electrode; 2) development of alignment/bonding technology; 3) development of technology for existence maintenance/activation of nerve cells; 4) study of performance evaluation and applicability of the system. In 1), an electrode is developed in which the high density multipoint platinum electrode was built on glass substrate, and the following are conducted: making a pattern of alignment of this electrode, making the shape of electrode 3D, and technical development of surface composition. In 2), the following are developed: technology to align cells on the patterned electrode element correctly and technology to bond cells on the element for a long time. In 3), the following are developed: functional materials to hold living nerve cells/nerve systems on the electrode element for a long time, nutrition system, and technology to monitor the state of cells/systems on the substrate. In 4), conducted are the evaluation of performance of the developmental system and the applicability to the screening in nervous function molecular search, etc. (NEDO)

  9. [Morphological and functional studies on nerve regeneration after corneal nerve injuries].

    Zhang, Z Q; Xie, L X; Dong, X G

    1994-07-01

    Using gold chloride impregnation of nerves and horse-radish peroxidase (HRP) axoplasma retrograde tracing technique, we monitored nerve regeneration over a period of 6 months following penetrating perilimbal incisions and penetrating keratoplasties (PKP) in rabbits. Post-operatively, at 1 month after a 180 degrees perilimbal incision, loose unconnected subepithelial plexus were present in the limbus, at 2 months 1-2 bundles of deep stromal nerve were seen in the stroma and by 6 months only a few stromal nerves regenerated. There was no difference in nerve regeneration between post-operative autograft and allograft PKP. By 6 months, the quantity of HRP-labelled cells in the trigeminal ganglia was less than the normal level. The results indicated that nerve regeneration by 6 months after corneal nerve injuries was inadequate to restore a normal corneal nerve extent and function. PMID:7843026

  10. From the brachial plexus to the hand, multiple connections between the median and ulnar nerves may serve as bypass routes for nerve fibres.

    Yang, H; Gil, Y; Kim, S; Bang, J; Choi, H; Lee, H Y

    2016-07-01

    Axons from the median and ulnar nerves can pass to each other through aberrant connections between them. Multiple interconnections between the nerves may provide a detour route for nerve fibres going to the hand. We investigated the incidence of variations and the associations between them in 90 cadaveric upper limbs. In 91% of upper limbs, one to five variations were found, with several statistically significant associations. The contribution of the C8 nerve to the lateral cord was positively associated with an accessory contribution of the lateral cord to the ulnar nerve. The latter variation showed positive association with the occurrence of any of the variations in the hand itself. Ulnar innervation of the superficial head of the flexor pollicis brevis was positively associated with the Riche-Cannieu communication. The co-existence of the variations and their associations may be the explanation for unusual clinical findings related to median and ulnar conduction, which appear contrary to anatomical knowledge. PMID:26763269

  11. Cranial nerve palsies in childhood

    Lyons, C J; Godoy, F; ALQahtani, E

    2015-01-01

    We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the g...

  12. 21 CFR 876.5090 - Suprapubic urological catheter and accessories.

    2010-04-01

    .... This generic type of device includes the suprapubic catheter and tube, Malecot catheter, catheter punch... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suprapubic urological catheter and accessories... Suprapubic urological catheter and accessories. (a) Identification. A suprapubic urological catheter...

  13. 14 CFR 23.1437 - Accessories for multiengine airplanes.

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Accessories for multiengine airplanes. 23... TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Equipment Miscellaneous Equipment § 23.1437 Accessories for multiengine airplanes. For multiengine...

  14. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  15. 26 CFR 48.4161(a)-3 - Parts and accessories.

    2010-04-01

    ....4161(a)-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) MISCELLANEOUS EXCISE TAXES MANUFACTURERS AND RETAILERS EXCISE TAXES Sporting Goods § 48.4161(a)-3 Parts and accessories. (a) In general. The tax attaches with respect to parts and accessories for articles specified...

  16. Torsion of Pedunculated Accessory Liver Lobe with Acute Acalculous Cholecystitis

    Khandelwal, Kamlesh K.; Gomes, Rachel M.; Bhagvat, Vikrant

    2012-01-01

    Accessory lobes of the liver are very uncommon and rarely symptomatic. We report the occurrence of torsion and infarction of a pedunculated accessory lobe of the liver with acute cholecystitis. The speculated possibilities of the coexistent pathologies and its management are discussed.

  17. Sensory nerve function and auto-mutilation after reconstruction of various gap lengths with nerve guides and autologous nerve grafts.

    den Dunnen, W F; Meek, M F

    2001-05-01

    The aim of this study was to evaluate sensory nerve recovery and auto-mutilation after reconstruction of various lengths of nerve gaps in the sciatic nerve of the rat, using different techniques. Group 4, in which the longest nerve gap (15 mm) was reconstructed with a thin-walled p(DL-lactide-gamma-caprolactone) nerve guide filled with modified denatured muscle tissue, showed the best results in the electro-stimulation tests and signs of severe auto-mutilation were not observed. Even in the control group, in which a 10 mm nerve gap was left open, in two of the five rats improvement of the sensory nerve function was observed, which was caused by re-innervation of the sciatic nerve and not by expansion of the neighboring saphenous nerve. It is hypothesized that a better quality of nerve reconstruction/guidance channel/support results in faster regeneration and hence re-innervation, thereby, preventing auto-mutilation. A thin red glabrous skin, anhydrosis (dryness of the skin), short nails and edema were interpreted as signs of autonomic dysfunction. PMID:11352096

  18. Results of radiotherapy achieved in patients treated at Kiel between 1967 and 1980 for malignant tumours of the nasal cavity or accessory nasal sinuses and of the salivary glands

    The report describes the results achieved with high-voltage telecobalt radiotherapie in 154 patients suffering from malignant changes to the acessory nasal sinuses or nasal cavity and malignancy of the salivary glands. 36% of the nasal tumours continued to grow and local recidivation was reported for 23% of these cases. In the group of salivary gland changes, further tumour development was seen in 29%, while 35% of the treated patients remained free from recidivation. The realtionships between survival rates and sex, tumour stage and therpeutic strategy attained statistical significance. The rates of patients surviving were higher for women than for men. The chances of survival appear to be good solely for patients, in which all tumour manifestations have completely disappeared. (orig.)

  19. A comparative study of acellular nerve xenografts and allografts in repairing rat facial nerve defects.

    Huang, Haitao; Xiao, Hongxi; Liu, Huawei; Niu, Yu; Yan, Rongzeng; Hu, Min

    2015-10-01

    Acellular nerves are composed of a basal lamina tube, which retains sufficient bioactivity to promote axon regeneration, thereby repairing peripheral nerve gaps. However, the clinical application of acellular allografts has been restricted due to its limited availability. To investigate whether xenografts, a substitute to allograft acellular nerves in abundant supply, could efficiently promote nerve regeneration, rabbit and rat acellular nerve grafts were used to reconstruct 1 cm defects in Wistar rat facial nerves. Autologous peroneal nerve grafts served as a positive control group. A total of 12 weeks following the surgical procedure, the axon number, myelinated axon number, myelin sheath thickness, and nerve conduction velocity of the rabbit and rat‑derived acellular nerve grafts were similar, whereas the fiber diameter of the rabbit‑derived acellular xenografts decreased, as compared with those of rat‑derived acellular allografts. Autografts exerted superior effects on nerve regeneration; however, no significant difference was observed between the axon number in the autograft group, as compared with the two acellular groups. These results suggested that autografts perform better than acellular nerve grafts, and chemically extracted acellular allografts and xenografts have similar effects on the regeneration of short facial nerve defects. PMID:26239906

  20. Fluid assisted installation of electrical cable accessories

    Mayer, Robert W.; Silva, Frank A.

    1977-01-01

    An electrical cable accessory includes a generally tubular member of elastomeric material which is to be installed by placement over a cylindrical surface to grip the cylindrical surface, when in appropriate assembled relation therewith, with a predetermined gripping force established by dilation of the tubular member, the installation being facilitated by introducing fluid under pressure, through means provided in the tubular member, between the tubular member and the cylindrical surface, and simultaneously impeding the escape of the fluid under pressure from between the tubular member and the cylindrical surface by means adjacent one of the ends of the tubular member to cause dilation of the tubular member and establish a fluid layer between the tubular member and the cylindrical surface, thereby reducing the gripping force during installation.

  1. Activation of axonal Kv7 channels in human peripheral nerve by flupirtine but not placebo - therapeutic potential for peripheral neuropathies: results of a randomised controlled trial

    Fleckenstein, Johannes; Sittl, Ruth; Averbeck, Beate; Lang, Philip M; Irnich, Dominik; Richard W Carr

    2013-01-01

    Background: Flupirtine is an analgesic with muscle-relaxing properties that activates Kv7 potassium channels. Kv7 channels are expressed along myelinated and unmyelinated peripheral axons where their activation is expected to reduce axonal excitability and potentially contribute to flupirtine’s clinical profile. Trial design: To investigate the electrical excitability of peripheral myelinated axons following orally administered flupirtine, in-vitro experiments on isolated peripheral nerve s...

  2. Activation of axonal Kv7 channels in human peripheral nerve by flupirtine but not placebo - therapeutic potential for peripheral neuropathies: results of a randomised controlled trial

    Fleckenstein, Johannes; Sittl, Ruth; Averbeck, Beate; Lang, Philip M; Irnich, Dominik; Richard W Carr

    2013-01-01

    Background Flupirtine is an analgesic with muscle-relaxing properties that activates Kv7 potassium channels. Kv7 channels are expressed along myelinated and unmyelinated peripheral axons where their activation is expected to reduce axonal excitability and potentially contribute to flupirtine’s clinical profile. Trial design To investigate the electrical excitability of peripheral myelinated axons following orally administered flupirtine, in-vitro experiments on isolated peripheral nerve segme...

  3. Accessory liver lobe of the gallbladder in adults.

    Handra-Luca, Adriana

    2016-09-01

    The accessory liver lobe (ALL) of the gallbladder wall is rare, mentioned by Meckel since 1822. We present two cases of ALL occurring in two adult women. The ALLs were diagnosed at microscopic examination of cholecystectomy specimens for lithiasic cholecystitis and were located at the gallbladder body level. They measured 0.5 and 1.1 cm and were pediculated from the gallbladder serosa. Luschka duct complexes were seen in the adjacent subserosa in one of the cases. The main clinical relevance of ALL of the gallbladder resides in the differential diagnosis with a lymph node and in the risk of peroperative hemorragia or bile leakage by sectioning of the connecting blood vessels and/or bile duct. Intraparietal ALL may interfere with dysmotility, possibly resulting in bile stagnation and stone formation. PMID:27147442

  4. Optic nerve hypoplasia

    Savleen Kaur

    2013-01-01

    Full Text Available Optic nerve hypoplasia (ONH is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65% than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED.

  5. Optic nerve hypoplasia.

    Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B S; Rastogi, Anju; Kamlesh

    2013-05-01

    Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

  6. Surgical anatomy of the pectoral nerves and the pectoral musculature.

    Porzionato, Andrea; Macchi, Veronica; Stecco, Carla; Loukas, Marios; Tubbs, R Shane; De Caro, Raffaele

    2012-07-01

    The pectoral nerves (PNs) may be selectively injured through various traumatic mechanisms such as direct trauma, hypertrophic muscle compression, and iatrogenic injuries (breast surgery and axillary node dissection, pectoralis major muscle transfers). The PN may be surgically recovered through nerve transfers. They may also be used as donors to the musculocutaneous, axillary, long thoracic, and spinal accessory nerves and for reinnervation of myocutaneous free flaps. Thus, in this article, we reviewed the surgical anatomy of PN. A meta-analysis of the available literature showed that the lateral pectoral nerve (LPN) arises most frequently with two branches from the anterior divisions of the upper and middle trunks (33.8%) or as a single root from the lateral cord (23.4%). The medial pectoral nerve (MPN) usually arises from the medial cord (49.3%), anterior division of the lower trunk (43.8%), or lower trunk (4.7%). The two PN are usually connected immediately distal to the thoracoacromial artery by the so-called ansa pectoralis. The MPN may also show communications with the intercostobrachial nerve. In 50%-100% of cases, it may pass, at least with some branches, through the pectoralis minor muscle. The LPN supplies the upper portions of the pectoralis major muscle; the MPN innervates the lower parts of the pectoralis major and the pectoralis minor muscle. Among the accessory muscles of the pectoral girdle, the LPN may also innervate the tensor semivaginae articulationis humero-scapularis, pectoralis minimus, sternoclavicularis, axillary arch, sternalis, and infraclavicularis muscles; the MPN may innervate the pectoralis quartus, chondrofascialis, axillary arch, chondroepitrochlearis, and sternalis muscles. PMID:22125052

  7. Hyperviscosity of semen in patients with male accessory gland infection:direct measurement with quantitative viscosimeter.

    La Vignera, S; Condorelli, R A; Vicari, E; D'Aagata, R; Salemi, M; Calogero, A E

    2012-05-01

    The aim of this study was to evaluate whether the viscosity of semen in patients with male accessory gland infection is related to the extension of the inflammatory process to the various glands. To achieve this, viscosity was assessed by quantitative viscosimeter and the results were expressed in centipoise (cps). The study was conducted on 30 infertile patients with clinical evidence of male accessory gland infection and a mean age of 29.0 ± 4.0 years. Their semen viscosity was evaluated through quantitative viscometer. All patients showed an increase of viscosity evaluated according to WHO criteria, while this parameter was normal in all controls. Semen viscosity of patients with male accessory gland infection (28.6 ± 2.2 cps) was significantly (P < 0.05) higher than that in the controls (10.7 ± 0.6 cps). Significantly increasing values were observed in patients with involvement of multiple gland inflammation (prostatitis accessory gland infection. PMID:21919943

  8. Accessory roots and root canals in human anterior teeth: a review and clinical considerations.

    Ahmed, H M A; Hashem, A A

    2016-08-01

    Anterior teeth may have aberrant anatomical variations in the number of roots and root canals. A review of the literature was conducted using appropriate key words in major endodontic journals to identify the available reported cases as well as experimental and clinical investigations on accessory roots and root canals in anterior teeth. After retrieving the full text of related articles, cross-citations were identified, and the pooled data were then discussed. Results revealed a higher prevalence in accessory root/root canal variations in mandibular anterior teeth than in maxillary counterparts. However, maxillary incisor teeth revealed the highest tendency for accessory root/root canal aberrations caused by anomalies such as dens invaginatus and palato-gingival groove. Primary anterior teeth may also exhibit external and internal anatomical variations in the root, especially maxillary canines. Therefore, dental practitioners should thoroughly assess all teeth scheduled for root canal treatment to prevent the undesirable consequences caused by inadequate debridement of accessory configurations of the root canal system. PMID:26174943

  9. Automatic Inspection and Processing of Accessory Based on Vision Stitching and Spectral Illumination

    Wen-Yang Chang

    2014-08-01

    Full Text Available The study investigates automatic inspection and processing of the stem accessories based on vision stitching and spectral illumination. The vision stitching mainly involves algorithms of white balance, scale-invariant feature transforms (SIFT and roundness for whole image of automatic accessory inspection. The illumination intensities, angles, and spectral analyses of light sources are analyzed for image optimal inspections. The unrealistic color casts of feature inspection is removed using a white balance algorithm for global automatic adjustment. The SIFT is used to extract and detect the image features for big image stitching. The Hough transform is used to detect the parameters of a circle for roundness of the bicycle accessories. The feature inspections of a stem contain geometry size, roundness, and image stitching. Results showed that maximum errors of 0°, 10°, 30°, and 50° degree for the spectral illumination of white light LED arrays with differential shift displacements are 4.4, 4.2, 6.8, and 3.5 %, respectively. The deviation error of image stitching for the stem accessory in x and y coordinates are 2 pixels. The SIFT and RANSAC enable to transform the stem image into local feature coordinates.

  10. Regeneration of the Nerves in the Aerial Cavity with an Artificial Nerve Conduit -Reconstruction of Chorda Tympani Nerve Gaps-

    Yamanaka, Toshiaki; Hosoi, Hiroshi; Murai, Takayuki; Kobayashi, Takehiko; Inada, Yuji; Nakamura, Tatsuo

    2014-01-01

    Objectives/Hypothesis Due to its anatomical features, the chorda tympani nerve (CTN) is sometimes sacrificed during middle ear surgery, resulting in taste dysfunction. We examined the effect of placing an artificial nerve conduit, a polyglycolic acid (PGA)-collagen tube, across the gap in the section of the resected chorda tympani nerve (CTN) running through the tympanic cavity. Methods The CTN was reconstructed with a PGA-collagen tube in three patients with taste disturbance who underwent C...

  11. Immediate versus delayed primary nerve repair in the rabbit sciatic nerve

    Ahmet Piskin; Berrin Zhal Altunkaynak; Atilla tlak; Hicabi Sezgin; Ozgr Yazc; Sleyman Kaplan

    2013-01-01

    It is wel known that peripheral nerve injury should be treated immediately in the clinic, but in some instances, repair can be delayed. This study investigated the effects of immediate versus delayed (3 days after injury) neurorrhaphy on repair of transected sciatic nerve in New Zealand rabbits using stereological, histomorphological and biomechanical methods. At 8 weeks after immediate and de-layed neurorrhaphy, axon number and area in the sciatic nerve, myelin sheath and epineurium thickness, Schwann cellmorphology, and the mechanical property of nerve fibers did not differ ob-viously. These results indicate that delayed neurorrhaphy do not produce any deleterious effect on sciatic nerve repair.

  12. Immediate versus delayed primary nerve repair in the rabbit sciatic nerve.

    Piskin, Ahmet; Altunkaynak, Berrin Zühal; Çitlak, Atilla; Sezgin, Hicabi; Yazιcι, Ozgür; Kaplan, Süleyman

    2013-12-25

    It is well known that peripheral nerve injury should be treated immediately in the clinic, but in some instances, repair can be delayed. This study investigated the effects of immediate versus delayed (3 days after injury) neurorrhaphy on repair of transected sciatic nerve in New Zealand rabbits using stereological, histomorphological and biomechanical methods. At 8 weeks after immediate and delayed neurorrhaphy, axon number and area in the sciatic nerve, myelin sheath and epineurium thickness, Schwann cell morphology, and the mechanical property of nerve fibers did not differ obviously. These results indicate that delayed neurorrhaphy do not produce any deleterious effect on sciatic nerve repair. PMID:25206663

  13. Peripheral nerve involvement in Bell's palsy

    J. A. Bueri

    1984-12-01

    Full Text Available A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.

  14. An audit of traumatic nerve injury.

    O'Connor, G

    2009-07-01

    The impact of trauma in the Irish healthcare setting is considerable. We present the results of a retrospective assessment of referrals to a Neurophysiology department for suspected traumatic nerve injury. A broad range of traumatic neuropathies was demonstrated on testing, from numerous causes. We demonstrate an increased liklihood of traumatic nerve injury after fracture \\/ dislocation (p = 0.007). Our series demonstrates the need for clinicians to be aware of the possibility of nerve injury post trauma, especially after bony injury.

  15. The association of hallux limitus with the accessory navicular.

    Evans, R D Lee; Averett, Ryan; Sanders, Stephanie

    2002-06-01

    Hallux limitus is one of the most prevalent, debilitating disorders of the first metatarsophalangeal joint, and it has many proposed etiologies. This article reviews these etiologies, focusing primarily on the pes planus foot. The pes planus foot type is often associated with symptomatic hallux limitus and the accessory navicular. This article discusses this correlation, although a causal relationship has not been proven. The prevalence and classification of the accessory navicular are also discussed. Clinical cases involving symptomatic hallux limitus occurring concomitantly with an accessory navicular are reviewed, including radiographic findings, symptoms, and surgical treatment. PMID:12070237

  16. Diabetes and nerve damage

    Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complicaiton ... In people with diabetes, the body's nerves can be damaged by ... sugar level . This condition is more likely when the blood sugar ...

  17. Degenerative Nerve Diseases

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many ... viruses. Sometimes the cause is not known. Degenerative nerve diseases include Alzheimer's disease Amyotrophic lateral sclerosis Friedreich's ...

  18. Radial nerve dysfunction (image)

    The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. ... the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the ...

  19. Sensory nerves and pancreatitis

    Li, Qingfu; PENG, JIE

    2014-01-01

    Sensory nerves are a kind of nerve that conduct afferent impulses from the periphery receptors to the central nervous system (CNS) and are able to release neuromediators from the activated peripheral endings. Sensory nerves are particularly important for microcirculatory response, and stimulation of pancreatic sensory nerves releases a variety of neuropeptides such as substance P (SP), calcitonin gene-related peptide (CGRP), etc., leading to neurogenic inflammation characterized as the local ...

  20. The Furcal Nerve Revisited

    Harshavardhana, Nanjundappa S.; Harshad V. Dabke

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to t...

  1. Neonatal (+)-methamphetamine increases brain derived neurotrophic factor, but not nerve growth factor, during treatment and results in long-term spatial learning deficits

    Skelton, Matthew R.; Williams, Michael T.; Schaefer, Tori L.; Vorhees, Charles V.

    2007-01-01

    In this study, brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were examined at five time points [postnatal day (P)11, 15, 20, 21, and 68 (the latter with or without behavioral testing)] during and after P11–20 (+)-methamphetamine (MA) (10 mg/ kg 4 × day) treatment. BDNF in MA-treated animals was elevated on P15 and P20 in the hippocampus but not in the hypothalamus and was unchanged on P11 and P21. On P68 (1 h after Morris water maze testing) MA-treated offspring showe...

  2. The Physics of Nerves

    Heimburg, Thomas

    2010-01-01

    The accepted model for nerve pulse propagation in biological membranes seems insufficient. It is restricted to dissipative electrical phenomena and considers nerve pulses exclusively as a microscopic phenomenon. A simple thermodynamic model that is based on the macroscopic properties of membranes allows explaining more features of nerve pulse propagation including the phenomenon of anesthesia that has so far remained unexplained.

  3. Intraparotid facial nerve schwannoma.

    Shah H; Kantharia C; Shenoy A

    1997-01-01

    Intraparotid facial nerve schwannoma are uncommon. Preoperative diagnosis of parotid tumour as schwannoma is difficult when facial nerve function is normal. A rare case of solitary schwannoma involving the upper branch of the facial nerve is described and the literature on the subject is reviewed.

  4. Laryngeal nerve damage

    Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box. ... Injury to the laryngeal nerves is uncommon. When it does occur, it can be from: A complication of neck or chest surgery (especially thyroid, lung, ...

  5. Optic Nerve Pit

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  6. An effect of wrapping peripheral nerve anastomosis with pedicled muscle flap on nerve regeneration in experiment

    Naumenko L.Yu.

    2010-01-01

    Full Text Available Despite intrinsic capacity of peripheral nerves to regenerate, functional outcomes of peripheral nerves injury remain poor. Nerve ischemia, intra-/perineurial fibrosis and neuroma formation contribute a lot to that. Several authors demonstrated beneficial effects of increased vascularization at the site of injury on peripheral nerves regeneration. The use of highly vascularized autologous tissues (greater omentum as a source of peripheral nerves neovascularization shows promising re-sults. We proposed a surgical technique in which injured peripheral nerves anastomosis was wrapped in a pedicled muscular flap and performed morphological assessment of the efficacy of such technique with the aid of immunohistochemistry. 14 rats (which underwent sciatic nerve transection were operated according to proposed technique. Another 14 rats, in which only end-to-end nerve anastomosis (without muscular wrapping was performed served as controls. Morphological changes were evaluated at 3 weeks and 3 months periods. Higher blood vessel and axon counts were observed in experimental groups at both checkpoints. There was also an increase in Schwann cells and macrophages counts, and less collagen content in pe-ripheral nerves of experimental groups. Axons in neuromas of experimental groups showed a higher degree of arrangement. We conclude that proposed surgical technique provides better vascularisation of injured peripheral nerves, which is beneficial for nerve regeneration.

  7. Chitosan Conduit for Peripheral Nerve Regeneration

    1999-01-01

    Chitosan, the N-deacetylated form of chitin, has good biocompatibility and biodegradability.This paper investigates the feasibility of using chitosan conduits for peripheral nerve regeneration.Cell culture experiments were used to test the material's cytotoxicity and affinity to nerve cells.Conduit implantation experiments were used to study the degradation of the material and the regeneration of injured sciatic nerves.The primary results indicate that chitosan has good mechanical properties, biocompatibility, and biodegradability and it may be a promising biomaterial for peripheral nerve regeneration.

  8. Nerve Biopsy In The Diagnosis Of Leporsy

    Hazra B

    1997-01-01

    Full Text Available Skin and nerve biopsies were done in 33 cases of different clinical types of leprosy selected from Dermatology OPD of Medical College and Hospitals, Calcutta during 1994-95. Histopathological results were compared with emphasis on the role of nerve biopsies in detection of patients with multibacillary leprosy. The evident possibility of having patients with multibacillary leprosy in peripheral leprosy with multiple drugs. It is found that skin and nerve biopsy are equally informative in borderline and lepromatour leprosy and is the only means to diagnose polyneuritic leprosy. Nerve biopsy appears to be more informative in the diagnosis of all clinical types of leprosy.

  9. Cartilage oligomeric matrix protein enhances the vascularization of acellular nerves

    Wei-ling Cui

    2016-01-01

    Full Text Available Vascularization of acellular nerves has been shown to contribute to nerve bridging. In this study, we used a 10-mm sciatic nerve defect model in rats to determine whether cartilage oligomeric matrix protein enhances the vascularization of injured acellular nerves. The rat nerve defects were treated with acellular nerve grafting (control group alone or acellular nerve grafting combined with intraperitoneal injection of cartilage oligomeric matrix protein (experimental group. As shown through two-dimensional imaging, the vessels began to invade into the acellular nerve graft from both anastomotic ends at day 7 post-operation, and gradually covered the entire graft at day 21. The vascular density, vascular area, and the velocity of revascularization in the experimental group were all higher than those in the control group. These results indicate that cartilage oligomeric matrix protein enhances the vascularization of acellular nerves.

  10. 21 CFR 878.1800 - Speculum and accessories.

    2010-04-01

    ...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Diagnostic Devices § 878.1800 Speculum and accessories.... Class I (general controls). The device is exempt from the premarket notification procedures in subpart...

  11. Accessory Fissures of the liver: CT and sonographic appearance

    Auh, Y.H.; Rubenstein, W.A.; Zirinsky, K.; Kneeland, J.B.; Pardes, J.C.; Engel, I.A.; Whalen, J.P.; Kazam, E.

    1984-09-01

    Invaginations of the liver by the diaphragm form accessory fissures that may mimic the major hepatic fissures on sectional images. Accessory fissures are most common in the superior right hepatic lobe. Their average incidence on computed tomographic (CT) scans is 25%. Their frequency increases with age, approaching 70% in the seventh and eighth decades. Their depth may equal or exceed 2 cm in one-third of cases. Multiple accessory fissures may mimic pathologic liver nodules on CT and may be associated with diaphragmatic scalloping or eventration on the chest film. When only parts of these fissures are seen sonographically, they may be mistaken for echogenic liver lesions. The differentiation of accessory fissures from the major hepatic fissures, from pathologic lesions, and from sonographic pseudofissure artifacts is discussed.

  12. Accessory Fissures of the liver: CT and sonographic appearance

    Invaginations of the liver by the diaphragm form accessory fissures that may mimic the major hepatic fissures on sectional images. Accessory fissures are most common in the superior right hepatic lobe. Their average incidence on computed tomographic (CT) scans is 25%. Their frequency increases with age, approaching 70% in the seventh and eighth decades. Their depth may equal or exceed 2 cm in one-third of cases. Multiple accessory fissures may mimic pathologic liver nodules on CT and may be associated with diaphragmatic scalloping or eventration on the chest film. When only parts of these fissures are seen sonographically, they may be mistaken for echogenic liver lesions. The differentiation of accessory fissures from the major hepatic fissures, from pathologic lesions, and from sonographic pseudofissure artifacts is discussed

  13. PAINFUL ACCESSORY NAVICULAR IN CHILDREN – CASE PRESENTATION

    RE Iacob; Daniela Iacob

    2010-01-01

    Accessory bones, called sesamoid bones, may be occasionally located in the foot. Such a situation is seen in the case of accessory navicular. Its presence is mostly asymptomatic, in some cases in teenagers and adults and more rarely before this age, leading to pains in the leg. This paper presents the case of a 10 year girl experiencing such a pathology that was managed surgically.

  14. An incidental finding of the accessory inferior thyroid artery

    Sedy J

    2008-01-01

    We report a case of an incidental finding of the right accessory inferior thyroid artery, emerging from the thyrocervical trunk together with a typical inferior thyroid artery, present in a normal position. On the left side, only single inferior thyroid artery was present. Only one inferior thyroid vein was found on each side. The accessory inferior thyroid artery entered the thyroid gland approximately 1 cm above the normal inferior thyroid, above the superior parathyroid gland. Although acc...

  15. Accessory enzymes from Aspergillus involved in xylan and pectin degradation

    Vries, de, G.

    1999-01-01

    The xylanolytic and pectinolytic enzyme systems from Aspergillus have been the subject of study for many years. Although the main chain cleaving enzymes and their encoding genes have been studied in detail, little information is available about most of the accessory enzymes and their corresponding genes. This thesis describes the purification and characterisation of two accessory enzymes from Aspergillus , feruloyl esterase A (FaeA) andα-glucuronidase A (AguA), and the activities of these enz...

  16. SCIATIC NERVE AND ITS VARIATIONS: AN ANATOMICAL STUDY

    Anbumani T.L

    2015-06-01

    Full Text Available Background and aims: The Sciatic nerve is the widest nerve of the body, consists of two components namely tibial and common peroneal components, derived from the lumbosacral plexus from the ventral rami of L4 to S3 spinal nerves. The Sciatic nerve usually enters the gluteal region under the piriformis muscle. The purpose of this study is to identify the variations in the course and branching pattern of the sciatic nerve and its relation to the piriformis muscle which may lead to various clinical manifestations like non-discogenic sciatica. Materials and methods: 50 gluteal regions and posterior compartment of thigh from 25 formalin fixed adult cadavers are used for this study, of which one is a female cadaver. Gluteal regions and the posterior aspect of thigh on both sides are dissected to expose the sciatic nerve. Variations in the sciatic nerve and their relationship to piriformis muscle are observed. Results: 41 gluteal regions and posterior compartments of thigh (82% showed normal anatomy of sciatic nerve and also piriformis muscle. 9 regions (18% showed variations in the sciatic nerve, of which 5 regions (10% showed variation of sciatic nerve in relation to piriformis muscle. Other details are explained further in the article. Conclusion: A proper knowledge about the variations of sciatic nerve, its relation to piriformis muscle is must for medical professionals during posterior hip surgeries, sciatic nerve decompression, total hip replacement, sciatic nerve injury during deep intramuscular gluteal injections, failed sciatic nerve block during anaesthetic procedures etc.

  17. The effects of irreversible electroporation (IRE on nerves.

    Wei Li

    Full Text Available BACKGROUND: If a critical nerve is circumferentially involved with tumor, radical surgery intended to cure the cancer must sacrifice the nerve. Loss of critical nerves may lead to serious consequences. In spite of the impressive technical advancements in nerve reconstruction, complete recovery and normalization of nerve function is difficult to achieve. Though irreversible electroporation (IRE might be a promising choice to treat tumors near or involved critical nerve, the pathophysiology of the nerve after IRE treatment has not be clearly defined. METHODS: We applied IRE directly to a rat sciatic nerve to study the long term effects of IRE on the nerve. A sequence of 10 square pulses of 3800 V/cm, each 100 µs long was applied directly to rat sciatic nerves. In each animal of group I (IRE the procedure was applied to produce a treated length of about 10 mm. In each animal of group II (Control the electrodes were only applied directly on the sciatic nerve for the same time. Electrophysiological, histological, and functional studies were performed on immediately after and 3 days, 1 week, 3, 5, 7 and 10 weeks following surgery. FINDINGS: Electrophysiological, histological, and functional results show the nerve treated with IRE can attain full recovery after 7 weeks. CONCLUSION: This finding is indicative of the preservation of nerve involving malignant tumors with respect to the application of IRE pulses to ablate tumors completely. In summary, IRE may be a promising treatment tool for any tumor involving nerves.

  18. Raman microspectroscopy for visualization of peripheral nerves

    Minamikawa, Takeo; Harada, Yoshinori; Koizumi, Noriaki; Takamatsu, Tetsuro

    2013-02-01

    The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery is essential for improving quality of life of patients. To preserve peripheral nerves, detection of ne peripheral nerves that cannot be identi ed by human eye or under white light imaging is necessary. In this study, we sought to provide a proof-of-principle demonstration of a label-free detection technique of peripheral nerve tissues against adjacent tissues that employs spontaneous Raman microspectroscopy. A line-illumination confocal Raman microscope was used for the experiment. A laser operating at the wavelength of 532 nm was used as an excitation laser light. We obtained Raman spectra of peripheral nerve, brous connective tissue, skeletal muscle, blood vessel, and adipose tissue of Wistar rats, and extracted speci c spectral features of peripheral nerves and adjacent tissues. By applying multivariate image analysis, peripheral nerves were clearly detected against adjacent tissues without any preprocessing neither xation nor staining. These results suggest the potential of the Raman spectroscopic observation for noninvasive and label-free nerve detection, and we expect this method could be a key technique for nerve-sparing surgery.

  19. Hypoxia inhibits abdominal expiratory nerve activity.

    Fregosi, R F; Knuth, S L; Ward, D K; Bartlett, D

    1987-07-01

    Our purpose was to examine the influence of steady-state changes in chemical stimuli, as well as discrete peripheral chemoreceptor stimulation, on abdominal expiratory motor activity. In decerebrate, paralyzed, vagotomized, and ventilated cats that had bilateral pneumothoraces, we recorded efferent activity from a phrenic nerve and from an abdominal nerve (cranial iliohypogastric nerve, L1). All cats showed phasic expiratory abdominal nerve discharge at normocapnia [end-tidal PCO2 38 +/- 2 Torr], but small doses (2-6 mg/kg) of pentobarbital sodium markedly depressed this activity. Hyperoxic hypercapnia consistently enhanced abdominal expiratory activity and shortened the burst duration. Isocapnic hypoxia caused inhibition of abdominal nerve discharge in 11 of 13 cats. Carotid sinus nerve denervation (3 cats) exacerbated the hypoxic depression of abdominal nerve activity and depressed phrenic motor output. Stimulation of peripheral chemoreceptors with NaCN increased abdominal nerve discharge in 7 of 10 cats, although 2 cats exhibited marked inhibition. Four cats with intact neuraxis, but anesthetized with ketamine, yielded qualitatively similar results. We conclude that when cats are subjected to steady-state chemical stimuli in isolation (no interference from proprioceptive inputs), hypercapnia potentiates, but hypoxia attenuates, abdominal expiratory nerve activity. Mechanisms to explain the selective inhibition of expiratory motor activity by hypoxia are proposed, and physiological implications are discussed. PMID:3624126

  20. Optic nerve oxygenation

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    The oxygen tension of the optic nerve is regulated by the intraocular pressure and systemic blood pressure, the resistance in the blood vessels and oxygen consumption of the tissue. The oxygen tension is autoregulated and moderate changes in intraocular pressure or blood pressure do not affect the...... optic nerve oxygen tension. If the intraocular pressure is increased above 40 mmHg or the ocular perfusion pressure decreased below 50 mmHg the autoregulation is overwhelmed and the optic nerve becomes hypoxic. A disturbance in oxidative metabolism in the cytochromes of the optic nerve can be seen at...... similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...

  1. [Ganglia of peripheral nerves].

    Tatagiba, M; Penkert, G; Samii, M

    1993-01-01

    The authors present two different types of ganglion affecting the peripheral nerves: extraneural and intraneural ganglion. Compression of peripheral nerves by articular ganglions is well known. The surgical management involves the complete removal of the lesion with preservation of most nerve fascicles. Intraneural ganglion is an uncommon lesion which affects the nerve diffusely. The nerve fascicles are usually intimately involved between the cysts, making complete removal of all cysts impossible. There is no agreement about the best surgical management to be applied in these cases. Two possibilities are available: opening of the epineural sheath lengthwise and pressing out the lesion; or resection of the affected part of the nerve and performing a nerve reconstruction. While in case of extraneural ganglion the postoperative clinical evolution is very favourable, only long follow up studies will reveal in case of intraneural ganglion the best surgical approach. PMID:8128785

  2. Peripheral nerve injuries in the athlete.

    Feinberg, J H; Nadler, S F; Krivickas, L S

    1997-12-01

    outcome. Proximal nerve injuries have a poorer prognosis for neurological recovery. The most common peripheral nerve injury in the athlete is the burner syndrome. Though primarily a football injury, burners have been reported in wrestling, hockey, basketball and weight-lifting as a result of acute head, neck and/or shoulder trauma. Most burners are self-limiting, but they occasionally produce permanent neurological deficits. The axillary nerve is commonly injured with shoulder dislocations but is also susceptible to injury by direct compression. The sciatic and common peroneal nerves can be injured by trauma. The suprascapular, musculocutaneous, ulnar, median and tibial nerves are susceptible to entrapment. The long thoracic and femoral nerves can be injured by severe traction. PMID:9421863

  3. Use of superficial peroneal nerve graft for treating peripheral nerve injuries

    Samuel Ribak

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source. METHODS: This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve was identified. The proximal limit of the sensitive branch was found at this point. RESULTS: The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking. CONCLUSIONS: Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources.

  4. Use of superficial peroneal nerve graft for treating peripheral nerve injuries☆

    Ribak, Samuel; da Silva Filho, Paulo Roberto Ferreira; Tietzmann, Alexandre; Hirata, Helton Hiroshi; de Mattos, Carlos Augusto; da Gama, Sérgio Augusto Machado

    2016-01-01

    Objective To evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source. Methods This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point. Results The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking. Conclusions Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources. PMID:26962502

  5. Pan-genome sequence analysis using Panseq: an online tool for the rapid analysis of core and accessory genomic regions

    Villegas Andre

    2010-09-01

    Full Text Available Abstract Background The pan-genome of a bacterial species consists of a core and an accessory gene pool. The accessory genome is thought to be an important source of genetic variability in bacterial populations and is gained through lateral gene transfer, allowing subpopulations of bacteria to better adapt to specific niches. Low-cost and high-throughput sequencing platforms have created an exponential increase in genome sequence data and an opportunity to study the pan-genomes of many bacterial species. In this study, we describe a new online pan-genome sequence analysis program, Panseq. Results Panseq was used to identify Escherichia coli O157:H7 and E. coli K-12 genomic islands. Within a population of 60 E. coli O157:H7 strains, the existence of 65 accessory genomic regions identified by Panseq analysis was confirmed by PCR. The accessory genome and binary presence/absence data, and core genome and single nucleotide polymorphisms (SNPs of six L. monocytogenes strains were extracted with Panseq and hierarchically clustered and visualized. The nucleotide core and binary accessory data were also used to construct maximum parsimony (MP trees, which were compared to the MP tree generated by multi-locus sequence typing (MLST. The topology of the accessory and core trees was identical but differed from the tree produced using seven MLST loci. The Loci Selector module found the most variable and discriminatory combinations of four loci within a 100 loci set among 10 strains in 1 s, compared to the 449 s required to exhaustively search for all possible combinations; it also found the most discriminatory 20 loci from a 96 loci E. coli O157:H7 SNP dataset. Conclusion Panseq determines the core and accessory regions among a collection of genomic sequences based on user-defined parameters. It readily extracts regions unique to a genome or group of genomes, identifies SNPs within shared core genomic regions, constructs files for use in phylogeny programs

  6. Ulnar Nerve Compression after Silastic Ulnar Head Replacement

    El-Gammal, Tarek A.; Blair, William F.

