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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; 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.

  13. 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.

  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. 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.

  16. 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...

  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

    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.

  10. 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

  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. 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 ...

  19. 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 ...

  20. 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

  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

    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.

  12. 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

  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. 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

  12. 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.

  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. 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...

  16. 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

  17. 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

  18. 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.

  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. 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 ...

  1. 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.

  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 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...

  5. 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...

  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. 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 ...

  9. 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...

  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. 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...

  19. 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.

  20. 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...

  1. 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...

  2. 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)

  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. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  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. 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

  17. 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

  18. 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

  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. 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.

  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. 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...

  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. 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.

  4. 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

  5. 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

  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. 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.

  9. 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

  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. 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...

  20. 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 ...

  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. 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.

  3. 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, ...

  4. 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 ...

  5. 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.

  6. 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.

  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. 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.

  11. 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

  12. 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...

  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. 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.

  16. 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

  17. 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

  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. 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.)

  2. 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.

  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. 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.

  7. 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...

  8. 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

  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. 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...