    1991-01-01

    A patient with silastic radiocarpal and ulnar head replacement arthroplasty presented six years after the operation with symptoms of ulnar neuropathy. Bone resorption of the distal ulna resulted in volar subluxation of the ulnar head implant which compressed the ulnar nerve at its entrance into Guyon's canal. Removal of the implant and decompression of the nerve resulted in recovery of ulnar nerve funcions. Compression neuropathy of the ulnar nerve should be considered a potential complicatio...

  7. Electrical Stimulation Enhances Reinnervation After Nerve Injury

    Willand, Michael P

    2015-01-01

    Electrical muscle stimulation following peripheral nerve injury has been a controversial method of treatment due primarily to the inconsistent literature surrounding it. In this presentation transcript I outline ongoing experiments investigating a clinically translatable daily muscle stimulation paradigm in rats following nerve injury. Results show that reinnervation of muscle and functional behavioural metrics are enhanced with daily stimulation with upregulation of intramuscular neurotrophi...

  8. Imaging the trigeminal nerve

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  9. Imaging the trigeminal nerve

    Borges, Alexandra [Radiology Department, Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof. Lima Basto, 1093, Lisboa (Portugal)], E-mail: borgalexandra@gmail.com; Casselman, Jan [Department of Radiology, A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals (Belgium)

    2010-05-15

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  10. Chitosan-film enhanced chitosan nerve guides for long-distance regeneration of peripheral nerves.

    Meyer, Cora; Stenberg, Lena; Gonzalez-Perez, Francisco; Wrobel, Sandra; Ronchi, Giulia; Udina, Esther; Suganuma, Seigo; Geuna, Stefano; Navarro, Xavier; Dahlin, Lars B; Grothe, Claudia; Haastert-Talini, Kirsten

    2016-01-01

    Biosynthetic nerve grafts are developed in order to complement or replace autologous nerve grafts for peripheral nerve reconstruction. Artificial nerve guides currently approved for clinical use are not widely applied in reconstructive surgery as they still have limitations especially when it comes to critical distance repair. Here we report a comprehensive analysis of fine-tuned chitosan nerve guides (CNGs) enhanced by introduction of a longitudinal chitosan film to reconstruct critical length 15 mm sciatic nerve defects in adult healthy Wistar or diabetic Goto-Kakizaki rats. Short and long term investigations demonstrated that the CNGs enhanced by the guiding structure of the introduced chitosan film significantly improved functional and morphological results of nerve regeneration in comparison to simple hollow CNGs. Importantly, this was detectable both in healthy and in diabetic rats (short term) and the regeneration outcome almost reached the outcome after autologous nerve grafting (long term). Hollow CNGs provide properties likely leading to a wider clinical acceptance than other artificial nerve guides and their performance can be increased by simple introduction of a chitosan film with the same advantageous properties. Therefore, the chitosan film enhanced CNGs represent a new generation medical device for peripheral nerve reconstruction. PMID:26517563

  11. Sciatic nerve regeneration in rats by a promising electrospun collagen/poly(ε-caprolactone nerve conduit with tailored degradation rate

    Jiang Xinquan

    2011-07-01

    Full Text Available Abstract Background To cope with the limitations faced by autograft acquisitions particularly for multiple nerve injuries, artificial nerve conduit has been introduced by researchers as a substitute for autologous nerve graft for the easy specification and availability for mass production. In order to best mimic the structures and components of autologous nerve, great efforts have been made to improve the designation of nerve conduits either from materials or fabrication techniques. Electrospinning is an easy and versatile technique that has recently been used to fabricate fibrous tissue-engineered scaffolds which have great similarity to the extracellular matrix on fiber structure. Results In this study we fabricated a collagen/poly(ε-caprolactone (collagen/PCL fibrous scaffold by electrospinning and explored its application as nerve guide substrate or conduit in vitro and in vivo. Material characterizations showed this electrospun composite material which was made of submicron fibers possessed good hydrophilicity and flexibility. In vitro study indicated electrospun collagen/PCL fibrous meshes promoted Schwann cell adhesion, elongation and proliferation. In vivo test showed electrospun collagen/PCL porous nerve conduits successfully supported nerve regeneration through an 8 mm sciatic nerve gap in adult rats, achieving similar electrophysiological and muscle reinnervation results as autografts. Although regenerated nerve fibers were still in a pre-mature stage 4 months postoperatively, the implanted collagen/PCL nerve conduits facilitated more axons regenerating through the conduit lumen and gradually degraded which well matched the nerve regeneration rate. Conclusions All the results demonstrated this collagen/PCL nerve conduit with tailored degradation rate fabricated by electrospinning could be an efficient alternative to autograft for peripheral nerve regeneration research. Due to its advantage of high surface area for cell attachment, it

  12. Morphological differences in skeletal muscle atrophy of rats with motor nerve and/or sensory nerve injury

    Lei Zhao; Guangming Lv; Shengyang Jiang; Zhiqiang Yan; Junming Sun; Ling Wang; Donglin Jiang

    2012-01-01

    Skeletal muscle atrophy occurs after denervation. The present study dissected the rat left ventral root and dorsal root at L4-6 or the sciatic nerve to establish a model of simple motor nerve injury, sensory nerve injury or mixed nerve injury. Results showed that with prolonged denervation time, rats with simple motor nerve injury, sensory nerve injury or mixed nerve injury exhibited abnormal behavior, reduced wet weight of the left gastrocnemius muscle, decreased diameter and cross-sectional area and altered ultrastructure of muscle cells, as well as decreased cross-sectional area and increased gray scale of the gastrocnemius muscle motor end plate. Moreover, at the same time point, the pathological changes were most severe in mixed nerve injury, followed by simple motor nerve injury, and the changes in simple sensory nerve injury were the mildest. These findings indicate that normal skeletal muscle morphology is maintained by intact innervation. Motor nerve injury resulted in larger damage to skeletal muscle and more severe atrophy than sensory nerve injury. Thus, reconstruction of motor nerves should be considered first in the clinical treatment of skeletal muscle atrophy caused by denervation.

  13. Atrial flutter in the fetus and young infant: an association with accessory connections.

    Till, J; WREN, C.

    1992-01-01

    OBJECTIVE--To highlight the association between atrial flutter and accessory connections in the fetus and young infant. DESIGN--A retrospective review from January 1985 to January 1990. PATIENTS--Fetuses, neonates, and young infants with atrial flutter. RESULTS--Four fetuses and five infants presented with atrial flutter. In two fetuses and one infant sinus rhythm returned spontaneously. The other six required cardioversion. Three of them developed orthodromic atrioventricular re-entry tachyc...

  14. The consumer behaviour of german honor students regarding garment and accessories

    Coudouratzis, J.; Abreu, Maria José

    2012-01-01

    The purpose of this research was to determine the consumer behaviour of german honor students concerning branded clothes and accessories. The data acquisition was done by developing a questionnaire, which was sent to three different universities in Germany The attention has been turned to identify a correlation between branded clothes and the development of a personal identity. According to the results of the realised survey there is no correlation.

  15. Sciatic nerve injection injury.

    Jung Kim, Hyun; Hyun Park, Sang

    2014-06-11

    Nerve injury is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected nerve, especially in children, the elderly and underweight patients. The neurological presentation may range from minor transient pain to severe sensory disturbance and motor loss with poor recovery. Management of nerve injection injury includes drug treatment of pain, physiotherapy, use of assistive devices and surgical exploration. Early recognition of nerve injection injury and appropriate management are crucial in order to reduce neurological deficit and to maximize recovery. Sciatic nerve injection injury is a preventable event. Total avoidance of intramuscular injection is recommended if other administration routes can be used. If the injection has to be administered into the gluteal muscle, the ventrogluteal region (gluteal triangle) has a more favourable safety profile than the dorsogluteal region (the upper outer quadrant of the buttock). PMID:24920643

  16. The furcal nerve revisited

    Nanjundappa S. Harshavardhana

    2014-10-01

    Full Text Available Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked is an independent nerve with its own ventral and dorsal branches (rootlets and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/ professionals involved in spine care.

  17. The Furcal Nerve Revisited

    Dabke, Harshad V.

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

  18. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst

    Kwak, Kyung-Woo; Kim, Min-Su; Chang, Chul-Hoon; Kim, Seong-Ho

    2011-01-01

    Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve c...

  19. Expression of apolipoprotein E during nerve degeneration and regeneration

    Ignatius, M J; Gebicke-Härter, P J; Skene, J H; Schilling, J W; Weisgraber, K H; Mahley, R. W.; Shooter, E M

    1986-01-01

    A 37-kDa glycoprotein has been described recently, whose synthesis is dramatically increased after injury of the rat sciatic and optic nerves. Cells in the nerve sheath, distal to the site of injury, produce and secrete large amounts of this protein, so that by 3 weeks after injury, it represents 2-5% of the total soluble extracellular protein in the regenerating sciatic nerve sheath, although it fails to accumulate in damaged optic nerve. Results presented here reveal extensive homology betw...

  20. Intraparotid facial nerve schwannoma: Report of two cases

    Seyyed Basir Hashemi

    2008-07-01

    Full Text Available Introduction: Intra parotid facial nerve schowannoma is a rare tumor. Case report: In this article we presented two cases of intra parotid facial nerve schowannoma. In two cases tumor presented with asymptomatic parotid mass that mimic pleomorphic adenoma. No preoperative facial nerve dysfunction in cases is detected. Diagnostic result and surgical management are discussed in this paper.  

  1. Photosynthetic accessory pigments - Evidence for the influence of phycoerythrin on the submarine light field

    Hoge, Frank E.; Swift, Robert N.

    1990-01-01

    Upwelled water-leaving spectral radiances and the submarine light-field source are theorized to have the physical scattering and absorption effects of photosynthetic accessory pigments. A laser is employed to induce phycoerythrin pigment fluorescence, and the presence of the photosynthetic accessory pigment is measured in oceanic waters with a spectral fluorescence method. Experimental data from active-passive correlation spectroscopy demonstrate that water-leaving spectral radiances of about 600 nm are highly correlated with phycoerythrin pigment fluorescence. Because the data on the phycoerythrin and chlorophyll fluorescences are entered randomly in the correlation the results are considered unambiguous. An estimate of the photopigment is derived that agrees with measurements of its laser-induced fluorescence.

  2. Terminal phalangeal accessory ossification center of the thumb: an additional radiographic finding in Larsen syndrome

    Larsen syndrome is an autosomal-dominant disorder characterized by multiple joint dislocations, vertebral anomalies and dysmorphic facies. Both autosomal-dominant and autosomal-recessive forms of the disorder have been proposed. Individuals with autosomal-dominant Larsen syndrome have characteristic ''cylindrical-shape'' thumbs caused by broad, shortened phalanges. Autosomal-dominant Larsen syndrome results from heterozygosity for mutations in filamin B, a cytoskeletal protein involved in multicellular processes. We report here a patient with a duplicated or accessory distal thumb phalanx and multiple large joint dislocations who was shown to be heterozygous for a filamin B mutation predicting the amino acid substitution G1691S. This adds a new radiographic finding, duplicated or accessory distal phalanx, to the radiographic abnormalities seen in this rare dominant disorder. (orig.)

  3. Facial Nerve Neuroma Management

    Weber, Peter C; Osguthorpe, J. David

    1998-01-01

    Three facial nerve neuromas were identified in the academic year 1994-1995. Each case illustrates different management dilemmas. One patient with a grade III facial nerve palsy had a small geniculate ganglion neuroma with the dilemma of decompression versus resection clear nerve section margins. The second patient underwent facial neuroma resection with cable graft reconstruction, but the permanent sections were positive. The last patient had a massive neuroma in which grafting versus other f...

  4. Axon-Schwann cell interactions during peripheral nerve regeneration in zebrafish larvae

    Ceci, Maria Laura; Mardones-Krsulovic, Camila; SÁNCHEZ, MARIO; Valdivia, Leonardo E.; Allende, Miguel L

    2014-01-01

    Background Peripheral nerve injuries can severely affect the way that animals perceive signals from the surrounding environment. While damage to peripheral axons generally has a better outcome than injuries to central nervous system axons, it is currently unknown how neurons re-establish their target innervations to recover function after injury, and how accessory cells contribute to this task. Here we use a simple technique to create reproducible and localized injury in the posterior lateral...

  5. Isolated muscle hypertrophy as a sign of radicular or peripheral nerve injury.

    Mattle, H.P.; Hess, C W; Ludin, H P; Mumenthaler, M

    1991-01-01

    Two patients with isolated neurogenic hypertrophy of the trapezius muscle due to accessory nerve injury and a patient with neurogenic hypertrophy of the anterior tibial muscle due to chronic radicular lesion L4 are described. Electromyography of the affected muscles showed dense continuing spontaneous discharges of complex potentials. Muscle biopsy performed in two patients showed abundant hypertrophic muscle fibres, identified in one case by ATP-ase reaction as being of predominantly type I....

  6. A novel electrical model of nerve and muscle using Pspice

    Peasgood, W; Lam, C K; Armstrong, A G; Wood, W

    2003-01-01

    In this work, a model is developed to simulate the biological processes involved in nerve fibre transmission and subsequent muscle contraction. The model has been based on approximating biological structure and function to electrical circuits and as such was implemented on an electronics simulation software package called Pspice. Models of nerve, the nerve-muscle interface and muscle fibre have been implemented. The time dependent ionic properties of the nerve and muscle membranes have been simulated using the Hodgkin-Huxley equations and for the muscle fibre, the implementation of the Huxley sliding filament theory for muscular contraction. The results show that nerve may be considered as a fractal transmission line and that the amplitude of the nerve membrane depolarization is dependent on the dimensions of the fibre. Additionally, simulation of the nerve-muscle interface allows the fractal nerve model to be connected to the muscle fibre model and it is shown that a two sarcomere molecular simulation can pr...

  7. Ischemic and reperfusion injury of rat peripheral nerve

    A rat model of severe nerve ischemia was used to study the effects of ischemia and reperfusion on nerve conduction, blood flow, and the integrity of the blood-nerve barrier. Conduction failure was consistently found in the sciatic-tibial nerve during 1- and 3-hr ischemic periods. Recovery of the compound muscle action potential was prompt and complete upon reperfusion following 1 hr of ischemia. However, after 3 hr of ischemia, recovery in the proximal portion of the sciatic nerve was 14C]sucrose following 1 hr of ischemia but was significantly impaired after 3 hr of ischemia. The permeability-surface area product was consistently greater following 1 hr of reperfusion than during the immediate reperfusion period. These data indicate that severe ischemia of peripheral nerve results in reperfusion injury, conduction block, and blood-nerve barrier disruption. Microvascular events, which may occur during reperfusion, may be important in amplifying the nerve fiber damage that began during ischemia

  8. Bridging peripheral nerve defect with chitosan-collagen film

    魏欣; 劳杰; 顾玉东

    2003-01-01

    Objective: To seek new method for the treatment of peripheral nerve injury. Methods: In rat model with sciatic nerve defect, chitosan-collagen film was sutured into conduit to bridge 5 mm, 10 mm nerve defects. Rats that underwent end-to-end anastomosis were taken as controls. General observation, electrophysiological study, histological study and image analysis were performed at 4, 8, 12 weeks postoperatively. Results: In 5 mm nerve defects, the quality of nerve regeneration was similar to that of the control group. For 10 mm nerve defect, nerve regeneration was inferior to that of the control group. Chitosan-collagen film obviously degraded at 12 weeks postoperatively. Conclusions: Chitosan-collagen film conduit can be used to bridge peripheral nerve defect.

  9. Conjoined nerve root of the lumbar spine

    There have been a number of reports on lumbosacral nerve root anomalies. Among the most common of these anomalies is the conjoined nerve root. However, it is difficult to diagnose this condition preoperatively. We review the records of 142 patients who underwent microendoscopic discectomy (MED) for herniation of the lumbar disc. All patients had undergone magnetic resonance imaging (MRI) of the lumbar spine before surgery. For most patients, only sagittal and axial images were obtained; coronal images were obtained in only a minority of the patients. Postoperative coronal images were obtained in patients with conjoined nerve roots. A diagnosis of conjoined nerve roots was made intraoperatively in 4 patients; this diagnosis had not been possible preoperatively. After surgery, new coronal images were obtained for the 4 patients with conjoined nerve roots; however, there was no evidence of the condition on the new images. The surgical procedure employed was endoscopic decompression and herniotomy. The results were favorable, even though pediculotomy was not performed. It is difficult to diagnose nerve root anomalies preoperatively. However, the possibility of nerve root anomalies should always be considered during surgery to ensure a safe procedure, without intraoperative occurrence of nerve root injury. (author)

  10. Accessory left gastric artery: angiographic anatomy

    Lee, Kang Soo; Lim, Hyung Guhn; Kim, Hong Soo; Jeon, Doo Sung [Presbyterian Medical Center, Chunju (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Soon Young [Myongji Hospital, College of Medicine, Kwandong University, Seoul (Korea, Republic of)

    2000-09-01

    To evaluate the angiographic anatomy of the accessory left gastric artery (accLGA). We evaluated the angiographic findings of the accLGA in 50 patients (Angiostar; Siemens, Erlangen, Germany). Performing celiac and selective angiography in 50 and 34 patients, respectively. By means of celiac angiography, (1) site of origin, (2) anatomical course, (3) diameter, (4) degree of tortuosity, and (5) distal tapering were evaluated, while selective angiography was used to determine (1) arterial branching, (2) area of blood supply, and (3) patterns of gastric wall stain. Celiac angiography showed that the accLGA arose from the left hepatic artery (LHA) in 45 cases (90%) and from the proper hepatic artery in five (10%). If the accLGA arose from the LHA, its origin entirely depended on the branching pattern of the latter. It always arose from the lateral branch of the LHA furthest to the left and uppermost, and proximal to its umbilical point. The most common anatomical course of the accLGA, seen in 27 cases (54%), was between the S2 and S3 segmental branch. The diameter and degree of tortuosity of the accLGA were similar to those of adjacent intrahepatic branches in 21 (42%) and 33 cases (66%), respectively. The degree of tapering was less than that of adjacent intrahepatic vessel in 28 (56%). Selective angiography demonstrated esophageal branching of the acc LGA in 27 cases (79%), inferior phrenic arterial branching in three (9%), a mediastinal branch in one (3%), and hypervascularity of the lung in one (3%). In 15 cases (44%), bifurcation of the accLGA was recognized. The vascular territory of the accLGA was the gastric fundus together with the distal esophagus in 21 cases (62%), mainly the gastric fundus in six (18%), and mainly the distal esophagus in four (12%). The pattern of gastric mucosal stain was curvilinear wall in 31 cases (91%) and nodular in three (9%). A knowledge of the angiographic anatomy of the accLGA facilitates accurate recognition of this artery on

  11. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto; Winge, Søren; Hölmich, Per

    2014-01-01

    PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time...... year after HA concerning symptoms of nerve dysfunction, possible localization, and erectile dysfunction. Fifty patients participated and returned fully completed questionnaires. Patients reporting symptoms of nerve dysfunction 1 year after HA were re-examined. RESULTS: Twenty-three of 50 patients (46......%) reported symptoms of nerve dysfunction during the first week after HA; this was reduced to 14 patients (28%) after 6 weeks, 11 patients (22%) after 26 weeks, and 9 patients (18%) after 1 year. One patient experienced temporary erectile dysfunction. No difference in traction time between patients with...

  12. The use of microdebrider for the treatment of accessory axillary breast.

    Jeremy, Sun Mingfa; Jack, Chong Si; Vincent, Yeow Kok Leng; Evan, Woo Kok Yen

    2012-11-01

    Accessory axillary breast tissue can be fairly common occurring in 2-6% of women. Treatment modalities thus far include direct excision as well as liposuction. While direct excision allows for accessible and adequate tissue resection, it results in long unsightly scars and the creation of significant amount of dead space. This may be complicated by seroma and haematoma formation. Liposuction is not without its drawbacks either. It is often very difficult to remove fibro-glandular breast tissue resulting in inadequate excision, thus leaving behind a visible core of breast tissue. This has led some surgeons to use a combination of direct excision and liposuction to manage accessory axillary breast tissue. Hence, we present the use of the microdebrider for sharp and precise excision of accessory axillary breast tissue. This day procedure can be performed through a single 5-mm incision which is well hidden in the axillary skin folds while allowing the operator the amount of control needed to accurately remove fibro-glandular breast tissue and restore an aesthetically pleasing contour to the axilla. PMID:22735506

  13. Maxillary nerve compression in cynomolgus monkey Macaca fascicularis: altered somatic sensation and peripheral nerve firing

    Guo Ning

    2012-12-01

    Full Text Available Abstract Background Trigeminal nerve is a major source of the sensory input of the face, and trigeminal neuropathology models have been reported in rodents with injury to branches of the maxillary or mandibular division of the trigeminal nerve. Non-human primates are neuroanatomically more closely related to human than rodents; however, nerve injury studies in non-human primates are limited. Results We describe here a nerve injury model of maxillary nerve compression (MNC in the cynomolgus macaque monkey, Macaca fascicularis, and the initial characterization of the consequences of damage to this trigeminal nerve branch. The nerve injury from the compression appeared to be mild, as we did not observe overt changes in home-cage behavior in the monkeys. When mechanical stimulation was applied to the facial area, monkeys with MNC displayed increased mechanical sensitivity, as the avoidance response scores were lower than those from the control animals. Such a change in mechanical sensitivity appeared to be somewhat bilateral, as the contralateral side also showed increased mechanical sensitivity, although the change on the ipsilateral side was more robust. Multiple-unit recording of the maxillary nerve showed a general pattern of increasing responsiveness to escalating force in mechanical stimulation on the contralateral side. Ipsilateral side of the maxillary nerve showed a lack of responsiveness to escalating force in mechanical stimulation, possibly reflecting a maximum stimulation threshold effect from sensitized nerve due to MNC injury. Conclusions These results suggest that MNC may produce increased sensitivity of the ipsilateral maxillary nerve, and that this model may serve as a non-human primate model to evaluate the effect of injury to trigeminal nerve branches.

  14. Biomechanical properties of peripheral nerve after acellular treatment

    MA Xin-long; SUN Xiao-lei; YANG Zhao; LI Xiu-lan; MA Jian-xiong; ZHANG Yang; YUAN Zhen-zhen

    2011-01-01

    Background Peripheral nerve injury causes a high rate of disability and a huge economic burden,and is currently one of the serious health problems in the world.The use of nerve grafts plays a vital role in repairing nerve defects.Acellular nerve grafts have been widely used in many experimental models as a peripheral nerve substitute.The purpose of this study was to test the biomechanical properties of acellular nerve grafts.Methods Thirty-four fresh sciatic nerves were obtained from 17 adult male Wistar rats (age of 3 months) and randomly assigned to 3 groups:normal control group,nerve segments underwent no treatment and were put in phosphate buffered saline (pH 7.4) and stored at 4℃ until further use; physical method group,nerve segments were frozen at -196℃ and then thawed at 37℃; and chemical method group,nerve segments were chemically extracted with the detergents Triton X-200,sulfobetaine-10 (SB-10) and sulfobetaine-16 (SB-16).After the acellularization process was completed,the structural changes of in the sciatic nerves in each group were observed by hematoxylin-eosin staining and field emission scanning electron microscopy,then biomechanical properties were tested using a mechanical apparatus (Endura TEC ELF 3200,Bose,Boston,USA).Results Hematoxylin-eosin staining and field emission scanning electron microscopy demonstrated that the effects of acellularization,demyelination,and integrity of nerve fiber tube of the chemical method were better than that of the physical method.Biomechanical testing showed that peripheral nerve grafts treated with the chemical method resulted in some decreased biomechanical properties (ultimate load,ultimate stress,ultimate strain,and mechanical work to fracture) compared with normal control nerves,but the differences were not statistically significant (P >0.05).Conclusion Nerve treated with the chemical method may be more appropriate for use in implantation than nerve treated with the physical method.

  15. Dorsal penile nerves and primary premature ejaculation

    ZHANG Hai-feng; ZHANG Chun-ying; LI Xing-hua; FU Zhong-ze; CHEN Zhao-yan

    2009-01-01

    Background Based on our clinical experience, the number of dorsal penile nerves in patients with primary premature ejaculation (PPE) is not consistent with the average number (2 branches). In this study, we evaluated the number and distribution of dorsal penile nerves among healthy Chinese adults and patients with PPE.Methods The dorsal nerve of the penis, the deep dorsal vein of the penis, and the dorsal artery of the penis between the deep fascia of the penis and the albuginea penis were carefully educed, observed, and counted in 38 adult autopsy specimens. The number and distribution of the dorsal penile nerve in 128 surgical patients with PPE were determined. Results The numbers of dorsal penile nerves of the 38 cases were as follows:7 branches in 1 case; 6 branches in 1 case; 5 branches in 6 cases; 4 branches in 9 cases; 3 branches in 14 cases; and 2 branches in 7 cases. Most of the dorsal nerves were parallel to each other and in the dorsum of the penis. In only 8 cases, the branches were connected by some communicating branches. In 4 cases, 1 or 2 thin dorsal nerves continued their pathway over the ventral aspect of the penis. The average number of branches of the dorsal penile nerve in patients with PPE was 7.16. Conclusions Based on the study of 38 cases, the average number of dorsal penile nerves was 3.55 branches and that of patients with PPE was greater. These preliminary results suggest that the excessive dorsal penile nerves may have an impact on PPE via increased sensitivity and provide topographic data for the possible treatment of PPE.

  16. Nerve transfer for treatment of brachial plexus injury: comparison study between the transfer of partial median and ulnar nerves and that of phrenic and spinal accessary nerves

    侯之启; 徐中和

    2002-01-01

    Objective: To compare the effect of using partial median and ulnar nerves for treatment of C5-6 or C5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods: The patients were divided into 2 groups randomly according to different surgical procedures. Twelve cases were involved in the first group. The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft, and the spinal accessary nerve was to the suprascapular nerve. Eleven cases were classified into the second group. A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve. The cases were followed up from 1 to 3 years and the clinical outcome was compared between the two groups. Results: There were 2 cases (16.6%) who got the recovery of M4 strength of biceps muscle in the first group but 7 cases (63.6%) in the second group, and the difference was statistically significant (P<0.025). However, it was not statistically different in the recovery of shoulder function between the two groups. Conclusions: Partial median and ulnar nerve transfer, phrenic and spinal accessary nerve transfer were all effective for the reconstruction of elbow or shoulder function in brachial plexus injury, but the neurotization using a part of median nerve could obtain more powerful biceps muscle strength than that of phrenic nerve transfer procedure.

  17. Dynamic expression pattern of kinesin accessory protein in Drosophila

    Ritu Sarpal; Krishanu Ray

    2002-09-01

    We have identified the Drosophila homologue of the non-motor accessory subunit of kinesin-II motor complex. It is homologous to the SpKAP115 of the sea urchin, KAP3A and KAP3B of the mouse, and SMAP protein in humans. In situ hybridization using a DmKAP specific cRNA probe has revealed a dynamic pattern of expression in the developing nervous system. The staining first appears in a subset of cells in the embryonic central nervous system at stage 13 and continues till the first instar larva stage. At the third instar larva stage the staining gets restricted to a few cells in the optic lobe and in the ventral ganglion region. It has also stained a subset of sensory neurons from late stage 13 and till the first instar larva stage. The DmKAP expression pattern in the nervous system corresponds well with that of Klp64D and Klp68D as reported earlier. In addition, we have found that the DmKAP gene is constitutively expressed in the germline cells and in follicle cells during oogenesis. These cells are also stained using an antibody to KLP68D protein, but mRNA in situ hybridization using KLP64D specific probe has not stained these cells. Together these results proved a basis for further analysis of tissue specific function of DmKAP in future.

  18. Reliable sex and strain discrimination in the mouse vomeronasal organ and accessory olfactory bulb.

    Tolokh, Illya I; Fu, Xiaoyan; Holy, Timothy E

    2013-08-21

    Animals modulate their courtship and territorial behaviors in response to olfactory cues produced by other animals. In rodents, detecting these cues is the primary role of the accessory olfactory system (AOS). We sought to systematically investigate the natural stimulus coding logic and robustness in neurons of the first two stages of accessory olfactory processing, the vomeronasal organ (VNO) and accessory olfactory bulb (AOB). We show that firing rate responses of just a few well-chosen mouse VNO or AOB neurons can be used to reliably encode both sex and strain of other mice from cues contained in urine. Additionally, we show that this population code can generalize to new concentrations of stimuli and appears to represent stimulus identity in terms of diverging paths in coding space. Together, the results indicate that firing rate code on the temporal order of seconds is sufficient for accurate classification of pheromonal patterns at different concentrations and may be used by AOS neural circuitry to discriminate among naturally occurring urine stimuli. PMID:23966710

  19. Newborn Interneurons in the Accessory Olfactory Bulb Promote Mate Recognition in Female Mice

    Livio eOboti

    2011-09-01

    Full Text Available In the olfactory bulb of adult rodents, local interneurons are constantly replaced by immature precursors derived from the subventricular zone. Whether any olfactory sensory process specifically relies on this cell renewal remains largely unclear. By using the well-known model of mating-induced imprinting, we demonstrate that this olfactory memory formation critically depends on the presence of newborn granule neurons in the accessory olfactory bulb. Accordingly, we show that, in adult female mice, exposure to male pheromones increases the number of new granule cells surviving in the accessory olfactory bulb. This neuronal addition depends on the detection of sensory cues by the vomeronasal organ and requires centrifugal feedback activity from the amygdala. The stimuli affecting neuronal survival are contained in the low molecular weight fraction of urine and are implied in pheromonal recognition during mating. By chemical depletion of newly generated bulbar interneurons, we show a direct role of renewed granule cells in the accessory olfactory bulb in preventing pregnancy block by mating male odours. Taken together, our results indicate that adult neurogenesis is essential for specific brain functions such as persistent odour learning and mate recognition.

  20. Comparison of divided sciatic nerve growth within dermis, venous and nerve graft conduit in rat

    Fatemi, Mohammad Javad; Foroutan, Kamal Seyed; Ashtiani, Abass Kazemi; Mansoori, Maryam Jafari; Vaghardoost, Reza; Pedram, Sepehr; Hosseinpolli, Aidin; Rajabi, Fatemeh; Mousavi, Seyed Jaber

    2010-01-01

    BACKGROUND: Considering the common origin of skin and peripheral nervous system, a tube of dermal layer of skin hypothetically can be an ideal conduit for nerve reconstruction. An experimental study performed to evaluate the nerve regeneration of efficacy into a dermal tube. METHODS: Sixty male Wistar rats were used. A 10 mm gap was produced in right sciatic nerves. In group A the autogenous nerve grafts were used to bridge the defects. In group B vein conduit were use to reconstruct the gaps. In group C dermal tube were used to bridge the defects. Morphologic studies were carried out after 3 month. RESULTS: The density of nerve fibers was significantly higher in autogenous nerve graft group. The efficacy of nerve growth into the dermal tube group was significantly poor in comparison to other groups. CONCLUSIONS: In the present study, dermis was used as the nerve conduit for the first time. This study indicates that the dermal tube is not a suitable conduit for nerve regeneration till further studies to resolve the problems before clinical application. PMID:21526083

  1. Using Eggshell Membrane as Nerve Guide Channels in Peripheral Nerve Regeneration

    Gholam Hossein Farjah

    2013-08-01

    Full Text Available Objective(s:  The aim of this study was to evaluate the final outcome of nerve regeneration across the eggsell membrane (ESM tube conduit in comparison with autograft. Materials and Methods: Thirty adult male rats (250-300 g were randomized into (1 ESM conduit, (2 autograft, and (3 sham surgery groups. The eggs submerged in 5% acetic acid. The decalcifying membranes were cut into four pieces, rotated over the teflon mandrel and dried at   37°C. The left sciatic nerve was surgically cut. A 10-mm nerve segment was cut and removed. In the ESM group, the proximal and distal cut ends of the sciatic nerve were telescoped into the nerve guides. In the autograft group, the 10 mm nerve segment was reversed and used as an autologous nerve graft. All animals were evaluated by sciatic functional index (SFI and electrophysiology testing.  Results:The improvement in SFI from the first to the last evalution in ESM and autograft groups were evaluated. On days 49 and 60 post-operation, the mean SFI of ESM group was significantly greater than the autograft group (P 0.05. Conclusion:These findings demonstrate that ESM effectively enhances nerve regeneration and promotes functional recovery in injured sciatic nerve of rat.

  2. Histological observation on acellular nerve grafts co-cultured with Schwann cells for repairing defects of the sciatic nerve

    Xiaohong Sun; Jiangyi Tian; Xiaojie Tong; Xu Zhang; Zheng He

    2006-01-01

    myeline sheath were observed under electron microscope. ② The images were processed with the Mias-1000 imaging analytical system to calculate the number of myelinated nerve fibers, and the thickness of myeline sheath.RESULTS: All the 24 Wistar rats were involved in the analysis of results. ① Results observed under transmission electron microscope: The regenerated myelinated nerve fibers in the group of acellular nerve grafts with Schwann cells were more even than those in the group of acellular nerve grafts, the number of myelinated nerve fibers and thickness of myelin sheath were close to those in the allografts group (P > 0.05),but significantly different from those in the group of acellular nerve grafts (P < 0.05). ② Results observed under scanning electron microscope: A great amount of Schwann cells with two polars were observed in the group of grafts with Schwann cells, the feature of cultured Schwann cells showed shoulder by shoulder,head to head. ③ The number of myelinated nerve fibers and thickness of myelin sheath analyzed by Mias-1000 imaging system in the group of acellular nerve grafts with Schwann cells were close to those in the autografts group (P > 0.05), but significantly different from those in the group of acellular nerve grafts (P < 0.05).CONCLUSION: Host axonal regeneration is significantly increased after implant of acellular nerve grafts.Acellular nerve grafts with Schwann cells offers a novel approach for repairing the gap of nerve defect.

  3. Repairing Peripheral Nerves: Is there a Role for Carbon Nanotubes?

    Oprych, Karen M; Whitby, Raymond L D; Mikhalovsky, Sergey V; Tomlins, Paul; Adu, Jimi

    2016-06-01

    Peripheral nerve injury continues to be a major global health problem that can result in debilitating neurological deficits and neuropathic pain. Current state-of-the-art treatment involves reforming the damaged nerve pathway using a nerve autograft. Engineered nerve repair conduits can provide an alternative to the nerve autograft avoiding the inevitable tissue damage caused at the graft donor site. Commercially available nerve repair conduits are currently only considered suitable for repairing small nerve lesions; the design and performance of engineered conduits requires significant improvements to enable their use for repairing larger nerve defects. Carbon nanotubes (CNTs) are an emerging novel material for biomedical applications currently being developed for a range of therapeutic technologies including scaffolds for engineering and interfacing with neurological tissues. CNTs possess a unique set of physicochemical properties that could be useful within nerve repair conduits. This progress report aims to evaluate and consolidate the current literature pertinent to CNTs as a biomaterial for supporting peripheral nerve regeneration. The report is presented in the context of the state-of-the-art in nerve repair conduit design; outlining how CNTs may enhance the performance of next generation peripheral nerve repair conduits. PMID:27027923

  4. Facial nerve identification with fluorescent dye in rats.

    de Melo, Giulianno Molina; Cervantes, Onivaldo; Covolan, Luciene; Baptista, Heloisa Allegro; Ferreira, Elenn Soares; Abrahao, Marcio

    2016-02-01

    PURPOSE The parotidectomy technique still has an elevated paresis and paralysis index, lowering patient life's quality. The correct identification of the facial nerve can prevent nerve damage. Fluorescent dye identifies nerves in experimental studies but only few articles focused its use on facial nerve study in parotidectomies. We aimed to stain the rat facial nerve with fluorescent dye to facilitate visualization and dissection in order to prevent injuries. METHODS Forty adult male Wistar rats were submitted to facial injection of saline solution (Gsf-control group, 10) or fluorescent dye solution (Gdye group, 30) followed by parotidectomy preserving the facial nerve, measuring the time for localization and facility of localization (LocTime and LFN). Nerve function was assessed using the Vibrissae Movements (PMV) and Eyelid Closure Motion (PFP) scores. RESULTS Nerve localization was faster in Gdye group, with 83% Easy LFN rate. The Gdye group presented with low nerve injury degree and better PMV and PFP scores, with high sensitivity and accuracy. CONCLUSIONS This experimental method of facial nerve fluorescence was effective for intraoperative nerve visualization, identification and preservation. The technique may be used in future facial nerve studies, translated to humans, contributing to the optimization of parotid surgery in the near future. PMID:26959618

  5. Cranial nerve palsies in childhood.

    Lyons, C J; Godoy, F; ALQahtani, E

    2015-02-01

    We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the globe in adduction related to the innervation of the lateral rectus by the III nerve causing co-contraction in adduction. Clinical features that may be of concern in adulthood may not be relevant in childhood; whereas the presence of mydriasis in III palsy suggests a compressive aetiology in adults, this is not the case in children. However, the frequency of associated CNS abnormalities in III palsy and the risk of tumour in VI palsy can be indications for early neuroimaging depending on presenting features elicited through a careful history and clinical examination. The latter should include the neighbouring cranial nerves. We discuss the impact of our evolving knowledge of congenital cranial dysinnervation syndromes on this field. PMID:25572578

  6. Preoperative transcutaneous electrical nerve stimulation for localizing superficial nerve paths.

    Natori, Yuhei; Yoshizawa, Hidekazu; Mizuno, Hiroshi; Hayashi, Ayato

    2015-12-01

    During surgery, peripheral nerves are often seen to follow unpredictable paths because of previous surgeries and/or compression caused by a tumor. Iatrogenic nerve injury is a serious complication that must be avoided, and preoperative evaluation of nerve paths is important for preventing it. In this study, transcutaneous electrical nerve stimulation (TENS) was used for an in-depth analysis of peripheral nerve paths. This study included 27 patients who underwent the TENS procedure to evaluate the peripheral nerve path (17 males and 10 females; mean age: 59.9 years, range: 18-83 years) of each patient preoperatively. An electrode pen coupled to an electrical nerve stimulator was used for superficial nerve mapping. The TENS procedure was performed on patients' major peripheral nerves that passed close to the surgical field of tumor resection or trauma surgery, and intraoperative damage to those nerves was apprehensive. The paths of the target nerve were detected in most patients preoperatively. The nerve paths of 26 patients were precisely under the markings drawn preoperatively. The nerve path of one patient substantially differed from the preoperative markings with numbness at the surgical region. During surgery, the nerve paths could be accurately mapped preoperatively using the TENS procedure as confirmed by direct visualization of the nerve. This stimulation device is easy to use and offers highly accurate mapping of nerves for surgical planning without major complications. The authors conclude that TENS is a useful tool for noninvasive nerve localization and makes tumor resection a safe and smooth procedure. PMID:26420473

  7. Neurotization of oculomotor, trochlear and abducent nerves in skull base surgery

    李世亭; 潘庆刚; 刘宁涛; 刘忠; 沈峰

    2003-01-01

    Objective To anatomically reconstruct the oculomotor nerve, trochlear nerve, and abducent nerve by skull base surgery. Methods Seventeen cranial nerves (three oculomotor nerves, eight trochlear nerves and six abducent nerves) were injured and anatomically reconstructed in thirteen skull base operations during a period from 1994 to 2000. Repair techniques included end-to-end neurosuture or fibrin glue adhesion, graft neurosuture or fibrin glue adhesion. The relationships between repair techniques and functional recovery and the related factors were analyzed.Results Functional recovery began from 3 to 8 months after surgery. During a follow-up period of 4 months to 6 years, complete recovery of function was observed in 6 trochlear nerves (75%) and 4 abducent nerves (67%), while partial functional recovery was observed in the other cranial nerves including 2 trochlear nerves, 2 abducent nerves, and 3 oculomotor nerves.Conclusions Complete or partial functional recovery could be expected after anatomical neurotization of an injured oculomotor, trochlear or abducent nerve. Our study demonstrated that, in terms of functional recovery, trochlear and abducent nerves are more responsive than oculomotor nerves, and that end-to-end reconstruction is more efficient than graft reconstruction. These results encourage us to perform reconstruction for a separated cranial nerve as often as possible during skull base surgery.

  8. Effects of subcutaneous implant of peripheral nerve allograft on the regeneration of defected sciatic nerve

    Mingtang Gao; Dianming Jiang; Hong An

    2006-01-01

    antegradely at the nerve defect on the left side with 11/0 nylon line. Twelve rats in autologous nerve grafting group underwent a 10 mm sciatic nerve defect incision on the right thigh and implant of fresh sciatic nerve from left thigh. The incision on the left thigh was repaired in situ. ②2,4,8 and 14 weeks after grafting, the nerve specimen of anastomosis segment was observed under optical microscope. Fourteen weeks after grafting, the ultrathin section of distal sciatic nerve was observed under transmission electron microscope. The number and size of regenerated axons at the cross section of anastomosis of proximal and distal sciatic nerve were analyzed with biomedical image analysis system. Neuroelectrophysiological change of in vivo sciatic nerve was detected with myoelectricity scanner. ③ t test was used in the comparison of difference of measurement data.MAIN OUTCOME MEASURES: ① Observation of anastomosis part of sciatic nerve under optical and electron microscopes in the two groups. ② Comparison of motor nerve conduction velocity, latent period and action potential peak as well as the number and size of cross-section of anastomosis part of proximal and distal sciatic nerve between two groups.RESULTS: ①Observation under optical microscope:Two weeks after grafting, neve axon of repaired region broke and medullary sheath denatured in the allogenic nerve grafting group and autologous nerve grafting group. At the same time, vascular engorgement and a little lymphocytes infiltration were found in the autologous nerve grafting group, but those were found worsened in the allogenic nerve grafting group. Four weeks after grafting, the intensity of the inflammatory reaction was similar between two groups, some collagen fibers at the proximal end proliferated; 8 weeks after grafting, the inflammatory reaction ended basically and the collagen fibers proliferated obviously in the two groups. ② Observation under electron microscope:Fourteen weeks after grafting, the

  9. 21 CFR 884.6190 - Assisted reproductive microscopes and microscope accessories.

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction.... Assisted reproduction microscopes and microscope accessories (excluding microscope stage warmers, which are classified under assisted reproduction accessories) are optical instruments used to enlarge images of...

  10. Chemoattractive capacity of different lengths of nerve fragments bridging regeneration chambers for the repair of sciatic nerve defects

    Jiren Zhang; Yubo Wang; Jincheng Zhang

    2012-01-01

    A preliminary study by our research group showed that 6-mm-long regeneration chamber bridging is equivalent to autologous nerve transplantation for the repair of 12-mm nerve defects.In this study,we compared the efficacy of different lengths (6,8,10 mm) of nerve fragments bridging 6-mm regeneration chambers for the repair of 12-mm-long nerve defects.At 16 weeks after the regeneration chamber was implanted,the number,diameter and myelin sheath thickness of the regenerated nerve fibers,as well as the conduction velocity of the sciatic nerve and gastrocnemius muscle wet weight ratio,were similar to that observed with autologous nerve transplantation.Our results demonstrate that 6-,8-and 10-mm-long nerve fragments bridging 6-mm regeneration chambers effectively repair 12-mm-long nerve defects.Because the chemoattractive capacity is not affected by the length of the nerve fragment,we suggest adopting 6-mm-long nerve fragments for the repair of peripheral nerve defects.

  11. Beneficial effects of treadmill training in experimental diabetic nerve regeneration

    Tais Malysz

    2010-01-01

    Full Text Available OBJECTIVES: We investigated the effects of treadmill training (10 weeks on hindlimb motor function and nerve morphometric parameters in diabetic rats submitted to sciatic nerve crush. MATERIALS AND METHOD: Wistar rats (n = 64 were divided into the following groups: non-diabetic; trained non-diabetic; non-diabetic with sciatic nerve crush; trained non-diabetic with sciatic nerve crush; diabetic; trained diabetic; diabetic with sciatic nerve crush or trained diabetic with sciatic nerve crush. Diabetes was induced by streptozotocin injection (50 mg/kg, iv. Hindlimb motor function was evaluated weekly by assessing sciatic functional indices, and the proximal and distal portions of the sciatic nerve were used for morphometric analysis. RESULTS: At 13 weeks post-injury, the distal nerve portion of all injured groups and the proximal nerve portion of the diabetic with sciatic nerve crush group presented altered morphometric parameters such as decreased myelinated fiber diameter (~7.4 + 0.3μm vs ~4.8 + 0.2μm, axonal diameter (~5 + 0.2μm vs ~3.5 + 0.1μm and myelin sheath thickness (~1.2 + 0.07μm vs ~0.65 + 0.07μm and an increase in the percentage of area occupied by endoneurium (~28 + 3% vs ~60 + 3%. In addition, in the non-diabetic with sciatic nerve crush group the proximal nerve portion showed a decreased myelinated fiber diameter (7.4+0.3μm vs 5.8 + 0.3μm and myelin sheath thickness (1.29 + 0.08μm vs 0.92 + 0.08μm. The non-diabetic with sciatic nerve crush, trained non-diabetic with sciatic nerve crush, diabetic with sciatic nerve crush and trained diabetic with sciatic nerve crush groups showed normal sciatic functional index from the 4th,4th,9th and 7th week post-injury, respectively. Morphometric alterations in the proximal nerve portion of the diabetic with sciatic nerve crush and non-diabetic with sciatic nerve crush groups were either prevented or reverted to values similar to the non-diabetic group by treadmill training. CONCLUSION

  12. Antidromic Atrioventricular Reciprocating Tachycardia Using a Concealed Retrograde Conducting Left Lateral Accessory Pathway.

    Gonzalez, Jaime E; Zipse, Matthew M; Nguyen, Duy T; Sauer, William H

    2016-03-01

    Atrioventricular reciprocating tachycardia is a common cause of undifferentiated supraventricular tachycardia. In patients with manifest or concealed accessory pathways, it is imperative to assess for the presence of other accessory pathways. Multiple accessory pathways are present in 4% to 10% of patients and are more common in patients with structural heart disease. In rare cases, multiple accessory pathways can act as the anterograde and retrograde limbs of the tachycardia. PMID:26920167

  13. Retrobulbar diameter of optic nerve in glaucoma

    Stefanović Ivan

    2009-01-01

    Full Text Available Introduction. The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO and measuring of its retrobulbar diameter. With B-scan, by Schraeder's method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc. Objective. In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part. Methods. There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc. Results. In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r=0.109; p>0.05. Conclusion. In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values, even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.

  14. Forearm soft tissue mass caused by an accessory muscle

    Lopez Milena, G.; Ruiz Santiago, F.; Canadillas Barea, L. [Dept. of Radiology, University Hospital, Granada (Spain); Chamorro Santos, C. [Dept. of Pathology, University Hospital, Granada (Spain)

    2001-08-01

    We present a case of forearm soft tissue mass caused by an accessory muscle, distal and deep to flexor carpi ulnaris muscle. Imaging studies, mainly magnetic resonance and ultrasound, allow a specific diagnosis, and obviate unnecessary surgery. In this case, the symptoms associated with ulnar compression led to surgery and confirmed the preoperative diagnosis. (orig.)

  15. 21 CFR 878.4350 - Cryosurgical unit and accessories.

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4350 Cryosurgical unit... to destroy tissue during surgical procedures by applying extreme cold. (2) Cryosurgical unit with a... and accessories is a device intended to destroy tissue during surgical procedures,...

  16. 21 CFR 876.4890 - Urological table and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological table and accessories. 876.4890 Section 876.4890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4890 Urological table...

  17. 21 CFR 876.5130 - Urological catheter and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological catheter and accessories. 876.5130 Section 876.5130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5130...

  18. Cancer of the accessory breast - a case report

    Breast neoplasm may develop in ectopically located glandular tissue. This paper presents an interesting and rare case of a 50-year-old female who despite regular mammography screening examination developed an invasive accessory breast cancer. Clinical examination revealed a 2 cm - tumour localized 4 cm below the left infra mammary fold. The lesion was immobile, the skin and the atrophic nipple were retracted, the tumour infiltrated the thoracic wall. Oligo biopsy and additional examinations showed an invasive stage IIIB ductal breast cancer (Bloom II, G-2). The receptor status was: ER(+), PGR(+), HER2(-). The increased level of cancer antigen 15.3 was found. The patient was submitted to pre-operative chemotherapy. She also underwent surgery and subsequently post-operative chemotherapy and radiotherapy. On the basis of the presented case, it could be concluded that the accessory mammary glands are out of the image of screening breast examinations. Accessory breast cancer is usually diagnosed by clinical examination and ultrasonography. Preventive resection of accessory breast in women at high risk of developing breast cancer can be considered as the treatment of choice in most patients. (authors)

  19. Accessory thyroid in the anterior mediastinum: case report

    A case of accessory thyroid in the anterior mediastinum, physically separated from the thyroid gland, is reported. The mediastinal thyroid was incidentally discovered during the preoperative evaluation of a patient with breast carcinoma. The extreme rarity of the case is outlined

  20. [Radiofrequency ablation of accessory pathways in pre-excitation syndrome].

    Pfeiffer, D; Tebbenjohanns, J; Jung, W; Manz, M; Lüderitz, B

    1993-04-16

    Various parameters relating to the radio-frequency ablation of accessory pathways were studied in 53 patients (27 males, 26 females: mean age 38.5 [14-64] years) with a history of paroxysmal tachycardia (over 1 month to 50 years), shown to be caused by an accessory pathway (Wolff-Parkinson-White syndrome). In all patients the following values were obtained: (1) number of procedures necessary to achieve permanent blockage of the accessory pathway (1-4); (2) duration of each procedure (45-420 min); (3) duration of fluoroscopy (5-102 min); (4) number of necessary radio-frequency applications (1-48); and (5) cumulative energy per procedure. To ablate left-lateral pathways (n = 10) required fewer procedures, shorter duration per procedure, shorter fluoroscopy time, fewer current applications and less total energy than coagulation of right-sided pathways (n = 10). Those various parameters were greatest for ablation of septal and para-septal pathways (n = 9). Pathways which conducted only retrogradely (n = 15) were more difficult to ablate than those with anterograde conduction (n = 38). There were two complications. In one case a tension pneumothorax occurred after faulty puncture of the subclavian vein; in the other, the left ventricle was perforated causing an acute tamponade which required pericardiocentesis with subsequent suture closure of the perforation. It is concluded that, in principle, all accessory pathways, regardless of their conduction potential and site, can be ablated by a radio-frequency current. PMID:8472633

  1. 76 FR 585 - In the Matter of Certain Handbags, Luggage, Accessories and Packaging Thereof; Notice of...

    2011-01-05

    ... COMMISSION In the Matter of Certain Handbags, Luggage, Accessories and Packaging Thereof; Notice of... States after importation of certain handbags. luggage, accessories and packaging thereof by reason of... certain handbags, luggage, accessories and packaging thereof that infringe the `594 trademark; the...

  2. Male accessory gland secretory protein polymorphism in natural populations of Drosophila nasuta nasuta and Drosophila sulfurigaster neonasuta

    K. Ravi Ram; S. R. Ramesh

    2007-12-01

    Male accessory gland secretory protein polymorphism was analysed in natural populations of Drosophila nasuta nasuta and D. sulfurigaster neonasuta for the first time, using SDS-PAGE to score polymorphism of these proteins in 2788 individuals of D. n. nasuta and 2232 individuals of D. s. neonasuta from 12 different populations from southern India. A total of 25 and 18 variant protein phenotypes were identified in D. n. nasuta and D. s. neonasuta, respectively. Protein fractions of group III were more polymorphic than those from groups I and II. The results show that accessory gland secretory proteins show high levels of polymorphism, irrespective of species or habitat. Moreover, we have used the variation in the accessory gland proteins to assess the extent of divergence between the species and to infer their population structure. The study suggests that though both D. n. nasuta and D. s. neonasuta belong to the same subgroup, they differ in population structure, as far as accessory gland protein polymorphism is concerned.

  3. A diagnostic study of muco-pyocele of the posterior nasal accessory sinuses accompanied by visual disturbances

    Two cases of muco-pyocele of the posterior nasal accessory sinuses were reported. The diagnostic procedure of the disease was considered with special reference to a clinical evaluation of ''computed tomography''. The following conclusions were drawn: 1) Muco-pyocele of the posterior nasal accessory sinuses is one of the most clinically significant disease causing visual disturbances. An early establishment of both diagnosis and surgical treatment is of prime importance for a satisfactory results. 2) Conventional ophthalmological examinations, plain sinus and skull films, tomograms of the region of the posterior nasal accessory sinuses and angiograms of the internal carotid artery and the orbital vessels may be useful for making differential diagnosis of that pathologic condition, though these may require considerable experiences. 3) The computed tomographic scanning (CT) is very valuable in the investigation of the posterior paranasal and the surrounding lesions, since the CT scan is capable of demonstrating whether these lesions are arising from, or extending into the posterior nasal accessory sinuses. The CT scan may be helpful to identify muco-pyocele and to differentiate it from many other diseases such as hypophyseal tumor or orbital lesions on the basis of detailed findings. (author)

  4. High Ulnar Nerve Injuries: Nerve Transfers to Restore Function.

    Patterson, Jennifer Megan M

    2016-05-01

    Peripheral nerve injuries are challenging problems. Nerve transfers are one of many options available to surgeons caring for these patients, although they do not replace tendon transfers, nerve graft, or primary repair in all patients. Distal nerve transfers for the treatment of high ulnar nerve injuries allow for a shorter reinnervation period and improved ulnar intrinsic recovery, which are critical to function of the hand. PMID:27094893

  5. 电生理法对豚鼠副嗅球功能分区的显示%Functional subdivisions of the guinea pig accessory olfactory bulb revealed by electrophysiology

    余青松; 须贝外喜夫

    2001-01-01

    目的:探讨豚鼠副嗅球(AOB)是否存在多个功能分区。方法:在豚鼠副嗅球矢状位切片上,将双钨电极插入副嗅球前部或后部的犁鼻神经纤维层(VNL),以单个方波刺激传入神经纤维,用玻璃微电极记录AOB前部或后部外橄状层(EPL)细胞外场电位。结果:电刺激VNL,可在EPL记录到典型的衰减性场电位,且后EPL记录到的场电位的持续时间较前部分明显延长。刺激前VNL仅在前EPL记录到场电位,而刺激后VNL只在后EPL记录到场电位。结论:豚鼠副嗅球可分为前后两个亚区,两区存在解剖学上的差异,说明在犁鼻系统中至少存在两个不同的传入-传出通路。%Objective:To elucidate possible functional subdivisions in the guinea pig accessory olfactory bulb.Method:The guinea pig accessory olfactory bulbs were cut in sagittal slice.Bipolar tungsten electrodes were inserted into anterior or posterior vomeronasal nerve layers and single square-pulses were delivered through the eletrodes to activate afferent fibres.Glass microelectrodes were used to record extracellular field potentials of anterior or posterior external plexiform layers.Result:A single shook of the VNL provoked a characteristic damped oscillatory field potential and the oscillation in the pAOB was more distinct in wave form and longer in duration than those in the aAOB.The stimulation of anterior VNL elicited field potentials exelusively in the anterior region of EPL,whereas shocks to the posterior VNL provoked oscillatory responses only within the posterior EPL.Conclusion:The accessory olfactory bulb in the guinea-pig is distinctly segregated into the anterior and posterior subdivisions and an anatomical boundary exists in both regions.The results suggested that there are at least two different input-output pathways in vomeronasal systems.

  6. Bilateral variant of sciatic nerve exhibiting intra-pelvic division

    Rejeena P Raj, Kunjumon PC, More Anju B

    2014-04-01

    Full Text Available Context (background: In case of high division of the sciatic nerve in the pelvis its, common peroneal component may pierce the Piriformis muscle. This anatomical variant can explain many clinical findings. Aims: Its objective is to report a case of high division of the sciatic nerve in order to contribute towards better anatomical understanding of the gluteal region. Methods and Material: Routine undergraduate dissection of a male cadaver revealed bilateral variation in sciatic nerve. Results: Sciatic nerve is dividing into tibial and common peroneal components in the pelvis. Common peroneal component is piercing through the piriformis muscle. Tibial component is emerging between piriformis and superior gemelli muscle. Conclusions: Sciatic nerve variation can lead to a Piriformis muscle syndrome, inadvertent injury during operations in the gluteal region, failure of sciatic nerve block and/or sciatic neuropathy. The differences in routes of these two nerve components can explain them.

  7. Poly(lactic-co-glycolic acid) conduit for repair of injured sciatic nerve A mechanical analysis*

    Tao Yu; Changfu Zhao; Peng Li; Guangyao Liu; Min Luo

    2013-01-01

    Tensile stress and tensile strain directly affect the quality of nerve regeneration after bridging nerve defects by poly(lactic-co-glycolic acid) conduit transplantation and autogenous nerve grafting for sciatic nerve injury. This study col ected the sciatic nerve from the gluteus maximus muscle from fresh human cadaver, and established 10-mm-long sciatic nerve injury models by removing the ischium, fol owing which poly(lactic-co-glycolic acid) conduits or autogenous nerve grafts were transplanted. Scanning electron microscopy revealed that the axon and myelin sheath were torn, and the vessels of basilar membrane were obstructed in the poly(lactic-co-glycolic acid) con-duit-repaired sciatic nerve fol owing tensile testing. There were no significant differences in tensile tests with autogenous nerve graft-repaired sciatic nerve. Fol owing poly(lactic-co-glycolic acid) conduit transplantation for sciatic nerve repair, tensile test results suggest that maximum tensile load, maximum stress, elastic limit load and elastic limit stress increased compared with autogen-ous nerve grafts, but elastic limit strain and maximum strain decreased. Moreover, the tendencies of stress-strain curves of sciatic nerves were similar after transplantation of poly(lactic-co-glycolic acid) conduits or autogenous nerve grafts. Results showed that after transplantation in vitro for sciatic nerve injury, poly(lactic-co-glycolic acid) conduits exhibited good intensity, elasticity and plasticity, indicating that poly(lactic-co-glycolic acid) conduits are suitable for sciatic nerve injury repair.

  8. US and MR imaging of peripheral nerves in leprosy

    Objective. To analyze peripheral nerves with ultrasonography (US) and magnetic resonance imaging (MR) in leprosy and assess the role of imaging in leprosy patients. Results. Leprosy nerves were classified into three groups based on imaging appearance: group I consisted of 17 normal-appearing nerves; group II, of 30 enlarged nerves with fascicular abnormalities; group III, of 11 nerves with absent fascicular structure. Group II nerves were from patients subjected to reversal reactions; 75% of patients with group III nerves had a history of erythema nodosum leprosum. Nerve compression in osteofibrous tunnels was identified in 33% of group II and 18% of group III nerves. Doppler US and MR imaging were 74% and 92% sensitive in identifying active reactions, based on detection of endoneural color flow signals, long T2 and Gd enhancement. In 64% of cases, follow-up studies showed decreased color flow and Gd uptake after steroids and decompressive surgery.Conclusions. US and MR imaging are able to detect nerves abnormalities in leprosy. Active reversal reactions are indicated by endoneural color flow signals as well as by an increased T2 signal and Gd enhancement. These signs would suggest rapid progression of nerve damage and a poor prognosis unless antireactional treatment is started. (orig.)

  9. Diabetic Nerve Problems

    ... at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get ... you change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. ...

  10. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Bai, Lu; Han, Yan-ni; Zhang, Wen-tao; Huang, Wei; Zhang, Hong-lei

    2015-01-01

    Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Patients received oral vitamin B12 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory function in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months. PMID:25788928

  11. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Lu Bai

    2015-01-01

    Full Text Available Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Patients received oral vitamin B 12 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory function in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months

  12. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Lu Bai; Yan-ni Han; Wen-tao Zhang; Wei Huang; Hong-lei Zhang

    2015-01-01

    Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Pa-tients received oral vitamin B12 and methylcobalamin. We examined ifnal follow-up data of 17 patients, including seven with sural nerve injury, ifve with superifcial peroneal nerve injury, and ifve with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no signiifcant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory func-tion in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months.

  13. Bridging sciatic nerve gap using tissue-engineered nerves constructed with neural tissue-committed stem cells derived from bone marrow

    Zhiying Zhang; Congli Ren; Chuansen Zhang; Fang Liu; Liang Li

    2009-01-01

    inoculated, was used to bridge the sciatic nerve gap.MAIN OUTCOME MEASURES: Following surgery, sciatic nerve functional index and electrophysiology functions were evaluated for nerve conduction function, including conduction latency, conduction velocity, and action potential peak. Horseradish peroxidase (HRP, 20%) was injected into the gastrocnemius muscle to retrogradely label the L4 and L5 nerve ganglions, as well as neurons in the anterior horn of the spinal cord, in the three groups. Positive expression of nestin, NSE, GFAP, and S-100 were determined using an immunofluorescence double-labeling method.RESULTS: NTCSCs differentiated into neuronal-like cells and glial-like cells within 12 weeks after NTCSC engineered nerve transplantation. HRP retrograde tracing displayed a large amount of HRP-labeted neurons in L4-5 nerve ganglions, as well as the anterior horn of the spinal cord, in both the autograft nerve transplantation and the NTCSC engineered nerve transplantation groups. However, few HRP-labeled neurons were detected in the blank nerve scaffold transplantation group. Nerve bridges in the autograft nerve transplantation and NTCSC engineered nerve transplantation groups exhibited similar morphology to normal nerves. Neither fractures or broken nerve bridges nor neuromas were found after bridging the sciatic nerve gap with NTCSCs-inoculated acellular nerve graft, indicating repair. Conduction latency, action potential, and conduction velocity in the NTCSC engineered nerve transplantation group were identical to the autograft nerve transplantation group (P>0.05), but significantly different from the blank nerve scaffold transplantation group (P<0.05). CONCLUSION: NTCSC tissue-engineered nerves were able to repair injured nerves and facilitated restoration of nerve conduction function, similar to autograff nerve transplantation.

  14. Optic nerve oxygen tension

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T;

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  15. NATURAL FIBER REINFORCED POLYMER COMPOSITES FOR AUTOMOBILE ACCESSORIES

    D. Chandramohan

    2013-01-01

    Full Text Available The invention is an effort to utilize the advantages offered by renewable resources for the development of composite materials based on polymer and particles of natural fibers for Conservation of natural resources. In this research, natural fibers like Sisal (Agave sisalana, Banana (Musa sepientum and Roselle (Hibiscus sabdariffa, Sisal and banana (hybrid, Roselle and banana (hybrid and Roselle and sisal (hybrid are fabricated with bio epoxy resin using molding method. The applications of these materials require a sustainable approach to creating green products. Green materials are very important to form environment friendly from renewable resources and decrease the use of petroleum based chemicals. Nowadays natural fibers form an interesting alternative for the most widely applied fibre in the composite technology, glass. The use of fibers like sisal, Roselle and banana in this industry so far is small since availability of a durable semi-finished product with constant quality is often a problem. Recent research and development have shown that these aspects can be improved considerably. Knowing that natural fibers are cheap and have a better stiffness per weight than glass, which results in lighter components, the grown interest in natural fibers is clear. Secondly, the environmental impact is smaller since the natural fibre can be thermally recycled and fibers come from a renewable resource. Their moderate mechanical properties restrain the fibers from using them in high-tech applications, but for many reasons they can compete with glass fibers. In this paper the optimum mixing of fiber and resin is achieved by using Taguchi method. In this work, tensile and hardness of Sisal and banana (hybrid, Roselle and banana (hybrid and Roselle and sisal (hybrid composite at dry and wet conditions were studied. Hardness test were conducted using Brinell hardness testing machine. In this work micro structure of the specimens are scanned by the Scanning

  16. Nerve regeneration following implantation of axotomized nerves pretreated with gamma radiation

    Xinyuan Wang; Dehai Chang; Shihua Xie; Chunming Han; Jinsheng Sheng

    2008-01-01

    BACKGROUND: It has been shown that irradiation to the neurolemma can reduce immunogenicity. However, it is still poorly understood whether the degenerated nerve can affect peripheral nerve regeneration.OBJECTIVE: To observe the effect of radiation-damaged nerve transplantation on functional recovery of the peripheral nerve.DESIGN, TIME AND SETTING: Self-control animal trial was performed at the Experimental Center of Orthopedics, Tangdu Hospital of Fourth Military Medical University from January to October 2005.MATERIALS: Fifty-four healthy, Chinese rabbits, irrespective of gender, were randomly divided into experimental (n = 36) and control (n = 18) groups. A60 Co γ -radiation machine and NDI-200 nerve electromyograph were provided by the Experimental Center of Orthopedics, Tangdu Hospital of Fourth Military Medical University.METHODS: A median incision was made in the posterior right thigh of rabbits after abdominal anesthesia. A 30-mm segment of sciatic nerve was excised from the inferior margin of the piriform muscle to the tibiofibular intersection. The sciatic nerve in the experimental group was sterilely radiated with 350 Gy for 9.5 minutes. The damaged nerve segment was then re-transplanted. In the control group, the sciatic nerve was re-transplanted directly following excision. Nerve conduction velocity was determined at 4, 6, and 8 months post-surgery.MAIN OUTCOME MEASURES: Functional assessments, such as gait, nutritional status of skin on dorsum of foot, toe spreading reflex, and foot holding, were made between 1 and 180 days post-surgery. The common peroneal nerve and tibial nerve reflexes under clamping were observed at 4, 6, and 8 months post-surgery to evaluate functional restoration of the peripheral nerve. Eiectromyogram was performed to observe nerve conduction velocity.RESULTS: From postoperative days 1 to 26, the limbs that were transplanted with irradiated nerve exhibited dragged walking, foot drop, sole ulcers, depilation, self

  17. Genetic instability in nerve sheath cell tumors

    Rogatto, Silvia Regina; Casartelli, Cacilda; Rainho, Claudia Aparecida; Barbieri Neto, J

    1995-01-01

    After in vitro culture, we analyzed cytogenetically four acoustic nerve neurinomas, one intraspinal neurinoma and one neurofibroma obtainedfrom unrelated patients. Monosomy of chromosomes 22 and 16 was an abnormality common to all cases, followed in frequency by loss of chromosomes 18 (three cases......, reflected by the presence of polyploid cells with inconsistent abnormalities, endoreduplications and telomeric associations resulting in dicentric chromosomes. It is probable that these cytogenetic abnormalities represent some kind of evolutionary advantage for the in vitro progression of nerve sheath...

  18. Sciatic Nerve Injury Associated with Acetabular Fractures

    Issack, Paul S; Helfet, David L

    2008-01-01

    Sciatic nerve injuries associated with acetabular fractures may be a result of the initial trauma or injury at the time of surgical reconstruction. Patients may present with a broad range of symptoms ranging from radiculopathy to foot drop. There are several posttraumatic, perioperative, and postoperative causes for sciatic nerve palsy including fracture–dislocation of the hip joint, excessive tension or inappropriate placement of retractors, instrument- or implant-related complications, hete...

  19. Stabilized subcutaneous transposition of the ulnar nerve

    Hashiguchi, Hiroshi; Ito, Hiromoto; Sawaizumi, Takuya

    2003-01-01

    We treated 50 patients (average age 47.9 years) with a stabilized subcutaneous transposition of the ulnar nerve. The average follow-up period was 42.4 months. The indication was cubital tunnel syndrome in 19 patients and injuries around the elbow in 31 patients. Postoperatively, satisfactory results were obtained in all the patients, and there was no complication or aggravation of the preoperative symptoms. None of the patients experienced slipping back of the nerve to the cubital tunnel. In ...

  20. 带蒂筋膜管的耳大神经移植治疗面神经缺失性损伤%Treating defective damage of facial nerve with great auricular nerve grafting covered by pediculated fascial tube

    蒋立新

    2002-01-01

    Objective To study the curative effect of grafting great auricular nerve with pediculated fascial tube in defective damage of facial nerve.Method All the patients in the study were treated by grafting great auricular nerve which was covered by pediculated fascial tube near facial nerve trunk.Result The 3 otogenic fascial paralysis patients had grade III recovery of facial nerve function(30% ~ 38% ) 2.0 to 2.5 years after the nerve grafting operation; 2 post- traumatic facial paralysis patients had grade II recovery of facial nerve function (69% ~ 71% ) 2.5 to 3.5 years after the nerve grafting operation.Conclusion The grafting of pediculated fascial tube surrounded great auricular nerve can provide a biological environment with excellent blood supply for the plerosis and regeneration of nerves and can accelerate the functional recovery of nerves after the nerve grafting.

  1. Study on reduction of accessory horsepower requirements. Eleventh quarterly progress report

    1977-04-30

    Progress in a program for optimizing automotive accessory systems to achieve greater vehicle fuel economy and improved accessory performance is reported. The major technical accomplishments during this reporting period were: all candidate advanced air conditioning concepts were evaluated; advanced air conditioning and hybrid accessory drive component trade-studies were completed; improved alternator, water pump and power steering system concepts were evaluated; the vehicle integrated accessory systems trade-study was completed; and the technical summary report for the Phase V Automotive Accessory Systems Optimization Program was initiated. (LCL)

  2. Nerve Conduction Studies and Electromyography

    Keyes, Robert D.

    1990-01-01

    Nerve conduction studies and electromyography can aid in the diagnosis of peripheral nervous system disease. The author reviews various techniques used during electromyography and nerve conduction studies. He reviews briefly peripheral nerve and muscle neuroanatomy and neurophysiology. The author defines terms used in nerve conduction studies and electromyography and relates terminology to the underlying pathophysiology and histopathology. He also reviews briefly typical nerve conduction and ...

  3. In vivo MRI monitoring nerve regeneration of acute peripheral nerve traction injury following mesenchymal stem cell transplantation

    Objective: To assess the continuous process of nerve regeneration in acute peripheral nerve traction injury treated with mesenchymal stem cells (MSCs) transplantation using MRI. Materials and methods: 1 week after acute nerve traction injury was established in the sciatic nerve of 48 New Zealand white rabbits, 5 × 105 MSCs and vehicle alone were grafted to the acutely distracted sciatic nerves each in 24 animals. Serial MRI and T1 and T2 measurements of the injured nerves were performed with a 1.5-T scanner and functional recovery was recorded over a 10-week follow-up period, with histological assessments performed at regular intervals. Results: Compared with vehicle control, nerves grafted with MSCs had better functional recovery and showed improved nerve regeneration, with a sustained increase of T1 and T2 values during the phase of regeneration. Conclusion: MRI could be used to monitor the enhanced nerve regeneration in acute peripheral nerve traction injury treated with MSC transplantation, reflected by a prolonged increase in T1 and T2 values of the injured nerves

  4. In vivo MRI monitoring nerve regeneration of acute peripheral nerve traction injury following mesenchymal stem cell transplantation

    Duan, Xiao-Hui, E-mail: duanxiaohui-128@163.com [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Cheng, Li-Na, E-mail: kobe10716@163.com [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Zhang, Fang, E-mail: xinxin110007@yahoo.com.cn [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Liu, Jun, E-mail: docliujun@hotmail.com [Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Guo, Ruo-Mi, E-mail: guoruomi-521@163.com [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Zhong, Xiao-Mei, E-mail: enough300@yahoo.com.cn [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Wen, Xue-Hua, E-mail: xuehuasuqian@126.com [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China); Shen, Jun, E-mail: junshenjun@hotmail.com [Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong (China)

    2012-09-15

    Objective: To assess the continuous process of nerve regeneration in acute peripheral nerve traction injury treated with mesenchymal stem cells (MSCs) transplantation using MRI. Materials and methods: 1 week after acute nerve traction injury was established in the sciatic nerve of 48 New Zealand white rabbits, 5 × 10{sup 5} MSCs and vehicle alone were grafted to the acutely distracted sciatic nerves each in 24 animals. Serial MRI and T1 and T2 measurements of the injured nerves were performed with a 1.5-T scanner and functional recovery was recorded over a 10-week follow-up period, with histological assessments performed at regular intervals. Results: Compared with vehicle control, nerves grafted with MSCs had better functional recovery and showed improved nerve regeneration, with a sustained increase of T1 and T2 values during the phase of regeneration. Conclusion: MRI could be used to monitor the enhanced nerve regeneration in acute peripheral nerve traction injury treated with MSC transplantation, reflected by a prolonged increase in T1 and T2 values of the injured nerves.

  5. Fracture resistance of structurally compromised premolar roots restored with single and accessory glass or quartz fiber posts

    Farahnaz Sharafeddin

    2014-01-01

    Full Text Available Background: Glass and quartz fiber posts are used in restoration of structurally compromised roots. Accessory fiber posts are recently introduced to enhance the fiber post adaptation. This study evaluated the effectiveness of glass versus quartz accessory fiber posts. Materials and Methods: In this experimental study, 40 mandibular premolar roots with similar dimension (radius of 3.5 ± 0.2 mm and length of 13 ± 0.5 mm were selected and their root canals were flared until 1.5 mm of dentin wall remained. They were randomly assigned to four groups (n = 10 and restored as follows: Exacto glass fiber post (EX, Exacto glass fiber post + 2 Reforpin accessories (EXR, D. T. Light quartz fiber post (DT, and D. T. Light quartz fiber post + 2 Fibercone accessories (DTF. All posts were cemented with Duo-Link resin cement and the cores were built with the particulate filler composite. Following 1-week water storage, specimens were subjected to fracture loads in a universal testing machine. The maximum loads and failure modes were recorded and analyzed with the two-way analysis of variance (ANOVA and Fisher′s exact tests (α = 0.05. Results: The mean fracture resistance values (N were 402.8 (EX, 378.4 (EXR, 400.1 (DT, and 348.5 (DTF. Two-way ANOVA test showed neither reinforcing method (P = 0.094, nor post composition (P = 0.462 had statistically significant differences on fracture resistance of the structurally compromised premolar teeth. Fisher′s exact test also demonstrated no statistically significant difference regarding two variables (P = 0.695. Core fracture was the most common failure mode (62.5%. Conclusion: Glass and quartz fiber posts with or without accessories restored the weakened premolar roots equally.

  6. Optic Nerve Sheath Mechanics in VIIP Syndrome

    Raykin, Julia; Feola, Andrew; Gleason, Rudy; Mulugeta, Lealem; Myers, Jerry; Nelson, Emily; Samuels, Brian; Ethier, C. Ross

    2015-01-01

    Visual Impairment and Intracranial Pressure (VIIP) syndrome results in a loss of visual function and occurs in astronauts following long-duration spaceflight. Understanding the mechanisms that lead to the ocular changes involved in VIIP is of critical importance for space medicine research. Although the exact mechanisms of VIIP are not yet known, it is hypothesized that microgravity-induced increases in intracranial pressures (ICP) drive the remodeling of the optic nerve sheath, leading to compression of the optic nerve which in turn may reduce visual acuity. Some astronauts present with a kink in the optic nerve after return to earth, suggesting that tissue remodeling in response to ICP increases may be taking place. The goal of this work is to characterize the mechanical properties of the optic nerve sheath (dura mater) to better understand its biomechanical response to increased ICP.

  7. Can preoperative MR imaging predict optic nerve invasion of retinoblastoma?

    Purpose: To evaluate the accuracy of pre-operative MRI for the detection of optic nerve invasion in retinoblastoma. Materials and methods: Institutional review board approval and informed consent were waived for this retrospective study. A total of 41 patients were included. Inclusion criteria were histologically proven retinoblastoma, availability of diagnostic-quality preoperative MR images acquired during the 4 weeks before surgery, unilateral retinoblastoma, and normal-sized optic nerve. Two radiologists retrospectively reviewed the MR images independently. Five imaging findings (diffuse mild optic nerve enhancement, focal strong optic nerve enhancement, optic sheath enhancement, tumor location, and tumor size) were evaluated against optic nerve invasion of retinoblastoma. The predictive performance of all MR imaging findings for optic nerve invasion was also evaluated by the receiver operating characteristic curve analysis. Results: Optic nerve invasion was histopathologically confirmed in 24% of study population (10/41). The differences in diffuse mild enhancement, focal strong enhancement, optic sheath enhancement, and tumor location between patients with optic nerve invasion and patients without optic nerve invasion were not significant. Tumor sizes were 16.1 mm (SD: 2.2 mm) and 14.9 mm (SD: 3.6 mm) in patients with and without optic nerve involvement, respectively (P = 0.444). P-Values from binary logistic regression indicated that all five imaging findings were not significant predictors of tumor invasion of optic nerve. The AUC values of all MR imaging findings for the prediction of optic nerve invasion were 0.689 (95% confidence interval: 0.499–0.879) and 0.653 (95% confidence interval: 0.445–0.861) for observer 1 and observer 2, respectively. Conclusion: Findings of MRI in patients with normal-sized optic nerves have limited usefulness in preoperatively predicting the presence of optic nerve invasion in retinoblastoma.

  8. Can preoperative MR imaging predict optic nerve invasion of retinoblastoma?

    Song, Kyoung Doo, E-mail: kdsong0308@gmail.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Eo, Hong, E-mail: rtombow@gmail.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Kim, Ji Hye, E-mail: jhkate.kim@samsung.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Yoo, So-Young, E-mail: sy1131.yoo@samsung.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Jeon, Tae Yeon, E-mail: hathor97.jeon@samsung.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)

    2012-12-15

    Purpose: To evaluate the accuracy of pre-operative MRI for the detection of optic nerve invasion in retinoblastoma. Materials and methods: Institutional review board approval and informed consent were waived for this retrospective study. A total of 41 patients were included. Inclusion criteria were histologically proven retinoblastoma, availability of diagnostic-quality preoperative MR images acquired during the 4 weeks before surgery, unilateral retinoblastoma, and normal-sized optic nerve. Two radiologists retrospectively reviewed the MR images independently. Five imaging findings (diffuse mild optic nerve enhancement, focal strong optic nerve enhancement, optic sheath enhancement, tumor location, and tumor size) were evaluated against optic nerve invasion of retinoblastoma. The predictive performance of all MR imaging findings for optic nerve invasion was also evaluated by the receiver operating characteristic curve analysis. Results: Optic nerve invasion was histopathologically confirmed in 24% of study population (10/41). The differences in diffuse mild enhancement, focal strong enhancement, optic sheath enhancement, and tumor location between patients with optic nerve invasion and patients without optic nerve invasion were not significant. Tumor sizes were 16.1 mm (SD: 2.2 mm) and 14.9 mm (SD: 3.6 mm) in patients with and without optic nerve involvement, respectively (P = 0.444). P-Values from binary logistic regression indicated that all five imaging findings were not significant predictors of tumor invasion of optic nerve. The AUC values of all MR imaging findings for the prediction of optic nerve invasion were 0.689 (95% confidence interval: 0.499–0.879) and 0.653 (95% confidence interval: 0.445–0.861) for observer 1 and observer 2, respectively. Conclusion: Findings of MRI in patients with normal-sized optic nerves have limited usefulness in preoperatively predicting the presence of optic nerve invasion in retinoblastoma.

  9. Case report: Double nerve transfer of the anterior and posterior interosseous nerves to treat a high ulnar nerve defect at the elbow.

    Delclaux, S; Aprédoaei, C; Mansat, P; Rongières, M; Bonnevialle, P

    2014-10-01

    Double neurotization of the deep branch of ulnar nerve (DBUN) and superficial branch of ulnar nerve using the anterior interosseous nerve (AIN) and the recurrent (thenar) branch of the median nerve was first described by Battiston and Lanzetta. This article details the postoperative results after 18 months of a patient who underwent this technique using the posterior interosseous nerve (PIN) instead of the recurrent branch of the median nerve for sensory reconstruction. A 35-year-old, right-handed man suffered major trauma to his right upper limb following a serious motor vehicle accident. One year later, a pseudocystic neuroma of the ulnar nerve was evident on ultrasound examination and MRI. After the neuroma had been resected, the nerve defect was estimated at 8 cm. One and a half years after the initial trauma, with the patient still at M0/S0, we transferred the AIN and PIN onto the deep and superficial branches of the ulnar nerve respectively. Nerve recovery was monitored clinically every month and by electromyography (EMG) every three months initially and then every six months. At 18 months postoperative, 5th digit abduction/adduction was 28 mm. Sensation was present at the base of the 5th digit. The patient was graded M3/S2. Clear re-innervation of the abductor digiti minimi was demonstrated by EMG (motor conduction velocity 50 m/s). Given that the ulnar nerve could not be excited at the elbow, this re-innervation had to be the result of the double nerve transfer. Neurotization of the DBUN using the AIN produces functional results as early as 1 year after surgery. Using PIN for sensory neurotization is easy to perform, has no negative consequences for the donor site, and leads to good recovery of sensation (graded as S2) after 18 months. PMID:25260763

  10. [Biophysics of nerve excitation].

    Kol'e, O R; Maksimov, G V

    2010-01-01

    The studies testifying to the presence of the interrelation between the physiological functions of the organism and physical and chemical processes in nerves are discussed. Changes in some physical and chemical parameters observed both upon elicited rhythmic exaltation of nerves and during the spontaneous rhythmic activity of neurons are analyzed. Upon rhythmic exaltation, a complex of physical and chemical processes is triggered, and reversible structural and metabolic rearrangements at the subcellular and molecular levels occur that do not take place during the generation of a single action potential. Thus, only in conditions of rhythmic exaltation of a nerve, it is possible to reveal those processes that provide exaltation of nerves in the organism. The future possibilities of the investigations combining the biophysical and physiological approaches are substantiated. Characteristic changes in physicochemical parameters are observed in nerves during the generation of a series of action potentials of different frequency and duration ("frequency dependence") under normal physiological conditions, as well as in extreme situations and in nerve pathology. The structural and metabolic rearrangements are directly related to the mode of rhythmic exaltation and proceed both in the course of rhythmic exaltation and after its termination. Participation and the basic components of the nervous fulcrum (an axon, Shwan cell, myelin, subcellular organelles) in the realization of rhythmic exaltation is shown. In the coordination of all processes involved in rhythmic exaltation, the main role is played by the systems of redistribution and transport of intercellular and endocellular calcium. The idea is put forward that myelin of nerve fibers is not only an isolator, but also an "intercellular depot" of calcium and participates in the redistribution of different ions. Thus, the rhythmic excitation is of great importance in the realization of some physiological functions, the

  11. Adenoid Cystic Carcinoma of Accessory Parotid Gland: A Case Report.

    Das, Somdipto; Nayak, Umanath K; Buggavetti, Rahul; Sekhar, Shobana

    2016-05-01

    The accessory parotid gland is salivary gland tissue separated from the main gland at a variable distance. This gland is histologically similar to the main gland, but has a higher incidence of malignant neoplasms than the main gland. Regarding the various malignant neoplasms, studies have shown higher incidences of mucoepidermoid carcinoma, with less than 2% being adenoid cystic carcinoma. We present a case of swelling in the midcheek region that, after clinical examination, was diagnosed as a case of neoplasm of the accessory parotid gland. On the basis of auxiliary investigations including intraoperative frozen section, it was concluded that it was adenoid cystic carcinoma, grade I, and after wide surgical resection, the tumor was removed without undergoing superficial parotidectomy. The patient received postoperative radiotherapy (RT) and was followed for 14 months without any recurrence or substantial facial asymmetry. PMID:26851989

  12. Comparative neuroanatomy of the lateral accessory lobe in the insect brain

    Shigehiro eNamiki

    2016-06-01

    Full Text Available The lateral accessory lobe (LAL mediates signals from the central complex to the thoracic motor centers. The results obtained from different insects suggest that the LAL is highly relevant to the locomotion. Perhaps due to its deep location and lack of clear anatomical boundaries, few studies have focused on this brain region. Systematic data of LAL interneurons are available in the silkmoth. We here review individual neurons constituting the LAL by comparing the silkmoth and other insects. The survey through the connectivity and intrinsic organization suggests potential homology in the organization of the LAL among insects.

  13. Peculiarities of accessory zircon from the carter seamount tuffs (Sierra Leone Rise in the East Atlantic)

    Petrova, V. V.; Skolotnev, S. G.; Chistyakova, N. I.

    2010-03-01

    In volcanic tuffs, dredged during Cruise 23 of the R/V Akademik Nikolaj Strakhov, accessory zircon was found; except for the mineral-forming components, there were ˜2% of ThO2 and 0.75% of Ce2O3 in zircon. During rapid uplift of magmatic masses to the ocean bottom surface, admixture elements isolated into specific minerals. As a result, destruction structures were formed in the rim parts of primary zircon crystals, and the new-formed association of zircon + thorite + cerite + thoriante + baddeleyite appeared.

  14. EST analysis of male accessory glands from Heliconius butterflies with divergent mating systems

    Harrison Richard G

    2008-12-01

    Full Text Available Abstract Background Heliconius butterflies possess a remarkable diversity of phenotypes, physiologies, and behaviors that has long distinguished this genus as a focal taxon in ecological and evolutionary research. Recently Heliconius has also emerged as a model system for using genomic methods to investigate the causes and consequences of biological diversity. One notable aspect of Heliconius diversity is a dichotomy in mating systems which provides an unusual opportunity to investigate the relationship between sexual selection and the evolution of reproductive proteins. As a first step in pursuing this research, we report the generation and analysis of expressed sequence tags (ESTs from the male accessory gland of H. erato and H. melpomene, species representative of the two mating systems present in the genus Heliconius. Results We successfully sequenced 933 ESTs clustering into 371 unigenes from H. erato and 1033 ESTs clustering into 340 unigenes from H. melpomene. Results from the two species were very similar. Approximately a third of the unigenes showed no significant BLAST similarity (E-value -5 to sequences in GenBank's non-redundant databases, indicating that a large proportion of novel genes are expressed in Heliconius male accessory glands. In both species only a third of accessory gland unigenes were also found among genes expressed in wing tissue. About 25% of unigenes from both species encoded secreted proteins. This includes three groups of highly abundant unigenes encoding repetitive proteins considered to be candidate seminal fluid proteins; proteins encoded by one of these groups were detected in H. erato spermatophores. Conclusion This collection of ESTs will serve as the foundation for the future identification and evolutionary analysis of male reproductive proteins in Heliconius butterflies. These data also represent a significant advance in the rapidly growing collection of genomic resources available in Heliconius

  15. Accessory Navicular Bone Mimicking Navicular Fracture after Ankle Sprain

    Muharrem Çidem; Murat Uludağ; Kerem Gün; Ülkü Akarırmak

    2011-01-01

    An accessory navicular bone (ANB) is present in 10-30% of normal feet. A morphological classification of ANB on the basis of the radiographic appearance distinguishes three types. Most symptomatic ANBs are of type 2. Although the diagnosis and treatment of sprained ankle are generally straightforward, together with an ANB, it might be misdiagnosed as a fracture. We present a 20-year-old male with type 2 ANB who was misdiagnosed as navicular fracture following sprained ankle. Turk J Phys Med...

  16. Importing home decorating accessories from India to Finland

    Ruuska, Jenni

    2011-01-01

    The commissioner of this thesis is a start-up company interested in importing home decorating accessories from India to Finland. There are two main goals of this thesis: firstly, to discover how importing from India would happen in practice, and secondly, to investigate what are the fairs the commissioner should visit in India. Thus, the theoretical framework includes following areas: logistics, consisting of money transfer and transportation; customs duties, discussing for instance the tarif...

  17. Engineering a multimodal nerve conduit for repair of injured peripheral nerve

    Quigley, A. F.; Bulluss, K. J.; Kyratzis, I. L. B.; Gilmore, K.; Mysore, T.; Schirmer, K. S. U.; Kennedy, E. L.; O'Shea, M.; Truong, Y. B.; Edwards, S. L.; Peeters, G.; Herwig, P.; Razal, J. M.; Campbell, T. E.; Lowes, K. N.; Higgins, M. J.; Moulton, S. E.; Murphy, M. A.; Cook, M. J.; Clark, G. M.; Wallace, G. G.; Kapsa, R. M. I.

    2013-02-01

    Injury to nerve tissue in the peripheral nervous system (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss of sensation from the tissue innervated by the harvested nerve. The challenges that persist with nerve repair have resulted in development of nerve guides or conduits from non-neural biological tissues and various polymers to improve the prognosis for the repair of damaged nerves in the PNS. This study describes the design and fabrication of a multimodal controlled pore size nerve regeneration conduit using polylactic acid (PLA) and (PLA):poly(lactic-co-glycolic) acid (PLGA) fibers within a neurotrophin-enriched alginate hydrogel. The nerve repair conduit design consists of two types of PLGA fibers selected specifically for promotion of axonal outgrowth and Schwann cell growth (75:25 for axons; 85:15 for Schwann cells). These aligned fibers are contained within the lumen of a knitted PLA sheath coated with electrospun PLA nanofibers to control pore size. The PLGA guidance fibers within the nerve repair conduit lumen are supported within an alginate hydrogel impregnated with neurotrophic factors (NT-3 or BDNF with LIF, SMDF and MGF-1) to provide neuroprotection, stimulation of axonal growth and Schwann cell migration. The conduit was used to promote repair of transected sciatic nerve in rats over a period of 4 weeks. Over this period, it was observed that over-grooming and self-mutilation (autotomy) of the limb implanted with the conduit was significantly reduced in rats implanted with the full-configuration conduit compared to rats implanted with conduits containing only an alginate

  18. The Dehiscent Facial Nerve Canal

    Sertac Yetiser

    2012-01-01

    Full Text Available Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.

  19. Comparison of murine hepatic accessory cells and splenic dendritic cells

    Accessory cells are required for proliferation and antibody synthesis of B lymphocytes and proliferation of T lymphocytes in primary immune responses in vitro. The obligatory cells derived from the spleen are referred to as dendritic cells. Accessory cells were isolated from normal adult livers which were functionally interchangeable with splenic DC. Both hepatic accessory cells (AC) and splenic DC adhere firmly to plastic culture dishes or wells within 2 hr; but hepatic AC, unlike splenic DC, do not detach during 22 hr additional incubation. Hepatic AC, unlike splenic DC, are not lysed or inactivated by monoclonal antibody 33D1 and C'. Hepatic AC and splenic DC are similarly sensitive to irradiation in vivo and insensitive to irradiation in vitro. Hepatic AC are separated with cells which are predominantly phagocytic and FcR+ and contain nonspecific esterase. Both hepatic AC and splenic DC are suppressed or eliminated by activation of NK cells in vivo, a phenomenon prevented by prior elimination of NK cells

  20. Electromyographic evaluation of functional electrical stimulation to injured oculomotor nerve

    Min Yang; Shiting Li; Youqiang Meng; Ningxi Zhu; Xuhui Wang; Liang Wan; Wenchuan Zhang; Jun Zhong; Shugan Zhu; Massimiliano Visocchi

    2011-01-01

    Functional electrical stimulation delivered early after injury to the proximal nerve stump has been proposed as a therapeutic approach for enhancing the speed and specificity of axonal regeneration following nerve injury. In this study, the injured oculomotor nerve was stimulated functionally by an implantable electrode. Electromyographic monitoring of the motor unit potential of the inferior oblique muscle was conducted for 12 weeks in two injury groups, one with and one without electric stimulation. The results revealed that, at 2, 4, 6, 8 weeks after functional electric stimulation of the injured oculomotor nerve, motor unit potentials significantly increased, such that amplitude was longer and spike duration gradually shortened. These findings indicate that the injured oculomotor nerve has the potential for regeneration and repair, but this ability is not sufficient for full functional recovery to occur. Importantly, the current results indicated that recovery and regeneration of the injured oculomotor nerve can be promoted with functional electrical stimulation.

  1. Study on development of accessory sex glands in prepubertal kids using two-dimensional ultrasonography

    Kumari, Sonu; Luthra, R. A.; Chandolia, R. K.; Kumar, Sandeep; Kumar, Parveen; Devender; Kumar, Ankit; Bishnoi, Nidhi; Bishnoi, Sunil

    2016-01-01

    Aim: The present study was undertaken to study growth pattern of accessory sex glands in prepubertal kids from 2 weeks to 6 months of age using two-dimensional ultrasonography. Materials and Methods: The study was conducted on six Beetal kids. The scanning of accessory sex glands was done in standing position using rectal probe and measurements were recorded. Data collected were statistically analyzed using one-way ANOVA followed by Duncan multiple range test was performed using the SPSS (16.0) system for windows. Results: With the advancement of age all the dimensions of glands increased. Both the lobes of prostate gland showed an increase in width with advancement of age. Width of prostate above the urethra (W1) showed a significant increase at 2, 10, and 20 weeks of age, whereas non-significant increase from 2 to 8, 10 to 19, and 20 to 24 weeks of age was recorded. Width of prostate below the urethra (W2) showed a significant increase at 20 weeks of age, whereas non-significant increase was recorded during rest of period of growth. Left and right bulbourethral gland showed a similar pattern of growth with the advancement of age. The circumference dimensions increased significantly at 2, 16, 20, and 21 weeks of age for both glands. The increase was non-significant from 4 to 14, 16 to 19, and 20 to 23 weeks of age. The same pattern was observed for left and right seminal vesicular gland. Conclusion: Significant growth in three accessory sex glands in prepubertal kids was not observed at the same age. The trend observed was that the prostate was the first gland to show significant growth at 10 weeks of age followed by a significant increase in seminal vesicles and bulbourethral gland at 14 and 16 weeks of age, respectively.

  2. Ventricular Dyssynchrony and Function Improve following Catheter Ablation of Nonseptal Accessory Pathways in Children

    Sylvia Abadir

    2013-01-01

    Full Text Available Introduction. Paradoxical or hypokinetic interventricular septal motion has been described in patients with septal or paraseptal accessory pathways. Data regarding nonseptal pathways is limited. Methods and Results. We quantified left ventricular dyssynchrony and function in 16 consecutive children, 14.2±3.7 years, weighing 53 ± 17 kg, prior to and following catheter ablation of bidirectional septal (N=6 and nonseptal (N=10 accessory pathways. Following ablation, the left ventricular ejection fraction increased by 4.9±2.1% (P=0.038 from a baseline value of 57.0%±7.8%. By tissue Doppler imaging, the interval between QRS onset and peak systolic velocity (Ts decreased from a median of 33.0 ms to 18.0 ms (P=0.013. The left ventricular ejection fraction increased to a greater extent following catheter ablation of nonseptal (5.9%±2.6%, P=0.023 versus septal (2.5%±4.1%, P=0.461 pathways. The four patients with an ejection fraction 50% after ablation. Similarly, the improvement in dyssynchrony was more marked in patients with nonseptal versus septal pathways (difference between septal and lateral wall motion delay before and after ablation 20.6±7.1 ms (P=0.015 versus 1.4±11.4 ms (P=0.655. Conclusion. Left ventricular systolic function and dyssynchrony improve after ablation of antegrade-conducting accessory pathways in children, with more pronounced changes noted for nonseptal pathways.

  3. Cranial nerve palsies

    This paper evaluates the utility of multiplanar reconstructions (MPRs) of three-dimensional (3D) MR angiography data sets in the examination of patients with cranial nerve palsies. The authors hypothesis was that 3D data could be reformatted to highlight the intricate spatial relationships of vessels to adjacent neural tissues by taking advantage of the high vessel-parenchyma contrast in high-resolution 3D time-of-flight sequences. Twenty patients with cranial nerve palsies and 10 asymptomatic patients were examined with coronal T1-weighted and axial T2-weighted imaging plus a gadolinium-enhanced 3D MRA sequence (40/7/15 degrees, axial 60-mm volume, 0.9-mm isotropic resolution). Cranial nerves II-VIII were subsequently evaluated on axial and reformatted coronal and/or sagittal images

  4. Improved peripheral nerve regeneration with sustained release nerve growth factor microspheres in small gap tubulization

    Wang, Zhenwei; Han, Na; Wang, Jiancheng; Hua ZHENG; Peng, Jianping; Kou, Yuhui; Xu, Chungui; An, Shuai; Yin, Xiaofeng; Zhang, Peixun; Jiang, Baoguo

    2014-01-01

    Objective: To evaluate the long-term results of the use of nerve growth factor (NGF)-loaded poly-D, L-lactide-co-glycolide (PLGA) microspheres for improve nerve regeneration with small gap tubulization. Methods: NGF microspheres were prepared by a modified W/O/W emulsion solvent evaporation method. Forty-eight male SD rats were separated into 4 groups and received a chitin conduit to bridge a sciatic nerve injury left a 2 mm gap. Saline (Group A), 20 ng/ml NGF solution (Group B), blank PLGA m...

  5. The gross anatomy of the renal sympathetic nerves revisited.

    Mompeo, Blanca; Maranillo, Eva; Garcia-Touchard, Arturo; Larkin, Theresa; Sanudo, Jose

    2016-07-01

    Catheter-based renal denervation techniques focus on reducing blood pressure in resistant hypertension. This procedure requires exact knowledge of the anatomical interrelation between the renal arteries and the targeted renal nervous plexus. The aim of this work was to build on classical anatomical studies and describe the gross anatomy and anatomical relationships of the renal arteries and nerve supply to the kidneys in a sample of human cadavers. Twelve human cadavers (six males and six females), age range 73 to 94 years, were dissected. The nervous fibers and renal arteries were dissected using a surgical microscope. The renal plexus along the hilar renal artery comprised a fiber-ganglionic ring surrounding the proximal third of the renal artery, a neural network along the middle and distal thirds, and smaller accessory ganglia along the course of the nerve fibers. The fibers of the neural network were mainly located on the superior (95.83%) and inferior (91.66%) surfaces of the renal artery and they were sparsely interconnected by diagonal fibers. Polar arteries were present in 33.33% of cases and the renal nerve pattern for these was similar to that of the hilar arteries. Effective renal denervation needs to target the superior and inferior surfaces of the hilar and polar arteries, where the fibers of the neural network are present. Clin. Anat. 29:660-664, 2016. © 2016 Wiley Periodicals, Inc. PMID:27090982

  6. Nerve Transfers in Tetraplegia.

    Fox, Ida K

    2016-05-01

    Hand and upper extremity function is instrumental to basic activities of daily living and level of independence in cervical spinal cord injury (SCI). Nerve transfer surgery is a novel and alternate approach for restoring function in SCI. This article discusses the biologic basis of nerve transfers in SCI, patient evaluation, management, and surgical approaches. Although the application of this technique is not new; recent case reports and case series in the literature have increased interest in this field. The challenges are to improve function, achieve maximal gains in function, avoid complications, and to primum non nocere. PMID:27094894

  7. Facilitation of facial nerve regeneration using chitosan-β-glycerophosphate-nerve growth factor hydrogel.

    Chao, Xiuhua; Xu, Lei; Li, Jianfeng; Han, Yuechen; Li, Xiaofei; Mao, YanYan; Shang, Haiqiong; Fan, Zhaomin; Wang, Haibo

    2016-06-01

    Conclusion C/GP hydrogel was demonstrated to be an ideal drug delivery vehicle and scaffold in the vein conduit. Combined use autologous vein and NGF continuously delivered by C/GP-NGF hydrogel can improve the recovery of facial nerve defects. Objective This study investigated the effects of chitosan-β-glycerophosphate-nerve growth factor (C/GP-NGF) hydrogel combined with autologous vein conduit on the recovery of damaged facial nerve in a rat model. Methods A 5 mm gap in the buccal branch of a rat facial nerve was reconstructed with an autologous vein. Next, C/GP-NGF hydrogel was injected into the vein conduit. In negative control groups, NGF solution or phosphate-buffered saline (PBS) was injected into the vein conduits, respectively. Autologous implantation was used as a positive control group. Vibrissae movement, electrophysiological assessment, and morphological analysis of regenerated nerves were performed to assess nerve regeneration. Results NGF continuously released from C/GP-NGF hydrogel in vitro. The recovery rate of vibrissae movement and the compound muscle action potentials of regenerated facial nerve in the C/GP-NGF group were similar to those in the Auto group, and significantly better than those in the NGF group. Furthermore, larger regenerated axons and thicker myelin sheaths were obtained in the C/GP-NGF group than those in the NGF group. PMID:26881479

  8. In vivo interactions between tungsten microneedles and peripheral nerves

    Sergi P.N.; Jensen W.; Micera S.; Yoshida K.

    2013-01-01

    Tungsten microneedles are currently used to insert neural electrodes into living peripheral nerves. However, the biomechanics underlying these procedures is not yet well characterized. For this reason, the aim of this work was to model the interactions between these microneedles and living peripheral nerves. A simple mathematical framework was especially provided to model both compression of the external layer of the nerve (epineurium) and the interactions resulting from penetration of the ma...

  9. Bilateral variant of sciatic nerve exhibiting intra-pelvic division

    Rejeena P Raj, Kunjumon PC, More Anju B

    2014-01-01

    Context (background): In case of high division of the sciatic nerve in the pelvis its, common peroneal component may pierce the Piriformis muscle. This anatomical variant can explain many clinical findings. Aims: Its objective is to report a case of high division of the sciatic nerve in order to contribute towards better anatomical understanding of the gluteal region. Methods and Material: Routine undergraduate dissection of a male cadaver revealed bilateral variation in sciatic nerve. Result...

  10. Clinical anatomy of greater petrosal nerve and its surgical importance

    Prashant E Natekar; Fatima M De Souza

    2013-01-01

    Background: Surgical approach towards greater petrosal nerve has to be done with caution as many surgeons are unfamiliar with the anatomy of the facial nerve. The anatomical landmarks selected must be reliable and above all easy to identify for identification of the greater petrosal nerve so as to avoid injury to the structures in the middle cranial fossa. Observation and Results: The present study is carried out on 100 temporal bones by examining the following measurements of the right and t...

  11. Cardiac Autonomic Nerve Stimulation in the Treatment of Heart Failure

    Kobayashi, Mariko; Massiello, Alex; Karimov, Jamshid H.; Van Wagoner, David R.; Fukamachi, Kiyotaka

    2013-01-01

    Research on the therapeutic modulation of cardiac autonomic tone by electrical stimulation has yielded encouraging early clinical results. Vagus nerve stimulation has reduced the rates of morbidity and sudden death from heart failure, but therapeutic vagus nerve stimulation is limited by side effects of hypotension and bradycardia. Sympathetic nerve stimulation that has been implemented in the experiment may exacerbate the sympathetic-dominated autonomic imbalance. In contrast, concurrent sti...

  12. The puerperium alters spinal cord plasticity following peripheral nerve injury

    Gutierrez, Silvia; Hayashida, Ken-ichiro; Eisenach, James C.

    2012-01-01

    Tissue and nerve damage can result in chronic pain. Yet, chronic pain after cesarean delivery is remarkably rare in women and hypersensitivity from peripheral nerve injury in rats resolves rapidly if the injury occurs in the puerperium. Little is known regarding the mechanisms of this protection except for a reliance on central nervous system oxytocin signaling. Here we show that density of inhibitory noradrenergic fibers in the spinal cord is greater when nerve injury is performed in rats du...

  13. Axillary nerve conduction changes in hemiplegia

    Ring Haim

    2008-12-01

    Full Text Available Abstract Aim To prove the possibility of axillary nerve conduction changes following shoulder subluxation due to hemiplegia, in order to investigate the usefulness of screening nerve conduction studies in patients with hemiplegia for finding peripheral neuropathy. Methods Forty-four shoulders of twenty-two patients with a first-time stroke having flaccid hemiplegia were tested, 43 ± 12 days after stroke onset. Wasting and weakness of the deltoid were present in the involved side. Motor nerve conduction latency and compound muscle action potential (CMAP amplitude were measured along the axillary nerve, comparing the paralyzed to the sound shoulder. The stimulation was done at the Erb's point whilst the recording needle electrode was inserted into the deltoid muscle 4 cm directly beneath the lateral border of the acromion. Wilcoxon signed rank test was used to compare the motor conduction between the sound and the paralytic shoulder. Mann-Whitney test was used to compare between plegic and sound shoulder in each side. Results Mean motor nerve conduction latency time to the deltoid muscle was 8.49, SD 4.36 ms in the paralyzed shoulder and 5.17, SD 1.35 ms in the sound shoulder (p Mean compound muscle action potential (CMAP amplitude was 2.83, SD 2.50 mV in the paralyzed shoulder and was 7.44, SD 5.47 mV in the sound shoulder (p p p = 0.003, 1-sided for amplitude, and patients with left paralyzed shoulder compared to patients with left sound shoulder (p = 0.011, 1-sided for latency, p = 0.001, 1-sided for amplitude, support the same outcomes. The electro-physiological changes in the axillary nerve may appear during the first six weeks after stroke breakout. Conclusion Continuous traction of the axillary nerve, as in hypotonic shoulder, may affect the electro-physiological properties of the nerve. It most probably results from subluxation of the head of the humerus, causing demyelinization and even axonopathy. Slowing of the conduction velocities of

  14. Acupuncture-Like Transcutaneous Electrical Nerve Stimulation Versus Pilocarpine in Treating Radiation-Induced Xerostomia: Results of RTOG 0537 Phase 3 Study

    Purpose and Objectives: This report presents the analysis of the RTOG 0537 multicenter randomized study that compared acupuncture-like transcutaneous stimulation (ALTENS) with pilocarpine (PC) for relieving radiation-induced xerostomia. Methods and Materials: Eligible patients were randomized to twice-weekly 20-minute ALTENS sessions for 24 sessions during 12 weeks or PC (5 mg 3 times daily for 12 weeks). The primary endpoint was the change in the University of Michigan Xerostomia-Related Quality of Life Scale (XeQOLS) scores from baseline to 9 months from randomization (MFR). Secondary endpoints included basal and citric acid primed whole salivary production (WSP), ratios of positive responders (defined as patients with ≥20% reduction in overall radiation-induced xerostomia symptom burden), and the presence of adverse events based on the Common Terminology Criteria for Adverse Events version 3. An intention-to-treat analysis was conducted. Results: One hundred forty-eight patients were randomized. Only 96 patients completed the required XeQOLS and were evaluable at 9 MFR (representing merely 68.6% statistical power). Seventy-six patients were evaluable at 15 MFR. The median change in the overall XeQOLS in ALTENS and PC groups at 9 and 15 MFR were −0.53 and −0.27 (P=.45) and −0.6 and −0.47 (P=.21). The corresponding percentages of positive responders were 81% and 72% (P=.34) and 83% and 63% (P=.04). Changes in WSP were not significantly different between the groups. Grade 3 or less adverse events, mostly consisting of grade 1, developed in 20.8% of patients in the ALTENS group and in 61.6% of the PC group. Conclusions: The observed effect size was smaller than hypothesized, and statistical power was limited because only 96 of the recruited 148 patients were evaluable. The primary endpoint—the change in radiation-induced xerostomia symptom burden at 9 MFR—was not significantly different between the ALTENS and PC groups. There was significantly less

  15. Acupuncture-Like Transcutaneous Electrical Nerve Stimulation Versus Pilocarpine in Treating Radiation-Induced Xerostomia: Results of RTOG 0537 Phase 3 Study

    Wong, Raimond K.W., E-mail: wongrai@hhsc.ca [McMaster University, Juravinski Cancer Centre, Hamilton, Ontario (Canada); Deshmukh, Snehal [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Wyatt, Gwen [Michigan State University, East Lansing, Michigan (United States); Sagar, Stephen [McMaster University, Juravinski Cancer Centre, Hamilton, Ontario (Canada); Singh, Anurag K. [Roswell Park Cancer Institute, Buffalo, New York (United States); Sultanem, Khalil [McGill University, Montreal, Quebec (Canada); Nguyen-Tân, Phuc F. [Centre Hospitalier de l' Université de Montréal-Hôpital Notre-Dame, Montreal, Quebec (Canada); Yom, Sue S. [University of California San Francisco, San Francisco, California (United States); Cardinale, Joseph [Yale-New Haven Hospital Saint Raphael Campus, New Haven, Connecticut (United States); Yao, Min [University Hospitals of Cleveland, Cleveland, Ohio (United States); Hodson, Ian [McMaster University, Juravinski Cancer Centre, Hamilton, Ontario (Canada); Matthiesen, Chance L. [University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Suh, John [Cleveland Clinic Foundation, Cleveland, Ohio (United States); Thakrar, Harish [John H. Stroger, Jr. Hospital of Cook County MB-CCOP, Chicago, Illinois (United States); Pugh, Stephanie L. [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Berk, Lawrence [University of South Florida H. Lee Moffitt Cancer Center, Tampa, Florida (United States)

    2015-06-01

    Purpose and Objectives: This report presents the analysis of the RTOG 0537 multicenter randomized study that compared acupuncture-like transcutaneous stimulation (ALTENS) with pilocarpine (PC) for relieving radiation-induced xerostomia. Methods and Materials: Eligible patients were randomized to twice-weekly 20-minute ALTENS sessions for 24 sessions during 12 weeks or PC (5 mg 3 times daily for 12 weeks). The primary endpoint was the change in the University of Michigan Xerostomia-Related Quality of Life Scale (XeQOLS) scores from baseline to 9 months from randomization (MFR). Secondary endpoints included basal and citric acid primed whole salivary production (WSP), ratios of positive responders (defined as patients with ≥20% reduction in overall radiation-induced xerostomia symptom burden), and the presence of adverse events based on the Common Terminology Criteria for Adverse Events version 3. An intention-to-treat analysis was conducted. Results: One hundred forty-eight patients were randomized. Only 96 patients completed the required XeQOLS and were evaluable at 9 MFR (representing merely 68.6% statistical power). Seventy-six patients were evaluable at 15 MFR. The median change in the overall XeQOLS in ALTENS and PC groups at 9 and 15 MFR were −0.53 and −0.27 (P=.45) and −0.6 and −0.47 (P=.21). The corresponding percentages of positive responders were 81% and 72% (P=.34) and 83% and 63% (P=.04). Changes in WSP were not significantly different between the groups. Grade 3 or less adverse events, mostly consisting of grade 1, developed in 20.8% of patients in the ALTENS group and in 61.6% of the PC group. Conclusions: The observed effect size was smaller than hypothesized, and statistical power was limited because only 96 of the recruited 148 patients were evaluable. The primary endpoint—the change in radiation-induced xerostomia symptom burden at 9 MFR—was not significantly different between the ALTENS and PC groups. There was significantly less

  16. The role of exosomes in peripheral nerve regeneration

    Rosanna C Ching

    2015-01-01

    Full Text Available Peripheral nerve injuries remain problematic to treat, with poor functional recovery commonly observed. Injuries resulting in a nerve gap create specific difficulties for axonal regeneration. Approaches to address these difficulties include autologous nerve grafts (which are currently the gold standard treatment and synthetic conduits, with the latter option being able to be impregnated with Schwann cells or stem cells which provide an appropriate micro-environment for neuronal regeneration to occur. Transplanting stem cells, however, infers additional risk of malignant transformation as well as manufacturing difficulties and ethical concerns, and the use of autologous nerve grafts and Schwann cells requires the sacrifice of a functioning nerve. A new approach utilizing exosomes, secreted extracellular vesicles, could avoid these complications. In this review, we summarize the current literature on exosomes, and suggest how they could help to improve axonal regeneration following peripheral nerve injury.

  17. Craniocerebral injury promotes the repair of peripheral nerve injury

    Wang, Wei; Gao, Jun; Na, Lei; Jiang, Hongtao; Xue, Jingfeng; Yang, Zhenjun; Wang, Pei

    2014-01-01

    The increase in neurotrophic factors after craniocerebral injury has been shown to promote fracture healing. Moreover, neurotrophic factors play a key role in the regeneration and repair of peripheral nerve. However, whether craniocerebral injury alters the repair of peripheral nerve injuries remains poorly understood. Rat injury models were established by transecting the left sciatic nerve and using a free-fall device to induce craniocerebral injury. Compared with sciatic nerve injury alone after 6–12 weeks, rats with combined sciatic and craniocerebral injuries showed decreased sciatic functional index, increased recovery of gastrocnemius muscle wet weight, recovery of sciatic nerve ganglia and corresponding spinal cord segment neuron morphologies, and increased numbers of horseradish peroxidase-labeled cells. These results indicate that craniocerebral injury promotes the repair of peripheral nerve injury. PMID:25374593

  18. Functional outcome of nerve transfer for restoration of shoulder and elbow function in upper brachial plexus injury

    Faruquee Sajedur

    2008-05-01

    Full Text Available Abstract Background Purpose of this study was to evaluate the functional outcome of spinal accessory to suprascapular nerve transfer (XI-SSN done for restoration of shoulder function and partial transfer of ulnar nerve to the motor branch to the biceps muscle for the recovery of elbow flexion (Oberlin transfer. Methods This is a prospective study involving 15 consecutive cases of upper plexus injury seen between January 2004 and December 2005. The average age of patients was 35.6 yrs (15–52 yrs. The injury-surgery interval was between 2–6 months. All underwent XI-SSN and Oberlin nerve transfer. The coaptation was done close to the biceps muscle to ensure early recovery. The average follow up was 15 months (range 12–36 months. The functional outcome was assessed by measuring range of movements and also on the grading scale proposed by Narakas for shoulder function and Waikakul for elbow function. Results Good/Excellent results were seen in 13/15 patients with respect to elbow function and 8/15 for shoulder function. The time required for the first sign of clinical reinnervation of biceps was 3 months 9 days (range 1 month 25 days to 4 months and for the recovery of antigravity elbow flexion was 5 months (range 3 1/2 months to 8 months. 13 had M4 and two M3 power. On evaluating shoulder function 8/15 regained active abduction, five had M3 and three M4 shoulder abduction. The average range of abduction in these eight patients was 66 degrees (range 45–90. Eight had recovered active external rotation, average 44 degrees (range 15–95. The motor recovery of external rotation was M3 in 5 and M4 in 3. 7/15 had no active abduction/external rotation, but they felt that their shoulder was more stable. Comparable results were observed in both below and above 40 age groups and those with injury to surgery interval less than 3 or 3–6 months. Conclusion Transfer of ulnar nerve fascicle to the motor branch of biceps close to the muscle consistently

  19. Optical stimulation of peripheral nerves in vivo

    Wells, Jonathon D.

    This dissertation documents the emergence and validation of a new clinical tool that bridges the fields of biomedical optics and neuroscience. The research herein describes an innovative method for direct neurostimulation with pulsed infrared laser light. Safety and effectiveness of this technique are first demonstrated through functional stimulation of the rat sciatic nerve in vivo. The Holmium:YAG laser (lambda = 2.12 mum) is shown to operate at an optimal wavelength for peripheral nerve stimulation with advantages over standard electrical neural stimulation; including contact-free stimulation, high spatial selectivity, and lack of a stimulation artifact. The underlying biophysical mechanism responsible for transient optical nerve stimulation appears to be a small, absorption driven thermal gradient sustained at the axonal layer of nerve. Results explicitly prove that low frequency optical stimulation can reliably stimulate without resulting in tissue thermal damage. Based on the positive results from animal studies, these optimal laser parameters were utilized to move this research into the clinic with a combined safety and efficacy study in human subjects undergoing selective dorsal rhizotomy. The clinical Holmium:YAG laser was used to effectively stimulate human dorsal spinal roots and elicit functional muscle responses recorded during surgery without evidence of nerve damage. Overall these results predict that this technology can be a valuable clinical tool in various neurosurgical applications.

  20. Immune reactions and nerve repair in mice with sciatic nerve injury 14 days after intraperitoneal injection of Brazil☆

    Cao, Jian; Niu, Zhongping; Wang, Yongan; Jiang, Yiwen; Liu, Haoyu; Wang, Binfeng; Yin, Weitian; LI, LISEN

    2012-01-01

    BALB/c mice were intraperitoneally injected with 10, 5 or 2.5 mg/kg Brazil for 14 days after sciatic nerve injury. Results demonstrate that the spleen T/B lymphocyte stimulation index and serum circulating immune complex concentration were significantly reduced, and the morphology of the soleus muscle was restored in mice with sciatic nerve injury. These effects of Brazil were dose-dependent. Our experimental findings indicate that Brazil can regulate immune responses after nerve injury and p...

  1. High division of sciatic nerve

    Tripti Shrivastava; Lalit Garg; B. K. Mishra; Neeta Chhabra

    2014-01-01

    Background: The Sciatic nerve is the largest and thickest nerve in the human body with a long course in the inferior extremity. It divides into tibial and common peroneal nerves which can occur at any level from the sacral plexus to the inferior part of the popliteal space. Sciatic nerve variations are relatively common. These variations may contribute to clinical conditions ex sciatica, coccygodynia and piriformis syndrome and have important clinical implications in anaesthesiology, neurolog...

  2. STUDY ON VARIATIONS OF SHAPE, SIZE, LOCATION AND POSITION OF MENTAL FORAMEN AND INCIDENCE OF ACCESSORY MENTAL FORAMEN IN HUMAN MANDIBLES

    Rajkumari

    2016-01-01

    Full Text Available AIM AND OBJECTIVE The present study was conducted with an objective to determine the size, shape, location, position and number of Mental Foramen (MF and Accessory Mental Foramen (AMF on both sides of mandible and incidence of MF and AMF with respect to the surgically encountered important anatomical landmarks and compare with the findings of available literatures. METHODS AND MATERIALS The study was conducted on 50 dry adult human mandibles of unknown sex and age obtained from the Department of Anatomy of Regional Institute of Medical Sciences (RIMS, Imphal, Manipur, India. The shape, size, location and position of MF were measured on both sides of mandible by using Digital Vernier Caliper. RESULTS Mental foramen was present in all 50 mandibles and it was bilateral and the incidence of AMF was observed in only four mandibles (8%. In the present study, the round shape MF was observed in 17.05% and the oval shape of MF in 82.95%. Average size of AMF was 1.50 mm ranging from 1.00 mm to 2.00 mm. The location of the MF was found mostly below the apex of second premolar in 74.50 %, while it was 25.50% between the first and second premolars. CONCLUSION The knowledge about variations in size, shape, location and position of MF and presence of AMF will help the Dental Surgeons to determine accurate site of local anaesthesia and in avoiding injury to mental nerve and prevent unwanted spread of infections while performing periodontal or endodontic surgery.

  3. Progress of peripheral nerve repair

    陈峥嵘

    2002-01-01

    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  4. Tumors of the optic nerve

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  5. Optic nerve oxygen tension

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T;

    2004-01-01

    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta...

  6. Magnetic resonance neurography of peripheral nerve tumors and tumorlike conditions.

    Ahlawat, Shivani; Chhabra, Avneesh; Blakely, Jaishri

    2014-02-01

    Peripheral nerve enlargement may be seen in multiple conditions including hereditary or inflammatory neuropathies, sporadic or syndromic peripheral nerve sheath tumors, perineurioma, posttraumatic neuroma, and intraneural ganglion. Malignancies such as neurolymphoma, intraneural metastases, or sarcomas may also affect the peripheral nervous system and result in nerve enlargement. The imaging appearance and differentiating factors become especially relevant in the setting of tumor syndromes such as neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. This article reviews the typical magnetic resonance neurography imaging appearances of neurogenic as well as nonneurogenic neoplasms and tumorlike lesions of peripheral nerves, with emphasis on distinguishing factors. PMID:24210319

  7. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst.

    Kwak, Kyung-Woo; Kim, Min-Su; Chang, Chul-Hoon; Kim, Seong-Ho

    2011-02-01

    Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery. PMID:21519507

  8. Anatomical Study of the Intercostobrachial Nerve in Sprague-Dawlay Rats

    Liansheng Ning; Xin Wang; Kai Zhao; Zhenfang Yang; Hui Sun; Jie Ge

    2006-01-01

    OBJECTIVE The aim of the study was to explore the anatomy of the intercostobrachial nerve in rats.METHODS Dissections of 8 Sprague-dawley rats were performed to examine the intercostobrachial nerve. Fifteen dissections were successful.The position of the nerve, origin, termination, length and diameter were measured and recorded.RESULTS 1) 80% of the nerves originated from the second intercostal space and 20% from the first intercostal space; 2) 60% of the nerves terminated in the latissimus dorsi and 40% in the axillary skin 3) the branches of the nerves only were divided into 2 types, single and double; 4) the length of the nerves ranged from 2.4 to 3.4 cm with an average of 2.97±0.90 cm; 5) the diameter of the nerves was thicker at their origin compared to their termination.CONCLUSION The intercostobrachial nerve is simple in rats with 60%terminating in the latissimus dorsi.

  9. Follow-up evaluation with ultrasonography of peripheral nerve injuries after an earthquake

    Man Lu; Zirui Jiang; Yue Wang; Linxian Yue; Jack Chiu; Fanding He; Xiaojing Wu; Bin Zang; Bin Lu; Xiaoke Yao

    2014-01-01

    Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efifcient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgi-cal repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonogra-phy. The concordance rate of ultrasonographic ifndings with those of surgical ifndings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only ifve nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which veriifed that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves.

  10. MR Imaging Findings of Painful Type II Accessory Navicular Bone: Correlation with Surgical and Pathologic Studies

    Choi, Yun Sun; Lee, Kyung Tai; Kang, Heung Sik; Kim, Eun Kyung

    2004-01-01

    Objective To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. Materials and Methods The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on th...

  11. Reliable Sex and Strain Discrimination in the Mouse Vomeronasal Organ and Accessory Olfactory Bulb

    Tolokh, Illya I.; Fu, Xiaoyan; Holy, Timothy E.

    2013-01-01

    Animals modulate their courtship and territorial behaviors in response to olfactory cues produced by other animals. In rodents, detecting these cues is the primary role of the accessory olfactory system (AOS). We sought to systematically investigate the natural stimulus coding logic and robustness in neurons of the first two stages of accessory olfactory processing, the vomeronasal organ (VNO) and accessory olfactory bulb (AOB). We show that firing rate responses of just a few well-chosen mou...

  12. BILATERAL ACCESSORY BREAST TISSUE PRESENTING AS MASS IN AXILLA WITH LEAKING MILK

    Vineet

    2014-11-01

    Full Text Available Accessory breasts are an uncommon entity. They may present as asymptomatic masses or cause symptoms such as pain or restriction of arm movements even some time milk leaks from accessory breast. It may prove to be diagnostic challenge if found in locations along or outside the mammary line. We report a very rare case of an ectopic bilateral accessory breast presenting as mass in axilla with leaking milk in lactating young female. FNAC was diagnostic tool

  13. An exploration study to find important factors influencing on brand in car accessory market

    Naser Azad; Seyed Mohsen Seyed Aliakbar; Majid Tavassoli; Mohammad Reza Jafar Zadeh

    2013-01-01

    Supplying car accessory is one of the most important growing industries in the world. Every year, millions of cars are produced and people need to have the access to necessary car accessory. In this paper, we present an exploration study to detect important factors influencing car accessory market. The proposed study designs a questionnaire in Likert scale consists of 16 questions, distributes it among 200 experts and analyses it using factor analysis. Cronbach alpha and Kaiser-Meyer-Olkin Me...

  14. Ultrastructural changes in the optic nerve and capillary vessels during early stages of optic nerve injury

    Xuehong Ju; Xiuyun Li; Xiaoshuang Li; Hongtao Tang; Hongguo Liu

    2008-01-01

    BACKGROUND: Capillaries are the only blood supply for optic nerves, which makes the system more vulnerable to impaired blood circulation. OBJECTIVE: To observe the ultrastructural changes in the optic nerves and capillaries in rabbits following intracanalicular segment injury to the optic nerve. DESIGN, TIME AND SETTING: Comparative, observational, pathological morphology was performed at the Department of Anatomy, Weifang Medical College from September to November 2007. MATERIALS: Models of intracanalicular segment injury to the optic nerve were induced in the right eye of thirty healthy, adult rabbits by a flee-falling metal cylinder. The H-7500 transmission electron microscope was provided by Hitachi, Japan. METHODS: All rabbits were randomly assigned into experimental (n = 25) and control (n = 5) groups. Optic nerve specimens were obtained from the experimental group at 0.5, 6, 12, 48, and 96 hours, respectively, following injury. Uitrastructural changes to the optic nerves and their capillaries were observed by electron microscopy. Optic nerve injury was not established in the control group, but optic nerve specimens were collected similarly to the experimental group. MAIN OUTCOME MEASURES: Ultrastructural changes in the injured optic nerves and their capillaries. RESULTS: Thirty rabbits were included in the final analysis. In the control group, cross-sections of the optic nerves exhibited varied thicknesses with regularly arranged fibers. The axons appeared to be smooth with condensed myelin sheaths and oval mitochondria. The microtubules and mierofilaments were clearly seen. The lumens of the capillaries were regular with densely arranged endothelial cells and visible mitochondria. In the experimental group, 30 minutes after injury to the optic nerves, swollen axons, sparse myelin sheath, disordered microtubules and microfilaments, swollen mitochondria, and a decreased number of pinocytosis vesicles and microfilaments in endothelial cells of the capillaries

  15. Strain and stress variations in the human amniotic membrane and fresh corpse autologous sciatic nerve anastomosis in a model of sciatic nerve injury☆

    Peng, Chuangang; Zhang, Qiao; Yang, Qi; Zhu, QingSan

    2012-01-01

    A 10-mm long sciatic nerve injury model was established in fresh normal Chinese patient cadavers. Amniotic membrane was harvested from healthy maternal placentas and was prepared into multilayered, coiled, tubular specimens. Sciatic nerve injury models were respectively anastomosed using the autologous cadaveric sciatic nerve and human amniotic membrane. Tensile test results showed that maximal loading, maximal displacement, maximal stress, and maximal strain of sciatic nerve injury models an...

  16. A New Rerouting Technique for the Extensor Pollicis Longus in Palliative Treatment for Wrist and Finger Extension Paralysis Resulting From Radial Nerve and C5C6C7 Root Injury.

    Laravine, Jennifer; Cambon-Binder, Adeline; Belkheyar, Zoubir

    2016-03-01

    Wrist and finger extension paralysis is a consequence of an injury to the radial nerve or the C5C6C7 roots. Despite these 2 different levels of lesions, palliative treatment for this type of paralysis depends on the same tendon transfers. A large majority of the patients are able to compensate for a deficiency of the extension of the wrist and fingers. However, a deficiency in the opening of the first web space, which could be responsible for transfers to the abductor pollicis longus, the extensor pollicis brevis, and the extensor pollicis longus (EPL), frequently exists. The aim of this work was to evaluate the feasibility of a new EPL rerouting technique outside of Lister's tubercle. Another aim was to verify whether this technique allows a better opening of the thumb-index pinch in this type of paralysis. In the first part, we performed an anatomic study comparing the EPL rerouting technique and the frequently used technique for wrist and finger extension paralyses. In the second part, we present 2 clinical cases in which this new technique will be practiced. Preliminary results during this study favor the EPL rerouting technique. This is a simple and reproducible technique that allows for good opening of the first web space in the treatment of wrist and finger extension paralysis. PMID:26709570

  17. Immune reactions and nerve repair in mice with sciatic nerve injury 14 days after intraperitoneal injection of Brazil

    Jian Cao; Zhongping Niu; Yongan Wang; Yiwen Jiang; Haoyu Liu; Binfeng Wang; Weitian Yin; Lisen Li

    2012-01-01

    BALB/c mice were intraperitoneally injected with 10, 5 or 2.5 mg/kg Brazil for 14 days after sciatic nerve injury. Results demonstrate that the spleen T/B lymphocyte stimulation index and serum circulating immune complex concentration were significantly reduced, and the morphology of the soleus muscle was restored in mice with sciatic nerve injury. These effects of Brazil were dose-dependent. Our experimental findings indicate that Brazil can regulate immune responses after nerve injury and promote sciatic nerve repair.

  18. Biological conduit small gap sleeve bridging method for peripheral nerve injury:regeneration law of nerve ifbers in the conduit

    Pei-xun Zhang; Li-ya A; Yu-hui Kou; Xiao-feng Yin; Feng Xue#; Na Han; Tian-bing Wang; Bao-guo Jiang

    2015-01-01

    The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair periph-eral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good his-tocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve ifbers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2–8 weeks), the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objec-tive and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

  19. Biological conduit small gap sleeve bridging method for peripheral nerve injury: regeneration law of nerve fibers in the conduit

    Pei-xun Zhang

    2015-01-01

    Full Text Available The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2-8 weeks, the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

  20. Improvement of sciatic nerve regeneration using laminin-binding human NGF-beta.

    Wenjie Sun

    Full Text Available BACKGROUND: Sciatic nerve injuries often cause partial or total loss of motor, sensory and autonomic functions due to the axon discontinuity, degeneration, and eventual death which finally result in substantial functional loss and decreased quality of life. Nerve growth factor (NGF plays a critical role in peripheral nerve regeneration. However, the lack of efficient NGF delivery approach limits its clinical applications. We reported here by fusing with the N-terminal domain of agrin (NtA, NGF-beta could target to nerve cells and improve nerve regeneration. METHODS: Laminin-binding assay and sustained release assay of NGF-beta fused with NtA (LBD-NGF from laminin in vitro were carried out. The bioactivity of LBD-NGF on laminin in vitro was also measured. Using the rat sciatic nerve crush injury model, the nerve repair and functional restoration by utilizing LBD-NGF were tested. FINDINGS: LBD-NGF could specifically bind to laminin and maintain NGF activity both in vitro and in vivo. In the rat sciatic nerve crush injury model, we found that LBD-NGF could be retained and concentrated at the nerve injury sites to promote nerve repair and enhance functional restoration following nerve damages. CONCLUSION: Fused with NtA, NGF-beta could bind to laminin specifically. Since laminin is the major component of nerve extracellular matrix, laminin binding NGF could target to nerve cells and improve the repair of peripheral nerve injuries.

  1. Pathology of the vestibulocochlear nerve

    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: bert.defoer@GZA.be; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: christophkenis@hotmail.com; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Deborah.vanmelkebeke@Ugent.be; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: jphver@yahoo.com; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Thomas.somers@GZA.be; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: marc.pouillon@GZA.be; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Erwin.offeciers@GZA.be; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail: jan.casselman@azbrugge.be

    2010-05-15

    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.

  2. Multiple schwannomas of the digital nerves and superficial radial nerve: two unusual cases of segmental schwannomatosis.

    Gosk, Jerzy; Gutkowska, Olga; Kuliński, Sebastian; Urban, Maciej; Hałoń, Agnieszka

    2015-01-01

    Two cases of segmental sporadic schwannomatosis characterized by unusual location of multiple schwannomas in digital nerves (case 1) and the superficial radial nerve (case 2) are described in this paper. In the first of the described cases, 6 tumours located at the base of the middle finger and in its distal portion were excised from both digital nerves. In the second case, 3 tumours located in the proximal 1/3 and halfway down the forearm were removed from the superficial radial nerve. In both cases, symptoms such as palpable tumour mass, pain, paraesthesias, and positive Tinel-Hoffman sign resolved after operative treatment. Final diagnoses were made based on histopathological examination results. In the second of the described cases, the largest of the excised lesions had features enabling diagnosis of a rare tumour type - ancient schwannoma. PMID:26216119

  3. Accessory breast tissue in axilla masquerading as breast cancer recurrence

    Goyal Shikha

    2008-01-01

    Full Text Available Ectopic or accessory breast tissue is most commonly located in the axilla, though it may be present anywhere along the milk line. Development is hormone dependent, similar to normal breast tissue. These lesions do not warrant any intervention unless they produce discomfort, thus their identification and distinction from other breast pathologies, both benign and malignant, is essential. We report a case with locally advanced breast cancer who presented with an ipsilateral axillary mass following surgery, radiotherapy, and chemotherapy. Subsequent evaluation with excision biopsy showed duct ectasia in axillary breast tissue and the patient was continued on hormone therapy with tamoxifen.

  4. Accessory auricles with ectopic digit a new association

    Mittal R

    2002-01-01

    Full Text Available A 25- year -old male had accessory auricles at birth and developed ectopic digit since 1 year. As this association could not be traced in literature, it is being reported. Ectopic digit in the present case was differentiated from supernumerary digit because of late onset at the age of 24 years, ruccurence after surgery, unilateral appearance, had origin from central depression of a well defined, round plaque on the distal inter-phalangeal joint of left thumb and had curvature simulating cutaneous horn. X-ray thumb did not reveal any bone formation in this ectopic digit.

  5. GSM accessories now available from the CERN Stores

    Labo Telecom

    2001-01-01

    As of 1st October you can order and receive GSM accessories from the CERN stores like any other article. The CERN stores also manage GSM telephones but, for technical reasons, only the Labo Telecom shop (Building 31, Room S026) is able to make the standard sales, repairs and exchanges for authorised persons with a CERN subscription. Labo Telecom will thus become a specialist shop, open from 11 a.m. to 12 a.m., and will apply the usual rules and authorisation procedures of the stores. The paper form for requests for GSM subscriptions is being computerized and will be available on EDH in the near future.

  6. Tardy ulnar nerve palsy after fracture non-union medial epicondyle of humerus – An unusual case

    Thiyam, Rajesh; Lalchandani, Rajesh

    2015-01-01

    Tardy ulnar nerve palsy is a chronic clinical condition characterised by delayed onset ulnar neuropathy. Typically tardy ulnar nerve palsy occurs as a consequence of non-union of lateral condyle in child resulting in cubitus valgus deformity which ultimately is the cause of ulnar nerve palsy. However very few literature are available for tardy ulnar nerve palsy as a result of old fracture of medial epicondyle without cubitus varus or valgus deformity. We report a rare case of tardy ulnar nerv...

  7. Size of the optic nerve in computed tomography

    Recently, the measurement of optic nerve diameter from CT images has become of great interest. For measuring the optic nerve diameter, the method of Neuro-Ocular index is advocated by Magadure, 1978. But it is very difficult to support this method, because no relationship exists between the ocular diameter and the optic nerve diameter. In order to measure the optic nerve diameter directly by CT image, we examined several Window Level and Window Width settings and print out tables. Results are as follows, 1) Width 400 and all Level settings, all optic nerves appear thick. 2) Width 100, 75, 50 and Level 0 settings show optic nerves thin. 3) Optic nerve looks thick by Width of 100, 75, 50 and Level of -50 settings. 4) By the Level set of CT value of optic nerve in each case and Width set 75 or 50, optic images show nearly the correct diameter. 5) The midpoint of CT value of optic nerve obtained from print out tables are 8 to -22 and the the average is -10. (author)

  8. Morphometry of Axons in Optic Nerves of Siamese's Twins

    Xinzu Gu; Zhenping Zhang; Qi Lin; Jiongji Liang; Wenyu Lu; Xiulan Ye; A A Sadun

    2002-01-01

    Purpose: To observe the development of optic nerve, we examined four optic nerves from Siameses Twins by absolute counts of axons.Methods: Mean axon diameter, mean axon density, totally axonal population and optic nerve area were noted for each optic nerve. The mean axon diameter and the mean axon density were compared between paraxial (inner sectors)and cortical (outer sectors)areas of the nerves.Results: More myelinated axons were seen in the inner sectors as compared to the outer sectors(average 11 axons/1 000 μm2 in inner sectors and 34 axons/l 000 μm2 in outer sectors( P=0. 036) . The myelinated fibers were also smaller(63 microns) in the outer sectors as compared to the inner sectors(72 microns) ( P = 0. 001 ). The average cross sectors area for the four 40 week stage optical nerves of Siamese Twins was 3.32 × 103 as compared to 1 million axons for 32-week-old normals.Conclusion: Our finding of fewer axonal number and small myelinated fibers in the Siamese Twins suggests hypoplasia. Myelination was more abnormal in the paraxial optic nerve than that in the peripheral sectors, suggesting anomalous development of optic nerve peripherally and delayed developnent centrally. Axonal density is higher in inner sectors than that in outer sectors, suggesting delayed development of the outer nerve sector.

  9. Non-traumatic peroneal nerve palsy: MRI findings

    Aim: To present magnetic resonance imaging (MRI) findings of non-traumatic peroneal nerve palsy and to evaluate the usefulness of MRI in patients with non-traumatic peroneal nerve palsy. Materials and methods: In a retrospective study, 11 consecutive patients presenting with peroneal nerve palsy were included. MR images of the lower leg and electrophysiological examinations were also reviewed. The cause of peroneal nerve palsy was determined on the basis of MRI findings and was evaluated using electrophysiological data. Nine patients with causative lesions detected on MRI, underwent surgery. Results: Clinical examination and electromyography (EMG) disclosed 11 peroneal lesions. MRI and EMG revealed three types of signal intensity change, i.e. deep peroneal nerve palsy type, common peroneal nerve palsy type, and superficial peroneal nerve palsy type. The MRI and EMG findings were in agreement in seven (65%) of the 11 study patients. In nine patients the causative lesions were identified using MRI, including ganglion cyst (n = 6), osteochondroma (n = 1), synovial cyst (n = 1), and aneurysm (n = 1). Conclusion: Ganglion cyst is the most common cause of non-traumatic peroneal nerve palsy. MRI offers a noninvasive method for obtaining useful information to assess, localize, and monitor peripheral peroneal nerve palsy

  10. Non-traumatic peroneal nerve palsy: MRI findings

    Kim, J.Y. [Departments of Radiology St Vincent' s Hospital, Catholic University of Korea, Paldal-gu, Suwon city, Gyeonggi-do (Korea, Republic of); Ihn, Y.K. [Departments of Radiology St Vincent' s Hospital, The Catholic University of Korea, Paldal-gu, Suwon city, Gyeonggi-do (Korea, Republic of)]. E-mail: Ihn@catholic.ac.kr; Kim, J.S. [Department of Rehabilitation medicine, St Vincent' s Hospital, The Catholic University of Korea, Paldal-gu, Suwon city, Gyeonggi-do (Korea, Republic of); Chun, K.A. [Department of Radiology, Uijeongbu St. Mary' s Hospital, The Catholic University of Korea, Geumo-dong, Uijeongbu city, Gyeonggi-do (Korea, Republic of); Sung, M.S. [Department of Radiology, Holy Family Hospital, The Catholic University of Korea, Sosa-dong, Wonmi-gu, Bucheon city, Gyeonggi-do (Korea, Republic of); Cho, K.H. [Department of Radiology, College of Medicine, Yeungnam Univ. Medical Center, Nam-gu, Daegu (Korea, Republic of)

    2007-01-15

    Aim: To present magnetic resonance imaging (MRI) findings of non-traumatic peroneal nerve palsy and to evaluate the usefulness of MRI in patients with non-traumatic peroneal nerve palsy. Materials and methods: In a retrospective study, 11 consecutive patients presenting with peroneal nerve palsy were included. MR images of the lower leg and electrophysiological examinations were also reviewed. The cause of peroneal nerve palsy was determined on the basis of MRI findings and was evaluated using electrophysiological data. Nine patients with causative lesions detected on MRI, underwent surgery. Results: Clinical examination and electromyography (EMG) disclosed 11 peroneal lesions. MRI and EMG revealed three types of signal intensity change, i.e. deep peroneal nerve palsy type, common peroneal nerve palsy type, and superficial peroneal nerve palsy type. The MRI and EMG findings were in agreement in seven (65%) of the 11 study patients. In nine patients the causative lesions were identified using MRI, including ganglion cyst (n = 6), osteochondroma (n = 1), synovial cyst (n = 1), and aneurysm (n = 1). Conclusion: Ganglion cyst is the most common cause of non-traumatic peroneal nerve palsy. MRI offers a noninvasive method for obtaining useful information to assess, localize, and monitor peripheral peroneal nerve palsy.

  11. Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

    Anupama Wadhwa

    2011-01-01

    Full Text Available Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits.

  12. Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

    Wadhwa, Anupama; Kandadai, Sunitha Kanchi; Tongpresert, Sujittra; Obal, Detlef; Gebhard, Ralf Erich

    2011-01-01

    Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits. PMID:21808644

  13. Progesterone and peripheral nerve regeneration

    Fei Fan; Haichao Li; Yuwei Wang; Yanglin Zheng; Lianjun Jia; Zhihui Wang

    2006-01-01

    OBJECTIVE: To explore the effect of progesterone on peripheral nerve regeneration.DATA SOURCES: An online search of Medline and OVID databases was under taken to identify articles about progesterone and peripheral nerve regeneration published in English between January 1990 and June 2004 by using the keywords of "peripheral nerve, injury, progesterone, regeneration".STUDY SELECTION: The data were primarily screened, those correlated with progesterone and peripheral nerve regeneration were involved, and their original articles were further searched, the repetitive studies or reviews were excluded.DATA EXTRACTION: Totally 59 articles about progesterone and peripheral nerve regeneration were collected, and 26 of them were involved, the other 33 excluded ones were the repetitive studies or reviews.DATA SYNTHESIS: Recent researches found that certain amount of progesterone could be synthetized in peripheral nervous system, and the expression of progesterone receptor could be found in sensory neurons and Schwann cells. After combined with the receptor, endogenous and exogenous progesterone can accelerate the formation of peripheral nerve myelin sheath, also promote the axonal regeneration.CONCLUSION: Progesterone plays a role in protecting neurons, increasing the sensitivity of nerve tissue to nerve growth factor, and accelerating regeneration of nerve in peripheral nerve regeneration, which provides theoretical references for the treatment of demyelinated disease and nerve injury, as well as the prevention of neuroma, especially that the in vivo level of progesterone should be considered for the elderly people accompanied by neuropathy and patients with congenital luteal phase defect, which is of positive significance in guiding the treatment.

  14. Changes in the blood-nerve barrier after sciatic nerve cold injury: indications supporting early treatment

    Hao Li

    2015-01-01

    Full Text Available Severe edema in the endoneurium can occur after non-freezing cold injury to the peripheral nerve, which suggests damage to the blood-nerve barrier. To determine the effects of cold injury on the blood-nerve barrier, the sciatic nerve on one side of Wistar rats was treated with low temperatures (3-5°C for 2 hours. The contralateral sciatic nerve was used as a control. We assessed changes in the nerves using Evans blue as a fluid tracer and morphological methods. Excess fluid was found in the endoneurium 1 day after cold injury, though the tight junctions between cells remained closed. From 3 to 5 days after the cold injury, the fluid was still present, but the tight junctions were open. Less tracer leakage was found from 3 to 5 days after the cold injury compared with 1 day after injury. The cold injury resulted in a breakdown of the blood-nerve barrier function, which caused endoneurial edema. However, during the early period, the breakdown of the blood-nerve barrier did not include the opening of tight junctions, but was due to other factors. Excessive fluid volume produced a large increase in the endoneurial fluid pressure, prevented liquid penetration into the endoneurium from the microvasculature. These results suggest that drug treatment to patients with cold injuries should be administered during the early period after injury because it may be more difficult for the drug to reach the injury site through the microcirculation after the tissue fluid pressure becomes elevated.

  15. Regeneration of the nerves in the aerial cavity with an artificial nerve conduit --reconstruction of chorda tympani nerve gaps-.

    Toshiaki Yamanaka

    Full Text Available Due to its anatomical features, the chorda tympani nerve (CTN is sometimes sacrificed during middle ear surgery, resulting in taste dysfunction. We examined the effect of placing an artificial nerve conduit, a polyglycolic acid (PGA-collagen tube, across the gap in the section of the resected chorda tympani nerve (CTN running through the tympanic cavity.The CTN was reconstructed with a PGA-collagen tube in three patients with taste disturbance who underwent CTN resection. To evaluate the effect of the reconstruction procedure on the patients' gustatory function, we measured the patients' electrogustometry (EGM thresholds. The patients were followed-up for at least two years.Gustatory function was completely restored in all of the patients after the reconstruction. The patients' EGM thresholds exhibited early improvements within one to two weeks and had returned to their normal ranges within three months. They subsequently remained stable throughout the two-year follow-up period. In a patient who underwent a second surgical procedure, it was found that the PGA-collagen tube used in the first surgical procedure had been absorbed and replaced by new CTN fibers with blood vessels on their surfaces.These results suggest that reconstruction of the CTN with an artificial nerve conduit, a PGA-collagen tube, allows functional and morphological regeneration of the nerve and facilitates the recovery of taste function. PGA-collagen tubes might be useful for repairing CTNs that are resected during middle ear surgery. Further research is required to confirm these preliminary results although this is the first report to describe the successful regeneration of a nerve running through an aerial space.

  16. A novel electrospun nerve conduit enhanced by carbon nanotubes for peripheral nerve regeneration

    Yu, Wenwen; Jiang, Xinquan; Cai, Ming; Zhao, Wen; Ye, Dongxia; Zhou, Yong; Zhu, Chao; Zhang, Xiuli; Lu, Xiaofeng; Zhang, Zhiyuan

    2014-04-01

    For artificial nerve conduits, great improvements have been achieved in mimicking the structures and components of autologous nerves. However, there are still some problems in conduit construction, especially in terms of mechanical properties, biomimetic surface tomography, electrical conductivity and sustained release of neurotrophic factors or cells. In this study, we designed and fabricated a novel electrospun nerve conduit enhanced by multi-walled carbon nanotubes (MWNTs) on the basis of a collagen/poly(ɛ-caprolactone) (collagen/PCL) fibrous scaffold. Our aim was to provide further knowledge about the mechanical effects and efficacy of MWNTs on nerve conduits as well as the biocompatibility and toxicology of MWNTs when applied in vivo. The results showed that as one component, carboxyl MWNTs could greatly alter the composite scaffold’s hydrophilicity, mechanical properties and degradability. The electrospun fibers enhanced by MWNTs could support Schwann cell adhesion and elongation as a substrate in vitro. In vivo animal studies demonstrated that the MWNT-enhanced collagen/PCL conduit could effectively promote nerve regeneration of sciatic nerve defect in rats and prevent muscle atrophy without invoking body rejection or serious chronic inflammation. All of these results showed that this MWNT-enhanced scaffold possesses good biocompatibility and MWNTs might be excellent candidates as engineered nanocarriers for further neurotrophic factor delivery research.

  17. A novel electrospun nerve conduit enhanced by carbon nanotubes for peripheral nerve regeneration

    For artificial nerve conduits, great improvements have been achieved in mimicking the structures and components of autologous nerves. However, there are still some problems in conduit construction, especially in terms of mechanical properties, biomimetic surface tomography, electrical conductivity and sustained release of neurotrophic factors or cells. In this study, we designed and fabricated a novel electrospun nerve conduit enhanced by multi-walled carbon nanotubes (MWNTs) on the basis of a collagen/poly(ε-caprolactone) (collagen/PCL) fibrous scaffold. Our aim was to provide further knowledge about the mechanical effects and efficacy of MWNTs on nerve conduits as well as the biocompatibility and toxicology of MWNTs when applied in vivo. The results showed that as one component, carboxyl MWNTs could greatly alter the composite scaffold’s hydrophilicity, mechanical properties and degradability. The electrospun fibers enhanced by MWNTs could support Schwann cell adhesion and elongation as a substrate in vitro. In vivo animal studies demonstrated that the MWNT-enhanced collagen/PCL conduit could effectively promote nerve regeneration of sciatic nerve defect in rats and prevent muscle atrophy without invoking body rejection or serious chronic inflammation. All of these results showed that this MWNT-enhanced scaffold possesses good biocompatibility and MWNTs might be excellent candidates as engineered nanocarriers for further neurotrophic factor delivery research. (paper)

  18. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica

    Shi, Yin; Zong, Min; Xu, Xiaoquan; Zou, Yuefen; Feng, Yang; Liu, Wei; Wang, Chuanbing; Wang, Dehang, E-mail: njmu_wangdehang@126.com

    2015-04-15

    Highlights: •In the present study, we first elected ROIs corresponding to the proximal, medial, and distal levels of the lumbar foraminal zone. •The ROC analysis for FA values of distal nerves indicated a high level of reliability in the diagnosis of sciatica. •The declining trend of FA values from proximal to distal along the nerve tract may correlate with the disparity of axonal regeneration at different levels. •DTI is able to quantitatively evaluate compressed nerve roots and has a higher sensitivity and specificity for diagnosing sciatica than conventional MR imaging. •DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and probable localization of nerve compression. -- Abstract: Objective: To quantitatively evaluate nerve roots by measuring fractional anisotropy (FA) values in healthy volunteers and sciatica patients, visualize nerve roots by tractography, and compare the diagnostic efficacy between conventional magnetic resonance imaging (MRI) and DTI. Materials and methods: Seventy-five sciatica patients and thirty-six healthy volunteers underwent MR imaging using DTI. FA values for L5–S1 lumbar nerve roots were calculated at three levels from DTI images. Tractography was performed on L3–S1 nerve roots. ROC analysis was performed for FA values. Results: The lumbar nerve roots were visualized and FA values were calculated in all subjects. FA values decreased in compressed nerve roots and declined from proximal to distal along the compressed nerve tracts. Mean FA values were more sensitive and specific than MR imaging for differentiating compressed nerve roots, especially in the far lateral zone at distal nerves. Conclusions: DTI can quantitatively evaluate compressed nerve roots, and DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and localization of probable nerve compression. DTI has great potential utility for evaluating lumbar nerve compression in sciatica.

  19. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica

    Highlights: •In the present study, we first elected ROIs corresponding to the proximal, medial, and distal levels of the lumbar foraminal zone. •The ROC analysis for FA values of distal nerves indicated a high level of reliability in the diagnosis of sciatica. •The declining trend of FA values from proximal to distal along the nerve tract may correlate with the disparity of axonal regeneration at different levels. •DTI is able to quantitatively evaluate compressed nerve roots and has a higher sensitivity and specificity for diagnosing sciatica than conventional MR imaging. •DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and probable localization of nerve compression. -- Abstract: Objective: To quantitatively evaluate nerve roots by measuring fractional anisotropy (FA) values in healthy volunteers and sciatica patients, visualize nerve roots by tractography, and compare the diagnostic efficacy between conventional magnetic resonance imaging (MRI) and DTI. Materials and methods: Seventy-five sciatica patients and thirty-six healthy volunteers underwent MR imaging using DTI. FA values for L5–S1 lumbar nerve roots were calculated at three levels from DTI images. Tractography was performed on L3–S1 nerve roots. ROC analysis was performed for FA values. Results: The lumbar nerve roots were visualized and FA values were calculated in all subjects. FA values decreased in compressed nerve roots and declined from proximal to distal along the compressed nerve tracts. Mean FA values were more sensitive and specific than MR imaging for differentiating compressed nerve roots, especially in the far lateral zone at distal nerves. Conclusions: DTI can quantitatively evaluate compressed nerve roots, and DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and localization of probable nerve compression. DTI has great potential utility for evaluating lumbar nerve compression in sciatica

  20. Homology of the fifth epibranchial and accessory elements of the ceratobranchials among gnathostomes: insights from the development of ostariophysans.

    Carvalho, Murilo; Bockmann, Flávio Alicino; de Carvalho, Marcelo Rodrigues

    2013-01-01

    Epibranchials are among the main dorsal elements of the gill basket in jawed vertebrates (Gnathostomata). Among extant fishes, chondrichthyans most resemble the putative ancestral condition as all branchial arches possess every serially homologous piece. In osteichthyans, a primitive rod-like epibranchial 5, articulated to ceratobranchial 5, is absent. Instead, epibranchial 5 of many actinopterygians is here identified as an accessory element attached to ceratobranchial 4. Differences in shape and attachment of epibranchial 5 in chondrichthyans and actinopterygians raised suspicions about their homology, prompting us to conduct a detailed study of the morphology and development of the branchial basket of three ostariophysans (Prochilodus argenteus, Characiformes; Lophiosilurus alexandri and Pseudoplatystoma corruscans, Siluriformes). Results were interpreted within a phylogenetic context of major gnathostome lineages. Developmental series strongly suggest that the so-called epibranchial 5 of actinopterygians does not belong to the epal series because it shares the same chondroblastic layer with ceratobranchial 4 and its ontogenetic emergence is considerably late. This neomorphic structure is called accessory element of ceratobranchial 4. Its distribution among gnathostomes indicates it is a teleost synapomorphy, occurring homoplastically in Polypteriformes, whereas the loss of the true epibranchial 5 is an osteichthyan synapomorphy. The origin of the accessory element of ceratobranchial 4 appears to have occurred twice in osteichthyans, but it may have a single origin; in this case, the accessory element of ceratobranchial 4 would represent a remnant of a series of elements distally attached to ceratobranchials 1-4, a condition totally or partially retained in basal actinopterygians. Situations wherein a structure is lost while a similar neomorphic element is present may lead to erroneous homology assessments; these can be avoided by detailed morphological and

  1. The accessory coracobrachialis muscle: ultrasound and MR features

    Bauones, Salem [Centre hospitalier de l' Universite de Montreal (CHUM), Department of Radiology, Hopital Saint-Luc, Montreal, Quebec (Canada); Moraux, Antoine [Imagerie Medicale Jacquemars Gielee, Lille (France)

    2015-09-15

    To present the prevalence, clinical relevance, and ultrasound (US) and magnetic resonance imaging (MRI) appearances of the accessory coracobrachialis (ACB) muscle. We present an US prospective study of the ACB muscle over a 2-year period. Five of the eight patients with suspected ACB on US were subsequently examined by MRI. An ACB muscle was demonstrated by US in eight patients (eight shoulders), including seven females, one male, with mean age 39 years, over 770 (664 patients) consecutive shoulder US examinations referred to our institution yielding a prevalence of 1.04 %. In dynamic US assessment, one case of subcoracoid impingement secondary to a bulky ACB was diagnosed. No thoracic outlet syndrome was encountered in the remaining cases. MRI confirmed the presence of the accessory muscle in five cases. ACB muscle is a rarely reported yet not uncommon anatomic variation of the shoulder musculature encountered only in eight of 664 patients referred for shoulder US study. Its US and MRI appearance is described. One of our patients presented with subcoracoid impingement related to the presence of an ACB. (orig.)

  2. Digital dermatitis of the accessory digits of dairy cows

    Celso A. Rodrigues

    2010-03-01

    Full Text Available This report characterizes the digital dermatitis (DD lesions in the accessory digits of dairy cows and presents data on the applied therapy. Fifteen Holstein cattle with DD affecting the accessory digits of the hindlimbs from four dairy farms with previous history of DD were evaluated. Lesions were excised, the wounds were sutured, and a topical application of oxytetracycline powder covered by bandaging was associated with a single parenteral administration of long acting oxytetracycline IM (20mg/kg. Tissue samples were obtained for histopathology and transmission electronic microscopy (TEM. Lesions from all the animals were recuperated 15 days after surgical procedure. Overal, most DD lesions were papillomatous epidermal projections or wartlike verrucous lesions. Histopathologically, samples revealed hyperplasia of epidermis with hyperkeratosis, several mitoses in the stratum basale and elongated rete ridges in the superficial and middle dermis. TEM revealed long, thin spirochete-like bacteria. Morphologic features of lesions and its response to therapy were comparable to those described for DD.

  3. The accessory coracobrachialis muscle: ultrasound and MR features

    To present the prevalence, clinical relevance, and ultrasound (US) and magnetic resonance imaging (MRI) appearances of the accessory coracobrachialis (ACB) muscle. We present an US prospective study of the ACB muscle over a 2-year period. Five of the eight patients with suspected ACB on US were subsequently examined by MRI. An ACB muscle was demonstrated by US in eight patients (eight shoulders), including seven females, one male, with mean age 39 years, over 770 (664 patients) consecutive shoulder US examinations referred to our institution yielding a prevalence of 1.04 %. In dynamic US assessment, one case of subcoracoid impingement secondary to a bulky ACB was diagnosed. No thoracic outlet syndrome was encountered in the remaining cases. MRI confirmed the presence of the accessory muscle in five cases. ACB muscle is a rarely reported yet not uncommon anatomic variation of the shoulder musculature encountered only in eight of 664 patients referred for shoulder US study. Its US and MRI appearance is described. One of our patients presented with subcoracoid impingement related to the presence of an ACB. (orig.)

  4. Nipple adenoma arising from axillary accessory breast: a case report

    Shioi Yoshihiro

    2012-11-01

    Full Text Available Abstract Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the axillary accessory breast have very seldom been reported in the English literature. We report a case of nipple adenoma arising from axillary accessory breast including clinical and pathological findings. An 82-year-old woman presented with the complaint of a small painful mass in the right axilla. Physical examination confirmed a well-defined eczematous crusted mass that was 8 mm in size. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Microscopic structural features included a compact proliferation of small tubules lined by epithelial and myoepithelial cells, and the merging of glandular epithelial cells of the adenoma into squamous epithelial cells in the superficial epidermal layer. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for axillary tumor neoplasms. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1186821489769063

  5. Forest haulage accessories for agricultural tractors in 1995

    This bulletin is a review of hydraulic timber cranes, forest trailers and skidding grapples and winches available on the Finnish markets in autumn 1995 as accessories for mounting onto agricultural tractors. The information is mainly based on the responses of the manufacturers and distributors to a mail questionnaire. Ten producers make timber cranes and a total of 46 crane models are presented. Nearly all the cranes can be mounted onto either the 3-point hitching device, the connecting rail of a trailer/sled, or directly onto the tractor frame. The net lifting force of the cranes varies in between 19.9 - 40.0 kNm. The maximum reach of the cranes varies between 4.3 and 9.8 m. The mechanical twin-lever system has almost entirely replaced the conventional six-lever operating type. Electro-hydraulic pre-control is included in the accessories available for many of the cranes. There are twelve producers and 37 models of forestry trailers, with eight including power transmission. All these trailers are of the bogie type. Their carrying capacity varies between 6 000 - 12 500 kilos. Five manufacturers produce six models of 3-point hitchable hydraulic skidding grabbles were listed. all are provided with a frame joint easing the job of grasping and skidding of timber. Skidding winches mountable onto the 3-point hitching device are of three producers and seven models. The tractive force varies between 28 and 60 kN. All are provided with a disc clutch

  6. Subject-Specific Effect of Metallic Body Accessories on Path Loss of Dynamic on-Body Propagation Channels.

    Rahim, H A; Abdulmalek, M; Soh, P J; Rani, K A; Hisham, N; Vandenbosch, G A E

    2016-01-01

    This paper presents the investigation of path loss variation for subject-specific on-body radio propagation channels, considering the effect of metallic spectacles and loop like metallic accessories. Adding metallic items may affect the operability of Body Centric Wireless Communications (BCWC). Measurements were carried out in an RF-shielded room lined with microwave absorbing sheets for strategically placed bodyworn antennas covering the upper front torso and the lower limbs. The path loss of the on-body radio channel was characterized explicitly taking into account the body size of the subjects. For metallic loop-like accessories, the results indicate that for underweight subjects, there was a slightly higher influence, up to 2%, compared to normal and overweight subjects. Our findings indicate that a noticeable effect exists on on-body channels for dynamic movements where the metallic watch acts as a local scatterer that affects the non-line-of-sight (NLOS) signal path between transmitter and receiver for underweight subjects in comparison to normal and overweight subjects. The path loss decreases when the receiving terminal was positioned very close to the metallic item. If a loop-like metallic accessory is not appropriately considered when designing the radio channel on a subject, the reliability of the body-centric wireless system may degrade. PMID:27436496

  7. Subject-Specific Effect of Metallic Body Accessories on Path Loss of Dynamic on-Body Propagation Channels

    Rahim, H. A.; Abdulmalek, M.; Soh, P. J.; Rani, K. A.; Hisham, N.; Vandenbosch, G. A. E.

    2016-07-01

    This paper presents the investigation of path loss variation for subject-specific on-body radio propagation channels, considering the effect of metallic spectacles and loop like metallic accessories. Adding metallic items may affect the operability of Body Centric Wireless Communications (BCWC). Measurements were carried out in an RF-shielded room lined with microwave absorbing sheets for strategically placed bodyworn antennas covering the upper front torso and the lower limbs. The path loss of the on-body radio channel was characterized explicitly taking into account the body size of the subjects. For metallic loop-like accessories, the results indicate that for underweight subjects, there was a slightly higher influence, up to 2%, compared to normal and overweight subjects. Our findings indicate that a noticeable effect exists on on-body channels for dynamic movements where the metallic watch acts as a local scatterer that affects the non-line-of-sight (NLOS) signal path between transmitter and receiver for underweight subjects in comparison to normal and overweight subjects. The path loss decreases when the receiving terminal was positioned very close to the metallic item. If a loop-like metallic accessory is not appropriately considered when designing the radio channel on a subject, the reliability of the body-centric wireless system may degrade.

  8. Synergistic action of recombinant accessory hemicellulolytic and pectinolytic enzymes to Trichoderma reesei cellulase on rice straw degradation.

    Laothanachareon, Thanaporn; Bunterngsook, Benjarat; Suwannarangsee, Surisa; Eurwilaichitr, Lily; Champreda, Verawat

    2015-12-01

    Synergism between core cellulases and accessory hydrolytic/non-hydrolytic enzymes is the basis of efficient hydrolysis of lignocelluloses. In this study, the synergistic action of three recombinant accessory enzymes, namely GH62 α-l-arabinofuranosidase (ARA), CE8 pectin esterase (PET), and GH10 endo-1,4-beta-xylanase (XYL) from Aspergillus aculeatus expressed in Pichia pastoris to a commercial Trichoderma reesei cellulase (Accellerase® 1500; ACR) on hydrolysis of alkaline pretreated rice straw was studied using a mixture design approach. Applying the full cubic model, the optimal ratio of quaternary enzyme mixture was predicted to be ACR:ARA:PET:XYL of 0.171:0.079:0.100:0.150, which showed a glucose releasing efficiency of 0.173 gglc/FPU, higher than the binary ACR:XYL mixture (0.122 gglc/FPU) and ACR alone (0.081 gglc/FPU) leading to a 47.3% increase in glucose yield compared with that from ACR at the same cellulase dosage. The result demonstrates the varying degree of synergism of accessory enzymes to cellulases useful for developing tailor-made enzyme systems for bio-industry. PMID:26433794

  9. Anatomical peculiarities of sensory tracts of the wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve defect

    Sixin Ouyang; Zhenshan Peng; Jianguo Tan; Tianhong Peng; Jianzhong Xiao

    2006-01-01

    BACKGROUND: Translocation or transplantation of nerve stem has good effect;however, nervous function of donator is completely lost. If some nerve stem is damaged, sensory tracts are intercepted from the near nerve stem by nutrient vessels to regard as neural graft for transferring and bridging which may repair injured nerve and decrease neural functional loss of donator.OBJECTIVE: To observe anatomical peculiarities on sensory tracts of wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve defect, and to investigate its feasibility.DESIGN: Duplicated and measured design.SETTING: Anatomy Department of Medical College affiliated to Nanhua University.MATERIALS: A total of 14 samples of upper limbs were selected from adult unnamed corpse and volunteers.METHODS: The experiment was completed at the Clinical Application Anatomy Laboratory of Medical College affiliated to Nanhua University from September to November 2005. Samples were perfused with red emulsion through artery to observe length, fibrous bands and blood supply of median nerve and ulnar nerve at wrist. Boundary of median nerve at wrist ranged from superficial site between flexor carpi radialis and palmaris longus to branch of common palmar digital nerves. Ulnar nerve at wrist ranged from branch of back of the hand to site of common palmar digital nerves. Proximal boundary of the two nerves was crossed from 1/8 to 2/8 region of forearm. Samples of upper limbs from 1 case were selected to simulate operation on sensory tracts of wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve.MAIN OUTCOME MEASURES: Anatomical peculiarities on sensory tracts of wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve defect.RESULTS: ① The length of wrist median nerves was 7.8 (7.5-8.1) cm. There were 19 to 27 nerve tracts in it and the majority belonged to sensory tracts on the ulnar side, in which non

  10. Prevalence of nerve-vessel contact at cisternal segments of the oculomotor nerve in asymptomatic patients evaluated with magnetic resonance images

    WANG Jin; GONG Xiang-yang; SUN Yi; HU Xing-yue

    2010-01-01

    Background Some studies indicated that cases of idiopathic oculomotor nerve palsy can be explained by vascular compression of the oculomotor nerve. Vascular contact with or compression to the cisternal segment of the oculomotor nerve has been reported frequently in asymptomatic individuals. In this study, we retrospectively analyzed the relationship between the oculomotor nerve's cisternal segment and adjacent arteries in asymptomatic patients and the prevalence of this occurrence via magnetic resonance imaging (MRI).Method MRI of bilateral oculomotor nerves in 93 asymptomatic patients were reviewed. The oculomotor nerve-artery relationship was evaluated and classified from levels 1 to 3, representing the degrees of contact on oblique transverse and oblique sagittal reconstructed MRI. Prevalence of the nerve-artery relationship at each level was described. The correlation between the nerve-vessel relationship (levels) and the age was analyzed by Spearman's rank correlation analysis.Results Cisternal segment of the oculomotor nerve did not have contact with any artery (level 1) in 27.4% (51/186) nerves. One hundred nerves made contact with at least one artery (level 2), but their shapes or configurations were not changed; 35 nerves (18.8%) were displaced or distorted due to artery compression (level 3). The posterior cerebral artery had the greatest incidence of making contact with or compressing the cisternal segment of the oculomotor nerve (58.1%). No significant correlation between nerve-vessel relationship (levels) and the age was found in this study. Conclusions Whether oculomotor nerve contact with or compression by one or more arteries is of high prevalence in asymptomatic individuals as evidenced by MRI examination. There is no correlation with individual age. Discretion should be used when making an etiological diagnosis of vascular compression for patients with oculomotor nerve palsy. Further investigation of other causes is warranted.

  11. Mesenchymal Stem Cells Enhance Nerve Regeneration in a Rat Sciatic Nerve Repair and Hindlimb Transplant Model

    Cooney, Damon S.; Wimmers, Eric G.; Ibrahim, Zuhaib; Grahammer, Johanna; Christensen, Joani M.; Brat, Gabriel A.; Wu, Lehao W.; Sarhane, Karim A.; Lopez, Joseph; Wallner, Christoph; Furtmüller, Georg J.; Yuan, Nance; Pang, John; Sarkar, Kakali; Lee, W. P. Andrew; Brandacher, Gerald

    2016-01-01

    This study investigates the efficacy of local and intravenous mesenchymal stem cell (MSC) administration to augment neuroregeneration in both a sciatic nerve cut-and-repair and rat hindlimb transplant model. Bone marrow-derived MSCs were harvested and purified from Brown-Norway (BN) rats. Sciatic nerve transections and repairs were performed in three groups of Lewis (LEW) rats: negative controls (n = 4), local MSCs (epineural) injection (n = 4), and systemic MSCs (intravenous) injection (n = 4). Syngeneic (LEW-LEW) (n = 4) and allogeneic (BN-LEW) (n = 4) hindlimb transplants were performed and assessed for neuroregeneration after local or systemic MSC treatment. Rats undergoing sciatic nerve cut-and-repair and treated with either local or systemic injection of MSCs had significant improvement in the speed of recovery of compound muscle action potential amplitudes and axon counts when compared with negative controls. Similarly, rats undergoing allogeneic hindlimb transplants treated with local injection of MSCs exhibited significantly increased axon counts. Similarly, systemic MSC treatment resulted in improved nerve regeneration following allogeneic hindlimb transplants. Systemic administration had a more pronounced effect on electromotor recovery while local injection was more effective at increasing fiber counts, suggesting different targets of action. Local and systemic MSC injections significantly improve the pace and degree of nerve regeneration after nerve injury and hindlimb transplantation. PMID:27510321

  12. Vascular endothelial growth factor promotes peripheral nerve regeneration after sciatic nerve transection in rat

    Rahim Mohammadi; Sima Ahsan; Masoume Masoumi; Keyvan Amini

    2013-01-01

    Objective:To evaluate the local effect of vascular endothelial growth factor (VEGF) on transected sciatic nerve regeneration.Methods:Sixty male white Wistar rats were divided into four experimental groups randomly (n=15).In transected group the left sciatic nerve was transected and the stump was fixed to adjacent muscle.In treatment group the defect was bridged using a silicone graft filled with 10μL VEGF.In silicone group the graft was filled with phosphate-buffered saline.In sham-operated group the sciatic nerve was exposed and manipulated.Each group was subdivided into three subgroups with five animals in each and nerve fibers were studied 4,8 and 12 weeks after operation.Results:Behavioral test,functional study of sciatic nerve,gastrocnemius muscle mass and morphometric indices confirmed a faster recovery of regenerated axons in VEGF group than in silicone group (P<0.05).In immunohistochemical assessment,reactions to S-100 in VEGF group were more positive than that in silicone group.Conclusion:Local administration of VEGF will improve functional recovery and morphometric indices of sciatic nerve.

  13. Changes of medium-latency SEP-components following peripheral nerve lesion

    Straschill Max

    2006-10-01

    Full Text Available Abstract Background Animal studies have demonstrated complex cortical reorganization following peripheral nerve lesion. Central projection fields of intact nerves supplying skin areas which border denervated skin, extended into the deafferentiated cortical representation area. As a consequence of nerve lesions and subsequent reorganization an increase of the somatosensory evoked potentials (SEPs was observed in cats when intact neighbouring nerves were stimulated. An increase of SEP-components of patients with nerve lesions may indicate a similar process of posttraumatic plastic cortical reorganization. Methods To test if a similar process of post-traumatic plastic cortical reorganization does occur in humans, the SEP of intact neighbouring hand nerves were recorded in 29 patients with hand nerve lesions. To hypothetically explain the observed changes of SEP-components, SEP recording following paired stimulation of the median nerve was performed in 12 healthy subjects. Results Surprisingly 16 of the 29 patients (55.2% showed a reduction or elimination of N35, P45 and N60. Patients with lesions of two nerves showed more SEP-changes than patients with a single nerve lesion (85.7%; 6/7 nerves; vs. 34.2%; 13/38 nerves; Fisher's exact test, p Conclusion The results of the present investigation do not provide evidence of collateral innervation of peripherally denervated cortical neurons by neurons of adjacent cortical representation areas. They rather suggest that secondary components of the excitatory response to nerve stimulation are lost in cortical areas, which surround the denervated region.

  14. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  15. Clavicle fractures - incidence of supraclavicular nerve injury

    Pedro Jose Labronici

    2013-08-01

    Full Text Available OBJECTIVE: To analyze retrospectively 309 fractures in the clavicle and the relation with injury of the supraclavicular nerve after trauma. METHODS: It was analyzed 309 patients with 312 clavicle fractures. The Edinburgh classification was used. Four patients had fractures in the medial aspect of the clavicle, 33 in the lateral aspect and 272 in the diaphyseal aspect and three bilateral fractures. RESULTS: 255 patients were analyzed and five had paresthesia in the anterior aspect of the thorax. Four patients had type 2 B2 fracture and one type 2 B1 fracture. All patients showed spontaneous improvement, in the mean average of 3 months after the trauma. CONCLUSION: Clavicle fractures and/ or shoulder surgeries can injure the lateral, intermediary or medial branches of the supraclavicular nerve and cause alteration of sensibility in the anterior aspect of the thorax. Knowledge of the anatomy of the nerve branches helps avoid problems in this region.

  16. Malignant Peripheral Nerve Sheath Tumor of the Infraorbital Nerve.

    D'Addino, José Luis; Piccoletti, Laura; Pigni, María Mercedes; de Gordon, Maria José Rodriguez Arenas

    2016-06-01

    The objective of this study is to report a large, rare, and ulcerative infiltrated skin lesion. Its diagnosis, therapeutic management, and progress are described. The patient is a 78-year-old white man, who presented with a 12-month ulcerative perforated lesion that had affected and infiltrated the skin, with easy bleeding. He had a history of hypertension, although controlled, was a 40-year smoker, had chronic atrial fibrillation, diabetes, and microangiopathy. During the consultation, the patient also presented with ocular obstruction due to an inability to open the eye. He mentioned having reduced vision. The computed tomography scan showed upper maxilla osteolysis without eye involvement. We underwent a radical resection in which upper maxilla and the anterior orbital margin were included. We used a Becker-type flap that allowed us to rebuild the cheek and to complete a modified neck dissection. Progress was favorable; the patient recovered ocular motility and his vision improved to 20/200. The final biopsy result was "malignant peripheral nerve sheath tumor, malignant schwannoma." Malignant schwannoma of the peripheral nerve is extremely rare. The total resection and reconstruction being completed in one surgery represented a challenge due to the difficulty in obtaining tissues in addition to the necessity of an oncological resection. PMID:27162577

  17. Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect

    Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide

  18. Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect

    Luo, Lihua [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China); Center of Molecular Medicine, School of Medicine, Hubei University of Arts and Sciences, Xiangyang 441053 (China); Gan, Li; Liu, Yongming; Tian, Weiqun; Tong, Zan [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China); Wang, Xiong; Huselstein, Celine [Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), UMR 7365 CNRS – Université de Lorraine, Biopôle, 54500 Vandoeuvre-lès-Nancy (France); Chen, Yun, E-mail: yunchen@whu.edu.cn [Department of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University, Wuhan 430071 (China)

    2015-02-20

    Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide

  19. Nerve conduction and excitability studies in peripheral nerve disorders

    Krarup, Christian; Moldovan, Mihai

    2009-01-01

    counterparts in the peripheral nervous system, in some instances without peripheral nervous system symptoms. Both hereditary and acquired demyelinating neuropathies have been studied and the effects on nerve pathophysiology have been compared with degeneration and regeneration of axons. SUMMARY: Excitability....... Studies of different metabolic neuropathies have assessed the influence of uremia, diabetes and ischemia, and the use of these methods in toxic neuropathies has allowed pinpointing damaging factors. Various mutations in ion channels associated with central nervous system disorders have been shown to have......PURPOSE OF REVIEW: The review is aimed at providing information about the role of nerve excitability studies in peripheral nerve disorders. It has been known for many years that the insight into peripheral nerve pathophysiology provided by conventional nerve conduction studies is limited. Nerve...

  20. Urokinase plasminogen receptor and the fibrinolytic complex play a role in nerve repair after nerve crush in mice, and in human neuropathies.

    Cristina Rivellini

    Full Text Available Remodeling of extracellular matrix (ECM is a critical step in peripheral nerve regeneration. In fact, in human neuropathies, endoneurial ECM enriched in fibrin and vitronectin associates with poor regeneration and worse clinical prognosis. Accordingly in animal models, modification of the fibrinolytic complex activity has profound effects on nerve regeneration: high fibrinolytic activity and low levels of fibrin correlate with better nerve regeneration. The urokinase plasminogen receptor (uPAR is a major component of the fibrinolytic complex, and binding to urokinase plasminogen activator (uPA promotes fibrinolysis and cell movement. uPAR is expressed in peripheral nerves, however, little is known on its potential function on nerve development and regeneration. Thus, we investigated uPAR null mice and observed that uPAR is dispensable for nerve development, whereas, loss of uPAR affects nerve regeneration. uPAR null mice showed reduced nerve repair after sciatic nerve crush. This was a consequence of reduced fibrinolytic activity and increased deposition of endoneurial fibrin and vitronectin. Exogenous fibrinolysis in uPAR null mice rescued nerve repair after sciatic nerve crush. Finally, we measured the fibrinolytic activity in sural nerve biopsies from patients with peripheral neuropathies. We showed that neuropathies with defective regeneration had reduced fibrinolytic activity. On the contrary, neuropathies with signs of active regeneration displayed higher fibrinolytic activity. Overall, our results suggest that enforced fibrinolysis may facilitate regeneration and outcome of peripheral neuropathies.

  1. Construction of a three-dimensional bionic nerve conduit containing two neurotrophic factors with separate delivery systems for the repair of sciatic nerve defects

    Zhiyue Li; Qun Zhao; Ran Bi; Yong Zhuang; Siyin Feng

    2011-01-01

    Previous studies of nerve conduits have investigated numerous properties, such as conduit luminal structure and neurotrophic factor incorporation, for the regeneration of nerve defects. The present study used a poly(lactic-co-glycolic acid) (PLGA) copolymer to construct a three-dimensional (3D) bionic nerve conduit, with two channels and multiple microtubule lumens, and incorporating two neurotrophic factors, each with their own delivery system, as a novel environment for peripheral nerve regeneration. The efficacy of this conduit in repairing a 1.5 cm sciatic nerve defect was compared with PLGA-alone and PLGA-microfilament conduits, and autologous nerve transplantation. Results showed that compared with the other groups, the 3D bionic nerve conduit had the fastest nerve conduction velocity, largest electromyogram amplitude, and shortest electromyogram latency. In addition, the nerve fiber density, myelin sheath thickness and axon diameter were significantly increased, and the recovery rate of the triceps surae muscle wet weight was lowest. These findings suggest that 3D bionic nerve conduits can provide a suitable microenvironment for peripheral nerve regeneration to efficiently repair sciatic nerve defects.

  2. EFFECTS OF CAPSAICIN ON RAT SCIATIC NERVE IN VINCRISTINE-INDUCED NEUROPATHIC PAIN MODEL

    Thanaa A. El-Masry *, Magda E. El Sayaad , Ibrahim A. Gaaboub and Wafaa M. Fouda

    2013-02-01

    Full Text Available Capsaicin, the pungent ingredient of red pepper, is used topically to treat different types of neuropathic pain, in rat model of vincristine induced neuropathic pain we tried to investigate the effect of capsaicin on sciatic nerve through electrophysiological and histopathological studies. We found that treatment of animals with vincristine results in significant decrease in sciatic nerve conduction velocity and degeneration of the nerve fibers, where combined treatment of vincristine and capsaicin showed highly significant decrease in sciatic nerve conduction velocity and degeneration of the nerve fibers compared with that treated with vincristine only. In new trial, we tried to investigate the effect of direct capsaicin titration on sciatic nerve fibers that results in nearly abolishment of nerve conduction velocity. All of these findings may illustrate the mechanism of capsaicin effect through afferent nerves degeneration.

  3. 21 CFR 878.4200 - Introduction/drainage catheter and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Introduction/drainage catheter and accessories. 878.4200 Section 878.4200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Introduction/drainage catheter and accessories. (a) Identification. An introduction/drainage catheter is...

  4. 77 FR 27663 - Airworthiness Directives; Aeronautical Accessories, Inc. High Landing Gear Forward Crosstube...

    2012-05-11

    ... Accessories, Inc. High Landing Gear Forward Crosstube Assembly AGENCY: Federal Aviation Administration (FAA... directive (AD) for Aeronautical Accessories, Inc. (AAI) high landing gear forward crosstube assemblies... crosstubes. The proposed actions are intended to prevent failure of a crosstube, collapse of the landing...

  5. 77 FR 67261 - Airworthiness Directives; Aeronautical Accessories, Inc., High Landing Gear Forward Crosstube...

    2012-11-09

    ... Accessories, Inc., High Landing Gear Forward Crosstube Assembly AGENCY: Federal Aviation Administration (FAA... Accessories, Inc. (AAI) high landing gear forward crosstube assemblies (crosstubes) installed on Agusta S.p.A..., collapse of the landing gear, and subsequent loss of control of the helicopter. DATES: This AD is...

  6. 77 FR 5420 - Airworthiness Directives; Aeronautical Accessories Inc. High Landing Gear Aft Crosstube Assembly

    2012-02-03

    ... Accessories Inc. High Landing Gear Aft Crosstube Assembly AGENCY: Federal Aviation Administration (FAA), DOT... (AD) for the Aeronautical Accessories Inc. (AAI) High Landing Gear Aft Crosstube Assembly (aft... proposed actions are intended to prevent failure of a crosstube, collapse of the landing gear,...

  7. 77 FR 37768 - Airworthiness Directives; Aeronautical Accessories, Inc., High Landing Gear Aft Crosstube Assembly

    2012-06-25

    ... Accessories, Inc., High Landing Gear Aft Crosstube Assembly AGENCY: Federal Aviation Administration (FAA), DOT... Accessories, Inc. (AAI), High Landing Gear Aft Crosstube Assembly (aft crosstube) installed on certain Bell... failure of a crosstube, collapse of the landing gear, and subsequent loss of control of the...

  8. Intermittent torsion of accessory hepatic lobe: An unusual cause of recurrent right upper quadrant pain

    An accessory lobe of the liver is a rare congenital anomaly that can undergo torsion and present as an acute surgical emergency. It is rarely diagnosed preoperatively. We report the preoperative utility of CT scan and MRI in the diagnosis and surgical planning of a case of intermittent accessory hepatic lobe torsion

  9. Ex Vivo Preparations of the Intact Vomeronasal Organ and Accessory Olfactory Bulb

    Doyle, Wayne I.; Hammen, Gary F.; Meeks, Julian P.

    2014-01-01

    The mouse accessory olfactory system (AOS) is a specialized sensory pathway for detecting nonvolatile social odors, pheromones, and kairomones. The first neural circuit in the AOS pathway, called the accessory olfactory bulb (AOB), plays an important role in establishing sex-typical behaviors such as territorial aggression and mating. This small (

  10. ACCESSORY FUNCTIONING BREAST TISSUE AS A LARGE MASS IN THE AXILLA

    Tripathi

    2013-01-01

    Full Text Available ABSTRACT: Accessory breasts are an uncommon entity & more un common when it is functioning. They may present as asymptomatic mass al ong the mammary ridge or symptoms evident during menarche, menstruation, pregnancy & l actation. We report a case of unilateral accessory breast in right axilla which was secretin g milk on day 3rd postpartum

  11. Chloroquine inhibits accessory cell presentation of soluble natural and synthetic protein antigens

    Buus, S; Werdelin, O

    1984-01-01

    We have studied the in vitro effect of the lysosomotrophic agent, chloroquine, on the presentation of soluble protein antigens by guinea pig accessory cells. Chloroquine inhibited the capacity of antigen-pulsed accessory cells to stimulate proliferation in appropriately primed T cells. The effect...

  12. 21 CFR 878.4400 - Electrosurgical cutting and coagulation device and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electrosurgical cutting and coagulation device and....4400 Electrosurgical cutting and coagulation device and accessories. (a) Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and...

  13. Intermittent torsion of accessory hepatic lobe: An unusual cause of recurrent right upper quadrant pain

    Jambhekar Kedar

    2010-01-01

    Full Text Available An accessory lobe of the liver is a rare congenital anomaly that can undergo torsion and present as an acute surgical emergency. It is rarely diagnosed preoperatively. We report the preoperative utility of CT scan and MRI in the diagnosis and surgical planning of a case of intermittent accessory hepatic lobe torsion.

  14. 76 FR 24522 - In the Matter of Certain Handbags, Luggage, Accessories, and Packaging Thereof; Notice of...

    2011-05-02

    ...,519,828. 76 FR 585-6 (Jan. 5, 2011). The complainant named as respondents T&T Handbag Industrial Co... COMMISSION In the Matter of Certain Handbags, Luggage, Accessories, and Packaging Thereof; Notice of... handbags, luggage, accessories, and packaging thereof by reason of infringement of certain claims of...

  15. Laryngeal Nerves Monitoring Versus Non-monitoring in Thyroid Surgery

    Mohammed Fatehy Zidan, Ahmed Abdou Moustafa

    2010-06-01

    Full Text Available Background and objectives: Thyroid surgery is the most common cause of recurrent nerve (RLN injury. Deliberate identification of the RLN minimizes the risk of injury. When the nerve is identified and dissected, the reported RLN injury rate during thyroidectomy is 0-2.1%. Continuous intra-operative nerve monitoring during surgery remains a controversial issue. The basic technique involves a skin surface electrode or muscle electrode used to make electromyography (EMG recordings, which have an audible alarm to alert the surgeon if passive (e.g.stretch during traction or active nerve stimulation has occurred. We aim to evaluate the use of intra-operative nerve monitoring (IONM to preserve the laryngeal nerves that may be at risk for injury during thyroid surgery and show the merits of using electrophysiologic laryngeal nerve monitoring during thyroid surgery. Patients and methods: This study was conducted as a prospective study on 28 patients whom are thyroidectomy candidates; we elected 14 thyroidectomy candidates in whom we don't use NIM during surgery (Control group_A. These patients were chosen to be evenly matched with another 14 thyroidectomy candidates to monitor the recurrent laryngeal (RLN and external branch of superior laryngeal (EBSLN throughout thyroidectomy procedures (NIM group_ B to compare the laryngeal nerves risk of injury with and without the use of nerve monitor. Results: Four patients (2 patients in-group A and 2 patients in-group B were dysphonic after operation. Laryngoscopy revealed unilateral recurrent laryngeal nerve palsy in all except one bilateral in group A. There were no significant differences in RLN paralysis, paresis, or total injury rates between both groups. The number of patients in the presented study was limited to draw a statistical conclusion for significance. Conclusions: The routine application of IONM cannot prevent or reduce recurrent laryngeal nerve injury. However the study signifies the trend towards

  16. Chitosan crosslinked flat scaffolds for peripheral nerve regeneration.

    Fregnan, F; Ciglieri, E; Tos, P; Crosio, A; Ciardelli, G; Ruini, F; Tonda-Turo, C; Geuna, S; Raimondo, S

    2016-01-01

    Chitosan (CS) has been widely used in a variety of biomedical applications, including peripheral nerve repair, due to its excellent biocompatibility, biodegradability, readily availability and antibacterial activity. In this study, CS flat membranes, crosslinked with dibasic sodium phosphate (DSP) alone (CS/DSP) or in association with the γ-glycidoxypropyltrimethoxysilane (CS/GPTMS_DSP), were fabricated with a solvent casting technique. The constituent ratio of crosslinking agents and CS were previously selected to obtain a composite material having both adequate mechanical properties and high biocompatibility. In vitro cytotoxicity tests showed that both CS membranes allowed cell survival and proliferation. Moreover, CS/GPTMS_DSP membranes promoted cell adhesion, induced Schwann cell-like morphology and supported neurite outgrowth from dorsal root ganglia explants. Preliminary in vivo tests carried out on both types of nerve scaffolds (CS/DSP and CS/GPTMS_DSP membranes) demonstrated their potential for: (i) protecting, as a membrane, the site of nerve crush or repair by end-to-end surgery and avoiding post-operative nerve adhesion; (ii) bridging, as a conduit, the two nerve stumps after a severe peripheral nerve lesion with substance loss. A 1 cm gap on rat median nerve was repaired using CS/DSP and CS/GPTMS_DSP conduits to further investigate their ability to induce nerve regeneration in vivo. CS/GPTMS_DSP tubes resulted to be more fragile during suturing and, along a 12 week post-operative lapse of time, they detached from the distal nerve stump. On the contrary CS/DSP conduits promoted nerve fiber regeneration and functional recovery, leading to an outcome comparable to median nerve repaired by autograft. PMID:27508969

  17. Hemiplegic peripheral neuropathy accompanied with multiple cranial nerve palsy

    Hirohisa Okuma

    2012-03-01

    Full Text Available A 32-year-old man experienced double vision around January, 2010, followed by weakness of his left upper and lower extremities. Articulation disorders and loss of hearing in his left ear developed, and he was admitted to our hospital on February 14, 2010. Physical examination was normal, and neurological examination showed clear consciousness with no impairment of cognitive function, but with articulation disorders. Olfactory sensation was reduced. Left ptosis and left gaze palsy, complete left facial palsy, perceptive deafness of the left ear, and muscle weakness of the left trapezius muscle were observed. Paresis in the left upper and lower extremities was graded 4/5 through manual muscle testing. Sensory system evaluation revealed complete left-side palsy, including the face. Deep tendon reflexes were slightly diminished equally on both sides; no pathologic reflex was seen. No abnormality of the brain parenchyma, cerebral nerves or cervicothoracolumbar region was found on brain magnetic resonance imaging. On electroencephalogram, alpha waves in the main frequency band of 8 to 9 Hz were recorded, indicating normal findings. Brain single photon emission computed tomography (SPECT scan showed reduced blood flow in the right inner frontal lobe and both occipital lobes. Nerve biopsy (left sural nerve showed reduction of nerve density by 30%, with demyelination. The patient also showed manifestations of multiple cranial nerve disorder, i.e., of the trigeminal nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve. Whole-body examination was negative. Finally, based on ischemic brain SPECT images, spinal fluid findings and nerve biopsy results, peripheral neuropathy accompanied with multiple cranial nerve palsy was diagnosed.

  18. Microscopic details of age related changes in rat optic nerve

    Fernanda Pacella

    2014-03-01

    Full Text Available Background: Age-related changes in the number and density of optic nerve fibres were studied in 12-month-old (adult and 24-month-old (aged male Wistar rats. Methods: Two-micrometer-thick resin-embedded optic nerve cross-sections obtained from two different age groups were stained with toluidine blue and examined under a light microscope at low (5x and high (500x magnification. The optic nerve cross-sectional area, and the number of nerve fibres with diameters less or higher than 1 μm were evaluated by means of computerized image analysis and statistical analysis of results. Results: Retrobulbar optic nerve cross-sectional area decreased in relation to ageing. The number of optic nerve fibres with a diameter of less than 1 μm decreased by about 39% in 24-month-old rats versus 12 month-old animals (P 0.05. Conclusions: Data suggest that age-related impairment of nerve cell population also occurs at the optic nerve level. Our data allow us to hypothesize that all major components of the rat optic paths are sensitive to the aging process.

  19. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    Gintaras Juodzbalys

    2011-01-01

    Full Text Available Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

  20. Role of nuclear medicine imaging in differential diagnosis of accessory spleens in patients after splenectomy

    More than 10% of healthy population has one or more accessory spleens. The most common location is the hilum of the spleen or area near the tail of the pancreas. The radiological appearance of accessory spleens in oncologic patients who underwent splenectomy can be misinterpreted as a recurrence, especially in the case of compensatory growth of an accessory spleen in successive radiological examinations. We present the cases of three patients who underwent splenectomy for gastric carcinoid, gastric adenocarcinoma and cancer of the left adrenal gland, respectively. CT examination and/or PET-CT scan revealed suspicious findings in the left upper abdomen. In one patient, the dimensional increase of this finding in successive examinations was initially considered suggestive for cancer recurrence. Scintigraphy with 99mTc-nanocolloid was able to confirm the presence of an accessory spleen in all these patients. Splenic scintigraphy is an economical, accessible and accurate tool in differential diagnosis of accessory spleens in patients after splenectomy

  1. Cranial Nerve Development Requires Co-Ordinated Shh and Canonical Wnt Signaling

    Kurosaka, Hiroshi; Paul A Trainor; Leroux-Berger, Margot; Iulianella, Angelo

    2015-01-01

    Cranial nerves govern sensory and motor information exchange between the brain and tissues of the head and neck. The cranial nerves are derived from two specialized populations of cells, cranial neural crest cells and ectodermal placode cells. Defects in either cell type can result in cranial nerve developmental defects. Although several signaling pathways are known to regulate cranial nerve formation our understanding of how intercellular signaling between neural crest cells and placode cell...

  2. Bridging peripheral nerves using a deacetyl chitin conduit combined with short-term electrical stimulation

    Zhang, Zhongli; Xin LI; Zuo, Songjie; Xin, Jie; Zhang, Peixun

    2014-01-01

    Previous studies have demonstrated that deacetyl chitin conduit nerve bridging or electrical stimulation can effectively promote the regeneration of the injured peripheral nerve. We hypothesized that the combination of these two approaches could result in enhanced regeneration. Rats with right sciatic nerve injury were subjected to deacetyl chitin conduit bridging combined with electrical stimulation (0.1 ms, 3 V, 20 Hz, for 1 hour). At 6 and 12 weeks after treatment, nerve conduction velocit...

  3. Conduction in ulnar nerve bundles that innervate the proximal and distal muscles: a clinical trial

    Oğuzhanoğlu Attila; Güler Sibel; Çam Mustafa; Değirmenci Eylem

    2010-01-01

    Abstract Background This study aims to investigate and compare the conduction parameters of nerve bundles in the ulnar nerve that innervates the forearm muscles and hand muscles; routine electromyography study merely evaluates the nerve segment of distal (hand) muscles. Methods An electrophysiological evaluation, consisting of velocities, amplitudes, and durations of ulnar nerve bundles to 2 forearm muscles and the hypothenar muscles was performed on the same humeral segment. Results The velo...

  4. An Optic Nerve Crush Injury Murine Model to Study Retinal Ganglion Cell Survival

    Tang, Zhongshu; Zhang, Shuihua; Lee, Chunsik; Kumar, Anil; Arjunan, Pachiappan; LI Yang; Zhang, Fan; Li, Xuri

    2011-01-01

    Injury to the optic nerve can lead to axonal degeneration, followed by a gradual death of retinal ganglion cells (RGCs), which results in irreversible vision loss. Examples of such diseases in human include traumatic optic neuropathy and optic nerve degeneration in glaucoma. It is characterized by typical changes in the optic nerve head, progressive optic nerve degeneration, and loss of retinal ganglion cells, if uncontrolled, leading to vision loss and blindness.

  5. Prolactinoma presenting with intermittent third nerve palsy.

    Wykes, W N

    1986-01-01

    A patient presented with a painful third nerve palsy. This resolved spontaneously, but recurred several months later. At his second presentation carotid angiography gave normal results, but a high resolution CT scan showed a tumour in the right parasellar region. The serum prolactin was raised at over 22,000 millimicrons/, showing this to be a prolactinoma.

  6. Progress in the clinical imaging research of bone diseases on ankle and foot sesamoid bones and accessory ossicles

    Li, Xiaozhong; Shi, Lenian; Liu, Taiyun; Wang, Lin

    2012-01-01

    Sesamoid bones and accessory ossicles are research focuses of foot and ankle surgery. Pains of the foot and ankle are related to sesamoid bones and accessory ossicles. The specific anatomical and functional relationship of sesamoid bones and accessory ossicles can cause such bone diseases as the dislocation of sesamoid bones and accessory bones, infection, inflammation and necrosis of sesamoid bones, cartilage softening, tenosynovitis of sesamoid bones and the sesamoid bone syndrome. However,...

  7. Direct Cranial Nerve Involvement by Gliomas: Case Series and Review of the Literature.

    Mabray, M C; Glastonbury, C M; Mamlouk, M D; Punch, G E; Solomon, D A; Cha, S

    2015-07-01

    Malignant gliomas are characterized by infiltrative growth of tumor cells, including along white matter tracts. This may result in clinical cranial neuropathy due to direct involvement of a cranial nerve rather than by leptomeningeal spread along cranial nerves. Gliomas directly involving cranial nerves III-XII are rare, with only 11 cases reported in the literature before 2014, including 8 with imaging. We present 8 additional cases demonstrating direct infiltration of a cranial nerve by a glioma. Asymmetric cisternal nerve expansion compared with the contralateral nerve was noted with a mean length of involvement of 9.4 mm. Based on our case series, the key imaging feature for recognizing direct cranial nerve involvement by a glioma is the detection of an intra-axial mass in the pons or midbrain that is directly associated with expansion, signal abnormality, and/or enhancement of the adjacent cranial nerves. PMID:25857757

  8. Normal and pathological findings for the facial nerve on magnetic resonance imaging

    Al-Noury, K., E-mail: Kalnoury@kau.edu.sa [Department of Otolaryngology, King Abdulaziz University, Jeddah (Saudi Arabia); Lotfy, A. [Radiology Department, King Abdulaziz University Hospital and International Medical Centre, Jeddah (Saudi Arabia)

    2011-08-15

    Aim: To demonstrate the enhanced radiological anatomy and common pathological conditions of the facial nerve by using magnetic resonance imaging (MRI). Materials and methods: A retrospective review of the MRI findings of the facial nerve of 146 patients who visited a tertiary academic referral center was conducted. Results: The radiological anatomy of the facial nerve was well illustrated using MRI, as were most of the common pathological conditions of the facial nerve. Conclusions: Enhancement of the facial nerve in MRI should be correlated with the clinical data. Normal individuals can show enhancement of the tympanic or vertical segments of the facial nerve. Enhancement of the labyrinthine portion of the nerve is almost diagnostic of Bell's palsy. No specific enhancement patterns were observed for tumours or for infections of the middle or external ear. A larger population study is required for the accurate assessment of facial nerve enhancement in multiple sclerosis patients.

  9. Laser-activated protein solder for peripheral nerve repair

    Trickett, Rodney I.; Lauto, Antonio; Dawes, Judith M.; Owen, Earl R.

    1995-05-01

    A 100 micrometers core optical fiber-coupled 75 mW diode laser operating at a wavelength of 800 nm has been used in conjunction with a protein solder to stripe weld severed rat tibial nerves, reducing the long operating time required for microsurgical nerve repair. Welding is produced by selective laser denaturation of the albumin based solder which contains the dye indocyanine green. Operating time for laser soldering was 10 +/- 5 min. (n equals 20) compared to 23 +/- 9 min. (n equals 10) for microsuturing. The laser solder technique resulted in patent welds with a tensile strength of 15 +/- 5 g, while microsutured nerves had a tensile strength of 40 +/- 10 g. Histopathology of the laser soldered nerves, conducted immediately after surgery, displayed solder adhesion to the outer membrane with minimal damage to the inner axons of the nerves. An in vivo study is under way comparing laser solder repaired tibial nerves to conventional microsuture repair. At the time of submission 15 laser soldered nerves and 7 sutured nerves were characterized at 3 months and showed successful regeneration with compound muscle action potentials of 27 +/- 8 mV and 29 +/- 8 mW respectively. A faster, less damaging and long lasting laser based anastomotic technique is presented.

  10. Histomorphogenesis of cranial nerves in Huso huso larvae.

    Tavighi, Sherma; Saadatfar, Zohreh; Shojaei, Bahador; Behnam Rassouli, Morteza

    2016-01-01

    In this study the cranial nerves development of H. huso are explained from 1 to 54-days-old (1, 3, 6, 15, 21 and 54 days). Despite all the researches on fish brain, there are no study on nerves evolution on H. huso during their larvae life. For this research 40 samples of larvae H. huso were obtained (from each age, about six samples were selected). The specimens were maintained in fiberglass tank, then histological samples were taken from tissues and stained with hematoxylin and eosin for general histological studies using light microscope. According to the results, on 1 and 3-days-old, no nerve was observed. The terminal nerve and their dendrites were observed around the nasal cavity and the axons projected to different areas in forebrain especially around olfactory bulb diffusely, on 6-day-old fish. Also, olfactory, optic, oculomotor, trochlear, trigeminal, lateral line and vagus nerves were detected on 6-day-old fish, however two parts of lateral line nerve were separated on 54-day-old. Three nerves, profundus, facial and octaval were observed on 54-day-old, however, up to this age, epiphysial nerve was not observed. PMID:27482355

  11. Analysis of trigeminal nerve disorders after oral and maxillofacial intervention

    Ghassemi Alireza

    2010-10-01

    Full Text Available Abstract Background Quantitative sensory testing (QST is applied to evaluate somatosensory nerve fiber function in the spinal system. This study uses QST in patients with sensory dysfunctions after oral and maxillofacial surgery. Methods Orofacial sensory functions were investigated by psychophysical means in 60 volunteers (30 patients with sensory disturbances and 30 control subjects in innervation areas of the infraorbital, mental and lingual nerves. The patients were tested 1 week, 4 weeks, 7 weeks and 10 weeks following oral and maxillofacial surgery. Results QST monitored somatosensory deficits and recovery of trigeminal nerve functions in all patients. Significant differences (p Conclusion QST can be applied for non-invasive assessment of sensory nerve function (Aβ-, Aδ- and C-fiber in the orofacial region and is useful in the diagnosis of trigeminal nerve disorders in patients.

  12. Reception of infrasound and audio current in derma nerves

    Jianwen Li; Ziyu Li; Xuezong Ma

    2010-01-01

    Determining the frequency range of derma nerve that responds to audio current is fundamental for the development of skin-hearing technology.Previous studies have shown that the range of derma nerve responding to audio current is 15-15 000 Hz,because audio amplification is not separated from the step-up transformer.Therefore,the present study used a signal generator which directly drives plane electrodes,simplified the original experimental environment for skin-hearing,measured lower limit voltage of frequency for derma nerve receiving pulse current signals,and revealed that the frequency range of human derma nerve response was as wide as 0.1-30 000 Hz.Results demonstrate that human derma nerve receives audio signals and infrasound within a wide frequency range.

  13. Optical coherence tomographic findings in optic nerve hypoplasia

    Daruchi Moon

    2013-01-01

    Full Text Available We investigated a case of unilateral optic nerve hypoplasia using spectral domain optical coherence tomography (SDOCT. Optical coherence tomography was done on both eyes using 5-line Raster scan for the fovea to analyze the retinal nerve fiber layer thickness, inner retinal layer thickness, outer retinal layer thickness, and optic disc cube scan for the disc. Retinal nerve fiber layer thickness, inner retinal layer thickness, and outer retinal layer thickness were manually measured at 21-points of each five lines, and results were compared between both eyes. Retinal nerve fiber layer thickness and inner retinal layer thickness of optic nerve hypoplasia were significantly thinner than the opposite eye, but there was no significant difference in the thickness of the outer retinal layer between both eyes.

  14. Should we routinely expose recurrent laryngeal nerve(s) during thyroid surgery

    Objective: To compare the frequency of recurrent laryngeal nerve(s) (RLNs) palsy after various thyroid procedures with and without identification of recurrent laryngeal nerve during the operation. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Surgery, Military Hospital, Rawalpindi, from August 2008 to April 2010. Methodology: Patients undergoing indirect laryngoscopy with normal vocal cords and those with carcinoma and re-do surgery having normal vocal cord were included in the study. Patients with hoarseness of voice, abnormal vocal cord movements and with solitary nodule in the isthmus were excluded. These patients were randomly divided into 2 groups of 50 each using random number tables. RLN was identified by exposing the inferior thyroid artery and traced along its entire course in group-A. Whereas, in group-B, nerves were not identified during the operations. Immediate postoperative direct laryngoscopy was performed by a surgeon with the help of an anaesthesiologist for the assessment of vocal cords. Patients with persistent hoarseness of voice were followed-up with indirect laryngoscopy at 3 and 6 months. Results: Temporary unilateral recurrent laryngeal nerve palsies occurred in 2 (4%) patients in group-A where the voice and cord movements returned to normal in 6 months. In group-B, it occurred in 8 (16%) patients, 2 bilateral (4%) injuries requiring tracheostomy and 6 unilateral injuries (12%). Among the 2 bilateral recurrent laryngeal nerve injuries, the tracheostomy was removed in one case after 6 months with persistent hoarseness of voice but no respiratory difficulty during routine activities. Tracheostomy was permanent in the other case. Among the 6 cases of unilateral nerve injuries, the voice improved considerably in 4 cases within 6 months but in 2 cases hoarseness persisted even after 6 months. Frequency of recurrent laryngeal nerve palsies was significantly lower in group-A as compared to group-B (p = 0

  15. 30 CFR 75.1106-5 - Maintenance and tests of liquefied and nonliquefied compressed gas cylinders; accessories and...

    2010-07-01

    ... nonliquefied compressed gas cylinders; accessories and equipment; requirements. 75.1106-5 Section 75.1106-5... liquefied and nonliquefied compressed gas cylinders; accessories and equipment; requirements. (a) Hose lines, gages, and other cylinder accessories shall be maintained in a safe operating condition. (b)...

  16. Trigeminal nerve schwannoma

    Prashant Kashyap

    2016-05-01

    Full Text Available Trigeminal schwannomas are uncommon slow growing encapsulated tumours composed of schwann cells. Trigeminal schwannomas are the second most common type of schwannoma, after the far more common acoustic schwannoma. In this case definite diagnosis could not be made after 1 CT (computerized tomography scan and 3 MRI (magnetic resonance imaging (outside hospital but finally after proper clinical examination and discussion with radiologist about the best diagnostic imaging in this case we reached to a diagnosis of trigeminal nerve schwannoma after MRI brain with contrast. [Int J Res Med Sci 2016; 4(5.000: 1739-1741

  17. New Scopes, New Accessories, New Stents for Interventional Endoscopic Ultrasound.

    Chapman, Christopher G; Siddiqui, Uzma D

    2016-01-01

    Technological advances have rapidly expanded the therapeutic potential of endoscopic ultrasound (EUS). Innovations in stent technology; directed adjunctive therapy for pancreatic tumors, including radiofrequency ablation and fiducial marker placement; advanced imaging modalities, including needle-based confocal laser endomicroscopy; and new echoendoscopes, such as the forward-viewing linear echoendoscope, are emerging as safe and effective tools and devices for providing a broad range of treatments and therapies previously not thought possible. In this review, we summarize and discuss the new echoendoscopes, accessories, and stents for interventional EUS and highlight the recent literature on technical and therapeutic efficacy. The therapeutic role and indications for EUS are rapidly evolving well beyond its current limits as new EUS-specific designed tools are designed, and ultimately, should help achieve the goal of improving patient outcomes. PMID:26855923

  18. An accessory skull suture mimicking a skull fracture.

    Wiedijk, J E F; Soerdjbalie-Maikoe, V; Maat, G J R; Maes, A; van Rijn, R R; de Boer, H H

    2016-03-01

    This paper describes an investigation of the sudden and unexpected death of a five-and-a-half-month-old boy. As in every Dutch case of sudden unexpected death in infancy (SUDI), a multidisciplinary diagnostic approach was used. This included post-mortem radiography, showing a linear discontinuity of the parietal bone. Originally this was interpreted as a skull fracture, but autopsy indicated no signs of mechanical trauma. Instead the defect was defined as a unilateral accessory suture of the parietal bone. The initial erroneous diagnosis had severe adverse consequences and thus every health care professional or forensic specialist dealing with paediatric mechanical traumas should be cautious of this rare anomaly. PMID:26860068

  19. Morphological features of allogenic nerve segment in rats after subcutaneous embedment

    Mingtang Gao; Dianming Jiang

    2006-01-01

    BACKGROUND: Some studies demonstrate that allogenic peripheral nerve segment embedded subcutaneously significantly reduce the infiltration of lymphocyte and decrease immunological reaction.OBJECTIVE: To observe the gross shape, optical and electron microscope results of allogenic nerve segment in rats 2 weeks after subcutaneous embedment, and compare with subcutaneous emdedment of autologous nerve segment.DESIGN: A randomized and controlled experiment.SETTING: Department of Orthopaedics of Fifth People's Hospital of Zhengzhou; Department of Orthopaedics,First Hospital Affiliated to Chongqing Medical University MATERIALS: Totally 30 adult healthy Wistar male rats, with body mass of (200±20) g, were enrolled. Ten rats were chosen as the donors of allogenic nerve transplantation. The other 20 rats were randomly divided into 2 groups: allogenic nerve embedment group and autologous nerve embedment group, with 10 rats in each one.JEM-1220 transmission electron microscope (Japan) and Olympus BX50 optical microscope (Japan) were used.METHODS: This experiment was carried out at the laboratory of Orthopaedic Department, Chongqing Medical University from October 2000 to April 2002. ① Sciatic nerve of donor rats for allogenic nerve transplantation was cut off at 5 mm distant from pelvic strait.15 mm sciatic nerve segment was chosen from lateral part as graft. Allogenic nerve embedment group: 15 mm sciatic nerve form the donor rats was embedded in the posterior part of right legs. Autologous nerve embedment group: 15 mm sciatic nerve segment of autologous left side was embedded in the posterior side of right legs. ② Nerve segment embedded subcutaneously was taken out at postoperative 2 weeks and performed gross observation; then 5 samples chosen randomly respectively from 2 groups and given haematoxylin-eosin staining and observation under optical microscope (×400);The other 5 samples were made into ultrathin sections (0.5 μm)and observed under transmission electron

  20. An unusual ulnar nerve-median nerve communicating branch.

    Hoogbergen, M M; Kauer, J M

    1992-01-01

    Branching of the ulnar nerve distal to the origin of the dorsal cutaneous branch was investigated in 25 hands in one of which an anatomical variation was observed. This finding may be of importance in the evaluation of certain entrapment phenomena of the ulnar nerve or unexplained sensory loss after trauma or surgical intervention in that particular area.

  1. The accessory papillary muscle with inferior J-waves - peculiarity or hidden danger?

    du Toit Lorraine

    2009-10-01

    Full Text Available Abstract Originally described in 1953, today the so-called J-wave is the source of much controversy. As a marker of so-called "early repolarization", this variant has been regarded as a totally benign variant since the 1960's. However, since then a wealth of data have indicated that the J-wave may be a marker of a highly arrhythmogenic substrate with a resultant high risk of sudden cardiac death. In this case report a case of an accessory papillary muscle with a prominent J-wave is described. This may be the first of many possible cases where papillary muscle variants may be the cause of the J-wave.

  2. Augmentation of partially regenerated nerves by end-to-side side-to-side grafting neurotization: experience based on eight late obstetric brachial plexus cases

    Moharram Ashraf N

    2006-12-01

    Full Text Available Abstract Objective The effect of end-to-side neurotization of partially regenerated recipient nerves on improving motor power in late obstetric brachial plexus lesions, so-called nerve augmentation, was investigated. Methods Eight cases aged 3 – 7 years were operated upon and followed up for 4 years (C5,6 rupture C7,8T1 avulsion: 5; C5,6,7,8 rupture T1 avulsion:1; C5,6,8T1 rupture C7 avulsion:1; C5,6,7 ruptureC8 T1 compression: one 3 year presentation after former neurotization at 3 months. Grade 1–3 muscles were neurotized. Grade0 muscles were neurotized, if the electromyogram showed scattered motor unit action potentials on voluntary contraction without interference pattern. Donor nerves included: the phrenic, accessory, descending and ascending loops of the ansa cervicalis, 3rd and 4th intercostals and contralateral C7. Results Superior proximal to distal regeneration was observed firstly. Differential regeneration of muscles supplied by the same nerve was observed secondly (superior supraspinatus to infraspinatus regeneration. Differential regeneration of antagonistic muscles was observed thirdly (superior biceps to triceps and pronator teres to supinator recovery. Differential regeneration of fibres within the same muscle was observed fourthly (superior anterior and middle to posterior deltoid regeneration. Differential regeneration of muscles having different preoperative motor powers was noted fifthly; improvement to Grade 3 or more occurred more in Grade2 than in Grade0 or Grade1 muscles. Improvements of cocontractions and of shoulder, forearm and wrist deformities were noted sixthly. The shoulder, elbow and hand scores improved in 4 cases. Limitations The sample size is small. Controls are necessary to rule out any natural improvement of the lesion. There is intra- and interobserver variability in testing muscle power and cocontractions. Conclusion Nerve augmentation improves cocontractions and muscle power in the biceps, pectoral

  3. Visualization of Cervical Nerve Roots and Their Distal Nerve Fibers by Diffusion-Weighted Scanning Using Parallel Imaging

    Purpose: To report a technique developed for visualizing cervical nerve roots and distal nerve fibers using diffusion-weighted magnetic resonance imaging employing parallel imaging. Material and Methods: We performed maximum intensity projection for a stack of isotropic axial diffusion-weighted images obtained with parallel imaging applying a motion-probing gradient in six directions with a b-value of 500 s/mm2 in a preliminary series of 13 subjects. Results: This method worked well for visualizing the spinal cord and most of the nerve roots, the dorsal root ganglia, and proximal peripheral nerves. Conclusion: Although the technique remains limited in depicting the brachial plexus and distal nerves, the ability to visualize the proximal peripheral nervous system at the cervical level is promising

  4. Visualization of Cervical Nerve Roots and Their Distal Nerve Fibers by Diffusion-Weighted Scanning Using Parallel Imaging

    Tsuchiya, K.; Fujikawa, A.; Tateishi, H.; Nitatori, T. [Kyorin Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology

    2006-07-15

    Purpose: To report a technique developed for visualizing cervical nerve roots and distal nerve fibers using diffusion-weighted magnetic resonance imaging employing parallel imaging. Material and Methods: We performed maximum intensity projection for a stack of isotropic axial diffusion-weighted images obtained with parallel imaging applying a motion-probing gradient in six directions with a b-value of 500 s/mm{sup 2} in a preliminary series of 13 subjects. Results: This method worked well for visualizing the spinal cord and most of the nerve roots, the dorsal root ganglia, and proximal peripheral nerves. Conclusion: Although the technique remains limited in depicting the brachial plexus and distal nerves, the ability to visualize the proximal peripheral nervous system at the cervical level is promising.

  5. High-resolution measurement of electrically-evoked vagus nerve activity in the anesthetized dog

    Yoo, Paul B.; Lubock, Nathan B.; Hincapie, Juan G.; Ruble, Stephen B.; Hamann, Jason J.; Grill, Warren M.

    2013-04-01

    Objective. Not fully understanding the type of axons activated during vagus nerve stimulation (VNS) is one of several factors that limit the clinical efficacy of VNS therapies. The main goal of this study was to characterize the electrical recruitment of both myelinated and unmyelinated fibers within the cervical vagus nerve. Approach. In anesthetized dogs, recording nerve cuff electrodes were implanted on the vagus nerve following surgical excision of the epineurium. Both the vagal electroneurogram (ENG) and laryngeal muscle activity were recorded in response to stimulation of the right vagus nerve. Main results. Desheathing the nerve significantly increased the signal-to-noise ratio of the ENG by 1.2 to 9.9 dB, depending on the nerve fiber type. Repeated VNS following nerve transection or neuromuscular block (1) enabled the characterization of A-fibers, two sub-types of B-fibers, and unmyelinated C-fibers, (2) confirmed the absence of stimulation-evoked reflex compound nerve action potentials in both the ipsilateral and contralateral vagus nerves, and (3) provided evidence of stimulus spillover into muscle tissue surrounding the stimulating electrode. Significance. Given the anatomical similarities between the canine and human vagus nerves, the results of this study provide a template for better understanding the nerve fiber recruitment patterns associated with VNS therapies.

  6. Effects of Alcohol Injection in Rat Sciatic Nerve

    Mazoch, Mathew J.; Cheema, Gulraiz A.; Suva, Larry J.; Thomas, Ruth L.

    2015-01-01

    Background Previous studies have shown that the injection of dehydrated alcohol has been successful for the treatment of Morton's neuroma in the foot. In this study, we determined the cellular effect of injection of alcohol into and around the sciatic nerve of rats, and measured the extent of cell necrosis and/or any associated histologic or inflammatory changes. Methods Twenty-two male (~375g) Wistar rats were randomized into two groups each receiving alcohol injections into or around the sciatic nerve after nerve exposure under sterile technique. Group 1 rats were injected with a 0.5ml solution of 0.5% Marcaine in the left sciatic nerve as a control group. In the right sciatic nerve a 0.5ml solution of 4% ethanol with 0.5% Marcaine was injected. Group 2 rats received 0.5ml of 20%ethanol with 0.5% Marcaine injected into the left sciatic nerve and 0.5 ml of 30% ethanol with 0.5% Marcaine injected into the right sciatic nerve. In each group, the rats were placed in 3 subgroups: intraneural, perineural, perimuscular injections. All rats were sacrificed and tissue harvested for histologic evaluation at day 10 post injection. Results No evidence of alcohol-associated cell necrosis, apoptosis or apparent inflammation was observed in histologic specimens of any injected nerves, perineural tissue, or muscles in controls or experimental groups regardless of concentration of ethanol injected on day 10. Conclusion We concluded that alcohol injection (≤30% ethanol) into and/or around the sciatic nerve or the adjacent muscle of rats has no histologic evidence of necrosis or inflammation to the nerve or surrounding tissue. There was no observable histological change in apoptosis, or cell number, in response to the alcohol injection. PMID:25097192

  7. Magnetic resonance imaging in optic nerve lesions with multiple sclerosis

    Magnetic resonance imaging (MRI) of the optic nerve was performed in 10 patients with multiple sclerosis (MS) using short inversion time inversion recovery (STIR) pulse sequences, and the results were compared with the visual evoked potentials (VEP). The 10 patients had optic neuritis in the chronic or remitting phase together with additional symptoms or signs allowing a diagnosis of clinically definite or probable MS. Sixteen optic nerves were clinically affected and 4 were unaffected. MRI was performed using a 0.5 tesla supeconducting unit, and multiple continuous 5 mm coronal and axial STIR images were obtained. A lesion was judged to be present if a focal or diffuse area of increased signal intensity was detectd in the optic nerve. In VEP, a delay in peak latency or no P 100 component was judged to be abnormal. With regard to the clinically affected optic nerves, MRI revealed a region of increased signal intensity in 14/16 (88%) and the VEP was abnormal in 16/16 (100%). In the clinically unaffected optic nerves, MRI revealed an increased signal intensity in 2/4 (50%). One of these nerves had an abnormal VEP and the other had a VEP latency at the upper limit of normal. The VEP was abnormal in 1/4 (25%). In the clinically affected optic nerves, the degree of loss of visual acuity was not associated with the longitudinal extent of the lesions shown by MRI. The mean length was 17.5 mm in optic nerves with a slight disturbance of visual acuity and 15.0 mm in nerves with severe visual loss. MRI using STIR pulse sequences was found to be almost as sensitive as VEP in detecting both clinically affected and unaffected optic nerve lesions in patients with MS, and was useful in visualizing the location or size of the lesions. (author)

  8. Isolated cranial nerve palsies in multiple sclerosis

    Zadro, Ivana; Barun, Barbara; Habek, Mario; Brinar, Vesna V.

    1997-01-01

    During a 10 year period 24 patients with definite multiple sclerosis with isolated cranial nerve palsies were studied (third and fourth nerve: one patient each, sixth nerve: 12 patients, seventh nerve: three patients, eighth nerve: seven patients), in whom cranial nerve palsies were the presenting sign in 14 and the only clinical sign of an exacerbation in 10 patients. MRI was carried out in 20 patients and substantiated corresponding brainstem lesions in seven patients (...

  9. Dynamic computed tomography findings of an accessory spleen in the pelvis: a case report.

    Ota, Hiroshi; Ojima, Yasutomo; Sumitani, Daisuke; Okajima, Masazumi

    2016-12-01

    We report the case of a 60-year-old man with an accessory spleen in the pelvis. He visited our outpatient clinic because of abdominal discomfort. Computed tomography (CT) showed an enhanced mass (40 mm in diameter) in the pelvis. Preoperative diagnosis was difficult even after magnetic resonance imaging and colonoscopy. The patient underwent surgery for suspicion of a gastrointestinal stromal tumor or malignant lymphoma of the rectum. Intraoperative findings showed a mass in the pelvis and a long cord-like tissue reaching the mass and arising from the great omentum; the mass was excised. Histopathologic examination indicated that the mass was splenic tissue, and feeding vessels were found in the cord-like tissue, which were determined to be derived from the left gastroepiploic artery and vein. Thus, we diagnosed it as an accessory spleen in the pelvis. An accessory spleen is not rare and can occur anywhere in the abdominal cavity. However, an accessory spleen in the pelvis is an infrequent finding, and only 9 other cases of an accessory spleen in the pelvis have been reported. Therefore, it is very difficult to make a correct diagnosis preoperatively. However, 7 of the 9 cases (77.8 %) of a pelvic accessory spleen had vascular pedicles from the great omentum or splenic hilum as feeding vessels; hence, determining the feeding blood vessels on dynamic CT may be useful for diagnosing an accessory spleen in the pelvis. Additionally, if the accessory spleen is symptomatic or has a vascular pedicle, surgeons should attempt to resect the accessory spleen in the pelvis using minimally invasive laparoscopy. PMID:26970956

  10. Deleterious effect of ultraviolet-B radiation on accessory function of human blood adherent mononuclear cells

    The effects of ultraviolet-B radiation (UV-B) on accessory function of human blood adherent mononuclear cells (ADH) for antigen and mitogen-induced responses, and production by ADH of the amplifying cytokine interleukin 1 (IL-1) were examined. Responder lymphocytes were rendered accessory cell dependent by treatment of nonadherent cells with OKIal + complement. UV-B depressed accessory function of ADH in a dose-dependent manner. UV-B decreased accessory function of ADH for tetanus toxoid-induced responses and phytohaemagglutinin-induced responses. UV-B also decreased accessory activity of peripheral blood mononuclear cells but not Epstein-Barr virus-transformed B cells for a PPD-reactive T cell line. Interleukin 1 (IL-1) activity of supernatants of ADH was assayed on C3H/HeJ mouse thymocytes. Pretreatment of ADH with UV-B decreased lipopolysaccharide-stimulated IL-1 activity. Lysates of UV-B irradiated, LPS-stimulated ADH had no discernible IL-1 activity. Addition of IL-1 partially restored accessory activity of UV-B irradiated ADH for lymphocyte responses to TT. Exposure of ADH to TT or PHA for 30 min before irradiation blocked the inhibitory effect of UV-B on accessory activity. Thus, low doses of UV-B are deleterious to accessory function and to production of IL-1 by ADH. Interference with production of cytokines and with initial interactions of accessory cells with antigen and mitogen may be critical to the effects of UV-B on immunoregulatory function of ADH. (author)

  11. Immune cell distribution and immunoglobulin levels change following sciatic nerve injury in a rat model

    Wei Yuan

    2016-07-01

    Full Text Available Objective(s: To investigate the systemic and local immune status of two surgical rat models of sciatic nerve injury, a crushed sciatic nerve, and a sciatic nerve transection Materials and Methods:Twenty-four adult male Sprague-Dawley rats were randomly divided into three groups: sham-operation (control group, sciatic nerve crush, and sciatic nerve transaction. Sciatic nerve surgery was performed. The percentage of CD4+ cells and the CD4+/CD8+ratio were determined by flow cytometry. Serum IgM and IgG levels were analyzed by ELISA. T-cells (CD3 and macrophages (CD68 in sciatic nerve tissue sections were identified through immunohistochemistry. Results: Compared to sham-operated controls, in rats that underwent nerve injury, the percentage of CD4+ cells and the CD4+/CD8+ ratio in the peripheral blood were significantly  decreased 7 days after surgery, serum IgM levels were increased 14 days after surgery, and serum IgG levels were increased 21 days after surgery. There were a large number of CD3+ cells and a small number of CD68+ cells in sciatic nerve tissue sections 21 days after surgery, indicating T-cell and macrophage activation and infiltration. Local IgG deposition was also detected at the nerve injury site 21 days after surgery. Conclusion: Rat humoral and cellular immune status changed following sciatic nerve injury, particularly with regard to the cellular immune response at the nerve injury site.

  12. Immune cell distribution and immunoglobulin levels change following sciatic nerve injury in a rat model

    Yuan, Wei; Feng, Xinhong

    2016-01-01

    Objective(s): To investigate the systemic and local immune status of two surgical rat models of sciatic nerve injury, a crushed sciatic nerve, and a sciatic nerve transection Materials and Methods: Twenty-four adult male Sprague-Dawley rats were randomly divided into three groups: sham-operation (control group), sciatic nerve crush, and sciatic nerve transaction. Sciatic nerve surgery was performed. The percentage of CD4+ cells and the CD4+/CD8+ratio were determined by flow cytometry. Serum IgM and IgG levels were analyzed by ELISA. T-cells (CD3) and macrophages (CD68) in sciatic nerve tissue sections were identified through immunohistochemistry. Results: Compared to sham-operated controls, in rats that underwent nerve injury, the percentage of CD4+ cells and the CD4+/CD8+ ratio in the peripheral blood were significantly decreased 7 days after surgery, serum IgM levels were increased 14 days after surgery, and serum IgG levels were increased 21 days after surgery. There were a large number of CD3+ cells and a small number of CD68+ cells in sciatic nerve tissue sections 21 days after surgery, indicating T-cell and macrophage activation and infiltration. Local IgG deposition was also detected at the nerve injury site 21 days after surgery. Conclusion: Rat humoral and cellular immune status changed following sciatic nerve injury, particularly with regard to the cellular immune response at the nerve injury site.

  13. Invasive ductal carcinoma arising from dense accessory breast visualized with 99mTc-MIBI breast-specific γ imaging.

    Yoon, Hai-Jeon; Sung, Sun Hee; Moon, Byung In; Kim, Bom Sahn

    2014-08-01

    Primary accessory breast cancer is extremely rare, and the diagnostic efficacy of Tc-MIBI breast-specific γ imaging (BSGI) has not been reported elsewhere. We present a case of primary carcinoma arising from dense accessory breast that was visualized with BSGI. A 43-year-old female patient with a palpable axillary mass underwent mammography, which showed dense parenchyma on both of the anatomic and accessory breasts with no abnormality. Subsequent BSGI showed no abnormal uptake in bilateral anatomic breasts, but focal abnormal uptake was noted in the accessory breast. Permanent pathologic evaluation confirmed invasive ductal carcinoma (not otherwise specified type) of the accessory breast. PMID:24445272

  14. The quantitative effect of an accessory ostium on ventilation of the maxillary sinus.

    Na, Yang; Kim, Kyunghun; Kim, Sung Kyun; Chung, Seung-Kyu

    2012-04-15

    The airflow and gas exchange behaviors of the human maxillary sinus were quantified to better understand the effect of an accessory ostium (AO). An anatomically correct numerical domain was constructed using CT data from a male patient with mild nasal obstruction. For the purpose of comparison, a numerical model without an AO was also generated by artificially removing the AO from the original model using CAD software. A steady-flow field through the nasal cavity was simulated using ANSYS-FLUENT v13.0 with a target flow rate of 250 ml/s. The Volume of Fluid (VOF) method was used to investigate the concentration field of nitric oxide (NO) initially filled in the maxillary sinus. The simulation results showed that a transit flow through the maxillary sinus developed in the presence of an AO. As the flow entered the sinus through either a natural or accessory ostium from the middle meatus, the velocity was significantly reduced to a local maximum of approximately 0.034 m/s inside the sinus. This by-pass flow rate through the sinus of 2.186×10(-1) to 3.591×10(-1) ml/s was a small fraction of the total flow rate inhaled from the nostril, but it effectively changed the local flow topology and led to a larger reduction in NO concentration in the maxillary sinus. This more rapid reduction in NO concentration was due to enhanced ventilation activity afforded by convective transport of the transit stream through the flow path connecting the natural ostium and the AO. The inspiration and expiration phases were qualitatively similar in flow pattern except for the flow direction in the maxillary sinus, suggesting that the AO plays a similar physiological role during both inspiration and expiration in terms of ventilation. PMID:22326723

  15. MR imaging evaluation of suprascapular nerve entrapment

    The aim of this study was to assess the significance of muscular edema, atrophy, and fatty changes in the diagnosis of suprascapular nerve entrapment (SSNE), and to confirm muscular edema as the most significant sign of neuropathy. A retrospective study of 18 patients with suprascapular nerve entrapment was performed. All patients underwent electromyographic studies and MR imaging with a 1.5-T Echo Speed system (General Electric, Milwaukee, Wis.). The diagnosis of muscle edema was reached when muscles presented a high signal on T2-weighted fast spin-echo (SE) fat-suppressed images. Muscular trophicity and fatty changes were analyzed on a sagittal oblique cut using SE T1-weighted images. Intra- and inter-observer reproducibility using kappa test, sensitivity, and specificity were analyzed, together with negative and positive predictive value of each criterion. The topographic diagnosis was correct as edema affected the infraspinatus muscle alone when the suprascapular nerve was entrapped at the spinoglenoid notch. Both the supraspinatus and infraspinatus muscles were affected when nerve was compressed at the suprascapular notch. Sensitivity and specificity of muscular edema were, respectively, 94.5 and 100%. Muscular atrophy sensitivity and specificity were 81 and 80%, respectively. Fatty changes sensitivity and specificity were 25 and 96%, respectively. Muscular edema seems to be a more sensitive sign of SSNE than muscle atrophy and fatty changes when compared with EMG results. Magnetic resonance imaging can reach a positive, topographic, and etiologic diagnosis of SSNE. (orig.)

  16. Adipose derived stem cells and nerve regeneration

    Alessandro Faroni; Richard JP Smith; Adam J Reid

    2014-01-01

    Injuries to peripheral nerves are common and cause life-changing problems for patients along-side high social and health care costs for society. Current clinical treatment of peripheral nerve injuries predominantly relies on sacriifcing a section of nerve from elsewhere in the body to pro-vide a graft at the injury site. Much work has been done to develop a bioengineered nerve graft, precluding sacriifce of a functional nerve. Stem cells are prime candidates as accelerators of re-generation in these nerve grafts. This review examines the potential of adipose-derived stem cells to improve nerve repair assisted by bioengineered nerve grafts.

  17. Ultrasound-Guided Peripheral Nerve Procedures.

    Strakowski, Jeffrey A

    2016-08-01

    Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma. For each procedure, the indications, relevant anatomy, preprocedural scanning technique, and injection procedure itself are detailed. PMID:27468673

  18. Effects of different nerve autografts on greater auricular nerve deficit in rabbits

    Shaozong Chen

    2007-01-01

    and 12 weeks, 2μ m sections were prepared, each stained with either HE or methylene blue to assess axon number and density, cross-section area, and myelin sheath thickness. ③Electrophysidogical tests: At 12 weeks, the bilateral GAN along with the nerve grafts of 4 animals in each group were exposed. Points A, B and C were marked on each specimen: point A: at the proximal GAN segment, 7 cm from the proximal anastomosis; point B: 0.5 cm from the proximal anastomosis; point C: at the distal GAN segment, 0.5 cm from the distal anastomosis. The whole nerve including nerve graft and proximal and distal GAN segments, as a block, was harvested and immersed in Ren's solution for several minutes until its excitability was stabilized. The specimen was then placed on the electrodes of the shield box to examine the action potential and conduction velocity on segment AB and AC with BL-420E+biologic function testing system. AC/AB would be the recovery rate of action potential on segment AC. ④Horseradish peroxidase (HRP) fascicle: At 12 weeks, at the site on the distal segment of GAN 1.0 cm from the distal anastomosis of nerve graft, the GAN was crushed by a pair of haemostatic forceps and HRP water solution was injected into the nerve. Two rabbits in GAN group, SN group and LFCN group, after having survived for 24 hours, 36 hours and 48 hours were selected. The C2 ganglion was exposed and the distance from C2 ganglion to HRP injection site was taken as the axoplasmic transport distance, from which, the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells were calculated.MAIN OUTCOME MEASURES: ①The greatest distance of nerve regeneration; ②the axon number and density, cross-section area, and myelin sheath thickness; ③the action potential and conduction velocity; ④the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells. RESULTS: All 42 experimental rabbits were involved in the final analysis. ①The greatest

  19. Crosslinking of the T cell-specific accessory molecules CD7 and CD28 modulates T cell adhesion

    1992-01-01

    Regulated adhesion enables T cells to migrate through tissue and transiently interact with an endless succession of cells. Monoclonal antibody (mAb) engagement of the CD3/T cell receptor (TCR) complex results in a rapid and transient augmentation of the adhesion function of LFA-1 and VLA integrin molecules on human T cells. We show in this study that mAb crosslinking of the T cell-specific accessory molecules CD7 and CD28, or treatment with the Ca2+ ionophore A23187, results in the rapid indu...

  20. A morphological study of the vomeronasal organ and the accessory olfactory bulb in the Korean roe deer, Capreolus pygargus.

    Park, Changnam; Ahn, Meejung; Lee, Jae-Yuk; Lee, Sang; Yun, Youngmin; Lim, Yoon-Kyu; Taniguchi, Kazumi; Shin, Taekyun

    2014-01-01

    The vomeronasal organ (VNO) and accessory olfactory bulb (AOB) of the Korean roe deer (Capreolus pygargus) were studied histologically to evaluate their morphological characteristics. Grossly, the VNO, encased by cartilage, has a paired tubular structure with a caudal blind end and a rostral connection through incisive ducts on the hard palate. In the VNO, the vomeronasal sensory epithelium (VSE) consists of galectin-3-positive supporting cells, protein gene product (PGP) 9.5-positive receptor cells, and basal cells. The vomeronasal respiratory epithelium (VRE) consists of a pseudostratified epithelium. The AOB strata included a vomeronasal nerve layer (VNL), a glomerular layer (GL), a mitral/tufted cell layer, and a granular cell layer. All lectins used in this study, including Bandeiraea simplicifolia agglutinin isolectin B4 (BSI-B4), soybean agglutinin (SBA), Ulex europaeus agglutinin I (UEA-I), and Triticum vulgaris wheat germ agglutinin (WGA), labeled the VSE with varying intensity. In the AOB, both the VNL and the GL reacted with BSI-B4, SBA, and WGA with varying intensity, but not with UEA-I. This is the first morphological study of the VNO and AOB of the Korean roe deer, which are similar to those of goats. PMID:24055195

  1. Artifacts produced during electrical stimulation of the vestibular nerve in cats. [autonomic nervous system components of motion sickness

    Tang, P. C.

    1973-01-01

    Evidence is presented to indicate that evoked potentials in the recurrent laryngeal, the cervical sympathetic, and the phrenic nerve, commonly reported as being elicited by vestibular nerve stimulation, may be due to stimulation of structures other than the vestibular nerve. Experiments carried out in decerebrated cats indicated that stimulation of the petrous bone and not that of the vestibular nerve is responsible for the genesis of evoked potentials in the recurrent laryngeal and the cervical sympathetic nerves. The phrenic response to electrical stimulation applied through bipolar straight electrodes appears to be the result of stimulation of the facial nerve in the facial canal by current spread along the petrous bone, since stimulation of the suspended facial nerve evoked potentials only in the phrenic nerve and not in the recurrent laryngeal nerve. These findings indicate that autonomic components of motion sickness represent the secondary reactions and not the primary responses to vestibular stimulation.

  2. Recurrent isolated abducens nerve paresis associated with persistent trigeminal artery variant.

    Nakamagoe, Kiyotaka; Mamada, Naomi; Shiigai, Masanari; Shimizu, Kotone; Koganezawa, Tadachika; Tamaoka, Akira

    2012-01-01

    We report a 74-year-old woman who presented with recurrent isolated abducens nerve paresis. Cranial magnetic resonance imaging revealed that the right abducens nerve was sandwiched between the right internal carotid artery and a persistent trigeminal artery (PTA) variant, which might have led to neurovascular compression of the abducens nerve, resulting in abducens nerve damage. Normal variants of PTA, which are cerebellar arteries originating from a precavernous portion of the internal carotid artery, must be carefully observed as such variants can potentially cause a neurovascular compression of the abducens nerve. PMID:22892506

  3. Repairing peripheral nerve defects with tissue engineered artificial nerves in rats

    WEI Ai-lin; LIU Shi-qing; TAO Hai-ying; PENG Hao

    2008-01-01

    Objective: To observe the effect of tissue engineered nerves in repairing peripheral nerve defects ( about 1. 5 cm in length) in rats to provide data for clinical application.Methods: Glycerinated sciatic nerves (2 cm in length) from 10 Sprague Dawley ( SD) rats ( aged 4 months) were used to prepare homologous dermal acellular matrix. Other 10 neonate SD rats (aged 5-7 days) were killed by neck dislocation. After removing the epineurium, the separated sciatic nerve tracts were cut into small pieces, then digested by 2.5 g/L trypsin and 625 U/ml collagenase and cultured in Dulbecco's modified Eagle's medium (DMEM) for 3 weeks. After proliferation, the Schwann cells ( SCs) were identified and prepared for use. And other 40 female adult SD rats (weighing 200 g and aged 3 months) with sciatic nerve defects of 1.5 cm in length were randomly divided into four groups: the defects of 10 rats bridged with proliferated SCs and homologous dermal acellular matrix (the tissue engineered nerve group, Group A), 10 rats with no SCs but homologous dermal acellular matrix with internal scaffolds ( Group B ), 10 with autologous nerves ( Group C) , and the other 10 with nothing (the blank control group, Group D). The general status of the rats was observed, the wet weight of triceps muscle of calf was monitored, and the histological observation of the regenerated nerves were made at 12 weeks after operation.Results: The wounds of all 40 rats healed after operation and no death was found. No foot ulceration was found in Groups A, B and C, but 7 rats suffered from foot ulceration in Group D. The triceps muscles of calf were depauperated in the experimental sides in all the groups compared with the uninjured sides,which was much more obvious in Group D. The wet weight of triceps muscle of calf and nerve electrophysiologic monitoring showed no statistical difference between Group A and Group C,but statistical difference was found between Groups A and B and Groups B and D. And significant

  4. Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study.

    Tuite, Gerald F; Polsky, Ethan G; Homsy, Yves; Reilly, Margaret A; Carey, Carolyn M; Parrish Winesett, S; Rodriguez, Luis F; Storrs, Bruce B; Gaskill, Sarah J; Tetreault, Lisa L; Martinez, Denise G; Amankwah, Ernest K

    2016-08-01

    OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3-4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical studies of patients with spinal dysraphism who underwent the Xiao procedure, high success rates (70%-85%) were reported for the establishment of a "skin-CNS-bladder" reflex arc that allows spontaneous, controlled voiding in children with neurogenic bladder dysfunction. However, many of these studies did not use blinded observers, did not have control groups, and/or featured only limited follow-up durations. METHODS A randomized, prospective, double-blind trial was initiated in March 2009, enrolling children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed the patients' strength, sensory function, mobility, voiding, and urodynamic bladder function before surgery and at regular intervals during the 3-year follow-up. RESULTS Twenty patients were enrolled in the study: 10 underwent only DT and the other 10 underwent DT+X. The addition of the Xiao procedure to spinal cord DT resulted in longer operative times (p = 0.024) and a greater chance of wound infection (p = 0.03). Patients in both treatment arms could intermittently void or dribble small amounts of urine (< 20% total bladder capacity) in response to scratching in dermatomes T-9 through S-2 using a standardized protocol, but the voiding was not reproducible and the volume voided was not clinically useful in

  5. Nanofibrous nerve conduits for repair of 30-mm-long sciatic nerve defects

    Biazar, Esmaeil; Keshel, Saeed Heidari; Pouya, Majid; Rad, Hadi; Nava, Melody Omrani; Azarbakhsh, Mohammad; Hooshmand, Shirin

    2013-01-01

    It has been confirmed that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit can promote peripheral nerve regeneration in rats. However, its efficiency in repair of over 30-mm-long sciatic nerve defects needs to be assessed. In this study, we used a nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit to bridge a 30-mm-long gap in the rat sciatic nerve. At 4 months after nerve conduit implantation, regenerated nerves were cally observed and histologicall...

  6. Combination of Acellular Nerve Graft and Schwann Cells-Like Cells for Rat Sciatic Nerve Regeneration

    Songtao Gao; Yan Zheng; Qiqing Cai; Zhansheng Deng; Weitao Yao; Jiaqiang Wang; Xin Wang; Peng Zhang

    2014-01-01

    Objective. To investigate the effect of tissue engineering nerve on repair of rat sciatic nerve defect. Methods. Forty-five rats with defective sciatic nerve were randomly divided into three groups. Rats in group A were repaired by acellular nerve grafts only. Rats in group B were repaired by tissue engineering nerve. In group C, rats were repaired by autogenous nerve grafts. After six and twelve weeks, sciatic nerve functional index (SFI), neural electrophysiology (NEP), histological and tra...

  7. Study of nerve fibers nature reinforcing duodenal contractions by electrical stimulation of sympathetic nerve

    Sveshnikov D.S.

    2011-09-01

    Full Text Available The subject of the article is to investigate the mechanism of increased reactions by electrical stimulation of the sympathetic nerve. Materials and methods: Experiments on dogs have shown that stimulant reactions during blockade of a-adrenergic by phentolamine and (3-adrenergic receptors with propranolol were completely eliminated by lizer-gol —the blocker of 5-HT12-receptors. Results: Infusion of lizergol did not influence on duodenal motor activity and the function of the vagus nerve. Conclusion: Effector neuron is found out to be serotonergic and its action is provided by 5-HT1 2 receptors

  8. Intraneural perineurioma of the sciatic nerve in early childhood

    Østergaard, John R; Smith, Torben; Stausbøl-Grøn, Brian

    2009-01-01

    Intraneural perineurioma is an uncommon benign neoplasm characterized by focal perineural cell proliferation. The typical course is indolent, with gradual onset and slow progression of motor loss. In early childhood, uncertainty concerning the time of onset can lead to difficulty in distinguishing....... Initially, peroneal neuropathy was suspected. The case illustrates that sciatic intraneural perineuriomas do occur in early childhood, and that traction on the sciatic nerve may result in earlier damage to the peroneal nerve than to the tibial nerve, thus mimicking a more peripheral lesion....

  9. Facial Nerve Morbidity Following Surgery for Benign Parotid Tumours

    Objective: To determine the frequency and severity of facial nerve dysfunction following surgery for benign parotid gland tumours. Study Design: A case series. Place and Duration of Study: ENT Department, Karachi Medical and Dental College and Abbasi Shaheed Hospital and Ziauddin University Hospital, from 1990 to 2010. Methodology: Data was collected of all patients who were surgically managed for benign parotid tumours from 1990 to 2010. Data was reviewed for presentation of tumour, age and gender of the patient, site of tumour, nature and morphology of the tumour, primary or recurrent, surgical procedure adopted and the complications of the surgery especially the facial nerve dysfunction, its severity, complete or partial paresis and transient or permanent and time of recovery. Results were described as frequency percentages. Results: Out of 235 patients, 159 (67.65%) were female and 76 (32.35%) were male. Age ranged from 18 to 70 years. Pleomorphic adenoma was the most common tumour (n=194, 82.6%), followed by Warthin's tumour. Superficial parotidectomy was done in 188 cases and extended parotidectomy in 47 cases. In the immediate postoperative period facial nerve function was normal in 169 (72%) patients and nerve dysfunction was observed in 66 (28%) patients. Complete paresis involving all the branches of facial nerve was seen in 25 (10.6%) patients and 41 (17.4%) patients were having incomplete dysfunction. Of these, 62 (26.3%) recovered and 04 (1.7%) had permanent facial nerve dysfunction. Marginal mandibular branch of facial nerve was involved in 57 (86.3%) cases. Conclusion: The frequency of temporary and permanent facial nerve dysfunction was 26.3% and 1.7% respectively in 235 consecutive parotidectomies for benign parotid gland tumours. Higher frequency of facial nerve dysfunction was found in recurrent and deep lobe tumours. (author)

  10. Morphometric analysis of the fascicular organisation of the optic nerve

    Radunović Miroslav

    2015-01-01

    Full Text Available Background/Aim. The optic nerve is anatomically observed in four segments: intrabulbar, orbital, canalicular, and cranial. According to the literature, the surface of the transversal cut of the nerve is different through it. The aim of this study was to evaluate the fascicular organisation of the optic nerve, throughout its three segments from the eye. Methods. Five pairs of optic nerves, obtained from the autopsies were examined. Using Heidenhain's (azan staining, the cuts were prepared for microscopy. Morphometric analysis was performed using the stereological methods for morphometric cytology - the Weible’s testing system M42. The following measures were established: the surface of the transverse cut of the nerve, the entire surface of fasciculi, the entire surface of connective tissue and blood vessels, the number of fasciculi, the surface of a single fasciculus. Results. The surface of the transverse cut of the nerve was found to grow from the orbital to the cranial segment, as well as the entire surface of fasciculi. While their number is significantly lower in the cranial segment, the number of fasciculi varied slightly between the orbital and the canalicular segment. The surface of a single fasciculus grows from the bulb to the chiasma. There is probable a cause to believe that this may be due to fusion of the “small” fasciculi in the orbitocranial direction. Conclusion. There are significant differences among the examined parameters of the different parts of the optic nerve.

  11. Case of Cytomegalovirus Infection Causing Isolated Oculomotor Nerve Palsy

    Halil Sen

    2014-06-01

    Full Text Available The third cranial nerve is called the oculomotor nerve. The pathology is revealed by limitation of eye movement inward-up-down, mydriasis, loss of light reflex and ptosis. Oculomotor nerve pathologies are frequently seen in neurology practice and are situations that may be very difficult for differential diagnosis. Differential diagnosis first involves disqualifying intracranial etiologies by imaging because these intracranial etiologies may be situations that can result in death and should be primarily evaluated. If intracranial events are ruled out, generally rarer etiologic reasons with generally difficult differentiation should be researched. Viral infections are among the rare etiological reasons causing 3rd cranial nerve involvement. Our case was a 71-year old female with etiological research due to 3rd cranial nerve palsy. The patient with diabetes-linked immune deficiency was found to have cranial nerve involvement developed secondary to cytomegalovirus (CMV infection. We report this case as 3rd cranial nerve involvement is rarely observed developing linked to CMV infection.

  12. Ocular motor nerve palsy: A clinical and etiological study

    Mwanza Jean-Claude

    2006-01-01

    Full Text Available Purpose: To clinically describe cases of ocular motor nerve palsy and to determine the possible causes. Materials and Methods: Thirty-one consecutive patients with ocular motor nerve palsies were investigated. All underwent complete ophthalmological, as well as neurological, otorhinolaryngological and general examination. Computerised tomography (CT-scan of the brain and complementary laboratory tests were obtained from each participant. Results: Paralysis of the sixth (38.4% and the third (35.3% cranial nerve were the most common. The Lees screen test was found to be very sensitive, confirming the diagnosis of ocular motor nerve palsy, even in cases with minimal manifestations. Complete ptosis and full mydriasis were mostly seen in isolated cases of the third cranial nerve palsy. The majority of eyes (63.2% with third cranial nerve palsy had pupil sparing. Overall, an etiological diagnosis was made in 93.5% of cases. The common causes were vascular conditions (25.8%, otorhinolaryngologic diseases (19.7% and trauma (12.9%. CT scan failed to reveal any abnormality in 54.8% of cases. Conclusion: Patients with ocular motor nerve palsy should be carefully examined in close collaboration with other specialists, especially where sophisticated, complementary investigations are impossible.

  13. Axillary nerve injuries in contact sports: recommendations for treatment and rehabilitation.

    Perlmutter, G S; Apruzzese, W

    1998-11-01

    Axillary nerve injuries are some of the most common peripheral nerve injuries in athletes who participate in contact sports. Resulting deltoid muscle paralysis is secondary to nerve trauma which occurs following shoulder dislocation or a direct blow to the deltoid muscle. Compression neuropathy has been reported to occur in quadrilateral space syndrome as the axillary nerve exits this anatomic compartment. The axillary nerve is also extremely vulnerable during any operative procedure involving the inferior aspect of the shoulder, and iatrogenic injury to the axillary nerve remains a serious complication of shoulder surgery. Accurate diagnosis of axillary nerve injury is based on a careful history and physical examination as well as an understanding of the anatomy of the shoulder and the axillary nerve in particular. Inspection, palpation and neurological testing provide the bases for diagnosis. A clinically suspected axillary nerve injury should be confirmed by electrophysiological testing, including electromyography and nerve conduction studies. During the acute phase of injury, the athlete should be rested and any ligamentous or bony injury should be treated as indicated. Patients should undergo an extensive rehabilitation programme emphasising active and passive range of motion as well as strengthening of the rotator cuff, deltoid and periscapular musculature. Shoulder joint contracture should be avoided at all costs as a loss of shoulder mobility may ultimately affect functional outcome despite a return of axillary nerve function. If no axillary nerve recovery is observed by 3 to 4 months following injury, surgical exploration is indicated. Athletes who sustain injury to the axillary nerve have a variable prognosis for nerve recovery, although the return of function of the involved shoulder is typically good to excellent. We recommend that athletes who sustain axillary nerve injury may return to contact sport participation when they achieve full active range of

  14. Expression of accessory molecules and cytokines in acute EAE in marmoset monkeys (Callithrix jacchus)

    Laman, J.D.; Meurs, M. van; Schellekens, M.M.; Boer, M. de; Melchers, B.; Massacesi, L.; Lassmann, H.; Claassen, E.; Hart, B.A. 't

    1998-01-01

    Accessory molecules and cytokines are involved in the immunopathogenesis of multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE) in rodent models, and are potential targets for immunotherapy. Evaluation of such experimental therapies requires appropriate animal models. Therefo

  15. One nose, one brain: contribution of the main and accessory olfactory system to chemosensation

    Carla eMucignat

    2012-11-01

    Full Text Available The accessory olfactory system is present in most tetrapods. It is involved in the perception of chemical stimuli, being implicated also in the detection of pheromone. However, it is sensitive also to some common odorant molecules, which have no clear implication in intraspecific chemical communication. The accessory olfactory system may complement the main olfactory system, and may contribute different perceptual features to the construction of a unitary representation, which merges the different chemosensory qualities. Crosstalk between the main and accessory olfactory systems occurs at different levels of central processing, in brain areas where the inputs from the two systems converge. Interestingly, centrifugal projections from more caudal brain areas are deeply involved in modulating both main and accessory sensory processing. A high degree of interaction between the two systems may be conceived, and partial overlapping appears to occur in many functions. Therefore, the central chemosensory projections merge inputs from different organs to obtain a complex chemosensory picture.

  16. Biomechanical properties of acellular sciatic nerves treated with a modified chemical method

    Xinlong Ma; Zhao Yang; Xiaolei Sun; Jianxiong Ma; Xiulan Li; Zhenzhen Yuan; Yang Zhang; Honggang Guo

    2011-01-01

    Nerve grafts are able to adapt to surrounding biomechanical environments if the nerve graft itself exhibits appropriate biomechanical properties (load, elastic modulus, etc.). The present study was designed to determine the differences in biomechanical properties between fresh and chemically acellularized sciatic nerve grafts. Two different chemical methods were used to establish acellular nerve grafts. The nerve was chemically extracted in the Sondell method with a combination of Triton X-100 (nonionic detergent) and sodium deoxycholate (anionic detergent), and in the modified method with a combination of Triton X-200 (anionic detergent), sulfobetaine-10 (SB-10, amphoteric detergents), and sulfobetaine-16 (SB-16, amphoteric detergents). Following acellularization, hematoxylin-eosin staining and scanning electron microscopy demonstrated that the effect of acellularization via the modified method was similar to the traditional Sondell method. However, effects of demyelination and nerve fiber tube integrity were superior to the traditional Sondell method. Biomechanical testing showed that peripheral nerve graft treated using the chemical method resulted in decreased biomechanical properties (ultimate load, ultimate stress, ultimate strain, and mechanical work to fracture) compared with fresh nerves, but the differences had no statistical significance (P > 0.05). These results demonstrated no significant effect on biomechanical properties of nerves treated using the chemical method. In conclusion, nerve grafts treated via the modified method removed Schwann cells, preserved neural structures, and ensured biomechanical properties of the nerve graft, which could be more appropriate for implantation studies.

  17. Vitamin B complex and vitamin B12 levels after peripheral nerve injury

    Altun, Idiris; Kurutaş, Ergül Belge

    2016-01-01

    The aim of the present study was to evaluate whether tissue levels of vitamin B complex and vitamin B12 were altered after crush-induced peripheral nerve injury in an experimental rat model. A total of 80 male Wistar rats were randomized into one control (n = 8) and six study groups (1, 6, 12, 24 hours, 3, and 7 days after experimental nerve injury; n = 12 for each group). Crush-induced peripheral nerve injury was performed on the sciatic nerves of rats in six study groups. Tissue samples from the sites of peripheral nerve injury were obtained at 1, 6, 12, 24 hours, 3 and 7 days after experimental nerve injury. Enzyme-linked immunosorbent assay results showed that tissue levels of vitamin B complex and vitamin B12 in the injured sciatic nerve were significantly greater at 1 and 12 hours after experimental nerve injury, while they were significantly lower at 7 days than in control group. Tissue level of vitamin B12 in the injured sciatic nerve was significantly lower at 1, 6, 12 and 24 hours than in the control group. These results suggest that tissue levels of vitamin B complex and vitamin B12 vary with progression of crush-induced peripheral nerve injury, and supplementation of these vitamins in the acute period may be beneficial for acceleration of nerve regeneration.

  18. Vitamin B complex and vitamin B12 levels after peripheral nerve injury

    Idiris Altun; Ergl Belge Kuruta

    2016-01-01

    The aim of the present study was to evaluate whether tissue levels of vitamin B complex and vitamin B12 were altered after crush-induced peripheral nerve injury in an experimental rat model. A total of 80 male Wistar rats were randomized into one control (n = 8) and six study groups (1, 6, 12, 24 hours, 3, and 7 days after experimental nerve injury;n = 12 for each group). Crush-induced peripheral nerve injury was per-formed on the sciatic nerves of rats in six study groups. Tissue samples from the sites of peripheral nerve injury were obtained at 1, 6, 12, 24 hours, 3 and 7 days after experimental nerve injury. Enzyme-linked immunosorbent assay results showed that tissue levels of vitamin B complex and vitamin B12 in the injured sciatic nerve were signiifcantly greater at 1 and 12 hours after experimental nerve injury, while they were signiifcantly lower at 7 days than in control group. Tissue level of vitamin B12 in the injured sciatic nerve was signiifcantly lower at 1, 6, 12 and 24 hours than in the control group. These results suggest that tissue levels of vitamin B complex and vitamin B12 vary with progression of crush-induced peripheral nerve injury, and supplementation of these vitamins in the acute period may be beneficial for acceleration of nerve regeneration.

  19. Schwannomatosis of the sciatic nerve

    A 52-year-old woman with schwannomatosis in the left sciatic nerve is presented. The patient had no stigmata of neurofibromatosis (NF) type 1 or 2. Cutaneous or spinal schwannomas were not detected. Magnetic resonance (MR) imaging of the sciatic nerve revealed more than 15 tumors along the course of the nerve. Histological examination revealed schwannomas consisting of Antoni A and B areas. Immunohistochemical study showed most cells reacting intensely for S-100 protein. The patient underwent conservative follow-up treatment due to the minimal symptoms. The relationship of the disease with NF-2 and plexiform schwannoma is discussed. (orig.)

  20. Schwannomatosis of the sciatic nerve

    Yamamoto, Tetsuji; Maruyama, Shigeki; Mizuno, Kosaku [Dept. of Orthopaedic Surgery, Kobe University School of Medicine (Japan)

    2001-02-01

    A 52-year-old woman with schwannomatosis in the left sciatic nerve is presented. The patient had no stigmata of neurofibromatosis (NF) type 1 or 2. Cutaneous or spinal schwannomas were not detected. Magnetic resonance (MR) imaging of the sciatic nerve revealed more than 15 tumors along the course of the nerve. Histological examination revealed schwannomas consisting of Antoni A and B areas. Immunohistochemical study showed most cells reacting intensely for S-100 protein. The patient underwent conservative follow-up treatment due to the minimal symptoms. The relationship of the disease with NF-2 and plexiform schwannoma is discussed. (orig.)

  1. One nose, one brain: contribution of the main and accessory olfactory system to chemosensation

    Mucignat-Caretta, Carla; Redaelli, Marco; Caretta, Antonio

    2012-01-01

    The accessory olfactory system is present in most tetrapods. It is involved in the perception of chemical stimuli, being implicated also in the detection of pheromones. However, it is sensitive also to some common odorant molecules, which have no clear implication in intraspecific chemical communication. The accessory olfactory system may complement the main olfactory system and may contribute different perceptual features to the construction of a unitary representation, which merges the diff...

  2. Migration and Labour mobility in the Leather Accessories Manufacture in India

    Jesim Pais

    2006-01-01

    Liberalisation and the policies thereafter have lead to a definite increase in production and export from the leather accessories industry in India. The focus of this paper is on migration and labour mobility in the leather accessories manufacture in Dharavi, Mumbai. The core data for the paper are from field surveys conducted in the industry in Dharavi, Mumbai, in 2000–2001, roughly 10 years after the economic reforms of the 1990s were initiated.

  3. Loss of Function of the Melanocortin 2 Receptor Accessory Protein 2 Is Associated with Mammalian Obesity

    Asai, M; Ramachandrappa, S.; Joachim, M.; Shen, Y.; Zhang, R.; Nuthalapati, N.; V. Ramanathan; Strochlic, D. E.; Ferket, P.; Linhart, K.; Ho, C.; Novoselova, T. V.; Garg, S.; Ridderstrale, M.; Marcus, C

    2013-01-01

    Melanocortin receptor accessory proteins (MRAPs) modulate signaling of melanocortin receptors in vitro. To investigate the physiological role of brain-expressed Melanocortin 2 Receptor Accessory Protein 2 (MRAP2), we characterized mice with whole body and brain-specific targeted deletion of Mrap2, both of which develop severe obesity at a young age. Mrap2 interacts directly with Melanocortin 4 Receptor (Mc4r), a protein previously implicated in mammalian obesity, and it enhances Mc4r-mediated...

  4. Diagnostic difficulties and therapeutic choices in intrapancreatic accessory spleen: case reports

    Massani M; Maccatrozzo P; Morana G; Fabris L; Ruffolo C; Bonariol L; Pauletti B; Bassi N

    2016-01-01

    Marco Massani,1 Paola Maccatrozzo,1 Giovanni Morana,2 Luca Fabris,3 Cesare Ruffolo,1 Luca Bonariol,1 Bruno Pauletti,1 Nicolò Bassi1 1IV Department of Surgery, Regional Center for HPB Surgery, 2Diagnostic and Interventional Radiology, Regional Hospital of Treviso, Treviso, 3Molecular Medicine Department, University Hospital, Padua, Italy Introduction: Accessory spleen has a worldwide prevalence of 10%–30% and is defined as intrapancreatic accessory spleen (IPAS) when it locates w...

  5. Activity Regulates Functional Connectivity from the Vomeronasal Organ to the Accessory Olfactory Bulb

    Hovis, Kenneth R.; Ramnath, Rohit; Dahlen, Jeffrey E.; Romanova, Anna L.; LaRocca, Greg; Bier, Mark E.; Urban, Nathaniel N.

    2012-01-01

    The mammalian accessory olfactory system is specialized for the detection of chemicals that identify kin and conspecifics. Vomeronasal sensory neurons (VSNs), residing in the vomeronasal organ, project axons to the accessory olfactory bulb (AOB) where they form synapses with principle neurons, known as mitral cells. The organization of this projection is quite precise and is believed to be essential for appropriate function of this system. However, how this precise connectivity is established...

  6. Accessory renal arteries in a Caribbean population: a computed tomography based study

    Johnson, Peter B.; Cawich, Shamir O.; Shah, Sundeep D; Aiken, William; McGregor, Roy G; Brown, Hilary; Gardner, Michael T.

    2013-01-01

    Introduction The commonest variation to the classic anatomic description of renal arterial supply is the presence of accessory renal arteries. The incidence varies widely according to ethnicity. There is no data on the prevalence of these anomalies in persons of Caribbean ethnicity. Methods All CT scans done over two years from July 1, 2010 to June 30, 2012 were retrospectively evaluated. The anatomy of the renal arterial supply was reported from these studies and the anatomy of accessory ren...

  7. Digital Branding and Multichannel Marketing : Engaging German Millennials : Lumi Accessories LTD

    Astikainen, Pauliina

    2015-01-01

    The purpose of this thesis was to create a multichannel marketing handbook for Lumi Accessories LTD. Lumi is a leading leather handbag, shoe, and accessories designer brand in Finland, which has strong ecological and sustainable values. The handbook was created especially for the marketing team to guide how digital branding can increase brand awareness among German Millennials so that the awareness of the new Lumi store will increase in Berlin. The aim was to identify measurable objectives, e...

  8. Cummins MD & HD Accessory Hybridization CRADA -Annual Report FY15

    Deter, Dean D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-10-01

    There are many areas of MD and HD vehicles that can be improved by new technologies and optimized control strategies. Component optimization and idle reduction need to be addressed, this is best done by a two part approach that includes selecting the best component technology, and/or architecture, and optimized controls that are vehicle focused. While this is a common focus in the light duty industry it has been gaining momentum in the MD and HD market as the market gets more competitive and the regulations become more stringent. When looking into systems optimization and idle reduction technologies, affected vehicle systems must first be considered, and if possible included in the new architecture to get the most benefit out of these new capabilities. Typically, when looking into idle reduction or component optimization for MD/HD, the vehicle s accessories become a prime candidate for electrification or hybridization. While this has already been studied on light duty vehicles (especially on hybrids and electric vehicles) it has not made any head way or market penetration in most MD and HD applications. If hybrids and electric MD and HD vehicles begin to break into the market this would be a necessary step into the ability to make those vehicles successful by allowing for independent, optimized operation separate from the engine.

  9. Rock sealing - large scale field test and accessory investigations

    The experience from the pilot field test and the basic knowledge extracted from the lab experiments have formed the basis of the planning of a Large Scale Field Test. The intention is to find out how the 'instrument of rock sealing' can be applied to a number of practical cases, where cutting-off and redirection of groundwater flow in repositories are called for. Five field subtests, which are integrated mutually or with other Stripa projects (3D), are proposed. One of them concerns 'near-field' sealing, i.e. sealing of tunnel floors hosting deposition holes, while two involve sealing of 'disturbed' rock around tunnels. The fourth concerns sealing of a natural fracture zone in the 3D area, and this latter test has the expected spin-off effect of obtaining additional information on the general flow pattern around the northeastern wing of the 3D cross. The fifth test is an option of sealing structures in the Validation Drift. The longevity of major grout types is focussed on as the most important part of the 'Accessory Investigations', and detailed plans have been worked out for that purpose. It is foreseen that the continuation of the project, as outlined in this report, will yield suitable methods and grouts for effective and long-lasting sealing of rock for use at stategic points in repositories. (author)

  10. Estudio anatómico de la transferencia de los nervios accesorio y toracodorsal al nervio cubital en el gato Anatomic study of spinal accesory and thoracodorsal nerves transfer to ulnar nerve in cats

    J.R. Martínez-Méndez

    2008-09-01

    Full Text Available Las lesiones del plexo braquial son una de las patologías más graves y con mayor número de secuelas del miembro superior. En el momento actual las transferencias nerviosas se encuentran en primera línea del armamento terapéutico para reconstruir funciones proximales del miembro superior. En el estudio que presentamos se realizaron 20 transferencias nerviosas al nervio cubital del gato común, tomando bien el nervio accesorio del espinal (10 casos o bien el nervio toracodorsal (10 casos. Como grupo control se utilizó el lado contralateral al intervenido. Durante el año siguiente, se evaluó la reinervación mediante estudios electromiográficos, histológicos de nervio y músculo, así como histoquímicos de médula espinal. Tras el análisis de los resultados encontramos que las motoneuronas de ambos nervios donantes son capaces de conseguir reinervaciones parciales del territorio cubital.A brachial plexus injury is one of the most severe pathologies of the upper limb, and also has severe sequels. In the actual state of the art, nerve transfers are being used as first line of therapeutic approach in the reconstruction of proximal functions of the upper limb. In this study 20 nerve transfers were made to the ulnar nerve of the cat, using the spinal accessory nerve (10 cases or the thoracodorsal nerve (10 cases. The opposite side was used as control. During next year, reinnervation was assessed by electromyography, nerve and muscle histology and histochemical evaluation of the spinal cord. We found that motoneurons of both donor nerves are able to make partial reinervation of the ulnar nerve territory.

  11. Laser-activated protein bands for peripheral nerve repair

    Lauto, Antonio; Trickett, Rodney I.; Malik, Richard; Dawes, Judith M.; Owen, Earl R.

    1996-01-01

    A 100 micrometer core optical fiber-coupled 75 mW diode laser operating at a wavelength of 800 nm has been used in conjunction with a protein solder to stripe weld severed rat tibial nerves, reducing the long operating time required for microsurgical nerve repair. Welding is produced by selective laser denaturation of the protein based solder which contains the dye indocyanine green. Operating time for laser soldering was 10 plus or minus 5 min. (n equals 24) compared to 23 plus or minus 9 min (n equals 13) for microsuturing. The laser solder technique resulted in patent welds with a tensile strength of 15 plus or minus 5 g, while microsutured nerves had a tensile strength of 40 plus or minus 10 g. Histopathology of the laser soldered nerves, conducted immediately after surgery, displayed solder adhesion to the outer membrane with minimal damage to the inner axons of the nerves. An in vivo study, with a total of fifty-seven adult male wistar rats, compared laser solder repaired tibial nerves to conventional microsuture repair. Twenty-four laser soldered nerves and thirteen sutured nerves were characterized at three months and showed successful regeneration with average compound muscle action potentials (CMAP) of 2.4 plus or minus 0.7 mV and 2.7 plus or minus 0.8 mV respectively. Histopathology of the in vivo study, confirmed the comparable regeneration of axons in laser and suture operated nerves. A faster, less damaging and long lasting laser based anastomotic technique is presented.

  12. Partial recovery of respiratory function and diaphragm reinnervation following unilateral vagus nerve to phrenic nerve anastomosis in rabbits.

    Junxiang Wen

    Full Text Available Respiratory dysfunction is the leading cause of mortality following upper cervical spinal cord injury (SCI. Reinnervation of the paralyzed diaphragm via an anastomosis between phrenic nerve and a donor nerve is a potential strategy to mitigate ventilatory deficits. In this study, anastomosis of vagus nerve (VN to phrenic nerve (PN in rabbits was performed to assess the potential capacity of the VN to compensate for lost PN inputs. At first, we compared spontaneous discharge pattern, nerve thickness and number of motor fibers between these nerves. The PN exhibited a highly rhythmic discharge while the VN exhibited a variable frequency discharge pattern. The rabbit VN had fewer motor axons (105.3±12.1 vs. 268.1±15.4. Nerve conduction and respiratory function were measured 20 weeks after left PN transection with or without left VN-PN anastomosis. Compared to rabbits subjected to unilateral phrenicotomy without VN-PN anastomosis, diaphragm muscle action potential (AP amplitude was improved by 292%, distal latency by 695%, peak inspiratory flow (PIF by 22.6%, peak expiratory flow (PRF by 36.4%, and tidal volume by 21.8% in the anastomosis group. However, PIF recovery was only 28.0%, PEF 28.2%, and tidal volume 31.2% of Control. Our results suggested that VN-PN anastomosis is a promising therapeutic strategy for partial restoration of diaphragm reinnervation, but further modification and improvements are necessary to realize the full potential of this technique.

  13. Topographical anatomy features of branching of nerves of lower extremities of rat

    Tsarev A.A.

    2008-01-01

    Full Text Available 12 white rats of the reproductive period were the material for research. The topography of sciatic and femoral nerves of lower extremities of rats were studied by the method of level-by-level preparation. Femoral and sciatic nerves, their branches are ventral branches lumbar and sacral plexuses. Sciatic nerve was characterized by dispersed type of ramifying (78 % of cases, for the femoral nerve – the main type of branching (86%. The femoral nerve is projected on a medial surface of a hip and in the region of knee joint lies superficially that has a practical value. The rest portion of femoral nerve is located in hard-to-reach areas in the view of preparation and experimental approach. The sciatic nerve is projected on the skin of dorsal surfaces of pelvic areas where it leaves sciatic notch. For more reliable results of experimental research we propose to took into account age, sex, and topographical features.

  14. Compression neuropathy of the common peroneal nerve secondary to a ganglion cyst.

    Yazid Bajuri, M; Tan, B C; Das, S; Hassan, S; Subanesh, S

    2011-01-01

    There are various causes of the common peroneal nerve palsy. However, common peroneal nerve palsy caused by ganglia are uncommon. We hereby present a case of a 55-year-old man with a 1 week history of foot drop and swelling in the region of the right leg. Physical examination and nerve conduction study studies confirmed a diagnosis of common peroneal nerve palsy. Magnetic resonance imaging (MRI) revealed a lobulated, elongated cystic-appearing mass anterior to the head of fibula. Surgical decompression of the nerve with removal of the mass was performed. Surgical pathology reports confirmed the diagnosis of a ganglion cyst. Findings on physical examination, nerve conduction study and MRI results of this interesting case are being discussed. We wish to highlight that even a tumour which is benign and within the nerve sheath can cause compression. PMID:22262327

  15. Efficacy of nanofibrous conduits in repair of long-segment sciatic nerve defects*

    Esmaeil Biazar; Saeed Heidari Keshel; Majid Pouya

    2013-01-01

    Our previous studies have histomorphological y confirmed that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) conduit can be used to repair 30-mm-long sciatic nerve defects. However, the repair effects on rat behaviors remain poorly understood. In this study, we used nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) conduit and autologous sciatic nerve to bridge 30-mm-long rat sciatic nerve gaps. Within 4 months after surgery, rat sciatic nerve functional re-covery was evaluated per month by behavioral analyses, including toe out angle, toe spread anal-ysis, walking track analysis, extensor postural thrust, swimming test, open-field analysis and noci-ceptive function. Results showed that rat sciatic nerve functional recovery was similar after nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) conduit and autologous nerve grafting. These findings suggest that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) conduit is suitable in use for repair of long-segment sciatic nerve defects.

  16. Updates on the diagnosis and treatment of intracranial nerve malignant peripheral nerve sheath tumors

    L'Heureux-Lebeau B

    2013-04-01

    Full Text Available Bénédicte L'Heureux-Lebeau,1 Issam Saliba2 1University of Montreal, 2Department of Otolaryngology Head and Neck Surgery, Montreal University Hospital Center (CHUM, University of Montreal, Montreal, Quebec, Canada Background: Malignant peripheral nerve sheath tumors (MPNSTs are rare entities and MPNSTs of intracranial nerves are even more sporadic. MPNSTs present diagnosis and treatment challenges since there are no defined diagnosis criteria and no established therapeutic strategies. Methods: We reviewed literature for MPNST-related articles. We found 45 relevant studies in which 60 cases were described. Results: We identified 60 cases of intracranial nerve MPNSTs. The age ranged from 3 to 75 years old. Male to female ratio was 1.5:1. The most involved cranial nerves (CNs were CN VIII (60%, CN V (27%, and CN VII (10%. Most of the MPNSTs reported (47% arose sporadically, 40% arose from a schwannoma, 8% arose from a neurofibroma, and 6% arose from an unspecified nerve tumor. Twenty patients had a history of radiation exposure, four patients had neurofibromatosis type 1 (NF1, four patients had neurofibromatosis type 2 (NF2, and NF2 was suspected in two other patients. Twenty-two patients were treated with radiotherapy and presented a higher survival rate. Seventy-two percent of patients died of their disease while 28% of patients survived. One-year survival rate was 33%. Forty-five percent of tumors recurred and 19% of patients had metastases. Conclusion: MPNSTs involving CNs are very rare. Diagnosis is made in regards to the histological and pathological findings. Imaging may help orient the diagnosis. A preexisting knowledge of the clinical situation is more likely to lead to a correct diagnosis. The mainstay of treatment is radical surgical resection with adjuvant radiotherapy. Since these tumors are associated with a poor prognosis, a close follow-up is mandatory. Keywords: malignant peripheral nerve sheath tumor, MPNST, neurofibroma

  17. MR imaging findings of painful type II accessory navicular bone: correlation with surgical and pathologic studies

    Choi, Yun Sun; Lee, Kyung Tai; Kim, Eun Kyung [Eulji Hospital, Eulji University School of Medicine, Daejeon (Korea, Republic of); Kang, Heung Sik [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

    2004-12-15

    To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on the T1-weighted and fat-suppressed T2-weighted images were analyzed. The MR imaging findings were compared with the surgical and pathologic findings. The fat-suppressed T2-weighted images showed high signal intensity in the accessory navicular bones and synchondroses in all patients, and in the soft tissue in 11 (64.7%) of the 17 patients, as well as synchondrosis widening in 3 (17.6%) of the 17 patients. The MR images showed tendon pathology in 12 (75%) of the 16 patients with PTT dysfunction at surgery. The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap. The MR imaging findings of painful type II accessory navicular bone are a persistent edema pattern in the accessory navicular bone and within the synchondrosis, indicating osteonecrosis, inflammation and destruction of the cartilage cap. Posterior tibial tendon dysfunction was clinically evident in most patients.

  18. MR imaging findings of painful type II accessory navicular bone: correlation with surgical and pathologic studies

    To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on the T1-weighted and fat-suppressed T2-weighted images were analyzed. The MR imaging findings were compared with the surgical and pathologic findings. The fat-suppressed T2-weighted images showed high signal intensity in the accessory navicular bones and synchondroses in all patients, and in the soft tissue in 11 (64.7%) of the 17 patients, as well as synchondrosis widening in 3 (17.6%) of the 17 patients. The MR images showed tendon pathology in 12 (75%) of the 16 patients with PTT dysfunction at surgery. The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap. The MR imaging findings of painful type II accessory navicular bone are a persistent edema pattern in the accessory navicular bone and within the synchondrosis, indicating osteonecrosis, inflammation and destruction of the cartilage cap. Posterior tibial tendon dysfunction was clinically evident in most patients

  19. Correlates of degree of nerve involvement in early Bell's palsy

    Hsieh Ru-Lan

    2009-06-01

    Full Text Available Abstract Background This study aimed to evaluate the still unknown factors correlating with the degree of nerve involvement in early Bell's palsy. Methods This retrospective chart review study of newly diagnosed cases of Bell's palsy was conducted over a three-year period. Information on age, sex, day of onset, comorbidities, corticosteroid use, and electroneurographic test results were collected. The electroneurographic quotient (amplitude of compound muscle action potential on the affected side divided by that on the healthy side and expressed in percent was used as an index of nerve involvement, with lower quotient indicating more severe disease. Results Data were collected on 563 patients. The mean electroneurographic quotient varied inversely with age (p vs. 40.3%; p = 0.002. There was no correlation between the degree of nerve involvement and sex, season of onset, hypertension, or diabetes. Conclusion The degree of nerve involvement in early Bell's palsy correlates positively with age and negatively with corticosteroid use.

  20. Ultrasound-guided peripheral nerve blocks: what are the benefits?

    Nielsen, Zbigniew Jerzy Koscielniak

    2008-01-01

    MESH terms 'nerve block' and 'ultrasonography'. The following limits were applied: studies with abstracts, only in humans, published in core clinical journals. Trial type: meta-analysis, randomized-controlled trial and clinical trial. RESULTS: When peripheral nerves are adequately imaged by ultrasound......BACKGROUND: Use of ultrasound by anaesthesiologists performing regional blocks is rapidly gaining popularity. The aims of this review were to summarize and update accumulating evidence on ultrasound-guided nerve blocks, with an emphasis on the clinical relevance of the results and to critically...... appraise changing standards in regional anaesthesia. METHODS: A search of MEDLINE and EMBASE (1966 to 31 December 2007) was conducted using the following free terms: 'ultrasound and regional anesthesia', 'ultrasound and peripheral block' and 'ultrasound and nerve and block'. These were combined with the...